[FSH-producing hypophyseal tumor in a 13-year-old girl]. / FSH-produzierender Hypophysentumor bei einem 13jährigen Mädchen.

We report on a 13 year old girl with a FSH, secreting pituitary tumour, who was presented with recurrent bleeding disorders. Gynaecological examination revealed large cystic ovarian tumours on both sides. The endocrinological work-up showed high serum levels of oestradiol and FSH, and low serum levels of testosterone and LH. Computed tomography demonstrated a pituitary tumour of 3 cm diameter.

[Relation of steroid hormone receptors to axillary lymph node metastasis in breast carcinoma]. / Die Beziehung der Steroid-Hormon-Rezeptoren zum axillären Lymphknotenbefall beim Mammakarzinom.

In 337 patients with primary cancer of the breast, the oestrogen and progesterone receptor concentration was correlated to the metastasis of axillary lymph nodes taking into account the age of the patients and the size of the primary tumour. The frequency of axillary lymph node involvement increases significantly with size, although not quite steadily but rather stepwise within the T classification. Whereas the tumour diameter influences the receptor status only slightly, the age of the patients plays a major rôle in the oestrogen receptor concentration. In the age group up to 50 years the oestrogen receptor concentration is significantly lower than in the age group over 50 years. There is no comparable influence of age on progesterone receptor concentration. With all 337 breast cancers, no difference in axillary lymph node metastasis is found either between oestrogen receptor positive and oestrogen receptor negative cancers, or between progesterone receptor positive and progesterone receptor negative cancers. In the age group up to 50 years, if looked upon separately, the oestrogen receptor positive cancers do show significantly more often an axillary lymph node involvement, than do oestrogen receptor negative cancers. As this difference exists in the age group up to 50 years only, it is assumed that endogenous oestradiol favours the axillary spread in oestrogen receptor positive cancers. With oestrogen receptor negative cancers the axillary lymph node involvement increases from the younger to the older age group, explaining why in unselected series the oestrogen receptor negative cancers show a more unfavourable course.

[Significance of the albumin content for axillary metastasis in breast cancer]. / Die Bedeutung des Albumingehalts für die axilläre Metastasierung beim Mammakarzinom.

A very pronounced and significant difference in albumen concentration is seen in 337 breast cancer tissues compared with 94 histologically benign breast tissues. In cancer of the breast the mean albumen concentration is 8.4 mg/g tissue, whereas benign breast tissues show in 94% of the cases an albumen concentration of over 10 mg/g tissue, mean 16.4 mg/g. In breast cancer, 72% of the tissues have an albumen concentration up to 10 mg/g (cancers of low albumen content), whereas in 28% the albumen concentration lies over 10 mg/g (cancers of high albumen content). On analysing the axillary lymph node involvement in the two groups: low albumen and high albumen concentration, we find significantly more axillary metastases in the low-albumen than in the high-albumen cancer group. The difference is most pronounced when more then 3 lymph nodes are involved. This high lymph node involvement is found twice as often in the low-albumen than in the high-albumen group. It can be concluded that low-albumen breast cancers show a noticeably higher tendency to axillary lymph node metastases than do high-albumen cancers.

[Late results in fallopian tubes studies on the Bleier clip]. / Spätergebnisse bei der Tubenuntersuchung mit dem Bleier-Clip.

We report on 243 patients with sterilisation by the Bleier Clip. 234 patients were operated by coeliotomia posterior. 9 cases were sterilized in combination with Caesarean section. In 4 of 243 women we observed pregnancies during the follow-up period (failure rate = 16%). The mean time of the 4 conceptions after operation was 43 months. This result shows that the primary cause was not the operation technique but the systemic failure of the Bleier Clip. In cases with controls by hysterosalpingography all Fallopian tubes were occluded, 84% together with a sactosalpinx.

[Diagnostic possibilities of the function of the fetal thyroid gland by amniocentesis (author's transl)]. / Diagnostik der fötalen Schilddrüsenfunktion durch Amniocentese.

The assessment of fetal thyroid function by measurement of reverse triiodothyronine (RT3) in amniotic fluid (AF) seems to be a valuable diagnostic tool in detecting fetal hypothyroidism. The concentrations of RT3 were measured by radioimmunoassay in 346 samples of AF which were obtained by transabdominal amniocentesis. Among these, 323 were obtained from normal pregnancies between weeks 8 and 41 of gestation and the remaining 23 from various complications of pregnancy: Rh-isoimmune disease, Down's syndrome, Klinefelter's syndrome (XXY), M. Krabbe, and anencephaly. The highest concentrations of RT3 in AF were observed between weeks 15 to 20 of gestation, followed by a gradual decrease with advancing gestational age. In complicated pregnancies a similar distribution of RT3 values was found. It is suggested that RT3 in AF should be measured in order to assess fetal thyroid function whenever amniocentesis is performed between weeks 16 and 20 of gestation, in particular when hypothyroidism of the fetus is suspected.

Dose-response study with a new LH-RH analogue, D-Ser (TBU)6 LH-RH 1-9 (EA)10 during the follicular phase of the menstrual cycle.

D-Ser (TBU)6 LH-RH 1-9 (EA)10 (HOE 766) a highly active LH-RH analogue, was studied with regard to its effects on the release of follicle stimulating hormone (FSH), luteinizing hormone (LH) and oestradiol-17beta (Oe2) during the follicular phase of the menstrual cycle. Forty-two regularly menstruating women were allowed to five different treatment groups with different doses (1.25 microgram; 2.5 microgram; 5.0 microgram; 10.0 microgram; 20.0 microgram) of HOE 766 given as intravenous bolus injections and the plasma concentrations of FSH, LH and Oe2 were measured up to 24 h after injection using specific radioimmunoassays. In the majority of cases, peak values of both FSH and LH occurred 4 h after injection being significantly different from pre-injection levels (P less than 0.02 in the 1.25 microgram treatment group, P less than 0.005 for the other treatment groups). Statistical analysis of maximum values as well as the absolute and relative increase in the different treatment groups revealed a dose-dependent effect of HOE 766. Maximum values of Oe2 occurred 8 h after injection and were found to be significantly different from pre-injection levels (P less than 0.005). However, no dose dependent effect was observed. It was concluded that HOE 766 is a potent and long-acting stimulator of FSH, LH and OE2 release in women. The effect of HOE 766 is dose dependent for FSH and LH but not for Oe2.

[First experiences with prenatal affection of infantile lung maturation by betamethason (author's transl)]. / Erste Erfahrungen mit der praenatalen Beeinflussung der kindlichen Lungenreife durch Betamethason

Because of premature labour, probability of fetal retardation, discrepance at term of delivery, Rh-incompatibility or EPH-gestosis 185 patients were hospitalized. 76 pregnant women received twice 1.5 ml Celestan Depot i.m. (4.5 betamethasone acetate and 6mg betamethasome dinatrium phosphate per injection) within an interval of 24 hours. It was necessary to maintain a tocolysis for at least 48 hours as a minimum after the first injection of Celestan Depot. The other 109 patients without treatment of glucocorticoids were considered as a controlgroup. We could show that antepartum application of betamethasone before the 38. week of gestation was associated with a reduction of RDS in our premature infants. Only one baby of the betamethasone-treated infants died of hyaline membrane disease during the first 7 days of life compared with 11 of the control group. In 11 patients patients amniocentesis was performed before the first injection of glucocorticoids and was repeated 2 to 7 days later. The amniotid fluid lecithin phosphorus concentration was determined. In the same period of pregnancy and the same iterval the lecithin phosphours level of amniotic fluid was analysed in 11 other patients who were not rreated with glucocorticoids. The difference between amniotic fluid lecithin phosphorus concentration in the first and second anslysis was found significant by a level of significance of alpha = 5%. There was no evidence of an influence of the therapy with Celestan Depot on this increase. The excretion of oestorgens in the urine of 24 hours was analysed in 22 gradidae before and 7 days after the treatment with betamethasone. The oestogen values of the day before application of betamethasone served as baseline figures. All patients showed a market fall in urinary oestrogens excretion, especially after the second day of therapy. After day 2 the values returned rapidly to baseline values. There were no differences between treated and control groups in Apgar scores at birth or in the incidence of icterus neonatroum (bilirubine level is greater that 10 mg% in the serum). The results of our study support the hypothesis that in humans glucocorticoid administration to the fetus accelerates lung maturation. Relatively brief intrauterine exposure of human infants to pharmacological doses of betamethasone was associated with a substantial reduction in the incidense of RDS.