Early diagnosis of malignancies of the cervix and uterus.
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Cervix Uteri↗
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In situ morphologic dynamics of ovaries, uterus, and cervix in llamas.
The morphologic appearance of the ovaries, uterus, and cervix of nonpregnant and pregnant (less than 50 days) llamas (n = 21) were monitored daily by transrectal ultrasonography, and uterine tone was monitored by transrectal digital palpation. Follicle size and the presence or absence of corpora lutea were recorded and related to changes in morphology of uterus and cervix. Emphasis was given to the dynamics of curling of uterine horns and changes in uterine tone. For statistical purposes, uterine and cervical characteristics were scored 1 to 4 (minimal to maximal). Data were placed into 1 of the following reproductive statuses: 1) follicular dominance, 2) luteal dominance, and 3) pregnancy. Follicles were characteristically arranged along the periphery of the ovary, and large follicles and the corpus luteum protruded distinctly from the ovarian surface. The preovulatory follicle grew at a mean rate of 0.7 mm/day and the average diameter on the day before ovulation was 10.6 +/- 0.9 mm. Ovulation (Day 0) was detected an average of 1.8 days after a single mating. The mature corpus luteum was 11-13 mm in diameter and was characteristically hypoechogenic with a white (echogenic) horizontal area in the center. Pregnancy was detected as early as 11 days post-mating and all (7/7) singleton embryonic vesicles were detected in the left uterine horn. Uterine and cervical echotexture was darker (p less than 0.01) during follicular dominance than during luteal dominance and pregnancy, indicating a decrease in tissue interfaces or an increase in intercellular fluid during follicular dominance. The cervical folds became echogenic and prominent during luteal dominance.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
[The regional differences of the pH-value in the vagina, cervix, and uterus of cows during interestrus].
This study aimed to ascertain the pH value of the vagina, cervix, and uterus in cows during interoestrus. Measurements were made with an ambulant, digital pH meter with a flexible probe and a measuring frequency of one value per second. The genital tract (vagina, cervix, uterus) of 50 cows were analyzed with this instrument immediately post mortem. The sexual health of the animals was evaluated via clinical, histological, and microbiological tests. Statistically significant regional differences in the pH value were documented (p < 0.01). Whereas a decrease was measured between the values for the vagina (6.92 +/- 0.51) and the cervix (6.22 +/- 0.31), increased values were measured in the uterus (6.62 +/- 0.32). The physiological pH value in the genital tract of the cow should be taken into consideration for the development of new therapeutic measures in terms of the local application of probiotically active bacterial strains.
Animals↗
Comparison of vaginal and cervical beta-glucuronidase in relation to cancer of the cervix and uterus.
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Cervix Uteri↗
Autoradiographic study on the localization of estradiol-17beta in neonatal mouse uterus and cervix.
The uptake of 3H-estradiol-17beta in the neonatal mouse uterus and cervix has been studied by an autoradiographic method. When the radioactive hormone is administered in vivo and in vitro, grains are found to be concentrated above the nuclei both in the uterine and cervical epithelium and stroma. Grain counts revealed that the nuclear concentration of grains is higher at 4 h than at 2 h after isotope injection. The cervical epithelium has a higher nuclear concentration than the uterine epithelium both in vivo and in vitro. In the stroma, this situation is reversed except after in vitro treatment of the tissues. In the cervix, more of the hormone seems to be located within the nucleus while in the uterus a higher proportion of the grains are found in the vicinity of the nuclear periphery. Although the nuclear concentration of grains is higher at 4 h than at 2 h, the number of grains above the sections is lower at 4 h. Both in vivo and in vitro, the number of grains is higher above the stromal than above the epithelial compartments of the uterus and cervix. Five days old animals showed the same labeling pattern. The differences in uptake and distribution of 3H-estradiol are discussed in relation to other known differences in the hormone responsiveness in these tissues.
Animals↗
Control and assessment of the uterus and cervix during pregnancy and labour.
Preterm labour and resultant preterm birth are the most important problems in perinatology. Countless efforts have failed to establish a single effective treatment of preterm labour, partly because the mechanisms regulating the uterus and cervix during pregnancy are not well understood. New knowledge is needed to inhibit early progression of labour (uterine contractility and cervical ripening), and adequate quantitative tools to evaluate the uterus and cervix during pregnancy are lacking. In this review, we outline studies showing that the uterus (myometrium) and cervix pass through a conditioning step in preparation for labour. This step is not easily identifiable with present methods to assess the uterus or cervix. In the uterus, this seemingly irreversible step consists of changes in the electrical properties to make muscle more excitable and responsive to produce forceful contractions. In the cervix, the step consists of softening of the connective tissue components. Progesterone appears to have a dominant role in controlling both the uterus and cervix, as antiprogestins induce early, preterm conditioning leading to preterm labour. Apparently, nitric oxide (NO) also controls conditioning of the uterus and cervix. In the uterus, NO, in concert with progesterone, inhibits uterine contractility. At term, NO production by the uterus and placenta are decreased and allow labour to progress. In contrast, NO in the cervix increases at the end of pregnancy and it may be the final pathway for stimulating cervical ripening by activation of metalloenzymes. The progress of labour can be assessed non-invasively using electromyographic (EMG) signals from the uterus (the driving force for contractility) recorded from the abdominal surface. Uterine EMG bursts detected in this manner characterize uterine contractile events during human and animal pregnancy. A low uterine EMG activity, measured transabdominally throughout most of pregnancy, rises dramatically during labour. EMG activity also increases substantially during preterm labour in humans and rats. This method may be used one day to predict impending preterm labour and identify control steps and treatments. A quantitative method also assesses the cervix, using an optical device which measures collagen fluorescence in the cervix. The collascope estimates cervical collagen content from a fluorescent signal generated when collagen cross-links are illuminated with excitation light of about 340 nm. The system has proved useful in rats and humans at various stages of pregnancy, and indicates that cervical softening occurs progressively in the last one-third of pregnancy. In rats, collascope readings correlate with resistance measurements made in the isolated cervix, which may help to assess cervical function during pregnancy, and indicate control and treatments.
Animals↗
MR imaging of the uterus and cervix in healthy women: determination of normal values.
The purpose of this study was to establish normal values for the volume of the uterus and cervix in MRI based on age and the menstrual cycle phase. We performed MRI of the pelvis in 100 healthy women. For the uterus, they were further divided into two groups: one with myomas and/or adenomyosis and one without either. The volume of the uterus and cervix and thickness of the uterine wall layers were analysed by age and the menstrual cycle phase. The mean volume of the uterus in both groups and the cervix significantly increased with age to reach its peak at 41-50 years, and then dropped. Likewise, the thickness of the endometrium and the junctional zone, but not the myometrium, significantly increased until 41-50 years, and then decreased. When we compared the volume of the uterus and cervix and the thickness of the uterine wall layers between the two phases of the menstrual cycle, we found no significant differences. The volume of the uterus and cervix and the thickness of the endometrium and junctional zone differ significantly with age, but not between the two phases of the menstrual cycle. Knowledge of MRI-related normal values can be expected to aid the early identification of uterine pathologies.
Adult↗
The cervix and uterus in sterility.
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Cervix Uteri↗
Complete duplication of the uterus and cervix with a unilaterally imperforate vagina.
Complete duplication of the uterus and cervix with a unilaterally imperforate vagina must be suspected when a unilateral pelvic mass terminates in a purpuric bulge of the lateral vaginal wall in a young woman with severely progressive dysmenorrhea. Intravenous pyelography will reveal renal agenesis ipsilateral to the imperforate vagina. The prompt and accurate diagnosis of this unusual anomaly should lead to transvaginal drainage of the retained menstrual fluids prior to irreversible damage of the pelvic viscera from chronic cryptomenorrhea.
Adolescent↗
Regulation of urokinase- and tissue-type plasminogen activator by relaxin in the uterus and cervix of the prepubertal gilt.
Changes in plasminogen activator are associated with the reproductive tissue remodelling that occurs during growth. Given the trophic effects of relaxin on the pig uterus and cervix, the present study was designed to examine the impact of relaxin on urokinase and tissue-type plasminogen activator (uPA and tPA) protein and activity in the uterus and cervix of prepubertal pigs. After relaxin administration in vivo to induce growth of the immature uterus and cervix, plasminogen activator activity was measured in uterine flushes and uterine and cervical tissue using a chromogenic substrate assay. Immunoreactive uPA and tPA protein in uterine flushes and uterine and cervical tissue was detected by western blotting. Urokinase plasminogen activator activity was significantly higher (P < 0.05) in uterine flushes from relaxin-treated animals than in controls. However, there was no change in uterine flush tPA activity or protein in response to in vivo relaxin treatment. There was no evidence for acid-labile inhibitors of plasminogen activator in uterine flushes of any of the animals. Cell-associated uterine tissue uPA and tPA activity, as well as protein, were similar in relaxin-treated and control prepubertal pigs. In the cervix, cell-associated tPA activity decreased significantly (P < 0.05) in relaxin-treated animals, while cervical uPA activity was unchanged. These results support the view that at least one means by which relaxin promotes pig uterine growth is by increasing uterine secretion of uPA. In addition, these studies suggest that relaxin administration in vivo to prepubertal gilts has tissue-specific effects with respect to plasminogen activator.
Animals↗
Differential regulation of nitric oxide in the rat uterus and cervix during pregnancy and labour.
The aim of this study was to determine if nitric oxide (NO) production and nitric oxide synthase (NOS) isoforms change within the uterus and cervix during pregnancy and labour either at term or preterm. NO production was compared in the rat uterus and cervix of non-pregnant and pregnant rats on days 18-22 prior to labour, day 22 during delivery, 1 day post-partum and after treatment with either 10 mg onapristone or progesterone. Uterine NO synthesis, reflected in nitrite production, increased during gestation (194.2 +/- 22.6 nmol/g on day 19) compared with the non-pregnant state (76.2 +/- 18.4 nmol/g, P < 0.05) and decreased during term labour and post-partum. Furthermore, injection of lipopolysaccharide (LPS) (100 micrograms/rat i.p.) on day 20 of gestation resulted in a significant increase in NO synthesis after 6 h. Conversely, cervical NO synthesis and nitrite production was low in the non-pregnant (65.1 +/- 9.2 nmol/g) and pregnant animals on days 18-22 of gestation (53.2 +/- 9.0 nmol/g on day 22, P > 0.05), but markedly increased during term labour (139 +/- 28.6 nmol/g, P < 0.05). Treatment with the antiprogestin onapristone suppressed uterine NO production and increased cervical production while continuous administration of progesterone from day 19 had the opposite effect. LPS produced a significant increase in cervical NO production in both the pregnant (8-fold) and non-pregnant (4-fold) states. All three known NOS isoforms (i.e., iNOS, nNOS and eNOS) were detected in the cervical samples but only two were present in the uterus (iNOs and eNOS). An increase in the presence of iNOS occurred during labour at term compared with cervices collected from day 19. This was contrary to the measurements of the isoform in the uterus. Also, there was a similar increase of nNOS in the cervix during labour. This isoform seemed absent in the uterus during gestation. No significant changes occurred in the abundance of eNOS in the cervix during labour at term compared with day 19. During preterm labour after onapristone, iNOS concentrations increased significantly in the cervix. In order to examine whether the NO pathway plays a role in cervical ripening, the effects of the nitric oxide synthesis inhibitor L-nitro-arginine methylester (L-NAME) on the duration of delivery and on cervical extensibility were also investigated. The duration of delivery was significantly prolonged in L-NAME-treated rats compared with the control group (2.4-fold). Moreover, cervical extensibility decreased significantly (1.7-fold) after in-vitro incubation with L-NAME (P < 0.005). We conclude that the NO system may have an active role in the cascade of processes involved in preparing the uterus and cervix for parturition.
Animals↗
MRI of the uterus, uterine cervix, and vagina: diagnostic performance of dynamic contrast-enhanced fast multiplanar gradient-echo imaging in comparison with fast spin-echo T2-weighted pulse imaging.
The aim of this study was to compare the diagnostic performance of contrast-enhanced fast multiplanar gradient-echo (GRE) and T2-weighted fast spin-echo (FSE) image sets in the assessment of uterus, cervix, and vagina. Fast (up to 20 contiguous sections in 23 s) multiplanar GRE and FSE images of 45 patients referred for imaging of the female pelvis were evaluated retrospectively with regard to overall image quality and the ability to detect normal anatomic structures, as well as lesion conspicuity. Results were compared with histologic findings (n = 29) or clinical follow-up. Furthermore, a quantitative assessment of contrast-to-noise ratios among normal uterine and cervical structures as well as uterine lesions was performed for both sequences. On GRE images, uterine and cervical differentiation was best seen on the image sets acquired 15 and 60 s following contrast enhancement and results were significantly better compared with delayed images (p < 0.05). Delineation of the junctional zone was significantly (p < 0.05) better on FSE compared with GRE images; no significant difference was seen for the other anatomic structures. Overall image quality of GRE and FSE images was similar. Sensitivity for lesion detection based on both GRE and FSE images was 96% with a sensitivity of 93% for GRE, and 81% for FSE images alone, respectively. Using the extended McNemar chi 2 test, the difference in diagnostic performance between FSE and GRE revealed no significant difference, whereas the combination of both techniques performed better than FSE imaging alone (p < 0.05). The presented data suggest that dynamic contrast-enhanced GRE imaging should be part of an MR examination of the female pelvis. Combined GRE and FSE imaging provide an excellent sensitivity in the assessment of uterine and vaginal pathologies.
Adolescent↗
Correlation between the alterations in the mRNA expressions of the alpha1-adrenoceptor and estrogen receptor subtypes in the pregnant human uterus and cervix.
Our present aim was to determine the association between the mRNA expressions of the estrogen and adrenoceptor subtypes in the pregnant human uterus and cervix. The presence of the mRNA expressions of all the alpha1-adrenoceptor and estrogen receptor subtypes in the uterus and cervix was proved by means of a reverse transcription polymerase chain reaction method, with a predominance of the mRNAs of the alpha1B-adrenoceptor and estrogen alpha receptors, respectively. The change in the mRNA expression of the estrogen receptor alpha correlated strongly with the change in mRNA level of the alpha1B-adrenoceptors. We presume that the expression of the alpha1B-adrenoceptors at 33-34 weeks in the pregnant human uterus is regulated by estrogen through the estrogen receptor alpha subtypes.
Adult↗
Localization of Simian immunodeficiency virus-infected cells in the genital tract of male and female Rhesus macaques.
The SIV/Rhesus macaque model of HIV transmission has led to an increased understanding of the interactions between virus and host during the sexual transmission of HIV. SIV can be transmitted across the intact mucosa (stratified squamous epithelium) of the foreskin and glans of the penis of Rhesus macaques. SIV-infected cells can be found at all levels of the male Rhesus macaque reproductive tract and SIV can infect cells in the mucosal epithelium of the foreskin of the penis. SIV can be transmitted to female Rhesus macaques by infusing a cell-free virus suspension into the vaginal canal through a soft plastic pediatric nasogastric feeding tube. There does not appear to be any correlation between inoculation at any particular point in the menstrual cycle and the susceptibility of an animal to infection. Furthermore, the surgical removal of the cervix and uterus did not affect the dose of cell-free virus required for the genital transmission of SIV. Thus, target cells for SIV are present in the vaginal mucosa. In chronically-infected female Rhesus macaques, SIV-infected cells are present in the uterus, cervix and vagina. SIV-infected CD1a+ and p55+ Langerhans cells are also found within the stratified squamous epithelium of the vagina. Taken together these results are consistent with the hypothesis that the virus initially infects antigen-presenting cells in the vagina (macrophages and Langerhans cells) and then subsequent rounds of replication occur in the draining lymph nodes prior to spreading to more proximal lymphoid nodes and finally to the bloodstream and distant lymphoid tissue.
Animals↗
Treatment of patients with lymphomas of the uterus or cervix with combination chemotherapy and radiation therapy.
BACKGROUND: Primary lymphomas of the uterus or cervix are so rare that treatment series of single institutions consist of very small numbers of patients, making standard treatment difficult to define. The outcome of patients treated with a combination of chemotherapy and radiation therapy was analyzed for all but patients with the most advanced disease. METHODS: From 1976 to 1992, 16 patients received definitive treatment. Thirteen patients had intact uteri (group 1) and 3 presented with paracolpal lymphomas after previous hysterectomies (group 2). Twelve of the patients received chemotherapy and external irradiation. The remaining four underwent only chemotherapy. The overall survival and freedom from disease progression were analyzed according to Kaplan-Meier methods. Prognoses were related to the International Index, Ann Arbor stage, and International Federation of Gynecology and Obstetrics stage. RESULTS: Five-year survival and freedom from disease progression were 77% and 67%, respectively, for group 1, and all patients in group 2 were cured. A statistically significant correlation of survival with scores of the International Index was found in group 1. For patients with scores in the low or low-intermediate range (n = 10), 5-year survival was 90%. All patients who scored in the high-intermediate or high range (n = 3) died by 66 months after their diagnosis (P = 0.0153). The Ann Arbor stage had less predictive value, with 5-year survival of 89% for Stage I and II patients (n = 9), compared with 50% survival for the four Stage III and IV patients (P = 0.0701). International Federation of Gynecology and Obstetrics staging did not predict outcome. CONCLUSIONS: The combination of chemotherapy and irradiation is the most effective treatment regimen for all uterine and cervical lymphomas. The International Index is most predictive of outcome.
Adult↗
Uptake of relaxin in the uterus and cervix of rats in vivo: influence of ovarian steroids and tolerance.
The influence of oestradiol benzoate and progesterone treatment and of tolerance to relaxin on the uptake of 125I-labelled porcine relaxin by reproductive tissues was investigated in anaesthetized female rats. In ovary-intact rats, 125I-labelled relaxin uptake increased with time in reproductive tissues and in tissues concerned with metabolism and excretion. Administration of 50 micrograms unlabelled porcine relaxin before injection of 125I-labelled relaxin significantly reduced uptake of 125I-labelled relaxin into the uterus and cervix, but had no effect on uptake of 125I-labelled relaxin into other tissues, indicating that specific uptake of relaxin was occurring in the uterus and cervix. In ovariectomized rats, treatment with oestradiol benzoate or oestradiol benzoate plus progesterone for 1 day did not significantly increase uterine or cervical 125I-labelled relaxin uptake compared with corn oil-treated rats, but induced a significant increase in uterine uptake of 125I-labelled relaxin after treatment for 2 days. Induction of tolerance to relaxin by i.v. infusion of a high dose of relaxin significantly reduced uterine and cervical uptake of 125I-labelled relaxin at 3 h after termination of infusion compared with saline-infused rats. By 12 h after termination of infusion, 125I-labelled relaxin uptake in the uterus and cervix was similar in saline-infused rats and in rats given an infusion of relaxin. Infusion of glibenclamide (20 mg kg-1) did not influence uterine or cervical uptake of 125I-labelled relaxin; however, treatment with phentolamine (10 mg kg-1) significantly reduced 125I-labelled relaxin uptake in uterus, bladder and jejunum. This study demonstrates that steroid hormone treatment and tolerance modulate relaxin uptake in reproductive tissues.
Animals↗
Injuries of the cervix and uterus; prevention and management.
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Biomedical Research↗
The effect of platelet activating factor antagonist (BN 52021) on pregnancy duration and collagen content in the pregnant rat uterus and cervix.
In order to study the role of Platelet Activating Factor (PAF) in the mechanism of parturition and connective tissue metabolism in the pregnant rat uterus, we investigated the influence of the Platelet Activating Factor Receptor Antagonist (BN 52021) on gestation duration and collagen concentration in pregnant rat uterus and cervix at term. Total and soluble collagen as well as dry tissue/wet tissue ratio were measured in the BN 52021 treated group (n = 9) and in the control group (n = 13). Gestation duration was evaluated in a group receiving BN 52021 (n = 10) and in a control group (n = 19) receiving pure solvent. There were no significant differences in water content. The total and soluble collagen concentration was also similar to the control in both the uterus and the cervix. The only significant difference was observed in the soluble collagen/total collagen ratio in the uterus. BN 52021 administration did not alter the gestational period. Basing on this experiment we suggest that not all the phospholipid metabolites activated by phospholipase A2 significantly influence the duration of pregnancy and connective tissue metabolism in the pregnant rat uterus.
Animals↗