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PubMed2005

Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in a porcine model.

BACKGROUND: We have previously reported the feasibility and safety of the peroral transgastric endoscopic approach for diagnostic peritoneoscopy, liver biopsy, and gastrojejunostomy with long-term survival in a porcine model. This approach eliminates incisions of the abdominal wall, providing a less invasive alternative to diagnostic and therapeutic laparoscopy. We now report successful performance of peroral endoscopic transgastric ligation of Fallopian tubes with long-term survival in a porcine model. METHODS: Six female 50-kg pigs had general anesthesia and irrigation of the stomach with an antibiotic solution. Gastric puncture was performed with needleknife electrocautery followed by balloon dilatation of the tract with 20-mm TTS dilating balloon (Microvasive). A standard upper endoscope that underwent high-level disinfection and gas sterilzation was advanced into the peritoneal cavity through a sterile overtube. Both Fallopian tubes were identified and one was ligated using Olympus Endoloops. The other patent tube served as a control. Tubal patency was evaluated by hysterosalpingogram before and after ligation. After a follow-up period of 2-3 weeks, the pigs were sacrificed for postmortem examination. RESULTS: The Fallopian tubes were easily accessed, identified and ligated in all 6 pigs. In each pig, fluoroscopy confirmed complete obstruction of the ligated tube with preserved patency of the other tube. All pigs survived well and ate heartily without any ill-effects. Postmortem examination did not reveal any peritonitis or intra-abdominal adhesions. The Endoloops were in place with complete obstruction of the ligated tubes and patency of the controls. Histopathologic examination of the tubes showed chronic inflammatory infiltrates without abscesses. CONCLUSIONS: The peroral endoscopic transgastric approach to ligation of the Fallopian tubes with long-term survival is technically feasible and safe in a porcine model. The endoscopic transgastric approach to the peritoneal cavity has potential for a wide array of diagnostic and therapeutic procedures.

Animals↗
PubMed1994

Expression of epidermal growth factor and transforming growth factor-alpha in fallopian tube epithelium and their role in embryogenesis.

We studied the expression of epidermal growth factor (EGF) and transforming growth factor (TGF)-alpha in human fallopian tube epithelium at various menstrual stages. Immunohistochemical staining using anti-EGF and anti-TGF-alpha antibodies showed a specific staining in ampullary tube epithelium at late follicular and luteal stages but the staining was very weak at the early follicular stage. Quantitative reverse transcription and polymerase chain reaction (RT-PCR) using beta-actin mRNA as an internal standard revealed the menstrual-stage-specific expression of EGF and TGF-alpha gene transcripts: amounts of EGF and TGF-alpha mRNA relative to those of beta-actin were significantly higher at late follicular and luteal stages than at the early follicular stage. To clarify the biological role of these growth factors, mouse 2-cell embryos were cocultured with human fallopian tube epithelial cells with or without blocking the action of these growth factors. Cocultures significantly promoted blastocyst formation, but this promotive effect of the tubal epithelial cells was completely abolished by the addition of anti-EGF and/or anti-TGF-alpha monoclonal neutralizing antibodies to the coculture system. These results demonstrated that EGF and TGF-alpha were synthesized and expressed in fallopian tube epithelium at specific menstrual stages, and may be involved in early embryonic development.

Animals↗
PubMed1990

[One or two-point devitalization of the fallopian tubes? A study of methods of bipolar high-frequency coagulation].

122 women were sterilized by laparoscopic electrocoagulation of the fallopian tube using bipolar high-frequency current. In 59 cases the coagulation was performed only once in the isthmic part of each fallopian tube, whereas in 63 cases this was done twice at a distance of 2 cm. Only in the first group of women 3 cases of spontaneous recanalization were registered which means a failure rate of 5%. The histologic examination revealed a completely regenerated regular mucous epithelium. The total rate of complications for both groups amounts to 0.8%. Consequently, in its security, the method of burning twice each fallopian tube is definitely superior to the practice of one-point devitalization only.

Adult↗
PubMed1995

Nitric oxide synthase in the rat fallopian tube is regulated during the oestrous cycle.

Nitric oxide produced from L-arginine by nitric oxide synthase (NOS) acts in a variety of biological processes via the stimulation of guanylyl cyclase and subsequent elevation of cGMP. Constitutive, calcium-dependent isoforms of NOS are found in endothelial cells (eNOS) and neurones (nNOS), while macrophages express an inducible, calcium-independent isoform (iNOS) in response to the action of certain cytokines or bacterial endotoxin. While the regulation of NOS by exogenous glucocorticoids and steroid hormones is well documented, the effects of endogenous steroid hormones on NOS activity, such as those released during the oestrous cycle, is unknown. Here we demonstrate, using specific antibodies for eNOS, nNOS and iNOS, the presence of NOS in the epithelium of rat fallopian tubes at pro-oestrus, late pro-oestrus, oestrus, metoestrus and dioestrus. Western blot analysis of rat fallopian tube homogenates revealed a protein band at approximately 125 kDa which was recognised by antibodies to different isoforms of NOS, but no bands at the expected molecular weights (eNOS, 140 kDa; nNOS, 160 kDa; iNOS, 135 kDa). NOS activity in fallopian tubes was measured by the conversion of L-[3H]arginine to L-[3H]citrulline. Both calcium-dependent and -independent NOS activities were present. However, in late pro-oestrus when circulating oestrogens are low, NOS activity was reduced in comparison to all other stages of the oestrous cycle. Thus we show that NOS is present in the epithelial lining of the fallopian tube and is recognised at a previously undescribed molecular weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Clinical and pathological study of 24 patients with fallopian tube malignancy].

Clinical and pathological analyses were carried out in 24 patients with fallopian tube malignancy. The results are as follows: 1. Twenty-three patients had adenocarcinoma (well differentiated 11, moderately 6, poorly 6) and one patient had MMT (Müllerian mixed tumors). 2. There were 11 cases in stage I, 4 in stage II, 8 in stage III and 1 in stage IV according to Dodson's classification. 3. Atypical genital bleeding was the most common symptom, whereas 12.5% of patients had no symptoms. 4. Positive rates in cytology were 25.0% in cervico-vaginal smear and 55.0% in endometrial aspiration cytology. 5. The overall 5-year survival rate is 60.0%. The 5-year survival rates for stage I/II and stage III/IV were 88.9% and 16.7%, respectively. 6. The relapse rate of 16 patients treated with complete surgery was 25.0% (well differentiated 11.1%, moderately 0%, poorly 75.0%). Based on these observation, it is likely that patients with stage I/II have a good prognosis, however, patients with poorly differentiated adenocarcinoma have a high relapse rate, indicating that intensive adjuvant chemotherapy would be necessary in these cases. Cytologic examination, particularly endometrial aspiration cytology, is an effective method to use in detecting cases with fallopian tube malignancy early.

Adenocarcinoma↗
PubMed1991

Organic vs functional obstruction of the fallopian tubes: differentiation with prostaglandin antagonist- and beta 2-agonist-mediated hysterosalpingography and selective ostial salpingography.

In order to determine the prevalence and cause of functional vs organic obstruction of the fallopian tubes, hysterosalpingography was repeated after pharmacologic manipulation with a prostaglandin antagonist (aspirin) and/or a beta 2-agonist (terbutaline) in 100 patients in whom the fallopian tubes did not fill with contrast medium on the initial hysterosalpingogram. Selective ostial salpingography was performed in those in whom the fallopian tubes did not fill on the second hysterosalpingogram. Patients referred from three infertility clinics were included in the study if they could be rescheduled for a second hysterosalpingogram after at least 1 week of preparation with aspirin. Hysterosalpingograms obtained after administration of aspirin showed normal filling in 21 of 100 patients with initially obstructed tubes; the tubes filled in four more patients after administration of terbutaline. Selective ostial salpingography opacified the tubes in another 36 patients in whom the tubes had so far failed to fill. On the basis of the radiographic appearance and sometimes laparoscopic observation, initial nonfilling was attributed to spasma and debris in 49 patients, submucosal fibroids in six, synechiae in three, salpingitis isthmica nodosa in two, and septated uterus in one. Hysterosalpingography, after pharmacologic manipulation with aspirin and/or selective ostial salpingography, revealed false-positive and functional tube obstructions in 61 of 100 patients. Moreover, the radiologic appearance improved categorization of organic obstructions.

Adrenergic beta-Agonists↗
PubMed1986

Treatment of carcinoma of the fallopian tube using cisplatin, doxorubicin, and cyclophosphamide.

Nine patients with metastatic carcinoma of the fallopian tube were treated with a combination of cisplatin, doxorubicin, and cyclophosphamide. Three are in complete clinical remission following surgically documented complete response, at 18-56 months following the onset of chemotherapy. Two others died of intercurrent causes without evidence of disease. The remaining four died of tumor at 12, 23, 28, and 52 months following the initiation of treatment. Four second-look laparotomies were performed upon patients who were in complete clinical remission. No disease was found in any of these patients. It is concluded that this combination is an effective treatment for adenocarcinoma of the fallopian tube, and that second-look laparotomy may be useful in assessing response to chemotherapy in this disease.

Aged↗
PubMedDate not supplied

Electron microscopic and pharmacologic evidence for a functional adrenergic innervation of the smooth musculature in the human fallopian tube.

Triple fixation for electron microscopy of the isthmic region of the human Fallopian tube distinguished adrenergic nerve terminals through their content of synaptic vesicles with a diameter of 50-60 nm. Non-vascular adrenergic nerves were found both outside and within smooth muscle bundles. Adrenergic varicosities, partly devoid of their Schwann cell ensheathing, frequently approached the smooth muscle cells within a distance of about 200 nm, and sometimes as close as 60-100 nm. These close contacts often occupied a considerable area of the naked varicosity. Electrical field stimulation of adrenergic nerves in the isthmic smooth muscle preparations in vitro induced an alpha-receptor mediated, frequency-dependent contractile response. The results show that the sympathetic nerves in the human Fallopian tube are able to exert a motor control of its smooth musculature, and may thus be involved in local functions essential for the normal fertilization process.

Adrenergic Fibers↗
PubMed2005

[Dermatomyositis with cutaneous necrosis revealing a fallopian tube carcinoma].

INTRODUCTION: Adult dermatomyositis is a rare inflammatory myopathy associated with typical cutaneous lesions and an increased incidence of internal malignancies, notably cancers of the female genital tract. Nevertheless, fallopian tube carcinoma is exceptionally associated with dermatomyositis. EXEGESIS: We report an unusual case of dermatomyositis because of cutaneous necrosis revealing a cancer of the fallopian tube. CONCLUSION: Predictive factors of cancer can improve prognosis of dermatomyositis due to earlier diagnosis of associated cancer. In our observation as in literature review, cutaneous necrosis lesions are highly predictive of an associated neoplasia even as rare as a fallopian tube carcinoma.

Carcinoma↗
PubMed1988

[Diagnosis of occult fallopian tube cancers by intraoperative peritoneal cytology].

Clinical and ultrasonographic examination are the usual methods of diagnosis for carcinomas of the fallopian tubes and ovarian carcinomas. It is only in rare cases that the diagnosis is based on the cytology of the cervical smear. The use of cytology--more exactly, the cytological examination of secretion in Douglas' space in cases of vaginal hysterectomies--for the detection of ovarian and tubal carcinomas that cannot be diagnosed by clinical and paraclinical procedures, is a rather unusual and rarely described method. However, it is quite justified, as demonstrated by the detection of two carcinomas of the fallopian tubes within a short time.

Adenocarcinoma↗
PubMed1994

Juxtaposition of contralateral ovary and fallopian tube to allow pregnancy in unicornuate uterine anomaly.

Infertile patients who have undergone unilateral oophorectomies or salpingectomies or those with uterine anomalies may require juxtaposition of a remaining fallopian tube and contralateral ovary. A 28-year-old woman with previous left oophorectomy for endometriosis was found to have a left unicornuate uterus during subsequent infertility evaluation. Laparotomy and resection of a right rudimentary horn and juxtaposition of the left fallopian tube and the right ovary was performed. A large endometrioma was also resected from the right ovary. The patient conceived during the second month postoperatively. A simple procedure for juxtaposing a contralateral fallopian tube and ovary is described. Careful evaluation of the pelvic organs should be performed before removal of an ovary in a young woman.

Adult↗
PubMed1997

Human Fallopian tube epithelial cell co-culture increases fertilization rates in male factor infertility but not in tubal or unexplained infertility.

In order to investigate the effect of human Fallopian tube epithelial cell co-culture on fertilization and cleavage rates in tubal, male and unexplained infertility, oocytes collected from 91 patients were randomized to wells containing Fallopian tube epithelial cell monolayers or conventional culture medium, and inseminated with spermatozoa. Fertilization and cleavage were assessed at 18 and 52 h, respectively. Co-culture significantly increased the fertilization rates over the control values in male infertility (41.67 versus 23.43%, P = 0.00005), but not in tubal infertility (69.33 versus 67.93%) or unexplained infertility (65.93 versus 54.36%). Cleavage rates were not different in co-culture and conventional in-vitro fertilization systems in any of the infertility subgroups. The number of blastomeres was significantly higher in the co-culture group on the day of embryo transfer (3.63 +/- 1.12 versus 3.04 +/- 1.26, P < 0.001). Pregnancy rates were similar in all infertility subgroups. There was no significant association between the number of co-cultured embryos transferred and the pregnancy, abortion and multiple pregnancy rates. It was concluded that human Fallopian tube epithelial cell co-culture clearly improves fertilization rates in male infertility but not in tubal or unexplained infertility. Improved fertilization rates in co-culture may be due to positive effect of co-culture on impaired sperm function.

Blastomeres↗
PubMed1985

Dual effects of adenosine and adenosine analogues on motor activity of the human fallopian tube.

Effects of adenosine and adenosine analogues on spontaneous contractility of the human fallopian tube during different phases of the menstrual cycle were studied. In isthmic preparations, a stimulatory effect by L-N6-phenylisopropyladenosine (L-PIA), with preference for adenosine A1-receptors, was seen mainly during the proliferative phase. In ampullary preparations, stimulation by L-PIA was seen both in the secretory and proliferative phases. Adenosine and 2-chloroadenosine exerted similar stimulatory effects. 5'-N-ethylcarboxamide-adenosine (NECA), with selectivity for adenosine A2-receptors, or D-PIA never showed a stimulatory effect. At concentrations above those needed for stimulation, adenosine, 2-chloroadenosine and L-PIA inhibited spontaneous contractions, in common with NECA and D-PIA. Here, NECA was more potent than L-PIA. The D-PIA and L-PIA were equipotent. The inhibition was seen during the whole menstrual cycle. The competitive adenosine antagonist 8-p-sulphophenyltheophylline (PSøT) reversibly antagonized the stimulatory and inhibitory effects elicited by adenosine and the analogues. The PSøT alone could exert a stimulatory or an inhibitory action on spontaneous contractility. We suggest that adenosine can modulate contractile activity in the human fallopian tube via stimulatory A1-and inhibitory A2-receptors. These receptors are located on the smooth muscle cells, and might act via cAMP. The relative receptor dominance may be influenced by cyclic hormonal changes.

2-Chloroadenosine↗
PubMedDate not supplied

A substantial part of the fallopian tube is left after standard prophylactic bilateral salpingo-oophorectomy.

Women with a deleterious germline mutation in BRCA1 or BRCA2 are candidates for bilateral salpingo-oophorectomy (BSO). To address the need for adjustment of the current BSO procedure, we investigated the length and the nature of the fallopian tube epithelium that is not removed by BSO. Fourteen consecutive hysterectomy specimens were collected. Complete cross-sections with a 3-mm interval were made of the tubal lumen from the outside of the uterus at the cutoff point of the current BSO procedure to the uterine cavity and examined for the presence or absence of tubal type (ciliated) epithelium and subepithelial endometrial stroma. The fallopian tube remnant had a median length of 12 mm (range 6-15 mm). Tubal type (ciliated) epithelium was shown to be present in all uteri in the first cross-section containing 100% endometrial stroma, as well as in the uterine cavity of all but two of the hysterectomy specimens. A substantial part of the fallopian tube remains in situ after prophylactic BSO and is covered with tubal type ciliated epithelium. More research is necessary to investigate the role of this remnant part of the tube for BRCA carriers.

Adult↗
PubMed2005

Weekly single-agent carboplatin in heavily pretreated patients with recurrent ovarian, peritoneal and fallopian tube carcinoma.

PURPOSE OF INVESTIGATION: To report the experience of a single institution in the south of Israel with weekly carboplatin in heavily pretreated patients with platinum-sensitive recurrent ovarian, peritoneal and fallopian tube carcinoma. METHODS: The hospital records of ten patients with platinum-sensitive recurrent ovarian, peritoneal and fallopian tube carcinoma who had 2nd-line or later chemotherapy with weekly carboplatin between January 2003 and December 2004 were retrospectively reviewed. Weekly carboplatin, at a dose calculated with use of the Hilary Calvert's formula at AUC = 2, was given intravenously in 500 ml dextrose 5% over 30 minutes on day 1 of every seven days. Response was determined using clinical evaluation, radiological reports and CA-125 level. Toxicity was graded using the National Cancer Institute (NCI) criteria. RESULTS: Overall, 155 courses of weekly carboplatin were given. The median number of courses per patient was 14 (range, 2-37) and median duration of treatment was 22.5 (range, 2-40) weeks. Four patients (40%) had complete response lasting for 8-20 (median, 12) weeks, two (20%) had partial response lasting for five and 14 weeks, respectively, one (10%) had stable disease lasting for 23 weeks and three (30%) had progressive disease. Toxicity was mainly hematological with only grade 1-2 hematological toxicity as follows: anemia--four patients (40%), leukopenia--three (30%), neutropenia--three (30%) and thrombocytopenia--two (20%). CONCLUSION: Weekly carboplatin has considerable activity and low and well tolerated toxicity in heavily pretreated patients with platinum-sensitive recurrent ovarian, peritoneal and fallopian tube carcinoma.

Adenocarcinoma↗
PubMed1981

Primary adenocarcinoma of the fallopian tube. A case report with discussion of its pattern of endometrial spread and possible resulting diagnostic confusion.

The case of a 59-year-old woman with primary adenocarcinoma of the fallopian tube is reported. The case presented with pain and a pelvic mass, and at laparotomy appeared to represent severe pelvic inflammatory disease with a hydrosalpinx. Histologically a poorly differentiated adenocarcinoma of the fallopian tube was found. There was contiguous spread of the tumor to the endometrial surface, to endometrial polyps, and to the opposite fallopian tube. The difficulty of clinical diagnosis is discussed, especially in regard to the pattern of endometrial spread.

Adenocarcinoma↗
PubMed1988

The ultrastructural changes of the mucosa of blocked fallopian tubes.

The ultrastructure of the epithelium was studied in four blocked fallopian tubes which differed in the site of blockage and the degree of luminal distension. In all four specimens, there were large areas of the luminal surface which became barren and devoid of both the secretory and ciliated cells. Necrotic secretory cells and partially sloughed ciliated cells were observed in the remaining epithelium. Isolated patches of attenuated epithelium decorated with ciliated cells were sometimes found in the crypt of the mucosal folds. Results of this study suggest that pathological changes in the epithelium are common to tubes of both the terminal and cornual blockage.

Fallopian Tube Diseases↗