Interactions between the CXCR4 chemokine receptor in breast cancer cells and the ligand CXCL12/SDF-1alpha are thought to play an important role in breast cancer metastases. In this pilot study, CXCR4 expression along with other biomarkers including HER2-neu and EGFR, were measured in primary tumor samples of patients with operable breast cancer to test whether any of these biomarkers alone and in combination could indicate breast cancer with high likelihood of metastasizing to bone marrow. Cytokeratin (CK) positive cells in bone marrow were identified by flow-cytometry following enrichment with CK 7/8 antibody-coupled magnetic beads. Primary tumors (n = 18) were stained with specific antibodies for CXCR4, HER2-neu, EGFR, and PCNA using an indirect avidin-biotin horseradish peroxidase method. The majority of the patients had T2/T3 tumors (72%), or lymph node involvement (67%) as pathologic characteristics that were more indicative of high-risk breast cancer. High CXCR4 cytoplasmic expression was found in 7 of 18 patients (39%), whereas 6 of 18 patients (33%) were found to have CK positivity in bone marrow. The median number of CK(+) cells was 236 (range, 20-847) per 5 x 10(4) enriched BM cells. The presence of CK(+) cells in bone marrow was found to be associated with increased expression of CXCR4 alone or in addition to EGFR and/or HER2-neu expression (P = 0.013, P = 0.005, and P = 0.025, respectively) in primary tumors. Furthermore, three patients with high CK positivity (>236 CK(+) per 5 x 10(4) enriched bone marrow cells) in bone marrow exclusively expressed high levels of CXCR4 with EGFR/HER2-neu (P = 0.001). Our data suggest that high CXCR4 expression in breast cancer may be a potential marker in predicting isolated tumor cells in bone marrow. CXCR4 coexpression with EGFR/HER2-neu might further predict a particular subset of patients with high CK positivity in bone marrow.

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Objective:The aim of this study was to determine the depression and anxiety levels of pregnant women with hyperemesis gravidarum by using the Beck depression and anxiety inventory scoring system in a Turkish population. Material and Methods:To ascertain this relationship, a case-control study was conducted involving 86 pregnant women in their first trimester of pregnancy. Forty-one subjects had hyperemesis gravidarum, and 45 were healthy pregnant women who served as control subjects. The groups were adjusted for age, parity, and body mass index. All included women were subjected to baseline laboratory investigations including serum TSH and total hCG levels.Results: There were no statistically significant differences between the groups with respect to the demographic and obstetric parameters and baseline laboratory investigations except the mean serum potassium level, which was significantly lower in patients with hyperemesis gravidarum than in the control group (p=0.039). Patients with hyperemesis gravidarum had significantly higher depression and anxiety scores than control cases (p=0.0001 and p=0.049, respectively). Conclusion:Our results suggest that increased anxiety and depression levels may be involved in the pathogenesis of hyperemesis gravidarum and extra psychological support may be necessary during the treatment and follow-up of these patients. (J Turkish-German Gynecol Assoc 2012; 13: 32-6) Key words: Hyperemesis gravidarum, depression, anxiety, pregnancy, psychological tests Received: 1 August, 2011 Accepted: 20 November, 2011 Amaç: Bu yazıda Beck anksiyete ve depresyon skorlama sistemi kullanılarak hiperemezisli gebelerde anksiyete ve depresyon düzeyleri-nin araştırılması amaçlandı.

BackgroundThrombophilic gene polymorphism is known to be a risk factor for recurrent pregnancy loss (RPL), but few studies have confirmed a possible role of thrombophilic genes polymorphism in RPL risk. This study was conducted to understand the relationship of the mutations of some thrombophilia-associated gene polymorphism (heterozygous/homozygous) with RPL. We compared patients with 2 abortions to patients with 3 or more abortions among Turkish women.Material/MethodsIn this study, patients previously diagnosed with habitual abortus at Obstetrics and Gynecology outpatient clinics in Turkey between 2012 and 2016 were included. In their peripheral blood, we detected factor V Leiden H1299R, prothrombin G20210A, MTHFR C677T, MTHFR A1298C, PAI-1 4G/5G, and PAI-1 4G/4G gene mutations.ResultsIn this study, we have observed statistically meaningful data (P<0.01) related to the relationship between RPL and thrombophilia-associated gene polymorphisms such as heterozygous factor V Leiden H1299R, heterozygous prothrombin G20210A, PAI-1 4G/5G, and PAI-1 4G/4G.ConclusionsWe found that diagnosis of thrombophilic genes polymorphism is useful to determine the causes of RPL, recognizing that this multifactorial disease can also be influenced by various acquired factors, including reproduction-associated risk factors and prolonged immobilization.

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