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Objective To compare endometrial stromal cell invasion from women with and without adenomyosis and the effect of myometrial cells using a three-dimensional coculture. Design Case-controlled blinded comparison. Setting University department. Patient(s) Premenopausal women with and without uterine adenomyosis. Intervention(s) Human endometrial stromal and myometrial cells were grown in a three-dimensional coculture with crossover between cells from uteri with and without adenomyosis. Surface-enhanced laser desorption/ionization–time of flight–mass spectrometry proteomic analysis was performed on culture supernatants. Main Outcome Measure(s) Depth of stromal cell invasion into collagen matrix and protein expression profiles. Result(s) The depth of invasion for adenomyosis stromal cells (AS) was statistically significantly higher than controls (CS) whether grown on plain collagen, control muscle (CM), or adenomyosis muscle (AM). Coculture with AM enhanced invasion of both CS and AS. Enhanced invasion by AS was more marked in cocultures with AM than CM. Proteomic analysis identified differences that may account for the invasiveness and also many similarities between secretory products related to the disease status. Conclusion(s) Enhanced stromal invasion in adenomyosis is influenced by the myometrium in the in vitro coculture model. This suggests that adenomyosis may be a disease of both the endometrial stroma and myometrium.

The uterine endometrium responds to blastocyst implantation with extensive proliferation and differentiation of stromal cells into decidual cells, forming the antimesometrial and mesometrial decidua. These undergo regression by apoptosis but as this process occurs at different time periods suggest that there is spatially dependent temporal control of apoptosis in these specific regions. To elucidate the role of the mitochondrion-dependent signalling pathway in tissue regression, we investigated the spatial and temporal pattern of expression of the Bcl-2 family members in uterine tissues of the implantation site, from the post-implantation period to parturition. Furthermore, the activities of the initiator caspases-8 and -9, and of the executioner caspase-3 were determined. Overall Bax and Bcl-2 were expressed from day 8 till day 19, whilst Bcl-x(L) was extinguished by day 16. In the antimesometrial and in the mesometrial decidua both Bcl-2 and Bax declined from days 10 to 12. In the latter Bcl-2 immunoreactivity decreased till the end of pregnancy, whilst for Bax a constant level remained thereafter. The pattern of variation of enzymatic activities throughout pregnancy for all the enzymes was similar, increasing from days 10 to 14 and decreasing towards the end of pregnancy. The increased levels of active caspase-9 correlated with Bax/Bcl-2 and Bcl-x(L) expression suggesting that the apoptotic mitochondrion-dependent pathway is involved in decidual regression during pregnancy progression.

Computer-assisted learning combined with interactive video provides an excellent teaching method for a visual subject such as pathology. A system, based on the BBC microcomputer, is described. A videodisc provides illustrative material and the output from both the computer and the videodisc player are mixed to a single screen. Using the mouse as a pointing device, the students can interact directly with the video picture and so improve their understanding of what they see. A program listing for this type of interaction is given. Interactive methods are based on the pre-identification of features on the video frame by the creation of “maps” in text coordinates with storage to a data file. The use of “maps” and overlay diagrams to provide feedback is discussed and the other features of a tutorial are described. The outline of a program to design maps and diagrams is also included. These methods should prove useful in teaching any subject with an important visual content.