Background. LACC trial demonstrated inferiority of laparoscopic approach for the treatment of early-stage cervical cancer. There are still limited data from retrospective trials regarding whether ...survival outcomes after laparoscopic radical hysterectomy are equivalent to those after open abdominal radical hysterectomy. In this study, we present results of combined vaginal radical laparoscopic hysterectomy in the treatment of early-stage cervical cancer. Methods. This retrospective study was carried out at the Department of Gynecology in Mathilden Hospital (Herford, Germany). Between January 2008 and April 2018, all the patients with invasive cervical cancer who underwent combined vaginal assisted radical laparoscopic hysterectomy (VARLH) without the use of any uterine manipulator were enrolled to the study. Results. A total number of 124 patients with diagnosis of invasive cervical cancer were enrolled in the study. All of the patients underwent minimally invasive surgery and were divided according to FIGO 2019: stage IA (25.9%), IB1 (25.0%), IB2-IIB (28.4%), and III/IV (20.7%). Overall, the mean age of the patients was 51.84 years. After a study collection, a median follow-up was 45.6 (range 23.7-76.5) months. The 3- and 5-year disease-free survival rates for early-stage cervical cancer were both 98%, and the 3- and 5-year overall survival rates were 100% and 97%, respectively. We have not observed any recurrence in our study group of patients with early-stage cervical cancer. Conclusions. Combined VARLH can be considered a safe and effective procedure for the treatment of early-stage cervical cancer. Surgical strategy with oncological principles determines the quality and long-term success of the operation in early cervical cancer regardless of laparoscopic approach.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Currently, only a few scoring systems are available to differentiate benign fibroids from malignant sarcomas 14, 15. Unfortunately, it does not make the surgeon’s task any simple. Collecting multiple ...epidemiological, anamnestic, and clinical variables in order to make a proper decision about the probability of sarcoma, do not help to undertake right decision about the surgery. Also, not every diagnostic technique is available in every center, and different techniques are advocated in different countries. Creating measurable, attainable preoperative scheme could improve the standardization of uterine fibroid diagnostics, without exposing the large number of low-risk patients to unnecessary surgical procedures. The aim of this study was to determine the feasibility and preliminary effectiveness of preoperative score in patients, primary diagnosed with uterine fibroid, and qualified for surgery. Our intention was to identify group of patients who could benefit from such proceeding and through preoperative consulting take advantage of the entire range of operative procedures.
Caesarean section is one of the most common surgeries worldwide, even though there is no evidence supporting maternal and perinatal long-term benefits. Furthermore, the mechanical behavior of a ...caesarean scar during a vaginal birth after caesarean (VBAC) is not well understood since there are several questions regarding the uterine wound healing process. The aim of this study is to investigate the biomechanical Maylard fiber reorientation and stiffness influence during a VBAC through computational methods. A biomechanical model comprising a fetus and a uterus was developed, and a chemical–mechanical constitutive model that triggers uterine contractions was used, where some of the parameters were adjusted to account for the matrix and fiber stiffness increase in the caesarean scar. Several mechanical simulations were performed to analyze different scar fibers arrangements, considering different values for the respective matrix and fibers stiffness. The results revealed that a random fiber arrangement in the Maylard scar has a much higher impact on its mechanical behavior during a VBAC than the common fibers arrangement present in the uninjured uterine tissue. An increase of the matrix scar stiffness exhibits a lower impact, while an increase of the fiber’s stiffness has no significant influence.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
During a normal vaginal delivery, the muscle cells propagate electrical signals throughout the uterine wall, resulting in uterine contractions. However, uncoordinated uterine activity may disturb the ...uterine contractions pattern and negatively impact fetal and maternal health. Some of the abnormalities identified by the specialists are excessively short resting intervals and tachysystole. This work aims to investigate the influence of abnormal uterine activity in terms of maximum principal stress distribution and collagen fibers stretch in the uterine tissue during vaginal delivery with (i) excessively short resting intervals without changing the contraction time, and (ii) tachysystole (contraction and reduced resting times). These patterns are compared with a normal uterine contraction pattern. To achieve our aims, a biomechanical model was developed, including finite element models of the uterus and the fetus, and an electro-chemo-mechanical constitutive model. Generally, the excessively short resting intervals exhibit higher average maximum principal stresses during the contraction and resting stages, lower average fibers stretch values in the longitudinal direction and higher stretch in the circumferential direction. On the other hand, the tachysystole exhibit generally lower stress values during the uterine contraction and higher stress values during the resting stages, higher stretch in the longitudinal direction, and lower stretch in the circumferential direction.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Exogenous surfactant therapy (EST) in surfactant-deficient premature infants has been shown to improve lung compliance, decrease morbidity, and improve survival. Reports have demonstrated that ...newborns with congenital diaphragmatic hernia (CDH) have lung compliance, pressure-volume curves, and hyaline membrane formation resembling those changes seen in surfactant deficient premature newborns. We hypothesize that EST may also benefit infants with CDH. All high risk cases of prenatally diagnosed CDH at Children's Hospital of Buffalo from November 1988 to February 1991 were prospectively evaluated for EST. In those families who chose to participate, the surfactant preparation, Infasurf (100 mg/kg), was instilled into the newborn's lungs prior to the first breath. The remainder of the perinatal, neonatal, and surgical care was performed in a routine manner. Three high-risk prenatally diagnosed newborns with left CDH were treated with EST. All showed signs of decreased pulmonary compliance, but could still be adequately oxygenated and ventilated. Surgical correction was performed after stabilization and all required patch closures. Two of the three infants suffered no life-threatening episodes of pulmonary hypertension and all survived. These infants had many known indicators for poor outcome in CDH with an expected survival of less than 20%. We believe that EST in these neonates with CDH contributed to their survival with minimum morbidity. These results suggest that surfactant replacement for the high-risk neonate with CDH warrants further consideration and a randomized clinical trial is being planned.
In order to standardize the analytical methods and procedures with the ones used in the EU, a method of free formaldehyde determination in cosmetic products preserved with formaldehyde donors, ...recommended by Commission Directive (90/207/EEC of 4th April, 1990), has been tested. The free formaldehyde level is determined by HPLC using post column derivatisation with acetylacetone. Formaldehyde content was determined in 44 fortified samples of cosmetic emulsions and shampoos. Recoveries ranged from 94.8-97.5%. Relative Standard Deviation 1-2.3%.
The properties, mode of action and its duration of the preparations used for hair dyeing are described, together with their chemical components, and also preparations of herbal origin. The chemical ...reactions are described in detail which lead the development of a color polymer occurring during hair dyeing. The studies are presented which are used for toxicological assessment of the raw materials which are the components of the colorants, and the list is included of hair colorants permitted for use in Poland.
Total formaldehyde content was determined by the colorimetric method with acetylacetone in cosmetic emulsions and household products. The commercial products not containing formaldehyde were ...fortified with 150 micrograms of the investigated compound. Recovery in this method was 93.3-102.6%. The method was found useful in routine determinations of formaldehyde in cosmetics and household products and can be used by the State Sanitary Inspections.
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