Successful radiotherapy for endometrial serous carcinoma with local repeated recurrence.

The incidence of endometrial serous carcinoma (ESC) has been increasing, and ESC is resistant to treatment. We report a patient with ESC who responded to radiotherapy for multiple recurrences. The first recurrence was detected in the vaginal wall and left internal iliac lymph node 5 months after the initial treatment. Concurrent chemoradiotherapy (CCRT) was administered. Radiation was delivered using the intensity modulated radiation therapy technique. The second recurrent tumor was detected in the right internal iliac lymph node after 4 months, and CCRT was conducted. After 4 months, the third recurrence was detected in the right common iliac node, and CCRT was performed. After 8 months, the fourth recurrence was detected in the horizontal portion of the duodenum, and radiotherapy was administered. After 9 months, the fifth recurrence was detected in the vaginal wall. Interstitial brachytherapy was conducted. Grade 2 gastrointestinal injury, nausea and radiodermatitis were observed. During the subsequent 13-month follow-up, there has been no recurrence. Although ESC is resistant to treatment, radiotherapy could be effective in some cases. Even when multiple recurrences occur, radiotherapy may be considered a treatment option if the irradiation level is permissible.

Survey of prenatal testing for genetic disorders in Japan: Recent report.

AIM: In order to investigate the current status of prenatal testing for genetic disorders, we conducted a multicenter retrospective questionnaire survey. METHODS: The questionnaire was sent to 105 facilities with genetic counseling systems. The questionnaire consisted of two parts: (i) the number of prenatal tests conducted for genetic disorders from January 2010 to December 2012, whether the laboratory was combined with the counseling facility or separate, the sampling procedure method, the testing results, and the outcomes of the affected fetus in addition to treatment; and (ii) a survey of personal comments regarding prenatal testing for genetic disorders. RESULTS: We received responses from 69 of the 105 facilities (65.7%), and genetic testing was performed at 26 of these facilities. Nucleic acid sequential testing was performed on 45 disorders and 252 cases during a three-year period. There were 67 cases of affected fetuses. Six cases continued pregnancy and were treated. The comment survey highlighted difficulties in locating a laboratory to assess prenatal samples, as well as inadequate counseling and preparation for genetic disorders. CONCLUSIONS: Our study revealed that a number of prenatal testing for genetic disorders are conducted in Japan; however, it is difficult for counselors to locate a laboratory capable of testing for specific genetic disorders. Inadequate counseling and healthcare providers' lack of knowledge is a current problem. A well-established system of prenatal testing for genetic disorders and the further education of general physicians is required.

Effects of menopause and hormone therapy on erythrocyte deformability.

OBJECTIVE: The climacteric disturbance seen among perimenopausal women often includes symptoms related to poor microcirculation. This hemorheological condition plays an important role in the hemodynamism of microcirculation. Specifically, erythrocyte deformability is considered to be one of the most significant factors in determining this hemorheological condition. METHODS: The present study investigated the level of erythrocyte deformability in four groups of women: namely, 10 healthy premenopausal women (PRE group), 25 postmenopausal women (POST group), 20 postmenopausal women on estrogen therapy (ET group) who received conjugated equine estrogens 0.625 mg/day, and 20 postmenopausal women on estrogen plus progestogen therapy (EPT group) who received conjugated equine estrogens 0.625 mg/day plus medroxyprogesterone acetate 2.5 mg/day. The erythrocyte deformability score (EDS), measured by the Micro Channel Array Flow Analyzer, was determined as an index of erythrocyte deformability. RESULTS: The mean EDS for the POST group was significantly higher (mean +/- SE, 1.02 +/- 0.04) (P < 0.01) than that for the PRE group (0.78 +/- 0.05). The mean EDS for the ET group (0.88 +/- 0.03) was significantly lower than that for the POST group and close to that of the PRE group. There was no difference in the EDS values between the ET group and the EPT group (0.87 +/- 0.03). CONCLUSIONS: These results indicate that erythrocyte deformability may worsen with the decrease in the estrogen level because of the onset of menopause, and also suggest that ET and EPT may allow it to recover.

Morphologic effects of epithelial ion channels on the mouse uterus: differences between raloxifene analog (LY117018) and estradiol treatments.

OBJECTIVE: Estrogen regulates the expression of epithelial Na(+) channel (ENaC) and cystic fibrosis transmembrane conductance regulator (CFTR). Our purpose was to assess the effects of raloxifene analog LY117018 on the expression of ENaC and CFTR in ovariectomized mice. STUDY DESIGN: Three groups of 5 female ovariectomized mice were treated with 17beta-estradiol benzoate (E2), LY117018 (LY), or vehicle, respectively, for 4-12 weeks. Effects on the messenger ribonucleic acid expression levels of ENaC and CFTR channels in the uterus were studied using real-time reverse transcriptase-polymerase chain reaction. RESULTS: E2 treatment induced CFTR expression, repressed ENaC expression and resulted in fluid accumulation in the uterus. In contrast, LY induced CFTR expression, did not repress ENaC expression, and caused no fluid accumulation. CONCLUSION: Estradiol and LY117018 differentially regulate the expression of CFTR and ENaC in ovariectomized mouse uterus. This finding suggests that uterine fluid accumulation can be controlled mainly by targeting the ENaC.