Loss of RUNX3 is significantly associated with advanced tumor grade and stage in endometrial cancers.

Loss of runt­related transcription factor 3 (RUNX3) has been reported in various cancers, and one of the mechanisms mediating loss of RUNX3 expression is DNA methylation. However, the role of RUNX3 expression and its DNA methylation status as prognostic factors in endometrial cancer remain unclear. In the present study, the expression and promoter methylation of RUNX3 was examined in endometrial cancer tissues and cell lines, as well as their association with endometrial cancer prognosis. Fifty­five endometrial cancer tissues and two endometrial cancer cell lines (HEC1­α and Ishikawa) were studied. RUNX3 expression and promoter methylation were examined using reverse transcription­polymerase chain reaction (RT­PCR), methylation specific PCR (MS­PCR), and immunohistochemical staining. The demethylating agent 5­aza­2'­deoxycytidine (ADC) was used to reverse the methylation of the RUNX3 promoter. Loss of RUNX3 expression was observed in 50.9% (27/53) of endometrial cancer tissues and in the HEC1­α cell line by immunohistochemistry and RT­PCR, respectively. Methylation of the RUNX3 promoter was observed in 62.2% (33/53) of endometrial cancer tissues, 12.5% (1/8) of normal endometrial tissues, and the HEC1­α cell line by MS­PCR. Tumor grade and stage were significantly correlated with loss of RUNX3 expression. The expression of RUNX3 was restored by treatment with ADC and resulted in growth inhibition in HEC1­α cells. The present results suggested that methylation may serve a critical role in the silencing of RUNX3 and loss of RUNX3 expression may serve as a prognostic marker in endometrial cancer.

Expression of Ezrin and Estrogen Receptors During Cervical Carcinogenesis.

RATIONALE: Development of cervical squamous carcinoma (CXCA) is accompanied by changes in estrogen receptors (ERs, ERα and ERß) and ezrin expression; however, reports have been conflicting. Using histologically documented staging of cervical biopsies, we determined ezrin and ER relationships during CXCA development. METHODS: Immunoreactive (ir) ezrin, ir-ERα, and ir-ERß were studied in normal epithelium, carcinoma in situ/cervical intraepithelial neoplasia (CIN) 1 to 3, and local invasion or metastatic CXCA. Results were compared using H scoring. Cultures of Caski metastatic CXCA cells were treated with estradiol and/or tamoxifen and studied for ER-driven ir-ezrin and the morphologic response. RESULTS: Koilocytosis was present and indicated viral presence. The ezrin H score increased from CIN1 to CIN3, reaching significant differences from normal by CIN3 ( P = .004) and 2× normal in metastatic CXCA. Estrogen receptor α and ERß H scores fell, reaching significance by CIN3 (ERα, P = .0001; ERß, P = .024). During estradiol treatment, ezrin in Caski cells increased and localized to the periphery, in ruffles and processes. The selective ER modulator tamoxifen blocked the estradiol-induced changes. CONCLUSIONS: During cervical carcinogenesis, the usual relationship between estrogen and ezrin induction is abridged. This is consistent with the effects of human papilloma virus viral proteins such as E6 and E7 that upregulate SIX1, a protein that induces ezrin. Cervical carcinogenesis is progressive but arrests at the preinvasive stage for varying lengths of time. These studies suggest that changes in ezrin may be associated with the development of the invasive phenotype and penetration of the basement membrane. They also raise the possibility that inhibiting ezrin expression could be a target for the prevention of invasive CXCA.

Expression of Vitamin D Receptor in Seminal Vesicles of Cholesterol Formula Mice.

OBJECTIVES: Genomic function of vitamin D receptor (VDR) indicates spermatogenesis that is important for in male reproductive organ authors evaluated the VDR expression in seminal vesicles with high cholesterol (HC) formula diet rat, because there is no report about relationship or difference in VDR in seminal vesicles between HC and control. METHODS: Male C57BL/6 mice aged 5 weeks were raised for 13 weeks. After one week of adaptation-period, they were fed different diet on normal AIN-93G diet, or HC diet containing 2% cholesterol for 12 weeks. The antibodies used were rabbit anti-VDR primary polyclonal. RESULTS: There was no significant difference in VDR reactivity in seminal vesicles, body weight of rat and weight of seminal vesicles between HC group and normal control group. CONCLUSION: Our data give the no difference in expression of VDR of seminal vesicles rat between HC formula diet and normal AIN-93G diet. But we confirmed the VDR expression in seminal vesicles.

Is complementary and alternative therapy effective for women in the climacteric period?

Vasomotor symptoms start about 2 years prior to menopause in women who are approaching menopause, and early menopause symptoms appear including emotional disturbance and anxiety, followed by physical changes such as vaginal dryness, urinary incontinence and skin wrinkles. As time progresses, osteoporosis, cardiovascular diseases, and dementia occur consecutively. Hormone therapy is primarily considered for the relief of menopause symptoms in postmenopausal women. However, as hormone replacement has emerged as a therapy that increases the potential risk of thrombosis, cerebral infarction and breast cancer, complementary and alternative medicine has drawn much attention. This study aimed to examine the types and effects of evidence-based complementary and alternative therapies that are currently used.

A case of solitary fibrous tumor in the pelvis presenting massive hemorrhage during surgery.

Solitary fibrous tumors (SFTs) are unique soft-tissue tumors of submesothelial origin. These tumors are mainly located in the pleural space but they can be originated within a variety of sites, including the abdomen, the pelvis, the soft tissues and the retroperitoneum. SFTs from all sites are usually benign, and the surgical resection is curative in almost all cases. According to the review of literatures, during the surgical resection, massive hemorrhage could occur due to the hypervascular nature of SFTs. This is a case report on SFT in the pelvis presenting great vessel injury, which resulted in life threatening hemorrhage during the resection of tumor. We wish this paper alerts gynecologists about the risk of massive bleeding during the resection of tumor located at adjacent to great vessels in the pelvis.

An Ethical Issue in Medical Education of Obstetrics and Gynecology.

There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice.

Uterine Serous Adenocarcinoma in an Elderly Postmenopausal Woman: Clinically Misdiagnosed as Uterine Cervix Cancer.

Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer.

Cervical intraepithelial neoplasia based on array comparative genomic hybridization.

Uterine cervical cancer is one of the most frequently observed malignant gynaecologic tumors. Carcinoma in situ or invasive cervical carcinoma develops from a low-grade intraepithelial lesion of the cervix over time. Human papillomavirus (HPV) is known to be a major contributing factor. With improvements in molecular genetic technologies, the authors attempted to identify the genomic changes associated with cervical precancerous lesions. In this study, changes in gene copy numbers were evaluated in five cases of severe uterine cervical dysplasia (HPV negative, two cases; HPV 16 and 18 positive only, three cases) by array comparative genomic hybridization (array CGH), and genes with copy number changes were compared between the two groups. Between the HPV positive and negative groups, only one gene was found to be upregulated more than 1.5 fold (3q23-q24), and no downregulated genes were identified. In conclusion, it is useful to evaluate genomic aberrations in cervical cancer using array CGH.

The Timing Hypothesis remains a valid explanation of differential cardioprotective effects of menopausal hormone treatment.

OBJECTIVE: Randomized clinical trials (RCTs) using delayed hormone treatment (HT) have failed to validate the reduction in cardiovascular disease-associated events found in observational studies of early menopausal HT (MHT). The Timing Hypothesis--effects of differences between the chronologic age/length of postmenopause of study participants--continues to be questioned as an explanation for the discrepant outcomes. We reviewed evidence regarding the basis of the hypothesis and its suitability to explain differences in outcomes between MHT and HT trials. METHODS: Literature review. RESULTS: Reports of laboratory, animal, and human clinical studies support the differential effect of HT on normal versus diseased vessels. Age and time since menopause have been related to the extent of vascular disease in women. CONCLUSIONS: There is ample evidence of the validity of the Timing Hypothesis as an entity and as an explanation of the different outcomes of observational studies and RCTs. The available delayed HT RCT data do not rule out the validity of the Timing Hypothesis or protection by MHT against cardiovascular events. Cardiovascular disease remains the single largest cause of death in women, and research on its prevention by MHT should be the highest national priority.

Risk factors for complications in patients undergoing myomectomy at the time of cesarean section.

AIM: The aim of this study was to evaluate the risk factors for complications of myomectomy at cesarean section (CS). METHODS: The subjects were a non-complicated group (n = 100) and a complicated group (n = 10) of patients aged between 20 and 43 years who underwent CS and simultaneous myomectomy at our institution from January 2006 until December 2008. Complications were defined as blood transfusion greater than three packed red blood cells, postoperative ileus, and two days longer than average hospitalization. RESULTS: The complicated group (n = 10) had (i) a myoma larger than 10 cm and no secondary change; and (ii) intramural myoma type. CONCLUSION: Myomectomy during CS can be performed in selected cases, but some patients had significant complications like ileus and postoperative atonic bleeding.