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Int Urogynecol J Pelvic Floor Dysfunct. 2004 Dec;15(6):407-412. Epub 2004 Jul 31.
Surgical treatment of ureteral obstruction from endometriosis: our experience with thirteen cases.
Antonelli A, Simeone C, Frego E, Minini G, Bianchi U, Cunico SC.
Clinica Urologica, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy, alxanto@hotmail.com.
Endometriosis is a biologically benign albeit aggressive pathology marked by high local recurrences. Ureteral involvement accounts for only a minority of cases (0.1-0.4%) with often non-specific symptoms at clinical presentation and difficult preoperative diagnosis. Thirteen cases of severe ureteral endometriosis (i.e. causing significant obstruction to the urinary flow) were observed and surgically treated, out of 17 ureteral units affected (three cases of bilateral involvement, one case of complete pyeloureteral duplicity). The initial symptomatology was acute and related to ureteral obstruction in eight cases, silent and non-specific in the other five; a presumptive diagnosis was made only for the seven patients (53.9%) with a positive medical history for pelvic (and in two cases also ureteral) endometriosis. Preoperative drainage of urine proved necessary for eight patients due to the complete functional exclusion of the excretory axis. One patient (7.7%) underwent nephrectomy due to renal atrophy. Segmental ureteral resection and termino-terminal anastomosis were performed in two patients, while seven patients underwent segmental ureterectomy and ureterocystoneostomy, with bladder psoas hitching in four cases and vesical flap according to Casati-Boari in one case. All three cases of bilateral involvement were treated by bilateral segmental ureterectomy and trans-uretero-uretero-cystoneostomy with bladder psoas hitching. Following histological examination, all patients were diagnosed with active ureteral endometriosis, which was found to be intrinsic in five cases (38.5%) and extrinsic in the other eight. One of the two patients that had undergone ureterectomy and termino-terminal anastomosis had to undergo ureteral resection and ureterocystoneostomy 22 months later due to relapsing endometriosis-induced stenosis. Conversely, no ureteral endometriosis relapses occurred in the remaining 12 patients within the mean follow-up time of 41.1 months (range 6-91). Ureteral endometriosis is marked by non-specific symptoms, making preoperative diagnosis often difficult. Therefore, an ultrasound or urographic examination of the urinary tract in case of pelvic endometriosis is absolutely essential. In our experience, terminal ureterectomy with ureterocystoneostomy has provided long-term favourable results as extended ureteral resection can be performed and continuity of the urinary tract can be restored without resorting to the distal pelvic ureter, which is often affected by the disease besides being more subject to relapses.
PMID: 15549259 [PubMed – as supplied by publisher]

Int J Gynaecol Obstet. 2004 Dec;87(3):252-253.
Extra-pelvic endometriosis presenting as a vulvar mass in a teenage girl.
Su HY, Chen WH, Chen CH.
Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
PMID: 15548401 [PubMed – as supplied by publisher]

Am J Obstet Gynecol. 2004 Nov;191(5):1725-1727.
Endometriosis of the liver containing mullerian adenosarcoma: Case report.
Jelovsek JE, Winans C, Brainard J, Falcone T.
We present a case of a liver endometrioma in a postmenopausal woman. After failed management with leuprolide acetate, the mass was resected and contained focal areas of mullerian adenosarcoma. This is a rare case of mullerian adenosarcoma that appeared to arise within an endometrioma of the liver.
PMID: 15547552 [PubMed – as supplied by publisher]

Am J Obstet Gynecol. 2004 Nov;191(5):1539-1542.
Is rectovaginal endometriosis a progressive disease?
Fedele L, Bianchi S, Zanconato G, Raffaelli R, Berlanda N.
Objective The purpose of this study was to observe the natural history of untreated asymptomatic rectovaginal endometriosis. Study design This was a prospective, observational study. Eighty-eight patients with untreated asymptomatic rectovaginal endometriosis were followed for 1 to 9 years. Pain symptoms and clinical and transrectal ultrasonographic findings were evaluated before and every 6 months after diagnosis. Results Two patients had specific symptoms that were attributable to rectovaginal endometriosis that was associated with an increase in lesion size and underwent surgery. In 4 other patients, the size of the endometriotic lesions increased, but the patients remained symptom free. The estimated cumulative proportion of patients with progression of disease and/or appearance of pain symptoms that were attributable to rectovaginal endometriosis after 6 years of follow up was 9.7%. For the remaining patients, the follow-up period was uneventful, with no detectable clinical nor echographic changes of the lesions and with no appearance of new symptoms. Conclusion Progression of the disease and appearance of specific symptoms rarely occurred in patients with asymptomatic rectovaginal endometriosis.
PMID: 15547522 [PubMed – as supplied by publisher]

J Midwifery Womens Health. 2004 Nov-Dec;49(6):547-8.
New route of danazol for endometriosis needs more study Cobellis L, Razzi S, Fava A, Severi FM, Igarashi M, Petraglia F. A danazol-loaded intrauterine device decreases dysmenorrheal, pelvic pain, and dyspareunia associated with endometriosis. Fertil Steril 2004;82:239-40.
Johnston JT Jr, Erickson-Owens D.
PMID: 15544987 [PubMed – in process]

J Midwifery Womens Health. 2004 Nov-Dec;49(6):546.
Women’s lived experience with endometriosis assists clinician sensitivity and awareness Denny E. Women’s experience of endometriosis. J Adv Nurs 2004;46:641-8.
Curtis AP, Erickson-Owens D.
PMID: 15544986 [PubMed – in process]

Curr Med Chem. 2004 Nov;11(22):3017-28.
Non-peptidic GnRH receptor antagonists.
Armer RE, Smelt KH.
Ardana Bioscience, 58 Queen Street, Edinburgh, EH2 3NS, Scotland, UK. richard@ardana.co.uk
Gonadotropin-releasing hormone (GnRH) or luteinizing hormone-releasing hormone (LHRH) is a decapeptide (pGlu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-NH2) hypothalamic hormone that acts upon 7-trans membrane spanning GnRH receptors in the pituitary. This action leads to the secretion of the gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) that in turn act on the reproductive organs regulating gonadal steroid production, spermatogenesis and follicular development. Peptidic agonists of the GnRH receptor have been known for many years and are currently employed therapeutically in the treatment of prostate and breast tumours, uterine fibroids, precocious puberty, endometriosis, premenstrual syndrome, contraception and infertility. Peptidic antagonists to date have only been employed commercially in the treatment of infertility during assisted reproductive therapy; however, many peptidic antagonists are currently in late stage development for many of the aforementioned indications. Whilst peptidic agonists and antagonists of the GnRH receptor have been discovered and exploited clinically, they are limited to predominantly parenteral administration due to their poor oral bioavailability. Recently, several small molecule GnRH antagonist series have been discovered offering the prospect of orally active therapeutics based on GnRH receptor antagonism. This article will review the current medicinal chemistry literature and structure activity relationships known for non-peptidic GnRH receptor antagonists.
PMID: 15544487 [PubMed – in process]

Eur J Obstet Gynecol Reprod Biol. 2004 Dec 1;117(2):236-9.
Endometriosis with FDG uptake on PET.
Jeffry L, Kerrou K, Camatte S, Metzger U, Lelievre L, Talbot JN, Lecuru F.
Service de Chirurgie Gynecologique et Cancerologique, Hopital Europeen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
Background: The value of [ [Formula: see text] ]fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in endometriosis has not yet been extensively reported. Case report: A 32-year-old woman was examined to find an explanation for right pelvic pain associated with right subcostal pain. A computerised tomography (CT) scan was compatible with a haemangioma or a focus of endometriosis in the liver. Transvaginal sonography and magnetic resonance imaging (MRI) showed a complex ovarian cyst on the left. Blood CA125 levels were elevated. FDG-PET revealed a focus of uptake in the right paravesical area. Laparoscopy showed a left endometrioma associated with diffuse inflammatory pelvic adhesions. After surgery and 3 months GnRH agonist treatment the pain had disappeared and neither MRI nor FDG-PET showed any pelvic abnormality. The patient subsequently presented with dyspareunia and rectal pain resulting from a right uterosacral nodule and a rectal nodule. These were resected laparoscopically. After a 1-year follow-up, the patient is doing well. Conclusion: Endometriosis can give rise to false-positive results on FDG-PET. However, the FDG uptake in this particular case of endometriosis seems to have been due to inflammation rather than to a cyst. This report highlights the relationship between some of the biological features of endometriosis and some observed in neoplastic lesions.
PMID: 15541863 [PubMed – in process]

Lancet. 2004 Nov 13;364(9447):1800.
Coping with endometriosis.
Wang CY.
PMID: 15541454 [PubMed – in process]

Lancet. 2004 Nov 13;364(9447):1789-99.
Giudice LC, Kao LC.
Division of Reproductive Endocrinology and Infertility, Center for Research on Women’s Health and Reproduction, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305-5317, USA. giudice@stanford.edu
Endometriosis is an oestrogen-dependent disorder that can result in substantial morbidity, including pelvic pain, multiple operations, and infertility. New findings on the genetics, the possible roles of the environment and the immune system, and intrinsic abnormalities in the endometrium of affected women and secreted products of endometriotic lesions have given insight into the pathogenesis of this disorder and serve as the background for new treatments for disease-associated pain and infertility. Affected women are at higher risk than the general female population of developing ovarian cancer, and they also may be at increased risk of breast and other cancers as well as autoimmune and atopic disorders. Clinicians should assess and follow up affected women for these and other associated disorders. There will probably be a new repertoire of approaches for treatment and perhaps cure of this enigmatic disorder in the near future.
PMID: 15541453 [PubMed – in process]

J Genet. 2004 Aug;83(2):189-92.
Cytochrome P450c17alpha 5′-untranslated region *T/C polymorphism in endometriosis.
Hsieh YY, Chang CC, Tsai FJ, Lin CC, Tsai CH.
Department of Obstetrics and Gynecology, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, Taiwan.
Estrogen plays a role in the pathogenesis of endometriosis. The CYP17 gene codes for the cytochrome P450c17alpha enzyme that is involved in the estrogen biosynthesis. We aimed to investigate if CYP17 polymorphism could be used as marker to predict the susceptibility of endometriosis. Women were divided into two groups: (1) severe endometriosis (n=119); (2) non-endometriosis groups (n=128). A 169-bp fragment encompassing the T/C polymorphic site in 5′-untranslated promoter region (5′-UTR) of the CYP17 was amplified by the polymerase chain reaction, treated with restriction enzyme MspA1I, and electrophoresis. The polymorphism was divided into restriction-enzyme indigestible (T homozygote), T/C heterozygote, and digestible (C homozygote). Genotypes and allelic frequencies for this polymorphism in both groups were compared. We observed a higher but non-significant percentage of T homozygote in the endometriosis women compared with the non-endometriosis women. Proportions of T homozygote / heterozygote / C homozygote for CYP17 in both groups were: (1) 26.1/46.2/27.7% and (2) 17.2/45.3/37.5% (p-value=0.131). T allele was related with higher susceptibility of endometriosis. T and C allele frequencies in both groups were: (1) 49.2/50.8%; (2) 39.8/60.2% (p-value=0.046). Despite the CYP17* T allele appearing to be associated with a trend of increased risk of endometriosis, CYP17 5′-UTR gene polymorphism might not be a useful marker for prediction of endometriosis susceptibility.
PMID: 15536258 [PubMed – in process]

Curr Opin Obstet Gynecol. 2004 Dec;16(6):487-90.
Levonorgestrel-releasing intrauterine system in the treatment of heavy menstrual bleeding.
Hurskainen R, Paavonen J.
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.
PURPOSE OF REVIEW: Menorrhagia is a frequent reason for women to seek medical care and an increasingly common health problem. The levonorgestrel-releasing intrauterine system is an effective medical treatment for menorrhagia. Emerging clinical and research evidence suggests that this new treatment modality has major health benefits. RECENT FINDINGS: The levonorgestrel-releasing intrauterine system is a cost-effective treatment modality for menorrhagia. The quality of life improves significantly which is comparable to that gained with hysterectomy. The costs are about half those of hysterectomy after 5 years of follow-up. Unscheduled breakthrough bleeding is the most common side effect of the treatment. There are different new theories about the mechanism underlying this problem. Women with endometriosis or fibroids also benefit from this treatment. SUMMARY: Because menorrhagia is often a reason for seeking medical attention, it is important to consider the outcomes and costs to provide the most appropriate care. The levonorgestrel-releasing intrauterine system improves health-related quality of life significantly at relatively low cost. It is the most effective medical treatment for menorrhagia and comparable to surgical interventions. The system is not associated with serious complications. Although not all women are successfully treated, about 60% avoid hysterectomy and are satisfied with the treatment. Thus, the levonorgestrel-releasing intrauterine system should be the first line of treatment for heavy menstrual bleeding.
PMID: 15534445 [PubMed – in process]

Fertil Steril. 2004 Nov;82(5):1407-11.
Transient abdominal ovariopexy for adhesion prevention in patients who underwent surgery for severe pelvic endometriosis.
Ouahba J, Madelenat P, Poncelet C.
Service de Gynecologie Obstetrique, Hopital Bichat-Claude Bernard.
OBJECTIVE: To assess adhesion reformation and subsequent fertility after a transient ovariopexy performed during severe pelvic endometriosis surgery. DESIGN: Retrospective study. SETTING: University hospital. PATIENT(S): Twenty young women who underwent severe pelvic endometriosis surgery. INTERVENTION(S): Unilateral or bilateral transient ovariopexy to the anterior abdominal wall was performed as the last step in the surgical procedure. Median duration of ovariopexy was 4 days. MAIN OUTCOME MEASURE(S): Adhesion reformation and subsequent fertility. RESULT(S): This well-tolerated procedure induced neither specific complication nor prolonged hospital stay. A second-look laparoscopy, performed in eight patients (40%), has shown a reduction of the occurrence, the extent, and the severity of ovarian adhesions. Two thirds of the suspended ovaries had no or smooth adhesions at second-look laparoscopy, even though all ovaries were initially adherent. Fifteen infertile women without male infertility factors tried actively to conceive after surgery. In this group of patients, four conceived spontaneously, and four conceived after IVF (total pregnancy rate = 53.3%). Seven patients delivered, and one pregnancy is ongoing. Median pregnancy delay was 11.5 months (range, 4-24 months). CONCLUSION(S): Transient ovariopexy appears to be a simple, safe, and effective technique in preventing postoperative adhesion reformation in severe pelvic endometriosis.
PMID: 15533368 [PubMed – in process]

Fertil Steril. 2004 Nov;82(5):1309-15.
Cyclooxygenase-2 expression in deep endometriosis and matched eutopic endometrium.
Matsuzaki S, Canis M, Pouly JL, Wattiez A, Okamura K, Mage G.
Department of Gynecology, Hotel-Dieu, Polyclinique, CHU, Clermont-Ferrand, Clermont-Ferrand, France; Department of Obstetrics & Gynecology, Tohoku University Graduated School of Medicine, Sendai, 980-8574, Japan.
OBJECTIVE: To identify any relationship between cyclooxygenase-2 expression and the intensity of severe, endometriosis-related dysmenorrhea. DESIGN: Prospective study. SETTING: University hospital. PATIENT(S): Patients with deep endometriosis. INTERVENTION(S): During surgery, paired samples of tissue representing deep endometriosis and eutopic endometrium were obtained from 46 patients. Control endometrial tissue samples were obtained from 34 fertile women who underwent laparoscopic tubal ligation or reversal of tubal sterilization. Pain assessment for dysmenorrhea was done with a 10-point linear analogue scale. MAIN OUTCOME MEASURE(S): The percentage of surface immunostained for Cox-2 was determined by an immunohistochemical technique. Relationships between pain score for dysmenorrhea and Cox-2 expression were analyzed. RESULT(S): Cox-2 expression was significantly higher in eutopic endometrial stromal cells from patients with deep endometriosis than in stroma from controls during the early, mid, and late secretory phases. In endometriosis patients, Cox-2 expression in eutopic endometrial stromal cells was significantly higher in women with more severe dysmenorrhea (pain score >/=7 vs. <7) during early and mid secretory phases. CONCLUSION(S): Elevated Cox-2 expression in stromal cells in eutopic endometrium from patients with deep endometriosis may play a role in severe, endometriosis-related dysmenorrhea.
PMID: 15533352 [PubMed – in process]

Fertil Steril. 2004 Nov;82(5):1303-8.
Add-back therapy in the treatment of endometriosis-associated pain.
Zupi E, Marconi D, Sbracia M, Zullo F, De Vivo B, Exacustos C, Sorrenti G.
Department of Obstetrics and Gynecology, "Tor Vergata" University, Rome, Italy.
OBJECTIVE: To determine the efficacy of GnRH analogue plus add-back therapy compared with GnRH analogue alone and estroprogestin in patients with relapse of endometriosis-associated pain. DESIGN: Randomized, controlled study. SETTING: University hospital. PATIENT(S): One hundred thirty-three women with relapse of endometriosis-related pain after previous endometriosis surgery. INTERVENTION(S): Forty-six women were treated with GnRH analogue plus add-back therapy, 44 women were given GnRH analogue alone, and 43 women received estroprogestin, for 12 months. MAIN OUTCOME MEASURE(S): Pain evaluation by a visual analogue scale, quality of life in treated patients according to the SF-36 questionnaire, and occurrence of adverse effects, including bone mass density loss, at pretreatment, after 6 months of treatment, at the end of treatment (12 months), and 6 months after discontinuation of treatment. RESULT(S): Patients treated either with GnRH analogue alone or GnRH analogue plus add-back therapy showed a higher reduction of pelvic pain, dysmenorrhea, and dyspareunia than patients treated with oral contraceptive, whereas patients treated with add-back therapy showed a better quality of life, as assessed with the SF-36 questionnaire, and adverse effects rate than the other two groups. CONCLUSION(S): Add-back therapy allows the treatment of women with relapse of endometriosis-associated pain for a longer period, with reduced bone mineral density loss, good control of pain symptoms, and better patient quality of life compared with GnRH analogue alone or oral contraceptive.
PMID: 15533351 [PubMed – in process]

Minerva Ginecol. 2004 Oct;56(5):419-35.
Pathophysiology, diagnosis and treatment of endometriosis.
Schindler AE.
Institute for Medical Research and Education, Essen, Germany.
Endometriosis is generally a benign condition. However, there is a tendency towards progression and in part deep infiltrating processes occur, which can lead to obstruction and even silent loss of organ function such as kidney failure. Hereditary, genetic and immunological peculiarities have been found. Important are symptoms such as pain and infertility, which burden the life of the women involved. In spite of extensive research in the past the pathogenesis and epidemiology of the disease are not definitely clarified as yet. The estimated prevalence of endometriosis ranges between 10% and even more than 50% depending on the underlying problems of the women studied. Besides the main location of the disease within the pelvis also extra pelvic locations have been found (lung, lymphnotes, scars). The diagnosis should be established by histological verification. The main therapeutic modalities consist of surgery and medical treatment or combinations, which need to be individually adjusted, because of the high risk of recurrence and progression of the disease. The aim should be early detection and treatment as complete as possible, since symptom relief, resolution or prevention of infertility and decrease of recurrences are at their best under these circumstances.
PMID: 15531860 [PubMed – in process]

Mol Hum Reprod. 2004 Nov 5; [Epub ahead of print]
Polymorphisms of the genes encoding the GSTM1, GSTT1 and GSTP1 in Korean women: no association with endometriosis.
Hur SE, Lee JY, Moon HS, Chung HW.
Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, South Korea.
Endometriosis, one of the most common gynaecologic disorders, shows significantly elevated prevalence in industrial areas and there is also a possible genetic predisposition. Glutathione-S-transferases (GSTs) are enzymes involved in the metabolism of many disease-causing carcinogens and mutagens that are present in human environments. An association between the incidence of endometriosis and the GST genotypes of patients has been suggested. The objective of the present study was to investigate whether the polymorphisms of GSTM1, GSTT1 and GSTP1 are related to endometriosis. Blood samples were available from 259 controls and 194 patients with advanced endometriosis diagnosed by both pathology and laparoscopic findings. The proportion of the GSTM1, GSTT1 and GSTP1 genotypes of the control group were comparable to other populations. There was no significant evidence that the distribution of the GSTM1 and GSTT1 genotype differed between the patients and the controls, with an allelic odds ratio (OR)=1.074 [95% confidence interval (CI)=0.737-1.564] and 1.239 (95% CI = 0.853-1.799), respectively. Also, there was no significant difference in the proportion of GSTP1 genotypes between the women with endometriosis and the control group with the OR = 0.823 (95% CI = 0.536-1.264). The higher risk alleles were contended as GSTM1, GSTT1 null mutation and GSTP1 Ile105Ile polymorphism. There was no significant increase in the risk of endometriosis as the number of higher risk alleles of the GST family increased. In conclusion, our findings suggest that the GSTM1, GSTT1 and GSTP1 genetic polymorphisms are not associated with the development of endometriosis in Korean women.
PMID: 15531593 [PubMed – as supplied by publisher]

Mol Hum Reprod. 2004 Nov 5; [Epub ahead of print]
Angiotensin I-converting enzyme ACE 2350*G and ACE-240*T-related genotypes and alleles are associated with higher susceptibility to endometriosis.
Hsieh YY, Chang CC, Tsai FJ, Hsu CM, Lin CC, Tsai CH.
Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
Endometriosis displays features similar to malignancy, ranging from neovascularization to local invasion and aggressive spread to distant organs. The altered vascular-related genes might be related to the development of endometriosis. This study investigates whether angiotensin I-converting enzyme (ACE) *A2350G and A-240T gene polymorphisms could be used as markers of susceptibility in endometriosis. Women were divided into two groups: (1) endometriosis group (n=150) and (2) non-endometriosis group (n=159). Genomic DNA was obtained from peripheral leukocytes. ACE A2350G and A-240T gene polymorphisms were amplified by PCR and detected after restriction enzyme digestion with BstUI and XbaI. Genotypes and allelic frequencies in both groups were compared. We observed that genotype distribution and allele frequency of ACE 2350 and ACE-240 gene polymorphisms in both groups were significantly different. Proportions of ACE 2350*A homozygote/heterozygote/G homozygote in both groups were: (1) 66.7/29.3/4% and (2) 96.2/3.1/0.7%. Proportions of ACE-240*A homozygote/heterozygote/T homozygote in both groups were: (1) 43.3/46/10.7% and (2) 62.9/35.8/1.3%. We concluded that ACE 2350*G and ACE-240*T-related genotypes and alleles are associated with higher susceptibility to endometriosis. ACE A2350G and A-240T gene polymorphisms might be associated with endometriosis development.
PMID: 15531592 [PubMed – as supplied by publisher]

Mod Pathol. 2004 Nov 05; [Epub ahead of print]
A brief history of the pathology of the gonads.
Young RH.
1James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harward Medical School, Boston, MA, USA.
Our understanding of gonadal pathology has reached its current state as a result of the contributions of numerous outstanding investigators. Knowledge of testicular tumor pathology dates back to the great British workers Percival Pott and Sir Astley Cooper but the single greatest early stride was made with the description in 1906 by the French urologist Maurice Chevassu of the seminoma. The seminal 1946 paper of Nathan B Friedman and Robert A Moore, which segregated out as a distinct entity embryonal carcinoma, is, however, the foundation for the current classification of testicular tumors. In that year Pierre Masson described the distinctive neoplasm, the spermatocytic seminoma. The 1950s saw the publication of an important paper by Frank J Dixon and Dr Moore and they also wrote the first series fascicle on testicular tumors. In this same timeframe, and thereafter, Robert E Scully made significant contributions to testicular pathology, writing the first English language paper on spermatocytic seminoma, describing several subtypes of sex cord tumor, and also the distinctive lesion of intersex, the gonadoblastoma, as well as playing a major role in 1980 in formulating the current classification of premalignant lesions of the testis. The current classification of testicular tumors was arrived at in the early 1970s when the World Health Organization, under the leadership of Dr FK Mostofi, who himself made notable contributions to testicular pathology, devised what is fundamentally the current classification of neoplasms of the male gonad. Although comments on ovarian pathology were made by such legendary figures of earlier times as Giovanni Battista Morgagni and Matthew Baillie, it is only in the mid to later years of the 19th century that contributions, mostly in Europe, began to move knowledge of ovarian pathology to its current state. Thomas Hodgkin, Richard Bright, and Sir James Paget all wrote extensively on ovarian neoplasms. In 1870, Heinrich Waldeyer, and later in that century, another German, Hermann Johannes Pfannenstiel wrote important papers on the surface epithelial tumors. The latter was likely the first to refer to neoplasms now known as of ‘borderline malignancy’ and also wrote on pseudomyxoma peritonei and other topics. Their work was followed by that of Robert Meyer who made monumental contributions to gynecological pathology, including recognizing the Brenner tumor as a distinctive neoplasm and proposing the first classification of Sertoli-Leydig cell tumors (arrhenoblastomas). He also coined the term ‘disgerminoma’ (soon changed to dysgerminoma) for the ovarian tumor that had been described in detail by the French investigator Marcel Chenot 5 years after Chevassu had mentioned the tumor in his paper describing the seminoma. During the Meyer era other significant contributions were made by, among others, Howard C Taylor writing on the borderline tumors and John A Sampson writing on endometriosis and tumors, associated with it. In the second-half of the 20th century major contributions were made by Gunnar Teilum of Denmark and Lars Santesson of Sweden. Dr Teilum delineated the morphologic features of the yolk sac tumor and noted the resemblance of papillary formations within it to the endodermal sinuses of the rat placenta. He also wrote extensively on sex cord tumors in both gonads. At a FIGO meeting in 1961 Dr Santesson played a major role in formulating the first organized classification of the surface epithelial-stromal tumors of the ovary and also promoted the endometrioid carcinoma as a special variant of ovarian cancer. In a career spanning over 50 years, Dr Scully was the architect of the modern classification of ovarian tumors being the driving force behind the influential 1973 World Health Organization classification of them. His many original observations have touched upon virtually all categories of ovarian tumor pathology. His second series fascicle ‘Tumors of the Ovaries and Maldeveloped Gonads’ utilized the WHO classification and presented a lucid elaboration of his by then vast experience with ovarian tumors. All the above have left a rich legacy which those who follow in their path will be challenged to equal.Modern Pathology advance online publication, 5 November 2004; doi:10.1038/modpathol.3800305.
PMID: 15529187 [PubMed – as supplied by publisher]

J Endocrinol. 2004 Oct;183(1):19-28.
Steroid signalling in human ovarian surface epithelial cells: the response to interleukin-1alpha determined by microarray analysis.
Rae MT, Niven D, Ross A, Forster T, Lathe R, Critchley HO, Ghazal P, Hillier SG.
University of Edinburgh Centre for Reproductive Biology, The Chancellor’s Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK. mrae1@staffmail.ed.ac.uk
The human ovarian surface epithelium (HOSE) is a common site of gynaecological disease including endometriosis and ovarian cancer, probably due to serial injury-repair events associated with successive ovulations. To comprehend the importance of steroid signalling in the regulation of the HOSE, we used a custom microarray to catalogue the expression of over 250 genes involved in the synthesis and reception of steroid hormones, sterols and retinoids. The array included a subset of non-steroidogenic genes commonly involved in pro-/anti-inflammatory signalling. HOSE cells donated by five patients undergoing surgery for non-malignant gynaecological conditions were cultured for 48 h in the presence and absence of 500 pg/ml interleukin-1alpha (IL-1alpha). Total RNA was reverse-transcribed into biotin-labelled cDNA, which was hybridised to the array and visualised by gold-particle resonance light scattering and charge-coupled device (CCD) camera detection. Results for selected genes were verified by quantitative reverse-transcription PCR. In five out of five cases, untreated HOSE cells expressed genes encoding enzymes required for de novo biosynthesis of cholesterol from acetate and subsequent formation of C21-pregnane and C19-androstane steroids. Consistent with the inability of HOSE cells to synthesise glucocorticoids, oestrogens or 5alpha-reduced androgens de novo, CYP21, CYP19 and 5alpha-reductase were not detected. The only steroidogenic gene significantly up-regulated by IL-1alpha was 11beta-hydroxysteroid dehydrogenase type 1 (11betaHSD1). Other cytokine-induced genes were IL-6, IL-8, nuclear factor kappaB (NFkappaB) inhibitor alpha, metallothionein-IIA and lysyl oxidase: inflammation-associated genes that respond to glucocorticoids. The only steroidogenic gene significantly suppressed by IL-1alpha was 3betaHSD1. Other genes suppressed by IL-1alpha were aldehyde dehydrogenase (ALDH) 1, ALDH 10, gonadotrophin hormone-releasing hormone receptor, peroxisome proliferation-activated receptor-binding protein (PPAR-bp) and nuclear receptor subfamily 2 group F member 2. These results define a steroidogenic phenotype of cultured HOSE cells and provide a limited expression profile for genes with associated signalling functions. IL-1alpha co-ordinately induces 11betaHSD1 and a panel of glucocorticoid-regulated, inflammation-associated genes in HOSE cells, providing further evidence that cortisol generated by 11betaHSD1 could participate in the local resolution of inflammation associated with ovulation.
PMID: 15525570 [PubMed – in process]

Harefuah. 2004 Aug;143(8):580-4, 622.
[Aromatase inhibitors–new applications in gynecology] [Article in Hebrew] Shrim A, Elizur SE, Beiner ME, Wiser A, Seidman DS.
IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
P-450 aromatase inhibitors, designed for suppressing estradiol production, were first approved for the treatment of advanced breast cancer. Recent studies have provided evidence that aromatase inhibitors may be effective in the short term for induction of ovulation and in the long-term for treatment of endometriosis. Based on current data, the role of aromatase inhibitors in the management of various gynecological conditions may soon be widely determined.
PMID: 15523811 [PubMed – in process]

BJOG. 2004 Nov;111(11):1269-72.
Current practice for the laparoscopic diagnosis and treatment of endometriosis: a national questionnaire survey of consultant gynaecologists in UK.
Moses SH, Clark TJ.
Department of Obstetrics and Gynaecology, Worcester Royal Hospital, UK.
OBJECTIVE: To determine current practice regarding laparoscopic diagnosis and treatment of endometriosis. DESIGN: A prospective questionnaire survey. SETTING: The United Kingdom. POPULATION: All 1411 UK consultant gynaecologists identified from a Royal College of Obstetricians and Gynaecologists database. METHODS: A postal questionnaire was sent to all consultants with reply paid envelopes. A postal reminder was sent three months following the initial questionnaire. MAIN OUTCOME MEASURE: Current practice for the laparoscopic diagnosis and treatment of endometriosis and willingness to participate in a randomised trial. RESULTS: The response rate was 66% (893/1411). Diagnostic laparoscopy was performed by 87% (772/893) of respondents. Seventy-six percent of these (58/772) were confident to visually diagnose endometriosis and 6% (47/772) routinely verified the diagnosis histologically. Laparoscopic surgery was routinely undertaken by 41% (318/772) of respondents. Ablative therapy was the most frequently employed technique utilised [620/653 (95%)] and electrodiathermy was the most popular energy modality (80%). Among respondents expressing a preference, excision of disease was believed to be more effective, but less safe compared with ablation. One-third of respondents (273/893) were willing to enter patients into a randomised controlled trial to compare laparoscopic treatments for pelvic pain associated with endometriosis. CONCLUSION: Laparoscopic surgery for endometriosis associated with pelvic pain is routinely undertaken by a large number of UK consultant gynaecologists, but techniques used and beliefs about efficacy vary. In view of this division of opinion regarding the relative roles of laparoscopic treatment methods, a randomised trial comparing the efficacy and safety of these methods is urgently needed.
PMID: 15521873 [PubMed – in process]

BJOG. 2004 Nov;111(11):1213-7.
Evidence for asymmetric distribution of lower intestinal tract endometriosis.
Vercellini P, Chapron C, Fedele L, Gattei U, Daguati R, Crosignani PG.
First Department of Obstetrics and Gynecology, University of Milan, Italy.
PMID: 15521865 [PubMed – in process]

BJOG. 2004 Nov;111(11):1204-12.
Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review.
Wykes CB, Clark TJ, Khan KS.
Academic Department of Obstetrics and Gynaecology, Birmingham Women’s Hospital, UK.
PMID: 15521864 [PubMed – in process]

J Med Assoc Thai. 2004 Jul;87(7):740-4.
Positive predictive value of clinical diagnosis of endometriosis.
Cheewadhanaraks S, Peeyananjarassri K, Dhanaworavibul K, Liabsuetrakul T.
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla 90110, Thailand. csophon@medicine.psu.ac.th
OBJECTIVE: To determine the positive predictive value of the combined symptoms of severe dysmenorrhea with the sign of tenderness and/or nodularity of the cul-de-sac and/or uterosacral ligament(s) in diagnosing endometriosis clinically. MATERIAL AND METHOD: In this prospective study, 116 patients with severe dysmenorrhea, after excluding urinary and gastrointestinal disease, underwent pelvic examination by the same investigator. Women having adnexal mass on pelvic examination were excluded Tenderness, and also nodularity, of the cul-de-sac, right and left uterosacral ligament were recorded separately. The laparoscopist did not know the findings of the pelvic examination. The diagnosis of endometriosis was made visually when lesions were typical and all other lesions were biopsied. RESULTS: The prevalence of endometriosis was 78.4%. Tenderness, nodularity, tenderness and nodularity, and also tenderness or nodularity of cul-de-sac and/or uterosacral ligament(s) were all statistically significantly associated with the presence of endometriosis (P = .048, .005, .004, and .004 respectively). The positive predictive values were 85.5%, 94.0%, 94.6% and 86.7%, respectively. CONCLUSION: The positive predictive value of severe dysmenorrhea with nodularity of the cul-de-sac and/or uterosacral ligament(s) was 94.0%.
PMID: 15521226 [PubMed – in process]

J Med Assoc Thai. 2004 Jul;87(7):735-9.
Effect of tubal ligation on pelvic endometriosis externa in multiparous women with chronic pelvic pain.
Cheewadhanaraks S.
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. csophon@medicine.psu.ac.th
OBJECTIVE: To determine whether tubal ligation is associated with decreased prevalence and less severity of pelvic endometriosis in multiparous patients with chronic pelvic pain. MATERIAL AND METHOD: From January 1995 to April 2002, 322 chronic pelvic pain patients underwent laparoscopy. Of these, 125 patients were multiparous (parity > or = 2). Their obstetric history, present contraceptive methods and laparoscopic findings were recorded perioperatively. The medical record of each patient was reviewed and analyzed. RESULTS: Among multiparous women with chronic pelvic pain, the prevalence of endometriosis in patients with and without tubal ligation was 45.1% (23 of 51 patients) and 59.5% (44 of 74 patients), respectively. Moderate-severe endometriosis was found in 8.7% (2 of 23 patients) and 36.4% (16 of 44 patients) among patients with and without sterilization. Tubal ligation was statistically significantly associated with severity of disease [P = 0.036, Crude OR (95% CI) = 0.17 (0.02-0.85), Adjusted OR (95% CI) = 0.21 (0.04-1.08)]. There was no statistically significant relationship between tubal ligation and prevalence of endometriosis. The small sample size of the study might account for this statistical result. CONCLUSION: Nearly half of multiparous women with chronic pelvic pain and tubal ligation had endometriosis. Tubal ligation was related to less severity of disease, with statistically significant difference.
PMID: 15521225 [PubMed – in process]

Obstet Gynecol. 2004 Nov;104(5):1170-2.
Early abdominal incision recurrence in a patient with stage I adenocarcinoma of the endometrium.
Chen CC, Straughn JM Jr, Kilgore LC.
Division of Gynecologic Oncology, University of Alabama, Birmingham, Alabama.
BACKGROUND: Although most patients with a surgical stage I endometrial cancer have an excellent prognosis, some patients will experience a recurrence. Endometrial cancer typically recurs at the vaginal cuff or in the pelvis; however, it can recur distantly in the abdomen or lung. Although recurrences have been reported at laparoscopic trochar sites, it is unusual to have a recurrence in the abdominal incision after laparotomy. CASE: A 51-year-old woman was diagnosed with stage Ib grade 2 adenocarcinoma of the endometrium and stage IV endometriosis. Six months after surgery, she presented with a mass in the lateral aspect of her Maylard incision. Computed tomography scans of the chest, abdomen, and pelvis showed no evidence of recurrent disease. The mass was resected and confirmed to be an adenocarcinoma similar to the endometrial primary. CONCLUSION: This case is interesting because of the rapid recurrence of the endometrial primary at an unusual site-the abdominal incision. It illustrates the need to carefully evaluate all suspicious masses, even as early as 6 months after diagnosis and surgical staging.
PMID: 15516440 [PubMed – in process]

Obstet Gynecol. 2004 Nov;104(5):1149-51.
Symptomatic diaphragmatic endometriosis ten years after total abdominal hysterectomy.
Nahir B, Eldar-Geva T, Alberton J, Beller U.
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, and the Faculty of Health Sciences, Ben-Gurion University of The Negev, Be’er-Sheva, Israel.
BACKGROUND: Endometriosis is a disease that affects women, mostly in the age range of 25-35 years, and in most cases pelvic organs are involved. Involvement of the diaphragm after hysterectomy is extremely uncommon. CASE: A 50-year-old woman presented to our department with right upper-quadrant abdominal pain. Ten years before her admission, she underwent total hysterectomy and right salpingo-oophorectomy for a large leiomyomatous uterus. On evaluation, a right diaphragmatic lesion was identified by computed tomography. An explorative laparotomy was then performed, which revealed a 4-cm diaphragmatic cyst compressing the liver surface and containing thick chocolate-colored material. The lesion was totally excised. Pathological examination confirmed the diagnosis of endometriotic cyst. CONCLUSION: The diagnosis of endometriosis involving the diaphragm with no evidence of disease in the pelvis 10 years after hysterectomy, although a rare situation, should be considered in the differential diagnosis of a symptomatic diaphragmatic lesion in a woman with a single functioning ovary.
PMID: 15516432 [PubMed – in process]

Obstet Gynecol. 2004 Nov;104(5):1147-9.
Low-grade endometrial stromal sarcoma arising from sciatic nerve endometriosis.
Lacroix-Triki M, Beyris L, Martel P, Marques B.
Departments of Pathology, Radiology, and Gynecologic Surgery, Institut Claudius Regaud, Toulouse, France.
BACKGROUND: Endometrial stromal sarcoma arising from extrauterine endometriosis is a rare and not easily diagnosed tumor. We present a case arising from sciatic nerve endometriosis in a 50-year-old woman. CASE: The patient had a long history of endometriosis and presented with a left buttock mass and motor deficit. Magnetic resonance imaging showed a large tumor of the sciatic nerve with pelvic extension. She underwent total hysterectomy, bilateral salpingo-oophorectomy, and excision of pelvic endometriotic pockets, allowing the diagnosis of low-grade endometrial stromal sarcoma arising from endometriosis. She received systemic chemotherapy, gonadotropin-releasing hormone agonist therapy, and palliative radiation therapy, but her disease progressed. CONCLUSION: Aggressive endometriosis raises important diagnostic and therapeutic difficulties and may correspond to misdiagnosed rare malignant neoplasms, which should be treated.
PMID: 15516431 [PubMed – in process]

Obstet Gynecol. 2004 Nov;104(5):965-974.
Reproductive History and Endometriosis Among Premenopausal Women.
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Malspeis S, Willett WC, Hunter DJ.
Channing Laboratory, Department of Medicine, and the Department of Obstetrics, Gynecology, and Reproductive Medicine, Brigham and Women’s Hospital and Harvard Medical School; the Departments of Epidemiology, Biostatistics, and parallelNutrition, Harvard School of Public Health; and the Center for Cancer Prevention, Harvard School of Public Health, Boston, Massachusetts.
OBJECTIVE: To clarify the temporal complexities of the relation between reproductive factors and endometriosis. METHODS: We analyzed 10 years of prospective data from the Nurses’ Health Study II cohort. Information was obtained through questionnaires sent every 2 years to 116,678 women aged 25-42 years when enrolled in 1989. Cox proportional hazards models were used to adjust for age, calendar time, and confounding variables. RESULTS: During 726,205 woman-years of follow-up, 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. Greater incidence was observed among women with an earlier age at menarche (rate ratio of 1.3 comparing menarche at age < 10 to age 12 years; 95% confidence interval [CI] 1.0-1.8; P value, test for trend < .001) and shorter cycle length during late adolescence (rate ratio of 1.3 comparing < 26 days to 26-31 days; 95% CI 1.1-1.5). Time to cycle regularity was not associated with risk. Among parous women, a linear decrease in risk was observed with number of liveborn children (rate ratio of 0.5 comparing > 3 with 2 children; 95% CI 0.4-0.7; P value, test for trend < .001) and lifetime duration of lactation if time since last birth was less than 5 years (rate ratio of 0.2 comparing > 23 months with never; 95% CI 0.1-0.4; P value, test for trend < .001). CONCLUSION: Hormonal and anatomical changes associated with menstruation and pregnancy may affect the rate of laparoscopically confirmed endometriosis. Within this cohort, risk was greatest among nulliparous women with earlier age at menarche and shorter menstrual cycles. Among parous women, parity and lifetime duration of lactation were associated with decreased risk.
PMID: 15516386 [PubMed – as supplied by publisher]

Hum Reprod. 2004 Oct 28; [Epub ahead of print]
Increased frequency of migraine among women with endometriosis.
Ferrero S, Pretta S, Bertoldi S, Anserini P, Remorgida V, Del Sette M, Gandolfo C, Ragni N.
Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Largo R. Benzi 1 Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, via De Toni 5, 16132 Genoa, Italy.
BACKGROUND: Our aim is to assess the prevalence and characteristics of headache in patients with endometriosis compared with women without this disease. METHODS: One hundred and thirty-three women with histologically proven endometriosis and 166 controls were interviewed by a neurologist experienced in headache diagnosis; the headache disorders were classified according to the 1988 International Headache Society criteria. RESULTS: The prevalence of migraine was significantly higher among women with endometriosis [n=51, 38.3%; 95% confidence interval (CI) 30.1-47.2%] than in controls (n=25, 15.1%; 95% CI 10.0-21.4%) (P<0.001). Migraine with aura was observed in 18 women with endometriosis (13.5%) and in two controls (1.2%; P<0.001). The age at migraine onset was significantly lower in women with endometriosis than in controls (16.4 versus 21.9 years; P=0.001). No significant difference was observed in pain intensity and attack frequency between the two groups; a trend for women with endometriosis to have longer unmedicated attacks was observed. No significant correlation was observed between attack frequency, unmedicated headache duration, migraine intensity and the severity of endometriosis. CONCLUSION: Migraine is more frequent in women with endometriosis than in controls, although its presence and characteristics are not related to the severity of endometriosis.
PMID: 15513980 [PubMed – as supplied by publisher]

Hum Reprod. 2004 Oct 28; [Epub ahead of print]
Environmental PCB exposure and risk of endometriosis.
Buck Louis GM, Weiner JM, Whitcomb BW, Sperrazza R, Schisterman EF, Lobdell DT, Crickard K, Greizerstein H, Kostyniak PJ.
Epidemiology Branch, Division of Epidemiology, Statistics & Prevention Research, National Institute of Child Health & Human Development, 6100 Executive Boulevard, Room 7B03, Rockville, MD 20852, USA.
BACKGROUND: Hormonally active environmental agents have recently been associated with the development of endometriosis. METHODS: We undertook a study to assess the relationship between endometriosis, an estrogen-dependent gynaecological disease, and 62 individual polychlorinated biphenyl (PCBs) congeners. We enrolled 84 eligible women aged 18-40 years undergoing laparoscopy for study, which included an interview and blood specimen (n=79; 94%). Thirty-two women had visually confirmed endometriosis at laparoscopy while 52 did not. Blood specimens were run in batches of 14 including four quality control samples for toxicological analysis. Each PCB congener was adjusted for recovery; batch-specific reagent blanks were subtracted. All PCB concentrations were log transformed and expressed in ng/g serum first as a sum and then as tertiles by purported estrogenic or anti-estrogenic activity of PCB congeners. RESULTS: Using unconditional logistic regression analysis, a significantly elevated odds ratio (OR) was observed for women in the third tertile of anti-estrogenic PCBs [OR 3.77; 95% confidence interval (CI) 1.12-12.68]. Risk remained elevated after controlling for gravidity, current cigarette smoking and serum lipids (OR 3.30; 95% CI 0.87-12.46). CONCLUSIONS: These data suggest that anti-estrogenic PCBs may be associated with the development of endometriosis.
PMID: 15513976 [PubMed – as supplied by publisher]

J Obstet Gynaecol. 2000;20(5):514-6.
An audit of conservative survery for endometriosis in a district general hospital 1995-1998.
Guyer A Moors K Louden C.
As conservative surgery for endometriosis is a relatively new introduction to our hospital we felt it would be of value to audit our results and compare these with results from published series. We sent postal questionnaires to 104 patients who had undergone surgery over the past 3 years to assess their response to treatment. We combined this with an additional questionnaire to patients who had a Laparoscopic uterine nerve ablation (LUNA) procedure. We received replies from 81% of the patients with 81% having symptom improvement following their operation. Eighty-seven per cent of patients who had LUNA returned the questionnaire with 64% having some symptom improvement following surgery. On the basis of our results we will continue to offer conservative surgery for endometriosis as the best primary treatment but have some reservations about the addition of LUNA in patients with endometriosis.
PMID: 15512639 [PubMed – in process]

J Obstet Gynaecol. 2000;20(2):207.
Elevated CA125 levels in association with endometriosis.
Bhaumik N C W Hill J.
PMID: 15512531 [PubMed – in process]

J Obstet Gynaecol. 1999;19(6):647-8.
Complications of unopposed oestrogen following radical surgery for endometriosis.
Taylor P Bowen-Simpkins J Barrington M.
Four cases are presented here of patients who had total abdominal hysterectomy and bilateral salpingooophorectomy for severe endometriosis. All were eventually placed on unopposed oestrogen replacement therapy, two immediately and the other two after a few months. All subsequently developed recurrence of their endometriosis whilst on oestrogen therapy, one developing an endometroid carcinoma. All required surgery and three were placed on continuous oestrogen/progestogen preparation or alternatively tibolone (which has oestrogenic, progestogenic and androgenic properties) postoperatively. No further recurrence of their disease occurred. The literature was reviewed regarding oestrogen therapy for women who have had bilateral oophorectomy. There were various suggestions as to management but no report on using continuous oestrogen/ progestogen or tibolone. We suggest this as a logical form of replacement therapy for patients who have bilateraloophorectomy for severe endometriosis, as unopposed oestrogen therapy can cause recurrence.
PMID: 15512424 [PubMed – in process]

J Obstet Gynaecol. 1999;19(4):417-20.
The role of GnRH analogue therapy in the management of proximal fallopian tube occlusion.
R Masood D Visvanathan S M Sathanandan M.
Ten infertile women were diagnosed as having bilateral or unilateral proximal tubal occlusion in the presence of minimal to mild endometriosis. They were treated with GnRH analogue for 3 months. The aim was to assess the usefulness of therapy in reversing the tubal block. Diagnosis was based on hysterosalpingography, laparoscopy and hysteroscopy. At completion of therapy tubal patency was confirmed by hysterosalpingography. Three patients had bilateral cornual block whereas seven had unilateral. All patients had achieved bilateral tubal patency immediately following therapy. Four women achieved pregnancy during a follow-up of 3-20 months. Our results show that if early endometriosis causes proximal tubal occlusion (without fibrosis) GnRH analogues may be considered as the first line of treatment.
PMID: 15512346 [PubMed – in process]

J Obstet Gynaecol. 1998;18(5):490-1.
A case of spontaneous umbilical endometriosis.
Carter T Davidson N Hussain J M Claughlin S.
PMID: 15512155 [PubMed – in process]

J Obstet Gynaecol. 1998;18(2):196-7.
Intestinal-ovarian fistula associated with endometriosis.
J M Lowe L Burmeister G T Kovacs P.
PMID: 15512053 [PubMed – in process]

J Obstet Gynaecol. 1997;17(5):457-60.
Transport in vitro fertilisation: three years experience at a district general hospital.
S Qureshi S E Walker D J Pike And A Murray N.
Transport in vitro fertilisation (IVF) is an important development in assisted conception. We report our experience of transport IVF treatment from May 1993 to April 1996 at Arrowe Park Fertility Centre. A total of 74 patients were treated during this period. The main indications of treatment were tubal damage, unexplained infertility of more than 3 years duration, polycystic ovarian disease and endometriosis. Total number of simulated ovarian cycles were 101. Thirteen cycles were abandoned. Eighty-eight transport IVF cycles led to 29 pregnancies, giving a live birth rate and on-going pregnancy rate per patient of 31% and per cycle rate of 23%. There was one case of severe ovarian hyperstimulation syndrome. Of the 74 patients, 70 (95%) patients preferred to have treatment at the local hospital. Transport IVF is an effective, efficient and economic way of providing assisted conception at district general hospital. The success rate and safety of transport IVF are comparable with conventional IVF treatment.
PMID: 15511921 [PubMed – in process]

J Obstet Gynaecol. 1997;17(3):301-2.
Endometriosis of the abdominal wall: a clinical-pathologic contribution.
Zacche G Tonni S Bellomi And S Montagna G.
PMID: 15511861 [PubMed – in process]

J Obstet Gynaecol. 1997;17(2):204-5.
Recurrent tubal pregnancy in a woman with endometriosis and unprotected coitus.
Lurie D Rabinerson And Z Katz S.
PMID: 15511825 [PubMed – in process]

An Med Interna. 2004 Oct;21(10):507-13.
[A 41 year-old female with abdominal pain and fever of 24 hours.] [Article in Spanish] Ramos J, Torroba A, Garcia Santos J, Marin M.
Unidad de Enfermedades Infecciosas. Servicio de Medicina Interna. Hospital General Universitario de Elche. Alicante, Spain.
A 41 year-old female with intrauterine contraceptive device (ICD) from 8 year ago that complained fever and abdominal pain during 24 hours and leucocitosis. The radiology examination tests showed cegal, appendiceal, and right ovary enlargement with swollen of fat adjacent. In the differential diagnosis should be include: apendicitis, diverticulitis, chronic inflammatory digestive disease or mesenterical adenitis. In the differential diagnosis included: ovarian neoplasm, endometriosis, ectopic pregnancy, ovarian torsion and pelvic inflammatory diseases. From pelvic infections, it is import consider pelvic inflammatory disease, genital tuberculosis and pelvic actinomycosis. With the antecedent of ICD, the clinic and the radiological finding as abdominal mass with invasion of adjacent structures and absence of adenopathy; the first diagnosis is a abdominopelvic actinomycosis and the second is a genital tuberculosis.
PMID: 15511204 [PubMed – in process]

J Clin Endocrinol Metab. 2004 Oct 26; [Epub ahead of print]
Expression of Allograft Inflammatory Factor-1 in Human Eutopic Endometrium and Endometriosis: Possible Association with Progression of Endometriosis.
Koshi H, Kitawaki J, Teramoto M, Kitaoka Y, Ishihara H, Obayashi H, Ohta M, Hara H, Adachi T, Honjo H.
Department of Obstetrics and Gynecology (H.K., J.K., M.T., Y.K., H.I., H.Ho.), Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; Institute of Bio-Response Informatics (H.O.), Kyoto 602-0845, Japan; Department of Clinical Chemistry (M.O.), Kobe Pharmaceutical University, Kobe 658-8558, Japan; Laboratory of Clinical Pharmaceutics (H.Ha., T.A.), Gifu Pharmaceutical University, Gifu 502-8585, Japan.
Allograft inflammatory factor-1 (AIF-1) is a cytokine originally identified in rat cardiac allografts with chronic rejection. AIF-1

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