Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis

Introduction

Sexual dysfunction occurs in any phase of sexual performance or any period of the sexual response cycle, and polycystic ovary syndrome (PCOS) affects self-image with repercussions on sexuality.

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and its therapeutic potential in breast and gynecologic cancers

OBJECTIVE: The relationship between the apoptotic pathway and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a promising area of scientific interest for cancer researchers. TRAIL-receptor-activating agents have demonstrated favorable in vitro and in vivo activity for the treatment of several malignancies including breast and gynecologic cancers. METHODS: This article reviews the available peer-reviewed literature and our own institution's experience with specific TRAIL-receptor-activating agents. Emphasis was placed on the apoptotic/TRAIL mechanism, preclinical evaluation, and phase I studies in various malignancies. RESULTS: Preclinical and early phase I studies indicate that these novel agents are safe with enhanced target specificity for malignancy. When these targeted agents are combined with conventional chemotherapy drugs or radiation therapy, they appear to increase cell death over single-agent modalities. CONCLUSIONS: TRAIL-receptor-activating agents represent an exciting new class of targeted therapies that hold promise to improve the treatment of women with breast and gynecologic malignancies.     

Ovarian neuroendocrine carcinoma, non-small cell type, associated with serous carcinoma

BACKGROUND: Neuroendocrine carcinoma of the non-small cell type of the ovary is a rare aggressive tumor, interestingly associated with either a surface epithelial tumor or teratoma. CASE: A 71-year-old woman presented with a pelvic mass and underwent a total abdominal hysterectomy with a bilateral salpingo-oophorectomy. Pathology examination showed a 6.5 cm in greatest dimension ovarian tumor composed of neuroendocrine carcinoma of the non-small cell type and serous carcinoma. Immunohistochemical studies including keratin 7, WT-1, and neuroendocrine markers demonstrated differences in the two components. Microsatellite instability (MSI) analysis using five polymorphic markers also showed a different pattern in the two components. CONCLUSION: This is the first report of an ovarian neuroendocrine carcinoma, non-small cell type, associated with a serous carcinoma. Immunohistochemistry and MSI are very helpful in making a definite diagnosis.     

The effects of iloprost, a prostacyclin analogue, in experimental ischaemia/reperfusion injury in rat ovaries

Ovarian torsion is a surgical emergency affecting not only the ipsilateral ovary but also contralateral ovary. Although the conventional treatment is salpingo-oophorectomy, recent studies advocate detorsion. We hypothesized that iloprost, an analogue of prostacyclin with cytoprotective properties, may prevent the harmful effects of ischaemia–reperfusion injury in bilateral ovaries after unilateral ovarian torsion–detorsion in rat. In this study, 24 female Wistar-albino female rats were divided into four groups. Ovarian torsion was produced by applying vascular clamps to right ovaries. In Group I, bilateral oophorectomy was performed. In group II, bilateral oophorectomy was performed after a unilateral torsion period of 4 h. In group III, bilateral ovaries were removed, following unilateral torsion–detorsion periods each lasted for 4 h. Saline was injected i.p. 30 min before detorsion. In group IV, same experimental protocol, which was conducted in group III, was repeated. Iloprost was injected i.p. 30 min before detorsion instead of saline in group IV. Tissue levels of malondialdehyde (MDA) and nitric oxide (NO), which are the indicators for oxidative stress were determined and histopathological evaluation was performed in bilateral ovaries in all groups. The MDA and NO levels for ipsilateral ovaries of four groups were compared and no significant difference was found (p>0.05). The same comparison were done for the contralateral sides and no difference was seen either (p>0.05). In histological examination, iloprost produced improvement in I/R-induced alterations in ipsilateral and contralateral ovaries. In conclusion, these results showed that iloprost has beneficial effect on the histological appearences in both the ipsilateral and contralateral rat ovaries after unilateral torsion–detorsion.     

Evaluation of Preoperative Serum Levels of CA 125 and Expression of p53 in Ovarian Neoplasms: A Prospective Clinicopathological Study in a Tertiary Care Hospital

Objectives

To assess the preoperative serum levels of CA 125 with its diagnostic role and to evaluate the p53 expression in patients of primary ovarian neoplasms. We also wished to judge their relationship with other parameters like clinical staging and histopathologic tumor type.

Materials and Methods

The present study was conducted on 86 patients during the study period of 2.5 years. Preoperative CA 125 levels were evaluated by an automated immunoassay analyzer. p53 expression was judged immunohistochemically with pre-diluted monoclonal antibody. An objective scoring was done depending on distinct nuclear immunopositivity.

Results

Median value of preoperative CA 125 levels was 32 U/mL in benign surface epithelial-stromal tumors (BSEST), 53 U/mL in borderline surface epithelial-stromal tumors (BOT), 346 U/mL in malignant surface epithelial-stromal tumors (MSEST) and 560 U/mL in serous adenocarcinomas (SAC). Most of ovarian tumors were in the FIGO stage I (64 cases, 74.4%), but higher stages (II, III, IV) were observed mostly in MSESTs. SACs displayed the maximum p53 expression. Considering the cut-off value of more than 35 U/mL in CA 125 levels, the sensitivity to diagnose MSESTs was 94.7%. Preoperative CA 125 levels strongly and positively correlated with FIGO staging and p53 expression. Similarly p53 expression strongly and positively correlated with FIGO staging and histopathological categories.

Conclusion

Higher values of preoperative CA 125 levels and higher expression p53 are associated with MSESTs and BOTs especially of serous type. They strongly correlate with each other and with tumor stage. But there is no serum CA 125 concentration that can clearly differentiate benign and malignant ovarian masses.     

Effects of hexestrol on mouse ovarian morphology and ovulation

OBJECTIVE: To analyze histological aspects of ovaries as well as the ovulation of adult mice treated with the anabolic agent hexestrol. METHODS: Thirty adult mice were divided into three groups of 10 animals each: (GI) the animals received a dose of 3 mg/kg of hexestrol; (GII) the animals were given a dose of 6 mg/kg of hexestrol; (GIII) the animals were injected with distilled water (vehicle). Another 10-animal group (GIV) was included, and these mice were injected with propionate testosterone (1.25 mg) after 5 days from the day of birth. Hexestrol was administered intraperitoneally once a day and the treatment lasted 30 days. The mice were then sacrificed; their ovaries and oviducts were removed, submitted to histological routine and analyzed under light microscopy. RESULTS: In mice treated with hexestrol (6 mg/kg) (Group II), ovaries were smaller than those from the controls but highly vascularized; similar results were obtained in GIV. A great number of follicles in several stages of development were found -- however, with no corpora lutea -- in six animals in GII. No corpora lutea were found in GIV. The number of luteal bodies and oocytes in GII was lower than that in GI or GIII. No oocytes were detected in GIV. Finally, the nuclear volume of interstitial cells in GII and GIV was the largest. CONCLUSION: Our data suggest that the anabolic agent hexestrol in a high dose may decrease ovulation in mice.     

卵巢辐射损伤对大鼠腰椎骨密度和生物力学的影响

目的探讨大鼠卵巢辐射损伤后腰椎骨密度、微结构和生物力学的改变。方法手术暴露大鼠双侧卵巢并应用50Gy的γ射线局部照射,术后90d取大鼠腰椎,DEXA测定骨密度,扫描电镜显示微结构,并行压缩实验检测腰椎最大载荷。结果与假手术组相比,卵巢辐射组大鼠的腰椎骨密度显著减少(P<0.05),骨微结构破坏,生物力学性能下降(P<0.05)。结论卵巢辐射损可导致大鼠腰椎的骨质疏松样改变。     

硫氧还蛋白过氧化物酶Ⅵ在小鼠卵巢、输卵管和子宫中的分布

目的探讨硫氧还蛋白过氧化物酶VI(PrxVI)卵母细胞生长发育和早期胚胎发育中的可能作用。方法用免疫组织化学方法观察6～8周雌性昆明小鼠卵巢、输卵管和子宫PrxVI的分布。结果在卵巢中,PrxVI免疫阳性见于卵巢卵母细胞和黄体;在输卵管中,输卵管上皮呈PrxVI免疫阳性反应;在子宫中,PrxVI免疫阳性反应见于子宫内膜上皮、腺上皮和子宫内膜基质细胞。结论PrxVI的定位分布提示其可能参与小鼠卵母细胞生长发育和卵母细胞成熟过程的调节,并为受精卵和早期胚胎发育提供抗氧化的良好微环境。     

大豆异黄酮及主要活性成分Genistein对大鼠卵巢LRH-1基因表达的影响

目的 观察大豆异黄酮(soy isoflavones,SI)及主要活性成分Genistein对初老大鼠卵巢及体外培养卵巢颗粒细胞中肝受体类似物-1(liver receptor homolog-1,LRH-1)基因表达的影响,初步探讨大豆异黄酮作用于卵巢的分子机制.方法 采用自然老化法建立围绝经期大鼠动物模型,分别给予低剂量(50mg/kg)、中剂量(158 mg/kg)、高剂量(500 mg/kg)的SI灌胃处理8 w.分别采用原位杂交和RT-PCR检测卵巢组织中LRH-1 mRNA的表达.采用大鼠孕马血清促性腺激素(pregnant mare serum gonadotrophin,PMSG)皮下注射法建立促卵泡发育模型,分离、培养颗粒细胞24 h后,给予大豆异黄酮主要活性成分Genistein (0、0.1、1、5、10、100 μmol/L)以及雌激素受体(estrogen receptor,ER)阻断剂ICI182、780(1μmol/L)继续处理细胞24 h,采用RT- PCR方法检测卵巢颗粒细胞中LRH-1 mRNA的表达情况.结果 各剂量SI处理组卵巢LRH-1 mRNA的表达(低剂量0.563±0.037,中剂量0.926±0.127和高剂量1.223±0.134),与围绝经期模型组(0.460±0.082)相比均显著增加(P＜0.05).1～10 μmol/L的Genistein作用卵巢颗粒细胞24 h,LRH-1 mRNA的表达(分别为0.844±0.042,0.879±0.056,0.882±0.079)与空白对照组(0.678±0.052)相比均增加,结果具有统计学意义(P＜0.05).ER阻断剂ICI182,780预处理细胞30 min后再给予Genistein继续处理细胞24 h后,发现1～10 μmol/L的Genistein上调LRH-1表达作用,并未受ER阻断剂的影响.结论 一定剂量的大豆异黄酮可明显上调衰老卵巢LRH-1 mRNA的表达,1～10 μmol/L的Genistein可上调体外培养大鼠卵巢颗粒细胞中LRH-1 mRNA的表达,可能并非通过经典ER介导的.     

BRUNOL4在小鼠卵巢内的定位与分布

目的观察BRUNOL4在昆明(Kunming,KM)小鼠卵巢内的定位与分布。方法应用免疫组织化学法进行定位观察。结果BRUNOL4的免疫阳性反应见于卵巢的卵母细胞、黄体细胞和部分卵泡膜细胞的胞质。结论在KM小鼠的卵巢中,BRUNOL4可能参与小鼠卵泡发育成熟和黄体形成等过程。