Lower Uterine Weight Research Articles

Seventy-Day Toxicity Study in Juvenile Sprague-Dawley Rats with Semicarbazide (SEM) from Weaning to Sexual Maturity.

The study was conducted to evaluate the toxicological effects, functional observation battery tests, and sexual maturity of semicarbazide oral gavage administration to juvenile Sprague-Dawley rats for 70 days at 0, 15, 30, and 60 mg/kg/day weaning to sexual maturity. At 60 mg/kg/day, there was a delay in mean age at acquisition of balano-preputial and vaginal patency and a decrease in body weight and food consumption in males. Treatment increased reticulocyte count, aspartate aminotransferase, and alanine aminotransferase levels in both sexes and decreased hematocrit and protein in males. Increased absolute and relative liver and spleen weight in both sexes were observed. Male rats had lower thymus and testes weights, whereas female rats had lower uterine weights. Semicarbazide caused significant changes in sperm motility, sperm count, and sperm abnormality. Histopathologically, semicarbazide caused cortical hypertrophy in adrenals and increased extramedullary hematopoiesis in the spleen; hepatocellular hypertrophy, follicular epithelial hypertrophy in the thyroid, and degeneration of seminiferous tubules in the testis were observed at 60 mg/kg/day when compared to control. Results suggest that 60 mg/kg/day of semicarbazide can exert systemic toxicity in juvenile rats. The no observed adverse effect level (NOAEL) of semicarbazide for juvenile Sprague-Dawley rats was estimated to be 30 mg/kg/day.

Intraoperative Factors Associated with More Postoperative Opioid Use after Laparoscopic Hysterectomy.

BACKGROUND AND OBJECTIVES:To identify intraoperative factors during laparoscopic hysterectomy associated with postoperative opioid use and increased pain scores during the acute postoperative period.METHODS:This is a prospective survey-based cohort study at two teaching hospitals in the Boston metropolitan area. A total of 125 patients undergoing laparoscopic hysterectomy were enrolled. Surveys were administered by telephone at one-week postoperatively and in-person at their two-week postoperative visit to elicit opioid consumption converted to morphine milligram equivalents (MMEs) and pain scores.RESULTS:The median total opioid consumption was 37.5 MME (range 0–960 MMEs). Intraoperative factors associated with increased total MME consumption were lower uterine weight and resection of endometriosis at the time of surgery. Patients with uteri less than 250 grams used twice as much opioid compared to participants with uteri greater than 250 grams (median of 49.8 MME (interquartile range [IQR] 7.5–120.5) vs. 22.5 MME (IQR 7.5–61.0). The median opioid consumption by patients with resection or ablation of endometriosis was three times that of those who did not undergo surgical treatment of endometriosis (97.0 MME (IQR 53.1–281.3) vs. 30.0 MMEs (IQR 7.5–81.3 MME)). Maximum pain scores and reported pain score at one and two-week interviews were also significantly higher in patients with these characteristics.CONCLUSION:Several easily identified intraoperative factors may be correlated with opioid requirements during the acute postoperative period. This can allow surgeons to set expectations and dispense patient-specific opioid prescriptions. Individualizing prescriptions may lower the amount of excess circulating opioids and help combat the opioid epidemic.

The Large Uterus Classification System: a prospective observational study.

ObjectiveTo investigate the Large Uterus Classification System (LUCS) ability to predict surgical outcomes and complications in total laparoscopic hysterectomies (TLHs) for large uteri.DesignProspective observational study.SettingTwo referral centres.Population or sampleThree hundred and ninety‐two women who underwent TLH for a large uterus (uterine fundus at or over the transverse umbilical line).MethodsBetween 2004 and 2019, the intraoperative LUCS was estimated in all patients. The LUCS considers the uterine and adnexal vascular pedicles displacement. Type 1 is without vascular pedicles displacement. Type 2 has the cephalad displacement of adnexal vascular pedicles. The uterine vessels displacement regardless of adnexal pedicles defines Type 3.Main outcome measuresPatients’ characteristics with perioperative outcomes were prospectively collected and compared between the three types of large uteri.ResultsTwo hundred and fifty‐one (64%), 82 (20.9%) and 59 (15.1%) women had Type 1, Type 2 and Type 3 uteri, respectively. Women with Type 1 uteri had a lower uterine weight, shorter operative time, less blood loss and lower complication rates than women with Types 2 and 3. The conversion rate to laparotomy in Type 1 was similar to that in Type 2 (odds ratio [OR] 0.98; 95% CI 0.32–3.56) but lower than Type 3 (OR 0.35; 95% CI 0.14–0.97); in Type 2 it was lower than Type 3, although without the conventional statistical significance (OR 0.36; 95% CI 0.13–1.13; P = 0.07). Multivariable analysis showed that the uterine Type (1 versus 2–3) was independently associated with the total complications rate (OR 2.00; 95% CI 1.09–3.68; P = 0.02).ConclusionsThe LUCS appears associated with surgical outcomes and complications, potentially stratifying the surgical risk and guiding the surgical technique in TLHs for large uteri.Tweetable abstractThe Large Uterus Classification System may predict outcomes in total laparoscopic hysterectomy of large uteri.

Effects of Isoliquiritigenin on Bone Metabolism and Uterus in Ovariectomized Rats

Abstract Objectives Isoliquiritigenin (ILQ) is a phenolic compound found in licorice and is a popular dietary supplement. ILQ exhibits model-specific antioxidant, anti-inflammatory, anti-tumor, and estrogenic activities. Limited data suggest the potential of ILQ to prevent or treat osteoporosis. Therefore, this study evaluated the effects of short-duration treatment with ILQ on bone and uterine tissue in estrogen-deplete ovariectomized (ovx) rats. The uterus was important to evaluate because ILQ stimulates proliferation of MCF7 breast cancer cells through an estrogen receptor-dependent mechanism. Methods Six-week-old rats (ovx'd at 4 weeks of age) were fed diets containing 0, 100, 250 or 750 ppm ILQ (n = 5/treatment) for 1 week and sacrificed. Gene expression in femur and uterus, blood markers of global bone turnover, body composition, and uterine weight and epithelial cell height were determined. In addition, the effect of ILQ on in vitro differentiation of osteoclasts derived from bone marrow was assessed. Results Treatment resulted in a dose-dependent increase in serum ILQ with levels reaching 2.4 ± 0.2 mM in rats receiving the highest dose. ILQ did not alter serum levels of osteocalcin, a global marker of bone formation, or osteocalcin gene expression in femur. Additionally, there was little or no effect of ILQ on genes related to osteoblast differentiation or activity in femur. These largely null findings contrast with a reduction in serum CTX, a global marker of bone resorption, at all dose levels of ILQ. At the gene level, ILQ resulted in lower mRNA for genes related to osteoclast differentiation and function in femur, including Acp5 (tartrate resistant acid phosphatase), Timp2 and Mmp2, and suppressed osteoclast differentiation in vitro. ILQ had no effect on the ovx-induced increase in body weight. Ovx resulted in lower uterine weight. Treatment with ILQ at 750 ppm resulted in development of severe uterine epithelial cell hyperplasia in two of five animals. Conclusions ILQ supplementation led to reduced biochemical and gene expression markers of bone resorption in vivo and reduced osteoclast differentiation in vitro without increasing estrogen-dependent gene expression. However, the potential benefits must be weighed against potential detrimental off-target effects, including uterine hypertrophy. Funding Sources NIH [P50AT006268].

THE IMPACT OF ANIMAL MANAGEMENT TECHNOLOGIES ON THE PHYSICAL AND PHYSIOLOGICAL DEVELOPMENT OF REPLACEMENT GILTS

The paper find out the regularities of physical and physiological development of the replacement young pigs, bred at different housing technologies. The experiment was conducted in OOO “SVK” Krasnogvardeyskiy district (industrial technology) and “SHP Svobodny trud” (traditional technology) of Novoselytsya districts of Stavropol Territory. In order to conduct the experiment on the basis of analogues, the Company selected bipedal pigs (50% large white (CB) + 50% Landrace (L)) aged one month. Each group had 25 pigs. In order to study the development of reproductive organs at the age of 6 and 8 months, a control slaughter of experimental animals was carried out (3 pigs from each group). The live body weight of 6-month-old pigs in OOO “SVK” averaged 110 kg, while in OOO “SHP “Svobodnyy trud” the animals weight was 67-70 kg. At the age of 8 months, the weight of animals in “SHP “Svobodnyy trud” was 103-110 kg, and in OOO “SVK” - 145-150 kg. At the age of 180 days the animal reproductive organs were at the initial stage of development. Only primary follicles of 0.1-0.3 cm in diameter were observed in ovaries weighing 3.1-3.5 g. The bipedal hybrids grown on the intensive technology were inferior to the pigs with the traditional technology of breeding for the development of reproductive organs. They had a lower uterine weight by 9.1%, ovarian weight by 12.9%, and the length of uterine and ovarian horns by 10.9 and 8.6%, respectively. Repair pigs grown according to the traditional technology had ovaries weighing 9.2 g and had fresh yellow bodies. When growing guinea pigs under industrial technology, the rejection of first-pigs amounted to 63.6%, while in the case of animals grown under traditional technology, this indicator was within 26.6%.

Effect of Dayak Onion (Eleutherine bulbosa (Mill.) Urb) on Uterine wall and Lipid Profiles of Ovariectomized Rat

Menopause is a physiologic condition, in which women no longer experience menstruation. Decreased estrogen during and after menopause causes structural, physiological and biochemical changes that alter the health of women in general, both in organs and non-reproductive organs. Dayak onion contains eleuterinol, an naphtoqunone derivative that can be as SERM. Therefore, we evaluated the effects of dayak onions on lipid profiles and uterine wall. This study used female white rats of Sprague-Dawley. All groups, except the sham group, is ovariectomized to obtain the conditions of hypoestrogen. Rats were divided into 6 groups. SHAM (CMC Na 0,5%), OVX (CMC Na 0,5%), TAM (tamoxifen), DOE dose 1 (dayak onion extract 8 mg/200), DOE dose 2 (dayak onion extract 12 mg/200 g) and DOE dose 3 (dayak onion extract 18 mg/200 g). Mouse model of ovariectomy given 3 doses of extract, from giving each extract it was seen that the weight of uterine DOE dose 1, DOE dose 2 and DOE dose 3 respectively 55,24, 53,38 and 61,85 mg had lower uterine weight when compared with Positive control given tamoxifen 72.2 mg. The effects of onion on uterine weight reduction are greater than that of tamoxifen on the animal model menopause.

Role of estrogen receptor signaling in skeletal response to leptin in female ob/ob mice.

Leptin, critical in regulation of energy metabolism, is also important for normal bone growth, maturation and turnover. Compared to wild type (WT) mice, bone mass is lower in leptin-deficient ob/ob mice. Osteopenia in growing ob/ob mice is due to decreased bone accrual, and is associated with reduced longitudinal bone growth, impaired cancellous bone maturation and increased marrow adipose tissue (MAT). However, leptin deficiency also results in gonadal dysfunction, disrupting production of gonadal hormones which regulate bone growth and turnover. The present study evaluated the role of increased estrogen in mediating the effects of leptin on bone in ob/ob mice. Three-month-old female ob/ob mice were randomized into one of the 3 groups: (1) ob/ob + vehicle (veh), (2) ob/ob + leptin (leptin) or (3) ob/ob + leptin and the potent estrogen receptor antagonist ICI 182,780 (leptin + ICI). Age-matched WT mice received vehicle. Leptin (40 µg/mouse, daily) and ICI (10 µg/mouse, 2×/week) were administered by subcutaneous injection for 1 month and bone analyzed by X-ray absorptiometry, microcomputed tomography and static and dynamic histomorphometry. Uterine weight did not differ between ob/ob mice and ob/ob mice receiving leptin + ICI, indicating that ICI successfully blocked the uterine response to leptin-induced increases in estrogen levels. Compared to leptin-treated ob/ob mice, ob/ob mice receiving leptin + ICI had lower uterine weight; did not differ in weight loss, MAT or bone formation rate; and had higher longitudinal bone growth rate and cancellous bone volume fraction. We conclude that increased estrogen signaling following leptin treatment is dispensable for the positive actions of leptin on bone and may attenuate leptin-induced bone growth.

Comparison of the laparoscopic versus conventional open method for surgical staging of endometrial carcinoma

ObjectiveAlthough laparoscopic surgery is widely utilized in the treatment of endometrial cancer, its efficacy in staging the cancer is not well established. The aim of this study was to compare staging endometrial cancer with laparoscopic and conventional open methods. Materials and MethodsFrom January 2002 to June 2012, 151 patients (70 treated by laparoscopy and 81 by laparotomy) diagnosed with endometrial cancer were enrolled. This was a retrospective cohort review of endometrial cancer surgically staged using laparoscopy or laparotomy in the Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan. ResultsThe two groups did not significantly differ in patient age, body mass index, previous obstetrical history, or amount of previous abdominal surgery. No differences between the surgical cohorts were observed in relation to cancer status, including stage, grade, myometrial invasion, lymphovascular space invasion, lymph node involvement, and recurrence rate. The laparoscopic approach had less intraoperative blood loss, longer operative time, lower uterine weight, number of removed lymph nodes, and shorter hospital stay. ConclusionOur preliminary results showed that the laparoscopic method for staging endometrial cancer was technically feasible and efficient.

Endogenous and Exogenous Equol Are Antiestrogenic in Reproductive Tissues of Apolipoprotein E-Null Mice1–3

Equol is an isoflavone (IF) metabolite produced by intestinal microbiota in a subset of people consuming dietary soy. Equol producers may show different responses to soy foods and phenotypes related to cancer risk. Here, we assessed the effects of soy IF, endogenous microbial equol production, and dietary racemic equol in a 3 × 2 × 2 factorial experiment using gnotobiotic apoE-null mice ( n = 9–11/group/sex). At age 3–6 wk, equol-producing microbiota were introduced to one-half of the colony ( n = 122). At age 6 wk, mice were randomized to receive a diet that contained 1 of 3 protein sources: casein and lactalbumin, alcohol-washed soy protein (low IF), and intact soy protein (high IF), with total IF amounts of 0, 42, and 566 mg/kg diet, respectively. One-half of each diet group also received racemic equol (291 mg/kg diet). After 16 wk of dietary treatment, serum isoflavonoid profiles varied with sex, soy IF amount, and intestinal microbiota status. There were no treatment effects on tissues of male mice. In females, reproductive tissue phenotypes differed by equol-producing ability (i.e., microbiota status) but not dietary equol or IF content. Equol producers had lower uterine weight, vaginal epithelial thickness, total uterine area, endometrial area, and endometrial luminal epithelial height compared with nonproducers ( P < 0.05 for all), with an association between microbiota status and estrous cycle ( P> chi-square = 0.03). Exogenous equol reduced expression of progesterone receptor (PGR) and the proliferation marker Ki67 ( P< 0.0001) in vaginal epithelium and endometrium; for endogenous equol, only PGR was reduced ( P <0.0005). Our findings indicate that equol diminishes estrogen-dependent tissue responses in apoE-null mice.

Estradiol Release Kinetics Determine Tissue Response in Ovariectomized Rats

Estrogen replacement is an effective therapy of postmenopausal symptoms such as hot flushes, bone loss, and vaginal dryness. Undesired estrogen effects are the stimulation of uterine and mammary gland epithelial cell proliferation as well as hepatic estrogenicity. In this study, we examined the influence of different estradiol release kinetics on tissue responsivity in ovariectomized (OVX) rats. Pulsed release kinetics was achieved by ip or sc administration of estradiol dissolved in physiological saline containing 10% ethanol (EtOH/NaCl) whereas continuous release kinetics was achieved by sc injection of estradiol dissolved in benzylbenzoate/ricinus oil (1+4, vol/vol). Initial 3-d experiments in OVX rats showed that pulsed ip estradiol administration had profoundly reduced stimulatory effects on the uterus and the liver compared with continuous release kinetics. On the other hand, both administration forms prevented severe vaginal atrophy. Based on these results, we compared the effects of pulsed (sc in EtOH/NaCl) vs. continuous (sc in benzylbenzoate/ricinus oil) estradiol release kinetics on bone, uterus, mammary gland, and liver in a 4-month study in OVX rats. Ovariectomy-induced bone loss was prevented by both administration regimes. However, pulsed estradiol resulted in lower uterine weight, reduced induction of hepatic gene expression, and reduced mammary epithelial hyperplasia relative to continuous estradiol exposure. We conclude that organ responsivity is influenced by different hormone release kinetics, a fact that might be exploited to reduce undesired estradiol effects in postmenopausal women.

Uncovering Novel Reproductive Defects in Neurokinin B Receptor Null Mice: Closing the Gap Between Mice and Men

Patients bearing mutations in TAC3 and TACR3 (which encode neurokinin B and its receptor, respectively) have sexual infantilism and infertility due to GnRH deficiency. In contrast, Tacr3(-/-) mice have previously been reported to be fertile. Because of this apparent phenotypic discordance between mice and men bearing disabling mutations in Tacr3/TACR3, Tacr3 null mice were phenotyped with close attention to pubertal development, estrous cyclicity, and fertility. Tacr3(-/-) mice demonstrated normal timing of preputial separation and day of first estrus, markers of sexual maturation. However, at postnatal d 60, Tacr3(-/-) males had significantly smaller testes and lower FSH levels than their wild-type littermates. Tacr3(-/-) females had lower uterine weights and abnormal estrous cyclicity. Approximately half of Tacr3(-/-) females had no detectable corpora lutea on ovarian histology at postnatal d 60. Despite this apparent ovulatory defect, all Tacr3(-/-) females achieved fertility when mated. However, Tacr3(-/-) females were subfertile, having both reduced numbers of litters and pups per litter. The subfertility of these animals was not due to a primary ovarian defect, because they demonstrated a robust response to exogenous gonadotropins. Thus, although capable of fertility, Tacr3-deficient mice have central reproductive defects. The remarkable ability of acyclic female Tacr3 null mice to achieve fertility is reminiscent of the reversal of hypogonadotropic hypogonadism seen in a high proportion of human patients bearing mutations in TACR3. Tacr3 mice are a useful model to examine the mechanisms by which neurokinin B signaling modulates GnRH release.

Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients

To better characterize adenomyosis as a disease entity. We retrospectively reviewed the medical records of women undergoing hysterectomy with a histologic diagnosis of adenomyosis, adenomyosis and leiomyomas, and leiomyomas alone. The study included 291 women: 38 with adenomyosis alone, 56 with adenomyosis and leiomyomas, and 197 with leiomyomas alone. In univariate analysis, women with adenomyosis were younger (p = 0.018) and had lower uterine weights (p < 0.001) and more disease-specific symptoms (p = 0.008). In multinomial logistic regression analysis, a lower uterine weight (OR 0.99, CI 95% 0.99-1.0), pelvic pain (OR 4.8, CI 95% 1.5-15.2), a history of smoking (OR 2.6, CI 95% 1.1-6.5) and at least one delivery (OR 4.3, CI 95% 1.5-12.3) were associated with a greater likelihood of having adenomyosis but not leiomyomas alone. Women undergoing hysterectomy with adenomyosis alone have different clinical characteristics from women with adenomyosis and leiomyomas and from those with only leiomyomas.

Kisspeptin/Gpr54‐Independent Gonadotrophin‐Releasing Hormone Activity in Kiss1 and Gpr54 Mutant Mice

The kisspeptin/Gpr54 signalling pathway plays a critical role in reproduction by stimulating the secretion of gonadotrophin-releasing hormone (GnRH), yet mice carrying mutations in Kiss1 (which encodes kisspeptin) or Gpr54 exhibit partial sexual maturation. For example, a proportion of female Kiss1(-/-) and Gpr54(-/-) mice exhibit vaginal oestrus, and some male Kiss1(-/-) and Gpr54(-/-) mice exhibit spermatogenesis. To characterise this partial sexual maturation, we examined the vaginal cytology of female Kiss1(-/-) and Gpr54(-/-) mice over time. Almost all mutant mice eventually enter oestrus, and then spontaneously transition from oestrus to dioestrus and back to oestrus again. These transitions are not associated with ovulation, and the frequency of these transitions increases with age. The oestrus exhibited by female Kiss1(-/-) and Gpr54(-/-) mice was disrupted by the administration of the competitive GnRH antagonist acyline, which also resulted in lower uterine weights and, in Kiss1(-/-) mice, lower serum follicle-stimulating hormone (FSH) and luteinising hormone (LH) concentrations. Similarly, male Kiss1(-/-) and Gpr54(-/-) mice treated with acyline had smaller testicular sizes and an absence of mature sperm. In addition to examining intact Kiss1(-/-) and Gpr54(-/-) mice, we also assessed the effects of acyline on gonadotrophin concentrations in gonadectomised mice. Gonadectomy resulted in a significant increase in serum FSH concentrations in male Gpr54(-/-) and Kiss1(-/-) mice. Acyline administration to gonadectomised Kiss1(-/-) and Gpr54(-/-) male mice lowered serum FSH and LH concentrations significantly. By contrast to males, gonadectomy did not result in significant gonadotrophin changes in female Kiss1(-/-) and Gpr54(-/-) mice, but acyline administration was followed by a decrease in LH concentrations. These results demonstrate that, although kisspeptin signalling is critical for the high levels of GnRH activity required for normal sexual maturation and for ovulation, Kiss1(-/-) and Gpr54(-/-) mice retain some degree of GnRH activity. This GnRH activity is sufficient to produce significant effects on vaginal cytology and uterine weights in female mice and on spermatogenesis and testicular weights in male mice.

Granulosa Cell-Specific Inactivation of β-Catenin Alters Aromatase Production and Normal Folliculogenesis

We recently reported that FSH signaling to induce Cyp19a1 (aromatase), the rate-limiting enzyme in estrogen biosynthesis, requires the co-activator β-catenin (Ctnnb1) in a primary rat granulosa cell model. The purpose of the following investigation was to ascertain the physiological significance of β-catenin to granulosa cell maturation and folliculogenesis in an in vivo mouse model. To achieve this purpose, Ctnnb1flox/flox mice were intercrossed with mice that express Cre recombinase under the control of Amhr2 (Ctnnb1flox/flox;Amhr2Cre/+). Amhr2 is expressed along the Mûllerian ducts and in developing ovaries at embryonic day 13.5. Postnatally granulosa cells express Amhr2 specifically in developing follicles. Conditional deletion of the β-catenin gene in 8 week-old females resulted in lower uterine weights when compared to their wild-type counterparts, consistent with the recognized requirement for β-catenin in reproductive tract development. However, conditional deletion of the β-catenin gene did not affect the time to puberty (d 33). No obvious ovarian phenotype was detected between conditional knockouts and wild-type mice at 8 weeks of age. Follicles appeared to undergo maturation to the preovulatory phenotype and to form normal numbers of corpora lutea compared to wild-type mice. Ctnnb1flox/flox;Amhr2Cre/+ mice were found to be infertile after they failed to produce a litter within six months when paired with proven male studs, a result most likely attributable to aberrant reproductive tract development. Unexpectedly, pituitary Fshb mRNA but not Lhb mRNA levels were greater in conditional knockouts compared to wild-type mice. Similarly, the FSH-regulated ovarian genes Inhα and Lhr were also up-regulated in conditional knockout mice compared to wild-type mice. Serum estradiol concentrations and Cyp19a1 mRNA expression also tended to be elevated in knockout compared to wildtype mice. However, total ovarian β-catenin mRNA levels were not reduced in conditional knockout mice. To focus on the effect of β-catenin in granulosa cells we therefore used an in vitro knockout model for β-catenin in primary cultures of mouse granulosa cells. Granulosa cells from Ctnnb1flox/flox were isolated and exposed to a Cre recombinase adenovirus, resulting in a marked reduction of β-catenin mRNA and protein. Deletion of β-catenin in granulosa cells resulted in loss of the ability of FSH to induce Cyp19a. Consequently, estradiol concentrations in cell culture media were higher in FSH-stimulated control granulosa cells compared to FSH-stimulated granulosa cells in which β-catenin was deleted (15.4 ± 3.2 pg/ml and 7.6 ± 2.3 pg/ml, respectively). Collectively, the data herein indicate that β-catenin plays a role in folliculogenesis in the developing ovary, specifically enabling granulosa cells to respond to FSH by expressing Cyp19a1. In addition, our results indicate that β-catenin, normally viewed as an essential component of the canonical WNT signaling pathway, is also required for mediating hormonal signaling through G-protein coupled receptors that regulate the production of estrogen. Supported by a minority fellowship to JAHG (P01 HD21921 to MHD).

Total Laparoscopic Hysterectomy for Female-to-Male Transsexuals

To compare the results of laparoscopic hysterectomy, salpingo-oophorectomy, and incidental appendectomy for female-to-male transsexuals with those of female patients. Retrospective chart abstraction of all patients undergoing total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and appendectomy since September 1996. Significance from analysis of covariance or chi2 was set at .05. Five hundred ninety-three patients underwent total laparoscopic hysterectomy, oophorectomy, and appendectomy. Forty-one were identified as transsexual, 552 as females. The transsexuals were significantly younger (mean 32 years compared with 51 years, median 32 years compared with 49 years, P<.001), with lower parity (mean 0.05 pregnancies compared with 1.34 pregnancies, median 0 pregnancies compared with 1 pregnancy, P<.001), yet had similar body mass index and height. Transsexuals' surgeries had shorter operating times (mean 74 minutes compared with 120 minutes, median 57.5 minutes compared with 116 minutes, P<.001), with less blood loss (mean 27 mL compared with 107 mL, median 20 mL compared with 50 mL, P<.001) and lower uterine weight (mean 118 g compared with 167 g, median 89 g compared with 140.5 g, P<.001). The total complication rates (12.2% compared with 8.3%), as well as the reoperative complication rates (4.9% compared with 4.3%) were not significantly different. Total laparoscopic hysterectomy offers appropriate surgical outcomes for those patients identifying themselves as transsexual.

Health-related quality of life after laparoscopically assisted vaginal hysterectomy: Is uterine weight a major factor?

To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH). Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively. Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH. Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia.

Estrogenic isoflavones in rodent diets

Many rodent diets contain components such as soy isoflavones (daidzein and genistein) known to have estrogenic properties. The dietary background of phytoestrogens may modulate some responses to environmental estrogens when these compounds are tested in rodent bioassays. Thus, and since only few data were available on the phytoestrogen content of rodent diets commonly used in European laboratories, it was of interest to analyze the daidzein and genistein contents of our standard animal feeds. Isoflavone contents were determined in seven batches of rodent chow (from two suppliers in Germany, Altromin and Ssniff) by high-performance liquid chromatography, and also analyzed in six rodent diets from the United States. The soy-based rodent diets from Germany contained isoflavone (daidzein plus genistein) concentrations in the range of 0.3–0.55 mg/g feed. These isoflavone contents are similar to those analyzed in the US rodent diets, and similar to values reported by others, including one particular lot of feed (with 0.35 mg isoflavones per g) which produced a large uterotrophic response in immature ovariectomized rats [Environ. Health Perspect., 106 (1998) 369]. Coumestrol was found in a sample of commercial rabbit food at rather high levels (0.27 mg/g), but, this phytoestrogen was not detected (<1 μg/g feed) in any of the other samples we analyzed. The soy components in our rodent diet produce a measurable background of daidzein and genistein in blood of female DA/Han rats, total isoflavones (aglycone plus conjugates) ranging between 90 and 290 ng/ml plasma. The ovariectomized animals kept on this chow, showed no signs of estrogenization of the reproductive tract (uterus, vagina), and responded normally to (xeno-)estrogen administration in a uterotrophic assay [J. Steroid Biochem. Mol. Biol., 73 (2000) 1]. Moreover, ovariectomized Wistar rats on our standard rodent diet (Ssniff R/M H) had lower uterine weights than animals kept on the isoflavone-free (solvent extracted) chow; both groups of rats responded to genistein administration with an increase in uterine weights. These results suggest that—albeit the sensitivity of the rodent uterotrophic assay is not reduced by the use of a diet containing soy isoflavones at commonly encountered levels—attention should be given to a variable dietary phytoestrogen background.

Roles of progesterone on suppression of uterine decidualization and implantation failure induced by triphenyltin chloride in rats

ABSTRACT In our previous studies, an administration of triphenyltin chloride (TPTCl) at 4.7 or 6.3 mg/kg on days 0–3 of pregnancy caused implantation failure, and the same doses of TPTCl on days 0–3 of pseudopregnancy caused a suppression of uterine decidualization correlated with a reduction in serum progesterone levels in rats. This study was conducted to determine the roles of progesterone on the TPTCl‐induced suppression of uterine decidualization and implantation failure in rats. Although lower uterine weight was found in hormone‐maintained ovariectomized rats given TPTCl at 4.7 or 6.3 mg/kg on days 0–3 and induced decidual cell response on day 4, no statistical significance in the uterine weight was detected between the control group and the TPTCl‐treated groups. The pregnancy rate and number of implantations in the groups given TPTCl at 4.7 or 6.3 mg/kg on days 0–3 of pregnancy and progesterone on days 0–8 of pregnancy were significantly higher than those in the groups given TPTCl alone. No significant differences in these parameters were found between the control group and the groups given TPTCl and progesterone. It can be concluded that the TPTCl‐induced suppression of uterine decidualization is mediated, at least partially, via the ovarian hormones, and that progesterone protects against the TPTCl‐induced implantation failure.

Impact of dietary lysine intake during lactation on follicular development and oocyte maturation after weaning in primiparous sows.

Primiparous sows (n = 36) were used to evaluate the effects of dietary lysine intake in lactation on follicular development and oocyte maturation after weaning. Sows were assigned randomly to one of three diets containing .4% (low lysine, LL), 1.0% (medium lysine, ML), or 1.6% (high lysine, HL) total lysine. All diets contained 2.1 Mcal NE/kg and exceeded NRC (1988) requirements for all other nutrients. Actual lysine intakes over an 18-d lactation were 16, 36, and 56 g/d for sows consuming LL, ML, and HL, respectively. Ovarian data were analyzed for sows determined to have been slaughtered during the first proestrus period after weaning, using previously established criteria. Compared with sows fed ML and HL, sows fed LL tended to have lower uterine weight, follicular fluid volume, and follicular fluid (FF) estradiol (E2) content (P < .15), but similar ovarian weight and follicular fluid IGF-I concentration. Within the largest 15 preovulatory follicles, sows fed LL had a lower percentage of large (> or = 7.0 mm) follicles (33 vs 50 and 58%; P < .01) and a higher percentage of medium (5.5 to 7.0 mm) follicles (62 vs 44 and 39%; P < .01) but a similar percentage of small (< or = 5.5 mm) follicles (4.4 vs 5.9 and 3.7%; P > .15), respectively, compared with sows fed ML or HL. Standardized pools of oocytes aspirated from follicles of prepubertal gilts were incubated for 44 h with pooled FF recovered from the largest 15 follicles of each experimental sow. Fewer oocyte nuclei matured to metaphase II of meiosis when cultured with FF recovered from sows fed LL, than from sows fed ML or HL (47.1 vs 59.8 and 63.8%, respectively; P < .01). Our results suggest that low lysine (protein) intake in primiparous lactating sows impaired follicular development and reduced the ability of follicles to support oocyte maturation. However, high compared with medium lysine (protein) intake had no further positive effects on ovarian function.

Dynamic pituitary and ovarian changes occurring during the anestrus to estrus transition in the golden hamster.

Anestrous hamsters exhibit daily afternoon gonadotropin and progesterone surges, but little estrogen secretion. In the first experiment, short day anestrous females were transferred to long days to detect hormonal changes associated with recovery of cyclicity. Morning and afternoon blood samples were taken at increasing durations in long days. Females autopsied at their first vaginal estrus after transfer to long days differed from long day estrous controls only in their lower uterine weights. Some females at all durations exhibited signs of recovery, though they had not yet shown estrus. They did not display afternoon gonadotropin surges and had low circulating progesterone but high estradiol levels, stimulated uteri, and enhanced follicular development. Results of the second and third experiments provided evidence that the daily gonadotropin surges are not the cause per se of anestrus, and that changes in estrogen secretion are essential for the transition to and from anestrus. Phenobarbital blockade of the daily surges in anestrous females did not result in increased follicular growth and estrogen secretion. Furthermore, daily afternoon injections of gonadotropins it appears that the daily surges in anestrous hamsters simply reflect low estradiol levels. It is still not known what signal promotes rapid follicular maturation during the recovery from anestrus. Once initiated, however, this recovery appears to occur within a few days, with a rapid cascade of events. First, follicular development and estrogen secretion resume, and the daily LH surges cease. Then, progesterone levels decline, and an ovulatory surge of gonadotropins is triggered.