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The aim of the study was to determine the effectiveness of an alternative method of open fetal surgery to prevent severe unfavorable prenatal events, both for the mother and the fetus.In this study, the previously published results for a cohort of 46 patients, who had undergone intrauterine myelomeningocele repair (IUMR) at our Center by 2014, constituted the retrospective control group (CG). The MOMS protocol had been applied for hysterotomy, with an automatic uterine stapling device. The study group (SG) n = 57 was assembled during a prospective observation. IUMR was performed using an alternative method of hysterotomy, with the typical opening and closure of the uterus, without automatic stapling device, as described by Moron et al. Additionally, our single-center results were compared with the post-MOMS findings of other centers: CHOP (Children' S HOSPITAL OF PHILADELPHIA: ) and VUMC (Vanderbilt University Medical CENTER: ).No cases of delivery before 30 weeks of gestation (0%, 0/55) were observed in the study group, which is a statistically significant difference (p0.05) as compared to controls (15/44). Statistically significantly lower incidence of chorioamniotic separation (5.4% (3/55) vs CHOP 22.9% (22/96), p0.001) and contractile activity resulting in preterm labor (16.3% (9/55) vs CHOP 37.5% (36/96), p0.05) was found in the study group. Premature rupture of the membranes was statistically significantly less common in the study group as compared to controls, CHOP and VUMC (SG 12.7% (7/55) vs CG 52.2% (24/46), p0.001; vs CHOP 32.3% (31/96), p0.001; vs VUMC 22% (9/43), p0.01, respectively).The presented IUMR method is associated with improved perinatal outcomes, i.e., lower rates of preterm delivery at30 weeks of gestation, preterm premature rupture of membranes, and uterine contractility resulting in preterm delivery. That, in turn, results in lower prematurity rates and, consequently, more favorable neonatal outcomes.

Objectives: The aim of the study was to compare Insulin-like Growth Factor-1 (IGF-1)concentration in pregnancies complicated by pregnancy-induced hypertension and/or intrauterine hypotrophy, and its correlation with maternal pressure and umbilical artery pulsatility and resistance indices. Material and methods: 65 pairs pregnant-newborn were included to four groups: I — control, II — PIH, III — Hypotrophy, IV — PIH and Hypotrophy. In the study we analyzed cord blood IGF-1 concentration, newborns antropometry, umbilical artery pulsatility and resistance indices and maternal pressure before delivery. Results: The concentration of IGF-1 was the lowest in IV group of hypotrophic newborns from pregnancies complicated by pregnancy-induced hypertension. In this group of patients there was strong negative correlation between IGF-1 concentration and maternal systolic and diastolic pressure. Conclusions: There is a strong negative correlation between IGF-1 concentration and maternal systolic pressure in group of hypotrophic newborns from pregnancies complicated by pregnancy-induced hypertension.

Objectives: We aimed to show how increased experience of a surgery team in fMMC repair influences maternal and fetal/neonatal outcomes. Material and methods: We compare perinatal results of fMMC repair in our Fetal Surgery Center (FSC) in cohort groups for the early period (2005–2011 year; previous — PFSC, n = 46) and current period (2012–2015 year; current — CFSC, n = 74) to results of the randomized Management of Myelomeningocele Study (MOMS, 78 patients). Results: The maternal morbidity due to fMMC repair was low and there was no difference comparing CFSC to PFSC and MOMS. The frequency of iatrogenic preterm labor (iPTL) ≤ 30 weeks of gestation decreased from 34.1% in PFSC to 23.9% in CFSC. Iatrogenic preterm premature rupture of membranes (iPPROM) was a common complication after fMMC repair in all cohorts. The total reduction rate of hindbrain hernation (HH) was similar in CFSC — 90.3% and PFSC — 82.1%. Conclusions: The increasing experience of our surgery team in fMMC repair majorly decreased the risk of iPTL.

Objectives: Heat shock proteins are overexpressed in many human malignancies. The role of heat shock proteins as a thera- peutic target in cancer as well as their association with drug resistance were widely documented. The aim of this study was to evaluate the concentration of IgG class HSP27 and HSP60 antibodies in serum of patients with endometrial and cervical cancer, as well as to analyse the variability of concentrations of the examined antibodies depending on the cancer stage. Material and methods: The study included 59 women with adenocarcinoma of the endometrium and 36 women with cervical cancer, the control group consisted of 54 healthy women. The concentrations of IgG class antibodies against the tested heat shock proteins were determined by an immunoenzymatic assay (ELISA) using commercial assays. Results: In both endometrial and cervical cancer, the serum concentration of IgG anti-HSP27 antibody was significantly higher than in the healthy control group. The concentration of IgG anti-HSP60 antibody in endometrial cancer, cervical cancer and healthy control was similar. The median IgG anti-HSP27 antibody serum concentration of endometrial cancer patients was not correlated with FIGO-stage. In cervical cancer inverse correlation between concentration of this antibody and FIGO stage was observed. The median IgG anti-HSP60 antibody concentration in serum of endometrial cancer patients was lower in FIGO stage I and II compared to FIGO stage IV and in FIGO stage IA compared to FIGO stage IB. Concentrations of examined antibodies correlated positively with each other, both in the group of women with cancer and in the group of healthy women. The strongest correlations were found in the group of patients with endometrial cancer. Conclusions: Concentration of anti-HSP27 antibody could help in detection of cervical and endometrial cancer. We need to look for the cut-off point in large cohort studies. Anti-HSP27 and anti-HSP60 antibodies should be further evaluated for their potential usage as biomarkers in cervical and endometrial cancer as they shown some correlation with stage of disease.

Objectives: Ovarian cancer remains a very common cause of death among women worldwide. The cause is to be found in too late of a diagnostic process and therapeutic difficulties The presence of heat shock proteins in the serum of ovarian cancer patients is still a new area of study. It is necessary to continue studies on the possibilities for using these markers to predict a patient’s response to a specific therapy and to monitor treatment progress. Material and methods: The study included 52 women with ovarian cancer, hospitalised at the Department of Obstetrics, Gynaecology and Oncological Gynaecology, Medical University of Silesia. The control group consisted of 25 healthy women. The levels of HSP27 in the studied sera were determined by an immunoenzymatic method (ELISA). Results: The mean concentration of HSP27 in the group of patients with ovarian cancer was significantly higher than in the control group of healthy women. We have shown that mean HSP27 levels in ovarian cancer patients increase with tumour progression and further depend on the clinical stage of the disease (FIGO). Positivity values analysis revealed in all clinical stages of ovarian cancer, excluding stage 1, it was significantly higher than in the control group, and at the 4 th stage, it is significantly higher than at the 1 st , 2 nd , and 3 rd stages. However, both for the untreated patients and those patients after chemotherapy, the mean HSP27 levels were significantly higher than in the control group. Conclusions: Our studies indicate a significant contribution of HSP27 to the pathogenesis of ovarian cancer. It seems that serum HSP27 can be a marker for this cancer’s development, and a marker for the clinical stage.

The publication presents recommendations on the performance of surgical procedures in gynecology during the COVID- 19 pandemic. The recommendations were prepared by the Polish Society of Gynecologists and Obstetricians, based on current knowledge of SARS CoV-2. These recommendations contain the latest guidelines of scientific societies related to the subject of operational procedures.

Objectives: The role of human papilloma virus (HPV) in the development of cancerous states of female reproductive tract has been widely debated. However, the information about presence of HPV in the Caucasian women living in the central Europe diagnosed with vulvar intraepithelial neoplasia (VIN) is missing. So far, no recommendation was made to complete HPV detection in time of vulvar biopsy or after the results of positive VIN are obtained. We aimed to assess the presence of HPV in women with vulvar intraepithelial neoplasia diagnosed at the Department of Gynecology, Obstetrics and Oncological Gynecology in Bytom, Poland. Material and methods: The retrospective examination of 120 consecutive vulvar biopsies obtained from women with persistent vulvar itching was done. Only patients with diagnosis of VIN were included in the further analysis. HPV DNA was detected using HPV Linear Array Genotyping Test including 14 HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68). Results: Out of 120 vulvar samples retrieved, 18 women were positive for VIN, including15 usual VIN (uVIN) and three differentiated type (dVIN ). 10 samples were eligible for DNA detection. HPV DNA was found in two women with uVIN (HPV 16 and 51). Conclusions: It is advisable to recommend HPV genotyping in women with VIN, regardless of their age and histologic type. The incidence of HPV infection in Caucasian women from the central Europe with VIN should be further studied.

Myelomeningocele (MMC) is the most frequent congenital defect of the central nervous system for which there is no satisfactory alternative to postnatal treatment. On the contrary prenatal MMC surgery is conducting before birth and is aimed at protecting from Chiari II malformation. The main goal of fetal MMC repair is to improve development and life quality of children with Chiari II malformation. Management of Myelomeningocele Study (MOMS) which was published in 2011 clearly confirmed effectiveness of prenatal surgery. In this paper we compare MOMS results with our own clinical experience. Thanks to high effectiveness and significant improvement in safety of maternal-fetal surgery prenatal MMC surgery become a new standard of treatment.

Objectives: The aim of the study was to analyze the perinatal outcome of twin gestations and estimate the influence of chorionicity on the outcome in a large cohort of twin pregnancies in Poland. Material and methods: A retrospective analysis of 465 twin deliveries in 6 Polish centers in 2012 was conducted. Baseline characteristics, the course of pregnancy and labor, as well as the neonatal outcome were analyzed in the study group and according to chorionicity. Results: A total of 356 twin pregnancies were dichorionic (DC group) (76.6%), and 109 were monochorionic (MC group) (23.4%). There were no differences in the occurrence of pregnancy complications according to chorionicity, except for IUGR of at least one fetus (MC 43.1% vs. DC 34.6%; p = 0.003). 66.5% of the women delivered preterm, significantly more in the MC group (78% vs. 62.9%; p = 0.004). Cesarean delivery was performed in 432 patients (92.9%). Mean neonatal birthweight was statistically lower in the MC group (2074 g vs. 2370 g; p < 0.001). Perinatal mortality of at least one twin was 4.3% (2.8% in the DC group vs. 9.2% in the MC group; p = 0.004). Neonatal complications, including NICU admission, respiratory disorders, and infections requiring antibiotic therapy, were significantly more often observed among the MC twins. Conclusions: The overall perinatal outcome in the presented subpopulation of Polish twins and its dependence on cho­rionicity is similar to the reports in the literature. Nevertheless, the rates of preterm and cesarean deliveries remain higher. It seems that proper counselling of pregnant women and education of obstetricians may result in reduction of these rates.

Rupture of membranes before 37 weeks of pregnancy occurs in 2-3% of all pregnant women and is the leadingcause of premature birth. It always significantly complicates the course of pregnancy. The scale of the problemincreases with decreasing gestational age. This paper summarizes the current state of knowledge on epidemiology,diagnosis, monitoring, available methods of treatment, and the outcome of this serious complication.

Vulvar cancer accounts for about 3-5% of all female genital carcinomas. TGF-β protein is a member of a superfamily of cytokines that regulate cell functions. A correlation between this protein and many neoplastic processes was reported. Objectives: In our study we analyzed TGF-β expression in vulvar tumor among patients with diagnosed squamous cell carcinoma (with and without inguinal nodes metastases). Material and methods: Paraffin embedded blocks obtained from vulvar tissues and inguinal nodes (from 31 patients with vulvar carcinoma FIGO II-IV) were prepared. Next, the hematoxylin and eosin staining was performed. Monoclonal antibody NCL-TGF-β was used for immunohistochemical tests. Results: Higher expression of TGF-β in cancer cells corresponds to more advanced cancer stages (FIGO). A positive correlation between TGF-β and metastases, as well as a number of inguinal nodes metastases was observed. The ratio between the number of stained cells in vulvar tumor and of inflammatory cells proved to be higher in FIGO stage III than IV. Possibly, TGF-β increase in vulvar tumor contributes to the breakdown of immunological processes limiting cancer progression. Higher TGF-β expression leads to metastasis in regional lymphatic nodes. Conclusions: TGF-β overproduction is observed in vulvar neoplastic processes. In early stages of carcinogenesis TGF-β inhibits cancer cell proliferation, but in more advanced stages it accelerates cancer progression by inhibiting the immunological response.

Marfan syndrome is an autosomal dominant disorder of connective tissue with up to 25% of cases related to a spontaneous mutation. It has been associated with perinatal loss, preterm labor, and, potentially, a rupture of the maternal aortic arch. We present a case of a woman diagnosed with Marfan syndrome after a miscarriage of her first pregnancy. At the time of diagnosis she had mild aortic bulb dilation and insufficiency of the mitral and tricuspid valves. She underwent cardiosurgical correction, after which she had two uneventful pregnancies. This case suggests that preconceptional correction of valve defects in women with Marfan syndrome may decrease the risk of cardiac decompensation during future pregnancies. Additionally, close clinical follow up and the appropriate use of beta-adrenergic blockade may decrease the risk of aortic rupture, a significant risk factor for mortality in pregnant women.

Vaginal cancer is a rare neoplasm and in about 65% to 90% of cases it is a metastatic one. It is diagnosed in women aged from 60 to 70 years, but it can also appear in younger patients. Squamous cell carcinoma is the most frequently found histopathological type. Risk factors for the development of vaginal cancer are thought to be similar to those of cervical cancer. We present a case of a 52-year old woman with vaginal cancer treated with brachytherapy. Due to neoplasm recurrence, additional examinations were performed in the course of one year. The patient was qualified for total pelvic exenteration. A leakage from the abdominal wound was observed post operatively. It was successfully noninvasively treated. In 3 months time she was hospitalized because of the superficial abdominal abscess which was located next to the left ureterostomy. The patient undergoes regular gynecological, surgical and urological control examinations. So far, the results do not show any recurrence of the neoplastic process. Total pelvic exenteration should be considered in selected groups of patients.

Endometrial cancer is one of the most frequently diagnosed malignant neoplasms among women. In Poland, it is in the fourth place in terms of incidence. The highest morbidity concerns women aged 50-70 years, however it may also appear in women in their reproductive period. Endometrial cancer concerns about 3% of premenopausal women. We present a case of a 25-year-old patient who underwent endometrial curettage because of irregular menstrual bleeding for the last 5 months. Histopathology revealed endometrial cancer. We attempted to apply a conservative treatment. During the next 6 months the patient was treated with lynestrenol. After one month of hormonal therapy endometrial curettage was repeated. In histopathology endometrial tissues corresponding to the hormonal treatment were found. After 6 months of treatment hysteroscopy with endometrial biopsy followed by endometrial curettage, were performed. Hormonal treatment resulted in disease regression. About 5 months after successful treatment the patient conceived spontaneously. One year after she gave birth to her first child, she conceived spontaneously once more. Both children were born vaginally. In selected cases of atypical hyperplasia and early endometrial cancer in young women the attempt of hormonal treatment is acceptable.

Cyclopia is a deformation of the facial skeleton with one eye orbit formed in the place where both eyes should be present. As a result of hypoplasia there is absence (hypothesized loss) of central nervous system structures. Teratogenic factors leading to the occurrence of this anomaly may include irregular cholesterol biosynthesis, viruses, alcohol intake and maternal diabetes. Many authors suggest genetic etiology of this illness. The following work presents a case of a female patient whose fetus was diagnosed with multiple defects, among others with cyclopia. After pharmacological induction of labor, a male fetus with vital signs was born but died after two hours. As far as cyclopia is concerned, special attention should be paid to proper diagnosis of this pathology at an earliest possible stage of fetal life. Early ultrasound diagnostics of this anomaly must be emphasized most strongly leading to the conclusion that patients suspected of fetal facial skeleton defects should be referred to medical centers which are qualified in prenatal examinations.

Premature rupture of membranes (PROM) complicates approximately 8% of all pregnancies, however in 3% of the cases the membrane rupture occurs before 37 weeks of gestation (preterm PROM--PPROM). The consequences of such an early loss of amniotic fluid are very serious. Serious complications and mortality of neonates born prematurely due to PPROM is very high and inversely proportional to gestational age. The diagnosis of PROM is based on medical history and physical examination. In case of doubt, a test determining the pH of vaginal secretions and ultrasonography with assessment of amniotic fluid index may be applied. In difficult cases vaginal fluid diagnostic markers are very helpful. Proposed markers include: beta-human chorionic gonadotropin (beta-HCG), placental alpha-microglobulin-1 (PAMG-1), insulin-like growth factor binding protein-1 (IGFBP-1) and alpha-fetoprotein (AFP). Other markers were also proposed, namely interleukin 6 (IL-6), prolactin, creatinine and lactates. Several tests for the analysis of cervico-vaginal secretions are already commercially available. In Poland various tests based on the analysis of vaginal pH and a test Actim Prom based on the analysis of IGFBP-1 are available. In clinical practice, approximately 10% of cases of PROM require additional confirmation, which can be difficult, especially in the outpatient setting. Various types of bedside tests, the so-called point-of-care testing--POCT are increasingly used in contemporary medical practice. Their implementation does not require a laboratory specialized equipment or trained personnel. This paper presents only those markers that either are already used in the diagnosis of PROM in the form of POCT testing, or could be relatively easily adapted for this purpose.

Vulvovaginitis is the most common cause of gynecological complaints in young girls. Factors which cause vulvovaginitis include, among other things, low level of sexual hormones (hypoestrogenism), the anatomical proximity of the rectum and delicate vulvar skin and vaginal mucosa. Usually vulvovaginitis in young girls is caused by non-specific factors. The aim of the study was to present the most frequent causes of vulvovaginitis in young girls.

A germinal matrix is an area of the fetal brain where neuroblasts proliferate till the 20th week of gestation after which their migration takes place. Germinal matrix hemorrhage (GMH) is a frequent cause of fetal ventriculomegaly or hydrocephalus, yet the pathophysiological conditions of GMH remain unclear. A case of fetal ventriculomegaly resulting from GMH has been reported in the article. A prenatal ultrasonographic examination (US) carried out in the 30th week of gestation revealed enlarged ventricles. Utero magnetic resonance imaging (MRI) performed in the 34th week of gestation demonstrated asymetric ventriculomegaly and the changes suggesting the occurance of GMH and ependymal intraventricular hemorrhage. Fetal ventriculomegaly and hydrocephalus are commonly detected by ultrasonographic examination, but it is often difficult to determine the causes of the diseases by US. In these cases MRI allows to establish the final diagnosis.

The study presents a retrospective review of patients diagnosed with abdominal wall endometrioma in the cesarean section scar between the years 2001-2006.The study presented age symptoms, size of tumor, time between cesarean section and symptoms, results of treatment.Between 2001-2006, 34 patients, all of which suffered from abdominal pain and palpable mass, were diagnosed and treated in our hospital. In 8 cases the disease returned and reoperation was necessary. In one case we observed adenocarcinoma papillare.Endometriosis in postoperative abdominal wall scar after cesarean section is rarely observed. Because to the fact that the number of cesarean sections is constantly increasing, this complication becomes more frequent. The treatment of choice is surgical resection.

Vulvar intraepithelial neoplasia may lead to vulvar cancer. Vulvar cancer is a rare (accounting for about 2,5-5% of all malignant neoplasms), female genital organs cancer. Photodynamic therapy is a new treatment for a wide variety of malignancies and premalignant dysplasias. We wanted to examine the effectiveness of photodynamic therapy (PDT) on vulvar intraepithelial neoplasia (VIN).The aim of the study was to analyze the effectiveness of photodynamic therapy (PDT) on vulvar intraepithelial neoplasia (VIN).We have analyzed 20 women with VIN, who were treated in our center - Clinic of Vulvar Diseases. All these women had photodynamic diagnosis (PDD), photodynamic therapy followed (PDT), with 5% ALA applied to the entire vulva.We have noted the reduction of subjective complaints, but the histopathological improvement was observed in fewer degree.

Uterine cervical cancer may be the direct result of persistent HPV infection. The DNA analysis shows over 200 HPV types. The natural history of uterine cervix cancer is a constantly progressing process, from low pathology changes, through medium to major pathology changes, including microinvasion and invasive carcinoma. The population studies show that over 20% of women at the moment of examination is infected with HPV. The study of cervical cancer tissue revealed the HPV in the DNA, whereas the serological study revealed the presence of specific antibodies to HPV capsid antigens in most women (in USA the number amounts up to 70%). The serological conversion after HPV infection is not a common process. Therefore, the naturally infected women, still do not have enough antibodies and they are at the risk of infection, just as seronegative women. The vaccination of women between the ages of 15 and 25, causes the increase of the number of antibodies, several times higher than in the case of naturally acquired ones. The positive results of HPV examination is not a contraindication to vaccination. However, in case of vaccinated women, the negative test for 14 oncogenic HPV types has an overwhelmingly negative predictive value. Independent of the presence or absence of HPV infection, it is essential to continue cytological. The vaccination does not protect patients from all oncogenic HPV types. Cytological screening enables doctors to recognize cervical pathology at the early stage and introduce a proper treatment.

The purpose of the study was to demonstrate our approach to qualification for open fetal surgery (OFS) and surgery techniques. We also tried to determinate the outcome of fetal surgical treatment. OFS was performed in 10 out of 15 cases with prenataly diagnosed myelomeningocele. Patients were qualified for the surgery on the basis of precisely determined inclusion criteria and after assessment by multidisciplinary team of specialists. Surgery was performed between 22nd and 29th week of pregnancy. Fist and second surgery were performed in 29th and 27th week of pregnancy, some patients have undergone the surgery before 26th week of pregnancy. Babies were delivered by cesarean section. Gestational age by the time of the delivery ranged from 25th and 37th and a half week of pregnancy. In two cases the delivery was at term. Main complications included: PROM, placental ablation and vaginal bleeding. In half of all the cases we did not observe hydrocephalus increase after the surgery. OFS can be beneficial but it can also carry certain amount of risk both for the fetus and the mother. Therefore, further randomized research deems necessary to better comprehend and determine the safety and effectiveness of such procedures.

Abdominal wall endometriosis is usually a secondary process in scars after a cesarean section or appendectomy. Malignant transformation is an infrequent complication of endometriosis. The great majority of cases belong to adenocarcinoma. Only 21.3% of cases of malignant transformation of endometriosis occur at extragonadal pelvic sites, 4% of cases in scars after laparotomy.This is a case report of malignant transformation of endometriosis to adenocarcinoma in scar after cesarean section in 45-year old woman.In cases of abdominal wall endometriosis in scars after cesarean section surgical treatment is a method of choice. Treatment consisted in wide surgical resection followed by prosthetic abdominal wall repair. Using a plastic mesh is a method of choice for abdominal wall reconstruction after surgery.

Photodynamic diagnosis (PDD) is a new method based on the detection of different forms of fluorescence of tissues after previous administration of photosensitizers. The photosensitizer is gathered in the pathological tissue at much higher concentration than in the healthy tissue, thus the fluorescence differs. Localizing wrong fluorescence allows precise choosing of the spot to collect tissue for histopathological or cytological study. Photodynamic therapy (PDT) is a technique in which tissue is irradiated with light after the use of a photosensitizing drug that produces singlet oxygen, which has a cytotoxic effect. The authors describe new trends in photodynamic diagnosis and treatment of some vulvar epithelial diseases (VIN, lichen sclerosus, condylomata acuminata) and cervical intraepithelial neoplasia. They describe photodynamic method in their own studies: diagnosis and treatment of lichen sclerosus and diagnosis of uterine cervix cancer.

The subject of our analysis was pregnancy, delivery and perinatal outcome in adolescent girls treated in I Clinical Unit of Obstetrics and Gynecology in Bytom in the period 1997-2001.Our materials were 164 pregnant adolescent girls aged 14-18. Course of pregnancy, type of delivery, perinatal outcome and the recourse to cesarean section were retrospectively analysed in our study.Mean age of adolescent patients in this study was 16 years and 10 months. 141 pregnancies were conducted by natural birth and 23 (14%) by cesarean section. The rate of preterm birth in this analysis was 15.85%.1. Adolescent patient pregnancy need special perinatal care. 2. The perinatal outcome of analysed cases were similar to other authors.

Vulva cancer makes up 2.5-5% of all malignant neoplasms developing within the female genital organs. The average age of patients with vulvar cancer is 60 years, and most cases occur between 70-80. The great majority of cases (95%) belong to squamous cell carcinoma with endophytic or exophytic growth, for example carcinoma verrucosum. It is malignant neoplasms showing a significant histologic maturity, which however, does not cause metastases.This is a case report concerning a 101 year old patient with vulvar cancer treated surgically.In cases of vulvar cancer, surgical treatment is still the method of choice. The surgical removal of the tumor together with the surrounding tissues proved to be sufficient.

Histones are involved in process of proliferation and differentiation of the cells. In many lesions the expression of mRNA of histones is a marker of proliferation. The expression of kinin receptors B1 and B2 coexist with inflammatory processes, but in some studies the expression of these receptors was found to influence the growth and differentiation of different cells.In search of proliferation markers in squamous cell vulvar cancer we have analysed the correlation between the expression of the mRNA of histone H2B and H4 and mRNA of kinin receptors B1 and B2.The specimen obtained from 46 women operated for squamous cell vulvar cancer stages I to IV according to FIGO were analysed. RNA was extracted and the number of mRNA copies were assessed by QRT-PCR using ABI PRISM 7700 (TaqMan).The results obtained in this study indicate a statistically significant correlation between mRNA B1 and mRNA H4 (p0.01), B2 and histone H4 (p0.01) B1 and histone H2B (p0.01).The expression of mRNA of histones and kinins receptors may reflects the dynamics of neoplastic growth in vulvar cancer.

The aim of the study was estimating the expression of isoforms of mRNA vascular endothelial growth factor: VEGF121, VEGF145, VEGF165, VEGF183, VEGF189, VEGF206, in tissue samples of vulvar cancer, normal and inguinal lymph nodes metastases.The material for this investigation of expression of mRNA selected genes was 4 tissue specimens from women with vulvar cancer T1N2M0. The method used for quantitative determination of the numbers of mRNA copies of selected genes was the QRT-PCR and QPCR technique, with the use of an ABI PRISM 7700 (TaqMan) sequence detector. The nucleotide sequence for starters and probes for quantitative RT-PCR was designed with the use of the Primer Express Version 1.0 ABI PRISM software.Expression of all mRNA isoforms VEGF was found in the samples. The number of mRNA copies obtained in 1 microgram total mRNA extract of the genes examined in tissue sections with various pathomorphology were clearly differentiated.Expression profile of aforementioned genes indicated a definitive relationship between vascular endothelial growth factor isoform and vulvar cancer. These findings provide evidence that the expression pattern of mRNA VEGF isoform should find broad applications in clinical and research settings.

We present a case of 30-year old female patient with persistent cervicitis and vulvovaginal warts. In the course of diagnosis were found cervical dysplasia and a HPV infection type 6 and 11. In therapy we applied antibiotics, chemical therapy of the warts, laser vaporization of the warts, laser conisation, immunotherapy. Three years' intensive therapy didn't lead to satisfactory results. Finally hysterectomy led to the acceptable therapeutical effect.

The presence of adnexal tumours in pregnancy is a significant problem for obstetricians requiring quick diagnosis and operation.The paper presents 22 cases of ovarian tumours diagnosed and treated during pregnancy. In 12 cases laparoscopical cystectomies were performed, in 10 cases laparotomies were done.Fifteen patients delivered at term, 7 of them by the natural way. In 8 cases cesarean sections were performed: in 4 cases because of obstacle to labour in the next 4 because of other obstetricians reasons. Benign ovarian tumors were found in 20 cases (cystis dermoidalis 18%, cystis follicularis 13.8%, cystoma serosum 13.8%, cystis simplex 18%, cystis corporis lutei 9.2%, cystis picea 18%). In 1 case borderline malignancy cystadenoma papillare mucinosum were diagnosed and in 1 case during laparoscopy in 21 weeks of pregnancy ovarian malignant metastatic tumors were found. Two patients miscarriage in 11 and 13 weeks of pregnancy. Last two pregnancies are still observed.Ovarian tumors diagnosed during pregnancy have to be removed because of the thread of malignancy and pregnancy or labour complications.

The problem of breast cancer during pregnancy was touched. Usually in pregnant women with breast cancer the prognosis is bad. Authors described 3 cases of pregnant patients with breast cancer. All those pregnancies were pre-term finished by cesarean section: 2 after induction of fetal lungs maturation with Mucosolvan (2 newborns in a good state) and 1 case in 19th week of pregnancy. In 2 cases during the cesarean section ovariectomy was performed. In all cases very dynamical progress of illness was described what is consistent with other reports. In one case we observed an inflammatory form of breast cancer. We suggest three breast examinations during pregnancy should be performed.