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Preoperative and postoperative CA-125 serum levels in primary fallopian tube carcinoma.

Levels of CA-125 were determined pre- and postoperatively in 13 patients with fallopian tube cancer. Values before surgery were significantly higher (Median 1220 IU/ml, 90-5000 IU/ml) compared with postoperative levels (Median 194 IU/ml, 67-880 IU/ml) (P = 0.0052). Correlation analysis with FIGO stage and grading failed to show any statistical significance, but a trend for a positive correlation with FIGO stage and preoperative values could be observed. The CA-125 antigen is expressed by fallopian tube carcinoma and should therefore be used in diagnosis and follow-up.

Adenocarcinoma, Mucinous↗

Selective fallopian tube catheterisation in female infertility: clinical results and absorbed radiation dose.

Clinical results of fluoroscopic fallopian tube catheterisation and absorbed radiation doses during the procedure were evaluated in 30 infertility patients with unilateral or bilateral tubal obstruction documented on hysterosalpingography. The staged technique consisted of contrast injection through an intrauterine catheter with a vacuum cup device, ostial salpingography with the wedged catheter, and selective salpingography with a coaxial microcatheter. Of 45 fallopian tubes examined, 35 (78%) were demonstrated by the procedure, and at least one tube was newly demonstrated in 26 patients (87%). Six of these patients conceived spontaneously in the follow-up period of 1-11 months. Four pregnancies were intrauterine and 2 were ectopic. This technique provided accurate and detailed information in the diagnosis and treatment of tubal obstruction in infertility patients. The absorbed radiation dose to the ovary in the average standardised procedure was estimated to be 0.9 cGy. Further improvement in the X-ray equipment and technique is required to reduce the radiation dose.

Adult↗

Ultrasonic features of fallopian tube carcinoma.

With the routine use of sonography in the evaluation of patients with pelvic masses, it is essential to be familiar with the sonographic features of fallopian tube carcinoma so that diagnosis can be made early and thus contribute to prompt management of these patients. The authors present the clinical manifestations, sonographic features, and pathologic correlations in three cases of fallopian tube carcinoma.

Adenocarcinoma↗

[Primary fallopian tube cancer--an Austrian multicenter study].

Incidence and prognostic factors of primary carcinomas of the Fallopian tubes were studied in a retrospective multi-centre analysis of 81 women during the period of 1980 to 1990. Data from 13 departments (university as well as general hospitals) were included in the present study which was designed to evaluate the state-of-the-art of diagnosis and treatment of carcinoma of the Fallopian tubes in Austria, and to compare the results with those from the literature. Stages were classified according to the modified FIGO-system for ovarian cancer; grading followed the criteria of Hu, Taylor and Hertig. The mean age of the patients was 62.1 years. Thirty-seven (45.7%) tumours were found to be in stage I, sixteen (19.8%) in stage II, nineteen (23.4%) in stage III, and nine (11.1%) tumours in stage IV. In 66 Patients, the tumour could be radically removed. The surgical method applied in 68 cases was removal of the uterus, the adnexa, and/or the omentum, or lymph nodes. Post-operatively, patients underwent an adjuvant therapy which was either irradiation (n = 32; 39.5%), or chemotherapy (n = 34; 42.0%). Fifteen patients had no therapy after operation. The five-year survival rate for stages I and II was 75% compared to 17% in stages III and IV.

Adult↗

[A case of actinomycosis of the fallopian tube (author's transl)].

Reported is the rare case of an actinomycosis of the right Fallopian tube. The clinical picture is characterized by a comparatively sudden onset of abdominal pain, obstipation and feaver as well as a markedly increased ESR. Good co-operation between the various clinical disciplines (urology, surgery, internal medicine, gynecology) lead to an exact preoperative localization of the scaring and infiltrating process that is then verified by laparotomy. The right adnexae show massive inflammatory infiltrates and form a conglomerate tumor with the adjacent sigma and appendix. Characteristic actinomycetic druses are found histologically only in the right Fallopian tube. On the left side a florid non-specific salpingitis is antibiotics is withoug complications. Mode of infection, differential diagnosis and prognosis that is dependent on a correct diagnosis at an early stage are discussed.

Actinomycosis↗

In vitro occlusion of human fallopian tubes with Nd:YAG laser.

BACKGROUND: There is a need for an atraumatic, fast, reliable, inexpensive, reversible-on-demand method for female sterilization which is also free from side-effects. The use of an Nd:YAG laser for occlusion of human fallopian tubes in vitro was assessed for achieving these aims. METHODS: An in vitro study was performed on coagulation of fallopian tube tissue using continuous wave Nd:YAG laser. Posthysterectomy human uteri were exposed to laser radiation either directly through an optical fibre or through a sapphire contact probe at the ostia at different laser powers and inter-action times. RESULTS: Laser-induced tissue coagulation plugged the ostia in a clean, controlled and predictable manner. Microscopic examination of the coagulated tissue showed about 50 microns wide blind holes without any continuous channel; thus eliminating the possibility of passage of sperms through such a plug. The depth of coagulation along the lumen of the fallopian tubes increased linearly with the interaction time of the laser beam at a constant power, either by direct irradiation or through a contact probe. The maximum depth of coagulation was found to be about 3 mm in case of direct irradiation at a laser power of about 6.5 W and interaction time of 50 seconds. Beyond these values, charring occurred at the surface of the tissue. CONCLUSION: Nd:YAG laser might be a suitable means for female sterilization. Further studies in experimental and clinical settings would be required to confirm its utility.

Electrocoagulation↗

[Fallopian tube endoscopy in 1996].

AIM: To establish the statement in 1996 of the exploration of the Fallopian tubes by falloposcopy in the framework of the tubal or unexplained sterility. MATERIAL AND METHODS: The feasibility of the method, the endotubal aspect and the potential contribution of the falloposcopy in the exploration of the tubes of infertile women were analyzed from a review of the literature and a personal experience of 145 tubal endoscopies. RESULTS: Tubal catheterism rate is 91%; duration of the exploration varies from 30 to 40 minutes and decreases with the experience of the surgeon. The tubal lumen is explored correctly on all its length in more of 71% of cases. The tubal complications represented by perforations occur in 5% of cases and essentially on pathological tubes. False-negative and false-positive rates of the couple hysterosalpingography/laparoscopy are respectively 57 and 17% as compared to the falloposcopy. CONCLUSION: The falloposcopy is a safe and reproductible method. The exploration of Fallopian tubes by this technique dressed more precise than that obtained from indirect manner by known examinations that are hysterosalpingography and the laparoscopy.

Endoscopy↗

Estradiol and progesterone binding components in the cytosol of normal human fallopian tubes.

The in vitro binding of labeled estradiol and R5020 to receptor proteins from human fallopian tube cytoplasmic fractions has been studied. Both compounds give rise to two separate peaks in density gradient analysis experiments under low ionic strength conditions: a "8 S" steroid-hormone-specific peak and a "4 S" peak accounted for by non-specific binding. The receptor molecules were further characterized by a competition studies, electrophoretic technique and gel chromatography. The receptor content for both steroid hormones varied throughout the menstrual cycle. The estradiol and progesterone receptor concentration were highest during the proliferative phase and were very significantly lower in the second half of the menstrual cycle. Furthermore measurement of both receptors in the cytosol revealed differences among the anatomical segments of the fallopian tube. The highest estradiol and progesterone binding could be detected in the ampullary region, significantly lower levels of estradiol and progesterone receptor were seen in the infundibulum and the isthmus.

Binding, Competitive↗

Progesterone receptor isoform B in the human fallopian tube and endometrium following mifepristone.

The distribution of progesterone receptor isoform B may have important clinical significance. The aim of this study was to compare the expression, localization and regulation of progesterone receptor isoform B in the human Fallopian tube and endometrium following mifepristone in a dose effective for contraception. Fertile women were treated with a single dose of 200 mg mifepristone on day luteinizing hormone (LH)+2. Biopsies were obtained from the Fallopian tube on day LH+4 to LH+6 and from the endometrium on day LH+6 to LH+8. Progesterone receptor isoform B expression was analyzed by immunohistochemistry and reverse transcriptase polymerase chain reaction. Treatment with mifepristone increased progesterone receptor isoform B concentration in epithelial and stromal cells in the Fallopian tube and also increased progesterone receptor isoform B concentration in the glandular cells of the endometrium. These results further support the hypothesis that the contraceptive effect of mifepristone when given postovulatory is primarily due to alteration of the peri-implantation milieu influencing endometrial receptivity.

Adult↗

The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers.

OBJECTIVE: To compare the safety and efficacy of laparoscopic staging of ovarian or fallopian tube cancers to staging via laparotomy for epithelial ovarian carcinoma. STUDY DESIGN: We performed a case-control study of all patients with apparent stage I adnexal cancers who had laparoscopic staging from October 2000 to March 2003. The control group consisted of all patients with apparent stage I epithelial ovarian carcinoma who had staging via laparotomy during the same time period. RESULTS: Staging was laparoscopic in 20 patients and via laparotomy in 30. There were no differences in mean age and body mass index. There were also no differences in omental specimen size and number of lymph nodes removed. Estimated blood loss and hospital stay were lower for laparoscopy, but operating time was longer. There were no conversions to laparotomy or complications in the laparoscopic group, compared with 3 minor complications in the laparotomy group. CONCLUSION: In this preliminary analysis, it appears that patients with apparent stage I ovarian or fallopian tube cancer can safely and adequately undergo laparoscopic surgical staging.

Adult↗

Comparison of virulence markers of peritoneal and fallopian tube isolates with endocervical Neisseria gonorrhoeae isolates from women with acute salpingitis.

Neisseria gonorrhoeae strains which cause acute salpingitis are presumed to ascend the genital tract from the cervix. Previous studies utilized isolates obtained from endocervical canal cultures, although it was not known if the isolates truly represented the organisms present in the fallopian tubes. In this study, we compared N. gonorrhoeae isolates from endocervical canal cultures with fallopian tube or peritoneal cul-de-sac isolates or isolates from both sites obtained at laparoscopy. Potential virulence markers were studied, including colony phenotype, auxotype, antimicrobial agent susceptibility, protein patterns on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and susceptibility to normal human serum. Six of seven cervical isolates had the same antibiograms and molecular weight for major outer membrane proteins as those of the corresponding peritoneal isolates. Auxotypes also were the same and included prototrophic, proline-requiring, and proline-and-arginine-requiring isolates. The isolates as a group appeared to be very susceptible to the bactericidal action of pooled serum from normal women. Colony phenotypes varied between sites; the fallopian tubecul-de-sac isolates were predominantly of transparent phenotype and piliated. The cervical isolates were either mixtures of equal quantities of opaque and transparent phenotypes or predominantly opaque phenotype. By these markers, patients' N. gonorrhoeae cervical isolates appeared to be the same as their isolates from fallopian tubes except for a difference or shift in colony phenotype.

Anti-Bacterial Agents↗

Developing an artificial fallopian tube: successful in vitro trials in mice.

This report describes the design and testing of an artificial fallopian tube for the treatment of tubal infertility. Within the device, mouse eggs incubated with sperm were fertilized and a microinfusion pump was used to transport the fertilized ova through the tube. Normal offspring resulted from transfer of the developing embryos into pseudopregnant recipients. These results provide encouraging evidence that an artificial fallopian tube warrants further investigation as a potential alternative to in vitro fertilization.

Animals↗

A 10-year review of primary fallopian tube cancer at a community hospital: a high association of synchronous and metachronous cancers.

Primary fallopian tube carcinomas (PFTC) are rare gynecological tumors infrequently diagnosed prior to operative intervention. A retrospective review was performed to characterize the distribution and clinicopathologic significance of these tumors. Identification of PFTC was achieved through a review of the tumor registry and medical record ICD-9 codes at a community teaching hospital. A total of 1.5% of all gynecological cancers were PFTC. Most patients were presumed to have ovarian cancer. Ultrasound had the highest sensitivity (82%) for preoperative diagnosis. Surgical exploration was needed for definitive diagnosis in all patients. Optimal debulking was predictive of survival and of a negative second-look laparotomy (P < 0.05). Twenty-five percent of patients had a metachronous cancer diagnosed prior to their fallopian tube cancer, and 22% had a synchronous gynecological malignancy diagnosed at the time of surgical exploration. The response rate to platinum-based chemotherapy was 78%. The 5-year survival rate was 87%, and the overall survival rate was 75%. The median follow-up was 38 months. This report details the diagnostic and therapeutic experience of patients with PFTC and describes the occurrence of synchronous and metachronous gynecological cancers.

Adult↗

[Fallopian tube torsion in appendicitis--case report].

The authors report a rare clinical case of coincidence appendicitis and Fallopian tube torsion. A 14-years-old girl is presented with acute pelvic pain, dysuria and diarrhoea. Acute appendicitis and right side Fallopian tube torsion were detected by laparotomy. Symptoms, differential diagnoses, etiology and diagnostic procedures are discussed.

Acute Disease↗

Retrospective analysis of patients with primary fallopian tube carcinoma treated at the University of Louisville.

Medical records of patients diagnosed with primary fallopian tube carcinoma between 1979 and 1989 were reviewed. Twenty-six patients were eligible; 8 patients were excluded after pathologic review, leaving 18 patients included in the study for this analysis. The median and mean age were 61 and 59 years, respectively, with a range of 39-80 years. There were three Stage I, five Stage II, seven Stage III, and three Stage IV patients. The most common presenting symptoms were abdominal/pelvic pain, abdominal distension, and vaginal discharge/bleeding. The primary site of the lesion was determined to be the right tube in 44% of the cases, the left tube in 39% of the patients, bilateral lesions in 11% of the patients, and indeterminate in 6%. Histologic grade was poorly differentiated (Grade III) in 13 patients, moderately differentiated (Grade II) in 4 patients, and well differentiated (Grade I) in one. No patient was correctly diagnosed preoperatively. Survival at 5 years of the entire group was 35% with a 3 year minimum followup. Corresponding disease free survival was 30%. Mean and median survival times were 74 and 37 months, respectively. The range of survival times was from 1 to 120 months. All Stage I patients, 80% (4/5) of Stage II, and 29% (2/7) of Stage III patients are alive without disease. None (0/3) of the Stage IV patients are alive. Treatment regimens consisted of intraperitoneal P-32, external beam radiotherapy, and/or chemotherapy. Radiotherapy was associated with a low incidence of treatment-related complications, the majority being gastrointestinal related. There was one chemotherapy-related death. These patients and their treatment outcomes add to the data base of numerous previous reports on fallopian tube carcinoma. Stage I and II patients fared excellently with primary surgical and adjuvant therapy. While the prognosis of Stage III and IV patients is much worse, significant levels of long term survival can be achieved with aggressive treatment.

Adult↗

[Primary carcinoma of the fallopian tube: a clinicopathological study of 11 cases].

OBJECTIVES: Clinicopathological study of eleven cases of carcinoma of the fallopian tube to understanding possible risk factors for therapeutic failure. DESIGN: The study group consisted of 11 cases of primary carcinoma of the fallopian tube treated in our Department over 25-year period. Clinical and pathologic data were obtained from the hospital records review. RESULTS: The mean age of the patients was 57.22 years. Pelvic pain was the predominant symptom (81.8%). Three of 11 patients had the classic syndrome of "hydrops tubae profluens". On the physical examination the pelvic mass was the most frequent finding (72.7%). Five of the 11 patients had never been pregnant and five had had a single pregnancy. In all patients the diagnosis was established at the time of laparotomy. The tumor was unilateral in 72.7% of the cases with equal frequency in the left or the right tube. The tube was significantly dilated in nine patients, in two other the tumor was smaller then 10 mm. Histologically the vast majority of the tumors was papillary serous adenocarcinoma, and only in one case clarocellulare adenocarcinoma was found. The histologic grade was in 63.6% poorly- and in 36.4% moderate differentiated. In 6 patients we found evidence of salpingitis. All of the patients received postoperative adjuvant therapy: irradiation and or chemotherapy. The mean interval from diagnosis to death was 44.5 months. CONCLUSIONS: Multicenter studies are needed to improve the understanding of possible risk factors for diagnostic additionally therapeutic failure and the optimal treatment for each stage of the disease should be defined.

Adenocarcinoma, Clear Cell↗