The effects of benzoylecgonine, oxytocin, ritodrine and atosiban on the contractility of myometrium. An experimental study.

PURPOSE: To investigate the response of pregnant and non pregnant rat myometrium to benzoylecgonine, a cocaine metabolite, and oxytocin and to investigate the efficiency of ritodrine and atosiban to overcome the effects of benzoylecgonine and oxytocin. METHODS: Isolation of rat myometrial tissue and recording of contractile activity with isotonic muscle transducer. RESULTS: Benzoylecgonine and oxytocin increase myometrial contractility, while atosiban and ritodrine induce myometrial relaxation. Atosiban was able to revoke the action of oxytocin but not the action of benzoylecgonine. Ritodrine was able to induce muscle relaxation in both oxytocin and benzoylecgonine administration. CONCLUSION: Cocaine metabolites seem to act on the myometrium through different pathways compared with oxytocin. After comparing two widely used tocolytic agents: atosiban and ritodrine, it is indicated that only ritodrine, a beta2 adrenergic receptor agonist, can inhibit the action of cocaine metabolites. This finding indicates that the actions of cocaine on adrenergic mechanisms are responsible to a large part for its effects on myometrium contractility. The use of beta2 adrenergic receptor agonists seems to be preferable for the treatment of myometrial contractions induced by cocaine consumption.

Effectiveness of transvaginal colporrhaphy with porcine acellular collagen matrix in the treatment of moderate to severe cystoceles.

PURPOSE: The aim of this study was to determine the effectiveness of transvaginal anterior colporrhaphy with the use of porcine acellular collagen matrix in the treatment of moderate to severe cystocele. MATERIALS AND METHODS: This retrospective study included 95 patients who underwent anterior colporrhaphy with the use of porcine dermus from September 2003 through March 2008 at the Gynaecological Department of University General Hospital of Alexandroupolis in Greece. The inclusion criterion was a grade 2-4 cystocele by the Baden-Walker halfway system. Postoperatively patients were evaluated at one, six and 12 months. Objective cure was defined as no or grade 1 cystocele with an asymptomatic patient at 12 months postoperatively. Improved outcome was considered as an asymptomatic patient with a grade 2 cystocele and failure symptomatic patients or with grade 3 or 4 cystocele. RESULTS: All of the patients had a 12-month postoperative follow-up or were noted as a failure prior to the 12-month assessment. The majority of the women were menopausal (88.4%) and overweight (mean BMI 26.1). The overall cure rate was 81.1%, the improvement of the cystocele was 10.5% while the failure rate was 8.4%. The complications we noted were vaginal erosion in 2.01% and graft extrusion in 1.05% of the patients. CONCLUSION: Transvaginal anterior colporrhaphy using porcine dermal in the treatment of moderate to severe cystocele is simple, safe, easily learned and performed with a high success rate and low morbidity.

Intraoperative estimation of sentinel lymph nodes in breast cancer by imprint cytology.

BACKGROUND: Frozen section biopsy has been widely used for intraoperative diagnosis and evaluation of sentinel lymph nodes, so a decision can be made regarding whether to perform axillary clearance during primary surgery. This study aims to discuss the reliability of a simpler and faster method - touch imprint cytology - in the interpretation of metastasis from breast cancer. METHODS: A retrospective review of 41 sentinel lymph node biopsies from patients with breast cancer were examined by intraoperative imprint cytology using rapid Diff-Quick staining. Paraffin-embedded permanent sections were examined using hematoxylin and eosin stained sections from the sentinel lymph nodes in collaboration with the employment of an anti-cytokeratin antibody. RESULTS: Sixteen of all sentinel nodes harbored metastases in the paraffin sections, of which all 16 were identified by imprint cytology (sensitivity 93%). CONCLUSION: Touch imprint cytology is a fast and reliable alternative for intraoperative evaluation of sentinel lymph nodes in breast cancer patients.

Results after hysteroscopic management of premenopausal patients with dysfunctional uterine bleeding or intrauterine lesions.

AIM: The purpose of this study was to evaluate the efficacy, safety and benefits of hysteroscopic surgery in the management of dysfunctional uterine bleeding or intrauterine lesions causing menstrual disorders in premenopausal women. METHODS: We enrolled in this study 228 patients who underwent operative hysteroscopy because of metrorrhagia due to endometrial polyps or submucous myomas diagnosed by hysterosalpingography, transvaginal ultrasound and diagnostic hysteroscopy. In addition, the study population included 27 patients who presented dysfunctional uterine bleeding resistant to medical therapy. These patients underwent total or partial transcervical resection of endometrium (TCRE). RESULTS: Operative hysteroscopy was a successful procedure in 250 of the 255 cases (98%) but it needed to be repeated in three cases with large submucous myomas of type I and II and after two polypectomies. Mean duration of the procedure was 26.1 min (range 4-58) and mean postoperative hospital stay was six hours (range 2-48 hours). There were two cases with fluid overload and five with postoperative uterine bleeding reported in this study. During postoperative follow-up (12-36 months) the majority of patients (246/255 or 96.5%) were free of symptoms. After total or partial TCRE, 23/27 patients (85.2%) reported eumenorrhea or hypomenorrhea, 2/27 (7.4%) amenorrhea and 2/27 (7.4%) metrorrhagia (due to adenomyosis). CONCLUSION: Hysteroscopic surgery is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. In addition, it has the advantages of quick recovery, early return to normal activities and reduced hospital stay for the patient. Careful monitoring of the patients avoids serious complications.

A stromal myoid cell line provokes thymic T-cell immigration at the second and third gestational trimesters.

UNLABELLED: Once lymphoid precursors enter the thymus form the blood stream, they come into contact with thymic stromal cells that guide their maturation into functionally competent T cells. Thymic myoid cells are one such cell type. They have been described as a regular constituent of the thymus of embryonic and young vertebrates and express muscle proteins including myosin, desmin, acetylcholine receptor (AChR), C-protein, MyoD, troponin T, rapsyn, and utrophin. It has been emphasized recently that the thymic myoid cells play an important role in the protection of thymocytes from apoptosis, and in the process of T-cell differentiation and maturation. AIM: To provide a quantitative estimation of thymic myoid cells and T-cell population in different stages of development. A probable interaction between these two populations could explain an additional mechanism to the active T-cell migration from the thymus that is a direct contact to a specific myoid cell line. MATERIALS AND METHODS: Paraffin-embedded specimens from the thymus of forty five human embryos at the first, second and third trimester of gestation respectively, were investigated by conventional histology, and immunohistology for the presence in the stroma of the thymic medulla, of myosin in the myoid cells, and UCHL1 (pan T-cell) antigen in the medullary thymocytes. RESULTS: Our results demonstrated a quantitative difference in the second and third trimester of development concerning the expression of myosin in the stromal myoid cells of the thymic medulla over the equivalent expression of the protein in the first trimester. Similar changes in the above periods were found concerning the population of medullary thymocytes expressing UCHL1 antigen. CONCLUSIONS: Our results indicate that: (1) Thymic myoid cells play an important role in the thymic microenvironment as they are well conserved throughout species evolution. (2) The increased population of myoid cells in the medullary area during mid and late gestational age, in comparison with first trimester, probably reflects the increased demand of the growing fetus for mature T lymphocytes. Contractions of myoid cells mediated by their cytoplasmic structural proteins, including myosin which is well preserved during development, might aid the movement of thymocytes expressing UCHL1 antigen, across or out of the gland, suggesting a potential involvement of myoid cells in the thymic function. Further studies on larger series are needed to corroborate this.

Human embryonal tissues of all three germ layers can express the CD30 antigen. An immunohistochemical study of 30 fetuses coming after therapeutic abortions from week 8th to week 16th of gestation.

Originally, expression of the CD30 antigen was shown to be typical of the tumor cells of Hodgkin disease and of anaplastic large cell lymphomas. In reactive lymphoid tissue, CD30 is expressed only in a small population of activated lymphoid blasts. Since then, several reports have been published describing CD30 expression in non lymphoid tissues and neoplasms, such as embryonal carcinomas, seminomas, cultivated macrophages, histiocytic neoplastic cells, deciduals cells, and mesothelioma cells. In order to gain insight into the functions of CD30, given that it can mediate signals for cell proliferation and apoptosis, we studied the distribution of the antigen in different fetal archival paraffin-embedded tissues from week 8th to 16th of gestation. We investigated the immunohistochemical expression of CD30 in 30 paraffin-embedded tissue samples representing all three germ layers, using the monoclonal antibody Ber-H2 CD30 is expressed early in human fetal development (8th-10th week) in a wide variety of tissues, with the exception of the skin and thymus in which it is expressed later on. This is consistent with the observation that these organs are not fully differentiated before 10th and 13th week, respectively. No expression was observed in the cardiovascular and respiratory systems. The finding of CD30 expression in the terminal period of organogenesis, period, which is highly hormone related, implies that the antigen has an important role in cell development, maturation, and pathway to terminal differentiation in almost all fetal tissues and structures.

NCL-CD30 staining of epithelial cells in the basal germinative layer of the epidermis and epithelial buds during foetal skin development.

The fact that the CD30 molecule can mediate signals for cell proliferation or apoptosis prompted us to perform a systematic investigation of CD30 antigen expression in embryonal tissues during proliferation and differentiation stages. We first targeted the foetal human intestinal cryptae cells with positive results. The epidermis is a dynamic epithelium that is constantly renewed throughout life. The basal layer, attached to the basement membrane, contains the dividing cells of the skin and as cells move up from this layer they undergo differentiation, ending in the formation of a terminally differentiated anucleate cell called squame. It is intriguing to find out if cells in the basal layer can express the CD30 antigen. We investigated the immunohistochemical expression of CD30 antigen in 15 paraffin-embedded tissue samples representing epidermis and epidermal buds from foetuses after spontaneous abortion in the 8th, 10th and 12th weeks of gestation, respectively, using the monoclonal antibody NCL-CD30. A Northern blotting analysis was additionally performed. The results showed that: (1) the epithelial cells of the epidermis in the developing skin express the CD30 antigen; (2) CD30 expression in these epithelial cells is higher in cases of hormonal administration than in normal gestation; (3) a similar positive reaction involved the epidermal buds associated with the development of the skin appendages. Northern blots of tissue sections using a CD30 cDNA probe detected mRNAs of the same molecular mass and variety similarly to those in the positive control cell line HUT 102.

Distribution of somatostatin in pancreatic ductal adenocarcinoma remodels the normal pattern of the protein during foetal pancreatic development: an immunohistochemical analysis.

AIM: To determine the immunoreactivity of somatostatin during the development of the human fetal pancreas and pancreatic ductal adenocarcinoma, given that, somatostatin-positive cells were demonstrated either into its embryonic anlage or into pancreatic cancer. METHODS: Tissue sections from 15 pancreatic fetal specimens, and an equal number of ductal adenocarcinoma specimens were assessed. RESULTS: The density of positive cells in the primitive exocrine ductal epithelium and endocrine epithelium was significantly different from the relevant density in the neoplastic pancreatic tissue of mixed (ductal-endocrine) and pure ductal type (P1=0.021 P2=0.001, P3<0.0001, P4=0.003 respectively). The above values were estimated from the 8th to 10th week. There was no significant difference in the density of positive cells in the mantle zone of the islets from the 13th to the 24th week, and the neoplastic tissue of mixed (P5=0.16) and pure ductal type (P6=0.65). CONCLUSION: The immunostaining for somatostatin identifies a subgroup of pancreatic ductal adenocarcinomas with a neuroendocrine component, (initially considered as pure ductal tumors), and mixed ductal and neuroendocrine tumors. This pattern of expression in neoplasms recapitulates the normal pattern during the embryonal development of the organ, raising the question of therapeutic efficacy of somatostatin and analogues as monotherapy in pancreatic cancer management.

Ber-H2 (CD30) immunohistochemical staining of human fetal tissues.

OBJECTIVE: CD30 antigen has long been considered to be restricted to the tumour cells of Hodgkin's disease and of anaplastic large cell lymphoma as well as to T and B activated lymphocytes. It is now apparent that the range of normal and neoplastic cells, which may express CD30 antigen, is much wider than was at first thought. In order to gain insight into the physiological function of CD30 antigen, we studied the distribution of its expression in the tissues of fetuses from week 8th to week 16th. MATERIALS AND METHODS: We investigated the immunohistochemical expression of CD30 antigen in paraffin-embedded tissue samples representing all systems from 30 fetuses after therapeutic abortion at 8th to 10th and 12th to 16th week of gestation, respectively, using the monoclonal antibody Ber-H2. RESULTS: Our results demonstrated that CD30 is expressed early in human fetal development (8th to 10th week of gestation) in several fetal tissues derived from all three germ layers (gastrointestinal tract, special glands of the postpharyngeal foregut, urinary, musculoskeletal, reproductive, nervous, endocrine systems), with the exception of the skin and hematolymphoid system (thymus), in which the antigen is expressed later on (10th week onwards). Expression of CD30 was restricted to the hematolymphoid system in the 12-16 weeks of gestation. No expression of the marker was observed in the respiratory and cardiovascular systems during the entire period examined. CONCLUSIONS: CD30 antigen is of importance in cell development, and proliferation. It is also pathway-related to terminal differentiation in many fetal tissues and organs.

Cigarette smoking and the degree of maturation of the vaginal squamous epithelium in postmenopausal women.

To determine the effects of cigarette smoking on vaginal squamous epithelium in postmenopausal women, we studied the vaginal smear patterns of 199 healthy postmenopausal non-smokers and 41 healthy postmenopausal smokers, with a mean age of 56 years. A statistically significant difference to the hazard of smokers was found in the percentage of smears manifesting absence of maturation of vaginal squamous cells. A high incidence of atrophic-type vaginal smears in the group of smokers was also found independent of postmenopausal age. In the group of non-smokers, there was a statistically significant difference between the cytologic patterns of smears of women who were in the early postmenopausal age (<10 years) and those many years after (> or =10 years). Finally our data suggest that smokers had an earlier menopause, on average 2.4 years sooner than non-smokers. Cigarette smoking has an effect on vaginal squamous epithelium, but pathophysiology still remains unclarified.

Biomagnetic measurements of the brain activity of preeclamptic pregnant women using a superconducting quantum interference device.

Biomagnetic brain activity was studied in 17 full-term pregnant women with symptoms of pre-eclampsia using the biomagnetometer SQUID. The results show obvious differences both in the waveforms and in the spectra that obtained from statistical Fourier analysis by comparing them with the corresponding results from 87 pregnant women with normal full-term pregnancies. Specifically, in the pathological pregnancies the high magnetic field activity emitted from points of the mother's brain is distributed in the 2-7 Hz band frequency range whereas in normal pregnancies we found low magnetic field activity distributed over the 7 Hz band frequency.

Biomagnetic measurements in uterine leiomyomas using a superconducting quantum interference device (SQUID).

Using the biomagnetometer superconducting quantum interference device (SQUID), the magnetic signals relating to spontaneous uterine activity were measured for the first time in 25 women with uterine leiomyomas, and 12 women with normal, non-leiomyomatous, uteri. Magnetic radiation, in the range of low frequency (below 2 Hz), was of low amplitudes in normal uterine tissues and of high amplitudes in benign leiomyomas. The observed differences were confirmed by the corresponding power spectra obtained from the statistical Fourier analysis. It is suggested that biomagnetic measurements may facilitate the detection of uterine leiomyomas in equivocal cases.