Laparoscopic management of ectopic pregnancy during a 9-year period.

The present study analyzed the epidemiology and outcome of ectopic pregnancy during a 9-year period on a total of 473 women. Our follow-up shows that laparoscopic salpingostomy, performed in 84.9% of the patients, is a safe and effective treatment for ectopic pregnancy.

Bridge-1 is expressed in human granulosa cells and is involved in the activin A signaling cascade.

The present study investigates the expression of the coactivator Bridge-1 in the human ovary and its role in activin A signaling in the human granulosa cell line HGL-5. Expression of Bridge-1 can be stimulated by activin A, an important factor for follicle maturation, matching the increase of Smad 2, 3, and 4; treatment with Bridge-1-small interfering RNA is decreasing not only the expression of Bridge-1 but also the expression of Smad2, 3, and 4 in HGL-5 cells.

The molecular signature of endometriosis-associated endometrioid ovarian cancer differs significantly from endometriosis-independent endometrioid ovarian cancer.

OBJECTIVE: To determine whether endometriosis-associated endometrioid cancer (EAOC) is a specific entity compared with endometrioid cancer not associated with endometriosis (OC). DESIGN: Case-control study. SETTING: University hospital research laboratory. PATIENT(S): Seven patients with endometriosis-associated ovarian cancer EAOC and five patients each with OC, ovarian endometriosis, and benign ovaries. INTERVENTION(S): Ovarian tissue samples were collected from surgical procedures. MAIN OUTCOME MEASURE(S): We hybridized cRNA samples to the Affymetrix HG-U133A microarray chip. Representative genes were validated by real time polymerase chain reaction. RESULT(S): We identified two main groups of genes: The first group contained the genes SICA2, CCL14, and TDGF1. These genes were equally regulated in endometriosis and EAOC but not in OC and benign ovaries. The second group contained the genes StAR, SPINT1, Keratin 8, FoxM1B, FOLR1, CRABP1, and Claudin 7. They were equally regulated in EAOC and OC but not in ovarian endometriosis and benign ovaries. CONCLUSION(S): That the first group is composed of the cytokines SICA2 and CCL14 and the growth factor TDGF1 indicates that the regulation of the autoimmune system and of inflammatory cytokines may be very important in the etiology of endometriosis and EAOC. That the second group is composed of genes that play a central role in cell-cell interaction, differentiation, and cell proliferation indicates that they may be important in the development of ovarian cancer in women with endometriosis.

Primary peritoneal carcinoma in a young woman with suspected endometriosis.

OBJECTIVE: To describe the treatment of a 23-year-old patient with primary peritoneal carcinoma and preservation of her fertility. DESIGN: Case report. SETTING: University of Schleswig-Holstein, Campus Lübeck, Department of Gynecology and Obstetrics. PATIENT(S): A 23-year-old patient with primary peritoneal carcinoma. INTERVENTION(S): The patient was given treatment by first preserving her fertility with oocyte vitrification and cryoconservation of ovarian biopsy samples. Surgery was performed with radical resection of the peritoneal lesion, ovarian biopsies, omentectomy, and pelvic and para-aortic lymph node sampling before starting chemotherapy with carboplatin and paclitaxel (Taxol). Hysterectomy and bilateral salpingo-oophorectomy were not performed. MAIN OUTCOME MEASURE(S): Treatment of peritoneal carcinoma and number of vitrified oocytes. RESULT(S): Twenty-five oocytes of the patients were vitrified before chemotherapy was performed. CONCLUSION(S): Primary peritoneal carcinoma is a rare disease that laparoscopically resembles peritoneal endometriosis and histologically is very similar to primary epithelial ovarian cancer. The advised therapy is based on ovarian cancer treatment; however, it is unclear whether the radical operation improves prognosis. In this case, a 23-year-old patient underwent treatment preserving her fertility with oocyte vitrification and cryoconservation of ovarian biopsy samples before surgery and chemotherapy were performed.

Is endometriosis associated with systemic subclinical inflammation?

Endometriosis is a pelvic inflammatory process with altered function of immune-related cells and increased number of activated macrophages in the peritoneal environment that secrete various local products, such as growth factors and cytokines. The elevation of cytokines and other factors in the peritoneal fluid is accompanied by the elevation of similar factors, such as CRP, SAA, TNF-alpha, MCP-1, IL-6, IL-8 and CCR1, in the peripheral blood of patients with endometriosis. CD44+ and CD14+ monocytes are significantly increased, while CD3+ T lymphocytes and CD20+ B lymphocytes show modest, but significant decrease in peripheral blood of women with endometriosis. This indicates that endometriosis could be viewed as a local disease with systemic subclinical manifestations. This review provides an overview of data on the changes of various factors in peripheral blood and their potential use as diagnostic tools in patients with endometriosis.

Interactions with p300 enhance transcriptional activation by the PDZ-domain coactivator Bridge-1.

Transcriptional coactivators are essential mediators of signal amplification in the regulation of gene expression in response to hormones and extracellular signals. We previously identified Bridge-1 (PSMD9) as a PDZ-domain coregulator that augments insulin gene transcription via interactions with the basic helix-loop-helix transcription factors E12 and E47, and that increases transcriptional activation by the homeodomain transcription factor PDX-1. In these studies, we find that transcriptional activation by Bridge-1 can be regulated via interactions with the histone acetyltransferase and nuclear receptor coactivator p300. In transfection assays, transcriptional activation by Bridge-1 is increased by the inhibition of endogenous histone deacetylase activity with trichostatin A, indicating that the transcriptional activation function of Bridge-1 can be regulated by histone modifications. The exogenous expression of p300 enhances the transcriptional activation by Bridge-1 in a dose-dependent manner. In contrast, the sequestration of p300 by the overexpression of the adenoviral protein E1A, but not by an E1A mutant protein that is unable to interact with p300, suppresses the transcriptional activation by Bridge-1. We demonstrate that p300 and Bridge-1 proteins interact in immunopre-cipitation and glutathione-S-transferase (GST) pull-down assays. Bridge-1 interacts directly with multiple regions within p300 that encompass C/H1 or C/H2 cysteine- and histidine-rich protein interaction domains and the histone acetyltransferase domain. Deletion or point mutagenesis of the Bridge-1 PDZ domain substantially reduces transcriptional activation by Bridge-1 and interrupts interactions with p300. We propose that p300 interactions with Bridge-1 can augment the transcriptional activation of regulatory target genes by Bridge-1.

Women's attitude and perceptions towards menopause in different cultures. Cross-cultural and intra-cultural comparison of pre-menopausal and post-menopausal women in Germany and in Papua New Guinea.

OBJECTIVE: To study cross-cultural and intra-cultural differences between the perception and the experience of menopause in pre-menopausal and post-menopausal German and Papua New Guineas women. DESIGN: Concepts concerning menopause and the experience of the menopause were assessed by the symptom categories (i.e. hot flashes, cardiac or sleeping disorders, depression, irritability, lack of drive, vaginal dryness, painful joints or muscles) according to the Menopause Rating Scale (MRS). In addition to the translated English version, a questionnaire in Pidgin-English was offered. Questions about positive and negative expectations of menopause and the acceptance of hormonal replacement therapy were included. Statistical analysis was performed using Chi-square test and the Mann-Whitney U-test as indicated. RESULTS: One hundred and one pre-menopausal and 40 post-menopausal women in Germany as well as 36 pre-menopausal and 41 post-menopausal women in Papua New Guinea were questioned. The expectations regarding the menopause differed significantly in favor of a higher trait intensity concerning the item of hot flashes in Germany and a significantly higher trait intensity in the items cardiac trouble, lack of drive, urological symptoms, vaginal dryness, joint and muscle symptoms in Papua New Guinea. In the menopause experience, significant differences between the cultures are confirmed in favor of a higher trait intensity in Papua New Guinea concerning experienced depression, drop in performance, sexual disturbances and vaginal dryness. The intra-cultural comparison between the concepts concerning menopause and the menopause experience in Germany shows a significantly higher trait intensity with regard to the expected disturbance from hot flashes, depression, agitation, lack of drive and sexual problems as compared to the experienced disturbances. In Papua New Guinea, the survey showed a difference in expected and experienced vaginal dryness. CONCLUSIONS: Perception and concepts concerning illness and health are based on culturally produced patterns.