摘要:

Recent studies using newly devised serologic techniques have dramatically advanced our understanding of gonadal organogenesis and aberrant sexual differentiation. Thus XY gonadal dysgenesis, XX male syndrome, and XX true hermaphroditism, for example, may be seen as typifying specific errors of regulation, synthesis, or function of a phylogenetically conserved plasma membrane component heretofore recognized solely as the male-specific transplantation antigen of mice. This report seeks to convey the excitement of these recent studies, and to provide the clinician with new and useful insights into the fundamental mechanism of primary sex determination.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The timing of ovulation was studied daily during the periovular period in 19 women attending an artificial insemination clinic during 24 menstrual cycles; B-mode ultrasound examination and plasma estradiol (E2) determinations were used. The maximum diameters of the ovarian follicles and the peak plasma E2determinations all occurred within 2 days prior to and including the day of ovulation, as determined by conventional means, in the 12 normal cycles studied. The average values on the day prior to ovulation (day −1) for maximum follicle size and peak E2determination were 2.5 cm and 1660 pmole/liter, respectively. Two definite ultrasonic patterns were noted after ovulation: The follicle either disappeared or filled with internal echoes. It is concluded from the preliminary study that ultrasound examination and plasma E2determinations are equally effective in predicting the time of ovulation.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Four women with primary amenorrhea and hyperprolactinemia are presented. These patients started thelarchal and pubarchal development but never had a spontaneous menses. Hypothyroidism was not demonstrable in these patients. The causes for hyperprolactinemia in these patients and the clinical follow-up are discussed. In the authors' experience, hyperprolactinemia is seen in about one third of women with normogonadotropic primary amenorrhea, and primary amenorrhea is seen in about 3% of women with hyperprolactinemia.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Maternal serum prolactin level (PRL) was determined with radioimmunoassay in normal and complicated late pregnancy. The mean basal PRL levels were not statistically different among normal (179.3 ng/ml), preeclamptic (169.7 ng/ml), hypertensive (171.4 ng/ml), twin (194.8 ng/ml), or diabetic pregnancies (134.4 ng/ml), although 3 of 17 diabetic women had abnormally low PRL levels. The PRL response to 200 jug of intravenously administered thyrotropin-releasing hormone (TRH) was investigated and found similar in normal, preeclamptic, hypertensive, and twin pregnancies. There was no response to TRH in 2 of 3 diabetics with a low basal PRL level. One of these diabetic patients experienced an unexplained intrauterine death 4 weeks later; the others delivered term infants, 1 of whom died of respiratory distress syndrome (RDS). These preliminary results suggest that low basal PRL levels and unresponsiveness to TRH may be related to a poor fetal or neonatal prognosis in diabetic pregnancies.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Fetal movements (FM) were measured using a real-time B-scan method in 50 women in the third trimester. One hundred ninety-five observations were made. The number of FM per 20-minute observation period was similar in normal, diabetic, and hypertensive pregnancies and in patients with placenta previa, but was significantly lower in patients with Rh isoimmunization and an affected fetus. The number of FM did not vary with gestational age, mode of delivery, or birth weight and was significantly increased in patients either with a reactive nonstress test (NST) or in the presence of fetal breathing movements (FBM). Fetal movements were absent before delivery in 4 patients: In 3, the fetus died in utero and in the other a positive contraction stress test (CST) was observed. Conversely, in 2 other fetuses who died in utero, FM were observed during the last examination before death. In both, the cause of fetal death was related to an acute change. No relationship between FM and neonatal death was observed. These data suggest FM monitoring may be helpful in evaluating antepartum fetal condition.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The phospholipids in amniotic fluid from diabetic pregnancies were compared with those in normal pregnancies. There was little difference in the lecithin/sphingomyelin (L/S) ratios on the basis of the gestational ages. However, in diabetic pregnancies, phosphatidylglycerol (PG) was absent or low, and phosphatidylinositol (PI) remained high even if the L/S ratio was > 2. The phosphatidylglycerol/ phosphatidylinositol (PC/PI) ratio was expressed as a function of the L/S ratio. The PG/PI ratio was significantly lower in maternal diabetes. Respiratory distress syndrome (RDS) coincided with an L/S ratio of between 2.0 and 3.0 only when PG was absent. Infants of insulin-dependent diabetic mothers with a particularly low PG/PI ratio (< 50% of the median) had higher relative birth weights and more often had hypoglycemia than those infants born to mothers with a high PG/PI ratio (> 200% of the median). The phospholipids of amniotic fluid correlate with fetal functional maturity and may reflect deviations of hormonal balance required for normal perinatal development.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A sterile gel containing prostaglandin (PG) E2 (2 mg PGE2 10 ml gel) was instilled vaginally in 65 primigravidas with unripe cervixes to accelerate ripening before planned surgical induction of labor. The patients treated with the gel were compared with 30 similar untreated controls. In the PGE2-treated group a significant improvement in cervical score was achieved before labor began, and 47% began to labor “spontaneously” without further treatment. Both the duration of subsequent labor and the incidence of cesarean section were significantly lower in the PGE2-treated group. There were no unwanted fetal or maternal effects. Pre-treatment with intravaginal PGE2gel reduces the risk of failed induction and provides the mother with an experience similar to spontaneous labor without harming the fetus.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Roentgenography and ultrasonography have been recommended for location of an intrauterine contraceptive device (IUCD) when the strings are not visible at the cervical os. Real-time ultrasound may have limited application compared to gray-scale B-scanning in certain clinical applications. Because of previous difficulty in locating an IUCD in 2 gravid and 2 nongravid patients, a blind study of 68 women was conducted. Seven patients were eliminated from the study because of inadequately filled bladders and failure to return for follow-up visits. There were 37 patients with IUCDs and 24 patients in the control group who used other forms of contraception. An incorrect diagnosis was made in 12 of 61 patients. Ten of 37 patients with an IUCD were identified as having no IUCD and 2 of 24 patients without an IUCD were identified as having an IUCD present. The accuracy of correctly identifying the presence or absence of an IUCD appears to be related to the type of device used. All of the 20 patients with a Copper-7 were correctly identified as having an IUCD, although the type was in error in 11 of the 20. Five of 7 patients with a Lippes Loop and none of the patients with a Saf-T-Coil were correctly identified as having an IUCD. Prior literature is reviewed, and possible sources of error are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Plasma levels of estradiol (E2), prostaglandin (PG)E2, and progesterone (P) were measured in both phases of the menstrual cycle in 22 women with benign mastopathies and in 5 normal women. In both phases of the cycle, PGE2 blood levels were significantly higher in patients with benign mastopathies than in normal women. In contrast, the plasma levels of both steroids were lower in patients than in controls. An estrogen-directed synthesis of PGE2 is proposed. In 10 patients, breast thermogenic response to inhibitors of PG biosynthesis (aspirin and indomethacin) revealed a cooling effect in 4 cases, a partly positive response in 3 cases, and no response in 3 cases. The 7 cases with positive responses also had a deficiency of variable magnitude of both steroids without an unbalanced P/E2ratio. In contrast, patients with a negative thermographic response manifested very low levels of progesterone and a low P/E2ratio. The significance of patients' unresponsiveness to inhibitors of PGE2biosynthesis is discussed, as well as the implications with regard to breast cancer.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A prospective study was undertaken to determine the diagnostic accuracy of fine-needle aspiration (FNA) cytology in gynecology. A total of 77 aspirations were performed on 74 patients. In 34 instances the purpose was to rule out or confirm a diagnosis of primary disease, and in 43 cases the procedure was used for suspected metastatic disease or disease recurrent after surgery, radiation therapy, and/or chemotherapy. Excellent correlation was noted between the cytologic and subsequent histopathologic diagnoses of 58 aspirations from patients who also underwent surgical biopsy. Two specimens were false negatives as the result of sampling errors. The applicability of FNA cytology in the field of gynecologic oncology is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID