Measurement of chromosomal instability and level of DNA damage in peripheral blood mononuclear cells of endometrial cancer patients

Endometrial cancer is one of the most common invasive gynecologic malignancies in developed countries. The aim of this study was to evaluate chromosomal instability and level of DNA damage in peripheral blood mononuclear cells (PBMCs) of newly diagnosed endometrial cancer patients in relation to health status (diagnosis), age, histological grade of cancer, residence, smoking, number of pregnancies, miscarriages, and abortions. The analyzed sample consisted of 60 individuals, 30 endometrial cancer patients with an average age of 64.37 ± 7.08, and 30 healthy control women with an average age of 60.23 ± 11.55. Chromosomal instability was evaluated by the cytokinesis-block micronucleus (CBMN) assay, and the level of DNA damage by the single-cell gel electrophoresis (comet) assay in PBMCs. The average frequencies of micronuclei (MNi), nucleoplasmic bridges (NPBs) as well as nuclear buds (NBUDs) were significantly higher in cancer patients compared to controls (P < .0005). There was no difference in the nuclear division index (NDI) among the analyzed samples. The comet assay showed that the patients had a significantly increased genetic damage index (GDI) compared with controls (P < .0005). Using linear regression analysis, we found that health status (diagnosis) had the strongest influence on the MN frequency as well as GDI (P < .0005). Our results indicated that there is a high level of genetic damage in both the level of DNA and the level of chromosomes in the PBMCs of newly diagnosed patients with endometrial cancer, where the frequency and level of damage were significantly affected by health status, grade of cancer, residence, number of pregnancies, miscarriages, and abortions.

Neuroactive steroids in the neuroendocrine control of food intake, metabolism, and reproduction

Neuroactive steroids are a type of steroid hormones produced within the nervous system or in peripheral glands and then transported to the brain to exert their neuromodulatory effects. Neuroactive steroids have pleiotropic effects, that include promoting myelination, neuroplasticity, and brain development. They also regulate important physiological functions, such as metabolism, feeding, reproduction, and stress response. The homoeostatic processes of metabolism and reproduction are closely linked and mutually dependent. Reproductive events, such as pregnancy, bring about significant changes in metabolism, and metabolic status may affect reproductive function in mammals. In females, the regulation of reproduction and energy balance is controlled by the fluctuations of oestradiol and progesterone throughout the menstrual cycle. Neurosteroids play a key role in the neuroendocrine control of reproduction. The synthesis of neuroestradiol and neuroprogesterone within the brain is a crucial process that facilitates the release of GnRH and LH, which in turn, regulate the transition from oestrogen-negative to oestrogen-positive feedback. In addition to their function in the reproductive system, oestrogen has a key role in the regulation of energy homoeostasis by acting at central and peripheral levels. The oestrogenic effects on body weight homoeostasis are primarily mediated by oestrogen receptors-α (ERα), which are abundantly expressed in multiple brain regions that are implicated in the regulation of food intake, basal metabolism, thermogenesis, and brown tissue distribution. The tight interplay between energy balance and reproductive physiology is facilitated by shared regulatory pathways, namely POMC, NPY and kisspeptin neurons, which are targets of oestrogen regulation and likely participate in different aspects of the joint control of energy balance and reproductive function. The aim of this review is to present a summary of the progress made in uncovering shared regulatory pathways that facilitate the tight coupling between energy balance and reproductive physiology, as well as their reciprocal interactions and the modulation induced by neurosteroids.

Multi- and Gray-Scale Thermal Lithography of Silk Fibroin as Water-Developable Resist for Micro and Nanofabrication

Silk fibroin (SF) is a natural material with polymorphic structures that determine its water solubility and biodegradability, which can be altered by exposing it to heat. Here, a hybrid thermal lithography method combining scalable microscale laser-based patterning with nanoscale patterning based on thermal scanning probe lithography is developed. The latter enables in addition grayscale patterns to be made. The resolution limit of the writing in silk fibroin is studied by using a nanoscale heat source from a scanned nanoprobe. The heat thereby induces local water solubility change in the film, which can subsequently be developed in deionized water. Nanopatterns and grayscale patterns down to 50 nm lateral resolution are successfully written in the silk fibroin that behaves like a positive tone resist. The resulting patterned silk fibroin is then applied as a mask for dry etching of SiO2 to form a hard mask for further nano-processing. A very high selectivity of 42:1 between SiO2 and silk fibroin is obtained allowing for high-aspect ratio structure to be fabricated. The fabricated nanostructures have very low line edge roughness of 5 ± 2 nm. The results demonstrate the potential of silk fibroin as a water-soluble resist for hybrid thermal lithography and precise micro/nanofabrication.

Putative application of Najas marina L. extracts as a source of bioactive compounds and their antioxidant, antimicrobial, antibiofilm, and genotoxic properties

In this research paper, the total phenols (TP), flavonoids (TF), and tannins (TT) content in the acetone and ethyl acetate extracts of Najas marina L. and the identification and quantification of phenolic acids and flavonoids from the ethyl acetate extract were performed. Antioxidant, antimicrobial, and antibiofilm properties of the mentioned extracts were investigated in vitro. The genotoxic potential was analyzed in cultured human peripheral blood lymphocytes (PBL). The TP and TF content was higher in the ethyl acetate extract, dominated by quercetin (172.4 µg mg-1) and ferulic acid (22.74 µg mg-1), while the TT content was slightly higher in the acetone extract. Both extracts tested showed limited antioxidant effects compared to ascorbic acid. The strongest antibacterial activity was observed with Gram-positive bacteria, particularly Staphylococcus aureus (MIC and MMC at 0.31 mg ml-1) and S. aureus ATCC 25923 (MIC at <0.02 mg ml-1), while antifungal activity was limited. Both extracts tested showed better activity on preformed biofilms. Acetone extract had no genotoxic activity but showed significant genoprotective activity against mitomycin C-induced DNA damage in cultured PBLs. Results of our research demonstrate the potential for the development of plant-based antibacterial and biofilm agents.

Relating environmental pressures to littoral biological water quality indicators in Western Balkan lakes: Can we fill the largest gaps?

Along six transects in each of six lakes across the Western Balkans, we collected data for three groups of littoral biological water quality indicators: epilithic diatoms, macrophytes, and benthic invertebrates. We assessed the relationships between them and three environmental pressures: nutrient load (eutrophication), hydro-morphological alteration of the shoreline, and water level variation, separating the effect of individual lakes and continuous explanatory variables. Lake water total phosphorus concentration (TP) showed substantial variation but was not related to any of the tested biological indicators, nor to any of the tested pressures. We suggest that this may be due to feedback processes such as P removal in the lake littoral zone. Instead, we found that a gradient in surrounding land-use towards increasing urbanization, and a land-use-based estimate of P run-off, served as a better descriptor of eutrophication. Overall, eutrophication and water level fluctuation were most important for explaining variation in the assessed indicators, whereas shoreline hydro-morphological alteration was less important. Diatom indicators were most responsive to all three pressures, whereas macrophyte biomass and species number responded only to water level fluctuation. The Trophic Diatom Index for Lakes (TDIL) was negatively related to urbanization and wave exposure. This indicates that it is a suitable indicator for pressures related to urbanization, although a confounding effect of wave exposure is possible. Invertebrate abundance responded strongly to eutrophication, but the indicator based on taxonomic composition (Average Score Per Taxon) did not. Our results suggest that our metrics can be applied in Western Balkan lakes, despite the high number of endemic species present in some of these lakes. We argue that local water management should focus on abating the causes of eutrophication and water level fluctuation, whilst preserving sufficient lengths of undeveloped shoreline to ensure good water quality in the long run.

Assessment of Chromosomal Damage in Umbilical Blood Lymphocytes of Newborns from Kragujevac in Central Serbia Born 18 Years after Environmental Contamination

The measurement of micronuclei (MN) in umbilical blood lymphocytes of newborns are increasingly used in cytogenetic epidemiology as one of the preferred methods for assessing chromosomal damage resulted from maternal exposure to mutagen. In the present study, we evaluated the effect of strong environmental contamination (EC) (which occured in the City of Kragujevac, Central Serbia in 1999) on the MN frequency in group of 22 newborns born in Kragujevac 18 years after EC, using cytokinesis-block micronucleus (CBMN) assay. The mean MN frequency in umbilical lymphocytes of these newborns was 5.14 ± 2.17/1,000 binucleated (BN) cells, which is significantly lower than mean MN frequency of newborns born 12 months after contamination (9.36 ± 5.60/1,000 BN cells). Sex of newborns, age of mothers, cigarette smoking, and number of pregnancies did not affect the MN frequency of newborns. Our results showed that in utero exposure to environmental pollution affected genome instability of the fetuses, but that by improving the quality of environmental conditions there was a decrease in mean MN frequency of newborns born 18 years after contamination. In general, genome of umbilical lymphocytes shows a realistic picture of all changes in body and the environment.

Current progress in the therapeutic options for mitochondrial disorders

Mitochondrial disorders manifest enormous genetic and clinical heterogeneity - they can appear at any age, present with various phenotypes affecting any organ, and display any mode of inheritance. What mitochondrial diseases do have in common, is impairment of respiratory chain activity, which is responsible for more than 90% of energy production within cells. While diagnostics of mitochondrial disorders has been accelerated by introducing Next-Generation Sequencing techniques in recent years, the treatment options are still very limited. For many patients only a supportive or symptomatic therapy is available at the moment. However, decades of basic and preclinical research have uncovered potential target points and numerous compounds or interventions are now subjects of clinical trials. In this review, we focus on current and emerging therapeutic approaches towards the treatment of mitochondrial disorders. We focus on small compounds, metabolic interference, such as endurance training or ketogenic diet and also on genomic approaches.

Littoral eutrophication indicators are more closely related to nearshore land use than to water nutrient concentrations: A critical evaluation of stressor-response relationships

Biological assessment metrics and water chemistry measurements are used to quantify the link between stressors and their effects on lake ecosystems, for the Water Framework Directive. However, correlations between metrics and water chemistry are often poor. This is seen as major weaknesses of Water Framework Directive-related monitoring and assessment. We analyzed macrophytes, benthic algae, benthic macroinvertebrates, water chemistry and sediment total phosphorus content in the littoral of six lakes in the Western Balkans and used CORINE land use data to estimate nutrient enrichment via runoff from the adjacent land. Lakes with a higher estimated phosphorus runoff from the adjacent land did not have higher littoral water nutrient concentrations, but littoral diatom assemblages indicated more eutrophic conditions. These lakes also had higher abundances of littoral benthic primary producers, which in turn were associated with low concentrations of dissolved nutrients, but only in autumn, not in spring. This is consistent with primary producers taking up nutrients during the summer growth season. In lakes with high abundances of benthic primary producers, it is likely that the littoral vegetation plays a large role in the transfer of nutrients from the water to the benthos. This process impairs correlations between biological metrics and water nutrient concentrations. Our results suggest that CORINE land cover may be more useful to characterize littoral nutrient enrichment than lake water chemistry. Increased benthic primary producer biomasses and "eutrophic" diatom indices may indicate littoral nutrient enrichment even if water nutrient concentrations are low.

Methanol extracts of Teucrium arduini L. and Teucrium flavum L. induce protective effect against mitomycin C in human lymphocytes in vitro

The study was designed to evaluate antigenotoxic effect of methanol Teucrium arduini and Teucrium flavum extracts against mitomycin C (MMC)-induced chromosome and DNA damage in vitro. Cytokinesis-block micronucleus (CBMN) and comet assays were used to investigate effect of plant extracts in different concentrations (125, 250, 500 and 1000 µg/mL) on human peripheral blood lymphocytes (PBLs). The obtained results showed that the all tested concentrations of T. arduini and the highest concentration of T. flavum significantly reduced the MMC-induced micronucleus (MN) frequency in comparison to positive control (only MMC). There were significantly negative correlations between the extracts concentrations and MN frequencies (Pearson, r = -0.905, p = 0.0001 for T. arduini; r = -0.861, p = 0.0001 for T. flavum). The extracts of both plants further lowered the MMC-decreased nuclear division index (NDI) in a dose dependent-manner (Pearson, r = -0.837, p = 0.001 for T. arduini; r = -0.598, p = 0.040 for T. flavum), but significantly only in the highest concentration (1000 µg/mL). Comet assay showed that extracts reduced MMC-increased genetic damage index (GDI), significantly in the concentrations of 500 and 1000 μg/mL, in comparison with positive control. Based on our results, it can be concluded that methanol T. arduini and T. flavum extracts possess protective proapoptotic and antigenotoxic effect which is indication of their medicinal relevance and use in treatment.

The Health Promoting Effects of the Fruiting Bodies Extract of the Peppery Milk Cap Mushroom Lactarius piperatus (Agaricomycetes) from Serbia

Antioxidant, antimicrobial, genoprotective, anticancer, and neuroprotective potential of acetone extract of the fruiting bodies of the edible mushroom Lactarius piperatus was studied. The antioxidant activity was evaluated using different methods (DPPH radical scavenging, superoxide anion radicals scavenging, reducing power assay, and determination of total phenolic compounds). The microdilution method was used to reveal the antimicrobial potential. The genoprotective potential was determined by Comet assay. Cytotoxic activity was tested using MTT. The capacity of the extract to inhibit acetylcholinesterase was used for determining its neuroprotective potential. The received results show that L. piperatus extract possessed potent health enhancing effects. In the antioxidant activity, IC50 was 33.97 μg/mL for DPPH radicals scavenging and 22.52 μg/mL for superoxide anion radicals scavenging, whereas the absorbance for the reducing power was from 0.0510 to 0.1451. The total content of phenolic compounds in the extract was 5.08 μg PE/mg. The testing of the antimicrobial activity showed that MIC values were from 0.039 to 10 mg/mL. For Comet assay, all concentrations of extract increased the GDI values from 0.46 ± 0.05 to 0.99 ± 0.31. L. piperatus extract expressed relatively strong cytotoxic activity with IC50 values ranging from 37.83 to 65.94 μg/mL. Finally, the percentage of inhibition of acetylcholinesterase activity of tested extract was within the range 16.75-44.35%. Our results imply that the acetone extract of L. piperatus has rather strong antioxidant, antimicrobial, genoprotective, anticancer, and neuroprotective effects; thus this mushroom represents healthy food that could be used in the pharmaceutical industry and to prevent various diseases.

Polyphenolic contents of Teucrium polium L. and Teucrium scordium L. associated with their protective effects against MMC-induced chromosomal damage in cultured human peripheral blood lymphocytes

Teucrium species have been used in traditional medicine for treatment of different diseases. The aim of this study was to investigate polyphenolic contents by high-performance liquid chromatography (HPLC), and the genotoxic effect of methanolic extracts of Teucrium polium and Teucrium scordium using the cytokinesis-block micronucleus (CBMN) assay on human peripheral blood lymphocytes (PBLs) from healthy donors. The HPLC  analysis  showed that extracts consist of phenolic acid (gallic, vanillic, caefic, chlorogenic, p-coumaric, sinapic) and flavonoids (catechin, rutin, myricetin, luteolin, quercetin and apigenin). Cultures were treated with extracts of both plants separately and in combinations with mitomycin C (MMC). In separate treatments, both herbal extracts significantly induced micronucleus (MN) frequency only at the highest concentrations. All concentrations of T. scordium , except the lowest, and all concentrations of T. polium extracts in combined treatment with MMC significantly reduced the frequency of MN. The extract of T. polium did not significantly aefct the nuclear division index (NDI), whereas T. scordium in higher concentrations, separately and in combined treatment with MMC, significantly decreased the NDI value. Our results suggest that both herbal extracts in combination with MMC have antimutagenic (T. polium) and proapoptotic effects (T. scordium), which indicates their protective effects in PBLs.

Autoimmune polyglandular syndrome type 2 shows the same HLA class II pattern as type 1 diabetes

Autoimmune polyglandular syndrome (APS) type 2 is defined by the manifestation of at least two autoimmune endocrine diseases. Only few data exist on genetic associations of APS type 2. In this controlled study, 98 patients with APS type 2, 96 patients with type 1 diabetes (T1D), and 92 patients with autoimmune thyroid disease, both as a single autoimmune endocrinopathy, were tested for association with alleles of the human leukocyte antigen (HLA) class II loci DRB1, DQA1, and DQB1. Patients with APS type 2 had significantly more often the alleles DRB1*03 (P(c) < 0.0001), DRB1*04 (P(c) < 0.000005), DQA1*03 (P(c) < 0.0001), and DQB1*02 (P(c) < 0.05), when compared with controls. Less frequent in APS were DRB1*15 (P(c) < 0.05), DQA1*01 (P(c) < 0.0005), and DQB1*05 (P(c) < 0.005). With regard to frequency and linkage of these alleles, the susceptible haplotypes DRB1*0301-DQA1*0501-DQB1*0201 and DRB1*0401/04-DQA1*0301-DQB1*0302 were deduced. Protective haplotypes in this study were DRB1*1501-DQA1*0102-DQB1*0602 and DRB1*0101-DQA1*0101-DQB1*0501. Comparing APS patients with vs without AD, no significant differences regarding HLA class II alleles were noted in our collective. Patients with T1D as a singular disease had the same susceptible and protective HLA alleles and haplotypes. The prevalence of DRB1*03 and DRB1*04 in APS patients was not because of the presence of diabetes, as the APS type 2 patients without diabetes had the same allele distribution. In conclusion, these data suggest a common immunogenetic pathomechanism for T1D and APS type 2, which might be different from the immunogenetic pathomechanism of other autoimmune endocrine disease.

[Effect of certain aspects of female sexual behavior on the development of cervical intraepithelial neoplasia]

The paper presents results of investigation of certain parameters of female sexual activity and their effect on the appearance of squamous intraepithelial cervical lesions (SIL). This correlation was investigated in the context of Human Papilloma Virus (HPV) infection, in view of the role attributed to certain types of these viruses in the appearance and development of cervical SIL. Research was done on 1000 patients suffering from low histological grade (LSIL) or high histological grade (HSIL) intraepithelial cervical neoplasms. It transpired that such lesions were most frequent in women in the second, third and fourth decade of life, and that one third of pathological lesions was a function of age. Human Papilloma Virus infection was detected in 65% of patients. The frequency of HPV negative results or presence of non-oncogenic types of viruses (6 and 11) was significantly higher in LSIL type lesions, while the frequency of detection of oncogenous HPV types (16, 18, 31 and 33) was significantly higher in more severe stadiums of the disease. Of the investigated parameters of sexual activity, early onset of such activity and several sexual partners proved to be significant. The number of parturitions and abortions did not appear to be significant risk factors for the onset and development of these diseases.

[The modern approach to hysterectomy]

Being quite experienced in the field of gynaecologic surgery and hysterectomies especially, being familiar with recent innovations in laparoscopic surgery and also having some own experience in laparoscopic surgery, the authors discuss the advantages and disadvantages of all surgical methods of hysterectomy. Comparing the techniques, the duration, bearing in mind the the risks, overall costs and all other surgical details, the authors concluded that laparoscopically assisted vaginal hysterectomy is the best choice because it is the least invasive, less risky, no scars are left, the postoperative recovery is quick, there are numerous indications for it, the preparation obtained as a whole can be used for further clinical examination. The only disadvantage is it is too costly and sometimes the operation itself lasts too long, so it should not be applied in some cases.

[The ovarian hyperstimulation syndrome]

The use of controlled ovarian hyperstimulation has increased the efficacy of ovulation induction and enhanced the ability to recruit multiple mature oocytes for use in the assisted reproductive technologies. However, the administration of medications is not without risk. Ovarian hyperstimulation syndrome is a serious complication with various manifestations. Two fundamental pathologic changes are characteristic: ovarian enlargement with underlying stromal oedema and multiple haemorrhages of luteinized cysts coupled with a dramatic shift of fluid from the intravascular spaces into the peritoneal, pleural, and pericardial cavities. The most efficacious treatment of hyperstimulation syndrome is its prevention. The correction of hypovolaemia and electrolyte abnormalities is one of the most important procedures in the treatment of this syndrome.

[Antibiotic therapy in the treatment of inflammatory diseases in the minor pelvis]

Pelvic inflammatory diseases are usually caused by sexually transmitted microorganisms, as are Neisseria gonorrhoeae and Chlamydia trachomatis, either alone or associated with endogenous flora of the lower genital tract, as with other gram-positive and gram-negative anaerobic and aerobic bacteria [1, 2].

SUBJECT

The aim of the study was to estimate the effect of three broad-spectrum combinations of antimicrobial therapy in the treatment of pelvic inflammatory diseases in hospitalized patients.

MATERIAL AND METHODS

We analysed the therapeutic success of some antimicrobial therapies in 154 patients with pelvic inflammatory disease, who were treated in the Narodni Front Hospital of Gynaecology and Obstetrics in Belgrade, during 1992 and 1993. Three drug therapies were applied. The combination of Ceftriaxon plus Doxycycline was given to 51 women. Fifty five women were treated by a combination of Gentamycin plus Clidamycin, and 48 women were treated by a combination of Gentamycin and Metronidazole.

RESULTS

The therapeutic success after the application of the three different antibiotic therapies was recorded in 139 of 154 women (90.26%). Of 136 patients with uncomplicated pelvic inflammatory diseases, the therapeutic success was noted in 129 (94.85%) individuals, while of 18 women with tubo-ovarian abscess therapeutic success was recorded in 10 (55.56%) patients. Of 51 women treated by the combination of Ceftriaxon plus Doxycycline, the therapeutic success was observed in 46 (90.19%) patients. Fifty five women treated by the combination of Gentamycin plus Clindamycin, the therapeutic success was noted in 50 (90.19%) subjects. Of 48 women, treated by the combination of Gentamycin plus Metronidazole, the therapeutic success was found in 43 (89.58%) women. No statistically significant difference was found among the applied antibiotic therapies (p > 0.05). Of 18 women with tubo-ovarian abscess 8 were operated on. Of these 8 women in 6 patients hysterectomy with bilateral salpingo-oophorectomy was performed and in two women unilateral salpingo-oophorectomy was carried out.

DISCUSSION

Pelvic inflammatory diseases are often of polymicrobial aetiology. In 43 patients we found two types of bacteria in the cervical culture. The therapeutic success was achieved by these three antibiotic therapies. It was 90.26%, the therapeutic success in the treatment of pelvic inflammatory diseases by Ceftriaxon plus Doxycycline was noted in 90.19% of patients. The therapeutic success of antibiotic therapy with Gentamycin plus Clindamycin was obtained in 90.91% of patients. The success of antibiotic therapy with Gentamycin plus Metronidazole was recorded in 89.59% of patients. Our results are similar to those of other authors [3, 4, 6, 7]. No statistically significant difference was found among the applied antibiotic therapies.

CONCLUSION

An early diagnosis and an aggressive treatment may prevent serious sequelae of this increasingly common sexually transmitted disease. The antibiotics should be of antimicrobial broad spectrum. Good effects can be best reached by a combined antibiotic therapy. Duration of parenteral administration of antibiotics should be several days and for at least 48 hours after the patient's defervescence.

[Diagnostic value of hysterosalpingography and laparoscopy in infertile women]

Tubal pathology with tubal blockage due to the pelvic inflammatory diseases is one of the most frequent causes of infertility in a woman [1]. The two most important diagnostic procedures which are used for evaluation of tubal patency are hysterosalpingography and laparoscopic hydrotubation [4].

SUBJECT

The aim of the study was the comparison of hysterosalpingographic and laparoscopic findings and determination of accuracy of these two procedures in the diagnosis of tubal patency.

MATERIAL AND METHODS

We studied and compared the results of hysterosalpingography and laparoscopy in 102 infertile women who were operated on at the Narodni Front Hospital of Gynaecology and Obstetrics in Belgrade during 1993 and 1994. Of 102 operated women 47 women were with primary infertility and 55 with secondary infertility. The patients were from 20 to 41 years of age, the average 28 +/- 2.4 years.

RESULTS

Of one hundred and two operated women tubal blockage was found in 94 (92.1%) patients. Unilateral hydrosalpinx was found by hysterosalpingography in 16 (15.7%) subjects and bilateral hydrosalpinx in 30 (29.4%) women. Unilateral hydrosalpinx was found by laparoscopy in 17 (16.1%) patients and bilateral hydrosalpinx in 32 (31.4%) subjects. The concordant findings by hysterosalpingography and laparoscopy in the diagnostics of unilateral hydrosalpinx were found in 76.5% of cases, and in bilateral hydrosalpinx in 70.4%. This difference was not statistically significant. Unilateral tubal blockage was identified by laparoscopy in 26 (25.5%) patients and bilateral in 27 (26.5%) subjects. The concordant findings by hysterosalpingography and laparoscopy in unilateral tubal blockage were found in 61.5% of cases, and in bilateral tubal blockage in 70.4% of women. The total concordant findings by hysterosalpingography and laparoscopy in tubal blockage were found in 65.7 of cases, and concordant findings after hysterosalpingography and surgery were noted in 61.7% cases. The findings by laparoscopy and surgery were in harmony in 86.3% patients. Ovarian abnormalities were found by laparoscopy and surgery in 22 (21.6%) women. Pelvic adhesions were found by laparoscopy in 42 women of 49 patients in whom pelvic adhesions were found during the operation. Uterine congenital anomalies were found by laparoscopy in 3 (2.9%), women and by hysterosalpingography in 6 (5.9%) patients.

DISCUSSION

Of 102 operated women tubal blockage was found in 94 (92.2%) women. Unilateral tubal blockage was found in 38 (40.4%) patients, and bilateral tubal blockage in 56 (59.6%) subjects. Hysterosalpingographic and laparoscopic hydrotubation findings in the diagnosis of tubal patency were concordant in 65% of cases, hysterosalpingographic and operative findings in 61.7% of patients, and laparoscopic and operative findings in 86.3% of subjects. Although concordant findings of 65.7% were noted in this study, which were similar to findings of other authors, the percentage of 62.5% [4], and 76% was observed [5]. During the operation pelvic adhesions were found in 49 patients, and laparoscopic in 42 women only. Ovarian abnormalities were found by laparoscopy in 22 (21.6%) patients, while uterine fibroid was found in 10 (9.8%) subjects. Uterine congenital anomalies were found by hysterosalpingography in 6 (5.9%) cases and by laparoscopy only in 3 (2.9%) patients. The advantage of visual hysterosalpingography seems to be in identification of some congenital uterine anomalies. However, the advantage of laparoscopy is identified by the possibility of visualisation of some other pelvic abnormalities which may be the cause of infertility.

CONCLUSION

There are some hysterosalpingographic and laparoscopic advantages and disadvantages in the diagnosis of infertility in women. Only by using both procedures accurate results can be achieved in the tubes, the uterus and the ovary, that can be a cause of infertility in women.

[Importance of daily serum progesterone measurement in ovulation induction]

It is known that the rise of serum progesterone concentration frequently precedes the rise of serum luteinizing hormone in spontaneous menstrual cycles and during induction of ovulation. The aim of this study was to evaluate the role of single serum progesterone measurement in the prediction of spontaneous serum luteinizing hormone rise in patients with ovulation induction. The study concerned 97 infertile women. The induction of ovulation was performed according to individual endocrine profile of a patient. In 59 (61%) patients spontaneous increase of luteinizing hormone was not recorded and in 31 (32%) patients this increase was evident. In 7 (7%) high serum luteinizing hormone concentration was measured at the time of use of human chorionic gonadotropin. The correlation between serum progesterone level and serum luteinizing hormone concentration in patients with spontaneous serum luteinizing hormone rise was statistically significant (r=0.79; p<0.01). The double daily serum progesterone rise is an important method for prediction of serum luteinizing hormone rise (x2=24.08; p<0.001). After the use this method the pregnancy rate was 29 percent in our study group.

[Correlation between ultrasonographic and celioscopic findings during stimulated cycles in women undergoing fertilization in vitro]

The authors emphasize the importance of ultrasonographic follow-up of the growth and development of the follicle in patients prepared for fertilization in vitro. The study concerned 30 patients in whom an appropriate stimulation was carried out. Correlation between ultrasonographic and coelioscopic findings is analysed. On the basis of the obtained results it was concluded that ultrasonographic diagnosis may be useful in the evaluation of the number, size and volume of a follicle. This method was also appropriate for the evaluation of the follicle maturity and determination of the best time for their puncture. In this was follicles that are in the most favourable time for fertilization in vitro, can be obtained.

[Value of the fetal biophysical profile in intensive monitoring of high risk pregnancy]

The fetal biophysical profile (FBP) is a combination of both acute and chronic condition markers of the fetus in the uterus (fetal movements, fetal breathing movements, amniotic fluid volume, maturity of the placenta, intestine distension, cardiotocographic "non stress test", cardiotocographic "oxytocin stress test" cardiotocographic "physical stress test") presented numerically, is an irreplaceable method for monitoring the condition of the fetus in the uterus. In 271 women with high risk pregnancies at the gestational age of 34-44 weeks, depending on the FBP value, the time and mode of pregnancy termination were chosen. There is a significant difference regarding the outcome of pregnancy (general bad outcome--p less than 0.001, mortality--p less than 0.004, low 5 min Apgar score--p less than 0.002, fetal distress during labour--p less than 0.001) depending on the FBP value (normal or pathological) and the connection of the pathological FBP values with the low fetal biochemical profile values (estriol in 24th urine less than 40,000 n mol/day and HPL less than 5 mg). Sensitivity (46.4%), specificity (99.2%), the prognostic value of the pathological test PVP (86.7%), and prognostic value of the normal test - PVN (94.1%) show a high FBP value as a diagnostic test. It is necessary to stick to the protocol while using this test which is very simple, cheap and not at all harmful.

[Cervical maturation using Prepidil gel in pregnancy termination in primigravidas]

The study investigated the possibility of pharmacological servical ripening induced by Dinoprostone (Prepidil Gel--Upjohn Co) prior to therapeutic abortion in primigravida. The study concerned patients-volunteers choosen by random. 73 patients were divided into two groups with the same average age, term of gestation, cervix consistency and passage through the cervical canal before the application of gel. In the first group therapeutic abortion was carried out 6 hours after the application of gle into cervical canal, and in the second group--4 hours after the gel application. Cervical maturation, testified by its consistency and spontaneous cervical ripening, was equal in both groups (average delta Hegar I was 7.32 and delta Hegar II--7.02), and it enabled medical procedure only with the local anaesthesia with 2% hylocein in 82% ob pregnant women. In a fifth of patients ob both groups it was necessary to do additional mechanical dilatation, which was easily performed due to the already soft cervix; these patients were also administered 1 ampulla ob Fortral I.V. In both groups during the action of Dinoprostone there were no significant changes either in blood pressure or in body temperature. More expressed uterine activity, followed by initial and incompleted abortions, were more frequent in patients of the first group (3529%) than in those from the second group (17.95%) in which only contractions occurred (33.33%). The rate of gastrointestinal side effects was 29.41% in the first group and 41.03% in the second group. There was no uterine complication during the activity of Dinoprostone as well as during and after medical procedure.

[Growth of the fetal cerebellum in normal pregnancy]

An ultrasonographic study was carried out in 203 physiological pregnancies whose menstrual gestational age (MGA) was between 20 and 40 weeks. The following biometric parameters were determined: transversal cerebellar diameter (TCD), biparietal diameter (BPD), occipito-frontal diameter (OFD) and head circumference (HC). The data analysis gave the optimal mathematical models with the following relations: 1) TCD/MGA (R2 = 0.904; SD = 2.6 mm); 2) MGA/TCD (R2 = 0.924; SD = 1.7 wks); 3) BPD/TCD (R2 = 0.914; SD = 4.3 mm); 4) HC/TCD (R2 = 0.919; SD = 14.3 mm), which are graphically and tabularly presented. Also the variability in the determination of MGA from TCD is calculated before 26 weeks (2 SD = 2.6 wks) and after 26 weeks (2 SD = 3.5 wks). TCD can be practically applied in cases where it is difficult or impossible to measure BPD, or in cases where it is unsuitable because of the expressed moulding of the head, since the cerebellum is not liable to changes in forms and its size is in correlation with MGA and BPD. The use of TCD is also important in the detection of congenital malformations which are manifested in the posterior cranial fossa. The potential importance of TCD in the diagnosis of the fetal intrauterine growth retardation is based on the assumption that the cerebellum is not liable, or at least not considerably liable, for growth retardation.

[Effect of intensive cardiotocographic monitoring on the time and method of completion of labor]

The authors examined selected groups of pregnant women so as to define the influence of intensive cardiotocographic monitoring of a foetus on the time and procedure of completing a labour. Two groups of pregnant women were selected: with high risk-pregnancy and with normal pregnancy monitored cardiotocographically. The results obtained were evaluated by means of the Hammacher scale. Two control groups were also examined--one group of high-risk pregnancies and the other of normal pregnancies, both monitored in the classical way (auscultation of the heart of a foetus, amnioscopy and obstetric examination). In the group of pregnant women monitored cardiotocographically, the authors found a good tolerance of the labour lasting more than 12 hours. The condition of mothers and foeti, in spite of high-risk pregnancies, was good. This was confirmed by high evaluation of newborns by means of the Apgar scale and the level of pH in the blood in the umbilical artery. In the group monitored by classical methods, from the moment of appearing a condition threatening the foetus, there was a tendency towards a fast completion of the labor. In some cases, this was worse, not better. By comparing a procedure of completing a labour in women monitored cardiotocographically and those monitored by classical methods the authors found that in the group monitored cardiotocographically labour was completed instrumentally in 25% of women, whereas in the group monitored classically--in 39% of women, which is statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)