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Objective: Preeclampsia appears to be associated with a higher extent of inflammation than in uncomplicated pregnancies. We aimed to test whether this was the case in patients with hemolysis, elevated liver functions and low platelet count (HELLP) syndrome and to clarify the contribution of placental and systemic inflammatory variables in the development of this syndrome., Materials and Methods: Thirty healthy pregnant women (control group) and 20 patients with HELLP syndrome (study group) were included in the study. Placental inflammatory activity was evaluated by quantifying immunohistochemically the levels of p65/RelA expression of nuclear transcription factor-kappa beta (NF-kB) in paraffin-embedded tissue samples. In addition, ultrastructural changes in placental morphology in HELLP patients were evaluated by transmission electron microscopy (TEM). The serum concentrations of myeloperoxidase (MPO) and C-reactive protein (CRP) were also measured and compared., Results: p65/RelA immunoexpression and serum MPO and CRP levels were significantly higher in patients with HELLP syndrome (p < 0.05). TEM of placenta in the study group revealed severely vacuolized syncytiotrophoblasts, irregular basal lamina and damaged capillary endothelium when compared with the placenta of control subjects., Conclusion: Our results suggest that over-expression of placental NF-kB is correlated with elevation of serum inflammatory markers and placental ultrastructural changes, which may point to an important role of local and systemic inflammatory activation in the pathogenesis of HELLP syndrome.

Objective: To evaluate the effects of an intrauterine device producing a static magnetic field on the endometrial histology of rats., Methods: The experiments involved 20 adult female Wistar albino rats that were divided into five groups. Group 1 was sham-operated; Groups 2, 3 and 4 had a copper intrauterine device (IUD), an uncovered intrauterine magnet (IUM) or an intrauterine silicone-coated IUM, respectively, inserted into one of the uterine horns; in Group 5 an uncovered IUM was implanted subcutaneously. Six days later the rats were sacrificed; endometrial and subcutaneous tissues were harvested and examined microscopically., Results: Copper IUDs caused classical cellular infiltration through the endometrium. IUMs, producing a static magnetic field, also caused leucocyte and monocyte infiltration of the endometrium and, in addition, a significant leucocyte accumulation over the endometrial surface., Conclusion: This preliminary study reveals that an intrauterine magnet induces the accumulation of leucocytes in the uterine cavity in addition to the classic stromal infiltration caused by commercially available nonmagnetic IUDs. This activity could contribute to a greater efficacy of intrauterine contraception and should be investigated further.

Calciphylaxis is a poorly understood and highly morbid syndrome of vascular calcification and skin necrosis. Hypercalcemia, hyperphosphatemia, and secondary hyperparathyroidism are the factors implicated in the pathogenesis of calciphylaxis, which is generally identified in patients with hyperparathyroidism secondary to end-stage renal disease. It has also been observed in primary hyperparathyroidism, end-stage liver disease, and rheumatoid arthritis, in the absence of renal disease. There are few case reports of calciphylaxis occurring in hypercalcemia of malignancy. An unusual case is reported of calciphylaxis associated with malignant melanoma of the soft parts in the absence of renal or parathyroid disease. This is the first reported case of this soft tissue sarcoma showing calciphylactic changes.

A previously well 42-year-old man presented with a three-hour history of pain in the right flank of acute onset. At laparotomy he was found to have a ruptured right kidney which was treated by nephrectomy. Eight days later he developed similar symptoms on the left: at operation 21 of blood were drained and nephrostomy and catheterisation carried out. He recovered after a complicated postoperative course, and histological examination of the removed kidney, and biopsy specimens, showed classic polyarteritis nodosa. This is a rare cause of spontaneous rupture of the kidney but must be considered whenever a patient presents with renal haemorrhage of unknown cause.