Influence of antibiotic therapy on the level of selected angiogenic factors in patients with benign gynecologic tumors--preliminary report.

An increased fibrin level enhances the activity of proangiogenic factors and may contribute to tumor formation. Formation of new blood vessels during angiogenesis leads to neoplasm development through interaction with factors such as basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and interleukins. The aim of this study was to investigate the influence of perioperative antibiotic therapy in women with benign gynecological tumors with regard to basic fibroblast growth factor level, fibrinogen concentration and fibrin viscosity. The influence of clindamycin plus metronidazole therapy (group I) and cephazolin therapy (group II) on fibrinogen concentration, level of bFGF and fibrin viscosity was studied in women diagnosed with nonmalignant myomas and cysts. In patients with benign gynecologic tumors, higher bFGF levels (51.40 +/- 13.72 pg/ml), fibrinogen concentration (348.26 +/- 164.74 mg/dl) and fibrin viscosity (2.63 +/- 0.36 mPa) were observed, as compared with healthy women. There were strong indications that antiangiogenic activity occurred with both clindamycin plus metronidazole and cephazolin, although the response to these particular antibiotic therapies was different. The use of various drug therapies in groups I and II resulted in faster and delayed antiangiogenic effects, respectively. Further research is essential to provide more detailed information about the mechanisms of the induction of antiangiogenic activity by perioperative adjuvant antibiotic treatment.

[Nafarelin acetate (Synarel) and thermocoagulation in the treatment of endometriosis]. / Octan nafareliny (Synarel) i termokoagulacja w leczeniu endometriozy plciowej zewnetrznej.

We evaluated the results of united treatment (thermocoagulation and nafarelin acetate) of the node type of endometriosis) among women with pain syndrome in pelvis minoris. During the treatment we observed withdrawal of pain in lower abdomen among 60% of patients and assuagement in remaining cases. During the treatment by Synarel the menses were absent together with complaints connected with menstruation. The efficacy of the drug together with surgical intervention was many times higher then that of thermocoagulation alone.

[Decapeptyl (triptorelin) in the treatment of endometriosis genitalis externa]. / Decapeptyl (triptorelina) w leczeniu endometriosis genitalis externa.

The study involved 69 patients in whom endometriosis was diagnosed. The patients were divided into three groups randomly. In each of the groups, a different method of treatment was applied. In group A thermocoagulation was used, in group B triptorelin was used and in group C the above monitored methods of treatment were applied. Combined therapy involving the use of both thermocoagulation and triptorelin seen to be the most effective.

[The evaluation of the effect of combined treatment (laparoscopic ante-fixation of the uterus and Danazol-therapy) in patients with endometriosis and retroflexion of the uterus]. / Ocena skutecznosci skojarzonego leczenia laparoskopowego ustalenia macicy w przodozgieciu i terapii Danazolem u pacjentek z endometrioza i tylozgieta macica.

14 patients suffered from endometriosis and retroflected uterus were presented. They were treated with laparoscopic ante-fixation of the uterus and Danazol-therapy. Combined treatment was successful, the pain had ceased.

[Adnexectomy as therapeutic method of non-operative case of endometriosis: a case report]. / Usuniecie jajników jako metoda leczenia w nieoperacyjnej endometriozie krocza--opis przypadku.

Perianal endometriosis is an infrequent form of extragenital endometriosis. A case of endometriosis in an episiotomy scar with involvement of the external anal sphincter is presented. The question of treatment is discussed. Adnexectomy is suggested when wide involvement of the external anal sphincter is diagnosed.

[Endometriosis in surgical scars after cesarean section comparison of the operative methods]. / Endometrioza w bliznach pooperacyjnych po cieciach cesarskich. Sposób operowania.

The investigation group comprised 33 women who, between 1983-2000, passed an operation of removal of endometrial tumors in site of abdominal scars after cesarean section. Among 15 patient routine procedures are performed while among 18 patients the endometrial tumors were enucleated using coagulation. Separation of endometrial tumors which usually does not have a distinct outlines and often infiltrates the surrounding tissues by using coagulation, leads to smaller bleeding and enable the complete excision of the tumor.

[Endometriosis of the appendix vermiformis]. / Endometrioza wyrostka robaczkowego.

11 cases of the endometriosis of the appendix vermiformis were analyzed among women in age between 19-57 years. We observed that endometriosis of appendix were accompanied by advanced stages of the ovarian or peritoneum endometriosis in 9 cases. Diagnosis of endometriosis of the appendix is almost impossible before operation because it often could be covered by other genital organs diseases such like: uterine fibromas, ectopic pregnancy, PID. The clinical symptoms of appendicitis observed before an operation seldom find confirmation in results of additional laboratory tests.

[Rapidly growing endometrial cyst of the uterus in a young woman]. / Gwaltownie rosnaca torbiel endometrialna miesnia macicy u mlodej kobiety.

A case of a rapidly growing endometriotic cyst of uterus in young women diagnosed for sterility, and previously treated by GnRH analogues was presented. The case was difficult to diagnose before the operation.

[The implantation of bipolar coagulation to remove endometriosis foci]. / Zastosowanie koagulacji bipolarnej, kulki bikoagulacyjnej, do niszczenia ognisk endometriozy.

The paper compares the results of bipolar coagulation bey means of ERBE ICC 300 diatermy coagulator and WISAP endocoagulator. The results of both types of coagulation were assessed with reference to the changes occurring on peritoneum ligamenti sacro-uterini, Douglas pouch and ovary. The best results of endometriosis foci coagulation were obtained with bipolar ball at 20-30 W; no side effects or feelings of malaise were observed in patients just after the operation or over a longer period of convalescence.

[Transvaginal hydrolaparoscopy]. / Przezpochwowa hydrolaparoskopia.

The paper presents a simple and cheap method of transvaginal hydro-laparoscopy used for the observation women pelvic organs. The method may be useful to diagnose sterility, indefinite pains the pelvis or to control the patients previously undergoing operations. Hydro-laparoscopy was carried out in 12 patients by means of a modified 3 mm hysteroscope equipped with modified Verres needle. The method worked successfully in 10 cases. The quality of the endoscopic pictures od pelvic organs was satisfactory. No complications during the operation or convalescence were observed.

[Laparoscopic evaluation of adolescent girls suffering from algomenorrhea and acyclic pelvic pain]. / Algomenorrhoea i acykliczne bóle w dole brzucha w diagnostyce laparoskopowej u dziewczat.

120 adolescent girl suffered from acyclic pelvic pain and dysmenorrhoe (algomenorrhoee) was presented. They were treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs) and underwent a laparoscopy to determine the etiology of pelvic pain. Endometriosis was classified according to American Fertility Society classification. Adolescent with pelvic pain not responding to therapy with NSAIDs and OCPs have different rate of endometriosis.

[The case of uterus unicornis with rudimentary horn in a 15-year-old girl]. / Przypadek jednoroznej macicy z rogiem szczatkowym u 15 letniej dziewczynki.

The 15 years old adolescent with a rare mullerian anomaly, uterus unicornis with a rudimentary horn is presented. Patient was 15 years old girl suffered from pelvic pain. In this case we illustrate diagnosis, symptoms and therapy. Patient was submitted complex surgical treatment.

[Intraoperative phlebography in the diagnosis of varicocele]. / Flebografia sródoperacyjna w doraznej diagnostyce zylaków powrózka nasiennego.

We studied 42 infertile men, who had been surgically treated with modified Palomo method, with intraoperative phlebography of single or multiple testicular veins. We evaluated the efficacy of the performed procedure as well as the presence of other ways of recoil outflow and the connections between the venous vessels of the right testis. In 42 cases surgically treated men with varicocele only in 4 cases the varicocele have been observed additionally on the right side. We are of the opinion that the intraoperative phlebography allows us to performed the proper and the most effective method of the operation of varicocele.

[The role of hysteroscopy in the diagnosis of infertility in materials of the 2nd Gynecological Clinic of the Medical Academy in Lódz]. / Histeroskopia w diagnostyce nieplodnosci w materiale II Kliniki Ginekologii AM w Lodzi.

Hysteroscopy is one of the routine methods use in gynaecology for diagnosis of "uterine factor" in infertility. The range of the indications for hysteroscopy is very wide and few side effects make it relatively safe. The main aim of the study was the retrospective evaluation of hysteroscopic results among patients with infertility. Physiologic shape of the uterine cavity was diagnosed in 57.1% patients. The number of adhesions inside uterine cavity was lower than described in literature. Different pathology of uterine cavity was diagnosed as frequently as described by other authors.

[Endoscopic diagnosis of mechanic sterility]. / Diagnostyka laparoskopowa nieplodnosci mechanicznej.

An attempt has been made to classify mechanical tubal obliteration (proximal, distal, external obliteration). The material consisted of 798 laparoscopic procedures done in order to find the cause of female infertility. Tubal obliteration in females with secondary infertility are often associated with foci of endometriosis genitalis.

[Coexistence of genito-urinary system malformation and endometriosis in a 13 year old girl]. / Wspóistnienie wady rozwojowej ukladu moczowo-plciowego z endometrioza u 13-letniej dziewczynki.

One presents the case of 13 aged girl with malformation of internal genitals in the form of double uterus, cervix and vagina (one vagina was obliterated) and total lack of kidney on the side of vaginal atresia. Simultaneously tumoral endometriosis of external genitals was found.

[Ovarian neoplasms in teenagers]. / Guzy jajników u mlodocianych.

Between 1980-1992, 41 teen-agers with ovarian tumors were operated. Adult teratoma and follicular cysts were most often encountered. adenocarcinoma and dysgerminoma were found at 6 cases. The way of operation was depended upon clinical course of stage and result of direct, histo-pathological examination.

[Laparoscopy in the gynecologic clinic]. / Laparoskopia w klinice ginekologii.

Three thousand and twelve (3012) diagnostic laparoscopies in children, girls and women were carried out during the period 1970--1992. The age of the patients was between 6--49 years. The present studies show that laparoscopy fills up the space between the clinical investigation and laparotomy probatoria. It helps to solve in a clear way, a lot of diagnostic problems in gynecology in adult women, in gynecology of developmental age and gynecological endocrinology. There were the following indications to laparoscopy: 1. Adnexitis chronica 2. Infertility-primary and secondary. 3. Unclear tumor and pelvic infections in adolescence. 4. Primary and secondary failure of ovaries. 5. Suspicion of polycystic ovaries. 6. Second look laparoscopy. 7. Suspicion of endometriosis. 8. Suspicion of ectopic pregnancy. 9. Developmental faults of sexual organs. 10. Pubertas praecox.