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Gynecologic and Obstetric Investigation

Lisa B E Shields, Mary E Gordinier
Advanced vulvar cancer is associated with a very poor prognosis. Surgical resection is the mainstay of treatment, with radiation indicated for areas at high risk for recurrence. When surgical and radiation options have been exhausted, the effectiveness of systemic chemotherapy is poor. No biologic or targeted agents have been approved for the management of advanced or recurrent vulvar cancer. Pembrolizumab, a humanized monoclonal antibody against programmed death 1 (PD-1), has been successfully used as a target of tumor immune therapy in small cell lung cancer and melanoma...
July 17, 2018: Gynecologic and Obstetric Investigation
Jorge Valencia-Ortega, Arturo Zárate, Renata Saucedo, Marcelino Hernández-Valencia, José G Cruz, Edgardo Puello
OBJECTIVE: To evaluate the placental and decidual gene expression and maternal and umbilical serum concentrations of tumor necrosis factor alpha, interleukin 6 (IL-6), IL-8, IL-10, IL-1 receptor antagonist (IL-1RA), intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 (VCAM-1), along with the proinflammatory/anti-inflammatory cytokine ratios in women with preeclampsia (PE) vs. women with normal pregnancy (NP), and to analyze PE classified as early- (EO) and late-onset (LO)...
July 13, 2018: Gynecologic and Obstetric Investigation
Shahar Kol
Gonadotropin-releasing hormone (GnRH) antagonist-based ovarian stimulation protocol is gaining popularity. This protocol allows for the use of GnRH agonist as a trigger of final oocyte maturation, instead of the "gold standard" human chorionic gonadotropin (hCG) trigger. GnRH agonist trigger causes quick luteolysis, hence its widespread use in the context of ovarian hyperstimulation syndrome (OHSS) prevention. To secure pregnancy post GnRH agonist trigger, the luteal phase must be supplemented to counteract the luteolysis...
July 13, 2018: Gynecologic and Obstetric Investigation
Augusto Pereira, Tirso Pérez-Medina, Ana Rodríguez-Tapia, Yoana Chiverto, Santiago Lizarraga
BACKGROUND: The objective was to describe clinical findings and outcomes of patients with pudendal neuralgia in relation with the anatomical segment affected. METHODS: Fifty-one consecutive patients with chronic perineal pain (CPP) located in the areas supplied by the pudendal nerve (PN), from January 2011 to June 2012, were analyzed. RESULTS: The distribution of pain at perineal, dorsal clitoris and inferior anal nerves was 92.2, 31.4 and 25...
July 13, 2018: Gynecologic and Obstetric Investigation
Ebru Ersoy, Sibel Özler, Efser Öztaş, Ali Özgür Ersoy, Merve Ergin, Aytekin Tokmak, Nafiye Yilmaz
BACKGROUND/AIMS: A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) enzymes take part in extracellular matrix (ECM) remodeling which has been shown to contribute to the ovulation and follicular functions. We aimed to compare serum levels of ADAMTS-19 in patients with different fertility situations. METHODS: A total of 86 women were enrolled to this cross sectional and case-control study. Four groups were constituted with respect to women's clinical and hormonal status: group 1, women with premature ovarian failure (POF; n = 21); group 2, women with natural menopause (n = 21); group 3, women with polycystic ovary syndrome (PCOS; n = 22); and group 4, healthy fertile controls...
July 6, 2018: Gynecologic and Obstetric Investigation
Takahiro Nakajima, Fumihisa Chishima, Takehiro Nakao, Chuyu Hayashi, Akiko Kasuga, Kaori Shinya, Takuo Nakayama, Hiromitsu Azuma, Go Ichikawa, Atsushi Komatsu, Tatsuo Yamamoto, Kei Kawana
BACKGROUND/AIM: We demonstrated that AT1 and AT2 are expressed and both pathways balance the renin-angiotensin system in endometriosis. MAS1, a specific receptor of angiotensin (1-7), opposes AT1 pathway-associated tissue remodelling. It is not known whether MAS1 has an effect on the pathogenesis of endometriosis or not. MATERIALS AND METHODS: Ovarian endometriotic tissues (endo-Ov) and eutopic endometrial tissues (endo-Em) were obtained from 29 patients with endometrial cysts...
July 6, 2018: Gynecologic and Obstetric Investigation
Lichen Guo, Aimin Zhao, Rui Zhang, Yan Xie, Xiaofeng Xu
AIMS: To discuss the correlation between the expression of fibroblast growth factor receptor 4 (FGFR4) and human papillomavirus (HPV) infection in cervical cancer and precancerous lesions. METHODS: One hundred and sixty four cases of cervical lesions tissue samples were collected (60 cases of cervical cancer, 38 cases of cervical intraepithelial neoplasia [CIN] stage I, 32 cases of CIN II, 34 cases of CIN III). HPV infection status and expression strength of FGFR4 of all samples were detected and compared among different groups...
July 6, 2018: Gynecologic and Obstetric Investigation
Péter Török, Balázs Harangi
AIMS: The study aimed to determine the accuracy of deep neural network in identifying the plane between myoma and normal myometrium. METHODS: On the images of surgery, different structures were signed and annotated for the training phase. After the appropriate training of the deep neural network with 4,688 images from that training set, 1,600 formerly unseen images were used for testing. Indication for surgery was heavy menstrual bleeding and hysteroscopic finding was submucous fibroid...
July 5, 2018: Gynecologic and Obstetric Investigation
Polina Advolodkina, Mark P Lachiewicz, Gabriela Oprea-Ilies, Bhagirath Majmudar, Alan N Gordon
Li-Fraumeni syndrome (LFS) is a rare highly penetrant cancer syndrome characterized by mutation in the TP53 tumor suppressor gene. Recent data suggest that this germline mutation is more frequent than once thought. While LFS has not been associated previously with pelvic serous carcinoma, gynecologic malignancies have been reported in this patient population. We present the case report of a 37-year-old patient with known LFS and a history of multiple cancers who underwent total abdominal hysterectomy for benign indications with incidental bilateral salpingo-oophorectomy...
June 26, 2018: Gynecologic and Obstetric Investigation
Hadas Ganer Herman, Zviya Kogan, Daniel Tairy, Masha Ben Zvi, Ram Kerner, Shimon Ginath, Jacob Bar, Ron Sagiv
AIM: To compare clinical variables, sonographic findings and pregnancy outcomes following the hysteroscopic removal of retained products of conception (RPOC) after delivery and abortion. METHODS: This is a retrospective cohort of operative hysteroscopies performed between 2011 and 2015 for suspected RPOC, during which trophoblastic tissue was obtained. Patient demographics, clinical presentation, sonographic evaluation, subsequent infertility and pregnancy outcomes were compared between post-delivery (n = 85) and post-abortion (n = 93) cases...
June 26, 2018: Gynecologic and Obstetric Investigation
Mine Kiseli, Gamze Sinem Caglar, Asli Yarci Gursoy, Tolga Tasci, Tuba Candar, Egemen Akincioglu, Emre Goksan Pabuccu, Nurettin Boran, Gokhan Tulunay, Haldun Umudum
BACKGROUND: Gastrin-releasing peptide (GRP) is thought to play a role in the metastatic process of various malignancies. The more stable precursor of GRP, pro-GRP (ProGRP), has been shown to be secreted by neuroendocrine tumors. This study was designed to assess the validity of ProGRP as a diagnostic marker in endometrioid adenocarcinomas (EAs) of the endometrium. METHODS: Thirty-seven patients with a diagnosis of EA, 23 patients with endometrial hyperplasia, and 32 age-matched controls with normal endometrial histology were recruited for this study...
June 13, 2018: Gynecologic and Obstetric Investigation
Brian W Wakefield, Crystal M C Masterson, Manuel T Borges, K Joseph Hurt
Stroke and hepatic vein thrombosis are highly associated with neoplasia but are extremely rare events in young, pregnant women. Rare and recurrent thrombotic events in pregnancy increase the suspicion for occult malignancy. We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer...
June 8, 2018: Gynecologic and Obstetric Investigation
Ya-Nan Zhang, You-Sheng Zhang, Qian Yu, Zi-Zhen Guo, Jin-Long Ma, Lei Yan
AIM: To study whether infertile patients with endometriosis have a higher prevalence of endometrial polyps, and to clarify the characteristics of the pathology of combined polyps. METHODS: Infertile patients who had undergone both hysteroscopy and laparoscopy in Reproductive Hospital Affiliated with Shandong University from January 2014 to May 2017 were enrolled. Patients with and without endometriosis, diagnosed by laparoscopy, were staged and included in the study group and control group, respectively, and the prevalence of polyps was compared...
June 7, 2018: Gynecologic and Obstetric Investigation
Marwan Habiba, Nicola Pluchino, Patrick Petignat, Paola Bianchi, Ivo A Brosens, Giuseppe Benagiano
To confirm the origin of cancer found in both the endometrium and the myometrium is difficult. Cancer may spread from the endometrium into adenomyotic foci or vice versa. Also, premalignant changes may arise at either or both sites. Investigating disease origin enhances our understanding of pathophysiology and prognosis. Additional critical questions are whether women with adenomyosis have a higher risk of endometrial cancer; whether the invasive properties and prognosis of cancer in adenomyosis differ from those arising in the eutopic endometrium and whether the ectopic glandular tissue in adenomyosis becomes altered in the presence of eutopic endometrial cancer...
June 6, 2018: Gynecologic and Obstetric Investigation
Melissa A Parks, Kurt T Barnhart, David L Howard
BACKGROUND: When managing a nonviable pregnancy of unknown location (PUL), a debate has emerged in the literature whether to perform uterine curettage for definitive diagnosis of pregnancy location or administer methotrexate for a presumed ectopic pregnancy. The purpose of this study is to describe the treatment patterns when managing a PUL. METHODS: A prospective, anonymous Internet based-electronic survey of PUL case scenarios was administered to a random sample of physicians across the United States...
June 6, 2018: Gynecologic and Obstetric Investigation
Reinhard Altmann, Christian Specht, Iris Scharnreitner, Caroline Schertler, Richard Mayer, Wolfgang Arzt, Matthias Scheier
OBJECTIVE: The study aimed to describe reference values for structures of the posterior fossa in fetuses with a crown-rump length (CRL) between 45 and 84 mm. MATERIALS AND METHODS: This was a prospective, cross-sectional study including 216 normal appearing fetuses. In transvaginal acquired 3-dimensional volume blocks, the longest diameter of the vermis (VE), posterior membranous area (PMA), medulla-oblongata-pons angle (MOPA), diameters of the medulla oblongata (MO) and pons (PO), and the area of Blake's pouch (BP) were measured...
June 5, 2018: Gynecologic and Obstetric Investigation
Roxana Knobel, Maíra L S Takemoto, Mariane O Menezes, Claudia G Magalhães, Carla B Andreucci, Leila Katz, Melania M R Amorim
No abstract text is available yet for this article.
June 1, 2018: Gynecologic and Obstetric Investigation
Tolga Karacan, Taner Usta, Aysel Ozkaynak, Omer Onur Cakir, Aslı Kahraman, Eser Ozyurek
BACKGROUND/AIMS: The objective of this study was to compare the depth and width of thermal spread caused on rat uterine tissue after application of 3 different electrosurgical generators. METHODS: Alsa Excell 350 MCDSe (Unit A), Meditom DT-400P (Unit M), and ERBE Erbotom VIO 300 D (Unit E) electrosurgical units (ESUs) were used. The number of Wistar Hannover rats required to obtain valid results was 10. The primary objective of the study was to compare the 3 ESUs using the same instrument and the same waveform...
May 23, 2018: Gynecologic and Obstetric Investigation
Sezen Bozkurt Koseoglu, Funda Dinc Elibol
AIMS: Polycystic ovary syndrome (PCOS) is the commonest cause of menstrual irregularity and hirsutism during reproductive age. We hypothesized in the alterations in the pituitary gland in PCOS. METHODS: We measured the volume of the pituitary gland in 39 PCOS patients and 42 age-matched healthy controls using 0.35 mm thick T1-weighted sagittal cranial images. Serum levels of estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured on days 3-5 of the menstrual cycle of the participants...
May 15, 2018: Gynecologic and Obstetric Investigation
Cigdem Yayla Abide, Enis Ozkaya, Ilhan Sanverdi, Evrim Bostancı Ergen, Meryem Kurek Eken, Belgin Devranoglu, Bulent Emre Bilgiç, Cetin Kilicci, Semra Kayatas Eser
OBJECTIVE: To compare embryo transfer (ET) technique based on catheter rotation during its withdrawal in cases with unexplained infertility in a prospective, randomized trial (NCT03097042). METHODS: Two hundred intracytoplasmic sperm injection (ICSI) patients undergoing ET with cleaving or blastocyst-stage fresh embryos were randomized into 2 groups: cases with (n = 100), and without (n = 100) catheter rotation during its withdrawal. Groups were matched for age and some clinical parameters...
May 14, 2018: Gynecologic and Obstetric Investigation
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