ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Through the study of naturally occurring mutations in humans, the creation of mutations by site-directed mutagenesis, and the production of transgenic knockout mice, further understanding of molecular reproductive endocrinology had been achieved. Mutations in the aromatase gene in females have confirmed that its deficiency results in a previously unrecognized form of sexual ambiguity with a 46,XX karyotype, and delayed puberty with multicystic ovaries. It has long been known that estrogen is necessary for skeletal growth and epiphyseal closure in the female, but aromatase and estrogen receptor gene mutations in men have demonstrated, for the first time, that estrogen is important for epiphyseal closure in the male. Mutations in the steroidogenic acute regulatory protein have been recently described that demonstrate the cause for lipoid congenital adrenal hyperplasia, a disorder characterized by the complete lack of steroid production. New gene mutations in gonadotropin p-subunits, pituitary hormones, G-protein coupled receptors, G-proteins, steroid enzymes and their receptors have also been characterized recently. Site-directed mutagenesis experiments and transgenic knockout mice have been increasingly used to study the effects of normal endocrine function. Normal functions of steroid receptor genes (steroidogenic factor-1, estrogen receptor, progesterone receptor) the glycoprotein a-subunit, luteinizing hormone P, and proto-oncogenes such as RFThave been better characterized by creating knockout models. Molecular biology techniques permit these types of studies which may be difficult, if not impossible, to perform otherwise in physiologic settings.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The understanding of the pathogenesis of polycystic ovary syndrome has advanced significantly, and improvements have been made in the treatment of the commonly associated symptoms. New data continue to implicate a derangement in insulin secretion and metabolism as a cause of the disease. Therapeutic regimens for those patients unsuccessfully treated by traditional approaches have been further validated, especially for the treatment of infertility. Future therapeutic strategies involving the retrieval of unstimulated, immature oocytes that are fertilized and matured in vitro are a possibility.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Most patients with hirsutism demonstrate hyperandrogenemia, which may be caused by polycystic ovary syndrome, nonclassic congenital adrenal hyperplasia, insulin resistance and, occasionally, neoplasms. In this review, current methods of diagnosis and recent advances in the medical treatment of hirsutism and hyperandrogenemia are discussed, including the use of gonadotropin-releasing hormone analogs, flutamide, spironolactone, finasteride, and ketoconazole.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Endocrine disorders are among the potential causes of repeated spontaneous abortion although their role is uncertain. Those disorders most frequently associated with repeated spontaneous abortion are corpus luteum insufficiency, polycystic ovary syndrome, diabetes mellitus, and hypo- and hyperthyroidism. The best method of diagnosing corpus luteum insufficiency has not yet been established. It seems that treatment for this condition cannot be based on simple supplementation with progesterone, but ovulation induction preceded by pituitary suppression and human chorionic gonadotropin administration might be more successful. There is increasing evidence that polycystic ovary syndrome is a cause of repeated spontaneous abortion, but possibly only in the presence of oligomenorrhea and luteinizing hormone hypersecretion. Diabetes, if well controlled by treatment, and thyroid dysfunction, probably play a minor role.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This review of recurrent pregnancy loss examines our current understanding of the major etiologies of this unfortunate condition including genetic and endocrine abnormalities, anatomic variations, autoimmune conditions, alloimmune problems, systemic disease, and infection. Diagnostic protocols and treatment strategies are briefly presented. With a high rate of spontaneous normal pregnancy outcome, great care must be taken to do more good than harm.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Abnormalities of thyroid function may cause irregularity or absence of the menstrual period, inhibit pubertal development and linear growth, and suppress reproductive function. Furthermore, pregnancy may itself affect thyroid function. New information is presented about the diagnosis and treatment of various forms of congenital and acquired thyroid disease. Issues ranging from the molecular biology of thyroid hormone resistance to public health measures developed to eliminate endemic goiter are addressed.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Anorexia nervosa, primarily a disorder in adolescent and young women, is not only a psychiatric illness; the disorder can have serious gynecologic and medical ramifications. As obstetricians and gynecologists assume a broader role in preventative medicine and health maintenance, an awareness is needed of the latest issues regarding this relatively common disorder. These issues include the newly recognized effects on the neuroendocrine system and the possible implications for treatment, the relationship of anorexia nervosa to amenorrhea and osteoporosis, and the relationship of anorexia nervosa with a history of childhood sexual abuse and the possible implications of maternal anorexia nervosa on infant development.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Ambulatory monitoring of lower and upper urinary tract continues to develop. The addition of electronic urine-loss measurements to indicate the exact time-related loss is an important new feature. In the near future, quantitative urine-loss measurements will become available. The additional possibility of plugging in a flowmeter completes the technique with respect to pressure-flow analysis. At present, however, ambulatory urodynamics is still confined to specialized urodynamic centers. Ambulatory urodynamic monitoring has shown that de-novo detrusor instability after a suspension operation is frequently missed as a preoperative diagnosis of detrusor overactivity. The first steps are being taken toward giving a quantitative analysis of detrusor activity during the filling phase. This justifies a more widespread use of this ambulatory monitoring.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID