Expression of CD44 mRNA induced by interleukin-1beta in human cultured uterine cervical fibroblasts.

OBJECTIVE: Hyaluronic acid in the cervix plays an important role in the process of cervical ripening. CD44 is a receptor for hyaluronic acid. We investigated whether CD44 is related to cervical ripening by examining the expression of CD44 mRNA in human cultured cervical fibroblasts with or without inflammatory cytokines. STUDY DESIGN: CD44 mRNA expressions derived from cultured human uterine cervical fibroblasts in the presence or absence of interleukin-1beta (IL-1beta) (1-100 pg/ml) or interleukin-8 (IL-8) (1-100 ng/ml) were analyzed by the Northern blot analysis. The human CD44 cDNA probe was hybridized with three species of mRNA. Sizes of the mRNAs were 1.6, 2.2, and 5.0 kilobases (kb). RESULTS: Interleukin-1beta stimulated the expression of CD44 mRNA in a dose-dependent manner. Interleukin-8 did not stimulate the expression. CONCLUSIONS: It is concluded from the present study that human cervical CD44 mRNA expression is induced by interleukin-1beta. Accordingly, we deduce that the concentration of hyaluronic acid in the cervical tissue is increased because of the expression of CD44.

Vaginal Myomectomy for Semipedunculated Cervical Myoma during Pregnancy.

Objective Cases of prolapsed myoma in which pregnancy was carried to full term or near term after vaginal myomectomy are very rare. Previously, only two such cases have been reported. In addition, both those patients had a pedunculated leiomyoma, which could be treated by twisting or clamping. Here, we report a case of a patient who was able to carry her pregnancy to term despite vaginal myomectomy for semipedunculated myoma at 13 weeks of pregnancy. Study Design This study is a case presentation. Results The myoma nucleus was removed by making an incision on the surface of the mass. Systemic and transvaginal antibiotics were prescribed after the surgery. Uterine contractions, short cervix, or cervical funneling was not observed in the remaining duration of pregnancy. Conclusion While performing myomectomy during pregnancy, removal of the myoma nucleus is safer than twisting. In addition, postoperative administration of local or systemic antibiotic agents does not adversely affect pregnancy.

Neutrophil elastase and interleukin-6 in amniotic fluid as indicators of chorioamnionitis and funisitis.

OBJECTIVE: We wished to assess the diagnostic value of amniotic fluid concentrations of neutrophil elastase and interleukin-6 concentrations for the rapid detection of chorioamnionitis and funisitis. STUDY DESIGN: A retrospective study of 56 women who underwent transabdominal amniocentesis within 48 h before preterm delivery or spontaneous abortion. Statistical analyses included Student's t-test and Tukey-Kamer's HSD test. Receiver operating characteristics (ROC) curves were drawn to assess the predictive performance of the two markers. RESULTS: Neutrophil elastase concentrations differed significantly between patients with chorioamnionitis and other stages of chorioamnionitis, while interleukin-6 concentrations did not. To predict chorioamnionitis, concentrations of 3563 ng/ml for neutrophil elastase and 11,279 pg/ml for interleukin-6 were optimal. Comparison of ROC curves showed that neutrophil elastase was a significantly more sensitive predictor of funisitis than interleukin-6. CONCLUSION: Amniotic fluid concentrations of neutrophil elastase are more sensitive than interleukin-6 for the rapid detection of chorioamnionitis and funisitis.