Antioxidant polysaccharide/gelatin blend films loaded with curcumin - A comparative study

Curcumin (CUR; 0, 0.005, 0.01, 0.02 %) was loaded into binary 75/25 blend films based on polysaccharides (carboxymethyl cellulose (CMC), gum Arabic (GAR), octenyl succinic anhydride modified starch (OSA), water-soluble soy polysaccharides (WSSP)) and gelatin (GEL). The GAR-based system was the least rough and, consequently, the most transparent of the films. An opposite result was found for the WSSP-based film. Despite the phase separation, the CMC75/GEL25 film exhibited excellent mechanical strength and stiffness. CUR improved the UV/VIS light-barrier characteristics of the films, but did not affect most of other physiochemical properties. X-ray diffractograms revealed that CUR provoked the rearrangement of the triple helical structure of GEL. As highly erodible, the CMC75/GEL25 carrier ensured the fastest and the most complete release of CUR. The OSA75/GEL25 system exhibited an opposite behavior. The kinetic profiles of the antiradical activity of the films did not reflect CUR release. A comparison of 2,2-diphenyl-1-picrylhydrazyl (DPPH*) scavenging on the plateau revealed that the CUR-supplemented films had quite comparable antiradical potential. The CMC75/GEL25 system exhibited the highest colorimetric stability, likely as a result of complete encapsulation of CUR in the GEL-rich microspheres. Weak symptoms of physical aging (enthalpy relaxation) were found in the films.

Safety of Three-Dimensional versus Two-Dimensional Laparoscopic Hysterectomy during the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has resulted in a significant decrease in the number of surgical procedures performed. Therefore, it is important to use surgical methods that carry the lowest possible risk of virus transmission between the patient and the operating theater staff.

AIM

Safety evaluation of three-dimensional (3D) versus two-dimensional (2D) laparoscopic hysterectomy during the COVID-19 pandemic.

METHODS

44 patients were assigned to a prospective case-control study. They were divided either to 3D (n = 22) or 2D laparoscopic hysterectomy (n = 22). Fourteen laparoscopic supracervical hysterectomies (LASH) and eight total laparoscopic hysterectomies (TLH) were performed in every group. The demographic data, operating time, change in patients' hemoglobin level and other surgical outcomes were evaluated.

RESULTS

3D laparoscopy was associated with a significantly shorter operating time than 2D. (3D vs. 2D LASH 70 ± 23 min vs. 90 ± 20 min, p = 0.0086; 3D vs. 2D TLH 72 ± 9 min vs. 85 ± 9 min, p = 0.0089). The 3D and 2D groups were not significantly different in terms of change in serum hemoglobin level and other surgical outcomes.

CONCLUSIONS

Due to a shorter operating time, 3D laparoscopic hysterectomy seems to be a safer method both for both the surgeon and the patient. Regarding terms of possible virus transmission, it may be particularly considered the first-choice method during the COVID-19 pandemic.

A Comprehensive Study on Gelatin- and Whey Protein Isolate-Based Edible Films as Carriers of Fireweed (Epilobium angustifolium L.) Extract

Gelatin (GEL) and whey protein isolate (WPI) are often taken into account as carriers of phytoantioxidants for developing active packaging. The materials obtained, however, have not yet been systematically compared to demonstrate their potential benefits and drawbacks. Fireweed extract (FE) is a rich source of polyphenols with high antioxidant activity. Therefore, in this study, the structural, physicochemical, and antiradical properties of GEL and WPI films incorporated with freeze-dried fireweed extract (FE; 0, 0.0125, 0.025, 0.05%) were simultaneously evaluated. As verified by X-ray diffraction, the GEL-based films were more crystalline and, consequently, mechanically stronger (~ 9–11 vs. ~ 6 MPa) and less permeable to water vapor than the WPI films (44.95–52.02 vs. 61.47–70.49 g mm m−2 day−1 kPa−1). Furthermore, GEL offered a bit more transparent, less yellow, and more stretchable films (~ 50–59% vs. ~ 26%). In turn, the WPI films had superior UV-protective potential. The higher FE concentration yielded more yellow films with improved UV-blocking ability. The FE (0.05%) made the GEL cryogel denser. Based on the half-time reduction of 2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) radical cation (tABTS50%), the 0.025, and 0.05% FE-supplemented WPI films exhibited ~ 1.6 and ~ 1.9 times better antiradical potential than the GEL counterparts. This result implies that the WPI-based films, being more soluble (35.12–36.74 vs. 31.51–33.21%) and less swellable (192.61–205.88 vs. 1056.93–2282.47%), ensured faster release of FE into aqueous medium. The slower building up of the antiradical activity of the FE-supplemented GEL films suggests that GEL could be more useful in the development of slow/less migratory active packaging systems for high moisture food.

Corn starch and methylcellulose edible films incorporated with fireweed (Chamaenerion angustifolium L.) extract: Comparison of physicochemical and antioxidant properties

The properties of edible films derived from corn starch (CS) and methylcellulose (MC) supplemented with fireweed extract (FE; 0.0125-0.05% w/w) were analyzed. Due to their more crystalline structure, the MC films were significantly stronger (~26 MPa) than the CS films (~4 MPa). In turn, CS produced films with lower water vapor permeability (WVP, 50.12-51.74 vs. 56.52-59.10 g mm m^-2 d^-1 kPa^-1). The hydrothermally-disrupted starch granules contributed to high roughness and opacity of the CS films. The FE-supplemented films exhibited an intensive yellow color and improved the UV-absorbing effect. FE delayed starch retrogradation, as indicated by the reduced crystallinity and slightly improved transparency of the CS films. Incorporation of FE significantly enhanced the released radical scavenging activity (RSA) of the films, while did not affect the WVP and mechanical properties. Due to better FE-trapping capacity, the CS-based films exhibited lower antioxidant activity (RSA_60min = 2.21-19.75%) as compared to the MC counterparts (RSA_60min = 4.87-38.31%).

A comprehensive use of ultrasound examination in infertility workup

Considering the growing availability of ultrasound diagnostic methods in gynecology, its role in the infertility setting is increasing.In this review, we present an up-to-date ultrasound based diagnostic scheme in infertility workup comprising the evaluation of ovarian anatomy and function, uterine exploration, as well as tubal patency. The possibility of performing the vast majority of infertility diagnostics by ultrasound in the ambulatory settings is not only attractive and beneficial to patients, but also to health care system.Thus, it is vital for gynecologists to implement modern non-invasive ultrasound modalities in their everyday practice.

Gum Arabic/Gelatin and Water-Soluble Soy Polysaccharides/Gelatin Blend Films as Carriers of Astaxanthin-A Comparative Study of the Kinetics of Release and Antioxidant Properties

Polymer blending and incorporation of active substances offer a possibility of generation of novel packaging materials with interesting features. Astaxanthin is one of the most powerful antioxidants. Hence, in this study, water-soluble AstaSana astaxanthin (AST) was incorporated into 75/25 gum arabic/gelatin (GAR75/GEL25) and water-soluble soy polysaccharides/gelatin (WSSP75/GEL25) blend films in different concentrations (0, 0.25%, 0.5%, 1%). Microscope images showed good compatibility between the polysaccharides and GEL. Basing on time required for 50% release, the WSSP-based film exhibited an approximately four-fold slower release rate (t_50% = 65.16–142.80 min) than the GAR-based film (t_50% = 14.64–34.02 min). This result was mainly ascribed to the slower dissolution of the WSSP-based carrier. The faster release rate of the GAR-based films resulted in stronger antioxidant activity (quarter-scavenging time (t_25%ABTS) = 0.22–7.51 min) in comparison to the WSSP-based films (t_25%ABTS = 0.91–12.94 min). The increase in the AST concentration was accompanied by gradually reduced solubility and the release rate. It is possible that the increasing number of starch granules (from the AST formulation) acted as a dissolution blocking agent. In general, the WSSP75/GEL25 film displayed the most linear (the Zero-order similar) release profile. So, this carrier has potential for release of AST at a quasi-constant speed.

The Influence of Treated and Untreated Subclinical Hypothyroidism on Metabolic Profile in Women with Polycystic Ovary Syndrome

BACKGROUND

Polycystic ovary syndrome (PCOS) and hypothyroidism are the most common endocrinological disorders among women of reproductive age. Since hypothyroidism occurs more frequently in PCOS patients, it is vital to explain its clinical impact.

AIM

To evaluate the impact of subclinical hypothyroidism (SCH) and its treatment on the metabolic profile of patients with PCOS.

METHODS

190 women with PCOS phenotype A were enrolled in the case-control study. They were divided into three groups: 38 women with PCOS and subclinical hypothyroidism, 76 women with PCOS and SCH under thyroid replacement therapy, and 76 women with PCOS and normal thyroid function (control group). Serum lipids, fasting glucose, and insulin, as well as oral glucose tolerance tests were performed.

RESULTS

In the analyzed parameters, there were no statistic differences between the groups in relation to thyroid function. BMI turned out to be the main factor dividing the patients in terms of serum lipids, fasting glucose, fasting insulin, and oral glucose tolerance test. TSH was associated with total cholesterol and LDL cholesterol levels, whereas BMI has a dominant impact on HDL cholesterol, triglycerides, glucose, and insulin resistance.

CONCLUSIONS

SCH is associated with mild lipid serum alterations in women with PCOS, but it is BMI to have a dominant impact on glucose and insulin. It seems that treatment of SCH in PCOS does not significantly alter lipid and glucose metabolism.

BNIP3L Is a New Autophagy Related Prognostic Biomarker for Melanoma Patients Treated With AGI-101H

BACKGROUND/AIM

Skin melanoma belongs to the most invasive malignancies with no cure for a progressing disease. Personalized therapy would allow for the selection of patients that will benefit from treatment. For this purpose, proper predictive biomarkers must be defined.

MATERIALS AND METHODS

Allogeneic whole-cell gene-modified therapeutic melanoma vaccine (AGI-101H) was applied in advanced melanoma patients. Humoral responses were analyzed using SEREX, and in silico gene expression analysis in TCGA melanoma patients was performed.

RESULTS

A specific antibody response was raised against an antigen identified as BNIP3L, which correlated with a good prognosis. Moreover, AGI-101H directs an immune response against autophagy, as BNIP3L is a marker of this process. Medium and high expression of BNIP3L was also linked with longer overall survival.

CONCLUSION

BNIP3L is a candidate prognostic marker of clinical outcome of melanoma patients treated with AGI-101H, and may be considered as a prediction marker for patient survival.

Regional Diversification of Influenza Activity in Poland During the 2015/16 Epidemic Season

The National Influenza Center (NIC) at the Department of Influenza Research of the National Institute for Public Health-National Institute of Hygiene (NIPH-NIH) participates in the Global Influenza Surveillance and Response System (GISRS) and continuously coordinates epidemiological and virological surveillance of influenza in Poland. The aim of this study was to determine the regional differences of influenza activity in Poland in the 2015/16 epidemic season. The influenza surveillance involved 16 administrative districts in which there are Voivodeship (province) Sanitary Epidemiological Stations set up to report influenza and influenza-like illness among the Polish population. Over 8000 specimens were tested in the season with regard to the respiratory viral infections in all regions investigated. The circulation of influenza viruses A and B was confirmed, with the subtype A/H1N1/pdm09 being predominant in the Pomerania, Podlaskie, Subcarpathian, Lubuskie, Silesian, and Warmian-Masuria provinces. The influenza-like virus occurred in individual cases, except for respiratory syncytial virus that also was detected in the Greater Poland and Warmia-Masuria provinces. The highest incidence of cases and suspected cases of influenza was recorded in Pomerania and the lowest one in Lubuskie provinces. The knowledge of regional differences in influenza activity is important for streamlining the distribution of preventive, therapeutic, and economic resources to combat the epidemic.

Circulation of Influenza Virus in the 2015/2016 Epidemic Season in Poland: Serological Evaluation of Anti-hemagglutinin Antibodies

The diagnostic of influenza virus infections is possible using molecular biology methods as well as the analysis of anti-hemagglutinin (anti-HA) antibodies in the blood serum. The aim of this study was to determine the level of anti-HA antibodies in 7 age groups of patients during the 2015/2016 epidemic season in Poland. A total of 1050 serum samples were tested using the hemagglutination inhibition (HAI) assay. We confirmed the presence of anti-HA antibodies for the influenza virus strains: A/California/7/2009(H1N1)pdm09, A/Switzerland/9715293/2013(H3N2), and B/Phuket/3073/2013, which were the components of the influenza vaccine for the 2015/2016 epidemic season. The level of specific anti-HA antibodies was different in each age group. The geometric mean titers were highest at age 5-9 years, where the antibody protection level reached 61.3% against B/Phuket/3073/2013 and 52.7% for A/Switzerland/9715293/2013(H3N2) antigen. The antibody level amounted to 56.7% against for antigen B at age 45-64. In the remaining age groups, the protection levels for all hemagglutinin types did not exceed 50%. These findings confirm the urgent need to increase a persistently low influenza vaccination coverage in the Polish population, which may have had its part in the noticeable increase in the confirmed cases of influenza and influenza-like virus infection during the season.

Co-infection with Influenza Viruses and Influenza-Like Virus During the 2015/2016 Epidemic Season

Concerning viral infection of the respiratory system, a single virus can cause a variety of clinical symptoms and the same set of symptoms can be caused by different viruses. Moreover, infection is often caused by a combination of viruses acting at the same time. The present study demonstrates, using multiplex RT-PCR and real-time qRT-PCR, that in the 2015/2016 influenza season, co-infections were confirmed in patients aged 1 month to 90 years. We found 73 co-infections involving influenza viruses, 17 involving influenza viruses and influenza-like viruses, and six involving influenza-like viruses. The first type of co-infections above mentioned was the most common, amounting to 51 cases, with type A and B viruses occurring simultaneously. There also were four cases of co-infections with influenza virus A/H1N1/pdm09 and A/H1N1/ subtypes and two cases with A/H1N1/pdm09 and A/H3N2/ subtypes. The 2015/2016 epidemic season was characterized by a higher number of confirmed co-infections compared with the previous seasons. Infections by more than one respiratory virus were most often found in children and in individuals aged over 65.

Circulation of Antibodies Against Influenza Virus Hemagglutinins in the 2014/2015 Epidemic Season in Poland

The aim of this study was to determine the level of anti-hemagglutinin antibodies in the serum of people in different age-groups during the 2014/2015 epidemic influenza season in Poland. A total of 1050 sera were tested. The level of anti-hemagglutinin antibodies was determined using the hemagglutinin inhibition test. The results provided information on the incidence of circulating A/California/7/2009(H1N1)pdm09, A/Texas/50/2012(H3N2), and B/Massachusetts/2/2012 viruses. The level of antibodies against influenza differed between age-groups. The protection rate was the highest for the antigen B/Massachusetts/2/2012, with the decreasing order of values in the following age-groups: ≥65 years (76.7 %), 15-25 years (72.7 %), and 0-4 years (62.0 %). The average values of the protection rate in other age-groups were as follows: 43.3 % in 22-64 years, 40% in 5-9 years, and 39.3 % in 45-64 years of age, while the lowest value of 22.7 % was in 10-14 years old subjects. In the 2014/2015 epidemic season in Poland only were 3.6 % of the population vaccinated. That is why the presented results could be interpreted as a response of the immune system of patients after infection caused by influenza virus.

The Sentinel System as the Main Influenza Surveillance Tool

Poland has implemented the influenza surveillance system called Sentinel as of 2004. The system consists of both epidemiological and virological surveillance. It is an important tool for monitoring the situation in the entire country, coordinated by the National Influenza Center situated at the National Institute of Public Health-National Institute of Hygiene (NIPH-NIH) in Warsaw, Poland. In the 2015/2016 epidemic season, more than 1600 samples were tested in the Sentinel System, of which 38.6% were positive. The samples were evaluated in seven age-groups: 0-4, 5-9, 10-14, 15-25, 26-44, 45-64, and over 65 years of age. Significant differences were reported in the number of confirmed cases of infection caused by influenza and influenza-like viruses, depending on the age-group. The highest number of confirmed cases of infections was reported for the age range of 26-44 years, accounting for 30% of the total. In each age-group, the presence of infection caused by influenza-like viruses, collectively accounting for only 3.8% of all positive tests, was also confirmed. Weekly reports generated by the Sentinel System enable to determine and control a current influenza activity in the country, which is of essential importance in case of the emergence of a new strain with a pandemic potential.

Thyroid disorders in polycystic ovary syndrome

OBJECTIVE

Thyroid disorders, especially Hashimoto's thyroiditis (HT), are observed significantly more often in patients with polycystic ovary syndrome (PCOS) than in the general population - approximately 27% and 8%, respectively. This is extremely important in young women, because both disorders are connected with fertility problems. As HT and PCOS occur together, fertility problems may become a serious clinical issue in these patients.

MATERIALS AND METHODS

A systematic literature review in PubMed of PCOS- and HT-related articles in English, published until December 2015 was conducted.

RESULTS

The reasons for joint prevalence still remain unclear. Genetic and autoimmune backgrounds are recognized to be possible common etiological factors. Three genetic polymorphisms have been described to play a role in PCOS as well as in HT. They are polymorphism of the gene for fibrillin 3 (FBN3) regulating the activity of transforming growth factor-b (TGF-b) and regulatory T cell levels, gonadotropin-releasing hormone receptor (GnRHR) polymorphism and CYP1B1 polymorphism standing for estradiol hydroxylation. High estrogen-to-progesterone ratios owing to anovulatory cycles, as well as high estrogen levels during prenatal life, disrupt development of the thymus and its function in maintaining immune tolerance, and are suspected to enhance autoimmune response in PCOS. Vitamin D deficiency could be also involved in the pathogenesis of HT and PCOS.

CONCLUSIONS

The above-mentioned common etiological factors associated with fertility problems in HT and PCOS require further research.

Short communication: A nanoemulsified form of oil blends positively affects the fatty acid proportion in ruminal batch cultures

Two consecutive rumen batch cultures were used to study the effect of nanoemulsified oils as a new type of supplement, on the in vitro fatty acid proportion and vaccenic acid formation. Three levels (3, 5, and 7%) of 2 different oil blends [soybean:fish oil (SF) or rapeseed-fish oil (RF)] were used. Both oil blends were used either in the raw form (SF or RF, respectively) or in the nanoemulsified form (NSF or NRF, respectively). The diets were the control (0%), which consisted of a dry total mixed ration without any supplements, the control plus 3, 5, or 7% of the SF or RF oil blend in appropriate form (raw or nanoemulsified). For each treatment, 6 incubation vessels were used. Each batch culture was incubated for 24h and conducted twice in 2 consecutive days. All supplements were calculated as a percentage of the substrate dry matter (400mg). Nanoemulsified supplements were recalculated to make sure the oil amount was equal to the raw oil supplementation levels. The results from both experiments indicated that the proportions of vaccenic acid and cis-9,trans-11 C18:2 increased when a raw oil blend was supplemented; on the other hand, no influence of nanoemulsified form of oil blend was observed on the proportion cis-9,trans-11 C18:2. Generally, supplementation with the nanoemulsified oil blends had less effect on biohydrogenation intermediates than the raw form of oil blends. However, the nanoemulsified form had a greater effect on the increase of n-3 and n-6 fatty acids. Nanoemulsified oil blends had a positive effect on decreasing the transformation rate of polyunsaturated fatty acids to saturated fatty acids in the biohydrogenation environment. Supplements of nanoemulsified oil blends tended to be more effective than supplements of raw oils in preserving a greater proportion of polyunsaturated fatty acids in the fermentation culture.

Diagnosis of true umbilical cord knot

INTRODUCTION

Many abnormalities are observed in the morphology and pathology of the umbilical cord. The aim of the study was to assess the role of 3D sonography in pathology of true umbilical cord knots.

MATERIAL AND METHODS

In our materials we observed 10 cases of true umbilical cord knots in a population of 2,864 deliveries. The 2-dimensional transverse scan of the umbilical cord was shown in 3- and 4-dimensional volume scan in order to get a precise image.

RESULTS

Four knots were diagnosed prenatally, 3 knots were not diagnosed before the delivery and in the 3 remaining cases ultrasound examinations were not undertaken because the patients were in the course of delivery. In the pregnant subjects with diagnosed true umbilical cord knot once a week the Doppler blood flow indices were examined in the umbilical cord sections before and after the knot. In the three shown cases there were no signs of constriction or tightening of the knot. Four newborns were delivered spontaneously and five by caesarean section. In none of the cases was a pathological FHR trace an indication for emergency delivery.

CONCLUSIONS

Four-dimensional and Color Doppler examination is very important to diagnose a true umbilical cord. To make a precise diagnosis a longer observation of the abnormality is necessary and its repeated confirmation by color Doppler and power Doppler. This diagnosis requires strict monitoring of fetal wellbeing during pregnancy and the delivery. Perfection of true umbilical cord knot diagnoses may reduce sudden and unforeseen fetal distress.

Clinical value of real time 3D sonohysterography and 2D sonohysterography in comparison to hysteroscopy with subsequent histopathological examination in perimenopausal women with abnormal uterine bleeding

OBJECTIVE

In many publications the transvaginal ultrasound is regarded as the first step to diagnose the cause of uterine bleeding in perimenopausal women. In order to improve the sensitivity and specificity of the conventional ultrasound physiological saline solution was administered to the uterine cavity and after expansion of its walls the interior uterine cavity was examined. And this procedure is called 2D sonohysterography (SIS 2D). By the ultrasound scanners which enable to get 3D real time image a spatial evaluation of the uterine cavity is possible. Clinical value of the real time 3D sonohysterography and 2D sonohysterography compared to hysteroscopy with histopathological examination in perimenopausal women.

MATERIAL AND METHODS

The study concerned a group of 97 perimenopausal women with abnormal uterine bleeding. In all of them after a standard transvaginal ultrasonography a catheter was inserted into the uterine cavity. After expansion of the uterine walls by administering about 10 ml of 0,9% saline solution the uterine cavity was examined by conventional sonohysterography. Then a 3D imaging mode was activated and the uterine interior was examined by real time 3D ultrasonography. The ultrasound results were verified by hysteroscopy, the endometrial lesions were removed and underwent a histopathological examination.

RESULTS

In two cases the SIS examination was impossible because of uterine cervix atresion. In the rest of examined group the SIS 2D sensitivity and specificity came up to 72 and 96% respectively. In the group of SIS 3D the sensitivity and specificity reached 83 and 99% respectively.

CONCLUSIONS

Adding SIS 3D, a minimally invasive method, to conventional sonohysterography improves the precision of diagnosis of endometrial pathology, allows to get three-dimensional image of the uterine cavity and enables examination of endometrial lesions. The diagnostic precision of this procedure is similar to the results achieved by hysteroscopy.

[Analysis of the course of pregnancy and labor after genetic amniocenthesis in women after 35 years of age]

THE PURPOSE OF THE RESEARCH

Analysis of the course of pregnancy and labor in patients qualified for the prenatal diagnostic tests program in Opole Region.

MATERIAL AND METHODS

2513 pregnant women participated in the program. There were 1763 (70.1%) patients above 35 years of age, out of whom 515 women (20.5%) were qualified for amniocentesis and 394 of them (15.6%) decided to undergo the test. Within the group of patients who underwent amniocentesis, 39 karyotypes (9.8%) were found. Analysis of the number of amniocenteses carried out and the number of detected fetal defects showed that initially the number of invasive tests was rising. However since 2007, i.e. since the introduction of biochemical diagnostic tests based on Kryptor technology a significant decrease of amniocenteses tests has been observed, while the rate of detected chromosome aberrations in fetuses has not changed. The course of pregnancy and labor in patients above 35 years of age, who gave birth to children in Gynecology and Obstetrics Hospital in Opole, has also been analyzed. The investigated group comprised 106 patients who underwent amniocentesis, and 138 patients who did not consent to having the invasive test. Apart from a small difference in average birth weight, the analysis of infant condition and their biophysical parameters after the labor has not shown any significant differences. In both groups gestational diabetes was the most frequent disease, and statistically it was diagnosed more often in patients who had not undergone amniocentesis. No statistically significant differences in the frequency of occurrence of other pregnancy complications have been found.

CONCLUSIONS

1. Amniocentesis carried out due to genetic indications between 150th and 20th week of pregnancy may be considered to be a procedure which is safe both for a mother and a fetus. 2. Amniocentesis does not affect the course of pregnancy or the mode of delivery in any significant way. 3. Proper genetics counseling service based on biochemical research enables to decrease the number of amniocenteses tests, while the rate of detected chromosome defects in fetuses remains unchanged.

Transvaginal hydrolaparoscopy (THL) in diagnosing infertility

INTRODUCTION

In recent years novel gynecological diagnostic methods have emerged. One of them is transvaginal hydrolaparoscopy (THL). This method allows endoscopic visualization of the organs within the women pelvis accessed through the posterior fornix of the vagina (Veress's needle was used) and with peritoneal distension by saline.

OBJECTIVE

To evaluate a THL as a new technique for diagnosing pelvic pathology.

METHODS AND RESULTS

In years 2002-2004, 56 patients underwent THL due to primary (40 cases) or secondary (16 cases) infertility (age 20-40). None of the patients had any history of previous pelvic surgery and all had normal findings on gynecological examination and vaginal sonography. The quality of the pelvic pictures was satisfactory in all cases. In the infertile group we observed in 42.8% cases of no macroscopic changes, in 57.2% some form of pelvic pathology ; 28.6% of demonstrated endometriosis, and 28.6% had tubal occlusion. There were no complications during or after the operation.

CONCLUSIONS

THL is well-tolerated and accepted by the patients. THL is a safe, simple and inexpensive diagnostic method for pelvic pathology and infertility.

Pentoxyfylline in and prevention and treatment of chronic lung disease

The anti-inflammatory effects of pentoxfylline are associated with a number of clinical benefits. These include reduction in mortality in patients who have undergone bone marrow transplants or suffer peritonitis. In infants with sepsis, a reduction in mortality has also been associated with pentoxyfylline administration. The anti-inflammatory effects of pentoxyfylline, as well as its bronchodilator, diuretic and respiratory muscle stimulant effects suggest it may have a useful role in BPD. Interim analysis of a prophylactic trial suggests pentoxyfylline may reduce treatment requirements after the neonatal period and that, in established BPD, pentoxyfylline and dexamethasone may be of similar efficacy.

[Doppler measurements of blood flow in the middle cerebral artery for the diagnosis of fetal anemia]

OBJECTIVES

This paper presents a possibility of non-invasive diagnosis of fetal anemia based on the Doppler assessing of peak systolic velocity (PSV) in the fetal middle cerebral artery. The results of Doppler measurements were compared with fetal peripheral blood count estimated after cordocentesis.

MATERIALS AND METHODS

Doppler measurements of blood flow velocity in the fetal middle cerebral artery were performed in years 2000 and 2001 in 22 pregnancies complicated by maternal blood group alloimmunisation. Gestation age varied from 27 to 36 weeks, the mean gestation age was 32 weeks. Depending on hemoglobin concentration in the fetal blood sample the severity of anemia was divided into three groups: severe anemia (Hb = < 7 g%), middle (Hb = = 8-10 g%) and light (Hb = = 10-12 g%). The fourth group consisted of fetuses without anemia (Hb > 12 g%). The results were statistically analyzed to estimate correlation between the Doppler blood flow indexes (PI, RI, SD and PSV) in the middle cerebral artery and the peripheral blood count (Hb, Ht, erythrocyte count) of fetal blood received by cordocentesis. Using T-Student-test the differences of average maximal blood flow velocities and mean Doppler indexes in the group of fetuses with severe anemia (Hb < 7 g%) and fetuses without anemia (Hb > 12 g%) were compared.

RESULTS

Highest (negative) correlation was found between the peak systolic velocity and the fetal hemoglobin concentration. The correlation index was -0, 85, which means the higher the peak systolic velocity the lower the hemoglobin concentration. The difference between the mean peak systolic velocity in the group of fetuses with severe anemia and the group without anemia was statistically significant (p < 0.001). However, there was no statistical significant difference in the mean peak systolic velocity between the group with middle anemia (Hb = 10-12 g%) and the group without anemia (Hb > 12 g%).

CONCLUSIONS

Doppler ultrasonography with the measurement of peak systolic velocity in the middle cerebral artery is a good method in evaluating of fetal peripheral blood count. Non-invasive peak systolic velocity measurements in the middle cerebral artery allow to assess the fetal hemoglobin concentration and also to reduce the count of diagnostic cordocentesis.

Glucocorticoid receptor functions as a potent suppressor of mouse skin carcinogenesis

Glucocorticoids are effective inhibitors of epidermal proliferation and skin tumorigenesis. Glucocorticoids affect cellular functions via glucocorticoid receptor (GR), a well-known transcription factor. Recently, we generated skin-targeted transgenic mice overexpressing GR under control of the keratin5 promoter (K5-GR mice). To test the hypothesis that GR plays a role as a tumor suppressor in skin, we bred K5-GR transgenic mice with Tg.AC transgenic mice, which express v-Ha-ras oncogene in the skin, and compared the susceptibility of F1 offspring to TPA-induced skin carcinogenesis. GR overexpression in the epidermis dramatically inhibited skin tumor development. In K5-GR/ras+ double transgenic mice papillomas developed later and the average number of tumors per animal was 15% (in males) and 40% (in females) of the number seen in wild type (w.t./ras+) littermates. In addition, the papillomas in w.t./ras+ animals were eight to nine times larger. GR overexpression resulted in a decrease in keratinocyte proliferation combined with a modest increase in apoptosis and differentiation of keratinocytes in K5-GR/ras+ papillomas. Our data clearly indicate that interference of GR transgenic protein with nuclear factor kappa B (NF-kappaB) transcription factor had resulted in NF-kappaB blockage in K5-GR/ras+ tumors. We discuss the role of NF-kappaB blockage in tumor-suppressor effect of GR.

Intracellular cytokine production by Th1/Th2 lymphocytes and monocytes of children with symptomatic transient hypogammaglobulinaemia of infancy (THI) and selective IgA deficiency (SIgAD)

Intracellular expression of several cytokines was assessed in lymphocytes and monocytes of children with transient hypogammaglobulinaemia of infancy (THI) and selective IgA deficiency (SIgAD). THI was characterized by an increased frequency of CD3+/CD4+ lymphocytes expressing tumour necrosis factor alpha (TNF-alpha), TNF-beta and interleukin 10 (IL-10), while in SIgAD elevated numbers of these cells containing TNF-alpha and interferon gamma (IFN-gamma) were observed. No changes in the number of CD4+ T cells expressing IL-4 in both diseases were noted. The proportion of CD33+ monocytes containing TNF-alpha both in THI and SIgAD was unchanged. The secretion of IL-12 by peripheral blood mononuclear cells (PBMCs) of patients with THI and SIgAD was significantly elevated and associated with an increased frequency of IL-12 expressing monocytes in THI but not in SIgAD. IL-18 secretion was slightly, but not significantly, elevated in both diseases. Intracellular Th1 and Th2 type cytokines within CD3+/CD4+ lymphocytes were also determined in the normal blood donors that showed high or low production of IgG and IgA in vitro. In low producers of IgG an increased proportion of CD3+/CD4+ cells expressing TNF-alpha and IFN-gamma was found, while in low IgA responders only elevated TNF-alpha positive CD3+/CD4+ cells were observed. These results suggest that THI and SIgAD may represent diseases with an excessive Th1 type response that is associated with an up-regulation of IL-12 secretion and, at least in THI, elevated numbers of monocytes expressing intracellular IL-12. Up-regulation of IL-12 may be the essential factor in the patomechanism(s) of these diseases as already described in common variable immunodeficiency (CVID).