Anna Knafel

Postgraduate School of Molecular Medicine

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Marcin Wiecheć

Jagiellonian University

Agnieszka Nocuń

QT Ultrasound (United States)

Artur Ludwin

Jagiellonian University

Tomasz Banaś

The Maria Sklodowska-Curie National Research Institute of Oncology

Kazimierz Pityński

Jagiellonian University

Robert Jach

Jagiellonian University

I. Ludwin

Jagiellonian University

ŁW

Łukasz Wicherek

Postgraduate School of Molecular Medicine

Ewa Wiercińska

Head Office of Geodesy and Cartography

Antoni Basta

Foundation for Research and Technology Hellas

Cooperative Institutions

Baylor College of Medicine

Texas Children's Hospital

Thomas Jefferson University

University of Alabama

Jagiellonian University

Baylor University

Division of Undergraduate Education

University of Alabama at Birmingham

Northeast Ohio Medical University

Universitat de Barcelona

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Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012)

Gynecologic and Obstetric Investigation (2015)

Tomasz Banaś Kzimierz Pitynski Robert Jach Anna Knafel Artur Ludwin

The aim of this study was to determine the incidence, mortality rates and trends of vulvar and vaginal cancers in Poland.Data were retrieved from the Polish National Cancer Registry. Age-standardised rates (ASRs) of cancer incidence and mortality were calculated by direct standardisation, and joinpoint regression was performed to describe the trends using the average annual percent change (AAPC).From 1999 to 2012, the number of diagnosed cases of vulvar cancer was 5,958, and the ASRs of incidence varied from 0.99 to 1.18, with a significant trend towards a decrease (AAPC -0.78; p < 0.05). The ASR of mortality varied from 0.39 to 0.62, with a slight but insignificant increase in trend (AAPC 0.72; p > 0.05). The ASR of vaginal cancer incidence varied from 0.21 to 0.31, while the ASR of mortality ranged from 0.09 to 0.22. This study also proved a significantly falling trend in vaginal cancer mortality (AAPC -4.69; p < 0.05) and a decreasing trend in vaginal cancer incidence (AAPC -1.67; p > 0.05).The rarity of vulvar and vaginal cancers as well as the decline in their incidence rates should not discourage further research on the epidemiology and treatment of these conditions.

10.1159/000381770

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Citations (7)

Acknowledgement to the Reviewers

Gynecologic and Obstetric Investigation (2015)

Hua-Qian Liu Qiang Liu Xue-Bing Sun Wen-Min Chang Flavia Sorbi

Acknowledgement

10.1159/000442361

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Citations (0)

Two- and Three-Dimensional Ultrasonography and Sonohysterography versus Hysteroscopy With Laparoscopy in the Differential Diagnosis of Septate, Bicornuate, and Arcuate Uteri

Journal of Minimally Invasive Gynecology (2013)

Artur Ludwin Kazimierz Pityński I. Ludwin Tomasz Banaś Anna Knafel

Bicornuate uterus

Septate

Transvaginal ultrasonography

Transvaginal sonography

10.1016/j.jmig.2012.09.011

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Citations (130)

How Effective Is First-Trimester Screening for Trisomy 21 Based on Ultrasound Only?

Fetal Diagnosis and Therapy (2015)

Marcin Wiecheć Anna Knafel Agnieszka Nocuń Anna Matyszkiewicz Magdalena Juszczak

To evaluate the most common first-trimester ultrasound features of fetuses with trisomy 21 (T21) and to examine the screening performance for Down syndrome (DS) using only ultrasound-based protocols. To investigate whether maternal age (MA) has an impact on the efficacy of the ultrasound-based screening methods.In a prospective study, 6,265 patients were examined. Two ultrasound-based risk calculation protocols were applied: 'NT' (based on nuchal translucency) and 'NT+' (based on NT and secondary markers).A total of 5,696 patients were enrolled for analysis; 84 subjects with T21 were identified. Combinations of abnormal ultrasound markers were observed in only 1.2% of euploid fetuses compared to 71.5% of fetuses with T21. Among 17.9% of DS cases with cardiac anomaly, 14.3% comprised atrioventricular septal defects. For a false-positive rate of 3%, the detection rates of T21 were 73.8 and 91.7% for the 'NT' and 'NT+' protocols, respectively. The efficacy of both methods was affected by MA.Most of the fetuses with DS demonstrate a combination of ultrasound markers of aneuploidy in the first trimester. The 'NT+' protocol is efficient and provides comparable performance as a combined screening test. It is a valuable method, especially when the access to biochemical analysis is restricted.

Trisomy

10.1159/000434632

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Citations (12)

Combined screening test for trisomy 21 – is it as efficient as we believe?

Journal of Perinatal Medicine (2016)

Marcin Wiecheć Agnieszka Nocuń Anna Knafel Ewa Wiercińska Jiri Sonek

To compare two first-trimester screening strategies: traditional combined screening and the one based on ultrasound markers only. We investigated the effect of maternal age (MA) on the screening performance of both of these strategies.This was a prospective observational study based on a non-selected mixed-risk population of 11,653 women referred for first-trimester screening. The study population was divided in two groups: combined screening (CS) and ultrasound-based screening (US). Absolute risk was calculated to determine the influence of MA on screening performance.The CS arm comprised 5145 subjects including 51 cases of trisomy 21 (T21), and the US arm comprised 5733 subjects including 87 subjects with T21. Seven hundred and seventy-five subjects were excluded from the study. For a false positive rate (FPR) of 3%, the detection rate (DR) of T21 in CS arm was 78% vs. 90% in US arm. For 5% FPR, DR was 84% and 94% in CS and US arm, respectively. MA had an influence on DR positive rates in CS: both DR and FPR for T21 increased with advance in MA.The US protocol showed higher DR of T21 compared to the CS one. It may be considered as a viable alternative to CS for T21 where access to biochemical testing is limited.

Trisomy

False positive rate

Medical screening

Screening test

10.1515/jpm-2016-0031

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Citations (8)

Front & Back Matter

Gynecologic and Obstetric Investigation (2012)

Aysel Uysal Derbent Mustafa Ulukanlıgil Esra Aktepe Keskin Gül Soylu Hasan Kafalı

10.1159/000338917

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“Y Sign” at the Level of the 3‐Vessel and Trachea View: An Effective Fetal Marker of Aortic Dextroposition Anomalies in the First Trimester

Journal of Ultrasound in Medicine (2017)

Marcin Pasternok Agnieszka Nocuń Anna Knafel Mariusz Grzesiak Maciej Orzechowski

The "Y sign" at the level of the 3-vessel and trachea view corresponds to thinning of main pulmonary artery and arterial duct and a dilated transverse aortic arch. The purpose of this study was to evaluate the Y sign for the diagnosis of aortic dextroposition anomalies at the time of the first-trimester scan and to assess the screening performance of only the Y sign, only abnormal left axis deviation (axis sign), and their combination for the diagnosis of aortic dextroposition anomalies.A prospective evaluation of 6025 pregnant women undergoing first-trimester ultrasonography was conducted. The cardiac axis was measured in all examined patients and considered abnormal (positive axis sign) at greater than 57 °. The frequency of the Y sign and the axis sign was assessed for this population, and their screening performance for the diagnosis of aortic dextroposition anomalies was calculated.A total of 5775 patients fulfilled the inclusion criteria. Aortic dextroposition anomalies were diagnosed in 17 cases (tetralogy of Fallot in 8 and Fallot-like double-outlet right ventricle in 9). The Y sign was found in 18 of 5775 (0.3%) fetuses examined, of which 7 of 18 were confirmed with tetralogy of Fallot, 9 of 18 with a Fallot-like double-outlet right ventricle, and 2 of 18 with pulmonary stenosis. A positive axis sign of greater than 57 ° was found in 20 fetuses, including 4 with normal heart anatomy. The sensitivity values of the Y sign, the axis sign, and their combination were 94%, 76%, and 94%, respectively.Visualization of the Y sign should increase the suspicion of aortic dextroposition anomalies in the late first trimester. The screening performance of the Y sign alone and in combination with an abnormal cardiac axis was high and may aid in the early diagnosis of aortic dextroposition anomalies in the fetus.

Dextrocardia

10.1002/jum.14533

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Citations (10)

OP16.01: 3D‐SIS in differential diagnosis of septate, bicornuate and arcuate uterus; the comparative study of accuracy with 2D‐TVS, 3D‐TVS and 2D‐SIS

Ultrasound in Obstetrics and Gynecology (2010)

Artur Ludwin I. Ludwin Anna Knafel Tomasz Banaś P. Basta

To evaluate the diagnostic accuracy of 3D-SIS, 3D-TVS, 2D-TVS (initial TVS diagnosis and an expert TVS) and 2D-SIS in the differential diagnosis of septate, bicornuate and arcuate uteri. 117 women with recurrent abortion or infertility and 2D-TVS initial diagnosis of septate, bicornuate or arcuate uterus were included in the study. Diagnostics work-up comprised of initial 2D-TVS diagnosis, followed by 2D-TVS performed by an experienced examiners, 3D-TVS, 2D-SIS and 3D-SIS. In order to assess the accuracy of these methods all the patients underwent hysterolaparoscopy (HL) to establish the final diagnosis. The correlation between the results of each method was evaluated and diagnostic accuracy of each method was assessed in the whole group of women as well as in the subgroups of arcuate, septate and bicornuate uteri using receiver operator curves (ROC) method by estimating the area under the curve (AUC). The 3D-SIS was found to be the best diagnostic method with an exact agreement with HL-obtained diagnosis. Other tools had a lower positive correlation (gamma index 3D-TVS: 0.93; 2D-SIS: 0.89, 2D-TVS by expert user: 0.77; and initial 2D-TVS: 0.48; all statistically significant, P < 0.001). All techniques, except initial 2D-TVS diagnosis, were found to have the highest (100%) accuracy, sensitivity and specificity in detection of bicornuate uterus cases. Both 2D-SIS and 3D-SIS were found to be better tools in detection of septate uterus (ACC 100%). They were followed by 3D-USG (ACC 97.5%). In diagnosis of arcuate uterus, after 3D-SIS,the 3D-TVS was found to have the highest accuracy (96.2%). 3D-SIS is the most accurate differentiation method of septate, bicornuate and arcuate uterus. It should be used in cases of ambiguous 3D-TVS results. 2D-SIS is comparable to 3D-SIS in differentiation of septate uterus with bicornuate uterus and it may be used in order to verify 2D-TVS results that depend on the investigator's experience, especially when the access to 3D-imaging technology is restricted.

Bicornuate uterus

Septate

10.1002/uog.8069

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Expression of the Costimulatory Molecule B7-H4 in the Decidua and Placental Tissues in Patients with Placental Abruption

Biomedicines (2022)

Monika Bączkowska Magdalena Dutsch-Wicherek Ewa Przytuła Jan Faryna Cezary Wojtyła

B7 homolog 4 protein (B7-H4), a member of the B7 family, is a immunomodulatory membrane protein. The aim of the study was to evaluate the expression of this protein in the decidua and placental tissues in case of placental abruption (PA) compared to cases of retained placental tissue (RPT) and controls. Tissue samples were obtained from 47 patients with PA, 60 patients with RPT, and 41 healthy controls. The samples were stained for B7-H4 expression, analyzed by an expert pathologist, and a semi-quantitative scale was applied. A statistical analysis revealed that the expression of B7-H4 was significantly higher in the decidua in PA samples compared to samples from patients with RPT (p-value < 0.001) and healthy controls (p-value < 0.001). The expression of B7-H4 in the placental chorionic villus was significantly higher in PA samples in relation to samples from healthy controls (p-value < 0.001) but not in relation to RPT samples (p-value = 0.0853). This finding suggests that B7-H4 might play an important role in mechanisms restoring reproductive tract homeostasis. Further research is necessary in regard to the role of B7-H4 in PA.

Decidua

Placental abruption

10.3390/biomedicines10040918

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Citations (3)

OC08.05: Sonohysterography with constant infusion pressure (SHG‐CP) in the assessment of myomas qualified to hysteroscopic myomectomy

Ultrasound in Obstetrics and Gynecology (2010)

Artur Ludwin I. Ludwin P. Basta Anna Knafel Tomasz Banaś

To assess and compare the sonohysterography with constant infusion pressure (SGH-CP) as preoperative evaluation method of submucous myomas in their classification and qualification to hysteroscopic myomectomy to traditional diagnostic methods i.e. TVS, diagnostic hysteroscopy (DH), and conventional sonohysterography (SHG). 58 women underwent preoperative evaluation of myomas according to ESH classification and STEP-W classification by TVS, SHG, SHG-CP, DH and were compared with intraoperative assessment by transrectal intraoperative ultrasonography (TRUS) during hysteroscopy. Electronically controlled constant infusion pressure of saline solution during SGH-CP (120 mmHg) was used. Statistical analysis: Chi2 Pearsons and tau-b Kendall tests. The group appurtenance of myomas by ESH classification and assessment by STEP-W system was completely consistent with intraoperative results of assessment if to diagnostics the SHG was used (tau-b = 1). High conformity was obtained by using traditional SHG (tau-b = 0.96 and 0.94) and DH (tau-b = 0.84 i 0.85). USG TV showed the lowest conformity (tau-b = 0.71 i 0.7). SHG-CP should be the method of choice in preoperative assessment of myomas qualified to hysteroscopic myomectomy. This especially concerns the myomas with deep penetration of myomectrium.

Transvaginal ultrasonography

10.1002/uog.7814

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Citations (0)