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The Argonaute family genes (piwi and aub) involved in the production of small RNAs are responsible for the regulation of many cellular processes, including the suppression of genome instability, modulation of gene activity, and transposable elements. Dysfunction of these genes and the associated activation of transposable elements adversely affect reproductive development and quality of life. The role of transposons in contrast to retrotransposons and their interaction with genes of the Argonaute family in aging processes have not been studied. This study considers a scenario in which the piwi and aub genes in the presence of functional hobo transposons can modify the effects from the level of DNA damage to lifespan. The simultaneous presence of mutation (piwi or aub) and hobo (regardless of size) in the genome has practically no effect or (less often) leads to a decrease in the level of DNA damage in ovarian cells. A high level of sterility and low ovarian reserve were noted mainly with a combination of mutations and full-sized hobo elements. The combination of these two genetic factors negatively affects the fertility of young females and embryonic survival. Isolated cases of restoration of reproductive functions with age were noted but only in females that had low fertility in the early period of life. The presence of hobo transposons contributed to an increase in the lifespan of both mutant and non-mutant females. Dysfunction of the piwi and aub genes (without hobo) can reduce the lifespan of both sexes. Together, each mutation and hobo transposons act antagonistically/additively (in females) and synergistically/antagonistically (in males) to change the lifespan. In parameters of locus-specific instability, hobo activation was more pronounced in piwi gene dysfunction. The results obtained complement data on the study of new functions of Argonaute family genes and their interactions with transposable elements in the aging process. [ABSTRACT FROM AUTHOR]

The endometrium is a dynamic target organ in a woman's reproductive life. It undergoes cyclical change regulated by the fine balance between oestrogen and progesterone. The endometrial thickness (ET) varies according to the phases of the menstrual cycle. Endometrium contains both oestrogen and progesterone receptors, which respond to above hormones, irrespective of whether the woman is in reproductive or menopausal phase. Abundance of oestrogen leads to endometrial hyperplasia, and paucity causes endometrial atrophy. The initial best modality of assessing ET or aberration is high resolution transvaginal ultrasonogram. Thickened endometrium is always a clinical conundrum. Dilemma does remain as to the thickness of endometrium which requires intervention, mostly in symptomatic pre and perimenopausal women. In post-menopausal women with bleeding, the cut-off of ET that warrants investigation is almost defined. However, the cut-off value of ET in asymptomatic postmenopausal women; beyond which intervention is required, is still debated. Dilemma also exists about the cut-off of ET in both symptomatic and asymptomatic women on HRT and Tamoxifen. This article will discuss the above issues and reach at some consensus about the cut-off of ET after critical analysis of evidence and experience and will help clinicians in arriving at a proper decision in dealing with such clinically confounding situations. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the feasibility, efficacy, safeness, and patients' acceptability of a modified transcervical endometrial resection (TCER) technique for the treatment of menorrhagia. Eighty-four premenopausal women with menorrhagia after careful investigation and 2 months therapy with GnRHa underwent a modified TCER. It was performed with a standard dual channel, 26 French irrigating resectoscope (Karl Storz, GmbH, Germany) after cervix dilatation to 10 mm and sorbitol mannitol solution used as distension medium. The modified technique was based on the resection of the endometrium and of the first myometrial layers only on the anterior and posterior walls, without treating fundus and cornual areas as usually performed. Endometrial resection was performed to a depth of 4 to 5 mm. Clinical and hysteroscopic follow-up was performed for 60 months. Early and late complications, changing in bleeding patterns, and patients' satisfaction were recorded. Sixty-four out of 73 patients that completed the 60 months improved. Eumenorrhea was achieved in 68.5 %, hypomenorrhea in 5.5 %, and amenorrhea in 13.7 %. Most of the patients (86.3 %) showed satisfaction at the follow-up interview. Control hysteroscopy showed that post modified TCER uterine cavity maintained the possibility of macroscopic and histopathology investigation during follow-up. Modified TCER is a technique easy to perform and effective in the long-term resolution of menorrhagia. In particular, it avoids the formation of synechiae and the shrinkage of the uterine cavity that may be the cause of various long-term complications, such as the delay in the diagnosis of endometrial carcinoma onset. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the accuracy of transvaginal sonography (TVS) and saline infusion sonohysterography (SIS) for detection of uterine cavity abnormalities in patients with abnormal uterine bleeding (AUB) taking hysteroscopy as the gold standard. Methods: This was a prospective study done in the department of Obstetrics and Gynecology of a tertiary care academic hospital. Sixty premenopausal and postmenopausal women who presented with AUB underwent TVS, SIS, and hysteroscopy. The presence of focal abnormality and the type of abnormality, i.e., polyp, submucous myoma, and endometrial hyperplasia, were noted. The results of TVS and SIS were compared with hysteroscopy. Results: On hysteroscopy, 76.67 % ( n = 46) patients were diagnosed with intra cavity abnormalities. SIS showed sensitivity, specificity, PPV, and NPV of 89.1, 100, 100, and 73.7 %, respectively. In comparison, TVS showed sensitivity, specificity, PPV, and NPV of 43.48, 78.57, 86.96, and 29.73 %, respectively. Conclusions: SIS was found to be more sensitive and specific than TVS in detection of intra cavity abnormalities. [ABSTRACT FROM AUTHOR]

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