Cervical cuff carcinoma: causes and prevention

Over an 11-year period (1990-2000) a total of 59 patients with cervical cuff carcinoma were hospitalized (I stage--17; II stage--30; III-IV stage--12 patients). Seventeen patients were subjected to radical extirpation with lymphadenectomy for cervical cuff carcinoma, while 42 patients received combined radiotherapy. In the last 20-year period the patients had undergone supravaginal amputation of the uterus due to uterine fibromyoma, polyposis, and ovarian tumors in various gynecological clinics. In 12 patients the onset of cervical cuff carcinoma occurred within one year after supravaginal amputation of the uterus; in another six patients cancer developed within two years postoperatively, 15 patients in a 3 to 9 year period and 26 developed cancer 10-20 years after surgery. It seems in fact that when cervical cuff carcinoma developed within one year after supravaginal amputation of the uterus the patients had cervical carcinoma which was not identified due to physician negligence. In cases of latent periods up to ten years the patients must have had at least pre-existing disease. To prevent development of cervical cuff carcinoma in the future when operating on the uterus and/or adnexa the scope of surgery (extirpation, amputation) shall be decided based on colposcopic examination of the cervix (target cytology).     

Cervical carcinoma and pregnancy

Abortion and conization of the cervix is the treatment of choice for patients with preinvasive cervical carcinoma combined with first-term pregnancy. With the second and third term, the pregnancy is led to delivery and a secondary examination is carried out. In case of preienvasive carcinoma only conization of the cervix is performed. In late-term pregnancy the surgical operation starts with a cesarean section. A combination of cervical carcinoma and pregnancy was observed in 31 (44%) of 6,890 patients admitted to the Gynecological Clinic of the National Cancer Center from 1964-2001. Of 1,911 patients with radical hysterectomy (Stage I--58.4%, Stage II--21.8%, Stage III--20%) a combination of cervical carcinoma and pregnancy was diagnosed in 31 women [Stage I--23 (74.2%), Stage II--4 (12.9%), Stage III--4 (12.9%)]; 93.5% of the patients had a first or second term pregnancy. Five-year survival of the patients with surgery only was 83.3%, while with combined therapy--60%. Twenty-nine percent of the patients were 30 and younger. Pregnancy contributed to early manifestation of cervical cancer and did not favor the aggression of malignant tumor growth. The five-year survival rate of patients without staging and those combined with pregnancy was 72.7%; five-year survival rate of patients with early pregnancy was worse compared to those with second or third term pregnancies. Pregnancy is not a contraindication for performance of radical hysterectomy.     

Cellular composition of the rat piriform cortex in experimental epilepsy

Cellular composition of all the layers of anterior, central and posterior regions of rat cerebral piriform cortex was studied 2 weeks and 1 month after specific electrical stimulation (kindling) of ventral hippocampus through electrodes implanted one week earlier. According to the data of stereological analysis, following at both time intervals after kindling, all the layers in all the regions of piriform cortex demonstrated the significant decrease in numbers of interneurons and pyramidal cells. Three weeks after electrode implantation into the ventral hippocampus, the number of both pyramidal cells and interneurons was also found to be reduced in the central region of piriform cortex of rats in which stimulation had not been performed. The participation of piriform cortex in epileptogenesis is suggested on the basis of literature and personal data.