Morphology of the Willis chords in the superior sagittal sinus during various periods of life

Numerous fibrous elements known as the Willis chords are situated in the light of the superior sagittal sinus. The paper is aimed at a comparative evaluation of the appearance of the Willis chords appearing in the superior sagittal sinus during various periods of human life and a determination of their role. The material comprises 200 brains at the foetal period as well as 200 adult and senile brains. The experimental methods include injection methods, infrared light, the Pickworth method and computer image analysis. During adulthood, various elements such as valvulae, divisions, plates, beams and arachnoidal granulation are situated in the light of superior sagittal sinus. The number of arachnoidal granulations increases continuously due to age, new ones appearing close to those already in existence and old granulation spreading. The superior sagittal sinus contains numerous valvulae similar to the feedback flaps typical for hydraulic systems. Divisions act as orifices which lead to a fall in pressure and induce blood into the sinus. Large differences between the cross-sections of meningeal veins and bridge veins were noticed, which resembles the structure of ejector. The blood flow in the bridge veins ending at the superior sagittal sinus is controlled by the valvulae and their geometrical form changes according to age. Conclusion: the Willis chords situated in the superior sagittal sinus may control the circulation. Their number grows with age and their morphology changes

Planar measurements of foetal lateral ventricles

To compare the linear dimensions (width) of the foetal atrium and occipital horns to their areas, 31 foetuses (15–24 weeks, C-R 12.5–23.5 mm) from spontaneous abortions were evaluated. Images of the axial sections of the brains were transferred to computer and Scion for Windows 98 software was used for image analysis. 11 brains appeared normal and 20 were abnormal (leukomalacia in 9 cases, periventricular and intraventricular haemorrhage in 6 cases, ventriculomegaly in 3 cases, colpocephaly in 1 case, vascular malformation in 1 case). High-range linear and planar asymmetries in the atrium and occipital horns were observed both in normal and abnormal brains. There was no close correlation between the width and the area of the structures under investigation, although it was stronger in case of the occipital horns. The wider occipital horns and atria often had a smaller area than the narrower ones. Some abnormal cerebral hemispheres had relatively narrow atria and occipital horns in comparison with their large areas. Further investigation should be carried out to assess the utility and potential superiority of planar measurements over linear in the image diagnosis of foetal ventricles

Ocena wartości testu DNA HPV HR u kobiet po leczeniu z powodu śródnabłonkowej neoplazji szyjki macicy jako markera nawrotu procesu chorobowego

Summary Aim: The basic assumption of the prevention of cervical cancer is to early detect and treat CIN (cervical intraepithelial neoplasia) as well as to prevent recurrence of neoplasia after therapy. This study involved comparison of the cytology test value and determination of HPV (human papilloma virus) DNA in women treated for CIN so as to find a sensitive and specific marker of disease recurrence. Methods: A group of 107 females after CIN treatment underwent 14-month follow-up and regular cytological and molecular evaluations. Results: Based on the follow-up data the recurrence of CIN was found in 9 females who despite effective therapy for the entire follow-up period were HPV positive. Evaluation of value of HR (high risk) - HPV DNA assay used to detect CIN showed its 100% sensitivity. Conclusion: The HR-HPV DNA assay is likely to be a valuable diagnostic tool facilitating more precise detection of recurrent neoplasia risk than cytological test alone.Streszczenie Cel pracy: Podstawowym założeniem profilaktyki raka szyjki macicy, jest wczesne wykrycie i leczenie CIN a także zapobieganie nawrotom neoplazji po leczeniu. W pracy porównano wartość testu cytologicznego oraz oznaczania DNA HPV u kobiet leczonych z powodu CIN w celu poszukiwania czułego i swoistego markera nawrotu procesu chorobowego. Metoda: 14-miesięcznej obserwacji poddano 107 kobiet po leczeniu CIN, u których regularnie wykonywano ocenę cytologiczną i molekularną. Wyniki: Nawrót CIN wykryto u 9 obserwowanych kobiet, które mimo skutecznej terapii przez cały okres obserwacji były HPV pozytywne. Ocena wartości testu na obecność DNA HPV HR, użytego do wykrycia CIN wykazała 100% czułość tej metody. Wnioski: Test na obecność DNA HPV HR może być cennym narzędziem diagnostycznym, pozwalającym bardziej precyzyjnie niż badanie cytologiczne wykryć ryzyko nawrotu neoplazji

Economic aspects of using selected biomarkers in cervical cancer screening

Summary Increasing knowledge about the cervical cancer etiology, combined with the development of molecular diagnostics technology using DNA matrix and mRNA matrix, introduced a new quality in cervical cancer screening. Moving the diagnostics from the cellular level into the molecular level allowed not only to identify the existing precancerous states, but also to foresee these pathologies in the stage of cellular or molecular changes using oncogenesis biomarkers. The new diagnostic tools give hope for the improvement of effectiveness of cervical cancer screening and for a significant reduction of costs

Human papilloma virus genotyping in women with CIN 1

Abstract Introduction: Cervical cancer remains a considerable diagnostic and therapeutic problem in Poland. Despite progress in creating an active cancer prevention program in our country, Poland occupies one of the last places in the EU in terms of cervical cancer morbidity and mortality. Supplement of secondary prevention of primary prophylaxis – HPV 16, 18 vaccination, offers hope for improvement of the situation. Epidemiology of individual HPV types differs, depending on the geographical location of the study population. So far in Poland, we have had no reliable data on the participation of selected oncogenic HPV types in the development of cervical pathology. Objective: Identification of the most frequent, oncogenic HPV types in women diagnosed with CIN 1, from the Central and Western Poland. Material: In the course of the conducted studies, genotyping of 13 types of human papilloma virus has been done in 126 HPV DNA-positive women diagnosed with CIN 1. Method: Each cell material in which the presence of HPV DNA identified 13 types of oncogenic human papillomavirus was subsequently subjected to genotyping using the molecular test – Linear Array HPV Genotyping (Roche Diagnostics). Results and conclusion: In women from the Central and Western Poland diagnosed with CIN 1, HPV 16 (53,97%) was the most common, followed by HPV 33 (21.3%), HPV 18 (16.67%), HPV 31 (10.32%), HPV 45 (7.94%), HPV 52 (1.59%). Current HPV vaccines are designed to protect against two of the three most common genotypes, in women diagnosed with CIN 1 in Central and Western Poland

Risk assessment of chronic HPV HR infection in babies who contacted the virus in the perinatal period

Objectives: Risk assessment of the development of chronic HPV HR infection in babies who had contact with the virus in the perinatal period. Materials and methods: During the pre-and perinatal period, research was carried out among 185 pregnant women and a group of 105 newborns (5 pairs of twins), hospitalized in the Delivery Room of the Gynecology and Obstetrics Clinic of the Poznań Medical University, between 2005–2007. Cellular material from the uterine cervical canal using a brush-type Cervex Brush was collected from each woman participating in the study and oral swabs using swab sticks were taken from the newborns. The second phase of testing was conducted following the postpartum, 3 to 6 months after the delivery. Uterine cervix swabs were re-collected from 28 HPV HR positive women and swab from the mouth and nasopharynx were taken from their children (29 samples – 1 pair of twins). The study was conducted with the use of PCR, trade named AMPLICOR® Human Papilloma Virus (HPV) Test by Roche. Results: DNA HPV HR was found in 55 cases of the cellular material derived from 185 swabs taken from the cervical canal, representing 29.7% of researched women. The chronic HPV HR viral infection was detected in 25 cases out of the 28 HPV HR positive women, representing 89.2% of the study group. Of the 105 infants from whom oral swabs were taken in the perinatal period, presence of DNA HPV HR was found in 2 infants (2%) after traditional birth. Whereas the repeated test, within 3–6 months after delivery, revealed the presence of DNA HPV HR viruses in swab oral in 1 infant, who had been DNA HPV HR positive. Conclusions: Perinatal transmission of Human Papillomavirus of the high-risk oncogenic type is rare and concerns below 2% of babies of HPV HR positive mothers. Prolonged infection by the Human Papillomavirus is an extremely rare complication of pregnancy and delivery and concerns below 1% of children of HPV HR positive mothers. Perinatal transmission of the oncogenic type infection of the virus in humans is primarily of the ascending type or occurs during the perinatal period if the delivery was a traditional one

Genotyping of oncogenic human papilloma viruses in women with HG SIL diagnosis

Abstract Introduction: Development of primary prevention of cervical cancer, in other words a vaccination against selected, oncogenic HPV types, entails an increasing importance of epidemiological studies and prevalence of various types of human papilloma virus. The incidence of HPV varies depending on the geographic location of the population. The effectiveness of primary prevention against HPV 16, 18, in the context of reducing the incidence of cervical cancer will depend, among others, on the prevalence of these types in the population and virus-like antigens, which are partially cross-resistant. Objective: Identification of the most frequent, oncogenic HPV types in women with HG SIL diagnosis from Central and Western Poland to assess the merits of the development of primary prevention. Material: For the purpose of molecular tests identifying the presence of 13 DNA oncogenic virus types, swabs were taken with the cyto-brush from 76 women diagnosed with CIN 2 or CIN 3 (HG SIL). Patients eligible for the study were diagnosed at the Laboratory of Pathophysiology of Uterine Cervix, Gynecology and Obstetrics Clinical Hospital of Karol Marcinkowski University of Medical Sciences. Patients came from Central and Western parts of Poland. Method: Cell material in which the method of Amplicor HPV (Roche Diagnostics) identified the presence of DNA of oncogenic HPV types was in each case subsequently subjected to genotyping using the molecular test – Linear Array HPV Genotyping (Roche Diagnostics). Results: Five most common oncogenic HPV types in order of detection included: 16, 33, 18, 31, 56. Together, these five types of virus comprised 75,86% (88/116) of all detected HPV types. Conclusions: 1. In women from Central and Western Poland, diagnosed with HG SIL, the most common HPV genotypes were HPV 16, HPV 33, HPV 18, HPV 31, HPV 56. 2. Two HPV types 16 and 18, against which vaccinations are directed, belong to the group of three genotypes of HPV most commonly identified in the evolution of CIN 2, CIN 3 diagnosed in women from Central and Western Poland

Analiza ekspresji hMLH1 i hMSH2 u pacjentek z rakiem jajnika leczonych za pomocą pochodnych platyny

Background: Loss of DNA mismatch repair may result in resistance to platinum- based anticancer drugs. The hMLH1 and hMSH2 proteins play a critical role in the maintenance of genome integrity and are involved in resistance to platinum-based therapy in colorectal cancer, which is deficient in hMLH1 protein and endometrial cancer, as well as in hMSH2 protein. However, the predictive value of MLH1 and MSH2 expression in ovarian cancer cisplatinresistance is still to be determined. Objective: The aim of this study was to investigate the expression of hMLH1 and hMSH2 proteins in ovarian carcinoma specimens and to evaluate their prognostic significance by means of overall survival (OS) and progression-free survival rates (PSF). Material: Ovarian cancer tissues were obtained from 61 patients: 45 platinum-sensitive and 16 platinum-resistant. hMLH1 and hMSH2 proteins expression was evaluated by immunohistochemistry, with the use of mouse monoclonal antibodies clone 14 for hMLH1 and clone FE11 for hMSH2. The log-rank test and Kaplan-Meier statistics were used to analyze the relationship between proteins expression and progression free survival, as well as the overall survival. Result: No significant correlation was found between hMLH1 and hMSH2 expression and overall survival and progression free survival in the group of patients sensitive and resistant to cisplatin. No significant difference was found in proteins expression intensity between the two compared groups of patients. Age of patients, type of cancer histology, FIGO staging, grading, clinical response and CA 125 did not reveal correlation with the expression of the analyzed proteins. Conclusion: The immunohistochemical expression of hMLH1 and hMSH2 proteins in ovarian cancer has no predictive value in resistance to cisplatin.Wstęp: Białka hMLH1 i hMSH2 pełnią kluczową rolę w naprawie genomu. Utrata tej zdolności może powodować zwiększoną oporność na leki przeciwnowotworowe oparte na pochodnych platyny. Jakkolwiek wartość prognostyczna oznaczania ekspresji białek hMLH1 i hMSH2 w raku jajnika w celu przewidywania oporności na cisplatynę pozostaje wciąż nieokreślona. Cel pracy: Celem tego opracowania było zbadanie ekspresji białek hMLH1 i hMSH2 w komórkach raka jajnika pochodzących od 61 pacjentek, w tym: 45 wrażliwych i 16 opornych na cisplatynę oraz ocena wpływu tych białek na ogólne przeżycie i czas wolny od wznowy. MateriaΠ i metody: Ekspresję białek hMLH1 i hMSH2 oceniono metoda immunohistochemiczna przy użyciu mysich przeciwciał monoklinalnych, klon 14 dla hMLH1 i klon FE11 dla hMSH2. Do analizy zale˝noEci pomi´dzy ekspresja białek a czasem wolnym od wznowy i przeżyciem ogólnym użyto testu log rank i statystyki Kaplana-Meiera. Wartość

Electrosurgery of cervical changes and its place in cervical cancer prophylaxis

Summary For many years electrosurgical procedures have been used to treat cervical changes. The equipment and the technique of performing these procedures have evolved considerably during the recent years. The Fisher cone and electrocoagulation of the cervix have been replaced with the LLETZ/LEEP procedure. Low cost, the simplicity of performance, high safety and high therapeutic effectiveness in treating precancerous cervical changes make the LLETZ/LEEP procedure a very good method of accomplishing the cervical cancer preventive program. The indications, contra-indications, the technique of performance along with postoperative complications after the LLETZ/LEEP procedure and the physical basics of electrosurgical procedures were thoroughly presented in the article

Ten years of anti-HPV vaccinations : what do we know?

Human papillomavirus (HPV) is one of the most important carcinogens in humans. Vaccines against HPV are now considered the first anti-cancer vaccinations. Since 2007, in many developed countries, there have been recommendations present for preventive vaccines against HPV. At present, the degree of implementation of these recommendations depends on a number of country-specific factors such as the health care system organization or the ways of funding. HPV vaccines are primarily to prevent the development of cervical cancer and other genital cancers. Therefore, only their long-term effectiveness can be measured, when a correspondingly large cohort of vaccinated teenagers reaches the age of the greatest incidence of these cancers. However, great care should be taken in assessing the results of vaccinations due to the possibility of misinterpretation and possible erroneous data. Undoubtedly, teenagers are the target population of HPV vaccines. However, vaccinating young sexually active women is also justified from an individual point of view. A 9-valent vaccine has been registered in the USA and in Europe - including Poland - as one of the three preventive vaccines. It is recommended to vaccinate women between 13 and 26 and men between 13 and 21, previously unvaccinated. It is also recommended to vaccinate men aged 26 years or less who have sexual relations with other men and people with reduced immunity, including HIV-positive people who have not been vaccinated previously