Laparoscopic Management of Sclerosing Stromal Tumors of the Ovary Combined with Ectopic Pregnancy.

Like other stromal-derived gynecological tumors, a sclerosing stromal tumor of the ovary (SSTO) is a rare benign tumor that is difficult to distinguish from a malignant ovarian tumor in clinical practice. An SSTO is routinely treated with laparotomy. Here, we present two extremely rare cases of SSTO with contralateral and ipsilateral tubal pregnancies, in which laparoscopic surgery was performed to remove the tumors. After surgery, one patient (case 1) became pregnant twice within 29 months, and the other patient (case 2) did not become pregnant within 6 months postoperatively. These two cases suggest that laparoscopic management is not only useful in treating SSTO and complicating diseases, but it may also help to reduce unnecessary surgical injury to the ovary.

Indirect electrical injuries from capacitive coupling: a rarely mentioned electrosurgical complication in monopolar laparoscopy.

Electrothermal injuries in monopolar laparoscopy may derive indirectly, but rarely, from capacitive coupling releasing stray currents into neighboring non-targeted tissues, with intact instrument insulation. Since 2007, seven episodes of indirect electrosurgical damage to non-targeted tissues have been observed in our gynecological practice, including incidental coagulative necrosis of appendix, Fallopian tube, cystic pedicle, and broad ligament stump. Such an electrical response becomes greater where there is increased contact with the cystic wall (cysts <3 cm in diameter). Appropriate measures are available for minimizing capacitive coupling specifically caused by monopolar electrocautery. Thorough staff training, regular safety inspections, and strict procedure performance should exist to minimize such risks and injuries.

Is unilateral uterine adnexa absence a congenital developmental abnormality or posteriority? Summary of 39 cases and literature review.

PURPOSE: Unilateral uterine adnexa absence with a normal uterus is extremely rare but meaningful in clinical. To date, this rare malformation is still not well understood. Here, we present a new case and systematically summarize 38 historical cases to make this rare anomaly be understood better by clinicians. METHOD: The Chinese and English language medical literature were searched for all cases reported to date, and 39 were identified. All 39 cases were assessed for age, menstrual history, reproductive history, pelvic adhesions, other organ abnormalities, and mode of diagnosis. RESULTS: Patient age ranged from 6 days to 46 years. Menstrual history included normal (n = 27), irregular (n = 4), or unknown (n = 7). Childbearing history included pregnancy (n = 21), no history of pregnancy (n = 3), and primary infertility (n = 7). The absence of uterine adnexa involved either the left (n = 17) or right (n = 22) structures, showing a right adnexa preferential bias (22/39). CONCLUSIONS: The unilateral absence of uterine adnexa may be a congenital anomaly of reproductive organs; it does not significantly affect fertility or childbearing and is usually not diagnosed until adulthood.

Suppression of fatty acid synthase, differentiation and lipid accumulation in adipocytes by curcumin.

Curcumin is a well-known component of the cook seasoning and traditional herb turmeric (Curcuma longa), which has been reported to prevent obesity. However, the mechanism still remains to be determined. In this study, curcumin is found to be an effective inhibitor of fatty acid synthase (FAS), and its effects on adipocytes are further evaluated. Curcumin shows both fast-binding and slow-binding inhibitions to FAS. Curcumin inhibits FAS with an IC50 value of 26.8 µM, noncompetitively with respect to NADPH, and partially competitively against both substrates acetyl-CoA and malonyl-CoA. This suggests that the malonyl/acetyl transferase domain of FAS possibly is the main target of curcumin. The time-dependent inactivation shows that curcumin inactivates FAS with two-step irreversible inhibition, a specific reversible binding followed by an irreversible modification by curcumin. Like other classic FAS inhibitors, curcumin prevents the differentiation of 3T3-L1 cells, and thus represses lipid accumulation. In the meantime, curcumin decreases the expression of FAS, down-regulates the mRNA level of PPARγ and CD36 during adipocyte differentiation. Curcumin is reported here as a novel FAS inhibitor, and it suppresses adipocyte differentiation and lipid accumulation, which is associated with its inhibition of FAS. Hence, curcumin is considered to be having potential application in the prevention of obesity.

Inhibitory effects of thioethers on fatty acid synthase and 3T3-L1 cells.

Thioethers are the main flavor compounds found in Liliaceae Allium vegetables and have been shown to have beneficial effects against several diseases correlated with metabolic syndrome. The inhibitory effects of six thioethers on fatty acid synthase (FAS) were investigated. Dose-dependent and time-dependent inhibitions of FAS by one trisulfide and two disulfides were revealed. Diallyl trisulfide (DATS, IC(50) = 8.37 microM) was the most active of these thioethers. Inhibition kinetics, substrate protection analysis, and stoichiometric assay revealed that DATS interacted with both essential sulfhydryl groups on the acyl-carrier protein and beta-ketoacyl synthase domain of FAS to inactivate the enzyme. The inactivation by DATS represented affinity-labeling kinetics. The active thioethers also inhibited the differentiation and lipid accumulation of 3T3-L1 preadipocytes, and the effect was related to their inhibition of FAS. It is suggested that the inhibition on FAS by thioethers and Allium vegetables is an important factor for their effects against metabolic syndrome.