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ISRN Obstet Gynecol. 2011;2011:272159. Epub 2010 Nov 4.

Inguinal endometriosis: an uncommon differential diagnosis as an inguinal tumour.

Wong WS, Lim CE, Luo X.

Source

School of Women & Childrens Health, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia.

Abstract

Inguinal endometriosis can present as a rare tumor when it occurs outside the abdomen and pelvis. We present a patient with a painful tumor in the right inguinal region, where its diagnosis was made before the operation. This enabled a conservative excisional surgery to be performed. The literature is reviewed and the diagnosis as well as management are discussed.

Int J Surg Pathol. 2011 Jun 1. [Epub ahead of print]

Mullerianosis of the Urinary Bladder.

Vella JE, Nair N, Ferryman SR, Athavale R, Latthe P, Hirschowitz L.

Source

Birmingham Women’s NHS Foundation Trust.

Abstract

Müllerianosis of the urinary bladder is a rare condition that encompasses 3 histological entities (endometriosis, endocervicosis, and endosalpingiosis). The authors report 2 patients with bladder müllerianosis, one of whom had endometriosis and the other a history of past pelvic surgery, describe the histological and cystoscopic features, and review the literature on this condition. Mucosal hyperemia and submucosal nodules or cysts with associated fibrosis and distortion of the bladder wall may mimic malignancy on cystoscopy, as may the infiltrative growth pattern sometimes evident histologically. Recognition of this complex diagnostic entity is important to avoid misdiagnosis and inappropriate investigation. There is a clinical association with endometriosis and past pelvic surgery.

Clin Colon Rectal Surg. 2010 Jun;23(2):72-9.

Endometriosis for the colorectal surgeon.

Slaughter K, Gala RB.

Source

Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, Louisiana.

Abstract

Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity. Although the exact pathophysiology is unclear, endometriosis is a well-known cause of pelvic pain and infertility in reproductive-aged women. Endometriosis can have extrapelvic manifestations relevant for colorectal surgeons to appreciate, such as cyclic constipation, diarrhea, hematochezia, and dyschezia. The treatment of endometriosis involves a combination of medical and surgical interventions where close collaboration between the gynecologist and colorectal surgeon can help achieve prolonged periods of symptom remission.

Clin Colon Rectal Surg. 2010 Jun;23(2):63-71.

Adnexal masses and malignancies of importance to the colorectal surgeon.

Kline RC, Bazzett-Matabele LB.

Source

Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, Louisiana.

Abstract

In this article, the authors review both benign and malignant ovarian masses, as the colorectal surgeon who encounters an adnexal mass at the time of surgery should be aware of the steps necessary for surgical staging and optimal tumor resection.Ovarian tumors-most of which are benign-are divided into three major categories, in order of frequency: epithelial, germ cell, and sex cord-stromal tumors. Nonneoplastic conditions of the ovary that may present as adnexal masses include the following, according to World Health Organization (WHO) classification: pregnancy luteoma, hyperplasia of ovarian stroma, hyperthecosis, massive edema, solitary follicle cysts and corpus luteal cysts, multiple follicle cysts, and endometriosis.Epithelial ovarian tumors arise from the surface epithelium and can be benign or malignant. Histologic types are serous, mucinous, endometrioid, clear cell, or Brenner. Germ cell tumors are more likely to appear in females under 20 years, accounting for 70% of ovarian tumors in this age group. Approximately 3% are malignant. Teratomas are the most common germ cell tumors. Malignancies, in addition to malignant teratomas, include dysgerminomas, endodermal sinus tumors, and embryonal carcinomas. The more common sex cord-stromal tumors include granulosa stromal cell tumors, Sertoli-Leydig cell tumors, and gynandroblastomas.Surgical staging and optimal tumor resection are also addressed, with a focus on epithelial malignancies, as they are the most relevant to colorectal surgeons.

Hum Reprod. 2011 Aug;26(8):2258. Epub 2011 May 30.

Trichostatin A, a histone deacetylase inhibitor, reduces lesion growth and hyperalgesia in experimentally induced endometriosis in mice.

Lu Y, Nie J, Liu X, Zheng Y, Guo SW.

J Obstet Gynaecol. 2011 Jul;31(5):452-3.

Pulmonary parenchymal endometriosis presenting as bilateral pneumothoraces.

Poh CL, Yan TD, Vallely MP, Bannon PG, McCaughan BC.

Source

Department of Cardiothoracic Surgery, The University of Sydney, Royal Prince Alfred Hospital, Sydney, Australia. cl.poh@student.unsw.edu.au

Rev Bras Ginecol Obstet. 2011 Jan;33(1):37-42.

Analysis of codon 72 polymorphism of the TP53 gene in infertile women with and without endometriosis.

[Article in Portuguese]

Bianco B, Christofolini DM, Brandes A, Lerner TG, Gonçalves-Filho RP, Souza AM, Barbosa CP.

Source

Departamento de Ginecologia e Obstetrícia, Santo André, SP, Brasil. bianca.bianco@hotmail.com

Abstract

PURPOSE:

to evaluate the frequency of TP53 codon 72 polymorphism in infertile women with endometriosis, women with idiopathic infertility, controls and its relation to the disease.

METHODS:

a case-control study that included 198 infertile women with endometriosis, 70 women with idiopathic infertility and 169 fertile women without endometriosis as control. Detection of TP53 codon 72 gene polymorphism (rs1042522, Arg/C:Pro/G), that promotes a C/G exchange in the coding region of the gene, was performed by real time Polymerase Chain Reaction (PCR), using the TaqMan system of primers, that flank the implicated region and probes labeled with different fluorescent dyes, one for allele C and other for allele G. When two dyes were observed, the patient was considered to be heterozygous CG. In the presence of only one dye, the individual was considered to be homozygous CC or GG. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value <0.05 was considered to be statistically significant.

RESULTS:

we found no statistically significant difference in the distribution of TP53 codon 72 polymorphism genotypes CC, CG or GG (p=0.7) and alleles C or G (p=0.4) between infertile patients with endometriosis and controls (p=0.4), regardless of the stage of the disease. In relation to infertility, no statistically significant difference in the genotype or allele distribution (p=1.0 and p=0.9, respectively) was observed between idiopathic infertile women and controls. Considering the dominant inheritance model, again, no statistically significant difference was found even in the endometriosis (p=0.5) or the idiopathic infertility group (p=0.9) when compared to controls. Regarding the recessive inheritance model no statistically significant difference was found, with p=0.6 and p=1.0, respectively, for the endometriosis and idiopathic infertility groups.

CONCLUSION:

the results suggest that the TP53 codon 72 polymorphism does not confer genetic susceptibility to endometriosis and/or infertility in the Brazilian population, not even the severe form of the disease.

Gynecol Obstet Invest. 2011 May 31. [Epub ahead of print]

Perinatal Environment and Endometriosis.

Somigliana E, Vigano P, Abbiati A, Paffoni A, Benaglia L, Vercellini P, Fedele L.

Source

Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Abstract

Background/Aims: Perinatal environmental exposure may affect fetal development and reprogram the developing organism for adult-onset disease. In this case-control study, we aimed at assessing this pathogenetic model in endometriosis. Methods: Consecutive patients with a first laparoscopic diagnosis of endometriosis were selected as cases. Controls were women who underwent laparoscopy during the same study period, but who were found to be free of the disease. Selected women and their mothers were interviewed. Results: Ninety-one women with endometriosis and 82 controls were selected. Handedness, a variable believed to be determined prenatally by hormonal environment in utero significantly differed between the study groups. Women with the disease were less likely to be left- or mixed-handed (adjusted OR: 0.24, 95% CI: 0.08-0.71). In contrast, we failed to detect any association with birth order, maternal age, smoking, nausea, weight gain, prematurity, birth weight and breast-feeding. Conclusions: Our results generally do not support the view that in utero exposure may play a major role in the pathogenesis of endometriosis. The association with handedness, however, is intriguing in this regard and deserves further investigation.

Am J Reprod Immunol. 2011 May 27. doi: 10.1111/j.1600-0897.2011.01009.x. [Epub ahead of print]

Transforming Growth Factor-β1 Gene Polymorphisms in Korean Women With Endometriosis.

Lee HJ, Kim H, Ku SY, Kim SH, Kim JG.

Source

Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea Department of Obstetrics and Gynecology, Incheon Medical Center, Incheon, Korea Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

Abstract

Citation Lee HJ, Kim H, Ku S-Y, Kim SH, Kim JG. Transforming growth factor-β1 gene polymorphisms in Korean women with endometriosis. Am J Reprod Immunol 2011  To investigate the association between Problem endometriosis107) = 131) and without (n =  The -509C/T, 868T/C, 913G/C and 979G/A polymorphisms of the TGFB1 gene were analyzed in women with (n , transforming growth factor-β1 (TGFB1) gene polymorphisms, and serum TGF-β1 levels in Korean women. Method of study endometriosis  The 913G/C and 979G/A polymorphisms were not observed in the study participants. The genotype and allele distribution of the -509C/T and 868T/C polymorphisms in using restriction fragment length polymorphism (RFLP) analysis. Serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results endometriosis were similar to those in controls. However, the -509T/868C (TC) haplotype allele was observed 4.55 times more frequently in early-stage endometriosis than in other haplotype alleles. Serum TGF-β1 levels were significantly higher in endometriosis  The TC haplotype allele of TGFB1-509C/T and 868T/C polymorphisms may be associated with early-stage than in controls. The single and haplotype genotype of -509C/T and 868T/C polymorphisms were not related with serum TGF-β1 levels. Conclusion endometriosis in Korean women.

Front Biosci (Schol Ed). 2011 Jun 1;3:1196-204.

Role of chemokines in the pathogenesis of endometriosis.

Nishida M, Nasu K, Narahara H.

Source

Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita, Japan. nishida@med.oitau.ac.jp

Abstract

Chemokines, proteins that operate within the body’s immune system, play numerous roles in menstruation, bacterial infection, implantation of embryos, and the maintenance of early pregnancy. They are also strongly related to the pathogenesis of endometriosis. Several chemokines including interleukin (IL)-8, growth-related oncogene (GRO) alpha, regulated on activation, normal T expressed and secreted (RANTES), and macrophage inflammatory protein (MIP)-1 are reported to be elevated in the peritoneal fluid (PF) of women with endometriosis. Chemokines IL-8 and GRO alpha as well as epithelial cell-derived neutrophil-activating protein (ENA)-78, eotaxin, and interferon-inducible protein (IP)-10 might be involved in macrophage activation, inflammatory reaction, and adhesion of endometriotic tissues in the peritoneal cavity, and enhanced angiogenesis in the progression of endometriosis. The chemokines closely related with the pathogenesis of endometriosis form a complex network locally and systemically in women with the disease. Understanding this network is a key to improving our understanding of endometriosis as well as developing new, more effective therapies.

Front Biosci (Elite Ed). 2011 Jun 1;3:1139-53.

DNA microarray analysis in endometriosis for development of more effective targeted therapies.

Matsuzaki S.

Source

Centre Hospitalier Universitaire de Clermont-Ferrand, Chirurgie Gynecologique, Clermont-Ferrand, France. sachikoma@aol.com

Abstract

Microarray technology has become a widely used tool for analyzing the expression of tens of thousands of genes simultaneously on high-density microarrays in a single experiment, together with the availability of the complete nucleotide sequence of the human genome. DNA microarray technologies are powerful tools in the laboratory setting for scientific research, hypothesis generation, and the production of leads for subsequent validation through more sophisticated technologies. Since 2002, and particularly in the past few years, the utility of various DNA microarray technologies in endometriosis has rapidly and tremendously evolved; DNA microarray studies provide extremely important information that enable a better understanding of pathophysiology and disease etiology. This is a review of the literature focused on new findings of endometriosis pathophysiology obtained using various microarray technologies: gene expression profiling, microarray-based comparative genomic hybridization (CGH) (array CGH) single nucleotide polymorphism (SNP) arrays, the combination of chromatin immunoprecipitation (ChIP) with hybridization of microarrays (ChIP-on-chip). The present review discusses the results of a decade of DNA microarray technology experience, with emphasis on the pathophysiology of endometriosis in the context of clinical studies.

Eur J Obstet Gynecol Reprod Biol. 2011 May 27. [Epub ahead of print]

The impact of deep disease on surgical treatment of endometriosis.

Setälä M, Kössi J, Silventoinen S, Mäkinen J.

Source

Department of Obstetrics and Gynecology, Päijät-Häme Central Hospital, Lahti, Finland.

Abstract

OBJECTIVE:

To compare the difficulty of surgery in patients with and without deeply infiltrating endometriosis.

STUDY DESIGN:

Prospective cohort study performed in one hospital specialized in the surgical treatment of endometriosis. 193 consecutive patients undergoing excision of all visible endometriosis by laparoscopy (176 patients, 91.2%) or by laparotomy (17 patients, 8.2%). The duration of surgery, the number of operations, the number of day-surgery operations, the need to operate with a surgeon, the ability to perform complete excision during one operation, and the ability to perform operation by laparoscopy were compared in patients with and without deep lesions.

RESULTS:

The mean duration of surgery was 192 (SD 96), and 76 (SD 41)min in patients with and without deep lesions (p<0.001). Ureterolysis (66% vs. 20%, p<0.001), division of adhesions (92% vs. 69%, p<0.001), and hysterectomy (32% vs., 8%, p<0.001), were more often performed on patients with deep lesions. 41 patients (42%) with deep lesions, and 1 patient (1%) without deep lesions were operated with a surgeon (p<0.001). Day-surgery was less often performed on patients with deep lesions (11% vs. 45%, p<0.001). Complete excision during one operation was performed on 95% and on 97% of the patients with and without deep lesions (p=1.0). Complete excision was less often performed by laparoscopy in patients with deep lesions (79% vs. 95%, p<0.001).

CONCLUSIONS:

Surgical treatment of deep lesions is more demanding and time-consuming than surgical treatment of other types of endometriosis, and collaboration with a surgeon is often necessary. Complete excision during one operation is a realistic goal for endometriosis surgery, but it is significantly less often achievable by laparoscopy in patients with deep lesions than in patients without deep lesions.

Fertil Steril. 2011 Jul;96(1):107-12. Epub 2011 May 31.

Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity.

Fourquet J, Báez L, Figueroa M, Iriarte RI, Flores I.

Source

Microbiology Department, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico.

Abstract

OBJECTIVE:

To quantify the impact of endometriosis-related symptoms on physical and mental health status, health-related quality of life, and work-related aspects (absenteeism, presenteeism, work productivity, and activity impairment).

DESIGN:

Cross-sectional quantitative study.

SETTING:

Academic and research institution.

PATIENT(S):

Women (n = 193) with self-reported surgically diagnosed endometriosis from the Endometriosis Patient Registry at Ponce School of Medicine and Health Sciences (PSMHS).

INTERVENTION(S):

Anonymous questionnaire divided into three sections consisting of questions from the Patient Health Survey (SF-12), the Endometriosis Health Profile (EHP-5), and the Work Productivity and Activity Impairment Survey (WPAI).

MAIN OUTCOME MEASURE(S):

Quantification of impact of endometriosis symptoms on physical and mental health status, health-related quality of life, absenteeism, presenteeism, work productivity, and activity impairment.

RESULT(S):

Patients had SF-12 scores denoting statistically significant disability in the physical and mental health components. They also reported an average of 7.41 hours (approximately one working day) of work time lost during the week when the symptoms are worse. In addition, the WPAI scores showed a high impact on work-related domains: 13% of average loss in work time (absenteeism), 65% of work impaired (presenteeism), 64% of loss in efficiency levels (work productivity loss), and 60% of daily activities perturbed (activity impairment).

CONCLUSION(S):

Endometriosis symptoms such as chronic, incapacitating pelvic pain and infertility negatively and substantially impact the physical and mental health status, health-related quality of life, and productivity at work of women.

Fertil Steril. 2011 Jul;96(1):40-6. Epub 2011 May 31.

Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success.

Garrido N, Bellver J, Remohí J, Simón C, Pellicer A.

Source

Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.

Abstract

OBJECTIVE:

To report the use of cumulative live-birth rates (CLBRs) per ovarian stimulation cycle to measure the success of IVF is proving to be the most accurate method for advising couples who failed to conceive, although the accuracy yielded is relatively low, and cycle outcome is highly dependent on the number of embryos replaced. Our aim with this work is to report the CLBRs of IVF as a function of the number of embryos required to reach a live birth (EmbR), considering age, day of ET, and infertility etiology.

DESIGN:

Survival curves and Kaplan-Meier methods to analyze CLBR in a retrospective cohort with respect to the number of EmbR.

SETTING:

University-affiliated infertility center.

PATIENT(S):

Infertile couples undergoing IVF using own oocytes.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

CLBR per embryo transferred.

RESULT(S):

CLBRs increase rapidly between 1 and 5 EmbR, moderately between 5 and 15, and slowly thereafter. Live-birth rates rise more slowly when embryos are transferred on days 2-3 rather than on days 5-6, with comparable long-term results. Women’s age is a negative factor from 35 to 37 years old, with a dramatic decrease in live-birth rates beyond age 40 years. In addition, there are significant worse results in endometriosis patients.

CONCLUSION(S):

The relationship between CLBR and number of EmbR provides realistic and precise information regarding IVF success and can be used to guide couples and practitioners.

J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):419-27. Epub 2011 May 26.

Role of eutopic endometrium in pelvic endometriosis.

Carvalho L, Podgaec S, Bellodi-Privato M, Falcone T, Abrão MS.

Source

Center for Reproductive Medicine, Obstetrics and Gynecology, and the Women’s Health Institute, Cleveland Clinic, Cleveland, Ohio.

Abstract

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is considered a benign gynecologic condition; however, in some cases, it may be aggressive. The pathogenesis of endometriosis is complex and multifactorial. Despite being one of the most widely studied gynecologic diseases, its pathogenesis remains uncertain. The intrinsic endometrial abnormalities thought to be associated with endometriosis include abnormal expression of genes, modification of endometrial response to hormones such as progesterone; increased nerve density, and oxidative stress. Evaluation of the endometrium in patients with endometriosis is an important line of investigation in the pathophysiology of the disease. It has been suggested that investigation of eutopic endometrium may help to achieve this goal. Presented herein is a literature review and a comprehensive evaluation of the role of eutopic endometrium in pelvic endometriosis. Clinical correlations of the disease are highlighted, with the objective of understanding the role of eutopic endometrium in endometriosis.

Eur J Obstet Gynecol Reprod Biol. 2011 May 25. [Epub ahead of print]

Laparoendoscopic single-site surgery (LESS) for adnexal tumors: one surgeon’s initial experience over a one-year period.

Kim WC, Lee JE, Kwon YS, Koo YJ, Lee IH, Lim KT.

Source

Department of Obstetrics and Gynecology, Cheil General Hospital and Women’s Healthcare Center, Kwandong University College of Medicine, Seoul, Republic of Korea.

Abstract

OBJECTIVE:

In this article, we present our initial experience with laparoendoscopic single-site surgery (LESS) for adnexal tumors and report on the safety and feasibility of this technique.

STUDY DESIGN:

We retrospectively reviewed the medical records of the first 94 consecutive patients who underwent LESS for adnexal tumors at Cheil General Hospital and Women’s Healthcare Center, Seoul, Korea between March 2009 and July 2010. Our retrospective chart review was approved by our local Institutional Review Board (IRB). We used a homemade wound retractor and surgical glove as the single-port device. All LESS procedures were performed by a single surgeon.

RESULTS:

Of 94 patients, 90 (95.7%) successfully underwent LESS for the treatment of an adnexal tumor. The mean age of the patients was 38.51±11.65 years, and the mean body mass index was 21.22±2.79kg/m(2). The mean operative time was 50.33±13.26min, and the mean diameter of the adnexal tumors was 6.26±3.19cm. The procedures included enucleation of an ovarian cyst (n=56), salpingo-oophorectomy (n=32), and salpingectomy (n=4). Two cases with suspicion for malignancy underwent conversion to laparotomy (2.1%), and frozen sections revealed serous ovarian adenocarcinoma (n=1) and chronic inflammation (n=1). Except for those two cases, the pathologic diagnoses were confirmed as mature cystic teratoma (n=30), endometriosis (n=24), mucinous cystadenoma (n=14), serous cystadenoma (n=14), borderline ovarian tumor (n=4), hydrosalpinx (n=4), serous adenocarcinoma of the salpinx (n=1), and ectopic pregnancy (n=1). Two cases required an additional trocar for adhesiolysis of severe pelvic adhesion. No major intraoperative or postoperative complications occurred.

CONCLUSIONS:

Our results suggest that LESS is a safe and feasible alternative to conventional laparoscopic surgery for the treatment of adnexal tumors.

Fertil Steril. 2011 Jun 30;95(8):2759-60. Epub 2011 May 26.

A “conditionally essential” nutrient, L-carnitine, as a primary suspect in endometriosis.

Vassiliadis S, Athanassakis I.

Source

Department of Biology, University of Crete, Heraklion, Greece; Obstetrics/Gynecology Clinic, University of Crete Hospital, Heraklion, Greece.

Abstract

L-Carnitine, when administered to young female mice, has been shown to induce a pathologic condition resembling human endometriosis accompanied by a marked degree of infertility. Thus, the use of this nutrient by young women may be a potential risk factor responsible for the onset of endometriosis at a later stage of their lives.

Am J Obstet Gynecol. 2011 Apr 14. [Epub ahead of print]

Could chronic pelvic pain be a functional somatic syndrome?

Warren JW, Morozov V, Howard FM.

Source

Department of Medicine and of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.

Abstract

The cause of noncyclical chronic pelvic pain (CPP) in many women is unknown: 30% have no identifiable pelvic pathology, and in those who do the relationship of CPP and the pathology is often unclear. Moreover, epidemiologic studies demonstrate that the common findings of endometriosis and adhesions do not greatly increase the odds of having CPP. CPP and the functional somatic syndromes (fibromyalgia, irritable bowel syndrome, and others) share many characteristics including pain as a prominent symptom and comorbidity. For the functional somatic syndromes, the initial focus of etiologic investigations has been on local mechanisms and then on systemic pathogeneses. We believe that the research trajectories of the functional somatic syndromes and CPP are converging. Their juncture might reveal an important pathologic mechanism for CPP in some women that is primarily outside the pelvis. This observation would open up new areas of exploration and treatment of CPP.

G Chir. 2011 May;32(5):263-5.

Isolated inguinal endometriosis. Case report with ultrasonographic preoperative diagnosis.

Calò PG, Esu F, Tatti A, Pilloni L, Madas F, Pisano G, Nicolosi A.

Abstract

Inguinal endometriosis is rare and accounts for 0.3-0.6% of patients affected by endometriosis. A correct preoperative diagnosis is rare. Diagnosis is frequently made by histologic examination. A 36-year-old nulliparous woman presented with a painful mass in her right groin of 2 years duration. The pain fluctuated according to the menstrual period. Physical examination revealed an elastic hard mobile mass measuring 2×2 cm in the right inguinal region. Ultrasound examination confirmed a hypoechoic tumor in the right inguinal region with poorly defined boundaries and perilesional and intralesional vascular flow suspect for endometriosis. Wide excision of the lump with a part of the round ligament was carried out. Histology showed endometrial glands and stroma within the fibrous tissue. The patient had an uneventful recovery and was discharged the next day. After surgery, the pain disappeared completely. No signs of recurrence occurred at approximately 16 months after the surgery. Although rare, extrapelvic endometriosis should be considered in the differential diagnosis in women of reproductive age presenting with an inguinal mass, especially if the groin mass is associated in size and tenderness with menstrual variability. US appearance is very useful in diagnosis so ultrasonography can be considered the examination of choice.

Reprod Sci. 2011 Aug;18(8):747-54. Epub 2011 May 26.

Endometrial stromal cells and immune cell populations within lymph nodes in a nonhuman primate model of endometriosis.

Hey-Cunningham AJ, Fazleabas AT, Braundmeier AG, Markham R, Fraser IS, Berbic M.

Source

1Department of Obstetrics, Gynaecology and Neonatology, Queen Elizabeth II Research Institute for Mothers and Infants, The University of Sydney, NSW, Australia.

Abstract

Mounting evidence suggests that immunological responses may be altered in endometriosis. The baboon (Papio anubis) is generally considered the best model of endometriosis pathogenesis. The objective of the current study was to investigate for the first time immunological changes within uterine and peritoneal draining lymph nodes in a nonhuman primate baboon model of endometriosis. Paraffin-embedded femoral lymph nodes were obtained from 22 normally cycling female baboons (induced endometriosis n = 11; control n = 11). Immunohistochemical staining was performed with antibodies for endometrial stromal cells, T cells, immature and mature dendritic cells, and B cells. Lymph nodes were evaluated using an automated cellular imaging system. Endometrial stromal cells were significantly increased in lymph nodes from animals with induced endometriosis, compared to control animals (P = .033). In animals with induced endometriosis, some lymph node immune cell populations including T cells, dendritic cells and B cells were increased, suggesting an efficient early response or peritoneal drainage.

Fertil Steril. 2011 Jun 30;95(8):2687-9. Epub 2011 May 25.

Vascular endothelial growth factor expression up-regulated by endometrial ischemia in secretory phase plays an important role in endometriosis.

Ren QZ, Qian ZH, Jia SH, Xu ZZ.

Source

Department of Obstetrics and Gynecology, Second Hospital Affiliated with Soochow University, Suzhou City, Jiangsu, People’s Republic of China.

Abstract

Primary human endometrial cells were exposed to hypoxia preconditioning (HPC), HPC-hypoxia, and hypoxia conditions, and then endometrial tissue treated with ischemia preconditioning (IPC) was transplanted onto the chick embryo chorioallantoic membrane to investigate the role of slight ischemia of endometrium in the pathologic process of endometriosis. IPC up-regulated vascular endothelial growth factor expression and decreased apoptosis of endometrial cells, thus facilitating the endometrial fragments’ ectopic implantation.

Free Radic Res. 2011 Aug;45(8):906-17. Epub 2011 May 26.

Iron as a target of chemoprevention for longevity in humans.

Toyokuni S.

Source

Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine , Nagoya 466-8550 , Japan.

Abstract

Abstract Iron is universally abundant and no life can exist without it. However, iron levels should be maintained within a narrow range. Iron deficiency causes anaemia, whereas excessive iron increases cancer risk, presumably by free radical generation. Several pathological conditions such as genetic haemochromatosis, chronic viral hepatitis B and C, conditions related to asbestos fibre exposure and ovarian endometriosis have been recognized as iron overload-associated conditions that also increase human cancer risks. Iron’s carcinogenicity has been documented in animal experiments. Surprisingly, these studies have revealed that the homozygous deletion of CDKN2A/2B is a major hallmark of iron-induced carcinogenesis. Recently, the hormonal regulation of iron metabolism has been elucidated. A commonly hypothesized mechanism may be the lack of any iron disposal pathway other than for bleeding and a mechanism of iron re-uptake as catechol chelate has been discovered. Iron overload in neurons via the ferroportin block may play a role in Alzheimer’s disease. Furthermore, a recent epidemiological study reported that iron reduction by phlebotomy was associated with decreased cancer risks in a general population. Given that the required amounts of iron decrease during ageing, the fine control of body iron stores would be a wise strategy for chemoprevention of several diseases.

 

 

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