Curing the human embryo--curing the placenta.
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Embryo Implantation↗
Biomedical subjects
J Hustin
Publications and source records attributed to J Hustin.
[Sacrococcygeal teratoma in adults].
This report describes a case of sacrococcygeal teratoma, a rare pathology belonging to the group of presacral tumors. Its clinical presentation is very variable. In this case, the tumor presented as a pilonidal cyst, which is an atypical form. The teratoma was associated with a spinal malformation, described in 25% of all cases. It was treated by "en bloc" resection with sacrectomy.
Adult↗
Doppler ultrasonographic features of the developing placental circulation: Correlation with anatomic findings.
Color Doppler was used to study the placental circulations of 28 pregnancies between 10 and 17 weeks' gestation. A histomorphometric investigation was performed on placental tissue samples from those pregnancies, and the results were compared with Doppler features. Important changes were found around 14 weeks' gestation in both uterine and umbilical circulations. The appearance of end-diastolic frequencies in the umbilical arteries was related to an abrupt and significant (p less than 0.005) increase in uterine velocity and to the establishment of a continuous intervillous circulation.
Blood Flow Velocity↗
Expression of c-erbB2, TGF-beta 1 and pS2 genes in primary human breast cancers.
The presence of c-erbB2, TGF-beta 1 and pS2 mRNAs was examined in primary breast tumours. The c-erbB2 mRNA was overexpressed in 34% of the tumours. There was a positive, statistically significant correlation between c-erbB2 gene overexpression and nodal status. TGF-beta 1 mRNA was detected in 84% of the tumours, regardless of their clinical status. When possible, the c-erbB2 and TGF-beta 1 proteins were identified immunohistochemically on frozen sections from the same tumours. For TGF-beta 1, the mRNA and immunohistochemical results were divergent in 6 cases, 5 of which did contain clearly detectable mRNA but did not stain with the antibody. The pS2 mRNA was detected in 22% of the tumours and in the BT474 cell line. There was a significant correlation between the presence of pS2 mRNA and of oestrogen receptors. No statistically significant correlation was observed between pS2 and TGF-beta 1 genes expression and the clinical parameters of the tumours.
Aged↗
Histological examination of first trimester spontaneous abortions: the impact of materno-embryonic interface features.
Cytogenetic findings and placental histological features of 319 consecutive first trimester spontaneous abortions were retrospectively investigated. Correlation of cell culture results and microscopic examination based on conventional villous histological criteria showed an overall sensitivity of 45.1% for histology in detecting chromosomal anomalies. Discrepant cases, i.e. normal histology with unequivocal chromosomal anomaly and abnormal histological features suggesting a chromosomal anomaly according to the classical criteria but with a normal karyotype, were reviewed by two independent observers using extended histological criteria including features of the materno-embryonic interface. There was a significant (P < 0.001) increase of the sensitivity of histology to 66.4% for both observers after the second histological examination. Macerated specimens or incomplete specimens made of chorion laeve or maternal decidua only are difficult to evaluate, and represent the main cause of discrepancy between cytogenetics and morphology. The results of this study indicate that the sensitivity and specificity of microscopic examination in cases of early spontaneous abortion may be improved by adding features of the materno-embryonic interface to classical villous histological criteria.
Abortion, Spontaneous↗
The human placenta becomes haemochorial at the 13th week of pregnancy.
Histological specimens of recent implantation sites are the basis of our current concept on human embryo implantation and placental development. In the Carnegie Collection maternal red blood cells were detected early in the primitive intervillous space (10th-12th day after conception). These cells were localized to the trophoblastic lacunae and originated from distended peripheral maternal sinusoids (Kaufmann, 1981). The classical theory states that progressively more and more maternal vessels are tapped. A true maternal blood flow is established around the 29th day. Dynamic investigations of human placental development in vivo are scarce and hampered by ethical considerations and the absolute requirement to refrain from using non aggressive and potentially harmful techniques. Despite these limitations such studies provide new insights that surprisingly contradict our previously and seemingly definitely established knowledge of the early phases of placental vascularization, and lead us to conclude that there is an absence of maternal blood circulation in the intervillous placental space (IVS) during the 12 first weeks of human pregnancy.
Female↗
Prenatal diagnosis of cystic hygroma and chorioangioma in the Wolf-Hirschhorn syndrome.
We report the prenatal diagnosis of Wolf-Hirschhorn syndrome (4p-) in a 24-week-old fetus. Echographic features included cystic hygroma, a complex heart defect with right ventricular hypoplasia, and a large placental chorioangioma. We suggest that chorioangioma may be associated with chromosomal imbalance and that systematic careful morphologic examination of the fetus and karyotyping of any pregnancy in which large chorioangioma is detected is advisable. Jugular lymphatic obstruction sequence has not been reported so far in association with 4p-syndrome.
Abnormalities, Multiple↗
Unusual intramandibular neural tumor.
Neural tumors within the jaw bones are exceptional. We present the histologic observation of a central mandibular tumor of neural origin. Immunohistochemistry confirmed the neural nature of the tumor, which had features of a schwannoma (neurilemmoma) together with ganglion cells as seen in ganglioneuroma. Moreover, the association with an intracranial tumor, possibly a meningioma, is emphasized.
Aged↗
Investigation of placental circulations by color Doppler ultrasonography.
The placental circulations of 25 normal and five complicated pregnancies were studied by color Doppler ultrasonography. Flow velocity waveforms were obtained in all 30 pregnancies and could discriminate between fetal and maternal intraplacental blood flow. We believe that color Doppler ultrasonography will improve our understanding of the pathophysiology of various pregnancy disorders that alter the placental circulations and that color ultrasonography is useful for the prenatal differential diagnosis of intrauterine masses.
Blood Flow Velocity↗
Placental vascular anomaly with diffuse mesenchymal stem villous hyperplasia. A new clinico-pathological entity?
Diffuse mesenchymal hyperplasia of placental stem villi produces a pathological increase of placental volume, gives images of partial hydatidiform mola on ultrasound examination and is associated with elevated levels of alpha feto-protein. On gross examination, the placenta is enlarged, the vessels on the fetal plate show aneurysmal and varicose dilatations, and the stem villi appear as distinct, semitranslucent lobulated structures. At microscopy level, stem villi show excessive proliferation of mesenchymatous tissue with foci of myxoid degeneration and large macrophages containing alcian blue positive material within cytoplasmic vacuoles. Involved areas show blood vessels with abnormally thin walls, which are negative to factor VIII and alpha feto-protein immunohistochemical reactions. Pathological trophoblastic proliferation or stromal trophoblastic inclusions are not part of this condition. Although there is a clear predominance of a female genotype in this cases, the true sex incidence in placental vascular anomalies with diffuse mesenchymal stem villus hyperplasia has yet to be defined.
Adult↗
Development of the secondary human yolk sac: correlation of sonographic and anatomical features.
Transvaginal ultrasound examination of the secondary yolk sac was performed in 145 first trimester pregnancies with a normal outcome (Group A), in 10 normal pregnancies undergoing artificial termination (Group B) and in 25 pregnancies that subsequently failed (Group C) due to embryonic death (n = 17) or to spontaneous abortion of a live embryo (n = 8). The yolk sac structure of all cases from Group B and from 12 cases of Group C were examined morphologically, in order to investigate the changes secondary to normal yolk sac senescence or to pregnancy complication and to evaluate the relationship existing between these changes and ultrasound features. The yolk sac diameter measured in vivo increased significantly between 6 and 10 weeks of gestation and then decreased significantly. Morphologically, the yolk sac showed degenerative changes after 9 weeks of gestation suggesting that the disappearance of the yolk sac in normal pregnancies was a spontaneous event of embryonic development rather than the result of mechanical compression by the expanding amniotic cavity. Yolk sac measurements in complicated pregnancies were not predictive of pregnancy outcome. Irrespective of gestational age, important degenerative changes were found in pregnancies complicated by embryonic death or disappearance, suggesting that variation of yolk sac size and appearance in these cases is the consequence of abnormal embryonic development of death rather than being the primary cause of early pregnancy failure.
Cytoplasm↗
Markedly elevated maternal serum alpha-fetoprotein associated with a normal fetus and choriocarcinoma of the placenta.
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Choriocarcinoma↗
[Amniocentesis and trophoblastic biopsy. Comparison of results].
The purpose of this study was to compare the changes observed over 4 years in the prenatal diagnosis of genetic diseases and congenital malformations by amniocentesis (AC) and trophoblast biopsy (TB). Between January 1, 1986 and December 31, 1989, 2,591 requests were recorded in a wide geographical area. A general increase in the number of cases per year was observed (414 in 1986, 870 in 1989). The number of requests for TB has distinctly raised in absolute values (14 cases in 1986, 250 in 1989), as well as in relative values compared with AC (3.5% in 1986 40% in 1989). The number of foetal abnormalities detected has tended to diminish with AC (3%) and to increase with TB (4%). At the time of sampling, there was no significant difference in the mothers' mean age between AC (33.9 years) and TB (36.4 years).
Adolescent↗
Transvaginal color Doppler assessment of the uteroplacental circulation in early pregnancy.
Transvaginal color Doppler was used to investigate the uteroplacental circulation of 45 patients with normal intrauterine pregnancies at 4-18 weeks' gestation. The main uterine artery and the radial and spiral arteries were demonstrated, and characteristic flow velocity waveforms were obtained in more than 90% of cases. The indices of impedance to flow decreased with gestation and there was a progressive fall in these indices from the uterine artery, through the radial, to the spiral artery. Blood velocity in the uterine artery increased exponentially with gestation.
Adult↗
Hematoma of the umbilical cord secondary to cordocentesis for intrauterine fetal transfusion.
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Blood Transfusion, Intrauterine↗
Placental alkaline phosphatase in developing normal and abnormal gonads and in germ-cell tumours.
The evolution of the gonads during intra-uterine development has been followed by immunohistochemical demonstration of placental-like alkaline phosphatase (PLAP) at the germ-cell level. PLAP immunopositivity was restricted to the limited period when germ cells were not surrounded by granulosa or Sertoli cells. Abnormal fetuses or neonates presenting with chromosomal anomalies frequently had disorganized gonads where germ cells retained their membrane PLAP immunopositivity. This abnormal immunopositivity is similar to that expressed by abnormal germ cells in testicular in situ carcinoma, in gonadoblastoma (case of 45,XO/46,XY mosaic) and in seminoma. The pattern of positivity for other germ-cell tumours was highly variable. We suggest that in abnormal gonads, dysgenetic or neoplastic, an early embryonic property is retained by abnormal germ cells. Its importance in the process of neoplastic induction remains to be defined.
Adolescent↗
[Breast tumor with myoepithelial cells. Apropos of a case report].
A case of malignant myoepithelioma of the breast is reported. Mammographic and echographic features are not typical. Diagnosis of this rare lesion mainly relies on histological and immunocytological findings. This potentially malignant tumor must be totally resected given the risk of recurrence. To the author's knowledge, this is the third report of a breast myoepithelioma that has metastasized.
Adult↗
Embryonic remnants of the umbilical cord: morphologic and clinical aspects.
Embryonic vestiges of the umbilical cord are classic findings in routine morphologic examination of the placenta. In order to evaluate their clinicopathologic significance, we examined samples from the fetal and placental ends of 1,000 umbilical cords and collected the principal clinical findings of the corresponding newborns. Microscopic evidence of embryonic remnants were found in 231 cases (23.1%) divided into remnants of the allantoic duct (63%), the omphalomesenteric duct (6.6%), and the embryonic vessels (30.4%), including one case of hemangioma and an accessory small artery. There were no significant clinical differences between the three vestigial groups, and no particular association with congenital malformations or perinatal complications. In 70.9% of the cases, the embryonic remnants were found at the fetal end of the umbilical cord, where most tumors of the cord develop.
Allantois↗