Effect of Autologous Adipose-Derived Stromal Vascular Fraction Transplantation on Endometrial Regeneration in Patients of Asherman's Syndrome: a Pilot Study.

This study aimed to investigate the efficacy of the transplantation of autologous adipose-derived stromal vascular fraction (AD-SVF) containing adipose stem cells (ASCs) in regenerating functional endometrium in patients with severe Asherman's syndrome (AS). This was a prospective clinical study involving six infertile women aged 20-44 years who were diagnosed with severe AS by hysteroscopy. Autologous AD-SVF were isolated from patient's adipose tissue obtained by liposuction and then transplanted into uterus by transcervical instillation using an embryo transfer catheter followed by estrogen hormone therapy. Endometrial growth and pregnancy outcomes were assessed after fresh or frozen embryo transfer. Of the five patients who remained in the study, two women who had amenorrhea resumed their menstruation with irregular scant bleeding. Three women with oligomenorrhea had increased menstrual amount. Before therapy, the maximum EMT measured ultrasonographically was 3.0 ± 1.0 mm (range: 1.7 to 4.4 mm), which significantly increased to 6.9 ± 2.9 mm (range: 5.2 to 12.0 mm, p = 0.043) after cell transplantation and hormone therapy. Five women had embryo transfer after therapy: one fresh and four frozen-thawed. One woman conceived but aborted spontaneously at 9-week gestation. AD-SVF is a safe and easily available cell product containing adipose-derived stem cells. Autologous transplantation of AD-SVF may regenerate damaged human endometrium and increase endometrial receptivity. Our study showed the feasibility of AD-SVF in restoring endometrial function and increasing endometrial thickness. This cell therapy may become a promising treatment for infertile women with endometrial dysfunction and needs further investigation.

Oncologic and obstetric outcomes of conservative surgery for borderline ovarian tumors in women of reproductive age.

OBJECTIVE: To compare the oncologic and obstetric outcomes in reproductive-age females with borderline ovarian tumors (BOTs) treated with cyst enucleation (CE) or unilateral salpingo-oophorectomy (USO). METHODS: The medical records of patients with BOTs treated between 1998 and 2014 were retrospectively reviewed. The recurrence rates in the USO and CE groups were compared, and the postoperative obstetric outcomes were assessed via telephone survey. RESULTS: Eighty-nine patients with BOTs underwent USO, and 19 underwent CE. Of these, six patients had recurrent BOTs. The recurrence rate was significantly lower in the USO group (3/89, 3.4%) than in the CE group (3/19, 15.8%) (P=0.032). All patients with recurrent disease were successfully treated with further surgery. Of the 76 patients interviewed by telephone, 71 (93.4%) resumed regular menstruation after surgery. Twenty-six of the 32 patients (81.3%) who attempted to conceive had successful pregnancies. USO (19/24, 79.2%), like CE (7/8, 87.5%), resulted in favorable pregnancy rates for patients with BOTs. CONCLUSION: USO is a suitable fertility-preserving surgery for women with BOTs. CE is also an acceptable option for select patients.

Tinnitus in patients with chronic otitis media before and after middle ear surgery.

The objective of this study was to investigate the clinical features of tinnitus in patients with chronic otitis media (COM) and to evaluate changes in tinnitus following middle ear surgery in relation to audiologic outcome. Medical records were reviewed for 117 patients with COM who underwent middle ear surgery between March 2009 and March 2010. Of them, 44 patients who pre-operatively reported tinnitus on a tinnitus questionnaire and 28 patients who completed a tinnitus questionnaire 8 weeks after surgery were evaluated to determine the clinical characteristics of tinnitus in patients with COM and any change in tinnitus following middle ear surgery, respectively. New tinnitus symptoms that developed after surgery were also evaluated in previously asymptomatic patients. The pre-operative incidence of tinnitus in patients with COM was 43% (50/117), with 87% of these patients displaying sensorineural tinnitus. After middle ear surgery, tinnitus handicap inventory scores were reduced in 82% of patients (23/28). Mean values of loudness, annoyance, effect on life, and awareness of tinnitus were also significantly reduced. One patient displayed newly developed tinnitus after surgery. Analysis of the relationship between improvement in tinnitus and audiologic outcome demonstrated that the group of patients whose tinnitus handicap inventory was reduced by more than 10 showed significantly greater improvements in mean air-conduction thresholds than did patients in the other group. In conclusion, following middle ear surgery, most patients experienced a reduction in tinnitus and restored hearing, with surgery perceived as an important contributory factor.

Citri Reticulatae Viride Pericarpium extract induced apoptosis in SNU-C4, human colon cancer cells.

Citri Reticulatae Viride Pericarpium (CR) has been used traditionally in Korea to promote the Liver Qi activity and the function of digestive system. We investigated whether the immature peels of Citrus reticulata Blanco (Rutaceae) induced cell-death on SNU-C4, human colon cancer cells. Cytotoxicity of CR was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The cell death was identified as apoptosis using 4,6-diamidineo-2-phenylindole (DAPI) staining and terminal deoxy-nucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay. The expression of pro-apoptotic gene, Bax, was increased and the expression of anti-apoptotic gene, Bcl-2, was decreased by CR-treatment. The expression and activity of major apoptotic gene, caspase-3 was significantly increased by CR-treatment. Considering the above results, CR could induce the apoptosis on SNU-C4, human colon cancer cells via Bax-related caspase-3 activation. And it might provide the experimental data for the future clinical use of CR on colon cancer.