Evaluation of abnormal vaginal bleeding with the Gravlee jet Washer.
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Biomedical subjects
Publications and source records attributed to T H Parmley.
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The spontaneous development of total vaginal occlusion as the result of postmenopausal atrophy is unusual. This poorly described entity may give rise to diagnostic confusion, as the site of vaginal occlusion resembles an atrophic cervix flush with the top of a stenotic vaginal vault. Fluid collections above this site of occlusion may produce pelvic masses with a characteristic physical sign. The absence of any history of vaginal injury or disease distinguishes these cases from other types of acquired vaginal occlusion.
Leiomyomatosis peritonealis disseminata (LPD) is a rare clinical entity. Widespread subperitoneal nodules of apparent smooth muscle are found in patients who are pregnant or have recently been so. This clinical appearance together with mitotic figures found in frozen sections suggests malignancy. We believe, in contrast, that LPD is a benign reparative process in which fibroblasts replace subperitoneal decidua.
Seven cases of invasive vulvar Paget's disease are presented. These are compared with 10 cases of intraepithelial vulvar Paget's disease. On the basis of both clinical and histopathologic observations, the concept of intraepithelial vulvar Paget's disease is supported, and this entity is distinguished from the invasive form. Therapy for the latter is discussed.
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The case reports of two female adolescents with congenital absence of the Müllerian ducts and a unilaterally enlarged uterine anlage containing functioning endometrial tissue are presented. The clinical manifestations may vary depending upon the delay in diagnosis after the onset of endometrial shedding within the anlage. A high index of suspicion and proper diagnostic evaluation may prevent unnecessary hospitalization. In our experience, prompt removal of the functioning uterine anlage affords complete relief of the symptoms.
Broad ligament adrenal rests are well known. A case of adrenal rest external to the surface of the broad ligament and adjacent to the fallopian tube is reviewed, with specific emphasis on its histogenesis. The rest is associated with a foreign body, and it is suggested that it has arisen as a secondary development of celomic epithelial metaplasia.
OBJECTIVE: To examine the cyclin D1 mRNA expression level in ovarian tumor samples as compared with normal ovaries and to determine the relationship between cyclin D1 overexpression and p53 mutation status in ovarian tumors. METHODS: mRNA was isolated and cDNA was prepared from 27 epithelial ovarian tumors (3 tumors of low malignant potential (LMP) and 24 cancers) and 6 normal ovaries. The cyclin D1 sequences were amplified by using a thermal cycler in parallel with the beta-tubulin gene as an internal control. The cyclin D1 mRNA expression level relative to beta-tubulin was determined by 32P phosphoimager analysis. To confirm the overexpression of the cyclin D1 protein in ovarian tumor cells, immunostaining was performed. The p53 gene mutation status was examined by direct cDNA sequencing. RESULTS: mRNA levels of cyclin D1 were significantly higher in 21 (78%) of the 27 ovarian tumors than in normal ovaries. Cyclin D1 overexpression was detected in ovarian LMP tumors as well as in ovarian cancer cases. Positive immunostaining of cyclin D1 protein was observed in 10 of 18 (56%) ovarian tumors examined. p53 mutations were found in 11 (61%) of 18 ovarian tumors. Of 11 ovarian tumor cases with p53 mutations, 5 showed overexpression of cyclin D1. All 7 ovarian tumor cases without p53 mutations showed significant cyclin D1 mRNA overexpression. CONCLUSION: Cyclin D1 overexpression seems to be an early genetic event in ovarian tumor development. Although p53 may be one of the proteins whose function regulates the expression of G1 cyclins, ovarian tumors with no p53 mutation consistently showed cyclin D1 overexpression. Cyclin D1 overexpression may play an important role in the tumorigenesis of epithelial ovarian tumors.
We have previously reported that the stratum corneum chymotryptic enzyme (SCCE) is overexpressed in ovarian cancers and that SCCE has potential as a useful marker and/or a therapeutic target for ovarian carcinoma. Antileukoprotease (ALP) has been shown to be a specific inhibitor of SCCE. The objective of this study was to investigate the potential cotranscription and overexpression of ALP in carcinoma of the ovary. The expression of ALP transcript was evaluated by Northern blot hybridization and by semiquantitative polymerase chain reaction (PCR) technique. The presence of the ALP protein in ovarian tumor cells was evaluated by immunohistochemistry. Northern blot hybridization showed that the ALP transcript was abundant in ovarian carcinomas but was not detected in the normal ovary. Semi-quantitative PCR examination revealed that the mRNA level of ALP was significantly elevated in low-malignant-potential tumors and in ovarian carcinomas compared with that in normal ovaries (P < 0.01). There was significant positive correlation between SCCE and ALP mRNA overexpression status in ovarian tumor cases (P < 0.01). Immunohistochemical expression of ALP protein was observed in ovarian tumor cells, whereas little or no staining was observed in normal ovarian surface epithelium. Like SCCE, ALP is highly overexpressed in ovarian tumor cells, which begs the question of whether it remains an effective inhibitor of SCCE or whether it is discordant in time or space and is ineffective as an inhibitor of the SCCE enzyme.
Matrix metalloproteases are known to play an important role in tumor invasion by mediating degradation of extracellular matrix. In this study, we have investigated the expression of the matrix metalloprotease pump-1 gene (also referred to as MMP-7, Matrilysin) in 44 ovarian tumors (12 low malignant potential tumors, 32 carcinomas) and 10 normal ovaries using quantitative PCR. The PCR product was labelled with 32P and a phosphoimager was used to determine the relative expression of pump-1 compared to an internal control beta-tubulin. mRNA expression levels of pump-1 were significantly elevated in 9 of 12 low malignant potential tumors and 26 of 32 carcinomas. Northern blot hybridization showed that the 1. 1-kb pump-1 transcript was abundant in carcinoma but seldom expressed in normal adult tissues including normal ovary. Immunohistochemical localization of the pump-1 protein confirms its expression by ovarian tumor cells. Our results suggest that pump-1 is frequently overexpressed in ovarian tumors and may contribute to its invasive nature or growth capacity, therefore pump-1 may serve as a useful marker for early detection of disease and/or a target for therapeutic intervention in downregulation of tumor progression.