Biomedical subjects

H Maia

Publications and source records attributed to H Maia.

At least 19 recordsLinked to original sources

PubMed2004

Proliferation kinetics in adenomyosis during the menstrual cycle and during oral contraceptive use.

Our objective was to investigate the presence of focal p53 expression in relation to proliferation rates in adenomyotic lesions during the menstrual cycle and in women on oral contraception. Fifty-nine perimenopausal patients with menorrhagia and adenomyosis were submitted to endometrial resection. The procedure was carried out during menstruation (n = 14), during the proliferative phase (n = 15), during the luteal phase (n = 20) or following the use of oral contraceptives (n = 10). The number of Ki-67-positive cells was low during menstruation, during the luteal phase and following the use of progestins. In the proliferative phase, on the other hand, there was a significant increase in the percentage of Ki-67-positive cells. Focal p53 expression was detected mainly during the proliferative phase of the menstrual cycle when proliferation rates were high. PTEN expression was detected in all cases irrespective of the phase of the menstrual cycle or use of oral contraception. We conclude that proliferation rates in adenomyotic lesions undergo marked cyclic variations and this affects the percentage of cases showing focal p53 expression in the glandular epithelium.

Adult↗

PubMed2004

Effect of previous hormone replacement therapy on endometrial polyps during menopause.

The aim of this study was to evaluate the effect of hormone replacement therapy (HRT) on the expression of Ki-67, bcl-2 and c-erb.B2 in endometrial polyps during menopause. Sixteen patients using HRT and 24 untreated controls with endometrial polyps were enrolled in this study. Polypectomy was carried out by hysteroscopy. The presence of c-erb.B2, bcl-2 and Ki-67 expression was determined by immunohistochemistry. HRT was found to decrease Ki-67 and bcl-2 expression in endometrial polyps without affecting the c-erb.B2 staining reaction. HRT may cause endometrial polyp involution by decreasing proliferation and stimulating apoptosis.

Administration, Cutaneous↗

PubMed2001

Proliferation profile of endometrial polyps in post-menopausal women.

OBJECTIVE: To determine whether or not the presence of c-erbB2 over-expression in endometrial polyps affects the percentage of cells positive for Ki-67 proliferation marker. METHODS: Thirty-five patients with endometrial polyps were submitted to polypectomy by hysteroscopy. Ki-67 and c-erbB2 over-expression were investigated in the polyps by immunohistochemistry. RESULTS: The presence of c-erbB2 over-expression by immunohistochemistry was observed in 80% of endometrial polyps and was associated with higher proliferation rates as determined by the number of positive Ki-67 cell nuclei. In c-erbB2-negative polyps, the proliferation rates were low. CONCLUSION: Ki-67 and c-erbB2 over-expression are frequent in endometrial polyps in post-menopausal women.

Aged↗

PubMed2001

Detection of testosterone and estrogen receptors in the postmenopausal endometrium.

OBJECTIVE: To detect the presence of testosterone and estrogen receptors in the stroma and glandular epithelium in the malignant and non-malignant endometrium. METHODS: One hundred and forty-five consecutively-enrolled peri- or postmenopausal patients were submitted to diagnostic or operative hysteroscopy. These patients either had a history of abnormal uterine bleeding or they were asymptomatic with an endometrial echo greater than 4 mm. The presence of estrogen and testosterone receptors was determined in endometrial samples by immunohistochemistry, using monoclonal antibodies and a streptavidin-biotin peroxidase complex system with diamino benzidine as the chromogen. RESULTS: Testosterone receptors were detected mainly in the stroma in the non-malignant endometrial lesions and in the atypical glandular epithelium in cases of estrogen-positive endometrial carcinomas. CONCLUSIONS: The presence of testosterone receptors in estrogen receptor positive endometrial carcinomas may be involved in the mechanism of cell proliferation in these tumors. The strong staining reaction for testosterone receptors in the endometrial glands can be considered one of the features of invasive malignancy.

Adult↗

PubMed2001

Hysteroscopic and immunohistochemical findings in type I and type II endometrial carcinomas.

STUDY OBJECTIVE: To determine whether types I and II endometrial carcinomas have different precursor lesions recognized at hysteroscopy and immunohistochemistry. DESIGN: Single center case study (Canadian Task Force classification II-2). SETTING: A private, university affiliated hospital. PATIENTS: One hundred forty-six postmenopausal women with endometrial pathology diagnosed by hysteroscopy and biopsy. INTERVENTION: Hysteroscopy and immunohistochemical determination of p53 overexpression. MEASUREMENTS AND MAIN RESULTS: The number of cells showing p53 overexpression was low in endometrial polyps, hyperplasia, and G1 endometrioid carcinomas. A marked increase was seen only in high-grade G2-G3 endometrioid carcinomas and in cases of uterine papillary serous carcinoma. In the latter, strong p53 overexpression was detected in early forms still confined to endometrial polyps. Hysteroscopy could not differentiate between high- and low-grade endometrioid carcinomas. CONCLUSION: The p53-driven pathway plays an important role in the origin of papillary serous carcinoma but not in G1 endometrioid cancer that evolves from estrogen-stimulated endometrium. However, this pathway is important for progression of low-grade endometrioid carcinomas to higher-grade tumors.

Cell Nucleus↗

PubMed1997

Polypectomy and endometrial resection in postmenopausal patients.

STUDY OBJECTIVE: To evaluate the therapeutic efficacy of polypectomy associated with endometrial resection for the treatment of polyps in postmenopausal women. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Private urban hospital with facilities for endoscopic surgery. PATIENTS: Sixty-six women with endometrial polyps. INTERVENTIONS: Sixty-four of the 66 patients underwent polypectomy followed by endometrial resection. One patient had hysterectomy because endometrial biopsy showed serous papillary carcinoma. MEASUREMENTS AND MAIN RESULTS: No major complications were associated with the procedure. Histopathology showed hyperplasia in most polyps. One patient had a papillary uterine carcinoma in the polyp that was not detected by preoperative endometrial biopsy. The women were followed with transvaginal sonography for 1 year after surgery. CONCLUSION: Polypectomy followed by endometrial resection is a very low-risk procedure for postmenopausal patients. There was no recurrence after the first year in women who completed follow-up.

Aged↗

PubMed1997

Administration of medroxyprogesterone acetate after endomyometrial resection.

STUDY OBJECTIVE: To assess the efficacy of endometrial resection for treatment of menorrhagia in women to whom no preoperative agent was given to prepare the endometrium. DESIGN: Retrospective analysis of patients' records for all endometrial resections in which medroxyprogesterone acetate was used postoperatively. SETTING: Hospital day surgery unit. PATIENTS: Seventy patients with menorrhagia. INTERVENTIONS: The women underwent transvaginal sonography, followed by hysteroscopy and endometrial biopsy. The endometrium was removed using the 27F resectoscope followed by coagulation with the rollerball. Medroxy-progesterone acetate was prescribed for 2 months after surgery. MEASUREMENTS AND MAIN RESULTS: All women achieved a reduction in menstrual flow and 50% reported amenorrhea after endometrial resection. In only two was hysterectomy necessary due to recurrence of menorrhagia. CONCLUSION: Preoperative endometrial preparation was unnecessary when endometrial resection was carried out for treatment of menorrhagia. However, the patients received medroxyprogesterone acetate postoperatively.

Adult↗

PubMed1996

Evaluation of the endometrial cavity during menopause.

OBJECTIVE: To compare transvaginal sonography (TVS), hysteroscopy and suction curettage in the evaluation of uterine bleeding during the menopause. METHODS: Forty-seven patients who presented with either postmenopausal bleeding (31 cases) or sonographic endometrial abnormalities at menopause (16 cases) were evaluated using TVS, hysteroscopy, and curettage with a Karman curette. RESULTS: When endometrial thickness measured by TVS was < 4 mm, there was no endometrial pathology. However TVS could not differentiate accurately between hyperplasia, polyps or endometrial carcinoma. In these cases, endometrial thickness was invariably greater than 5 mm. CONCLUSIONS: Hysteroscopy proved superior to curettage in the diagnosis of endometrial polyps.

Adult↗

PubMed1996

Hysteroscopy and transvaginal sonography in menopausal women receiving hormone replacement therapy.

STUDY OBJECTIVE: To evaluate the endometrial cavity of menopausal women with irregular bleeding while receiving hormone replacement therapy. DESIGN: Comparative evaluation of hysteroscopic and biopsy findings. SETTING: A center for reproductive studies. PATIENTS: Forty-one patients receiving different regimens of hormone replacement therapy. INTERVENTIONS: Hysteroscopy, endometrial biopsy, and transvaginal sonography were performed in all 41 women. In 10 patients, endometrial polyps were removed with the resectoscope. MEASUREMENTS AND MAIN RESULTS: Irregular bleeding during hormone replacement therapy was associated with atrophic endometrium whenever transvaginal sonography showed endometrial thickness to be less than 4 mm. In patients who developed increased endometrial thickness after hormone replacement therapy, hysteroscopy revealed the presence of endometrial polyps in the uterine cavity. Histopathologic examination of excised polyps revealed cystic or adenomatous hyperplasia confined to these lesions. CONCLUSIONS: Endometrial polyps can appear in menopausal women receiving hormone replacement therapy despite the presence of progestins to oppose the action of estrogens.

Atrophy↗

PubMed1996

Evaluation of Ovarian Endometriotic Cysts by Transvaginal Sonography and Videolaparoscopy

Transvaginal sonography made a preoperative diagnosis of ovarian endometriotic cyst in 45 women (age 20-45 yrs). The cyst was unilocular in 37 patients and multilocular in the rest. Intracystic projections were noted in seven. Doppler studies revealed benign ovarian masses. Videolaparoscopy was carried out to remove the ovarian cyst using a three-puncture technique. The cyst was aspirated before removal, which revealed chocolate material. Peritoneal or ovarian surface endometriotic lesions, with or without adhesions, associated with chocolate cysts were present in 35 women. Histopathologic examination of excised material revealed functional ovarian cysts in 12 patients, serous cystadenomas in 20, nonspecific ovarian cysts with fibrotic tissue in 4, and endometriotic cysts in 9. These results indicate that the majority of ovarian chocolate cysts are not true endometriomas but rather an association between endometriotic lesions and other neoplastic or functional ovarian cysts.

Journal Article↗

PubMed1996

Administration of Medroxprogesterone Acetate after Endomyometrial Resection

Seventy women (age 32-47 yrs) with a history of menorrhagia were evaluated by transvaginal sonography, hysteroscopy, and endometrial biopsy. Hysteroscopy revealed a normal uterine cavity in 60 patients, endometrial polyps in 4, and submucous myomas in 6. Endometrial biopsy revealed normal histology in 67 women and 3 cases of cystic endometrial hyperplasia. All patients underwent endometrial resection using the 27F resectoscope followed by coagulation with the rollerball. Glycine 1.5% was used as the distention medium. Endometrial resection was carried out under paracervical block plus intravenous propofol. Oral medroxyprogesterone acetate (MPA) 20 mg/day for 2 months was prescribed postoperatively for 40 women. The remaining women received a placebo. All patients were evaluated by transvaginal sonography at 1, 3, and 6 months after resection. The frequency of amenorrhea was 40% in the placebo group and 70% in the MPA group. These initial results suggest that postoperative treatment with MPA increases the frequency of amenorrhea after endometrial resection.

Journal Article↗

PubMed1983

Induction of ovulation with clomiphene citrate followed by LH-RH in women.

Luteinizing hormone-releasing hormone (LH-RH) was used to induce ovulation following clomiphene priming to stimulate follicular growth. Ovulation was assumed to have occurred following LH-RH injection when progesterone levels started to rise within 48 h following treatment and LH pretreatment levels were below 8 mIU/ml. Ovulation occurred in eight of 10 patients following the administration of LH-RH and six pregnancies were achieved in the first 4 months of treatment.

Anovulation↗

PubMed1980

Effect of prostaglandin F2 alpha on oviduct contractility in marmoset monkeys.

Prostaglandin F2 alpha (PGF2 alpha) increased oviductal contractility under different hormonal conditions. Changes in the response of the oviduct to PGF2 alpha were observed during the reproductive cycle. The response to PGF2 alpha was reduced during the follicular phase, but it increased markedly following both spontaneous and human chorionic gonadotropin-induced ovulation. During the luteal phase the effect of PGF2 alpha on the oviduct was significantly greater than during the follicular phase. The spontaneous motility of the oviduct also increased significantly following ovulation. This increase in motility occurred when progesterone blood levels reached values higher than 1.5 ng/ml, and it was not suppressed by indomethacin, a potent inhibitor of prostaglandin synthesis.

Animals↗

PubMed1979

Effect of indomethacin on prostaglandin and steroid synthesis by the marmoset ovary in vivo.

Indomethacin decreased Prostaglandin F 2 alpha levels in the ovaries of marmoset monkeys which were treated with PMS/HCG. The production of estradiol and progesterone, however, was unaffected by the blockade in prostaglandin synthesis. The number of ovulations following PMS/HCG treatment was significantly reduced by indomethacin treatment. These observations suggest that prostaglandins are required for follicular rupture but not for progesterone and estradiol production by the ovary.

Animals↗

PubMed1978

Inhibition of ovulation in marmoset monkeys by indomethacin.

The effect of indomethacin on human menopausal gonadotropin/human chorionic gonadotropin-induced ovulation was studied in marmoset monkeys. Indomethacin was effective in preventing follicular rupture and ovum extrusion when administered simultaneously with gonadotropin. The production of progesterone and luteinization of the granulosa cells were not affected by indomethacin treatment. Histologic examination of corpora lutea from indomethacin-treated animals revealed the presence of entrapped oocytes surrounded by luteal cells. These results suggest that prostaglandin synthesis is required for ovulation in this species, but not for luteinization and progesterone production.

Animals↗

PubMed1977

Time course of ovum transport in guinea pigs.

The time course of ovum transport was determined in cycling guinea pigs. The occurrence of ovulation was determined in assessing changes in vaginal cytology. The day of the postovulatory leukocyte influx was considered day 1 of the cycle. Ovum transport in guinea pigs is characterized by a relatively long sojourn in the ampulla, followed by rapid transport through the isthmus. This pattern is similar to that seen in women and subhuman primates and different from the pattern in rabbits.

Animals↗

PubMed1977

Pharmacologic modification of the time course of ovum transport in guinea pigs.

Various agents were examined for their effects on ovum transport in the guinea pig. Estrogen significantly accelerated ovum transport in this species. The experiments further demonstrated that estrogen did not act by inducing prostaglandin synthesis, nor by altering plasma progesterone levels. The estrogen-induced acceleration was significantly antagonized by tamoxifen, an antiestrogen that acts by interfering with estrogen receptor synthesis. Cycloheximide also antagonized the effects of estrogen on ovum transport. These data suggest that the modification of ovum transport by estrogen is due to the entrance of estrogen into the nuclei of target cells, and subsequent protein synthesis. Although we assume that this action occurs at the level of the oviduct, our experiments do not prove this assumption.

Animals↗

PubMed1977

Effect of ovulation and hormonal treatment on the in vitro response of rabbit oviducts to prostaglandins E1 and F2alpha.

Rabbit oviductal circular muscle isometric contractile response was measured in relation to treatment with prostaglandin E1 (PGE1) and prostaglandin F2alpha (PGF2alpha). PGE1 (1 mug/ml) inhibition of the contractile response of the rabbit oviduct to field stimulation was increased in the proximal isthmus after ovulation. Estrogen and progesteron, in doses known to alter ovum transport, did not affect the response of the oviduct to PGE1. In comparison to the response of estrous tissues, the stimulatory effect of PGF2alpha on the isthmus was decreased 24 hours after administration of human chorionic gonadotropin (HCG). Treatment with estrogen and progesterone did not affect these postovulatory changes. The response of the ampullary-isthmic junction to PGF2alpha was significantly reduced 72 hours after administration of HCG. Neither ovulation nor steroid treatment affected the response of the ampulla to PGF2alpha. Changes in the sensitivity of the oviduct to prostaglandins after ovulation may be necessary for successful ovum transport.

Animals↗