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Z Rokyta

Publications and source records attributed to Z Rokyta.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Sperm antibodies and immunologic intolerance to metals in infertile couples].

OBJECTIVE: Verification of the hypothesis of a relationship between the presence of antibodies against sperm cells and immunological reactivity to some metals in infertile couples by the MELISA test. SETTING: Department of Obstetrics and Gynecology, Medical Faculty, Charles University and Faculty Hospital, Plzen. METHOD: From 23 female patients and 21 men (a total of 44 subjects treated for infertility) with confirmed serum antibodies against sperm cells the authors isolated lymphocytyes from the peripheral blood stream, divided them into individual cultures and investigated them by the MELISA test using different metal compounds. RESULTS: The outcome of the MELISA test are values of the stimulation index (SI) by means of which the authors investigated the reactivity of the organism to the given metal. Special attention was devoted to compounds of organic and inorganic mercury. The SI values were subsequently compared with different data obtained from a detailed anamnestic questionnaire which was focused specially on contact with metals and on allergic reactions. In the investigated group of patients the authors detected a positive immune reactivity to inorganic mercury, Ag, Al, Fe. In some subjects they found a very high positive immune reactivity to inorganic mercury, Ni, Al, Cd and Ti. The control groups were formed by healthy fertile subjects without antibodies against sperm cells and with physiological SI values. CONCLUSION: The authors did not prove a direct relationship between the intensity of the laboratory reactivity to metals and the presence of antibodies against sperm cells which cause deterioration of fertility. An exogenous load of metals could in case of genetic predisposition be only one of the factors which participate in the formation of antibodies against sperm cells. The investigation proved that its is not essential, contrary to the view of many stomatologists, to eliminate metal compounds completely from dental practice.

Adult↗
PubMed2003

[Delivery and anal incontinence: definition, classification, prevalence and pathophysiology].

OBJECTIVE: Summary of the mutual relationship between vaginal delivery and anal incontinence. DESIGN: Review. SETTING: Department of Gynecology and Obstetric, Charles University and Faculty Hospital Pilsen. SUMMARY: Review of the current international literature covering the given problem. Anal incontinence is defined as an unvoluntary leakage of flatus, liquid or solid stool. Fecal incontinence means the leakage of liquid and solid stool only. Women are at eighttimes higher risk of developing anal incontinence (the leakage of flatus, fluid or hard stool). The main reason considered to be the cause of this difference is a birth. Postnatal anal incontinence is a disabling problem for as much as 13-20% of women. Review describes classification, prevalence, incidence and cause of AI in women considering maternal position at birth, second stage of labor, breastfeeding, anal sexual intercourse and multiple births. Two main pathogenetic mechanisms are presented. 1) Perineal neurological injury is described in earlier studies. This looks to be the major reason for 3rd and following vaginal births. 2) An apparent or occult anal sphincter tear seems to be the main factor particularly for the 1st vaginal birth. 2.3% of primigravidae have an apparent tear and 35% sonographically detected occult anal sphincter tear. Anal incontinence develops nearly exclusively in these groups. 42% of afflicted women complain of impaired quality of life. Anal incontinence appears to be improved within the time (in 36-76%). Longterm outcome is not known yet. The postnatal check-up should also include the question of de novo developed anal and urine incontinence or impaired sexual health.

Delivery, Obstetric↗
PubMed2003

[Vaginal delivery in primiparas and anal incontinence].

OBJECTIVE: An investigation of incidence and degree of anal incontinence after vaginal delivery among primiparas and characterizing of the risk factors. DESIGN: Prospective observational study. SETTING: Department of Gynecology and Obstetrics, Charles University and Faculty Hospital Pilsen. METHODS: 346 primiparas after consecutive vaginal delivery between May 2000 and February 2001 were included. All delivered in lithotomy position. Questionnaires were sent few days after delivery and then two and 6-9 months later. Analysis of the returned questionnaires. 28 obstetric parameters assessed. RESULTS: 46.5% women responded. 23 women registered leakage of flatus before delivery. Two months postpartum one (0.6%) patient reported fecal incontinence and 22 (14.3%) flatus incontinence de novo or impaired already present incontinence. 6-9 months after delivery the same patient (0.6%) reported fecal incontinence and 16 women (10.4%) incontinence of flatus. Ten of them felt impaired quality of life. Anal incontinence gradually improved during the time (in 76%). Risk factors of developing (worsening) of anal incontinence were antenatal anal incontinence (in two months period) and women weight (or BMI) measured at 6-9 months after birth. None of nine patients after forceps delivery (Breus traction forceps) which responded reported signs of anal incontinence. Neither the range of episiotomy nor the length of perineum had any relation to the development of anal incontinence. However episiotomy has been shown to be a protective factor of 3rd degree tear in primiparas (RR 0.24). Third degree tear was diagnosed in seven cases (2%), three out of 6 women reported anal incontinence postpartum. CONCLUSION: This study shows relatively frequent development of flatus incontinence after vaginal delivery in primiparas. These symptoms usually improve within the time. Only minimum of women after vaginal delivery suffers of fecal incontinence. 42% of women with anal incontinence feel impaired quality of life. At the first postpartum check every woman should be asked, whether she has any symptoms of anal or urine incontinence or impaired sexual health. If positive the answer, the woman should get information where to find a help.

Adult↗
PubMed2002

[Penetration of cervical mucus by native and cryopreserved sperm--the Kremer test].

OBJECTIVE: The penetration of native and cryopreserved human spermatozoa into cervical mucus--the Kremer's test. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty, Charles University and Faculty Hospital, Plzen. METHODS: Human cervical mucus was collected from 73 women visiting the Division of immunology of reproduction, Department of Obstetrics and Gynaecology in Plzen. Native spermatozoa was obtained from the patients of the Division of Immunology of Reproduction as well. Cryopreserved only in its seminal plasma was obtained from the spermabank of our department. The distance of penetration in centimetres from the start was examined in inverse microscopy after 30, 60, 90 and 90 minutes. Also the character and duration of the sperm motility was analyzed. RESULTS: The penetration of native spermatozoa was higher than the penetration of cryopreserved spermatozoa in each case. The native spermatozoa had a higher penetrability, motility and life-ability. Spermatozoa preserved only in its seminal plasma had the parameters demonstrably lower. Nevertheless these spermatozoa can be successfully used for homologue or heterologue insemination or for IVF because these spermatozoa do not loose its enzymatic and remaining energetic equipment by penetration the cervical canal. CONCLUSION: The Kremer's test belongs to the reliable methods of penetration ability of native and cryopreserved sperms.

Adult↗
PubMed2002

[Fructose and glucose in follicular fluid and serum of women undergoing stimulation in an in vitro fertilization program].

OBJECTIVE: To find out if there is some amount of fructose in the follicular fluid of IVF stimulated patients. If so then to compare fructose and glucose levels with IVF outcome, type of stimulation and infertility factors. DESIGN: Retrospective study. SETTING: Department of Gynaecology and Obstetrics, Charles University, the Czech Republic. METHODS: 202 women undergoing IVF treatment since 11/1999 till 02/2001 were evaluated. We measured a level of fructose and glucose in a sample of serum and follicular fluid (FF) obtained at ovum pick-up. Then the results were compared with the IVF outcome, the length of stimulation and infertility factors. The control group consists of 23 women with a pure andrologic factor of infertility. RESULTS: At the day of pick-up the serum concentration of glucose and fructose taken on an empty stomach is on average 5.43 +/- 1.35 mmol/l and 25.05 +/- 9.26 micrograms/ml compared to 5.26 +/- 1.00 mmol/l and 23.69 +/- micrograms/ml in control group. The concentration of both glucose and fructose in FF correlates with their serum level. The FF concentration of glucose is on average 3.75 +/- 1.32 mmol/l (70% of serum concentration) and fructose 11.34 +/- 5.29 micrograms/ml (48% of serum concentration) by comparison with 3.78 +/- 0.91 mmol/l (73%) and 12.37 +/- 7.06 micrograms/ml (53%) in control group. CONCLUSION: There is a possible influence of follicular fluid saccharides like glucose and fructose in process of fertilization. We derived this hypothesis from studies evaluating the role of saccharides in endometrial secretion, cervical mucous and seminal plasma. We assumed that patients with a successful IVF cycle have a lower fructose concentration in FF. The clinical pregnancy is really mildly lower but this difference is not statistically significant. We confirmed FF fructose is in close correlation with its serum concentration. But we did not confirm the FF glucose and FF fructose concentration is related to the IVF outcome.

Adult↗
PubMed2002

[Analysis of the zona pellucida in human oocytes and embryos in an assisted reproduction program].

OBJECTIVE: Our aim was to design simple method for quantitative evaluation of oocyte and embryo morphology in in vitro fertilization (IVF) programme efforting of embryo implantation prediction to be able to set the optimal number of embryos for transfer for given specific case. This study deals with zona pellucida (ZP)--the one interesting and for oocyte unique structure. The work is the part of comprehensive research of oocyte, zygote and embryo morphology. DESIGN: Prospective study. SETTING: Center of Assisted Reproduction, Department of Gynaecology and Obstetrics, Medical Faculty of Charles University, Pilsen. METHODS: The study includes analysis of 66 microphotography pictures of oocytes, zygotes and embryos of patients who were treated by IVF on our department between September and December 2000. The microphotographs were taken by digital microphotographic system. Analysis of zona pellucida parameters was conducted by image analysis software called AnalySIS, Soft Imaging System GmbH. RESULTS: It was found out the average width of the zona pellucida 18.4 microns +/- 2.1 microns, the minimum width was 12.3 microns a maximum 23.1 microns. CONCLUSION: There was found significant narrower zona pellucida in women who conceived in this IVF cycle then in the women who did not.

Adult↗
PubMed2002

[Obesity and reproductive disorders].

INTRODUCTION: Obesity and overweight correlate with endocrine disorders in women, polycystic ovary syndrome, there are more atretic follicles in the ovary of obese women, overweight affects ovulation, pregnancy rates and outcomes in natural as well as in treated cycles. Similarly starvation correlates with menstrual cycle disturbances with anovulation. MATERIAL AND METHODS: The study includes 309 IVF treatment cycles performed in our IVF centre between 1/1/97 and 30/6/99. The patients were divided into five groups according to nutrition evaluated by body mass index (BMI). The parameters of IVF treatment includes the number of follicles, the number of collected oocytes, the recovery rate, the number of fertilized oocytes, the fertilization rate, the number of cleaved embryos, the cleavage rate, the clinical pregnancy rate, the take home baby rate, the miscarriage rate. The unpaired t-test was used in statistical analysis. RESULTS: There were found statistically significant less number of cycles with more than 10% fertilized oocytes and lower recovery rate in the obese and overweight women. CONCLUSIONS: Overweight and obesity significantly affect the parameters and outcomes of IVF treatment. The fertilization of the oocytes failed more often in the obese and overweight women. The lower pregnancy rates were achieved although the high oocytes recovery and high normal cleaved embryos were found in the obese women. The cause of the bad IVF treatment outcomes in the obese women seems to be probably the affected quality of the oocytes with lower fertilization and implantation potential eventually affected endometrium quality. The overweight reduction is the important part of infertility treatment in obese women.

Body Mass Index↗
PubMed2001

[Endometrial ablation and resection techniques].

OBJECTIVE: To summarize all currently used and experimental, hysteroscopic and non-hysteroscopic methods of endometrial ablation and resection, their indications, operation techniques, and treatment results. DESIGN: Literary review. SETTING: Department of Obstetrics and Gynecology, Medical Faculty and Faculty Hospital, Charles university, Capkovo námĕstí 1, Plzen, Czech Republic. METHODS: Analysis of the literature (textbooks, medical journals, database Medline, Current Contents, Embase, PubMed). RESULTS AND CONCLUSION: Endometrial ablation and resection play an important role in the treatment of dysfunctional uterine bleeding. Hysteroscopic methods visualize the uterine cavity and enable to treat lesions in it at the same time. Non-hysteroscopic methods are less invasive for the patient and comfortable for the surgeon. Both groups of methods have similar treatment results.

Electrocoagulation↗
PubMed2001

[Meconium and postnatal neurologic handicaps].

OBJECTIVE: A review of meconium pathophysiology and its contribution to the incidence of postnatal neurological handicap. DESIGN: Reviewed article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. SUBJECT AND METHOD: Meconium can be a cause of infant neurological handicap. Two main pathogenetic pathways are mentioned. 1. Meconium (and its components: bile acids) may have a direct vasoconstrictive effect on umbilical and placental vessels. This way still remains controversial. 2. Meconium as a possible cause of intraamniotic infection results in a release of fetal cytokines (TNF alpha, IL-1 beta, IL-6), which can damage myelinogenesis in periventricular white matter. RESULTS: Meconium in premature labour is a higher risk factor compared to term delivery. 41% of premature infants were diagnosed as having CP when meconium was present compared to 10% in the same group with clear amniotic fluid. The incidence in term pregnancy with meconium present is 0.4% compared to 0.3% in a population without any obstetrical risk. CONCLUSION: Ultrasonographically found periventricular leukomalacia is the most reliable sign of subsequent cerebral palsy or other neurological sequelae.

Amniotic Fluid↗
PubMed2000

Prolapse of the fallopian tube after hysterectomy associated with exuberant angiomyofibroblastic stroma response: a diagnostic pitfall.

We report two cases of prolapse of the fallopian tube associated with an exuberant angiomyofibroblastic stroma response, which occurred after hysterectomy and which is a hitherto unreported feature of this lesion. The tumors were composed of richly vascularized stroma arranged in a retiform pattern and mildly atypical glandular inclusions, which had the morphology of tubal epithelium. The stroma of the lesion was composed of either thin bipolar cells with tapered nuclei and stellate-shaped cells with minimal amount of cytoplasm or small epithelioid-looking cells with eosinophilic cytoplasm. The tubal glandular inclusions displayed mildly atypical nuclear features. If the tubal glandular component was overlooked, these tumors might be erroneously diagnosed as mesenchymal lesions of the vagina, such as vaginal fibroepithelial polyp, angiomyofibroblastoma, aggressive angiomyxoma, or superficial myofibroblastoma.

Adult↗
PubMed2000

Effect of corticosteroids on sperm antibody concentration in different biological fluids and on pregnancy outcome in immunologic infertility.

OBJECTIVE: In the last fourteen years, detection of free spermagglutinating antibodies has been performed by tray agglutination test (TAT) and by direct/indirect mixed antiglobulin reaction test (MAR) in 696 infertile couples aged 23-42 years (female) and 26-52 years (male) with previously undiagnosed infertility. MATERIAL AND METHODS: Oral decreasing doses of prednisone or dexamethasone for three months in the case of serum or seminal plasma spermantibodies, plasmapheresis in one patient with serum spermantibodies were used. Hydrocortisone to the ectocervix was applicated in patients with spermagglutinating antibodies in cervical ovulatory mucus. RESULTS: Serum IgG spermagglutinating antibodies totally disappeared in 3 out of 11 men, and four out of 15 women. But serum IgM sperm antibodies persisted. One female patient was treated with corticosteroids and also with plasmapheresis. Seminal plasma IgG spermagglutinating antibodies were greatly influenced in 57.8% of the patients, IgA in 38.9% and each case by oral corticosteroids. A decrease of IgG and IgA spermagglutinating antibodies in ovulatory cervical mucus during hydrocortisone local application was registered in 61.3%, IgG in 50.7% and IgA in 65.9%. Levels of IgM spermagglutinating antibodies in cervical ovulatory mucus were not influenced, spermantibodies in IgA and IgE were affected very little. CONCLUSION: The corticosteroid influence of immunocompetent cells in each case must be chosen individually with regard to the localisation of spermantibodies. We often combine the long lasting corticosteroids treatment with in vitro fertilization. The therapy seems to be very promising for the improvement of immunological causes of infertility.

Administration, Oral↗
PubMed2000

[The effect of follicular fluid pH on the quality and number of oocytes produced in the in vitro fertilization program].

OBJECTIVE: The aim of our study was to evaluate the role of follicular fluid pH as the marker of quality of the human oocyte in the IVF treatment efforting to predict and to enhance the effect of IVF treatment: oocyte quality, fertilization rate, cleavage rate, implantation rate. DESIGN: Prospective study. SETTING: Center of assisted reproduction, Department of Gynaecology and Obstetrics, Medical Faculty of Charles University, Pilsen. METHODS: The pH of the follicular fluid was measured in 147 IVF cycles. The oocyte quality was evaluated according to the oocyte-cumulus-cells complex morphology during the ovum pick up, according to fertilization rate, number of recovered oocytes and recovery rate. RESULTS: The lower pH of the follicular fluid correlated with significant higher occurrence of the cycles with more then half of oocyte-cumulus complexes with normal mature morphology (P = 0.026) and correlated with significant higher occurrence of cycles with fertilization rate more then 10% (P = 0.033). CONCLUSION: There was found a lower pH of the follicular fluid in the IVF cycles where the quality of oocytes was higher.

Adult↗
PubMed2000

[Use of cryopreserved sperm in the microagglutination test].

OBJECTIVE: The aim of this study was to find out the behavior of sperm cryopreserved in microagglutination test (TAT). METHODS: TAT using native sperm pertains to the screening methods in spermagglutinating antibodies. Spermatozoa cryopreserved in egg-yolk medium, just in seminal plasma or in the commercial made medium--Medi-Cult (Denmark) were used in this study. SETTING: Department of Gynaecology and Obstetrics, Institute of Clinical Immunology and Allergology Medical Faculty of Charles University, Pilsen. RESULTS: 367 tests were performed together. It includes 108 examinations with native spermatozoa, 59 with spermcryopreserved in egg-yolk medium, 109 with spermcryopreserved just in seminal plasma and 91 in Medi-Cult medium. The correspondance of results with native and cryopreserved sperm was found in 24% for egg-yolk medium, in 69% for seminal plasma and in 77% for commercial medium Medi-Cult. CONCLUSION: The results show that spermcryopreservation in Medi-Cult medium or just in the seminal plasma are able to be used in TAT for detection of spermagglutinating antibodies.

Antibodies↗
PubMed2000

[Hysteroscopic polypectomy versus fractionated curettage in the treatment of corporal polyps--recurrence of corporal polyps].

OBJECTIVE: The evaluation of hysteroscopy contribution in the treatment of endometrial polyp. The evaluation of the risk of endometrial polyp recurrence. DESIGN: Prospective clinical study. SETTING: Department of Obstetrics and Gynecology of Medical faculty and Faculty Hospital, Pilsen. METHODS: Two groups of patients were followed. Group I had 81 patients (30 premenopausal and 51 postmenopausal) that underwent hysteroscopical polypectomy followed by diagnostic hysteroscopy in 6-12 months. Group II consisted of 100 patients (36 premenopausal and 64 postmenopausal) that underwent fractional curretage with histological diagnosis of endometrial polyp. These patients were checked by diagnostic hysteroscopy in up to 12 months. Presence of endometrial polyp during diagnostic hysteroscopy and a relation of its recurrence or persistence to a type of preceding procedure, risk factors and histological findings during the first procedure were evaluated. RESULTS: 11 (13.5%) cases of an endometrial polyp were recorded in hysteroscopical controls in group I. 46 (46%) cases of an endometrial polyp were recorded in group II. Recurrence of the endometrial polyp was revealed only in one case of atrophic endometrium and in no case of atrophic endometrial polyp. CONCLUSION: Hysteroscopical polypectomy showed considerably better results in the treatment of endometrial polyp comparing to fractional curretage. The recurrence risk of endometrial polyp is expected in a case of presence of an abnormal proliferative activity or hyperplasia both in the endometrial polyp and the surrounding endometrium.

Aged↗