Combination of cervical interleukin-6 and -8, phosphorylated insulin-like growth factor-binding protein-1 and transvaginal cervical ultrasonography in assessment of the risk of preterm birth.

Objective: To determine the value of combinations of cervical interleukin-6 (IL-6), cervical interleukin-8 (IL-8), the phosphorylated isoform of insulin-like growth-factor binding protein-1 (IGFBP-1), and cervical ultrasonography in the prediction of preterm birth.

Design: Prospective follow up.

Setting: Oulu University Hospital maternity clinic from February 1997 to July 1998.

A randomised controlled trial of vaginal clindamycin for early pregnancy bacterial vaginosis.

Objective: To determine whether treatment of bacterial vaginosis (BV) with vaginal clindamycin affects pregnancy outcome.

Materials And Methods: Mothers with singleton pregnancies and without previous preterm delivery in 17 health centres in Oulu from March 1996 Until March 1998, in whom BV was diagnosed by Gram stain of a vaginal swab at the first antenatal visit (at the 12th gestational week) were randomised at Oulu University Hospital to have a one-week course of vaginal clindamycin, or placebo. A follow up sample of Gram stain was taken two weeks after randomisation and at the 30th gestational weeks.

The prognostic value of peritoneal cytology in ovarian cancer.

We studied the significance of peritoneal cytology as a prognostic factor in primary epithelial ovarian cancer. Intraperitoneal specimens for cytological examination were taken from 73 patients at primary operation for ovarian cancer. The prognostic value of cytological findings was analyzed by the Kaplan-Meier method.

Tenascin in human papillomavirus associated lesions of the uterine cervix.

The immunohistochemical expression of tenascin was studied in 80 morphologically diagnosed condylomas and cervical intraepithelial neoplasia (CIN) lesions. The results were compared with the human papillomavirus (HPV) DNA subtype, which was determined by HPV dot blot and in situ hybridisation. Tenascin mRNA synthesis was also determined in 10 selected cases by in situ hybridisation.

Maturation of vaginal and endometrial epithelium in postmenopausal breast cancer patients receiving long-term tamoxifen.

To assess the estrogenic effects of tamoxifen on vaginal and endometrial epithelium and to investigate whether these changes are associated with any pathological findings in the endometrium, 53 postmenopausal breast cancer patients receiving long-term tamoxifen and 52 control breast cancer patients without any hormonal treatment were examined. Pathological findings in the endometrium were evaluated by hysteroscopy and curettage. The main outcome measures were the maturation index in Papanicolaou (Pap) smears, estrogen-like epithelial changes in the endometrium, serum concentrations of gonadotropins, sex hormone-binding globulin (SHBG), estradiol (E2), and testosterone (T).

Expression of p53 and proliferating cell nuclear antigen in lichen sclerosus et atrophicus with different histological features.

In this study, immunohistochemistry was used to investigate p53 and proliferating cell nuclear antigen (PCNA) expression in 40 cases of lichen sclerosus et atrophicus (LSA). Nuclear immunoreactivity for both p53 and PCNA was found in the basal and parabasal keratinocytes in the majority (91%) of the lesions. Typically, there was a widely varying positivity for PCNA, suggesting a wide range of proliferative capacity in individual LSA lesions.

Acitretin in the treatment of severe lichen sclerosus et atrophicus of the vulva: a double-blind, placebo-controlled study.

Background: Promising results have been reported from treatment with oral retinoids in patients with severe lichen sclerosus et atrophicus (LSA) of the vulva.

Objective: The aim of our study was to determine the efficacy of acitretin (20 to 30 mg/day) for 16 weeks in LSA.

Methods: Seventy-eight patients were enrolled into a multicenter, randomized, placebo-controlled, double-blind trial.

Detection of human papillomavirus infection by non-isotopic in situ hybridisation in condylomatous and CIN lesions.

Aims: To study the value of non-isotopic in situ hybridisation (NISH) in detecting human papillomavirus (HPV) infection in female genital lesions positive for the virus by conventional histology but negative by filter DNA hybridisation.

Methods: Forty three cases, which showed the histological hallmarks of the HPV infection but produced negative results in filter dot blot hybridisation tests (Vira Pap and Vira Type kits), were identified in the course of an investigation of 304 vaginal, vulvar, and cervical samples from 267 patients. These cases were studied by NISH for the presence of HPV infection.

Detection and typing of human papillomavirus infection affecting the cervix, vagina and vulva. Comparison of DNA hybridization with cytological, colposcopic and histological examinations.

The sensitivity of human papillomavirus (HPV) detection was compared by colposcopy, histology and DNA hybridization among 304 women with abnormal Papanicolaou (Pap) smear. Colposcopically directed biopsies revealed HPV infection in 71% of cases, DNA hybridization in 35%, and both together in 78%. DNA hybridization detected HPV in 24% of the 84 benign cases with no histological signs of HPV, in 32% of the 133 condylomas verified by biopsies and in 51% of the 85 cases with intraepithelial neoplasia, 95% of which presented histological signs of HPV.

Anaerobic vaginosis: treatment with tinidazole vaginal tablets.

A prospective randomized trial comprising 90 patients was undertaken to evaluate three different regimens of tinidazole in the treatment of anaerobic vaginosis. Each group consisted of 30 women. The three regimens were: (A) oral tinidazole (150 mg X 2) for 7 days, (B) same oral treatment as above but also the partner received 500 mg X 2 for 4 days, and (C) intravaginal tinidazole (500 mg) at bedtime for 2 weeks.

Endobrush sampling for endometrial cancer.

The two intra-uterine cytological sampling methods Endobrush and Pistolet were compared for clinical applicability in 66 premenopausal and 47 postmenopausal women. The taking of the specimens succeeded in 94% of the cases with the Endobrush method and in 99% with the Pistolet method. The two intra-uterine sampling methods were both almost painless.

Tamoxifen and natural progesterone as supplements to low-dose postmenopausal estrogen therapy.

Postmenopausal women received 1 mg estrone sulfate a day for 3 weeks in 12 sequences separated by a 7-day interval without medication and every second time by a 10-day treatment with natural progesterone, 100 mg 2 times daily (n = 16), or tamoxifen, 10 mg 2 times daily (n = 17). Both treatments alleviated climacteric symptoms, maturated the vaginal epithelium, and decreased follicle-stimulating hormone, luteinizing hormone, and prolactin concentrations while lipid metabolism remained unaltered. In the estrogen-progesterone group 4 women (25%) were persistently amenorrheic, 12 (75%) experienced 1-5 bleedings per year, and 4 women had proliferative endometrium after treatments.

Screening of asymptomatic postmenopausal women for gynecological malignancies, with special reference to endometrial sampling methods.

To investigate the applicability of cytological and histological endometrial sampling methods and to study the incidence of silent premalignant or malignant gynecological diseases during the postmenopausal years, 415 asymptomatic women were examined both clinically and with cytological smears and 360 of them also examined with jet wash or pistolet aspiration and Vabra curettage. Examination with jet wash, pistolet aspiration and Vabra curettage was possible in 57.2%, 83.

Investigation of gynecological cancer with nuclear magnetic relaxation methods.

Nuclear magnetic relaxation times T1 and T2 of cell water protons in benign and malignant uterine cervical tissue (37 samples taken from 22 patients) were measured using a resonance frequency of 19.8 MHz. The means of relaxation times recorded for malignant tissue were (mean +/- S.