Modern possibilities for the diagnosis of adenomyosis
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Abstract:
This review article presents modern data on the diagnosis and pathogenesis of adenomyosis, various classifications of the disease being highlighted. The role of genetic and immunological factors in the development of internal endometriosis is discussed. The results of domestic and foreign studies are presented, with the most informative non-invasive markers for the diagnosis of adenomyosis described.Keywords:
Adenomyosis
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Journal Article The effect of hysterectomy on serum CA 125 levels in patients with adenomyosis and uterine fibroids Get access Hannu Halila, Hannu Halila 1 Department I of Obstetrics and Gynaecology, Helsinki University Central HospitalHaartmaninkatu 2, SF-00290 Helsinki, Finland 1To whom correspondence should be addressed Search for other works by this author on: Oxford Academic PubMed Google Scholar Anne-Maria Suikkari, Anne-Maria Suikkari Department I of Obstetrics and Gynaecology, Helsinki University Central HospitalHaartmaninkatu 2, SF-00290 Helsinki, Finland Search for other works by this author on: Oxford Academic PubMed Google Scholar Markku Seppälä Markku Seppälä Department I of Obstetrics and Gynaecology, Helsinki University Central HospitalHaartmaninkatu 2, SF-00290 Helsinki, Finland Search for other works by this author on: Oxford Academic PubMed Google Scholar Human Reproduction, Volume 2, Issue 3, 1 April 1987, Pages 265–266, https://doi.org/10.1093/oxfordjournals.humrep.a136529 Published: 01 April 1987 Article history Received: 26 January 1987 Accepted: 12 February 1987 Published: 01 April 1987
Adenomyosis
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Adenomyosis is a relatively frequent finding in series of hysterectomies performed for menorrhagia and dysmenorrhea. Evident selection biases of the available studies on adenomyosis have always limited the possibilities of defining the real clinical importance of the condition. Until now the only certain diagnoses have been made by histopathologists on uteri removed at surgery, but recently various sufficiently accurate techniques have been suggested which allow diagnosis on the uterus in situ. With the these methods it might be possible to obtain correct information on the epidemiologic characteristics of adenomyosis and to clarify whether it has a pathogenic role in unexplained ovulatory menorrhagia and juvenile dysmenorrhea. Furthermore, resectoscopic treatment has been proposed in some mild forms of adenomyosis to avoid hysterectomy, whereas it seems improbable that medical treatment can offer a definitive solution. The adoption of standard histologic criteria for adenomyosis seems important. Until this is done, it will be difficult to establish whether adenomyosis is really a disease or merely a paraphysiologic condition.
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Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in the world. An important implication of this disease is the progression of the disease to a more complicated condition called non-alcoholic steatohepatitis (NASH) and the wide variety of clinical presentations. Over the past 5 years, remarkable progresses have been made in understanding the genetic basis for the disease. Recent clinical trials in pharmacotherapy for the disease have been encouraging as well. It is anticipated that the integration of the wide spectrum information retrieved from genomics, transcriptomics and proteomics studies conducted in NAFLD and NASH will mediate a better understanding of the disease pathogenesis and facilitate the postulation of disease pathobiology pathways. Genetic and biological markers identified from the omics studies may hold promise for diagnosis, personalized treatment, early prevention and new drug development.
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Diabetes mellitus (DM) is a complex metabolic disorder characterized by low insulin production/secretion by pancreatic beta cells and/or low responsiveness by insulin target tissues MicroRNAs have been associated with DM, but it is not clear whether this is a cause or an effect of metabolic abnormalities related to DM. In the hyperglycemic environment miRNAs are in involved in multiple stages of cardiovascular disease development and progression. In diabetic patients with cardiovascular disease miRNAs could potentially serve as early biomarkers for diagnosis and as therapeutic agents. The current review focuses on the involvement of miRNAs in molecular mechanisms underlying the pathogenesis of DM and its cardiovascular complications.
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Cardiovascular disease has been the leading cause of death worldwide for the last few decades. Even with the rapid progression of the biomedical field, conquering/managing cardiovascular disease is not an easy task because it is multifactorial disease. One of the key players of the development and progression of numerous diseases is microRNA (miRNA). These small, non-coding RNAs bind to target mRNAs to inhibit translations of and/or degrade the target mRNAs, thus acting as negative regulators of gene expressions. Accumulating evidence indicates that non-physiological expressions of miRNAs contribute to both development and progression of cardiovascular diseases. Since even a single miRNA can have multiple targets, dysregulation of miRNAs can lead to catastrophic changes of proteins that may be important for maintaining physiologic conditions of cells, tissues, and organs. Current knowledge on the role of miRNAs in cardiovascular disease is mostly based on the observational data such as microarray of miRNAs in animal disease models, thus relatively lacking insight of how such dysregulation of miRNAs is initiated and regulated. Consequently, future research should aim to elucidate the more comprehensive mechanisms of miRNA dysregulation during pathogenesis of the cardiovascular system so that appropriate counter-measures to prevent/manage cardiovascular disease can be developed.
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Purpose: Recently, focal adenomyosis was classified into three subtypes according to magnetic resonance imaging findings: connected to the endometrium (subtype I), connected to the perimetrium (subtype II), and not connected to either the endometrium or the perimetrium (subtype III). However, diffuse adenomyosis and cystic adenomyosis have not been investigated. We attempted to classify diffuse-type adenomyosis and cystic-type adenomyosis according to magnetic resonance imaging findings and verified the validity of the previous classification of focal adenomyosis. Methods: A total of 1504 cases of adenomyosis (focal, n = 1093; nodular, n = 15; diffuse, n = 383; cystic, n = 13) shown in magnetic resonance imaging findings of patients who underwent conservative surgical treatment from 2002 to 2016 at our hospital were reviewed according to the criteria of Kishi. Results: Of the 383 patients with diffuse adenomyosis, 272 (70.8%) were classified as subtype I, while all cases of cystic-type adenomyosis developed in the lateral wall of the uterus were classified as subtype III. Conclusion: Our findings indicate that diffuse adenomyosis develops from the same mechanism as focal adenomyosis subtype I. In addition, we consider that subtype III has greater relationship with cystic adenomyosis than the other types.
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[Objective] To determine the expression of angiopoietin-2 (Ang-2) in eutopic and ectopic endometrium of endometriosis and adenomyosis, and to investigate the role of it in the pathogenesis of endometriosis and adenomyosis. [Methods] Expression of Ang-2 mRNA in the eutopic and ectopic endometrium of 65 patients with endometriosis (endometriosis group) and 40 patients with adenomyosis (adenomyosis group) and the expression of Ang-2 mRNA in the normal endometrium of 30 patients (control group) without endometriosis and adenomyosis were detected by RT-PCR. [Results] Expression levels of Ang-2 mRNA in the eutopic and ectopic endometrium with endometriosis and adenomyosis were significantly higher than that in control group, and there was not significant relevance between the expression level and the clinical staging. [Conclusion] Expression of Ang-2 mRNA has a high level in the eutopic and ectopic endometriotic tissues with endometriosis and adenomyosis. Ang-2 may play a very important role in the development of endometriosis and adenomyosis and may relate to the pathogenesis of endometriosis and adenomyosis.
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Diabetic heart disease (DHD) is the leading cause of morbidity and mortality among the people with diabetes, with approximately 80% of the deaths in diabetics are due to cardiovascular complications. Importantly, heart disease in the diabetics develop at a much earlier stage, although remaining asymptomatic till the later stage of the disease, thereby restricting its early detection and active therapeutic management. Thus, a better understanding of the modulators involved in the pathophysiology of DHD is necessary for the early diagnosis and development of novel therapeutic implications for diabetes-associated cardiovascular complications. microRNAs (miRs) have recently been evolved as key players in the various cardiovascular events through the regulation of cardiac gene expression. Besides their credible involvement in controlling the cellular processes, they are also released in to the circulation in disease states where they serve as potential diagnostic biomarkers for cardiovascular disease. However, their potential role in DHD as modulators as well as diagnostic biomarkers is largely unexplored. In this review, we describe the putative mechanisms of the selected cardiovascular miRs in relation to cardiovascular diseases and discuss their possible involvement in the pathophysiology and early diagnosis of DHD.
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