Hormone receptor expressions and proliferation markers in postmenopausal endometrial polyps.

BACKGROUND/AIMS: Endometrial polyps are quite common in the general population, they have a significant role in postmenopausal bleeding, and the pathogenesis is unclear. The aim of this study was to investigate proliferation markers and expression of estrogen and progesterone receptors in endometrial polyps in postmenopausal women. METHODS: Endometrial polyps were removed by hysteroscopy from 36 women who presented with postmenopausal bleeding. None were using hormonal therapy. The control group consisted of 16 inactive-atrophic postmenopausal endometrial specimens removed at hysterectomy. Immunohistochemistry was used to demonstrate expression of estrogen and progesterone receptors and the cell growth and apoptosis markers, Ki67, bcl-2, c-erbB-2. RESULTS: In both the glandular epithelium and stroma of endometrial polyps, estrogen and progesterone receptors, Ki67 and bcl-2 showed significantly more positive staining than the inactive endometrium from the control group. There was no difference in expression of c-erbB-2 between the two groups. CONCLUSIONS: Estrogen may have a role in the development of postmenopausal endometrial polyps, either by direct stimulation of localized proliferation or by stimulation of proliferation via other pathways, such as activation of Ki67 or through inhibition of apoptosis via bcl-2. c- erbB-2 is unlikely to play any role in development of these lesions.

Effect of angiotensin-converting enzyme-inhibiting therapy on the expression of vascular endothelial growth factor in hyperstimulated rat ovary.

OBJECTIVE: To determine the effect of angiotensin-converting enzyme-inhibiting therapy on the expression of vascular endothelial growth factor (VEGF) in the hyperstimulated rat ovary. DESIGN: Experimental study. SETTING: University animal research laboratory. ANIMAL(S): Thirty Wistar albino adult female rats were studied; 20 rats were stimulated with gonadotropins (groups 1 and 2), and 10 were controls (group 3). Ten of the stimulated rats received additional treatment with enalapril (group 2). INTERVENTION(S): At the end of the treatment period, rat ovaries were subjected to immunohistochemical staining with anti-VEGF antibodies. MAIN OUTCOME MEASURE(S): VEGF staining intensity was graded semiquantitatively, and the H-score was calculated by light microscopic examination of the groups. RESULT(S): VEGF expression was found to be significantly higher in the endothelium and stroma in groups 1 and 2 compared with group 3. Although VEGF immunoreactivity was lower in the stimulation regimen plus enalapril group compared with the stimulation regimen-only group, the difference was insignificant. CONCLUSION(S): Enalapril does not seem to have a significant effect on VEGF expression in the hyperstimulated rat ovary. Because angiotensin II exerts its multiple actions via specific receptors, there may be other factors, such as a receptor blockade, that contribute to the VEGF expression.

Endometrial thickness and the Doppler sonographic parameters of the uterine arteries as discriminators of endometrial status in postmenopausal women receiving anti-hypertensive treatment.

AIM: The aim of the present study was to establish the Doppler sonographic parameters of the uterine arteries in postmenopausal patients with or without hypertension and to determine the value of their measurement in the prediction of endometrial pathology. METHODS: Healthy postmenopausal women (n = 23) and the ones receiving anti-hypertensive medication (n = 34) examined for both endometrial thickness and Doppler velocimetry of the uterine arteries by transvaginal sonography. RESULTS: There was no significant difference between endometrial thickness and uterine artery Doppler sonographic parameters in hypertensive postmenopausal women compared to normotensive controls. CONCLUSION: The role of Doppler examination in the differential diagnosis of endometrial pathology in patients with or without hypertension seemed not to be effective.

Different anesthesiologic strategies have no effect on neonatal jaundice.

OBJECTIVE: In this prospective study, we examined the influence of either segmental epidural anesthesia with bupivocaine hydrochloride or general anesthesia with sevoflurane on serum bilirubin levels and jaundice in neonates born with caesarean section. MATERIALS AND METHODS: The patients at 38-40 weeks were included into this prospective study. General anesthesia group (sevoflurane); Group A, (n=66) and segmental epidural anesthesia group (bupivocaine hydrochloride); Group B, (n=76) underwent caesarean section under elective circumstances. Neonatal serum bilirubin levels were determined at the ages of 24 h and 5 days in 142 infants. The sexuality, weight, 5th minute APGAR scores, hematocrit levels of the neonates were recorded. The neonates who needed phototherapy were also noted. The results in Group A and Group B were compared. RESULTS: There was no significant difference on bilirubin levels between two groups and the incidence of hyperbilirubinemia did not differ statistically (p>0.05). The percent of the newborns who needed phototherapy displayed no significant differences between the deliveries by caesarean section under general or segmental epidural anesthesia. CONCLUSION: Our findings support the clinical studies which have not demonstrated an association between different anesthesiologic strategies and neonatal jaundice.