PubMed Health⌕ Search

Biomedical subjects

P Dzvincuk

Publications and source records attributed to P Dzvincuk.

13 recordsLinked to original sources
PubMed2006

[Discrepancy of ultrasound biometric parameters of the head (HC--head circumference, BPD--biparietal diameter) and femur length in relation to sex of the fetus and duration of pregnancy].

OBJECTIVE: To compare female and male fetuses in terms of intrauterine ultrasound growth measurements (HC--head circumference, BPD--biparietal diameter, FL--femur lenght) depending on gestational age. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Department of Preventive Medicine, University Hospital, Olomouc. METHODS: All ultrasound biometric measurements were performed according to the methodology published with the reference charts. Risk pregnancies, multiple pregnancies and breech presentations were excluded. RESULTS: Fetal HC, BPD and FL were measured in 427 ultrasound examinations at 16-38 weeks. Male fetuses had significantly larger HC and BPD measurements compared to female fetuses and these differences increased with advancing gestation. In the 16-21 week scans estimated difference was (HC + 3.9 days, 3.0% and BPD + 4.1, 3.2%), during the 21-30 week scans (HC + 6.8 days, 4.3% and BPD + 6.9, 4.4%) and in the 31-38 week scans (HC + 12.3 days, 5.6% and BPD + 12.9, 5.9%) for males. Male fetuses had significantly larger HC compared to FL measurements. In the 16-21 week scans, estimated difference was + 2.1 days (95%CI 1.7-2.6, P < 0.001), during the 21-30 week scans + 3.4 days (95%CI 2.5-4.2, P < 0.001) and in the 31-38 week scans + 9.7 days (95%CI 7.3-12.1, P < 0.001). CONCLUSION: This study suggests that male fetuses have significantly larger head circumference (HC) and biparietal diameter (BPD) measurements compared to female fetuses. These prenatal sex-related differences are established by as early as 16 weeks of gestation and tend to increase with advancing gestational age. In the case of discrepancy finding between head (HC, BPD) and femur lenght (FL) measurements the fetal gender should be taken into account.

Anthropometry↗
PubMed2006

[Sentinel lymph node detection using 99mTc-nanocolloid in endometrial cancer].

OBJECTIVE: The aim of this study was to evaluate the feasibility of pre-operative lymphoscintigraphy and radio-guided surgery in endometrial cancer patients after intramyometrial administration of labelled colloid. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology of the Palacký University Medical School and University Hospital, Olomouc, Czech Republic. PATIENTS AND METHODS: Between April 2002 and March 2005, thirty three patients with endometrial cancer received pre-operatively 50 MBq of 99mTc-nanocolloid. The radiopharmaceutical agent was administered by a 25 Gauge needle transcervically into the myometrium. Subsequently, series of static lymphoscintigrams were made 20 to 90 min after injection. Two hours after injection the surgery started. Twenty eight patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Five patients were scheduled for laparoscopically assisted vaginal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Paraaortal lymphadenectomy was performed in 11 cases. A gamma detecting probe was used to locate radioactive lymph nodes during operation. Each hot lymph node was removed separately. RESULTS: Sentinel lymph nodes (SLN) were identified in 26 (79%) of 33 patients. The mean number of sentinel nodes detected was 2.9 (range 1-10). Seventy two (15.3%) of 472 nodes obtained in total, were identified as radioactive-colloid positive. Histopathological analysis revealed five (7%) of 72 lymphonodes to be positive of metastases. Sentinel nodes in paraaortic area were identified in 11 (33%) patients. No false negative sentinel lymphonodes were observed. CONCLUSION: The preoperative lymphoscintigraphy and intraoperative gamma probe guided biopsy may be useful in identifying sentinel nodes in endometrial cancer. No false negative sentinel lymphonodes were observed if representative SLNs were diagnosed with tumor.

Adenocarcinoma↗
PubMed2006

[Preoperative assessment of myometrial invasion in endometrial cancer patients by ultrasonography and magnetic resonance imaging (MRI)].

OBJECTIVE: To compare the accuracy of transvaginal sonography and magnetic rezonance imaging (MRI) in determining the depth of myometrial invasion in proven cases of endometrial cancer. DESIGN: A prospective study. SETTING: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Department of Radiology, University Hospital, Olomouc. METHODS: Fifty five patients diagnosed as having FIGO stage I endometrial carcinoma were evaluated preoperatively by transvaginal ultrasound; 44 cases of the same group were also evaluated by magnetic resonance imaging (MRI). The degree of invasion evaluated by transvaginal sonography and by MRI was compared to the pathological specimens. RESULTS: Transvaginal sonography was successful in evaluating myometrial invasion in 44 of 55 cases (accuracy 80%, sensitivity 80%, specificity 88%, positive predictive value 77%, negative predictive value 87%). Evaluation with MRI was accurate in 37 of 44 cases (accuracy 84%, sensitivity 84%, specificity 91%, positive predictive value 81%, negative predictive value 91%). CONCLUSION: Although MRI is superior to transvaginal sonography in evaluating myometrial invasion, it is expensive and time consuming, and would not be suitable as a screening test for depth of invasion. On the other hand, transvaginal sonography is relatively low-cost technique, which can be easily performed and repeated. However, it requires more operator experience than MRI in order to achieve high accuracy.

Carcinoma↗
PubMed2005

[Histological grade in management of carcinoma of endometrium].

OBJECTIVE: To correlate histological differentiation of endometrial cancer assessed from material obtained at diagnostic operation (hysteroscopy and targeted biopsy or curettage) and definitive radical surgical treatment. DESIGN: A prospective multicentric study. SETTING: Department of Obstetrics and Gynaecology, Institute of Pathology, Palacký University Medical School and University Hospital, Olomouc. MATERIAL AND METHODS: 237 patients with endometrial adenocarcinoma diagnosed between 1997-2001 were enrolled into this study. Histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive radical operation were compared. RESULTS: Discrepancies in histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive operation were found to be present in 42.2% of grade 1 (G1), 34.8% of grade 2 (G2), and 25.6% of grade 3 (G3) samples. When divided into subgroups, we observed discrepancies in 37.1% of G1, 31.5% of G2, and 26.7% of G3 tumors diagnosed at hysteroscopy and targeted biopsy. In patients with D&C the discrepancies were present in 53.1% of G1, 41.4% of G2, and 23.1% of G3 tumors. CONCLUSIONS: Low correlation between histopathologic differentiation of tumoral tissue obtained at diagnostic and definitive surgery supports the necessity of surgical staging in all patients with endometrial cancer. Primary radiotherapy should be reserved only for patients, in which the surgery is contraindicated.

Adenocarcinoma↗
PubMed2004

[Preoperative detection of lymph nodes by means of computer tomography in patients with endometrial carcinoma].

OBJECTIVE: To determine the value of computed tomography (CT) in predicting preoperatively nodal disease in patients with endometrial cancer. DESIGN: A prospective multicentric study. SETTING: Department of Obstetrics and Gynecology of the Palacky University Medical School and University Hospital, Olomouc, Obstetrical and Gynecological Departments of collaborating hospital, Czech Republic. METHODS: A total of 164 women with endometrial carcinoma that was diagnosed between 1998 and 2002 were recruited for this study. Final pathological findings were compared with those of the preoperative CT scans to assess nodal disease. RESULTS: Among 164 women who had preoperative scans and lymph node samplings, sensitivity, specificity, positive and negative predicting values of CT scans at predicting lymph node metastasis was 30, 95.5, 30 and 95.5% respectively. CONCLUSION: Routine preoperative CT scanning is a poor predictor of nodal disease in patients with endometrial cancer. Its preoperative routine use should be discouraged.

Adult↗
PubMed2004

[Sacrospinous fixation of the prolapsed vagina after the Miyazaki hysterectomy procedure].

OBJECTIVE: Implementation of a new surgical method for treatment of vaginal prolapse after hysterectomy. DESIGN: The description of a new surgical method. The results in the first 16 patients. SETTING: Department of Obstetric and Gynecology, Medical Faculty of the Palacký University and University Hospital, Olomouc. METHODS: The description of a new surgical method, pointing out the advantages and possibilities of the use in clinical practice. Presentation of the results in the group of 16 patients treated. CONCLUSIONS: Sacrospinous fixation of vaginal prolapse after hysterectomy sec. Miyazaki is a modification of sacrospinous fixation sec. Amreich-Richter. Contrary to the classical procedure this new method has several advantages. It makes easier the exact placement of the stitches to the sacrospinous ligament which decreases the danger of bleeding often substantially complicating the classical procedure. The procedure requires a special instrument, namely the so called Miyazaki hook. The results in the first 16 patients operated on by this method are presented.

Female↗
PubMed2003

[Lymphangiogenesis and new markers for lymphatic endothelium].

OBJECTIVE: To summarise recent knowledge about lymphangiogenesis, markers of the lymphatic endothelium and their importance to the tumor dissemination. DESIGN: A literature review. SETTING: Department of Gynecology and Obstetrics, Medical Faculty, Palacký University, University Hospital, Olomouc. ABSTRACTS: Clinicopathological data suggest that the lymphatics are an initial route for the spread of solid tumors. Detection of sentinel lymph nodes by biopsy provides significant information for staging and designing therapeutic regimens. The role of angiogenesis (formation of new blood vessels) in facilitating the growth of tumors has been well established, but the presence of lymphatic vessels and the relevance of lymphangiogenesis (formation of new lymphatics) to tumor spread are less clear. Growth factors involved in lymphangiogenesis during embryogenesis have been recently identified and showed to be able to induce formation of intratumoral lymphatics and thus facilitate metastatic spread to lymph nodes. The development of approaches to block tumor lymphangiogenesis and treat lymphedema would benefit from the availability of markers specific for lymphatic endothelium.

Animals↗
PubMed2002

[Risks in hysteroscopy in patients with endometrial carcinoma--a prospective clinical study].

OBJECTIVE: The evaluation of the risk of hysteroscopy (HSC) in patients with endometrial carcinoma with regard to the dissemination of disease and the deterioration of its prognosis. DESIGN: A prospective multicentric study. SETTING: Department of Obstetrics and Gynaecology and Institute of Pathology of the Palacky Univerzity Medical School and University Hospital, Olomouc; Obstetrical and Gynecological Departments of collaborating hospitals. METHODS: Two groups of patients with endometrial carcinoma were compared on the basis of cytological examinations from the peritoneal cavity. The study group (n = 156) consisted of patients whose diagnosis was made on the base of HSC and targeted biopsy. The control group (n = 71) included patients with the classical D&C. Both groups were comparable as to the distribution of clinical stages of the disease (P < 0.05). Cytological examinations were performed from the fluid obtained by the puncture of the cul de sac at the end of the HSC procedure and from the peritoneal lavage at the beginning of the following operation. Results of both groups were compared and statistically evaluated. RESULTS AND CONCLUSIONS: The comparison of the cytological findings from the punctures of the cul de sac after the HSC and from the lavages at the following operation did not show an increased penetration of malignant cells from the uterus into the abdominal cavity. Similarly, the comparison of cytological findings from the peritoneal lavages after HSC and probatory curettage did not show a statistically significant difference between both groups. We assume that HSC does not increase the risk of dissemination of tumour cells into the peritoneal cavity and does not deteriorate the prognosis of the disease.

Carcinoma↗
PubMed2002

[Antepartal cardiotocography and doppler flowmetry in the diagnosis of fetal hypoxia ].

OBJECTIVE: To evaluate by analysis of the most serious obstetric cases during a five-year period the contribution of ante-partum CTG and Doppler flowmetry in the diagnosis of foetal risk and to assess the part of risk factors of hypoxia during pregnancy. DESIGN: Retrospective epidemiological analysis. SETTING: Gynaecological and Obstetric Clinic Medical Faculty Palacký University and Faculty Hospital Olomouc. METHOD: In a retrospective analysis based on 6494 deliveries during a five-year period (1996-2000) the authors evaluate a selected sample of 1087 most serious conditions with the diagnosis of imminent foetal hypoxia. In the evaluated group 90.3% of the women had a cardiotocographic examination, 50.8% Doppler flowmetry with assessment of umbilical RI and PI indexes. The diagnosis of neonatal hypoxia was based on evaluation according to Apgar score < 7 and pH of arterial blood < 7.20. The authors compare both diagnostic methods with a common gold standard as regards their ability to predict hypoxia. In the logistic regression model they evaluate risk factors of pregnancy in relation to foetal hypoxia. RESULTS: Clinical manifestations of hypoxia were recorded in 114 neonates (10.5%). Perinatal deaths occurred in 46 infants, 16 were stillborn. Pathological ante-partum CCTG findings are associated with more active approaches (earlier termination of pregnancy, SC, preinduction by prostaglandins). Pathological ante-partum CTG and flowmetry was paradoxically more frequently associated with a better condition of the neonate. Pathological findings of ante-partum CTG were significantly less frequent in neonates with hypoxia than those without it (27%) vs. (40.9%), (relative risk 0.56 [95% CL 0.36-0.88], P = 0.01) while pathological findings of umbilical flowmetry were insignificantly more frequent (34.9%) vs. (33%), (relative risk 1.08 [95% Cl 0.59-1.97], P = 0.9). Both examinations were made in 547 (50.3%) women of the whole group, in 43 (7.9%) hypoxia of the foetus developed. Sensitivity: CTG 32.6%, Doppler 34.9%, Specificity: CTG 51.4%, Doppler 67.3%. Falsely positive CTG 48.6%, Doppler 32.7%. Analysis of risk factors of pregnancy in relation to foetal hypoxia defines by retrospective elimination as significant risks haemorrhage during pregnancy (n = 76, OR 2.35 [95% Cl 1.31-4.23], P = 0.01) and premature delivery (n = 258, OR 2.02 [95% Cl 1.34-3.05], P = 0.0004). CONCLUSION: The value of ante-partum CTG and Doppler flowmetry in the prognosis of neonatal hypoxia is low. The lower rate of pathological findings in affected neonates is probably associated with the fact that part of the hypoxias develop during delivery and cannot be predicted before delivery. The high number of falsely positive findings may by due by the adaptational abilities and reserves of the infant, by a more active approach when there are signs of danger and incorrect interpretation of findings. Premature delivery and haemorrhage are significant risks of neonatal hypoxia.

Adult↗
PubMed2001

[Preoperative ultrasound evaluation of myometrial invasion in patients with endometrial carcinoma].

OBJECTIVE: To evaluate the diagnostic accuracy of preoperative transvaginal sonography in the detection of myometrial invasion in endometrial cancer patients classified by the grade of disease. DESIGN: Prospective multicenter study. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty, Palacky University, Olomouc, Czech Republic. METHODS: In the period 1998-2001, 195 patients from 10 cooperating centers in the Czech Republic were enrolled in the RHOCE (risk of hysteroscopy in endometrial cancer) study. Sixteen patients did not meet the vaginal sonography study criteria (insufficient surgical staging, missing ultrasound examination). Sonographic results in 179 patients were categorized as M0--absence of infiltration (n = 97), M1--infiltration less than 1/2 myometrial depth (n = 61), M2--infiltration greater than 1/2 myometrial depth (n = 21). The final histopathology report of myoinvasion was used as a golden standard. RESULTS: We proved lower accuracy of vaginal sonography in detecting myometrial invasion in patients with higher grade of disease. CONCLUSION: Based on these data, the value of preoperative vaginal sonography as the sole criterion in the decision to perform extensive surgical procedures is questionable and warrants further evaluation.

Carcinoma↗
PubMed2000

[Cervix length measured by transvaginal ultrasonography in women with twin pregnancy--prospective study].

OBJECTIVE: To evaluate cervical length in twin pregnancies measured by transvaginal ultrasonography. DESIGN: A prospective clinical study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Palacky, Olomouc, Czech republic. METHODS: Clinical data of cervical length in twin pregnancies measured by transvaginal ultrasonography were summarized. RESULTS: 69% of patients delivered after 36th week of gestation, mean gestational age at the time of delivery was 35.5 week. Mean cervical length measured bi-weekly from the 16th till 34th week was 34.9, 34.6, 33.8, 33.2, 29.7, 28.7, 29.1, 28.4, 23.6, 22.8 mm. The creation of the funneling was recorded in more than 80% of patients with preterm delivery at the mean gestational age 23 week. Mean cervical length in patients delivered before 36th week was in the 23rd week of gestation 21.5 mm, while in woman delivered near term was average cervical length 33.1 mm. Genital infection in patients with preterm labours was present in 27%. CONCLUSION: Transvaginal ultrasonography seems to be a useful method in antenatal care of risk pregnancies with twins.

Cervix Uteri↗
PubMed1996

[Risk of fluid overload syndrome during hysteroscopy procedures].

At present increasingly liquid media are preferred to gaseous ones in hysteroscopic procedures. In operations the former media are used almost exclusively. The use of liquid media involves, however, some risks, the greatest one being the so-called fluid overload syndrome. It develops as a result of overload and upset of the milieu interior due to excessive escape of the distension medium. Medium escapes also via the oviducts into the peritoneal cavity. It is therefore necessary to adhere to safety measures which include in particular selection of a suitable medium, the time factor, correct surgical procedure and specially continuous control of consumption of the medium.

Extravasation of Diagnostic and Therapeutic Materi↗