Serum trace mineral variations in Nili-Ravi buffaloes suffering with prepartum vaginal prolapse in two different agro-ecological zones of Punjab, Pakistan.

The present study was conducted during 2005 and 2006 on 200 Nili-Ravi buffaloes kept in two agroecological zones (irrigated [zone 1] and rain-fed [zone-2]) of Punjab, Pakistan, with the objective to determine the level of trace minerals (Cu, Fe, Zn, Se) in serum of the buffaloes suffering from vaginal prolapse and to compare them with their healthy counterparts. In each zone 50 buffaloes suffering from prepartum vaginal prolapse during their seventh month of gestation were identified through survey. Vaginal prolapse-affected buffaloes belonging to zone 1 were identified as group VPB1 (N = 50), whereas buffaloes belonging to zone 2 were recognized as VPB2 (N = 50). The buffaloes of control group in zone 1 and zone 2 were identified as NCB1 and NCB2, respectively. The blood samples in all four groups of buffaloes were collected three times, i.e., first when these animals were in the eighth month of gestation, second during the eighth to ninth month of gestation, and finally when these animals were in the ninth or later month of gestation. The mean serum copper concentrations in buffaloes of group VPB1 were significantly lower (P < 0.05) in comparison with NCB1 and NCB2, whereas there were nonsignificant differences (P > 0.05) in copper concentrations between VPB1 and VPB2. There was a significant difference (P < 0.05) of iron concentration in VPB1 compared with NCB1 and NCB2. Similarly, VPB2 also had significantly lower (P < 0.05) iron concentrations compared with NCB1 and NCB2. Serum zinc concentrations were significantly lower (P < 0.05) in animals of the VPB1 group when compared with NCB1 and NCB2. Similarly, lower zinc concentrations were observed in VPB2 in comparison with NCB1 and NCB2. There was significantly lower (P < 0.05) zinc concentration in affected buffaloes (VPB1 and VPB2) from the ninth month of gestation to term when compared with those in the eighth to ninth mo of gestation, and with those not yet in the eighth month of gestation. Serum selenium concentration were significantly higher (P < 0.05) in control group buffaloes (NCB1 and NCB2) in comparison with vaginal prolapse-affected buffaloes (VPB1 and VPB2). During different stages of gestation, mean serum selenium concentrations varied nonsignificantly (P > 0.05) within each group of buffalo. Based on information obtained from this study, it was concluded that the low serum concentration of copper and selenium are linked to increased incidence of vaginal prolapse in buffaloes during the last trimester of gestation.

Histological, hormonal and biomolecular analysis of the pathogenesis of ovine Prolapsus vaginae ante partum.

The objectives of the present study were to evaluate the hormonal profiles, histology of the vagina and biomolecular analysis of connective tissue of ewes with and without vaginal prolapse. Blood samples from the jugular vein and biopsies of the vaginal tissue were taken from five late term pregnant, unaffected animals, four sheep during parturition and six ewes suffering from vaginal prolapse ante partum. The blood samples were submitted for determining the concentration of the steroid hormones progesterone by automatic luminescence immunoassay and estradiol-17ß by the sequence test. Investigations in the mRNA-expression including the estimation of the transcript levels of the α(2)-chain of collagen I, the collagenolytic metalloproteinase 1 (MMP 1), the tissue inhibitor of MMP 1 (TIMP 1) and the estrogen receptor α were carried out by using semiquantitative reverse transcription-PCR. Additionally, the histology of the vaginal wall of ewes with and without vaginal prolapse and animals intra partum was assessed. Because of a right-skewed distribution, data were logarithmised and described using the geometric mean (xg) and the dispersion factor (DF). The average progesterone concentration of affected ewes (xg = 19.35 ng/ml, DF 1.33) was above those of control animals ante (xg = 10.44 ng/ml, DF 1.58) and intra partum (xg = 9.24 ng/ml, DF 1.92). Compared to the pregnant control group (xg = 20.13 pg/ml, DF 1.49) the plasma levels of 17ß-estradiol in animals suffering from ante partum vaginal prolapse (xg = 27.81 pg/ml, DF 1.56) appeared to be slightly increased, but the difference was without statistical significance. The analysis of mRNA expression revealed a difference in the ante partum collagen metabolism in affected sheep. In prolapsed tissue the α2-chain of collagen I showed a decreased expression level in relation to the control animals in late-term pregnancy (P < 0.01). The average mRNA synthesis of MMP 1 or TIMP 1 in affected ewes was higher or lower, respectively, than the synthesis in healthy, late-term pregnant sheep. Significant differences were not observed. The production of transcripts of the estrogen receptor α was significantly decreased within the group of affected sheep compared to the unaffected pregnant ewes. Histological assessment showed that oedema was only detected in the subepithelial zone of the vaginal wall of intra partum sheep. There was no evidence for an inflammation of the prolapsed vaginal tissue since infiltration of leucocytes was present in all samples equally. The thickest vaginal epithelium due to hyperplasia of the epithelial cells was observed in sheep suffering from ante partum vaginal prolapse (xg = 83.95 µm, DF 1.21). This difference was statistically significant between the ante (xg = 31.12 µm, DF 1.22) and intra partum groups (xg = 33.27 µm, DF 1.24). Peripheral concentrations of progesterone and estradiol-17ß seem to have no influence on the occurrence of vaginal prolapse in ewes. Regarding histology of the vaginal wall in combination with the expression of local estrogen receptors, it was determined that there is neither a pronounced oedema nor an overexpression of the estrogen receptor α in affected animals, which means that no local estrogenic effect provokes the prolapse of vaginal tissue. The biomolecular analysis led to the new result, that ewes suffering from vaginal prolapse show alterations in the antepartal metabolism of vaginal connective tissue.

Markers of collagen synthesis and degradation in urogenital tissue and serum from women with and without uterovaginal prolapse.

Diverging results have been published concerning collagen metabolism in uterovaginal prolapse (UP). We have investigated collagen turnover in urogenital tissue in urologically healthy women with (UP patients) and without UP or any history of UP (controls). Markers of collagen turnover, carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of procollagen III (PIIINP) and carboxy-terminal telopeptide of type I collagen (ICTP) were assayed in urogenital tissue homogenates and serum. Tissue and serum concentrations of collagen turnover markers were related to UP and to menopausal/estrogen status. UP patients were significantly older than the controls. UP patients had significantly higher tissue PICP and PIIINP and significantly lower tissue ICTP levels than the controls, but the difference in ICTP disappeared after matching for menopausal/estrogen status and age. There were no associations between tissue collagen turnover markers on the one hand and menopausal/estrogen status or age on the other. The higher tissue concentrations of PICP and especially PIIINP in tissue from women with UP compared to controls, suggest an increased collagen breakdown in UP. This pattern differs from that in stress urinary incontinent women without UP, where tissue levels of collagen turnover markers are low, indicating reduced collagen breakdown.

Levels of tibolone and estradiol and their nonsulfated and sulfated metabolites in serum, myometrium, and vagina of postmenopausal women following treatment for 21 days with tibolone, estradiol, or estradiol plus medroxyprogestrone acetate.

Tibolone has estrogenic effects on the vagina but not on the uterus. To explain this, levels of tibolone and estradiol and their metabolites were determined in serum, myometrium, and vagina. Thirty-four postmenopausal women with uterine prolapse received either no treatment, tibolone, E(2) or E(2) + medroxyprogesterone acetate (MPA) for 21 days, or a single dose of tibolone. Twenty +/- 6 hours after administration, >98% of the 3-hydroxytibolone metabolites in serum and tissues were disulfated. Of the unconjugated metabolites, the estrogenic 3alpha-hydroxytibolone predominated in serum, whereas the progestagenic/ androgenic Delta(4)-tibolone predominated in myometrium and vagina. Levels of disulfated metabolites in serum and tissues were higher (3- to 5-fold) after multiple dosing than after a single dose. Tissue:serum ratios were <1, except for Delta(4)-tibolone. In all groups, E(2) tissue levels were higher than serum levels; the percentage of serum E(1)S was >90%. Tibolone did not affect endogenous E(1), E(2), or E(1)S levels in serum, but in myometrium and vagina, E(1) levels were significantly higher and E(1)S levels tended to be lower than in controls. Serum and tissue levels of endogenous and exogenous E(1), E(2), and E(1)S were markedly increased 20 hours after E(2) or E(2) + MPA; the percentage of E(1)S and tissue:serum ratios were not affected. MPA had no effect on the degree of sulfation of E(1). Compared with serum, tissue levels of E(2) were high in all groups; absolute E(2) levels in control and tibolone groups were much lower than in the E(2) groups. Tibolone metabolite patterns are different in serum, myometrium, and vagina.

Estrogen levels and estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse.

OBJECTIVES: To investigate the histologic characteristics of tissues presumed to be the cause of urinary stress incontinence and pelvic organ prolapse. METHODS: Cardinal ligament and uterosacral ligament samples were obtained from 73 women undergoing hysterectomy. The evaluation of estrogen receptors (ERs) by immunohistochemical staining was semi-quantitative. Serum estrogen was determined by ELISA. Statistical analyses were performed by the independent-sample t-test and one-way ANOVA. RESULTS: Serum estradiol levels and ER values in the premenopausal women with pelvic organ prolapse were significantly lower than in the control group (P<0.01). A positive correlation was found between ERs and the number of postmenopausal years (P<0.01). ER values were similar in the cardinal and uterosacral ligaments. CONCLUSIONS: Serum estrogen levels and ER values are significantly lower in the uterine ligaments of premenopausal women with pelvic organ prolapse, and there was a positive correlation between ER values in the uterine ligaments and the duration of postmenopausal years. Serum estrogen levels and ER values were similar in the cardinal ligament and the uterosacral ligament.

Uterine prolapse in 2 dromedary camels.

Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels.

Hormonal patterns in postmenopausal women during gynecological surgery.

The endocrine effects of surgical trauma are incompletely understood. We have measured serum levels of cortisol, 17 alpha-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHA), 4-androstene-3,17-dione (A4) and total (free + conjugated) estrone (tE1) before, during and up to 6 days after surgery in 30 postmenopausal women undergoing repair of vaginal prolapse. Anesthetic procedures were standardized. During surgery and the early postoperative hours the serum steroid pattern closely resembled that found during a diagnostic ACTH challenge test with a simultaneous increase in all adrenocortical steroids, while tE1 levels were unchanged. During the late postoperative period the levels of cortisol, 17-OHP and A4 were still elevated up to 24 h after surgery while the levels of DHA were normal or even decreased. The postoperative pattern of adrenocortical steroids may reflect a redistribution of the intra-adrenal steroid flux in favor of cortisol production. The tE1 levels were elevated in the early and, most pronounced, in the late postoperative phase. tE1 was positively correlated to A4, in the early but not in the late postoperative phase. The late increase in tE1 probably reflects an impaired bowel function in connection with surgery, leading to increased reabsorption during enterohepatic circulation.

[Heparin-associated type II thrombocytopenia as a cause of multiple thromboembolism complications]. / Heparin-assoziierte Thrombozytopenie Typ II als Ursache multipler thromboembolischer Komplikationen.

13 days after hysterectomy and subcutaneous treatment with unfractionated heparin (10000 IU daily) a 68 year old women developed a pulmonary embolism and deep vein thrombosis of the right leg. She thereupon received intravenous heparin (1000 IU/h). Eight days later she developed acute ischaemia of both legs, and Doppler examination revealed acute Leriche's Syndrome with thrombosis of both iliac arteries. Platelet count fell from, initially 152 x 10(9)/I, to 44 x 10(9)/I. Although heparin-associated thrombocytopenia type II was suspected a confirmation by demonstrating a heparin dependent antibody with the heparin-induced platelet activation (HIPA)-test failed and therefore crossreactivity of low molecular heparins or heparinoids could not be assessed. After discontinuation of heparin and iliacal artery thrombectomy a combination therapy with aspirin plus ticlopidine (500 mg/d respectively) was started and continued until phenprocoumon could exert its full effect. No recurrent thromboembolic events occurred, the platelet counts normalized and the patient fully recovered.

Nutritional factors associated with vaginal prolapse in ewes.

Serum calcium, magnesium and phosphate values of ewes recently affected by vaginal prolapse were compared with unaffected ewes in four flocks. Subclinical hypocalcaemia was demonstrated in some affected and unaffected ewes in three flocks. Magnesium and phosphate values were normal. In two flocks the body condition of ewes recently affected by vaginal prolapse was variable and reflected the variation in condition found in the flock. In a third flock affected ewes had significantly lower body condition scores than unaffected ewes (P less than 0.001). Analysis of the fourth flock was not possible. Oestrogenic mycotoxins were not detected in any of the feed samples taken from these flocks. The following year the management, nutrition and energy, and the protein and calcium status of ewes in 12 flocks of greyface/mule ewes with a history of a regular high (greater than 3 per cent) or low (less than 1 per cent) prevalence of vaginal prolapse were compared. A high prevalence was not associated with any particular feedstuff. A high or intermediate (1 to 3 per cent) prevalence of vaginal prolapse was found in three of the four flocks managed as a single group and these three flocks were fed on an unrestricted basis. Body condition scoring and beta-hydroxybutyrate estimation confirmed that ewes in these flocks were overfed. The prevalence of vaginal prolapse in the flocks was not related to the serum albumin, calcium or urea of the ewes. Therefore subclinical hypocalcaemia was probably a consequence of vaginal prolapse rather than a cause.

Morphology of menstrual hemostasis in essential menorrhagia.

We performed a morphologic and morphometric study with light and electron microscopy on early menstrual hemostasis in five menorrhagic uteri and one control uterus, related the data to measured menstrual blood loss and compared the data with our previous study on normal menstruation. Menstrual blood loss ranged from 39 to 234 ml. Menorrhagic uteri contained large hemostatic plugs, protruding with a large part into the extravascular space. These plugs often consisted of loosely packed, poorly degranulated platelets with few fibrin fibers. Recanalized plugs, consisting of fibrin fibers and platelet remnants at the periphery of the vessel, were also observed in menorrhagic uteri. Using morphometry, we demonstrated a positive correlation between menstrual blood loss and the number of occlusive and nonocclusive hemostatic plugs, but not with other aspects of hemostatic plug formation such as the vessel area occluded by the plug, plug transformation, or intra- or extravascular localization of the plug. Vasodilation or endometrial height were not correlated with the amount of menstrual blood loss. These data suggest that essential menorrhagia is associated with fragile hemostatic plugs or with more extensive vessel damage.

Studies on antepartum prolapse of the vagina in buffalo--plasma trace element concentrations.

Plasma micro-element concentrations of copper, zinc, iron, and manganese were studied in 25 buffaloes at varying stages of gestation, between 7 months to term and with varying degrees of vaginal prolapse. A similar number of animals, normally pregnant at identical stages and with no previous history of antepartum vaginal prolapse, was used for control purposes. Plasma iron and manganese concentrations in affected animals were similar to values in normal pregnant animals at all stages. However, plasma copper levels were slightly but not significantly lower in affected animals at all stages, whereas plasma zinc concentrations were significantly low in affected animals from 9 months to term. Possible interactions are discussed between plasma copper and zinc levels, on the one hand, and hormones, like oestrogens and cortisol, on the other.

A note on post partum utero vaginal prolapse in Gir cows: estimation of serum calcium, phosphorus, proteins, and cholesterol.

Reported are results obtained from determination of calcium, phosphorus, protein, and cholesterol in blood serum of 10 Gir cows with uterine prolapse. Particular reference is made to possible adverse effects of hypocalcaemia in conjunction with physiological stress resulting from pregnancy and parturition.

[Effect of hysterectomy in swine on health status and various indicators of peripheral blood. II. Hematological studies]. / Wplyw amputacji macicy u swin na stan zdrowia i niektóre wskazniki krwi obwodowej. II. Badania hematologiczne.

The effect of uterus amputation in various physiological and pathological conditions on the morphological picture of the peripheral blood in pigs was studied. It was found that amputation of the uterus in sows caused a decrease in the level of haematocrit and haemoglobin, in the number of erythrocytes and an increase of leucocytes. In the leucocyte picture an increase of segmented and rod-shaped granulocytes and a decrease of lymphocytes, eosinophils and basophils were found. The greatest changes observed were in the group of sows which were amputated pregnant uterus, the uterus short after delivery and that pathologically changed. The return of most of the indices studied to physiological values depended on the magnitude of the operation trauma and health condition of the pigs before operation.

[Effect of hysterectomy in swine on health status and various indicators of peripheral blood. III. Serum electrolyte levels]. / Wplyw amputacji macicy u swin na stan zdrowia i niektóre wskazniki krwi obwodowej. III. Zachowanie sie elektrolitów w surowicy krwi.

The studies carried out on sows which were amputated the uterus in various physiological and pathological conditions showed that this operation caused a decrease in the content of sodium and chloride and an increase of magnesium in blood serum. The changes in the level of electrolytes were the highest in the groups of sows which were amputated unpregnant and pregnant uterus and that short after delivery.