Integrin αv·β3 has been reported to be present in endometrial stromal cells throughout menstrual cycle, while in endometrial epithelial cells it was detected only at the timing of implantation. Too elucidate the mechanism underlying the regulation of integrin αv·β3 expression in the endometrium, we studied the effects of sex steroid hormones on integrin αv·β3 expression in cultured endometrial stromal and epithelial cells.
With the informed consent, endometrial specimens were obtained from patients with uterine myoma at the time of hysterectomy in the proliferative phase. Endometrial stromal and epithelial cells were separated to culture individually by the filtration through the mesh sized 37mm and the affinity to the dishes. Cultured endometrial stromal and epithelial cells treated with 17β-estradiol (E2) 1ng/ml and/or progesterone (P4) 100ng/ml for 48h were analysed for immunocytochemistry and Western blot using monoclonal antibodies to integrin αv and β3.
Treatment with sex steroid hormones did not affect integrin αv and β3 expression in cultured endometrial stromal cells. By contrast, integrin av expression in cultured endometrial epithelial cells was increased by the treatment with E2 alone and remarkably augmented by the combined treatment with E2 and P4. Integrin β3 expression was increased by E2 treatment without further increase after supplemental P4 to E2 treatment. Western blot analysis revealed that integrin αv and β3 expression was not detected in the stromal cells, whereas in the epithelial cells integrin αv and β3 expression was detected and augmented by the treatment with E2 alone or E2 and P4.
These results suggest that sex steroid hormones are involved in the regulation of integrin αv and β3 expression in endometrial epithelial cells and that endometrial stromal cells are not affected in the expression of integrin αv and β3 by the sex steroid hormones.

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IGF is a well known proliferative and survival factor of granulosa cells and luteinized cells in the ovary. IGF has six high affinity binding proteins (IGF binding proteins; IGFBP-1∼-6) and most of IGF molecules in blood and in local tissues are bound to these proteins, which regulate the IGF bioactivity. IGFBP-1 has been reported to be expressed in granulosa cells of growing follicles while IGFBP-2 and -4 were expressed in atretic follicles.
The present study was undertaken to investigate the relationship between the follicular IGFBPs and oocyte maturity or embryo development of the human oocyte in women undergoing assisted conception.
Follicular fluid (FF) was collected from individual follicle during oocyte retrieval for in vitro fertilization with the informed consent. FFs were divided into groups by the maturity of oocytes, mature (M) group and immature (IM) group, or by the developing capacity of oocytes, high potential (HP) group and low potential (LP) group. Oocytes of mature group corresponded to metaphase II, and oocytes of high potential group developed into 4 cells with less than 20% fragmentation within 42 hours after the insemination. The concentrations of total IGF-I, estradiol (E2), and testosterone (T) in FF were measured using RIA, and free IGF-I concentration in FF was determined using ratio assay. IGFBPs in FF and in plasma were analyzed with Western ligand blot using ¹²⁵I-IGF-II. Hormone concentration and IGFBP profiling were compared between M group and IM group, and between HP group and LP group.
No significant differences were found in the concentrations of sex steroid hormones either between M group and IM group, or between HP group and LP group. On the other hand, concentrations of both total IGF-I and free IGF-I in M group were significantly higher than those in IM group. In HP group the concentrations of total IGF-I were significantly higher than those in LP group, while no significant difference was noted in the concentration of free IGF-I between those two groups.
Western ligand blot analysis with ¹²⁵I-IGF-II revealed that IGFBP-1, -2, -3 and -4 were expressed in FF. Compared with IM group, M group showed higher expression of IGFBP-2, -3, and -4. Compared with LP group, HP group showed significantly higher expression of IGFBP-1, -2 and -4. The IGFBP-2 levels in FF of all groups were significantly higher than those in plasma, suggesting the local production of IGFBP-2 in ovarian follicles.
These results indicate that IGFBPs are necessary for oocyte to acquire fertilizing capacity against the high level of total IGF-I at the time of ovulation, and that the concentrations of IGFBPs were high in the follicles with high quality oocyte.

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Novel cisplatin (CDDP)-resistant subclones were established from two CDDP-sensitive cancer cell lines, human ovarian cancer cell line MCAS and human cervical squamous cell carcinoma cell line ME180. The CDDP-resistant cells were induced by chronic exposure to CDDP, and then single cell-derived sublines were selected by limiting dilution analysis. The CDDP-resistant sublines had 5 to 125-fold higher 50% lethal doses of CDDP than did parent cells, and showed resistance to CDDP-induced DNA fragmentation. Seven CDDP-resistant sublines derived from MCAS showed cross-resistances only to 5-fluorouracil (5-Fu) and 4-hydroperoxycyclophosphamide, while immunocytochemical study revealed that the resistant cells expressed high levels of known multidrug resistance gene products such as MDR-1, MRP, and LRP. Six CDDP-resistant sublines from ME180 were strongly cross-resistant to all 8 anticancer drugs examined. However immunocytochemical reactivity of MDR-1, MRP, and LRP in the ME180-derived sublines were as strong as those of parent ME180 cells. Although the CDDP-resistant cells from MCAS and ME180 were simultaneously established by a single protocol, the chracteristics of MCAS-derived cells were much different from those of ME180-derived ones. The CDDP-resistant cells will be very useful in investigations of the molecular mechanisms of anticancer drug-resistance in ovarian and cervical cancer cells.

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Forceps manipulation is a useful procedure for emergent delivery, as are vacuum extraction and cesarean section. Because of its technical difficulty and side effects for both mothers and newborn infants, the application of forceps manipulation has been decreased and vacuum extraction has been more popular in recent days. But the efficacy of the use of forceps by well trained obstetricians based on adequate indications is being reconsidered by Japan association of obstetricians and gynecologists. In order to assess the risk of forceps manipulation, we analayzed 75 forceps deliveries during the past 5 years in contrast to vaginal deliveries with no manipulation in the Kansai Medical University Kohri Hospital. All the deliveries analyzed were managed by a same doctor, and the results were as follows: 1) There was no severe maternal complications resulted from the use of forceps manipulation, but the amount of bleeding in forceps group significantly increased compared with that in control group. 2) There was one fetal intracranial hemorrhage in midforceps manipulation. However, there was no peripheral never problem, cerebral palsy, or developmental delay seen in the infant delivered by forceps manipulation.
These results suggest that forceps manipulation under adequate indications do not increase the incidence of maternal and fetal complications.

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We have experienced 95 women with uterine cancer in the last decade. Four of them were revealed to have sarcomatous component in histopathological specimens. Age of each patient was 60, 66, 69 and 75 years old. The chief complaint in all the cases was postmenopausal genital bleeding. One patient had a medical history of breast cancer, and another one had diabetes mellitus. In three patients, preoperative endometrial cytology was positive: endometrial adenocarcinoma in two cases and endometrial stromal sarcoma in one. Preoperative histological diagnosis were endometrial stromal sarcoma in two cases, endometrial adenocarcinoma in one case and carcinosarcoma in one case. Operations were performed as initial therapies in all the cases. In three of them, each of chemotherapy, irradiation, or both of them was carried out as postoperative adjuvant treatment.
Histological gradings of malignancy in glandular component showed well differentiated pattern in one, moderate in two and poor in the other. Clinical stagings revealed stage III in two and stage I in the other two cases. One case of moderately differentiated endometrioid adenocarcinoma and endometrial stromal sarcoma, has survived without any evidence of recurrence for 4 years after surgery. The other three cases presented lung metastases in the postoperative course, which showed a limited response to additional therapies. The periods of postoperative survive of them were 10 months, 1 year 4 months and 2 years 5 months after initial therapy, respectively. There have been very few reports describing that lung metastasis is frequently seen in cases of uterine corporeal carcinosarcoma. However, the presenting cases suggest that routine examination with chest X-ray is important in postoperative following-up of the disease.

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