[Clinical analysis of patients operated with squamous cell carcinoma of the uterine cervix]. / Analiza kliniczna chorych leczonych operacyjnie z powodu raka plaskonablonkowego szyjki macicy.

OBJECTIVES: The aim of our study was clinical analysis of patients operated with squamous cell carcinoma of the uterine cervix. MATERIALS AND METHODS: Between 1972 and 1991 at the 2nd Department of Obstetrics and Gynecology Medical University of Gdansk 687 total hysterectomies in Wertheim-Meigs method were performed in the patients with, various clinical stages cervical carcinoma. The clinical analysis has been done in 499 patients with diagnosed invasive cervical cancer stages Ia2, Ib and IIa. The clinical progression of cancer was established on the basis of FIGO classification from the year 1985. In the 18 patients invasive cervical cancer occurred together with a pregnancy (cervical cancer was diagnosed in the I, II and III trimester). In this group squamous carcinoma was diagnosed in 16 cases (88.8%). Endocervical type was diagnosed in 8 cases (1.6%), among which 4 cases were of a squamous type (0.8%). Two 10-year-periods of time have been separated: since 01.01.1972 to 31.12.1981 and since 01.01.1982 to 31.12.1991. RESULTS AND CONCLUSIONS: In the studied 20-year period (1972-1991) in all 499 performed operations squamous carcinoma was the most often occurring histological type of cervical cancer--439 cases (88.0). Comparing the incidence of squamous carcinoma in both 10-year periods of time there were no significant differences (only almost a 3-fold decrease of the incidence of microcellular cancer in the second decade was observed). It was stated that a percentage share of squamous carcinoma in the clinical stages Ib and IIa did not change. The number of pregnancies and labours in the patients with squamous carcinoma was close to the patients with other histological types of cervical cancer. The mean age of patients with squamous carcinoma was 45.6 (22-74) and was lower than the age of patients with adenocarcinoma--49.1 years (22-73). The clinical symptoms of a cancer occurred in 81.4% of the studied group. Asymptomatic course was seen in 18.6% of patients. The incidence of positive lymph nodes in the patients with squamous carcinoma stages Ib-IIa was close to the patients with carcinoma adenosquamous (25.0% and 23.7% respectively) and lower than in the case of adenocarcinoma (34%) or anaplastic carcinoma (33.3%, because of a small number of patients in this group the figures are not reliable). In the patients with squamous carcinoma the highest 5-year survival (almost 80.4%) was stated.

[Clinical analysis of patients operated for adenocarcinoma and adenosquamous carcinoma of uterine cervix]. / Analiza kliniczna chorych leczonych operacyjnie z powodu raka gruczolowego i gruczolowo-plaskonablonkowego szyjki macicy.

OBJECTIVES: The aim of our study was clinical analysis of patients with operated adenocarcinoma and adenosquamous carcinoma of uterine cervix. STUDY DESIGN: The mean age, number of pregnancies and labours, the incidence of adenocarcinoma and carcinoma adenosquamous in the stage Ib and IIa, and also in 2 following decades (1972-81 and 1982-91), the influence of positive lymph nodes on the survival have been estimated. MATERIALS AND METHODS: Between 1972 and 1991 at the 2nd Department of Obstetrics and Gynecology, Medical University of Gdansk, 499 radical hysterectomies were performed in the patients with cervical cancer stage Ia, Ib and IIa. In this group there were 41 (8.2%) patients selected with adenocarcinoma and 16 (3.2%) with carcinoma adenosquamous. In the group of 18 pregnant women (3.6% of the whole group) there was diagnosed 1 case of adenocarcinoma and 1 case of carcinoma adenosquamous. The incidence of both-adenocarcinoma and carcinoma adenosquamous amounted to 11.4%. RESULTS: The number of pregnancies and labours was similar to other histological types. Nulliparas made up respectively 10.5% adenocarcinoma and 6.25% carcinoma adenosquamous. The incidence of adenocarcinoma stage Ib has been found to be more than twice higher than the incidence of adenocarcinoma stage IIa (9.0% and 3.8% respectively). The percentage of carcinoma adenosquamous in those two clinical stages was similar. The three times decrease in the incidence of adenocarcinoma, and the four times increase in the incidence of carcinoma adenosquamous has been found in the years 1982-91 in comparison to 1972-81. It was also stated that an adenouse type, comparing to other histological types, most often occurs without any clinical symptoms--in 23.1% a course of the disease was asymptomatic. As for an adenosqamous type the figures were lower--12.5%. In the patients with adenocarcinoma the incidence of positive pelvic nodes in the stage Ib-IIa was 34%. The incidence of positive lymph nodes in the patients with carcinoma adenosqamous and adenocarcinoma was lower and similar--25% and 23.7% respectively. The analysis of the 5-year survival showed 69.8% in patients with adenocarcinoma stage Ib-IIa and 66.3% in patients with carcinoma adenosquamous the (same stages). The difference is not statistically significant (p = 0.8).

[Pregnancy and delivery after liver transplantation: case report]. / Przebieg ciazy, porodu i pologu u mlodej kobiety po przeszczepie watroby z powodu choroby Wilsona.

We report a case of successful pregnancy in a 22-year-old primigravida who became pregnant 19 months after orthotopic liver transplantation for end-stage liver dysfunction caused by Wilson disease. The mother continued immunosuppressive therapy (tacrolimus) during the pregnancy. No complications were observed. Labour started spontaneously at 40th week's gestation. As a result the healthy male infant weighing 3900 g was born. Patient and the baby were discharged from hospital, both in good condition, on the fifth day after delivery.

[Problems of contraception in women with Wilson disease]. / Problemy antykoncepcji u kobiet z choroba Wilsona.

Because of the constant progress in medical therapy, the fertility status of patients with Wilson's disease may be preserved. Contraceptive counselling is, therefore, essential to these women. Some contraceptive methods can have a negative influence on hepatic function or hepatic insufficiency may reduce the efficacy of other contraceptives. Different contraceptive options for patients with Wilson's disease are described. Second generation intrauterine devices with copper and estrogen-containing oral contraceptives are contraindicated. Spermatocide and barrier contraceptives and progesterone-only preparations can be safely used.

[Pregnancy in women with multiple sclerosis (MS): a report of 2 cases]. / Ciaza u kobiet ze stwardnieniem rozsianym (SM)--opis dwóch przypadków.

We report two cases of pregnancy in patients with multiple sclerosis. Both of women were primigravidas. In both cases pregnancy were ended by cesarean section: in first case due to obstetric indications, in second due to neurological indications. Our experience and a review of current literature are presented.

[Hypothyroidism coexisting with pregnancy]. / Niedoczynnosc tarczycy podczas ciazy.

DESIGN: The aim of the study was to describe pregnancies, deliveries, and puerperal times, and to compare them with the reached scientific communications. MATERIAL AND METHODS: Four pregnancies in women with the hypothyroidism were described. All cases were taken from the group of twenty pregnancies (18 women) who were treated because of thyroid gland diseases in our clinic. RESULTS: We found that every infant was born in good condition, deliveries and childbeds were uncomplicated. CONCLUSIONS: Our notices are similar to new scientific communications, that hypothyroidism coexists with pregnancy much often then everybody, till now, suspected and infants have not so often congenital defects.