Beata Osuch

Expression of vascular endothelial growth factor mRNA in human leiomyomas.

Aim. Growth factors play a major role in the pathogenesis of uterine myomas. The aim of this study was to evaluate vascular endothelial growth factor (VEGF) mRNA expression during leiomyoma growth at different phases of the menstrual cycle with RT-PCR. Method. We studied 56 patients: 43 with myomas, 13 with healthy myometriums. In patients with myomas (secretory phase), VEGF expression was 2.82 times higher than in control patients (p < 0.05). In patients with myomas (phase I), VEGF expression was 2.53 times higher (p < 0.05) than in control patients. For all patients with myomas, those who were in menopause had 1.52 times higher VEGF expression than those who menstruated. For patients with healthy myometriums, those who were in menopause had 1.97 times higher VEGF expression than those who menstruated. A comparison of all the patients in menopause revealed that VEGF expression was 2.03-fold higher in those with myomas than in those with healthy myometriums. Conclusion. We observed the highest VEGF mRNA expression in women with myomas who were in menopause. Among menstruating patients, VEGF expression was significantly higher in those with myomas compared to those with a healthy myometrium. This suggested that VEGF may play a significant role in the pathogenesis of uterine myomas.

Photodynamic therapy in the treatment of vulvar lichen sclerosus

BACKGROUND Vulvar lichen sclerosus is a chronic and incurable disease that causes various unpleasant symptoms and serious consequences. OBJECTIVE The purpose of the study was to assess the effectiveness of photodynamic therapy in the treatment of vulvar lichen sclerosus. METHODS Participants in the study included 102 female patients aged 19-85 suffer from vulvar lichen sclerosus. The patients underwent photodynamic therapy (PDT). In the course of PDT the 5% 5- aminolevulinic acid was used in gel form. The affected areas were irradiated with a halogenic lamp PhotoDyn 501 (590-760nm) during a 10-min radiation treatment. The treatment was repeated weekly for 10 weeks. RESULT PDT has brought about a good therapeutic effect (complete or partial clinical remission), with 87.25% improvement rate in patients suffering from lichen sclerosus. The greatest vulvoscopic response was observed in the reduction of subepithelial ecchymoses and teleangiectasia (78.95%), and the reduction of erosions and fissures (70.97%). A partial remission of lichenification with hyperkeratosis was observed in 51.61% of cases. The least response was observed in the atrophic lesions reduction (improvement in 37.36% of cases). CONCLUSION Our patients suffering from vulvar lichen sclerosus demonstrated positive responses to photodynamic therapy and the treatment was well tolerated. Photodynamic therapy used to treat lichen sclerosus yields excellent cosmetic results.

Zalecenia postępowania diagnostyczno-terapeutycznego u chorych na mięsaki macicy

1 Klinika Nowotworów Tkanek Miękkich, Kości i Czerniaków, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie. Kierownik: prof. dr hab. n. med. Piotr Rutkowski 2 Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie w Warszawie. Kierownik: prof. dr hab. n. med. Beata Śpiewankiewicz Correspondence to: Klinika Nowotworów Tkanek Miękkich, Kości i Czerniaków, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, ul. Roentgena 5, 02-781 Warszawa, tel.: 22 643 93 75, e-mail: rutkowskip@coi.waw.pl Source of financing: Department own sources

New directions in cervical cancer prophylaxis worldwide and in Poland – Case study of the Polish rural female population

INTRODUCTION Cervical cancer is one of the most frequent malignant neoplasms in females. Such neoplasms can be almost completely eliminated by means of adequate primary and secondary prophylaxis. The most developed countries focus their attention on the improvement of prophylaxis systems, test quality, and efficacy improvement, as well as on the expansion of the primary prophylaxis. In Poland, the discussions focus on the improvement of the malfunctioning population programme. OBJECTIVE Drawing on recent research findings, the article presents current Polish and global recommendations with regard to screening tests for cervical cancer. The results of the Population Programme of Prophylaxis and Early Detection of Cervical Cancer are discussed in the context of current trends of healthy behaviour among women inhabiting rural areas. DESCRIPTION OF THE STATE OF KNOWLEDGE In the future, it will be relevant to increase the number of human papillary virus (HPV) tests as part of the prophylaxis programme, especially among the high risk patient group. In particular, there is a necessity to increase the number of vaccinations among young women, especially before the beginning of their sexual activity, as well as to establish new strategies of secondary prophylaxis in this group. At present, women who had been vaccinated should undergo routine screening. In Poland, the report based on SIMP registry (IT System of Prophylaxis Monitoring), shows that only 27% of the 3.3 million of invited women participated in the cytology tests. The data analysis shows that women living in rural areas more often respond and participate in the tests, compared to women living in the cities (39.3% vs. 16.8%).

Practical considerations for intraoperative anesthesia in patients undergoing surgery in combination with hyperthermic intraperitoneal perfusion chemotherapy – a series of 60 cases

Uwagi praktyczne do śródoperacyjnej anestezji u pacjentów operowanych z zastosowaniem dootrzewnowej perfuzyjnej chemioterapii w warunkach hipertermii – seria 60 przypadków Practical considerations for intraoperative anesthesia in patients undergoing surgery in combination with hyperthermic intraperitoneal perfusion chemotherapy – a series of 60 cases Практические замечания по интраоперационной анестезии у пациентов оперированных с применением внутрибрюшинной перфузионной химиотерапии в условиях гипертермии – серия 60 случаев