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Z Rokyta

Publications and source records attributed to Z Rokyta.

At least 55 records · Page 3Linked to original sources

Diagnostic reliability of prebioptic methods in the prediction of a histological basis of cervical lesions and its correlation with accuracy of colposcopically directed biopsy in patients with cervical neoplasia.

OBJECTIVE: High incidence of cervical cancer in the Czech Republic leads us to look for an optimal model of screening. The evaluation of the realiability of prebiopsy (cytology and colposcopy) and of punch biopsy is an important diagnostic step. MATERIAL AND METHODS: In a prospective study we examined 308 women detected by cytological screening who afterwards underwent surgery for a cervical lesion. Punch biopsy before the operation, most frequently by conization, was performed in every patient after assessing the prebioptic prediction (colposcopy and cytology). RESULTS: Reliable cytological screening associated with good colposcopy permits a correct diagnosis with high reliability. The rate of errors which increase the risk (threatening of health or the life of women) was 2.9% by prebioptic methods (high reliability) and 4.4% by punch biopsy. CONCLUSION: These good results are achieved in centers led by trained physicians and experts in cytology and skilled in colposcopy.

Adolescent↗

[Meconium and its significance].

OBJECTIVE: A review of meconium patophysiology and its contribution to the incidence of perinatal infection. DESIGN: Review article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. METHOD: The reported incidence of meconium-stained amniotic fluid varies between 7 and 22%. The patophysiology of the presence of meconium in the amniotic fluid is not sufficiently explained. Meconium in fetal bowels is under hormonal and neurol control. The presence of the meconium-stained amniotic fluid was always considered to be a potential risk for the fetal and neonatal well-being. The review is further divided in to three chapters. (II. Meconium and meconium aspiration syndrome, III. Meconium and postnatal neurological handicap). RESULTS AND CONCLUSION: The first chapter on deals with meconium risk in the development of perinatal infection: intraamniotic infection/chorioamnionitis, postnatal endometritis, infection of the abdominal wound after Caesarean and neonatal infection. The incidence of clinical chorioamnionitis is 15% with the presence of meconium compared to 3% in controls. The incidence of puerperal endometritis is 10% in comparison to 3% under normal conditions. Two main mechanisms of development (or coincidence) of intraamniotic infection in the presence of meconium exist. 1) Infection may be a cause of meconium passage. 2A) Alteration of Zn/P ratio in the amniotic fluid can promote bacterial growth. 2B) Meconium attached to macrophages or absorbed by phagocytosis can impair cellular immune response. The antibiotic prophylaxis is discussed.

Amniotic Fluid↗

Immunity to spermatozoa and male fertility.

Immunological characterization of semen and male fertility are discussed. The pH of seminal plasma is very similar in groups of fertile and infertile men. Nonspecific immunological factors such as lysozyme, C3c, alpha-1 antitrypsin and beta-2 microglobulin were significantly higher in 14% of infertile men. Seminal antibodies agglutinating spermatozoa are frequently observed in IgG and IgA isotypes. High levels of seminal anti-phospholipid antibodies in seminal plasma could influence epitopes on the endometrium, oocyte or early embryo in patients with repeated unexplained spontaneous miscarriages.

Adult↗

[Immunologic factors in the serum and peritoneal fluid in women after laparoscopy. I. Nonspecific factors].

The authors examined by diagnostic laparoscopy and immunologically 180 patients in 1993-1995. They assessed in serum and peritoneal fluid IgG, IgA, IgM, haptoglobulin, A2-macroglobulin, A1-antitrypsin, transferrin, C4- and C3-complement, orosomucoid, A2AP-glycoprotein, albumin, prealbumin and hemopexin. The authors found that some individual pathological results as regards non-specific immunity supplement the clinical diagnosis, in particular in endomeriosis, multiple adhesions, polycystic ovaries and chronic anovulation.

Adult↗

[Monitoring immunity factors in serum and peritoneal fluid after laparoscopy in women. II. Sperm and zona pellucida antibodies].

A team of authors investigated antibody levels against spermatozoa and against the zona pellucida in sera and peritoneal fluids in infertile women where diagnostic laparoscopy was indicated. The immunological cause of infertility was diagnosed in some women with a normal laparoscopic finding on the inner genital, as well as in patients with endometriosis and in women with adhesions. A minimal antibody response to antigens of gametes was recorded in women with the diagnosis of uterus myomatosus, uterus hypoplasticus and polycystic ovary. The authors present detailed findings on antibodies in different groups of patients.

Adult↗

[Diagnostic reliability of pre-biopsy methods (colposcopy and cytology) in predicting the histological basis of cervical lesions].

The more frequent incidence of cancer of the uterine cervix and thus of precanceroses in younger age groups, the introduction of new therapeutic methods (cryotherapy, CO2 laser, modernized diathermocoagulation) call for an estimate of the histological basis of the cervical lesion and in precanceroses assessment of its grade. These data must be provided by prebioptic methods (cytology and colposcopy). This diagnosis is essential to provide optimum therapy under the given circumstances. During the two-year period of 1985-1986 at the Gynaecological Clinic in Plzen 308 women detected by cytological screening were examined who were subsequently operated on account of a cervical lesion. In the investigated group a prebioptic predicition of high reliability was made. A concordant finding was recorded in 286 women, i.e. 92.9%. False negative, i.e. so-called risk errors were made in 9 women, i.e. 2.9%. False positive errors without risk, where the only consequence was unnecessarily radical treatment, were made in 13, i.e. in 4.2% women.

Adult↗

Six kinds of anti-phospholipid antibodies (aPLs) in ovulatory mucus and seminal plasma from couples with repeated miscarriages.

OBJECTIVE: Determination of aPLs in ovulatory mucus and in seminal plasma in 18 infertile couples (women, median age 33.2, range 28-39 years; men, median age 36.4, range 29-46 years) with repeated unexplained miscarriages (four to nine spontaneous abortions). Women with high levels of aPLs in sera were excluded from the study. METHODS: aPL screening included cardiolipin (Sevac Prague), L-alpha-phosphatidic acid, L-alpha-phosphatidylethanolamine, L-alpha-phosphatidyl-DL-glycerol, L-alpha-phosphatidylinositol, and L-alpha-phosphatidyl/serine (Sigma, USA). These were determined in isotypes IgG and IgA by an ELISA method. Statistical analysis of aPL results was made by cut-off levels of aPLs for both Ig isotypes by using 3 SD or 95th percentile calculated by STATGRAPHICS. Control group was created from four fertile healthy couples. RESULTS: Levels of aPLs in ovulatory cervical mucus were in the majority very low, except for IgA-aPLs-inositol. Very high interindividual differences in aPLs were found in seminal plasma. IgA-aPL-ethanolamine and -DL-glycerol, and IgG-aPL-L-serine and -DL-glycerol predominated in seminal plasma. Extremely high IgA levels of aPLs in all above-mentioned antigens, except cardiolipin, were found in one man of an infertile couple. CONCLUSION: The passage of abnormal aPLs levels from seminal plasma into the site of conception during often repeated, unprotected intercourses is supported by the findings.

Abortion, Habitual↗

Beta 2-glycoprotein I is a good indicator of certain adverse pregnancy conditions.

OBJECTIVE: To compare levels of beta2-glycoprotein I antibodies with six different antiphospholipid antibodies (aPL) in sera from patients with certain adverse pregnancy conditions. PATIENTS AND METHODS: aPL levels were examined in pregnant women with anti-phospholipid syndrome (26), pre-eclampsia (32), autoimmune disease (12), or diabetes mellitus (23) and in a group with physiological pregnancy (38). A commercial ELISA was used to determine the serum levels of anti-beta2-GPI (Immunotech) in isotypes IgG and IgA, and anti-cardiolipin levels (Milenia) in IgG and IgM. aPL screening also included L-alpha-phosphatidic acid, L-alpha-phosphatidylethanolamine, L-alpha-phosphatidyl-DL-glycerol, L-alpha-phosphatidylinositol, and L-alpha-phosphatidyl-serine (Sigma, U.S.A.) in IgG and IgM. Statistical analysis of all aPL levels was made by cut-off levels for Ig isotypes by using 3 SD or 95th percentile calculated using STATGRAPHICS. RESULTS: Positive levels of antibodies against beta2-GPI in IgA are more frequently associated with a diagnosis of anti-phospholipid syndrome, pre-eclampsia, and autoimmune disease in pregnant women than with diabetes mellitus in pregnancy. Very high interindividual differences in aPLs (against inositol, L-serine, cardiolipin, and beta2-glycoprotein in IgG and IgA) were found in serum from women with pregnancy complicated by anti-phospholipid syndrome, pre-eclampsia, and autoimmune disease. Pregnant patients with diabetes mellitus had higher serum levels in aPLs to DL-glycerol, inositol, L-serine, and beta2-glycoprotein. Positive aPL levels predominate in isotype IgG. Very low levels of aPLs to phosphatidic acid and phosphatidyl-ethanolamine were detected in all groups studied. CONCLUSION: Serum levels of anti-beta2-GPI could serve as a better prognostic marker in complicated pregnancy than the panel of seven different anti-phospholipid antibodies. Detection of anti-beta2-GPI is proposed as a first step of the screening for aPLs.

Adult↗

CD44v6 as a prognostic factor in cervical carcinoma FIGO stage IB.

The aim of our study was to clarify whether CD44v6 evaluation can serve as a universally applicable prognostic factor in patients with FIGO stage IB cervical carcinoma. A retrospective study was performed on 178 FIGO stage IB (142 IB N0, 36 IB N1) radically operated cervical carcinoma patients. The expression of CD44v6 was investigated by immunohistochemistry (IHC). The prognostic significance of established prognostic factors and CD44v6 expression was analyzed by univariate and multivariate analyses. To test the reproducibility and to account for interobserver variability, all specimens were evaluated independently at two institutions. Two different IHC scoring systems, several cut-off levels for CD44v6 positivity and several statistical methods for IHC results evaluation were used. In a univariate analysis, the most significant prognostic factor for overall survival (OS) was lymph node status (p<0.001) followed by tumor volume, LVSI, GOG score (p<0.01) and a deep stromal invasion (p = 0.06). We found a strong correlation between CD44v6 expression and squamous cell carcinoma (SCC) (SCC vs. adenocarcinoma - p<0.001) and between CD44v6 expression and deep stromal invasion, LVSI and GOG score (p<0.05). The CD44v6 expression was not a statistically significant prognostic factor for OS in a univariate analysis (p=0.39 Vienna; p=0.54 Freiburg). In a multivariate analysis, the most significant prognostic factor for OS was lymph node status (p =0.002), followed by tumor diameter and LVSI (p<0.05). CD44v6 expression was not a statistically significant prognostic factor for OS or disease-free interval (DFI) independent of the scoring method used. In conclusion, we demonstrated that CD44v6 expression is associated with LVSI, deep stromal invasion and SCC, but has no prognostic influence on OS and DFI in a population of 178 women with FIGO stage IB cervical carcinoma.

Adenocarcinoma↗