Pretreatment with melatonin improves ovarian tissue cryopreservation for transplantation.

BACKGROUD: Melatonin has anti-inflammatory and antioxidative actions at the mitochondrial level. This indole-containing molecule may protect ovarian grafts during the process of cryopreservation. Therefore, we aimed to determine whether melatonin pretreatment improves rat ovarian graft quality. METHODS: Twenty-six female rats were allocated to two study groups of thirteen animals each: 1) control group: ovaries cryopreserved using the standard protocol; and 2) melatonin group: ovaries cryopreserved in a medium with melatonin. Ten rats of each group were submitted to 24-h freezing, and whole ovaries autologous and avascular transplantation with retroperitoneal placement. After postoperative (PO) day 15, daily vaginal smears were obtained for estrous cycle characterization. Between PO days 30 and 35, the animals were euthanized and ovarian grafts were recovered for histological and immunohistochemical (Ki-67, cleaved caspase-3, TUNEL, von Willebrand factor, estrogen, and progesterone receptors) analyses. The ovaries of the three remaining rats from each group were studied immediately after thawing to assess the effects of cryopreservation. ANOVA and Tukey's tests were used and the rejection level of the null hypothesis was set at 0.05 or 5% (p < 0.05). RESULTS: Melatonin promoted faster restart of the estrous cycle and increased the expression of mature follicles, collagen type I, von Willebrand factor, Ki-67, and cleaved caspase-3 on corpora lutea and estrogen receptors in the ovaries as compared to control. There was a reduction in apoptosis by TUNEL on follicles, corpora lutea, and collagen type III. CONCLUSION: Based on the evaluated parameters, melatonin may promote the quality of ovarian grafts. Reproductive function enhancement should be further studied.

Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either "asymptomatic" or "much better" than before treatment and were "very satisfied" or "satisfied" with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.

Líquen escleroso vulvar: descrição de cinco casos de sucesso com laser Erbium-YAG 2940 / Vulvar lichen sclerosus: description of 5 cases successfully treated with the 2940nm Erbium-YAG laser

Líquen escleroso é dermatose crônica com predileção pela região genital. Acomete, principalmente, a raça branca, sendo mais frequente em mulheres. O tratamento-padrão é feito com corticosteroides tópicos de alta potência. Tratamentos com propionato de testosterona, imunomoduladores tópicos, terapia fotodinâmica, crioterapia, antibioticoterapia e laserterapia são citados na literatura. Neste artigo são relatados cinco casos de pacientes com liquen escleroso vulvar, sem sucesso com o clobetasol tópico, submetidas ao tratamento com Laser Erbium YAG 2940 fracionado. Os resultados foram bastante satisfatórios, sugerindo a laserterapia como opção no tratamento do líquen escleroso, incluídos casos de insucesso com o uso corticoides tópicos.

Lichen sclerosus is a chronic dermatosis, usually anogenital and mainly affecting pos-menopausal women. The use of topical corticosteroids is the mainstay of medical treatment. Other treatments are topical testosterone, calcineurin inhibitors, photodynamic therapy, cryotherapy, antibiotic therapy and laser therapy. In this article, five patients with vulvar lichen sclerosus which had no response to treatment with topical clobetasol, had good results when treated with fractional Erbium:YAG laser 2940.