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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: Evaluation of CCCT results and anti-Müllerian hormone (AMH) plasma levels in women with menstrual cycle irregularities and/or infertility., Patients and Methods: 70 patients with menstrual cycle disturbances were recruited to the study. Clomiphene citrate challenge test (CCCT) was carried out in each patient enrolled. At day 3 of the cycle plasma basic levels of FSH, estradiol, progesterone, IGFBP-1, TSH, prolactin, DHEAS and anti-Müllerian hormone were measured. At day 10 of the cycle plasma levels of FSH and estradiol were evaluated. Plasma levels of hormones were measured by commercially available ELISA kits., Results: 50 women with normal result of CCCT (group A) had higher mean plasma level of AMH compared to 20 women with abnormal result of CCCT (group B). Mean plasma FSH level at day 3 of the cycle was lower in group A compared to group B. There were no other statistically significant differences in mean values of assessed parameters between groups A and B. Taking into account all patients enrolled to the study AMH correlated significantly with patients' age and plasma levels of FSH at day 3 and day 10 of the cycle). Basic AMH plasma levels in group A correlated negatively with plasma levels of FSH at day 3 and day 10. In group B plasma levels of FSH at day 10 of the cycle also correlated with basic AMH plasma levels. Plasma levels of estradiol at day 10 of the cycle were related inversely with basic AMH plasma levels in group A, but directly in group B., Conclusion: It should be recommended to perform the CCCT before infertility treatment. Evaluation of the anti-Müllerian hormone plasma level reflects the results of the CCCT.

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.

Objective: Ovarian hormonal function may be as important contributing factor to hGH-IGF-I-IGFBP-3 axis as age., Aim: To examine plasma hGH, IGF-1 and IGFBP-3 levels in women with premature ovarian failure compared to healthy normal controls and postmenopausal ones., Patients: Group A-15 women with premature ovarian failure (POF) (mean: age 38.9+/-5.2 years, FSH 101.4+/-29.0 IU/l; 17beta-estradiol 22.5+/-14.6 ng/l). Group B consisted of 15 menopausal women (mean: age 54.7+/-2.7 years; FSH 81.9+/-32.1 IU/l; 17beta-estradiol 17.1+/- 8.0 ng/l). Group C - controls - 15 normally menstruating women (mean: age 37.1+/-9.0 years; FSH 6.2+/-1.0 IU/l; 17beta-estradiol 144.8+/-117.1 ng/l)., Methods: Body mass and BMI were measured. Basic fasting plasma hGH, IGF-I, IGFBP-3, insulin, testosterone and LH as well as prolactin (PRL), FSH and estradiol were assessed by RIA kits. Statistical analysis. Shapiro-Wilk test, Mann-Whitney u-test, Spearman rang correlation coefficient, stepwise multiple regression., Results: Mean serum IGF-I level was the lowest (p<0.005) in group B (172.0+/-54.6 microg/l) and the highest in group C (273.6+/-109.0 microg/l). The mean plasma IGF-I level in group A was similar (NS) (208.3+/-66.5 microg/l) to that found in group B and lower (p<0.02) compared with that in group C. The lowest (p<0.005) serum IGFBP-3 level was found in group B (3.1+/-0.7 microg/l) compared to group C (4.4+/-0.3 microg/l). The mean plasma IGFBP-3 level (3.1+/-1.0 microg/l) in group A was lower than in group C (p<0.005) but identical as in group B. No statistically significant differences between groups were observed in mean hGH levels. Women in group A and C were younger (p<0.001) than those in group B. The lowest mean estradiol level was found in groups A and B. The highest was in group C (p<0.001). Mean plasma LH and FSH levels were higher (p<0.001) in groups A and B vs group C. In group C there were links between IGF-I and age (r=-0.60; p=0.014) The IGF-I/age relation disappeared in the groups A and B (rA=-0.26; rB=0.10; NS). The same regards IGFBP-3/ age link (rA=-0.44, NS; rB=0,31;NS). Estradiol level was related to hGH levels in group C (r=-0.54; p<0.05). In none of groups hGH/IGF-1 as well as IGFBP-3/hGH relations were found. Prolactin accounted for 69% of the variance in IGF-I level in the group B (p=0.003) and for 24% in group A (NS). Testosterone accounted for 88% (p=0.004) of the variance in IGF-I level in group B and IGFBP-3 was responsible for 86% (p=0.038) of the variance in IGF-I level in group C. Again IGFBP-3 was responsible for 47% (p=0.023) in group A and for 49% (p=0.04) in group B of the hGH variance., Conclusions: 17b-estradiol may be as important contributor to insulin-like growth factor-I (IGF-I) plasma level as age in hypoestrogenic, hypogonadotropic women.

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.

Aim: As the link between body fat and leptin is well known, the aim of the study was to seek for secondary regulators of plasma leptin level., Patients: 86 women (mean: age 47.0+/-14.3 years; estradiol 50.0+/-60.6 ng/l; FSH 52.4+/-42.9 IU/l; BMI 26.9+/-5.9) divided into three groups according to their BMI. Group A: 39 normal weight women (mean: age 44.4+/-16.0 years; estradiol 69.6+/-79.8 ng/l; FSH 50.4+/-47.7 IU/l; BMI 22.9+/-1.3). Group B: 27 overweighted women (mean: age 55.0+/-6.4 years; estradiol 25.1+/-17.2 ng/l; FSH 75.6+/-26.3 IU/l; BMI 27.7+/-1.6). Group C: 21 obese women with mean: age 48.7+/-12.2 years; estradiol 36.9+/-44.0 ng/l; FSH 42.3+/-36.6 IU/l and BMI 34.6+/-4.9., Methods: Standard clinical evaluation and hormone evaluation (LH, FSH, prolactin, estradiol, leptin, insulin-like growth factor-I (IGF-I), human growth hormone (hGH), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, dihydroepiandrosterone sulphate (DHEAS), sex hormone binding globin (SHBG) and testosterone were done in basic condition which levels of were measured by RIA kits. Statistical analysis. Shapiro-Wilk test, Mann-Whitney-Wilcoxon u test, Spearman rank correlation coefficient and stepwise multiple regression: p values of 0.05 or less were considered as significant., Results: Taking all women into account (n=86) the plasma leptin level correlated directly with age (r=0.32; p<0.02), body mass (r=0.60; p<0.001), BMI (r=0.71; p<0.001) as well as inversely with estradiol (r=-0.21; p<0.05), IGF-I (r=-0.24; p<0.05), SHBG (r=-0.34; p<0.01) and DHEAS (r=-0.30; p<0.01). However only in the group B leptin/age relation remained (r=0.40; p<0.05) after the division according to BMI. In the group B the leptin /DHEAS (r=-0.40; p<0.05) and leptin/PRL (r=0.51; p<0.05) links were also present. In the group C the leptin/SHGB relation (r=-0.56; p<0.02) only remained and an association between insulin and leptin was found (r=0.48; p<0.05). The body mass and BMI relation to age were again present only in all 86 women (r=0.30; p<0.002: r=0.36; p<0.001 resp.). Having split the women into groups, these links either disappeared or became inverse (rC=-0.39; p<0.05). Taking into consideration age/leptin relation in all women, the division according to the menopausal status revealed the direct relation in premenopausal women (n=29; r=0.43; p<0.02) and a reverse one in postmenopausal women (n=38; r=-0.32; p<0.05). The plasma leptin level was the highest (p<0.001) in group C (23.2+/-10.4 microg/l) and the lowest was found in the group A (8.9+/-4.1 microg/l). That corresponded with the differences in mean body mass index and mean body mass. The stepwise multiple regression revealed that body mass index accounted for 31% (p<0.001) and plasma SHBG level accounted for 17.7% (p<0.02) of plasma leptin variance in all women. In the group A body mass and age together accounted for 61% (p<0.01) and estradiol alone accounted for 44% (p<0.02) of plasma leptin variance. In the group B insulin alone accounted for 39% (p<0.05) and together with testosterone accounted for 46% (p<0.05) of plasma leptin variance. Finally in obese women none of the evaluated parameters significantly accounted for leptin variance., Conclusion: The results presented in this paper confirmed the strong influence of body fat mass on serum leptin concentration. However insulin, SHBG, sex steroids as well as age may also exert secondary influence on plasma leptin level in certain groups of women.

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.

The aim of the present study was to investigate direct effects of estrogen (E2) or progesterone (P4) given separately vs. estrogen+progesterone on local IGF-I, IGFBP-3 and IGFBP-2 secretion. Explants obtained from estrogen receptor positive plus progesterone receptor positive (ER+/PR+) and hormone receptors negative (ER-/PR-) tumors were incubated with E2, P4 or both. Tamoxifen was added to E2-exposed cultures; mifepristone (RU 486) was added to P4, and both were given to E2+P4-supplemented cultures. In hormone-dependent and hormone-independent tissues, treatment with estrogen+progesterone increased IGF-I and IGFBP-2 secretion with concomitant decrease in IGFBP-3, in the same manner as E2 or P4 given alone. Tamoxifen decreased the E2- and E2+P4-stimulated IGF-I secretion by hormone-dependent breast cancer explants. RU 486 decreased the P4- and E2+P4-stimulated IGF-I secretion with parallel stimulation of IGFBP-3 secretion by ER+/PR+ explants. Estradiol and progesterone had a synergistic action on IGFBP-2 secretion by hormone-dependent breast cancer explants. In conclusion, the presented data suggest that there is no synergistic action of E2 and P4 in influencing IGF/IGFBPs ratio and, additionally, suggest a protective action of antiestrogen and antiprogestagen against excessive IGF-I secretion.

Background: Increased incidence of cardiovascular diseases frequently reported in postmenopausal women may follow disturbed activity of cardiac autonomic nervous system (cANS). Our purpose was to evaluate the influence of continuous combined hormonal replacement therapy (ccHRT) on cANS reflected by parameters of heart rate variability (HRV)., Method: Thirty four healthy postmenopausal women aged 56+/-6 years (7+/-4 years after last menorrhoea) were divided into 2 equal groups--women receiving ccHRT (serum estradiol--81+/-75 ng/l, FSH--45+/-27 IU/l) and control group (serum estradiol--31+/-45 ng/l, FSH--74+/-32 IU/l). The ccHRT women have been receiving daily 50 mg of 17beta-estradiol (Oesclim 50, Fournier) in transcutaneous depot and 5 mg of oral progesterone (Duphaston, Solway Pharma) for recent 1.4+/-0.6 years. All recordings began at 8.00 a.m. and were carried out in supine position and resting conditions (room temperature 24 degrees C). The protocol applied consisted of 5 min. of resting ECG recording, 5 min. of deep breathing (DB) test, 6 min of sham feeding (SF) and 5 min. of ECG recording after SF., Results: Analysis of the resting HRV didn't reveal any significant differences between the compared groups. In the control group during DB increases of mean LF (455+/-500 vs. 1381+/-1540; p<0.001) and LF/HF (1.5+/-1.1 vs. 5.4+/-4.3; p=0.002) ratio were observed. No influence of SF on HRV was noticed in this group. In the ccHRT women significant increases of mean LF (189+/-125 vs. 728+/-929; p=0.02) and LF/HF ratio (3.1+/-4.8 vs. 9+/-7.3; p=0.002) were observed during DB. SF revealed significant increases of mean RR (841+/-92 vs. 918+/-82; p<0.001), SDNN (35+/-14 vs. 43+/-20; p=0.02), LF (189+/-125 vs. 372+/-434; p=0.03) and HF (150+/-133 vs. 300+/-332; p=0.01)., Conclusions: Our results revealed increased reactivity of the HRV parameters to vagal stimulation by DB and SF in the postmenopausal women receiving ccHRT that suggests increased activity of cANS in the analysed group. Application of ccHRT restores the premenopausal reactivity of cANS.

Objectives: Insulin-like growth factor-I (IGF-I) is regarded as one of mammary tissue proliferative factors. Insulin-like growth factor binding protein-3 (IGFBP-3) limits the IGF-I binding potential to its receptor. That limits the IGF-I bioavailability. Recently experimental studies indicated that insulin-like growth factor binding proteins (IGFBPs) might have their own biological actions beyond their ability to regulate insulin-like growth factors (IGFs). Our earlier results showed the progesterone-induced rise in hGH and IGF secretion by human breast cancer explants., Aim: To determine the ability of progesterone to stimulate simultaneous local IGF-I and IGFBP-3 secretion by non-malignant and malignant mammary tissue collected from different receptor phenotype tumours., Material and Methods: Explants from the tumour and surrounding normal non-malignant tissue were obtained during surging. Breast cancer explants were defined as: ER+ PR+; ER-PR-; ER+ PR-; and ER-PR+. Part of the explants was fixed in 10% buffered formalin for steroid receptor determination by immunohistochemistry. Other parts were cut into small pieces, weight and cultured in Parker medium (M199) supplemented with 5% of calf serum at 37 degrees C in an atmosphere containing 5% CO2 for 48 hours in control medium or with the addition of progesterone (10-7 M). Later media were collected for IGF-I and IGFBP-3 concentration analysis., Results: Progesterone increased (p < 0.01) IGFBP-3/IGF-I index in ER(-)PR(-) non-malignant tissue and decreased the IGFBP-3/IGF-I index in ER(-)PR(+), ER(+)PR(-) non-malignant explants. That increased the IGF-I bioavailability. Breast malignant explants showed the progesterone induced IGFBP-3/IGF-I index decrease. The decrease was most evident (p < 0.01) in malignant explants expressing progesterone receptor., Conclusion: Progesterone increased local IGF-I bioavailability in malignant breast tissue. That phenomenon depended on steroid receptor phenotype of breast tissue and was most evident in tissue expressing progesterone receptor. In non-malignant tissue that phenomenon was also found in estrogen receptor expressing tissue. Lack of steroid receptor expression in breast explants reversed that phenomenon.

Objective: The aim was to compare the direct effect of most toxic 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as well as of naturally occurring congener mixture of polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) extracted from fly ash on the placental steroidogenesis. The concentration of all 17 toxic congeners was reported and the toxic equivalent (TEQ) was calculated as a 27.7 micrograms-TEQ/kg of fly ash., Methods: Placental cotyledons were harvested immediately after expulsion of placenta. The cells were prepared according to KLIMAN et al. (1986). To examine TCDD and PCDDs/PCDFs mixture action on cytochrome P450 side change cleavage enzyme (P450 scc) and 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD) activity the placental cells were cultured either in basal conditions or with the addition of 25-hydroxycholesterol (25-OH) or pregnenolone (P5)., Results: TCDD in all doses used decreased basal P4 secretion, while did not show any effect on 25-hydroxycholesterol (25-OH) and pregnenolone (P5) supplemented cultures. In all variants of culture PCDDs/PCDFs mixture was without effect on basal and substrate supplemented progesterone (P4) secretion suggesting a reduction in the activity of cytochrome P450scc or 3 beta-HSD. To examine TCDD and PCDDs/PCDFs mixture action on aromatase cytochrom P450 (P450 arom) activity the placental cells were cultured in basal condition or with the addition of dehydroepi-androsterone (DHEA) or testosterone (T). Significant increase of estradiol secretion under the influence of TCDD in DHEA and T supplemented cultures suggests its action on the activity of P450 arom., Conclusion: The discrepancy found between the action of pure TCDD and dioxin mixture on placental steroids secretion is possibly due to an additional effect of pentachlorodibenzo-p-dioxin (PeCDD) and pentachlorodibenzo-furan (PeCDF) which covered > 50% of the total toxic equivalents (TEQ) present in this mixture.

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.

On the basis of our clinical experience and literary data there were presented views on etiopathogeny of decidual transformations of the uterine cervix. Localization and colposcopic pictures of these lesions were discussed, and according to our clinical data discrimination between four forms of decidual ectopy was carried out. The vessel pattern of these changes, visible in colposcopic picture was characterized as well as its differentiation from vascular picture of malignant lesions. Possibility of cytological diagnosis in cases of decidual ectopy was also noted. On the basis of many years clinical experience there was showed the importance of colposcopic diagnosis of decidual ectopy in evaluation of early pregnancy and its complications.