Vaginal hysterectomy for therapeutic abortion and simultaneous sterilization (author's transl)

Report about the experiences in termination of 25 early pregnancies by vaginal hysterectomy in cases final infertilisation was necessary. Advantages of the method are seen in avoiding dilatation of the cervix and in the calculable blood loss as compared to suction or curettage for abortion and simultaneous sterilization. In contrast to many apprehensions the risks do not seem to rise when performing vaginal hysterectomy of the pregnant uterus up to the 12th week. Advantages and criteria of the method are discussed.     

Induction of abortion with 15(S)-15-methyl PGF2alpha (Tham) vaginal suppositories

The repeated administration of vaginal suppositories containing 1 mg 15(S)-15 methyl PGF2alpha (Tham) sucessfully induced abortions in 60 of 62 patients. Among patients who successfully aborted, the mean abortion time was 19.0 hours. The mean abortion time was not related to gestational age or parity. Sixty (96.8 precent) aborted within 48 hours, and 53 (85.5 percent) aborted within 24 hours. Gastrointestinal side effects occurred for 33.9 percent of the patients. Diarrhea was the most frequent side effect. The abortion was complete for 40.3 percent of the patients.     

Serum placental protein 14 (PP14) levels in patients with threatened abortion

Serum placenta protein 14 (PP14) were significantly lower serum levels in patients with threatened abortion at 10 to 20 weeks controls than in normal (normal group, n = 133, median: 52,0 microgram/l [16-83, SD: 17,9],risk group: n=20, median: 34,0 microgram/l [13-63, SD: 13,7]).     

The vaginal transverse low segment hysterotomy for second trimester therapeutic abortion (author's transl)

A series of 100 therapeutic abortions by vaginal hysterotomy is reported. This method of vaginal hysterotomy with a transverse low segment incision just above the internal os of the cervix was first described by Fuchs in 1939. The important advantage of this method is complete avoidance of the uterine cervix. With this method a therapeutic abortion after the tenth week of gestation and in a few cases, up to the 20th week of gestation can be accomplished by a fast one stage technique with few side effects. The method is considered to be superior to the injection methods and the two stage procedures. With skill in vaginal operative techniques, this method can be used in any gynaecological department as a routine method. In this series, 28 cases had concomitant tubal ligations. There were two subsequent pregnancies. Complications were one uterine perforation during the curettage requiring laparotomy and suture. There was one laceration of the trigon of the bladder requiring suture. There were 2 cases of hemorrhage. There were 6 inflammatory reactions in the perimetria of which two required administration of antibiotics. There was superficial thrombophlebitis in one case. And there was a severe coagulation defect in one case of a missed abortion at 5 months gestation.     

Epithelial cell adhesion molecule (Ep-CAM) modulates cell-cell interactions mediated by classic cadherins

The contribution of noncadherin-type, Ca2+-independent cell-cell adhesion molecules to the organization of epithelial tissues is, as yet, unclear. A homophilic, epithelial Ca2+-independent adhesion molecule (Ep-CAM) is expressed in most epithelia, benign or malignant proliferative lesions, or during embryogenesis. Here we demonstrate that ectopic Ep-CAM, when expressed in cells interconnected by classic cadherins (E- or N-cadherin), induces segregation of the transfectants from the parental cell type in coaggregation assays and in cultured mixed aggregates, respectively. In the latter assay, Ep-CAM-positive transfectants behave like cells with a decreased strength of cell-cell adhesion as compared to the parental cells. Using transfectants with an inducible Ep-CAM-cDNA construct, we demonstrate that increasing expression of Ep-CAM in cadherin-positive cells leads to the gradual abrogation of adherens junctions. Overexpression of Ep-CAM has no influence on the total amount of cellular cadherin, but affects the interaction of cadherins with the cytoskeleton since a substantial decrease in the detergent-insoluble fraction of cadherin molecules was observed. Similarly, the detergent-insoluble fractions of alpha- and beta-catenins decreased in cells overexpressing Ep-CAM. While the total beta-catenin content remains unchanged, a reduction in total cellular alpha-catenin is observed as Ep-CAM expression increases. As the cadherin-mediated cell-cell adhesions diminish, Ep-CAM-mediated intercellular connections become predominant. An adhesion-defective mutant of Ep-CAM lacking the cytoplasmic domain has no effect on the cadherin-mediated cell-cell adhesions. The ability of Ep-CAM to modulate the cadherin-mediated cell-cell interactions, as demonstrated in the present study, suggests a role for this molecule in development of the proliferative, and probably malignant, phenotype of epithelial cells, since an increase of Ep-CAM expression was observed in vivo in association with hyperplastic and malignant proliferation of epithelial cells.     

Mechanism of ion transport through lipid bilayer-membranes mediated by peptide cyclo-(D-Val-L-Pro-L-Val-D-Pro)

The cyclic dodecapeptide PV, cyclo-(D-Val-L-Pro-L-Val-D-Pro)3, a structural analogue of the ion-carrier valinomycin, increases the cation permeability of lipid bilayer membranes. This paper reports the results of two types of relaxation experiments, namely relaxation of the membrane current after a voltage jump and decay of the membrane voltage after a charge pulse in lipid bilayer membranes exposed to PV. From the relaxation data, the rate constant for the translocation of the ion carrier complex across the membrane, as well as the partition coefficient of the complex between water and membrane solution interface were computed and found to be about one order of magnitude less than the comparable values for valinomycin (Val). Furthermore, the dependence of the initial membrane conductivity on ion concentration was used to evaluate the equilibrium constant, K, of complexation between PV and some monovalent cations in water. The values of K yield the following selectivity sequence of PV: Na+ less than NH4+ less than K+ less than Cs+ less than Rb+. These and earlier results are consistent with the idea that PV promotes cation movement across membranes by the solution complexation mechanism which involves complexation between ion and carrier in the aqueous phase and transport of the carrier across the membrane. In the particular form of the solution complexation mechanism operating here, the PV present in the PV-cation complex carrying charge across the membrane derives from the side from which the current is flowing (cis-mechanism). As shown previously, valinomycin, in contrast to PV, acts by an interfacial complexation mechanism in which the Val in the Val-cation complex derives from the side toward which current is flowing (trans-mechanism). The comparison of the kinetic properties of these two closely related compounds yields interesting insights into the relationship between chemical structure and function of ion carriers.     

Complement resistance of pathogenic Entamoeba histolytica mediated by trypsin-sensitive surface component(s)

Pathogenic forms of the protozoan parasite Entamoeba histolytica were reported previously to resist the cytolytic effect of the alternative complement pathway (AP) only temporarily during exposure to complement. In contrast, nonpathogenic forms of E. histolytica had been found to show AP resistance as a stable property. We studied the mechanisms of AP resistance of the two forms. Upon exposure to AP activity, resistant pathogenic or nonpathogenic forms bound significantly less C3 products than complement-sensitive pathogenic amebae, indicating that the two resistant forms both inhibited AP amplification. Various enzymatic treatments and inhibition of membrane mobility by cytochalasin B and glutaraldehyde fixation showed that the mechanisms of AP inhibition differed between pathogenic and nonpathogenic forms; in contrast to nonpathogenic forms, pathogenic amebae required intact membrane mobility and a trypsin-sensitive surface component(s) to inhibit AP activation.     

Measurement of placental protein 14 (PP14) not helpful in predicting infertility or spontaneous abortion

Detailed depiction of the vertebral-basilar system is often obscured by other vascular structures on the MR angiogram. A special MR angiography technique that can better delineate the branches of the vertebral-basilar system has been designed and has proved particularly useful in the identification of tortuous vascular branches when they come in contact with the seventh or fifth cranial nerves.     

Legal abortion

We discuss from an analytical point of view the mechanism of pre-pattern formation in a diffusion governed morphogenetic field. The model here considered is a normalized form of one of the models, proposed by Gierer and Meinhardt, based on the general principle of lateral inhibition. The results, obtained in the framework of bifurcation theory, shows that there is a spontaneous formation of a gradient both for activator and inhibitor concentrations if the ratio between the mean squares of the diffusion ranges of inhibitor and activator is greater than a well defined critical value.     

Midtrimester and missed abortion treated with intramuscular 15 (s)-15 methyl PGF2alpha

Abortion was successfully induced in 79 of 80 patients in midtrimester, by the serial administration of 250 microgram of 15 (S)-15 methyl PGF2alpha intramuscularly every second hour until abortion occurred. All 12 patients with missed abortion and 87% of the legal abortion patients aborted within 24 hours. The average period until abortion occurred in the missed abortion group was 8.2 hours (+/- 4.5 SD), and in the legal abortion group 16.4 hours (+/- 7.3 SD). All the patients were given prophylactic treatment for vomiting, using prochlorperazine. The average number of episodes of vomiting was 2.8 per ptient. All but 3 patients were given loperamide or diphenoxylate for "diarrhoea". The average number of episodes of diarrhoea was 2.5 per patient. The frequency of complications was low apart from a case of low uterine rupture.