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The thyroid is an endocrine gland synthesizing, storaging and secreting thyroxine (T4) and triiodothyronine (T3). Currently, there are more and more reports and evidences that various chemical contaminants present in the environment, mainly polychlorinated biphenyls, interfere with stages of regulation, synthesis, secretion, transport of thyroid hormones. That can have a significant negative impact on the human body's endocrine homeostasis.

Metformin, a drug from the biguanide class, is now one of the most widely used drugs in the treatment of type 2 diabetes. This drug was also used in the treatment of polycystic ovarian syndrome and recent reports indicate the possibility of using this drug in oncology. Latest findings show that metformin has an anticancer effect. Influencing the transduction mechanisms primarily through activation of protein kinase activated by 5'AMP (AMPK) regulates the activity of the AMPK/mTOR signaling pathway. MTOR pathway dysregulation may be a factor in the pathogenesis of various human diseases, especially cancers. Overactivation of mTOR is observed in malignant cells and is associated with their resistance to treatment. It can therefore be concluded that metformin as an inhibitor of mTOR may be a factor that suppresses tumor development. There are also studies showing that metformin prevents the formation of metastases, reducing tumor vasculature and improves the effectiveness of anticancer drugs. The anticancer effect of metformin has been proven in the treatment of colorectal and breast cancer. The current studies reports the positive effects in the treatment of gynecological cancers such as ovarian, endometrial and cervical cancer. Incidence for these tumors in 2009 in Poland was: for ovarian cancer 11.01100000; for endometrial cancer 15.0/100000; for cervical cancer 10.5/100000. Metformin has antitumor activity in monotherapy and also synergistically with other anticancer agents. Metformin has antiproliferative properties; reduces the VEGF levels, causing a reduction in tumor vasculature; causes an increase in progesterone receptor, which increases the response to hormonal therapy; inhibits the expression of glyoxalase I, mediating resistance to chemotherapy; decreases in the concentration of human telomerase; reduces the activity of Akt and Erk kinases, key regulators of metabolism and progression of tumors and also inhibits the formation of metastases.

Aim: The aim of the present work was to assess the influence of estradiol administration mode on the plasma IGF-I, IGFBP-1, IGFBP-3 levels in postmenopausal women treated with norethisterone acetate., Material and Methods: 39 women were enrolled into the study Group A--14 women received transdermal 17beta-estradiol (Oesclim 50--Fournier-Solvay) combined with oral norethisterone 2.5 mg daily (Primolut-Nor--Schering), Group B--10 women on oral 2 mg 17beta-estradiol combined with oral 1 mg daily norethisterone (Kliogest--Novo-Nordisk). Control group (group C) consisted of 15 postmenopausal women who received no treatment. Basic plasma FSH, estradiol and total IGF-I, IGFBP-1 as well as IGFBP-3 levels were measured initially and at the 52nd week of the study., Results: The mean plasma FSH level was reduced and mean plasma estradiol level was increased in groups A and B during hormone therapy. Mean plasma levels of total IGF-I, IGFBP-1, IGFBP-3 as well as IGFBP-3/IGF-I ratio did not changed significantly during 52 weeks of observation in groups A, B and C. The comparison of plasma IGF-I, IGFBP-1, IGFBP-3 between groups at the initial visit and after 52 weeks showed the lowest concentration f IGBP-3 in group B. Other parameters showed no differences among the three groups., Conclusion: Mode of administration of estradiol did not influenced the plasma levels of IGF-I, IGFBP-1, IGFBP-3 in postmenopausal women treated with norethisterone acetate.

There are discordant opinions about the influence of subclinical hypothyroidism to the fertility of the women. No unequivocal opinion has been presented concerning the purposefulness of the diagnostics process and treatment of the pregnant women with subclinical hypothyroidism. Few clinical studies suggest that there is a connection between thyroid antibodies and infertility, spontaneous miscarriages, implantation failures and fetal malformations.

The authors presented coeliac disease diagnostic and treatment methods and its links with infertility. The hormonal disturbances in women with coelic disease were also shown. Perinatal complications in pregnant women with the disease were presented. The need for involvement of coelic disease into differential diagnosis algorythm were given.

The conteporary views on the influence of placenta on the fetal hypothalamo-hypophyseo-thyroid axis has been given. The role of hCG, estrogens, deiodineses, transfereses and arylosulphateses has been presented. Transthyretin role has been mentioned.

Aim: The 12 months' observation of body mass index (BMI) influence on natural course of aortic valve stenosis (AVS)., Patients: 60 AVS patients who did not agree for operational treatment were divided into group A (n = 15) with BMI 20-25, group B (n = 27) with BMI 25,01-30 and group C BMI > 30., Methods: Plasma Lp(a), total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-alpha) as well as titers of immunoglobulin (Ig) class G, A, M against chlamydia pneumoniae were measured every 12 months. Echo-cardiographic evaluation of aortic valve was also done every 12 months., Results: Means serum CRP at 12 month was the highest in group C. No differences in mean serum TNF-alpha and IL-6 levels as well as in Ig titers between groups A, B, C were found. At 12 month of observation HDL/total cholesterol ratio as well as HDL/LDL-cholesterol ratio were the lowest in group B. Left atrium diameter and right ventricle diameter were bigger in groups B and C compared to group A at the visit I and after 12 months of observation. Systolic intraventricular septum (IVS syst) thickness was the highest in group C at visit I. Diastolic left ventricle posterior wall thickness (LVPW) was the highest in group C during 12 months of observation., Conclusion: The increase in fat tissue mass may lead to increase in inflammatory process and cardiac muscle remodeling in AVS patients.

Aim: Comparison of echocardiographic findings in AVS patients with and without high IgG, IgM, IgA titers against Chlamydia pneumoniae during 12 months' observation of AVS natural course., Patients: 60 AVS patients who did not agree for operational treatment were divided into group A (30 patients with high IgG titer) group B (30 patients with low IgG titer), group C (22 patients with high IgA titer) group D (38 patients with low IgA titer), group E (7 patients with high IgM titer), group F (53 patients with low IgA titer) Antibodies titers and echocardiographic scans were carried out every 12 months., Results: There were more (p < 0.02) patients with AVS deterioration in group A compared to group B. Group A patients had lower left ventricle posteriori wall systolic diameter compared to group B. There were no differences in echocardiographic parameters between group C and D. Mean ejection fraction was lower and mean right atrium diameter was higher in group E compared to group F., Conclusion: The results may suggest link between Chlamydia pneumoniae and deterioration of AVS.

The structure and turnover of polichlorinated biphenyls (PCB) in environment was presented. The PCB absorption and metabolism in organisms as well as the PCB induced disruption of placental and ovarian steroidogenesis were discussed.

Contraceptive is an important issue of women's life. In the present times there are many methods to prevent unwanted pregnancy. Each of them has its advantages and disadvantages and an appropriate choice of the method determines its promotion high efficiency and comfort its application. Today there is no method of contraception, which would not be charged some risk for the application. Following the review will allow literature to analyze impact of the various methods for the development of cancer control means diseases which may constitute a serious threat to health and life women.

Aim: The observation of natural course of aortic valvae stenosis (AVS) in patients with high lipoprotein (a) [Lp(a)]., Patients: 60 AVS patients who did not agree for operational treatment were divided into group A (n = 19) with high serum Lp(a) level and into group B (n = 41) with normal plasma Lp(a) level., Methods: Plasma Lp(a), total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-alpha) as well as titers of immunoglobulin (Ig) class G, A, M against chlamydia pneumoniae were measured every 12 months. Echocardiographic evaluation of aortic valve was also done every 12 months., Results: Means serum CRP at 12 month was higher in group A. Mean serum TNF-alpha level was also higher at visit I and at 12 month (visit II) in group A. Mean serum IL-6 level did not differ between groups. IgG titer was higher in group A at visit I and visit II. At 12 month of observation HDL-cholesterol plasma level was lower in group A. HDL/total cholesterol ratio as well as HDL/LDL-cholesterol ratio was laso lower in group A at 12 month of observation. No statistically significant differences in echocardiographic parameters were founf between groups., Conclusion: The results may suggest risk factors similarity of AVS and atherosclerosis.

The structure and turnover of polichlorinated biphenyls (PCB) in environment was presented. The PCB absorption and metabolism in organisms as well as the PCB influence on neoplastic process.

The aim of the study was to evaluate the impact of early, second trimester bacterial vaginosis [BV] on the number of threatened preterm deliveries. Group A consisted of 52 pregnant women in whom BV was diagnosed in the beginning of the 2nd trimester of pregnancy. Group A patients were treated with a 10 day course of metronidazole 0.5 g vaginally daily. Group B consisted of 122 pregnant women without BV. The number of cases with threatened preterm delivery was prospectively assessed in both groups. There were 28 cases of threatened preterm delivery in group A (53.8%) and 6 similar cases in group B (4.9%) (p < 0.05--Chi square test d.f.1). All cases (n = 20) of BV at the time of hospitalization due to threatened preterm delivery occurred in group A. The cases of threatened preterm delivery occurred significantly more frequently in pregnant patients who had the BV diagnosed in the beginning of the 2nd trimester. This may suggest the link between BV and the occurrence of threatened preterm deliveries.

Aim: Comparison of echocardiographic findings in AVS patients with and without hypercholesterolemia during 12 months' observation of AVS natural course., Patients: 60 AVS patients who did not agree for operational treatment were divided into group A (n = 47) with high serum total cholesterol and into group B (n = 13) with normal plasma cholesterol., Methods: plasma total cholesterol, HDL-cholesterol, LDL-cholesterol, tri-glycerides and lipoprotein (a) were measured every 12 months and echocardiographic evaluation of aortic valve was also done every 12 months., Results: Means total cholesterol did not change in group A, while increased in group B. HDL-cholesterol decreased in group A and LDL-cholesterol increased in group B. Mean TG and Lp(a) levels did not change in both groups. Increase in AOG max and AOG mean as well as V max were found only group A. LVPW syst increase was found in group A. LA diameter increased and AVA decreased only in group A., Conclusion: The results may suggest risk factors similarity of AVS progression and atherosclerosis.

Aim: Evaluation of the plasma levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglicerides, lipoprotein (a) during 12 months of the natural course of AVS., Patients & Methods: 60 patients with AVS and 14 controls had echocardiographic examination at the beginning and at the 12th months of observation. The AVS group was divided retrospectively at 12 month of the study into 2 groups. 30 patients with rapid deterioration of echocardiographic parameters (PAVS group) and 30 patients with slow deterioration of echocardiographic parameters (SAVS group). Plasma concentration of CRP, TNFalpha, IL-6, anti-chlamydial IgA, IgG, IgM antibodies were evaluated at the beginning and at the 12th month of the study., Results: Smokers' ratio was higher in the AVS group compared to controls. Body mass and body mass index increased only in the AVS group. Serum levels of triglicerides and lipoprotein (a) increased, while HDL-cholesterol level decreased during 12 months in the AVS group. HDL-cholesterol plasma level increased in the control group. LDL-cholesterol, HDL-cholesterol and the lipoprotein (a) were the parameters which differed between AVS and control groups. Lipoprotein (a) was the only lipoprotein which increased in the PAVS group. HDL-cholesterol was the only parameters which differed between PAVS and SAVS groups. Serum cholesterol level did not differ between groups., Conclusion: Smoking increase in plasma levels of triglicerides and lipoprotein (a) and decrease in HDL-cholesterol were associated with the AVS and its progression.

Aim: To compare the effect on total cholesterol and LDL and HDL cholesterol of oral dydrogesterone and medroxyprogesterone administration combined with continuous transdermal supplementation of 17beta-estradiol in postmenopausal women. MATERIAL & METHODS. The prospective study was carried out in 59 healthy postmenopausal women (mean age 54.5 +/- 3.34 years). They were randomized and treated either with continuous transdermal hormonal therapy (HT) (Group A; n=25; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral dydrogesterone at a daily dose of 5 mg or group B, n=24; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral medroxyprogesterone at a daily dose of 5 mg) or observed as a control group C (n=10). Basal plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol as well as basal estrogen and FSH levels were measured before HT and after 6 and 12 months of treatment. At the same time intervals, all the studied parameters were measured for group C., Results: After 6 months of continuous transdermal supplementation of 17beta-estradiol with oral dydrogesterone the plasma level of total cholesterol decreased (6.23 +/- 1.02 mmol/l vs 5.65 +/- 0.96 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (5.46 +/- 1.0 mmol/l). The plasma level of LDL-cholesterol was also decreased after 6 months of HT (3.87 +/- 0.83 mmol/ I vs 3.42 +/- 0.58 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (3.48 +/- 0.73 mmol/l). HDL-cholesterol plasma level was increased after 6 months of HT (1.52 +/- 0.45 mmol/l vs 1.76 +/- 0.45 mmol/l; p < 0.05) and was maintained after 12 months. The beneficial changes of plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol in group B did not reach the statistical significance. The lipid and lipoproteins mean plasma levels remained unchanged in the control group during 12 months of observation., Conclusion: Adding dydrogestrone or medroxyprogesterone to the continuous transdermal supplementation of 17beta-estradiol did not deteriorate the modificable atherosclerotic risk factors.

Aim: The evaluation of the influence of testosterone and fat tissue distribution on the serum leptin levels in perimenopausal women., Patients: 93 perimenopausal women without HRT (age: 51.0 +/- 8.8 yrs, FSH: 68.0 +/- 49.4 IU/l, estradiol: 38.3 +/- 37.0 ng/1) were divided into group A - 63 women with serum testosterone level < 0.6 ng/ml and group B--30 women with serum testosterone > or = 0.6 ng/ml. Each group was later divided according to WHR into subgroup I (AI and BI) (WHR < 0.8) and II (AII and BII) (WHR > or = 0.8)., Methods: Basic fasting serum levels of LH, FSH, PRL, estradiol, insulin, hGH, IGF-I, IGFBP-1, IGFBP-3, leptin, testosterone, DHEAS TNF-alpha and SHBG were measured by RIA kits. Total cholesterol, HDL and LDL cholesterol, as well as triglycerides plasma levels were measured. Statistical evaluation was carried out by ANOVA and linear regression., Results: BMI, WHR and plasma DHEAS level were higher in group B vs. group A. The lowest hGH, HDL-cholesterol and the highest TNF-alpha levels were found in group BII. The relations leptin/BMI and leptin/body mass were found in each group. The inverse relation between leptin and IGFBP-1 was found in groups A and B. In group A the inverse relations leptin/HDL-cholesterol and leptin/ DHEAS were observed. In group B the direct leptin/testosterone and inverse leptin/IGF-I relations were found. In group AI the inverse leptin/DHEAS relation remained, while in group AII inverse leptin/HDL-cholesterol relation remained and reverse leptin/IGFBP-1 relation was significant. The direct leptin/testosterone, leptin/WHR and inverse leptin/TNF-alpha links were observed in group BII., Conclusion: The serum leptin level was linked to WHR, serum testosterone, insulin, TNF-alpha levels only in groups of perimenopausal women with such cardiovascular risk factors as high WHR, overweight, high serum TNF-alpha and testosterone levels.

Introduction: The exceptionality of endometrium, differentiating it from other epithelial tissues is related with its ability to regulate the number and activity of infiltrating immunological cells according to menstrual cycle phases. The aim of this study was a comparative evaluation of the number of CD56 positive cells, as well the analysis of CD69 antigen expression during decidualization., Materials and Methods: The expression of CD56 and CD69 antigens was analyzed using the immunohistochemistry method in 20 decidual tissue samples derived after curettage following spontaneous abortion and in 38 endometrial tissue samples obtained during hysterectomy performed because of benign myoma diagnosis. The endometrial tissue samples were divided regarding to the menstrual cycle phases. Following phases were distinguished: early proliferative, mid-proliferative, late proliferative, early secretory, mid secretory and late secretory., Results: The higher CD56 positive cells were recognized in the endometrium during mid secretory cycle phase. The number of CD56 positive cells was significantly lower in endometrium, independent of menstrual cycle phase in comparison to endometrium following abortion. The expression of CD69 antigen was observed to increase beginning with early secretory cycle phase and remained at high level during the secretory cycle phase and the abortion., Conclusions: The observed differences in the number of CD56 positive cells during decidualization without the changes in immune cells activity evaluated using CD69 antigen expression may indicate the participation of activated mononuclear cells in the normal development of pregnancy beginning with implantation.

Aim: The evaluation of serum ICAM, VCAM, endothelin-1 (Et-1), TNF-alpha and its soluble receptor levels and the secretion of nitric oxide in postmenopausal women with hypercholesterolemia., Patients: 26 postmenopausal patients who neither received hormonal therapy nor cholesterol lowering treatment. Group A consisted of 16 women with high serum total cholesterol and group B of 10 women with normal cholesterol level., Methods: Basic fasting serum FSH, 17beta-estradiol, as well as total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides levels were evaluated. Standard exercise test was carried out according to Bruce protocol. Blood samples were taken thrice (prior to, at peak exercise, 15th min of recovery) during the test to evaluate the serum levels of ICAM, VCAM, ET-1, TNF-alpha and its soluble receptors as well as secretion of nitric oxide., Results: In group A--sVCAM (660.0 +/- 106.4 mg/l versus 518.6 +/- 65.4 mg/l; p < 0.05) and TNF-alpha serum levels (2.2 +/- 1.0 ng/l versus 1.2 +/- 0.4 ng/l; p < 0.05) at peak exercise were higher in group A compared to group B. There was a tendency (p > 0.05) of higher ET-1 plasma levels in group A., Conclusion: Serum levels of adhesion molecules and inflammatory mediators were higher during physical exercise in postmenopausal women with atherosclerosis risk factors.

One of the chief findings in polycystic ovaries syndrome may be the defective luteal phase of the menstrual cycle. There is a growing list of publications indicating a defective progesterone production by granulosa cells of ovarian follicles. In consequence, women with polycystic ovaries often require both the luteal phase and early pregnancy supplementation. From different routes of progesterone administration during the menstrual cycle, as the most clinically reliable in the early pregnancy either intramuscular or intravaginal route has been recommended.

Atypical endometrial hyperplasia has been associated with progression to endometrial cancer, the most common genital malignancy. There are multiple risk factors for endometrial cancer, such as early menarche, exogenous estrogen exposure, obesity and diabetes. Diabetics have a 3-4 fold relative risk of endometrial cancer. Also, several studies have demonstrated an association between insulin resistance and endometrial cancer. There is known the first description of atypical endometrial hyperplasia resistant to progestogen therapy, which was subsequently treated with an insulin-sensitizng agent, metformin. Metformin is a biguanide antihyperglycemic agent used in the treatment of adult-onset diabetes. Unlike the sulfonylureas, metformin does not act primarily by increasing insulin secretion. In contrast, metformin lowers the rate of gluconeogenesis in the presence of insulin. Therefore, it is considered an insulin-sensitizer. Increased insulin sensitivity may improve the metabolic effect of insulin and decrease its mitogenic effect by tissue-specific mechanisms. One explanation for tissue specific differences in insulin binding and action may be through the relative expression of the insulin receptor (IR) isoforms. The IR isoforms IR-A and IR-D differ by 12 amino acid residues, owing to the alternative splicing of exon. The IR-A is predominantly expressed in malignant tissues and may lead to mitogenic effects within the cell. The relative expressions of IR-A and IR-B in normal and malignant endometrial tissue is not known. Besides direct effects on the IR, several additional mechanisms have been proposed for the mitogenic effect of insulin in endometrial cancer. In addition to the possible direct mitogenic effects of insulin through the IR-A, insulin resistance may be associated with alterations in expression of insulin-like growth factors (IGFs) and the IGF binding proteins (IGFBPs) or may inhibit the protective effect of progestagens. Binding sites for IGF-1 and IGF-2 have been confirmed in both normal and malignant endometrium. Binding of IGF-1 is significantly higher in endometrial cancer compared to normal endometrium. In the Ishikawa human endometrial cancer cell line IGF-1 was a more potent mitogen than insulin or IGF-2. Insulin may increase mitogenicity by regulating the expression of IGFBPs. The IGFBPs are a family of proteins that have both proliferative and anti-proliferative effects. While all six high-affinity IGFBPs are expressed in the endometrium, IGFBP-1 is the best characterized. Hyperinsulinemia can decrease IGFBP-1 even in the presence of progesterone, perhaps inhibiting progesterone's protective effects. Interestingly, IGFBP-1 was undetectable or minimally expressed in endometrial cancers. Nestler discussed results of a 6-month treatment of 100 nonebese women with PCOS, which showed a somewhat greater effect of metformin than rosiglitazone and no benefit of administering both agents in combination. Long-term treatment with oral contraceptives decreases endometrial cancer, with a reduction in serum androgens and a decreases in hirsutism and acne, but may worsen insulin resistance and lead to deteriration in glucose tolerance. Insulin sensitizers, on the other hand, should decrease endometrial hyperplasia by inducing regular menses, but may not be as beneficial in improving androgen - related symptoms. Note that the Nurses Health Study (NHS) showed increased risk of diabetes in oral contraceptive users. These considerations may be related to the finding that women who used oral contraceptives have increased risk of myocardial infarction. Thus, in view of the particular increase in CVD risk among women with PCOS, one might be less likely to recommend oral contraceptives, while insulin sensitizers may be of particular benefit, decreasing androgens, improving ovulation and fertility, and reducing the risk of diabetes and CVD. Theoretically, metformin, a treatment which is now widely used to treat infertile women with PCOS, may have a role in preventing endometrial hyperstimulation by lowering insulin concentrations and restoring ovulation. However, the long-term effects of this drug in women with PCOS are not known and more studies are required before suggesting its use for preventing endometrial cancer.

Objectives: Postmenopausal lack of estrogens may accelerate cardiovascular atheromatic changes. Standard exercise test (SET) challenges hidden signs of the vascular involvement. Although the test is known not to carry a risk of thromboembolic complications, it may influence plasma concentrations of endothelial and platelet factors. The question is if and to what extend the menopause aggravates the SET induced changes., Aim: Plasma concentrations of nitric oxide, endothelin-1, beta-thromboglobulin and von Willebrand factor activity before, at the maximum exercise and 15 minutes after the SET referred to, as a recovery time were estimated., Method: SET was performed according to Bruce protocol in group of 31 premenopausal and 57 postmenopausal women. Standard RIA kits for plasma beta-thromboglobulin (beta-TG) (Boehringer Mannheim) and endothelin-1 (Et-1) (Blotrack) concentration were used. The von Willebrand factor (vWF) activity was assayed by ELISA system (Boehringer Manheim). Plasma nitric oxide (NO) concentration was calculated from nitrides/nitrates levels, by Griess reaction, modified by use of NADPH reductase., Results: Mean plasma levels of beta-TG, Et-1, NO and vWF activity do not differ between pre and postmenopausal women. The standard exercise test significantly increases both beta-TG plasma concentration and vWF activity (p < 0.00001). During the 15 minutes rest period the changed values do not return to preexercise levels. Neither plasma NO nor Et-1 plasma concentrations change during the exercise test. There was a similar increase in beta-TG plasma levels and vWF activity during the SET in pre- and postmenopausal women and a slighter increase of plasma Et-1 levels in postmenopausal women (p < 0.04). The close relationships between NO plasma concentration and both vWF activity (p < 0.002) and vascular endothelial growth factor (VEGF) level (p < 0.04) were observed in postmenopausal women. The vWF activity in postmenopausal; women inversely correlates with insulin-like growth factor-I (IGF-I) concentration (p < 0.001). In premenopausal women the important modulators of vWF activity were: body mass (p < 0.04), serum total cholesterol (p < 0.02) and sex hormone binding globulin (SHBG) levels (p < 0.04). The postmenopausal beta-TG increase during SET depends on body mass (p < 0.02), whereas the preexercise levels seem to be related to VEGF level (p < 0.03) and inversely to Et-1 (p < 0.007) and dehydroepiandrosterone sulfate (DHEAS) concentration (p < 0.03) Both the basal and stimulated by exercise vWF activity are higher in obese women (p < 0.003), but the net increase is larger in lean group (BMI < 30 kg/m2). In premenopausal women plasma NO concentration depends on 17 beta-estradiol serum level (p < 0.02). The higher VEGF (p < 0.01) levels as well as vWF activity was observed (p < 0.03) in hypercholesterolemic women., Conclusion: The standard exercise test increases the procoagulatory von Willebrand factor activity so as the platelets activity (beta-thromboglobulin concentration) in both pre and postmenopausal women. The slight endothelin-1 rise has been found at the maximum exercise in postmenopausal women. The close relation between plasma nitric oxide and endothelin-1 levels was found in postmenopausal women. Obesity and hypercholesterolemia may contribute to the observed changes.

Sexual dysfunction in depressed patients is an important clinical problem. Its complex etiology involves depressive symptoms, comorbid medical disorders, medication, difficulties in interpersonal relationships with partner, level of sexual functioning prior to the onset of illness. Also, mechanisms of action of psychotropic medication on sexual function are complex. Sexual dysfunction is a source of additional suffering for depressed patients and may contribute to poor compliance with treatment. It is an important challenge for the therapy of depression.

Serum basal fasting IGF-I, hGH, insulin, prolactin and gonadotropins as well as estradiol and SHBG levels were evaluated in: 15 women with the empty sella turcica syndrome [1A], 14 women with the empty sella and pituitary microadenoma[1B], 6 ones with normal CT scan [2A] and 20 subjects with CT signs of pituitary microadenoma [2B]. There were no differences in age of the women. Both mean body mass and body mass index were the highest in group 1A. The lowest mean serum IGF-I, LH, estradiol, SHBG and the highest insulin levels were found in group 1A. Serum IGF-I level correlated negatively with age in all but 1A group. An inverse hGH/age as well as positive hGH/IGF-I correlation found in group 2A was impaired either by presence of the empty sella or microadenoma. IGF-I/insulin correlation did not occur in all but 1A group. Normally existing reverse estradiol/age correlation became positive in group 1A and vanished in patients microadenoma. Serum IGF-I level correlated negatively with gonadotropins in patients with CT signs of microadenoma.

Immunological competent cells and their cytokines exert a potent influence on both the placental function and the fetus. The different fetal and placental cells and in the same way modify cytokines production by the immunological system. The further characteristic of decidual lymphocytes subpopulations and their role in the regulation of embryonic development has been presented. The interactions between cytokines and growth factors derived from both decidua and trophoblast have been reviewed. The role of HLA-G, TLX and expressed cell differentiation antigens (complement system suppression) in the early pregnancy protection as well as trophoblast invasion inhibition have been discussed. The potential role of these factors in the early pregnancy loss has been considered.

Changes in the proportion of macrophages, granulocytes and subpopulations of lymphocytes in the secretory endometrium and decidua have been reviewed. The decidual transformation and principles of the neutralization of an adaptative response to embryonic tissues as well as the fetal growth promoting decidual factors have been discussed. The immunological response can broadly be divided into two types, cell mediated and humoral. Cell-mediated immune responses involve the activation of macrophages and the induction of macrophages and the induction of cytotoxic CD8+ and CD4+. T cells, whereas humoral immunity is characterized by antibody production. These two arma of the immune response are regulated by distinct subsets of CD4+ helper T cells, termed Th1 and Th2 cells, which secrete different patterns of cytokines. The pregnancy induced possible Th2 prevalence so as role of such factors like PGE2, TGF2, 1.25-(OH)2-Vit. D3, IL-2, progesteron, estrogens and dehydroepiandrosteron have been reviewed.

Computerized tomography (CT) of the sella turcica was performed in 106 women with hypothalamic-hypophyseal-ovarian hypofunction, aged from 15 to 50 years. In each patient we evaluated tomographically hypophyseal volume and subarachnoid space cistern invaginated into the sella turcica. We analysed statistically the incidence of amenorrhea, infertility, obesity and arterial hypertension in five groups of patients classified according to hypophyseal volume i.e. from below 100 to over 400 mm3. Is was found that hypophyseal volume of women in the so-called empty sella turcica that could correlate significantly with obesity and arterial hypertension was up to about 200 mm3, and in case of amenorrhea and infertility below 100 mm3. In case of empty sella turcica in women with amenorrhea mean hypophyseal volume was significantly lower (about 194 mm3) than in menstruating women (about 248 mm3). Invagination of cisterns of the cerebral basis into the sella turcica equal to or exceeding three time hypophyseal volume in about 82% was associated with its small size i.e. below 150 mm3. Basing on our analysis it seem justified to assume that hypophyseal volume up to 150 mm3 is a CT criterion of diagnosing completely empty sella turcica.