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Biomedical subjects

M Jóźwik

Publications and source records attributed to M Jóźwik.

At least 19 recordsLinked to original sources

Umbilical threonine uptake during maternal threonine infusion in sheep.

OBJECTIVE: The infusion into the maternal circulation of amino acid solutions failed to increase umbilical threonine (THR) uptake above normal even when THR was present in the infusate at a relatively high concentration. The purpose of the present study was to determine whether umbilical THR uptake can be increased by infusing a THR solution that does not contain any other amino acids. STUDY DESIGN: Five pregnant sheep (130+/-1.0 days after conception) were infused for 2h with a threonine solution (4.4+/-0.2 micromol.kg(-1).min(-1)). Plasma amino acids, glucose and lactate, hematocrit, blood O(2) content in maternal arterial, uterine venous, umbilical arterial and venous blood were measured. Uterine and umbilical blood flows were measured before and during the infusion and were used to calculate uterine and umbilical uptakes. Maternal and foetal plasma insulin and glucagon concentrations were also measured. RESULTS: The THR infusion increased maternal plasma THR (904 vs 236 microM, P< 0.001), foetal plasma THR (539 vs 334 microM, P< 0.01), and both uterine (20.4 vs 4.7 micromol.min(-1).kg(-1)(fetalweight), P< 0.05) and umbilical (8.6 vs 3.8 micromol.min(-1).kg(-1)(fetalweight), P< 0.001) THR uptakes. The uterine-umbilical THR uptake difference increased significantly (11.8 vs 0.9 micromol.min(-1).kg(-1)(fetalweight), P< 0.05). There were significant (P< 0.001) decreases in the foetal arterial plasma concentrations of tyrosine and the branched chain amino acids, as well as in isoleucine umbilical uptake (P< 0.05). There was a significant increase in maternal plasma glucagon (P< 0.01). CONCLUSION: A maternal THR infusion that causes a 3.8-fold increase in maternal plasma THR concentration above normal, with no significant increase in the concentration of other amino acids, leads to a 2.3-fold increase in umbilical THR uptake. This contrasts with the absence of a significant increase in umbilical THR uptake when THR was infused as part of an amino acid mixture in previous studies. The evidence supports the hypothesis that, in vivo, THR flux from placenta to foetus is mediated by a saturable, rate limiting transport system which is subject to inhibition by other neutral amino acids.

Amino Acids↗

Ammonia concentration in human preovulatory ovarian follicles.

OBJECTIVES: To determine ammonia concentrations in both the direct environment of the oocyte, ovarian follicular fluid, and peripheral blood. STUDY DESIGN: Samples of preovulatory follicular fluid and antecubital venous blood were obtained from 23 randomly selected women attending an in vitro fertilization program in an academic department. Ammonia concentrations were measured using the indophenol method. RESULTS: In every patient examined, the ratio of ammonia concentration in follicular fluid to that in blood exceeded 1.0. Mean ammonia concentration in follicular fluid (38.01+/-2.61 microM) was significantly higher than that in blood (22.70+/-1.35 microM; P<0.001 paired Student's t test). CONCLUSIONS: There is an ammonia gradient from follicular fluid to blood. The human preovulatory oocyte grows in an environment of a moderately increased ammonia concentration. This study suggests that the preovulatory follicle is a source of ammonia production.

Adult↗

[The effect of pelvic floor exercises in the antepartum and postpartum periods on occurrence of stress urinary incontinence: implications for health care provision].

The aim of the present work was to review the existing evidence on the impact of pelvic floor exercises on the occurrence and the role in the treatment of stress urinary incontinence in the perinatal period. Our analysis indicates that pelvic floor exercises are a safe and highly effective measure in the prevention of occurrence and treatment of stress urinary incontinence, both antepartum and postpartum. Their performance in the inpatient setting during early puerperium can allow proper physiotherapeutic instruction and supervision without additional admission and costs. Poland has an opportunity to become the first country worldwide to implement peripartum pelvic floor exercises as a preventive method for urinary incontinence on a regular basis.

Exercise Therapy↗

Contribution of branched-chain amino acids to uteroplacental ammonia production in sheep.

The uteroplacental tissues are a principal site of ammonia production for the conceptus. The goal of this study was to examine the effect of the composition of maternal amino acid (AA) infusate on uteroplacental ammonia production. Seven pregnant ewes (126 +/- 1. 4 days gestation) were infused through the maternal femoral vein (duration 3.5 h, rate 240 ml per hour) with three solutions of AAs. The first infusate was comparable to commercial parenteral nutrition preparations, the second infusate contained the same solution without branched-chain AAs (BCAAs), and the third infusate contained only BCAAs. Blood samples were simultaneously collected from the maternal artery, uterine vein, fetal artery, and umbilical vein to determine plasma AA concentrations and whole blood ammonia concentrations, before (control) and 2 h after (experimental) the start of infusion. Uterine and umbilical blood flows were measured using the ethanol steady-state diffusion method. Results showed that fetal arterial and venous ammonia concentrations increased significantly after infusions with all AAs or only BCAAs, but not without BCAAs. Uteroplacental ammonia production increased in response to each of the three infusates. However, this increase was much greater when the BCAAs were present in infusates. We conclude that there is a significant contribution of BCAAs to the uteroplacental ammonia production. Maternal AA infusions containing BCAAs can result in increased fetal blood ammonia concentrations.

Amino Acids, Branched-Chain↗

Spontaneous closure of vesicouterine fistula. Account for effective hormonal treatment.

OBJECTIVES: To analyze the incidence of spontaneous closure, or non-surgical resolution, of vesicouterine fistula and discuss the resultant implications for the management. METHODS: Review of the literature supplemented by case report of a young woman with spontaneous healing of vesicouterine fistula. RESULTS: This is the 41st patient with spontaneous closure of vesicouterine fistula reported to date. Her clinical course was suggestive of endocrine involvement in the lesion's formation. Spontaneous healing was observed in 5% of 796 vesicouterine fistula cases. Induction of amenorrhea was effective in 8 (89%) of the 9 patients treated, a rate significantly higher (p < 0.001) than that observed without hormonal manipulation (4%). CONCLUSIONS: Conservative management by means of hormonal treatment should be considered before surgical repair. We suggest the role of estrogens and the endometrium in the formation of vesicouterine fistulas.

Adult↗

Stress urinary incontinence in women. III. Different tissue biochemistry in patients with concomitant detrusor instability. Preliminary report.

The glycogenolysis markers (glycogen content, active and total glycogen phosphorylase [EC 2.4.1.1.] activities, and active and total acid exo-alpha-1,4-glucosidase [EC 3.2.1.3.] activities) in the urinary bladder muscle from two patients with stress urinary incontinence and concomitant detrusor instability were studied. Glycogen depletion and activation of glycogen phosphorylase were found.

Female↗

Uptake and transport by the ovine placenta of neutral nonmetabolizable amino acids with different transport system affinities.

Placental uptake and transport of three nonmetabolizable amino acids with different reactivities for transport systems were studied in sheep under normal physiologic conditions. Methylaminoisobutyric acid (MeAIB), which has specific affinity for the sodium-dependent A system transporters, demonstrated placental concentrative uptake from the uterine and the umbilical circulations, but virtually no transport from mother to fetus. By contrast, aminoisobutyric acid (AIB) and aminocyclopentane-1-carboxylic acid (ACP), which have affinity for both sodium-dependent and sodium-independent transporters, demonstrated both concentrative uptake and transport from mother to fetus. ACP transport rate to the fetus was approximately twice the AIB transport rate. It is concluded that a neutral amino acid which interacts almost exclusively with the weakly reversible system A transporters may be transported rapidly into the placenta and may attain high concentrations within this organ but cannot escape from placenta to fetus down its own concentration gradient because the exit route is controlled by reversible amino acid transporters at the fetal surface of the placenta. Conversely, high affinity for reversible Na-independent transporters may be a necessary condition for the rapid transport of an amino acid from placenta to fetus.

ATP-Binding Cassette Transporters↗

Dysuria due to bladder distortion after repeat cesarean section.

Abnormalities of the lower urinary tract resulting from cesarean section are rare. We present a patient who developed urinary frequency, nocturia and acute pains in the late phase of micturition which we think was due to bladder distortion after repeat cesarean section. She was diagnosed cystographically and treated successfully by bladder flap release.

Adult↗

[Antepartum amniotic fluid index and pregnancy outcome].

Our purpose was to evaluate prognostic value of antepartum amniotic fluid index (AFI) on fetal and newborn outcome, because oligohydramnion is associated with increased risk of fetal and newborn distress. Perinatal outcome was defined by 1' and 5' Apgar score, intrapartum fetal heart rate (FHR), blood gas, acid-base status in umbilical artery, mode of delivery and meconium-stained amniotic fluid. Data was analysed with CSS Statistica for Windows package by test t for independent samples and chi 2. Prospective observations was conducted with 84 singleton pregnancies complicated by oligohydramnion (AFI < or = 5 cm). A 336 pregnant women, with normal amniotic fluid index and no complicated pregnancy, was considered as controls. No increased operative delivery and meconium-stained amniotic fluid rate was noted. There was no significant effects AFI on blood gases in umbilical artery and Apgar score. Oligohydramnion was associated with increased risk of fetal acidosis (pH < 7.16) (p = 0.009) and abnormalities of FHR (variable decelerations) (p = 0.004). Reduced AFI had poor predictive value of fetal acidosis and newborn depression positive predictive value (8-13%). Summarizing the results, our investigation showed that amniotic fluid index is only one point in the prognosis of perinatal outcome.

Adult↗

[Hormonal dependence of vesicouterine fistulas].

Vesicouterine fistulas are more and more frequently reported. This paper reviews available data suggesting the role of the endometrium in the fistula's formation. At least a proportion of these fistulas fulfil the criteria of external endometriosis. Conservative management by means of hormonal treatment should be considered before surgical repair. We also present a new clinical classification of this disorder, based on the routes of menstrual flow: type I--with menouria, type II--with dual flow via both the bladder and vagina, and type III--with normal vaginal menses.

Danazol↗

Antioxidant defence of red blood cells and plasma in stored human blood.

Blood collected routinely from donors, and preserved with CPDA-1 anticoagulant (citrate, phosphate, dextrose, adenine), was investigated. The concentration of reduced glutathione, and glutathione peroxidase, glutathione S-transferase, glutathione reductase, superoxide dismutase, and catalase activities in erythrocytes, as well as the total radical-trapping antioxidant parameter in plasma were determined on days 1, 3, 7, 12, 16, 20 and 25 of storage. At the end of the study, a 30% decrease in the reduced glutathione concentration (P < 0.001) and decreases in glutathione S-transferase (over 20%, P < 0.001), glutathione reductase (over 8%, P < 0.01) and superoxide dismutase (over 10%, P < 0.001) activities in erythrocytes, together with up to a 30% diminution of total antioxidant activity in plasma (P < 0.001) were noted. Thus, during blood storage, glutathione-dependent antioxidant systems in erythrocytes and antioxidant defence in plasma are depleted. From the present study, a twelve-day period can be considered a safe storage limit. The sequence of events occurring in stored blood, leading to peroxidative injury in erythrocytes, is discussed.

Adult↗

Nonenzymatic antioxidant activity of human seminal plasma.

OBJECTIVE: To examine the nonenzymatic antioxidant properties of human seminal plasma. DESIGN: Determination of total (peroxyl) radical-trapping antioxidant parameter and malondialdehyde concentration in seminal plasma of 112 men attending IVF-ET or intracytoplasmic sperm injection (ICSI) programs. SETTING: University-based center for reproductive medicine. PATIENT(S): Normozoospermic men, ages 25 to 50 years, of fertility proved by a pregnancy resulting from IVF-ET, and men ages 25 to 50 years with negative IVF-ET or ICSI outcome, distinguished by their smoking status. INTERVENTION(S): Seminal plasma was obtained from ejaculates collected for IVF-ET or ICSI procedures. MAIN OUTCOME MEASURE(S): Total (peroxyl) radical-trapping antioxidant parameter and malondialdehyde concentrations. RESULT(S): No significant differences for total (peroxyl)-radical-trapping antioxidant parameter were observed between normozoospermic IVF-ET or asthenozoospermic ICSI patients; neither was a difference revealed for pregnancy-positive or -negative couples within those groups. Age, smoking status, or increased leukocyte count had no effect on total (peroxyl) radical-trapping antioxidant parameter or malondialdehyde concentrations in seminal plasma. CONCLUSION(S): Nonenzymatic antioxidant activity in seminal plasma does not reflect sperm fecundity ability.

Adult↗

Vesicouterine fistula--an analysis of 24 cases from Poland.

OBJECTIVE: This study was undertaken to evaluate what clinical events or situations are currently associated with the occurrence of vesicouterine fistula. METHOD: A retrospective investigation was carried out on 24 patients treated in a tertiary referral center during a 12-year period. Clinical data were collected from the patients directly, the medical records, urographic and/or cystoscopic findings before repair and intraoperative findings at repair. RESULTS: All fistulas were iatrogenic, and 21 (87.5%) occurred following cesarean section or cesarean hysterectomy. Bladder injury occurred two times more often after repeat operations than after the primary. The proportion of repeat cesarean section resulting in a fistula was significantly increased (58.3% vs. 29.6%, P < 0.013) when compared to that previously reported. CONCLUSIONS: Cesarean sections are currently the single major risk factor associated with the occurrence of vesicouterine fistulas. Repeat procedures increase the risk of bladder injury and resultant fistulas.

Adult↗

Stress urinary incontinence in women. II. Abnormalities of glycogenolysis in tissues related to the lower urinary tract.

The aim of the study was the investigation of the biochemical condition of elements likely to directly participate in active closing of the urethral lumen. We estimated glycogenolysis in urinary bladder, perivesical connective tissue and levator ani muscle (LAM) samples obtained intraoperatively from 80 stress incontinent women. Glycogen content as well as activities of active and total glycogen phosphorylase and acid exo-1,4-alpha-glucosidase were measured. Material from the urinary bladder and perivesical connective tissue was insignificantly altered, and glycogen contents in the bladder (2.03 +/- 1.38 g/100 g wet tissue) were considered to be normal. In the LAM glycogenolysis was much more activated than in other tissues (p < 0.001 by Fischer's exact test). Of LAM specimens 78% (22/28) revealed imbalanced biochemistry of glycogen with activation of hydrolytic decomposition. We conclude that stress urinary incontinence in women is frequently associated with metabolic alterations in the periurethral striated fibres. This study indirectly supports our recent hypothesis on the pathogenesis of the disease in terms of muscle fibre type transitions.

Adult↗

Prognosis of fertility after surgical closure of vesicouterine fistula.

OBJECTIVES: To evaluate fertility of women following surgical closure of vesicouterine fistula. STUDY DESIGN: Long-term retrospective investigation combined with a follow-up in the setting of an academic department. Operative hospital records (15,718) were reviewed for a 12-year period. RESULTS: Sixteen women with a vesicouterine fistula at reproductive age entered the study. Five pregnancies were recorded after repair, of which four resulted in a full term delivery. In comparison with the data reported to date this series showed significantly higher rates of pregnancy (31.25% vs. 9.7%; P = 0.012) and term deliveries (25% vs. 6.2%; P = 0.01). The majority of women were afraid of recurrence if pregnant again. CONCLUSIONS: Fertility after repair of vesicouterine fistula can be much better than previously described.

Adult↗