Tumor necrosis factor-alpha-induced cyclooxygenase-2 overexpression in eutopic endometrium of women with endometriosis by stromal cell culture through nuclear factor-kappaB activation.

OBJECTIVE: To investigate the role of NF-kappaB during the induction of COX-2 by TNF-alpha in the eutopic endometrium of women with and without endometriosis using stromal cell culture. STUDY DESIGN: Experimental study in cultured stromal cells of the eutopic endometrium of women with and without endometriosis in the presence of TNF-alpha. RESULTS: Within 5-20 minutes of stimulation with TNF-alpha, p-IkappaB was clearly observed in the eutopic endometrium of women with endometriosis and in that of women without endometriosis. COX-2 protein was significantly induced by treatment with TNF-alpha in both eutopic endometrial stromal cells of women with and without endometriosis (p < 0.05), but the degree of induction was significantly increased in eutopic endometrial stromal cells of women with endometriosis than those of women without endometriosis (p < 0.05). CONCLUSION: Overexpression of COX-2 by TNF-alpha in the eutopic endometrium of women with endometriosis may play a critical role in such pathophysiologic processes as endometriosis formation.

Uterine artery pseudoaneurysm manifesting delayed postabortal bleeding.

OBJECTIVE: To study a case of a huge pseudoaneurysm of the uterine artery presenting with vaginal bleeding 2 years after termination of pregnancy in a 23-year-old woman. DESIGN: Retrospective clinical case. SETTING: Academic-based gynecology center of university hospital. PATIENT(S): A 23-year-old women, 2 years after termination of pregnancy, presenting with vaginal bleeding. INTERVENTION(S): The diagnosis of uterine artery pseudoaneurysm was made by color and duplex Doppler ultrasonography and confirmed by arteriography. The angiographic study showed a pseudoaneurysm arising from the right uterine artery. MAIN OUTCOME MEASURE(S): Clinical response to treatment. RESULT(S): The uterine artery pseudoaneurysm was successfully treated by embolization. The vaginal bleeding subsided immediately after embolization. The patient was monitored monthly for 12 months, during which she had normal menstruation period and no further vaginal bleeding. CONCLUSION(S): Although likely not a common complication of abortion, the diagnosis should be considered in those patients with postabortive bleeding and cystic lesion in the pelvis on ultrasonography.