[Comparative evaluation of ultrasonic virtopsia and classical autopsy for antenatal fetal death]. / Sravnitel'naya otsenka ul'trazvukovoi virtopsii i klassicheskoi autopsii pri antenatal'noi gibeli ploda.

AIM OF STUDY: Comparison of the data obtained by ultrasound examination of a pregnant woman with antenatal death of the fetus and stillborn child, with the autopsy results. MATERIALS AND METHODS: The protocols of ultrasound examinations and the autopsy protocols of 126 fetuses that died antenatally were analyzed. RESULTS: In our study of 126 patients, 95 showed no structural changes either during ultrasound examination or during further pathomorphological examination. The ultrasound conclusion corresponded to the results of classical autopsy in the presence of congenital malformations in two patients. 29 pregnant women had discrepancies in the results of ultrasound examination and subsequent pathomorphological examination. At the same time, in 7 patients there was an overdiagnosis, in 22 - an underdiagnosis. CONCLUSIONS: Ultrasound diagnostics in cases of suspected fetal death does not allow verification of the diagnosis, ultrasound examination of a pregnant woman with antenatal fetal death and post-mortem ultrasound examination of a stillborn cannot replace autopsy, pathoanatomical and histological examinations.

The Role of Brain-Derived Neurotrophic Factor and Glial Cell Line-Derived Neurotrophic Factor in Chronic Fetal Oxygen Deprivation.

The aim of the study was to define the role of brain-derived and glial cell line-derived neurotrophic factors (BDNF and GDNF) in realization of compensative and adaptive mechanisms of a neonatal organism to hypoxia. MATERIALS AND METHODS: The experiments in vivo have been carried out on pregnant C57BL/6 mice (n=36). Chronic hypobaric hypoxia has been modeled in different pregnancy trimesters. On gestation days E19-20, concentration of BDNF and GDNF in the blood of the pregnant females was determined by enzyme immunoassay. Further, the number of neonatal mice, their weight and body length parameters have been assessed.Parturient mothers (n=88) and their newborn babies followed up at the Clinic of Obstetrics and Gynecology of Pavlov University took part in the clinical investigations. Concentration of BDNF, GDNF, neuron-specific enolase (NSE), and hypoxia-inducible factor (HIF-1ß) in the fetal cord blood has been determined by ELISA. The obtained data were retrospectively compared with cardiotocography, dopplerometry, presence of meconium-stained amniotic fluid and the neonate state at birth, assessment according to the Apgar score, and the course of adaptation period. RESULTS: Chronic hypobaric hypoxia in pregnant mice in trimester I and II resulted in the significant decrease of BDNF and GDNF level, decrease in the number of embryos, and in significant changes in weight/height characteristics of the newborn pups.According to the clinical observations, an increased expression of the neurotrophic factors BDNF, GDNF provides protection to a neonate even if hypoxia factors are present and realized. A low content of BDNF and GDNF was observed in the group of infants with a high risk of developing unfavorable hypoxic damaging effects. CONCLUSION: The protective role of BDNF and GDNF in the regulation of fetal homeostasis in chronic hypoxia has been established experimentally and clinically.

[Association of matrix metalloproteinases' polymorphisms of MMP3 and MMP9 with development of genital endometriosis].

We present a comparative analysis of the allelic polymorphism of the matrix metalloproteinase (MMP) gene family, including MMP3 (rs3025058), MMP7 (rs11568818), MMP9 (rs17576, rs2250889), MMP12 (rs2276109), and MMP13 (rs2252070), in patients with external genital endometriosis (EGE) and in a control group of healthy women proven to be free of disease by laparoscopic inspection. We found significant differences in the incidence of particular MMP3 and MMP9 alleles, which substantiate the role of matrix metalloproteinases in EGE pathogenesis. We used the Multifactor Dimensionality Reduction (MDR) analysis to show that 14 allelic combinations of the MMP containing MMP3 (rs3025058) x MMP7 (rs11568818) x MMP9 (rs17576) alleles showed a statistically significant association with an increased risk of EGE, while 10 other combinations correlated with a reduced risk of the disease. MDR analysis produced two statistically significant models for MMP allelic combinations involved in EGE progression, both with 100% penetrance and 83% and 78% accuracy.

[MED12 gene mutations in women with uterine myoma].

Uterine leiomyoma (UL) is a benign and most common tumor that affects 20-45% of women of fertile age. In this study, we analyzed the MED12 second exon nucleotide sequence from 15 DNA samples extracted from LM of 15 subjects with uterine leiomyoma and 15 DNA samples extracted from peripheral blood leukocytes of the same female subjects. It was shown that somatic mutations in the MED12 gene occur in 73% of cases with deletions of varying sizes and missense mutations being most common at codon 44. Mutations in the MED12 gene could play an indirect role in leiomyoma progression by modifying the activity of other genes that encode proteins involved in growth and tumor progression.

[Complications of endoscopic video-assisted surgical interventions in gynaecology].

An analysis of specific complications in gynaecological endovideosurgery has been conducted, such as occurrence of extra-abdominal gas after laparoscopic surgery or resorption of the irrigation solution in hysteroscopy. Possible mechanisms of subcutaneous emphysema, pneumothorax, mediastinal emphysema and hyperhydration development are presented along with discussion of diagnosing and treatment methods.

[Algorithm of examination and treatment of women with mixed urine incontinence].

The examination including filling cystometry, urethral profilometry, uroflowmetry, perineal ultrasonography was made in 62 females aged from 29 to 66 years with a clinical diagnosis of mixed urine incontinence (MUI). Irrespective of the verified diagnosis, the treatment started with conservative methods. Surgical intervention was performed if moderate and severe MUI persisted after conservative therapy. The diagnosis of MUI was confirmed in 66.1% examinees. Stress urine incontinence and hyperactive urinary bladder were diagnosed in 9.7 and 24.2% cases, respectively. The conservative treatment resulted in disappearance of the symptoms of MUI in 43.9%, in partial response in 34.1% patients. 22% patients were treated surgically. Urodynamic and ultrasonic indices helping choice of surgical policy in MUI were not determined. Thus, the principle of staged and comparative assessment of clinical, urodynamic and ultrasound findings improves diagnosis of MUI. Pathogenetic conservative treatment, as the first stage of MUI therapy, provides indications for surgery.

[The assessment of the immune status of women exposed to the action of radiation and chemical factors]. / K otsenke immunnogo statusa zhenshchin, podvergshikhsia deistviiu radiatsionnykh i khimicheskikh faktorov.

Some results of a complex medical study of Chernobyl disaster liquidators and its contaminated catchment areas population. The immunity status of 279 women had been analyzed as compared to that of control groups of 92 women, living in similar conditions. It was found out, that long after the disaster factors' disappearance, in the women's immunity system a derangement has been noticed in the form of T-lymphocyte increased content and a suppressed functional activity of immune-competent cells, which should be born in mind at the regular medical check-ups. Long-time and low-intensive radiation usually resulted in cell and humoral immunity disorders. That in combination with chemical factors lead to a secondary immunodeficiency state development with a following pharmacological correction necessity (by cytokines).

[The nature of the changes in the immunity of the women who worked in the cleanup of the sequelae of the accident at the Chernobyl Atomic Electric Power Station and were evacuated from the radioactively contaminated area]. / Kharakter izmenenii immuniteta u zhenshchin-likvidatorov posledstvii avarii na Chernobyl'skoi AES i évakuirovannykh s radioaktivno zagriaznennoi territorii.

During examination of 37 women taking part in elimination of consequences of Chernobyl's disaster was revealed, that complex of disaster factors action resulted the formation of disbalance in the system of immunocompetence cells and caused the oppression of functional activity of neutrophils. In 110 women living on the radioactive contaminated zone (5-40 Ci/km) the phenomena of the secondary immunodeficiency in the form of defeat as cellular as humoral factors of immunity and nonspecific resistance system was diagnosed.