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Effects of cornual catheterization on uterotubal histology and function.

OBJECTIVE: To assess histologic damage and functional impairment following coaxial tubal catheterization. DESIGN: Prospective randomized controlled study. SETTING: Research laboratory. PATIENT(S): Ninety-two female New Zealand rabbits. INTERVENTION(S): Tubal cannulation and mating. MAIN OUTCOME MEASURE(S): Rabbits randomized for placement of unilateral catheter and guide wire (group 1), unilateral catheter and guide wire plus falloposcope (group 2), and catheterization as in group 1 or 2 but using a cage catheter (groups 3 and 4, respectively). A fifth group consisted of rabbits with tubal perforations. Rabbits were killed at 2 or 4 weeks after catheterization or after mating. The sixth group consisted of only control rabbits. RESULT(S): Only one catheterized tube in groups 1 and 3 showed inflammation, fibrosis, or edema. None of the tubes manifested ciliary loss. Serosal tubal adhesions were identified in two tubes in group 1, in one in group 3, in three tubes in group 5, and one in the control group. The nidation index in control and nonperforated catheterized tubes ranged from 72%-95% (not significant). Nidation index in tubes unintentionally perforated was 81%. CONCLUSION(S): Catheterization of the uterotubal junction and fallopian tube in rabbits does not cause long-term tubal damage or impair tubal function.

Animals↗

The effect of tubal injection of methotrexate on fertility in the rabbit.

OBJECTIVE: To investigate the fertility of rabbits after tubal injection of methotrexate (MTX). DESIGN: The side of injection of MTX was randomly decided in a prospective experimental trial. PARTICIPANTS: Fourteen female New Zealand White Rabbits were believed to be of normal reproductive status. INTERVENTIONS: Methotrexate or Ringer's solution were injected into the tubes of the rabbits. The nidation index was used to measure the fertility of the animals. RESULTS: The average nidation index of the control tubes was not statistically different of the one of the tubes treated with MTX. CONCLUSION: Tubal injection of MTX has no adverse effect on fertility of rabbits. It seems ethical to investigate tubal injection of MTX as an alternative to laparoscopic management of unruptured ectopic pregnancy in the human.

Animals↗

[Spleen autotransplantation--comparative animal experiment study of implantation sites].

Iatrogenically induced local splenosis seems to be a method for the partial preservation of splenic functions with appealing surgical simplicity. Pathophysiological aspects, such as flow direction of splenic venous blood, the ectopic occurrence of potential splenic affections, and the formation of pseudoabscesses as well as the preconditions for nidation of the autografts have not been sufficiently investigated so far. Sixty Wistar-rats, divided into four groups according to the surgical procedure performed (sites of implantation: omentum majus, liver, retroperitoneal space, pedicular omental flap), were subjected to macroscopical and histological studies with regard to the nidation of splenic autografts. Based on the results obtained and considering the above mentioned criteria, a pedicular omental wrap technique with or without retroperitoneal shifting and autograft fixation with fibrin glueing are suggested as the most preferable procedure.

Animals↗

Postoperative adhesion formation and reproductive outcome using Interceed after ovarian surgery: a randomized trial in the rabbit model.

The efficacy of an oxidized regenerated cellulose barrier (Interceed) in reducing postoperative adhesion formation and improving reproductive outcome after ovarian surgery was evaluated in a prospective randomized trial. Twenty-nine New Zealand White female rabbits were submitted to a mid-line laparotomy and a standardized surgical incision was made on both ovaries. At random, one ovary was entirely wrapped in a sheet of Interceed, whereas the contralateral ovary was left uncovered. Four weeks following surgery, the rabbits were mated with a male of proven fertility. Two weeks later, a second-look laparotomy was performed by a blinded observer who evaluated the incidence and score of adhesions, the number of corpora lutea in each ovary, the number of embryos in the ipsilateral uterine horn and also calculated the nidation index for each side. Adhesions were observed in 66% of Interceed-covered and in 97% of control ovaries (P < 0.0001). The adhesion score on the Interceed side was significantly lower than on the control side. The nidation index for the Interceed side was significantly higher than for the control side. The authors conclude that, in the rabbit model, Interceed significantly reduces the incidence and score of postoperative ovarian adhesions and significantly improves reproductive outcome.

Animals↗

Hormonal dependence of pinopode formation at the uterine luminal surface.

The uterine luminal epithelium during the period of receptivity for nidation displays characteristic protrusions of the apical surface named pinopodes. The effects of oestradiol and progesterone, singly or in combination, on the formation and regression of pinopodes were investigated using scanning electron microscopy. The appearance of pinopodes was found to be strictly progesterone dependent. When given together with progesterone, before the development of pinopodes, high doses of oestradiol (plasma level approximately 300 pmol/l) inhibited pinopode formation; on the contrary, low doses of oestradiol (nidatory doses) did not interfere with the process until the 4th day of treatment. When oestradiol was given as a single injection, after pinopode formation, both doses were equivalent in inducing their regression 48-72 h later. It appears that the hormonal conditioning for pinopode formation and for the development of uterine receptivity for egg implantation is the same. These observations support the hypothesis that pinopodes could be an extremely useful tool to estimate uterine receptivity. The experiments we describe here, together with observations made a few years ago, in stimulated cycles in the human, suggest that implantation failure as a result of a hormonal imbalance during the time intervening between ovulation and nidation, may be a general phenomenon.

Animals↗

Phospholipids reduce gastric cancer cell adhesion to extracellular matrix in vitro.

BACKGROUND: Nidation of floating tumour cells initiates peritoneal carcinosis and limits prognosis of gastro-intestinal tumours. Adhesion of tumour cells to extracellular matrix components is a pivotal step in developing peritoneal dissemination of intraabdominal malignancies. Since phospholipids efficaciously prevented peritoneal adhesion formation in numerous animal studies we investigated their capacity to reduce adhesions of gastric cancer cells to extracellular matrix components (ECM). METHODS: Human gastric cancer cells (NUGC-4, Japanese Cancer Research Resources Bank, Tokyo, Japan) were used in this study. Microtiter plates were coated with collagen IV (coll), laminin (ln) and fibronectin (fn). Non-specific protein binding of the coated wells was blocked by adding 1% (w/v) BSA (4 degrees C, 12 h) and rinsing the wells with Hepes buffer. 50.000 tumour cells in 100 microl medium were seeded into each well. Beside the controls, phospholipids were added in concentrations of 0.05, 0.1, 0.5, 0.75 and 1.0/100 microl medium. After an incubation interval of 30 min, attached cells were fixed and stained with 0.1% (w/v) crystal violet. The dye was resuspended with 50 microl of 0.2% (v/v) Triton X-100 per well and colour yields were then measured by an ELISA reader at 590 nm. Optical density (OD) showed a linear relationship to the amount of cells and was corrected for dying of BSA/polystyrene without cells. RESULTS: The attachment of gastric cancer cells to collagen IV, laminin, and fibronectin could be significantly reduced up to 53% by phospholipid concentrations of 0.5 mg/100 microl and higher. CONCLUSION: These results, within the scope of additional experimental studies on mice and rats which showed a significant reduction of peritoneal carcinosis, demonstrated the capacity of phospholipids in controlling abdominal nidation of tumour cells to ECM components. Lipid emulsions may be a beneficial adjunct in surgery of gastrointestinal malignancies.

Cell Adhesion↗

Effect of the timing of perphenazine administration on pregnancy in the rat.

Perphenazine in doses of 10--50 mg kg-1 day-1 given at the early stages of pregnancy delayed nidation up to day 8 of pregnancy. Once nidation had occurred the length of the rest of the gestation period was normal. Doses of up to 20 mg perphenazine kg-1 day-1, injected on days 1--7, prolonged gestation but the mothers and young were apparently normal; lower doses were effective only when treatment commenced soon after copulation. The delay in implantation of the ovum caused by perphenazine was corrected and and implantation was brought about immediately, by injection of 0.1 microgram oestradiol together with perphenazine. It is suggested that perphenazine delays and prevents implantation in rats by counteracting oestrogen release from the ovaries.

Animals↗

Ultrastructure of endometrial surface relief in normal menstrual cycle and after hormonal stimulation.

Ultrastructure of the superficial relief of the endometrial epithelium was investigated under the scanning (SEM) and transmission electron microscopes (TEM) in a group of patients after the hormonal stimulation, performed in the program of in vitro fertilization and embryotransfer. The results were compared with those obtained in a group of patients studied during the secretory phase of normal menstrual cycle. Total 26 bioptic samples were subjected to the investigation, 13 in each group. Different types of the epithelial surface were classified in TEM and SEM and their relative amount was evaluated quantitatively in TEM. Special attention was paid to the pinopodes, considered as specific markers of the nidation window. Differences in the number of pinopodes were observed under the SEM in two groups of patients after different schemes of the hormonal treatment. These differences were not manifested under the TEM due to the small frequency of pinopodes in the ultrathin sections. The ultrastructural changes observed in the two groups of patients after different schemes of hormonal stimulation can be considered as signs of the changed metabolic activity of the endometrial epithelium and they can reflect the different endometrial receptivity for nidation.

Cell Membrane↗

[Functional aspects of healing in microsurgical tubal anastomosis--experimental studies of the rabbit fallopian tube].

Ovarian function and fertility was studied in 46 female New Zealand White rabbits after isthmic-isthmic reanastomosis of the oviduct. Postoperative ovarian function was slightly suppressed and returned to normal after two month. No significant differences were found between the control side and the side of anastomosis. Fertility was reduced directly after surgery on the side of anastomosis as well as on the control side. On the side of reanastomosis a continuous increase of tubal function occurred up to two month after surgery. At this time tubal function was reduced to 30%, the nidation index was about 0.6. Tubal function of the untreated oviduct was nearly normal (nidation index 0.8) two weeks after surgery.

Animals↗

A single continuous suture as a possible alternative to the interrupted suture for tubal anastomosis.

A simple alternative for microsurgical anastomosis of the fallopian tube is presented. The anastomosis is composed of a single continuous suture (8-0 nylon) extending through the serosa and muscularis, avoiding the mucosa. Experimentally this technique was performed on the uterine horns of 30 female rats and compared with the conventional interrupted suture technique on 30 additional female rats. Patency was established histologically in 100% of operated horns in both groups, with an average nidation index of 0.7 in the study group as compared with 0.6 in the conventional technique group. The results indicate that this simple method of anastomosis, which reduces operative time significantly, does not affect patency or nidation index in this model as compared with the conventional interrupted suture technique. It may, therefore, be a suitable procedure for anastomosis of equal-sized segments of the fallopian tubes, especially in cases of reversal of sterilization.

Anastomosis, Surgical↗

[Morphological causes of tubal pregnancy].

Histological examination was done of 103 fallopian tubes removed surgically due to tubal pregnancy. The examinations were done for finding the causes of abnormal nidation of the fertilized ovum. Sections were taken semiserially. The most frequent change (54.3% of cases) was presence of chronic inflammation with infiltrations composed of lymphocytes and plasma cells, and adhesions between the mucosal folds. Foci of decidual transformation in tubal wall were found in 13.6%, diverticula in 9.7%, and foci of tubal endometriosis in only 2.9% of cases. It is postulated that histological diagnosis should include, besides information on the presence of fertilized ovum, also a description of associated lesions which could be responsible for abnormal nidation.

Adult↗

The expression of alpha(1)-acid glycoprotein mRNA during rat development. High levels of expression in the decidua.

During the acute phase response to inflammation the plasma concentration of some proteins, such as alpha(1-acid glycoprotein (AGP), increases dramatically. Since breakdown and remodeling of tissue is common to both nidation and inflammation we studied the tissue distribution and regulation of AGP mRNA levels during the embryonic development of the rat. High levels of mRNA coding for AGP were detected in the placenta during early fetal development. Expression of this mRNA was confined to the decidua and was first observed approximately 1 day after implantation when proliferation of the decidua is already well advanced. Maximum levels were attained about 5 days after implantation, after which the levels decreased rapidly. In contrast to the high levels of AGP mRNA in the decidua only very low levels were detected in fetal liver and visceral yolk sac, and there was only a small increase in the levels in maternal liver. Corticosteroid hormone responsiveness of AGP mRNA synthesis by hepatocytes appeared 3 days before birth. It is likely that the synthesis of AGP by the cells of the decidua is important in establishing the precisely controlled interaction between mother and embryo during nidation.

Aging↗

[Reproductive pharmacology of prostaglandins].

Effects of prostaglandins and their analogues in reproduction were investigated using rats and Japanese monkeys. Prostaglandin of the F series exerted uterine contractile, luteolytic, anti-nidation and abortifacient effects. Prostaglandins of the E series exhibited a potent uterine contractile effect, although their luteolytic, anti-nidation and abortifacient effects were much less potent than those of the PGF series. A comparison of animal and human data on prostaglandins and their analogues indicated a good cor-relationship between the uterine contractile effect in animals (rates and monkeys) and the abortifacient or labor inducing effect in humans.

Abortifacient Agents↗

Loupes or microscope for tubal anastomosis? An experimental study.

Standardized tubal anastomoses were performed alternatively using magnifying loupes or an operating microscope in 44 rabbits. The surgeon's personal assessment of the integrity of the anastomoses was subsequently compared with the histologic result and with pregnancies and nidation indices. After an initial learning period, the surgeon became equally satisfied with his intraoperative assessment of the anastomoses in both treatment groups. Healing was marginally better when the microscope was employed. Animals which had tubal anastomosis performed with the use of the microscope became pregnant in 81% of cases, whereas when the loupes were employed only 5% became pregnant. Measurement of the nidation index showed similar trends. It is concluded that the use of the microscope will offer superior results once the surgeon has gained limited experience with its use.

Animals↗

[Clinical significance of detection time and site of early gestational sac by ultrasonography].

Ultrasonography was used to determine not only the shape but also the appearance time and site of GS before the formation of the embryo. These factors were analysed for their clinical significance in association with early GS. The following results were obtained. 1. GS with diameters of 2 < or = approximately < or = 4 mm (abr. EGS) were found at 17-25 postovulatory days (gestational age: GA 4w2d-5w3d) in the ovulation presumed group. EGS was detected at GA 4w2d-7w5d in the normal menstrual group and 17.6% of cases were detected at GA 6w or later. 2. 95.3% of EGS were found in the upper 2/3 of the uterine cavity, while only 4.6% were found in the lower 1/3. This difference in incidence was significant. When EGS was found in the lower uterine segment at GA 6w or later, the abortion rate was very high. 3. In cases where gestation continued to term, there was no difference between the ovulation presumed and normal menstrual groups in terms of various fetal conditions. When normal menstrual group cases where EGS was detected at GA 6w or later were compared with the members of the ovulation presumed group, gestation duration was prolonged in the former. From the above mentioned findings, it can be concluded that even in the early stage of gestation, there can be individual growth differences and that in cases with normal menstrual cycles, gestation can take place much later than the expected date of ovulation, and further that the diagnosis of intrauterine gestation should be postponed until the end of GA 6w. Many blighted ova are detected in cases where GS is found at GA 6w or later, but when gestation is carried to term, no fetal growth abnormalities are found. The ideal nidation site is the endometrium near the fundus and when nidation takes place in the lower segment, the incidence of abortion or placenta previa is very high.

Abortion, Spontaneous↗

Changes in lysosomal enzyme activities in pre-ovulatory follicles and endometrium of PMSG superovulated rats.

Large superovulatory doses of gonadotrophins result in reduced fertility in laboratory and large domestic animals and it has been postulated that some of the superovulated oocytes are derived from abnormal follicles which would not ovulate under normal physiological stimuli. Follicular growth, follicular maturation and atresia, ovulation and the nidation of the fertilized oocyte require intense tissue remodelation which can be accomplished only through the action of hydrolytic enzymes. We have studied the activities and sub-cellular distribution of three lysosomal enzymes (acid phosphatase, N-acetyl-beta-D-glucosaminidase and beta-glucuronidase) in the follicular fluid, granulosa and theca cells of preovulatory follicles and in the endometrial tissue of immature Wistar rats injected with 4 (control) or 40 (superovulated) IU of pregnant mare serum gonadotrophin (PMSG). Enzyme activities were from four to ten times higher in theca than in granulosa cells. This difference was particularly important in the case of beta-glucuronidase. Large preovulatory follicles tended to have higher activities of lysosomal enzymes in the free fraction of all the compartments studied. This difference was remarkable in theca cells where free enzymes would be required to help ovulation. Forty IU of PMSG induced higher activities of acid phosphatase in theca and granulosa cells than 4 IU, but in endometrial tissue this latter dose of PMSG was more efficient to induce higher activities of this enzyme. The endometrial bound fraction of N-acetyl-beta-D-glucosaminidase was almost three times higher than the free activity. This behavior was also observed in endometrial beta-glucuronidase but only in the control rats. The results observed in follicular fluid were less homogeneous. The activities of glucosaminidase and acid phosphatase were two to three times higher in rats overstimulated with 40 IU of PMSG than in the control rats, whereas the activities of beta-glucuronidase were lower in the superovulated rats. Our results suggest that alterations in the process of tissue remodeling required for ovulation of mature, normal oocytes and for nidation of the fertilized ovum may be important factors to explain pregnancy failure in the PMSG superovulated female.

Animals↗

Pregnancy in relapsing polychondritis: twenty-five pregnancies in eleven patients.

OBJECTIVE: To determine maternal and fetal outcome in pregnant women with relapsing polychondritis (RP). METHODS: Retrospective review of 11 records selected from among those of 116 female RP (Michet's criteria) patients. RESULTS: In these 11 women, 25 pregnancies occurred after or concomitantly with the onset of RP. The mean (+/- SD) age at RP onset was 25 +/- 5 years (range 15-31). Therapeutic abortion was performed in 1 woman because of ongoing cyclophosphamide treatment. Disease flare occurred in 7 of 24 pregnancies, requiring treatment modification in 2 cases. RP was considered stable in 16 and asymptomatic in 1 of the 24. Treatment of RP was with nonsteroidal antiinflammatory drugs (2 of 24), steroids (13 of 24), dapsone (7 of 24), or plasma exchanges (1 of 24); no treatment was given in 8 of the 24 pregnancies. In 14 pregnancies, the course was uneventful. Ten pregnancies were complicated by ectopic nidation (n = 3), spontaneous abortion (n = 3), premature birth (n = 3), and premature rupture of membranes (n = 1). Eighteen normal children were born. CONCLUSION: Pregnancy does not seem to modify the course of RP. Successful pregnancies may be achieved in women with RP. No RP was observed in the neonates.

Abortion, Spontaneous↗

Morphogenesis of the fetal membranes of an American mole, Scalopus aquaticus.

Scalopus membranes are characterized by: Superficial nidation; antimesometrial orientation of the embryonic disc; amniogenesis by folding; an extensive but transitory choriovitelline placenta; a large yolk sac with late and incomplete inversion; large persistent allantoic vesicle; a very broad, thin, villous, epitheliochorial chorioallantoic placenta of annular shape interrupted mesometrially, dotted with numerous areolae, and bordered by a nonvillous sparsely vascular chorioallantoic membrane connected with the persistent bilaminar omphalopleure by a very narrow rim of chorion. There is no decidua. Electron microscopy shows that at 8 mm, CR, (limb bud embryo) the uterine epithelium of the interhemal membrane may be 0.5 micron or less in thickness, but that it shows no signs of degeneration. Trophoblastic microvilli often penetrate the epithelium to within 0.2 micron of its base. At this time there is active secretion by the uterine glands, and cellular hypertrophy and cytolysis of the epithelium at the gland mouths, with active phagocytosis by the areolar cytotrophoblast. The occurrence of absorptive areolae in an insectivore emphasizes the probable primitiveness of this widely distributed placental mechanism. In spite of similarities of the yolk sac to that of rabbits and rodents, the bilaminar omphalopleure produces no invasive trophoblastic giant cells. The definitive membranes of Parascalops breweri and Scapanus latimanus are like those of Scalopus. The placentae of Talpa europaea, Condylura cristata, and Neurotrichus gibbsii are discoid and relatively much smaller, thicker and more complex in internal structure. There is some reason to believe that the fetal membrane systems of moles and shrews (Soricoidea) are more like those of the ancestral mammalian stock than are those of any other recent eutherians.

Animals↗