Sorafenib targets and inhibits the oncogenic properties of endometrial cancer stem cells via the RAF/ERK pathway.

BACKGROUND: Distinct subsets of cancer stem cells (CSCs) drive the initiation and progression of malignant tumors via enhanced self-renewal and development of treatment/apoptosis resistance. Endometrial CSC-selective drugs have not been successfully developed because most endometrial cell lines do not contain a sufficient proportion of stable CSCs. Here, we aimed to identify endometrial CSC-containing cell lines and to search for endometrial CSC-selective drugs. METHODS: We first assessed the presence of CSCs by identifying side populations (SPs) in several endometrial cancer cell lines. We then characterized cell viability, colony-formation, transwell invasion and xenotransplantion capability using the isolated SP cells. We also conducted real-time RT-PCR, immunoblot and immunofluorescence analyses of the cells' expression of CSC-associated markers. Focusing on 14 putative CSC-selective drugs, we characterized their effects on the proliferation and apoptosis of endometrial cancer cell lines, examining cell viability and annexin V staining. We further examined the inhibitory effects of the selected drugs, focusing on proliferation, invasion, expression of CSC-associated markers and tumor formation. RESULTS: We focused on HHUA cells, an endometrial cancer cell line derived from a well-differentiated endometrial adenocarcinoma. HHUA cells contained a sufficient proportion of stable CSCs with an SP phenotype (HHUA-SP). HHUA-SP showed greater proliferation, colony-formation, and invasive capabilities compared with the main population of HHUA cells (HHUA-MP). HHUA-SP generated larger tumors with higher expression of proliferation-related markers, Ki67, c-MYC and phosphorylated ERK compared with HHUA-MP when transplanted into immunodeficient mice. Among the 14 candidate drugs, sorafenib, an inhibitor of RAF pathways and multiple kinase receptors, inhibited cell proliferation and invasion in both HHUA-SP and -MP, but more profoundly in HHUA-SP. In vivo treatment with sorafenib for 4 weeks reduced the weights of HHUA-SP-derived tumors and decreased the expression of Ki67, ZEB1, and RAF1. CONCLUSIONS: Our results suggest that HHUA is a useful cell line for discovery and identification of endometrial CSC-selective drugs, and that sorafenib may be an effective anti-endometrial cancer drug targeting endometrial CSCs.

The orientation of a decellularized uterine scaffold determines the tissue topology and architecture of the regenerated uterus in rats†.

A decellularized uterine scaffold (DUS) prepared from rats permits recellularization and regeneration of uterine tissues when placed onto a partially excised uterus and supports pregnancy in a fashion comparable to the intact uterus. The underlying extracellular matrix (ECM) together with an acellular, perfusable vascular architecture preserved in DUS is thought to be responsible for appropriate regeneration of the uterus. To investigate this concept, we examined the effect of the orientation of the DUS-preserving ECM and the vascular architecture on uterine regeneration through placement of a DUS onto a partially defective uterine area in the reversed orientation such that the luminal face of the DUS was outside and the serosal face was inside. We characterized the tissue structure and function of the regenerated uterus, comparing the outcome to that when the DUS was placed in the correct orientation. Histological analysis revealed that aberrant structures including ectopic location of glands and an abnormal lining of smooth muscle layers were observed significantly more frequently in the reversed group than in the correct group (70% vs. 30%, P < 0.05). Despite the changes in tissue topology, the uteri regenerated with an incorrectly oriented DUS could achieve pregnancy in a way similar to uteri regenerated with a correctly oriented DUS. These results suggest that DUS-driven ECM orientation determines the regenerated uterus structure. Using DUS in the correct orientation is preferable when clinically applied. The disoriented DUS may deteriorate the tissue topology leading to structural disease of the uterus even though the fertility potential is not immediately affected.

Impact of borderline-subclinical hypothyroidism on subsequent pregnancy outcome in women with unexplained recurrent pregnancy loss.

AIM: Because subclinical hypothyroidism (thyroid-stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine-treated women before pregnancy. The purpose of this study was to determine whether borderline-subclinical hypothyroidism (borderline-SCH; 2.5 < TSH ≤ 4.5 IU/mL) affects the outcome of subsequent pregnancies in women with unexplained recurrent pregnancy loss (uRPL). METHODS: After workup for antinuclear antibody (ANA), anti-phospholipid syndrome, thrombophilia, uterine abnormalities, hormone disorders, and/or chromosomal abnormalities, 317 women with a history of uRPL were enrolled. The women were classified into two groups: borderline-SCH, and euthyroidism (0.3 ≤ TSH ≤ 2.5 IU/mL). All women had normal serum free thyroxine (T4) and did not receive levothyroxine before or during the subsequent pregnancy. RESULTS: There were no significant differences in age, number of previous pregnancy losses, number of live births, or body mass index between the borderline-SCH (n = 56) and the euthyroid (n = 261) groups, but the rate of ANA positivity differed significantly (53.6% vs 33.7%, respectively; P = 0.005). The subsequent pregnancy rate did not differ between the two groups (55.4%, 31/56 vs 51.3%, 134/261, respectively). The pregnancy loss rate (<22 weeks of gestation) tended to be higher in the borderline-SCH than the euthyroid group (29.0%, 9/31 vs 17.9%, 24/134), although not significantly so (P = 0.16). CONCLUSIONS: Although some subset of uRPL is though to be due to as-yet-unidentified cause(s), borderline-SCH is unlikely to be involved in uRPL.

How to Create an Embryo Penetration Route.

Numerous past investigations into human implantation have tended to pay attention to the mechanism of embryo adhesion to endometrial cells or embryo invasion into endometrial stromal tissue. For successful pregnancy, however, embryo penetration through the endometrial epithelial cell (EEC) sheet is also absolutely required. To improve the performance of assisted reproductive technology, implantation studies should also focus on EEC dynamics, in particular, the action of EECs during embryo penetration. Although only EEC apoptosis has been proposed as a mechanism for the formation of the embryo penetration route, we have also recently reported that characteristic EEC collective motion, regulated by the epithelial to mesenchymal transition, also plays a key role in permitting embryo penetration. We review here how EECs form embryo penetration routes in light of our findings.

Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency.

The objective of this study was to assess the potential predictive factors for follicle growth, ovulation, and pregnancy rate in patients with primary ovarian insufficiency/premature ovarian failure (POI/POF). We enrolled 25 POI patients with desired fertility who were treated and monitored for a minimum of 7 months between the years of 2000-2009 into this retrospective study. The clinical, endocrinologic, chromosomal, and autoimmunologic parameters of these patients were collected. Furthermore, hormonal backgrounds on each of 620 treatment cycles were investigated. The main outcome measures were follicle growth, ovulation, and pregnancy rate. Four of 25 patients (16%) conceived while being monitored and undergoing treatment. Follicle growth, ovulation, and pregnancy rate were not significantly different as a function of parity, iatrogenic history (e.g., chemotherapy), age of disease onset, serum estradiol (E(2))/follicle stimulating hormone (FSH) level at the time of diagnosis, chromosomal abnormality, and positive autoantibody titer. The serum E2 levels on days 1-5 of withdrawal bleeding (Day 1-5 E(2)) were significantly higher in the cycles with successful follicle growth and ovulation than unsuccessful cycles (P<0.05). Receiver-operator characteristic curve analysis revealed the cut-off value of the Day 1-5 E(2) to be 15.5 pg/mL, and an area under the curve (AUC) value of 0.674 for follicle growth and 0.752 for ovulation. The results suggest that cycles with a Day 1-5 E(2)≥15.5 pg/mL have a higher rate of follicle growth and ovulation in patients with POI.

[An analysis of fall accidents in ambulance service records of fire department in Japan: investigation of time and location].

PURPOSE: The aim of this study was to examine fall accidents in Japan by analyzing records of ambulance responses. METHOD: The survey period was one year, from January to December, 2007. During this period, a total of 31,002 ambulance responses to fall accidents were recorded by 37 fire departments throughoutiapan. The ambulance responses to fall accidents were analyzed in terms of sex, age, place, time of fall, and degree of injury. RESULTS: The number of ambulance responses per population sample of 1000 people was 1.9 cases among people ranging in age from 20 to 64, 6.3 cases for people ranging in age from 65 to 74 and 15.9 cases for people aged 75 years or over. When excluding males in the 75 year or older group, more falls occurred from December to February than in the other seasons. There were also more falls in December than in any other month. In addition, more falls occurred in houses than at other locations. Roadside locations followed houses regarding the location of falls for males. In addition, public places were the second most common location for females. The degree of injury was higher for females than for males. Females 75 years of age or older sustained 2.8 times more serious injuries than females ranging from 20 to 64 years of age. CONCLUSION: The causes and other characteristics of fall accidents were thus found to vary according to sex and/or age.

[An analysis of fall accidents using Kochi Fire Department ambulance statistics].

PURPOSE: The aim of this study was to examine ambulance usage due to fall accidents in Kochi City. METHOD: The survey period was one year, from January to December, 2005. A total of 967 ambulance responses to fall accidents were recorded by the Kochi Fire Department during this period. Ambulance responses to fall accidents were analyzed in terms of sex, age, time, and place of fall. Adults were defined as subjects between the ages of 18 and 64; elderly adults were defined as being 65 or older. RESULTS: The number of ambulance responses per a population sample of 1000 people was 1.32 cases in adults (men 1.55, women 1.11) and 10.48 cases in elderly adults (men 9.14, women 11.32). The proportion of outdoor falls for adults was 60.8%, for women and 56.8% for men. The respective values for elderly adults were 54.9% and 36.6%. The majority of elderly adult women fell down indoors. More falls occurred in winter (from December to February) than in the other seasons. There were more falls in December than other months. CONCLUSION: Fall incidence varies according to sex, age and season. We can conclude that the causes and places of falls are related to physical activity and season. Fire department ambulance records can be utilized to analyze fall situation in local areas. Such analyses should lead to new approaches to fall prevention measures.

Comparative study of zinc, copper, manganese, and iron concentrations in organs of zinc-deficient rats and rats treated neonatally with l-monosodium glutamate.

The effects of a zinc-deficient (ZD) diet on the growth and trace element concentrations of various organs (body hair, liver, kidney, gastrocnemius muscle, and femur) of male rats were studied. Furthermore, these trace element concentrations of the above-mentioned organs in male rats neonatally treated with l-monosodium glutamate (MSG) are compared with those of the ZD rats. The ZD rats showed growth retardation compared to rats fed a zinc- adequate diet (controls). The feed efficiency of the ZD rats was only one-fifth of the controls. This is one reason why the ZD rats showed retarded growth. Body hair concentration of zinc (Zn) in the ZD rats was significantly lower than in the controls. On the other hand, copper (Cu), manganese (Mn), and iron (Fe) concentrations in the body hair were significantly higher in the ZD rats than in the controls. Moreover, the apparent absorption rate of these trace elements was significantly higher in the ZD rats than in the controls. The reason for the decrease in Zn contents of the body hair in the ZD rats is probably the reduced dietary Zn intake. Liver and kidney concentrations of Zn in the ZD rats were significantly lower than in the controls. Femur Zn concentrations in the control rats showed higher values than in the ZD rats. Cu and Mn concentrations in the femur in the ZD rats showed higher values than in the controls. Ninh et al. suggested that growth retardation in ZD rats is the result of a decrease in protein biosynthesis. The results of this study support their theory. The reasons for the use of MSG-treated rats in this study are as follows. (1) We reported on the head hair concentration of the above-mentioned elements from pituitary dwarfism (human growth hormone deficient) patients. In that study, the sample was restricted to head hair from pituitary dwarfism patients. More detailed physiological data may be obtained by the used of MSG-treated rats. (2) We took notice of many resemblances between the pituitary dwarfism patients and the MSG-treated rats in morbidity. The MSG-treated rats showed a severe growth retardation compared to NaCl-treated controls. Zn concentration in the body hair was significantly higher in the MSG-treated rats that in the NaCl-treated controls. For other trace element concentrations, there were no significant differences between the MSG-treated rats and the NaCl-treated controls. The concentrations of these trace elements in the liver of the MSG-treated rats were lower than in the NaCl-treated controls. In the MSG-treated rats, the concentrations of Zn and Cu in the femur were higher than in the NaCl-treated controls. However, the Fe concentration in the femur of teh MSG-treated rats showed lower values compared with NaCl-treated controls. The results of this study suggest that the reduction of rat growth hormone (rGH) secretion and/or its synthesis are a consequence of the impairment of rGH anabolic effects. Furthermore it indicates that MSG-treated rats are useful as an in vivo model for the study of the effects of GH.

Measurement of zinc, copper, manganese, and iron concentrations in hair of pituitary dwarfism patients using flameless atomic absorption spectrophotometry.

Pituitary dwarfism (hGHD) is known to be associated with trace element deficiency, which causes improper functioning of the involved endocrine system. Previously, we reported on the head hair concentrations of zinc, copper, manganese, and iron from a total of 418 normal subjects (154 male and 264 female). In this report, we analyzed the head hair concentrations of the same four trace metals of 103 hGHD children (60 male and 43 female) under treatment with human growth hormone (hGH). These subjects ranged in age from 5 to 18 yr. The results were compared with 338 age-matched normal subjects (120 male and 218 female). Both male and female hGHD showed approx 1.7 times higher zinc concentrations than normal subjects. Cheruvanky et al. reported a similar trend but with a slightly lower difference between hGHD and normal subjects. The average copper content in the hair of both male and female subjects also showed higher values for the hGHD than for the normal subjects, a trend similar to the values reported by Teraoka et al. In the case of manganese, the concentrations in hair of the hGHD were approx 50% of the values in the normal subjects. Head hair concentrations of iron in the hGHD were commensurate with the normal subjects. Because the content of trace elements in hair varies with the age of subjects, as a control, we investigated the head hair concentration of zinc from 20 healthy girls ranging in age from 10 to 18 yr. The average zinc concentration decreased from 10 to 12 yr, but no clear relation to age was observed from 13 yr and older. These trends were similar to our previous report. The zinc concentration in hair and body weight gain over a year was negatively correlated. The age variation in the content of zinc, copper, manganese, and iron in hair was measured comparing hGHD with the normal subjects in various ages. Concerning the zinc-level variation of hGHD and normal subjects, there were conspicuous differences between hGHD and normal subjects. For copper, the variations in concentration with age were similar to zinc. Regarding the age variations for manganese, hGHD had lower concentrations in hair compared to the normal subjects throughout adolescence (11-18 yr). We have studied the effects between the hair and these trace element concentrations in hGHD before and after hGH administration. These results suggest that hGH affects the metabolism of these trace elements.