Impact of obstetric physiotherapy and transcutaneous electrical nerve stimulation (TENS) on pain management and gastrointestinal function following cesarean birth: A randomized controlled trial.

INTRODUCTION: The study aimed to compare the impact of the physiotherapeutic method combined with TENS and physiotherapy alone on post-cesarean pain levels and the time required for intestinal peristalsis recovery. The study was conducted at the Specialist Hospital in Kraków, from January to March 2020. METHODS: The study was designed as a parallel randomized controlled trial (RCT). Participants were randomly assigned to one of three groups: TENS (n=52), nTENS (n=50) and control group (n=34), based on block randomization of 6. The allocation sequence was provided using a computer-generated random list. The participants were 136 postpartum primiparous women after cesarean birth, aged ≥18 years, having a healthy newborn, with no contradictions to TENS. The TENS group received a physiotherapeutic procedure involving a 20-minute exercise program plus a 40-minute session of TENS. The nTENS group received physiotherapeutic procedure alone, and the control group was under the routine care of midwives. The pain was assessed using the Numerical Rating Scale (NRS) at 6, 7, 12 and 24 hours after cesarean birth and twice during verticalization. RESULTS: TENS and nTENS groups had decreased pain intensity immediately after the intervention compared to the control group (p=0.002, p=0.027, respectively). During the first stage of the verticalization, the smallest increase in pain was observed in the TENS (p=0.044 compared to nTENS, p=0.000 compared to the control group). Within the increase in the pain score, the intestinal peristalsis recovery time was longer. In both groups undergoing physical therapy, a shortened recovery time of intestinal peristalsis was demonstrated (p=0.000). CONCLUSIONS: The proposed physiotherapy program, combined with TENS and instruction, proved effective in relieving post-cesarean pain and accelerating the time to first defecation and should be considered part of the standard patient management program in maternity units.

Immunotherapy of cervical cancer as a biological dissipative structure.

Cervical cancer can be not only prevented, but also effectively treated. Decreased efficiency of biochemical, neurohormonal and/or immunological mechanisms leads to infectious states which, irrespective of their bacterial, viral or parasitic aetiology, are only the necessary, but not the sufficient causes of neogenesis. The cause of cancer is the natural and common phenomenon of the self-organization of systems, endangered by ending of their existence, into more efficient time-space structures at the expense of their surrounding. Infected cells or infectiously changed tissues in their final phase of existence are often recognized as a precancerous state, but their genome does not differ from other organism cells, and that is why the carcinogenesis can still be prevented by direct fighting of pathogenic microorganisms, and indirectly by strengthening the body by neurohormonal therapy or vaccine immunopotentialization. Primary prophylaxis of neoplasms requires that not only the dissipathogenic state of cells be prevented, but also their tissue surrounding be normalized to head off the risk of the self-organization of neoplastic forms of life, differing in their genetic identity from the surrounding cells. Lactovaginal immunopotentialization complements the conservative and operative methods of oncological treatment, as well as has prophylactic application in women with the history of miscarriages, premature deliveries, lack of or significantly shortened lactation, neurohormonal menstruating disorders, chronic and recurrent inflammations of the reproductive organs, long-term hormonal contraception and hormone replacement therapy during menopause, or only deficiency of Lactobacillus vaginalis, as indicators of risk of cervical cancer.

Differences in the blood serum levels of soluble HLA-G concentrations between the menstrual cycle phases and menopause in patients with ovarian endometriosis and uterine leiomyoma.

BACKGROUND: HLA-G is an antigen whose participation in the regulation of the immune system is well documented. The aim of the present study has therefore been to evaluate the sHLA-G blood serum concentrations levels in both women with ovarian endometriosis and women with uterine leiomyomas. METHODS: In our study, the soluble HLA-G concentration level was evaluated in the blood serum samples obtained from 98 women who underwent laparotomies or laparoscopies due to either ovarian endometriosis or leiomyomatous uterus. The control group consisted of 42 women, including women on whom a diagnostic laparoscopy identified no lesions, and volunteers-healthy women who returned their blood serum samples during menstrual bleeding. RESULTS: Patients who underwent surgical treatment because of ovarian endometriosis or uterine leiomyoma, as well as patients from the control group, exhibited no sHLA-G blood serum concentration level fluctuations between the proliferative and secretory menstrual cycle phases. The sHLA-G levels were significantly lower in the patients with ovarian endometriosis and in the patients from the control group during the menstrual cycle phase than in those patients with leiomyoma. A similar relation between the sHLA-G levels of the postmenopausal patients suffering from leiomyoma and the control patients was found. In contrast, the postmenopausal women suffering from endometriosis were typified by levels of sHLA-G blood serum concentration comparable to those of the patients with leiomyoma, and the levels were significantly higher than those observed in the blood sera of the postmenopausal patients from the control group. CONCLUSION: The soluble HLA-G blood serum level would seem to be a useful marker for evaluating the status of the microenvironment, where the tumor-immune cell and ectopic and eutopic endometrial interactions take place.

Soluble HLA-G changes in maternal blood serum during the progression of labor.

BACKGROUND: The expression of the HLA-G antigen from implantation toward term is crucial for the growth of a semiallogenic fetus as it shields this fetus from the maternal cytotoxic response. Little is known, however, about the potential role of soluble HLA-G isoforms during delivery. The initiation of labor is associated with a complex molecular response leading to a brief activation of the maternal immune system with an accompanying capacity to restrict this activation, and HLA-G seems to be an important factor in enabling the proper immune response at the maternal fetal interface. METHODS: In our study the levels of soluble HLA-G concentration were evaluated in the blood serum samples obtained from 47 pregnant women who either underwent cesarean sections or delivered vaginally. The patients were divided into three subgroups according to the progression of labor at the time of the cesarean or, in cases of vaginal delivery, according to the duration of the pregnancy. RESULTS: We have observed that the progression of labor is associated with a continuous increase in the sHLA-G plasma level. The sHLA-G levels were statistically significantly higher in the blood sera obtained from the women in advanced labor than from the women who were at the beginning of labor. CONCLUSION: The changes in sHLA-G concentration levels observed during the stages of labor may indicate that this isoform participates in maintaining reproductive tract homeostasis.

The analysis of CD34 antigen immunoreactivity level in invasive ductal breast cancer with respect to the presence of lymph node metastases.

BACKGROUND: Angiogenesis is a basic process that enables neoplasms to thrive. Microvessel density (MVD) evaluation is an accepted parameter for assessing the angiogenesis process within a tumor. The aim of the present study has been to assess the number of microcapillaries in both invasive ductal breast cancer with the presence of metastases in regional lymph nodes and in invasive ductal breast cancer without such metastases. METHODS: The CD34 antigen immunoreactivity level was assessed by immunohistochemistry in both types of invasive ductal breast cancer. Tissue samples were obtained from 40 patients and were divided into two groups according to whether or not there were lymph node metastases. RESULTS: The patients with lymph node metastases exhibited statistically significantly higher numbers of stained microcapillaries than the patients who did not have lymph node metastases. CONCLUSION: Thus the number of stained microcapillaries as evaluated by using the CD34 immunoreactivity level seems to be a useful predictor for the development of local lymph node metastases in female invasive ductal breast cancer.

The length of menstrual bleeding and the risk of urogenital infections in the context of the activity of hemoglobin-derived microbicidal peptides.

OBJECTIVE: Well-known natural unspecific antimicrobial factors acting in the vagina are additionally reinforced during menstrual bleeding by hemocidins--a recently discovered novel class of microbicidal peptides generated proteolytically from hemoglobin. The aim of the presented research was to investigate the relation between the average length of menstrual bleeding and the frequency of urogenital infections. We expected that the shorter menstrual bleeding might increase the risk of urogenital infections because is synonymous with the shorter period of exposition on bactericidal action of hemocidins. STUDY DESIGN: The study contains statistical analysis of an average declared length of menstrual bleeding in the group of 267 young, sexually active women with the symptoms of urogenital infections. The control group consisted of 300 young healthy women. RESULTS: The length of menstrual bleeding in the group of patients with urogenital infections (average 4.35 days) was statistically significantly shorter than in the control group (average 4.95 days). The average length of the menstrual cycle was equal and counted ca. 28 days in both groups. CONCLUSION: The length of menstrual bleeding seems to be a significant factor in the vaginal ecology maintenance.

Metallothionein expression and infiltration of cytotoxic lymphocytes in uterine and tubal implantation sites.

INTRODUCTION: In spite of increasing number of immune cells in the endometrium during the decidualization, the integrity of endometrial tissue in each menstrual cycle is maintained by adaptive changes in expression of several factors that regulate activity of immune cells and concomitant hormonal alterations during the menstrual cycle. This regulatory function of endometrium is also related to resistance to apoptosis, in which metallothionein (MT) may play a role. MATERIALS AND METHODS: Study group included 26 women with spontaneous abortion and 18 patients with tubal ectopic pregnancy. Control group included 17 women whose endometrial tissue samples were taken during the normal secretory cycle phase. Expression of metallothionein (MT), CD56 and CD69 were assessed in tissue samples by immunohistochemistry. RESULTS: The number of CD56-positive cells was significantly higher in women with ruptured than unruptured ectopics. MT expression was higher in tubal mucosa distant from the implantation site in ruptured compared to unruptured ectopics. It was found also to be significantly lower than in decidua taken from women with spontaneous abortion. CD69 expression was similar in women with spontaneous abortion as well as patients with ruptured ectopics compared to the control group. On the other hand, CD69 expression in unruptured ectopics was significantly lower than in women with spontaneous abortion and the control group. CONCLUSION: The concentration of immune cells and increase of their activity in tubal mucosa, with insufficient protection against immune-mediated apoptosis assessed by MT expression, might result in tubal rupture during ectopic pregnancy.

The molecular changes during placental detachment.

OBJECTIVES: RCAS1 is a membrane protein that plays a role in the maintenance of maternal immune tolerance during pregnancy. The work presented here demonstrates the results of RCAS1 expression in placenta in cases of placental abruption and patients with retained placental tissue during the third stage of labor. STUDY DESIGN: The placenta tissue samples were obtained during vaginal and cesarean delivery (derived from 117 pregnancies). Pregnant women were divided into four groups according to the onset of labor and the time of placental detachment in term labors. The samples were analyzed by the Western blot method. Statistical analysis was performed using the Shapiro-Wilk procedure. The Mann-Whitney test and Student's t-test were applied to compare the differences between parametric data. RESULTS: The average relative amount of RCAS1 observed in those patients with retained placental tissue was statistically significantly higher than in the patients with placental abruption. CONCLUSION: The differences observed in placental RCAS1 levels confirm the participation of this protein in the inhibition of maternal immune response during gestation. The present results also indicate that RCAS1 participates in the changes in the maternal immune system that take place during parturition and reinforce its potential involvement in the mechanism of placental abruption.

A case of left interstitial pregnancy after left adnexectomy--why surgical management?

Interstitial pregnancy is a rare condition of tubal pregnancy with a mortality rate of 2-2.5% [4] that can easily be misdiagnosed. The prevalence of interstitial pregnancy is 0.8% in normal population and it increased during the past few decades due to reproduction techniques development even up to 11% in groups of women after in vitro fertilization. A comprehensive MEDLINE and OLDMEDLINE search covering years 1950-2005 using query terms "interstitial", "pregnancy" and "adnexectomy" identified only 10 cases reported in worldwide literature. The first treatment of interstitial pregnancy used to be a resection of the uterus body via laparotomy. Along with the evolution of sensitive biochemical assays, imaging technologies and the development of operative techniques, the management of interstitial pregnancy became less invasive. We report a case of spontaneous left interstitial pregnancy after left adnexectomy due to left ovarian tumor of borderline malignancy.

Cycle dependent RCAS1 expression with respect to the immune cells presence and activity.

INTRODUCTION: The number of cytotoxic immune cells grows in the endometrium during the secretory cycle phase. RCAS1 is a protein inhibiting the activated immune cytotoxic cells. The expression of RCAS1 has been confirmed in endometrium. The aim of the present study was to evaluate the RCAS1 expression alterations with respect to the menstrual cycle changes and the number and activity of cytotoxic immune cells. MATERIAL AND METHODS: RCAS1, CD25, CD69, CD56, CD16, CD68 antigens expression was assessed by immunohistochemistry in endometrial tissue samples which were obtained from 33 patients. Tissue samples were classified according to the menstrual cycle phases, with division of the cycle into three phases: proliferative (8 cases), periovulatory (10 cases), and secretory (15 cases) ones. RESULTS: A significantly higher RCAS1 expression was observed in the periovulatory and the secretory menstrual cycle phases than in the proliferative phase. The changes in RCAS1 expression were combined with significant differences in the number of immune cells and their activity. The highest level of CD69 antigen expression was observed during the periovulatory cycle phase, while the highest level of CD25 antigen expression was observed during proliferative phase, the number of CD56 positive cells was at the highest level during the secretory cycle phase. No significant differences in the number of macrophages and CD16 antigen expression were observed with respect to the menstrual cycle phases. CONCLUSION: RCAS1 endometrial expression may favor the coexistence of active lymphocytes and endometrial cells.

High grade intermediate cell neuroendocrine cancer of the larynx--case report.

Primary poorly differentiated neuroendocrine carcinomas are rare pathological findings in the upper respiratory tract, approximately 650 cases have been reported in the literature. We report a case of 51-year old male with a high grade intermediate cell neuroendocrine epiglottic cancer. The current classification according to the WHO Classification of Tumors published in 2005 is discussed.

The characterization of the exposure to immune mediated apoptosis and the regulation of immune cytotoxic activity in the environment of a neoplasm and in decidua.

Acquiring the immune-mediated apoptosis and the ability to regulate the cytotoxic immune response are the main phenomena playing fundamental roles in such situations as neoplasm survival and creation of immune tolerance during pregnancy. The aim of this study was to investigate these phenomena through the evaluation of metallothionein and RCAS1 proteins in neoplasm and its healthy environment (clear surgical margin), physiological conditions in placenta and its environment (decidua) and the comparison to non-neoplasmatic lesions originating from the environment (nasal polyps, endometriosis). We have shown that the growth of RCAS1 expression was simultaneous to the infiltration of activated immunological cells of tumor environment as well as decidua. The activity of immunological cells was in our study selectively suppressed. Metallothionein expression growth was also observed in healthy tumors stroma and in decidua probably in response to the growing cytotoxic activity and tumor spread. Alterations in RCAS1 and Metallothionein expression seem to be associated with local immune dysfunction in nasal polyps and endometriosis. In conclusion, the ability to compensate the growing cytotoxic immune response is physiologically observed in decidua, the lost of this ability in tumor environment might participate in the development of tumor spread.

The metallothionein and RCAS1 expression analysis in breast cancer and adjacent tissue regarding the immune cells presence and their activity.

INTRODUCTION: The generation of proper immune response in the tumor environment seems to be essential in antitumor defense. RCAS1 expression has been shown to participate in the regulation of immune cytotoxic activity, metallothionein participates in the protection of cells against immune mediated apoptosis. Since MT and RCAS1 expression is observed within healthy tumor environment we aimed to focus on the proteins expression in tumor and its healthy adjacent tissue in invasive ductal breast cancer regarding the immune cells presence and activity. MATERIAL AND METHODS: RCAS1, metallothionein, CD3, CD56, CD4, CD25, CD69, CD68 and CD16 antigens expression was assessed by immunohistochemistry in invasive ductal breast cancer. Tissue samples were obtained from 45 patients and were grouped according to the presence of lymph nodes metastases. Two groups were obtained: with and without lymph nodes metastases. RESULTS: Significant differences were observed in RCAS1 and metallothionein expression in tumor and significant differences in metallothionein expression in healthy stroma regarding the presence of lymph nodes metastases. The significantly higher RCAS1 expression was noticed in tumor in comparison to stroma in patients with the presence of lymph nodes metastases. No such difference was observed in patients without the metastases. Significantly higher metallothionein expression was identified in tumor than in stroma in both groups of patients, with and without lymph nodes metastases. These changes in RCAS1 and metallothionein expression were significantly related with the changes in the number and activity of immune cells. CONCLUSION: RCAS1 and metallothionein expression in breast cancer healthy stroma seems to be essential for the coexistence of cytotoxic immune cells and normal epithelial cells. The loss of the ability to compensate the growing cytotoxic immune response in the environment might participate in the development of tumor spread.

[Influence of ACTH-depot doses on neuroendocrine gestosis treatment]. / Wplyw dawkowania acth-depot na leczenie neuroendogennej gestozy.

OBJECTIVE OF THE STUDY: Two dosing methods of ACTH-depot therapy were compared dependently on gestational age and sequence of applied injections. It has been concluded that better efficacy was observed in single doses method comparing to serial doses in 2nd trimester. MATERIAL AND METHODS: Retrospectively, 380 pregnancies were analyzed, in which ACTH-depot therapy was applied using 0,5 mg doses. In 140 subjects (Group I, 1990-1991) 3 injection series every 2nd day with additional antibiotic (i.e. Monural 3g) were administrated. In the rest 240 (Group II, 1997-2002) single doses were applied during the whole period of pregnancy due to recurrent vomiting or decreased CAP1 serum levels under 0,8 micromol/l/min and CAP2 under 1,4 micromol/l/min in 1st trimester and compulsory in ACTH serum levels under 5,0 pg/ml. RESULTS: Clinical results can be compared with oxytocinase and ACTH serum levels, what allows to understand enzymatic control of internal maternal state. Role of ACTH not only in lung maturation, but also in onset of labor was proved in the mechanism of influence on immunologic tolerance. In hormonal threatening pregnancies enzymatic component is less helpful in predicting birth date because of common irregular oxitocinase pattern in such patients. On the other hand constant enzymatic increase proves effectiveness of ACTH-depot therapy in neurendocrine-gestoses, or in insulin-requiring pregnant patients. CONCLUSIONS: Acquired results of neonatal state proved that: 1. in pregnancies after infertility treatment early application of substitutional hormonotherapy wsith single doses of 0,5 mg ACTH-depot in early gestational weeks is more efficient method of ACTH dosing than 3 injections method in 2nd trimester 2. serum prelabour oxitocinase levels were precise factors of clinical results.

[Prenatal ACTH-depot therapy]. / Prenatalna terapia ACTH-depot.

ACTH-depot therapy is one of the therapeutic methods in threatening abortion or premature labor, introduced by Prof. R. Klimek in the 60-ies of the last century. Administration of syntetic ACTH is the method of first choice in treatment of neuroendocrinologically complicated pregnancy, safe for mother as for infant. The first trials of application of this method disclosed good results determined by very high birth rate of at term pregnancies (96%) and delivery of live infants, in comparison to 18.5% or 37% supported pregnancies treated conservatively, in the same group of women previously. Because hypothalamic hormones induce synthesis of enzyme-oxytocinase, it becomes possible to observe the development of pregnancy in women treated with ACTH-depot by CAP-level determination. In women with hypothalamic hypofunction, level of oxytocinase is low, increasing slowly, sometimes even its decrease is observed. Current multiple ACTH-depot doses: 0.5 mg i.m. are routinely used, instead of hitherto applied series of 3 injections in the second and third trimester. Number of doses depend on: levels of oxyto-cinase, rate of its increase, reactivity of patient and progression of pregnancy. Administration of ACTH-depot seems to be more beneficial than aministration of corticoids, because this hormone does not cross the placenta, but increases the production of endogenic hormones. Unwelcome symptoms of ACTH-depot treatment are similar to those observed in course of the corticold therapy, but they are less expressed. Development of features connected with hypercatabolism of proteins like: muscular atrophy, striae and osteoporotic changes, are not observed. Only single therapy with ACTH-depot causes regression of clinical symptoms of threatening premature labor, without necessity of tocolitic treatment. Thanks to steroidogenesis, normalisation of the number of preterm labors and respiratory disorders decreases.

The placental RCAS1 expression during stillbirth.

BACKGROUND: Independently of the fetal death cause the beginning and course of stillbirth is closely related with the growing cytotoxic activity at the maternal-fetal interface. RCAS1 participates in the inhibition of maternal immune response during pregnancy. The alterations of RCAS1 protein expression in placental cells seem to determine the beginning of the labor and participate in the placental abruption. The aim of the present study was to investigate RCAS1 expression in placentas obtained following stillbirths or normal term births. METHODS: RCAS1 expression was evaluated by Western blot method with the use of monoclonal anti-RCAS1 antibody in 67 placental tissue samples. Pregnant women were divided into four groups according to the mode of labor onset--spontaneous or induced, and the type of labor, stillbirth or labor at term. Placental beta-Actin expression was chosen as a control protein. Relative amounts of placental RCAS1 were compared with the use of Student's t-test, whereas beta-Actin control data were compared with the use of Mann-Whitney U test. RESULTS: The average relative amount of RCAS1 was significantly lower in women with induced stillbirths than in women with induced labor at term. Similarly, significantly lower RCAS1 placental levels were observed in patients with spontaneous stillbirths than in women with spontaneous labor at term. Significant differences in RCAS1 expression were also observed with the respect to the beginning of the stillbirth: spontaneous and induced. Lowest RCAS1 placental levels were observed in women with spontaneous stillbirth. CONCLUSIONS: These preliminary results indicate that the alterations of RCAS1 expression in the human placenta may be involved in the changes of maternal immune system that take place during stillbirth.

Comparative analysis of ACTH and oxytocinase plasma concentration during pregnancy.

INTRODUCTION: Normal function of the hypothalamo-adrenal axis is important for the regulation of feto-maternal intrauterine homeostasis including immunomodulating activity and may influence the timing of parturition. ACTH is produced during pregnancy by mother pituitary gland and by trophoblast cells, which are the place of oxytocinase production. Oxytocinase is basically secreted by syncytiotrophoblast cells and rises progressively during pregnancy until the labor. Oxytocinase may play a role as one of the main factors suppressing uterine contractions, controlling the vascular resistance and the volume of the retroplacental blood pool. MATERIAL AND METHODS: The study group consisted of 102 patients with pregnancy following infertility treatment. The assessment was provided longitudinally in six selected groups progressively according to the gestational age. Immunoassay was used to measure ACTH plasma concentration. Oxytocinase plasma activity was established using l-cystine-di-beta-naphthylamide as a substrate. RESULTS: Significantly increased oxytocinase plasma level was identified during pregnancy, progressive rise was observed beginning with the first trimester of pregnancy, until the labor. ACTH plasma concentration was observed to be at comparable level in the first and second trimester of pregnancy, while sudden statistically significant increase of ACTH plasma level was noted beginning with 28th week of gestation. CONCLUSIONS: The assessment of ACTH and oxytocinase plasma concentration might be useful for the evaluation of pregnancy development.

The level of maternal immune tolerance and fetal maturity.

OBJECTIVES: Fetal maturity does not seem to be directly connected with the phenomenon of immune tolerance during pregnancy although the fetal maturation influences the process of initiation of the labor at term finishing the immune tolerance during pregnancy. CAP and RCAS1 are expressed by the trophoblast cells and afterwards by the placenta, these proteins are able to modulate the maternal immune response. MATERIALS AND METHODS: 160 patients were randomly selected to our study. The patients were divided into two groups using K score according to the newborn's maturity: maturated and not fully maturated. Within the groups of matured and not fully matured newborns the subgroups were selected according to the type of the labor: spontaneous or induced. The oxytocinase plasma activity was established in plasma samples obtained from pregnant women a few days before delivery. The placental RCAS1 relative amount was assessed by Western blot analysis. RESULTS: The differences in oxytocinase plasma level with respect to the fetal maturity were identified in our study however no RCAS1 expression changes were found regarding the fetal maturation. We determined the alterations in RCAS1 expression with respect to the occurrence of clinical symptoms of the spontaneous beginning of the labor in maturated and not-fully maturated groups of newborns. CONCLUSIONS: Oxytocinase seems to be a useful marker of normal fetal development. The assessment of RCAS1 in placenta directly after delivery appears to indicate the level of maternal immune tolerance during the labor initiation. The level of the immune tolerance at the moment of the delivery drops independently of the fetal maturity.

Cycle dependent expression of endometrial metallothionein.

OBJECTIVES: Molecular changes observed in endometrium with respect to menstrual cycle changes seem to be crucial for the reproductive function. Accumulation of cytotoxic cells increases the exposure of endometrial cells to apoptosis. Protection against apoptosis may be reached by endometrial cells by self molecular regulation. Metallothionein was suggested to participate in this process. The aim of our study was to evaluate endometrial MT immunoreactivity with respect to the menstrual cycle phases. MATERIALS AND METHODS: MT expression was assessed using immunohistochemistry method in 47 endometrial tissue samples derived from randomly selected patients with respect to the menstrual cycle phases--proliferative and secretory with distinguishing early, mid and late subphases in each. RESULTS: MT expression changes were observed respectively to hormonal fluctuations with the highest level during mid secretory phase and its respective decrease during the early, late secretory and mid proliferative menstrual cycle phases. The lowest MT immunoreactivity level was disclosed during early proliferative phase. CONCLUSION: Significant differences in MT expression observed in endometrium with respect to menstrual cycle changes might suggest MT participation in endometrial cells protection against apoptosis.

[Non Hodgkin lymphoma during pregnancy]. / Chloniak nieziarniczy u ciezarnej.

The coexistence of Non Hodgkin Lymphoma and pregnancy has been rarely reported. We are describing the case of 26-year-old pregnant woman, to whom two chemotherapy courses were administered because of the lymphoma. In 32 week of pregnancy cesarean section was performed due to patient general state worsening. Despite of chemotherapy children have been developing well. In the course of treatment autologous STEM cell transplant was performed. Since 13 months patient has been in remission.