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J Emerich

Publications and source records attributed to J Emerich.

At least 19 recordsLinked to original sources
PubMed2006

Mannan-binding lectin (MBL) in women with tumours of the reproductive system.

Mannan-binding lectin (MBL) is an important factor of innate immunity contributing to the clearance of microorganisms. Recently, an antitumourigenic role of MBL has been suggested. We investigated mbl2 genotypes, MBL concentrations, and MBL-MASP-2 complex activity in patients with ovarian cancer. The expression of both mbl2 and masp-2 genes were investigated in ovarian tissue sections. Additionally, samples from patients with other malignant and benign tumours of the reproductive tract were tested. A significantly higher incidence of MBL deficiency/insufficiency-associated genotypes was found among patients with malignant disease compared to age-matched controls. Unexpectedly, no differences in median MBL level or MBL-MASP-2 complex activity were found between the groups. This was partly a reflection of higher MBL concentrations and MBL-MASP-2 activity in cancer patients compared with healthy women carrying corresponding genotypes. MBL-specific mRNA expression was detected in several normal and malignant ovarian tissues, as well as in ovarian epithelial cell lines. Intracellular staining with MBL-specific antibodies demonstrated the presence of MBL in ovarian cell lines, and in normal as well as malignant ovarian tissue sections. In contrast, MASP-2-specific mRNA expression was detected only in the ovary tissues of patients with malignant disease. No significant changes in MBL concentration during 3 months of chemotherapy were noticed. MBL was detected in ascites and in the fluid of benign ovarian cysts. Our findings may reflect anti-tumourigenic activity of MBL protein which might suggest potential therapeutic application. However, it cannot be excluded that mbl-2 mutant alleles may be in linkage disequilibrium with an unidentified tumour susceptibility gene(s).

Adult↗
PubMed2005

Management of massive presacral pelvic bleeding in patients with gynecological malignances: review of the literature.

Hemorrhage has always been a significant potential complication in the field of gynecological oncology. Throughout the years, a variety of medical and surgical modalities aimed at controlling pelvic hemorrhage have been developed. Most recently, these have focused on attempting to decrease the morbidity associated with pelvic bleeding. The effectiveness of and the complications involved in controlling massive hemorrhage by the preemptive method of vascular clamping of the aorta, intraoperative methods, such as the local application of procoagulants and of prolonged compression (pelvic gauze packing, plastic wrapped gauze packing, autograft tissue compression and balloon compression) have all been reviewed. Surgeons are able to acquaint themselves with the choice of methods that can be employed during massive pelvic bleeding resulting from procedures on gynecological malignancies.

Female↗
PubMed2005

The role of pelvic exenteration for treatment of pelvic malignancy--a nine-year experience.

Pelvic exenteration offers the last chance for some women with gynecological and rectal malignancy. A series of 23 patients who underwent pelvic exenteration for local advanced gynecological and rectal malignancies between 1996 and 2004 were retrospectively reviewed. The exenteration was performed because of vulvar cancer in 14 patients and other pelvic malignancies in nine cases: rectal cancer in four cases, in three cases cervical cancer, in one case ovarian cancer and in one case uterine sarcoma. Nine patients developed major complications of the operative field involving the urinary tract or the wound. Early complications included massive bleeding from the sacral plexus in two cases (one patient died during surgery), acute respiratory distress syndrome (ARDS) in one case and thrombophlebitis in one case. Urinary incontinence was observed in two women as a late complication. Only one patient had a complication connected with the gastrointestinal tract. Twenty-two patients were followed-up. In the group of patients with vulvar cancer five women died after 4-29 months because of recurrence of disease. The nine surviving patients are still being followed-up and are without disease; survival time ranges from 6-74 months. In the group of patients with other malignancies four women died.

Aged↗
PubMed2004

TP53 status determines clinical significance of ERBB2 expression in ovarian cancer.

ERBB2 expression has been found in 19 to 44% of ovarian carcinomas; however, its predictive value has not been demonstrated, and trastuzumab has not found clinical application in ovarian cancer patients. We evaluated clinical significance of ERBB2 expression in relation to TP53 accumulation in ovarian carcinoma patients treated with platinum-based regimens. Immunohistochemical analysis with CB11 and a novel NCL-CBE356 antibody (against the internal and external domains of ERBB2, respectively) was performed on 233 tumours (FIGO stage IIB-IV); the US Food and Drug Administration-approved grading system with 0 to 3+ scale was used for evaluation, and the results were analysed by the Cox and logistic regression models. In all, 42% of the tumours expressed (category 1+, 2+ or 3+) either CB11 or CBE356 or both (CB11/CBE356 parameter). Associations between ERBB2 expression and clinical factors were observed only if tumours with staining category 1+ were grouped together with tumours showing staining categories 2+ and 3+. CB11/CBE356 parameter had a better predictive value than CB11 alone. CB11/CBE356 expression was negatively associated with platinum sensitivity (PS) in the TP53(-) group (P=0.022) and with disease-free survival (DFS) in the TP53(+) group (P=0.009). Our results may suggest that trastuzumab should be given postoperatively to patients with TP53(-)/ERBB2(+) ovarian carcinomas to enhance PS, and after completion of chemotherapy to patients with complete remission and TP53(+)/ERBB2(+) carcinomas to extend DFS time (in total to 30.4% of all patients analysed). Thus, novel criteria for ovarian cancer patient inclusion for clinical trials with trastuzumab should be considered and tested.

Adult↗
PubMed2004

HPV and histological status of pelvic lymph node metastases in cervical cancer: a prospective study.

AIMS: The purpose of this prospective study was to describe the incidence and distribution pattern of human papillomavirus (HPV) DNA in intraoperative dissected lymph nodes and to relate this to the pathological confirmation of metastasis. METHODS: Samples of primary cervical cancer lesions and dissected lymph nodes were obtained from women undergoing surgical treatment. The presence of HPV DNA was detected by the polymerase chain reaction. RESULTS: Tissue from 79 tumours and 365 lymph nodes was analysed. Metastasis to the lymph nodes was found in 19 cases. Metastasis correlated with the volume of the primary lesion, the depth of cervical and vaginal invasion, and with invasion of the corpus. HPV DNA was found in 60 of the primary lesions and 31 of the lymph nodes. The presence of HPV DNA in the lymph nodes correlated with the volume of the primary lesion and vaginal invasion. CONCLUSIONS: The incidence of HPV DNA in lymph nodes is twice as high as that of histopathologically confirmed metastases. The risk of the presence of HPV DNA and histopathologically confirmed metastases in lymph nodes is related to certain features of the primary tumour.

Adult↗
PubMed2004

Acute renal failure after anterior pelvic exenteration: a case report and review of the literature.

This is a report of a case of advanced cervical carcinoma in a 34-year-old woman treated with anterior pelvic exenteration at the Department of Gynecology of the Medical University in Gdańsk. Despite annual gynecological check-ups, the patient presented with profuse bleeding from the genital tract. IVa cervical carcinoma according to the International Federation of Gynecology and Obstetrics (FIGO) staging was diagnosed. A vesicovaginal fistula was confirmed. In the postoperative period acute renal failure occurred. Twenty-four days after the operation when normal renal parameters had been restored, the patient was transferred to the Department of Radiotherapy for supplementary treatment. Pelvic exenteration offers the last chance for some women with gynecological malignancy and can provide a good chance of long-term survival in carefully selected patients with gynecological cancer.

Acute Kidney Injury↗
PubMed2003

Evaluation of clinical significance of TP53, BCL-2, BAX and MEK1 expression in 229 ovarian carcinomas treated with platinum-based regimen.

In cell line studies, BCL-2, BAX, as well as novel MEK1 protein levels have strong influence on ovarian cancer response to cisplatin-based chemotherapy. However, such associations have not been demonstrated clinically. We evaluated prognostic/predictive significance of these proteins with regard to TP53 status. Immunohistochemical analysis was performed on 229 ovarian carcinomas FIGO stage IIB-IV treated with platinum-based chemotherapy; the results were analysed by the Cox and logistic regression models. Clinical parameters (residual tumour size, patient age, FIGO stage) were the only indicators of overall survival (OS) and the strongest predictors of complete remission (CR). On the other hand, BAX expression was the strongest (P=0.005) or the only (in FIGO IIIC, P=0.02) prognostic indicator of disease-free survival (DFS) in the TP53(+) group. TP53(+) and TP53(-) ovarian carcinomas differed in clinical and molecular prognostic and predictive factors. Another novel finding is that CR was negatively influenced by high BAX expression in all patients group (P=0.047) and by BCL2 expression in the TP53(-) group (P=0.05). High MEK1 expression was associated with endometrioid and clear cell carcinomas (P=0.049); its loss was found with advancing FIGO stage (P=0.002). Our results suggest that binomial TP53 status divides ovarian carcinomas into two biologically distinct groups. BAX expression is an important factor of DFS in the TP53(+) group. BCL-2 and BAX, but not MEK1 expressions have predictive value in ovarian cancer patients treated with platinum-based chemotherapy.

Adult↗
PubMed2003

P21WAF1, P27KIP1, TP53 and C-MYC analysis in 204 ovarian carcinomas treated with platinum-based regimens.

BACKGROUND: The prognostic and predictive value of cell cycle regulatory proteins in ovarian cancer has not been established. We evaluated the clinical and biological significance of P21(WAF1), P27(KIP1), C-MYC, TP53 and Ki67 expressions in ovarian cancer patients. MATERIALS AND METHODS: Immunohistochemical analysis was performed on 204 ovarian carcinomas of International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IV treated with platinum-based chemotherapy. Multivariate analysis with Cox and logistic regression models was performed in the whole group, and in the TP53-negative and TP53-positive subgroups. RESULTS: High P21(WAF1) labeling index (LI) was an independent positive predictor of platinum-sensitive response (P = 0.02). Overall survival was positively influenced by P21(WAF1) LI (P = 0.02) or by P21(WAF1) plus P27(KIP1) LI (P = 0.004) in the TP53-negative group only. Ki67 LI showed borderline association with disease-free survival (P = 0.05). Growth fraction was negatively associated with P21(WAF1) and P27(KIP1) indices in the TP53-negative group (P = 0.023 and 0.008, respectively), and these associations were borderline or lost in the TP53-positive group. Endometrioid and clear cell carcinomas differed from other carcinomas by having a low incidence of TP53 accumulation, a high incidence of C-MYC overexpression (70%) and a low median Ki67 LI (all with P <0.001). CONCLUSIONS: We have shown an independent predictive value of P21(WAF1) LI in ovarian carcinoma patients. The prognostic value of P21(WAF1) and P21(WAF1) plus P27(KIP1) LI was determined by TP53 status. A high frequency of C-MYC overexpression in endometrioid and clear cell carcinomas may suggest its role in the development of these tumor types.

Adult↗
PubMed2001

[A rare case of non-Hodgkin's lymphoma of the uterine cervix].

We report a rare case of primary extranodal non-Hodgkin lymphoma of the uterine cervix. A 58-year old, postmenopausal multipara was admitted to the hospital with metrorrhagia and vaginal discharge. After diagnostic biopsy, the patient underwent radical abdominal hysterectomy, bilateral salpigo-oophorectomy and pelvic lymph node dissection. histologically, the lymphoma was classified as non-Hodgkin lymphoma of intermediate malignancy. Immunohistochemical studies revealed that the atypical lymphoid cells were B-cells (CD 20+), indicating that the lymphoma was of B-lineage. Postoperatively, she received adjuvant chemiotherapy. Our experience and a review of current literature are presented.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

[Conservative treatment of patients with borderline ovarian tumors].

OBJECTIVES: The aim of this study was to characterise group of patients with borderline tumours undergoing surgical treatment. DESIGN: The analysis included 83 patients with ovarian tumours of borderline malignancy at stage Ia, operated in the Gynaecological Department of Medical University of Gdańsk between 1978-1997. The study takes into account comparison of: age of patients, type of surgery, tumour pathology, post surgical treatment. Furthermore, long term follow up was assessed. RESULTS: In the group of 83 patients with stage Ia 37 ware treated with conservative surgery, 46 underwent radical treatment. Postsurgical chemical treatment was not applied. Three patients had to be reoperated because of neoplasm disease recurrence. 8 patients were died from reasons not connected with main disease. CONCLUSIONS: Conservative surgery is proper treatment for young women with borderline ovary tumours in stage Ia. For older, perimenopausal women TAH with BSO without additional chemotherapy is suggested.

Adolescent↗
PubMed2001

[Evaluation of risk factors after intraperitoneal chemotherapy in patients with ovarian cancer].

DESIGN: The authors sought to evaluate risk factors of patients with ovarian cancer treated with intraperitoneal cisplatin based chemotherapy (IPC). MATERIAL AND METHODS: From January 1996 to December 1998, 24 patients with recurrent or persistent ovarian cancer were treated. We divide them in two groups first beneath 65 year old (19 patients), second above 65 year (5 patients), and in three groups with residual microscopic diseases, residual below 0.5 cm, and between 0.5 and 2 cm in the time of the beginning of treatment with IPC. We also estimate stage (FIGO) as a risk factor. RESULTS: In the first group the study showed (CRP) among 9 patients (SD) among 2 patients PD in among patients. In the second group CRP were observed among 2 patients PD among 2 patients, and SD 1 patient. CONCLUSION: IPC is the valuable method of second line chemotherapy for ovarian cancer. Age is not a risk factor in IPC. IPC prolongs survival in ovarian cancer patients, progression free survival, and gives only slightly adverse effects.

Aged↗
PubMed2001

[Endometrial carcinoma in patients with family history of neoplasms].

OBJECTIVES: The aim of the study was multifactorial clinical analysis of patients with neoplasmatic family history operated because of endometrial carcinoma in 2nd Dept. of Obstetrics and Gynecology Medical University of Gdańsk between 1983-1997. MATERIAL AND METHODS: The group of 117 women who answered inquiry forms was analysed. The other data was obtained from case histories. The subgroup of patients with neoplasmatic family history was selected. RESULTS: The subgroup of patients with neoplasmatic family history was 41.9% of all treated women (49 women). The median age was 58.8; most of them were para- and postmenopausal women. In the group of patients with adenocarcinoma of endometrium the neoplasmatic family history was obtained twice more often then in group with adenosquamous carcinoma. The neoplasmatic disease was found in different members of family (parents, sisters, brothers, grandparents, uncles, aunties and other). In 1/3 cases a neoplasmatic disease was found in few members of the family. CONCLUSION: Women with neoplasmatic family history have to be controlled more strictly because of "coexisted" genetic, internal and economic factors.

Adenocarcinoma↗
PubMed2001

[Premenstrual syndrome - treatment with serotonin uptake inhibitor antidepressants].

Premenstrual syndrome (PMS) is complicated disease which is similar to depressive disorders due to its symptoms. Antidepressant treatment becoming alternative treatment near traditional hormonal therapy. Paper gives literature review of selective serotonin reuptake inhibitors (SSRI) in premenstrual syndrome treatment.

Antidepressive Agents↗
PubMed2000

Factors influencing period of time between negative second-look laparotomy and ovarian carcinoma recurrence. Multicenter study in Poland.

OBJECTIVE: The aim of our study was to evaluate factors such as primary clinical stage, presence of ascites, serum CA 125 antigen level, histological type of ovarian cancer, cell differentiation and number of chemotherapy cycles influencing the time of recurrence after negative second-look operations. MATERIAL AND METHODS: Having observed complete clinical remission in 356 patients with ovarian cancer, second-look laparotomy was performed. In 180 patients complete pathologic remission was detected and in 73 recurrence was observed. Correlation analysis between time of recurrence and the above-mentioned prognostic factors was carried out by means of the Mann-Whitney and Kruskal-Wallis tests. RESULTS: The time from the second-look operation till diagnosis of relapse ranged from 7 to 36 months (average 21 months). The statistical analysis showed a correlation between the presence of ascites, increased serum CA 125 antigen level, the administration of six chemotherapy courses and the time of recurrence. In all those cases relapse occurred earlier than in patients without ascites, with normal CA 125 antigen levels and after ten courses of chemotherapy. CONCLUSION: Our findings suggest that the stage of clinical advancement and histologic grading do not influence the time of recurrence. The presence of ascites, increased serum CA 125 antigen level and the administration of fewer chemotherapy courses (6 versus 10) after primary surgery affects the earlier relapse of disease.

Adenocarcinoma↗
PubMed2000

[Appendiceal mucinous carcinoma].

Appendiceal carcinoma is very rare. Preoperative diagnosis of this kind of neoplasm is difficult. Even at operation in under half of cases this diagnosis is considered. We present a case of a woman admitted to the hospital with diagnosis of adnexal tumor of the right ovary. The diagnosis of adnexal mass was confirmed by ultrasound examination. Laparotomy was performed and tumor of appendix was found. There was also a small tumor (2 cm) in small bowel and some increased lymphatic nodules. Uterus with adnexis, tumor of appendix, part of small bowel and colon were resected. Because of infiltration of the neoplasm a part of the bladder was resected as well. There were no complications after operation. She received chemotherapy with 5-FU. After 9 months computed tomography revealed no changes in abdomen. Diagnosis of pelvic masses when they do not origin of adnexis is usually very difficult. In many cases proper diagnosis is made only during laparotomy.

Adenocarcinoma, Mucinous↗
PubMed1999

[Neurofibroma plexiforme of the small pelvis: a case report].

There are reports of rare cases of nerve tissue tumors of the small bowel, ovary, urinary bladder or retroperitoneal space. We report a case of neurofibroma plexiforme of pelvis minoris in 42-year-old woman. The first diagnosis was adnexal tumor. Laparotomy was performed and a big, solid tumor of left parametrium was found. The histology of the tumor was described as neurofibroma plexiforme. There was also an inflammatory tumor of appendix involving right Fallopian tube. The described by other authors cases suggest, that diagnosis of nerve tissue tumors in pelvis minoris is very difficult. Surgery is an adequate way of final diagnosis and management.

Adult↗
PubMed1999

[Clinical analysis of patients operated with squamous cell carcinoma of the uterine cervix].

OBJECTIVES: The aim of our study was clinical analysis of patients operated with squamous cell carcinoma of the uterine cervix. MATERIALS AND METHODS: Between 1972 and 1991 at the 2nd Department of Obstetrics and Gynecology Medical University of Gdańsk 687 total hysterectomies in Wertheim-Meigs method were performed in the patients with, various clinical stages cervical carcinoma. The clinical analysis has been done in 499 patients with diagnosed invasive cervical cancer stages Ia2, Ib and IIa. The clinical progression of cancer was established on the basis of FIGO classification from the year 1985. In the 18 patients invasive cervical cancer occurred together with a pregnancy (cervical cancer was diagnosed in the I, II and III trimester). In this group squamous carcinoma was diagnosed in 16 cases (88.8%). Endocervical type was diagnosed in 8 cases (1.6%), among which 4 cases were of a squamous type (0.8%). Two 10-year-periods of time have been separated: since 01.01.1972 to 31.12.1981 and since 01.01.1982 to 31.12.1991. RESULTS AND CONCLUSIONS: In the studied 20-year period (1972-1991) in all 499 performed operations squamous carcinoma was the most often occurring histological type of cervical cancer--439 cases (88.0). Comparing the incidence of squamous carcinoma in both 10-year periods of time there were no significant differences (only almost a 3-fold decrease of the incidence of microcellular cancer in the second decade was observed). It was stated that a percentage share of squamous carcinoma in the clinical stages Ib and IIa did not change. The number of pregnancies and labours in the patients with squamous carcinoma was close to the patients with other histological types of cervical cancer. The mean age of patients with squamous carcinoma was 45.6 (22-74) and was lower than the age of patients with adenocarcinoma--49.1 years (22-73). The clinical symptoms of a cancer occurred in 81.4% of the studied group. Asymptomatic course was seen in 18.6% of patients. The incidence of positive lymph nodes in the patients with squamous carcinoma stages Ib-IIa was close to the patients with carcinoma adenosquamous (25.0% and 23.7% respectively) and lower than in the case of adenocarcinoma (34%) or anaplastic carcinoma (33.3%, because of a small number of patients in this group the figures are not reliable). In the patients with squamous carcinoma the highest 5-year survival (almost 80.4%) was stated.

Adult↗