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2. A unique anatomical variation of the vascular supply of the ovary, uterine tube, and uterus from the greater omentum - an anatomical case study

Creator:
Kachlík, David, Naňka, Ondřej, Blanková, Alžběta, Turyna, Radovan, Csöbönyeiová, Mária, and Varga, Ivan
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
anatomical vascular variations, internal female genital organs, greater omentum, omental arcade of barkow, uterine artery, and ovarian artery
Language:
English
Description:
It is well known that the blood supply of the greater omentum and female internal genital organs are not physiologically connected. There is also no mention of such anatomical variation in anatomical, radiological, or surgical textbooks. Here we present a very rare case report of atypical double arterial anastomosis (the first and second variant artery) between the right limb of the omental arcade of Barkow, uterus, and right ovary, which was found during a routine student anatomical dissection course. It is very challenging to find a proper explanation for the presence of the described anatomical variation; however, we hypothesized that it is based on their common embryonic origin - the mesentery. The first and second variant arteries could be remnants of transient anastomoses or collateral circulation, which were present during embryonic development and persisted until adulthood. Moreover, during our literature review, we noticed that the general description of omental blood supply and its possible variations is relatively poor; therefore, we emphasize the need for more precise knowledge regarding these anatomical parts, which could help surgeons who are performing abdominal or pelvic surgeries in preventing avoidable bleeding.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

3. Acellular dermal matrix in plastic and reconstructive surgery

Creator:
Mihalečko, Ján, Boháč, Martin, Danišovič, Ľuboš, Koller, Ján, Varga, Ivan, and Kuniaková, Marcela
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
acellular dermal matrix, tissue engineering, and reconstructive surgery
Language:
English
Description:
Despite significant advances in medical research, plastic surgeons still face a shortage of suitable patient tissues, and soft tissue reconstruction is no exception. In recent years, there has been a rapid boom in the use of acellular dermal matrix (ADM) in reconstructive and aesthetic surgery. ADM is incorporated into the surrounding tissue and gradually replaced by the host's collagen, thus promoting and supporting the healing process and reducing the formation of scar tissue. The main goal of this article is to provide a brief review of the current literature assessing the clinical applications of ADM across a broad spectrum of applications in plastic and reconstructive surgery.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

4. Arterial blood supply of the mesosalpinx appears segmentally organized in absence of uterine tubes arteries

Creator:
Tamash, Yana, Hammer, Niels, Varga, Ivan, Supilnikov, Alexey, and Iukhimetc, Sergei
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
uterine tube, mesosalpinx, ovarian reserve, salpingectomy, salpinx, and vascularization
Language:
English
Description:
Arterial branches to the uterus and ovaries that pass through the mesosalpinx contribute significantly to the maintenance of the ovarian reserve. Especially arterial supply of the uterine tube is provided by a number of anastomoses between both the uterine and ovarian vessels. Knowledge on the morphologic peculiarities will allow to identify main contributors especially blood flow ultrasound examination for the purpose of ovary preserving surgery. This study aimed at identifying landmarks especially for so-called low-flow tubal vessels. Arteries of 17 female Thielembalmed bodies were studied along three preselected paramedian segments and measurements taken. A section was made through the center of the ovary perpendicular to uterine tube, then the mesosalpinx tissue distance was divided into 3 equivalent zones: upper, middle and lower thirds. The surface area of the mesosalpinx averaged 1088 ± 62 mm2 . 47.7 ± 7.1 % of the mesosalpinx zones included macroscopically visible vessels. The lower third segment of mesosalpinx was the thickest averaging 2.4 ± 1.5 mm. One to three tubal branches were identified in the middle third of the mesosalpinx. Arterial anastomoses were found in the upper segment of the mesosalpinx, but no presence of a marginal vessel supplying the fallopian tube could be found. Statistically significant moderate positive correlations were established between the diameters of the mesosalpingeal arteries between the three zones. The mesosalpinx, uterine tube and the ovary form areas of segmental blood supply. Variants of tubal vessels appear to be a sparse source of blood supply.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

5. From a passive conduit to highly dynamic organ - what are the roles of uterine tube epithelium in reproduction?

Creator:
Csöbönyeiová, Mária, Varga, Ivan, Lapides, Lenka, Pavlíková, Lada, Feitscherová, Claudia, and Klein, Martin
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
embryo, epithelium, fertilization, immune system, spermatozoa, tubal fluid, and uterine tube
Language:
English
Description:
It is well known that the mammalian uterine tube (UT) plays a crucial role in female fertility, where the most important events leading to successful fertilization and pre-implantation embryo development occur. The known functions of these small intraabdominal organs are: an uptake and transport of oocytes; storage, transportation, and capacitation of spermatozoa, and finally fertilization and transport of the fertilized ovum and early embryo through the isthmus towards the uterotubal junction. The success of all these events depends on the interaction between the uterine tube epithelium (UTE) and gametes/embryo. Besides that, contemporary research revealed that the tubal epithelium provides essential nutritional support and the most suitable environment for early embryo development. Moreover, recent discoveries in molecular biology help understand the role of the epithelium at the cellular and molecular levels, highlighting the factors involved in regulating the UT signaling, that affects different steps in the fertilization process. According to the latest research, the extracellular vesicles, as a major component of tubal secretion, mediate the interaction between gametes/embryo and epithelium. This review aims to provide up-to-date knowledge on various aspects concerning tubal epithelium activity and its cross-talk with spermatozoa, oocytes and preimplantation embryo and how these interactions affect fertilization and early embryo development.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

6. Functional morphology of the human uterine tubes in the 21st century: anatomical novelties and their possible clinical applications

Creator:
Varga, Ivan, Csöbönyeiová, Mária, Visnyaiová, Kristína, Záhumenský, Jozef, Pavlíková, Lada, Feitscherová, Claudia, and Klein, Martin
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
uterine tube, uterine tube functions, tubal telocytes, tubal lymphatic lacunae, tubal immune cell repertoire, high-gradeserous ovarian cancers, and tubal cell cultures and organoids
Language:
English
Description:
The uterine tube (UT) pathologies account for 25-35 % of female factor infertility. Although these peculiar organs were first studied several hundred years ago, they have become overlooked and neglected mainly due to the successes of reproductive medicine. Nevertheless, reproductive medicine still faces many challenges regarding the fertility outcomes of in vitro fertilization (IVF). Many obstacles and problems can be resolved by a more detailed understanding of the UT morphology and function during normal reproduction. Over the course of the 21st century, many new insights have been obtained: the presence of a population of telocytes in the tubal wall responsible for normal motility and hormone sensory function, the demonstration of lymphatic lacunae of the mucosal folds necessary for oocyte capture and tubal fluid recirculation, or a thorough profiling of the immune makeup of the UT epithelial lining with the discovery of regulatory T cells presumably important for maternal tolerance towards the semiallogenic embryo. New discoveries also include the notion that the UT epithelium is male sex hormone-sensitive, and that the UT is not sterile, but harbors a complex microbiome. The UT epithelial cells were also shown to be the cells-of-origin of high-grade serous ovarian carcinomas. Finally, yet importantly, several modern morphological directions have been emerging recently, including cell culture, the development of tubal organoids, in silico modelling, tissue engineering and regenerative medicine. All these novel insights and new approaches can contribute to better clinical practice and successful pregnancy outcomes.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

7. Immunohistochemical and scanning electron microscopic confirmation of the lymphatic lacunae in the uterine tube mucosal folds. What are the clinical implications?

Creator:
Csöbönyeiová, Mária, Klein, Martin, Juríková, Miroslava, Feitscherová, Claudia, Gálfiová, Paulína, and Varga, Ivan
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
uterine tube, Lymphatic lacunae, immunohistochemistry, D2-40, podoplanin, VEGFR-3, and SEM
Language:
English
Description:
Uterine tubes (UTs) are essential during physiological reproduction. The most intriguing part of its wall is the mucosa. Apart from the epithelial cells vital for its normal function, the connective tissue lamina propria contains wide spaces whose function, morphology and structure are yet to be elucidated. The present study used bioptic samples from 25 premenopausal (mean age 48.3 years, σ=3.56) and 25 postmenopausal women (mean age 57.8 years, σ=7.79). In both study groups, samples were obtained from two anatomically distinct parts of the UT – ampulla and infundibulum with fimbriae. The specimens were processed for scanning electron microscopy (SEM) and immunohistochemical detection of podoplanin (clone D2-40) and VEGFR-3 – two markers of lymphatic endothelial cells. The results showed that specimens from premenopausal and postmenopausal women contain wide lymphatic spaces, also known as lymphatic lacunae. The most probable function of the lacunae in the fimbriae is oocyte pick-up upon ovulation thanks to their ability to get engorged with lymph, thus serving as an erectile-like tissue. The ampullary lacunae are probably responsible for tubal fluid maintenance and recirculation. These results indicate that they are vital for normal reproduction because tubal fluid dynamics are as important as fluid composition. Further research on this topic is highly warranted because more detailed insights into UT function have a great potential to refine the methods of reproductive medicine, e.g. in vitro fertilization (IVF), which are still far from optimal regarding fertility outcomes.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

8. Is there a need to change the basic principles of histology? Educational, functional and embryological perspective

Creator:
Varga, Ivan, Kachlík, David, Csöbönyeiová, Mária, Feitscherová, Claudia, and Klein, Martin
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
classification, education, four tissue types, and Terminologia Histologica
Language:
English
Description:
Although it is not an easy task to classify cells into different types, or in turn cell types into tissue types, a clear, understandable, didactically and clinically relevant tissue classification is indispensable for undergraduate medical education, expert discussions in biomedical research as well as for clinical practice. From the earliest discovery of the light microscope on, tissue classification has been a dynamic process. Historically, it was not a rare occurrence that different textbooks offered different tissue classifications. Nowadays, classifications have almost become uniform – the most common is the histological classification into four basic tissue types (epithelial, connective, muscle, nervous), which is recognized by the majority of modern histology and pathology textbooks. The reason is that, with some exceptions, this classification seems to be the most relevant not only for educational purposes but also from an embryological perspective and clinical-histopathological practice. Recently, attempts have been made to abandon this established classification and replace it with a new one. Any new classification, which would improve the presently used is welcomed. However, if the proposed innovation does not satisfy the needs of modern education and clinical practice, it should be handled with great caution or reconsidered.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

9. Microbiota of female genital tract - functional overview of microbial flora from vagina to uterine tubes and placenta

Creator:
Liptáková, Adriana, Čurová, Katarína, Záhumenský, Jozef, Visnyaiová, Kristína, and Varga, Ivan
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
microbiota, female genital tract, reproductive functions, and Lactobacillus spp.
Language:
English
Description:
Microorganisms and eukaryotic human cells coexist in synergistic relationships in nearly every niche of the human body. The female genital tract consisting of the vagina, uterus with its cervix and endometrium, uterine tubes and ovaries – harbors its own typical microbiota, which accounts for 9 % of the total bacterial population in females. To this organ system, we also assigned the microbiome of the placenta, which has not been studied much until now. Among the spectrum of microbial species, the female genital tract is mainly dominated by Lactobacillus species, which are considered to be one of the simplest yet most important microbial communities. However, this relationship between macro- and micro-organisms seems to have a number of physiological functions, e.g., the vaginal and cervical microbiota have unique impact on reproductive health. The aim of this review was to provide current view on female genital tract microbiota and its role in reproductive health. We describe in detail the association of vaginal or tubal epithelium with microbiota or the role of microbiota in normal placental function.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

10. Our first experience implementing “clinical embryology and reproductive medicine” as a curriculum course of the Study Program General Medicine at the Faculty of Medicine in Bratislava, Slovakia

Creator:
Varga, Ivan, Lapides, Lenka, Brucknerová, Ingrid, Gálfiová, Paulína, Visnyaiová, Kristína, Csöbönyeiová, Mária, Klein, Martin, Žiaran, Stanislav, Sysák, Rastislav, and Záhumenský, Jozef
Format:
počítač and online zdroj
Type:
model:article and TEXT
Subject:
assisted reproduction, clinical embryology, congenital malformations, infertility, prenatal diagnosis, and reproductive immunology and endocrinology
Language:
English
Description:
There is no separate course in the medical curriculum summarizing all aspects of human reproduction in most medical school curricula. At the same time, such a course would logically connect knowledge from clinical embryology and assisted reproduction, encompassing the issue of female and male infertility, mechanisms of birth defect formation, their prenatal diagnosis and subsequent specialized neonatal care. The aim of a wide team of university teachers comprising embryologists, gynecologists, neonatologists, endocrinologists, geneticists and others was to create and implement a new course entitled "Clinical Embryology and Reproductive Medicine" into the fourth-year curriculum of the study program General Medicine at the Faculty of Medicine, Comenius University in Bratislava. There has been a great interest in the course, as evidenced by the number of medical students enrolled. The lecture syllabuses have been divided into several thematic areas: 1) Clinical embryology including a laboratory part of assisted reproduction, 2) Cause and treatment options of female and male infertility, 3) A comprehensive view of the issue of birth defects, 4) The issue of preconception education, prenatal and childbirth training, family planning, 5) Reproductive immunology and endocrinology. Despite the complexity of human reproduction being a mainstay of gynecology and obstetrics, it is underemphasized in the medical school curricula worldwide. It is often reflected in shorter hospital / practical trainings during undergraduate studies and lower requirements at the final exam. Therefore, as students almost unanimously valued, this new course is extremely helpful in preparing for the final state exam.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public