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PubMed2006

The association of Atopobium vaginae and Gardnerella vaginalis with bacterial vaginosis and recurrence after oral metronidazole therapy.

BACKGROUND: We investigated associations between Atopobium vaginae and bacterial vaginosis (BV) and the role that A. vaginae plays in recurrent BV after oral metronidazole therapy. METHODS: Women with abnormal vaginal discharge or odor were enrolled in a cross-sectional study (n=358); the proportion of those infected with Gardnerella vaginalis and A. vaginae was determined by polymerase chain reaction. Women with BV (Nugent score [NS] 7-10 or 4-6 with > or =3 Amsel criteria; n=139) were treated with oral metronidazole (400 mg twice a day for 7 days) and examined at 1, 3, 6, and 12 months or until they reached an NS of 7-10 and recurrence of A. vaginae and G. vaginalis infection was established. RESULTS: A. vaginae and G. vaginalis were highly sensitive for BV--96% (95% confidence interval [CI], 91%-98%) and 99% (95% CI, 97%-100%), respectively. However, A. vaginalis was more specific for BV (77% [95% CI, 71%-82%]) than was G. vaginalis (35% [95% CI, 29%-42%]). G. vaginalis was detected in 100% and A. vaginae in 75% of women with recurrent BV; higher organism loads were present in women with recurrent BV. A. vaginae was rarely detected without G. vaginalis, and women in whom both organisms were detected had higher rates of recurrent BV (83%) than women infected with G. vaginalis only (38%) (P<.001). CONCLUSIONS: Infection with A. vaginae is more specific for BV than infection with G. vaginalis. The higher recurrence rates in women in whom both A. vaginae and G. vaginalis were detected suggest that A. vaginae makes a significant contribution to BV. However, its etiological role remains unclear.

Actinobacteria↗
PubMed1998

Immunoglobulin G, plasma cells, and lymphocytes in the murine vagina after vaginal or parenteral immunization with attenuated herpes simplex virus type 2.

This investigation evaluated immunity to vaginal herpes simplex virus type 2 (HSV-2) infection after local or parenteral immunization with attenuated HSV-2. Vaginal immunization induced sterilizing immunity against challenge with a high dose of wild-type virus, whereas parenteral immunizations protected against neurologic disease but did not entirely prevent infection of the vagina. Vaginal immunization caused 86- and 31-fold increases in the numbers of immunoglobulin G (IgG) plasma cells in the vagina at 6 weeks and 10 months after immunization, whereas parenteral immunizations did not increase plasma cell numbers in the vagina. Vaginal secretion/serum titer ratios and specific antibody activities in vaginal secretions and serum indicated that IgG viral antibody was produced in the vagina and released into vaginal secretions at 6 weeks and 10 months after vaginal immunization but not after parenteral immunizations. In contrast to the case for plasma cells, the numbers of T and B lymphocytes in the vagina were similar in vaginally and parenterally immunized mice. Also, lymphocyte numbers in the vagina were markedly but similarly increased by vaginal challenge with HSV-2 in both vaginally and parenterally immunized mice. Lymphocyte recruitment to the vagina after virus challenge appeared to involve memory lymphocytes, because it was not observed in nonimmunized mice. Thus, local vaginal immunization with attenuated HSV-2 increased the number of IgG plasma cells in the vagina and increased vaginal secretion/serum titer ratios to 3.0- to 4.7-fold higher than in parenterally immunized groups but caused little if any selective homing of T and B lymphocytes to the vagina.

Animals↗
PubMed1990

Antigen recognition in the female reproductive tract: I. Uptake of intraluminal protein tracers in the mouse vagina.

Local immunization in the vagina of several species elicits immune responses, but little is known about the uptake, processing and recognition of antigens at this site. We investigated the uptake of intravaginally administered tracers using FITC-bovine albumin, FITC-horse ferritin and FITC-horseradish peroxidase in non-pregnant and pregnant mice. Tracers were detected in cells in the vaginal epithelium and stroma at diestrus, proestrus and metestrus, but not at estrus. During pregnancy, racers were present in vaginal cells on Day 6 but not on Day 13. The distribution of tracers in the vagina was the same in all mice. They were present in vaginal epithelium in cells similar to Langerhans' cells and in the stroma in cells that resembled dendritic cells, fibroblasts or macrophages. In some non-pregnant mice, tracers were present in cells adjacent to lymphatic nodules located in the adventitia between the vagina and urethra. Tracers were seen in phagocytic cells lining the marginal and medullary sinuses of the draining lymph nodes (iliac nodes) in some non-pregnant mice at 4 h after intravaginal administration, or in small, dendritic cells in the paracortex at 17 h. To test the possibility that transfer of proteins into the vagina was due to toxic effects of the tracers, FITC-conjugated proteins were also administered into the lumen of uterine horns, and their distribution in horns, cervix and vagina was studied. In uterine horns, tracers were either absent or were located only in apical vesicles in the luminal epithelium. Tracers were present in the cervix and vagina as described above for intravaginal tracers. This result suggests that uptake of tracers in the vagina was not due to toxic effects, and that the vagina and cervix are major sites of protein uptake into the reproductive tract.

Administration, Intravaginal↗
PubMed1986

Estrogen and progesterone receptors in the fetal and newborn vagina of guinea pig: biological, morphological, and ultrastructural responses to tamoxifen and estradiol.

Estrogen and progesterone receptors were characterized in the fetal and newborn vagina of guinea pig. The concentrations of estrogen receptor (total sites, cytosol plus nuclei) which were very high [7090 +/- 1700 (+/- SD) fmol/mg DNA] in the fetal vagina (62-64 days gestation) decreased significantly after birth and increased slightly at 2 weeks of age. Tamoxifen (TAM) and estradiol (E2) or the combined treatment (TAM + E2) induced a great increase in weight and DNA content in both the fetal and newborn vagina. After a 12-day treatment to pregnant or newborn guinea pigs, the fetal vagina wet weights (milligrams +/- SD) were as follows: control animals, 87 +/- 14; +TAM, 254 +/- 38; +E2, 177 +/- 19; +(TAM+E2), 218 +/- 41. The values in newborn vaginas were: 155 +/- 40, 434 +/- 75, 477 +/- 49, and 512 +/- 76, respectively. The DNA contents per vagina (in micrograms per +/- SD) in the fetal tissues were as follows: control, 187 +/- 64; +TAM, 563 +/- 74; +E2, 650 +/- 100; and +(TAM+E2), 776 +/- 113; in the newborn vagina these values were: 592 +/- 75, 880 +/- 113; 781 +/- 75, and 901 +/- 15, respectively. Histological studies showed drastic morphological alterations after each of the treatments, particularly in the epithelial cells. Similarly, the ultrastructural examination with transmission electron microscopy showed the alteration of mitochondria, the development of the rough endoplasmic reticulum, and the formation of numerous vacuoles and secretory granules. TAM stimulated the number of specific sites for progesterone, but less intensely than did E2. However, in the combined experiment (TAM+E2), TAM did not block the action of E2. It is concluded that TAM acts in the fetal and newborn vagina of guinea pigs as a real estrogen agonist.

Animals↗
PubMed2000

[Long-term monitoring of artificial vagina reconstructed with sigmoid colon].

OBJECTIVE: To observe the influence of the artificial plastic vagina on overall patient health. METHODS: Length and width of the artificial vagina were measured. Histological studies were performed under light and electron microscope. Vaginal bacterial flora were analyzed using the drop-implant method. Vaginal HPV and ER were detected with ABC histochemical staining. RESULTS: According to the results of anatomic measurements, artificial vagina was similar to normal vagina. The reductions of glands in the mucosa and collagen fibers as well as interstitial tissue hyperplasia in the lower segment of artificial vagina were documented. Four kinds of bacteria indigenous to the sigmoid colon were found in artificial vagina and were studied microbiologically with only differences in the amount and detection rates of bacteria flora. The positive presentation of HPV was not significantly different from that in the control group. The positive presentation of estrogen receptor (ER) in the epithelium of artificial vagina was not found. CONCLUSION: The reconstruction of artificial vagina with sigmoid colon is a safe, effective and satisfactory procedure for the patient.

Adolescent↗
PubMed2001

Vault prolapse I: Dynamic supports of the vagina.

The relative contributions of muscle forces and vaginal suspensory ligaments to the anatomical support of the vagina have been long disputed. The aim of this study was to gain further insights into the role of striated muscle forces. Fifty consecutive patients presenting to a pelvic floor clinic were tested with perineal ultrasound, lateral X-rays at rest and on straining, 10 ml of radio-opaque dye having been injected into bladder, vagina, rectum and, in 12 patients, into the levator plate also. The relevance of muscle forces to the three anatomical levels of support, the cardinal/uterosacral ligament complex (level 1), the rectovaginal fascia (level 2) and the perineal body (level 3), was analyzed. Biopsies of the suspensory ligaments were performed per vaginam. During effort, the upper part of the vagina was stretched backwards and downwards against the perineal body. Compression of level 2 on standing lateral X-ray appeared to be related to the angle of the upper vagina to the horizontal at rest. In 23 patients in whom the angle was 45 degrees or more to the horizontal, only 2 demonstrated significant angulation of the upper vagina and therefore compression of level 2 on straining. In contast, all 27 patients with an angle less than 45 degrees to the horizontal demonstrated both vaginal angulation and compression. Histology demonstrated smooth muscle and nerves in the suspensory ligaments, indicating an active contractile role for these structures. Analysis of the directional forces suggests that inability ot angulate the vagina sufficiently may predispose to herniations of the walls of the vagina owing to the twin influences of gravity and downward muscle forces exerted by the levator muscles.

Adult↗
PubMed2003

Histological and functional aspects of different regions of the rabbit vagina.

Relatively little data is available on regional differences in both morphological and functional studies of vaginal smooth muscle in the rabbit. Histological and in vitro strip studies were performed upon the vaginal walls of 10-week-old New Zealand White rabbits discriminately according to location (upper, middle or lower) and the type of muscle arrangement (longitudinal or circular). The contraction and relaxation responses of the vaginal smooth muscle were assessed. The upper and middle third of the vagina were histologically characterized by an abundance of smooth muscle, while the lower third was composed of numerous sinusoids scattered among smooth muscle bundles. The peak amplitudes of 60 mM KCl-induced contraction per tissue strip weight were regionally different (upper>middle>lower). Contractile responses induced by adrenergic agonists (epinephrine, norepinephrine, phenylephrine and isopreterenol) showed regional differences, and were mainly of a tonic nature in lower part and strong phasic in middle and upper vagina. Electrical field stimulation induced a prominent relaxation response in the lower third of the vagina precontracted with phenylephrine (5 microM). This relaxation response was partially inhibited by N-omega-nitro-L-arginine methyl ester (NAME, 43.3+/-6.9%, s.e.), a nitric oxide synthase inhibitor, and D-vasoactive intestinal peptide (VIP) (11.3+/-4.4%), a VIP receptor antagonist. The type of muscle arrangement did not affect the results. Our results demonstrated that rabbit vagina has regional difference, not only histologically but also functionally. The contractile response was induced in all regions of the rabbit vagina by sympathetic agonists, while the prominent nerve-mediated relaxation was identified in the lower third portion of the rabbit vagina. The nature of relaxation and contractile function of vagina awaits future investigation.

Adrenergic alpha-Agonists↗
PubMed2006

Experimental contributions to the study of the embryology of the vagina.

BACKGROUND: Acién's hypothesis, deduced from patients with malformations of the female genital tract, especially those with renal agenesis and ipsilateral blind hemivagina, affirms the embryology of the human vagina as deriving from the Wolffian ducts and the Müllerian tubercle and could explain the embryological origin of all the female genital malformations reported. In this study, we investigated the hypothesis in rats. METHODS: Twenty-five pregnant rats were used to analyse female embryos (64) from day 15 (stage indifferent) to day 20 postcoitum (vagina completely formed). We performed transverse and longitudinal sections of embryos, haematoxylin-eosin tinction and immunohistochemical staining using markers specific to Wolffian derivatives. We also analysed the presence of these markers in the vagina of four adult rats. RESULTS: The Müller ducts converge until they fuse into one tube, but caudally they diverge and finally they fuse with the 'urogenital sinus bulbs' that are actually the distal portion of the Wolffian ducts according to the immunohistochemical marking with GZ1 and GZ2. The Müllerian tubercle is observed between those elements. Then, the immunohistochemical staining can be seen all along the completely formed vagina, which is also observed in the vagina of the adult rat. CONCLUSION: We prove the participation of Müller tubercle and Wolffian ducts in the formation of the vagina in rats, so we confirm experimentally Acién's hypothesis about the human vagina embryology.

Animals↗
PubMed1996

Residence half-life of IgG administered topically to the mouse vagina.

Antibodies delivered directly to the vagina can provide passive immunoprotection against pregnancy and sexually transmitted disease. The duration of protection is limited by the residence time of the antibodies in the vagina; to our knowledge such residence times have not been reported. We investigated the time-course of disappearance of IgG delivered to the mouse vagina using three different methods to monitor the amount of administered IgG remaining in the vagina: gamma counting of 125I-IgG, viral neutralization of unlabeled monoclonal anti-herpes virus IgG2a, and ELISA of biotinylated IgG. The test IgG was delivered to the vagina in saline and recovered by lavage. All three methods yielded similar results, suggesting that the residence half-life is not significantly affected by the volume administered, phase of the estrous cycle, or labeling of IgG. In awake mice, a significant fraction of IgG disappeared with a relatively short half-life, (t1/2)alpha, of 0.7 +/- 0.1 h; but this rapid (alpha phase) decrease did not occur in anesthetized mice, suggesting that the movements of awake mice expel some of the test IgG-saline solution from the vagina. Over the next 25 h, the test IgG disappeared with a residence half-life, (t1/2)beta, of 5 +/- 2 h. We believe this slow elimination of IgG may depend on the rate that mucus secretions are shed from the vagina.

Administration, Topical↗
PubMed1999

[Repair of vagina with segment of vascularized ileal graft following pelvic exenteration for carcinoma of rectum].

OBJECTIVE: To introduce a method to repair the vagina following pelvic exenteration for carcinoma of rectum in which the posterior wall of the vagina and cervix of the uterus were often involved. METHODS: From 1990 to 1997 segment of the vascularized ileum was used to repair the vagina in 5 cases, and in 2 of which the whole vagina was repaired while in the other 3 cases only the posterior wall of the vagina was repaired. RESULTS: All of the patients had successful results after operation repair. CONCLUSION: Vascularized graft was an ideal material for the repair of vagina defect following pelvic exenteration for carcinoma of rectum, because this material was easily accessible, and its vascular pedicle was long enough for its transferring to the perineal region and the ileum had good blood supply which made healing easy. The vagina following repair had a thick posterior wall, good elasticity and very little scar tissue surrounded.

Adult↗
PubMed1976

[Trials of artificial vaginas for bulls (author's transl)].

Introduction of short artificial vaginas with smooth plastic inner liners and without any internal pressure reduced the bacterial contamination of bull semen to a very considerable extent. Moreover, semen production increased, partly because of lower semen losses in short artificial vaginas with smooth inner liners which were not under pressure, partly because more intensive sexual preparation of the bulls was required to collect semen with this type of artificial vagina. When adequate sexual preparation of the bulls is practised, all bulls will accept short artificial vaginas with smooth inner liners which are not under pressure. The use of particularly rough rubber inner liners in artificial vaginas for bulls and using long artificial vaginas with internal pressure is not advisable because of unnecessarily high semen losses in the artificial vagina and unnecessary contamination of the crude semen.

Animals↗
PubMed2001

[Clinical analysis of 25 cases of leiomyoma of the vagina].

OBJECTIVE: To study the histologic source, clinical features and treatment methods of leiomyoma of the vagina. METHODS: From January of 1988 to January of 1999, 25 patients with leiomyoma of the vagina were retrospectively analyzed. RESULTS: The clinical features of leiomyoma of the vagina were slow in growth and solitary in number. Leiomyoma of the vagina can be recurrence and sarcomatous change. The symptoms of leiomyoma of the vagina depended on the size and location of the leiomyoma. Treatment consisted of surgical excision by vagina. CONCLUSIONS: Leiomyoma of the vagina is a rare condition. Whenever such a tumor is detected, it has to be removed immediately to prevent further growing and sarcomatous change in the future.

Adult↗
PubMed2003

[Clinico-pathologic analysis of 26 cases of leiomyoma of the vagina].

OBJECTIVE: To study the clinicopathological features, the histogenesis, and the correlation between the expressions of estrogen receptor(ER) and epidermal growth factor receptor(EGFR) in leiomyoma of the vagina. METHODS: The data of 26 patients with leiomyoma of the vagina were analyzed retrospectively, and S-P immunohistochemistry was used to detect smooth muscle actin(SMA), S-100 protein, CD34, ER and EGFR in the tumor tissues. RESULTS: All patients with leiomyoma of the vagina in this group were married women, with age ranging from 30 to 52 years (mean, 44.5 years). Leiomyoma of the vagina was slow in growth and occasionally recurred with borderline and malignant transformation. Immunohistochemical staining demonstrated to be strongly positive for SMA, and negative for S-100 protein and CD34 in all cases. Positive expression rates for ER and EGFR were 38.5 (10/26) and 34.6 (9/26) respectively. There was a significant positive correlation between the expressions of ER and EGFR (Fisher exact, P = 0.0023, r = 0.75). Resection of the tumor mass was an effective method to cure the disease. CONCLUSION: Leiomyoma of the vagina is a rare condition, which may be derived from stem cells of mesenchyma of the vagina differentiating towards smooth muscle. The estrogen hormone and EGF may play an important role in the development and growth of leiomyoma of the vagina. Follow-up is needed after operation for the patient with borderline tumor.

Adult↗
PubMed1985

The vagina is formed by downgrowth of Wolffian and Müllerian ducts. Graphical reconstructions from normal and Tfm mouse embryos.

We use the Tfm (testicular feminization) mutation of the mouse to reexamine the role of Wolffian and Müllerian ducts during formation of the vagina. Three dimensional graphical reconstructions of the lower genital tract are prepared from serial sections of male, female, and Tfm embryos from day 15 p.c. until 8 days after birth. The reconstructions show that in female and Tfm animals the caudal segments of Wolffian and Müllerian ducts fuse and migrate caudally, whereas in the male they do not fuse and remain in their original position. Following down-growth, separate Wolffian and Müllerian ducts emerge from the fused caudal tips of the ducts. The Wolffian ducts degenerate, while the Müllerian ducts fuse with each other and form the vagina. Wolffian and Müllerian ducts are connected to the urogenital sinus by the sinus ridges which in later stages are separated from the sinus by lateral furrows. The sinus ridges are replaced by the Müllerian ducts. We conclude that the vagina develops by down-growth of Wolffian and Müllerian ducts along the sinus ridges. Wolffian ducts and sinus ridges regress so that the definitive vagina is formed by the Müllerian ducts. In Tfm embryos the vagina forms as in the female but subsequently degenerates, probably due to the action of AMH. The vaginal pocket in the Tfm is the variable remainder of the vagina at the end of the degeneration process.

Animals↗
PubMed1990

Surgical treatment of dorsocaudal dislocation of the vagina after excision of the rectum. The Kylberg operation.

Retained menstrual blood, colpitis, chronic discharge from the vagina, and dyspareunia are not uncommon symptoms after proctectomy. In patients suffering from this syndrome, the vaginal drainage is impaired because of a pouch caused by adhesions formed between the coccyx and the vagina, and an angulation of the upper part of the vagina. Surgical treatment consists of extirpation of the coccyx, separation of the posterior fornix from the lower part of the sacrum, and interposition of muscle flaps from the right and left gluteus maximus muscle, which shifts the vagina to a more vertical position. The authors report the results of this procedure in nine women observed for more than two years. Wound infection occurred in two patients, and one underwent a second operation because of relapsing symptoms. Eight patients were relieved of impaired drainage of the vagina; one patients empties her menstrual blood by straining. Dyspareunia disappeared in all patients. The operation can be recommended in patients with "the horizontal vagina syndrome."

Adult↗
PubMed1997

Role of the pelvic floor in bladder neck opening and closure II: vagina.

The aim of the study was to examine the role of vaginal stretching during bladder neck opening and closure. The study group comprised 12 patients with GSI and 4 controls. The position of the bladder neck relative to the vagina was assessed in the resting, straining and 'squeezing' positions using video-radiological studies. Radio-opaque dye was instilled into the bladder, vagina, rectum and levator plate. Vascular clips applied to the midurethral, bladder neck and bladder base parts of the anterior vaginal wall assisted in determining differential movements of these parts of the vagina during bladder neck opening and closure. The suburethral vagina (hammock) was shown to stretch downwards and forwards during straining, and downwards and backwards during micturition. The bladder neck, upper part of the vagina and the rectum were stretched backwards and downwards in an identical manner during straining and micturition, apparently in response to backward contraction of the levator plate and downward angulation of its anterior lip. All organs were stretched upwards and forwards during 'squeezing'. The findings support the hypothesis that, during stress and micturition, selective pelvic floor contractions stretch the vagina against intact pubourethral and uterosacral ligaments to assist opening and closure of the urethra and bladder neck.

Aged↗
PubMed1985

Estrogen and progesterone receptors in the human vagina.

Estrogen (E) and progesterone (Pg) receptor (R) levels were determined in the human vagina in relation to menopausal status, day of ovarian cycle and pregnancy. The results obtained confirmed that the human vagina contains ER and, in addition, demonstrated for the first time the presence of PgR in this organ in humans. In cycling women, ER and PgR did not vary significantly during the ovarian cycle; however low (less than or equal to 10 fmoles/mg cytosol protein) concentrations of PgR were more frequently (6 out of 8 cases) detected during the secretory phase. No substantial difference was seen in ER and PgR values between anterior and posterior wall of the vagina. In postmenopausal patients the levels of ER (range: 10-83 fmoles/mg) were similar to those found in premenopause (range: 12-78 fmoles/mg). As regards PgR, the majority (14 out of 20) of vaginae were devoid of PgR, 4 had a very low (less than or equal to 6 fmoles/mg) PgR content and only 2 cases had a PgR level higher than 10 fmol/mg cytosol protein. In pregnant patients (6th to 8th week) ER were found in all vaginae, while PgR were present only in some cases (3 out of 8). It was concluded that the behavior of ER in the human vagina seems different from that in the human endometrium, since ER levels do not vary in relation to changes in the concentrations of sexual hormones in the circulation. On the contrary, PgR levels appear to depend on blood estradiol and progesterone concentration, as in other target tissues.

Adult↗
PubMed2004

Involvement of keratinocyte growth factor (KGF)-KGF receptor signaling in developmental estrogenization syndrome of mouse vagina.

Exposure of mice to estrogen or keratinocyte growth factor (KGF) in vivo during the neonatal period results in estrogen-independent persistent proliferation and cornification of the vaginal epithelium when the animals become adults. Here, whether and how KGF-signaling is involved in the effects of estrogen on the neonatal mouse vagina were studied with an in vitro method. Newborn mouse vaginae were cultured for 3 days in serum-free medium containing various combinations of estradiol-17beta (E2), KGF, anti-KGF antibody, KGFR inhibitory peptide and heparin, and then transplanted into ovariectomized host mice for 35 days. The vaginae cultured with 5 microg/ml E2 or 5 microg/ml KGF had a cornified thick epithelium, while the epithelium of the vehicle-treated controls stayed thin. The E2 effect was blocked by concurrent treatment with anti-KGF antibody or KGFR inhibitory peptide. KGF treatment alone at doses less than 500 ng/ml did not induce permanent vaginal changes but such changes did occur in vaginae treated with heparin plus as little as 10 ng/ml KGF. On the other hand, heparin inhibited the permanent vaginal changes induced by estrogen. These results suggest that irreversible vaginal changes are induced by the direct action of KGF on the developing vagina and that the developmental estrogenization syndrome of mouse vagina is caused by intensification of endogenous KGF/KGFR signaling by exogenous estrogen.

Animals↗