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M060 EXPRESSION OF CD44 IN ENDOMETRIAL CELLS AND CORRELATION WITH ADHERENCE TO PERITONEAL MESOTHELIAL CELLS FROM WOMEN WITH AND WITHOUT ENDOMETRIOSIS
S550
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
was made and this time at cystoscopy, a full thickness resection of the nodule was performed. Histology revealed florid endometriosis within the detrusor muscle with no evidence of mucosal involvement. Results: Three months following the bladder resection, symptoms had significantly improved. The patient received appropriate counseling and was commenced on six months of leuprorelin with Tibolone as “add back” therapy. The patient remained asymptomatic, 18 months following the bladder resection. Conclusions: The national caesarean section rate currently exceeds 24% and is rising due to factors such as advancing maternal age and increasing maternal BMI. The increase in Caesarean section rate may become even more problematic following publication of the new NICE Caesarean section guideline. The intense media scrutiny of the guideline has been misinterpreted and thus misinformed the public, that maternal request of caesarean section is acceptable. As a result, the number of recognized complications at caesarean sections may rise. We would therefore suggest that bladder endometriosis and menstrual dysfunction should be mentioned as potential complications when consenting for caesarean section.
Conclusions: Tubal morphology was significantly worse in patients with bilateral ovarian endometriosis than in those with monolateral disease and the presence of tubal alterations was significantly associated with the side (left or right) of the endometriosis cyst. Previous interventions for endometriosis seems to be strongly related with the presence of tubal alterations.
Figure 1. M059 DO WOMEN WITH BILATERAL OVARIAN ENDOMETRIOSIS HAVE MORE TUBAL ALTERATION THAN THOSE WITH MONOLATERAL DISEASE? OBJECTIVE EVALUATION OF PATIENTS N. Di Donato1 , A. Benfenati1 , D. Raimondo1 , G. Montanari1 , G. Ferrini1 , G. Giovanardi1 , M. Mabrouk1 , S. Venturoli1 , R. Seracchioli1 . 1 Ginecologia e Fisiopatologia della Riproduzione Umana, Azienda Ospedaliero-Universitaria Policlinico S.Orsola Malpighi, Bologna, Italy Objectives: To evaluate if bilateral ovarian endometriosis is more associated with tubal alteration and with and worse alteration than monolateral ovarian endometriosis. Materials: Design: Retrospective analysis. Setting: Tertiary care university hospital. Patients: 284 patients affected by ovarian endometriosis who underwent operative laparoscopy from January 2005 to December 2008. Women were divided in two groups: 138 with bilateral ovarian endometriosis (Group A) and 146 with mono lateral ovarian endometriosis (Group B). Methods: Intervention: Tubal morphology and patency were evaluated during laparoscopic excision of endometriotic lesions. Tubal morphology was assessed using a score (Tubal Morphology Score) obtained by a total grade of four parameters: tubal caliber, course, surface and fimbrial morphology. In this score, 0 and 14 were related respectively to women without and with worst tubal morphology alterations (Fig 1). The tubal patency was valuated by Tubal Dye Test in operative laparoscopy. Statistical analysis: (SPSS 9.0 software; SPSS inc., Chicago IL, USA) One Way ANOVA was performed to test hypotheses about means of different groups. When the Levene test for homogeneity of variances was significant (p < 0.05) the Mann Whitney test (two independent groups), or the Kruskal Wallis test (three or more independent groups) were used to check ANOVA results. The Fisher exact test was performed to investigate the relationships between grouping variables with 2 groups. Results: The global tubal score was significantly worse in the group A (6.4±4.56) than in group B (4.8±4.11) (p: 0.003), whereas no significant difference in the two groups was found regarding the presence of tubal occlusion. The monolateral ovarian endometriosis was significantly associated with an ipsi-lateral tubal alteration (p < 0.0005). Moreover, previous surgery for endometriosis was associated with higher rate of tubal occlusion (p < 0.0005) and more severe morphological alterations (p < 0.0005). There was a positive correlation between number of previous surgical interventions and worse score (p < 0.0005).
M060 EXPRESSION OF CD44 IN ENDOMETRIAL CELLS AND CORRELATION WITH ADHERENCE TO PERITONEAL MESOTHELIAL CELLS FROM WOMEN WITH AND WITHOUT ENDOMETRIOSIS Y.J. Song1 , J.E. Hong1 , H.N. Jeon1 , J.T. Kim1 , Y.H. Koo1 , H.G. Kim1 , Y.J. Na1 . 1 Pusan National University Yangsan Hospital, Yangsan-si, Korea, Republic of Objectives: This study was performed to compare the expression of CD44 in endometrial cells of women with and without endometriosis and to evaluate the role of CD44 in the adherence of endometrial cells to peritoneal mesothelial cells. Materials: PMC adherence assay was performed to evaluate the adherence of endometrial stromal cells (ESCs) to peritoneal mesothelial cells in women with endometriosis and in controls. Methods: The expression of CD44 mRNA was measured by RT-PCR. CD44 protein was evaluated by western blot analysis. Results: There were no significant difference in binding of ESCs to mesothelial cells between endometriosis and controls. There were no significant difference in the expression of CD44 mRNA and protein in ESCs between endometriosis and controls. The expression of CD44 protein were decreased in both endometriosis and controls after anti-CD44 antibody treatment, there was no effect on ESCs binding to mesothelial cells though decreased expression of CD44 protein in both group. Treatment of ESCs with peritoneal fluid from endometriosis patients resulted in a significant increase in binding of ESCs to mesothelial cells compared to untreated ESCs in endometriosis group. There was no effect on the expression of CD44 protein when ESCs were pretreated with peritoneal fluid in both endometriosis and controls. Conclusions: This study demonstrates that the expression of CD44 protein in ESCs might not be directly associated with adherence to peritoneal mesothelial cells. M061 ACETYLSALICYLIC ACID-INDUCED COMPLETE DESTRUCTION OF PERITONEAL ENDOMETRIOSIS – AN EXPERIMENTAL STUDY IN RABBITS R. Saad-Hossne1 , A.B. Barreto1 , R. Denadai1 . 1 Surgery, Paulista State University, Botucatu Medical School, Botucatu, Sao Paulo, Brazil Objectives: To evaluate the effects of 20% acetylsalicylic acid (AAS) on peritoneal endometriosis. Materials and Methods: Thirty adult female rabbits with peritoneal endometriosis induced by auto-transplanting endometrial
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
was made and this time at cystoscopy, a full thickness resection of the nodule was performed. Histology revealed florid endometriosis within the detrusor muscle with no evidence of mucosal involvement. Results: Three months following the bladder resection, symptoms had significantly improved. The patient received appropriate counseling and was commenced on six months of leuprorelin with Tibolone as “add back” therapy. The patient remained asymptomatic, 18 months following the bladder resection. Conclusions: The national caesarean section rate currently exceeds 24% and is rising due to factors such as advancing maternal age and increasing maternal BMI. The increase in Caesarean section rate may become even more problematic following publication of the new NICE Caesarean section guideline. The intense media scrutiny of the guideline has been misinterpreted and thus misinformed the public, that maternal request of caesarean section is acceptable. As a result, the number of recognized complications at caesarean sections may rise. We would therefore suggest that bladder endometriosis and menstrual dysfunction should be mentioned as potential complications when consenting for caesarean section.
Conclusions: Tubal morphology was significantly worse in patients with bilateral ovarian endometriosis than in those with monolateral disease and the presence of tubal alterations was significantly associated with the side (left or right) of the endometriosis cyst. Previous interventions for endometriosis seems to be strongly related with the presence of tubal alterations.
Figure 1. M059 DO WOMEN WITH BILATERAL OVARIAN ENDOMETRIOSIS HAVE MORE TUBAL ALTERATION THAN THOSE WITH MONOLATERAL DISEASE? OBJECTIVE EVALUATION OF PATIENTS N. Di Donato1 , A. Benfenati1 , D. Raimondo1 , G. Montanari1 , G. Ferrini1 , G. Giovanardi1 , M. Mabrouk1 , S. Venturoli1 , R. Seracchioli1 . 1 Ginecologia e Fisiopatologia della Riproduzione Umana, Azienda Ospedaliero-Universitaria Policlinico S.Orsola Malpighi, Bologna, Italy Objectives: To evaluate if bilateral ovarian endometriosis is more associated with tubal alteration and with and worse alteration than monolateral ovarian endometriosis. Materials: Design: Retrospective analysis. Setting: Tertiary care university hospital. Patients: 284 patients affected by ovarian endometriosis who underwent operative laparoscopy from January 2005 to December 2008. Women were divided in two groups: 138 with bilateral ovarian endometriosis (Group A) and 146 with mono lateral ovarian endometriosis (Group B). Methods: Intervention: Tubal morphology and patency were evaluated during laparoscopic excision of endometriotic lesions. Tubal morphology was assessed using a score (Tubal Morphology Score) obtained by a total grade of four parameters: tubal caliber, course, surface and fimbrial morphology. In this score, 0 and 14 were related respectively to women without and with worst tubal morphology alterations (Fig 1). The tubal patency was valuated by Tubal Dye Test in operative laparoscopy. Statistical analysis: (SPSS 9.0 software; SPSS inc., Chicago IL, USA) One Way ANOVA was performed to test hypotheses about means of different groups. When the Levene test for homogeneity of variances was significant (p < 0.05) the Mann Whitney test (two independent groups), or the Kruskal Wallis test (three or more independent groups) were used to check ANOVA results. The Fisher exact test was performed to investigate the relationships between grouping variables with 2 groups. Results: The global tubal score was significantly worse in the group A (6.4±4.56) than in group B (4.8±4.11) (p: 0.003), whereas no significant difference in the two groups was found regarding the presence of tubal occlusion. The monolateral ovarian endometriosis was significantly associated with an ipsi-lateral tubal alteration (p < 0.0005). Moreover, previous surgery for endometriosis was associated with higher rate of tubal occlusion (p < 0.0005) and more severe morphological alterations (p < 0.0005). There was a positive correlation between number of previous surgical interventions and worse score (p < 0.0005).
M060 EXPRESSION OF CD44 IN ENDOMETRIAL CELLS AND CORRELATION WITH ADHERENCE TO PERITONEAL MESOTHELIAL CELLS FROM WOMEN WITH AND WITHOUT ENDOMETRIOSIS Y.J. Song1 , J.E. Hong1 , H.N. Jeon1 , J.T. Kim1 , Y.H. Koo1 , H.G. Kim1 , Y.J. Na1 . 1 Pusan National University Yangsan Hospital, Yangsan-si, Korea, Republic of Objectives: This study was performed to compare the expression of CD44 in endometrial cells of women with and without endometriosis and to evaluate the role of CD44 in the adherence of endometrial cells to peritoneal mesothelial cells. Materials: PMC adherence assay was performed to evaluate the adherence of endometrial stromal cells (ESCs) to peritoneal mesothelial cells in women with endometriosis and in controls. Methods: The expression of CD44 mRNA was measured by RT-PCR. CD44 protein was evaluated by western blot analysis. Results: There were no significant difference in binding of ESCs to mesothelial cells between endometriosis and controls. There were no significant difference in the expression of CD44 mRNA and protein in ESCs between endometriosis and controls. The expression of CD44 protein were decreased in both endometriosis and controls after anti-CD44 antibody treatment, there was no effect on ESCs binding to mesothelial cells though decreased expression of CD44 protein in both group. Treatment of ESCs with peritoneal fluid from endometriosis patients resulted in a significant increase in binding of ESCs to mesothelial cells compared to untreated ESCs in endometriosis group. There was no effect on the expression of CD44 protein when ESCs were pretreated with peritoneal fluid in both endometriosis and controls. Conclusions: This study demonstrates that the expression of CD44 protein in ESCs might not be directly associated with adherence to peritoneal mesothelial cells. M061 ACETYLSALICYLIC ACID-INDUCED COMPLETE DESTRUCTION OF PERITONEAL ENDOMETRIOSIS – AN EXPERIMENTAL STUDY IN RABBITS R. Saad-Hossne1 , A.B. Barreto1 , R. Denadai1 . 1 Surgery, Paulista State University, Botucatu Medical School, Botucatu, Sao Paulo, Brazil Objectives: To evaluate the effects of 20% acetylsalicylic acid (AAS) on peritoneal endometriosis. Materials and Methods: Thirty adult female rabbits with peritoneal endometriosis induced by auto-transplanting endometrial