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PubMed1991

Applications of computed tomography in gynecologic diseases.

Computed tomography (CT) has evolved to play a significant role in the assessment of gynecologic diseases, primarily gynecologic malignancies. The cross-sectional display provides clear depiction of the female pelvic organs, viscera, and their surrounding fat planes. In the evaluation of certain pelvic malignancies, CT has become a fundamental study in the initial staging and subsequent follow-up of patients undergoing chemotherapy and radiation treatment. This manuscript describes and illustrates the role of CT in evaluating a spectrum of gynecologic pathology.

Female↗
PubMed1996

[Laparoscopy in the differential diagnosis and treatment of acute appendicitis and acute gynecological diseases].

Laparoscopy was used in differential diagnostics of acute appendicitis in 524 female patients. Acute gynecological diseases were diagnosed in 123-of them, inflammatory processes in appendages being most frequent. The laparoscopic technology allowed not only to avoid diagnostic errors in all the cases, but also to take all necessary surgical measures. The effectiveness of laparoscopic operations for acute gynecological diseases was confirmed by the absence of complications and recovery within short terms.

Acute Disease↗
PubMed2000

[Vocal tract disorders in women with hormonal gynecological diseases].

The paper analyzes the incidence rates and specific features of vocal apparatus disorders in dyshormonal gynecological diseases in the reproductive and menopausal periods. It presents a complex procedure for diagnosis and treatment, which includes the management of the patient by a phoniatrist jointly with an endocrinological gynecologist, a psychoneurologist, and a phonopedist. Drugs for correcting sexual hormone levels, psychoemotional status, venous tone, breathing exercises and phonopedic classes by using biological feedback, and physiotherapeutical methods of treatment have been used. Indications and contraindications for the use of hormonal drugs in the treatment of dyshormonal gynecological diseases in individuals of voice-and-speech professions are considered.

Adult↗
PubMed1981

[Difficulties and errors of diagnosis of acute appendicitis and gynecologic diseases].

Differential diagnosis of acute appendicitis and acute gynecological diseases frequently presents great difficulties since they often have similar symptoms. The attention of nubile women should be given to gynecological anamnesis, vaginal and rectal methods of examination in admission. In certain cases women admitted with the diagnosis of acute appendicitis, should be dynamically observed. When necessary, a repeated gynecological examination must be made. With symptoms of acute appendicitis and internal hemorrhage the laparotomy by Lennard's incision of inferio-median laparotomy is indicated. The process with secondary changes during extrauterine pregnancy should be ablated.

Acute Disease↗
PubMed2006

Gene transfer approaches for gynecological diseases.

Gene transfer presents a potentially useful approach for the treatment of diseases refractory to conventional therapies. Various preclinical and clinical strategies have been explored for treatment of gynecological diseases. Given the direst need for novel treatments, much of the work has been performed with gynecological cancers and ovarian cancer in particular. Although the safety of many approaches has been demonstrated in early phase clinical trials, efficacy has been mostly limited so far. Major challenges include improving gene transfer vectors for enhanced and selective delivery and achieving effective penetration and spread within advanced and complex tumor masses. This review will focus on current and developmental gene transfer applications for gynecological diseases.

Adenoviridae↗
PubMed1991

Evaluation of tumor-associated trypsin inhibitor (TATI) in women with benign and malignant gynecological disease.

Tumor-associated trypsin inhibitor (TATI) was assayed in healthy subjects and in women with benign and malignant gynecological diseases. Significantly lower levels were found in boys than in healthy adult subjects. No variations in level were evident over the course of a 24 h period. At a cut-off level of 20 micrograms/l elevated concentrations were found in 42%, 11.4% and 19% of women with ovarian, endometrial and cervical neoplasia, respectively. In patients with ovarian tumors TATI level were elevated both in mucinous and serous tumors. TATI does not seem to be useful for diagnosis of uterine tumors, but could have a specific place in the study and management of ovarian tumors, in which serum concentrations can reach levels 100-200 micrograms/l. In the other gynecological diseases maximum levels of 30-40 micrograms/l were observed.

Adolescent↗
PubMed1987

Mechanical intestinal obstruction in patients with gynecologic disease: a review of 368 patients.

To review the management of intestinal obstruction associated with gynecologic disease, the authors studied the records of 368 patients with acute intestinal obstruction. Most patients (83%) had gynecologic malignancies. Obstruction of the small intestines was more common than obstruction of the large intestines (77% versus 23%). Major causes of mechanical small bowel obstruction included extrinsic neoplasms (62%, mostly ovarian carcinomas), radiation therapy-associated strictures and adhesions (17%), postoperative adhesions (14%), and inflammatory strictures and adhesions (3%). Obstruction of the colon was caused mainly by extrinsic neoplasms (45%), strictures and adhesions associated with radiation therapy (26%), fecal impaction (9%), and intrinsic neoplasms (8%). Gastrointestinal intubation successfully relieved 81% of small bowel obstructions caused by postoperative adhesions. Tube suction alone was rarely successful when the obstruction was caused by malignant neoplasms. The prognosis was dependent on the cause of the underlying disease. The cases studied in this report were compared with a large number of cases of bowel obstruction in general surgery. It is concluded that bowel obstruction associated with gynecologic disease has unique features deserving wider recognition.

Adult↗
PubMed1991

[Our experience with the surgical treatment of acute gynecological diseases].

Experience is recorded in the treatment of acute gynecological diseases based on a series of 61 patients operated in the Clinic of Propedeutics of Surgical Diseases at the Research Institute of Surgery in Sofia for the period Jan. 1983-April 1990. They comprise 6.08 per cent of all emergency cases. The most common gynecological pathology was, as follows: 59 per cent ovarian cysts, 11.5 per cent adnexitis, 26.2 per cent adnexitis + pelvioperitonitis, 6.6 per cent extrauterine pregnancy, etc. The early postoperative results were very good--zero case fatality rate, absence of serious complications, 6.6 per cet suppurations. Taking into account also the very good remote results, the authors point to the trivial appraisal of the surgical activity and the need of thorough evaluation of the patient's fertility, all the more that 78.7 per cent of the women were younger than 39. In the light of the current trends in gynecological practice, the authors specify the indications and contraindications for surgical interventions in these diseases.

Acute Disease↗
PubMed2001

Soluble urokinase plasminogen activator receptor in preoperatively obtained plasma from patients with gynecological cancer or benign gynecological diseases.

OBJECTIVE: The present study was planned to measure preoperative levels of soluble urokinase plasminogen activator receptor (suPAR) in plasma from patients with gynecological diseases, and to test for a relationship to clinical and biochemical patient characteristics. METHODS: Using a specific and sensitive kinetic ELISA, suPAR levels were determined in preoperative citrate plasma samples from 53 ovarian, 34 endometrial, and 30 cervical cancer patients, 17 patients with benign ovarian tumors, and 28 patients with benign endometrial diseases. In addition, suPAR was measured in citrate samples from 31 female blood donors. RESULTS: suPAR was measurable in all samples. No significant difference was found between plasma suPAR in the blood donors and the patients with benign diseases (P = 0.58). The groups of cancer patients had suPAR levels that were significantly higher than those found in the blood donors (P < 0.0001, P < 0.0001, and P = 0.001 for patients with ovarian, endometrial, and cervical cancer, respectively). In all groups of cancer patients a trend toward increasing suPAR levels with increasing FIGO stage was noted (P = 0.0003, P = 0.02, and P = 0.01 for patients with ovarian, endometrial, and cervical cancer, respectively). Using the median suPAR level to dichotomize the ovarian cancer patients, FIGO stages I-III, a significantly increased risk of progression/relapse was found for patients with high suPAR levels (Hazard ratio (HR) = 3.1, 95% CI: 1.1-8.8, P = 0.03). A multivariate analysis was performed, including suPAR, FIGO stage, and CA-125. Only FIGO stage III compared with FIGO stage I was significant (HR = 15, 95% CI: 1.8-129, P = 0.01). Survival analyses were not performed in the endometrial or cervical cancer patients due to few progressions/relapses during the follow-up period. CONCLUSION: This study concludes that patients with gynecological cancers have elevated plasma suPAR levels as compared with healthy female blood donors and patients with benign gynecological diseases. In addition, high preoperative plasma levels of suPAR are significantly associated with poor outcome of ovarian cancer patients. However, additional studies are needed to further validate the clinical usefulness of plasma suPAR measurements in the management of ovarian cancer patients.

Adult↗
PubMedDate not supplied

Prospective comparative cytologic study of direct peritoneal smears and lavage fluids in patients with epithelial ovarian cancer and benign gynecologic disease.

Direct peritoneal samples obtained by scraping or brushing (with a Cytobrush) were compared to peritoneal lavages (washings) for the cytologic evaluation of patients with gynecologic disease. The direct samples were obtained during laparotomy or laparoscopy, following saline lavage if that was performed, and were immediately smeared on glass slides and fixed in 95% alcohol. Only 9 of the direct peritoneal samples taken from 64 patients with benign gynecologic disease were unsatisfactory for cytologic interpretation while 19 of the 33 lavage specimens simultaneously collected from these patients were considered unsuitable for analysis (P less than .001). Two direct smears from cases with benign histology were reported as suspicious. Nineteen patients with epithelial ovarian cancer also had cytologic specimens collected by direct sampling and by washing. The direct smears were positive for malignancy in 12 cases, suspicious in 4 cases and negative in 3 cases while the lavage samples were positive in 9 cases, suspicious in 4 cases, negative in 4 cases and unsatisfactory in 2 cases. These results indicate that direct peritoneal sampling is a simple and reliable alternative to peritoneal lavage and produces a significantly lower incidence of unsatisfactory specimens.

Ascitic Fluid↗
PubMed1991

Qualitative and quantitative analysis of peritoneal fluids from women with gynecologic diseases. Comparison of cytology and flow cytometry for the detection of malignancy in lavage and ascitic fluids.

A prospective study was undertaken to compare flow cytometric (FCM) analysis to conventional cytologic evaluation for the detection of malignant cells in peritoneal fluids (peritoneal lavages and ascitic fluids) from women with gynecologic diseases. The 94 peritoneal fluids analyzed came from 63 cancer patients (with epithelial ovarian carcinomas) and 31 control patients (with benign gynecologic diseases). The FCM DNA histograms were generated using propidium iodide as a DNA fluorochrome. Samples for cytologic analysis were stained with the standard May-Grünwald-Giemsa or Papanicolaou stains. Of the 94 samples, 90 were evaluable cytologically while 70 were suitable for FCM analysis. The sensitivities were 55% for FCM DNA analysis and 80% for cytologic analysis. FCM DNA analysis had a 30% false-positive rate; cytologic analysis produced no false-positive results. These results indicate that there is no advantage in employing FCM analysis instead of conventional cytologic evaluation for the detection of malignant cells in peritoneal fluids from gynecologic cases.

Adolescent↗
PubMedDate not supplied

[Role of Chylamydia in the pathology of pregnancy and chronic gynecological diseases].

For the elucidation of the role of chlamydial infection in pathological pregnancies, serological examination by the CFT with group-specific and species ornithosis antigen was carried out on 723 blood serum specimens from women with obstetrical pathology, 124 specimens from patients with various chronic gynecological diseases and 124 control blood serum specimens from women with nromal pregnancy and favourable obstetrical anamnesis. The complement-fixing antibody (CF) was detected in 72 (9.9%) serum specimens from women with obstetrical pathology and chronic gynecological diseases. No CF antibody was found in control sera. Negative results of the CFT were obtained with species ornithosis antigen in all sera. In parallel examinations of the blood serum specimens from women with obstetrical and gynecological pathology by the CFT and intradermal test, correlation of positive results was demonstrated in 62.5% of the patients. Among the women with positive reactions for chlamydial infection, in 52.8% thee pregnancy was pathological. Among 52 sero-positive pregnant women the death of the fetus was observed in the perinatal period in 21.2%. Among 111 babies born alive after previous pregnancies 55 babies (49.5%) died at the age under 1 year. Thus, chlamydial infection may possibly have causative relation to pathological pregnancy, death of the fetus in the perinatal period, and death of the babies under 1 year.

Adolescent↗
PubMed1989

[Experiences with the cancer marker CA 125 in gynecologic diseases].

CA 125 was determined in the sera of 94 female patients afflicted with various gynecological diseases. Benign ovarian tumors and gynecologic malignancies outside the ovaries had normal CA 125 values in most cases. Patients with ovarian carcinomas in advanced stage had high levels. 6 women, who had hepatic metastases from ovarian cancer, showed a so-called prozone effect in serum titration, that means, the CA 125 concentration at first rises to reach a peak at a dilution of 1:2 to maximally 1:20, and then reveal a normal reciprocal dilution behavior. Whether hepatic metastases as a possible source of marker production are responsible for this phenomenon should be examined in future studies.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

[Treatment of gynecological diseases by laparoscopic operation].

A series of 101 cases of gynecological diseases were treated laparoscopically by Nd: YAG laser (n = 68), electrocautery (n = 23) and microwave (n = 10) from September 1989 to November 1990 at PUMC Hospital in Beijing. This series included 64 patients with endometriosis, 17 with ectopic pregnancy, 13 with paraovarian cysts and other ovarian cysts; 4 with hydrosalpinx; 2 with subserosal myomata and 1 with polycystic ovary disease. All the operations were performed under local and topical anesthesia with procaine and dicaine respectively. Follow-up for 2-16 months revealed that, all the cases of endometriosis and other ovarian cysts produced good results. The patients of ectopic pregnancy were treated successfully by mere laparoscopy without laparotomy. No operative complications occurred. The technique, indications and characteristics of the operations are discussed.

Adult↗
PubMed1990

[Methodological approach to the study of gynecologic diseases among children and adolescents].

Guidelines for the assessment of gynecologic morbidity in children and adolescents have been developed by the authors. A methodology of elucidation of gynecologic morbidity in children and adolescents was obtained and a classification of gynecologic diseases suggested. Efficiency of current therapy in childhood and adolescence as a determinant of reproductive health in womanhood is shown.

Adolescent↗