ABSTRACT
CONTEXT: Endometrium of fertile women expresses progesterone-regulated Mucin 1 (MUC1) that carries selectin ligands recognized by the human blastocyst. Altered MUC1 expression at the time of implantation may contribute to endometrial infertility. OBJECTIVE: The aim was to assess the expression of MUC1 in the endometrium from polycystic ovary syndrome (PCOS), endometriosis, and fertile women in comparison with other hormone-regulated proteins [hydroxysteroid dehydrogenase (HSD) 1, HSD2, estrogen receptor (ER) and progesterone receptor (PR)]. DESIGN AND PATIENTS: Endometrial samples were obtained from 33 fertile patients, 26 ovulatory PCOS patients, 15 anovulatory PCOS patients, and 25 endometriosis patients. MAIN OUTCOME MEASURE: Immunohistochemistry assessed the expression of MUC1 subunits ER, PR, HSD1, and HSD2 in endometrial epithelium. Endometrial MUC1 expression was quantified by immunoblots and RT-PCR. HSD1 and HSD2 expression was assayed by RT-PCR. RESULTS: MUC1ND expression was significantly higher in ovulatory PCOS than in fertile and anovulatory PCOS patients, even after progesterone stimulation. MUC1ND and -CD expression was lower in anovulatory PCOS than in fertile patients. Only MUC1CD expression was lower in endometriosis patients. Endometrial ER expression was significantly higher in PCOS and endometriosis patients, whereas PR expression was significantly higher in PCOS than in fertile patients. The expression of HSD1 was significantly higher in anovulatory PCOS than in fertile patients. Expression of HSD2 was significantly higher in PCOS patients and lower in endometriosis patients. CONCLUSION: Expression of MUC1 subunits in the infertile endometrium is significantly different from fertile and appears to be a component of altered gene expression that potentially contributes to endometrial insufficiency.
Subject(s)
Anovulation/metabolism , Endometriosis/metabolism , Mucin-1/genetics , Polycystic Ovary Syndrome/metabolism , Anovulation/genetics , Antigens, Surface/genetics , Diagnosis, Differential , Endometriosis/diagnosis , Endometriosis/genetics , Endometrium/metabolism , Female , Humans , Membrane Proteins/genetics , Mucin-1/metabolism , Ovulation/physiology , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/genetics , Protein Subunits/genetics , Receptors, Estrogen/genetics , Receptors, Progesterone/genetics , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Our study investigated the personal experience and satisfaction of patients with menstrual disorders treated with the Mirena intrauterine system in secondary care. A retrospective questionnaire was sent to all 1,100 women treated with a Mirena intrauterine system in the Menstrual Disorders Clinic between 1995-2003 at the Queens' Medical Centre, Nottingham, England. A total of 1,056 (96%) women responded and were included in the study. The majority (73%) of women continued to use the Mirena. The women reported a decrease in the heaviness, frequency and pain associated with their period. The commonest side-effect experienced was spotting (19%). Women ranked their satisfaction on a scale of 1-10, with a mean score of 7.07/10. The majority of women are satisfied with the Mirena as a treatment for menstrual disorders. Less than 5% of the women required subsequent operative treatment for menstrual disorders following treatment with the Mirena.
Subject(s)
Levonorgestrel/administration & dosage , Menstruation Disturbances/drug therapy , Patient Satisfaction , Adult , Aged , Aged, 80 and over , Female , Humans , Intrauterine Devices, Medicated , Levonorgestrel/adverse effects , Middle Aged , Retrospective Studies , Surveys and Questionnaires , United KingdomABSTRACT
OBJECTIVES: The primary aim of this validation study was to determine the interobserver reliability and validity of measurements of phantom objects of known volume using conventional and rotational techniques of volume calculation according to measurement technique. METHODS: Two observers each acquired a single three-dimensional ultrasound dataset of three water-filled objects of different size and shape. The same two observers measured all six datasets using both the conventional technique and the newer rotational technique (Virtual Organ Computer-aided AnaLysis, VOCAL( trade mark )) of volume calculation. Reliability was assessed by calculating intraclass correlation coefficients (ICC) and validity by examining the percentage difference from the 'true' volume, as determined by a water displacement technique, by the limits of agreement method. RESULTS: All of the techniques were highly reliable (ICC: 0.9962-0.9997) and valid to within 4% of the 'true' volumes. There were no significant differences in reliability according to measurement plane or between observers. Measurements made with the 6 degrees rotation step were significantly more reliable than those made by all other techniques with the exception of the 9 degrees rotation step (P < 0.05) and significantly more valid than those made with the 30 degrees rotation step or conventional technique (P < 0.05). CONCLUSIONS: Volume calculation in the in vitro setting is both reliable and valid but is dependent upon the technique applied, with rotational measurements of volume proving superior to conventional techniques.
