Non-Hodgkin's lymphomas involving the uterus: a clinicopathologic analysis of 26 cases.

Non-Hodgkin's lymphomas (NHL) involving the uterus may be either low-stage neoplasms that probably arise in the uterus (primary) or systemic neoplasms with secondary involvement. In this study, 26 NHL involving the uterus are reported. Ten cases were stage I(E) or II(E) and are presumed to be primary. The mean age of patients at presentation was 55 years (range, 35 to 67 years), and abnormal uterine bleeding was the most frequent complaint (six patients). Nine of 10 tumors involved the cervix. Histologically, eight were diffuse large B-cell lymphoma (DLBCL); one was follicle center lymphoma, follicular, grade 1; and one was marginal zone B-cell lymphoma. At 5 years of clinical follow-up, five of six patients were alive after treatment. In 12 cases, uterine involvement was part of a systemic disease at diagnosis, either stage III(E) or IV. The mean patient age at the time that uterine involvement was detected was 58 years (range, 22 to 75 years); 6 of 12 had abnormal uterine bleeding. Six tumors involved both cervix and corpus, four corpus, and two cervix. Six were DLBCL; two were small lymphocytic lymphoma; three were follicle center lymphoma, follicular, grade 1 (two cases) or grade 2 (one case); and one was precursor T-cell lymphoblastic lymphoma. At 5 years of clinical follow-up, two of seven patients were alive after treatment. Four DLBCL arose in patients with incomplete clinical information; therefore, stage is unknown. We conclude that low-stage (presumably primary) uterine NHL are most commonly DLBCL, predominantly arise in the cervix, and cause abnormal uterine bleeding. High-stage NHL are a heterogeneous group of B-cell neoplasms that can involve the cervix or the corpus.     

Distribution of peroxidase and granulocytes in the human uterus

A variety of uterine cell types demonstrate endogenous peroxidase activity. Ultracytochemical localization, biochemical assays, and uterine granulocyte counts were used to characterize peroxidase activity in various regions of the human uterus and cervix during the menstrual cycle and during the postmenopausal period. Previous studies of rat uteri, using electron microscopy and biochemical assays, have shown that endometrial peroxidase is induced by estrogenic stimulation (Anderson, De Sombre, and Kang, J Cell Biol 64:668, 1975; and Biol Reprod 16:409, 1977). Tissue samples from four regions of the human uterus and one sample from the endocervix were processed for ultrastructural cytochemistry, biochemical assay, and histology. Endogenous peroxidase activity was identified with electron microscopy in the endoplasmic reticulum of endometrial epithelial cells lining four regions of the uterine cavity; the isthmus, body (2), and fundus, of some proliferative phase (2 of 6), all secretory phase (4 of 4) and all postmenopausal (3 of 3) endometria. Peroxidase activity was not demonstrable in endocervical epithelial cells. Endogenous peroxidase activity was also identified in the cytoplasmic granules of uterine eosinophils and neutrophils and in the endoplasmic reticulum of mast cells. These uterine granule-containing cells, identified with special stains in the histologic sections, were quantitated. Approximately 80% of these "uterine granulocytes" from normal uteri without intrauterine devices were neutrophils. In women of reproductive age the uterine granulocytes, although present throughout the menstrual cycle, were most numerous in the endocervix and lower uterine segment. The highest biochemical assays of peroxidase activity were also obtained in the cervix and lower uterine segment. Uterine granulocyte counts varied directly with biochemical assays of peroxidase activity indicating that they were a major determinant of biochemical peroxidase activity. Endometrial epithelial peroxidase is anatomically and temporally well placed to function as an important adjunct in maintaining a mucosal barrier to microorganisms.     

The embryo versus endometrium controversy revisited as it relates to predicting pregnancy outcome in in-vitro fertilization-embryo transfer cycles

To evaluate embryonic and endometrial factors for their value in predicting pregnancy outcome in in-vitro fertilization (IVF) and embryo transfer, a retrospective data collection and prospective uterine artery colour Doppler imaging study was performed in a university-based IVF-embryo transfer programme setting. A total of 210 patients were included and grouped as follows: (I) IVF with controlled ovarian stimulation (214 cycles); (II) frozen-thaw cycle of autologous embryos (30 cycles); (III) oocyte donation, no cryopreservation (12 cycles); (IV) frozen-thaw cycle with embryos from donated oocytes (10 cycles). Embryo quality was significantly better in pregnant than non-pregnant cycles (group I, P = 0.0104; groups II-IV, P = 0.0418). The endometrial echo was significantly thicker in pregnant versus non-pregnant patients in group I (P = 0.0059), but not in groups II-IV (P = 0.741). Past uterine surgery or abnormalities had no effect on pregnancy outcome. There were no significant differences in mean uterine artery resistance index or peak systolic velocity in pregnant versus non-pregnant patients in groups II-IV. Thus, embryo quality is the most reliable predictor of pregnancy outcome. Endometrial measurements were significantly thicker in subsequently pregnant patients only in group I, where the endometrium reflects the hormonal environment. Doppler parameters were not useful in predicting pregnancy outcome.      

女性盆底子宫骶主韧带MRI的观察研究

目的通过MRI不同序列对健康女性盆底扫描,比较两种扫描序列对子宫骶主韧带的显示图像特点和清晰度,选择优化MRI扫描序列进一步三维建模研究女性盆底功能障碍。方法选择无盆底功能障碍性疾病的健康女性10例,分别采用质子密度加权自旋回波序列和TSE T2WI序列行盆底薄层MR成像,获得连续薄层断面的图像集,在横断面分别观察骶主韧带起源及终止点,观察每层的显示情况,辨认盆底器官与子宫骶主韧带解剖位置及与周围器官的关系,通过同一检查者相同的每一层辨认评分,比较两种扫描序列对子宫骶主韧带的显示图像辨认率和清晰度。结果质子密度加权自旋回波序列对子宫骶主韧带的显示优于TSE T2WI,有显著性差异（P〈0.05）,能更清楚地显示骶主韧带边界。10例检查者中骶韧带起自骶骨2例（20%）、尾骨肌/骶棘韧带复合体6例（60%）、坐骨棘2例（20%）;插入宫颈3例（30%）、阴道1例（10%）、宫颈和阴道6例（60%）;主韧带起自同侧骨盆侧壁坐骨大孔,解剖末端7例（70%）至宫颈,1例（10%）至阴道,2例（20%）至宫颈和阴道。结论采用MRI质子密度加权自旋回波脉冲序列对女性盆底成像,可清楚显示盆底器官与子宫骶主韧带解剖位置及与周围器官关系,活体骶主韧带解剖起止点、走行方向,与临床解剖对子宫骶主韧带观察一致,为探讨子宫脱垂患者的骶主韧带解剖改变与功能障碍关系奠定了研究基础。     

Control and assessment of the uterus and cervix during pregnancy and labour

Preterm labour and resultant preterm birth are the most important problems in perinatology. Countless efforts have failed to establish a single effective treatment of preterm labour, partly because the mechanisms regulating the uterus and cervix during pregnancy are not well understood. New knowledge is needed to inhibit early progression of labour (uterine contractility and cervical ripening), and adequate quantitative tools to evaluate the uterus and cervix during pregnancy are lacking. In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labour. This step is not easily identifiable with present methods to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties to make muscle more excitable and responsive to produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone appears to have a dominant role in controlling both the uterus and cervix, as antiprogestins induce early, preterm conditioning leading to preterm labour. Apparently, nitric oxide (NO) also controls conditioning of the uterus and cervix. In the uterus, NO, in concert with progesterone, inhibits uterine contractility. At term, NO production by the uterus and placenta are decreased and allow labour to progress. In contrast, NO in the cervix increases at the end of pregnancy and it may be the final pathway for stimulating cervical ripening by activation of metalloenzymes. The progress of labour can be assessed non-invasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labour. EMG activity also increases substantially during preterm labour in humans and rats. This method may be used one day to predict impending preterm labour and identify control steps and treatments. A quantitative method also assesses the cervix, using an optical device which measures collagen fluorescence in the cervix. The collascope estimates cervical collagen content from a fluorescent signal generated when collagen cross-links are illuminated with excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy, and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy, and indicate control and treatments.     

Glycosaminoglycan Distribution in the Rat Uterine Cervix During the Estrous Cycle

OBJECTIVE:

To analyze the amount of glycosaminoglycans in the uterine cervix during each phase of the rat estrous cycle.

DESIGN:

Based on vaginal smears, forty female, regularly cycling rats were divided into four groups (n = 10 for each group): GI – proestrous, GII – estrous, GIII – metaestrous and GIV – diestrous. Animals were sacrificed at each phase of the cycle, and the cervix was immediately removed and submitted to biochemical extraction and determination of sulfated glycosaminoglycans and hyaluronic acid. The results were analyzed by ANOVA followed by the Bonferroni post-hoc test.

RESULTS:

The uterine cervix had the highest amount of total sulfated glycosaminoglycans and dermatan sulfate during the estrous phase (8.90 ± 0.55 mg/g of cetonic extract, p<0.001; and 8.86 ± 0.57 mg/g of cetonic extract, p<0.001). In addition, there was more heparan sulfate at the cervix during the proestrous phase (0.185 ± 0.03 mg/g of cetonic extract) than during any other phase (p<0.001). There were no significant changes in the concentration of hyaluronic acid in the uterine cervix during the estrous cycle.

CONCLUSION:

Our data suggest that the amount of total sulfated glycosaminoglycans may be influenced by hormonal fluctuations related to the estrous cycle, with dermatan sulfate and heparan sulfate being the glycosaminoglycans most sensitive to hormonal change.     

骨化性肌炎的MRI表现特点与演变

目的分析骨化性肌炎的MRI表现特点与演变规律,以提高其诊断和鉴别诊断的水平。方法对13例患者（男性4例,女性9例,年龄11～65岁,平均年龄39.69岁）经手术或穿刺组织病理学诊断证实为骨化性肌炎的共16例次MRI检查图像进行回顾性分析。结果早期（2～3周,4例次）为边界不清的T1WI中等偏高信号、T2WI高信号为主的软组织肿块;中期（1-12个月,11例次）：T1WI由不均匀中等偏高信号逐渐变为中低信号,T2WI以团块和分叶状不均匀中低信号为主,夹杂有片状高信号区的软组织肿块,周边有低信号带形成。1例次内见有出血和液一液平,周围的水肿带（T1WI低信号、T2WI高信号）变窄。晚期（1～2年,1例次）：肿块缩小,T1WI和BWI上以高信号为主,夹杂有条带状低信号影。结论骨化性肌炎MRI表现有一定的特点和变化规律．具有一定的特征性．提高对其MRI表现的认识有助于诊断和鉴别诊断．避免不必要的手术。     

Targeted drug delivery in gynaecology: the first uterine pass effect

The objective was to verify the hypothesis of a 'first uterine pass effect' or direct preferential vagina-to-uterus transport, suggested by the evidence of higher than expected uterine tissue concentrations after vaginal administration of progesterone; we used a human ex-vivo uterine perfusion model. A mixture of tritiated (3H) and unlabelled progesterone was applied to the cuff of vaginal tissue remaining attached to the cervix after hysterectomy. At the end of the perfusion period (up to 12 h), 3H and 14C radioactivity was measured in samples of uterine tissue. Tritiated water and [14C]dextran were tested to determine the extent of non-specific vagina-to-uterus transport (leaks). Finally, sections of uterine tissue exposed only to [3H]progesterone were prepared for autoradiography. By 4-5 h after application progesterone had diffused to the entire uterus and had reached a steady state; 4 h after application, progesterone concentrations reached 185 +/- 155 and 254 +/- 305 ng/100 mg of endometrial and myometrial tissue respectively. Endometrial extraction of progesterone was higher when the experiment was performed on uteri obtained during the luteal phase (280 +/- 156 ng/100 mg of endometrial tissue) than those removed during the proliferative phase of the menstrual cycle (74 +/- 28 ng/100 mg of endometrial tissue). These data demonstrate that a 'first uterine pass effect' occurs when drugs are delivered vaginally, thereby providing an explanation for the unexpectedly high uterine concentrations relative to the low serum concentration observed after vaginal administration. Hence, the vaginal route permits targeted drug delivery to the uterus, thereby maximizing the desired effects while minimizing the potential for adverse systemic effects.      

Laparoscopic hemi-hysterectomy in treatment of a didelphic uterus with a hypoplastic cervix and obstructed hemivagina.

Maldevelopment of the Müllerian duct system may result in various urogenital anomalies including didelphic uterus with a hypoplastic cervix and obstructed hemivagina. We report a patient with this anomaly who was treated by laparoscopic hemi-hysterectomy and hysteroscopic resection of hemivagina. A 17 year old patient who had complained of vaginal pus-like discharge on and off for 1 year was diagnosed by MRI to have a double uterus with obstructed right hemivagina and ipsilateral renal agenesis. After hysteroscopic identification of hypoplasia of the right uterine cervix, laparoscopic resection of the right uterus and right Fallopian tube and hysteroscopically assisted resection of the vaginal septa were performed successfully. From our experience, combined laparoscopy and hysteroscopy may be an efficacious alternative in the management and diagnosis of Müllerian anomalies.     

Distribution and origin of secretoneurin-immunoreactive nerves in the female rat uterus

Secretoneurin is a 33-amino acid peptide derived from secretogranin II. Secretoneurin immunoreactivity has been localized in the peripheral nervous system where it exerts potent chemotactic activity for monocytes and may play a role in inflammation. Secretoneurin could play a role in this process, although the presence and distribution of secretoneurin-immunoreactive neurons in the female reproductive system has not been documented. Thus, this study was undertaken to examine secretoneurin immunoreactivity in nerves of the rat uterus and uterine cervix. A moderate plexus of secretoneurin-immunoreactive nerve fibers was present in the myometrium and endometrium of the uterus as well as in the smooth muscle and endocervix of the cervix. Many of these fibers were associated with the vasculature as well as the myometrium. Secretoneurin immunoreactivity was present in small- to medium-sized neurons of dorsal root and nodose ganglia. Retrograde tracing with FluoroGold indicated that some of these sensory neurons project axons to the cervix and uterine horns. Secretoneurin-immunoreactive terminal-like structures were associated with neurons in the sacral parasympathetic nucleus of the lumbosacral spinal cord. In addition, some secretoneurin terminals were apposed to pelvic parasympathetic neurons in the paracervical ganglia that projected axons to the uterus and cervix. Double-immunostaining indicated co-existence of calcitonin gene-related peptide or substance P with secretoneurin in some sensory neurons, in some terminals of the pelvic ganglia, as well as nerve fibers in the uterine horn and cervix. Finally, fibers in the uterus and cervix were depleted of secretoneurin by capsaicin treatment. This study indicates that secretoneurin is present in the uterus in C-afferent nerve fibers whose cell bodies are located in sensory ganglia. Some of these fibers contain both secretoneurin and calcitonin gene-related peptide or substance P. These substances have functions in inflammatory reactions. Further, secretoneurin could influence postganglionic parasympathetic "uterine-related" neurons in the pelvic ganglia and preganglionic parasympathetic neurons in the lumbosacral spinal cord.     

促红细胞生成素基因修饰内皮祖细胞移植治疗下肢动脉闭塞：磁标记MR成像评价

文章快速阅读：文题释义： 内皮祖细胞：是存在于外周血及骨髓中的重要前体细胞,是能够特异性归巢于血管新生组织并进行分化、增殖成为成熟内皮细胞的一群祖细胞,其在不同环境中可向不同的方向进行分化。 促红细胞生成素：是糖蛋白中的一种,可对哺乳动物中红细胞的生成进行调节,主要由肾小管周细胞产生,也有少部分来自于肝脏,主要功能是使延缓细胞凋亡,其可以协同其他生长因子加速红系组细胞的增殖及成熟,并能促进骨髓中红细胞的释放。 摘要 背景：促红细胞生成素及内皮祖细胞移植均对下肢动脉闭塞有一定的治疗作用。 目的：探讨超顺磁氧化铁纳米颗粒(super paramagnetic iron oxide,SPIO)标记的内皮祖细胞体外促红细胞生成素基因修饰效果及体外磁共振成像的可行性。 方法：将对数生长期的大鼠骨髓来源内皮祖细胞分4组培养,内皮祖细胞组,SPIO标记转染组将pcDNA3-EPO 重组质粒并转染至内皮祖细胞,随后进行SPIO标记;SPIO标记空载病毒组将空质粒转染至内皮祖细胞,随后进行SPIO标记;SPIO标记内皮祖细胞组直接进行SPIO标记。采用4.7 T MR成像SPIO标记的内皮祖细胞;检测4组细胞增殖、细胞周期分布及促红细胞生成素蛋白表达。 结果与结论：①MR成像：T1WI、T2WI、T2*WI序列均见细胞信号降低,随着细胞数目增多,信号降低逐渐明显;相同数量级细胞,T1WI信号降低最弱,T2*WI信号降低最明显;T1WI、T2WI、T2*WI所能检测到的最小细胞数分别为2×10⁴、1×10⁴、0.5×10⁴;②细胞增殖、细胞周期分布：3组标记内皮祖细胞增殖、细胞周期分布与内皮祖细胞组比较差异均无显著性意义;③促红细胞生成素蛋白表达：仅SPIO标记转染组可见促红细胞生成素蛋白表达;④结果表明：SPIO标记的内皮祖细胞体外促红细胞生成素基因修饰后对细胞增殖、细胞周期无影响,4.7 T MR能够在体外对SPIO标记的促红细胞生成素基因修饰内皮祖细胞成像。   中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程 ORCID: 0000-0002-2568-7449(徐广宇)     

Oxygenation in cervical cancer and normal uterine cervix assessed using blood oxygenation level‐dependent (BOLD) MRI at 3T

Hypoxia is reported to be a biomarker for poor prognosis in cervical cancer. However, a practical noninvasive method is needed for the routine clinical evaluation of tumor hypoxia. This study examined the potential use of blood oxygenation level‐dependent (BOLD) contrast MRI as a noninvasive technique to assess tumor vascular oxygenation at 3T. Following Institutional Review Board‐approved informed consent and in compliance with the Health Insurance Portability and Accountability Act, successful results were achieved in nine patients with locally advanced cervical cancer [International Federation of Gynecology and Obstetrics (FIGO) stage IIA to IVA] and three normal volunteers. In the first four patients, dynamic T₂*‐weighted MRI was performed in the transaxial plane using a multi‐shot echo planar imaging sequence whilst patients breathed room air followed by oxygen (15 dm³/min). Later, a multi‐echo gradient echo examination was added to provide quantitative R₂* measurements. The baseline T₂*‐weighted signal intensity was quite stable, but increased to various extents in tumors on initiation of oxygen breathing. The signal in normal uterus increased significantly, whereas that in the iliacus muscle did not change. R₂* responded significantly in healthy uterus, cervix and eight cervical tumors. This preliminary study demonstrates that BOLD MRI of cervical cancer at 3T is feasible. However, more patients must be evaluated and followed clinically before any prognostic value can be determined. Copyright © 2012 John Wiley & Sons, Ltd.     

Sonographic evidence for the involvement of the utero-ovarian counter-current system in the ovarian control of directed uterine sperm transport

Sperm transport from the cervix into the tube is an important uterine function within the process of reproduction. This function is exerted by uterine peristalsis and is controlled by the dominant ovarian structure via a cascade of endocrine events. The uterine peristaltic activity involves only the stratum subvasculare of the myometrium, which exhibits a predominantly circular arrangement of muscular fibres that separate at the fundal level into the fibres of the cornua and continue into the circular muscles of the respective tubes. Since spermatozoa are transported preferentially into the tube ipsilateral to the dominant follicle, this asymmetric uterine function may be controlled by the ovary via direct effects utilizing the utero-ovarian counter-current system, in addition to the systemic circulation. To test this possibility the sonographic characteristics of the uterine vascular bed were studied during different phases of the menstrual cycle. Vaginal sonography with the measurement of Doppler flow characteristics of both uterine arteries and of the arterial anastomoses of the uterine and ovarian arteries (junctional vessels) in the cornual region of both sides of the uterus during the menstrual phase of regular-cycling women demonstrated significant lower resistance indices of the junctional vessels ipsilateral to the side of the dominant ovarian structure as compared with the corresponding arteries contralaterally. By the use of the perfusion mode technique, it could be observed that vascular perfusion of the fundal myometrium was significantly increased ipsilateral to the dominant follicle during the late follicular phase of the cycle. These results show that the endocrine control of the dominant ovarian structure over uterine function is not only exerted via the systemic circulation but also directly, most probably utilizing the utero-ovarian counter-current system.     

Uterus and endometrium: Transvaginal ultrasound studies of vascular and morphological changes in uteri exposed to diethylstilbestrol in utero

The aim of this prospective study was to establish complementarydata of uteri exposed to diethylstilbestrol (DES) in utero fortransvaginal analysis and vascularity changes during the menstrualcycle. A total of 28 women with DES-exposed uteri were comparedwith 60 non-exposed women. Transvaginal ultrasound and colourDoppler imaging were performed on days 5 and 22 of the menstrualcycle. Uteri were measured on sagittal and transverse scans.Uterine length, width, thickness and uterine cavity length andwidth were measured. Uterine volume and uterine cavity areawere calculated. DES-exposed uterine volume was equal to 31.84± 337 cm³. The cavity area of DES-exposed uterus wasequal to 35.85 ± 3.93 cm². Cervix length of DES-exposeduterus was significantly smaller than that of non-exposed uterus.The uterine artery pulsatility index (PI) of DES-exposed uteruswas significantly higher than that of normal uterus. Blood flowremained stable throughout the menstrual cycle. The PI of DES-exposeduterus remained stable during the menstrual cycle, as in non-exposeduterus, and it decreased during the luteal phase. This lackof modification in vascularity of DES-exposed uterus may explainmiscarriages and obstetric complications such as intrauterinegrowth retardation or pre-eclampsia. The data may have implicationsfor the assessment of reproductive status and the design offuture studies on disorders of implantation in DES-exposed uterus.     

Incidence of pelvic organ prolapse in Nigerian women

OBJECTIVE: To establish the incidence and types of utero-vaginal prolapse. METHODS: Retrospective medical records analyses of women who were subjected to reconstructive pelvic surgery for various types of pelvic relaxation at the Nnamdi Azikiwe University Teaching Hospital, Nnewi and the University Of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. The study was conducted from January 1996 to December 1999 during which there were 7515 surgical admissions. The inclusion criteria were those women who complained of feeling a mass in the vagina with demonAstrable descent of the anterior and/or posterior and/or apical vaginal walls and/or perineal descent. Excluded were patients who had other symptoms other than utero-vaginal prolapse and those whose grades and sites of prolapse were not determinable from the clinical or surgical notes. Also excluded were patients with nerve injury or disease, connective tissue disorders and neuromuscular diseases. The subjects were divided into two groups. Group I consisted of 54 women (age < or = 40 years), and group II included 105 women (age > or = 40 years). The findings between those two groups were compared with reference to sites, types and degree of prolapse. Also, coexistence of pelvic relaxation and underlying medical conditions were evaluated. RESULTS: A total of 159 subjects out of 492 charts studied met the inclusion criteria for the study. In group I, mean age was 32.839 with a standard deviation (SD) of +/- 6.012 years; and in group II the mean age was 56.543 with a SD of 8.094. Hypertrophic (elongated) cervix was determined in 15 (6.3%) subjects in group I for an incidence of 1.58% per year, cystocele (vaginal anterior wall descent) was present in 21 (8.9%) women for an incidence of 2.2% per year; rectocele (posterior vaginal wall descent) was identified in 15 (6.3%) women for an incidence of 1.58% per year; vaginal cough prolapse (apical descent) was present 21 (8.9%) women for an incidence of 2.2% per year. Perineal descent was absent in this group. In group II, there was no hypertrophic cervix; cystocele was present in 39 (16.5%) cases for an incidence of 4.13% per year; rectocele was identified in 27 (11.4%) women, amounting to an incidence of 2.85% per year; vaginal cough prolapse was present in 36 (15.%) women, an incidence of 3.75% per year; perineal descent was present in 63 (25.6%) women, for an incidence of 6.4% per year. CONCLUSION: (1) The incidence of hypertrophic cervix without any other abnormality amounted to 1.58% per year. This medical entity can present as uterine prolapse and was noted only in group I. (2) The annual incidence for hospital admission with a diagnosis of uterine prolapse was 2.1%. (3) The incidence of cystocele, and rectocele was not statistically different in the two groups; but the incidence of perineal descent and uterine prolapse were significantly more in group II than group I. (4) The etiology of hypertrophic cervix is not known, but it is of importance especially in the childbearing age when it may be related to prolonged pregnancy, cervical dystocia, etc.     

Flow Cytometric Analysis of Leukocytes in the Human Female Reproductive Tract: Comparison of Fallopian Tube,Uterus, Cervix,and Vagina

PROBLEM: The tissues of the human female reproductive tract (Fallopian tube, uterus, cervix, and vagina) may play different roles in the provision of mucosal immunity. The purpose of this study was to develop a uniform method suitable for quantitative comparison of the leukocytes from all these tissues. METHOD OF STUDY: Tissues, typically 0.5-1.0 g, were dispersed by enzyme treatment. A flow cytometric gating procedure based on CD45-positivity and low far-red autofluorescence permitted unfractionated, freshly dispersed cells to be phenotyped with respect to T lymphocytes, B lymphocytes, macrophages, and granulocytes. RESULTS: Reproductive tract tissues contain leukocytes that represent approximately 6–20% of the total number of cells, with the Fallopian tubes and uterus containing a higher proportion of leukocytes than the cervix and vagina. The uterine endometrium from postmenopausal women has fewer leukocytes than does uterine endometrium from pre-menopausal women. T lymphocytes are a major constituent (30–60%) of leukocytes from all tissues. The Fallopian tube contains granulocytes as another major constituent; granulocytes are significantly less numerous in the other tissues. All tissues contain B lymphocytes and macrophages as clearly detectable but minor components. CONCLUSIONS: Three-color flow cytometry is an appropriate method for quantitative comparison of leukocytes from the different tissues of the female reproductive tract, during all phases of the menstrual cycle and within post-menopausal samples. Results indicate that the tissues differ from each other, particularly with respect to the large number of granulocytes in the Fallopian tubes.     

利用3.0T磁共振观察子宫恶性肿瘤组织弥散效应的初步研究

目的： 利用磁共振成像（MRI）的弥散加权成像（DWI）技术,观察子宫恶性肿瘤的弥散受限程度。方法: 采用3.0 T磁共振成像仪,对子宫颈癌病例及正常子宫颈对照组、子宫内膜癌病例及正常子宫内膜对照组进行常规MRI及DWI扫描,测量其表观弥散系数（ADC）,并对子宫颈癌与正常子宫颈、子宫内膜癌与正常子宫内膜的ADC值进行统计学分析。结果: (1)37例子宫颈癌和16例正常子宫颈的ADC值分别为（0.92±0.20）×10-3 mm2/s和（1.26±0.24）×10-3 mm2/s,子宫颈癌和正常子宫颈2组ADC值比较有显著差异（P<0.01）。(2)14例子宫内膜癌和14例正常子宫内膜的ADC值分别为（0.87±0.17）×10-3 mm2/s和 （1.34±0.26）×10-3 mm2/s,子宫内膜癌和正常子宫内膜2组ADC值比较有显著差异（P<0.01）。结论: 子宫颈癌和子宫内膜癌较正常子宫组织弥散受限,3.0T磁共振DWI的ADC值测量能够定量反映子宫恶性肿瘤的弥散受限程度。     

Comparison of MRI signatures in pattern I and II multiple sclerosis models

The majority of individuals with multiple sclerosis (MS) exhibit T‐cell‐ and macrophage‐dominated lesions (patterns I and II; as opposed to III and IV). These lesions, in turn, may be distinguished on the basis of whether or not there are immunoglobulin and complement depositions at the sites of active myelin destruction; such depositions are found exclusively in pattern II lesions. The main aim of this study was to determine whether pattern I and pattern II MS lesions exhibit distinct MRI signatures. We have used a recently described focal MOG‐induced EAE model of the rat brain, which recapitulates many of the hallmarks of pattern II MS; we compared this with our previous work in a delayed type hypersensitivity model of a pattern I type lesion in the rat brain. Demyelinating lesions with extensive inflammation were generated, in which the T2‐weighted signal was increased. Magnetisation transfer ratio (MTR) maps revealed loss and subsequent incomplete recovery of the structure of the corpus callosum, together with changes in tissue water diffusion and an associated increase in ventricle size. Notably, the MTR changes preceeded histological demyelination and may report on the processes leading to demyelination, rather than demyelination per se. Immunohistochemically, these MRI‐detectable signal changes correlated with both inflammatory cell infiltration and later loss of myelin. Breakdown of the blood–brain barrier and an increase in the regional cerebral blood volume were also evident in and around the lesion site at the early stage of the disease. Interestingly, however, the MRI signal changes in this pattern II type MS lesion were remarkably consistent with those previously observed in a pattern I lesion. These findings suggest that the observed signal changes reflect the convergent histopathology of the two models rather than the underlying mechanisms of the disease. Copyright © 2009 John Wiley & Sons, Ltd.     

Parallel reflex pathways from flexor muscle afferents evoking resetting and flexion enhancement during fictive locomotion and scratch in the cat

Reflex actions of muscle afferents in hindlimb flexor nerves were examined on ipsilateral motoneurone activity recorded in peripheral nerves during midbrain stimulation-evoked fictive locomotion and during fictive scratch in decerebrate cats. Trains of stimuli (15–30 shocks at 200 Hz) were delivered during the flexion phase at intensities sufficient to activate both group I and II afferents (5 times threshold, T ). In many preparations tibialis anterior (TA) nerve stimulation terminated ongoing flexion and reset the locomotor cycle to extension (19/31 experiments) while extensor digitorum longus (EDL) stimulation increased and prolonged the ongoing flexor phase activity (20/33 preparations). The effects of sartorius, iliopsoas and peroneus longus muscle afferent stimulation were qualitatively similar to those of EDL nerve. Resetting to extension was seen only with higher intensity stimulation (5 T ) while ongoing flexor activity was often enhanced at group I intensity (2 T ) stimulation. The effects of flexor nerve stimulation were qualitatively similar during fictive scratch. Reflex reversals were consistently observed in some fictive locomotor preparations. In those cases, EDL stimulation produced a resetting to extension and TA stimulation prolonged the ongoing flexion phase. Occasionally reflex reversals occurred spontaneously during only one of several stimulus presentations. The variable and opposite actions of flexor afferents on the locomotor step cycle indicate the existence of parallel spinal reflex pathways. A hypothetical organization of reflex pathways from flexor muscle afferents to the spinal pattern generator networks with competing actions of group I and group II afferents on the flexor and extensor portions of this central circuitry is proposed.     

Evaluation of reproductive cycle with cervical and uterine cytology in Iranian dromedary camels

Various uterine disorders in camelids, such as uterine infections, play an important role in reduced fertility in these species. Cytological techniques can be used to identify the presence of uterine infection. In this study 44 reproductive tracts of slaughtered female camels were examined. The reproductive phase of each tract was estimated by ovarian performance. The uterus and ovary dimensions were measured by caliper. Cytological smears were prepared from cervical mucosa and uterine fluid collected by aspiration methods. The smears were stained and examined for differential cellular counts. The results showed no significant difference (P0.05) for cellular densities between cervical and uterine smears. There was no significant difference (P0.05) for cellular densities between cervix and uterus in different phases of anestrus, estrus cycle (follicular and luteal phases), and pregnancy. Therefore, in dromedary camel, cervical smears may be used for evaluation of uterine condition. However, more work is required on live and synchronized camels before the importance of these findings can be assessed.