Acute stress may induce ovulation in women

<p>Abstract</p> <p>Background</p> <p>This study aims to gather information either supporting or rejecting the hypothesis that acute stress may induce ovulation in women. The formulation of this hypothesis is based on 2 facts: 1) estrogen-primed postmenopausal or ovariectomized women display an adrenal-progesterone-induced ovulatory-like luteinizing hormone (LH) surge in response to exogenous adrenocorticotropic hormone (ACTH) administration; and 2) women display multiple follicular waves during an interovulatory interval, and likely during pregnancy and lactation. Thus, acute stress may induce ovulation in women displaying appropriate serum levels of estradiol and one or more follicles large enough to respond to a non-midcycle LH surge.</p> <p>Methods</p> <p>A literature search using the PubMed database was performed to identify articles up to January 2010 focusing mainly on women as well as on rats and rhesus monkeys as animal models of interaction between the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes.</p> <p>Results</p> <p>Whereas the HPA axis exhibits positive responses in practically all phases of the ovarian cycle, acute-stress-induced release of LH is found under relatively high plasma levels of estradiol. However, there are studies suggesting that several types of acute stress may exert different effects on pituitary LH release and the steroid environment may modulate in a different way (inhibiting or stimulating) the pattern of response of the HPG axis elicited by acute stressors.</p> <p>Conclusion</p> <p>Women may be induced to ovulate at any point of the menstrual cycle or even during periods of amenorrhea associated with pregnancy and lactation if exposed to an appropriate acute stressor under a right estradiol environment.</p

Successful implantation after reducing matrix metalloproteinase activity in the uterine cavity

BACKGROUND: Recently, the concept of recurrent implantation failure (RIF) in assisted reproductive technology has been enlarged. Chronic uterine inflammation is a known cause of implantation failure and is associated with high matrix metalloproteinase (MMP) activity in uterine cavity flushing. MMP activity of women with RIF has been reported to be higher than that of fertile women. In the present retrospective study we evaluated the efficacy of treatment for high MMP activity in the uterine cavity of patients with RIF. METHODS: Of the 597 patients recruited to the study, 360 patients underwent MMP measurements and 237 patients did not (control group). All patients had failed to become pregnant, despite at least two transfers of good-quality embryos. Gelatinase MMP-2 and MMP-9 activity in uterine flushing fluid was detected by enzymology (MMP test). All samples were classified into two groups (positive or negative) based on the intensity of the bands on the enzyme zymogram, which represents the degree of MMP activity. Patients who tested positive on the initial test were treated for 2 weeks with a quinolone antibiotic and a corticosteroid, and subsequently underwent a second MMP test. Negative results on the second MMP tests after treatment and subsequent rates of pregnancy and miscarriage were used to evaluate the efficacy of treatment. Data were analyzed by the Mann–Whitney U-test and the chi-square test. RESULTS: Of the patients who underwent the MMP test, 15.6% had positive results (high MMP activity). After treatment, 89.3% of patients had negative results on the second MMP test. These patients had a significantly better pregnancy rate (42.0%) than the control group (26.6%), as well as a lower miscarriage rate (28.5% vs 36.5%, respectively). CONCLUSIONS: A 2-week course of antibiotics and corticosteroids effectively improves the uterine environment underlying RIF by reducing MMP activity

Involvement of a novel preimplantation-specific gene encoding the high mobility group box protein Hmgpi in early embryonic development

Mining gene-expression-profiling data identified a novel gene that is specifically expressed in preimplantation embryos. Hmgpi, a putative chromosomal protein with two high-mobility-group boxes, is zygotically transcribed during zygotic genome activation, but is not transcribed postimplantation. The Hmgpi-encoded protein (HMGPI), first detected at the 4-cell stage, remains highly expressed in pre-implantation embryos. Interestingly, HMGPI is expressed in both the inner cell mass (ICM) and the trophectoderm, and translocated from cytoplasm to nuclei at the blastocyst stage, indicating differential spatial requirements before and after the blastocyst stage. siRNA (siHmgpi)-induced reduction of Hmgpi transcript levels caused developmental loss of preimplantation embryos and implantation failures. Furthermore, reduction of Hmgpi prevented blastocyst outgrowth leading to generation of embryonic stem cells. The siHmgpi-injected embryos also lost ICM and trophectoderm integrity, demarcated by reduced expressions of Oct4, Nanog and Cdx2. The findings implicated an important role for Hmgpi at the earliest stages of mammalian embryonic development

Expression of HER2 and MUC1 in Advanced Colorectal Cancer: Frequency and Clinicopathological Characteristics

There have been many reports on the overexpression of human epidermal growth factor receptor 2 (HER2) in patients with colon cancer. However, the role and frequency of HER2 overexpression have not been clearly defined. Anti-HER2 therapy has been shown to improve the prognosis of HER2-positive patients with breast and stomach cancers. In this study, we explored HER2 expression in patients with colon cancer at stages II and III by immunohistochemistry (IHC) and dual-color in situ hybridization (DISH), and examined the correlation between HER2 expression and clinicopathological factors. Moreover, we examined the correlation between HER2 expression and mucin 1 (MUC1) expression. The subjects were 121 patients with colon cancer at stages II and III who underwent surgery in our hospital during the period from 2007 to 2009. Sections containing the deepest part of a lesion were subjected to immunostaining for HER2 and MUC1. HER2 expression was assessed in accordance with Ventana\u27s Guidelines for HER2 Testing in Stomach Cancer, with sections comprising less than 10% of weakly to moderately stained tumor cells scored as 1 > 2. HER2 expression scored as 2 was defined with sections comprising more than 10% of the weakly to moderately stained tumor cells. Patients with a score of 1 > 2 and 2 were also subjected to DISH using a Dual ISH HER2 kit. MUC1 expression was scored according to the percentage of stained area as follows: 0, 0 to 5%; 1, 5 to 50%; and 2, 50% and higher. Patients with a score of 1 and 2 were defined as MUC1-positive. The analysis of HER2 by IHC yielded the following scores: 45 patients (37.2%), 0; 38 patients (31.4%), 1; 14 patients (11.6%); 1 > 2; 24 patients (19.8%), 2; and 0 patients (0%), 3. For the 38 patients with a score of 1 > 2 and 2, DISH returned ratios of HER2 to Chr17 expression (HER2: Chr17 ratio) from 1.13 to 1.93 (mean = 1.46). There was no significant correlation between HER2 expression and clinicopathological factors. The numbers of MUC1-positive patients according to HER2 score were as follows: 22 patients (48.9%) in the score 0 group (45 patients); 25 patients (65.8%) in the score 1 group (38 patients); 10 patients (71.4%) in the score 1 > 2 group (14 patients), and 22 patients (91.7%) in the score 2 group (24 patients). There was a positive correlation between HER2 expression and MUC1 expression. Specifically, MUC1 expression levels increased with HER2 expression level, and the percentage of MUC1-positive patients was significantly higher in the HER2 score 2 group than in the HER2 score 0 group (P < 0.01). Rates of HER2 positivity by DISH or fluorescence in situ hybridization (FISH) in patients who had an HER2 score of 2+ by IHC were 45% and 24% in the patients with stomach and breast cancers, respectively. However, the positivity rate was 0% in the patients with colon cancer in this study. This result indicates that patients with colon cancer who have an IHC HER2 score of 2+ are more likely to be HER2 negative by DISH than patients with breast and stomach cancers, although larger cohort studies are required before a definitive conclusion can be made. There was a positive correlation between HER2 expression and MUC1 expression in this study, although further examination is required because there were no patients who had an HER2 score of 3+ or 2+ by IHC and were HER2 positive by DISH in this study. HER2 expression in colon cancer should be cautiously assessed by both IHC and DISH

An Autopsy Case of Multiple Jejunal Diverticula Showing Severe Malabsorption

A rare autopsy case of multiple jejunal diverticula showing severe malabsorption is reported. A 56-year-old man was admitted due to vomiting and leg edema. On admission, his height was 160cm, his body weight was 39kg, and laboratory data revealed severe hypoproteinemia (TP: 4.0g/dl, ALB: 2.1g/dl). On the 14th day of admission, agonal breathing and disturbance of consciousness occurred after massive vomiting of gastric juice, and the patient died of respiratory failure. At autopsy, on abdominal sectioning, multiple diverticula situated on the mesenterium side of the enteron extending 70cm in length from the proximal jejunum were identified. However there were no findings suggesting perforation or diverticulitis. Histologically, the diverticula were lined by ordinal jejunum mucosa associated with muscularis mucosa, but the muscularis propria was not involved in the diverticular walls. The diverticula were identified as false diverticula. In both lower lungs, aspiration pneumonia was widely seen. The cause of death was considered to be aspiration pneumonia due to the vomiting caused by multiple jejunal diverticula.Only 16 case reports of multiple jejunal diverticulosis in Japan could be found in the literature however most of the reported complications were perforation and diverticulitis, and there were no reports of malabsorption. Therefore, the present case is significant concerning the cause of malabsorption in routine explorations

Positive Relationship between L-type Amino Acid Transporter 1 Expression and Liver Metastasis in T3 Colorectal Cancer

The aim of this retrospective study was to evaluate L-type amino acid transporter 1 (LAT1) expression in colorectal cancer with invasion to the subserosal layer (T3), its relationship with clinicopathological characteristics, and its potential metastatic significance. LAT1 expression was measured by immunohistochemistry in tumors from 65 patients with primary colorectal carcinomas. LAT1 expression was deemed positive when more than 10% of the tumor cells showed distinct membranous immunoreactivity. Positive LAT1 expression was demonstrated in 29.2% (19 of 65) of primary tumors. LAT1 expression showed no significant relationship with clinicopathological characteristics, such as age, gender, tumor location, tumor size, macroscopic/microscopic classification, or lymph node metastasis. However, LAT1 expression showed a positive relationship with liver metastasis (P < 0.05). LAT1 expression in cancer cells may be a good marker for predicting potential metastasis to the liver in colorectal cancer

A Rare Case of Peripheral Primitive Neuroectodermal Tumor Arising from the Minor Salivary Gland in a Young Woman

We report here a case of peripheral primitive neuroectodermal tumor (PNET) arising from the minor salivary gland. A 22-year-old woman was admitted to our hospital for surgical excision of a small painless cheek tumor with a 7-month history. Macroscopically, the tumor measured 10 × 5 × 6mm and was located in the minor salivary gland. Microscopically, the tumor comprised proliferating, small, round cells with scant cytoplasm and high nuclear cytoplasmic ratios. The tumor cells showed some mitotic figures and Homer-Wright-type rosettes. Immunohistochemically, the tumor cells were immunopositive for CD99, synaptophysin, CD56, S-100 protein, and vimentin. Based on these findings, the patient was diagnosed as having PNET arising from the minor salivary gland. There are very few case reports of PNET in the head and neck region, and to the best of our knowledge, this is the first case report of PNET arising from the minor salivary gland

A Case of Unusual Polypoid Mixed Hemangioma of the Sigmoid Colon: Possibly an Angioadenomatous Polyp

Herein, we report on an unusual case of polypoid mixed hemangioma of the sigmoid colon. An 85-year-old woman who underwent colonoscopic examination was found to have a smooth, red polypoid tumor, 6mm in diameter, in the sigmoid colon. The polyp was resected endoscopically. Microscopically, the polyp contained two pathologic components: (i) adenomatous proliferative glands as the epithelial component; and (ii) mixed hemangioma as the mesenchymal component. On the basis of these findings, a pathological diagnosis of angioadenomatous polyp was made. Although seven previous cases of polypoid hemangioma located in the submucosa have been reported in the literature, the present case is the first in which the hemangioma is localized only in the mucosa. The mixed hemangioma may be the pathogen stimulating the adenomatous proliferation of the glands