Safe extirpating of AFJ after preoperative tumor obliteration with tissue adhesive glue

The purpose of this work is to present the method of operating juvenile nasopharyngeal angiofibroma with the use of preoperative obliteration with tissue adhesive glue (Histoacryl). Authors described the case of 15 years old patient, who was admitted to ENT Department because of epistaxis, nasal obturation and returning headaches. To explain this problem, the routine diagnostics CT and angio-CT scan was applicated. Angiography confirmed well vascularized tumor supplied from facial and palatine arteries. Therapy based on the obliteration of tumor vessels with the glue-tissue was applied. As the next step the tumour was surgically extirpated. The application of this method gave a very good, simply bloodless operation effects. It allows a very good, simple and fully precise tumor extirpation. The extirpation of AFJ which is a highly vascularized tumor with the previous obliteration of the supplying vessels is a safe procedure and results in complete removal of the tumour.     

Choristoma of visual organ in children

PURPOSE: The aim of this study was to present the clinical and histopathological characteristics of choristoma tumors of the eye in children and to estimate the surgical treatment. MATERIAL AND METHODS: The study comprised 23 children with choristoma of visual organ including 10 girls (43.5%) and 13 boys (56.5%) in age between 2 months and 16 years, hospitalized in Department of Pediatrics Ophthalmology between 1999 and 2005. Complete ophtalmological examination and ultrasonography of eyeballs and orbital cavity was performed. In each case surgical procedure was implemented and the operated neoplastic changes were verified histopathologically. RESULTS: The tumors were placed within the eyeball in 10 children (43.5%) including corneal limbus placement in 4 children (40%), epibulbar placement with orbital cavity penetration in 5 children (50%) and one patient was diagnosed with lacrimal caruncule tumor (10%). Periorbital choristoma was diagnosed in 13 children (56.5%), while in 9 of them (69.2%), the tumor was placed within the upper lid and in case of 3 (23.1%), the tumor crossed orbital cavity septum and in one patient (7.6%) penetrated towards temporal cranial fossa. The eyeball tumors were entirely removed in 6 children (60%). In 4 children (40%) the surgical procedure was limited to excision of anterior parts of the changes protruding to the orbital cavity. The excision of palpebral, palpebral-orbital and palpebral-cranial tumors was complete (100%). Histopathological examination showed dermoids in 17 children (73.9%), including epidermal cyst in 13 patients (76.5%) and dermoid cyst in 4 patients (23.5%). Additionally, dermolipoma tumors were diagnosed in 6 children (26.1%). CONCLUSIONS: Choristoma tumors are characteristically placed within the organ of vision and have characteristic clinical picture. Both therapeutic and cosmetic results of surgical treatment of choristoma in children were satisfactory.     

Assessment of fetal circulation in the late first trimester--preliminary study

OBJECTIVES: to confirm that fetal echocardiography is indeed possible in late first trimester and that it improves the standard of the so-called "genetic" ultrasound scan. MATERIAL AND METHODS: Early echocardiography was performed in 75 fetuses from high and low risk pregnancies. All fetuses underwent echocardiography examination in 18-22 weeks of gestation and established follow up. RESULTS: The most suitable method of visualization seems to be transabdominal examination, between 13.0-13.6 weeks of gestation, an transvaginal one, between 12.0-12.6 weeks of gestation, with 90% effectiveness. In researched group of 75 fetuses (with established follow up) there were four heart defects (5.3%). Three of them were diagnosed before 14th week of gestation. One case (tetralogy of Fallot) was overlooked. There were two false positive diagnosis verified at 20th week of gestation. CONCLUSIONS: Early echocardiography, especially between 12.0-13.6 weeks of gestation, is a possible and valuable method of diagnosis. Reference evaluation should be performed between 18 and 22 weeks of gestation. In cases with suspected anomalies karyotyping is recommended. Congenital heart disease diagnosed at late first trimester should be treated as the next potential marker of genetic disorder.     

Assessment of expression of luteinizing hormone (LH)/human chorionic gonadotropin (hCG) receptor (LH/hCGR) and hCG protein in ovarian cancer tissues

OBJECTIVES: Ovarian cancers still remain a significant worldwide epidemiological problem. The vast majority of newly diagnosed cases are in advanced clinical stages, and the five-year survival rate in all clinical stages amounts up to less than fifty percent. A better understanding of the biology of ovarian cancer can bring us closer to successful treatment and recovery. The aim of this study was to evaluate the expression of luteinizing hormone (LH)/human chorionic gonadotropin (hCG) receptor (LH/hCGR) and the expression of hCG protein in the ovarian cancer tissue. MATERIALS: Histologically proven primary ovarian cancer samples (n=20) were obtained from women undergoing gynecologic surgery. Frozen sections of ovarian cancer tissues were evaluated by means of indirect immunofluorescence. RESULTS: The expression of hCG protein was ubiquitous throughout all samples, while LH/hCGR was detected in only sixty percent of samples. Co-expression of LH/hCGR and hCG protein was detected in some individual cells in tumor tissue. Some cancer cells expressed only hCG protein, but not LH/hCGR. CONCLUSIONS: Expression of LH/hCG receptor is a characteristic feature of various histological types of ovarian cancer. Co-expression of LH/hCGR and hCG protein in individual cancer cells may point to an autocrine or paracrine mechanism of _hCG activity in the tumor microenvironment. Further studies are needed to evaluate LH/hCGR and hCG protein function in the course of neoplastic development.     

Transvesical laparoendosopic single-site surgery as a valuable option to remove eroded materials from the bladder: single-center experience and a review of the literature

International Urology and Nephrology - Currently, polypropylene materials are used widely for the treatment of various urogynecologic disorders. This type of treatment can be complicated, although...     

The influence of body injuries on bone union of femoral shaft fractures treated by different operative methods]

Femoral shaft fracture is very often main musculo-skeletal injury in polytrauma patient. We analysed bone union of femoral shaft fractures treated by different operative open methods--AO plate osteosynthesis, Zespol method and open intramedullary nailing and by closed intramedullary nailing, in patients with concomitant body injuries. We compared patients operated by open methods without complications with the group demanding fracture reoperation. We found out no statistical correlation between the frequency of local complications demanding reoperation and the presence of associated injuries p = 0.209 or their severity expressed in ISS p = 0.202. The highest ISS 29.5 points occurred in the group operated on by closed intramedullary nailing. Lack of complications in this group gives evidence of efficiency of this method of treatment.