Investigation of pituitary adenylate cyclase activating polypeptide in human gynecological and other biological fluids by using MALDI TOF mass spectrometry.

Pituitary adenylate cyclase activating polypeptide (PACAP) is a multifunctional and pleiotropic neuropeptide. PACAP has diverse effects in the endocrine system, among others, it plays important roles in oogenesis, implantation and development of the nervous system. However, it is not known whether PACAP is present in the fluids of the human reproductive organs. The aim of the present study was to determine, by means of mass spectrometry and radioimmunoassay, whether PACAP is present in human amniotic fluid, ovarian follicular fluid and cervico-vaginal fluid. Samples were obtained from healthy adult volunteers. Our MALDI TOF and MALDI TOF/TOF spectrometry results show that PACAP38 is present in all of the follicular fluid samples, and PACAP-like immunoreactivity was also measured by radioimmunoassay. However, we did not find the characteristic peak representing the unmodified 38 amino acid form of the peptide in normal cervico-vaginal smear and amniotic fluid samples. Furthermore, we analyzed other body fluids for comparison, such as human nasal fluid, saliva and aqueous humor. PACAP was not found in these latter samples. In summary, the present study provides evidence for the presence of PACAP in human follicular fluid, suggesting a role in oocyte function, but determination of the exact physiological significance awaits further investigation.

Correlation of prenatal clinical findings with those observed in fetal autopsies: pathological approach.

Our objective was to present a comprehensive description of the clinicopathological findings of 173 abortions, including 121 therapeutic and 52 spontaneous ones in the period between 1992 and 1998. In all of these fetuses pathological examination was carried out. It was complemented when indicated by immunohistochemistry, in situ hybridization, flow cytometry, and X-ray examination. In the 121 therapeutic abortions the distribution of malformations was: 45 central nervous system anomalies (37%), 12 genitourinary anomalies (10%), 25 gastrointestinal anomalies (21%), two respiratory system anomalies (1.65%), eight cardiac anomalies (6.6%) and 28 other anomalies (17.2%) as revealed by autopsy. From the clinically selected 52 spontaneous abortions, major malformations were seen in 15/52 cases. With the comparison of the pathological and clinical findings in 121 therapeutic abortions, the percentage of cases with correct clinical designation and no missed anomalies amounted for 49%. However in 51% additional or different lethal, severe, or major malformations were revealed or excluded by fetopathological examinations. In 4% the clinical observation and diagnosis were modified, but without implications for the therapeutic termination of pregnancy. The clinical indication could not be supported in another 3% of the cases.

[Parvovirus B19 infection in hydrops fetalis]. / Parvovírus B19-infekció foetalis hydropsban.

In a retrospective study from 210 foetal autopsies carried out in a period between 1992 and 1999 fifteen hydropic foetuses were found. The cause of the hydrops was shown to be Rh incompatibility in one case only. The cause of hydrops was not discernible in one case. In the others pathological examination clarified the cause and pathomechanism of non-immune hydrops. One isolated cystic hygroma, one monochorionic twin pregnancy with twin to twin transfusion, one case of sacrococcygeal teratoma and 4 cases of congenital heart diseases were reported. Postmortem interphase cytogenetic examination showed X0 monosomy in 2 cases. In further 4 foetuses pathognomic viral inclusions in the proerythroblasts raised the probability of parvovirus B19 infection what was confirmed by immunohistochemistry and electronmicroscopic examination. The occurrence of the parvovirus B19 associated cases of foetal hydrops was shown to be higher (4/15) in this series than in the literature. The accumulation of cases in 1998 is suggestive of an outbreak. The prenatal diagnostic implications and the attempts on further management are also discussed.

[Dopamine, noradrenaline and serotonin levels in amniotic fluid during the second trimester in normal and pathologic pregnancy]. / A magzatvíz dopamin, noradrenalin és szerotonin értékei a terhesség második trimeszterében, normális és kóros kimenetelü terhességekben.

Authors measured the dopamine (DA), noradrenaline (NA) and serotonin (5-HT) contents of amniotic fluid between 19 and 21 weeks with fluorimetric method. The amniotic fluid samples were obtained by transabdominal amniocenteses performed due to elevated maternal serum-alphafetoprotein levels and suspect ultrasound findings. They considered as normal values the average of 30 amniotic fluid samples obtained from pregnant women who gave birth to healthy babies at term. The mean values (mean+SE) of normal cases were 136.6 + 20.2 nmol/l for DA, 29.5 + 9.4 nmol/l for NA and 72.6 + 4.9 nmol/l for 5-HT. Against these values, in cases of open spina bifida the level of NA showed no significant difference, the DA level was higher (p < 0.05) and the 5-HT level was also higher (p < 0.001). The DA level was found higher (p < 0.05) in cases of intrauterine retardation as well, however there was no difference in the NA and 5-HT levels in these cases. In cases of preterm deliveries, none of the above parameters showed differences. Authors suggest that in cases of spina bifida the measurement of 5-HT in the amniotic fluid can be a complementary diagnostic method. They also state that no prognosis about the outcome of pregnancies can be expected from such examinations.

[Exclusion of Sandhoff disease (Tay-Sachs 0 variant) by chorion biopsy]. / Sandhoff-betegség (Tay-Sachs 0 varians) kizárása chorionbiopszia segítségével.

Transcervical chorionic villus sampling with ultrasound guidance at the 11-th week of pregnancy was made at a woman with the history of one lethal case of Sandhoff disease. The total hexosaminidase and the hexosaminidase A were determined. At the 16-th week amniocentesis was performed and the characteristic enzymes were determined from the amniotic cell culture. The results of the examinations made possible to advise the patient to carry out the pregnancy. The examinations after delivery confirmed the newborn to be a carrier.

Two different methods of prostaglandin administration for cervix priming before interruption of the first trimester pregnancy.

Priming of uterine cervix with PGF2 alpha has been applied to 253 primigravidae before interruption of first trimester pregnancy. Of them, 140 patients were treated with intracervical PGF2 alpha, while 113 other patients with extraamniotic PGF2 alpha. Spontaneous abortion or complete dilatation occurred in 65% of cases in the first group and in 68% in the second one. Side effects were observed less frequently with intracervical application but no serious complication occurred in either of the groups. Intracervical application of PGF2 alpha gel is recommended because of its effectiveness and low rate of side-effects.