Biomedical subjects

Tomasz Rechberger

Publications and source records attributed to Tomasz Rechberger.

35 records · Page 2Linked to original sources

PubMed2004

Serum resistin levels in women taking combined oral contraceptives containing desogestrel or gestodene.

Resistin is a hormone secreted by adipose tissue that could be involved in the development of insulin resistance. Previous studies confirmed that endogenous sex steroids may influence serum resistin concentration in women. The aim of our study was to investigate the influence of combined oral contraceptives containing desogestrel or gestodene on circulating levels of resistin. Fifty-three women were enrolled in the study. Thirteen patients received 20 microg ethinylestradiol/150 microg desogestrel, 15 women were treated with 20 microg ethinylestradiol/75 microg gestodene, 11 with 30 microg ethinylestradiol/150 microg desogestrel and 14 with 30 microg ethinylestradiol/75 microg gestodene. Blood samples for estimation of serum resistin and insulin levels were drawn before administration of oral contraceptive and after 6 cycles of therapy. We found that serum resistin level remained unchanged in women receiving ethinylestradiol/desogestrel and was reduced in women treated with formulations containing gestodene. We conclude that ethinylestradiol combined with desogestrel or gestodene is unlikely to induce insulin resistance through resistin pathway.

Adolescent↗

PubMed2004

TGF-beta signaling is disrupted in endometrioid-type endometrial carcinomas.

OBJECTIVE: Previous studies have demonstrated deregulation of the expression and changes in the intracellular distribution of TGF-beta pathway components in human endometrial cancer (EC). The aim of this study was to assess the relationship between the expression of TGF-beta cascade components, including TGF-beta receptor type I (TGF beta RI) and type II (TGF beta RII), SMAD2, SMAD3, SMAD4, and clinicopathological features--tumor grade, FIGO classification, and depth of myometrial invasion--of type I (endometrioid-type) ECs to give some insight into the role of TGF-beta cascade components in endometrial tumorigenesis. METHODS: The expression of TGF beta RI, TGF beta RII, SMAD2, SMAD3, and SMAD4 was evaluated both at the mRNA and protein level using reverse transcription polymerase chain reaction (RT-PCR) and ELISA, respectively. RESULTS: Infiltrating endometrial carcinomas (less and more than half of the myometrial wall thickness) express significantly higher TGF beta RII protein level compared with non-infiltrating tumors (P = 0.04 and P = 0.01, respectively). Decreased level of SMAD2 and SMAD4 mRNAs was observed in the uterine tumors infiltrating less and more than half of the myometrial wall (P = 0.03 and P = 0.02, respectively) compared with noninfiltrating ECs. Significantly higher SMAD4 protein level in the cytoplasmic fraction of ECs was found when tumor grade and depth of myometrial invasion were considered (P < 0.05). Generally, tumor progression was associated with a decreased number of cases characterized by the presence of SMADs in the nuclear fraction only. CONCLUSION: Our data suggest that disturbances of the TGF beta RII and SMAD4 expression as well as localization of SMADs may be important to the infiltration of the myometrial wall by the type I endometrial carcinomas.

Activin Receptors, Type I↗

PubMed2003

A randomized comparison between monofilament and multifilament tapes for stress incontinence surgery.

Our objective was to compare monofilament and multifilament tapes positioned without tension at the midurethra for postoperative complications and cure rate. One hundred patients with stress urinary incontinence were randomly allocated into two study groups. Using identical surgical methodology, 50 patients had a monofilament tape inserted at the midurethra using the TVT delivery instrument, and another 50 a multifilament tape using the IVS delivery instrument. The only significant difference between the groups was in the incidence of postoperative urinary retention ( p=0.023). Ten patients from the monofilament group required longer than normal ('normal' means to the morning of the next day) catheterization, in contrast to only two from the multifilament group. The clinical efficacy of both procedures was equally high. Conclusions were that both tapes appear to be equally effective in the surgical treatment of SUI. The higher incidence of postoperative urinary retention in the monofilament group was most likely caused by the elastic feature of this tape.

Adult↗

PubMed2003

Activity of matrix metalloproteinases-2 and -9 in advanced laryngeal cancer.

OBJECTIVES: Matrix metalloproteinases-2 and -9 (MMP-2 and MMP-9) are proteolytic enzymes that digest collagen type IV and other components of the basement membrane. They play a key role in local invasion and the formation of distant metastases by malignant tumors. The aim of this study was to evaluate the activity of MMP-2 and MMP-9 in stage III and IV laryngeal cancers. STUDY DESIGN: In the study we used specimens of laryngeal cancer and surrounding normal mucosa obtained from 23 patients undergoing surgical treatment as a primary therapy. After extraction of MMP-2 and MMP-9 from tissue samples, their activity was assessed with zymography. RESULTS: Greater activity of MMP-2 and MMP-9 and a higher active/latent MMP-2 ratio were found in cancer compared with normal mucosa. Moreover, N2 tumors revealed greater activity of MMP-2 in comparison with N1 and N0 tumors. CONCLUSIONS: Results of the study indicate that both MMP-2 and MMP-9 may be involved in the expansion of laryngeal cancer. MMP-2 may also play an important role in the lymphatic spread of some laryngeal tumors.

Adult↗

PubMed2003

[Immunotherapy as an effective treatment of recurrent spontaneous abortion--own experience].

OBJECTIVES: Recent data emphasize relationship between antiphospholipid antibodies (APA) and increased natural killer cell activity in women with recurrent spontaneous abortion (RSA). Therefore, it has been proposed that final common mechanism involved in the pathogenesis of RSA is associated with auto- and alloimmunity. DESIGN: The aim of this study was to present our data concerning diagnosis and treatment of women with RSA. MATERIALS AND METHODS: Sixty nonpregnant women with the history of RSA were studied, among them 41 were screened at the beginning of their next pregnancy. We investigated the existence of inherited (deficiencies of protein C, protein S, antithrombin III, a resistance to the activated protein C-including Leiden V mutation) or acquired thrombophilia (APA-anticardiolipin antibodies, antiphosphatidylserine antibodies, lupus anticoagulant). Natural killer cell activity was measured using flow cytometry. In addition, the following lymphocytes surface antigens: CD3, CD4, CD8, CD16, CD56 were studied using flow cytometry. We also studied the existence of autoimmunity: antinuclear antibodies (ANA), antithyroid antibodies (ATA). According to presence of auto- or alloimmunity, we introduce immunotherapy: intravenous immunoglobulin, alloimmunization, heparin/aspirin, aspirin alone, steroids or combine therapy. RESULTS: We determined the existence of thrombophilia in 17 women, ANA in 5 women, ATA in 5 women, increased number of NK cells in 16 women and increased NK cell activity in 14 women. Forty-one women were pregnant and followed up during pregnancy, among them 33/41 delivered normal healthy baby, 7/41 experienced the next abortion and 1/41 had ectopic pregnancy. Therefore, overall success of immunotherapy was 80.5%. CONCLUSIONS: Immunotherapy seems to be effective treatment for women with the history of RSA and combined immune abnormalities. Regulation of immune system activity may underlie possible effect of such therapy.

Abortion, Habitual↗

PubMed2003

[Effect of 17 beta-estradiol and phytoestrogen daidzein on the proliferation of pubocervical fascia and skin fibroblasts derived from women suffering from stress urinary incontinence].

OBJECTIVES: The past decade has witnessed many publications indicating that estrogens play an important role in the function of the female lower urinary tract. Sex steroids receptors have been discovered in areas of the brain involved in the initiation and control of micturition, as well as other target tissues: bladder, urethra and pubocervical fascia. Connective tissue metabolism and collagen biosynthesis are modulated by ovarian steroids. Estrogen deficiency has been linked to the reduction of total vaginal and periurethral collagen content. Therefore, menopause and hypoestrogenism have been associated with several urogenital complaints including stress urinary incontinence (SUI), urgency, recurrent infection and genitourinary prolapse. DESIGN: The main purpose was to evaluate the proliferation ability of fibroblasts from pubocervical fascia after exposure to 17 beta-estradiol and phytoestrogen daidzein. MATERIALS AND METHODS: Specimens of human pubocervical fascia were obtained from 8 perimenopausal women during IVS procedure. Fibroblasts were isolated and cultured by outgrowth technique. After reaching confluency fibroblasts were subcultured every four days and cells after passage number 3 to 8 were used for assessment. Next day culture medium was changed and cells were exposed to serial dilutions of 17 beta-estradiol and daidzein in medium supplemented with only Serum Replacement 2. Cell proliferation was assessed after 96 hrs by means of MTT method. A human skin fibroblast culture served as a control. RESULTS: Pubocervical fascia fibroblasts showed increased proliferation capacity after 17 beta-estradiol than daidzein treatment. Proliferative activity of skin fibroblast was lower when compared to genitourinary cells in all groups investigated. CONCLUSIONS: The results indicate that, at least in vitro, fibroblasts from pubocervical fascia taken from women suffering from SUI are more capable to proliferate after estrogen treatment, when compared to skin fibroblasts. This is an indirect rationale for local estrogen treatment in case of female SUI.

Adult↗

PubMed2003

[Serum concentration of leptin and resistin in girls during puberty].

UNLABELLED: The aim of this study was to find the link, if any between leptin, resistin and amount of adipose tissue in girls during puberty. MATERIAL AND METHODS: Forty six healthy girls aged 9, 8-15, 4 took part in this study, from which 12 were after menarche. Height, weight, body mass index, arm circumference and thickness of skin-fold were assessed. Serum concentrations of estradiol, FSH, LH, insulin, leptin and resistin were estimated. RESULTS: As it was expected, girls before menarche were younger, smaller, lighter, had smaller BMI, arm circumference and serum concentration of sex hormones than those after menarche. No significant differences between skinfold thickness on abdomen and at triceps site as well as between serum leptin (4, 88 +/- 4, 16 ng/ml in girls before menarche, 6.56 +/- 5.15 ng/ml), were found. The concentrations of insulin occurred to be similar, too. No correlations between serum resistin and insulin concentration as well as between serum resitin and leptin concentration were noticed, either. The existence of high positive correlations between leptin concentration and skin-fold thickness was confirmed but the correlation between resistin concentration and skinfold thickness was not proved. Interdependences between the serum concentrations of leptin, resistin and sex hormones were not found, either.

Adipose Tissue↗

PubMed2003

[Quality of life after mid-urethra polypropylene tape sling surgery (IVS, TVT) in female stress urinary incontinence].

INTRODUCTION: Urinary incontinence exerts a huge influence on women's quality of life in regard to hygienic problems. The great progress in female stress urinary incontinence (SUI) surgery was introduction of mid-urethra polypropylene sling procedures, which are characterized by very high efficacy, safety and minimal invasiveness. The aim of our study was to assess if functioning of lower urinary tract after minimum 1 year from TVT or IVS procedure has an impact on women's quality of life. MATERIALS AND METHODS: Analysis was done by means of King's quality of life questionnaire in Polish version from 1993. One hundred and sixty patients operated because of SUI in II-nd Department of Gynecology in Lublin in years: 1999-2001 were assessed. The mean time relapsed from surgery was 19 +/- 6 months. Eighty women were operated by TVT method (monofilament tape) and eighty by IVS method (multifilament tape. Statistical analysis was done by means of STATISTICA program, version 6. To estimate patient's quality of life according to King's questionnaire the mode value (Mo) and the frequency of mode value (fr Mo) were used in respective questions. The results in both groups were compared by Mann-Whitney test. RESULTS: Most of patients assessed the general health condition as good (fr Mo = 25; 36.9%). In TVT group Mo value indicated good health condition (fr Mo = 30; 37.5%), whereas in IVS group general health condition was estimated most commonly as satisfactory (fr Mo = 33; 41.25%). In respect to incontinence impact on life in TVT group 37.5% of patients (fr Mo = 30) reported some influence, while in IVS group 50% of women (fr Mo = 40) reported no influence (p = 0.16). Moreover, analysis revealed that in both groups the functioning of lower urinary tract does not influence their normal functioning, social contacts, physical activity, personal life, emotions or sleep. CONCLUSION: After modern incontinence surgery (TVT, IVS methods) the majority of patients reported that current bladder symptoms have no negative impact on their quality of life.

Adult↗

PubMed2003

[Tissue reaction to polypropylene mono-or multi-filament tapes used in surgical techniques of stress urinary incontinence treatment].

OBJECTIVES: The "gold standard" in surgical treatment of stress urinary incontinence (SUI) is sling operation with polypropylene tape appliance under the mid urethra. There are two types of polypropylene tape which are the most popular nowadays. These two tapes are differently knitted so they have different biomechanical features. The TVT tape is monofilament, rarely knitted and highly elastic but the IVS mesh is multifilament, densly knitted and has only little possibility to stretch. The aim of our study was to assess the tissue reaction to the mono-(TVT) and multifilament (IVS) tapes. MATERIAL AND METHODS: The 10 mm x 10 mm pieces of TVT and IVS tapes were implanted inlay the fascia of musculus abdominis rectus of 14 rat females (2 groups of 7 animals). The tapes with the margin of surrounding fascia were taken off after 6 weeks of healing. All samples were fixed in 10% Formaldehyde in phosphate buffered saline and embedded in paraffin. Four micron tissue sections were stained with hematoxylin and eosin, the reticulin silver impregnation stain according to Gomori (for collagen type III) and periodic acid Schiff and alcian blue (for proteoglycan). RESULTS: In all sections filaments visible as elipsoids were surrounded by resorptive granulation with large multinucleated giant cells like around "foreign body". The diameter of monofilaments was about 150 microns. The connective tissue in the vicinity of mesh was rich of inflammatory cells like histiocytes, lymphocytes, a few polymorphonuclear leucocytes as well as adipocytes and fibroblasts. The large multinucleated giant cells adjacent to monofilaments were relatively bigger than these cells around multifilaments. Moreover, this granulation tissue has a lot of new blood vessels and collagenous fibrous tissue. The multifilaments were about 40 microns in diameter. The inflammatory granulation infiltrated aggregates of multifilaments. This tissue had only few inflammatory cells in comparison to tissue around monofilaments. The large multinucleated giant cells apposed to the mesh were small and collagen created thicker, more compacted bundles. CONCLUSION: The multifilament polypropylene tape induces weaker inflammatory tissue reaction than monofilament mesh. The thicker and more compacted collagen bundles are created around multifilaments so the natural tensile strength of the surrounding tissue is probably higher.

Animals↗

PubMed2003

[Diagnosis of overactive bladder influenced by methods of clinical assessment--micturition diary vs. urodynamics].

INTRODUCTION: Most characteristic symptom of overactive bladder is urgent, possibly painful, desire to void. This complaint is caused by autonomous bladder contractions. The increased activity of detrusor muscle is not only responsible for the urgency but also is the direct reason for the development of urge urinary incontinence. THE AIM OF THE STUDY: The comparison of the subjective (micturition diary) and objective (urodynamic investigation) mode of diagnosis of overactive bladder. MATERIAL AND METHOD: Twenty one women complaining of symptoms of the overactive bladder were included into the study. The infection of lower urinary tract was ruled out based on the results of urinalysis. Each patient reported urinary symptoms (number of urgency episodes and urge urinary leakages) in micturition diary for seven days. Thereafter, all participants underwent the urodynamic investigation that included uroflowmetry and cystometry. RESULTS: Data obtained from micturition diaries proved that all patients had subjective symptoms of overactive bladder (n = 21). However, only 8 subjects met overactive bladder diagnostic criteria on urodynamic investigation. The data obtained from micturition diaries and urodynamics were compared between group with objectively (urodynamic investigation) and subjectively (micturition diary) diagnosed overactive bladder. CONCLUSIONS: 1. There is marked discrepancy between data obtained from micturition diary and the results of urodynamic investigation. 2. It was shown that the diagnosis of overactive bladder cannot be made solely on the basis of maturation diary. 3. Volume of voided urine measured at uroflowmetry and volume of infused fluid causing strong desire to void are best markers of urodynamically proven diagnosis of overactive bladder.

Diagnosis, Differential↗

PubMed2002

Is diminished pubocervical fascia collagen content a risk factor for failure of surgical management of genuine stress urinary incontinence in women?

OBJECTIVE: The assessment of relationship between pubocervical collagen content and clinical results of surgical treatment of genuine stress urinary incontinence (GSUI) in women. METHODS: Twenty-four women treated for genuine stress urinary incontinence were included into the study. All women underwent the same surgical procedure. The samples of pubocervical fascia were taken at the time of surgery. The contents of acid soluble, pepsin soluble, insoluble fraction of collagen, total collagen and collagen crosslinks were measured. The study of pubocervical fascia collagen metabolism included also estimation of collagenase activity. At follow-up done 5 years following surgery, 20 patients reported symptoms of GSUI (study group). Four women were still without symptoms of urine leakage (control group). RESULTS: The biochemical parameters of pubocervical fascia did not show, statistically significant differences between compared groups. CONCLUSION: The pubocervical fascia collagen metabolism does not have impact on the results of anti-incontinence surgery.

Cervix Uteri↗

PubMed2002

Enhanced T cells interactions with extracellular matrix proteins in infertile women with endometriosis.

Essential features of endometriosis involve interactions with extracellular matrix (ECM). Recent data emphasize the important role of ECM proteins in the regulation of T cell function. The aim of this study was to determine activated T cell adhesion to ECM proteins in infertile women with endometriosis. Nine women with endometriosis diagnosed by laparoscopy according to the Revised American Fertility Society classification and ten normal healthy women with a previous successful pregnancy outcome were studied. We investigated phorbol acetate myristate (PMA) or phytohemaglutinin (PHA) activated peripheral blood T cell adhesion to the following proteins of ECM: collagen IV (C-IV), elastin (E) and fibronectin (Fn). In addition, CD4, CD8, CD29, CD45RO expression on peripheral CD3(+) T cells were studied using flow cytometry. We determine that PHA-activated T cell adhesion to C-IV and Fn are significantly higher in infertile women with endometriosis when compared to normal healthy women (P<0.05). No significant differences were noted in T cell's surface antigens expression between study groups. Our data suggest the existence of disturbed T cell-ECM interactions in infertile women with endometriosis. Further studies are needed to determine the role of these abnormalities in the pathogenesis of endometriosis.

Adult↗

PubMed2002

The efficacy and safety of the tension-free vaginal tape procedure do not depend on the method of analgesia.

OBJECTIVE: The original tension-free vaginal tape (TVT) method, described by Ulmsten et al., routinely uses local anaesthesia during the procedure. Since the anaesthetic effect after local application of lidocaine hydrochloride was not always satisfactory we decided to introduce the spinal anaesthesia during this operation. The aim of the present study was to compare local and spinal anaesthesia with respect to their efficacy and safety in the TVT procedure. METHODS: 103 women, with objectively confirmed stress urinary incontinence, were randomised into the study. Sixty-seven women were anaesthetised locally and 36 patients spinally. All TVT procedures were performed as originally described. Objective assessment of the influence of anaesthesia on intra-abdominal pressure at rest and during the cough test was done using a rectal catheter and a central venous pressure manometer. The efficacy of the TVT procedure was based on a gynaecological examination with a cough test and a three-degree subjective scale: complete cure, improvement or failure. RESULTS: The success of the TVT procedure performed under local anaesthesia is comparable with that achieved under spinal analgesia (p=0.42). The number of complications that occurred in the two groups does not differ significantly (p=0.57). CONCLUSIONS: Spinal anaesthesia impairs the ability to cough effectively during the TVT procedure. However, the efficacy and safety of the operations performed under this type of anaesthesia are comparable with the efficacy and safety of operations done under local anaesthesia.

Adult↗

PubMed2002

Serum concentrations of markers of type I collagen metabolism in women taking monophasic oral contraceptives.

OBJECTIVES: To investigate serum concentrations of the carboxy-terminal propeptide of type I procollagen (PICP) and cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), reflecting the rate of synthesis and degradation of the parent collagen respectively, in women using monophasic oral contraceptives. STUDY DESIGN: PICP and ICTP were estimated in 60 women taking 20 micrograms of ethinyl estradiol (EE) + 150 micrograms of desogestrel (DSG) or 30 micrograms of EE + 150 micrograms DSG over six months. RESULTS: Mean PICP concentration decreased in women receiving 20 micrograms of EE + 150 infinity g of DSG after three cycles of administration. However, after six months this value returned to a level comparable to the initial one. In women taking 30 micrograms of EE + 150 micrograms of DSG the mean concentrations of PICP did not change significantly throughout the period studied. None of the oral contraceptives noticeably influenced the concentrations of ICTP. CONCLUSION: Investigated oral contraceptives do not significantly affect the metabolism of type I collagen, however a transient decrease in its biosynthesis may be expected during the use of formulations containing 20 micrograms of EE.

Adult↗

PubMed2002

[TVT procedure--the critical analysis of clinical effectiveness and complications among first 100 cases].

RATIONALE: Since its clinical debut in 1996 TVT procedure has been offering an excellent clinical tool both for patients and surgeons to treat SUI suffering women. Since the learning curve is an important factor influencing the rate of surgical complications as well as the clinical outcome of any new surgical technique we decided to analyse the first 100 cases of SUI women treated with TVT technique. AIM OF THE STUDY: To analyse clinical effectiveness and complications among first 100 consecutive cases of TVT procedures. MATERIAL AND METHODS: One hundred women aged from 30 to 89 years (old mean 55.6) were hospitalised in our Department from September 1999 to November 2000 because of SUI as confirmed by the complete urogynecologic assessment including history and physical examinations, catheterised residual volume determination, and multichannel urodynamic testing. TVT procedure was performed as originally described by Ulmsten et al. except the fact that 43 operations were performed not under local but epidural anesthesia. For 80 patients TVT was offered as the primary surgery for SUI treatment whereas for 14 it was the second and for 6 the third or more attempt. RESULTS: Operation was performed without any technical difficulties in all cases (mean time 25 min). Bladder injury (treated by 1 or 2 days catheterization) occurred in 9 cases, urinary retention in 13 (in 6 cases after 10-14 days tape was cut). Urinary tract infections occurred in 4 women despite intraoperative 2.0 g i.v. piperacillin prophylactics and fosfomycin trometamol 3.0 g p.o. in first postoperative day. Subsequent urge incontinence developed in 4 patients. Clinical efficacy based on medical history, cough test and Gaudenz questionnaire was 95% (observation period 3 to 16 months, mean 8 months). CONCLUSIONS: In our opinion TVT procedure is an operation of choice to treat SUI in women regardless of their age because of its excellent clinical effectiveness accompanied by its technical simplicity, reproducibility and low percentage of serious complications. Previous urogenital surgery is a risk factor for bladder perforation during TVT procedure.

Adult↗

PubMedDate not supplied

Endometrial carcinoma with pleural metastasis: A case report.

BACKGROUND: There have been a limited number of studies giving the incidence of pleural metastasis from female genital tract tumors. CASE: An unusual case occurred of recurrent pleural malignant effusion associated with disseminated serous papillary endometrial adenocarcinoma (EC). A total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, appendectomy and omentectomy was performed. Treatment of the pleural malignant effusion consisted of thoracotomy with partial decortication, systemic chemotherapy and radiotherapy. The patient died of circulatory failure 8 months after the primary diagnosis. CONCLUSION: Although the pleura is a rare site of widespread EC, one should recognize the possibility of pleural spread from female genital tract neoplasms presenting with associated symptoms. Cytopathologic examination of the pleural effusion and the finding ofcarcinoma cells mandate an investigation for the primary site of the neoplasm by a multidisciplinary group.

Adenocarcinoma↗

PubMedDate not supplied

[Potential application of stem cells in urogynecology].

Recent advances in stem cells therapy and tissue engineering techniques hold great promise for recovery of external urethral sphincter proper functioning and urinary incontinent patients treatment. Adult stem cells (ASCs) may be derived from striated muscles, fat tissue or as mesenchymal cells from bone marrow. These cells can differentiate in functionally normal smooth or striated muscle cells. ASCs injected to external urethral sphincter or bladder neck cause the increase in urethral closure pressure. Favourable findings of trials in animal models and in vitro encouraged to first trials in humans and hold a promising future for the treatment of urinary incontinence.

Animals↗