Fallopian tubes--literature review of anatomy and etiology in female infertility.

RATIONALE: Around 30% of the infertile women worldwide have associated Fallopian tubes pathology. Unfortunately, for a long time, this aspect of infertility has been neglected due to the possibility of bypassing this deadlock through IVF. OBJECTIVE: Up to date free full text literature was reviewed, meaning 4 major textbooks and around 100 articles centered on tubal infertility, in order to raise the awareness on this subject. METHODS AND RESULTS: The anatomy of the Fallopian tube is complex starting from its embryological development and continuing with its vascular supply and ciliated microstructure, that is the key to the process of egg transport to the site of fertilization. There are many strongly documented causes of tubal infertility: infections (Chlamydia Trachomatis, Gonorrhea, and genital tuberculosis), intrauterine contraceptive devices, endometriosis, and complications after abdominal surgery, etc. DISCUSSIONS: Although there are still many controversies about the etiology of tubal sterility with the advent of molecular diagnosis of infections there has been cleared the pathway of infection through endometriosis or through ciliary immobility towards the tubal obstruction.

Current management of tubal infertility: from hysterosalpingography to ultrasonography and surgery.

RATIONALE: The development of IVF techniques has diminished the importance of tubal infertility but recent discoveries shed a new light on reproductive tubal surgery prior to any IVF cycle. OBJECTIVE: To adapt current state of the art recommendations concerning tubal factor infertility to actual possibilities in Romanian healthcare system and to grow the awareness of fellow fertility specialists and general practitioners to the improved outcomes of novel management and treatment modalities. METHODS AND RESULTS: 67 free full text articles centered on the subject of management in tubal infertility were identified in international databases. Four articles described general diagnosis using data from medical history, 21 works approached the diagnosis through hysterosalpingography, 14 papers introduced the use of different sonographic procedures, 8 files analyzed the importance of exploratory laparoscopy and 20 articles reviewed different treatment modalities. DISCUSSIONS: Current data show that active implementation of the large scale use of tubal surgery prior to any IVF cycle will reduce up to 30% the costs associated with obtaining a viable pregnancy in cases with tubal factor sterility.

Electron microscopy of the morphological changes in rat viscera during experimental hyperthermic shock.

Hyperthermic shock is a thermoregulatory disorder that affects living organisms that are acutely or chronically exposed to high temperatures or when performing intense physical activity in a hot environment. In this paper, we will show the changes embodied in hyperthermic shock caused by multiple injuries to vital organs in Wistar rats that were suddenly exposed to high temperatures of up to 410 for about 10-15 minutes, their central temperature rising above 40.60C. This process resulted in multiple injuries of the vital organs, evidenced by electron microscopy. In addition, this suggested that most changes caused by hyperthermic shock are incompatible with life.

Morphological study of congenital megaureter.

Congenital anomalies of the kidney and urinary tract are frequent. They can be detected once every 500 ultrasonography fetal examinations. Causes that determine a dilated ureter compared to the rest of the urinary tract are still partly unknown. If concerning the exploration and the clinical diagnosis of these anomalies important progresses have been made, the morphological research is still able to bring forth data that, together with genetic researches, may help reveal the pathogeny of the disease and may ease the planning of the screening genetic tests for early diagnosis. Material and methods. During the surgical operations realized in order to recalibrate the ureter, ureter fragments have been harvested, colored with 1% tionin, in sections thinner then 1 micron and examinated through immersion, ob. 100x. Other fragments have been prepared and examinated through electronic microscope. We have followed the structural modifications of the muscular tissue, nervous tissue, connective tissue and the rapports between these components. Results. Congenital megaureter presents qualitative and quantitative anomalies of the connective tissue and muscular tissue, and also structural modifications of the nervous tissue. Connective tissue. We have noticed the abundance of the connective tissue in congenital megaureter. Connective tissue, with an important representation of typical elements, such as fibroblasts, mastocytes and plasmocytes is partly hyalinated, dissociating muscular fiber bundles and nervous fiber bundles. Connective tissue/muscular tissue report is evidently increased. Muscular tissue. Muscular fibers are hypoplasic, smooth endoplasmic reticulum is present in the tubular form, rare mitochondria are vacuolized. Dense corps are increased in number, plasmatic membranes are folded. Sarcoplasm contains vacuolized organites. The nuclei are rigged with visible nucleoli. Nervous structures. We have noticed varied alterations of the axons and myelin. In some axons there are multiple cavities that may produce the opacifiation of the entire axonal structure. The proliferation of the myelin sheath under the nodular form or vortex form produces the destruction of the axonal structure. Mitochondria are condensed, partially vacuolized. The modifications in the axonal structure and those of the myelin sheath determine modifications of the nervous excitability and conductibility. All the lesions we have pointed out in congenital megaureter participate in compromising of the peristaltic. Nervous and muscular structures lesions indicate a process of incomplete development of the ureter. They are structures that do not achieve functional maturation. We may consider congenital megaureter as a digenesis with hypoplasia.

The histological changes of digestive organs in experimental decreases of hepatic venous outflow at the rat.

The hepatic venous outflow may be diminishing in right-sided heart diseases, constrictive pericarditis, obstruction of suprahepatic veins or an inferior vena cave. It was created an experimental model by obstruction of the suprahepatic veins lumen and inferior vena cave, too, at the adult Wistar rats. The animals were sacrificed in the 30 days after operation. At the iterative laparatomy it was found the liver more increased in volume, a little amount of ascites in peritoneal cavity, oedema of the digestive organs walls. Liver and stomach fragments were prelevated and were processed for optic microscopy and electronic microscopy. The morphological study using by usual technics has highlighted vascular stasis in gastric submucosa. In liver it is standed out the pericentrolobular vascular stasis, inflammatory lymphoplasmocytic infiltrate around the end of hepatic vein. In the gastric submucosa have found vascular stasis, and within the chorion mucosa, the high capillary hyperemia. There is a discreet vacuolar feature on epithelium surface of the gastric mucosal in pyloric region. In the other layers, at rats the epithelium multistratum keratinizated of the stomach is without changes, in this region is maintaining the hyperemia in mucosal chorion.

Esophageal porto-caval anasthomosis. Critical view of the hypothesis of F.C. Carvalho.

The apparition and the breakage of esophageal varices et the level of cardioesophageal junction in the portal hypertension still represents a problem of pathological surgery. The presence of these varicose dilatations in this region is due to an important zone of porto-caval anastomoses. Angioarhitectonical study of lower abdominal esophagus represents a disputed problem in the specialty literature. The hypothesis of south American anatomist F. C. Carvalho (1966) looks to be the best model that could explain the appear of cardioesophageal varices. Studies realized in the past within the Anatomy Department of Medicine "Carol Davila" Bucharest tried to demonstrate the validity of Carvalho's theory, and the results of these researches are exposed in the present paper.

[Microvascularization of the liver in vagotomy]. / La microvascularisation du foie dans la vagotomie.

Sub-diaphragmatic truncal vagotomy produces early and late changes in the microvascular network of the liver. Bilateral sub-diaphragmatic truncal vagotomy was performed experimentally in the dog. After 7 days, 60 days and 2 years, the animals were subjected to laparotomy under general anaesthetic and China ink was injected into the aorta above the coeliac trunk. Samples were then taken from the hepatic parenchyma to be examined under the photomicroscope. The following early modifications were observed: absence of the injection in the central and intermediary zones of the lobe, stasis in the centro-lobular vein. These modifications are also present at 60 days. After 2 years, there is an improvement in the hepatic microcirculation, but modifications of micro-irrigation are still present.

Elements of structure and ultrastructure of the blood-thymus barrier in ACTH involuted thymus.

The ACTH influence upon the thymus may be a reliable model for stress involution. In this case, the cortical lymphocytic depletion is accompanied by mast cell accumulation and increased caliber of the blood vessels. The blood-thymus barrier which has an active role in involution shows an enriched transport activity of the endothelial cells, great enlargement of the basement membrane, increased macrophage activity within the perivascular space with elevated values of acid phosphatase activity, and thickening of the fibrillar network. The epithelioreticular cells show plenty of vacuoles in their cytoplasm, the mitochondria undergo swelling processes, and their cristae are diminished. The ultrastructural data show that lymphocyte depletion is carried out by macrophage-mediated lymphocytolysis. But by counting the peripheral blood cells an earlier mechanism is revealed; i.e. migration through the enlarged but more permeable blood-thymus barrier. The epithelioreticular cells do not seem to have an active, direct implication in any of the phenomena.