Electron microscopic study of the endometrium lining the uterus in women with endometriosis

The structure of the endometrium in women diagnosed with endometriosis was compared to matched normal controls, using the electron microscope [EM]. The study was conducted at Ain-Shams University Obstetrics and Gynecology Hospital in the period between March 1999 and March 2001. The endometriosis group included 18 patients diagnosed to have endometriosis with mean age 39.2 +/- 1.3 years. In 11 patients the diagnosis was based on laparoscopic findings of moderate to severe endometriosis, in 7 patients the diagnosis was based on laparoscopy together with histopathology of pelvic nodules. The control group comprised 9 women in the reproductive age undergoing hysterectomy for benign gynecological conditions not involving the endometrium, the mean age for this group was 41.5 +/- 2.1 years, in 7 women the indication for hysterectomy was uterine descent and 2 for subserous fibroids of the uterus, in these 2 patients there was no complaint of abnormal uterine bleeding. None of the women included in this study had used steroidal contraceptives or intrauterine device in the lest 6 months before specimen collection. Only endometrium showing normal histology was included in the study. Compared with the normal, the endometrium from women affected by endometriosis showed abnormal features. The secretory cells had more numerous and longer microvilli. In the cytoplasm, there were more secretory granules and mitochondria. The rougie endoplasmic reticulum [RER] was more promirent and with dilated cisternae. Lipid droplets and electron dense particles were frequently seen. The cilia of ciliated, cells were increased, and elongated remarkably. The basement membrane was markedly tortuous. This might be the origin of endometriosis and the cause of infertility. The effect of these morphological differences on implantation needs further study

Studies on nephrotoxicity aspirin and gentamicin in combination in rats

Aspirin [ASA] and gentamicin [GM] are widely used by many patients in Egypt. The aim of this work was to investigate the nephrotioxic effect GM and in combination with administration of ASA in rats. 28 adult male Sprague Dawley rats were used in the present work. They were divided ino 4 equal group. The second group was injected with ASA, third group was given GM and the fourth group was given combination of GM and ASA. The biochemical indices measured were body weight, urine volume, plasma creatinine and blood urea nitrogen levels. When ASA and GM were used in combination, a marked increase in the nephrotoxic parameters was observed. A signficiant increase in plasma creatinine, blood urea and urine volume. Electron microsopic examination confirmed the extensive renal damage following combined administration of ASA and GM. The intertubular spaces were greatly wide and loaded with thick bundles of collagen fibrils and many inflammatory interstitial cells. The cytoplasm of the severely affected tubular cells were loaded with heavy aggregations of many large myeloid bodies as well as heterogeneous lysosomes containing masses of electron-dense deposits and sequestrated organelles. Multivesicualr bodies and residual bodies containing lipid droplets were also noticed, however, the size and number of these inclusion were more frequently encountered than in any of the other treated group of animals. There were occasional thickening of the lamina densa of the capillary basement membrance and fusion of the foot preocesses of podocytes. The thickened endothelial lining of the glomerular basement membrane was observed to affect more expanded sections of the glomerular capillaries with more obliteration of its fenestrae. The capillary lumen and the urinary spaces also contained many cellular bedris. In conclusion, the results of this study clearly indicate that ASA potentiates the severity of GM nephrotoxicity within two weeks of treatment when both drugs were given concurrently; and the possibility that interaction might increase the nephrotoxic risk associated with gentamicin administration should be taken in consideration. So, these results recommend to aviod the use of this combination especially in high persons with compromised renal function

range of morphological variation of the middle meatus of the nose in cases without clinical sinusitis

Twenty cadaveric head regions were sagitally sectioned and examined for the anatomy of the middle meatus region. Serial coronal CT section [1-3 mm] of fifty persons were done. Twenty five of tehm belong to patients suffering from chronic sinusitis, and the other twenty five of sinusitis-free persons. Selected measures were applied on both cadaveric speciments and coronal CT scans. The results of the present study showed a wide range of anatomical cariations in this region, even in the sinusitis-free. Certain anatomical structures showed marked discrepancy in frequency of variations or its dimensions in patient suffering from chronic sinusitis in relation to sinusitis-free persons. The most important variation in the middle turbinate was the concha bullosa which was present in 28% of sinusitis-free bit it was found in 52% of sinusitis patients. Also, the curvature of the middle turbinate was abnormal in 20% sinusitis patient while no cases of abnormal curvature were recorded in sinusitis-free persons. The distance between the middle turbinate and the bulla ethmoidalis was wider in sinusitis-free persons as it was of mean value 1.9 mm than in sinusitis patients which was of mean value 1.7 mm. As regards the uncinate process, it showed abnormal deflections in 28% of sinusitis-free persons and in 60% of sinusitis patients. Concerning the hiatus semilunaris and the infundibulum, it was found that in sinusitis-free persons the hiatus semilunaris was more wide as it was of mean value 2.7 mm while in sinusitis patients the mean width was 1.4 mm. The infundibulum depth was more shallow in sinusitis-free persons as its mean depth was 5.6 mm, while in sinusitis patients, the mean depth was 6.6 mm. Concerning the bulla ethmoidalis size, it was larger in sinusitis patients as it was of mean value 17 x 7 mm while in sinusitis-free persons, it was of mean value 14 x 6 mm. Haller's cells were detected in 28% of sinusitis-free persons and in 60% of sinusitis patients. As regards the maxillary sinus ostium, it was found that its transverse diameter was of mean value 6 mm in sinusitis-free persons while it was 3.5 mm in patients of sinusitis. Scanning of the anatomical variations and measures in cadavers and sinusitis-free persons could act as an accurate Egyptian guide serving surgical procedures. The higher incidence of variations in certain parts and discrepancy in dimensions of other parts between the sinusitis and non-sinusitis cases may support the theory that emphasizes the role of anatomical variations in the aetiology of chronic sinusitis and consequently may help to settle the controversy around this point