摘要:

Endometrial biopsies were obtained from 46 hypogonadal patients (44 with gonadal dysgenesis; 2 panhypopituitary) who were receiving estrogen-progestogen therapy. Endometrial abnormalities occurred only in patients receiving a total lifetime conjugated estrogen dose of ≥2500 mg and who had received estrogen treatment for a period longer than 4.2 years. The biopsy outcome was significantly related (P<0.01) to the estrogen dose at time of biopsy and to the total lifetime dose (P<0.05). The progestational drugs administered did not protect against development of endometrial abnormalities. None of the abnormal endometrial patterns were associated with abnormal vaginal bleeding.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This study was designed to test the assumption that women with regular menstrual cycles and premenstrual symptoms are ovulatory. Forty women aged 20 to 40 years were selected as probably ovulatory on the basis of their recent histories of regular menstrual cycles consistently accompanied by premenstrual molimina. Each subject recorded menses and basal body temperatures (BBT) for 1-3 consecutive menstrual cycles during which luteal phase serum progesterone (P) concentrations were determined by radioimmunoassay. All subjects were rated ovulatory or anovulatory by each of several espoused P criteria, which confirmed 39/40 subjects (98%) to be ovulatory by a 3 ng/ml criterion, 38/40 subjects (95%) by a 5 ng/ml criterion, and 36/40 (90%) by a 15 ng/ml criterion. Thus, P measurements confirmed the clinical impression of ovulation in 90-98% of subjects depending on which P criterion was selected. Basal body temperatures correlated well with P measurements in that 61/66 cycles (92%) displayed a biphasic BBT pattern, 2/66 cycles (3%) displayed a monophasic BBT pattern, and 3/66 cycles (5%) were uninterpretable. Only 1 subject was not ovulatory in either of 2 consecutive cycles by even the most liberal P criterion, and both cycles were abnormally long and would have been suspected of being anovulatory on clinical grounds. We conclude that patients presenting with a history of regular menstrual cycles accompanied by premenstrual molimina are identifiable as ovulatory without the necessity of measuring luteal phase serum P concentrations.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Danazol is widely used in the management of endometriosis and mammary dysplasia. However, its mechanism of action is still obscure because of the few studies done and the controversial results obtained. Antigonadotropic activity has been postulated by some investigators, whereas others have observed no effect on the gonads. In the present study, three castrated female rhesus monkeys received 400 mg of danazol daily, by gavage for 19 days, while 2 controls received 400 mg of lactose daily. Bid ml samples were drawn every other day from 2 weeks prior to 3 weeks after the administration of the drug. Plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH) decreased rapidly and then were maintained until danazol was discontinued. Prompt return to pretreatment levels occurred 1-2 days after the discontinuation of therapy. Prolactin levels were normal during therapy. Luteinizing hormone releasing factor (LH-RF), 100 /ig, administered intravenously during danazol therapy, caused a normal, prompt release of gonadotropins, demonstrating an intact pituitary response. The authors conclude that 1) danazol is a potent antigonadotropic agent, 2) its effect is abolished promptly after discontinuation, and 3) its probable biological action is at the hypothalamic level.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The pathology of 1436 cases of female genital tuberculosis (FGTB) observed from 1946 to 1977 is reviewed. The frequency of FGTB was highest in 1956, when it represented 5.5% of all gynecologic pathology specimens. The incidence declined in 1964 as a result of a nationwide antituberculosis campaign, falling to 0.27% in 1977. Sixty-six percent of the patients were 25-35 years of age, and 11% were postmenopausal. All patients presented with either primary (94%) or secondary (6%) infertility. The percentages of involvement of the different parts of the genital tract were: fallopian tubes 100%, endometrium 79%, cervix 24%, vulva and vagina 0.07%, and ovaries 11%. The clinicopathologic and diagnostic criteria of FGTB in the different regions arc described, and special attention is paid to the effects of specific treatment on the tuberculous lesion.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

An animal model is presented that demonstrates that following cervicovaginal inoculation, infective doses of herpesvirus hominis type II induce a form of herpetic encephalitis. Immunofluorescent results indicate that there is both neural and hematogenous spread of the herpes infection. The possible role of a latent viral infection in the genesis of an acute disease of the central nervous system is investigated in this experimental system.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Only occasionally is there a good indication for either abdominal myomectomy or vaginal myomectomy. Among 3205 patients who had major gynecologic operations, 1022 had leiomyofibromas; 718 needed abdominal hysterectomy, 253 needed vaginal hysterectomy, and only 51 were treated by myomectomy. Vaginal myomas and a few submucous uterine myomas were excised vaginally. Parasitic myomas and a few intramural myomas were excised abdominally. Indications, symptoms, number, size, tissue characteristics, methods, subsequent fertility, and subsequent pelvic operations are all discussed. In 26 of these patients, myomas were discovered during other conservative gynecologic operations, requiring decision-making during operations; criteria are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Ultrasonography has been used as an adjunct in managing pelvic infections when culdocentesis is contraindicated. Twenty-three of 42 women presenting with endometritis/salpingilis/peritonitis (ESP) had ultrasonographic masses. The erythrocyte sedimentation rate (ESR), white blood cell count (WI3C), and the highest temperature in the first 24 hours failed to distinguish those with sonographic masses from 19 patients without pelvic masses. The clinical parameter that tended to distinguish patients with masses versus no masses occurred in individuals who had an IUD at the time of admission. If a patient had an ESR>65 mm/hr and an IUD, sonography demonstrated a mass in 71.4% of the cases. The clinical response to multidrug therapy (bactericidal- bacteriostatic, bactericidal-bactericidal, and tripledrug therapy) were comparable in the patient populations with or without a sonographic mass. Sonography is of little use in the acute phase of ESP. It is best reserved for those patients who do not respond to adequate antibiotic therapy and for the serial evaluation of a large tubo-ovarian complex when conservative management is indicated.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

At the Mayo Clinic from January 1960 through December 1975, 673 patients underwent a modification of the Marshall- Marchetti-Krantz operation as a primary or secondary procedure for recurrent stress incontinence. There were 96 patients (14%) lost to follow-up, and 28 patients have died; 549 patients have been followed for 2-16 years. Of the 549 patients, 227 underwent the procedure as a primary operative effort; 91% of these were cured or much improved from socially disabling stress urinary incontinence, 7% were unchanged, and 2% became worse. There were 322 patients who underwent surgery for persistent or recurrent stress incontinence. This group had had a total of 740 previous unsuccessful operations (an average of 2.3 per patient) specifically for stress incontinence; 90% of these patients were cured or much improved, 5.3% were unchanged, and 4.7% became worse. The Marshall-Marchetti- Krantz operation is an effective and safe procedure associated with minimal morbidity and no mortality.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Evidence is presented for the coexistence of smooth muscle and decidual cells in nodules on and within the ovarian tunica albuginea at term. Routine histologic techniques and electron microscopy have been employed in characterizing the morphology of the nodules. Recent literature concerning the frequency of ovarian decidualization during pregnancy is discussed with respect to the possible relationship of such decidualization to the histogenesis of leiomyomatosis peritonealis disseminala (LPD). The hypothesis that LPD may represent “disseminated fibrosing decidua” is discussed in light of finding collagen fibrils, secretory decidual cells, and smooth muscle cells in these nodules. It is concluded that the present case does not represent “fibrosing decidua.” The authors agree with others who have proposed that the smooth muscle in ovarian decidua and LPD result from proliferation of stem cells which may reside in the subperitoneal stroma in association with ectopic endometrial stroma and which may respond to the hormones of pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One hundred eighty-four patients with benign breast disease (BBD) were studied and compared with 50 normal women. All of the women had ovulatory cycles according to a biphasic basal body temperature and a plasma prolactin in the normal range. Their corpus luteum function was evaluated by way of plasma progesterone (P) and estradiol (E,) determinations at days 5, 7, and 9 of the hyperthermic phase. In the 184 patients, plasma P over plasma E, ratio during the luteal phase was found significantly lower than in normal women. When the patients were grouped according to type of breast lesions, it appeared that plasma P was constantly lower in all groups than in the normal women, while plasma E2was either normal or elevated in the groups of patients with adenosis tumors and increased odularity of both breasts. From these results it may be postulated that an imbalance in the secretion of E2and P by the corpus luteum is a constant finding in women with benign breast disease.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID