Cervical Tract Research Articles

Primary Cervical Adenocarcinoma With Intestinal Differentiation and Colonic Carcinoma Metastatic to Cervix: An Investigation Using Cdx-2 and a Limited Immunohistochemical Panel

Cdx-2 is expressed in normal colonic epithelia and in most colorectal adenocarcinomas. No data exist on Cdx-2 expression in primary cervical adenocarcinoma with colonic differentiation. To ascertain the utility of Cdx-2 and a limited immunohistochemical panel in differentiating between primary cervical adenocarcinoma with intestinal differentiation and secondary (colonic) cervical adenocarcinoma, which call for different surgical and chemotherapeutic treatment protocols. We examined cervical tract adenocarcinomas in women with previously negative medical histories for neoplastic disease and in women with colonic carcinoma. An immunohistochemical panel consisting of cytokeratin 7, cytokeratin 20, carcinoembryonic antigen, and a new marker, Cdx-2, was evaluated in all cases. The clinical data, the morphologic features, and the immunohistochemical staining patterns were compared. Of the tumors diagnosed as metastatic intestinal adenocarcinoma of the cervix, based on clinical data and hematoxylin-eosin-stained sections, all were Cdx-2 positive, whereas Cdx-2 was not expressed in any of our cases of primary cervical adenocarcinoma with colonic differentiation. Carcinoembryonic antigen was expressed both in primary cervical tumor and in secondary (intestinal) cervical adenocarcinoma. Cytokeratin 20 was not expressed in our cases of cervical adenocarcinoma, and it was not expressed in 7.15% of cervical metastases from intestinal carcinoma. Immunostaining with cytokeratin 7 was positive in cervical adenocarcinoma, but was negative in secondary (intestinal) cervical adenocarcinoma. Our immunohistochemical analysis shows that Cdx-2 has good specificity and would be a good marker to use in a limited panel of immunohistochemical markers, such as cytokeratin 7, cytokeratin 20, and carcinoembryonic antigen, to distinguish primary cervical adenocarcinoma from intestinal metastases to the cervix.

Organization of the ferret lateral cervical nucleus and cervicothalamic tract

To elucidate the organization of the ferret spinocervicothalamic pathway (SCTP), we examined the lateral cervical nucleus (LCN) and the termination of the cervicothalamic tract (CTT) in this species. In thionin-stained sections, the ferret LCN appeared as an easily delineated column of cells in the dorsolateral funiculus from about mid-C3 to the rostral end of C1, with most cells located in the C1 and C2 segments. In transverse sections, the LCN was elongated along a dorsolateral to ventromedial axis and in the rostral half of C2 and caudal half of C1 continuous with the neck of the dorsal horn. The number of ferret LCN cells was estimated to 2,500-3,700, with an average of 3,340. Substance P-like immunoreactive fibers located preferentially in the ventromedial part of the LCN, whereas serotonin-like immunoreactive fibers were found throughout the nucleus. Anterograde transport of wheat germ agglutinin-horseradish peroxidase conjugate and biotinylated dextran amine demonstrated that the ferret CTT terminates extensively in the peripheral parts of the ventral posterior lateral nucleus. Sparser termination was evident in the ventral posterior inferior nucleus, in the medial nucleus of the posterior complex, and in the medial part of the magnocellular medial geniculate nucleus. Thus, although the LCN is significantly smaller in ferrets than in cats and raccoons, the organization of the LCN and of the cervicothalamic tract is closely similar in the three species. These findings indicate a conserved general organization of the SCTP among carnivores.

Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization

Objective: To report a case of cervical stenosis repaired by hysteroscopic cervical shaving that created a smooth passage for ET in a patient undergoing IVF. Design: Case report. Setting: University-based IVF program. Patient(s): A woman with a history of multiple failed IVF attempts in whom ET was extremely difficult. Intervention(s): Operative hysteroscopy with creation of a cervical tract. Main Outcome Measure(s): Ease of postoperative ET and outcome of IVF treatment after the hysteroscopic procedure. Result(s): Easy performance of ET and a resulting triplet pregnancy. Conclusion(s): This novel hysteroscopic repair of cervical stenosis resulted in a markedly easier ET and a viable pregnancy.

Death of oligodendrocytes and microglial phagocytosis of myelin precede immigration of Schwann cells into the spinal cord.

Small, circumscribed electrolytic lesions were made in the upper cervical corticospinal tract in adult rats. In the centre of the lesion, the axons and all other tissue elements were totally destroyed. Surrounding this region of destruction is an area of tissue which is only partially damaged. In this area TUNEL positive staining of contiguous rows of tract glial cells indicates massive oligodendrocytic apoptosis at 1-3 days after operation, but axons, astrocytes and blood vessels survive. From around 4 days, the corticospinal axons in this area are demyelinated, and the microglia contain ingested myelin, identified in electron micrographs as characteristic MBP immunoreactive laminar cytoplasmic bodies. After around 3 weeks, large numbers of Schwann cells, continuous with those on the pial surface of the spinal cord, accumulate along the lesion track and selectively infiltrate the perilesional reactive area, where they mingle intimately with the phagocytic microglia. Electron micrographs show that at this time basal lamina-enclosed Schwann cell processes establish non-myelinated ensheathment of axons. From around 4 weeks after operation, prominent Schwann cell myelination is indicated by P0 immunoreactivity, and peripheral type, one-to-one myelination in electron micrographs. Thus the effect of the selective loss of oligodendrocytes is to first activate microglia, and then to induce a replacement of myelin by Schwann cells.

The Role of Intraoperative Ultrasound Imaging in the Surgical Removal of Intramedullary Cavernous Angiomas

Five intramedullary cavernous angiomas were surgically removed after being localized by intraoperative ultrasound imaging. Two patients were men, and three were women; in three patients, the symptoms had an acute onset, whereas in the other two, it was gradual. The vascular malformation was localized in the dorsal tract in three patients and in the cervical tract in two. Intraoperative ultrasound imaging visualized the lesion, which appeared hyperechogenous in all cases, and showed its relationship with the surrounding anatomical structures. Surgical removal was always total and was confirmed by both intraoperative echography and postoperative magnetic resonance imaging. In our experience, intraoperative ultrasound imaging was useful for localizing intramedullary cavernous angiomas, especially in cases where the lesion did not appear on the posterior surface of the spinal cord. In this way, it was possible to limit posterior myelotomy and confirm radical tumor removal intraoperatively.

Osteoblastoma of the atlas

A case of cervical spine (atlas) osteoblastoma in a 14-year-old patient is reported. Osteoblastoma is a rare primary bone tumour and in young patients it mainly occurs in the spine. Occurrence in the cervical tract is uncommon and in the atlas it is very rare. Only two other cases were found in our literature review.

Health of The Nation: Way Forward in Sexual Health

Sexual health is a wide concept encompassing education, health promotion and disease prevention, diagnosis and management of sexually transmitted diseases, screening and counselling for HIV antibodies, management of HIV infected patients, family planning, termination of pregnancy, psychosexual counselling, prevention of cervical and lower genital tract cancers, and sexual abuse. Implementation of The Health of the Nation (1992) will include assessing the current situation, views, alliances and interventions, need for research and development and within alliances setting challenging but achievable targets. The Health of the Nation includes a target for gonorrhoea which is a surrogate for partner change, sexually transmitted diseases in general and HIV infection, and a target for conceptions among those under 16 years of age. These targets need to be adjusted locally and may be staged. All interventions to achieve these targets must be available. Implementation of The Health of the Nation to achieve the main objectives which are to reduce the incidence of HIV infection and other sexually transmitted diseases as well as reducing the number of unwanted pregnancies and provision of effective family planning services will be challenging but sexual health gain will be well worthwhile.

An effective pharyngoesophageal reconstruction with free radial forearm flaps

Treatment of cancer of the cervical aerodigestive tract is challenging due in part to the difficulty in reestablishment of pharyngoesophageal continuity after resection of the involved tract. From May 1989 to August 1990, six patients underwent immediate reconstruction utilizing microvascular transfer of free radial forearm flaps following resection of pharyngoesophageal neoplasms. A small island flap connected to the radial vascular pedicle by fasciocutaneous branch was used to monitor the vascular condition of the hidden fabricated free forearm flap. Stricture is the most troublesome complication of esophageal reconstruction using a conventional free forearm flap. Two small triangular flaps were designed and inserted bilaterally in the distal anastomosis of both lateral esophageal walls to prevent circular contracture. The outer layer sutures were anchored to surrounding rigid structures to withstand shrinkage and circular contraction. The problem of stricture was solved by these procedures. This one-stage, easily monitored operation for pharyngoesophageal reconstruction is considered to be as useful as a free jejunal transfer.

Changes in Body Weight, Egg Production, Hackle Growth, and Plasma Sex Steroid Hormones and Prolactin during the Annual Reproductive Cycle in Domestic Geese.

This study was conducted to elucidate the changes in body weight, feather molts, hackle (cervical tract feather) growth, and plasma sex steroid hormones and prolactin in relation to annual reproductive cycle in adult domestic geese. Maximum body weight was observed in January (three of nine geese started laying), and gradually decreased during laying period (January to June). A positive correlation was observed between changes in food intake and body weight (rs=0.81, P<0.01). Plasma concentration of estradiol started to increase in January and reached maximum levels in coincidence with the highest egg production which occurred in May. Estradiol concentrations showed a positive correlation with egg production (rs=0.84, P<0.01). High levels of plasma concentrations of testosterone were observed from November to April. High levels of plasma progesterone were relatively confined to the second half of the laying period (April to June). Maximum prolaction concentration in plasma was observed in May, and was probably associated with broody behavior in two of the nine geese; this value was significantly greater than those observed in February, March, September and October (P<0.01). Changes in hackle growth showed a negative correlation with egg production (rs=-0.90, P<0.01). The nadir in hackle growth was clearly coincident with maximal egg production.

Slow recovery of central axons in acrylamide neuropathy

To study the differential vulnerability of central versus peripheral axons, we observed serial changes in conduction over comparable segments of central and peripheral axons of the primary sensory neuron in 17 rats with acrylamide neuropathy using somatosensory evoked potentials. Central conduction abnormalities persisted even after peripheral conduction and clinical abnormalities had recovered. Morphometric studies showed prompt restoration of the largest-diameter fibers in the peripheral nerve after clinical recovery but persistent or even more severe loss of large- and medium-sized fibers in the cervical gracile tract. This finding suggests that recovery from central-peripheral distal axonopathy begins in the largest peripheral axons, perhaps even at the expense of central axons, and that clinical recovery can occur at a time when central conduction remains abnormal. The selective central axonopathy found in certain chronic degenerative disorders may be a consequence of this slow central recovery process associated with chronic or intermittent metabolic derangements.

Responses of cervical spinocerebellar tract neurones to natural stimulation of vestibular and neck muscle receptors

Responses of cervical spinocerebellar tract neurones to natural stimulation of vestibular and neck muscle receptors

Electrophysiological studies on the termination sites of double projection spinal dorsal horn neurons in the cat.

Some projection neurons in laminae III, IV and V of the feline lumbar dorsal horn have been found to be antidromically driven from stimulation of both the ipsilateral cervical dorsal and dorsolateral funiculi that are well-dissected and insulated from one another. No detectable responses can be evoked from these neurons when stimulation is applied to sites rostral to the lateral cervical nucleus and the dorsal column nuclei, suggesting that the dorsal and dorsolateral funicular branches of these neuron's axons terminate in the lateral cervical nucleus and the dorsal column nuclei, respectively. The results indicate that these neurons are an intersection set of the spinal cervical tract (SCT) and dorsal column postsynaptic (DCPS) neurons and have been thus named spinal cervical tract-dorsal column postsynaptic (SCT-DCPS) neurons.

Comparison of the human evoked electrospinogram recorded from the intrathecal, epidural and cutaneous levels

In 30 patients (17 of whom had a clinically normal spinal cord) spinal cord potentials evoked by peripheral nerve stimulation were studied with computer averaging techniques in order to compare the intrathecal, epidural and skin records. In epidural and skin records, segmental spinal cord potentials either recorded from lower cervical or lower thoracic intervertebral levels often had similar shapes and latencies, especially with regard to the first component of the intrathecally recorded responses. The second slow component became less significant and was even absent in some cases. The amplitude of the first component was on average 33% of that recorded intrathecally when recorded epidurally and only 10% when recorded from the skin. In three cases potentials of very prolonged onset latency were recorded epidurally or cutaneously while in the same cases intrathecal records resulted in potentials with normal latencies. Cervical tract responses at the C6–C7 intervertebral level after stimulation of the posterior tibial nerve were studied by the 3 recording methods. Epidural and skin records failed to reveal such a response regularly, while intrathecal recording invariably provided the cervical tract response. The 3 recording methods were discussed with respect to clinical applications and research. It can be stated with some reservation that epidural and skin surface recording techniques could be exploited if one could know the time of arrival of segmental afferent inputs at the spinal cord.

CERVICAL CYTOMEGALOVIRUS EXCRETION IN PREGNANT AND NONPREGNANT WOMEN

Comparison of 659 pregnant and 202 nonpregnant women with similar demographic characteristics showed overall rates of cervical cytomegalovirus excretion that were identical (9.5% vs. 9.4%) and were surprisingly high, especially since 89% of the pregnant group possessed antibody to cytomegalovirus when admitted to the study. Prevalence of cytomegalovirus among gravidas was significantly lower during the first (1.6%) than during the third (11.3%) trimester. Thus, early pregnancy appeared to exert a suppressive effect on viral excretion that waned with advancing gestation. A similar but less significant occurrence was observed in the two groups with respect to viuria. Increasing age also appeared to suppress the virologic expression of cervical and urinary tract infection, whereas multiparity seemingly produced such an effect only in the cervix. Among both cervical and urinary excreters, a few shed virus thoughout pregnancy, and others shed virus intermittently; however, viral shedding most commonly began in late gestation and frequently continued into the postpartum period. Primary infection was not documented, and antibody status remained unchanged with the advent of viral excretion in most cases. Thus, reactivation of endogenous virus seems the most likely explanation for viral shedding in our population. Similar rates of isolation of Neisseria gonorrhoeae in excreters and nonexcreters further argue against the other major possibility, venereal reinfection.

PTERYLOGRAPHY, PLUMAGE DEVELOPMENT AND MOULT OF JAPANESE QUAIL COTURNIX C. JAPONICA IN CAPTIVITY

SummaryJapanese Quail were kept in small cages under controlled conditions of temperature and light, and their pterylography and moult are described. There are 10 primaries, 14 secondaries and corresponding numbers of greater upper and lower wing coverts. The alula has four feathers and the tail from five to six pairs of feathers. There is an apterium in the dorso‐pelvic tract similar to that in other quail genera. The arrangement of feathers in the ventral and cervical tracts appears to differ from that described for some North American quail.The chicks hatch with a covering of natal down. Pre‐juvenile moult can be seen when the chicks are three days old. Juvenile body plumage is complete in about 30 days; the sides of the face, around the eyes, are the last places to acquire feathers. The tenth and last juvenile primary to grow is mature when the chicks are 41 days old.The moult in which the juvenile plumage is replaced overlaps the post‐natal moult and in part of the ventral tract natal down is replaced by the first adult feathers. This makes it possible to sex the quail at 14 days old. The first adult moult is complete, in the body tracts, by the time the birds are five to six weeks old. The dropping of juvenile primaries commences at about three weeks old and ceases when about eight weeks old. Only from three to six primaries are replaced; most birds studied replaced five. The significance of this difference from other Galliformes is discussed; it is thought to be associated with the species' migratory behaviour. Quail which remained in the controlled laboratory environment did not undergo any further moult. All birds moulted when both temperature and light period were reduced and most birds moulted when the light period alone was reduced. Adult birds housed in small cages in an unheated, unlit shed underwent a complete moult between August and December in which all primaries were replaced. This moult took 8–14 weeks to complete.

Neurohistological observations on the oesophageal innervation of rabbit.

The vegetative, motor, and sensitive innervation of the oesophagus of rabbit was studied by means of several neurohistological techniques. A great deal of vegetative and somatic nervous formations were found and described within the various segments of the organ; namely at level of the cervical, thoracic, prediaphragmatic, and abdominal oesophageal tracts. In particular, isolated and grouped ganglion cells, interstitial and associative neurons, free nervous terminations, and an amyelinated subepithelial network sending delicate fibrils to the basal layers of the impending epithelium were described. The vegetative nervous component is organized into an extramural oesophageal plexus, and into an intramural one. The numerous motor endplates lying on the striated muscle fibres show different forms and several other structural pecularities. The sensitive terminations are represented by simple and non-capsulated Ruffini's corpuscles contained within the submucous connective tissue. The possible functional correlations of these morphological findings are discussed.

Posterior Paralysis of Hamsters with Herpes simplex Infection of the Cervix

LITTLE has been reported about specific virus infections of the female genital tract. Most text-books on gynaecology make sparse or no reference to virus infections of the tract except for lymphogranuloma venereum in human beings. As part of an investigation of the role of ‘ordinary’ viruses in neoplasia of the cervical tract, an attempt was made to develop an experimental model which would enable the interrelationships of viruses and carcinogens to be studied. Herpes simplex virus was selected for initial investigation because of the relatively frequent occurrence of vesicles in the tract of women and because of the latency aspect of its pathogenesis.

SPERM MIGRATION AND CERVICAL MUCUS STUDIES IN INDIVIDUAL CYCLES

7 couples who consulted for infertility were observed during 12 menstrual cycles. The couples had repeated normal semen analysis normal coital technique normal ovulatory cycles as determined by basic body temperature normal vaginal smears and endometrial biopsies; quality of cervical mucus was also investigated. 65 PCT (post coital tests) measured by the number of motile spermatozoa present in the cervical tract were performed between 3 to 13 hours after spontaneous sexual relations. A rise was observed in PCT results and in the quality of cervical mucus from a preovulatory low to an anovulatory plateau with a postovulatory deterioration of quality; PCT quality however deteriorated more slowly than cervical mucus quality. Results showed a superiority of 5-15% in the morphology of the spermatozoa which were able to penetrate the cervical mucus as compared to masturbated semen specimens.