PubMed Health⌕ Search

Biomedical subjects

J S Dericks-Tan

Publications and source records attributed to J S Dericks-Tan.

At least 19 recordsLinked to original sources
PubMed1992

Influence of oral contraceptives on integrated secretion of gonadotropins.

The mechanism of action of various oral contraceptives has not yet been satisfactorily resolved, as to how gonadotropins affect ovarian function. Alterations of the pulsatile release of LH might be a common denominator. As methodological difficulties for the evaluation of LH pulse pattern with low basal levels exist, we elected to determine the area under the curve (AUC) for LH and FSH for 6 hours before and during treatment with oral contraceptives. LH and FSH were determined every 15 min for 6 hours on day 4 and day 20 of a control cycle and a treatment cycle in 22 women with ovulatory cycles. They received either a combined preparation containing 150 micrograms desogestrel and 30 micrograms ethinyl estradiol, a sequential preparation containing 50 micrograms of ethinyl estradiol and 125 g of desogestrel or only 125 micrograms desogestrel. There was no difference between the sum of LH pulses on day 4 and day 20 of the control cycle. The AUC for FSH was lower on day 20. When the combined preparation was taken, FSH was suppressed on day 4, and FSH and LH on day 20 of treatment. The degree of suppression was even more pronounced when the sequential OC was taken. Ethinyl estradiol alone was as effective as the combination with desogestrel. Desogestrel alone inhibited ovulation without affecting serum LH and FSH in a comparable manner, suggesting a direct effect on the ovary. The determination of the AUC seems to be a sensitive tool for the evaluation of OC-induced changes in gonadotropin output.

Adolescent↗
PubMed1992

Is 3 alpha, 17 beta-androstanediol-glucuronide a diagnostic marker in women with androgenic manifestations?

3 alpha, 17 beta-androstanediol-glucuronide (Adiol-G) has been described as a marker of local androgen excess due to the increased activity of 5 alpha-reductase in the cells of the hair follicles. In order to test the diagnostic value of Adiol-G, the serum level was compared to that of testosterone, free testosterone, dehydroepiandrosterone sulfate (DHEA-S), androstenedione and to the body mass index in 44 women with androgenic symptoms (Group I), 27 women with menstrual disturbances but no androgenic symptoms (Group II), and 48 healthy women (Group III) who served as controls. Adiol-G was significantly higher (7.8 +/- 5.1 nmol/l) in women with androgenic symptoms than in the other groups, but there was a considerable overlap. Serum testosterone was also found to be higher in Group I than in Groups II and III, respectively. There was a significant correlation between Adiol-G and testosterone, and Adiol-G and DHEA-S. No significant correlation could be shown to exist between androstenedione and Adiol-G. When Adiol-G and testosterone were simply classified as 'normal' or 'increased' (Adiol-G 9.4 nmol/l; testosterone greater than 2.4 nmol/l), higher than normal values of the former were found in the presence of normal testosterone in only 4% of the cases. It is concluded that the level of Adiol-G generally parallels that of testosterone. Consequently, it does not seem to be an effective marker of peripheral androgen excess.

Acne Vulgaris↗
PubMed1991

[The behavior of serum hCG level in normal and disordered pregnancy--a prognostic factor].

The increase of serum hCG was determined in 305 pregnant women at least twice in the first 10 to 12 weeks of pregnancy. In a large number of cases this was done to rule out a disturbance of pregnancy. The results were evaluated by means of a comparison to the time-dependent changes of the normal range. They were classified in the following manner: 1 = Normally increasing values, 2 = Values lower than normal, but normal increase, 3 = values to low and increasing too slowly, 4 = Serum hCG too low or declining, 5 = initially normal values failing to rise. A type 4 secretion pattern was invariably followed by a demise of pregnancy. In about one half of the cases showing a type 2 pattern, the pregnancy either miscarried or was found to be in an ectopic location. In normal pregnancies, type 2 pattern was found in 29% and type 1 in 71%. A comparison of the results of the first and second hCG determination revealed close agreement in more than 90% of the cases, and in 84% when the comparison was extended to a third sample.

Abortion, Spontaneous↗
PubMed1990

[Secretion of beta-hCG in pregnancy: an artefact?].

The concentration of beta-subunit (hCG beta) cannot be exactly quantified by means of competitive immunoassay in the presence of high levels of hCG, e.g. during normal pregnancy. Although the specificity and sensitivity of immunometric assay with mixed monoclonal antibodies was much improved, false positive results of hCG beta can, however, be obtained, if a high concentration of hCG is present in the hCG beta-IRMA (Ozturk et al. 1987). In this study hCG beta was therefore measured by subtraction of the values obtained by 2 immunometric assays for hCG + hCG beta and hCG in 174 serum samples of normal pregnant women during the 4th and 20th week of pregnancy. As both values did not differ, no hCG beta activity could be confirmed. Serum samples from pregnant women or authentic substances (hCG and hCG beta) were analyzed qualitatively by means of gel filtration (Sephadex-G100 column) and measurement of hCG and hCG + hCG beta activity in the fractions. In the chromatograms of pregnant serum, only one fraction with a hCG activity was observed. No additional fraction corresponding to the hCG beta activity could be identified in these chromatograms. It is concluded that, the secretion of hCG beta in serum during pregnancy is very low (less than 1%) and that the hCG beta activity measured by means of radioimmunoassay may possibly be due to an artifact.

Chorionic Gonadotropin↗
PubMed1990

The ovary-suppression test in the evaluation of hyperandrogenemia.

Forty hyperandrogenemic women were investigated in order to determine whether the source of androgen excess could be attached to a dysfunction of the ovary or the adrenal cortex with a higher degree of accuracy when both steroid-producing organs were subjected to a supposedly specific suppression test. Dexamethasone (DXM) was administered at a dose of 2 mg for 2 days. The ovary-suppression test (OST) was carried out after a combined preparation containing 35 micrograms of ethinyl estradiol and 2 mg of cyproterone acetate (EE-CPA) had been taken for 2-3 weeks. Before and after the tests, the serum levels of testosterone (T), free testosterone (fT), DHEA-S and SHBG were determined. Serum T was lowered by DXM and EE-CPA to the same degree: the latter was more effective with respect to fT. DHEA-S responded much better to DXM than to EE-CPA. The basal level of SHBG was below the lower limit of the norm in 45% of the women. This indicates that hyperandrogenemia can be associated with normal and subnormal levels of SHBG. T and/or fT were elevated in all 40 women. DHEA-S was higher than normal in only 22 of the 40. DXM normalized the DHEA-S level in all but 1 case. In another 18 women, serum T and fT remained unaffected by DXM. This indicates an ovarian source of androgen excess in these cases. The number of cases was reduced from 18 to 4 when the OST was carried out. Even though DXM and EE-CPA are not completely organ-specific in action, the combination of both suppression tests seems to allow a higher degree of discrimination to be made between an ovarian and an adrenal component of hyperandrogenemia than is possible with either test alone.

Adolescent↗
PubMed1989

Human chorionic gonadotropin levels in various compartments in disturbed early pregnancy.

The hCG level in the uterine cavity was higher than in peripheral blood in a case of choriocarcinoma and in patients with spontaneous expulsion of the conceptus. In two patients with missed abortion, the hCG concentrations in peripheral blood and in serum from the uterine cavity did not differ. In contrast, the hCG concentrations in PF in these patients were lower than in peripheral blood. The measurement of hCG in these compartments may provide evidence concerning the location of the trophoblast.

Biomarkers, Tumor↗
PubMed1988

[Quantitative hCG spot test of the serum and peritoneal fluid in intrauterine and tubal pregnancy].

The concentration of hCG was measured in serum and peritoneal fluid (PF) of women with normal intrauterine pregnancy (34), extrauterine pregnancy (21), and intrauterine abortion (12) by two different methods. A new rapid, quantitative method (Spot-Test; ICON-QSR) which provides the results within 10 minutes was compared to an immunofluorometric method requiring 90 minutes (IFMA). The serum concentration of hCG and the ratio of hCG in serum and in the PF correlated well when determined by both methods (p less than 0.001). Comparable results were also obtained when hCG was measured in the serum of 4 patients with extrauterine pregnancy for a period of 2 to 3 weeks before and after surgery. When hCG was measured by means of the spot test in samples of undiluted serum containing less than 30 IU/l, lower values were obtained as compared to the IFMA. In samples containing more than 200 IU/l, the relationship was reversed. In all cases of intact intrauterine pregnancy, the level of hCG in serum exceeded that in PF, whereas the converse was observed in 19 out of 21 tubal pregnancies. These results show the spot test to be suitable for the rapid and quantitative determination of hCG in serum and the PF, provided that there is no strong hemolysis in the samples. When the concentration of hCG exceeds 300 IU/l, the measurement has to be repeated with diluted samples. Differences in concentrations of less than 20% cannot always be distinguished. Even though the results of the present study are promising, the usefulness of the spot test for routine clinical practise has to be examined in further studies.

Abortion, Spontaneous↗
PubMed1988

[HCG in serum and peritoneal fluid in suspected ectopic pregnancy].

HCG was measured in peripheral serum and peritoneal fluid (PF), obtained by punction of the Douglas pouch (n = 12) or by laparoscopy (n = 14) in 26 patients with suspected ectopic pregnancy. In 10 patients with tubal pregnancy, the hCG-concentration in the PF was in every case higher than in serum. Contrary to this, in 11 disturbed and 2 normal intrauterine pregnancies the PF-hCG was lower than in serum. No hCG-gradient could be observed in 1 patient with an interstitial pregnancy. Moreover, in 2 patients with inconclusive laparoscopic findings, the PF-hCG was higher than in serum; this pointed to a probable harbouring of a suspected missed ectopic pregnancy, and treatment was therefore conservative. The PF-hCG level 35 h after i. m. application of 5000 IU hCG to non-pregnant women varied between 11 and 42% as compared to that of the serum. It is concluded that the gradient of hCG between PF and serum can be used for the verification of a suspected ectopic pregnancy in addition to other diagnostic methods.

Abortion, Spontaneous↗
PubMed1987

Spontaneous recovery of ectopic pregnancy: a preliminary report.

Twelve patients with silent (occult) ectopic pregnancy were clinically managed by a non-surgical conservative approach. The laparoscopic findings in 4 patients were not conclusive enough to justify laparotomy, and there was only minimal clinical symptomatology. The serum hCG level in these cases did not exceed 2000 IU/l and no typical rise was found. Serum hCG was measured serially under careful clinical observation until it reached non-pregnant levels over a period of 20-45 days. Tubal patency could be demonstrated 6 months later in 2 patients who desired to become pregnant.

Adult↗
PubMed1987

Double-stimulation with LH-RH in primary amenorrhea caused by chronic internal hydrocephylus: a case study.

A 19-year-old female patient with primary amenorrhea and pubertas tarda due to chronic internal hydrocephalus presented with normal hormonal findings except for low estradiol and a prepubertal type of reaction in the double-stimulation test with LH-RH. After successful operative treatment with a Spitz-Holter high-pressure valve, the intracranial decompression was promptly followed by pubertal development, she began to menstruate, and the LH-RH double-stimulation test showed an adult pattern of response. The results of the test support the view that a partial deficiency in the secretion of LH-RH is the cause of hypogonadism in such a case.

Adult↗
PubMed1986

Maternal serum alpha-fetoprotein levels in a triplet pregnancy with 2 papyraceous fetuses.

Serum Alpha-Fetoprotein (AFP) was found to rise to exceedingly high levels in a case of triplet pregnancy after two fetuses died in the 21st week of gestation. The surviving infant was born in the 36th week accompanied by the two fetus papyracei. By the time the process of mummification of the two dead fetuses appeared to be complete on ultrasound, the maternal AFP level had returned to the normal range for singleton pregnancies. HCG, hPL, and estriol and the coagulation profile remained within the normal range throughout the pregnancy.

Adult↗
PubMed1985

Inverse ratio of hCG in peritoneal fluid to that in serum in normal and tubal pregnancies.

The ratio of hCG in peritoneal fluid (PF) to that in serum (S) was studied in 60 patients with normal pregnancies (5th-15th wk of gestation = control group) and in 12 tubal pregnancies, 7 tubal abortions (5th-10th wk of amenorrhea) and one case of an early interstitial pregnancy (8th wk). The PF level in the control group was in every patient lower than in S independent of the gestational age. The ratio PF to S ranged from 0.24 to 0.87 (mean +/- S.E.: 0.51 +/- 0.02). In contrast to this, the patients with tubal pregnancy and tubal abortion showed in each case higher PF levels than in S. The ratio in the group with tubal pregnancy ranged from 1.1 to 374 (54 +/- 30) and in the group with tubal abortion from 1.2 to 162 (33 +/- 23). The difference in the ratio between the control group and both tubal pregnancy and tubal abortion was highly significant (P less than 0.001). The ratio of PF to S in the patient with interstitial pregnancy (0.73) did not differ from the control group. At the time of investigation, the S levels in all but 2 patients with ectopic pregnancy were below the range for normal pregnancy of the same gestational age. These findings indicate that the hCG ratio of PF to S may be dependent on the location of the gestational product.

Abortion, Spontaneous↗
PubMed1985

[AFP and HbF determination in maternal blood as a parameter of fetomaternal microtransfusion in interventions of the pregnant uterus].

The applicability of AFP assay (radioimmunologic) and of erythrocytes containing Hb-F (Kleihauer et al. 1957) in maternal blood as a means of detecting fetomaternal microtransfusion was examined in 57 cases of abruptio and 65 women in whom genetically indicated amniocentesis was performed. There was a significant increase in AFP postoperatively in 40% of the abruptiones; after amniocenteses such behavior was far less pronounced (18.5%). The count of cells containing Hb-F in maternal blood smears revealed no significant increase in any of the cases examined. A correlation on the basis of these examination results is therefore unlikely. However, an evaluation of them demands that the assay methods used for AFP and Hb-F cells and, above all, their physiology, be taken into account. The diaplacental passage rates of the two substances are probably different, and under certain conditions they may also be produced by the maternal organism to a varying extent. It could be concluded from this that even though the AFP assay involves a simpler method and is more sensitive, neither parameter can replace the other, and therefore neither can be made the basis for a decision against anti-D immunoglobulin prophylaxis.

Abortion, Induced↗
PubMed1984

Pseudohypergonadotropinemia and pseudohyperprolactinemia induced by heterophilic antibodies?

The serum of 20 apparently hypergonadotropic and/or hyperprolactinemic patients (14 females, 6 males, ages 13-75 years) without evidence of neoplasia or pituitary adenomas was found to contain a large amount of molecular material (MW ca. 100,000) resulting in factitiously elevated levels of peptide hormones when measured by double-antibody radioimmunoassay with a long second incubation time. The interference by this material with the test system could be avoided by using polyethylene glycol (PEG) for the separation of free from bound antigen, or by preincubation of the samples with normal rabbit serum. No definite disease process can as yet be linked to these findings. They rather seem to be caused by the presence of heterophilic antibodies in serum, as the serum of approximately one half of the patients was found to give a positive Paul-Bunnell test. Moreover, the beta hCG activity in the urine of these patients was low, probably as a result of the low clearance of substances with igh MW. It is therefore suggested to apply to following diagnostic measures before clinical consequences are being considered in a case of hypergonadotropinemia and/or hyperprolactinemia without pertinent clinical findings: (1) validation of the immunoassay, (2) preincubation of the samples with serum from other species, (3) the use of another separation procedure than the double-antibody method, and (4) measurement of the respective hormone in urine.

Adolescent↗