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Objectives: A proper implantation of trophoblastic cells and an appropriate metalloproteinases activity is required to cause disintegration of basal membranes of cells. The activity of tissue matrix metaloproteinases can be inhibited by their matrix inhibitors — TIMP-s. Survivin is a member of inhibitor of apoptosis proteins family (IAP), that suppresses caspase activation, influences VEGF expression and promotes proliferative action of endothelial cells. Material and methods: The aim of the study was to assess concentrations of two independent anti-apoptotic factors. TIMP-1 and survivin in serum of women in their third trimester of pregnancy and in umbilical cord blood of neonates – drawn separately from veins and arteries. The study group consisted of 29 pregnant women in physiological pregnancy and with correct fetal development, in gestational age between 37 to 40 weeks of gestation. Blood used in the study was collected from maternal cubital fossa veins and from neonatal umbilical cords (from veins and from arteries separately). The research was conducted using TIMP-1 and Survivin ELISA kits from R & D Systems according to manufacturers’ recommendations and protocols. Results: The concentrations of TIMP-1 were similar and independent of the source of blood samples. Arterial values of TIMP-1 in umbilical cord compared to maternal and fetal veins were slightly lower, but no statistical difference was found. The mean concentrations of Survivin were comparable but we found that in some cases the results in cord blood serum in both vessels-vein and arteries were almost negative. Arterial values of Survivin in umbilical cord compared to maternal blood were higher, but no statistical difference was found. Conclusions: In III-rd trimester of pregnancy parameters of Timp-1 and Survivin — anti-apoptotic substances concentration were similar in maternal and cord blood in both artery and vein. We found no increased activity of selected antiapoptotic factors.

Objectives: The main aim of the study was to investigate the expression of Platelet-Derived Growth Factor Receptors alpha (PDGFR-alpha) and beta (PDGFR-beta) in malignant and benign ovarian tumors. We performed an analysis of the correlation of PDGFRs expression and stage of the disease, tumor grade and histopathological type of epithelial ovarian cancer (EOC). Additionally, we evaluated patient prognosis according to PDGFR expression. Material and methods: Our study group was composed of 52 samples of EOCs, 35 samples of benign ovarian tumors (BOTs), and 21 samples of unchanged ovaries (UOs). The samples were collected from patients who had been operated on in the Division of Gynecological Surgery of the Poznan University of Medical Sciences. Results: PDGFR-alpha was found to be expressed more frequently in cancer cells of EOCs, when compared with tumor cells of BOTs and epithelium of UOs. On the other hand, PDGFR-alpha receptors were present less frequently in the stroma of EOCs, when compared with the stroma of BOTs and UOs. Comparing the studied groups, there were no statistically significant differences in the expression of PDGFR-beta. The expression of both PDGFRs was not related to the FIGO stage, grade or histopathological type of EOCs. The expression of the PDGFR-beta receptor in cancer cells was associated with an improved overall survival among patients with EOCs. Patient prognosis was not affected by either PDGFR-alpha expres- sion or by PDGFR-beta tumor stroma expression. Conclusions: The expression of PDGFR-alpha is significantly different when comparing EOCs, BOTs and UOs. However, the prognosis of EOC only seems to be affected by PDGFR-beta expression in cancer cells.

Objectives: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease. Material and methods: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method. Results: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients’ age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients’ OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group. Conclusions: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.

Objectives: The the study was to estimate the concentrations of antiapoptotic sFas and pro-apoptotic FasL in the serum of pregnant women in the third trimester of pregnancy and in the cord blood serum of neonates from vein and arteries separately. The correlation could be crucial for evaluation of apoptosis process intensity in placenta and the role of fetal blood circulation system on distribution of sFas and FasL. Material and methods: The study group consisted of 28 pregnant women in physiological pregnancy, between 38– 41 weeks. Vein blood was taken from maternal elbow vein and umbilical cord, separately from vein and arteries. The research was done by sets for sFas and FasL from R&D Systems Elisa kit. Results: In arterial and vein cord blood there were much more lower concentrations of sFas than in maternal blood-arterial cord blood 3351.78 pg/mL, vein cord blood 3351.78 pg/mL versus maternal blood 5769.62 pg/mL (p < 0.001). No differ­ence was found in sFas concentrations between cord arterial and vein blood sera. Statistical difference was found between mean concentration of Fas ligand in maternal blood serum (71.36 pg/mL) and arterial cord blood serum (164.57 pg/mL) p < 0.05 (p = 0.001). Cord arterial blood serum showed much higher concentrations of FasL than maternal blood serum. No difference was found between cord arterial and vein blood sera concentrations of FasL: 164.57 pg/mL vs. 170.00 pg/mL (p = 0.701). Conclusions: Obtained results suggest no influence of sFas and FasL production on fetal organism apoptosis. Lowering of sFas concentration in fetal blood could mean the increase of apoptosis in fetal organism compared to maternal. Higher concentration of FasL in cord blood than in mothers suggests higher apoptosis intensification in fetal circulation and no influence of blood flow across placenta on its concentration.

Objectives: Subjective ultrasonographic assessment is currently considered to be the best method of differentiation between various types of ovarian tumors. The aim of the study was to evaluate selected ultrasonographic features and CA125 levels of hormonally active ovarian tumors. Material and methods: A total of 1135 women with ovarian tumors were diagnosed between 2006 and 2014 at the Division of Gynecologic Surgery, Poznan University of Medical Sciences. Within these tumors, there were 60 hormone-secreting ovarian tumors, including: 20 granulosa cell tumors, 28 fibrothecomas, 10 dysgerminomas, 2 struma ovarii, and 9 metastatic ovarian tumors. The tumors were evaluated by ultrasonography according to the International Ovarian Tumor Analysis group criteria. Additionally, we evaluated serum CA125 levels in all patients. Results: Granulosa cell tumors occurred most frequently as large unilocular-solid cysts, moderately to highly vascularized, with low-resistance vascularization. Dysgerminomas were predominantly large unilocular-solid cysts or purely solid tumors, with minimal to moderate low-resistance vascularization. Fibrothecomas were solid masses with minimal, high-resistance vascularization. Struma ovarii occurred as small, solid masses with abundant, highresistance vascularization. Metastatic ovarian tumors presented mainly as multilocular-solid tumors with strong, low-resistance vascularization. Papillary projections were most frequently observed in metastatic tumors and granulosa cell tumors in 56% and 50% of the cases respectively, although only half of granulosa cell tumors papillary projections exceeded 3 mm. Elevated CA125 levels were found only in metastatic ovarian tumors. Conclusions: Hormonally active ovarian tumors present several ultrasonographic features which may facilitate preoperative diagnosis.

INTRODUCTION To achieve physiological pregnancy development proper implantation and placental development is needed to establish good exchange between mother and fetus. Metaloproteinases of extracellular matrix are responsible of its degradation, their action is decreased by metaloproteinases inhibitors - TIMPs. OBJECTIVES Assessment of the concentrations soluble extracellular matrix metaloproteinases inhibitors TIMP-2 and TIMP-4 in blood of pregnant healthy women in III-rd trimester and in umbilical cord blood separately from arteries and umbilical cord vein. MATERIAL AND METHOD The study was conduced in High Risk Pregnancy Clinic, Medical University Lodz. The study group consisted from 29 women in normal, eutrophic pregnancy between 37 and 40 weeks of pregnancy TIMP-2 and TIMP-4 were measured in blood samples from maternal blood and umbilical cord vessels - separately from arteries and vein. RESULTS Mean TIMP-2 concentration in maternal blood was 101,27 ng/ml, from umbilical artery 108,88 ng/ml, and from vein 108,28 ng/ml. Mean concentration of TIMP-4 in maternal blood was 726,73 pg/ml in umbilical artery was 529,95 pg/ml, in umbilical vein - 537,87 pg/ml. Comparing obtained results of TIMP-4 statistical difference between maternal blood and umbilical cord blood was found. CONCLUSIONS The lack of increase of TIMP-2 synthesis in III-rd trimester of physiological pregnancy may be result of stabile vascularisation process. Observed decrease of TIMP-4 concentration may be the result of normal blood vessels development and the lack of increase angiogenesis process in both mother and fetus.

We present the first case of a patient with a synchronic occurrence of three neoplasms: non-small cell lung cancer serous cancer of the ovary and carcinosarcoma of the colon. Moreover, the possible origin of the carcinosarcoma is an endometriotic focus, which is an extremely rare occurrence, especially in women with no history of endometriotic treatment. Immunohistochemical staining of the carcinosarcoma was positive for CD10, estrogen receptors and desmin--typical markers for endometriotic foci. The growth of endometriosis depends on estrogen, which is produced at reduced levels after menopause. However, in some cases endometriosis could be diagnosed de novo in postmenopausal women. On the basis of the reported patient we discuss possible correlations between endometriosis and carcinosarcoma, as well as treatment methods of carcinosarcoma.

Objectives: Currently transvaginal ultrasonography is the most effective method for ovarian tumor malignancy prediction. The aim of the study was to estimate the risk of false negative results in subjective interpretation of the ultrasound examination of ovarian tumors according to menopausal status. Material and methods: 318 women (210 pre and 108 post menopause) with adnexal masses were diagnosed preoperatively between 2004 and 2010. Subjective assessment of tumor characteristics was conducted by experienced ultrasound examiner. Tumors were divided into groups of: “certainly benign” (n=84), “probably benign” (n=116), “uncertain” (n=61), “probably malignant” (n=47), and “certainly malignant” (n=10). The percentage of false negative results was calculated among the first two groups according to menopausal status. Results: There were 91 malignant and 227 benign adnexal masses diagnosed in histopathological evaluation. There was one false negative result of subjective interpretation of ultrasound findings in postmenopausal women – 1.6% (1/64). She was a 63-year-old woman with bilateral solid ovaries sized: 4.2x3.1cm and 4.6x2.5 cm in ultrasound evaluation, where serous adenocarcinoma was diagnosed. There were three false negative results in premenopausal women – 2.2% (3/136). The first was a 34-year-old woman with a cyst with the appearance of ground glass of 19 x11cm in size where endometrioid ovarian adenocarcinoma was diagnosed. The second woman was a 32-year-old with a bilocular cyst 8x4.5cm diagnosed with borderline mucinous tumor. The third patient was a 21-year-old woman with unilocular-solid cyst 4.2x3.2cm where histopathological examination revealed borderline serous tumor. Conclusions: Subjective ultrasound evaluation of adnexal masses has high specificity but even in the group of tumors considered benign in premenopausal as well as postmenopausal women malignancy can be found. This occurs slightly more often before menopause.

Pregnancy causes changes in the hormonal balance, musculoskeletal, cardiovascular and lymphatic systems. The swelling of the lower limbs may also be one of the consequences of the enlarging uterus that increases body weight during pregnancy Determination of the serum concentrations of myeloperoxidase - MPO, extracellular matrix metalloproteinase - MMP, and intreleukine-6 - IL-6 allows for the assessment of inflammation. MPO belongs to the group of peroxidase enzymes with strong antibacterial and anti viral action. It is produced and released from the granules of neutrophils in inflammatory reactions, degenerative changes and neoplasmatic diseases. IL-6 is the main mediator of the inflammation in the live organism, released by monocytes and macrophages stimulated by interleukin-1.To assess the levels of inflammatory mediators: MMP MPO and IL-6 in women in the third trimester of pregnancy both healthy and those who experienced idiopathic edema of the lower limbs.We analyzed the changes in the concentration of biochemical parameters as: MMP-1, MPO and IL-6 in the serum of 20 healthy pregnant women between 36 and 40 weeks of gestation, and 8 pregnant women who developed idiopathic edema of the lower limbs. The RD Systems Elisa tests were used to perform the measurement. The Quantikine Human IL-6 Immunoassay was used to measure the concentration of IL-6. The concentration was expressed in pg/ml. MMP-1 was measured using The Quantikine Human Pro -MMP-1. The value of MMP-1 concentration was expressed in ng/ml. MPO was measured using The Quantikine Human MPO Immunoassay and expressed in ng/ml.The mean concentration of IL-6 was higher in the group of pregnant women with swelling of the lower limbs (group II) in comparison to healthy pregnant women (group I) and it was approximately 3,01 pg/ml, SD = 2,64, and 2,3 pg/ml, SD = 1,92, respectively. No statistical difference was found (p = 0,436). Parity has no influence on IL-6 concentration. The mean concentration of MPO in group I was 1797,04 ng/ml, SD = 1378,89, in II group it was 1702,54 ng/ml, SD = 1289,64. (p = 0,866). Parity has also no influence on MPO concentration. The mean concentration of MMP-1 in group I was 7,61 ng/ml, SD = 4,6, in group II it was 10,46 ng/ml, SD = 4,03. (p = 0,137). Significantly higher results were observed in primiparas with lower limbs swelling- 11,36 ng/ml when compared to multiparas - 9,57 ng/ml.1. There are no significant differences in the concentrations of the studied inflammatory mediators between the groups of healthy pregnant women and those with idiopathic edema observed in the lower limbs. The significance of these differences requires further confirmation. 2. There was a statistically significant difference between the concentrations of MPO in the group of primiparas with a multiparas with lymphatic edema.

Hemangioma is the most common primary tumor of the spine. Pregnancy is a risk factor increasing the possibility of disclosure or exacerbation of symptoms of spinal hemangioma. This paper presents a case of 32-year-old woman with hemangioma of Th6 vertebrae, which was revealed by paresis of the lower limbs and sphincters dysfunction at 34 weeks gestation. Pregnancy has ended with a cesarean section. Then posterolateral thoracotomy and removal of hemangioma were performed. Spinal cord was decompressed and stabilization of the spine with metal implants was carried out. Histological examination discovered cavernous hemangioma weaving. The patient is followed up in the outpatient clinic. Despite the improvement of neurological status--enhancement of the sensory function and development of bladder and rectal sphincter automatism--she did not regain the ability to walk alone.

Obesity poses a serious problem to human population as it increases the risk of diabetes, hypertension, metabolic syndrome. In pregnancy obesity increases the frequency of its complications.The main aim of the study was to estimate the increase of body mass and insulin and neuropeptide Y concentrations in pregnant women.The changes of body mass and BMI in women before pregnancy and before delivery and the concentrations of insulin and neuropeptide Y in blood were estimated.The increase of body mass and BMI during the pregnancy period was higher in the group with high body mass and I stage obesity and increase of insulin concentration depended on increase of the body mass. Higher concentration of NPY was found in the group of women with normal body mass and obese if compared to stages II and III of obesity No correlation between insulin increase and concentration of NPY was found.In most pregnant women body mass gain is excessive and leads to obesity of different stages. Insulin concentration increases as BMI increases. Neuropeptide Y concentration in the obese women group was lower than in the normal weight group.

The main aim of our study was to determine the features of the greatest importance in the prognosis of the functional nature of ovarian cysts, as well as the evaluation of the role of morphological index and CA 125 in the diagnosis of functional ovarian cysts.187 premenopausal women with ovarian tumor (between the ages of 13 and 52) were enrolled in the study. Each patient underwent transvaginal ultrasonography and the morphology of the tumor was assessed on the basis of morphological index. The level of CA 125 was measured. The patients were divided into two groups: 1) patients with functional cyst, 2) patients with non-functional cyst. The study was performed between the years 2003-2006.Functional ovarian cysts in ultrasonography included: unilocular with smooth internal wall, anechoic, without solid elements and with a thin wall of the structure (3 mm). They were usually unilateral and ascites was rarely present. The morphological index (SM) achieved the highest accuracy (71.6%) at the cut-off level ofor = 5. The area under ROC curve for SM was 0.834. The level of CA 125 did not differ significantly between the analyzed groups.Tumors with 5 points or less in morphological index estimation may be safely observed during 2 or 3 menstruation cycles, as their spontaneous regression is anticipated. Assessment of CA 125 concentration is a test with low clinical usefulness and marginal statistical significance.