11beta-Hydroxysteroid dehydrogenase activity in pregnancies complicated by hydatidiform mole.

Problem: 11beta-Hydroxysteroid dehydrogenase (11beta-HSD) plays an important role in regulating active glucocorticoid reaching the fetus. In normal pregnancy, placental 11beta-HSD functions primarily in oxidative direction. Placental tissue of patients with pregnancies complicated by pre-eclampsia exhibit significantly lower type 1 and 2 11beta-HSD activities and significantly high cortisol level in cord blood suggesting fetal exposure to higher level of active glucocorticoids.

Vaginal intraepithelial neoplasia: risk factors for persistence, recurrence, and invasion and its management.

Objective: Our purpose was to profile patients with vaginal intraepithelial neoplasia, evaluate the response to treatment and define risk factors for persistence and progression.

Study Design: We reviewed records and histopathology slides of 94 patients with vaginal intraepithelial neoplasia diagnosed from 1977 to 1986. For 74 patients with follow-up, we evaluated risk factors by univariate and multivariate analyses.

Variations in human placental 11 beta-dehydrogenase and 11-oxoreductase activities of 11 beta-hydroxysteroid dehydrogenase enzyme during pregnancy.

Human placental 11 beta-hydroxysteroid dehydrogenase enzyme has an important role in controlling glucocorticoids reaching the fetus. Excess glucocorticoids impair fetal growth. Recent investigations show that the placenta is rich in NAD- and NADP-dependent 11 beta-hydroxysteroid dehydrogenase activity.

Multiple recurrences of cervical intraepithelial neoplasia in women with the human immunodeficiency virus.

Objective: To evaluate the long-term outcomes after treatment of cervical intraepithelial neoplasia (CIN) in women infected with the human immunodeficiency virus (HIV).

Methods: Human immunodeficiency virus-infected and HIV-negative women treated for CIN by ablation or excision were followed-up prospectively by cytology and colposcopy for periods of up to 73 months.

Results: Among 127 HIV-infected CIN patients, 62% developed recurrent CIN by 36 months after treatment, compared with 18% of the 193 HIV-negative CIN patients.

Adenomyosis.

The clinical diagnosis of adenomyosis is elusive but should be suspected in women who complain of abnormal uterine bleeding or dysmenorrhea and have a regular but enlarged uterus. The use of newer diagnostic imaging modalities and recent research on myometrial biopsies should enable the clinician to arrive at a definite preoperative diagnosis and offer the patient treatment tailored to her needs.