RESUMO
Endometriosis is a major cause of infertility and pelvic pain, affecting more than 10% of reproductive-aged women. Progesterone resistance has been observed in the endometrium of women with this disease, as evidenced by alterations in progesterone-responsive gene and protein expression. cAMPResponse Element-Binding 3-like protein 1 (Creb3l1) has previously been identified as a progesterone receptor (PR) target gene in mouse uterus via high density DNA microarray analysis. However, CREB3L1 function has not been studied in the context of endometriosis and uterine biology. In this study, we validated progesterone (P4) regulation of Creb3l1 in the uteri of wild-type and progesterone receptor knockout (PRKO) mice. Furthermore, we observed that CREB3L1 expression was significantly higher in secretory phase human endometrium compared to proliferative phase and that CREB3L1 expression was significantly decreased in the endometrium of women with endometriosis. Lastly, by transfecting CREB3L1 siRNA into cultured human endometrial stromal cells (hESCs) prior to hormonal induction of in vitro decidualization, we showed that CREB3L1 is required for the decidualization process. Interestingly, phosphorylation of ERK1/2, critical factor for decidualization, was also significantly reduced in CREB3L1-silenced hESCs. It is known that hESCs from patients with endometriosis show impaired decidualization and that dysregulation of the P4-PR signaling axis is linked to a variety of endometrial diseases including infertility and endometriosis. Therefore, these results suggest that CREB3L1 is required for decidualization in mice and humans and may be linked to the pathogenesis of endometriosis in a P4-dependent manner.
Assuntos
Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/genética , Endometriose/genética , Endométrio/metabolismo , Proteínas do Tecido Nervoso/genética , Progesterona/farmacologia , Receptores de Progesterona/genética , Adulto , Animais , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/antagonistas & inibidores , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Endometriose/metabolismo , Endometriose/patologia , Endometriose/cirurgia , Endométrio/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Histerectomia , Ciclo Menstrual/efeitos dos fármacos , Ciclo Menstrual/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pessoa de Meia-Idade , Proteína Quinase 1 Ativada por Mitógeno/genética , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/genética , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Proteínas do Tecido Nervoso/antagonistas & inibidores , Proteínas do Tecido Nervoso/metabolismo , Cultura Primária de Células , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Receptores de Progesterona/deficiência , Transdução de Sinais , Células Estromais/efeitos dos fármacos , Células Estromais/metabolismo , Células Estromais/patologiaRESUMO
We carried out a retrospective review of 75 children with unicameral bone cysts, who had sustained 52 pathological fractures, to determine which cysts were likely to be at risk and whether healing was accelerated after a fracture. Most lesions were in the metaphysis of a tubular bone, the commonest sites being the the upper part of the humerus and femur. The percentage of bone occupied by the cyst in the transverse plane was more than 85% in both anteroposterior and lateral radiographs in every case of pathological fracture. In most cases, the cyst recurred and sometimes became large without any acceleration of healing.
Assuntos
Cistos Ósseos/complicações , Fraturas do Fêmur/epidemiologia , Fraturas do Fêmur/etiologia , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Fraturas do Úmero/epidemiologia , Fraturas do Úmero/etiologia , Fraturas da Tíbia/epidemiologia , Fraturas da Tíbia/etiologia , Adolescente , Repouso em Cama , Cistos Ósseos/classificação , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/epidemiologia , Cistos Ósseos/terapia , Transplante Ósseo , Moldes Cirúrgicos , Criança , Pré-Escolar , Terapia Combinada , Curetagem , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/terapia , Consolidação da Fratura , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/terapia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/terapia , Incidência , Metilprednisolona/uso terapêutico , Radiografia , Recidiva , Estudos Retrospectivos , Fatores de Risco , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/terapiaRESUMO
We report a case of an intraosseous ganglion of the lateral malleolus of the ankle. The lesion was accompanied by a cystic bursa overlying the lateral malleolus. There were connections between the ankle joint, the intraosseous ganglion, and the overlying cyst. Radiographs of the lesion showed the cystic defect in the lateral malleolus surrounded by a sclerotic rim, suggesting that the lesion had progressed very slowly.
Assuntos
Cistos Ósseos/cirurgia , Cisto Sinovial/cirurgia , Tornozelo , Feminino , Humanos , Pessoa de Meia-Idade , Radiografia , Cisto Sinovial/diagnóstico por imagem , Cisto Sinovial/patologiaRESUMO
A case report on a 23-year-old female patient with cerebrotendinous xanthomatosis (CTX) is presented. From 8 years of age, the patient clinically showed multiple xanthoma masses on both knees, both heels, and the nasal bridge, juvenile cataracts, multiple abnormal neurologic dysfunctions, and dementia. The level of cholestanol in urine, serum, and xanthoma mass tissues was increased, as determined by capillary gas chromatography.