Extracellular matrix proteins in healthy and retained placentas, comparing hemochorial and synepitheliochorial placentas.

The placenta expresses structural and biologically active proteins. Their synthesis is mainly regulated by genomic or nongenomic signals and modulated by hormones. These protein profiles are altered during different stages of pregnancy. The biological properties of extracellular matrix (ECM) proteins were defined and described in a number of tissues including placenta. These properties enable them to be the main players in the processes of attachment or invasion into the endometrium during initial placenta formation and its timely separation after delivery and detachment. In this review, we focused on the role of ECM proteins during attachment of the placenta to the uterine wall, its timely separation, and the implications of this process on retained or pathologically attached placenta. Although the amount of published information in this area is relatively scant, some of the key proteins and processes are well defined. We focused on the available data detailing the ECM protein profiles of human (histologically thin; hemochorial) and bovine (histologically thick; epitheliochorial) placentas and compared the shared and unique ECM proteins that are relevant to placental attachment and separation.

Phenotype of dendritic cells generated from peripheral blood monocytes of patients with ovarian cancer.

OBJECTIVES: The aim of our study was to generate dendritic cells (DCs) from peripheral blood monocytes (PBMC) of patients suffering from ovarian cancer. MATERIALS AND METHODS: Immature DCs were generated from PBMC cultured in RPMI 1640 medium with 2% human serum albumin (HSA), supplemented with recombinant human (rh) granulocyte macrophage colony stimulating factor (GM-CSF) and rh interleukin (IL)-4. After 5 days of culture, DC maturation was induced by the addition of an ovarian cancer cell line (CAOV3) lysate and after 6 days of rh tumor necrosis factor (TNF)-α for a further 2 days. The phenotype of the generated cells was assessed by flow cytometry for the expressions of human leukocyte antigen (HLA)-DR, costimulatory molecules (e.g., CD86, CD80), CD83, CD1a, and CD14. PBMC cultured in 2% HSA without rhIL-4, rhGM-CSF, rh-TNF-α, or tumor cell lysate formed the control group. RESULTS: The 2.41% (interquartile range, 1.51%-3.52%) of CD45+/CD14+ cells in cultures with rhIL-4, rhGM-CSF, rhTNF-α and tumor cell lysate was significantly lower than in the control group (31.10%; interquartile range, 11.11%-64.06%). Cultures with rhIL-4, rhGM-CSF, rhTNF-α, and tumor cell lysate showed a higher percentage (19.96%; interquartile range, 9.30%-24.42%) of fully mature CD83+/CD1a-/HLA-DR+ DCs compared with control culture (6.02%; interquartile range, 3.01%-7.37%). There was no significant difference in the expression of the immature DC marker (CD1a) between the cultures. The expression of co-stimulatory markers (CD80, CD86, HLA-DR) was greater (24.29%; interquartile range, 18.68%-33.95%) on DCs from cultures with rhIL-4, rhGM-CSF, TNF-α, and tumor cell lysate versus controls (4.93%; interquartile range, 2.67%-9.09%). CONCLUSION: Our data demonstrated that immature and mature DCs can be generated from adherent human PBMC from ovarian cancer patients cultured with rhIL-4, rhGM-CSF, rhTNF-α, and tumor cell lysates.

[Ultrasonographic detection of endometrial thickness and uterine blood flow in perimenopausal women]. / Ultrasonograficzne badanie grubosci endometrium i przeplywu w tetnicach macicznych u kobiet przed i po menopauzie.

The aim of our study was to comparison of a thickness of endometrium and blood flow parameters measured by transvaginal ultrasonography with color and "power" angio Doppler. We examined 81 women in perimenopausal period. Blood flow characteristics and histopathological changes were evaluated. There were no endometrial changes in 34 women. We detected 22 perimenopausal women and 12 postmenopausal with endometrial hyperplasia. In 13 cases we find endometrial carcinoma, 10 in postmenopausal women. Transvaginal ultrasonography with color Doppler can be using to diagnose pathology of endometrium providing that all suspicious images will be verified by other more invasive method.

[Omental torsion in pregnant woman]. / Skret sieci wiekszej u kobiety ciezarnej.

A case of triple omental torsion in the 17th week of pregnancy is presented. A 29-year old woman, gravida 3, para 2 was admitted to the hospital because of acute right sided, lower abdominal pain. Clinical symptoms suggested acute appendicitis and/or peritonitis. Due to the worsening of abdominal pain and tachycardia the laparatomy was performed. A 15 cm tumor of omentum twisted around its pedicle was found. It must be stressed that the correct diagnosis was made only after laparotomy. The omentum and appendix were excised. Further postoperative course and pregnancy was uneventful and the woman delivered at term. Clinical difficulties with the correct preoperative diagnosis of this rare entity are discussed.

[Endometriosis in adolescents and young women. Can we afford to delay the diagnosis?]. / Endometrioza u dziewczat i mlodych kobiet. Czy mozemy zwlekac z diagnostyka?

Retrospective analysis performed on medical records of 129 adolescents and young women treated surgically at I Dept. of Surgical Gynaecology during the nine years period (1989-1998) revealed 22 cases (17%) of endometriosis. Main indication for surgical intervention, apart from dysmenorrhoea and cyclic abdominal pain, had been the presence of endometriod cyst, as disclosed by ultrasound investigation (66%). Despite of negative result of imaging or clinical examination subjective complaints necessitated laparotomy in 27% of cases. According to American Fertility Society endometriosis classification, 17% subjects presented endometriosis in I stage, 17%--in stage II and remaining 66%--endometrioid cysts with stage III. Authors conclude, that in cases with persistent abdominal pain, not responding to conventional therapy, diagnostic laparoscopy/laparotomy in young women should not be delayed, unless endometriosis is suspected.

[Usefulness of clinical evaluation for the level of CA-125 antigen and ultrasonographic color Doppler examination in diagnosis of ovarian tumor]. / Przydatnosc kliniczna oceny poziomu antygenu CA-125 i badania ultrasonograficznego z kolorowym Dopplerem w diagnostyce raka jajnika.

The objective of our study was to evaluate the predictive value of serum CA-125 levels and transvaginal ultrasound with color Doppler flow mapping (RI) in patients with benign and malignant ovarian tumors. The retrospective analysis included 78 women in whom 92 tumors were detected. Eleven patients had ovarian carcinoma (a total of 16 tumors). Predictive values were compared for tumor morphology, lowest resistive index (RI) < 0.40 and CA-125 > 35 IU/ml. Sensitivity, specificity, positive and negative predictive values in differentiating malignancy were highest for RI (94%, 87% 87% and 94%, respectively). Morphological criteria or CA-125 levels alone had lower predictive accuracy. Combining of the correctly identified all of the malignancies. It is concluded that preoperative transvaginal ultrasound with color Doppler flow mapping is valuable tool in the assessment of adnexal tumors and can be of assistance in prediction of ovarian cancer.