Browsing by Author "Zamurovic, M. (16065246600)"

Sertoli-Leydig cell tumors are rare stromal tumors of the ovary. They account for less than 0.5% of ovarian neoplasms. From a histological point of view, they show large diversity, making their clinical symptoms diverse as well. They are mostly unilateral, with average diameter 13.5 cm at the moment of diagnosis. Histologically, poorly-differentiated Sertoli-Leydig tumors pose a diagnostic problem, often being clinically asymptomatic which makes their detection relatively late, preventing efficient treatment, and resulting in worse prognosis. This article presents a rare case of bilateral poorly-differentiated Sertoli-Leydig ovarian tumor, characterized by heterologous histological structure, without hormonal unbalance, and without signs of defeminization and/or virilization, its diagnostics, and treatment.

This paper presents a case of carcinosarcoma localized in the endometrial polyp inside the uterus of a 74-year-old patient. This carcinosarcoma was diagnosed in the first clinical disease stage. Postoperative treatment was conducted but was not followed by additional chemo or radiotherapy due to the fact that the illness was in the first clinical stage. Secondary deposits in the abdomen and in the pelvis appeared exactly six months after surgery. Illness progression was sudden causing death three months after the appearance of secondary deposits or nine months after the illness was detected, despite attempts with Chemotherapie treatment. Although uterine carcinosarcomas account for three to seven percent of all uterine malignities while malignant polyp degeneration occurs in only 0.36% cases, treatment of this malignant disease is a special challenge to all those involved in oncological gynecological practice with the aim of prolonging the progression-free interval and the overall survival of patients suffering from this rare malignity.

Purpose of investigation: The objective of this study was to evaluate the electrolytic status of Na+, K+, Ca2+, and Mg2+ in serum and red blood cells in idiopathic preterm and term deliveries. Methods: The study included 105 pregnant women diagnosed with idiopathic premature delivery (study group) and 36 pregnant women with physiologically term delivery (controls). Samples of mother's blood were collected and analyzed for the level of electrolytes in the serum/plasma and red blood cells. Results: Measured values of magnesium in red blood cells in the study group were far lower than physiological values, intracellular calcium levels were higher in the study group compared to levels measured in the controls. Sodium concentrations in cells were significantly lower in subjects with premature delivery. Conclusion: The magnesium intracellular level is the best representative value of magnesium in the body.

This is a case report of a 47-year-old patient that came to our Clinic due to bleeding during the 23rd week of twin pregnancy after in vitro fertilization-intracervical insemination/embryo transfer (IVF-ICI/ET) treatment. Prior to this pregnancy, this patient had had ten spontaneous miscarriages, eight of which following IVF-ICI/ET, and two following spontaneous conception, all in the eighth week of pregnancy. After several miscarriages by the age of 43, the patient was suggested to be tested for thrombophilia; it was then discovered that she had the methylenetetrahydrofolate reductase (MTHFR) gene defect, in the homozygous Tobiano (TT) form. Thus she was treated with cardiolipin and folic acid before pregnancy, and continued with folic acid after the pregnancy had been diagnosed. Fraxiparine 0.4 ml subcutaneous (s.c.) should be introduced from the second month of pregnancy until one day before delivery. It is a useful treatment for the patients with MTHFR defect, as it prevents miscarriage and promotes successful pregnancy.

This study describes prenatal diagnostics of fetal omphalocele by ultrasonographic examination, planned childbirth by cesarean section and surgical correction of the anomaly in an older primipara who became pregnant through a spontaneous menstrual cycle after a five-year long medical examination and treatment of infertility. Pregnancy was carried out to full term. Planned cesarean section performed at 40 weeks of pregnancy gave birth to an infant with a giant omphalocele 8-9 cm in size with an abdominal wall defect approximately 5 cm in size. The same day the newborn was subjected to surgery during which the hernial sac containing intestine was repositioned inside the child's abdomen and a paraumbilical defect in the abdominal wall was sutured. The newborn spent seven days in the intensive care unit on assisted ventilation in order to maintain a constant level of intraabdominal pressure. The postoperative period was complication-free. The infant was released from the hospital after 14 days completely adapted and ready for breastfeeding. The rest of the neonatal period remained without complications.

Vaginal bleeding during the first half of pregnancy occurs in approximately 25% of women and about half of these pregnancies terminate in abortion. In many instances a retrochorial hematoma (RCH) is sonographically found. The aim of the present study was to determine the frequency of a RCH in the group of threatened miscarriages and to examine the possible relationship of parity, previous miscarriages, hematoma size and localization, and duration of vaginal bleeding to pregnancy outcome. The study group consisted of 45 women of 852 (5.2 %) referred for ultrasound examination due to vaginal bleeding in the first trimester of pregnancy, who were found to have a RCH in the presence of a singleton live embryo. The control group consisted of 807 women with the same gestational age, with vaginal bleeding, and vital singleton pregnancy without sonographically proven RCH. All were followed with repeated sonograms at seven days intervals until bleeding ceased, the RCH disappeared or abortion occurred. The authors have examined the possible relationship of duration of vaginal bleeding, hematoma size and localization, parity, and previous miscarriages to pregnancy outcome (spontaneous abortion, term or preterm delivery). The researches have shown that the previous miscarriages and deliveries do not affect the occurrence of RCH. In the group with a RCH on the back wall of uterus, as well as repeated bleedings affect higher frequency of spontaneous miscarriages. Hematoma size itself does not affect higher frequency of spontaneous miscarriage. Ultrasound is the method of choice for diagnosing the existence of aRCH. The frequency of RCH in the group of threatened spontaneous miscarriages is 5.2 %. A RCH on the back wall and repeated bleedings affect higher frequency of spontaneous miscarriages. Therapy procedure is based on strict bed rest and administration of: pregnyl, gestagenic drugs, progesterone, antihistamines, and sedatives.