Eva Patek

The Epithelium of the Human Fallopian Tube

A study was undertaken from September 1971 to October 1973 with the scanning electron microscope (SEM) to investigate the surface epithelium of the human Fallopian tube during fetal reproductive and postmenopausal life. The aim was to obtain information on the normal conditions and possible cyclic behavior of the ciliated and nonciliated cells. The study was also extended to include the investigation of the intracellular content of DNA and the concentration of various trace elements of the endosalpinx in the normal menstrual cycle. Quinacrine dihydrochloride is known to bind to DNA forming a clot in the intramural portion of the tube. The effect of different trace elements on Quinacrine was studied. It was determined that the ciliated and nonciliated cells of the endosalpinx are fully developed early in embryonic life. The ciliated cells exhibit no specific cyclic behavior in the adult while a pronounced cyclic behavior is found in the nonciliated cells. Pregnancy gives the picture of late secretory phase which is most pronounced at term when there is a period of cellular rest. Activity and restoration take place in the postpartum period. Progestational agents generally give a picture of late secretory phase and estrogen gives a proliferative picture. There appears to be no synchronization of the DNA synthesis in the epithelium of the tube in the menstrual cycle. Increased DNA values were observed around ovulation which are probably due to the influence of 17-beta-estradiol with the effect of loosening of the chromatin swelling of the nuclei and a higher dye binding capacity of the nuclei. Trace elements concentrations are fairly constant in the menstrual cycle when the endosalpingeal values are compared with those of the endometrium.

Scanning Electron Microscopic Study of the Human Fallopian Tube. Report III. The Effect of Midpregnancy and of Various Steroids

The scanning electron microscope was used to examine fallopian tubes removed from 18 women including 3 on the low dose progestin contraceptive .5 mg megestrol acetate 3 on different combined oral contraceptives 3 fertile and 3 postmenopausal women on .05 mg ethinyl estradiol 3 women 18-20 weeks pregnant and 3 transsexuals injected monthly with 250 mg testosterone enanthate. The microscope revealed few differences in cell distribution or structure. More ciliated cells usually located on edges of plicae and fewer secretory cells were found in the ampulla and infundibulum than the isthmus and intramural portions of the endosalpinx. Subjects taking progestogen or in midpregnancy had a normal distribution of ciliated cells but the cilia appeared drooping and granulated. Both fertile and postmenopausal subjects taking estrogen had tall vigouous cilia. Only testosterone decreased the number of ciliated cells in the distal tube significantly.

CAESAREAN SECTION A clinical study with special reference to the increasing section rate

Abstract. At Huddinge University Hospital 539 Caesarean Sections (C. S.) were made among 8415 deliveries from October 1972 to June 1976, corresponding to an over all C. S. rate of 6.4%. Over these years the rate has increased from 3.5% in 1972 to 9.7% in 1976. The main increase was due to a higher incidence of abdominal deliveries in cases of imminent fetal asphyxia. The maternal complication rate and the neonatal morbidity rate were both 6.5 times higher and the neonatal mortality rate was 4.1 times higher in emergency than in elective surgery. There was neither any mortality nor any morbidity in infants delivered by elective C. S. from healthy mothers at term.

Quinacrine hydrochloride. Review and mode of action of an antimalarial, used as an occlusive agent for transvaginal human sterilization.

Abstract. Quinacrine hydrochloride, mainly used as an antimalarial, has been used as a nontoxic chemosterilant in a transvaginal procedure in the human female. Clinical experiments indicate that Quinacrine acts as a powerful obstructive agent exclusively on the epithelium of the intramural portion of the tube without alterating the histology of the endometrium.

Recurrent hydatidiform mole. Report of a case with five recurrences.

Abstract. A report on a patient having five consecutive molar pregnancies is presented. None of the pregnancies was associated with a fetus and all five hydatidiform moles were histologically benign. The treatment of recurrent moles is discussed and the literature concerning this problem is reviewed.

Sterilant Action of Quinacrine

A question concerning the mode of action and degree of effectiveness of the chemosterilant quinacrine for achieving tubal occlusion for sterilization in women is posed. Quinacrine acts as a powerful obstructive agent exclusively on the epithelium of the intramural portion of the tube without altering the histology of the endometrium. The precise mechanisms of action are unknown. It may bind to epithelial DNA. The procedure is 90% effective with 2 instillations of quinacrine.

The Proliferative Behavior of the Human Fallopian Tube Epithelium

Using autoradiography after in vitro administration of tritiated thymidine a low grade of DNA synthesis had been found to take place in the epithelium of the human Fallopian tube in reproductive and postmenopausal age. No synchronization was found to take place in the menstrual cycle. There seems to be no relationship between tubal renewal and the endogenous hormones of the reproductive system in the human.

Hydrosalpinx Simplex as Seen by the Scanning Electron Microscope**Supported by Swedish Medical Research Council Grant B-72-12-X-2712-04; Karolinska Institutet; the World Health Organization, Geneva, Switzerland; The Ford Foundation, New York, N. Y.; and JEOL Inc., Tokyo, Japan.

Five cases of hydrosalpinx simplex were studied by light microscopy and scanning electron microscopy (SEM). Comparison was made with normal fallopian tube epithelia. By light microscopy numerous ciliated cells as well as nonciliated cells were found in both hydrosalpinx and normal tubal material. In hydrosalpinx material the epithelium was found to be compressed to one-sixth its usual height. The SEM survey of large areas of hydrosalpinx did not reveal any deciliation. In fact, the mucosa of the hydrosalpinx did not differ conspiciously from that of a healthy fallopian tube. However, some nonciliated cells with collapsed areas were revealed by SEM. The significance of the compressed areas is unknown.

Scanning Electron Microscopic Study of the Human Fallopian Tube. Report I. The Proliferative and Secretory Stages**Supported by Swedish Medical Research Council Grant B72-12-x-2712-04, Karolinska Institutet Stockholm, the Swedish International Development Authority, and The Ford Foundation and JEOL Inc.

An examination of the epithelial surface of the Fallopian tubes of 10 women treated by salpingohysterectomy or salpingectomy was performed with a scanning electron microscope. Different regions of the oviduct were studied during the midproliferative and late secretory phases to note differences in the ciliated and nonciliated cells as well as the distribution of the ciliae. It was found that the ciliae were unevenly distributed with more in the fimbral end and the ampulla and fewer in the intramural portion of the tube. Cyclic changes occurred in nonciliated cells during the secretory phase and the number and size of microvilli decreased and changed appearance. The ciliae changed somewhat in superficial structure became more granulated and lost vigor. These epithelial alterations as well as the distribution of the ciliae may have importance for the transport of the fertilized ovum.(AUTHORS MODIFIED)