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ABSTRACT: INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the results of conservative treatment of urodynamic stress urinary incontinence (SUI) using transvaginal electrical stimulation with surface-electromyography-assisted biofeedback (TVES + sEMG) in women of premenopausal age. METHODS: One hundred and two patients with SUI were divided into two groups: active (n = 68) and placebo (n = 34) TVES + sEMG. The treatment lasted for 8 weeks and consisted of two sessions per day. Women were evaluated before and after the intervention by pad test, voiding diary, urodynamic test, and the Incontinence Quality of Life Questionnaire (I-QOL). RESULTS: Mean urinary leakage on a standard pad test at the end of 8th week was significantly lower in the active than the placebo group (19.5 ± 13.6 vs. 39.8 ± 28.5). Mean urinary leakage on a 24-h pad test was significantly reduced in the active group at the end of 8th and 16th weeks compared with the placebo group (8.2 ± 14.8 vs. 14.6 ± 18.9 and 6.1 ± 11.4 vs. 18.2 ± 20.8, respectively). There was also a significant improvement in muscle strength as measured by the Oxford scale in the active vs the placebo group after 8 and 16 weeks (4.2 vs 2.6 and 4.1 vs 2.7, respectively). No significant difference was found between groups in urodynamic data before and after treatment. At the end of 8th week, the mean I-QOL score in the active vs the placebo group was 78.2 ± 17.9 vs 55.9 ± 14.2, respectively, and at the end of 16th week 80.8 ± 24.1 vs. 50.6 ± 14.9, respectively. CONCLUSION: Our study showed that TVES + sEMG is a trustworthy method of treatment in premenopausal women with SUI; however, its reliability needs to be established.
International Urogynecology Journal 02/2013; · 1.83 Impact Factor
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Polish Journal of Surgery 08/2012; 84(8):426-8.
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ABSTRACT: The aim of the study was to evaluate the expression of tumor necrosis factors -alpha and beta (TNF), their receptor and content in human uterine leiomyomas at various stages of tumor growth.
Studies were performed on human myometrium and uterine leiomyomas of various weights (small: less than 10 g and large: more than 100 g). Presence of both growth factors and their receptor was detected by Western Immunoblotting technique. The content of TNF-alpha was evaluated by immunoenzymatic method (ELISA).
Changes in the expression of tumor necrosis factors and their receptor and difference in content of TNF-alpha during the tumor growth were found.
Myometrium conversion into leiomyoma and an increase in its mass is accompanied by changes in the expression and contents TNF and TNF RI.
Ginekologia polska 06/2010; 81(6):431-4. · 0.41 Impact Factor
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ABSTRACT: Angiogenesis is of crucial importance for endometrial tumor growth and Vascular Endothelial Growth Factor (VEGF) is the key mediator of angiogenesis.
The purpose of our study was to assess the prognostic value of VEGF and its receptors in relation to endometrioid endometrial carcinomas.
In this study we conducted an immunohistochemical evaluation of VEGF and VEGFRs expression in 84 tissue samples obtained from endometrioid endometrial cancer patients undergoing curative surgical treatment.
Out of 84 cancers, strong positive expression of VEGF was seen in 35 (42%) tumors. The overall strong positive rates were 33% for VEGFR-1 and for 15% for VEGFR-2. There was a significant correlation between clinical stage and VEGF and VEGFR-1 overexpression (p=0.027 and p=0.004, respectively). Additionally there was a significant correlation between histological grade and VEGF and VEGFR-1 overexpression (p<0.001 and p<0.01, respectively). The 5-year DFS of patients with VEGF and VEGFR-1 overexpression was significantly lower than that of those with a weakly positive or negative tumor (p<0.001).
Immunohistochemical evaluation of VEGF and VEGFR-1 overexpression may be a useful marker for predicting 5-year DFS in endometrioid endometrial cancer.
Ginekologia polska 06/2010; 81(6):422-5. · 0.41 Impact Factor
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ABSTRACT: The significance of circulating levels of TNF-alpha and its soluble receptors (sTNF-Rs) in the plasma of patients with epithelial ovarian cancer (EOC) has not been fully elucidated. The present study was to investigate the relationship of pretreatment plasma levels of TNF-alpha, sTNFR-1 and sTNFR-2 with outcome in 126 patients with EOC. Concentrations of TNF-alpha and sTNF-Rs were determined by enzyme-linked immunosorbent assay (ELISA). Median TNF-alpha and sTNF-Rs levels were significantly higher in EOC patients than in healthy controls. High plasma levels of TNF-alpha and sTNF-Rs were correlated with tumor stage and with reduced mean survival time (MST). The results of the present study suggested that preoperative plasma TNF-alpha and sTNF-Rs levels in EOC patients correlated with the highest risk of cancer progression. Thus, the clinical value of an activated TNF system in EOC needs to be further investigated.
European cytokine network. 09/2009; 20(3):131-4.
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ABSTRACT: The aim of the present study was to characterize the expression pattern of tumor necrosis factor (TNF)-alpha and its receptors (TNF-Rs) in the epithelial ovarian cancer (EOC) and compare these results with the outcome of 126 patients. Presence of TNF-alpha, TNFR-1 and TNFR-2 were studied by Western blotting and immunohistochemistry. The proportion of samples positive for TNF-alpha and TNF-R2 was higher in epithelial ovarian cancer patients than in benign ovarian diseases (p<0.001 and p=0.016, respectively). Immunostaining intensity of TNF-R2 were correlated with tumor stage (p<0.001) and with reduced mean survival time (MST) (p=0.002). The results of the present study suggested that tissue expression of TNF-R2 in epithelial ovarian cancer was correlated with the highest risk of cancer progression. Thus, the clinical value of activated TNF system in epithelial ovarian cancer needs to be further investigated.
Folia Histochemica et Cytobiologica 01/2009; 47(4):609-13. · 0.81 Impact Factor
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ABSTRACT: Gestational Diabetes Mellitus (GDM) comprises different forms of glucose metabolism disturbances with first recognition during pregnancy. There are a number of publications that have suggested that diabetes with onset during pregnancy is not a monogeneous disease and apart from "classical" form of GDM, which precedes type 2 diabetes development, MODY 2 diabetes, caused by monogenic defect of glucokinase gene, is relatively frequent "subtype" of gestational diabetes. The aim of our study was to estimate the risk of diabetes mellitus development, including MODY 2 diabetes, between 6 months - 10 years after delivery in 225 women with gestational diabetes. Gucokinase gene mutations and polymorphisms were performed by direct sequencing of DNA. In the present study it was shown that the frequency of glucokinase gene mutation is 6.7% in the Polish population of gestational diabetic women and 17.8% of new onset or persistant diabetes recognised during 5 years after pregnancy could be a result of this mutation. We have also observed that risk of type 2 diabetes development is about 50% in the next 5 years after delivery in women with gestational diabetes and is associated with higher levels of BMI during or after delivery and with clinical and biochemical features of insulin resistance (high values of WHR abd HOMA-R). Moreover, our study suggests that c.1253+8 C-->T polymorphism in intron 9 of glucokinase gene could have a role in predisposition to type 2 diabetes in women with gestational diabetes. In summary, our results suggest that, because of high costs and time-consuming methods of genetic studies, the investigations of glucokinase gene mutations should be concentrated in women with gestational diabetes without clinical and biochemical features of insulin resistance, but with family history of diabetes in two generations.
Przegla̧d lekarski 02/2007; 64(6):401-5.
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ABSTRACT: Tumor necrosis factor-alpha (TNF-alpha) system is potentially involved in the development of insulin resistance during pregnancy. Plasma concentrations of TNF-alpha and its soluble receptors sTNFR-1 and sTNFR-2 were measured in 80 patients with gestational diabetes (GDM) (mean age 29.0 +/- 4.9 years) and 30 pregnant women with normal glucose tolerance (NGT) (mean age 28.2 +/- 6.0 years). We found that patients with GDM had significantly higher levels of TNF-alpha in comparison to NGT women (1.71+/- 0.92 vs. 1.27 +/- 0.42 pg/ml, p = 0.0175). The differences remained statistically significant after adjusting for BMI (p = 0.027). Plasma levels of sTNFR-1 and sTNFR-2 were only slightly higher in patients with GDM (2.83 +/- 0.79 ng/ml vs. 2.55 +/- 0.99 ng/ ml, p = 0.057 and 7.46 +/- 2.21 ng/ml vs. 6.83 +/- 1.46 ng/ml, p=0.206, respectively). In the group with GDM TNF-alpha concentrations correlated with sTNFR-1 (r = 0.444, p = 0.00008), sTNFR-2 (r = 0.364, p = 0.0016) and with C-peptide concentrations (r = 0.318, p = 0.016), whereas in women with NGT - only with triglyceride levels (r = 0.50, p = 0.024). Multivariate linear regression analysis revealed that early pregnancy BMI was the most predictive indicator of TNF-alpha concentrations in GDM women (p=0.008). In NTG group triglyceride concentrations, as well as BMI in early pregnancy and at the time of sampling were significant predictors, explaining together 62% of the variance in TNF-alpha concentration. In conclusion, increased TNF-alpha concentrations in women with GDM class G1 indicates its contribution to the development of insulin resistance during pregnancy, but the lack of the differences in sTNFR concentrations between the groups studied suggests only moderate TNF-alpha system activation in relatively slim patients treated with diet.
Przegla̧d lekarski 02/2006; 63(4):173-5.
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ABSTRACT: Type 1 diabetes is believed to be a Th1 lymphocyte-mediated disease, and both environmental and genetic factors play a role in its pathogenesis. It was recently found that interleukin (IL)-18 acts as a proinflammatory cytokine and, in synergy with IL-12, promotes development of Th1 lymphocyte response by induction of gamma-interferon production. The aim of our study was to evaluate the frequency of known polymorphisms in the IL-18 promoter in patients with type 1 diabetes in comparison with healthy control subjects, since higher levels of IL-18 were recently reported in the subclinical stage of type 1 diabetes. We studied two recently described single-nucleotide polymorphisms of the promoter of IL-18 gene at the position -137 and -607, which have been suggested to cause differences in transcription factor binding and have an impact on IL-18 gene activity. The genotype distribution differed significantly between patients with type 1 diabetes and control subjects. The difference reflected an increase in the GC genotypes and a decrease in GG genotypes at position -137 in the promoter of IL-18 gene. AA genotype at position -607 was found only in the control group. The results also demonstrated that the contribution of -137GC genotypes to genetic susceptibility to type 1 diabetes differs depending on the combination of IL-18 promotor gene haplotypes. Our study suggests the first evidence of an association between type 1 diabetes and polymorphisms in the promoter of IL-18 gene.
Diabetes 12/2002; 51(11):3347-9. · 8.29 Impact Factor
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Polskie archiwum medycyny wewnȩtrznej 08/2002; 108(1):687-93. · 1.37 Impact Factor
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ABSTRACT: Amylin (Islet Amyloid Pancreatic Polypeptide - IAPP) is a hormone cosecreted with insulin by pancreatic beta cells in a pulsatile pattern. Recent reports point to its essential part in glucose homeostasis. Postpartum evaluation of IAPP release in Gestational Diabetes Mellitus (GDM) patients was performed. Our data were compared to insulin and peptide-C secretion patterns. We were not able to demonstrate a dynamic increase of IAPP in response to glucagon stimuli. However, related to GDM, puerperal IAPP levels were significantly higher than in normal controls. Lack of postpartum amylin response to glucagon stimulation might be interpreted as a primary result of previously reported increases in circulatory levels of IAPP during pregnancy complicated by GDM. Post partum elevated IAPP may be a useful marker to identify patients with high risk of type 2 diabetes mellitus.
Medycyna wieku rozwojowego 6(1):75-80.
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ABSTRACT: Leptin is a protein hormone mainly produced by the adipocytes. Apart from its autocrine role within the placenta in humans, plasma circulating leptin contributes to the endocrine function. Leptin levels may serve as an index of metabolic and energy balance in pregnancy. Recent reports have shown a positive correlation between leptin concentrations and plasma levels of glycated haemoglobin (HbA(1c)) in patients with gestational diabetes mellitus (GDM).
The aim of the present study was to evaluate leptin levels after delivery in GDM and normal glucose tolerance (NGT) women.
Plasma leptin concentration and insulin, c-peptide and glycated haemoglobin were measured in both. NGT women and in patients with a history of GDM in all patients total LDL - and HDL cholesterol concentrations were estimated. We also calculated the anthropometric parameters of the mother and birth weight in both groups.
The plasma leptin concentration after delivery was not different in patients with GDM in comparison with the NGT individuals.
We concluded that in patients with GDM and normal BM1 the postpartum leptin level was not different in comparison with the NGT patients.
Medycyna wieku rozwojowego 8(3 Pt 2):703-10.
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ABSTRACT: Interdisciplinary team work and recommendations of diabetologist and obstetrician is the condition of success of antenatal care and consequently perinatal outcome in pregnancy complicated by diabetes. Careful insight into the metabolic, haemodynamic and vascular disturbances is the basic of contemporary surveillance in diabetic pregnancy. The authors emphasise that a diabetic pregnant woman must not only pay attention to adequate nutrition and balanced exercise, but also be aware of and cope with characteristic, momentary swings in glycemia in order to overcome them by appropriate insulin therapy. Continuous supervision for several other complications associated with diabetic pregnancy, viz. hypertension, retinopathy, thyroid dysfunction, nephropathy and the threat of in utero foetal death is justified. Briefly, rigorous measures to sustain normoglycemia and normal blood pressure, examination of the retina, thyroid and renal functions as well as foetal status evaluation are paramount in appropriate management of major common diabetic complications in pregnancy.
Medycyna wieku rozwojowego 8(3 Pt 2):691-701.
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ABSTRACT: This paper is a review of recent reports on autoimmune aspects of gestational diabetes mellitus (GDM). In a subgroup of GDM patients distinct phenotypic and genotypic features could be distinguished. Islet autoantibodies with variable frequency are present in samples of sera taken from women with GDM. Beta-cell destruction may follow different time course patterns. For this reasons GDM patients may develop variable forms of autoimmune DM. We believe that women who experienced autoimmune GDM are at risk of type l DM and simultaneously, they are candidates for possible immunomodulatory preventive therapy in the future.
Medycyna wieku rozwojowego 8(3 Pt 2):711-8.
