[Risk of fetal cytomegaly virus infection depending on number of CMV genome in mother's blood and amniotic fluid]. / Ryzyko zakazenia plodu wirusem cytomegalii w zaleznosci od ilosci kopii genomu CMV w krwi matki i plynie owodniowym.

The cytomegalovirus infection is most common causes of intrauterine infection of the fetus. Using of serologic diagnostic methods the kind of infection is unknown. The aim of the study was assessment of the risk of CMV infection depending of genome account in mother's blood and I amniotic fluid. The study was performed in choosen pregnancies, in which we expected cytomegalovirus infection using serological criteria. In prenatal diagnostic CMV infection using QPCR, the best material is amniotic fluid. Mother's blood assessment of CMV genome count does not make growth diagnostic possibility of the assesement of transmission the infection from mother to fetus.

[Risk assessment for preterm delivery in pregnant women with active periodontitis]. / Próba oceny ryzyka porodu przedwczesnego u ciezarnych z aktywnym zapaleniem tkanek przyzebia.

INTRODUCTION: Premature labor has been regarded as a highly problematic clinical event not only due to its relation with perinatal mortality but also in the light of the remote results of the prematurity. Therefore many ongoing studies concentrate on evaluation of potentially avoidable risk factors of premature labor. Relatively few studies have suggested chronic periodontitis as such a determinant. OBJECTIVES: Prospective evaluation of periodontium changes in the course of otherwise normal pregnancy. Assessment of potential influence of periodontium pathology, and its severity, on the obstetrical complications. The authors have made literature search on the relation of active periodontitis and premature labor. MATERIALS AND METHODS: Study involved 120 randomized gravidae attending electively dental clinic for a routine control. INCLUSION CRITERIA: single pregnancy, no preterm delivery in a history, mother's age 18 to 35 years, gestational age 10 to 20 weeks based on a last menstrual period date--confirmed on ultrasound. Every patient underwent dental examination twice--at the inclusion date and 48 hours after delivery. Patients were divided into three groups. Group I (n = 25)--healthy patients. Group II (n = 61)--patients with mild or moderate periodontitis. Group III (n = 39) patients with a severe periodontitis. Progression of lesions was recognized if the post-delivery dental assessment revealed increase of the pockets depth higher than 2mm and in at least 4 places compared with the initial findings. RESULT: In the course of otherwise normal pregnancy women with signs of inflammation within periodontium revealed progression of this pathology proportional to its severity in early pregnancy. This increase was associated with 4-fold higher rate of preterm deliveries in Group II and 12-fold in Group III compared with healthy patients. CONCLUSION: Active and severe periodontitis should be regarded as independent and highly influential risk factor of the preterm delivery.

[Diagnostic difficulties of Toxoplasma gondii infection in pregnant women. Is it possible to explain doubts by polymerase chain reaction?]. / Trudnosci w diagnostyce zarazenia ciezarnych Toxoplasma gondii. Czy metoda polimerazowej reakcji lancuchowej moze wyjasnic watpliwosci?

OBJECTIVES: Toxoplasma gondii infection during pregnancy is still a difficult problem in the contemporary perinatology. Difficulties met during interpretation of serological tests carried out in pregnant patients to detect Toxoplasmosis implies more and more frequent use of the Polymerase Chain Reaction (PCR). DESIGN: To evaluate the dependence between serological tests and quantity of the Toxoplasma gondii genomes in mothers' blood and amniotic fluid or neonatal blood, the quantitative PCR (q-PCR) method was applied. MATERIALS AND METHODS: The analysis was performed in 81 pregnant women. Maternal blood, amniotic fluid and newborns' umbilical blood samples were evaluated for the presence of Toxoplasma gondii DNA. IgG and IgM Toxoplasma gondii antibodies were evaluated by the ELISA method. RESULTS: High seroprevalence (51.9%) of the Toxoplasma gondii was confirmed. Toxoplasma gondii genetic material in blood and/or amniotic fluid was found in 33 patients. It was stated that quantity of the protozoa and anti-IgM presence in mothers' blood are the factors influencing significantly the Toxoplasma gondii manifestation in amniotic fluid. CONCLUSION: High suitability of PCR in diagnosis of Toxoplasmosis during pregnancy and vertical transmission was confirmed.

[Changes to the periodontium in postmenopausal women]. / Wplyw zmian okresu menopauzy na stan tkanek przyzebia.

Few up to date studies on the influence of hormonal replacement therapy (HRT) on periodontium has been conducted on small groups of patients and the conclusions made may require further investigation on a larger population. It has been widely accepted that decreased estrogen levels in postmenopausal women are associated with a gradual loss of a bone density and increased risk of a dental loss. Much less stress is put however on the fact that the same phenomenon, especially suboptimal levels of estradiol, may deteriorate periodontal tissue condition. The authors made a literature search on the influence of HRT on periodontium.

[Mediastinal tumor as a cause of fetal hydrops]. / Guz sródpiersia przyczyna uogólnionego obrzeku plodu.

Unusual case of fetal hydrops was presented. In a stillborn infant an Rh incompatibility was suspected as a cause of hydrops, although prentally an immunologic source of the illness was excluded. Post-mortem a large polycystic mediastinal teratoma with cardiac and pulmonary hypoplasia was stated as a main cause of the hydrops. Additionally, histopathological examination proved this diagnosis. The mediastinal tissue contained immature epithelial, mesenchymal and blastemal elements. The congenital teratomas should be taken for account in problematic diagnosis of complicated cases.

[Etiology of intrauterine growth retardation. Part I: placental-fetal interrelationship disorder]. / Etiologia wewnatrzmacicznego opóznionego wzrastania plodu. Czesc I--Czynniki zwiazane z zaburzeniami jednostki plodowo-lozyskowej.

Intrauterine growth retardation (IUGR) increases a risk of perinatal complications and may carry a negative influence on a later baby's mental and physical development. Poorer function revealed by many vital organs seems to be the effect of their lower mass and their relative immaturity. In the first part of a paper the authors discuss two groups of factors thought to be responsible for IUGR. The first one has been related to the fetal status-genetic anomalies, other primary developmental defects and different growth patterns.

[Etiology of intrauterine growth retardation. Part II: maternal disorders]. / Etiologia wewnatrzmacicznego opóznionego wzrastania plodu. Czesc II--Czynniki pochodzenia matczynego.

The second part of discussion incorporates maternal conditions influencing the risk of intrauterine growth retardation. Special attention was paid to the systemic abnormalities, and those pregnancy related, known for their links with affected placenta-uterine barrier or otherwise related to abnormal fetal growth. Both social and environmental groups of factors potentially influencing prenatal development have been discussed.

[Doppler measurements of blood flow velocity and waveforms in fetal venous circulation]. / Zastosowanie ultrasonografii dopplerowskiej w badaniach zylnej czesci ukladu naczyniowego plodu.

Ultrasonic velocimetry of the fetal circulation became a very useful method in assessment of fetal well-being, especially in high risk pregnancies. There are many papers concerning on distribution and regulation of blood flow in umbilical artery, middle cerebral artery, and much less dealing with flow velocity waveforms in inferior vena cava and ductus venosus and their clinical significance. Fetal compromise is associated with significant alterations in the fetal arterial and venous circulation. Changes in venous Doppler waveforms develop due to increased afterload and perhaps myocardial failure in deterioration after arterial redistribution is established. Doppler investigation of the fetal venous circulation may play an important role in monitoring the redistribution and may help to determine the optimal time for delivery.

[Frequency of vaginal infections in pregnant women in the Department of Perinatology and Gynaecology in Zabrze]. / Czestosc zakazen Pochwy Ciezarnych Hospitalizowanych w Klinice Perinatologii i Ginekologii, Zabrzu.

OBJECTIVES: The analysis of vaginal infections in pregnant women admitted to the Department of Perinatology and Gynaecology in Zabrze, from January 2001 to September 2003. MATERIALS AND METHODS: They were screened for BV, candidiasis and trichomoniasis. 450 pregnant women (the age of pregnancy 25 +/- 9 weeks gestation) were examined for the presence of these microorganisms in the vagina. Diagnosis was based on symptoms, pH measurement and microscopic examination of the vaginal discharge. CONCLUSIONS: The most common vaginal infection was candidiasis--188 (42%), 86 (19 %) women had BV, 17 (4%) Trichomonas vaginalis and 159 (35%) patients had normal vaginal flora.

[Prevention of iron deficiency anemia--influence on the course of pregnancy, delivery and the infant's status]. / Wplyw profilaktyki niedokrwistosci z niedoboru zelaza na przebieg ciazy, porodu oraz stan pourodzeniowy noworodka.

BACKGROUND: Iron deficiency is probably the most common nutritional disturbance in the world. At the highest risk, irrespective of economical status, are women at the reproductive age--especially those who are pregnant. Retrospective analysis of a course of gestation, delivery and the infant's status depending on mothers' iron supplementation during pregnancy. Medical notes of healthy 860 pregnant women hospitalized at term in the Clinic of Perinatology and Gynaecology, Zabrze, Poland were analyzed. Patients were divided into two categories: Group I (n = 610) were those having iron subjunction and Group II (n = 250) those who did not. Mean gestational age at the delivery was significantly lower in those without the prophylaxis. These patients had significantly higher rate of preterm deliveries and caesarean sections. Macroscopic abnormalities of the afterbirth were commoner in this group as were bleeding during III labour stage and indications for postpartum curettage. insignificantly lower mean birth weight and 1st/5th minute Apgar scores had children born to women without supplementation. Routine iron supplementation in women with initially normal haemoglobin levels seems to be a safe strategy for preventing perinatal complications.

[Value of selected biophysical surveillance methods in prediction and prophylaxis of complications associated with adverse pregnancy outcome in intrauterine growth restriction]. / Analiza wartosci parametrów wybranych testów biofizycznych w przewidywaniu i profilaktyce problemów zdrowotnych zwiazanych ze zlym stanem pourodzeniowym noworodków w ciazach powiklanych wewnatrzmacicznym opóznionym wzrastaniem.

Intrauterine growth restriction is associated with higher rate of complications occurring during pregnancy and in labour, increased morbidity and mortality rate in neonatal period, impaired psychosomatic development in childhood and increased susceptibility for particular diseases in adulthood. For improvement of perinatal outcome it is essential to establish objective criteria based on biophysical surveillance methods for prediction and prophylaxis of adverse outcome in IUGR pregnancies. The aim of the study was to compare selected biophysical surveillance methods in prediction and prophylaxis of complications associated with adverse pregnancy outcome in intrauterine growth restriction. There were statistically significant differences in CTG, BPS, AFI, and pulsatile index values in umbilical artery and MCA between IUGR and normal fetuses. The best predictor of adverse pregnancy outcome in IUGR fetuses was PI value in umbilical artery.

[Microcytomorphometric video-image detection of nuclear chromatin in ovarian cancer]. / Diagnostyka mikrocytomorfometryczna typu video-image chromatyny jadrowej w raku jajnika.

UNLABELLED: Technology of detection of tissue preparates precisious evaluates contents of nuclear chromatine, largeness and shape of cellular nucleus, indicators of mitosis, DNA index, ploidy, phase-S fraction and other parameters. Methods of detection of picture are: microcytomorphometry video-image (MCMM-VI), flow, double flow and activated by fluorescence. Diagnostic methods of malignant neoplasm of ovary are still nonspecific and not precise, that is a reason of unsatisfied results of treatment. OBJECTIVE: Evaluation of microcytomorphometric measurements of nuclear chromatine histopathologic tissue preparates (HP) of ovarian cancer and comparison to normal ovarian tissue. MATERIAL AND METHODS: Estimated 10 paraffin embedded tissue preparates of serous ovarian cancer, 4 preparates mucinous cancer and 2 cases of tumor Kruckenberg patients operated in Clinic of Perinatology and Gynaecology Silesian Medical Academy in Zabrze in period 2001-2002, MCMM-VI estimation based on computer aided analysis system: microscope Axioscop 20, camera tv JVCTK-C 1380, CarlZeiss KS Vision 400 rel.3.0 software. Following MCMM-VI parameters assessed: count of pathologic nucleus, diameter of nucleus, area, min/max diameter ratio, equivalent circle diameter (Dcircle), mean of brightness (mean D), integrated optical density (IOD = area x mean D), DNA index and 2.5 c exceeding rate percentage (2.5 c ER%). MCMM-VI performed on the 160 areas of 16 preparates of cancer and 100 areas of normal ovarian tissue. Statistical analysis was performed by used t-Student test. RESULTS: We obtained stastistically significant higher values parameters of nuclear chromatine, DI, 2.5 c ER of mucinous cancer and tumor Kruckenberg comparison to serous cancer. MCMM-VI parameters of chromatine malignant ovarian neoplasm were statistically significantly higher than normal ovarian tissue. CONCLUSION: Cytometric and karyometric parametres of nuclear chromatine estimated MCMM-VI are useful in the diagnostics and prognosis of ovarian cancer.

[Analysis of mode of delivery in cases with fetal premature atrial contractions]. / Analiza sposobu ukonczenia ciazy w przypadkach nadkomorowych skurczów dodatkowych u plodu.

OBJECTIVE: Premature atrial contractions are common in obstetrical practise but there is little information available on recommended management and mode of delivery. DESIGN: The aim of the study was to describe our clinical experience in the management of fetal arrhythmia including the indications for certain time and way of labour. MATERIALS AND METHODS: 128 fetuses with diagnosed supraventricular arrhythmia described as atrial extrasystole were examined. They were divided into 3 main groups: group I (84 fetuses) with single PAC, group II (37 fetuses) with quantitatively significant arrhythmia or accompanied by another kind of arrhythmia and group III (7 fetuses) associated with extracardiac abnormalities. RESULTS: Among 128 fetuses with supraventricular arrhythmia, 44 cases (31%) required systematic monitoring. Quantitatively significant arrhythmia was recognized in 15 cases, blocked bigeminy (2:1) in 2 fetuses, 10 cases were accompanied by another arrhythmias: 4x SVT, 4x sinus bradycardia, 2x premature ventricular contractions (PVC). There were 3 fetuses diagnosed with heart defects and 7 with extracardiac malformations. Fetal echocardiography revealed additional functional circulatory changes in 7 fetuses with premature atrial contractions. Myocarditis was recognized in 2 fetuses. The mode of delivery was analyzed in 128 cases. In the first group 27 patients (32%) underwent caesarean section, in the second group--23 (62%), in the third group 3 patients (43%), respectively. Cardiac indications for caesarean section equalled 22% of all the indications occurring in fetuses suffering from arrhythmia. CONCLUSIONS: Caesarean section is much more commonly performed among fetuses diagnosed with arrhythmia accompanied by another fetal anomalies comparing to the group of fetuses with isolated arrhythmia. Although there are no particular cardiac indications for such way of delivery, total amount of caesarean sections performed in that group is really great. Above all, it may suggest that the obstetrician is under pressure of stress while making decision concerning caesarean section performance, even when there are no other indications and the condition of fetus is stable enough.

[Manifestation of glutathione S-transferase GSTM1 and GSTT1 in female patients with bleomycin-positive chromosome instability]. / Ekspresja Transferazy S-glutationu GSTM1 i GSTT1 u pacjentek z niestabilnoscia chromosomowa potwierdzona testem bleomycynowym.

OBJECTIVES: The purpose of this research is to assess the incidence of gene polymorphisms coding the GSTM1 and GSTT1 enzymes in a population of female patients with chromosome instability. MATERIALS AND METHODS: The PCR method was used to determine the genotype for GSTM1 and GSTT1. The breaks per cell and the percentage of damaged cells were calculated. The separation point used to diagnose chromosome instability in tested females was assumed to be 2.5. RESULTS: In a tested population of 85 females with chromosome instability, the deletion of both the alleles of the GSTT1 gene was observed in 22 females (25% of the group) and deletion of both the alleles of the GSTM1 gene was observed in 42 females (53% of the group). In addition, the incidence of individual genes was calculated for the tested population. The X2 test showed that the differences between the observed and expected values of the tested genes were statistically immaterial, i.e. the likelihood of randomness for these differences exceeded 99%. CONCLUSIONS: No relationship between the manifestation of genotypes for the GSTM1 and GSTT1 glutathione S-transferases and an increased chromosome instability confirmed with the bleomycin test was proven for a population of females with a neoplastic risk.

[Rare case of a malignant brain neoplasm in an 18-years old pregnant woman]. / Rzadki przypadek nowotworu zlosliwego mózgu u 18-letniej ciezarnej.

Authors presented rare case of anaplastic ependymoma diagnosed in the first trimester of pregnancy 18-years of age patient. Main symptoms of increased intracranial pressure and cerebral edema were vomits, severe headache and apathy. In the sixteen week of pregnancy performed craniotomy and evacuated malignant tumor of region IV ventricle trunk of the brain. Follow during pregnancy made brachytherapy (LDR). Cesarean section performed in the 30th week of pregnancy. Then indispensable radical radiotherapy was continued.

[Serum levels of CA-125 antigen during the first trimester of pregnancy complications and the risk of miscarriage]. / Ocena stezenia antygenu CA125 w surowicy krwi ciezarnych w i trymestrze ciazy powiklanej zagrazajacym poronieniem.

BACKGROUND: The ultrasound, serum beta-HCG and progesterone titres are widely used to assess the risk of miscarriage at the early stages of pregnancy. Though very useful, they are not considered as satisfactorily accurate predictors of imminent abortion during the first three months of pregnancy. AIM OF STUDY: Prospective evaluation of clinical usefulness of serum CA125 from 4-12th week of pregnancy in a group of women with symptoms of imminent abortion. MATERIAL AND METHODS: A study group were 250 consecutive women with symptoms of imminent abortion. Inclusion criteria were: abdominal pain, spotting, ultrasound picture of the embryo in the uterus, monovular pregnancy, normal ultrasound picture of ovaries, gestational age ranging from 4-12 weeks (assessed on a last menstrual period basis with ultrasound corroboration). 55 women with physiological course of pregnancy made up a control group. CA125 levels was evaluated with Roche Cobas Core CA125 II EIA. RESULTS: In patients with symptoms of imminent abortion, serum CA125 titration in 4 to 12 weeks' gestation seems to be valuable only in woman with vaginal spotting or bleeding.

[Serum CA125 variability--new aspects of clinical usefulness]. / Zachowanie sie stezenia antygenu CA125--nowe aspekty przydatnosci klinicznej.

Serum levels of CA125 turned out to be a valuable parameter not only as a marker of ovarian carcinoma but also in other fields of obstetrics and gynaecology. Up to date most of the studies dealing with the subject remain experimental and their clinical usefulness is not widely acknowledged. Accessible and relatively cheap tests measuring the serum level of this antigen together with its proven clinical value might contribute to a more frequent and much wider use than it takes place contemporarily.

The influence of calyculin A on lymphocytes in vitro.

Human lymphocytes were cultured in vitro and treated with calyculin A. The aim of this work was to estimate the influence of calyculin A on chromosome morphology and banding patterns. It was also interesting whether calyculin A treatment is useful in cytogenetic analysis of human karyotype. We proved that calyculin A induces chromosome condensation in lymphocytes and raises the mitotic index significantly. Moreover, calyculin A does not influence the banding patterns. Therefore it is concluded that calyculin A can be clinically useful for human karyotyping.

Clinical value of a single serum CA-125 level in women with symptoms of imminent abortion during the first trimester of pregnancy.

OBJECTIVE: To assess the clinical value of a single serum CA-125 level in women presenting with symptoms of imminent abortion from 5 to 12 weeks' gestation. STUDY DESIGN: Two hundred women with symptoms of imminent abortion from 5 to 12 weeks' gestation were allocated to 3 subgroups: group I (n = 50), abdominal pain only; group II (n = 80), abdominal pain and vaginal bleeding of less than 3 days' duration; and group III (n = 70), abdominal pain and vaginal bleeding of > or = 3 days' duration. The control group (n = 55) was women undergoing a normal pregnancy of comparable gestational age. In all patients, CA-125 and beta-human chorionic gonadotropin (beta-hCG) levels were determined with commercially available enzymatic immunoassay tests. RESULTS: A significant increase in serum CA-125 levels was observed in patients with vaginal bleeding (groups II and III) in comparison with the control group. In contrast to CA-125, serum beta-hCG levels were significantly lower in patients who went on to miscarry. Receiver operating characteristic curve analysis revealed that all women with symptoms of imminent abortion who have a CA-125 level of > or = 43.1 U/mL should be considered as having a greater risk of miscarriage. Patients with bleeding of > or = 3 days should have a threshold value of 66.5 U/mL applied as a risk determinant. CONCLUSION: A single serum CA-125 level determination is valuable in women with imminent abortion presenting with abdominal pain, vaginal bleeding or both.