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Jan Kotarski

Publications and source records attributed to Jan Kotarski.

36 records · Page 2Linked to original sources
PubMed2003

[Identification of myeloid dendritic cells in peritoneal fluid by flow cytometry].

The myeloid lineage-derived DCs are the most potent antigen-presenting cells (APC), which are highly specialized in capturing antigens and triggering adaptive immune responses. The purpose of our study was to identify of the myeloid DCs in peritoneal fluid of women with nonmalignant ovarian tumors. With use of flow cytometry we detected myeloid dendritic cells in peritoneal fluid of the studied patients. Myeloid DCs were identified as a discrete population of mononuclear cells expressing high levels of HLA-DR and CD33, but without expression of CD14 and CD16. The number of DCs was shown as a percentage of mononuclear cells. Dendritic cells comprised 3.02% (0.35%-8.41%) in patients with ovarian tumors and 1.72% (0.51%-6.2%) of peritoneal fluid mononuclear cells in women with unexplained infertility. The percentage of DCs in peritoneal fluid was significantly higher than in peripheral blood.

Adult↗
PubMed2003

[Uterine arteries embolization as a treatment of uterine leiomyoma].

Uterine artery embolization is a new method of treating uterine leiomyomata, first carried out in France in the early 90s. The procedures involve placing a small catheter into an artery in the groin and directing it to the blood supply of the fibroid. Little plugs of polyvinyl alcohol are injected through the catheter to block these arteries. This cause the fibroid to shrink. Indications for uterine fibroid embolization include menorrhagia, pelvic pain or pressure, other "bulk" syndrome (low-back pain, urinary frequency and constipation. The fluoroscopic-guided procedure is performed under local anesthesia. Most patients are discharged within 72 hours. Post-embolization syndrome including severe pain is managed with morphine via patient-controlled pump. Paper reviews long term outcomes. Uterine artery embolization has several advantages: high efficacy, less invasiveness, ability to treat multifocal changes, uterine preservation, shorter hospitalisation and recovery (low cost) and disadvantages: postembolic syndrome (pain and fever), unknown relations to pregnancy and lack of long term results.

Chemoembolization, Therapeutic↗
PubMed2003

Successful treatment with recombinant factor VIIa for intractable bleeding at pelvic surgery.

BACKGROUND: Postoperative bleeding may be complicated by failure to identify the site of bleeding, multiple bleeding points, and persistent hemorrhage despite surgical intervention. CASE: Activated recombinant factor VII was used successfully in a patient with life-threatening postsurgical bleeding after resection of two large extraperitoneal pelvic sarcomas. CONCLUSION: In severe hemorrhage, hemostasis can be achieved with activated recombinant factor VII.

Factor VIIa↗
PubMed2003

[Non-closure of the peritoneum after hysterectomy--postoperative clinical assessment].

Dynamic development in modern medicine permanently brings the modifications of operation techniques. Both closure and non-closure of the peritoneum after gynecologic operations has been discussed recently. According to clinical observations provided by many authors, the controversial problem of non-closure of the peritoneum is still under discussion. Thus we decided to assess the influence of closing or non-closing of the peritoneum on short-term postoperative morbidity. The patients operated because of uterine myomae were the participants of our study. Total abdominal hysterectomy with suturing or non-closing of visceral and parietal peritoneum was performed. Our study revealed that non-closing of the peritoneum did not increase the amount of postoperative complications and it seemed to be a safe procedure.

Adult↗
PubMed2003

[Application of unabsorbable polypropylene mesh in patients with vaginal prolapse after hysterectomy].

OBJECTIVES: Vaginal prolapse is one of delayed complications of hysterectomy. DESIGN: The aim of this work is estimation of efficiency of the application of unabsorbable polypropylene mesh in patients with vaginal prolapse after a prior operation of hysterectomy. MATERIALS AND METHODS: In the work the authors have described the operation procedure. It was performed in 6 women aged 49-73. Patients were inspected in 1, 3 and 6 months after the operation. RESULTS: The authors have estimated anatomical relations and postsurgical complications. CONCLUSION: The operation with the use of unabsorbable polypropylene mesh is an easy and efficient method of treatment of vaginal prolapse in patients after hysterectomy.

Aged↗
PubMed2003

[Evaluation of the morphology of the human placental cotyledon following dual in vitro perfusion in variable magnetic field].

UNLABELLED: Objectives and the aim of the study was electron-microscopy morphological estimation of the human placental cotyledon after 180 minutes of dual closed perfusion in vitro. MATERIALS AND METHODS: In the experimental group the cotyledons were exposed to variable magnetic field of 2 mT magnetic induction and 50 Hz frequency. The control group K (10 perfusions) was not subjected to magnetic field while the experimental group B (10 perfusions) was influenced by magnetic field. RESULTS: It was found that homogeneous variable magnetic field disturbs the ultrastructure of the nuclei and cytoplasma and it increases the density of the vascular-epithelial membrane of villi cells of human placenta in vitro. CONCLUSION: Variable sinusoildal, magnetic field of 2 mT magnetic induction and 50 Hz frequency disturbs the ultrastructure of the nuclei and cytoplasma and it increases the density of the vascular-epithelial membrane of villi cells of human placenta in vitro after 180 minutes of dual closed perfusion in vitro.

Cell Nucleus↗
PubMed2003

[Assessment of serum lipid peroxide levels and antioxidant status in females who had undergone total abdominal hysterectomy without closing of the peritoneum].

INTRODUCTION: Reactive oxygen species (ROS) generated after the trauma caused by surgical intervention, have the capacity to react in an indiscriminate manner leading to damage to almost any cellular component (proteins, nucleid acids) and to lipid peroxidation. The assessment of ROS generation intensity process may help in understanding of molecular processes observed in the intracellular environment after operations. The evaluation of antioxidative level may give an answer about the efficiency of antioxidative defence mechanism. The peritoneum is an organ of high metabolic activity, connected with ROS generation and participated in healing process. The modern opinions suggest closing of postoperative wound without closing of peritoneum. The aim of this study was assessment of antioxidant status and serum lipid peroxide levels in early postoperative period, in females who had undergone total abdominal hysterectomy without closing of peritoneum. MATERIALS AND METHODS: 30 women after total abdominal hysterectomy with salpingooophorectomy were studied, including 13 patients after peritoneal suturing (control group--C) and 17 women with nonclosed peritoneum (study group--S). The total serum antioxidant status (FRAP) was evaluated spectrophotometrically. The concentration of lipid peroxidation products was assessed in serum collected before operation and 8 and 24 hours after, as the concentration of lipid hydroxyperoxides (HPETE), malonyl dialdehyde (MDA) and 4-hydroxyalkenals (4-HDA). RESULTS: The antioxidative level before operation was 1147.09 +/- 93.6 microM/l in S group; 1022.04 +/- 115.4 microM/l in C group and did not changed significantly in early postoperative period. MDA + 4-HDA level before operation was 1.08 +/- 0.2 microM/l in S group and 1.06 +/- 0.2 microM/l in C group; HPETE level before operation was 4.58 +/- 0.1 microM/l in S group and 4.72 +/- 0.1 microM/l in C group, 8 and 24 hours after the operation MDA + 4-HDA level increased respectively to 1.34 +/- 0.2 microM/l (by 27%; p > 0.05) and 1.46 +/- 0.2 microM/l (37%) in S group and to 1.16 +/- 0.2 microM/l (by 8%) and 1.62 +/- 0.2 microM/l (by 52%; p < 0.05) in C group. HPETE level decreased to 4.56 +/- 0.1 microM/l (by 1%) and increased to 5.23 +/- 0.2 microM/l (by 14%) in S group and increased respectively to 6.0 +/- 0.2 microM/l (by 27%; p < 0.01) and to 6.43 +/- 0.2 microM/l (by 36%; p < 0.01) in C group. CONCLUSIONS: The concentration of lipid peroxidation products after the operation was lower in study group, where peritoneum was left without closing. Total antioxidative level was the same in both groups. Obtained results suggest smaller ROS generation in study group.

Biomarkers↗
PubMed2003

[Color Doppler blood flow measurements and microvessel density assessment in ovarian tumors].

OBJECTIVE: The aim of our study was to compare ultrasound vascular blood flow indices with the expression of CD-34 in women with benign and malignant adnexal tumors. MATERIALS AND METHODS: Transvaginal color and pulsed Doppler sonography was performed before surgical procedure in 105 women with adnexal tumors. Blood flow indices: pulsatility index (PI) and resistive index (RI) in blood vessels with the highest flow velocity were measured within each tumor. Immunohistochemical analysis of microvessel density (MVD) was performed on representative highly vascular tumor specimens fixed in 10% formalin and paraffin embedded. The primary monoclonal mouse anti-human CD-34 antibody (1:25, DAKO, Denmark) was used. Statistical calculations included group comparison with Kruskal-Wallis ANOVA on ranks and correlation analysis (Statistica for Windows 6.0, Statsoft Poland). RESULTS: Mean age of the studied women was 55.6 +/- 11.5 yrs. Of 104 tumors, 35 (33.6%) were benign and 69 (66.4%) were malignant. The latter included 14 FIGO stage I cases. Low resistance or pulsatility indices (RI < 0.5 or PI < 0.8) were found in 58 of 69 (84%) malignant masses and in 21 of 35 (60%) benign tumors. Substantial overlap in measured indices was found between both studied groups. Median number of microvessels per high power field in the benign and malignant tumors were 37 (range: 14-156) and 68 (range: 25-177), respectively. These differences were statistically significant (p = 0.007, Mann-Whitney U test). Also, a significant correlation was found between MVD and low resistance to blood flow as measured by the PI or RI (r = 0.43, p < 0.05). However, no statistically significant differences in MVD were found between FIGO stage I and other stages of ovarian cancer. CONCLUSION: Low resistance to blood flow as measured by the resistive or pulsatlity indices used in color Doppler sonography may by positively correlated with the microvessel density in the malignant ovarian tumors.

Adult↗
PubMed2003

[Use of multilayer perception artificial neutral networks for the prediction of the probability of malignancy in adnexal tumors].

BACKGROUND: Advanced statistical methods are currently are more often used in the prediction of ovarian malignancy when adnexal tumor is detected. These methods include logistic regression analysis and artificial neural networks (ANN's), i.e. computer programs which are capable of learning from presented data and further predict various events, such as clinical diagnosis or outcome of a given treatment. MATERIALS AND METHODS: We have analyzed data of 307 women with adnexal tumors who were operated in the Ist Dept. of Gynecology, Medical University in Lublin between 2000-2002. Following clinical and sonographic variables were included: age, menopausal status, serum CA-125, bilaterality, tumor size and volume, papillary projections, septa, solid parts presence, Doppler blood flow indices (PI, RI, Vmax), and subjective-color Doppler score. A multiple layer perceptron (MLP) neural network with 13 input variables, 11 hidden neurons and one output variable was constructed to assess probability of malignancy in each women (Statistica v. 6.0 for Windows, Statsoft, USA). Sensitivity, specificity and accuracy of the model were calculated. Receiver-Operating Characteristics curves were generated and corresponding Areas Under ROC Curves (AUROC's) for all diagnostic tests were compared. RESULTS: Final histologic examination revealed 228 (74.3%) benign tumors and 79 (25.7%) malignant masses including 21 women with FIGO stage I ovarian cancer. With a 75% cut-off probability of malignancy level the sensitivity and specificity of the best network in the testing set was 96.7% and 100%, respectively. In the validation set the corresponding values of sensitivity and specificity were 82.3% and 97.5%. The highest of all used tests AUROC equal to 0.9749 was found for the ANN predictive model. CONCLUSIONS: ANN may help in the extraction of the most useful predictive clinical and ultrasound data. The sensitivity and specificity of the ANN's generated model were higher than currently used single clinical and diagnostic tests. However, a prospective testing in a new, much larger group of women with adnexal tumors is essential for the clinical usefulness of the proposed statistical model.

Adult↗
PubMed2003

[Usefulness of logistic regression model to predict the endometrial carcinoma based on blood flow indices measured wit the of three-dimensional Doppler sonography].

AIM: Construction and prospective verification of predictive model permitting to rate individual probability of existence of endometrial carcinoma with use of three-dimensional Doppler Doppler sonography. MATERIAL AND METHODS: We analyzed the results of 3D sonography of 123 women (mean age 53.8 +/- 10.6; mean BMI--28.2 +/- 5.4). We estimated: endometrial thickness and volume, blood flow indices. All ultrasound measurements were verified by histology. In aim of finding the best combination of features essentially affect on endometrial cancer's risk and for estimate individual probability of endometrial cancer we use a logistic regression analysis. The obtained model was verified on 20 new cases. RESULTS: There were 24 women with endometrial cancer, 59 women with endometrial hyperplasia and 40 women without endometrial changes. We affirmed that only three variables had statistical significant influence on the constructed predictive model. Probability of endometrial carcinoma was: P(X) = 1/(1 + e-z), where "e" is mathematical constant and z = 0.12 x age + 0.16 x endometrial thickness + 0.47 x VI -11.3. The best sensitivity and specificity were 70.8% and 98.9%. The sensitivity and specificity in 20 new cases was adequately 75% and 91.6%. CONCLUSION: The usefulness of a predictive model built with the help of logistic regression analysis increase sonographic diagnostic precision. The usefulness of endometrial blood flow indices permit to estimate the individual risk of endometrial cancer in women examined with three-dimensional sonography.

Adult↗
PubMed2003

[Tumor necrosis factor alpha and interferon gamma levels in peritoneal fluid of infertile women].

UNLABELLED: Changes in the peritoneal fluid environment have been implicated in the pathogenesis of endometriosis as well as in the decrease of fertility. Tumor necrosis factor alpha (TNF alpha) and interferon gamma (IFN gamma) play a critical role in the generation of the immune response, leading to the enhanced proinflammatory cytokines and free radicals production. MATERIALS AND METHODS: 59 women were studied, including 24 patients with unexplained infertility, 10 infertile women with endometriosis (Io or IIo rAFS), 11 patients with PCOS and 14 patients with tubal occlusion. TNF alpha and IFN gamma concentrations were measured in the PF using commercially available ELISA kits. RESULTS: Peritoneal fluid IFN gamma concentrations did not differ significantly between the studied groups. TNF alpha levels were significantly (p = 0.02) higher in the PF of endometriotic patients compared to women with tubal infertility. The positive correlation (R = 0.83; p < 0.01) has been found between TNF alpha and IFN gamma levels. CONCLUSIONS: Increased PF TNF alpha levels observed in patients with endometriosis may play a role in activation of peritoneal macrophages. Positive correlation between TNF alpha and IFN gamma suggests their synergistic stimulatory effect on the immunocompetent PF cells.

Adult↗
PubMed2003

[The use of magnetic resonance imaging for the evaluation of treatment outcome in uterine artery embolisation for fibroids].

THE AIM: Of the study was to evaluate utility of magnetic resonance (MR) in the assessment of the women who fulfilled inclusion criteria for uterine artery embolisation as a symptomatic leiomyoma treatment and outcome of procedures. MATERIALS AND METHODS: MR examination was performed in 220 patients. Uterine artery embolizations were performed in 170 patients. RESULTS: The reasons for disqualification were: no correlation between symptoms and size an position of leiomyoma--61%, adenomyosis--20%. In MR imaging dominant leiomyoma volumes were diminished by 59.6% (p < 0.05) over a period of 3 months. CONCLUSIONS: MR is the method of choice in the assessment of women referred to uterine artery embolisation as a symptomatic leiomyoma treatment. MR imaging is effective and objective method of evaluation outcomes of uterine embolisation.

Adult↗
PubMed2002

[The diagnostic and therapeutic management of pregnant women with neoplasms of the reproductive organs].

OBJECTIVES: The aim of the study was the evaluation of the way of diagnostic and therapeutic management in case of neoplasm of the reproductive organ in pregnant women treated in the I Clinic of the Operative Gynaecology in Lublin. MATERIAL AND METHODS: In the years 1990-2000 in the I Clinic of the Operative Gynaecology in Lublin, 3556 operations were performed. In 9 cases the operations were carried out because of the neoplasm of the reproductive organ diagnosed in the course of pregnancy. In 8 cases, pregnant women with tumors in the pelvis minor were operated on and in 6 cases benign ovary neoplasms were stated. RESULTS: In one patient, extraperitoneal tumor coming out from the region of the sacral bone was diagnosed. In one case the patient in the 16th week of pregnancy was operated on and she had 10 cm in diameter myoma enucleated. The myoma was localized on the anterior uterus wall. In patient in the 33rd week of pregnancy with the diagnosed cervical carcinoma of the 2nd degree, diagnosed on the basis of histopathological examination, Caesarean section and Meigs operation were performed. In all operated patients tocolysis was employed. In one case there was a miscarriage in the 16th week of pregnancy following the myoma enucleation. The postoperative course in the remaining women was uncomplicated and pregnancies ended with the delivery of healthy infant. CONCLUSIONS: The most common neoplasms occurring in pregnancy are simple ovarian cysts and uterine myomas. Among malignant changes sporadically ovarian and cervical carcinomas are met. Although tumors of the reproductive organ in pregnant women are quite rarely met, the diagnostic and therapeutic difficulties reveal the necessity of the though differential diagnosis and accurate establishment of indications for the operation.

Adult↗
PubMed2002

[The dually perfused human placenta by Schneider method modified by Miller. I. Changes of arterial and venous pH in material and fetal blood].

The study was carried out on 7 human placental cotyledons. Placental perfusions performed by Schneider method modified by Miller were conducted for 180 min. Assessment of arterial and venous pH in maternal and fetal blood was performed. There were no statistically significant differences between obtained parameters throughout the experiment. The results of this study point to the conclusion that the method can be used for assessment of other perfusion liquid parameters and introduced to subsequent experiments.

Female↗
PubMed2002

[The dually perfused human placenta by Schneider method modified Miller. II. Changes of arterial and venous fetal blood pressure].

The study was carried out on 7 human placental cotyledons. Placental perfusions performed by Schneider method modified by Miller were conducted for 180 min. assessment of arterial and venous pressure in fetal blood was performed. There were no statistically significant differences between obtained values of perfusion pressure obtained the experiment. The range of vessels perfusion resistance was stable during the experiment. The results ot this study lead to conclusion that the method used can be valuable for assessment of other perfusion liquid parameters and introduced to subsequent experiments.

Female↗
PubMed2002

[Three dimensional sonography in the endometrial volume measurement in women with perimenopausal irregular uterine bleeding].

OBJECTIVES: Evaluation of the role of three-dimensional (3D) ultrasonographic measurement of the endometrium volume in perimenopausal women with irregular uterine bleeding. MATERIAL AND METHODS: We have assessed 45 women (23 postmenopausal) with 3D transvaginal probe and automatic volume measurement (VOCAL) software using Voluson V730 scanner (Kretztechnik, Austria). Additionally, doppler blood flow indices PI, RI and PSV in uterine artery as well as endometrial thickness were measured. All ultrasound data were verified by histology of the endometrial specimens removed during D&C or hysterectomy. RESULTS: The age of the study group ranged between 43-70 years (median 53 years). The mean volume of endometrium in women with endometrial cancer was 19.9 +/- 7.5 ml. The mean volumes measured in women with endometrial hyperplasia and normal endometrium were 12.2 +/- 7.9 ml and 7.4 +/- 4.8 ml, respectively. There was a significant difference in endometrial volume between each pair of study groups (P < 0.05). Moreover, significant differences were found in mean endometrial thickness between endometrial cancer and benign but not in hyperplastic endometrium. In contrast, there were no significant differences in study groups in mean values of Doppler blood flow indices measured in uterine artery. CONCLUSION: We conclude that 3D sonography and automatic volume measurement might be used better to characterize endometrial changes in women with perimenopausal bleeding.

Adult↗
PubMed2002

[Three dimensional sonography and 3D power angiography in differentiation of adnexal tumors].

BACKGROUND: Three-dimensional sonography is a novel diagnostic method proposed to be an additional non-invasive tool in the assessment of ovarian tumors. OBJECTIVE: To study diagnostic potential of 3D sonography and power Doppler angiography in the preoperative differentiation of adnexal masses. MATERIAL AND METHODS: One hundred twenty-eight women with tumors thought to be of adnexal origin were examined preoperatively. Following morphological (papillae, septae, tumor size and volume) and color Doppler (PI, RI, Vmax and TAMX) assessment, 3D ultrasound of adnexal tumors according to Kurjak et al. (2000) was performed. Various scanners were used and included: ATL 5000 HDI (Phillips, USA) and Combison 530 and Voluson 730 (Kretztechnik, Austria) machines. Following variables were studied: inner wall structure, presence of papillae, thickening > 3 mm of septa as well as vascular branching pattern, number and localization of small blood vessels and the presence of vascular anastomoses. RESULTS: Twenty-one tumors were malignant (3 FIGO stage I) and 101 masses were benign. Power Doppler combined with 3D sonography predicted malignancy with a sensitivity of 92.6% (25 of 27 patients). Commonly used morphological and Doppler criteria produced lower sensitivity, the values being in range of 45% to 87.5%. Negative predictive value of 97.2% was the highest for 3D sonography (> 7 points in Kurjak's scale). CONCLUSIONS: Selective use of 3D ultrasound and power Doppler angiography could be used to better characterize adnexal tumors. Detailed 3D sonography may help to identify women who, if needed, may have less invasive surgical procedure such as laparoscopy or be referred to gynecological oncologist.

Adolescent↗