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Z Rokyta

Publications and source records attributed to Z Rokyta.

At least 19 recordsLinked to original sources
PubMed2006

[Ovulatory mucus and its pH, arborization and spermagglutination antibodies in women with fertility disorders].

OBJECTIVE: We studied pH of ovulatory mucus, sperm penetration through capillary filled with ovulatory mucus in one hour and presence of local spermagglutinating antibodies. METHODS: We measured pH, arborization and Kremer test in ovulatory mucus in 127 women with fertility disorder. Indirect mixed antiimunoglobulin reaction test (i-MAR-test for IgG, IgA, IgM and IgE) was used for detection of spermagglutinating antibodies. RESULTS: pH 7.4-9.6 (physiological limit) was found in 94/127 women (74%), pH < 7.4 in 33 women (26%). 60% of 94 patients with physiological pH had Kremer's test above 2cm/hour (normal sperm penetration in ovulatory mucus), in 40% of them reduction of sperm penetration (< 2cm/hour, swelling, shaking, cytotoxicity) was seen. Sperm antibodies in ovulatory mucus in 24% patients with pH < 7.4 and 22% patients with physiological pH were studied. In 111 patients with regular menstrual cycle a classical arborization was found in 81%, in 14% was not proved. In 16 patients with irregular menstrual cycle classical arborization was observed in 11 of them. Local sperm antibodies were detected only in 13% of the total count of patients, it means in 17 patients. Their ovulatory mucus showed classical arborization. 30 healthy fertile women created the control group, only one secretion had pathological findings in all studied parameters owing to latent mycotic infection. SUMMARY: Pathological pH of ovulatory mucus, hormonal dysbalance, and presence of local spermagglutinating antibodies evidently influence penetration of sperm cells through cervix uteri. Otherwise pathological microbial vaginal environment can start a cross reaction with the surface microbes and sperm epitopes. One sign of ovulation, arborization of cervical ovulatory mucus, is not connected directly with the presence of local sperm antibodies, but insufficient estrogen influence is a sign of the reduced immunosuppression in cervix area.

Antibodies↗
PubMed2006

[Inhibin B and intraacrosomal proteins in men from the couples with fertility disorders].

THE AIM: To monitor the basic andrologic and immunologic sperm factors and the levels of inhibin B in serum and in seminal plasma in men from the couples with infertility disorders. SETTING: Department of Gynecology and Obstetrics, Medical School, Charles University and University Hospital, Plzen, Institute of Molecular Genetics, AV CR, Prague, Institute of Clinical Immunology and Allergology, LF UK a FN, Plzen. METHODS: We used conventional methods for estimation of sperm quality according to WHO and we detected the intra-acrosomal proteins by monoclonal antibodies (Hs8 and Hs14, immunofluorescent method), spermantibodies by direct mixed antiimunoglobulin reaction (MAR) test, and we examined inhibin B in serum (< or =400 pg/ml= A) and in seminal plasma (< or = 600 pg/ml= N) by ELISA in 355 men aged 21-52 years (ø 34 years) with normal levels of FSH, LH and testosterone. The control group was created by 56 health sperm donors. RESULTS: We found 65% normospermatics in the group of 355 patients, 34.9% men with various kind of pathologies. Predominance of spermagglutinating antibodies was found in 15.77% in IgG, in 19.44% in IgA, in 8.44% in IgA and IgG together. Normal intraacrosomal proteins were reached in 74.65% for Hs8, in 20.85% pathologic, in 86.2% normal findings for Hs14, in 4.23% pathologic. The immunological results in control group were completaly negative. Pathological levels of inhibin B in seminal plasma was found in 37.2% (152 men), in 25% in serum, and in 5.6% in serum and in seminal plasma together. In 54.7% of patients we found physiological levels of inhibin B in both biological fluids. We also compared physiological 109/152 (71.71%), and pathological spermiogrammes 43/152 (28.29%) with abnormal levels of inhibin B in seminal plasma, with intraacrosomal proteins to levels of inhibin B in serum. Our detailed study shows high interidividual results, which must be studied in complex with diagnosis of decreased fertility in man. CONCLUSION: Andrologic and immunologic analysis in the group of 355 men showed normal parameters of spermiogrammes in 231 patients (65%), in the rest of men the immunologic profil was in various parts pathologic. Only 105 men have got excellent spermiogrammes. Inhibin B as hormon regulates in back the secretion of FSH, and serves as good indicator in male reproductive failures.

Acrosome↗
PubMed2006

[Serum antibodies against annexin V and other phospholipids in women with fertility failure].

THE AIM: To study serum antibodies against annexin V and against other phospholipids in women with fertility failure. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Institute of Imunology and Alergology, Institute of Forensic Medicine, Charles University and Faculty Hospital, Pilsen, Czech Republic. PATIENTS AND METHODS: We investigated sera from a total of 1550 women aged 26-41 years who attended the Division for Infertility and Reproductive imunology, in the Department of Obstetrics and Gynecology, Charles University, and Faculty Hospital, Pilsen, Czech Republic. ELISA was used for detection of antibodies against annexin V, phosphatidic (ph)-acid, ph-ethanolamine, D-L glycerol, ph-inositol, L-serine, cardiolipine, beta-glycoprotein, and prothrombine), antibodies against zona pellucida by passive hemmagglutination. Antibodies against annexin V in ovulatory cervical mucus were studied only in 47, and in follicular fluid in 168 women. Eighty-four fertile healthy women were included in the control group. RESULTS: Antibodies against annexin V were found in 13% (in 170 infertile women). Anamnestic data showed two or more unexplained pregnancy losses in 48 (28.2%), 108 (63.5%) patients had two or more unsuccessfull in vitro fertilization, polycystic ovaries (PCO) was diagnosed in 3 (1.7%), and endometriosis in 11 (6.6%) of them. The increased levels of antibodies against ph-inositole (28.8%), and L-serine (19.4%) were detected. 353% of patients had positive levels against zona pellucida. In ovulatory cervical mucus only in six (6/47) antibodies against annexin V were detected, in 5.55% in follicular fluid (6/108). CONCLUSION: Our study also demonstrated serum positivity against annexin V as a significant risk factor mainly in patiens with repeated reproductive failure.

Abortion, Habitual↗
PubMed2005

Role of the leukemia-inhibitory factor gene mutations in infertile women: the embryo-endometrial cytokine cross talk during implantation--a delicate homeostatic equilibrium.

Locally secreted cytokines of both the embryonic and the endometrial origin control the implantation process. The defects in their signaling that lead to unfavorable environment within the uterus may cause embryo implantation failure. The leukemia inhibitory factor (LIF), interleukin-11 (IL-11) as well as IL-12/IL-15/IL-18 system are regarded to be important signaling vectors. LIF plays an essential role in the preimplantation embryo development and the blastocyst implantation and its gene mutations in women contribute to the implantation failure and subsequent infertility. IL-11 signaling has been shown to be required for the uterine decidualization response as well as for the hatching and attachment of blastocysts. The IL-12/IL-15/IL-18 system interacts with endometrial leukocytes, particularly with NK cells, and influences directly the local angiogenesis and tissue remodeling. Differences in the levels of endometrial leukocytic subpopulations and in the patterns of intra-uterine cytokine concentrations that are observed between fertile and infertile women contribute to infertility probably by affecting the embryonic maternal dialogue during the implantation and early placentation period. Focusing on this cross talk promises to open new era in assisted reproduction techniques that will be based on diagnostics of missing signaling molecules and impairments of uterine receptivity as well as on therapeutic applications of individualized embryo culture and transfer media.

Cytokines↗
PubMed2005

Laparoscopic uterine artery dissection in an undiagnosed endometrial stromal sarcoma. Case report.

We present a case of a 24-year-old woman, gravida 0, with menometrorrhagia and pelvic pain. A uterine hemorrhagic fibroid was diagnosed after ultrasound and magnetic resonance imaging (MRI). The endometrial biopsy was negative for malignancy. Laparoscopic sentinel lymph node sampling, lavage, and myometrial biopsy with negative results were performed before dissection of the uterine vessels. The final diagnosis of endometrial stromal sarcoma was made by myomectomy and hysterectomy one year later. This case should demonstrate the difficulty of making the right diagnosis of sarcoma before laparoscopic dissection of uterine vessels in patients with symptomatic fibroids.

Adult↗
PubMed2005

[Risk factors for 3rd and 4th degree perineal ruptures during delivery].

OBJECTIVE: Summary of the mutual relationship between vaginal delivery and anal incontinence. DESIGN: Retrospective case-control study. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Pilsen, Czech Republic. METHODS: 9600 vaginal deliveries between January 1997 and March 2004 were evaluated. The aim of the study was to observe the incidence of the 3rd degree tear and identification of the risk factors. The recognition of the perineal injury was open to the individual interpretation and assessment of the doctors involved. RESULTS: The incidence of the 3rd degree tear was 0.84%. The diagnostics of the 3rd degree tear was significantly more frequent if the evaluation of the perineal injury was performed by the urogynaecologists (p<0.001). Statistically significant risk factors of the 3rd degree tear in the univariate and multivariate analysis were: forceps, shoulder dystocia, the length of the 2nd stage of labour and maternal cooperation at the final phase of delivery. Parturity (primiparity), birth weight and episiotomy (when all types of episiotomy were included) were statistically significant only in the univariate analysis. Mediolateral episiotomy was not proved to be either the risk or the protective significant factor. SUMMARY: The diagnostics of the 3rd degree tear demands a detailed knowledge of the structure and anatomy of the pelvic floor. A sufficient amount of experience and erudition are the requirements for the prevention, diagnostics and subsequent treatment of this injury.

Adult↗
PubMed2005

[Electrophoretic analysis (SDS PAGE) of ovulatory cervical mucus in patients with fertility failure and after unsuccessful IVF].

OBJECTIVE: To evaluate the presence and activity of local sperm antibodies and electrophoretic analysis of ovulatory cervical mucus (OCM) to prove the correlation of results of Kremer mucus sperm capillary penetration test and i-MAR (mixed antiimmunoglobulin reaction) test with SDS-PAGE. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Charles University, Pilsen. METHODS: 94 patients aged 22-40 (average age 32.3 years) were chosen for our study. Ovulatory cervical mucus was taken from uterine cervical canal in Consultation for Reproductive Immunology. Kremer test and indirect mixed antiglobulin reaction test for IgG, IgA, IgM and IgE were used for detection of sperm antibodies. For the SDS-PAGE analysis, OCM was incubated with sodium dodecyl sulfate. We studied separated protein fractions from OCM. RESULTS: Sperm-capillary ovulatory mucus penetration test (Kremer) was 0-10 cm/hour in our group (average value in patiens without sperm antibodies was 2.43 cm/hour, with sperm agglutinating antibodies 1.4 cm/hour), significant levels (> 45%) of spermagglutinating antibodies were detected in IgA in 6 patients (6.38%), IgG in 5 (5.32%) patients, sperm-cytotoxic levels (IgA and/or IgG) in 5 patients (5.32%); levels of IgE less than 30% in 3 patients (3.19%). Individual immunological factors gained by SDS-PAGE showed the spectrum of various molecular weights with range of 14.4- 350 kDa. The presence of IgG and/or IgA was in 53 cases (56.38%), with 13 ASA positivities (24.53% correlation with i-MAR test) and no ASA activity in 40 cases (75.47%); 6 ASA positive patiens (31.58%) were not detected by SDS-PAGE. CONCLUSIONS: Analysis of 94 OCM by SDS-PAGE showed several significant correlates, but their specifications will be based on further immunoblot research.

Adult↗
PubMed2005

[The perineal body length and injury at delivery].

OBJECTIVE: Evaluation of mutual relationship between the perineal length, vaginal delivery and perineal injury. DESIGN: Prospective study. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Pilsen. METHODS: 318 women (92%) entered the study after their first vaginal delivery having given their consent. Instrumental vaginal deliveries were excluded. According to the perineal length, the women were divided into three study groups: short perineum (less or equal 30 mm), normal perineum (> 30 mm and < 60 mm), long perineum (equal to 60 mm and longer). Parameters evaluated: incidence of episiotomy, length of episiotomy, angle of episiotomy of the midline, shortest distance between episiotomy and anus, episiotomy and perineum length ratio. If episiotomy was not performed, the perineal tear has been evaluated in grades. RESULTS: The total proportion of episiotomy makes up 75%. The proportion of episiotomy and its angle has not reached statistical significance amongst the study groups. The length of episiotomy has been statistically significant amongst all study groups--the shortest being in the group of short perineum and the longest in the group of long perineum (p = 0.001). However the shortest distance between episiotomy and anus was statistically significant in the group of short perineum compared to normal perineum (p = 0.026) and long perineum (p = 0.005). If episiotomy was not performed, the total average perineal tear (in grades) was minimum in the group of short perineum and maximum in the group of long perineum (p = 0.018). SUMMARY: The short perineum does not appear to be the risk factor in the higher rate of episiotomy and perineal tears in this study. However if episiotomy was performed, the part of perineum which was not injured was found significantly shorter than in the other study groups. This could subsequently lead to postpartum anal incontinence. In this group the use of episiotomy as a prevention of perineal injury seems unjust. The group of long perineum has a significantly longer episiotomy and grade of perineal tear. This could contribute to the development of dyspareunia.

Adult↗
PubMed2004

[Detection of chlamydia antibodies in non-standard biological fluids in women with fertility disorders].

OBJECTIVE: Detection of IgA and IgG antibodies against Chlamydia trachomatis in various biological materials in patients with fertility disorders. DESIGN: Retrospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty of Charles University and Faculty Hospital, Plzen. METHODS: Antichlamydial antibodies IgA and IgG were detected in 73 patients. Examination of sera was performed in all 73 women, peritoneal fluid was examined in 20 patients who underwent diagnostic laparoscopy, follicular fluid samples in 22 women from IVF programme and antibodies in cervical ovulatory mucus were examined in 31 patients of the Division of Immunology of Reproduction. Results were compared with clinical findings and data of personal histories. Blood donors sera examination were used as a control group. RESULTS: High number of chlamydial antibody positivity was found in follicular fluid--in IgA (18/22, 82%) and IgG (16/22, 73%) and also in ovulatory cervical mucus in IgA (13/31, 42%). Examinations of sera did not differ significantly from the control group. CONCLUSION: High levels of chlamydial antibodies in follicular fluid samples could display connection between chlamydia infection and infertility, mainly as its organic cause (adhesions, tubal factor). IgA positivity in cervical ovulatory mucus is caused by local antibody production. Serologic examination of chlamydial antibodies is one of the most suitable examinations of entry in infertile patients as well as in pregnant women.

Adult↗
PubMed2004

[Antizonal antibodies in ovulatory cervical mucus and in serum of patients with fertility disorders].

OBJECTIVE: Detection of antizonal antibodies (aZPs) in cervical ovulatory mucus and in serum in patients with fertility failure. DESIGN: Retrospective study. SETTING: Department of Gynaecology and Obstetrics, Medical Faculty of Charles University, and Faculty Hospital, Plzen. METHODS: Detection of aZPs (passive hemagglutination test) in cervical ovulatory mucus (OM) and in serum from 105 patients with reproductive failure and in 25 fertile healthy women (control group). RESULTS: Positive levels of aZP in OM were found in 79 (75.2%) patients, in 56 of them aZP were observed in OM and in serum together, only ovulatory aZPs in 23 (21.9%), and only serum aZPs in 18 (17.1%) were found. aZPs predominate in 47 patients (of 48 women) with more than two in vitro fertilization processes, in thirty of them aZPs in serum and in OM together were observed. On the other hand, repeated spontaneous miscarriage and obesity have no connection with detection of aZPs in our patients. CONCLUSION. The increased levels of serum and OM aZPs are very often seen in patients after repeated unsuccessful IVF. This very important result in reproductive immunology means to go on the micromanipulation technics combined with immunosuppression in the next planned IVF procedure.

Adult↗
PubMed2004

[Comparison of steroid metabolism markers in endometrium of women with endometriosis, endometrial hyperplasia and without pathological changes of endometrium].

OBJECTIVE: To find out any relationship between presence of P450 aromatase and estrogen (ER) and progesterone (PR) receptors in eutopic endometrium of women with and without endometriosis and in estrogen-dependent gynecologic lesions (endometrial hyperplasia and endometriosis). DESIGN: Retrospective study. SETTING: Sikl's Institute of Pathology, Department of Gynecology and Obstetrics, University Hospital and Medical Faculty in Pilsen, Charles University. METHODS: The examined samples were obtained from patients of Department of Gynecology and Obstetrics, University Hospital and Medical Faculty in Pilsen (2001-2002) and elaborated in Sikl's Institute of Pathology, University Hospital and Medical Faculty in Pilsen. There were four experimental groups: endometrial hyperplasia, endometriosis and eutopic endometrium of women with and without endometriosis. P450 arom, ER and PR were detected by using immunohistochemical methods with specific antibodies. RESULTS: P450 aromatase was detected in a higher amount in endometriosis, hyperplasia and some samples of metaplasia. Estrogen and progesterone receptors were detected in all examined tissues. Number and spreading of ER and PR depend on the phase of the cycle. Lower number of ER was found in atrophic and metaplastic endometrium and in atypic hyperplasia. There was not found any direct relationship between presence of P450 aromatase and both types of receptors. CONCLUSION: Steroid metabolism in examined pathologically changed tissues is due to molecular aberrations regulated on the local level. It is not possible to use detection of P450 aromatase as a diagnostic test for pelvic endometriosis.

Adult↗
PubMed2004

[Clinical relevance of tumor markers in epithelial ovarian cancer].

AIM OF STUDY: The authors present the view of possible usage of tumour markers in epithelial ovarian cancer, and they aim at their use in routine clinic practice. TYPE OF STUDY: Review article. SETTING: Oncology and Radio-Therapeutic Department, Faculty Hospital, Pilsen. SUBJECT AND METHODS OF THE STUDY: Summary of data published in Czech and foreign professional literature. CONCLUSION: In case of epithelium tumours of ovaries, CA 125 is the tumour marker of the first choice. For the reason of low sensitivity, it is not possible to use the tumor markers for screening and primary diagnostics. Regarding prognoses, high pre-operational levels of CA 125 are considered unfavourable. At the same time the study demonstrates that CA 125 levels monitoring in the course of chemotherapy appears to be one of the most significant indicators of chemotherapy effects and, therefore, also of prognoses. Regular CA 125 monitoring in the course of follow up can contribute to early detection of tumour disease relapses. The optimal time interval for monitoring seems to be three months for the period of the first two years, and then six-month interval. Other tumour markers used in routine clinic practice are mainly CA 19-9 and CA 72-4, particularly in case of mucinoid epithelium tumours. However, these markers are of subsidiary importance only.

Biomarkers, Tumor↗
PubMed2004

[Prognostic factors of the cervical carcinoma].

OBJECTIVE: Review of prognostic factors of the cervical carcinoma, new perspective methods. SETTING: Department of Obstetrics and Gynecology, Medical Faculty Hospital, Plzen. DESIGN: Review article. RESULTS: The most important prognostic factors of the early cervical carcinoma are the stage and regional lymph node status followed by the depth of stromal invasion, tumor volume, and lymphovascular invasion. Other factors are still only subjects of research. CONCLUSION: A detailed knowledge of particular prognostic factors of the cervical carcinoma is necessary for optimal treatment and flow-up strategy.

Carcinoma↗
PubMed2004

[Significance of determination of intra-acrosomal proteins and sperm antibodies in human reproduction].

OBJECTIVE: Comparison of the positive intra-acrosomal proteins and spermagglutinating antibodies in human semen samples from various groups of patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics and Faculty Hospital, Charles University, Pilsen, Institute of Molecular Genetics, Czech Academy of Science, Prague. METHODS: Monoclonal antibodies Hs-8 and Hs-14 (prepared in the Institute of Molecular Genetics, Prague) were used for detection of intra-acrosomal sperm proteins. Microscopic immunofluorescent methods detected the incidence, the character and the percentage of the spermatozoa specified by above-mentioned monoclonal antibodies. Direct mixed anti-immunoglobulin reactions test (MAR-test) for IgG, IgM, IgA, IgE was used for detection of spermagglutinating antibody. We examined 315 infertile patients from Special Consultation for Immunology of Reproduction and from the IVF programme, and sperm healthy donors (January 2002-March 2003). RESULTS: Native donor's sperm cells had excellent positive intra-acrosomal proteins stained with monoclonal antibodies Hs8 and Hs14 and after thawing as well as. No spermagglutinating antibodies were found. In the group with normal sperm count and light microscopic morphology we found the presence of seminal spermagglutinating antibodies in 11% (IgG), in 14.5% (IgA), in 3.6% (IgM), in 5.2% (IgE). Significant positivity of intra-acrosomal protein stained with Hs8 monoclonal antibody was reached in 68.4%, and with Hs14 monoclonal antibody in even 81.3% of men. On the other hand, in oligoasthenospermatic patients we found significant increasing of spermagglutinating antibodies (for IgG 40.5%, for IgA 28.6%, for IgM 9.5%, for IgE 11.9%). Dominant good staining of intra-acrosomal proteins were seen only in 15.5% of men (for Hs8) and in 20.2% (for Hs14). CONCLUSION: The quantitative detection of intra-acrosomal sperm proteins and spermagglutinating antibodies are used as important properties of human semen and serve for evaluation of acrosomal state, and male fertility together.

Acrosome↗