| 1. |
- Dahm-Kähler, Pernilla, 1964, et al.
(författare)
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Monocyte chemotactic protein-1 (MCP-1), its receptor, and macrophages in the perifollicular stroma during the human ovulatory process
- 2009
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 91:1, s. 231-239
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the expression and localization of the macrophage-specific chemokine monocyte chemotactic protein-1 (MCP-1), CC chemokine receptor 2 (CCR2), and macrophages (CD68) in the perifollicular stroma of different phases of the human ovulatory process and its relation to macrophage influx. DESIGN: Experimental study on patient-controlled material. SETTING: University hospital. PATIENT(S): Twenty-eight women planned to undergo laparoscopic sterilization. INTERVENTION(S): Surgery was performed at either of four distinct ovulatory phases, and a biopsy sample was obtained from the perifollicular stroma of the ovulatory follicle. MAIN OUTCOME MEASURE(S): Real-time polymerase chain reaction, immunoblotting, and immunohistochemistry were used for measurements of MCP-1, CCR2, and macrophages. RESULT(S): The messenger RNA levels of MCP-1 in the perifollicular stroma increased from the preovulatory to the late ovulatory phase and declined during the postovulatory phase. A higher density of macrophages was found in the preovulatory and early ovulatory phases compared with late and postovulatory phases. Monocyte chemotactic protein-1 and CCR2 were present in the stroma. Protein expression of CD68 and CCR2 were identified in the four ovulatory phases. CONCLUSION(S): This study demonstrates an upregulation of MCP-1 in the stroma compartment around the human follicle during the ovulatory process, and a high density of macrophages was found at earlier phases. Thus, inflammation-like reactions are integral in the ovulatory process and may be targeted to stimulate or inhibit this process.
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| 2. |
- Lind, Anna Karin, 1962, et al.
(författare)
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Collagens in the human ovary and their changes in the perifollicular stroma during ovulation
- 2006
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Ingår i: Acta Obstet Gynecol Scand. ; 85:12, s. 1476-84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Remodeling of the collagens around the follicle is a major event in ovulation. The aim of the present study was to investigate the distribution of collagen I, III, and IV in the human ovary. METHODS: Biopsies of the perifollicular stroma were obtained at sterilization during the preovulatory phase (follicle size >14 mm) or at any of three intervals (12-18 h after human chorionic gonadotrophin: early ovulatory phase; >18-24 h: late ovulatory phase; 44-77 h: postovulatory phase) after human chorionic gonadotrophin. Excised dominant follicles and whole ovarian sections were also obtained. Immunohistochemistry using antibodies against collagen I, III, IV, vimentin, and CD 45 was performed. RESULTS AND CONCLUSIONS: Collagens I and III were distributed in concentric layers in the capsular stroma with bundles of collagens connecting these layers to form a mesh. Collagen I was present in larger quantities in the outer layers and collagen III showed the inverse distribution. In the theca, collagen I was present in the externa and collagen III in the entire layer. The staining intensity of collagens I and III in the perifollicular stroma decreased from the preovulatory stage. Collagen IV was present in the basal lamina separating granulosa and theca cells. This study shows that collagen I and III are abundant in and around the ovulating human follicle with typical patterns of distribution. Collagen IV is present in the basal membrane that separates the granulosa from the theca cells. Taking into account the abundance of collagens in the follicular wall and their specific localization, major site-directed degradation of collagens seems to be necessary for follicular rupture to occur.
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| 3. |
- Lind, Anna Karin, 1962, et al.
(författare)
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Gelatinases and their tissue inhibitors during human ovulation: increased expression of tissue inhibitor of matrix metalloproteinase-1
- 2006
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Ingår i: Mol Hum Reprod. ; 12:12, s. 725-36
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Tidskriftsartikel (refereegranskat)abstract
- Remodelling of the extracellular matrix (ECM) of the follicular wall by matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) has been suggested to be crucial in ovulation. To investigate the expression of the gelatinases, MMP-2 and MMP-9, together with their inhibitors, TIMP-2 and TIMP-1, in the perifollicular ovarian stroma from women just before and during ovulation, we obtained biopsies of the stroma adjacent to the leading follicle. Laparoscopic surgery was performed either before the LH peak or at any of three intervals after ovulation triggering by hCG. Immunoblotting, immunohistochemistry and quantitative RT-PCR were performed. All four proteins were expressed by immunoblots, with no detectable changes in the expression of MMP-2, MMP-9 and TIMP-2. Scattered immunostaining for MMP-9 and TIMP-2 was seen, and MMP-2 was demonstrated in a concentric layer. A significant increase in TIMP-1 protein and mRNA was seen during the three ovulatory phases, and a strong and patchy immunostaining for TIMP-1 was shown. This is the first study that has demonstrated an ovulation-associated expression of these ECM-remodelling enzymes around the human follicle at ovulation. The increased expression of TIMP-1 may reflect a specific temporal inhibition of collagenolysis and thereby a time-dependent regulation of ECM breakdown in areas surrounding the apex of the follicle.
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| 4. |
- Lindfors, Anna, et al.
(författare)
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Long-term survival in obese patients after robotic or open surgery for endometrial cancer
- 2020
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Ingår i: Gynecologic Oncology. - : Elsevier BV. - 0090-8258. ; 158:3, s. 673-680
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate surgical outcomes and survival after primary robotic or open surgery in obese women with endometrial cancer (EC). Methods. The study included obese women (BMI >= 30 kg/m(2)) with EC who underwent primary surgery before and after the introduction of robotics between 2006 and 2014. Data on complications, survival, and recurrence was obtained through the National Cancer Registry and medical files. Survival curves were calculated for overall (OS), relative (RS) and disease-free survival (DFS). Cox proportional hazards regression models to assess OS and DFS. Results. In total, 217 patients were identified, 131 robotic and 86 open surgical procedures. Significantly lower estimated blood loss, surgical time and hospital stay were found in the robotic group and the relative risk ratio of complications grades II-V, using the Clavien Dindo classification, was 0.54 (95% CI 0.31-0.93) for the robotic compared to the open group. A significant difference in OS (p = 0.029) and RS (p = 0.024) in favor of robotics was shown in the univariable survival curves, using log rank tests. No difference was seen for DFS. The 5-year RS was 96.2% (95% CI 89.7-103.3) for the robotic and 81.6% (95% CI 72.1-92.3) for the open group. Multivariable analysis showed high risk histology to be an independent risk factor, for both OS (HR 2.90; 95% CI 1.42-5.93; p < 0.05) and DFS (HR 2.74; 95% CI 1.45-5.17; p < 0.05). Robotic surgery was not found a significant independent factor for survival. Conclusions. Robotic surgery in obese women with EC had equivalent long-term and disease-free survival compared to open with significantly less complications, lower estimated blood loss, shorter surgical time and hospital stay. (c) 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 5. |
- Lindfors, Anna, et al.
(författare)
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Robotic vs Open Surgery for Endometrial Cancer in Elderly Patients: Surgical Outcome, Survival, and Cost Analysis.
- 2018
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Ingår i: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. - 1525-1438. ; 28:4, s. 692-699
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to compare robotic and open surgery in elderly women diagnosed as having endometrial cancer, in terms of costs, survival, surgical outcome, and operating time.Women 70 years or older undergoing open and robotic surgery for endometrial cancers were included consecutively before and after the introduction of robotic surgery at a tertiary center. Costs were calculated using the case-costing system, cost per patient, including the first 30 postoperative days. Relative and overall survival outcomes were obtained from the Swedish National Cancer Registry and analyzed using the Kaplan-Meier method. Surgical outcomes including operating and anesthesia times, estimated blood loss, hospital stay, and intraoperative and postoperative complications were reviewed.In all, 137 and 141 women 70 years or older were identified to have undergone open and robotic surgery, respectively. The groups showed similar body mass index, comorbidities, and tumor characteristics. No statistically significant differences were seen in costs (robotic &OV0556;11,874 vs open &OV0556;11,521, P = 0.463) or 5-year survival outcomes (robotic 94% [95% confidence interval {CI}, 84-105] vs open 87% [95% CI, 78-98], P = 0.529). Robotic surgery was associated with significantly lower estimated blood loss (P < 0.001) and shorter hospital stay (P < 0.001) but longer anesthesia time (186 vs 174 minutes; P < 0.05) and operating theater time (205 vs 190 minutes; P < 0.05). There were no significant differences in intraoperative complications, but robotic surgery resulted in fewer postoperative Clavien-Dindo grade II complications.Elderly women can safely undergo robotic surgery for endometrial cancer and could be offered this technique to the same extent as younger patients. They may benefit from shorter hospital stay, decreased blood loss, and postoperative complications, without resulting in higher costs to the health care system or jeopardizing their survival.
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