摘要:

Substantial decreases in both incidence of and mortality from cancer of the uterine cervix have occurred during the past 30 years. Decreases are apparent among both whites and nonwhites, although rates among black women remain considerably higher than those among white women. In spite of geographic differences in rates, decreases have been observed in all areas of the United States for which data are available. The decline in mortality and in invasive cancer incidence has been occurring within virtually all age groups. Diagnosed infrequently in the past, carcinoma in situ now has an incidence rate two to three times higher than that of invasive cancer and also has a much younger age distribution. Carcinoma of the cervix occurs much more frequently among women of lower income and education level; this accounts for much of the observed racial difference in incidence.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The colposcopic findings in 86 virgin teenagers are reported and compared with a matched control group of 172 sexually active teenagers. The results show that an atypical transformation zone may be observed in virgins and that the prevalence rate of this condition is different when compared with that of sexually active teenagers. These data suggest that: 1) the presence of a colposcopically observed atypical epithelium is due to a normal maturation process occurring in young women after the menarche, and 2) coitus is responsible for the prolongation of this process in sexually active teenagers.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To elucidate the roles of prostaglandins in peritoneal fluid and sex steroids in patients with endometriosis (N=29), tubal disorders (N=15), and unexplained infertility (N=13), assays were performed using 6-keto-prostaglandin F1α(6-keto-PGF1α) (a metabolite of prostacyclin), thromboxane B2(a metabolite of thromboxane A2), estradiol, and progesterone. Women with normal pelvic anatomy (N=25) served as controls. Peritoneal fluid 6-keto-PGF1αconcentrations in patients with endometriosis (742 ± 104 pg/ml, mean ± SE), tubal disorders (987 ± 211 pg/ml), and unexplained infertility (1659 ± 770 pg/ml) were higher than those in the control women (515 ± 77 pg/ml). The thromboxane B2levels in the peritoneal fluid in endometriosis (554 ± 73 pg/ml), tubal disorders (614 ± 107 pg/ml), and unexplained infertility (668 ± 161 pg/ml) were higher than the levels in the control subjects (333 ± 23 pg/ml). There was no relationship between 6-keto-PGF1α/thromboxane B2in peritoneal fluid and day of menstrual cycle. The concentrations of estradiol and progesterone were normal in all patient groups and were not related to the 6-keto-PGF1αand thromboxane B2levels. The authors suggest that these prostanoids, which may contribute to infertility, may originate mainly from the peritoneum as a result of irritation by endometriotic implants, tubal adhesions, and scarring.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The short-term effects of different types and doses of estrogen therapy on coagulation and fibrinolysis were studied in 35 surgically menopausal women. Dynamic tests of the coagulation cascade, tests indicative of ongoing, intravascular coagulation, and assessments of coagulation inhibition and fibrinolysis were performed. No clinically abnormal responses were found with the tested regimens—1 and 2 mg of 17/β-estradiol and 0.625 and 1.25 mg of conjugated equine estrogens. Increased plasminogen antigen and activity were found with the conjugated estrogens but not with the 17/β-estradiol preparations. The age of the woman had no effect on either the direction or magnitude of response to treatment. Estrogen therapy at the reported doses does not appear to adversely affect the coagulation-fibrinolysis systems of surgically menopausal women. Based on their ability to enhance plasminogen activity, conjugated estrogens may be preferred over the 17/β-estradiol preparations for this clinical population.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Luteal phase deficiency is usually a problem of inadequate progesterone production associated with inadequate ovarian follicular development. The hypothesis that luteal phase deficiency results from an abnormal secretion pattern of luteinizing hormone (LH) was tested in these women. To this end, the early follicular LH secretion pattern in four women with luteal phase deficiency was characterized and compared with patterns in normal women. Blood samples were obtained through indwelling catheters every ten minutes for eight hours (10 am to 6 pm), and plasma levels of LH and FSH were measured. Luteinizing hormone and FSH secretion profiles were analyzed for pulse frequency, amplitude, and mean plasma level. A significantly greater LH pulse frequency in women with luteal phase deficiency was observed when compared with the frequency in normal controls (luteal phase deficiency, 10.5 pulses/eight hours; normal, 5.2 pulses/eight hours;P≤·05). The mean FSH concentration was less in the women with luteal phase deficiency, but the level was not significant. These data suggest that the abnormal LH secretion pattern observed in women with luteal phase deficiency is responsible for their inadequate luteal phase progesterone secretion and their infertility.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors have suggested that dysfunction of a central structure (above the pituitary level) is the primary etiologic factor responsible for the production of the polycystic ovary syndrome. To investigate further the functional integrity of the hypothalamic pituitary axis, plasma levels of /β-endorphin, γ3-melanocyte stimulating hormone, and γ1-melanocyte stimulating hormone-like immunoreactivity were measured in six patients with polycystic ovary syndrome, and in ten women with normal ovarian function. The limit of sensitivity for the radioimmunoassays was 20 pg/mL. Plasma β3-endorphin was significantly higher in polycystic ovary syndrome than in control subjects: (mean ± SE) 60 ± 10 versus 30 ± 4 pg/mL, respectively (P<.05). γ3-Melanocyte stimulating hormone was detectable in four of six patients with polycystic ovary syndrome (mean for the whole group: 45 ± 15 pg/mL); it was undetectable in all the control subjects. Control of plasma β-endorphin and γ3-melanocyte stimulating hormone secretion in PCO was evaluated with metyrapone and dexamethasone. Overnight administration of metyrapone to polycystic ovary syndrome patients resulted in rises of β-endorphin and γ3-melanocyte stimulating hormone. Dexamethasone suppressed only partially (to basal concentrations) β-endorphin and γ3-melanocyte stimulating hormone levels. Plasma adrenocorticotropic hormone concentrations were within the normal range and displayed the expected changes in response to metyrapone and dexamethasone. The present report presents an additional central (hypothalamic-pituitary) abnormality in patients with the polycystic ovary syndrome.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Thirty-four hypothyroid women on thyroid hormone substitution were followed through 37 pregnancies, and 16 women having previous surgery for thyroid carcinoma and thereafter placed on suppressive thyroxine treatment were followed through 19 pregnancies. The thyroxine treatment needed readjustment in 13 pregnancies (23%) to maintain euthyroidism. At delivery, the maternal free thyroxine index was 126 nmol/L in the group of patients treated for hypothyroidism and 146 nmol/L in the patients with treated thyroid carcinoma. The amniotic fluid thyroxine level in normal pregnancies was 6.7 nmol/L, in hypothyroid patients 6.7 nmol/L, and in patients with thyroid carcinoma 5.6 nmol/L. The amniotic fluid reverse triidothyronine level in normal pregnancies was 0.51 nmol/L, in hypothyroid patients 0.66 nmol/L, and in patients with thyroid carcinoma 0.70 nmol/L. All infants were euthyroid.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To investigate the changes in pituitary responsiveness to hypothalamic releasing hormones during the periparturitional period, women undergoing labor and vaginal delivery were stimulated with thyrotropin-releasing hormone. The percentage of incremental changes in prolactin and thyroidstimulating hormone were significantly lower in pregnant women at term than in nonpregnant control subjects. Evidence of augmented release of prolactin was disclosed after the onset of active labor. The percent increases in prolactin and thyroid-stimulating hormone were significantly higher at 24 hours post partum than at term. Administration of thyrotropin-releasing hormone to the gravid patient in active labor caused a brisk response in fetal thyroid-stimulating hormone, although the increase in fetal prolactin remained low. These findings suggest that the changes in serum triiodothyronine (T3) significantly influence the release of prolactin and thyroid-stimulating hormone in response to thyrotropin-releasing hormone during the periparturitional period.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Multivariate models have great potential value in enhancing the understanding of why some pregnancies have poor outcomes. Recently, such models have been advocated as a basis for predictive scoring systems that attempt to classify patients into high-risk and low-risk groups. In this report the usefulness of such an approach was assessed by studying the predictability of preterm delivery at The Johns Hopkins Hospital during 1980, using a multiple logistic model. Choosing a cutoff point (or probability of preterm delivery) of 10%, 697 of 2865 patients were placed in the high-risk group. The sensitivity, specificity, and positive predictive value of the model, as applied to this select population, were 62.2, 79.4, and 22.7%, respectively. Thus, only 23% of patients predicted to have preterm deliveries in fact delivered preterm. The predictive value could have been improved by increasing the cutoff point, but only at the expense of markedly reducing the sensitivity of the model. It was concluded that the potential value of multivariate analyses of pregnancy outcome as a predictive, risk-classification technique is limited. Nevertheless, such studies may aid the clinical evaluation of each individual patient by providing a better understanding of the etiologies of poor outcome.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A survey of the management of postterm pregnancy was conducted among the 80 institutions with approved maternal-fetal medicine programs. Seventy-two (90%) completed questionnaires were received. After 42 weeks' gestation, when the cervix is unfavorable for induction, the nonstress test is the most commonly used test to assess fetal well-being (84.7%). In 50% of the institutions, pregnancy is terminated at some point beyond the 42nd week, in spite of an unripe cervix and lack of evidence of fetal compromise. In the other half, intervention does not take place under such conditions. The need for more consistent guidelines for the management of postterm pregnancy is emphasized.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID