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인체자궁내막기질세포에 관한 전자현미경적 연구

Other Titles
 Ultrastructure of the human endometrial stromal cells during the menstrual cycle and pregnancy 
Authors
 김대현 
Issue Date
1973
Description
의학과/박사
Abstract
[한글]
[영문] In these days of intense interest in gynecologic and endocrine disorders the knowledge of endometrial histology has become a great clinical value. The endometrium is under the physiologic subservience of the overian homones and therefore it fairly reflects the endocrine activites(Novak, et al., 1970). Numerous studies have been made about endometrial glandular epithelial cells including ultrastructural observation (Birch and Collins, 1961; Gompel, 1962; De Brux and Ancia, 1964; Cavazos, et al., 1967; Thrasher & Richart, 1972), but there are few studies reported about the endometrial stromal cells, especially in electron microscopic aspects (Wienke, et al., 1968; Lawn, et al., 1971), although the endometrial stromal cell responds to the cyclic change of the ovarian hormones and shows the corresponding morphologic alteration as well (Noyes, et al., 1951; Wienke, et al., 1968). Most of the studies in the morphologic change of stromal cells dealt little about the fine structure of human stromal cells (Finn and Keen, 1962; De Feo, 1963; Marcus and Shelesnyak, 1967). Lawn et al. (1971) observed the human decidual and predecidual cells electron microscopically, and Orsini et al. (1970) and Brinsfield et al. (1972) described the fine structure of the decidua of the pregnancy and pseudopregnancy in the rat, but as yet there are no other reports which are able to support the findings of them. In addition, the terminology of the endometrial decidual cell in ectopic (tubal) pregnancy is confused in usage, having the name of pseudodecidua by some (Anderson, 1971) and true decidua by others (Novak and Woodruff, 1967). This study was made to investigate the ultrastructural changes of the human endometrial stromal cells during the menstrual cycle and to determine whether there are any ultrastructual differences among the pseudodecidual cells of late secretory phase, the decidual cells of intrauterine pregnancy, and the decidual cells of ectopic pregnancy. Materials and Methods Meterials were curetted endometrial tissues from 59 healthy women who aged 20 to 40 years with the history of normal menstrual cycle and without clinical or histological evidence of gynecologic disease. The materials were divided into following groups. Group Ⅰ: Non-pregnant group………………………………………35 cases a. Early proliferative phase (Menstrual cycle 4-7th day)… 4 cases b. Mid-proliferative phase(Menstrual cycle 8-10th day)…… 4 cases c. Late proliferative phase(Menstrual cycle 11-15th day)… 4 cases d. Early secretory phase(Menstrual cycle 16-19th day)………7 cases e. Mid-secretory phase(Menstrual cycle 20-23rd day)…………4 cases f. Late sectetory phase(Menstrual cycle 24-28th day)……… 6 cases g. Menstrual phase(Menstrual cycle 1-3rd day)…………………6 cases Group Ⅱ: Pregnant group………………………………………………24 cases a. Intrauterine pregnancy 1 month…………………………………5 cases b. Intrauterine pregnancy 2 months………………………………11 cases c. Intrauterine pregnancy 3 months……………………………… 4 cases d. Ectopic (tubal) pregnancy……………………………………… 4 cases For the light microscopic examination, the one half of the obtained endometrial tissue was fixed in 10% neutral formalin. Paraffin embedded blocks were cut in 6 micron thickness, and sections were stained by hematoxylin-eosin methods. According to the criteria of Noyes et al. (1951), the phase of the endometrium was determined. For the electron microscopic examination, the other half was cut in about 1 cubic mm size and fixed in 1% osmium tetraoxide in phosphate buffer pH 7.4 after one to two days fixation in 4% glutaraldehyde in phosphate buffer pH 7.4 and dehydrated with graded alcohol. The sections were cut with a glass knife following Epon 812 embedding in 400-500 A thickness and stained with uranyl acetate and lead hydroxide. Observations were made with the Hitachi HU 11-E model electron microscope. Results and Summary 1) The endometrial stromal cell showed, likewise endometrial epithelial cells, cyclic morphological changes during the menstrual cycle. The undifferentiated fibroblast-like stromal cell of early proliferative phase progressively matured and took the form of functionally active cell as progressed towards the secretory and pregnancy state. 2) The stromal cell during either intrauterine or ectopic pregnancy showed marked morphological changes, which consisted of distinct cytoplasmic membrane of increased density, many well developed cytoplasmic processes some of which containing membranebound granular material, and specialized cell-junction apparatus, gap-junctions, between the cell surface and cytoplasmic processes and between the cytoplasmic processes. The stromal cell of late secretory phase did not have the specialized structures observed in the pregnant decidual cell. On the basis of the above results it is considered that the decidual tissues represent a system of communication, uniting decidual cells into a functional syncytium which might play a part in determining the chemical and physical environment suitable for the development of a blastocyst and it is also speculated that gap-junctions bind the cells into a mechanical barrier, protecting the blastocyst and preventing deeper invasion of the uterus. It seems to be more reasonable that the decidual cell of ectopic pregnancy will be called as true decidua as of intrauterine pregnancy and the stromal cell of non-pregnant late secretory phase will be called as pseudodecidua as has been used.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/115256
Appears in Collections:
2. Thesis / Dissertation (학위논문) > 1. College of Medicine (의과대학) > Ph.D. (박사)
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