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R Dimitrov

Publications and source records attributed to R Dimitrov.

At least 19 recordsLinked to original sources

Correlations between c-myc gene copy-number and clinicopathological parameters of ovarian tumours.

The objective of this study was to investigate increases in c-myc gene copy-number in ovarian tumours, and to analyze their correlations with clinicopathological parameters. Here we applied FISH on TMA (tissue microarrays) containing 507 ovarian tumour samples from different malignancy, histology, stage and grade. Overall, we found high frequency for c-myc copy-number increases (38.5%) in ovarian cancers: 22.1% amplifications and 16.4% gains. We established c-myc amplification in more than 30% in endometrioid and mixed epithelial ovarian carcinomas. c-myc gains were found in a high proportion (42.9%) of clear cell carcinomas. We found associations between c-myc copy-number changes and clinicopathological parameters of ovarian tumours such as degree of malignancy and histological type. We suggested that c-myc amplifications are characteristics for endometrioid, and c-myc gains for clear cell ovarian cancers. We suggest that copy-number increases of c-myc and 20q13.2 represent a possible mechanism for the regulation of the pathway STK15--c-myc--hTERT.

Aurora Kinase A↗

[Potentialities of immunodiagnostics in endometriosis].

In this study, the authors tried to figure out the value of immunodiagnostics, and especially the protein characteristics of the peritoneal fluid in women with endometriosis. The main purpose was to establish whether this kind of diagnostics is reliable enough for clinical purposes.

Ascitic Fluid↗

[LUTS in women and possible therapeutic effects of alfa1-adrenoblockers].

UNLABELLED: Lower Urinary Tract Symptoms (LUTS), including urinary incontinence, are one of the most common problems in women pathology. OBJECTIVE: The objective of the authors is to determine the symptomatic index, to perform an urodynamic assessment and to establish the therapeutic possibilities of the alfa1-adrenoblokers in women with LUTS. MATERIAL AND METHODS: In the course of a three year period (2001-2003) 74 women, ranging in age from 26 to 76 years old (average age of 48.6), have been examined and monitored. The symptomatic index was measured by a questionnaire, developed on the basis of IPSS and BFLUTS. The urodynamic study was performed with a multi-channel system Dantec-Meneut and includes multi-chanel cystrometry, followed by measuring of the pressure and the speed of urinary flow before the treatment and after it. Therapy with the L1-adrenoblocker Doxazosin was applied to 42 (56.7%) of the patients. RESULTS: 51 (68.9%) women were with predominantly irritative symptoms, and 23 (31.1%)--with predominantly obstructive. The urodynamic studies reval: 1. Obstruction of the lower urinary tract--7 (9.4%); 2. Obstruction with detrusor hyperactivity--15 (20.3%); 3. Detrusor hyperactivity--33 (44.6%); 4. Sensory urge-syndrome--6 (8.1%); 5. Disturbed contractility of the urinary bladder--4 (5.4%); 6. With no significant deviations--9 (12.2%) Total disappearance of the symptoms was achieved in 64.3% of the patients with the prescribed therapy, while in 11.9% symptoms have relapsed after discontinuation of the therapy. CONCLUSIONS: LUTS in women is not only a gerontology problem. It affects more and more often women in active and child-bearing age. The therapeutic use of alfa1-adrenoblockers is one alternatives in the treatment of these patients.

Adrenergic alpha-Antagonists↗

[A case of unruptured intrafollicular ovarian pregnancy diagnosed prior to operation].

A case of an unruptured intrafollicular ovarian pregnancy of 8 gestational weeks diagnosed by ultrasonography in a virtually asymptomatic patient is reported. A 32 year-old woman with 1 vaginal delivery 8 years ago presented with a history of intermittent spotting after removal of an IUD during her last menstrual period 4 weeks ago. IUD was inserted 6 years prior. The patient was symptom-free and showed no abnormal findings upon vaginal examination. Transvaginal ultrasonography however disclosed a gestational sac with a live embryo within the left ovary. The woman was operated on via laparotomy without delay. The intraoperative finding showed a normally appearing corpus luteum in the intact left ovary without any visible abnormality of the pelvic organs. Having in mind the US finding a resection of the corpus luteum was done revealing the gestational sac within it. The authors describe the following three US signs specific of unruptured intrafollicular ovarian pregnancy: extremely thickened uniformly echogenic wall of the sac, the sac is partially surrounded by ovarian structure, no corpus luteum is detected in either ovary. The essential role of transvaginal ultrasonography in the precise diagnosis of the ectopic pregnancy and its location is emphasized. The absence of specific complaints and findings until rupture of the ovary occurs and the association of ovarian pregnancy and IUD are also confirmed by the case-report.

Adult↗

[Laparoscopic hysterectomy--the initial experience in Bulgaria].

The paper presents the first cases of laparoscopic-assisted vaginal hysterectomy and laparoscopic hysterectomy with removal of the uterus through the vagina performed in Bulgaria as well as the experience gained by the team from II gynaecology clinic at State University Hospital "Maĭchin dom" in Sofia from seven patients operated on by these techniques. The indications, the conditions and the implemented technique with its advantages and difficulties are described. The procedures are associated with less trauma and blood loss than abdominal surgery and are followed by a very smooth postoperative period which is very well tolerated by the patients. No intraoperative complications occurred. The postoperative period was free of any problems in 5 of the patients while in two there were minor complications. Marked shortening of the duration of the procedures is achieved with the initial experience.

Adult↗

[Detrusor instability--an important but underestimated factor in urinary incontinence in women].

157 consecutive female patients complaining of urinary incontinence were studied by history and urodynamics. 21 of them (13.4%) demonstrated urge-incontinence due to severe detrusor instability, 20 (12.7%) showed mixed (both urge and stress) incontinence, 14 (9%) only detrusor instability and 12 (7.6%)--stress incontinence accompanied by detrusor instability. Pure stress incontinence was diagnosed in 79 cases (50.3%) while 11 patients (7%) manifested no abnormality during the urodynamics. A total of 67 patients (42.7%) showed urodynamic evidence of detrusor overactivity. In 55 (35% of the studied subjects) it was the main urodynamic finding. The prevalence of detrusor instability was higher among those with recurrent incontinence and was the highest (60%) among the women with more than one previous operations. When urge incontinence was present it occurred at detrusor pressures lower than the maximum urethral closure pressure, which implies possible failure of the sphincteric mechanisms associated with detrusor instability. 14% of the women with detrusor instability did not report complaints typical for this disorder but had history of stress incontinence alone. The authors confirm the necessity of objective assessment of the lower urinary tract in all cases with history suspicious of detrusor instability as well as when surgical treatment for stress incontinence is planned.

Adult↗

[The zinc concentration of the blood serum in women with ovarian tumors (preliminary report)].

The aim of the study is to determine the concentration of blood serum zinc of women with ovarian tumors. The patients included in the study are as follows: 15 women with benign ovarian cysts, 5 with endometrial cysts and 5 with ovarian carcinoma. The control group consists of 157 healthy women whose serum zinc concentration was 13.50 +/- 2.60 mmol/L. We could not demonstrate a significant difference in serum zinc concentration of different groups: benign cysts, endometrial cysts and ovarian carcinoma in comparison control group.

Analysis of Variance↗

[A comparative study of the efficacy of antibiotic prophylaxis with cephalosporins in operative gynecology].

The article presents the results of a comparative study on the efficacy of perioperative prophylaxis with cefalosporins in abdominal gynaecological operations. A total of 155 women meeting certain inclusion criteria were operated on and were randomly assigned to one of the following regimens: Cefoxitin 3 x 1 g--14 subjects, Cefotetan 2 x 1 g--43 subjects, Cefalotin 3 x 2 g for 24 hours--27 subjects, Cefalotin 3 x 2 g for 72 hours--41 subjects and a control group of 30 subjects without prophylaxis. The course of the postoperative period, the hospital stay and the average costs in each group were assessed and compared. None of patients receiving any prophylaxis developed infectious complications, while such complications occurred in 10% of the control without prophylaxis. The authors conclude that antibiotic prophylaxis effectively prevent the infectious complications and shortens the postoperative hospital stay. Despite its narrower anti-bacterial spectrum Cefalotin is not inferior in its efficacy to the second and the third-generation cefalosporins. While providing equal effect, the 24-hours Cefalotin regimen is from 2.8 to 4.9 times cheaper then the other prophylaxis regimens and is twice cheaper than the no-prophylaxis regimen. The longer 72-hours Cefalotin scheme shows no advantages to the 24-hours one but almost triples the expenses. Additional antibacterial treatment in the postoperative period needs more precise indications since unequivocal reasons for its administration are missing in a number of cases.

Adolescent↗

[The use of cefotetan for the prevention of infectious postoperative complications in gynecology].

The study presents the results from the use of cefotetan for perioperative prophylaxis in 43 gynaecology patients compared with 29 controls without perioperative antibiotic prophylaxis with similar diseases and operations. Both groups show equal percentage of the cases with smooth postoperative period (70 and 72% respectively). 13 of the patients on cefotetan prophylaxis received additional antibiotic treatment (9 because of temperature up to 37.5 degrees and 4 because of temperature from 37.6 to 38.5 degrees). Mo major infections postoperative complications occurred among the patients on cefotetan prophylaxis. 8 of the non-prophylacted patients needed antibiotic treatment postoperatively including 4 with temperature above 38.5 degrees. Two infections of the operative wounds also occurred in the same group. The conclusion is that cefotetan effectively prevents the major infection postoperative complications in gynaecology. The administration of additional antibiotic treatment is most often not warranted.

Adolescent↗

[Clinical and urodynamic findings in women with recurrent urinary incontinence].

The study includes 40 subjects with recurrent urinary incontinence who were subjected to a detailed clinical examination to detect descent of the bladder neck and the proximal urethra and to a full urodynamic investigation in the aim to determine the reasons for operative failure. A high incidence of urge-incontinence was found (37.5%), as well as of extremely and very low urethral closure pressure (35.7%). In 67.7% of the recurrences the bladder neck was not adequately elevated but many of them also showed very low urethral closure pressure failure are probably not the technical ones but those concerning the exact preoperative estimation of the disorder and the prospects for surgical treatment.

Adult↗

[The dynamics and trends in surgical delivery at the Maternity Home of the State Institutional Hospital].

The study discusses the frequency of operative obstetric deliveries (cesarean section, forceps extraction and vacuum extraction) over a period of 18 years from 1976 till 1993. A total of 100,545 deliveries with 100,192 livebirths took place during this period with a decrease of the annual number of deliveries in the last years. The frequency of the various kinds of operative deliveries shows different tendencies. The frequency of cesarean section has increased from 4.87 per cent in 1976 to 19.58 per cent in 1993, this increase being particularly marked during the last 6 years. Meanwhile the vaginal operative deliveries have decreased their frequency. The decrease of forceps extraction is from 4.33 to 2.22 per cent (steadily about 2 per cent during the last years). The frequency of vacuum extraction has dropped from 1.89 per cent to 0 by the end of the 1980 and the beginning of the 1990. The tendencies of the development of obstetric operations are analysed as well as their influence on perinatal outcome.

Bulgaria↗

[A case of mesenteric thrombosis occurring in a woman with a uterine myoma during her hospital stay].

The paper describes a case of a 40-year old woman who presented with complaints of crampy abdominal pain, weight loss, hypermenorrhea, anaemia, fever and peritoneal effusion which were attributed to a large solid pelvic tumour. During the preoperative investigations she had an attack of acute abdominal pain with bloody diarrhea assumed to be caused by gastrointestinal infection. The attack ceased quickly after intravenous infusions and antispasmodics were started. Several days later a second even stronger attack of abdominal pain with evidence of intestinal obstruction necessitated urgent laparotomy which revealed extensive necrosis of the small intestine with a coexistent large uterine myoma. A resection of the small intestine with a side-to-side anastomosis and hysterectomy with bilateral salpingo-oophorectomy were performed. The patient had an uncomplicated recovery gaining weight but still experienced mild discomfort after meals. The symptoms, the diagnostic difficulties as well as the therapeutic approaches in mesenteric ischaemia are discussed.

Acute Disease↗