[The results of the treatment of carcinoma of the vulva with radiation therapy alone]. / Analiza wyników leczenia raka sromu metoda samodzielnej radioterapii.

This report consists of a retrospective analysis of 33 patients with carcinoma of the vulva treated with radiation therapy alone at Bydgoszcz Regional Cancer Center between 1986-1996. Patients were divided into two subgroups, group I (N = 25) treated with curative intent and group II (N = 8) treated with palliative intent. Five year actuarial overall and disease free survival for patients treated in definitively manner was 36.0% and 28.0% respectively. The overall local control rate was 48.5% or 16/33 patients. There was a suggestion that better local control was obtained in patients who received gross tumour radiation dose with interstitial brachytherapy and external beam irradiation.

[Analysis of long-term survival in patients with endometrial carcinoma depending on selected clinical factors]. / Analiza odleglych przezyc chorych na raka trzonu macicy w zaleznosci od wybranych czynników klinicznych.

In the period from 1980 to 1990 491 women operated for the cancer of the body of the uterus (stage I, II, III) underwent radiotherapy in the Department of Oncology and Radiotherapy and in Regional Oncological Centre in Bydgoszcz. The patients were at the age from 34 to 78. In the paper the patients' clinical condition was described and assessed according to FIGO/1972 and FIGO/1988 classifications the stages of progression of neoplasms were compared. The distant results of treatment depending on neoplasm's stage, histological type and the method of postoperative radiotherapy were presented.

[The preliminary evaluation of the value of interstitial brachytherapy combined with external irradiation in the treatment of advanced vulvar cancer]. / Wstepna ocena skutecznosci brachyterapii sródtkankowej i teleradioterapii w leczeniu zaawansowanego raka sromu.

Results of treatment of 10 patients with local-regionally advanced vulvar cancer are described. Loco-regional control of tumor was achieved in 6 patients. These patients remain disease-free with follow-up from 18 till 36 months. The procedure was well tolerated with low serious toxicity rate.

[Use of intraluminal brachytherapy for treatment of patients with non-small cell lung cancer in cases of local failure after teleradiotherapy]. / Zastosowanie sródoskrzelowej brachyterapii w leczeniu chorych na niedrobnokomórkowego raka pluca w przypadku niepowodzen miejscowych po teleradioterapii.

Remote afterloading high-dose-rate brachytherapy was used for the treatment in 38 patients with non-small cell lung cancer local failure after previous teleradiotherapy. The high dose unit we used is called microSelectron HDR. A dose of 18 Gy or 22.5 Gy was delivered in three fractions repeated weekly. Before treatment, symptomatic occlusions were seen in all patients. After treatment palliative improvement was seen in 30 patients (78.9%). The average follow up time was 7.2 months and range from 3 to 17. Median response time was 6.8 months. 12 patients died meanwhile. The procedure has been well tolerated with low toxicity. We conclude that palliative endobronchial high dose rate brachytherapy is a useful palliative modality in patients with recurrent endobronchial symptomatic carcinoma.

Non-Hodgkin's lymphoma of the uterine cervix: a report of three patients.

Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are described. The results of their treatment and a review of the international literature would support the statement that more patients with localized primary non-Hodgkin's lymphoma of the uterine cervix can be cured with radiotherapy, or with a combination of chemotherapy and irradiation.

[Direction of pharmacotherapeutic changes used in cardiovascular diseases assessed by examination of two population samples from Warsaw]. / Kierunki zmian farmakoterapii stosowanej w chorobach ukladu krazenia, ocenione na podstawie badania dwóch próbek populacji Warszawy.

The aim of the study was to analyse the changes in pharmacotherapy of ischaemic heart disease (HD) and arterial hypertension (AH) between 1984 and 1988 using the results of screenings of two independent samples of Warsaw inhabitants. In this period the prevalence of IHD in Warsaw population aged 35-64 increased by 4.3% (from 30.3% to 31.6%) as well as the percentage of treated subjects by 19.5% (from 39.0% to 46.6%). Prevalence of arterial hypertension (AH) decreased in this period by 4.7% (from 35.8% to 34.1%) whereas the percentage of undertaking pharmacotherapy in these patients increased by 47.9% (from 33.8% to 50.0%) as well as the effectiveness of undertaken treatment (goal of treatment: < or = 160/95 mmHg) increased by 115.8% (from 22.8% to 49.2%). In subjects with IHD selected from general population the consumption of nitrates, beta blockers and calcium channel blockers increased and these drugs were the most frequently taken in IHD. In treatment of AH diuretics, the most frequently used in 1984, were replaced, to some extent, in 1988 by beta blockers and calcium channel blockers. Consumption of drugs by general population, expressed in DDD/1000 i/day, changed too--the consumption of beta blockers increased in 1988 twice, of calcium channel blockers 3-fold and of nitrates 1.5 fold, whereas that of dipyridamole decreased by 60%, while comparing of these consumption in 1984.

[Evaluation of the efficiency of gemfibrozil in treating hyperlipidemia type IIb and IV]. / Ocena skutecznosci gemfibrozilu w leczeniu hiperlipidemii typu IIb i IV.

Analysis of the efficacy and tolerability of gemfibrozil (Gevilon-Parke Davis) was performed including 29 patients aged 19-69 years with primary hyperlipoproteinemia (HLP) type IIb-16 persons, IV-13 persons. All patients got dietary recommendations and received gemfibrozil 450-900 mg/day for 3 months. In both types of HLP a significant reduction of serum cholesterol (TCh)--15.5% triglycerides (TG)--32.1% VLDL-Ch--34.9% and VLDL-TG concentration--36.6% was observed as well as an increase of HDL3 fraction-16.3%. The greatest reduction of serum TCh concentration and VLDL-Ch were observed in type IIb, while that of TG and VLDL-TG in type IV HLP. The best therapeutic effect was obtained during the first month of treatment. The percent of TCh, TG, VLDL-Ch, VLDL-TG reduction correlated with their initial level. Tolerability of gemfibrozil was very good. Only in 2 patients transient abdominal pain was observed.

[Evaluation of gonadal hormone function in adolescent girls after antineoplastic therapy]. / Ocena funkcji hormonalnej gonad u dziewczat po przebytym leczeniu przeciwnowotworowym.

In 17 girls after the complex anti-neoplasm therapy we estimated the state of genital organs and the course of menorrhagia cycle together with plasma levels of beta-estradiol, progesterone and prolactin assessed by RIA. We found the secondary lack of menorrhagia together with lowered progesterone and beta-estradiol levels in 3 girls, in whom the abdominal cavity was irradiated. In other 3 girls the transient lack of menorrhagia was stated in the course of chemotherapy.

[Psychophysical examinations of adolescent girls with neoplastic diseases during puberty after multidrug chemotherapy]. / Badania psychofizyczne dziewczat z choroba nowotworowa w okresie pokwitania, po zakonczeniu chemioterapii wielolekowej.

We estimated the psychosomatic development of 25 girls aged 13-19 years after antineoplastic therapy. Normal parameters of physical development were stated in all cases. No injury of central nervous system in all cases was seen. Psychological examination revealed strong suppression reactions and evident anxiety signs in majority of girls.

[Drug consumption by the patients with ischemic heart disease (IHD) studied by the Pol-Monica Warsaw and the effect of selected factors on the treatment of IHD]. / Spozycie leków przez chorych na chorobe niedokrwienna serca (CHNS) w badaniu Pol-Monica Warszawa oraz wplyw wybranych czynników na fakt leczenia CHNS.

As part of a multicentre WHO MONICA-Project the present drug consumption by Warsaw population was assessed (evaluated by DDD). In Warsaw population 2646 inhabitants aged 35-64 years were examined. Ischaemic heart disease was diagnosed in 30% screened persons. Only 39% of subjects were involved in taking cardiovascular drugs. In ischaemic heart disease the drugs used most frequently were pentaerythritol tetranitrate and dipyridamole. The influence of several psychosocial factors on the fact of undertaking of pharmacological therapy was analysed using multivariant logistic function method. Significant relationships were found for age, health self-care self-estimation of health status and fact of medical consultation. Persons with high values of MLF (fifth quintile) underwent drug treatment six time more often, then persons with low values of MLF (first quintile).

[Effect of bezafibrate on serum lipid, lipoprotein and apoprotein levels in patients with hyperlipoproteinemia type II and IV]. / Wplyw bezafibratu na lipidy, lipoproteiny i apoproteiny surowicy u chorych z II i IV typem hiperlipoproteinemii.

The effect of six months' treatment with bezafibrate (400-600 mg daily) on serum lipids, lipoproteins and apolipoproteins concentrations was investigated in 32 patients with primary hyperlipoproteinemia (HLP) type IIa, IIb and IV. In all types of HLP the reduction of serum cholesterol (CH), triglycerides (TG), very low density lipoprotein (VLDL) fraction and increase in high density lipoprotein (HDL) cholesterol, HDL3-CH and apolipoprotein AI concentrations was observed. In type IIa and IIb HLP low density lipoprotein (LDL) cholesterol and apolipoprotein B levels decreased while in type IV increased. The greatest fall of serum CH concentrations was observed in type IIb while of serum TG level--in type IV. In 15 (46.9%) patients the side effects were noted. They were: abdominal pain, skin rash, myalgia, moderate increase in CPK and aminotransferase activities. Most of there side effects disappeared spontaneously without treatment cessation.

[Lovastatin in the treatment of primary hypercholesterolemia]. / "Lovastatin" w leczeniu hipercholesterolemii pierwotnej.

The results of 12 weeks treatment of primary hyperlipidemias with Lovastatin are presented. This drug belonging to a new generation of hypercholesterolemic drugs inhibits the endogenous synthesis of cholesterol by means of inhibiting the HMG-CoA reductase. The sample consisted of 30 men aged 28-68 years: in 17 of them heterozygotic familial hypercholesterolemia (FH) was diagnosed and in 13--primary non familial hypercholesterolemia (NFH). After 12 weeks of treatment in both groups a significant reduction of total serum cholesterol concentration was observed--(-28%) and--(-32%) as well as LDL-cholesterol concentration (in both groups about -37%) and apo B concentration--(-32%) and -34%. Only in one patients with NFH a significant reduction of VLDL-cholesterol (-29%) and or triglycerides (-15%) concentrations was observed. In this group also a 9% increase of HLD-cholesterol, mainly HDL-2 concentration, was found. Side effects were observed in 6 patients--in 4 of them a minor increase of ALAT, AsPAT or CPK activities (less than 3 times above norm were observed) without any symptoms and with a spontaneous normalization with no need to stop treatment, and in 2 of them abdominal pains not causing drug treatment cessation.

[Pharmacologic control of hypertension in the population of the right-bank Warsaw districts based on research from the Pol-Monica study]. / Farmakologiczna kontrola nadcisnienia tetniczego w populacji prawobrzeznej Warszawy na podstawie badan Pol-Monica.

The results of a number of Polish epidemiological studies raised the importance of hypertension in the Polish population. In view of a high frequency and insufficient control of it. The detection rate of hypertension in the Warsaw population was not exceeding 59% in men and 73% in women, and treatment was undertaken in 42% and 64% of them respectively. The effectiveness of pharmacological control was 5.9% in men and 10.3% in women. The study was carried out in a representative population sample of 1309 men and 1337 women living in right-bank Warsaw districts aged 35-64 years. Hypertension was found in 515 men and 457 women. Only 132 men and 188 women were currently treated. Drugs were recorded which were taken in the last 14 days, and were grouped into pharmacological classes. The most frequently taken drugs were those blocking the sympathetic system activity (78%) and diuretics (34%). Monotherapy was used by 38.5% of patients, 32.5% took two drugs, and 7.5% took three drugs. Drug consumption was expressed in DDD for comparing the obtained data with those reported from other centres.

[Myocardial infarction incidence and mortality among urban and rural populations during the 3-year period]. / Zachorowalnosc i smiertelnosc spowodowana zawalem serca populacji wielkomiejskiej i rolniczej w okresie 3-letniej obserwacji.

In years 1984-1986 3639 men and 1885 women were registered with suspected myocardial infarction from right-side Warsaw, simultaneously 2371 men and 917 women with the same suspected disease were registered from the Tarnobrzeg province population. The myocardial infarction diagnosis was confirmed in 54% of men and 43% of women from the Warsaw population as well as in 77% of men and 66% of women from Tarnobrzeg province population. In Warsaw the standardized incidence due to myocardial infarction increased during years of study from 466 to 588/100,000 among men and from 178 to 206/100,000 among women. The analogous increase among the Tarnobrzeg province population was 302 to 559/100,000 among men and 64 to 195 among women. Fatality during 28 days from the onset of the disease did not show any relationship with year of study and corresponded yearly among men to 45% and among women to 37% in Warsaw and to 42% among men and 33% among women in the Tarnobrzeg province . High fatality was noted during first 24 hours of hospitalization (Warsaw: 36% among men and 26% among women, Tarnobrzeg: 39% among men and 32% among women). The highest fatality was noted in the youngest of analysed groups.

[Stroke incidence and mortality among urban and rural populations during the 3-year period]. / Zachorowalnosc i smiertelnosc na udar mózgu w populacji wielkomiejskiej i rolniczej w okresie trzyletniej obserwacji.

In years 1984-1986 582 men and 338 women have been registered with clinical diagnosis of cerebral stroke. The respective numbers in the Tarnobrzeg province were 340 and 263. Preliminary diagnosis of cerebral stroke was confirmed according to criteria of registration in 82% of men or women from Warsaw and in 81% of men and 84% of women in the Tarnobrzeg province . Standardized incidence due to cerebral stroke was significantly higher in every of analysed years in the Warsaw population both among men and women in compare with that in the Tarnobrzeg province . In both population studied the incidence was significantly higher among men than among women. Standardized fatality during 28 days from the start of sickness was higher in the Tarnobrzeg province population than in the Warsaw population so far as both men and women are concerned. In both populations among men and women the most frequently diagnosis was acute disease of cerebral vessels.

[Characteristics of the main risk factors of coronary disease among the population of Warsaw and rural agricultural population of the Tarnobrzeg province]. / Charakterystyka glównych czynników ryzyka choroby niedokrwiennej serca w populacji wielkomiejskiej Warszawy i rolniczo-przemyslowej województwa tarnobrzeskiego.

Basing on results of first screening of the Pol-MONICA Project in 1984 in two centres that is the Tarnobrzeg province and two districts of Polish capital Warsaw (Praga South and Praga North) the level of 11 main coronary disease risk factors was compared in 2469 men and 2729 women. The following 5 risk factors were statistically significant for both men and women: the Durnin index of body fat content, the total cholesterol concentration in the plasma, triglyceride level, numbers of daily meals. The mean level of two factors that is the HDL-cholesterol concentration and the HDL-cholesterol/total cholesterol ratio was lower in the Warsaw sample what speaks in favor of concept that the ischemic heart disease threat is greater in that population. Among men the Warsaw population exhibited moreover the significantly higher value of diastolic blood pressure as well as of Quetelet body mass index; age and numbers of cigarettes smoked daily has also been higher in that population. In women from the Tarnobrzeg province ++ the diastolic blood pressure was higher than that in the Warsaw population. The two populations studied showed also highly significant differences so far as the complex of all 11 features is concerned what enabled the qualification of 72.3% of men, and 68.4% of women as belonging to the big city population or to the agricultural-industrial population using the discriminant Fisher function.

[Effect of inter-population differences in the levels of selected factors on the differences in arterial blood pressure]. / Wplyw miedzypopulacyjnych róznic w poziomie wybranych czynników na róznice w cisnieniu tetniczym krwi.

According to the Pol-MONICA program the random selected population samples were studied in inhabitants of Warsaw or the Tarnobrzeg province . After excluding from analysis the subjects treated with the hypotensive++ or hypolipemic drugs the differences between populations studies with regard to range of mean pressure value, except systolic pressure (RRs) in women, appeared significant ones. In populations studied the arterial blood pressure (CTK) was influenced by: age, sex, education, family history with regard to the circulatory system, the alcohol intake, smoking, heart action frequency the Quetelet coefficient value, triglyceride concentration and daily sodium intake. After analysis of inter-population differences in values of above factors the mean RRs values in populations studied did not differed significantly whereas differences in mean values of diastolic pressure (RRr) were highly statistically significant.

[Comparison of parameters and factors affecting the differences in obesity among urban population of Warsaw and the rural agricultural-industrial population of the Tarnobrzeg province]. / Porównanie parametrów i czynników mogacych wplywac na zróznicowanie otylosci w populacji wielkomiejskiej Warszawy i rolniczo-przemyslowej województwa tarnobrzeskiego.

Comparison of the parameters of obesity between two populations, urban from Warsaw and agricultural-industrial from Tarnobrzeg province revealed that skinfolds thickness, Quetelet index and body fat index, and per cent of overweight were statistically significantly higher in men from urban population. In the group of women these parameters were also statistically higher in Warsaw population with the exception of triceps skinfold and Quetelet index--differences of no statistical significance. There were also differences in the set of variables which correlate with the parameters of obesity between these two tested populations.

[Regional differences in drug use in relation to the causes]. / Regionalne zróznicowanie w spozyciu leków w zaleznosci od przyczyny.

The purpose of the study was in comparison of drug use in the treatment of coronary disease or hypertension in the random selected representative population sample of Warsaw and Tarnobrzeg province . In the study women and men aged 35 to 64 years were included according to POL-MONICA studies. Among 2646 subjects studied in Warsaw 23% used drugs whereas among 2722 subjects from the Tarnobrzeg province the drug users represented 12.1%. The most frequently used drugs in the treatment of coronary disease were nitrates, curantyl and beta-blockers. The drug use in subjects with coronary disease (DDD/1000 inhabitants/day) was 4.5-fold higher in Warsaw than in the Tarnobrzeg province . The most frequently drug used in treatment of hypertension in Warsaw were beta-blockers and diuretics, whereas in the Tarnobrzeg province among men diuretic and composed drug preparations; women in the last region used frequently composed drug preparations and smooth muscle relaxants. The relationship between the use of particular drug groups and the region was significant in women. The hypotensic drug use in Warsaw was twice as high as in the Tarnobrzeg voivodship despite similar frequency of hypertension in both regions.

Epidemiology of cardiovascular diseases in Warsaw Pol-MONICA area.

In the Warsaw Pol-MONICA area, which is inhabited by 274,000 people of ages 25-64, trends in total mortality showed increases similar to those for the whole of Poland. In Warsaw, mortality from cardiovascular disease in men and from ischaemic heart disease (IHD), myocardial infarction (MI), and cerebrovascular disease in both sexes decreased from 1976 to 1986, whereas trends for these diseases were increasing for the whole of Poland. Within the last 11 years, the MI attack rate and case-fatality rate increased in Warsaw. In the Warsaw male population, an increase in the majority of CHD risk factors was also observed. Age-adjusted mortality rates, MI attack and incidence rates, and stroke attack rates in Warsaw were all higher in men than in women. The mean values of HDL cholesterol and LDL cholesterol, Quetelet's index, and prevalence of hypercholesterolaemia in Warsaw were higher in women than in men, whereas the mean values of triglycerides, diastolic blood pressure, and number of cigarettes smoked as well as prevalence of hypertriglyceridaemia, hypertension, and smoking were higher in men.