PubMed Health⌕ Search

Biomedical subjects

R Pilka

Publications and source records attributed to R Pilka.

28 records · Page 2Linked to original sources
PubMed2003

[Matrix metalloproteinases, embryo implantation and tumor invasion].

OBJECTIVE: To summarise which metalloproteinases and specific inhibitors have been already described, their regulatory mechanisms, the connection with implantation and in cases of tumour invasion. In conclusion we would like to point to the possibilities of practical use of this information. DESIGN: A literature review. SETTING: Department of Obstetrics and Gynecology, Medical Faculty, Palacký University, Olomouc. ABSTRACTS: Metalloproteinases are important for many biological processes including for instance cell proliferation, differentiation and remodelation of extracellular matrix (ECM) or vascularisation and cell migration. These events are in progress during organogenesis both in the normal development and in tumour progression. Mechanisms of activity of metalloproteinases during these processes include proteolysis of growth factors which in this way become available to cells. The motion of cells through tissues and fission of signal receptors made possible by degradation of the ECM is vital for cell migration. The majority of these processes requires a balanced equilibrium between the activity of matrix metalloproteinases (MMP) and their natural tissue inhibitors (TIMP). It is precisely this equilibrium between metalloproteinases and their tissue inhibitors that is decisive for the site and extent trophoblast invasion during embryo implantation and as well as for the cell invasion during tumour progression. In our literary review we would like to shortly summarize which metalloproteinases and specific inhibitors have been already described and what are their regulatory mechanisms. Which of them were detected in tissues in connection with implantation and which are most often expressed in cases of tumour invasion. In conclusion we would like to point to the possibilities of practical use of this information.

Animals↗
PubMed2003

[Significance of matrix metalloproteinases in pregnancy].

OBJECTIVE: To summarise which metalloproteinases and specific inhibitors have been already described, their regulatory mechanisms in obstetric complications. DESIGN: A literature review. SETTING: Department of Gynecology Obstetric and University Hospital, Palacký University, Olomouc. ABSTRACTS: The invasion of extravillous trophoblast cells into the maternal endometrium is one of the key events in human placentation. The ability of these cells to infiltrate the uterine wall and to anchor the placenta to it as well as their ability to infiltrate and adjust utero-placental vessels to pregnancy depends, among other things, on their ability to secrete enzymes that degrade the extracellular matrix. Most of these enzymes belong to the family of matrix metalloproteinases. In the literature review, we focus on the role of these proteases in normal pregnancy as well as on their importance in the development of some pregnancy complications.

Animals↗
PubMed2003

[Pregnancy and delivery after traumatic panhypopituitarism].

OBJECTIVE: We describe a case of 23 years old woman who, with a history of car accident at the age of 11 and severe head injury, attended our Center of Reproductive Medicine complaining of primary infertility. The accident preceded menarche and the development of inner genitalia (uterus 46 mm, cervix:corpus ratio 1:1) as well as secondary sexual development was not fully accomplished. Ovarian failure was accompanied by amenorrhea, if not substituted. Under replacement therapy regular menstruation was established. Basal hormonal levels was extremely low (FSH and LH 0.2-0.3 IU/l, PRL 0.5 ng/ml, estrogens 0.08 nmol/l, PRGE was not detected). With oral administration of micronized estradiol (Check et al., 2001) endometrial thickness of 9 mm was achieved. All of five retrieved oocytes were fertilized with partner sperm (normospermy) and three embryos were transferred. Already the first attempt was successful. Patient suffered with transitional anorexia and vomiting which could be handled conservatively. Hormonals level were normal. Patient substituted with Hydrocortison and Euthyrox. On January 2, 2003 the pregnancy was finished by caesarian section, one week before the delivery term (girl, 2970, Apgar score 10-10-10). DESIGN: Case report. SETTING: Center of Reproductive Medicine, Zlin. CONCLUSION: This care report demonstrates that recent progress in assisted reproduction field enables to manage successfully even exceptional pathological conditions.

Adult↗
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↗
PubMed2001

DNA ploidy correlates with grade, proliferation and clinical outcome but not with presence of human oncogenic HPVs or expression of Bcl-2 in preneoplastic and neoplastic lesions of the uterine cervix.

The aim of this study was to analyse whether DNA ploidy correlates with proliferative activity as measured by PCNA expression, presence of oncogenic human papillomaviruses (HPVs), histological grade, expression of antiapoptotic protein Bcl-2 and clinical outcome in a cohort of 57 preneoplastic and neoplastic lesions of the uterine cervix. The samples were analysed using computer image cytomorphometry of Feulgen stained sections, standard indirect immunohistochemistry and hybridisation of HPV DNA in situ. The ploidy data were found to be significantly different between low/high grade preneoplasia and invasive carcinoma. Significant positive relationships were also found between DNA content and proliferation of lesions, and DNA content and clinical behavior of the lesions. Nevertheless, no relationship between DNA ploidy and HPV/Bcl-2 status was established.

Cell Division↗
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↗
PubMed2001

Is there a real risk in patients with endometrial carcinoma undergoing diagnostic hysteroscopy (HSC)?

OBJECTIVE: The penetration of distention medium into the peritoneal cavity as well as directly into the bloodstream via injured endometrial vessels occurs in a great proportion of patients at hysteroscopy (HSC). This may cause potential risk of dissemination of the malignant cells of endometrial cancer patients. To evaluate the real risk of a poorer prognosis of these patients a prospective multicentric study was started in 1998. MATERIAL AND METHODS: Two groups of patients with endometrial carcinoma have been compared. The diagnosis was made in the study group by HSC and targeted biopsy, while in the control group by classical D&C. At the end of the HSC procedure puncture of the cul de sac was performed and the fluid obtained was cytologically examined. In both groups peritoneal lavage was performed at the beginning of the subsequent operation and the collected fluid was again cytologically examined. In the first phase of the study the cytology findings in both groups were compared. In the second phase which is planned for the next five years. the results of follow-up of both groups of patients will be evaluated. RESULTS: The results were evaluated in 134 patients with HSC and in 61 patients with D&C. In the study group a positive finding of malignant cells from the cul de sac was found in four patients (5.3%), a suspect finding in eight patients (10.7%), and a negative finding in 63 patients (84%). In the remaining 59 patients with HSC no peritoneal fluid was obtained. In the fluid from lavage at the beginning of the operation in the same group of HSC patients, a positive finding of malignant cells was found in 12.1%, a suspect finding in 18.2%, and a negative finding in 69.7%. In the control group (after D&C) the fluid from lavage contained malignant cells in eight patients (13.6%), suspect cells in 12 patients (20.3%), and no malignant cells in 39 patients (66.1%). Both groups were comparable for clinical stages of disease. CONCLUSIONS: Our results suggest that HSC does not increase the risk of penetration of tumour cells into the peritoneal cavity more than estimates in D&C.

Carcinoma↗
PubMed2000

Expression of Bcl-2 in dysplastic and neoplastic cervical lesions in relation to cell proliferation and HPV infection.

Expression of the bcl-2 gene has been shown to effectively confer resistance to programmed cell death in a variety of tumors. The bcl-2 proto-oncogene is involved in the development of human follicular lymphomas and also in a number of solid tumors such as carcinomas of prostate, breast, lung and GIT. The present study was designed to analyze the role of Bcl-2 expression in cervical intraepithelial squamous neoplasias (CIN) and cervical invasive carcinomas. Special attention was given to the association of Bcl-2 expression with the grade of the lesion, proliferative activity (expression of nuclear antigen of proliferative cells - PCNA) and human papillomavirus (HPV) DNA positivity. We examined tissue samples obtained from 86 women with varying degrees of cervical disease. Bcl-2 and PCNA were investigated using immunohistochemical staining and detection of HPV DNA was performed by hybridization in situ. Increased Bcl-2 expression was observed in advanced degrees of dysplasia and in carcinomas. We found a strong association between the presence of Bcl-2 in pathological epithelium with both the degree of dysplasia and the proliferative activity. We also observed a significant correlation between the amount of Bcl-2 positive lymphocytes infiltrating the lesions and the degree of disease. We, therefore, suggest that Bcl-2 expression in these lymphocytes may influence the antiviral or antitumor immune response. On the other hand we did not detect any significant correlation between the Bcl-2 oncoprotein and the presence of HPV. These results indicate that Bcl-2 may play an important role in the development of cervical cancer.

Adolescent↗