[Ultrastructural aspects of the human uterine tube epithelium during menstrual cycle]. / Aspectos ultra-estruturais do epitélio da tuba uterina humana durante o ciclo menstrual.

PURPOSE: The authors perform an electron microscopy analysis of the human uterine tube epithelium during the menstrual cycle. TYPE OF STUDY: Prospective, experimental. Site: São Paulo School of Medicine. PATIENTS: Four eumenorrheic multiparous patients, two in the proliferating stage, and two in the secreting stage of the cycle. INTERVENTIONS: PATIENTS were submitted to bilateral salpingectomy because they presented a high reproductive risk. MEASUREMENTS AND RESULTS: The authors evaluated ultrastructural aspects of the epithelium in the isthmus, ampulla, and infundibulum. Two types of cells were identified: ciliated and non-ciliated or secretory. Secretory cells have more marked ultrastructural changes than ciliated cells during the cycle. In the luteal stage, secretory cells present quite developed and dilated endoplasmatic reticulum and Golgi apparatus, and numerous electro-lucent vesicles. They also verified that during the second stage of the cycle, the secretory cells in the ampullar region seems to release part of its cytoplasm in the tube lumen. CONCLUSIONS: The ampullar region of the uterine tube suffers greater hormonal influences than the other regions. Morphological changes occurring in the ampullar might have their role to play in the nutrition of the egg cell during the time it remains inside it.

[Morphologic and morphometric aspects of the uterine tube epithelium during the menstrual cycle]. / Aspectos morfológicos e morfométricos do epitélio da tuba uterina durante o ciclo menstrual.

PURPOSE: Under light microscopy, the authors observed the morphologic and morphometric features of the human uterine tube during the menstrual cycle. TYPE OF STUDY: Experimental, prospective study. SITE: Escola Paulista de Medicina. PATIENTS: Specimens obtained from ten eumenorrheic, multigesta patients, ages ranging from 22 to 35 years. INTERVENTION: They were all submitted to salpingectomy because they showed a high reproductive risk. They were operated during the proliferating and secretory phase of the menstrual cycle. The isthmus, ampullae and infundibulum were studied under light microscopy. MEASUREMENTS AND RESULTS: The authors observed that the epithelium of the human tube has a single layer of cylindrical and ciliated cells. Three kinds of cells were present: ciliated, secretory, and non-differentiated. Height of the epithelium was uniform in the secretory phase, but not in the isthmus and ampullae. Images of mitosis were rarely seen. In the isthmus, the number of secretory cells predominated in both phases of the cycle; in the ampullae, the number of ciliated cells was increased in the proliferation phase, while secretory cells were proeminent in the lutheal phase. In the infundibulum and fimbrae, ciliated cells were increased. Morphometric features of human uterine epithelium were studied during the menstrual cycle and showed: 1) the height of the epithelium in the ampullae was significantly higher in the proliferating phase; 2) the number of secretory cells was significantly higher in the isthmus, while in the infundibulum ciliated cells were increased in number in both phases of the cycle. The number of ciliated cells in the ampullae was significantly higher in the proliferating phase while secretory cells predominated in the secretory phase; 3) The nuclear volume of ciliated and secretory cells is not statistically significant in all regions during the two phases of the cycle. CONCLUSIONS: The uterine tube epithelium shows cyclic modifications which are probably associated to its function in reproductive physiology.

Tumor do seio endodermico do ovario. / Endodermal sinus tumor of the ovary

Os autores estudam um caso de tumor no seio endodermico; neoplasia rara, de linhagem germinativa em paciente de 14 anos de idade, com queixa clinica de crescimento progressivo de abdome. Os exames clinico e ginecologico revelaram abdome abaulado, tenso, com sinais de ascite e presenca de um tumor palpavel no hipogastrico. O achado operatorio mostrou o ovario esquerdo transformado em tumor de aproximadamente 12 cm de diametro, sem sinais de propagacao (estadio lai). O exame histopatologico revelou tumor do seio endodermico. A vista da idade da paciente e do estadiamento do tumor, optou-se, apesar de sua indubitavel malignidade, pela cirurgia conservadoura: anexectomia unilateral com biopsia do ovario contralateral e do omento, complementado pela poliquimioterapia.A citologia do liquido peritoneal e a biopsia do ovario oposto e do omento foram negativas. Decorridos quase tres anos da cirurgia, a paciente acha-se viva, aparentemente sem sinais clinicos de recidiva nem de metastases

Tumor mesodermico misto, heterologo do corpo do utero. / Mixed mesodermic heterologous tumor of the uterine corpus

Os autores analisam um exemplo de tumor mesodermico misto, heterologo do corpo do utero, em paciente de 69 anos de idade. Apresentava, entre as manifestacoes clinicas, hemorragia genital com duracao de um ano e crescimento do abdome ha dois meses. Os exames clinico e ginecologico revelaram abdome abaulado, tenso com sinais de ascite e presenca de uma volumosa massa tumoral, ocupando todo abdome. A citologia oncotica cervico-vaginal e endometrial eram positivas e compativeis com neoplasia do corpo do utero. Foi submetida, inicialmente, a curetagem uterina fracionada, que revelou tratar-se de tumor mesedermico misto, heterologo, maligno, do corpo do utero A ulterior laparotomia mostrou carcinomatose difusa, generalizada, sendo realizada apenas biopsia das massas tumorais. Por esse fato, constituiu a terapeutica na quimioterapia intraperitoneal e sistemica e na hormonioterapia (progestogenioterapia). A evolucao foi insatisfatoria, tendo o obito ocorrido cinco meses apos a cirurgia

Variacao do nimero de lisossomos no epitelio endometrial humano, nas fases proliferativa e secretora do ciclo menstrual. / Variation of lysosome number in human endometrial epithelium, in the proliferative and secretory phases of the menstrual cycle

Foi realizado um estudo do comportamento do numero de lisossomos no epitelio endometrial humano nas fases proliferativa e secretora do ciclo menstrual, pela tecnica preconizada por Pricoli (25). Apos submetidos os resultados a tratamento estatistico, verificou-se que: 1o) o numero de lisossomos e significativamente diferente nas diversas fases do ciclo menstrual; 2o) o maior numero e observado em torno da epoca provavel da ovulacao e, o menor, no inicio do ciclo menstrual

Novo tratamento da moniliase vaginal recidivante. / New treatment of recurrent vaginal maniliasis

Os autores estudaram 22 pacientes portadores de moniliase vaginal recidivante submetidos ao tratamento pela metil-partricina por via oral e topica vaginal. Sao apresentados e discutidos os aspectos e resultados do tratamento simultaneo das formas vaginal recidivante e intestinal