[An ultrastructural study of capillary permeability of rabbit ovarian follicles using horseradish peroxidase as a tracer (author's transl)]

In the previous study, using carbon tracer, we reported the ultrastructural evidences which suggested the increased capillary permeability of preovulatory rabbit ovarian follicles. In the present study, another tracer, horseradish peroxidase (HRP 50 A in diameter, mw. 40,000), being smaller than carbon particle, was used to examine the permeability of perifollicular capillaries. HRP left capillaries and appeared in the follicular cavity immediately after the injection into aorta, through all stages of follicular development. In the capillaries, the narrow interendothelial clefts (about 100-200 A in width) were observed through preovulatory stages. Fenestrations were noted at 3,4,6 hours after the hCG injection, and interendothelial gaps (about 1,000-10,000 A in width) were seen at 10, 12 hours. HRP passed through these structures and infiltrated the capillary basal lamina and the basal lamina of the follicle and went through the intercellular spaces between granulosa cells. Therefore, the increased permeability of perifollicular capillaries, just prior to ovulation, were not so obvious as when carbon particles were used. On the other hand, carbon particles, injected via marginal ear vein, were incorporated in the endothelial vesicles 15 min. after its administration and retained beneath the basal lamina outside the follicle within 60 min. These observations indicated that "blood follicle barrier" consisting of capillary endothelium, basal lamina, basal lamina of the follicle and granulosa layer played an inhibitory role to large molecules but not to small molecules.

[Case of malignant melanoma of the external genitalia responding satisfactorily to a combination of local injection of OK-432 and chemotherapy]

A 59-year-old woman with recurrent malignant melanoma of the vulva has well responded to a combination of immunotherapy and chemotherapy. As an immunotherapy, 10KE OK-432 were injected into the tumor twice a week. Chemotherapeutic regimen consisted of intravenous push of 1 mg vincristine on day 1,100 mg dacarbazine from day 1 through 5 and 50 mg nitrosourea (ACNU) on day 5. This treatment was repeated with 4 week intervals. Before treatment, the patient had a 3 X 3 X 5 cm subcutaneous mass on the left vaginal wall near the introitus. Fifty percent objective reduction of the tumor was achieved 6 weeks after commencement of intralegional immunotherapy and chemotherapy, and the tumor almost disappeared 8 months later. At this time, the treatment was changed to a supportive immunotherapy with intramuscular injection of 1KE OK-432 twice a week. But the tumor began to enlarge 2 months later and the patient is now being treated with the same combination therapy. Major side effects were febrile episodes on the day of intratumor injection of OK-432 and nausea, vomiting during the interval of chemotherapy. Anemia was the main hematologic side effect, but leukocytopenia and thrombocytopenia were not severe. The combination of intratumor injection of OK-432 and chemotherapy seems to be effective for the treatment of malignant melanoma.

Collagenolytic enzyme activity in human ovary: an ovulatory enzyme system

Collagenolytic enzyme activities presumed to play an important role in ovulation were investigated in the human follicular apex, base, and granulosa cell layer throughout the ovarian cycle. Those analyzed were human ovarian collagenase, 2,4-dinitrophenyl-Pro-Gln-Gly-Ile-Ala-Gly-Gln-D-Arg-OH peptidase, N-carbobenzoxy-Gly-Pro-Gly-Gly-Pro-Ala peptidase, and alpha-N-benzoyl-DL-arginine beta-naphthylamide hydrolase. Collagenase activity was also measured in human granulosa cell cultures. The activities of all four enzymes showed a marked preovulatory decrease in the apex. The activities in the apex were slightly higher than those in the base throughout the ovarian cycle. However, the activities in the granulosa cell layer and collagenase activity in the granulosa cell cultures increased toward preovulation and decreased after ovulation. These findings suggest that collagenase is synthesized in the granulosa cells maximally at preovulation and is consumed in the follicular apex at the same time, resulting in collagen degradation and disruption of the follicular wall in collaboration with other collagenolytic enzymes investigated here.

[DNP-peptidase activity in the rabbit ovary (author's transl)]

To examine the possible roles of collagenolytic enzymes in the follicular wall at ovulation, we measured in rabbit ovaries collagenolytic enzymes by using synthetic substrates, DNP-Pro-Gln-Gly-Ile-Ala-Gly-Gln-D-Arg OH supposed to be specific for vertebrate collagenase. Our results clearly demonstrated that DNP-peptidase activity existed, with its optimal pH7.6-pH7.8 in rabbit ovarian follicles. DNP-peptidase activity steadily increased for nine hours following the hCG injection. After nine hours of enzyme activity decreased sharply until about the tenth hour, at which time ovulation had occurred. This pattern of enzyme activities indicates that the DNP-peptidase was consumed for degradation of collagen fibers. After collagen fibers have been completely degraded, this enzyme was increased again. These changes of DNP-peptidase activities at ovulation were similar to cathepsin B1 activities with its optimal pH6.0. It is concluded that DNP-peptidase could be one of ovulatory enzymes in the rabbit.

[Morphological and endocrinological study of ovarian arrhenoblastoma (author's transl)]

Morphological and endocrinological studies were performed on a 19-year-old case of an arrhenoblastoma with marked virilization. The tumor was an intermediate type of Meyer's classification. Histochemically, 3 beta-HSD and G-6-PDH activities were demonstrated in Leydig cells. These cells also had ultrastructures typical of steroid-producing cells. Basal blood cells of pregnenolone, dehydroepiandrosterone, testosterone (T), androstenedione (A), progesterone, estradiol, estrone, LH, and FSH were determined pre- and postoperatively. T and A showed a very high level preoperatively, and were markedly decreased immediately after removal of the tumor. Stimulation of tumor cells by HMG-HCG did not show any significant changes in their main products of T and A. These findings suggest that Leydig cells of the present tumor produced mainly A and T independently on gonadotropins, and these hormones had virilized the patient.

[Ultrastructural observation of the ovulatory changes in the capillary of the human follicular apex (author's transl)]

To clarify its possible participation and mode of action in follicle rupture at human ovulation, the capillary in the apex of the ovarian follicle was investigated electronmicroscopically with 16 human ovaries. In the follicle at the mid-proliferative phase with 6 mm diameter, capillary lumen was narrow and empty. Capillary vessels observed in the theca interna of the preovulatory follicle were dilated and filled with blood cells. Their endothelial cells had indented nuclei and elongated thin cytoplasm with unusually irregular membranous protrusions. In cytoplasm there were numerous vesicles, some of which had fine granule-like contents of low electron density to be released into extracapillary space. These results indicate increased capillary permeability due to active transport around the time of ovulation. Polymorphonuclear leucocytes, rich in specific granules containing collagenase activity, were often observed in the capillary lumen as well as extracapillary space only close to the time of ovulation. This observation implies possible roles of leucocytes in collagen degradation. The present ultrastructural results suggest that the vast capillary network in the follicle wall plays an important role in the mechanism of follicle rupture through its increased permeability and collagenolytic activities of leucocytes.

[Histological studies of multiple subperitoneal nodules produced by prolonged administration of estrogen (author's transl)]

It has been reported that multiple peritoneal fibroids were produced in guinea pigs treated with large doses of estrogens, and the nodules regressed when the steroid stimulant was discontinued. Recently, these experimental nodules were considered to be simulating the disseminated pattern of Leiomyomatosis Peritonealis Disseminata (LPD). Although these experimental nodules were considered to be composed of fibroblasts by light-microscopic studies, LPD was verified to be composed of smooth muscle by electronmicroscopic studies. Therefore, it is indispensable to study these experimental nodules by electronmicroscopy, when we discuss about the similarities between experimental nodules and LPD. Guinea pigs were treated with various doses of estradiol benzoate (E) [40, 80, 100, 200 microgram/day, thrice a week, intramuscular injection]. After treatment for three months, every dose of E produced the lesions simulating the disseminated pattern of LPD: multiple nodules in various sizes, scattered on the surface of the uterine horn, peritoneum, spleen and pancreas, and in the omentum and mesocolon. Ultrastructurally, the nodules were composed of the cells resembling fibroblast. We conjectured that estrogen differentiates and proliferates the cells of the features of fibroblast-like cells from subcoelomic mesenchyme, resulting in the production of multiple superitoneal nodules simulating the disseminated pattern of LPD.

Progesterone-induced smooth muscle-like cells in the subperitoneal nodules produced by estrogen. Experimental approach to leiomyomatosis peritonealis disseminata

In order to examine the pathogenesis and histogenesis of leiomyomatosis peritonealis disseminata (LPD), guinea pigs were treated with various doses of estradiol benzoate (E) (40, 80, 100, and 200 microgram/day, three times a week, by intramuscular injection). After treatment for 3 months, each dose of E produced lesions simulating the disseminated pattern of LPD. Ultrastructurally, the nodules were considered to be composed of cells resembling those of fibroblast. In guinea pigs, pretreatment with estradiol benzoate (100 microgram/day, three times a week intramuscularly for 3 months followed by combination treatment with E and progesterone (P) (0.5 and 1.0 mg/day, once a week, intramuscularly) for 1 to 3 months produced nodules similar to those with estrogen alone. Ultrastructurally, these nodules were composed of cells resembling smooth muscle and decidual cells. According to these results, we conjectured that estrogen differentiates and proliferates cells with the features of fibroblast-like cells from the subcoelomic totipotential mesenchyme, and these cells are differentiated into smooth muscle-like cells and decidua-like cells under the influence of both estrogen and progesterone, resulting in the production of multiple subperitoneal nodules.

[Scanning electron microscopic observations of microcorrosion casts for rabbit ovarian vasculature before ovulatory stimulus (author's transl)]

Ovarian vasculature of juvenile and adult rabbits was studied using a method of resin injection-corrosion casts. Arteries and arterioles in the ovarian stroma and capillary networks surrounding the follicles were observed on a three dimensional scale by scanning electron microscopy with the following findings: 1) The strongly coiled arteries are observed in adult rabbit ovaries. The first order arterioles arise from the spiral artery, and the second order arterioles stemming from these first order arterioles enter into each follicle. 2) Vasculature of follicles starts as glove-finger-like ramified capillary networks. As follicles grow, follicular vessels increase remarkably and form multilayered complex vascular networks surrounding the follicles. 3) The observations of circular impressions around the arterioles near the follicle and in the follicular wall suggest the existence of sphincteric control mechanism of blood flow into the follicle. 4) There are several pathways of venous drainage from a wall of large follicle and arterio-venous shunts are observed in the wall of such follicles. These structures may exert an important effect upon the follicular hemodynamics in the process of follicle rupture.

[An ultrastructural study of primary carcinoma of the fallopian tube (author's transl)]

Primary carcinoma of the fallopian tube is one of the least common neoplasms arising from the female genital tract with rare preoperative correct diagnosis. Recently, we had chances to experience two cases of this tumor, one of which was examined electron microscopically. Both of them revealed the well-differentiated pattern of papillary adenocarcinoma. Electron microscopically, most of the cancer cells had pleomorphic nuclei, giant or multiple nucleoli, numerous mitochondria, poorly developed rER and abundant polysomes. Small number of cells rich in lysosome-like granules were also observed near the basement membrane. Among the cancer cells, "ultrastructural alveolar spaces", composed of several cancer cells, were prominent. In the cancer cells, there were observed the following interesting observations; annulate lamellae-like structure, unusual bundles of the filamentous elements and lamellar body-like structures. Normal tubal epithelium consisted of ciliated cells, secretory cells, peg cells and so-called "indifferent cells". The fact that the present tumor had no ciliated cells and few secretory cells indicated that this tumor was originated from "indifferent cells" or peg cells.

[Cytochemical demonstration of 3 beta-hydroxysteroid dehydrogenase activity in human corpora lutea (author's transl)]

3 beta-hydroxysteroid dehydrogenase (3 beta-HDS) activity was demonstrated ultrastructurally in human corpora lutea obtained from the women aged 32-46 who were treated by the hysterectomy for various gynecological indications. The corpora lutea were removed from ovaries and cut into small pieces of 1 mm3. Specimens were incubated at 25 degrees C for 20 min. in the media containing dehydroepiandrosterone 0.6 mg, 0.1 M sodium citrate 0.3 ml, 5 mM potassium ferricyanide 1 ml, 30 mM copper sulfate 1 ml, N.A.D. 3.6 mg, sucrose 1.0 g and 0.1 M phosphate buffer (pH 7.2) 6 ml. For a control study, 1.5 mg cyanoketone (by the courtesy of Dr G.O. Pott), the specific inhibitor for 3 beta-HSD, was added to the media. The materials were fixed in 4% glutaraldhyde and 1% OsO4 and embedded in Epon 812. Electron dense reaction products of copper ferrocyanide were observed in smooth endoplasmic reticulum (sER) and in intercristal and outer space of mitochondria. In control studies, 3 beta-HSD activity were completely abolished. It is concluded that not only sER but also mitochondria has 3 beta-HSD activity in human corpora lutea. Furthermore, mitochondria seems to have capability to synthetize progesterone from cholesterol by itself.

Human fibroblastoid interferon: immunosorbent column chromatography and N-terminal amino acid sequence

Three mice and one rabbit were inoculated with purified human fibroblastoid interferon. Neutralizing activity to human fibroblastoid interferon was observed in the serum of these animals with the rabbit showing the highest anti-interferon titers (10(6) neutralizing units/mL). Rabbit antiserum was coupled to cyanogen bromide activated Sepharose, and the resulting material was tested for use in the purification of human fibroblastoid interferon. Pure interferon obtained by this procedure was analyzed, and we report the sequence of the first 13 N-terminal amino acid residues of this protein.

[An ultrastructural study of capillary permeability of rabbit ovarian follicles during ovulation using carbon tracer (author's transl)]

The observations that perifollicular capillaries of the ovary become engorged with prominent edema in the theca interna and externa around the time of ovulation, suggest a preovulatory increase in permeability of perifollicular capillaries. In previous study, we reported ultrastructural evidences which suggested the increased permeability of perifollicular capillaries just prior to ovulation. In this study, we further examined the perifollicular capillaries of rabbit ovary by using carbon particles as a tracer at various time intervals after the hCG injection for induction of ovulation. Pinocytotic vesicles exhibited no significant changes in size, number and distribution through all preovulatory stages. Carbon particles were not taken into them. Fenestrations were observed at 0,3,4,6 hrs after the hCG injection, most frequently at 4 hrs, but no carbon particles could penetrate them. Intercellular gaps between two adjacent endothelial cells began to be observed at 10 hrs after the hCG injection. Carbon particles passed through these gaps with staying inside the basement membrane (so-called intramural leaking). These observations indicated that the increased permeability of the perifollicular capillaries, just before ovulation, were due to intercellular gaps.

[Activity of vertebrate collagenase in the human ovary (author's transl)]

Participation of collagenolytic activities in the ovulatory process had been recently studied in the experimental animals, though their existence in the human ovary remains obscure. In the previous report, we demonstrated the collagenolytic activity by using synthetic substrates N-carbobenzoxy-Gly-Pro-Gly-Gly-Pro-Ala and the cathepsin B1 activity in human ovarian follicles. To investigate the activity for degradation of native collagen in the human ovary, we used 14C-labeled collagen prepared from young rat skin in the present study. Collagenolytic activity for synthetic substrate DNP-Pro-Gln-Gly-Ile-Ala-Gly-Gln-D-Arg OH supposed to be specific for vertebrate collagenase was also measured. Our results clearly demonstrated that there existed vertebrate collagenase activity and the collagenolytic activity measured by using DNP-peptide in the human ovarian follicles. The correlation coefficient between both enzymatic activities was 0.56. The DNP-peptide-degrading activity seemed to partly represent the collagenolytic activity from vertebrate collagenase. It was concluded that vertebrate collagenase besides collagenolytic activities did exist in the human ovary and they seemed to be involved in the degradation of collagen fibers in the follicular apex at the time of ovulation.

[An ultrastructural study of capillaries of rabbit ovarian follicles during ovulatory process (author's transl)]

The observations that perifollicular capillaries of the ovary become engorged with prominent edema in the theca interna and externa around the time of ovulation, suggest a preovulatory increase in permeability of perifollicular capillaries. In order to obtain an ultrastructural evidence for this increased capillary permeability, we examined the perifollicular capillaries in the theca interna by using mature rabbit ovaries at various time intervals after the hCG injection for induction of ovulation. We observed a capillary engorgement at 9, 10, 12 hours after the hCG injection, most prominent at 9 hours, and edema in the pericapillary space at 10, 12 hours. Pinocytotic vesicles were seen through the all stages of follicular development and they did not show any significant changes in their size, number and distribution. Fenestrations were observed at 0, 3, 4, 6 hours after the hCG injection, most frequent at 4 hours. Intercellular gaps (500 approximately 1,200 A) between two endothelial cells were demonstrated at 10, 12 hours, and thrombocytes in these gaps were also noticed. The present observations suggest that increased permeability of perifollicular capillaries just prior to ovulation were mainly due to the formation of gaps between the endothelial cells.

[A cytochemical study of acid-phosphatase activity in follicular granulosa cells of human ovaries (author's transl)]

In order to clarify the nature and possible roles of lysosome-like granules observed electronmicroscopically in the granulosa cells of human preovulatory follicles, lysosomal activities in human preovulatory granulosa cells were investigated ultrastructurally by staining a marker enzyme acid phosphatase with modified Gomori technique. In the granulosa cells of follicles 10 approximately 15 mm in diameter, acid phosphatase reaction products were seen only in the Golgi apparatus. In follicles around 20 mm in diameter with extremely thin apical walls, granulosa cells with abundant nexuses and steroidogenic organelles (sER, large spherical mitochondria with tubular cristae and lipid-droplets), had many lysosome-like granules in the perinuclear regions and/or close to lipid droplets. Acid phosphatase reaction products were observed mainly in these granules, and infrequently in Golgi apparatus. These morphological results not only identify such granules as lysosomes, but also indicate that the granulosa cells are rich in the lysosomal activity. Possible roles of lysosomes in preovulatory granulosa cells deduced from the present results are as follows, 1) a role in steroidogenesis or in steroid-secretion, 2) an involvement in the ovulatory process with their proteolytic enzymes.

Physiological study of the human mesotubarium ovarica

The human mesotubarium ovarica has been shown to contain bundles of smooth muscle cells. Its contractility at various phases of the menstrual cycle was studied in vitro in 51 tissue strips obtained at laparotomy. The strips obtained at the ovulatory phase showed the greatest spontaneous contractile activity as well as the greatest contractile response to norepinephrine, acetylcholine, and prostaglandin F2 alpha. This corresponds to the increased contractility of the ovary at this phase of the cycle. It is suggested that these contractile actions may, under the influence of chemical transmitters, play a role in ovum pick-up by the tubal fimbria at ovulation.

Leiomyomatosis peritonealis disseminata

The ninth documented case of leiomyomatosis peritonealis disseminata (LPD) combined with pregnancy is presented. Light and electron microscopic studies revealed that the smaller tumors were composed partly of decidual cells and partly of fibroblasts, and the larger tumors contained cells resembling smooth muscle cells. Plasma steroid levels were determined during pregnancy. Estrogen levels were within normal range, but progesterone levels were lower than normal, resulting in relative hyperestrogenism. In the case presented, pregnancy, especially with relative hyperestrogenism, may have been a major cause of LPD.