Usefulness of three dimensional transvaginal ultrasonography and hysterosalpingography in diagnosing uterine anomalies

Objective and methods: In this study we discuss the advantages and disadvantages of HSG and 3D TV USG in diagnosing uterine anomalies. Additionally we present the results of HSG and 3D TV USG of 155 patients referred to our Department because of infertility and/or suspected uterine anomalies. Results: After performing HSG, in the studied group 118 patients were diagnosed with a normal uterus, 4 with unicornuate (including 1 patient with an unicornuate uterus, with rudimentary horn), and 6 with didelphys uterus. In 22 cases, due to the lack of evaluation of external contour of the uterus, we could not differentiate arcuate, septate and bicornuate uterus. After performing 3D TV USG we confirmed the HSG diagnosis and precise differentiated 22 disputable cases: 8 with arcuate, 11 with septate (2 complete and 9 partial) and 3 with complete bicornuate uterus. In 5 patients, severe pain and lack of cooperation during HSG made the acquisition of diagnostic X-ray images impossible. In these cases 3D TV USG allowed the anatomic assessment of the uterus, a normal uterus was found in all of them. All uterine anomalies were then confirmed by hysteroscopy and/or laparoscopy. for diagnosing uterine anomalies, while 3D TV USG can accurately show the uterus anomalies and may become an alternative method to MRI

The Filtering of the Posturographic Signals Shows the Age Related Features

Objective. Lower frequencies of slow oscillations of the posturographic signals can be removed using high-pass filtering. This procedure releases postural reflexes possessing higher frequencies and lower amplitude range. Mutual dependence between the x and y components of posturographic signals was analyzed using principal component analysis (PCA). The posturographic signals of old patients with idiopathic gait disturbance were compared with the control group of similar age and with younger patients. There was also the analysis of the influence of the eyes state (open versus closed) and the head position (normal or bent back). The statistically significant differences in the mutual dependence between x and y components between the groups of patients were analyzed using MANOVA. The significant differences were observed mainly in the range of filter frequencies f=0.1–1.5 Hz and f=2.2–5.5 Hz with a maximum effect at approximately 4-5 Hz. A detailed post-hoc analysis is also presented. The differences in the higher frequency range suggest the main disturbance to be connected with the spinal reflexes. Visual and vestibular support appear insufficient for postural stability control in the idiopathic gait disturbance group. The results suggest that idiopathic gait disturbance is the final stage of the aging process of postural system

Embolizacja tętnic macicznych – zagadnienia kliniczne

The aim of the study was to present clinical issues concerning uterine artery embolization (UAE) in women with uterine fibromas. In order to ensure high clinical efficiency of UAE and prevent subsequent complications, it is necessary to carefully select patients eligible for the procedure. Patients with intramural fibromas, who do not plan to conceive, are the best candidates for the procedure. Fibroma necrosis, with following infection, and premature ovarian failure remain to be the most common complications after UAE. UAE may cause amenorrhea and increase FSH levels, what is typical for menopause. Thus, it may be responsible for problems with conception as well as optimal development of a pregnancy. It may also cause premature, iatrogenic menopause. This complication significantly more frequently occurs in women over the age of 45 as compared to younger patients. UAE is considered as an alternative therapeutic procedure, available to women who do not desire the surgery or wish to preserve the uterus. Patients subject to this procedure should be informed about the possible side effects.Celem pracy było przedstawienie zagadnień klinicznych związanych z zabiegami embolizacji tętnic macicznych (UAE) w przypadku objawowych mięśniaków macicy. Zwrócono uwagę, że odpowiednia kwalifikacja chorych do zabiegu ma kluczowe znaczenie dla wysokiej skuteczności klinicznej oraz zapobiegania powikłaniom po UAE. Kandydatkami powinny być kobiety z objawowymi mięśniakami położonymi śródściennie, które w przyszłości nie planują zachodzić w ciążę. Przedwczesne wygasanie czynności jajników, obok martwicy mięśniaka z następową infekcją stanowi jedno z najczęstszych powikłań embolizacji. Może być przyczyną przedwczesnej, jatrogennej menopauzy oraz trudności w zajściu i donoszeniu ciąży. UAE może niekorzystnie wpłynąć na funkcję jajników, powodując czasowe lub stałe zatrzymanie miesiączki, a także typowy dla okresu menopauzy wzrost poziomu FSH. Znacznie częściej to powikłanie UAE obserwuje się u kobiet po 45 roku życia, niż młodszych. Embolizacja tętnic macicznych przeprowadzana w celu leczenia objawowych mięśniaków macicy stanowi alternatywną opcję terapeutyczną, istotną dla kobiet, które nie chcą poddawać się operacji lub pragnących zachować macicę. Chore poddawane tego typu leczeniu powinny być poinformowane o możliwych skutkach ubocznych

Ecophysiological determinants of the human skeletal system

This review assessed relationships between external factors and the level of joint pathology (hip, knee, ankle, elbow, shoulder, hands and feet) in humans with dysplastic arthritis, psoriatic arthritis, rheumatoid arthritis, Sjögren’s syndrome, systemic lupus erythematosus, systemic sclerosis, degenerative joint disease, ankylosing spondylitis, osteoporosis, osteomalacia and gout. The accumulation of physiologically different chemical elements in different types of bones in humans of different ages allows for a more accurate assessment of the causal quoted response from parallel biochemical systems. These allow a better understanding of the link between exposure arising from smoking, alcohol, drugs, diseases, heredity, effects of amalgam dental fillings, diet, food preferences, chemical elements, occupational and environmental exposure to toxicants, lipoperoxidation and pro-antioxidant reactions. Physiology of the osteoarticular system determines what is responsible for bone and long-term body accumulation of toxic metals, which may be involved in the pathogenesis of bone diseases. While relationships between stressors, antioxidant system and bone condition predict potential risks in certain abnormalities and change oxidative stress. Elemental instability in the environment combined with salinity, acidity, redox potential and local changes in hydrochemical balance, enhances adverse effects. Processes of remodeling and bone mineralization continue throughout life and therefore may be a determinant of long-term accumulation of toxicants. Environmental issues affecting bioaccumulation of chemical elements in the osteoarticular system in humans is poorly understood. Alloplastic procedures, including the need for prostheses, supplemented by image layouts oxidative enzyme activities, as well as lipoperoxidation and the level of stress proteins, give a complete picture of skeletal response to external stressors. Simultaneously, the analysis of the impact of stressors on bones allows a more accurate tracing of causal quoted responses from parallel reactions. They have a direct relationship with stressors and affect the nature and degree of responses and defense capabilities. Thus they have a role in the diagnosis of diseases of the skeletal system

Anterior region of the atrioventricular perinodal area in relation to radiofrequency ablation procedures

Atrioventricular nodal reentry tachycardia base on reentry circulation in nodal-perinodal area. The radical treatment of choice is radiofrequency ablation. Procedure approached from the anterior-superior (fast) region sufficient a few seconds of energy delivery for success, however this can result in A-V block. The possibility that arrhythmias substrate may lie very superficially (success of ablation) and damage the normal structures (complication) in the perinodal region must be considered. In order to confirm this hypothesis we examined the autopsy material of 100 normal hearts, both sexes from 18 to 105 years of age (control) and 50 hearts with A-V total block 45-95 years of age (block). We paid attention to the morphology of the nodal artery (NA), atrial inputs (AI) and transitional inputs (TI). It was observed that NA at the level of the central fibrous body was positioned in 94% in the central and in 6% in the inferior part of Koch&#8217;s triangle. It was removed from the endocardium 3-6 mm in control and 2-5 mm in block group respectively (NS). In the perinodal area we distinguished AI that directly joined the A-V compact node: superficial (right part of the interatrial septum) or deep (left part). The former occurred in 100% of controls and in 80% of block groups (NS), and the latter in 80% of control group and in 34% in block respectively (p < 0.05). The real substrate of arrhythmia in anterior-superior region lies very superficially and far from the conduction tissue; NA in examined hearts was lying deep beneath the endocardium; ablation close to the node could result in A-V block

The analysis of activity of cathepsin D and &#945;1-antitrypsin with obese people and the evaluation of the influence of body mass changes to the above-mentioned parameters

WSTĘP. Otyłość jest chorobą przewlekłą charakteryzującą się zwiększeniem ilości tkanki tłuszczowej powyżej 25% u mężczyzn i powyżej 30% u kobiet oraz wskaźnikiem masy ciała (BMI, body mass index) &#8805; 30 kg/m2. Otyłość upośledza liczne funkcje metaboliczne i mechaniczne organizmu człowieka, prowadząc do pogorszenia jakości życia i zwiększenia ryzyka przedwczesnego zgonu. Celem niniejszej pracy była ocena wpływu zmiany masy ciała na aktywność katepsyny D i &#945;1-antytrypsyny w surowicy krwi u osób z otyłością. Określono także BMI, masę ciała i obwód talii. Oznaczenie aktywności i stężenia wymienionych parametrów biochemicznych oraz antropometrycznych wykonano przed i po leczeniu niefarmakologicznym z zastosowaniem diety i wysiłku fizycznego. MATERIAŁ I METODY. Badaną grupę stanowiło 67 pacjentów, 40 kobiet i 27 mężczyzn, w wieku 25-70 lat, z BMI 30-45,9 kg/m2 i obwodem talii 81-125 cm u kobiet oraz 96-154 cm u mężczyzn. Otyli pacjenci stosowali dietę o obniżonej kaloryczności opartą na modelu diety śródziemnomorskiej oraz poddani byli co najmniej 3 razy w tygodniu wysiłkowi fizycznemu (nordic walking, pływanie, spacer, jazda na rowerze). Grupę kontrolną stanowiło 56 zdrowych ochotników, 28 kobiet i 28 mężczyzn w wieku 32-89 lat, z normowagą i prawidłowym obwodem talii. WYNIKI. Po 3-miesięcznym leczeniu z zastosowaniem diety i wysiłku fizycznego uzyskano istotne statystycznie zmniejszenie parametrów antropometrycznych. Średnia redukcja masy ciała wynosiła 6,6 kg, obwód talii zmniejszył się średnio o 6,1 cm, a BMI o 2,6 kg/m2. Oceniana w niniejszej pracy aktywność katepsyny D w grupie kontrolnej oraz u osób otyłych była podobna. Wzrastała ona w sposób istotny statystycznie po zmniejszeniu masy ciała za pomocą ruchu i diety. Aktywność &#945;1-antytrypsyny nie zmieniła się zarówno przed, jak i po leczeniu. Wykazano natomiast, że u osób z otyłością jest ona istotnie statystycznie wyższa niż u osób z prawidłową masą ciała. Stężenie białka całkowitego w surowicy krwi osób otyłych było istotnie statystycznie wyższe w porównaniu z grupą kontrolną, natomiast po 3-miesięcznym leczeniu niefarmakologicznym uległo istotnie statystycznej redukcji. WNIOSKI. 1. Po 3-miesięcznym leczeniu niefarmakologicznym za pomocą diety i wysiłku fizycznego wykazano zmniejszenie masy ciała, obwodu talii i BMI. 2. Trzymiesięczne leczenie niefarmakologiczne, obejmujące dietę i wysiłek fizyczny, spowodowało wzrost aktywności katepsyny D i obniżenie stężenia białka całkowitego. 3. Aktywność fizyczna i dieta są istotnymi czynnikami w redukcji tkanki tłuszczowej i masy ciała oraz w przywróceniu równowagi proteolityczno-antyproteolitycznej organizmu, która u osób z otyłością była zaburzona. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii 2010, tom 6, nr 4, 155-166INTRODUCTION. Obesity is a chronic disease which characterizes in the increase of adipose tissue by over 25% in men and by over 30% in women, and the body mass index (BMI) &#8805; 30 kg/m2. Obesity disables numerous metabolic and motor human function leading to deterioration of standard of living and increasing the risk of premature death. The goal of the presented work is to evaluate the influence of body mass changes to the activity of cathepsin D and &#945;1-antitrypsin in blood serum of obese people. BMI of obese people, body weight and waist size were determined. Marking of the activity and concentration of above-mentioned biochemical and anthropometric parameters were made before and after non-pharmacological treatment with physical exercise and diet. MATERIAL AND METHODS. The examined group consisted of 67 patients (40 women and 27 men) aged 25-70 with BMI 30-45,9 kg/m2, waist size 81-125 cm with women and 96-154 cm with men. The obese patients were on a diet with lowered caloric value based on the model of Mediterranean diet and were submitted at least three times a week to a physical effort (nordic walking, swimming, walks, cycling). The control group consisted of 56 healthy volunteers (28 women and 28 men) aged 32-89, with normal weight and waist size. RESULTS. After a three-months treatment with physical exercise and diet the statistically relevant decrease of anthropometric parameters was achieved. The average loss of body weight amounted to 6.6 kg, waist size decreased by average of 6.1 cm and the BMI factor dropped by 2.6 kg/m2. The activity of cathepsin D was similar in the control group and the obese people. It has grown in a statistically relevant way after decreasing the body weight with exercise and diet. The &#945;1-antitrypsin activity did not change before, as well as after the treatment. It was, however, pointed out that it is statistically higher in the obese people than in people with normal weight. The concentration of the total protein in blood serum of obese people was statistically higher in comparison with the control group, whereas after three months of non-pharmacological treatment it dropped statistically. CONCLUSIONS. 1. After three months of non-pharmacological treatment with exercise and diet the decrease in body weight, waist size and BMI was pointed out. 2. Three months of non-pharmacological treatment with physical exercise and diet caused an increase in the activity of cathepsin D and a decrease in concentration of the total protein. 3. Exercise and diet are significant factors in adipose tissue and body mass reduction as well as in restoring of proteolytic-antiproteolytic balance in the organism which people with obesity were upset with. Endocrinology, Obesity and Metabolic Disorders 2010, vol. 6, No 4, 155-16