Avaliação da ocorrência de apoptose em células foliculares da tiróide de rato após estimulação seguida de supressão do hormônio tireotrófico endógeno

Objective: In this study, the levels of pituitary TSH in rats were modulated by pharmacological treatment in vivo to evaluate the possible cell loss through apoptosis during TSH supression of thyroid gland. Methods. Male Winstar rats (~220gr body weight-bw) were given methimazole (MTZ) 0.03% in drinking water for three weeks. Then the animals received tyroxine (T4) 20mg/100g bw/day ip for one (T4-1d), two (T4-2d), three (T4-3d) or five (T4-5d) days while the control group (MTZ) was not treated with T4. After perfusion of the rats with physiologic serum (0.09%), the thyroids were surgically dissected and weighed. DNA were quantified to verify cell loss and the DNA value measured the espectrophotometer set at A595 was compared to the normal curve of salmon sperm DNA. Results. The table show the thyroid weight (T) and the DNA concentration of T4 treatment groups and the control group (MTZ). Mean ±SD. On themorphological analysis of the tissue by optical and electron microscopy (OM, EM), the follicules of the rats treated with MTZ present hight tyrocytes with closed lumens whith gradual reappearance of lumens and reduction of cell height were observed in the tissue of the groups treated with T4. In some of their lumens, particularly in those subjected to prolongedtreatment, electrondense structures containing cellular residue were seen. The fragments containing intensely condensed cromatine, cell structure residue (apoptotic bodies) or even cells with cromatine condensed in a half-moon shape (apoptotic cells) sporadically appear in the basal follicular region of the T4 groups. Conclusion. In the thyroids of animalstreated with T4, there is a reduction of DNA and the presence of morphological structures suggesting apoptosis. In addition with the hypoplasia of the folicular cells, the cell loss by apoptotic process could be contributing to the shrinkage in the rat thyroid gland submitted to TSH supression.Objetivo: Neste estudo foram modulados os níveis de TSH hipofisário de ratos por tratamento farmacológico in vivo, para avaliação da possível perda celular por apoptose durante a involução da glândula tiróide por supressão de TSH. Métodos: Ratos Winstar machos (~220g peso corporal pc) foram tratados com metimazol (MTZ) 0,03% na água de beber por três semanas. Após este período receberam tiroxina (T4) 20 mg/100 g pc/dia intraperitonealmente por 1(T4-1d), 2 (T4-2d), 3 (T4-3d) e 5 (T4-5d) dias e o grupo controle (MTZ) sem tratamento com T4. Foi realizada a quantifição de DNA para verificação da perda celular e o valor obtido na A595 no espectofotômetro foi comparada à curva padrão de DNA de esperma de salmão. Resultados: O peso da tiróide (T)/100g de pc do animal e os valores de DNA calculados em mg/100 g de pc, Média ± SE, e a variação da quantidade de DNA (%) e m comparação ao grupoMTZ. Na análise morfológica do tecido à microscopia óptica e eletrônica (MO e ME), os folículos dos ratos tratados com MTZ apresentam tirócitos altos com lúmens fechados e se observam reaparecimento gradativo dos lúmens e redução variada da altura das células nos tecidos com tratamento com T4. E m alguns lúmens, dos grupos tratados com T4 nota-se a presença de estruturas eletrondensas contendo resíduos de organelas, sendo mais freqüente nos tratamentos prolongados. Na região basal dos folículos aparecem esporadicamente células envolvendo fragmentos densos contendo cromatina intensamente condensada e resíduos de organelas (corpos apoptóticos) ou ainda células com cromatina condensada em meia-lua (células apoptóticas) nos grupos que receberam tratamento com T4. Conclusão: Nas tiróides dos animais tratados com T4 ocorre redução de DNA e observam-se estruturasmorfológicas de apoptose à MO e ME . A perda celular por processo de apoptose contribui juntamente com a hipoplasiadas células foliculares na involução da glândula tiróide de ratos submetidos a supressão de TSH

Uterine transplantation: a systematic review

Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women

Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program

OBJECTIVE: This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep. METHOD: The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of São Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed. RESULTS: The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period. CONCLUSION: We describe the success of four uterine auto-transplants in sheep models

Evaluation the endometrial histomorphometry of fertile and infertile women during their luteal period

OBJETIVO: avaliar a histomorfometria do endométrio na fase lútea de mulheres férteis e inférteis. MÉTODOS: foram triadas 40 pacientes, 30 inférteis e 10 férteis, em seguimento na Clínica Ginecológica do HC-FMUSP, que concordaram em participar deste estudo. Foi realizada avaliação ultrassonográfica seriada a partir da menstruação, para determinação da ovulação. Na fase lútea as pacientes eram submetidas à histeroscopia. Foram excluídas 14 pacientes sendo 12 por falta durante a avaliação ultrassonográfica e 2 pela presença de pólipos. A casuística foi composta por 6 controles férteis, que foram comparadas a 20 casos inférteis (endometriose-8, causa tubo-peritoneal-5, causa masculina-5, sem causa aparente-2). Na histeroscopia foram coletadas duas biópsias dirigidas (sistema de Bettocchi) da parede posterior (terço distal), e da parede anterior (terço médio), e uma biópsia aspirativa com Pipelle. Foram avaliados parâmetros histomorfométricos endometriais. RESULTADOS: as duas formas de biópsia foram apropriadas para análise endometrial; a dirigida coletou menor área tecidual, porém sem sangue. Nenhum paciente fértil apresentou heterogeneidade endometrial (atraso de fase em algum sítio); isto ocorreu em 7 (35%) das inférteis (p=0,11). Foi diagnosticada endometrite em 2 (10%) casos. CONCLUSÃO: não foram observadas diferenças histomorfométricas entre o endométrio de mulheres férteis e inférteis na fase lútea. Parte das pacientes inférteis mostrou heterogeneidade endometrial e endometrite. A biópsia dirigida, assim como a aspirativa, foi adequada ao estudo endometrial na fase lúteaObjective: to evaluate the endometrial histomorphometry of fertile and infertile women during their luteal period. Methods: 40 female patients- 30 infertile and 10 fertile- who were being followed-up at the Gynecological Clinic at the Hospital das Clinicas (HC),-Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), agreed to participate in the study. Serial ultra sonograms, starting from their menstrual period, were performed to identify their ovulation. In the luteal phase the patients underwent hysteroscopy. From the initial sample, 14 patients were excluded from the study, 12 of whom for being absent during scheduled ultra sonograms and 2 for presenting polyps. The final sample thus consisted of 6 fertile females (control subjects) who were compared to 20 patients with infertility, categorized as follows: 8 due to endometriosis, 5 due to peritoneal tube conditions, 5 due to male infertility, and 2 with no apparent cause. During the hysteroscopy 2 directed biopsies (Bettocchis System) of the posterior wall (distal third section) and of the anterior wall (medial third) were performed, as well as Pipelle sampling. Endometrial histomorpholometric parameters were evaluated. Results: the two forms of endometrial sampling performed were appropriate for the endometrial analysis. The directed biopsy collected tissue from a smaller area, but it had no blood. None of the fertile patients presented endometrial heterogeneity, i.e., phase delay in any site. In contrast, this occurred in 7(35%) of the infertile females (p=0.11). Endometritis was diagnosed in 2 (10%) of the cases. Conclusions: no histomorphometric differences were observed in the endometrium of the fertile and infertile female patients during their luteal phase. About a third of infertile cases (35%) displayed endometrial heterogeneity and a small percentage of which (10%) had endometritis. Both the directed biopsy and Pipelle sampling were found satisfactory for studies of endometrium during the luteal phas

Seric and peritoneal assessment of interleukin 1ß, 6 and protein amyloid A concentrations in patients with pelvic endometriosis.

Objetivo: determinar as concentrações séricas e peritoneais das interleucinas 1ß (IL-1ß) e 6 (IL-6) e da proteína amilóide A (SAA) em pacientes com endometriose pélvica. Métodos: foram avaliadas 97 pacientes submetidas à videolaparoscopia, 57 com endometriose (A), 27 com sintomas sugestivos porém sem endometriose (B) e 13 sem sintomas e doenças (C). Foram coletados no ato cirúrgico líquido peritoneal e sangue. As concentrações dos mediadores foram determinadas em pg/ml (IL-1 e 6) e ng/ml (SAA) por método imunoenzimático e leitura óptica. Resultados: (líquido peritoneal e sangue medianas) IL-1ß: A- 11,22 and 1,83; B- 15,62 and 1,16; C- 1,92 and 0,80; IL-6: A- 6,80 and 3,70; B- 8,60 and 3,90; C- 3,40 and 2,0; SAA- A- 310,30 and 14,01; B- 306,20 and 10,39; C- 53,4 e 9,5. Conclusão: as concentrações dos mediadores de inflamação avaliados estão elevadas no líquido peritoneal e no soro das mulheres com endometriose. Estas concentrações foram semelhantes às das pacientes com sintomas sugestivos porém sem a doença. A fase do ciclo menstrual, o tipo histológico envolvido e o local de acometimento da doença não influíram de forma significante nas concentrações séricas ou peritoneais de IL-1ß, IL-6 e SAA.Objective: to assess peritoneal and seric interleukin-1ß (IL-1ß), 6 (IL-6), and protein amyloid A (SAA) concentrations in patients with pelvic endometriosis. Methods: 97 patients were submitted to video laparoscopic surgery, 57 with endometriosis (A), 27 with suggestive symptoms but no endometriosis (B), and 13 without symptoms and diseases (C). Peritoneal fluid and blood were collected during the procedure. Mediator s concentration was determined in pg/ml (IL-1ß and IL-6) and ng/ml (SAA) through immunoenzimatic test and optic measure. Results: (peritoneal fluid and blood -medians) IL-1ß: A- 11,22 and 1,83; B- 15,62 and 1,16; C- 1,92 and 0,80; IL-6: A- 6,80 and 3,70; B- 8,60 and 3,90; C- 3,40 and 2,0; SAA- A- 310,30 and 14,01; B- 306,20 and 10,39; C- 53,4 e 9,5. Conclusion: the inflammation mediators are increased in the peritoneal fluid and blood of women with pelvic endometriosis. The concentrations are similar to those found in patients with suggestive symptoms but no endometriosis. The place of the disease, the histological type and the day of the menstrual cycle didn t alter peritoneal or seric concentration of these cytokines

Minimally invasive surgical treatment for early-stage ovarian cancer: a case report

Case report of a 54-year-old patient, with no complaints and noalterations detected during the physical examination, who underwenta routine pelvic ultrasound that showed a complex cyst on the rightovary which was confirmed with a CT scan. The serum CA125 levelwas elevated while other tumor markers – carcinoembryonic antigen,alphafetoprotein antigen and the beta human chorionic gonadotrophinwere normal. Videolaparoscopy was used for the diagnosis andtherapeutic management, revealing vegetating lesions on bothovaries but no other alterations. Biopsies were performed on thetumor masses and analyzed using the frozen section technique duringthe surgical procedure which revealed a serous neoplasm of lowmalignant potential - borderline. Next, ovarian carcinoma stagingwas performed in accordance with the standards recommended bythe International Federation of Gynecology and Obstetrics: bilateralsalpingo-oophorectomy, total abdominal hysterectomy, bilateralpelvic and para-aortic lymphadenectomy. To complete the staging,an omentectomy was performed by means of a 4 cm transverseincision in the epigastric region which was enlarged using a specialDexterity Protractor™retractor. The incision also enabled the removalof surgical specimens. The patient was discharged from the hospitalon the following day and recovered without any complications.Histological analysis confirmed the borderline tumor and no malignantcells were found on the other surgical specimens. Videolaparoscopy,minilaparotomy and the special retractor enabled adequate diagnosis,staging and removal of the localized ovarian tumor