UNLABELLED: Pregnant women with diabetes mellitus type 1 and poor metabolic control are with high frequency of spontaneous abortion. PURPOSE: To determine the correlation between the poor glycaemic control of diabetes in early pregnancy and the risk of spontaneous abortion. DESIGN OF STUDY: A prospective study over 116 women with type 1 diabetes mellitus who have been hospitalized in SHATOG "Maichin dom" during the period: January 1998-January 2004 have been done. The pregnant women have been divided in two groups. Pregnant women with pre-planned pregnancy n = 44 and pregnant women with unplanned pregnancy n = 72. The levels of pre- and postprandial blood glucose and those of glycosylated hemoglobin Hb A1c at first trimester have been measured. RESULTS: In 20 of all pregnant women (17.2%) spontaneous abortion have been observed. In those women with abortion the initial glycaemia has been significantly higher-preprandial glucose is 10.2 +/- 3.4 mmol/l and postprandial glucose is 12.2 +/- 4.2 mmol/l in contrast to those in women without abortions--preprandial glucose 6.6 +/- 1 mmol/l postprandial glucose is 7.9 +/- 1.9 mmol/l. The mean values of Hb A1c at first trimester have been higher in those women with abortions--10.1% +/- 1.5 in contrast to those without abortions 7.0% +/- 0.7. CONCLUSION: The pregnant women with diabetes type 1 and higher initial levels of blood glucose and glycosylated hemoglobin in the first trimester of pregnancy have a higher risk of spontaneous abortions. The rate of spontaneous abortions in diabetic women with pre-planned pregnancy and optimized metabolic control before conception is lower.

Abortion, Spontaneous↗

PubMed2004

[Role of laterally extended parametrectomy in the surgical treatment of cervical cancer stage IB with lymph node metastases (summary of own and foreign experience)].

We summarized the world experience as well as our experience in the surgical treatment of women with early cervical cancer stage IB with lymph node metastases, laterally extended parametrectomy was used. 62 women with IB stage cervical cancer who were with metastases of the pelvic lymph nodes were examined. The patients were followed for 20-120 months (median 56 months). 50 patients were alive and free from disease at the end of the researched period. We used the Kaplan-Meier 5 years cumulative proportion survival which was 82%. 8 complications were observed which necessitated a second operation. In 2 patients we had treatment-refractory incontinence. According to the foreign experience as well our experience the metastases in the pelvic lymph nodes can be treated by surgery alone without chemo and radiotherapy especially in the early stages cervical cancers. Additional research in this field will give more light and information in this field.

Adenocarcinoma↗

PubMed2003

Expression of cell surface transmembrane carbonic anhydrase genes CA9 and CA12 in the human eye: overexpression of CA12 (CAXII) in glaucoma.

PURPOSE: Carbonic anhydrase enzymes (CAs) are universally involved in many fundamental physiological processes, including acid base regulation and fluid formation and movement. In glaucoma patients, CA inhibitors are very effective in lowering intraocular pressure by reducing the rate of aqueous humour secretion mediated by the CAs in the ciliary epithelium. In this work, we investigated the expression and tissue distribution of two recently discovered CA genes CA9 (CAIX) and CA12 (CAXII) in fetal, neonatal, and adult human eyes with and without glaucoma. METHODS: CAIX and CAXII expression in 16 normal and 10 glaucomatous eyes, and in cultured non-pigmented ciliary epithelial cells (NPE) from normal and glaucoma eye donors was assessed by immunostaining. In addition, northern blot hybridisation was performed to assess expression of CA4, CA9, and CA12 mRNA in cultured NPE cells from normal and glaucoma donors. RESULTS: CAXII was localised primarily to the NPE with its expression prominent during embryonic eye development but which decreased significantly in adults. CAIX expression in the NPE was very low. The epithelium of cornea and lens occasionally expressed both enzymes at low levels during development and in adult eye, and no expression was detected in the retina. The NPE from glaucoma eyes expressed higher levels of CAXII, but not CAIX, in comparison with normal eyes. This expression pattern was retained in cultured NPE cell lines. NPE cells from a glaucoma patient showed a five-fold increase in the CA12 mRNA level with no detectable expression of CA9 mRNA. Also, no expression of the CA4 gene encoding a GPI anchored plasma membrane protein was detected on these northern blots. CONCLUSIONS: Transmembrane CAIX and CAXII enzymes are expressed in the ciliary cells and, thus, may be involved in aqueous humour production. CA12 may be a targeted gene in glaucoma.

Blotting, Northern↗

PubMed2003

[Epithelial ovarian cancer--preoperative assessment of Ca 125 levels as an independent prognostic factor].

UNLABELLED: The aim of our study was to assess the relationship between the preoperative assessment of Cal25 levels in patients with primary ovarian cancer. METHODS: Two hundred and thirteen patients with epithelial ovarian cancer were preoperatively examined for the levels of Cal25. They were assessed retrospectively. The relationship between the preoperatively levels of Cal25 and different preoperative and postoperative variables were examined. RESULTS: The mean level of Cal25 for all the patients was 623 U/ml/normal range to 35 U/ml/. The preoperative levels of Cal25 have no relationship with increased age, but are very much connected with the histological type--mainly with serous component. Mean levels of Cal25 with serous histology is 780 U/ml and other histological types is 322 U/ml, p = .03. In patients with high stage /III/IV/ the levels are 783 against 145 U/ml--with lower stage--p < .001. In patients with tumor grade /3/ the levels of Cal25 are 956 U/ml against with low tumor grade 12.11 the levels of Cal25 are 34711/ml, p < 0.01. The presence of ascites is connected with Cal25 levels--897 U/ml against without ascites Cal25 levels are 230 U/ml, p < .001. Patients received inadequate cytoreduction /with big residual tumor/were connected with significantly higher Cal25 levels--1125 U/ml against patients with optimal cytoreduction--403 U/ml, p < .001. The preoperative levels of Cal25 less than 450 U/ml have positive predictive value for optimal cytoreduction--78% and negative predictive value 39%. We found significant relationship between the levels of Cal25 and the survival of the patients. With the increase of preoperative levels of Cal25 is increasing the risk of death for the patients. CONCLUSIONS: We think tht the preoperative evaluation of the Cal25 levels can be an independent risk factor, which can define the death rate in the patients with ovarian cancer, but not always the levels can be the ideal factor predicting optimal cytoreduction. Nevertheless this the levels of Cal25 can significantly help the oncogynaecologist in the fight against the ovarian cancer.

Biomarkers, Tumor↗

PubMed2003

[Diagnostic conization of the uterine cervix and its effect on survival of patients after Wertheim-Meigs hysterectomy].

The aim of this retrospective work was to evaluate the diagnostic conization and its influence on morbidity and survival of patients with cervical cancer IB and IIA stage after radical hysterectomy a modo Wertheim-Meigs. The impact and influence of the irradical conization on the lymph node metastases and prognosis was analyzed. 535 patients in stage IB and IIA were examined for the period of 1990 and 2002. All of them were radically operated by Wertheim-Meigs method. There were 35 patients mainly from the countryside, who were treated by conization priory to radical hysterectomy. The time interval between the conization and the radical hysterectomies was between 5 and 8 weeks. The surgical morbidity and death incidence for patients with prior conization was not significantly different from other patients with directly radical hysterectomies. The survival was not significantly different between the two groups (84% vs 81%, p = 0.21). The Multivariate analysis which we used showed us that the irradical conization is not connected with higher risk of metastases or poor prognosis. We think that in early cervical cancer, the diagnostic conization has no adverse negative effect on the following radical hysterectomy a modo Werheim-Meigs. The irradical conization has no influence on prognosis.

Cervix Uteri↗

PubMed2003

[Antibiotic prophylaxis in limited gynecological surgeries for pregnancy termination].

The authors attempted with this trial to confirm the necessity of periabortal antibiotic prophylaxis after spontaneous and induced abortion. The trial included 172 patients with abortion; 53 of them with induced abortion and 119 with spontaneous abortion. The term of gestation was between 5 and 22 week. Three therapeutic groups were compared to a control no-treatment group. The first group was given Ampicillin orally 4 x 500 mg for 5 consecutive days. The second group was administered a combination of Ampicillin orally 4 x 500 mg plus Gentamycin 2 x 80 mg i.m. for 3 to 5 days postoperatively. The third group was given 3 x 2 g i.v. Cefazolin intraoperatively and 24 hours following the manipulation. The trial aimed at establishing the efficiency and cost-effectiveness of the antibiotic prophylaxis. The results tend to prove the perioperative prophylaxis with Cefazolin is preferable since it is most efficient and cost-effective.

Abortion, Induced↗

PubMed2003

[Prevention of neural tube defects with folic acid].

Neural Tube Defects (NTD's) include a large number of congenital malformations produced when the open neural tube presents a very early stages in the development of the human embryo fails to close on or before the first month post conception. NTD's are considered to be one of the most common forms of malformations with varying degrees depending of genetic and environmental conditions. The studies prove that the additional taken of folic acid plays an important role against the NTD's. Numerous studies prove this "B" vitamin has an important protective effect not only for the recurrence of NTD's, but for new cases too. In light of these, in 1992 the US Public Health Services issued the recommendation that all women in child-bearing age should consume at least 0.4 mg (400 micrograms) of folic acid daily.

Female↗

PubMed2003

[Metastatic cancer in transposed ovaries after radical Wertheim-Meigs hysterectomy for a stage I B and II A cervical cancer].

In this research work we show our and foreign experience in preserving the ovarian function in young women and cervical cancer stage I B and II A. 6 cases are quoted for the period of time from 1987 till 2003 (4 patients with ovarian metastases from our experience and 2 patients with ovarian metastases found from the greek colleagues). Histologically 3 patients were with adenosquamous metastatic cervical cancers and 3 patients with squamous metastatic cervical cancers in the region of the transposed ovaries. The metastases occurred mostly 2 to 3 years after the radical hysterectomies a modo Wertheim-Meigs. Nevertheless our experience which is connected with radical hysterectomies a modeo W. Meigs including both ovaries, we have also experience in transposing ovaries /one or both of them/. In some of them we found metastases. In our research work we found 4 cases with metastases in transposed ovaries. In these cases a chemotherapy was applied: mitomicin C, etoposide, and cysplatinum. The greek colleagues also have applied such schemes of chemotherapy. 3 from the patients had a very good effect from the chemotherapy, in 2 the recurrences have appeared 2 years after the chemotherapy, and in one case there was a very big progression of the disease, nevertheless the chemotherapy. IT is very important for the oncogynaecologist to clear up if the transposition of the ovaries is safe and effective, especially in young patients with early cervical cancer receiving postoperative radiotherapy. That is why we did this research work in order to give more light on this problem.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2002

[Borderline ovarian tumors].

Forty three patients with borderline ovarian tumours were examined from 1987 till 2000. 28 patients (65.1%) were serous tumours and 15 patients (35%) were mucinous. The median age was 42.2 +/- 15.4 years. The follow-up period was 5.4 +/- 3.2 years. Preoperatively Ca125 were 52.5 +/- 50.3 and of Ca19.9-42.4 +/- 46.8 IU. 83% of the patients were in stage I and 17% in stage III. There was no significant difference in the tumour volumes. Ca125 were significantly increased in the serous tumours and Ca19.9 were increased in the mucinous tumours. All the patients were followed up and are in good health or remission with exception of 2 who developed recurrence.

Adult↗

PubMed2002

[Characteristics of neonates whose mothers have congenital and acquired heart disease].

It was made a study of the body dimensions, Apgar evaluation, and frequency of innate body defects in 141 new-borns by mothers with innate and acquired heart valvular defects. It was found that the average values of body weight, height, and the evaluation with Apgar of the new-borns by mothers with heart defects do not deviate from the average values of the same indices of new-borns by healthy mothers. Despite that 90% of the young mothers with heart defects are with light to moderate degree of the heart defect, and with I or II functionality class, the percent of their new-borns born prematurely is big--31.9, compared to 6.6 for new-borns by healthy mothers. In 2.8% of the new-borns by mothers with heart defects, hypotrophy is observed, and in 3.5%--clinical criteria for immaturity. Perinatal death rate is 0.7% and zero for the control group of new-borns--ones born by healthy women. Six cases (6.7%) of new-borns by mothers with heart defects had innate body defects, 4 (4.5%) of which were innate heart defects. The frequency and the kind of the congenital defects in new-borns by mothers with heart defects is discussed.

Adolescent↗

PubMed2002

Current vulvar cancer treatment in Bulgaria.

PURPOSE OF INVESTIGATION: Our aim was to outline the treatment of carcinoma of the vulva at the National Oncological Centre in Sofia, Bulgaria. METHODS: We examined the records of 250 patients over a 10-year period treated at the Gynaecologic-Oncology Clinic of our Centre. RESULTS: There were 130 patients (52%) treated with surgery and radiation. There were 120 patients (48%) treated by surgery only. Thirty of these patients were treated by pelvic exenteration with radical vulvectomy. The five-year survival rate was 36% - 12 patients. The 1-year survival rate for all patients was 80% - 200 patients. The five-year survival rate was 50%. DISCUSSION: We have results similar to other clinics in the world working in this field. We now emphasize external radiation for advanced disease but the treatment must be individualized. CONCLUSION: We have outlined the treatment of carcinoma of the vulva at our Centre, over a 10-year period.

Bulgaria↗

PubMed2002

[Hemodynamic measurements with the Swan-Ganz catheter (in the pulmonary artery) in severe preeclampsia patients].

We compared the results of Swan-Ganz measurements in 11 preeclamptic women and report of the hemodynamic profile in severe preeclampsia. Measurements were performed between 28-36 weeks of gestation.

Adolescent↗

PubMed2002

[Assessment of oxygen delivery (DO2) and oxygen consumption (VO2) in severe pre-eclamptic patients].

We compared the results of oxygen delivery and oxygen consumption measurements in 11 preeclamptic patients and report of the oxygen transport in severe preeclampsia. Measurements were performed between 28-36 weeks of gestation.

Adolescent↗

PubMed2002

[Large condylomatous lesions of the vulva and their malignant transformation].

For the period of 1987 till 2001 were examined 23 women with big condilomatous lesions of the vulva. There were examined the diagnostic and the therapeutical approach and in the last few years the type of HPV in some of these patients. Our aim was to study and reveal the potential for malignant transformation of the big condimatous lesions of the vulva. Different histological types squamous cell cancer of the vulva were found in 18 women (78.26%): condilomatous cancers--9, verucous--7 and basaloid types--2 vulvar cancer. HPV type 16 was found in 6 cases (4 condilomatous and 2 basaloid cancers). HPV type 6 was revealed in 6 cases with verucous cancer, type 11 in 1 case with verucous and 1 case with condilomatous cancer. In 1 case with condilomatous cancer we found HPV type 18. We used mostly radical vulvectomy with bilateral inguinofemoral lymph dissection a modo Ducuing. This kind of operation was performed in all women with the exception of the benign lesions with negative lymph nodes, where simple vulvectomy was mostly used. Wide local excision was used in 1 woman with verucous cancer and in 1 patient with basaloid cancer hemivulvectomy was performed.

Adult↗