Laparoscopic Diagnosis of Adenomyosis : a Case Report

Usually, Adenomyosis is diagnosed after surgery. Laparoscopic diagnosis may have advantages over other surgical procedures, especially for infertility patients undergoing expectant therapy. We successfully diagnosed adenomyosis using a laparoscopic needle biopsy technique in an infertility patient

A Detailed Observational Study of Molecular Loops 1 and 2 in the Galactic Center

Fukui et al. (2006) discovered two huge molecular loops in the Galactic center located in (l, b) ~ (355 deg-359 deg, 0 deg-2 deg) in a large velocity range of -180-40 km s^-1. Following the discovery, we present detailed observational properties of the two loops based on NANTEN 12CO(J=1-0) and 13CO(J=1-0) datasets at 10 pc resolution including a complete set of velocity channel distributions and comparisons with HI and dust emissions as well as with the other broad molecular features. We find new features on smaller scales in the loops including helical distributions in the loop tops and vertical spurs. The loops have counterparts of the HI gas indicating that the loops include atomic gas. The IRAS far infrared emission is also associated with the loops and was used to derive an X-factor of 0.7(+/-0.1){\times}10^20 cm^-2 (K km s^-1)^-1 to convert the 12CO intensity into the total molecular hydrogen column density. From the 12CO, 13CO, H I and dust datasets we estimated the total mass of loops 1 and 2 to be ~1.4 {\times} 106 Msun and ~1.9 {\times} 10^6 Msun, respectively, where the H I mass corresponds to ~10-20% of the total mass and the total kinetic energy of the two loops to be ~10^52 ergs. An analysis of the kinematics of the loops yields that the loops are rotating at ~47 km s-1 and expanding at ~141 km s^-1 at a radius of 670 pc from the center. Fukui et al. (2006) presented a model that the loops are created by the magnetic flotation due to the Parker instability with an estimated magnetic field strength of ~150 {\mu}G. We present comparisons with the recent numerical simulations of the magnetized nuclear disk by Machida et al. (2009) and Takahashi et al. (2009) and show that the theoretical results are in good agreements with the observations. The helical distributions also suggest that some magnetic instability plays a role similarly to the solar helical features.Comment: 40 pages, 22 figures, submitted to publication in PAS

Discovery of Molecular Loop 3 in the Galactic Center: Evidence for a Positive-Velocity Magnetically Floated Loop towards L=355∘−359∘L=355^\circ-359^\circ

We have discovered a molecular dome-like feature towards $355^{\circ} \leq l \leq 359^{\circ}$ and $0^{\circ} \leq b \leq 2^{\circ}$. The large velocity dispersions of 50--100 km s$^{-1}$ of this feature are much larger than those in the Galactic disk and indicate that the feature is located in the Galactic center, probably within $\sim1$ kpc of Sgr A$^{*}$. The distribution has a projected length of $\sim600$ pc and height of $\sim300$ pc from the Galactic disk and shows a large-scale monotonic velocity gradient of $\sim130$ km s $^{-1}$ per $\sim600$ pc. The feature is also associated with HI gas having a more continuous spatial and velocity distribution than that of $^{12}$CO. We interpret the feature as a magnetically floated loop similar to loops 1 and 2 and name it "loop 3". Loop 3 is similar to loops 1 and 2 in its height and length but is different from loops 1 and 2 in that the inner part of loop 3 is filled with molecular emission. We have identified two foot points at the both ends of loop 3. HI, $^{12}$CO and $^{13}$CO datasets were used to estimate the total mass and kinetic energy of loop 3 to be \sim3.0 \times 10^{6} \Mo and $\sim1.7 \times 10^{52}$ ergs. The huge size, velocity dispersions and energy are consistent with the magnetic origin the Parker instability as in case of loops 1 and 2 but is difficult to be explained by multiple stellar explosions. We argue that loop 3 is in an earlier evolutionary phase than loops 1 and 2 based on the inner-filled morphology and the relative weakness of the foot points. This discovery indicates that the western part of the nuclear gas disk of $\sim1$ kpc radius is dominated by the three well-developed magnetically floated loops and suggests that the dynamics of the nuclear gas disk is strongly affected by the magnetic instabilities.Comment: 30 pages, 10 figures. High resolution figures are available at http://www.a.phys.nagoya-u.ac.jp/~motosuji/fujishita09_figs

Histological and Immunohistochemical Analysis of Fetal Hypoplastic Lungs: Preliminary Study

To investigate cellular growth and differentiation of the airway epithelium of the human fetal lung using immunohistochemistry, with a particular focus on cases of pulmonary hypoplasia. A total of 25 autopsy cases of stillbirth and early neonatal death were examined at Nagasaki University Hospital from 1986 to 1997. Using immunohistochemistry, we determined the expression of a variety of growth factors (EGFR, HGFR, GRP and SAPA) in lung tissues with or without pulmonary hypoplasia. A significant decrease in radial alveolar count was detected in hypoplastic lungs compared with normal lungs. The expressions of EGFR, HGFR and GRP in tissues from hypoplastic lungs were significantly lower than in tissues from normal lungs, but the expression of SAPA was not different between the two groups. Our results indicated that significant abnormalities of cellular growth and differentiation are present in pulmonary hypoplasia. However, lung maturation in pulmonary hypoplasia was not significantly different to that in normal lungs

Changes in serum anti-Müllerian hormone levels may predict damage to residual normal ovarian tissue after laparoscopic surgery for women with ovarian endometrioma.

We measured serum anti-Müllerian hormone levels before and after surgery in women undergoing unilateral and monolocular cystectomy for benign ovarian diseases. Comparing to control benign cysts, we found a significant decline in serum anti-Müllerian hormone levels with consequent depletion of follicles in tissue specimens after surgery for women with ovarian endometrioma

Adenocarcinoma of the Uterine Cervix Detected Over Long-Term Mass Screening in Japan

We retrospectively reviewed the history, records of detailed examination and/or treatment, and cytologic/histologic specimens of 32 adenocarcinoma cases (0.006%) detected among 482,451 examinees in a mass screening for cervical cancer conducted over a 20-year period (1975-1994). The detection rate of adenocarcinoma had increased gradually until 1989 with the increase of total examinees but became markedly lower in the last five-year period (p = 0.0227), probably because of the significant decrease in the number of initial examinees (p<0.0001). The frequency of early-stage adenocarcinoma (stage 0 or Ia) was 37.5% (12/ 32), markedly higher than the 8.4% (7/83) of the adenocarcinoma cases treated at our institution during the same period (p = 0.0004). Glandular epithelial neoplasms were suggested by cervical smears at detection in only 5/12 (41.7%) of the early-stage adenocarcinoma cases and in 17/ 20 (85.0%) of the frankly invasive adenocarcinoma cases (p= 0.0184). Atypical glandular epithelial cells could not be found in the smears at detection from the remaining 10 cases. Atypical cells from coexisting squamous cell neoplasms were found. The rate of the histologic coexistence of squamous cell neoplasms was 9/12 (75.0%) in the earlystage group and 6/20 (30.0%) in the frankly invasive group (p = 0.0269). This rate tended to decrease with the progress of the stage. Mass screening can detect early-stage adenocarcinoma in cervical smears, but half or more of the cases are discovered in smears with atypical cells from coexisting squamous cell neoplasms and incidentally found later in histologic specimens. To improve the accuracy of detecting cervical adenocarcinomas, we should investigate the cytologic features of atypical glandular epithelial cells obtained from early-stage adenocarcinomas. The its epidemiologic profile of this cancer should be furthur delineated for efficient mass screening programs

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

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 without endometriosis. Estrogen receptor (ER) and progesterone receptor (PR) expression in macrophages was demonstrated by immunohistochemistry and RT-PCR. Production of HGF in the culture media of basal and ovarian steroid-stimulated macrophages was examined by enzyme-linked immunosorbent assay. Expression of mRNA for HGF and its receptor, c-Met in macrophages and stromal cells in response to ovarian steroid was investigated by RT-PCR. The single and combined effect of HGF and estrogen on the growth of macrophages and stromal cells was analysed by bromodeoxyuridine (BrdU) incorporation. Results: ER and PR were expressed in isolated macrophages and intact tissue at the protein and mRNA levels. Macrophages derived from women with endometriosis produced significantly higher concentration of HGF (352.2 ± 4.9 pg/ml) in conditioned media after treatment with estradiol (10-8 mol/l) than that of basal macrophages (221.5 ± 32.8 pg/ml, P < 0.05) or women without endometriosis (170.6 ± 2.6 pg/ml, P < 0.05). These effects were less evident after treatment with progesterone. Treatment with tamoxifen (10-6 mol/l) reversed the production of HGF and other macromolecules. Secretion of HGF in response to ovarian steroids was further enhanced after activation with lipopolysaccharide. The mRNA expressions of HGF and its receptor, c-Met, were also detected in macrophages and stroma in response to estrogen, suggesting an autocrine regulation. HGF mRNA expression was higher in cells of women with endometriosis than non-endometriosis women. Bromodeoxyuridine incorporation indicated that exogenous stimulation with HGF and estrogen, either alone or in combination, significantly increased the cell proliferation of both endometrial stroma and macrophages compared to that of non-endometriosis or non-treated cells. Conclusion: These results suggest that besides other inflammatory mediators, ovarian steroids also participate in the production of HGF by peritoneal macrophages which may be involved in the growth of endometriosis either alone or in combination with estrogen

Changes in tissue inflammation, angiogenesis and apoptosis in endometriosis, adenomyosis and uterine myoma after GnRH agonist therapy

Background: Information is limited regarding multifunctional role of GnRH agonist (GnRHa) therapy in reproductive diseases. We investigated pattern of changes in inflammatory reaction, micro-vessel density and apoptosis in the tissues collected from women with endometriosis, adenomyosis and uterine myoma who were treated with or without GnRHa therapy. Methods: Biopsy specimens were collected from lesions, myometria and corresponding endometria of 45 women with ovarian endometrioma, 35 women with adenomyosis, and 56 women with uterine myoma. A fraction of these women were treated with GnRHa therapy for a variable period of 3-6 months before surgery. We performed immunohistochemical analysis of CD68, a macrophage (Mφ) marker, and von Willebrand factor (VWF), a vessel marker, using respective antibodies. The changes in apoptosis were examined using TdT-mediated dUTP-biotin nick end-labeling (TUNEL) assay and by the immunoexpression of activated caspase-3 in tissues after GnRHa therapy. Results: The infiltration of CD68-positive M φ and VWF-positive micro-vessel density were significantly decreased in the endometria of women with endometriosis, adenomyosis and uterine myoma in the GnRHa-treated group when compared with that in the non-treated group. A marked decrease in inflammatory and angiogenic responses were observed in lesions and myometria of these diseases. When compared with non-treated group, a significantly increase in apoptotic index (apoptotic cells per 10 mm2 area) and quantitative-histogram (Q-H) scores of activated caspase-3 after GnRHa therapy were observed in the eutopic endometria, lesions and myometria of these diseases. Conclusion: GnRH agonist was able to markedly reduce the inflammatory reaction and angiogenesis and significantly induce apoptosis in tissues derived from women with endometriosis, adenomyosis and uterine myoma. These multiple biological effects at the tissue level may be involved in the regression of these reproductive diseases

Effect of human seminal fluid on the growth of endometrial cells of women with endometriosis.

OBJECTIVES: We investigated the effect of human seminal fluid on the growth of endometrial cells derived from women with and without endometriosis. STUDY DESIGN: Seminal plasma (SP) was collected from 18 healthy fertile men. Serum, peritoneal fluid (PF) and tissue specimens of eutopic and ectopic endometrium were collected from 45 women with endometriosis and 20 women without endometriosis during laparoscopic surgery. Prostaglandin (PG) E2, hepatocyte growth factor (HGF), and estradiol (E2) levels in each sample of SP, serum and PF were measured by enzyme-linked immunosorbent assay. The growth pattern of cells derived from eutopic and ectopic endometria in response to SP was examined by 5-bromo-2-deoxyuridine (BrdU) incorporation assay. RESULTS: Seminal plasma was able to significantly stimulate the growth of epithelial cells and stromal cells derived from the eutopic and ectopic endometria of women with endometriosis (2-3-fold) when compared with control media. The SP-promoted proliferation of both gland cells and stromal cells derived from eutopic endometria was also remarkably higher in women with endometriosis than that of women without endometriosis. Although levels of PGE2, HGF and E2 in SP were variable when compared with other body fluids, the levels of PGE2 and HGF in SP were significantly higher than those in either peritoneal fluid or serum of women with or without endometriosis. Pretreatment of cells with individual anti-PGE2 antibody, anti-HGF antibody and two selective estrogen receptor modulators, tamoxifen and raloxifene was unable to suppress SP-mediated growth of endometrial cells. However, pretreatment of cells with combined anti-PGE2 antibody plus anti-HGF antibody or combined anti-PGE2 antibody plus anti-HGF antibody plus tamoxifen or raloxifene was able to significantly suppress SP-promoted growth of eutopic and ectopic endometrial cells. CONCLUSION: Human seminal fluid enriched with different macromolecules may promote the growth of endometrial cells derived from women with endometriosis. Our findings may suggest some detrimental effect of unprotected sexual intercourse in women with endometriosis

High Excitation Molecular Gas in the Galactic Center Loops; 12CO(J =2-1 and J =3-2) Observations

We have carried out 12CO(J =2-1) and 12CO(J =3-2) observations at spatial resolutions of 1.0-3.8 pc toward the entirety of loops 1 and 2 and part of loop 3 in the Galactic center with NANTEN2 and ASTE. These new results revealed detailed distributions of the molecular gas and the line intensity ratio of the two transitions, R3-2/2-1. In the three loops, R3-2/2-1 is in a range from 0.1 to 2.5 with a peak at ~ 0.7 while that in the disk molecular gas is in a range from 0.1 to 1.2 with a peak at 0.4. This supports that the loops are more highly excited than the disk molecular gas. An LVG analysis of three transitions, 12CO J =3-2 and 2-1 and 13CO J =2-1, toward six positions in loops 1 and 2 shows density and temperature are in a range 102.2 - 104.7 cm-3 and 15-100 K or higher, respectively. Three regions extended by 50-100 pc in the loops tend to have higher excitation conditions as characterized by R3-2/2-1 greater than 1.2. The highest ratio of 2.5 is found in the most developed foot points between loops 1 and 2. This is interpreted that the foot points indicate strongly shocked conditions as inferred from their large linewidths of 50-100 km s-1, confirming the suggestion by Torii et al. (2010b). The other two regions outside the foot points suggest that the molecular gas is heated up by some additional heating mechanisms possibly including magnetic reconnection. A detailed analysis of four foot points have shown a U shape, an L shape or a mirrored-L shape in the b-v distribution. It is shown that a simple kinematical model which incorporates global rotation and expansion of the loops is able to explain these characteristic shapes.Comment: 59 pages, accepted to PAS