Alterations in water content of the stratum corneum following long-term topical corticosteroids.

The water content of the stratum corneum (SC), profilaggrin/filaggrin (PF/FG) and stratum corneum neutral lipids were examined in 23 patients following use of long-term topical corticosteroids (TCS). All patients showed the rebound phenomenon after stopping TCS. Biopsy specimens were taken from the atrophic skin and from the peripheral normal skin of patients. The histopathological examination showed a thinning of the horny layer and the epidermis, along with a decrease in or the absence of the granular layer in the patient's lesional skin. Oil red 0 staining for SC neutral lipids revealed that the intensity of the lipid staining was markedly reduced. Ultrastructural observation also revealed an obvious decrease in both the formation of keratohyalin granules and in the membrane-coating granules of steroid-treated skin. Furthermore, indirect immunofluorescence for PF/FG demonstrated markedly reduced immunofluorescence. In agreement with the above results, the mean water content of the SC in lesional skin was also significantly decreased when compared with that of controls. Since the water content of SC is suggested to be dependent on both the keratohyalin-derived natural moisturizing agents of the SC and the SC intercellular lipids, the present results suggest that the diminution in SC lipids and PF/FG in steroid-treated skin may play an important role in the low hydration state of the SC and the clinical manifestations of scaling and dryness of the skin in patients suffering from the rebound phenomenon after stopping TCS.     

Cytotopochemistry of lipids in vaginal smears of pregnant women]

The author presents a preliminary paper upon cytotopochemical evaluation of lipids in the vagina epithel in physiological and pathological gravidity to the Vth lunar month. The staining has been carried out by the method with Red Oil O. Besides that the vaginal smears have been evaluated also on the base of their pycnotic and eosinophilic index by staining after Shorr. There have been examined 94 women divided into two groups, i.e. with physiological and pathological course of gravidity and evaluated 282 smears in total. The author means that the occurence of irregularly located bigger lipid inclusions in the cytoplasma of cells is a signalisation of cytotopochemically estimated structural changes caused most probably by a disturbance of the hormonal balance. The results have been worked out statistically.     

Nile blue and fetal maturity. Further investigations.

The consistency of results using Nile blue staining of fetal cells in amniotic fluid to estimate fetal maturity has been demonstrated. Recently, evidence to support this method has been published from this laboratory. Several biochemical and technical factors were cited as important to the success of the method. This report deals with further testing of several Nile blue dyes (hydrochloride and sulfate) necessitated by changes in production and federal regulation of this compound. The results show Nile blue hydrochloride (HCl) to be the most superior dye regardless of color index. Buffered solutions (6.6) of Nile blue A (sulfate) improve its performance, but not to levels demonstrated by the HCl preparation. Storage at room temperature adversely affects each dye; however, the sulfate variety appears to be the most unreliable under these circumstances. For best results, it is recommended that Nile blue HCl be used and the solution (buffered or normal) be kept refrigerated.     

Immunohistochemical study of the distribution of secretory component and IgA in the normal and diseased uterine mucosa

The distribution of secretory component (SC) and IgA in the normal and diseased uterine mucosa was studied by means of an immunoperoxidase method. Both substances could not be demonstrated in ectocervical epithelium, whereas in endocervical epithelium both were present and staining intensity appeared to be related to the degree of inflammatory activity in the underlying stroma. Local IgA-containing plasma cells most likely are the source of epithelial IgA. Well-differentiated adenocarcinomas of the endocervix were shown to display SC immunoreactivity. In endometrial glands SC was observed in the postovulatory phase of the menstrual cycle, in increasing quantities toward menstruation. Hyperplastic conditions of the endometrium showed a weak focal staining for SC. In contrast, in most well-differentiated adenocarcinomas of the endometrium, SC and IgA could be detected in most neoplastic elements, whereas poorly differentiated carcinomas were largely negative. It is concluded that: (a) in contrast to the endometrium, in the endocervix a local secretory immune system operates similar to that of the gastrointestinal tract; (b) the ability of the endometrium to synthesize SC is at least partly regulated by hormonal factors and, as such, is confined to the progestagen-dominated phase of the menstrual cycle; and (c) immunohistochemical detection of SC may be of help in the grading of adenocarcinomas of the endometrium.     

Extracellular vesicles and female reproduction

Extracellular vesicles (EVs) are nano-sized membrane bound complexes that have been identified as a mean for intercellular communication between cells and tissues both in physiological and pathological conditions. These vesicles contain numerous molecules involved in signal transduction including microRNAs, mRNAs, DNA, proteins, lipids, and cytokines and can affect the behavior of recipient cells. Female reproduction is dependent on extremely fine-tuned endocrine regulation, and EVs may represent an added layer that contributes to this regulation. This narrative review article provides an update on the research of the role of EVs in female reproduction including folliculogenesis, fertilization, embryo quality, and implantation. We also highlight potential pitfalls in typical EV studies and discuss gaps in the current literature.     

控制性超促排卵对黄体期子宫内膜胶原纤维表达的影响

目的:探讨IVF-ET妇女控制性超促排卵(COH)时着床窗期子宫内膜胶原纤维(collagen fibril,CF)对子宫内膜容受性(ER)的影响。方法:共对25个刺激周期(SC)和20个自然周期(NC)妇女分别在取卵后或排卵后的第7±1日行外周血雌、孕激素水平检测和子宫内膜活检术,常规HE染色确定组织学分期,采用透射电子显微镜观察CF增生情况和改良Masson染色进行CF定量分析。结果:SC组外周血雌、孕激素水平均显著高于NC组(P<0.05)。SC组分泌期较NC组提前1～2 d,内膜腺体扩张和间质水肿明显。SC组分泌早、中和晚期内膜间质中的CF较NC组显著升高(P<0.01,P<0.05和P<0.05),且SC组分泌早期SC明显高于分泌中期(P<0.05)。结论:COH过程中过高的雌、孕激素水平可使子宫内膜分泌期提前并刺激内膜CF的过度增生,这可能是导致COH周期ER下降和着床失败的原因。     

Ca-ATPase Activity of Human Red Cell Ghosts: Preeclampsia,Lipid Peroxidation and MgSO4

The increased level of lipid peroxidation of red blood cells during preclampsia is considered to be responsible for the diminished Ca-ATPase activity in these cells. The level of lipid peroxidation and the Ca-ATPase activity of red blood cells from preeclamptic women, return to their normal values after in vivo and in vitro treatment with MgSO₄ for 24 h. In order to evaluate whether or not cell intactness is essential for these changes, we used either intact red blood cells or red cell ghosts from normotensive pregnant women. The intact red blood cells were treated with Fenton's reagent and then incubated with 4 mM MgSO₄. The red cells ghosts were irradiated with UV light and afterwards incubated with MgSO₄ at 4°C. Lipid peroxidation and Ca-ATPase activity were determined for all the preparations. Both, Fenton's reagent and UV irradiation increased the level of lipid peroxidation and diminished the Ca-ATPase activity of the red cell membranes. Incubation of the cells treated with Fenton's reagent, or the ghosts irradiated with UV, with 4 mM MgSO₄, returned Ca-ATPase activity and lipid peroxidation levels to normal values. The presence of MgSO4 blocked the effects in the ghosts of UV irradiation. MgSO₄ seems to better protect the red cell membrane against lipid peroxidation than other SO₄⁼ and Cl^? salts. These results indicate that the changes in the lipid peroxidation of the red cell ghosts and their Ca-ATPase activity are a result of changes to the cell membranes.     

Lipids in plasma of enterally-fed very low-birthweight neonates

Plasma lipid patterns (total lipids, free glycerol, triglycerides, free fatty acids, and cholesterol) were studied in 10 very low-birthweight neonates assigned alternately to continuous drip versus every 2-hr bolus feedings with a formula containing 50% of its fat as medium-chain triglycerides. In the group of neonates fed continuously, plasma lipids did not vary significantly during the 4-day study. In the bolus-fed group, free fatty acid concentrations peaked 30 min after feeding; the other fractions did not vary significantly during 2 hr after feeding. Mean plasma concentrations of total lipids and triglycerides were higher in the continuous than in the bolus-fed neonates; concentrations of the other fractions were similar. Compared to plasma concentrations measured in a group of 4-day-old very low-birthweight neonates before any exposure to exogenous fat, continuously fed neonates had higher total lipid, triglyceride, free fatty acid, and cholesterol concentrations; bolus-fed neonates only had significantly higher triglyceride levels. These data emphasize the need to obtain information on plasma lipid patterns that is specific for gestational maturity, postnatal age, and method and type of feeding.     

Determining fetal lung maturity: a sensitive surfactant method

The presence of fetal lung surfactant in amniotic fluid is indicative that fetal lungs are sufficiently mature for delivery without subsequent respiratory distress. However, current methods for detecting surfactant fail to positively distinguish saturated phosphatidylcholine (primarily dipalmitoyl phosphatidlycholine) from the many similar phosphatidylcholines also present in amniotic fluid. As a result small amounts of this lipid are obscured by the presence of the other lipids and delivery of many patients is delayed unnecessarily. A sensitive method is here described in which extraneous phosphatidylcholines are oxidized while the saturated phosphatidylcholines remain intact for positive determination by thin-layer chromatography. The method is insensitive to contaminating lipids from blood or meconium and provides an unequivocal test for the presence of disaturated phosphatidylcholine in a relatively short time. About one half of the patients tested in whom lecithin/sphingomyelin ratios were 1.4 to 1.7 had this surfactant lipid present in their fluids and presumably could have been delivered immediately.     

Clomiphene-associated combined hyperlipidemia: a case report

BACKGROUND: Hyperlipidemia associated with clomiphene use is an uncommon but potentiallly serious complication of this therapy. Clomiphene is structurally similar to other synthetic estrogen analogs, which are known to induce marked hypertriglyceridemia. There is a paucity of data regarding the effects of clomiphene on lipid metabolism in humans. CASE: A 33-year-old woman with obesity, polycystic ovary syndrome and a long history of amenorrhea was treated with clomiphene therapy to induce ovulation. Baseline lipids were suggestive of an underlying lipid disorder, but there was a marked deterioration in her lipid profile in association with the use of clomiphene. On cessation of the clomiphene therapy her lipid profile slowly improved, and specific lipid-lowering therapy was not used. Further investigation for the possibility of an underlying lipid disorder confirmed the diagnosis of familial dysbetalipoproteinemia. CONCLUSION: Clomiphene should be used cautiously in women known to have dyslipidemia. We recommend that patients with predisposing risk factors have their lipids measured prior to ovulation induction with clomiphene.     

Amniotic fluid gel acetylcholinesterase determination in prenatal diagnosis: dark field illumination as a method for improving the detection of precipitation bands

This paper describes a sensitive method for the detection of precipitation bands in the qualitative acetylcholinesterase (AChe) gel test. This method--dark field illumination--is compared with two existing methods of detection: epi-illumination of unstained gels and transillumination of dithio-oxamide stained gels. The comparison has been carried out on a selected series of 271 amniotic fluid samples, taken before the 22nd week of gestation. All 96 samples from normal pregnancies were scored as negative with all three visualization methods. For the detection of neural tube defects (NTD) and omphaloceles, dark field illumination proved to be more efficient than epi-illumination or dithio-oxamide staining. In case of another congenital defect, we obtained a positive result with dark field illumination, and a negative one with the other detection methods. It is concluded that dark field illumination was shown to be the most sensitive method for the detection of precipitation bands.     

High resolution imaging of endometriosis and ovarian carcinoma with optical coherence tomography: feasibility for laparoscopic-based imaging.

High resolution imaging of gynaecological tissue offers the potential for identifying pathological changes at early stages when interventions are more effective. Optical coherence tomography (OCT) is a high resolution high speed optical imaging technology which is analogous to ultrasound B-mode imaging except reflections of light are detected rather than sound. The OCT technology is capable of being integrated with laparoscopy for real-time subsurface imaging. In this report, the feasibility of OCT for differentiating normal and pathologic laparoscopically-accessible gynaecologic tissue is demonstrated. Differentiation is based on architectural changes of in vitro tissue morphology. OCT has the potential to improve conventional laparoscopy by enabling subsurface imaging near the level of histopathology.     

Study of the liver changes by B-ultrasound and histopathology in severe pregnancy induced hypertension

OBJECTIVE: To investigate the liver changes in severe pregnancy induced hypertension (PIH) on B-ultrasound and pathological examination and to detect a possible connection with fatty liver of pregnancy. METHODS: From Jan 1992 to Nov 1997, 90 pregnant women in the third trimester were enrolled for study. They were divided into 3 groups: the pregnant women with liver diseases; mild and moderate PIH; and severe PIH (30 cases each). Ultrasonography of the liver was performed on each patient after admission. 15 percutaneous liver biopsies were performed under the guidance of real-time ultrasound scans on 15 severe PIH patients with or without liver dysfunction. Tissues were stained with specific lipid staining (Sudan) and with hematoxylin-eosin. All specimens were analyzed by light microscopy. RESULTS: Fatty liver was observed by B-ultrasound in 2 and 12 cases of the pregnancy with liver diseases group and the severe PIH group, respectively. 14 of the 15 liver biopsy specimens showed fatty infiltration of varying degrees. however, only 8 of the 14 cases were detected fatty liver by B-ultrasound. CONCLUSIONS: These findings suggest that liver involvement in severe PIH is a pathological change. Severe PIH and acute fatty liver in pregnancy could have related pathogenesis components of the same.     

Reducing light and sound in the neonatal intensive care unit: an evaluation of patient safety, staff satisfaction and costs.

OBJECTIVES: To modify an existing Level III neonatal intensive care unit and to compare light and sound levels in the renovated nursery with an adjacent traditionally configured nursery. Further, to assess the impact of this practice on patient safety, staff perceptions of the nursery environments, and to document costs of renovation. STUDY DESIGN: Prospective comparison of light and sound levels in identical six-bed patient rooms within an existing intensive care unit. One room was modified to reduce light and sound, and the other served as a control. Costs of renovation were documented. Patient characteristics, severity of illness and safety outcomes were documented following modifications. Physician and nursing staff were surveyed on their perceptions of the renovations. RESULTS: Both light and sound were reduced with modifications that incurred modest costs. Patient safety was not influenced adversely by reduced light or sound levels. Staff members were highly satisfied with reductions in sound levels. Reactions to reduced lighting levels were more mixed and led to modification of bedside lighting. CONCLUSIONS: Cost-effective renovations to an existing NICU are possible, desirable, and do not impact patient safety. The reductions achieved, however, are less than those reached with new construction.     

A randomized controlled trial of electroacupuncture at body acupoints and Fenglong for regulating serum lipids in dyslipidemic patients in Thailand

The primary objective of this randomized, controlled, open-label study was to compare the efficacy of body acupuncture and Fenglong method in controlling serum lipids in patients with dyslipidemia in Thailand. Patients were randomized into two treatment groups (body acupuncture and Fenglong) and a control group. By the end of intervention period, serum lipid level in both treatment groups was significantly lower than its baseline value while in the control group serum lipid levels significantly increased during the same period. At follow-up visit, total cholesterol and LDL cholesterol were significantly lower in both treatment groups when compared to the control group. The effect of both acupuncture interventions was seen in both obese and non-obese patients. In conclusion, body acupuncture and Fenglong method have a positive impact on the regulation of serum lipids that is sustained after the treatment regardless of patient's baseline weight.     

High resolution imaging of endometriosis and ovarian carcinoma with optical coherence tomography: feasibility for laparoscopic-based imaging

High resolution imaging of gynaecological tissue offers the potential for identifying pathological changes at early stages when interventions are more effective. Optical coherence tomography (OCT) is a high resolution high speed optical imaging technology which is analogous to ultrasound B–mode imaging except reflections of light are detected rather than sound. The OCT technology is capable of being integrated with laparoscopy for real–time subsurface imaging. In this report, the feasibility of OCT for differentiating normal and pathologic laparoscopically–accessible gynaecologic tissue is demonstrated. Differentiation is based on architectural changes of in vitro tissue morphology. OCT has the potential to improve conventional laparoscopy by enabling subsurface imaging near the level of histopathology.     

Positive correlation between mature amniotic fluid optical density readings and the absence of neonatal hyaline membrane disease

Fetal pulmonary maturity is generally determined by analyzing amniotic fluid for surfactants. This task is accomplished by lipid extraction of the fluid and resolution, identification and quantitation of the isolated lipids with thin-layer chromatography. These methods are lengthy, cumbersome and often not available on demand. A quick, simple, reliable and economical test therefore would be highly desirable. We have been able to correlate an optical density (OD) reading of amniotic fluid at 650 nm greater than or equal to 0.15 with the absence of hyaline membrane disease (HMD). For 428 fluids in which an OD reading of greater than or equal to 0.15 was found and delivery occurred within 48 hours, HMD was present in only two infants. The accuracy of the test was 99.53% , with a false-positive rate of 0.47%. With the use of this simple and accurate test one can satisfy the requirement of an on-demand test to determine fetal pulmonary maturity.     

在妊娠合并免疫性血小板减少症动物模型中骨髓间充质干细胞的改变#br#

Objective?To establish a method for isolation and culture of bone marrow mesenchymal stem cells (BM-MSCs) in mice with immune thrombocytopenia (ITP) during pregnancy. Methods?Mesenchymal stem cells were isolated and cultured from mouse bone marrow of normal pregnancy, ITP and ITP pregnancy group. Cell growth and proliferation were observed under optical microscope. The immunophenotype of mesenchymal stem cells was analyzed by flow cytometry. Oil red 0 and alizarin red staining were used to evaluate the ability of lipid osteogenesis differentiation. CCk-8 test was used to detect cell proliferation. The PI test measures the cell cycle.Annexin-v /PI staining was used to detect apoptosis. Results?①BM-MSCs derived from pregnant mice with ITP group grew slowly and were irregular in shape. BM-MSCs from different sub-groups were highly expressed in stem-cell related antigens CD44, CD29 and scal-1, partially expressing CD90, but not expressing leukocyte surface antigen CD45 and lymphocyte surface antigen CDllb. They can be induced to differentiate into osteoblasts and lipoblasts in vitro. ②Compared with the normal pregnancy group, the proliferation of BM-MSCs in the ITP group and the ITP pregnancy group was significantly inhibited (P<0.05), the cell proportion in G0/G1 phase was significantly increased (P<0.05), and the apoptosis rate was significantly increased (P<0.05). Compared with the ITP group, the growth rate of BM-MSCs in the ITP pregnancy group was inhibited and the apoptosis rate was increased (P<0.05). Conclusions?The BM-MSCs derived from mice in the ITP pregnancy group showed abnormal morphology, impaired proliferation ability and excessive apoptosis.     

Prognostic significance of stromal metalloproteinase-2 in ovarian adenocarcinoma and its relation to carcinoma progression

OBJECTIVES: MMP-2 expression in ovarian cancer cells has been correlated with poor prognosis. This study attempts to assess the prognostic importance of stromal MMP-2 in patients with ovarian endometrioid and serous adenocarcinoma. METHODS: MMP-2, MMP-2 activator, MT1-MMP, and its inhibitor (TIMP-2) were immunostained in 84 primary epithelial ovarian carcinomas (EOCs) (35 endometrioid adenocarcinomas [ECs] and 49 serous adenocarcinomas [SCs]). Results were correlated to pathological subtypes, tumor stage, grade, size, and to recurrence-free and cancer-specific survival. RESULTS: MMP-2 and stromal MMP-2 were detected in all carcinoma cells of 22.2% of EC and 77.8% of SC tumors. MT1-MMP co-localized with MMP-2. TIMP-2 staining was weak and cytoplasmically distributed in all tumors. Univariant analysis showed expression of stromal MMP-2 significantly associated with advanced stage (P = 0.018), higher grade (P = 0.005), serous subtype (P = 0.02), smaller tumor size at operation (P = 0.001), and higher incidence of recurrence (P = 0.042), but not with the rate of death due to cancer. By multiple Cox proportional hazard regression analysis, patient survival and disease-free survival were significantly related to the presence of stromal MMP-2 in EC but not SC patients (P < 0.05). However, after multivariant analysis, the associations with patient age, tumor stage, grade, and size no longer existed. In stepwise selection, tumor stage remained the most important predictor of patient survival and disease-free survival in ovarian EC and SC, but stromal MMP-2 remained the most important predictor of recurrence-free survival in patients with EC. CONCLUSIONS: Stromal MMP-2 occurs early and may play a role early in EOC invasion. Tumor stage and stromal MMP-2 are important predictors of disease-free survival.     

Immunohistochemical localization of secretory component and IgA in the normal and cancerous endometrium

Using normal and cancerous endometrial tissues obtained from climacteric and postmenopausal women as the subjects, localizations of secretory component (SC) and IgA were immunohistochemically investigated. The results were as follows: Similar to cyclic women, in normal endometrial tissues from climacteric and postmenopausal women, SC and IgA localized mainly in glandular epithelia. However, in women over 60 years of age, immunoreactivity of SC and IgA decreased. In cancerous tissues, staining intensity of SC and IgA decreased clearly as compared to normal tissues. Also, the loss of polarity was recognized in the localization pattern of SC and IgA. In relation to the tissue differentiation, a further decline was recognized in the SC and IgA staining intensity in the poorly differentiated carcinoma as compared to the well differentiated type. The above findings suggested that the decline of the local immune system in the endometrium, namely, weakening of the local defense mechanism against infections, took place in women of advanced age. Also it was recognized that weakening of the ability to produce SC was caused by the malignant transformation of endometrium, and it was suggested that SC was a substance which had a close relationship to tissue differentiation.