小鼠细胞外基质与颗粒子宫腺细胞发育的关系

采用免疫组织化学ＬＳＡＢ法对妊娠小鼠胎盘进行研究，显示Ⅰ、Ⅳ、Ⅴ型胶原蛋白，纤维粘连蛋白及层粘连蛋白的分布及其在妊娠过程中的变动情况，从而了解细胞外基质与颗粒子宫腺细胞（ＧＭＧ细胞）的关系。结果表明，妊娠１６天左右大部分细胞外基质在子宫腺细胞区出现高峰，这一时期正是ＧＭＧ细胞数量最多而且分化最为成熟的时期。这一结果提示：细胞外基质与ＧＭＧ细胞增殖及分化等方面关系密切。     

小鼠子宫腺的免疫功能评价

子宫腺是啮齿动物妊娠时出现的一种暂时性子宫结构,含有基质及血管成分,以及一种形态特殊、体积较大、带有颗粒的子宫腺细胞。子宫腺可能在妊娠时具有免疫学方面的作用,子宫腺细胞可能具有免疫活性。     

子宫蜕膜NK细胞和妊娠

子宫蜕膜中NK细胞是妊娠早期出现最多的淋巴细胞，与外周NK细胞(CDl6^ CD56^-)相比，子宫NK细胞表面抗原通常为CD56^ CDl6^-mCD3^-。在着床过程中，NK细胞的活性一般处于抑制状态。从子宫NK细胞的细胞毒性作用和分泌的细胞因子阐述其在妊娠期可能起的作用，提示子宫NK细胞与反复自然流产、异位妊娠及先兆子痫的关系。说明在复杂的母胎界面免疫内分泌网络中，子宫NK细胞能影响滋养细胞侵入过程和胎盘的生长发育。     

腹腔镜下应用激光与微波手术治疗子宫内膜异位症

于腹腔镜下应用Ｎｄ：ＹＡＧ激光与微波手术治疗子宫内膜异位症２００例。术后随诊１０－４８个月。结果：２００例中，合并不孕７６例，术后妊娠率６０．５％；合并卵巢巧克力囊肿１１４例，术后囊肿消失率为７１．１％，有效率为９２．１％；主诉疼痛症１８０例，术后疼痛完全缓解为５８．３％，有效率为９２．２％。     

妊娠滋养细胞肿瘤的子宫血管结构特点

妊娠滋养细胞肿瘤的子宫血管结构特点万小云石一复妊娠滋养细胞肿瘤（ＧＴＮ）起源于胎盘绒毛的滋养细胞，该肿瘤具有不同于人类其它实体肿瘤的一般特性，它本身并无固有的血管，但滋养细胞极易侵袭并破坏邻近血管以获取营养，临床上较早即出现远处血行转移灶。本研究用血...     

子宫蜕膜NK细胞和妊娠

子宫蜕膜中NK细胞是妊娠早期出现最多的淋巴细胞,与外周NK细胞(CD16+CD56-)相比,子宫NK细胞表面抗原通常为CD56+CD16-mCD3-.在着床过程中,NK细胞的活性一般处于抑制状态.从子宫NK细胞的细胞毒性作用和分泌的细胞因子阐述其在妊娠期可能起的作用,提示子宫NK细胞与反复自然流产、异位妊娠及先兆子痫的关系.说明在复杂的母胎界面免疫内分泌网络中,子宫NK细胞能影响滋养细胞侵入过程和胎盘的生长发育.     

异位妊娠时子宫内膜的形态变化

目的：探讨异位妊娠时子宫内膜形态变化的规律。方法：回顾分析我院２１７例异位妊娠子宫内膜的形态变化。结果：异位妊娠时子宫内膜变化有７种类型：（１）蜕膜和Ａｒｉａｓ－Ｓｔｅｌａ反应（Ａ－Ｓ反应）；（２）高度分泌反应；（３）分泌反应不同步；（４）部分呈分泌反应、部分呈增生反应，并出现一种“小Ａ－Ｓ”腺体；（５）早、中、晚分泌期；（６）增生反应；（７）腺囊型增生过长。异位妊娠时内膜形态与有无阴道流血、流血时间长短及尿ｈＣＧ水平有关。结论：不能以是否出现蜕膜和Ａ－Ｓ反应做为诊断异位妊娠的依据，须结合病史和实验室检查才能准确判断。     

妊娠32周子宫卵巢静脉丛自发破裂一例

妊娠３２周子宫卵巢静脉丛自发破裂一例姚玉洁患者２５岁。因妊娠３２周，无诱因突然出现持续性腹痛８小时，自感胎动消失，于１９９４年１１月２４日急诊入院。入院检查：血压１０／８ｋＰａ（７５／６０ｍｍＨｇ），脉搏１１０次。神志清楚，急性病容。腹部膨隆，子宫底...     

控制性超排卵周期的子宫内膜容受性研究

目的 研究控制性超排卵(COH)对子宫内膜容受性的影响。方法 扫描电镜观察COH后子宫内膜胞饮突的变化和免疫组化法检测整合素β3、TGFβl的表达；以正常月经周期分泌中期子宫内膜作对照。结果 COH周期，完全发展的胞饮突出现在月经周期的第18—19d，较正常周期提前l一2d出现和消失；整合素β3、TGFβl在正常月经周期第2l一23d的子宫内膜腔上皮和腺上皮细胞的细胞质高表达，而COH周期在第18—20d高表达。COH周期和正常周期，整合素β3和TGFβl在子宫内膜上皮细胞的高表达与完全发展胞饮突的出现在时期上存在着一致性。结论 COH可能通过改变子宫内膜与着床密切相关的粘附分子、细胞因子和超微结构的时序性表达来影响子宫内膜的容受性，使子宫内膜着床窗的开放与胚泡的发育不同步，这可能是影响IVF妊娠率的重要原因。     

子宫角妊娠4例分析

目的探讨子宫角妊娠的诊断及治疗方法，减少误诊率。方法分析我院1998—2005年7年内收治的子宫角妊娠4例进行临床分析并复习相关文献。结果术前误诊2例，其中1例因延误手术时机而死亡，1例术中才明确诊断；1例孕早期B超确诊后在B超监测下行人工流产；另1例发生破裂后B超诊断为官角妊娠行剖腹探查证实。结论 妊娠早期常规B超检查及引产前常规B超检查，提示胎盘是否位于子宫角部，可减少子宫角妊娠的误诊及破裂。该病极易与输卵管间质部妊娠相混淆。根据Jansen等对子宫角妊娠的诊断标准可与输卵管间质部妊娠相鉴别。     

Behavioural pattern of tumour cells in mouse uterus

The behavioural pattern of transplantable mouse fibrosarcoma (MFS) cells infused into the pregnant, pseudopregnant and nonpregnant mouse uteri was studied histologically. In some nonpregnant and pseudopregnant uteri, the tumour cells, without colonizing inside the uterus, traverse the endometrium and within 5 days of treatment form tumour nodules outside the myometrium, indicating the presence of an initial and temporary tumour rejection mechanism in these uteri. In later stages MFS cells form large necrotic tumours in these uteri. In the pregnant uterus no tumour nodules are formed outside the myometrium even after 20 days of treatment. Furthermore, the size of the tumour formed in the endometrium of the pregnant uterus is quite small and the tumour cell growth rate is lower than that of the tumour cells in the nonpregnant and pseudopregnant uteri. These results indicate that, in the pregnant mouse uterus, fibrosarcoma cells display an altered pattern of invasion and decreased growth rate compared to those in nonpregnant and pseudopregnant uteri.     

A monoclonal antibody, 4H12, recognizes a surface antigen found on granulated metrial gland cells in the murine decidua

A monoclonal antibody (MAb), designated 4H12, was selected for reactivity to a surface antigen on PYS-2 teratocarcinoma cells. 4H12 was the product of a fusion of lymphoid cells of a non-immunized pregnant C57BL/6 mouse to NS-1 myeloma cells. Initial studies utilizing immunohistochemistry revealed that MAb 4H12 bound to an antigen found on cells in the decidua basalis of 7-, 8- and 10-day pregnant mice. Antigen-positive cells of 11--19-day pregnant mice were also found predominantly in the decidua. A few antigen-positive cells were found in the labyrinth of the placenta and up against Reichert's membrane. Antigen-positive cells were morphologically and spatially distinct, oval to round with large periodic acid Schiff positive granules. Indirect immunofluorescent (IIF) labeling of decidual cultures showed antigen on the surface of cells that were small, oval to round and adherent. The antigen recognized by MAb 4H12 was removed from tissue sections with trypsin and protease and therefore is suggested to be a protein. We conclude that MAb 4H12 recognizes a surface antigen found on cells historically described as granulated metrial gland (GMG) cells. This MAb should greatly facilitate the further analysis of the life history and function of GMG cells during pregnancy.     

Trophoblastic interferons: do they modulate uterine cellular markers at the time of conceptus attachment in the pig?

Between days 12 and 20 of pregnancy, the trophectoderm of the porcine conceptus secretes two species of interferons (IFN): IFN-gamma (Type II), which is produced in substantial amounts, and IFN-delta (type I), for which secretion peaks at days 15-16 of gestation. The role of these embryonic IFNs is not known. We made the assumption that, in the pig, one possible role of these IFNs may be the remodelling and/or depolarization of the uterine endometrial epithelium, as a prerequisite for implantation and establishment of a functional placenta. A comparative analysis by immunohistochemistry of several cell membrane markers and ECM components of the cyclic and pregnant uterus was performed at day 15 post-oestrus. The markers were those likely to differ between a pregnant and cyclic uterus, or between different stages of pregnancy. A highly specific marker of IFN-gamma activity, namely MHC class II antigens in the uterine mucosa, was also examined. This study provides so far unreported data: in the endometrial epithelium of the pregnant uterus, we observed a partial relocalization of ZO-1, a marker of epithelial tight junctions, thus suggesting significant changes to the endometrial polarity. Heparan-Sulphate Proteoglycan (HSPG) expression did not differ significantly between cyclic and pregnant uteri. In contrast with the accepted rodent model of trophoblast-uterus adhesion, the porcine trophoblast and luminal epithelium were negative for HSPG. Finally, MHC class II antigens were absent from the cyclic uterus, but markedly induced in the day 15 pregnant uterus, particularly in endothelial cells, suggesting that IFN-gamma may indeed cross the maternal epithelium. This hypothesis was supported by the observation of IFN-gamma immunoreactivity associated with clusters of endometrial cells in the pregnant uterus.     

Evaluation of the murine metrial gland for immunological function

The metrial gland (MG) is a transient uterine structure associated with rodent pregnancy. The gland is a complex structure consisting of stromal and vascular elements, as well as a population of histologically distinctive, large, granulated metrial gland (GMG) cells. The functions of the MG and of the GMG cells, as well as their relationship to the success of pregnancy, are unknown. Based upon morphological and morphometric studies it has been proposed that the MG might be involved in the immunology of pregnancy and that GMG cells could be immunocompetent. Explant cultures of MG have therefore been evaluated for immunological function. Lytic activity against the NK sensitive target cell line YAC and mitogen responsiveness could not be detected. MG tissue and medium conditioned by overnight culture of MG tissue (MG-CM) suppressed the response of murine spleen cells to Con A. MG-CM also reduced the lytic activity of splenic NK cells against YAC target cells. However, uptake of [3H]thymidine was elevated when YAC cells were cultured in MG-CM. The response of embryonic and uterine cells to growth in MG-CM was complex. MG-CM had little effect on isotope incorporation by decidual cells recovered at 6.5 days or by embryonic cells recovered from 12.5 day embryos. However, thymidine incorporation was less in MG-CM than in control medium for 12.5 day placental cells, 6.5 day embryonic sac, 6.5 day ectoplacental cone and 3.5 day blastocysts. Cytotoxicity and cytostasis accounted for reduced uptake of isotope in cultures of 3.5 day blastocysts and 6.5 day embryonic tissues. Loss of viability could not be detected in any other assays. Both YAC cells and unstimulated splenocytes showed altered morphology and improved viability when cultured in MG-CM. This study suggests that the only immunological role the MG might have during normal pregnancy is that of non-specific intra-uterine suppression. Alternatively, differential regulation of cell proliferation might be a function of the MG, within the pregnant uterus. The latter mechanism could also account for the apparent observation of non-specific immunosuppression.     

Spontaneous uterine rupture at 35 weeks' gestation, 3 years after laparoscopic myomectomy, without signs of fetal distress

Laparoscopic myomectomy (LM) is a recently developed surgical technique, and every obstetrician should be aware of its possible complications, which can occur not only during labor but also during pregnancy. We report a case of a primigravid woman who was hospitalized at 35 weeks' gestation because of irregular abdominal pain. She conceived spontaneously 3 years after LM. After a 20-h stay on the obstetrician ward due to increased abdominal tenderness and vaginal bleeding, the patient was qualified for an emergency cesarean section without any symptoms of fetal distress in cardiotocography. During cesarean section a newborn with 9 Apgar points was delivered and a rupture of the uterine wall was seen. Dehiscence of the pregnant uterus following LM is an incidental case, and can therefore be misdiagnosed. Close attention should be paid to every pregnancy in previously operated uteri as the dehiscence of the pregnant uterus can occur without symptoms of fetal distress.     

Co-existence of myoma uteri and pregnancy

OBJECTIVE: Myomas of uterus are the most common mild tumours of uterus. There is often observed the rapid increase of them during the pregnancy and then they could caused complications from 0.3% to 2.6% of pregnancies. DESIGN: The aim of study was the general valuation of the course and delivery means of the pregnancies coexisted with myoma uteri. MATERIALS AND METHODS: We have analysed 11 pregnancies, which we observed during hospitalisation of pregnant women at 2nd Department of Obstetrics and Gynaecology at Medical University of Gdańsk. RESULTS: We observed pain in abdomen during pregnancy in 63.6% of analysed group. The 6 (54.5%) pregnant women were pharmacologically treated against symptoms of miscarriages and preterm labors. We investigated in the connection of the complicated pregnancy at women with myomatous uterus. The results confirm the high risk of the pregnancy. Almost 82% of analysed group delivered at time. The frequency of caesarean sections in our study was about 36%, but 2 of them were performed because of myomas. CONCLUSION: We made conclusion that pregnancy complicated by myomas had not significant increase in failure at the end. Myomatous uterus in pregnancy required to be quickly diagnosed and take care to prevent complications.     

Receptors for IgG2b on cells of the mouse metrial gland

Single cells prepared from metrial glands of mice killed at days 10, 13 and 17 of pregnancy were assayed for the expression of Fc gamma receptors in a standard rosetting assay using sheep red blood cells sensitised with a mouse monoclonal IgG2b antibody. Rosettes, indicating Fc gamma receptors, were found on both granulated metrial gland (GMG) cells and non-GMG cells, comprising mainly stromal cells, from each stage of pregnancy. Some animals were given an intravenous injection of horseradish peroxidase 2 h before they were killed in order to identify endocytic cells. No GMG cells were found to have endocytosed the horseradish peroxidase. Non-GMG cells which showed endocytic activity all expressed Fc gamma receptors but these receptors were also found on some of the non-GMG cells which had not exhibited endocytosis. The finding of Fc gamma receptors on GMG cells provides further evidence that these cells may be related to NK cells.     

Uterine natural killer cells are immunogenic in syngeneic male mice

Uterine natural killer (uNK) cells expand rapidly during endometrial decidualization and account for 70% of leukocytes in early gestational uteri of humans and rodents. These cells make unique contributions to pregnancy, contributing to the success of embryo implantation and maintenance of decidual tissue that supports placental and fetal development. We postulated that uNK cells express molecules that are not shared by circulating NK (cNK) cells or other leukocytes and, therefore, would be immunogenic for male mice. We isolated viable uNK cells from gestation day 9 pregnant mice and inoculated them into syngeneic males. This induced antibodies reactive with mouse uNK cells but not with cNK cells or other lymphocytes. The antibodies reacted identically with uNK cells in tissue sections from five different mice strains from gestational day 7-12 and in pregnant rat uterus, suggesting that the recognized antigen should be a specific marker of uNK cell. Spleen cells from inoculated males were used subsequently to produce a monoclonal antibody reactive to a uNK cell surface antigen. These experiments confirm that uNK cells are a pregnancy-specific subset of NK cells expressing distinct surface antigen from those found in other tissues.     

Uterine torsion in pregnancy.

Torsion of the pregnant uterus is defined as rotation more than 45 degrees around the long axis of the uterus. Uterine torsion is observed in all age groups of the reproductive period, in all parity groups, and at all stages of pregnancy. Torsion from 60 degrees to 720 degrees has been described. It is not possible to clarify why uterine torsion occurs, but numerous abnormalities have appeared with uterine torsion; most often, abnormal fetal presentation, myoma uteri and uterine malformations. The most usual symptoms of uterine torsion are birth obstruction, abdominal pain, vaginal bleeding, shock, and urinary and intestinal symptoms. Eleven percent are asymptomatic. The treatment in the earlier months of pregnancy is immediate laparotomy and detorsion of the uterus and, if practicable, adjunct surgery to eliminate the possible etiologic factors. Near term or during labor cesarean section is carried out, and elimination of the possible etiologic factors. The fetal and maternal mortality rates since 1976 are 12% and 0% respectively.