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Gestational trophoblastic disease

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https://www.readbyqxmd.com/read/27900108/high-dose-chemotherapy-with-autologous-peripheral-blood-stem-cell-transplantation-for-choriocarcinoma-a-case-report-and-literature-review
#1
Eiko Yamamoto, Kaoru Niimi, Kayo Fujikake, Tetsuya Nishida, Makoto Murata, Ayako Mitsuma, Yuichi Ando, Fumitaka Kikkawa
Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899973/expression-patterns-of-maspin-and-mutant-p53-are-associated-with-the-development-of-gestational-trophoblastic-neoplasia
#2
Pengming Sun, Qibin Wu, Guanyu Ruan, Xiu Zheng, Yiyi Song, Jianfan Zhun, Lixiang Wu, Walter H Gotlieb
Gestational trophoblastic disease (GTD) is a group of conditions that originate from the abnormal proliferation of trophoblastic cells. GTDs encompass hydatidiform moles (HMs) and gestational trophoblastic neoplasia (GTN). GTNs are a group of malignant diseases that require chemotherapy, or more aggressive treatment. There is a requirement for more tumor markers to predict the development of GTN from HMs. The current study evaluated the expression of maspin and tumor protein p53 (p53) in GTD, and their role in predicting the development of GTN...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27896261/giant-invasive-mole-presenting-as-a-cause-of-abdominopelvic-mass-in-a-perimenopausal-woman-an-unusual-presentation-of-a-rare-pathology
#3
Alpaslan Akyol, Memet Şimşek, Özlem Üçer
Invasive mole is a benign gestational trophoblastic disease that arises from the myometrial invasion of any gestational event via direct extension through tissue or vascular structures. Invasive mole (and other gestational trophoblastic diseases) may present with life-threatening complications including uterine perforation, excessive bleeding, acute hemoperitoneum, and abdominal pain. We report a case of invasive mole presenting as abdominal distention in a 51-year-old perimenopausal woman (gravida 12, para 12, abortion 0)...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27871471/endocan-expression-is-increased-in-the-placenta-from-obese-women-with-gestational-diabetes-mellitus
#4
Padma Murthi, Ramona Sarkis, Ratana Lim, Caitlyn Nguyen-Ngo, Anita Pratt, Stella Liong, Martha Lappas
INTRODUCTION: Endocan, a member of the proteoglycan family, is involved in a wide range of diseases including obesity and diabetes. The aim of this study was to determine the effect of (i) maternal obesity and gestational diabetes mellitus (GDM) on placental endocan expression; and (ii) endocan knockdown on markers of inflammation. METHODS: Endocan mRNA and protein expression was determined in human placenta from (i) lean and obese and normal glucose tolerant (NGT) pregnant women (n = 10 patients per group); and (ii) women with GDM and BMI-matched NGT women (n = 40 patients per group)...
December 2016: Placenta
https://www.readbyqxmd.com/read/27871274/chemotherapy-curable-malignancies-and-cancer-stem-cells-a-biological-review-and-hypothesis
#5
Philip Savage
BACKGROUND: Cytotoxic chemotherapy brings routine cures to only a small select group of metastatic malignancies comprising gestational trophoblast tumours, germ cell tumours, acute leukemia, Hodgkin's disease, high grade lymphomas and some of the rare childhood malignancies. We have previously postulated that the extreme sensitivity to chemotherapy for these malignancies is linked to the on-going high levels of apoptotic sensitivity that is naturally linked with the unique genetic events of nuclear fusion, meiosis, VDJ recombination, somatic hypermutation, and gastrulation that have occurred within the cells of origin of these malignancies...
November 21, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27849611/notch1-controls-development-of-the-extravillous-trophoblast-lineage-in-the-human-placenta
#6
Sandra Haider, Gudrun Meinhardt, Leila Saleh, Christian Fiala, Jürgen Pollheimer, Martin Knöfler
Development of the human placenta and its different epithelial trophoblasts is crucial for a successful pregnancy. Besides fusing into a multinuclear syncytium, the exchange surface between mother and fetus, progenitors develop into extravillous trophoblasts invading the maternal uterus and its spiral arteries. Migration into these vessels promotes remodelling and, as a consequence, adaption of blood flow to the fetal-placental unit. Defects in remodelling and trophoblast differentiation are associated with severe gestational diseases, such as preeclampsia...
November 14, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27819410/comparing-and-evaluating-the-efficacy-of-methotrexate-and-actinomycin-d-as-first-line-single-chemotherapy-agents-in-low-risk-gestational-trophoblastic-disease
#7
Young Jae Lee, Jeong Yeol Park, Dae Yeon Kim, Dae Shik Suh, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Joo Hyun Nam
OBJECTIVE: The aim of this study was to compare responses to single-agent chemotherapies and evaluate the predictive factors of resistance in low risk (LR) gestational trophoblastic disease (GTD). The chemotherapy agents included methotrexate (MTX) and actinomycin D (ACT-D). METHODS: We conducted a retrospective study of 126 patients with GTD who were treated between 2000 and 2013. A total of 71 patients with LR GTD were treated with MTX (8-day regimen or weekly regimen, n=53) or ACT-D (bi-weekly pulsed regimen or 5-day regimen, n=18)...
October 7, 2016: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/27807286/fetal-genome-profiling-at-5-weeks-of-gestation-after-noninvasive-isolation-of-trophoblast-cells-from-the-endocervical-canal
#8
Chandni V Jain, Leena Kadam, Marie van Dijk, Hamid-Reza Kohan-Ghadr, Brian A Kilburn, Craig Hartman, Vicki Mazzorana, Allerdien Visser, Michael Hertz, Alan D Bolnick, Rani Fritz, D Randall Armant, Sascha Drewlo
Single-gene mutations account for more than 6000 diseases, 10% of all pediatric hospital admissions, and 20% of infant deaths. Down syndrome and other aneuploidies occur in more than 0.2% of births worldwide and are on the rise because of advanced reproductive age. Birth defects of genetic origin can be diagnosed in utero after invasive extraction of fetal tissues. Noninvasive testing with circulating cell-free fetal DNA is limited by a low fetal DNA fraction. Both modalities are unavailable until the end of the first trimester...
November 2, 2016: Science Translational Medicine
https://www.readbyqxmd.com/read/27793555/a-longitudinal-analysis-of-angiotensin-ii-type-1-receptor-antibody-and-angiogenic-markers-in-pregnancy
#9
Shikha Aggarwal, Neroli Sunderland, Charlene Thornton, Bei Xu, Annemarie Hennessy, Angela Makris
BACKGROUND: Preeclampsia can be caused by shallow trophoblast invasion and results in endothelial dysfunction. Angiotensin II type 1 receptor antibodies (AT1AA) may have a role in both processes. Other angiogenic markers (placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and endoglin (sEng) alter before clinically evident preeclampsia. OBJECTIVES: The aim of this study is to assess the longitudinal changes and utility of biomarkers AT1AA and angiogenic markers in hypertensive disorders of pregnancy; gestational hypertension (GHT) and preeclampsia (PE)...
October 25, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27793374/decreased-toll-like-receptor-2-messenger-ribonucleic-acid-and-increased-toll-like-receptor-4-in-the-tubal-epithelium-next-to-the-infiltrated-trophoblasts-during-tubal-pregnancy
#10
Yin Fen Ji, Jian Xu, Tao Zhang, Li You Chen
OBJECTIVE: To explore the expression patterns of Toll-like receptor (TLR)2 and TLR4 in the tubal epithelial cells next to the infiltrated trophoblasts at the maternal-fetal interface during tubal pregnancy. DESIGN: Prospective, observational study. SETTING: University-based obstetrics and gynecology hospital. PATIENT(S): Thirty-seven women undergoing salpingectomy for tubal ampullary pregnancy and nine nonpregnant patients with benign uterine or appendix disease...
October 25, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27789293/molecular-hydrogen-ameliorates-several-characteristics-of-preeclampsia-in-the-reduced-uterine-perfusion-pressure-rupp-rat-model
#11
Takafumi Ushida, Tomomi Kotani, Hiroyuki Tsuda, Kenji Imai, Tomoko Nakano, Shima Hirako, Yumiko Ito, Hua Li, Yukio Mano, Jingwen Wang, Rika Miki, Eiko Yamamoto, Akira Iwase, Yasuko K Bando, Masaaki Hirayama, Kinji Ohno, Shinya Toyokuni, Fumitaka Kikkawa
Oxidative stress plays an important role in the pathogenesis of preeclampsia. Recently, molecular hydrogen (H2) has been shown to have therapeutic potential in various oxidative stress-related diseases. The aim of this study is to investigate the effect of H2 on preeclampsia. We used the reduced utero-placental perfusion pressure (RUPP) rat model, which has been widely used as a model of preeclampsia. H2 water (HW) was administered orally ad libitum in RUPP rats from gestational day (GD) 12 to 19, starting 2 days before RUPP procedure...
October 24, 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/27789086/placental-site-trophoblastic-tumors-and-epithelioid-trophoblastic-tumors-biology-natural-history-and-treatment-modalities
#12
REVIEW
Neil S Horowitz, Donald P Goldstein, Ross S Berkowitz
Placental site (PSTT) and epithelioid trophoblastic tumor (ETT) are rare types of gestational trophoblastic neoplasia (GTN) that arise from intermediate trophoblast. Given that this cell of origin is different from other forms of GTN, it is not surprising that the clinical presentation, tumor marker profile, and treatment paradigm for PSTT and ETT are quite different as well. The mainstay for therapy for stage I PSTT and ETT is hysterectomy with adjuvant chemotherapy reserved for those presenting greater than four years from the antecedent pregnancy...
October 24, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27777478/clinical-and-radiological-correlations-in-patients-with-gestational-trophoblastic-disease
#13
Lana de Lourdes Aguiar Lima, Raphael Câmara Medeiros Parente, Izildinha Maestá, Joffre Amim Junior, Jorge Fonte de Rezende Filho, Carlos Antonio Barbosa Montenegro, Antônio Braga
Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for regression, invasion, metastasis, and recurrence. In the past, it was common for patients with molar pregnancy to present with marked symptoms: copious bleeding; theca lutein cysts; uterus larger than appropriate for gestational age; early preeclampsia; hyperemesis gravidarum; and hyperthyroidism. Currently, with early diagnosis made by ultrasound, most patients are diagnosed while the disease is still in the asymptomatic phase...
July 2016: Radiologia Brasileira
https://www.readbyqxmd.com/read/27770612/let-7i-induced-atg4b-suppression-is-essential-for-autophagy-of-placental-trophoblast-in-preeclampsia
#14
Yinyan Xu, Xinyan Huang, Juan Xie, Yanni Chen, Jing Fu, Li Wang
Autophagy, identified as type II programmed cell death, has already been known to be involved in the pathophysiology of preeclampsia (PE), which is a gestational disease with high morbidity. The present study aims to investigate the functional role of let-7i, a miRNA, in trophoblastic autophagy. Placental tissue used in this study was collected from patients with severe preeclampsia (SPE) or normal pregnant women. A decreased level of let-7i was found in placenta of SPE. In addition, autophagic vacuoles were observed in SPE and the expression of microtubule associated protein 1 light chain 3 (LC3) II/I was elevated...
October 22, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27756557/risk-adapted-single-agent-dactinomycin-or-carboplatin-for-second-line-treatment-of-methotrexate-resistant-low-risk-gestational-trophoblastic-neoplasia
#15
M C Winter, J A Tidy, A Hills, J Ireson, S Gillett, K Singh, B W Hancock, R E Coleman
OBJECTIVE: To evaluate the outcome of patients treated with second-line chemotherapy for methotrexate-resistant low-risk GTN at the Sheffield Centre, UK between 2001 and 2015, including the novel use of single-agent carboplatin as a strategy to reduce exposure to combination chemotherapy. METHODS: 392 low-risk GTN patients were treated with first-line methotrexate. The selection of chemotherapy regimen following methotrexate-resistance depended on the volume of residual disease as indicated by the serum hCG value at the time, with patients switching to either single-agent dactinomycin at an hCG level<150IU/L from 2001-2010 and <300IU/L since 2010, or to combination treatment with etoposide/dactinomycin (EA) above these thresholds...
December 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27743739/15years-of-progress-in-gestational-trophoblastic-disease-scoring-standardization-and-salvage
#16
Jubilee Brown, R Wendel Naumann, Michael J Seckl, Julian Schink
Significant improvements in treatment and the understanding of gestational trophoblastic neoplasia have occurred in the last 15years. These diseases are almost always curable, and refractory patients have more options for salvage therapy. Recent improvements in the understanding of epidemiology, diagnosis, and cell biology have resulted in changes in staging, advances in treatment options, and opportunities for fertility preservation.
October 13, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27741549/management-of-hyperthyroidism-during-the-preconception-phase-pregnancy-and-the-postpartum-period
#17
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27738663/fertility-sparing-surgery-in-gestational-trophoblastic-neoplasia-a-report-of-4-cases
#18
Malihe Hasanzadeh, Ftemeh Vahid Roodsari, Shahnaz Ahmadi, Masoumeh Gavedan Mehr, Tabari Azadeh
BACKGROUND: Gestational trophoblastic neoplasia (GTN) is a curable disease that involves the development of malignant tumor in the woman after a normal or molar pregnancy. The position of surgery in GTN is not properly specified and is changing due to new chemotherapy protocols. However, the role of surgery is highlighted in chemotherapy-resistant GTN. Other indications of surgery in trophoblastic diseases are drug toxicity and uterine perforation. Based on the fact that most women in certain age tend to preserve fertility, this study reported 4 cases of successful treatment after fertility sparing surgery...
September 2016: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/27692520/-placental-site-trophoblastic-tumor-when-do-we-suspect-it-and-which-treatment-shall-we-decide
#19
E Nguyen Ba, F Golfier, C Malhaire, L Louafi, S Alran
Tumors of trophoblast implantation site TTSI are rare gestational tumors. This case highlights the diagnostic difficulties and treatment of tumors of trophoblastic implantation site early. Patient of 28 years with no medical history, G1P1 who gave birth 11 months ago presented bleeding with an HCG level of 73IU that led to the diagnosis of early miscarriage. Treatment of miscarriage by hysteroscopy and curettage is complicated leading to the realization of an abdominopelvic CT and pelvic ultrasound that show an atypical uterine vascularity and an intracavitary heterogeneous mass...
September 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27685354/transcriptional-analysis-by-nascent-rna-fish-of-in-vivo-trophoblast-giant-cells-or-in-vitro-short-term-cultures-of-ectoplacental-cone-explants
#20
Catherine Corbel, Edith Heard
The placenta derives from one extra-embryonic lineage, the trophectoderm. In the peri-implantation murine blastocyst, mural trophectoderm cells differentiate into primary trophoblast giant cells (TGCs) while the polar trophectoderm overlying the inner cell mass continues to proliferate later differentiating into secondary TGCs. TGCs play a key role in developing placenta and are essential for a successful pregnancy. Investigation of transcriptional regulation of specific genes during post-implantation development can give insights into TGCs development...
August 31, 2016: Journal of Visualized Experiments: JoVE
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