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This report describes an instrument designed for locating and delivering the Fallopian tube through an incision of less than 2 cm. Since no gas insufflation, fibre optic illumination, or electricity is required for successful use of this instrument, it is well suited for performing outpatient tubal sterilizations in areas where other methods, such as laparoscopic procedures, are not feasible.
An extensive review of the currently available literature on primary fallopian tube carcinoma is presented. The role of vaginal ultrasonography and the importance of an aggressive evaluation of every tubal deformity is stressed. A staging system which takes into account recent data on the biology of this malignancy is proposed. We emphasize the largely underestimated importance of early lymphatic spread of this disease, necessitating a thorough staging laparotomy with pelvic and para-aortic lymph node sampling in the apparent early stages. The need for adjuvant treatment is obvious, but until now no firm data exist as to what the optimal strategy should be. We recommend that until more representative studies are available, ovarian carcinoma protocols should be used in clinical practice.
Nuclear DNA content and p53 immunoreactivity were determined in 53 cases of primary fallopian tube cancer (PFTC). All tumors showed a distinctly aneuploid DNA distribution pattern, whereas p53 immunoreactivity was observed in 51% of the cases. If the patients were divided into two groups according to survival time, p53 immunoreactivity was present in 40% of the tumors from patients surviving for more than 8 years and in 65% of tumors from patients who died within 2 years. This difference was not statistically significant (P = 0.438). Patient survival was significantly correlated to the clinical stage (FIGO) (P = 0.0009).
OBJECTIVE: To evaluate the impact of postoperative therapy (chemotherapy vs. irradiation) on overall survival. DESIGN: A nationwide retrospective analysis. SETTING: Hanusch-Krankenhaus, Department of Gynaecology, SUBJECTS: 115 patients with histologically proved primary carcinoma of the Fallopian tube: 49 received six treatment cycles of a cis-platinum regimen (group I), 24 patients were treated by full irradiation using 50 Gray minimum (group II). The two groups had a similar distribution of stage I and II; in the more advanced stages chemotherapy was the predominant method of treatment. RESULTS: The five-year survival rate was 53% for women receiving irradiation as against 27% for those given cis-platinum. If the analysis was restricted to those patients with comparable stage I and stage II lesions, the p-value (0.07) was of borderline significance. There was no advantage in adding abdominal to pelvic irradiation (P = 0.62). CONCLUSIONS: Stage I and stage II carcinoma is probably better treated postoperatively by radiotherapy than chemotherapy. Chemotherapy may have more therapeutic potential in patients with more advanced lesions.
OBJECTIVE: The protocol was designed to examine the biological effects and clinical activity of interferon-beta in patients with platinum/taxane-resistant ovarian cancer. METHODS: Patients with resistant ovarian and fallopian tube cancers and primary peritoneal carcinoma were treated with recombinant human interferon-beta (Rebif, Serono International) at doses ranging from 6 to 24 million international units (MIU)/day, based on their tolerance to therapy. Levels of IP-10, an interferon-inducible protein, were measured in the serum to evaluate the biological effects of the drug. Also, the peripheral blood mononuclear cells and serum were examined for the induction of previously described novel regulators of interferon-induced death. RESULTS: Eighteen patients were treated, of whom 9 (50%) could be treated at the highest dose level (24 MIU). The major toxicities were fever, chills and fatigue. The median duration of therapy was 6 weeks (range 1-22). No objective responses were observed. IP-10 levels were significantly increased, compared with baseline, at 2, 4, and 6 weeks after initiation of therapy (p < 0.01). CONCLUSIONS: Recombinant human interferon-beta produced a definite biological effect in the serum of treated patients, but this outcome was not translated into any clinically observable or meaningful impact on the disease process.
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PURPOSE: This open-label study assessed the safety and immunogenicity of two doses and two routes of the anti-idiotypic monoclonal antibody abagovomab (formerly ACA125) in patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer. EXPERIMENTAL DESIGN: Eligible patients from the three participating institutions were any stage at diagnosis, had relapsed, and had complete or partial response to additional chemotherapy. Patients were randomized to receive abagovomab at 2.0 versus 0.2 mg and i.m. versus s.c. for four immunizations every 2 weeks and then monthly for two additional immunizations. Planned evaluation included interval physical examinations and laboratory assessments with immune assessment, including HLA typing, human anti-mouse antibody, ELISA, and enzyme-linked immunospot. Patients were required to remain on study until week 10 (the first post-baseline Ab3 determination) to be considered for immunologic assessment. The primary end points were safety and immunogenicity primarily determined by Ab3 response. RESULTS: Forty-two patients received at least one vaccination and were eligible for safety analysis. Thirty-three patients were available for Ab3 analysis (removed for progression of disease, 6; withdrawal of consent, 2; unrelated adverse event, 1). The most common adverse events were self-limited pain at injection site, myalgia, and fever. No hematologic or nonhematologic toxicity grade>2 related to immunization was seen. Ab3 was detectable in all patients (median, 236,794 ng/mL); none of route of administration (P=0.6268), dose (P=0.4602), or cohort (P=0.4944) was statistically significant in terms of effect on maximum post-baseline Ab3 titer. Human anti-mouse antibody was not detectable at baseline but was present in all patients at week 16 (range, 488-45,000 ng/mL). CONCLUSIONS: Immunization with abagovomab is well tolerated and induced robust Ab3 responses at the two doses and routes tested. A phase III randomized study with abagovomab (2.0 mg s.c.) is warranted.
Mouse epididymal spermatozoa in the cryopreservation solution (18% raffinose and 3% skim milk in distilled water) were frozen and stored at -196 degrees C, and later thawed at room temperature. The thawed sperm suspension was inseminated into the Fallopian tubes containing ovulated oocytes in pseudopregnant females on the day of finding the vaginal plug. Five out of 12 females gave birth to 28 Young (5.6 per liter).
Coculturing one- and two-cell embryos with various cell lines has been shown to overcome species-specific developmental blocks and to improve blastocyst transformation rates. The objective of this study was to assess whether human fallopian tube epithelium organ explants influence in vitro fertilization and subsequent early embryo development in a murine model. Fertilization, blastocyst transformation, and blastocyst expansion and hatching rates were significantly higher in the coculture group when compared with rates for culture in standard media or media conditioned by human tubal explant cultures. The results from conditioned and unconditioned media were not significantly different.
OBJECTIVE: Data on histochemical and biochemical characteristics of the human oviduct are scarce. The exact mechanisms of ovum transport and pickup are not fully understood. STUDY DESIGN: Human fallopian tubes were obtained and prepared for histochemistry. We analyzed the distribution of negatively charged groups on the oviduct epithelium and cumulus cells and examined the distribution of glycoconjugates by means of lectin histochemistry. We tested the possible influence of poly-L-lysine and considered ABO blood group expression since these characteristics are determined by specific terminal sugar residues. RESULTS: A negatively charged glycocalyx exists on tubal epithelial cells and cumulus cells. Adherence by affinities similar to sugar-lectin binding forces could be disproven in case of commonly used lectins. Poly-L-lysine inhibited the cationic binding reaction but did not influence lectin binding. The blood group A glycoprotein presents terminal D-N-acetyl-galactosamine residues, which are demonstrated by HPA lectin binding. CONCLUSION: Our study indicates that it is unlikely that electrostatic interactions play a major role in ovum transport or pickup. Since poly-L-lysine has been described as inhibiting ovum transport, sugar-lectin binding affinities seem not to operate in ovum transport or pickup.