scholarly journals The influence of acute and chronic hypercalcemia on the parathyroid hormone response to hypocalcemia in rabbits

2002 ◽  
pp. 411-418 ◽  
Author(s):  
S Bas ◽  
E Aguilera-Tejero ◽  
JC Estepa ◽  
B Garfia ◽  
I Lopez ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Elevated Level ◽  
Renal Mass ◽  
Hormone Response ◽  
Group Iii ◽  
Surgical Reduction ◽  
Group I ◽  
Group Ii ◽  
Acute Hypercalcemia ◽  
Stimulation Of

OBJECTIVE: To investigate the influence of acute and chronic hypercalcemia on the parathyroid hormone (PTH) response to hypocalcemia. DESIGN: The PTH response to hypocalcemia has been evaluated in three groups of rabbits: Group I, normal rabbits, Group II, normal rabbits subjected to an acute hypercalcemic clamp (induced by CaCl(2) infusion) and Group III, rabbits with chronic hypercalcemia (due to surgical reduction of renal mass). RESULTS: In Group I (baseline Ca(2+)=1.69+/-0.02 mM), hypocalcemia resulted in stimulation of PTH secretion which reached a maximum (PTHmax) of 91.7+/-6.4 pg/ml. In rabbits from Group II, which also had normal baseline Ca(2+) (1.70+/-0.02 mM), plasma Ca(2+) was maintained at an elevated level for 2 h, at around 2.05 mM. The PTH response to hypocalcemia in Group II was attenuated and the PTHmax in these rabbits was 45.6+/-7.4 pg/ml. In rabbits from Group III, baseline Ca(2+) was elevated (2.06+/-0.06 mM) for 1 month. The PTH response to hypocalcemia in Group III was esentially the same as in Group I and PTHmax reached levels of 94.8+/-9.9 pg/ml. CONCLUSIONS: A difference in PTH response to hypocalcemia has been found in rabbits after exposure to either acute or chronic hypercalcemia. After acute hypercalcemia, an attenuated PTH response to hypocalcemia has been identified. Chronic hypercalcemia, however, did not influence the PTH response to hypocalcemia.

Functional adaptation to reduced renal mass in early development

1982 ◽  
Vol 242 (2) ◽  
pp. F190-F196 ◽  
Author(s):  
R. L. Chevalier
Keyword(s):  
Renal Mass ◽  
Left Kidney ◽  
Extracellular Fluid ◽  
Functional Adaptation ◽  
Fluid Loss ◽  
Group Iii ◽  
Arterial Blood ◽  
India Ink ◽  
Group I ◽  
Group Ii

To determine whether reduced renal mass in the newborn results in acceleration of normal renal development, the response to unilateral nephrectomy (N) before 36 h of age was compared with sham-operated (S) guinea pigs during the period of most rapid nephron maturation. Studies were performed at 7-13 days (group I) and 19-25 days (group II). Mean arterial blood pressure (AP), left kidney glomerular filtration rate (LKGFR), and urine sodium excretion (UNaV) were measured. Superficial single nephron GFR (sSNGFR) and proximal fractional water reabsorption (FRH2O) were measured by micropuncture, and the number of glomeruli (NG) was determined by India ink perfusion. In view of the susceptibility of the neonate to extracellular fluid loss, groups I and II were plasma infused to maintain euvolemia and group II was compared with 19- to 25-day-old hydropenic animals (group III). Increase in body weight with age was unaffected by neonatal N. In group IN, the compensatory increase in sSNGFR was greater than SNGFR for deeper nephrons, which normally contribute most to GFR at this age. In group IIN there was an 80% adaptive increase in LKGFR that could not be entirely explained by the rise in SNGFR. Since NG in group IIN was greater than in group IIS and similar to that in adulthood, the enhanced adaptation in LKGFR in group IIN may be due in part to earlier recruitment of a population of underperfused glomeruli. FRH2O did not change significantly with age and did not differ in N and S groups. Animals in group III developed a rise in hematocrit during the experiment, and AP, LKGFR, and UNaV were lower in group IIIN than in group IIN. It is concluded that following N at birth, the sequence of renal functional maturation is accelerated while glomerulotubular balance is preserved. As a result of these adaptative changes, homeostasis is maintained and body growth proceeds without impairment.

scholarly journals Development of an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques

2020 ◽  
pp. 27-34
Author(s):  
A. A. Kalinin ◽  
A. K. Okoneshnikova ◽  
Yu. Ya. Pestryakov ◽  
V. V. Shepelev ◽  
V. A. Byvaltsev
Keyword(s):  
Lumbar Spine ◽  
Surgical Techniques ◽  
Degenerative Changes ◽  
Lumbar Pain ◽  
Group Iii ◽  
Pain Syndromes ◽  
Group I ◽  
Neuroimaging Data ◽  
Group Ii ◽  
Stimulation Of

Background. Pain syndromes developing as a result of degeneration of the lumbar segments of the spine constitute a significant problem in modern vertebrology. The results of the application of preoperative diagnostic provocative tests are contradictory, and therefore the mixed effectiveness of puncture surgical techniques is recorded.Objective. To develop an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques.Material and Methods. The study included 923 patients who underwent provocative diagnostic techniques on the intervertebral disk (IVD) and the arched joints (AJ) between 2012 and 2017. Taking into account clinical and instrumental data, the following are made: in group I (n=246) – laser IVD nucleoplasty, in group II (n = 287) – laser denervation of FJ, in group III (n = 390) – simultaneous use of laser exposure to IVD and AJ. We analyzed the dynamics of the level of pain in the lumbar spine and lower extremities according to The Visual Analogue Scale and quality of life according to The Short Form-36 (SF-36) questionnaire.Results. When performing provocative diagnostic tests, the minimum number of adverse effects was recorded: 3.2% in group I, 2.4% in group II, and 2.1% in group III. After puncture methods of surgical treatment, a significant persistent decrease in the severity of preoperative pain was observed both in the lumbar spine (p = 0.002, p = 0.005 and p = 0.004, respectively) and in the lower extremities (p = 0.003, p = 0.001 and p = 0.005, respectively) A significant improvement in the physical and psychological components of health was also established in group I (p = 0.02 and p = 0.01, respectively), in group II (p = 0.01 and p = 0.03, respectively) and group III (p = 0.03 and p = 0.02, respectively).Conclusion. In the presence of neuroimaging parameters of IVD according to C. Pfirrmann III–IV and protrusion size 4–6 mm, minimal degenerative changes in the AJ according to A. Fujiwara I–II and D. Weishaupt I–II, as well as a positive disruption test, it is possible to perform laser nucleoplasty. In case of detection of neuroimaging data of IVD according to C. Pfirrmann I–II and protrusion size less than 4 mm, moderately pronounced degenerative changes in the AJ according to A. Fujiwara II–III and D. Weishaupt II–III, as well as positive paraarticular stimulation of AJ, laser denervation of AJ is recommended. When determining, according to neuroimaging data, moderate degenerative changes in IVD according to C. Pfirrmann over III and protrusion size 4–6 mm, as well as degeneration of AJ according to A. Fujiwara more than II and D. Weishaupt more than II, positive of samples and paraarticular stimulation of AJ, it is advisable to perform simultaneous surgical intervention in the volume of laser IVD nucleoplasty and laser denervation of AJ.

Effect of parathyroid hormone on renal excretion of sodium and hydrogen ions

1977 ◽  
Vol 55 (3) ◽  
pp. 628-638 ◽  
Author(s):  
Hubert Hermkens ◽  
Tewfik Nawar ◽  
Claude Caron ◽  
Gerard E. Plante
Keyword(s):  
Parathyroid Hormone ◽  
Renal Plasma Flow ◽  
Extracellular Volume ◽  
Phosphate Transport ◽  
Left Renal Artery ◽  
Group Iii ◽  
Titratable Acid ◽  
Group I ◽  
Group Ii ◽  
The Right

The contribution of parathyroid hormone (PTH) to the renal adjustment of phosphate transport has been extensively investigated, whereas the action of this hormone on bicarbonate and hydrogen excretion has not received as much attention.Nineteen dogs were studied before and during a 2-h infusion of PTH in the left renal artery (8 mU/min per kilogram) under slight expansion of extracellular volume (fractional sodium excretion = U/FNa = 3.8 ± 0.3%). Group I (n = 7) was studied under normal acid–base condition while group II (n = 6) was studied during metabolic acidosis. Bicarbonate titration curves were obtained from group III (n = 6) in which the right kidney was used as control. In all studies, plasma pCO2 was kept constant.[Formula: see text] rose from 4.2 ± 1.1 to 15.6 ± 3.0% and from 3.8 ± 0.4 to 25.0 ± 3.5% in groups I and II, respectively. U/FNa was unchanged in both groups. [Formula: see text] rose from 5.8 ± 0.6 to 10.1 ± 0.7% in group I but remained at 1.0 ± 0.2% in group II during PTH. Urinary titratable acid and ammonium were not influenced by PTH in group II. In group III, plasma HCO3 was progressively increased from 15 to 40 mM/litre. For all plasma values exceeding 22 mM/litre, HCO3 reabsorption was 1 mM/litre of filtrate lower in the left than in the right kidney. Glomerular filtration and renal plasma flow remained constant during PTH.The results indicate that PTH affects sodium and hydrogen excretion in a very modest fashion. Bicarbonaturia obtains whenever plasma HCO3 exceeds 22 mM/litre during PTH. This phenomenon is associated with a demonstrable reduction in tubular HCO3 reabsorption per unit of filtrate.

Parathyroid hormone contributes to volume expansion-induced inhibition of proximal reabsorption

1985 ◽  
Vol 248 (1) ◽  
pp. F100-F103 ◽  
Author(s):  
O. Mercier ◽  
M. Bichara ◽  
M. Paillard ◽  
J. P. Gardin ◽  
F. Leviel
Keyword(s):  
Parathyroid Hormone ◽  
Volume Expansion ◽  
Sprague Dawley ◽  
Nacl Transport ◽  
Free Expansion ◽  
Group Iii ◽  
Group I ◽  
Sprague Dawley Rats ◽  
Stimulation Of ◽  
Intact Rats

Volume expansion inhibits the proximal reabsorption of water, bicarbonate, and chloride. The present work tested a hypothetical role of parathyroid hormone (PTH) in the expansion effect. We studied 19 Sprague-Dawley rats during a plasma-replete euvolemic state and following 10% body wt colloid-free expansion. In group I, six intact rats, volume expansion decreased plasma ionized calcium concentration ([Ca2+]P) from 2.28 +/- 0.06 to 2.11 +/- 0.04 meq/liter and increased nephrogenous cAMP (NcAMP) from 29 +/- 5 to 66 +/- 10 pmol X min-1 X g kidney wt-1. In group II, six acutely thyroparathyroidectomized (TPTX) rats, [Ca2+]P also fell from 2.18 +/- 0.08 to 1.80 +/- 0.08 meq/liter but NcAMP did not rise significantly (9 +/- 3 vs. 17 +/- 5 pmol X min-1 X g kidney wt-1). These data strongly suggest that stimulation of PTH activity occurred during expansion in intact animals. In group III, seven TPTX rats, volume expansion inhibited proximal reabsorption of total CO2 by 11%, of chloride by 24%, and of water by 19%. Volume expansion-induced reduction in bicarbonate, chloride, and water reabsorption was smaller in TPTX than in intact rats previously studied. We conclude that volume expansion inhibits proximal reabsorption in part by decreasing the active transcellular NaHCO3 and NaCl transport secondary to stimulation of PTH activity.

Differential Changes of Group II and Group III mGluR Function in Central Amygdala Neurons in a Model of Arthritic Pain

2006 ◽  
Vol 96 (4) ◽  
pp. 1803-1815 ◽  
Author(s):  
Weidong Li ◽  
Volker Neugebauer
Keyword(s):  
Metabotropic Glutamate Receptors ◽  
Central Nucleus ◽  
Noxious Stimulation ◽  
Adult Rats ◽  
Group Iii ◽  
Metabotropic Glutamate ◽  
Group I ◽  
Group Ii ◽  
Joint Arthritis ◽  
Stimulation Of

Metabotropic glutamate receptors (mGluRs) play important roles in neuroplasticity and disorders such as persistent pain. Group I mGluRs contribute to pain-related sensitization and synaptic plasticity of neurons in the laterocapsular division of the central nucleus of the amygdala (CeLC), although the roles of groups II and III mGluRs are not known. Extracellular single-unit recordings were made from 60 CeLC neurons in anesthetized adult rats. Background activity and evoked responses were measured before and during the development of the kaolin/carrageenan-induced knee-joint arthritis. Drugs were administered into the CeLC by microdialysis before and/or after arthritis induction. A selective group III mGluR agonist (LAP4) inhibited CeLC neurons' responses to stimulation of the knee and ankle in arthritis ( n = 7) more potently than under normal conditions ( n = 14). A selective group II agonist (LY354740) inhibited responses under normal conditions ( n = 12) and became more potent in inhibiting responses to noxious stimulation of the knee in arthritis ( n = 10). The effect of LY354740 on innocuous stimulation of the knee and stimulation of the ankle did not change in arthritis. Antagonists for groups II (EGLU, n = 9) and III (UBP1112, n = 8) had no effects under normal conditions. In arthritis, UPB1112 ( n = 5) facilitated the responses to stimulation of knee and ankle, whereas EGLU ( n = 5) selectively increased the responses to stimulation of the knee. These data suggest that mGluRs of groups II and III can inhibit nociceptive processing in CeLC neurons. The increased function and endogenous activation of group II mGluRs in the arthritis pain model appear more input-selective than the general changes of group III mGluRs.

scholarly journals Mid-Term Outcomes of Primary Hip Replacement in Patients with End-Stage Chronic Renal Disease

2019 ◽  
Vol 25 (2) ◽  
pp. 44-54
Author(s):  
A. N. Tsed ◽  
A. K. Dulaev ◽  
N. E. Mushtin ◽  
K. G. Iliushchenko ◽  
A. V. Shmelev
Keyword(s):  
Parathyroid Hormone ◽  
Renal Disease ◽  
Hip Replacement ◽  
Chronic Renal Disease ◽  
Group Iii ◽  
Dihydroxyvitamin D ◽  
Group I ◽  
Group Ii ◽  
End Stage ◽  
Primary Hip Replacement

Purpose — to evaluate mid-term outcomes of primary hip replacement in patients with end-stage chronic renal disease and to develop an algorithm for selection of surgical tactics and perioperative treatment.Materials and Methods. The authors evaluated outcomes of primary hip replacement in 45 patients receiving renal substitution therapy and 47 patients without chronic renal disease. Patients with end-stage chronic renal disease (CRD) were divided into two groups: group I included 30 (66.6%) patients receiving chronic hemodialysis (CH) and group II included 15 (33.4%) patients after renal transplantation (RT). Group III of 47 (51.1%) patients without any signs of CRD who underwent hip arthroplasty within relevant period of time was established to evaluate the effectiveness of primary hip replacement. Blood serum Ca2+ and P5+ levels as well as levels of parathyroid hormone (PTH) and 1.25-dihydroxyvitamin D were measured to determine the rate of calcium- phosphoric metabolism disturbance. Multi-spiral CT scans of hip joint were performed to identify bone mineral density and the mean Hounsfield (Hu) value was calculated for which the data was obtained from five various points on the proximal femur and acetabulum. Beta-2 microglobulin (B2M) blood test was performed to confirm amyloid bone disease.Results. The authors did not observe statistically significant differences for arthroplasty outcomes in patients of group II and III. Patients receiving long-term hemodialysis demonstrated significantly lower parameters of Harris score and Barthel’s index of social adaptation after hip replacement as compared to groups II and III: patients of group I demonstrated outcomes improvement at 19.55%, in group II — at 13.03%, in group III — at 10.15% as compared to preoperative status. Decrease of 1.25-dihydroxyvitamin D below 20,0 mcg results in resorption of cancellous bone in proximal femur and acetabulum along with myopathy of gluteus muscles. Sharp increase of parathyroid hormone level (over 600 pcg/ml) was accompanied by inhibition of osteoblasts proliferation and differentiation resulting in substantial impairment of mineralization.Conclusion. According to the algorithm suggested by the authors the key parameters that need to be evaluated in preoperative period are parathyroid hormone (PTH) and 1.25-dihydroxyvitamin D. Five-fold increase of PTH (>600 pcg/ml) demands parathyroidectomy as the first stage of treatment to decrease risk of early aseptic loosening of hip prosthesis and development of periprosthetic fracture.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

1998 ◽  
Vol 80 (09) ◽  
pp. 393-398 ◽  
Author(s):  
V. Regnault ◽  
E. Hachulla ◽  
L. Darnige ◽  
B. Roussel ◽  
J. C. Bensa ◽  
...  
Keyword(s):  
Fluid Phase ◽  
Anticardiolipin Antibodies ◽  
Dual Reactivity ◽  
Group Iii ◽  
Important Group ◽  
Epitope Specificity ◽  
Glycoprotein I ◽  
Group I ◽  
Group Ii ◽  
Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

Oxygen Fraction Adjustment According to Body Surface Area during Extracorporeal Circulation

2015 ◽  
Vol 18 (3) ◽  
pp. 098
Author(s):  
Cem Arıtürk ◽  
Serpil Ustalar Özgen ◽  
Behiç Danışan ◽  
Hasan Karabulut ◽  
Fevzi Toraman
Keyword(s):  
Body Temperature ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Extracorporeal Circulation ◽  
Group Iii ◽  
Oxygen Fraction ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii

<p class="p1"><span class="s1"><strong>Background:</strong> The inspiratory oxygen fraction (FiO<sub>2</sub>) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO<sub>2</sub>) to reach hyperoxemic levels (&gt;180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO<sub>2</sub> levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO<sub>2</sub> levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO<sub>2</sub> during cardiac surgery.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO<sub>2</sub> adjustment strategies applied to the patients in the groups were as follows: FiO<sub>2</sub> levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Mean PaO<sub>2</sub> was significantly higher in Group I than in Group II at T2 and T3 (<em>P</em> = .0001 and <em>P</em> = .0001, respectively); in Group I than in Group III at T1 (<em>P</em> = .02); and in Group II than in Group III at T2, T3, and T4 <br /> (<em>P</em> = .0001 for all). </span></p><p class="p1"><span class="s1"><strong>Conclusion: </strong>Adjustment of FiO<sub>2</sub> according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO<sub>2</sub> between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO<sub>2</sub> levels in concordance with the body temperature in the <br /> rewarming period.</span></p>

Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  
Keyword(s):  
Reproductive Age ◽  
Cervix Uteri ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Group Iii ◽  
Aggressive Form ◽  
Group I ◽  
Group Ii ◽  
Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

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