Is the leptin/BMI ratio a reliable biomarker for endometriosis?

Background: The aim of this study was to analyze the concentration of leptin in peritoneal fluid and plasma and to assess their role as potential biomarkers in the diagnosis of endometriosis. Materials & methods: Leptin adjusted for BMI (leptin/BMI ratio) was measured using surface plasmon resonance imaging (SPRI) biosensors. Patients with suspected endometriosis were included in the study. Plasma was collected from 70 cases, and peritoneal fluid from 67 cases. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group and a control group (patients without endometriosis). Results: Leptin/BMI ratio in plasma did not differ between women with endometriosis and the control group (0.7159 ± 0.259 vs 0.6992 ± 0.273, p= 0,7988). No significant differences were observed in peritoneal leptin/BMI ratio levels in patients with and without endometriosis (0.6206 ± 0.258 vs 0.6215 ± 0.264, p= 0,9896). Plasma and peritoneal leptin/BMI ratios were significantly lower in women with endometriosis - related primary infertility compared to women with endometriosis without primary infertility (0.640 ± 0.502 vs 0.878 ± 0.623, p < 0.05). The difference was observed in case of primary infertility, but not in terms of the secondary one. No significant differences were noted between leptin/BMI ratio in the proliferative phase and the secretory phase (0.716 ± 0.252 vs 0.697 ± 0.288, p= 0,7785). Conclusion: The results of present study do not support the relevance of leptin concentration determination as a biomarker of the endometriosis. Due to the limited number of samples in the tested group, further studies are needed to confirm its role.

The SPRi determination of cathepsin L and S in plasma and peritoneal fluid of women with endometriosis.

PURPOSE: Endometriosis is a common disease with a complex pathomechanism and atypical symptoms, often leading to delayed diagnosis. Currently, the sole method for confirming the presence of the disease is through laparoscopy and histopathological examination of collected tissue. However, this invasive procedure carries potential risk and complications, necessitating the exploration of non-surgical diagnostic methods for endometriosis. This study aims to analyze peritoneal fluid and plasma samples for the expression of cathepsin L and cathepsin S to identify potential biomarkers for non-invasive diagnostic approaches to endometriosis. MATERIAL AND METHODS: In this cross-sectional study, plasma and peritoneal fluid samples were obtained during laparoscopy from 63 patients diagnosed with chronic pelvic pain or infertility. The study group consisted of women with confirmed endometriosis. The concentrations of cathepsins L and S were determined using an SPRi biosensor. RESULTS: The study did not reveal significant differences in the concentrations of cathepsin L and cathepsin S between the control group and the study group, both in peritoneal fluid and plasma. CONCLUSIONS: Based on the results of this study, it appears that cathepsins L and S are not suitable candidates as biomarkers for endometriosis.

Plasma and Peritoneal Fluid Annexin A2 Levels in Patients with Endometriosis.

Introduction: Endometriosis is an inflammatory-related reproductive age disease characterized by the presence of endometrial cells outside the uterine cavity. Current laboratory practice does not provide specific markers for detecting and assessing the advancement of endometriosis in either plasma or peritoneal fluid. The severity of disease is assessed in stages from I to IV based on the results of laparoscopic inspection. The protein annexin A2 (ANXA2) has been reported to be associated with inflammatory processes. Aim of the Study: The study aimed to investigate and compare ANXA2 protein concentration using the ELISA method in plasma and peritoneal fluid in a group of women with endometriosis compared to controls. Materials and Methods: Biological material was collected during a multicenter, cross-sectional study, which was conducted at eight departments during elective laparoscopy from 53 women with and 40 women without endometriosis. Patients were divided by endometriosis stage and infertility status, and then compared with subgroups. Analysis included the Chi-square test for categorical variables, Mann-Whitney U-test and two-sided Wilcoxon rank-sum test for continuous variables. Results: Women with endometriosis had significantly elevated plasma ANXA2 levels compared to women without endometriosis (mean concentrations 28.69 vs 19.61 ng/L, p=0.01). Differences in peritoneal fluid ANXA2 levels were statistically insignificant (mean concentrations of 23.7 vs 22.97 ng/L, p=0.06). Plasma concentrations in patients with stage III and IV endometriosis were significantly higher compared to controls (mean concentrations of 24.19 vs 19.71 ng/L, p=0.03). No such differences were observed in plasma when comparing stages I-II vs III-IV, and stages I-II vs controls (mean concentrations of 33.82 vs 24.19 ng/L, p=0.72 and 33.82 vs 19.71 ng/L, p=0.12, respectively). Comparison of samples from patients with or without infertility, primary or secondary infertility, endometriosis with or without infertility, and non-endometriosis with or without infertility showed no significant differences in the plasma nor in the peritoneal fluid concentrations. Conclusion: ANXA2 is possibly involved in the pathogenesis of endometriosis, especially in advanced stages. Due to the limited group of tested samples, further studies are needed to confirm its role.

Evaluation of Proteasome and Immunoproteasome Levels in Plasma and Peritoneal Fluid in Patients with Endometriosis.

Endometriosis is a chronic disease in which the endometrium cells are located outside the uterine cavity. The aim of this study was to evaluate circulating 20S proteasome and 20S immunoproteasome levels in plasma and peritoneal fluid in women with and without endometriosis in order to assess their usefulness as biomarkers of disease. Concentrations were measured using surface plasmon resonance imaging biosensors. Patients with suspected endometriosis were included in the study-plasma was collected in 112 cases and peritoneal fluid in 75. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group (confirmed endometriosis) and a control group (patients without endometriosis). Proteasome and immunoproteasome levels in both the plasma (p = 0.174; p = 0.696, respectively) and the peritoneal fluid (p = 0.909; p = 0.284, respectively) did not differ between those groups. There was a statistically significant difference in the plasma proteasome levels between patients in the control group and those with mild (Stage I and II) endometriosis (p = 0.047) and in the plasma immunoproteasome levels in patients with ovarian cysts compared to those without (p = 0.017). The results of our study do not support the relevance of proteasome and immunoproteasome determination as biomarkers of the disease but suggest a potentially active role in the pathogenesis of endometriosis.

Investigation of the Changes in Concentrations of Vitamin D-Binding Protein and Lactoferin in Plasma and Peritoneal Fluid of Patients with Endometriosis.

An evaluation of the association between the concentrations of vitamin D-binding protein and lactoferrin in the plasma and peritoneal fluid may facilitate the elucidation of molecular mechanisms in endometriosis. Vitamin D-binding protein and lactoferrin concentrations were measured by ELISA in plasma and peritoneal fluid samples from 95 women with suspected endometriosis as classified by laparoscopy into groups with (n = 59) and without endometriosis (n = 36). There were no differences (p > 0.05) in the plasma and peritoneal fluid concentrations of vitamin D-binding protein and lactoferrin between women with and without endometriosis. In women with endometriosis, there was a significant correlation between plasma and peritoneal fluid vitamin D-binding protein concentrations (r = 0.821; p = 0.000), but there was no correlation between lactoferrin concentrations in those compartments (r = 0.049; p > 0.05). Furthermore, in endometriosis, lactoferrin was found to correlate poorly with vitamin D-binding protein (r= -0.236; p > 0.05) in plasma, while in the peritoneal fluid, the correlation between those proteins was significant (r = 0.399; p = 0.002). The characteristic properties of vitamin D-binding protein and lactoferrin and the associations between their plasma and peritoneal fluid concentrations found in women with endometriosis may provide a novel panel of markers to identify high-risk patients in need of further diagnostic measures.

Autoantibody screening of plasma and peritoneal fluid of patients with endometriosis.

STUDY QUESTION: Are there specific autoantibody profiles in patients with endometriosis that are different from those in controls? SUMMARY ANSWER: This study did not reveal a significantly higher prevalence of autoantibodies in the studied groups of patients. WHAT IS KNOWN ALREADY: Various inflammatory factors are postulated to be involved in the pathomechanisms of endometriosis, and a potential link exists with autoimmune diseases, which may also play an important role. As the diagnosis of endometriosis remains invasive, it can only be confirmed using laparoscopy with histopathological examination of tissues. Numerous studies have focused on identifying useful biomarkers to confirm the disease, but without unequivocal effects. Autoantibodies are promising molecules that serve as potential prognostic factors. STUDY DESIGN, SIZE, DURATION: A multicentre, cross-sectional study was conducted over 18 months (between 2018 and 2019), at eight Departments of Obstetrics and Gynaecology in several cities across Poland on 137 patients undergoing laparoscopic examination for the diagnosis of endometriosis. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: During laparoscopy, we obtained plasma samples from 137 patients and peritoneal fluid (PF) samples from 98 patients. Patients with autoimmune diseases were excluded from the study. Autoantibody profiling was performed using HuProt v3.1 human proteome microarrays. MAIN RESULTS AND THE ROLE OF CHANCE: We observed no significant differences in the expression of autoantibodies in the plasma or PF between the endometriosis and control groups. The study revealed that in the PF of women with Stage II endometriosis, compared with other stages, there were significantly higher reactivity signals for ANAPC15 and GABPB1 (adj. P < 0.016 and adj. P < 0.026, respectively; logFC > 1 in both cases). Comparison of the luteal and follicular phases in endometriosis patients revealed that levels of NEIL1 (adj. P < 0.029), MAGEB4 (adj. P < 0.029), and TNIP2 (adj. P < 0.042) autoantibody signals were significantly higher in the luteal phase than in the follicular phase in PF samples of patients with endometriosis. No differences were observed between the two phases of the cycle in plasma or between women with endometriosis and controls. Clustering of PF and plasma samples did not reveal unique autoantibody profiles for endometriosis; however, comparison of PF and plasma in the same patient showed a high degree of concordance. LIMITATIONS, REASONS FOR CAUTION: Although this study was performed using the highest-throughput protein array available, it does not cover the entire human proteome and cannot be used to study potentially promising post-translational modifications. Autoantibody levels depend on numerous factors, such as infections; therefore the autoantibody tests should be repeated for more objective results. WIDER IMPLICATIONS OF THE FINDINGS: Although endometriosis has been linked to different autoimmune diseases, it is unlikely that autoimmune responses mediated by specific autoantibodies play a pivotal role in the pathogenesis of this inflammatory disease. Our study shows that in searching for biomarkers of endometriosis, it may be more efficient to use higher-throughput proteomic microarrays, which may allow the detection of potentially new biomarkers. Only research on such a scale, and possibly with different technologies, can help discover biomarkers that will change the method of endometriosis diagnosis. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by a grant from the Polish Ministry of Health (grant no. 6/6/4/1/NPZ/2017/1210/1352). It was also funded by the Estonian Research Council (grant PRG1076) and the Horizon 2020 Innovation Grant (ERIN; grant no. EU952516), Enterprise Estonia (grant no. EU48695), and MSCA-RISE-2020 project TRENDO (grant no. 101008193). The authors declare that there is no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.

The Influence of Lactoferrin in Plasma and Peritoneal Fluid on Iron Metabolism in Women with Endometriosis.

The aim of this study was to investigate the relationship between lactoferrin and iron and its binding proteins in women with endometriosis by simultaneously measuring these parameters in plasma and peritoneal fluid. Ninety women were evaluated, of whom 57 were confirmed as having endometriosis. Lactoferrin was measured by ELISA, transferrin, ferritin and iron on a Cobas 8000 analyser. Lactoferrin and transferrin in peritoneal fluid were lower compared to plasma, in contrast to ferritin and iron. In plasma, lactoferrin showeds associations with iron and transferrin in endometriosis and with ferritin in the group without endometriosis. Lactoferrin in peritoneal fluid correlated with lactoferrin, iron and transferrin of plasma in patients without endometriosis. The ratio of lactoferrin concentration in peritoneal fluid to plasma differentiated stage I versus IV of endometriosis and was negatively correlated with the iron ratio in patients without endometriosis. The ferritin ratio differentiated women with and without endometriosis. The very high ferritin ratios, especially in advanced stages of endometriosis, suggest the protective involvement of this protein in peritoneal fluid and the loss of this role by lactoferrin. The results demonstrate the validity of assessing iron metabolism in women with endometriosis, which may be useful as a marker of the disease and its progression.

Plasma and Peritoneal Fluid Fibronectin and Collagen IV Levels as Potential Biomarkers of Endometriosis.

Laparoscopy as a diagnostic tool for patients with suspected endometriosis is associated with several potentially life-threatening complications. Therefore, it is imperative to identify reliable, non-invasive biomarkers of the disease. The aim of this study was to analyse the concentrations of fibronectin and type IV collagen in peritoneal fluid and plasma to assess their role as potential biomarkers in the diagnosis of endometriosis. Fibronectin and collagen IV protein levels were assessed by surface plasmon resonance imaging (SPRi) biosensors with the usage of monoclonal antibodies. All patients enrolled in the study were referred for laparoscopy for the diagnosis of infertility or chronic pelvic pain (n = 84). The study group included patients with endometriosis confirmed during surgery (n = 49). The concentration of fibronectin in the plasma (329.3 ± 98.5 mg/L) and peritoneal fluid (26.8 ± 11.1 µg/L) in women with endometriosis was significantly higher than in the control group (251.2 ± 84.0 mg/L, 7.0 ± 5.9 µg/L). Fibronectin levels were independent of endometriosis stage (p = 0.874, p = 0.469). No significant differences were observed in collagen IV levels (p = 0.385, p = 0.465). The presence of elevated levels of fibronectin may indicate abnormalities in cell-ECM signalling during the course of endometriosis, and may be a potential biomarker for early detection.

Plasma and Peritoneal Poly (ADP-Ribose) Polymerase Levels in Patients with Endometriosis.

The evidence of poly (ADP-ribose) polymerase (PARP) association with the immune response could be coherent with the immunological theory of endometriosis and suggests the possibility of a new research direction. The aim of the study was to evaluate the levels of PARP in plasma and peritoneal fluid of patients with and without endometriosis. It was a multicenter, cross-sectional study. Plasma and peritoneal fluid samples were collected from patients with and without endometriosis during planned laparoscopic procedures in eight clinical centers. In total, 84 samples of plasma and 84 samples of the peritoneal fluid were included in the final analyses. Double-antibody sandwich enzyme-linked immunosorbent assay was performed in order to assess levels of PARP in collected samples. No statistically significant differences regarding the detected levels of PARP in plasma and peritoneal fluid comparing patients with and without endometriosis were observed. Patients with a history of infertility had significantly higher plasma PARP concentrations (p = 0.04). We have not observed the potential role of PARP concentration levels in plasma nor peritoneal fluid as an endometriosis biomarker. We have determined an association between a higher plasma PARP concentration and a history of infertility.

Plasma and Peritoneal Fluid ZEB Levels in Patients with Endometriosis and Infertility.

Zinc finger E-box-binding homeobox 1 (ZEB1) and zinc finger E-box-binding homeobox 2 (ZEB2) are transcription factors that regulate epithelial−mesenchymal transformation (EMT). The aim of this study was to compare levels of ZEB1 and ZEB2 in the peritoneal fluid and plasma between patients with and without endometriosis in order to assess their utility in the diagnostic process. Plasma and peritoneal fluid samples were collected from 50 patients with and 48 without endometriosis during planned surgical procedures in eight clinical centers. Quantitative ZEB1 and ZEB2 levels analyses were performed using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). No significant differences were observed in ZEB1 levels in any of the subanalyses nor any differences regarding ZEB2 levels between patients with and without endometriosis. Plasma ZEB2 levels were significantly higher among patients with infertility compared to fertile women (16.07 ± 12.70 ng/L vs. 12.07 ± 11.92 ng/L; p < 0.04). Both ZEB1 and ZEB2 do not seem to have a significant value in the initial diagnosis of endometriosis as a single marker. The differences in ZEB2 plasma levels between patients with and without infertility indicate the possibility of EMT dysregulation in the pathogenesis of adverse fertility outcomes.

The Role of Cadherin 12 (CDH12) in the Peritoneal Fluid among Patients with Endometriosis and Endometriosis-Related Infertility.

Cadherin 12 (CDH 12) can play a role in the pathogenesis of endometriosis. The aim of this study was to compare the levels of cadherin 12 in the peritoneal fluid between women with and without endometriosis. This was a multicenter cross-sectional study. Eighty-two patients undergoing laparoscopic procedures were enrolled in the study. Cadherin 12 concentrations were determined using the enzyme-linked immunosorbent assay. The level of statistical significance was set at p < 0.05. No differences in cadherin 12 concentrations between patients with and without endometriosis were observed (p = 0.4). Subgroup analyses showed that CDH 12 concentrations were significantly higher in patients with infertility or primary infertility and endometriosis in comparison with patients without endometriosis and without infertility or primary infertility (p = 0.02) and also higher in patients with stage I or II endometriosis and infertility or primary infertility than in patients without endometriosis and infertility or primary infertility (p = 0.03, p = 0.048, respectively). In total, CDH 12 levels were significantly higher in patients diagnosed with infertility or primary infertility (p = 0.0092, p = 0.009, respectively) than in fertile women. Cadherin 12 can possibly play a role in the pathogenesis of infertility, both in women with and without endometriosis.

[Perinatal results of intrauterine open fetal surgery of fetuses diagnosed with myelomeningocoele--the clinical report of ten cases]. / Wyniki perinatalne wewnatrzmacicznej operacji zamkniecia przepukliny oponowo-rdzeniowej plodu. Raport kliniczny 10 przypadków.

The purpose of the study was to demonstrate our approach to qualification for open fetal surgery (OFS) and surgery techniques. We also tried to determinate the outcome of fetal surgical treatment. OFS was performed in 10 out of 15 cases with prenataly diagnosed myelomeningocele. Patients were qualified for the surgery on the basis of precisely determined inclusion criteria and after assessment by multidisciplinary team of specialists. Surgery was performed between 22nd and 29th week of pregnancy. Fist and second surgery were performed in 29th and 27th week of pregnancy, some patients have undergone the surgery before 26th week of pregnancy. Babies were delivered by cesarean section. Gestational age by the time of the delivery ranged from 25th and 37th and a half week of pregnancy. In two cases the delivery was at term. Main complications included: PROM, placental ablation and vaginal bleeding. In half of all the cases we did not observe hydrocephalus increase after the surgery. OFS can be beneficial but it can also carry certain amount of risk both for the fetus and the mother. Therefore, further randomized research deems necessary to better comprehend and determine the safety and effectiveness of such procedures.

Galanin concentrations in maternal circulation, amniotic fluid and umbilical cord blood during term labor: relationship with maternal body mass and neonatal birth weight.

BACKGROUND: Galanin is a hypothalamic regulatory peptide involved in the regulation of appetite. It is synthesized by the nervous system, anterior pituitary gland, adrenal medulla, pancreas, intestine and placenta. Placental secretion of galanin has until now only been investigated in animals. Additionally, galanin concentration has not been assessed in umbilical cord blood and amniotic fluid. PATIENTS AND METHODS: Galanin concentrations were measured in maternal circulation before term delivery, in cord blood and in amniotic fluid of 45 healthy pregnant women (gestational age 38 - 40 gestational weeks). The control group consisted of 26 normally menstruating healthy women. RESULTS: Plasma galanin concentrations were found to be similar in pregnant healthy women before term delivery (20.8 +/- 1.9 pg/ml) and non-pregnant women (19.0 +/- 1.7 pg/ml). Galanin concentration in umbilical cord blood (26.5 +/- 2.2 pg/ml) was significantly higher (p < 0.05) than in maternal circulation. Galanin concentration in amniotic fluid (20.4 +/- 1.0 pg/ml) was similar to that observed in maternal plasma, but significantly (p < 0.01) lower than in umbilical cord blood. A significant correlation was found between maternal body mass index and plasma galanin concentration (tau = 0.246; p < 0.05) and between birth weight and cord blood galanin concentration (tau = 0.345; p = 0.01). There was no significant correlation between placental mass and cord blood galanin concentration (tau = 0.124; p = 0.26). CONCLUSIONS: Plasma galanin concentration in pregnant women before term delivery is similar to that in non-pregnant women. The fetus rather than the placenta is the source of the high galanin concentration in umbilical cord blood. The role of galanin in the regulation of newborn weight is uncertain.

[Assessment of occurrence frequency of cotinine and trans-3'-hydroxycotinine in chosen body fluid samples]. / Ocena czestosci wystepowania kotyniny i trans-3'-hydroksykotyniny w wybranych próbkach plynów ustrojowych.

Kind of the main nicotine metabolites, occurrence frequency of trans-3'-hydroxycotinine (HK) and cotinine (K) in mother and foetus serum, amniotic fluid and urine of chosen group of children (10 - 12 years old) determined by planar chromatography with densitometry as well as ratio of (HK)/(K) has been compared. The obtained data allowed to state, that the main nicotine metabolite concentrations (HK and K) were higher in foetus serum in comparison to mother serum. In the case of occurrence both of them ratio of (HK)/(K) was close to 1 in 20% of examined body fluid samples, but it was above this value in significant majority cases. It can be a prove that trans-3'-hydroxycotinine was dominating metabolite of nicotine in these samples and statistically significant more often occur in foetus serum, in the case when cotinine was determined in mother serum.

[The influence of metabolic changes on intrauterine fetal growth in normal gestation and gestation complicated by diabetes]. / Wplyw zmian metabolicznych w ciazy prawidlowej i powiklanej cukrzyca na wewnatrzmaciczne wzrastanie plodu.

Based on published clinical studies, this paper reviews the influence of metabolic changes during pregnancy on intrauterine fetal growth. Data are collected concerning the metabolic aspects of both normal pregnancies and those complicated by diabetes as well as hormonal changes having significant impact on metabolism during pregnancy. The issues of gestational insulin resistance and the metabolism of carbohydrates, lipids, proteins, and amino acids are discussed. Factors influencing birth weight and intrauterine fetal growth, including metabolic and hormonal mechanisms and the function of the placental barrier, are also considered.

Panniculectomy in gynecologic cancer surgical procedures by using a harmonic scalpel.

OBJECTIVE: To demonstrate that panniculectomy in obese gynecologic oncology patients undergoing surgical gynecologic procedures reduces operative time, gives better surgical exposure and does not increase the number of operative complications. METHODS: A retrospective review of 90 patients who had panniculectomy at the time of gynecologic surgery between 1992 and June 2003. Analyzed data included indication for surgery, patient's weight, operative times, blood loss and complications. RESULTS: Panniculectomy was performed in 20 patients operated because of uterine cervix cancer and 70 because of uterine body cancer. The mean age was 57.3 years, weight 126.7 kg and body mass index (BMI) 47 kg/m(2). The following procedures were performed: radical hysterectomy by the Wertheim-Meigs method (22 cases), total hysterectomy (68 cases) with bilateral salpingoophorectomy, pelvic lymphadenectomy and also periaortal lymphadenectomy (four cases). The mean operative time was 169 min, including from 20 to 25 min opening and closing time, and blood transfusion was undertaken in 15.6% of patients. The average weight of removed panniculus was 4900 g. In 82.2% of patients there were no wound complications, in 17.8% the healing was delayed. Daily drains secretion was 65.3 mL (range 0-300 mL). One patient died because of pulmonary embolism, and another because of myocardial infarction. There were no cases of damage to the urinary tract, intestines or large vessels. During the histopathological examination metastatic carcinoma in lymph nodes was found in 29.3% of the cases. CONCLUSIONS: Massively obese women can safely undergo gynecologic oncological surgery with simultaneous panniculectomy. Panniculectomy improves surgical access and facilitates radical surgery.

[Correlation between amniotic fluid index (AFI) and glucose concentration in amniotic fluid, glycaemia, glycosylated haemoglobin concentration during normal pregnancy and pregnancy complicated by insulin-dependent diabetes mellitus]. / Korelacja pomiedzy wartoscia indeksu plynu owodniowego (AFI) a stezeniem glukozy w plynie owodniowym, glikemia, stezeniem hemoglobiny glikowanej podczas ciazy prawidlowej oraz powiklanej cukrzyca insulinozalezna.

INTRODUCTION: In spite of confirming an association between type I diabetes of pregnancy with hydramnios, in the most recent studies there is still no clarity about which of the maternal or foetal metabolic parameters linked with amniotic fluid volume play the most important role. AIM: To determine which of the maternal or foetal metabolic parameters has the closest association with amniotic fluid volume. MATERIAL AND METHODS: The research was performed in two groups: normal healthy pregnant women (n=43) and group of pregnant women with insulin-dependent diabetes mellitus (n=17) and their newborns. We measured: amniotic fluid index, glucose level in serum and in amniotic fluid, in newborn serum, HbA1c level in serum of women and newborns. RESULTS: We found statistically significant higher values of amniotic fluid index 16.3 +/- 5.2 cm (p<0.01), glucose level in amniotic fluid 2.7 +/- 0.3 mmol/l (p<0.01), serum glucose level before delivery 8.4 +/- 1.6 mmol/l (p<0.001), glycosylated haemoglobin in serum levels 7.9 +/- 0.4% (p<0.05), levels of glucose and glycosylated haemoglobin in serum newborns 3.4 +/- 0.3 mmol/l (p<0.05), 7.7 +/- 0.4% (p<0.001) in patients with insulin-dependent diabetes mellitus as compared with these values in the group of healthy parturient women and their newborn infants. Performed correlation study shows statistical correlation between amniotic fluid index and glycosylated hemoglobin serum levels in the group of women with insulin-dependent diabetes mellitus (p<0.05), t=0.56. CONCLUSION: We conclude that long hyperglycemia or increased HbA1c level have an important role in amniotic fluid index increase in patients with insulin-dependent diabetes mellitus.

[Results of amnioinfusion in pregnancies with oligohydramnios and non-ruptured fetal membranes]. / Wyniki leczenia malowodzia technika amnioinfuzji u ciezarnych z zachowanym pecherzem plodowym.

Authors analysed results of amnioinfusion in the group of 65 pregnant women with oligohydramnios and non-ruptured fetal membranes. Amnioinfusions were the most efficient in the pregnancies with oligohydramnios and asymmetric hypotrophy, idiopathic oligohydramnios or oligohydramnios with pathological FCG. The group with oligohydramnios and fetal malformations showed the worst results of the treatment. The findings confirm mainly the diagnostic character of the method before the end of 25 week of pregnancy because during period the oligohydramnios usually occurs together with lethal fetus malformations. The amnioinfusion in the cases of fetal hypotrophy and pregnancy-induced hypertension seems to be the prophylactic procedure.

[The intranatal analysis of trans-3'-hydroxycotinine concentrations in serum of mother and neonate exposed to tobacco smoke]. / Analiza stezen trans-3'-hydroksykotyniny w surowicy matki i noworodka w okresie okoloporodowym u kobiet narazonych na dym tytoniowy.

The smoking habit is widely spread between pregnant women too. Tobacco smoke components have negative influence on infant's development. In human trans-3'-hydroxycotinine is besides cotinine, one of the main nicotine metabolites. The research covered 17 patients with physiological pregnancy, which ended with delivery through natural passages at term. All women were active smokers as we revealed before according to their serum cotinine concentrations. Assessment of cotinine and trans-3'-hydroxycotinine concentrations has been done by the use of very sensitive liquid chromatographic techniques in the mothers venous blood samples and in the mixed umbilical cord blood of the newborns. Obtained results of the research have been statistically analysed using the STATISTICA package. Significance level p < 0.05 has been adopted as statistically relevant. In conclusion, trans-3'-hydroxycotinine concentrations were significantly lower in the neonates then in their smoking mothers and there was strong positive linear relationship between maternal and neonatal trans-3'-hydroxycotinine concentrations. The value of linear correlation coefficient was 0,7 with a p-value of 0.05.

[The coexistence of vulvovaginal warts and cervical dysplasia with HPV infection and cervicitis]. / Wspólistnienie klykcin pochwy i sromu oraz dysplazji szyjki macicy z infekcja HPV oraz stanem zapalnym szyjki macicy.

We present a case of 30-year old female patient with persistent cervicitis and vulvovaginal warts. In the course of diagnosis were found cervical dysplasia and a HPV infection type 6 and 11. In therapy we applied antibiotics, chemical therapy of the warts, laser vaporization of the warts, laser conisation, immunotherapy. Three years' intensive therapy didn't lead to satisfactory results. Finally hysterectomy led to the acceptable therapeutical effect.