Development of uterine adenomyosis after treatment with dopamine antagonists in mice

Development of uterine adenomyosis was studied in SHN mice treated with psychotherapeutic drugs, sulpiride and perphenazine, and gastroenteric drug, metoclopramide, which act as dopamine antagonists to increase prolactin release from the pituitary gland. Administration of these drugs twice daily for 40-70 or 40-90 days of age induced an elevation in serum level of prolactin. Furthermore, the treated mice showed a prolongation of metestrous plus diestrous phase and a high incidence of uterine adenomyosis compared with vehicle-treated control mice. These results indicate that hyperprolactinemia produced by continuous treatment with psychotherapeutic and gastroenteric drugs is responsible for the occurrence of irregular estrous cycles and the genesis of uterine adenomyosis in mice.

[Changes in blood levels of progesterone, triiodothyronine and thyroxine and the results of quantitative histological analysis of the placentoma and corpus luteum in cows after prolonged labor]

Changes in the cell structure of the placentoma and the corpus luteum were subjected to quantitative histological investigation, parallel with the examination of the concentrations of progesterone (P4), triiodotyronine (T3) and tyroxin (T4) during parturition (Oth hour) and two and six hours after parturition. The hormone concentrations were determined by the RIA method. The results of the quantitative histological analysis of the placentomae and the corpus luteum suggest that when the placenta is retained there is a significantly higher number of maintained epithelial cells in the placentoma crypts and a higher number of unchanged small, dark and large, light lutein serraetion cells in the biopsy of the corpus luteum during the period under investigation. The morphological finding significantly correlates with higher concentrations of P4 in the blood of the cows with retained placenta, as compared with those whose placenta was not retained. It can be derived from the pattern of changes in T3 and T4 concentrations, compared with P4 and with the histological finding, that there is a functional relationship between the placentoma, corpus luteum, and the thyroid gland.

Inspection of the ovaries and steroids in serum and peritoneal fluid at various time intervals after ovulation in fertile women: implications for the luteinized unruptured follicle syndrome

In 20 fertile women one menstrual cycle was monitored by ovarian ultrasonography, laparoscopy, and estimation of 17 beta-estradiol (E2) and progesterone levels in serum and peritoneal fluid (PF). Three groups were studied, performing the laparoscopy within 1, 3, and 5 days after ovulation. The results indicate that the opening in the corpus luteum remains at least during the first 1.5 postovulatory days. The process of the closure starts thereafter and has been accomplished 4 to 5 days after ovulation. Progesterone and E2 levels in PF follow a similar pattern, showing high levels in the first, decreasing levels in the second, and low levels in the last laparoscopy groups. Therefore the significance of inspection of the ovaries and hormone level estimation in PF depend on the timing of the laparoscopy in relation to the moment of ovulation, especially in the first 5 postovulatory days.

Luteal cysts and unexplained infertility: biochemical and ultrasonic evaluation

A prospective, controlled study of ovarian function using ovarian ultrasound and daily plasma hormone estimations (estradiol, progesterone [P], follicle-stimulating hormone [FSH], luteinizing hormone [LH]) was carried out on 175 spontaneously cycling patients with unexplained infertility. Forty-one (23.4%) demonstrated luteal phase cyst formation. In 21 cycles the dominant follicle reduced in size after the LH peak (cystic corpus luteum cycles), and in 20 no shrinkage was seen (luteinized unruptured follicles). Progesterone concentrations in the early luteal phase were significantly reduced in the luteinized unruptured follicle cycles. Elevation in plasma FSH was seen in the early follicular and luteal phases of both cyst forming groups and may be due to disturbances in ovarian metabolism. Follicular rupture is important for efficient P release by the corpus luteum.

Autoimmune oophoritis: a clinicopathologic assessment of 12 cases

Twelve cases of histologically confirmed autoimmune oophoritis are described. Eight presented with symptoms and laboratory evidence of premature ovarian failure (POF). Four were diagnosed unexpectedly after hysterectomy for endometrial pathology or for sequelae of cystic enlargement of the ovaries. Two of eight patients tested had serum anti-ovarian autoantibodies (Aab), while five of seven had anti-adrenal Aab. Two women had, or subsequently developed, Addison's disease, and two patients had Hashimoto's disease at presentation. All women with this disease risk the development of adrenal failure and hypothyroidism. Microscopically, 11 cases showed a lymphoplasmacytic infiltrate that spared primordial follicles but involved, with progressive intensity, early and late preovulatory follicles and corpora lutea. Sparse perivascular and perineural inflammatory infiltrates were also present. The twelfth case appeared to be a unique case of granulomatous oophoritis, considered autoimmune because of the folliculotropic nature of the inflammatory process. Three cases showed evidence of follicular dysplasia.

[The effect of Enzaprost-F (PGF2) cervical tablets on the corpus luteum in the human body]

Authors removed dextro-ovary of a patient having 7-9th week of gestation for ovarian cyst during abortion. Preoperative cervical dilation was performed by Enzaprost-F cervical tablet containing 20 mg PGF2 agent. Before and 2, 4 and 6 hours after treatment, serum-progesterone and 17-beta-estradiol level was determined. Drug cervical dilation enabled instrumental termination of pregnancy within 4 hours. Histological finding of yellow body showed initial signs of colloid-cystic degeneration, which was followed by minimal decrease of values of serum-steroid concentrations. Authors presume that change in histological picture of yellow body was caused by effect of cervical tablet containing PGF2 agent.

Remission of the polycystic ovarian condition (PCO) in the rat following hemiovariectomy

The estradiol valerate-induced polycystic ovarian condition in the rat represents a normal ovarian response to aberrant endocrine stimuli. Although we have shown that removal of one polycystic ovary (hemiovariectomy) results in restoration of cyclicity and normal morphology in the remaining ovary by 1 week, nothing is known about the process of recovery or about the role of the hypothalamo-pituitary unit in initiating recovery. We have therefore examined ovaries at 3, 12, 24, 48, and 120 hours following removal of the contralateral polycystic ovaries. The ovarian content and size distribution of healthy and atretic follicles was determined, as well as the occurrence of follicular cysts, type III large follicular structures, and corpora lutea. The plasma LH pattern was also examined at a short postoperative interval. At 3 hours, there was a significant increase in mean ovarian weight that coincided with the emergence of healthy large secondary follicles. By 12 hours, there was a significant sustained diminution in the number of atretic follicles of all sizes, but the total number of healthy follicles did not increase significantly until 120 hours. The cystic follicles had all but disappeared by 120 hours because of mechanical compression by newly developing ovarian tissue. Ovarian recovery is, therefore, biphasic, consisting of a very early diminution in atresia coincident with, and perhaps caused by, a major alteration in the plasma LH pattern. The second phase is characterized by a wave of follicular recruitment and development.

Ovarian malignant luteinized thecoma--an unusual tumor in an adolescent

Malignant luteinized thecoma is an extremely rare ovarian tumor. The fifth reported case of this tumor presenting in a 13-year-old epileptic child on anticonvulsant therapy with a rapidly enlarging pelvic-abdominal mass is discussed. At laparotomy, bilateral ovarian involvement, massive ascites, and omental and bowel serosal metastases were present. The pathological diagnosis was difficult with initial diagnoses of ovarian edema, endodermal sinus tumor, and ovarian fibrosarcoma. The final diagnosis of malignant luteinized thecoma was made by recognizing the presence of lutein cells with foamy vacuolated cytoplasm and intracytoplasmic staining for oil red O. Electron microscopy also demonstrated vacuolated cells with multiple fat globules. After surgical debulking the patient was treated with combination chemotherapy with complete response. The similarities of this case to three previously reported bilateral thecomas presenting in children on anticonvulsant therapy is discussed.

Luteal phase defect: the possibility of an immunohistochemical diagnosis

Monoclonal antibody D9B1 has been shown to bind to a carbohydrate epitope associated with high molecular weight secretory sialoglycoprotein(s) of human endometrium. The authors demonstrate that, in a group of 28 patients diagnosed on the basis of histopathologic assessment as exhibiting luteal phase defect, 68% reveal significantly diminished expression of the epitope. Furthermore, histologic assessment of the secretory activity in single glands does not correlate simply with the level of expression of the epitope. Of specimens from patients complaining of infertility, 92% showed defective production of the D9B1 epitope. Thus, D9B1 immunohistochemistry provides a new molecular criterion for defective endometrial function.

Evaluation of histopathologic and physiologic changes in cows having premature births after consuming Ponderosa pine needles

Premature calving, typified by early expulsion (17 to 43 days) of weak or dead calves and accompanied by retained placentas, was induced in 8 of 9 pregnant cows fed a mixture of Ponderosa pine needles and alfalfa hay. Five control cows of comparable gestation age fed only alfalfa hay maintained normal pregnancies until they were euthanatized at the time the pine needle-treated cows were producing premature calves. Serum specimens from all cows were assayed for progesterone concentration and ovaries and placentomes were examined for histopathologic changes. There were no bacterial, fungal, chlamydial, or viral agents determined to be associated with the premature births. Serum progesterone concentration in the treated cows decreased progressively and were 0.4 to 1.5 ng/ml at the time of premature calving. Histopathologic changes were evident in the placenta and corpora lutea of treated cows only. The number of binucleate trophoblastic giant cells in placentomes was less than normal and the number of necrotic luteal cells in corpora lutea was greater than normal.

Quantitative light microscopic analysis of corpus luteum growth during pseudopregnancy in the rabbit

We employed stereological methods at the light-microscope level to examine the mechanism by which corpora lutea (CL) grow during the course of pseudopregnancy in the rabbit. Corpus luteum volume per ovary, the absolute volume of luteal cells per CL, individual luteal cell volume, the number of luteal and endothelial cells per CL, and capillary surface area per CL were examined in rabbits at Days 1, 4, 7, 11, and 18 of pseudopregnancy. Total CL volume increased from 3.7 +/- 0.1 microliter to 30.3 +/- 0.5 microliter over Days 1 to 11 and thereafter decreased to 15.2 +/- 1.1 microliter by Day 18. Stereological analyses showed that the increases in CL volume from Day 1 to Day 11 were due primarily to increases in the volume of individual luteal cells (from 2.6 +/- 0.2 pl on Day 1 to 23.5 +/- 1.7 pl on Day 11, 1 pl = (10 mu)3; r = 0.96), and that the decrease in CL volume after Day 11 resulted largely from a decrease in luteal cell volume (to 12.8 +/- 1.5 pl). In contrast, no change was seen in the number of luteal cells per CL (range 9.1 x 10(5)-12.5 x 10(5)). These data show that CL growth and subsequent regression during pseudopregnancy result primarily from changes in the volume of individual luteal cells, and not from changes in the number of luteal cells. These data support the hypothesis that modulation of progesterone production during pseudopregnancy is due to changes in individual luteal cell volume and not to changes in cell number.

On the rate of tubal pregnancy contralateral to the corpus luteum

Ectopic implantation of the embryo in the tube opposite to the ovary containing the corpus luteum constitutes evidence of peritoneal or uterine transmigration of the egg. The frequency of this phenomenon was reinvestigated utilizing histopathologic confirmation of the side of the corpus luteum. A tubal pregnancy contralateral to the ovulating ovary was found in 28% of 67 cases, indicating that either the oocyte, the zygote or the embryo had entered the tube in which implantation took place from a medial site such as the peritoneal or the uterine cavity rather than directly from the ovulating ovary. Assuming that once in the medial site there is equal chance of entering either tube, it follows that in 56% of tubal pregnancies the egg has entered the tube from a midline location. Attempts to recover the oocyte from the tubes in normal women were successful in fewer than 5% of cases contralateral to the corpus luteum. It is concluded that tubal pregnancy is associated with a significant increase in the occurrence of transmigration of the egg.

The contralateral corpus luteum and tubal pregnancy

One hundred fourteen cases of tubal pregnancy were examined for evidence of active or chronic salpingitis, other anatomic and functional etiologies, and the side of the corpus luteum relative to the pregnancy. A corpus luteum was found ipsilateral to the tubal pregnancy in 80 cases (70%) and contralateral in 18 (16%). In 16 cases (14%), the position of the corpus luteum could not be identified by inspection. No differences were noted among the groups in days from last normal menstrual period or the incidence of irregular bleeding. Of the 98 cases in which a corpus luteum was identified, 53 women (54%) had at least one condition that could be considered etiologic for tubal pregnancy, including 38 (39%) who had microscopic evidence of chronic salpingitis. No association was found between the laterality of the corpus luteum and the presence of risk factors, including mechanical factors. Possible explanations for absent corpora lutea in association with tubal pregnancies are discussed.

Massive multiple theca lutein cysts complicating nonmolar pregnancy

A case of massive bilateral multiloculated theca-lutein cysts occurring in association with a nonmolar singleton pregnancy is described. Surgical removal of the cysts became necessary and was followed some weeks later by the spontaneous rupture of the membranes at a nonviable stage of gestation.

[The corpus luteum in the ultrasound image and its endocrine function]

The corpora lutea of 38 patients with sterility problems were sonographically measured. In a total of 51 cycles the corpus luteum values were compared with the estradiol (E2) and progesterone (P) plasma levels on the day of sonographic examination (SE). In 49 SEs performed immediately following ovulation the corpus luteum was cystic in 26 cases (means = 14.9 mm) and solid in 23 cases (means = 12.8 mm, p less than 0.05). The postovulatory differences between the corresponding E2 and P values, respectively, were not significant. In the midluteal phase the corpora lutea were cystic in 22 cases (means = 18.2 mm) and solid in 14 (means = 13.4 mm, p less than 0.001). Both E2 (means = 362.8 pg/ml) as well as P (means = 27.7 ng/ml) were higher in the women with cystic than in those with solid corpora lutea (E2 means = 222 pg/ml; P means = 19.4 ng/ml; p less than 0.01 in each case). When the patient collective was split into two groups, with and without stimulation therapy, a significantly higher E2 was only found in the "with therapy" group in patients with cystic corpus luteum in the midluteal phase. The size of the midluteal corpus luteum correlated in particular with the E2 plasma concentrations in all patients (p less than 0.005). Thus, in addition to sonographic measurement of the endometrium, sonographic demonstration of the corpus luteum is also useful in assessing the luteal phase.

Influence of age on induction of mammary tumors by diethylstilbestrol in C3H/HeN mice with low murine mammary tumor virus titer

C3H/HeN female mice with low murine mammary tumor virus titer (MTV-) were fed diets containing a targeted concentration of 640 ppb diethylstilbestrol [(DES) CAS: 56-53-1; 4,4'-(1,2-diethyl-1,2-ethenediyl)bis-phenol]. Mice were started on DES at 3, 5, 7, or 9 weeks of age. Some continued on the diet throughout the rest of their life-spans, whereas others were killed as soon as they had been fed DES for 2, 4, 6, 8, 10, or 12 weeks. Controls were also examined throughout the study. Among mice killed early, the only observation significantly influenced by age at the start of DES treatment was the presence or absence of corpora lutea (CL). DES did not prevent CL from appearing in mice started on DES at 7 or 9 weeks of age, but it did prevent their appearance in about 25% of the mice started at 5 weeks and in up to 75% of the mice started at 3 weeks of age. In the life-span-exposure groups, CL either disappeared or were never formed in 88% or more of the mice, regardless of age at the start of treatment. Neoplastic or presumptive preneoplastic lesions apparently influenced by DES in the life-span-treatment groups included ovarian tubular adenomas; granulosa cell tumors and luteomas; pituitary cystoid degeneration, hyperplasia, and adenomas; uterine adenocarcinomas and cervical adenosis; mesotheliomas; and mammary hyperplastic alveolar nodules (HANs) and adenocarcinomas. Luteoma and granulosa cell tumor incidences were reduced by DES, regardless of age at the start of treatment. Influence of age at the start of treatment was minimal or not apparent for mesotheliomas, uterine adenocarcinomas, or pituitary adenomas; however, pituitary cystoid degeneration and hyperplasia and cervical adenosis occurred in higher frequency and/or with shorter duration of DES exposure the earlier that treatment was started. A delay in the start of DES treatment was associated with a remarkable delay in HAN and mammary adenocarcinoma development. This was especially apparent in young mice (3-7 wk old) in which a 2-week delay in treatment resulted in a 20-week delay in HAN or tumor onset. Age at the start of treatment was a major factor in susceptibility of C3H/HeN-MTV- female mice to DES-induced mammary tumorigenesis.

Cytomegaly in benign ovarian cysts

We report two cases of benign ovarian cysts that revealed cytomegaly of the epithelial lining cells. One case was a large solitary luteinized follicle cyst of pregnancy and puerperium. The other case was an endometrial cyst. Changes in the cells included marked pleomorphism and hyperchromasia of the nuclei, large amounts of cytoplasm, and lack of mitotic figures. We ascribed these cellular features to hormonal effects and stress the importance of recognizing such changes and differentiating them from malignancy.

Post-mortem stability of progesterone in rat brain

Progesterone concentrations in the brains of female rats kept at +20 degrees C or +4 degrees C for 0 to 48 hours after death were investigated. After two hours at +20 degrees C the progesterone concentration in seven studied brain areas were equal to that in control brains (dissected immediately after death). After four hours at +20 degrees C, levels decreased significantly in three brain regions. Intact rats that were placed in a refrigerator (+4 degrees C) after four hours at room temperature (+20 degrees C) showed no further changes in brain progesterone concentration. In the control group, the cerebral cortex, the hypothalamus and the hippocampus contained progesterone levels significantly higher than in all other areas (p less than 0.05). After four hours at room temperature only the hypothalamus showed higher levels (p less than 0.05). In conclusion, time after death and storage temperature affect the post-mortem levels of progesterone. Because of their differences in body masses, the conditions in the rat brain are not comparable to those in the human brain. However, it might be possible to study the regional distribution of progesterone in the human brain if control cases matched with regard to post-mortal time and brain temperature are used.

Size distribution and hormonal responsiveness of dispersed rabbit luteal cells during pseudopregnancy

Due to the evidence for two distinct steroidogenic cell types in corpora lutea of large domestic animals, cells of the rabbit corpus luteum were characterized with respect to cell diameters, relative abundance, steroidogenic capacity and responsiveness to hormones. Pseudopregnancy was induced in New Zealand rabbits by injection of 30-160 IU pregnant mare's serum gonadotropin (PMSG) followed in 2-4 days by an i.m. injection of 20-35 micrograms gonadotropin-releasing hormone (GnRH). Corpora lutea were obtained 2, 5 and 9 days after injection of GnRH and dissociated into single cell suspensions. Suspended steroidogenic cells were incubated (2 h, 37 degrees C) in medium 199 alone or in medium containing ovine luteinizing hormone (oLH) (100 ng/ml), or isoproterenol (100 microM). Media were collected and assayed for progesterone content. Secretion of progesterone (means +/- SE, n = 4) was stimulated (p less than 0.05) by oLH on each day: Day 2 = 1.7 +/- 0.2-fold; Day 5 = 3.5 +/- 0.4-fold; and Day 9 = 3.1 +/- 0.6-fold stimulation above controls. Isoproterenol also stimulated (p less than 0.05) secretion of progesterone by suspended luteal cells on Days 2 and 9. Microscopic examination of cell suspensions stained for 3 beta-hydroxysteroid dehydrogenase (3 beta HSD) activity provided identification of cells with steroidogenic capacity. The diameters (means +/- SE) for steroidogenic cells increased (p less than 0.05) from Days 2 to 9 (Day 2 = 15.2 +/- 0.2 micron; Day 5 = 22.4 +/- 0.4 micron; Day 9 = 28.3 +/- 1.6 micron). The large cell to small cell ratio increased from 0.01 on Day 2 to 2.03 on Day 9.(ABSTRACT TRUNCATED AT 250 WORDS)

Endocrine studies in a pregnancy complicated by ovarian theca lutein cysts and hyperreactio luteinalis

Severe virilization developed in a pregnant woman in association with the occurrence of theca lutein cysts and hyperreactio luteinalis of the ovaries. At term, maternal serum levels of androstenedione (58 ng/mL) and testosterone (20 ng/mL) were elevated massively; estrone (24 ng/mL) and estradiol-17 beta (23 ng/mL) levels were increased moderately. Maternal serum levels of human chorionic gonadotropin (hCG) just before delivery, 22,276 mlU/mL, though twice the mean for normal women at term, were within the normal range. The levels of androstenedione (1.06 ng/mL) and testosterone (0.26 ng/mL) in umbilical cord serum of her normal newborn female infant were normal. The levels of androstenedione and testosterone in serum of this woman declined slowly, but progressively, during the first two months after delivery; the serum levels of androstenedione and testosterone increased substantially, however, after she was treated with hCG eight weeks postpartum. These results are suggestive that, for reasons unknown, markedly increased androgen production with theca lutein cysts and hyperreactio luteinalis in some pregnant women results ultimately because of increased ovarian sensitivity to hCG.

The oocytic origin of dysgerminoma

An early dysgerminoma, found by chance in a grossly normal ovary, was completely blocked and multiply sectioned. It was found to have a mainly cortical location, being densest in the subtunical and adjacent zones where primordial follicles are normally most numerous, and to be associated with a reduction of the oocyte count in tumor-involved areas. An oocytic origin of the tumor is inferred from these findings and from other data, including the age incidence, available in the literature.

Ovarian pregnancy with a contralateral corpus luteum: case report

A case is described of a woman who was found to have an ovarian pregnancy on the left with a corpus luteum on the right ovary. This was determined by both pelvic sonography and laparotomy. The case did fulfill the four criteria of Spiegelberg.