Urodynamic evaluation of lower urinary tract function in relation to total abdominal hysterectomy.

This study was performed to evaluate lower urinary tract functions in asymptomatic patients by urodynamic measurements after total abdominal hysterectomy and bilateral salpingo-oophorectomy. Twenty asymptomatic patients who had undergone hysterectomy for benign diseases were included in the study and urodynamic measurements were performed before and 6 weeks after total abdominal hysterectomy and bilateral salpingo-oophorectomy. There was no postoperative difference in first urge, normal urge, urgency and maximum bladder capacity but average urethral length, functional urethral length and maximum urethral closing pressure were decreased and also bladder discharging time was increased. Voided volume and residual urine volume were unchanged. It was concluded that total abdominal hysterectomy and bilateral salpingo-oophorectomy did not change the postoperative bladder loading functions in asymptomatic patients but that significant changes occurred in urethral functions.

Comparison of vaginal aminopeptidase enzymatic activities in various animals and in humans.

The specific enzymatic activity of four different aminopeptidases (aminopeptidase N, leucine aminopeptidase, aminopeptidase A and aminopeptidase B) in vaginal homogenates from rabbit, rat, guinea-pig, sheep and humans was compared. The purpose of the study was to find an appropriate animal model that can be used in degradation studies of protein and peptide drugs. Different substrates were used as the relative specific substrates for the determination of aminopeptidase enzymatic activity: 4-methoxy-2-naphthylamide of L-alanine for aminopeptidase N, 4-methoxy-2-naphthylamide of L-leucine for leucine aminopeptidase, 4-methoxy-2-naphthylamide of L-glutamic acid for aminopeptidase A and 4-methoxy-2-naphthylamide of L-arginine for aminopeptidase B. The vaginal aminopeptidase enzymatic activity of different species was determined spectrofluorometrically. The inhibition of aminopeptidase activity in the presence of bestatin and puromycin inhibitors was also investigated. The results showed the presence of aminopeptidase enzymatic activity in all vaginal homogenates in the order: sheep > guinea-pig > rabbit > or = human > or = rat. Based on the results of the hydrolysis and inhibition of the 4-methoxy-2-naphthylamide substrates, it was difficult to have an exact decision on the aminopeptidase type in the vaginal homogenates from the species studied. It was found that the aminopeptidase activity in rat, rabbit and humans was not statistically different. Therefore, we suggest that rats and rabbits could be used as model animals for vaginal enzymatic activity studies and for determination of the degradation of protein and peptide drugs in the vagina.

Effects of estrogen and alendronate on sister chromatid exchange (SCE) frequencies in postmenopausal osteoporosis patients.

OBJECTIVE: To compare two types of osteoporosis treatment for genotoxicity by using sister chromatid exchange (SCE) frequencies. METHOD: Fifty-seven women, aged between 40 and 64 years, composed the population in the study. SCE values of patients under estrogen replacement therapy (ERT) or alendronate therapy were compared to controls who never used any drugs for osteoporosis. RESULT: The difference between the SCE values of women taking ERT and control women was found to be statistically significant (P<0.05). The difference between women taking alendronate and untreated controls was not statistically significant. CONCLUSION: Our results indicate that alendronate does not have genotoxic effects based on SCE frequency, while ERT increases SCE frequencies.

Pelvic tuberculosis.

Pelvic tuberculosis was diagnosed in 72 patients analyzed during the years 1979-1989. Twenty-nine percent of the patients were over 40 years of age. The most common complaints were infertility (47.2%), abdominal or pelvic pain (32%) and abnormal uterine bleeding (11%). Only 2 patients had past or family history of pulmonary tuberculosis. The physical examination was normal in 31.6% of the patients. The chest X-ray was normal in 81% of the patients. Blocked tubes were present in 32 of 34 patients who had hysterosalpingograms. Even if the diagnosis can be made from a histopathologic examination, hysterosalpingography is also a very useful aid in establishing a diagnosis. The most common site of infection was the tubes. Reconstructive surgery was performed in nine patients. Only one pregnancy was found in the present study without any medical or surgical treatment of pelvic tuberculosis. In one patient with habitual abortion as a cause endometrial tuberculosis was also found.

Effects of clomiphene citrate on cytosolic estradiol and progesterone receptor concentrations in secretory endometrium.

Cytosolic estradiol and progesterone receptor concentrations were measured in luteal phase endometrial biopsy samples obtained from 12 anovulatory or oligoovulatory women on clomiphene citrate therapy and from 40 normal control subjects. Clomiphene citrate treatment (250 to 750 mg per cycle) decreased both endometrial estradiol and progesterone receptor concentrations. Estradiol receptor levels were nondetectable in seven tissue samples and progesterone receptor levels in four samples from the 12 subjects given clomiphene citrate compared to nondetectable estradiol receptor concentrations in one tissue sample and progesterone receptor concentrations in two samples from the 40 normal control subjects. In histologically dated endometrium, mean estradiol receptor concentrations on days 20 to 23 and progesterone receptor levels on days to 24 to 27 were lower than the values observed in the comparable dated endometrium of normal ovulatory women. Steroid receptor concentrations correlated negatively with the duration of clomiphene citrate therapy, which implies a time-dependent suppressive effect of clomiphene citrate on measurable cytosolic estradiol and progesterone receptor concentrations during the luteal phase of the cycle.

Endometrial estradiol and progesterone receptors in patients with luteal phase defects and endometriosis.

Endometrial cytosol estrogen receptors (ERs) and progesterone receptors (PgRs) were quantitated in postovulatory endometrial biopsy samples of patients with luteal phase defect (LPD), those with endometriosis, and normal control subjects. Serum levels of estradiol (E2) and progesterone (P), obtained on the day of the biopsy, were also measured. No significant differences among endometrial ER, PgR, serum E2, and P levels were detected between the patients with endometriosis and normal control subjects. Although ER concentrations in the luteal defect group did not differ from those of control subjects, the PgR levels in day 20 to 23 endometrium were significantly higher. Mean serum E2 and P levels in the group with luteal insufficiency were significantly lower than those of the control subjects. Our data suggest that in patients with LPD the increase in PgR levels during the midluteal days is compatible with a relative deficiency of P secretion by the corpus luteum.

Failures following tubal sterilization.

PIP: Of the 1024 women who underwent surgical sterilization, 426 had Pomeroy technic, 223 had bilateral partial salpingectomy, 193 had electrocauterization with or without division, and 183 had tubal silastic rings. The overall failure rate was 2.1 per 100, 0.94 with Pomeroy technic, 0.89 with bilateral partial salpingectomy, 6.7 with electrocautgerization, and 1.6 with silastic ring. Of these, 22 women who became pregnant following tubal sterilization, 18 have been subsequently evaluated and 4 refused the evaluation and repeat sterilization. 11 of these 18 women had surgical error (either incomplete or inappropriate procedures), 3 had luteal phase pregnancies, 2 had recanalization, and 2 had tuboperitoneal fistulae.^ieng