Maciej Wilczak

Impact of heavy metals on the female reproductive system.

INTRODUCTION It has been recognized that environmental pollution can affect the quality of health of the human population. Heavy metals are among the group of highly emitted contaminants and their adverse effect of living organisms has been widely studied in recent decades. Lifestyle and quality of the ambient environment are among these factors which can mainly contribute to the heavy metals exposure in humans. OBJECTIVE A review of literature linking heavy metals and the female reproductive system and description of the possible associations with emission and exposure of heavy metals and impairments of female reproductive system according to current knowledge. RESULTS The potential health disorders caused by chronic or acute heavy metals toxicity include immunodeficiency, osteoporosis, neurodegeneration and organ failures. Potential linkages of heavy metals concentration found in different human organs and blood with oestrogen-dependent diseases such as breast cancer, endometrial cancer, endometriosis and spontaneous abortions, as well as pre-term deliveries, stillbirths and hypotrophy, have also been reported. CONCLUSIONS Environmental deterioration can lead to the elevated risk of human exposure to heavy metals, and consequently, health implications including disturbances in reproduction. It is therefore important to continue the investigations on metal-induced mechanisms of fertility impairment on the genetic, epigenetic and biochemical level.

Anaphylactic reaction to methylene blue dye after laparoscopic chromopertubation.

A 25-year-old infertile woman was admitted to our department with occluded right Fallopian tube and left sactosalpinx. Diagnostic hysteroscopy (Wolf, Knittlingen, Germany) showed a normal, follicular-phase endometrium with a small endometrial polyp in the uterine fundus. Electroresection of the polyp was performed with no complication or excessive bleeding. After hysteroscopy, a laparoscopic examination was performed (Aesculap, Tuttlingen, Germany). It revealed adenomyosis of the uterus, small patches of pelvic endometriosis, and endometriosis of the right ovary. Electrocoagulation of the right ovarian endometriosis was performed. Chromopertubation with methylene blue (Patenblau V; Guerbet, Roissy, France) showed bilateral tubal dilatation and occlusion. Bilateral salpingoneostomy was performed successfully, with no complication or bleeding. Tubal patency was checked with repeated chromopertubation. The total amount of methylene blue used was 20 mg of dye diluted in 100 ml of

Serum tumor necrosis factor alpha receptors p55/p75 ratio and ovarian cancer detection

Early ovarian cancer detection is still very difficult and patients are mostly in advanced stages, with obvious influence on poor prognosis.

Vaginal hysterectomy with bipolar coagulation forceps (BiClamp) as an alternative to the conventional technique

PurposeThe aim was to identify the advantages and disadvantages of using bipolar coagulation forceps in vaginal hysterectomy and to compare the effects of this method with those of the conventional technique.MethodsA group of 30 patients was operated on with bipolar coagulation forceps and the next 30 were operated on using the traditional method. The following parameters were observed: duration of procedure, blood loss, complications, postoperative pain, hospitalization time and cost of treatment.ResultsThe duration of the surgical procedure and hospitalization time were similar in both groups. Blood loss was lower in the BiClamp group. There were no serious complications in either group. In one case with BiClamp, laparotomy was performed to stop persistent bleeding; the after-effects of the laparotomy were not statistically significant. The patients in the BiClamp group reported less pain, experienced shorter recuperation times and incurred lower treatment costs.ConclusionsThe BiClamp technique is a good alternative to traditional hysterectomy methods as it causes lower blood loss during surgery, causes less post-operative pain and is economically more favorable for the patient and hospital.

Association between single nucleotide polymorphisms (SNPs) of XRCC2 and XRCC3 homologous recombination repair genes and triple-negative breast cancer in Polish women

XRCC2 and XRCC3 genes involved in homologous recombination repair (HRR) of DNA and in the maintenance of the genome integrity play a crucial role in protecting against mutations that lead to cancer. The aim of the present work was to evaluate associations between the risk of triple-negative breast cancer (TNBC) and polymorphisms in the genes, encoding for two key proteins of HRR: XRCC2 Arg188His (c. 563 G>A; rs3218536, Genbank Accession Number NT 007914) and XRCC3 Thr241Met (c. 722 C>T; rs861539, Genbank Accession Number NT 026437). The polymorphisms of the XRCC2 and XRCC3 were investigated by PCR–RFLP in 70 patients with TNBC and 70 age- and sex-matched non-cancer controls. In the present work, a relationship was identified between XRCC2 Arg188His polymorphism and the incidence of triple-negative breast cancer. The 188His allele and 188His/His homozygous variant increased cancer risk. An association was confirmed between XRCC2 Arg188His and XRCC3 Thr241Met polymorphisms and TNBC progression, assessed by the degree of lymph node metastases and histological grades. In conclusion, XRCC2 Arg188His and XRCC3 Thr241Met polymorphisms may be regarded as predictive factors of triple-negative breast cancer in female population.

Overweight, obesity and female sexuality in perimenopause: a preliminary report

Introduction The research was conducted among patients of the Department of Perinatology and Gynaecology of the Poznań University of Medical Sciences. Its aim was to investigate the influence of overweight and obesity on female sexuality during the perimenopausal period. Preliminary results of the research are presented in the thesis, which was as a matter of fact intended as a preliminary report. The examination of sexual functions of the patients was performed with the use of the Female Sexual Function Index (FSFI) form. Material and methods Sixty-one women during the perimenopausal period filled out the survey, with the average age of these women being 51 years. Forty-two of the examined women had an appropriate body mass index (BMI), i.e. between 18.5 and 25, while for 19 of the women, the BMI was above normal. For statistical analysis and in order to assess the differences between the two above-mentioned groups of patients, the nonparametric Mann-Whitney test was applied. A statistically significant value was assumed at p < 0.05. The results of the conducted research indicated no such difference between the women with differing BMI for the specific domains of the FSFI test. Results The results obtained show that research in the area needs to be continued. Conclusions All the hitherto existing scientific studies also seem to indicate that the influence of overweight and obesity on female sexuality during the perimenopause has not yet been unambiguously proven. Beyond any doubt, however, sexual disorders appear in women at this time of life and the factors which determine them can vary greatly. Given the character of the situation, women ought to be supported both by a team of specialists representing different branches of medicine as well as by their relatives. The whole situation also calls for more research of the important subject matter.

Influence of sex hormones in women on breast elasticity measured by shear wave sonoelastography--a cross-sectional study.

The physiology of breast depends on age, hormonal status, menstrual cycle, lactation, and others. The aim of our study was to evaluate correlations between hormonal status and breast glandular and fat tissue elasticity in healthy women. We examined 77 women aged 20–55 with shear wave sonoelastography and estimated their hormonal levels. There were no important correlations between breast elasticity, follicle-stimulating hormone (FSH), estrogen, prolactine, and thyroid hormones (p > 0.05). Androgens negatively influenced glandular to fat elasticity ratio (Rs = −0.25, p < 0.005). Luteinizing hormone to FSH ratio correlated positively with glandular and fat elasticity, especially in outer-upper quadrant (Rs = 0.24, p = 0.003).

The diagnostic value of evaluating the maximum velocity of blood flow in the uterine arteries of women with postmenopausal bleeding

PurposeThe aim was to evaluate the utility of ultrasonographic examinations, such as the Doppler technique, in diagnosing women with postmenopausal bleeding.MethodsSpecifically, maximum end-diastolic velocity of blood flow (MEDV), time-averaged maximum velocity of blood flow (TAMXV) and peak systolic velocity of blood flow (PSV) were evaluated. Data were obtained and analyzed from a group of 100 female patients diagnosed and treated because of abnormal bleeding from the genitals in the Gynecological-Obstetrics Clinical Hospital of Poznan University of Medical Sciences. The following packages were used for statistic analyses: STATISTICA v 7.1 (StatSoft, Inc. 2005), StatXACT v.5.0.3, CYTEL SOFTWARE CORPORATION and Analyse-it Software v.1.68.ResultsThe parameters evaluated were highest in the carcinoma group, lower when proliferation was diagnosed and the lowest in the control group.ConclusionsTransvaginal ultrasonography diagnostics using the Doppler technique was found to play an important role in the diagnostic process of pathologies within the endometrium.

Do soluble p55 and p75 TNF-α receptor concentrations play a role in women with primary sterility?

Introduction In modern medicine the cause of infertility is believed to be immune mechanism disorders as well as immune over-reactivity. The objective of this thesis is to evaluate the diagnostic usefulness of measuring the concentration of soluble TNF-α receptors p55 and p75 in women with primary infertility. Material and methods Examination subjects: 41 female patients with primary sterility in the period January-September 2005. The control group consisted of 13 female patients. For identification of soluble receptors’ p55 and p75 TNF-α concentration was used commercial ELISA kits. Quantitative in vitro method of hormone identification in blood serum of plasma (ECLIA) has been used to estimate hormone concentration. Results have been analyzed with Students t-test, Wilcoxons test, Fishers exact test and Spearmans test. P value<0.05 was considered significant. Results There is no significant statistical relation between concentration of soluble p55 and p75 TNF-α receptors and age, BMI index, or length of periods. In the case of soluble p75 TNF-α receptor a statistical correlation with length of period was found (p = 0.004). From the statistical point of view, the most advantageous relation was found in the case of p75 TNF-α soluble receptor and thickness of endometrium (p = 0.007) as well as the correlation of p55/p75 soluble receptors (p = 0.05). The statistical analysis of correlations between TNFR1 and TNFR2 receptors and concentration of hormones FSH, LH, PRL, E2 and testosterone showed no dependence of TNFR1 and TNFR2 receptor concentrations and concentrations of examined hormones. Statistical analysis of relations of TNFR1/TNFR2 receptor concentrations revealed a significant correlation between these receptors and concentration of LH (p = 0.05). Conclusions The correlation between endometrium thickness, size of dominating vesicle and concentration of LH compared to concentrations of soluble TNF-α?receptors p55 and p75 and their ratio might condition the time of survival of the vesicle or lead to excessive expression of its atresion-leading conditions.

Impact of selected environmental factors on attendance in the Breast and Cervical Cancer Early Detection Programme in the Wielkopolska Province of Poland during 2007–2012

Breast and cervical cancer represent a significant health and economic issue for Polish society, although if detected early, both can be cured successfully. For this reason, since 2006, according to the National Cancer Combat Programme, population-based screening programmes have been implemented, aimed at reducing the mortality and morbidity for breast and cervical cancer. The aim of this study is to determine which of the selected four environmental factors affect attendance for screening mammography and cytology. Analysis included data from questionnaires filled in during mammography by 582,959 women aged 50-69 years, and 288,142 women during cytology, aged 25-59 years, in 2007-2012 in the Wielkopolska Province of Poland. It was found that the impact of medical staff on the attendance for cytological screening was the strongest statistically significant factor (p = 0,0001). Invitation by name (p=0,001) and other factors (p= 0,0001) also affected the attendance. In the cytological screening, medical staff was the factor that had the greatest impact on attendance. Other factors, such as self-reporting, increased participation in the next screening rounds, although the factors that affect attendance changed over time. Their constant analysis is essential for the efficient and effective evaluation of screening programsme.