Pathogenesis of endometriosis--current research

Proliferative, secretory and menstrual endometrial cells of both the stroma and epithelium adhere to intact peritoneal mesothelium and mesothelial monolayers. Endometrial attachment to the mesothelium appears to occur rapidly (within 1 h) and transmesothelial invasion occurs between 1 and 18-24 h. These results demonstrate that the mesothelium is not a 'no-stick' surface and indicates that molecules present at the surface of the mesothelium are involved in the pathogenesis of the early endometriotic lesion. The inhibition of endometrial cell adherence to peritoneal mesothelium by hyaluronidase indicates that CD44-hyaluronan binding is at least one of the mechanisms involved in the pathogenesis of endometriosis. We believe that investigation of mesothelial cell adhesion molecules is central to understanding the pathogenesis of endometriosis.     

Assessment of changing technologies in medicine

Technology is the outcome of man's use of tools and reason to change the environment to his benefit. New technology creates opportunities for some and threats for others. New technology will be dramatically influenced by the political, social, economic, and ethical milieu in which it develops. An overriding concern in the near future may be cost. Cost-benefit analysis/cost-effectiveness analysis can be a helpful planning tool but should not be used exclusively to plan for technological change. Knowledge of the humanities as well as a science will be essential if we are to make the decisions needed as we approach the 21st century.     

Therapeutic potentiation of combined cis-dichlorodiammineplatinum (II) and irradiation by ICRF-159

The effect of fractionated ICRF-159 (25 mg/kg, g3h×4) pretreatment on the antitumor activity of cis DDP+irradiation combinations has been evaluated using the Lewis lung tumor. All three agents given alone as single treatments result in transient interruption of proliferative activity with only slight to moderate alterations of tumor growth. Fractionated ICRF-159 treatment, while eliciting low cytotoxicity, results in a partial cytokinetic redistribution of tumor cells enhancing subsequent radiotherapy and chemotherapy with cis DDP. For cis DDP-radiation combinations, where cis DDP precedes irradiation, increasing the intertreatment time from 6 hr to 24 hr results in synergistic interactions and increased treatment efficacy. When cis DDP-radiation combinations followed fractionated ICRF-159, regression was greatly enhanced suggesting that relatively non-cytotoxic agents may be used to sensitize low growth fraction, resistant tumors to subsequent combined-mode therapy.     

Enhanced adriamycin—induced delayed gastrointestinal radiosensitivity in tumor-bearing mice

Intestinal proliferative activity in BDF, mice bearing the Lewis lung tumor (LL_ca/BDF₁) was markedly depressed with increasing tumor burden. When compared with non-tumor-bearing mice (BDF₁), integrated cell production over 7 days was reduced to 56% in animals with small (400 mm³) tumors and to 30% in animals with large (2500 mm³) tumors. Gastrointestinal radiosensitivity was measured by proliferative compensatory response kinetics to a radiation dose of 600 rad. The presence of tumor (mean tumor volume = 859 ± 209 mm³) delayed the jejunal response to radiation by 24 hr and reduced the integrated cell production from 136% in BDF₁ mice to 119% in the LL_ca/BDF₁ mice. While the presence of tumor did not alter the temporal response of the colonic epithelium to radiation, the compensatory peak was reduced from 248% (BDF₁) to 200% (LL_ca/BDF₁). Adriamycin (Adr; 10 mg/kg) given 60 days prior to radiation failed to enhance the jejunal radiosensitivity in BDF₁ mice. However, when tumor-bearing LL_ca/BDF₁ mice were treated under an identical dose and time configuration, the jejunal response to 600 rad was significantly impaired: proliferative peaks were reduced from 182 to 115% ; integrated cell production was reduced from 119 to 72%. In the colon of tumor-bearing mice, pretreatment with AdR reduced the proliferative compensatory peak from the subsequent radiation dose to 120% of pretreatment levels.     

Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome

In women with polycystic ovary syndrome, chromium picolinate (200 microg/d) improves glucose tolerance compared with placebo but does not improve ovulatory frequency or hormonal parameters. This pilot study indicates that future studies in the polycystic ovary syndrome population should examine higher dosages or longer durations of treatment.