摘要:

&NA;Nonpuerperal galactorrhea and amenorrhea have been reported following the use of oral contraceptives. Treatment of this condition with ergot alkaloids has proved to be of great therapeutic value. Pretreatment plasma hLH and hFSH concentrations in 13 women with postpill galactorrhea‐amenorrhea (PPGA) were 6.6 ± 0.6 (SE.) and 5.0 ± 0.8 mIU/ml, respectively. The mean prolactin concentration was 80.7 ± 13.2 ng/ml. After complete evaluation in which diagnostic evidence of pituitary tumor was absent, the patients were treated with ergocryptine (CB‐154). The mean hPRL concentration at 14 days of therapy was 7.8 ± 1.9 ng/ml. Cyclic gonadotropin secretion resumed in all but one instance; ovulation was confirmed on the basis of a biphasic temperature chart and in 5 cases, endometrial biopsy. Measurement of serum dopamine‐beta‐hydroxylase (DBH) activity indicated a significant decline at the end of 8 weeks of CB‐154 therapy. The fall in hPRL was not necessarily associated with a fall in DBH. The majority of women in this study exhibited a consistent personality suggesting varying degrees of anxiety unrelated to the PPGA and usually antedating the use of oral contraceptives. PPGA was found in women without hyperprolactinemia, but altered hPRL secretion was evident in all instances. The data suggest that the disorder of cyclic gonadotropin secretion is related to altered hPRL secretion, but the mechanism is possibly related to a catecholamine abnormality. The data support the presence of an inherent cyclic mechanism for the secretion of gonadotropins. CB‐154 therapy does not affect conception, and no teratogenic effects were observed in 2 infants born to women who had received CB‐154 during the first 40 days of gestation.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;The occurrence of breast secretion more than 1 year postpartum was studied in 800 healthy, parous women of childbearing age. Among the 418 women who were using a combination‐type oral steroid contraceptive, the incidence of breast secretion was lower than among the nonusers. The incidence of bilateral secretion decreased with increasing duration of use of the oral contraceptives. Statistical material is presented for the incidence of breast secretion as related to age, time elapsed since last delivery, and duration of nursing the last child. Brownish secretion rather than white or yellowish is seen more often in women over 30 years of age. Various menstrual irregularities (excluding amenorrhea) do not appear to be associated with an increased incidence of breast secretion.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Ten patients with hypothalamic anovulation were treated with a “retard” preparation of synthetic luteinizing hormone releasing hormone (LHRH) after an HMG stimulation in order to induce ovulation and pregnancy. Four of the patients ovulated after intramuscular administration of the LHRH preparation. This study suggests that it is possible to induce ovulation with LHRH in patients pretreated with HMG, and that LHRH has advantages over HCG since it does not induce hyperstimulation even in the presence of exaggerated follicular growth. Nevertheless, the optimal conditions for the use and monitoring of LHRH treatment have yet to be clarified.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Eighteen patients hospitalized for excessive ovarian hyperstimulation syndrome are reported. In 14 cases the ovarian hyperstimulation was induced by human menopausal gonadotropins and in 4 cases by combined treatment with clomiphene and HCG. In 5 patients the hyperstimulation was associated with conception, which resulted in 1 quintuplet delivery, 1 early quintuplet abortion, 1 twin abortion, 1 normal delivery, and 1 missed abortion. The regimen of treatment was a conservative one. The patients were hospitalized and treated with infusion of plasma expanders. Anticoagulant therapy was administered only in cases that showed clinical evidence of thromboembolic phenomena or laboratory evidence of severe hemoconcentration. The pathogenesis of the ovarian hyperstimulation syndrome, prevention, and management are discussed. This syndrome should be diagnosed early and treated intensively.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;In order to assess the ovarian and adrenal contribution to peripheral steroid levels in 2 hirsute women, 1 with regular menstrual cycles (H‐E) and the other with oligomenorrhea (HOA), daily blood samples were collected during two consecutive menstrual cycles. The first cycle served as control, and dexamethasone (Dex), 0.5 mg four times a day, was administered during the second cycle. The serum levels of the following steroids were measured: pregnenolone (&Dgr;5‐P), 17‐hydroxy‐pregnenolone (17‐&Dgr;5‐P), progesterone (P), 17‐hydroxy‐progesterone (17‐P), cortisol (F), dehydroepiandrosterone (DHEA), its sulfate (DHEA‐S), androstenedione (A), testosterone (T), 5&agr;‐dihydrotestosterone (DHT), estrone (E1), and estradiol‐17&bgr; (E2). Peripheral levels of P were suggestive of ovulatory cycles in all four cycles studied. Peripheral levels of 17‐P were elevated during the follicular phase of both control cycles and did not suppress to normal levels during the treated cycle, suggesting the ovary as the main source of excess 17‐P secretion in both subjects. The H‐E subject showed elevated F levels during the control cycle. In both subjects, F suppressed maximally within 5 days of treatment and remained low during Dex administration. Assuming that Dex treatment had no significant effect on ovarian steroidogenesis and suppressed completely the zona fasciculata and reticularis of the adrenal cortex, the following conclusions can be made: 1) the steroid 17‐&Dgr;5‐P is almost exclusively of adrenal origin in both subjects; 2) there is an increased secretion of &Dgr;5‐P during the luteal phase which was masked by the adrenal contribution to peripheral &Dgr;5‐P; 3) in both subjects there is evidence for mixed adrenal and ovarian causes of excess androgens; 4) the elevated DHEA and DHEAS levels observed in both subjects were of adrenal origin; 5) the elevated T and DHT were of ovarian origin in the H‐OA subject and of mixed adrenal‐ovarian origin in the H‐E subjects; and 6) the data suggest a different mechanism of control for DHEA‐S and F secretion by the adrenal cortex.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Micronized 17&bgr;‐estradiol (E2) was used as oral replacement therapy in 369 patients with estrogen deficiency and related menopausal symptoms. Over 95% of 319 patients evaluable for efficacy gained satisfactory relief of their symptoms from cyclic (on 21 days/off 7 days) E2therapy. Approximately 77% required no adjustment of their initial daily dose, viz, 1 mg (5 or less hot flushes per day) or 2 mg (6 or more flushes daily). In addition, 80% (58/72) of the patents who did not obtain adequate control from their starting dose were successfully titrated, either upward to a maximum of 4 mg/day or downward for maintenance. Overall, a higher percentage of patients were treated successfully with 2 mg daily (209/319; 66%) than with 1 mg/day (22%). About 8% of the patients required 3 or 4 mg daily, while 4% failed to derive adequate benefit from micronized E2. Oral E2therapy was well tolerated; hence, the attrition rate due to side effects or lack of control was only 6% (22/369). Moreover, all laboratory findings were within normal limits, even in patients treated with E2for over 12 months. Coincidental endometrial changes were found in 9 patients, all of whom had received long‐term (9 months‐3 years) estrogen therapy prior to entering this study. Thus, the state of the endometrium should be determined before any estrogens are given for the menopause. It is concluded that micronized E2is highly efficacious, well accepted, and safe for oral estrogen‐replacement therapy in menopausal women.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;An open cuff technic was employed in 2421 consecutive patients with total abdominal hysterectomy. Extraperitoneal drainage without a drain was the purpose of the method. The two most serious complications were postoperative hemorrhage (7 cases, 0.28%) and intestinal obstruction (6 cases, 0.24%). The morbidity rate was 20.8%. Of those without colporrhaphy (two‐thirds), the morbidity rate was 18.2%. Prophylactic antibiotics were not used in the latter group. In no instance was a pelvic abscess or cuff abscess recognized. Death occurred in 1 case (0.041%). This method may diminish the occurrence of apical infections above a closed vagina by allowing immediate extraperitoneal drainage. Postoperative bleeding and intestinal obstruction, along with other rare conditions, continue to represent occasional but severe complications.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Besides its diagnostic value, laparoscopy is a useful operative tool in the treatment of infertility. We have used dilatation of phimotic tubal ostia and salpingolysis by laparoscopy as our primary approach. In the total series of 33 cases a pregnancy rate of 42.1% was obtained.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Pregnancy performance of 471 patients under age 15 who delivered between 1968 and 1972 was compared with that of the same number of control patients between 19 and 25 years of age. The control group was selected by the paired method technic, whereby each study patient was paired with a control patient utilizing identical race and contribution to hospital cost as the economic determinant. The results of the study showed that young patients differed significantly from the control group in having an earlier menarche and a greater number of recurring pregnancies within 18 months of the initial one. Pregnancyinduced hypertension and pelvic inlet contraction were pregnancy complications occurring more frequently among study patients than control patients.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

&NA;Experience with the management of 4 pairs of locked twins is described and analyzed. In view of the high morbidity figures, a proposed preemptive management is suggested.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID