Gene expression signatures associated with chronic endometritis revealed by RNA sequencing

IntroductionChronic endometritis (CE) is a persistent inflammatory condition of the endometrium characterized by the infiltration of plasma cells in the endometrial stroma. CD138 immunohistochemistry is considered to improve the CE diagnosis rate.MethodsUsing the number of CD138-positive cells equal or greater than five as a diagnostic criterion for CE, we identified 24 CE and 33 non-CE cases among women with infertility. We conducted RNA-sequencing analysis for these 57 cases in total as an attempt to elucidate the molecular pathogenesis of CE and to search for new biomarkers for CE.Results and DiscussionBy comparing CE and non-CE groups, we identified 20 genes upregulated in the endometria of CE patients, including 12 immunoglobulin-related genes and eight non-immunoglobulin genes as differentially expressed genes. The eight genes were MUC5AC, LTF, CAPN9, MESP1, ACSM1, TVP23A, ALOX15, and MZB1. By analyzing samples in the proliferative and secretory phases of the menstrual cycle separately, we also identified four additional non-immunoglobulin genes upregulated in CE endometria: CCDC13 by comparing the samples in the proliferative phase, and OVGP1, MTUS2, and CLIC6 by comparing the samples in the secretory phase. Although the genes upregulated in CE may serve as novel diagnostic markers of CE, many of them were upregulated only in a limited number of CE cases showing an extremely high number of CD138-positive cells near or over one hundred. Exceptionally, TVP23A was upregulated in the majority of CE cases regardless of the number of CD138-positive cells. The upregulation of TVP23A in the endometria of CE cases may reflect the pathophysiology of a cell-type or cell-types intrinsic to the endometrium rather than the accumulation of plasma cells. Our data, consisting of clinical and transcriptomic information for CE and non-CE cases, helped us identify gene expression signatures associated with CE

第5回「卒業生の保健師の集い」をふりかえって

報告Report第5回「卒業生の保健師の集い」のまとめの目的は、卒業生保健師と在学生ボランティア、そして地域看護教員3者での協働の側面が確立されつつあり、3者の角度から「集い」を評価することであった。評価した結果、活動発表者は各自の活動を評価し新たな目標を見出していた。一方参加者間ではセルフ・エンパワメント、ピア・エンパワメント効果が示されていた。さらに在学生ボランティアは保健師活動の面白さを見つけていた。このことより企画・運営・評価を担当する地域看護教員の目標は達成されたと考えられた。さらにこの「集い」を毎年行うことで、一つの行事として定着し、3者がそれぞれの役割を持ち、協働する中でエンパワーメントを目標にした「集い」として位置づいてきたと感じている

Surgical and oncological outcome of laparoscopic surgery, compared to laparotomy, for Japanese patients with endometrial cancer

Study objective: The purpose of this study was to elucidate the surgical and oncological outcomes after laparoscopic surgery for endometrial cancer at our hospital. Materials and methods: Surgical outcomes, complications rates, 2-year survival rates, and recurrence rates were evaluated in 44 patients who underwent total laparoscopic hysterectomy (TLH) and 57 patients who underwent total abdominal hysterectomy (TAH) for endometrial cancer at our hospital between August 2010 and November 2013. Results: There was no significant difference between the two groups with respect to age or body mass index. More than 80% of patients in both groups had stage I cancer. In the TLH group, the histological types were endometrioid adenocarcinoma in 42 of 44 patients, carcinosarcoma in one patient, and serous adenocarcinoma in one patient. Operative times were significantly longer in the TLH group, but patients in this group had less intraoperative blood loss, shorter hospital stays, and reduced levels of postoperative pain, compared to patients in the TAH group. There were four cases of postoperative infection and one case of vessel injury in the TLH group. No patient in this group required blood transfusion or conversion to open surgery. There were recurrences in two (4.7%) patients in the TLH group (i.e., carcinosarcoma and serous adenocarcinoma) and in five (8.6%) patients in the TAH group. Conclusion: Laparoscopic surgery is safe and feasible for patients with early-stage endometrial cancer. However, patients with carcinosarcoma and other histologic types of endometrioid adenocarcinoma require special attention because of the high risk of recurrence and poor prognosis

Use of magnetic resonance analysis for clinical evaluation of the peripheral area of gestational sac in bleeding and non-bleeding ectopic pregnancy cases

Purpose To evaluate preoperative magnetic resonance (MR) imaging features of bleeding and non-bleeding ectopic pregnancy (EP) by comparison with surgical findings. Methods Eighteen suspected EP cases underwent preoperative MR imaging. We classified 8 cases as the bleeding group and 7 cases as the non-bleeding group with or without intra-abdominal bleeding and/or hematoma at the site of EP, and compared, retrospectively, gestational sac (GS)-like structure, particularly the peripheral area of the GS via MR analysis. Excluded were 3 cases that were insufficient for assessing extrauterine GS-like structure: ruptured tubal pregnancy and uterine horn pregnancy. Results GS-like structures were typically observed as low intensity on T1-weighted image (T1WI) and as high intensity on T2-weighted image (T2WI). In non-bleeding cases, most peripheral areas of the GS were of intermediate intensity on T1WI and high intensity on T2WI. Most bleeding cases were of high intensity on T1WI and low to high intensity on T2WI. Furthermore, the peripheral area of the GS was of higher intensity on T1WI with fat suppression than on T1WI. Conclusions It is clear that MR imaging is effective for diagnosis of cases of suspected EP. EP conditions may be predicted by signal intensity of the peripheral area of the GS via MR analysis

Initial closed trocar entry for laparoscopic surgery: Technique, umbilical cosmesis, and patient satisfaction

Background/Aims: Despite the benefits of laparoscopic surgery, which is being performed with increasing frequency, complications that do not occur during laparotomy are sometimes encountered. Such complications commonly occur during the initial trocar insertion, making this a procedural step of critical importance. Methods: In 2002, we experienced, upon initial trocar insertion, a serious major vascular injury (MVI) that led to hemorrhagic shock, and we thus modified the conventional closed entry method to an approach that we have found to be safe. We began developing the method by first measuring, in a patient undergoing laparoscopic cystectomy, the distance between the inner surface of the abdominal wall and the anterior spine when the abdominal wall was lifted manually for trocar insertion and when it was lifted by other methods, and we determined which method provided the greatest distance. We then devised a new approach, summarized as follows: The umbilical ring is elevated with Kocher forceps. The umbilicus is everted, and the base is incised longitudinally. This allows penetration of the abdominal wall at its thinnest point, and it shortens the distance to the abdominal cavity. A bladeless trocar (Step trocar) is used to allow insertion of the Veress needle. We began applying the new entry technique in July 2002, and by December 2014, we had applied it to 9676 patients undergoing laparoscopic gynecology surgery. Results: All entries were performed successfully, and no MVI occurred. The umbilical incision often resulted in an umbilical deformity, but in a questionnaire-based survey, patients generally reported satisfaction with the cosmetic outcome. Conclusion: A current new approach provides safe outcome with a minor cosmetic problem. Keywords: Closed laparoscopy, Laparoscopic myomectomy, Major vascular injury, Umbilical deformit

Tables for fpkm values

Tables for fpkm values for RNA-seq data calculated using Cufflinks:genes.fpkm_tracking, isoforms.fpkm_tracking, and tss_groups.fpkm_trackin

bigwig_files

"bigwig_files.zip" (md5 checksum: a7cee3f55c6c3d53dd562475aa7fc1f3). The "bigwig_files.zip" file contains the following 25 bigwig files (19 files for ChIP-seq data and 6 files for RNA-sea data). EM0409_D0_H3K27ac.hg19.bw EM0409_D0_H3K27me3.hg19.bw EM0409_D0_H3K9me3.hg19.bw EM0409_D4_H3K27ac.hg19.bw EM0409_D4_H3K27me3.hg19.bw EM0409_D4_H3K9me3.hg19.bw EM0409_D4_input.hg19.bw EM0409_D8_H3K27ac.hg19.bw EM0409_D8_H3K27me3.hg19.bw EM0409_D8_H3K9me3.hg19.bw EM0519_D0_H3K27ac.hg19.bw EM0519_D0_H3K27me3.hg19.bw EM0519_D0_H3K9me3.hg19.bw EM0519_D4_H3K27ac.hg19.bw EM0519_D4_H3K27me3.hg19.bw EM0519_D4_H3K9me3.hg19.bw EM0519_D4_input.hg19.bw EM0519_D8_H3K27me3.hg19.bw EM0519_D8_H3K9me3.hg19.bw RNAseq_EM0409_D0.hg19.bw RNAseq_EM0409_D4.hg19.bw RNAseq_EM0409_D8.hg19.bw RNAseq_EM0519_D0.hg19.bw RNAseq_EM0519_D4.hg19.bw RNAseq_EM0519_D8.hg19.b