The usefulness of periostin determination in gynecology and obstetrics.

Periostin (POSTN) is a multifunctional glycoprotein that belongs to the group of extracellular matrix (ECM) proteins. Due to the molecular structure, cellular interactions, tissue locations as well functions of POSTN, we realize that its pivotal role is organization and regulation of ECM microenvironment. In available databases there is a lack of data summarizing current knowledge about POSTN expression in the field of gynecology and obstetrics. We conducted a search in PubMed of the National Library of Medicine and Google Scholar. Databases were extensively searched for all original and review articles/book chapters published in English until December 2019 and related to periostin expression. All relevant articles were reviewed and presented as appropriate. In the field of POSTN expression there is only one paper evaluating its involvement in cervical cancer cell metabolism and only two studies analyzing its myometrial commitment: maintenance during pregnancy and induction of parturition in physiology as well control of fibroids biology in pathology. Much more attention has been devoted to the expression of described protein in the endometriosis, and above all in ovarian cancer. Finally, a few studies carried out among pregnant women were presented. In this review study we presented current knowledge about periostin expression in the field of gynecology and obstetrics. Many achieved results are interesting and further studies are needed to verify some hypotheses. Structure, signaling pathways as well many functions of periostin are well-described. However, as it was clearly shown there is a lot of unknown issues which are waiting to be explored.

Correlation of Pyruvate Kinase M2 Expression with Clinicopathological Data in Ovarian Cancer.

BACKGROUND/AIM: It has been shown in many studies that expression of pyruvate kinase (PK) enzyme plays a key role during cellular metabolism. There is evidence that cancer cells manifesting very dynamic proliferation may control their division in various mechanisms, i.a. by expression of PKM2 isoform. The exact role of PKM2 in ovarian cancer (OC) cells and cancer associated fibroblasts (CAFs) have not been elucidated. MATERIALS AND METHODS: The present study was focused on analysis of PKM2 expression in cancer cells and CAFs in 97 OC cases, mostly of serous histological type. Moreover, relationships between expression of PKM2 and proliferation (Ki-67; MCM-2, -3, -7; cyclin D1), vascular (CD31, D2-40) and mesenchymal (Vim and αSMA) markers as well as receptors (ER, PR, HER2, EGFR) were examined. All observations were evaluated in regard to available clinicopathological data. RESULTS: The expression of PKM2 was disclosed only in cytoplasm of OC cells. No statistically significant correlation between PKM2 and tested markers was found. In regard to available clinicopathological data only an increasing trend of PKM2 expression with increasing grade of histological malignancy G was found (p=0.07). CONCLUSION: Due to achieved results concerning expression of PKM2 there is a lack of evidence for its diagnostic and prognostic usage in OC.

Comparison of minichromosome maintenance proteins (MCM-3, MCM-7) and metallothioneins (MT-I/II, MT-III) expression in relation to clinicopathological data in ovarian cancer.

BACKGROUND: Despite great progress in the understanding of ovarian cancer biology, clinicopathological data (i.e. grade, stage, histological type and residual disease after surgery) seem to be the most important prognostic factors. MATERIALS AND METHODS: The present study aimed to investigate the relationship between expression of minichromosome maintenance proteins (MCM-3, MCM-7), metallothioneins (MT-I/II, MT-III), and Ki-67 in 103 ovarian cancer cases, mostly of the serous histological type. RESULTS: Statistical analysis revealed strong positive correlations in the expression of MCM-3 vs. Ki-67 (r=0.492), MCM-7 vs. Ki-67 (r=0.651), and MCM-3 vs. MCM-7 (r=0.515) (all p<0.0001). The Kruskal-Wallis test showed an association of increased expression of MCM-3 and Ki-67 with increasing grade of histological malignancy (p=0.0011, p=0.029, respectively). Regarding clinical progression, cytoplasmic MT-I/II expression was significantly higher in more advanced disease stages (III+IV vs. I+II; p=0.0247). CONCLUSION: Due to the correlations shown here, the determination of MCM proteins as proliferation markers of ovarian cancer, should be strongly considered.

Initiation of preterm labor.

Preterm births are still a major problem in obstetrics. It is estimated that preterm births occur in about 12% of all pregnancies. Due to advances in medical technology and better care of fetuses and premature babies, the preterm mortality rate has been falling (as recently as 1995 the survival rate in the US for premature infants born at 34 weeks amounted to only a fraction of the corresponding rate for those born after 37 weeks). In the US in 2005, preterm births cost society approximately $26 billion, and medical care for premature babies cost more than $51 billion. Only the richest countries can afford such costly medical care. That is why it is not only the individual aspects but also the social aspects that are important when studying preterm birth mechanisms and ways of preventing them. The existing research indicates that both spontaneous mature birth and preterm birth begin and proceed in a similar manner. This is confirmed by the similar involvement in both processes of corticotropin-releasing hormone, urocortin, extracellular stress protein HSP70 (amniotic fluid heat shock protein), prostaglandins, proinflammatory cytokines or glucocorticosteroids. Apparently, at the beginning of either a preterm birth or a term birth, there is a stimulus that ends the development of the fetus or initiates birth. This stimulus works via feedback through placental hormones and through substances present in the fetal membranes, ultimately leading to functional progesterone withdrawal (FPW), thus leaving the uterus sensitive to contractive factors.

Depression in women aged 75-89--predisposing factors and preventive measures.

BACKGROUND: There are analyses showing the relationship between low and irregular physical activity and the risk of more frequent occurrences of depression symptoms in the future. There are studies that do not prove the connection between those two dependencies. OBJECTIVES: The aim of this study was to find the relationship between physical activity before menopause and the occurrence of depression in senium. MATERIAL AND METHODS: The study was comprised of 200 randomly selected women, aged 75-89 years, who were treated in the local department of general surgery and oncology from January to June 2009. The study used a 15-point Geriatric Depression Scale which is an integral part of the EASY care (Polish version 1999-2002) questionnaire to assess emotional efficiency, and the Questionnaire Survey for Research on Physical Activity in Older People which contains 8 questions. The results were statistically analyzed using a Student's test and basic probabilities calculations. RESULTS: The probability of depression in women aged 75-89 is 0.8. Increased physical activity in pre-menopausal women neither affects the level of depression, nor prevents it (p < 0.1). Depression was more common in people living alone, in which case the probability is 0.85. Postmenopausal women enjoy a beneficial impact on physical activity in the following areas: previous activity (p < 0.001), family support (p < 0.0001), GP support (p < 0.001), and television education (p < 0.001). CONCLUSIONS: Depression among elderly women is very common. In this study, depression was found in 80% of senior women. There is a relationship between depression and physical activity. Increased physical activity in premenopausal women neither affects the level of depression, nor prevents it. There was no correlation between age, weight, education, place of residence and depression. Depression was more common in people living alone.

[Assessment of cell proliferation based on group analysis of Ki-67 index in serous ovarian cancers]. / Ocena aktywnosci proliferacyjnej komórek na podstawie calosciowej analizy indeksu Ki-67 w rakach surowiczych jajnika.

OBJECTIVES: Ovarian neoplasms are very important problems in medicine, because they account for 23% of all female genital neoplasms, and they are the cause of 47% deaths among women suffering from cancers of the female reproductive organs. Growth of the neoplasms depends on the speed of cells' reproduction. Monoclonal antibody Ki-67 detects specific antigen--nonhistonic protein of cellular nucleus, which is characteristic for dividing cells. It gives the possibility of using Ki-67 to establish proliferating index, especially in intensely proliferating neoplasm tissues. PURPOSE: The aim of the study was the evaluation of clinical parameters compared with histological and laboratory findings in serous carcinomas. The research analysed the level of proliferating index Ki-67 in patients with ovarian cancers and in control group. MATERIALS: The material used consisted of 41 cases of serous ovarian cancer. For clinical examinations we chose only patients who underwent primary surgical operation. The control group for Ki-67 levels were 15 patients with benign serous ovarian adenomas. METHODS: For showing Ki-67 reacting antigen in paraffin samples of ovarian cancer we used DAKO Serum (Rabbit Anti Human Ki-67 Antigen N 1574 LSAB). Tissue proliferation activity called proliferation index--IP Ki-67 was measured as a proportion of numbers of cells reacting with antigen to the total number of cells in the sample. RESULTS: Mean level of IP Ki-67 in examined group was 29.01%, compared to 5.84% in the control group and that was statistically significantly higher (p<0.05). CONCLUSIONS: The analysis of cells' proliferative activity differentiates benign adenomas from ovarian serous carcinomas. But I didn't find this kind of correlation among analysed clinical and laboratory parameters and the level of Ki-67 index in ovarian serous cancers.

[Analysis of labor methods after cesarean sections in the last 50 years]. / Analiza sposobów ukonczenia ciazy po przebytych cieciach cesarskich w ostatnim piecdziesiecioleciu.

The aim of the work was to analyze the incidence and changes in the labors after previous cesarean section in the last 50 years. The study was conducted on the basis of the labors documented in our Clinic between 1946 and 1996 year. Cesarean sections are more and more frequent in these years and the amount of the patients with previous cesarian section elevates. We observed the increase rate of repeat cesarean delivery in comparison to vaginal birth after cesarean section. The trial of vaginal labor after cesarean section is usually successful in young patients (under 25 years old), repeat cesareans is mainly observed in patients older than 35. The permanent decrease in the incidence of instrumental deliveries in comparison with cesarean section was observed. The trial of vaginal labor after cesarean section, after exclusion of contraindicatins, should be routine procedure decreasing the amount of cesarean sections.

[Antibiotic prophylaxis after abdominal hysterectomy--comparative analysis of two treatment patterns]. / Profilaktyczna antybiotykoterapia stosowana podczas zabiegu histerektomii brzusznej--analiza porównawcza dwóch schematów postepowania.

OBJECTIVES: The aim of the study was to evaluate the efficacy of antibiotic prophylaxis after abdominal hysterectomy. Additionally we compared costs of the treatment patterns and the periods of hospitalization. MATERIALS AND METHODS: We studied 70 cases of women operated in I Obstetrics and Gynaecology Clinic in Wroclaw without serious internal diseases, divided in two groups: on the basis of the treatment patterns. RESULTS: We showed that: Antibiotic prophylaxis decreases the risk of infectious complications after surgery in patients with abdominal hysterectomy. We did not observe any essential therapeutic differences between short-term monotherapy and longterm combined antibiotic treatment in perioperative prophylaxis. CONCLUSIONS: Monotherapy should be a method of choice in antibiotic perioperative prophylaxis. Monotherapy essentially reduces the cost of surgery procedure.

[Etiology and diagnostic problems in pregnant women with uterine myomas]. / Etiopatogeneza i implikacje terapeutyczne wynikajace z problemu ciazy powiklanej wystepowaniem miesniakow macicy.

OBJECTIVES: Authors present different aspects of coexistence of uterine myomas with pregnancy. In the article special attention was given to etiology, complications and practical methods of treating pregnant women. DESIGN: The occurrence of uterine myomas is connected with the period of hormonal activity of the ovaries, so with the female reproductive age. Uterine myomas are tumors whose actions are dependent on hormonal action of estrogens which are often characterized by acceleration of growth especially in the first trimester of pregnancy. The dynamics of uterine myomas is specifically different and independent of neither the original size nor localisation of the myomas. During the antenatal period together with the involutional changes of the uterine muscle there is an observed decrease in the size of the myomas. MATERIALS: Based on literature, the effect of uterine myomas on fertility of women, pregnancy follow-up, development of foetus and occurrence of perinatal complications was analysed. The diagnostic methods as well as procedures underwent analysis depending on the localisation of the changes. The effect of nonpharmacological and surgical therapy were compared in pregnant women and those planning to conceive. CONCLUSION: In modern obstetrics, pregnancy complications as a result of uterine myomas is still actual and there is a lot of controversy on this topic. This is because up until now, there is no generalised opinion on therapeutic procedures and ways of resolving pregnancy complicated by the presence of uterine myomas.

Gliomatosis peritonei with mature teratoma of the ovary.

We report a case of menstrual mature teratoma of ovary with implants of glial tissue in peritoneum and its adnexa. After resection of the tumour and omentum laparoscopic examination was performed and revealed reduction, fibrosis of glial implants and massive cellular reaction.