Giant recurrent perineal endometriosis in an episiotomy scar--a case report.

The occurrence of perineal endometriotic lesions can be explained by mechanical dissemination and transplantation of endometrial cells. Viable decidual endometrial cells are likely to be transplanted into the episiotomy wounds or perineal tears during normal vaginal delivery and subsequent growth may occur A case of a 33-year old woman with a medical history of recurrent perineal endometriosis was described. An endometriotic giant mass (8 centimeter in diameter) was wide-excised, together with the episiotomy scar.

Patterns of infertility in Poland - multicenter study.

Objective: Infertility seems to be a great worldwide problem. Many publications present the epidemiology of infertility, but the percentage distribution of factors responsible for infertility varies significantly. The objective was to define infertility profiles in Poland assessed according to the information provided by 4 large infertility centers: Bialystok, Poznan, Szczecin and Warsaw.

Is mid-gestational cervical length measurement as sensitive prediction factor of preterm delivery in IVF as in spontaneous singleton pregnancies?

Objectives: To verify the relation between pregnancy duration and cervical length (CL) at 22-24 wks of spontaneous and IVF singleton gestations and to assess its predictive value for preterm delivery (< 37 wks).

Material & Methods: CL at 22-24 wks was performed according to FMF recommendations in 344 women who conceived spontaneously and in 107 IVF singleton pregnancies. The results of CL in both groups were divided into subgroups: ≤ 29 mm, 30-34 mm; 35-39 mm; 40-44 mm; 45-49 mm and ≥ 50 mm.

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency - management in adults.

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of the adrenal glands by adrenocorticotropic hormone (ACTH), adrenal hyperplasia, and excessive androgen synthesis. The syndrome is characterised by a considerable correlation between the genotype and the phenotype with the type of CYP21A2 gene mutation affecting the severity of 21-hydroxylase deficiency.

[Congenital adrenal hyperplasia due to 21-hydroxylase deficiency--management in adults].

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive hereditary diseases. The impairment of cortisol synthesis leads to excessive stimulation of the adrenal glands by adrenocorticotropic hormone (ACTH), adrenal hyperplasia, and excessive androgen synthesis. The syndrome is characterised by a considerable correlation between the genotype and the phenotype with the type of CYP21A2 gene mutation affecting the severity of 21-hydroxylase deficiency.

Pregnancy after organ transplantation.

Ovarian function with regular menstrual cycles is usually restored in women of reproductive age after solid organ transplantation. The number of pregnancies reported in these patients increases gradually. Pregnancy is always considered high risk, and not properly planned may lead to serious complications.

Gynecological issues after organ transplantation.

Organ transplantation has become universally accepted treatment of end-stage organ failure. The main problem focuses on preventing the graft from rejection with the use of immunosuppressive agents. High incidence of infection is the most frequent adverse effect of immunosuppressive therapy.

[Peripartum cardiomyopathy and preeclampsia complicated with HELLP syndrome--a case report].

Peripartum cardiomyopathy (PC) and preeclampsia with HELLP syndrome are serious complications of pregnancy, but the coincidence of both in one pregnancy is extremely rare. Here, we report a case of 32-year-old primipara who in 35th Hbd presented for the first time in her life symptoms of severe heart failure (HF) in NYHA class III/IV. In 37th Hbd the diagnosis of PC was established based on clinical status and echocardiographic examination, which demonstrated a dilatation of heart chambers and impaired left ventricular systolic function with decreased ejection fraction (EF) 17%.

Cancer of the urinary bladder neovagina in a patient with Morris' syndrome.

Background: Vaginal agenesis is a rare condition, therefore the incidence of a malignant transformation in the neovagina is extremely low.

Case Report: We report on a 42-year-old patient with Morris' syndrome and urinary bladder neovagina with a history of prolonged infections of the urinary bladder and intertrigo of the perineal region. The biopsy revealed a squamous cell carcinoma arising from the neovagina.

[The preliminary evaluation of surgical treatment of pelvic organ prolapse with polypropylene mesh by double transobturator approch technique (double TOT)].

Objectives: The aim of this study was to evaluate preliminary results of a new, simple surgical technique with the use of polypropylene mesh (double TOT) used for the treatment of cystocele associated / not associated with urinary incontinence in females.

Material And Methods: 19 women, aged 49-76, BMI 24-40, with cystocele associated or not with urinary incontinence, were operated on at the 1st Department of Obstetrics and Gynaecology in Warsaw, using double TOT technique. In this technique, described by Theobald, the trapezoidal polypropylene four-arm vaginal mesh is inserted through the obturator foramens from the outside to the inside and is positioned without tension under the urethra.

Clinical, hormonal and sonographic features of the identical twins with Klinefelter syndrome--a case report.

A rare case of Klinefelter syndrome in identical twins is reported. Hormonal levels before and after hCG administration and testicular artery Doppler flow measurements are presented.

Effects of free fatty acids on the course of gestational diabetes mellitus.

Aim Of The Study: The investigation of the influence of maternal serum free fatty acids (FFA) levels on the course of gestational diabetes mellitus (GDM).

Material And Methods: On the basis of GDM diagnosis 52 diabetic and 39 non-diabetic pregnant women were recruited to the study. Treatment modalities for diabetic group included diet alone (GDM1; n-36) or a combination of insulin and diet (GDM2; n-16).

Molecular analysis of defects in the CFTR gene and AZF locus of the Y chromosome in male infertility.

Objective: To investigate the frequency and potential impact of mutations and polymorphisms in the CFTR gene and deletions in AZF locus of the Y chromosome in patients with azoospermia (AZOO), cryptozoospermia (CRYPTO) or oligoasthenoteratozoospermia (OAT) who were to be included in an assisted reproductive technologies (ART) program.

Study Design: A total of 188 infertile men were enrolled in the study: 100 patients with AZOO, 38 with CRYPTO and 50 with OAT.

Results: The CFTR gene mutations or IVS8-5T variant in at least 1 allele was identified with similar frequencies among the AZOO (33%) and CRYPTO (21%) patients; 55% of the AZOO patients with normal spermatogenesis (NS) had mutations in 1 or 2 alleles.

[Heterotopic pregnancy].

We report a case of combined intrauterine and extrauterine (tubal) pregnancy in 24-year-old woman. The patient was admitted to the Clinic at 9 weeks gestational age with abdominal pain lasting 2 hours. Pelvic ultrasonography revealed alive 9-week intrauterine pregnancy, free fluid in the peritoneal cavity and left adnexal mass.

[HELLP syndrome in the postpartum period].

The HELLP syndrome was described by Weinstein as a complication of pregnancy induced hypertension (PIH). There are few clinical reports about HELLP during postpartum period. We present the history of 31 years old pregnant patient, who developed in 36 week of her first pregnancy PIH, pregnancy was terminated in 39 week by cesarean section and postpartum period was complicated with HELLP syndrome (class I).

Multiple neoplastic lesions of the lower genital tract in a human papilloma virus-infected kidney-pancreas allograft recipient: a case report.

States of immunodeficiency are associated with an increased rate of certain cancers. Immunosuppressed allograft recipients are at high risk of Human Papilloma Virus (HPV)-related de novo malignancies. A female pancreas plus kidney transplant patient developed multiple genital malignancies within 6 years.

Immunoexpression of androgen receptors and aromatase in testes of patient with Klinefelter's syndrome.

Klinefelter's syndrome (47, XXY) is the most common chromosome aneuploidy in men and is usually characterized by underdeveloped testes and sterility. The aim of the present study was to detect cellular distribution of androgen receptors (AR) and aromatase in testes of patient with KS. The tissue sections were processed for morphological and immunohistochemical staining.

The naloxone test in Klinefelter syndrome.

Unlabelled: AIM TO THE STUDY: The investigation of the influence of anti-opioid drug on hypophyseal and gonadal hormones secretion in case of Klinefelter syndrome.

Material And Methods: The naloxone test (0,4 mg iv) was performed in 14 patients with Klinefelter syndrome aged from 19 to 32 and in 12 age matched control subjects with azoospermia and normal spermatogenesis in testicular histology. The plasma levels of FSH, LH, prolactin, testosterone and estradiol were established before and after 30, 60, 60 and 120 minutes respectively, following the drug administration.

[Use of misoprostol in the termination of missed abortion].

The efficiency of misoprostol in the termination of missed abortion was estimated. The group of 66 patients aged 19 - 37, who received 400 microg of vaginal misoprostol for termination of missed abortion was subjected. The overall success rate for a complete abortion was 30.

[Protocol of GNRH antagonist in poor responders in IVF-ET cycles].

Introduction: Response to stimulation is one of the factors that affect the results of infertility treatment in IVF-ET cycles. Poor responders as well as the occurrence of ovulation prior to the oocyte retrieval is a main reason of nearly 30% of cancellations of the treatment cycles. In poor responders high doses of gonadotrophins are sometimes required.

Proteasome localization and ultrastructure of spermatozoa from patients with varicocele--immunoelectron microscopic study.

Localization of proteasomes in spermatozoa from patients with varicocele-associated sterility was studied by means of immunolabeling with the MPC21 monoclonal antibody detecting the C3 subunit of the 20S proteasome. The reaction was visualized for electron microscopy using the secondary Nano-Gold-coupled antibody with Gold-Enhancement in pre-embedding technique. We found that semen samples from varicocele patients contained a large amount of abnormal spermatozoa characterized by the presence of dispersed chromatin and large residual bodies (cytoplasmic droplets) as well as spermatids at various stages of spermiogenesis.

[Testicular artery Doppler flow evaluation in men with degenerative changes of seminiferous tubules].

Aim: The aim of this study was to assess the eventual impact of degenerative changes of seminiferous tubules on Doppler flow parameters in testicular vessels.

Material And Methods: There were 12 men with degenerative changes of seminiferous tubules (diagnosed by testicular biopsy) in study group and 24 healthy men with normal semen parameters in control group. Patients' age in both groups was respectively 32.

[Computer-assisted analysis of cardiotocographic recordings in the course of fetal hemolytic disease].

Objectives: The aim of this study was to assess the usefulness of computerized cardiotocography in the diagnostics of fetal hemolytic disease.

Study Design: 50 invasive diagnostic and therapeutic procedures proceeded by computer assisted CTG recording were analysed. The values of particular parameters of CTG were compared with adequate values obtained in uncomplicated pregnancy.

[Doppler flowmetry measurements in testicular artery of aging men].

Aim: Testicular artery Doppler flow measurements in aging males were performed for the evaluation of eventual disorders of vascular flow in vessels supplying the testes.

Material And Methods: 40 men aged between 51 and 80 years (studied group) and 40 healthy men aged below 40 (control group) were examined. The volume of testes and qualitative flow indices (S: D, PI, RI) in terminal section of testicular artery were measured.

[The naloxone test in patients with varicocele].

Aim: Is there any influence of naloxone administration on plasma levels of hypophyseal and gonadal hormones in varicocele patients?

Material And Methods: The naloxone test (0.4 mg i.v.