Three medicinal plants affecting human ovarian cell viability, hormone release, and response to environmental contaminant toluene

The present study examined the effect of medicinal plants - ginkgo, tribulus (puncture vine), and yucca - on ovarian functions and their response to the toxic influence of toluene. Therefore, we analyzed the effect of toluene with and without these plant extracts on cultured human ovarian granulosa cells. Cell viability and the release of progesterone, insulin-like growth factor I (IGF I), oxytocin, and prostaglandin F (PGF) were analyzed using the trypan blue test, enzyme immunoassay, and enzyme-linked immunosorbent assay, respectively. The ginkgo, tribulus and yucca were able to suppress ovarian cell viability and alter the release of hormones. Toluene suppressed cell viability and the release of PGF, but not of progesterone, IGF-I, or oxytocin. The negative effect of toluene on cell viability was prevented and even reversed by ginkgo and yucca, whereas its effect on PGF was prevented or inverted by all tested plant extracts. These findings (1) demonstrated the direct toxic effect of toluene on ovarian cells, (2) showed the direct effect of some medicinal plants on ovarian cell functions, and (3) demonstrated the ability of these plants to inhibit the effects of toluene and to act as natural protectors against the suppressive effect of toluene on female reproduction.

Cold Atmospheric Pressure Plasma (CAP) as a New Tool for the Management of Vulva Cancer and Vulvar Premalignant Lesions in Gynaecological Oncology

Vulvar cancer (VC) is a specific form of malignancy accounting for 5–6% of all gynaecologic malignancies. Although VC occurs most commonly in women after 60 years of age, disease incidence has risen progressively in premenopausal women in recent decades. VC demonstrates particular features requiring well-adapted therapeutic approaches to avoid potential treatment-related complications. Significant improvements in disease-free survival and overall survival rates for patients diagnosed with post-stage I disease have been achieved by implementing a combination therapy consisting of radical surgical resection, systemic chemotherapy and/or radiotherapy. Achieving local control remains challenging. However, mostly due to specific anatomical conditions, the need for comprehensive surgical reconstruction and frequent post-operative healing complications. Novel therapeutic tools better adapted to VC particularities are essential for improving individual outcomes. To this end, cold atmospheric plasma (CAP) treatment is a promising option for VC, and is particularly appropriate for the local treatment of dysplastic lesions, early intraepithelial cancer, and invasive tumours. In addition, CAP also helps reduce inflammatory complications and improve wound healing. The application of CAP may realise either directly or indirectly utilising nanoparticle technologies. CAP has demonstrated remarkable treatment benefits for several malignant conditions, and has created new medical fields, such as “plasma medicine” and “plasma oncology”. This article highlights the benefits of CAP for the treatment of VC, VC pre-stages, and postsurgical wound complications. There has not yet been a published report of CAP on vulvar cancer cells, and so this review summarises the progress made in gynaecological oncology and in other cancers, and promotes an important, understudied area for future research. The paradigm shift from reactive to predictive, preventive and personalised medical approaches in overall VC management is also considered.

Transcription factor p53 regulates healthy human ovarian cells function

The aim of our study was to understand the role of transcription factor p53 in the control of healthy human ovarian cell functions. Ovarian granulosa cells were transfected with a cDNA construct encoding p53. The intracellular accumulation of p53, of the apoptosis marker bax, and of the proliferation marker PCNA, as well as the release of progesterone (P4), insulin-like growth factor I (IGF-I), oxytocin (OT), and prostaglandin F (PGF) and E2 (PGE) were evaluated by quantitative immunocytochemistry and RIA/IRMA. Transfection with the p53 cDNA construct resulted in the accumulation of p53 and bax, in a reduced level of released PCNA and PGF, and in an increased PGE output. No changes in P4, IGF-I, and OT secretion were found. These observations are the first demonstration of the involvement of p53 in the control of healthy human ovarian cell functions, namely, in the downregulation of proliferation, in the upregulation of apoptosis, and in the alteration of PGF and PGE release, but not of P4, IGF-I, or OT.

Comparison of the effects of synthetic and plant-derived mTOR regulators on healthy human ovarian cells

The aim of the present in vitro study was to compare the effects of synthetic and plant-derived mTOR regulators on healthy human ovarian cells. We compared the effect of two synthetic mammalian mTOR blockers MC2141 and MC2183 with that of natural/plant-derived mTOR blocker rapamycin and mTOR activator resveratrol on cultured human ovarian granulosa cells. We evaluated the accumulation of markers for the mTOR system (sirtuin 1; SIRT 1), proliferation (PCNA), and apoptosis (caspase 3) along with the expression of the transcription factor p53 by quantitative immunocytochemistry. It was observed that MC2183 but not MC2141 or rapamycin reduced SIRT 1 accumulation. MC2141, MC2183, and rapamycin inhibited the accumulation of PCNA, caspase 3, and p53. On the contrary, resveratrol promoted the accumulation of SIRT-1, PCNA, caspase 3, and p53. We have demonstrated the involvement of the mTOR system in the regulation of healthy human ovarian cell proliferation and apoptosis for the first time and indicated that the action of mTOR regulators on ovarian cell apoptosis can be mediated by p53. We have further shown that mTOR regulators can affect ovarian functions without any changes in SIRT-1 accumulation and that the stimulatory effects of resveratrol on analyzed ovarian cell functions are opposite to the inhibitory effects of rapamycin and synthetic mTOR blockers.

Dietary Phytochemicals Targeting Cancer Stem Cells

There is an increasing awareness of the importance of a diet rich in fruits and vegetables for human health. Cancer stem cells (CSCs) are characterized as a subpopulation of cancer cells with aberrant regulation of self-renewal, proliferation or apoptosis leading to cancer progression, invasiveness, metastasis formation, and therapy resistance. Anticancer effects of phytochemicals are also directed to target CSCs. Here we provide a comprehensive review of dietary phytochemicals targeting CSCs. Moreover, we evaluate and summarize studies dealing with effects of dietary phytochemicals on CSCs of various malignancies in preclinical and clinical research. Dietary phytochemicals have a significant impact on CSCs which may be applied in cancer prevention and treatment. However, anticancer effects of plant derived compounds have not yet been fully investigated in clinical research.

Involvement of microRNA Mir15a in control of human ovarian granulosa cell proliferation, apoptosis, steroidogenesis, and response to FSH

Our study aimed to examine the role of micro RNA Mir15a in control of basic ovarian cell functions: proliferation, apoptosis, and secretory activity. In the first series of experiments, primary human ovarian granulosa cells were transfected with antisense construct blocking Mir15a (anti-Mir15a) and cultured without hormonal treatments. Accumulation of markers of proliferation (MAPK/ERK1,2 and PCNA) and apoptosis (caspase 3 and bax), and release of steroid hormones (progesterone, testosterone, and estradiol) were evaluated by immunocytochemical analysis and by enzyme immunoassay. In the second series of experiments, granulosa cells were transfected with gene construct encoding Mir15a precursor (pre-Mir15a) and cultured with and without follicle-stimulating hormone (FSH; 0, 1, 10, and 100 ng/ml). Expression of markers of proliferation (MAPK/ERK1,2) apoptosis (caspase 3), and steroidogenesis (release of progesterone, testosterone, and estradiol) were evaluated. Transfection of cells with anti-Mir15a resulted in a significant increase in accumulation of both proliferation and apoptosis markers, a reduction in progesterone and testosterone release, and an increase in estradiol release. Transfection of cells with pre-Mir15a had an opposite effect: it reduced accumulation of proliferation- and apoptosis-related proteins MAPK/ERK1,2 and caspase 3, and promoted release of progesterone and testosterone, but not estradiol. Moreover, pre-Mir15a reversed the effect of FSH on caspase 3, progesterone, and testosterone, but not on MAPK/ERK1,2 and estradiol. Our observations demonstrate involvement of Mir15a in control of multiple ovarian functions: proliferation, apoptosis, release of progesterone, androgen, and estrogen, and response to gonadotropin. Moreover, this is the first demonstration that miRNAs can affect response of cells to hormonal regulators. We propose that Mir15 could potentially be used for control of different reproductive processes.

[Spontaneous rupture of uterine vessels during pregnancy in a patient with previous endometriosis]

Spontaneous rupture of the utero-ovarian vessels during pregnancy is a rare condition that can be life-threatening. Endometriosis is one of the factors associated with this complication of the pregnancy. Location of the pain as well as the course of this complication can simulate various diseases that must be dealt with. We describe the case associated with haemoperitoneum and hemorrhagic shock.

Follow-up after primary therapy of malignant epithelial ovarian tumors

Follow-up after finishing the primary therapy has become a routine aimed to an early detection of relapse, decreasing the mortality and improving the quality of patient's life. Main aim of the follow-up is to prolong the life of the patient. No prospective randomized study confirming the scientific character of such aims has been published, so far. Opinions on benefit from the follow-up are conflicting. It is supposed, that early relapse detection can contribute to prolonged survival and on the other hand, there are opinions, that regular medical examinations can postpone relapse detection in symptomatic patients. Patients after treatment of an early stage should be followed up in regular intervals according to the presented scheme. Patients in advanced stages of the disease should be treated in a principally different way, based on free access to post primary treatment care. Quality of life has to be emphasized. The main purpose of the follow-up is to detect relapse during the time, when it is curable. When this condition has been fulfilled, the follow- up can have medical and economic relevance. Optimal screening is based on results from prospective randomized studies which objectively compare different models of the follow-up. Routine intensive follow-up might not be cost-effective and might substantially raise patient's anxiety at the same time. Patient education regarding early symptoms of relapse and free access could represent a cost-effective model. In order to decide between minimal and intensive follow-up, needs of all three participating members: patients, doctors and healthcare system have to be taken into account (Tab. 1, Ref. 105).

[Education of gynecologic surgeons]

OBJECTIVE

To point out the latest trends in the surgical training that need to be implemented in Slovak and Czech Republic, not only in gynecology and obstetrics but also in all surgical specialties.

SUBJECT

Review article.

SETTING

Department of Obstetrics and Gynecology, Faculty Hospital Nitra and Constantine the Philosopher University Nitra.

METHODS

Analysis of the database Medline 1979-2010 with the searching words education, competency, surgeon.

CONCLUSION

The development of high-technologies, mainly minimally invasive surgery, working-hours shortage and public medical awareness are the factors that have major influence on the education of surgeons. Subspecialization, shortage of learning curve and higher safety of surgical procedures are the key elements of the surgical training.

[Assessment of routine surveillance of patients after primary treatment for cervical cancer in stage I. and II.: retrospective analysis]

OBJECTIVE

Evaluate the monitoring and diagnosis of recurrence after primary treatment for cervical cancer.

DESIGN

Retrospective analysis.

SETTING

Department of Obstetrics and Gynecology Faculty Hospital and Constantine the Philosopher University Nitra.

METHODS

We retrospectively analyzed 199 patients who have undergone surgical treatment for cervical cancer between 2000 and 2008 at the Faculty Hospital Nitra and they received chemoradioterapy after evaluation of risk factors. Monitoring after primary treatment consisted of general physical examination, gynecological examination, vaginal and abdominal ultrasonography, chest X-ray and determining the level of SCCA. The examinations were performed by gynecologist and clinical oncologist. We compared the survival of patients with symptomatic and asymptomatic recurrences.

RESULTS

The recurrence after 6 months post primary therapy were identified in 17 cases. At the time recurrence diagnosis 3 patients were asymptomatic and 14 were symptomatic. Recurrences all 3 asymptomatic patients were detected during regular examinations. Asymptomatic and symptomatic patients had similar survival.

CONCLUSION

Regular monitoring of patients after primary treatment of cervical cancer in the rigid intervals and diagnosis of recurrence in the asymptomatic stage does not improve survival compared with symptomatic patients. It is necessary to re-evaluate the algorithm of follow-up not only in terms of survival but also in terms of economic consequences.

[Peripartum hysterectomy--an audit in Slovakia in 2007]

OBJECTIVE

An audit was performed to assess the number, indications and complications of peripartum hysterectomy at the departments of obstetrics/gynecology in Slovakia in 2007.

DESIGN

Observational descriptive study.

SETTING

Department of Obstetrics and Gynecology, Faculty Hospital Nitra and Constantine the Philosopher University Nitra.

METHOD

An official questionnaire of Slovak Society of Obstetrics and Gynecology was sent to all 63 departments of obstetrics/gynecology to find the number of peripartum hysterectomy performed in the year 2007. Differences between intrapartum and postpartum cases were compared.

RESULTS

44 from 63 institutions responded to the survey (response rate 69.8%). There were 38,485 deliveries and 24 cases of peripartum hysterectomies. The incidence of peripartum hysterectomy was 0.62/1000 deliveries, 1 case occurred in 1604 deliveries. 16 (66.7%) patients had a total abdominal hysterectomy with the remaining 8 (33.3%) having a sub-total hysterectomy. All operations were emergent. 18 procedures were performed during delivery and 6 in the postpartum period. Hypogastric artery ligation before hysterectomy were performed on 2 patients in the postpartum group. 20 of 24 (83.3%) patients delivered by cesarean section, three (12.5%) by spontaneous vaginal delivery and one (4.2%) with vaccumextraction. The indications for emergency peripartum hysterectomy were: placenta praevia 6 cases (25%), placental abruption with disseminated intravascular coagulation 6 (25%), placenta accreta 3 (12.5%), uterine atony 3 (12.5%), uterine rupture 3 (12.5%) and retroperitoneal haematoma 3 (12.5%). The youngest patient was 15 year-old, the oldest one was 39. After hysterectomy 10 (41.7%) women were admitted to the intensive care unit. There was no maternal mortality, but five newborns died due to perinatal asphyxia. There were more blood transfusions in the group of postpartum hysterectomies in comparison with intrapartum cases (4.0 +/- 1.3 transfusion units vs 9.1 +/- 3.5, p < 0.05), as well as the longer hospital stay (10.3 +/- s4.2 days vs. 19.1 +/- 5.3, p < 0.05).

CONCLUSIONS

Peripartal hysterectomy is a dramatic but a life saving procedure. It is usually associated with significant maternal and fetal morbidity and mortality. Every obstetric service should have access to a surgical team capable of performing emergency peripartal hysterectomy.

Identification of microRNAs controlling human ovarian cell proliferation and apoptosis

Previous studies have shown that microRNAs (miRNAs) can control steroidogenesis in cultured granulosa cells. In this study we wanted to determine if miRNAs can also affect proliferation and apoptosis in human ovarian cells. The effect of transfection of cultured primary ovarian granulosa cells with 80 different constructs encoding human pre-miRNAs on the expression of the proliferation marker, PCNA, and the apoptosis marker, Bax was evaluated by immunocytochemistry. Eleven out of 80 tested miRNA constructs resulted in stimulation, and 53 miRNAs inhibited expression of PCNA. Furthermore, 11 of the 80 miRNAs tested promoted accumulation of Bax, while 46 miRNAs caused a reduction in Bax in human ovarian cells. In addition, two selected antisense constructs that block the corresponding miRNAs mir-15a and mir-188 were evaluated for their effects on expression of PCNA. An antisense construct inhibiting mir-15a (which precursor suppressed PCNA) increased PCNA, whereas an antisense construct for mir-188 (which precursor did not change PCNA) did not affect PCNA expression. Verification of effects of selected pre-mir-10a, mir-105, and mir-182 by using other markers of proliferation (cyclin B1) and apoptosis (TdT and caspase 3) confirmed specificity of miRNAs effects on these processes. This is the first direct demonstration of the involvement of miRNAs in controlling both proliferation and apoptosis by ovarian granulose cells, as well as the identification of miRNAs promoting and suppressing these processes utilizing a genome-wide miRNA screen.

Identification of protein kinases that control ovarian hormone release by selective siRNAs

The goal of this study was to identify protein kinases (PKs) that control the secretory activity of human ovarian cells. Cultured ovarian granulosa cells were transfected with 264 siRNA constructs that selectively block the expression of 88 known PKs. The efficiency of transfection and of silencing marker molecules (glyceraldehyde 3-phosphate dehydrogenase, GAPDH and CDC2/p34 PK) was validated by fluorescence microscopy, real-time reverse transcription-PCR, and immunocytochemistry. Release of steroid hormones (progesterone, P(4)) and IGF1 was determined by RIA. siRNA suppressed the expression of marker molecules by up to 84%. P(4) release was suppressed after inhibiting 34 individual PKs and was stimulated after inhibiting 12 PKs. Blocking nine individual PKs inhibited IGF1 release, while the inactivation of 17 others stimulated IGF1 release. Together, these results demonstrate that the release of both steroid and peptide hormones by human ovarian cells is controlled by a large number of PKs, and that siRNA constructs may be useful tools for further defining the role of PKs in controlling ovarian secretory function.

[Fitz-Hugh-Curtis syndrome: a case report]

Fitz-Hugh-Curtis syndrome (FHCS) is a liver inflammation associated with pelvic inflammatory disease (PID). It is usually associated with a sharp pain in the right upper quadrant at the rib margin. Chlamydia trachomatis and Neisseria gonorrhoeae are thought to be primary causative agents of FHCS. Location of pain as well as the course FHCS can simulate various diseases which is necessary in the differential diagnosis of abdominal pain thinking. In the case report we describe the occurrence of a typical syndrome in an association with PID.

Identification of microRNAs controlling human ovarian cell steroidogenesis via a genome-scale screen

The aim of our studies was to identify miRNAs affecting the release of the major ovarian steroid hormones progestagen, androgen and estrogen by human ovarian cells. The effect of transfection of cultured primary ovarian granulosa cells with 80 different gene constructs encoding human pre-miRNAs on release of progesterone, testosterone and estradiol was evaluated by enzyme immunoassay. In addition, effect of two selected antisense constructs blocking corresponding miRNA on progesterone release was tested. Efficiency of transfection (incorporation transfection reagent) and silencing of marker substances (GAPDH mRNA, GAPDH and CREB-1) were validated by fluorescent microscopy, real-time reverse transcription-PCR analysis and immunocytochemical analysis. Thirty-six out of 80 tested miRNA constructs resulted in inhibition of progesterone release in granulosa cells, and 10 miRNAs promoted progesterone release. Transfected of cells with antisense constructs to two selected miRNAs blocking progesterone release induced increase in progesterone output. Fifty-seven miRNAs tested inhibited testosterone release, and only one miRNA enhanced testosterone output. Fifty-one miRNAs suppressed estradiol release, while none of the miRNAs tested stimulated it. This is the first demonstration that miRNAs can control reproductive functions resulting in enhanced or inhibited release of ovarian progestagen, androgen and estrogen. We hypothesize that such miRNA-mediated effects could be potentially used for regulation of reproductive processes, including fertility, and for treatment of reproductive and other steroid-dependent disorders.

Nucleolar development and allocation of key nucleolar proteins require de novo transcription in bovine embryos

The goal of the present study was to investigate whether key nucleolar proteins involved in ribosomal RNA (rRNA) transcription and processing are transcribed de novo or from maternally inherited messenger RNAs (mRNA) in bovine embryos, and to which extent de novo transcription of these proteins mRNA is required for the development of functional nucleoli during the major activation of the embryonic genome. Immunofluorescence for localization of key nucleolar proteins, autoradiography for detection of transcriptional activity, and transmission electron microscopy were applied to in vitro produced bovine embryos cultured from the 2-cell stage with or without (control groups) alpha-amanitin, which blocks the RNA polymerases II and III transcription and, thus the synthesis of mRNA. In the control groups, weak autoradiographic labeling was initially observed in the periphery of few nuclei at the 4-cell and the early 8-cell stage, and the entire nucleoplasm as well as nucleolus precursor bodies (NBBs) were prominently labelled in all late 8-cell stages. The NPBs displayed initial transformation into fibrillo-granular nucleoli. In the alpha-amanitin group, lack of autoradiographic labeling was seen at all developmental stages and disintegrated NPBs stage were found at the late 8-cell. Our immunofluorescence data indicate that RNA polymerase I, UBF, topoisomerase I and fibrillarin are transcribed de novo whereas nucleolin and nucleophosmin are maternally inherited as demonstrated by alpha -amanitin inhibition. However, localization of these two proteins to the nucleolar compartments was negatively affected by the alpha-amanitin treatment. Consequently, functional nucleoli were not established.

Appendiceal adenocarcinoma presenting with bilateral Krukenberg tumors

Primary appendiceal malignancy metastatic to the ovaries is a condition that may mimic advanced stage ovarian cancer. This condition is rarely diagnosed preoperatively. A 52-year-old woman referred to our institution for presumed advanced stage of ovarian cancer was found to have primary appendiceal adenocarcinoma metastatic to ovaries at laparotomy. We describe the clinical course of the patient. It is important for the gynecologist-oncologist to include tumors of the appendix into the differential diagnosis of any case of ovarian tumor.

[The use of recombinant factor VIIa on the therapy of massive bleeding after cesarean section]

OBJECTIVE

To present a case report of severe post-partum bleeding after caesarean section and successful treatment using recombinant factor VIIa.

SETTING

Obstetrics and Gynecology Department, Faculty Hospital, Nitra, Slovak Republic.

CASE REPORT

A 29-year old secundigravida presented with major post-partum bleeding after caesarean section due to uterine atony. The patient developed hemorrhagic shock, associated with disseminated intravascular coagulation (DIC). Treatment with uterotonic drugs, prostaglandins and hysterectomy failed to control diffuse bleeding. Recombinant factor VIIa (90 microg/kg intravenous injection) was given as a final attempt to control the bleeding. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy.

CONCLUSION

This case suggests a potential role of recombination factor VIIa in the treatment of severe post-partum bleeding associated with DIC.

[Choledochal cyst complication of pregnancy]

Authors in this case report describe rare complication of pregnancy. Ultrasound examination showed cystic lesion in abdominal cavity. It was indicated caesarean section because of deterioration of patient's condition. After the removal of foetus it was peroperative found cystic lesion in subhepatal area in right mesogastrium. Cystic lesion compressed stomach, colon transverse and loops of small intestine. After the revision of abdominal cavity and local finding surgeon detected choledochal cyst. It was resected and sutured hepaticojejunoanastomosis.

Leptin affects proliferation-, apoptosis- and protein kinase A-related peptides in human ovarian granulosa cells

The aim of our in vitro studies was to understand the role of leptin in controlling proliferation, apoptosis, and protein kinase A (PKA) in human ovarian cells. We analyzed the in vitro effects of leptin (0, 1, 10 or 100 ng/ml) on the accumulation of proliferation-related peptides (PCNA, cyclin B1), apoptosis-associated peptide (Bax) and the intracellular signaling molecule PKA in cultured human granulosa cells using immunocytochemistry and Western immunoblotting. It was observed that leptin stimulated in a dose-dependent manner the accumulation of PCNA (at doses 1-100 ng/ml), cyclin B1 (at doses 10 or 100 ng/ml), Bax (at doses 10 or 100 ng/ml) and PKA (at doses 1-100 ng/ml) in cultured human ovarian cells. These observations suggest the ability of leptin to control directly human ovarian cell functions: proliferation, apoptosis, and intracellular messenger PKA.

Endometrial Adenocarcinoma Presenting with an Osseous Metastasis

BACKGROUND

Gynecologic cancers metastatic to bone are rare. Endometrial carcinoma usually presents with vaginal bleeding.

CASE REPORT

A 67-year-old woman presented with pain, erythema and swelling of the right foot and no history of postmenopausal bleeding. Biopsy revealed primary endometrioid carcinoma metastatic to the calcaneus, talus and metatarsal bones. Lower leg amputation, total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node sampling were performed. Postoperatively the patient received cisplatin with adriamycin and megestrol acetate and is alive with no evidence of disease 20 months after the diagnosis.

CONCLUSION

Endometrial carcinoma can present as a metastatic lesion of bone.

Surgical management of endometrial cancer in Slovak Republic

AIM

To evaluate the routine surgical treatment of endometrial cancer in Slovak Republic in relation to current international recommendations.

METHODS

A retrospective study based on a questionnaire was undertaken. Data on surgical and post-operative adjuvant therapy of endometrial cancer patients in Slovakia in 2001 were collected, assessed and validated for good clinical practice.

RESULTS

We presented data of 298 cases of endometrial adenocarcinoma from 48 of 66 Slovak gynecologic departments. Laparotomy with hysterectomy and bilateral salpingo-oophorectomy was performed in 280/298 patients. Peritoneal washings were examined in 41/298 cases. Lymphadenectomy (pelvic and/or para-aortic) was performed in 52/298 of the women. Malignancy remained undiagnosed in 29/298 of the cases until it was detected by histological investigation of extirpated uterus.

CONCLUSION

The study demonstrates that surgical management of endometrial cancer is far from optimal. It seems necessary to restrict treatment to the centres with gynecologic oncologists trained in pelvic surgery.

Leptin directly controls secretory activity of human ovarian granulosa cells: possible inter-relationship with the IGF/IGFBP system

AIMS

The aim of our in vitro studies was to understand the role of leptin and the insulin-like growth factor I/insulin-like growth factor protein (IGF/IGFBP) system in controlling human ovarian function.

METHODS

We studied the action of leptin (0, 1, 10, or 100 ng/ml) and immunoneutralization of IGF-I using specific antiserum (0.1%) on the release of progesterone (P), estradiol (E), oxytocin (OT), IGF-I, IGFBP-3, and prostaglandins F (PGF) by these cells using radioimmunoassay/immunoradiometric assay.

RESULTS

It was found that leptin stimulated the secretion of OT, IGFBP-3, and PGF. It suppressed the secretion of E and IGF-I, but not P, into the medium. The addition of antiserum against IGF-I decreased IGF-I output, increased P, OT, IGFBP-3, and PGF secretion, and had no effect on E release. Immunoneutralization of IGF-I also prevented or reversed the effects of leptin on P, E, IGF-I, IGFBP-3, PGF, but not on OT.

CONCLUSIONS

These observations (1) demonstrate that leptin directly controls the secretory activity of human ovarian cells, (2) confirm the involvement of IGF-I in the regulation of ovarian cells, and (3) suggest an inter-relationship between leptin and the IGF/IGFBP system in the control of these functions and the involvement of IGF/IGFBP system in mediating leptin action on the ovary.

Peritoneal cytology in endometrial cancer

The results as well as prognostic interpretation of peritoneal washing cytology in endometrial cancer cases is still controversial. The incidence rate of positive cytology varies widely and the clinical significance of the positive results, especially in patients with early stage of endometrial cancer remains also controversial. Prognostic significance of malignant peritoneal cytology in endometrial cancer patients in comparison with those with ovarian cancer has been less well defined. At present, positive peritoneal cytology is not a negative prognostic factor itself, but it enhance other negative prognostic indicators. Literature regarding the significance of peritoneal cytology in endometrial cancer was reviewed in order to draw conclusions for possible therapeutic implications in patients with positive cytologic findings.

[Sacral colpopexy using prolene mesh]

OBJECTIVE

To present two case reports of the surgical correction of vaginal vault prolapse with prolene mesh.

DESIGN

Case Report.

SETTING

Department of Gynecology and Obstetrics, Hospital Nitra.

METHOD

Description of surgical method.

CONCLUSION

Sacral colpopexy is method of the choice for correction of vaginal vault prolapse in younger sexually active women.

[Supplemental imaging methods in evaluation of the extent of cervical carcinoma]

OBJECTIVE

To present a review of literature and to analyse of contribution of imaging methods in staging of cervical carcinoma.

SUBJECT

Review.

SETTING

Department of Obstetrics and Gynaecology, Medical Faculty Trnava, Slovak Republic.

SUBJECT AND METHOD

Discussion about relevant evidence from literature, information database (MEDLINE) review, and results from own prospective study.

CONCLUSION

FIGO staging of cervical carcinoma is based on clinical examinations but is complemented by imaging methods to optimalize treatment planning. From used imaging methods (computed tomography, magnetic resonance imaging, lymphography, sentinel node mapping, ultrasonography) is combination of abdominal and endoluminal ultrasonography the best available and affordable method with significant benefit in decision making procedure.

[Acebutolol in the treatment of arterial hypertension in pregnancy--comparison with commonly used hypertensive agents]

OBJECTIVE

The main purpose of our study was to analyse efficacy and safety of acebutolol (Sectral) in the treatment of hypertension in pregnancy.

DESIGN

Cohort clinical study comparing efficacy and safety of acebutolol with other antihypertensive drugs by 77 patients and their 81 newborns. The number of 48 patients were treated by acebutolol.

SETTING

Internal Medicine and Clinical Pharmacology Department, Regional Hospital, Nitra and The Faculty of Health Service and Social Work, University of Trnava; Department of Gynaecology and Obstetrics, Regional Hospital Nitra and The Faculty of Health Service and Social Work, University of Trnava; Institute of Pharmacology, The Faculty of Medicine, Komenského University, Bratislava; Environment, a.s. Nitra.

METHODS

During the period of 6 years our patients were divided into subgroups according to the type of hypertension in pregnancy and the severity of the illness which was the basis for used antihypertensive drugs. One of the topics of the study was to provide monitoring of adverse events by mother and possible drug influence on their new-born has been evaluated by investigating the week of birth, weight and length of the new-born and evaluating of Apgar score.

RESULTS

In the subgroup of 48 women treated by acebutolol we have confirmed the efficacy and safety of this antihypertensive drug without any clinically significant effect on the quality of life of their new-born and evaluating of Apgar score.

CONCLUSION

With regard to the results of our clinical study we can consider acebutolol to be effective and safe antihypertensive drug in the treatment of hypertension in pregnancy.

[Treatment of pelvic endometriosis with goserelin, an LHRH agonist]

OBJECTIVE

To determine the safety and effectiveness of ZOLADEX depot (goserelin) in the therapy of endometriosis (study No. 9393CZ/0001).

MATERIAL AND METHODS

A multicentric prospective open study of 60 women with endometriosis. R-AFS score of pelvic endomemtriosis was established in patients suffering from pelvalgia, dyspareunia and dysmenorrhoea during pre-treatment laparoscopy. The effect of Zoladex depot applied subcutaneously were evaluated by gynaecological and laboratory examinations, including assessment of subjective complaints every four weeks in the course of six months. Laparoscopic check-up was carried out immediately after terminating the therapy.

RESULTS

(1) The average total score of subjective complaints decreased by 90% after 24 weeks of treatment. (2) Treatment was successful in 67% patients, i.e. laparoscopic examination showed a decrease of the R-AFS score by at least 50%. In 28% treated women visible endometrial foci disappeared completely. (3) The most frequent side-effects of therapy are associated with hypoestrogenic effects of GnRH agonists. Vasomotor instability, flushes and night hyperidrosis occurred in 93% and 90% treated women, respectively.

CONCLUSION

Goserelin acetate is a synthetic GnRH agonist suitable for safe and effective therapy of pelvic endometriosis. The administration of 3.6 mg goserelin every day for 24 weeks reduced markedly the size of endomerial foci and painful symptoms.

Oxytocin affects the release of steroids, insulin-like growth factor-I, prostaglandin F2alpha and cyclic nucleotides by human granulosa cells in vitro

The aim of the present experiments was to examine the effects of oxytocin (1-10 000 ng/ml) on hormone and cyclic nucleotide secretion by human granulosa cells cultured in a serum-supplemented medium. The release of progesterone, oestradiol, insulin-like growth factor-I, prostaglandin F2alpha, cAMP and cGMP into the incubation medium was analysed by radioimmunoassay. An inhibition of progesterone, but not of oestradiol release was observed. Oxytocin also stimulated insulin-like growth factor-I, prostaglandin F2alpha, cAMP and cGMP output. The results suggest an involvement of oxytocin in the autocrine/paracrine regulation of steroid, insulin-like growth factor, prostaglandin and cyclic nucleotide release by human ovarian cells.

Laparoscopy without use of the Veress needle: results in a series of 1,600 procedures

OBJECTIVE

To describe a method of laparoscopy without use of the Veress needle and to analyze the associated complications.

DESIGN

We retrospectively reviewed all 1,600 laparoscopic procedures performed in the Department of Obstetrics and Gynecology at Nitra Hospital from Aug. 23, 1989, to Jan. 31, 1994.

MATERIAL AND METHODS

Our laparoscopic techniques were outlined, and our complication rate was assessed and compared with that from the literature.

RESULTS

In the 1,600 procedures, 6 complications occurred (0.375%)--4 technical failures in extremely obese patients, 1 case of umbilical granuloma 2 months after the procedure, and 1 case of omental prolapse on the sixth postlaparoscopic day.

CONCLUSION

Results from this series of procedures suggest that laparoscopy without use of the Veress needle is simple, safe, efficient, and easy to learn.