摘要:

An overview of mass screening for precancer and invasive cancer of the cervix uteri in Sweden 1964–1980 is given. Results of the screening program are presented. The decrease of incidence and mortality from invasive cancer of the cervix is presented and discussed. The increase of diagnosis of cancer in situ is illustrated.

ISSN:0378-7346    

DOI:10.1159/000298892

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Human chorion can synthesize and metabolize progesterone, and changes in progesterone synthesis by chorion at term might be important in the processes leading to parturition. We examined whether other steroids present within the maternal compartment and amniotic fluid during late pregnancy influence progesterone output by explants of chorion. We also sought differences in steroid effects on progesterone output in association with labor. Explants were prepared from chorion collected after the spontaneous onset of labor and vaginal delivery and chorion collected after cesarean section without active labor. To study the short-term effects of steroids on progesterone output by chorion, explants were incubated for 4 h with 3 μM pregnenolone and 3 μM of a potential interacting steroid. Other explants were preincubated for 24 h with steroid, then rinsed and incubated for 4 h with 3 μM pregnenolone and 3 μM of the same steroid as during preincubation. Under these conditions, dehydroepiandrosterone and androstenedione inhibited progesterone output by explants of chorion obtained at spontaneous labor and at cesarean section. Testosterone also inhibited progesterone output, but only in cesarean section chorion. If explants were preincubated for 24 h with steroid and then rinsed and incubated for 4 h with pregnenolone only, progesterone synthesis returned to control values. This finding indicates that the mechanism of action of these inhibitory steroids is likely through an effect on 3β-HSD activity and not due to a change in the rate of enzyme synthesis. We also noted apparent stimulatory effects of steroids. When explants were preincubated with pregnenolone sulfate and then incubated for 4 h with 3 μM pregnenolone only or with 3 μM pregnenolone +3 μM pregnenolone sulfate, there was an increase in media progesterone concentrations. To examine the effects of steroids on basal progesterone synthesis, we incubated explants for 24 h with 3 μM steroid without addition of exogenous pregnenolone. 5α-dihydrotestosterone in spontaneous vaginal chorion and 5α-pregnanediol in cesarean section chorion caused an increase in media progesterone concentrations. Progesterone concentrations increased during 24-hour incubations with 20α-dihydroprogesterone and pregnenolone sulfate; the effect of pregnenolone sulfate was greater in chorion collected at spontaneous labor than at elective cesarean section. Addition of pregnenolone sulfate with pregnenolone during 24-hour incubations and during the 2nd incubation of 4 h further increased progesterone accumulation in the media. We conclude that several steroids can modify net progesterone output by explants of chorion in the presence of endogenous or exogenous precursors and that the steroid effects vary with the type of delivery.

ISSN:0378-7346    

DOI:10.1159/000298893

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The output of progesterone by explants of chorion incubated without exogenous precursor was increased in the presence of 20α-dihydroprogesterone (20α-diHP). We have now examined the nature of the 20α-diHP effect. Explants of chorion were incubated with [3H]progesterone and 3 μM non-radiolabelled 20α-diHP to examine the effect of 20α-diHP on progesterone metabolism. Significantly more radioactivity remained as unmetabolized [3H]progesterone compared to chorion incubated in the absence of non-radiolabelled 20α-diHP. There was also a decrease in the output of [3H]-20α-diHP by the explants but no change in the output of a second metabolite of progesterone [3H]-5α-pregnanedione. When explants were incubated with 20α-diHP in the presence of the 3β-hydroxysteroid dehydrogenase inhibitor, trilostane, the output of progesterone was significantly greater than with explants incubated with trilostane but without addition of 20α-diHP. Radiochemically pure [3H]progesterone was produced by explants of chorion incubated with [3H]-20α-diHP. We conclude that 20α-diHP may serve as substrate for chorionic progesterone production through 20α-hydroxysteroid dehydrogenase. 20α-diHP, formed from progesterone, may also exert product feedback inhibition on this enzyme.

ISSN:0378-7346    

DOI:10.1159/000298894

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Fetal weight prediction with ultrasonic measurements of biparietal diameter (BPD) and abdominal circumference (AC) using the equation by Shepard et al. [1982] was tested prospectively in 310 fetuses. Fetuses of all weight categories were included. The error of weight prediction was in the range of+684 to –880 g. One SD of prediction error was 242 g or 8.5% of birth weight. An overestimation was seen in a fetus with a birth weight of less than 2,500 g (1 SD = 183 g or 10% of birth weight). An underestimation could be observed in a fetus with a birth weight of more than 4,000 g (1 SD = 259 g or 5.7% of birth weight). The use of a combination of BPD and AC is more accurate than the use of each of these parameters. In a fetus with a birth weight of less than 2,500 g, the equations by Thurnau et al. [1983] and Weinberger et al. [1984] are of equal clinical value. The method of Shepard et al. should be complemented with measurements of the ‘cephalic index’ to exclude fetuses with brachycephaly or dolichocephaly, but one should be aware that the variability of weight prediction is high (2 SD = 11.4–19.8% of birth weight).

ISSN:0378-7346    

DOI:10.1159/000298895

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Embryonic and fetal mortality is studied, which is induced by human chorionic gonadotropin (hCG) and luteinizing hormone-releasing hormone (LHRH) given prior to ovulation. 5-day cyclic rats were injected with 20 IU hCG or with 1 μg LHRH on day 3 of di-oestrus or on the day of pro-oestrus, and mated 4 h later. Autopsy was performed on day 3 or between days 13 and 18 of pregnancy. Advancement of ovulation by LHRH did not induce embryonic or fetal mortality. Administration of hCG at pro-oestrus or day 3 of di-oestrus induced a considerable mortality, which for the greater part occurred after day 3 of pregnancy but before implantation. This embryonic mortality could be prevented by anti-hCG serum given 21 h after hCG. It is speculated that embryonic mortality induced by hCG is caused by a relatively long-lasting disturbance of steroid metabolism, due to a long metabolic half-life of hCG. The disturbance of steroid metabolism as a possible cause of implantation failure is discussed.

ISSN:0378-7346    

DOI:10.1159/000298896

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A population of 40 mother-newborn pairs with a wide range of birth weight has been studied. Seventeen of the mothers were diabetic, while the other 23 were normal pregnant women. The chronic blood glucose levels were assessed in the mothers through the percentage of glycosylated hemoglobin (HbA1) at delivery. The functional activity of the pancreatic β-cells in the newborns was estimated through the concentration of insulin and C-peptide in the cord blood. Maternal HbA1 was not quantitatively related to the birth weight ratio. In contrast, both insulin and C-peptide correlated significantly with it. Is is concluded that in populations with a good metabolic control, blood glucose levels, as measured by HbA1 are not the major determinant of fetal growth.

ISSN:0378-7346    

DOI:10.1159/000298897

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Biopsies from 30 cases of vulvar condyloma, 460 cases of cervical dysplasia, 30 cases of carcinoma in situ and 75 cases of invasive carcinoma of the cervix were screened for the presence of human papillomavirus (HPV) antigen by means of the peroxidase-antiperoxidase method. Positive reaction for HPV was detected in 14 cases of condyloma and 80 cases of dysplasia as a brown intranuclear precipitate in the superficial layer of the epithelium. None of the cases of carcinoma in situ and invasive cancer were positive for HPV. The mean age of the women with HPV-positive dysplasia was significantly lower than that of the women with HPV-negative dysplasia. Condylomatous dysplasia showed a significantly higher positive rate than did noncondylomatous dysplasia. Cases of condylomatous dysplasia with severe stromal inflammation were negative for HPV more frequently than those with mild stromal inflammation.

ISSN:0378-7346    

DOI:10.1159/000298898

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Six cases with a coexistence of endometriosis and genital anomalies among 112 patients with external endometriosis and 90 patients with genital anomaly were detected. Three cases of severe endometriosis associated with uterovaginal duplication, unilateral renal agenesis and ipsilateral blind vagina and the latter in a patient with Rokitansky-Kuster-Hauser syndrome are presented. Another case with obstructive genital anomaly without endometriosis is also presented. The histogenetic mechanisms of endometriosis are discussed. The transplantation theory is not sufficient to explain all the cases and, therefore, the theory of celomic metaplasia and the theory of müllerian remains or Cullen’s theory, as well as the intervention of genetic-constitutional, immunologic, hormonal and other factors must also be consider

ISSN:0378-7346    

DOI:10.1159/000298899

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A digoxin-like immunoreactive substance (DLIS) has been reported in the amniotic fluid. Since radioimmunoassay kits are standardized using serum-based standards, we hypothesized that measurement of DLIS may be an artifact related to the low protein content of amniotic fluid. We analyzed 12 amniotic fluid samples before and after supplementation with lyophilized human serum. The means ± SDs for DLIS (nmol/l) at protein concentrations of 0, 32 and 63 g/l were 1.4 ± 0.16, 0.6 ± 0.09, and 0.4 ± 0.09 nmol/l, respectively. We, therefore, hypothesize that DLIS in amniotic fluid may in part be explained by a technical artifact.

ISSN:0378-7346    

DOI:10.1159/000298900

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

A severe case of starch peritonitis is presented where surgical intervention and resection of the major granuloma abruptly improved the patient’s condition. The theoretical basis of the syndrome and the treatment are discusse

ISSN:0378-7346    

DOI:10.1159/000298901

出版商:S. Karger AG    

年代:1986

数据来源: Karger