Alveolar soft part sarcoma of the uterine cervix

A rare case of an alveolar soft part sarcoma of the uterine cervix in an 8 year old girl is presented. The patient was admitted because of genital bleeding lasting for 7 months. A polypoid tumor, 2times1.5 cm in diameter, was found in her external uterine os and was surgically resected. Microscopically, the tumor consisted of a uniform sheet of tumor cells in the cytoplasm which contained granules and which were stained with periodic acid-Schiff, both before and after the diastase digestion. Alveolar arrangement of the tumor cells was manifested with reticulin silver impregnation. Dense, membrane bound granules were evident at an ultrastructural level in the cytoplasm of the tumor cells. An immunohistochemical examination demonstrated a positive reaction for anti-desmin, anti-myoglobin, anti-HHF35 and anti-neuron specific enolase in the cytoplasm.     

改良单宁酸-氯化铁法媒染子宫血管的实验研究

目的：光镜下观察大鼠子宫各部位血管构筑。方法：应用单宁酸一氯化铁法(TA—Fe法)灌流固定大鼠，取子宫不同位置做冰冻切片，氯化铁显色，常规脱水、透明、封片，显微摄影。结果：子宫壁出现类似电镜负染色效果，组织结构灰黑色，血管双线条状，分支明显，过管壁切面可见内皮细胞或平滑肌；子宫动脉进入肌层分支并形成一、二级血管网和多支环状动脉，环行动脉或二级血管网发出的微动脉和毛细血管进入粘膜，形成密集的三级毛细血管网。结论：经灌流的子宫标本较长时间保存在媒染固定液内，导致血管外结构也被媒染；子宫壁有三级血管网；每个子宫有多支环状动脉；各段子宫血管构筑不尽相同。     

Effect of estradiol on mouse uterine epithelial cell transepithelial resistance (TER)

PROBLEM: The effects of estradiol on epithelial cell function in the uterus may either be direct or indirect through the paracrine effects of underlying stromal cells. The aim of this study was to test whether estradiol-17beta (E(2)) acts directly to regulate uterine epithelial cell monolayer integrity. METHODS OF STUDY: Mouse uterine epithelial cells were isolated and grown on cell culture inserts to form confluent, polarized monolayers, as indicated by the development of high transepithelial resistance (TER). RESULTS: When polarized epithelial cells were treated with E(2), TER was significantly decreased within 24 hr of exposure. Epithelial cells remained hormonally responsive in culture for at least 10 days. In contrast to estradiol, incubation with progesterone, cortisol, aldosterone, and DHT had no effect on uterine epithelial cell TER. The ability of E(2) to decrease TER was inhibited following co-incubation with ICI 182,780, a pure estrogen receptor antagonist. To further investigate the mechanism involved in estradiol-induced decreases in TER, we tested the effect of TAPI-0, an inhibitor of matrix metalloproteinases. Our findings indicate that TAPI-0 reversed the inhibitory effect of E(2) on TER. CONCLUSIONS: These studies demonstrate that epithelial monolayer integrity is directly influenced by E(2) and ER mediated. Further, it suggests that the mechanism through which estradiol decreases TER is mediated by matrix metalloproteinases.     

Recent advances in immunohistochemistry in gynaecological pathology

Recent years have witnessed significant developments in the use of immunohistochemistry in diagnostic gynaecological pathology. This review details the most significant of these. In ovarian pathology, differential cytokeratin staining (CK7 and 20) assists in distinguishing between a primary ovarian adenocarcinoma and a metastatic adenocarcinoma, especially of colorectal origin. The development of markers characteristic of ovarian sex cord-stromal tumours (especially alpha-inhibin) facilitates diagnosis of these neoplasms which is often difficult by morphology alone due to the wide differential diagnosis. In the uterus, the distinction between a primary endometrial and endocervical adenocarcinoma may be facilitated by use of a small panel of antibodies, including CEA, ER and vimentin. Newly developed antibodies such as CD10 and h-caldesmon may be of use in the diagnosis of uterine mesenchymal lesions, especially in the distinction between endometrial stromal and smooth muscle lesions. Proliferation markers, such as MIB1, are of value in the cervix in the diagnosis of preinvasive squamous and glandular lesions. Recent studies have shown that cervical adenoma malignum exhibits a gastric phenotype. Advances have also been made in trophoblastic disease with the development of antibodies reactive against trophoblast such as alpha-inhibin, mel-Cam and p57. A newly developed monoclonal antibody HMGIC which is expressed in vulvovaginal aggressive angiomyxoma may prove to be of value in the often difficult distinction of this lesion from its histological mimics.     

Extraembryonic motor activity during the embryogenesis of higher vertebrates

Extraembryonic rhythmic motor activity in higher vertebrates, along with the intrinsic motor activity of the embryo, is important for the normal development of the embryo. This can have different natures in different classes of amniotes (i.e., motor activities of the amnion, yolk sac, and uterus), but these have similar functional importance. This activity changes reproducibly during the process of embryogenesis, providing the optimum conditions for normal embryo development. During embryogenesis, a system for controlling extraembryonic rhythmic motor activity is also formed. There is a trend for the regulation of this activity to become more complex in mammals as compared with birds. Reptiles have received little study from this point of view. In addition to regular changes in extraembryonic rhythmic motor activity during embryogenesis which depend on the developmental stage of the embryo, motor activity can also change in response to changes in a number of environmental factors (for example, temperature and the gas composition of the air). This demonstrates the possible involvement of embryo-associated extraembryonic motor activity in adapting the embryo to changing environmental conditions and maintaining homeostasis for the development of the embryo itself. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 84, No. 10, pp. 961–968, October, 1998.     

Lower mesodermal defects: A common cause of fetal and early neonatal death

Among the first 1,130 referrals to the Wisconsin Stillbirth Service Program 17 infants have been recognized to share phenotypic characteristics involving the genital, urinary, lower gastrointestinal, and axial skeletal systems. The pattern of abnormalities identified appears to be limited to structures sharing a common embryologic origin. These features, for the most part, are shown to be non-randomly associated. No clearly definable sub-groups within this population are demonstrable. The pattern of abnormalities is defined to include abnormalities of the following structures as pathogenetically primary features: lumbosacral vertebrae, kidneys, ureters, uterus/fallopian tubes, vagina, bladder, urethra, adrenals, gonads, anorectum, external genitalia, and umbilical arteries. An embryologic mechanism is proposed which explains this non-random association as arising secondary to disruption of structures derived from the lower portion of the primitive intra-embryonic mesoderm. The Lower Mesodermal Defects Sequence appears to be a rather common (and under-recognized) cause of stillbirth and immediate neonatal death. © 1994 Wiley-Liss, Inc.     

Pharmacological characteristics of P2 receptors in human uterus

We studied contractile responses of isolated smooth muscles from human uterus induced by P2 receptor agonists. In preparations from pregnant uterus all tested P2 receptor agonists caused smooth muscle contractions. The relative activity of P2 receptor agonists decreased in the following order: a,b-methylene-ATP-uridine triphosphate-ATP. Responses induced by ATP and ADP were similar. The amplitude of contractions induced by alpha,beta-methylene-ATP significantly decreased in the presence of P2 receptor antagonist pyridoxal-phosphate-6-azophenyl-2',4'-disulfonic acid. None of tested P2 receptor agonists induced contractions of isolated myometrium from nonpregnant women. Our results indicate that pregnant human uterus contains P2 receptors mediating the contractile response.     

A novel serine protease of the mammalian HtrA family is up-regulated in mouse uterus coinciding with placentation

This paper characterizes a novel gene, previously identified as uniquely regulated at implantation in mouse uterus. We cloned its full mRNA sequence encoding a serine protease possessing an IGF-binding domain and named it pregnancy-related serine protease (PRSP). PRSP is structurally similar to mammalian HtrA1 (56% amino acid similarity). Northern analysis revealed that the expression of PRSP mRNA was low before pregnancy, but it was increased at implantation and markedly up-regulated post-implantation. In-situ hybridization localized low levels of mRNA expression to the epithelium and stroma during very early pregnancy, but high expression to the decidual cells on day 8.5, primarily at the mesometrial pole where the placenta was forming. By day 10.5, PRSP mRNA was detected in the placenta. We also cloned an alternatively spliced PRSP mRNA that is expressed at a very low level. We located PRSP gene on chromosome 5 and established its intron/exon structure, which unambiguously explains how the two mRNA variants are produced through alternative splicing. Based on PRSP protein domain structure and its unique expression during pregnancy, we propose that PRSP plays an important role in the formation/function of the placenta.     

Physiological and pharmacological aspects of local transfer of substances in the ovarian adnexa in women

An intimate arrangement between the utero-ovarian vein and the ovarian artery has been found in many species. The anatomical structure suggests the existence of a counter-current system of exchange, and many animal experiments point to a physiological importance of this transfer system. In man, the utero-ovarian vein forms a plexus around the ovarian artery. In-vitro experiments have demonstrated a local transfer of progesterone; in-vivo experiments have proved that krypton and progesterone can be transferred from the utero-ovarian vein to the ovarian artery. The physiological and pharmacological importance of the counter-current system is still under evaluation, and further investigations are needed. It has been suggested that counter-current transfer facilitates local communication between the ovary, Fallopian tube, and uterus. This may be important in a context of luteolysis, follicular selection and maturation, fertilization, and the recognition and maintenance of pregnancy. The pharmacological and therapeutic potential may be limited, as the ovarian adnexa are relatively difficult to access. Instillation of hormones into the uterine lumen will probably induce a higher plasma concentration in the ovarian arterial blood than in peripheral arterial plasma. A culdoscopic or endoscopic approach might permit introduction of long-acting depots in the uterine fundus near the Fallopian tubes and/or ovaries.