Hormonal and metabolic aspects of acne vulgaris in women with polycystic ovary syndrome

OBJECTIVE

Acne vulgaris in women can indicate a systemic disease, such as polycystic ovary syndrome (PCOS), which is associated with hormonal and metabolic disorders. The aim of this study was to investigate the influence of hormonal and metabolic disorders on acne vulgaris in women with PCOS.

PATIENTS AND METHODS

The study included 110 women with PCOS. Women were divided according to their androstenedione concentration: within reference range (n=66) or higher (n=44). All patients were between 17-36 years old. Acne was graded according to the US FDA scale for a five-category global system (acne global severity scale). Hirsutism was defined using a modified Ferriman-Gallwey method. Fasting plasma glucose, insulin, luteinizing hormone, follicle-stimulating hormone, 17α-hydroxyprogesterone, 17-beta-estradiol, sex hormone-binding globulin and androgen (androstenedione, total testosterone, free testosterone, dehydroepiandrosterone sulfate) were assessed, as were prolactin and cortisol concentrations. Thyrotropin and free thyroxine concentrations were also measured. The free androgen index (FAI) and homeostatic model assessment-insulin resistance (HOMA-IR) index were calculated.

RESULTS

The average age and rating on the hirsutism scale were similar in both analyzed groups. A higher percentage of severe acne was observed in the group of women with an androstenedione concentration within reference range than in the group with the higher concentration. Meanwhile, the severity of acne in the group of PCOS women with the higher androstenedione concentration was correlated with higher concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate, and cortisol. Increased glucose concentration was also proportional to the severity of acne. We did not observe a statistically significant correlation between the severity of acne and the androstenedione concentration. In the group of PCOS women as a whole, the severity of acne was correlated only with higher dehydroepiandrosterone sulfate concentration; other androgens did not affect the severity.

CONCLUSIONS

The acne global severity scale in PCOS women is associated with higher concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate, and FAI value. Higher concentrations of androstenedione did not affect acne severity.

The effect of abdominal obesity in patients with polycystic ovary syndrome on metabolic parameters

OBJECTIVE

Polycystic ovarian syndrome and obesity contribute to the metabolic complications for women of reproductive age. The aim of present study was to analyze the effect of abdominal obesity expressed using waist/hip ratio (WHR) in patients with polycystic ovary syndrome on metabolic parameters.

PATIENTS AND METHODS

The study included 659 women with PCOS with WHR <0.8 and ≥0.8 aged between 17 and 44 years. Patients were tested for follicular stimulating hormone, luteinizing hormone, 17-beta-estradiol, dehydroepiandrosterone sulfate, androstenedione, sex hormone binding globulin, and total lipid profile during the follicular phase (within 3 and 5 days of their menstrual cycle). Also, fasting glucose and insulin concentrations, and after, oral-glucose glucose administration, were determinate. De Ritis and Castelli index I and II were calculated.

RESULTS

Women with WHR ≥0.8 had higher concentration of glucose and  insulin (both fasting and after 120 min of oral administration of 75 g glucose), as well as HOMA-IR value, than women with WHR value < 0.8. Also, abdominal obesity disorders hormonal parameters. Higher free androgen index and lower concentration of sex hormone binding globulin and dehydroepiandrosterone sulfate were found in female with WHR ≥ 0.8. Follicular stimulating hormone, luteinizing hormone, androstenedione, and 17-beta-estradiol, were on similar level in both groups. Elevation in triglycerides, total cholesterol, and low-density lipoprotein levels, as well as decrease in high density lipoprotein level in serum of women with WHR value ≥ 0.8, were found when compared to women with WHR < 0.8. A statistically significant correlation was found between WHR value and glucose, insulin, sex hormone binding globulin, free androgen index and lipid profile parameters.

CONCLUSIONS

Abdominal obesity causes additional disorders in metabolic and hormonal parameters in PCOS women, which confirmed changes in analyzed parameters between PCOS women with WHR < 0.8 and WHR ≥ 0.8 and statistically significant correlations between WHR value and analyzed parameters.

Doppler study of the embryonic heart in normal pregnant women

OBJECTIVE

To describe normal fetal cardiac and hemodynamic development in normal early first trimester pregnancies.

MATERIALS AND METHODS

Eighty-eight women with singleton, uncomplicated pregnancies were prospectively studied with transvaginal ultrasound, pulsed and color Doppler. Heart diameter, heart rate, and inflow and outflow waveforms with valve signals were documented. The proportion of the cardiac cycle of isovolumetric relaxation time (IRT%) and isovolumetric contraction time (ICT%) as well as Tei index were calculated.

RESULTS

Ninety-one percent of studies were successful. Heart diameter and the fetal heart rate showed a positive correlation with increasing gestational age: R = 0.80 (p < 0.000001), R = 0.76 (p < 0.000001), respectively. Mean heart diameter at 6 weeks was 1.28 +/- 0.26 mm and mean fetal heart rate was 117 +/- 6 bpm compared to 3.88 +/- 0.54 mm and 171 +/- 6 bpm at 10 weeks. The inflow waveform was monophasic (atrial contraction) in all cases from 6 to 9 weeks. Eight pregnancies (9%) miscarried between 6 and 12 weeks of gestation and the heart exams were characterized by increased IRT% compared with the survivors. In survivors, IRT% decreased between 7 and 8 weeks, from 32.9 +/- 10.7% to 20.8 +/- 5.7% (p < 0.0001). ICT% decreased from 18.6 +/- 4.4% of the cardiac cycle at 8 weeks to 12.6 +/- 4.4% at 9 weeks (p < 0.0008) (after heart development period).

CONCLUSIONS

Doppler examination of the fetal cardiac function is possible after 5 weeks of gestation. After 8 weeks of gestation, the fetal heart is morphologically mature but has not yet achieved effective myocardial compliance. The embryonic human heart is dependent on the atrial contraction for ventricular filling throughout the period of cardiac development. Non-survivors manifest myocardial dysfunction.

[Arrhythmias in perinatal period and neonatal outcome--analysis of own experiences]

OBJECTIVE

The paper presents review of different kinds of fetal arrhythmias, diagnosed in our centres.

DESIGN

The aim of our study was to analyse results of echocardiographic examinations of 141 fetuses with diagnosed arrhythmias referred for fetal cardiac examination in years VI. 1996-V. 2001 and neonatal outcome.

RESULTS

Premature contractions were recognised in 113 (80%) fetuses, tachyarrhythmias in 7 (5%) cases and complete atrioventricular block in 5 (4%). Heart defects were diagnosed in three cases. Three fetuses developed congestive heart failure (2x SVT, 1x HLHS + block a-v III*). From all group 6 newborns died.

CONCLUSION

In case of fetal arrhythmias echocardiography should be widely applied in order to evaluate the kind of arrhythmia, sufficiency of circulation and coexistence of heart defects or functional abnormalities with arrhythmia in fetal circulation.

Fractal analysis of placenta mature villi in healthy, smoking and non-smoking women

Not all the objects created by nature can be described by means of the classical Euclidean geometry rules. New, quickly developing fractal theory can provide another instrument for describing irregular surfaces of e.g. geometric structures and objects whose development results from growth, differentiation and degeneration processes. In the present study we decided to perform fractal analysis of mature, terminal villi of placenta taken from smoking and non-smoking women, during the third trimester of pregnancy. The aim of this study was to find another morphometric parameter, independent of subjective factors, which would provide new information about the studied structure. Placentas were taken from healthy women, untreated primiparas, who did not undergo any hormonal treatment, aged 18 to 27. The material was divided into: control group--placentas from non-smoking women, and two experimental groups--placentas from non-smoking up to 30 cigarettes daily and placentas from women smoking up to 30 cigarettes daily and placentas from women smoking over 30 cigarettes daily. Fractal dimension was determined by three methods: box counting, dilation and mass scaling method. Taking under consideration the results obtained in the present study it seems that fractal dimension, objectively and independently of many factors, allows to perform mathematical estimation of the parameter which is the terminal villi occurrence density within placenta. Among the applied fractal analysis methods, used for placenta terminal villi density grade estimation, the most useful seems to be the box counting method, whereas for estimating villi surface complication--the ratio--mass scaling method. Comparing obtained fractal dimension results, we have found that they increase together with the amount of cigarettes smoked during pregnancy.

Evaluation of wear of selected prosthetic materials in contact with enamel and dentin

STATEMENT OF PROBLEM

The proper choice of prosthetic materials for restoration of occlusal surfaces is important for the protection of the hard tissue of the opposing teeth and for regular functioning of the stomatognathic system.

PURPOSE

This study evaluated the resistance to wear of gold, Palliag M, Dentacolor, Chromasit, and Stellon materials and the enamel and dentin of natural teeth during functional contacts in an artificial oral environment with and without an abrasion material (Al2 O3 ).

MATERIAL AND METHODS

The 5 nonceramic prosthetic materials used in the restoration of occlusal surfaces of fixed partial dentures were examined in contact with enamel and dentin during a simulated masticatory process in 2 environments (with and without abrasion). Wear was evaluated by means of a special device designed for wear examination.

RESULTS

The findings highlighted that the wear of nonceramic prosthetic materials in contact with enamel or dentin was similar. Dentin showed greater wear when in contact with these materials than with the enamel surface.

CONCLUSION

Artificial environmental factors significantly influenced the wear of the hard tissue of teeth, especially when in contact with materials having low microhardness.

Fetal functional pulmonary atresia with ascites resolving spontaneously before birth. A case report

In this case we report functional pulmonary atresia in a fetus with significant tricuspid valve regurgitation and severe ascites, with spontaneous improvement without prenatal intervention and a subsequent follow-up at 8 weeks after birth.

Non-insulin-dependent diabetes mellitus as a risk factor for denture stomatitis

The prevalence of denture stomatitis as well as the frequency of isolation of Candida species and their density on the palatal mucosa have been compared in 70 acrylic denture-wearers suffering from non-insulin-dependent diabetes mellitus (NIDDM) versus 58 acrylic denture-wearers with normal glucose metabolism. The adherence of C. albicans to palatal epithelial cells in vitro was also assessed in both groups. The patients with NIDDM had a significantly higher prevalence of denture stomatitis compared with the controls. The frequency of Candida colonization was increased in diabetics, but not significantly. According to the imprint culture technique, the density of Candida species was significantly higher in patients with NIDDM compared with the controls. The adherence of C. albicans to palatal epithelial cells from patients with NIDDM showed a significant increase compared with that observed in cells collected from the controls. This study supports the view that NIDDM predisposes to Candida-associated denture stomatitis.

[Examination of activity of certain phosphatases in the placenta of female rats exposed to cadmium]

The enzymatic examinations were carried out to determine, as early as possible, the functional changes in cells of fetal and maternal part of placenta, as well as pointing out those elements which were the most susceptible to cadmium toxic action. The experiments were carried out on 80 pregnant female rats which were divided into three experimental groups and a control one. The experimental animals were daily administered, intragastrically, aqueous solution of cadmium chloride, between the 7th and 19th day of pregnancy, in doses depending on experimental groups: 2, 10 and 20 mg of CdCl2 per kilogram of body weight, respectively, the animals were killed on the 21st day of pregnancy. Placenta sections were determined for activity of adenosinetriphosphatase stimulated by Mg++ ions (ATP-ase Mg++) E.C.3.6.1.3., and acid phosphatase (AcP) E.C.3.1.3.2. When administered to pregnant females, cadmium chloride was proved to cause a considerable impairment of active transport through biological membranes in placenta, which is indicated by a decrease of reactivity to Mg++ ions stimulated ATP-ase; and an increase in intracellular catabolic processes, which in turn is shown by an increase in reactivity to acid phosphatase. The fetal part of the placenta proves to be more susceptible to the lesion causing activity of cadmium than the maternal part of this organ.

[Dynamics of morphological and cytochemical changes in the placenta following cadmium chloride intoxication]

The experiments carried out for the study aimed at determining the prenatal sensitivity to cadmium in the aspect of beth morphological and functional condition of placenta. The experiments were carried out on 80 pregnant female rats divided into three experimental groups and a control one. The experimental animals were daily administered, intragastrically, aqueous solution of cadmium chloride, from the 7th to the 19th day of pregnancy, in doses differing between the experimental groups: 2, 10 and 22 mg of CdCl2 per kilogram of body weight, respectively. The animals were decapitated on the 21st day of pregnancy. Placenta sections, besides hematoxylin and eosin staining, were examined for the activity of the following enzymes: succinic dehydrogenase (SDH) E.C.1.3.99.1., lactate dehydrogenase (LDH) E.C.1.1.1.27., NADH-tetrazole reductase (NADH-t.r.), without a catalog number, and their glycogen reaction was checked. The results of the experiments proved cadmium chloride to cause considerable damage to the enzymatic apparatus of placenta, leading to energy deficit in the cells of both the fetal and the maternal part of this organ. The multienzymatic changes observed preceded the morphologic ones by far.

[Dental caries in children aged 7 and 12 years in the Province of Poznan]

The authors present the results of stomatological epidemiological studies in the Province of Poznán in 1987 for establishing the prevalence of dental caries in children aged 7 and 12 years. The assessment was done using the index of caries prevalence, value of the mean DMF-H and dmf-h indices, and their components. In both studied age groups a high prevalence of caries was found, reaching 90% in children aged 7, years and 80% in those aged 12 years. The intensity of caries in children aged 7 years measured by the index DMF-h+dmf-h (mixed teeth) was high--4.99. The intensity of caries was higher in children from rural areas (5.43) than in those from urban areas (4.455). The mean value of DMF-h was 0.49 for the whole population studied, and 0.41 for urban children and 0.56 for rural children. The mean DMF-z value in children aged 12 years was below 3.0 (2.34), and it was higher in children from rural areas (2.96) than in those from urban areas. The values of these indices were influenced mainly by high mean numbers of milk and permanent teeth with active caries. In the studied population a small number of filled teeth was noted.

[The condition of teeth in adult population aged 35-44 years living in a small town and in villages in the Province of Poznan]

In an epidemiological study the condition of teeth was assessed in 120 subjects aged 35-44 years living in Sroda Wielkopolska and villages around it. Group I (60 subjects) lived in the town and group II (60 subjects) came from villages. Each group contained 30 women and 30 men. A high prevalence of caries was found, (99.16% for the whole studied population) with the mean DMF value 16.79%. The highest DMF values were found in group II in women--21.66. These high values of DMF were due to a great number of carietic teeth, teeth removed because of caries, and a relatively small number of teeth with fillings. Slight developmental disturbances of the enamel were observed.

[Requirements for prosthetic treatment of adults aged 35-44 years in the Province of Poznan]

Stomatological examination of a group of 120 adults aged 35-44 years living in the Province of Poznań showed considerable loss of teeth (mean loss--7 in towns and 9 in villages). It was found that a small percent of these adults had prosthetic replacements. The greatest requirements were for partial lower prostheses and upper partial prostheses. Generally, greater loss of teeth was found in the rural population compared with the urban one.

Placental phospholipase A2 activities in pre-eclampsia

Phospholipase A2 activity was significantly increased in placental homogenates from 22 patients with preeclampsia in comparison to placental homogenates from women with uncomplicated pregnancy. Such an abnormality may be responsible for a altered release of free arachidonic acid, thus playing a major role in the pathogenesis of this syndrome.