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Biomedical subjects

A Kurjak

Publications and source records attributed to A Kurjak.

At least 91 records · Page 5Linked to original sources
PubMed1994

Ovarian cancer screening.

To reduce the mortality from ovarian cancer various studies by transvaginal color Doppler (TVCD) sonography and serum CA-125 tumor marker, alone or in combination, have been performed. Relatively poor specificities of CA-125 and transvaginal conventional sonography can be improved with the use of TVCD. Furthermore, high specificity can be achieved on screening asymptomatic postmenopausal women by combining serum CA-125 measurement with TVCD. Combining tests should not necessarily increase the overall cost of screening because of the expected decrease in the number of unnecessary surgical interventions. Until the results of large, prospective studies are available, the efficacy of potential tests for screening of ovarian cancer will remain unproven and they should not be used to screen apparently healthy women outside of scientific interest.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1993

Stage I ovarian cancer by transvaginal color Doppler sonography: a report of 18 cases.

A total of 18 cases with ovarian carcinoma stage I (15 stage Ia and three stage Ib) were studied retrospectively to evaluate the efficiency of transvaginal color Doppler sonography in detecting the disease in its early stages. Four asymptomatic women (two cases with morphologically normal ovaries, and two with simple unilocular cysts) were found during the screening program. These cases would have been missed without the use of transvaginal color Doppler sonography. One ovary with stage Ia, and another ovary in a case with stage Ib ovarian cancer were missed. These data show the ability of transvaginal color Doppler sonography to detect ovarian cancer as early as stage I even in asymptomatic women as well as in the morphologically normal ovary.

Journal Article↗
PubMed1993

The assessment of normal early pregnancy by transvaginal color Doppler ultrasonography.

Transvaginal color Doppler was performed in 198 volunteer pregnant women whose menstrual age ranged from the fifth to the twelfth week. In all patients an attempt was made to obtain signals from both uterine arteries, peritrophoblastic/retroplacental vessels, umbilical arteries, fetal aorta, intracranial vessels, and corpus luteum flow. With the combination of color and pulsed Doppler transvaginal sonography, detection of vascular structures was greatly facilitated and the amount of time for examination significantly reduced. Flow velocity waveforms were measured and results were analyzed by calculation of the Resistance Index. During the early stage of pregnancy, we were able to locate both uterine arteries in all cases and continuous diastolic shift signal was found. Flow in the peritrophoblastic/retroplacental area was observed with an overall success rate of 94%. Blood flow in the umbilical artery and fetal aorta was visualized by color Doppler starting from the seventh week. Intracranial blood flow could be visualized starting from the tenth week in some cases. Diastolic flow in these vessels was detectable starting from the twelfth week. Corpus luteum flow was found in 148 cases (75%) and the Resistance Index decreased as pregnancy progressed.

Arteries↗
PubMed1993

Transvaginal color and pulsed Doppler assessment of adnexal tumor vascularity.

The objective of the study was assessment of the adnexal tumor vascularization with transvaginal color and pulsed Doppler sonography. Vessel location, its arrangement, and pulsed Doppler waveform characteristics were used to distinguish benign from malignant vascularity. The study was designed as a retrospective one in which sonographic and personal records of 254 women were investigated. The significance between ultrasonic results was analyzed by difference between group means and pooled estimate of variance. Results showed that peripheral and pericystical location with single vessel displayed and resistance index above 0.40 were highly associated with benign ovarian lesions. Blood vessels located in the centar, septum, and papillary projection of the tumor with diffuse dispersed vascular arrangement and resistance index below 0.41 were highly correlated with malignancy. There were no statistically significant differences in blood flow velocities observed at different vascular locations and vessel arrangement between benign and malignant ovarian masses. In conclusion, in addition to resistance index analysis of blood flow, vascular arrangement and location are important for accurate discrimination of benign from malignant ovarian lesions.

Adnexa Uteri↗
PubMed1993

Endometrial carcinoma in postmenopausal women: evaluation by transvaginal color Doppler ultrasonography.

OBJECTIVE: This study was conducted to evaluate the role of transvaginal color Doppler ultrasonography in detecting endometrial carcinoma in postmenopausal women and in evaluating the depth of myometrial invasion and tumor staging. STUDY DESIGN: A group of 750 postmenopausal women were examined by transvaginal color Doppler ultrasonography 1 day before the planned hysterectomy. Histopathologic and blood flow characteristics were evaluated. Analysis of variance was used to test the significance among the subgroups. RESULTS: Thirty-five women had endometrial carcinoma; 32 (91.4%) cases were detected by transvaginal color Doppler ultrasonography. Visualization of abnormal blood flow within the endometrium was 100% in the diagnosed cases with resistance index near or < 0.40, which constituted a statistically significant difference compared with that of endometrial hyperplasia. No flow was detected in normal, atrophic, and in 92% of cases with hyperplastic endometria. The color Doppler ultrasonography depicted 18 of 19 histologically proved cases of myometrial invasion. Three asymptomatic cases were discovered on the basis of morphologic and blood flow patterns. CONCLUSION: Transvaginal color Doppler ultrasonography can depict endometrial carcinoma, even in asymptomatic women, determine the depth of myometrial invasion, and help in tumor staging.

Endometrial Neoplasms↗
PubMed1993

Transvaginal color Doppler in the assessment of placental blood flow.

A cross-sectional transvaginal color and pulsed Doppler study was performed on 95 normal singleton pregnancies to establish blood flow characteristics of maternal and placental components of circulation. During the pregnancy, vascular impedance to blood flow decreases from the main uterine artery to the spiral arteries in the maternal component of uteroplacental circulation. In the placental component of circulation, vascular impedance decreases from the umbilical artery to the fetal arteries within placenta-intraplacental arterioles. At the same time, in both components of uteroplacental circulation, an increase of blood flow velocity with gestational aging was observed. There was no significant drop of vascular impedance of blood flow or increase of blood flow velocity around the 12th or 14th gestational week, which should prove the hypothesis of 'opening' of spiral arteries which have tips plugged with trophoblast tissue.

Adult↗
PubMed1993

Early detection of endometrial cancer by transvaginal color Doppler.

The present study aimed at evaluating the possibility of using transvaginal color Doppler sonography in early detection of endometrial cancer. This method was performed on 276 patients with uterine tumors before hysterectomy. Neovascularization was detected in 167 (67%) benign masses, while all malignant masses (26) were vascularised. The final diagnosis was made following pathological examination. Tumoral arterial blood flow was detected in all (26) patients with endometrial cancer. The blood flow analysis showed a significantly lower (P < 0.05) resistance index (RI = 0.37 +/- 0.07) in the cases of endometrial cancer than in patients with benign uterine lesions (0.54 +/- 0.09). Central vessels within endometrial carcinoma tended to have lower velocity and impedance compared to peripheral ones. Significant difference in the impedance of uterine artery blood flow, represented with RI between mentioned groups occurred (P < 0.05). There is a downward trend in the uterine artery RI in patients with endometrial cancer (mean RI = 0.64, ranged from 0.53 to 0.72) regarding benign lesions (mean RI 0.74, ranged from 0.64 to 0.82).

Blood Flow Velocity↗
PubMed1993

Uterine and ovarian perfusion during the periovulatory period assessed by transvaginal color Doppler.

OBJECTIVE: To measure the flow velocity of the uterine, radial, spiral, and ovarian arteries during the periovulatory period in spontaneous and induced ovarian cycles with confirmed ovulation. DESIGN: Daily measurements during the periovulatory period in 78 patients attending an infertility clinic because of the male factor in infertility. RESULTS: Uterine flow velocity in spontaneous cycles has a pulsatility index (PI) of 3.16 2 days before ovulation and starts to decrease the day before ovulation (PI = 2.22). In stimulated cycles these changes do not occur, and mean PI of 3.06 remains at that level during the periovulatory period. Clear flow velocity waveforms are obtained from the endometrium and myometrium around the time of ovulation. Data obtained from the radial arteries suggest better myometrial perfusion in patients with natural cycles. Spiral artery flow velocity in spontaneous cycles has a PI of 1.13 the day before ovulation and a nadir of 0.72 is reached the day after ovulation. On the contrary, the mean PI of the spiral artery blood flow in the group with ovulation induction rises during the day before ovulation (PI = 2.32) and reaches a nadir of 1.09 the day after ovulation. CONCLUSIONS: These data suggest the presence of better uterine receptivity during the periovulatory phase of natural cycles compared with induced ovarian cycles. Endometrial perfusion presents accurate noninvasive assay of uterine receptivity that may be used to predict implantation success rate, to reveal unexplained infertility problems, and to select patients for correction of endometrial perfusion abnormalities by an appropriate treatment.

Blood Flow Velocity↗
PubMed1993

Transvaginal color Doppler in the assessment of the uteroplacental circulation in normal early pregnancy.

Transvaginal color Doppler investigation of the uteroplacental circulation was performed on 108 pregnant women with normal intrauterine pregnancy. Decline of resistance index (RI) and pulsatility index (PI) and increase of peak systolic velocity (Ps velocity) were found in all segments of the uteroplacental circulation with advancing gestational age. There was a decrease of RI and PI from the uterine artery through its branches: arcuate, radial and spiral arteries. Ps velocities decreased from the uterine, through the arcuate, to the radial arteries, but Ps velocities in the spiral arteries were higher than those in the radial arteries. According to our results RI seems to be more precise in the assessment of the uteroplacental than the PI.

Adolescent↗
PubMed1993

Recent advances in the Doppler study of early fetomaternal circulation.

Transvaginal color Doppler has enabled precise investigation of feto-maternal circulation in early pregnancy. Decrease of peripheral impedance, as well as increase of blood flow velocity was found in all segments of the uteroplacental circulation with gestational age. The same finding was observed in umbilical artery, fetal aorta and intracranial blood vessels. A significant decrease of vascular impedance in cerebral blood vessels exists earlier than in fetal aorta or umbilical artery which could be explained by the establishment of cerebral autoregulation mechanisms which ensure adequate oxygen and glucose supply to embryonic brain. There was no significant difference for RI values of luteal blood flow from the 6th to the 12th gestational week. No difference was found between RI values of luteal blood flow in normal and ectopic pregnancy. In threatened, incomplete and missed abortions RI of luteal blood flow was significantly higher in comparison with normal pregnancy. It seems that in the group of patients with threatened abortion, follow up of the luteal flow might give some prognostic value. No difference in peripheral impedance and blood flow velocity of the uteroplacental blood vessels was found between women with normal pregnancies and women with threatened abortions and normal pregnancy outcome. There was no significant difference in terms of RI and PSV in uteroplacental blood vessels between women with threatened abortion and normal pregnancy outcome and women with threatened abortion whose pregnancy terminated with complete abortion and blighted ovum. In 46% of 21 women with visible retrochorionic hematoma RI in spiral arteries was higher and PSV was lower on the side of the hematoma. These values could be explained by compression of the wall of the spiral arteries caused by hematoma. In missed abortion the mean RI value of the uterine artery was lower than the mean value in normal pregnancy, but was not in spiral arteries. Some authors reported RI values in cases of missed abortions around and above the cutoff point value of 0.63. In blighted ovum RI in uterine and spiral arteries was lower in comparison to normal pregnancy, but in the other studies this was not the case. Increased blood flow in radial arteries in patients with pregnancy associated with uterine myomata could be explained by higher levels of estriol hormone metabolized in the placenta. Transvaginal color Doppler could be helpful in diagnosis and differentiation of the different forms of a gestational trophoblastic disease. It seems that this technique is a good substitute for pelvic angiography.(ABSTRACT TRUNCATED AT 400 WORDS)

Abortion, Spontaneous↗
PubMed1992

Transvaginal color Doppler study of middle cerebral artery blood flow in early normal and abnormal pregnancy.

Transvaginal color and pulsed Doppler sonography was performed on 106 singleton pregnant women; 75 had clinically normal pregnancies, and the remaining 31 patients had complicated pregnancies with vaginal bleeding. The gestational ages ranged from the 7th to 18th menstrual weeks. The aim of the study was to establish the earliest gestational age at which intracranial blood flow could be detected, in particular in the middle cerebral artery. The intracranial circulation becomes visible at the 8th week of gestation (7 weeks and 3 days). The end-diastolic component of blood flow is inconstantly present from the 11th to the 13th gestational week, and is always detected thereafter. A significant decrease in the pulsatility index (p < 0.05) and peripheral flow impedance index (p < 0.001) was observed during the early weeks of pregnancy in both the normal and complicated pregnancies. There was no significant difference between the groups (p > 0.05). Results suggest that Doppler studies of middle cerebral arteries in early pregnancy are unlikely to be of value in identifying fetal hemodynamic disorders in the early stages of spontaneous abortion.

Journal Article↗
PubMed1992

Fallopian tube carcinoma: recent diagnostic approach by color Doppler imaging.

A case of primary adenocarcinoma of the Fallopian tube is presented. The diagnosis was made preoperatively by transvaginal color Doppler imaging. The tumor revealed areas of neovascularization with characteristic low impedance (resistance index, 0.35) and high blood flow velocity (peak systolic velocity, 16.7 cm/s).

Journal Article↗