Endometrial pattern in patients with primary hypoestrogenic amenorrhea receiving estrogen replacement therapy.

The histologic pattern of the endometrium was studied in 38 patients, 19 to 44 years old, with primary hypoestrogenic amenorrhea treated by estrogen replacement therapy. At the time of endometrial biopsy 3 patients were receiving estrogens only and 35 patients were taking 1 of the following cyclic estrogen-progestogen combinations: 1) conjugated estrogens, 1.25 or 2.5 mg per day, combined with medroxyprogesterone, 5 or 10 mg for the last 5 to 10 days; 2) ethinyl estradiol, 50 microgram per day, combined with medroxyprogesterone, 5 mg per day for the last 5 days; or 3) mestranol, 40 microgram per day, in combination with norethindrone, 0.5 mg for the last 7 days. Evidence of endometrial hyperplasia was found in 3 patients. Two of them were taking unopposed estrogens and developed cystic hyperplasia; the other patient, treated with norethindrone in addition to mestranol, disclosed focal cystic glandular hyperplasia. This study and the review of the available data reported in the literature on the endometrial response to estrogen therapy in patients with gonadal dysgenesis stress the importance of appropriate estrogen and progestogen dosage to avoid the hazards of abnormal endometrial pattern in young patients receiving estrogen replacement therapy.

Marine Diagenesis of Shallow Marine Lime-Mud Sediments: Insights from dgrO18 and dgrC13 Data.

Shallow marine lime-mud sediments of the Ste. Genevieve Formation (Mississippian), in part of the Illinois Basin, underwent at least three diagenetic changes: (i) local dolomitization in seawater or a brine, producing dolostone having average deltaC(13) of +2.5 per mille and deltaO(18) of +1.9 per mille (versus PDB-1); (ii) more usually cementation of unreplaced CaCO(3), in intrasediment seawater, yielding isotopically marine lime mudstone mainly composed of calcite, 4-micron or finer, with deltaO(18) of from -1 to +1 per mille; (iii) later partial alteration of CaCO(3), in permeable dolomitic rocks, by isotopically "lighter" waters, to calcite with an estimated deltaO(18) of -10 per mille or less. Isotope data appraised by petrographic analysis thus suggest "submarine" cementation of these carbonates in shallow marine conditions.