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At least 19 recordsLinked to original sources

Defining postpartum uterine disease in cattle.

Uterine function is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist, causing uterine disease, a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies among research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Puerperal metritis should be defined as an animal with an abnormally enlarged uterus and a fetid watery red-brown uterine discharge, associated with signs of systemic illness (decreased milk yield, dullness or other signs of toxemia) and fever > 39.5 degrees C, within 21 days after parturition. Animals that are not systemically ill, but have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina, within 21 days post partum, may be classified as having clinical metritis. Clinical endometritis is characterised by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 days or more after parturition, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 days post partum. In the absence of clinical endometritis, a cow with subclinical endometritis is defined by > 18% neutrophils in uterine cytology samples collected 21-33 days post partum, or > 10% neutrophils at 34-47 days. Pyometra is defined as the accumulation of purulent material within the uterine lumen in the presence of a persistent corpus luteum and a closed cervix. In conclusion, we have suggested definitions for common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.

Animals↗

Investigating uterine disease in the bitch: uterine cannulation for cytology, microbiology and hysteroscopy.

A technique for transcervical cannulation of the uterus of the bitch for the collection of samples for cytology and microbiology was developed. This technique involved passing a cannula into the uterus with the aid of an endoscope. The uterus was cannulated successfully in mature bitches (over 10 kg) 110 times in 144 attempts. Success of cannulation was influenced by the experience of the operator and ease of cannulation by the stage of the reproductive cycle, the size of the bitch and the type of cannula. Complications associated with the procedure were endometritis, vaginitis and vaginal tears. Uterine cannulation was generally possible in all bitches studied at all stages of the reproductive cycle. Techniques for the collection of samples from the uterus for cytology and microbiology and for the processing of samples for uterine cytology are outlined. Hysteroscopy was performed on seven occasions in post partum bitches and was found to be possible at least until day 17 after whelping.

Animals↗

Immunohistochemical study of the distribution of secretory component and IgA in the normal and diseased uterine mucosa.

The distribution of secretory component (SC) and IgA in the normal and diseased uterine mucosa was studied by means of an immunoperoxidase method. Both substances could not be demonstrated in ectocervical epithelium, whereas in endocervical epithelium both were present and staining intensity appeared to be related to the degree of inflammatory activity in the underlying stroma. Local IgA-containing plasma cells most likely are the source of epithelial IgA. Well-differentiated adenocarcinomas of the endocervix were shown to display SC immunoreactivity. In endometrial glands SC was observed in the postovulatory phase of the menstrual cycle, in increasing quantities toward menstruation. Hyperplastic conditions of the endometrium showed a weak focal staining for SC. In contrast, in most well-differentiated adenocarcinomas of the endometrium, SC and IgA could be detected in most neoplastic elements, whereas poorly differentiated carcinomas were largely negative. It is concluded that: (a) in contrast to the endometrium, in the endocervix a local secretory immune system operates similar to that of the gastrointestinal tract; (b) the ability of the endometrium to synthesize SC is at least partly regulated by hormonal factors and, as such, is confined to the progestagen-dominated phase of the menstrual cycle; and (c) immunohistochemical detection of SC may be of help in the grading of adenocarcinomas of the endometrium.

Adenocarcinoma↗

Insulin-like growth factors and their binding proteins in benign and malignant uterine diseases.

Evidence available supports the concept that the proliferative response of the uterus to oestrogen is through activation of local regulatory factors, IGFs amongst them. Oestrogen stimulates the expression of IGF-I and IGF-I receptor mRNAs, whereas progesterone induces the major endometrial IGFBP, IGFBP-1, which is proposed to act as an inhibitor of IGF actions in normal endometrium. Since both benign and malignant uterine diseases are related to oestrogen action, the hormonally regulated local IGF system may play an important role in the pathophysiology of uterine diseases. In support of this hypothesis, we found differences in the expression of IGFBP mRNAs and in the presence of translated IGFBPs between benign and malignant uterine tissues. Furthermore, receptor binding of IGF-I has been found to be higher in neoplastic uterine tissues compared to normal tissues.

Animals↗

Combination of a tension-free vaginal tape procedure and laparoscopic-assisted vaginal hysterectomy for the treatment of benign uterine disease associated with stress urinary incontinence.

BACKGROUND: Women undergoing hysterectomy for benign uterine disease (BUD) may experience stress urinary incontinence (SUI). We performed tension-free vaginal tape (TVT) procedure and laparoscopic-assisted vaginal hysterectomy (LAVH) simultaneously and assessed the feasibility and efficacy of TVT performed under general anesthesia and the resultant anti-incontinence effects following the combined procedures. METHODS: Between March, 2000 and March, 2002 inclusively, 63 patients, who suffered from both BUD and SUI, underwent LAVH and TVT. Preoperative evaluation included history-taking, physical examination and ultrasonography. One-hour pad test, multichannel urodynamics and urinary questionnaire were conducted preoperatively and postoperatively. Details about surgical procedures undertaken, hospitalization and urinary problems in the follow-up period were recorded. RESULTS: 50 patients completed the study with a mean follow-up period of 34 (25-48) months. The mean age was 49 (39-67) years and mean parity 3 (2-6). The mean surgical duration was 163 (95-240) minutes and blood loss 284 (100-1,500) milliliters. Mean duration of hospital stay was 5.5 days and bladder drainage 1.9 days. Three patients suffered bladder perforation and one patient was complicated with excess blood loss. Postoperative urinary problems included transient urine retention, de novo frequency/urgency symptoms and voiding difficultly. CONCLUSIONS: The efficacy of concomitant TVT in LAVH procedure remained satisfactory in treatment of SUI associated with BUD. Both procedures reflect the benefits of less-invasive surgery. So the combination of LAVH and TVT is probably a good alternative for the patient who needs to undergo hysterectomy and anti-incontinence surgery simultaneously.

Adult↗

[Diagnosis of uterine diseases by combined hysteroscopy and ultrasonography].

OBJECTIVE: To investigate the diagnostic value of combined hysteroscopy with ultrasonography. METHODS: 477 patients were diagnosed by hysteroscopy, ultrasonography, or hysteroscopy combined with ultrasound. The results of the 3 groups were compared with the findings after operations. RESULTS: This study indicated to diagnose intrauterine lesions, intramural diseases or pelvic disorders, hysteroscopy with ultrasonography was significantly better than either methods alone. The accuracy rate, false positive rate as well as false negative rate were 98.32%, 1.26% and 0.04% respectively. CONCLUSION: Hysteroscopy is used for diagnosis and treatment of intrauterine lesions, and ultrasonography is difficult to show actual location of lesions within uterine cavity. The present study has shown that hysteroscopy combined with ultrasound could increase the effectiveness and accuracy of uterine diseases' diagnosis.

Adult↗

Histopathologic features, environmental factors, and serum estrogen, progesterone, and prolactin values associated with ovarian phase and inflammatory uterine disease in cats.

Forty-four female American Shorthair cats with inflammatory uterine disease or infertility were evaluated. Data collected included age, month of diagnosis, housing, reproductive history, results of bacteriologic culture of uterine specimens, serum concentrations of estrogen, progesterone, and prolactin and histopathologic features of the ovaries and uterus. Histologically, the ovaries of 19 cats were dominated by active or cystic follicles, whereas 25 cats had luteal-phase ovaries. Of the 25 cats with active corpora lutea, 20 had either recently weaned litters (n = 11) without subsequent exposure to a male cat, or had been housed individually for lengthy periods (n = 9). The finding of active corpora lutea under these circumstances indicates that in queens, ovulation may occur by mechanisms not involving coitus. Prominent, active corpora lutea on the ovaries were associated with adenomatotic proliferative changes in the superficial and glandular epithelium of the uterus and with myometrial hyperplasia, compared with the uterus of cats with follicular ovaries (P less than 0.01). Serum progesterone concentration greater than or equal to 1.87 ng/ml was consistently associated with luteal-phase ovaries. Serum progesterone values less than or equal to 0.15 ng/ml were consistently associated with follicular-phase ovaries. Escherichia coli was the organism most commonly isolated from uterine contents.

Animals↗

The place of hysterectomy in the management of benign uterine disease.

The wide variation in hysterectomy rates may reflect professional uncertainty as to the appropriateness of the procedure for managing benign uterine disease. This is thought to be due to diagnostic difficulties and especially to a lack of outcomes data. Many patients experience symptomatic relief after hysterectomy, but the long-term costs and benefits remain uncertain. Alternative treatments are available that spare the uterus and/or ovaries and appear to be as effective as hysterectomy. Vaginal hysterectomy is also associated with significantly reduced hospitalization and convalescent time and a lower rate of post-operative complications compared to abdominal hysterectomy, yet most hysterectomies continue to be performed abdominally. Based on the review, a number of steps are proposed for dealing with the problem of excess hysterectomy rates within a managed care setting.

Endometrium↗

Ovarian and uterine disease in women with colorectal cancer.

OBJECTIVE: To identify the nature of adnexal and uterine disease in women with a history of colorectal adenocarcinoma who develop new pelvic masses or uterine cancers during follow-up. METHODS: We conducted a retrospective chart review of the Memorial Hospital Gynecology Service database and identified 50 women, each with a history of colorectal carcinoma who underwent a hysterectomy or adnexectomy between January 1, 1977, and February 29, 1996. Subject characteristics, indications for re-operation, and findings at surgery were recorded. RESULTS: The mean age at re-operation was 66 years (range, 37-76), with a median interval from initial diagnosis to re-operation of 25 months (range, 3-444). Indications for re-operation were: 1) new pelvic mass in 35 women, and 2) cancer on endometrial or cervical biopsy in 15. Twenty-six of the 35 (74%) women who presented with a pelvic mass had a malignancy in the ovary, with metastatic colon cancer noted in 20 of 26 (77%) women, and epithelial ovarian cancer in six of 26 (23%). The mean ovarian tumor size for metastatic colorectal carcinoma, ovarian cancer, and benign tumors was 15, 8, and 6 cm, respectively. Fifteen women underwent hysterectomy for a newly diagnosed cancer in the uterus, with the majority, 11 (73%), having endometrial adenocarcinoma, followed by metastatic colon cancer to the endometrium or cervix in three (20%) women, and primary cervical carcinoma in one. CONCLUSION: Women with a history of colorectal cancer who underwent adnexectomy for a new pelvic mass had metastatic colon cancer to the ovary in 57%, benign ovarian neoplasm in 26%, and primary ovarian cancer in 17% of cases. Women who underwent hysterectomy for a newly diagnosed carcinoma in the uterus had primary endometrial adenocarcinoma in 73% and metastatic colon cancer in 20% of cases.

Adenocarcinoma↗

Prophylactic oophorectomy of benign uterine disease in premenopausal women: 11 years review.

Between 1982 and 1992, 695 consecutive abdominal hysterectomies and prophylactic oophorectomies in premenopausal women for benign uterine diseases were performed in our department. The trend of prophylactic oophorectomy has declined since 1988 to a minimum in 1990. 60 per cent were 41-45 years of age, 28 per cent were more than 46 years, 12 per cent were 36-40 years. Uterine fibroid was the most frequent indication (77.7%), followed by adenomyosis (21.0%). Ovarian histologies revealed abnormalities only in 1.3 per cent of the removed ovaries, the remainder appeared to be normal.

Adult↗

[Clinical application of magnetic resonance imaging (MRI) in uterine disease].

We investigated the value of MRI in investigating uterine anatomy and disease. 1. Normal uterus: The signal intensity and endometrial thickness changed during the menstrual cycle. Endometrial thickness in the secretory phase was 12.8 +/- 3.6 mm, significantly greater than in the proliferative phase (5.4 +/- 0.7 mm, p less than 0.01). In contrast, endometrial thickness was reduced in postmenopausal women (4.1 +/- 0.9 mm) and was never over 6 mm. 2. Uterine disease: a. T2-weighted images were useful in differentiating leiomyoma and adenomyosis. Leiomyomas appeared as well-circumscribed nodules with sharp margins, while adenomyosis was seen as a low signal intensity area with an irregular border extending beneath the endometrium. b. In endometrial carcinoma, endometrial thickening with a high signal intensity was a characteristic of T2-weighted images, the maximal thickness being 16.5 +/- 6.9 mm. Moreover, endometrial carcinomas invading over 1/3 of the myometrium showed the following features: (1) The ratio of maximal endometrial thickness to uterine cross sectional diameter was over 50%. (2) The minimal myometrial thickness was under 5.0 mm. (3) The minimal to maximal myometrial thickness ratio was under 50%. Furthermore, cervical extension could be detected in all cases of endometrial carcinoma extending to the myometrium in T2-weighted images.

Adult↗

Adenomyosis--an ignored uterine disease.

Health care providers who supply primary care to women will at some time encounter a patient presenting with symptoms of abnormal uterine bleeding and secondary dysmenorrhea. Adenomyosis, an elusive uterine disease, is a frequently ignored causative factor of these symptoms. Adenomyosis is considered a benign uterine condition in which the endometrial glands embed into the myometrium of the uterus. It is usually found in multiparous, middle-aged women who present with heavy, painful, cyclical bleeding associated with menstruation. This article addresses the incidence, etiology, symptomatology, and treatment modalities for adenomyosis. Implications for health care providers are discussed.

Adult↗

[Hysteroscopy as a diagnostic aid for uterine diseases of cattle].

A method for hysteroscopy in cattle, using a rigid tube for passage through the cervical canal, is described. Using this method, passage through the cervical canal is possible independent of the stage of the gynaecological cycles. The hysteroscopic findings of 105 examinations in cows are described and discussed.

Animals↗