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Effects of contrast agents on the fallopian tube in a rabbit model.

The authors evaluated the effect of different iodinated contrast agents on the fallopian tube and adnexal tissue in 15 rabbits. Ethiodized oil, an oil-soluble agent, was used in five rabbits. The following water-soluble agents were used: iothalamate meglumine 30% (n = 3), iothalamate meglumine 60% (n = 3), and ioxilan (n = 4). The agents were injected through catheters placed in the fallopian tubes. Fallopian tubes and peritoneal cavities were histologically evaluated. The contralateral tube served as a control. Ioxilan and iothalamate meglumine 30% produced no pathologic response in the tube or peritoneal cavity. Iothalamate meglumine 60% was associated with mild inflammatory infiltrate, mucosal edema, giant cell reaction, and periovarian adhesions that were bilateral but more pronounced on the injected side. Use of ethiodized oil resulted in papillary fibrous adhesions on the ovarian surface, and fat granulomas were seen in the periovarian tissues. The safety of oil-based contrast agents for use in hysterosalpingography is therefore questioned. No significant differences were found among the water-soluble contrast agents.

Adnexa Uteri

Exfoliative cytology in a case of prolapsed fallopian tube.

The appearances of cells from a prolapsed fallopian tube found in a vault smear are described, and the differential diagnosis is discussed. It is concluded that if the distinctive appearance of the small, regular and occasionally ciliated columnar cells with granular nuclei and prominent nucleoli are recognized, it may be possible for the cytologist to help the clinician differentiate the unusual condition of a prolapsed fallopian tube from other vault "granulations". Prolapse of the fallopian tube is a rare complication of hysterectomy. This is a report of the cytologic findings in a vault smear from a patient suffering from this complication.

Adult

Carcinoma of the fallopian tube.

Carcinoma of the fallopian tube is the least frequent tumor of the female genital tract. It may occur at any age but is more common in the sixth decade. The tumor involves both tubes in 26 per cent of cases. The spread is by direct extension to peritoneum. The symptoms include metrorrhagia, leukorrhea, abdominal pain, singly or in combination. The diagnosis is difficult but could be made more frequently if the causes of abnormal bleeding were thoroughly investigated by means of cytology and endometrial curettage. Treatment is by resection of the tumor, total hysterectomy, and bilateral salpingo-oophorectomy followed by chemotherapy. The 5-year survival rate is 38 per cent.

Adult

Benign teratoma of the Fallopian tube.

Teratoma of the Fallopian tube is very uncommon. Only 47 cases have been reported since 1865. Many have been discovered incidentally and none has been diagnosed preoperatively. The majority are cystic, show great variation in size, are commonly located in the ampulla or isthmus and are either intraluminal or attached to the luminal surface by a pedicle. Histologically they are similar to teratomas of the ovary and elsewhere. Only one instance of malignant tubal teratoma has been recorded. An association with nulliparity or reduced parity has been noted in some cases. The present case of benign tubal teratoma is the 48th and apparently the smallest reported.

Fallopian Tube Neoplasms

The presence and estrogen control of immunoreactive calbindin-D9k in the fallopian tube of the rat.

The present study was undertaken to localize and investigate the endocrine control of immunoreactive 9K calbindin-D9k in the fallopian tube (oviduct) of the rat. Rat fallopian tubes were excised with the uterus, immediately fixed by freeze-substitution, and processed for immunoperoxidase staining. Staining employed a rabbit antiserum against purified rat intestinal calbindin-D9k and the streptavidin-biotin technique. Calbindin-D9k immunoreactivity was localized to luminal epithelial cells of the fallopian tube of mature rats, with no staining observed in other tissue layers of the tube. Epithelial cells in both the isthmus and the ampulla were positive for calbindin-D9k. In weanling rats, which have little ovarian function but high levels of 1,25-dihydroxyvitamin D, no immunoreactive calbindin-D9k was observed in any part of the tube. However, after daily injections of estradiol (6 micrograms/day) for 3 days, intense staining was observed in the epithelial cells of the immature rat fallopian tube. Progesterone treatment (1 mg/day for 3 days) of immature rats had no effect on calbindin-D9k in fallopian tube. The lumen of the fallopian tube (oviduct) is the key location for fertilization, a process that requires a narrowly defined concentration of extracellular calcium. By analogy to the intestine, calbindin-D9k may play a role in the transcellular movement of calcium across the fallopian tube epithelium in the fallopian tube lumen.

Animals

Localization of gonococcal lipopolysaccharide and its relationship to toxic damage in human fallopian tube mucosa.

An experimental model using human fallopian tubes in organ culture was used to study the localization of purified gonococcal lipopolysaccharide (LPS). LPS was visualized by light microscopy with immunoperoxidase staining. Immediately after addition to fallopian tube organ cultures, gonococcal LPS aggregated on the tips of cilia. By 1 to 2 h after exposure, LPS could be seen distributed throughout the cytoplasm of ciliated and nonciliated cells in structures resembling vesicles. By 12 h, there were sloughed, ciliated cells present in the fallopian tube lumen, which had positive LPS stain on their surfaces as well as in their cytoplasm. By 24 h, LPS was distributed throughout the cytoplasm. Control experiments with rabbit oviduct organ cultures showed that LPS failed to attach, enter, or damage mucosal cells. These studies illustrate the initial localization of LPS on human mucosal cells and its uptake into the cells, which are coincident with toxicity for ciliated epithelial cells.

Animals

Completed pregnancy following vascularized heterotopic autotransplantation of the Fallopian tube in the ewe.

Transplantation of the Fallopian tube is a technically feasible operation. Previous authors have reported pregnancies following turbo-ovarian transplants, but there appears to be no record of gestation following transplantation of the isolated oviduct. This communication illustrates the method that we have used to perform Fallopian tube transplants in the ewe and documents our first full-term pregnancy following this operation. It provides further evidence of the technical feasibility of Fallopian tube transplants.

Animals

Unexplained displacement of ipsilateral ovary and fallopian tube.

During routine laparoscopy, the right fallopian tube and ovary were noted to be displaced. Ovarian and fallopian tube tissue were found on biopsy of adjacent omentum. The most probable cause is asymptomatic torsion of the right adnexum; therefore, evaluation of the renal system with intravenous pyelogram is probably not necessary.

Adnexal Diseases

Effect of Lippes loop on sperm recovery from human fallopian tubes.

Recovery of human sperm from the fallopian tubes after natural insemination have been studied in sixty women; out of these, thirty cases were fitted with the Lippes loop, type C, for at least six months. The mean sperm count/high power field (HPF X 400) and percentage of motile sperm in the cervical mucus in both control and Lippes loop groups showed no significant differences. No sperm were recovered from the fallopian tubes of the Lippes loop group, while fourteen control cases had a positive recovery of sperm from the tubal washings. The mean number of white blood corpuscles in the tubal washings of Lippes loop-fitted cases was found to be significantly higher than in control cases. The phagocytic capacity of these cells may explain the low incidence of sperm recovered from the fallopian tubes in such cases.

Adult

[Regeneration of the Fallopian tubes following sterilization (author's transl)].

After any trauma to the fallopian tubes by a sterilizing operation, pregnancy occurs. If the sterilizing procedure was by high frequency current coagulation, large areas of the fallopian tube must be destroyed down into the mesosalpinx in order to avoid the preprogrammed recanalization tendency of the muellerian duct. Fertilization has occurred in recanalized fallopian tubes which only showed a cubic epithelium. Extensive destruction of the fallopian tube is today not justifiable because of the possibility of interference with the ovarian blood supply and subsequent hormonal damage. At present the safest method of female sterilization is by tissue coagulation of segment of the fallopian tube at 100 centigrade and division of the coagulated portion. In 1000 cases there were no pregnancies.

Electrocoagulation

Adenocarcinoma of the Fallopian tube. An ultrastructural study.

A case of fallopian tube adenocarcinoma was studied by light and transmission electron microscopy. The neoplastic cells contained abundant mitochondria, moderate to large amounts of rough endoplasmic reticulum (RER) arranged in parallel arrays and often containing amorphous material, annulate lamellae, possible secretory vesicles, and glycogen. The presence of stacked RER and annulate lamellae together is unusual in papillary serous cystadenocarcinoma of the ovary, and has not been described in Fallopian tube adenocarcinoma. Golgi complexes were are. Small acini with projecting microvilli as well as junctional complexes were present, but cilia were not found. The electron microscopic findings suggest secretory activity, and are remarkably similar to those found in papillary serous cystadenocarcinomas of the ovary. The findings also support the hypothesis that ovarian serous tumors and adenocarcinomas of the Fallopian tube are derived from coelomic epithelium.

Adenocarcinoma

[Experimental and clinical study of tong jing bao and Angelicae complex injection in treating fallopian tube obstruction].

Twenty-two female rabbits with fallopian tube obstruction as the model, were made by 25% Phenol-Tragacanth Mucilage in the laboratory study. Eight rabbits were treated by taking Tong Jing Bao and giving transcervical intrauterine injecting of Angelicae complex injection. Seven were treated with the latter and other seven with 0.9% saline only as the control group. The study showed that in the opening fallopian tube, anti-inflammation, limiting the hyperplasia of fibro-connective tissue and improving the regeneration of epithelial tissue, the first group was more effective than the other two groups (P less than 0.05). Forty-eight infertile women, in whom the fallopian tube obstruction were proved by hysterosalpingography, were divided into two groups for the clinical study. Thirty patients were treated as same as the first group of rabbits. As the control group, other eighteen women were treated with transcervical intrauterine injecting of gentamycin and 0.9% saline in 3 to 6 months. The effective rates were 94.6% and 56.6% (P less than 0.01) and the subsequent pregnancy rates were 46.7% and 27.8% respectively in the different two groups.

Adult

New concepts in the diagnosis and treatment of proximal fallopian tube blockage.

If a blocked fallopian tube is initially diagnosed and is cleared by simple means, and there is no clinical evidence of other pathology it is reasonable for the patient to go on and attempt to conceive for a time before any further investigation is required. This might be three to six months. A significant amount of cost and morbidity would be eliminated by this pathway, rather than the current push to laparoscopy.

Adult

Treatment of fallopian tube carcinoma with cisplatin, doxorubicin, and cyclophosphamide.

Primary carcinoma of the fallopian tube is uncommon and is often treated using regimens active in ovarian carcinoma. Evidence is scant that such therapies benefit patients with fallopian tube carcinoma. Between December 1979 and July 1988, we treated 18 patients who had adenocarcinoma of the fallopian tube with the combination of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2) administered intravenously on 1 day every 28 days. Histologic confirmation of fallopian tube carcinoma was obtained before entry in the study. Three patients had stage I disease, five had stage II, nine had stage III, and one had stage IV. Sixteen patients received the combination therapy as first-line treatment after cytoreductive surgery, and two patients received it for recurrent carcinoma. Seven patients had clinically measurable disease at the start of therapy. Two of these patients had a complete clinical response, two had stable disease, and three had progressive disease. Eight of the 15 patients with stages II-IV disease underwent second-look laparotomy; four had a complete response to therapy and four had a partial response, making the overall response rate 53%. The toxicity of the regimen was moderate. The median survival was 81 months. Patients with stages II-IV disease had a median survival of 43.9 months and a progression-free survival of 22.5 months. This regimen appears to be active in fallopian tube carcinoma and can result in response rates comparable to those reported for epithelial ovarian cancer.

Adenocarcinoma

Fallopian tube patency demonstrated at ultrasonography.

Fallopian tube patency was assessed in 24 infertile patients by hysterosalpingography (HSG) and ultrasonographic examination of the pouch of Douglas following transcervical injection of a sterile isotonic solution of NaCl. The presence of fluid in the pouch, after the injection, was taken to indicate tubal patency. The results of the HSG and the ultrasonographic diagnosis as to the presence of at least unilateral tubal patency were concordant in 21 patients. Pitfalls consisted of fluid accumulation in periadnexal adhesions, edema in the bowel wall, and spill of the injected saline into a large hydrosalpinx. Ultrasonography is advocated as the initial examination in assessing infertility in young women. If tubal patency is demonstrated, the patient should be recommended a six month trial period, to become pregnant, before invasive procedures are initiated.

Adolescent

Fallopian tube cancer. The Roswell Park experience.

Sixty-four patients with primary fallopian tube cancer treated at Roswell Park Memorial Institute from 1964 to 1987 underwent retrospective clinicopathologic review. In 40 patients fallopian tube cancer was the only primary, but in 24 patients primary fallopian tube cancer was part of a multifocal upper genital tract malignancy. Of the 40 patients with unifocal fallopian disease, the median survival was 28 months. Only 15% of patients were alive and disease free with follow-up ranging from 22 to 141 months (median, 90.5 months). Survival was not associated with stage of disease, tumor histology, grade, or depth of invasion in this series. Fourteen patients who received cisplatin-based chemotherapy were evaluable for response. Three patients (21%) responded; two complete and one partial. Twelve patients without clinical evidence of disease underwent second-look procedures, ten laparotomy and two laparoscopy. Four of ten second-look laparotomies were negative. Secondary debulking was done in three of four patients with gross disease, one of which had a negative third-look laparotomy. Negative laparotomy, second-look or third-look, was associated with improved survival (P = 0.016). One of the two laparoscopies was negative, but the patient recurred. In the remaining 24 patients cancer of the fallopian tube was part of a multifocal upper genital tract malignancy. In 12 patients tubal disease was invasive, and in 12, it was in situ. Separate primaries occurred in the ovaries (n = 20); uterus (n = 7); and cervix (n = 2). This represents 1.3% of ovarian malignancies treated at Roswell Park Memorial Institute during the study period. Fallopian tube cancer seems as virulent as ovarian cancer with few long-term survivors. It is frequently associated with other sites of upper genital tract malignancy. Second-look laparotomy is an important predictor of survival. Second-look laparoscopy may be useful if positive.

Adenocarcinoma

Malignant mixed müllerian tumor of the fallopian tube.

Primary malignant mixed müllerian tumor of the fallopian tube is uncommon. Only 37 cases of malignant mixed müllerian tumor of the fallopian tube have been reported to date and of these only 16 contained heterologous components (mesodermal mixed tumor). This rarity made us report a case of malignant mixed müllerian tumor of the fallopian tube containing heterologous components which was operated on in our gynecologic oncology department. Postoperatively the patient was placed on six courses of adjuvant chemotherapy consisting of cis-platinum, adriamycin and cyclophosphamide (PAC). Second look laparotomy was performed after completion of chemotherapy. Presently, she is doing well, at two months follow-up, with no evidence of disease.

Adult

Biochemical and immunochemical studies on the GABAergic system in the rat fallopian tube and ovary.

gamma-Aminobutyric acid (GABA) and glutamic acid decarboxylase (GAD) activities were measured in the ovary and the Fallopian tube of rats and compared with brain values. GABA levels in the Fallopian tube were about twice as high as in the brain, while in the ovary they represented only about 5% of the amino acid content of the CNS. In vitro decarboxylation of glutamate, measured via CO2 formation, occurred both in the Fallopian tube and in the ovary. These two organs contained, respectively, 10% and 1% of brain GAD activity. However, the actual formation of GABA from glutamate in a high-speed supernatant was detectable only in the Fallopian tube, where it represented about 5% of brain GAD activity. In contrast with the enzyme present in ovary, liver, anterior pituitary, and kidney, that in the Fallopian tube was quantitatively precipitated by a specific antiserum directed against rat neuronal GAD. Moreover, subcutaneous transplantation resulted in a quantitative decrease of both GABA levels and GAD activity in the Fallopian tube while no change occurred in the ovary, and vagus nerve section induced a 50% decrease of GAD activity in the Fallopian tube, although GABA levels were not significantly altered. The findings suggest an extrinsic GABAergic innervation in the rat Fallopian tube but not in the ovary.

Animals