[Coeliac disease as a possible cause of some gynecological and obstetric abnormalities]. / Celiakia ako mozná prícina niektorých gynekologicko-pôrodníckych ochorení.

OBJECTIVE: To bring a review of available literature sources on the prevalence of coeliac disease and its possible impact on gynecological and obstetric disorders. DESIGN: Review article. SETTING: Gynecology and Obstetrics Clinic, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia. METHODS: Analysis of literary sources. CONCLUSION: Coeliac disease is an autoimmune enteropathy caused by abnormal immune system response to gluten. Over the last decade when the prevalence of the disease increases rapidly confirming the relationship between coeliac disease and a range of reproductive disorders. Problems in this area are mostly confirmed in untreated women. Among the atypical symptoms of coeliac disease also include infertility such as delayed onset of menstruation, early menopause, secondary amenorrhea, infertility and pregnancy complications, such as recurrent abortions, intrauterine fetal growth restriction, small fetus for gestational age, low birth weight and premature birth.

[Methylation of selected tumor-supressor genes in benign and malignant ovarian tumors]. / Metylácia vybraných tumor-supresorických génov v benígnych a malígnych ovariálnych nádoroch.

OBJECTIVE: To evaluate the usefullness of examination of methylation status of selected tumor-supressor genes in early diagnosis of ovarian cancer. DESIGN: Prospective clinical study. SETTING: Department of Gynecology and Obstetrics, Department of Molecular Biology, Jessenius Medical Faculty, Commenius University, Martin, Slovak Republic. METHODS: In this study we analyzed hypermethylation of 5 genes RASSF1A, GSTP, E-cadherin, p16 and APC in ovarian tumor samples from 34 patients - 13 patients with epithelial ovarian cancer, 2 patients with border-line ovarian tumors, 12 patients with benign lesions of ovaries and 7 patients with healthy ovarian tissue. The methylation status of promoter region of tumor-supressor genes was determined by Methylation Specific Polymerase Chain Reaction (MSP) using a nested two-step approach with bisulfite modified DNA template and specific primers. RESULTS: Gene methylation analysis revealed hypermethylation of gene RASSF1A (46%) and GSTP (8%) only in malignant ovarian tissue samples. Ecad, p16 and APC genes were methylated both in maignant and benign tissue samples. Methylation positivity in observed genes was present independently to all clinical stages of ovarian cancer and to tumor grades. However, there was observed a trend of increased number and selective involvement of methylated genes with increasing disease stages. Furthermore, there was no association between positive methylation status and histological subtypes of ovarian carcinomas. CONCLUSION: RASSF1A and GSTP promoter methylation positivity is associated with ovarian cancer. The revealed gene-selective methylation positivity and the increased number of methylated genes with advancing disease stages could be considered as a useful molecular marker for early detection of ovarian cancer. However, there is need to find diagnostic approach of specifically and frequently methylated genes to determining a methylation phenotype for early detection of ovarian malignancies.

The nucleus acts as a ruler tailoring cell responses to spatial constraints.

The microscopic environment inside a metazoan organism is highly crowded. Whether individual cells can tailor their behavior to the limited space remains unclear. In this study, we found that cells measure the degree of spatial confinement by using their largest and stiffest organelle, the nucleus. Cell confinement below a resting nucleus size deforms the nucleus, which expands and stretches its envelope. This activates signaling to the actomyosin cortex via nuclear envelope stretch-sensitive proteins, up-regulating cell contractility. We established that the tailored contractile response constitutes a nuclear ruler-based signaling pathway involved in migratory cell behaviors. Cells rely on the nuclear ruler to modulate the motive force that enables their passage through restrictive pores in complex three-dimensional environments, a process relevant to cancer cell invasion, immune responses, and embryonic development.

Even illumination in total internal reflection fluorescence microscopy using laser light.

In modern fluorescence microscopy, lasers are a widely used source of light, both for imaging in total internal reflection and epi-illumination modes. In wide-field imaging, scattering of highly coherent laser light due to imperfections in the light path typically leads to nonuniform illumination of the specimen, compromising image analysis. We report the design and construction of an objective-launch total internal reflection fluorescence microscopy system with excellent evenness of specimen illumination achieved by azimuthal rotation of the incoming illuminating laser beam. The system allows quick and precise changes of the incidence angle of the laser beam and thus can also be used in an epifluorescence mode.

[Validity of hysteroscopy in clinical setting: single centre analysis of 605 consecutive hysteroscopies]. / Opodstatnenost' hysteroskopie v klinickej praxi analýza 605 výkonov jedného centra.

OBJECTIVE: Hysteroscopy represent standard diagnostic and therapeutic method in the treatment of endometrial pathology, where patient selection for this procedure depends in majority on preoperative uterine ultrasound scan. Hysteroscopy can be used for removal of polyps or myomas, endometrial tumor resection, synechiolysis, sterilisation or removal of remnants from pregnancy. Hysteroscopic surgery can be also an option for patients who wish to preserve the uterus for the treatment of recurrent bleeding. We aimed to evaluate the validity, complication rate and accuracy of hysteroscopy in correlation with preoperative ultrasound and postoperative histopathological findings. SETTING: Department of Gynecology and Obstetrics, Jessenius Medical Faculty, Commenius University, Martin, Slovak Republic. SUBJECT AND METHOD: Retrospective analysis of hysteroscopies for period of 24 months. RESULTS: During study period a total of 605 hysteroscopies were performed. In three (0.5%) cases we did not acquired sufficient bioptic material required for histopathological diagnosis, thus only 602 cases were included in the final analyses. The most frequent indication for hysteroscopy was history of postmenopausal bleeding (35.88%), followed by endometrial polyp (30.9%), hyperplasia (28.24%), cervical polyp (2.32%), corpus alienum in the uterus (1.66%) and fertility disorders (1%). Multifactorial analysis of hysteroscopy, ultrasound and histopathological findings revealed 69.41% sensitivity rate for ultrasound finding of endometrial hyperplasia, 48.16% sensitivity rate for submucous myoma and 81.72% sensitivity for endometrial polyp. The last group of patients showed the highest correlation rate (r)=0.41, p<0.01. The false pozitivity of preoperative ultrasound was 30.59%, 51.84% and 18.28% for mentioned groups, respectively. The association between hysteroscopic and histopathological results showed a 97.1% agreement in patients with endometrial polyp and 89.3% agreement for cases with endometrial hyperplasia (p<0.05). In 66.45% was hysteroscopy associated with biopsy or curretage. The causally surgery (tumor or endometrium ablation, myoma or septum resection) was performed in 27.9% and in 5.65% others types of intrauterine hysteroscopic sugery were done. Out of all surgical procedures polyp ablation represented 63.2%, resection of submucous fibroids 21.2%, endometrial resection or ablation 7.2% and 8.4% others procedures. In studied population we diagnosed 18 (3%) cases of endometrial carcinoma (13 cases associated with hyperplasia, 5 with polyp). Complication rate was 0.66%. Diagnostic hysteroscopic procedures were associated with a significantly lower complication rate (0.19%) than operative procedures (0.82%; p<0.05). The most frequent surgical complication was perforation of the uterine cavity (three cases 0.50%), followed by fluid overload syndrome (0.17%). CONCLUSION: Hysteroscopy is safe diagnostic and operative method with high sensitivity, particularly for endometrial polyps. The validity of sonography in case of hyperplasia prior surgery could be improved by control uterine ultrasound scan reflecting cycle phase one-two days before surgery.