Uterine malignant leiomyosarcoma associated with high levels of serum beta-human chorionic gonadotropin: A case report.

We present the case of a 54-year-old woman diagnosed with uterine leiomyosarcoma that produced beta-human chorionic gonadotropin (ß-hCG), evident by both serum and immunohistologic examination. Based on this and similar cases from the available literature, ß-hCG-producing sarcomas tend to have poorer prognosis, indicating that ß-hCG could potentially be used as a marker of disease status and response to the therapy; however, this association is inconsistent and should be further investigated.

Measurement of luminal nitric oxide in the uterine cavity using a silicon balloon catheter.

The aim of this pilot case-control study was to measure nitric oxide (NO) gas in air incubated in a catheter balloon in the uterus of healthy women and patients with pelvic inflammatory disease, to determine the optimal time of incubation and to find whether NO level rises after manipulation in the uterine cavity. We measured nitric oxide levels in air incubated for 2-10 min in a catheter balloon in the uterine cavity in 6 non pregnant women from 22 to 50 years of age with lower abdominal pain and 10 healthy women with regular menstrual cycles. After an incubation time of just 2 min, intrauterine nitric oxide levels were significantly increased in patients with diagnosed pelvic inflammatory disease compared to healthy women. Uterine nitric oxide levels did not rise after manipulation in the uterine cavity. In conclusion, NO gas can be measured directly in the uterine cavity with a fast, simple, well-tolerated and safe method. The levels of nitric oxide are increased in women diagnosed with pelvic inflammatory disease already after an incubation time of 2 min.

High-mobility group box protein 1 and its signalling receptors in human preterm and term cervix.

The objective of this study was to identify possible changes in mRNA and protein expression of high-mobility group box protein 1 (HMGB1) and its suggested receptors - receptor for advanced glycation end-products (RAGE) and Toll-like receptor 2 (TLR2) and TLR4 - in human cervix during pregnancy, term and preterm labor. Cervical biopsies were taken from 58 women: 20 at preterm labor, 24 at term labor, 10 at term not in labor and 4 from non-pregnant women. Real-time RT-PCR was used to quantify mRNA expression, and immunohistochemistry and ELISA for protein analysis. HMGB1, RAGE, TLR2 and TLR4 proteins were localized and their mRNA expression was detected in the cervix. There was more extranuclear HMGB1 in the cervical epithelium and stroma in preterm and term labor compared to the term not in labor. TLR2 mRNA expression was upregulated 5-fold in term labor and 3-fold in preterm labor compared to term not in labor and non-pregnant controls. There was lower expression of TLR2 and TLR4 mRNAs in preterm labor compared to term. Lower mRNA expression of HMGB1 was found in the subgroup with preterm premature rupture of membranes than in the rest of the preterm group, where levels were significantly higher than in term labor. In conclusion, extranuclear expression of HMGB1 during labor suggests a possible role of HMGB1 during the process of cervical ripening. Changes in expression of mRNAs encoding HMGB1, TLR2 and TLR4 in preterm labor suggest differences in the mechanism of cervical ripening at preterm and term delivery.

Successful pregnancy after treatment for ovarian malignant teratoma with growing teratoma syndrome.

OBJECTIVE: To report a case of successful IVF-pregnancy after treatment for ovarian growing teratoma syndrome. DESIGN: Case report. SETTING: Gynecologic department at a university hospital. PATIENT(S): A 20-year-old woman, gravida 0 para 0, was diagnosed with malignant teratoma of the ovary. She was treated by unilateral salpingo-oophorectomy and chemotherapy. A couple of years later she was diagnosed with growing teratoma syndrome. INTERVENTION(S): Fertility-preserving surgery with unilateral salpingo-oophorectomy and chemotherapy. In vitro fertilization. MAIN OUTCOME MEASURE(S): Disease free, successful pregnancy. RESULT(S): After treatment for ovarian immature teratoma and growing teratoma syndrome the patient was free of the disease. She underwent in vitro fertilization treatment with autologous embryo transfer and gave birth to a healthy child. CONCLUSION(S): Growing teratoma syndrome is an extremely rare metastatic complication of a malignant germ cell tumor after a combination treatment with surgery and adjuvant chemotherapy. This case shows that successful pregnancy outcome is possible after effective treatment for ovarian growing teratoma syndrome.

Measurement of nitric oxide in the vagina.

OBJECTIVE: Local measurement of nitric oxide (NO) gas has been used to detect and monitor inflammatory processes in the airways, the colon and in the urinary bladder, but so far NO has not been studied in the lower female genital tract. The objective of this study is to measure NO gas directly in the vaginal lumen of healthy women and in patients with vaginitis. SETTING: The outpatient clinic of a university hospital. METHODS: Eighteen non-pregnant women from 19 to 65 years of age with symptoms of vaginitis, eight healthy women in reproductive age with regular menstrual cycles and nine healthy postmenopausal women were enrolled in the study. NO levels were measured in air incubated for five minutes in a catheter balloon in the vagina. RESULTS: In patients with symptoms of vaginitis, NO concentration was almost 100-fold increased compared to healthy controls (p<0.001) with no individual overlap. Vaginal NO levels were uniformly low among healthy women, both in reproductive age and in menopause. CONCLUSIONS: NO gas can be measured directly in the vagina with a fast, simple and safe method. The levels of NO are increased in patients with vaginitis.

Intrauterine nitric oxide in pelvic inflammatory disease.

OBJECTIVE: To measure nitric oxide gas directly in the uterus of healthy women and patients with suspected pelvic inflammatory disease. DESIGN: Pilot case-control study. SETTING: The emergency department of a university hospital. PATIENT(S): Twenty premenopausal, nonpregnant women from 18 to 48 years of age with lower abdominal pain and nine healthy women with regular menstrual cycles were included. INTERVENTION(S): We measured nitric oxide levels in air incubated for 5 minutes in a catheter balloon in the uterine cavity. MAIN OUTCOME MEASURE(S): Intrauterine nitric oxide concentration in controls and patients. RESULT(S): In patients with lower abdominal pain, nitric oxide was almost 100-fold increased in those in whom pelvic inflammatory disease had been diagnosed compared with those in whom appendicitis had been diagnosed with no individual overlap. Uterine nitric oxide levels were uniformly low in healthy women throughout the menstrual cycle, compared with those with pelvic inflammatory disease. CONCLUSION(S): Nitric oxide gas can be measured directly in the uterine cavity with a fast, simple, and safe method. The levels of nitric oxide are increased in patients with pelvic inflammatory disease.