-
Akira Iwase,
Tomomi Kotani,
Maki Goto,
Hiroharu Kobayashi,
Sachiko Takikawa,
Tatsuo Nakahara,
Tomoko Nakamura,
Mika Kondo,
Bayasula,
Yoshinari Nagatomo,
Fumitaka Kikkawa
[show abstract]
[hide abstract]
ABSTRACT: A reduced response to progesterone in the eutopic endometrium with endometriosis and in endometriotic tissues is considered to be the underlying factor for endometriosis. CD10 is known to be expressed by endometrial and endometriotic stromal cells and may be induced by progestins, although the function of CD10 is not fully revealed in endometrial or endometriotic tissues. In the current study, the expression of CD10 was significantly increased by treatment of the cells with progesterone, 17β-estradiol, and dibutyryl cyclic adenosine monophosphate (cAMP) in the endometrial stromal cells. On the other hand, the expression of CD10 following treatment with progesterone, 17β-estradiol, and dibutyryl cAMP was not significantly increased in endometriotic stromal cells. The adhesion assay for endometrial and endometriotic stromal cells to hyaluronan using 5- or 6-(N-succinimidyloxycarbonyl)-fluorescein 3', 6'-diacetate-labeled cells demonstrated that the CD44-dependent adhesion of stromal cells was inhibited by CD10. As far as the induction of CD10 is concerned, the effect of progesterone was different between endometrial stromal cells and endometriotic stromal cells. CD10 might be involved in the development of endometriosis due to its influence on CD44-dependent cell adhesion.
Reproductive sciences (Thousand Oaks, Calif.) 05/2013; · 2.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: To investigate whether the serum antimüllerian hormone (AMH) levels recover within 1 year after cystectomy for endometriomas, and to analyze the pattern of sequential changes in the serum AMH levels. DESIGN: Prospective study. SETTING: University hospital. PATIENT(S): Thirty-nine patients undergoing cystectomy for unilateral endometrioma (n = 22) and bilateral endometriomas (n = 17). INTERVENTION(S): Serum samples collected 2 weeks before, and 1 month and 1 year after surgery were assayed for AMH levels. MAIN OUTCOME MEASURE(S): Assessment of the ovarian reserve damage based on alterations in the serum AMH levels and the association with parameters of endometriosis and surgery for endometriomas. RESULT(S): The median AMH levels were 3.56, 1.90, and 2.10 ng/mL before, 1 month after, and 1 year after surgery, respectively. Twenty patients showed higher AMH levels 1 year after surgery than 1 month after surgery (increase group); 19 patients showed lower AMH levels (decrease group). We found a statistically significant difference in the number of follicles removed by surgery between the two groups. CONCLUSION(S): The decrease in the serum AMH levels caused by cystectomy can recover. Our results suggest that removal of ovarian cortex might be involved in the decrease of the ovarian reserve just after surgery, and that a continuous decrease of the ovarian reserve after cystectomy might be attributed to other mechanisms.
Fertility and sterility 04/2013; · 3.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Abstract With proper and careful selection of patients, fertility-preserving surgery may be feasible in patients with ovarian malignancies. However, the loss of follicles by oophorectomy and chemotherapy results in decreased ovarian reserve, which consecutively affects reproductive capacity. We evaluated postoperative levels of serum anti-Müllerian hormone (AMH) in women with ovarian malignancies to assess the impact of the fertility-preserving surgery with or without the administration of chemotherapy on ovarian reserve. In 13 patients who underwent the fertility-preserving surgery with (n = 9) or without (n = 4) the administration of chemotherapy, serum AMH levels were measured and compared with serum AMH levels measured in patients undergone cystectomy for benign ovarian tumors as a control. We found that the mean AMH level in the treatment group measured 0.9 ng/mL, which was significantly lower than that measured in the control group (4.70 ± 3.77 ng/mL). The possibility of decreased ovarian reserve occurring in patients with ovarian malignancies following treatment with fertility-preserving surgery with or without the administration of chemotherapy should be considered for fertility planning.
Gynecological Endocrinology 01/2013; · 1.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: The loss of primordial follicles from gonadal damage caused by chemotherapy results in decreased ovarian reserve. To assess the impact of chemotherapy for patients with gestational trophoblastic neoplasia (GTN) on the ovarian reserve, we evaluated the post-chemotherapy serum anti-Müllerian hormone (AMH) levels. STUDY DESIGN: In 22 patients with GTN receiving chemotherapy, serum AMH levels were measured after the administration of chemotherapy and compared with serum AMH levels measured in patients with hydatidiform mole who did not receive chemotherapy, as a control. We also analyzed differences in the serum AMH levels following the administration of different anti-cancer agents. RESULTS: The serum AMH levels measured in the GTN group after chemotherapy was administered (median 1.18, range 0.32-3.94ng/mL) significantly decreased in comparison to those measured in the control group (median 4.22, range 0.77-6.53ng/mL, P=0.002). Serum AMH levels were significantly lower in the patients who had received a regimen including etoposide than in the patients who had not received treatment with etoposide (0.71 vs. 1.30ng/mL, P=0.027). CONCLUSION: Our results suggest that chemotherapy administered to treat GTN does indeed affect the ovarian reserve, especially in patients who receive a medication regimen that includes etoposide. Measuring their serum AMH levels might therefore be helpful for counseling GTN patients regarding their ovarian reserve.
European journal of obstetrics, gynecology, and reproductive biology 12/2012; · 1.97 Impact Factor
-
Archives of Gynecology 09/2012; · 0.91 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Background aims. Mesenchymal stromal cells (MSC) can be isolated from the perivascular connective tissue of umbilical cords, called Wharton's jelly. These human umbilical cord perivascular cells (HUCPVC) might provide therapeutic benefits when treating skeletal or cutaneous malformations in neonatal patients. Methods. HUCPVC were isolated, and their proliferation rate, marker expression and multilineage differentiation potential determined. HUCPVC or their conditioned medium (HUCPVC-CM) was injected into the excisional wound of a mouse splinted-wound model. The effects of the treatment on wound closure were examined by morphohistochemical and gene expression analyses. Results. HUCPVC expressed typical MSC markers and could differentiate into osteoblastic and adipogenic lineages. HUCPVC transplanted into the mouse wound accelerated wound closure. Immunohistologic analysis showed that the HUCPVC accelerated wound healing by enhancing collagen deposition and angiogenesis via paracrine mechanisms. Furthermore, treatment with HUCPVC-CM alone significantly enhanced wound closure. HUCPVC-CM increased the number of anti-inflammatory M2 macrophages expressing resistin-like molecule (RELM)-α/CD11b and promoted neovessel maturation. Quantitative polymerase chain reaction (PCR) analysis showed that HUCPVC-CM increased the expression of tissue-repairing cytokines interleukin (IL)-10, transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF)-1 and angiopoietin-1 at the healing wound. Conclusions. Our results show that HUCPVC promotes wound healing via multifaceted paracrine mechanisms. Together with their ability to differentiate into the osteogenic linage, HUCPVC may provide significant therapeutic benefits for treating wounds in neonatal patients.
Cytotherapy 08/2012; 14(10):1171-81. · 3.63 Impact Factor
-
Tatsuo Nakahara, Akira Iwase,
Tomoko Nakamura,
Mika Kondo,
Bayasula,
Hiroharu Kobayashi,
Sachiko Takikawa,
Shuichi Manabe,
Maki Goto,
Tomomi Kotani,
Fumitaka Kikkawa
[show abstract]
[hide abstract]
ABSTRACT: To investigate the protective effect of sphingosine-1-phosphate (S1P) against H(2)O(2)-induced apoptosis in human granulosa cell cultures with freshly harvested granulosa cells.
Experimental study.
Academic medical center for reproductive medicine.
Cultures of primary granulosa cells isolated from women undergoing in vitro fertilization (IVF).
None.
Cell apoptosis and Western blot analysis of signaling pathway proteins.
We found that S1P (1 and 10 mM) statistically significantly decreased granulosa cell apoptosis after H(2)O(2) treatment. The decreased cell apoptosis induced by S1P was abolished after treatment with VPC23019, an inhibitor of S1P1 and S1P3 receptors, W146, an inhibitor of S1P1 receptors, and CAY10444, an inhibitor of S1P3 receptors. A Western blot analysis revealed that the level of phospho-Akt increased and peaked at 10 minutes after 10 mM S1P exposure.
Treatment with S1P can inhibit the apoptosis of granulosa cells in response to oxidative stress induced by H(2)O(2). The protective effect of S1P is mediated by activating the PI3K/Akt pathway, and the antiapoptotic effect of S1P is mainly mediated through the S1P1 and S1P3 receptor.
Fertility and sterility 07/2012; 98(4):1001-1008.e1. · 3.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PurposeSupport both from medical centers and from local government is indispensable to the growing number of infertile couples who
are seeking treatment after advances in medical technology.
MethodsA self-administered questionnaire survey of the demand for infertility support was conducted among those who attended a public
lecture offered by Aichi Prefecture, asking specifically about their requests for Aichi Prefectural government aid.
ResultsThe survey results indicated that information was obtained about financial support by administrative and infertility support
programs in Aichi Prefecture. Because most people usually received this information at medical institutions, local government
coordinated with medical institutions. Men and women were found to have different demands for infertility support—while women
typically sought psychological support, for example counseling, men usually sought learning opportunities in study groups.
In particular, women sought opportunities to interact with interested parties, which suggested that the establishment of peer
activities would be a helpful form of support.
ConclusionsWe need collaboration of government services with medical institutions, support, and investigation to form an infertility
network that accepts sex differences.
KeywordsConsultation-Gender-Infertile couples-Infertility support-Local government
Reproductive Medicine and Biology 04/2012; 9(3):145-150.
-
Bayasula, Akira Iwase,
Tohru Kiyono,
Sachiko Takikawa,
Maki Goto,
Tomoko Nakamura,
Yoshinari Nagatomo,
Tatsuo Nakahara,
Tomomi Kotani,
Hiroharu Kobayashi,
Mika Kondo,
Shuichi Manabe,
Fumitaka Kikkawa
[show abstract]
[hide abstract]
ABSTRACT: The ovary is a complex endocrine organ responsible for steroidogenesis and folliculogenesis. Follicles consist of oocytes and two primary steroidogenic cell types, the granulosa cells, and the theca cells. Immortalized human granulosa cells are essential for researching the mechanism of steroidogenesis and folliculogenesis. We obtained granulosa cells from a 35-yr-old female and immortalized them by lentivirus-mediated transfer of several genes so as to establish a human nonluteinized granulosa cell line (HGrC1). We subsequently characterized HGrC1 and investigated its steroidogenic performance. HGrC1 expressed enzymes related to steroidogenesis, such as steroidogenic acute regulatory protein, CYP11A, aromatase, and gonadotropin receptors. Stimulation with FSH increased the mRNA levels of aromatase, which consequently induced the aromatization of androstenedione to estradiol. Activin A increased the mRNA levels of the FSH receptor, which were synergistically up-regulated with FSH stimulation. HGrC1 also expressed a series of ligands and receptors belonging to the TGF-β superfamily. A Western blot analysis showed that bone morphogenetic protein (BMP)-4, BMP-6, and BMP-7 phosphorylated small mother against decapentaplegic (Smad)1/5/8, whereas growth differentiation factor-9 phosphorylated Smad2/3. BMP-15 and anti-Müllerian hormone phosphorylated Smad1/5/8 while also weakly phosphorylating Smad2/3. These results indicate that HGrC1 may possess the characteristics of granulosa cells belonging to follicles in the early stage. HGrC1 might also be capable of displaying the growth transition from a gonadotropin-independent status to gonadotropin-dependent one.
Endocrinology 03/2012; 153(6):2851-60. · 4.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Endoglin is a coreceptor for TGF-β, which is expressed in syncytiotrophoblasts. The soluble form of endoglin (sEng) has been observed to increase in the serum of preeclamptic patients. Several studies have shown that endoglin is involved in cancer invasion. However, the role of endoglin in extravillous trophoblasts (EVT), which have an invasive phenotype, remains unknown. The present study was designed to investigate the expression and role of endoglin in human EVT. We found that endoglin was mainly expressed on cytotrophoblasts within the cell column during the first trimester and its expression decreased in the EVT by immunohistochemistry and immunocytochemistry. The expression of endoglin significantly increased after treatment with TGF-β1 and TGF-β3 in the human EVT cell line, HTR-8/SVneo, as detected by semiquantitative RT-PCR. To investigate the role of endoglin in EVT, the stable knockdown of endoglin was performed by lentiviral short hairpin RNA transfection into the HTR-8/SVneo cells. Although proliferation was not affected, the motility and invasiveness of the HTR-8/SVneo cells significantly increased by the knockdown of endoglin. Both the mRNA expression and secretion of urokinase-type plasminogen activator significantly increased in endoglin knockdown cells. The secretion of sEng was very low in HTR-8/SVneo, and the treatment of endoglin knockdown cells with 10 ng/ml sEng had no effect on their invasiveness. Therefore, the suppression of sEng was not involved in the increased invasiveness of endoglin knockdown cells. These results suggested that EVT increased their invasive function as a result of decreasing expression of transmembrane endoglin.
Endocrinology 09/2011; 152(11):4386-94. · 4.46 Impact Factor
-
Shuichi Manabe, Akira Iwase,
Maki Goto,
Hiroharu Kobayashi,
Sachiko Takikawa,
Yoshinari Nagatomo,
Tatsuo Nakahara,
Bayasula,
Tomoko Nakamura,
Wakana Hirokawa,
Fumitaka Kikkawa
[show abstract]
[hide abstract]
ABSTRACT: Inflammatory mediators, including chemokines, may play crucial roles in the development of endometriosis. Therefore, we investigated the expression and localization of CXCL16 and its receptor, CXCR6, in ovarian endometriotic tissues. We also examined whether CXCL16 induces IL-8 production in endometriotic stromal cells.
We performed immunohistochemical and Western blotting analyses of in vivo and in vitro samples. IL-8 production was assayed using an ELISA.
Both CXCL16 and CXCR6 were expressed by endometriotic epithelial cells and stromal cells, but not normal ovarian stroma. A Western blotting analysis using primary cultured endometriotic stromal cells showed a constant expression of CXCL16 and CXCR6 in the proliferative phase, secretory phase and during gonadotropin-releasing hormone agonist therapy. CXCL16 induced IL-8 production in several endometriotic stromal cells in vitro.
CXCL16 and CXCR6 might be involved in the pathophysiology of endometriosis through regulation of the inflammatory response.
Archives of Gynecology 07/2011; 284(6):1567-72. · 0.91 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND To assess the impact of ovarian cystectomy for endometriomas on the ovarian reserve, we evaluated the pre- and post-operative levels of serum anti-Müllerian hormone (AMH). We also analyzed the correlations between factors related to endometriosis and surgery for endometriomas and the serum AMH levels to investigate which factors affect ovarian reserve. METHODS Thirty-eight patients who were undergoing ovarian cystectomy for unilateral endometrioma (n = 20) and bilateral endometriomas (n = 18) participated. Preoperative and post-operative serum samples were collected and assayed for AMH levels, and changes between the two samples were analyzed in association with parameters of endometriosis and surgery for endometriomas. RESULTS The mean AMH level was 3.9 ng/ml prior to surgery, and was reduced to 2.1 ng/ml at 1 month post-surgery. The rate of decline of the serum AMH level was significantly higher in the bilateral group than the unilateral group (62.8 ± 29.6 versus 24.7 ± 32.5%, P < 0.001). The rate of decline in the serum AMH levels showed a significant correlation to the revised American Society for Reproductive Medicine (rASRM) score (P = 0.003), but not age, cyst diameter, blood loss during the operation or the number of follicles removed in the specimens. CONCLUSIONS Our results suggest that the decrease in ovarian reserve should be taken into account in patients indicated for cystectomy for bilateral endometriomas or unilateral endometrioma with high rASRM scores.
Human Reproduction 02/2011; 26(4):904-10. · 4.47 Impact Factor
-
Akira Iwase,
Maki Goto,
Shuichi Manabe,
Wakana Hirokawa,
Hiroharu Kobayashi,
Tatsuo Nakahara,
Sachiko Takikawa,
Tomomi Kotani,
Seiji Sumigama,
Hiroyuki Tsuda,
Takayuki Nakayama,
Nobuaki Suzuki,
Tadashi Matsushita,
Fumitaka Kikkawa
[show abstract]
[hide abstract]
ABSTRACT: To report the case of a patient with factor V deficiency who achieved pregnancy with the planned transfusion of fresh frozen plasma (FFP) while monitoring follicle development and ovulation induction using gonadotropin.
Case report.
University hospital.
A 28-year-old nulliparous female.
Medical management including infertility treatment.
Clinical follow-up.
A patient with factor V deficiency experienced repeated ovulation-related hemoperitoneum following the withdrawal of oral contraceptive pills. The monitoring of follicle development and ovulation induction using gonadotropin followed by FFP transfusion was useful to avoid hemoperitoneum. Pregnancy was achieved within a relatively short period using intrauterine insemination.
Planned prophylactic FFP administration and intervention with infertility treatment might be useful to minimize the risk of ovulation-related hemoperitoneum in patients with factor V deficiency.
Fertility and sterility 02/2011; 95(6):2124.e5-7. · 3.97 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the impact of laparoscopic surgery on ovarian reserve, we evaluated pre- and postoperative levels of serum anti-Müllerian hormone (AMH) in comparison with basal levels of FSH. The median AMH level was 2.98 ng/mL and 3.92 ng/mL before operation and was significantly reduced to a median level of 2.24 ng/mL and 3.29 ng/mL at 1 month after operation in the endometrioma group (n = 29) and the nonendometrioma group (n = 21), respectively, whereas postoperative basal FSH levels did not significantly change in comparison with preoperative levels.
Fertility and sterility 12/2010; 94(7):2846-9. · 3.97 Impact Factor
-
Tatsuo Nakahara, Akira Iwase,
Maki Goto,
Toko Harata,
Miyabi Suzuki,
Miki Ienaga,
Harumi Kobayashi,
Sachiko Takikawa,
Shuichi Manabe,
Fumitaka Kikkawa,
Hisao Ando
[show abstract]
[hide abstract]
ABSTRACT: To assess the effects of light from an integrated optical microscope and evaluate the safety of time-lapse observations using a built-in microscope incubator.
We prospectively compared the fertilization rate and embryonic morphology after intracytoplasmic sperm injection between embryos cultured with time-lapse observations every 15 min in an incubator with an integrated optical microscope and embryos with intermittent observations (once a day) in conventional incubators.
No significant differences were observed in the fertilization rate (57.5% vs. 57.5%) or the rate of excellent-good cleavage embryos (36.0% vs. 36.0%).
These results suggest that time-lapse observations using an incubator with an integrated optical microscope may therefore be safely utilized in clinical practice.
Journal of Assisted Reproduction and Genetics 02/2010; 27(2-3):93-6. · 1.84 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the correlation of intrafollicular insulin, leptin and adiponectin levels with assisted reproductive technologies (ART) outcome.
This was a retrospective study of 46 patients undergoing in vitro fertilisation/intracytoplasmic sperm injection. Follicular fluid (FF) samples collected at oocyte retrieval were assayed for insulin, leptin and adiponectin levels using enzyme-linked immunosorbent assay, and correlations with ART outcome were analysed.
There was no significant correlation between intrafollicular insulin, leptin and adiponectin levels. There was a significant difference in the concentration of insulin (P = 0.007), but not leptin or adiponectin, between pregnant (n = 20) and non-pregnant (n = 26) cycles. Only two pregnancies was observed in the 12 cycles in which the concentration of insulin was greater than 7 mU/l in FF, while 18 pregnancies was observed in the 34 cycles in which the concentration of insulin was less than 7 mU/l (P = 0.043). The significantly high concentration of insulin in FF was observed in non-pregnant cycles of patients with polycystic ovary syndrome (PCOS).
Our results suggest the possible involvement of intrafollicular insulin in folliculogenesis. Insulin resistance-related substances may affect the reproductive process in patients with PCOS.
Gynecological Endocrinology 02/2010; 26(7):494-9. · 1.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Perivascular epithelioid cell tumors (PEComa) are mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelial cells. Although the uterine corpus seems to be one of the most prevalent sites of involvement, PEComa of the uterine cervix are very rare. Only four cervical PEComa cases have been described, and were treated with hysterectomy and radiotherapy.We report a case of a 24-year-old nulligravida woman who presented with acute abdominal pain and was diagnosed with a rupture of an ovarian chocolate cyst. Subsequent surgery revealed that the tumor arose in the uterus, and the histological diagnosis was uterine PEComa with low potential malignancy. Recurrent PEComa in the uterine cervix were excised twice, and she remains disease free 12 months after the last operation. To the best of our knowledge, this is the first report of recurrent cervical PEComa with fertility-preserving surgery. Estimating the malignant potential and appropriate surgery are essential for young patients with uterine PEComa.
Rare tumors 01/2010; 2(2):e26.
-
[show abstract]
[hide abstract]
ABSTRACT: The reduced migration/invasion of extravillous trophoblasts (EVTs) is a key feature of the genesis of preeclampsia. We and others previously reported that transcriptional factors activator protein-2 (AP-2) alpha and AP-2gamma act as suppressors of tumor invasion. The present study examined the expressions of AP-2alpha and AP-2gamma in preeclamptic placenta vs. control placenta and investigated their effect on the function of EVTs. The expressions of AP-2alpha and AP-2gamma were elevated in the preeclamptic placentas in comparison with the gestational age-matched control placentas. Their expressions also increased in EVTs of the preeclamptic placentas. Thereafter, we transfected AP-2alpha or AP-2gamma into human EVT cell line, HTR-8/SVneo. The overexpression of AP-2alpha or AP-2gamma decreased the migratory and invasive abilities in HTR-8/SVneo cells. This was followed by the reduction of protease activated receptor-1 and matrix metalloproteinases and a significant induction of plasminogen activator inhibitor-1 and the tissue inhibitor of metalloproteinase-1. AP-2alpha and AP-2gamma were weakly expressed in the cultured EVTs and HTR-8/SVneo cells, whereas they were induced by TNF-alpha, which increases in preeclamptic placenta and impairs trophoblast invasion. In the presence of TNF-alpha, the invasion of the HTR-8/SVneo cells was partially restored by a blocking of AP-2 induction using small interfering RNA of AP-2. The present data suggest that AP-2 may suppress trophoblast migration and invasion, thus leading to a shallow placentation in preeclampsia.
Endocrinology 06/2009; 150(9):4376-85. · 4.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Insulin resistance is considered as part of the pathogenesis of polycystic ovary syndrome (PCOS), and PCOS patients often show hyperinsulinemia. The influence of insulin on folliculogenesis in women with PCOS has not been fully investigated.
Our objective was to assess the induction of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expression with insulin treatment and effects of PTEN on IGF-I-induced granulosa cell proliferation as well as the correlation of PTEN levels with the concentration of insulin in follicular fluid in PCOS and non-PCOS patients. DESIGN, SETTING, PATIENTS, AND MAIN OUTCOME MEASURES: A cell proliferation assay, real-time RT-PCR, and Western blotting for PTEN, Akt, and ERK1/2 were conducted in primary cultured granulosa cells under IGF-I stimulation with or without insulin pretreatment. Phosphorylation of Akt and ERK1/2 was also determined by Western blotting. We also measured the insulin concentration in follicular fluid and the levels of PTEN expression in granulosa cells collected at the time of oocyte retrieval of in vitro fertilization in PCOS (n = 13) and non-PCOS patients (n = 37).
PTEN expression was induced by insulin. Pretreatment with insulin attenuated the IGF-I-induced Akt phosphorylation and cell proliferation but not ERK1/2 phosphorylation. A phosphatidylinositol 3-kinase inhibitor, LY294002, inhibited the IGF-I-induced cell proliferation. Suppression of insulin-induced PTEN expression using small interfering RNA recovered IGF-I-induced Akt phosphorylation. PTEN levels in granulosa cells, which tended to be higher in PCOS patients, were correlated with the insulin concentration in follicular fluid.
PTEN may influence the proliferation of human granulosa cells as well as disturbance of follicular growth in PCOS patients.
The Journal of clinical endocrinology and metabolism 04/2009; 94(6):2184-91. · 6.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Ectopic endometriosis is an uncommon disease. Abdominal scar endometriosis is especially rare.
A 38-year-old gravid 1, para 1 woman underwent dilatation and curettage due to an intrauterine infection. During the procedure, uterine perforation occurred and an emergency laparotomy was performed to provide hemostasis and suturing. Three years later, she complained of pain and swelling at the lower end of her abdominal scar during menstruation. A biopsy of the abdominal scar demonstrated endometriosis. The patient elected to receive conservative management rather than a surgical procedure. Therefore, hormonal therapy was initiated. The hormonal therapy provided symptomatic relief and reduced the size of the lesion.
We reported an extremely rare case of scar endometriosis after a laparotomy for a uterine perforation that occurred as a complication of dilatation and curettage. We suggest that hormonal therapy using gonadotropin-releasing hormone agonist might be an alternative to surgical treatment for ectopic endometriosis.
Archives of Gynecology 03/2009; 279(6):941-3. · 0.91 Impact Factor
