The investigation of the factors affecting retroperitoneal lymph node metastasis in stage IIIC and IV epithelial ovarian cancer.

Introduction: The appropriate management of advanced ovarian cancer has been controversial in recent years. Lymphatic node involvement is known one of the most important prognostic factors in epithelial ovarian carcinomas. On the other hand in patients with advanced ovarian cancer involving the upper abdomen (with/without lymph node involvement) the evaluation of pelvic and para-aortic lymph nodes does not contribute to the staging and more importantly it does not improve overall-survival.

Fetal malformations associated with the use of methylphenobarbital and carbamazepine during pregnancy. Two case reports and review of the literature.

The use of antiepileptic drugs (AEDs) during pregnancy has been associated with an increased risk of major and minor fetal malformations. This paper describes 2 infants with malformations born to epileptic mothers who used AEDs throughout pregnancy. In the first case, the AED used for seizure control was methylphenobarbital, while in the second case the patient had been prescribed carbamazepine.

Transdermal testosterone may improve ovarian response to gonadotrophins in low-responder IVF patients: a randomized, clinical trial.

Background: Studies in macaques have indicated that androgens have some synergistic effects with FSH on folliculogenesis. This study investigated the usefulness of pretreatment with transdermal testosterone in low-responder IVF patients.

Methods: Randomized clinical trial including 62 infertile women who had a background of the first IVF treatment cycle cancelled because of poor follicular response.

Does the learning curve of conservative laparoscopic surgery in women with rectovaginal endometriosis impair the recurrence rate?

Objective: To assess the effect of surgeon's increasing experience in conservative laparoscopic surgery of women with rectovaginal endometriosis on the surgical outcome of these patients recurrence rate.

Design: Prospective cohort study.

Setting: University teaching hospital.

Long-term safety and tolerability of flutamide for the treatment of hirsutism.

Objective: To evaluate the long-term safety and tolerability of flutamide therapy for hirsutism.

Design: Prospective observational study.

Setting: Gynecology department in a teaching hospital.

Increased messenger ribonucleic acid expression of the cyclin-dependent kinase inhibitor p27Kip1 in cleavage-stage human embryos exhibiting developmental arrest.

Objective: To quantify p27 messenger RNA (mRNA) levels in human arrested and normally developing embryos and nonfertilized oocytes to determine whether the p27 protein abundance, reported in cleavage-stage embryos exhibiting developmental arrest, is regulated at the mRNA expression level.

Design: Real-time reverse transcription quantitative polymerase chain reaction was used to quantify the expression of p27 in three samples: arrested embryos (group A, n = 29), normally developing embryos (group D, n = 34), and nonfertilized oocytes (group O, n = 20).

Setting: Research laboratory working closely with a clinical IVF practice.

Follicle-stimulating hormone does not directly regulate bone mass in human beings: evidence from nature.

Objective: To evaluate the effect of FSH levels in the development of human osteoporosis.

Design: Case-series study.

Setting: Gynecology department in a teaching hospital.

Effects on serum lipid and leptin levels of three different doses of norethisterone continuously combined with a fixed dose of 17beta-estradiol for nasal administration in postmenopausal women: a controlled, double-blind study.

Objective: To evaluate the effect of intranasal continuous combined hormone therapy on serum lipids and leptin levels in healthy postmenopausal women.

Design: Multicenter, double-blind, double-dummy, randomized, controlled study conducted in parallel groups.

Setting: Outpatient clinics of three Spanish hospitals and two private health centers.

Premature ovarian failure in a patient with a complex chromosome rearrangement involving the critical region Xq24, characterized by analysis using fluorescence in situ hybridization by chromosome microdissection.

Objective: To characterize a complex chromosome rearrangement previously detected by G-banding in peripheral blood lymphocytes as 46,X, inv(X)(p11;q2?), inv(4)(q?),ins(8)(q?) in a patient with primary amenorrhea.

Design: Case report.

Setting: University faculty of medicine and hospital.

Histopathological findings in postoperative specimens in cervical cancer patients with stages IB2-IVA after neoadjuvant chemotherapy and preoperative plus postoperative radiotherapy.

Purpose: To determine the incidence of the histopathological findings indicative for risk of recurrence in patients with locally advanced cervical cancer (LACC) who were treated with neoadjuvant chemotherapy (NCT) and radiation therapy (RT) before operation.

Patients And Methods: Sixty-three patients were included: 45 patients (group 1) underwent external beam RT and then surgical treatment followed by postoperative RT, and 18 (group 2) patients were treated with NCT and surgery followed by postoperative RT. Surgery was class III-V radical hysterectomy with pelvic lymph node dissection (LND), and paraaortic LND at indication.

Flexible hysteroscopy in irregular uterine bleeding.

Purpose: The objective of our study was to analyze the possibilities of diagnostic flexible hysteroscopy in women with irregular uterine bleeding.

Patients And Methods: The study involved 661 women aged 26-72 years (mean 46.23) with mild to moderate irregular uterine bleeding who agreed to have invasive investigations.

Treatment of heterotopic cervical pregnancy after in vitro fertilization-embryo transfer by using transvaginal ultrasound-guided aspiration and instillation of hypertonic solution of sodium chloride.

Objective: To report a case of successful treatment of heterotopic cervical pregnancy resulting from IVF-embryo transfer.

Design: Case report.

Setting: Tertiary university clinical center.

Role of Fra-2 in breast cancer: influence on tumor cell invasion and motility.

Fra-2 (Fos-related antigen 2) is a member of the Fos family of AP-1 transcription factors which is often up-regulated in mammary carcinomas. Previous results suggested that it might be involved in the regulation of breast cancer invasion and metastasis. In order to analyze the role of Fra-2 in breast cancer cells, it was silenced in the highly invasive MDA-MB231 cells using RNA interference.

Clinical aspects of gynecological cancers' prophylaxis.

Purpose: To analyze the modern possibilities of primary and secondary prophylaxis in gynecological cancers and their place in the medical practice in our country.

Materials And Methods: The data of the Bulgarian National Cancer Registry and the relevant world literature served as a source for review and analysis of different primary and secondary prevention measures for gynecological malignancies.

Results: For 2003 high levels of incidence and mortality were established: standardized yearly incidence of cervical cancer 19.

Neoadjuvant chemotherapy followed by radical surgery and radiotherapy vs. pelvic irradiation in patients with cervical cancer FIGO stage IIB - IVA.

Purpose: To compare the 2-year recurrence-free survival, recurrence rates and their localization after treatment with definitive radiation therapy (RT) vs. neoadjuvant chemotherapy (NCT) followed by radical surgery and post-operative RT in cervical cancer patients with FIGO stages IIB through IVA.

Patients And Methods: 43 patients were included in the study, 25 of whom (group 1) were treated with pelvic RT(50-52 Gy external beam RT) and 18 (group 2) with NCT followed by surgery and postoperative RT(50-52 Gy).

Vascular endothelial growth factor levels in serum and plasma from patients undergoing controlled ovarian hyperstimulation for IVF.

Background: Vascular endothelial growth factor (VEGF) has been investigated as a marker of ovarian response to controlled ovarian hyperstimulation and as a predictor of ovarian hyperstimulation syndrome (OHSS) in IVF cycles. In most studies, serum has been used for circulating VEGF concentration measurement, but it has been suggested that plasma is the preferred medium to measure VEGF levels because of the potential contribution of VEGF released from platelets during blood clotting. This study investigated VEGF concentrations in paired serum and plasma samples from patients undergoing controlled ovarian hyperstimulation for IVF.

Proof of partial imbalances 6q and 11q due to maternal complex balanced translocation analyzed by microdissection of multicolor labeled chromosomes (FISH-MD) in a patient with Dandy-Walker variant.

We report on a family in which a daughter is described with mental retardation, as well as malformations of the heart, and of the brain (Dandy-Walker variant). The patient's phenotype suggests a chromosomal rearrangement. However, her karyotype was unremarkable by conventional cytogenetic analysis.

Hyperbaric oxygenation as a possible therapy of choice for infertility treatment.

Endometrial sonographic and color doppler features can be used to predict the occurrence of pregnancy in natural or stimulated cycles. Implantation will usually only take place if the endometrium has reach a certain stage of vascularisation and development. The aim of this study was to evaluate endometrial development -- endometrial thickness and reflectivity , subendometrial, endometrial and uterine perfusion, after hyperbaric oxygenation, using transvaginal color doppler.

Mean of CA 125 in making therapy decision in adnexal inflammatory tumors.

Unlabelled: LABORATORY FINDINGS such are white blood count and sedimentation rate are of relative value in inflammations of the upper genital tract and adnexal inflammatory tumors. Antibiotics are administrated in all cases according to the protocol but some of them need operative treatment also. Inflammatory tumors can develop in endometriotic and even in cancer adnexal masses.

Topooptical investigations and enzymatic digestions on tissue-isolated amyloid fibrils.

Chemical and biochemical analysis of isolated amyloid fibrils reveals the presence of different classes of proteins which are often related to distinct clinical forms of amyloidosis and are useful to classify the amyloid deposits. In this study, enzymatic digestions using hyaluronidase, chondroitinase AC and B, neuraminidase, and chemical extractions using mild acid hydrolysis with hydrochloric and sulfuric acid, were used to control the specificity of various topooptical reactions. The disappearance of intense staining after these extraction methods indicates that tissue-isolated amyloid fibrils contain sialic acids and glycosaminoglycans (GAGs).

LH in the follicular phase: neither too high nor too low.

The role of LH in the natural menstrual cycle is not disputed. However, there are a variety of opinions regarding the potential role of exogenous LH in ovulation induction and whether it is actually needed. Recent years have seen renewed interest in this issue for several reasons.

Case report: amyloid tumors in a case of non-secretory multiple myeloma.

Multiple myeloma (MM) is a neoplastic disorder characterized by proliferation of a single clone of plasma cells derived from B cells, which proliferates in the bone marrow and frequently invades the adjacent bone, producing skeletal destruction that results in bone pain and fractures. Patients with MM can furthermore present with anemia, hypercalcemia and renal failure. Non-secretory multiple myeloma (NSMM) is characterized by the absence of a monoclonal (M) protein in both the serum and urine.

Effects of recombinant human luteinizing hormone supplementation on ovarian stimulation and the implantation rate in down-regulated women of advanced reproductive age.

Objective: To evaluate the effects of recombinant human luteinizing hormone (rhLH) supplementation on ovarian stimulation and implantation rate in down-regulated women of advanced reproductive age.

Design: Prospective randomized study.

Setting: University teaching hospital.

Pretreatment with transdermal testosterone may improve ovarian response to gonadotrophins in poor-responder IVF patients with normal basal concentrations of FSH.

Background: Treatment of poor-responder patients to controlled ovarian stimulation for assisted reproduction, who have normal basal FSH concentrations, is one of the most difficult challenges in reproductive medicine. This study investigated the usefulness of testosterone pretreatment in such patients.

Methods: Prospective, therapeutic, self-controlled clinical trial including 25 consecutive infertile patients who had a background of the first and second IVF treatment cycle cancellations due to poor follicular response, in spite of vigorous gonadotrophin ovarian stimulation and having normal basal FSH levels.