摘要:

Hysterosocpic intrauterine findings and levels of human decidua-associated protein 200 (hDP 200) in the uterine fluid were recorded in 116 women investigated for infertility or recurrent abortions. The levels of hDP 200 were significantly higher in the presence of submucous myomas or endometrial polyps, and lower in the presence of intrauterine adhesions in comparison to those in normal uterine cavities. hDP 200, an immunoglobin secreted by the endometrium, may be involved in implantation and placentation and its level in the uterine cavity is influenced by the presence of intrauterine pathology

ISSN:0378-7346    

DOI:10.1159/000292484

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Serum magnesium levels, as well as magnesium content of red blood cells and peripheral mononuclear cells, were examined in 31 pregnant women in their third trimester. Ten were preeclamptic; chronic hypertension was found in 10, and 11 were normotensive. Magnesium serum levels were 1.2 ± 0.1,1.2 ± 0.1 and 1.3 ± 0.1 mEq/1 in the normotensives, chronic hypertensives and pre-eclamptics, respectively. Red blood cell magnesium concentration was 3.4 ± 0.4, 3.7 ± 0.7 and 3.5 ± 0.5 mEq/1, and mononuclear magnesium content was 37.9 ± 30.6, 27.6 ± 15.9 and 30.2 ± 25.7 fg/cell in the same groups, respectively. These changes were not statistically significant. The results do not support the hypothesis that magnesium deficiency is involved in the pathophysiology of preeclampsia.

ISSN:0378-7346    

DOI:10.1159/000292485

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Plasma levels of triglycerides, cholesterol, cholesterol esters, phospholipids, lipoperoxides, vitamin E and erythrocyte glutathione peroxidase activity showed no significant differences between 40 women with habitual abortion and controls. However, the levels of free fatty acids (FFA), which are extremely cytotoxic compounds, were significantly higher in women with habitual abortion (HA) than in controls (16.8 ± 6.7 vs. 8.6 ± 3.7mg/l00ml, p < 0.01, respectively). The high amounts of FFA in HA women during pregnancy were probably due to a continuous and/or excessive stress-dependent discharge into the blood of catecholamines from autonomic nerve endings. These catechol-amines can induce a strong uterine vasoconstriction and placental ischemia-hypoxia which, in association with additional insults caused by reoxygenation, might lead to eventual miscarriage.

ISSN:0378-7346    

DOI:10.1159/000292486

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Following spontaneous delivery (n = 12) a pronounced increase in the maternal total white blood cell count was found (to [X ± SD]: 20 ± 6 × 109 total leukocytes/1), which would be considered highly ‘pathological’ in nonpregnant women. The alteration was predominantly due to an increase in polymorph-nuclear cells and band forms. Simultaneously, a drastic decrease in the percentage and the absolute number of lymphocytes was noticed in venous blood (from 32 to 5%, or [X ± SD]: from 2.7 ± 0.7 to 1.1 ± 0.3 × 109 total lymphocytes/1). In this decrease nearly all lymphocyte subtypes were involved, although to differing extents. Following elective caesarean delivery (n = 6), no leukocytosis was found, however the percentage and absolute number of lymphocytes was also decreased, although not as pronounced as after spontaneous delivery. Again not all the lymphocyte subpopulations were affected to the same degree, and the effect was especially obvious for the suppressor T cells and B cells. Following emergency caesarean delivery (n = 5), no obvious effect on the absolute number of lymphocytes or on the pattern of lymphocyte sub-populations was observed. However, the total number of white blood cells was clearly increased, as after spontaneous deliveries. The possible significance of these findings, also for therapeutic consequences during the perinatal period, is discussed.

ISSN:0378-7346    

DOI:10.1159/000292487

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Pregnancy is associated with modifications in the maternal immune system that may be involved in the absence of rejection of the fetoplacental graft characterized by the presence of paternal antigens. This active and specific tolerance towards the fetoplacental unit seems to be compromised in pregnancy-induced hypertension (PIH). To evaluate whether the immunological state in patients with PIH is altered with respect to normal pregnant women we studied 15 patients with PIH, 15 uncomplicated pregnant and 10 healthy nonpregnant women using monoclonal antibodies directed to specific lymphocyte antigen determinants, cytokines (TNF) and soluble molecules (sIL·2R, sCD8). The percentage of CD4 lymphocytes and of natural killer (NK) cells was significantly higher in PIH patients compared to controls (CD4: 42.9 ± 10.5 vs. 32.7 ± 12.5%; p < 0.05; NK: 14.7 ± 6.3 vs. 8.3 ± 3.4%; p < 0.01). However, these values did not differ when compared to normotensive nonpregnant controls (CD4: 53.1 ± 5.9%; NK: 17.2 ± 7.1%). In addition, the soluble IL·2 receptor (sIL-2R) was higher in PIH patients when compared to control patients (725.5 ± 194.2 vs. 482.5 ± 187.2 U/ml; p < 0.01). The immune response observed in normal pregnancies responsible for the tolerance towards the fetoplacental unit seems to be altered in PIH patients as suggested by higher levels of CD4 and NK cells, and sIL-2R. This may lead to a chronic rejection syndrome and be involved in the pathophysiology of PIH.

ISSN:0378-7346    

DOI:10.1159/000292488

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The effect of uterine distension on the cervix was studied in 16 women (mean age 38.4 years). Carbon dioxide was infused, in increments up to 50 ml, into a condom-ended catheter introduced into the uterus. The response of uterine and cervical pressures to uterine distension was determined before and after anesthetizing the uterine body and the cervix, respectively. Upon slow uterine distension, the cervical pressure increased (p < 0.01), while the uterine pressure showed insignificant changes (p > 0.05). Rapid distension led to cervical pressure decrease (p < 0.01) and increase of uterine pressure (p < 0.01). The cervical pressure did not respond to slow or rapid inflation of the anesthetized uterus, neither did the anesthetized cervix respond to uterine inflation. A reflex relationship seems to exist between the uterine body when distended and the cervix, which we call ‘uterocervical reflex’. The study demonstrates that the uterus behaves differently under physiologic and pathologic conditions. Upon slow uterine distension as in pregnancy, the uterus adapts by uterine dilatation and cervical tightening. In pathologic conditions which distend the uterus rapidly, the latter reacts with uterine contraction and cervical dilatation, discharging the uterine contents. Dysfunction of the uterocervical reflex may result in uterine and cervical disorders. The reflex may thus be included as a diagnostic tool in such disorders.

ISSN:0378-7346    

DOI:10.1159/000292489

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To examine antiestrogenic effects of danazol through the receptor system and to clarify its direct effects on the endometrium in vivo, we applied danazol jelly directly into the rabbit uterine cavity and measured uterine estrogen, progesterone and androgen receptors (ER, PR and AR, respectively). Danazol significantly reduced ER, PR and AR (p < 0.05). Treatment with receptor-blocking agents (RU 486 and oxendolone) showed that the decrease in the ER level showed a closer association with that in PR than with AR. These results indicate that danazol directly administered into the uterine cavity is absorbed by the endometrial tissue and exerts its antiestrogenic effects possibly through PR in the cells.

ISSN:0378-7346    

DOI:10.1159/000292490

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Fifty-six patients with pelvic endometriosis were treated with a buserelin dosage of 200 μg/day s.c. for 6 months. Scoring of the American Fertility Society (AFS) for endometriosis was performed by laparoscopy in all cases before and at the end of therapy. Serum CA-125 and estradiol levels were determined before the treatment, and monthly during therapy and follow-up (6 months; respectively). A slight positive correlation was found between serum CA-125 concentrations before treatment and AFS scores for adhesions only. Before treatment, serum CA-125 values also correlated slightly with total AFS scores of patients with adhesions. At the end of the 6-month therapy, no correlation was found between CA-125 concentrations and second-look AFS scores for implants and/or adhesions. Serum CA-125 and estradiol values were closely parallel to each other during and after therapy with the gonadotrophin-releasing hormone agonist buserelin. In conclusion, (1) adhesions may play a role in the elevation of serum CA-125 levels in endometriosis, and (2) a significant decrease in serum CA-125 values during the buserelin therapy may result from a rather different mechanism, such as ovarian suppression, other than the therapeutic effect of this agent.

ISSN:0378-7346    

DOI:10.1159/000292491

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Oestrogen-containing vaginal rings of various designs have been utilised in hormone replacement therapy. In contrast to the traditional ‘homogeneous’ design, rings designed with a steroid-containing core and outer polymer sheath provide a diffusion-controlled release rate which enables the delivery of low doses of drug. The aim of this investigation was to evaluate in vitro oestradiol release from a ‘core’ designed vaginal ring (Estring®) and furthermore, to establish the in vivo concentration-time course of oestradiol, oestrone and total oestrone (unconjugated plus conjugated) in consecutive applications of such an oestradiol-containing vaginal ring in postmenopausal women. Results indicate that the controlled release design of Estring® produces stable, low systemic plasma concentrations of oestradiol and has an extended time period of release.

ISSN:0378-7346    

DOI:10.1159/000292492

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Insulin-like growth factor-1 (IGF-1) levels were analyzed in 43 healthy, nulliparous women aged 19–25 years. Blood samples were drawn in a standardized way in follicular and luteal phases, for present users during cycle days 5–10 and 18–23, respectively. In each women, absolute levels and a difference in p-IGF-1 levels between the two menstrual cycle phases (ΔIGF-1) were related to oral contraceptive (OC) use, height, weight, age, gonadotropin and serum sexual hormone binding globulin (s-SHBG) levels. In the follicular phase and cycle days 5–10, absolute values of p-IGF-1 did not significantly differ between present, former and never users of OCs, in contrast to a significant difference (p = 0.0013) in the luteal phase and cycle days 18–23 between present users and never users, after adjustment for age. ΔIGF-1 was significantly negatively correlated to present OC use, compared with nonusers (p = 0.0002). ΔIGF-1 did not significantly differ between former and never users. While height and weight were not significantly related to ΔIGF-1, there was a significant negative correlation between age and ΔIGF-1 (p = 0.05). Also, s-SHBG and p-IGF-1 were significantly negatively related in the luteal phase and cycle days 18-23 after adjustment for age (p = 0.006), although this relationship disappeared after adjustment for present OC use.

ISSN:0378-7346    

DOI:10.1159/000292493

出版商:S. Karger AG    

年代:1994

数据来源: Karger