Growth-hormone secretion in patients with endometrial carcinoma.
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Biomedical subjects
Publications and source records attributed to F Benjamin.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The vaginal hormone cytology and the serum estrogen levels (as determined by radioimmunoassay) of 39 post-menopausal patients were compared. All cytologic parameters showed high statistical correlations with radioimmunoassay values, but these general associations could not be applied to individual patients. A more detailed analysis showed that an atrophic smear (eg, karyopyknotic index [KI], < 10%; parabasal level, > 20%; maturation value [MV], < 40%) indicate estrogen deficiency in the postmenopause. When the KI is 20%-40%, the parabasal cells less than 20% or the MV 40%-60%, the evaluation of estrogen status, on the basis of hormone cytology alone, is indeterminate. The three cytologic indices studied seem much more useful for detecting estrogen deficiency than estrogen excess in the postmenopause. The fact that immunochemical characteristics are not always related to biologic behavior must also be considered when interpreting these findings.
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A comparison was made of the ACTH stimulation test in the proliferative and luteal phases of the menstrual cycle in 13 subjects, each of whom served as her own control. The test yielded a 53.9% false-positive rate in the luteal phase. The study, therefore, clearly shows that from a practical, clinical point of view, the test is completely unreliable in the luteal phase, and is only valid when carried out in the follicular phase of the cycle.
The charts of 500 sequential perimenopausal patients were reviewed and their alterations in menstrual flow were characterized as fitting one of three patterns. Sixty-two patients (12%) had sudden amenorrhea, 347 (70%) had oligomenorrhea and/or hypomenorrhea, and 91 (18%) had menorrhagia, metrorrhagia, and/or hypermenorrhea. All of the patients in the menorrhagia/metrorrhagia and/or hypermenorrhea group had histologic evaluations to rule out the presence of premalignant or malignant disease; 17 women (19%) in this group had premalignant or malignant findings. In addition, 4 of the 5 women with malignancies had intermenstrual bleeding. Of the 9 women in the study with intermenstrual bleeding, 4 had invasive cancer and 2 had endometrial hyperplasia. This study documents and highlights the high incidence of premalignant and malignant findings in perimenopausal patients with bleeding patterns other than amenorrhea or oligomenorrhea/hypomenorrhea, and underscores the need for perimenopausal women with menorrhagia, metrorrhagia, and/or hypermenorrhea to undergo thorough evaluation.
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