Morphofunctional changes in the hemo- and lymphomicrocirculatory bed of the uterus and its regional lymph nodes in venous congestion during pregnancy

Interrelations of the blood and lymphatic systems of the uterus have been examined in rats at pregnancy complicated with the ++phlebo-occlusive syndrome. Blood stream impediment in the caudal vena cava results in increasing diameter of the arterioles, capillaries and venules of the endo- and myometrium. Certain disturbances of blood circulation in the uterus at the ++phlebo-cclusive syndrome in the pregnancy animals, as a rule, reflect in the uterine lymph outflow; this is demonstrated as dilatation and deformity of the lymphatic vessels and capillaries, appearance of protrusions of the lymphatic vessels wall. There is a definite co-ordination in the reaction to the caudal vena cava occlusion in the intra-, ++extra-organic uterine lymphatic bed and in its regional lymph nodes, manifested as the following morphological signs: decreasing relative volume, that the lymphoid tissue occupies and increasing relative volume of the cortical and medullary intermediate sinuses.     

Anatomy and topography of external iliac lymph nodes in adults]

The investigation of the external iliac lymph nodes has been performed in 152 preparations of corpses of mature persons of both sex, who died from causes not connected with any disease of the lymphatic system, lower extremities and pelvic organs. The external iliac lymph nodes and their afferent and efferent lymphatic vessels have been revealed by means of interstitial injection of the lower extremities and pelvic organs, as well as by means of direct injection of Gerota mass into the lymphatic vessels. Form, amount, dimensions and topography of common iliac lymph nodes have been studied. Lymphatic vessels, running from certain parts and organs of the body to various subgroups of the external iliac lymph nodes have been described, as well as efferent lymph vessels of these nodes. The external iliac lymph nodes are constant formations; the largest of them--lymph nodes of the lacuna--are nodes of the I step for the lower extremity lymph vessels. In 54% of cases in persons of both sex positive (right-sided) asymmetry has been revealed. Total amount of the iliac lymph nodes prevails in men, while their size is greater in women. The size of these nodes in persons of both sex is greater to the left than to the right. There are connections (in 3% of cases) between the external iliac lymph nodes and aortal and lumbar nodes of the opposite side.     

Anatomy and topography of the common iliac lymph nodes in human beings in the 1st period of maturity

The investigation of common iliac lymph nodes has been performed in 20 corpses of the first mature age of both sex (5 male and 5 female corpses) of persons died from causes not connected with the lymphatic system diseases, the lower extremities and the pelvic organs. The common iliac lymph nodes with their afferent and efferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and the pelvic organs and with direct injection into the lymphatic vessels. The form, amount, size and topography of the common iliac lymphatic vessels have been studied. The lymphatic vessels, that go from certain body parts and organs to various subgroups of the common iliac lymph nodes, as well as the lymphatic vessels that connect the nodes both within the subgroup and also between the subgroups. The amount and size of the lymphatic nodes of the lateral subgroup predominate over the nodes of other subgroups of the common iliac lymph nodes; the amount of the common iliac lymph nodes predominates in men, and their size--in women. Amount of these nodes in the right and their size in the left predominate in both sex. Among the common iliac lymph nodes there are no teniform nodes, and efferent lymphatic vessels of the lateral and medial subgroup of the common iliac lymph nodes in 15% of cases run towards the lumbar nodes in the opposite side.     

Functional morphology of the lymphatic system of the rat uterus during pregnancy

In the regional lymph nodes of the uterus the comparative volume of the paracortical zone significantly increases, especially within the period of the 13th-17th days of pregnancy. In the popliteal lymph node similar effect is not discovered. From the 7th up to the 11th day edema, vasodilatation, infiltration with special leucocytes are revealed. Endothelium of the postcapillary venules is hypertrophied, contains many migrating lymphocytes, which accumulate around the vessels mentioned. The volume of the microcirculatory bed is moderately increased. By the 17th day plasmoblasts, plasmocytes, Motta's cells, monocytes and especially macrophages appear in the paracortical zone. In B-zones and in medullary sinuses blasts, plasma cells, monocytes, macrophages, mitotically deviding cells increase in number. The part of the reticular cells decreases. The tensometric method demonstrates an increasing pressure of lymph in the iliac lymph node at pregnancy. Collateralies appear in the ovarian vein system, in the broad ligament of the uterus, in the lumbar area. The uterine vascular system is supposed to participate in adaptation to pregnancy. In genesis of the regional lymph node changes, discirculatory shifts, predominating during placental organogenesis, combine with phenomena of cell migration and proliferation (clearly revealed by the time when formation of the placenta is completed).     

Structure of the thymus, iliac and mesenteric lymph nodes in the rat at different stages of pregnancy

Development of pregnancy results in a systemic reaction of the immunogenetic organs: the structure of both the central (thymus) and peripheral lymphoid organs (lymph nodes) undergoes certain changes, beginning from its earliest stages (preimplantation period). Unidirection of the processes in the iliac (that are regional for the uterus) and mesenteric lymph nodes is stated. The reconstruction of the node occurs according to the reaction type at tissue allotransplantation, when hypertrophy of the thymus-dependent zone comes forward. During the period of the greatest manifestations of these alterations, however (the second half of pregnancy) the migration process of lymphocytes from blood into the lymph node is significantly inhibited. This is essentially clear in the iliac lymph nodes. The reconstruction of the thymus is in general similar with phenomena of accidental involution. However, accumulation of thymocytes in the medulla demonstrates blocking of their discharge into the blood stream. The disturbed processes of recirculation of result in incompleteness of the immune response at pregnancy and, perhaps, are included into the protective mechanisms of the offspring reproduction.     

Urogenital vasculature and local steroid concentrations in the uterine branch of the ovarian vein of the female tammar wallaby (Macropus eugenii)

The urogenital vasculature of the tammar comprises 4 major paired arteries and veins: the ovarian, the cranial urogenital, the caudal urogenital and the internal pudendal artery and vein. The ovarian artery and vein and their uterine branches which supply the ovary, oviduct and uterus, ramify extensively. Each anterior urogenital artery and vein supplies the caudal regions of the ipsilateral uterus, lateral and median vagina and cranial parts of the urogenital sinus. The caudal urogenital arteries and veins supply the urogenital sinus and caudal regions of the bladder. The internal pudendal artery and vein vascularize the cloacal region, with some anastomoses with branches of the external pudendal vessels. Anastomoses connect the uterine branch of the ovarian artery with the uterine branch of the cranial urogenital and cranial branches of the caudal urogenital arteries, and connect the caudal urogenital and the internal pudendal arteries. Anastomotic connections between the left and right arterial supply also occur across the midline of the cervical regions of the uteri and the anterior lateral vaginae. Similar connections are seen in the venous system. The uterine branch of the ovarian artery ramifies extensively very close to the ovary, giving a plexiform arrangement with the ovarian veins, and also with the uterine venous system on the lateral side of each uterus. This plexiform structure provides an anatomical arrangement which could allow a local transfer of ovarian hormones from ovarian vein into the uterine arterial supply, and thence to the ipsilateral uterus. Progesterone concentrations in plasma from the mesometrial side of the uterine branch of the ovarian vein are markedly higher than in tail vein plasma, especially during the 'Day 5 peak' early in pregnancy, and also at full term. There is also a marked decrease in progesterone concentration from all sites immediately before birth as previously reported for peripheral plasma. These results support the suggestion of a countercurrent transfer mechanism, at least for progesterone, and possibly other hormones, between the ovarian vein and uterine artery. Such a local transfer could explain the different morphological responses of the endometria of the two adjacent uteri during pregnancy in macropodid marsupial species.     

Extra-organic lymphatic vessels and regional lymph nodes of the kidneys in dogs

An anatomical investigation of extraorganic lymphatic vessels and regional renal lymph nodes has been performed in 70 dogs. The regional lymph nodes in the right kidney are stated to be quantitatively constant, as well as cranial and caudal lateroaortal lymph nodes in the left kidney in regard to the middle left lateroaortal nodes, that get lymph from the left kidney parenchyma. One middle left lateroaortal lymph node is found in 47 animals examined, two lymph nodes--in 17 animals. In 6 cases a lymphatic vessel, that gets lymph from the renal parenchyma and independently runs into the cistern of the thoracic duct is found for the first time. The variant revealed is an exception from the rule known in lymphology: lymph in its way from periphery to the central collector runs, at least, through one lymph node.     

Fate of superfluous sperm products after vasectomy and in the normal male tract of the mouse

The progression of 3H-labelled spermatozoa (thymidine or arginine) was followed through the tracts of unilaterally vasectomized, bilaterally vasectomized, oligozoospermic (t6/tw5) and normal mice; the regional lymph nodes were also investigated. The same rate of sperm production and transport was found in normal and in vasectomized tracts, down to the corpus epididymidis; there was some delay in spermatozoa entering the cauda in the vasectomized tracts. In the mouse, therefore, vasectomy does not affect the rates of sperm production or transport until just before the blockage in the swollen cauda epididymidis. Radioactivity appeared in the caudal and 'para-aortic' lymph nodes as the radioactive spermatozoa passed from the corpus, showing that this is one route of disposal of spermatozoa, or of sperm products, after vasectomy. Naturally oligozoospermic and normal mice gave similar results; again the caudal, iliac and renal lymph nodes received radioactive spermatozoa/sperm products. Some loss of (by definition) superfluous spermatozoa in the normal male tract therefore occurs naturally by this route, and we suggest that vasectomy further exploits this physiological pathway. This would account for the finding that many males do not make antisperm antibodies after vasectomy, just as normal males do not, even though their lymph nodes normally receive spermatozoa/sperm products.     

Morphofunctional reorganization of the kidneys in lymphatic outflow disturbance

In 115 Wistar male rats structures and rates of tissue blood flow have been studied in the cortical and medullary renal substance histologically, polarographically (estimation of the volumetric tissue blood flow by hydrogen clearance). Systemic arterial (peritoneal aorta), venous (caudal vena cava) and lymphatic (renal lymph nodes) pressures have been measured, normal and after ligation of the thoracic duct at early (1-3 days), middle (1 month) and late (2-3 months) periods. In 1-3 days edema and dystrophy of the renal parenchyma, decrease of the blood flow rate in the cortical and its increase in the renal medullary substance, as well as a sharp elevation of pressure in the lymph nodes are observed. In 1 month of the experiment together with dystrophy and edema moderate sclerosis, decreasing blood flow rate in the cortical and medullary substance are noted. Increase of the systemic arterial and venous pressure and decreasing pressure in the lymph nodes, as well as a sharp increase of the renal nodes mass are revealed. In 2-3 months of the experiment, together with sclerosis of the renal parenchyma, elevated blood flow rate is observed in the kidneys and decreasing pressure in the lymph nodes up to its initial value takes place.     

Topographo-anatomic basis for the reconstruction of lymphatic passages and the reinnervation of transplanted kidneys

Topographic anatomy of the deferent lymphatic vessels and the regional lymph nodes of the kidneys have been studied in 35 dogs. Basing on the topographoanatomical investigations performed the authors suggest a rational technique for restoring the lymph outflow combined with the reinnervation of the renal transplant. They suggest to take the right kidney together with the dorsocaval lymph nodes, and the left--with the left lateroaortal lymph nodes simultaneously cutting out the fascial-fatty graft with the nerves situating over the ventral surface of the renal hilar vessels. The lymph outflow is suggested to be restorted by means of anastomosis between the regional lymph nodes of the renal transplant and the iliac node, or the nearest vein, and to innervate the transplant--by means of stitching the fascial-fatty grafts of the anostomized blood vessels.     

Topography of lymphatic collectors and regional lymph nodes of the canine heart and their morphological characteristics

In 40 dogs lymphatic vessels and regional lymph nodes of the heart have been prepared. Morphology of the regional lymph nodes have been studied by means of various histological techniques. Lymph outflow from the canine ventricles is realized by three (less often), or by two (more often) collectors. In very rare cases one collector is formed. From the right atrium lymph flows out in two collectors (cranial and left). Lymphatic vessels of the left atrium get into the left collector of the ventricles, or into the tracheobronchial lymph nodes. Into the same nodes gets the lymphatic vessel, forming at the border of the left and right atrii. Cranial, medial, caudal mediastinal nodes (lymphatic mediastinal system) and right, middle and left tracheobronchial lymph nodes (tracheobronchial system) are regional lymph nodes of the canine heart. In the lymph nodes of the tracheobronchial system of puppies older than one month presence of exogenic pigment and signs of fibrous degeneration of parenchyma are noted.     

Cellular composition of various structural zones of the iliac and mesenteric lymph node of pregnant rats

The dynamic of cellular reactions demonstrates certain changes in functional activity of all structures of the node during pregnancy. A similar trend of processes in the iliac (regional for the uterus) and mesenteric lymph nodes has been defined. At early stages of pregnancy, lymph nodule are the most active, this is demonstrated as an increasing portion of lymphoblasts, macrophages and dividing cells. During this period, cell composition of the cortical plateau is relatively stable. For the paracortical zone of the mesenteric lymph nodes a rather significant decrease in the portion of middle lymphocytes and reticular cells is characteristic. There is not any significant change in the relative amount of the cells in the same functional zone of the iliac lymph nodes during the same period of pregnancy. The medullar cords demonstrate an increasing number of blast forms and young plasmocytes. However, as the pregnancy develops, the structure of the paracortical zone undergoes an essential change--progressively increases the portion of lymphoblasts and large lymphocytes. The blastic reaction in the mesenteric lymph nodes is proved to depend, to some extent, on that in the iliac lymph nodes of the same animal. Mature plasma cells become the dominating cellular element in the medullary cords. At the end of the pregnancy a relative amount of the reticular cells increases in all structural zones of the node.     

Ovarian and uterine lymphatic drainage in Australian flying-foxes (genus Pteropus,suborder Megachiroptera)

Ovarian lymphatics of flying-foxes were traced to determine if they could transport hormones directly from ovary to ipsilateral uterine horn, thereby stimulating the localised endometrial growth which is characteristic of these animals. Intra-ovarian injections of ink and serial histological sections did not reveal any such connection. All major ovarian lymphatics and those from the cranial tip of each uterine horn drain cranially, terminating in 1 or 2 lymph nodes lying caudal to the ipsilateral kidney. For much of their course, the major ovarian lymphatics run in the adventitia of the ovarian venous sinus. This sinus encloses the coiled ovarian artery, which provides the major blood supply to the cranial end of the ipsilateral uterine horn. Some fine ovarian lymphatics run in the adventitia of the coiled ovarian artery. The enclosure of the coiled ovarian artery by the ovarian venous drainage is thought to provide the main route for transfer of steroids from ovarian vein to ovarian artery and thence to ipsilateral uterine horn. The ovarian lymphatics described here do not bypass the vascular pathway but provide an additional route for counter-or cross-current transfer of ovarian steroids to the ovarian arterial supply to the uterus.     

Individual and sexual characteristics of the common iliac lymph nodes in elderly persons

The common iliac lymph nodes (CILN) have been investigated on 24 preparations from corpses of elderly persons (5 male and 7 female corpses), died from the causes not connected with the lymphatic system diseases, lower extremities and pelvic organs. The CILN with their afferent and deferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and pelvic organs, as well as by means of direct injection into lymphatic vessels. The form, amount, size and topography of CILN are studied. Lymphatic vessels, running from certain parts of the body and organs to various subgroups of CILN are described, as well as lymphatic vessels, connecting the nodes both within each subgroup and between the subgroups. There is a tendency in prevalence of amount and size of the lateral subgroup of the lymph nodes over the nodes of other subgroups of CILN; tendency in prevalence of amount of the lymph nodes in men, and their size--in women; prevalence of amount of right CILN and their size in the left--in persons of both sex; in 70% of the cases the amount of afferent lymphatic vessels to CILN prevails over that of the deferent lymph nodes.     

Characteristics of the regional lymphatic system of the external genitals in dogs in experimental studies

In the experiment performed on 80 mongrel female dogs by means of morphological and roentgenographical methods the structure of the lymphatic bed, pathways of lymph outflow and localization of the regional lymph nodes of the external genitals have been studied in the norm, at inflammation and at malignant tumors. Normal lymph outflow (53 animals) from the external genitals occurs via direct, cross and roundabout pathways. The regional nodes of the I order are inguinal lymph nodes and all the pelvic nodes, anorectal ones including. A part of vessels, without getting the lymph nodes mentioned, get into the retrosternal, caudal lumbar lymph nodes and the lumbar trunk. The cross of the lymphatic pathways occurs via the anterior, posterior commissures, at the level of the inguinal lymph nodes and within the limits of the pelvis. At an acute inflammation (24 animals) besides those mentioned above, roundabout vessels in the middle third of the femur are constantly revealed. They get into the femoral collector, and the vessels in the inferior third of the femur come into the popliteal lymph nodes. At malignant tumors of the external genitals (3 animals), besides all the pathways of the lymph outflow mentioned above, the femoral-crural roundabout pathway appears, it is connected with the lymphatic collector of the crus. Some vessels of the external genitals, combining with the vessels of the vagina, urethra and urinary bladder, get into the lumbar trunk and into the caudal lumbar lymph nodes. Increasing amount of all groups of the lymph nodes is noted.(ABSTRACT TRUNCATED AT 250 WORDS)     

Coordinate regulation of lymphocyte-endothelial interactions by pregnancy-associated hormones

Precursors of uterine NK cells home to the uterus during early pregnancy from multiple lymphohemopoietic sources. In mouse uterine tissue, pregnancy markedly up-regulates both L-selectin- and alpha(4) integrin-dependent adhesion pathways for circulating human CD56(bright) cells, the phenotype of human uterine NK cells. Based on roles for these adhesion molecules in lymphocyte homing, we examined effects of pregnancy or the steroid hormones 17beta-estradiol or progesterone on lymphocyte-endothelial interactions in secondary lymphoid tissues and in uterus. From preimplantation gestation day 3, specialized high endothelial venules in peripheral lymph nodes and Peyer's patches supported elevated L-selectin and alpha(4)beta(7) integrin-dependent lymphocyte adhesion under shear throughout pregnancy, as compared with high endothelial venules of virgin or postpartum donors. Squamous endothelium from nonlymphoid tissue was not affected. Pregnancy-equivalent endothelial responses were observed in lymph nodes and Peyer's patches from ovariectomized mice receiving 17beta-estradiol and/or progesterone replacement therapy. Adhesion of human CD56(bright) cells to uteri from pregnant or hormone-treated ovariectomized mice was enhanced through L-selectin- and alpha(4) integrin-dependent mechanisms and involved multiple vascular adhesion molecules including mucosal addressin cell adhesion molecule-1, VCAM-1, and peripheral lymph node addressin. Analysis of Tie2-green fluorescence protein transgenic mice demonstrated that CD56(bright) cells adhered primarily to vascular endothelium within the decidua basalis. Microdomain localization of adhesion involving large clusters of lymphocytes was induced on uteri from natural matings, but not pseudopregnancy. Steroid hormones also had independent effects on L-selectin function in splenic lymphocytes that mimicked physiological stimulation induced by pregnancy or fever-range temperatures. These results provide the first evidence for coordinated, organ-specific, steroid hormone-induced changes in lymphocyte homing mechanisms that could contribute to local and systemic immune responses during pregnancy.     

Early embryonic development and preimplantation changes in the uterus of the bat Rhinopoma hardwickei hardwickei (Gray) (Rhinopomatidae)

Rhinopoma hardwickei hardwickei has an annual reproductive cycle. Although many of the females become inseminated from the latter half of February until about the middle of April, ovulation has not been recorded until the 11th of March. A single follicle reached full development and released one ovum from either of the ovaries with nearly equal frequency, and a single conceptus was carried in the ipsilateral uterine cornu during each cycle. The embryo descended into the uterus as an early morula and attained the bilaminar blastocyst stage before undergoing implantation. As the morula advanced in age, the embryonic surface of the zona became progressively more basophilic. Hence in advanced morulae, the inner surface of the zona pellucida took a dark stain with hematoxylin and appeared like a distinct thin membrane, while the rest of the thickness of the zona was eosinophilic. Although progestational changes commenced in both uterine cornua, they became augmented in the uterine cornu on the side of ovulation and blastocyst attachment. After blastocyst attachment, the contralateral cornu reverted to an anestrus condition. The progestational changes became less conspicuous from the cranial to the caudal end of the uterus. Evidently, there was a linear gradient in the progestational response of the uterus with the cranial end being most responsive and the caudal end least responsive. The precise mechanism which brings this about is not known.     

Ultrastructural organization of capillary endotheliocytes of the popliteal and iliac lymph nodes in the rat

The popliteal and iliac lymph nodes have different regional specialization. The former belong to somatic lymph nodes, while the latter get lymph also from internal organs; this explains certain differences in their structural-functional organization. Some objective quantitative data have been obtained that characterize ultrastructure of blood capillaries in the rat popliteal and iliac lymph nodes under normal conditions of the organism's functioning. They demonstrate essential differences in the level of transendothelial transport and, hence, functional activity of these organs.     

Embolization of uterine arteries in gynecological patients with uterine bleeding of various etiology

Embolization of internal iliac and uterine arteries is one of the surgical treatments for hemorrhages that complicate the course of uterine myoma, cancer diseases and medical treatment-unresponsive conditions. Endovascular hemostasis was performed in 24 patients. The causes of hemorrhage were uterine myoma with intramural or submucous nodal location in 15 patients, cancer of the uterus corpus in 6 patients, cancer of the uterus cervix in 2, and uterine sarcoma with tumor grown in the adjacent organs in 1. In all cases, free Gianturco-type spirals were used for embolization of internal iliac and ulterine arteries. For better visualization and superselective catheterization of uterine arteries, a study was performed in the right or light oblique projections at an angle of 20-25 degrees. After embolization of iliac and uterine arteries, hemostasis was attained in all patients. At the same time there were no complications. Thus, embolization of uterine arteries is a safe and highly effective alternative to radical surgical intervention in patients with acute gynecological disease complicated by bleeding, which provides effective hemostasis and permits either avoidance of surgical intervention or a significant reduction in the volume of intraoperative blood loss.