No 3 (2015)

Objective: to determine the level of placental apoptosis and antioxidant defense enzyme genes (glutathione peroxidase (GPX1) and glutathione reductase (GSR)) expression in preeclampsia. Subjects and methods. The investigation included 31 patients. All the patients were divided into 2 groups: 1) 11 pregnant women with preeclampsia (a study group); 2) 20 healthy individuals (a comparison group). The gene expression was studied by a qPCR assay and apoptosis was evaluated by the TUNEL method in the placenta. Results. In preeclampsia, the placental expression of glutathione reductase and GPX1 was ascertained to be increased in 100 and 40% of cases, respectively. In the preeclamptic patients, the level of placental apoptosis was also found to be considerably higher than that in apparently healthy individuals and in some cases stem villi were destroyed due to programmed cell death in the villous stroma and syncyotiotrophoblast. Conclusion. GPX1 and GSD gene expression increases in the placenta of preeclamptic patients. Oxidative stress gives rise to the higher level of apoptosis in the placental villi. Not only trophoblast cells, but also, in some cases, villous stromal cells may undergo apoptosis.

Objective. To search for molecular genetic markers that can predict ovarian response during superovulation and the patterns of oogenesis and embryogenesis in assisted reproductive technology (ART) programs. Subjects and methods. One hundred and sixty patients referred to in vitro fertilization programs were examined during a prospective case-control study. A study group consisted of 80 patients with normal response to ovarian stimulation; Group 1 included 40 patients with poor ovarian response; Group 2 comprised 40 patients with ovarian hyper-response. Gene polymorphisms were determined by polymerase chain reaction and melting curve analysis. Results. The carriage of the G/G genotype of FSHR gene polymorphism 2039 G>A (Ser680Asn) predisposes to ovarian hyper-response (OR = 3.49 (95% CI = 1.3-11.6); р =0.021). The G/G genotype of LHCGR gene polymorphism 939A>G (Asn312Ser) and the C/C genotype of VEGFA gene polymorphism - 634 G>C increase the risk of obtaining only immature oocytes (OR = 3.41 (95% Cl = 1.05-11.1); р = 0.039 and OR = 4.09 (95% CI = 1.3-11.71); р = 0.040, respectively)). When these two poor genotypes are combined, the probability of obtaining mature oocytes was 62.5% whereas that for other genotypic combinations was 93.4% (OR = 0.12 (95% CI = 0.03- 0.52); р = 0.019). The carriage of the A/A genotype of AMHR2 gene polymorphism - 482 A>G increases the risk of obtaining immature oocytes by more than twice (OR = 2.23 (95% CI = 1.1-4.3); р = 0.025). According to the autosomal dominant model, the carriage of the G allele of ESR1 gene polymorphism -351 A>G [XBaI] increases the risk of obtaining Class C embryos (poor quality) by more than twice (OR = 2.3 (95% CI = 1.1-4.6); р = 0.022). Conclusion. The polymorphism of the FSHR 2039G>A (Ser680Asn), LHCGR 935A>G (Asn312Ser), VEGFA - 634G>C, AMHR2 - 482 A>G, ESR1 -351A>G [XBaI] genes is an independent factor that can predict the outcome of superovulation and the quality of oocytes and embryos in ART programs and supplement the arsenal of already existing markers.

Objective. To def ine the role of estradiol (nuclear α and β, membrane mER) and progesterone (nuclear α and β, membrane mPR and PGRmCl) receptor gene expression in the occurrence and development of endometrial polyps in pre- and postmenopausal patients to decide which treatment options to be performed. Subjects and methods. A total of 87 patients (29 in premenopause and 58 in postmenopause), including 54 with endometrial fibroglandular polyps (EFGPs) and 21 with endometrial glandular polyps (EGPs), and 12 with endometrial adenomatous polyps (EAPs) were examined. The polyp tissue expression of mER, ER α, ER β, mPR, PGRmC1, PR-А, PR-В was determined by a PCR assay. Results. The patients with EGPs showed the higher polyp tissue expression of ER α, ER β, mPR, and PGRmC1 in premenopause and that of PR-A in postmenopause than did those with EFGPs. The patients with EAPs were found to have signs of dedifferentiation: the lower polyp tissue expression of mER and ER α in premenopause than that in the patients with EFGPs and the higher expression of ER α and ER β in postmenopause than that in the patients with EFGPs. Conclusion. The steroid receptor transcriptome in the tissue of EFGPs, EGPs, and EAPs differs and depends on a woman’s life period. In this connection, we consider it promising to use the data on steroid hormone receptor expression to elaborate individual antirecurrent therapy regimens.

Objective. To study possibilities for enhancing the efficiency of minimally invasive diagnosis of ovarian cancer, by using a combination of serum A-SAA and CA-125 proteins detectable by mass spectrometry and enzyme immunoassay. Subjects and methods. Clinical and morphological data on examinees and their sera were explored. The study sample consisted of 91 patients, which was divided into 4 comparable groups: 1) 34 patients with ovarian cancer; 2) 14 with benign ovarian tumors; 3) 17 with uterine myoma; 4) 26 apparently healthy women. A Labsystems Multitiskan Plus spectrophotometer (Finland) was used to determine A-SAA and CA-125 concentrations. Results. The investigation has shown that SELDI-TOF mass spectrometry may be rather highly effective in recognizing the sera of patients with ovarian cancer, benign ovarian tumors, or uterine myoma and healthy women. The basis for the developed experimental diagnostic system was mass spectrometric data that could individually provide about 90% diagnostic accuracy. The concurrent use of mass spectrometric data and A-SAA and CA-125 concentrations measured by enzyme immunoassay caused an increase in diagnostic accuracy up to 95.2%. The use of the support vector method yielded the best results. The merit of our proposed profiling method is its simplicity. The absence of serum prefractionation steps leads to more reproducible results and increases chances of introducing the methods into practical diagnosis. The findings may serve as prerequisites for developing a special hardware and software complex for the timely diagnosis of ovarian cancer. Conclusion. Thus, A-SAA as an independent ovarian cancer marker detectable by SELDI-TOF mass spectrometry has a sensitivity of 50% and a specificity of 96.4%. One important point to remember is that addition of A-SAA and CA-125 concentrations measurable by enzyme immunoassay to A-SAA spectrometric data allows the diagnostic accuracy for ovarian cancer to be increased up to 95%.

Objective. To evaluate the efficiency of different therapies for cervical intraepithelial neoplasia (CIN) I-III. Subjects and methods. One hundred and thirteen patients with severe dysplasia were examined and treated; four groups were formed in accordance with performed treatment. Results. The most active epithelialization was noted after photodynamic therapy (PDT). Completed epithelialization after PDT alone was seen more frequently than after other therapy options. No cervical deformation was detected after PDT. Addition of PDT-induced excision caused an increase in the number of standard cytogram readings, followed by the most pronounced and long-term antiviral effect, and reduced the rate of the vaginal environmental alkalinization. Conclusion. PDT is a highly effective treatment option for cervical dysplasia, can avoid scarring after excision, provides an antiviral effect, and promotes vaginal microbiome normalization. This allows one to recommend that PDT should be incorporated into a complex of treatment for reproductive-aged women in particular.

Objective. To estimate the benefits of a knotless barbed suture material used during laparoscopic myomectomy. Subjects and methods. The results of laparoscopic myomectomy were analyzed in 183 patients who were divided into 2 groups according to used suture material: 1) 81 patients in whom a polyglactide-based suture material was used to close myometrial defect after enucleation of myomatous nodes; 2) 102 patients in whom knotless barbed threads to do this. For comparative analysis of the findings, hemoglobin and red blood cell counts were measured and the time of myometrial defect suturing and the volume of intraoperative blood loss were estimated in terms of the used suture material. Results. The use of a barbed thread to place a combined (glover’s and blanket) stitch reduces the time taken to suture the myometrium and, by doing so, decreases intraoperative blood loss. In Group 2, the time requiring for myometrial defect suturing after enucleation of myomatous nodes was less than in Group 1. At the same time there was a statistically significant difference in the reduction of hemoglobin and red blood cell counts in the patients of Groups 1 and 2. Conclusion. The application of a knotless barbed suture material makes it possible to decrease the time of laparoscopic uterine defect suturing after myomectomy and to considerably reduce the volume of blood loss.

Objective. To reveal computer dermography-recorded changes characteristic of male reproductive dysfunction and to elaborate diagnostic criteria for early diagnosis of this abnormality, by using a DgKTD-01 diagnostic unit. Subjects and methods. One hundred and seventy-six men aged 27 to 39 years were examined and assigned to three groups: 1) 51 men with differentiated reproductive dysfunction; 2) 79 men with certain complaints; 3) 46 apparently healthy men. Their health status was comprehensively studied using a computer dermographic method realized in the DgKTD-01 diagnostic unit. Results. Group 1, unlike Groups 2 and 3, was characterized by constrained adaptation due to a predominance of a sympathetic component of the autonomic nervous system, by the high extent of chronic pathology (a larger proportion of persons referred to as follow-up group III), and by lower immune system function. There was a specific combination of amplitude-configuration plots for the basic functions F2 in the segments С*4-5, L1, and S1 in mode 2, F2 and F3 in the segment Th6 in mode 4, and F5-1’, F5-2’, and F5-3’ in the segments L1 and S1 in mode 3. In the control group, the amplitude-configuration plots of the basic functions were represented as right synchronous curves within the physiological range. In Group 2, 65.8% of the examinees had amplitude-configuration plots for the basic functions, which were specific for Group 1 in different combination of the values recorded within the physiological range and 34.2% had the values that corresponded to those in the control group. In-depth examinations made by medical specialists using laboratory and instrumental methods in this patient group revealed that 65.8% had abnormalities characteristic of male sexual diseases. The agreement of the results of computer demography-assisted examinations and the data of in-depth examination by the medical specialists indicates that 65.8% of Group 2 persons are one cluster with Group 1 persons and a group at risk for impaired reproductive health. Conclusion. The health status examination using the computer demography technique on the DgKTD-01 diagnostic unit identified criteria for early detection of male reproductive abnormality. This could identify a group of persons at increased risk for reproductive dysfunction, which enables, even in the absence of an examinee’s complaints, timely and validated prophylactic measures to be implemented to prevent this disease. The computer dermographic technique may be incorporated as an additional diagnostic screening test when evaluating male reproductive health.

Acne is an androgen-dependent lesion in the pilosebaceous unit; in this connection, it is reasonable to use combined oral contraceptives containing antiandrogenic progestins for the treatment of this disease in conjunction with other therapy options. The paper provides a physiological rationale for the use of dienogest-containing agents to treat acne.