Laminin receptor 1 expression in premalignant and malignant squamous lesions of the cervix.

Laminin receptor 1 (LAMR) may have a role in the progression of premalignant squamous epithelial lesions to cervical cancer. Therefore, we aimed to investigate the expression of laminin receptor 1 (LAMR) in normal, premalignant, and malignant tissues of the uterine cervix. Paraffin blocks of 129 specimens with the diagnoses of normal cervical tissue (n = 33), cervical intraepithelial neoplasia (CIN) 1 (n = 30), CIN 2 (n = 14), CIN 3 (n = 28), and squamous cell carcinoma (n = 24) were immunohistochemically stained with LAMR antibody and its expression percentage, pattern, and intensity in these tissues were assessed. Compared to the other groups, the nonstaining with LAMR was highest in low grade squamous intraepithelial lesion (LSIL) (p < 0.0001). LAMR expression, which was positive in less than 50% of cells with weak staining, increased significantly between normal cervical epithelium and high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma, as well as between LSIL and HSIL (p < 0.0001). Between LSIL and invasive carcinoma, a significant increment was also observed for weak staining in less than 50% of cells (p < 0.001). LAMR expression, which was positive in more than 50% of cells with strong staining, was significantly higher in normal cervical tissue compared to the other groups (p < 0.0001). Disease progression related gradual increment of LAMR expression from normal cervical epithelium or LSIL towards HSIL or cervical cancer reveals that LAMR may play an important role in the transition from premalignant to malignant state in cervical lesions.

Expression of laminin-1 and matrix metalloproteinase-9 in benign and malignant endometrium.

BACKGROUND: Laminin-1 and matrix metalloproteinase (MMP)-9 may play roles in the progression from benign to malignant endometrium, so we aimed to investigate their levels of expression in these tissues. METHODS: This case-control study was conducted at a tertiary care center between January 2014 and December 2016. Paraffin blocks of 50 specimens of benign endometrium with proliferative (n = 20), secretory (n = 11), and atrophic (n = 5) endometrium; simple endometrial hyperplasia without atypia (n = 12); and endometrial polyp (n = 2) histology and 49 specimens of malignant endometrium with endometrioid (n = 40), serous (n = 7), clear cell (n = 1), and undifferentiated (n = 1) types were immunostained with laminin-1 and MMP-9 antibodies and assessed for basement membrane continuity for laminin-1 and the percentage and intensity of MMP-9 expression in epithelial cytoplasm. RESULTS: : Laminin-1 continuity in the basement membrane was higher in benign (92%) compared to malignant (16.3%) endometrium (p < 0.0001) without any difference between the subgroups within each group (p > 0.05). All atrophic endometria and endometrial polyps and 23.5% of low grade endometrioid and none of the other endometrial cancers showed uninterrupted basement membrane staining with laminin-1. All cases in malignant endometrium expressed MMP-9 with either low or high immunoreactivity while none of the cases in benign endometrium showed a high staining with MMP-9 (p < 0.01). Proliferative and hyperplastic endometrium together with grade 1 endometrioid cancer expressed MMP-9 better than the atrophic endometrium (p < 0.05). The immunoreactivity with MMP-9 increased gradually from secretory to hyperplastic endometrium and serous carcinoma (p < 0.05). MMP-9 expression in all types of cancers except grade 1 endometrioid and clear cell compared to proliferative endometrium was significantly higher (p < 0.05) and increased from proliferative to grade 2 endometrioid, grade 3 endometrioid, serous and undifferentiated endometrial carcinoma. DISCUSSION: Gradual increments in MMP-9 expression and basement membrane laminin-1 discontinuity may indicate progression from normal to hyperplastic and to low- and high-grade cancerous endometrium.

The Effect of Showing Images of the Foetus with the Virtual Reality Glass During Labour Process on Labour Pain, Birth Perception and Anxiety.

AIM AND OBJECTIVES: This study was conducted to determine the effect of showing images of the foetus to the pregnant women with the virtual reality glass during labour process on labour pain, childbirth perception and anxiety level. BACKGROUND: Virtual reality is an effective and inexpensive method that allows the creation of simulated scenarios in which it interacts with the virtual environment with multisensory stimuli. DESIGN: This is a randomised controlled experimental study. This study was conducted with the guidelines of Consolidated Standards of Reporting Trials (CONSORT). The study was enrolled in the Clinical Trials database (NCT04664114). METHODS: The study included 100 pregnant women (50 intervention group and 50 control group). Ultrasound images of the foetus were recorded on the 28th week of pregnancy of the women in the intervention group. These images were shown to the women with the virtual reality glass during labour process. Routine procedures were carried out for the women in the control group. The Visual Analog Scale (VAS) was applied to both groups when cervical dilatation was 4 cm and 9 cm. The Women's Perception for the Scale of Supportive Care Given During Labor (POBS) and the Perinatal Anxiety Screening Scale (PASS) were applied almost two hours after labour. RESULTS: The VAS scores of the women in the intervention group with 9 cm dilatation and their PASS mean scores were significantly lower than women in the control group while their POBS score were significantly higher (p < 0.01). CONCLUSION: The results of this study show that showing images of the foetus to women with virtual reality decreased labour pain and anxiety level. RELEVANCE TO CLINICAL PRACTICE: It is known that supportive care given during labour is important both for the mother's and baby's health. Therefore, it is important that nurses and midwives, who spend the most time with women and provide the most support, reduce the pain and anxiety of the woman with nonpharmacological practices and make them feel positive feelings about delivery.

Expression of Laminin Receptor 1 in Normal, Hyperplastic, and Malignant Endometrium.

Laminin receptor 1 may have a role in the progression from endometrial hyperplasia with or without atypia to endometrial cancer. Therefore, we aimed to investigate the pattern, percentage, and intensity of laminin receptor 1 expression in normal, hyperplastic, and neoplastic endometrium. Paraffin blocks of 131 specimens with the diagnoses of normal endometrium (n=25), endometrial hyperplasia with atypia (n=21) or without atypia (n=55), and endometrial cancer (n=30) were immunostained with laminin receptor 1 antibody, and its expression percentage, pattern, and intensity in the epithelial cytoplasm, basement membrane, and endometrial stroma of these tissues were assessed. When compared with hyperplasia with or without atypia and endometrial cancer, the percentage of nonstaining with laminin receptor 1 in the epithelial basement membrane was higher (96%), and the percentage of <50% staining with laminin receptor 1 was lower (4%) in the normal endometrium (P=0.001). While a progressive increment in staining percentage and density of epithelial cytoplasm and basement membrane was noted through an orderly progression from normal endometrium to endometrial hyperplasia without atypia, endometrial hyperplasia with atypia, and cancer of endometrium (P<0.001), such a relationship was not found for the staining percentage and density of endometrial stroma (P>0.05). Disease progression-related gradual increment in laminin receptor 1 expression in the epithelial basement membranes of hyperplastic endometrium with or without atypia and cancer of endometrium reveals that it may play a substantial role in the transition from premalignant to the malignant state of endometrial lesions.

The impact of serum adropin and ischemia modified albumin levels based on BMI in PCOS.

INTRODUCTION: The aim of this study was to evaluate the effects of polycystic ovary syndrome (PCOS) and body mass index (BMI) on serum adropin and ischemia modified albumin (IMA) levels. MATERIALS AND METHODS: This prospective cross-sectional study was performed with a total of 120 women [group1; non-PCOS = 60 (BMI < 25 = 30, BMI ≥25 = 30) and group 2; PCOS = 60 (BMI < 25 = 30, BMI ≥25 = 30)]. Blood samples were collected between the third and fifth days of the women's menstrual cycles after a night of fasting. RESULTS: There were no differences between the groups in relation to age, basal follicle stimulating hormone, estradiol, thyroid stimulating hormone, prolactin, high-density lipoprotein cholesterol, total testosterone, dehydroepiandrosterone sulfate levels, systolic and diastolic blood pressures. A significant difference was found in basal luteinizing hormone, fasting glucose, insulin, homeostatic model assessment of insulin resistance, total cholesterol, low-density lipoprotein cholesterol, triglycerides, free testosterone levels, waist-to-hip ratios and the Ferriman-Gallwey scores between the PCOS and non-PCOS patients in the lean and overweight groups (p < 0.05). The serum adropin levels in the lean PCOS group were lower than in the lean non-PCOS group (p < 0.05) and were lower in the overweight PCOS group than in the overweight non-PCOS group (p < 0.05). There was also a statistically significant difference in serum IMA levels in the PCOS group than in the non-PCOS group in both the lean and overweight groups (p < 0.05). CONCLUSIONS: Although serum adropin levels were significantly decreased in the PCOS group, IMA levels increased. Further studies are needed to determine the effects of adropin and IMA in women with PCOS and to use a new marker to monitorize treatment outcomes. < /p > < p >.

Selected maternal, fetal and placental trace element and heavy metal and maternal vitamin levels in preterm deliveries with or without preterm premature rupture of membranes.

AIM: To compare maternal, fetal and placental trace element (magnesium, zinc and copper) and heavy metal (cadmium and lead) and maternal vitamin (retinol, α [alpha]-tocopherol, vitamin D3 , 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 ) levels in preterm deliveries with and without preterm premature rupture of membranes (PPROM). METHODS: Sixty-eight patients giving birth preterm were grouped into preterm deliveries with PPROM (n = 35) and without PPROM (n = 33). Following delivery, maternal and umbilical cord blood sera and placental tissue samples were obtained. While magnesium, zinc, copper, cadmium and lead levels were measured in all samples, the levels of retinol, α-tocopherol, vitamin D3 , 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 were measured only in maternal serum. RESULTS: While magnesium level in maternal serum and zinc levels in both maternal and umbilical cord sera were lower, placental magnesium level was higher in preterm deliveries with PPROM (P < 0.01). Umbilical cord serum magnesium, placental tissue zinc and maternal and umbilical cord sera and placental tissue copper, cadmium, and lead levels did not differ between the groups (P > 0.05). In preterm deliveries with PPROM, 25-hydroxyvitamin D3 and retinol levels were higher, while vitamin D3 and 1,25-dihydroxyvitamin D3 levels were lower in maternal serum (P < 0.05). Maternal serum α-tocopherol levels were similar between the groups. CONCLUSION: Compared to spontaneous preterm births, PPROM is associated with low maternal serum together with high placental tissue magnesium and low maternal and umbilical cord sera zinc levels. Higher retinol and 25-hydroxyvitamin D3 and lower vitamin D3 and 1,25-dihydroxyvitamin D3 maternal serum levels are also evident in these patients.

Plasma total oxidant and antioxidant status after oral glucose tolerance and mixed meal tests in patients with polycystic ovary syndrome.

PURPOSE: Insulin resistance (IR) and increased oxidative stress (OS) are the characteristics of polycystic ovary syndrome (PCOS). In this study, we aimed to evaluate the effects of oral glucose tolerance (OGTT) and mixed meal tests (MMT) on plasma total oxidant (TOS) and total antioxidant status (TAS) in patients with PCOS and the relationship between these parameters and IR, calculated via homeostasis of model assessment-IR (HOMA-IR) and Matsuda's insulin sensitivity index (ISI) derived from OGTT and MMT. METHODS: Twenty-two patients with PCOS, and age- and body mass index (BMI)-matched 20 women as controls were enrolled into the study. Five-hour OGTT and MMT were performed on different days, and before and after these tests, plasma TOS and TAS levels were investigated. IR was calculated with HOMA-IR and Matsuda's ISI. RESULTS: HOMA-IR levels were higher in patients with PCOS, compared to controls, while Matsuda's ISI derived from OGTT and MMT was higher in controls. Plasma TOS levels before OGTT and MMT were higher in patients with PCOS than controls, while TAS levels were similar. After OGTT, plasma TOS levels became decreased at 5th hour, when compared to baseline values in PCOS group. Likewise, the same decrement was found in controls, but the decrement was not significant. After OGTT and MMT at 5th hour, no changes were observed in TAS levels, compared to baseline. CONCLUSION: Matsuda's ISIs derived from OGTT and MMT can be used instead of each other, and interestingly, we found a decrease in TOS levels after OGTT in patients with PCOS.

Frequency of nodular goiter and autoimmune thyroid disease in patients with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS), and nodular and autoimmune thyroid diseases are frequently seen disorders. Previous studies reported conflicting results regarding possible association between PCOS and thyroid disorders. In this study, we investigated the frequency of autoimmune thyroid disease (AITD) and nodular goiter in patients with PCOS. Seventy-three PCOS patients and 60 age-matched controls were enrolled in the study. In PCOS group, body mass index values (27.45 ± 5.73 vs. 22.55 ± 3.78 kg/m(2), p < 0.001, respectively), systolic [110 mmHg (90-130) vs. 100 mmHg (90-140), p = 0.016, respectively] and diastolic (72.67 ± 6.52 vs. 66.42 ± 8.88 mmHg, p < 0.001, respectively) blood pressure, waist circumference (86.27 ± 14.41 vs. 78.78 ± 8.87 cm, p < 0.001, respectively), and homeostasis model assessment-insulin resistance (HOMA-IR) levels (2.96 ± 2.11 and 1.77 ± 0.83 p < 0.001, respectively) were higher than controls. However, thyroid nodule frequency was similar in both groups [22 (30.1 %) vs. 12 (20 %)], also thyroid gland volume was not significantly different [9.23 ml (3.08-32.40) vs. 8.52 ml (4.28-50.29)] among groups. The percentages of patients with thyroid parenchymal heterogeneity, positive anti-thyroid peroxidase, anti-thyroglobulin, and AITD were similar. Cases were reclassified according to the presence of thyroid nodule in which similar HOMA-IR levels were detected (median 2.39 and 1.89, p = 0.093, respectively) despite the fact that the group with nodules had higher mean age (26.5 (18-37) vs. 21 (18-34), p = 0.013, respectively). Similar ratios of thyroid nodule and AITD were found in patients with PCOS and controls.

Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography.

PURPOSE: To investigate choroidal thickness in healthy pregnant women during different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: This prospective study included 90 healthy pregnant women in their first, second, or third trimester (groups 1, 2, and 3, respectively) and 30 non-pregnant healthy women (group 4). The age range for all groups was 18-40 years. Spectral domain optical coherence tomography scans were obtained to estimate the average choroidal thickness. Using EDI-OCT, we measured choroidal thickness manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal, and 3 mm nasal to the fovea. Differences among groups were analyzed by one-way ANOVA. RESULTS: We found a statistically significant difference between groups 2 and group 4 for subfoveal, temporal, and nasal mean choroidal thickness (p=0.007, p<0.001, p=0.026, respectively). The mean choroidal thickness for group 2 was 395 ± 80 µm, 338 ± 74 µm, and 233 ± 61 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness for group 4 was 335 ± 86 µm, 274 ± 54 µm, and 200 ± 53 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. No statistically significant differences were found for choroidal thickness among groups 1-4 (p=0.214, p=0.177, p=0.094, respectively) and between groups 3-4 (p=0.105, p=0.261, p=0.695, respectively) for all measured points. CONCLUSION: Our results suggest that choroidal thickening can occur at the regions subfoveal, temporal, and nasal to the fovea in the second trimester.

Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography / Medição da espessura da coroide em gestantes utilizando tomografia de coerência óptica com profundidade de imagem aprimorada

Purpose: To investigate choroidal thickness in healthy pregnant women during different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: This prospective study included 90 healthy pregnant women in their first, second, or third trimester (groups 1, 2, and 3, respectively) and 30 non-pregnant healthy women (group 4). The age range for all groups was 18-40 years. Spectral domain optical coherence tomography scans were obtained to estimate the average choroidal thickness. Using EDI-OCT, we measured choroidal thickness manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal, and 3 mm nasal to the fovea. Differences among groups were analyzed by one-way ANOVA. Results: We found a statistically significant difference between groups 2 and group 4 for subfoveal, temporal, and nasal mean choroidal thickness (p=0.007, p<0.001, p=0.026, respectively). The mean choroidal thickness for group 2 was 395 ± 80 µm, 338 ± 74 µm, and 233 ± 61 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness for group 4 was 335 ± 86 µm, 274 ± 54 µm, and 200 ± 53 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. No statistically significant differences were found for choroidal thickness among groups 1-4 (p=0.214, p=0.177, p=0.094, respectively) and between groups 3-4 (p=0.105, p=0.261, p=0.695, respectively) for all measured points. Conclusion: Our results suggest that choroidal thickening can occur at the regions subfoveal, temporal, and nasal to the fovea in the second trimester. .

Objetivo: Investigar a espessura da coroide em gestantes saudáveis durante os diferentes trimestres utilizando tomografia de coerência óptica com profundidade de imagem aprimorada (EDI-OCT). Métodos: Este estudo prospectivo incluiu 90 gestantes saudáveis nos primeiro, segundo e terceiro trimestres da gravidez (grupos 1, 2 e 3, respectivamente) e 30 mulheres saudáveis não-gestantes (grupo 4) com faixa etária de 18-40 anos de idade. Foi realizada tomografia de coerência óptica espectral para estimar a espessura média da coroide. A espessura da coroide foi medida manualmente da borda externa do epitélio pigmentar da retina até o limite interno da esclera nas regiões subfoveal, 3 mm temporal e 3 mm nasal à fóvea utilizando EDI-OCT. As diferenças entre os grupos foram analisadas com o teste ANOVA unicaudal. Resultados: Houve diferença estatística significativa na espessura média da coroide entre os grupos 2 e 4 nas regiões subfoveal, temporal e nasal à fóvea (p=0,007; p<0,001; p=0,026, respectivamente). A espessura média da coroide no grupo 2 foi: 395 ± 80 µm, 338 ± 77 µm e 233 ± 61 µm nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Em comparação, a espessura média da coroide no grupo 4 foi de: 335 ± 86 µm, 275 ± 54 µm e 200 ± 53 µm, nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Não foi encontrada diferença estatística significativa entre os grupos 1-4 (p=0,214, p=0,177, p=0,094, respectivamente) e os grupos 3-4 (p=0,105, p=0,261, p=0,695 respectivamente), para todas as medidas. Conclusão: Nossos resultados sugerem que há espessamento da coroide nas regiões subfoveal, temporal e nasal à fóvea no segundo trimestre gestacional. .

Spontaneous rupture of the imperforate hymen in an adolescent girl with hematocolpometra.

Background. Imperforate hymen is usually treated with hymenotomy, and the management after its spontaneous rupture is not very well known. Case. In this paper, we present spontaneous rupture of the imperforate hymen in a 13-year-old adolescent girl with hematocolpometra just before a planned hymenotomy operation. The patient was managed conservatively with a satisfactory outcome. Conclusion. Hymenotomy may not be needed in cases with spontaneous rupture of the imperforate hymen if adequate opening for menstrual discharge is warranted.

Expression of laminin receptor 1 in human placentas from normal and preeclamptic pregnancies and its relationship with the severity of preeclampsia.

OBJECTIVES: To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in preeclamptic and normal third-trimester placentas, as well as to investigate whether its expression differs with disease severity. STUDY DESIGN: Third trimester placental samples obtained from deliveries of preeclamptic (n=34) and normotensive healthy pregnant women (n=35) were immunohistochemically studied for the expression of LR1. The placentas from both mild (n=14) and severe (n=20) preeclamptic pregnancies were further assessed for strength of LR1 expression according to disease severity. RESULTS: When compared with normal placentas, the staining with LR1 protein in cytotrophoblasts and syncytiotrophoblasts was lower in preeclamptic placentas (P<0.05 and P<0.01, respectively). The intensity of staining with LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of preeclamptic placentas did not vary with disease severity (P>0.05). CONCLUSIONS: Decreased LR1 expression in cytotrophoblasts and syncytiotrophoblasts of preeclamptic placentas, which may be independent of disease severity, might have a role in shallow trophoblastic invasion in preeclampsia.

Isolated impairment of posterior pituitary function secondary to severe postpartum haemorrhage due to uterine rupture.

Cranial diabetes insipidus (DI) due to postpartum haemorrhage is an extremely rare clinical event. We describe herein isolated posterior pituitary insufficiency in a 26-year-old woman who had undergone subtotal hysterectomy for severe postpartum haemorrhage because of uterine rupture. The patient experienced polyuria within 6 h postoperatively. DI was suggested by the elevated urine volumes and low urine specific gravity. The diagnosis of DI was confirmed by water deprivation test and vasopressin stimulation test. The anterior pituitary function was within normal limits. A high clinical suspicion is certainly required for the diagnosis of DI in the immediate postpartum period. To rapidly initiate appropriate therapy, the possibility of DI should always be kept in mind while evaluating patients who have polyuria and polydipsia after severe postpartum bleeding. Delay or failure to treat this condition might result in hypovolemic shock.

Does residual amniotic fluid after preterm premature rupture of membranes have an effect on perinatal outcomes? 12 years experience of a tertiary care center.

OBJECTIVE: To review our experience with preterm premature rupture of membranes at a tertiary-care hospital in Turkey to determine whether the amount of residual amniotic fluid after rupture has prognostic value for adverse maternal and fetal outcomes. METHODS: We reviewed the medical records of 191 pregnant women with gestational ages between 24 and 34 weeks at the time of rupture of the amniotic membrane and of their babies delivered in our hospital between January 1996 and September 2008. On the basis of amniotic fluid index (AFI) values recorded at the time of admission, patients were categorized into two groups: those with an AFI < 50 mm (n = 119) and those with an AFI > 50 mm (n = 72). RESULTS: The patients with high gravidity (4-8) were more prevalent in the group with an AFI < 50 mm (37 vs. 23.6%), while nulliparous women were more common in the group with an AFI > 50 mm (44.4 vs. 30.2%) (P < 0.05). Seventy-two percent of the cesarean sections performed due to nonreassuring fetal status were in the group with an AFI < 50 mm (P < 0.01). In 71.4% of the cases with a 5 min Apgar score < or = 7, AFI was less than 50 mm (P < 0.01). AFI < 50 mm was present in 65, 70.8, 76.7, and 73.1% of the pregnancies complicated by chorioamnionitis, respiratory distress syndrome, composite neonatal morbidity, and neonatal death, respectively (P < 0.05). CONCLUSIONS: A residual AFI < 50 mm after preterm PROM between 24 and 34 weeks of gestation, which is mostly seen in grand multiparous women in Eastern Turkey, may be a valuable prognostic variable for anticipating adverse maternal and neonatal outcomes.

Comparison of the efficacy of intrauterine lidocaine, paracervical block and oral etodolac for decreasing pain in endometrial biopsy.

OBJECTIVE: To compare the effectiveness of paracervical block, intrauterine lidocaine and oral etodolac in decreasing the pain caused by pipelle endometrial sampling. A secondary goal of this study was to determine the adverse effects and compare possible effects of these methods on pulse and blood pressure. MATERIAL AND METHODS: The study was performed between April 2006 and October 2006 in the Obstetrics and Gynecology Department of Van Yüzüncü Yil University Research Hospital. One-hundred twenty patients were randomized into four groups: 1. Group: Paracervical block was performed with 3 ml 2% prilocaine solution. 2. Group: Five ml of 2% lidocaine solution was instilled through the endocervix into the uterine cavity. 3. Group: Subjects received 400 mg oral etodolac tablet 1-1.5 hour before the procedure. 4. Group: No method of anesthesia was used in the control group. Endometrial sampling was performed with pipelle. Severity of pain during the procedure was scored by the subjects according to the "6-point Verbal Rating Scale (VRS)". Blood pressure and pulse rate were measured before, during and 30 minutes after the procedure. RESULTS: Pain scores in intrauterine lidocaine group (2(nd) group) were found statistically significantly lower than the other three groups (p<0.05). CONCLUSION: Intrauterine lidocaine anesthesia technique decreases pain in endometrial sampling with pipelle more efficiently than paracervical block or oral etodolac. While indication of menorrhagia and endometrial thickness more than 5 mm increased pain scores, intrauterine lidocaine application or paracervical block decreased the scores significantly (p<0.05).

Brucellosis in pregnancy: a 6-year clinical analysis.

AIM: To review our experience with brucellosis in pregnancy and to characterize the risk factors, clinical presentations, the rates of possible perinatal complications, and the effect of hospitalization on pregnancy outcomes. METHODS: We reviewed the medical records of 21 pregnant women at a tertiary care hospital and 12 at a maternity hospital, who presented with acute, subacute, chronic, or relapsing brucellosis. Their risk factors and clinical presentations were defined. The reproductive outcomes of 29 cases were compared within themselves according to the hospitals they were managed and with the outcomes for all women followed in the maternity hospital for the period from January 2008 through December 2008. RESULTS: Consumption of unpasteurized dairy products had occurred in 92.3% of the cases. Spontaneous abortion, intrauterine fetal death, and preterm delivery rates were 24.14, 3.45, and 6.9%, respectively. Only spontaneous abortion rate substantially exceeded that among the general population of pregnant women in our maternity hospital (P<0.05). Hospitalization did not affect pregnancy outcomes significantly (P>0.05). CONCLUSIONS: Brucellosis in pregnancy is associated with increased incidence of spontaneous abortion without an association with the magnitude of serum agglutination titer, the clinical type of brucellosis and hospitalization. In endemic areas with inhabitants of low socioeconomic class and low educational level, educating women of childbearing age about brucellosis may help to prevent the disease and its complications in pregnancy.

Expression of laminin receptor 1 in gestational trophoblastic diseases and normal placenta and its relationship with the development of postmolar tumors.

OBJECTIVES: To investigate the expression of laminin receptor 1 (LR1), a non-integrin-type laminin receptor, in gestational trophoblastic diseases and normal first-trimester placenta, since it may play a role in controlling trophoblast invasion in normal and molar pregnancies. METHODS: Paraffin sections from 24 gestational age controlled normal first-trimester placentas, 47 partial moles, 56 complete moles, 3 invasive moles, 4 gestational choriocarcinomas, and 1 placental-site trophoblastic tumor were studied immunohistochemically for expression of LR1. RESULTS: In complete and partial moles, decidual cells showed significantly stronger LR1 protein staining compared to the normal placenta (p<0.01). When compared to the partial moles, weak staining in less than 33% of decidual cells was also more prominent in the normal placenta (p<0.05). Complete and partial moles, invasive moles, choriocarcinomas, and placental-site tumors did not differ from each other with respect to staining intensity. Strong immunostaining for LR1 in decidual cells, cytotrophoblasts, syncytiotrophoblasts, and extracellular matrix cells of partial and complete moles was not significantly correlated with the development of persistent postmolar gestational trophoblastic tumors. CONCLUSIONS: LR1 may be important in the pathogenesis of gestational trophoblastic diseases. The increased expression of LR1 in decidual cells of partial and complete moles may not influence the development of persistent gestational trophoblastic tumor. Since they are seen rarely, multicentric studies should be planned to study LR1 expression in invasive moles and gestational trophoblastic neoplasms.