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Antioxidant supplementation reduces endometriosis-related pelvic pain in humans.  


We previously suggested that women with endometriosis have increased oxidative stress in the peritoneal cavity. To assess whether antioxidant supplementation would ameliorate endometriosis-associated symptoms, we performed a randomized, placebo-controlled trial of antioxidant vitamins (vitamins E and C) in women with pelvic pain and endometriosis. Fifty-nine women, ages 19 to 41 years, with pelvic pain and history of endometriosis or infertility were recruited for this study. Patients were randomly assigned to 2 groups: vitamin E (1200 IU) and vitamin C (1000 mg) combination or placebo daily for 8 weeks before surgery. Pain scales were administered at baseline and biweekly. Inflammatory markers were measured in the peritoneal fluid obtained from both groups of patients at the end of therapy. Our results indicated that after treatment with antioxidants, chronic pain ("everyday pain") improved in 43% of patients in the antioxidant treatment group (P = 0.0055) compared with the placebo group. In the same group, dysmenorrhea ("pain associated with menstruation") and dyspareunia ("pain with sex") decreased in 37% and 24% patients, respectively. In the placebo group, dysmenorrhea-associated pain decreased in 4 patients and no change was seen in chronic pain or dyspareunia. There was a significant decrease in peritoneal fluid inflammatory markers, regulated upon activation, normal T-cell expressed and secreted (P ? 0.002), interleukin-6 (P ? 0.056), and monocyte chemotactic protein-1 (P ? 0.016) after antioxidant therapy compared with patients not taking antioxidants. The results of this clinical trial show that administration of antioxidants reduces chronic pelvic pain in women with endometriosis and inflammatory markers in the peritoneal fluid. PMID:22728166

Santanam, Nalini; Kavtaradze, Nino; Murphy, Ana; Dominguez, Celia; Parthasarathy, Sampath





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PubMed Central

Introduction Ectopic endometrial tissue is found in 1.5% to 6.2% of women of reproductive age, in up to 60% of those with dysmenorrhoea, and in up to 30% of women with subfertility, with a peak incidence at around 40 years of age. However, symptoms may not correlate with laparoscopic findings. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of hormonal treatments given at diagnosis of endometriosis? What are the effects of hormonal treatments before surgery for endometriosis? What are the effects of non-hormonal medical treatments for endometriosis? What are the effects of surgical treatments for endometriosis? What are the effects of hormonal treatment after conservative surgery for endometriosis? What are the effects of hormonal treatment after oophorectomy (with or without hysterectomy) for endometriosis? What are the effects of treatments for ovarian endometrioma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 40 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: combined oral contraceptives, danazol, dydrogesterone, gestrinone, gonadorelin analogues, aromatase inhibitors, hormonal treatment before surgery, hormonal treatment, laparoscopic cystectomy, laparoscopic removal of endometriotic deposits (alone or with uterine nerve ablation), laparoscopic removal plus presacral neurectomy, laparoscopic uterine nerve ablation, non-steroidal anti-inflammatory drugs, presacral neurectomy alone, and progestogens other than dydrogesterone.



MUC4 gene polymorphisms associate with endometriosis development and endometriosis-related infertility  

PubMed Central

Background Mucin 4 (MUC4) plays an important role in protecting and lubricating the epithelial surface of reproductive tracts, but its role in the pathogenesis of endometriosis is largely unknown. Methods To correlate MUC4 polymorphism with the risk of endometriosis and endometriosis-related infertility, we performed a case-control study of 140 patients and 150 healthy women. Six unique single-nucleotide polymorphisms (SNPs) (rs882605, rs1104760, rs2688513, rs2246901, rs2258447 and rs2291652) were selected for this study. DNA fragments containing the target SNP sites were amplified by polymerase chain reaction using the TaqMan SNP Genotyping Assay System to evaluate allele frequency and distribution of genotype in MUC4 polymorphisms. Results Both the T/G genotype of rs882605 and the frequency of haplotype T-T (rs882605 and rs1104760) were higher in patients than in controls and were statistically significant. The frequency of the C allele at rs1104760, the C allele at rs2688513, the G allele at rs2246901 and the A allele at rs2258447 were associated with advanced stage of endometriosis. Moreover, the G allele at rs882605 was verified as a key genetic factor for infertility in patients. Protein sequence analysis indicated that amino acid substitutions by genetic variations at rs882605, rs2688513 and rs2246901 occur in the putative functional loops and the type D von Willebrand factor (VWFD) domain in the MUC4 sequence. Conclusions MUC4 polymorphisms are associated with endometriosis development and endometriosis-related infertility in the Taiwanese population.




Microsoft Academic Search

Endometriosis, a condition defined by the presence of ectopic endometrium, is a disorder of increasing incidence and a significant cause of gastroenterologic distress in young women. Although clinical manifestations vary considerably depending upon the anatomic extent of disease, characteristic abdominal complaints and typical physical findings continue to be associated with misdiagnosis and delayed recognition of gastrointestinal involvement. The authors of

Felice R. Zwas; David T. Lyon



Relating Pelvic Pain Location to Surgical Findings of Endometriosis  

PubMed Central

Objective To study whether pain location is related to lesion location in women with chronic pelvic pain and biopsy-proven endometriosis. Methods A secondary analysis was performed to compare self-reported pain location with recorded laparoscopy findings for location and characteristics of all visible lesions. All lesions were excised. Endometriosis was diagnosed using histopathology criteria. The pelvic area was divided into three anterior and two posterior regions. Lesion depth, number of lesions or endometriomas, and disease burden (defined as sum of lesion sizes, or single versus multiple lesions) were determined for each region. Data were analyzed using t-tests, Fisher’s exact tests, and logistic regression modeling, with p-values corrected for multiple comparisons using the step-down Bonferroni method. Results Women with endometriosis (n=96) had a lower body mass index (BMI), were more likely to be white, had more prior surgery, and had more frequent menstrual pain and incapacitation than chronic pain patients without endometriosis (n=37). Overall, few patients had deeply infiltrating lesions (n=38). Dysuria was associated with superficial bladder peritoneal lesions. Other lesions or endometriomas were not associated with pain in the same anatomic locations. Lesion depth, disease burden, and number of lesions or endometriomas were not associated with pain. Conclusion In this group of women with biopsy-proven endometriosis, few had deeply infiltrating lesions or endometriomas. Dysuria and midline anterior pain were the only symptoms associated with the location of superficial endometriosis lesions. The lack of relationship between pain and superficial lesion location raises questions about how these lesions relate to pain. Clinical Trial Registration,, NCT00001848.

Hsu, Albert L.; Sinaii, Ninet; Segars, James; Nieman, Lynnette K; Stratton, Pamela




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... require the woman to limit sexual relations. Good communication will help her sexual partner understand the disease ... or she may recommend over-the-counter pain medications, such as aspirin or ibuprofen. Sometimes, stronger medications ...


Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review  

Microsoft Academic Search

This systematic review aims to assess the efficacy of aromatase inhibitors (AIs) in treating pain symptoms caused by endometriosis.\\u000a A comprehensive literature search was conducted to identify all the published studies evaluating the efficacy of type II nonsteroidal\\u000a aromatase inhibitors (anastrozole and letrozole) in treating endometriosis-related pain symptoms. The MEDLINE, EMBASE, PubMed,\\u000a and SCOPUS databases and the Cochrane System Reviews

Simone Ferrero; David J Gillott; Pier L Venturini; Valentino Remorgida



Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review  

PubMed Central

This systematic review aims to assess the efficacy of aromatase inhibitors (AIs) in treating pain symptoms caused by endometriosis. A comprehensive literature search was conducted to identify all the published studies evaluating the efficacy of type II nonsteroidal aromatase inhibitors (anastrozole and letrozole) in treating endometriosis-related pain symptoms. The MEDLINE, EMBASE, PubMed, and SCOPUS databases and the Cochrane System Reviews were searched up to October 2010. This review comprises of the results of 10 publications fitting the inclusion criteria; these studies included a total of 251 women. Five studies were prospective non-comparative, four were randomized controlled trials (RCTs) and one was a prospective patient preference trial. Seven studies examined the efficacy of AIs in improving endometriosis-related pain symptoms, whilst three RCTs investigated the use of AIs as post-operative therapy in preventing the recurrence of pain symptoms after surgery for endometriosis. All the observational studies demonstrated that AIs combined with either progestogens or oral contraceptive pill reduce the severity of pain symptoms and improve quality of life. One patient preference study demonstrated that letrozole combined with norethisterone acetate is more effective in reducing pain and deep dyspareunia than norethisterone acetate alone. However, letrozole causes a higher incidence of adverse effects and does not improve patients' satisfaction or influence recurrence of symptoms after discontinuation of treatment. A RCT showed that combining letrozole with norethisterone acetate causes a lower incidence of adverse effects and lower discontinuation rate than combining letrozole with triptorelin. Two RCTs demonstrated that, after surgical treatment of endometriosis, the administration of AIs combined with gonadotropin releasing hormone analogue for 6 months reduces the risk of endometriosis recurrence when compared with gonadotropin releasing hormone analogue alone. In conclusion, AIs effectively reduce the severity of endometriosis-related pain symptoms. Since endometriosis is a chronic disease, future investigations should clarify whether the long-term administration of AIs is superior to currently available endocrine therapies in terms of improvement of pain, adverse effects and patient satisfaction.



Epigenetics of endometriosis.  


Endometriosis is a common gynecologic disorder with an enigmatic etiopathogenesis. Although it has been proposed that endometriosis is a hormonal disease, an autoimmune disease, a genetic disease, and a disease caused by exposure to environmental toxins, our understanding of its etiopathogenesis is still inadequate, as reflected by recent apparent setbacks in clinical trials on endometriosis. In the last 5 years, evidence has emerged that endometriosis may be an epigenetic disease. In this article, the evidence in support of this hypothesis is reviewed, and its diagnostic, therapeutic and prognostic implications discussed. Publications, up to the end of June 2009, pertaining to epigenetic aberration in endometriosis were identified through PubMed. In addition, publications on related studies were also retrieved and reviewed. Epigenetics appears to be a common denominator for hormonal and immunological aberrations in endometriosis. Epigenetics also appears to have a better explanatory power than genetics. There is accumulating evidence that various epigenetic aberrations exist in endometriosis. In vitro studies show that histone deacetylase inhibitors may be promising therapeutics for treating endometriosis. In conclusion, several lines of evidence suggest that epigenetics plays a definite role in the pathogenesis and pathophysiology of endometriosis. As such, endometriosis is possibly treatable by rectifying epigenetic aberrations through pharmacological means. DNA methylation markers may also be useful for diagnostic and prognostic purposes. It is also possible that the delineation of the epigenetic changes accompanied by the genesis and progression of endometriosis could lead to interventions that reduce the risk of developing endometriosis. PMID:19651637

Guo, Sun-Wei



The G-protein-coupled estrogen receptor (GPER) is expressed in normal human ovaries and is upregulated in ovarian endometriosis and pelvic inflammatory disease involving the ovary.  


Estrogens play a crucial role in maintaining ovarian function. Deregulation of estrogen signals is associated with fertility-impairing disorders. The aim of this study was to investigate whether the G-protein-coupled estrogen receptor (GPER) is present in the human ovary. Additionally, we  analyzed the folliculogenesis and ovarian endometriosis in GPER expression. Seventy-nine patients (ovarian endometriosis, n = 26; ovarian pelvic inflammatory disease [PID], n = 10; normal ovaries/endometrium, n = 30/13) were analyzed by immunohistochemistry. Normal ovaries were also assessed by real-time polymerase chain reaction and double immunofluorescence. The most intense expression of GPER was noted in the ovarian surface epithelium. Theca cells and oocytes were also significantly positive. Expression of GPER was more frequent in mature follicles/oocytes than in primordial ones, implying that GPER could be a selector during folliculogenesis. Moreover, GPER was upregulated in ovarian endometriosis and PID. Overexpression of GPER in both inflammation and endometriosis affecting the ovary may prove useful in explaining/predicting the main endometriosis-related symptoms. PMID:22573494

Heublein, Sabine; Lenhard, Miriam; Vrekoussis, Thomas; Schoepfer, Jutta; Kuhn, Christina; Friese, Klaus; Makrigiannakis, Antonis; Mayr, Doris; Jeschke, Udo



Advantages of the association of resveratrol with oral contraceptives for management of endometriosis-related pain  

PubMed Central

Background The effect of resveratrol on the management of endometriosis-related pain was investigated in 12 patients who failed to obtain pain relief during use of an oral contraceptive containing drospirenone + ethinylestradiol. Methods and results The addition of 30 mg of resveratrol to the contraceptive regimen resulted in a significant reduction in pain scores, with 82% of patients reporting complete resolution of dysmenorrhea and pelvic pain after 2 months of use. In a separate experiment, aromatase and cyclo-oxygenase-2 expression were investigated in the endometrial tissue of 42 patients submitted to laparoscopy and hysteroscopy for the management of endometriosis. Sixteen of these patients were using oral contraceptives alone prior to hospital admission, while the remaining 26 were using them in combination with resveratrol. Inhibition of both aromatase and cyclo-oxygenase-2 expression was significantly greater in the eutopic endometrium of patients using combined drospirenone + resveratrol therapy compared with the endometrium of patients using oral contraceptives alone. Conclusion These results suggest that resveratrol potentiates the effect of oral contraceptives in the management of endometriosis-associated dysmenorrhea by further decreasing aromatase and cyclo-oxygenase-2 expression in the endometrium.

Maia, Hugo; Haddad, Clarice; Pinheiro, Nathanael; Casoy, Julio



Pathogenesis and the role of ARID1A mutation in endometriosis-related ovarian neoplasms.  


Endometriosis-related ovarian neoplasms (ERONs) are a unique group of tumors as they are associated with endometriosis, especially endometriosis presenting as an ovarian endometriotic cyst (endometrioma). ERONs include clear cell carcinoma, endometrioid carcinoma, and seromucinous borderline tumor. A growing body of evidence from both clinicopathologic and molecular studies suggests that most, if not all, ERONs develop from endometriotic cyst epithelium through different stages of tumor progression. The endometriotic cyst contains abundant iron-induced reactive oxygen species that are thought to be mutagenic, and chronic exposure of cystic epithelium to this microenvironment facilitates the accumulation of somatic mutations that ultimately result in tumor development. Molecular analyses of ERONs, including genome-wide screens, have identified several molecular genetic alterations that lead to aberrant activation or inactivation of pathways involving ARID1A, PI3K, Wnt, and PP2A. Among all molecular genetic changes identified to date, inactivating mutations of the ARID1A tumor suppressor gene are the most common in ERON. Understanding the molecular changes and pathogenesis involved in the development of ERON is fundamental for future translational studies aimed at designing new diagnostic tests for early detection and identifying critical molecular features for targeted therapeutics. PMID:23232571

Maeda, Daichi; Shih, Ie-Ming



MAPK/ERK signal pathway involved expression of COX-2 and VEGF by IL-1? induced in human endometriosis stromal cells in vitro  

PubMed Central

Objective: Now there are more and more evidences that Cyclooxygenase-2 (COX-2) plays an important role in angiogenesis of endometriosis (EMs). Vascular endothelial growth factor (VEGF) has a potent angiogenic activity. However, it is worth studying about the regulating mechanism of COX-2/COX-1 and VEGF in the development of human endometriosis in vitro. The current study was designed to investigate the effect of 4 cytokines on COX-2/COX-1 expression and the effect of IL-1? on VEGF release in human endometriosis stromal cells (ESC), and to explore the related signaling pathways involved in vitro. Methods: Isolation, culture and identification of ESC. Cells were treated with 4 cytokines, and the inhibitor mitogen-activated protein-Erk (MEK) and the inhibitor p38 mitogen-activated protein kinase (MAPK) prior to adding cytokine IL-1?. COX-2 protein expression was measured by western blot and VEGF secretion was determined by ELISA. Results: Among four kinds of cytokines, IL-1? treatment increased COX-2 protein expression and VEGF release in three ESC, and TNF-? had the same effect on COX-2 protein level as IL-1? only in ectopic and eutopic ESC, and MCSF had only slight effect on ectopic ESC. In contrast, cytokines had no effect on COX-1 expression. We also demonstrated that MAPK reduced the synthesis of COX-2 by IL-1? induced. COX-2 inhibitor reduced VEGF release by IL-1? induced. Conclusions: i) In human ESC in vitro, IL-1? up-regulated the COX-2 expression through the activation of p38 MAPK pathway, and not to COX-1. ii) Up-regulation of VEGF level by IL-1? treatment was found in human endometriosis stromal cell and COX-2 inhibitor was involved in this process.

Huang, Fengying; Cao, Jing; Liu, Qiuhong; Zou, Ying; Li, Hongyun; Yin, Tuanfang



Priorities for Endometriosis Research  

PubMed Central

Endometriosis is an estrogen-dependent disorder where endometrial tissue forms lesions outside the uterus. Endometriosis affects an estimated 10% of women in the reproductive-age group, rising to 30% to 50% in patients with infertility and/or pain, with significant impact on their physical, mental, and social well-being. There is no known cure, and most current medical treatments are not suitable long term due to their side-effect profiles. Endometriosis has an estimated annual cost in the United States of $18.8 to $22 billion (2002 figures). Although endometriosis was first described more than 100 years ago, current knowledge of its pathogenesis, spontaneous evolution, and the pathophysiology of the related infertility and pelvic pain, remain unclear. A consensus workshop was convened following the 10th World Congress on Endometriosis to establish recommendations for priorities in endometriosis research. One major issue identified as impacting on the capacity to undertake endometriosis research is the need for multidisciplinary expertise. A total of 25 recommendations for research have been developed, grouped under 5 subheadings: (1) diagnosis, (2) classification and prognosis, (3) treatment and outcome, (4) epidemiology, and (5) pathophysiology. Endometriosis research is underfunded relative to other diseases with high health care burdens. This may be due to the practical difficulties of developing competitive research proposals on a complex and poorly understood disease, which affects only women. By producing this consensus international research priorities statement it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.

Rogers, Peter A. W.; D'Hooghe, Thomas M.; Fazleabas, Asgerally; Gargett, Caroline E.; Giudice, Linda C.; Montgomery, Grant W.; Rombauts, Luk; Salamonsen, Lois A.; Zondervan, Krina T.



The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review  

PubMed Central

Purpose Endometriosis and its associated infertility have been the object of continuous research for over a century. To understand the molecular mechanisms underlying the disease, it has become necessary to determine the aspects of its etiology that are not explained by the retrograde menstruation theory. This could in turn elucidate how various clinical and surgical treatments might affect the evolution and remission of the disease. Methods This review is focused on the most recent clinical and laboratory findings regarding the association of HOXA10 with endometriosis and infertility. Result The homebox (Hox/HOX) proteins are highly conserved transcription factors that determine segmental body identities in multiple species, including humans. Hoxa10/HOXA10 is directly involved in the embryogenesis of the uterus and embryo implantation via regulation of downstream genes. Cyclical endometrial expression of Hoxa10/HOXA10, with a peak of expression occurring during the window of implantation, is observed in the adult in response to estrogen and progesterone. Women with endometriosis do not demonstrate the expected mid-luteal rise of HOXA10 expression, which might partially explain the infertility observed in many of these patients. Recent studies also demonstrated HOXA10 expression in endometriotic foci outside the Müllerian tract. Conclusions Multiple lines of evidence suggest that the actions of the homeobox A10 (Hoxa10/HOXA10) gene could account for some aspects of endometriosis.

Rocha, Andre M.; Carvalho, Filomena M.; Pereira, Ricardo M. A.; Taylor, Hugh S.; Motta, Eduardo L. A.; Baracat, Edmund C.; Serafini, Paulo C.



Coordinated but depressed expression of human leukocyte antigen-DR, intercellular adhesion molecule-1, and CD14 on peritoneal macrophages in women with pelvic endometriosis  

Microsoft Academic Search

ObjectiveTo investigate the macrophage response in endometriosis, we determined the expression of human leukocyte antigen (HLA)-DR, intercellular adhesion molecule (ICAM)-1, and CD14 on peritoneal macrophages.

Chiaki Izumiya; Nagamasa Maeda; Tomoaki Kusume; Takayuki Masumoto; Chika Yamashita; Yorito Yamamoto; Hiroyoshi Oguri; Takao Fukaya



[Pulmonary endometriosis].  


Endometriosis in less common locations can become a diagnostic pitfall both from the clinical and morphological point of view, as this diagnosis is only seldom considered in the first series of differential diagnoses. This was true also for our patient reported. 48-year-old woman underwent left superior lobectomy for the clinical diagnosis of pulmonary neoplasm. Slightly prominent subpleural whitish nodular partly cystic tissue was histologically identified as pulmonary endometriosis. It consisted of proliferative to hyperproliferative endometrial glands surrounded by proliferation type stroma. Focally slight cytological glandular atyplas and immature squamous metaplasia were present. Later another focus was located by x-ray examination. Without any surgery, it responded to six month treatment with competitive gonadoliberin agonist (GnRH analogue) Zoladex. Three years after the treatment no signs of the disease have been present. The correct clinical diagnosis accompanied with cautious morphological verification may prevent unnecessary extensive surgery. However, even some correctly diagnosed and morphologically verified cases may require radical operative removal. Either approach (conservative therapy and surgery) completed with subsequent dispensarisation may prevent both the common (cycle related progressive tissue damage) and rare (tissue destruction, malignant transformation) complications. PMID:11374226

Dusková, J; Vítková, I



Development of endometriosis-like lesions after transplantation of human endometrial fragments onto the chick embryo chorioallantoic membrane.  


The chick embryo chorioallantoic membrane (CAM) bioassay was used to investigate the early pathogenesis of endometriosis. Endometrial fragments were explanted onto the CAM. The grafts including the surrounding CAM were excised at 24, 48 or 72 h after explantation, fixed and embedded in paraffin. Immunohistochemical analysis was used to distinguish endometrial cells. To identify cells of human origin, in-situ hybridization was performed using a probe specific for human chromosome 1. After 24 h, direct contact between endometrial stromal as well as epithelial cells and the mesenchymal layer of the CAM was observed. Invasion of both stromal cells and intact endometrial glands into the mesenchymal layer was observed after 48 h. At 72 h, endometriosis-like lesions were observed in the mesenchymal layer. Positive staining with antibodies to vimentin and pan-cytokeratin was observed in the invading cells as well as in the lesions. In the lesions these positively stained cells showed in-situ hybridization signals for human chromosome 1, confirming their human origin. In conclusion, after 3 days of incubation, endometriosis-like lesions consisting of human endometrial glands and stromal cells were found in the mesenchymal layer of the CAM. These lesions apparently resulted from the invasion of intact human epithelial structures and stromal cells. PMID:11278208

Maas, J W; Groothuis, P G; Dunselman, G A; de Goeij, A F; Struijker-Boudier, H A; Evers, J L



XRCC1 399 Arg-related genotype and allele, but not XRCC1 His107Arg, XRCC1 Trp194Arg, KCNQ2, AT1R, and hOGG1 polymorphisms, are associated with higher susceptibility of endometriosis.  


X-ray repair cross-complementing group 1 (XRCC1) and human 8-oxoguanine glycosylase 1 (hOGG1) play important roles in base excision repair. KCNQ genes comprising voltage-gated ion-channels related with cell stability. Angiotensin II type 1 receptor (AT1R) is related with angiogenesis, which influence endometriosis growth, invasion and regression. We aimed to investigate whether these polymorphisms were associated with endometriosis susceptibility. Women were divided [ 1 ]: endometriosis (n?=?136 [ 2 ]); non-endometriosis groups (n?=?112). XRCC1 (codon 107, 194, 399), hOGG1, KCNQ2, AT1R polymorphisms were amplified by PCR and detected by electrophoresis after restriction enzyme (RsaI, HpaII, MspI, Fnu4HI, Ava II, Dde I) digestions. Genotypes and allelic frequencies in both groups were compared. Proportions of XRCC1 Arg399Gln*GG/GA/AA and G/A allele between both groups were [ 1 ]: 41.9/53.7/4.4% and 68.8/31.2% [ 2 ]; 30.4/54.5/15.1% and 57.6/42.4% (p < 0.05). Other 5 polymorphisms (XRCC1 codon 107 and 194, hOGG1, KCNQ2, and AT1R) between both groups were non-significantly different. Proportions of XRCC1 107*AA/AG/GG and XRCC1 194*TT/TC/CC between both groups were [ 1 ]: 3.7/27.2/69.1% and 5.8/34.6/59.6% [ 2 ]; 2.6/21.4/75.8% and 11.6/37.5/50.9%. HOGG1*CC/CG/GG, KCNQ2*AA/AC/CCC and AT1R*AA/AC/CC were [ 1 ]: 14.8/42.6/42.6, 14/41.9/44.1 and 92.6/7.4/0% [ 2 ]; 11.6/50/38.4, 17/50/33 and 100/0/0%. We concluded that XRCC1 399 Arg-related genotype and allele are correlated with higher susceptibility to endometriosis, which suggested its association with endometriosis pathogenesis. XRCC1 107 and 194, hOGG1, KCNQ2, and AT1R are not associated with endometriosis susceptibility. PMID:22084859

Hsieh, Yao-Yuan; Chang, Chi-Chen; Chen, Shih-Yin; Chen, Chih-Ping; Lin, Wen-Hsin; Tsai, Fuu-Jen



Endometriosis: a life cycle approach?  


To improve the still fragmented understanding of endometriosis, a life cycle approach was adopted that revealed unexpected aspects of the natural history of the disease throughout a woman's life. Three age-related stages of endometriosis are distinguished. In premenarcheal and adolescent endometriosis, 2 types can be distinguished: a classic form that can occur before menarche, and a congenital obstructive form that is caused by uterine anomaly and outflow obstruction. The lesions include superficial peritoneal implants, but adhesions and endometrioma can also occur. It is suggested that premenarcheal and possibly adolescent endometriosis develop by activation of resting stem cells shed at the time of neonatal retrograde uterine bleeding. In the adult, endometriosis can be related to uterine preconditioning by cyclic menstruations acting as a priming mechanism for deep placentation. In adult life, the typical lesions are peritoneal, ovarian, and deep or adenomyotic endometriosis. More recently, endometriosis has been associated with endometrial dysfunction and myometrial junctional zone hyperplasia. These uterine changes can be linked with some major obstetrical syndromes. In postmenopause, endometriosis can develop or be reactivated both in the presence or absence of exogenous estrogens and can spread to a variety of organs and structures causing constrictive lesions. PMID:23500453

Brosens, Ivo; Puttemans, Patrick; Benagiano, Giuseppe



Soluble human IL-1 receptor type 2 inhibits ectopic endometrial tissue implantation and growth: identification of a novel potential target for endometriosis treatment.  


Endometriosis is often associated with a chronic pelvic immuno-inflammatory process, which is closely related to disease pathogenesis and major symptoms. Our studies led to the detection of a marked imbalance between IL-1 and its natural inhibitor IL-1 receptor type 2 (IL1R2) in women with endometriosis. This points to a deficiency in the local control of IL-1 that, in view of the cytokine's elevated levels and potent proinflammatory, angiogenic, and growth-promoting effects, may contribute to endometriosis development. Using an in vivo model in which human endometrial tissue was inoculated into nude mice and left to establish before any further treatment, our data showed that sIL1R2 interferes with the capability of endometrial tissue to invade, grow, disseminate, and stimulate angiogenesis into the host tissue. sIL1R2 significantly down-regulated the expression of major cell adhesion receptors (?v and ?3 integrins), matrix metalloproteinases (MMP-2 and -9), and vascular endothelial cell growth factor. Interestingly, treatment with sILR2 (5 ?g/kg) led to a concomitant upregulation of matrix metalloproteinases natural inhibitors (TIMP1 and TIMP2) and down-regulation of BclII, a potent anti-apoptotic protein. This creates an imbalance between pro- and anti-proteolytic and apoptotic factors and may further contribute to IL1R2 growth-inhibitory effects. This study provides evidence that sIL1R2 alters ectopic endometrial tissue growth, remodeling, and survival in vivo and may represent an interesting potential therapeutic tool. PMID:22841820

Khoufache, Khaled; Bondza, Patrick Kibangou; Harir, Noria; Daris, Marleen; Leboeuf, Mathieu; Mailloux, Jacques; Lemyre, Madeleine; Foster, Warren; Akoum, Ali



Ectopic endometrium in human foetuses is a common event and sustains the theory of m?llerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer  

PubMed Central

Background Endometriosis is a gynecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity. Women with endometriosis have an increased risk of different types of malignancies, especially ovarian cancer and non-Hodgkin's lymphoma. Though there are several theories, researchers remain unsure as to the definitive cause of endometriosis. Our objective was to test the validity of the theory of müllerianosis for endometriosis, that is the misplacing of primitive endometrial tissue along the migratory pathway of foetal organogenesis Methods We have collected at autopsy 36 human female foetuses at different gestational age. We have performed a morphological and immunohistochemical study (expression of oestrogen receptor and CA125) on the pelvic organs of the 36 foetuses included en-block and totally analyzed. Results In 4 out of 36 foetuses we found presence of misplaced endometrium in five different ectopic sites: in the recto-vaginal septum, in the proximity of the Douglas pouch, in the mesenchimal tissue close to the posterior wall of the uterus, in the rectal tube at the level of muscularis propria, and in the wall of the uterus. All these sites are common location of endometriosis in women. Conclusion We propose that a cause of endometriosis is the dislocation of primitive endometrial tissue outside the uterine cavity during organogenesis.

Signorile, Pietro G; Baldi, Feliciano; Bussani, Rossana; D'Armiento, Mariarosaria; De Falco, Maria; Baldi, Alfonso



Human Relations.  

ERIC Educational Resources Information Center

Human relations units are presented in this guide designed for teachers of secondary grades. The aim is to educate students in the philosophy of humanism. Emphasis is upon social interaction in an attempt to help pupils not only realize their own potential, but moreover, to respond to the needs of others. Each of the four activity units deals with…

Dade County Public Schools, Miami, FL.


Ureteric and pulmonary endometriosis.  


Pulmonary lesions and ureter involvement are rare complications of endometriosis. We describe the first case with an involvement of both sites in this condition. The radiographs showed "pulmonary metastases" together with clinical findings of a hydronephrosis, mimicing a malignant metastatic gynecologic tumor of unknown primary. A laparoscopy showed severe endometriotic lesions; therefore the findings were most likely related to the condition of endometriosis. The patient was treated with gosereline acetate for six months (Zoladex). Control radiographs showed complete regression of the pulmonary lesions and the patient is symptom free at 36 months after diagnosis. PMID:11561747

Ludwig, M; Bauer, O; Wiedemann, G J; Diedrich, K



Art and Endometriosis.  

ERIC Educational Resources Information Center

|Relation of an art therapist's personal story concerning her struggle to overcome endometriosis, and how her artwork has played a vital role in coping with the disease. Illustrated with a chronology of artwork produced during a bout with the illness. (JPS)|

Berstein, Jane C.



Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial  

PubMed Central

Background When aromatase inhibitors are used to treat premenopausal women with endometriosis, additional drugs should be used to effectively down-regulate gonadal estrogen biosynthesis. This randomized prospective open-label study compared the efficacy in treating pain symptoms and the tolerability of letrozole combined with either norethisterone acetate or triptorelin. Methods Women with pain symptoms caused by rectovaginal endometriosis were treated with letrozole (2.5 mg/day) and were randomized to also receive either oral norethisterone acetate (2.5 mg/day; group N) or intramuscular injection of triptorelin (11.25 mg every 3 months; group T). The scheduled length of treatment was 6 months. A visual analogue scale and a multidimensional categorical rating scale were used to assess the severity of pain symptoms. The volume of the endometriotic nodules was estimated by ultrasonography using virtual organ computer-aided analysis. Adverse effects of treatment were recorded. Results A total of 35 women were randomized between the two treatment protocols. Significantly more patients in group N rated their treatment as satisfactory or very satisfactory (64.7%) as compared to group T (22.2%; p = 0.028). The intensity of both non-menstrual pelvic pain and deep dyspareunia significantly decreased during treatment in both study groups, though no statistically meaningful difference between the two groups was apparent. Reduction in the volume of endometriotic nodules was significantly greater in group T than in group N. Interruption of treatment due to adverse effects significantly differed between the groups, with 8 women in group T (44.4%) and 1 woman in group N (5.9%) interrupting treatment (p = 0.018). Similarly, 14 women included in group T (77.8%) and 6 women included in group N (35.3%) experienced adverse effects of treatment (p = 0.018). During treatment, mineral bone density significantly decreased in group T but not in group N. Conclusions Aromatase inhibitors reduce the intensity of endometriosis-related pain symptoms. Combining letrozole with oral norethisterone acetate was associated with a lower incidence of adverse effects and a lower discontinuation rate than combining letrozole with triptorelin.



Clinical approach for Iranian patients with endometriosis  

Microsoft Academic Search

Introduction: Endometriosis is a prevalent disease in reproductive age accompanied by pelvic pain, dysmenorrhea, dyspareunia and at times is a leading cause of infertility in women. No doubt, there is a significant debatable relation between endometriosis and infertility. Methods: Patients referring to Sarem Medical Center first undergo an initial investigation followed by a diagnostic laparoscopy and therefore the severity of

Aboutaleb Saremi; Jaleh Taheri



Endometriosis: presentation to general surgeons.  

PubMed Central

We present nine cases of endometriosis presenting to general surgeons over a period of 4.5 years at Gwynedd Hospital, Bangor. A total of 83 cases of endometriosis was found on analysis of pathology records. Of these, 73 presented to gynaecologists, one to a dermatologist and nine to general surgeons. The presentation to general surgeons includes swelling related to Pfannanstiel scar (two), swelling in inguinal canal (two), umbilical nodule (one), rectal bleeding (one), recurrent abdominal pain (one), mimicking ovarian tumour (one) and presenting as pelvic peritonitis (one). Six were elective admissions and three were admitted as an emergency. All were premenopausal (range 19-49 years) women. None had any previous history of endometriosis or subfertility. Two patients with cyclical symptoms were correctly diagnosed clinically, and the others were postoperative diagnosis. Six patients required gynaecological referral and four of these required further medical treatment. None of them has required further surgical intervention in follow-up (range 4 weeks to 3 years). Endometriosis usually presents to general surgeons with deposits at extragonadal sites. Some patients may present as an emergency with abdominal pain. Endometriosis should be included in the differential diagnosis of women presenting with swellings related to umbilicus, surgical scars, inguinal canal and pelvis, especially if symptoms are cyclical. Usually, surgical excision is adequate. Selected cases require gynaecological referral and further medical therapy.

Khetan, N.; Torkington, J.; Watkin, A.; Jamison, M. H.; Humphreys, W. V.



Clinical management of endometriosis.  


Endometriosis is a relatively common chronic gynecologic disorder that usually presents with chronic pelvic pain or infertility. The societal effect of this disorder is enormous both in monetary costs and in quality of life. The diagnosis of the disease can only be definitively made with surgical intervention. Fertility may be enhanced with surgical intervention, but medical suppressive therapy has no role apart from in vitro fertilization. Assisted reproductive technology is associated with excellent outcomes. Management of endometriomas is particularly complex because surgical intervention may reduce ovarian reserve. Both medical and surgical treatment of endometriosis-associated chronic pelvic pain are effective in the short-term. Recurrence is common with both modalities. Recurrence after surgical intervention can be decreased with the use of postoperative suppressive medical therapy such as hormonal contraceptives. This article presents the different types of peritoneal disease found in endometriosis patients. The technique used to safely and completely remove the disease is discussed. The specific areas of involvement include the pelvic side wall, the cul-de-sac, and bladder peritoneum. PMID:21860303

Falcone, Tommaso; Lebovic, Dan I



Genetic abnormalities detected by comparative genomic hybridization in a human endometriosis-derived cell line.  


Comparative genomic hybridization (CGH) was used in parallel with fluorescence in-situ hybridization (FISH) and conventional karyotyping to perform a genome-wide survey of DNA gains and losses in the endometriosis-derived permanent cell line, FbEM-1. The cytogenetic analysis showed a complex karyotype with numerical changes and multiple chromosome aberrations, including the der(1) complement marker exhibiting a large homogenous staining region (HSR). The chromosomal rearrangement interpreted as der(5) t(5;6)(q34;p11) was found in the majority of the metaphases indicating a clonal abnormality. Repeated CGH experiments demonstrated over-representation of chromosomes 1, 2, 3, 5, 6p, 7, 16, 17q, 20, 21q and 22q, while chromosomes 6q, 9, 11p, 12, 13q, 18 and X were under-represented. Using DNA from the original endometriotic tissues, including a peritoneal implant and ovarian endometrioma, CGH analysis revealed loss of DNA copy number on 1p, 22q and chromosome X, while gain was found on chromosomal arms 6p and 17q. FISH analysis confirmed that the gain at 17q includes amplification of the proto-oncogene HER-2/neu in 16% of the FbEM-1 nuclei and in 12% of cells from the primary ovarian endometrioma tissue. These findings demonstrate that FbEM-1 cells share certain molecular cytogenetic features with the original tissue and suggest that chromosomal instability is important in the development of endometriosis. PMID:10956554

Gogusev, J; Bouquet de Jolinière, J; Telvi, L; Doussau, M; du Manoir, S; Stojkoski, A; Levardon, M



Ability of recombinant human TNF binding protein-1 (r-hTBP-1) to inhibit the development of experimentally-induced endometriosis in rats  

Microsoft Academic Search

The aim of this study was to assess whether r-hTBP-1 (recombinant human tumor necrosis factor binding protein-1), the soluble form of tumor necrosis factor-? (TNF) receptor type 1 might be effective in counteracting the proliferation of ectopic endometrium using an in vivo experimental model of endometriosis. The in vivo model involved transplanting a square fragment of autologus uterine tissue onto

M D'Antonio; F Martelli; S Peano; R Papoian; F Borrelli



Japanese-Style Acupuncture for Endometriosis-Related Pelvic Pain in Adolescents and Young Women: Results of a Randomized Sham-Controlled Trial  

PubMed Central

Study Objective To assess feasibility, and collect preliminary data for a subsequent randomized, sham-controlled trial to evaluate Japanese-style acupuncture for reducing chronic pelvic pain and improving health related quality of life (HRQOL) in adolescents with endometriosis. Design Randomized, sham-controlled trial. Settings Tertiary-referral hospital. Participants Eighteen young women (13–22y) with laparoscopically-diagnosed endometriosis-related chronic pelvic pain. Interventions A Japanese style of acupuncture and a sham acupuncture control. Sixteen treatments were administered over 8 weeks. Main outcome measures Protocol feasibility, recruitment numbers, pain not associated with menses or intercourse, and multiple HRQOL instruments including Endometriosis Health Profile, Pediatric Quality of Life, Perceived Stress, and Activity Limitation. Results Fourteen participants (out of 18 randomized) completed the study per protocol. Participants in the active acupuncture group (n=9) experienced an average 4.8 (sd=2.4) point reduction on a 11 point scale (62%) in pain after 4 weeks, which differed significantly from the control group’s (n=5) average reduction of 1.4 (s.d.=2.1) points (P=0.004). Reduction in pain in the active group persisted through a 6 month assessment; however, after 4 weeks, differences between the active and control group decreased and were not statistically significant. All HRQOL measures indicated greater improvements in the active acupuncture group compared to the control; however, the majority of these trends were not statistically significant. No serious adverse events were reported. Conclusion Preliminary estimates indicate that Japanese-style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain in adolescents. A more definitive trial evaluating Japanese-style acupuncture in this population is both feasible and warranted.

Wayne, Peter M.; Kerr, Catherine E.; Schnyer, Rosa N.; Legedza, Anna T. R.; Savetsky-German, Jacqueline; Shields, Monica H.; Buring, Julie E.; Davis, Roger B.; Conboy, Lisa A.; Highfield, Ellen; Parton, Barbara; Thomas, Phaedra; Laufer, Marc R.



Inflammatory cytokines differentially up-regulate human endometrial haptoglobin production in women with endometriosis  

PubMed Central

BACKGROUND Evidence suggests that eutopic endometrium from women with endometriosis (US-E) has intrinsic functional anomalies compared with women without endometriosis (US-C). We hypothesized that differences in endometrial haptoglobin (eHp) mRNA and protein levels exist between eutopic endometrium from US-E and US-C and that inflammatory mediators may be involved. METHODS Endometrial stromal cells and tissue explants from US-E (n = 18) and US-C (n = 18) were cultured (24 h/48 h for cells/explants) with interleukin (IL)-1?, -1?, -6, -8 or tumor necrosis factor-alpha (TNF-?) at 0–100 ng/ml. eHp protein in media and mRNA levels were quantified by enzyme-linked immunosorbent assay and quantitative PCR. RESULTS In eutopic endometrial stromal cells from US-E, IL-1?, IL-6 and TNF-? (10 ng/ml) increased eHp mRNA levels (P = 0.002, P < 0.001 and P < 0.001, respectively) and eHp protein (P = 0.023, 0.031 and 0.006, respectively) versus control. In endometrial tissues from US-E, IL-1?, IL-6 and TNF-? increased eHp mRNA (P < 0.001, P = 0.017 and P < 0.001, respectively) and eHp protein (P < 0.001, P = 0.007 and 0.039, respectively) versus control. IL-1? and IL-8 had small or no effects on isolated endometrial cells or tissues. In US-C, IL-1?, IL-8 and TNF-? each reduced eHp mRNA in endometrial stromal cells (all P < 0.001) versus control; IL-1? and IL-6 had no effect. eHp mRNA increased in endometrial tissues from US-C in response to IL-1? (P = 0.008), IL-6 (P = 0.015) and TNF-? (P = 0.031) versus control; IL-1? or IL-8 had no effect. CONCLUSIONS Endometrium from US-E differentially responds to specific inflammatory cytokines by production of eHp. We propose that up-regulation of endometrial eHp by inflammatory mediators disrupts normal endometrial function and may facilitate the pathogenesis of endometriosis.

Sharpe-Timms, K.L.; Nabli, H.; Zimmer, R.L.; Birt, J.A.; Davis, J.W.



Pathogenesis of Ovarian Clear Cell Adenofibroma, Atypical Proliferative (Borderline) Tumor, and Carcinoma: Clinicopathologic Features of Tumors with Endometriosis or Adenofibromatous Components Support Two Related Pathways of Tumor Development  

PubMed Central

The clinicopathologic features of 472 ovarian epithelial clear cell neoplasms (4 adenofibromas [AFs], 41 atypical proliferative [borderline] tumors [APTs], and 427 carcinomas [CAs]) were studied in order to elucidate the morphologic steps involved in the pathogenesis of these tumors and determine whether clear cell CA is a type I or type II tumor in the dualistic model of ovarian carcinogenesis. Thirty-three percent of the CAs had an adenofibromatous background [CA(AF+)], and 67% did not [CA(AF-)]. Endometriosis was found in all types of tumors, but tumors arising in endometriotic cysts were more frequent with CA(AF-)s (p<0.0001). The subset of women with CA(AF-)s with endometriosis were younger (p<0.0001), their tumors were more frequently cystic (p<0.0001), they more commonly had a mixed carcinoma component of non-clear cell type (p=0.006), and they were more frequently oxyphilic (p=0.015) compared with CA(AF+)s. The architecture of the former tumors was more commonly papillary compared to tubulocystic in the latter (p=0.0006). Atypical endometriosis was more common in CA(AF-)s than in AFs, APTs, and CC(AF+)s [p=0.004]. The subset of CA(AF-)s without endometriosis presented more frequently in advanced stage (>I) and were higher grade compared to CA(AF+)s or CA(AF-) with endometriosis (p-values, <0.0001 to 0.0071). All AFs and APTs were stage I compared to 79% of CA(AF+)s. An increase in mean tumor size correlated with each respective tumor category from AF (6.8 cm) to CA(AF+) [12.9 cm]. Notable nuclear atypia was absent in all AFs but was focally present in 27% of APTs and in the adenofibromatous background of 24% of the CA(AF+)s. An increase in the proportion of carcinoma in the CA(AF+)s correlated with an increase in grade and advanced stage. In summary, ovarian clear cell CA appears to develop along two pathways, both of which are related to endometriosis. We speculate that, in one, epithelial atypia arises in an endometriotic cyst and then evolves into clear cell CA, and, in the other, non-cystic endometriosis induces a fibromatous reaction resulting in the formation of AF, which then develops into APT and subsequently a clear cell CA. The absence of endometriosis or adenofibromatous components in CC(AF-)s may be due to overgrowth and obliteration by the invasive carcinoma. Finally, the findings in this study support the view that both types of clear cell CA [CC(AF+) and CC(AF-)] are more closely related to type I tumors.

Zhao, Chengquan; Wu, Lee Shu-Fune; Barner, Ross



Detection of DNA copy number changes in human endometriosis by comparative genomic hybridization.  


Endometriosis is characterized by infertility and pelvic pain in 10-15% of women of reproductive age. The genetic events involved in endometriotic cell expansion remain in large part unknown. To identify genomic changes involved in development of this disease, we examined a panel of 18 selected endometriotic tissues by comparative genomic hybridization (CGH), a molecular cytogenetic method that allows screening of the entire genome for chromosomal gains and/or losses. The study was performed on native, nonamplified DNA extracted from manually dissected endometriotic lesions. Recurrent copy number losses on several chromosomes were detected in 15 of 18 cases. Loss of chromosome 1p and 22q were detected in 50% of the cases. Additional common losses occurred on chromosomes 5p (33%), 6q (27%), 7p(22%), 9q (22%), 16 (22%) as well as on 17q in one case. Gain of DNA sequences were seen at 6q, 7q and 17q in three cases. To validate the CGH data, selective dual-color FISH was performed using probes for the deleted regions on chromosomes 1, 7 and 22 in parallel with the corresponding centromeric probes. Cases showing deletion by CGH all had two signals at 1p36, 7p22.1 and 22q12 in less than 30% of the nuclei in comparison to the double centromeric labels found in more than 85% of the cells. These findings indicate that genes localized to previously undescribed chromosomal regions play a role in development and progression of endometriosis. PMID:10598811

Gogusev, J; Bouquet de Jolinière, J; Telvi, L; Doussau, M; du Manoir, S; Stojkoski, A; Levardon, M



Synchronous Rectovaginal, Urinary Bladder, and Pulmonary Endometriosis  

PubMed Central

Background: Extragenital endometriosis is an uncommon condition that can affect almost any organ system and tissue in the human body. Disease involving multiple distant sites is extremely uncommon. Methods: We report a rare case of synchronous rectovaginal, urinary bladder, and pulmonary endometriosis. We performed a Medline literature search using keywords “endometriosis,” “rectovaginal,” “pulmonary,” “bladder,” “ureteral,” “bowel,” “extrapelvic,” and “extragenital” and were unable to find any prior case reports of such findings. A 31-year-old female presented with catamenial dysuria of 1-year duration, pleurisy associated with spontaneous pneumothoraces of 7 months' duration and a long-standing history of pelvic pain. A multispecialty team with experience in endoscopic techniques was assembled, consisting of a thoracic, a urologic, and a gynecologic surgeon. Video-assisted thoracoscopic surgery with fulguration of all visible pleural endometriosis and pleurodesis was performed, followed by laparoscopic segmental bladder wall endometrioma excision and resection of rectovaginal endometriosis. Twelve months after surgery and without additional hormonal treatment, the patient is symptom free. Conclusion: Extragenital endometriosis may coexist in multiple sites. A high index of suspicion aids in the diagnosis. A multidisciplinary approach in a tertiary center, followed by appropriate surgical eradication of visible disease, can successfully treat endometriosis even in such extreme cases.

Payne, Christopher K.; Osias, Joelle; Cannon, Walter; Nezhat, Camran R.



What Are the Symptoms of Endometriosis?  


... 2012 Division of Intramural Research (DIR) Annual Report Global Consortium Identifies Best Management of Endometriosis Scientific Vision: The Next Decade All related news Home Accessibility Contact Disclaimer Privacy Policy FOIA Facebook YouTube NIH...Turning ...


Risk factors associated with endometriosis among infertile Iranian women  

PubMed Central

Introduction Endometriosis is defined as overgrowth of endometrial tissue outside the uterine cavity. Endometriosis may be asymptomatic or associated with dysmenorrheal symptoms, dyspareunia, pelvic pain, abnormal uterine bleeding and infertility. The aim of this study was to explore the risk factors related to endometriosis among infertile Iranian women. Material and methods In this case control study, infertile women referred for laparoscopy and infertility workup to two referral infertility clinics in Tehran, Iran were studied. According to the laparoscopy findings, women were divided into case (women who had pelvic endometriosis) and control (women with normal pelvis) groups. The case group was divided into two subgroups: stage I and II of endometriosis were considered as mild while stage III and IV were categorized as severe endometriosis. A questionnaire was completed for each patient. Results Logistic regression showed that age, duration of infertility, body mass index (BMI), duration of menstrual cycle, abortion history, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors for any type of endometriosis. In addition, it was shown that education, duration of infertility, BMI, amount and duration of menstrual bleeding, menstrual pattern, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors of severe endometriosis. The AUCs for these models were 0.781 (0.735-0.827) and 0.855 (0.810-0.901) for any type of endometriosis and severe endometriosis, respectively. Conclusions It seems that any type of endometriosis and severe ones could be predicted according to demographic, menstrual and reproductive characteristics of infertile women.

Malekzadeh, Farideh; Amirchaghmaghi, Elham; Kashfi, Fahimeh; Akhoond, Mohammad Reza; Saei, Maryam; Mirbolok, Mohammad Hossein



Reactive Oxygen Species Controls Endometriosis Progression  

PubMed Central

Endometriosis is associated with chronic inflammation, and reactive oxygen species (ROS) are proinflammatory mediators that modulate cell proliferation. We have investigated whether the dysregulation of ROS production in endometriotic cells correlates with a pro-proliferative phenotype and can explain the spreading of this disease. Stromal and epithelial cells were purified from ovarian endometrioma and eutopic endometrium from 14 patients with endometriosis to produce four primary cell lines from each patient. ROS production, detoxification pathways, cell proliferation, and mitogen-activated protein kinase pathway activation were studied and compared with epithelial and stromal cell lines from 14 patients without endometriosis. Modulation of the proliferation of endometriosis by N-acetyl-cysteine, danazol, and mifepristone was tested in vitro and in 28 nude mice implanted with endometriotic tissue of human origin. Endometriotic cells displayed higher endogenous oxidative stress with an increase in ROS production, alterations in ROS detoxification pathways, and a drop in catalase levels, as observed for tumor cells. This increase in endogenous ROS correlated with increased cellular proliferation and activation of ERK1/2. These phenomena were abrogated by the antioxidant molecule N-acetyl-cysteine both in vitro and in a mouse model of endometriosis. Human endometriotic cells display activated pERK, enhanced ROS production, and proliferative capability. Our murine model shows that antioxidant molecules could be used as safe and efficient treatments for endometriosis.

Ngo, Charlotte; Chereau, Christiane; Nicco, Carole; Weill, Bernard; Chapron, Charles; Batteux, Frederic



Radiation-induced endometriosis in Macaca mulatta  

SciTech Connect

Female rhesus monkeys received whole-body doses of ionizing radiation in the form of single-energy protons, mixed-energy protons, X rays, and electrons. Endometriosis developed in 53% of the monkeys during a 17-year period after exposure. Incidence rates for endometriosis related to radiation type were: single-energy protons, 54%; mixed-energy protons, 73%; X rays, 71%; and electrons, 57%. The incidence of endometriosis in nonirradiated control monkeys was 26%. Monkeys exposed to single-energy protons, mixed-energy protons, and X rays developed endometriosis at a significantly higher rate than control monkeys (chi 2, P less than 0.05). Severity of endometriosis was staged as massive, moderate, and minimal. The incidence of these stages were 65, 16, and 19%, respectively. Observations of clinical disease included weight loss in 43% of the monkeys, anorexia in 35%, space-occupying masses detected by abdominal palpation in 55%, abnormal ovarian/uterine anatomy on rectal examination in 89%, and radiographic evidence of abdominal masses in 38%. Pathological lesions were endometrial cyst formation in 69% of the monkeys, adhesions of the colon in 66%, urinary bladder in 50%, ovaries in 86%, and ureters in 44%, focal nodules of endometrial tissue throughout the omentum in 59%, and metastasis in 9%. Clinical management of endometriosis consisted of debulking surgery and bilateral salpingo-oophorectomy combined in some cases with total abdominal hysterectomy. Postoperative survival rates at 1 and 5 years for monkeys recovering from surgery were 48 and 36%, respectively.

Fanton, J.W.; Golden, J.G. (USAF School of Aerospace Medicine, Brooks AFB, TX (USA))



Selective progesterone receptor modulator development and use in the treatment of leiomyomata and endometriosis.  


Selective progesterone receptor modulators (SPRMs) represent a new class of progesterone receptor ligands. SPRMs exert clinically relevant tissue-selective progesterone agonist, antagonist, or mixed agonist/antagonist effects on various progesterone target tissues in vivo. Asoprisnil (J867) is the first SPRM to reach an advanced stage of clinical development for the treatment of symptomatic uterine fibroids and endometriosis. Asoprisnil belongs to the class of 11beta-benzaldoxime-substituted estratrienes that exhibit partial progesterone agonist/antagonist effects with high progesterone receptor specificity in animals and humans. Asoprisnil has no antiglucocorticoid activity in humans at therapeutic doses. It exhibits endometrial antiproliferative effects on the endometrium and breast in primates. Unlike progesterone antagonists, asoprisnil does not induce labor in relevant models of pregnancy and parturition. It induces amenorrhea primarily by targeting the endometrium. In human subjects with uterine fibroids, asoprisnil suppressed both the duration and intensity of uterine bleeding in a dose-dependent manner and reduced tumor volume in the absence of estrogen deprivation. In subjects with endometriosis, asoprisnil was effective in reducing nonmenstrual pain and dysmenorrhea. Asoprisnil may, therefore, provide a novel, tissue-selective approach to control endometriosis-related pain. SPRMs have the potential to become a novel treatment of uterine fibroids and endometriosis. PMID:15857972

Chwalisz, Kristof; Perez, Maria Claudia; Demanno, Deborah; Winkel, Craig; Schubert, Gerd; Elger, Walter



[Personal characteristics as risk factors of endometriosis].  


203 patients with pelvic endometriosis, all Beijing resident, were collected from the Peking Union Medical College Hospital and the Beijing Obstetrical and Gynecological Hospital. The diagnosis of endometriosis was confirmed by pathological examination of surgical specimens in 186 patients and by aspiration of chocolate substance under laparoscopy in 17. Two population controls, age matched +/- 1 year, were randomly selected for each patient from the same residential area, after careful pelvic examinations and ultrasonographies. A questionnaire for any possible risk factors to endometriosis was developed and with this questionnaire a face to face interview for each subject was carried out by the trained interviewers. All interviews were tape recorded and calculated in a AST 386 computer. The continuous logistic regression for matched sites was used to obtain a maximum likelihood point and to control the potential confounding effects of selected variables. Relative risk (RR) substituted for odds ratio together with the 95% confidence intervals was estimated. All the results were adjusted for the variables of the model including some relevant factors of menstruation, pregnancy and contraception. An increased risk for endometriosis was found to be related to women who had a higher level of education. Even it was adjusted for age of first marriage and pregnancy, gravidity, parity, contraception and all other variables of the model, the relative risk was 1.84 for endometriosis. Therefore, it is the education level itself that plays a true role in development of endometriosis. Although there was a trend in risk for endometriosis in height, it was statistically insignificant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7600319

Pan, L; Song, H; Wu, P



The Traditional Chinese Medicine Prescription Pattern of Endometriosis Patients in Taiwan: A Population-Based Study  

PubMed Central

Background. Traditional Chinese medicine (TCM), when given for symptom relief, has gained widespread popularity among women with endometriosis. The aim of this study was to analyze the utilization of TCM among women with endometriosis in Taiwan. Methods. The usage, frequency of service, and the Chinese herbal products prescribed for endometriosis, among endometriosis patients, were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 90.8% (N = 12, 788) of reproductive age women with endometriosis utilized TCM and 25.2% of them sought TCM with the intention of treating their endometriosis-related symptoms. Apart from the usage of either analgesics or more than one type of medical treatment, the odds of using TCM and Western medicine were similar in all types of conventional endometriosis treatment. However, endometriosis patients suffering from symptoms associated with endometriosis were more likely to seek TCM treatment than those with no symptoms. There were 21,056 TCM visits due to endometriosis and its related symptoms, of which more than 98% were treated with Chinese herbal products (CHPs). Conclusion. Gui-Zhi-Fu-Ling-Wan (Cinnamon Twig and Poria Pill) containing sedative and anti-inflammatory agents is the most commonly prescribed Chinese herbal formula mainly for the treatment of endometriosis-related symptomatic discomfort and the effects of these TCMs should be taken into account by healthcare providers.

Fang, Ruei-Chi; Tsai, Yueh-Ting; Lai, Jung-Nien; Yeh, Chia-Hao; Wu, Chien-Tung



The traditional chinese medicine prescription pattern of endometriosis patients in taiwan: a population-based study.  


Background. Traditional Chinese medicine (TCM), when given for symptom relief, has gained widespread popularity among women with endometriosis. The aim of this study was to analyze the utilization of TCM among women with endometriosis in Taiwan. Methods. The usage, frequency of service, and the Chinese herbal products prescribed for endometriosis, among endometriosis patients, were evaluated using a randomly sampled cohort of 1,000,000 beneficiaries recruited from the National Health Insurance Research Database. Results. Overall, 90.8% (N = 12, 788) of reproductive age women with endometriosis utilized TCM and 25.2% of them sought TCM with the intention of treating their endometriosis-related symptoms. Apart from the usage of either analgesics or more than one type of medical treatment, the odds of using TCM and Western medicine were similar in all types of conventional endometriosis treatment. However, endometriosis patients suffering from symptoms associated with endometriosis were more likely to seek TCM treatment than those with no symptoms. There were 21,056 TCM visits due to endometriosis and its related symptoms, of which more than 98% were treated with Chinese herbal products (CHPs). Conclusion. Gui-Zhi-Fu-Ling-Wan (Cinnamon Twig and Poria Pill) containing sedative and anti-inflammatory agents is the most commonly prescribed Chinese herbal formula mainly for the treatment of endometriosis-related symptomatic discomfort and the effects of these TCMs should be taken into account by healthcare providers. PMID:23056141

Fang, Ruei-Chi; Tsai, Yueh-Ting; Lai, Jung-Nien; Yeh, Chia-Hao; Wu, Chien-Tung



A novel role of the Sp/KLF transcription factor KLF11 in arresting progression of endometriosis.  


Endometriosis affects approximately 10% of young, reproductive-aged women. Disease associated pelvic pain; infertility and sexual dysfunction have a significant adverse clinical, social and financial impact. As precise disease etiology has remained elusive, current therapeutic strategies are empiric, unfocused and often unsatisfactory. Lack of a suitable genetic model has impaired further translational research in the field. In this study, we evaluated the role of the Sp/KLF transcription factor KLF11/Klf11 in the pathogenesis of endometriosis. KLF11, a human disease-associated gene is etiologically implicated in diabetes, uterine fibroids and cancer. We found that KLF11 expression was diminished in human endometriosis implants and further investigated its pathogenic role in Klf11-/- knockout mice with surgically induced endometriotic lesions. Lesions in Klf11-/- animals were large and associated with prolific fibrotic adhesions resembling advanced human disease in contrast to wildtype controls. To determine phenotype-specificity, endometriosis was also generated in Klf9-/- animals. Unlike in Klf11-/- mice, lesions in Klf9-/- animals were neither large, nor associated with a significant fibrotic response. KLF11 also bound to specific elements located in the promoter regions of key fibrosis-related genes from the Collagen, MMP and TGF-? families in endometrial stromal cells. KLF11 binding resulted in transcriptional repression of these genes. In summary, we identify a novel pathogenic role for KLF11 in preventing de novo disease-associated fibrosis in endometriosis. Our model validates in vivo the phenotypic consequences of dysregulated Klf11 signaling. Additionally, it provides a robust means not only for further detailed mechanistic investigation but also the ability to test any emergent translational ramifications thereof, so as to expand the scope and capability for treatment of endometriosis. PMID:23555910

Daftary, Gaurang S; Zheng, Ye; Tabbaa, Zaid M; Schoolmeester, John K; Gada, Ravi P; Grzenda, Adrienne L; Mathison, Angela J; Keeney, Gary L; Lomberk, Gwen A; Urrutia, Raul



Vascular development in endometriosis  

Microsoft Academic Search

Endometriosis, defined as the presence of endometrial tissue outside the uterus, is an estrogen-dependent disease which causes\\u000a pelvic pain and subfertility in women of reproductive age. The condition has a dramatic impact on the professional, social\\u000a and marital life of sufferers. Direct and indirect evidence suggests that angiogenesis is required for the development and\\u000a persistence of endometriosis. In this review

P. G. Groothuis; A. W. Nap; E. Winterhager; R. Grümmer



Endometriosis in Adolescence  

PubMed Central

Endometriosis is a common cause of pelvic pain and infertility. The majority of women report symptoms since adolescence, and there are rare cases of endometriosis in premenarchal age patients. Symptoms in adolescence are similar to those in adulthood. Treatment usually consists of oral contraceptives and nonsteroidal anti-inflammatory drugs. In cases where this treatment is not successful, laparoscopy and biopsy of the lesions are necessary for diagnosis. However, emerging new technologies provide new options, in particular the use of serological markers.

Dessole, Margherita; Melis, Gian Benedetto; Angioni, Stefano



Coping with endometriosis.  


Endometriosis not only has physical implications for women but also may affect their sexuality, self-image, and hopes for childbearing. This article discusses the role of parish nurses in a community faith-based setting collaborating to provide comprehensive care for women who are diagnosed with endometriosis. Physical, emotional, and spiritual dimensions of care are highlighted. Traditional and complimentary treatments are described. Examples of outcomes for women in the described program are included in case study exemplars. PMID:20409124

Kaatz, Joyce; Solari-Twadell, P Ann; Cameron, Julie; Schultz, Renee


Laparoscopic treatment of endometriosis.  


Endometriosis can be considered as a chronic disease which is characterized by the presence of ectopic endometrium outside the endometrial cavity and which is associated with symptoms as pelvic pain and infertility. Medical treatment is often not sufficient in patients with moderate to severe endometriosis and deep infiltrative endometriosis (DIE), therefore requiring surgical intervention. Over the past 15 years, we have built a multidisciplinary surgical team to perform a radical but fertility preserving resection of extensive endometriosis with involvement of surrounding organ systems, realizing a good clinical outcome with low complication and recurrence rate, a very good improvement of QOL and a high pregnancy rate. However, for future research evaluating surgical treatment of extensive endometriosis, it is important to reach agreement on study design and on reporting clinical outcome data. A multicenter study with clear patient identification and well defined outcome parameters needs to be set up. Moreover, prevention of DIE with colorectal extension is important, ideally by early identification and management of girls and women at risk. Years of pain and disability as well as a lot of money could be saved when patients, at risk of developing extensive forms of endometriosis could be diagnosed during adolescence. PMID:23598780

Meuleman, C; Tomassetti, C; Gaspar Da Vitoria Magro, M; Van Cleynenbreugel, B; D'Hoore, A; D'Hooghe, T



Endometriosis and the role of reproductive medicine.  


Endometriosis is a complex trait with significant environmental and genetic influences that are likely to affect its phenotype. Natural history of the disease varies from one individual to another. The gold standard of surgical diagnosis is limited in accuracy by visibility and recognition of lesions by the attending surgeon. Several lines of evidence suggest that pelvic endometriosis results from the reflux of viable endometrial tissue through the fallopian tubes. Endometriosis is an inflammatory disease that nuclear factor kappa B pathway may play an important role in its pathogenesis. Endometriotic lesions demonstrate increased aromatase expression in association with increased cyclo-oxygenase-2 expression, especially in red lesions which represent earlier stages of inflammation. Estrogen and progesterone receptor expressions vary according to the morphology and the inflammatory status of the endometriotic lesions. Normal endometrial tissue fragments can adhere and implant to peritoneum. Aromatase expression, a possible intrinsic survival factor for endometrial tissue, is inducible in human endometrial fragments by androstenedione at physiological concentrations found in peritoneal fluid. Inflammatory response to ectopic endometrial tissue, which may vary in each individual seems to be important in disease progression. Current therapies for endometriosis include surgical and medical approaches aimed at cytoreduction or hormonal suppression. However, the disease have tendency to recur in many symptomatic women. Although new management approaches are emerging, properly designed clinical trials are desperately needed in treatment of pain and subfertility associated with endometriosis. Future studies should also focus on identifying risk population to develop preventive strategies, since the treatment of endometriosis is costly and challenging. PMID:19745796

Bukulmez, O



Epidemiology of endometriosis in women attending family planning clinics.  

PubMed Central

OBJECTIVE--To describe the epidemiology of endometriosis in women attending family planning clinics with special reference to contraceptive methods. DESIGN--Non-randomised cohort study with follow up of subjects for up to 23 years. Disease was measured by first hospital admission rates since endometriosis can be diagnosed with accuracy only at laparotomy or laparoscopy. SETTING--17 family planning centres in England and Scotland. SUBJECTS--17,032 married white women aged 25-39 years at entry during 1968-74 who were taking oral contraceptives or using an intrauterine device or diaphragm. About 99% of the women approached agreed to participate and annual loss to follow up was about 0.3%. MAIN OUTCOME MEASURES--Diagnosis of endometriosis, age, parity, and history of contraceptive use. RESULTS--Endometriosis was significantly related to age, peaking at ages 40-44 (chi 2 for heterogeneity = 30.9, p < 0.001). Endometriosis was not linked to duration of taking oral contraceptives. Nevertheless, the risk of endometriosis was low in women currently taking oral contraceptives (relative risk 0.4; 95% confidence interval 0.2 to 0.7), but higher in women who had formerly taken them (1.8; 1.0 to 3.1 in women who had stopped 25-48 months previously) compared with women who had never taken the pill. A similar pattern was seen for use of intrauterine devices (relative risk 0.4 (0.2 to 0.7) in current users and 1.4 (0.4 to 3.2) in users 49-72 months previously compared with never users). No association was found between endometriosis and use of the diaphragm. CONCLUSIONS--Oral contraceptives seem to temporarily suppress endometriosis. Endometriosis may be diagnosed late in women using intrauterine devices as pain and bleeding occur with both.

Vessey, M P; Villard-Mackintosh, L; Painter, R



Recognising, understanding and managing endometriosis  

PubMed Central

Endometriosis is defined as the presence of tissue lesions or nodules, histologically similar to the endometrium, at sites outside the uterus. It is a highly variable condition that has a wide spectrum of symptoms. The aetiology of endometriosis is probably multifactorial, with a strong familial component recognised. Women with endometriosis have multiple disturbances of function in the eutopic endometrium that women without the disease do not have. A firm diagnosis of endometriosis is rarely possible in general practice. The ‘gold standard’ for the diagnosis of pelvic endometriosis is currently a diagnostic laparoscopy.




Priorities for endometriosis research: recommendations from an international consensus workshop.  


Endometriosis is an estrogen-dependent disorder where endometrial tissue forms lesions outside the uterus. Endometriosis affects an estimated 10% of women in the reproductive-age group, rising to 30% to 50% in patients with infertility and/or pain, with significant impact on their physical, mental, and social well-being. There is no known cure, and most current medical treatments are not suitable long term due to their side-effect profiles. Endometriosis has an estimated annual cost in the United States of $18.8 to $22 billion (2002 figures). Although endometriosis was first described more than 100 years ago, current knowledge of its pathogenesis, spontaneous evolution, and the pathophysiology of the related infertility and pelvic pain, remain unclear. A consensus workshop was convened following the 10th World Congress on Endometriosis to establish recommendations for priorities in endometriosis research. One major issue identified as impacting on the capacity to undertake endometriosis research is the need for multidisciplinary expertise. A total of 25 recommendations for research have been developed, grouped under 5 subheadings: (1) diagnosis, (2) classification and prognosis, (3) treatment and outcome, (4) epidemiology, and (5) pathophysiology. Endometriosis research is underfunded relative to other diseases with high health care burdens. This may be due to the practical difficulties of developing competitive research proposals on a complex and poorly understood disease, which affects only women. By producing this consensus international research priorities statement it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis. PMID:19196878

Rogers, Peter A W; D'Hooghe, Thomas M; Fazleabas, Asgerally; Gargett, Caroline E; Giudice, Linda C; Montgomery, Grant W; Rombauts, Luk; Salamonsen, Lois A; Zondervan, Krina T



Immune interactions in endometriosis  

PubMed Central

Endometriosis is a common, complex gynecologic disorder characterized by the presence of endometrial glands and stroma at extrauterine (ectopic) sites. In women who develop this disease, alterations in specific biological processes involving both the endocrine and immune systems have been observed, which may explain the survival and growth of displaced endometrial tissue in affected women. In the past decade, a considerable amount of research has implicated a role for alterations in progesterone action at both eutopic and ectopic sites of endometrial growth which may contribute to the excessive inflammation associated with progression of endometriosis; however, it remains unclear whether these anomalies induce the condition or are simply a consequence of the disease process. In this article, we summarize current knowledge of alterations within the immune system of endometriosis patients and discuss how endometrial cells from women with this disease not only have the capacity to escape immunosurveillance, but also use inflammatory mechanisms to promote their growth within the peritoneal cavity. Finally, we discuss evidence that exposure to an environmental endocrine disruptor, such as 2,3,7,8-tetrachlorodibenzo-p-dioxin, can mediate the development of an endometrial phenotype that exhibits both reduced progesterone responsiveness and hypersensitivity to proinflammatory stimuli mimicking the endometriosis phenotype. Future studies in women with endometriosis should consider whether a heightened inflammatory response within the peritoneal microenvironment contributes to the development and persistence of this disease.

Herington, Jennifer L; Bruner-Tran, Kaylon L; Lucas, John A; Osteen, Kevin G



Surgical scar endometriosis.  


Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1-2 % of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients. PMID:23307296

Mistrangelo, Massimiliano; Gilbo, Nicholas; Cassoni, Paola; Micalef, Salvatore; Faletti, Riccardo; Miglietta, Claudio; Brustia, Raffaele; Bonnet, Gisella; Gregori, Gianluca; Morino, Mario



[Studies on the relation between the classifications (including our private plan) and subsequent success in pregnancy in endometriosis].  


The relationship between classifications (Beecham, Acosta, Sugimoto, AFS and private plan) and chances of subsequent gestation was studied on 26 patients with laparoscopically diagnosed endometriosis. The success in conception was judged one year after diagnosis or completion of subsequent Danazol administration. In our private plan, [A] blueberry spots, blood blebs, [B] chocolate cyst, [C] periadnexal adhesions ([C']: only less involved side was evaluated) and [D] Closing change in cul-de-sac, were designated targets of evaluation and each was divided into 4 grades. As a result, a significant difference between success and failure groups was noted in initial classification with Beecham, AFS [posterior cul-de-sac obliteration] and private plan [C'], and was also noted in post-treatment classification with AFS [posterior cul-de-sac obliteration] and private plan [D]. (2) Only in the success group, Danazol was recognized as effective in every classification, and the improvement in AFD[posterior cul-de-sac obliteration] and private plan [D] was considered to be contributory. The effects, however, on adnexal adhesive changes were not significant. (3) Whenever conception is attempted by medication, the adnexal condition of the less involved side may significantly influence the chances of subsequent pregnancy. PMID:3611871

Nakatani, K; Hoshiai, H



Proton irradiation and endometriosis.  


Female rhesus monkeys given single total-body exposures of protons of varying energies developed endometriosis at a frequency significantly higher than that of nonirradiated animals of the same age. The minimum latency period was 7 years after exposure. The doses and energies of the radiation received were within the range that could be received by an aircrew member in near-earth orbit during a random solar flare event, leading to the conclusion that endometriosis should be a consideration in assessing the risk of delayed radiation effects in female crewmembers. PMID:6312953

Wood, D H; Yochmowitz, M G; Salmon, Y L; Eason, R L; Boster, R A



Expression Pattern of Stemness-Related Genes in Human Endometrial and Endometriotic Tissues  

PubMed Central

Endometriosis is a chronic disease characterized by the presence of ectopic endometrial tissue outside of the uterus with mixed traits of benign and malignant pathology. In this study we analyzed in endometrial and endometriotic tissues the differential expression of a panel of genes that are involved in preservation of stemness status and consequently considered as markers of stem cell presence. The expression profiles of a panel of 13 genes (SOX2, SOX15, ERAS, SALL4, OCT4, NANOG, UTF1, DPPA2, BMI1, GDF3, ZFP42, KLF4, TCL1) were analyzed by reverse transcription–polymerase chain reaction in human endometriotic (n = 12) and endometrial samples (n = 14). The expression of SALL4 and OCT4 was further analyzed by immunohistochemical methods. Genes UTF1, TCL1, and ZFP42 showed a trend for higher frequency of expression in endometriosis than in endometrium (P < 0.05 for UTF1), whereas GDF3 showed a higher frequency of expression in endometrial samples. Immunohistochemical analysis revealed that SALL4 was expressed in endometriotic samples but not in endometrium samples, despite the expression of the corresponding mRNA in both the sample groups. This study highlights a differential expression of stemness-related genes in ectopic and eutopic endometrium and suggests a possible role of SALL4-positive cells in the pathogenesis of endometriosis.

Forte, Amalia; Schettino, Maria Teresa; Finicelli, Mauro; Cipollaro, Marilena; Colacurci, Nicola; Cobellis, Luigi; Galderisi, Umberto



Inducers of G-protein coupled estrogen receptor (GPER) in endometriosis: potential implications for macrophages and follicle maturation.  


Endometriosis is an estrogen dependent chronic inflammation and thus a condition of stress. Though the G-protein coupled estrogen receptor (GPER) has been shown to be up-regulated in ovarian endometriosis, insights involved in inducing this receptor expression are largely elusive. Therefore, this study investigated whether stress-related factors (ACTH, prednisolone) or inflammatory factors (IL-1?, TNF?, and PGE(2)) factors may affect GPER. To further link GPER to endometriosis pathophysiology it was tracked in macrophages and follicles of endometriotic ovaries. This study found GPER expression to be modulated by stress-related hormones as well as inflammation and to be up-regulated in endometriosis-associated macrophages. At the same time, follicles of ovaries affected by endometriosis presented significantly reduced GPER positivity when compared to controls, suggesting a possible way by which endometriosis may affect folliculogenesis. The multiple roles of GPER as presented herein make it a promising future candidate for targeted molecular endometriosis treatment. PMID:23432876

Heublein, Sabine; Vrekoussis, Thomas; Kuhn, Christina; Friese, Klaus; Makrigiannakis, Antonis; Mayr, Doris; Lenhard, Miriam; Jeschke, Udo



A prospective study of dietary fat consumption and endometriosis risk  

PubMed Central

BACKGROUND Endometriosis is a prevalent but enigmatic gynecologic disorder for which few modifiable risk factors have been identified. Fish oil consumption has been associated with symptom improvement in studies of women with primary dysmenorrhea and with decreased endometriosis risk in autotransplantation animal studies. METHODS To investigate the relation between dietary fat intake and the risk of endometriosis, we analyzed 12 years of prospective data from the Nurses' Health Study II that began in 1989. Dietary fat was assessed via food frequency questionnaire in 1991, 1995 and 1999. We used Cox proportional hazards models adjusted for total energy intake, parity, race and body mass index at age 18, and assessed cumulatively averaged fat intake across the three diet questionnaires. RESULTS During the 586 153 person-years of follow-up, 1199 cases of laparoscopically confirmed endometriosis were reported. Although total fat consumption was not associated with endometriosis risk, those women in the highest fifth of long-chain omega-3 fatty acid consumption were 22% less likely to be diagnosed with endometriosis compared with those with the lowest fifth of intake [95% confidence interval (CI) = 0.62–0.99; P-value, test for linear trend (Pt) = 0.03]. In addition, those in the highest quintile of trans-unsaturated fat intake were 48% more likely to be diagnosed with endometriosis (95% CI = 1.17–1.88; Pt = 0.001). CONCLUSION These data suggest that specific types of dietary fat are associated with the incidence of laparoscopically confirmed endometriosis, and that these relations may indicate modifiable risk. This evidence additionally provides another disease association that supports efforts to remove trans fat from hydrogenated oils from the food supply.

Missmer, Stacey A.; Chavarro, Jorge E.; Malspeis, Susan; Bertone-Johnson, Elizabeth R.; Hornstein, Mark D.; Spiegelman, Donna; Barbieri, Robert L.; Willett, Walter C.; Hankinson, Susan E.



Potential mechanisms of postmenopausal endometriosis.  


Endometriosis is a chronic gynaecological disorder, the cause of which remains a subject of controversy. Oestrogen dependence is considered central to development and progression, and endometriosis is widely viewed as a disease of the premenopausal years, which normally regresses during the menopause. Increasingly however, reports of cases of postmenopausal endometriosis challenge our current understanding of the pathophysiology and raise further questions concerning the processes involved. Exploring the limited evidence available on postmenopausal disease we attempt to draw comparisons with pre-menopausal endometriosis, and in doing so to propose mechanisms for postmenopausal disease that are compatible with our current general understanding of the condition. PMID:22607814

Bendon, Charlotte L; Becker, Christian M



[Gynecological laparscopy, endometriosis and sterility].  


The authors presented the importance of the gynecological laparoscopy for diagnosis of the external genital endometriosis in its different forms. In the last 20 years, it was seen that laparoscopy is not only the basic method for diagnostics but also for the surgical treatment of the endometriosis. Thirty to fifty percent of the females with endometriosis in reproductive age have available sterility. The authors presented the cases, which have been laparoscopically proven for endometriosis and sterility for 7 years' period in Gynecological clinic in MBAL-Pleven and the results from the treatment with analog of the Gonadoliberins (Zoladex). PMID:15853006

Sto?kov, S; Popov, I; Emin, A



A new isoform of steroid receptor coactivator-1 is crucial for pathogenic progression of endometriosis  

PubMed Central

Endometriosis is considered as an estrogen-dependent inflammatory disease but its etiology is unclear. To date, a mechanistic role for steroid receptor coactivators (SRCs) in endometriosis progression has not been elucidated. An SRC-1?/? mouse model reveals that the SRC-1 gene plays an essential role in endometriosis progression. Notably, a novel 70-kDa SRC-1 proteolytic isoform is highly elevated both in the endometriotic tissue of mice with surgically induced endometriosis and in endometriotic stromal cells biopsied from endometriosis patients. Tnf?/? and Mmp9?/? mice with surgically induced endometriosis reveal that activation of TNF?-induced MMP9 activity mediates formation of the 70-kDa SRC-1 C-terminal isoform in endometriotic mouse tissue. In contrast to full-length SRC-1, the endometriotic 70-kDa SRC-1 C-terminal fragment prevents TNF-?-mediated apoptosis in human endometrial epithelial cells upon TNF-? treatment and causes the epithelial-mesenchymal transition and invasion of human endometrial cells that are hallmarks of progressive endometriosis. Collectively, the novel TNF-?/MMP9/SRC-1 isoform functional axis promotes pathogenic progression of endometriosis.

Han, Sang Jun; Hawkins, Shannon M.; Begum, Khurshida; Jung, Sung Yun; Kovanci, Ertug; Qin, Jun; Lydon, John P.; DeMayo, Francesco J.; O'Malley, Bert W.



Angiogenesis and Endometriosis  

PubMed Central

A comprehensive review was performed to survey the role of angiogenesis in the pathogenesis of endometriosis. This is a multifactorial disease in which the development and maintenance of endometriotic implants depend on their invasive capacity and angiogenic potential. The peritoneal fluid of patients with endometriosis is a complex suspension carrying inflammatory cytokines, growth factors, steroid hormones, proangiogenic factors, macrophages, and endometrial and red blood cells. These cells and their signaling products concur to promote the spreading of new blood vessels at the endometriotic lesions and surroundings, which contributes to the endometriotic implant survival. Experimental studies of several antiangiogenic agents demonstrated the regression of endometriotic lesions by reducing their blood supply. Further studies are necessary before these novel agents can be introduced into clinical practice, in particular the establishment of the safety of anti-angiogenic medications in women who are seeking to become pregnant.

Rocha, Ana Luiza L.; Reis, Fernando M.; Taylor, Robert N.



Genome-wide expressions in autologous eutopic and ectopic endometrium of fertile women with endometriosis  

PubMed Central

Background In order to obtain a lead of the pathophysiology of endometriosis, genome-wide expressional analyses of eutopic and ectopic endometrium have earlier been reported, however, the effects of stages of severity and phases of menstrual cycle on expressional profiles have not been examined. The effect of genetic heterogeneity and fertility history on transcriptional activity was also not considered. In the present study, a genome-wide expression analysis of autologous, paired eutopic and ectopic endometrial samples obtained from fertile women (n?=?18) suffering from moderate (stage 3; n?=?8) or severe (stage 4; n?=?10) ovarian endometriosis during proliferative (n?=?13) and secretory (n?=?5) phases of menstrual cycle was performed. Methods Individual pure RNA samples were subjected to Agilent’s Whole Human Genome 44K microarray experiments. Microarray data were validated (P?relative expressions of twenty eight (28) selected genes in RNA samples obtained from fresh pool of eutopic and ectopic samples from confirmed ovarian endometriosis patients with stages 3 and 4 (n?=?4/each) during proliferative and secretory (n?=?4/each) phases. Results Higher clustering effect of pairing (cluster distance, cd?=?0.1) in samples from same individuals on expressional arrays among eutopic and ectopic samples was observed as compared to that of clinical stages of severity (cd?=?0.5) and phases of menstrual cycle (cd?=?0.6). Post hoc analysis revealed anomaly in the expressional profiles of several genes associated with immunological, neuracrine and endocrine functions and gynecological cancers however with no overt oncogenic potential in endometriotic tissue. Dys-regulation of three (CLOCK, ESR1, and MYC) major transcription factors appeared to be significant causative factors in the pathogenesis of ovarian endometriosis. A novel cohort of twenty-eight (28) genes representing potential marker for ovarian endometriosis in fertile women was discovered. Conclusions Dysfunctional expression of immuno-neuro-endocrine behaviour in endometrium appeared critical to endometriosis. Although no overt oncogenic potential was evident, several genes associated with gynecological cancers were observed to be high in the expressional profiles in endometriotic tissue.



The surgical management of endometriosis  

Microsoft Academic Search

Endometriosis can be a debilitating condition that has a profound effect upon the quality of a woman's life causing untold misery and pain over many years. In a hospital based population, the prevalence of endometriosis will vary depending on the type of the population being studied, for example, it is seen more frequently among women being investigated for infertility (21%)

Enda McVeigh



Radionuclide migration through the genital tract in infertile women with endometriosis.  


The migration of radionuclide through the genital tract was observed, comparing 20 patients with endometriosis and infertility with a control group of 23 infertile patients who had a normal pelvis. All patients had patent tubes at laparoscopy and chromopertubation, performed in both groups for the investigation of infertility and to diagnose the presence and extent of endometriosis. A radionuclide tubal test, using human albumin microspheres labelled with 99m-technetium (99mTc) was subsequently undertaken to observe the extent of genital tract migration of radionuclide to uterus, Fallopian tube and peritoneal cavity. The results show that radionuclide migration to the peritoneal cavity was impaired in patients with endometriosis, compared with the control group (30 versus 83%, respectively; P < 0.001). There was no relationship between migration and the severity of endometriosis. We conclude that impaired tubal function may be a cause of infertility in some patients with endometriosis. PMID:8288759

McQueen, D; McKillop, J H; Gray, H W; Callaghan, M; Monaghan, C; Bessent, R G



Genome-Wide Association Study Link Novel Loci to Endometriosis  

PubMed Central

Endometriosis is a common gynecological condition with complex etiology defined by the presence of endometrial glands and stroma outside the womb. Endometriosis is a common cause of both cyclic and chronic pelvic pain, reduced fertility, and reduced quality-of-life. Diagnosis and treatment of endometriosis is, on average, delayed by 7–10 years from the onset of symptoms. Absence of a timely and non-invasive diagnostic tool is presently the greatest barrier to the identification and treatment of endometriosis. Twin and family studies have documented an increased relative risk in families. To identify genetic factors that contribute to endometriosis we conducted a two-stage genome-wide association study (GWAS) of a European cohort including 2,019 surgically confirmed endometriosis cases and 14,471 controls. Three of the SNPs we identify associated at P<5×10?8 in our combined analysis belong to two loci: LINC00339-WNT4 on 1p36.12 (rs2235529; P?=?8.65×10?9, OR?=?1.29, CI?=?1.18–1.40) and RND3-RBM43 on 2q23.3 (rs1519761; P?=?4.70×10?8, OR?=?1.20, Cl?=?1.13–1.29, and rs6757804; P?=?4.05×10?8, OR?=?1.20, Cl?=?1.13–1.29). Using an adjusted Bonferoni significance threshold of 4.51×10?7 we identify two additional loci in our meta-analysis that associate with endometriosis:, RNF144B-ID4 on 6p22.3 (rs6907340; P?=?2.19×10?7, OR?=?1.20, Cl?=?1.12–1.28), and HNRNPA3P1-LOC100130539 on 10q11.21 (rs10508881; P?=?4.08×10?7, OR?=?1.19, Cl?=?1.11–1.27). Consistent with previously suggested associations to WNT4 our study implicate a 150 kb region around WNT4 that also include LINC00339 and CDC42. A univariate analysis of documented infertility, age at menarche, and family history did not show allelic association with these SNP markers. Clinical data from patients in our study reveal an average delay in diagnosis of 8.4 years and confirm a strong correlation between endometriosis severity and infertility (n?=?1182, P<0.001, OR?=?2.18). This GWAS of endometriosis was conducted with high diagnostic certainty in cases, and with stringent handling of population substructure. Our findings broaden the understanding of the genetic factors that play a role in endometriosis.

Albertsen, Hans M.; Chettier, Rakesh; Farrington, Pamela; Ward, Kenneth



Endometriosis-associated Lyme disease.  


The aim of this study is to report three cases of patients with endometriosis and infertility, and associated with Lyme disease. The medical files of 405 women with endometriosis and 200 without endometriosis were studied retrospectively. We report 3 cases with endometriosis and Lyme disease. Of 405 patients with endometriosis treated in our study over a 6-year period, 3(0.8%) had Lyme disease. All cases presented with typical erythema migraines, fever and fatigue. The serological findings were positive for Borrelia burgdorferi, for 3 cases. Two out of 3 women underwent IVF-ET procedures and one of them conceived in the first cycle without complication during pregnancy or after childbirth recorded. We concluded that women with endometriosis are more likely to have chronic fatigue syndrome, systemic lupus erythematous, Sjögren's syndrome, rheumatoid arthritis, multiple sclerosis, and other autoimmune inflammatory and endocrine diseases. A review of the literature confirms the uniqueness of the co-existence of Lyme disease in women with endometriosis in these cases. PMID:20143981

Matalliotakis, I M; Cakmak, H; Ziogos, M D E; Kalogeraki, A; Kappou, D; Arici, A



Robotic Hybrid Technique in Rectal Surgery for Deep Pelvic Endometriosis.  


Background. Deep pelvic endometriosis is a complex disorder that affects 6% to 12% of all women in childbearing age. The incidence of bowel endometriosis ranges between 5.3% and 12%, with rectum and sigma being the most frequently involved tracts, accounting for about 80% of cases. It has been reported that segmental colorectal resection is the best surgical option in terms of recurrence rate and improvement of symptoms. The aim of this study is to analyze indications, feasibility, limits, and short-term results of robotic (Da Vinci Surgical System)-assisted laparoscopic rectal sigmoidectomy for the treatment of deep pelvic endometriosis. Patients and Methods. Between January 2006 and December 2010, 19 women with bowel endometriosis underwent colorectal resection through the robotic-assisted laparoscopic approach. Intraoperative and postoperative data were collected. All procedures were performed in a single center and short-term complications were evaluated. Results. Nineteen robotic-assisted laparoscopic colorectal resections for infiltrating endometriosis were achieved. Additional procedures were performed in 7 patients (37%). No laparotomic conversion was performed. No intraoperative complications were observed. The mean operative time was 370 minutes (range = 250-720 minutes), and the estimated blood loss was 250 mL (range = 50-350 mL). The overall complication rate was 10% (2 rectovaginal fistulae). Conclusions. Deep pelvic endometriosis is a benign condition but may have substantial impact on quality of life due to severe pelvic symptoms. We believe that robotic-assisted laparoscopic colorectal resection is a feasible and relatively safe procedure in the context of close collaboration between gynecologists and surgeons for treatment of deep pelvic endometriosis with intestinal involvement, with low rates of complications and significant improvement of intestinal symptoms. PMID:23657477

Cassini, Diletta; Cerullo, Guido; Miccini, Michelangelo; Manoochehri, Farshad; Ercoli, Alfredo; Baldazzi, Gianandrea



Genetic variation in the sex hormone metabolic pathway and endometriosis risk: an evaluation of candidate genes  

PubMed Central

OBJECTIVE To evaluate the relationship between common genetic variation in genes involved in the biosynthesis and signaling of estrogen and progesterone and endometriosis risk. DESIGN Genetic polymorphism analysis. SETTING Population-based case-control study conducted in Group Health Cooperative enrollees in Western Washington. PATIENT(S) Women with newly diagnosed, surgically confirmed endometriosis between 1996 and 2001 (n=256), and age and reference year matched female controls without a history of endometriosis (n=567). INTERVENTIONS(S) None. MAIN OUTCOME MEASURE We evaluated the relationship between common genetic variation and endometriosis risk, using gene-based tests and single variant analysis of genetic polymorphisms in ESR1, ESR2, PGR, CYP17A1, CYP19A1, HSD17B1, HSD17B2, CYP1A1, CYP1A2, COMT and GSTM1. RESULTS The most consistent gene-based association with endometriosis risk was for CYP19A1 (p-value = 0.02). We did not find evidence for consistent significant associations between previously reported candidate SNPs in sex hormone-related genes and endometriosis risk. CONCLUSION In summary, we report increased endometriosis risk with CYP19A1 gene-based tests; replication of the association between endometriosis and this gene or gene region is necessary in a larger study population.

Trabert, Britton; Schwartz, Stephen M; Peters, Ulrike; De Roos, Anneclaire J; Chen, Chu; Scholes, Delia; Holt, Victoria L



Mouse Model of Surgically-induced Endometriosis by Auto-transplantation of Uterine Tissue  

PubMed Central

Endometriosis is a chronic, painful disease whose etiology remains unknown. Furthermore, treatment of endometriosis can require laparoscopic removal of lesions, and/or chronic pharmaceutical management of pain and infertility symptoms. The cost associated with endometriosis has been estimated at 22 billion dollars per year in the United States1. To further our understanding of mechanisms underlying this enigmatic disease, animal models have been employed. Primates spontaneously develop endometriosis and therefore primate models most closely resemble the disease in women. Rodent models, however, are more cost effective and readily available2. The model that we describe here involves an autologous transfer of uterine tissue to the intestinal mesentery (Figure 1) and was first developed in the rat3 and later transferred to the mouse4. The goal of the autologous rodent model of surgically-induced endometriosis is to mimic the disease in women. We and others have previously shown that the altered gene expression pattern observed in endometriotic lesions from mice or rats mirrors that observed in women with the disease5,6. One advantage of performing the surgery in the mouse is that the abundance of transgenic mouse strains available can aid researchers in determining the role of specific components important in the establishment and growth of endometriosis. An alternative model in which excised human endometrial fragments are introduced to the peritoneum of immunocompromised mice is also widely used but is limited by the lack of a normal immune system which is thought to be important in endometriosis2,7. Importantly, the mouse model of surgically induced endometriosis is a versatile model that has been used to study how the immune system8, hormones9,10 and environmental factors11,12 affect endometriosis as well as the effects of endometriosis on fertility13 and pain14.

Pelch, Katherine E.; Sharpe-Timms, Kathy L.; Nagel, Susan C.



Human Cripto-Related Gene.  

National Technical Information Service (NTIS)

The invention relates, in general, to a human CRIPTO-related gene. In particular, the invention relates to a DNA segment encoding a human CRIPTO-related gene; polypeptides encoded by said DNA segment; recombinant DNA molecules containing the DNA segment; ...

D. Salomom M. Persico



Ureteral polypoid endometriosis causing hydroureteronephrosis.  


A 44-year-old Japanese woman presented with a left low back pain. Abdominal ultrasonography revealed the left hydroureteronephrosis. She had the past history of endometriosis interna 3 years before. Retrograde pyelography showed the defect in the ureter, and on ureteroscopy, a polypoid mass was identified. Biopsy specimen from the ureteral mass showed endometrioid epithelia and edematous endometrial stroma, immunohistochemically positive for progesterone receptor (PgR), estrogen receptor (ER), and CD 10. For the lesion (endometrioma), partial resection of the ureter and ureteroneocystostomy with Boari flap were performed. The resected specimen showed a 2-cm polypoid mass. Histologically, the lesion was ureteral endometriosis. The postoperative course was uneventful, the patient showed no evidence of local recurrence after the initial resection and continues to be under close follow up. Urinary tract involvement of endometriosis is uncommon. Endometriosis should be included in the differential diagnosis of ureteral strictures in sexually active young females. PMID:19332929

Kondo, Takeshi


Postcoital bleeding due to cervical endometriosis.  


Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosis should be considered in the differential diagnosis of cervical masses with postcoital bleeding. PMID:23376669

Seval, Mehmet Murat; Cavkaytar, Sabri; Atak, Zeliha; Guresci, Servet



Persistent Lipophilic Environmental Chemicals and Endometriosis: The ENDO Study  

PubMed Central

Background: An equivocal literature exists regarding the relation between persistent organochlorine pollutants (POPs) and endometriosis in women, with differences attributed to methodologies. Objectives: We assessed the association between POPs and the odds of an endometriosis diagnosis and the consistency of findings by biological medium and study cohort. Methods: Using a matched cohort design, we assembled an operative cohort of women 18–44 years of age undergoing laparoscopy or laparotomy at 14 participating clinical centers from 2007 to 2009 and a population-based cohort matched on age and residence within a 50-mile catchment area of the clinical centers. Endometriosis was defined as visualized disease in the operative cohort and as diagnosed by magnetic resonance imaging in the population cohort. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each POP in relation to an endometriosis diagnosis, with separate models run for each medium (omental fat in the operative cohort, serum in both cohorts) and cohort. Adjusted models included age, body mass index, breast-feeding conditional on parity, cotinine, and lipids. Results: Concentrations were higher in omental fat than in serum for all POPs. In the operative cohort, ?-hexachlorocyclohexane (?-HCH) was the only POP with a significant positive association with endometriosis [per 1-SD increase in log-transformed ?-HCH: adjusted OR (AOR) = 1.27; 95% CI: 1.01, 1.59]; ?-HCH was the only significant predictor in the population cohort (per 1-SD increase in log-transformed ?-HCH: AOR = 1.72; 95% CI: 1.09, 2.72). Conclusions: Using a matched cohort design, we found that cohort-specific and biological-medium–specific POPs were associated with endometriosis, underscoring the importance of methodological considerations when interpreting findings.

Chen, Zhen; Peterson, C. Matthew; Hediger, Mary L.; Croughan, Mary S.; Sundaram, Rajeshwari; Stanford, Joseph B.; Varner, Michael W.; Fujimoto, Victor Y.; Giudice, Linda C.; Trumble, Ann; Parsons, Patrick J.; Kannan, Kurunthachalam



Dominant Expression of Progesterone Receptor Form B mRNA in Ovarian Endometriosis  

Microsoft Academic Search

This study was designed to examine the biological implications of progesterone receptor form A (PR-A) and B (PR-B) mRNA expressions in human ovarian endometriosis (ectopic endometrium). A high ratio of PR-B to PR-AB (PR-A+PR-B) mRNA expression was found in 8 of 14 cases of endometriosis, compared with the ratio in eutopic endometrium. The mean ratio in ectopic endometria was significantly

Ryou Misao; Shigenori Iwagaki; Jiro Fujimoto; Wen-Shu Sun; Teruhiko Tamaya



How Many People Are Affected by or at Risk for Endometriosis?  


... 2012 Division of Intramural Research (DIR) Annual Report Global Consortium Identifies Best Management of Endometriosis Scientific Vision: The Next Decade All related news Home Accessibility Contact Disclaimer Privacy Policy FOIA Facebook YouTube NIH...Turning ...


Treatment of endometriosis in different ethnic populations: a meta-analysis of two clinical trials.  


Approaches to the treatment of endometriosis vary worldwide, but studies comparing endometriosis medications in different ethnic groups are rare. A systematic literature search identified two studies directly comparing dienogest (DNG) versus gonadotropin-releasing hormone (GnRH) analogues in European and Japanese populations. Meta-analysis of visual analogue scale scores revealed no heterogeneity in response between the trials, indicating equivalent efficacy of DNG and GnRH analogues for endometriosis-related pain across populations. DNG was significantly superior to GnRH analogues for bone mineral density change in both trials, but significant heterogeneity between the studies may indicate ethnic differences in physiology. PMID:22515510

Gerlinger, Christoph; Faustmann, Thomas; Hassall, Jeffrey J; Seitz, Christian



Laparoscopic trocar port site endometriosis: a case report and brief literature review.  


Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis. PMID:23102079

Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Bozdag, Zehra


Laparoscopic Trocar Port Site Endometriosis: A Case Report and Brief Literature Review  

PubMed Central

Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis.

Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Bozdag, Zehra



The impact of IVF procedures on endometriosis recurrence  

Microsoft Academic Search

ObjectiveIn infertile women with endometriosis requiring an in vitro fertilization (IVF) procedure, the potential risk of an IVF-related progression of the disease remains a matter of debate. Thus, since available data on this issue are scanty and controversial, an observational study has been herein conducted in order to clarify this issue.

Laura Benaglia; Edgardo Somigliana; Paolo Vercellini; Francesca Benedetti; Roberta Iemmello; Valentina Vighi; Giulia Santi; Guido Ragni



Endometriosis and the risk of cancer with special emphasis on ovarian cancer  

Microsoft Academic Search

BACKGROUND: Several observations of the coexistence of endometriosis and cancer have been published. One study concerning endometriosis patients from 1969 to 1986 showed an overall relative cancer risk of 1.2 and relative risks for breast cancer, ovarian cancer and non-Hodgkin's lymphoma to be 1.3, 1.9 and 1.8, respectively. The aim of this study was to see whether these risk ratios

A. Melin; P. Sparén; I. Persson; A. Bergqvist



Endometriosis and Chronic Pelvic Pain  

PubMed Central

Nurses often encounter patients with chronic pelvic pain associated with endometriosis, which is a puzzling and problematic gynecologic condition that has continued to plague women and baffle doctors and researchers worldwide since it was first identified by Dr. J. Sampson in the 1920s (Sampson, 1940). Endometriosis is defined as the growth, adhesion and progression of endometrial glands and stroma outside of the uterine cavity, with cellular activity evident in lesions, nodules, cysts or endometriomas (Audebert et al., 1992). Although it typically appears benign on histopathology, endometriosis has been likened to a malignant tumor since the lesions grow, infiltrate and adhere to adjacent tissues and interfere with physiologic processes (Kitawaki et al., 2002; Noble, Simpson, Johns, & Bulun, 1996). Ectopic endometriotic growths respond to cyclic changes of estrogen and proliferate and shed in a manner similar to eutopic endometrium. This cyclic ectopic activity results in internal bleeding, formation of scar tissue, inflammation and sometimes debilitating chronic pain (Kitawaki et al.).

Bloski, Terri; Pierson, Roger



Progesterone-dependent Regulation of Endometrial Cannabinoid Receptor Type 1 (CB1-R) Expression is Disrupted in Women with Endometriosis and in Isolated Stromal Cells Exposed to TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin)  

PubMed Central

Objective To examine the differentiation-related expression of CB1-R mRNA and protein in endometrial tissue obtained from women with and without endometriosis and to determine the impact of acute TCDD exposure on CB1-R gene expression in isolated endometrial stromal cells. Design Laboratory-based study Setting University-affiliated medical center Patients Women with and without endometriosis undergoing volunteer endometrial biopsies after informed consent. Interventions None Main Outcome Measures Analysis of in vivo CB1-R mRNA and protein expression in human endometrial tissues and mRNA expression in isolated stromal cells following exposure to TCDD or a progesterone receptor antagonist (Onapristone). Results CB1-R mRNA and protein expression was highest during the progesterone-dominated secretory phase in control women, while expression was minimal in endometrial tissues acquired from women with endometriosis, regardless of the cycle phase. Although progesterone was found to induce CB1-R mRNA expression in endometrial stromal cells from control donors, steroid-induced expression of this gene was inhibited by co-treatment with either TCDD or Onapristone. Conclusions Our studies reveal a role for the anti-inflammatory actions of progesterone in regulating endometrial cannabinoid signaling, which is disrupted in women with endometriosis. Significantly, our studies demonstrate, for the first time, that acute TCDD exposure disrupts cannabinoid signaling in the human endometrium.

Resuehr, David; Glore, Dana R.; Taylor, Hugh S.; Bruner-Tran, Kaylon L.; Osteen, Kevin G.



Malignant Transformation from Endometriosis to Atypical Endometriosis and Finally to Endometrioid Adenocarcinoma within 10 Years  

PubMed Central

Atypical endometriosis is reported to possess a precancerous potential attributed to premalignant changes characterized by cytological atypia and architecture proliferation. Moreover, the coexistence of atypical endometriosis and neoplasms had been reported. However, cases of atypical endometriosis transformation to carcinoma are rarely reported. We describe the case of a 33-year-old woman who had a long therapeutic history of endometriosis. Three laparoscopic surgeries were performed to treat endometriosis. After the third surgery, she was diagnosed as having grade 1 endometrioid adenocarcinoma. The histological review of the previous surgery confirmed the diagnosis of atypical endometriosis based on the second specimen. The patient's disease progressed from a benign endometriotic cyst to atypical endometriosis and finally to endometrioid adenocarcinoma within 10 years. When we encounter cases of atypical endometriosis, it is necessary to consider the possibility of ovarian cancer and carefully follow the patients for long periods.

Tanase, Yasuhito; Furukawa, Naoto; Kobayashi, Hiroshi; Matsumoto, Takashi



Altered Gene Expression Profile in Vaginal Polypoid Endometriosis Resembles Peritoneal Endometriosis and Is Consistent with Increased Local Estrogen Production  

PubMed Central

Background In a university hospital setting, a 25-year-old woman presented with large vaginal and cervical polyps. Past medical history was significant for stage IV endometriosis. Polypectomy was performed and the polyps were histologically consistent with endometriosis. Gene expression was compared with control vaginal tissue to assess if the altered gene expression profile was similar to peritoneal endometriosis. Methods and Results Using quantitative reverse transcription, real-time PCR, estrogen receptor-? expression was found to be upregulated 10-fold while estrogen receptor-? expression was downregulated 5-fold in the vaginal polyp relative to control vaginal tissue. The estrogen-synthesizing enzyme aromatase was upregulated 8-fold and 3?-hydroxysteroid dehydrogenase was upregulated 400-fold in the polyp. Immunohistochemical staining revealed altered cell type localization for progesterone receptor in the polyp and increased cell proliferation in polyp stromal cells relative to control. Conclusions Increased proliferation in the vaginal polypoid endometriotic tissue may be due to increased local estrogen production. The altered gene expression profile was very similar to the altered gene expression profile seen in peritoneal endometriosis.

Syrcle, S.M.; Pelch, K.E.; Schroder, A.L.; Nichols, B.M.; Mills, M.P.; Barrier, B.F.; Havey, A.D.; Nagel, S.C.



Assessing Chemical Mixtures and Human Health: Use of Bayesian Belief Net Analysis  

PubMed Central

Background Despite humans being exposed to complex chemical mixtures, much of the available research continues to focus on a single compound or metabolite or a select subgroup of compounds inconsistent with the nature of human exposure. Uncertainty regarding how best to model chemical mixtures coupled with few analytic approaches remains a formidable challenge and served as the impetus for study. Objectives To identify the polychlorinated biphenyl (PCB) congener(s) within a chemical mixture that was most associated with an endometriosis diagnosis using novel graphical modeling techniques. Methods Bayesian Belief Network (BBN) models were developed and empirically assessed in a cohort comprising 84 women aged 18–40 years who underwent a laparoscopy or laparotomy between 1999 and 2000; 79 (94%) women had serum concentrations for 68 PCB congeners quantified. Adjusted odds ratios (AOR) for endometriosis were estimated for individual PCB congeners using BBN models. Results PCB congeners #114 (AOR = 3.01; 95% CI = 2.25, 3.77) and #136 (AOR = 1.79; 95% CI = 1.03, 2.55) were associated with an endometriosis diagnosis. Combinations of mixtures inclusive of PCB #114 were all associated with higher odds of endometriosis, underscoring its potential relation with endometriosis. Conclusions BBN models identified PCB congener 114 as the most influential congener for the odds of an endometriosis diagnosis in the context of a 68 congener chemical mixture. BBN models offer investigators the opportunity to assess which compounds within a mixture may drive a human health effect.

Roy, Anindya; Perkins, Neil J.; Buck Louis, Germaine M.



[Intestinal obstruction caused by endometriosis ].  


We report a case of a 29-year old woman with intestinal obstruction caused by endometriosis localised in the proximity of the ileocecal valve. Right hemicolectomy was carried out. No other pathology was found. We discuss difficulties of establishing the preoperative diagnosis. PMID:12916263

Grodzi?ski, Tomasz; Gackowski, Wojciech; Radwa?ski, Pawe?



A Pilot Study of the Prevalence of Leg Pain Among Women with Endometriosis  

PubMed Central

Radiating leg pain is a common symptom presenting in manual therapy practices. Although this symptom has been reported as a complication of endometriosis, its prevalence and characteristics have not been studied. We surveyed members of a national endometriosis support group with endometriosis using a self-administered, mailed questionnaire. The main outcome measures were the prevalence and characteristics of leg pain. Of 94 respondents, leg pain was reported by 48 women (51%), and was bilateral in 59% of these symptomatic women. The likelihood of experiencing leg pain was related to weight gain since age 18, age, and height. The most common treatments tried included exercise, over-the-counter medications, and massage therapy, all with variable results. These data support leg pain as a prevalent complication of endometriosis, and that the disease may affect multiple peripheral nerves. Manual therapists should remain aware to this possible etiology for radiating pain.

Missmer, Stacey A.; Bove, Geoffrey M.



MicroRNAs expression profiling of eutopic proliferative endometrium in women with ovarian endometriosis  

PubMed Central

Background The eutopic endometrium of women with endometriosis, compared with disease-free individuals, contains certain molecular alterations, including the differential expression of microRNA (miRNA). The aim of the study was to compare the expression of the most relevant miRNAs in the eutopic endometrium of women with and without ovarian endometriosis. Methods A total of 46 regularly menstruating patients, 21 patients with ovarian endometriosis and 25 controls, underwent surgery in the proliferative phase of the cycle. The eutopic endometrium was collected through aspirating biopsy prior to laparoscopy. Only patients with advanced (stage III and IV) histopathologically confirmed ovarian endometriosis were included. TaqMan MicroRNA Array Cards were applied to examine the expression of 667 human miRNAs in 10 patients with endometriosis and 10 controls. Custom-made, low-density real-time PCR arrays were used to confirm the expression of 15 selected molecules in 21 endometriosis patients and 25 disease-free individuals. Results Of 667 miRNAs, 2 were highly likely to be upregulated and 13 were downregulated in the eutopic endometrium of patients with endometriosis compared with the controls. Validation using real-time PCR showed that hsa-miR-483-5p (p?=?0.012) and hsa-miR-629* (p?=?0.02) are significantly downregulated in patients with endometriosis. Conclusions Changes in the expression of select miRNAs might lead to or be a consequence of an early defect in the physiological activity of the proliferative endometrium, ultimately resulting in the overgrowth of this tissue outside the uterus.



[Ileocecal intussusception secondary to a cecal endometriosis].  


We report the case of a 43-year-old woman, who presented a complete and non-reductible ileo-cecal intussusception with pre-occlusion. An ileocecal resection with ileocolic anastomosis was performed. The pathologic examination confirmed the diagnosis of colic endometriosis with transmural lesions, causing the intussusception. Altough the digestive endometriosis is quite classical and well-known, particulary with vermiform appendix and rectosigmoïd involvement, ileo-cecal intussusception secondary to endometriosis is rare. PMID:18653289

Denève, E; Maillet, O; Blanc, P; Fabre, J-M; Nocca, D



Caldesmon: new insights for diagnosing endometriosis.  


Considerable effort has been invested in searching for less invasive methods of diagnosing endometriosis. Previous studies have indicated altered levels of the CALD1 gene (encoding the protein caldesmon) in endometriosis. The aims of our study were to investigate whether average CALD1 expression and caldesmon protein levels are differentially altered in the endometrium and endometriotic lesions and to evaluate the performance of the CALD1 gene and caldesmon protein as potential biomarkers for endometriosis. Paired biopsies of endometrial tissue (eutopic endometrium) and endometriotic lesions (ectopic endometrium) were obtained from patients with endometriosis to evaluate CALD1 gene expression and caldesmon protein levels by real-time PCR and Western blot analysis, respectively. In addition, immunostaining for caldesmon to determine cellular localization was also performed. Endometrium from women without endometriosis was used as a control. Increased CALD1 expression and caldesmon levels were detected in the endometriotic lesions. The electrophoretic profile of caldesmon by Western blot analysis was clearly different between the control group (endometrium of women without endometriosis) and the group of women with endometriosis (eutopic endometrium and endometriotic lesions). Caldesmon expression as determined by immunostaining showed no variation among the cell types in endometriotic lesions and eutopic endometrium. Stromal cells marked positively in eutopic endometrium from control patients and in the endometriotic lesions. The presence of caldesmon in the endometrium of patients with and without endometriosis permitted diagnoses with 95% sensitivity (specificity 100%) and 100% sensitivity (specificity 100%) for the disease and for minimal to mild endometriosis in the proliferative phase of the menstrual cycle, respectively. In the secretory phase, minimal to mild endometriosis was detected with 90% sensitivity and 93.3% specificity. Caldesmon is a possible predictor of endometrial dysregulation in patients with endometriosis. A potential limitation of our study is the fact that other endometrial diseases were not excluded, and therefore prospective studies are needed to confirm the potential of caldesmon as a biomarker exclusively for endometriosis. PMID:23575144

Meola, Juliana; Hidalgo, Gabriela Dos Santos; Silva, Julio Cesar Rosa E; Silva, Lilian Eslaine Costa Mendes; Paz, Claudia Cristina Paro; Ferriani, Rui Alberto



Cutaneous endometriosis: diagnostic immunohistochemistry and clinicopathologic correlation.  


Endometriosis is a condition where endometrial glands and stroma are ectopically located in sites other than the uterine cavity. Cutaneous endometriosis is very rare, representing approximately 1.1% of cases of extrapelvic endometriosis. We report a case of a 44-year-old female with no prior surgical history who presented with multiple tan brown periumbilical nodules. Histopathological examination revealed multiple glandular structures in the dermis with surrounding stroma. Immunohistochemistry cinches the diagnosis, as CD10, estrogen receptor and progesterone receptor are strongly positive in our case. The mainstay of treatment of cutaneous endometriosis is surgical excision of the lesion. PMID:21352260

Farooq, Uzma; Laureano, Ana C; Miteva, Mariya; Elgart, George W



Surgical management of endometriosis-associated pain.  


General surgical guidelines are reasonable, but treatment frequently must be individualized. Laparoscopic coagulation can be used for many cases of superficial endometriosis. Resection seems to be associated with an increased resolution of endometriosis. Resection increases the difficulty of the procedure, the time of the operation, and the cost, however. When endometriosis is found coincidentally, it may need no treatment because many women have endometriosis as a self-limited disease. Distinguishing patients who need no treatment from patients who need intermediate or extensive treatment can be difficult. Care is needed to attempt to ensure that patients are neither overtreated nor undertreated. PMID:12699263

Martin, Dan C; O'Conner, Daniel T



Endometriosis - Morphology, Clinical Presentations and Molecular Pathology  

PubMed Central

Endometriosis is found predominantly in women of childbearing age. The prevalence of endometriosis is difficult to determine accurately. Laparoscopy or surgery is required for the definitive diagnosis. The most common symptoms are dysmenorrhea, dyspareunia, and low back pain that worsen during menses. Endometriosis occurring shortly after menarche has been frequently reported. Endometriosis has been described in a few cases at the umbilicus, even without prior history of abdominal surgery. It has been described in various atypical sites such as the fallopian tubes, bowel, liver, thorax, and even in the extremities. The most commonly affected areas in decreasing order of frequency in the gastrointestinal tract are the recto-sigmoid colon, appendix, cecum, and distal ileum. The prevalence of appendiceal endometriosis is 2.8%. Malignant transformation is a well-described, although rare (<1% of cases), complication of endometriosis. Approximately 75% of these tumors arise from endometriosis of the ovary. Other less common sites include the rectovaginal septum, rectum, and sigmoid colon. Unopposed estrogens therapy may play a role in the development of such tumors. A more recent survey of 27 malignancies associated with endometriosis found that 17 (62%) were in the ovary, 3 (11%) in the vagina, 2 (7%) each in the fallopian tube or mesosalpinx, pelvic sidewall, and colon, and 1 (4%) in the parametrium. Two cases of cerebral endometriosis and a case of endometriosis presenting as a cystic mass in the cerebellar vermis has been described. Treatment for endometriosis can be expectant, medical, or surgical depending on the severity of symptoms and the patient's desire to maintain or restore fertility.

Agarwal, Neha; Subramanian, Arulselvi



Pleiotrophin (PTN) and midkine (MK) mRNA expression in eutopic and ectopic endometrium in advanced stage endometriosis.  


Endometriosis is characterized by the ectopic implantation of endometrium on peritoneal surfaces. Angiogenic and growth factors may play a significant role in the pathogenesis of endometriosis. Midkine (MK) and pleiotrophin (PTN) are two related peptides associated with carcinogenesis and angiogenesis. To test the hypothesis that a higher expression of MK and PTN in ectopic and eutopic endometrium from women with endometriosis might favour increased angiogenesis and growth with subsequent ectopic implantation, we investigated PTN and MK expression by quantitative competitive PCR (QC-PCR) in endometrium from 30 women with severe, stages III and IV endometriosis and from 30 women without endometriosis. Total RNA was extracted and reverse transcribed into cDNA, and QC-PCR was performed to evaluate PTN and MK mRNA expression. Results were analysed by analysis of variance. Eutopic endometrium from endometriosis patients showed increased expression of MK and PTN mRNA compared with endometrium from normal women in the luteal phase (P < 0.05). MK and PTN mRNA expression in ectopic endometrium was significantly lower than that in eutopic endometrium from women with and without endometriosis (P < 0.05). Our results suggest increased MK and PTN expression may be related to the initiation of ectopic endometrial implants and peritoneal invasion. PMID:11912283

Chung, Hye Won; Wen, Yan; Choi, Eun A; Hao-Li; Moon, Hye Sung; Yu, Han-Ki; Polan, Mary Lake



Severe endometriosis: laparoscopic rectum resection  

Microsoft Academic Search

Aim  Endometriosis is a frequent benign disease of women in reproductive age. An infiltration of the spatium rectovaginal is rare,\\u000a but if it occurs, in up to 73% the rectum is involved. If there is the indication for surgery, a partial resection of the\\u000a rectum might be necessary. This can be performed by a laparoscopic approach. It is the aim of

Ingolf Juhasz-Böss; Claus Lattrich; Alois Fürst; Eduard Malik; Olaf Ortmann



Endometriosis: the role of neuroangiogenesis.  


Endometriosis is a common cause of pelvic pain and infertility, affecting ?10% of reproductive-age women. Annual costs for medical and surgical care in the United States exceed $20 billion. The disorder is characterized by implants of endometrial tissue outside the uterine cavity. Endometriotic lesions induce a state of chronic peritoneal inflammation, accompanied by elevated prostaglandin, cytokine, and growth factor concentrations. The current therapy is surgical ablation of ectopic implants and hormones that block the hypothalamic-pituitary-ovarian axis, but these approaches are expensive, carry perioperative risks, or have unpleasant side effects of hypoestrogenism. Recent evidence indicates that ectopic endometriotic implants recruit their own unique neural and vascular supplies through neuroangiogenesis. It is believed that these nascent nerve fibers in endometriosis implants influence dorsal root neurons within the central nervous system, increasing pain perception in patients. We consider the mechanisms and therapeutic implications of neuroangiogenesis in these lesions and propose potential treatments for the control or elimination of endometriosis-associated pain. PMID:21054165

Asante, Albert; Taylor, Robert N



[Aromatase inhibitors--theoretical concept and present experiences in the treatment of endometriosis].  


The medical treatment of endometriosis needs to be optimized. Therapeutic management strategies of endometriosis-associated pain or recurrent disease is primarily aimed at downregulating the ovarian function or at antagonizing the effect of estrogen in ectopic endometrial implants. In this context, basic research is delivering powerful tools for the possible development of new, specific treatment modalities. Recently, aromatase overexpression has been detected in endometriotic tissue. Aromatase (p450arom) is responsible for conversion of C19 androgens to estrogen in several human tissues. Aromatase activity gives rise to local estrogen biosynthesis, which, in turn, stimulates prostaglandin E(2) production by upregulation of cyclooxygenase-2 (COX-2), thus establishing a positive feedback cycle. Another abnormality in endometriosis, i. e. the deficiency in 17 beta-hydroxysteroiddehydrogenase type-II (17 beta-HSD-Type-II) expression, impairs the inactivation of estradiol to estrone. In contrast to the eutopic endometrium, these molecular aberrations collectively favour accumulation of increasing amounts of local estradiol and prostaglandin E(2) in endometriosis. In several human cell lines, prostaglandin and estrogen concentrations are associated with proliferation, migration, angiogenesis, apoptosis resistance, and even invasiveness. Consequently, aromatase and COX-2 are promising new therapeutic targets. In summary, specific aromatase inhibitors (such as Letrozole, Anastrozol or Exemestan) or selective COX-2 inhibitors (e.g. Celecoxib, Rofecoxib) are of great interest to be studied in clinical trials in premenopausal woman with endometriosis to extend the spectrum of currently available treatment options. PMID:14505258

Ebert, A D; Bartley, J; David, M; Schweppe, K-W


Rectal endometriosis causing colonic obstruction and concurrent endometriosis of the appendix: a case report  

PubMed Central

Introduction Endometriosis is a clinical entity which presents with functioning endometrial tissue at sites outside the uterus. Bowel endometriosis is usually asymptomatic, but it may show non-specific symptoms. The presence and/or association of appendiceal endometriosis, concomitant with rectal endometriosis, is possible. Case presentation A 36-year-old Greek woman was admitted to the emergency room of our hospital with signs of acute abdomen. On physical examination, our patient had a painful distended abdomen. Digital examination revealed an empty rectum and bowel obstruction was diagnosed. Our patient underwent exploratory laparotomy and rectum stenosis (almost complete obstruction) was observed. The bowel stenosis was resected, and temporary colostomy and appendectomy were performed. The pathology report showed endometriosis of the colon and the appendix, and our patient received medical treatment for endometriosis. Six months after this operation our patient had another surgery for restoration of large bowel continuity. No endometriosis was found. Our patient was doing well at the one-year follow up. Conclusion Endometriosis of the bowel is a disease that may cause large bowel obstruction. In women of reproductive age, the surgeon should consider endometriosis as a differential diagnosis in case of various gastrointestinal symptoms.



Effect of GnRH analogues on apoptosis and expression of Bcl2, Bax, Fas and FasL proteins in endometrial epithelial cell cultures from patients with endometriosis and controls  

Microsoft Academic Search

BACKGROUND: Our purpose was to evaluate the effect of the GnRH agonist (GnRHa), leuprolide acetate (LA), and the GnRH antagonist (GnRHant), Antide, on apoptosis and expression of apoptosis-related proteins in endometrial epithelial cell (EEC) cultures from patients with endometriosis and controls (infertile women without endometriosis). METHODS: Biopsy specimens of eutopic endometrium were obtained from 22 patients with endometriosis and from

M. Bilotas; R. I. Baranao; R. Buquet; C. Sueldo; M. Tesone; G. Meresman



Bladder endometriosis, a remarkable resemblance in a monozygotic twin  

PubMed Central

It is known for many years that heritability plays a role in the development of endometriosis in many patients. Deep endometriosis of the bladder is a rare presentation of the disease and bladder endometriosis was not reported in monozygotic twin studies so far. Since monozygotic twins share the same genes, concordance and differences in presentation of endometriosis may help to discriminate between genetic and environmental determinants. The remarkable resemblance in the presentation of bladder endometriosis in this monozygotic twin seems to indicate that genetic factors are of importance in the arising of deep endometriosis in the bladder too.



How Do Health Care Providers Diagnose Endometriosis?  


... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Page Content Surgery is currently ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...


GSTM1 and GSTT1 polymorphisms in endometriosis in women from Goiás, Brazil.  


Endometriosis is a gynecologic pathology with a high prevalence and unknown etiology. Therefore, an increasing number of studies has been undertaken to search for associations between endometriosis and alterations or polymorphisms in candidate genes, including glutathione S-transferase mu 1 (GSTM1) and glutathione S-transferase theta 1 (GSTT1). We analyzed the frequency of present/absent polymorphisms of GSTM1 and GSTT1 in 50 women diagnosed with endometriosis and in a control group of 46 women without complaints related to this pathology. The association of these polymorphisms with p53 gene codon 72 was also evaluated within each group, and a higher frequency of absence of GSTM1 (61%) and GSTT1 (45%) genes in the group of women studied, women with endometriosis and control group was found. The contributions of GSTM1 and GSTT1 polymorphisms to the proliferation of endometriosis were not statistically significant, but the analysis of pathology and the association of GSTM1 and GSTT1 gene polymorphisms with p53 codon 72 revealed statistical significance. PMID:23979901

Frare, A B; Barbosa, A M; Costa, I R; Souza, S R; Silva, R C P C; Bordin, B M; Ribeiro Júnior, C L; Moura, K K V O



Human Milk Banking: Considerations Related to Human ...  

Center for Biologics Evaluation and Research (CBER)

Text Version... Human Milk Banking Procedures to Reduce ... of milk containers-Batch number, name of milk bank ... (donor procedure, HIV testing, PEP electronic links ... More results from


[Biological aspects of endometriosis in vitro fertilization].  


Rinsing cumulus oophorus after oocyte retrieval is routinely performed in our department in Lyon for in vitro fertilization procedures when ovarian endometriosis is suspected. The aim of this procedure is to remove factors which might alter oocyte and embryo quality and fertilization and pregnancy rates. These factors, such as Tumor Necrosis Factor alpha (TNFalpha) and reactive oxygen species are known to be surexpressed in endometriosis. Their effect is not exclusively on the development of the oocyte and embryo but also on fertilization and implantation. It has been demonstrated that peritoneal and follicular fluid contains some factors that interfere with effective gamete interaction, as it has been determined by an in vitro animal assay. Peritoneal fluid from patients with mild endometriosis has an increased activity of TNFalpha, interleukin-1 (IL-1), antibodies and reactive oxygen species. This observation might be of importance in explaining subfertility associated with early stages of endometriosis. Cumulus-oophorus rinsing after oocyte retrieval might help to remove these deleterious factors. IVF outcomes in women affecting by endometriosis seem to be similar after cumulus-oophorus rinsing, as compared to those of patients undergoing IVF for tubal-factor infertility. This rinsing procedure could also be usefull in women affected by unexplained infertility: peritoneal and follicular fluid of these women contains increased levels of TNFalpha and reactive oxygen species, like women affected by endometriosis. PMID:14968070

Lornage, J



[ENZIAN-score, a classification of deep infiltrating endometriosis].  


The ENZIAN-Score is presented as a new instrument to classify the deep infiltrating endometriosis. Especially the retroperitoneal part of the severe endometriosis is focussed on. In analogy to an oncological staging four different stages are pronounced. The localisation and the expansion of the endometriosis nodule was indicated to different subgroups. The still used rAFS-score is of no clinical evidence, as we pointed out in a retrospective study of our patients with severe intestinal endometriosis. PMID:16195969

Tuttlies, F; Keckstein, J; Ulrich, U; Possover, M; Schweppe, K W; Wustlich, M; Buchweitz, O; Greb, R; Kandolf, O; Mangold, R; Masetti, W; Neis, K; Rauter, G; Reeka, N; Richter, O; Schindler, A E; Sillem, M; Terruhn, V; Tinneberg, H R



Pregnancy outcome in pre-operative danazol treatment followed by laparoscopic correction in infertility associated with endometriosis.  


Probably, more has been written and less has been agreed upon, regarding the pathogenesis of the enigmatic disorder--endometriosis, which is the leading cause of disability in women of reproductive age group, resulting in infertility and pelvic pain. It is an accepted fact that the medical treatment of endometriosis does not help in infertility management, except certain situations like pain, limiting the attempt of pregnancy, or endometriosis presenting with cornual block, due to endosalpingiosis. The usual treatment of infertility being either surgical correction, or assisted reproductive technology procedures. In our patient population, the acceptance of In-vitro fertilisation or embryo transfer is much less, because of its high cost and social taboo. In this series, the improved pregnancy outcome is observed with medical treatment of endometriosis with danazol before and after the laparoscopic correction of the tubo-ovarian relation due to endometriosis or in certain cases of minimal to mild endometriosis, not requiring correction. Out of 722 suspected cases of endometriosis, 576 cases were subjected to prelaparoscopic treatment with danazol, and the result was compared with 424 cases of only laparoscopic treatment, and 216 cases of postlaparoscopic danazol treatment, during the years 2004 to 2008. A total of 1216 cases were included in the study. The initiation of medical treatment in the pre-operative period gives better pregnancy outcome, as compared to only surgical or postsurgical medical treatment. The experience proves that the adjuvant medical treatment with danazol, initiated before laparoscopy in suspected endometriosis cases is useful treatment procedure, to increase the pregnancy rate. PMID:23738401

Chatterjee, Siddhartha; Dey, Sandip; Chowdhury, Rajib Gon; Ganguly, Debi Das



Towards endometriosis diagnosis by gadofosveset-trisodium enhanced magnetic resonance imaging.  


Endometriosis is defined as the presence of endometrial tissue outside the uterus. It affects 10-15% of women during reproductive age and has a big personal and social impact due to chronic pelvic pain, subfertility, loss of work-hours and medical costs. Such conditions are exacerbated by the fact that the correct diagnosis is made as late as 8-11 years after symptom presentation. This is due to the lack of a reliable non-invasive diagnostic test and the fact that the reference diagnostic standard is laparoscopy (invasive, expensive and not without risks). High-molecular weight gadofosveset-trisodium is used as contrast agent in Magnetic Resonance Imaging (MRI). Since it extravasates from hyperpermeable vessels more easily than from mature blood vessels, this contrast agent detects angiogenesis efficiently. Endometriosis has high angiogenic activity. Therefore, we have tested the possibility to detect endometriosis non-invasively using Dynamic Contrast-Enhanced MRI (DCE-MRI) and gadofosveset-trisodium as a contrast agent in a mouse model. Endometriotic lesions were surgically induced in nine mice by autologous transplantation. Three weeks after lesion induction, mice were scanned by DCE-MRI. Dynamic image analysis showed that the rates of uptake (inwash), persistence and outwash of the contrast agent were different between endometriosis and control tissues (large blood vessels and back muscle). Due to the extensive angiogenesis in induced lesions, the contrast agent persisted longer in endometriotic than control tissues, thus enhancing the MRI signal intensity. DCE-MRI was repeated five weeks after lesion induction, and contrast enhancement was similar to that observed three weeks after endometriosis induction. The endothelial-cell marker CD31 and the pericyte marker ?-smooth-muscle-actin (mature vessels) were detected with immunohistochemistry and confirmed that endometriotic lesions had significantly higher prevalence of new vessels (CD31 only positive) than the uterus and control tissues. The diagnostic value of gadofosveset-trisodium to detect endometriosis should be tested in human settings. PMID:22457748

Schreinemacher, Marc H; Backes, Walter H; Slenter, Jos M; Xanthoulea, Sofia; Delvoux, Bert; van Winden, Larissa; Beets-Tan, Regina G; Evers, Johannes L H; Dunselman, Gerard A J; Romano, Andrea



Human Development: Definitions, Critiques, and Related Concepts  

Microsoft Academic Search

The purpose of this background paper is: i) to synthesize the discussions regarding the concept of human development, so as to inform the 2010 Report’s definition, and ii) drawing on the extensive policy and academic literatures, to propose relationships between the concept of human development and four related concepts: the Millennium Development Goals, Human Rights, Human Security, and Happiness. Inequality,

Sabina Alkire



Human Development: Definitions, Critiques, and Related Concepts  

Microsoft Academic Search

The purpose of this background paper is i) to synthesize the discussions regarding the concept of human development, so as to inform the 2010 Report’s definition, and ii) drawing on the extensive policy and academic literatures, to propose relationships between the concept of human development and four related concepts: the Millennium Development Goals, Human Rights, Human Security, and Happiness. Inequality,

Sabina Alkire



A polymorphism in a let-7 microRNA binding site of KRAS in women with endometriosis  

PubMed Central

Endometriosis is found in 5–15% of women of reproductive age and is more frequent in relatives of women with the disease. Activation of KRAS results in de novo endometriosis in mice, however, activating KRAS mutations have not been identified in women. We screened 150 women with endometriosis for a polymorphism in a let-7 microRNA (miRNA) binding site in the 3'-UTR of KRAS and detected a KRAS variant allele in 31% of women with endometriosis as opposed to 5% of a large diverse control population. KRAS mRNA and protein expression were increased in cultured endometrial stromal cells of women with the KRAS variant. Increased KRAS protein was due to altered miRNA binding as demonstrated in reporter assays. Endometrial stromal cells from women with the KRAS variant showed increased proliferation and invasion. In a murine model, endometrial xenografts containing the KRAS variant demonstrated increased proliferation and decreased progesterone receptor levels. These findings suggest that an inherited polymorphism of a let-7 miRNA binding site in KRAS leads to abnormal endometrial growth and endometriosis. The LCS6 polymorphism is the first described genetic marker of endometriosis risk.

Grechukhina, Olga; Petracco, Rafaella; Popkhadze, Shota; Massasa, Efi; Paranjape, Trupti; Chan, Elcie; Flores, Idhaliz; Weidhaas, Joanne B; Taylor, Hugh S



Malignant transformation of endometriosis within the urinary bladder  

PubMed Central

Although endometriosis of the pelvic organs is common, endometriosis of the urinary bladder is extremely rare. Malignant transformation of atypical endometriotic foci is an uncommon but well-documented sequela, occurring in approximately 1% of cases. This article reports the fourth case in the English literature of clear cell carcinoma arising from foci of endometriosis within the posterior bladder wall.

Patel, Purvak; Matthews, Carolyn M.; Pinto, Karen; O'Connor, Julie



Cyclic sciatica caused by infiltrative endometriosis: MRI findings  

Microsoft Academic Search

Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an

Ensar Yekeler; Basak Kumbasar; Atadan Tunaci; Ahmet Barman; Ergin Bengisu; Ekrem Yavuz; Mehtap Tunaci



Diet and endometriosis risk: a literature review.  


A connection between dietary factors and endometriosis onset has become a topic of interest mostly due to the observation that physiological and pathological processes of the disease can be influenced by diet. This paper systematically reviews prior publications dealing with this aspect in order to identify potentially modifiable risk factors. Comprehensive searches in the electronic databases MEDLINE, EMBASE and Science Citation Index Expanded were conducted to identify published studies evaluating the association between food intake (nutrients and food groups) and endometriosis. Eleven studies were identified: 10 case-control and one cohort study. Information on diet was collected using food frequency questionnaires in seven studies, while in one study the questionnaire focused on caffeine and alcohol intake. Women with endometriosis seem to consume fewer vegetables and omega-3 polyunsaturated fatty acids and more red meat, coffee and trans fats but these findings could not be consistently replicated. Most data have also been discussed herein in light of the available experimental and animal model results. At present, evidence supporting a significant association between diet and endometriosis is equivocal. Further studies are needed to clarify the role of diet on endometriosis risk and progression. A connection between dietary factors and endometriosis onset has become a topic of interest mostly due to the observation that physiological and pathological processes of the disease can be influenced by diet. We have herein systematically reviewed prior publications dealing with this aspect in order to identify risk factors for the disease. Comprehensive searches in the electronic databases MEDLINE, EMBASE and Science Citation Index Expanded were conducted to identify studies published on the relationship between endometriosis and both nutrients and food groups. We identified 11 studies: 10 case-control studies and one cohort study. Information on diet was collected using food frequency questionnaires in seven studies. A protective effect on endometriosis risk has been suggested for vegetable consumption and omega-3 polyunsaturated fatty acid intakes, whereas a negative impact has been reported for red meat consumption and trans fats and coffee intakes, but these findings could not be consistently replicated. Evidence supporting a role of diet on endometriosis risk is equivocal. Further studies are needed to clarify the role of diet on endometriosis risk and progression. PMID:23419794

Parazzini, Fabio; Viganò, Paola; Candiani, Massimo; Fedele, Luigi



Chemokines and human reproduction  

Microsoft Academic Search

Objective: To review the available information regarding chemotactic cytokines and their possible implications in human reproduction.Design: A thorough literature and MEDLINE search was conducted to identify studies relating to the role of chemokines in ovulation, menstruation, implantation, cervical ripening and preterm labor, and endometriosis.Result(s): Chemokines mediate leukocyte traffic through their specific receptors in various tissues. Although four families have been

Juan A Garc??a-Velasco; Aydin Arici



[Effect of endometriosis pill No. 2 on beta-endorphin and dynorphin in endometriosis].  


In order to explore the correlation between endometriosis and beta-Endorphin, Dynorphin, the beta-Endorphin and Dynorphin levels in menstrual blood of normal women and patients with endometriosis, and the pituitary-hypothalamic beta-Endorphin and Dynorphin levels in animal models were determined. The results indicated: (1) The plasma beta-Endorphin and Dynorphin levels in patients with endometriosis were significantly lower than those in normal women (P < 0.05); the plasma beta-Endorphin levels in patients with endometriosis were significantly higher after treatment of Endometriosis Pill No. 2 (P < 0.05). (2) The pituitary and hypothalamic beta-Endorphin levels in untreated group were significantly higher than those in the control group (P < 0.05); the hypothalamic beta-Endorphin in treated group were obviously higher than those in untreated group (108.35 +/- 35.38 and 66.63 +/- 14.29 respectively). The above-mentioned results presented evidence that the low beta-Endorphin and Dynorphin levels in endometriotic patients play a role in dysmenorrhea; the effect of Endometriosis Pill No. 2 in relieving dysmenorrhea was realized through an increase of plasma and hypothalamic beta-Endorphin levels. (3) The Pituitary and hypothalamic beta-Endorphin levels were significantly different between the animal models of endometriosis and normal control groups. PMID:8098971

Yu, C Q; Wang, D Z; Wang, Z Q





... that it causes a girl to miss school, sports, and social activities. Other possible symptoms include: pelvic ... to friends and teachers why they miss school, sports, or other activities, for example. If you feel ...


Endometriosis - clinical approach based on histological findings.  


Endometriosis is a benign disease defined by the presence of endometrial glands and stroma outside of the uterus and is associated with both pelvic pain and infertility. The most common sites of endometriosis, in decreasing order of frequency, are the ovaries, anterior and posterior cul-de-sac, posterior broad ligaments, uterosacral ligaments, uterus, fallopian tubes, sigmoid colon, appendix, and round ligaments. The main treatment is surgical, but often-microscopic islands of endometrial tissue remain, which proliferate and are responsible for relapses. We tested the efficacy of two drugs (Medroxyprogesterone and Triptorelinum), administered for six months to prevent recurrence after surgery. Treatment with Medroxyprogesterone was 100% effective in terms of relapse, while Triptorelinum could not prevent recurrence of endometriosis. PMID:23529314

Cristescu, C; Veli?cu, Andreea; Marinescu, B; P?tra?cu, Anca; Tra?c?, E T; Pop, O T



MR imaging of endometriosis: ten imaging pearls.  


Endometriosis, which is defined as the presence of ectopic endometrial glands and stroma outside the uterus, is a common cause of pelvic pain and infertility, affecting as many as 10% of premenopausal women. Because its effects may be devastating, radiologists should be familiar with the various imaging manifestations of the disease, especially those that allow its differentiation from other pelvic lesions. The "pearls" offered here are observations culled from the authors' experience with the use of magnetic resonance (MR) imaging for the detection and characterization of pelvic endometriosis. First, the inclusion of T1-weighted fat-suppressed sequences is recommended for all MR examinations of the female pelvis because such sequences facilitate the detection of small endometriomas and aid in their differentiation from mature cystic teratomas. Second, it must be remembered that benign endometriomas, like many pelvic malignancies, may exhibit restricted diffusion. Although women with endometriosis are at risk for developing clear cell and endometrioid epithelial ovarian cancers (ie, endometriosis-associated ovarian cancers), imaging findings such as enhancing mural nodules should be confirmed before a diagnosis of ovarian malignancy is offered. The presence of a dilated fallopian tube, especially one containing hemorrhagic content, is often associated with pelvic endometriosis. Deep (solid infiltrating) endometriosis can involve the pelvic ligaments, anterior rectosigmoid colon, bladder, uterus, and cul-de-sac, as well as surgical scars; the lesions often have poorly defined margins and T2 signal hypointensity as a result of fibrosis. The presence of subcentimeter foci with T2 hyperintensity representing ectopic endometrial glands within these infiltrating fibrotic masses may help establish the diagnosis. PMID:23065164

Siegelman, Evan S; Oliver, Edward R



Lifetime occupational history and risk of endometriosis  

PubMed Central

Objectives Endometriosis is the presence of functioning endometrial glands and stroma outside the uterine cavity, most often in the pelvic peritoneal cavity. Women with endometriosis commonly have dysmenorrhea, dyspareunia, pain, menorrhagia and/or metrorrhagia; disease complications can include adhesions, chronic pain, and infertility. This exploratory case-control study investigated the relationship between lifetime occupational history and surgically confirmed endometriosis in a population-based sample. Methods Interviews were conducted with cases, all reproductive-aged female enrollees of a large health-maintenance organization first diagnosed with surgically confirmed endometriosis between April 1, 1996 and March 31, 2001 and randomly selected controls from the reproductive-aged female enrollee list from the same time period. Each reported job was coded using US Census Occupations and Industries codes, and jobs were classed into categories. Having ever worked an occupation in a given job class was compared to never having done so using unconditional logistic regression. Results Having ever worked as a flight attendant, service station attendant, or health worker, particularly as a nurse or health aide, was associated with increased risk of endometriosis (flight attendant: OR 9.80, 95% CI 1.08 - 89.02; service station attendant: OR 5.77, 95% CI 1.03 -32.43; health worker: OR 1.49, 95% CI 1.03 - 2.15). Income and education did not make a difference in the odds ratio estimates for the occupations examined. Conclusions This exploratory study suggests that having ever worked as a flight attendant, service station attendant, or health worker, particularly as a nurse, may be associated with an increased risk of endometriosis.

Marino, Jennifer L.; Holt, Victoria L.; Chen, Chu; Davis, Scott



[Endometriosis of umbilical cicatrix: a clinical case].  


The Authors report a case of umbilical endometriosis in a 46-year-old patient. The woman came in for observation describing acute pain in the vicinity of the umbilical scar. The pain was occasional at first and then became steady and increased at the time of menstruation. Medical examination revealed a left paraumbilical nodule, measuring 1 cm in diameter. The patient underwent surgical treatment: the nodule was excised and the subsequent histological examination was diagnostic for umbilical endometriosis. The surgical excision was effective: at follow-up 3 months later, there was no recurrence and the patient was in good general condition. PMID:11396077

Mazzola, F; Castellini, C; Tosi, D; Vicenzi, L; Rizzo, S; Betresini, B; Lauro, E; Moser, A; Bonomo, S; Bottura, D; Colato, C; Rosa, G


Differential expression of CRH, UCN, CRHR1 and CRHR2 in eutopic and ectopic endometrium of women with endometriosis.  


Endometriosis is considered as a benign aseptic inflammatory disease, characterised by the presence of ectopic endometrium-like tissue. Its symptoms (mostly pain and infertility) are reported as constant stressors. Corticotropin releasing hormone (CRH) and urocortin (UCN) are neuropeptides, strongly related to stress and inflammation. The effects of CRH and UCN are mediated through CRHR1 and CRHR2 receptors which are implicated in several reproductive functions acting as inflammatory components. However, the involvement of these molecules to endometriosis remains unknown. The aim of this study was to examine the expression of CRHR1 and CRHR2 in endometriotic sites and to compare the expression of CRHR1 and CRHR2 in eutopic endometrium of endometriotic women to that of healthy women. We further compared the expression of CRH, UCN, CRHR1 and CRHR2 in ectopic endometrium to that in eutopic endometrium of women with endometriosis. Endometrial biopsy specimens were taken from healthy women (10 patients) and endometrial and endometriotic biopsy specimens were taken from women with endometriosis (16 patients). ?he expression of CRH, UCN, CRHR1, and CRHR2 was tested via RT-PCR, immunohistochemistry and Western blotting. This study shows for the first time that CRH and UCN receptor subtypes CRHR1? and CRHR2? are expressed in endometriotic sites and that they are more strongly expressed (p<0.01) in eutopic endometrium of women with endometriosis compared to healthy women endometrium at the mRNA and protein level. CRH, UCN, CRHR1 and CRHR2 mRNA were also more highly expressed in ectopic rather than eutopic endometrium (CRH, UCN, CRHR2?: p<0.01, CRHR1?: p<0.05) and protein (CRH and UCN: p<0.05, CRHR1 and CRHR2: p<0.01) in women with endometriosis. These data indicate that CRH and UCN might play an immunoregulatory role in endometriotic sites by affecting reproductive functions such as decidualization and implantation of women with endometriosis. PMID:23638035

Vergetaki, Aikaterini; Jeschke, Udo; Vrekoussis, Thomas; Taliouri, Eirini; Sabatini, Luca; Papakonstanti, Evangelia A; Makrigiannakis, Antonis



Natural conception rate following laparoscopic surgery in infertile women with endometriosis  

PubMed Central

Objective To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. Methods We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. Results The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. Conclusion Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.

Lee, Hye Jun; Lee, Jae Eun; Ku, Seung-Yup; Kim, Seok Hyun; Kim, Jung Gu; Moon, Shin Yong



Macrophage Migration Inhibitory Factor Antagonist Blocks the Development of Endometriosis In Vivo  

PubMed Central

Endometriosis, a disease of reproductive age women, is a major cause of infertility, menstrual disorders and pelvic pain. Little is known about its etiopathology, but chronic pelvic inflammation is a common feature in affected women. Beside symptomatic treatment of endometriosis-associated pain, only two main suboptimal therapeutic approaches (hormonal and invasive surgery) are generally recommended to patients and no specific targeted treatment is available. Our studies led to the detection of a marked increase in the expression of macrophage migration inhibitory factor (MIF) in the eutopic endometrium, the peripheral blood and the peritoneal fluid of women with endometriosis, and in early, vascularized and active endometriotic lesions. Herein, we developed a treatment model of endometriosis, where human endometrial tissue was first allowed to implant into the peritoneal cavity of nude mice, to assess in vivo the effect of a specific antagonist of MIF (ISO-1) on the progression of endometriosis and evaluate its efficacy as a potential therapeutic tool. Administration of ISO-1 led to a significant decline of the number, size and in situ dissemination of endometriotic lesions. We further showed that ISO-1 may act by significantly inhibiting cell adhesion, tissue remodeling, angiogenesis and inflammation as well as by altering the balance of pro- and anti-apoptotic factors. Actually, mice treatment with ISO-1 significantly reduced the expression of cell adhesion receptors ?v and ß3 integrins (P<0.05), matrix metalloproteinases (MMP) 2 and 9 (P<0.05), vascular endothelial cell growth factor (VEGF) (P<0.01), interleukin 8 (IL8) (P<0.05), cyclooxygenease (COX)2 (P<0.001) and the anti-apoptotic protein Bcl2 (P<0.01), but significantly induced the expression of Bax (P<0.05), a potent pro-apoptotic protein. These data provide evidence that specific inhibition of MIF alters endometriotic tissue growth and progression in vivo and may represent a promising potential therapeutic avenue.

Khoufache, Khaled; Bazin, Sylvie; Girard, Karine; Guillemette, Julie; Roy, Marie-Christine; Verreault, Jean-Pierre; Al-Abed, Yousef; Foster, Warren; Akoum, Ali



Genetic, epigenetic and stem cell alterations in endometriosis: new insights and potential therapeutic perspectives.  


Human endometrium is a highly dynamic tissue, undergoing periodic growth and regression at each menstrual cycle. Endometriosis is a frequent chronic pathological status characterized by endometrial tissue with an ectopic localization, causing pelvic pain and infertility and a variable clinical presentation. In addition, there is well-established evidence that, although endometriosis is considered benign, it is associated with an increased risk of malignant transformation in approximately 1.0% of affected women, with the involvement of multiple pathways of development. Increasing evidence supports a key contribution of different stem/progenitor cell populations not only in the cyclic regeneration of eutopic endometrium, but also in the pathogenesis of at least some types of endometriosis. Evidence has arisen from experiments in animal models of disease through different kinds of assays (including clonogenicity, the label-retaining cell approach, the analysis of undifferentiation markers), as well as from descriptive studies on ectopic and eutopic tissue samples harvested from affected women. Changes in stem cell populations in endometriotic lesions are associated with genetic and epigenetic alterations, including imbalance of miRNA expression, histone and DNA modifications and chromosomal aberrations. The present short review mainly summarizes the latest observations contributing to the current knowledge regarding the presence and the potential contribution of stem/progenitor cells in eutopic endometrium and the aetiology of endometriosis, together with a report of the most recently identified genetic and epigenetic alterations in endometriosis. We also describe the potential advantages of single cell molecular profiling in endometrium and in endometriotic lesions. All these data can have clinical implications and provide a basis for new potential therapeutic applications. PMID:24059589

Forte, Amalia; Cipollaro, Marilena; Galderisi, Umberto



Evaluation of Human Relations Training Programs.  

National Technical Information Service (NTIS)

An evaluation was made of computer assisted instruction on human relations skills implemented on the PLATO IV computer system. These materials had been devised for use by company commanders (CCs) at Naval Recruit Training Commands (RTCs) and were tested a...

G. Lukas A. S. Blaiwes D. Weller



Low-density lipoproteins oxidation and endometriosis.  


The etiopathogenesis of endometriosis still remains unknown. Recent data provide new valuable information concerning the role of oxidative stress in the pathophysiology of the disease. It has been proved that levels of different lipid peroxidation end products are increased in both peritoneal fluid (PF) and serum of endometriotic patients. We assessed the concentration of oxidized low-density lipoproteins (oxLDL) in PF of 110 women with different stages of endometriosis and 119 women with serous (n = 78) or dermoid (n = 41) ovarian cysts, as the reference groups. PF oxLDL levels were evaluated by ELISA. We found that concentrations of oxLDL in PF of endometriotic women were significantly higher compared to women with serous but not dermoid ovarian cysts. Interestingly, by analyzing concentrations of oxLDL in women with different stages of the disease, it was noted that they are significantly higher only in the subgroup of patients with stage IV endometriosis as compared to women with ovarian serous cysts. In case of minimal, mild, and moderate disease, PF oxLDL levels were similar to those noted in reference groups. Our results indicate that disrupted oxidative status in the peritoneal cavity of women with endometriosis may play a role in the pathogenesis of advanced stages of the disease. PMID:23861560

Polak, Grzegorz; Barczy?ski, Bart?omiej; Kwa?niewski, Wojciech; Bednarek, Wies?awa; Wertel, Iwona; Derewianka-Polak, Magdalena; Kotarski, Jan



Elevated peritoneal fluid TNF-? incites ovarian early growth response factor 1 expression and downstream protease mediators: a correlation with ovulatory dysfunction in endometriosis.  


Endometriosis-associated infertility manifests itself via multiple, poorly understood mechanisms. Our goal was to characterize signaling pathways, between peritoneal endometriotic lesions and the ovary, leading to failed ovulation. Genome-wide microarray analysis comparing ovarian tissue from an in vivo endometriosis model in the rat (Endo) with controls (Sham) identified 22 differentially expressed genes, including transiently expressed early growth response factor 1 (Egr1). The Egr1 regulates gene requisites for ovulation. The Egr1 promoter is responsive to tumor necrosis factor-alpha (TNF-?) signaling. We hypothesized that altered expression of ovarian EGR1 is induced by elevated peritoneal fluid TNF-? which is upregulated by the presence of peritoneal endometriosis. Endo rats, compared to controls, had more peritoneal fluid TNF-? and quantitative, spatial differences in Egr1 mRNA and EGR1 protein localization in follicular compartments. Interactions between elevated peritoneal fluid TNF-? and overexpression of follicular Egr1/EGR1 expression may affect downstream protease pathways impeding ovulation in endometriosis. Preliminary studies identified similar patterns of EGR1 protein localization in human ovaries from women with endometriosis and compared to those without endometriosis. PMID:23427178

Birt, Julie A; Nabli, Henda; Stilley, Julie A; Windham, Emma A; Frazier, Shellaine R; Sharpe-Timms, Kathy L



The social and psychological impact of endometriosis on women's lives: a critical narrative review.  


BACKGROUND Endometriosis is a chronic condition affecting between 2 and 17% of women of reproductive age. Common symptoms are chronic pelvic pain, fatigue, congestive dysmenorrhoea, heavy menstrual bleeding and deep dyspareunia. Studies have demonstrated the considerable negative impact of this condition on women's quality of life (QoL), especially in the domains of pain and psychosocial functioning. The impact of endometriosis is likely to be exacerbated by the absence of an obvious cause and the likelihood of chronic, recurring symptoms. The aims of this paper are to review the current body of knowledge on the social and psychological impact of endometriosis on women's lives; to provide insights into women's experience of endometriosis; to provide a critical commentary on the current state of knowledge and to make recommendations for future psycho-social research. METHODS The review draws on a method of critical narrative synthesis to discuss a heterogeneous range of both quantitative and qualitative studies from several disciplines. This included a systematic search, a structured process for selecting and collecting data and a systematic thematic analysis of results. RESULTS A total of 42 papers were included in the review; 23 used quantitative methods, 16 used qualitative methods and 3 were mixed methods studies. The majority of papers came from just four countries: UK (10), Australia (8), Brazil (6) and the USA (5). Key categories of impact identified in the thematic analysis were diagnostic delay and uncertainty; 'QoL' and everyday activities; intimate relationships; planning for and having children; education and work; mental health and emotional wellbeing and medical management and self-management. CONCLUSIONS Endometriosis has a significant social and psychological impact on the lives of women across several domains. Many studies have methodological limitations and there are significant gaps in the literature especially in relation to a consideration of the impact on partners and children. We recommend additional prospective and longitudinal research utilizing mixed methods approaches and endometriosis-specific instruments to explore the impact of endometriosis in more diverse populations and settings. Furthermore, there is an urgent need to develop and evaluate interventions for supporting women and partners living with this chronic and often debilitating condition. PMID:23884896

Culley, Lorraine; Law, Caroline; Hudson, Nicky; Denny, Elaine; Mitchell, Helene; Baumgarten, Miriam; Raine-Fenning, Nick



Ovarian cancer in endometriosis: epidemiology, natural history, and clinical diagnosis  

Microsoft Academic Search

We review whether endometriosis-associated ovarian cancer is a specific entity compared with ovarian cancer not associated\\u000a with endometriosis, with respect to epidemiology, natural history, and clinical diagnosis; we present a review of the English-language\\u000a literature for ovarian cancer in endometriosis with respect to these three features. A recent prospective study in Japan directly\\u000a showed that, during a follow-up of up

Hiroshi Kobayashi



The emerging use of aromatase inhibitors for endometriosis treatment  

Microsoft Academic Search

Endometriosis is defined as the growth of endometrial tissue outside of the uterine cavity. The disease occurs primarily in\\u000a women of reproductive age but recurrent endometriosis is also detected in post-menopausal women. Regardless of age, endometriosis\\u000a is associated with pain and reduces the quality of life for millions of women world-wide. Conventional therapies focus on\\u000a reducing systemic levels of estrogen

Warren B Nothnick



Human frontal lobes are not relatively large.  


One of the most pervasive assumptions about human brain evolution is that it involved relative enlargement of the frontal lobes. We show that this assumption is without foundation. Analysis of five independent data sets using correctly scaled measures and phylogenetic methods reveals that the size of human frontal lobes, and of specific frontal regions, is as expected relative to the size of other brain structures. Recent claims for relative enlargement of human frontal white matter volume, and for relative enlargement shared by all great apes, seem to be mistaken. Furthermore, using a recently developed method for detecting shifts in evolutionary rates, we find that the rate of change in relative frontal cortex volume along the phylogenetic branch leading to humans was unremarkable and that other branches showed significantly faster rates of change. Although absolute and proportional frontal region size increased rapidly in humans, this change was tightly correlated with corresponding size increases in other areas and whole brain size, and with decreases in frontal neuron densities. The search for the neural basis of human cognitive uniqueness should therefore focus less on the frontal lobes in isolation and more on distributed neural networks. PMID:23671074

Barton, Robert A; Venditti, Chris



Cyclic sciatica caused by infiltrative endometriosis: MRI findings.  


Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch. PMID:14740181

Yekeler, Ensar; Kumbasar, Basak; Tunaci, Atadan; Barman, Ahmet; Bengisu, Ergin; Yavuz, Ekrem; Tunaci, Mehtap



The impact of endometriosis on IVF/ICSI outcomes.  


This retrospective cohort study was aimed to investigate the impact of endometriosis on the IVF/ICSI outcomes. A total of 1027 cycles of patients undergoing IVF/ICSI treatment in a reproductive medicine unit of academic hospital were enrolled. In the present study, 431 cycles of patients with endometriosis constituted the study group, including 152 cycles of patients with stage I-II endometriosis and 279 cycles of patients with stage III-IV endometriosis, while 596 cycles of patients with tubal factors infertility were considered as the control group. Ovarian stimulation parameters and IVF/ICSI outcomes were compared. Patients with stage I-II and stage III-IV endometriosis required higher dosage and longer duration of gonadotropins, but had lower day 3 high-quality embryos rate, when compared to patients with tubal infertility. In addition, the number of oocytes retrieved, the number of obtained embryos, the number of day 3 high-quality embryos, serum E2 level on the day of hCG, fertilization rate were lower in patients with stage III-IV endometriosis than those in tubal factors group. Except reduced implantation rate in stage III-IV endometriosis group, no differences were found in other pregnancy parameters. This study suggests that IVF/ICSI yielded similar pregnancy outcomes in patients with different stages of endometriosis and patients with tubal infertility. Therefore, IVF/ICSI can be considered as an effective approach for managing endometriosis-associated infertility. PMID:24040458

Dong, Xiyuan; Liao, Xiuhua; Wang, Rui; Zhang, Hanwang



Increased risk of placenta previa is associated with endometriosis and tubal factor infertility in assisted reproductive technology pregnancy.  


Although assisted reproductive technology (ART) is suspected to increase the risk of placenta previa, a life-threatening complication of pregnancy, the reason is poorly understood. We recruited consecutive 318 pregnancies conceived by ART in our clinic and examined relation of ten variables, i.e. maternal age, gravidity, parity, male or female fetus, previous abortion, previous cesarean delivery, endometriosis, ovulatory disorder, tubal disease, and male infertility, to placenta previa, by logistic regression analysis. As a result, we found that endometriosis (odds ratio = 15.1; 95% CI = 7.6-500.0) and tubal disease (odds ratio = 4.4; 95% CI = 1.1-26.3) were significantly associated with placenta previa. It would be preferable to take the increased risk of placenta previa into account in treating ART pregnancy with endometriosis and tubal disease. PMID:22835092

Takemura, Yuri; Osuga, Yutaka; Fujimoto, Akihisa; Oi, Nagisa; Tsutsumi, Ryo; Koizumi, Minako; Yano, Tetsu; Taketani, Yuji



Possible role of endometriosis in the aetiology of spontaneous miscarriage in patients with septate uterus  

Microsoft Academic Search

A recent study found a significant correlation between endometriosis and non-obstructive forms of Müllerian anomalies. Other studies described an increased miscarriage rate in patients with endometriosis. This study assessed the effect of endometriosis on pregnancy outcome in a group of patients with endometriosis and septate uterus. Spontaneously achieved pregnancies were taken into consideration. The outcome of 179 infertile women who

Marco Gergolet; Luca Gianaroli; Nataša Kenda Šuster; Ivan Verdenik; M. Cristina Magli; Stephan Gordts



A cross-study gene set enrichment analysis identifies critical pathways in endometriosis  

Microsoft Academic Search

BACKGROUND: Endometriosis is an enigmatic disease. Gene expression profiling of endometriosis has been used in several studies, but few studies went further to classify subtypes of endometriosis based on expression patterns and to identify possible pathways involved in endometriosis. Some of the observed pathways are more inconsistent between the studies, and these candidate pathways presumably only represent a fraction of

Hongbo Zhao; Qishan Wang; Chunyan Bai; Kan He; Yuchun Pan



[Essential data set's archetypes for nursing care of endometriosis patients].  


This study aimed to develop an Essential Data Set for Nursing Care of Patients with Endometriosis (CDEEPE), represented by archetypes. An exploratory applied research with specialists' participation that was carried out at Heath Informatics Laboratory of PUCPR, between February and November of 2010. It was divided in two stages: CDEEPE construction and evaluation including Nursing Process phases and Basic Human Needs, and archetypes development based on this data set. CDEEPE was evaluated by doctors and nurses with 95.9% of consensus and containing 51 data items. The archetype "Perception of Organs and Senses" was created to represents this data set. This study allowed identifying important information for nursing practices contributing to computerization and application of nursing process during care. The CDEEPE was the basis for archetype creation, that will make possible structured, organized, efficient, interoperable, and semantics records. PMID:23596913

Spigolon, Dandara Novakowski; Moro, Claudia Maria Cabral



Relating equivalence relations to equivalence relations: A relational framing model of complex human functioning  

PubMed Central

The current study aimed to develop a behavior-analytic model of analogical reasoning. In Experiments 1 and 2 subjects (adults and children) were trained and tested for the formation of four, three-member equivalence relations using a delayed matching-to-sample procedure. All subjects (Experiments 1 and 2) were exposed to tests that examined relations between equivalence and non-equivalence relations. For example, on an equivalence-equivalence relation test, the complex sample B1/C1 and the two complex comparisons B3/C3 and B3/C4 were used, and on a nonequivalence-nonequivalence relation test the complex sample B1/C2 was presented with the same two comparisons. All subjects consistently related equivalence relations to equivalence relations and nonequivalence relations to nonequivalence relations (e.g., picked B3/C3 in the presence of B1/C1 and picked B3/C4 in the presence of B1/C2). In Experiment 3, the equivalence responding, the equivalence-equivalence responding, and the nonequivalence-nonequivalence responding was successfully brought under contextual control. Finally, it was shown that the contextual cues could function successfully as comparisons, and the complex samples and comparisons could function successfully as contextual cues and samples, respectively. These data extend the equivalence paradigm and contribute to a behaviour-analytic interpretation of analogical reasoning and complex human functioning, in general.

Barnes, Dermot; Hegarty, Neil; Smeets, Paul M.



Kr?ppel-Like Factor 9 and Progesterone Receptor Coregulation of Decidualizing Endometrial Stromal Cells: Implications for the Pathogenesis of Endometriosis  

PubMed Central

Context: Endometriosis is characterized by progesterone resistance and associated with infertility. Krüppel-like factor 9 (KLF9) is a progesterone receptor (PGR)-interacting protein, and mice null for Klf9 are subfertile. Whether loss of KLF9 expression contributes to progesterone resistance of eutopic endometrium of women with endometriosis is unknown. Objective: The aims were to investigate 1) KLF9 expression in eutopic endometrium of women with and without endometriosis, 2) effects of attenuated KLF9 expression on WNT-signaling component expression and on WNT inhibitor Dickkopf-1 promoter activity in human endometrial stromal cells (HESC), and 3) PGR and KLF9 coregulation of the stromal transcriptome network. Methods: Transcript levels of KLF9, PGR, and WNT signaling components were measured in eutopic endometrium of women with and without endometriosis. Transcript and protein levels of WNT signaling components in HESC transfected with KLF9 and/or PGR small interfering RNA were analyzed by quantitative RT-PCR and Western blot. KLF9 and PGR coregulation of Dickkopf-1 promoter activity was evaluated using human Dickkopf-1-luciferase promoter/reporter constructs and by chromatin immunoprecipitation. KLF9 and PGR signaling networks were analyzed by gene expression array profiling. Results: Eutopic endometrium from women with endometriosis had reduced expression of KLF9 mRNA together with those of PGR-B, WNT4, WNT2, and DKK1. KLF9 and PGR were recruited to the DKK1 promoter and modified each other's transactivity. In HESC, KLF9 and PGR coregulated components of the WNT, cytokine, and IGF gene networks that are implicated in endometriosis and infertility. Conclusion: Loss of KLF9 coregulation of endometrial stromal PGR-responsive gene networks may underlie progesterone resistance in endometriosis.

Pabona, John Mark P.; Simmen, Frank A.; Nikiforov, Mikhail A.; Zhuang, DaZhong; Shankar, Kartik; Velarde, Michael C.; Zelenko, Zara; Giudice, Linda C.



Malignant transformation of superficial peritoneal endometriosis lesion.  


A 63-year-old woman with no medical history underwent an abdominal surgery with hysterectomy and bilateral salpingo-oophorectomy for a 10 cm peritoneal cyst with increased cancer antigene-125. A large suspicious tumour of the Douglas space, with contact to the uterus and the rectal wall was described. The rest of the exploration was normal, specially the rest of the peritoneum. Histopathology revealed a malignant transformation of a superficial peritoneal endometriosis. Secondary surgery was thus completed by laparoscopy with bilateral pelvic and para-aortic lymph node dissections, omentectomy and multiple peritoneal biopsies. All staging samples were free of cancer; therefore no complementary therapy was administered. After 18 months of follow-up, consisting of clinical examination and pelvis magnetic resonance imaging every 6 months, we did not observe any recurrence. Malignant transformation of superficial peritoneal endometriosis is a rare disease and surgical management seems to be the main treatment. PMID:23978494

Marchand, Eva; Hequet, Delphine; Thoury, Anne; Barranger, Emmanuel



[Pharmacotherapy for pelvic endometriosis in women].  


Pelvic endometriosis in women is a very common disease. The incidence of this condition in Poland in reproductive age women is about 7-15%, and as much as 50% of cases is diagnosed in patients with co-existing infertility and/or pain and adhesion of a true pelvis. The choice of a therapeutic method depends on the patient's age, stage of the disease, desire for pregnancy, the presence of adhesion, focus localization and a reaction to previous treatment. Currently, the most popular is surgical treatment sometimes followed by pharmacotherapy. Pharmacological treatment includes hormone therapy and symptomatic treatment, also the use of painkillers. Hormonal agents are administered to suppress ovarian activity and cause atrophy of ectopic foci of endometrium. At present, post-surgical pharmacotherapy for endometriosis uses mainly such hormones as: the Combined Oral Contraceptive Pill (COCP), progestagens, danazol, GnRh (gonadotropin-releasing hormone) analogues, aromatase inhibitors and other less common drugs. Also other therapeutic procedures are recommended in endometriosis treatment, procedures which support and in certain clinical situations even replace classical pharmacological methods. Some of them are immunotherapy and a diet rich in isoflavones, organic compounds which modulate estrogen receptor activity. Numerous clinical trials proved that preoperative pharmacotherapy does not improve treatment results and is not applicable to endometriomas in women. On the other hand, postoperative pharmacotherapy still ignites controversy. As maintained by the most recent literature, in the case of mild endometriosis (clinical Stage I and II according to the American Society for Reproductive Medicine) endometrial ablation has better effects than observation only, however postoperative pharmacotherapy does not improve the results of treatment. In more severe cases (clinical Stage III and IV), the best results are achieved by the combined treatment. Nevertheless, no randomized research has been carried out on a wide scale in this group of patients. PMID:19388539

Starczewski, Andrzej; Brodowska, Agnieszka; Brodowski, Jacek



Human RAS Superfamily Proteins and Related GTPases  

NSDL National Science Digital Library

Proteins that bind and hydrolyze GTP (guanosine triphosphate), known as GTPases, are pervasive mediators of intracellular signal transduction. Among the first human GTPases studied were the RAS proteins, which are often found in mutated, hyperactive forms in cancer cells. Over the past 25 years, a family of RAS-related proteins has been identified. This review considers recent progress in understanding the biochemical properties and biological function of RAS family proteins. Analysis of the human genome was used to identify novel members of this family. In addition, comparisons with the completed genomes of fly and worm revealed new insights into evolution and structural conservation, with implications for predicting function. An overview of the full complement of human RAS superfamily proteins, and how they fit within a larger group of human GTPases, is presented.

John Colicelli (University of California Los Angeles;Department of Biological Chemistry and Molecular Biology Institute REV)



Spontaneous External Endometriosis in a Gorilla (Gorilla gorilla)  

PubMed Central

The present report describes a case of external endometriosis in a 28 year old female gorilla (Gorilla gorilla). Microscopical examination of a pelvic mass observed at necropsy revealed ovarian tissue together with uterine glands and stroma, fibrous tissue and many siderophages. Theories of pathogenesis of external endometriosis are briefly reviewed. ImagesFigure 1 and 2.

Dore, Monique; Lagace, Andre



[Physiopathology and therapeutic management of stage I and II endometriosis].  


Stage I and II endometriosis is defined by a r-AFS score respectively ranging from 1 to 5 and from 6 to 15. This mild, superficial endometriosis is a very common pathology occurring in infertile women. Nevertheless, these women with stage I/II endometriosis have usually few pelvic pain. This review summarizes the recent literature concerning new data on the pathogenesis of peritoneal endometriosis and its clinical management. Retrograde menstruation, peritoneal adhesion of shed endometrial tissue, and outgrowth of endometrial cells, glands and stroma, are essential elements in the pathogenesis of endometriosis according to Sampson's classic implantation theory. Nevertheless, exact pathophysiology of endometriosis remains unknown. Superficial endometriotic lesions observed by laparoscopy have to be treated. Surgical procedure is not difficult for stage I and II of endometriosis. Surgical procedure remains controversial. Carbon dioxide (CO2) Laser can be used for laparoscopic destruction of endometriosis. Newer procedures, such as SurgiTouch (Lumenis), are more effective in vaporization and decrease the risk thermal damage of contiguous structures. The monopolar scissors can also be used in order to excise the peritoneal endometriotic lesions. Medical treatment may be usefull if surgical treatment is not complete or if the pelvic cavity is hypervascularized. In these cases, Gonadotropin-Releasing Hormone agonists (Gn-RHa) are the most common and effective treatment.; PMID:14968061

Nisolle, M; Nervo, P



Pain recurrence: A quality of life issue in endometriosis  

Microsoft Academic Search

Studies reveal endometriosis to be present in 38–51% of women undergoing laparoscopy for chronic pelvic pain. Symptoms attributable to endometriosis include dysmenorrhea, dyspareunia, generalized pelvic pain, dyschezia, and radiation of pain to the back or leg. Psychological factors may also contribute to a more intense pain experience. Medical therapy provides symptom relief in 72–93% of patients, although recurrence is common

M. A. Damario; J. A. Rock



Endometriosis, a disease of the macrophage  

PubMed Central

Endometriosis, a common cause of pelvic pain and female infertility, depends on the growth of vascularized endometrial tissue at ectopic sites. Endometrial fragments reach the peritoneal cavity during the fertile years: local cues decide whether they yield endometriotic lesions. Macrophages are recruited at sites of hypoxia and tissue stress, where they clear cell debris and heme-iron and generate pro-life and pro-angiogenesis signals. Macrophages are abundant in endometriotic lesions, where are recruited and undergo alternative activation. In rodents macrophages are required for lesions to establish and to grow; bone marrow-derived Tie-2 expressing macrophages specifically contribute to lesions neovasculature, possibly because they concur to the recruitment of circulating endothelial progenitors, and sustain their survival and the integrity of the vessel wall. Macrophages sense cues (hypoxia, cell death, iron overload) in the lesions and react delivering signals to restore the local homeostasis: their action represents a necessary, non-redundant step in the natural history of the disease. Endometriosis may be due to a misperception of macrophages about ectopic endometrial tissue. They perceive it as a wound, they activate programs leading to ectopic cell survival and tissue vascularization. Clearing this misperception is a critical area for the development of novel medical treatments of endometriosis, an urgent and unmet medical need.

Capobianco, Annalisa; Rovere-Querini, Patrizia



Aromatase inhibitors in post-menopausal endometriosis  

PubMed Central

Postmenopausal endometriosis is a rare clinical condition. The diagnosis and treatment of an endometriotic lesion in postmenopausal women is complicated. First line treatment choice should be surgical, given that there is a potential risk of malignancy. Medical treatment may be considered as second line or as an alternate first line treatment whenever surgery is contradicted and aims to alter the hormonal pathway leading to endometriosis progress. Different hormonal regimens have been administered to these patients, with conflicting however results. Aromatase inhibitors (AIs) represent one of the most recently used drugs for postmenopausal endometriosis. Clinical data for the use of (AIs) in postmenopausal patients is scarce. Up to date only 5 case reports are available regarding the use of these agents in postmenopausal women. Although definite conclusions may be premature, AIs appear to considerably improve patients' symptoms and reduce endometriotic lesions size. Nonetheless the subsequent induced reduction in estrogen production, leads to certain short-term and long-term adverse effects. Despite the limited available data, AIs appear to represent a new promising method which may improve symptoms and treat these patients, either as first line treatment, when surgery is contraindicated or as a second line for recurrences following surgical treatment. However, careful monitoring of patients' risk profile and further research regarding long-term effects and side-effects of these agents is essential prior implementing them in everyday clinical practice.



Diagnosis of endometriosis with imaging: a review.  


Endometriosis corresponds to ectopic endometrial glands and stroma outside the uterine cavity. Clinical symptoms include dysmenorrhoea, dyspareunia, infertility, painful defecation or cyclic urinary symptoms. Pelvic ultrasound is the primary imaging modality to identify and differentiate locations to the ovary (endometriomas) and the bladder wall. Characteristic sonographic features of endometriomas are diffuse low-level internal echos, multilocularity and hyperchoic foci in the wall. Differential diagnoses include corpus luteum, teratoma, cystadenoma, fibroma, tubo-ovarian abscess and carcinoma. Repeated ultrasound is highly recommended for unilocular cysts with low-level internal echoes to differentiate functional corpus luteum from endometriomas. Posterior locations of endometriosis include utero-sacral ligaments, torus uterinus, vagina and recto-sigmoid. Sonographic and MRI features are discussed for each location. Although ultrasound is able to diagnose most locations, its limited sensitivity for posterior lesions does not allow management decision in all patients. MRI has shown high accuracies for both anterior and posterior endometriosis and enables complete lesion mapping before surgery. Posterior locations demonstrate abnormal T2-hypointense, nodules with occasional T1-hyperintense spots and are easier to identify when peristaltic inhibitors and intravenous contrast media are used. Anterior locations benefit from the possibility of MRI urography sequences within the same examination. Rare locations and possible transformation into malignancy are discussed. PMID:16155722

Kinkel, Karen; Frei, Kathrin A; Balleyguier, Corinne; Chapron, Charles



Umbilical endometriosis: report of a case and its dermoscopic features*.  


Cutaneous endometriosis is a rare manifestation of endometriosis, representing 0.5% to 1% of all endometriosis cases. It can be divided into primary and secondary, when appearing spontaneously or after a surgical procedure, when it is mostly found on surgical scar tissue. Some etiologies were proposed, but none of them could entirely explain the appearance of the tumor. Differential diagnosis includes melanoma, metastatic nodule, keloid and pyogenic granuloma. Dermoscopic features are not yet well established, but there are some characteristics that suggest the diagnosis. Treatment is surgical in larger sized lesions. Malignization can occur. The screening for endometriosis is mandatory by means of gynecologic, imaging and marked-tumor evaluation. We report a case of primary umbilical endometriosis and discuss its dermoscopic aspects. PMID:23539017

Jaime, Thais Jerez; Jaime, Tatiana Jerez; Ormiga, Patrícia; Leal, Fabiano; Nogueira, Osvania Maris; Rodrigues, Nilton


[Endometriosis as a risk factor for ovarian cancer].  


A history of endometriosis is a risk factor for some subtypes of epithelial ovarian cancer. Endometriosis is associated with increased risk of ovarian clear cell, serous low-grade endometrioid cancer, but it is unclear what the role of endometriosis is in the development of other histopathological subtypes of ovarian cancer, such as high-grade serous borderline tumors subtypes or borderline serous and mucinous cancers. An understanding of the mechanisms leading to malignant transformation of endometriosis will be needed to identify subgroups of women at increased risk of ovarian cancer. This is important because of their high prevalence and cause of infertility in Mexico and the world. All factors must be considered during the decision-making process for the treatment of endometriosis, including the rare malignant transformation. PMID:23522320

Vargas-Hernández, Víctor Manuel


Developmental Exposure of Mice to TCDD Elicits a Similar Uterine Phenotype in Adult Animals as Observed in Women with Endometriosis  

PubMed Central

Whether environmental toxicants impact an individual woman’s risk for developing endometriosis remains uncertain. Although the growth of endometrial glands and stroma at extra-uterine sites is associated with retrograde menstruation, our studies suggest that reduced responsiveness to progesterone may increase the invasive capacity of endometrial tissue in women with endometriosis. Interestingly, our recent studies using isolated human endometrial cells in short-term culture suggest that experimental exposure to the environmental contaminant 2,3,7,8-tetracholorodibenzo-p-dioxin (TCDD) can alter the expression of progesterone receptor isotypes. Compared to adult exposure, toxicant exposure during development can exert a significantly greater biological impact, potentially affecting the incidence of endometriosis in adults. To address this possibility, we exposed mice to TCDD at critical developmental time points and subsequently examined uterine progesterone receptor expression and steroid responsive transforming growth factor-?2 expression in adult animals. We find that the uterine phenotype of toxicant-exposed mice is markedly similarly to the endometrial phenotype of women with endometriosis.

Nayyar, Tultul; Bruner-Tran, Kaylon L.; Piestrzeniewicz-Ulanska, Dagmara; Osteen, Kevin G.



Relational and Transcendental Humanism: Exploring the Consequences of a Thoroughly Pragmatic Humanism  

ERIC Educational Resources Information Center

|The relational and transcendental elements of humanism are considered. Although the relational component of humanism is extraordinarily valuable, the author argues that the transcendental portion of humanism should be abandoned. The implications of a thoroughly pragmatic humanism are explored.|

Hansen, James T.



Human RAS Superfamily Proteins and Related GTPases  

PubMed Central

The tumor oncoproteins HRAS, KRAS, and NRAS are the founding members of a larger family of at least 35 related human proteins. Using a somewhat broader definition of sequence similarity reveals a more extended superfamily of more than 170 RAS-related proteins. The RAS superfamily of GTP (guanosine triphosphate) hydrolysis–coupled signal transduction relay proteins can be subclassified into RAS, RHO, RAB, and ARF families, as well as the closely related G? family. The members of each family can, in turn, be arranged into evolutionarily conserved branches. These groupings reflect structural, biochemical, and functional conservation. Recent findings have provided insights into the signaling characteristics of representative members of most RAS superfamily branches. The analysis presented here may serve as a guide for predicting the function of numerous uncharacterized superfamily members. Also described are guanosine triphosphatases (GTPases) distinct from members of the RAS superfamily. These related proteins employ GTP binding and GTPase domains in diverse structural contexts, expanding the scope of their function in humans.

Colicelli, John



Communicating endometriosis with young women to decrease diagnosis time.  


Issues addressed Endometriosis is estimated to affect approximately 10% of women. Although early detection may enhance health outcomes and fertility, there is a recognised diagnostic delay of 6.7 years. There are limited data on ways to discuss endometriosis with young women. The aims of the present study were to determine what young women know about endometriosis, what young women want to know about endometriosis and how this is best communicated to promote early detection. Methods Women aged 16-25 years were invited to complete an online survey that was advertised via Facebook, email, Twitter and flyers at high schools and a university. Results In all, 131 women responded to the survey. Fifty-two percent of participants had heard of endometriosis, 89% thought teenagers should be educated about endometriosis and 78% thought that young men should also be educated about the condition. Favoured sources for obtaining information were schools (40%), the Internet (22%) and magazines (13%). Participants were most comfortable talking to a doctor (75%), parent (59%) or friend (51%). Participants primarily wanted to know about the disease, its symptoms, risk factors and treatment. Many participants' descriptions of endometriosis were vague or inaccurate. Conclusions The results of the present study indicate that young women are keen to learn about endometriosis, particularly its symptoms. Preferential sources of information appear to be schools or the Internet, and young women appear more comfortable talking to doctors. So what? To promote early detection of endometriosis, health promotion activities should direct their information towards sources that young women prefer. PMID:24168743

Shadbolt, Naomi A; Parker, Melissa A; Orthia, Lindy A



Clinical Prediction of Deeply Infiltrating Endometriosis before Surgery: Is It Feasible? A Review of the Literature  

PubMed Central

Background. Endometriosis is a chronic benign gynecologic disease that can cause pelvic pain and infertility affecting almost 10% of reproductive-age women. Deeply infiltrating endometriosis (DIE) is a specific entity responsible for painful symptoms which are related to the anatomic location of the lesions. Definitive diagnosis requires surgery, and histological confirmation is advisable. The aim of this paper is to review the current literature regarding the possibility of diagnosing DIE accurately before surgery. Despite its low sensitivity and specificity, vaginal examination and evaluation of specific symptoms should not be completely omitted as a basic diagnostic tool in detecting endometriosis and planning further therapeutic interventions. Recently, transvaginal ultrasound (TVUS) has been reported as an excellent tool to diagnose DIE lesions in different locations (rectovaginal septum, retrocervical and paracervical areas, rectum and sigmoid, and vesical wall) with good accuracy. Conclusion. There are neither sufficiently sensitive and specific signs and symptoms nor diagnostic tests for the clinical diagnosis of DIE, resulting in a great delay between onset of symptoms and diagnosis. Digital examination, in addition to TVS, may help to gain better understanding of the anatomical extent and dimension of DIE which is of crucial importance in defining the best surgical approach.

Mendonca Carneiro, Marcia; de Sousa Filogonio, Ivone Dirk; Pyramo Costa, Luciana Maria; de Avila, Ivete; Franca Ferreira, Marcia Cristina



Lumbar Ureteral Stenosis due to Endometriosis: Our Experience and Review of the Literature  

PubMed Central

Endometriosis is a chronic gynaecological disorder characterized by the presence of endometrial tissue outside the uterus. The disease most often affects the ovaries, uterine ligaments, fallopian tubes, and cervical-vaginal region. Urinary tract involvement is rare, accounting for around 1%-2% of all cases, of which 84% are in the bladder. We report a case of isolated lumbar ureteral stenosis due to endometriosis in a 37-year-old patient. The patient came to our observation complaining from lumbar back pain and presented with severe fever. The urological examination found monolateral left positive sign of Giordano. Blood tests evidenced marked lymphocytosis and increased valued of C-reactive protein. Urologic ultrasound showed hydronephrosis of first degree in the left kidney and absence of images related to stones bilaterally. Uro-CT scan evidenced ureteral stenosis at the transition between the iliac and pelvic tracts. We addressed the patient to surgery, and performed laparoscopic excision of the paraureteral bulk, endoscopic mechanical ureteral dilation, and stenting. The histological examination evidenced glandular structures lined by simple epithelium and surrounded by stroma. Immunohistochemical test of the glandular epithelium showed positivity for estrogen and progesterone receptors and moreover stromal cells were positive for CD10. The finding suggested a very rare diagnosis of isolated lumbar ureteral endometriosis.

Buttice, Salvatore; Barresi, Valeria; Inferrera, Antonino; Mucciardi, Giuseppe; Di Benedetto, Antonina; D'Amico, Carmela Emanuela; Magno, Carlo



Liver endometriosis presenting as a liver mass associated with high blood levels of tumoral biomarkers.  


Endometriosis is a dissemination of endometrial-like tissue outside the uterine cavity, responsible for pain and impaired fertility in women of childbearing age. Although endometriosis generally occurs in the pelvis, it can be located further away. We describe the case of a 35-year-old woman who was admitted for further evaluation of a cystic mass of the liver that had invaded the right ventricle and caused pain. Serum levels of the tumor markers CA 125, CA 15-3 and CA 19-9 were elevated. The tumor was resected with a small part of the right ventricle free wall, the diaphragm and the left liver lobe. A histological analysis confirmed that the mass was a benign endometrial cyst. The postoperative course was uneventful and the patient remains asymptomatic with 5 year follow-up. A diagnosis of endometriosis should be considered for thoraco-abdominal cystic masses associated with menses-related pain in women of childbearing age. PMID:23562788

Bouras, Ahmed Fouad; Vincentelli, André; Boleslawski, Emmanuel; Truant, Stéphanie; Liddo, Guido; Prat, Alain; Pruvot, François-René; Zerbib, Philippe



Cancer antigen 125, human epididymis 4, kallikrein 6, osteopontin and soluble mesothelin-related peptide immunocomplexed with immunoglobulin M in epithelial ovarian cancer diagnosis.  


Abstract Background: Human epididymis protein 4 (HE4), kallikrein 6 (KLK6), osteopontin (OPN) and soluble mesothelin-related peptide (SMRP) are new promising biomarkers that could integrate CA125 in epithelial ovarian cancer (EOC) diagnosis. The autoantibody response to tumor antigens is a potential tool for improving the diagnostic performances of biomarkers. The aim of this study was to assess the diagnostic potential of these biomarkers in the form of free markers and immunocomplexed with immunoglobulin M (IgM). Moreover, we analyzed the association between these markers and clinico-pathological characteristics of EOC patients. Methods: Serum and plasma samples of 60 healthy controls, 60 ovarian benign cysts, 60 endometriosis and 60 EOCs, collected before any treatment, were tested for CICs and free antigens by immunoassays. Results: Immunocomplexes were characterized by poor sensitivity and specificity, since they allowed the detection only of a small number of EOC patients and were increased in patients with benign gynecological pathologies. However, the markers in the form of free antigens showed good diagnostic performances. Of note, CA125 and HE4 showed high sensitivity in the detection of the malignancy and HE4 emerged as a useful biomarker in differential diagnosis between EOC and endometriosis. Finally, elevated KLK6 and OPN, were associated with advanced FIGO stage, high grade disease, suboptimally debulked tumor and ascites. Conclusions: This study confirms the diagnostic role of CA125, HE4, KLK6, OPN and SMRP, and for the first time showed that CA125, HE4, KLK6, OPN and SMRP immunocomplexed with IgM are not a potential tool for EOC diagnosis. PMID:24013103

Bandiera, Elisabetta; Zanotti, Laura; Fabricio, Aline S C; Bucca, Elisa; Squarcina, Elisa; Romani, Chiara; Tassi, Renata; Bignotti, Eliana; Todeschini, Paola; Tognon, Germana; Romagnolo, Cesare; Gion, Massimo; Sartori, Enrico; Maggino, Tiziano; Pecorelli, Sergio; Ravaggi, Antonella



Human herpesvirus 6 is closely related to human cytomegalovirus.  

PubMed Central

A sequence of 21,858 base pairs from the genome of human herpesvirus 6 (HHV-6) strain U1102 is presented. The sequence has a mean composition of 41% G + C, and the observed frequency of CpG dinucleotides is close to that predicted from this mononucleotide composition. The sequence contains 17 complete open reading frames (ORFs) and part of another at the 5' end of the sequence. The predicted protein products of two of these ORFs have no recognizable homologs in the genomes of other sequenced human herpesviruses (i.e., Epstein-Barr virus [EBV], human cytomegalovirus [HCMV], herpes simplex virus [HSV], and varicella-zoster virus [VZV]). However, the products of nine other ORFs are clearly homologous to a set of genes that is conserved in all other sequenced herpesviruses, including homologs of the alkaline exonuclease, the phosphotransferase, the spliced ORF, and the major capsid protein genes. Measurements of similarity between these homologous sequences showed that HHV-6 is clearly most closely related to HCMV. The degree of relatedness between HHV-6 and HCMV was commensurate with that observed in comparisons between HSV and VZV or EBV and herpesvirus saimiri and significantly greater than its relatedness to EBV, HSV, or VZV. In addition, the gene for the major capsid protein and its 5' neighbor are reoriented with respect to the spliced ORFs in the genomes of both HHV-6 and HCMV relative to the organization observed in EBV, HSV, and VZV. Three ORFs in HHV-6 have recognizable homologs only in the genome of HCMV. Despite differences in gross composition and size, we conclude that the genomes of HHV-6 and HCMV are closely related.

Lawrence, G L; Chee, M; Craxton, M A; Gompels, U A; Honess, R W; Barrell, B G



Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis  

PubMed Central

Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

Achach, Thouraya; Rammeh, Soumaya; Trabelsi, Amel; Ltaief, Rached; Ben Abdelkrim, Soumaya; Mokni, Moncef; Korbi, Sadok



[YAG laser contact therapy of ovarian endometriosis under laparoscopy].  


Thirty-six patients with ovarian endometriosis were treated with Nd:YAG laser contact irradiation under laparoscopic control. Indications for laparoscopy were infertility (n = 20) and dysmenorrhea (n = 16). The laparoscopic procedures so far undertaken in our clinic include: Aspiration of chocolate cyst, removal of ovarian endometriosis, adhesion-lysis, uterine nerve ablation, coagulation of peritoneal endometriosis and irrigation. No complications were seen. After undergoing this procedure, eight of 20 patients achieved pregnancy and 15 of 16 patients obtained pain relief. Serum CA125 levels were significantly decreased postoperatively. We confirmed that contact irradiation with a cone-shaped sapphire probe provides adequate incision and lysis at lower power levels, and that this method is an effective treatment for ovarian endometriosis. PMID:1828481

Kojima, E; Yano, Y; Morita, M; Otaka, K; Miyagi, M; Usui, A; Watanabe, H; Omura, G; Kubo, H; Nonaka, H



Endoureterotomy is not a sufficient treatment for intrinsic ureteral endometriosis  

PubMed Central

Aim To investigate whether intrinsic ureteral endometriosis could be managed by laser endoureterotomy. Material and methods We studied retrospectively 6 patients with intrinsic ureteral endometriosis who underwent laser endoureterotomy and reviewed their clinical data. Pathological sections of them have also been studied by immunohistochemistry for expressional levels of oestrogen (ER) and progesterone (PR) receptors. Ten sections of normal endometrium were included as a control. Results Five patients had recurrence of ureteral stricture within 6 months postoperatively despite hormonal therapy for 3 to 6 months. One patient had recurrence 8 months after endoureterotomy. Two patients had secondary surgery for ureteroureterostomy and pathology confirmed recurrence of endometriosis. Immunohistochemistry revealed decreased ER and PR expression compared to the control. Conclusions Endoureterotomy with hormonal therapy may not be suitable for ureteral endometriosis due to inadequate cutting and expressional change of ER and PR.

Guo, Ting; Gu, Chao; Feng, Chenchen; Ding, Qiang; Xu, Congjian



Neonatal uterine bleeding as antecedent of pelvic endometriosis.  


We elaborate on a new theory to explain pelvic endometriosis, including endometriosis in premenarcheal girls, based on the finding that the neonatal endometrium can display secretory activity immediately after birth and, in some cases, changes analogous to those seen at menstruation in adults. The neonatal uterus is therefore capable of shedding its endometrium. Indeed, occult vaginal bleeding occurs in a majority of neonates, although overt bleeding is estimated to occur in only 5% of neonates. This may be due to functional plugging of the endocervical canal in the neonate, which in turn would promote retrograde flux of endometrial cells contained in menstrual debris. Ectopic endometrial implantation in a newborn with hydrometrocolpos has been documented. These data, coupled with the observation of a significantly increased risk of endometriosis in adolescents with cervical outflow obstruction and patent Fallopian tubes, indicate that endometriosis, especially in children and young adolescents, may originate from retrograde uterine bleeding soon after birth. PMID:24048011

Brosens, Ivo; Brosens, Jan; Benagiano, Giuseppe



The impact of endometriosis on work and social participation.  


Endometriosis is a debilitating chronic disease that can affect many aspects of everyday life owing to symptoms such as pain and fatigue. This paper reports the findings of a study exploring the impact of symptomatic endometriosis on women's social and working life. The study used a feminist approach. Eighteen women were interviewed and a thematic approach used to analyse the data. The analysis is structured around three themes focusing on issues around disclosure of symptoms in the work place; the impact of symptoms on work, education and social participation; and the strategies used by women in the study to manage endometriosis. A range of health and employment implications are discussed in this paper. In particular, nurses can provide useful support to women by careful assessment and prompt referral for diagnostic procedures and by providing timely and comprehensive information, including information about the lifestyle and nutritional factors recommended by women with endometriosis. PMID:19126072

Gilmour, Jean A; Huntington, Annette; Wilson, Helen V



Update on the diagnosis and treatment of bladder endometriosis  

Microsoft Academic Search

Bladder endometriosis is rare, although the bladder is the urinary tract structure most often affected by this condition.\\u000a The common clinical manifestations of bladder endometriosis include menouria and urethral and pelvic pain syndrome occurring\\u000a cyclically. Imaging methods are not conclusive for the definitive diagnosis. Cystoscopy is the most useful diagnostic test\\u000a with confirmation by histologic study. Treatment must be individualized

Héctor Pastor-Navarro; José M. Giménez-Bachs; María J. Donate-Moreno; José M. Pastor-Guzman; Rafael Ruíz-Mondéjar; Manuel Atienzar-Tobarra; Antonio S. Salinas-Sánchez; Julio A. Virserda-Rodriguez



Endometriosis and abdominal myofascial pain in adults and adolescents.  


Endometriosis and myofascial pain are common disorders with significant impact on quality of life. Increasingly, these conditions are being recognized as highly interconnected through processes that have been described for more than a century. This review is directed to this interconnection through a description of the relationships of endometriosis to proposed mechanisms of pain and chronic pain physiology; the clinical assessment of myofascial representations of this pain; and an approach to the management of these interconnected disorders. PMID:21755274

Jarrell, John



Olfactomedin-4 regulation by estrogen in the human endometrium requires epidermal growth factor signaling.  


Olfactomedin-4 (OLFM-4) is an extracellular matrix protein that is highly expressed in human endometrium. We have examined the regulation and function of OLFM-4 in normal endometrium and in cases of endometriosis and endometrial cancer. OLFM-4 expression levels are highest in proliferative-phase endometrium, and 17?-estradiol up-regulates OLFM-4 mRNA in endometrial explant cultures. Using the luciferase reporter under control of the OLFM-4 promoter, it was shown that both 17?-estradiol and OH-tamoxifen induce luciferase activity, and epidermal growth factor receptor-1 is required for this estrogenic response. In turn, EGF activates the OLFM-4 promoter, and estrogen receptor-? is needed for the complete EGF response. The cellular functions of OLFM-4 were examined by its expression in OLFM-4-negative HEK-293 cells, which resulted in decreased vimentin expression and cell adherence as well as increased apoptosis resistance. In cases of endometriosis and endometrial cancer, OLFM-4 expression correlated with the presence of epidermal growth factor receptor-1 and estrogen receptor-? (or estrogen signaling). An increase of OLFM-4 mRNA was observed in the endometrium of endometriosis patients. No change in OLFM-4 expression levels were observed in patients with endometrial cancer relative with controls. In conclusion, cross-talk between estrogen and EGF signaling regulates OLFM-4 expression. The role of OLFM-4 in endometrial tissue remodeling before the secretory phase and during the predisposition and early events in endometriosis can be postulated but requires additional investigation. PMID:21048224

Dassen, Hellen; Punyadeera, Chamindie; Delvoux, Bert; Schulkens, Iris; Marchetti, Claudia; Kamps, Rick; Klomp, Jan; Dijcks, Fred; de Goeij, Anton; D'Hooghe, Thomas; Kyama, Cleophas; Ederveen, Antwan; Dunselman, Gerard; Groothuis, Patrick; Romano, Andrea



A novel gene-environment interaction involved in endometriosis  

PubMed Central

Objective To establish a well-defined cohort for genetic epidemiology studies of endometriosis and conduct a pilot study to confirm validity using existing data associated with endometriosis. Methods Between January and May 2010, a nested cohort within a population-based biobank was established in Marshfield, Wisconsin, USA. The inclusion criteria were women who had laparoscopy or hysterectomy. Fifty-one pleiotropic genetic polymorphisms and other established risk factors, such as smoking status and body mass index, were compared between endometriosis cases and controls. Results From the existing biobank, 796 cases and 501 controls were identified, and 259 women with endometriosis were enrolled specifically for the nested cohort within this biobank. A single nucleotide polymorphism in the MMP1 gene significantly differed between cases and controls only when stratified by smoking status. Minor allele frequency was higher in control women who smoked than in women with endometriosis who smoked (55.5% versus 45.5%, ?2=8.2, P=0.017); the inverse relationship was found in non-smoker control women. Conclusions Women with endometriosis were successfully recruited to participate in a general biobank, and a novel gene–environment interaction was identified. The findings suggest that important potential genetic associations may be missed if gene–environment interactions with known epidemiologic risk factors are not considered.

McCarty, Catherine A.; Berg, Richard L.; Welter, Joseph D.; Kitchner, Terrie E.; Kemnitz, Joseph W.



The emerging use of aromatase inhibitors for endometriosis treatment  

PubMed Central

Endometriosis is defined as the growth of endometrial tissue outside of the uterine cavity. The disease occurs primarily in women of reproductive age but recurrent endometriosis is also detected in post-menopausal women. Regardless of age, endometriosis is associated with pain and reduces the quality of life for millions of women world-wide. Conventional therapies focus on reducing systemic levels of estrogen which results in cessation of endometriotic implant growth and pain symptoms associated with the disease. However, these treatments are not effective in all women and are not without side effects. Based upon the discovery that endometriotic tissue over-expresses aromatase, an enzyme critical for estrogen production, emphasis has been placed upon the use of aromatase inhibitors for the treatment of endometriosis and its associated symptoms. This article will review the rationale behind the use of aromatase inhibitors in treating endometriosis and summarize those studies which have evaluated the use of aromatase inhibitors in the treatment of endometriosis and its associated symptoms.



[The role of iron metabolism and oxidative stress in the pathogenesis of endometriosis].  


Despite many years of extensive investigations and increasing number of studies, the pathogenesis of endometriosis remains unclear Accumulated data suggests that disrupted iron metabolism may induce oxidative stress in the peritoneal cavity of endometriosis patients. PMID:23488312

Polak, Grzegorz; Wertel, Iwona; Kwa?niewski, Wojciech; Derewianka-Polak, Magdalena; Kotarski, Jan



Bronchial Artery Embolization in the Management of Pulmonary Parenchymal Endometriosis with Hemoptysis  

SciTech Connect

Pulmonary parenchymal endometriosis is extremely rare and usually manifests itself with a recurrent hemoptysis associated with the menstrual cycle. The therapies proposed for women with endometriosis consist of medical treatments and surgery. Bronchial artery embolization has become a well-established and minimally invasive treatment modality for hemoptysis, and to the best of our knowledge, it has not been reported in pulmonary endometriosis. We report a case of pulmonary parenchymal endometriosis treated with embolotheraphy for hemoptysis.

Kervancioglu, Selim, E-mail:; Andic, Cagatay [Gaziantep University Medical Faculty, Department of Radiology (Turkey); Bayram, Nazan [Gaziantep University Medical Faculty, Department of Pulmonary Diseases (Turkey); Telli, Cumali; Sarica, Akif; Sirikci, Akif [Gaziantep University Medical Faculty, Department of Radiology (Turkey)



Bronchial artery embolization in the management of pulmonary parenchymal endometriosis with hemoptysis.  


Pulmonary parenchymal endometriosis is extremely rare and usually manifests itself with a recurrent hemoptysis associated with the menstrual cycle. The therapies proposed for women with endometriosis consist of medical treatments and surgery. Bronchial artery embolization has become a well-established and minimally invasive treatment modality for hemoptysis, and to the best of our knowledge, it has not been reported in pulmonary endometriosis. We report a case of pulmonary parenchymal endometriosis treated with embolotheraphy for hemoptysis. PMID:18196330

Kervancioglu, Selim; Andic, Cagatay; Bayram, Nazan; Telli, Cumali; Sarica, Akif; Sirikci, Akif



Aberrant expression of regulators of cell-fate found in eutopic endometrium is found in matched ectopic endometrium among women and in a baboon model of endometriosis  

PubMed Central

BACKGROUND We have recently shown that women with endometriosis express an increased amount of telomerase and nucleolin, with concomitant loss of ?-H2AX in eutopic endometrium. To further examine these selected factors that regulate cell fate, in the pathogenesis of endometriosis, we studied the expression of telomerase, nucleolin, proliferating cell nuclear antigen and ?-H2AX in ectopic endometriotic deposits from women, and in matched eutopic and ectopic endometrial tissue from a baboon model of endometriosis. METHODS Ectopic active peritoneal endometriotic lesions were collected from seven symptomatic women. Endometriosis was induced in six baboons by intra-peritoneal autologous inoculation of menstrual endometrium. Eutopic and matched ectopic endometrial tissues were collected prior to and 6, 12 and 15 months after the induction of endometriosis as previously described. Eutopic endometrium was also obtained from eight healthy fertile control baboons. Immunohistochemistry was performed as previously described, and telomerase activity was confirmed using the telomeric repeat amplification protocol assay. RESULTS All active human endometriotic lesions expressed the proliferative markers but showed weak or absent staining for ?-H2AX. A similar expression pattern of these markers was seen in the ectopic lesions of the baboons with induced disease. In these baboons, the eutopic endometrium also showed intense immunoreactivity for all proliferative markers 6–12 months after induction with a parallel loss of ?-H2AX. The opposite staining pattern was seen in eutopic endometrium of healthy animals and in pre-induction endometrium of animals with induced disease. CONCLUSIONS Endometriotic lesions have excess proliferative potential; in baboons, these were present within 12 months of the initiation of the disease. In eutopic tissue, these changes appear to be induced by the development of endometriosis.

Hapangama, D.K.; Turner, M.A.; Drury, J.; Heathcote, L.; Afshar, Y.; Mavrogianis, P.A.; Fazleabas, A.T.



Angiopoietin-1, angiopoietin-2 and Tie2 expression in eutopic endometrium in advanced endometriosis  

Microsoft Academic Search

Endometriosis is one of the most common gynaecological disorders, but its aetiology and pathogenesis remain obscure. The refluxed menstrual debris in women with endometriosis may be more prone to implantation, invasion and growth in the perito- neum or ovary through the actions of extracellular proteolysis and angiogenesis. It has been hypothesized that the endometrium from women with endometriosis has higher

Sung Eun Hur; Ji Young Lee; Hye-Sung Moon; Hye Won Chung



Metachronic malignant transformation of small bowel and rectal endometriosis in the same patient  

Microsoft Academic Search

BACKGROUND: Malignant transformation of intestinal endometriosis is a rare event with an unknown rate of incidence. Metachronous progression of endometriosis to adenocarcinoma from two distant intestinal foci happening in the same patient has not been previously reported. CASE PRESENTATION: We describe a case of metachronic transformation of ileal and rectal endometriosis into an adenocarcinoma occurring in a 45-year-old female without

Joaquin Marchena-Gomez; Alicia Conde-Martel; Marion Hemmersbach-Miller; Ana Alonso-Fernandez



Non-Dioxin-Like Polychlorinated Biphenyls and Risk of Endometriosis  

PubMed Central

Background Endometriosis, a gynecologic disorder affecting 8–10% of reproductive-age women in the United States, is defined as the presence of endometrial tissue outside the uterus and is linked to pelvic pain and infertility. Environmental contaminants, including polychlorinated biphenyls (PCBs), are hypothesized to contribute to endometriosis risk through effects on steroid hormones. Objective We evaluated serum concentrations of certain noncoplanar PCBs, which have no or only weak dioxin-like properties, as risk factors for endometriosis. Methods In a case–control study of Group Health enrollees in western Washington State, 20 PCB congeners were measured in serum from surgically confirmed endometriosis cases that were newly diagnosed between 1996 and 2001 (n = 251) and from female controls matched for age and reference year (n = 538). Results Summed and estrogenic PCB concentrations were not associated with endometriosis risk [summed: odds ratio (OR) = 1.3; 95% confidence interval (CI), 0.8–2.2; estrogenic: OR = 1.1; 95% CI, 0.8–1.4]. Although several congener-specific ORs were statistically above or below the null (PCB 170: third quartile vs. lowest: OR = 0.5; 95% CI, 0.3–0.9; PCB 196: third quartile vs. lowest: OR = 0.4; 95% CI, 0.2–0.7; PCB 201: second vs. lowest: OR = 0.5; 95% CI, 0.3–0.8; third quartile vs. lowest: OR = 0.4; 95% CI, 0.2–0.7), there were no overall consistent patterns of endometriosis risk. Conclusions Taken in context with other North American studies, our findings suggest that noncoplanar PCB concentrations consistent within the range of exposure currently observed in western Washington State do not contribute meaningfully to endometriosis risk.

Trabert, Britton; De Roos, Anneclaire J.; Schwartz, Stephen M.; Peters, Ulrike; Scholes, Delia; Barr, Dana B.; Holt, Victoria L.



A Logistic Model for the Prediction of Endometriosis  

PubMed Central

Objective To develop a model using individual and lesion characteristics to help surgeons choose lesions with a high probability of containing histologically-confirmed endometriosis. Design Secondary analysis of prospectively collected information. Setting: Government research hospital. Patients Healthy women aged 18–45 with chronic pelvic pain and possible endometriosis, enrolled in a clinical trial. Intervention All participants underwent laparoscopy, and information was collected on all visible lesions. Lesion data were randomly allocated to a training and test dataset. Main Outcome Measures(s) Predictive logistic regression with the outcome of interest being histologic diagnosis of endometriosis. Results After validation, the model was applied to the complete dataset with a sensitivity of 88.4% and specificity of 24.6%. The positive predictive value was 69.2% and the negative predictive value was 53.3%, equating to correct classification of a lesion of 66.5%. Mixed color, larger width and location in the ovarian fossa, colon, or appendix were most strongly associated with the presence of endometriosis. Conclusions This model identified characteristics which indicated a high and low probability of biopsy-proven endometriosis. It is useful as a guide in choosing appropriate lesions for biopsy, but is not sufficiently robust to use alone.

Stegmann, Barbara J.; Funk, Michele Jonsson; Sinaii, Ninet; Hartmann, Katherine E.; Segars, James; Nieman, Lynnette K.; Stratton, Pamela



Networks Related to Human Use of Tools  

Microsoft Academic Search

Greater manual dexterity and greater conceptual knowledge of tool use represent two main features that distinguish humans from other primates. Studies of human brain lesions suggest that the left hemisphere (at least in right-handed people) includes a system for processing manual skills that is specialized for tool use that interacts with another system involved more with conceptualizing, planning, and accessing



[The statement of Polish Society's Experts Group concerning diagnostics and methods of endometriosis treatment].  


Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success. PMID:23379199

Basta, Antoni; Brucka, Aleksandra; Górski, Jaros?aw; Kotarski, Jan; Kulig, Bartosz; Oszukowski, Przemys?aw; Poreba, Ryszard; Radowicki, Stanis?aw; Radwan, Jerzy; Sikora, Jerzy; Skret, Andrzej; Skrzypczak, Jana; Szy??o, Krzysztof



Is abnormal eutopic endometrium the cause of endometriosis? The role of eutopic endometrium in pathogenesis of endometriosis  

PubMed Central

Summary Endometriosis (EM) is one of the most common diseases which severely affect the health and reproductive function of women of childbearing age. There are fundamental abnormal changes within the eutopic endometrium of women with endometriosis compared to normal endometrium of women without endometriosis. Eutopic endometrium shows enhanced ability of proliferation, implantation and angiogenesis, and greater probability of escaping the unfavorable conditions of the ectopic environment. Therefore, the character of eutopic endometrium determines the fate of the backward-flowing endometrial tissue – to live or to die. The abnormal endometrial tissue in EM patients flows backward to the pelvic cavity, completing a 3-step procedure of pathogenesis (attachment-aggression-angiogenesis), and ultimately develops into EM. Abnormal eutopic endometrium may also play important roles in endometriosis-associated infertility. This recognition regarding the pathogenesis of endometriosis ultimately will help to discover new methods for diagnosis and treatment. Endometrial markers for micro-invasive diagnosis and direct treatment of eutopic endometrium as the origin of the disease should be further investigated.

Liu, Haiyuan; Lang, Jing He



Pain recurrence: a quality of life issue in endometriosis.  


Studies reveal endometriosis to be present in 38-51% of women undergoing laparoscopy for chronic pelvic pain. Symptoms attributable to endometriosis include dysmenorrhea, dyspareunia, generalized pelvic pain, dyschezia, and radiation of pain to the back or leg. Psychological factors may also contribute to a more intense pain experience. Medical therapy provides symptom relief in 72-93% of patients, although recurrence is common following treatment discontinuation. Surgical therapy has had varying results for long-term pain relief; adequacy of the initial surgical treatment appears to be a critical factor. Important adjunctive measures include presacral neurectomy and excisional techniques to remove deep, fibrotic, retroperitoneal lesions. The quality of life of women with endometriosis will improve with greater focus on achieving the long-term relief of pelvic pain. Limitation of pain recurrence would benefit the patient greatly, by providing symptom relief and preventing the cycle of its probably adverse effects on physical activity, work productivity, sexual fulfilment, and mood. PMID:8529772

Damario, M A; Rock, J A



Primary umbilical endometriosis - Diagnosis by fine needle aspiration  

PubMed Central

Primary (spontaneous) umbilical endometriosis is very rare with an estimated incidence of 0.5-1% of all patients with endometrial ectopia. Endometriosis is a common gynecological condition, the pelvis being the most common site of the disease. Extrapelvic site is less common and even more difficult to diagnose due to the extreme variability in presentation. A 38-year-old woman presented with a blackish nodule over the umbilicus of 3 years duration. Fine needle aspiration cytology of the lesion showed cells in clusters and sheets with background of scant stromal fragment, hemosiderin laden macrophages and RBCs, leading to a suggestion of umbilical endometriosis. Histopathological examination of the excised lesion confirmed the same.

Fernandes, Hilda; Marla, Nisha J; Pailoor, Kirana; Kini, Reshma



Progestins and medical treatment of endometriosis - physiology, history and society.  


The transitory effect of hormonal treatment is the alleged main reason to criticize progestins (PGS) and combined pills (OP) in the managment of endometriosis. To the contrary their poor efficacy in the long run is often underlined. As a result, medical treatment is too seldom advised in endometriosis. In this article, we shall focus on the analysis of the reasons of the paucity of the medical interest given to progestins, reasons, which are not of a scientific or objective nature. The ultimate aim of this analysis is to develop arguments in favour of continuous administration of hormones as to obtain not simply an anovulation but a state of prolonged amenorrhea much more efficacious than the simple suppression of ovulation too often advised. And, with an emphasis on the fundamental role of surgery in the treatment of endometriosis, to give the greatest consideration to the specific nature of this disease, which is a chronic disease, justifying the long duration of hormonal administration. PMID:19903054

Belaisch, Jean



Endometriosis and Organochlorinated Environmental Pollutants: A Case-Control Study on Italian Women of Reproductive Age  

PubMed Central

Background Endometriosis is a common gynecologic disease characterized by the ectopic growth of endometrial tissue. In industrialized countries, it affects approximately 10% of women of reproductive age. Its etiology is unclear, but a multifactorial origin is considered to be most plausible. Environmental organochlorinated persistent pollutants, in particular dioxins and polychlorinated biphenyls (PCBs), have been hypothesized to play a role in the disease etiopathogenesis. However, results of studies carried out on humans are conflicting. Objective We evaluated the exposure to organochlorinated persistent pollutants as a risk factor for endometriosis. Methods We conducted a case–control study in Rome on 158 women comprising 80 cases and 78 controls. In all women, serum concentrations of selected non-dioxin-like PCBs (NDL-PCBs) and dioxin-like PCBs (DL-PCBs), 1,1-dichloro-2,2,-bis(4-chlorophenyl)-ethene (p,p?-DDE), and hexachlorobenzene (HCB) were determined by ion-trap mass spectrometry. DR-CALUX bioassay was employed to assess the 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity equivalent (TEQ) concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and DL-PCBs. Results We found an increased risk of endometriosis for DL-PCB-118 [odds ratio (OR) = 3.79; 95% confidence interval (CI), 1.61–8.91], NDL-PCB-138 (OR = 3.78; 95% CI, 1.60–8.94), NDL-PCB-153 (OR = 4.88; 95% CI, 2.01–11.0), NDL-PCB-170 (OR = 3.52; 95% CI, 1.41–8.79), and the sum of DL-PCBs and NDL-PCBs (OR = 5.63; 95% CI, 2.25–14.10). No significant associations were observed with respect to HCB or to the sum of PCDDs, PCDFs, and DL-PCBs given as total TEQs. Conclusions The results of this study show that an association exists between increased PCB and p,p?-DDE serum concentrations and the risk of endometriosis.

Porpora, Maria Grazia; Medda, Emanuela; Abballe, Annalisa; Bolli, Simone; De Angelis, Isabella; di Domenico, Alessandro; Ferro, Annamaria; Ingelido, Anna Maria; Maggi, Antonella; Panici, Pierluigi Benedetti; De Felip, Elena



Morphologic features of endometriosis in various types of cytologic specimens.  


Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. This study evaluates the cytomorphologic features of endometriosis in various cytologic specimen types [fine-needle aspiration (FNA), effusion cytology (EF), touch imprint (ToP), and cervical smear (PAP)], and assesses the key elements helpful in recognizing this lesion. A total of 18 cases (8 FNA, 4 EF, 5 ToP, and 1 PAP) of cytologically diagnosed and histologically/clinically confirmed endometriosis diagnosed between 1988 and 2006 comprises the material for this study. The morphologic features evaluated of the three components included: cellularity, presence of sheets of glandular cells, three-dimensional (3D) glandular clusters, tubular structures, single cells, syncytial groups of stromal cells, stromal cells entrapped within basement membrane (BM)-like material, cytologic atypia, presence of mitotic figures, and hemosiderin-laden histiocytes. Endometrial glands, stroma, and hemosiderin-laden histiocytes were all identified in 14/18 (77.8%) cases. FNA specimens were more cellular than that of both EF and ToP specimens. Tubular structures, 3D glandular clusters, stromal cells entrapped in BM and syncytial stromal groups were more common in FNAs, and ToPs compared with the EFs. The ratio of the endometrial glandular and stromal cells was similar in all specimen types. Atypia and mitotic figures were rarely encountered. Diagnosis of endometriosis could be made independently on either smears/ThinPrep(™) slides or on cell blocks in all cases where these preparations were available. On follow up, none of the patients developed malignancy. Endometriosis can be reliably and safely diagnosed in various cytologic materials. Cytologic atypia is uncommon. Components of endometriosis could show minor morphologic alterations in different specimen types. Diagn. Cytopathol. 2013;41:936-942. © 2013 Wiley Periodicals, Inc. PMID:23529978

Barkan, Güliz A; Naylor, Bernard; Gattuso, Paolo; Küllü, Sevgi; Galan, Kristine; Wojcik, Eva M



Return of Chronic Pelvic Pain From Endometriosis After Raloxifene Treatment  

PubMed Central

OBJECTIVE To evaluate whether 6 months of raloxifene was effective in treatment of chronic pelvic pain in women with endometriosis. METHODS Women with chronic pelvic pain and no endometriosis treatment for 6 months underwent laparoscopy for excision of all lesions. Those with biopsy-proven endometriosis were randomly allocated to raloxifene (180 mg) or placebo daily. A second laparoscopy was performed at 2 years, or earlier, if pain returned. Return of pain was defined as 2 months of pain equal to or more severe than that at study entry. Menstrual cycles and adverse events were recorded. The log rank test was used to compare the time to return of pain by drug group. Analyses were done as intent-to-treat. RESULTS A total of 127 of 158 women underwent surgery. Of these, 93 had biopsy-confirmed endometriosis and were randomly assigned to study treatment. Menstrual cycle length, pelvic pain severity, quality of life, bone mineral density, and adverse events did not differ between treatment groups. The Data Safety Monitoring Committee terminated the study early when the raloxifene group experienced pain (P=.03) and had second surgery (P=.016) significantly sooner than the placebo group. Interestingly, biopsy-proven endometriosis was not associated with return of pain (P=.6). CONCLUSION Raloxifene significantly shortened the time to return of chronic pelvic pain. Because recurrence of endometriosis lesions did not correlate with return of pain, other factors are implicated in pelvic pain. CLINICAL TRIAL REGISTRATION,, NCT00001848 (Obstet Gynecol 2008;111:88–96) LEVEL OF EVIDENCE I

Stratton, Pamela; Sinaii, Ninet; Segars, James; Koziol, Deloris; Wesley, Robert; Zimmer, Carolyn; Winkel, Craig; Nieman, Lynnette K.



MicroRNA 135 Regulates HOXA10 Expression in Endometriosis  

PubMed Central

Context: Homeo box A10 (HOXA10) regulates endometrial receptivity and its expression is decreased in women with endometriosis. Although sex steroids regulate HOXA10, these hormones are unaltered in endometriosis. We hypothesized a role for microRNA in the regulation of HOXA10. Objective: MicroRNA 135a and -b are small noncoding RNA with predicted targets that include HOXA10. We evaluated miR135a/b expression and HOXA10 regulation in endometrium from subjects with and without endometriosis. Design: The design of the study was the measurement of miR135a/b expression by quantitative PCR and in vitro analysis of HOXA10 regulation. Setting: The study was conducted at a university medical center. Patients: Patients included 50 controls and 32 women with endometriosis. Interventions: Study interventions included endometrial biopsies and in vitro transfection. Main Outcome Measures: miR135a/b and HOXA10 expression were measured in the study. Results: All endometrial samples expressed miR135a and -b. miR135a expression in controls was increased during the proliferative phase, decreased at the time of ovulation, and increased during the luteal phase. Subjects with endometriosis had 3-fold higher expression of miR135a in the proliferative phase than controls. miR135b showed less variation across the menstrual cycle; however, it was significantly increased in women with endometriosis in the proliferative and secretory phases. HOXA10 expression was simultaneously repressed in the endometrium of women with endometriosis. Transfection of endometrial stromal cells with mir135a/b or miR135a/b inhibitors resulted in the altered expression of HOXA10 mRNA and protein. miR135a or -b decreased luciferase expression driven by the HOXA10 3? untranslated region containing the miR135 binding site. miR135a regulation of HOXA10 was absent in MCF-7 cells, demonstrating cell specificity. Conclusions: HOXA10 was aberrantly regulated in the endometrium of women with endometriosis by both miR135a and miR135b. Increased microRNA expression likely suppresses genes required for implantation.

Petracco, Rafaella; Grechukhina, Olga; Popkhadze, Shota; Massasa, Efi; Zhou, Yuping



Laparoscopic segmental colorectal resection for endometriosis: limits and complications  

Microsoft Academic Search

Background  Deep pelvic endometriosis with colorectal involvement is a complex disorder often requiring segmental bowel resection. This\\u000a study investigated the limits and complications of laparoscopic segmental colorectal resection.\\u000a \\u000a \\u000a \\u000a Methods  Laparoscopic segmental colorectal resection was performed for 71 women with bowel endometriosis. Intra- and postoperative\\u000a complications were evaluated, together with symptom outcomes, by means of questionnaires completed before and after surgery.\\u000a Surgical procedures

E. Darai; G. Ackerman; M. Bazot; R. Rouzier; G. Dubernard



The pathophysiology of endometriosis and adenomyosis: tissue injury and repair  

Microsoft Academic Search

Introduction  This study presents a unifying concept of the pathophysiology of endometriosis and adenomyosis. In particular, a physiological\\u000a model is proposed that provides a comprehensive explanation of the local production of estrogen at the level of ectopic endometrial\\u000a lesions and the endometrium of women affected with the disease.\\u000a \\u000a \\u000a \\u000a Methods  In women suffering from endometriosis and adenomyosis and in normal controls, a critical

G. Leyendecker; L. Wildt; G. Mall



Human rights in industrial relations – the Israeli approach  

Microsoft Academic Search

Basic human rights are supposed to protect people from abuse and harm. They are the means whereby we protect our humanity. One would expect, therefore, that basic human rights would be valid and sacred in any context, including industrial relations. However, the complexity of the employee–employer relationship obscures this issue, and it is not clear whether such rights can be

David A. Frenkel; Yotam Lurie



Possible role of endometriosis in the aetiology of spontaneous miscarriage in patients with septate uterus.  


A recent study found a significant correlation between endometriosis and non-obstructive forms of Müllerian anomalies. Other studies described an increased miscarriage rate in patients with endometriosis. This study assessed the effect of endometriosis on pregnancy outcome in a group of patients with endometriosis and septate uterus. Spontaneously achieved pregnancies were taken into consideration. The outcome of 179 infertile women who underwent surgery for septate uterus was analysed in a retrospective study. Stage I or II endometriosis was found by laparoscopy in 36 patients. The pregnancy outcomes, before and after metroplasty, of the group of 36 patients with septum and endometriosis were compared with the pregnancy outcomes of 143 patients with septate uterus with no endometriosis. Before metroplasty the incidence of pregnancy loss was 67% in patients without endometriosis and 75% in patients with endometriosis and the difference was not significant. After metroplasty, no significant differences have been found between the two groups, suggesting that endometriosis could be an occasional finding not influencing pregnancy outcome. PMID:20801084

Gergolet, Marco; Gianaroli, Luca; Kenda Suster, Natasa; Verdenik, Ivan; Magli, M Cristina; Gordts, Stephan



A Human Relations Approach to the Practice of Educational Leadership.  

ERIC Educational Resources Information Center

This book centers on the human-relation skills and knowledge that educational leaders need to lead public schools effectively. The purpose of the book is to help administrators and those studying to become administrators enhance their human-relations skills. The content and method of this book are centered on the first four of the six Interstate…

Rebore, Ronald W.


Can Orange County Afford To Lose the Human Relations Commission?  

Microsoft Academic Search

1. Summary The Orange County Human Relations Commission (OCHRC)—established by the county to build mutual understanding among residents and to eliminate prejudice, intolerance, and discrimination—is in danger of losing county support. The OC Board of Supervisors (BOS) directed the Human Relations Commission to go to cities and the private sector to solicit funds to augment a drastically reduced commission allocation.

BOS Orange County



A Human Relations Approach to the Practice of Educational Leadership.  

ERIC Educational Resources Information Center

|This book centers on the human-relation skills and knowledge that educational leaders need to lead public schools effectively. The purpose of the book is to help administrators and those studying to become administrators enhance their human-relations skills. The content and method of this book are centered on the first four of the six Interstate…

Rebore, Ronald W.


Teacher Leader Human Relations Skills: A Comparative Study  

ERIC Educational Resources Information Center

|In this study, 142 graduate school teachers working in schools throughout southwestern Ohio assessed their human relation skills. A human relations survey was used for the study, and results were compared with colleagues assessing the teachers in the study. The survey was developed using a Likert-type scale, and was based on key elements…

Roby, Douglas E.



Relational Human Ecology: Reconciling the Boundaries of Humans and Nature  

Microsoft Academic Search

Global change is transforming the planet at unprecedented rates. Global warming, massive species extinction, increasing land degradation, overpopulation, poverty and injustice, are all the result of human choices and non-sustainable ways of life. What do we have to do and how much do we have to change to allow a transition to a more ecologically-conscious and just society? While these

J. McNiel; V. L. Lopes



A Case Study in Human Relations  

ERIC Educational Resources Information Center

The principal described here does not exist. His character and his situation were developed by the author in order to illustrate some techniques for improving interpersonal relations in the school. (Editor/RK)

Ingari, Sandro



Radicular Compression by extradural spinal endometriosis. Case report  

Microsoft Academic Search

Summary The case of a 35 years old woman affected by endometriosis located inside the spinal canal in the extradural space at the level of the third left lumbar root, and developing through the corresponding foramen into the paraspinal muscles, is presented. The clinical aspect, radiological picture and surgical treatment are described. Pathogenesis is discussed on the basis of the

F. Carta; G. Guiducci; E. Fulcheri; C. Bernucci; C. Rivano



Is there an association between septate uterus and endometriosis?  

Microsoft Academic Search

BACKGROUND: The question of whether Müllerian anomalies are significantly more often combined with endome- triosis is a controversially discussed problem. Some publications described this association in patients with obstructive but not non-obstructive Müllerian anomalies or controls without Müllerian anomalies. The aim of this study was to evaluate the incidence of endometriosis in patients with a septate uterus as a non-obstructive

Frank Nawroth; Gohar Rahimi; Claudia Nawroth; Dolores Foth; Michael Ludwig; Torsten Schmidt


Case study of a rare form of endometriosis  

PubMed Central

Endometriosis is a common, benign, chronic, estrogen-dependent disorder. The endometrial tissue implants itself outside the uterus and can be usually found in the pelvis or, in rare cases, it can be found nearly anywhere in the body. There are no pathognomonic symptoms of this disease, therefore, in some cases the tumors are incidentally discovered during surgery. Deep infiltrative endometriosis (DIE) is a rare form of this condition, which mostly affects the uterosacral ligaments, the rectovaginal space, and the upper third of the posterior vaginal wall, the bowel, and the urinary tract. We present the case of a 29-year-old pregnant female who was diagnosed with infiltrative endometriosis during the cesarean section at 38 weeks of gestation. The tumors involving the vesicouterine peritoneum had a tendency of infiltrating the urinary bladder, but the patient had been completely asymptomatic prior to this incidental discovery. As cited by literature, the discovery and management of urinary endometriosis, as well as that of other localizations of DIE, is not based on high-level evidence data, but rather on case-series reported by surgical teams working in different centers worldwide.

Cirstoiu, M; Bodean, O; Secara, D; Munteanu, O; Cirstoiu, C



Human milk and related oligosaccharides as prebiotics.  


Human milk oligosaccharides (HMO) are believed to have a range of biological activities beyond providing nutrition to the infant. Principal among these is that they may act as prebiotics. Prebiotics are dietary ingredients, usually oligosaccharides that provide a health benefit to the host mediated by the modulation of the human gut microbiota. While it is clear that such oligosaccharides may have potential applications in infants and adults alike, this potential is limited by the difficulties in manufacturing HMO. Consequently functional alternatives such as galacto-oligosaccharides (GOS) are under investigation. GOS are produced enzymatically from lactose for commercial use in food applications--including addition to infant formulae--as similar to breast milk oligosaccharides, they encourage a gut bacteria population that promotes health and reduces the incidence of intestinal infections. New methods for separation and concentration of complex, breast milk-like oligosaccharides from bovine milk industrial streams that contain only low amounts of these valuable oligosaccharides are providing the opportunity to investigate other viable sources of specific oligosaccharides for use as prebiotics in supplements or food products. PMID:23434179

Barile, Daniela; Rastall, Robert A



Human evolution and osteoporosis-related spinal fractures.  


The field of evolutionary medicine examines the possibility that some diseases are the result of trade-offs made in human evolution. Spinal fractures are the most common osteoporosis-related fracture in humans, but are not observed in apes, even in cases of severe osteopenia. In humans, the development of osteoporosis is influenced by peak bone mass and strength in early adulthood as well as age-related bone loss. Here, we examine the structural differences in the vertebral bodies (the portion of the vertebra most commonly involved in osteoporosis-related fractures) between humans and apes before age-related bone loss occurs. Vertebrae from young adult humans and chimpanzees, gorillas, orangutans, and gibbons (T8 vertebrae, n?=?8-14 per species, male and female, humans: 20-40 years of age) were examined to determine bone strength (using finite element models), bone morphology (external shape), and trabecular microarchitecture (micro-computed tomography). The vertebrae of young adult humans are not as strong as those from apes after accounting for body mass (p<0.01). Human vertebrae are larger in size (volume, cross-sectional area, height) than in apes with a similar body mass. Young adult human vertebrae have significantly lower trabecular bone volume fraction (0.26±0.04 in humans and 0.37±0.07 in apes, mean ± SD, p<0.01) and thinner vertebral shells than apes (after accounting for body mass, p<0.01). Since human vertebrae are more porous and weaker than those in apes in young adulthood (after accounting for bone mass), even modest amounts of age-related bone loss may lead to vertebral fracture in humans, while in apes, larger amounts of bone loss would be required before a vertebral fracture becomes likely. We present arguments that differences in vertebral bone size and shape associated with reduced bone strength in humans is linked to evolutionary adaptations associated with bipedalism. PMID:22028933

Cotter, Meghan M; Loomis, David A; Simpson, Scott W; Latimer, Bruce; Hernandez, Christopher J



Detection of Relative Motion by Human Infants  

Microsoft Academic Search

Two experiments were conducted on the detection of relative motion by 8- and 20-week-old infants. In Experiment 1, three types of displays were used: a single target moving with respect to a set of surrounding static reference features, a static target surrounded by a set of reference features with common motion, and a target and surrounding reference features moving in

James L. Dannemiller; Robert L. Freedland



HDAC1 and HDAC2 are differentially expressed in endometriosis.  


Epigenetic mechanisms have been ascribed important roles in endometriosis. Covalent histone modifications at lysine residues have been shown to regulate gene expression and thus contribute to pathological states in many diseases. In endometriosis, histone deacetylase inhibition (HDACi) resulted in reactivation of E-cadherin, attenuation of invasion, decreased proliferation of endometriotic cells, and caused lesion regression in an animal model. This study was conducted to assess basal and hormone-regulated gene expression levels of HDAC1 and HDAC2 (HDAC1/2) in cell lines and protein expression levels in tissues. Basal and steroid hormone-regulated HDAC1/2 gene expression levels were determined by quantitative polymerase chain reaction in cell lines and tissues. Protein levels were measured by immunohistochemistry (IHC) in tissues on an endometriosis tissue microarray (TMA). Basal HDAC1/2 gene expression levels were significantly higher in endometriotic versus endometrial stromal cells, which was confirmed by Western blot analysis. Estradiol (E2) and progesterone (P4) significantly downregulated HDAC1 expression in endometrial epithelial cells. Levels of HDAC2 were upregulated by E2 and downregulated by E2 + P4 in endometrial stromal cells. Hormone modulation of HDAC1/2 gene expression was lost in the endometriotic cell line. Immunohistochemistry showed that HDAC1/2 proteins were expressed in a substantial proportion of lesions and endometrium from patients, and their expression levels varied according to lesion localization. The highest proportion of strong HDAC1 immunostaining was seen in ovarian, skin, and gastrointestinal lesions, and of HDAC2 in skin lesions and endometrium from patients with endometriosis. These studies suggest that endometriosis etiology may be partially explained by epigenetic regulation of gene expression due to dysregulations in the expression of HDACs. PMID:22344732

Colón-Díaz, Maricarmen; Báez-Vega, Perla; García, Miosotis; Ruiz, Abigail; Monteiro, Janice B; Fourquet, Jessica; Bayona, Manuel; Alvarez-Garriga, Carolina; Achille, Alexandra; Seto, Edward; Flores, Idhaliz



Deep Infiltrating Colorectal Endometriosis Treated With Robotic-Assisted Rectosigmoidectomy  

PubMed Central

Background and Objective: Deep infiltrating pelvic endometriosis with bowel involvement is one of the most aggressive forms of endometriosis. Nowadays, robotic technology and telemanipulation systems represent the latest developments in minimally invasive surgery. The aim of this study is to present our preliminary results and evaluate the feasibility of robotic-assisted laparoscopic colorectal resection for severe endometriosis. Methods: Between September 2009 and December 2011, 10 women with colorectal endometriosis underwent surgery with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). We evaluated the following parameters: short-term complications, clinical outcomes and long-term follow-up, pain relief recurrence rate, and fertility outcomes. Results: Extensive ureterolysis was required in 8 women (80%). Ovarian cystectomy with removal of the cystic wall was performed in 7 women (70%). Torus resection was performed in all women, with unilateral and bilateral uterosacral ligament resection in 1 woman (10%) and 8 women (80%), respectively. In addition to segmental colorectal resection in all cases, partial vaginal resection was necessary in 2 women (20%). An appendectomy was performed in 2 patients (20%). The mean operative time with the robot was 157 minutes (range, 90–190 minutes). The mean hospital stay was 3 days. Six patients had infertility before surgery, with a mean infertility time of 2 years. After a 12-month follow-up period, 4 women (67%) conceived naturally and 2 (33%) underwent in vitro fertilization. Conclusion: We show that robotic-assisted laparoscopic surgery for the treatment of deep infiltrating bowel endometriosis is feasible, effective, and safe.

Schraibman, Vladimir; Okazaki, Samuel; Maccapani, Gabriel; Chen, Winston Jenning; Domit, Cassia Danielle; Kaufmann, Oskar Grau; Advincula, Arnold P.



HDAC1 and HDAC2 are Differentially Expressed in Endometriosis  

PubMed Central

Epigenetic mechanisms have been ascribed important roles in endometriosis. Covalent histone modifications at lysine residues have been shown to regulate gene expression and thus contribute to pathological states in many diseases. In endometriosis, histone deacetylase inhibition (HDACi) resulted in reactivation of E-cadherin, attenuation of invasion, decreased proliferation of endometriotic cells, and caused lesion regression in an animal model. This study was conducted to assess basal and hormone-regulated gene expression levels of HDAC1 and HDAC2 (HDAC1/2) in cell lines and protein expression levels in tissues. Basal and steroid hormone-regulated HDAC1/2 gene expression levels were determined by quantitative polymerase chain reaction in cell lines and tissues. Protein levels were measured by immunohistochemistry (IHC) in tissues on an endometriosis tissue microarray (TMA). Basal HDAC1/2 gene expression levels were significantly higher in endometriotic versus endometrial stromal cells, which was confirmed by Western blot analysis. Estradiol (E2) and progesterone (P4) significantly downregulated HDAC1 expression in endometrial epithelial cells. Levels of HDAC2 were upregulated by E2 and downregulated by E2 + P4 in endometrial stromal cells. Hormone modulation of HDAC1/2 gene expression was lost in the endometriotic cell line. Immunohistochemistry showed that HDAC1/2 proteins were expressed in a substantial proportion of lesions and endometrium from patients, and their expression levels varied according to lesion localization. The highest proportion of strong HDAC1 immunostaining was seen in ovarian, skin, and gastrointestinal lesions, and of HDAC2 in skin lesions and endometrium from patients with endometriosis. These studies suggest that endometriosis etiology may be partially explained by epigenetic regulation of gene expression due to dysregulations in the expression of HDACs.

Colon-Diaz, Maricarmen; Baez-Vega, Perla; Garcia, Miosotis; Ruiz, Abigail; Monteiro, Janice B.; Fourquet, Jessica; Bayona, Manuel; Alvarez-Garriga, Carolina; Achille, Alexandra; Seto, Edward; Flores, Idhaliz



ARID1A Mutations and PI3K/AKT Pathway Alterations in Endometriosis and Endometriosis-Associated Ovarian Carcinomas  

PubMed Central

Endometriosis is a common gynecological disease affecting 6%–10% of women of reproductive age and is characterized by the presence of endometrial-like tissue in localizations outside of the uterine cavity as, e.g., endometriotic ovarian cysts. Mainly, two epithelial ovarian carcinoma subtypes, the ovarian clear cell carcinomas (OCCC) and the endometrioid ovarian carcinomas (EnOC), have been molecularly and epidemiologically linked to endometriosis. Mutations in the gene encoding the AT-rich interacting domain containing protein 1A (ARID1A) have been found to occur in high frequency in OCCC and EnOC. The majority of these mutations lead to a loss of expression of the ARID1A protein, which is a subunit of the SWI/SNF chromatin remodeling complex and considered as a bona fide tumor suppressor. ARID1A mutations frequently co-occur with mutations, leading to an activation of the phosphatidylinositol 3-kinase (PI3K)/AKT pathway, such as mutations in PIK3CA encoding the catalytic subunit, p110?, of PI3K. In combination with recent functional observations, these findings strongly suggest cooperating mechanisms between the two pathways. The occurrence of ARID1A mutations and alterations in the PI3K/AKT pathway in endometriosis and endometriosis-associated ovarian carcinomas, as well as the possible functional and clinical implications are discussed in this review.

Samartzis, Eleftherios P.; Noske, Aurelia; Dedes, Konstantin J.; Fink, Daniel; Imesch, Patrick



[Clinical study of the treatment of endometriosis with promoting blood circulation and stasis removing method].  


The treatment of endometriosis by blood circulation promoting and stasis removing method is based on the experience carried in the "Ji Yin Gang Mu" and the fact that this disease belongs to the category of pelvic stagnant blood. The study group consisted of 53 women with endometriosis. They were manifested as dysmenorrhea, menoxenia, ovarian chocolate cysts and enlarged uterus. The control group consisted of ten women with normal regular menstrual cycle. This article deals with the method of using the hemodynamic index of uterus arterial blood flow. After treatment the blood flow amount of uterus arteries of 53 cases (study group) obviously decreased and their uterus arterial blood flow speed reduced markedly as compared with pretreatment status, (P < 0.001 and P < 0.01) respectively, while pre-treatment group was significantly higher than that of control group (P < 0.001). After medical treatment for 3.5 months, symptoms such as dysmenorrhea and menstrual disorder basically disappeared. 22 ovarian chocloate cysts became smaller and 16 disappeared. The pregnancy rate was 45%. The data of this study suggest that the mechanism of treatment of promoting blood circulation to remove stasis might be closely related to the regulation of physico-chemical characteristics of blood and the adjustment of the function of hemodynamics. PMID:8499728

Zhu, W X; Cheng, X A



Teenagers, adolescents, endometriosis and recurrence: a retrospective analysis of recurrence following primary operative laparoscopy  

Microsoft Academic Search

In this paper, we aim to describe the clinical features and treatment outcome following the laparoscopic treatment of endometriosis\\u000a in teenagers and adolescents. This is a retrospective review of girls aged 21 and below who underwent operative laparoscopy\\u000a for endometriosis. We identified two groups: (1) the EMAT group, being those who underwent their primary laparoscopic surgery\\u000a under the Endometriosis and

Emmanuel Kalu; William McAuley; Robert Richardson



Association of HLA class I and class II alleles with susceptibility to endometriosis  

Microsoft Academic Search

Although the exact etiology of endometriosis is unclear, several lines of evidence support roles for both cell-mediated and humoral immunity in its pathogenesis. To assess the association between HLA genotypes and endometriosis, we investigated the frequencies of HLA-A, -B, -C, and -DRB1 antigens or alleles in 123 Japanese patients with endometriosis and 165 healthy women as controls. Significant positive association

Jo Kitawaki; Hiroshi Obayashi; Noriko Kado; Hiroaki Ishihara; Hisato Koshiba; Etsuko Maruya; Hiroh Saji; Mitsuhiro Ohta; Goji Hasegawa; Naoto Nakamura; Toshikazu Yoshikawa; Hideo Honjo



Human biomonitoring issues related to lead exposure.  


Lead as a toxic environmental metal has been an issue of concern for 30-40 years. Even though the exposures experienced by the general public have been significantly reduced, so have the acceptable blood lead concentrations assessed to safeguard health (specifically of children). The impact of these concurrent changes are reviewed and discussed in terms of the following: blood lead as the primary biomarker of exposure; pertinent toxicokinetic issues including modelling; legacy and newer sources of this toxic metal; improvements in lead quantification techniques and its characterization (chemical forms) in exposure media; and in vivo markers of lead sources. It is concluded that the progress in the quantification of lead and its characterization in exposure media have supported the efforts to identify statistical associations of lead in blood and tissues with adverse health outcomes, and have guided strategies to reduce human exposure (especially for children). To clarify the role of lead as a causative factor in disease, greater research efforts in biomarkers of effect and susceptibility seem timely. PMID:23970117

Nieboer, Evert; Tsuji, Leonard J S; Martin, Ian D; Liberda, Eric N



Laparoscopic Management of Bowel Endometriosis: Predictors of Severe Disease and Recurrence  

PubMed Central

Background and Objectives: The identification of high-stage and recurrent cases of bowel endometriosis is critical, because these cases require careful surgical planning. We aim to describe the clinical characteristics of women with bowel endometriosis, our principles in laparoscopic management of this pathology, and to identify predictors of severe disease and recurrence. Methods: This was a retrospective study of 193 patients with pathologically confirmed bowel endometriosis. Results: Predictors of higher-stage endometriosis include a history of previous laparoscopic surgery (P=.04) and a presenting complaint of abnormal uterine bleeding (P=.01). The higher the stage of endometriosis, the more likely there would be coexistent urinary tract endometriosis (P=.02), a need for enterolysis (P=.002), ovarian cystectomy (P<.001), and bowel resection (P=.01) performed during laparoscopy. Patients with higher body mass index (BMI) had significantly higher recurrence rates of endometriosis compared to those with lower BMI (P=.002). Within our cohort, 87% of our patients achieved amelioration of symptoms by the end of the first postoperative month. Conclusions: Our study confirms that laparoscopic management of bowel endometriosis is safe and effective. We found 2 statistically significant predictors of higher-stage disease that should prompt careful surgical planning. Obesity is associated with a higher rate of recurrence of endometriosis.

Hajhosseini, Babak; King, Louise P.



SNPs in the Lysyl Oxidase-like Protein 4 (LOXL4) and Complement Component 3 (C3) genes are Associated with Increased Risk for Endometriosis and Endometriosis-Associated Infertility  

PubMed Central

This study was conducted to assess genetic associations to endometriosis in a Puerto Rican population. Significant differences in allelic frequencies and genotype distribution of genetic variants in LOXL4 and C3 were documented in patients with endometriosis-associated infertility vs controls, and in patients with endometriosis vs controls, respectively, and in women having the risk genotype at both SNPs, the estimated risk for endometriosis nearly doubled.

Ruiz, Lynnette A.; Dutil, Julie; Ruiz, Abigail; Fourquet, Jessica; Abac, Sonia; Laboy, Joaquin; Flores, Idhaliz



Fretting in prosthetic devices related to human body  

Microsoft Academic Search

Many bio-tribological problems are often associated with fretting. In fact, related to the human body, fretting may occur in prosthetic devices. General features can be obtained as follows: complex fretting modes, fretting loading condition, environment, and properties of the natural tissues. According to clinical applications, as two typical examples, fretting tests of the human skin and femur cortical bone have

M. H. Zhu; Z. B. Cai; W. Li; H. Y. Yu; Z. R. Zhou



Similarity or Dissimilarity in the Relations Between Human Service Organizations  

Microsoft Academic Search

Exchange theory and homophily theory give rise to counteracting expectations for the interaction between human service organizations. Based on arguments of exchange theory, more interaction is expected between dissimilar organizations having complementary resources. Based on arguments of homophily theory, organizations having similar characteristics are expected to interact more. Interorganizational relations between human service organizations in two regional networks in Flanders

Kevin Bruynooghe; Mieke Verhaeghe; Piet Bracke



Enamel Fluoride in Relation To Severity of Human Dental Fluorosis  

Microsoft Academic Search

The aim of this study was to test whether the concentrations of fluoride in fluorotic human enamel are related to the degree of severity of dental fluorosis classified according to the index described by Thylstrup and Fejerskov. Teeth representing the entire spectrum of human dental fluorosis were analyzed. Fluoride concentrations were determined by serial acid-etching from surface to interior of

A. Richards; O. Fejerskov; V. Baelum



Human Metabolism and Interactions of Deployment-Related Chemicals.  

National Technical Information Service (NTIS)

This study examines the human-metabolism and metabolic interactions of a subset of deployment-related chemicals, including chlorpyrifos, DEET, permethrin, pyridostigmine bromide, and sulfur mustard metabolites. Chiorpyrifos is metabolized by cytochiome P4...

E. Hodgson



Age-related differences in human skin proteoglycans  

PubMed Central

Previous work has shown that versican, decorin and a catabolic fragment of decorin, termed decorunt, are the most abundant proteoglycans in human skin. Further analysis of versican indicates that four major core protein species are present in human skin at all ages examined from fetal to adult. Two of these are identified as the V0 and V1 isoforms, with the latter predominating. The other two species are catabolic fragments of V0 and V1, which have the amino acid sequence DPEAAE as their carboxyl terminus. Although the core proteins of human skin versican show no major age-related differences, the glycosaminoglycans (GAGs) of adult skin versican are smaller in size and show differences in their sulfation pattern relative to those in fetal skin versican. In contrast to human skin versican, human skin decorin shows minimal age-related differences in its sulfation pattern, although, like versican, the GAGs of adult skin decorin are smaller than those of fetal skin decorin. Analysis of the catabolic fragments of decorin from adult skin reveals the presence of other fragments in addition to decorunt, although the core proteins of these additional decorin catabolic fragments have not been identified. Thus, versican and decorin of human skin show age-related differences, versican primarily in the size and the sulfation pattern of its GAGs and decorin in the size of its GAGs. The catabolic fragments of versican are detected at all ages examined, but appear to be in lower abundance in adult skin compared with fetal skin. In contrast, the catabolic fragments of decorin are present in adult skin, but are virtually absent from fetal skin. Taken together, these data suggest that there are age-related differences in the catabolism of proteoglycans in human skin. These age-related differences in proteoglycan patterns and catabolism may play a role in the age-related changes in the physical properties and injury response of human skin.

Carrino, David A; Calabro, Anthony; Darr, Aniq B; Dours-Zimmermann, Maria T; Sandy, John D; Zimmermann, Dieter R; Sorrell, J Michael; Hascall, Vincent C; Caplan, Arnold I



Endometriosis in Patients with Chronic Pelvic Pain: Is Staging Predictive of the Efficacy of Laparoscopic Surgery in Pain Relief?  

Microsoft Academic Search

Background\\/Aims: Endometriosis is considered an important cause of chronic pelvic pain. Despite its high prevalence, controversy still exists regarding the true association between the extent of endometriosis and the severity of symptoms. We conducted this prospective study to investigate the association between the stage of endometriosis and type and severity of pain, and to evaluate the efficacy of laparoscopic surgery

Spyros Milingos; Athanasios Protopapas; George Kallipolitis; Petros Drakakis; Dimitrios Loutradis; Anthoula Liapi; Aris Antsaklis



Association of Endometriosis Risk and Genetic Polymorphisms Involving Sex Steroid Biosynthesis and Their Receptors: A Meta-Analysis  

Microsoft Academic Search

Endometriosis is a sex steroids-dependent disease. It has been postulated that certain genetic polymorphisms involved in sex steroids biosynthesis and metabolisms may be associated with increased risk of developing endometriosis. Despite a deluge of reports of positive associations of endometriosis with numerous polymorphisms involving sex steroids production and metabolism, the results are often conflicting. We performed a meta-analysis of 12

Sun-Wei Guo



Estrogen and progesterone receptor expression in macrophages and regulation of hepatocyte growth factor by ovarian steroids in women with endometriosis  

Microsoft Academic Search

BACKGROUND: Information regarding macrophage-mediated regulation of hepatocyte growth factor (HGF) by ovarian steroid hormones in women with endometriosis is limited. Therefore, we investigated the regulation of HGF by steroid hormones in isolated macrophages and stromal cells derived from women with or without endometriosis. METHODS: We isolated CD68 immunoreactive adherent macrophages in vitro from 46 women with endometriosis and 30 women

Khaleque Newaz Khan; Hideaki Masuzaki; Akira Fujishita; Michio Kitajima; Ichiro Sekine; Toshifumi Matsuyama; Tadayuki Ishimaru



Proteomic analysis of endometrium from fertile and infertile patients suggests a role for apolipoprotein A-I in embryo implantation failure and endometriosis  

PubMed Central

Pregnancy is dependent upon the endometrium acquiring a receptive phenotype that facilitates apposition, adhesion and invasion of a developmentally competent embryo. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry of mid-secretory endometrial biopsies revealed a 28 kDa protein peak that discriminated highly between samples obtained from women with recurrent implantation failure and fertile controls. Subsequent tandem mass spectroscopy unambiguously identified this peak as apolipoprotein A-I (apoA-I), a potent anti-inflammatory molecule. Total endometrial apoA-I levels were, however, comparable between the study and control group. Moreover, endometrial apoA-I mRNA expression was not cycle-dependent although there was partial loss of apoA-I immunoreactivity in luminal and glandular epithelium in mid-secretory compared with proliferative endometrial samples. Because of its putative anti-implantation properties, we examined whether endometrial apoA-I expression is regulated by embryonic signals. Human chorionic gonadotrophin (hCG) strongly inhibited apoA-I expression in differentiating explant cultures but not when established from eutopic endometrium from patients with endometriosis. Pelvic endometriosis was associated with elevated apoA-I mRNA levels, increased secretion by differentiating eutopic endometrial explant cultures and lack of hCG-dependent down-regulation. To corroborate these observations, we examined endometrial apoA-I expression and its regulation by hCG in a non-human primate model of endometriosis. As in humans, hCG strongly inhibited endometrial apoA-I mRNA expression in disease-free baboons, but this response was entirely lost upon induction of pelvic endometriosis. Together, these observations indicate that perturbations in endometrial apoA-I expression, modification or regulation by paracrine embryonic signals play a major role in implantation failure and infertility.

Brosens, Jan J.; Hodgetts, Andrea; Feroze-Zaidi, Fahkera; Sherwin, J. Robert A.; Fusi, Luca; Salker, Madhuri S.; Higham, Jenny; Rose, Gillian L.; Kajihara, Takeshi; Young, Steven L.; Lessey, Bruce A.; Henriet, Patrick; Langford, Paul R.; Fazleabas, Asgerally T.



Impaired CXCL4 expression in tumor-associated macrophages (TAMs) of ovarian cancers arising in endometriosis  

PubMed Central

Inflammatory cells play important roles in progression of solid neoplasms including ovarian cancers. Tumor-associated macrophages (TAMs) contribute to angiogenesis and immune suppression by modulating microenvironment. Ovarian cancer develops occasionally on the bases of endometriosis, a chronic inflammatory disease. We have recently demonstrated differential expressions of CXCR3 variants in endometriosis and ovarian cancers. In this study, we showed impaired CXCL4 expression in TAMs of ovarian cancers arising in endometriosis. The expressions of CXCL4 and its variant CXCL4L1 were investigated among normal ovaries (n = 26), endometriosis (n = 18) and endometriosis-associated ovarian cancers (EAOCs) composed of clear cell (n = 13) and endometrioid (n = 11) types. In addition, four cases of EAOCs that contained both benign and cancer lesions contiguously in single cysts were investigated in the study. Western blot and quantitative RT-PCR analyses revealed significant downregulation of CXCL4 and CXCL4L1 in EAOCs compared with those in endometriosis. In all EAOCs coexisting with endometriosis in the single cyst, the expression levels of CXCL4 and CXCL4L1 were significantly lower in cancer lesions than in corresponding endometriosis. Histopathological study revealed that CXCL4 was strongly expressed in CD68+ infiltrating macrophages of endometriosis. In microscopically transitional zone between endometriosis and EAOC, CD68+ macrophages often demonstrated CXCL4? pattern. The majority of CD68+ TAMs in overt cancer lesions were negative for CXCL4. Collective data indicate that that CXCL4 insufficiency may be involved in specific inflammatory microenvironment of ovarian cancers arising in endometriosis. Suppression of CXCL4 in cancer lesions is likely to be attributable to TAMs in part.

Furuya, Mitsuko; Tanaka, Reiko; Miyagi, Etsuko; Kami, Daisuke; Nagahama, Kiyotaka; Miyagi, Yohei; Nagashima, Yoji; Hirahara, Fumiki; Inayama, Yoshiaki; Aoki, Ichiro



Baboons, like humans, solve analogy by categorical abstraction of relations.  


Reasoning by analogy is one of the most complex and highly adaptive cognitive processes in abstract thinking. For humans, analogical reasoning entails the judgment and conceptual mapping of relations-between-relations and is facilitated by language (Gentner in Cogn Sci 7:155-170, 1983; Premack in Thought without language, Oxford University Press, New York, 1986). Recent evidence, however, shows that monkeys like "language-trained" apes exhibit similar capacity to match relations-between-relations (Fagot and Thompson in Psychol Sci 22:1304-1309, 2011; Flemming et al. in J Exp Psychol: Anim Behav Process 37:353-360, 2011; Truppa et al. in Plos One 6(8):e23809, 2011). Whether this behavior is driven by the abstraction of categorical relations or alternatively by direct perception of variability (entropy) is crucial to the debate as to whether nonhuman animals are capable of analogical reasoning. In the current study, we presented baboons (Papio papio) and humans (Homo sapiens) with a computerized same/different relational-matching task that in principle could be solved by either strategy. Both baboons and humans produced markedly similar patterns of responding. Both species responded different when the perceptual variability of a stimulus array fell exactly between or even closer to that of a same display. Overall, these results demonstrate that categorical abstraction trumped perceptual properties and, like humans, Old World monkeys can solve the analogical matching task by judging the categorical abstract equivalence of same/different relations-between-relations. PMID:23334572

Flemming, Timothy M; Thompson, Roger K R; Fagot, Joël



ABH-related antigens in human male genital tract  

Microsoft Academic Search

Summary  The localization of ABH related antigens in human male reproductive tract was examined using monoclonal antibodies and an avidin biotin complex method. No positive reaction with blood group antibodies on spermatozoa was observed in testis and ductus epididymidis apart from erythrocytes and endothelial cells. The expression of ABH and ABH related antigens in ductuli efferentes testis, ductus epididymidis, seminal vesicle

Katsuji Nishi; Tatsushige Fukunaga; Yoshio Yamamoto; Mitsuko Yamada; Masateru Kane; Akio Tanegashima; Steven Rande; Bernd Brinkmann



Umbilical endometriosis in a woman with bicornuate uterus.  


A 39-year-old woman presented for evaluation of a tender nodule on the umbilicus that had been present for 6 months. She stated that it had slowly been increasing in size and would occasionally open up and crust over with dried blood. Physical examination revealed a 4-mm firm, tender, brown papule in the umbilicus (Figure 1). She had a history of chronic pelvic pain and exploratory laparoscopy for endometriosis 10 years prior, at which time the diagnosis ofa bicornuate uterus was made. Subsequently, hysterectomy was performed (Figure 2) at which time the entire umbilical lesion was excised. Histopathology revealed branching tubular glands in the dermis lined by stratified columnar epithelium, surrounded by small cells with scant cytoplasm, characteristic of proliferative-phase endometrial stroma (Figure 3 and Figure 4). These findings were consistent with a diagnosis of umbilical endometriosis (Villar's nodule). Subsequent examination revealed no evidence of recurrence. PMID:23008945

Baird, David; Klepeiss, Stacy; Wehler, Amanda; Harkins, Gerald; Anderson, Bryan


Intestinal occlusion caused by endometriosis of the sigmoid colon.  


Endometriosis (E) is an estrogen-dependent inflammatory disorder that is observed in approximately 10% of women in childbearing age, and is the most common benign gynecological disorder requiring hospitalization. In 5% of cases, there is an involvement of the gastrointestinal tract, for the most part of the sigmoid colon and rectum (~ 90%). However intestinal obstruction due to severe stenosis of the sigmoid colon, as in the case described by the authors, is rare. The differential diagnosis should include cancer, inflammatory diseases and actinic colitis which has a similar clinical picture to E. Surgical treatment - resection and anastomosis or conservative procedures - provides better results especially when a multidisciplinary approach is used (colorectal surgeon, gynecologist, urologist). The authors report a case of obstruction of the sigmoid colon due to endometriosis and analyze the pathophysiology, diagnosis and surgical management of this disorder. PMID:22610080

Conzo, Giovanni; Docimo, Giovanni; Candela, Giancarlo; Palazzo, Antonietta; Della Pietra, Cristina; Mauriello, Claudio; Santini, Luigi


The Mesothelium, Teflon or Velcro? Mesothelium in endometriosis pathogenesis.  


Sampson's transplantation theory for the pathogenesis of peritoneal endometriosis is widely accepted. The events that take place, however, on the cellular and subcellular level during the transition of endometrial tissue in the abdominal cavity into peritoneal endometriosis remain controversial. The mesothelium plays a central role in the debate on this subject. The interaction between endometrium and peritoneum has been studied in an in-vitro model using amnion, peritoneum and mesothelial cells in culture on the one hand and cyclic and menstrual endometrium on the other hand. The results of these studies indicate that (i) an intact mesothelial lining prevents adhesion of shed endometrial tissue, (ii) shed endometrial tissue adheres to the peritoneal extracellular matrix and (iii) menstrual effluent creates its own adhesion sites by damaging the mesothelial lining thus exposing the extracellular matrix. Therefore we conclude that the mesothelium has the properties of Teflon, while the extracellular matrix resembles Velcro. PMID:11278202

Dunselman, G A; Groothuis, P G; de Goeij, A F; Evers, J L



The role of prostaglandin E2 in endometriosis.  


Endometriosis is a leading cause of infertility in women of reproductive age. It involves the occurrence of endometrial tissue outside the uterine endometrium, mainly in the peritoneal cavity. Prostaglandin E(2) is up regulated in the peritoneal cavity in endometriosis and is produced by macrophages and ectopic endometrial cells. This prostaglandin is involved in the pathophysiology of the disease and elicits cell signals via four receptor types. Prostaglandin E(2) increases estrogen synthesis by up regulating steroidogenic acute regulatory protein (StAR) and aromatase. It inhibits apoptosis and up regulates fibroblast growth factor-9 (FGF-9) promoting cell proliferation. Prostaglandin E(2) affects leukocyte populations and promotes angiogenesis through its effect on estrogen and up regulation of vascular endothelial growth factor (VEGF). Dienogest is a synthetic progestin targeting expression of genes involved in prostaglandin synthesis. PMID:22003899

Sacco, Keith; Portelli, Mark; Pollacco, Joël; Schembri-Wismayer, Pierre; Calleja-Agius, Jean



Human immunodeficiency virus–related lymphoma: relation between clinical features and histologic subtypes  

Microsoft Academic Search

PurposeNon-Hodgkin’s lymphoma occurs frequently in patients with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). We determined the association between the clinical and histologic features of HIV-related lymphoma.

Jean Gabarre; Martine Raphael; Eric Lepage; Antoine Martin; Eric Oksenhendler; Luc Xerri; Micheline Tulliez; Josée Audouin; Régis Costello; Jean Baptiste Golfier; Daniel Schlaifer; Olivier Hequet; Nabih Azar; Christine Katlama; Christian Gisselbrecht



Aberrant expression of the pluripotency marker SOX-2 in endometriosis.  


Expression of the pluripotency factors SOX-2, OCT-4, KLF-4, and NANOG was analyzed by quantitative real-time polymerase chain reaction, immunohistochemistry, and immunofluorescence microscopy in the endometrium, myometrium, and endometriotic tissue of 36 patients. Aberrant expression of SOX-2 may indicate a stem cell origin of endometriosis, whereas the presence of all progenitor markers in endometrial tissue marks the endometrium as a potential source for induced pluripotent stem cell generation. PMID:20850729

Götte, Martin; Wolf, Maria; Staebler, Annette; Buchweitz, Olaf; Kiesel, Ludwig; Schüring, Andreas N



Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis  

Microsoft Academic Search

Aberrant up-regulation of aromatase in eutopic endometrium and implants from women with endometriosis has been re- ported. Aromatase induction may be mediated by increased cyclooxygenase-2 (COX-2). Recently, we demonstrated that progesterone receptor (PR)-A and PR-B serve an antiinflam- matory role in the uterus by antagonizing nuclear factor B activation and COX-2 expression. PR-C, which antagonizes PR-B, is up-regulated by inflammation.

Orhan Bukulmez; Daniel B. Hardy; Bruce R. Carr; R. A. Word; C. R. Mendelson



Progestins for symptomatic endometriosis: a critical analysis of the evidence  

Microsoft Academic Search

Objective: To obtain estimates of the effects of progestin treatment for pelvic pain associated with endometriosis.Data Identification: Information from studies published in the English-language literature between 1966 and 1996 was pooled. Articles were identified through hand and computerized searches using MEDLINE.Study Selection: A total of 27 trials that were published in peer-reviewed journals were identified, and 13 of these were

Paolo Vercellini; Ilenia Cortesi; Pier Giorgio Crosignani



The molecular connections between the cannabinoid system and endometriosis.  


The endocannabinoid system consists of an array of endogenously produced bioactive lipids that activate cannabinoid 1 (CB1) and 2 (CB2) receptors. Alterations of this system have been described in almost every category of disease. These changes can be protective or maladaptive, making the endocannabinoid network an attractive therapeutic target. Little is known about the potential role of endocannabinoids in endometriosis development although this is a topic worthy of further investigation since endocannabinoid modulators have recently been shown to affect specific mechanisms critical to endometriosis establishment and maintenance. A literature review was herein performed with the aim of defining the regulation and function of the endocannabinoid signaling in in vitro and animal models of endometriosis. The components of the endocannabinoid system, CB1 and CB2 receptors and the enzymes N-acylphosphatidylethanolamine-phospholipase D and fatty acid amide hydrolase are differentially regulated throughout the menstrual cycle in the endometrium and are expressed in deep endometriotic nodules and in sensory and sympathetic neurons innervating the lesions. Selective cannabinoid receptor agonists, such as WIN 55212-2, appear to have a favorable action in limiting cell proliferation and in controlling pain symptoms. Conversely, endometrial cell migration tends to be stimulated by receptor agonists. The phosphatidylinositol 3-kinase/Akt and extracellular signal-regulated kinase 1/2 pathways seem to be involved in these processes. However, the underlying mechanisms of action are only just beginning to unfold. Given the complexity of the system, further studies are needed to clarify whether the endocannabinoid system might represent a promising target for endometriosis. PMID:22923487

Sanchez, A M; Vigano, P; Mugione, A; Panina-Bordignon, P; Candiani, M



Apolipoprotein E polymorphisms and spontaneous pregnancy loss in patients with endometriosis  

PubMed Central

Endometriosis affects >10% of women during their reproductive years, many of whom report high rates of spontaneous pregnancy loss (SPL). We examined whether gene polymorphisms in apolipoprotein E (APOE), which is involved in lipoprotein metabolism, are associated with endometriosis and/or endometriosis-associated infertility. We conducted a cross-sectional genetic association study of women surgically confirmed to have endometriosis (n = 345) and no surgical evidence of the disease (n = 266). Genotyping of APOE polymorphism (?2, ?3, ?4) was conducted by polymerase chain reaction–restriction fragment length polymorphism followed by visualization of specific patterns by gel electrophoresis. Statistical significance of differences in genotype and allelic frequencies was assessed using Pearson's ?2 test and Risk analysis. Overall, we found no association between APOE genotype and diagnosis of endometriosis. However, patients with endometriosis who reported at least one SPL were three times more likely to be ?2 carriers and 2-fold less likely to be ?4 carriers. Compared with ?3 carriers, patients with endometriosis who were ?2 carriers and had at least one live birth reported four times the rate of SPL, while ?4 carriers were <0.4-fold less likely to report an SPL. Our data suggest that there may be an association between APOE allelic frequency and SPL in patients with endometriosis, which appears to be independent of mechanisms associated with infertility, an intriguing observation that deserves further investigation.

Collazo, Madeline S.; Porrata-Doria, Tirtsa; Flores, Idhaliz; Acevedo, Summer F.



Endometriosis-induced acute small and large bowel obstruction: rare clinical entities.  


The extragonadal manifestations of intestinal endometriosis necessitating immediate abdominal surgical exploration are, to date, sparsely represented within the literature. We present two cases of acute complete small and large bowel obstruction secondary to endometriosis, requiring emergent laparotomy; and review the pertinent literature. PMID:15980898

Chaer, Rabih; Sam, Albert; Teresi, Miguel; Cintron, Jose



Generalized hyperalgesia in women with endometriosis and its resolution following a successful surgery.  


Although pains of various kinds top the list of complaints from women with endometriosis and are the most debilitating of the disease, little is known about the mechanism/mechanisms of endometriosis-associated pains. To test the hypothesis that women with endometriosis have generalized hyperalgesia which may be alleviated by a successful surgery, we recruited 100 patients with surgically and histologically confirmed endometriosis and 70 women without, and tested their responses to pain stimulations. Before the surgery, all patients rated their dysmenorrhea severity by Visual Analog scale (VAS) and went through an ischemic pain test (IPT) and an electrical pain test (EPT). The controls were also administrated with IPT/EPT. Three and 6 months after surgery, all patients were administrated with IPT/EPT and rated their severity of dysmenorrhea. We found that patients with endometriosis had significantly higher IPT VAS scores and lower EPT pain threshold than controls, but after surgery their IPT scores and EPT pain threshold were significantly and progressively improved, along with their dysmenorrhea severity. Thus, we conclude that women with endometriosis have generalized hyperalgesia, which was alleviated by surgery. Consequently, central sensitization may be a possible mechanism underlying various forms of pain associated with endometriosis, and its recognition should have important implications for the development of novel therapeutics and better clinical management of endometriosis. PMID:20923950

He, Weiwei; Liu, Xishi; Zhang, Yuqiu; Guo, Sun-Wei



Apolipoprotein E polymorphisms and spontaneous pregnancy loss in patients with endometriosis.  


Endometriosis affects >10% of women during their reproductive years, many of whom report high rates of spontaneous pregnancy loss (SPL). We examined whether gene polymorphisms in apolipoprotein E (APOE), which is involved in lipoprotein metabolism, are associated with endometriosis and/or endometriosis-associated infertility. We conducted a cross-sectional genetic association study of women surgically confirmed to have endometriosis (n = 345) and no surgical evidence of the disease (n = 266). Genotyping of APOE polymorphism (?2, ?3, ?4) was conducted by polymerase chain reaction-restriction fragment length polymorphism followed by visualization of specific patterns by gel electrophoresis. Statistical significance of differences in genotype and allelic frequencies was assessed using Pearson's ?(2) test and Risk analysis. Overall, we found no association between APOE genotype and diagnosis of endometriosis. However, patients with endometriosis who reported at least one SPL were three times more likely to be ?2 carriers and 2-fold less likely to be ?4 carriers. Compared with ?3 carriers, patients with endometriosis who were ?2 carriers and had at least one live birth reported four times the rate of SPL, while ?4 carriers were <0.4-fold less likely to report an SPL. Our data suggest that there may be an association between APOE allelic frequency and SPL in patients with endometriosis, which appears to be independent of mechanisms associated with infertility, an intriguing observation that deserves further investigation. PMID:22266326

Collazo, Madeline S; Porrata-Doria, Tirtsa; Flores, Idhaliz; Acevedo, Summer F



Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications  

PubMed Central

BACKGROUND Many clinicians and patients believe that endometriosis-associated pain is due to the lesions. Yet causality remains an enigma, because pain symptoms attributed to endometriosis occur in women without endometriosis and because pain symptoms and severity correlate poorly with lesion characteristics. Most research and reviews focus on the lesions, not the pain. This review starts with the recognition that the experience of pain is determined by the central nervous system (CNS) and focuses on the pain symptoms. METHODS Comprehensive searches of Pubmed, Medline and Embase were conducted for current basic and clinical research on chronic pelvic pain and endometriosis. The information was mutually interpreted by a basic scientist and a clinical researcher, both in the field of endometriosis. The goal was to develop new ways to conceptualize how endometriosis contributes to pain symptoms in the context of current treatments and the reproductive tract. RESULTS Endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the CNS. This engagement provides a mechanism by which the dynamic and hormonally responsive nervous system is brought directly into play to produce a variety of individual differences in pain that can, in some women, become independent of the disease itself. CONCLUSIONS Major advances in improving understanding and alleviating pain in endometriosis will likely occur if the focus changes from lesions to pain. In turn, how endometriosis affects the CNS would be best examined in the context of mechanisms underlying other chronic pain conditions.

Stratton, Pamela; Berkley, Karen J.



Effect of palmitoylethanolamide–polydatin combination on chronic pelvic pain associated with endometriosis: Preliminary observations  

Microsoft Academic Search

ObjectiveEndometriosis is a chronic oestrogen-dependent gynaecological disorder, the most common symptom of which is pain. Inflammation can be considered one of the major causes of pain in endometriosis. In particular, degranulating mast cells have been found in significantly greater quantities in endometriotic lesions than in unaffected tissues. The increase in activated and degranulating mast cells is closely associated with nerve

Ugo Indraccolo; Fabrizio Barbieri



A Pilot Feasibility Multicenter Study of Patients After Excision of Endometriosis  

PubMed Central

Objective: To serve as a pilot feasibility study for a randomized study of excision versus ablation in the treatment of endometriosis by (1) estimating the magnitude of change in symptoms after excision only at multiple referral centers and (2) determining the proportion of women willing to participate in a randomized trial. Methods: We performed a multicenter prospective study of women undergoing excision for endometriosis (Canadian Task Force class II-3) at Duke University Center for Endometriosis Research & Treatment (currently the Saint Louis University Center for Endometriosis), Center for Endometriosis Care, Northshore University Health System, Memorial University (Canada), and Florida Hospital. The study comprised 100 female patients, aged 18 to 55 years, with endometriosis-suspected pelvic pain. The intervention was laparoscopic excision only of the abnormal peritoneum suspicious for endometriosis. The main outcome measures were quality of life, pelvic pain, dysmenorrhea, dyspareunia, and bowel and bladder symptoms. Results: The mean follow-up period was 8.5 months. Excision of endometriosis showed a significant reduction in all pain scores except bowel symptoms, as well as significant improvement in quality of life. Of the patients, 84% were willing to participate in a randomized study. Conclusions: Quality of life is a needed primary outcome for any randomized study comparing excision versus ablation. A multicenter comparative trial is feasible, although quality assurance would have to be addressed. Patients were willing to be randomized even at surgical referral centers.

Tu, Frank; Bajzak, Krisztina; Lamvu, Georgine; Guzovsky, Olga; Agnelli, Rob; Peavey, Mary; Winer, Wendy; Albee, Robert; Sinervo, Ken



Aromatase inhibitors and cyclooxygenase-2 (COX2) inhibitors in endometriosis: New questions—old answers?  

Microsoft Academic Search

The medical treatment of endometriosis needs to be optimized. Therapeutic management strategies for endometriosis-associated pain or recurrent disease are primarily aimed at downregulating ovarian function or antagonizing the effect of estrogen in ectopic endometrial implants. In this context, basic research is providing important results for the development of new, specific treatment modalities. Aromatase overexpression has recently been detected in endometriotic

Andreas D. Ebert; Julia Bartley; Matthias David



A New Technique for Laparoscopic Anterior Resection for Rectal Endometriosis  

PubMed Central

Background: Anterior rectal resection is sometimes necessary to treat deeply infiltrating rectovaginal endometriosis. We describe a completely laparoscopic approach as a new way of excising rectal endometriosis that can be used without opening any part of the rectum. This avoids opening the abdomen or any risk of fecal spillage. Methods: The patient received preoperative oral bowel preparation. Ureteric stents (6 F) were inserted cystoscopically. The peritoneum in the ovarian fossae was opened lateral to any disease and the rectum reflected off the back of the cervix, leaving any endometriosis on the front of the rectum. The pelvic peritoneum was reflected medially, below the level of the ureters. The mesorectum was then dissected off a 6-cm length of rectum by using a Harmonic scalpel. A circular end-to-end anastomosis instrument was passed anally until the outline of the anvil was visible, inside the colon, above the diseased rectum. The anvil was detached and held by a soft grasper before the rectum was then divided above and below the disease using a laparoscopic stapling device. The tip of the anvil was pushed through the proximal end of the colon allowing reanastomosis of the rectal stump. Conclusion: The patient was discharged after 5 days without complications.

English, James; Miles, W. F. Anthony; Giannopoulos, Theo



Implications of endometriosis for women who observe Jewish law (halakha).  


Endometriosis is a chronic disease characterized by ectopic deposits of endometrial glands and stroma located outside the uterus. Women with symptomatic endometriosis may experience premenstrual bleeding or staining, pain and other physical sensations, as well as other symptoms dependent upon the stage and location of the endometrial implants. We discuss the particular implications of these symptoms for women who observe the part of Jewish law known as hilkhot niddah. The laws of niddah, also known as taharat hamishpahah (family purity), dictate the timing of the physical relationship between a married couple. These laws proscribe any physical contact between the couple during the time that the wife has the status of niddah. This status is obtained by any uterine bleeding that is not caused by injury. Menstruation is the most common cause of the niddah status, but niddah and menstruation are not synonymous. Since, to the best of our knowledge, there is no written discussion of the specific implications of endometriosis for this population, we discuss the relevant halakhic and medical literature and hope that such analysis will facilitate efforts to assist the observant couple in gaining regular niddah-free segments of time. PMID:15729953

Chertok, Ilana R; Zimmerman, Deena R; Taragin, Shoshana; Silverman, Zeev; Hallak, Mordechai



[Treatment of endometriosis. Evaluation of preoperative therapy with danazol, gestrinone and buserelin (nasal spray and implant)].  


In order to adequately assess the effectiveness of danazol, gestrinone, buserelin-nasal spray (IN) and buserelin-implant (SC), a prospective non randomized study was initiated in 178 patients with laparoscopically confirmed ovarian endometriosis. After hormonal therapy, laparotomy with microsurgical resection of endometriotic cysts or laparoscopy laser was carried out. Regression (greater than 25%) of ovarian endometriosis was noted in 30, 34, 73 and 91% of cases after danazol, gestrinone and buserelin IN and buserelin SC respectively. Histological study proves that hormonal treatment leads to an incomplete suppression of ovarian endometriotic implants and this suggests the necessity to remove surgically invasive ovarian endometriosis. The pregnancy rate in moderate endometriosis (55%) differed significantly from the rate obtained in severe endometriosis (44%). The highest percentages were found after buserelin therapy. In conclusion, preoperative use of a potent GnRH agonist, administered subcutaneously, seems to be the best therapeutic approach when associated to surgery (CO2 laser or microsurgery). PMID:2124231

Nisolle, M; Clerckx, F; Casanas-Roux, F; Gillerot, S; Bourgonjon, D; Donnez, J



Induction of a local pseudo-pregnancy for the treatment of endometriosis.  


As a common cause of chronic pelvic pain, endometriosis affects 10% of women of reproductive age. The most popular strategy for treating endometriosis is pseudo-pregnancy therapy. However, the efficacy of common systemic pseudo-pregnancy therapy is significantly attenuated by poor compliance because of so many side effects. While levonorgestrel-releasing intrauterine systems (LNG-IUS) successfully localize the effect of pseudo-pregnancy to the genital tract in treating endometriosis, it seemed to be insufficient to suppress the ovarian and extragenital endometriosis. We postulate that induction of a local pseudo-pregnancy via progestogen-loaded microsphere in the lesions of endometriosis may provide a more effective treatment with fewer side effects. PMID:19699590

Yuan, Peng; Huang, Yanhong; Cheng, Biliang; Zhang, Jianfang; Xin, Xiaoyan



Evaluation of the Relationship between Endometriosis and Omega-3 and Omega-6 Polyunsaturated Fatty Acids  

PubMed Central

Background: Endometriosis is a common chronic inflammation causing major problems including infertility. The role of omega-3 and omega-6 fatty acids as their potential anti-inflammatory effects in endometriosis needs to be further explored. The objective of this study was to compare serum phospholipid fatty acid profile in endometriosis patients with controls, and to explore the correlation of this profile with the severity of the disease. Methods: Sixty-four endometriosis patients and 74 control women, in reproductive age, participated in this study. Among the endometriosis patients, 19 cases were in stage I, 27 cases in stage II, 8 cases in stage III, and 10 cases in stage IV. Each patient underwent laparoscopy. Before surgery, 5 ml of blood was obtained. After extraction of the total lipids, serum total phospholipid fraction was isolated by thin layer chromatography. Fatty acid composition of the phospholipid fraction was determined by gas chromatography and the resulted profile was compared in endometriosis patients and controls. The profile was also compared in the endometriosis group based on the severity of disease. Results: Stearic acid was significantly lower in the endometriosis group as compared to controls (P= 0.030). No other fatty acid compositions were significantly different between patients and controls. Serum ratio of eicosapentaenoic acid (EPA) to arachidonic acid (AA) was in reasonable correlation with the severity of endometriosis (r = 0.34, P = 0.006). Conclusion: According to these findings, levels of fatty acids in serum total phospholipids seem not to be a marker for endometriosis, but the EPA to AA ratio was a relevant factor indicating severity of illness.

Khanaki, Korosh; Nouri, Mohammad; Ardekani, Ali M.; Ghassemzadeh, Alieh; Shahnazi, Vahideh; Sadeghi, Mohammad R.; Darabi, Masoud; Mehdizadeh, Amir; Dolatkhah, Homayon; Saremi, Abotaleb; Imani, Ali R.; Rahimipour, Ali



Quality of life associated to chronic pelvic pain is independent of endometriosis diagnosis-a cross-sectional survey  

Microsoft Academic Search

Background  Pain is strongly related to poor quality of life. We performed a cross-sectional study in a universitary hospital to investigate\\u000a quality of life in women suffering from chronic pelvic pain (CPP) due to endometriosis and others conditions.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Fifty-seven patients aged between 25 and 48 years-old submitted to laparoscopy because of CPP were evaluated for quality of\\u000a life and depressive symptoms.

Carlos A Souza; Luciano M Oliveira; Camila Scheffel; Vanessa K Genro; Virginia Rosa; Marcia F Chaves; João S Cunha Filho



Human movement coordination implicates relative direction as the information for relative phase  

Microsoft Academic Search

The current studies explore the informational basis of the coupling in human rhythmic movement coordination tasks. Movement stability in these tasks is an asymmetric U-shaped function of mean relative phase; 0° is maximally stable, 90° is maximally unstable and 180° is intermediate. Bingham (2001, 2004a, 2004b) hypothesized that the information used to perform coordinated rhythmic movement is the relative direction

Andrew D. Wilson; David R. Collins; Geoffrey P. Bingham



Human immunodeficiency virus (HIV) related heart disease: A review  

Microsoft Academic Search

Summary Recent advances in the knowledge of human immunodeficiency virus (HIV) replication and transmission as well as the emergence of effective antiretroviral therapies are leading to longer survival times for HIV- infected individuals. As a result, organ-related manifestations of late-stage HIV infection, including HIV-related heart diseases have emerged. It is now clear that cardiac involvement in HIV seropositive patients is

Mahmoud U. Sani; Basil N. Okeahialam; Sani H. Aliyu; David A. Enoch



Age-Related Changes in Deformability of Human Erythrocytes  

Microsoft Academic Search

The present study was designed to further the characteri- zation of age-related changes in the deformability of human erythrocytes. The top (- young) and bottom (- old) 10% fractions of density-separated red cells from ten normal donors were subjected to graded levels of shear stress in a rheoscope. Measurements were made of steady-state elongation (cells tank treading in a state

S. P. Sutera; R. A. Gardner; C. W. Boylan; G. L. Carroll; K. C. Chang; J. S. Marvel; C. Kilo; B. Gonen; J. R. Williamson



Vegetation dynamics in a fishpond littoral related to human impact  

Microsoft Academic Search

To determine how fishpond vegetation reflects human activities, changes of littoral vegetation of the Opatovický fishpond (South Bohemia) were studied over a period of 26 years. The littoral vegetation of this fishpond has been mapped in 1992 and 1997, and compared with a former study in 1971 together with relation to the soil chemistry of the bottom sediments. The following

Zdenka Hroudová; Petr Zákravský



Relational agents: effecting change through human-computer relationships  

Microsoft Academic Search

Abstract What kinds of social relationships can people have with computers? Are there activities that computers can engage in that actively draw people into relationships with them? What are the potential benefits to the people who participate in these human - computer relationships? To address these questions this work introduces a theory of Relational Agents, which are computational artifacts designed

T. W. Bickmore



One-month release injectable microcapsules of a luteinizing hormone-releasing hormone agonist (leuprolide acetate) for treating experimental endometriosis in rats.  


Leuprolide acetate is a highly potent analog of luteinizing hormone-releasing hormone. We have prepared 1-month release injectable microcapsules of leuprolide acetate using a biodegradable polymer, poly (dl-lactide-co-glycolide), to treat an endocrine-dependent tumor, prostate cancer. In the present study, the possibility using the microcapsules to treat endometriosis was investigated. In rats, the microcapsules exhibited a pseudo-zero order release from the injection site for 1 month after being administered s.c. and i.m., and maintained effective constant serum levels of the analog during the 4-week treatment. A single injection of the microcapsules (100 micrograms/kg/day as leuprolide acetate) suppressed luteinizing hormone, follicle-stimulating hormone and estradiol for more than 4 weeks, and caused a dramatic regression of growth of Jones experimental endometriosis model in female rats. These results encourage the belief that a 1-month release parenteral preparation of leuprolide acetate may be potentially useful in the therapy of endometriosis in human beings. PMID:3126294

Okada, H; Heya, T; Ogawa, Y; Shimamoto, T



Validation of rat endometriosis model by using raloxifene as a positive control for the evaluation of novel SERM compounds.  


Approximately 10% of women of reproductive age suffer from endometriosis, a potentially painful disease process and important cause of female infertility. Raloxifene, a commercially available SERM (selective estrogen receptor modulator) compound, used for the treatment of postmenopausal osteoporosis, has preclinically demonstrated its estrogen antagonist effect on uterine tissue in rats. There is potential that SERM compounds may become a viable treatment option for human endometriosis, although more investigation is needed. In this study, raloxifene was administered at various doses to determine the efficacy and an appropriate dose level for use as a positive control in a rat model of endometriosis. Prior to dose administration, all rats underwent a bilateral ovariectomy, autologous transplantation of uterine tissue onto the peritoneal surface of the abdominal wall, and implantation of a subcutaneous estrogen pellet (E2). Two separate postsurgical experiments were performed. In experiment 1, following a 4-wk recovery, the rats bearing implants were assigned to three groups: (1) removal of the E2 pellet and dosing vehicle only (n = 7); (2) E2 and vehicle (n = 6); and (3) E2 and raloxifene at 10.0 mg/kg (n = 6). In experiment 2, also following a 4-week recovery, the rats bearing implants were assigned to five groups (n = 8/group): (1) E2 and vehicle only; (2) E2 and raloxifene, 0.3 mg/kg/d; (3) E2 and raloxifene, 1.0 mg/kg/d; (4) E2 and raloxifene, 3.0 mg/kg/d; (5) E2 and raloxifene, 10.0 mg/kg/d. All rats were dosed orally BID for 14 d. At the end of the study, the implanted endometrium was remeasured and compared to the pretreatment measurement. The results from both studies demonstrated that Raloxifene at only one dose (10.0 mg/kg) displayed significant implant regression (p < .05). Subsequently, our rat endometriosis experimental model consistently uses the exogenous E2 pellet and raloxifene at 10 mg/kg, BID, as a positive control to help screen and compare novel SERM compounds. PMID:16126628

Yao, Z; Shen, X; Capodanno, I; Donnelly, M; Fenyk-Melody, J; Hausamann, J; Nunes, C; Strauss, J; Vakerich, K


Higher expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 (Flk-1) and metalloproteinase-9 (MMP-9) in a rat model of peritoneal endometriosis is similar to cancer diseases  

PubMed Central

Background Endometriosis is a common disease characterized by the presence of a functional endometrium outside the uterine cavity, causing pelvic pain, dysmenorrheal, and infertility. This disease has been associated to development of different types of malignancies; therefore new blood vessels are essential for the survival of the endometrial implant. Our previous observations on humans showed that angiogenesis is predominantly found in rectosigmoid endometriosis, a deeply infiltrating disease. In this study, we have established the experimental model of rat peritoneal endometriosis to evaluate the process of angiogenesis and to compare with eutopic endometrium. Methods We have investigated the morphological characteristics of these lesions and the vascular density, VEGF and its receptor Flk-1 and MMP-9 expression, and activated macrophage distribution, using immunohistochemistry and RT-PCR. Results As expected, the auto-transplantation of endometrium pieces into the peritoneal cavity is a well-established method for endometriosis induction in rats. The lesions were cystic and vascularized, and demonstrated histological hallmarks of human pathology, such as endometrial glands and stroma. The vascular density and the presence of VEGF and Flk-1 and MMP-9 were significantly higher in endometriotic lesions than in eutopic endometrium, and confirmed the angiogenic potential of these lesions. We also observed an increase in the number of activated macrophages (ED-1 positive cells) in the endometriotic lesions, showing a positive correlation with VEGF. Conclusion The present endometriosis model would be useful for investigation of the mechanisms of angiogenesis process involved in the peritoneal attachment of endometrial cells, as well as of the effects of therapeutic drugs, particularly with antiangiogenic activity.



Identification of multiple pathways involved in the malignant transformation of endometriosis (Review)  

PubMed Central

The association between endometriosis and malignant transformation has often been described in the medical literature. A search was conducted between 1966 and 2010 through the English language literature (online Medline PubMed database) using the keywords endometriosis combined with malignant transformation. The search revealed an increase in reports describing endometriosis and malignancy. Approximately 1.0% of women with endometriosis have lesions that undergo malignant transformation. The malignant processes that are associated with endometriosis may be classified into three groups: i) epithelial ovarian cancers (endometrioid adenocarcinoma and clear cell carcinoma), ii) other Müllerian-type tumors, including Müllerian-type mucinous borderline tumor and serous borderline tumor and iii) sarcomas such as adenosarcoma and endometrial stromal sarcoma in the female pelvic cavity. Persistent oxidative stress induced by endometriosis-dependent hemorrhage may be associated with carcinogenesis. In conclusion, the malignant transformation of endometriosis has multiple pathways of development and may share a common pathogenic mechanism; iron-induced oxidative stress derived from repeated hemorrhage.




Pleural Endometriosis in an Aged Rhesus Macaque (Macaca Mulatta): A Histopathologic and Immunohistochemical Study  

PubMed Central

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is one of the most common reproductive abnormalities encountered in women as well as Old World primates. The majority of endometriosis cases in Old World primates occur within the abdominal cavity, with spread to extraabdominal sites considered to be a rare event. A 19-year-old multiparous female rhesus macaque (Macaca mulatta) presented to necropsy for difficulty breathing and weight loss. Grossly, the animal had marked abdominal endometriosis and severe hemoabdomen and hemothorax, the latter of which was accompanied by marked pleural fibrosis. Histologic examination confirmed the abdominal endometriosis and also revealed numerous uterine glands and stroma embedded within the pleural fibrosis. Rafts of endometrial tissue were present within pulmonary lymphatics and the tracheobronchial lymph nodes. Immunohistochemically, all ectopic endometrial tissue had varying degrees of positive immunoreactivity to cytokeratin, vimentin, progesterone and estrogen receptors, and calretinin but was negative for desmin and carcinoembryonic antigen. Pleural endometriosis is an extremely rare manifestation of endometriosis in nonhuman primates. This case report emphasizes lymphatic spread as a likely mechanism for extrauterine endometriosis.

Assaf, Basel T.; Miller, Andrew D.



Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study.  


The etiology of endometriosis is poorly understood, and few modifiable risk factors have been identified. Dairy foods and some nutrients can modulate inflammatory and immune factors, which are altered in women with endometriosis. We investigated whether intake of dairy foods, nutrients concentrated in dairy foods, and predicted plasma 25-hydroxyvitamin D (25(OH)D) levels were associated with incident laparoscopically confirmed endometriosis among 70,556 US women in Nurses' Health Study II. Diet was assessed via food frequency questionnaire. A score for predicted 25(OH)D level was calculated for each participant. During 737,712 person-years of follow-up over a 14-year period (1991-2005), 1,385 cases of incident laparoscopically confirmed endometriosis were reported. Intakes of total and low-fat dairy foods were associated with a lower risk of endometriosis. Women consuming more than 3 servings of total dairy foods per day were 18% less likely to be diagnosed with endometriosis than those reporting 2 servings per day (rate ratio = 0.82, 95% confidence interval: 0.71, 0.95; P(trend) = 0.03). In addition, predicted plasma 25(OH)D level was inversely associated with endometriosis. Women in the highest quintile of predicted vitamin D level had a 24% lower risk of endometriosis than women in the lowest quintile (rate ratio = 0.76, 95% confidence interval: 0.60, 0.97; P(trend) = 0.004). Our findings suggest that greater predicted plasma 25(OH)D levels and higher intake of dairy foods are associated with a decreased risk of endometriosis. PMID:23380045

Harris, Holly R; Chavarro, Jorge E; Malspeis, Susan; Willett, Walter C; Missmer, Stacey A



Diet and risk of endometriosis in a population-based case-control study  

PubMed Central

Diet plausibly has a role in the aetiology of endometriosis through effects on steroid hormone levels; however, few published studies have examined the diet and endometriosis risk. We evaluated dietary risk factors for endometriosis in a population-based case–control study. Cases were 284 Group Health (GH) enrollees aged 18–49 years with newly diagnosed, surgically confirmed endometriosis between 1996 and 2001. Controls were 660 randomly selected age-matched female GH enrollees without a history of endometriosis. Nutrients and selected food groups were assessed using the Women’s Health Initiative FFQ. OR of endometriosis risk associated with dietary exposures were estimated using unconditional logistic regression and adjusted for identified covariates. Increased total fat consumption was associated with decreased endometriosis risk (fourth quartile v. lowest: OR 0·5, 95% CI 0·2, 1·0, P-trend=0·12). Increased ?-carotene consumption and servings/d of fruit were associated with increased risk (?-carotene third quartile v. lowest: OR 1·7, 95% CI 1·1, 2·6; fourth quartile v. lowest: OR 1·6, 95% CI 1·0, 2·5, P-trend 0·16; fruit >2 servings/d v. <1: OR 1·5, 95% CI 1·0, 2·3, P -trend=0·04). We also found a suggestion of decreased endometriosis risk associated with the consumption of dairy products (2 servings/d v. ?1: OR 0·6, >2 servings/d v. ?1: OR 0·7), but this association was not statistically significant for the highest tertile. The present study suggests that specific dietary components may be associated with endometriosis risk.

Trabert, Britton; Peters, Ulrike; De Roos, Anneclaire J.; Scholes, Delia; Holt, Victoria L.



Using Location, Color, Size, and Depth to Characterize and Identify Endometriosis Lesions in a Cohort of 133 Women  

PubMed Central

Objective Correlating histology with endometriosis characteristics. Design Secondary data analysis. Setting Government Research Hospital. Patients Women with chronic pelvic pain and endometriosis. Intervention Laparoscopic excision of lesions. Main Outcome Measures(s) Histologic examination for endometriosis. Materials and Methods Between 1999 and 2004, 133 women underwent laparoscopic surgery, during which lesion characteristics and surgical impression of the lesions were recorded. All biopsied were sent for histological examination, and surgical and histological findings were compared. Results 357 of 544 lesions felt to be endometriosis by the surgeon had positive histology. Mixed color lesions most commonly contained endometriosis (76%), with the percent of positive lesions being similar between single color groups. 58% (164/283) of subtle (red or white) lesions were positive for endometriosis. Thirty women had only red or white lesions, and 18 (60%) had at least one lesion positive for endometriosis. Lesions were most commonly located in the cul-de-sac (64%), utero-sacral ligaments (68%), and ovarian fossa (70%). Conclusion(s) Wide, deep, mixed color lesions in the cul-de-sac, ovarian fossa or the utero-sacral ligaments had the highest frequency of endometriosis. Over half of subtle lesions had endometriosis. These results should be considered when diagnosing endometriosis.

Stegmann, Barbara J.; Sinaii, Ninet; Liu, Shannon; Segars, James; Merino, Maria; Nieman, Lynnette K.; Stratton, Pamela



ARID1A Mutations in Endometriosis-Associated Ovarian Carcinomas  

PubMed Central

BACKGROUND Ovarian clear-cell and endometrioid carcinomas may arise from endometriosis, but the molecular events involved in this transformation have not been described. METHODS We sequenced the whole transcriptomes of 18 ovarian clear-cell carcinomas and 1 ovarian clear-cell carcinoma cell line and found somatic mutations in ARID1A (the AT-rich interactive domain 1A [SWI-like] gene) in 6 of the samples. ARID1A encodes BAF250a, a key component of the SWI–SNF chromatin remodeling complex. We sequenced ARID1A in an additional 210 ovarian carcinomas and a second ovarian clear-cell carcinoma cell line and measured BAF250a expression by means of immunohistochemical analysis in an additional 455 ovarian carcinomas. RESULTS ARID1A mutations were seen in 55 of 119 ovarian clear-cell carcinomas (46%), 10 of 33 endometrioid carcinomas (30%), and none of the 76 high-grade serous ovarian carcinomas. Seventeen carcinomas had two somatic mutations each. Loss of the BAF250a protein correlated strongly with the ovarian clear-cell carcinoma and endometrioid carcinoma subtypes and the presence of ARID1A mutations. In two patients, ARID1A mutations and loss of BAF250a expression were evident in the tumor and contiguous atypical endometriosis but not in distant endometriotic lesions. CONCLUSIONS These data implicate ARID1A as a tumor-suppressor gene frequently disrupted in ovarian clear-cell and endometrioid carcinomas. Since ARID1A mutation and loss of BAF250a can be seen in the preneoplastic lesions, we speculate that this is an early event in the transformation of endometriosis into cancer. (Funded by the British Columbia Cancer Foundation and the Vancouver General Hospital–University of British Columbia Hospital Foundation.)

Wiegand, Kimberly C.; Shah, Sohrab P.; Al-Agha, Osama M.; Zhao, Yongjun; Tse, Kane; Zeng, Thomas; Senz, Janine; McConechy, Melissa K.; Anglesio, Michael S.; Kalloger, Steve E.; Yang, Winnie; Heravi-Moussavi, Alireza; Giuliany, Ryan; Chow, Christine; Fee, John; Zayed, Abdalnasser; Prentice, Leah; Melnyk, Nataliya; Turashvili, Gulisa; Delaney, Allen D.; Madore, Jason; Yip, Stephen; McPherson, Andrew W.; Ha, Gavin; Bell, Lynda; Fereday, Sian; Tam, Angela; Galletta, Laura; Tonin, Patricia N.; Provencher, Diane; Miller, Dianne; Jones, Steven J.M.; Moore, Richard A.; Morin, Gregg B.; Oloumi, Arusha; Boyd, Niki; Aparicio, Samuel A.; Shih, Ie-Ming; Mes-Masson, Anne-Marie; Bowtell, David D.; Hirst, Martin; Gilks, Blake; Marra, Marco A.; Huntsman, David G.



Treatment independent pregnancy with operative laparoscopy for endometriosis in an in vitro fertilization program.  


Thirty-nine patients with Stage I to IV endometriosis and at least 5 years of primary infertility were enrolled in the Johns Hopkins In Vitro Fertilization Program. At the time of laparoscopic oocyte retrieval, operative endoscopy with lysis of adhesions, fulguration or resection of pelvic endometriosis, or enucleation of ovarian endometriomas was performed. Although the in vitro fertilization-embryo transfer cycle did not result in pregnancy, 12 patients (28%) conceived within 10 months of the operative laparoscopic procedure. Nine of the pregnancies occurred in patients with Stage I to II endometriosis. PMID:2970406

Damewood, M D; Rock, J A



Ecological integrity of streams related to human cancer mortality rates.  


Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate community structure (West Virginia Stream Condition Index, SCI) and quantified human cancer mortality rates using county-level data from the Centers for Disease Control and Prevention. Regression and spatial analyses revealed significant associations between ecological integrity and public health. SCI was negatively related to age-adjusted total cancer mortality per 100,000 people. Respiratory, digestive, urinary, and breast cancer rates increased with ecological disintegrity, but genital and oral cancer rates did not. Smoking, poverty, and urbanization were significantly related to total cancer mortality, but did not explain the observed relationships between ecological integrity and cancer. Coal mining was significantly associated with ecological disintegrity and higher cancer mortality. Spatial analyses also revealed cancer clusters that corresponded to areas of high coal mining intensity. Our results demonstrated significant relationships between ecological integrity and human cancer mortality in West Virginia, and suggested important effects of coal mining on ecological communities and public health. Assessments of ecological integrity therefore may contribute not only to monitoring goals for aquatic life, but also may provide valuable insights for human health and safety. PMID:20361230

Hitt, Nathaniel P; Hendryx, Michael



Surgery for deep infiltrating endometriosis: technique and rationale.  


The surgical treatment of deep infiltrating endometriosis is challenging and complex. Currently, the gold standard for patient care is the referral to tertiary centers with a multidisciplinary team including gynecologists, colorectal surgeon and urologist with adequate training in advanced laparoscopic surgery. The surgical technique is essential to adequately manage the disease and to minimize the risk of complications; however, the technique is rarely taught and described in details. This paper reviews our current technique and all the tricks to allow the reproduction and even the improvement of this technique by other surgeons. PMID:23276992

Kondo, William; Bourdel, Nicolas; Zomer, Monica Tessmann; Slim, Karem; Botchorischvili, Revaz; Rabischong, Benoit; Mage, Gérard; Canis, Michel



Consumption of Human Milk Oligosaccharides by Gut-related Microbes  

PubMed Central

Human milk contains large amounts of complex oligosaccharides that putatively modulate the intestinal microbiota of breast-fed infants by acting as decoy binding sites for pathogens and as prebiotics for enrichment of beneficial bacteria. Several bifidobacterial species have been shown to grow well on human milk oligosaccharides. However, little data exists on other bacterial species. In this work we examined 16 bacterial strains belonging to 10 different genera for growth on human milk oligosaccharides. For this propose, we used a chemically-defined medium, ZMB1, which allows vigorous growth of a number gut–related microorganisms in a fashion similar to complex media. Interestingly, Bifidobacterium longum subsp. infantis, Bacteroides fragilis and Bacteroides vulgatus strains were able to metabolize milk oligosaccharides with high efficiency, while Enterococcus, Streptococcus, Veillonella, Eubacterium, Clostridium, and Escherichia coli strains grew less well or not at all. Mass spectrometry-based glycoprofiling of the oligosaccharide consumption behavior revealed a specific preference for fucosylated oligosaccharides by Bifidobacterium longum subsp. infantis and Bacteroides vulgatus. This work expands the current knowledge of human milk oligosaccharides consumption by gut microbes, revealing bacteroides as avid consumer of this substrate. These results provide insight on how human milk oligosaccharides shape the infant intestinal microbiota.

Marcobal, Angela; Barboza, Mariana; Froehlich, John W.; Block, David E.; German, J. Bruce; Lebrilla, Carlito B.; Mills, David A.



The agouti-related protein and body fatness in humans  

Microsoft Academic Search

OBJECTIVE: The objective of this study was to examine the impact of a single nucleotide polymorphism (SNP) (?38C>T) in the promoter of the human agouti-related protein (hAgRP) gene on promoter affinity for transcription factors (TFs) and its possible association with body composition phenotypes.DESIGN: Electrophoretic mobility shift assays for the functional studies and association analyses for the population studies.SUBJECTS AND METHODS:

G Argyropoulos; T Rankinen; F Bai; T Rice; M A Province; A S Leon; J S Skinner; J H Wilmore; D C Rao; C Bouchard



The OSBP-related protein family in humans  

Microsoft Academic Search

Oxysterols are oxygenated derivatives of cholesterol that have a number of biological effects and play a key role in the maintenance of the body cholesterol balance. In this study, we describe the cDNA sequences and genomic structures of the recently identified human oxysterol-binding protein (OSBP)-related protein (ORP) family (Laitinen, S. et al. 1999. J. Lipid Res. 40: 2204-2211). The family

Markku Lehto; Saara Laitinen; Giulia Chinetti; Marie Johansson; Christian Ehnholm; Bart Staels; Elina Ikonen; Vesa M. Olkkonen


Human resource involvement, job-related factors, and their relation with firm performance: experiences from Greece  

Microsoft Academic Search

A great deal of debate exists regarding the relationship between human resource (HR) practices and firm performance. The purpose of this paper is to examine the relationship between HR involvement in firm's strategic planning, job-related constructs (job characteristics, workplace characteristics, and satisfaction), and their impact on firm performance. A new research model is proposed exploring the above-mentioned relationships. The validity

Anastasios D. Diamantidis; Prodromos D. Chatzoglou



Millwright Apprenticeship. Related Training Modules. 6.1-6.12 Human Relations.  

ERIC Educational Resources Information Center

This packet, part of the instructional materials for the Oregon apprenticeship program for millwright training, contains 12 modules covering human relations. The modules provide information on the following topics: communications skills, feedback, individual strengths, interpersonal conflicts, group problem solving, goal setting and decision…

Lane Community Coll., Eugene, OR.


Representation of stable social dominance relations by human infants  

PubMed Central

What are the origins of humans’ capacity to represent social relations? We approached this question by studying human infants’ understanding of social dominance as a stable relation. We presented infants with interactions between animated agents in conflict situations. Studies 1 and 2 targeted expectations of stability of social dominance. They revealed that 15-mo-olds (and, to a lesser extent, 12-mo-olds) expect an asymmetric relationship between two agents to remain stable from one conflict to another. To do so, infants need to infer that one of the agents (the dominant) will consistently prevail when her goals conflict with those of the other (the subordinate). Study 3 and 4 targeted the format of infants’ representation of social dominance. In these studies, we found that 12- and 15-mo-olds did not extend their expectations of dominance to unobserved relationships, even when they could have been established by transitive inference. These results suggest that infants' expectation of stability originates from their representation of social dominance as a relationship between two agents rather than as an individual property. Infants’ demonstrated understanding of social dominance reflects the cognitive underpinning of humans’ capacity to represent social relations, which may be evolutionarily ancient, and may be shared with nonhuman species.

Mascaro, Olivier; Csibra, Gergely



DRUMS: a human disease related unique gene mutation search engine.  


With the completion of the human genome project and the development of new methods for gene variant detection, the integration of mutation data and its phenotypic consequences has become more important than ever. Among all available resources, locus-specific databases (LSDBs) curate one or more specific genes' mutation data along with high-quality phenotypes. Although some genotype-phenotype data from LSDB have been integrated into central databases little effort has been made to integrate all these data by a search engine approach. In this work, we have developed disease related unique gene mutation search engine (DRUMS), a search engine for human disease related unique gene mutation as a convenient tool for biologists or physicians to retrieve gene variant and related phenotype information. Gene variant and phenotype information were stored in a gene-centred relational database. Moreover, the relationships between mutations and diseases were indexed by the uniform resource identifier from LSDB, or another central database. By querying DRUMS, users can access the most popular mutation databases under one interface. DRUMS could be treated as a domain specific search engine. By using web crawling, indexing, and searching technologies, it provides a competitively efficient interface for searching and retrieving mutation data and their relationships to diseases. The present system is freely accessible at PMID:21913285

Li, Zuofeng; Liu, Xingnan; Wen, Jingran; Xu, Ye; Zhao, Xin; Li, Xuan; Liu, Lei; Zhang, Xiaoyan



Plasticity of the human auditory cortex related to musical training.  


During the last decades music neuroscience has become a rapidly growing field within the area of neuroscience. Music is particularly well suited for studying neuronal plasticity in the human brain because musical training is more complex and multimodal than most other daily life activities, and because prospective and professional musicians usually pursue the training with high and long-lasting commitment. Therefore, music has increasingly been used as a tool for the investigation of human cognition and its underlying brain mechanisms. Music relates to many brain functions like perception, action, cognition, emotion, learning and memory and therefore music is an ideal tool to investigate how the human brain is working and how different brain functions interact. Novel findings have been obtained in the field of induced cortical plasticity by musical training. The positive effects, which music in its various forms has in the healthy human brain are not only important in the framework of basic neuroscience, but they also will strongly affect the practices in neuro-rehabilitation. PMID:21763342

Pantev, Christo; Herholz, Sibylle C



Selective progesterone receptor modulators (SPRMs): a novel therapeutic concept in endometriosis.  


Endometriosis, the presence of endometrial tissue outside the uterus, is a progressive, estrogen-dependent disease and occurs nearly exclusively in menstruating women of reproductive age. Pain syndrome, however, represents the major clinical problem of this disease, manifested as dysmenorrhea, pelvic pain, lower abdominal pain, and dyspareunia. The manifestation of the disease, that is, the pain syndrome, rather than the disease itself currently represents the major indication for both the medical and surgical therapies of endometriosis. The major drawbacks of current medical therapies of endometriosis are sometimes severe side effects. In this review, selective progesterone receptor modulators (SPRMs, mesoprogestins) as a potential therapeutic concept in endometriosis are discussed. Due to endometrial selectivity and favorable pharmacological profile, SPRMs may have advantages over the current medical treatments of this disease. Other emerging therapeutic approaches for this disease are also mentioned. PMID:11949964

Chwalisz, Kristof; Garg, Ramesh; Brenner, Robert M; Schubert, Gerd; Elger, Walter



Unusual manifestations and complications of endometriosis--spectrum of imaging findings: self-assessment module.  


The educational objectives for this self-assessment module are for the participant to exercise, self-assess, and improve his or her understanding of the imaging spectrum of endometriosis. PMID:20489123

Bennett, Genevieve L; Slywotzky, Chrystia M; Cantera, Mariela; Hecht, Elizabeth M



Medical management of endometriosis: emerging evidence linking inflammation to disease pathophysiology.  


Progesterone action normally mediates the balance between anti-inflammatory and proinflammatory processes throughout the female reproductive tract. However, in women with endometriosis, endometrial progesterone resistance, characterized by alterations in progesterone responsive gene and protein expression, is now considered a central element in disease pathophysiology. Recent studies additionally suggest that the peritoneal microenvironment of endometriosis patients exhibits altered physiological characteristics that may further promote inflammation-driven disease development and progression. Within this review, we summarize our current understanding of the pathogenesis of endometriosis with an emphasis on the role that inflammation plays in generating not only the progesterone-resistant eutopic endometrium but also a peritoneal microenvironment that may contribute significantly to disease establishment. Viewing endometriosis from the emerging perspective that a progesterone resistant endometrium and an immunologically compromised peritoneal microenvironment are biologically linked risk factors for disease development provides a novel mechanistic framework to identify new therapeutic targets for appropriate medical management. PMID:23598784

Bruner-Tran, K L; Herington, J L; Duleba, A J; Taylor, H S; Osteen, K G



Single-nucleotide polymorphisms in the lysyl oxidase-like protein 4 and complement component 3 genes are associated with increased risk for endometriosis and endometriosis-associated infertility.  


This study was conducted to assess genetic associations with endometriosis in a Puerto Rican population. Statistically significant differences in the allelic frequencies and genotype distribution of genetic variants in lysyl oxidase-like protein 4 (LOXL4) and complement component 3 (C3) were documented in patients with endometriosis-associated infertility versus controls, and in patients with endometriosis versus controls, respectively. In women who have the risk genotype at both single-nucleotide polymorphisms, the estimated risk for endometriosis nearly doubled. PMID:21733505

Ruiz, Lynnette A; Dutil, Julie; Ruiz, Abigail; Fourquet, Jessica; Abac, Sonia; Laboy, Joaquín; Flores, Idhaliz



Perfluorooctanesulfonate and related fluorochemicals in human blood from several countries.  


Perfluorooctanesulfonyl fluoride based compounds have been used in a wide variety of consumer products, such as carpets, upholstery, and textiles. These compounds degrade to perfluorooctanesulfonate (PFOS), a persistent metabolite that accumulates in tissues of humans and wildlife. Previous studies have reported the occurrence of PFOS, perfluorohexanesulfonate (PFHxS), perfluorooctanoate (PFOA), and perfluorooctanesulfonamide (PFOSA) in human sera collected from the United States. In this study, concentrations of PFOS, PFHxS, PFOA, and PFOSA were measured in 473 human blood/serum/plasma samples collected from the United States, Colombia, Brazil, Belgium, Italy, Poland, India, Malaysia, and Korea. Among the four perfluorochemicals measured, PFOS was the predominant compound found in blood. Concentrations of PFOS were the highest in the samples collected from the United States and Poland (>30 ng/mL); moderate in Korea, Belgium, Malaysia, Brazil, Italy, and Colombia (3 to 29 ng/mL); and lowest in India (<3 ng/mL). PFOA was the next most abundant perfluorochemical in blood samples, although the frequency of occurrence of this compound was relatively low. No age- or gender-related differences in the concentrations of PFOS and PFOA were found in serum samples. The degree of association between the concentrations of four perfluorochemicals varied, depending on the origin of the samples. These results suggested the existence of sources with varying levels and compositions of perfluorochemicals, and differences in exposure patterns to these chemicals, in various countries. In addition to the four target fluorochemicals measured, qualitative analysis of selected blood samples showed the presence of other perfluorochemicals such as perfluorodecanesulfonate (PFDS), perfluoroheptanoic acid (PFHpA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorododecanoic acid (PFDoA), and perfluoroundecanoic acid (PFUnDA) in serum samples, at concentrations approximately 5- to 10-fold lower than the concentration of PFOS. Further studies should focus on identifying sources and pathways of human exposure to perfluorochemicals. PMID:15461154

Kannan, Kurunthachalam; Corsolini, Simonetta; Falandysz, Jerzy; Fillmann, Gilberto; Kumar, Kurunthachalam Senthil; Loganathan, Bommanna G; Mohd, Mustafa Ali; Olivero, Jesus; Van Wouwe, Nathalie; Yang, Jae Ho; Aldoust, Kenneth M



Mitochondrial Genome Variations in Advanced Stage Endometriosis: A Study in South Indian Population  

PubMed Central

Background Endometriosis is a chronic gynecological benign disease that shares several features similar to malignancy. Mitochondrial DNA (mtDNA) mutations have been reported in all most all types of tumors. However, it is not known as to whether mtDNA mutations are associated with endometriosis. Methodology We sequenced the entire mitochondrial genome of analogous ectopic and eutopic endometrial tissues along with blood samples from 32 advanced stage endometriosis patients to analyze the role of somatic and germ-line mtDNA variations in pathogenesis of endometriosis. All ectopic tissues were screened for tumor-specific mtDNA deletions and microsatellite instability (MSI). We also performed mtDNA haplogrouping in 128 patients and 90 controls to identify its possible association with endometriosis risk. Principal Findings We identified 51 somatic (novel: 31; reported: 20) and 583 germ-line mtDNA variations (novel: 53; reported: 530) in endometriosis patients. The A13603G, a novel missense mutation which leads to a substitution from serine to glycine at the codon 423 of ND5 gene showed 100% incidence in ectopic tissues. Interestingly, eutopic endometrium and peripheral leukocytes of all the patients showed heteroplasmy (A/G; 40–80%) at this locus, while their ectopic endometrium showed homoplasmic mutant allele (G/G). Superimposition of native and mutant structures of ND5 generated by homology modeling revealed no structural differences. Tumor-specific deletions and MSI were not observed in any of the ectopic tissues. Haplogrouping analysis showed a significant association between haplogroup M5 and endometriosis risk (P: 0.00069) after bonferroni correction. Conclusions Our findings substantiate the rationale for exploring the mitochondrial genome as a biomarker for the diagnosis of endometriosis.

Govatati, Suresh; Tipirisetti, Nageswara Rao; Perugu, Shyam; Kodati, Vijaya Lakshmi; Deenadayal, Mamata; Satti, Vishnupriya



Implementation of certified endometriosis centers: 5-year experience in German-speaking Europe.  


The idea of quality improvement in the management of endometriosis has been brought to attention throughout Europe. This - first and foremost - includes the implementation of centers specialized in treating endometriosis. This leads to qualification of both physicians and other medical staff, enforcement of research efforts, and informing the patients, the public, politicians, healthcare providers, and industry. Given limited budgets, focusing on the existing national commitment may be the first step. PMID:23391712

Ebert, A D; Ulrich, U; Keckstein, J; Müller, M; Schindler, A E; Sillem, M; Tinneberg, H-R; De Wilde, R L; Schweppe, K-W



Human parietofrontal networks related to action observation detected at rest.  


Recent data show a broad correspondence between human resting-state and task-related brain networks. We performed a functional magnetic resonance imaging (fMRI) study to compare, in the same subjects, the spatial independent component analysis (ICA) maps obtained at rest and during the observation of either reaching/grasping hand actions or matching static pictures. Two parietofrontal networks were identified by ICA from action observation task data. One network, specific to reaching/grasping observation, included portions of the anterior intraparietal cortex and of the dorsal and ventral lateral premotor cortices. A second network included more posterior portions of the parietal lobe, the dorsomedial frontal cortex, and more anterior and ventral parts, respectively, of the dorsal and ventral premotor cortices, extending toward Broca's area; this network was more generally related to the observation of hand action and static pictures. A good spatial correspondence was found between the 2 observation-related ICA maps and 2 ICA maps identified from resting-state data. The anatomical connectivity among the identified clusters was tested in the same volunteers, using persistent angular structure-MRI and deterministic tractography. These findings extend available knowledge of human parietofrontal circuits and further support the hypothesis of a persistent coherence within functionally relevant networks during rest. PMID:22275475

Molinari, Elisa; Baraldi, Patrizia; Campanella, Martina; Duzzi, Davide; Nocetti, Luca; Pagnoni, Giuseppe; Porro, Carlo A



I405V polymorphism of CETP gene and lipid profile in women with endometriosis.  


Genetic factors have an important role in the pathophysiology of endometriosis. In addition, abnormalities in lipid profile and intrinsic inflammatory status are associated with disease progression. The purpose of this study was to evaluate the effect of the I405V polymorphism of cholesteryl ester transfer protein (CETP) gene and lipid profile with the risk of endometriosis in women. Ninety-seven women with laparoscopy-diagnosed endometriosis were recruited for this study, and 107 patients with no evidence of endometriosis confirmed by laparoscopy served as controls. Samples were analyzed for polymorphism of the CETP gene using polymerase chain reaction-restriction fragment length polymorphism-based methods. After adjustment for body mass index, high-density lipoprotein-C and low-density lipoprotein-C, the risk of endometriosis in patients with normal genotype homozygous was more of the rare allele (p < 0.001, odds ratio = 0.21, 95% confidence interval = 0.09-0.45). Our results suggest that I405V polymorphism of CETP gene plays an important role as independent factor in the risk of endometriosis in women. PMID:23772784

Sahmani, Mehdi; Ghaleh, Talaat Dabbaghi; Darabi, Maryam; Darabi, Masoud; Rashvand, Zahra; Najafipour, Reza



Endometriosis in a rural remote setting: a cross-sectional study.  


Women in Western nations are exposed to an "unnatural" high number of menstrual cycles and this has been claimed to favour the development of endometriosis. If so, the prevalence of the disease should be low in remote rural settings characterized by high fertility rate, frequent teen-age pregnancy and protracted breast-feeding. To verify this hypothesis, we investigated the prevalence of endometriosis among women referring to the District Hospital of Aber, Northern Uganda for gynecological complaints. Subjects were considered affected if they had a history of surgery for endometriosis or if they had a positive clinical or ultrasound examination. Overall, a total of 528 gynecological consultancies were performed during the one year study period. Endometriosis was recorded in only one case. The frequency of the disease in the whole cohort of referred cases was thus 0.2% (95% confidence intervals (CI): 0.01-0.9%). When focusing on non-pregnant women in their reproductive age, it was 0.3% (95% CI: 0.01-1.3%). When considering women complaining symptoms suggestive for endometriosis, it was 0.4% (95% CI: 0.02-1.9%). In conclusion, endometriosis is rare in a community characterized by high fertility rate, frequent teen-age pregnancy and protracted breast-feeding, supporting the idea that the reproductive pattern plays a crucial role in the pathogenesis of the disease. PMID:22553964

Somigliana, Edgardo; Vigano, Paola; Benaglia, Laura; Crovetto, Francesca; Vercellini, Paolo; Fedele, Luigi



TP53 PIN3 and PEX4 polymorphisms and infertility associated with endometriosis or with post-in vitro fertilization implantation failure.  


p53 has a crucial role in human fertility by regulating the expression of leukemia inhibitory factor (LIF), a secreted cytokine critical for blastocyst implantation. To examine whether TP53 polymorphisms may be involved with in vitro fertilization (IVF) failure and endometriosis (END), we have assessed the associations between TP53 polymorphism in intron 2 (PIN2; G/C, intron 2), PIN3 (one (N, non-duplicated) or two (D, duplicated) repeats of a 16-bp motif, intron 3) and polymorphism in exon 4 (PEX4; C/G, p.P72R, exon 4) in 98 women with END and 115 women with post-IVF failure. In addition, 134 fertile women and 300 women unselected with respect to fertility-related features were assessed. TP53 polymorphisms and haplotypes were identified by amplification refractory mutation system polymerase chain reaction. TP53 PIN3 and PEX4 were associated with both END (P=0.042 and P=0.007, respectively) and IVF (P=0.004 and P=0.009, respectively) when compared with women both selected and unselected for fertility-related features. Haplotypes D-C and N-C were related to higher risk for END (P=0.002, P=0.001, respectively) and failure of IVF (P=0.018 and P=0.002, respectively) when compared with the Fertile group. These results support that specific TP53 haplotypes are associated with an increased risk of END-associated infertility and with post-IVF failure. PMID:23013791

Paskulin, D D; Cunha-Filho, J S L; Souza, C A B; Bortolini, M C; Hainaut, P; Ashton-Prolla, P



TP53 PIN3 and PEX4 polymorphisms and infertility associated with endometriosis or with post-in vitro fertilization implantation failure  

PubMed Central

p53 has a crucial role in human fertility by regulating the expression of leukemia inhibitory factor (LIF), a secreted cytokine critical for blastocyst implantation. To examine whether TP53 polymorphisms may be involved with in vitro fertilization (IVF) failure and endometriosis (END), we have assessed the associations between TP53 polymorphism in intron 2 (PIN2; G/C, intron 2), PIN3 (one (N, non-duplicated) or two (D, duplicated) repeats of a 16-bp motif, intron 3) and polymorphism in exon 4 (PEX4; C/G, p.P72R, exon 4) in 98 women with END and 115 women with post-IVF failure. In addition, 134 fertile women and 300 women unselected with respect to fertility-related features were assessed. TP53 polymorphisms and haplotypes were identified by amplification refractory mutation system polymerase chain reaction. TP53 PIN3 and PEX4 were associated with both END (P=0.042 and P=0.007, respectively) and IVF (P=0.004 and P=0.009, respectively) when compared with women both selected and unselected for fertility-related features. Haplotypes D-C and N-C were related to higher risk for END (P=0.002, P=0.001, respectively) and failure of IVF (P=0.018 and P=0.002, respectively) when compared with the Fertile group. These results support that specific TP53 haplotypes are associated with an increased risk of END-associated infertility and with post-IVF failure.

Paskulin, D D; Cunha-Filho, J S L; Souza, C A B; Bortolini, M C; Hainaut, P; Ashton-Prolla, P



Climate-related variation of the human nasal cavity.  


The nasal cavity is essential for humidifying and warming the air before it reaches the sensitive lungs. Because humans inhabit environments that can be seen as extreme from the perspective of respiratory function, nasal cavity shape is expected to show climatic adaptation. This study examines the relationship between modern human variation in the morphology of the nasal cavity and the climatic factors of temperature and vapor pressure, and tests the hypothesis that within increasingly demanding environments (colder and drier), nasal cavities will show features that enhance turbulence and air-wall contact to improve conditioning of the air. We use three-dimensional geometric morphometrics methods and multivariate statistics to model and analyze the shape of the bony nasal cavity of 10 modern human population samples from five climatic groups. We report significant correlations between nasal cavity shape and climatic variables of both temperature and humidity. Variation in nasal cavity shape is correlated with a cline from cold-dry climates to hot-humid climates, with a separate temperature and vapor pressure effect. The bony nasal cavity appears mostly associated with temperature, and the nasopharynx with humidity. The observed climate-related shape changes are functionally consistent with an increase in contact between air and mucosal tissue in cold-dry climates through greater turbulence during inspiration and a higher surface-to-volume ratio in the upper nasal cavity. PMID:21660932

Noback, Marlijn L; Harvati, Katerina; Spoor, Fred



Structural studies of human glioma pathogenesis-related protein 1  

PubMed Central

Human glioma pathogenesis-related protein 1 (GLIPR1) is a membrane protein that is highly upregulated in brain cancers but is barely detectable in normal brain tissue. GLIPR1 is composed of a signal peptide that directs its secretion, a conserved cysteine-rich CAP (cysteine-rich secretory proteins, antigen 5 and pathogenesis-related 1 proteins) domain and a transmembrane domain. GLIPR1 is currently being investigated as a candidate for prostate cancer gene therapy and for glioblastoma targeted therapy. Crystal structures of a truncated soluble domain of the human GLIPR1 protein (sGLIPR1) solved by molecular replacement using a truncated polyalanine search model of the CAP domain of stecrisp, a snake-venom cysteine-rich secretory protein (CRISP), are presented. The correct molecular-replacement solution could only be obtained by removing all loops from the search model. The native structure was refined to 1.85?Å resolution and that of a Zn2+ complex was refined to 2.2?Å resolution. The latter structure revealed that the putative binding cavity coordinates Zn2+ similarly to snake-venom CRISPs, which are involved in Zn2+-dependent mechanisms of inflammatory modulation. Both sGLIPR1 structures have extensive flexible loop/turn regions and unique charge distributions that were not observed in any of the previously reported CAP protein structures. A model is also proposed for the structure of full-length membrane-bound GLIPR1.

Asojo, Oluwatoyin A.; Koski, Raymond A.; Bonafe, Nathalie



Perfluorooctanesulfonate and related fluorochemicals in human blood samples from China.  


Perfluorooctanesulfonylfluoride (POSF)-based compounds have been manufactured and used in a variety of industrial applications. These compounds degrade to perfluorooctanesulfonate (PFOS) which is regarded as a persistent end-stage metabolite and is found to accumulate in tissues of humans and wildlife. PFOS, perfluorohexanesulfonate (PFHxS), perfluorooctanoate (PFOA), and perfluorooctanesulfonamide (PFOSA) have been found in human sera from the United States. In this study, concentrations of PFHxS, perfluorobutanesulfonate (PFBS), PFOS, perfluorohexanoic acid (PFHxA), PFOA, perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), and PFOSA were measured in 85 samples of whole human blood collected from nine cities (eight provinces) in China, including Shenyang (Liaoning), Beijing (Hebei), Zhengzhou (Henan), Jintan (Jiangsu), Wuhan (Hubei), Zhoushan (Zhejiang), Guiyang (Guizhou), Xiamen (Fujian), and Fuzhou (Fujian). Among the 10 perfluorinated compounds (PFCs) measured, PFOS was the predominant compound. The mean concentration of PFOS was greatest in samples collected from Shenyang (79.2 ng/mL) and least in samples from Jintan (3.72 ng/mL). PFHxS was the next most abundant perfluorochemical in the samples. No age-related differences in the concentrations of PFOA, PFOS, PFOSA, and PFHxS were observed. Gender-related differences were found,with males higher for PFOS and PFHxS, and females higher in PFUnDA. Concentrations of PFHxS were positively correlated with those of PFOS, while concentrations of PFNA, PFDA, and PFUnDA were positively correlated with those of PFOA. There were differences in the concentration profiles (percentage composition) of various PFCs in the samples among the nine cities. PMID:16509308

Yeung, Leo W Y; So, M K; Jiang, Guibin; Taniyasu, S; Yamashita, N; Song, Maoyong; Wu, Yongning; Li, Jingguang; Giesy, J P; Guruge, K S; Lam, Paul K S



Economic Burden of Human Papillomavirus-Related Diseases in Italy  

PubMed Central

Introduction Human papilloma virus (HPV) genotypes 6, 11, 16, and 18 impose a substantial burden of direct costs on the Italian National Health Service that has never been quantified fully. The main objective of the present study was to address this gap: (1) by estimating the total direct medical costs associated with nine major HPV-related diseases, namely invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, and head and neck, anogenital warts, and recurrent respiratory papillomatosis, and (2) by providing an aggregate measure of the total economic burden attributable to HPV 6, 11, 16, and 18 infection. Methods For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, and 18, in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection. Results The total direct costs (expressed in 2011 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €528.6 million, with a plausible range of €480.1–686.2 million. The fraction attributable to HPV 6, 11, 16, and 18 was €291.0 (range €274.5–315.7 million), accounting for approximately 55% of the total annual burden of HPV-related disease in Italy. Conclusions The results provided a plausible estimate of the significant economic burden imposed by the most prevalent HPV-related diseases on the Italian welfare system. The fraction of the total direct lifetime costs attributable to HPV 6, 11, 16, and 18 infections, and the economic burden of noncervical HPV-related diseases carried by men, were found to be cost drivers relevant to the making of informed decisions about future investments in programmes of HPV prevention.

Baio, Gianluca; Capone, Alessandro; Marcellusi, Andrea; Mennini, Francesco Saverio; Favato, Giampiero



Relative clock verifies endogenous bursts of human dynamics  

NASA Astrophysics Data System (ADS)

Temporal bursts are widely observed in many human-activated systems, which may result from both endogenous mechanisms like the highest-priority-first protocol and exogenous factors like the seasonality of activities. To distinguish the effects from different mechanisms is thus of theoretical significance. This letter reports a new timing method by using a relative clock, namely the time length between two consecutive events of an agent is counted as the number of other agents' events appeared during this interval. We propose a model, in which agents act either in a constant rate or with a power-law inter-event time distribution, and the global activity either keeps unchanged or varies periodically vs. time. Our analysis shows that the bursts caused by the heterogeneity of global activity can be eliminated by setting the relative clock, yet the bursts from real individual behaviors still exist. We perform extensive experiments on four large-scale systems, the search engine by AOL, a social bookmarking system —Delicious, a short-message communication network, and a microblogging system —Twitter. Seasonality of global activity is observed, yet the bursts cannot be eliminated by using the relative clock.

Zhou, Tao; Zhao, Zhi-Dan; Yang, Zimo; Zhou, Changsong



Calcitonin gene-related peptide receptors in human gastrointestinal epithelia.  

PubMed Central

1. The secretory responses to calcitonin gene-related peptide (CGRP) receptor agonists have been characterized in two human adenocarcinoma cell lines, namely HCA-7 and Colony-29 (Col-29) epithelia. These cells form polarized epithelial layers when grown on permeable supports and allow changes in electrogenic ion transport in response to agonists to be monitored continuously. 2. alpha-CGRP (rat and human sequences), rat beta-CGRP and human [Tyr0]CGRP applied to the basolateral surface were found to be full agonists, causing prolonged increases in short-circuit current. Concentration-response curves exhibited EC50 values of 0.6-1.5 nM in HCA-7 cells. The same agonists were less effective in Col-29 epithelia, the EC50 values ranging from 1 to 10 nM in these cells. [Cys(ACM)2,7]CGRP was effective in both cell lines and was more potent in HCA-7 cells. 3. CGRP receptors were preferentially located on the basolateral surface in both cell types. Addition of r alpha-CGRP to the apical domain produced significantly smaller secretory responses (8.1% in HCA-7 and 29.2% in Col-29) compared with those produced following basolateral application (100%). 4. In both cell lines r alpha-CGRP-elevated short-circuit current was inhibited by the loop diuretic piretanide (200 microM) and by somatostatin (100 nM). Pretreating epithelia with the cyclo-oxygenase inhibitor, piroxicam (5 microM) had no significant effect upon CGRP responses in either cell line. 5. Rat alpha-CGRP (0.2 nM) responses in HCA-7 epithelia were inhibited by the C-terminal fragment CGRP(8-37) (1 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

Cox, H M; Tough, I R



[Dinitrosyl iron complexes with glutathione recover rats with experimental endometriosis].  


The effect of binuclear dinitrosyl iron complexes (DNIC) with glutathione on endometrioid tumors in rats with experimental endometriosis has been studied. The latter was induced by an autotransplantation model, where two fragments of endometrium with myometrium (2 x 2 mm) from the left uterine horn was grafted to the inner surface of the anterior abdominal wall. The test animals received intraperitoneal injections of 0.5 ml DNIC-glutathione at the dose of 12.5 micromole per kg daily for 12 days 28 days after operation. The injections resulted in more than a 2-fold decrease in the total volume of both large tumors formed from grafts and small additive tumors formed nearby grafts. The disappearance of the additive tumors was also observed in test animals. The EPR signal with g(av) = 2.03 characteristic of protein bound DNIC with thiol-containing ligands was recorded in livers, graft and additive tumors of test and control animals pointing out intensive generation of nitric oxide in rats with experimental endometriosis. Ribonucleotide reductase activation discovered by doublet the EPR signal at g = 2.0 with 2.3 mT hyperfine structure splitting was found in small tumors. The cytotoxic effect of DNIC-glutathione on endometrioid tumors was suggested to be due to DNIC degradation nearby the tumors induced by iron chelating compounds released from the tumors. The degradation resulted in release of a high amount of nitric oxide molecules and nitrosonium ions from DNICs affecting the tumors by way of the cytotoxic effect. PMID:23755558

Adamian, L V; Burgova, E N; Tkachev, N A; Mikoian, V D; Stepanian, A A; Sonova, M M; Vanin, A F


HLA-G: A human pregnancy-related immunomodulator  

PubMed Central

In human pregnancies mothers and their embryo/fetuses are invariably genetically different. Thus, attenuation of the adaptive maternal immune response, which is programmed to reject “foreign” entities, is required for pregnancy to be initiated and maintained. Unexpectedly, given the propensity of the immune system to dispose of non-self entities, at least 50% of expected human pregnancies reliably go forward. This indicates that to a large extent, effective systems of tolerance have evolved. Although overlapping and redundant mechanisms of tolerance have been identified, production of HLA-G by trophoblast cells derived from the external trophectoderm layer of the blastocyst appears to be of major importance. At this point in time, no pregnancies in which all of the proteins derived from the HLA-G gene are absent have as yet been reported. Many studies have shown that both membrane-bound and soluble isoforms of the proteins derived from this HLA class Ib gene are produced by placental trophoblast cells, with consequences that include but are not restricted to immune suppression at the maternal-fetal interface. Here we report new studies that are leading to a better understanding of the HLA-G proteins, their unique structures, unusual modes of regulation, diverse functions and potential for use in diagnostic and therapeutic procedures related to suboptimal fertility in women.

Hunt, Joan S.; Langat, Daudi L.



Human and animal studies of schizophrenia-related gating deficits.  


Prepulse Inhibition (PPI) of the startle response and the P50 auditory-evoked potential suppression are used to assess impairments in the regulation of the neural substrates and to determine the clinical significance of inhibitory deficits in schizophrenia. The study of gating deficits in schizophrenia and in related animal model studies have already advanced our understanding of the neural substrates of information processing abnormalities in patients with schizophrenia. Individuals with schizotypal personality disorder as well as clinically unaffected family members of patients with schizophrenia show PPI and P50 suppression deficits. These "schizophrenic spectrum" populations are not grossly psychotic, nor are they receiving antipsychotic medications. Therefore, the gating deficits are presumed to reflect core (eg, intermediate phenotypic) schizophrenia-linked information processing abnormalities. Several studies have reported that gating deficits are associated with clinical ratings of psychiatric symptoms, thought disorder, and neuropsychologic deficits in patients with schizophrenia. In addition, recent human pharmacologic studies have indicated that gating deficits can be reversed by rationally-selected compounds. Animal model studies have generally shown convergence with the human studies and may lead to improved identification of efficacious new antipsychotic medications for patients with schizophrenia. PMID:11122903

Light, G A; Braff, D L



Human nonverbal discrimination of relative and absolute number.  


The nonverbal discrimination of relative and absolute number of sequential visual stimuli was investigated with humans in bisection, reproduction, and report tasks. Participants viewed a sequence of 40 red and black objects on each trial, randomly intermixed, and had to identify the number of red objects, which varied from 1 to 20. To prevent the use of a verbal-counting strategy, participants were required to name the objects as they appeared. The characteristics of human performance resembled those of pigeons in analogous procedures (Tan & Grace Learning and Behavior 38:408-417, 2010; Tan, Grace, Holland, & McLean Journal of Experimental Psychology 33:409-427, 2007): Average response number increased systematically with sample number, and bisection points were located at the arithmetic, not the geometric, mean. Additionally, in both the reproduction and report tasks, coefficients of variation decreased for values less than 6 but increased or remained constant for larger values, suggesting that different representations were used for small and large numbers. PMID:22038738

Tan, Lavinia; Grace, Randolph C



Human crew-related aspects for astrobiology research  

NASA Astrophysics Data System (ADS)

Several space agencies and exploration stakeholders have a strong interest in obtaining information on technical and human aspects to prepare for future extra-terrestrial planetary exploration. In this context, the EuroGeoMars campaign, organized with support from the International Lunar Exploration Working Group (ILEWG), the European Space Agency (ESA), the National Aeronautics and Space Administration (NASA) Ames Research Center and partner institutes, was conducted by the crews 76 and 77 in February 2009 in The Mars Society's ‘Mars Desert Research Station’ (MDRS) in Utah. The EuroGeoMars encompasses two groups of experiments: (1) a series of field science experiments that can be conducted from an extra-terrestrial planetary surface in geology, biology, astronomy/astrophysics and the necessary technology and networks to support these field investigations; (2) a series of human crew-related investigations on crew time organization in a planetary habitat, on the different functions and interfaces of this habitat, and on man-machine interfaces of science and technical equipment. This paper recalls the objective of the EuroGeoMars project and presents the MDRS and its habitat layout. Social and operational aspects during simulations are described. Technical and operational aspects of biology investigations in the field and in the habitat laboratory are discussed in detail with the focus point set on the polymerase chain reaction (PCR)-based detection of microbial DNA in soil samples.

Thiel, Cora S.; Pletser, Vladimir; Foing, Bernard



The bubble test: a new tool to improve the diagnosis of endometriosis.  


The objective of this study was to determine the clinical sensitivity and specificity of a bubbling phenomenon, including peritoneal surfaces, as a diagnostic test for endometriosis during laparoscopy. A prospectively controlled study of women with infertility of at least 1 year duration, who underwent laparoscopy, was conducted at a medical school-affiliated private infertility centre and research foundation. The study included 48 prospectively enrolled female infertility patients who underwent laparoscopy. Of these, 32 were found to suffer from endometriosis (group A) and 16 control patients did not show any evidence of disease (group B). The study involved the irrigation of the posterior cul-de-sac with short bursts of either saline or lactated Ringer's solution, utilizing a standard laparoscopic aspiration/irrigation system, and the subsequent observation for an excessive soap-like bubbling phenomenon (positive bubble test) in association with endometriosis. All 32 endometriosis patients (group A) demonstrated a positive bubble test. In contrast, only two of the 16 control patients (group B) were positive (P = 0.00242, Fisher's exact test; odds ratio, 8.000). A positive bubble test during laparoscopy was thus 100% sensitive and 88% specific for the diagnosis of endometriosis by laparoscopy, resulting in positive and negative predictive values of 94 and 100% respectively. Since the literature provides considerable evidence that the diagnosis of endometriosis during laparoscopy is frequently missed, a positive bubble test during laparoscopy therefore may be considered a reason to search further (possibly with biopsies) for endometriosis in the absence of obviously visible disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7650144

Gleicher, N; Karande, V; Rabin, D; Dudkiewicz, A; Pratt, D



Glycoconjugates and Related Molecules in Human Vascular Endothelial Cells  

PubMed Central

Vascular endothelial cells (ECs) form the inner lining of blood vessels. They are critically involved in many physiological functions, including control of vasomotor tone, blood cell trafficking, hemostatic balance, permeability, proliferation, survival, and immunity. It is considered that impairment of EC functions leads to the development of vascular diseases. The carbohydrate antigens carried by glycoconjugates (e.g., glycoproteins, glycosphingolipids, and proteoglycans) mainly present on the cell surface serve not only as marker molecules but also as functional molecules. Recent studies have revealed that the carbohydrate composition of the EC surface is critical for these cells to perform their physiological functions. In this paper, we consider the expression and functional roles of endogenous glycoconjugates and related molecules (galectins and glycan-degrading enzymes) in human ECs.

Toyoda, Masashi



Properties of human erythrocyte hexokinase related to cell age.  


The kinetic, electrophoretic and immunological properties of hexokinase from human erythrocytes have been studied in relation to cell age. No differences in kinetic behaviour between hexokinase partly purified from reticulocytes, 10% youngest cells, normal red cell population or from 10% oldest cells were observed. The stability of the enzyme preparations showed little differences; hexokinase from the 10% youngest cells was the most labile enzyme, followed respectively by the enzyme from reticulocytes, normal red cell population and the 10% oldest cells. The electrophoretic pattern of erythrocyte hexokinase changed during senescence. The hexokinase activity located in the second band from the anode is shifted to the third with increasing cell age. The molecular specific acitivity of the enzyme from the 10% youngest cells, the normal red cell population and the 10% oldest cells remains the same, while the molecular specific activity of hexokinase from reticulocytes was much lower. PMID:409574

Rijksen, G; Schoop, I; Staal, G E



Laparoscopic conservative management of ureteral endometriosis: a survey of eighty patients submitted to ureterolysis  

PubMed Central

Background this study aims to evaluate the effectiveness and safety of laparoscopic conservative management of ureteral endometriosis. Methods Eighty cases of histologically confirmed endometriosis affecting the ureter, 10 of which with bladder involvement were prospectively studied. In detail, patients were 13 women with ureteral stenosis (7 with hydronephrosis), 32 with circular lesions totally encasing the ureter, and 35 with endometriotic foci on the ureteral wall, but not completely encasing it. They were submitted to laparoscopic ureterolysis with or without partial cystectomy, ureteroneocistostomy. The rate of surgical complications, the recurrence rate, the patients' satisfaction rate was assessed during 22 months (median) follow-up. Results Laparoscopic ureterolysis was employed for all patients and set free the ureter from the disease in 95% of cases, whereas ureteroneocystostomy was necessary for 4 patients showing severe stenosis with hydronephrosis, among which 2 had intrinsic endometriosis of the ureteral muscularis. Three post-surgery ureteral fistulae occurred in cases with ureteral involvement longer than 4 cm: two cases were successfully treated placing double J catheter, the third needed ureteroneocistostomy. During follow-up, ureteral endometriosis recurred in 2 patients who consequently underwent ureteroneocystostomy. Most patients expressed high satisfaction rate throughout the whole follow-up period. Conclusion laparoscopic ureterolysis is effective and well tolerated in most cases of ureteral endometriosis. Ureteroneocystostomy is a better strategy for patients with extended (more than 4 cm) ureteral involvement or with severe stenosis with or without hydronephrosis.

Camanni, Marco; Bonino, Luca; Delpiano, Elena Maria; Berchialla, Paola; Migliaretti, Giuseppe; Revelli, Alberto; Deltetto, Francesco



Putting the pieces together: endometriosis blogs, cognitive authority, and collaborative information behavior*  

PubMed Central

Objective: A discourse analysis was conducted of peer-written blogs about the chronic illness endometriosis to understand how bloggers present information sources and make cases for and against the authority of those sources. Methods: Eleven blogs that were authored by endometriosis patients and focused exclusively or primarily on the authors' experiences with endometriosis were selected. After selecting segments in which the bloggers invoked forms of knowledge and sources of evidence, the text was discursively analyzed to reveal how bloggers establish and dispute the authority of the sources they invoke. Results: When discussing and refuting authority, the bloggers invoked many sources of evidence, including experiential, peer-provided, biomedical, and intuitive ones. Additionally, they made and disputed claims of cognitive authority via two interpretive repertoires: a concern about the role and interests of the pharmaceutical industry and an understanding of endometriosis as extremely idiosyncratic. Affective authority of information sources was also identified, which presented as social context, situational similarity, or aesthetic or spiritual factors. Conclusions: Endometriosis patients may find informational value in blogs, especially for affective support and epistemic experience. Traditional notions of authority might need to be revised for the online environment. Guidelines for evaluating the authority of consumer health information, informed by established readers' advisory practices, are suggested.

Neal, Diane M; McKenzie, Pamela J



Circulating Endothelial Progenitor Cells Are Up-Regulated in a Mouse Model of Endometriosis  

PubMed Central

Endometriosis is a debilitating disease characterized by the growth of ectopic endometrial tissue. It is widely accepted that angiogenesis plays an integral part in the establishment and growth of endometriotic lesions. Recent data from a variety of angiogenesis-dependent diseases suggest a critical role of bone marrow–derived endothelial progenitor cells (EPCs) in neovascularization. In this study we examined the blood levels of EPCs and mature circulating endothelial cells in a mouse model of surgically induced endometriosis. Fluorescence-activated cell sorting analysis revealed elevated levels of EPCs in the blood of mice with endometriosis compared with control subject that underwent a sham operation. EPC concentrations positively correlated with the amount of endometriotic tissue and peaked 1 to 4 days after induction of disease. In a green fluorescent protein bone marrow transplant experiment we found green fluorescent protein–positive endothelial cells incorporated into endometriotic lesions but not eutopic endometrium, as revealed by flow cytometry and immunohistochemistry. Finally, treatment of endometriosis-bearing mice with the angiogenesis inhibitor Lodamin, an oral nontoxic formulation of TNP-470, significantly decreased EPC levels while suppressing lesion growth. Taken together, our data indicate an important role for bone marrow–derived endothelial cells in the pathogenesis of endometriosis and support the potential clinical use of anti-angiogenic therapy as a novel treatment modality for this disease.

Becker, Christian M.; Beaudry, Paul; Funakoshi, Tae; Benny, Ofra; Zaslavsky, Alexander; Zurakowski, David; Folkman, Judah; D'Amato, Robert J.; Ryeom, Sandra



Proteomic identification of neurotrophins in the eutopic endometrium of women with endometriosis  

PubMed Central

Objective To evaluate neurotrophin (NT) expression in the endometrium of women with and without endometriosis Design Prospective, cross-sectional, translational study Setting Academic hospital Patient(s) Thirty-three reproductive age women undergoing laparoscopy for infertility, pelvic pain, intramural fibroids, or tubal ligation Intervention(s) Endometrial biopsies, protein microarrays, RT-PCR, ELISAs and Western blotting Main Outcome Measures Neurotrophin proteins and mRNAs in eutopic endometrial biopsies Results Among seven neurotrophic proteins detected on the antibody microarrays, RT-PCR analysis confirmed nerve growth factor (NGF), NT-4/5, and brain-derived neurotrophic factor (BDNF) mRNAs in endometrial tissue. Quantitative ELISAs revealed that NT-4/5 (806 ± 701 vs. 256 ± 190 pg/100 mg protein, P=0.04) and BDNF (121 ± 97 vs. 14 ± 11 ng/100 mg protein, P<0.01) concentrations were significantly higher in women with endometriosis. NGF (100 ± 74 vs. 93 ± 83 pg/100 mg protein) levels did not differ between cases and controls (P=0.83). Conclusions Neurotrophins are synthesized in situ within the endometrium. NT-4/5 and BDNF proteins were more concentrated in biopsies from endometriosis cases than controls, whereas NGF levels were similar. We hypothesize that the local production of NTs induces sensory innervation of endometrium of women with endometriosis. These NTs represent novel targets for the diagnosis and treatment of endometriosis.

Browne, Aimee S.; Yu, Jie; Huang, Ruo-Pan; Francisco, Antonio M. C.; Sidell, Neil; Taylor, Robert N.



Vitamin D binding protein plays an important role in the progression of endometriosis.  


Endometriosis, characterized by the growth of the endometrial gland and stroma outside the uterine cavity, is a gynecological disorder affecting 6?10% of women of reproductive age. However, the pathogenesis of endometriosis and the molecular mechanisms involved in the progression of this disease remain to be clarified. Therefore, in this study two-dimensional gel electrophoresis (2?DE) combined with mass spectrometry (MS) were applied to explore endometrial proteins with a role in the progression of endometriosis. Expression of global proteins in ectopic endometrial tissue (n=13; endometriosis group) was compared with that of the normal endometrial tissue (n=6; control group). Sixteen differently expressed proteins, including Vitamin D binding protein (DBP), with various functions were primarily identified in the ectopic endometrial tissue. DBP was confirmed to be significantly increased in the ectopic endometrial tissue compared with that in the normal endometrial tissue (P<0.05). Results of the present study therefore showed that DBP may play an important role in the progression of endometriosis. PMID:24064663

Hwang, Jin-Hee; Wang, Tao; Lee, Kyu-Sup; Joo, Jong-Kil; Lee, Hong-Gu



Relational frame theory and the experimental analysis of human sexuality  

Microsoft Academic Search

Behavior analysts have not been particularly active in the experimental analysis of human sexual behavior. This may be because the complexity of human sexuality suggests that it defies a molecular empirical analysis. Recent developments in the experimental analysis of complex behavior and language, however, have opened the way for a modern behavior-analytic research program into human sexual conduct. The present

Bryan Roche



Human axillary odor: are there side-related perceptual differences?  


Most studies on perception of human social odors in axillary sweat do not distinguish between samples from the right and left axillae. However, each axilla might not produce identical odor samples due, for instance, to the increased use of one arm as a result of lateralization. The aim of the present study was to test whether odor samples from the right and left axillae provided by right- and left-handed men were perceived differently by female raters. Participants were 38 males and 49 females, aged 19-35 years. Fresh odor samples (cotton pads worn underarm for 24 h) were evaluated for attractiveness, intensity, and masculinity, with left and right samples being presented as independent stimuli. A side-related difference emerged in left-handers only (no difference in right-handers): The odor from the axilla corresponding to the dominant side (left) was rated more masculine and more intense than the other side (right). This effect was limited to the ratings of a restricted group of females, that is, those who did not take hormone-based contraception and were estimated to be in the fertile phase of their menstrual cycle. In conclusion, future studies using axillary odor samples can consider left and right samples as perceptually equivalent stimuli when the participant samples are representative of the general population, which comprises relatively low proportions of left-handed men and spontaneously ovulating fertile women. The results also provide new evidence of the variation of female sensitivity to biologically relevant stimuli across the menstrual cycle. PMID:19556335

Ferdenzi, Camille; Schaal, Benoist; Roberts, S Craig



Global burden of human papillomavirus and related diseases.  


The worldwide prevalence of infection with human papillomavirus (HPV) in women without cervical abnormalities is 11-12% with higher rates in sub-Saharan Africa (24%), Eastern Europe (21%) and Latin America (16%). The two most prevalent types are HPV16 (3.2%) and HPV18 (1.4%). Prevalence increases in women with cervical pathology in proportion to the severity of the lesion reaching around 90% in women with grade 3 cervical intraepithelial neoplasia and invasive cancer. HPV infection has been identified as a definite human carcinogen for six types of cancer: cervix, penis, vulva, vagina, anus and oropharynx (including the base of the tongue and tonsils). Estimates of the incidence of these cancers for 2008 due to HPV infection have been calculated globally. Of the estimated 12.7 million cancers occurring in 2008, 610,000 (Population Attributable Fraction [PAF]=4.8%) could be attributed to HPV infection. The PAF varies substantially by geographic region and level of development, increasing to 6.9% in less developed regions of the world, 14.2% in sub-Saharan Africa and 15.5% in India, compared with 2.1% in more developed regions, 1.6% in Northern America and 1.2% in Australia/New Zealand. Cervical cancer, for which the PAF is estimated to be 100%, accounted for 530,000 (86.9%) of the HPV attributable cases with the other five cancer types accounting for the residual 80,000 cancers. Cervical cancer is the third most common female malignancy and shows a strong association with level of development, rates being at least four-fold higher in countries defined within the low ranking of the Human Development Index (HDI) compared with those in the very high category. Similar disparities are evident for 5-year survival-less than 20% in low HDI countries and more than 65% in very high countries. There are five-fold or greater differences in incidence between world regions. In those countries for which reliable temporal data are available, incidence rates appear to be consistently declining by approximately 2% per annum. There is, however, a lack of information from low HDI countries where screening is less likely to have been successfully implemented. Estimates of the projected incidence of cervical cancer in 2030, based solely on demographic factors, indicate a 2% increase in the global burden of cervical cancer, i.e., in balance with the current rate of decline. Due to the relative small numbers involved, it is difficult to discern temporal trends for the other cancers associated with HPV infection. Genital warts represent a sexually transmitted benign condition caused by HPV infection, especially HPV6 and HPV11. Reliable surveillance figures are difficult to obtain but data from developed countries indicate an annual incidence of 0.1 to 0.2% with a peak occurring at teenage and young adult ages. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. PMID:23199955

Forman, David; de Martel, Catherine; Lacey, Charles J; Soerjomataram, Isabelle; Lortet-Tieulent, Joannie; Bruni, Laia; Vignat, Jerome; Ferlay, Jacques; Bray, Freddie; Plummer, Martyn; Franceschi, Silvia



Error-related electrocorticographic activity in humans during continuous movements.  


Brain-machine interface (BMI) devices make errors in decoding. Detecting these errors online from neuronal activity can improve BMI performance by modifying the decoding algorithm and by correcting the errors made. Here, we study the neuronal correlates of two different types of errors which can both be employed in BMI: (i) the execution error, due to inaccurate decoding of the subjects' movement intention; (ii) the outcome error, due to not achieving the goal of the movement. We demonstrate that, in electrocorticographic (ECoG) recordings from the surface of the human brain, strong error-related neural responses (ERNRs) for both types of errors can be observed. ERNRs were present in the low and high frequency components of the ECoG signals, with both signal components carrying partially independent information. Moreover, the observed ERNRs can be used to discriminate between error types, with high accuracy (?83%) obtained already from single electrode signals. We found ERNRs in multiple cortical areas, including motor and somatosensory cortex. As the motor cortex is the primary target area for recording control signals for a BMI, an adaptive motor BMI utilizing these error signals may not require additional electrode implants in other brain areas. PMID:22326993

Milekovic, Tomislav; Ball, Tonio; Schulze-Bonhage, Andreas; Aertsen, Ad; Mehring, Carsten



Error-related electrocorticographic activity in humans during continuous movements  

NASA Astrophysics Data System (ADS)

Brain-machine interface (BMI) devices make errors in decoding. Detecting these errors online from neuronal activity can improve BMI performance by modifying the decoding algorithm and by correcting the errors made. Here, we study the neuronal correlates of two different types of errors which can both be employed in BMI: (i) the execution error, due to inaccurate decoding of the subjects’ movement intention; (ii) the outcome error, due to not achieving the goal of the movement. We demonstrate that, in electrocorticographic (ECoG) recordings from the surface of the human brain, strong error-related neural responses (ERNRs) for both types of errors can be observed. ERNRs were present in the low and high frequency components of the ECoG signals, with both signal components carrying partially independent information. Moreover, the observed ERNRs can be used to discriminate between error types, with high accuracy (?83%) obtained already from single electrode signals. We found ERNRs in multiple cortical areas, including motor and somatosensory cortex. As the motor cortex is the primary target area for recording control signals for a BMI, an adaptive motor BMI utilizing these error signals may not require additional electrode implants in other brain areas.

Milekovic, Tomislav; Ball, Tonio; Schulze-Bonhage, Andreas; Aertsen, Ad; Mehring, Carsten



Role of Estrogen Receptor Signaling Required for Endometriosis-Like Lesion Establishment in a Mouse Model  

PubMed Central

Endometriosis results from ectopic invasion of endometrial tissue within the peritoneal cavity. Aberrant levels of the estrogen receptor (ER), ER? and ER?, and higher incidence of autoimmune disorders are observed in women with endometriosis. An immunocompetent mouse model of endometriosis was used in which minced uterine tissue from a donor was dispersed into the peritoneal cavity of a recipient. Wild-type (WT), ER?-knockout (?ERKO), and ?ERKO mice were donors or recipients to investigate the roles of ER?, ER?, and estradiol-mediated signaling on endometriosis-like disease. Mice were treated with vehicle or estradiol, and resulting location, number, and size of endometriosis-like lesions were assessed. In comparison with WT lesions in WT hosts, ?ERKO lesions in WT hosts were smaller and fewer in number. The effect of ER status and estradiol treatment on nuclear receptor status, proliferation, organization, and inflammation within lesions were examined. ?ERKO lesions in WT hosts did not form distal to the incision site, respond to estradiol, or proliferate but did have increased inflammation. WT lesions in ?ERKO hosts did respond to estradiol, proliferate, and show decreased inflammation with treatment, but surprisingly, progesterone receptor expression and localization remained unchanged. Only minor differences were observed between WT lesions in ?ERKO hosts and ?ERKO lesions in WT hosts, demonstrating the estradiol-mediated signaling responses are predominately through ER?. In sum, these results suggest ER in both endometriosis-like lesions and their environment influence lesion characteristics, and understanding these interactions may play a critical role in elucidating this enigmatic disease.

Burns, Katherine A.; Rodriguez, Karina F.; Hewitt, Sylvia C.; Janardhan, Kyathanahalli S.; Young, Steven L.



Endometriosis of the lung: report of a case and literature review  

PubMed Central

This paper reports a case of endometriosis of the lung in a 29-year-old woman with long-term periodic catamenial hemoptysis. A chest computed tomography image obtained during menstruation revealed a radiographic opaque lesion in the lingular segment of the left superior lobe. During bronchoscopy, bleeding in the mucosa of the distal bronchus of the lingular segment of the left superior lobe was observed. Histopathology subsequent to an exploratory thoracotomy confirmed the diagnosis of endometriosis of the left lung. The 2-year follow-up after lingular lobectomy of the left superior lobe showed no recurrence or complications.



[Limited effect of gonadotrophin-releasing hormone analogues for patients with endometriosis].  


A Cochrane review concluded that gonadotrophin-releasing hormone analogues (GnRHas) are more effective at relieving endometriosis-associated pain than no treatment/placebo, while there was not found any difference in pain relief between GnRHas and danazol or between GnRHas and intrauterine levonorgestrel. A high frequency of hypoestrogenic side effects was found for GnRHas, since none of the studies included add-back therapy. This review confirmed that GnRHas can be used for endometriosis therapy, but first choice of medical treatment should be oral contraceptives or intrauterine levonorgestrel. PMID:22681992

Seyer-Hansen, Mikkel; Kruse, Christina



A Guide to Human Relations in Business and Industry.  

ERIC Educational Resources Information Center

This publication ranges from discussion of the reasons for human behavior to details important in effective selection and training of personnel. Divided into 15 chapters, the material covered includes such topics as Understanding Behavior, The Human Being on the Job, Training, Planning Work, and Handling Individual Problems. Intended primarily for…

Bruce, Martin M.



EPA Science Inventory

The effect of 'acid air' on human health was studied by considering the effects of hygroscopicity upon aerosol deposition in the lung as a function of human subject age. Children are a critical sub-population to be incorporated into health effects analyses following ambient expos...


The relations between neuroscience and human behavioral science.  

PubMed Central

Neuroscience seeks to understand how the human brain, perhaps the most complex electrochemical machine in the universe, works, in terms of molecules, membranes, cells and cell assemblies, development, plasticity, learning, memory, cognition, and behavior. The human behavioral sciences, in particular psychiatry and clinical psychology, deal with disorders of human behavior and mentation. The gap between neuroscience and the human behavioral sciences is still large. However, some major advances in neuroscience over the last two decades have diminished the span. This article reviews the major advances of neuroscience in six areas with relevance to the behavioral sciences: (a) evolution of the nervous system; (b) visualizing activity in the human brain; (c) plasticity of the cerebral cortex; (d) receptors, ion channels, and second/third messengers; (e) molecular genetic approaches; and (f) understanding integrative systems with networks and circadian clocks as examples.

Strumwasser, F



Statins Inhibit Monocyte Chemotactic Protein 1 Expression in Endometriosis  

PubMed Central

Statins are potent inhibitors of the endogenous mevalonate pathway. Besides inhibiting cholesterol biosynthesis, statins may also demonstrate anti-inflammatory properties. Inflammation is implicated in the attachment and invasion of endometrial cells to the peritoneal surface and growth of ectopic endometrium by inducing proliferation and angiogenesis. In this study, the effect of statins on monocyte chemotactic protein 1 (MCP-1) expression in endometriotic implants in nude mouse model and in cultured endometriotic cells was evaluated. In mouse model, simvastatin decreased MCP-1 expression in a dose-dependent manner in endometriotic implants (P < .05). Similarly, both simvastatin and mevastatin revealed a dose-dependent inhibition of MCP-1 production in cultured endometriotic cells (P < .01). This inhibitory effect of the statins on MCP-1 production was reversed by the downstream substrates of the mevalonate pathway. Moreover, statins decreased MCP-1 messenger RNA expression in cultured endometriotic cells (P < .05). In conclusion, statins exert anti-inflammatory effect in endometriotic cells and could provide a potential treatment of endometriosis in the future.

Cakmak, Hakan; Basar, Murat; Seval-Celik, Yasemin; Osteen, Kevin G.; Duleba, Antoni J.; Taylor, Hugh S.; Lockwood, Charles J.; Arici, Aydin



Involvement of the Wnt/?-Catenin Signaling Pathway in the Cellular and Molecular Mechanisms of Fibrosis in Endometriosis  

PubMed Central

Background During the development and progression of endometriotic lesions, excess fibrosis may lead to scarring, chronic pain, and altered tissue function. However, the cellular and molecular mechanisms of fibrosis in endometriosis remain to be clarified. Objectives The objective of the present study was to investigate whether the Wnt/?-catenin signaling pathway was involved in regulating the cellular and molecular mechanisms of fibrosis in endometriosis in vitro and to evaluate whether fibrosis could be prevented by targeting the Wnt/?-catenin pathway in a xenograft model of endometriosis in immunodeficient nude mice. Methods Seventy patients (40 with and 30 without endometriosis) with normal menstrual cycles were recruited. In vitro effects of small-molecule antagonists of the Tcf/?-catenin complex (PKF 115-584 and CGP049090) on fibrotic markers (alpha smooth muscle actin, type I collagen, connective tissue growth factor, fibronectin) and collagen gel contraction were evaluated in endometrial and endometriotic stromal cells from patients with endometriosis. In vitro effects of activation of the Wnt/?-catenin signaling pathway by treatment with recombinant Wnt3a on profibrotic responses were evaluated in endometrial stromal cells of patients without endometriosis. The effects of CGP049090 treatment on the fibrosis of endometriotic implants were evaluated in a xenograft model of endometriosis in immunodeficient nude mice. Results Treatment with PKF 115-584 and CGP049090 significantly decreased the expression of alpha smooth muscle actin, type I collagen, connective tissue growth factor and fibronectin mRNAs in both endometriotic and endometrial stromal cells with or without transforming growth factor-?1 stimulation. Both endometriotic and endometrial stromal cell-mediated contraction of collagen gels was significantly decreased by treatment with PKF 115-584 and CGP049090 as compared to that of untreated cells. The animal experiments showed that CGP049090 prevented the progression of fibrosis and reversed established fibrosis in endometriosis. Conclusion Aberrant activation of the Wnt/?-catenin pathway may be involved in mediating fibrogenesis in endometriosis.

Matsuzaki, Sachiko; Darcha, Claude



[The age-related characteristics of human mental work capacity].  


The aim of investigation was to study the ageing peculiarities of human mental working capacity with mathematical models. Were examined 150 women and 125 men in five aged groups: 13-18, 19-29, 30-39, 40-49, 50-60. The human mental activity was presented with special computer's tests. The regression ageing models for assessment of mental working capacity is proposed. The study showed that high level of human mental working capacity is determined with the decreasing of mental experience variation and the increasing of speed of remaking the information. PMID:10687072

Korobe?nikov, H V



Integrated Pharmacometrics and Systems Pharmacology Model-Based Analyses to Guide GnRH Receptor Modulator Development for Management of Endometriosis  

PubMed Central

Endometriosis is a gynecological condition resulting from proliferation of endometrial-like tissue outside the endometrial cavity. Estrogen suppression therapies, mediated through gonadotropin-releasing hormone (GnRH) modulation, decrease endometriotic implants and diminish associated pain albeit at the expense of bone mineral density (BMD) loss. Our goal was to provide model-based guidance for GnRH-modulating clinical programs intended for endometriosis management. This included developing an estrogen suppression target expected to provide symptomatic relief with minimal BMD loss and to evaluate end points and study durations supportive of efficient development decisions. An existing multiscale model of calcium and bone was adapted to include systematic estrogen pharmacologic effects to describe estrogen concentration-related effects on BMD. A logistic regression fit to patient-level data from three clinical GnRH agonist (nafarelin) studies described the relationship of estrogen with endometrial-related pain. Targeting estradiol between 20 and 40 pg/ml was predicted to provide efficacious endometrial pain response while minimizing BMD effects.

Riggs, M M; Bennetts, M; van der Graaf, P H; Martin, S W



[Social support and proper human relations in high school pupils in relation to psychosomatic disease prevention].  


The examination concerned 313 girls and boys from the second and third class of the secondary schools in Kraków. The translated German version questionnaire "Woman Self Image and Social Ideal" was used in the examination; mainly its parts such as: 1. "The social support" which includes 22 questions. 2. "Human Relations" which includes 64 questions. The five step scale of feeling was applied. One of the five possibilities was chosen by the examined persons and analysed. Stepwise regression was performed. More than half of the examined pupils have a good friend, who is helpful any time and who has never lets them down. They are relaxed with him, may discuss important problems and can give him charge over their home in their absence. 5% of the examined pupils could not share psychological problems with any friends and 10% could not count on house or flat care. 10% of pupils often felt as outsiders among other young people, while 1/3 did not experience such a feeling. The need of better understanding, care and support in the family and from close acquaintances was observed by 15%. Simultaneously only 14% claimed that relation in this matter were satisfactory. 19% of examined persons wanted more safety and friendship. Only 14% had a feeling of full safety. Juveniles most often claimed, that it is not difficult for them to buy a gift for another person (71% vs 2%), or cherish happiness of other people (67% vs 0.3%), and to express sympathy to others (65% vs 2.8%). More than half of the respondents judge themselves as non-aggressive against others, that they do not place their own needs above other peoples' needs, and that they are not afraid of contact with others. The frequency of choosing opposite extreme did not exceed 5% of the respondents. With the majority of questions we found a number of answers regarding discussed problem, ex. accepting orders from superiors (never--28%, sometimes--28%, average--21%, often--12%, very often--11%). In analogical proportions we found answers regarding such facts as a being strong and steady person, without bothering of hurting somebody's feelings or taking care of their own goals when anyone else is in need. We showed very differentiated, individual approach of examined adolescents to matters regarding their relations with people important for shaping their attitude towards life. It was also shown, that most of the 16-17 year old adolescents from Krakow enjoy a satisfactory relationship with people important in their lives, on the other hand, it is distressing that almost 20% of the examined pupils do not get enough support, care, safety and understanding either from their peers, families or adults. PMID:12418281

Kolarzyk, Emilia; Ostachowska-Gasior, Agnieszka; Kwiatkowski, Jacek



Matrix Metalloproteinases and Tace Play A Role in The Pathogenesis of Endometriosis  

Microsoft Academic Search

Endometriosis, a benign gynecologic disorder, occurs in about 10% of women in reproductive age and in up to 50 % of women with infertility. The basic etiologic factors causing this disease are unknown as yet. Matrix metalloproteinases (MMP) are involved in degradation of the extracellular matrix (ECM). Their proteolytic activity is regulated by tissue inhibitors of metalloproteinases (TIMPs). Tumor necrosis

Constanze Gottschalk; Kurt Malberg; Marco Arndt; Johannes Schmitt; Albert Roessner; Dagmar Schultze; Jürgen Kleinstein; Siegfried Ansorge


Discussion: 'Ovarian epithelial carcinoma with pelvic endometriosis,' by Wang et al.  


In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Wang S, Qui L, Lang JH, et al. Clinical analysis of ovarian epithelial carcinoma with coexisting pelvic endometriosis. PMID:23500450

Van Le, Linda; Jackson, Amanda; Schuler, Kevin; Suri, Anuj; Doll, Kemi; Stine, Jessica; Kim, Kenneth



Glucoregulatory Function in Adult Rhesus Macaques (Macaca mulatta) Undergoing Treatment with Medroxyprogesterone Acetate for Endometriosis  

PubMed Central

Endometriosis affects a large percentage of the rhesus macaques (Macaca mulatta) at our institution. When the disease is diagnosed in macaques on long-term research protocols, the treatment of choice in our facility is monthly administration of medroxyprogesterone acetate (MPA) to decrease estrogen release and subsequently diminish clinical signs associated with the disease. Because hormonal fluctuations associated with the normal menstrual cycle are known to affect parameters of glucoregulatory function in rhesus macaques, we evaluated the effect of MPA treatment on glucoregulatory function cross-sectionally in 6 animals and longitudinally in 4 animals with endometriosis. Our hypothesis was that monthly administration of MPA for the treatment of endometriosis would negatively affect glucoregulatory function in rhesus macaques. We found that adult female rhesus macaques on MPA therapy for 1.4 to 36.1 mo had lower insulin sensitivity than did age- and weight-matched healthy control animals. In addition, glucoregulatory function was reduced after MPA treatment as compared with pretreatment levels in a group of 4 macaques. These data suggest that glucoregulatory function should be considered when endometriosis treatment is planned for rhesus macaques.

Cruzen, Christina L; Baum, Scott T; Colman, Ricki J



Estrous changes in vaginal nociception in a rat model of endometriosis  

Microsoft Academic Search

A rat model of endometriosis, in which pieces of uterine horn (versus fat in controls) are autotransplanted into the abdomen where they form cysts, reduces fecundity and produces vaginal hyperalgesia. The cysts gradually enlarge over a 2-month period postsurgically and then plateau. Cysts regress with low estrogen levels and reappear when they rise. Based on the hypothesis that the vaginal

Angie M. Cason; Chad L. Samuelsen; Karen J. Berkley



Carcinosarcoma, endometrial intraepithelial carcinoma and endometriosis after tamoxifen therapy in breast cancer  

Microsoft Academic Search

The fourth case of heterologous mesodermal tumour of the uterine corpus, that developed 7 years following tamoxifen therapy for breast cancer in a postmenopausal woman with no previous pelvic irradiation, is presented with coincidental endometriosis and endometrial intraepithelial carcinoma. This coincidence after tamoxifen treatment appears to be an indication for the possible carcinogenic potency of tamoxifen.

M Friedrich; C Villena-Heinsen; D Mink; H Bonkhoff; W Schmidt



Endometriosis research: animal models for the study of a complex disease  

Microsoft Academic Search

Endometriosis is a common gynaecological disease that is characterized and defined as the presence of endometrial tissue outside the uterus, causing painful periods and subfertility in approximately 10% of women. After more than 50 years of research, little is known about the mechanisms underlying the development and establishment of this condition. Animal models allow us to study the temporal sequence

Irene Tirado-González; Gabriela Barrientos; Nadja Tariverdian; Petra C. Arck; Mariana G. García; Burghard F. Klapp; Sandra M. Blois



Elevated glycodelin-A concentrations in serum and peritoneal fluid of women with ovarian endometriosis.  


The aim of this study was to evaluate serum and peritoneal fluid (PF) glycodelin-A concentrations in women with ovarian endometriosis. Ninety-nine matched pairs of serum and PF samples were included in our study. The case group comprised 57 women with ovarian endometriosis and the control group 42 healthy women undergoing sterilization or patients with benign ovarian cysts. Glycodelin-A concentrations were measured using ELISA. Endometriosis patients had significantly higher serum and PF glycodelin-A concentrations compared to controls, and this increase was observed in both proliferative and secretory cycle phases. Glycodelin-A concentrations were more than 10-fold higher in PF than in serum and correlated with each other. Intensity and frequency of menstrual pain positively correlated with glycodelin-A concentrations. Sensitivity and specificity of glycodelin-A as a biomarker for ovarian endometriosis were 82.1% and 78.4% in serum, and 79.7% and 77.5% in PF, respectively. These results indicate that Glycodelin-A has a potential role as a biomarker to be used in combination with other, independent marker molecules. PMID:23461865

Kocbek, Vida; Vouk, Katja; Mueller, Michael D; Rižner, Tea Lanišnik; Bersinger, Nick A



Deregulation of LOXL1 and HTRA1 gene expression in endometriosis.  


Endometriosis is a gynecologic disease characterized by the presence of endometrial tissue outside the uterine cavity. Although 15% of the female population in reproductive age is affected by endometriosis, its pathogenesis remains unclear. According to the most accepted pathogenesis hypothesis, endometrial fragments from the menstrual phase are transported through the uterine tubes to the peritoneal cavity, where they undergo implantation and growth, invading adjacent tissues. However, the establishment of the disease requires that endometrial cells present molecular characteristics favoring the onset and progression of ectopic implantation. In this investigation, we analyzed the differential gene expression profiles of peritoneal and ovarian endometriotic lesions compared to the endometrial tissue of nonaffected women using rapid subtraction hybridization (RaSH). In our study, this method was applied to samples of endometriotic lesions from affected women and to biopsies of endometrium of healthy women without endometriosis, where we could identify 126 deregulated genes. To evaluate the expression of genes found by RaSH method, we measured LOXL1, HTRA1, and SPARC genes by real-time polymerase chain reaction. Significant different expression was obtained for HTRA1 and LOXL1, upregulated in the ectopic endometrium, suggesting that these genes are involved in the physiopathology of endometriosis and may favor the viability of endometrial cells at ectopic sites. PMID:20940247

Dentillo, Daniel Blassioli; Meola, Juliana; Rosa e Silva, Julio Cesar; Giuliatti, Silvana; Silva Junior, Wilson Araujo; Ferriani, Rui Alberto; Martelli, Lucia



The international endogene study: a collection of families for genetic research in endometriosis  

Microsoft Academic Search

Objective: The aim of the International Endogene Study is to discover genes that influence susceptibility to endometriosis.Design: The study brings together two research groups based in Australia and the United Kingdom that independently have been collecting families for linkage analysis and candidate gene studies. Both groups used similar methods to recruit families, obtain clinical notes, assign disease status based on

Susan Treloar; Ruth Hadfield; Grant Montgomery; Ann Lambert; Jacki Wicks; David H Barlow; Daniel T O’Connor; Stephen Kennedy



Understanding the human person from the standpoint of the relational sociology  

Microsoft Academic Search

This article deals with the question of how to conceptualize the human person as a living subject. The main difficulty consists on relating the single components of the human person to itself and to the external world. It is based on Margaret Archer's thesis about the shortcoming of modernity in dealing with the human person and the need for a

Pierpaolo Donati


Conceptual versus Competency Approach in Human Relations Training Programs.  

ERIC Educational Resources Information Center

|Examines how changes in the Carkhuff Human Resources Development (HRD) training model affect the acquisition of defined interpersonal discrimination and communication skills. Compares a competency-based with a conceptual-based training group. Findings support competency-based training as more effective. (Author)|

Cash, Robert W.; Vellema, Clara K.



Human health risk assessment related to cyanotoxins exposure.  


This review focuses on the risk assessment associated with human exposure to cyanotoxins, secondary metabolites of an ubiquitous group of photosynthetic procariota. Cyanobacteria occur especially in eutrophic inland and coastal surface waters, where under favorable conditions they attain high densities and may form blooms and scums. Cyanotoxins can be grouped according to their biological effects into hepatotoxins, neurotoxins, cytotoxins, and toxins with irritating potential, also acting on the gastrointestinal system. The chemical and toxicological properties of the main cyanotoxins, relevant for the evaluation of possible risks for human health, are presented. Humans may be exposed to cyanotoxins via several routes, with the oral one being by far the most important, occurring by ingesting contaminated drinking water, food, some dietary supplements, or water during recreational activities. Acute and short-term toxic effects have been associated in humans with exposure to high levels of cyanotoxins in drinking and bathing waters. However, the chronic exposure to low cyanotoxin levels remains a critical issue. This article identifies the actual risky exposure scenarios, provides toxicologically derived reference values, and discusses open issues and research needs. PMID:18259982

Funari, Enzo; Testai, Emanuela



Plasticity of the human auditory cortex related to musical training  

Microsoft Academic Search

During the last decades music neuroscience has become a rapidly growing field within the area of neuroscience. Music is particularly well suited for studying neuronal plasticity in the human brain because musical training is more complex and multimodal than most other daily life activities, and because prospective and professional musicians usually pursue the training with high and long-lasting commitment. Therefore,

Christo Pantev; Sibylle C. Herholz



Pyroelectricity in human skin related to physiological skin properties  

Microsoft Academic Search

The skin of living humans reacts to rapid changes of temperature, light, external electrical fields, hydrostatic pressure, and of uniaxial mechanical stress with voltage responses, which are analogous to the pyroelectric or piezoelectric voltage responses of pyroelectric materials. The electrical field dependence and the hydrostatic pressure dependence show strong non-linearity. The pyroelectric and the piezoelectric coefficients and their temperature dependence

H. Athenstaedt; H. Claussen; D. Schaper



Praxis and Pedagogy as Related to the Arts and Humanities  

ERIC Educational Resources Information Center

|Based on a review of its historical evolution and the contributions of significant writers in the field, this article addresses perennial questions of purpose, content and pedagogy in education in the arts and humanities and, more broadly, liberal education. Taking cognizance of the educational significance of service-learning and practical…

Mulcahy, D. G.



Adults' Knowledge and Behaviors Related to Human Papillomavirus Infection  

Microsoft Academic Search

Background: Our objective was to assess adults' knowledge, risk behaviors, and preference for infor- mation about human papillomavirus (HPV). Methods: A cross-sectional study using a self-administered questionnaire given in 3 locations (a uni- versity health service and 2 community family practice offices); 289 people completed the question- naire. The primary outcome measure was a knowledge score calculated from the responses

Bryan Holcomb; Joanne Motino Bailey; Kathleen Crawford; Mack T. Ruffin


A Relational Hermeneutical Approach to Human Rights Education  

ERIC Educational Resources Information Center

|This research is an effort to transcend the debate of universalism and cultural relativism by offering a new conceptualization of human rights. The conceptualization is presented through the development of a theoretical framework in the form of an epistemology. The research articulates and defends the epistemology, which is grounded on…

Al-Daraweesh, Fuad



Relative Over-Reactivity of Human versus Chimpanzee Lymphocytes: Implications for the Human Diseases Associated with Immune Activation  

PubMed Central

Although humans and chimpanzees share >99% identity in alignable protein sequences, they differ surprisingly in the incidence and severity of some common diseases. In general, humans infected with various viruses, such as HIV and hepatitis C virus, appear to develop stronger reactions and long-term complications. Humans also appear to suffer more from other diseases associated with over-reactivity of the adaptive immune system, such as asthma, psoriasis, and rheumatoid arthritis. In this study, we show that human T cells are more reactive than chimpanzee T cells to a wide variety of stimuli, including anti-TCR Abs of multiple isotypes, L-phytohemagglutin, Staphylococcus aureus superantigen, a superagonist anti-CD28 Ab, and in MLRs. We also extend this observation to B cells, again showing a human propensity to react more strongly to stimuli. Finally, we show a relative increase in activation markers and cytokine production in human lymphocytes in response to uridine-rich (viral-like) ssRNA. Thus, humans manifest a generalized lymphocyte over-reactivity relative to chimpanzees, a finding that is correlated with decreased levels of inhibitory sialic acid-recognizing Ig-superfamily lectins (Siglecs; particularly Siglec-5) on human T and B cells. Furthermore, Siglec-5 levels are upregulated by activation in chimpanzee but not human lymphocytes, and human T cell reactivity can be downmodulated by forced expression of Siglec-5. Thus, a key difference in the immune reactivity of chimp and human lymphocytes appears to be related to the differential expression of Siglec-5. Taken together, these data may help explain human propensities for diseases associated with excessive activation of the adaptive immune system.

Soto, Paula C.; Stein, Lance L.; Hurtado-Ziola, Nancy; Hedrick, Stephen M.; Varki, Ajit



'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis.  


Conservative surgical treatment for symptomatic endometriosis is frequently associated with only partial relief of pelvic pain or its recurrence. Therefore, medical therapy constitutes an important alternative or complement to surgery. However, no available compound is cytoreductive, and suppression instead of elimination of implants is the only realistic objective of pharmacological intervention. Because this implies prolonged periods of treatments, only medications with a favourable safety/tolerability/efficacy/cost profile should be chosen. In the past few years, innumerable new drugs for endometriosis, which would interfere with several hypothesized pathogenic mechanisms, have been studied and their use foreseen. However, robust evidence of in vivo safety and efficacy is lacking and, at the moment, the principal modality to interfere with endometriosis metabolism is still hormonal manipulation. Regrettably, in spite of consistent demonstration of a major effect on pain even in patients with deeply infiltrating lesions, progestins are underestimated and dismissed in favour of more scientifically fashionable and up-to-the-minute alternatives. Moreover, oral contraceptives (OCs) dramatically reduce the rate of post-operative endometrioma recurrence and should now be considered an essential part of long-term therapeutic strategies in order to limit further damage to future fertility. Finally, women who have used OC for prolonged periods will be protected from an increased risk of endometriosis-associated ovarian cancer. To avoid the several subtle modalities for distorting facts and orientating opinions in favour of specific compounds, progestins and monophasic OC used continuously are here proposed as the reference comparator in all future randomized controlled trials on medical treatment for endometriosis. PMID:21071490

Vercellini, Paolo; Crosignani, PierGiorgio; Somigliana, Edgardo; Viganò, Paola; Frattaruolo, Maria Pina; Fedele, Luigi



Steroids and protein markers in the follicular fluid as indicators of oocyte quality in patients with and without endometriosis  

Microsoft Academic Search

Purpose: To investigate the concentrations of steroid hormones (estradiol, progesterone), pregnancy–associated protein-A, IGF-binding protein-4 and leptin in the follicular fluid of infertile patients with and without endometriosis.

Dorothea M. Wunder; Michael D. Mueller; Martin H. Birkhäuser; Nick A. Bersinger



Study on real world relations among humans and objects using cellular phone and barcode  

Microsoft Academic Search

The purpose of this research is to find the methods for understanding our lifestyles by analyzing the relational network among humans and objects. We created a cellular phone application for use as our experimental system that can read barcodes. Users can describe the relations between humans and objects or objects and objects using this application. We experimented using this application

Akifumi Kimura; Ikki Ohmukai; Tomohiro Fukuhara; Hideaki Takeda


Association between ovarian endometriosis and malignancy in the peri-menopausal period: report of two cases and review of the literature  

Microsoft Academic Search

The association of endometriosis and ovarian malignancy is about 1%, with a peak incidence in patients over 45 years. The\\u000a best way of treating peri- and post-menopausal women with endometriosis is still a very controversial issue. We report two\\u000a cases of peri-menopausal women in which endometriosis was associated to ovarian malignancy. The first case was a 49-year-old\\u000a woman who underwent laparoscopic

Eugenio Volpi; Elisa Peano; Annamaria Ferrero; Luciano Mosso; Alberto Daniele; Piero Sismondi



Relating Human Genetic Variation to Variation in Drug Responses  

PubMed Central

Although sequencing a single human genome was a monumental effort a decade ago, more than one thousand genomes have now been sequenced. The task ahead lies in transforming this information into personalized treatment strategies that are tailored to the unique genetics of each individual. One important aspect of personalized medicine is patient-to-patient variation in drug response. Pharmacogenomics addresses this issue by seeking to identify genetic contributors to human variation in drug efficacy and toxicity. Here, we present a summary of the current status of this field, which has evolved from studies of single candidate genes to comprehensive genome-wide analyses. Additionally, we discuss the major challenges in translating this knowledge into a systems-level understanding of drug physiology with the ultimate goal of developing more effective personalized clinical treatment strategies.

Madian, Ashraf G.; Wheeler, Heather E.; Jones, Richard Baker; Dolan, M. Eileen



Human biometeorological evaluation of heat-related mortality in Vienna  

NASA Astrophysics Data System (ADS)

The relationship between heat stress and mortality in the federal state of Vienna (Austria) was analyzed from 1970 to 2007. Long-term trends of mortality data and short-term adaptation to heat stress were considered by two complex approaches. The evaluation is based on the human biometeorological parameter, physiologically equivalent temperature. The results revealed a significant impact of heat stress on the human health, with a significantly higher sensitivity on women compared to men. Additionally, higher risks of deaths due to cardiovascular and respiratory diseases were found. During the long period of 38 years, some significant decreases of the sensitivity were found, especially in the medium heat stress levels. This could indicate active processes of long-term adaptation to the increasing heat stress.

Matzarakis, Andreas; Muthers, Stefan; Koch, Elisabeth



Human biometeorological evaluation of heat-related mortality in Vienna  

NASA Astrophysics Data System (ADS)

The relationship between heat stress and mortality in the federal state of Vienna (Austria) was analyzed from 1970 to 2007. Long-term trends of mortality data and short-term adaptation to heat stress were considered by two complex approaches. The evaluation is based on the human biometeorological parameter, physiologically equivalent temperature. The results revealed a significant impact of heat stress on the human health, with a significantly higher sensitivity on women compared to men. Additionally, higher risks of deaths due to cardiovascular and respiratory diseases were found. During the long period of 38 years, some significant decreases of the sensitivity were found, especially in the medium heat stress levels. This could indicate active processes of long-term adaptation to the increasing heat stress.

Matzarakis, Andreas; Muthers, Stefan; Koch, Elisabeth



Quantitative Evaluation of the Effects of Human Carcinogens and Related Chemicals of Human Foreskin Fibroblasts.  

National Technical Information Service (NTIS)

Twelve compounds representative of diverse classes of chemicals were evaluated for their cytotoxicity and transforming ability of human skin fibroblasts in vitro in the presence and absence of human liver S-9 mix. In the absence of the human liver S-9 mix...

P. Kurian S. Nesnow G. E. Milo




EPA Science Inventory

We have evaluated 12 compounds representative of diverse classes of chemicals for their cytotoxicity and transforming ability of human skin fibroblasts in vitro in the presence and absence of human liver S-9 mix. n the absence of the human liver S-9 mix, only seven of the 12 comp...


Reward-related processing in the human brain: Developmental considerations  

Microsoft Academic Search

The pursuit of rewarding experiences motivates everyday human behavior, and can prove beneficial when pleasurable, positive consequences result (e.g., satisfying hunger, earning a paycheck). However, reward seeking may also be maladaptive and lead to risky decisions with potentially negative long-term consequences (e.g., unprotected sex, drug use). Such risky decision making is often observed during adolescence, a time in which important

Dominic S. Fareri; Laura N. Martin; Mauricio R. Delgado



Issues related to mineralized tissue biology in human evolutionary research  

Microsoft Academic Search

This comunication has two primary aims concerned with mineralized tissue biology (e.g. hard tissue biology of bone and tooth)\\u000a research in human evolutionary studies: First, to introduce the literature and the methods (at the time of this symposium)\\u000a so that one has an idea of the nature of this research and where one can go for details of the methodologies,

T. G. Bromage



Identification of Endocannabinoids and Related Compounds in Human Fat Cells  

Microsoft Academic Search

Objective: Recently, an activation of the endocannabinoid system during obesity has been reported. More particularly, it has been demonstrated that hypothalamic levels of both endocannabinoids, 2-arachidonoylglycerol and anandamide (N-arachidonoylethanolamine), are up-regulated in genetically obese rodents. Circulating levels of both endocannabinoids were also shown to be higher in obese compared with lean women. Yet, the direct production of endocannabinoids by human

Marie-Paule Gonthier; Laurence Hoareau; Franck Festy; Isabel Matias; Marta Valenti; Sandrine Bès-Houtmann; Claude Rouch; Christine Robert-Da Silva; Serge Chesne; Christian Lefebvre d’Hellencourt; Maya Césari; Vincenzo Di Marzo; Régis Roche



Ecological Integrity of Streams Related to Human Cancer Mortality Rates  

Microsoft Academic Search

Assessments of ecological integrity have become commonplace for biological conservation, but their role for public health\\u000a analysis remains largely unexplored. We tested the prediction that the ecological integrity of streams would provide an indicator\\u000a of human cancer mortality rates in West Virginia, USA. We characterized ecological integrity using an index of benthic macroinvertebrate\\u000a community structure (West Virginia Stream Condition Index,

Nathaniel P. Hitt; Michael Hendryx



Reward-related responses in the human striatum.  


Much of our knowledge of how reward information is processed in the brain comes from a rich animal literature. Recently, the advancement of neuroimaging techniques has allowed researchers to extend such investigations to the human brain. A common finding across species and methodologies is the involvement of the striatum, the input structure of the basal ganglia, in a circuit responsible for mediating goal-directed behavior. Central to this idea is the role of the striatum in the processing of affective stimuli, such as rewards and punishments. The goal of this article is to probe the human reward circuit, specifically the striatum and its subdivisions, with an emphasis on how the affective properties of outcomes or feedback influence the underlying neural activity and subsequent decision making. Discussion will first focus on anatomical and functional considerations regarding the striatum that have emerged from animal models. The rest of the article will center on how human neuroimaging studies map to findings from the animal literature, and how more recently, this research can be extended into the social and economic domains. PMID:17344522

Delgado, Mauricio R



Agents Blocking the Nuclear Factor-?B Pathway Are Effective Inhibitors of Endometriosis in an in vivo Experimental Model  

Microsoft Academic Search

Background: In vitro studies suggest that the transcription factor nuclear factor-kappa B (NF-?B) is implicated in the transduction of proinflammatory signals in endometriosis. The aim of this study was to investigate the involvement of NF-?B and the processes regulated by NF-?B in the initial development of endometriotic lesionsin vivo.Methods: Endometriosis was induced in nude mice by intraperitoneal injection of fluorescent-labeled

Reinaldo González-Ramos; Anne Van Langendonckt; Sylvie Defrère; Jean-Christophe Lousse; Marcel Mettlen; Alain Guillet; Jacques Donnez



Association study of the TNF-? -1031T/C and VEGF?+?450G/C polymorphisms with susceptibility to endometriosis.  


Abstract Tumor necrosis factor-? (TNF-?), a multifunctional proinflammatory cytokine, and vascular endothelial growth factor (VEGF), a major mediator of angiogenesis and vascular permeability, have been investigated in endometriosis patients of different populations. This study was carried out to investigate whether the two polymorphisms, TNF-? -1031T/C and VEGF?+?450G/C are associated with susceptibility to endometriosis in an Iranian population. Totally, 135 women with diagnosis of endometriosis and 173 women with no evidence of the disease were included in this study. The -1031T/C and +450G/C polymorphisms were assessed by PCR-RFLP analysis, using the two restriction enzymes BbsI and BsmFI, respectively. The frequencies of the TNF-? -1031TC genotype (p?=?0.038) and the -1031 C allele (p?=?0.048) were significantly lower in patients than control group. In contrast, no significant differences in the genotype and allele frequencies of the VEGF?+?450G/C polymorphism were found between the case and control groups. Our results suggest that the TNF-? -1031T/C polymorphism was associated with susceptibility to endometriosis in Iranian population, and the -1301C allele may have a protective role in development of endometriosis; On the contrary, we find no association between the VEGF?+?450G/C polymorphism and risk of endometriosis. PMID:23952049

Saliminejad, Kioomars; Memariani, Toktam; Ardekani, Ali M; Kamali, Koorosh; Edalatkhah, Haleh; Pahlevanzadeh, Zhamak; Khorram Khorshid, Hamid Reza



Genome-wide association study identifies a locus at 7p15.2 associated with endometriosis  

PubMed Central

Endometriosis is a common gynaecological disease associated with pelvic pain and sub-fertility. We conducted a genome-wide association (GWA) study in 3,194 surgically confirmed endometriosis cases and 7,060 controls from Australia and the UK. Polygenic predictive modelling showed significantly increased genetic loading among 1,364 cases with moderate-severe endometriosis. The strongest association signal was on 7p15.2 (rs12700667) for ‘all’ endometriosis (P = 2.6 × 10?7, OR = 1.22 (1.13-1.32)) and for moderate-severe disease (P = 1.5 × 10?9 (OR = 1.38 (1.24-1.53)). We replicated rs12700667 in an independent US cohort of 2,392 self-reported surgically confirmed endometriosis cases and 2,271 controls (P = 1.2 × 10?3, OR = 1.17 (1.06-1.28)), resulting in a genome-wide significant P-value of 1.4 × 10?9 (OR = 1.20 (1.13-1.27)) for ‘all’ endometriosis in our combined datasets of 5,586 cases and 9,331 controls. SNP rs12700667 is located in an inter-genic region upstream of plausible candidate genes NFE2L3 and HOXA10.

Painter, Jodie N.; Anderson, Carl A.; Nyholt, Dale R.; Macgregor, Stuart; Lin, Jianghai; Lee, Sang Hong; Lambert, Ann; Zhao, Zhen Z.; Roseman, Fenella; Guo, Qun; Gordon, Scott D.; Wallace, Leanne; Henders, Anjali K.; Visscher, Peter M.; Kraft, Peter; Martin, Nicholas G.; Morris, Andrew P.; Treloar, Susan A.; Kennedy, Stephen H.; Missmer, Stacey A.; Montgomery, Grant W.; Zondervan, Krina T.



Detection of multiple, novel reverse transcriptase coding sequences in human nucleic acids: relation to primate retroviruses  

SciTech Connect

A variety of chemically synthesized oligonucleotides designed on the basis of amino acid and/or nucleotide sequence data were used to detect a large number of novel reverse transcriptase coding sequences in human and mouse DNAs. Procedures involving Southern blotting, library screening, and the polymerase chain reaction were all used to detect such sequences; the polymerase chain reaction was the most rapid and productive approach. In the polymerase chain reaction, oligonucleotide mixtures based on consensus sequence homologies to reverse transcriptase coding sequences and unique oligonucleotides containing perfect homology to the coding sequences of human T-cell leukemia virus types I and II were both effective in amplifying reverse transcriptase-related DNA. It is shown that human DNA contains a wide spectrum of retrovirus-related reverse transcriptase coding sequences, including some that are clearly related to human T-cell leukemia virus types I and II, some that are related to the L-1 family of long interspersed nucleotide sequences, and others that are related to previously described human endogenous proviral DNAs. In addition, human T-cell leukemia virus type I-related sequences appear to be transcribed in both normal human T cells and in a cell line derived from a human teratocarcinoma.

Shih, A.; Misra, R.; Rush, M.G.



The relations between Technologies for Human Learning and Agents  

Microsoft Academic Search

In this position paper we review the historical emergence of Agents and the current developments around our integrated Web and Agent platform. The focus of the paper is to show that research results in Intelligent Tutoring and Learning Environments are strongly related to most of current hot issues in Agents and Agent Communication Languages, and vice- versa: that realistic dialogues

Daniele Maraschi; Stefano A. Cerri



Age related changes in accommodative dynamics in humans  

Microsoft Academic Search

Age related changes in the dynamics of accommodation (far to near focus) and disaccommodation (near to far focus) are reported in this study. Dynamic responses to step stimulus demands from 1 D to 6 D, in 1 D steps, were recorded with a PowerRefractor in 66 sub- jects in the age range 14-45 years. The accommodative and disaccommodative responses were

Sanjeev Kasthurirangan; Adrian Glasser



Human resource management and industrial relations in European companies  

Microsoft Academic Search

The paper explores the different patterns of labour relations in European companies. It is based on comparative research carried out in fifteen companies in Italy, France, Germany, Great Britain and Spain.In each country, three companies in the chemical, food-processing and engineering industries have been studied, through interviews with the company management as well as with workers' representatives. The starting point

Marino Regini



The meaning of work, employment relations, and strategic human resources management in Israel  

Microsoft Academic Search

The paper deals with the meaning of work, employment relations, and strategic human resources management. First it shows that Israeli workers have become more individualistic and materialistic, and less collectively oriented, as instrumental achievements outweigh contributions to society. These issues apparently influence employment relations and organizational policies. Next, it deals with the corporatist employment relations system, based on tri-partite collective

Itzhak Harpaz; Ilan Meshoulam



A chronic fatigue syndrome - related proteome in human cerebrospinal fluid  

PubMed Central

Background Chronic Fatigue Syndrome (CFS), Persian Gulf War Illness (PGI), and fibromyalgia are overlapping symptom complexes without objective markers or known pathophysiology. Neurological dysfunction is common. We assessed cerebrospinal fluid to find proteins that were differentially expressed in this CFS-spectrum of illnesses compared to control subjects. Methods Cerebrospinal fluid specimens from 10 CFS, 10 PGI, and 10 control subjects (50 ?l/subject) were pooled into one sample per group (cohort 1). Cohort 2 of 12 control and 9 CFS subjects had their fluids (200 ?l/subject) assessed individually. After trypsin digestion, peptides were analyzed by capillary chromatography, quadrupole-time-of-flight mass spectrometry, peptide sequencing, bioinformatic protein identification, and statistical analysis. Results Pooled CFS and PGI samples shared 20 proteins that were not detectable in the pooled control sample (cohort 1 CFS-related proteome). Multilogistic regression analysis (GLM) of cohort 2 detected 10 proteins that were shared by CFS individuals and the cohort 1 CFS-related proteome, but were not detected in control samples. Detection of ?1 of a select set of 5 CFS-related proteins predicted CFS status with 80% concordance (logistic model). The proteins were ?-1-macroglobulin, amyloid precursor-like protein 1, keratin 16, orosomucoid 2 and pigment epithelium-derived factor. Overall, 62 of 115 proteins were newly described. Conclusion This pilot study detected an identical set of central nervous system, innate immune and amyloidogenic proteins in cerebrospinal fluids from two independent cohorts of subjects with overlapping CFS, PGI and fibromyalgia. Although syndrome names and definitions were different, the proteome and presumed pathological mechanism(s) may be shared.

Baraniuk, James N; Casado, Begona; Maibach, Hilda; Clauw, Daniel J; Pannell, Lewis K; Hess S, Sonja



Studies of the SIM1 gene in relation to human obesity and obesity-related traits  

Microsoft Academic Search

Objective:The single-minded 1 (SIM1) is a basic helix–loop–helix transcription factor, which plays a critical role in the development of the paraventricular nucleus (PVN) of the hypothalamus. SIM1-deficient mice have a hypocellular PVN and are severely obese with increased food intake.Design:We examined whether variants in the SIM1 gene might be associated with severe early-onset obesity in humans. Two hundred and seventy-seven

C-C C Hung; J Luan; M Sims; J M Keogh; C Hall; N J Wareham; S O'Rahilly; I S Farooqi



Distinct roles of haptoglobin-related protein and apolipoprotein LI in trypanolysis by human serum  

Microsoft Academic Search

Apolipoprotein L-I (apoL-I) is a human high-density lipoprotein (HDL) component able to kill Trypanosoma brucei brucei by forming anion-selective pores in the lysosomal membrane of the parasite. Another HDL component, haptoglobin-related protein (Hpr), has been suggested as an additional toxin required for full trypanolytic activity of normal human serum. We recently reported the case of a human lacking apoL-I $({\\\\rm

Benoit Vanhollebeke; M. J. Nielsen; Yoshihisa Watanabe; Philippe Truc; Luc Vanhamme; Kazunori Nakajima; S. K. Moestrup; Etienne Pays



Is "Circling" Behavior in Humans Related to Postural Asymmetry?  

PubMed Central

In attempting to walk rectilinearly in the absence of visual landmarks, persons will gradually turn in a circle to eventually become lost. The aim of the present study was to provide insights into the possible underlying mechanisms of this behavior. For each subject (N?=?15) six trajectories were monitored during blindfolded walking in a large enclosed area to suppress external cues, and ground irregularities that may elicit unexpected changes in direction. There was a substantial variability from trial to trial for a given subject and between subjects who could either veer very early or relatively late. Of the total number of trials, 50% trajectories terminated on the left side, 39% on the right side and 11% were defined as “straight”. For each subject, we established a “turning score” that reflected his/her preferential side of veering. The turning score was found to be unrelated to any evident biomechanical asymmetry or functional dominance (eye, hand…). Posturographic analysis, used to assess if there was a relationship between functional postural asymmetry and veering revealed that the mean position of the center of foot pressure during balance tests was correlated with the turning score. Finally, we established that the mean position of the center of pressure was correlated with perceived verticality assessed by a subjective verticality test. Together, our results suggest that veering is related to a “sense of straight ahead” that could be shaped by vestibular inputs.

Bestaven, Emma; Guillaud, Etienne; Cazalets, Jean-Rene




Technology Transfer Automated Retrieval System (TEKTRAN)

To determine whether adipocyte differentiation-related protein (ADRP), a lipid droplet-associated protein that binds to and sequesters intracellular fatty acids, is 1) expressed in human skeletal muscle and 2) differentially regulated in human skeletal muscle obtained from obese non-diabetic (OND) a...


No Evidence of Murine Leukemia Virus-Related Viruses in Live Attenuated Human Vaccines  

Microsoft Academic Search

BackgroundThe association of xenotropic murine leukemia virus (MLV)-related virus (XMRV) in prostate cancer and chronic fatigue syndrome reported in previous studies remains controversial as these results have been questioned by recent data. Nonetheless, concerns have been raised regarding contamination of human vaccines as a possible source of introduction of XMRV and MLV into human populations. To address this possibility, we

William M. Switzer; HaoQiang Zheng; Graham Simmons; Yanchen Zhou; Shaohua Tang; Anupama Shankar; Beatrix Kapusinszky; Eric L. Delwart; Walid Heneine



Attitude Change Scores Of Middle School Student Participants In A One-Year Human Relations Program  

Microsoft Academic Search

Purpose. Desegregation of the public schools of the United States was mandated by the Brown Decisions of the Supreme Court in 1954 and 1955. The implementation of desegregation brought about many problems in human relations. To deal with these problems, additional educational programs, and personnel with additional knowledge of human behavior, and expertise in coping with differences in socio-economic, racial,

Orr Allen Eugene Sr



Sex-related variation in human behavior and the brain  

PubMed Central

Male and female fetuses differ in testosterone concentrations beginning as early as week 8 of gestation. This early hormone difference exerts permanent influences on brain development and behavior. Contemporary research shows that hormones are particularly important for the development of sex-typical childhood behavior, including toy choices, which until recently were thought to result solely from sociocultural influences. Prenatal testosterone exposure also appears to influence sexual orientation and gender identity, as well as some, but not all, sex-related cognitive, motor and personality characteristics. Neural mechanisms responsible for these hormone-induced behavioral outcomes are beginning to be identified, and current evidence suggests involvement of the hypothalamus and amygdala, as well as interhemispheric connectivity, and cortical areas involved in visual processing.

Hines, Melissa



The importance of being we: human nature and intergroup relations.  


The author discusses the nature of in-group bias and the social motives that underlie ethnocentric attachment to one's own membership groups. Two common assumptions about in-group bias are challenged: that in-group positivity necessitates out-group derogation and that in-group bias is motivated by self-enhancement. A review of relevant theory and research on intergroup relations provides evidence for 3 alternative principles: (a) in-group attachment and positivity are primary and independent of out-groups, (b) security motives (belonging and distinctiveness) underlie universal in-group favoritism, and (c) attitudes toward out-groups vary as a function of intergroup relationships and associated threats to belonging and distinctiveness PMID:18020737

Brewer, Marilynn B



Relative Viscosity and Specific Gravity of Human Blood During Cold Storage.  

National Technical Information Service (NTIS)

The objective of the research was to explore alterations in physical parameters, such as relative viscosity, specific gravity and density distribution of red cell population when human blood is stored under blood banking conditions for a prolonged period ...

F. DeVenuto S. M. Wilson C. V. Lowe



Feature Extraction of Event-Related Potentials Using Wavelets: An Application to Human Performance Monitoring.  

National Technical Information Service (NTIS)

This report describes the development and evaluation of mathematical models for predicting human performance from discrete wavelet transforms (DWT) of event-related potentials (ERP) elicited by task-relevant stimuli. The DWT was compared to principal comp...

L. J. Trejo M. J. Shensa



Guidelines for Roadless Area Campsite Spacing to Minimize Impact of Human-Related Noises.  

National Technical Information Service (NTIS)

This report offers guidelines for campsite spacing location in roadless areas to allow several levels of insulation from noise impacts between camping parties. The guidelines are based on the distance that different human-related noises travel in a variet...

T. Dailey D. Redman



Polymorphisms in the promoter regions of the matrix metalloproteinases-7, -9 and the risk of endometriosis and adenomyosis in China.  


Matrix metalloproteinases (MMPs) may contribute to the development of endometriosis. The aim of this study was to assess the effects of the polymorphisms in the promoters of MMP-7 (181A/G) and MMP-9 (1562C/T) on the risk of occurrence of endometriosis and adenomyosis. We genotyped 219 patients (143 women with endometriosis, 76 women with adenomyosis) and 160 control women in North China. There was a significant difference in frequency of the MMP-7 genotype between endometriosis and controls (P = 0.01) and also between adenomyosis and controls (P = 0.01). The frequency of the G allele in two groups of patients (7.3 and 7.9%) was significantly higher than in the controls (2.8%) (P = 0.01 and 0.01, respectively). Compared to the A/A genotype, the genotype with the -181G allele showed a significantly increased susceptibility to both diseases, with adjusted odds ratio of 2.62 [95% confidence interval (CI) = 1.17-5.87] for endometriosis and 3.14 (95% CI = 1.26-7.81) for adenomyosis. However, the overall genotype and allelotype distribution of the MMP-9 in the two case groups were not different from that of controls. We conclude that MMP-7-181A/G polymorphism has a potential to be a susceptibility factor for endometriosis and adenomyosis while MMP-9-1562C/T polymorphism may not provide a useful marker to predict susceptibility to endometriosis and adenomyosis, at least in women from North China. PMID:16455621

Shan, Kang; Lian-Fu, Zuo; Hui, Du; Wei, Guo; Na, Wang; Xia, Jin; Yan, Li



The effect of LHRH agonist therapy in the treatment of endometriosis (English experience).  


The preliminary findings of a comparative study of buserelin and danazol in the treatment of endometriosis are presented. Eighty patients with laparoscopically proven symptomatic endometriosis have been allocated at random to open treatment with intra-nasal buserelin or oral danazol. Forty-five patients have been assessed after completion of seven months treatment. Changes in endometriotic lesions have been examined by second laparoscopy and scored according to a modification of the criteria of the American Fertility Society (AFS). Both treatments were associated with reductions in modified AFS scores reflecting partial resolution of the condition. Adverse effects were reported with the use of both drugs, but appeared to be more extensive during therapy with danazol. Further evaluation and post treatment follow up are required. PMID:3097668

Jelley, R Y; Magill, P J



Intranasal treatment with luteinising hormone releasing hormone agonist in women with endometriosis.  


An agonist analogue of luteinising hormone releasing hormone (buserelin) was successfully used to treat women with endometriosis. A dose of 200 micrograms administered intranasally thrice daily was found to be effective in five patients, in whom the endometriotic lesions resolved after six months' treatment. Failure occurred in a sixth patient, who received only 400 micrograms once daily. Anovulation was induced in all subjects together with suppression of menstruation after the first month of treatment. Symptoms of abdominal pain, dysmenorrhoea, and dyspareunia were relieved during treatment, and one previously infertile patient conceived within two months of stopping treatment. No side effects were reported with this dosage, and the results suggest a new form of treatment for patients with endometriosis. PMID:6416542

Shaw, R W; Fraser, H M; Boyle, H



Intranasal treatment with luteinising hormone releasing hormone agonist in women with endometriosis.  

PubMed Central

An agonist analogue of luteinising hormone releasing hormone (buserelin) was successfully used to treat women with endometriosis. A dose of 200 micrograms administered intranasally thrice daily was found to be effective in five patients, in whom the endometriotic lesions resolved after six months' treatment. Failure occurred in a sixth patient, who received only 400 micrograms once daily. Anovulation was induced in all subjects together with suppression of menstruation after the first month of treatment. Symptoms of abdominal pain, dysmenorrhoea, and dyspareunia were relieved during treatment, and one previously infertile patient conceived within two months of stopping treatment. No side effects were reported with this dosage, and the results suggest a new form of treatment for patients with endometriosis.

Shaw, R W; Fraser, H M; Boyle, H



Black-white wage differential: The relative importance of human capital and labor market structure  

Microsoft Academic Search

This article uses the decomposition analysis developed by Neumark and the 1987 CPS data to investigate the relative importance\\u000a of human capital and labor market structure in explaining the observed wage differential between white males and blacks (both\\u000a male and female). We find that labor market structure, as opposed to differences in human capital, explains a relatively large\\u000a portion of

Kwabena Gyimah-Brempong; Rudy Fichtenbaum



The effects of levamisole on experimental endometriosis: a randomized controlled trial in a rat model.  


PURPOSE: To assess the effects of levamisole on experimental endometriosis in rats through the histopathology of the implants, the blood leukocyte and lymphocyte counts and the concentrations of interleukin-6, vascular endothelial growth factor-A and tumor necrosis factor-alpha in the peritoneal environment at the three healthy, endometriotic and post-treatment milestones. METHODS: Twenty-two 8-week-old Sprague-Dawley rats with normal estrus cycles were recruited in a prospective, parallel-group, placebo-controlled, double-blind, stratified-randomized animal trial with the equal allocation ratio of 1:1 challenging the efficacy of levamisole. Endometriosis was induced. After 6 weeks, laparotomy was performed to randomly excise one implant for histopathology assessment. Based on the results, they were stratified randomized and allocated (by software) to two groups of nine: levamisole (5 mg/rat/day) or placebo. After 6 weeks, necropsy was done. Two days before each laparotomy, blood samples and during the procedure, peritoneal wash were collected for ELISA. RESULTS: Seven rats showed success in treatment in the levamisole group, while three did in the other group. The histopathology results descriptively revealed a drop in the levamisole group, which was not meaningful statistically (0.66 ± 1.32 vs. 2.00 ± 1.50, p = 0.065). The comparisons of the post-treatment leukocytes and lymphocytes in the groups showed significant differences (11088.88 ± 5869.50 vs. 4677.77 ± 3476.98, p = 0.008, and 8588.88 ± 5721.32 vs. 3511.11 ± 2835.24, p = 0.014, respectively). The results of the cytokines were mostly, but not completely, in favor of the efficacy of levamisole. CONCLUSION: This study indicates a possible successful role for levamisole in the treatment of experimental endometriosis. Further studies to assess the effects of high dose levamisole on endometriosis are recommended. PMID:23712737

Azimirad, Afshin; Alborzi, Saeed; Kumar, Perikala Vijayananda; Zarei, Afsoon; Azimirad, Mina



High plasma concentrations of di-(2-ethylhexyl)-phthalate in women with endometriosis  

Microsoft Academic Search

BACKGROUND: Emerging evidence suggests a potential role for ubiquitous environmental contaminants in the physiopathology of endometriosis. Di-(2-ethylhexyl)-phthalate (DEHP), the most commonly used plasticizer in flex- ible polyvinylchloride (PVC) formulations, is a widespread environmental contaminant with potentially adverse effects on fertility in animal models. In the present study, we tested the hypothesis that DEHP and\\/or and its main metabolite, mono-ethylhexyl phthalate

L. Cobellis; G. Latini; C. DeFelice; S. Razzi; F. Ruggieri; P. Mazzeo; F. Petraglia



Selective Progesterone Receptor Modulator Development and Use in the Treatment of Leiomyomata and Endometriosis  

Microsoft Academic Search

Selective progesterone receptor modulators (SPRMs) rep- resent a new class of progesterone receptor ligands. SPRMs exert clinically relevant tissue-selective progesterone ago- nist, antagonist, or mixed agonist\\/antagonist effects on var- ious progesterone target tissues in vivo. Asoprisnil (J867) is the first SPRM to reach an advanced stage of clinical de- velopment for the treatment of symptomatic uterine fi- broids and endometriosis.

Kristof Chwalisz; Maria Claudia Perez; Deborah DeManno; Craig Winkel; Gerd Schubert; Walter Elger



Intercellular Adhesion Molecule1 and Interleukin6 Gene Polymorphisms in Patients with Advanced-Stage Endometriosis  

Microsoft Academic Search

Background\\/Aims: The aim of this study was to investigate the possibility that the K469E and G241R polymorphisms in the intercellular adhesion molecule-1 (ICAM-1) gene and the C-634G polymorphism in the interleukin (IL)-6 gene are associated with endometriosis in the Korean population. Methods: The ICAM-1 gene K469E and G241R polymorphisms and the IL-6 gene C-634G polymorphism were evaluated in 390 patients

Soo Jin Chae; Gyoung Hoon Lee; Young Min Choi; Min A Hong; Jong Mee Kim; Kyu Sup Lee; Seung Yup Ku; Shin Yong Moon



Pregnancy outcome after IVF and ICSI in unexplained, endometriosis-associated and tubal factor infertility  

Microsoft Academic Search

with IVF or ICSI complied with the inclusion criteria. RESULTS: Live birth rate, twin birth rate after transfer of two embryos and abortion rate prior to 6 weeks of gestation were superior for the unexplained (78.8, 23.5 and 11.7%) compared to endometriosis-associated (66.0, 15.0 and 19.3%) and tubal factor (66.7, 18.1 and 18.0%) infer- tility groups ( P< 0.05). Compared

Anne K. Omland; Thomas Abyholm; Peter Fedorcsak; Gudvor Ertzeid; Nan B. Oldereid; Sverre Bjercke; Tom Tanbo



Aromatase: a key molecule in the pathophysiology of endometriosis and a therapeutic target  

Microsoft Academic Search

Objective: To provide a clinically useful model illustrating the molecular aberrations affecting estrogen biosynthesis and metabolism in endometriosis and to discuss the therapeutic role of aromatase inhibitors.Design: Literature review.Result(s): Several molecular aberrations were found in endometriotic lesions (in contrast to eutopic endometrium) that favor increased local concentrations of E2. Endometriotic stromal cells aberrantly express aromatase, which converts C19 steroids to

Khaled M Zeitoun; Serdar E Bulun



[Endometriosis of the terminal ileum: differential diagnosis to the Crohn's disease (author's transl)].  


We report on the clinical course of a 30 year old female patient with endometriosis of the terminal ileum. The course was complicated by development of intestinal abscesses, entero-cutaneous and entero-vesical fistulas and stenosis of the terminalö ileum. A diagnosis of Morbus Crohn was made and was only corrected after the patient had to be operated upon because of mechanical obstruction of the terminal ileum. The problems of diagnosis and management are presented. PMID:7234032

Hütteroth, T H; Beger, H G; Schnoy, N; Eckhardt, R; Meyer zum Büschenfelde, K H



Is helium thermal coagulator therapy for the treatment of women with minimal to moderate endometriosis cost-effective? A prospective randomised controlled trial  

Microsoft Academic Search

This study compared the cost and time involved of helium thermal coagulator (HTC) treatment with medical therapy using gonadotrophin-releasing hormone analogues in women with minimal to moderate endometriosis. In a prospective randomised controlled trial, 35 women with history of pain were, upon confirmation of minimal to moderate endometriosis at diagnostic laparoscopy, randomised to immediate surgical or medical treatment. They were

S. Lalchandani; A. Baxter; K. Phillips



Nuclear Factor-?B (NF-?B): An Unsuspected Major Culprit in the Pathogenesis of Endometriosis That Is Still at Large?  

Microsoft Academic Search

Endometriosis, defined as the ectopic presence of endometrial glandular and stromal cells outside the uterine cavity, is a common benign gynecological disorder with an enigmatic pathogenesis. Many genes and gene products have been reported to be altered in endometriosis, yet some of them may not be major culprits but merely unwitting accomplices or even innocent bystanders. Therefore, the identification and

Sun-Wei Guo



A Novel Human Polyomavirus Closely Related to the African Green Monkey-Derived Lymphotropic Polyomavirus?†  

PubMed Central

We identified a novel human polyomavirus from a kidney transplant patient under immunosuppressive treatment, by use of a generic PCR. The genome of the virus was completely amplified and sequenced. In phylogenetic analyses, it appeared as the closest relative to the African green monkey-derived lymphotropic polyomavirus (LPV). Further investigation of clinical samples from immunocompromised patients with specific nested PCR revealed additional positive samples, indicating that the virus naturally infects humans. The virus was tentatively named human polyomavirus 9 (HPyV9). The previously observed seroreactivity to LPV in human populations might find a partial explanation in the circulation of HPyV9.

Scuda, Nelly; Hofmann, Jorg; Calvignac-Spencer, Sebastien; Ruprecht, Klemens; Liman, Peter; Kuhn, Joachim; Hengel, Hartmut; Ehlers, Bernhard



Genome-wide association meta-analysis identifies new endometriosis risk loci  

PubMed Central

We conducted a genome-wide association (GWA) meta-analysis of 4,604 endometriosis cases and 9,393 controls of Japanese1 and European2 ancestry. We show that rs12700667 on chromosome 7p15.2, previously found in Europeans, replicates in Japanese (P = 3.6 × 10?3), and confirm association of rs7521902 on 1p36.12 near WNT4. In addition, we establish association of rs13394619 in GREB1 on 2p25.1 and identify a novel locus on 12q22 near VEZT (rs10859871). Excluding European cases with minimal or unknown severity, we identified additional novel loci on 2p14 (rs4141819), 6p22.3 (rs7739264) and 9p21.3 (rs1537377). All seven SNP effects were replicated in an independent cohort and produced P < 5 × 10?8 in a combined analysis. Finally, we found a significant overlap in polygenic risk for endometriosis between the European and Japanese GWA cohorts (P = 8.8 × 10?11), indicating that many weakly associated SNPs represent true endometriosis risk loci and risk prediction and future targeted disease therapy may be transferred across these populations.

Nyholt, Dale R.; Low, Siew-Kee; Anderson, Carl A.; Painter, Jodie N.; Uno, Satoko; Morris, Andrew P.; MacGregor, Stuart; Gordon, Scott D.; Henders, Anjali K.; Martin, Nicholas G.; Attia, John; Holliday, Elizabeth G.; McEvoy, Mark; Scott, Rodney J.; Kennedy, Stephen H.; Treloar, Susan A.; Missmer, Stacey A.; Adachi, Sosuke; Tanaka, Kenichi; Nakamura, Yusuke; Zondervan, Krina T.; Zembutsu, Hitoshi; Montgomery, Grant W.



Oral contraceptive pills for endometriosis after conservative surgery: a systematic review and meta-analysis.  


Abstract To assess the effects of oral contraceptive pills (OCPs) for endometriosis in women after conservative surgery, we performed a search of PubMed, Embase, ISI Web of Science, Cochrane Library, Scidirect, Chinese VIP, CNKI and WANGFANG database. Randomized controlled trials (RCTs) of OCPs in postoperative medical therapy for endometriosis were collected. Articles published as of January 2013 with no language restriction were identified using defined keywords, and 15 studies comprising 1850 patients were included. There was a significantly higher rate of total endometriosis remission [OR?=?2.55, 95% CI (1.68, 3.86), p?

Wu, Lixia; Wu, Qianyu; Liu, Lan



Physical therapy and psychological intervention normalize cortisol levels and improve vitality in women with endometriosis.  


There is as yet no effective treatment for endometriosis. The objective of this study was to evaluate the effectiveness of submitting women with endometriosis and chronic pelvic pain to a therapeutic protocol involving physical and psychological therapy. Twenty-six female volunteers were submitted to a treatment protocol consisting of 2.5-h sessions, once a week for 10 weeks. We applied a Visual Analogue Scale, the Perceived Stress Questionnaire (PSQ), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Morning, afternoon, and evening levels of cortisol were determined in saliva samples. The PSQ scores were significantly lower after treatment, whereas the scores for the SF-36 vitality and physical functioning domains were significantly higher. Salivary cortisol levels were higher after treatment in the samples collected in the morning, but not in those collected in the afternoon or evening. The post-treatment cortisol levels were similar to those reported for healthy women. There were positive correlations between vitality, role emotional, social functioning, and mental health, and negative correlations to perceived stress. In conclusion, the physical and psychological intervention protocol applied in this study to women suffering of endometriosis was effective in reducing perceived stress, normalizing cortisol levels, increasing vitality and improving physical functioning. PMID:23094607

Friggi Sebe Petrelluzzi, Karina; Garcia, Marcia Carvalho; Petta, Carlos Alberto; Ribeiro, Daniel Araki; de Oliveira Monteiro, Nancy Ramacciotti; Céspedes, Isabel Cristina; Spadari, Regina Celia



The mTOR/AKT Inhibitor Temsirolimus Prevents Deep Infiltrating Endometriosis in Mice  

PubMed Central

Deep infiltrating endometriosis (DIE) is a particular clinical and histological entity of endometriosis responsible for chronic pelvic pain and infertility. Here we characterize the proliferative phenotype of DIE cells, to explore the cellular and molecular mechanisms that could explain their aggressive potential. In addition, the inhibition of mTOR/AKT pathway was tested, as a potential treatment of DIE. Included were 22 patients with DIE and 12 control patients without endometriosis. Epithelial and stromal cells were extracted from biopsies of eutopic endometrium and deep infiltrating endometriotic nodules from patients with DIE. Cell proliferation was determined by thymidine incorporation. Oxidative stress was assayed by spectrofluorometry. The ERK and mTOR/AKT pathways were analyzed in vitro by Western blot and for AKT in vivo in a mouse model of DIE. The proliferation rate of eutopic endometrial cells and of deep infiltrating endometriotic cells from DIE patients was higher than that of endometrial cells from controls. The hyperproliferative phenotype of endometriotic cells was associated with an increase in endogenous oxidative stress, and with activation of the ERK and mTOR/AKT pathways. mTOR/AKT inhibition by temsirolimus decreased endometriotic cell proliferation both in vitro and in vivo in a mouse model of DIE. Blocking the mTOR/AKT pathway offers new prospects for the treatment of DIE.

Leconte, Mahaut; Nicco, Carole; Ngo, Charlotte; Chereau, Christiane; Chouzenoux, Sandrine; Marut, Wioleta; Guibourdenche, Jean; Arkwright, Sylviane; Weill, Bernard; Chapron, Charles; Dousset, Bertrand; Batteux, Frederic



38 CFR 1.486 - Disclosure of information related to infection with the human immunodeficiency virus to public...  

Code of Federal Regulations, 2013 CFR

...information related to infection with the human immunodeficiency virus to public health authorities. 1.486 Section 1.486...information related to infection with the human immunodeficiency virus to public health authorities. (a) In the...



38 CFR 1.487 - Disclosure of information related to infection with the human immunodeficiency virus to the...  

Code of Federal Regulations, 2010 CFR

...information related to infection with the human immunodeficiency...virus to the spouse or sexual partner of the patient...information related to infection with the human immunodeficiency...virus to the spouse or sexual partner of the...



38 CFR 1.487 - Disclosure of information related to infection with the human immunodeficiency virus to the...  

Code of Federal Regulations, 2010 CFR

...information related to infection with the human immunodeficiency...virus to the spouse or sexual partner of the patient...information related to infection with the human immunodeficiency...virus to the spouse or sexual partner of the...



1H NMR Based Targeted Metabolite Profiling for Understanding the Complex Relationship Connecting Oxidative Stress with Endometriosis  

PubMed Central

Accumulating evidence indicates the active role of oxidative stress in the development of endometriosis; however, the mechanism of reactive oxygen species generation is poorly understood. Metabonomics/metabolomics is a scientific discipline that can be used to study changes in metabolite ensembles associated with disease pathophysiology. The present study focuses on the use of proton nuclear magnetic resonance spectroscopy based targeted metabolite profiling approach to explore dysregulation in metabolites expression in women with endometriosis. Further, association of oxidative stress with the metabolite ensembles, if any, is investigated. Using multivariate statistics, partial least square discriminant analysis model was generated which could classify endometriosis patients with sensitivity and specificity of 92.83% and 100%, respectively, and with a classification rate of 96.4%. In conjunction with increased glucose metabolism, citrate and succinate were found to be elevated in endometriosis patients. Higher levels of reactive oxygen species, lipid peroxidation, and advanced oxidation protein products and lower levels of total antioxidant capacity, superoxide dismutase, catalase, and glutathione were also observed. Increased glucose metabolism and defects in the mitochondrial respiratory system are suggested to be the possible sources of excessive reactive oxygen species generation in endometriosis.

Jana, Saikat K.; Srivastava, Sudha; Chakravarty, Baidyanath



The Expression Status of G Protein-Coupled Receptor GPR30 Is Associated with the Clinical Characteristics of Endometriosis.  


Introduction. GPR30 is a seven-transmembrane G protein-coupled estrogen receptor that regulates endometrial cellular responses to estrogen. GPR30 is often highly expressed in cancer cells from aggressive tumors. The aim of this study was to evaluate the expression patterns of GPR30 in endometriosis during medical treatment. Patients. A total of 38 females, 28 patients with endometriosis and 10 patients with leiomyoma who underwent laparoscopic surgery were included this study. Intervention. Eutopic endometrial tissue sampling from women without endometriosis and ectopic endometrial tissue sampling from women with endometriosis. Main Outcome Measure. A quantitative real-time polymerase chain reaction analysis of the mRNA expression in eutopic and ectopic endometrial tissues with or without GnRH agonist treatment. The expression of GPR30 was confirmed by immunohistochemistry. Results. There was an increased level of GPR30 mRNA in eutopic endometrium during the proliferative phase, whereas higher expression was observed in the ectopic endometrium during the secretory phase. Increased GPR30 mRNA was observed in ectopic endometrium in comparison to eutopic endometrium. GnRH agonist treatment before laparoscopic surgery decreased GPR30 mRNA in ectopic endometrium. The immunohistochemical analysis also revealed that GPR30 was strongly expressed in epithelial cells in ectopic endometrium, whereas GnRH agonist treatment decreased the GPR30 expression. Conclusion. High levels of GPR30 expression can play an important role in the progression of endometriosis. PMID:23458722

Yuguchi, Hiroko; Tanabe, Akiko; Hayashi, Atsushi; Tanaka, Yoshimichi; Okuda, Kiyoji; Yamashita, Yoshiki; Terai, Yoshito; Ohmichi, Masahide



Fatal hemophagocytic syndrome related to active human herpesvirus-8/Kaposi sarcoma-associated herpesvirus infection in human immunodeficiency virus-negative, non-transplant patients without related malignancies.  


Hemophagocytic syndrome (HS) may occur as a consequence of herpes viral infections. Human herpesvirus 8 (HHV-8)/Kaposi sarcoma-associated herpesvirus has so far been recognized as a trigger of HS only in immunosuppressed subjects or in patients with Kaposi sarcoma and/or HHV-8-related lymphoproliferative diseases. We report two Italian human immunodeficiency virus (HIV)-negative elderly men who developed an HS with a rapidly fatal course, following treatment with corticosteroids for autoimmune hemolytic anemia. An overwhelming active infection with HHV-8 was unequivocally documented by molecular and immunohistochemical methods, in the absence of HHV-8-related tumors. The occurrence of HHV-8-associated HS, although rare, may be considered, even out of the HIV or the transplantation settings, at least in areas endemic for HHV-8 infection. PMID:17331129

Re, A; Facchetti, F; Borlenghi, E; Cattaneo, C; Capucci, M A; Ungari, M; Barozzi, P; Vallerini, D; Potenza, L; Torelli, G; Rossi, G; Luppi, M



Communication and relational culture: Bases for the study of human relationships  

Microsoft Academic Search

This article elaborates two concepts centrally important in the study of human relationships: communication and relational culture. Communication is represented as a formative process which constitutes, defines and disassembles relationships. Arising out of communication is relational culture, a privately transacted system of discourse and definition that coordinates attitudes, actions, and identities of partners in a relationship. These two concepts are

Julia T. Wood



Different representations of relative and absolute subjective value in the human brain  

Microsoft Academic Search

Relative reward value is important for the choice between a set of available rewards, and absolute reward value for stable and consistent economic choice. It is unclear whether in the human brain subjective absolute value representations can be dissociated from relative reward value representations. Using fMRI, we investigated how the subjective pleasantness of an odor is influenced by whether the

Fabian Grabenhorst; Edmund T. Rolls