Search PubMed⌕ Search

Biomedical subjects

K Bilek

Publications and source records attributed to K Bilek.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Variability of quantitative DNA parameters in endometrial carcinoma].

We performed image analysis examinations of 20 cases of endometrial carcinoma and the compared quantitative DNA parameters within each carcinoma. Specimens were taken from each carcinoma, at standardised, pre-defined sites. Six smear preparations were made from each case and DNA parameters were determined after Feulgen staining. 17 of the 20 cases of endometrial carcinoma (85%) showed in all the examined preparations a uniform diploid or aneuploid (n = 1) DNA distribution. Only 3 carcinomas showed diploid as well as non-diploid DNA distributions. For each carcinoma the mean values of DNA-MG were found to be between 0.37 +/- 0.12 and 2.16 +/- 0.11 and those of the 5cER between 0.91 +/- 0.78 and 15.37 +/- 4.17. Relationships were shown between DNA distribution, DNA-MG, 5cER and morphological prognostic factors while a reliable diagnostic of dignity based on DNA distribution and 5cER as a marker of single cell ploidy seems not possible. With an increase in DNA-MG, the coefficient of variation of this parameter decreased within the individual cases. Concluding, quantitative DNA parameters, owing to their relatively small variability within specific cases of endometrial carcinomas seem to be suitable objective indicators of prognosis to plan a risk-adapted therapy.

Aneuploidy↗
PubMed1994

[Simultaneous coexistence of a hydatidiform mole and a live premature infant].

Moles and coexisting living fetus are rare. Most cases are twin gestations. We report a case of a single placenta with focal hydatidiform mole of the placenta and a coexisting living fetus. The fetus with hypotrophy was born in the 34th weeks of gestation with a normal diploid female karyotype. The placenta showed a complex alteration of the non molar part with consecutive vascular hyperplasia. The differential diagnosis of molar pregnancies and coexistent living fetuses are discussed. Postpartal are cytogenetic examination of fetal tissue (skin biopsy) and both parts of the placenta, the molar and non molar, necessary. In each case should be a postpartal measurement of beta-HCG in serum of the mother to rule out a gestational trophoblastic disease.

Adult↗
PubMed1993

[Primary squamous cell carcinomas of the endometrium. Clinico-pathologic data and histogenetic classification].

Primary squamous cell carcinomas of the endometrium are rare tumours. We have studied 7 primary and 2 secondary squamous cell carcinomas immunohistochemically with anti-all-cytokeratin (KL 1), anti-CEA and anti-vimentin. The non-keratinizing carcinomas and the non-keratinizing component of the keratinizing carcinomas showed a strong expression of vimentin. Contrary to this, the keratinizing parts were strongly positive with anti-CEA. Additionally, some cases showed a direct transformation of the (dysplastic) glandular endometrial epithelium into neoplastic squamous cells. These findings suggest that the primary squamous cell carcinoma of the endometrium is the result of a bidirectional differentiation of pluripotent endometrial precursor cells. Like in other non-endometrioid adenocarcinomas, such metaplasias develop from pluripotent Müllerian epithelium. They show various differentiations, perhaps endocervical determination with keratinization and positive reaction against CEA or primitive endometrioid with squamous cell appearance, positive anti-vimentin reaction and non-keratinization.

Adult↗
PubMed1992

The relation between the results of cytophotometric examination of endometrial carcinoma and clinical course of these disease.

We made a prospective cytophotometric study of 48 cases of endometrial carcinoma. Thirty-two (66.7%) of the cases had diploid DNA content and the proportion of non-diploid tumors increased with the staging of tumors, lack of differentiation and depth of myometrial invasion. DNA content (AE), DNA malignancy grade (DNA-MG) and 5c exceeding rate were statistically significant in relation to the clinical course of the disease and the histological grade of differentiation. DNA parameters appear to be especially suitable for the objective assessment of malignancy.

Adenocarcinoma↗
PubMed1992

[Ultrasound image of endometrial cancer].

In this prospective study 571 patients with postmenopausal bleeding/discharge (group I) and 300 patients without symptoms (group II) were ultrasonographically examined. The sonographic findings were compared with those of histology to evaluate the value of ultrasonography in endometrium diagnosis. The main parameters which we considered in the diagnosis of malignancy of the endometrium, were the thickness of the endometrium, the boundary of the endometrium, homogeneity and collection of fluid in the uterine cavity. However, the size of the uterus and the central endometrial echo were found not to be sensitive signs of malignancy. The sensitivity of sonography in group I was 86.3% higher than group II which is 75%. The rate of false-positive and false-negative in the total study population was 7.1%. We believe that ultrasonography is the easiest, most painless out-patient based and non-invasive diagnostic method in comparison to all other endometrium diagnostic measures, and is an advance towards better approach in the early diagnosis of endometrial carcinoma.

Carcinoma↗
PubMed1992

[Ultrasound assessment of the endometrium in early detection of endometrial cancer in high risk patients].

In 300 postmenopausal adipose and complaint-free patients but with one risk factor for the development of endometrial carcinoma one prospective study transabdominal and transvaginal ultrasonographic examinations by 3.75-MHZ abdominal and 5-MHZ vaginal sound was carried out. In all cases with endometrial thickness of 10 mm and also with endometrial thickness of 5-10 mm and irregular endometrial boundary fractional curettage was done. The rate of abnormal findings was 8% of which in 18 patients the findings were histologically confirmed (3 endometrial cancer, 5 hyperplasia, 8 polyp and 2 submucosal myomas). The sensitivity of ultrasonography was found to be 75%. Patients with normal findings were controlled in 6 months, none of these patients showed pathological symptoms.

Diabetes Complications↗
PubMed1991

[Degree of DNA ploidy and steroid hormone receptors as prognostic factors in endometrial carcinoma].

In a prospective investigation the concentration of DNA (ploidy) and of steroid hormone receptors (ER and PgR, resp.) were studied in endometrial carcinoma and related to each other, to established morphological prognostic criteria (stage, typing, grading, relative invasion of myometrium), and to the clinical progress of disease, respectively. The microscopic spectrophotometric analysis of DNA showed diploid main lines in 2/3 of investigated endometrial carcinoma. It could be demonstrated a relationship between heteroploidy, decreased mean concentrations of ER and PgR, unfavourable prognostic factors (stage II-IV, G3, myometrial invasion of greater than 2/3) and clinical progress of disease. The mean value of ER and PgR was higher in diploid carcinoma than in heteroploid ones. Significant differences were found both in the relation of the PgR concentration to different tumor stages (stage I vs. II-IV) and of the concentration to the different types of ploidy. Exceeding the histological differentiation, the determination of DNA and ER/PgR receptors can results in additional prognostic informations for a scientific proved, adjuvant or curative strategy of therapy after the operation.

Carcinoma↗
PubMed1991

[Sonographic studies of patients with postmenopausal hemorrhage (endometrium/myometrium index)].

Ultrasonographic examination was performed in 120 patients with post-menopausal bleedings before a diagnostic curettage. In comparison with the final histological diagnoses the sonographic diagnoses were found to be correct in 97 patients (86.2% right-negative; 79.7% right-positive). The proportion of false-negative and false-positive results was found to be 12.1% and 16.9% respectively. Specificity and sensitivity values were 83.3% and 87.1%. The endometrium/myometrium-index enabled us to make a good judgment of the endometrium, since it considers both the endometrial and myometrial thicknesses simultaneously. This index was found to be below 0.5 (0.27) in those patients with normal sonographic findings and in patients with pathological sonographic findings it was found to be 1.3. Ultrasound is therefore a non-invasive diagnostic aid for the diagnoses of pathological changes of the endometrium.

Endometrial Neoplasms↗
PubMed1990

[Genetic aspects of early spontaneous abortion].

Spontaneous abortions are the most frequent complications in pregnancy. Especially in early pregnancy abortions are often genetically caused. The most important role between chromosomal disorders play the Trisomy, Triploidy and X0-Monosomy. Against the background of more recent findings the frequency, origins of several genetic disorders and the morphological expression in placental tissue are discussed in this review. The chromosomal situation of hydatidiform and partial mole as well as the question for the causes of malignancy-tendence of complete moles from genetic view are also considered. The importance of the knowledge of genetic disorders to correlate the microscopic placental findings and the karyotype and to support medical consultation is referred, too.

Abortion, Spontaneous↗
PubMed1990

[The immunologic situation of the placenta and its significance for disorders in early pregnancy].

Reference is made in numerous recent immunological studies to immunological mechanisms which were found to play a role in acceptance of pregnancy or habitual abortions. The most important theories likely to offer explanations for these phenomena are reviewed in some detail, including hormonal immunosuppression, immunologic-anatomic barrier at the placenta as well as blocking factors and anti-sperm antibodies. Molar pregnancy is associated with a particular immunological situation. None of the theories mentioned can be preferred, for the time being, to explain acceptance of normal pregnancy or the causes of recurrent spontaneous abortions.

Abortion, Habitual↗
PubMed1989

[Microinvasive stage Ia cancer of the uterine cervix--results of a multicenter clinic based analysis].

A retrospective multicentre study to investigate diagnosis, treatment and end results of treatment of cervical cancer stage Ia, was carried out in 6 departments of gynaecological oncology. After reclassification by a reference pathologist, among the 936 cervical cancer cases primarily diagnosed and treated as stage Ia between 1970 and 1980, only 530 (56.6%) met the criteria of microinvasive cancer stage Ia. Misclassifications concerned all participating centres with statistically significant differences amongst them. Overdiagnosis (reference diagnosis only CIN I-III, 42.5%) was more frequent than underdiagnosis (reference diagnosis stage Ib--0.9%). In comparison to 1970-74, in the period 1975-80 a significant increase of cases detected asymptomatically (86.5%) was observed. The percentage of cases primarily diagnosed by cone biopsy, also increased significantly and amounted to 71.2%. Patients with cervical cancer stage Ia were most frequently treated by surgery alone (93.2%). Radiotherapy alone did not play any important role (5.7%). There were only a few cases treated by combined surgery and radiotherapy (5.7%) with a decreasing trend over time. Women under the age of 45 years were significantly more frequently treated by the conservative method (cone biopsy, simple hysterectomy) than older ones, without any significant relation between depth of invasion and radicality of treatment. A total of 19 (14 local, 5 lymph node) recurrences were diagnosed between 9 and 110 months after primary treatment. Local recurrences could be observed more frequently after limited than extended treatment. There was no significant relation between depth of invasion and frequency of recurrences, but the latter were significantly increased in cases with histologically proven invasion of blood or lymph vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Therapeutic results in uterine sarcoma (1955-1985)].

This is a retrospective analysis of prognostic factors and treatment outcomes in 126 uterine sarcoma cases from the period of 1955 to 1985 inclusively. Up to now there lacks unanimity and extensive scientific based therapeutic concept; and treatment results could not be improved despite better operative and radiation therapy possibilities. From the examined charts and materials, the five year survival rate achieved for all stages is 31%. The mean age of the patients is 57.9 years and significant prognostic differences will be appreciated only in relation to the clinical stages at the commencement of therapy and also after local total operative intervention (stages I and II) in conjunction with postoperative radiation therapy. The difference in course in relation to the histologic tumour type can not be statistically verified.

Adult↗
PubMed1987

[Histomorphologic prognostic factors in stage I endometrial cancers].

The prognostic significance of qualitative and quantitative morphological tumour characteristics for endometrial carcinoma of stage I (FIGO) is to be ascertained from the available 230 operation specimens from 1976 to 1983 (inclusive). The fundamental objective is to design a standardized and reliably reproducible histological technique. By utilizing a multi-dimensional statistical comparison (multiple regression analysis), the maximal relative extent of the endometrial invasion as a determinant prognostic feature shall also be ascertained. Furthermore, the degree of differentiation (Grading) and tumour type (Typing) influence the survival rate whereas the maximal superficial extension of the carcinoma has no significant prognostic importance.

Female↗
PubMed1987

[Prognostic significance of different therapeutic procedures in stage I endometrial cancer].

The prognostic importance of the different lines of therapeutic management are retrospectively reviewed from 230 patients who have been primarily operated on for endometrial carcinoma stage I (FIGO). The postoperative radiation therapy taking into consideration the prognostic significance of the tumour criteria (tumour type, degree of differentiation and extent of myometrial invasion) as well as the age and the general condition of the patient would largely be individualized. 56 (24%) patients has been operated on only. There were no significant prognostic differences for vaginal and abdominal hysterectomies with bilateral salpingo-oophorectomy. Extensive operative measures have been carried out seldom and could not yet be included in the evaluation. A simultaneous gestagen administration in 39 (17%) of the cases with invasively growing carcinomas (greater than 1/3 myometrial invasion), independent from the previous therapeutic regimen, is shown not to have improved the healing results. The favourable prognosis of women mostly with lower primary risk and operated on only as opposed to postoperatively radiated ones underlines the primary prognostic significance of morphological characteristics of the tumour although no definite conclusions can be derived from the concurrent effectivity of the adjuvant radiotherapy for early tumour stages. A postoperative radiation therapy, because of its late consequences which have been observed during tumour follow up, is indicated only in those cases with unfavourable prognostic criteria.

Adult↗
PubMed1986

[Infections with penicillinase-producing Neisseria gonorrhoeae in females. Report on 24 cases].

Between the last few weeks of 1980 and March 1985 the susceptibilities of 881 strains of Neisseria gonorrhoeae to penicillin were tested by a simple screening method (disc diffusion test). 76.6% of the isolates were good susceptible, 17.7% moderately susceptible and 5.7% resistant to 3 units of penicillin G. Penicillinase-producing Neisseria gonorrhoeae (PPNG) could be detected in 24 cases (2.7%), most of them between July 1983 and January 1984 (n = 18). 23 patients have been treated successfully with oxytetracycline. All infections had been acquired in the GDR, however, the sources of infection could be firmly traced in 6 cases only. On the basis of the results some clinical and microbiological aspects of infections with penicillin resistant gonococci are discussed.

Adolescent↗