[Risk factors for recurrent disease in borderline ovarian tumors]. / Rizikové faktory pro vznik recidivy u borderline nádoru ovaria.

OBJECTIVE: To evaluate risk factors for development of recurrent disease in borderline ovarian tumors. DESIGN: Retrospective study of 10-years single institution population. SETTING: Dept. of Gynecology and Obstetrics, 3rd Medical Faculty of Charles University in Prague. METHOD: 59 consecutive cases of borderline ovarian tumors (BOT) were analyzed for age, histopathological type, DNA ploidy, stage, presence of invasive and non-invasive peritoneal implants, type of surgical procedure, residual disease, adjuvant therapy, recurrence and long-time prognosis of the patients. RESULTS: Median follow-up was 47 months (range 1-144). There were 5 (8.5%) patients with DNA aneuploid tumors in the study group; 4 of them were younger than 50 years, 4 of them were early stage serous BOT; no one recur so far. No death of disease was described in the whole study group; only 2 patients (3.4%) developed recurrent disease - both were young patients after conservative surgery for serous diploid stage I/II BOT. Conservative surgery was the only significant factor for recurrence in univariate analysis (p = 0.0159) in our setting. CONCLUSION: DNA ploidy was not proved to be prognostic factor in borderline ovarian tumors in our study group. The only significant risk factor for development of recurrent disease was conservative surgery, with no influence on overall survival.

[Guideline for treatment of gynaecological malignant tumours 2010---endometrial carcinoma]. / Guideline gynekologických zhoubných nádoru 2010. Primární chirurgická lécba zhoubných nádoru endometria.

OBJECTIVE: To develop guideline for primary surgical treatment of endometrial carcinoma. DESIGN: Review, consensus of expert group. SETTING: Dept. of Gynaecology and Obstetrics, 3rd Medical Faculty of Charles University in Prague. METHOD: A retrospective review of published data, analysis of statistic data from Czech Republic, consensus among proposers and opponents. RESULTS: The guideline recognizes endometrial carcinoma patients based on their risk and recommends type of surgical treatment for certain group. It emphasizes the importance of centralized oncogynaecological treatment. Surgical staging remains the basic principle for treatment of endometrial carcinoma patients. The aim of pre-operative diagnostics is to estimate the extent of the disease--"interim staging", that can be different from definitive histopathological staging. Based on risk factors patients are divided into low or high risk group. Standard procedure for low risk patients is hysterectomy and bilateral salpingoophorectomy. It is advisable to use peroperative biopsy in these patients that can shift the patient to high risk group. High risk patients are recommended for hysterectomy, bilateral salpingoophorectomy, and systematic aortopelvic lymphadenectomy. The guideline contains recommendation for young patients wishing to preserve their fertility, for cases of inadequate surgery and for follow-up. CONCLUSION: Guideline for treatment of endometrial carcinoma is recommendation for clinicians and other subjects who participate on the process of the diagnostics/treatment of endometrial carcinoma patients. All points of the guideline were discussed and voted about by all participants of expert group.

[Guideline for gynecological malignant tumors I. Standard--a complex therapy of ovarian epithelial malignant tumors]. / Guideline gynekologických zhoubných nádoruu I. Standard--komplexní lécba ovariálních epiteliálních zhoubných nádoru.

OBJECTIVE: Elaboration of guideline for primary and secondary treatment of ovarian cancer. DESIGN: Review, consensus between proposers and opponents. METHOD: A retrospective review of published data, analysis of Czech statistics and consensus between proposers and opponents. RESULTS: We underline importance of comprehensive approach in therapy of ovarian cancer. We notice importance of expert ultrasound and CA 125 level in diagnostic algorithm. Extension of surgery depends on result of frozen section. All departments which want to perform surgery for ovarian resistance must have possibility to do peroperative histopathology. We can perform conservative fertility sparing surgery in patient with wishing of pregnancy and low stage disease. The effort of maximal debulking with radical surgery including lymphadenectomy is the standard procedure. When we diagnose ovarian cancer during laparoscopy, we have to convert on laparotomy procedure. We define the role of the neoadjuvant chemotherapy followed by surgery after 3-4 cycles of chemotherapy. We define adequate surgery treatment, indication for adjuvant chemotherapy and indication for second line therapy. CONCLUSION: Guideline for the treatment of epithelial ovarian cancer should become directions for clinicians and others, who participate in the process of treatment of the ovarian cancer. The guidelines include all parts of the process from diagnosis, treatment to follow up. All topics of the guidelines arose from a voting of the proposers and opponents.

[Guideline for gynecological malignant tumors--primary complex therapy in operable stages of malignant tumors of uterus cervix]. / Guideline gynekologických zhoubných nádoru 2004--primární komplexní lécba operabilních stadií zhoubných nádoru delozního hrdla.

OBJECTIVE: Elaboration of guideline for primary treatment of operable cervical cancer. DESIGN: Review, consensus between proposers and opponents. SETTING: Department of Obstetrics and Gynecology, Charles University, Prague, 2nd Medical Faculty and Faculty Hospital Motol. METHOD: A retrospective review of published data, analysis of Czech statistics and consensus between proposers and opponents. RESULTS: Team work is essential in the diagnostic and therapeutic procedure. For the preoperative diagnostic management it is possible to perform magnetic resonance volumometry. For the treatment of early stage cervical cancer it is possible to perform sentinel lymph node mapping (SLNM) by patent blau and 99mTc together with frozen section. SLNM does not substitute systematic pelvic lymphadenectomy. For the treatment of IB2 stage cervical cancer, an alternative for primary surgery or chemoradiotherapy is neoadjuvant chemotherapy, followed by radical surgery. In other topics only minor changes were made from the 1998 guideline. CONCLUSION: The guideline for cervical cancer treatment should represent directions for clinicians and others, who participate in the process of the treatment of cervical cancer. The guidelines include all parts of the process (from diagnosis to follow up). It originated from the consensus between proposers and opponents: we voted about all parts of guideline.

[Guideline for gynecological malignant tumors 2004--primary complex therapy in operable stages of malignant tumors of vulva]. / Guideline gynekologických zhoubných nádoru 2004--Primární komplexní lécba operabilnich stadií zhoubných nádoru vulvy.

OBJECTIVE: Elaboration of guideline for primary treatment of operable vulvar cancer. DESIGN: Review, consensus between proposers and opponents. SETTING: Department of Obstetrics and Gynecology, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Prague. METHOD: A retrospective review of published data, analysis of Czech statistics and consensus between proposers and opponents. RESULTS: Guideline for the diagnosis remain the same as in the proposal from 1998. We elaborated practically new guideline for surgical treatment. Wide excision or simplex vulvectomy is adequate only for stage la without angioinvasion, free margins have to be 5 mm. Standard surgical procedure is radical vulvectomy with inquinofemoral lymphadenectomy in stage 1a with angioinvasion, 1b and 2. In laterally localised lesions it is possible to perform hemivulvectomy or radical excision with inquinofemoral lymphadenectomy. Free margins have to be more than 8 mm. An alternative procedure in internally high-risk patients is sentinel node detection with radical vulvectomy (hemivulvectomy). Sentinel node detection has to by performed by combined method of blue dye and radiocoloid Tc 99 simultaneously. Bilateral inquinofemoral lymphadenectomy is indicated in case of positive sentinel node. Primary radiotherapy is indicated in higher stages, in stage 3 we can perform an exenteration with the agreement of patient. CONCLUSION: Guideline for the treatment of vulva cancer should be directions for clinicians and others, who participate in the process of treatment of the vulva cancer. Guidelines include all parts of the process (from diagnosis to follow up). All topics of the guidelines were arise from a voting of the proposers and opponents.

Tissues of the clawed frog Xenopus laevis contain two closely related forms of UDP-GlcNAc:alpha3-D-mannoside beta-1,2-N-acetylglucosaminyltransferase I.

UDP-GlcNAc:alpha3-D-mannoside beta-1,2-N-acetylglucosaminyltransferase I (GnTI; EC 2.4.1.101) is a medial-Golgi enzyme that is essential for the processing of oligomannose to hybrid and complex N-glycans. On the basis of highly conserved sequences obtained from previously cloned mammalian GnTI genes, cDNAs for two closely related GnTI isoenzymes were isolated from a Xenopus laevis ovary cDNA library. As typical for glycosyltransferases, both proteins exhibit a type II transmembrane protein topology with a short N-terminal cytoplasmic tail (4 amino acids); a transmembrane domain of 22 residues; a stem region with a length of 81 (isoenzyme A) and 77 (isoenzyme B) amino acids, respectively; and a catalytic domain consisting of 341 residues. The two proteins differ not only in length but also at 13 (stem) and 18 (catalytic domain) positions, respectively. The overall identity of the catalytic domains of the X. laevis GnTI isoenzymes with their mammalian and plant orthologues ranges from 30% (Nicotiana tabacum) to 67% (humans). Isoenzymes A and B are encoded by two separate genes that were both found to be expressed in all tissues examined, albeit in varying amounts and ratios. On expression of the cDNAs in the baculovirus/insect cell system, both isoenzymes were found to exhibit enzymatic activity. Isoenzyme B is less efficiently folded in vivo and thus appears of lower physiological relevance than isoenzyme A. However, substitution of threonine at position 223 with alanine was sufficient to confer isoenzyme B with properties similar to those observed for isoenzyme A.

[Interleukin-6 and acute phase reactants in the diagnosis of ovarian carcinoma]. / Interleukin-6 a reaktanty akutní fáze v diagnostice ovariálního karcinomu.

In 115 women (healthy controls and patients with benign and malignant gynaecological tumors) interleukin-6 was determined in blood plasma with the aim to decide whether elevated IL-6 levels may be used as a marker of ovarian carcinoma. In spite of statistically significantly increased IL-6 levels the authors do not regard at present the IL-6 values as a useful marker of ovarian carcinoma for two reasons: first, until now it is not decided whether elevated IL-6 values originate only from the cells of epithelial ovarian carcinoma or if they are also produced by tumour-associated macrophages or both and second: in a large number of cases (both controls and patients with malignant tumors) no IL-6 levels in blood plasma could be detected. For these reasons it seems to be more convenient (even economically) to determine in suspected cases and after exclusion of any inflammatory process the levels of prealbumin and transferrin. Significantly decreased levels of both have a high value of primary sensitivity (66% and 87% resp.).

Measurement of tissue impedance in the prevention of carcinoma of the uterine cervix.

The authors tested the possibilities of an apparatus for the assessment of tissue impedance -- DIACA LDN 200 -- in routine prevention of carcinoma of the uterine cervix. They found that by assessment of the impedance it is possible to differentiate normal squamous epithelium from calumnar epithelium and pathological epithelium. The latter two cannot be differentiated reliably by the apparatus. Therefore DIACA is not suited as a single method for the detection of precancerous conditions but in combination with colposcopy it may provide reliable services. In the discussion the authors reflect where to include most aptly the above method in the complex of prevention of carcinoma of the uterine cervix. Recently a new apparatus, DIACA LDN 200, was introduced on the market which can be used to measure tissue impedance. This apparatus proved useful in the detection of precancerous conditions and early carcinoma of the intestine (1, 2, 3). The basic idea links up with the work of Zwinger and Vrana (5, 6, 7) which some time ago aroused considerable attention but never was introduced in practice on a major scale. It is therefore of interest to test whether measurement of tissue impedance by means of this apparatus can be used in gynaecology and whether we may count on this method as a screening procedure in the prevention of carcinoma of the cervix.

Prevalence of seropositive reactions to Brucella canis in a limited survey of domestic cats.

The prevalence of Brucella canis agglutinins was determined in 170 cats (114 from animal shelters in California and 56 from an animal hospital in Texas). Seropositive reactions in the cats from animal shelters were 5.3, 11.4, and 0%, respectively, the the rapid slide agglutination test, salt 2-mercaptoethanol tube agglutination test, salt 2-mercaptoethanol tube agglutination test, and brucellosis card test. For hospitalized cats, the respective percentages were 7.1, 8.9, and 0%. One (0.9%) of 114 cats from the animal shelters and 5 (8.9%) of 56 hospitalized cats were seropositive by the salt 2-mercaptoethanol tube agglutination test at titers greater than or equal to 1:200. Isolation of bacteria was not attempted; thus, the findings of this study may need cautious interpretation.