Pag. 3 Minerva Ginecol. 2010 Oct;62(5):415-32. Medical treatments for endometriosis. Kappou D, Matalliotakis M, Matalliotakis I. Department of Obstetrics and Gynecology, University of Crete, Heraklion, Greece - firstname.lastname@example.org. Despite the extensive research, endometriosis remains an enigmatic disease as up to now there is no consensus regarding the exact underlying mechanisms which could explain its development and progress. A local environment enriched in estrogens, progesterone resistance, local inflammatory response and multiple other ...
1: J Obstet Gynaecol. 2003;23(4):453-454. Links
Isolated torsion of haematosalpinx associated with tubal endometriosis.
N O, F N, S M.
PMID: 12881105 [PubMed – as supplied by publisher]
2: Histopathology. 2003 Aug;43(2):144-150. Links
CD10 and calretinin staining of endocervical glandular lesions, endocervical stroma and endometrioid adenocarcinomas of the uterine corpus: CD10 positivity is characteristic of, but not specific for, mesonephric lesions and is not specific for endometrial stroma.
McCluggage WG, Oliva E, Herrington CS, McBride H, Young RH.
Department of Pathology, Royal Group of Hospitals Trust, Belfast, UK, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, and Department of Pathology, Royal Liverpool University Hospital, Liverpool, UK.
AIMS: In the female genital tract CD10 has been used to assist in the evaluation of mesenchymal tumours of the uterus and in determining whether endometrial stroma is present. CD10 positivity has also been shown in cervical mesonephric remnants and this antibody has been suggested as a useful immunohistochemical marker of mesonephric lesions in the female genital tract. Calretinin has also been shown to be positive in mesonephric lesions. In this study the specificity of these two antibodies in evaluating cervical and uterine glandular lesions and the value of CD10 in determining whether stroma is endometriotic or not were investigated. METHODS AND RESULTS: Cases of cervical tubo-endometrial metaplasia (TEM) (n = 11), microglandular hyperplasia (MGH) (n = 10), endometriosis (n = 8), mesonephric remnants/hyperplasia (n = 12), endocervical adenocarcinoma, usual type (n = 15), mucinous variant of minimal deviation adenocarcinoma (MDA) (n = 7) and mesonephric adenocarcinoma (n = 3) were stained with antibodies against CD10 and calretinin. Nine cases of endometrial adenocarcinoma of endometrioid type were also stained. In all the cervical cases normal endocervical glands were negative with both antibodies except for one case with strong positive luminal staining with CD10. All cases of TEM, MGH and endometriosis were negative with CD10 and calretinin except for focal staining with CD10 in one case each of MGH (cytoplasmic staining) and endometriosis (luminal staining). Most usual endocervical adenocarcinomas were negative with both antibodies, although one exhibited focal cytoplasmic staining with calretinin and five exhibited limited luminal positivity with CD10. All MDAs were negative with both antibodies. Ten of 12 mesonephric remnants/hyperplasia showed luminal positivity with CD10 and one exhibited cytoplasmic and nuclear staining with calretinin. Two of three mesonephric adenocarcinomas showed luminal positivity with CD10 and nuclear and cytoplasmic positivity with calretinin. Seven of nine endometrial adenocarcinomas were positive with CD10 (four cytoplasmic, two membranous and cytoplasmic, one luminal and cytoplasmic) and three with calretinin (two cytoplasmic, one nuclear and cytoplasmic). Positive staining of endometriotic stroma with CD10 was present in all endometriosis cases but normal cervical stroma was also strongly positive, especially around glands. Endometriotic stroma and cervical stroma were negative with calretinin. CONCLUSIONS: We conclude that most endocervical glandular lesions, including mesonephric remnants/ hyperplasia, are negative with calretinin. However, the focal nuclear and cytoplasmic positivity with calretinin in two of three mesonephric adenocarcinomas suggests that this may be a useful indicator of a mesonephric origin of a cervical adenocarcinoma. Most mesonephric remnants/hyperplasias exhibit luminal positivity with CD10, although this is not invariable and staining is usually focal. Positive luminal staining of a benign endocervical glandular lesion with CD10 may help confirm mesonephric remnants. Although positive staining with CD10 was found in two of three mesonephric adenocarcinomas, the observed immunoreactivity of several conventional cervical adenocarcinomas limits the diagnostic value of CD10 in confirming a mesonephric origin for an adenocarcinoma. Since all cervical MDAs were negative with CD10, positivity with this antibody may be of value in distinguishing mesonephric hyperplasia from MDA, although this distinction rarely necessitates immunohistochemistry. Most endometrial adenocarcinomas of endometrioid type stain with CD10 and thus positivity with this antibody is not specific for a mesonephric origin of an endometrial adenocarcinoma. Positivity of normal cervical stroma limits the value of CD10 staining in confirming a diagnosis of cervical endometriosis.
PMID: 12877729 [PubMed – as supplied by publisher]
3: Chin Med J (Engl). 2003 Apr;116(4):639-40. Links
Perineal endometriosis without perineal trauma: a case report.
Zhu L, Lang J, Wong F, Guo L.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China.
PMID: 12875740 [PubMed – in process]
4: Chin Med J (Engl). 2003 May;116(5):777-80. Links
Glutathione S-transferase M1 and T1 genotypes and endometriosis risk: a case-controlled study.
Lin J, Zhang X, Qian Y, Ye Y, Shi Y, Xu K, Xu J.
Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
OBJECTIVE: To investigate the correlation between glutathione S-transferase (GST) M1 and T1 genotypes and endometriosis risk (EM). METHODS: Polymerase chain reaction (PCR) technique was used to detect the presence or absence of the GSTM1 and GSTT1 genes in genomic DNA isolated from the blood samples of 68 Han Chinese women with endometriosis and 28 without endometriosis. RESULTS: The frequencies of GSTM1 and GSTT1 null genotypes in women with endometriosis were 0.721 (49/68) and 0.779 (53/68), respectively, and in women without endometriosis were 0.429 (12/28) and 0.321 (9/28), respectively. There was a significant difference with regard to the frequencies of GSTM1 and GSTT1 null genotypes between the women with and without endometriosis (P < 0.01). Furthermore, the frequencies of GSTM1 and GSTT1 null genotypes were significantly higher in the patients with stage III and IV endometriosis [0.731 (38/52) and 0.788 (41/52), respectively] than in women without endometriosis (P < 0.01), and the frequency of GSTT1 null genotype was statistically higher in patients with stage I and II endometriosis [0.75 (12/16)] than in the women without endometriosis (P < 0.01). No correlation between GSTM1 and GSTT1 null genotypes and age, induced abortion or dysmenorrhea was detected in this study (P > 0.05). CONCLUSION: GSTM1 and GSTT1 null genotypes may be risk factors for the development of endometriosis.
PMID: 12875700 [PubMed – in process]
5: Chin Med J (Engl). 2003 May;116(5):688-91. Links
Application of ovarian transposition during hysterectomy.
Guo Y, Shen W, Jiang Y, Liu W, Li X.
Department of Gynecology, First Clinical College, China Medical University, Shenyang 110001, China. email@example.com
OBJECTIVE: To study the optimal position and method for ovarian transposition and its benefits and indications. METHODS: We performed ovarian transposition in 34 patients from August 1989 to December 2000. Twelve patients were diagnosed with stage Ib to IIa cervical cancer, 4 had stage Ia endometrial carcinoma, 12 had stage III to IV endometriosis, 4 had myoma of uterus, 1 had dysfunctional uterine bleeding, and 1 had an ovarian granulosa cell tumor. Surgery went as follows: the ovary was dissociated by clamp, the skin was incised and a tunnel was made, then the ovary was translocated to the subcutaneous site. In the cases of benign lesions, the ovarian vessel pedicel went in through the abdominal cavity, but in malignant tumors, it went out through the peritoneum. RESULTS: In both cases (benign lesions or malignant tumors), the short-term and long-term endocrine function of the translocated ovary remained normal. Furthermore, patients could supervise their translocated ovary themselves. CONCLUSIONS: Subcutaneous ovary transposition might prevent not only implantation of gastrointestinal cancer but also the extension of pelvic carcinoma to the ovary. Because of the shallow transposition and the incision scar, it is easy for patients to supervise themselves. Moreover, the site of the ovary is easy to locate for ultrasound examinations. Thus, it can obtain the goal of early prevention for cancer. Subcutaneous ovarian transposition with skin incision is the optimal selection and suitable for all patients with various gynecologic diseases in which ovary removal is not necessary.
PMID: 12875681 [PubMed – in process]
6: Nurs Times. 2003 Jul 1-7;99(26):26. Links
What you need to know about… endometriosis.
[No authors listed] PMID: 12875111 [PubMed – in process]
7: Arch Pathol Lab Med. 2003 Aug;127(8):1003-6. Links
CD10 is helpful in detecting occult or inconspicuous endometrial stromal cells in cases of presumptive endometriosis.
Groisman GM, Meir A.
Department of Pathology, Hillel Yaffe Medical Center, Hadera, Israel. firstname.lastname@example.org
BACKGROUND: Previous studies have shown that CD10 is a marker for normal, ectopic, and neoplastic endometrial stromal cells. However, its value in confirming a diagnosis of presumptive endometriosis has not been extensively studied. OBJECTIVE: To assess the reactivity of CD10 in a series of cases of presumptive endometriosis and to establish the potential usefulness of this antibody in confirming the diagnosis. DESIGN: We studied hematoxylin-eosin sections and immunoreactivity of CD10 in 20 cases diagnosed as "suspicious for," "suggestive of," or "compatible with" endometriosis as well as in 12 cases of lesions that may be confused with endometriosis (3 endosalpingioses, 3 mesothelial hyperplasias, 3 ovarian follicular cysts, and 3 hemorrhagic corpora lutea). RESULTS: Routine sections from cases of presumptive endometriosis showed glands lacking a distinct cuff of endometrial stromal cells because of atrophy or because of changes secondary to hemorrhage, inflammation, fibrosis, and/or cystic dilatation. In a few cases, the distinction between endometrial and ovarian stroma could not be assessed with certainty. CD10 immunostaining confirmed the diagnosis in 17 (85%) of the cases, as it strongly stained endometrial stromal cells that were not apparent on hematoxylin-eosin sections. All sections from lesions that may simulate endometriosis were CD10-. CONCLUSION: CD10 is helpful in detecting occult or inconspicuous ectopic endometrial stromal cells and in distinguishing endometriosis from its potential mimickers. We recommend its use to confirm or exclude the presence of endometrial stromal cells in cases of presumptive endometriosis and in lesions that may be mistaken for this entity.
PMID: 12873175 [PubMed – in process]
8: Int Surg. 2003 Apr-Jun;88(2):114-8. Links
Thoracic endometriosis syndrome in Jamaica.
Ramphal PS, Blidgen J, Coye A, Irvine R.
Department of Surgery, University of the West Indies, Kingston, Jamaica. email@example.com
Thoracic endometriosis syndrome (TES) is a rare presentation of systemic endometriosis. An unusual cluster of patients from the Caribbean who were treated at a single hospital during the year 2001 is presented. All patients were managed surgically in the acute phase, with satisfactory results. The etiology and management of TES has been controversial. A therapeutic approach that includes aggressive surgery to obliterate the pleural space combined with a course of hormonal suppression offers the best chance of cure for these patients.
PMID: 12872907 [PubMed – in process]
9: Hum Reprod. 2003 Aug;18(8):1686-1692. Links
Transvaginal sonography and rectal endoscopic sonography for the assessment of pelvic endometriosis: a preliminary comparison.
Bazot M, Detchev R, Cortez A, Amouyal P, Uzan S, Darai E.
Services de Radiologie, Gynecologie-Obstetrique and Anatomo-pathologie, Hopital Tenon, 4 rue de la Chine, 75020 Paris and Assistance Publique – Hopitaux de Paris, Centre d’Exploration de l’Appareil Digestif, 17 rue des Pretres, St Germain l’Auxerois, 75017 Paris, France.
BACKGROUND: Endometriosis and possible rectal involvement are difficult to assess by physical examination. Previous studies have shown the diagnostic value of magnetic resonance imaging and rectal endoscopic sonography (RES) in this setting, but not that of transvaginal sonography (TVS). The aims of this study were to compare the accuracy of TVS and RES for the diagnosis of pelvic endometriosis, and to compare the results with histological findings. PATIENTS AND METHODS: In a prospective study, 30 consecutive patients referred with clinical signs of endometriosis underwent TVS and RES; the images were interpreted blindly with regard to physical findings. RESULTS: Endometriosis was confirmed histologically in 28 (93%) of the 30 patients. Endometriomas were also present in 67% of cases. For the diagnosis of uterosacral endometriosis, the sensitivity, specificity, and positive and negative predictive values of TVS and RES were 75 and 75%, 83 and 67, 95 and 90%, and 45 and 40% respectively. For the diagnosis of rectosigmoid endometriosis, the sensitivity, specificity, and positive and negative predictive values of TVS and RES were 95 and 82%, 100 and 88%, 100 and 95%, and 89 and 64% respectively. CONCLUSION: Despite the large proportion of our patients who had intestinal endometriosis, representing a possible source of bias, our results suggest that TVS is as efficient as RES for detecting posterior pelvic endometriosis and should therefore be used as the first-line examination.
PMID: 12871883 [PubMed – as supplied by publisher]
10: Hum Reprod. 2003 Aug;18(8):1674-80. Links
Levels of vascular endothelial growth factor (VEGF) in serum of patients with endometriosis.
Gagne D, Page M, Robitaille G, Hugo P, Gosselin D.
MetrioGene BioSciences (a subsidiary of PROCREA BioSciences), Montreal, Canada, H4P 2R2.
BACKGROUND: Elevated concentrations of vascular endothelial growth factor (VEGF) have been detected in the peritoneal fluid of patients with endometriosis. Furthermore, it was postulated that VEGF is involved in the development of endometriotic lesions. The present study is aimed at determining whether high levels of VEGF could also be found in the serum of patients with endometriosis. METHODS: VEGF levels were measured by enzyme-linked immunosorbent assay (ELISA) in serum from 131 subjects with surgically confirmed endometriosis and 146 controls with no clinical evidence of the disease or detectable endometriotic lesions at the time of surgical examination. Parameters such as demographics, personal habits, menstrual characteristics and clinical profile were collected from each subject included in this study. RESULTS: The mean VEGF levels were not significantly modulated in serum samples of cases compared with controls in a crude general linear model and in a model adjusted for possible confounders. VEGF serum levels did not correlate with the score, stage of endometriosis or the presence of benign gynaecological disorders. However, a correlation was found between circulating concentrations of VEGF and body mass index. CONCLUSION: Although VEGF seems to play a pivotal role locally in the implantation and development of endometriotic lesions, the disease is not associated with a significant modulation in the levels of circulating VEGF.
PMID: 12871881 [PubMed – in process]
11: Rev Med Chil. 2003 Apr;131(4):367-72. Links
[In Process Citation] [Article in Spanish] Bianchi M, Macaya R, Durruty G, Manzur A.
Unidad de Reproduccion Humana, Departamento de Obstetricia y Ginecologia, Facultad de Medicina, Pontificia Universidad Catolica de Chile. firstname.lastname@example.org
BACKGROUND: Endometriosis affects at least 15% of infertile women. The diagnosis is made by direct visualization of implants either at laparoscopy or laparotomy. Elevation of plasma CA-125 levels has been associated with the presence of endometriosis. AIM: To search for a correlation between CA-125 and the presence of endometriosis and its severity, among infertile patients requesting a diagnostic laparoscopy. PATIENTS AND METHODS: A total of 117 women were prospectively enrolled in the study between May 2000 and March 2002. A serum sample for CA-125 was taken immediately before surgery and the value obtained was correlated with the presence or absence of endometriosis and the severity of the disease. RESULTS: Sixty nine patients had endometriosis (59%). Patients with severe endometriosis, or grade IV, showed statistically significant higher levels of CA-125 compared to women without endometriosis or with grades I, II or III of the disease. DISCUSSION: The overall sensibility of CA-125 in detecting patients with endometriosis was low, however, it worked better for patients with advanced disease. Considering the rather low cost and simplicity of the test, we believe that it should be included in the evaluation of infertile couples.
PMID: 12870230 [PubMed – in process]
12: Gynecol Obstet Invest. 2003 [Epub ahead of print]. Epub 2003 Jul 14. Related Articles, Links
The Keeper((R)), a Menstrual Collection Device, as a Potential Cause of Endometriosis and Adenomyosis.
Spechler S, Nieman LK, Premkumar A, Stratton P.
Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Md., USA.
Barrier contraceptive devices like the cervical cap and diaphragm and menstrual collecting devices may block menstrual flow, increase retrograde menstruation, and thus theoretically increase the likelihood of developing endometriosis or adenomyosis. We describe the case of a woman with a prior tubal ligation who after 4 years of regular use of the Keeper((R)), a menstrual collecting device, developed adenomyosis and endometriosis. Copyright 2003 S. Karger AG, Basel
PMID: 12867766 [PubMed – as supplied by publisher]
13: Gynecol Obstet Invest. 2003;55(3):162-7. Related Articles, Links
Laparoscopy-assisted intrapelvic sonography with a high-frequency, real-time miniature transducer to assess the ovary: a preliminary report.
Senoh D, Tanaka H, Shiota A, Ohno M, Hata T.
Department of Midwifery, Kagawa Prefectural College of Health Sciences, Mure, Kagawa, Japan.
OBJECTIVE: Our purpose was to evaluate the normal and pathologic internal textures of the ovary using laparoscopy-assisted intrapelvic sonography (LAIPS) with a specially developed 20-MHz flexible catheter-based high-resolution real-time miniature (2.4 mm in outer diameter) ultrasound transducer in patients with gynecologic disorders and infertile women. METHODS: 30 women (19 patients with gynecologic disorders and normal menstrual cycles (2 adenomyoses, 1 cervical cancer, 5 fibromyomas, 5 simple ovarian cysts, 1 endometriosis, 3 benign cystic teratomas, and 2 endometriomas), and 11 patients with infertility including 4 with polycystic ovarian syndrome, PCOS) were studied by intrapelvic sonography using a high-frequency real-time miniature transducer with pelvic saline effusion and laparoscopy. RESULTS: In the normal ovary in the mid-follicular phase, follicles were depicted more distinctly than with transvaginal sonography (TVS). In the late-follicular phase, cumulus oophorus formations were visualized in 6 of 9 patients (54.5%), but were not clear using TVS. In the luteal phase, the corpus luteum was noted in 9 of 12 patients (75%) by both TVS and LAIPS. In patients with PCOS, the thickened capsule of the ovary was distinguished clearly especially in the peripheral type, in which numerous small cysts were aligned in the subcapsular region of the ovary, whereas it could not be detected by TVS. In all 4 cases with PCOS (8 ovaries), the ovarian capsular thickness could be measured by means of LAIPS. In subjects with benign cystic teratoma, minimal high echoic lesions were depicted. In subjects with endometrioma, a diffuse coarse-granular internal texture was visualized. However, depiction of internal structures in large pathologic ovarian lesions was markedly limited because of the shallow scanning range of the high-frequency transducer. CONCLUSION: LAIPS with a high-frequency real-time miniature transducer might be a useful diagnostic modality to evaluate the normal physiologic textures of the ovary, as well as those with PCOS. Copyright 2003 S. Karger AG, Basel
PMID: 12865596 [PubMed – in process]
14: East Afr Med J. 2000 Jul;77(7):398-9. Related Articles, Links
Endometriosis presenting as a groin tumour: case report.
Oyetunde O, Akang EE.
Department of Surgery, State Hospital, Ring Road, Ibadan, Nigeria.
A case of endometriosis presenting to a general surgeon as a groin mass in a 22-year old lady with no abdominal or pelvic symptoms and who had previously been pregnant is reported. Though similar presentations have been reported previously, we believe this is the first case to be reported from Ibadan in this form and we wish to emphasis the importance of consideration of this diagnosis in any groin swelling in a young female as well as the necessity of having a histological examination done on all excised lumps.
PMID: 12862163 [PubMed – in process]
15: Am J Obstet Gynecol. 2003 Jul;189(1):280-94. Related Articles, Links
Endometriosis and ovarian cancer: Thoughts on shared pathophysiology.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, the University of Pittsburgh Cancer Institute, and the Magee-Womens Research Institute.
BACKGROUND: Endometriosis appears to predispose to ovarian cancer. How this may occur has been little discussed.Study Design: This article reviews the English language literature for in vitro, animal, clinical, and epidemiologic studies linking the two conditions. RESULTS: Pathology case series consistently report endometrioid and clear cell types of ovarian cancer arising from endometriotic foci. Epidemiologic studies have been consistent with this association. There are also marked similarities between the proposed etiology of ovarian cancer and the observed pathophysiology of endometriosis. Specifically, both are characterized by immune alterations. Both conditions are promoted by estrogen excess and by progesterone deficit. Finally, steroid hormones interacting with the immune system may stimulate both endometriosis and ovarian cancer. I propose that the biology common to endometriosis and ovarian cancer represents not just a parallelism, but instead a causal pathway: aberrant immune function, fed by and feeding on estrogens, unbalanced by progesterone, may create a positive feed-forward loop that enhances the growth and invasiveness of endometriosis and promotes its malignant transformation. CONCLUSIONS: The same pathophysiology may orchestrate the progression of endometriosis and its transformation to endometroid and clear cell ovarian neoplasias. This notion of a unifying biology suggests a directed approach to future research and identifies possible chemoprevention strategies for women with endometriosis.
PMID: 12861175 [PubMed – in process]
16: Am J Obstet Gynecol. 2003 Jul;189(1):5-10. Related Articles, Links
Effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis who were treated with laparoscopic conservative surgery: A 1-year prospective randomized double-blind controlled trial.
Zullo F, Palomba S, Zupi E, Russo T, Morelli M, Cappiello F, Mastrantonio P.
Departments Obstetrics and Gynecology, the University "Magna Graecia" of Catanzaro, the University of Rome "Tor Vergata," and the University of Messina.
OBJECTIVE: The purpose of this study was to assess the effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis that was treated with conservative surgical intervention.Study Design: One hundred forty-one sexually active women of fertile age with chronic severe dysmenorrhea caused by endometriosis were treated with conservative laparoscopic surgery. Patients were assigned randomly to not receive (group A) or receive (group B) presacral neurectomy. At 6 and 12 months after the surgical procedures, the cure rate was evaluated in each patient. The frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were also evaluated at the same time intervals. RESULTS: The cure rate was significantly higher in group B compared with group A at a follow-up examination at 6 months (87.3% vs 60.3%) and 12 months (85.7% vs 57.1%). At follow-up visits, the frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were significantly lower in both groups compared with baseline values; in particular, significantly lower values were observed in group B versus group A for the severity. CONCLUSION: Presacral neurectomy improves the cure rate in women who are treated with conservative laparoscopic surgery for severe dysmenorrhea caused by endometriosis.
PMID: 12861130 [PubMed – in process]
17: Eur J Obstet Gynecol Reprod Biol. 2003 Aug 15;109(2):234-5. Related Articles, Links
Acute abdomen due to endometriosis in a premenopausal woman taking tamoxifen.
de Velasco LA, Cano A.
Department of Obstetrics and Gynecology, Hospital Cli;nico Universitario, University of Valencia, Valencia, Spain
Tamoxifen exhibits agonistic properties on the uterus. We describe a premenopausal woman who, while having tamoxifen due to a diagnosis of in situ ductal carcinoma, developed endometriosis requiring surgery.
PMID: 12860350 [PubMed – in process]
18: Eur J Obstet Gynecol Reprod Biol. 2003 Aug 15;109(2):206-208. Related Articles, Links
Investigation of glutathione concentrations in peritoneal fluid from women with and without endometriosis.
Polak G, Wertel I, Koziol-Montewka M, Tarkowski R, Kotarski J.
Department of Gynecology, University School of Medicine, ul. Staszica 16, 20-081, Lublin, Poland
Changes in the peritoneal fluid (PF) environment have been implicated in the pathogenesis of endometriosis as well as in the decrease of fertility. OBJECTIVE: To evaluate the concentration of glutathione in PF of women with endometriosis. PATIENTS: Twenty-one patients with endometriosis (I or II rAFS stage, n=11; III or IV rAFS stage, n=10), and 29 patients with follicular or dermoid ovarian cysts (n=17 and n=12, respectively). RESULTS: Mean (+/-S.D.) PF glutathione concentration was 0.22+/-0.01micromol/ml in patients with minimal or mild endometriosis, 0.21+/-0.05micromol/ml in women with III or IV stage of the disease, 0.24 +/- 0.03micromol/ml in women with follicle ovarian cysts, and 0.23+/-0.05micromol/ml in patients with dermoid tumors of ovaries. No significant difference in the peritoneal glutathione level was found between the groups. CONCLUSION: These results suggest that PF glutathione is not involved in the progression of endometriosis.
PMID: 12860343 [PubMed – as supplied by publisher]
19: Curr Opin Obstet Gynecol. 2003 Jun;15(3):259-64. Related Articles, Links
Gonadotropin-releasing hormone antagonists: impact of IVF practice and potential non-assisted reproductive technology applications.
Tarlatzis BC, Bili HN.
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece. email@example.com
PURPOSE OF REVIEW: To provide the clinician with updated knowledge of the most recent findings on the clinical use of gonadotropin-releasing hormone antagonists. RECENT FINDINGS: Gonadotropin-releasing hormone antagonists, which have recently been introduced in clinical practice, cause an immediate suppression of gonadotropin secretion by competitive blocking of pituitary gonadotropin-releasing hormone receptors. Thus, they are effective in preventing the premature luteinizing hormone surges during ovarian stimulation for in-vitro fertilization and may improve the patient’s response to lower doses of gonadotropins. Better patient acceptance, shorter treatment cycles and fewer follicles and oocytes are also reported. Data existing so far concerning the necessity of luteal phase support after the use of gonadotropin-releasing hormone antagonists show that it might not be mandatory when used in clomiphene citrate costimulated cycles or in intrauterine insemination cycles. The use of gonadotropin-releasing hormone antagonists seems to be safe for pregnant women and their offspring. All sex-hormone-dependent disorders, currently treated with gonadotropin-releasing hormone agonists, may in future be indications for a gonadotropin-releasing hormone antagonist, including endometriosis, leiomyoma, and breast cancer in women, benign prostatic hypertrophy and prostatic carcinoma in men, and central precocious puberty in children. The vast majority of the available clinical data up till now, however, are in assisted reproduction and prostate cancer. SUMMARY: It is expected that the availability of gonadotropin-releasing hormone antagonist will lead to the use of ‘softer’ ovarian stimulation protocols, which will be shorter, cheaper and safer compared with the conventional protocols.
PMID: 12858116 [PubMed – in process]
20: Curr Opin Obstet Gynecol. 2003 Jun;15(3):243-9. Related Articles, Links
Immunomodulators and aromatase inhibitors: are they the next generation of treatment for endometriosis?
Department of Obstetrics and Gynecology, Leuven University Fertility Center, University Hospital Gasthuisberg, Leuven, Belgium. firstname.lastname@example.org
PURPOSE OF REVIEW: This article will present an overview of current and new hormonal and non-hormonal medical treatment in the management of endometriosis, with special emphasis on immunomodulators and aromatase inhibitors. RECENT FINDINGS: Recent research shows a very promising role for new hormonal medication (aromatase inhibitors, estrogen and progesterone receptor modulators) and anti-inflammatory drugs (tumor necrosis factor-alpha inhibitors, matrix metalloproteinase inhibitors, cyclooxygenase-2 inhibitors) in the management of endometriosis. SUMMARY: The ideal drug in the treatment of endometriosis alleviates pain and cures sub-fertility without inhibition of ovulation or menstruation and without significant side effects or teratological effects. Such a drug would allow conception during treatment and would fundamentally change the management of endometriosis from a surgical approach to medical management. Although such a drug does not yet exist, promising research using tumor necrosis factor inhibitors indicates that this could become possible in the not too distant future. We strongly recommend testing new medication for the prevention or treatment of endometriosis in the baboon model, an established research model for fundamental and preclinical research in endometriosis.
PMID: 12858113 [PubMed – in process]
21: Curr Opin Obstet Gynecol. 2003 Aug;15(4):321-6. Related Articles, Links
Ovarian endometriosis: from pathogenesis to surgical treatment.
Busacca M, Vignali M.
PURPOSE OF REVIEW This review analyzes the literature on ovarian endometrioma, examining the controversies on pathogenesis, malignant transformation and surgical therapy.RECENT FINDINGS Recent literature reflects the necessity of clearly defining the ethiologic and pathologic factors that determine the origin of ovarian endometriosis and explain the increase in the condition with the prospect of developing effective prevention therapy. The possibility that ovarian endometriomas undergo malignant transformation is widely reported in the literature. Recent studies underline the importance of detecting histological differences in endometriosis (hyperplasia and atypia) and several studies of molecular biology support the theory of genetic alterations interfering with malignant transformation of ovarian endometriosis.SUMMARY The surgical approach must take into account all this information and, when the therapy is conservative, complete excision of the disease must be laparoscopically performed without affecting the healthy ovarian tissue.
PMID: 12858105 [PubMed – in process]
22: Mediators Inflamm. 2003 Jun;12(3):131-8. Related Articles, Links
The involvement of T lymphocytes in the pathogenesis of endometriotic tissues overgrowth in women with endometriosis.
Szyllo K, Tchorzewski H, Banasik M, Glowacka E, Lewkowicz P, Kamer-Bartosinska A.
Surgical Gynecology Department, Research Institute of Polish Mother’s Memorial Hospital, Lodz, Poland.
BACKGROUND: Endometriosis, uncontrolled proliferation of ectopic and eutopic endometriotic tissues, is common in women at reproductive age, and may affect fertility. The role of macrophages in the pathogenesis is well proved, but engagement of T cells in the pathogenesis of endometriosis is a matter of controversy. AIMS: T-cell involvement in the pathogenesis of endometriosis was the objective of our study performed on women aged 24-46 years with diagnosed endometriosis. All the patients that were studied underwent diagnostic laparoscopy. METHODS: We evaluated the distribution of T-lymphocyte subpopulations in peripheral blood (PB), peritoneal fluid (PF) and in endometriotic tissues (ET), as well as cytokines [interleukin (IL)-2, IL-4, IL-10, IL-12, interferon (IFN)-gamma] production by peripheral blood lymphocytes. IFN-gamma, tumor necrosis factor (TNF)-alpha, IL-4 and IL-6 were investigated for their intracellular presence. The experiments were carried out before and after 6 months treatment with the GnRH-Analogous Goserelin (Zeneca Pharmaceuticals). The number of performed investigations is presented. Statistical analysis was performed using Statistica/Win 5.0 software and Student’s t-test, the paired Student t-test and Fisher’s exact test when appropriate. RESULTS: We have compared the lymphocyte subset re-distribution with regard to the American Fertility Society (AFS) stages and scores, but no differences were observed. The significant increase in CD4:CD8 ratio, the decrease in the number of natural killer (NK) cells in PB and the decrease in CD4:CD8 ratio in PF and ET of women with endometriosis was noted. The diminished IFN-gamma secretion by phytohemagglutinim (PHA)-stimulated lymphocytes in vitro derived from women with endometriosis and increased IL-4 production may be responsible for defective immunosurveillance against overgrowth of endometriotic tissues. The diminished NK cells number in PB of women with endometriosis argues for such a hypothesis. The increased deposits of proinflammatory IL-6 and TNF-alpha in the T lymphocytes of women with endometriosis may be related to T-regulatory lymphocyte function and their inability to suppress cell proliferation in endometriosis. GnRH-Analogous Goserelin treatment normalises cytokine production and induces patient recovery. CONCLUSIONS: The significant functional and phenotypic differences between the lymphocytes from healthy women and women with endometriosis were noted. The diminished IFN-gamma production in relation to decreased NK cells number and the increased IL-4 production before the treatment and normalisation after the treatment suggest the involvement of the deregulated T-cell system in the growth stimulation and recruitment of endometriotic cells. The increased CD4:CD8 ratio, IL-6, TNF-alpha deposits and diminished anti-inflammatory IL-10 production by lymphocytes may participate in the pathogenesis of endometriosis, and may secondarily affect the monocyte/macrophage function.
PMID: 12857596 [PubMed – in process]
23: Tohoku J Exp Med. 2003 Apr;199(4):219-28. Related Articles, Links
Morphological quantitative changes in the number of lymphocytes, macrophages and plasma cells in the uterus and lymph nodes of rats exposed to the systemic administration of BCG.
Kanter M, Gul A, Meral I, Koc A, Ilhan M, Erdogan E.
Department of Histology and Embryology, Faculty of Veterinary Medicine, Yuzuncu Yil University, Van, Turkey. email@example.com
This study was designed to investigate the effect of systemic administration of BCG on the morphological quantitative changes in the number of lymphocytes, macrophages and plasma cells in the uterus and lymph nodes of rats. Thirty female virgin Wistar Albino rats, aging 6 months and weighing between 200-250 g, were assigned to the two experimental groups; BCG treated and controls (n = 15). BCG group received 0.1 ml BCG in tail skin and control group received 0.1 ml saline at the same place. Two weeks after injections, rats in both groups were anesthesized with a high dose of ether and decapitated. Uterus and ileocecal lymph nodes were processed to determine a napthyl acid esterase (ANAE)-positive T lymphocytes and macrophages. The plasma cells were stained with the methyl green-pyronin method. It was found that the numbers of T lymphocytes, macrophages and plasma cells in the uterus and the ileocecal lymph nodes of BCG treated group significantly increased indicating the presence of an immune response to the systemic BCG administration. It was concluded that the systemic administration of BCG increases humoral and cellular immunity in endometrium, myometrium and regional lymph nodes. The immune deficiency system plays an important role in the pathogenesis of endometriosis. Therefore, the endometriosis might be prevented by using periodical administration of BCG. However, further experimental and clinical studies associated with these issue are required.
PMID: 12857062 [PubMed – in process]
24: J Reprod Med. 2003 Jun;48(6):466-8. Related Articles, Links
Neuropathic uterine pain after hysterectomy. A case report.
Chavez NF, Zweizig SL, Stewart EA.
Center for Uterine Fibroids, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA.
BACKGROUND: Neuropathic pain arises when there is damage to or dysfunction of the nervous system. Diabetic neuropathy, postherpetic neuralgia and phantom limb pain are common types of neuropathic pain. It is not commonly recognized in gynecologic practice. CASE: A patient underwent a hysterectomy for a tuboovarian abscess and underlying endometriosis. Despite maximal dosing with conventional pain medications, she continued to have significant pain that had not been present following prior surgeries. Use of low-dose amitriptyline successfully treated the pain, with no sequelae. CONCLUSION: Persistent pain following gynecologic surgery that does not respond to conventional therapy may have a neuropathic origin. Attention to appropriate history and physical examination may lead to an increase in the diagnosis of neuropathic pain in gynecology patients. This may have implications for persistent pain in other gynecologic diseases.
PMID: 12856521 [PubMed – in process]
25: J Reprod Med. 2003 Jun;48(6):463-5. Related Articles, Links
Pericardial effusion, right-sided pleural effusion and ascites associated with stage IV endometriosis. A case report.
Francis M, Badero OO, Borowsky M, Lee YC, Abulafia O.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Division of Cardiology, State University of New York, Downstate Medical Center, Brooklyn, USA.
BACKGROUND: Endometriosis has rarely been associated with ascites and less often with pleural (usually right-sided) effusion. CASE: A multiparous, reproductive-aged woman was referred for evaluation of possible ovarian carcinoma following the development of dyspnea, progressive abdominal distention, weight loss and increasing secondary dysmenorrhea. Imaging demonstrated normal ovaries in the presence of massive ascites and right-sided pleural and pericardial effusions. At laparotomy, grade IV endometriosis was noted. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and appendectomy were performed, with subsequent resolution of all cavity fluid accumulations. CONCLUSION: Pericardial and pleural effusions in the presence of ascites may be associated with endometriosis.
PMID: 12856520 [PubMed – in process]
26: Arch Gynecol Obstet. 2003 Jul 10 [Epub ahead of print]. Related Articles, Links
Vaginal hysterectomy in generally considered contraindications to vaginal surgery.
Paparella P, Sizzi O, Rossetti A, De Benedittis F, Paparella R.
Division of Gynecologic Endocrinology, Complesso Integrato Columbus, Via Moscati 31, 00168, Rome, Italy.
OBJECTIVE. The objective was to evaluate the feasibility and complication rate of vaginal hysterectomy with or without adnexectomy in women with enlarged uteri and/or other considered contraindications to the vaginal route. STUDY DESIGN. Over a period of 2 years, a total of 204 women underwent vaginal hysterectomy for benign pathology. Normally considered contraindications to the vaginal route were: moderate to excessive uterine enlargement, nulliparity or no prior vaginal delivery, previous cesarean or pelvic surgeries and adnexal pathologies. Laparoscopy was used only if it became necessary. Patients with uterine prolapse were excluded. The clinical outcomes and complication rate were analyzed even with regards to the type of contraindication. RESULTS. The mean age of the patients was 46.96+/-4.8 years (range: 38-68). The mean uterine weight was 427.74+/-254.75 g (range: 150-2,000). The operative time ranged from 30 to 140 min (mean: 61.59+/-21.80 SD) for vaginal hysterectomy alone, increasing up to 170 min (mean: 83.6+/-38.28 SD) in case of adnexectomy or laparoscopic assistance. The patient characteristics, the uterine weight and the postoperative results and clinical outcome did not differ among the groups of contraindications. Overall, the complication rate was 9.8%. No patient required a transfusion for surgical blood loss, a return to the operating room or readmission to the hospital. During vaginal hysterectomy, adnexectomy was possible in 90.6% of the cases in which it was indicated (unilateral in 21.8% because of adnexal pathology) and was technically impossible in 9.3%. In 4 cases (1.9%) it was not possible to complete vaginal hysterectomy owing to the presence of thick adhesions obliterating the cul-de-sac, of severe endometriosis or other unforeseen circumstances. In these few cases with a difficult access to the ovaries (2.9% of all VH) or with difficulties in mobilizing the uterus, we resorted to laparoscopy. The pneumoperitoneum was achieved by means of an insufflation tube inserted via the vagina into the abdominal cavity and packing the vagina. Thus, the risks associated to the insertion of the Veress needle were avoided. In all but two cases in which conversion to laparotomy was necessary, laparoscopy was successfully completed. CONCLUSIONS. Vaginal hysterectomy appears to be feasible in about 97% of cases in which this approach would have been judged unsuitable. This figure decreases to 94.2% when oophorectomy is indicated.
PMID: 12856131 [PubMed – as supplied by publisher]
27: Am J Reprod Immunol. 2003 May;49(5):285-96. Related Articles, Links
The role of cytokines in endometriosis.
Wu MY, Ho HN.
Department of Obstetrics and Gynecology, College of Medicine and the Hospital, National Taiwan University, Taipei, Taiwan.
PROBLEM: To review the literature on the role of peritoneal cytokines in the pathogenesis and endometriosis-related infertility. METHODS OF STUDY: A MEDLINE search was conducted by the key words of cytokine and endometriosis in the English publications, and references identified within the identified papers were also reviewed. RESULTS: Several cytokines including interleukin (IL)-1, 6, 8, 10, tumor necrosis factor (TNF)-alpha, and vascular endothelial growth factor (VEGF) were reported to be increased in the peritoneal fluid (PF) of women with endometriosis. Those cytokines may be involved in macrophage activation, inflammatory change and enhanced angiogenesis. However, some cytokines were less expressed such as IL-2, and interferon (IFN)-gamma. They reflect the impaired T- and natural killer (NK)-cell function. Endometriotic implants produce some factors, e.g. matrix metalloproteinases (MMPs), Bcl-2, and affect their capacity to implant into the peritoneum. CONCLUSION: Peritoneal cytokines, which are produced by mesothelial cells, leukocytes and ectopic endometrial cells, interwork locally and systemically in women with endometriosis. More studies about the specific role and interactions of these cytokines are needed to improve the understanding of endometriosis and to develop novel therapies.
PMID: 12854733 [PubMed – in process]
28: Int J Oncol. 2003 Aug;23(2):445-52. Related Articles, Links
Advanced indications for gonadotropin-releasing hormone (GnRH) analogues in gynecological oncology (Review).
Sugiyama M, Imai A, Takahashi S, Hirano S, Furui T, Tamaya T.
Department of Obstretrics and Gynecology, Gifu University School of Medicine, Gifu 500-8705, Japan.
Gonadotropin-releasing hormone (GnRH) analogue has beneficial effects on the size and symptoms of endometriosis and uterine leiomyomas as a result of suppressing ovarian steroidogenesis. GnRH analogues are also the preferred treatment for advanced and even metastatic or recurred carcinomas originated from the reproductive tract. The original rationale for a GnRH analogue in the treatment was to block the endogenous gonadotropin and thereby steroid hormone secretion which was thought to stimulate tumor growth. However, more than 80% of ovarian and endometrial cancers express receptors for GnRH, and the analogues inhibit proliferation of the GnRH receptor-bearing tumor cells both in vivo and in vitro, supporting evidence for a direct antiproliferative effect. These receptors could be used for targeted chemotherapy (by tumoricidal agents linked to GnRH analogues) to improve antitumor effects and reduce side effects compared with conventional systemic chemotherapy. In addition to the anticancer action, GnRH analogues act to protect the gonads during radiation and/or chemotherapy by preferentially steering cells into cell cycle arrest with a decline in responsibility to the chemotherapy and radiation. In women who wish to maintain potential fertility, GnRH analogue therapy is successful in preventing the most critical postoperative complication, adhesion formation. The additional unrecognized benefits may add to the advantage of GnRH analogues in cancer management in gynecology.
PMID: 12851694 [PubMed – in process]
29: Am J Epidemiol. 2003 Jul 15;158(2):156-64. Related Articles, Links
Recreational physical activity and endometrioma risk.
Dhillon PK, Holt VL.
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Endometriosis, defined by implantation of endometrial tissue outside the uterus, is commonly found on the ovaries and is characterized by a range of symptoms and severity, including chronic pelvic pain and infertility. The role of modifiable exogenous factors such as exercise in the development of this disease is not well understood. The authors conducted a 1990-1994 case-control study (77 cases, 735 controls) to evaluate the risk of cystic ovarian endometriosis (endometrioma) associated with recreational physical activity among females aged 18-39 years enrolled in the Group Health Cooperative of Puget Sound, Washington. Physical activity was evaluated according to its duration, frequency, and intensity during two periods of exposure: 2 years prior to the reference date and at ages 12-21 years. Women who reported frequent, high-intensity activity during the 2 years prior to the reference date had a 76% reduced endometrioma risk (odds ratio = 0.24, 95% confidence interval: 0.08, 0.71) compared with women who engaged in no high-intensity activity. A nonsignificant 53% reduction in risk was observed for women who reported such activity at ages 12-21 years (odds ratio = 0.47, 95% confidence interval: 0.18, 2.23). Activities of lower intensity, frequency, and duration were not associated with a woman’s risk of endometrioma.
PMID: 12851229 [PubMed – in process]
30: Fertil Steril. 2003 Jul;80(1):232-3. Related Articles, Links
Reply of the author: The best fit model for endometriosis.
, Bend, Oregon, USA
PMID: 12849841 [PubMed – in process]
31: Fertil Steril. 2003 Jul;80(1):232. Related Articles, Links
The best-fit model for endometriosis.
Department of Pediatrics, Medical College of Wisconsin, Watertown Plank Road, Milwaukee, Wisconsin, USA
PMID: 12849840 [PubMed – in process]
32: Fertil Steril. 2003 Jul;80(1):43-53. Related Articles, Links
Blood leukocyte subsets are modulated in patients with endometriosis.
Gagne D, Rivard M, Page M, Shazand K, Hugo P, Gosselin D.
Division of Research and Development, PROCREA BioSciences, Montreal, Quebec, Canada
To determine whether blood leukocyte populations could be modulated in endometriosis.Case-control study.Eight clinical institutions of the Montreal area.Women with regular menstrual cycles who underwent laparoscopy or laparotomy between 1997 and 2001 and who were not under hormonal treatment for at least 3 months were selected. This study includes 175 cases and 131 controls.The proportion of blood leukocytes expressing markers for T, B lymphocytes, monocytes, or natural killer (NK) cells were compared by flow cytometric analysis between cases and controls.Age and parity were identified as important confounders. Given that smoking, history of acute infection, and previous use of oral contraceptives strongly correlate with the level of some blood leukocyte populations, these parameters were taken into account in addition with age and parity when the level of blood leukocyte subsets were evaluated in cases and controls. Blood monocytes expressing CD14 and CD44 molecules were increased in patients with endometriosis. Alternatively, B lymphocytes were shown to be significantly decreased in cases compared with controls.Although these results suggest that endometriosis is associated with some systemic manifestations, the exact role of these modulations remains unclear.
PMID: 12849800 [PubMed – in process]
33: J Pediatr Adolesc Gynecol. 2003 Jun;16(3 Suppl):S29-39. Related Articles, Links
Teaching teens about endometriosis.
Children’s Hospital, Boston, Massachusetts 02115, USA.
PMID: 12848154 [PubMed – in process]
34: Saudi Med J. 2003 May;24(5):523-5. Related Articles, Links
Abdominal wall endometriosis. An overlooked diagnosis.
Khammash MR, Omari AK, Gasaimeh GR, Bani-Hani KE.
Associate Professor, Faculty of Medicine, Jordan University of Science and Technology, PO Box 3030, Irbid, Jordan. Tel. +962 (2) 7200624. Fax. +962 (2) 7060009. E-mail: firstname.lastname@example.org
OBJECTIVE: To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. METHODS: Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient’s files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. RESULTS: Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. CONCLUSION: The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses.
PMID: 12847630 [PubMed – in process]
35: Am J Reprod Immunol. 2003 Aug;50(2):124-30. Related Articles, Links
Fibroblast Growth Factor (FGF), Intracellular Adhesion Molecule (sICAM-1) Level in Serum and Follicular Fluid of Infertile Women with Polycystic Ovarian Syndrome, Endometriosis and Tubal Damage, and their Effect on ICSI Outcome.
Hammadeh ME, Fischer-Hammadeh C, Hoffmeister H, Huebner U, Georg T, Rosenbaum P, Schmidt W.
Department of Obstetrics and Gynecology, Central Laboratory, Institute of Medical Biometrics, Epidemiology and Medical Information, University of Saarland, Homburg/Saar, Germany.
PROBLEM: The objective of this study was to determine the concentration of fibroblast growth factor (FGF) and soluble intracellular adhesions molecule (sICAM-1) in serum and follicular fluid (FF) of polycystic ovary (PCO), endometriosis and tubal factor infertility and male factor infertility patients, and to investigate the relationship between these parameters and the outcome of intracytoplasmic sperm injection (ICSI). METHOD OF STUDY: The concentration of FGF and sICAM-1 in serum and FF were determined in patients undergoing controlled ovarian hyperstimulation (COH) for ICSI therapy for various etiology of infertility and the results of cytokines concentration and ICSI outcome were compared between the groups. Twenty patients with PCO (G.I), 17 with endometriosis (G.II), 19 with tubal damage (G.III) and 19 with male factor infertility (G.IV) were enrolled in this study. Quantitative determination of levels of FGF and sICAM-1 was performed using enzyme-linked immunosorbent assays (ELISAs). RESULTS: The FGF level in serum of PCO patients (G.I) were 4.8 +/- 2.3 and in FF were 104.0 +/- 39.0 pg/mL. The corresponding values in the endometriosis patients group (G.II) were 5.9 +/- 3.1 and 125.4 +/- 74.9 pg/mL. The concentration of FGF in tubal factor infertility group (G.III) in serum was significantly higher (P = 0.009) than those observed in the PCO group (G.I) 7.4 +/- 4.5 pg/mL, whereas the concentration in FF was at the same level like the other groups investigated, 128.7 +/- 75.9 pg/mL. Besides, the sICAM-1 (pg/ml) concentration in FF showed a significant difference between the groups investigated (G.I, 175.3 +/- 52.8; G.II 194.4 +/- 32.2; G.III 233.1 +/- 54.3; and G.IV 215.1 +/- 54.4 ng/mL; P = 0.003). The sICAM-1 levels in serum were not significantly different between the groups (217.0 +/- 42.9; 216.3 +/- 73.6; 254.8 +/- 79.6; 237.56 +/- 78.4 ng/ml; P = 0.267). The fertilization rate was significantly higher in G.III (66.0 +/- 23.89%) in comparison to G.II (38.8 +/- 33.9%; P = 0.014) or G.IV (38.7 +/- 22.7%; P = 0.012). The pregnancy rates were similar in all groups (30, 35.3 and 35.0, 38.6%, respectively). CONCLUSION: Both, FGF and sICAM-1 are present in serum and FF of patients undergoing controlled ovarian hyperstimulation for ICSI therapy. The FGF concentration in serum differs significantly between the groups investigated, whereas, no significant difference could be observed in the FF concentration of FGF. On the other hand, the sICAM in serum showed no significant difference between the groups, whereas, sICAM in FF demonstrated a significant difference between the patient groups investigated. On the whole, the ICSI outcome was not related to serum or FF concentrations of FGF or sICAM-1. Therefore, the mean concentration of FGF and sICAM-1 in serum and in FF could not be used to predict the fertilization rate in an ICSI program.
PMID: 12846675 [PubMed – in process]
36: J Tongji Med Univ. 2000;20(2):163-5. Related Articles, Links
Changes of cytokines levels in peritoneal fluids of patients with endometriosis and its effect on reproductive activity.
Liu Y, Luo L, Zhao H.
Department of Obstetrics & Gynecology, Xiehe Hospital, Tongji Medical University, Wuhan 430022.
To study the changes of cytokines in peritoneal fluids of patients with endometriosis and their effects on reproductive activity, levels of tumor necrosis factor (TNF) and interleukin 6 (IL-6) in peritoneal fluids and peritoneal macrophages’ culture supernatant were studied by using enzyme linked immunoassay (ELISA) in 14 infertile patients with endometriosis (EMT group) and 11 infertile women with normal pelvis (control group). The effects of peritoneal fluids in patients with endometriosis in vitro on sperm motility and development of 2-cell mouse embryos were also studied. The results showed that the levels of TNF and IL-6 in peritoneal fluids and peritoneal macrophages’ supernatant in EMT group were elevated significantly as compared with those in the control group (P < 0.01). The percent of sperm straight line movement and total sperm motility were decreased significantly in EMT group (P < 0.01). The percent of 2-cell mouse embryos developing to 16-cells was 32.5% in EMT group, while 47.6% in control group after 48 h co-culture with peritoneal fluid (P < 0.01). It is likely that the elevation of peritoneal fluid cytokines in patients with endometriosis may play a role in infertility associated with endometriosis.
PMID: 12845737 [PubMed – in process]
37: Ann Thorac Surg. 2003 Jul;76(1):290-1. Related Articles, Links
Catamenial pneumothorax caused by endometriosis in the visceral pleura.
Sakamoto K, Ohmori T, Takei H.
Department of Respiratory Surgery, Yokohama Rosai Hospital, Yokohama, Japan. email@example.com
Catamenial pneumothorax is a rare clinical entity of unknown etiology. The most well known hypothesis is passage of air from the genital tract through endometrial fenestrations in the diaphragm. Although some reports are associated with diaphragmatic endometriosis, few have been confirmed endometrial implants in the visceral pleura. We describe a very rare case of catamenial pneumothorax caused by ectopic endometriosis in the visceral pleura confirmed histopathologically in a woman 1-year after hysterectomy.
PMID: 12842566 [PubMed – in process]
38: J Tongji Med Univ. 1999;19(3):212-4. Related Articles, Links
Effect of IL-1 beta and TNF-alpha on the expression of monocyte chemotactic protein-1 in endometriotic cells.
Gao Y, Luo L, He F.
Department of Obstetrics and Gynecology, Xiehe Hospital, Tongji Medical University, Wuhan 430022.
To investigate the clinical significance of monocyte chemotactic protein-1 (MCP-1) produced by endometriotic tissues, the endometriotic tissues were taken from 15 patients with endometriosis. MCP-1 mRNA and MCP-1 protein were determined by dot blot analysis and enzyme linked immunosorbent assay (ELISA) in endometriotic cells cultured with or without interleukin-1 beta (IL-1 beta, 2 micrograms/L), tumor necrosis factor-alpha (TNF-alpha, 20 g/L). After exposure to IL-1 beta or TNF-alpha, the expression of MCP-1 mRNA in the endometriotic cells (8.635 +/- 0.826, 7.031 +/- 0.970, respectively) were significantly higher than that in the control group (4.482 +/- 0.435, P < 0.05); The expression of MCP-1 protein in IL-1 beta and TNF-alpha group was 4.52 +/- 0.09 micrograms/L, 2.87 +/- 0.27 micrograms/L, respectively, which were significantly higher than 1.74 +/- 0.16 micrograms/L in control (P < 0.01). The results suggested that IL-1 beta and TNF-alpha could up-regulate the expression of MCP-1 in endometriotic cells, which might be related to the development of endometriosis.
PMID: 12840897 [PubMed – in process]
39: Patol Fiziol Eksp Ter. 2003 Apr-Jun;(2):11-2. Related Articles, Links
[In Process Citation] [Article in Russian] [No authors listed] Endometriosis is the growth of endometrial tissue outside the uterus. A rat model of endometriosis was used to evaluate the potential for surgical invasions. Experimental endometriosis in albino female rats was induced by autotransplantation of the uterine endometrium to the peritoneum near the ovary. In all the rats endometrial implants developed into endometriotic tissues. The reproductive function and phagocytic activity of peritoneal macrophages were assessed. Rats with endometriosis had longer diestrus and estrous cycle. Increased number of peritoneal macrophages and enhancement of their adhesion and phagocytic activity were registered.
PMID: 12838764 [PubMed – in process]
40: Mol Hum Reprod. 2003 Aug;9(8):491-5. Related Articles, Links
Evaluation of germline sequence variants within the promoter region of RANTES gene in a cohort of women with endometriosis from Spain.
Antinolo G, Fernandez RM, Noval JA, Garcia-Lozano JC, Borrego S, Marcos I, Molini JL.
Unidad de Genetica Medica y Diagnostico Prenatal.
The RANTES (regulated upon activation normal T cells expressed and secreted) chemokine, is known to be expressed in endometriotic lesions in a concentration correlating with the severity of endometriosis. Since it has been widely demonstrated that endometriosis has a genetic basis, we postulated that the gene encoding RANTES could be a good candidate gene for the disease. We have used fluorescence resonance energy transfer (FRET) technology to genotype and evaluate the role of the variants -403G–>A and -28C–>G, located within the promoter region of the gene, as susceptibility factors in a cohort of Spanish women with endometriosis. No differences have been found in the allelic frequencies of both variants nor in the haplotype/ genotype distribution between patients and controls. These data are consistent with the lack of association between these polymorphisms and endometriosis in our population. They do not exclude completely a possible role of other variants within RANTES gene in this pathology.
PMID: 12837926 [PubMed – in process]
41: Obstet Gynecol Clin North Am. 2003 Jun;30(2):379-90. Related Articles, Links
Attaran M, Gidwani GP.
Section of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. firstname.lastname@example.org
Endometriosis is a cause of chronic, pelvic pain in adolescents. Lack of response to NSAIDS and OCPs should prompt further investigation and subsequent treatment. The goal of therapy is to minimize pelvic pain and dysmenorrhea primarily through long-term, medical therapy. Surgical intervention is principally indicated to establish a diagnosis. The poor response to surgical therapy negates the need for repetitive or radical surgery. Much patience and care should be directed toward these patients to provide them with an understanding of their disease and to help enhance the quality of their life.
Publication Types: · Review · Review, Tutorial
PMID: 12836726 [PubMed – indexed for MEDLINE]
42: Radiol Med (Torino). 2003 Apr;105(4):326-38. Related Articles, Links
[Staging of pelvic endometriosis using magnetic resonance imaging compared with the laparoscopic classification of the American Fertility Society: a prospective study] [Article in Italian] Zanardi R, Del Frate C,