Samoistny krwiak nerki : opis przypadku

Background: Spontaneous pararenal hematoma is a rare pathology most frequently coexisting with renal tumours, vascular anomalies and inflammatory processes. In some cases one cannot establish its etiology. Case report: The paper describes a case of a 58-year-old man with a spontaneous pararenal hematoma and presents a diagnostic algorithm. Conclusions: Ultrasonography and CT play an important role in diagnostics of spontaneous pararenal haemorrhages. These methods enable a precise evaluation of size and location of hematoma and its evolution

Klasyfikacja (3 klasy) limfadenektomii miedniczej i aortalnej u pacjentek z rakiem szyjki macicy

Abstract Currently, the extent of pelvic and aortic lymphadenectomy is currently described by numerous and ambiguous terms. The aim of this study is to present a classification of pelvic and aortic lymphadenectomy in cervical cancer patients. On the base of the data from the literature, pelvic and aortic lymphadenectomies have been assigned to three different classes, depending on surgical technique, the extent of the lymphadenectomy and the specificity of the removed lymph node groups. Class I equals removal of selected lymph nodes; Class II: removal of lymph nodes situated ventrally and laterally to large extraperitoneal vessels and the obturator nerve and of lymph nodes situated ventrally and laterally to the aorta and vena cava; Class III: total removal of lymphatic tissue around the iliac vessels and from the obturator fossa dorsally to the obturator nerve and from the presacral region and lymphatic tissue around the aorta and vena cava. The presented classification allows for a unequivocal assessment of pelvic and aortic lymphadenectomy.Streszczenie Zakres limfadenektomii miednicznej i aortalnej jest obecnie oceniany przez niejednoznaczne terminy. Celem pracy jest przedstawienie klasyfikacji limfadenektomii miednicznej i aortalnej u pacjentek z rakiem szyjki macicy. W oparciu o dane z literatury, limfadenektomia miedniczna i aortalna są zaliczane do trzech klas w zależności od techniki chirurgicznej, zakresu limfadenektomii i usuwanych grup węzłów chłonnych. Klasa I jest określana jako usuniecie wybranych węzłów chłonnych; klasa II jako usunięcie węzłów chłonnych znajdujących się po stronie brzusznej i bocznej w stosunku do dużych naczyń zaotrzewnowych miednicy mniejszej, nerwów zasłonowych i bocznie do aorty i żyły głównej dolnej; klasa III jako całkowite usunięcie tkanki limfatycznej wokół naczyń biodrowych, dołów zasłonowych w tym także grzbietowo od nerwów zasłonowych, z okolicy przedkrzyżowej oraz tkanki limfatycznej wokół aorty i żyły głównej dolnej. Przedstawiona klasyfikacja pozwala na jednoznaczne określenie limfadenektomii miednicznej i aortalnej

Uterine leiomyomas: correlation between histologic composition and stiffness via magnetic resonance elastography — a Pilot Study

Objectives: To evaluate magnetic resonance elastography as a tool for characterizing uterine leimyomas.Material and methods: At total of 12 women with symptomatic leiomyomas diagnosed in physical and ultrasound examinationswere enrolled in this pilot study. Before surgery, all patients underwent magnetic resonance elastography ofthe uterus using a 1.5 T MR whole-body scanner (Optima, GE Healthcare, Milwaukee, WI, USA). Surgical specimens wereforwarded for histological examination. The findings were allocated into 3 categories depending on the percentage contentof connective tissue: below 15%, from 15 to 30% and more than 30%. The median stiffness of leiomyomas for each of thegroup was calculated. The U-Mann Whitney test was used for statistical analysis.Results: The stiffness of the leiomyomas ranged between 3.7–6.9 kPa (median value 4.9 kPa). The concentration of extracellularcomponents in the leiomyomas did not exceed 40%. An increasing trend of the stiffness with the growing percentageof extracellular component was observed. Stiffness of the leiomyomas obtained by MRE varies depending on microscopiccomposition.Conclusions: The value of stiffness shows a trend of increasing with the percentage of extracellular component of theleiomyoma. Further studies are required to assess the usefulness of MRE in diagnostics of uterine leiomyomas

Factors affecting self-esteem and disease acceptance in patients from infertile couples

IntroductionInfertility has been diagnosed in millions of people around the world and is described as a complex medical, mental, and social problem that affects many aspects of life. The aim of the study was to extract the determining factors and the level of self-esteem and the degree of acceptance of the disease in infertile patients and to find differences between women and men in this aspect.MethodsA total 456 patients (235 women and 221 men) from infertile couples participated in a cross-sectional study. To collect data a Personal Information Form (PIF), Rosenberg Self-Esteem Scale (SES), and Acceptance of Illness Scale (AIS) were used.ResultsThe overall self-esteem score for the whole sample was 30.50 (15 ± 30) points and for acceptance of the disease 32.4 (8 ± 40) points. In the study group, men obtained a slightly higher level of self-esteem than women (31.00 vs. 30.04 points). Additionally, men had a higher level of acceptance of the disease (33.12 vs. 31.80) than women. Socio-demographic factors such as age and level of education had impact on scores SES and AIS. Clinical factors did not determine the results of SES and AIS, both in the overall sample and in the female and male groups.ConclusionSelf-esteem in patients from infertile couples increases with age and level of education. There are also significant differences between women and men, i.e., positive correlations between the level of education and self-esteem in men and the degree of acceptance of the disease in women

The differences in RCAS1 and DFF45 endometrial expression between late proliferative, early secretory, and mid-secretory cycle phases.

RCAS1 expression is related to the regulation of activated immune cells and to connective tissue remodeling within the endometrium. DFF45 seems to play an important role in the apoptotic process, most likely by acting through the regulation of DNA fragmentation. Its expression changes within the endometrium seem to be related to the resistance of endometrial cells to apoptosis. The aim of the present study was to evaluate RCAS1 and DFF45 endometrial expressions during ovulation and the implantation period. RCAS1 and DFF45 expression was assessed by the Western-blot method in endometrial tissue samples obtained from 20 patients. The tissue samples were classified according to the menstrual cycle phases in which they were collected, with a division into three phases: late proliferative, early secretory, and mid-secretory. The lowest level of RCAS1 and the highest level of DFF45 endometrial expression was found during the early secretory cycle phase. Statistically significantly higher RCAS1 and statistically significantly lower DFF45 endometrial expression was identified in the endometrium during the late proliferative as compared to the early secretory cycle phase. Moreover, statistically significantly higher RCAS1 and statistically significantly lower DFF45 expression was found in the endometrium during the mid-secretory as compared to the early secretory cycle phase. The preparation for implantation process in the endometrium is preceded by dynamic changes in endometrial ECM and results from the proper interaction between endometrial and immune cells. The course of this process is conditioned by the immunomodulating activity of endometrial cells and their resistance to immune-mediated apoptosis. These dynamic changes are closely related to RCAS1 and DFF45 expression alterations