Seropositivity for the human heat shock protein (Hsp)60 accompanying seropositivity for Chlamydia trachomatis is less prevalent among tubal ectopic pregnancy cases than individuals with normal reproductive history.

OBJECTIVES: To investigate the role of anti-human heat shock protein 60 (hHsp60) antibody positivity in the pathogenesis of ectopic pregnancy, following Chlamydia trachomatis (CT) infection. STUDY DESIGN: In a case-control study, serological tests for anti-hHsp60 were performed in ectopic pregnancies (study group) and parturients with normal reproductive histories (control group). All participants in both groups were CT IgG(+). hHsp60 IgG(+) prevalences were compared between the two groups, by semiquantitative ELISA. Data were evaluated using nonparametric and parametric tests and multivariable regression. RESULTS: After an initial pilot study, two groups were formed: 63 ectopic gestations (study group) and 95 normal parturients (control group), all CT IgG(+). Blood samples from all cases were tested for anti-hHsp60 IgG. Age, gravidity, and practising contraception were higher in the control group, while a history of pelvic infections were more common in the study group. Hsp60 IgG(+) was found to be significantly higher in the control group (63/95, 66.3%) compared to study group (30/63, 47.6%). Regression analysis revealed anti-hHsp60 positivity was an independent factor delineating the two groups. CONCLUSION: Immunity to hHsp60 is less common in CT IgG(+) ectopic pregnancies than CT IgG(+) fertile subjects without a history of ectopic pregnancies. Hence, our findings suggest that hHsp60 seropositivity may decrease the probability of an ectopic gestation in subjects with previous CT infections.

Appendectomy in the surgical treatment of benign ovarian mucinous cystadenomas - is it necessary?

OBJECTIVES: To determine if appendectomy as an adjunctive procedure is necessary in the surgical treatment of benign ovarian mucinous cystadenomas. MATERIAL AND METHODS: Retrospective analysis of clinical data: in a research hospital, obstetrics and gynecology depart-ment setting, 63 cases of benign ovarian mucinous cystadenomas confirmed in the pathological evaluation were revised. 59 had the complete clinical, final pathological and follow-up data available and were included. RESULTS: 20.6% (13/59) went through an appendectomy. Basic characteristics of patients with different appendiceal pathologies did not show any significant differences. In the study group the mean age, parity, adnexial mass size were (40.1 ± 12.4); (1.3 ± 1.1) and (9.1 ± 5.3 cm), respectively. Patients were either operated laparoscopically (20), laparotomically (39) to perform a unilateral salpingoopherectomy/cystectomy. In 7 patients, oopherectomy was an additional procedure with: 2 abdominal hysterectomies, 4 cesarean sections and 1 total laparoscopic hysterectomy. 2 synchronous appendiceal pathologies (mucinous cystadenomas of the appendix) were defined in appendectomies performed. In these cases, the ovarian tumour sizes were: 7 cm and 4 cm. CONCLUSIONS: In the presence of a benign or borderline unilateral ovarian mucinous tumour as defined during the operation and especially if it is larger than 10-12 cm and with normal peritoneal and appendiceal gross morphology, appendectomy is not a necessary adjunctive procedure.