The duration of pregnancy in ecologically-challenged area. The effects of environmental pollution with aromatic hydrocarbons on the angiogenesis and elements of the mesenchymal tissue of the human placenta

Introduction: The literature presents only few reports regarding the effects of elevated levels of aromatic hydrocarbons (AH) on the functions of the human placenta. The effects of environmental contamination with AH (including phenol and 1-hydroxypyrene) have certain negative effects on parenchymal organs such as human placenta. Objective: The paper aimed to assess the effects of elevated levels of AH on the placental angiogenesis and elements of the mesenchymal tissue of the placenta. Material and methods: Tissue material from 50 afterbirths from Płock constituted a study group, whereas 50 afterbirths from Kutno constituted a control group. Immunohistochemical reactions with the peroxidase method using LSAB kits (DAKO) were performed. The extent and intensity of reactions were analysed. The levels of phenols and 1-hydroxypyrene in the excreted urine of pregnant women (undergoing delivery) were detected using gas chromatography and colorimetry. Results: The levels of phenol and 1-hydroxypyrene in the excreted urine were demonstrated to be statistically significantly higher in patients living in the area of Płock. Statistically significantly higher expression of antibodies indicating placental angiogenesis was observed in the placentas in the Płock group (p < 0.01). Moreover, lower expression of vimentin indicating reactions with proteins in mesenchymal cells was observed in the Kutno group (p < 0.01). Conclusions: Pregnancy in the environment with elevated levels of aromatic hydrocarbons has detrimental effects on the human placenta. The foetus is protected by activation of adaptation and compensation mechanisms that are manifested as significant angiogenesis and greater development and differentiation of mesenchymal cells compared to the control group

Prostate specific antigen - PSA and histopathological findings of endometrium in women with fibrocystic breast disease

Abstract Objective: The aim of the study was to evaluate the relationship between serum free and total PSA and histopathological findings in women with fibrocystic mastopathy. Material and methods: 176 women with fibrocystic breast disease, aged 18 to 45 years. - group I: comprised 114 patients with cysts 10mm in diameter The control group consisted of 46 healthy women aged 18 - 45 years who had no breast pathology. Total PSA (PSA-T) and free PSA (PSA-Free) were measured by an ultra-sensitive fluoroimmunometric DELFIA assay (Prostatus PSA Free/Total Wallac, Turku, Finland). The detection limit for PSA was 0.01 ng/ml. Endometrial samples have been obtained with Pipelle probe between 22 and 24 days of the menstrual cycle. Results: In the control group secretory endometrium was more frequently detected than in the mastopathy group (chi2=11,15, p=0.01). Proliferatory (chi2=8.27, p=0.004) and presecretory endometrium (chi2=4.61, p=0.03) were more frequently detected in the mastopathy group than in controls. We did not find statistically significant relationship between the mean PSA concentrations between the groups in relation to histopathological findings. Conclusions: No relationships between free and total PSA measured in the follicular phase of the menstrual cycle and endometrial findings were detected in our study. Further research is required to evaluate the relationship between PSA and endometrial findings

Prostate specific antigen in women

Summary PSA–prostate specific antigen is considered to be a useful marker in the diagnosis and monitoring of prostate cancer. Currently, PSA was also detected in serum and tissues of women. We reviewed the literature dealing with the existence and role of this marker in women

Ocena obrazów morfologicznych endometrium u pacjentek z zespołem policystycznych jajników

Abstract Aim: To evaluate endometrial histologic morphology in patients with polycystic ovary syndrome. Material and methods: 93 women, aged 18-35, who were hospitalized in the Gynaecologic Endocrinology Department of Warsaw Medical University due to PCOS have been qualified for the research. All patients had menstrual pattern of oligomenorrhoea and mean cycle length of 49+/-38 days. The control group consisted of 40 healthy women with regular menstrual cycles and no symptoms of hyperandrogenism. In case of each patient the fallowing data were analyzed: age, menarche age, Body Mass Index and endometrium histologic findings. The endometrium was aspirated using the Pipelle probe. Statistic analysis was performed and the values of pStreszczenie Cel pracy: Celem pracy jest ocena obrazów histologicznych endometrium u pacjentek z zespołem policystycznych jajników. Materiał i metodyka: Do badania zakwalifikowano 93 kobiety w wieku 18-35 lat hospitalizowane w Klinice Endokrynologii Ginekologicznej Akademii Medycznej w Warszawie z powodu PCOS. Wszystkie pacjentki miały cykle miesiączkowe o typie oligomenorrhoea, średnia długość cyklu 49+/-38 dni. Grupę kontroląa stanowiło 40 zdrowych pacjentek z regularnymi miesiączkami, bez cech androgenizacji. U każdej pacjentki analizowano następujące dane: wiek metrykalny, wiek menarche, Indeks Masy Ciała (BMI) oraz oceniano obraz histologiczny endometrium po pobraniu materiału przy użyciu sondy Pipelle. Analizy statystycznej dokonano przy pomocy testu mediany oraz testu na równość dwóch frakcji z dwóch prob. Wartości

Androgen and 17-hydroxyprogesterone concentrations in blood serum versus menstrual patterns in women with polycystic ovary syndrome (PCOS)

Abstract The aim of the study: to evaluate correlation between androgen and 17-hydroksyprogetserone concentrations in blood serum and menstrual patterns of women with polycystic ovary syndrome. Material and methods: 227 patients with polycystic ovarian syndrome (PCOS), aged 18 to 35 years, hospitalized at the Department of Gynecological Endocrinology. All patients with PCOS presented clinical and biochemical evidence of hiperandrogenism with oligoovulation and/or ultrasonographic appearance of polycystic ovaries. PCOS was diagnosed according to the Rotterdam Criteria after excluding reasons such as: congenital adrenal hiperplasia, adrenal and ovarian tumors, hiperprolactinemia and hypo- hiperthyreosis. The following hormone concentrations were measured in each patient: total testosterone (TT), androstendione (A), dehydroepiandrosterone sulphate (DHEAS) and 17-hydroxyprogesterone (17-OHP). The patients were divided into 4 groups: I – eumenorrhoeic (n=66), II – polymenorrhoeic (n=32), III – oligomenorrhoeic (n=93), IV – with secondary amenorrhea (n=36). The control group consisted of 40 patients with normal regular menstrual cycles and no clinical/biochemical sings of hiperandrogenism. Statistical analysis was performed using one-way Anova and NIR test.

Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections

In recent years, the worldwide percentage of deliveries by caesarean section has increased. However, this has only improved obstetric outcomes in low-income countries [1, 2]. Unfortunately, in Poland and other high-income countries, the rate of caesarean section, which is greater than 20%, is no longer associated with decreases in the perinatal mortality of mothers and their offspring. Currently in Poland, 43.85% of births are by caesarean section [3]. The increased number of caesarean sections may be associated with the development of perinatal medicine, and of diagnostics in particular, which can have an impact on the frequency of detecting foetal abnormalities. The results of randomised multicentre study carried out across various populations in the last two decades have indicated there is a greater risk to a child during vaginal delivery in cases of breech presentation [4]. Also, among women with one prior caesarean, planned elective caesarean section compared with planned vaginal birth was associated with a lower risk of fetal and infant death or serious infant outcome [5]. As a consequently, some national associations of obstetricians and gynecologists recommended the classification of pregnant women with these abnormalities for elective caesarean section. Epidemiological data from various populations indicate, however, that the main indications for caesarean section are still labour arrest and intrapartum fetal hypoxia [6, 7]

Farmakoterapia mięśniaków macicy

Mięśniaki macicy są najbardziej rozpowszechnioną formą nienabłonkowych, niezłośliwych nowotworów ma­cicy. Są to monoklonalne guzy mięśniówki macicy zbudo­wane z dużej ilości macierzy zewnątrzkomórkowej zawie­rającej kolagen, fibronektynę oraz proteoglikany. Dostępne wyniki badań epidemiologicznych nie precyzują dokładnie częstości występowania mięśniaków macicy. Szacuje się, że u kobiet w wieku prokreacyjnym występują u 20–50% badanych, jednocześnie obserwuje się wzrost częstości występowania tej patologii do 70% w populacji kobiet w wieku około 50 lat oraz do 80% u kobiet rasy czarnej. U kobiet w wieku prokreacyjnym około 30% mięśniaków może dawać objawy kliniczne w postaci nieprawidłowych krwawień z macicy skutkujących anemizacją pacjentki. Diagnostyka krwawień w tej populacji kobiet powinna być pogłębiona w celu wykluczenia przerostu błony śluzowej macicy oraz raka endometrium. Duże mięśniaki macicy mogą powodować objawy dysfunkcji jelit oraz pęcherza moczowego. Objawami mięśniaków mogą też być bolesne miesiączki, niecykliczny ból w obrębie miednicy mniej­szej, niepłodność oraz nawracające poronienia. Należy podkreślić, że nieprawidłowe krwawienia miesiączkowe wywoływane przez mięśniaki na ogół ustępują samoist­nie w okresie menopauzy, a stopień nasilenia objawów uciskowych zmniejsza się w tym czasie wraz z fizjolo­gicznym procesem stopniowej inwolucji mięśniaków po menopauzie