Comparative analysis of two-dimensional protein patterns in malignant and normal human breast tissue.

Malignant and normal human breast tissue were compared by evaluating two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) maps of frozen tissue samples. Image analyzing software was used to scan and process 34 gels. Eight (8/34) of these gels (4 malignant breast tumor samples, 4 normal tissue samples) were selected on the basis of gel and image quality to build a database to identify and measure the expression of a previously unidentified proteome. Growth factor receptor proteins (GFRs), including ERBB2 (HER2) and ERBB3 (HER3), were expressed in the malignant tissue samples. Growth factor receptor proteins were not expressed in the normal tissue. Also, expression of PS2-protein (pS2) was detected in neither malignant nor normal tissue. In benign breast samples a higher intensity of protein expression could be observed for maspin, desmoglein 3 and keratin 8 than in malignant samples. Other proteins expressed in malignant breast tissue include mitogen-activated protein kinase 3 (MK03), heat shock protein 27 kDa (HS27), growth factor receptor-bound protein (GRB2), cathepsin D, G1/S specific cyclin E1 (CGEI), glucose transporter type 5 (GTR5), and a number of as yet unidentified proteins.

Human papilloma virus DNA: a factor in the pathogenesis of mammary Paget's disease?

The paraffin sections from 20 nipples with Paget's disease (10 central intraductal and 10 invasive ductal carcinomas) were analyzed for human papilloma virus (HPV) DNA of the low- and intermediate/high-risk groups. Polymerase chain reaction (PCR) and dot (slot) blot hybridization were used for the detection of HPV DNA types 6/11/16/18/31/33/35. In addition, we examined the c-erbB-2 oncogene expression in the specimens to differentiate benign cells in the surface epithelium of the nipple and areola from Paget cells. We found that the oncogene expression of the c-erbB-2 displayed a strong signal in the Paget cells. Using PCR and dot (slot) blot hybridization, we could not detect the HPV DNAs that are specific for the low- and intermediate/high risk-groups in the 20 cases of Paget's disease. Our results showed for the first time that this type of virus did not contribute to the pathogenesis of Paget's disease.

Salpingitis caused by Chlamydia trachomatis and its significance for infertility.

Between July and November 1991, 32 women (mean age 24.8 years) were examined laparoscopically in our department for suspected tubal sterility. All women had smears taken from cervix, vagina, and urethra, and all were negative regarding an infection with Chlamydia trachomatis. All women had open fallopian tubes, however, with inflammatory changes that varied in degree. Fifteen women reported pains and were classified as PID (pelvis inflammatory disease)-positive, as compared to the PID-negative group of 17 women without pain. In the group of the 15 PID-positive women, we could detect Chlamydia trachomatis in the form of salpingitis in 11 cases in the direct demonstration of the infectious agent. IgA antibodies were detected in the serum of all of these women, in 12 of them IgA + IgG antibodies. In the group of the 17 PID-negative women, three were positive in the direct detection of the infectious agent, and IgA and/or IgG antibodies were detected in five cases. 38% of the women in the PID-positive group and 68% in the PID-negative group conceived within a period of one year after having completed a treatment with antibiotics.

Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis.

OBJECTIVE: To compare the efficacy and tolerance with 2% clindamycin vaginal cream versus oral metronidazole for the treatment of bacterial vaginosis. METHODS: This was a multicenter, randomized, double-blind study in which patients were randomly assigned to one of the following two regimens in a 1:1 ratio: clindamycin phosphate vaginal cream 2% (5 g intravaginally at bedtime for 7 days) plus two placebo capsules (twice a day for 7 days) or metronidazole 500 mg (two 250-mg capsules orally twice a day for 7 days) plus placebo vaginal cream (5 g intravaginally at bedtime for 7 days). The patients were seen for follow-up at 5-10 days and 25-39 days after completion of therapy. RESULTS: Seven investigators, four in Germany, two in Austria, and one in Switzerland, enrolled 407 patients. Four patients never received either protocol drug, leaving 403 evaluable for safety. Two hundred thirty-four patients were evaluable for efficacy. The analysis for all evaluable patients showed no significant difference between treatment groups. The cure or improvement rate at 1 month after therapy was 83% in the clindamycin group versus 78% in the metronidazole group. The incidence of drug-related adverse medical events was approximately 12% in both groups. CONCLUSIONS: Oral metronidazole and intravaginal clindamycin cream had a similar efficacy of 78 to 83%. Both drugs were tolerated, with vaginal candidiasis developing in 8.5 and 4.7% of the patients in the clindamycin and metronidazole groups, respectively.

Laparoscopic surgery for tubal pregnancies utilizing laser.

Nine cases of ectopic pregnancy were treated by laser supported tubotomy and subsequent endoscopic evacuation by a forceps. The location of the ectopic pregnancies were as follows: ampulla (one patient); isthmus (five patients); and fallopian tube (three patients, in two of whom the whole tube was a hematosalpinx). The incision in the tube was made on the antimesenteric side according to the position and size of the ectopic pregnancy using an Nd YAG laser. Tissue destruction of the Nd YAG laser was diminished by using a crystal. After the incision, the conceptional debris was removed by a forceps. In all cases the fallopian tube was left open. Three months after the operation an X-ray was performed. In all nine cases, patent tubes could be documented on the affected and on the contralateral side. In the two patients with hematosalpinx, adhesions of the treated tube were found.

[Endoscopic laser incision of the polycystic ovary]. / Endoskopisch vorgenommene Laserinzision des polyzystischen Ovars.

Eight patients with a polycystic ovarial syndrome diagnosed endoscopically and endocrinologically were treated by laser incision of the ovaries via laparoscopy. The eight patients were preoperatively Clomiphen-refractory. After the incision, in every case spontaneous menstrual bleeding could be observed. Also in five women ovulation occurred, whilst in three cases, ovulation induction by Clomiphen was carried out successfully. Nevertheless these three patients were immediately after Clomiphen-refractory again. The observation period of the other five patients varied between 4 and 6 months. During this time an ovulation could be confirmed in all of them using basal temperature measurements. Pregnancy has not occurred in any to the present date.

Diagnosis of Chlamydia trachomatis infection--culture versus serology.

The diagnostic value of different laboratory methods in detecting Chlamydia trachomatis infections in high risk groups was analysed. The efficiency of a direct specimen test was compared with serology (IgG and IgM ELISA) and culture in L929 cells, stained either with fluorescein conjugated monoclonal antibodies or with iodine. Patients (no. = 1041) with localized genital infections attending a STD clinic, sexual contacts and patients with ascending infections from urological and gynecological clinics were examined. Chlamydia trachomatis was detected in 225 patients: 210 (93.3%) were reactive in the direct test (smears stained with monoclonal antibodies), whereas culture missed only 5 (sensitivity 97.8%) when stained by the same method. Cultures stained with iodine produced the lowest recovery rate (73.8%), but this rate increased to 80.9% when a second passage was performed. In addition the prevalence of Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans and Trichomonas vaginalis was investigated. In patients with non-gonococcal urethritis (no. = 331) and cervicitis (no. = 353), Chlamydia trachomatis was isolated in 32.3% and 12.8% respectively. However, this pathogen could be isolated in only 3 (15.8%) out of 19 patients with epididymitis and 15 (14%) out of 107 patients with adnexitis, although 66.7% and 93.3% respectively had specific IgG antibodies. Specific IgM could by detected with a sandwich ELISA in patients with adnexitis (46.7%), epididymitis (33.3%), cervicitis (22.2%), non-gonococcal urethritis (14%) and in the sexual partners of patients with genital infections (35.7%). The direct specimen test with monoclonal antibodies is the method of choice for the diagnosis of a C. trachomatis infection in patients with urethritis and cervicitis.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnosis and therapy of benign diseases of the vulva]. / Diagnostik und Therapie gutartiger Erkrankungen der Vulva.

During the last years, sexually transmitted diseases became more and more of interest. Besides the classic venereal diseases candidiasis, trichomoniasis, hemophilus and herpes infections, and also condylomata acuminata were found very frequently in the female population. Especially the HPV 16 and HPV 18 infections are of high interest: The oncogenic potency of the two virus become a big challenge for medicine and molecular biology.

[Incidence of Chlamydia trachomatis infections in pregnant patients in Vienna]. / Häufigkeit von Chlamydia-trachomatis-Infektionen bei Graviden in Wien.

Pregnant women were examined for chlamydia trachomatis-infection on a routine basis during a multicentric study in Vienna. Samples were taken from the cervix and fornix between the 30th and 34th week pregnancy. FTIC-conjugated monoclonal antibodies and immunofluorescence techniques were used to verify chlamydia trachomatis. Out of 1238 pregnant women, 101 (8.16%) were positive for chlamydia trachomatis. Since chlamydia infections can result in severe local or generalized complications and also spread to the newborn baby, screening investigations should be regularly performed during pregnancy and, if indicated, adequate treatment undertaken.