Influence of Active Exposure to Tobacco Smoke on Nitric Oxide Status of Pregnant Women.

Smoking tobacco can impair proper vascular endothelial functioning. This is exhibited through reduced nitric oxide synthesis as well as activity due to accompanying oxidative stress. We examined the relationship between nitric oxide and markers of oxidative stress/antioxidant defense in serum of smoking and non-smoking pregnant women. Subjects included 99 healthy pregnant women, who were tested for nitric oxide (NO), endothelial (eNOS) and inducible (iNOS) nitric oxide synthase, total oxidant capacity (TOC), and total antioxidant capacity (TAC). NO, eNOS, and TAC serum concentrations were significantly lower (p < 0.005), but iNOS (p < 0.05) and TOC (p < 0.001) were higher in smokers than in non-smokers. Multivariate regression analysis showed associations between NO concentration and eNOS, TAC, and smoking status in the whole group of patients. In the model estimated separately for smokers, the highest impact of eNOS (ß = 0.375; p = 0.021) and cotinine (ß = -0.323; p = 0.037) was indicated for NO concentration. In the model of non-smokers, eNOS (ß = 0.291, p = 0.030) and TAC (ß = 0.350; p = 0.015) were important for NO level. Smoking during pregnancy could exacerbate oxidative stress, impair the action of nitric oxide synthases, and adversely affect the balance of oxygen and nitrogen metabolism. Relationships between NO concentrations and TAC in the studied women's blood can confirm the antioxidant nature of nitric oxide.

[Serum concentrations of visfatin and oxidative stress markers in tobacco smoking pregnant women].

Tobacco smoking during pregnancy increases the risk of severity of oxidative stress, which can affect adipokines expression in adipose tissue. The aim of the study was to assess the effects of smoking on the level of visfatin and selected markers of oxidative stress (ox-LDL- oxidized low density lipoprotein, TOC - total oxidant capacity, TAC - total antioxidant capacity) and the association between them in pregnant women. Material and Methods: The research material was the venous blood of healthy women admitted to given birth in the Department of Obstetrics and Gynecology Institute of Mother and Child in the years 2015 - 2016. Based on an interview and determination of serum cotinine, women were divided into following groups: smoking (n=41) and non-smoking group (n=43). Concentrations of biochemical parameters were determined by enzyme immunoassay using commercial kits. Results: In serum of smoking pregnant women concentrations of visfatin, ox-LDL, and TOC were significantly higher while level of TAC was lower than observed in nonsmoking group (p<0.001). We found important association between number of cigarettes daily consumed and serum level of visfatin (r=0.43; p<0.01), ox-LDL (r=0.36; p<0.05), and TOC (r=0.39; p<0.05). Multivariate regression analysis showed a positive correlation between concentration of visfatin and level of ox-LDL as well as TOC both in the smoking women (ox- LDL: ß=0.381; TOC: ß=0.388; p<0.05), and in tobacco abstinent group (ox- LDL: ß= 0.470; TOC: ß=0.326; p<0.05). Conclusions: These results indicate that smoking during pregnancy adversely affect the oxidant/ antioxidant balance. The association between visfatin concentrations and markers of oxidative stress may suggest prooxidant tendency of this adipokine.

[Umbilical cord serum hepcidin levels and maternal smoking during pregnancy]. / Stezenia hepcydyny we krwi pepowinowej dzieci matek palacych tyton w przebiegu ciazy.

Anemia during pregnancy is a risk factor of disturbance in pre- and postnatal child's development. Hepcidin plays the key role in iron metabolism, as protein participating in the regulation of intestinal absorption of this element and its release from macrophages, and transport across the placenta. Maternal smoking during pregnancy can result in disturbances of iron homeostasis leading to a subclinical deficiency. The depletion of maternal iron can cause fetal hypoxia condition and decreased expression of hepcidin. The aim of the study was to evaluate the effect of smoking on the levels of hepcidin and erythropoietin (as an indicator of hypoxia) and their relationships in umbilical cord blood. The research material was the umbilical cord blood of 50 newborns born in the Department of Obstetrics and Gynecology (Institute of Mother and Child in Warsaw) in the years 2013-2014. Based on an interview and determination of cotinine in the blood of mothers, newborns were divided into following groups: children of smoking mothers (n=20) and children of tobacco abstinent mothers (n=30). Hepcidin and erythropoietin concentrations were determined by enzyme immunoassay using commercial kits (DRG, Germany). It has been shown that hepcidin concentrations were significantly lower in children of smoking mothers than in the group of tobacco abstinent (37.5 ng/mL vs 45.1 ng/mL, p<0.001). However, the level of erythropoietin was higher in children of smoking mothers than in children of non-smoking women (p<0.001). A negative correlation between the levels of hepcidin and erythropoietin (r = -0.41, p<0.05) and number of smoked cigarettes (r = -0.43, p<0.05) was observed. These results indicate that smoking during pregnancy significantly affects hepcidin levels in children born at term. Decrease of hepcidin concentration coexisting with high level of erythropoletin in umbilical cord blood in children of smoking pregnant women may be the cause of subclinical deficiency of iron in the newborn.

Effect of tobacco smoking on the maternal and fetal adipokine axis in relation to newborn birth weight and length.

We examined the effect of tobacco smoking on the concentrations of leptin, soluble leptin receptor (sOB-R), total adiponectin, and free leptin index (FLI) in the serum of maternal-cord pairs. We also investigated the correlations between these biochemical parameters and newborn birth weight and length. The study included eighty-five healthy pregnant women, who were divided into smoking and tobacco- abstinent groups according to serum cotinine concentrations. We found that maternal and fetal leptin, sOB-R concentrations, and free leptin index were similar in smoking and tobacco abstinent groups. We observed significant negative relationship between the reported number of cigarettes smoked daily during pregnancy and cord blood leptin (r=-0.37; p<0.05). In the group of smoking women, total serum adiponectin concentrations were significantly lower than in the tobacco abstinent group in mothers as well as in cord blood (p<0.05). A significant negative association between the number of cigarettes smoked per day and total adiponectin concentration in maternal as well as newborn serum was observed (r=-0.38; p<0.05). Umbilical serum leptin, sOB-R, and FLI levels were significantly lower and adiponectin higher compared with maternal concentrations at birth (p<0.05). Mean birth weight and body length of the smoking mothers' infants were significantly lower (p<0.001; p=0.015, respectively) compared with the abstinent group, and negatively correlated with the daily number of cigarettes consumed (birth weight r=-0.39; p<0.05; birth length r=-0.37; p<0.05). Cord blood values of leptin, FLI and adiponectin were significantly correlated with newborn birth weight. We also observed a positive relationship between cord blood adiponectin levels and the birth body length in the two studied groups (r=0.49; p<0.002). Tobacco smoking during pregnancy decreases maternal and fetal serum adiponectin levels but does not have a significant effect on blood leptin concentrations. The direct association between the cord blood values of these adipokines and birth weight and length suggest that rather fetal (not maternal) adiponectin and leptin concentrations may be involved in fetal development during pregnancy.

[The effect of tobacco smoking on serum concentration of selected angiogenic factors and somatomedin C in pregnant women and umbilical cord blood]. / Wplyw palenia tytoniu na stezenia wybranych czynników angiogennych oraz somatomedyny C w surowicy krwi kobiet ciezarnych i krwi pepowinowej.

The objective of this study was to evaluate the effect of cigarette smoking on concentration of selected angiogenic factors (vascular endothelial growth factor VEGF, placenta growth factor PIGF) and somatomedin C (insulin-like growth factor-I) in blood of mothers and umbilical cord blood. The correlations between studied biochemical parameters and markers of estimated intensity of cigarette smoking as well as birth weight were also determined. Fifty healthy pregnant women were divided into two groups: smoking and tobacco abstinent group according to serum cotinine concentration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. In the group of smoking mothers the mean serum concentration of cotinine was 91.6 microg/L and correlated positively with number of cigarettes daily consumed (r = 0.58, p < 0.01) as well as with time of smoking before conception (r = 0.40, p < 0.05). The mean serum concentration of PIGF in III trimester of pregnancy was significantly higher in the group of smokers than in non-smoking ones (p < 0.0001) and correlated with serum cotinine concentration (r = 0.41, p < 0.05) and number of cigarettes daily consumed (r = 0.58, p < 0.01). The concentration of serum VEGF was similar in both studied group. The mean serum level of IGF-I was significantly lower in group of smokers than in non-smokers in the I and III trimester of gestation (p < 0.01). Also in umbilical cord blood of smoking newborn the concentration of IGF-I was lower by 20% than in nonsmoking group (p < 0.05). We observed negative correlation between number of cigarettes daily consumed and serum level of IGF-I in blood of mothers as well as in blood of their children (I trimester: r = -0.43, p < 0.05; III trimester: r = -0.70, p < 0.001; umbilical cord blood: r = -0.45, p < 0.05). In both studied groups there were a positive correlation between birth weight and concentrations of IGF-I in blood of mothers and umbilical cord blood (group of smokers: mothers r = 0.43, p < 0.05, cord blood r = 0.50, p < 0.01; group of tobacco abstinent: mothers r = 0.51, p < 0.01, cord blood r = 0.41, p < 0.05). The birth weight of the smoking mothers' infants was lower by about 400 g (p < 0.01) and their birth body length by 1.5 cm (p < 0.05) and negatively correlated with number of cigarettes smoked per day (r = -0.55; p < 0.005). Our results indicate, that tobacco smoking during pregnancy increased serum PIGF levels in the final stages of gestation and has no effect on the concentration of VEGF, which may lead to an increase of trophoblast proliferation and uteroplacental dysfunction. Lower than in tobacco abstinent levels of IGF-I in serum of smoking mothers and in umbilical cord blood and their close relationship with birth weight, may suggests a direct effect of this factor on birth anthropometric parameters.

[The effect of tobacco smoking during pregnancy on concentration of pro-hepcidin and some parameters of iron metabolism in matched-maternal cord pairs]. / Wplyw palenia tytoniu przez kobiety ciezarne na stezenia pro-hepcydyny i wybrane parametry metabolizmu zelaza we krwi matki i we krwi pepowinowej noworodka.

Iron deficiency relatively observed in pregnant women is assumed to be enhanced by cigarette smoking. Hepcidin, a peptide hormone produced by the liver as pro-hepcidin, has recently emerged as a central mediator of iron metabolism. Hepcidin regulates intestinal iron absorption, macrophage iron release, and the placental passage of iron. Maternal smoking is associated with increased fetal iron requirements and stimulates fetal erythropoiesis. This is probably through a hypoxic effect on the fetus, and is dose related to the maternal smoking level. It is known that anemia and hypoxia suppress hepcidine mRNA expression. Therefore the aim of the study was to estimate the effect of tobacco smoking on serum pro-hepcidin levels and some iron parameters in pregnant women and umbilical cord blood. We also studied correlation between pro-hepcidin and others iron markers in mothers and their newborns. Healthy, pregnant women (n = 50), patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child were divided into groups nonsmoking and smoking according to questionnaire declaration. Serum concentrations of pro-hepcidin were determined by immunoenzymathic method using a commercial pro-hepcidin assay (DRG, Germany). Levels of ferritin and transferrin were measured by immunoturbidimetric method and iron by photometric test with ferrozine using HORIBA ABX kits (France) and Cobas Mira analyser (Roche, Switzerland). Levels of hemoglobin and hematocrite were determined using commercially available kits on Pentra 60 analyser (ABX, France). We observed that the mean concentration of pro-hepcidin in serum of smoking pregnant women was statistically lower than in tobacco abstinent (101.9 +/- 28.6 ng/ml vs 88.3 +/- 18.2 ng/ml; p < 0.01). Levels of others studied iron markers were similar in both group except total iron concentration, which was 20% lower in smoking mothers than in nonsmoking ones. In umbilical cord blood of infants born to smoking women level of pro-hepcidin was significantly lower than in tobacco abstinent (54.2 +/- 14.0 ng/ml vs 76.8 +/- 21.4 ng/ml, p < 0.0001). We observed positive correlation between concentrations of that prohormone in serum of mothers and cord blood of their newborns in nonsmoking group (r = 0.54; p < 0.02) as well as in smoking ones (r = 0.68; p < 0.05). In addition, concentrations of ferritin, transferin and total iron were lower by 30%, 13% and 20% respectively in cord blood of smoking than nonsmoking group. The differences were statistically significant (p < 0.05). Our analysis revealed no correlation between serum pro-hepcidin levels and other studied parameters of iron status both in the mothers and children groups. Our results indicate that tobacco smoking during pregnancy affected pro-hepcidine levels in serum of mothers and their newborns. Low concentrations of some iron markers in umbilical cord blood suggest that mother's smoking could lead to subclinical iron deficiency in fetus. No anemia were observed in both studied groups of mothers that could explain no relationships between pro-hepcidin and others parameters of iron status.

[Malignant tumors of the oral cavity and neck in clinic of maxillo-facial surgery in Poznan from 2002-2004]. / Nowotwory zlosiwe jamy ustnej i szyi w materiale kliniki chirurgii szczekowo-twarzowej w Poznaniu w okresie 2002-2004.

UNLABELLED: Increasing number of malignant neoplasms of the oral cavity and facial region as well as lower age of the patients hospitalized were the interest of the authors. MATERIAL AND METHODS: Clinical data from the years 2002-2004 were analysed in this paper. In this study the factors as: sex and age of patients, tumor localization, histological examinations, surgical treatment of the tumor and lymph nodes are reported. RESULTS: During the 3 years period there were 346 tumors of the oral cavity treated in Clinic of Maxillofacial Surgery in Poznan. Epidemiologic studies have revealed a increased number of squamous cell carcinomas and other malignant tumors as lymphomas, adenoid cystic carcinomas and sarcomas of the oro-facial region. The staging of the tumors is similar as in previous years. CONCLUSIONS: The study shows better knowledge about oral malignancies in dentists and general praticioners. The tumor patients are surgically treated earlyer as in previous years.

[Serum folate and homocysteine concentrations in women smoking during pregnancy and in umbilical cord blood of newborns]. / Stezenie kwasu foliowego i homocysteiny w surowicy krwi kobiet palacych tyton podczas ciazy oraz w krwi pepowinowej noworodków.

In metabolism of homocysteine several enzymes and vitamin cofactors are involves. Genetic abnormalities in these enzymes or nutritional deficiency vitamins, especially of folate may lead to hyperhomocysteinemia, a known risk factor for some pregnancy complications. High maternal homocysteine and low folate levels correlate with low birth weight. Maternal smoking affected significantly total homocysteine concentration in infants. Studies in this area are still scarce and report on limited number of patients. The aim of our study was to assess serum folate and total homocysteine (tHcy) concentrations in smoking pregnant women and in their newborn infants as compared with nonsmoking. The study consisted of 57 pregnant women, who qualified into two groups: smoking (n=28) and nonsmoking (n=29). The serum concentrations of folate were determined by electrochemiluninescent method and tHcy by fluorescence polarization immunoassay. We shown, that serum homocysteine concentrations were significantly higher in smoking as compared with nonsmoking pregnant women (p<0.05) as well as in umbilical cord blood of their newborns (p<0.001). The folate levels were comparable in serum both groups of mothers, but in infants born to smoking women were lower by 20%. In addition, the maternal serum levels of homocysteine and folate showed a significant positive correlation's with these parameters in newborns. Average birth weight infants born to smoking mother was significantly lower than nonsmoking cigarettes (p<0.05). It seems that tobacco smoking during pregnancy affected folate and homocysteine levels in serum of mothers and their infants. Smoking exposure is also associate with reduced birth weight.

[Atypical Stafne bone cavity of the mandible]. / Nietypowy ubytek w zuchwie typu Stafne.

The paper presents the case of atypical Stafne bone cavity in 41 years old male. The defect was situated under the mandibular nerve and second molar. There were the part of submandibular gland, arterial vesel and fat tissue in the 2 x 2 cm cavity.

[Dyskinesias of the tongue and other face structures]. / Dyskinezy jezzyka i innych struktur twarzy.

PURPOSE: A dyskinesia is a permanent disorder consisting of compulsory movements of the tongue, lips and facial muscles. Dyskinesias of other parts of the body are also known. They improve the diagnosis and treatment in dentistry and oral surgery. AIM: The aim of the study is to present cases of dyskinesia manifesting as involuntary movements and their treatment. RESULTS: Dyskinesias of various body parts accompanying Huntington's disease, Parkinson's disease, Down syndrome, Joubert's syndrome, arteriosclerosis, cerebral palsy, and tetanus are discussed.

[Perception of gustatory sensation after treatment of the third branch trigeminal nerve and lingual nerve by peripheral alcohol injection]. / Odczucia wrazliwosci smakowej po leczeniu neuralgii III galezi nerwu trójdzielnego i nerwu jezykowego blokadami alkoholowymi.

PURPOSE: Objective testing was an aim of the examination whether excluding the sensory zone of the tongue is causing the slope of the gustatory sensitivity after alcoholic blocks. MATERIAL AND METHODS: Material is embracing 15 ill neuralgia treated in a maxillary-facial surgical clinic in Poznan because of neuralgia, in the age on average 60 years, which one should block the sensory leadership of the mandibular nerve with alcohol at and additionally lingual branch. There were 6 women and 9 men amongst treated patients. RESULTS: Objective electrogustomertic examinations demonstrated worsening the gustatory sensitivity with the Pruszewicz's method at 86.7% of ill, on the alcoholised side of the lingual nerve, however at stayed impressions of the gustatory sensitivity were located in upper limits of the norm. CONCLUSION: Worsening gustatory impressions isn't forming with injuring of the of chorda tympani fibres but it is an effect of bearing feeling surface in the area of the innervation through the lingual nerve after of it alcoholization.

[Palatograms and linguograms for studying misarticulation following surgery for tumors of the tongue and oral cavity floor]. / Palato- i lingwogramy w ocenie zaburzen artykulacji glosek po operacjach nowotworów jezyka i dna jamy ustnej.

This work deals with the mechanism of misarticulation following surgery for malignancies in the oral cavity. The underlying cause was dysfunction of the tongue due to partial or total resection, consequences of the resection of the mandible together with the oral cavity floor, or dysfunkction of the lower lip failing to seal the space of Donders. Anatomic alternations reveal themselves as shifts in the points of contact between structures of the articulation system noticeable on palatograms or linguograms. Limited mobility of tongue tip may affect speech, particularly in the case of sounds of the first and second articulation zone.

[Oral appliances in the treatment of snoring]. / Ustne aparaty protetyczne w leczeniu chrapania.

There are many methods of snoring treatment from conservative and prosthetic to surgical. The snoring sound is produced by vibration of the soft tissues of the pharynx, soft palate and also uvula. Snoring occurs in 50% of the adult male population and it can be isolated or sign of the obstructive sleep apnoea syndrome. Oral appliances modify the position of the mandibule, the tongue and other structures in oral cavity. Oral appliances are recommended for the treatment of snoring and mild obstructive sleep apnoea syndrome. That is why we constructed the study to assess wheather oral appliances correct snoring. 12 mails (aged 43-57) with intensive snoring for at least 50% of the sleep time were qualified to the treatment with oral appliances. The decision about the type of the device were made by ENT surgeon and maxillo-facial surgeon. The various oral appliances were used; some of which were modyfied by us. During the treatment snoring was tested with Poly-Mesam device. The best results were obtained with the use of devices that correct the position of soft palate and uvula. All the devices decreased snoring significantly. They were tolerated by the majority of patients.

[Twin pregnancies and their outcome at the Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, in the period of 1993-2000]. / Przebieg ciazy i porodu w przypadkach ciaz mnogich w materiale Kliniki poloznictwa i Ginekologii Instytutu Matki i Dziecka w latach 1993-2000.

OBJECTIVE: The aim of this study was to analyse the course of twin pregnancies delivered at the Department of Obstetrics and Gynaecology, Institute of Mother and Child in Warsaw, from 1993 to 2000. MATERIALS AND METHODS: The medical documentation of women with twin pregnancy was looked into. Such parameters as mode of conception, maternal age and parity were taken into account. The data concerning the duration of pregnancy, mode of delivery, birth weight and condition of newly born infants were retrospectively reviewed. RESULTS: There a total of 232 (1.46%) twin pregnancies out of 15,869 births. A gradual increase in absolute number of twin deliveries and a relative increase of multiple pregnancies due to the use of assisted reproduction techniques was observed. The tendency to end twin pregnancies by caesarean section was detected. Although the perinatal care improved over the years, a small decrease of mean gestational age at delivery was observed. No significant difference in neonatal outcome in relation to the mode of delivery in researched material was noticed. CONCLUSIONS: The number of twin pregnancies due to the use of assisted reproduction techniques is on the increase. A percentage of women delivering for the first time has risen among women with twin pregnancy. Twin pregnancies are often ended by caesarean section and the frequency of caesarean sections has increased over time.

[Usefulness a buccal flaps for reconstruction tissue defects after operations cancers lip and nose]. / Wykorzystanie platów policzkowych do rekonstrukcji ubytków tkankowych po operacjach raków wargi i nosa.

The aim of this study was to describe methods in tissue reconstruction deficiences after operations due to upper and lower lip and nose cancer with using full thickness (musculomucosal cutaneus flap) and incomplete buccal flap (musculocutaneus). Flaps were collected bilaterally and sutured in the middle of the lips. Their usefulness was confirmed especially in total lip reconstruction.

[Intraamniotic surfactant supply as RDS prevention]. / Doowodniowe podanie surfaktantu jako profilaktyka zespolu zaburzen oddychania--doniesienie wstepne.

The importance of steroids given antenatally to the mothers in prevention of the respiratory distress syndrome (RDS) is unquestionable. Also intra tracheal surfactant application in newborn is proven method of prevention and treatment of RDS. However both options have some limitations and new methods useful in prevention of RDS are still needed. The aim of the study was to evaluate the efficiency and safety of the procedure of the intraamniotic surfactant supply as RDS prevention. Natural surfactant (Alveofact - Boehringer Ingelheim) has been given to 15 women at 24-32 weeks of pregnancy, two hours before expected childbirth (mainly cesarean section). To 8 of these women corticosteroids have been earlier administered. Just before surfactant injection amniotic liquid samples were taken to confirm lung immaturity and the patients were administered Aminophilline intravenously to provoke fetal breathing movements. Surfactant has been administered through the needle under direct ultrasound guidance into the amniotic cavity as close as possible to the fetal mouth and nose. Patients with the evidence of chorionamnionitis and fetal malformations were excluded from the study. No complications were observed during and after the procedure. None of the newborns had symptoms of severe asphyxia, the birth weight comprised between 670-1650 g (mean 1207). There was radiological evidence of RDS in two newborns and in 7 mechanical ventilation was needed. Of 15 newborns 13 survived (86.6%). There was no need for postpartum surfactant therapy in any case. Some authors expressed their view that this method is promising and further studies are desirable. In our study surfactant has been injected into the amniotic cavity shortly before childbirth, and Aminophilline has been administered intravenously in order to provoke fetal breathing movements before surfactant injection. The safety of the procedure was confirmed and the results of intraamniotic surfactant supply seems to be favourable to newborns. Small number of cases does not allow to draw any far-reaching conclusions. Still our preliminary results are encouraging and the study should be continued.

[Pregnancy and travel]. / Ryzyko dla przebiegu ciazy i rozwoju plodu zwiazane z podrózowaniem.

The special problems of travel during pregnancy have become clinically important as more women are traveling to remote places for business or recreation. Many issues need to be considered in providing health advice to the pregnant traveler. Health practitioners should be able to assist in the careful medical preparations that will ensure the safety of the pregnant woman and fetus during travel. Journey may increase the risk of pregnancy complications because of inherent physiological changes or exposure to environmental hazards and infectious disease. Usually standard interventions are not recommended during pregnancy. In pregnancy, the maternal and fetal benefits of protection from disease and its complications must be carefully balanced against the small, often theoretical risk, of adverse effects following immunization. In some circumstances the best advice may be to postpone travel if effective preventive measures against disease cannot be undertaken and access to medical care is uncertain.