Assessment of ER-alpha and ER-beta expression levels in malicious tumors of the uterine corpus.

PURPOSE: The purpose of this article is to present an assessment of the expression levels of estrogen receptors ER-alpha and ER-beta in malicious tumors of the uterine corpus. MATERIAL AND METHODS: Estrogen receptor expression levels were tested using semiquantitative immunohistochemical methods. Paraffin-embedded sections of tissue from the corpus of the uterus from 171 patients were used in the research. RESULTS: Analysis of the relation between ER-beta expression levels and the clinical grade of disease (based on FIGO classification) showed that these parameters are significantly related: p = 0.0099. There were no statistically significant relations between ER-alpha expression levels in tumors or clinical stages of tumors based on the FIGO criteria. The presence of high estrogen receptor beta expression levels is often accompanied by a low estrogen receptor alpha expression level and such arrangements allow the overt biological function of a dominant receptor. CONCLUSION: The differences in tissue distribution of both estrogen receptors could indicate their different biological roles.

The meaning of the methylation of genomic DNA in the regulation of gene expression levels.

INTRODUCTION: Methylation of genomic DNA is one of the major mechanisms that deactivates genes and regulates their tissue-specific transcription levels. Its patterns are based on clonal inheritance that occurs in the early stages of embryogenesis. All changes in the DNA methylation levels occurring especially in the promoter region of the genes, which involve hypo- as well as hyper-methylation, lead to cell differentiation and growth disorders. Therefore it can become an impulse that initiates different pathological processes including carcinogenesis. MATERIAL AND METHODS: The purpose of this review was to present the recent knowledge concerning methylation of genomic DNA based on recent references and authors' experience. RESULTS AND CONCLUSION: Genome stability disorders could be caused either by mutations, which damage the structure of the genes and have not been formerly removed, or as the consequence of an epigenetic mechanism. Methylation plays a decisive role in the activity of many genes and could be a natural weapon of an organism against the expression of foreign genetic material that degrades the original genome structure.

Environmental factors and risk for endometrial cancer development.

Getting to know the most important environmental risk factors for endometrial cancer development lets us provide well programmed primary preventive activity, thus avoiding or greatly reducing environmental risk factors for diseases. This activity may lead to a reduced number of new cases of endometrial cancer. We can help women live longer and better by well programmed preventive activity even when medical knowledge has reached such a high level of development. The authors analysed environmental risk factors for endometrial cancer development based on international medical references. The aim of our work was to review the environmental risk factors for endometrial cancer development which provoke initiation of the disease, sometimes change the clinical stage of the disease and influence medical treatment.

Expression and mutation of p53 in tumor effusion cells of patients with ovarian carcinoma: response to cisplatin-based chemotherapy.

p53 alterations are considered as one of the most important factors responsible for drug resistance in ovarian carcinomas, although the relationship between p53 gene status and response to cisplatin-based chemotherapy in ovarian cancer patients remains unclear. The aim of the study was to evaluate the relationship between p53 protein accumulation, p53 gene mutation and response to cisplatin-based chemotherapy in patients with ovarian carcinoma considering conventional clinicopathological parameters. Tissue sections and corresponding cyst and/or ascitic fluid cells from 79 patients with epithelial ovarian cancer were analyzed immunohistochemically for p53 expression. The PCR-SSCP analysis was performed in 25 cases and the results were compared with immunohistochemical data. It was demonstrated that p53 expression reaching approximately 50% of positive cells in immunostaining was usually associated with PCR-amplified exons showing abnormal migration and suspected for mutation. p53 gene changes were not correlated with histological structure, grade of differentiation or residual tumor after cytoreductive surgery, despite being detected more frequently in III/IV than in II FIGO stages and in patients with residual disease above 2 cm. A significant correlation between p53 accumulation and p53 gene alteration and poor response to cisplatin-based chemotherapy was shown. The overall survival time of patients decreased with an increase in p53 protein expression. A strong p53 expression especially accompanied by p53 changes detectable by PCR-SSCP analysis appears to be a good indicator of the resistance to cisplatin-based chemotherapy. The association between strong p53 overexpression and shorter overall survival time was also revealed.

[Comparative clinical analysis of cesarean section technique by Misgav Ladach method and Pfennenstiel method]. / Kliniczna analiza porównawcza ciecia cesarskiego sposobem Misgav Ladach i sposobem Pfannenstiela--doniesienie wstepne.

Clinical and biochemical parameters were analysed in 55 patients who underwent a caesarean section performed using Misgav Ladach method compared to reference group of 41 patients who underwent caesarean section using Pfannenstiel method. Shortened operation time, shortened hospitalisation time and less postoperative morbidity were observed in the Misgav Ladach group. This kind of method seems to have advantages in comparison to Pfannenstiel method.

Factors influencing period of time between negative second-look laparotomy and ovarian carcinoma recurrence. Multicenter study in Poland.

OBJECTIVE: The aim of our study was to evaluate factors such as primary clinical stage, presence of ascites, serum CA 125 antigen level, histological type of ovarian cancer, cell differentiation and number of chemotherapy cycles influencing the time of recurrence after negative second-look operations. MATERIAL AND METHODS: Having observed complete clinical remission in 356 patients with ovarian cancer, second-look laparotomy was performed. In 180 patients complete pathologic remission was detected and in 73 recurrence was observed. Correlation analysis between time of recurrence and the above-mentioned prognostic factors was carried out by means of the Mann-Whitney and Kruskal-Wallis tests. RESULTS: The time from the second-look operation till diagnosis of relapse ranged from 7 to 36 months (average 21 months). The statistical analysis showed a correlation between the presence of ascites, increased serum CA 125 antigen level, the administration of six chemotherapy courses and the time of recurrence. In all those cases relapse occurred earlier than in patients without ascites, with normal CA 125 antigen levels and after ten courses of chemotherapy. CONCLUSION: Our findings suggest that the stage of clinical advancement and histologic grading do not influence the time of recurrence. The presence of ascites, increased serum CA 125 antigen level and the administration of fewer chemotherapy courses (6 versus 10) after primary surgery affects the earlier relapse of disease.

[Chemotherapy in the treatment of the early relapse of cervical cancer]. / Chemioterapia w nawrotowym raku szyjki macicy.

OBJECTIVES: The treatment with chemotherapy in early recidivations or high clinical stages of the carcinoma of the cervix was analysed. MATERIALS AND METHODS: 17 cases early recidivation or high clinical stages in different histopathological types and clinical stages of the cervix cancer were treated with polychemotherapy (5-FU, Adriamycin, Vincrystin and Cyclophosphamide) and monochemotherapy with Carboplatin. The tolerance of these two chemotherapy programs was assessed. RESULTS: The same effectiveness of these two programs was observed, but the side effects after Carboplatin treatment were better tolerated then after polychemotherapy program. CONCLUSION: Carboplatin is the drug of choice in the treatment of the early recidivations of the cervix cancer.

[Intraoperative verification of hysterosalpingographic and laparoscopic examination in cases of oviductal infertility]. / Sródoperacyjna weryfikacja badania histerosalpingograficznego i laparoskopowego w przypadkach nieplodnosci pochodzenia jajowodowego.

There has been made an analysis of 45 cases of women's oviductal infertility qualified to surgical treatment. In search of the reasons of infertility these patients underwent hysterosalpingographic examination and 24 of them additionally, diagnostic laparoscopy with chromotubation. Positive intraoperative verification of HSG and laparoscopy, as a confirmation of tubal obstruction, they obtained at 40 women (88.9%) that made possible to carry out microsurgical operations in them. Such a big percentage of correct diagnoses makes sure, that both hysterosalpingography and laparoscopy are indispensable for proper qualification of a patient to microsurgical treatment of oviductal infertility.

[Laparoscopic verification of hysterosalpingographic image]. / Laparoskopowa weryfikacja obrazów histerosalpingograficznych.

The authors discuss 47 cases in which the HSG examination showed secondary tubular unpatency, then verified by laparoscopy. The patients were divided in three groups. The patients who belonged to the first group had two-sides tubular unpatency recognized by HSG. In 26 of these patients the HSG result was confirmed by laparoscopy, in 3 cases--it was not. The second group were 14 patients with partial tubular unpatency showed by HSG. In 10 of these cases the laparoscopic examination gave results consistent with HSG, in 4 cases--contradictory. The last group was formed by 6 patients with no tubular unpatency recognized through HSG. 4 of these recognitions were confirmed by laparoscopy, while 2 were not. In the opinion of the authors supported by the results the HSG examination may be considered only as a preliminary element of tubular patency examination. In case of planned microsurgery the only qualifying or disqualifying examination is the laparoscopy with introduction of colour contrast.

[Laparoscopic evaluation of reproductive organs in women treated for infertility]. / Laparoskopowa ocena narzadów plciowych u kobiet leczonych z powodu nieplodnosci.

The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubular inpatency was found. The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility.

[Primary dysmenorrhea in teenagers]. / Dysmenorrhoea primaria u pacjentek mlodocianych.

Authors demonstrate 21 cases with primary dysmenorrhoea at girls aged 14-17 years, which were observed between 1989-1992 and present way of treatment. In their opinion administration of nonsteroid, antiphlogistic medicaments and the spasmolytics is the most effective method.

[Clinical problems related to postmenopausal osteoporosis]. / Kliniczne problemy osteoporozy w okresie pomenopauzalnym.

Authors discuss current hypotheses related to the causes of osteoporosis and its possible therapy. One of the frequent menopausal disorders is osteoporosis, i.e. decrease in bone density, which may eventually lead to the pathological fractures and marked deformities of the skeleton. Etiology of the postmenopausal osteoporosis is not clearly explained. However, one may assume that hormonal disturbances, especially estrogen deficit, plays an important causative role. The treatment is difficult. It is usually aimed at preventing of bone loss.

[A case of coexistence of Bowen's disease of the vulva with pre-invasive cancer of the cervix uteri]. / Przypadek wspólistnienia choroby Bowena sromu z rakiem przedinwazyjnym szyjki macicy.

The Bowen disease is rare, especially when the focus is located on the vulva. In each case of diagnosis of+ the disease, one should also examine the patient with respect of the coexistence of an additional neoplastic focus in the skin or other internal organs. In their teaching hospital the authors observed a patient in whom the Bowen disease coexisted with preinvasive cervical carcinoma.