摘要:

If we see a young, phenotypically female patient with an XY karyotype, it is of great importance to differentiate between the testicular feminization syndrome and gonadal dysgenesis. Patients with testicular feminization will always have normal testes, which are situated either in the ovarian fossa or in the inguinal canal. Patients with gonadal dysgenesis always have streak gonads. The risk of developing a malignancy in an abnormally located testis is very low, certainly before puberty, whereas the risk for dysgenetic gonads to develop a malignancy is high. Testes in patients with testicular feminization have an important endocrine function in puberty, whereas in gonadal dysgenesis patients they do not. For these reasons, in patients with testicular feminization, one should not remove the testes until the completion of puberty, whereas in patients with gonadal dysgenesis removal should be performed immediately upon recognition of the disorder.

ISSN:0378-7346    

DOI:10.1159/000293367

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

We have examined the possibility that corticotropin-releasing hormone (CRH) and adrenocorticotropin (ACTH) might affect prostaglandin (PG) E2 and PGF2α output by term placenta, amnion and decidua during short-term (48-hour) culture, and that effects of CRH might be mediated by ACTH. In all three tissues PG output was stimulated by both CRH and ACTH. These effects were inhibited in the presence of antisera to CRH and to ACTH. Moreover, in placenta, but not in amnion or decidua, the stimulatory effects of CRH on PGE2 and PGF2α output were attenuated in the presence of an antibody to ACTH. Our results support the possibility of paracrine stimulation by CRH and ACTH of PG production in intrautenne tissues, and suggest that in part the effects of CRH on placental PG output might be mediated through ACTH.

ISSN:0378-7346    

DOI:10.1159/000293368

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Pregnancy-associated plasma protein A (PAPP-A), was reported to be an inhibitor in many in vitro systems. Since it was shown that the inhibition of coagulation and complement activity attributed to PAPP-A was in fact due to a contamination by heparin occurring during the purification process, we undertook the present study to see whether the reported PAPP-A-induced inhibition of human leukocyte elastase (HLE) could also be attributed to heparin contamination. PAPP-A was purified from maternal pregnancy EDTA plasma by a method which was previously shown to eliminate contaminating heparin: this preparation was inactive in the HLE assay. But PAPP-A isolated by heparin-Sepharose chromatography, or a PAPP-A-free washing of the heparin-Sepharose column were both inhibitors of HLE. Furthermore the inactive PAPP-A preparation, when incubated with the PAPP-A-free washing of the heparin-Sepharose column, yielded a high molecular weight preparation which inhibited HLE. It is concluded that PAPP-A is not an inhibitor of HLE and that the inhibition of HLE previously attributed to PAPP-A was due to contaminating heparin.

ISSN:0378-7346    

DOI:10.1159/000293369

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Labor-onset hypertension is a poorly documented category, and there is scanty information concerning the outcome of pregnancy in this condition. A retrospective study was performed to compare the pregnancy outcome of 36 patients with labor-onset hypertension (group A) with 36 patients with classical preeclampsia diagnosed before labor (group B) who were matched for parity and age. There was no difference in age, past history of hypertensive pregnancies or family history of hypertension between the two groups. The need for intrapartum hypertensive and anticonvulsant treatment as well as the outcome of pregnancy were similar in both groups. The only significant difference was that group A patients had lower maximum and booking systolic and diastolic pressures. The results indicate that labor-onset hypertension represents a late manifestation of the preeclampsia process, because these patients had lower blood pressure in pregnancy and would not be identified until intrapartum elevation of blood pressure satisfied the diagnostic criteria of preeclampsia

ISSN:0378-7346    

DOI:10.1159/000293370

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The levels of prostaglandin F2α metabolites (PGFM) in the peripheral blood were measured during third stage in a group of patients not given any oxytocic and this was compared with the levels produced in other groups given different oxytocics. There was a significant rise in PGFM within 5 min of delivery in all groups but there was no statistical difference in the serum concentrations of PGFM between the different groups. This suggests that oxytocics given during third stage do not act through release of prostaglandins.

ISSN:0378-7346    

DOI:10.1159/000293371

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The neonatal period is probably the only time when a higher incidence of spontaneous thromboembolic complications may occur in the otherwise normal healthy individual, and this may be related to the activation of the coagulation system at the time of parturition. This study was performed to look at the newborn coagulation and anticoagulation systems and compare these with the changes in the maternal circulation in normal cases. Paired umbilical cord venous and maternal venous blood samples were obtained and plasma levels of protein C, protein S, antithrombin III, fibronopeptide A, fibrinogen, plasminogen, and fibrinolytic inhibitory activity were measured. The maternal plasma level was significantly higher in all cases except for fibrinopeptide A which was similar, and for fibrinolytic inhibitory activity which was lower (p < 0.05). A significant correlation exists between maternal and newborn protein C levels (p < 0.02) and fibrinolytic inhibitory activity (p < 0.05). The findings indicate that parturition leads to a similar degree of activation of the newborn coagulation system as shown by the fibrinopeptide A level. As their anticoagulants and fibrinolytic activity levels are lower and the fibrinolytic inhibitory activity is higher, the newborns are thus predisposed to thrombosis even in the absence of complications such as sepsis.

ISSN:0378-7346    

DOI:10.1159/000293372

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Synthesis and secretion of atrial natriuretic peptide (ANP) is not confined to the heart, but also present in other tissues. ANP is known to affect steroidogenesis in the ovary. To assess the possibilities that (a) the human ovary is a source of ANP secretion as well, and (b) ovarian ANP stimulates progesterone secretion, we investigated ANP as well as progesterone concentrations in preovulatory ovarian follicular fluid from women in an in vitro fertilization program. In all women detectable ANP immunoreactivity was found in ovarian follicular fluid (range 3.3–60.1 pg/ml). Follicular fluid concentrations were low in all but 1 woman who demonstrated a higher ANP level in follicular fluid than in plasma. Follicular ANP and progesterone concentrations were not significantly correlated. These preliminary results suggest that the ovary could well be a site of ANP secretion. If and how ovarian ANP activity affects progesterone secretion remains as yet unknown.

ISSN:0378-7346    

DOI:10.1159/000293373

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

An in vitro model based on luteinised granulosa cells gained during an in vitro fertilisation programme examines the question of whether prednisolone, and thus glucocorticoids in general, are capable of exerting an influence on the secretion of oestradiol and progesterone. It can be demonstrated that prednisolone leads to dosage-dependent increases in the concentration of both steroids, even independently of concurrent stimulation by human chorionic gonadotropin. A similar mechanism for aromatase activity of human adipose cells is suggested.

ISSN:0378-7346    

DOI:10.1159/000293374

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Nineteen women were treated with the gonadotropin-releasing hormone (GnRH) agonist buserelin in order to suppress the pituitary prior to gonadotropin treatment. Eight women were oligomenorrheic, 6 had polycystic ovarian disease (PCOD) and 5 women had normal cycles. Buserelin was administered for 3 weeks before ovarian stimulation, and the pituitary down-regulation was proven by provocative tests. Ovarian stimulation was then achieved by human menopausal gonadotropin (hMG) 2 ampules a day. Several abnormal responses to the combined buserelin/hMG treatment were noted in some patients. This included a sudden decrease in E2 level without LH surge (2 patients), induced follicular growth with buserelin instead of ovarian suppression (2 patients) and ovarian hyper-stimulation syndrome in 3 patients with PCOD. From this we conclude that although pituitary suppression can easily be achieved by GnRH analog administration, this does not ensure the prevention of unwanted responses. It is possible that the common denominator for these abnormal responses is that they are ovarian in origin, hence they occur in spite of pituitary down-regulation. Close monitoring of the suppression and stimulation stages will detect most cases of such failures. Furthermore it is possible that not all patients are suitable for the combined treatment of gonadotropin and GnRH agonist.

ISSN:0378-7346    

DOI:10.1159/000293376

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The aim of the present study was to evaluate the effect of progesterone and of various synthetic progestins on hypothalamic gonadotropin-releasing hormone (GnRH) and on pituitary and plasma LH and prolactin (Prl) concentrations in ovariectomized rats. Groups of 6 rats were treated for 2 weeks with a pharmacological dose of progesterone, desogestrel, medroxyprogesterone acetate or norethisterone enanthate (NET). The same treatment was also repeated in association with estradiol benzoate (EB). Groups of ovariectomized rats were also treated with EB only or vehicle. Ovariectomized rats showed hypothalamic concentrations of GnRH significantly higher than control rats. Progesterone and NET significantly increased GnRH concentrations and reversed the EB-induced changes. Rats treated with progesterone and NET also showed reduced pituitary LH concentration, with high plasma LH levels. All progestins blocked the increase of pituitary LH induced by EB, but were inactive in influencing the inhibitory effect of EB on plasma LH levels. The administration of progesterone and progestins did not induce significant changes of pituitary or plasma Prl, but reversed the EB-induced increase. These results showed that progesterone and progestins have a marked effect on hypothalamic and pituitary hormone secretion and that they modulate estrogen-induced effects.

ISSN:0378-7346    

DOI:10.1159/000293378

出版商:S. Karger AG    

年代:1990

数据来源: Karger