Effect of Aqueous Glycyryhza Globra Extract on Menopausal Symptoms

S98 8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136 Methods: Seven EOC explants were incubated with FSH and LH (10mUI/L and 100mUI/L) and also with LH+FSH (50mUI/L and 500 mUI/L). NGF produced by explants was detected by ELISA in culture media. trkA expression was detected by immunohistochemistry. During carcinogenesis progression, NGF and trkA expression was evaluated by immunohistochemistry in 42 samples of ovarian tissues (n= 5 for each group: Inactive ovary, benign tumor, borderline tumor and EOC (grade I, II, III). Results: In EOC explants, FSH (10 mIU/L) and FSH+LH (500 mIU/L) stimulated NGF levels (p<0.05), whereas, trkA protein expression augmented with FSH (10 mIU/L), LH (100 mIU/L) and FSH+LH (500 mIU/L) (p<0.05). During ovarian carcinogenesis progression, a gradual increased of NGF and trkA expression was observed (p<0.001: EOC vs inactive ovary). Conclusions: Based on the high gonadotropin levels during menopause, the data of this study suggest a role for gonadotropins in ovarian carcinogenesis progression. Keywords: LH, FSH, trkA, NGF, Ovarian Cancer. 385 EXPERIENCE OF COMBINATION THERAPY WITH BEVACIZUMAB FOR RECURRENT/REFRACTORY CLEAR CELL CARCINOMA OF THE OVARY M. Takano 1 , Y. Kikuchi 2 , T. Kita 3 , K. Kudoh 4 , M. Kato 1 , T. Yoshikawa 1 , M. Miyamoto 1 , A. Watanabe 1 , N. Sasaki 1 , K. Furuya 1 , T. Goto 5 , H. Inoue 6 , M. Ohbayashi 6 . 1 National Defense Medical College, Department of Obstetrics and Gynecology, Tokorozawa, Japan; 2 Ohki Memorial Kikuchi Cancer Clinic for Women, Department of Gynecology, Tokorozawa, Japan; 3 Teikyo University School of Medicine, Department of Obstetrics and Gynecology, Tokyo, Japan; 4 National Hospital Organization Nishi Saitama Chuo Hospital, Department of Obstetrics and Gynecology, Tokorozawa, Japan; 5 Saitama Medical University International Cancer Center, Department of Gynecologic Oncology, Hidaka, Japan; 6 Shonan General Hospital, Department of Obstetrics and Gynecology, Kamakura, Japan Objectives: Recent reports confirmed extremely low response rate of second-line chemotherapy for recurrent or refractory clear cell carcinoma of the ovary (CCC). We report five case series of recurrent and refractory CCC treated with combination therapy with Bevacizumab. Methods: From August, 2007 to July, 2008, cases with recurrent or refractory CCC were treated with bevacizmab-containing chemotherapy after obtaining informed consent in Japanese cancer clinic. Response and toxicities were analyzed. Results: Median age of the patients was 54 years (range; 45-61). FIGO stage was stage IIc in 3 cases, and stage IIIc in 2 cases. Previous chemotherapy regimens were 2 regimens in 2 cases, and 3 in 3 cases. Bevacizumab was administered weekly at a dose of 2mg/kg/week in combination with cytotoxic agents. Among three response-assessable cases, PR was observed in two cases, and PD in one case. Although there were no hematological toxicities more than grade3 in 5 cases, one case with massive ascites and peritonitis carcinomastosis developed gastrointestinal perforation on the 28th day of the therapy. Conclusions: Combination therapy with bevacizumab showed a promising effect for recurrent/refractory clear cell carcinoma of the ovary. Our preliminary experience would facilitate the further investigation of bevacizumab-based regimen for CCC. Keywords: Ovarian cancer, clear cell carcinoma, bevacizumab, refractory, recurrence. (BMI 28). She presented with minimal breast development sparse axillary and pubic hairs and normal female external genitalia. Medical history comprised bipolar depression with two severe suicidal attempts. Endocrinological evaluation demonstrated hypogonadotropic hypogonadism. Abdominal imaging revealed hypoplastic uterus and streak gonads. A genetic testing was performed and 46 X Y karyorype was proven. The patient underwent diagnostic laparoscopy which confirmed the ultrasonographic diagnosis and bilateral gonadectomy was performed. Results: The histopathologic examination revealed dysgerminoma in the left gonad and Retiform Sertoli -Leydig cells tumor in the right gonad. Surgical staging was performed, consisted of bilateral pelvic lymphadenectomy, omentectomy and random peritoneal biopsies. Histology did not reveal additional metastatic disease. Two sessions of carboplatin chemotherapy followed and treatment with estrogens was prescribed. Three months later the patient presented with deterioration of her psychiatric condition with frequent episodes of mania despite of medical therapy. Conclusion: Because the occurrence of malignancy in dysgenetic gonads is high, early diagnosis and prophylactic removal of the dysgenetic gonads is essential. Hormonal replacement with estrogens must be given with caution in patients with underlying bipolar disease because of the possible destabilizing effects of estrogens. Keywords: Swyer syndrome, double primary, ovarian CA. 387 SIGNIFICANT CA125 DECREASE AFTER REMOVAL OF THE OVARIES IN PREMENOPAUSAL WOMEN; THE NECESSITY OF A NEW REFERENCE LEVEL A. van Altena 1 , H. Holtsema 1 , J. Hendriks 2 , L. Massuger 1 , J. de Hullu 1 . Radboud University Nijmegen Medical Centre, Department of Obstetrics & Gynaecology, Nijmegen, Netherlands; 2 Radboud University Nijmegen Medical Centre, Department of Epidemiology and Biostatistics, Nijmegen, Netherlands 1 Objectives: CA125 is the only biomarker available for follow-up after treatment for ovarian cancer. However, the same reference level is used before and after treatment involving a bilateral salpingo-oophorectomy (BSO). We investigated the contribution of the ovaries on the CA125 level by measuring the effect of a BSO on CA125. Methods: All BRCA mutation carriers in the Nijmegen screening program who underwent prophylactic BSO were included. Information was obtained on menopausal state, age, smoking, previous hysterectomy and breast cancer, histopathological examination of the adnexa, HRT and CA125. The logarithmic transformed CA125 levels were used in a linear mixed model to study the relative change in CA125 and possible confounding or interaction. Results: In 60 identified women a relative decrease of 18% in CA125 after BSO was found (p=0.004). The median serum CA125 level was 10.15 U/ml before and 8.36 U/ml after BSO. The only factor interacting with CA125 was menopausal state (p=0.0017). The premenopausal group showed a relative decrease of 25% after BSO. Additionally, the ovarian volume did not explain the difference in CA125 after BSO (p=0.94). Conclusions: After BSO a relative decrease in CA125 level is shown. Menopausal state is the only factor interacting with CA125. Ovarian volume was excluded as confounding factor. The hormonal effect of ovaries might play a role in CA125. Our study suggests that not the reference level of 35 U/ml but a lower level, as suggested for postmenopausal women, should apply to women after a BSO. Keywords: CA125, ovarian cancer, menopausal state. 386 DOUBLE PRIMARY OVARIAN MALIGNANCIES IN A GIRL WITH BIPOLAR DEPRESSION COMPLICATING SWYER SYNDROME N. Thomakos 1 , A. Rodolakis 1 , E. Zapanti 2 , A. Giakoumi 2 , A. Manoli 1 , P. Grigori 3 , A. Antsaklis 1 . 1 University of Athens, ’Alexandra’ Hospital, 1st Department of Obstetrics & Gynecology, Athens, Greece; 2 ’Alexandra’ Hospital, Department of Endocrinology, Athens, Greece; 3 ’Alexandra’ Hospital, Department of Genetics, Athens, Greece Objectives: Swyer Syndrome is a type of pure gonadal dysgenesis 46 XY caryotype in phenotypically female patients. A rare case of Swyer syndrome complicated by dysgerminoma and Retiform Sertoli-Leydig cell’s tumor is reported. Methods: A 20 year -old phenotypically female patient referred to our department wit primary amenorrhea. She measured 1.68 meters and 82 kg Preventive Medicine 388 EFFECT OF AQUEOUS GLYCYRYHZA GLOBRA EXTRACT ON MENOPAUSAL SYMPTOMS F. Abdollahy. Mazandaran University of Medical Sciences, Public Health, Sari, Iran, Islamic Republic of Objectives: There are many side effects of hormone therapy for menopausal symptoms. In different regions with various diet regimens, menopausal symptoms are different Glycyhrhza glabra has constituents with estrogen S99 8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136 like activity. In this study for the first time aqueous Glycyrrhza globra extract was evaluated for decreasing menopausal symptoms. Methods: Aqueous Glycyrrhza globra extract prepared by maceration method. The extract was concentrated and powdered. The powder used as 250 mg capsule and standardized by glycyrrhza content. After matching for age, menopausal age and BMI, 29 and 24 women were allocated in case and control groups respectively. Three 250 mg capsules were prescribed per day to women in case group and women in control group received placebo.The mean number of hot flashes and degree of menopausal symptoms, KI (Kupperman Index) were calculated every two weeks and classified as; without symptom, weak, medium and severs. Data were analyzed using T-test and the effects of drug on hot flash and KI were assessed in different weeks Results: The mean age and menopausal age were 50.5±3.75and 48±.45 respectively. Results showed that the mean numbers of hot flashes, KI and FSH decreased significantly in case group from 6±2.8, 32.2±6.8, 72.29±36 to 1.06±1.1, 9.5±5.2 and 65.12±36 but they were not significant in control group. Also estradiol hormone increased significantly in case group. Conclusions: Aqueous Glycyrrhza globra affect hot flash and KI and is a simple and cheap drug for menopausal symptoms without any side effects. Keywords: Aqueous Glycyrrhza globra, Menopause, Symptoms 389 had not completed the requested laboratory.Variables: Age-MenopauseCholesterol-Triglycerides- Glycemia- BMI.Statistics: Percentage- RangeStandard Deviation (SD) Descriptive and correlation statistics were used according to the variable scale and correlation model. Confidence intervals (CI) of 95% were calculated. Pearson’s linear correlation coefficient and logistic regression method was used for data analysis. It was considered an α error = 0, 05 and β error = 0, 10. Results: n= 220 PMW. Menopause: Mean 45,7, SD ±8,6. Range: 35-58. Cholesterol >200mg%: Triglycerides >140mg%, glycemia >110mg%, BMI > 25. The following results were obtained using coefficient correlation analysis and BMI as an independent variable. Table 1. Results Cholesterol Triglycerides Glycemia n r IC p 220 220 220 -0,070 0,190 0,419 -0,26 to 0,12 -0,0034 to 0,3700 0,241 to 0,570 0,4600 0,0500 0,0001 Conclusions: We found a statistically significant predictability between an increased BMI, hyperglycemia and hypertriglyceridemia, though the correlation between hypercholesterolemia and BMI did not appear to be significant in our study population. Keywords: BMI- Cholesterol- Triglycerides-Glycemia-Menopause. AFFECTIVE AND SELF-EFFICACY RESPONSES TO ACUTE EXERCISE IN SEDENTARY POSTMENOPAUSAL WOMEN 391 F. Barnett. James Cook University, Townsville, Australia COLPOSCOPY IN WOMEN ABOVE 45 YEARS Objectives: Positive psychological outcomes associated with an acute exercise bout may influence future exercise behaviour in postmenopausal women. Affective responses to exercise are influenced by many factors including self-efficacy, whereby individuals with greater self-efficacy demonstrate more positive affective responses following exercise. This study examined the psychological responses to an acute exercise bout in sedentary postmenopausal women. Methods: Twenty five (mean age 55.7±5.7yrs) participants completed a 20-minute bout of stationary cycling at 60% of VO2max . Affective responses were assessed prior to, during and immediately following exercise. Taskspecific self-efficacy was also assessed prior to and immediately following exercise. Results: Participants reported significantly higher self-efficacy immediately following exercise (F(1,24) = 55.3, p = 0.00). Participants also demonstrated a significant increase in tranquillity, positive engagement and revitalisation immediately following compared to prior to and during exercise.A significant correlation was found between postexercise self-efficacy and tranquillity during exercise (r=0.486, p=0.01) and post exercise (r=0.397, p=0.05). A significant correlation was also found between post exercise self-efficacy and postexercise revitalisation (r=0.587, p=0.00) and physical exhaustion (r=-0.604, p=0.00). Conclusions: Results suggest that postmenopausal women with higher postexercise self-efficacy have greater feelings of tranquillity and revitalisation during exercise and greater feelings of tranquillity and less fatigue immediately following exercise. Giving non-exercising postmenopausal women the opportunity to successfully complete previously unfamiliar exercise activities may promote a sense of accomplishment and the perception that exercise can be an enjoyable experience. Keywords: Exercise-induced affect; self-efficacy. G. Majeed, C. Lang, N. Wales. Chelsea and Westminster NHS Trust, Obstetrics & Gynaecology, London, United Kingdom 392 390 THE EFFECTS OF A 30-MONTH DIETARY INTERVENTION ON BONE MINERAL DENSITY AND QUANTITATIVE ULTRASOUND INDICES: THE POSTMENOPAUSAL HEALTH STUDY Objectives: Review of management of women above 45 years referred to the colposcopy clinic. Methods: Data was collected from the colposcopic database and systematic review of the clinical notes for all women refrred to colposcopy clinic between 1/106 to 31/12/06 with date of birth 1/163 and older. Results: The total number of women referred in this age group were 243. The referral sources were general practitioners n=211 (87%), hospital referrals n=37 (15%) and family planning clinics n=5 (2%).Indications for referral were abnormal cytology n=111 (46%), bleeding n=27 (11%), inadequate cytology n=25 (10%), suspicious cervix n=16 (6%), polyps n=16 (6%), other indications n=48 (21%).Demographics showed post menopausal women n=119 (49%), with only n=22 (9%) on HRT, parous n=109 (45%) and smokers n=66 (27%).The colposcopy was satisfactory n=178 (73%) and unsatisfactory n=53 (22%). DNA n=12 (5%). Treatment was performed in10% of patients (n=25) (Stage 1a1 cervical cancer diagnosed in two patients). Hysteroscopy and curettage n=3. Conclusions: Colposcopic assessment can be difficult in post menopausal women especially when squamocolumnar junction is not visible as in 22% of women in this study or when the upper limit of cervical lesion is not apparent as well as atrophic changes due to lack of estrogen (only 9% were on HRT). However, cytology surveillance with cyto brush and appropriate hysteroscopy can be helpful in the management of these women. Keywords: Colposcopy, HRT BODY MASS INDEX AND METABOLIC RISK IN POSTMENOPAUSAL WOMEN P. Carpintero 1 , M. Franchina 2 , D. Fusaro 3 , D. Della Latta 2 , G. Litterio 3 , B. Campostrini 2 . 1 Centro de Medicina Preventiva, Lanus, Argentina; 2 Hospital Narciso Lopez, Lanus, Argentina; 3 IGBA, Lanus, Argentina Objectives: To determine the number of postmenopausal women (PMW) assisted between 1/9/2007 and 31/1/2008, and establish the correlation between their lipid profile, glycemia and Body Mass Index (BMI), their statistical significance and predictability. Methods: Prospective, cross sectional correlation study.Population: Consecutive evaluation of 350 PMW that attended Centro de Medicina Preventiva, IGBA, and Hospital Narciso López de Lanús between 1/9/2007 and 31/8/2008. 220 cases were selected.Exclusion criteria: Patients that G. Moschonis, Y. Manios, R. Tenta, S. Tanagra, A. Vandorou, A.-E. Kyriakou, V. Dede, M. Petrogianni, O. Androutsos, M. Kantilafti, A. Naoumi. Harokopio University, Department of Nutrition and Dietetics, Kallithea, Greece Objectives: The aim of the current study was to examine the effects of a 30-month dietary intervention that combined supplementation of dairy products fortified with calcium and vitamin D3 and nutrition education sessions on bone mineral density (BMD) assessed by DXA and on quantitative ultrasound (QUS) indices of postmenopausal women. Methods: Sixty six postmenopausal women (55-65 years old) were randomized into a Dietary Intervention Group (DG: n=35), receiving daily and for 30 months, 1200 mg of calcium and 7.5 µg of vitamin D3 for the first 12 months that increased to 17,5 µg for the remaining 18 months