Evaluation of adnexal masses: Correlation between clinical, ultrasound and histopathological findings

Background/Aim. Concerning the growth of ovarian carcinoma incidence and bad prognosis for malignant forms, early and precise diagnostics is gaining in importance as a condition for precise and appropriate therapy for ovarian tumor masses. The aim of this study was to analyze pre- and postoperative findings of patients with adnexal masses in order to identify factors which could predict the nature and stage of the tumor prior to surgery. Methods. All patients with adnexal masses who were treated in a 6-month period in the Institute of Obstetrics and Gynecology, Clinical Center of Serbia, (IOG, CCS), Belgrade, had their epidemiologic and gynecologic anamnesis and standard laboratory analyses taken prior to surgery. Also, clinical and ultrasonographic check up of pelvic organs was performed, as well as calculation of body mass index (BMI) and risk of malignancy index (RMI). After surgery we analyzed histopathological (HP) findings of tumors as a mean of final diagnosis and staging. For statistical analysis, we used SPSS 15 program. Results. Throughout a 6-month period, we examined 81 patients with adnexal masses treated in the IOG CCS. HP findings showed that there were significantly more benign (n = 51) than malignant (n = 30) tumors in all the patients (χ2 = 5.512). The patients with malignant HP findings were significantly older than those with benign adnexal masses (t = 3.362; p = 0.001). Significantly more patients with malignant HP findings were in menopause (p = 0.034). BMI values were highly significantly higher in the patients with malignant adnexal tumors (t = 3.421; p = 0.001). There was a statistically significant positive correlation between HP categories (benign, malignant) and RMI categories (low, intermediate and high risk) of all the patients (high risk, more malignant HP) (Roxy = 0.428; df = 78; p = 0.000). Conclusion. Patients in menopause, especially older ones, with high BMI and RMI should immediately be referred to a tertiary level institution, where appropriate surgery could be performed

Analitičke metode određivanja cefalosporina u cerebrospinalnoj tečnosti

There are a lot of papers describing cephalosporin determination in biological samples, like plasma, urine and serum, but very few of them dealing with their determination in cerebrospinal fluids (CSF). The reason for this is probably the low cephalosporin concentration in CSF and difficulties with sample collection. This paper presents review of the articles dealing with determination of cephalosporins in the cerebrospinal fluid, published in last ten years. The aim of this article is to compare available analytical methods used for these determinations. There are several analytical methods that are used for cephalosporin determination in CSF, such as highperformance liquid chromatography (HPLC), capillary electrophoresis (capillary zone electrophoresis (CZE), micellar electrokinetic capillary chromatography (MECC)) and adsorptive stripping voltammetry (AdSV). Cefepime, ceftriaxone, cefuroxime, cefotaxime, cefixime and ceftazidime are cephalosporins already investigated and determined in CSF using above mentioned techniques. The lowest limit of detection (2,3 × 10-4 μg/mL) and limit of quantification (7,68 × 10-4 μg/mL) for cephalosporins in cerebrospinal fluid were determined for cefepime using Adsorptive "Stripping" Voltammetry. Other techiniques showed lower sensitivity, with LOD values in the range from 0.08 μg/mL to 0.2 μg/mL for HPLC, and above 0.3 μg/mL in the case of CZE and MEKC.Većina objavljenih radova bavi se određivanjem cefalosporina u biološkom materijalu, poput plazme, urina i seruma, ali je istovremeno malo radova u kojima je opisano njihovo određivanje u cerebrospinalnoj tečnosti, verovatno zbog male koncentracije cefalosporina u ovom fluidu i njegovog težeg uzorkovanja. Ovaj rad predstavlja pregled rezultata određivanja cefalosporina u cerebrospinalnoj tečnosti objavljenih u poslednjih desetak godina i istovremeno vrši uporednu analizu analitičkih metoda koje se koriste za ova merenja. Metode koje se koriste za analitičko određivanje ovih antibiotika u cerebrospinalnoj tečnosti su tečna hromatografija pod visokim pritiskom (HPLC), kapilarna elektroforeza (kapilarna zonska elektroforeza (CZE), micelarna elektrokinetička kapilarna hromatografija (MEKC)), kao i adsorptivna "stripping" voltametrija (AdSV). Cefalosporini koji su ispitani i određeni korišćenjem navedenih metoda su cefepim (HPLC, MEKC, AdSV), ceftriakson i cefotaksim (CZE, HPLC), cefiksim (HPLC), cefuroksim i ceftazidim (CZE). Najniže vrednosti granice detekcije (LOD) i granice određivanja (LOQ) cefalosporina u cerebrospinalnoj tečnosti dobijene su za cefepim i to metodom adsorptivne "stripping" voltametrije i iznose 2,3 × 10-4 μg/mL i 7,68 × 10-4 μg/mL, respektivno. Ostale razmatrane metode pokazale su manju osetljivost, kod HPLC vrednost LOD se kretala od 0,08 μg/mL do 0,2 μg/mL, a kod CZE i MEKC granica detekcije pojedinih cefalosporina iznosila je preko 0,3 μg/mL

Analysis of loss of heterozygosity of the tumor suppressor genes p53 and BRCA1 in ovarial carcinomas

Background/aim: Among the genes involved in ovarian carcinogenesis, there has been increased interest in tumor-suppressor genes p53 and BRCA1. Both of the genes make control of cell cycle, DNA repair and apoptosis. The p53 is a "genome guardian" inactivated in more than 50% of human cancers, while BRCA1 mutations are found mostly in breast and ovarian cancer. The aim of this investigation was to establish the frequency of loss of heterozygosity (LOH) in the regions of the genes p53 and BRCA1 in ovarian carcinomas, and to analyze the association of LOH with the disease stage and prognosis. Methods. We analyzed 20 patients with a confirmed diagnosis of epithelilal ovarian carcinoma. DNA for molecular-genetic analysis was extracted from the tumor tissue and blood as normal tissue of each person. Microsatellite markers of the regions of genes p53 and BRCA1 were amplified by PCR method. The determination of allelic status of microsatellites and detection of LOH was performed after PAA gel electroforesis. Results. Both of the analyzed microsatellite markers were informative in 13/20 (65%) cases. In the region of gene p53, LOH was established in 4/13 (30.7%) tumors. One of them had histological gradus G1, one had gradus G2, and two of them had gradus G3, while all were with the International Federation of Gynecology and Obstetrics (FIGO) IIIc stage. In the region of gene BRCA1, LOH was detected in 5/13 (38.5%) tumors. Four of them had histological gradus G2, and one had gradus G3, while by the (FIGO) classification one was with stage Ib, one was with stage IIIb, while the three were with stage IIIc. LOH in both of the analyzed regions was detected in one tumor (7.7%), with histological gradus G3 and the FIGO IIIc stage. Conclusion. The frequency of LOH in epthelial ovarian carcinomas was 30.7% and 38.5% for p53 and BRCA1 gene regions, respectively. Most of tumors with LOH had histological gradus G2 or G3, and the clinical FIGO stage IIIc, suggesting the association of this occurrence with a later phase of the disease

Atypical proliferating mucinous tumors of gigantic dimensions

Background. Ovarian tumors of low malignant potential (LMP) are also known as atypically proliferating tumors. Ovarian tumors of LPM account for approximately 15% of all epithelial ovarian cancers. Mean age of occurrence is 40 years and they are 15-20 cm in diameter. Case report. A 32-year-old female patient was hospitalized as an urgent case with a large tumor mass that filled the entire abdomen. Cyst was 100 × 70 cm dimensions belonging to the right ovary and filled with 18 liters of content. Right adnexectomy, resection of the second ovary, as well as biopsy of the omentum were performed. Lymphadenectomy of the right iliac and obturator area was also performed. After receiving definitive histopathological results it was decided to perform a radical reoperation. On the 10th postoperative day relaparotomy, total hysterectomy and left adnexectomy were performed. The patient was released on the 6th postoperative day. She used to come to regular examinations up to date. Conclusion. This case is a proof that LMP tumors have low malignant potential, they grow slowly and can reach great proportions

Screening methods of ovarian cancer in adults

Ovarian cancer is associated with high mortality rate which has improved a little despite therapeutic advances. It causes more deaths than combined cervical and uterine cancer. High mortality is believed to be a direct result of already advanced stage at the time of diagnosis. Survival is excellent in case of early stage disease but poor in late stage disease, regardless of histology. The goal of screening for ovarian cancer is restricted to detection of asymptomatic early stage disease, as precursor lesions of ovarian cancer have not been identified. At present, there is no reliable method of ovarian cancer screening which has been shown to reduce mortality from ovarian cancer. Therefore, routine screening of women in general population can not be currently advised. Screening should be limited to high-risk population and subjects participating in research projects as long as the results of current studies are available

Simultaneous determination of cefotaxime and desacetylcefotaxime in real urine sample using voltammetric and high-performance liquid chromatographic methods

Two rapid, accurate and sensitive methods are developed and validated for the quantitative simultaneous determination of cefotaxime (CFX) and its active metabolite desacetylcefotaxime (DCFX) in urine. Based on the previous results which showed the four electron reduction of CFX at approximate to -0.5 V, and the new findings that DCFX reduction occurred at more positive potential (-0.23 V), the new adsorptive stripping differential pulse voltammetric (AdSDPV) method was developed for determination of CFX in the presence of DCFX. Linear responses were observed over a wide concentration range (0.07-0.52 mu g/ml for CFX and 0.22-1.3 mu g/ml for DCFX) in urine. The second assay involves subsequent separation on a reversed-phase HPLC column, with ultraviolet detection at 262 nm. Retention times were 4.057 and 1.960 min for CFX and DCFX, respectively. Linear responses were observed over a wide range, 0.55-6.60 mu g/ml for CFX and 1.10-11.00 mu g/ml for DCFX, in urine. The statistical evaluation for both methods was examined by means of within-day repeatability (n=5) and day-to-day precision (n=3) and was found to be satisfactory with high accuracy and precision

Differences of metal concentrations and morpho-anatomical adaptations between obligate and facultative serpentinophytes from Western Serbia

Abstract — In the present study, some important macro- and micronutrients (Ca, Mg, Fe, Ni) and the trace element Cr are analyzed in the obligate serpentinophytes Fumana bonapartei and Stachys recta var. chrysophaea, Balkan endemic species, as well as in Seseli rigidum, a widespread facultative serpentinophyte. Differences of adaptive structural features between these plants relative to serpentine tolerance strategy are also presented. Our investigations were carried out on plant samples deriving from the serpentine area of Mt. Tara in Western Serbia

Leiomyoma of the uterus and retroperitoneal angioleiomyoma: case report

Retroperitoneal angiolciomyoma is a benign mesenchymal neoplasm that is composed of smooth muscle cells and thick-walled vessels. In a 36-year-old patient a retrouterine and retroperitoneal tumor, 70 x 65 x 50 mm in size, was discovered during a surgical procedure due to uterine myoma. The tumor had a soft consistency and was completely removed. Histopathology showed features of angioleiomyoma. Angioleiomyoma is a rare benign entity; hence a benign course and good prognosis are expected.nul

Leiomyoma of the uterus and retroperitoneal angioleiomyoma: case report

Retroperitoneal angiolciomyoma is a benign mesenchymal neoplasm that is composed of smooth muscle cells and thick-walled vessels. In a 36-year-old patient a retrouterine and retroperitoneal tumor, 70 x 65 x 50 mm in size, was discovered during a surgical procedure due to uterine myoma. The tumor had a soft consistency and was completely removed. Histopathology showed features of angioleiomyoma. Angioleiomyoma is a rare benign entity; hence a benign course and good prognosis are expected.nul