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Biomedical subjects

S Sajdak

Publications and source records attributed to S Sajdak.

At least 19 recordsLinked to original sources
PubMed2005

Serum tumor necrosis factor alpha receptors p55/p75 ratio and ovarian cancer detection.

OBJECTIVE: Early ovarian cancer detection is still very difficult and patients are mostly in advanced stages, with obvious influence on poor prognosis. METHOD: Fifty-one ovarian cancer patients and 16 healthy controls had the serum concentrations of TNF alpha receptor p55, p75 and CA-125 measured prospectively and preoperatively. RESULT: Mean concentrations of TNF alpha receptor p55, p75 and CA-125 in patients with ovarian cancer were higher than in controls. The ratios of p55 and p75 receptor in ovarian cancer and controls were 0.73+/-0.38 and 0.55+/-0.06 respectively. The areas under ROC curve in detecting malignancy (all FIGO stages) were 0.73, 0.65, 0.88 and 0.85 for p55, p75, p55/p75 ratio and CA-125 respectively. The areas under ROC curve in detecting stage I of ovarian cancer were 0.52, 0.60, 0.84 and 0.66 for p55, p75, p55/p75 ratio and CA-125 respectively. CONCLUSION: Serum TNF alpha p55/p75 ratio showed promising value in ovarian cancer detection.

CA-125 Antigen↗
PubMed2005

Artificial neural network computer prediction of ovarian malignancy in women with adnexal masses.

OBJECTIVE: Assessment of the usefulness of a neural model to predict which ovarian tumors are malignant. METHOD: Age, menopausal status, body mass index, grayscale and Doppler ultrasonographic features, as well as levels of specific markers (CA 125, tissue polypeptide specific antigen) were examined in 686 women with adnexal masses. The probability of malignancy was calculated using an artificial neural network software and the diagnostic efficiency of the received model was estimated using a receiver-operating characteristics (ROC) curve. RESULT: Of the 686 women, 431 (62.8%) had a benign and 255 (37.2%) had a malignant ovarian tumor. The significant malignancy predictors are age, menopausal status, maximum tumor diameter, internal wall structure of tumor, presence of septa and/or solid elements, tumor location, location of vessels, and blood flow indexes. The best network provided 96.0% sensitivity and 97.7% specificity. The area under the curve for the received model was 0.9716. CONCLUSIONS: An artificial neural network model based on clinical and ultrasonographic data allows to calculate the probability of tumor malignancy.

Adnexal Diseases↗
PubMed2005

An ultrasonographic morphological index for prediction of ovarian tumor malignancy.

PURPOSE OF INVESTIGATION: A newly created ultrasonographic scale called the Poznan index as well as scales already well known (introduced by Sassone, De Priest and Lerner) were compared in our group of patients. METHOD: A morphological index was based on seven sonographic ovarian tumor features. Examinations on 686 patients were evaluated. Comparison of prognostic values of the Poznan index with other applied morphological indices in our group of patients was based on the area under receiver operating characteristic (ROC) curves. RESULTS: The cut-off level of the new index is 8 points. The new morphological index has a specificity of 77.0%, and negative and positive predictive values of 90.7% and 69.1%, respectively. It has a sensitivity of 86.7% and accuracy of 80.6%. The Poznan index proved its usefulness and superiority (AU ROC = 0.89). CONCLUSION: Using this morphological index it is possible to make a precise prognosis of ovarian tumor malignancy. It also makes it possible to make the right decision concerning the manner of surgical treatment.

Adolescent↗
PubMed2004

Clinical value of the ultrasound Doppler index in determination of ovarian tumor malignancy.

PURPOSE OF INVESTIGATION: Clinical evaluation of the newly created Doppler index (DS) in preoperative early differentiation of ovarian tumor malignancy. PATIENTS AND METHODS: The study involved data concerning 464 ovarian tumor examinations of women treated between 1994 and 2002. One hundred and sixty-five woman had malignant ovarian tumors, and the other 299 tumors were benign on histopathology. Menopausal status of the studied women was also considered. Created ROC curves compare the diagnostic value of the suggested index. The number of vessels, their location and arrangement, shape of velocity waves as well as presence of the protodiastolic notch in the arterial vessels of the tumor were analyzed. Each of the mentioned features could acquire a point-value of 0 or 1. RESULTS: A cut-off point for the suggested Doppler index was determined at the level of 4 for the following prognostic values: sensitivity, specificity and accuracy which amounted to 86.7%; 93.3% and 90.9%, respectively. In the group of 101 postmenopausal women accuracy was higher--94.1%, specificity and positive predictive value (PPV) was estimated as 100%. CONCLUSIONS: The suggested Doppler index enables a precise prognosis of ovarian tumor malignancy and as a half-amount analysis helps in the decision making of the most effective therapeutic treatment.

Adult↗
PubMed2003

Evaluation of soluble intracellular adhesion molecule-1 (sICAM-1) in benign and malignant ovarian masses.

PURPOSE: To evaluate serum ICAM-1 levels preoperatively in patients with ovarian masses. METHODS: Estimation by ELISA assay in 101 women with pelvic tumours and 16 healthy controls was performed. Correlations of sICAM-1 levels with CA-125, Tumour Volume Index, morphological score and pathological findings were studied. RESULTS: Fifty-one ovarian tumours were malignant, five were borderline and 45 benign. Mean levels of sICAM-1 were respectively, 311.1 +/- 182.9 ng/ml, 172.6 +/- 40.1 ng/ml, 241.8 +/- 74.1 ng/ml and 195.6 +/- 68.7 ng/ml for controls. The area under ROC curve for sICAM-1 was 0.72 (95% CI 0.58-0.82), the cut-off 250 ng/ml, corresponding to 81.3% sensitivity and 52.9% specificity. Serum ICAM-1 correlated with morphological score (r = 0.51, p < 0.001), but not with FIGO stage, tumour grade, Tumour Volume Index and CA-125. CONCLUSION: sICAM-1 concentrations are higher in patients with malignant tumours, but poorly correlate with clinical status. The clinical use alone in ovarian malignancy detection and tumour differentiation seems to have limited application. Combinations of CA-125 and sICAM-1 could improve the test characteristics.

Biomarkers, Tumor↗
PubMed2003

Lower urinary tract function after postoperative radiotherapy in the treatment of cervical cancer.

OBJECTIVE: The aim of this study was the urodynamic assessment of lower urinary tract disturbance intensity (especially urinary incontinence) among irradiated women after the surgical treatment of cervical cancer. STUDY DESIGN: The analysis included 34 patients after radical hysterectomy and following radiotherapy for cervical cancer in clinical Stage Ib. Only patients without any previous urogynecological disorders were included. Urodynamic diagnostics was performed two weeks after oncological treatment termination. RESULTS: Urodynamic parameter changes were clearly present at all stages of functional diagnostics. The most remarkable changes included decreased bladder capacity (mean 196 ml) and residual urine volume (mean 19 ml). The mean value of maximal urine flow rate obtained from uroflowmetry was 26 ml/s, but for 20 women it was lower than 20 ml/s. Voiding time and flow time were abnormally delayed with the significant difference of five seconds. Bladder sensation points were increased and maximum cystometric capacity was decreased to 270 ml during filling cystometry. Bladder compliance was 28 ml/cm H2O on average; for the majority of patients it was below 20. Detrusor pressure was increased in 23 cases above 20 cm H2O and mean isometric pressure was 34 cm H2O. Urethral pressures were low, especially while taking effort. Urinary incontinence was diagnosed in 30% of the cases. CONCLUSIONS: The obtained results allow us to conclude that voiding disorders after combined radiotherapy and surgery are often and mainly apply to the detrusor muscle with the domination of functional disturbances. It seems that early quantitative and qualitative changes depend on combined therapy with a standard dose pattern. The presence of functional disorders after oncological treatment should be considered in the planning of prevention and further treatment. Urinary incontinence restricts patients' activity, affects the quality of their lives and is the cause of patient discomfort. Many patients suffering from lower urinary tract pathologies pose a therapeutic problem caused by lack of information.

Brachytherapy↗
PubMed2002

Biochemical markers of bone turnover in girls with secondary amenorrhoea.

Our aim has been to evaluate the influence of menstrual disturbances of the secondary amenorrhoea type on the metabolism of bone tissue. We pursued this goal by determining selected biochemical markers of bone metabolism. Alkaline phosphatase and osteocalcin were used as indices of bone remodelling. Deoxypiridinoline was used as an index of bone tissue resorption.

Adolescent↗
PubMed2001

[Coexistence of female sexual organ malformation and urinary tract anomalies].

OBJECTIVES: The aim of the study was to estimate the correlation between sexual organs and urinary tract malformation. MATERIALS AND METHODS: The retrospective analysis of clinical data obtained from 50 patients with sexual organs anomalies diagnosed in the Academic Gynaecological Centre between 1992-1999 was performed. RESULTS: Material included 24 patients with the Meyer-Rokitansky-Küster-Hauser syndrome and 26 with other sexual organs' malformations. Frequency of urinary tract anomalies was 42%, 11 patients with Meyer-Rokitansky-Küster-Hauser syndrome and 11 with other malformations. The gravity of urinary tract anomalies showed no statistical significant difference dependent on the type and symmetry of genital malformation. Urinary tract anomalies were more frequent in cases of asymmetric genital malformation and the difference was statistically significant. CONCLUSIONS: Intravenous urography proofed to be more sensitive than ultrasonography in diagnosing urinary tract anomalies.

Abnormalities, Multiple↗
PubMed2001

[Pathologies observed in barium enema examination in patients with gynecological disorders].

The aim of our study was to analyse retrospectively 171 patients with gynaecological diseases, who have undergone barium enema examination in Third Teaching Hospital in Poznań between 1992 and 1998. 79 patients were diagnosed with ovarian tumours, in 24 cases their colon was dislocated. Stenosis was detected in 20 women and in five situations inflammatory changes of the colon were present. Malignant infiltration of large intestine was suspected in ten patients. The second group included 24 women diagnosed with tubo-ovarian abscesses and adnexitis. Three of them had dislocated colons. Stenosis of large bowel was detected in 11 patients and inflammatory changes in 8. In the next group of 35 patients' myoma uteri, myometrial endometriosis and carcinoma of colli uteri were detected. Barium enema examination revealed that 10 women had dislocated colons. In the third group stenosis was detected in eight cases, two patients had radiological signs of cancer infiltration and twice inflammatory changes of the large bowel were present. Frequency of radiological changes in barium enema examination was evaluated in the aforementioned groups. Results were compared with group of 33 patients treated for endocrinological disorders, sterility and minor pelvis pain syndrome. Frequency of dislocation of colon was compared with size of changes of ovaries measured during ultrasound examination. Our results showed that barium enema is still an important supplementary examination, which can give a great deal of beneficial information concerning the clinical condition of the patient. This procedure is useful before surgical intervention especially in cases of suspected ovarian cancer. We must underline that the same or similar information can be obtained using other methods without such radiation exposure.

Adult↗
PubMed2001

[Changes in mammography and breast ultrasonography in women undergoing hormonal replacement therapy].

OBJECTIVES: The aim of this study was to compare changes in mammography and breast ultrasonography in women undergoing Hormonal Replacement Therapy (HRT) and a control group. MATERIALS AND METHODS: Retrospective analysis of clinical documentation form 12.1998 to 11.1999 of 1075 women over 45 years old. COLLECTED DATA INCLUDED: Breast imaging, hormonal therapy, gynecological, obstetrical and oncological interview and examination. Analysis was performed using MS Access DataBase and Statistica v5.0, p = 0.05 was considered significant. RESULTS: 710 women were actually undergoing HRT and 365 were qualified to the control group. Oral HRT was used by 72.2% women, transcutaneous by 24.1% and transvaginal by 3.7%. There were no differences of breast cancer risk factors, age and cancer suspicious changes (relative risk 1.03) in analyzed groups. Suspicious microcalcifications were rarer in women undergoing HRT (relative risk 0.49) while breast cysts (especially to 0.5 cm) were more frequent. There were no statistically significant differences in other changes like: benign breast masses, macrocalcifications and mastopathy. All findings referred to superiolateral quadrant in 50% of HRT women and 56% of control group. CONCLUSIONS: Hormonal Replacement Therapy has no marked influence on changes in mammography and ultrasonography. Among women undergoing HRT, microcysts are more frequent while suspicious microcalcifications are less.

Breast↗
PubMed2000

Estimation of neovascularisation in hyperplasia and carcinoma of endometrium using a "power" angio-Doppler technique.

The aim of this study was to estimate neovascularisation in hyperplasia and carcinoma of the endometrium using a "power" angio-Doppler technique. One hundred and eighty-two postmenopausal patients with irregular bleeding from the sexual organs were investigated. Age of the patients ranged between 46 and 78 years. No neovascularisation in a control group of women with normal histopathological results of the endometrium was observed. The sensitivity of this method with reference to the diagnosis of hyperplasia and cancer of the endometrium was 12.2% and 81.2%, respectively. The specificity and positive prediction values were equal to 100% each in both pathologies. The values of the analysed flow indices in the neovascular arteries in endometrial cancer were significantly lower (p<0.05) (properly PI-0.92+/-0.12; RI-0.46+/-0.08) in comparison to the corresponding values in hyperplasia of the endometrium (PI-1.38+/-0.28 and RI-0.66+/-0.18). In conclusion, using a "power" angio-Doppler technique irregular vascularity of the endometrium in a group of patients with hyperplasia was observed in 12.2% of all patients and in 81.2% of those with cancer of the endometrium. The analysis of the values of the blood flow qualitative parameters in the neovascularisation areas in the endometrium at the significance level of PI < or = 1.0; RI < or = 0.5 and TAMV > 18.0 cm can help determine the essential element in the differential diagnosis of benign and malicious lesions. Transvaginal ultrasonography with a "power" angio-Doppler technique can be a valuable diagnostic method in hyperplasia and cancer of the endometrium, especially useful in the early stages of these pathologies.

Adenocarcinoma↗
PubMed1998

Malignant melanoma of the vulva: 2 case reports.

It was described two cases of vulvar melanoma malignum. Both women after primary radical treatment, unfortunately died. It was discussed the classification of melanoma malignum, the efficiency of treatment nowadays and the problems in diagnosis. General results of treatment are poor. It is due to tendency for spreading in early stage of this neoplasm.

Aged↗
PubMed1997

[Ectopic cervical pregnancy--conservative treatment with methotrexate].

Ectopic pregnancy regardless its localization always remains difficult diagnostic and therapeutical problem. Special attention is paid to cervical pregnancy because of its rare incidence and poor prognosis (even in this day and age maternal death rate is 40-45%). In this paper there has been reported the case of 38 years old patient, admitted to Dept of Gynecological Oncology with suspicion of alive cervical pregnancy. Diagnostic procedures have been described as well as positive results of conservative treatment with Methotrexate (under careful monitoring--ultrasound, beta hCG levels). Also there has been presented detailed description of endocervix curettage after fetal death confirmed ultrasonographically. Current conservative therapy methods for cervical pregnancy have been discussed.

Adult↗
PubMed1997

[Primary melanoma of the uterine cervix in a 19 year old woman--case report].

UNLABELLED: Only 5% of all melanocytic malignancies in women originate in the genitalia, the most unusual of which is melanoma involving the uterine cervix. CASE: a 19 year old woman, presented with abnormal genital bleeding. In our hospital the clinical examination showed an exophytic bleeding tumor growing in the cervix uteri. A first vaginal biopsy showed a sarcoma colli uteri. A new biopsy confirmed the clinical diagnosis of malignant melanoma. Subsequently a Wertheim-Meigs hysterectomy with bilateral adnexectomy and removal of upper half of the vagina and regional lymphadenectomy was performed. Next the patient received several courses of chemotherapy (DTIC).

Adult↗