Ultrastructural effects of the nonsteroidal contraceptive centchroman on rat uterine luminal epithelium in early pregnancy

Centchroman (3,4-trans-2,2-dimethyl-3-phenyl-4-p-(beta-pyrrolidinoethoxy) -phenyl-7-methoxychroman), a nonsteroidal contraceptive developed by the Central Drug Research Institute, Lucknow, India, was administered orally (1.25 mg/kg) to rats in a state of experimentally delayed implantation both during the progesterone treatment (preattachment stage) and in conjunction with the addition of estradiol (attachment stage). When given during preattachment, centchroman did not change the characteristic ultrastructure of the uterine epithelium significantly, except that there was an increase in the size and number of secondary lysosomes. Thus, no definite estrogenic or antiprogestational potency of centchroman was observed in this test system. However, when administered simultaneously with, before, or after estrogen during attachment, centchroman both abolished the estradiol-induced attachment reaction and produced or potentiated some changes of an estrogen type. Thus, no typical antiestrogen action but the sign of an estrogen action was observed in this test system. Further, the drug also produced certain specific changes in the lysosomal system of the epithelial cells during attachment. It is suggested that, in addition to some estrogenic effects, centchroman also possesses specific cellular effects, probably of a nonhormonal nature.     

Uteroplacental hemodynamics during early human pregnancy: a longitudinal study

BACKGROUND: To determine normal physiologic changes in the uteroplacental hemodynamics during early placental development in the first trimester of pregnancy. METHODS: Sixteen normal singleton pregnancies were included in this longitudinal study. Transvaginal Doppler ultrasonographic examinations of uterine, arcuate, radial and spiral arteries were performed at the 5th, 7th, 8th and 10th completed gestational weeks. Peak systolic velocity (PSV), time-averaged maximum velocity (TAMXV) and the pulsatility index (PI) were measured. RESULTS: Uterine artery PSV, TAMXV and PI remained unchanged from the 5th to the 8th week of gestation. From the 8th to the 10th week, PSV (p = 0.02) and TAMXV (p = 0.005) increased and PI decreased (p = 0.006). Changes in the arcuate arteries were similar to those in uterine arteries. No significant changes in PSV, TAMXV or PI of the radial artery were noticed. Spiral artery PSV (p = 0.02) and TAMXV (p = 0.02) increased from the 5th to the 7th week. Thereafter they remained unchanged. Spiral artery PI decreased from the 5th to the 10th week, (p = 0.004). Throughout the study period, the PSV, TAMXV and PI values were significantly higher in the uterine artery than in the arcuate artery, and in the arcuate artery compared with the radial artery. At the 5th gestational week, no differences in PSV and TAMXV were found between radial and spiral arteries. From the 7th gestational week onwards, PSV and TAMXV were significantly lower in the radial artery than in the spiral artery. However, the PI values in the radial artery were significantly higher compared with those in the spiral artery during the whole study period. CONCLUSIONS: Spiral artery impedance decreases and blood flow velocities increase as early as between the 5th and the 7th weeks of gestation. During that period, the uterine and arcuate artery hemodynamics remain unchanged. In the uterine and arcuate arteries, decreases in impedance and increases in absolute velocities are detected after the 8th week of gestation. This delay between the changes in the spiral and uterine arteries may represent the magnitude of the increase of placental volume and spiral arterial involvement which is needed to affect uterine hemodynamics.     

A case of pure uterine lipoma: immunohistochemical and ultrastructural focus

Background  

Pure uterine lipoma is a rare clinical event and only a few cases have been reported in literature. The histogenesis of these lesions is still debatable. Preoperative diagnosis is difficult and should be pathologically confirmed postoperatively.     

Clinicopathological, ultrastructural and immunohistochemical study on adenoma malignum of the uterine cervix

A histological, cytological, immunohistochemical and electron microscopical study has been made on 9 cases of adenoma malignum of the cervix. Five patients out of 9 who received surgical treatment following correct diagnosis, and were followed by maintenance chemotherapy with tegafur have survived without evidence of recurrence for 15 to 60 months. The remaining 4 patients who were treated following incorrect diagnosis have died of the disease. Adenoma malignum is a potentially malignant tumor histologically characterized by adenomatous proliferation with structural abnormality in the shape and arrangement of the gland and budding invasive pattern into the stroma. The gland filled with mucous substance often ballooned and ruptured resulting in the leakage of mucous substance into the surrounding stromal tissue. Light and electron microscopical observation of the epithelial cells revealed that they were quite different from those of conventional adenocarcinoma. Excessive mucus-producing activity and variation in nuclear DNA content can lead to possible differential cytodiagnosis between tumorous and normal columnar cells. The finding of positive CEA in the cytoplasm of the tumor cell obtained in the immunohistochemical study led to further study to detect CEA in the cervical mucus in screening for this rare tumor.     

Doppler velocimetry measured in retrochorionic space and uterine arteries during early human pregnancy

The natural course of uterochorionic vascular resistance during the first trimester of pregnancy is described. We performed a weekly study using a pulsed Doppler in 25 normal pregnancies, with a total of 191 examinations made. The flow velocity waveform was studied simultaneously in the retrochorionic area as well as in the uterine arteries. Different velocimetry indices were analysed, which demonstrated the feasibility of the (D/S) x 100 index for study of the retrochorionic vessels and of the Pourcelot index (S-D/S) for the uterine arteries. A gradual weekly decrease in flow resistance was found, with significant differences before [(D/S) x 100 = 52.01 +/- 8.33; S-D/S = 0.83 +/- 0.09] vs after the 9th week [(D/S) x 100 = 58.9 +/- 8.78; S-D/S = 0.72 +/- 0.10]. Further evaluation of its predictive and diagnostic value in gestational pathology is necessary.     

Menstrual-cycle-dependent and -independent features of the human Fallopian tube fimbrial epithelium: an ultrastructural and cytochemical study

Ultrastructural and cytochemical features of 100 specimens of human Fallopian tube fimbrial epithelium were studied to determine whether they were dependent on or independent of the ovarian hormones. Characteristics which were independent of hormonal control included the presence of alkaline phosphatase reaction product along the apical cell membrane of the secretory cell and its absence in the ciliary cell. Acid phosphatase reaction product was found in ciliary and secretory cell lysosomes in similar numbers and calcium deposits were observed in ciliary and secretory cell nuclei, nucleoli and cell membranes. On the other hand, characteristics dependent on stages of the cycle included the presence of mitochondrial-bound calcium during the preovulatory phase and its depletion during the periovulatory phase. The same sequence was noticed in the content of the large ciliary cell perinuclear globules, which displayed accumulations of glycogen and lipid in preovulatory phase and their depletion during the periovulatory phase. It seems that during the periovulatory phase the increased metabolic activity of the cells is accompanied by utilization of some of the material stored within the cells.     

Primary osteosarcoma of the uterine corpus: report of a case with immunohistochemical and ultrastructural study.

BACKGROUND: Primary uterine osteosarcoma is extremely rare, with only 15 cases reported in the literature. CASE: A 41-year-old woman presented with abnormal vaginal bleeding due to a large tumor arising from the uterine corpus. Histologically, the tumor showed the features of a malignant mesenchymal neoplasm with osteoid formation and lacked an epithelial component. Immunohistochemical and ultrastructural studies showed no evidence of epithelial differentiation. The tumor was excised and the patient received chemotherapy and radiation therapy postoperatively, but the tumor recurred locally at the 8-month follow-up. CONCLUSION: Osteosarcoma as a primary uterine tumor is exceedingly rare and should be distinguished from carcinosarcoma, which shows different macroscopic and histologic features. Prognosis of this neoplasm is very poor with an average life expectancy of 5 months.     

Epithelioid trophoblastic tumor metastatic to the vagina: an immunohistochemical and ultrastructural study.

We describe an epithelioid trophoblastic tumor (ETT) metastatic to the vagina in a 30-year-old Japanese woman. A polypoid tumor in the vaginal orifice was composed of nests of intermediate trophoblastic cells that showed a striking epithelioid appearance. In the hysterectomy specimen, a tumor infiltrated through the myometrium and showed histologic findings similar to those of the vaginal tumor. The tumor cells were positive for cytokeratin, inhibin-alpha, and melanoma cell adhesion molecule (Mel-CAM, CD146) but were only focally positive for human placental lactogen. Electron microscopic examination revealed bundles of well-developed, intermediate-type filaments surrounding the nuclei.     

Villous adenoma of the uterine cervix associated with invasive adenocarcinoma: a histologic, ultrastructural, and immunohistochemical study

An unusual neoplasm of the uterine cervix had the features of a villous adenoma with an adjacent adenocarcinoma. Histologic and electron microscopic features of the lesion are described, as well as immunohistochemical staining of the lesion for carcinoembryonic antigen. Electron microscopic evidence of intestinal differentiation in the villous adenoma suggests a rarely recognized potential for intestinal metaplasia in the uterine cervix. The association of villous adenoma with cervical adenocarcinoma underscores the malignant potential and the need for complete excision of this rare cervical lesion.     

Intervillous space during uterine contractions in human subjects: an ultrasonic study.

Six patients at term were examined by ultrasound during uterine contractions. The length, thickness, and surface of the placental area were found to increase during uterine contraction compared to relaxation. The conclusion is drawn that during uterine contractions the intervillous space is distended. During uterine contraction more maternal blood is available for exchange with the fetal compartment.     

KIT protein expression in uterine sarcomas: an immunohistochemical study and review of the literature

PURPOSE: The aim of the present study was to investigate the possibility of treating uterine sarcomas with imatinib mesylate. Imatinib mesylate, a selective tyrosine kinase inhibitor, is very efficient against mesenchymal tumors of the gastrointestinal tract, known as GISTs. Imatinib mesylate acts against a tyrosine kinase encoded by the KIT gene in GISTs, and is more effective in tumors expressing this protein. METHODS: Expression of KIT was analyzed immunohistochemically (n = 12) in formalin-fixed paraffin-embedded primary uterine sarcomas. RESULTS: Using a semi-quantitative immunohistochemical score we found that KIT expression was very weak in the majority of tumors, while none of the uterine sarcomas tested showed strong expression. Overall, published studies addressing this issue in small series of uterine sarcomas yielded similar results. CONCLUSION: Current data suggest that it is unlikely that imatinib mesylate could be used effectively as a single agent in patients with uterine sarcomas.     

Langerhans'cells in human cervical epithelium: an immunohistological study

Summary. Langerhans'cells are intraepithelial dendritic cells believed to be important in the recognition and processing of exogenous antigens. They were demonstrated by immunohistological methods in cervical tissue obtained from 10 subjects ranging in age from 30 weeks gestational age to 62 years. Langerhans'cells were clearly delineated in all tissue sections and appear to form a relatively constant component of both the transformation zone and ectocervical epithelium. In addition to Langerhans'cells, a population of T lymphocytes characterized as predominantly T-cytotoxic/suppressor cells have also been demonstrated. The interaction between Langerhans'cells, T lymphocytes and stromal macrophages and their relation to antigen recognition is discussed.     

Distribution of basement membrane antigens in the uterine cervical adenocarcinomas: an immunohistochemical study

The distribution of laminin and collagen type IV in the basement membrane of 45 uterine cervical adenocarcinomas was studied using immunohistochemical techniques. Staining patterns of basement membranes were divided into three types, according to the intensity of staining: thick and discontinuous (type I), thin and discontinuous (type II), and fragmentary (type III). In well-differentiated adenocarcinomas, 17 of 24 cases (71%) showed type I and the remaining 7 showed type II. In contrast, in poorly differentiated adenocarcinomas 4 of 5 cases (80%) showed type III. Five of six cases (83%) of adenoma malignum, even though extremely well differentiated, showed type III. Staining patterns of the basement membranes correlated with histological grade. Five-year survival rate of patients with type I and II staining (74%) was better than that of patients with type III (55%).