Contraception and sexuality after termination of pregnancy: a comparison between Lugano and Geneva.

Objective: To evaluate the impact of a voluntary termination of pregnancy (TOP) on contraceptive practice and sexual well-being in women.

Study Design And Methods: Comparative evaluation of a retrospective study conducted in Lugano in 1995 with 85 women interviewed 3-6 months post-TOP, and a prospective study carried out in Geneva in 1998 with 103 women interviewed pre-TOP and 6 months post-TOP. In both studies TOP was performed during the first 12 weeks of pregnancy by vacuum aspiration and curettage.

Effects of leptin, interleukin-1alpha, interleukin-6, and transforming growth factor-beta on markers of trophoblast invasive phenotype: integrins and metalloproteinases.

Phenotypic changes of integrin and metalloproteinase secretion of the invasive human cytotrophoblast are regulated by cytokines and growth factors, but how this occurs is not completely understood. We used 24-h cytotrophoblast cultures from first trimester pregnancies to investigate the effects of leptin and cytokines on the expression of the alpha2, alpha5, and alpha6 integrin subunits and on the activity of metalloproteinase-2 (gelatinase A) and metalloproteinase-9 (gelatinase B). The alpha2 subunit was marginally upregulated by leptin and interleukin-1alpha (IL-1alpha).

Surgical methods for first trimester termination of pregnancy.

Background: Different surgical methods for termination of pregnancy have evolved over the years: Dilatation and curettage, power operated vacuum aspiration, manual vacuum aspiration (MVA) or hysterotomy. Local or general anaesthesia is used for all methods. Preabortion medical or mechanical cervical preparation may reduce the incidence of cervical or uterine injuries.

Reproductive health in eastern Europe: a collaborative training project in Romania.

Since the fall of the Berlin Wall, fundamental political changes in eastern Europe have affected the Soviet-style health care systems that formerly provided basic care for everyone. Many of these systems have collapsed, and the new systems of social insurance that have replaced them often are inadequate. Advanced Training in Reproductive Health in Romania aimed to create an authority in family planning and reproductive health in selected Romanian university centers and to improve training and research capabilities.

Biochemistry and molecular biology of trophoblast invasion.

Cytotrophoblastic cells (CTBs) from first-trimester placenta form columns of invasive CTBs. This invasive behavior is due to the ability of CTBs to secrete matrix metalloproteinases (MMPs), since tissue inhibitor of MMPs (TIMP) inhibits their invasiveness in the extracellular space. Although CTBs behave like metastic cells, in vivo they are only transiently invasive (first trimester), and their invasion is normally limited only to the endometrium and to the proximal third of the myometrium.

[Usefulness of implantable loop recorder in the diagnosis of undetermined syncope. Report of a clinical case].

In this paper we describe the case of a 42-year-old man who presented with rather infrequent episodes of syncope. In view of this symptomatology, he had been repeatedly hospitalized and submitted to a complete diagnostic workup inclusive of brain computed tomography, head-up tilt test, repeated Holter monitoring, and electrophysiologic evaluation. Unfortunately, none of these tests allowed the formulation of a precise diagnosis.

Combined screening for Chlamydia trachomatis and squamous intra-epithelial lesions using a single liquid-based cervical sample.

Background: Cervicitis is believed to alter cytological interpretation and could compromise a combined screening for Chlamydia trachomatis (CT) cervicitis and squamous intra-epithelial lesions (SIL). Liquid-based cytological methods have been shown to limit obscuring factors and permit the detection of infectious agents by DNA amplification techniques. The aim of this study was to evaluate a combined screening for SIL and CT cervicitis with a single liquid-based cervical sample.

Sexuality, partner relations and contraceptive practice after termination of pregnancy.

The aim of this study was to determine the impact of termination of pregnancy (TOP) on women's sexual well-being, the couple and contraceptive practice. In a prospective qualitative and quantitative study, 103 women undergoing induced abortion by vacuum aspiration were interviewed before the abortion and 6 months later. The interview was performed by means of a questionnaire including open and closed questions, and two psychological tests (Locke-Wallace and Horowitz).

Effect of a combined oral contraceptive containing 3 mg of drospirenone and 30 microg of ethinyl estradiol on the human endometrium.

Objective: To provide an in-depth assessment of the effects of the combined oral contraceptive containing 30 microg of ethinyl estradiol and 3 mg of drospirenone (Yasmin, Schering AG, Berlin) on the endometrium by means of endometrial morphometry in comparison to an untreated cycle.

Design: The open, multicenter study consisted of one untreated precycle and 13 treatment cycles.

Setting: Four gynecologic clinics in Belgium, The Netherlands, and Switzerland were involved.

Is cellular fibronectin a biological marker for pre-eclampsia?

Cellular fibronectin (cFn) appears to be an important factor in the regulation of cell-cell interactions. It is mostly synthesised by endothelial cells and its increased circulating values are thought to correspond to the endothelial damage. As pre-eclampsia is considered a pathology of endothelial cells, our study was intended to see if this circulating protein is increased during pre-eclampsia and to determine from which moment in pregnancy these changes occur.

Effects of human hydrosalpinx fluid on in-vitro murine fertilization.

Patients with hydrosalpinges show a decrease of both fertility and clinical outcome of IVF and embryo transfer treatment. Several reports have demonstrated the negative effects of hydrosalpinx fluid (HSF) on embryo development and implantation. The aim of this study was to determine whether human HSF, collected from infertile patients, might exhibit a deleterious effect on gametes and fertilization using a murine IVF system.

A putative role for oncogenes in trophoblast invasion?

Tumour invasion and trophoblastic invasion share the same biochemical mediators: the matrix metalloproteinases (MMP) and their inhibitors (TIMP). MMP are a family of enzymes capable of digesting the extracellular matrices of the host tissues. Human cytotrophoblastic cells are constitutively invasive and produce MMP.

Induced abortion and psychosexuality.

Little information exists on the impact of induced abortion on psychosexuality. Negative psychological effects and psychiatric complications due to termination of pregnancy seem to be rare. The objective of this study was to review the impact of induced abortion on sexuality and couple relationships.

Association between weather conditions and the incidence of emergency gynecological consultations.

Objective: This study examined the influence of weather conditions on the incidence of outpatient emergency consultations at the Department of Obstetrics and Gynecology at the Regional Hospital in Lugano, Switzerland.

Study Design: The medical records of all women who attended the outpatient emergency unit at the Department for Obstetrics and Gynecology over the 1-year study period were reviewed. The final diagnosis was pelvic pain of unidentified origin in 180 cases, menorrhagia and/or metrorrhagia in 95 cases, threatened abortion in 56 cases and spontaneous abortion in 54 cases.

Bax and p53 are differentially involved in the regulation of caspase-3 expression and activation during neurodegeneration in Lurcher mice.

Intrinsic Purkinje cell death in heterozygous Lurcher (Grid2Lc/+) mice is accompanied by the target-related death of granule cells and olivary neurons. The expression of pro-caspase-3 is increased in Grid2Lc/+ Purkinje cells and activated caspase-3 is detected in all three cell types before their death. Bax inactivation in Grid2Lc/+ mutants rescues granule cells but not Purkinje cells.

Comparison of the effects of GnRH-I and GnRH-II on HCG synthesis and secretion by first trimester trophoblast.

Gonadotrophin-releasing hormone (GnRH) is an important factor in the regulation of the synthesis and secretion of gonadotrophins from the pituitary gland. An isoform of this decapeptide, GnRH-II, with an amino acid sequence 70% homologous to GnRH-I, has been recently described. Since the physiological effects of GnRH-II are not yet known, we undertook the present study to see whether GnRH-II could be involved in the secretion and synthesis of HCG in first trimester trophoblast.

Expression of pro-EPIL peptides encoded by the insulin-like 4 (INSL4) gene in chromosomally abnormal pregnancies.

The recent development of a specific immunoassay based on monoclonal antibodies directed to chain C and chain A of early placenta insulin-like peptide (EPIL) encoded by the INSL4 gene, has made it possible to demonstrate pro-EPIL peptide expression during normal pregnancy. In the present study, we report on the expression of pro-EPIL peptides in chromosomally abnormal pregnancies, namely trisomy 21 and 18. EPIL peptide levels were measured in amniotic fluid (AF) and maternal serum (MS) from pregnancies with trisomy 21 (n=16) or 18 (n=14) and compared to levels detected in AF and MS from 33 chromosomally normal pregnancies between 12 and 32 weeks of gestation.

Molecular mediators of implantation.

Because cytotrophoblastic cells (CTB) from first-trimester placenta form columns of invasive CTB they have been considered as a model for blastocyst implantation. This invasive behaviour is due to the ability of CTB to secret matrix metalloproteinases (MMPs) because tissue inhibitor of MMP (TIMP) inhibits their invasiveness. Although CTB behave like metastatic cells, in vivo they are only transiently invasive (first trimester) and their invasion is normally limited only to the endometrium and to the proximal third of the myometrium.

Choriocarcinoma-like human chorionic gonadotrophin (HCG) and HCG bioactivity during the first trimester of pregnancy.

The objective of this study was to evaluate the distribution of choriocarcinoma-like human chorionic gonadotrophin (HCG) isoforms during first trimester pregnancy and their relationship with in-vitro HCG bioactivity. This was done by means of a retrospective analysis of patients' sera with first trimester normal intrauterine and abnormal (ectopic) pregnancies. Serum samples were obtained from 38 women with an amenorrhoea of <10 weeks.

Evaluation of 'round cells' in semen analysis: a comparative study.

The aims of this review are to evaluate the morphological differences between 'round cells' of spermatogenic and non-spermatogenic origin in semen. The latter group includes inflammatory cells like neutrophils, lymphocytes, and macrophages, and epithelial cells. A comparison was made between non-spermatogenic cells in semen samples and inflammatory cells in blood smears, using various staining procedures commonly used in routine andrology laboratories.

A role for the MEK-MAPK pathway in okadaic acid-induced meiotic resumption of incompetent growing mouse oocytes.

Fully grown competent mouse oocytes spontaneously resume meiosis in vitro when released from their follicular environment, in contrast to growing incompetent oocytes, which remain blocked in prophase I. The cell cycle regulators, maturation promoting factor (MPF; [p34(cdc2)/cyclin B kinase]) and mitogen-activated protein (MAP) kinases (p42(MAPK) and p44(MAPK)), are implicated in meiotic competence acquisition. Incompetent oocytes contain levels of p42(MAPK), p44(MAPK), and cyclin B proteins that are comparable to those in competent oocytes, but their level of p34(cdc2) is markedly lower.

Mechanisms of endometrial control of trophoblast invasion.

Tumour invasion and trophoblastic invasion share the same biochemical mediators: the matrix metalloproteinases (MMPs) and their inhibitors. MMPs are a family of enzymes capable of digesting the extracellular matrices of the host tissues. Human cytotrophoblastic cells are constitutively invasive and produce MMPs.

Is chronic hypoxemia in patients with chronic obstructive pulmonary disease associated with more marked nutritional deficiency? A study of the fat-free mass evaluated by anthropometry and bioelectrical impedance methods.

In order to determine wheter blood gases abnormalities, specially hypoxemia, are associated with more marked changes in fat-free mass in patients with chronic obstructive pulmonary disease (CPOD), nutritional assessment was performed on 16 normoxemic (PaO2 > 55 mm Hg) and 16 hypoxemic (PaO2 < 55 mm Hg) COPD patients in stable clinical condition. Body weight was expressed as percentage of the ideal body weight. Fat-free mass was estimated by anthropometry (FFM-Anthr) and by bioelectrical impedance (FFM-BI).

A case of 45,X Turner syndrome with spontaneous ovulation proven by ultrasonography.

A well-documented case of non-mosaic Turner syndrome, with spontaneous pubertal development and ovulatory cycles is reported. Mosaicism could be excluded both by karyotyping of 172 metaphases of blood lymphocytes and fibroblasts, and by fluorescence in situ hybridization, using an X-centromeric probe, in 200 blood lymphocyte nuclei. This Turner syndrome patient underwent normal pubertal development, with spontaneous menarche at 14 years, followed by regular monthly periods.