Induction of ovulation in long-standing secondary amenorrhea with clomiphene citrate and repeated injections of LH-RH. Preliminary report.
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Six sexual steroidal hormones (progesterone, pregnenolone, testosterone, ethinyl-oestradiol, oestriol and oestrone) inhibit acetylcholine- and histamine-induced contractions of the isolated guinea-pig ileum. Different degrees of inhibitory capacity were found. High concentrations of PGE1 and F2alpha reverse some of these inhibitions. This reversal seems to be non-specific and probably related to sensitization of the ileal smooth muscle by prostaglandins. The inhibitory action of sexual steroids might be non-specific as well. But a "corticoid-like" effect cannot be excluded.
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The ratio of estrogen excretion in urine (milligrams per 24 h) divided by creatinine (grams per 24 h) was determined in 571 specimens of 307 pregnant women and compared with total estrogen determinations. Use of estrogen-creatinine ratio reduced the daily variations of total estrogen values by one third resulting in a mean curve with less standard deviation.
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Investigations on the influence of the diuresis effect upon the results of quantitative oestrogen and HCG determinations revealed that the oestrogen values increase with the 24-hour amount of urine. Oliguria and polyuria affect oestrogen excretion to a considerable extent; they have to be taken into account in prenatal diagnosis of pregnancy. Comparative HCG checks show that HCG concentration also varies considerable depending on fluid excretion. Diagnostic errors can be diminished or avoided when the quantitative HCG assessment is made on the 24-hour urine and then referred to the whole amount of urine.
A case of an unusual combination of a metastasing bronchus cancer, a non-metastasing cancer of prostata and an excessive high level of serum-estrogen is described. This casuistic gives rise to some more general discussion of the pathogenesis and differential diagnosis of paraneoplastic endocrinopathies.
The aims of this study were to evaluate the serum estradiol level and the estrogenic activity in long-term DMPA users. From 1st January 1996 to 31st December 1996, fifty healthy women receiving DMPA for contraception for more than 36 months were recruited to the study. From the study, it was found that the mean duration of DMPA use was 59.1 +/- 30.7 months, the mean serum estradiol was 52.7 +/- 15.1 pg/ml and these women did not have problems of estrogen deficiency. This study revealed that long-term treatment with DMPA should not have any adverse effects on estrogenic activity.
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