Int J Cancer. 2006 Feb 27; [Epub ahead of print] Molecular genetic evidence that endometriosis is a precursor of ovarian cancer.
Prowse AH, Manek S, Varma R, Liu J, Godwin AK, Maher ER, Tomlinson IP, Kennedy SH.
Nuffield Department of Obstetrics and Gynaecology, The Women’s Centre, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
Histopathology and epidemiology studies have consistently demonstrated a strong link between endometriosis and endometriosis-associated ovarian cancers (EAOCs)-in particular, the endometrioid and clear cell subtypes. However, it is still unclear whether endometriosis is a precursor to EAOCs, or whether there is an indirect link because similar factors predispose to both diseases. In order to search for evidence of clonal progression, we analyzed 10 EAOCs (endometrioid = 4; clear cell = 6) with coexisting endometriosis for common molecular genetic alterations in both the carcinoma and corresponding endometriosis. We used 82 microsatellite markers spanning the genome to examine loss of heterozygosity (LOH) in the coexisting carcinoma and endometriosis samples. A total of 63 LOH events were detected in the carcinoma samples; twenty two of these were also detected in the corresponding endometriosis samples. In each case, the same allele was lost in the endometriosis and cancer samples. Interestingly, no marker showed LOH in the endometriosis alone. These data provide evidence that endometriosis is a precursor to EAOCs. (c) 2006 Wiley-Liss, Inc.
PMID: 16506222 [PubMed – as supplied by publisher]
Gastroenterol Clin Biol. 2005 Nov;29(11):1157-9.
[Exclusive ileal endometriosis] [Article in French] Roger N, Munoz-Bongrand N, Vila A, Allez M, Gornet JM, Cattan P, Lemann M, Sarfati E.
Services de Chirurgie Generale, Digestive et Endocrinienne, Hopital Saint-Louis, AP-HP, Paris.
Endometriosis is a common condition, but its exclusive localization on the ileum is very rare. Unless there is catamenial exacerbation of symptoms, and considering the lack of specificity of results, diagnosis can be difficult. We report the case of a 50 year-old woman presenting with chronic pain in the right lower quadrant. Initial explorations revealed an ileal tumor which was not characterized before the occurrence of acute small bowel obstruction. Ileo-caecal resection by laparotomy relieved the symptoms and alllesions were removed. Diagnosis of ileal endometriosis was made by pathological examination of the resected specimen.
Publication Types: ? Case Reports
PMID: 16505762 [PubMed – indexed for MEDLINE]
Saudi Med J. 2006 Feb;27(2):244-6.
A young woman with endometriosis of kidney.
Dutta P, Bhat MH, Bhansali A, Kumar V.
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Endometriosis of kidney is a rare manifestation of a relatively common disease. We report a case in which ovarian and renal endometriosis were diagnosed concurrently. The disease was probably silent for a long time due to coexistent thyrotoxicosis modifying estrogen metabolism. Fine needle aspiration cytology clinched the diagnosis of endometriosis and avoided unnecessary nephrectomy.
PMID: 16501686 [PubMed – in process]
Fertil Steril. 2006 Mar;85(3):775-9.
High plasma concentrations of polychlorinated biphenyls and phthalate esters in women with endometriosis: a prospective case control study.
Reddy BS, Rozati R, Reddy S, Kodampur S, Reddy P, Reddy R.
Department of Reproductive Medicine, Bhagwan Mahavir Medical Research Center, A.C. Guards, Hyderabad, India. satyanarayanareddyb@yahoo.com
The objective of this study was to detect the probable association between polychlorinated biphenyls (PCBs) and phthalate esters (PEs), and the occurrence of endometriosis in a prospective case control study. We found that PCBs and PEs may be instrumental in the etiology of endometriosis.
PMID: 16500362 [PubMed – indexed for MEDLINE]
Fertil Steril. 2006 Mar;85(3):764-6.
Estrogen receptor gene polymorphisms are associated with recurrence of endometriosis.
Luisi S, Galleri L, Marini F, Ambrosini G, Brandi ML, Petraglia F.
Department of Pediatrics, Gynecology and Reproductive Medicine, University of Siena, Siena, Italy.
The presence of gene polymorphisms of the estrogen receptors ERalpha (PvuII and XbaI) and ERbeta (AluI) in 61 women with endometriosis was investigated. A statistically significant correlation between PvuII ERalpha gene polymorphism (PvuII), both in homozygosity (PP) and in heterozygosity (Pp), and a recurrence of endometriosis was found. In conclusion, women affected by endometriosis with the ERalpha polymorphic allele, even if heterozygous, have a worse prognosis, and these results suggest that the ERalpha gene polymorphisms may be included among the genetic risk factors for endometriosis.
PMID: 16500359 [PubMed – indexed for MEDLINE]

Expert Opin Investig Drugs. 2006 Apr;15(4):399-407.
Investigational drugs for endometriosis.
Chlouber RO, Olive DL, Pritts EA.
Department of Obstetrics and Gynecology, University of Wisconsin, Madison 53792, USA.
Endometriosis is an enigmatic disease found in as many as 30% of reproductive age women. The symptoms for women who suffer from this malady vary but may include subfertility or chronic pelvic pain. Because endometriosis lesions rely on estradiol for growth, most of the existing drug regimens work by creating hypoestrogenism. Unfortunately, this leads to untoward side effects and alterations in ovulation and, subsequently, fertility potential. Newer drugs are currently under investigation that either create hypoestrogenemia more efficaciously or do not alter ovulation but still affect the growth of endometriosis. They target some of the pathophysiological pathways that are only now being elucidated, and include gonadotropin-releasing hormone antagonists, aromatase inhibitors, selective progesterone receptor modulators, angiogenesis inhibitors, matrix metalloprotease inhibitors, estrogen receptor beta-agonists and immune modulators.
PMID: 16548789 [PubMed – in process]
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Feb;26(2):110-3.
[Study on mechanism of Quyujiedu method in treating endometriosis of stasis-toxic syndrome type] [Article in Chinese] Lian F, Liu HP, Wang YX.
Reproductive Center, Hospital Affliated to Shandong University of Traditional Chinese Medicine, Jinan 250011. flian@chinaivf.com
OBJECTIVE: To observe the mechanism of Quyujiedu (QYJD, a method for removing stasis and detoxicating) in treating endometriosis of stasis-toxic syndrome type. METHODS: Clinical study: Sixty patients were randomly divided into two groups, the treated group treated with QYJD and the control group treated with Danazol. The changes of clinical symptoms, physical signs, pregnancy rate, as well as levels of interleukin-1 (IL-1), interleukin-6 (IL-6) and endometrial antibody (EMAb) in them before and after treatment were observed. Experimental study: Sixty rats were established into endometriosis model, and randomly divided into the QYJD treated group, the Danazol treated group for positive control and the untreated group for negative control to observe the expression of Bax. RESULTS: Clinical study showed that in the treated group and the control group, after treatment, dysmenorrhea score were 2.40 +/- 1.85 and 3.47 +/- 2.03, the menoxenia score 1.67 +/- 2.04 and 3.73 +/- 1.72 (P < 0.05), and the pregnancy rate 63.2% and 23.5% respectively, the difference between them was significant (all P < 0.05). Both of the two treatments can rectify immunity, reduce levels of IL-1 and IL-6, and lower the positive rate of EMAb. Experimental study showed that QYJD could improve the expression of Bax in ectopic endometrium, but could not affect the on-side expression of Bax in endometrium and muscle tissue. CONCLUSION: QYJD is effective in improving the stasis-toxic syndrome of endometriosis, its mechanism related with the regulation of the immune condition and the promotion of cell apoptosis in ectopic endometrium, indicating that QYJD is an effective remedy for endometriosis of stasis-toxic syndrome type.
PMID: 16548348 [PubMed – in process]
Aesthetic Plast Surg. 2006 Mar-Apr;30(2):249-50.
Abdominal wall endometrioma found during abdominoplasty.
Ostric SA, Martin WJ, Kouris GJ.
Department of Plastic and Reconstructive Surgery, Rush University, 1743 West Harrison Street, Suite 425, Chicago, IL, 60612, USA, sa_ostric@sbcglobal.net.
Extrauterine manifestations of endometriosis are well-recognized and frequently encountered by gynecologists, but are not necessarily familiar to the plastic surgery community. With the current increase in gastric bypass procedures performed and the subsequent increase in abdominal wall reconstructions secondary to massive weight loss, the plastic surgeon should have some familiarity with the diverse presentations of this common disease. To help with this, the authors present the case of an abdominal wall endometrioma diagnosed during abdominoplasty.
PMID: 16547624 [PubMed – in process]
Eur J Contracept Reprod Health Care. 2006 Mar;11(1):23-7.
The effect of hysterectomy on sexuality and psychological changes.
Vomvolaki E, Kalmantis K, Kioses E, Antsaklis A.
Alexandra Maternity Hospital, 1st Dept Ob/Gyn, University Medical School, Athens, Greece.
Every year, many women all over the world will undergo a hysterectomy, the removal of their uterus. The majority of hysterectomies are performed to treat conditions such as fibroids, heavy bleeding, endometriosis, adenomyosis and prolapse. A hysterectomy is not often a procedure that needs to be performed urgently, except in the case of cancer. Therefore, a woman considering the procedure should take time to investigate all her options, including other possible treatments. Deciding whether to have a hysterectomy can be a difficult and emotional process. Signs of depression may include severe and prolonged feelings of sadness and hopelessness; diminished interest in activities; significant weight loss or gain; insomnia; fatigue; and thoughts of death or suicide. Every person reacts differently, and reactions are a combination of emotional and physical responses. We still have much to learn about the effects of hysterectomy on sexual function. We investigated many studies published in different journals relative to this subject and we compare their results. Women are more likely to report improved sexual functioning after the surgery when their symptoms have been alleviated. A new hysterectomy procedure that ‘spares’ abdominal ligaments and nerves is quicker and results in less blood loss and shorter hospital stays and seems to respect the tissues more, without affecting the sexuality of the women.
PMID: 16546813 [PubMed – in process]
Sci Total Environ. 2006 Apr 15;359(1-3):90-100.
Fish intake and serum levels of organochlorines among Japanese women.
Tsukino H, Hanaoka T, Sasaki H, Motoyama H, Hiroshima M, Tanaka T, Kabuto M, Turner W, Patterson DG Jr, Needham L, Tsugane S.
Epidemiology and Prevention Division, Research Center for Cancer prevention and Screening, National Cancer Center 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
This study evaluates background serum levels of selected organochlorine compounds among Japanese women of reproductive age and investigates whether lifestyle factors, especially dietary factors, may be associated with these levels. A cross-sectional study was performed on 80 Japanese women, aged 26-43 years, who complained of infertility and were confirmed not to have endometriosis. The serum levels of total toxic equivalency (TEQ), 18 polychlorinated dibenzo-p-dioxins (PCDDs)/polychlorinated dibenzofurans (PCDFs), 4 coplanar polychlorinated biphenyls (cPCBs), 36 ortho-substituted polychlorinated biphenyls (PCBs), and 13 chlorinated pesticides or their metabolites were measured and data were collected on the women’s age, residence, occupation, body mass index (BMI), smoking and alcohol habit and 6 dietary intakes (fish, meats, rice, vegetables, fruits and dairy products). The serum median level of total TEQ was 25.1 pg TEQ/g lipid, that of PCDDs/PCDFs/cPCBs was 11.5 pmol/g lipid, that of PCBs was 0.46 nmol/g lipid, and that of total pesticides was 1.32 nmol/g lipid. The serum levels of total TEQ, PCDDs/PCDFs/cPCBs, PCBs and pesticides were positively associated with age (P for trend=0.003, 0.01, 0.005 and 0.01, respectively) and frequent fish consumption (P for trend=0.002, 0.003, 0.0003 and 0.006, respectively). Other lifestyle factors were not associated with serum organochlorine levels. The present study suggests that Japanese women who consume fish frequently in their reproductive period tend to accumulate organochlorines in their bodies.
PMID: 16546516 [PubMed – in process]
Int J Gynaecol Obstet. 2006 Mar 16; [Epub ahead of print] Endometriosis with intestinal perforation in term pregnancy.
Schweitzer KJ, van Bekkum E, de Groot CJ.
Department of Obstetrics and Gynecology, Erasmus Medical Centre Rotterdam, Division of Obstetrics and Prenatal Medicine, Rotterdam, The Netherlands.
PMID: 16545813 [PubMed – as supplied by publisher]
Gynecol Obstet Invest. 2006 Mar 15;62(1):48-54 [Epub ahead of print] Endometriosis in Patients with Chronic Pelvic Pain: Is Staging Predictive of the Efficacy of Laparoscopic Surgery in Pain Relief?
Milingos S, Protopapas A, Kallipolitis G, Drakakis P, Loutradis D, Liapi A, Antsaklis A.
First Department of Obstetrics and Gynecology, University of Athens, ‘Alexandra’ Maternity Hospital, Athens, Greece.
Background/Aims: Endometriosis is considered an important cause of chronic pelvic pain. Despite its high prevalence, controversy still exists regarding the true association between the extent of endometriosis and the severity of symptoms. We conducted this prospective study to investigate the association between the stage of endometriosis and type and severity of pain, and to evaluate the efficacy of laparoscopic surgery in pain relief. Methods: Ninety-five patients complaining of chronic pain were diagnosed with endometriosis and were treated with laparoscopic surgery. The severity of pain was assessed in patients with an endometriosis AFS (American Fertility Society) score less than 16 (group 1) and those with an AFS score greater than or equal to 16 (group 2), preoperatively and 6 months after surgery, using a visual pain scale. Any reduction in pain scores by 2 points or more was considered to be an improvement. Results: Dysmenorrhea and deep dyspareunia, were significantly more frequent in patients of group 2. Preoperative pain scores were significantly higher for dysmenorrhea (p = 0.0022) and deep dyspareunia (p < 0.0001) but not for non-menstrual pain in group 2. Deep dyspareunia was correlated with the presence of dense pelvic adhesions. After surgery, dysmenorrhea improved in 43% of cases in group 1, vs. 66% of cases in group 2 (p = 0.0037). For deep dyspareunia, improvement was reported by 33% in group 1, vs. 67% in group 2 (p = 0.074). Improvement in non-menstrual pain was not significantly different between the two groups (67% vs. 56%). Conclusions: Advanced endometriosis is more frequently related to dysmenorrhea and deep dypareunia in comparison to early disease. Laparoscopic surgery may offer relief or improvement in the majority of patients with endometriosis and chronic pelvic pain. Cases with advanced disease seem to benefit the most. Copyright (c) 2006 S. Karger AG, Basel.
PMID: 16543749 [PubMed – as supplied by publisher]
Gynecol Obstet Invest. 2006 Mar 14;62(1):45-47 [Epub ahead of print] A Rare Case of Rectovaginal Endometriosis with Lymph Node Involvement.
Thomakos N, Rodolakis A, Vlachos G, Papaspirou I, Markaki S, Antsaklis A.
First Department of Obstetrics and Gynaecology, ‘Alexandra’ Hospital, University of Athens, Athens, Greece.
A rare case of rectovaginal endometriosis with lymph node involvement is described in a 44-year-old patient. The presence of endometrial tissue in pelvic lymph nodes is rare and has been confirmed in the literature in subjects who underwent surgery for endometriosis. Involvement of pelvic lymph nodes by endometriosis seems unlikely to arise de novo and probably suggests lymphatic spread of the disease. Copyright (c) 2006 S. Karger AG, Basel.
PMID: 16543748 [PubMed – as supplied by publisher]
Hum Reprod. 2006 Mar 16; [Epub ahead of print] Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution.
Chapron C, Chopin N, Borghese B, Foulot H, Dousset B, Vacher-Lavenu MC, Vieira M, Hasan W, Bricou A.
Service de Gynecologie Obsterique II, Unite de Chirurgie Gynecologique; Institut Cochin, IFR.
BACKGROUND: To investigate whether knowledge of the anatomical distribution of histologically proven deeply infiltrating endometriosis (DIE) lesions contributes to understanding the pathogenesis. METHODS: Observational study between June 1992 and December 2004 (retrospective study between 1992 and 2000; prospective study between 2001 and 2004). Continuous series of 426 patients suffering from pelvic pain who underwent complete surgical exer-esis of DIE. DIE lesions were classified according to four different possibilities: (i) Firstly, DIE lesions were classified as located in the anterior or posterior pelvic compartment. (ii) Secondly, DIE were classified as left, median and right. (iii) Thirdly, DIE lesions were classified as pelvic or abdominal. (iv) Fourthly, DIE lesions that could present in a right and/or left location were classified as unilateral or bilateral. RESULTS: These 426 patients presented 759 histo-logically proven DIE lesions: bladder (48 lesions; 6.3%); uterosacral (USL) (400 lesions; 52.7%); vagina (123 lesions; 16.2%); ureter (16 lesions; 2.1%) and intestine (172, 22.7%). DIE lesions are significantly more often located in the pelvis (n = 730 lesions) than in the abdomen (n = 29 lesions) (P < 0.0001). Pelvic DIE lesions are significantly more often located in the posterior compartment of the pelvis [682 DIE lesions (93.4%) versus 48 DIE lesions (6.6%); P < 0.0001]. Pelvic DIE lesions are significantly more frequently located on the left side. For patients with unilateral pelvic DIE lesions, the anatomical distribution is significantly different in the three groups: left (172 lesions; 32.0%), median (284 lesions; 52.8%) and right (82 lesions; 15.2%) (P < 0.0001). For patients with lateral lesions, left DIE lesions (172 lesions; 67.8%) were found significantly more frequently than right DIE lesions (82 lesions; 32.2%) (P < 0.0001). A similar predisposition was observed when we included patients with bilateral pelvic DIE lesions (P = 0.0031). The same significantly asymmetric distribution is observed for total (pelvic and abdominal) DIE lesions. CONCLUSIONS: Our results demonstrate that distribution of DIE lesions is asymmetric. It is possible that this is related to the anatomical difference between the left and right hemipelvis and to the flow of peritoneal fluid. These findings support the hypothesis that retrograde menstruation of regurgitated endometrial cells is implicated in the pathogenesis of DIE.
PMID: 16543256 [PubMed – as supplied by publisher]
Am J Reprod Immunol. 2006 Apr;55(4):276-81.
Aberrant Expression of CD95 and CD69 Molecules among CD56 Cells in Women with Endometriosis.
Eidukaite A, Siaurys A, Tamosiunas V.
Department of Molecular Immunology, Institute of Immunology, Vilnius, Lithuania.
Problem Activated lymphocytes can be eliminated by Fas/Fas ligand (FasL)-induced cell death. Endometrial cells express FasL. The aim of our study was to determine the expression of CD56(+) cells (natural killer and natural killer T cells) Fas antigen CD95 and the early activation molecule CD69 in the peritoneal fluid of women with endometriosis. Method Two-colour flow cytometry was used. Results In the early stages of endometriosis, more CD56(+) cells expressed CD69 and CD95 molecules when compared with the control group. However, in case of severe endometriosis the percentage of CD95(+)CD56(+) cells in peritoneal fluid was similar to that of the control group, but the expression of CD69 molecules remained high. Conclusion Because of Fas/FasL mechanisms, in the initial stages of endometriosis the activated peritoneal fluid CD56(+) cells can be intensively eliminated, thus providing conditions for the survival of ectopic endometrial cells and the development of the disease.
PMID: 16533339 [PubMed – in process]
Acta Obstet Gynecol Scand. 2006;85(2):212-7.
Analysis of two polymorphisms in the promoter region of matrix metalloproteinase 1 and 3 genes in women with endometriosis.
Ferrari MM, Biondi ML, Rossi G, Grijuela B, Gaita S, Perugino G, Vigano P.
Department of Obstetrics, Gynecology and Neonatology, Clinica "L. Mangiagalli", San Paolo Hospital, University of Milan, Milan, Italy.
BACKGROUND: Matrix metalloproteinases are a family of proteolytic enzymes that can degrade extracellular matrix components and have been implicated in connective tissue remodeling associated with cancer invasion and metastasis. These proteins are also involved in the invasive events underlying endometriotic lesion formation and aggressive behavior. Given the established genetic background of endometriosis, the aim of this study was to examine the potential impact of two polymorphisms in the gene promoter region of two of these enzymes, matrix metalloproteinases 1 and 3, on predisposition and severity of the disease. METHODS: Genomic DNA was obtained from 56 Italian Caucasian women with a surgical diagnosis of endometriosis and a control group of 71 age-matched Caucasian healthy female blood donors. In control women, endometriosis was ruled out by evaluation of the medical history, gynecologic examinations, and ultrasound scanning. Two polymorphisms have been specifically investigated: 1. a single insertion polymorphism (2G) in the matrix metalloproteinase-1 promoter region known to elevate transcriptional level of matrix metalloproteinase-1; and 2. a single insertion/deletion polymorphism (5A/6A) located in the promoter of the matrix metalloproteinase-3 gene with functional significance in the regulation of its expression. Genotypes were determined by PCR amplification and sequence analysis. RESULTS: Allele and genotype frequencies of both polymorphisms did not significantly differ between endometriosis and control groups. Moreover, no significant difference for both polymorphisms was observed in relation to the clinical stage and recurrence status of the disease. CONCLUSIONS: This is the first study that has evaluated the possibility that gene variants of matrix metalloproteinases might be involved in the susceptibility to endometriosis. However, these results suggest that matrix metalloproteinases 1 and 3 promoter polymorphism do not constitute an important factor for the genetic predisposition to endometriosis and its invasive behavior in the Italian population.
PMID: 16532917 [PubMed – in process]
Eur J Cancer. 2006 Mar 10; [Epub ahead of print] Endometriosis as a model for inflammation-hormone interactions in ovarian and breast cancers.
Ness RB, Modugno F.
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, 130 DeSoto Street, Room 513 Parran Hall, Pittsburgh, PA 15261, USA; University of Pittsburgh Cancer Institute, 130 DeSoto Street, Room 513 Parran Hall, Pittsburgh, PA 15261, USA; Magee-Womens Research Institute, 130 DeSoto Street, Room 513 Parran Hall, Pittsburgh, PA 15261, USA.
Chronic inflammation has been implicated in a variety of cancers. In this review, we consider associations between endometriosis and cancers both local (ovarian) and distant (breast). We review the epidemiological data linking endometriosis to ovarian and breast cancers. We then consider evidence for a role for sex steroid hormones and for inflammation in the aetiology of each of these cancers. Finally, we consider that endometriosis may promote alterations in sex steroid hormones and inflammatory mediators. A possible explanation for the association between endometriosis and these reproductive cancers may then be local and systemic enhancement of aberrant inflammatory and hormonal mediators. If this hypothesis is true, endometriosis may need to be considered as a risk factor for ovarian and breast cancers, triggering increasingly intensive surveillance. Moreover, treatments for endometriosis may require consideration of the impact on long-term cancer risk.
PMID: 16531042 [PubMed – as supplied by publisher]
Gynecol Obstet Fertil. 2006 Mar;34(3):242-247. Epub 2006 Mar 10.
[From adolescence traumas to endometriosis.] [Article in French] Belaisch J, Allart JP.
Service de gynecologie-obstetrique, hopital Saint-Vincent-de-Paul, 74-82, avenue Denfert-Rochereau, 75674 Paris cedex 14, France.
Endometriosis is a recurrent and painful disease which sometimes disturbs severely the quality of life of women who suffer from it. It is then logical to include a psychological back-up to its medical and surgical treatment. Nevertheless this support is not often offered to patients. One can hypothesize another and completely different way of seeing the problem: the mood swings and depression of endometriotic patients could possibly be, at least in some of them, the cause of the graft of endometrial cells and not the effect of pain and infertility. The mechanism of the development of endometriotic lesions could be related to a lowering of immune defences due to an alteration of the psycho-neuro-endocrino-immunologic network, resulting from difficult life experiences which mostly happen during adolescence. This concept may have beneficial effects for the patient whose case would be more understood in depth. But very few medical teams consider it worthwhile to include in their practices.
PMID: 16530445 [PubMed – as supplied by publisher]
Zhong Xi Yi Jie He Xue Bao. 2006 Mar;4(2):189-93.
[Primary culture and morphologic observation of eutopic and ectopic endometrial cells from patients with endometriosis] [Article in Chinese] Yu CQ, Shi SF, Liu YH, Wang RX, Song YH, Yu J.
Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. chqyu81@gmail.com
OBJECTIVE: To explore the method of primary culture for endometriotic cells and to find out the differences in morphological manifestations among endometriotic cells and eutopic endometrial cells sampled from patients with endometriosis and endometriosis-free women. METHODS: Endometriotic and eutopic endometrial cells were cultured by modified method of primary culture. The endometriotic cell types were observed and differentiated under optical and electron microscopes. RESULTS: The success rates for culture of eutopic endometrial cells from endometriosis-free women and patients with endometriosis were 91.67% and 93.75% respectively. The success rate for culture of endometriotic cells was 75.00%. The size of endometriotic glandular cells was similar to those of eutopic endometrial glandular cells from endometriosis-free women and patients with endometriosis. The chromatin was manifold and the nucleus was augmented in the endometriotic glandular cells. The endometriotic stromal cells were smaller than the eutopic endometrial stromal cells from endometriosis-free women and patients with endometriosis. Many tiny villi and protuberances on plasma membrane could be seen in the endometriotic stromal cells. CONCLUSION: The success rate for culture of endometriotic cells can be elevated through improving the method of primary culture. The ultrastructures of endometriotic glandular and stromal cells are obviously different from those of eutopic endometrial glandular and stromal cells from endometriosis-free women and patients with endometriosis.
PMID: 16529698 [PubMed – in process]

J Obstet Gynaecol Can. 2005 Nov;27(11):1027-30.
Primary carcinoma of the rectovaginal septum diagnosed as uterine prolapse.
Nelson GS, Ghatage P, Mainprize TC, Duggan MA, Buie D, Nation JG.
Department of Obstetrics and Gynecology, Foothills Medical Centre, Calgary AB.
BACKGROUND: Primary carcinoma of the rectovaginal septum is very rare. Most cases are associated with documented endometriosis, and patients will often present with vaginal or rectal bleeding. CASE: A 47-year-old woman presented to the emergency department complaining of urinary symptoms and "something falling out of the vagina." She was diagnosed initially as having uterine prolapse. However, further investigations and surgery showed that she had a primary papillary serous carcinoma of the rectovaginal septum, and the carcinoma later metastasized to the lymph nodes. No evidence of endometriosis was found. Assessment and subsequent treatment of this aggressive tumour was likely delayed because of its initial benign presentation. CONCLUSION: Our presentation of the case of a woman with primary carcinoma of the rectovaginal septum not associated with a focus of endometriosis shows that this rare aggressive cancer may present in a clinically benign fashion.
PMID: 16529670 [PubMed – in process]
Hum Reprod. 2006 Mar 9; [Epub ahead of print] CYP17, CYP1A1 and COMT polymorphisms and the risk of adenomyosis and endometriosis in Taiwanese women.
Juo SH, Wang TN, Lee JN, Wu MT, Long CY, Tsai EM.
Graduate Institute of Medical Genetics; Department of Clinical Research; Department of Medical Research, Mackay Memorial Hospital.
BACKGROUND: The aim of the study was to test whether the COMT, CYP1A1 and CYP17 genes influence the risk of developing adenomyosis and endometriosis. METHODS: We conducted two case-control studies, where the cases (n = 198) had either of the two diseases, and controls (n = 312) were disease-free women. For the COMT gene, we selected the G/A nonsynonymous single-nucleotide polymorphism (SNP) that leads to valine-to-methionine (Val/Met) substitution. For the CYP1A1 gene, we used a functional T/C SNP in the 3′-noncoding region, and we genotyped a T/ C functional SNP in the 5′ region of the CYP17 gene for the present study. Hardy-Weinberg equilibrium was checked in both cases and controls. Logistic regression models were used to evaluate the genetic effect, with adjustment for other covariates. RESULTS: We found that the homozygous COMT genotype that encodes low enzyme activity had an increased risk for adenomyosis with an age-adjusted odds ratio of 3.2 (95% confidence interval 1.3-7.8; P = 0.006). The COMT gene, however, was not associated with endometriosis. Neither the CYP1A1 nor CYP17 genes had any significant association with either of the two diseases. CONCLUSION: The COMT gene significantly influences the risk of adenomyosis but not endometriosis. The present study does not provide evidence to support any of the three genes exerting pleiotropic effects on both diseases.
PMID: 16527884 [PubMed – as supplied by publisher]
J Minim Invasive Gynecol. 2006 Mar-Apr;13(2):164-5.
Laparoscopic approach to an endometriotic vault fistula causing posthysterectomy "menstruation".
Oliver R, Coker A, Khoo D.
Department of Obstetrics and Gynaecology, Harold Wood Hospital, Romford, United Kingdom. oliverreebs@aol.com
Endometriosis is a commonly prevalent disease but can include rare complaints posing a challenge to surgical treatment. We describe an unreported cause of menstruation after hysterectomy, which was revealed as an endometriotic tubo-ovarian mass that fistulated into the vaginal vault. A 37-year-old woman experienced monthly vaginal bleeding after hysterectomy. At laparoscopy a tubo-ovarian endometriotic mass was revealed with a fistula into the vaginal vault. The mass was adherent to the left ureter and the sigmoid colon. Laparoscopic excision of the mass and fistula after ureterolysis and bowel dissection was performed. This case describes an unreported cause of posthysterectomy menstruation. The management outlines the optimal surgical management of laparoscopic techniques combined with vaginal access to achieve complete excision with minimal patient morbidity.
PMID: 16527722 [PubMed – in process]
J Minim Invasive Gynecol. 2006 Mar-Apr;13(2):145-9.
Efficacy of laparoscopically-assisted extracorporeal cystectomy in patients with ovarian endometrioma.
Ceyhan T, Atay V, Gungor S, Karateke A, Oral O, Baser I.
Department of Obstetrics and Gynaecology, Gulhane Military Medical Academy and Medical School, Ankara, Istanbul, Turkey. stceyhan@gata.edu.tr
STUDY OBJECTIVE: To investigate the usefulness and effectiveness of the extracorporeal surgical technique in the treatment of endometriomas. DESIGN: Retrospective evaluation (Canadian Task Force Classification II-2). SETTING: Department of gynecology in a tertiary care faculty hospital and training hospital. PATIENTS: Of 89 patients with endometrioma, 53 had laparoscopic stripping, and 36 had laparoscopically-assisted extracorporeal cystectomy. INTERVENTIONS: Laparoscopic stripping and laparoscopically-assisted extracorporeal cystectomy were performed for the treatment of endometriomas diagnosed laparoscopically. MEASUREMENTS AND MAIN RESULTS: The size of the endometrioma diagnosed by the ultrasonographic examination was not statistically related to the severity of the endometriosis (p = .42). Conversion to extracorporeal technique was required in 17 of 58 cases with moderate endometriosis and 14 of 31 cases with severe endometriosis (p = .04). Operation time, visual analogue pain score, and hospitalization periods were similar between the 2 techniques. Among 53 specimens obtained with laparoscopic stripping, 29 (55%) had no ovarian tissue, and 24 (45%) had ovarian tissue with follicles. Of 36 specimens obtained with extracorporeal technique, 19 (52%) had no ovarian tissue, and 17 (48%) had ovarian tissue with follicles. Preservation of the ovarian tissue was not significantly different between both surgical techniques. CONCLUSIONS: Extracorporeal technique with laparoscopically-assisted minilaparotomy is a valuable alternative for laparoscopic stripping in selected cases.
PMID: 16527718 [PubMed – in process]
Urology. 2006 Mar;67(3):622.e13-5.
Ureteral endometriosis in patients after total abdominal hysterectomy: presentation and diagnosis: a case series.
Pugliese JM, Peterson AC, Philbrick JH Jr, Allen RC Jr.
Department of Surgery, Madigan Army Medical Center, Tacoma, Washington, USA. jennifer.pugliese@nw.amedd.army.mil
Although ureteral endometriosis is uncommon, it is a significant disease process that can cause irreversible renal damage because of delays in diagnosis. It is even more uncommon and therefore more likely to be left out of the differential diagnosis in postmenopausal women. This case series reviewed the clinical presentation and treatment of ureteral endometriosis, as well as the history and treatment of 3 postmenopausal women who presented with ureteral obstruction secondary to ureteral endometriomas.
PMID: 16527589 [PubMed – in process]
Gynecol Oncol. 2006 Mar 6; [Epub ahead of print] Ovarian nongestational choriocarcinoma mixed with various epithelial malignancies in association with endometriosis.
Hirabayashi K, Yasuda M, Osamura RY, Hirasawa T, Murakami M.
Department of Pathology, Tokai University, School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan.
BACKGROUND: Ovarian choriocarcinoma (CC) is rarely encountered as compared to uterine CC. Furthermore, ovarian CC coexisting with surface epithelial tumor is very rare. CASE: A 50-year-old postmenopausal woman, gravida 0, was admitted to our hospital with abdominal pain and distention due to a complex ovarian tumor. The laboratory data showed high serum level of CA125, neuron specific enolase (NSE), and hCG beta-subunit C-terminal peptide (hCG-beta-CTP). Total abdominal hysterectomy, right salpingoophorectomy, and lymph node dissection were performed. The right ovary revealed a cystic tumor with two solid parts: larger part, endometrioid adenocarcinoma and small cell carcinoma; smaller part, predominantly CC and focally clear cell adenocarcinoma. CA125 was rapidly decreased after first operation, but hCG-beta-CTP levels repeated distinctive fluctuations and NSE abruptly increased during the last few months before death. The patient died 10 months after the first operation. CONCLUSION: Only four cases of ovarian nongestational CC coexisting with surface epithelial tumor have been reported. This is the first reported case of admixture of CC with three epithelial malignancies. We assume that endometrioid and clear cell adenocarcinomas arose at different sites as tumorigenic factors in association with endometriosis, and the former may have been dedifferentiated into small cell carcinoma and the latter to CC. Coexistence of CC with small cell carcinoma is considered to be responsible for relative chemoresistance leading to poor prognosis.
PMID: 16527336 [PubMed – as supplied by publisher]
J Gynecol Obstet Biol Reprod (Paris). 2006 Apr;35(2):186-90.
[Malignant transformation of abdominal wall endometriosis: a new case report.] [Article in French] Sergent F, Baron M, Le Cornec JB, Scotte M, Mace P, Marpeau L.
Clinique Gynecologique et Obstetricale.
Cancer arising in abdominal wall endometriosis is a rare event, hindering diagnosis and making management uncertain. A cesarean section scar is generally at the origin of the disease. We report the case of a 45-year-old woman, with a past medical history of cesarean deliveries, complaining of a repeat abdominal wall endometriosis which transformed into a clear-cell carcinoma. Outcome was rapidly fatal. Compared with endometriosis-associated ovarian carcinoma, the prognosis of this abdominal scar complication is poor. In the literature, survival rate reaches only 57% after a short follow-up of 20 months. Clear-cell carcinoma is the most common histological subtype, followed by endometrioid carcinoma. Radical surgery is the main treatment. Good technique and proper care during cesarean section may help in preventing this endometriosis complication.
PMID: 16575366 [PubMed – in process]
Gynecol Obstet Fertil. 2006 Mar 28; [Epub ahead of print] [Endometriosis coaching.] [Article in French] Audebert A.
IGF1, 35, rue de Turenne, 33000 Bordeaux, France.
Coaching is a well-known terminology and an approach currently used, particularly in the worlds of company management and sport, but its use in the medical field appeared only recently. In the latter field, coaching bears behavioral and psychological aspects. It can not only be intended to a medical team, but also the practionner himself, for a better management of any disease, his patient for a better treatment effect and compliance and an optimal coping with the disease. In the case of endometriosis, a chronic disease, two key aspects are briefly reviewed to illustrate the benefits of coaching and to sensitize health providers to this approach. Thus, an appropriate diagnostic strategy should allow to reduce the delay in the diagnosis, so frequently blamed, and to identify other associated painful diseases. Also, management should be improved as well, not only by applying appropriate therapeutic recommandations, and alternative measures, but also by a better multidisciplinary support towards patient expectations with long-term guidance.
PMID: 16574460 [PubMed – as supplied by publisher]
Curr Med Res Opin. 2006 Mar;22(3):495-500.
A retrospective claims database analysis to assess patterns of interstitial cystitis diagnosis.
Wu EQ, Birnbaum H, Kang YJ, Parece A, Mallett D, Taitel H, Evans RJ.
Analysis Group, Inc., Boston, MA, USA.
OBJECTIVE: Interstitial cystitis (IC) is often misdiagnosed as one of several other conditions manifesting similar symptoms. This analysis assesses the potential extent of IC misdiagnosis while considering concomitant conditions in a managed care population and identifies predictors of IC diagnosis.Research design and methods: Administrative insurance claims data covering 1.7 million lives (1999-2003) were analyzed. Insurance enrollees with >/= 1 IC diagnosis (ICD-9-CM of 595.1x) were identified as IC patients. A random sample of non-IC controls was selected using a 10:1 matching ratio. Six-month incidence rates of ‘commonly misdiagnosed conditions’, (overactive bladder, urinary tract infection, chronic pelvic pain, endometriosis, prostatitis) were compared before and after patients’ initial IC diagnosis and the reduction in incidence rate of commonly misdiagnosed conditions was used as a suggestive measure of the extent of IC misdiagnosis. The Kaplan-Meier method was used to assess the extent that commonly misdiagnosed conditions were predictors of subsequent IC. A Cox Proportional Hazards regression model (that adjusts for patient demographics, concomitant and misdiagnosed conditions) was used to estimate the hazard ratio (HR) of these conditions. Similar analyses were performed for the ‘commonly concomitant conditions’ (fibromyalgia, irritable bowel syndrome, vulvodynia).RESULTS: There were 992 IC patients and 9920 controls identified. The reduced incidence of commonly misdiagnosed conditions after initial IC diagnosis suggests that the misdiagnosis rate could be as high as 38% within the 6-month period before initial IC diagnosis.CONCLUSIONS: Diagnoses of commonly misdiagnosed conditions are significant predictors of future IC diagnosis. When overlooked, potential misdiagnosis of IC can lead to underestimation of the true prevalence of IC. Similarly, diagnoses of commonly concomitant conditions are significant predictors of future IC diagnosis. These initial findings based on claims data suggest hypotheses for further investigation with clinical data. These results suggest more consideration of IC as a diagnosis is warranted, especially when certain diagnoses are repeatedly made and the resulting treatments do not alleviate the patient’s symptoms.
PMID: 16574033 [PubMed – in process]
Br J Health Psychol. 2005 Nov;10(Part 4):589-599.
A 12-month follow-up study of self-management training for people with chronic disease: Are changes maintained over time?
Barlow JH, Wright CC, Turner AP, Bancroft GV.
School of Health and Social Sciences, Coventry University, UK.
OBJECTIVE: A previous study reported some improved outcomes at 4-month follow-up after attendance on a lay-led, chronic disease self-management course (CDSMC). The purpose of this study was to determine whether changes were maintained over time (i.e. at 12 months) and to describe participants’ current use of self-management techniques. DESIGN: The study was a 12-month follow-up of a sample of 171 participants who attended a CDSMC in the UK. METHOD: Data were collected by self-administered questionnaires mailed to participants 12 months after they commenced a CDSMC and via telephone interviews with a sub-sample. RESULTS: The sample had a mean age of 54 years, mean disease duration of 16 years, 73% were women, and chronic diseases included endometriosis, depression, diabetes, myalgic encephalomyelitis, osteoporosis and polio. The significant improvements in outcomes identified at 4 months (i.e. cognitive symptom management, self-efficacy, communication with physician, fatigue, anxious and depressed moods and health distress) were sustained at 12 months. No significant changes between 4- and 12-month assessments were found on any study variables. Interview data confirmed that participants continued to use some of the self-management techniques learned on the course. CONCLUSION: Attendance on the CDSMC may lead to longer-term changes in key outcomes such as self-efficacy, use of some self-management behaviours and some aspects of health status (e.g. fatigue, depressed mood).
PMID: 16573947 [PubMed – as supplied by publisher]
Biol Reprod. 2006 Mar 29; [Epub ahead of print] Statins Inhibit Growth of Human Endometrial Stromal Cells Independently of Cholesterol Availability.
Piotrowski PC, Kwintkiewicz J, Rzepczynska IJ, Seval Y, Cakmak H, Arici A, Duleba AJ.
Endometriosis is characterized by ectopic growth of endometrial tissues. Statins, inhibitors of 3-hydroxy-3methylglutaryl-Coenzyme A reductase (HMGCR), have been shown to decrease proliferation of several mesenchymal tissues. Actions of statins may be related to decreased availability of cholesterol as well as intermediate metabolites of the mevalonate pathway downstream of HMGCR. This study was designed to evaluate effects of statins on growth of endometrial stromal cells and to investigate mechanisms of these effects. Human endometrial stromal cells were cultured in the absence and in the presence of serum and with or without mevastatin and simvastatin. DNA synthesis and viable cell numbers were determined. Effects of statins were also evaluated in the presence of mevalonate and squalene. Furthermore, effects on phosphorylation of mitogen-activated protein kinase 3/1 (MAPK3/1) (also known as extracellular signal-regulated kinase, ERK1/2) were determined. Mevastatin and simvastatin induced a concentration-dependent inhibition of DNA synthesis and viable cell count in chemically defined media and in the presence of serum. Mevalonate, but not squalene, abrogated inhibitory effects of statins on cell proliferation. Statins inhibited MAPK3/1 phosphorylation. This is the first study demonstrating that statins inhibit growth of endometrial stromal cells. This effect is also demonstrable in the presence of a supply of cholesterol and may be related to decreased activation of MAPK3/1. The present observations may be relevant to potential therapeutic use of statins in conditions such as endometriosis.
PMID: 16571871 [PubMed – as supplied by publisher]
Reprod Biomed Online. 2006 Mar;12(3):347-53.
Laparoscopic evaluation of infertile patients with chronic pelvic pain.
Milingos S, Protopapas A, Kallipolitis G, Drakakis P, Makrigiannakis A, Liapi A, Milingos D, Antsaklis A, Michalas S.
1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Athens, Greece.
In this study over a 10-year period, 1584 patients complaining of infertility of more than 1 year duration were evaluated for their laparoscopic findings in relation to the presence or not of chronic pelvic pain (CPP). Infertility was the only complaint in 1215 cases (group 1), whereas 369 patients complained of infertility and CPP (group 2). All cases underwent routine infertility investigation and pelvic ultrasonography, followed by diagnostic laparoscopy, with infertility-only cases acting as a control group. At laparoscopy 76.7% of patients with CPP were found with pelvic pathology, compared with only 42.6% of cases without CPP (P < or = 0.0001). Omental-abdominal wall adhesions, advanced endometriosis, endometriomas with adhesions, pelvic venous congestion, and hydrosalpinges with pelvic adhesions were significantly more frequent in cases with CPP. Dysmenorrhoea was the most frequent type of CPP. Cases with CPP and a negative laparoscopy were further investigated using a multidisciplinary approach. In conclusion, chronic pelvic pain can be the result of several pelvic pathologies. Infertile patients with CPP are much more frequently found with an abnormal pelvis in comparison with cases without CPP. Laparoscopy is an invaluable diagnostic tool especially for symptomatic patients and should be used early in their diagnostic infertility work-up.
PMID: 16569325 [PubMed – in process]
J Trauma Stress. 2006 Mar 27;19(1):45-56 [Epub ahead of print] PTSD and physical comorbidity among women receiving Medicaid: Results from service-use data*
Seng JS, Clark MK, McCarthy AM, Ronis DL.
University of Michigan Institute for Research on Women and Gender, School of Nursing, and Department of Obstetrics and Gynecology.
Patterns of physical comorbidity among women with posttraumatic stress disorder (PTSD) were explored using Michigan Medicaid claims data. PTSD-diagnosed women (n = 2,133) were compared with 14,948 randomly selected women in three health outcome areas: ICD-9 categories of disease, chronic conditions associated with sexual assault history in previous research, and reproductive health conditions. PTSD was associated with increased risk of all categories of diseases (OR range = 1.3-4.8), endometriosis (OR = 2.7), and dyspareunia (OR = 3.4). When PTSD was not complicated by other mental health conditions, odds ratios for chronic conditions ranged from 1.9 for fibromyalgia to 4.3 for irritable bowel. Comorbidity with depression or a dissociative or borderline personality disorder raised risk in a dose-response pattern.
PMID: 16568470 [PubMed – as supplied by publisher]
Fertil Steril. 2006 Mar 25; [Epub ahead of print] Expression of aromatase (P450 aromatase/CYP19) in peritoneal and ovarian endometriotic tissues and deep endometriotic (adenomyotic) nodules of the rectovaginal septum.
Heilier JF, Donnez O, Van Kerckhove V, Lison D, Donnez J.
Industrial Toxicology and Occupational Medicine Unit, Universite catholique de Louvain.
We found, by reverse transcription-real time-polymerase chain reaction, that the expression of aromatase (CYP19) in ovarian, peritoneal endometriosis, and deep endometriotic nodules is significantly different, which strengthens the theory of three distinct clinical entities. Compared with peritoneal endometriosis, ovarian endometriosis exhibits an 8-fold higher expression of aromatase, which suggests that aromatase inhibitors may be particularly active in this form of endometriosis.
PMID: 16566930 [PubMed – as supplied by publisher]
Ginekol Pol. 2005 Nov;76(11):902-5.
[Didelphic uterus coexisting with bladder extrophy] [Article in Polish] Wrobeld A, Stepnik D, Bar K, Rechberger T.
II Katedra i Klinika Ginekologii AM w Lublinie.
Congenital anomalies of structures originating from Mullerian ducts are important gynecological problem. They often coexist with malformations of urinary tract. In this report we describe the case of 31 year old women with didelphus and bladder extrophy. The surgical treatment consisted on transabdominal total hysterectomy due to endometriosis IV (rAFS) narrowing ureteroenterostomy.
PMID: 16566366 [PubMed – in process]
Hum Reprod Update. 2006 Mar 24; [Epub ahead of print] The reproductive significance of human Fallopian tube cilia.
Lyons RA, Saridogan E, Djahanbakhch O.
Academic Department of Obstetrics and Gynaecology, St. Bartholomew’s and The Royal London Hospital School of Medicine and Dentistry, Whitechapel.
Effective tubal transport of ova, sperm and embryos is a prerequisite for successful spontaneous pregnancy. Although there is much yet to be discovered about the mechanisms involved, it is evident that tubal transit is a far more complicated process than initially thought. Propulsion of gametes and embryos is achieved by complex interaction between muscle contractions, ciliary activity and the flow of tubal secretions. Evidence is accumulating of the important and possibly pre-eminent role of ciliary motion in this process; and this review describes current knowledge about ciliary activity and its physiological regulation. There is also a description of the effects on ciliary function of cigarette smoking and various pathological states, including endometriosis and microbial infection, with consideration given as to how altered ciliary activity may impact upon fertility.
PMID: 16565155 [PubMed – as supplied by publisher]
Acta Histochem. 2006 Mar 23; [Epub ahead of print] Human growth hormone and interleukin-6 are upregulated in endometriosis and endometrioid adenocarcinoma.
Slater M, Cooper M, Murphy CR.
Department of Anatomy and Histology, School of Medical Sciences, Anderson Stuart Building F13, The University of Sydney, NSW, Australia; Department of Endoscopic Surgery, King George V Hospital, Sydney, NSW, Australia.
In this retrospective and quantitated study on banked tissue we found that, compared to normal uterine epithelial cells, growth hormone (GH) is increased 3.4-fold in endometriosis and 3.8-fold in endometrial adenocarcinoma. Similarly, interleukin-6 (IL-6) is increased 2.4-fold in endometriosis and 4.4-fold in endometrial adenocarcinoma. These proteins appear to be involved in the progression of both these conditions. GH is particularly interesting in this context since it is known to not only promote cellular proliferation but also reduces cell-cell adhesion, thus allowing individual cells to break away from their parent architecture. Our results suggest that both IL-6 and GH may play a role in the progression of both endometriosis and endometrial carcinoma.
PMID: 16564564 [PubMed – as supplied by publisher]
Best Pract Res Clin Obstet Gynaecol. 2006 Mar 22; [Epub ahead of print] Adenomyosis: the pathophysiology of an oestrogen-dependent disease.
Kitawaki J.
Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.
Adenomyosis uteri is a common gynaecological disorder that is characterized by the presence of ectopic endometrial glands and stroma in the myometrium. Although adenomyosis and endometriosis are different diseases, both of them grow and regress in an oestrogen-dependent fashion. Polymorphisms in the oestrogen receptor alpha gene are associated with a risk of adenomyosis. Adenomyotic tissue contains steroid receptors as well as aromatase and sulphatase enzymes. Together with the circulating oestrogen, locally produced oestrogens stimulate the growth of tissue mediated by the oestrogen receptors. Oestrogen metabolism, including the expression pattern of aromatase and the regulation of 17beta-hydroxysteroid dehydrogenase type 2 is altered in the eutopic endometrium of women with endometriosis, adenomyosis, and/or leiomyomas compared to that in the eutopic endometrium of women without disease. In addition to the conventional hormonal treatment with gonadotropin-releasing hormone agonists and danazol, the use of steroid-releasing intrauterine devices may be applicable to clinics.
PMID: 16564227 [PubMed – as supplied by publisher]
Mol Endocrinol. 2006 Mar 23; [Epub ahead of print] Estrogen receptor-{beta}: Recent lessons from in vivo studies.
Harris HA.
Women’s Health and Musculoskeletal Biology, Wyeth Research, Collegeville PA 19426.
The unexpected discovery of a second form of the estrogen receptor (ER) designated ERbeta, surprised and energized the field of estrogen research. In the nine years since its identification, the remarkable efforts from academic and industrial scientists of many disciplines have made significant progress in elucidating its biology. A powerful battery of tools including knockout mice as well as a panel of receptor selective agonists have allowed an investigation into the role of ERbeta. To date, in vivo efficacy studies are limited to rodents. Current data indicate that ERbeta plays a minor role in mediating estrogen action in the uterus, on the hypothalamus/pituitary, the skeleton and other classic estrogen target tissues. However, a clear role for ERbeta has been established in the ovary, cardiovascular system, and brain as well as in several animal models of inflammation including arthritis, endometriosis, inflammatory bowel disease and sepsis. The next phase of research will focus on elucidating, at a molecular level, how ERbeta exerts these diverse effects and exploring the clinical utility of ERbeta selective agonists.
PMID: 16556737 [PubMed – as supplied by publisher]
Hum Reprod. 2006 Mar 23; [Epub ahead of print] Homocysteine, glutathione and related thiols affect fertility parameters in the (sub)fertile couple.
Ebisch IM, Peters WH, Thomas CM, Wetzels AM, Peer PG, Steegers-Theunissen RP.
Department of Obstetrics and Gynecology; Department of Epidemiology and Biostatistics; Department of Chemical Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen.
BACKGROUND: Thiols are scavengers of reactive oxygen species (ROS). We aim to investigate associations between thiols in various fluids in (sub)fertile couples and fertility outcome parameters. METHODS: In 156 couples undergoing assisted reproduction techniques (ART), we measured the concentrations of glutathione (GSH), cysteine (Cys), homo-cysteine (Hcy) and cysteinylglycine (CGS) and fertility outcome parameters in the ejaculate, purified spermatozoa and follicular fluid. RESULTS: All thiols were detectable in most ejaculates, spermatozoa and follicular fluids, of which Cys concentrations were highest. Thiol concentrations in the ejaculate were similar in fertile and subfertile men. However, Hcy in follicular fluid was higher in women with endometriosis compared with women in the idiopathic subfertile group (P = 0.04). The GSH, Cys, Hcy and CGS concentrations in spermatozoa of subfertile men were significantly higher compared with men in the idiopathic subfertile group and fertile men (P < 0.001). Most notably, Hcy concentrations in both the ejaculate and follicular fluid were negatively associated with embryo quality on culture day 3 in the IVF/ICSI procedure. CONCLUSIONS: Spermatozoa of subfertile men contain significantly higher thiol concentrations as compared with those of fertile men. The detrimental effect on embryo quality of a high Hcy concentration in the ejaculate and in follicular fluid is intriguing and may suggest that Hcy is inversely associated with fertility outcome.
PMID: 16556671 [PubMed – as supplied by publisher]
AJR Am J Roentgenol. 2006 Apr;186(4):1039-45.
CT and MRI of Adnexal Masses in Patients with Primary Nonovarian Malignancy.
Chang WC, Meux MD, Yeh BM, Qayyum A, Joe BN, Chen LM, Coakley FV.
Department of Radiology, University of California San Francisco, Box 0628, M-372 505 Parnassus Ave., San Francisco, CA 94143-0628.
OBJECTIVE: The purpose of this pictorial essay is to review the differential considerations when an adnexal mass is detected on CT or MRI in a patient with a primary nonovarian malignancy. CONCLUSION: Such adnexal masses may be metastases to the ovaries, primary ovarian malignancy, or incidental benign disorders. Solid masses are more likely metastases, but metastases can be predominantly cystic and primary ovarian cancers can be solid. MRI may help characterize incidental benign entities such as endometriosis, fibroma, and peritoneal inclusion cysts.
PMID: 16554576 [PubMed – in process]
Acta Obstet Gynecol Scand. 2006;85(3):336-42.
Increased ENA-78 in the follicular fluid of patients with endometriosis.
Wunder DM, Mueller MD, Birkhauser MH, Bersinger NA.
Department of Obstetrics and Gynaecology, University of Berne, Switzerland. dorothea.wunder@insel.ch
BACKGROUND: It is known that endometriosis is an inflammatory disease and those patients seem to have lower pregnancy rates. The aim of the study was to investigate the concentrations of chemokines and proinflammatory cytokines in the follicular fluid of patients with and without endometriosis. METHODS: Follicular aspiration, recovering follicular fluid during assisted reproductive treatment, follicular fluid storage and analysis of chemokines and proinflammatory cytokines were carried out. Tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, interleukin-8, interleukin-15, leukemia inhibitory factor, epithelial neutrophil-activating peptide 78, regulated upon activation, normal T-cell expressed and secreted, and growth-regulated oncogene-alpha were analyzed in the follicular fluid and compared between women with (n =47) and without endometriosis (n = 279). RESULTS: The above cytokines were detected in the follicular fluid samples. Epithelial neutrophil-activating peptide 78 levels were significantly higher in follicular fluid from endometriosis patients than from controls (p = 0.008). Increases (to twice the control level) were also observed for tumor necrosis factor-alpha and for interleukin-6. CONCLUSIONS: Increased follicular fluid levels of epithelial neutrophil-activating peptide 78, tumor necrosis factor-alpha and interleukin-6 indicate that these cytokines may influence oocyte quality and fecundability of women with endometriosis by deteriorating the microenvironment in the human follicle.
PMID: 16553183 [PubMed – in process]
Hum Reprod. 2006 Apr;21(4):1101-2.
Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging.
Bazot M, Fiori O, Darai E.
Departments of Radiology and Obstetrics and Gynecology, Hopital Tenon, Paris, France.
PMID: 16552093 [PubMed – in process]
Radiographics. 2006 Mar-Apr;26(2):407-17.
Malignant transformation of pelvic endometriosis: MR imaging findings and pathologic correlation.
Takeuchi M, Matsuzaki K, Uehara H, Nishitani H.
Department of Radiology, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan. mayumi@clin.med.tokushima-u.ac.jp
Malignant transformation is a rare complication of endometriosis. Endometriosis-associated ovarian cancers are seen more often in younger women than are ovarian cancers without endometriosis, and early detection is important to improve the prognosis and preserve fertility. However, normal decidual change of the ectopic endometrium in an endometrioma during pregnancy must be differentiated from malignant transformation. The finding that is most important for a diagnosis of malignant change is the presence of one or more contrast material-enhanced mural nodules within a cystic mass at magnetic resonance (MR) imaging. Dynamic subtraction MR imaging is useful in depicting small contrast-enhanced nodules within the hyperintense endometrioma on T1-weighted images. Intracystic coagulate may mimic a mural nodule; the absence of contrast enhancement is the diagnostic clue to its benignity. Enlargement of the endometrioma and the disappearance of shading within the mass on T2-weighted images are suggestive of malignant transformation. (c) RSNA, 2006.

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