Gynecologic investigation最新文献

In order to evaluate the clinical validity of the so-called "atropine test", it has been performed in 83 women in their 35th to 43rd week of pregnancy. A statistical evaluation of the data has shown a serious limitation of both diagnostic and prognostic possibilities of the test; this can be attributed to the great variability of maternal environments.

The simultaneous diffusion of 14C-succinylcholine and p-amino hippurate across human placental tissue in vitro was measured. Column chromatographic purification of the radioactivity followed by paper chromatographic analysis showed little alteration of the succinylcholine during the course of these experiments. Similar chloroform-buffer partition coefficients for the two solutes were measured. Thus in these experiments, the nearly identical transfer rates of these two similar sized, lipid-insoluble compounds indicated that succinylcholine crosses human placental tissue in quantitites compatible with its molecular size and lipophobic nature, and that the diffusion rate is not significantly influenced by its increased molecular charge.

Changes in the left uterine artery blood flow (YBF) after intraarterial administration of estradiol-17beta and cis- and trans-clomiphene citrate to conscious, oophorectomized ewes were monitored by chronically implanted electromagnetic flow probes. Cis-clomiphene produced UBF increases comparable to or greater than those produced by estradiol-17beta but at dose levels 20 times greater. Comparison of UBF response curves for cis-clomiphene with those for estradiol-17beta showed a delayed onset of initial vasodilation and a delayed peak response. The duration of uterine vasodilation produced by cis-clomiphene was dose-dependent and exceeded that produced by estradiol-17beta. Similar reponses were observed with trans-clomiphene but at dose levels at least 1,000 times those of estradiol-17beta. The characteristics of clomiphene-induced UBF responses that differed from those after estradiol-17beta may reflect differences in estrogen receptor activation between the compounds.

Human umbilical vein and artery diameters reduce significantly during the first 2 min after delivery, whereas blood gas tensions do not change significantly. Gas tension changes, therefore, cannot account for the reduction in the umbilical vessel diameters which occurs during this time.

The utilization of plasma dehydroisoandrosterone for estrogen production was studied in 4 normal young nonpregnant women and in one young surgical castrate woman. The mean transfer constant for total conversion to estrogen, [sigma] DE-BU' was 0.0016 of which about one third (0.0005) could be accounted for by conversion of dehydroisoandrosterone first to plasma androstenedione which in turn was converted to estrone. The remaining fractional conversion appeared to result principally in estradiol formation via a pathway probably not involving plasma androstenedione. The conversion of plasma dehydroisoandrosterone to estrogen was similar in the surgical castrate to that observed in the ovulating women. It is concluded that plasma dehydroisoandrosterone is converted to estrogen at extraglandular site(s) but this contribution represents only a minor fraction of total estrogen production in normal young women.

Phytohemagglutinin-induced lymphocyte transformation (PHA-T) was depressed in pregnant women, as compared with that in nonpregnant women. Pregnancy serum had a suppressive action on PHA-T which was enhanced with the advance in pregnancy. Hydrocortisone, progesterone, alpha-fetoprotein and trophoblast-specific antigen, were demonstrated as immune suppressive factors. From these results, it was concluded that cell-mediated immunity might be reduced in pregnant women and that this reduction might be one of the causes for the maintenance of pregnancy.

A 16-year-old phenotypic female with XY genotype presented an unusual form of nonfamilial male pseudohermaphroditism. Seemingly a normal girl during childhood, the patient failed to undergo pubertal changes presenting with scant pubic hair, absent axillary hair, lack of breast development, retarded bone age and primary amenorrhea. Neither uterus nor adnexa were palpable above the blind-ending vagina. Serum testosterone and estradiol were barely detectable by radioimmunoassay, while LH and FSH reached castrate levels. Two small testes were removed from the pelvic sidewalls which, on biopsy, showed atrophy and hyalinization of seminiferous tubules, but clusters of Leydig cells without signs of hypertrophy or hyperplasia. Administration of testosterone resulted in urinary nitrogen retention and a decrease in serum LH and FSH. Radioimmunoassay of various serum or plasma steroids and gas chromatographic determination of urinary steroids prior to and following ACTH stimulation yielded results which permitted to rule out 20,22-desmolase, 3beta-hydroxysteroid dehydrogenase, 17-hydroxylase and 17beta-hydroxysteroid dehydrogenase deficiency. Low plasma dehydroepiandrosterone sulfate (DHEA-S) and androstenedione (delta4 A) concentrations, low urinary 17-ketosteroid and particularly low dehydroepiandrosterone (DHEA) excretion and the minimal rise of plasma DHEA-S and delta4 A and of urinary DHEA in response to ACTH in conjunction with a normal response of other serum and urinary C-21 steroids are consistent with 17,20-desmolase deficiency. Direct confirmation of this defect, however, seems impossible in the absence of in vitro studies of testicular steroidogenesis.

The concept of protein binding of steroid hormones is traced from its origins through the period of confirmation and initial extension. Further considerations include cell surface recognition sites, subcellular sources of binding protein, and the new evidence that lysosomes participate in the translocation and intranuclear penetration of the hormone in steroid target cells. This short review thus aims to provide a link between current investigations and the ideas upon which they have been based.

The types of cell-to-cell contacts and the relationship between the nerve endings and the smooth muscle of the estrogen-treated rabbit oviduct have been investigated. The cell contacts most consistently found in the oviduct were simple appositions, with a 20-nm cell separation, which occasionally included a more dense region, and interdigitations of muscle cell processes with the same separation distances. Very rarely, wider intermediate contacts were present. Gap junctions (nexuses) were absent. It seems likely that simple appositions and interdigitations form the low resistance pathway for conduction of electrical activity. Nerves containing small dense-cored vesicles were present both within and near muscle bundles; they were rarely found close to smooth muscle cells.