[Adapted and standardised patient management in the treatment of neovascular AMD in the outpatient setting of a university eye hospital]. / Angepasstes und standardisiertes Patientenmanagement bei der Behandlung der neovaskulären AMD im ambulanten Bereich einer Universitäts-Augenklinik.

Visual results in treating neovascular age-related macular degeneration (AMD) using intravitreal injected anti-VEGF (IVT) clearly depend on injection frequency. Regarding to the European approval Ranibizumab has to be used only in cases of recurrent visual loss after the loading phase. In contrast monthly treatment--as also provided in the ANCHOR and MARINA studies--is generally allowed in Switzerland. However, it is commonly tried to reduce the injection frequency because of the particular cost situation in all health systems and of cause also due to the necessary strict monitoring and reinjection regimes, which raise management problems with increasing patient numbers. In this article the special treatment regimes of our University Eye Hospital is presented, in which a reduced injection frequency basically leads to the same increased and stable visual results as in ANCHOR and MARINA; however, needing significantly more injections as generally provided in other countries of Europe. The main focus for achieving this in a large number of patients is placed on re-structuring our outpatient flow for IVT patients with particular emphasis on patient separation and standardisation of treatment steps leading to significantly reduced time consumption per patient. Measurements of timing and patient satisfaction before and after restructuring underline its importance in order to be able to treat more patients at a high quality even in the future. The exceptional importance of spectral domain OCT measurements as the most important criterium for indicating re-treatment is illustrated.

[Imaging diagostics of geographic atrophy]. / Bildgebende Diagnostik bei geographischer Atrophie.

The development of imaging technologies has contributed to the understanding of the genesis and pathophysiological mechanisms of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Fundus autofluorescence (FAF) imaging allows accurate discrimination of the boundaries of atrophic patches. Furthermore, predictive markers for disease progression can be identified. Non-invasive FAF imaging now represents the gold standard for evaluating progressive enlargement of atrophic areas. By means of high resolution optical coherence tomography (OCT) microstructural retinal changes in GA can be identified. Anatomical endpoints are now being used in interventional GA trials and represent meaningful outcome parameters as surrogate markers in an overall slowly progressive disease which may not affect the fovea until later stages of the disease.

Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study.

OBJECTIVE: The expression of vascular endothelial growth factor (VEGF) is elevated in diabetic macular edema (DME). Ranibizumab binds to and inhibits multiple VEGF variants. We investigated the safety and efficacy of ranibizumab in DME involving the foveal center. RESEARCH DESIGN AND METHODS: This was a 12-month, multicenter, sham-controlled, double-masked study with eyes (age>18 years, type 1 or 2 diabetes, central retinal thickness [CRT]≥300 µm, and best corrected visual acuity [BCVA] of 73-39 ETDRS letters [Early Treatment Diabetic Retinopathy Study]) randomly assigned to intravitreal ranibizumab (0.3 or 0.5 mg; n=51 each) or sham (n=49). The treatment schedule comprised three monthly injections, after which treatment could be stopped/reinitiated with an opportunity for rescue laser photocoagulation (protocol-defined criteria). After month 1, dose-doubling was permitted (protocol-defined criteria, injection volume increased from 0.05 to 0.1 ml and remained at 0.1 ml thereafter). Efficacy (BCVA and CRT) and safety were compared between pooled ranibizumab and sham arms using the full analysis set (n=151, patients receiving≥1 injection). RESULTS: At month 12, mean±SD BCVA improved from baseline by 10.3±9.1 letters with ranibizumab and declined by 1.4±14.2 letters with sham (P<0.0001). Mean CRT reduction was 194.2±135.1 µm with ranibizumab and 48.4±153.4 µm with sham (P<0.0001). Gain of ≥10 letters BCVA from baseline occurred in 60.8% of ranibizumab and 18.4% of sham eyes (P<0.0001). Safety data were consistent with previous studies of intravitreal ranibizumab. CONCLUSIONS: Ranibizumab is effective in improving BCVA and is well tolerated in DME. Future clinical trials are required to confirm its long-term efficacy and safety.

[Seasonal fluctuations and influence of nutrition on macular pigment density]. / Jahreszeitliche Schwankungen und Einfluss der Ernährung auf die makuläre Pigmentdichte.

PURPOSE: We have previously reported on measuring macular pigment density (MPD) with a scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Heidelberg, Germany). This study war undertaken to evaluate the variation of MPD over a period of 1 year in healthy subjects. METHOD: We used autofluorescence images recorded with a HRA to evaluate MPD with a 2 degrees circle centered on the fovea. Healthy subjects were included in the study and MPD measurements were repeated every 2 months over a period of 1 year. RESULTS: We included a total of 30 healthy subjects aged 19-34 years (mean: 23+/-2 years). Mean MPD at time point 1 was 0.215+/-0.056 density units (DU), at time point 2 0.235+/-0.051 DU, at time point 3 0.218+/-0.055 DU, at time point 4 0.228+/-0.057 DU, at time point 5 0.225+/-0.053 DU, and at time point 6 0.203+/-0.050 DU. The statistical analysis revealed no significant variation of MPD over the follow-up period of 1 year. CONCLUSION: This study demonstrates that MPD shows no variation over a period of 1 year in healthy subjects.

The efficacy of a modified aluminosilicate as a detoxifying agent in Fusarium toxin contaminated maize containing diets for piglets.

Two feeding experiments with female weaned piglets were carried out applying a complete two by two factorial design to investigate the effects of the dietary inclusion of 500 g/kg Fusarium toxin contaminated maize (8.6 mg/kg deoxynivalenol (DON); 1.2 mg/kg zearalenone (ZON)) and of 4 g/kg aluminosilicate (AS) as a detoxifying agent. The resulting four diets were fed ad libitum to a total of 80 piglets (20 piglets per group, allotted to a total of 20 pens) covering a live weight range of 10.5 +/- 1.3 to 27.5 +/- 4.4 kg in experiment 1, and to a total of 48 piglets (12 piglets per group, allotted to 12 pens) covering a live weight range of 9.7 +/- 1.8 to 21.4 +/- 4.8 kg in experiment 2. The animals of experiment 1 were slaughtered on days 34-36 of feeding the experimental diets. The mycotoxin analyses revealed that the control maize also contained considerable concentrations of Fusarium toxins, but the differences in DON and ZON concentrations between control and contaminated diets were sufficiently high to demonstrate both dose-related toxin effects. Voluntary feed intake and live weight gain of the animals were significantly reduced by the inclusion of Fusarium toxin contaminated maize into the diets in both experiments, while a significantly decreased feed to gain ratio was found in experiment 1. Furthermore, the relative weight of the uterus, stomach and heart of the animals fed the contaminated maize containing diets were significantly increased. Serum albumin concentrations and the activity of GLDH were significantly reduced by the inclusion of the contaminated maize. The addition of AS to the Fusarium toxin contaminated diets did not prevent or alleviate any of the mentioned effects. Moreover, the feed intake tended to be decreased by this supplementation in both experiments, while a significantly decreased feed to gain ratio was indicated for this factor in experiment one as well. The serum concentration of albumin and the activities of ASAT and gammaGT were significantly increased if AS was present in the diets while serum concentration of cholesterol and alpha-tocopherol were decreased significantly or in tendency, respectively. The concentrations of retinol and retinyl esters in liver and serum were not altered by the treatments. The analysed concentrations of zearalenone (ZON) and its metabolites in the bile fluid clearly indicated the differences in dietary ZON concentrations and showed that AS was ineffective in preventing the absorption of the toxin from the gastrointestinal tract. Also, serum concentrations of DON reflected the DON intake prior to sampling. However, there were no differences between groups fed diets with or without AS which also suggests the inefficacy of the tested AS in preventing the DON absorption. The present investigations failed to demonstrate a detoxifying capacity of the tested additive and emphasize the general necessity for a critical verification of detoxifying agents in vivo.

[Fundus hypertonicus Okulare Veranderungen bei systemischen Erkrankungen]. / Fundus hypertonicus Okuläre Veränderungen bei systemischen Erkrankungen.

Cardiovascular disease is one of the major causes of mortality and morbidity in the western world. However, 30% of men and 15% of women were not aware of their elevated blood pressure. Hypertension has been defined as a multiply exceeded threshold value set by the WHO. With increasing blood pressure, mortality increases significantly. Studies have shown an increasing risk of stroke or cardiovascular disease in this patient group. The ophthalmologist plays an important role in the assessment and classification of vascular abnormalities. Typical parenchymal and vascular changes are helpful in arriving at a proper diagnosis, as well as providing a means of risk assessment and potentially helping to identify patients at risk.

Functional pathology of the ovaries and uteri of premature female piglets exposed to distinct amounts of zearalenone.

The objective of this study was to investigate the effects of four different concentrations (groups II-V) of orally administered zearalenone (ZON) over a feeding period of 35 days on parts of the genital tract of 75 day-old female piglets in comparison to a control group (I). In order to determine possible dose related characteristics for a ZON intoxication in ovaries and uteri, histomorphological (HE and Azan stained slides) and immunohistochemical methods [expression patterns of estrogen (ER) and progesterone (PR) receptor, proliferating cell nuclear antigen (PCNA)] were carried out. Using these methods, there were no obvious (immuno-) histomorphological differences within the treatment groups or in comparison to the control group. Nevertheless, compared to the group I, statistical analyses of all parameters investigated revealed significance only in the increased mitotic activity of muscle cells in the uterinelamina muscularis in treatment group V.

The effect of increasing concentrations of Fusarium toxins in piglet diets on histological parameters of the uterus and vagina.

The effects of feeding diets containing 0.01, 0.06, 0.15, 0.22 and 0.42 mg zearalenone and 0.2, 0.8, 1.0, 1.9 and 3.9 mg deoxynivalenol per kg, originating from Fusarium toxin contaminated maize, on the uterus of 50 prepubertal piglets (10 pigs per treatment; BW 32.6+/-5.4 kg; approximately 70 days of age) were investigated. The mean weight of the uteri of animals receiving the most highly contaminated diet was significantly increased at the time of slaughtering. The histological investigation showed no marked differences between the feeding groups. Histometrical parameters of the surface epithelium of the uterus, of the uterine glands and the vaginal epithelium were not altered by the treatment.

Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatment.

In most cases, the endometrioid adenocarcinoma of the endometrium is preceded by hyperplasia with different risk of progression into carcinoma. The original histologic slides from 560 consecutive cases with complex and atypical hyperplasia were re-examined to assess the interobserver-correlation. The hyperplasias were analyzed separately for their likelihood of progression to carcinoma in patients with and without progestogen hormonal therapy. In all cases, a fractional re-curreting was performed to establish the state of the disease. The leading symptom was vaginal bleeding in 65.5% of the cases in the postmenopausal period. Eighty-six percent of the patients presented with obesity (BMI > 30 kg/m(2)), 23% had had an exogeneous use of estrogens. Twenty-two cases were reclassified as simple hyperplasia and excluded from further analysis. The interobserver-correlation was 91% for complex, 92% for atypical hyperplasia, and 89% for endometrioid carcinoma, representing an overall correlation of 90%. Two percent of the cases with complex hyperplasia (8/390) progressed into carcinoma and 10.5% into atypical hyperplasia. Fifty-two percent of the atypical hyperplasias (58/112) progressed into carcinomas. In the case of progestogen treatment (n = 208; P < 0.0001) 61.5% showed remission confirmed by re-curetting, compared with 20.3% of the cases without hormonal treatment (n = 182; P < 0.0001). Endometrial hyperplasia without atypia is likely to respond to hormonal treatment. Especially in postmenopausal situation, atypical hyperplasia should be treated with total hysterectomy.

Effects of graded levels of Fusarium toxin contaminated maize in diets for female weaned piglets.

A dose response study was carried out with piglets to examine the effects of increasing amounts of Fusarium toxins in the diet on performance, clinical serum characteristics, organ weights and residues of zearalenone (ZON) and deoxynivalenol (DON) and their metabolites in body fluids and tissues. For this purpose, Fusarium toxin contaminated maize (1.2 mg ZON and 8.6 mg DON per kg maize) was incorporated into a maize based diet for piglets at 0, 6, 12.5, 25 and 50% at the expense of control maize. The experimental diets were tested on 100 female piglets allotted to 20 boxes (five animals per box) covering a body weight range of 12.4 +/- 2.2 kg to 32.5 +/- 5.6 kg. Voluntary feed intake and, consequently, body weight gain of the animals receiving the highest proportion of Fusarium toxin contaminated maize were significantly decreased while the feed conversion ratio was not affected by the treatment. The mean weight of the uterus related to the body weight of the animals of the same group was increased by almost 100% as compared to the control. For this group, significantly decreased values of total serum protein were determined, while the serum activity of the liver enzyme glutamate dehydrogenase and the serum concentration of the follicle stimulating hormone were decreased for all treatment groups receiving 6% contaminated maize or more in the diet. Serum concentrations of immuneglobulins were not consistently altered by the treatment. Corresponding to the dietary exposure, increasing concentrations of ZON and alpha-zearalenol were detected in the bile fluid, liver and in pooled urine samples. The metabolite beta-zearalenol was detected only in bile fluid. The total concentration of ZON plus its metabolites in bile fluid correlated well with the diet contamination (r = 0.844). DON was found in serum, bile fluid and pooled urine samples while de-epoxy-DON was detected only in urine. The serum concentration of DON correlated well with the respective toxin intake 3-4 h prior to slaughtering (r = 0.957). For all mentioned analyses of residues it has to be noted that toxin residues were detectable even if negligible concentrations were present in the diet.

Clinical findings in macular hole surgery with indocyanine green-assisted peeling of the internal limiting membrane.

PURPOSE: Indocyanine green (ICG) staining of the internal limiting membrane has facilitated ILM peeling in macular hole surgery. However, it has been reported that ICG-assisted peeling of the ILM may result in retinal damage and unfavorable functional outcome. Therefore, we analyzed our visual and anatomical results of ICG assisted macular hole surgery. METHODS: In a retrospective study the records of a consecutive series of 37 patients with full-thickness idiopathic macular holes operated with ICG-assisted ILM peeling by a single surgeon were analyzed. All patients underwent a standard three-port vitrectomy with surgically induced posterior vitreous detachment, staining of the ILM with ICG, peeling of the ILM in a circular manner around the fovea, and SF6 20% endotamponade. RESULTS: A total of 37 patients (37 eyes) were included in the study. The mean age was 69+/-7 years (range 52-81 years), and there were 26 women and 11 men. The follow-up ranged from 6 to 30 months (mean 18+/-6 months). At baseline visual acuity ranged from 20/400 to 20/40. Anatomically, 13 eyes had stage 2 holes, 21 eyes (57%) stage 3 holes, and three eyes stage 4 holes. At the postoperative visit (8-12 weeks after surgery) anatomical closure of the macular hole was achieved in 36 eyes. Visual acuity ranged between 20/400 and 20/20. At the last follow-up after initial surgery the macular hole was closed in all eyes. Visual acuity ranged from 20/200 to 20/20. CONCLUSION: In our retrospective series anatomical and functional results of macular hole surgery with ICG-assisted peeling of the ILM are satisfactory. Primary hole closure was achieved in 97% of eyes and visual acuity increased in 62% of eyes in our series.

The effect of increasing concentrations ofFusarium toxins in the diets for piglets on histological parameters of the uterus.

The effects of feeding diets containing 0.01, 0.06, 0.15, 0.22 and 0.42 mg zearalenone and 0.2, 0.8, 1.0, 1.9 and 3.9 mg deoxynivalenol per kg, coming fromFusarium toxin contaminated maize, on the uterus of 50 prepubertal piglets were investigated. The mean weight of the uteri of the animals which received the most contaminated diet was significantly increased at the time of slaughtering. The histological investigation showed no marked differences between the feeding groups. Histometrical parameters of the surface epithelium of the uterus and of the uterine glands were not altered by the treatment.

Effect of dietary beta-carotene on the early embryonic development and uterine fluid composition of gilts.

The role of beta-carotene in reproduction was investigated in gilts assigned to three dietary supplementations: VA (4000 IU vitamin A); VA + VA (4000 IU + 8300 IU); VA + BC (4000 IU + 100 mg beta-carotene) per kg diet for 14 weeks. Gilts were slaughtered at day 12 of gestation. In the VA + BC group, number of corpora lutea was lowest, but the number of embryos was greatest, resulting in a non-significant decreased prenatal mortality (p<0.07). The proportion of less developed spherical and tubular embryos compared with filamentous was greatest in the VA + BC group (p<0.01). No differences were observed for vitamin A and retinal binding protein (RBP) in the uterine fluid. When animals were grouped according to the development of blastocysts, vitamin A and RBP levels were higher in the VA + BC group with only filamentous embryos (p<0.01). This indicates that the supplementation of beta-carotene to gilts might affect embryonic losses possibly because of slower alterations in the uterine environment, resulting in a higher and less variable number of embryos, despite an apparently more heterogeneous development.

Histological findings of surgically excised choroidal neovascular membranes after photodynamic therapy.

AIM: To investigate effects of photodynamic therapy (PDT) on human choroidal neovascularisation (CNV). METHODS: Two patients with recurrences after PDT with verteporfin underwent surgical extraction of the CNV. Immediately after surgical excision the subfoveal neovascular membranes were divided for light microscopic and for electron microscopic processing. For light microscopy tissues were embedded in paraffin. Sections were stained with haematoxylin and eosin, and the periodic acid Schiff (PAS) reaction was performed to determine histological diagnosis and to ensure tissue quality. For electron microscopy the specimens were fixed in glutaraldehyde and embedded in epoxy resin. Semithin sections were stained with uranyl acetate and lead citrate and examined with a transmission electron microscope. RESULTS: Light microscopy showed thick fibrovascular membranes in both cases. On the outer surface remnants of retinal pigment epithelial cells resting on thickened inner aspect of Bruch's membrane were found. On the retinal side some outer segments were found. The membrane showed areas with irregularly shaped vessels. Electron photomicrographs showed occluded vessels within the CNV containing thrombotic masses and/or ultrastructural damage of the neovascular endothelium. Most of the vessels presented regressive changes with vacuolisation and fragmentation of the neovascular endothelium accompanied by disintegration of the endothelial cell layer. Extravasation of red blood cells was observed. Occasionally, vessels with normal endothelium containing intact red blood cells were observed. Some vessels contained immature endothelial cells. At some locations the retinal pigment epithelium cells (RPE) were metaplastic showing highly vacuolised cytoplasm. CONCLUSIONS: These findings suggest that the evidence of fluorescein leakage from the CNV and enlargement of the neovascular complex following PDT could be related to new vessel growth and recanalisation of occluded vessels. Additionally, RPE disturbances were observed in the specimens. This finding may be related to the original pathology or could indicate that PDT treatment may result in RPE atrophy.

[Endometrial hyperplasias: histology, classification, prognostic significance and therapy]. / Endometriale Hyperplasien: Histologie, Klassifikation, prognostische Bedeutung und Therapie.

Carcinomas of the endometrium are the most frequent neoplasias of the female genital tract. Precancerous lesions of the endometrium, including simple hyperplasia with and without atypism, complex hyperplasias as well as atypical complex hyperplasias occur 4.5 times more. The existence of hyperplastic or precancerous lesions of the endometrium is well established, but differences in terminology and difficulties in interpretation have complicated the communication between morphologists and clinicians. The risk of a metachronous endometrial carcinoma increases from about 1% in simple hyperplasia to 29-45% in atypical complex hyperplasia. Therapeutic procedures include the gestagen-therapy, depending from age and reproductive status of the women. Atypical complex hyperplasia requires the hysterectomy with bilateral salpingo-oophorectomy to treat a possible simultaneous carcinoma. Transvaginal sonography, hysteroscopy and pulsed Doppler sonography give additional informations and allows to distinguish a pathological from a normal endometrium. These methods may reduce the number of unnecessary diagnostic dilatation and curettage procedures, especially in patients with additionally cardio-vascular and other risk factors. But the histological examination of curettage material is still the "gold standard" for distinguishing between a normal and a pathologic endometrium. The classification and histologic criterias of precancerous lesions of the endometrium is presented and the need for better communication between pathologists and gynecologists is emphasised.

[Concentrations of 17 beta-estradiol, testosterone and progesterone in ovarian cyst fluid and intact ovarian follicles of swine]. / Konzentrationen des 17 beta-Ostradiols, Testosterons und Progesterons in der Flüssigkeit von Ovarialzysten sowie von intakten ovariellen Follikeln beim Schwein.

The concentrations of 17 beta-oestradiol, testosterone and progesterone were determined in the fluid of ovarian cysts of 80 sows. The cysts were grouped into the following categories: follicle theca cysts, follicle lutein cysts, lutein cysts, blood cysts and mixed forms. By comparison the concentrations of 17 beta-oestradiol, testosterone and progesterone were determined in the fluid of normal follicles of 100 pigs during the dioestrus, prooestrus and oestrus. The concentrations of progesterone were higher in the fluid of cysts of all groups investigated than in the fluid of normal follicles. The concentrations of 17 beta-oestradiol and testosterone were lower in the cyst fluid than in the follicular fluid. There were not serious differences in the hormone profiles of the cyst fluid between the cysts of the different categories.

[The occurrence of different forms of ovarian cysts in swine with special reference to their effect on the estrus cycle]. / Zum Vorkommen verschiedener Formen der Ovarialzysten des Schweines unter besonderer Berücksichtigung ihres Einflusses auf den Zyklusverlauf.

Ovaries of 100 sows with ovarian cysts were collected at the slaughterhouse after normal slaughter. The ovarian function was assessed macroscopically and representative sections of 55 ovaries were examined histologically. The cysts were grouped into the following categories: follicle theca cysts, follicle lutein cysts, lutein cysts, blood cysts and mixed forms with concurrent incidence of the above cyst forms. Only follicle theca cysts, follicle lutein cysts, lutein cysts or blood cysts were found in 24%, 7%, 32% and 10% of animals, respectively. In 27% of animals the above mentioned forms of cysts occurred concurrently. A large number of cysts per animal was found for follicle theca cysts (9.0 cysts per animal) and mixed forms (11.0 cysts per animal). Follicle lutein cysts, lutein cysts and blood cysts were developed in smaller numbers (3.1, 3.9 and 4.8 cysts per animal, respectively). Anestrus occurred only for follicle theca cysts, if their number exceeded 7 cysts per animal (13 per cent of the examined animals). Blood cysts occurred only during the metoestrus and follicle lutein and lutein cysts only during the corpus luteum phase. It is assumed that the cysts regress after the 13th day of the cycle, if normal corpora lutea are present at the same time. Only follicle theca cysts occurring in large numbers persist and block subsequent cyclic activity. There seems to be a particular predisposition for the development of cysts when the ovarian cycle is re-initiated after anestrus.

[Recovery and light microscopic evaluation of follicular oocytes of swine and relationship between the degeneration rate of oocytes and the estrus phase]. / Gewinnung und lichtmikroskopische Beurteilung follikulärer Oozyten des Schweines sowie Beziehungen zwischen der Degenerationsrate der Oozyten und der Zyklusphase.

Cumulus-oocyte complexes were recovered from 25 gilts by aspiration of follicular fluid or cutting of follicles from all Graafian follicles of greater than or equal to 3 mm in diameter during diestrus, proestrus or estrus. In 5 gilts the oocytes were collected post ovulation by flushing of oviducts. The recovery rate of follicular oocytes differed between 75.5% during the late diestrus (days 13-17) and 43.5% during the proestrus (days 18-21). During the proestrus and on day 1 of the estrus the recovery of oocytes was more difficult as a result of the higher viscosity of follicular fluid and the mucification of cumulus-oocyte complexes. The degeneration rate of oocytes was high during the diestrus with a peak at the time of regression of corpora lutea. From diestrus to the estrus the degeneration rate decreased. Following degeneration rates were found in the oocytes during the cycle: days 7-12: 38.8%, days 13-17: 50.0%, days 18-21: 29.6%, day 1 of the estrus: 10.8%, day 2 of the estrus ante ovulation: 11.8%, day 2 of the estrus post ovulation: 6.2%. Signs of degeneration were: Loss of cumulus cells (during diestrus and proestrus), damaged zona pellucida, enlargement of perivitelline space, deformation of oocyte, alteration of structure of the ooplasm, diameter of vitellus less than 100 microns. It was concluded that the selection of dominant follicles takes place in pigs during a long time of the cycle, especially during the diestrus. There were not any indications of a 2-wave hypothesis of follicular growth during the cycle in pig.

[Histologic and biochemical studies on the uteri of ovariectomized gilts during the first two months of pregnancy after different hormone substitutions. 1. Changes in the structure of the placenta during pregnancy weeks 3-8 after constant high doses of progesterone and estradiol benzoate]. / Histologische und biochemische Untersuchungen an Uteri ovarektomierter Jungsauen während der ersten zwei Graviditätsmonate nach unterschiedlicher Hormonsubstitution. 1. Mitteilung: Veränderungen der Struktur der Plazenta materna während der 3.-8. Graviditätswoche bei gleichbleibend hoher Applikation von Progesteron und Ostradiolbenzoat.

Sixteen pregnant gilts were ovariectomised (Groups 1 and 2: 11th to 15th days of gravidity, Group 3: 19th to 22nd days of gravidity, Group 4: 34th to 45th days of gravidity). Daily intramuscular injections of 120 mg of progesterone and 250 micrograms of oestradiol benzoate were applied to them, beginning on the day of ovariectomy to preserve gravidity. All experimental animals were sacrificed between the 21st and 25th days of gravidity (Group 1) and between the 31st and 37th days (Groups 2 and 3) as well as between the 52nd and 61st days (Group 4). Living and dead embryos were numerically recorded, and histological als well as biochemical studies were conducted in all uteri. Embryo survival rates were normal, that is between 62.8 and 80 percent in Groups 1, 2, and 3, with the numbers of living embryos being 9.5, 7.5, and 8.0. Gravidity-specific uterus alterations were typical, despite constant hormone substitution. The thickness of endometrium declined with significance over the period under review. Plication was intensified, while the surface epithelium was flattened. Vascularisation increased, particularly in the subepithelial region, and the endometrial stroma became more oedematous. Full functionality was retained by the uterine glands in the period under review (increase in glandular epithelium as well as rising activity of alkaline phosphatase). Significant increase was recorded from the activity of acid phosphatase, whereas glycogen concentrations went down in the myometrium.

[Histologic and biochemical studies of the uteri of ovariectomized gilts during the first two months of pregnancy after different hormone substitutions. 2. Effects of reducing the progesterone dosage on the survival rate of embryos and the structure of the placenta and the influence of oral administration of norgestrel]. / Histologische und biochemische Untersuchungen an Uteri ovarektomierter Jungsauen während der ersten zwei Graviditätsmonate nach unterschiedlicher Hormonsubstitution. 2. Mitteilung: Auswirkungen einer Reduzierung der Progesterondosis auf die Uberlebensrate der Embryonen und die Struktur der Plazenta materna sowie Einfluss einer oralen Verabreichung von Norgestrel.

Studies were conducted into ovariectomised gilts in early gravidity, with the view to finding out if reduction of daily progesterone doses had an impact upon embryo survival rate and on the structure of the placenta and if experimentally induced progesterone deficit could be offset by oral administration of norgestrel, a synthetic progestagen. Embryo survival were found to drop from 80 to 26.1 percent in response to reduced progesterone dosage from 120 mg to 40 mg, average numbers of living embryos per animal being 9.6 or 3.0. Oral administration of 12 mg of norgestrel, in addition to injection of 40 mg of progesterone, enhanced the survival rate to 64.6 percent, the average number of living embryos coming to 8.9. Reduction of progesterone doses compared to animals with sufficient progesterone supply. Depressed the beginning decrease of the thickness endometrium and surface epithelium oedematisation of the endometrial stroma was mitigated, and subepithelial hyperaemia disappeared altogether. The secretory activity of uterine glands declined, and so did the endometrial activities of acid and alkaline phosphatases. Administration of norgestrel proved helpful in substantive removal of manifestations observed in the progesterone deficit group.