Oxytocinase as the most important marker of fetal development.

Enzymes as biochemical markers come within the entire scope of the live mother-fetus system. The most important are the enzymes which regulate physiological processes, of which oxytocinase (a type of aminopeptidase) has a much wider scope of action than its name suggests, as it regulates also the level of aminopeptide hypothalamic hormones. Thus, it determines neurological, endocrinological and immunological regulation of entire steroidogenesis. Under the influence of gestational enlargement of the uterine cavity, the mothers hypothalamus produces an increasing amount of hormones, which in turn induces an increasing oxytocinase synthesis in the placenta in order to prevent the hormone in the blood reaching the level which could bring about uterine contractions. Also, the growing fetus additionally induces the production of oxytocinase by releasing its own hormones. All this occurs in combined action of the mother, fetus, placenta and even fetal membranes in one space-time process called pregnancy. When in the late pregnancy the enzyme remains at constant level or decreases without appearance of uterus contractions, labour induction is necessary due to fetus life hazard of as much as several percent. Reduction in enzyme level and even its insufficient growth in the second trimester of pregnancy, occur several weeks before preterm birth or death of the fetus. On the other hand, in the event of treatment of diseases accompanying the pregnancy,normalization of oxytocynasaemia shows the effectiveness of treatment. With the dominating profile of the steady increase of oxytocinase (>90% of cases), the target values are higher than in the case of irregular growth. Their close values are a result of the hormonal treatment of threatened pregnancies with ACTH depot. In the cases of the primary hypothalamic insufficiency, this treatment reduces the rate of fetal deaths, which would stand at several dozen percent. It is a classical example of biological pregnancy monitoring since the risk of fetal death can be predicted several weeks earlier when assessment of chemical compounds or physical changes still gives accurate results within physiological limits.

Threatened and recurrent abortions after treatment of infertility.

The aim of the study is to evaluate the cases of abortions in women after infertility treatment. The study group consists of 77 women with abortions, who were compared with 200 pregnant women (control group) comparable as to duration of pregnancy and time of hospitalization. All women conceived after successful infertility treatment. Martial history, methods of medical therapy as well as oxytocinase and isooxytocinase blood levels, urine HCG levels, cervical smear and ultrasonographic evaluation were studied during hospitalization. The results show the concordance between biochemical and biophysical pregnancy monitoring with data regarding high risk pregnancies. The medical history review shows no clinically useful differences which may be the background of the prognosis. Each pregnancy after successful infertility treatment should be regarded as a high risk one therefore its monitoring is more important than methods of treatment applied before pregnancy. The differences in ovulation induction methods are statistically significant, however in individual cases are not pathognomonic.

Comparison of periovulatory and early pregnancy blood levels of oxytocinase (CAP1) and isooxytocinase (CAP2).

The previous studies on oxytocinase concentrated on its practical usability in monitoring advanced pregnancies, both normal and abnormal. However in early pregnancy the enzymatic values are within the norm for non-pregnant women and because of that they were not interesting for medicine, which makes use only of enzymatic values beyond the range of the norm. The aim of our study was to compare serum levels of oxytocinase (CAP1) and isooxytocinase (CAP2) in the first trimester of pregnancy between women who had miscarriage and those who delivered healthy babies. The study involved 234 pregnant women after infertility treatment. Serum oxytocinase and isosoxytocinase levels were evaluated in 157 women who delivered and in 77 women who had spontaneous miscarriage. Oxytocinase was assessed by means of H. Tuppy and H. Nesvadbas method modified by R. Klimek. For the first time it has been shown, that oxytocinase and isooxytocinase may play some role in proper development of early pregnancy, because the level of both isoenzymes at the beginning of pregnancy is statistically significantly higher in pregnancies ending in labor. Also about 3 weeks later and only in those successful pregnancies both enzymes undergo statistically significant further increase. Enzymatic changes correspond to hCG measurements.

[Professional responsibility of Polish scientists]. / Zawodowa odpowiedzialnosc polskich uczonych.

Scientist gynecologist it is not only recognized by scientific title clever man, but first of all--physician, who's first obligation is not to harm and--just next--to treat! It is not easy task in the presence of still increasing overproduction of medically useful informations, before which the tradition considering as a practiced list of rules and proceedings in chosen physician's speciality or only performed in regionals schools takes still greater meaning. The tradition cannot be separated from Polish society with its the most widely understanding conditions. Unfortunately on Polish market foreign handbooks have appeared, in which generally known but passed over in silence facts, presented in this paper, are not included. If this fact didn't bring harm to Polish women I wouldn't lay the blame on Polish scientists. Professional obligation of teachers is to get acquainted with handbooks available for gynecologists at large what results as well from standing in the society for benefit of which the profession is exercised as from primary complying with moral physician's responsibility. Finally, about the level of professional responsibility decide the results of our the most generally understanding medical activity, but not reached titles and positions.

[Platelet activation and endothelial factors in standard exercise test before and after menopause]. / Aktywacja plytek i wybrane parametry funkcji sródblonka w trakcie standardowego wysilku fizycznego u kobiet w okresie okolomenopauzalnym.

OBJECTIVES: Postmenopausal lack of estrogens may accelerate cardiovascular atheromatic changes. Standard exercise test (SET) challenges hidden signs of the vascular involvement. Although the test is known not to carry a risk of thromboembolic complications, it may influence plasma concentrations of endothelial and platelet factors. The question is if and to what extend the menopause aggravates the SET induced changes. AIM: Plasma concentrations of nitric oxide, endothelin-1, beta-thromboglobulin and von Willebrand factor activity before, at the maximum exercise and 15 minutes after the SET referred to, as a recovery time were estimated. METHOD: SET was performed according to Bruce protocol in group of 31 premenopausal and 57 postmenopausal women. Standard RIA kits for plasma beta-thromboglobulin (beta-TG) (Boehringer Mannheim) and endothelin-1 (Et-1) (Blotrack) concentration were used. The von Willebrand factor (vWF) activity was assayed by ELISA system (Boehringer Manheim). Plasma nitric oxide (NO) concentration was calculated from nitrides/nitrates levels, by Griess reaction, modified by use of NADPH reductase. RESULTS: Mean plasma levels of beta-TG, Et-1, NO and vWF activity do not differ between pre and postmenopausal women. The standard exercise test significantly increases both beta-TG plasma concentration and vWF activity (p < 0.00001). During the 15 minutes rest period the changed values do not return to preexercise levels. Neither plasma NO nor Et-1 plasma concentrations change during the exercise test. There was a similar increase in beta-TG plasma levels and vWF activity during the SET in pre- and postmenopausal women and a slighter increase of plasma Et-1 levels in postmenopausal women (p < 0.04). The close relationships between NO plasma concentration and both vWF activity (p < 0.002) and vascular endothelial growth factor (VEGF) level (p < 0.04) were observed in postmenopausal women. The vWF activity in postmenopausal; women inversely correlates with insulin-like growth factor-I (IGF-I) concentration (p < 0.001). In premenopausal women the important modulators of vWF activity were: body mass (p < 0.04), serum total cholesterol (p < 0.02) and sex hormone binding globulin (SHBG) levels (p < 0.04). The postmenopausal beta-TG increase during SET depends on body mass (p < 0.02), whereas the preexercise levels seem to be related to VEGF level (p < 0.03) and inversely to Et-1 (p < 0.007) and dehydroepiandrosterone sulfate (DHEAS) concentration (p < 0.03) Both the basal and stimulated by exercise vWF activity are higher in obese women (p < 0.003), but the net increase is larger in lean group (BMI < 30 kg/m2). In premenopausal women plasma NO concentration depends on 17 beta-estradiol serum level (p < 0.02). The higher VEGF (p < 0.01) levels as well as vWF activity was observed (p < 0.03) in hypercholesterolemic women. CONCLUSION: The standard exercise test increases the procoagulatory von Willebrand factor activity so as the platelets activity (beta-thromboglobulin concentration) in both pre and postmenopausal women. The slight endothelin-1 rise has been found at the maximum exercise in postmenopausal women. The close relation between plasma nitric oxide and endothelin-1 levels was found in postmenopausal women. Obesity and hypercholesterolemia may contribute to the observed changes.

[Supplementary ultrasonometry of the fetus in evaluation of gestational age]. / Uzupelnienie ultrasonometrii plodu w ocenie wieku ciazowego.

The terminology quoted in the leaflet "Ultrasonometry of foetus in evaluation of gestational age" could change the diagnostic and therapeutic procedures in obstetrics from the point of view of only one out of many methods of imaging. The object of the study was to complement the "standards for eleven measurements pertinent to evaluation of pregnancy age and well-being of the foetus", in order to use them in compliance with the laws of auxology with recognize the priority of developmental age over the postmenstrual calendar age. Foetus is not a statistical patient, but an individual one, and it is not clinically important that, e.g. 15% of children are born at the foetal age of 38 or 41 weeks, but whether the examined foetus is born in either of the two weeks. Our complementation should be convincing about the great significance of ultrasonometry not of the foetus (as in the title of the publication in question), but of the foetuses in evaluation of their average gestational age, and about the necessity of reformulation of the published ultrasonomatric standarda, so as to render them clinically useful in regard of the foetuses of various gestational maturation rate.

Biology of cancer: thermodynamic answers to some questions.

All the theories of carcinogenesis have properly described this event from methodologically different points of view (medical, biological, social, biochemical psychological etc.). The point is that one should understand the thermodynamical rules underlying each of these approaches. On this level of knowledge, quantum thermodynamics combines matter and energy, while technical quantization in a novel way differentiates precancerous states as the dissipathogenic ones from the neoplasms as the newly formed dissipative structures (systems). From the essential nature of the neoplasm one can derive some general rules of therapy which focus mainly on: 1 degrees prevention and therapy of the dissipathogenic states, 2 degrees strengthening of the regenerative and defensive mechanisms of the organism and, finally, 3 degrees removal of neoplastic changes as widely as necessary but also as sparingly as possible. For a long time, these rules have been observed in reverse order. That cannot improve the medical outcome, which has not changed for a few dozen years, i.e. recovery depending on the clinical level at the moment of the diagnosis.

A new score for postnatal clinical assessment of fetal maturity in newborn infants.

OBJECTIVES: To investigate the clinical repeatability of Klimek's method of fetal maturity assessment in newborns. METHODS: A cohort of 800 consecutive singletons was assessed immediately after birth by a pediatrician, who was unaware of the infants' gestational age. The assessment, according to Klimek's method, consisted of six criteria to evaluate posture and skin appearance, and each variable was scored from 0 to 2 points. After dividing the material into two identical groups, the results were compared with those obtained by means of Ballard's method. RESULTS: Statistical analysis did not show statistically significant differences between the compared averages in both groups. A significant correlation between the clinically compared methods of fetal maturity grading was found (r> or =0.69, t> or =19, and P<0.001). CONCLUSIONS: Klimek's method of fetal maturity assessment offers a possibility of objective evaluation of maturity immediately after birth. The clinical methods used to date do not have such advantages. Moreover, they require the evaluation of 12-34 parameters, their point range is more complex and their results are given on the scale of 10-50 points. In each of the applied divisions of observed newborns, there was found a high, statistically significant correlation between the indexes evaluating maturity by means of both comparable methods (i.e. Ballard and Klimek scores), which do not take into account weight and fetal age, but refer directly to fetal maturity. The new scale, which has been proposed, is simple and produces comparable results encompassing full maturity in the range of only 6-12 points.

[Duration of lactation and the age of the menopause]. / Czas laktacji a wiek menopauzy.

The influence of lactation on the age of menopause has been estimated in the representative group of 120 women hospitalised because of climacteric complaints. The diagnosis of menopause has been based on the history of a patient and gynaecological examination and Kupperman index or on the estradiol and gonadothropin levels. Observation of menopausal patients reveals correlation between neuroendocrine complaints and symptoms in the climacteric syndrome and pregnancy dependent hypothalamus failure. According to the results of this analysis, shortened period of lactation correlates with earlier onset of menopause and duration of the lactation has a greater effect on menopause than course of labour.

[Prognostic factors in treatment of neoplasms as the dissipative structures]. / Czynniki rokownicze w leczeniu nowotworów zlosliwych jako struktur dysypatywnych.

The aim of the study is to define the systemic prognostic factors in the neoplasm according to thermodynamic theory of cancer a the self-organising dissipative structure. As the local, so called "specific" factors seem to be not adequate one should look for more general ones. It is shown, that such general factors as hormonal state of women' organism, preterm births, lactation, infertility treatment are important.

[Elective cesarean section in case of threatened twin pregnancy: a case report]. / Elektywne ciecie cesarskie w przypadku zagrozonej ciazy blizniaczej--opis przypadku.

The authors present the use of computer-aided monitoring of pregnancy in case of twin. In our case one twin was threatened of intrauterine death. The frequency of antepartum death of one twin varies from 0.5%-6.8% of all twin deliveries. The underlying causes for antepartum death are multiple. It suggests that fetal growth retardation is due to competition for uteroplacental circulation and nourishment. In this case, the smaller twin was threatened of intrauterine death, because of intrauterine growth retardation, so the pregnancy was delivered on 32. week of gestational age by cesarean section.

Enzymes: the most important markers of pregnancy development.

From ethical and moral reasons, the progress in neonatology and anesthesiology must not obscure the iatrogenic labors, which begin at the time improper for individual child, especially after induction and - because of that - very often instrumental. Enzymatic monitoring has enabled reduction of the number of preterm and instrumental deliveries, and--more importantly--the elimination of statistical (so-called post-datism) indications for terminating pregnancies instead of natural their individual occurrence in the entire range of physiological norm of human labors from 37 0/7 to 43 2/7 weeks. During pregnancy the mothers organism has to secure a proper environment for the growth and development of the child, which is accompanied by the constant increase in oxytocinase and isoxytocinase. These enzymes are closely connected even with the regulation of ovulation as well as with the embryo nidation and development of early pregnancy. Both enzymes are very important indicator of the threatened life and health of the fetus. It is important since these changes precede clinical symptoms by several weeks. On the other hand, they enable monitoring of the efficiency of ACTH depot therapy as well as pregnancy complicated by diabetes, hypertension and endocrinopathies. The values of prenatal oxytocinasaemia make possible prediction the date and course of delivery. Also, they are highly positively correlated with the weight, length and maturity of the newborn, as well as the size of the placenta. In multifetal pregnancies, levels of both enzymes are higher than in single ones.

Expression of an immunomodulatory protein known as progesterone induced blocking factor (PIBF) does not correlate with first trimester spontaneous abortions in progesterone supplemented women.

PROBLEM: An immunomodulatory protein known as the progesterone induced blocking factor (PIBF) has been found to positively correlate with early pregnancy beta human chorionic gonadotropin (B-hCG) levels. The study presented herein evaluated PIBF levels from conception to the end of the first trimester to determine if lower levels will correlate with first trimester spontaneous abortions (SAB). METHOD: Progesterone induced blocking factor expression by lymphocytes measured using an immunocytochemistry method was compared in pregnant women with ongoing vs. failed pregnancies. RESULTS: There were no differences in the proportion of women having lymphocytes expressing PIBF or in the median numbers when comparing ongoing vs. failed pregnancies. There was no B-hCG interval where failed pregnancies were found to have lower frequency of PIBF expressing lymphocytes. CONCLUSION: Inadequate PIBF expression independent of low P levels does not appear to be an etiologic factor for first trimester SABs; thus measuring this protein in pregnant women lacks practical usefulness.

[Prevention and treatment during the postmenopausal period]. / Prewencja i leczenie okresu postmenopauzalnego.

Osteoporosis will always be a subject of human interest. Thus, it has to be governed by general laws, which-in medicine-still too often differ from the latest truths of nature, to pamper to some fashionable medical views. Its diagnosis makes the doctor feel good, because it explains the cause of the symptoms or disorders. The process of osteoporosis clearly intensifies in the period of climax and therefore, not only the menopause but also the symptoms of climacteric syndrome, anovulatory cycles after 35 years of life, past hemorrhages connected with pregnancy, infections of mammary glands in puerperium involving lack or shortening down to 3 months of natural breast-feeding, states after treatment of sterility, and particularly the infertility, as well as after excessively prolonged use of oral contraception, are indications for diagnostic examination. The aforesaid limit of 35 years of age allows the commencement of prophylactic hormonal prevention of postmenopausal disorders and diseases a lot earlier (more than ten years), instead of their belated-literally substitutive-treatment. The most appropriate are physiological doses, which-by supporting the endogenic natural source-treat without post-pharmacological side-effects, of which the most frequent are unwanted postmenopausal bleeding and/or hemorrhages from the genital tract. The principal rule of postmenopausal hormonal treatment is to adjust not only to the doctors orders, but also to one's own feeling and the estimated effectiveness of currently administered doses.

[Index of fetal maturity]. / Wskaznik dojrzalosci plodu.

A fetal maturity is a typical evolutionary notion. It signifies some level of human development and if it concerns a fetus, it means an ability to survive outside mothers womb. This paper presents a new practical fetal maturity index (Q-quotient) which is common for all method of fetal maturity evaluation.

Quantitative rainbow schlieren deflectometry.

In the rainbow schlieren apparatus, a continuously graded rainbow filter is placed in the back focal plane of the decollimating lens. Refractive-index gradients in the test section thus appear as gradations in huerather than irradiance. Asimple system is described wherein a conventional color CCD array and video digitizer are used to quantify accurately the color attributes of the resulting image, and hence the associated ray deflections. The present system provides a sensitivity comparable with that of conventional interferometry, while being simpler to implement and less sensitive to mechanical misalignment.

[Pregnancy behavior and human sex education]. / Ciaza a wychowanie i nauczanie seksualne czlowieka.

Pregnancy as an notion used in both, positive and negative meaning, has the great importance in the human sexual education and as an consequence influences on possibility of conception and pregnancy development in adult women as an natural obligation of human being delivery.