The effects of Escherichia coli STa (heat stable) toxin on the contractility of isolated human myometrium in vitro.

OBJECTIVE: The purpose of the study was to assess the effects of Escherichia coli STa (heat stable) toxin on isolated human myometrial response to oxytocin. METHODS: One hundred and sixteen muscle strips were obtained from the lower uterine segment of 42 women undergoing cesarean section at term. Amniotic membranes and decidua were excluded. Uterine contractility in response to cumulative doses of E. coli STa toxin was recorded, as well as uterine response to cumulative doses of oxytocin before and after incubation with STa toxin or vehicle. The 50th percentile effective oxytocin concentration (EC50) of muscle strips with and without spontaneous activity before and after the incubation with STa toxin or vehicle was calculated. A paired t test was used for comparison. RESULTS: Muscle strips with and without spontaneous activity responded to cumulative doses of oxytocin before and after the incubation with STa toxin or vehicle. No differences in contraction force, duration, or frequency were noted between the groups (P > 0.05). Furthermore, this toxin was not able to induce uterine contractility when tested alone. CONCLUSIONS: The inability of this toxin to affect myometrial response to oxytocin in this study may be due to the absence of amnion cells, chorion, or decidua. Other possible explanations for the lack of response are discussed.

Endometrial ablation for severe menorrhagia in a patient with hereditary hemorrhagic Telangiectasia. A case report.

BACKGROUND: Hereditary hemorrhagic telangiectasia is a rare, inherited disease characterized by abnormal visceral and superficial blood vessel anastomoses. These telangiectasias predispose the patient to a lifelong history of recurrent bleeding for the nasal and gastrointestinal mucosa. Less commonly involved organs include the liver, brain and lung. To date there is no cure for this disease. Management requires many palliative minor surgical procedures to stop actively bleeding sites. Major surgery is often contraindicated in these patients due do coexisting medical sequelae of their underlying disease. CASE: Menorrhagia was diagnosed in a 42 year-old multipara with known history of hereditary hemorrhagic telangiectasia. The bleeding was unresponsive to hormonal therapy. Substantial preexisting conditions, including profound anemia, history of multiple strokes, a seizure disorder and ventricular arrhythmias, precluded major surgical intervention, including hysterectomy. Serial injections of leuprolide acetate injections were followed by hysteroscopic "rollerball" electrocoagulation of the endometrium under regional anesthesia. On long-term follow up, the patient was cured of her menorrhagia. CONCLUSION: Endometrial ablation provides patients who have significant medical complications with an effective, minimally invasive alternative to hysterectomy for control of menorrhagia.

Seminal concentssrations of total and ionized calcium from men with normal and decreased motility.

In this study, sperm motility, velocity, and progression were compared with the total and Ca++ concentrations in the SF from men with normal and decreased motility (less than 60%). No significant difference in SF total calcium content was observed in men with normal and hypomotility. However, a statistically significant decrease in seminal Ca++ was observed in those men with decreased motility, when compared with that of men with normal motility.

Platelet-activating factor in human luteal phase endometrium.

Platelet-activating factor (PAF; 1-O-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine) is one of the most potent mediators of vascular permeability. PAF levels change in the rabbit endometrium just prior to implantation, which suggests that PAF may be a key substance transducing preimplantation embryonic signals. To study whether PAF was present in the human endometrium, and if so, to determine the cellular origin and hormonal regulation of endometrial PAF, specimens were obtained from 14 women (aged 23-42 yr) undergoing elective hysterectomy during the luteal phase of the cycle (plasma progesterone levels greater than 2 ng/ml). No specimens were taken from women with malignant uterine pathology. Stromal cells and epithelial glandular cells were separated by collagenase and DNAse digestion, and then cultured to confluence in vitro in medium 199. Radioimmunoassays of prostaglandin F (PGF) and prolactin in the culture media were used to confirm cell type and viability. PGF release into the culture medium from stromal cells was low (control 1.52 +/- 0.20 ng/ml), and unchanged by hormone treatment. In contrast, release of PGF from unstimulated glandular cells was 6.05 +/- 0.52 ng/ml, and was significantly increased (p less than 0.05) by estradiol or progesterone plus estradiol, to 12.17 +/- 1.67, and 8.60 +/- 0.81, respectively. Progesterone alone was without effect. Prolactin was secreted by stromal cell cultures, increasing steadily from 24 to 120 h. The levels in the medium were increased by progesterone. PAF activity was assessed by rabbit platelet aggregation and serotonin-release bioassays after lipid extraction and separation by thin-layer chromatography.(ABSTRACT TRUNCATED AT 250 WORDS)