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PubMed1997

Computed tomography-detected hydrometra before irradiation for cancer of the cervix.

OBJECTIVE: To describe the risk and outcome of women with pretreatment CT-detected hydrometra who were treated by radiation for cancer of the cervix. METHODS: Between 1979 and 1995, 27 women with cervical cancer and a pretreatment CT scan of the pelvic cavity underwent definitive radiotherapy (pelvic teleirradiation and intracavitary brachytherapy). We compared the survival and morbidity in women with [n = 12] and without [n = 15] CT-diagnosed hydrometra. RESULTS: Only one patient from the group with hydrometra was found to have pyometra. There were no statistical differences between the compared groups with respect to patient age, disease stage or applied total radiation doses. The estimated survival at 3 years was 35 +/- 27% for women with and 56 +/- 26% for patients without CT-detected hydrometra [p > 0.20] the corresponding morbidity rates were 25 +/- 26% and 0% [p < 0.05]. CONCLUSION: The presence of hydrometra may heighten the morbidity risk even though pyometra is seldom observed in patients with cervical cancer treated by radiation.

Adult↗

PubMed1978

Squamous cell carcinoma in situ of the endometrium and fallopian tube as superficial extension of invasive cervical carcinoma.

Five cases of squamous cell carcinoma of the cervix associated with widespread squamous cell carcinoma in situ of the endometrial surface are reported. In one case, carcinoma in situ was also found in one fallopian tube in continuity with the cervicoendometrial lesion. A survey of the literature reveals only 20 cases with similar surface endometrial involvement by cervical squamous cell carcinoma. Of these, the fallopian tubes were involved by an identical lesion in six cases only. Pyometra and cervical stenosis were reported in about 66% of the cases. This rare form of upward cervical cancer extension was present in five of 680 cases (0.7%) of squamous cell carcinoma of the cervix in the file of the Tumor Registry of Magee-Womens Hospital.

Adult↗

PubMed1986

Primary squamous cell carcinoma with its spindle cell variant in the endometrium. A case report and review of literature.

A case of squamous cell carcinoma of the endometrium in a 72-year-old woman is presented. A review of the previous 28 cases of endometrial squamous cell carcinoma (ESCC) that are adequately substantiated in the literature revealed several misconceptions about this rare tumor: the association with pyometra is not as frequent; the lesion does occur in premenopausal women; squamous metaplasia of the endometrium is not always coexistent; and malignant transformation of squamous metaplasia to ESCC has never been convincingly demonstrated. In the current case, a focal sarcomatoid spindle-cell tumor was associated with typical ESCC; however, light and electron microscopic examinations provided convincing evidence that the tumor was composed solely of ESCC. Ultrastructure of the spindle-cell tumor revealed it to be essentially identical to that of a spindle-cell variant of squamous cell carcinoma reported previously.

Aged↗

PubMed2002

Clinical usefulness of color Doppler ultrasound in patients with endometrial hyperplasia and carcinoma.

BACKGROUND: The objective of this study was to examine the usefulness of transvaginal color Doppler ultrasound (TV-CDU) in differentiating between endometrial hyperplasia (EH) and endometrial carcinoma (EC) and in predicting tumor spread in patients with EC. METHODS: Seventy-one postmenopausal patients were enrolled with either EH or EC that had been diagnosed by endometrial biopsy. The presence or absence of intratumoral blood flow was assessed by TV-CDU. The intratumoral blood flow characteristics were analyzed using the resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV). The endometrial thickness also was measured in all patients by gray-scale sonography. The correlation of these sonographic findings with histologic type, tumor grade, surgical stage, myometrial invasion, or the presence or absence of pelvic lymph node metastasis was then evaluated in patients with EC. RESULTS: Although there were no patients with EC with endometrial thickness measuring < 5 mm, no significant difference was found in the mean value of endometrial thickness between patients with EH (n = 18 patients; 16.2 mm +/- 15.9 mm) and patients with EC (n = 53 patients; 18.7 mm +/- 17.1 mm). Intratumoral blood flow was detected in significant numbers of patients who had EC (71.7%; 38 of 53 patients) compared with patients who had EH (5.6%; 1 of 18 patients; P < 0.0001). Thus, no patients with EH showed any blood flow in the endometrial lesions, except for one patient who had EH complicated by pyometra. In patients with EC, the positive rate of intratumoral blood flow was correlated significantly with myometrial invasion, tumor grade, and pelvic lymph node metastasis (P < 0.05; Cochran-Armitage trend test). No associations were found between RI, PI, or PSV and the clinicopathologic parameters examined, including surgical stage. CONCLUSIONS: TV-CDU may be more useful in differentiating between EH and EC than measuring endometrial thickness by transvaginal gray-scale sonography. For patients with EC, the detection of intratumoral blood flow may be helpful in distinguishing between low-grade and high-grade tumors and predicting myometrial invasion. However, intratumoral blood flow analysis using RI, PI, or PSV may not be useful for predicting tumor spread before surgery.

Aged↗

PubMed1996

Squamous cell carcinoma of the endometrium: a report of eight cases and a review of the literature.

BACKGROUND: Endometrial squamous cell carcinoma is extremely rare, with only 56 cases reported in the literature. METHODS: Six cases of endometrial squamous cell carcinoma were found in a review of 1182 cases of uterine corpus cancer treated at the Massachusetts General Hospital from 1975 to 1993. Two additional cases were seen in pathological consultation. The clinicopathological features of these 8 cases and the 56 reported cases were analyzed. RESULTS: The average age of the patients was 67 years; almost all of them were postmenopausal. The most frequent presenting symptom was vaginal bleeding. Chronic pyometra and nulliparity were predisposing factors. The average duration of symptoms before diagnosis was 11.5 months. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was the primary treatment in 58 patients. Eighty percent of the patients with Stage I tumors survived; the median follow-up time was 32 months. The survival rate for patients with Stage III tumors was only 20%, and all 6 patients with Stage IV disease died. CONCLUSIONS: The preoperative diagnosis of endometrial squamous cell carcinoma may be difficult, since curettage specimens may show only highly differentiated squamous epithelium. The strong relationship between tumor stage and survival suggests that early diagnosis and treatment are imperative.

Aged↗

PubMed1976

Absence of carcinogenic effects of estradiol mustard (NSC-112259) in rats.

Estradiol mustard (NSC 112259) was subcutaneously injected to female Sprague-Dawley-rats in weekly doses of 10 and 20 mg/kg up to a total dose (Dmax) of 500 or 760 mg/kg respectively. Treatments reduced significantly the mean survival time. No carcinogenic properties were observed. Most of the estrogen mustard treated animals died from ovarian abscesses or peritonitis following pyometras. Toxic injuries were attributed to the chronical estrogenic stimulus.

Animals↗

PubMed1986

Usefulness of measuring serum lysozyme activity in dogs with neoplastic disease.

Serum lysozyme activity (SLA) was measured in a turbidimetric assay with a microcentrifugal analyzer. In a control group of 53 healthy dogs of both sexes and ranging in age from 4 to 10 years, SLA had a mean value of 1.2 mg/l with a range (+/- 2 SD) of 0.6 - 1.8 mg/l. In 80 dogs with a variety of neoplastic diseases the histopathological diagnosis was compared with the SLA value. SLA value was increased in 83% of the cases with malignant tumors and in 29% of the cases with benign tumors. Proper clinical examination is essential in differentiating between neoplastic disease and some interfering diseases, e.g. chronic dermatitis, pyometra and chronic nephritis. Measuring of SLA in dogs may be helpful in screening those animals with suspected malignancies.

Adenoma↗

PubMed1981

Urogenital tract infection in the bitch.

The establishment of urinary tract infection and pyometra in the bitch seems to have some characteristics in common, such as similar bacteria, association with kidney pathology and similar age disposition. both diseases are regarded as an ascending infection from the vagina. The ecological factors determining the host-microbe relationship, the protective mechanisms and the methods of diagnosis are discussed.

Age Factors↗

PubMed2006

Validation of a commercially available human immunoturbidimetric assay for haptoglobin determination in canine serum samples.

Haptoglobin is a positive acute-phase protein with a valuable role as a marker of inflammation in both human and veterinary medicine. The aim of this study was to validate a commercially available immunoturbidimetric method designed for human haptoglobin determination (Izasa SA, Barcelona, Spain) for its use in canine samples. Cross-reactivity between anti-human haptoglobin antiserum and canine haptoglobin was found when agarose gel immunodiffusion and ELISA tests were performed. The use of canine pooled serum with haptoglobin concentration of 6.3 g/L as standard provided higher analytical range than commercially available standards. Intra-assay and inter-assay coefficients of variation were 2.49% and 4.60%, respectively. A linear regression model between immunoturbidimetric results and a previously validated spectrophotometric method (Tridelta Development Limited, Ireland) yielded a slope at 95% confidence interval of 0.94 (0.86, 1.02) and y-intercept at 95% confidence interval of 0.11 (-0.59, 0.82). No significant differences were produced by anticoagulants, lipaemia and bilirubinaemia, although haemolysis significantly decreased haptoglobin. A significant increase of haptoglobin concentration was detected in inflammatory conditions such as pyometra and leishmaniasis, in neoplastic conditions, and after glucocorticoid administration. Canine serum haptoglobin concentration can be reliably measured using the commercially available Izasa immunoturbidimetric method developed for human haptoglobin determination. This method is precise and accurate, provides a wider analytical range than previous reported methods, and can be easily automated and used for routine haptoglobin determination in canine samples.

Animals↗

PubMed1978

Cervical bacterial flora in patients with gynecologic malignancies.

Radiation and gynecologic oncologists agree that pelvic irradiation in the presence of pelvic inflammatory disease, parametritis, or pyometra can be catastrophic. A temperature elevation in a patient having intrauterine radiation is very perplexing. This study was designed to investigate one of the three reported etiologies for this condition. Some investigators have suggested an exacerbation of a quiescent infection as a possible etiology because of the necrotic condition of many cancerous cervices. Aerobic, anaerobic, and fungus cultures were performed on 32 patients prior to intrauterine administration of cesium. The organisms cultured were similar to those identified as the normal cervical flora. The frequency of the organisms seemed independent of the amount of irradiation. The number of organisms cultured did not vary with the use or nonuse of cleansing vaginal suppositories. This study indicated no increase in bacterial growth in these cancerous necrotic cervices; also it did not indicate the growth of any unusual pathologic bacteria.

Adult↗

PubMedDate not supplied

An abattoir survey of female genital disorders of imported camels (Camelus dromedarius) in Kano, Nigeria.

An abattoir survey of 850 female genital organs of imported camels was conducted at the Kano abattoir between October 1987 and April 1988. An incidence of 4.49% of disorders was recorded, including follicular cystic degeneration (0.12%), ovarian haemorrhagic cysts (0.47%), pyometra (0.35%), early embryonic mortality (0.12%), endometrial haemorrhages (0.47%), fetal maceration (0.12%), abscess (0.24%), vulvar tick infestation (1.77%) and cervical hypoplasia (0.12%).

Abattoirs↗

PubMed1985

The clinical manifestations of a genetically determined deficiency of the third component of complement in the dog.

The clinical manifestations of a genetically determined deficiency of C3 were examined in a closed colony of dogs. One hundred and twelve dogs, including twenty C3-deficient dogs, were studied over a period of 6 years. Five of the C3-deficient dogs developed significant bacterial infections, such as pneumonia, sepsis, and pyometra, which were caused by Clostridium spp., Escherichia coli, and Klebsiella spp. Two of the C3-deficient dogs who had had significant infections also subsequently developed renal disease. Secondary amyloidosis was the predominant renal lesion in one dog. The predominant renal lesion in the second dog was membranoproliferative glomerulonephritis, although some amyloid was also present. The two dogs with renal disease also had positive rheumatoid factors. No other clinical or serological evidence of autoimmune disease or immune complex disease has been found. None of the dogs heterozygous for C3 deficiency, and none of the homozygous normal dogs in the colony has developed significant bacterial infections or renal disease. Thus, dogs deficient in C3, like C3-deficient humans, demonstrate both an increased susceptibility to infection and renal disease.

Animals↗

PubMed1988

Management problems associated with carcinoma of the cervix diagnosed in the second trimester of pregnancy.

A 29-year-old women presented in the second trimester of pregnancy with a stage IIB squamous carcinoma of the cervix. Fundal hysterotomy was performed with a view to radical radiotherapy the following week. The patient developed a pyometra in the postoperative period due to the position and nature of the tumor. Management strategies for dealing with similar cases are outlined.

Adult↗

PubMed1990

Invasive cervical cancer treated initially by standard hysterectomy.

Ninety-two patients with invasive cervical cancer initially treated by standard hysterectomy were evaluated for features related to survival. The cell type included squamous cell (64) and adenocarcinoma (28). Posthysterectomy therapy included radiation therapy (78), pelvic lymphadenectomy (3), and radical parametrectomy (1). Hysterectomy was initially performed for the following indications: invasive lesion missed on cone biopsy, 17; hemorrhage at cone biopsy, 2; bleeding, 16; abnormal cytology, 13; presumed endometrial cancer, 9; known cancer, 7; pelvic relaxation, 5; planned therapy, 3; fibroids, 3; adnexal mass, 2; chronic discharge, 1; pyometra, 1; postpartum endometritis, 1. The cumulative 5-year survival for all patients was 68%, for squamous cell 80%, and for adenocarcinoma 41% (P = 0.0001). On postoperative evaluation 84 patients had presumed Stage I and 7 had parametrial involvement (Stage II). Patients with Stage I disease were then examined separately by cell type. Fifty-seven patients with squamous cell disease had cumulative 5-year survival of 85%. Radiation therapy in the immediate postoperative period produced a survival of 88%, compared to observation only with a 69% survival (P = .10). Patients with squamous cell disease and more than 50% cervical invasion had a 75% survival compared to a 96% survival for those with less than 50% (P = .02). The presence of disease at the surgical margins, grade, age, and increase in radiation therapy did not influence survival. Twenty-seven patients with presumed Stage I adenocarcinoma had a cumulative 5-year survival rate of 42%. Survival was significantly influenced by tumor grade (P = .018) and the amount of postoperative radiation therapy (P = .03), while age, amount of residual tumor, and presence of tumor at surgical margins did not influence survival. Patients with invasive squamous cell carcinoma treated by standard hysterectomy and postoperative radiation therapy have a prognosis similar to those treated initially by either radical surgery or radiation therapy. Patients with adenocarcinoma appear to have a significantly decreased survival when compared to patients with squamous cell disease and their prognosis is related to tumor grade and the amount of postoperative pelvic radiation.

Adenocarcinoma↗

PubMed1992

Preliminary results of concurrent radiotherapy and chemotherapy with cis-platinum, vincristine, and bleomycin in bulky, advanced cervical carcinoma: a pilot study.

Twenty-four patients with bulky (greater than 4 cm), advanced (stages IIB-IVA) carcinoma of the uterine cervix were prospectively treated with a concurrent combination of radiotherapy (RT) and chemotherapy (CT). RT consisted of 4400 cGy (22 fractions) to the whole pelvis and a 1400-cGy boost to the parametrium. This was followed by two to three intracavitary brachytherapy courses. CT consisted of one to four course (median, three) of cisplatin (50 mg/m2) on Day 1, vincristine (1 mg/m2) on Day 2, and bleomycin (25 mg/m2) on Days 2-4. CT was started on the first day of external radiation and the scheduled course interval was 21 days. Among the 20 evaluable patients who completed at least one course of chemotherapy and a full course of radiation, 13 (65%) achieved complete response and 5 (25%) had partial response. Fatal complication occurred in 1 patient with stationary disease who died of septic shock due to ruptured pyometra. The other patient with primary stage IVA disease had progressive disease with ascites appearance after two courses of CT and later expired. Transient drug fever occurred in 19 (40.4%) of the 47 bleomycin-containing CT cycles. Grade 2 or 3 hematological toxicities occurred in 16 (30.2%) of a total of 53 CT cycles. Treatment delays of 1 to 7 days occurred in 15 (28.3%) CT cycles. Except for the case of septic shock, all of the other toxicities were generally tolerable and reversible. From this preliminary result we concluded that this particular combination of RT and CT in bulky, advanced cervical carcinoma is effective in enhancing local pelvic tumor control and well tolerated if strict selection of accrued patients is applied. Further investigation to assess its impact on long-term survival is in progress.

Adenocarcinoma↗

PubMed1983

Serum progesterone concentration in pyometritic and normal postpartum dairy cows.

Two studies were conducted to evaluate the concentration of serum progesterone in pyometritic cows and relate it to palpation of ovarian structures per rectum . In Trial 1, serum samples from 34 pyometritic cows were assayed for progesterone. Mean serum progesterone concentrations were 6.8 +/- 0.7 ng/ml. In Trial 2, each of 54 pyometritic cows was paired with a control cow on the basis of days post partum (18-50 days). Mean concentration of progesterone was 9.7 +/- 1.0 ng/ml for the pyometritic cows and 5.7 +/- 0.8 ng/ml in control cows (P<0.005). Progesterone concentration was greater (P<0.005) in both groups of cows with palpable corpora lutea (CLs). Ninety-six percent of the pyometritic cows had palpable CLs compared to 57% of the control group. Comparing serum progesterone only in cows with a palpable CL, the mean concentration was still greater (P<0.005) in the pyometritic group (10.6 +/- 1.0 ng/ml) than the control group (6.6 +/- 1.0 ng/ml). Compatability of rectal palpation findings and concentrations of serum progesterone were 92.6% for the pyometritic group and 72.2% for the control group. Progesterone concentration increased (P<0.05) by increased days post partum in Trial 2 (n=54) but not in Trial 1 (n=23). In both Trials 1 and 2, uterine size due to pyometra increased (P<0.05) with increased days post partum. No other associations were found.

Journal Article↗

PubMed1985

Amikacin sulfate in the cat: serum, urine and uterine tissue concentrations.

Puerperal metritis and pyometra in non-breeding cats is frequently caused by gram-negative bacteria that are resistant to a variety of antibiotics. Amikacin has been found to be effective against pathogens associated with uterine infections in the mare and the woman, but its efficacy has not been studied in the cat. Serum concentrations of amikacin were determined in healthy adult cats (six male and six female) after administration of 5, 10, and 20 mg/kg body weight of amikacin sulfate, each dose given subcutaneously (s.c.), intramuscularly (i.m.) and intravenously (i.v.) to each of the cats using a repeat treatment design. In a subsequent experiment, the six females were given 10 mg/kg s.c. amikacin and samples of blood, urine and full-thickness uterine wall were taken at 40 and 120 minutes after treatment. Mean serum concentrations of amikacin peaked between 30 and 45 minutes after i.m. injection and between 45 and 60 minutes after s.c. injections. The serum amikacin concentration curves were similar regardless of dose or administration route except for a slightly longer retention time after the 20 mg/kg dose given i.m. and s.c. After s.c. injection of 10 mg/kg, the mean uterine concentration of amikacin at two hours after treatment was 4.1 ug/g; the concurrent mean serum concentration was 18.6 ug/ml.

Journal Article↗

PubMed1987

Descriptive epidemiology of anestrus in Michigan Holstein-Friesian cattle.

Twenty-two Michigan Holstein-Friesian herds were studied to determine the incidence and epidemiology of anestrus. In 3,309 lactations studied, 42% were classified as having exhibited preservice anestrus (no estrus detected by 70 d after calving). Organic reasons (pyometra, cystic follicles, static ovaries) were identified by palpation per rectum for 237 (23%) of the cows with preservice anestrus that were examined by a veterinarian. Postservice anestrus, defined as failure to show estrus within 35 d after an unsuccessful insemination, was identified in 790 (47%) of 1,691 lactations. Veterinary examination identified 104 (20%) of postservice anestrous cows as having this condition because of organic causes. The average cow with preservice anestrus had an increase of 30 d open compared to her herdmates, and the average cow with postservice anestrus had an increase of 37 d open. Anestrous cows produced more milk than their unaffected herdmates in both the current and the previous lactation. Analysis of composite lactation curves indicates that, for preservice anestrus, this additional milk production was obtained gradually over the entire lactation. Anestrous cows were culled at a significantly higher rate than their herdmates. Cows with preservice anestrus were more likely to have begun their lactation in the spring months.

Journal Article↗