Rate of elimination of γ-hydroxybutyrate from blood determined by analysis of two consecutive samples from apprehended drivers in Norway.

Aim: Gamma-hydroxybutyrate (GHB) is a common drug of abuse with an elimination half-life of 20-45 min. However, there is some evidence that GHB might exhibit saturation kinetics after ingesting high recreational doses. The aim of this study was to investigate the elimination kinetics of GHB from blood in people apprehended by the police for impaired driving and secondary to describe concentrations in all GHB-positive drivers.

Intrauterine Progestin Therapy as a New Approach to Premalignant Endometrial Polyps: A Prospective Observational Study.

Background/aim: Endometrial hyperplastic polyps (EHP) may progress to endometrial carcinoma (EC) if left untreated. We aimed to prospectively investigate the efficacy of the low-dose levonorgestrel intrauterine system (LNG-IUS) as therapy for EHP with malignant potential.

Patients And Methods: In total, 37 women with EHP underwent therapy with LNG-IUS containing 13.

Low-dose LNG-IUS as Therapy for Endometrial Hyperplasia. A Prospective Cohort Pilot Study.

Background/aim: Progestin therapy has been accepted as therapy for low- and medium-risk endometrial hyperplasia. The aim of this study was to investigate the efficacy of the low-dose levonorgestrel-impregnated intrauterine system (LNG-IUS) 13.5 mg (Jaydess®, Bayer Pharmaceuticals, Berlin, Germany) as therapy for endometrial hyperplasia.

Prediction of Relapse After Therapy Withdrawal in Women with Endometrial Hyperplasia: A Long-term Follow-up Study.

Aim: To investigate whether risk of relapse of endometrial hyperplasia persists many years after successful primary therapy and whether clinical or biological markers observed at primary diagnosis may predict relapse.

Materials And Methods: A series of 57 women with endometrial hyperplasia received levonorgestrel-impregnated intrauterine system or oral progestin for three months during 1998-2000. Index biopsies were classified according to WHO1994 and D-score systems, and immunohistochemical staining for estrogen receptor α (ERα), estrogen receptor β (ERβ), progesterone receptor A (PRA), progesterone receptor B (PRB), B-cell lymphoma 2/apoptosis regulator (BCL2), BCL2-associated X protein/apoptosis regulator (BAX), paired box 2 (PAX2), and phosphatase and tensin homolog (PTEN) reported as H-scores.

HE4 is a novel tissue marker for therapy response and progestin resistance in medium- and low-risk endometrial hyperplasia.

Background: The aim of the present study was to investigate whether changes in the tissue expression of human epididymis-specific protein 4 (HE4) could predict therapy resistance and relapse after progestin hormone therapy for medium- and low-risk endometrial hyperplasia.

Methods: Endometrial biopsies were obtained from women participating in a multicentre RCT performed according to the CONSORT guidelines; the women were randomly assigned to either LNG-IUS; 10 mg of oral medroxyprogesterone acetate (MPA) administered for 10 days per cycle; or 10 mg of oral MPA administered daily for 6 months. Of the 153 women who completed therapy, 141 had adequate material for immunohistochemistry in pre- and post-treatment biopsies.

Expression of PAX2 and PTEN Correlates to Therapy Response in Endometrial Hyperplasia.

Aim: To investigate if a levonorgestrel-impregnated intrauterine system (LNG-IUS) was more efficient compared to oral progestin in the clearance of the paired box 2 gene (PAX2) - and phosphatase and tensin homolog (PTEN)-null endometrial glands and assess the significance of PAX2- and PTEN-null glands as markers for therapy response in endometrial hyperplasia.

Patients And Methods: Immunohistochemical staining using antibodies against PAX2 and PTEN was performed in 141 pre- and post-treatment endometrial biopsies comparing the effect of LNG-IUS, 10 mg medroxyprogesterone acetate (MPA) taken continuously, or 10 mg MPA taken 10 days per cycle for six months. PAX2- and PTEN-null glands were investigated by light microscopy in pre-and post-treatment biopsies.

Levonorgestrel-impregnated Intrauterine device reduces occurrence of hyperplastic polyps: a population-based follow-up cohort study.

Background: The main objective was to investigate if occurrence of hyperplastic polyps was reduced by use of the levonorgestrel-impregnated intrauterine system (LNG-IUS, Mirena®; Bayer) and if the LNG-IUS was more effective compared to oral medroxyprogesterone acetate (MPA) or observation-only.

Patients And Methods: Patients (N=59) with hyperplastic polyps were given LNG-IUS, 10 mg oral MPA taken 10 days per cycle, or had observation-only for six months. Diagnosis of histological specimens was performed by light microscopy according to the WHO classification and D-score prior to and after six months therapy.

Expression of iNOS--a favourable prognostic marker for early-stage carcinoma of the uterine cervix.

In former studies, raised urine cGMP levels have been reported to predict adverse outcome in cervical cancer. The main objective of the present study was to investigate the value of nitric oxide synthase (iNOS) and other members of the cGMP pathway as potential biomarkers for prognosis of cervical carcinoma. Tissue samples from 85 patients surgically treated for early-stage cervical carcinoma were immunohistochemically stained for iNOS, soluble guanylyl cyclase subunits α1 (sGC-α1), soluble guanylyl cyclase α2 (sGC-α2), and phosphodiesterase 5, each sample evaluated microscopically by a semi-quantitative score.

Down-regulated progesterone receptor A and B coinciding with successful treatment of endometrial hyperplasia by the levonorgestrel impregnated intrauterine system.

Objective: To investigate whether regression of endometrial hyperplasia observed after 3 months of treatment with levonorgestrel impregnated intrauterine system device (LNG-IUS) was sustained after 6 months and whether these effects were still occurring synchronously with extinguished expression of progesterone receptors and increased apoptosis.

Design: Retrospective population-based observational study.

Setting: Six local hospitals and one university hospital in northern Norway.

Prognostic markers for coexistent carcinoma in high-risk endometrial hyperplasia with negative D-score: significance of morphometry, hormone receptors and apoptosis for outcome prediction.

Objectives: Hysterectomy represents the current routine therapy for high-risk endometrial precancers. More sophisticated methods are needed for treatment decision among women who want to preserve fertility and seriously ill patients. Among women diagnosed with high-risk hyperplasia, approximately 40% show signs of endometrial cancer in the hysterectomy specimen.

Treatment results of endometrial hyperplasia after prospective D-score classification: a follow-up study comparing effect of LNG-IUD and oral progestins versus observation only.

Objectives: Three different treatment options for endometrial hyperplasia were evaluated in a prospective long-time follow-up study, comparing effects of intrauterine levonorgestrel impregnated device (LNG-IUD), low oral dose of medroxyprogesterone acetate (MPA) and no treatment (observation only). To select patients with high probability for co-existing or future carcinoma we used the objective morphometric algorithm, D-score, stratifying patients into three different risk groups. As far as we know, this is the first prospective long-time follow-up study in which treatment recommendation and outcome is based on the D-score assessment.

Prognosis of early cervical cancer (FIGO Stages IA2, IB, and IIA) in northern Norway predicted by malignancy grading score and objective morphometric image analysis.

Recurrence of early-stage cervical cancer after primary surgery represents a considerable clinical problem, and, so far, few reliable markers for prediction of recurrence exist. Thus, the prognostic value of the malignancy grading score (MGS) classification system was evaluated in 82 patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics stages IA2, IB, and IIA) and long-time follow-up (5-16 years). Recurrence or not, the likelihood of lymph node metastases and reproducibility of the MGS semiquantitative system were tested.

Effect of levonorgestrel IUD and oral medroxyprogesterone acetate on glandular and stromal progesterone receptors (PRA and PRB), and estrogen receptors (ER-alpha and ER-beta) in human endometrial hyperplasia.

Objectives: The effect on progesterone and estrogen receptor expression in glands and stroma after two different treatment regimens of endometrial hyperplasia was determined.

Methods: Pre- and post-treatment paraffin-embedded endometrial hyperplasia specimens from women treated with levonorgestrel (LNG) intrauterine device (n = 21) and women treated with 10 mg medroxyprogesterone acetate (MPA) for 10 days per cycle (n = 29) were examined immunohistochemically and evaluated by H-score (a semi-quantitative microscopical method evaluating staining intensity and number of stained cells, scale 0-3) for changes in expression of PRA (progesterone receptor A), PRB (progesterone receptor B), ER-alpha (estrogen receptor-alpha), ER-beta (estrogen receptor-beta) and AR (androgen receptors) after 3 months of treatment.

Results: All the patients in the LNG IUD group responded to treatment with no sign of hyperplasia after 3 months, while only about half of the patients given MPA orally responded.