Reduction of apoptosis and proliferation in endometriosis

Objective: To evaluate whether endometriosis could be related to an impaired balance between apoptosis and proliferation, two processes which could be modulated by hormonal status. Design: Immunohistochemical study. Setting: Academic research laboratory. Intervention(s): Endometriotic samples obtained from peritoneum of women aged 26-40 years who were undergoing laparoscopy for pain or infertility. Main Outcome Measure(s): Apoptotic cells were detected with the use of the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. The production of p53 and bcl-2, estrogen and Progesterone (P) receptors, and cellular proliferation were assessed by immunohistochemistry in eutopic and ectopic endometria from 30 patients with endometriosis throughout the menstrual cycle. Results were compared with those from normal endometria from 15 fertile patients. Result(s): Endometriotic lesions were characterized by reduced TUNEL and p53 stainings and by enhanced bcl-2 staining. No correlation between apoptosis and estrogen receptor or P receptor levels was found. A lower amount of steroid receptor was found in endometriotic tissues, without cyclic modulation, compared with the eutopic endometrium. Conclusion(s): Our results suggest that when endometrial tissue is located at ectopic locations, it differs from eutopic endometrium by its proliferation rate, steroid hormone levels, and markers of apoptosis. A reduced sensitivity of endometriotic cells to apoptosis could promote the dissemination and implantation of these cells to ectopic sites. (C) 2004 by American Society for Reproductive Medicine.Peer reviewe

Endométriose : pourquoi se développe-telle ?

peer reviewedL’endométriose est une maladie œstrogéno-dépendante responsable d’une morbidité importante liée notamment aux opérations multiples et aux phénomènes douloureux. De nouvelles données sur les facteurs génétiques, le rôle possible de l’environnement, du système immunitaire, de l’inflammation offrent des nouvelles perspectives concernant la physiopathogénie de cette affection permettant ainsi de nouvelles approches thérapeutiques et d’autres voies pour un diagnostic moins invasif que la cœlioscopie exploratrice.Endometriosis is an estrogen-dependent disorder that can result in substantial morbidity, including multiple operations, and pelvic pain. New findings on the genetics, the possible roles of the environment, the immune system, and the inflammation have given insight into the pathogenesis of this disorder and serve as the background for new treatments and new diagnostic approach

An unusual diagnosis of a bicornuate unicollis uterus

We present a case of an unusual diagnosis of a bicornuate unicollis uterus mimicking a uterus didelphys with blind hemivagina. Few cases of a bicornuate uterus have been reported with the primary symptom of a paracervical pyocolpos. The difficulties involved in the diagnosis and management of this particular congenital malformation are described in detail. The role of imaging techniques and adequate preoperative preparation is emphasised with a review of recent literatur

Gynaecological uses of a new class of steroids: the selective progesterone receptor modulators

Selective progesterone receptor modulators (SPRM) represent a new class of synthetic steroids, which can interact with the progesterone receptor (PR) and can exert agonist, antagonist or mixed effects on various progesterone target tissues in vivo. This review evaluates the actual and potential usefulness of SPRMs in gynaecolog

The presence of a type IV collagen skeleton associated with periductal elastosis in breast cancer

Using serial sections of frozen and AFA-fixed tissues from 34 breast cancers, we studied the presence of basement membrane material in the areas of elastosis. Various amounts of type IV collagen but not of laminin were demonstrated in areas of periductal elastosis. In some tumors, type IV collagen accumulated beneath the basement membrane. Periductal elastosis in areas of extensive fibrosis showed focal type IV collagen immunoreactivity, indicating remnants of ducts. Interstitial elastosis corresponded with weak type IV collagen reactivity. Each tumor showed type IV collagen immunostaining of the elastotic areas, with various degrees of intensity. Negative crossreactivity of the type IV collagen antibody with elastin was verified in skin biopsies with solar elastosis. Pre-incubation of the antibody with large amounts of elastin demonstrated an identical immunoreactivity. The specificity of the antibody was confirmed by ELISA and by Western blot analysis. To explain the periductal elastosis, we propose the following hypothesis. Excessive production of basement membrane material by the epithelial cells of the ducts leads to formation of a type IV collagen skeleton. This skeleton can act as the matrix for a secondary deposition of elastic material.Peer reviewe

Reticular fibroblasts in peripheral lymphoid organs identified by a monoclonal antibody.

peer reviewedWe have produced a panel of monoclonal antibodies directed against nonlymphoid cells in central and peripheral lymphoid organs. In this paper we present the reactivity of one of these antibodies, ER-TR7. This antibody detects reticular fibroblasts, which constitute the cellular framework of lymphoid and nonlymphoid organs and their products. In frozen sections of the spleen incubated with this antibody, the red pulp and white pulp are clearly delineated. Furthermore, the major white pulp compartments--the follicles and periarteriolar lymphoid sheath as well as the marginal zone--are recognized by their characteristic labeling patterns. In lymph nodes, the capsule, sinuses, follicles, paracortex, and medullary cords are clearly delineated. In the thymus and bone marrow no such specialized compartments were demonstrated. ER-TR7 reacts with an intracellular component of fibroblasts. Since ER-TR7 does not react with purified laminin, collagen types I-V, fibronectin, heparan sulfate proteoglycan, entactin, or nidogen, it detects a hitherto uncharacterized antigen. The possible role of the ER-TR7 positive reticular fibroblasts in the cellular organization of peripheral lymphoid organs will be discussed

Programme excentrique dans la pathologie du coude : tendinopathie épicondylienne

Lateral epicondylitis represents a common overuse injury caused by repetitive gestures through sports activity, industrial work and hobby activities. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently reported. The goal of our study was to compare the outcome of patients performing an adapted isokinetic eccentric training with that of patients receiving a non-strengthening classical rehabilitation. Results, dealing with pain score evaluation, disability questionnaire, muscle strength measurement and ultrasonographic examination, highlight the relevance of implementing isokinetic adapted eccentric training in the management of lateral epicondylitis

Adhesion of endometrial cells labeled with 111 Indium-tropolonate to peritoneum: a novel in vitro model to study endometriosis

Objective: To evaluate, in a new original in vitro assay, putative factors that could modulate the adhesion of endometrial cells to peritoneum. Design: Prospective, controlled in vitro study. Setting: Academic research laboratory. Patient(s): Fourteen nonmenopausal women undergoing hysterectomy or laparoscopy for benign gynecologic indication. Intervention(s): Endometrial cells obtained from women with regular cycles without endometriosis were labeled with (111)Indium and confronted in vitro with mouse peritoneum in the presence of various cytokines and/or antiadhesive compounds. Main Outcome Measure(s): Radioactivity in (111)Indium-labeled endometrial cells. Result(s): The adhesion of human endometrial cells to mouse peritoneum was increased by treatment with pro-inflammatory cytokines (interleukin IL-1 beta, IL-6, TNF alpha, TGF-beta1). Whereas heparan sulfate had no effect on cell adhesion, a gel of ferric hyaluronate (Intergel) was able to counteract the pro-adhesive effect of cytokines. Interestingly, the pretreatment of peritoneum with cytokines, 24 hours before cell seeding in the presence of the ferric hyaluronate gel, restored the cytokine-promoting effect on cell adhesion. Conclusion(s): Proinflammatory cytokines promote the in vitro peritoneal adhesion of endometrial cells. An antiadhesive hyaluronate gel used in clinics decreases the adhesion in a dose-dependent manner and reduces cytokine bioavailability. (Fertil Steril((R)) 2003;79(Suppl 1):724-9. (C) 2003 by American Society for Reproductive Medicine.).Peer reviewe

The impact of detailed explanatory leaflets on patient satisfaction with urodynamic consultation: A double-blind randomized controlled trial.

peer reviewedAims To develop and validate a scale that is applicable in Belgium to investigate the aspects of female patients' satisfaction with urodynamic consultation, and to use it to measure the impact of a detailed explanatory leaflet on their satisfaction. Materials and Methods Question items were obtained from a group consensus (Delphi process). Each item was scored on a five-point Likert scale. The satisfaction scale was administered to two groups of patients attending the clinics for urodynamics. One hundred twenty-nine patients were included in the study and randomized in two groups. One group (n = 60) received a detailed explanatory leaflet about urodynamic consultation and the other did not (n = 69). Responses were subjected to a reliability and principal component analysis (PCA) to achieve data reduction and analysis, and to assess the reliability of the new scale. Relevant items were retained to compare both interventions using regression analysis. Results A 15-item scale was derived from the Delphi process. Exploratory factor analysis suggested a single factor solution with 11 meaningful items. No significant difference was noted in global scores of satisfaction between the two groups (P = 0.051). Conclusions A short-form patient satisfaction scale with acceptable validity and reliability was developed and used to measure patient satisfaction with urodynamic consultation in this population of Belgian women. This study did not provide support for the effectiveness of explanatory leaflets in improving satisfaction