Flexible hysteroscopy in irregular uterine bleeding.

PURPOSE: The objective of our study was to analyze the possibilities of diagnostic flexible hysteroscopy in women with irregular uterine bleeding. PATIENTS AND METHODS: The study involved 661 women aged 26-72 years (mean 46.23) with mild to moderate irregular uterine bleeding who agreed to have invasive investigations. Diagnostic hysteroscopy by panoramic fibrohysteroscope Pentax LH-150 II (5 mm in diameter) was performed initially to all patients, followed by classical dilatation and curettage (D & C). RESULTS: Different types of normal endometrium were found in 248 (37.52%) women, hyperplasia and polyposis in 300 (45.39%), suspected changes for atypia and neoplasia in 82 (12.40%) and other different findings in 31 (4.69%). Subsequent D & C showed lack of adequate material from the uterine cavity in 26 (3.93%) women, in 538 (81.39%) the morphological findings were due to hormonal and dyshormonal reasons, 66 (9.98%) were with different precancer and cancer lesions and in 31 (4.69%) cases, clinically and morphologically, bleeding was due to the presence of submucosal myomas, intrauterine devices, residua and pathology of the chorion. CONCLUSION: The comparison of the hysteroscopy results with clinical and histological findings from D & C showed good diagnostic possibilities of the flexible hysteroscopy for evaluation of women with irregular bleeding (sensitivity 74.07% and specificity 90.61%). This examination is relatively simple, safe and requires simultaneous performance of a direct biopsy, in order to improve the accuracy of the results.

[Diagnostic possibilities of the flexible hysteroscopy in irregular uterine bleeding].

The aim of the present study was to evaluate the possibilities of diagnostic flexible hysteroscopy for women with irregular uterine bleeding. The study was based on 569 women aged between 26 and 72 years (mean age 46.78 years) with weak to moderate irregular uterine bleeding who had given agreement for invasive investigations. To all patients initially was performed diagnostic hysteroscopy with the help of a panoramic fibrohysteroscope Pentax LH-150 II (with 5 mm diameter), followed by classical endometrial curettage. The performed hysteroscopies found phase or other normal endometrium at 208 women (36.56%), hyperplasia and poliposis at 258 (45.34%), changes, suspected for atypia and neoplasia at 77 (13.53%) and other different findings at 26 women (4.57%). The following curettage showed the lack of adequate material from uterine cavity at 24 women (4.2%). From the rest patients, at 466 (81.9%) the morphological findings were due to the dysfunctional reasons, other 51 (8.9%) were with different precancer and cancer lesions and at 28 cases, clinically and morphologically was found that the bleeding was due to the presence of sub mucous nodules, intrauterine devices, residua and pathology of the chorion. The comparison of the hysteroscopy results with the clinical and histological findings from the curettage of 454 women, showed good diagnostic possibilities (sensitivity of 78.4% and specificity of 92.5%) of the flexible hysteroscopy for evaluation of women with irregular uterine bleeding. This examination is relatively simple and save endoscopic technique, which require simultaneously performance of a direct biopsy, in order to improve its diagnostic accuracy.

[Assessment of irregular uterine bleeding in premenopausal women]. / Otsenka na nepravilnite matochni kruvotecheniia pri zheni v premenopauza.

UNLABELLED: The aim of the present study was to investigate by diagnostic curettage the endometrial histological findings in women with irregular uterine bleeding in premenopause. MATERIALS AND METHODS: Two hundred and thirty women between 40 to 54 wears (mean 48.13) with history of irregular genital bleeding in premenopause were investigated. The classic dilatation and curettage of endometrial cavity was performed and histological results were analyzed. RESULTS AND DISCUSSION: The histological examination of the curettage material shows--normal endometrium in 32 (13.9%) women, anovulatory endometrium in 59 (26.6%), cystic hyperplasia and/or polyposis in 91 (39.6%), atrophic endometrium in 20 (8.7%), atypical hyperplasia in 15 (6.5%), endometrial cancer in 7 (3.1%) women and without adequate material were 6 (2.6%) cases. CONCLUSION: This study pointed out, that women with irregular uterine bleeding in premenopause still remain serious diagnostic and therapeutic problem. Nevertheless, the separate curettage keeps its important role in assessment of health status of these women.

[Diagnostic modalities of endometrial ultrasonography in women with irregular bleeding in menopause]. / Diagnostichni v'zmozhnosti na vaginalnoto ultrazvukovo izsledvane na endometriuma pri zheni s nepravilni kr'votecheniia v klimakteriuma.

UNLABELLED: The aim of the present study was to investigate the diagnostic possibilities of the endovaginal sonography for the assessment of the state of the endometrium in women with irregular bleeding in climax. MATERIALS AND METHODS: Fifty women between 40 to 60 years (mean 47.8) with irregular genital bleeding were investigate. Using transvaginal ultrasound, anterior-posterior, length and width dimensions of the uterus were measured and echostructure of the endometrium was defined. The dilatation and curettage of endometrial cavity was performed subsequently. RESULTS AND DISCUSSION: The histological examination of the curettage material shows - normal endometrium in 15 women, cystic hyperplasian in 16, atrophic endometrium in 11, atypical hyperplasia in 5 and endometrial cancer in 3 women. The correlation of these findings with the results from ultrasound investigation shows, that the degree of the endometrial thickness play a role as a criteria to establish the diagnostic protocol. CONCLUSION: The summarized data from our study shows, that in the limit of 8 mm, the diagnostic accuracy of the method - sensitivity - 75% specificity - 73.8% amd efficacy - 74% give us cause to recommend the transvaginal sonography of the endometrium in women in climax, as a screening tool in the diagnostic protocol for endometrial cancer.

Effect of thymosin fraction five (TF5) on early neuroembryogenesis in the newt Triturus cristatus.

Thymosin fraction five (TF5), a well-characterized immunoregulatory thymic preparation, has been reported to stimulate corticotropin (ACTH) release. The present study explores the morphogenetic role of TF5 on early stages of nerve tissue formation during embryogenesis. In vivo TF5-treatment of newt embryos during neurulation results in stimulation of the process expressed at a macro-microscopical level by emphasizing the embryo's relief and by accelerating the neural tube closure. The stimulating effect of TF5 on neurulation is manifested ultrastructurally by enhanced apical endocytosis, a well-developed contractile microfilamentous layer, increased apical intercellular junctions and changes of the cytoplasmic organelles linked with the protein synthesis. The polymorphism of mitochondria and the morphological expression of enhanced yolk material assimilation confirm the idea of TF5-stimulating effect on the neuroepithelial cells.

Localization of concanavalin A--binding sites on neuroepithelial cells in early newt's neurula after treatment with noradrenalin.

The concanavalin A (Con A)--binding sites on the cell surface of newt's neural plate and groove in norm and following treatment with noradrenaline (NA) were examined ultrastructurally. The changes in the distribution of Con A--binding sites as well as structural changes of endocytic vacuoles in experimental conditions were described. The present results suggest that the differences in the Con A--binding were caused by receptor interaction of the plasma membrane glycoconjugates and the applied neurotransmitter.

[Influence of nerve growth factor (NGF) on formation of synapses in newt embryonic neural tube]. / Influcence du facteur de croissance nerveuse (NGF) sur la genèse de synapses dans le tube neural d'embryons de tritons

Under the influence of the nerve growth factor (NGF) a general stimulation of the synthetic processes, especially protein synthesis, occurs in the neuroblasts. The morphological counterpart is an hypertrophy of the nucleoli and spiralization of nucleolonema, an increase of the number of ribosomes with the persistence of a specific organization for each stage of development, then the proliferation of the granular endoplasmic reticulum and the modification of the predominant shape of mitochondria, which becomes annular, their outer surface being largely increased. The nutrient stores are quickly exhausted, with an accelerated disintegration of yolk droplets. There is an obvious increase in the number of non-synaptic contacts (puncta adherentia) between processes of neuroblasts and neighbouring nervous structures, and also an acceleration of formation of typical synaptic zones, indicating that NGF stimulates the functional maturation of the nervous system.