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A group of proteins in the body called colony-stimulating factors can increase or decrease the amount of platelet-activating factor in the uterus. This is important because platelet-activating factor is involved in uterine contraction. Some pregnant women with increased amounts of colony-stimulating factors give birth prematurely.

High levels of interleukin-1beta and interleukin-8 in vaginal secretions may indicate the start of labor. These naturally occurring chemicals attract white blood cells that secrete enzymes to soften the cervix so the baby can pass through. Researchers measured the levels of interleukin-1beta and interleukin-8 in vaginal secretions of 119 pregnant women between 24 and 41 weeks's gestation. The levels were significantly higher in women in labor, including women in premature labor.

Maternal blood levels of parathyroid hormone (PTH) related-protein seem to steadily increase throughout pregnancy. Feeding methods after delivery seem to affect these levels. PTH-related hormone levels were measured in 90 pregnant women during each trimester, 33 bottle feeding mothers, 74 breast-feeding mothers, 33 bottle and breast-feeding mothers, 24 umbilical samples, and 40 non-pregnant women. PTH-related hormone levels were 1.04 picomoles/liter (pmol/L) in non-pregnant women, 1.17 pmol/L during the third trimester, 1.17 pmol/L in breast-feeding mothers, and 1.03 pmol/L in bottle-feeding mothers.

Untreated Wilson's disease during pregnancy can lead to maternal and fetal complications. Wilson' disease causes faulty copper metabolism that leads to liver cirrhosis and can lead to central nervous system dysfunction. A 23-year-old woman with untreated Wilson's disease delivered a child at 36 weeks' gestation with an enlarged liver and high liver enzyme levels. The woman in question developed severe leg swelling when she was 23 weeks pregnant. She did not disclose that she had Wilson's disease. Blood tests showed elevated liver enzymes, low serum proteins and a reduction in the number of blood platelets. The levels continued to decrease and at 26 weeks' gestation an ultrasound revealed liver cirrhosis. At 35-weeks' gestation Wilson's disease was suspected based on high levels of copper in the urine, low serum ceruloplasmin and pigmented rings around the patient's corneas. The patient had a cesarean section at 36 weeks. The child had an enlarged liver, high levels of liver enzymes and high levels of urinary copper. The infant's liver enzyme levels had not returned to normal by one year of age. On examination, placental copper accumulation was found on the maternal side.

The mechanism of oncogenesis is extremely complicated and controlled by various factors, most of which are based on cell proliferation, tumor invasion, neovascularization, and inhibition of apoptosis. We have investigated the relationship between thirty three oncogenes expression and histopathological prognostic factors of endometrial carcinomas, including clinical stage, histological grade, presence of invasion to greater than one-half the myometrium, clinical outcome, and survival rate. Scoring on the basis of the percentage of positive cells indicated that Plks, EphB4, ephrin-B2, Id1, CaMKIV, c- Ets1, Elf-1, and survivin expression were significantly associated with PCNA-labeling index, clinical stage, histological grade, the presence of invasion to greater than one-half the myometrium, and clinical outcome. Survival data were available for all patients, and univariate Cox regression analysis showed that Plks, CaMKIV, Elf-1, and survivin expression were significantly associated with poor prognosis. Our results demonstrate that some oncogenes expression in endometrial carcinoma correlate with the malignant potential of these tumors. Thus, in addition to being of diagnostic value, modulation of these oncogenes activity in the tumors by chemotherapeutic agents or gene therapy may prove to be of therapeutic value. In this review, we demonstrate the biologic behavior of seven novel molecules (Plks, Eph / ephrin, Id family, CaMK, c-Ets1, Elf-1, and survivin) in the endometrial carcinoma.

Endostatin is a potent angiogenic inhibitor that is derived from collagen XVIII by proteolytic cleavage. Localization of collagen XVIII has been reported in the basement membrane of blood vessels. To examine the involvement of collagen XVIII/endostatin during pregnancy, the distribution of collagen XVIII/endostatin protein in human umbilical vein was evaluated by immunohistochemistry. The expression of collagen XVIII/endostatin in cultured human umbilical vein endothelial cells (HUVEC) was also examined by immunocytochemistry and Northern blot analysis. To examine the release of endostatin in vivo and in vitro, concentrations of endostatin in umbilical venous blood and in HUVEC culture medium were determined using an enzyme-linked immunosorbent assay. Collagen XVIII/endostatin protein was localized to endothelial cells and their basement membrane in the umbilical vein. The expression of collagen XVIII mRNA and protein was detected in HUVEC. However, endostatin was not detected in umbilical venous blood or in HUVEC culture medium. The absence of endostatin release and the presence of its parental protein, collagen XVIII, suggest that the cleavage mechanisms of endostatin might be strongly inhibited under the physiological conditions present during pregnancy. It is therefore considered that vasculature in the feto–placental unit is highly angiogenic, even at the time of parturition.

Uterine arteriovenous malformation (AVM) is a rare disease. However, it is important to make a rapid and precise diagnosis when it does occur, because life-threatening massive genital bleeding may occasionally be a symptom of this disease. In this case report, we present a case of uterine AVM diagnosed by means of ultrasonographic, magnetic resonance imaging (MRI) and angiographic studies. A 47-year-old Japanese woman was admitted complaining of severe hypermenorrhea that had been occurring for 5 years. Her last pregnancy was an uncomplicated term delivery at 32 years of age. Transvaginal and transabdominal ultrasonography demonstrated a thickening of the anterior wall of the uterine corpus with numerous cystic lesions. Color Doppler ultrasound, dynamic MRI and magnetic resonance angiography as well as pelvic angiography were useful for detecting the hypervascular lesions in this case. She was treated by a total hysterectomy and bilateral salpingo-oophorectomy under the diagnosis of uterine AVM. These noninvasive techniques should be performed initially when this rare disease is suspected.

PROBLEM: Prostaglandins (PGs) are synthesized in the endometrium. Our objective was to evaluate interleukin (IL)‐1α‐induced production of PGE2and PGF2αin endometrial stromal cells (ESC) following treatment with ceramide analogues.
 METHODS OF STUDY: ESC were obtained from human uterine endometrium by enzymic digestion and filtration. ESC were treated with IL‐1α, IL‐1 receptor antagonist (ra), C2‐ceramide and C6‐ceramide. The concentrations of PGE2and PGF2αin media were determined using ELISA. The induction of prostaglandin H synthase (PGHS)‐2 mRNA was also ascertained by reverse transcription‐polymerase chain reaction (RT‐PCR).
 RESULTS: The production of PGE2and PGF2αwas significantly increased by IL‐1α and suppressed by IL‐1 ra, in a dose‐dependent manner. PGF2αproduction was further increased by treatment with the combination of IL‐1α and C2‐ceramide as compared with IL‐1α treatment alone. There was no significant difference in PGE2production between cells treated with IL‐1α and C2‐ceramide and those treated with IL‐1α alone. Both PGE2and PGF2αproduction were significantly increased by treatment with IL‐1α and C6‐ceramide as compared with IL‐1α treatment alone. Treatment of ESC with IL‐1α stimulated PGHS‐2 mRNA. PGHS‐2 mRNA was decreased when IL‐1 ra was added to the IL‐1α‐stimulated cells.
 CONCLUSIONS: These results suggest that IL‐1α stimulates the production of PGE2and PGF2αby a mechanism that involves the sphingomyelin‐ceramide system, and thus that ceramide may be important in increasing the production of PGE2and PGF2αin the human endometrium.

Polo-like kinase (PLK) is a cell cycle-regulated, cyclin-independent serine/threonine protein kinase. Recent reports have shown a critical role for PLK during tumorigenesis. To explore whether PLK plays a general role as a tumor marker of endometrial carcinomas, we examined the expression of PLK mRNA and protein in endometrial carcinomas and normal endometrium, and analyzed the relationship between PLK protein expression and malignant potential. We found that PLK mRNA was expressed in all specimens from endometrial carcinoma patients using RT-PCR methods, although some specimens from normal endometria were negative. Immunohistochemically, most of the PLK was found in the cytoplasm (around the nucleus), and partly in the nucleus of endometrial carcinoma glands and also secreted tissues from endometrial carcinoma glands. PLK was expressed at the basement membrane of carcinoma glands and partly expressed in the head portion of papillary carcinoma tissues. There was a significant correlation between percentages of PLK-positive cells and histological grade of endometrial carcinoma (P<0.0001). However, the expression of proliferating cell nuclear antigen and Ki-67 was independent of PLK expression. Moreover, we noted that PLK is strongly expressed in invading carcinoma cells. PLK expression could reflect the degree of malignancy and proliferation in endometrial carcinoma. Thus, in addition to being of diagnostic value, modulation of PLK activity in the tumors by chemotherapeutic agents or gene therapy may prove to be of therapeutic value.

Objective: Our objective was to evaluate the activity of cytochrome P4501A2 (CYP1A2), xanthine oxidase (XO), and N -acetyltransferase 2 (NAT2) from early to late pregnancy and after delivery.Methods: Twelve women were studied on three occasions during pregnancy (early, 8-16 weeks' gestation; middle, 20-28 weeks' gestation; and late, 32-39 weeks' gestation) and about 1 month after delivery. Caffeine was used as a metabolic probe. After the women ingested a can or a bottle of caffeine-containing soft drink, urine samples were collected for 12 hours. The caffeine metabolites measured were 5-acetylamino-6-amino-3-methyluracil (AAMU), 1-methylxanthine (1X), 1-methyl–uric acid (1U), 1,7-dimethyl–uric acid (17U), and 1,7-dimethylxanthine (17X). The hepatic enzyme activities were estimated by the urinary caffeine metabolic ratios as follows: CYP1A2 = (AAMU + 1X + 1U)/17U; XO = 1U/(1X + 1U); NAT2 = AAMU/(AAMU + 1X + 1U).Results: Statistically significant differences were found in CYP1A2 (P < .0001) and NAT2 (P < .01). The mean metabolic ratios for CYP1A2 during pregnancy (6.80, 5.18, and 4.97 for the early phase, middle phase, and late phase, respectively) were significantly lower than the ratio after delivery (10.39). The mean metabolic ratio for NAT2 in the early phase (0.57) was significantly lower than after delivery (0.66). There was no significant difference in metabolic ratios for XO during pregnancy and after delivery.Conclusion: The data demonstrate that pregnancy influences CYP1A2 and NAT2 activity. CYP1A2 activity decreases not only in late pregnancy but also in early and middle pregnancy.Clinical Pharmacology & Therapeutics (2001) 70, 121–125; doi: 10.1067/mcp.2001.116495

PROBLEM: In order to investigate the role of macrophage colony‐stimulating factor (M‐CSF) and macrophage chemoattractant protein‐1 (MCP‐1) in human ovulation, we measured the concentrations of M‐CSF and MCP‐1 in human follicular fluids (FFs) and correlated them with oocyte maturation.
 METHOD OF STUDY: The oocytes were obtained from the FFs of 46 women undergoing in vitrofertilization and embryo transfer (IVF–ET). The concentrations of M‐CSF and MCP‐1 in the FFs were measured by enzyme‐linked immunosorbent assay. In addition, granulosa cells obtained from the FFs of IVF patients were cultured and treated with forskolin and 12‐O‐tetradecanoylphorbol 13‐acetate (TPA) for 24–48 hr.
 RESULTS: Concentrations of M‐CSF and MCP‐1 were significantly higher in the FFs than in the serum (P<0.01). M‐CSF concentrations tended to be higher, while MCP‐1 concentrations were significantly higher in the FFs containing mature oocytes than in FFs containing immature oocytes (P<0.05). The production of M‐CSF was markedly increased over the basal level after treatment with forskolin (10 μM) for 24 (P<0.02) and 48 hr (P<0.01); however, the production of MCP‐1 was unchanged.
 CONCLUSIONS: Our data suggest that M‐CSF and MCP‐1 may play an important role in human preovulatory processes and that M‐CSF, in particular, may be regulated by cyclic adenosine monophosphate. M‐CSF and MCP‐1 may also be valuable biochemical markers in the evaluation of oocyte maturation.

The protooncogene c-ets1 is a transcriptional factor that controls the expression of a number of genes involved in extracellular matrix remodeling. It might play a role in the regulation of physiologic processes such as cell proliferation and differentiation and also is associated with angiogenesis, cell migration, and tumor invasion. To elucidate the involvement of c-Ets1 in endometrial carcinogenesis, the authors analyzed serial frozen sections for c-Ets1 protein expression in 20 cases of endometrial carcinoma and 20 cases of normal endometria by fluorescent immunohistochemistry. The authors analyzed the relation between the percentages of c-Ets1 stained cells and patient characteristics including histologic grade, surgical stage, presence of invasion to greater than one-half myometrium, presence of vascular involvement, presence of lymph node metastasis, and clinical outcome. In the normal endometria, c-Ets1 was weakly detected at the luminal surface of endometrial glands in both the proliferative and secretory phases. Most of the c-Ets1 proteins were found in the cytoplasm and partly in the nucleus of endometrial carcinoma glands, and also in fluid secreted from endometrial carcinoma glands. Moreover, c-Ets1 was strongly expressed in the head portion of papillary carcinoma tissues that invaded the stroma. c-Ets1 expression was associated significantly with histologic grade (P &lt; 0.005), the presence of invasion to greater than one-half myometrium (P &lt; 0.001), surgical stage (P &lt; 0.005), and vascular involvement (P = 0.009). The authors' results show that c-Ets1 expression in endometrial carcinoma correlates with the malignant potential of this tumor. Cancer 2000;89:2059–67. © 2000 American Cancer Society.

Platelet-activating factor (PAF) is involved in such reproductive processes as parturition. We investigated the effect of PAF on the expression of matrix metalloproteinase-1 (MMP-1) and that of tissue inhibitor of metalloproteinases-1 (TIMP-1) in human uterine cervical fibroblasts. Uterine cervical tissue was obtained from patients who underwent cesarean section at term. Collagenase-dispersed fibroblasts were cultured and used in the experiments. PAF receptor was identified in the uterine cervical fibroblasts by use of reverse transcription-polymerase chain reaction and Southern blot analysis. Northern blot analysis showed that PAF increased the expression of MMP-1 mRNA in a time-dependent manner, whereas expression of TIMP-1 mRNA was not affected by PAF. Concentration of MMP-1 protein in the PAF-treated culture media significantly exceeded that in control cultures. The PAF-induced production of MMP-1 protein was abolished by treatment with WEB 2170, a specific PAF receptor antagonist. Results suggest that PAF may accelerate collagenolysis in the human uterine cervix by inducing an imbalance in the activity between MMP-1 and TIMP-1, thus contributing to the cervical ripening during parturition.

PROBLEM: The aim of this study was to clarify the physiological effects of interferon (IFN)‐Γ on secretion of vascular endothelial growth factor (VEGF) by endometrial stromal (ES) cells. METHOD OF STUDY: ES cells were obtained from human uterine endometrium by enzymic digestion and filtration. The effects of IFN‐Γ on production of VEGF by ES cells were examined by analyzing VEGF mRNA expression with Northern blotting analysis and by assaying VEGF protein. RESULTS: IFN‐Γ inhibited VEGF mRNA and protein expression by ES cells in a dose‐dependent manner. In ES cells treated with IFN‐Γ, VEGF production was not significant until 6 hr of incubation and was significantly affected after 6 hr of incubation, but decreased significantly after 12 to 48 hr. IFN‐Γ also suppressed VEGF mRNA expression by ES cells. CONCLUSIONS: ES cells produce VEGF, which may contribute to endometrial neovascularization and proliferation. IFN‐Γ may play an important role in regulating VEGF production by ES cells.

The enzyme, polo-like kinase (PLK), is a mammalian serine/threonine kinase involved in cell cycle regulation. A great deal of evidence regarding the role of PLK in the cell cycle has been obtained through studies of cultured cells, though little is known about its function or even expression in vivo. The endometrium undergoes rapid proliferation and differentiation under ovarian steroid hormone control during the 28-day cycle. Thus, normal endometrium provides an excellent model in which to study the hormone dependency of PLK expression. In the present study, we examined the features of PLK expression in 20 samples of normal human endometrium during the menstrual cycle. The expression of Ki-67 and proliferating cell nuclear antigen (PCNA) were also examined as markers of proliferation. Immunohistochemical studies showed that PLK staining was detected in the basement membrane of many endometrial glands, stromal cells, and some endothelial cells. The number of PLK-positive endometrial gland cells was significantly higher in the late proliferative phase (19.16% 4.98%) and the early secretory phase (19.28% 4.99%) than in the early proliferative phase (2.60% 2.33%) or the late secretory phase (5.76% 2.16%) (P&lt;0.0001). PLK expression seemed to be correlated with the expression of Ki-67 and PCNA in many endometrial glands and stromal cells particularly in the late proliferative phase, reflecting a role of PLK in cellular proliferation. Nevertheless, in the early secretory phase, at which point the expression of Ki-67 and PCNA decreased in endometrial glands, PLK was strongly expressed. This finding suggests that PLK may have some post-mitotic functions in certain specialized cell types. Although the highest expression of PLK was observed in the late proliferative and the early secretory phases, the expression drastically decreased in the late secretory phase. These findings, taken together, indicate that the expression of PLK in normal endometrium fluctuates over the course of the menstrual cycle, suggesting in turn that PLK is associated with hormone-dependent cellular proliferation and that hormone functions may be involved in its regulation.

To examine the production of hepatocyte growth factor (HGF) by human endometrial stromal cells (ESC) in vitro, concentrations of HGF in the culture media of ESC were measured after the addition of various amounts of 12-O-tetradecanoylphorbol 13-acetate (TPA), forskolin, lipopolysaccharide (LPS), interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor α (TNFα), interferon-γ (IFNγ), or ethynylestradiol-17α using an ELISA. The expression of HGF mRNA was also assayed by a reverse transcription-polymerase chain reaction. The concentration of HGF in the culture media of unstimulated ESC was below the detection level of the assay. TPA stimulated the secretion of HGF by ESC in a dose-dependent manner. TPA also induced the transcription of HGF mRNA by ESC. Forskolin, LPS, IL-1β, IL-6, IL-8, TNFα, IFNγ, or ethynylestradiol-17α did not alter HGF mRNA or protein levels. TPA-stimulated production of HGF was partially inhibited by the addition of 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine or sphingosine. These results suggest that a protein kinase C-dependent pathway may play an important role in the regulation of HGF production by ESC. HGF secreted by ESC may be involved in the regeneration of the endometrium during the normal menstrual cycle.

In spite of many references to carcinoma arising from endometriosis at extrauterine sites, there are few documented cases of carcinoma developing in association with adenomyosis. We present 2 rare cases of adenocarcinoma arising from adenomyosis. The relationship between prior frequent estrogen use and carcinogenesis and the possible effects of chemotherapy and radiation therapy are reviewed.

Our purpose was to determine the correlation between cathepsin L mRNA levels and serum cathepsin L levels of patients with ovarian cancer. Moreover, we compared serum cathepsin L levels with cancer antigen 125 (CA125) and cancer antigen 72-4 (CA72-4) levels. Using an ELISA assay, serum samples of 30 patients with gynecological tumors were analyzed for cathepsin L, CA125, and CA72-4. We also examined whether cathepsin L gene expression was enhanced in ovarian cancer samples, by quantitative Northern blot analysis with a human cathepsin L complementary DNA (cDNA) probe. Significantly increased serum levels of cathepsin L in patients with ovarian cancer (P &lt; 0.05) were observed. We also measured serum levels of CA125 and CA72-4 in the same patients. Compared with CA125 and CA72-4, cathepsin L showed a lower false-positive rate (27.2%) in gynecological diseases, and no correlation was observed between cathepsin L and CA125 or CA72-4 values. Moreover, ovarian cancer samples were found to express higher levels of cathepsin L mRNA than those of uterine cancer, benign ovarian tumor, and normal ovary samples. Our data demonstrated that serum cathepsin L may be useful in the early detection of ovarian cancer. Furthermore, the combination assay consisting of cathepsin L, CA125, and CA72-4 may be a more useful method than those currently in use for the detection of ovarian cancer. Copyright 1995, 1999 Academic Press

To assess the effect of prenatal vitamin K1on the coagulation status of newborns

Assays measuring immunoreactive estrone glucuronide (E1G), estradiol-3-glucuronide (E2-3G), estradiol-17β-glucorine (E2-17G), estriol-3-glucuronide (E3-3G), estriol-16αλucuronide (E3-16G), and pregnanediol-3α-glucuronide (Pd-3G) directly in diluted urine were developed and validated. These etrogen and pregnanediol glucuronide fractions were measured in aliquots of 24-hour and overnight samples of urine collected daily form seven women for one menstrual cycle. Urinary hormone excretion was correlated with daily serum estradiol (E2), progesterone (P), and luteinizing hormone (LH) level. A sharp midcyle LH peak preceded by a preovulatory rise in serum E2and followed by luteal phase serum P levels were noted in each of the seven apparently ovulatory cycles. Twenty-four-hour and overnight urinary excretion patterns of estrogen glucuronides were similar to those of serum E2. Of the five estrogen glucuronide fractions tested, excretion of E2-17G exhibited the earliest and steepest ascending slope of the preovularoy estrogen surge and correlated best with serum E2levels. Urinary excretion of E1-G, E2-3G, and E3-16G also showed an early and steep preovulatory rise and precede that of E3-3G, whereas urinary excretion of E3-3G exhibited the poorest correlation with serum E2concentrations. The urinary excretion of Pd-3G rose parallel to serum P levels and was markedly elevated 2 to 3 days after the midcycle LH peak in both 24-hour and overnight collections of urine. These results indicate that among the urinary estrogen conjugate fractions tested, E2-17G is the one that most suitably predicts ovulation. The marked differences between preovulatory and postovulatory Pd-3G excretion and the fact that miligram quantities of Pd-3G are excreted each day render measurements of Pd-3G useful for the detection of ovulation and suggest that relatively simple immunochemical or enzymatic (dipstick) techniques may be developed successfully.

To examine the role of platelet-activating factor (PAF) metabolism in the periovulatory processes.

The purpose of this investigation was to evaluate the serum level of soluble intercellular adhesion molecule-1 (sICAM-1) in patients with squamous cell carcinoma of the cervix. Serum levels of sICAM-1 were measured by enzyme-linked immunosorbent assay in patients with cervical cancer (stage 0 through IV). Expression of mRNA in tumor tissues was evaluated by reverse transcriptase–polymerase chain reaction. Serum level of sICAM-1 in patients with advanced-stage (II–IV) or recurrent cervical cancer was found to be increased significantly. Expression of ICAM-1 mRNA was observed in most tumor tissues. Results suggest that sICAM-1 is shed from the cancerous tissue in patients with squamous cell carcinoma of the cervix.

A 16‐year‐old Japanese girl was admitted for evaluation of complaints of primary amenorrhea, cyclic lower abdominal pain, and urinary incontinence. Her vaginal introitus appeared rudimentary with a depth of 0.5 cm and hypoplasia of the hymenal ring. A hypoplastic urethra (diameter: 1cm; length: 0.5 cm) and 1 of 2 right ectopic ureters opened into the introitus. Transabdominal ultrasonography demonstrated fluid distending the uterus, the proximal 1/3 of the vagina, and the pouch of Douglas. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of hematometrocolpos and fluid collection in the pouch of Douglas. These associated anomalies can be due to faulty growth of the urogenital sinus. In addition to the transabdominal ultrasonography and CT, MRI was useful in the diagnosis and evaluation of vaginal agenesis.

Objective: To study the expression of c‐erb B‐2 in gynecologic malignancies, especially in malignant mixed müllerian tumors (MMTs).

Foeto-placental function and hormone levels in the maternal, foetal and amniotic compartments have been investigated in an acromegalic woman who was treated with 20 mg bromocriptine/day throughout gestation. Bromocriptine therapy during pregnancy had no effect on urinary oestriol excretion and plasma levels of unconjugated oestriol, progesterone, human placental lactogen, cystine aminopeptidase and heat-stable alkaline phosphatase. The maternal and foetal (cord) blood and amniotic fluid showed prolactin levels of 3.8, 6.5 and 1700 ng/ml, respectively, in the 39th week of pregnancy during bromocriptine therapy. Compared with data from normal pregnancies, these values demonstrated that bromocriptine or an active metabolite crossed the term placenta to suppress prolactin secretion from the foetal pituitary gland and that the prolactin level in amniotic fluid was scarcely affected by the drug. Maternal, foetal and amniotic fluid growth hormone levels were 27.0, 33.0 and 3.8 ng/ml, respectively, thus indicating that dopamine agonists suppress growth hormone only in acromegalic patients, and not in normal babies. Bromocriptine had no effect on thyroid-stimulating hormone concentrations in the maternal, foetal and amniotic compartments.

To determine if the measurement of hCG levels in vaginal fluid is useful for the diagnosis of premature rupture of membranes (PROM).

We report a case of torsion of an ovarian follicular cyst that developed during treatment with tamoxifen for breast cancer. A 40-year-old Japanese woman was admitted complaining of acute lower abdominal pain. Eight months earlier, she had undergone a partial mastectomy and local irradiation for ductal carcinoma of her left breast, estrogen receptor-positive stage I (T1a N1b M₀). The administration of tamoxifen, 20 mg/day, and doxifluridine, 600 mg/day, were started immediately postoperatively. Pelvic examination after admission revealed the left ovarian cyst and enlarged uterus. Transvaginal ultrasonography and computed tomography revealed a multilocular cystic mass in the pelvic cavity. The pathological diagnosis of the tumor after total hysterectomy and bilateral salpingo-oophorectomy was a typical follicular cyst with torsion and uterine leiomyoma. This ovarian cyst was believed to have developed during tamoxifen administration.

We report a case of adenomyomatous polyp that developed during treatment with tamoxifen for breast cancer. A 63-year-old Japanese woman was admitted complaining of atypical genital bleeding. Nine months earlier, she had undergone a modified radical mastectomy for cancer of her right breast, estrogen receptor-positive stage I (T1N0M0). The administration of tamoxifen, 20 mg/day, was started immediately postoperatively. Pelvic examination after tamoxifen administration for 9 months revealed that the uterus was enlarged to the size of a fist. Transvaginal ultrasonography and magnetic resonance imaging revealed a large solid mass with multiple cystic areas in the uterine cavity. The pathological diagnosis of the tumor after total hysterectomy was typical adenomyomatous polyp. It was believed to have developed during tamoxifen administration.

We compared the diagnostic utility of computed tomography (CT) and magnetic resonance imaging (MRI) in a patient with a pelvic schwannoma. This 46-year-old woman was admitted for evaluation of a retroperitoneal pelvic mass and myoma uteri. The retroperitoneal pelvic mass had been detected by a CT scan at a routine health examination. A CT scan revealed a well-circumscribed cystic tumor (4 × 3 cm) at the right internal obturator muscle portion. The CT number of the inner part of the tumor was 21. Only the cyst wall was enhanced by injection of a contrast medium. MRI showed a 4 × 3 × 3-cm retroperitoneal cystic tumor that demonstrated low-intensity signals on T1-weighted images and high-intensity signals on T2-weighted images. Small areas of low intensity inside the tumor were observed on T2-weighted images. Histological examination revealed a typical schwannoma of mixed Antoni type A and type B. These findings indicate that both MRI and CT are useful for diagnosis of retroperitoneal schwannomas.

The purpose of this investigation was to determine the serum concentration of soluble vascular cell adhesion molecule-1 (sVCAM-1) in women with squamous cell carcinoma of the cervix. Serum samples were obtained from 38 Japanese women with squamous cell carcinoma of the cervix before initial treatment (12 in stage 0, 7 in stage I, 5 in stage II, 9 in stage III and 5 in stage IV), 7 patients with a recurrence of this cancer, and 18 healthy female volunteers. Serum sVCAM-1 was measured with a sandwich enzyme-linked immunosorbent assay. Serum concentrations (means ± SD) of sVCAM-1 in the healthy volunteers, the patients with cervical cancer in stages 0–IV and in the patients with recurrent tumors were 597.2 ± 151.4, 690.1 ± 214.2, 1,234.8 ± 466.1, 1,159.8 ± 825.8, 1,529.6 ± 662.0, 1,053.0 ± 228.8, and 1,134.8 ± 211.3 ng/ml, respectively. Values for patients with stages I–IV or recurrent cervical cancer were significantly increased compared to those for healthy volunteers (p < 0.05). Results suggest that sVCAM-1 is shed from endothelial cells in the cancerous tissue.

The polo-like kinase (PLK) is a mammalian serine/threonine kinase involved in cell cycle regulation. Much evidence for the role of PLK in the cell cycle has come from studies of cultured cells; however, little is known about its function or even expression in vivo . The present study examined the features of PLK expression in the mouse placenta and ovary. Immunohistochemical studies showed that PLK is highly expressed in the basement membrane of the endometrial gland, in some endothelial cells, in endometrium after embryo implantation, in trophoblastic tissue invading the decidua, in the ovarian stroma and in some lutein bodies. In contrast, PLK was not detectable by immunohistochemistry in endometrial stroma before decidualization, in decidua, in trophoblastic tissue not invading the decidua or in ovarian follicles. PLK expression seemed to be correlated with the expression of proliferation cellular nuclear antigen (PCNA) in many placental and ovarian cells, reflecting a role in cellular proliferation. Nevertheless, in ovarian stroma and lutein bodies where PCNA was not expressed, PLK was strongly expressed. This finding indicates that PLK may have some post mitotic functions in certain specialized cell types.