Trophoblast apoptosis in placentas from pregnancies complicated by preeclampsia.

AIMS: To assess trophoblast apoptosis separately in the cytotrophoblast, syncytiotrophoblast, total villous trophoblast, syncytial knots and syncytial knot formation, and to investigate the expression of apoptotic factors Fas ligand (FasL), Bcl-2 and proliferation marker Ki-67 in the trophoblast of placentas from preeclamptic patients. METHODS: The study included placental samples from 25 preeclamptic and 25 normal pregnancies. For the detection of apoptosis and proliferation, antibody M30 and antibody against Ki-67 antigen were used. Expression of FasL and Bcl-2 was assessed using semi-quantitative HSCORE method. Syncytial knots were expressed as the number of syncytial knots per individual villus and as the total number of syncytial knots in each placental sample. RESULTS: Trophoblast apoptosis, number of syncytial knots per individual villus and the total number of syncytial knots in each placental sample were significantly higher in preeclamptic placentas than in control group placentas. FasL expression was significantly less, and Bcl-2 expression significantly greater in the villus trophoblast among the study subjects compared with controls. There was no difference in the trophoblast proliferation between groups. CONCLUSION: Our findings might suggest that increased apoptosis and syncytial knot formation combined with reduced FasL expression could be involved in pathophysiological mechanisms of preeclampsia.

Perinatal outcome of pregnancies in women aged 40 and over.

Perinatal outcome of pregnancies at forty and over was analyzed starting from the diagnosis of pregnancy to seven days following delivery. Retrospectively, pre-gestational health and reproduction status were dealt with, as well as the course of pregnancy, deliveries, and newborn children (study group). The control group was composed of pregnant women aged 20 to 29, who were identical to study group in terms of parity. Statistical data processing was done by means of chi2-test, and contingency 2 x 2 tables. The difference was significant if p < 0.05. Out of 2,099 diagnosed wanted pregnancies at forty and over, 415 (19.8%) had a miscarriage, in 33 (1.6%) an artificial abortion was performed after determining the fetus karyotype and 1,651 (78.2%) of pregnant women delivered. In 66.2% of pregnancies the fetus karyotype was determined and in 33 (2.5%) fetuses chromosomal abnormalities were found Incidence of deliveries at 40 and over is 1.38%, which is a 35.6-percent increase in the last ten years. Nullipara and pluripara had an increase, and multipara had a decrease. Pre-gestational health and reproduction status in study group is lower than in control group. Complications during pregnancy: threatened abortion, EPH gestosis, placenta praevia, gestational diabetes, late fetal death are more frequent than in control group (p < 0.05). In intrapartal terms, more frequent were induction of delivery, meconium-stained amniotic fluid, fetal distress, operative vaginal deliveries, and Cesarean section (p < 0.05). In neonatal outcome there are more premature infant, there are more VLBW, LBW, SGA, newborn with low Apgar index values, and the total perinatal death is greater than in the control group (p < 0.05). In perinatal terms, (from the diagnosis to the seventh day following delivery) 1,617 children survived (77.0%), meaning that perinatal loss was 482 (23.0%). Authors conclude that pregnancy at 40 and over is a high-risk pregnancy. There is a high risk of pre-gestational and gestational complications, and perinatal loss is high. Therefore, those pregnancies are not desirable from the medical point of view.

Hypertensive retinopathy and pre-eclampsia.

The aim of the study was to determine the relationship between hypertensive retinopathy and the severity of pre-eclampsia. Forty women with pre-eclampsia, mean age 29.1 (+/- 7.4; range, 19-44) years, were retrospectively analyzed. They were treated at the Department of Obstetrics and Gynecology of the Clinical Hospital Split, from January 1997 to December 1999. The mean age of gestation was 36.0 +/- 2.8 weeks (range, 28-39). Pre-eclampsia was classified according to Goecke. Based on the ophthalmoscopic fundus examinations the patients were divided into four groups, according to Keith-Wagner classification system of grading retinal changes. Of 40 analyzed women, 18 (45%) had ophthalmologically verified hypertensive retinopathy. Ten of them were classified as grade I, six as grade II and two as grade III. Twenty-two patients had mild pre-eclampsia, ten patients had moderate pre-eclampsia, and eight patients had severe pre-eclampsia. A statistically significant correlation (t-test) was found between the degree of hypertensive retinopathy and patient age, Apgar score, trophism, Goecke's index, proteinuria, systolic and diastolic pressure (P < 0.001) and edema (P = 0.01). The degree of hypertensive retinopathy was directly proportional with the severity of pre-eclampsia and significant correlation was found between them (r = 0.338, p = 0.033). These findings showed that the degree of hypertensive retinopathy in women with pre-eclampsia is a valid and reliable prognostic factor in determining the severity of the pre-eclampsia. Therefore, it can be concluded that the examination of the fundus is a valuable and necessary diagnostic procedure in pregnant women with pre-eclampsia.

Effect of insulin and insulin-like growth factor I on fetal macrosomia in healthy women.

The aim of the study was to determine the values of insulin, insulin-like growth factor I (IGF-I) and glucose in the umbilical cord blood of macrosomic (> or = 4000 g) and control (3,000-3,500 g) infants born to healthy mothers, and to assess their possible correlation with the newborns' birth weight and maternal anthropometric parameters. A series of 207 macrosomic term infants, and 200 control term infants, born to healthy mothers with normal oral glucose tolerance test throughout gestation, were studied. The glucose concentration did not differ between the macrosomic and control group while macrosomic infants had significantly higher values of insulin and IGF-I. Female macrosomic infants had significantly higher levels of insulin and IGF-I than male macrosomic infants. The levels of insulin and IGF-I, but not levels of glucose, differed between the macrosomic and control group according to the maternal weight, height, pregestational body mass index, weight gain during gestation, and maternal birth weight. The maternal anthropometric parameters were significantly greater in the macrosomic infants. Accordingly, macrosomia was concluded to be a multifactorial condition.

Influence of father's weight and height on weight of male and female newborns.

The study included 1,596 newborns and their parents living in Sibenik County, Croatia. All newborns are born between 37 and 42 weeks of gestation, with no congenital anomalies and from a single pregnancy. Fathers and mothers of male babies are older than those of girl babies (p < 0.01). Mean values for weight, height, BMI in parents and the woman's parity are equal (p = 0.05). Pregnancy with male baby lasts longer and the babies are heavier (p < 0.05). Where the fathers weight between 70 and 79 kg and 80 to 89 kg, and where the fathers are 175 to 179 cm or 180 to 184 cm tall with normal BMI the male babies are heavier than the females at birth (p < 0.05). Increased weight, height and BMI in the father increase the birth weight of both male and female babies (p < 0.00001). The authors concludes that the parents (father and/or mother) of male babies are older than those of girls, that pregnancy for males babies lasts longer and that male babies are born heavier than girls. With increased weight, and height and BMI in the father, the birth weight of both male and female babies increases.

Physiological anthropology and the Internet.

The Internet is the greatest computer network with many services like Web, FTP, Gopher, E-mail Discussion Groups, and Usenet Discussion Groups, that provides a rapid and the cheapest exchange of information. The benefits to anthropologists of using the Internet are growing rapidly, as the Internet becomes easier to use and ever more anthropological resources become available on line. Physiological anthropology is concerned with the evolution and biological features of human population and it's sources on the Internet are growing continuously. However, in that enormous number of data, is not easy to find a needed information. Currently, number of indexed physiological anthropology related sites on Web only is 233990 (October 98). This paper provides informations about Internet and needed hardware and software for using it. It also describes and lists the most important physiological anthropology addresses, together with physiological anthropology-related journals on the Internet, as well as the ways of searching them.

Oral lichen planus and HLA A.

Oral lichen planus (OLP) is autoimmune disease that appears on the oral mucosa only, or in combination with skin lesions. The occurrence of squamous cell carcinoma in areas of lichen erosions makes it necessary to follow up patients suffering from chronic lesions. Prevalence in general population varies from 0.9% to 1.2% and varies in different ethnic groups. It is known that cell-mediated immune mechanisms and genetic factors underline OLP pathogenesis. We tested 50 OLP unrelated patients (5 males) for HLA A and compared them to 1089 healthy controls. OLP patients had 3 times less frequently HLA A w19 and 5 times less frequently HLA A28, compared with controls. Erosive OLP type had 4 times less frequently HLA A11 and 2 times less frequently HLA A26 than plaque form. In conclusion, HLA A w19 and A28 appeared associated with OLP in particular, while HLA A11 and A26 with erosive types of OLP.

Oral lichen planus and HLA B.

Oral lichen planus (OLP) is mucocutaneous autoimmune disease of still unknown etiology. Among all etiological factors, OLP can be associated with carbohydrate disorders. As it is known that some HLA B and DR 3/4 antigens are cross-linked, we have determined the frequencies of HLA B antigens in group of 50 Croatian patients (5 males) with OLP and compared them with the 1089 healthy controls. Alterations in the frequencies of several HLA B antigens were noted, in particular, the frequencies of HLA B 15 were 4 times higher, and HLA B18 were 4 times lower compared with controls. The OLP patients with carbohydrate metabolism disorders had more frequently HLA B16, B2 and B40 and the patients with OLP without disturbed carbohydrate metabolism had more frequently HLA B5, B7 and BX. HLA B15 and B18 are closely connected with DR 3/4 antigens in diabetes mellitus, so these particular antigens may predispose a person to a lichen planus.

Oral lichen planus and HLA DR.

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease, predominantly seen in middle-aged female patients. Histopathologically, OLP includes parakeratosis with T-lymphocyte subepithelial infiltration. In etiology of OLP, chronically liver and biliary diseases, stress-induced hypertension, inheritance and most commonly carbohydrate metabolism disorders including diabetes mellitus are mentioned. Considering the autoimmune nature of the illness and the role of the HLA DR 3/4 antigens in development of diabetes mellitus we hypothesized that the same antigens could play role in the development of OLP. We examined 50 unrelated Croatian patients (5 males) from Institute of Oral Pathology, Faculty of Dental Medicine, Zagreb, with clinical and histopathological diagnosis of OLP. They were all tested for HLA DR and compared with 1089 Croatian controls that underwent the tissue standardization in fathership cases. OLP patients had blood sugar level controlled, and those with HLA DR 3/4 and those with blood sugar level higher then 5.6 mmol/l additionally underwent standard oral glucose tolerance test. Carbohydrate metabolism disorder was found in 13 OLP patients (26%) while 10 of them (20%) had diabetes mellitus type I. This finding is 400 times more frequent than is appearance of diabetes in healthy controls (0.05%) in Croatia.

[The breech partogram]. / Partogram zatka.

A partogram was made after analysis 383 spontaneous breech deliveries of primiparas and 343 of multiparas. The height of parturients was 160 cm or more, gestational age between 37 and 42 weeks and the newborn birthweight between 2500 and 3900 g. The newborns did not show any signs of fetal damage from the period of pregnancy or delivery. The duration of delivery was counted from the time of the cervical dilatation of 2 cm or more. A partogram was made after the statistical analysis of particular cervical dilatation phases; the duration of delivery in primiparas was up to 13 hours and 15 minutes and in multiparas up to 10 hours and 40 minutes. The second stage of delivery in primiparas was 1 hour and 20 minutes and in multiparas 40 minutes. The distribution of data concerning the duration of delivery demonstrated by the mean value and SD was symmetrical; the mean value of the duration of delivery with 99% of reliability was from 9 hours up to 10 hours and 54 minutes for primiparas and from 8 hours and 19 minutes up to 9 hours, and 18 minutes for multiparas. Breech delivery was accelerated in the earlier dilatation phase if compared to the later phase which was significantly slowed down.

[Intrauterine growth of live-born twins in the area of Sibenik, Split and Zadar]. / Intrauterini rast zivorodenih blizanaca na podrucju Sibenika, Splita i Zadra.

By a retrospective analysis the authors studied live-born twins by gestation weeks and birth weight and height: there were 1,195 first-born and 1,189 second-born twins, all from three neighbouring Dalmatian towns (Split, Sibenik and Zadar). A common curve was worked out of the intrauterine growth of both the first and the second twins and a separate curve of each of them. The curves have shown that the twins' birth weight was increassing up to the 40th week of pregnancy; in the 41st week the curve already went down. The authors conclude that twin pregnancy should not last more than 40 weeks.