Biomedical subjects

Kazimierz Pityński

Publications and source records attributed to Kazimierz Pityński.

10 recordsLinked to original sources

PubMed2003

[Pregnancy and delivery after hysteroscopic metroplasty].

AIM OF THE STUDY: Outcomes of treatment of habitual miscarriages and course of pregnancy and delivery in women after hysteroscopic metroplasty i.e. hysteroscopic resection of uterine septum. MATERIAL AND METHODS: Material consisted of 31 women with uterine septum operated between years of 1995-2002 because of habitual miscarriage by surgical hysteroscopic technique. The control group consisted of 26 women treated between years of 1990-1997 by Strassman's operation. Outcomes of treatment of habitual abortions, course of pregnancy and delivery were analyzed in both groups. The statistical analysis was performed by Chi 2 test (p < 0.05). RESULTS: After such treatment 27 out of 31 hysteroscopic treated women became pregnant. In first pregnancy in 12 women miscarriages and in 3 cases premature delivery were observed. Twelve pregnant women delivered pregnancy till 37 week. 15 infants survived (3 premature baby). Out of 26 women in control group after Strassman's operation 24 became pregnant, but 12 had miscarried. All pregnancy in control group i.e. ten mature pregnancy and 2 during premature delivery were ended by Cesarean section. The efficacy of treatment of habitual miscarriage due to uterine septum by hysteroscopic surgery was 55.5%, and there was no statistical significant difference between hysteroscopic surgery and Strassman's operation (50.0%). CONCLUSIONS: On the basis of result obtained the hysteroscopic metroplasty should be method of choice in the treatment of the uterine septum. Although the vaginal delivery is preferred one should have in mind the late complications of hysteroscopic surgery.

Abortion, Habitual↗

PubMed2003

[Sentinel node biopsy in breast cancer and primary tumor dimension].

INTRODUCTION: Sentinel lymph node (SLN) biopsy, primary used as an alternative to elective lymph node dissection in melanoma, is being applied successfully in management of patients with breast cancer. The aim of this method in breast cancer is to determine the presence of axillary node involvement while clinically normal axilla. The validity of the sentinel node concept in breast cancer is demonstrated in various studies. The results of identification rates, sensitivity, overall accuracy and false negative rate are so encouraging in most publications, as to implement this concept to every-day surgical practice. There is lack, however, of many fundamental answers pertaining relationship between tumor-size and the results of SLN Biopsy or related surgical standards. MATERIALS AND METHODS: 36 females at the age 33-66, with breast cancer underwent primary surgical treatment with SLN Biopsy in Department of Gynaecology and Oncology Jagiellonian University between 2001-2002. The study inclusion criteria were tumour size-T1, T2. The day before surgery the static scanning was performed after injection of Tc radiolabelled nannocolloid. SLN(s) were identified intraoperatively using a handheld gamma detection probe (Navigator GPS) and intraoperative lymphatic mapping with blue dye (Patent Blau V). After localization and excision of SLN(s), axillary's lymph node dissection (ALND) was performed. RESULTS: In 34 patients SLN Biopsy revealed accumulation of the tracer in axilla, which was classified as SLN. Detection rate was 94.4% (34/36). Overall sensitivity of the procedure was 81%, whereas negative predictive value 92%. False negative rate was 2.2%. Detection rate for T1 tumors was 100% (15/15 cases), and for T2 tumors was 90.4% (19/21 cases). Sensitivity for tumor classified as T1 was 100% (3/3 cases), whereas for tumor T2 was 75% (6/8 cases). CONCLUSION: SLN Biopsy seems to be very interesting alternative to ALND in patients with small tumor's dimension.

Adult↗

PubMed2003

The impact of progesterone on simultaneous, local secretion of IGFBP-3 and IGF-I [IGFBP-3/IGF-I index] by human malignant and non-malignant breast explants depends on tissue steroid receptor phenotype.

OBJECTIVES: Insulin-like growth factor-I (IGF-I) is regarded as one of mammary tissue proliferative factors. Insulin-like growth factor binding protein-3 (IGFBP-3) limits the IGF-I binding potential to its receptor. That limits the IGF-I bioavailability. Recently experimental studies indicated that insulin-like growth factor binding proteins (IGFBPs) might have their own biological actions beyond their ability to regulate insulin-like growth factors (IGFs). Our earlier results showed the progesterone-induced rise in hGH and IGF secretion by human breast cancer explants. AIM: To determine the ability of progesterone to stimulate simultaneous local IGF-I and IGFBP-3 secretion by non-malignant and malignant mammary tissue collected from different receptor phenotype tumours. MATERIAL AND METHODS: Explants from the tumour and surrounding normal non-malignant tissue were obtained during surging. Breast cancer explants were defined as: ER+ PR+; ER-PR-; ER+ PR-; and ER-PR+. Part of the explants was fixed in 10% buffered formalin for steroid receptor determination by immunohistochemistry. Other parts were cut into small pieces, weight and cultured in Parker medium (M199) supplemented with 5% of calf serum at 37 degrees C in an atmosphere containing 5% CO2 for 48 hours in control medium or with the addition of progesterone (10-7 M). Later media were collected for IGF-I and IGFBP-3 concentration analysis. RESULTS: Progesterone increased (p < 0.01) IGFBP-3/IGF-I index in ER(-)PR(-) non-malignant tissue and decreased the IGFBP-3/IGF-I index in ER(-)PR(+), ER(+)PR(-) non-malignant explants. That increased the IGF-I bioavailability. Breast malignant explants showed the progesterone induced IGFBP-3/IGF-I index decrease. The decrease was most evident (p < 0.01) in malignant explants expressing progesterone receptor. CONCLUSION: Progesterone increased local IGF-I bioavailability in malignant breast tissue. That phenomenon depended on steroid receptor phenotype of breast tissue and was most evident in tissue expressing progesterone receptor. In non-malignant tissue that phenomenon was also found in estrogen receptor expressing tissue. Lack of steroid receptor expression in breast explants reversed that phenomenon.

Biomarkers, Tumor↗

PubMed2003

[Value of saline infusion sonohysterography and hysteroscopy in postmenopausal patient with persistent abnormal ultrasonographic images after endometrial curettage with normal histological results].

AIM OF THE STUDY: Comparison of sonohysterography vs. outpatients diagnostic hysteroscopy in evaluation postmenopausal patient with persistent abnormal ultrasounds images after endometrial curettage revealed normal histological result. MATERIALS AND METHODS: Material consisted of 47 postmenopausal women age 44-91 years, diagnosed because of abnormal uterine bleeding and/or suspicious endometrial ultrasonographic pictures performed a month after curettage. Patients were evaluated by diagnostic sonohysterography (without analgaesia) and outpatients diagnostic hysteroscopy (local analgaesia). Outcomes of sonohysterography and hysteroscopy were compared with results of histological examinations of specimen (hysteroscopical biopsy, hysteroscopical resection or hysterectomy). Sensitivity and specificity of two diagnostic methods were compared. RESULTS: Intrauterine cause of abnormal ultrasonographic picture was disclosed by sonohysterography in 35 (74.46%) cases. Suspicious of focal endometrial carcinoma in SIS was reported in 1 (2.12%) case. Sensitivity of SIS in relation to all pathology was 0.97, specificity 0.90. Sensitivity and specificity amounted in relation to: polyps 1.00 and 0.83, hyperplasia 0.84 and 0.95. There was no significant statistical differences in sensitivity and specificity between SIS and diagnostic hysteroscopy. CONCLUSION: Diagnostic hysteroscopy and sonohysterography have the same diagnostic potential in evaluation of endometrium. Both methods are useful in patient with unsuspected histological results of the specimens. Ultrasonographic pictures imitating endometrial carcinoma or endometrial hyperplasia in most cases are connected with endometrial polyp. Advantage of applying liquid medium in SIS seems surpass the risk of passage of cells of carcinoma to peritoneal cavity.

Aged↗

PubMed2003

[Lymph node mapping and sentinel node detection in carcinoma of the cervix, endometrium and vulva].

OBJECTIVES: Validity of the sentinel node concept in patients with cervical, endometrial and vulvar cancer. MATERIAL AND METHODS: 47 cases of FIGO stage I and II cervical cancer, 33 cases of first clinical stage of endometrial cancer and 37 patients with FIGO stage I and II of vulvar cancer. In cervical and vulvar cancer preoperative lymphoscyntygraphy and intraoperative lymphatic mapping with blue dye and handheld gamma probe were performed. In patients with endometrial cancer intraoperative lymphatic mapping with blue dye injected into the cervix and into the uterine corpus subserously were done. In the last 10 cases radiolabeled nannocolloid were administered and the patients underwent preoperative lymphoscyntygraphy and intraoperative radio detection of sentinel node. Sentinel nodes were labeled as blue, radioactive, or blue/radioactive. RESULTS: In cervical cancer sensitivity of the dye and radiocolloid methods was 94%, specificity 100% and negative predictive value 97%. Out of 33 cases of endometrial cancer sentinel node was identified in 29 (87.87%) patients. None of women with histological negative sentinel node had metastases in the rest of lymph nodes resected. Sentinel node was detected in all cases of vulvar cancer. The status of sentinel nodes were representative for all lymph node resected. CONCLUSIONS: Concept of sentinel node may be applied first of all for vulvar cancer and also for cervical and endometrial cancer.

Endometrial Neoplasms↗

PubMed2003

Use of Tc99m-nanocolloid for sentinel nodes identification in cervical cancer.

BACKGROUND: The initial draining lymph node for a primary tumor is referred to as the "sentinel" node. Firstly adopted in the management of patients with cutaneous melanoma and breast cancer, it is now widely tested in cervical cancer. In patients with cervical cancer, lymph node status is the most important prognostic factor for survival. In patients with cervical cancer FIGO stage I and II pelvic lymph node metastases are expected in 0-16 and 24.5-31% and para-aortic lymph node metastases are expected in 0-22 and 11-19% of patients. The removal of pelvic and para-aortic lymph nodes is essential for assessing the biology of the disease. Lymphoscintigraphy enables the visualisation of lymphatic drainage patterns from a great variety of tumour sites prior to surgery. Therefore, the current procedure is to perform the pre-operative mapping of sentinel nodes by static and/or dynamic lymphoscintigraphy, followed by in vivo identification using a gamma detection probe and selective surgical resection. MATERIAL AND METHODS: Between 2001-2003, 37 patients with cervical cancer FIGO stage I-IIa were seemed to be qualified to undergo lymphoscintigraphy. The day before surgery (99m)Tc-nanocolloid (100 MBq; 0.5-1.0 ml in volume) was applied in each quadrant of the cervix or around the tumor. The static scintigraphic scans were performed after 2 hours p.i. using a dual-head large-field-of-view Siemens gamma-camera equipped with high resolution collimators. SNs were identified intra-operatively using a handheld gamma detection probe (Navigator GPS-Tyco) and intra-operative lymphatic mapping with blue dye. After a resection of the SNs, a standard radical hysterectomy with pelvic and low para-aortic lymph node dissection was performed. Tumor characteristics were compared with sentinel node detection and with the histopathological and immunohistochemical results. RESULTS: The scintigraphy showed a focal uptake in 35 of the 37 patients. In all women one or more sentinel lymph nodes were identified intra-operatively. Of them, 24 patients had those located bilaterally. Histologically positive SNs were found in 5 women (13.5%). CONCLUSIONS: A combination pre-operatively administered radioactively labelled albumin with blue dye allows the successful detection of SN in patient with cervical cancer. This technique will result in a real advance in the less aggressive management of patients with early stage cervical cancer. Sentinel lymph node status may be representative of the pelvic lymph nodes status in cervical cancer and thus could provide important information for further treatment.

Adenocarcinoma↗

PubMed2002

[The value of colposcopy and computerised colposcopy in diagnosis and therapeutic management of CIN and early invasive cervical cancer in pregnant women].

OBJECTIVES: The aim of the study was determining the value of colposcopy, especially with computerised documentation of serial colposcopic pictures in diagnosis and therapeutic management of CIN and early cervical cancer in pregnant women. MATERIAL AND METHODS: Material consisted of 96 pregnant women aged 26-45 with CIN and Ca IA. Patients were diagnosed and treated between 1990-1999. There were performed colposcopic examinations, cytology and histological evaluation of colposcopy directed specimen. Lately colposcopic pictures were stored as graphic files by camera connected to PC. RESULTS: The positive correlation between colposcopy and histology was established in 86 women (89.9%) and between cytology and histology in 76 women (79.2%). Progression of CIN and Ca IA was noted in 8 women (8.3%). CONCLUSIONS: Colposcopy, especially computerised colposcopy enables cervical lesion evaluation in pregnant women and thus enables proper therapeutic management.

Colposcopy↗

PubMed2002

[Precancerous lesions and cervical cancer vs HPV infection in pregnant women--cytological assessment].

An effort has been made in order to estimate the relationship between HPV, cervical intraepithelial neoplasia and cervical carcinoma. The authors have been trying also to create a reliable prophylactic scheme as far as precancerous lesions and cervical carcinoma are concerned. 2243 pregnant women have been subjected to cytology and colposcopy examination. In selected cases HPV DNA hybridisation technique examination of cervical smear as well as colposcopy directed punch biopsy have been performed. The results of the study indicate of high efficiency of these methods in cervical cancer prophylaxis.

Adult↗

PubMed2002

[Ovarian tumors in pregnancy in the material of the Department of Gynecology and Oncology Collegium Medicum of Jagiellonian University in Cracow].

OBJECTIVES: Although ovarian tumors are rare in pregnancy, they constitute a real diagnostic and therapeutic challenge. DESIGN: The aim of the study was to describe pathomorphological and clinical characteristic of ovarian tumor in pregnancy and to review the effects of diagnostics and treatment. MATERIALS AND METHODS: The study included 76 pregnant women treated due to ovarian tumors at Department of Gynaecology and Oncology, Collegium Medicum of Jagiellonian University. The age of patients range from 18 to 41 years (mean age 26 years). Diameter of each tumor was more then 5 cm. RESULTS: The symptoms of the tumors occurred in 25% of patients. Most of them were unilateral (96.05% cases). In 88.16% of cases the tumor diameter did not exceeded 10 cm. 71.05% of tumors were detected in first trimester of pregnancy. More then 50% of cystic tumors, that had not been surgically treated directly after detection disappeared during observation. Most common histological type of operated tumors were teratoma adultum (50%) and corpus luteum cyst. The malignant tumor of ovary was detected in 3.12% of cases. Spontaneous abortion after surgical treatment occurred in one patient after, emergency operation due to tumor torsion. CONCLUSIONS: Most of the ovarian tumors in pregnancy were benign. Incidence of ovarian malignancies in pregnancy did not exceed 4%. More then 50% of tumors that had not been removed directly after detection disappeared in the course of observation. Spontaneous abortion after operation rarely complicated surgical treatment.

Abortion, Spontaneous↗

PubMed2002

[Lymph node mapping and sentinel node detection in gynecological oncology].

The aim of this paper is the presentation of the latest opinions on the lymph node mapping and the sentinel node localization in the female genital organ neoplasm. The current strategies of lymph node resection in gynecologic oncology have been presented. The methods of lymph node staining and detection has been expounded as well. The paper also contains the results of sentinel node localization in the vulvar, cervical and endometrial cancers.

Coloring Agents↗