Human myometrial interstitial cajal like cell [Telocyte] in preterm and full term labour: histological and immunohistochemical studies

Introduction: Preterm labour is a common obstetric problem. The human myometrium is formed of two types of cells namely smooth muscles and interstitial Cajal like cells or telocytes which express both estrogen and progesterone receptors

Aim of the work: This study aimed to know how many telocytes are present in the pregnant uteri at time of labour in the different gestational ages and the possible role of telocytes in preterm labour

Patients and methods: 10 pregnant women were included in the study planned to do cesarean section. They were divided into two groups: Group I: included 5 cases whose gestational age was less than 37 weeks [preterm]. Group II: included 5 cases whose gestational age was more than 37 weeks [full term]. Specimens were obtained from the myometrium at the time of the operation and processed for histological and immunohistochemical study

Results: H and E stained sections revealed hypertrophied smooth muscle fibers with different orientations. Methylene blue stain revealed telocytes between the smooth muscle fibers as a branched cell with small cell body and thin long processes. CD 117 [ckit] immunostaining revealed an apparent increase in the number of telocytes in preterm cases [Group I] compared to full term cases [Group II]. Morphometric study revealed a significant increase in the number of ckit positive telocytes in preterm cases compared to the full term one

Conclusion: Telocytes are present in the pregnant uteri at different gestational ages with a significant increase in their number in the preterm cases; they may have a possible role in preterm labour

Transvaginal uterine artery ligation: a possible alternative treatment modality for the symptomatic fibroids

To determine the efficacy of Transvaginal Uterine Artery Ligationfor the management of symptomatic fibroids. 19 women, aged from 33 to 46 years, with symptomatic, single uterine fibroid, not exceeding 14 weeks, were recruited. Objective measurement of menstrual blood loss [MBL] by the alkaline hematin technique [Hallberg, et al, 1966], and ultrasonographic measurement of the fibroid volumes were determined preoperatively and at 3, 6 and 12 month post operative follow up. Improvement of the presenting symptoms -was observed during follow up. There was a significant decrease in the sonographic myoma volume at 3 month [P> 0.05], 6 months [P> 0.01], and 12 month [P> 0.01] postoperatively. The MBL was significantly lower in the postoperative follow up, when compared with the preoperative levels; at 3 month [P< 0.05], 6 month [P< 0.01], and 12 month [P< 0.01]. Rise in hemoglobin concentration was observed at 3 month postoperative [P>0.05]. Statistically significant higher hemoglobin concentrations were observed at 6 and 12 month postoperatively [P< 0.05]. There were no cases of ureteric injury, and none needed a second procedure. Transvaginal uterine artery ligation could be considered a possible, simple, alternative treatment modality for the symptomatic fibroids

Stage I cancer ovary: Diagnostic modality in our locality

The main objective was to evaluate the diagnostic tools used for diagnosis of stage 1 ovarian cancer. This is a descriptive study was conducted during the period from 1999 to 2003 at Sohag University Hospital. 53 patients out of 212 had stage I ovarian cancer was included in the study. They subjected to thorough history taking, proper examination and routine investigations. Ultrasonography with Doppler flowmetry, CT, IVP and CA-125 were done for all patients. Surgical staging and histopathologidal examination of all specimens was carried out. Ovarian cancer represented the most common type of genital tract malignancy 124[64.92%] 53[25%], 11[5.18%], 114 [53.77%] and 34[16.03%] cases were diagnosed as stage I, II. III and IV respectively, 27 patients [50%] with stage I ovarian cancer were symptoms at time of diagnosis. The most common symptoms in stage 1 ovarian cancer was abdominal swelling or fullness. Both of CT scan and Ultrasonography examination were found to be better than the clinical impression based on symptoms and signs in predicting the malignant nature of ovarian masses