Parasitic diseases control in the 21st century in China

The aim of this study was to determine whether the endometrium acts as a reservoir for Candida albicans in cases of recurrent vaginal candidiasis. Twenty-five women with documented history of recurrent vaginal candidiasis were enrolled in the study and endometrial samples were cultured for Candida albicans. Only two patients had positive cultures for Candida albicans. Therefore, we concluded that the endometrium is not a common reservoir for Candida albicans.     

Effect of fire on understory birds of a gallery forest in central Brazil

We developed a new quantitative method for detecting abnormal glycolipid expression in endometrial cells using a monoclonal antibody (MSN-1) and analyzed the glycolipid antigen recognized by MSN-1 in 173 clinical endometrial cell samples (66 normal endometria, 39 endometrial hyperplasias, and 68 endometrial adenocarcinomas). The mean glycolipid antigen levels in normal endometrium, endometrial hyperplasia, and endometrial carcinoma were 0.42 +/- 1.37, 2.13 +/- 3.84, and 19.4 +/- 25.8 (mean +/- SD) units, respectively. If the cutoff rate of this assay was fixed at 1.8 units, the positivity rates for patients with normal endometrium, endometrial hyperplasia, and endometrial carcinoma were 6.1% (4/66), 28.2% (11/39), and 76.5% (52/68), respectively. In 35 endometrial carcinoma patients, endometrial smears were simultaneously performed, and there were 22 positive smears (62.9%). When the cytological diagnosis was combined with our assay, 94.3% (33/35) of the carcinomas were detected. Thus, this assay seems to be a supplementary diagnostic method for endometrial carcinoma.     

Sex-role reversal and the absence of extra-pair fertilization in Wilson''s phalaropes

Human endometrial leukocytes undergo regular cyclical changes during the menstrual cycle, with a striking increase in the phenotypically unusual population of CD56+ CD16- endometrial granulated lymphocytes (eGLs) in the late secretory phase and early pregnancy. The factors that regulate this increase in eGL numbers are unclear; their unusual morphology, however, has led to the suggestion that they undergo apoptosis at the end of the menstrual cycle. Apoptosis, bcl-2 expression, and proliferative activity were examined in the stroma of normal cycling, progesterone-treated, and early-pregnancy endometrium. The expression of bcl-2 and the Ki67 proliferation marker by highly purified (> 98% CD56+) eGLs from endometrium during the menstrual cycle and from first-trimester decidua was also studied. Apoptotic cells were rarely observed in the endometrial stroma of any of the samples examined. Stromal bcl-2 expression, however, increased from the proliferative to the premenstrual phase, and double immunohistochemical labeling demonstrated large numbers of bcl-2+ CD56+ eGLs. In contrast, Ki67 expression was high in the endometrial stroma during the proliferative phase, fell during the secretory phase, and rose again premenstrually, because of expression by eGLs. Isolated CD56+ eGLs also showed high bcl-2 and Ki67 expression at the end of the menstrual cycle. Unlike premenstrual endometrium, progesterone-treated endometrium and first-trimester decidua contained few proliferating cells, expressed high levels of bcl-2, and showed no evidence of apoptosis. Thus, eGLs do not undergo apoptosis in premenstrual endometrium, and their regulatory mechanisms remain to be clarified.     

Placental protein 14 in endometrium during menstrual cycle and effect of early luteal phase mifepristone administration on its expression in implantation stage endometrium in the rhesus monkey

Placental protein 14 (PP14) is a glycoprotein which is secreted by secretory phase endometrium and decidua in women. Despite the suggestion that PP14 is involved in the process of endometrial maturation for blastocyst implantation, our understanding in this regard is poor. In the present study, the concentrations and distribution patterns of immunodetectable PP14 in the endometrium during proliferative and secretory phases of normal ovulatory menstrual cycles, as well as in implantation stage endometrium in naturally mated ovulatory cycles with or without early luteal phase mifepristone treatment, were investigated using the rhesus monkey as a primate model. Immunopositive PP14 was observed mainly in epithelial cells of glands and it was detected in one major immunopositive band at Mr 28 kDa in tissue homogenate and spent medium. The area of immunopositive precipitation of PP14 in glands was minimal in follicular phase endometrium, and was higher (P < 0.01) in early, mid- and late luteal phase endometrium compared with that in pre- and periovulatory phases of the cycle, but there was no change in its area profile in the glandular compartment throughout the luteal phase. Immunopositivity for PP14 in luminal contents of gland displayed an increasing profile from early to late secretory phases. Thus, the concentrations and the distribution of immunodetectable PP14 in luteal phase endometrium of the rhesus monkey showed marked similarity with those of human endometrium during the natural menstrual cycle. Although there was no marked change in the band characterstics for the protein in implantation stage endometrium following early luteal phase mifepristone treatment, it was markedly decreased (P < 0.01) in tissue homogenate and in vitro spent medium along with a lesser (P < 0.02) degree of immunoprecipitation in the glands in implantation stage samples of mifepristone treatment group compared with that in control group samples. Thus, the contragestional effect of early luteal phase mifepristone treatment appears to be associated with a decrease in the concentration of immunodetectable PP14 in implantation stage endometrial glands and its secretion in the rhesus monkey. It remains to be seen whether this decline is caused from direct antiprogesterone action on endometrial glands during progesterone dominance, or secondarily from associated retarded development of endometrium.     

Cytologic study of ascites and the endometrium in ovarian carcinoma. Clinical significance

OBJECTIVE: To ascertain the usefulness of endometrial cytology with ovarian cancers when examining extension of the disease and to analyze significant factors associated with migration of ovarian cancer cells into the uterine cavity. STUDY DESIGN: Cytologic results on ascites and the endometrium were analyzed in 87 patients with primary ovarian cancer in the absence of metastasis to the endometrium or cervicovagina. RESULTS: Positive results for cytology were found in 62/87 of ascites cases (71.3%) and in 20/87 endometrium cases (23.0%). The 15 cases (15/62 or 24.2%) positive for ascitic and endometrial cytology, divided clinically into stage III (6 cases) and stage IV (9 cases), were classified histologically as serous, 7 cases; mucinous, 2 cases; clear cell, 4 cases; endometrioid, 1 case; and unclassified, 1 case. Half the clear cell carcinomas (4/8 or 50.0%) were positive in the ascites and endometrium. The ascitic volume at surgery exceeded 500 mL in 9/15 cases (60.0%). CONCLUSION: Papillae with basement membrane material in the cores may be structurally associated with migration of ovarian cancer cells into the uterine cavity, especially in clear cell carcinomas. Cytologic positivity of the endometrium and ascites significantly correlated with ascitic volume.     

Impedance of a goat eye lens

Cyclins are essential proteins in cell cycle control, and their deranged expression has been reported to be associated with malignant transformation. Involvement of cyclins in the development of endometrioid carcinomas of the endometrium was studied immunohistochemically using antibodies against both cyclin A and tumor suppressor gene product p53, and their expression was compared with that of Ki-67 antigen. Sixty-two cases of endometrial endometrioid carcinoma and 20 cases of normal endometrium (10 proliferative and 10 secretory phase) were examined. Of the 62 endometrioid carcinomas, atrophic endometrium and hyperplasia were found adjacent to the cancers in 30 and 19 cases respectively. Cyclin A was expressed in < 1% of the glandular cells of normal endometrium in the proliferative phase and in hyperplasia, but was negligible in normal secretory phase and atrophic endometrium. p53 was almost always negative in normal endometrium and hyperplasia. Of the 62 endometrioid carcinomas, 12 tumors (19.4%) overexpressed cyclin A and 21 tumors (33.8%) overexpressed p53 (positive cells > 1%). Cyclin A and p53 were more frequently expressed in poorly differentiated tumors than in well differentiated tumors (cyclin A, p = 0.002; p53, p = 0.016). In addition, cyclin A-positive cells were topographically related to those cells positive for p53 as well as Ki-67. In conclusion, the abnormal expression of cyclin A and p53 is associated with high-grade endometrial endometrioid carcinomas.     

Gynecologic cancer and surgical infectious morbidity

The purpose of this study was to evaluate retrospectively the surgical infectious morbidity in gynecologic cancer. We examined 1,180 gynecologic oncology patients: 608 women had carcinoma of the endometrium, 510 cancer of the cervix, 48 ovarian cancer and 14 vulvar cancer. Thirty-five (6%), 92 (18%), 7 (15%) and 2 (14%) were complicated by infection in carcinoma of the endometrium, cancer of the cervix, ovarian cancer and vulvar cancer, respectively. Our conclusion is that the highest surgical infectious morbidity occurs in patients with cervical cancer and the lowest in patients with carcinoma of the endometrium.     

Usefulness of transvaginal ultrasound and hysteroscopy in diagnosing endometrial hyperplasia and endometrial carcinoma

Modern methods enabling evaluation of endometrium in all phases of the menstrual cycle were presented. Transvaginal ultrasound does not give characteristic pictures. The most frequently observed sonographic features in endometrial hyperplasia and endometrial carcinoma were compared. Most frequently, in 29% we observed the thickening of the endometrium. The enlargement of the uterine body was detected in 27%. The dominant feature in endometrial carcinoma was distortion or lack of medium-focus echo-90%. Different echogenicity was observed in 69% of all cases. Application of hysteroscopy enables us to visualize changed endometrium and also to sample focal lesions for histopathological examination. Endometrial carcinoma was detected in all analyzed cases with application of hysteroscopy and ultrasound. Pathological endometrial hyperplasia was diagnosed by ultrasound only in 44% and with application of hysteroscopy in 84% of all material.     

Ultrastructural aspects of endometrium in infertile women with septate uterus

OBJECTIVES: To evaluate the endometrial surface morphology in patients with septate uterus and primary infertility in an attempt to throw light on the question of whether endometrial anomalies are involved in the pathogenesis of infertility in women with mullerian malformations. DESIGN: Endometrial biopsies were performed in eight women with septate uterus and primary infertility during hysteroscopy scheduled in the preovulatory phase of the cycle (when a follicle > 17 mm was identified by ultrasonography and E2 levels were >200 pg/mL [conversion factor to SI unit, 3.671]). Two samples were obtained from each patient, one from endometrium covering the septum and the other from endometrium lining the lateral wall of the uterus. All specimens were examined by scanning electron microscopy. MAIN OUTCOME MEASURES: The number of glandular ostia, the ciliated:nonciliated cell ratio, and the number of cilia on ciliated cells were analyzed in endometrial specimen from both the covering of the septum and the corresponding uterine lateral wall. RESULTS: In five patients septal endometrium showed the following defective preovulatory changes with respect to endometrium of the lateral uterine wall: a reduced number of glandular ostia, irregular nonciliated cells with rare microvilli, incomplete ciliogenesis on ciliated cells, and decrease in the ciliated:nonciliated cell ratio (1:52 +/- 11 versus 1:21 +/- 8). CONCLUSIONS: Our results indicate a decrease in the sensitivity of endometrium covering the septa of malformed uteri to preovulatory hormonal changes. This could play a role in the pathogenesis of primary infertility in patients with septate uterus.     

Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection

An ultrasonographic evaluation of the endometrium was performed in 158 patients undergoing ovarian stimulation for an in-vitro assisted reproduction programme. Endometrial thickness was evaluated in 109 patients undergoing in-vitro fertilization (IVF) for female indications and in 49 patients undergoing intracytoplasmic sperm injection (ICSI) for male indications. The maximal endometrial thickness was measured on the day of human chorionic gonadotrophin (HCG) administration by longitudinal scanning of the uterus on the frozen image using electronic callipers placed at the junction of the endometrium-myometrium interface at the level of the fundus. Cases in which the endometrial thickness was >/=10 mm were included in group A; cases in which the endometrial thickness was <10 mm were assigned to group B. The age of the patients, serum 17-beta oestradiol concentrations on the day of HCG administration, the length of follicular stimulation, the number of follicles, 17-beta oestradiol concentrations per follicle on the day of HCG and the number of embryos transferred were analysed in each case. When comparing endometrial thickness and results in IVF and ICSI patients, an endometrium <10 mm predominated in IVF patients (27.5%) compared with those undergoing ICSI (16.7%) (P = 0.05); conversely an endometrium >=10 mm was more frequent in ICSI than in IVF patients. The incidence of pregnancy was higher in IVF group A patients (32/79; 41%) than in IVF group B patients (5/30; 17%) (P = 0.03), whereas no significant difference was found between ICSI group A (13/42; 31%) and ICSI group B (3/7; 43%) patients. Thus, a higher percentage of IVF patients had thin endometrium when compared with ICSI patients; thin endometrium was a prognostic indicator of pregnancy only in the case of a female indication for infertility (IVF). A thin endometrium in cases of female infertility may reflect a previous or present uterine pathology, whereas in indications of male infertility (i.e. cases using ICSI), in the absence of any associated uterine pathology, the presence of a thin endometrium is not predictive.     

Tc-99m DTPA renal scintigraphy using deconvolution analysis with six functional images of the mean time to evaluate acute pyelonephritis

The objective of the present study was to evaluate the cyclic changes and regional localization of immunoreactive c-fos and prolactin (PRL) in the human endometrium, using immunohistochemistry. Immunoreactive PRL was found in the epithelium of 9.1% of the proliferative specimens and in 55.6% of the secretory specimens (p < 0.05, Fisher's exact test). In the endometrial stroma, immunoreactive PRL was present in 9.1 and 66.7% of the proliferative and secretory samples, respectively (p < 0.01). Immunoreactive c-fos predominated in the stroma and was identified in 54.5% of the specimens in the proliferative phase, but in only 7.1% of those in the secretory phase (p < 0.05). The progesterone/estradiol ratio was lower in the patients expressing immunoreactive c-fos (median = 13.1 ng/ml) compared to those who did not (median = 84.5 ng/ml, p < 0.05). We conclude that immunoreactive c-fos is found mostly in stromal cells during the proliferative phase of the menstrual cycle, and is sharply reduced during the secretory phase, when the endometrium is under progesterone stimulation - attested by PRL production.     

Vabra aspirator and pipelle endometrial suction curette. A comparison

OBJECTIVE: To compare the Pipelle suction curette with the Vabra aspirating catheter in terms of their ability to obtain a sufficient amount of tissue (> or = 1 mm2 of endometrium) in order to make a histologic diagnosis. STUDY DESIGN: A prospective, randomized, double-blind, crossover study at Dartmouth-Hitchcock Medical Center, which serves as the clinical staff of the Dartmouth Medical School. RESULTS: Agreement between the Pipelle and Vabra was high: 74 of 79 (93.7%) samples. The Pipelle obtained adequate samples in 78 of 79 (98.7%) cases as compared with 75 of 79 (94.9%) for the Vabra. The McNemar test comparing these two proportions, adjusting for the fact that the Pipelle and Vabra readings were taken on the same subjects at the same visits, yielded a nonsignificant result (P = .180). CONCLUSION: The Pipelle and Vabra have equal diagnostic accuracy.     

Hantavirus pulmonary syndrome treated with inhaled nitric oxide

BACKGROUND: A retrospective study was done to assess the correlation between endometrial cells on routine cervical cytology and carcinoma of the endometrium. METHODS: In a 4-year period, endometrial cells of some type were identified on the Papanicolaou (Pap) smears of 61 women, of whom 52 had further diagnostic evaluation of the endometrium. Data were analyzed with a multivariate stepwise logistic regression. RESULTS: The results indicated an association of endometrial cells in Pap smears with carcinoma of the endometrium in seven patients (13.5%). In 45 patients (86.5%), the final diagnosis was benign. Factors that impacted the diagnosis of carcinoma were the findings of atypical or cancerous endometrial cells on Pap smear and abnormal vaginal bleeding. CONCLUSIONS: These data indicate the importance of further diagnostic evaluation with endometrial sampling in postmenopausal patients with endometrial cells seen in Pap smears, especially those with abnormal bleeding.     

Response of the primate secretory endometrium to subchronic hypercortisolemia

OBJECTIVE: To assess the impact of subchronic and moderate hypercortisolism on the secretory endometrium of the cynomolgus monkey. METHODS: Osmotic pumps containing hydrocortisone phosphate (HP) were implanted subcutaneously in each monkey on the first day of the menstrual cycle; each monkey also received pumps containing saline in another cycle. Blood was obtained three times per week and urine was collected daily for hormone analyses. Endometriectomy was performed 13 +/- 1 days after the serum estradiol (E2) peak in each study cycle. RESULTS: Infusion of HP elevated serum cortisol levels by an average of 70%. Mean serum progesterone (P) levels were decreased by 50% during the secretory phase of HP-treatment cycles by comparison with self-control cycles (P < .01); as a result, the mean endometrial glycogen concentration was reduced by 30% (P < .05) and the activity of 17 beta-hydroxysteroid dehydrogenase was decreased by 70% (P < .05). Serum E2 levels were not consistently elevated by HP treatment, but cytosolic estrogen receptor levels of the endometrium were decreased by 50% (P < .01), indicating increased estrogenic stimulation. Histologic development of the secretory endometrium was retarded, but the length of the secretory phase was not affected by the treatment. CONCLUSION: A moderate elevation of serum cortisol levels over one menstrual cycle consistently produced a reduction in serum P and a hypoprogestogenic-hyperestrogenic response of the secretory endometrium in the cynomolgus monkey.     

Studies on the increase in the incidence of endometrial and ovarian in cancer in Czechoslovakia during 1960-1973

During the time period of the last 12 years the incidence of the endometrium carcinoma in the whole CSSR rised to 155,5% in the consideration of the incidence in the years 1961 to 1963. In the same time period the incidence of the ovarial carcinoma has grown up to 117,8% only, what seems to be still in the limits of average incidence shift of all female malignancies in the CSSR (117,1%). The rising incidence of endometrium carcinoma affects primarily the elderly women, but testiefies also that this malignancy is among them today much more frequent. Therefore the rising incidence cannot be explained only as a manifestation of elderly of the female population. In agreement with this reality the endometrium carcinoma is today diagnosed significantly more frequently also among the younger women (at least since 40 years of age). The totals of all endometrium carcinomas rised even more than incidence. The gynaecologists meet today 162% of such malignancies in comparison with the numbers in the years 1961-1963. It means that in the whole CSSR yearly 500 endometrium carcinomas more are diagnosed than before 12 years. The incidence of cervix carcinoma dropped during the same period significantly and the endometrium carcinoma became therefore nearly as frequent as cervical malignancy (1:1,2). Possible reasons of these frequency changes are discussed.