Hormonal status and mycoplasma colonization in the female genital tract

Three hundred seventy-four cervical or vaginal specimens from patients with various hormonal states were cultured for Ureaplasma urealyticum and Mycoplasma hominis. Significantly, low recovery rates of U urealyticum were obtained in the prepuberty (5%), puerperium (24%), and postmenopause (25%) groups, whereas pregnant women showed the highest incidence of U urealyticum (82%). The recovery rate of U urealyticum from neonates was 42%. The incidence of U urealyticum in sexually inactive females was significantly lower (40%) than that in sexually active nonpregnant women (67%). Significantly, a higher incidence (36%) was observed in postmenopausal women with a uterine cervix than in those whose cervix had been removed by surgery (10%). It is suggested that there is a close relationship between hormonal status and the occurrence of genital mycoplasmas. Possible modes of transmission of genital mycoplasmas other than sexual contact are also discussed.     

Genital mycoplasma colonization in neonatal girls

Specimens obtained from the genital tract of 90 pairs of mothers and their female infants were cultured for Ureaplasma urealyticum (Ureaplasma) and Mycoplasma hominis (M.hominis). Ureaplasma and M.hominis were isolated from 80% and 17% of pregnant women, and 41% and 4.4% of female infants, respectively. Fifty nine per cent of infants were positive for Ureaplasma when they were borne per vaginam by Ureaplasma-positive mothers. However, Ureaplasma was not isolated from any of 11 infants delivered by cesarean section before rupture of the fetal membranes, in spite of positive colonization by Ureaplasma in the mothers. Quantitation of Ureaplasma revealed that neonatal colonization was closely associated with the colonization number of this microorganism in the cervical canal of mothers. Prolonged interval between rupture of fetal membranes and delivery caused a slightly increased frequency of isolation of this organism, but it was less significant. A study of mean birth weight revealed that there was no correlation between maternal or neonatal colonization by Ureaplasma and low birth weight.     

支原体在女性生殖道感染中的定位

支原体感染在临床上是热点问题,常见支原体为解脲支原体、人型支原体、生殖支原体。对于不同的疾病状态,不同的支原体意义并不相同。解脲支原体可导致尿道炎、绒毛膜羊膜炎,但正常女性阴道携带率非常高,临床意义经常被夸大。生殖支原体可导致宫颈炎、尿道炎、盆腔炎,但我国大部地区未能开展此项检查,故常常被忽视。人型支原体常见于细菌性阴道病及盆腔炎。对于不同的支原体检出,需要根据临床情况区别对待。     

Mast cells in the female genital tract

Mast cells in the human uterus and adnexa have been studied using basic lead acetate fixation and a long toluidine-blue technique to maximise the numbers of cells stained. Counts were performed on measured areas of tissue and the numbers of mast cells related to clinical and pathologic variables. Considerable variation in numbers was found among individual cases at all the sites studied. In the endometrium and myometrium, a drop in the number of mast cells has been demonstrated with advancing age, particularly after menopause. In leiomyomas the highest counts were in the smaller and more cellular lesions. It is concluded that the numbers of mast cells are at least partly related to the degree of cellularity or atrophy of the surrounding tissues. No significant association was found with menorrhagia or with the presence of leiomyomas.     

Tamoxifen and the female genital tract

Ugwumadu AHN, Carmichael P, Neven P. Tamoxifen and the female genital tract. Int J Gynecol Cancer 1998; 8 : 6–15.
Tamoxifen was originally developed by Imperial Chemical Industries (England) (ICI) in 1966 as an anti-estrogenic contraceptive. Ironically, it found a role in the treatment of anovulatory infertility, but its most important application to date is in adjuvant hormonotherapy for breast cancer. Tamoxifen has a complex and poorly understood mix of estrogenic and anti-estrogenic properties with variable and contrasting effects on hormone-sensitive target tissues, such as the endometrium. This article reviews the gynecologic lesions associated with tamoxifen therapy and discusses the merits and acceptability of endometrial surveillance tests and the role of progestogens.     

Microbiology of the female genital tract

Patients who contract genital tract infections are predominantly young, are otherwise healthy, and generally respond well to treatment for bacterial infections. These infections are most commonly polymicrobial in etiology, with several noteworthy exceptions. Often there is an inciting event such as childbirth, surgical intervention, pregnancy termination or intrauterine contraceptive device insertion. With treatment, prognosis for cure is excellent; however, sequelae such as recurrent infections, infertility, or ectopic pregnancy can be serious. Bacteria encountered in the female genital tract can be divided into aerobic and anaerobic organisms. Among the aerobic gram-positive organisms, several varieties of streptococci such as Group B streptococci and enterococci occur frequently. Staphylococcus aureus is an infrequent but important pathogen. Among the aerobic gram-negative organisms, the most common is Escherichia coli. Klebsiella sp. and Proteus sp. occur in about 5% of genital tract infections. Species that are more resistant to antibiotics, such as Pseudomonas aeruginosa and Enterobacter sp., occur in approximately 1% or 2% of these cases and are more likely to appear in patients who have previously received antibiotic therapy or who have been hospitalized for some time. Among the anaerobic organisms, the most common gram-positive isolates are Peptostreptococci and Peptococci. Clostridia sp. occurs less frequently. Among the anaerobic gram-negative organisms, the Bacteroides sp. most frequently encountered are Bacteroides bivius and Bacteroides disiens. Bacteroides fragilis is still a common problem but appears to be less predominant. Other organisms encountered are Chlamydia trachomatis, the genital mycoplasmas, yeasts, protozoa, and viruses.     

Adrenoceptor function in female genital tract

The function of adrenoceptors in the female genital tract was tested estimating the uptake of 3H-noradrenaline (3H-NA) in vitro in oviductal, uterine arterial and myometrial tissue samples obtained from 74 women. The highest 3H-NA value, 64 +/- 5 ng/g, was in the oviduct (p less than 0.001 vs. uterine artery and myometrium). The uterine isthmus showed some higher uptake capacity for 3H-NA than did the uterine fundus: 24 +/- 2 vs. 20 +/- 1 ng/g, respectively (p less than 0.05). No difference was found between the 3H-NA values for the proliferative and the secretory phase in tissues examined. High concentrations of oestradiol and progesterone effectively inhibited the 3H-NA uptake (p less than 0.05-0.001). Inhibition was greatest in the oviduct and lowest in the uterine fundus and weaker at the lower concentrations of oestradiol and progesterone.     

Actinomyces infection in female genital tract

OBJECTIVES: To analyze clinical and laboratory characteristics of patients with pelvic actinomyces. STUDY DESIGN: We studied five patients with pelvic actinomyces who were admitted between January 1, 2002 and December 31, 2002. The initial complaints, diagnostic methods, therapeutic alternatives and results of the therapies were examined. RESULTS: The ages of the cases varied between 32 and 52 years old. All five patients had been using an intrauterine device. Three cases had hydronephrosis due to infection. Two patients were diagnosed postoperatively while the other three cases were diagnosed with cervical smear and endometrial biopsy; penicillin G was administered to all. The patients are still under surveillance, and without any problems. CONCLUSION: In patients with an intrauterine device, actinomyces should be remembered in differential diagnosis of pelvic infections. Preoperative diagnosis is of the utmost importance in order to prevent morbidity of this infiltrative infection. Long-term penicillin therapy proved to be successful. Complicated or resistant cases to medical therapy should be candidates for surgical therapy.     

Beta interferon therapy of HPV infections of the female genital tract]

The aim of the study was to evaluate the incidence of cervical and vaginal lesions due to Papilloma virus before and after beta-interferon therapy. Clinical symptoms and the therapeutic approach are described, whereas drug efficacy was assessed on a long-term basis. The study of 19 cases, brought to the Author's attention over an eight-year period (1984-91) confirms previously published reports: the use of interferon shows a good level of tolerability without complications and undeniable efficacy following surgical treatment.     

Synchronous associations of tumors in the pelvic organs of the female genital tract]

The Authors report their findings concerning the synchronous associations of tumours involving pelvic organs in the female genital tract observed at the Gynecological Clinic, Aquila. From January 1980 to December 1991, 9 cases (4.28%) of synchronous tumours were found in a total of 210 cases of womb, ovary and vagina tumours. The paper examines the clinical problems and questions of anatomopathological characterisation raised by these associations.     

Angiogenesis in malignancies of the female genital tract

OBJECTIVE: The purpose of this work was to review current knowledge pertaining to angiogenesis in malignancies of the female genital tract. METHODS: We identified studies published in the English language regarding angiogenesis in gynecologic malignancies. The studies were obtained from a MEDLINE search from 1966 through June 1998; additional sources were identified through cross-referencing. RESULTS: A growing body of evidence confirms the ability of vulvar and cervical squamous cell carcinomas and endometrial and ovarian adenocarcinoma to induce angiogenesis. In vulvar intraepithelial neoplasia a correlation between vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), and progression of dysplasia has been demonstrated. In invasive vulvar carcinoma, high VEGF expression and MVD portend poor prognosis. Currently a debate exists regarding the ability of cervical squamous intraepithelial neoplasia to induce angiogenesis. Most studies, however, indicate angiogenesis to be of prognostic value in patients with invasive squamous cell carcinoma. The ability of complex endometrial hyperplasia to induce angiogenesis has been demonstrated. A direct correlation between angiogenesis, higher grade and depth of invasion in Stage I adenocarcinoma, and prognostic value in Stage I and II and recurrent disease has been noted. In ovarian epithelial adenocarcinoma, higher microvessel counts in the primary ovarian tumor or omental metastases may serve as a prognostic indicator for survival. CONCLUSIONS: Similar to other malignant diseases, angiogenesis appears to play an important role in disease progression and survival in patients with gynecologic malignancies. Preliminary data indicate angiogenesis may serve as a prognostic indicator in vulvar and cervical squamous cell carcinomas and endometrial and ovarian adenocarcinomas. These findings may lead to future application of therapeutic trials with antiangiogenic factors.