Endometrial maturation after sequential use of clomiphene citrate, human menopausal gonadotropin, and human chorionic gonadotropin in in vitro fertilization.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R Aine.
Explore the source record for details and available documents.
Concentrations of progesterone and oestradiol in peripheral serum and tumour cyst fluid were measured in 42 post-menopausal women with epithelial ovarian tumours (17 cancer, 6 borderline malignant, 19 benign tumours) and in 19 post-menopausal women without ovarian neoplasms. The hormonal response of the endometrium was assessed, progestogen and oestrogen receptor content in the tumour tissue case recorded, and tumour deoxyribonucleic acid (DNA) ploidy was measured by flow cytometry. No significant differences were found between the mean serum steroid levels in patients with malignant, borderline or benign tumours, but the mean serum levels of oestradiol in patients with malignant or benign ovarian tumours were higher than those in the controls. Endometrial hormonal activity was seen in 19% of the samples studied. Malignant and benign mucinous epithelial tumours were the types most frequently associated with hormonal activity. Increased levels of sex steroids were seen in the cyst fluid of serous malignant and borderline malignant tumours, while benign tumours were inactive. The steroid receptor content of the various tumour types did not vary significantly. Ten (59%) out of 17 ovarian carcinomas were found to be aneuploid and 41% diploid as measured by flow cytometry. No significant differences in serum levels of progesterone and oestradiol were found between aneuploid and diploid ovarian carcinomas. These results contribute to our knowledge of the hormonal activity of epithelial ovarian tumours in post-menopausal women.
Basement membrane proteins laminin, type IV collagen and aminoterminal propeptide of type III collagen (type III pN-collagen) are important components of extracellular matrix of normal lymph nodes; they are present in reticular fibres and in the walls of blood vessels and sinuses. We have studied the distribution of these proteins in 45 cases of non-Hodgkin's lymphomas representing different types of Kiel classification. Light microscopic immunohistochemistry was used on sections from formalin fixed, paraffin embedded biopsy specimens. Reticular cells were identified by using antibodies against S-100 protein, a marker for dendritic and interdigitating reticulum cells, and against cystatin A for the demonstration of follicular dendritic reticulum cells. The findings of the immunohistochemical stainings were generally similar in the different lymphoma types. Thus the method for the demonstration of extracellular matrix proteins could not give obvious aid for lymphoma classification. BM stainings proved to be efficient in the demonstration of sinuses. Marginal and medullary sinuses of the nodal cases were either totally or partly spared and open also in the cases in which there was extracapsular growth. The fibre content was variable, but generally the distribution of all the three extracellular matrix proteins was comparable with each other and mainly corresponded with the pattern seen in conventional Gomori's reticulin stain. This also holds for the tumor tissue infiltrated through the capsule and for extranodal cases. Areas of sclerosis of some cases contained only type III pN-collagen. Reticular fibres were at places seen to be closely associated with cells of spindle or dendritic shape. A few reticulum cells could be found to show cytoplasmic staining for laminin, type IV collagen and type III pN collagen. This finding suggests that the cells are synthetizing these proteins. The amount of cells staining for cystatin A or S-100 protein did not generally correlate with the amount of fibres, and most of the stained cells were not closely associated with fibres. The results show that in non-Hodgkin's lymphomas basement membrane proteins and type III pN-collagen are important components of reticular fibres. Results also indirectly support the main role of fibroblastic reticulum cells in the production of the fibres.
We analyzed serum lactate dehydrogenase (LDH), neuron-specific enolase (NSE) and thymidine kinase (TK) levels in 22 patients with small cell lung cancer. Tumor proliferation was expressed as the proportion of S-phase cells (SPF), determined by DNA flow cytometry, from concomitantly taken biopsy samples. A positive correlation between serum NSE (r = 0.41) or LDH (r = 0.65, p = 0.05) levels and tumor SPF was noted, but was not found between serum TK levels and the SPF. The correlation between NSE and SPF was even more pronounced if only patients with extensive disease were considered (r = 0.77). The serum NSE and LDH, but not TK levels, were significantly greater in the patients with extensive disease (NSE 50.4 ng/ml, LDH 621 U/ml) compared to the patients with limited disease (NSE 21.0 ng/ml, LDH 272 U/ml, p = 0.05). Our results suggest that the combined determination of serum LDH and NSE levels gives valuable data on the primary tumor mass and its proliferative activity in small cell lung cancer.
Explore the source record for details and available documents.
Upper genital tract infection was investigated in 45 women admitted to hospital for suspected acute pelvic inflammatory disease (PID). Salpingitis was diagnosed by laparoscopy in 30 (67%) women. Histopathological evidence of endometritis was found significantly more often in the 30 women with salpingitis (87%) than in the other 15 women without salpingitis (33%). C. trachomatis or N. gonorrhoeae, or both, were isolated from the upper genital tract in 14 of the 31 women who had both salpingitis and endometritis or endometritis only but in none of the four women who had salpingitis alone and in none of the 10 women who had no evidence of PID. Bacterial vaginosis was associated with histopathological evidence of upper tract infection. Non-chlamydial non-gonococcal organisms were frequently isolated from the upper genital tract. No organisms were isolated from the upper genital tract from 9 of 35 women with laparoscopic or histopathological evidence of PID compared with 7 of 10 women without evidence of PID. C. trachomatis or N. gonorrhoeae in the endometrium was associated with lymphoid follicles comprising transformed lymphocytes, and correlated with the density of plasma cells on biopsy. The microbiological results support the recommendations of broad spectrum antimicrobial therapy for PID.
The nuclear DNA content of 26 non-endemic Burkitt's lymphomas was studied by flow cytometry. Eighteen of the tumours showed a pattern characteristic for diploid chromosome distribution, while eight of the tumours were aneuploid. Six of the aneuploid tumours showed an almost diploid, aneuploid DNA index, while two were tetraploid tumours. Patients with aneuploid tumours had a significantly worse prognosis (p less than 0.005) than those with diploid tumours. One of the aneuploid tumours was positive for Epstein-Barr virus DNA.
We used second laparoscopy with dye insufflation to evaluate tubal findings in 20 women 15-45 weeks after treatment for acute pelvic inflammatory disease. Eight women had pelvic adhesions, including all six women with adhesions seen at first laparoscopy. However, in five of the six women, adhesions were milder or had disappeared unilaterally. Dye insufflation revealed tubal occlusion in five of eight women with adhesions and one of 12 women without adhesions. Thus, nine women (45%) had pelvic adhesions or tubal occlusion at second laparoscopy. Second laparoscopy is useful to objectively assess posttreatment tubal and peritubal morphology. Larger studies are needed to evaluate the cost-effectiveness of the procedure and the correlation of second laparoscopy findings to future infertility.
A retrospective clinical and histologic analysis of data on 60 cases of lymphoma of small non-cleaved follicular center cells (Lukes-Collins classification) was carried out. 19 cases were classified as Burkitt's lymphoma and 41 as non-Burkitt's. Non-Burkitt's lymphomas showed more diverse cellularity. Age distribution was bimodal in both subgroups. Half the patients irrespective of histology had stage III or IV disease. GI tract involvement was similarly frequent in both groups. Lymphadenopathy was slightly more frequent in patients with non-Burkitt's lymphoma. Median survival time was as low as 9.2 months for Burkitt's and 14.8 months for non-Burkitt's lymphoma (difference not statistically significant).
Explore the source record for details and available documents.
It has been shown previously that dendritic reticulum cells (DRC) in human secondary lymphoid follicles possess an immunoreactive acid cysteine-proteinase inhibitor (ACPI). In the present study, lymph nodes from 12 patients with AIDS-related persistent generalized lymphadenopathy (PGL) were investigated in order to detect whether or not any alterations occur in ACPI-immunoreactive DRC in this disorder. In the majority of PGL cases, profound alterations were found, the main characteristics of which were erosion, partial or total disruption of lymphoid follicles. However, similar though much less marked alterations were also found in some control cases. It is concluded that this type of follicular damage is a common and characteristic feature in PGL. It is not specific to PGL, however, but represents rather a special type of reaction in lymphatic tissue. The advantage of ACPI immunohistology for demonstrating the DRC pattern is that it can be performed on routinely fixed and paraffin-embedded tissues.
We have studied the role of serum C-reactive protein determination in the diagnosis of acute pelvic inflammatory disease. Acute-phase serum C-reactive protein concentration reflected the extent and the severity of pelvic inflammatory disease more closely than erythrocyte sedimentation rate or white blood cell count determinations. We recommend that both C-reactive protein concentration and erythrocyte sedimentation rate should be routinely used to augment the clinical diagnosis of pelvic inflammatory disease.
Explore the source record for details and available documents.
The best way of treating pelvic inflammatory disease (PID) is not known. The clinical response to two treatment regimens (penicillin plus metronidazole v doxycycline plus metronidazole) was studied in 33 patients with PID confirmed by laparoscopy and endometrial biopsy. The overall failure rate, according to the criteria used in this study was five of 11 (45%) women with chlamydial PID, none of six women with gonococcal PID, all of four women with chlamydial gonococcal PID, and three (25%) of 12 women with non-chlamydial non-gonococcal PID. The failure rate with penicillin plus metronidazole treatment was unacceptably high (53%), and significantly higher than that with doxycycline plus metronidazole (19%) (p = 0.038). In most cases the microbiological and histopathological evaluations identified a probable explanation for the poor response to the treatment regimen used.
In our previous studies acid cysteine-proteinase inhibitor (ACPI) was shown to be a common characteristic of human squamous epithelia and dendritic reticulum cells (DRC) in lymphoid secondary follicles. In the present study, the behaviour of ACPI-immunoreactive DRC in reactive lymphoid secondary follicles and neoplastic follicles of follicular-centre cell (FCC) lymphomas was compared by the peroxidase-antiperoxidase method. The secondary follicles in reactive lymphoid tissues revealed a staining pattern characteristic of DRC comparable with the results of other studies. Contrary to this, the number of ACPI-positive DRC in the neoplastic lymphoid follicles was greatly reduced. This was occasionally accompanied by a weak reaction and in many cases the DRC were totally abolished. Moreover, morphological aberrations were observed in ACPI-positive DRC, especially diminution and shortening of dendritic processes. On occasion, ACPI-positive cell types were observed, which may represent intermediate forms between DRC and fibroblastic reticulum cells. Only one case--with a rather favourable clinical outcome (out of 41 follicular FCC lymphomas) exhibited an ACPI-positive DRC pattern comparable with that of reactive lymphoid follicles. Thus it seems that the ACPI-immunohistochemistry of DRC provides an additional tool for discerning the difference between reactive and neoplastic lymphoid follicles. This method is of particular value since it can be used with formalin-fixed, paraffin-embedded tissues. There was a tendency among the follicular FCC lymphoma patients towards a better survival rate for those with ACPI-positive DRC than for those lacking this cell type, although no statistically significant differences emerged from this limited material.
Twenty-seven women with suspected acute pelvic inflammatory disease were studied by laparoscopy and endometrial biopsy. Overall, 67% (18 of 27) of the women had acute salpingitis at laparoscopy, 70% (19 of 27) had plasma cell endometritis, and 67% (10 of 15) had an inflammatory cytologic pattern of the peritoneal fluid. In comparison to laparoscopically detected salpingitis, endometritis detected with biopsy had a sensitivity of 89%, a specificity of 67%, a positive predictive value of 84%, and a false negative rate of 22% in the diagnosis of pelvic inflammatory disease. The corresponding figures for inflammation of the peritoneal fluid were 75%, 67%, 90%, and 25%. This study demonstrates that nonpuerperal endometritis is an entity associated with pelvic inflammatory disease, most likely representing an intermediate stage between cervicitis and salpingitis. Endometrial biopsy as an office procedure is a good alternative to laparoscopy in the diagnosis of acute pelvic inflammatory disease and may in fact detect early cases not yet visible at laparoscopy.
We describe two patients with laparoscopically diagnosed, severe acute salpingitis who had nontypable Haemophilus influenzae isolated directly from the fallopian tubes. Nontypable H. influenzae should be recognized as an important genital pathogen.
A retrospective clinical and histopathological analysis was made of patients with small non-cleaved-type malignant lymphoma according to the classification of Lukes-Collins. Nineteen cases were classified as the Burkitt type and 41 cases as the non-Burkitt type. The non-Burkitt type was more variable cytologically. A bimodal age distribution was seen in both subgroups. One half in both subtypes had an advanced disease (stage III-IV). Lymphadenopathy was slightly more common in the non-Burkitt type. No patient with non-Burkitt's lymphoma had mediastinal involvement (P less than 0.01). Liver and spleen were not involved by the tumor of the Burkitt type (P less than 0.005). Gastrointestinal involvement was seen in both types without differences. No statistical differences between the overall survivals of these subtypes were observed.