3 research outputs found
Histological villous maturation in placentas of complicated pregnancies
Chorioamnionitis and preeclampsia account
for the majority of preterm births worldwide. Thus far,
adequate methods for early detection or prevention of
these diseases are lacking. In preeclampsia, accelerated
villous maturation is believed to compensate placental
insufficiency. However, little is known about the effects
of placental inflammation in chorioamnionitis on villous
maturation. Therefore, we established a set of
morphological parameters to evaluate histological
villous maturity in pregnancies complicated by
chorioamnionitis and preeclampsia. Preterm placentas
complicated by chorioamnionitis or preeclampsia were
compared to idiopathic preterm placentas and term
controls. Histological villous maturation was analyzed
by means of 17 histological markers. Fourteen of these
markers provided information on absolute and relative
numbers of the terminal villi (TV), the extent of their
vascularization (using CD31-stained sections) and their
exchange capacity. In addition, the numbers of syncytial
bridges, syncytial apoptotic knots and shed
syncytiotrophoblasts were counted. Accelerated villous
maturation in preeclampsia was demonstrated by means
of histological villous remodeling and confirmed by 11
relevant markers. Chorioamnionitis, however, only
showed increased area of fetal capillaries. In
preeclampsia, placentas may transition from growth to
maturation earlier than placentas in normal pregnancies,
whereas in chorioamnionitis placental changes are more
acute and therefore less elaborated at a structural level.
Regression analysis suggests the number of all villi and
the number of terminal villi as a percentage of all villi as
parameters to evaluate histological villous maturity in
preeclamptic placentas and to assist diagnosis. However,
we would recommend to analyze all 11 relevant
parameters to judge placental maturity in detail
Hemorrhagic regression of melanoma metastases during therapeutic vaccination: a report of three cases.
Melanoma metastases are characterized by pronounced neo-angiogenesis and spontaneous bleeding frequently occurring within central nervous system metastases. Clinically apparent spontaneous hemorrhage within subcutaneous melanoma metastases, however, is a rare event that coincides with progression of such metastases. We report, to our knowledge the first observation, on regression of subcutaneous metastases with hemorrhage of the overlying skin in three patients with stage IV melanoma who participated in clinical trials on therapeutic vaccination. In two patients, loss of arterial flow on Doppler ultrasound imaging was documented in the metastasis at the time of hematoma formation. One patient suffered from an intracranial hemorrhage in a subcentimetric brain metastasis coincident with the hemorrhagic regression of some of his skin metastases