[Neurotrophic basis of atrophic changes in the vagina and vulva]. / Neurotroficzne podloze zmian zanikowych pochwy i sromu.

The aim of the study is the analysis of morphology and biochemistry of neurovascular peculiarities of biologically active cells of connective tissue and epithelium. Surgically treated women were examined in 3 age groups--active sexual cycle, menopause and senium. Histological-histochemical, neurohistological and neurohistochemical methods and techniques were applied. Morphological pictures of connective tissue proper and epithelium reflect the physiological retroplasia process, associated with age-dependent structural and cellular transformations. This is manifested in typical peculiarities observed in the peripheral innervation and in vascular rete, quantitative and localization changes in mastocytes, chromaffin cells, macrophages, lymphocytes and leucocytes. Quantitative and qualitative rebuilding takes place in fibrous and biochemical structures of basic intracellular substance with its hyalinization. This process of simple tissue atrophy includes pathological activation. In innervation and vascularization, active restructuring coexists with the pictures of quantitative and localization changes in biologically active cells in the series of hormone-immune reactions. This is expressed by dysplasia of innervation structures with angiogenesis, while in cells, apart from apoptosis or necrosis, by the appearance of stratified epithelium (anaplasia) in the reproductive layers.

Stress urinary incontinence in women. III. Different tissue biochemistry in patients with concomitant detrusor instability. Preliminary report.

The glycogenolysis markers (glycogen content, active and total glycogen phosphorylase [EC 2.4.1.1.] activities, and active and total acid exo-alpha-1,4-glucosidase [EC 3.2.1.3.] activities) in the urinary bladder muscle from two patients with stress urinary incontinence and concomitant detrusor instability were studied. Glycogen depletion and activation of glycogen phosphorylase were found.

Dysuria due to bladder distortion after repeat cesarean section.

Abnormalities of the lower urinary tract resulting from cesarean section are rare. We present a patient who developed urinary frequency, nocturia and acute pains in the late phase of micturition which we think was due to bladder distortion after repeat cesarean section. She was diagnosed cystographically and treated successfully by bladder flap release.

Vesicouterine fistula--an analysis of 24 cases from Poland.

OBJECTIVE: This study was undertaken to evaluate what clinical events or situations are currently associated with the occurrence of vesicouterine fistula. METHOD: A retrospective investigation was carried out on 24 patients treated in a tertiary referral center during a 12-year period. Clinical data were collected from the patients directly, the medical records, urographic and/or cystoscopic findings before repair and intraoperative findings at repair. RESULTS: All fistulas were iatrogenic, and 21 (87.5%) occurred following cesarean section or cesarean hysterectomy. Bladder injury occurred two times more often after repeat operations than after the primary. The proportion of repeat cesarean section resulting in a fistula was significantly increased (58.3% vs. 29.6%, P < 0.013) when compared to that previously reported. CONCLUSIONS: Cesarean sections are currently the single major risk factor associated with the occurrence of vesicouterine fistulas. Repeat procedures increase the risk of bladder injury and resultant fistulas.

[Clinical analysis of women with cervical carcinoma treated in the years 1989-1994]. / Analiza kliniczna kobiet z rakiem szyjki macicy leczonych w latach 1989-1994

Investigation covered 112 women treated for invasive cervical carcinoma. Standard clinical data were analysed: age, residence, number of pregnancies and deliveries. According to FIGO classification clinical development level and histological type of the carcinoma were assessed. Surgical treatment was applied in 53 cases with carcinoma I degree (47.3% of all women with invasive cervical carcinoma). The other patients with higher degrees of disease development underwent curie-therapy. No considerable differences between our own results and nationwide data were observed.

Prognosis of fertility after surgical closure of vesicouterine fistula.

OBJECTIVES: To evaluate fertility of women following surgical closure of vesicouterine fistula. STUDY DESIGN: Long-term retrospective investigation combined with a follow-up in the setting of an academic department. Operative hospital records (15,718) were reviewed for a 12-year period. RESULTS: Sixteen women with a vesicouterine fistula at reproductive age entered the study. Five pregnancies were recorded after repair, of which four resulted in a full term delivery. In comparison with the data reported to date this series showed significantly higher rates of pregnancy (31.25% vs. 9.7%; P = 0.012) and term deliveries (25% vs. 6.2%; P = 0.01). The majority of women were afraid of recurrence if pregnant again. CONCLUSIONS: Fertility after repair of vesicouterine fistula can be much better than previously described.

Dynamics and phases of changes in the primary focus of Morris hepatoma under local application of cytokine hrecTNF-alpha.

Biological activity of cytokine hreeTNF-alpha was tested on a transplantable Morris hepatoma 5123 in Buffalo rats. Local effects of hrecTNF-alpha activity were evaluated basing on morphological examinations. The cytokine effects on tumor biometric parameters and body mass of experimental animals were analyzed. It has been found that hrecTNF-alpha considerably decreases body mass and reduces studied parameters of the tumor, the changes being statistically significant. Three consecutive phases of the neoplasm regression have been distinguished. Phase I revealed prevailing hemorrhagic necrosis of the central and intermediate zones, with numerous thrombi in the vascular lumen and fibrinoid necrosis of vascular walls. Phase II presented a number of cellular infiltrations, clearance of necrotic foci and initial angiogenesis and fibroplasia. Phase III showed intensified angiogenesis and proliferation of the connective tissue in the peripheral and intermediate zones.

Neurohistochemical evaluation of adrenergic innervation in fetal development of the white rat.

Physiological development of adrenergic innervation, an important component of trophic and homeostatic regulation in the mammals was estimated. Our research is directed to evaluate both exo- and endogenous factors contributing to its impairment. The present investigation was carried out on 32 rat fetuses from three various 7-day periods of gestation. Histochemical studies included reactions to catecholamines according to Falck and Owman, and silver staining with AgNO3 according to the Bielschowsky-Gros method. Adrenergic innervation was examined in all fetal body regions, with a special reference to the pelvis. Catecholamines distribution and accumulation in plexuses, ganglia, neurons and chromatophilic cells, as well as serotonine content in mast cells were analyzed. It was found that in the initial period of gestation noradrenaline is absent. In the third week of gestation, the neurotransmitter's accumulation takes place to subsequently decrease gradually until the end of gestation. From this stage synaptic connections of adrenergic innervation with chromatophilic and mast cells could be detected.

Stress urinary incontinence in women. II. Abnormalities of glycogenolysis in tissues related to the lower urinary tract.

The aim of the study was the investigation of the biochemical condition of elements likely to directly participate in active closing of the urethral lumen. We estimated glycogenolysis in urinary bladder, perivesical connective tissue and levator ani muscle (LAM) samples obtained intraoperatively from 80 stress incontinent women. Glycogen content as well as activities of active and total glycogen phosphorylase and acid exo-1,4-alpha-glucosidase were measured. Material from the urinary bladder and perivesical connective tissue was insignificantly altered, and glycogen contents in the bladder (2.03 +/- 1.38 g/100 g wet tissue) were considered to be normal. In the LAM glycogenolysis was much more activated than in other tissues (p < 0.001 by Fischer's exact test). Of LAM specimens 78% (22/28) revealed imbalanced biochemistry of glycogen with activation of hydrolytic decomposition. We conclude that stress urinary incontinence in women is frequently associated with metabolic alterations in the periurethral striated fibres. This study indirectly supports our recent hypothesis on the pathogenesis of the disease in terms of muscle fibre type transitions.

Evaluation of biometric parameters of Morris hepatoma after application of human recombinant tumor necrosis factor.

The effect of human recombinant tumor necrosis factor alpha (h rec TNF-alpha) on the growth of Morris hepatoma 5123 implanted in the skeletal muscles of the thigh of Buffalo rats was investigated. The cytokine was repeatedly given in an intratumor administration (i.t.) in dose of 1.5 x 10(4) U once a day in regimens of four or eight days. Comparative groups consisted of animals which were given saline i.t. Control groups included healthy rats subjected to local cytokine effect. The experiments revealed an inhibitory effects of the preparation on the growth of tumors. Biometric parameters of the tumors induced indicated that the inhibition of Morris hepatoma was most effective after the eighth dose of h rec TNF-alpha. The administration of fourfold dose resulted in an initial loss of body mass increase. However, when injected eight times, the factor produced a relative tolerance reflected in minor reduction of actual body mass. The estimation of survival time in rats injected i.t. with h rec TNF-alpha, compared to those given saline, revealed statistically significant differences at the eighth repeated dose.

Inhibitory effect of the human recombinant tumor necrosis factor on the growth of the Morris hepatoma in rats.

The effect of the human recombinant tumor necrosis factor alpha (h rec TNF-alpha) on the transplantable Morris hepatoma 5123 was studied in Buffalo rats. The cytokine was repeatedly administered intratumorly (i.t.) in a dose of 1.5 x 10(4) U once a day in a cycle of four and eight days. The control groups consisted of animals given saline i.t. The experiments revealed an inhibitory effect of the h rec TNF-alpha upon the growth of neoplastic tumors. The biometric parameters of the tumors indicated that the inhibition of the Morris hepatoma was most effective after eight repeated doses of TNF. After injections of TNF-alpha, the tumors presented extensive hemorrhagic necrosis, the regressive alterations being found mainly in the central and intermediate tumor zones. In the early phase of the tumor growth, neoplastic tissue necrosis prevailed, as well as hemorrhages within the necrotic masses, necrosis of the blood vessel walls and thrombi in their lumina. In the later period, numerous fibres of the fibrous tissue, richly vascularized, occurred in the peripheral and intermediate zones. Clusters of eosinophilic granulocytes and macrophages with apoptotic bodies in the cytoplasm were seen on the border of the necrotic foci.

[Morphology of the neuroendocrine-immunologic network of connective tissue in rodent fetal development]. / Morfologia sieci ukladowej neuro-endokryno-odpornosciowej tkanki lacznej miednicy w rozwoju plodowym u gryzoni.

Multi-range neuro-endocrine-immunological function in regulation of body homeostasis gives reasons for establishment of peripheral morphological bonds. As a result from our study, the unit of trophic protection of pelvic connective tissue was identified in embryonal and fetal development of rodents. This unit connects blood vessels and their autonomic innervation with chromaffin cells, mast cells, and simple neurons. Nerve fibres of para-organ pelvic ganglions determine to complete. Author suggestion on integration of another connective tissue cells and erythroid cells with systemic network requires verification.

[Activity of acidic granulocyte phosphatase and myeloperoxidase among women with EPH gestosis]. / Aktywnosc granulocytarnej fosfatazy kwasnej i mieloperoksydazy u kobiet ciezarnych z EPH-gestoza.

Among 30 pregnant women with EPH-gestosis activity of myeloperoxidase was significantly decreased and activity of acid phosphatase was not much increased. Results of scientific researches can confirm the fact of weakness of anti-infection immunity among women with EPH-gestosis in compare with healthy pregnant women.

[Uroflowmetry in diagnosis of urinary stress incontinence in women]. / Badania uroflowmetryczne w diagnostyce wysilkowego nietrzymania moczu u kobiet.

The authors' aim was to evaluate the range of uroflowmetry in diagnostics of stress urinary incontinence (sui) in women. The examinations were carried out in 59 women with sui, aged from 35 to 45 years (group I). The control group consisted of 20 asymptomatic women (group II). To evaluate volumes of urine voided during micturition in a unit of time a urological flowmeter UF-1 (produced by COTM, Bialystok) was used. Numeric data of flow were analysed, as well as registered curves of flow were ascribed to one of the following flow patterns: normal, multi-peak or interrupted. The conducted studies revealed statistically significant differences in flow values in group I, compared to group II. A more frequent incidence of multi-peak and interrupted flow patterns was found in women with sui, which could be related to a neurogenic component in etiology of the disease.

[Results of surgical treatment of stress urinary incontinence in women]. / Wyniki leczenia operacyjnego wysilkowego nietrzymania moczu u kobiet.

Post-operation results of stress urinary incontinence treatment have been assessed and subjected to statistical analysis in 667 patients. The elaboration of the results was based on case history data, inquiries and control ambulatory examinations. Diagnostic procedures included sphincterometry, cystometry, cystoscopy, cystography and provocation test like coughing. Vaginal and urine biocenosis was always assessed microbiologically. The Marshall-Marchetti operation as modified by Durfée and Burch was made within the space of Retzius. Complementary procedure consisted in suturing levator ani muscles after previous bilateral opening of pararectal space within perineum. Third pair of sutures was placed according to the authors' own modification during the Durfée operations. The results of surgical treatment of SUI performed by the authors do not differ in principle from those reported by others. A small number of relapses the authors ascribe to local and systemic processes of aging which diminish the effectiveness and the value of previously made correction of urethra and of the bladder bottom topography.

[Results of the evaluation of intracystic and intraurethral pressure in women with stress urinary incontinence]. / Wyniki oceny cisnienia sródpecherzowego i sródcewkowego u kobiet z wysilkowym nietrzymaniem moczu.

Urodynamic measurements including sphincterometry and cystometry were made in 36 women with stress urinary incontinence (SUI). Out of this number in 32 affected with SUI of stages I, II and III surgical treatment was applied. Control group were 7 women without SUI symptoms. Marshall-Marchetti operation in the modification of Durfée or of Burch was made in the space of Retzius. The procedure was followed by simultaneous pararectal suturing of the wedges of levator ani muscle. The mean values of urodynamic measurements were compared using Student's "t" test and paired test. No evident difference was found when average values of pre-operative +cystic manometry were compared in particular groups of patients using statistical analysis. Sphincterometry made in women who had been effectively operated on showed statistically significant higher values of urethral closure pressure. Higher values of post-operative urodynamic measurements can speak for a complete recovery of the patients.