Studies on physiology and biochemistry of the fallopian tube: changes in the uterotubal junction of rabbits during early pregnancy.
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Glandular inclusions in lymph nodes. The problem of extensive involvement and relationship to salpingitis.
Para-aortic and pelvic lymph nodes surgically removed from 50 female patients were examined for glandular inclusions. The findings were correlated with fallopian tube changes in patients whose lymph nodes were found to contain inclusions. Seven of the 50 patients had lymph node glandular inclusions; in six, the inclusions were located primarily in the cortical or capsular regions and were few in number. Of these six patients, four had acute or chronic salpingitis. The seventh patient had exuberant lymph node glandular inclusions initially interpreted as metastatic adenocarcinoma and salpingitis isthmica nodosa. This patient is discussed in detail. The association of lymph node glandular inclusions with salpingitis has been reported twice previously; one of these two patients had salpingitis isthmica nodosa. These findings suggest a definite relationship between tubal disease lymph node glandular inclusions. The rare exuberant form of glandular inclusions is benign and should not be confused with adenocarcinoma. It appears definitely associated with salpingitis isthmica nodosa. We suggest two different mechanisms for the pathogenesis of these inclusions. The first is "benign metastasis" from the proliferating tubal epithelium to the draining lymph nodes. The second is a proliferative stimulus responsible for salpingitis isthmica nodosa which also acts on preexisting glandular inclusions to produce the extensive nodal lesion.
Adenocarcinoma, Papillary↗
Spontaneous motility and distribution of prostaglandins in different segments of human Fallopian tubes.
The "in vitro" spontaneous magnitude and stability with time of the isometric developed tension (IDT) and frequency of contractions of ampullar longitudinal and ampullar circular as well as isthmic longitudinal and isthmic circular muscle, from human Fallopian tubes, were explored. The effects of polyphloretin-phosphate (PPP), an inhibitor of prostaglandins (PG), upon the IDT and frequency of different tubal segments, were also explored. We looked for PGE, and F2alpha in extracts of ampullar and isthmic tubal segments. The initial IDT and frequency (recorded at 10 minutes following equilibration) as well as the stability with time (explored afterward during 40 minutes) were comparable among all the preparations, with the exception of the isthmic longitudinal muscle, which suffered a progressive decrement of IDT. PPP inhibited significantly the IDT of the isthmic circular muscle but had no effect upon the ampullar circular muscle. Whereas PGF2alpha was frequently detected in extracts from the isthmic region, those from the tubal ampullar region showed the consistent presence of PGE1. The results suggested a possible relationship between isthmic PGF2alpha and its spontaneous motility. Also, the peculiar distribution of PGE1 and PGF2alpha could have some bearing on the regulation of the different functions of isthmic and ampullar regions of human Fallopian tubes.
Fallopian Tubes↗
Structure and function of the fallopian tubes following exposure to diethylstilbestrol (DES) during gestation.
The association between the use of diethylstilbestrol (DES) and vaginal and cervical adenocarcinoma and adenosis in the progeny was first reported by Herbst et al. in 1971. This progeny will reach a peak as far as reproduction is concerned in this decade. It is estimated that 2 million women may be involved to varying degrees. Changes in uterine and cervical contour and structure have been detailed. Thus DES exposure and anatomic changes in the Müllerian system have been documented. In this report 16 women in the reproductive age group who were exposed to DES in utero and presented with infertility are discussed. On workup for infertility they were found to have unique tubal morphologic features consisting of a foreshortened, convoluted tube with "withered" fimbria with a pinpoint os at laparoscopy. The diagnosis could not be made at the time of hysterosalpingogram. Three patients had surgery in an attempt to correct this condition; and in all cases the surgery was unsuccessful. No statistical data is offered as to epidemiologic factors or incidence rates, but the suspected increase in infertility and ectopic pregnancy rates in patients with DES exposure may corroborate these findings.
Adult↗
Histopathologic changes in fallopian tubes subsequent to sterilization procedures.
Longitudinal serial and serial step sections of fallopian tubes from more than 100 patients, subsequent to tubal sterilization procedures, were examined. Thirteen of these patients had pregnancies following their sterilizations. The histologic findings at the previous surgical sites were compatible with what would be expected for a normal healing process. Evidence for a unique tubal epithelial process, as suggested by the terms "endosalpingiosis" or "recanalization," was lacking. Likewise, the author found no evidence of tuboperitoneal fistula formation and/or the subsequent occurrence of pregnancy secondary to localized endometriosis. The histologic notations of proximal luminal dilatation, plical attenuation, chronic inflammatory infiltrates with pseudopolyp formation, and the findings of plical thickening in the distal segment of remaining tube after an interruption type of procedure seem to be associated with the length of time from the sterilization procedure. These may be factors related to the apparent reduced success rate, with time, of microsurgical reanastomotic procedures.
Adult↗
Altered ciliary substructure in the endosalpinx in women using an IUCD.
Fallopian tube segments were removed from 20 women undergoing sterilization by laparoscopy or laparotomy. Ten of these patients used an intrauterine contraceptive device (IUCD). The other 10 had used neither IUCD nor oral contraceptives and served as controls. The ciliary ultrastructure was examined by light- and transmission electron microscopy. The IUCD users had a significantly reduced ciliary length and less well oriented cilia, as compared with the control group. Also, the proportion of cilia with a ciliary crown structure was significantly smaller in IUCD users than in the non-users. The mechanism that may cause these alterations and their putative consequences are discussed.
Adult↗