[Genetic factors of predisposition to endometriosis and response to its treatment]. / Geneticheskie factory predraspolozhennosti i terapii éndometrioza.

The relative frequencies of the normal (+) and null (0) alleles of the glutathione-S-transferase M1 (GSTM1) gene, as well as those of the rapid (R) and slow (S) forms of N-acetyl transferase 2 (NAT-2), were studied in the Russian and French populations and in endometriosis (EM) patients. In the total Russian and French populations, the proportions of homozygotes for deletion in gene GstM1 (0/0) were 42.2 and 45.8%, respectively, whereas in Russian and French EM patients, these values were 58.6 and 76.9%, respectively. The differences in these proportions between the total population and subjects with EM were significant at the confidence levels of 0.98 (chi 2 = 5.45; P < 0.02) and 0.90 (chi 2 = 3.01; P < 0.1) for the French and Russian populations, respectively. The frequencies of allele S of the Nat-2 gene were also similar in the Russian and French populations (60 and 63.1%, respectively), with these frequencies being somewhat higher in EM patients (71.2 and 77.7%, respectively). In Russians, the proportion of EM patients who were homozygous for the R form of NAT-2 (R/R) was significantly lower (chi 2 = 5.1). Forty-three of the patients with external genital EM received complex treatment with the use of the interferon inducer Cyclopheron. In 17 patients, a pronounced positive dynamics was observed, and 29 patients exhibited an increased resistance to the immunomodulating therapy. These groups comprised 1 and 25 GstM1 0/0 homozygotes, respectively; the number of patients with the slow NAT-2 form was 13 (7 S/S and 6 S/R genotypes) and 29 (20 S/S and 9 S/R genotypes), respectively. The obtained data indicate that the GstM1 and Nat-2 genes are involved in the EM pathogenesis. Therefore, molecular screening for the GstM1 0 and Nat-2 S alleles would be a good prognostic test when prescribing the postoperative treatment for EM and predicting its effectiveness.

[Changes in the human uterine vascular bed in myoma]. / Izmeneniia sosudistogo rusla matki cheloveka pri miomakh.

With scanning and transmission electron microscopy characteristic changes in the endothelial lining of myometrial vessels of uterus affected with myoma were revealed. In the presence of longitudinally oriented folds and microgrowths on the luminal surface in a healthy myometrial part, a number of changes were observed in the myoma vessels. These included the disappearance of cell surface derivatives, disturbance of tight junction of endothelial cells borders, the rise of cells over the endothelial monolayer and formation of crateriform pits. The partition of the endothelial cells on myoma vessels was accompanied by the disturbance of the microvesicular transendothelial transport.

[Local hyperestradiolemia of the uterus in the pathogenesis of hyperplastic endometrial processes]. / Lokal'naia giperéstradiolemiia matki v patogeneze giperplasticheskikh protsessov éndometriia.

The study of local blood flow in the uterus in 100 cases of uterine fibromyoma established increased blood levels of estradiol and progesteron. Blood estradiol level in the local flow of the uterus was relatively high in postmenopausal women, particularly, in those suffering uterine myoma. "Foreign" estradiol-dependent tissue substrates such as myoma and hyperplastic lesions of the endometrium were found to be responsible for potentiating local transfer and thus raising local concentration of ovarian hormones. Regulation of subovarian transfer and accumulation of hormones was shown to be to a large extent independent of levels of basic sex steroids in the general blood flow of the female body. Chronic local hyperestradiolemia in the uterus is the key factor for hyperplastic lesions development in the endometrium.

[The relief characteristics of the apical cell surface of endometrial epitheliocytes in women suffering from sterility]. / Osobennosti rel'efa apikal'noi kletochnoi poverkhnosti épiteliotsitov éndometriia zhenshchin, stradaiushchikh besplodiem.

Functional changes in the surface topography of the uterus in women of reproductive age have been studied using scanning electron microscopy. The state of the cell surface relief was estimated at different phases of the menstrual cycle and in sterile women. The presence of wide and short ruffles of epithelial cells covered with mucus is typical of the secretory phase of the cycle. No microvilli or cilia are seen on the epitheliocyte surface. In contrast, the follicular phase is characterized with numerous deep ruffles of epithelium covered with cylindrical cells. The apical surface is studded with numerous microvilli and cilia persisting even in sterile women at all the stages of the cycle. The disturbances of nidation processes in the fertilized ovule may apparently be associated with the patterns of the cell surface relief.

[Regulation of the levels of estradiol and progesterone in the regional blood flow of the uterus and the uterine tube]. / Reguliatsiia urovnia éstradiola i progesterona v lokal'nom krovotoke matki i matochnoi truby.

Direct studies of the levels of estradiol and progesterone in the uterine vein, uterus, and uterine tube as well as in the general circulation confirmed the existence of a mechanism of countercurrent transfer of hormones which is responsible for development of local uterine and tubal hyperhormonemia. This is of great importance in the physiology and pathology of the female reproductive system.

[Peptide-activator of cyclic nucleotide phosphodiesterases in the rat and human uterus]. / Peptid-aktivator fosfodiésteraz tsiklicheskikh nukleotidov v matke krys i cheloveka.

The presence of the cyclic nucleotide phosphodiesterase peptide-activator previously isolated from the calf myometrium was studied in uterine tissue of rats at different functional states (in puberty, estrus and diestrus stages, pregnancy) and in human myometrium and myoma. The peptide isolated from calf myometrium, immature rat myometrium and uterine tissue in myoma caused a 3-4-fold stimulation of the phosphodiesterase activity.

[Hormone-dependent characteristics of the myocyte cell surface in the human myoma and myometrium cultured in diffusion chambers]. / Gormonozavisimye osobennosti kletochnoi poverkhnosti miotsitov miomy i miometrii cheloveka pri kul'tivirovanii v diffuzionnykh kamerakh.

The normal and the pathologically changed human myometrium was cultured in the diffusion chamber implanted in the subcutaneous cellular tissue of the rat. In the absence of hormonal influence the growth of myometrium culture is only insignificant, while no myoma cell growth was found at all. Estradiol stimulates the growth and development of the myometrium culture and the myoma. A combined action of estradiol and progesterone stimulates the collagen formation.

[Human extracorporeal fertilization with subsequent successful embryo implantation and the birth of a child]. / Ekstrakorpoal'noe oplodotvorenie u cheloveka s poslediushchei uspeshnoi implantatsiei émbriona i rozhdeniem rebenka.

With the aim to use a previously elaborated method of extracorporeal fertilization of human ova for treating sterility, resulted from obstruction or absence of the uterine tubes, ova were obtained at laparoscopy after a previous hormonal stimulation of women. From 119 women 159 ova were obtained. Fertilization of the ova was performed in the medium Ham F-10 previously capacitated with the husband's spermatozoa. Fertilization rate was 66%. Embryos at the stage of 2-8 blastomeres were implanted transcervically into the uterine cavity with a special catheter. The embryo transfer was performed in 37 women with tubular infecundity. Menoschesis up to 3 weeks was noted in 5 women. In one woman on the 35th day after implantation, by means of hormonal-biological reaction and ultrasound investigation, pregnancy was diagnosed, it terminated in timely birth of a boy with body mass 3,500 gr. A conclusion was made that the main cause of failures at the embryo transfer was an inadequate preparation of the uterine mucosa (resulted from the main disease) to accept the fertilized ovum.

[Ultrastructure and relations between cells in the myometrium and in myomas of the human uterus]. / Ul'trastruktura i vzaimootnosheniia mezhdu kletkami v miometrii i v miomakh matki cheloveka.

The state of myocytes and their intercellular connections in an unaltered myometrium in the peripheral zone and in the central part of the myoma node has been studied electron microscopically. When analysing the peripheral zone of the uterine myoma, myocytes have resemblence with myometrial cells in the folliculine phase of the menstrual cycle. Simultaneously, certain changes are observed both in the intracellular components and in intercellular interrelations: myocytic nuclei swell, most part of chromatin is decondenced, cell cytoplasmic volume increases, in the prenuclear zone numerous agregates of ribosomes are revealed. The myocytes draw nearer and form specialized junctions, that ensure their cooperation.