Congenital Herpes Simplex Virus: A Histopathological View of the Placenta.

Congenital Herpes simplex virus (HSV) infection is considered a common pregnancy pathology that is not always easy to diagnose. This study aimed to present the spectrum of placental histopathological lesions in pregnancies complicated by HSV infection. MEDLINE and Google Scholar databases were searched using the keywords "HSV" and "placental histopathology" up to June 20, 2022. Study inclusion required presenting placental histopathological anomalies in pregnant women diagnosed with HSV infection antenatally, during labor, or postnatally. Herein, we briefly present placental pathogenesis conditions, which have been correlated with congenital HSV infection, providing clinicians with a short review describing herpetic placental pathology.

Differential apoptotic activity in trophoblast of spontaneous abortions and normal pregnancies.

INTRODUCTION: Apoptosis is a key process during normal trophoblastic development and, consequently, the whole gestation. However, in trophoblastic differentiation in spontaneous abortions apoptosis has been hardly investigated. Therefore, the aim of the study was to investigate the correlation between apoptotic frequency in trophoblast and spontaneous abortion incidences. MATERIAL AND METHODS: A total of 72 trophoblastic tissue samples were immunohistochemically examined. 42 of 72 derived from first-trimester spontaneous abortions and the remaining 30 from elective terminations during the same trimester of pregnancy. TUNEL assay and M30 marker were used for apoptosis evaluation by immunohistochemistry. RESULTS: Comparative study of tissues from spontaneous abortions and elective pregnancy terminations demonstrated increased expression of both apoptotic markers in tissues derived from spontaneous abortions compared to normal pregnancies. In addition, statistical analysis correlated maternal age and gravidity with increased spontaneous abortion incidences. Moreover, both M30 and TUNEL staining were significantly correlated with maternal age and primigravidity in spontaneous abortion cases. CONCLUSIONS: Our data proved that elevated apoptotic activity during the first pregnancy trimester is clearly involved in spontaneous abortions. Moreover, two well-established apoptotic markers revealed high statistical significance in the evaluation of post-abortive tissues.

Predictive value of repeated measurements of luteal progesterone and estradiol levels in patients with intrauterine insemination and controlled ovarian stimulation.

OBJECTIVE: The objective of this study is to assess if the difference of repeated measurements of estradiol and progesterone during luteal phase predict the outcome of intrauterine insemination. DESIGN: Prospective study. SETTING: Reproductive clinic. PATIENTS: 126 patients with infertility. INTERVENTION(S): Patients underwent controlled ovarian stimulation with recombinant FSH (50-150 IU/d). The day of IUI patients were given p.o natural micronized progesterone in a dose of 100 mg/tds. RESULTS: The area under the receiver characteristic operating curve (ROC curve) in predicting clinical pregnancy for % change of estradiol level on days 6 and 10 was 0.892 with 95% CI: 0.82-0.94. A cutoff value of change > -29.5% had a sensitivity of 85.7 with a specificity of 90.2. The corresponding ROC curve for % change of progesterone level was 0.839 with 95% CI: 0.76-0.90. A cutoff value of change > -33% had a sensitivity of 85 with a specificity of 75. CONCLUSIONS: The % change of estradiol and progesterone between days 6 and 10 has a predictive ability of pregnancy after IUI with COS of 89.2% and 83.4%, respectively. The addition of % of progesterone to % change of estradiol does not improve the predictive ability of % estradiol and should not be used.

Oocyte and embryo vitrification in the IVF laboratory: a comprehensive review.

Vitrification is an excellent tool in the IVF laboratory, enabling options and offering flexibility in assisted reproduction. The technology of cryopreservation has been underway since the early 20th century. The advent of vitrification has advanced the expectations in routine clinical practice in the IVF laboratory presenting impressive results both in post-thaw survival, and in clinical pregnancy rates, as well as significantly enhancing clinical results on preimplantation genetic diagnosis (PGD). Contradicting opinions have been published recently on the limitations and potential that vitrification has in the laboratory, as well as on the optimal approach to employ vitrification in IVF. This review aims to present a comprehensive analysis of the practical aspects of vitrification including concerns and options regarding its use on oocytes and embryos while comparing it with the traditional "slow-freezing" cryopreservation technique.

Cell adhesion molecules and in vitro fertilization.

This review addresses issues regarding the need in the in vitro fertilization (IVF) field for further predictive markers enhancing the standing embryo selection criteria. It aims to serve as a source of defining information for an audience interested in factors related to the wide range of multiple roles played by cell adhesion molecules (CAMs) in several aspects of IVF ultimately associated with the success of an IVF cycle. We begin by stressing the importance of enriching the standing embryo selection criteria available aiming for the golden standard: "extract as much information as possible focusing on non-invasive techniques" so as to guide us towards selecting the embryo with the highest implantation potential. We briefly describe the latest trends on how to best select the right embryo, moving closer towards elective single embryo transfer. These trends are: frozen embryo transfer for all, preimplantation genetic screening, non-invasive selection criteria, and time-lapse imaging. The main part of this review is dedicated to categorizing and presenting published research studies focused on the involvement of CAMs in IVF and its final outcome. Specifically, we discuss the association of CAMs with conditions and complications that arise from performing assisted reproductive techniques, such as ovarian hyperstimulation syndrome, the state of the endometrium, and tubal pregnancies, as well as the levels of CAMs in biological materials available in the IVF laboratory such as follicular fluid, trophectoderm, ovarian granulosa cells, oocytes, and embryos. To conclude, since CAMs have been successfully employed as a diagnostic tool in several pathologies in routine clinical work, we suggest that their multi-faceted nature could serve as a prognostic marker in assisted reproduction, aiming to enrich the list of non-invasive selection and predictive criteria in the IVF setting. We propose that in light of the well-documented involvement of CAMs in the developmental processes of fertilization, embryogenesis, implantation, placentation, and embryonic development, further studies could contribute significantly to achieving a higher quality of treatment and management of infertility.

A complete corticotropin releasing factor system localized in human fetal lung.

OBJECTIVE: The Corticotropin Releasing Factor (CRF) system (neuropeptides CRF, Ucn I, II, III and binding sites CRFR1, CRFR2, CRF-BP) is responsible for stress regulation and the homeostasis of an organism. Herein we study the CRF system in human normal and pathological fetal lungs. DESIGN: Lung tissues from 46 archival human fetuses were divided into Group A (normal), Group B (chromosomal abnormalities) and Group C (congenital disorders). Presence of elements of the CRF system was evaluated using immunohistochemistry and was correlated to pathology, lung developmental stage and clinicopathological characteristics. RESULTS: Immunoreactivity for all antigens was found in both epithelial and mesenchymal lung cells of the bronchi and alveoli. Ucn I and CRFR1 were more frequently present in Group A. Ucns were more frequently localized at the pseudoglandular stage. There was a positive correlation between the presence of the CRF neuropeptides and between CRFR1 and CRF. Two fetuses with lung malformations showed low or no detectable presence of the CRF system. CONCLUSIONS: We report the presence of a complete CRF system in human fetal lungs correlating its developmental stage and several pathologies. Our results are in agreement with findings in experimental animal models, implicating the CRF system in fetal lung development, its action being more significant in the early stages.

Biometric predictive models for the evaluation of olfactory recovery after endoscopic sinus surgery in patients with nasal polyposis.

BACKGROUND: Determination of predictive factors and specific values of olfactory function after endoscopic sinus surgery (ESS) using objective diagnostic methods may support consultation of respective patients. This study was designed to assess the longitudinal olfactory functional outcome after ESS in patients with severe chronic rhinosinusitis (CRS) with nasal polyposis, to evaluate associated clinical factors and to provide statistical models for prediction of olfactory recovery. METHODS: One hundred sixteen patients with nasal polyposis refractory to medical treatment underwent ESS. Olfactory testing was performed preoperatively and 1, 3, and 6 months after surgery using "Sniffin' Sticks" (Burghardt, Wedel, Germany). Using multivariate linear and logistic regression analysis, statistical models were generated to predict (i) the 6th-month composite threshold-discrimination-identification (TDI) score and (ii) the probability of attaining normal olfaction at 6 months. RESULTS: A significant stepwise increment of all olfactory function indices was found over time. Factors influencing final olfactory recovery were patients' age, duration of olfactory deficit, previous paranasal sinus surgery, and aspirin-exacerbated respiratory disease. The first model explained 70% of the observed variation in postoperative TDI scores. The second model correctly classified 76% of the patients. CONCLUSION: A significant progressive improvement of olfaction for at least 6 months was observed after ESS. The statistical models developed may be useful for consultation of ESS candidates in clinical practice.

Evaluation of prognostic factors for olfaction in nasal polyposis treated by endoscopic sinus surgery.

AIM: This prospective study aimed to assess treatment outcome on olfaction in patients undergoing Endoscopic Sinus Surgery (ESS) for nasal polyposis, and to evaluate the role of previous sinus surgery and the duration of olfactory deficit as prognostic factors for olfaction improvement. METHODS: In total, 116 patients with nasal polyposis who underwent ESS were studied. Olfactory testing was performed using the Sniffin' Sticks test, preoperatively and 1-, 3- and 6-month postoperatively. RESULTS: The values of the composite threshold discrimination identification score were significantly lower in patients with long duration of olfactory deficit and history of previous sinus surgery in all testing sessions. Adjustment for preoperative olfactory measures and all potential confounders revealed that both parameters remained strong independent predictors of normal olfactory function; a successful outcome was more frequent in patients with short duration of olfactory deficit and in patients who had not undergone previous sinus surgeries. However all patients achieved a significant stepwise increment of all indices of olfactory function over time, after ESS. CONCLUSIONS: Duration of olfactory deficit and previous sinus surgery presented highly significant predictive value for the short-term outcome of the olfactory function after ESS. However all patients suffering from nasal polyposis will probably improve olfaction significantly in a period up to six months after surgery.

Antineoplastic and cytogenetic effects of chlorpromazine on human lymphocytes in vitro and on Ehrlich ascites tumor cells in vivo.

The inhibitory effect of phenothiazines in tumor growth and cancer cell proliferation in vitro and in vivo has been established. These reports motivated us to investigate the genotoxic, cytotoxic, and cytostatic potential of chlorpromazine, alone or in combination with mitomycin C, in vitro and in vivo. Sister chromatid exchange levels were assessed providing a quantitative index of genotoxicity. In-vitro studies were performed on human lymphocyte cultures and in-vivo studies involved Ehrilch ascites tumor (EAT) cells. An antitumour study was also conducted on the survival time and the ascitic volume in EAT-bearing Balb/C mice. The combination of chlorpromazine plus caffeine and mitomycin C exerted cytostatic and cytotoxic actions in human lymphocytes. The combination of chlorpromazine plus mitomycin C exerted cytostatic and cytotoxic actions in EAT cells, significantly increased the survival span of the mice inoculated with EAT cells, and suppressed the expected tumor growth increase. The findings of this basic study illustrate that high chlorpromazine concentrations increase chemotherapeutic effectiveness of mitomycin C. Chlorpromazine concentrations within the observed human plasma concentration range need to be tested along with antineoplastic agents in vitro for its synergistic action so as to evaluate a potential clinical application. Further investigation including other phenothiazines, biological systems, and cancer models is required.

Allergic rhinitis and aspirin-exacerbated respiratory disease as predictors of the olfactory outcome after endoscopic sinus surgery.

BACKGROUND: Unlike the functional outcomes of endoscopic sinus surgery, which have been thoroughly studied, the effect of the surgery on olfactory performance and the relative predictive factors have not been adequately assessed by literature. Allergic rhinitis and aspirin-exacerbated respiratory disease (AERD) are examined as potential confounding factors of the olfactory outcome in patients with extensive nasal polyposis and rhinosinusitis treated with functional endoscopic sinus surgery (FESS). METHODS: A population of 116 adults with severe nasal polyposis was subjected to FESS after failure of the appropriate medical treatment. The olfactory outcome was quantified by Sniffin' Sticks at the 1st, 3rd, and 6th postoperative month in relation to the concomitant presence of allergic rhinitis (n = 62) or AERD (n = 18). RESULTS: Allergic patients seemed to perform worse than nonallergic patients at all time frames. However, when patients with similar olfactory acuity, age, and medical history are compared, allergic rhinitis does not seem to affect the postoperative improvement of the composite threshold-discrimination-identification scores. The same seems to apply for the likelihood of acquiring normosmia after surgery. On the contrary, AERD significantly limits the recovery of olfactory function at all follow-up examinations and patients with AERD are unlikely to become normosmic. CONCLUSION: The olfactory recovery after FESS for nasal polyposis is significantly affected by the concomitant presence of AERD. Although allergy seems to have a general negative effect on olfactory acuity, it was not found to affect the extent of the olfactory improvement, when patients with comparable preoperative characteristics are addressed.

Improvement of olfaction after endoscopic sinus surgery in smokers and nonsmokers.

OBJECTIVES: The aim of this prospective study was to examine the short-term benefit of endoscopic sinus surgery (ESS) on the olfactory function of patients operated on for nasal polyposis. We also studied the predictive value of smoking for the recovery of the olfactory function in these patients. METHODS: We studied 116 patients with nasal polyposis who underwent ESS. Olfactory testing was performed with the Sniffin' Sticks test before operation and 1, 3, and 6 months after operation. RESULTS: All patients achieved a statistically significant stepwise increment of all of the indices of olfactory function over time. The composite threshold-discrimination-identification score was lower in smokers than in nonsmokers in all testing sessions, but none of these differences reached statistical significance. After adjustment for preoperative olfactory measures and all other potential confounders, the effect of smoking on the 6-month postoperative measurement was not significant. However, we did find a statistically significant adverse effect of the quantity of smoking on the olfactory threshold scores. CONCLUSIONS: Both smokers and nonsmokers achieve a highly significant improvement on their olfactory function from ESS. Although smoking is not a major predictive factor for the short-term outcome of the olfactory function after ESS, a greater quantity of smoking may have an effect on the 6-month postoperative odor thresholds.

Supplementation of melatonin protects human lymphocytes in vitro from the genotoxic activity of melphalan.

Melatonin (MLT) is a natural oncostatic factor of the human body as well as an antioxidant thus protects the nuclear DNA from oxidative damage. It also has the ability to reduce the side effects of various drugs when used as a combination therapy. The anti-neoplastic agent melphalan (MEL), which encompasses a number of side effects, is a strong alkylating agent and a potent inducer of sister chromatid exchanges (SCEs). The aim of the current in vitro study was to investigate the ability of MLT to reduce the genotoxic effect of MEL on normal human cultured peripheral lymphocytes. Cells were treated with both agents at various concentrations (MLT 100, 200 and 400 microM and MEL 330, 490 and 650 nM) and incubated for 72 h prior harvesting. The levels of cytostaticity, cytotoxicity and genotoxicity were qualitatively evaluated using the proliferation rate index, the mitotic index and the SCE methodology, respectively. Our results demonstrated the protective effect of MLT on cells treated with MEL in vitro. The greatest protective effect of MLT at 100 and 400 microM was illustrated against 330 nM of MEL in comparison with all other doses of MEL. These observations imply that MLT may be proved useful in reducing some of the toxic effects associated with certain classes of chemotherapeutic agents and other chemical and physical mutagens and carcinogens, acting both as an antioxidant-radical scavenger and a protective mechanism against cellular damage due to exposure to free radical-producing agents. It is essential to investigate substances with protective properties which are normally produced from the human body.

DNA damage and chromosomal aberrations in various types of male factor infertility.

OBJECTIVE: To understand and delineate the nature and level of DNA damage in association to semen parameters in infertile men. DESIGN: A prospective experimental study. SETTING: Alexandroupolis University General Hospital. PATIENT(S): Eleven fertile and 27 infertile men with various types of infertility. INTERVENTION(S): DNA damage was induced by addition of mitomycin C and caffeine to lymphocyte cultures. MAIN OUTCOME MEASURE(S): Sister chromatid exchange (SCE) levels were assessed in cultures providing a quantitative index of genotoxicity and chromosomal analysis was performed using G-banding and C-banding techniques. RESULT(S): Karyotyping analysis indicated chromosomal fragility, trisomic lines, and marker chromosomes in some infertile men. Double minute chromosomes were noticed in 11 infertile men and were positively correlated with elevated SCE levels. Necrospermia and varicocele, irrespectively of the degree of severity, were positively correlated with elevated SCE levels. CONCLUSION(S): Infertile men are prone to have DNA damage; the nature and level of DNA damage varies and is associated with semen parameters. The presence of double minute chromosomes alone is associated with increased double-stranded breaks and abnormal sperm concentration. This study could provide the basis to establish whether and through which process double minute chromosomes could be related to poor semen parameters and regulation of DNA repair.