摘要:

Relative contribution of the ovaries and adrenals to the pool of steroids in postmenopausal women is still the subject of much controversy. Estradiol, >4-androstenedione, and testosterone were assayed in peripheral blood, adrenal, and ovarian vein blood of II postmenopausal patients. Intravenous administration of hCG resulted in increased androgen production by the ovaries but not estrogens while intravenous administration of adrenocorticotrophic hormone did not result in the enhancement of ovaria and adrenal estrogens.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The clinical features, ovarian pathology, and hormonal responses to dexamelhasone (Dex), Dex + clhinyl cstradiol (HE), and Dex + hCG were compared in 5 women with polycyslic ovarian disease (PCOD) who have normal 24-hr urinary luteinizing hormone (LH) levels to 5 who had elevated urinary LH levels. No differences were noted in the clinical features. There was no correlation between ovary size and LH levels. Three in the normal-LH group had hyperthecosis. Plasma androstenedione (A) was more frequently elevated in the high- LH group. Dex + EE markedly increased LH secretion in the high-LH group, suggesting increased responsiveness of the positive feedback control mechanism of LH secretion in the high-LH group. There was a greater response of A, testosterone (T), and 17-ketosteroids to Dex + hCG in the normal-LH group. Those with high-LH levels did not exhibit a significant increase in A, T, and 17-KS with hCG. The limitations and usefulness of the Dex -r hCG test are discussed. The hypothesis is advanced that the increased LH secretion in the high-LH group is due at least in part to positive feedback resulting from the increased A levels. The amount of 17β-oxidoreductasc activity in the ovary may influence LH secretion in PCOD.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The scrum levels uf the following steroids were measured in 59 hirsute patients before (control) and after (post-dexamclhasonc) administration of dexaincthasonc(Dcx) for 7 days: cortisol (F), dehydrocpiandrosterone (DI1EA), its sulfate (DIIKA-S). androstenedione (A), testosterone (T), and Sw-dihydrotestosterone (DHT). Assuming that Dcx-suppressibility implied adrenal origin, the source of excess androgens was also evaluated. All patients showed elevated levels of at least one androgen. Eleven patients had an elevated level of only one androgen: 4 had elevated DHEA-S; 4 had elevated T; .1 had elevated DHT. No patient had an elevated 1)11EA or A without an elevation of the other androgens. The control levels of DHEA-S were above normal in 45 patients; the DHT levels were elevated in 43 patients; 31 patients had elevated T levels; and 25 patients elevated A; and 24 patients, DIIKA levels. In 32 patients with adequate suppression of adrenal androgens after 7 days or Dex administration, the source of excess androgenscould be evaluated. Of 13 patients with elevated A levels, the excess A production was of adrenal origin in 6 cases, of ovarian origin in 5 cases, and of mixed origin in 2 cases. Of 15 patients with elevated T levels, the excess T production was of adrenal origin in 3 cases, of ovarian origin in 10 cases, and of mixed origin in the remaining 2 cases. Of 25 patients with elevated DHT levels, the excess DHT production was of adrenal origin in 16 patients, of ovarian origin in 5 patients, and of mixed origin in 4 patients. Of the 32 patients with an adequate Dex suppression test, 14 showed evidence of adrenal hyperandrogenism. 5 had ovarian hyperandrogenism, and mixed hypcrandrogenism was present in the remaining 13 patients. There was an adrenal source of hyperandrogenism in 27 of 32 patients (14 pure adrenal and 13 mixed adrenal-ovarian), which represents 85% of the 32 patients.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The pulsatile gonadotropin output and response to luteinizing hormone releasing hormone (LRH) administration was evaluated in 23 patients with primary amenorrhea. Pulsatile LH output and associated FSH pulses were readily observed in patients with hypergonadolropism. Responses in patients with congenital adrenal hyperplasia varied with the adequacy of the prior therapeutic management, which in turn apparently determined the maturational status of the individual. A patient with Kallmann's syndrome had both FSH and LH pulsatile activity. Patients thought to have simple delayed puberty had normal baseline gonadotropin values, and rcguiar LH pulsations, but no correlation of FSH with LH pulsatile activity. Correlated analysis of LRH response and pulsatile gonadotropin activity may allow differentiation of individuals showing a normal progression of maturation from those with maturational dysfunction.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Results of laparoscopic evaluation of 112 infertile women are presented. Laparoscopy performed prior to contemplated fallopian tube reconstructive surgery changed the plan of management in 41% of 44 cases. Of 64 women with a normal hysterogram, 58% were found to have evidence of pelvic disease, and 47% had changes in their management based on the findings at laparoscopy. The specific indications and timing of laparoscopy in relation to the remainder of the infertility evaluation are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Intramuscular injection of 6.6 mg of estradiol benzoate (EB) in oil was used in 34 women as a test of the ability of the pituitary-hypothalamic axis to produce a gonadotropin surge (positive feedback response). These responses were compared to Clomid responses. AH of the normal cycling women, two-thirds of oligo-ovulatory but menstruating women, and one-third of amenorrheic women had LH surges to EB challenge. Estradiol benzoate is a more specific test of positive feedback response than Clomid. It also may be effective in inducing ovulation in some amenorrheic patients refractory to Clomid treatment.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The physiologic events which may occur with the gravid woman in the supine position suggest that uteroplacental blood flow may be impaired as a consequence of decreased venous return to the heart and the resulting decrease in cardiac output. Since the metabolic clearance rate of dehydroisoandrosterone sulfate (MCRDS) previously has been shown to reflect alterations in uteroplacental perfusion, the MCRDSwas measured in a variety of different obstetric conditions during lateral and supine recumbency. No significant difference in the MCRDSwas induced by this specific positional change, suggesting that ulcroplacental perfusion was not altered. Experimental data are discussed which support this observation, and a possible mechanism for maintenance of uteroplacental blood flow under these circumstances is presented.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

The efficacy and lolcrabilily of cephacetrilc administered by the intravenous or intramuscular route nas evaluated in an openlabel study of 55 hospitalized females diagnosed as having mild to severe pelvic inflammatory disease. Rapid improvement was observed in most patients. All patients were classified as clinically cured or significantly improved. Pain was absent or mild in S6'r of the patients who received cephacetrilc by intramuscular injection. Seventy-two percent of the patients given the drug intravenously experienced no localized pain. Phlebitis occurred in 6 of the 53 patients (11%) who received intravenous cephacetrile and thrombosis was present in 3 (6%). Rash and pruritus was reported in 1 patient. Results of this study suggest that cephacetrilc is an important and useful drug in the treatment of pelvic inflammatory disease.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

Uterine anomalies are associated with an increase in cases of breech presentation, premature labor, abnormal presentation with dystocia, and the necessity for cesarean section. The yearly frequency of diagnosis of an anomaly has varied from 1.06 to 0.48 at this medical center depending on the physician's clinical suspicion. Thus, if the true incidence and the decrease of obstetric complications are to be accomplished, an increased interest in diagnosing uterine anomalies is essential.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID

摘要:

A 15-ycar survey of maternal mortality in a large urban hospital revealed an overall rate of 2.95 deaths per 10,000 pregnancies (3.44 per 10,000 live births), representing 31 maternal deaths among approximately 105,000 deliveries and spontaneous and therapeutic abortions. This rate showed marked improvement during the 15-year period, ie, 6.56 per 10,000 pregnancies for the first 5 years as compared to only 1.37 per 10,000 pregnancies Tor the last 10 years. In contrast to the classic triad of causes of maternal death—toxemia, hemorrhage, and sepsis—the principal cause of death in this series was amniotic fluid embolism. Other aspects of the causes of death and of the findings are discussed. Among the 32 fetuses, total fetal wastage was 63%, with a neonatal mortality of 87b and a fetal mortality of 46%.

ISSN:0029-7844    

出版商:OVID    

年代:1976

数据来源: OVID