Search

Introduction: The effect of in vitro fertilization (IVF) on neurodevelopmental outcome is unclear. Probably, IVF does not affect traditional measures of neurological development in infancy, but little is known on long-term effects. Recently a new video-based instrument to evaluate neuromotor development was developed. The Infant Motor Profile (IMP) evaluates neuromotor condition in infants in terms of the quality of spontaneous motor behaviour. The IMP does not only assess traditional neuromotor domains, such as performance, symmetry and movement fluency, but also two novel domains: variation and variability. Movement variation denotes the size of the child's movement repertoire. Previous studies demonstrated that reduced movement variation is associated with early lesions of the periventricular white matter and - more generally - reflects the integrety of cortical connectivity. In addition, reduced variation during infancy is associated with neurodevelopmental disorders in later life and reduced intelligence at school age. Variability denotes the child's ability to select from the repertoire of movements the strategy that suits the situation best. In this prospective, assessor-blinded cohort study, we address the question whether ovarian hyperstimulation and/or the in vitro procedure affect movement variation during infancy. Material and Methods: Singletons born following IVF with conventional controlled ovarian hyperstimulation (COH-IVF, n = 68), following IVF in a modified natural cycle (MNC-IVF, n = 57) and following natural conception born to subfertile couples (Sub-NC, n = 90) were assessed with the IMP at 4, 10 and 18 months. The assessment resulted in a total IMP score and 5 domain scores: variation (i.e. the size of movement repertoire), variability (i.e. the ability to select motor strategies), symmetry, fluency and performance. Primary outcome was the domain score variation. Outcome variables were analyzed with a mixed effects model. Results: The mixed model indicated an overall effect of treatment on variation (p Conclusions: The preliminary data suggest that ovarian hyperstimulation may be associated with reduced movement variation in infancy. These findings stress the need to carefully monitor neurodevelopment in IVF offspring.

To investigate two different doses of oral estradiol to reduce the number of hot flushes in Japanese women with climacteric symptoms.Women (n = 211) aged 40-64 years who had experienced natural menopause or bilateral oophorectomy, withor = three moderate/severe hot flushes per day in the week before study, were randomized to receive micronized estradiol (E2) 0.5 or 1.0 mg or placebo once daily for 8 weeks. The primary efficacy endpoint was percentage change in mean daily number of hot flushes over 7 days from baseline to final examination.Percentage change in mean daily number of hot flushes at final examination was similar for E2 0.5 mg and E2 1.0 mg (-79.58 +/- 28.29% vs. -82.49 +/- 25.31%, p = 0.555) but was significantly lower with placebo (-57.89 +/- 34.15%, p0.001 vs. E2, both doses). There was no significant difference in number of treatment-related adverse events occurring in the E2 0.5 and 1.0 mg groups (25% and 36.6%, respectively). The higher E2 dose showed more pronounced effects on symptom severity.The dose of 0.5 mg/day was effective as the oral E2 starting dose for treatment of hot flushes in Japanese women.

Purpose Several studies have reported that rhegmatogenous retinal detachment (RRD) has a high incidence in the summer season and it correlates with increased sunshine hours and the average temperature. However, there is no report in Japan where seasonal changes in climate are rather distinct. In this study, we examined the seasonal variation of the frequency of RRD and the influence of climate. Asahi General Hospital is located in Asahi city (Chiba, Japan) where there is only a small change of population and furthermore, there is no other hub hospital in the city. Methods Medical records of consecutive 271 patients (>13-year-old) who had surgery for idiopathic RRD at Asahi General Hospital from January 2007 to December 2011 were retrospectively reviewed. The incidence of RRD was counted by months and seasons, and its seasonal variation and the correlation with the climate factors including the sunshine hours, temperature, humidity, and rainfall were examined. Result: Results 271 RRD eyes of 271 patients (176 male and 95 female, 56.0±15.0 years old) were included in the study.The RRD occurred most frequently in early summer (May to June, 21%), and least frequently in winter (January to February, 14%). Its frequency was significantly correlated with increased sunshine hours (r=0.71, P

Decidualized tissues are characterized by the intensive outgrowth of the microvasculature. Several angiogenic factors are assumed to be involved during the drastic change in the vasculature occurring in the process of decidualization. We examined the possible role of platelet-derived endothelial cell growth factor (PD-ECGF), a known angiogenic factor, during the process of early decidualization in humans. The expression of PD-ECGF in human endometrium was demonstrated by Western blot analysis, a marked increase being found in decidualized endometrium. Immunohistochemical staining showed that PD-ECGF immunoreactivity was present mainly in decidualized endometrial stromal cells. We established a primary cell culture of human endometrial stromal cells which were differentiated into decidualized cells in vitro by the addition of progesterone. In this cell culture system, progesterone augmented the expression of PD-ECGF in a dose-dependent fashion. The addition of progesterone also resulted in an increased release of prolactin, a well-known marker for decidualization. These findings suggest that PD-ECGF may play a physiological role as a possible angiogenic factor in the process of decidualization of human endometrium.

Decidualized tissues are characterized by the intensive outgrowth of the microvasculature. Several angiogenic factors are assumed to be involved during the drastic change in the vasculature occurring in the process of decidualization. We examined the possible role of platelet-derived endothelial cell growth factor (PD-ECGF), a known angiogenic factor, during the process of early decidualization in humans. The expression of PD-ECGF in human endometrium was demonstrated by Western blot analysis, a marked increase being found in decidualized endometrium. Immunohistochemical staining showed that PD-ECGF immunoreactivity was present mainly in decidualized endometrial stromal cells. We established a primary cell culture of human endometrial stromal cells which were differentiated into decidualized cells in vitro by the addition of progesterone. In this cell culture system, progesterone augmented the expression of PD-ECGF in a dose-dependent fashion. The addition of progesterone also resulted in an increased release of prolactin, a well-known marker for decidualization. These findings suggest that PD-ECGF may play a physiological role as a possible angiogenic factor in the process of decidualization of human endometrium.

To develop a clinical device for monitoring FBM with a simplified mechanism, the multichannel pulsed Doppler device was achieved by modifying the ultrasonographic module and probe of a cardiotocograph. A new algorithm of signal processing with a high-accuracy displacement estimation technique produced real-time and continuous displacement calculations. In vivo measurements demonstrated that real-time output produced commendable quality in FBM tracking. The displacement of a few hundred micrometers because of FBM was measured successfully. The results suggest that quantitative assessments of FBM should be possible with this technique.

To assess the cost-effectiveness of universal vaccination of 11-year-old girls against human papillomavirus (HPV) infection and increased screening coverage to prevent cervical cancer in Japan where the coverage of Papanicolaou smears is very low.A cost-utility analysis from a societal perspective.Japan, 2010.The female Japanese population aged 11 years or older.A Markov model of the natural history of cervical cancer was constructed to compare six strategies: i.e. a screening coverage rate of 20, 50 and 80% with and without routine vaccination at age 11.Cervical cancer incidence, quality-adjusted life years (QALYs), costs and incremental cost-effectiveness ratios.Expanding the coverage of Papanicolaou smears from the current level of 20-50 and 80% yields a 45.5 and 63.1% reduction in cervical cancer incidence, respectively. Impact of combined strategies increases with coverage. Coverages of 20, 50 and 80% showed a 66.1, 80.9 and 86.8% reduction in disease, respectively. The costs of strategies with vaccination are four times higher than the cost of strategies without vaccination. Vaccinating all 11-year-old girls with bivalent vaccines with a Papanicolaou smear coverage rate of 50% is likely to be the most cost-effective option among the six strategies.The introduction of HPV vaccination in Japan is cost-effective as in other countries. It is more cost-effective to increase the coverage of the Papanicolaou smear along with the universal administration of HPV vaccine.

A fractal is a shape made of parts similar to the whole. Our objective was to determine whether surface growth patterns in malignant epithelial ovarian tumors are 3-D fractal, and if the mean fractal dimension differs according to histologic types.After the images of photographs of 139 resected malignant epithelial ovarian tumors were digitized, the fractal dimensions of surface of solid portions were measured using 3-D fractal analysis software.The mean fractal dimensions of the surface of a solid area of tumor in serous, mucinous, endometrioid, and clear cell adenocarcinoma were 2.320, 2.224, 2.229, and 2.298, respectively. Those of serous and mucinous cystadenoma of low malignant potential (LMP) were 2.398 and 2.282, respectively. These values were significantly greater than the topological dimension of a surface (= 2). The mean fractal dimensions of a solid area of tumor inside the cyst for serous, mucinous, endometrioid, and clear cell carcinoma were 2.347, 2.223, 2.228, and 2.310, respectively. The values for serous and mucinous cystadenoma of LMP were 2.398 and 2.282, respectively.This study shows that the surface of a solid area of malignant epithelial ovarian tumors has a 3-D fractal structure, and the mean fractal dimension may differ according to histologic types.

Cloacal dysgenesis is frequently associated with uterine anomalies. We report a case of pregnancy which resulted in an abortion in a woman with a persistent cloaca. Presumptive diagnosis before operation was ectopic pregnancy of the left tube. Postoperatively, the site of implantation of the conceptus was found to be the cavity of a unicornuate uterus in association with a rudimentary horn, the presence of which misled us to diagnose an ectopic pregnancy.

To investigate the usefulness of intraoperative sonography for the assessment of para-aortic lymph nodes in gynecological malignancies.The assessment of para-aortic lymph node swelling by computed tomography (CT), palpation during surgery and intraoperative sonography was performed in 43 women with a gynecological malignancy. The sensitivity, specificity and predictive values of each technique for assessment of node metastasis were examined in the 33 women who underwent para-aortic lymphadenectomy. For each of the three assessment techniques, the number of para-aortic lymphadenectomies that would have been performed and the number of women who would have had missed metastasis were evaluated assuming a para-aortic lymphadenectomy would be performed only when swollen nodes were detected.Para-aortic nodes were assessed to be swollen by CT, palpation, and intraoperative sonography, respectively, in one, six and 10 of 43 women in total, and in one, six and nine of the 33 women who underwent para-aortic lymphadenectomy. The sensitivity and negative predictive value of intraoperative sonography were 100%, while the specificity and positive predictive value of CT were 100%. If para-aortic lymphadenectomy had been performed only when swollen nodes were detected by intraoperative sonography, the number performed would have decreased from 33 to nine without missing lymph-node metastasis.Intraoperative sonography has potential for the assessment of para-aortic lymph nodes in gynecological malignancies.

To demonstrate the clinical benefit of 2.5 mg daily risedronate in the treatment of involutional osteoporosis, the effect of risedronate on bone mineral density (BMD) of the lumbar spine was compared with that of etidronate, selected as a representative of the bisphosphonates currently marketed in Japan. In this multicenter, randomized, double-masked, active (etidronate) controlled comparative study, a total of 235 Japanese patients with involutional osteoporosis were randomized to receive either treatment with 2.5 mg/day of risedronate for 48 weeks or intermittent treatment with etidronate (4 cycles of 2 weeks of treatment with 200 mg/day followed by 10-week medication-free periods). All patients received 200 mg of calcium supplement daily in the form of the calcium lactate. Bone mineral density of the lumbar spine (L2-L4 BMD) was determined at 12, 24, 36 and 48 weeks by dual-energy X-ray absorptiometry. The primary endpoint was the percent change in L2-L4 BMD from baseline to the time of final evaluation. Changes in biochemical markers of bone turnover and safety profiles were also compared. A significant increase in L2-L4 BMD was observed at 12 weeks after initiation of therapy in both the risedronate (2.8%) and etidronate (1.8%) groups. The increase in L2-L4 BMD at the time of final evaluation in the risedronate group (4.9%) was significantly greater ( p = 0.002) than that in the etidronate group (3.1%). The changes in bone resorption markers (urinary total deoxypyridinoline and N-terminal telopeptide of type I collagen) from baseline to 48 weeks were -37.6% and -41.3% for risedronate and -22.5% and -26.6% for etidronate, respectively. New vertebral fractures or deterioration of existing fractures were observed in 2.8% (3/106) of the patients in the etidronate group, while no such cases (0/101) were observed in the risedronate group. No significant difference in the incidence of adverse events was found between two treatments. Daily oral risedronate (2.5 mg) exhibited efficacy superior to that of intermittent cyclical etidronate (200 mg) in increasing L2-L4 BMD, and was well tolerated by Japanese patients with involutional osteoporosis.

An ultrasound examination in a woman at 9 weeks' gestation demonstrated a gestational sac with a live fetus in the left uterine horn which was surrounded by an extremely thin outer lining. An interstitial pregnancy was suspected and laparoscopy was performed. During laparoscopy the purple bulge in the left horn gradually reduced in size and eventually disappeared following the external pressure by the tip of the forceps. We believe this pressure caused contraction of the superficial myometrial fibers resulting in a shift in the location of the gestational sac to the central area of the uterus. The pregnancy continued and on Cesarean section at 34 weeks' gestation, a membranous protrusion of the uterine wall in the left horn was noticed. A myometrial defect caused by an intrauterine intervention in the patient's previous pregnancy was suspected to be the cause of this "movable gestational sac" phenomenon.

Although the prognostic impact of PTEN mutation in endometrial carcinoma is beginning to be analyzed, the prognostic significance of mutated PTEN exons has not ever been described. Sixty-seven endometrial carcinomas were analyzed for PTEN mutations using single-strand conformation polymorphism analysis and DNA sequencing. First, survival rates were compared according to PTEN status and mutated PTEN exons. Subsequently, univariate and multivariate analyses of various favorable prognostic factors for survival were conducted. The associations between PTEN mutation and clinicopathological features were also statistically evaluated. PTEN mutations were detected in 37 of 67 (55%) specimens. Among 47 mutations, frameshifts (57%) and mutations in exon 8 (38%) were most frequent. In univariate analysis, a factor of PTEN mutation only outside exons 5-7 was associated with significantly better survival (P = 0.02), although mutation in any exon of PTEN was not (P = 0.33). Subsequent multivariate analysis revealed that factors of mutation only outside exons 5-7 of PTEN, stage I/II, and G1 were significant and independent prognostic indicators for favorable survival (P = 0.004, 0.004, and 0.0006, respectively). In the subset of advanced-stage disease, mutation only outside exons 5-7 was associated with a trend toward better survival (P = 0.13). No significant correlation was observed between PTEN mutation and estrogen-related clinicopathological features. In conclusion, we find that PTEN mutation located only outside exons 5-7 is a significant and independent positive prognostic indicator for survival. The current observation has prognostic and therapeutic implications for the management of patients with endometrial carcinoma.

In view of a cytoprotective effect of elastase inhibitor on chemokine-mediated tissue injury, we examined the neuroprotective effect of ONO-5046, a specific inhibitor of neutrophil elastase, in rats with spinal cord injury. Standardized spinal cord compression markedly increased cytokine-induced neutrophil chemo-attractant (CINC)-1 mRNA and protein. Their increases correlated with neurologic severity of injured rats. Immunohistochemically, CINC-1 protein was detected sequentially in vascular endothelial cells at 4 h, in perivascular neutrophils at 8 h, and in neutrophils infiltrating into cord substance at 12 h. Pretreatment with ONO-5046 (50 mg/kg) markedly ameliorated motor disturbance in injured rats, and reduced CINC-1 protein and mRNA expression. ONO-5046 also significantly reduced the increase of neutrophil accumulation or infiltration estimated by myeloperoxidase activity, and the extent of vascular permeability by Evans blue extravasation in the injured cord segment in comparison to control animals receiving vehicle. These results suggest that CINC-1 contributed to inflammation in rat spinal cord injury and ONO-5046 attenuated neurologic damage partly by blocking CINC-1 production of the chemoattractant, preventing neutrophil activation and vascular endothelial cell injury.

Our purpose was to investigate the spillage of the endometrial carcinoma cells to the vaginal cavity and vaginal stump during the surgery.Cytologic examination of specimens obtained from the vaginal cavity and vaginal stump during surgery performed on 15 patients with endometrial carcinoma. And the risk factors of carcinoma cell spillage to the vaginal cavity were investigated.Carcinoma cells from the vaginal cavity were negative for nine patients and positive for six patients. Those from the vaginal stump were negative for l4 patients and positive for one patient. In one patient, both were positive. Total abdominal hysterectomy might be one risk of carcinoma cell spillage to the vaginal cavity compared with modified radical hysterectomy and radical hysterectomy.Endometrial carcinoma cells were spilled into the vaginal cavity in not a few cases and their spillage from there to the vaginal stump could follow during the surgery.

To get insight into the basis for the empirical usage of herbal medicines in the treatment of recurrent abortion, we examined whether Tokishakuyaku-san (Toki) and Sairei-to (Sai) modulate T helper-1 (Th1) and T helper-2 (Th2) cytokine release from peripheral blood mononuclear cells (PBMCs). The effects of these medicines were investigated as related to human leukocyte antigen (HLA)-G, a non-classical HLA class I antigen expressed on trophoblasts and a putative crucial player involved in fetomaternal immune interplay.Toki and Sai increased the release of Th1 group cytokines, tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma while preserving the inhibitory effect of HLA-G on the release of these cytokines. As for Th2 group cytokine release, Toki was without effect in modulating interleukin (IL)-4 release, regardless of the presence of HLA-G, whereas Sai nullified the effect of the presence of HLA-G to stimulate the release of IL-4 without affecting its release in the absence of HLA-G.Toki and Sai may have therapeutic potential, particularly in autoimmunity-related recurrent abortion where Th2 response is pathologically enhanced, but not in recurrent abortion involving alloimmune fetomaternal derangement, a condition of, rather, an enhanced Thl response.

Cephalopagus twinning, an extremely rare type of conjoined twins, is characterized by the anterior union of the upper half of the body, with two faces each situated on the opposite side of a conjoined head. The prognosis for cephalopagus twins is extremely poor because surgical separation is not an option. Thus early prenatal diagnosis of cephalopagus twins is important to provide an opportunity for pregnancy termination if desired. However, in many instances, cephalopagus twins are misdiagnosed as a singleton pregnancy because of the extreme degree of fusion which makes accurate demonstration of the abnormalities very difficult. This report presents a case of cephalopagus twins which was confirmed at 13 weeks of gestation using three-dimensional ultrasound.

In the quest for possible involvement of stem cell factor (SCF), a cytokine known to have multiple effects, in the pathogenesis of endometriosis, we evaluated concentrations of SCF in peritoneal fluid (PF) of women with or without endometriosis.SCF concentrations in PF collected from women undergoing laparoscopy were measured, using a specific enzyme-linked immunosorbent assay (ELISA). Reverse transcription-polymerase chain reaction (RT-PCR) analysis to detect gene expression of c-kit, the receptor for SCF, was performed using the endometriotic tissue and the eutopic endometrium collected during the operation.SCF concentrations in PF of women with endometriosis were significantly higher compared to women without endometriosis. Looking at SCF concentrations in PF of women with endometriosis stratified by disease stage, women with stage I and II exhibited relatively higher SCF levels in PF, whereas SCF levels in PF with stage III and IV were comparable with those without endometriosis. The expression of mRNA for c-kit was detected in both the endometriotic tissue and the eutopic endometrium.We demonstrated an elevation in SCF levels in PF associated with endometriosis and the presence of its receptor in endometriotic tissues. Given the known pleiotropic properties of SCF, the present results suggest that SCF might play a role in the pathogenesis of endometriosis.

It is well established that programmed cell death claims up to two-thirds of the oocytes produced during gametogenesis in the developing fetal ovaries. However, the mechanisms underlying prenatal germ cell loss in females remain poorly understood. Herein we report that caspase-11 null female mice are born with a reduced number of oocyte-containing primordial follicles. This phenotype is likely due to failed cytokine processing known to occur in caspase-11 mutants since neonatal female mice lacking both interleukin (IL)-1α and IL-1β also exhibit a reduced endowment of primordial follicles. In addition, germ cell death in wild-type fetal ovaries cultured ex vivo is suppressed by either cytokine, likely via ligand activation of type 1 IL-1 receptors expressed in fetal germ cells. Normal oocyte endowment can be restored in caspase-11 null female mice by simultaneous inactivation of the gene encoding the cell death executioner enzyme, caspase-2. However, caspase-2 deficiency cannot overcome gametogenic failure resulting from meiotic recombination defects in ataxia telangiectasia-mutated (Atm) null female mice. Thus, genetically distinct mechanisms exist for developmental deletion of oocytes via programmed cell death, one of which probably functions as a meiotic quality-control checkpoint that cannot be overridden. Cell Death and Differentiation (2001) 8, 614–620

Decapentaplegic (Dpp) is a member of the transforming growth factor-beta superfamily. Dpp governs various developmental processes in Drosophila through the transcriptional regulation of a variety of genes. Signals of Dpp are transmitted from the cell membrane to the nucleus by Medea and Mad, both belonging to the Smad protein family. Mad was shown to bind to the Dpp-responsive element in genes such as vestigial, labial, and Ultrabithorax. The DNA binding affinity of Smad proteins is relatively low, and requires other nuclear factor(s) to form stable DNA binding complexes. schnurri (shn) was identified as a candidate gene acting downstream of Dpp receptors, but its relevance to Mad has remained unknown.We characterized the biochemical functions of Shn. Shn forms homo-oligomers. Shn is localized in the nucleus, and is likely to have multiple nuclear localizing signals. Finally, we found that Shn interacts with Mad in a Dpp-dependent manner.The present results argue that Shn may act as a nuclear component of the Dpp signalling pathway through direct interaction with Mad.

Our own recent studies have demonstrated that inducible nitric oxide synthase (iNOS) is predominantly localized in granulosa cells of healthy immature follicles in the rat ovary, whereas granulosa cells of either healthy mature follicles or follicles destined to be atretic are devoid of iNOS. These findings suggest that iNOS is pivotal for immature follicles to remain dormant. To test this hypothesis, we examined the effects of a GnRH agonist (buserelin), a proapoptotic substance, and epidermal growth factor (EGF), a mitogenic and, consequently, antiapoptotic factor, on the amount of iNOS mRNA in rat granulosa cells. Administration of buserelin in immature female rats transiently diminished iNOS mRNA levels in the ovaries as determined by Northern blot analysis. In cultured rat granulosa cells, buserelin and EGF increased the incidence of apoptosis and DNA synthesis, respectively, whereas both reduced iNOS mRNA levels as determined by reverse transcription-coupled polymerase chain reaction. The concomitant addition of S-nitroso-N-acetyl-DL-penicillamine, an NO donor, together with buserelin or EGF eliminated the observed effects of these substances (i.e., induction of apoptosis and stimulation of DNA synthesis, respectively). These results suggest that the changes in developmental status of immature follicles either into development or atresia are associated with reduced iNOS levels in granulosa cells, thus reinforcing the notion of NO as a cytostatic factor in ovarian follicles.

Red cell type RhD(Va) lacks epD1 and 5 and is encoded by hybrid RHD-CE(5)-D alleles. We analyzed RhD(Va) and RhD(Va)-like samples in Japanese blood donors.Ten RhD(Va) samples lacked epD1 and 5 and 3 RhD(Va)-like variants also lacked, epD2 and a part of 6/7. We identified the full-length nucleotide sequences of the complementary DNA (cDNA) synthesized from 4 samples: 3 of type D(Va) and the 4th a D(Va)-like variant.Although their sequences differed from each other, all the substitutions were exclusively in exon 5. Three D(Va) samples had hybrid RHD-CE(5)-D alleles, but the D(Va)-like variant had a unique nucleotide substitution with a single amino acid change, E233K. Exon 5 of the genomic DNA from all 13 samples was analyzed by sequencing. No other sequences were identified.All RhD(Va) and RhD(Va)-like variants had the substitution for E233. E233 seems to be a determinant of epD1 and 5. A new category of RhD variant, DYO, was identified.

We assessed the expression of natural killer (NK) receptors in recurrent aborters before and after immunotherapy using their husbands' peripheral blood mononuclear cells (PBMCs).Using stored PBMCs from recurrent aborters before and after the immunotherapy, the expression of NK receptors, CD158a, CD158b, CD159 and CD94, were analyzed using monoclonal antibodies for respective receptors. The diversity of killer activatory receptors (KARs) and killer inhibitory receptors (KIRs) was also examined using reverse transcriptase-polymerase chain reaction (RT-PCR)-single strand conformation polymorphism (SSCP) method.In recurrent aborters, no apparent changes in NK receptor expression and the balance between KARs and KIRs were found before and after the immunotherapy.The allo-human leukocyte antigen (HLA)-stimulation caused by the immunotherapy for recurrent aborters did not affect the expression of NK receptors and the ratio of KARs to KIRs regardless of the outcome of subsequent pregnancies, suggesting that recurrent aborters may benefit from the immunotherapy through mechanisms unrelated to alteration in NK receptor status.

To examine how preexisting tubal adhesions and endometriosis affect pregnancy outcome after laparoscopic treatment in infertile women with no apparent causes of infertility other than tubal factors.Pregnancy outcomes in 186 infertile women for a follow-up period of 18 months after laparoscopy were analyzed. Laparoscopic manipulations consisted of adhesiolysis of tubes and removal of endometriotic lesions.The patients were classified into three groups, those with no tubal adhesions (group A, n = 83), unilateral tubal adhesions (group B, n = 46) and bilateral tubal adhesions with at least one tube patent (group C, n = 57). The cumulative pregnancy rate in group C (13.2%) was lower than in groups A (41.8%) and B (45.7%) 18 months after laparoscopy. The average time to conception in group A (6.7 +/- 0.8 months) tended to be shorter than that in group B (10.6 +/- 1.2 months). In group A, pregnancy rates were essentially the same between minimal/mild endometriosis and moderate/severe endometriosis. Regarding group B, women with minimal/mild endometriosis exhibited significantly higher pregnancy rates than those with moderate/severe endometriosis, while pregnancy rates in women without endometriosis fell in between.Pregnancy rates after laparoscopic treatment are different in relation to tubal status and the presence of endometriosis.

A tumor suppressor gene on chromosome 10q23, PTEN, encodes a phosphatidylinositol phosphatase that antagonizes activation of the phosphatidylinositol 3'-kinase-mediated pathway involved in cell growth. A gene encoding the catalytic subunit of phosphatidylinositol 3'-kinase (PIK3CA) is frequently activated in ovarian cancers; therefore, overexpression of the PTEN product through gene transfer might be an effective strategy for treating ovarian cancers. To test the potential for this type of gene therapy, we constructed a recombinant adenovirus encoding wild-type PTEN and examined its effects on nine cell lines derived from human ovarian carcinomas. Transduction of the PTEN gene significantly inhibited growth of six of these cell lines compared with infection with virus alone, and the degree of inhibition correlated with the efficiency of gene transfer as determined by beta-galactosidase assay. Results of flow cytometry suggested that the observed effects were mediated by two mechanisms, apoptosis and/or arrest in the G1 phase of the cell cycle, and that high adenoviral transduction efficiency of cells was associated with induction of apoptosis. We also found that the level of transcription of Integrin alpha(v) in ovarian cancer cells correlated with the efficiency of transduction (P = 0.014) and with the degree of growth inhibition after PTEN gene transfer (P = 0.009). These findings carry significant implications for adenovirus vector-based PTEN gene therapies for ovarian cancers.

Chronic administration of gonadotropin-releasing hormone agonist (GnRHa) leads to inhibition of the pituitary—gonadal axis, resulting in a marked suppression of ovarian estrogen production (Schally 1989). Accordingly, GnRHa has been used widely in the treatment of a variety of estrogen-dependent disorders such as endometriosis (Wheeler et al. 1992) and uterine leiomyoma (Adamson 1992). However, long-term GnRHa treatment is not recommended because of concern about bone loss due to hypoestrogenism (Adashi 1994; Surrey 1995). On the other hand, long-term GnRHa treatment is indispensable for women with serious medical illnesses (e.g., leukemia, aplastic anemia, and severe cardiac disease) that would contraindicate surgery. Women approaching menopause are also candidates for long-term treatment. It has recently been proposed that, in order to minimize bone loss caused by hypoestrogenism, but without undermining the therapeutic efficacy of GnRHa, low doses of estrogen and/or progestin should be added back, thus making long-term GnRHa treatment possible; this is known as “add-back therapy” (Adashi 1994; Surrey 1995). To date, however, there is no agreement on an optimal GnRHa/steroid add-back regimen.

Prolactin is known to inhibit the production of prostaglandins, key substances in the initiation of labour. To explore a possible role of prolactin in human parturition, prolactin levels were therefore measured in amniotic fluid and decidua at full-term pregnancy. Prolactin levels in amniotic fluid before labour were about three times higher than those at labour and they tended to decrease with time during labour. Prolactin levels in decidua before labour were about twice as high as those at labour. These findings suggest a possible involvement of prolactin in human parturition. Journal of Endocrinology (1991) 130, 151–153

Human papillomavirus 6 (HPV 6) causes benign condylomata. As a model for HPV vaccine development, we tested a HPV 6 DNA vaccine candidate, constructed by subcloning the major capsid protein (L1) gene into an expression plasmid having the cytomegalovirus promoter, for its immunogenicity in BALB/c mice. Three intracutaneous inoculations of the plasmid with a gene gun at 2-week intervals elicited anti-L1 serum antibodies. The antibodies were found to recognize highly type-specific, conformation-dependent epitopes, including those to neutralize pseudovirions capable of inducing beta-galactosidase in infected monkey COS-1 cells. The data support the idea that immunization with DNA capable of expressing HPV L1 can be used as an HPV vaccine strategy for humans.

The efficacy, safety, and optimum clinical dose of recombinant human interleukin-3 (rhIL-3) was examined in ovarian cancer patients with thrombocytopenia after cancer chemotherapy. In cases with a platelet count75,000/mm3 during the control observation period, rhIL-3 was administered subcutaneously at a dose of 5 or 10 micrograms/kg, once a day for 10 days starting from day 4 of the subsequent chemotherapy course. Comparison between the control observation period and the rhIL-3 administration period showed a significant improvement or a tendency toward improvement in increasing the nadir platelet count and the recovery of the platelet count. The major adverse reactions were pyrexia, fatigue, and headache, which were well controlled by the use of antipyretics, analgesics, and antiinflammatory agents. Adverse reactions were for the most part transient and disappeared quickly during or after rhIL-3 administration. Although severe adverse reactions were not observed, the incidence of grade 2 and 3 adverse reactions according to a World Health Organization (WHO) Toxicity Scale were slightly higher in the 10 micrograms/kg/d group. As a consequence, the 5 micrograms/kg/d dose was considered to have a slightly better safety profile than the 10 micrograms/kg/d dose. Although there was no significant difference in the efficacy (the platelet count) between the two doses, the safety profile of the 5 micrograms/kg/d dose was slightly better than the 10 micrograms/kg/d group. Therefore, the 5 micrograms/kg/d was considered to be the optimum clinical dose.

We investigated the physiological role of epidermal growth factor (EGF) in fetal growth in mice in which midgestational sialoadenectomy induced maternal EGF deficiency. Sialoadenectomy decreased the fetal weight significantly, indicating that maternal EGF deficiency caused intrauterine growth retardation. The weight of the fetal liver in the sialoadenectomized mice was reduced in proportion to the decrease in body weight (82.7+/-10.2 vs. 70.9+/-10.9 mg), whereas the brain weight was not reduced. Sialoadenectomy significantly decreased the glucose concentration in fetal plasma (86.0+/-13.0 vs. 63.0+/-11.8 mg/dl) without affecting the maternal plasma level of glucose. Transplacental transfer of 3H-2-deoxyglucose was significantly decreased by sialoadenectomy (5.17+/-1.25 vs. 2.94+/-1.02%), but transfer of 14C-aminoisobutyric acid was not affected. Northern blot analysis and in situ hybridization of glucose transporter isoform GLUT1 and GLUT3 messenger RNAs (mRNAs) in placenta revealed that sialoadenectomy significantly reduced the expression of GLUT3 mRNA without affecting GLUT1 mRNA levels. Administration of anti-EGF antiserum enhanced the effects of EGF deficiency, which were almost completely corrected by EGF supplementation. These results indicate that EGF plays an important role in fetal growth by regulating the transplacental supply of glucose via GLUT3 expression in the placenta.