Effects of HRT on serum levels of IGF-I in postmenopausal women.

OBJECTIVES: It is thought that insulin-like growth factor-1 (IGF-I) stimulates bone formation. We aimed to determine the effects of oral and transdermal hormone replacement therapy (HRT) on serum IGF-I levels and to investigate the effects of basal IGF-I levels on the levels obtained at the end of the therapy. METHODS: Sixty-six postmenopausal women were administered either oral (n=44) or transdermal (n=22) HRT for 6 months. Serum levels of IGF-I were determined before and after HRT in all subjects. Groups were divided into two subgroups according to the median value of serum IGF-I levels (basal IGF-I levels above or below the median value). The increase of IGF-I levels after HRT were calculated (%) for all women. Mean increases of subgroups were compared. Furthermore, study groups were divided into three subgroups according to the changing of IGF-I (increase>25%, between 25% increase and 25% decrease and decrease>25%). Mean basal IGF-I levels of these three subgroups were compared. RESULTS: Mean serum levels of IGF-I before and after HRT were not significantly different in both oral and transdermal groups (P>0.05). Mean increases of IGF-I after HRT for the patients with low basal IGF-I levels, were 65% in oral and 77% in transdermal groups. However, mean increase of the patients with high basal IGF-I levels were -8 and -16% respectively. Moreover, mean level of basal IGF-I was significantly low in women who have more than a 25% increase after HRT (P<0.05). CONCLUSION: HRT seems to significantly increase serum levels of IGF-I in postmenopausal women with low basal levels of IGF-I.

Accuracy of ovarian reserve tests.

Several tests predict ovarian reserve in women undergoing assisted reproductive technologies. However, the accuracy of these tests in assessing the number of the remaining follicles within the ovary (ovarian reserve) has not been previously validated. The aim of this study was to assess the accuracy of ovarian reserve tests, namely basal and clomiphene-stimulated follicle stimulating hormone (FSH) concentrations and gonadotrophin-releasing hormone (GnRH) agonist stimulation test in predicting the number of the follicles within the ovaries. The ovaries of 22 parous women over 35 years of age who underwent oophorectomy were examined histologically for follicle number. Early follicular phase serum FSH, clomiphene citrate challenge tests (CCCT) and GnRH agonist stimulation test (GAST) were performed in the menstrual cycle prior to the surgery. The predictive value of these tests was then assessed. A positive correlation was detected between basal serum oestradiol concentrations and follicles per unit tissue but no significant correlation was detected between basal and clomiphene-stimulated FSH and follicles per unit tissue. The receiver operator characteristic curves indicated that the clomiphene citrate challenge test was the most accurate of the three tests assessed. In conclusion, none of the tests in this study accurately reflects ovarian reserve.

Stress hormones and acid-base status in human fetuses at term delivery: the effect of delivery method.

To evaluate the effect of delivery mode on fetal stress hormones and acid-base status and also to investigate the relationship between fetal acidemia and these hormones. 64 women with term pregnancies were studied. All had singleton, healthy pregnancies. Twenty one women were delivered by spontaneous vaginal route, 23 by vaginal route following oxytocin infusion and 20 by elective caesarean section. Umbilical cord blood samples were obtained immediately following the delivery. Blood gas (pH, pCO2, pO2) and hormonal analysis (Cortisol, dehydroepiandrosterone sulphate, prolactin, androstenedione) were done in arterial and venous cord blood samples respectively. Higher pO2 and prolactin, lower pH levels were found in caesarean section compared to other two groups (p < 0.05). At the time of delivery 11 infants had acidemia (pH < 7.20) as judged by pH of umbilical arterial blood. Acidemic group had higher cortisol and pCO2; lower pH and pO2 levels compared to non-acidemic group (p < 0.05). Method of delivery may affect acid-base and hormonal status of human fetus. Fetal acidemia may alter fetal adrenal steroidogenesis leading to increased fetal cortisol production.

[Does the incidence of premature labor vary according to the season?]. / L'incidence de l'accouchement prématuré varie-t-elle selon les saisons?

To investigate the epidemiology of premature delivery, in particular regarding potential seasonal influences, a retrospective medical-record study was conducted in 3345 women who delivered prematurely over a six-year period (1988-1993). The control group was composed of 53,162 women who carried their pregnancies to term. Each study subject had delivered at least one liveborn baby, prematurely or at full term. The premature delivery rate (ratio of premature over term deliveries) was highest in May through July and decreased significantly in January and February (p < 0.05). Premature delivery rates were similar in primiparas and multiparas (p > 0.05) and were not influenced by the gender of the fetus (p > 0.05). In conclusion, premature delivery rates vary across seasons, suggesting an influence of weather conditions.

Maternal, fetal and amniotic fluid prolactin levels in term and post-term pregnancies.

Prolactin (PRL) levels in maternal serum, amniotic fluid and mixed cord blood from 11 women with post-term pregnancies and 64 women with normal term pregnancies were measured by immunoenzymetric assay in order to investigate their possible role in the onset of labor. No differences were found between term and post-term pregnancies, and it is concluded that PRL probably has no function in triggering labor.

[25 patients undergoing laparoscopy for pelvic pain]. / A propos de 25 patientes ayant subi une coelioscopie pour douleurs pelviennes.

25 patients have involved in this research, who have chronic gynecologic pelvic pain and each of them had normal gynecologic examination. Chronic pelvic pain has been found mostly between 30-39 years age group married, multipar females, associated with 44% dysmenorrhea, 36 p. cent dyspareunaie. Cultures and clinical examinations were all negative as a sign of infection. Experienced intra-abdominal operation or infection were causes of pelvic pain (48%), especially appendectomy has a prominent place (75%). Laparoscopic investigation showed: 16 p. cent adhesions, 28 p. cent chronic annexitis, 16 p. cent experienced pelvic inflammatory disease, 8 p. cent uterine leiomyoma, 4 p. cent each endometriosis, experienced parametritis and haemorrhagic lutein cysts. Instead of making group of lesions, we prefer to describe it, in numbers as infection importance coefficient (IIC), which is developed for this research. IIC 0-2 points presents insufficient organic causes, it does not represent the cause of pain. Non organic and non gynecologic reasons must be the cause of pain. Non organic and non gynecologic reasons must be investigated. IIC 3-5 points presents minor experienced intraabdominal infection. Secondary cases like myoma, ovarian cysts, chronic cervicitis should be considered first as reason. IIC 6 points and more presents direct organic deficiency suitable surgery is the treatment of choice of this group.

Prolactin and amniotic fluid electrolytes.

Prolactin (PRL) levels and Na+, K+, Cl-, Ca++ concentrations in maternal serum and amniotic fluid from 64 women in normal term pregnancy were measured by immunoenzymetric assay and flame photometry. The mean amniotic fluid PRL concentration was 597.7 (SE 31.5) ng/ml and the mean amniotic fluid Na+, K+, Cl- and Ca++ levels were 125.6 (SE 0.9) mmol/l, 4.5 (SE 0.1) mmol/l, 109.3 (SE 1.3) mmol/l and 2.0 (SE 7.5 E-02) mmol/l, respectively. There was no correlation between PRL levels in maternal serum and amniotic fluid, and the electrolyte concentrations in amniotic fluid. A close correlation was found between the concentrations of Na+ and Cl- in maternal serum and amniotic fluid. Thus, even though PRL may participate in the regulation of electrolytes in the amniotic fluid compartments, our findings provide indirect evidence for the existence of other regulatory mechanisms.

[A twin pregnancy in a bicornuate uterus]. / A propos d'une grossesse gémellaire développée dans un utérus bicorne.

A case of twin pregnancy in bicornuate uterus with a fetus in each horn is presented. During the second trimester, the rudimentary horn ruptured. This horn was extirpated and two non viable fetus were delivered by cesarean section. Later on, the patient had another pregnancy in the unicornuate uterus. She was delivered at 36th week of pregnancy by cesarean section. The baby was in good condition.

[Infections by Mycoplasma hominis and Ureaplasma urealytycum in vaginal discharge. Incidence and treatment]. / Infections à Mycoplasmes hominis et Ureaplasma urealytycum dans les écoulements vaginaux. Fréquence et traitements.

This report summarizes the studies carried out on 100 patients who were examined for vaginal discharge. The following observations were made: Mycoplasma hominis in 13.59% of the cases, Ureaplasma urealytycum in 8.73% of the cases, that is, the presence of at least one of these microorganisms in 22.32 of the cases. All these infections were treated by tetracyclines administered in appropriate doses.

[Culture of placental tissue by the modified roller tube method in vitro]. / Das Züchten von plazentarem Gewebe mit der modifizierten Tuben-Roller-Methode in vitro.

Tissue cultures of the placenta are being performed with various methods. Tissue cultivation is currently used as a method and as a medium for various investigations. In the present study, the authors have found that the Modified Roller Tube Methods appearing to be of a practical and repetitive nature in securing in vitro of the placenta.