Showing papers in "Gynecologic and Obstetric Investigation in 1989"
TL;DR: Although autosomal dominant inheritance could be excluded as an explanation for PCO in the whole data set, the findings were consistent with this mode of inheritance for a sizeable fraction of families.
Abstract: To assess the degree of familial clustering and the mode of inheritance of the polycystic ovarian syndrome (PCO), the prevalence of PCO-related symptoms among first- and second-degree relatives of 132 PCO patients and 71 controls was studied using questionnaire data. 19.7% of male first-degree relatives of PCO patients were reported to have early baldness or excessive hairiness, as opposed to 6.5% of relatives of controls. For female first-degree relatives, the percentages for PCO-related symptoms were 31.4 and 3.2, respectively, in the two groups. In a subgroup of 52 families of PCO patients where one of the parents was reported to have symptoms, 35% of brothers and 58% of sisters had symptoms. Although autosomal dominant inheritance could be excluded as an explanation for PCO in the whole data set, the findings were consistent with this mode of inheritance for a sizeable fraction of families. X-linked dominant inheritance of PCO could be discarded.
183 citations
TL;DR: Cesarean deliveries predispose to placenta previa, placente accreta and antepartum hemorrhage during subsequent pregnancies, and this relationship has to be considered in the cost-benefit equation for decision of route of delivery.
Abstract: A prospective study was conducted to determine the risk of placenta previa and unexplained antepartum hemorrhage after a previous cesarean section (CS). Of a total of 24,644 patients, 81 (0.33%) had a placenta previa which demanded abdominal delivery. The risk of placenta previa was 0.25% with an unscarred uterus and 1.22% in patients with one or more previous CS (the difference was statistically significant p less than 0.001). The corresponding figures for unexplained antepartum hemorrhage were 0.40% and 3.81%, respectively (p less than 0.001). Patients presenting with a placenta previa and a scarred uterus had a 16% risk of undergoing cesarean hysterectomy because of placenta accreta and severe hemorrhage compared to 3.6% in patients with placenta previa and an unscarred uterus. In conclusion, cesarean deliveries predispose to placenta previa, placenta accreta and antepartum hemorrhage during subsequent pregnancies. This relationship has to be considered in the cost-benefit equation for decision of route of delivery.
58 citations
TL;DR: There was a clear, significant association between steroid absorption kinetics and the condition of the vaginal mucosa as indicated by cytological data: significantly higher absorption was found in women with an atrophic vagina mucosa.
Abstract: Serum concentrations of estradiol-17 beta and its metabolites estrone (unconjugated) and total estrone (mainly estrone sulfate) and of progesterone were measured before and after application of one vaginal suppository containing 250 micrograms estradiol-17 beta and 10 mg progesterone to 10 previously unsubstituted healthy postmenopausal women with normal pretreatment serum steroid levels. Vaginal hormone cytology was performed prior to administration of the estrogen-progesterone combination. An atrophic vaginal mucosa was found in 5 and a moderate proliferation in the other 5 women. A significant association was found between proliferation and pretreatment values of estrone, but not with other steroids. There was a clear, significant association between steroid absorption kinetics and the condition of the vaginal mucosa as indicated by cytological data: significantly higher absorption was found in women with an atrophic vaginal mucosa.
52 citations
TL;DR: The results suggest a role of EGF or EGF-like substances in regulating the growth of gynecological malignancies, and indicate E GF-R expression as a possible prognostic factor.
Abstract: Epidermal growth factor receptor (IEGF-R) levels were analyzed in 72 gynecological tumor specimens. Measurable EGR-R levels were found in a significant percentage of ovarian and uterine tumors. Moreover, all vulvar epidermoid carcinomas and uterine sarcomas analyzed were EGF-R positive. In all tumor types examined, scattered EGF-R levels were observed. Higher EGF-R levels were found in metastatic than in primary ovarian tumors. Moreover, EGF-R were found to be more expressed in less differentiated than in well-moderately differentiated endometrial tumors. Our results suggest a role of EGF or EGF-like substances in regulating the growth of gynecological malignancies, and indicate EGF-R expression as a possible prognostic factor.
50 citations
TL;DR: In normal females, the follicular phase of the menstrual cycle was increased, and this increase was absent in the plasma of patients with cervical dysplasias, and the data direct attention to a possible etiologic association between RBP in human cervical epithelial abnormalities and cancer.
Abstract: Plasma concentrations of retinol-binding protein (RBP) were measured in a cross-sectional study of asymptomatic normal menstruating women (n = 94) who obtained Pap smears and participated in a double-blinded nutritional survey. Controls (n = 45) were women with negative cervical cytology, normal colposcopy and no known gynecologic pathology or dysfunction. Cases (n = 49) were subjects with abnormal cytology and colposcopically directed biopsy that established cervical epithelial dysplasias histopathologically in the previous 12-month period. In addition, 8 women with cancer of the cervix were also investigated. The mean plasma concentration of RBP was significantly lower in cases than in controls (p less than 0.001). In normal females, the follicular phase of the menstrual cycle was increased. This increase was absent in the plasma of patients with cervical dysplasias (p less than 0.05). The data direct attention to a possible etiologic association between RBP in human cervical epithelial abnormalities and cancer.
46 citations
TL;DR: It is suggested that the increase of contractile activity observed at the end of pregnancy could be partly mediated by the effect of histamine and 5-HT on smooth muscle of the human myometrium.
Abstract: The effects of histamine and serotonin and their antagonists on contractile activity of pregnant and nonpregnant human uterine strips were studied. Both histamine and serotonin (5-HT) increased contra
43 citations
TL;DR: The results suggest that stretch stimulation facilitates prostaglandin production in fetal membranes, which may contribute to uterine contraction in labor.
Abstract: Mechanical stretching increases synthesis and release of prostaglandin E2 (PGE2) in cultured amnion cells. The maximum level of PGE2 in stretched amnion cells is three times higher than that in nonstretched amnion cells. The maximum level of PGE2 in stretched cell medium is nine times higher than the maximal level of PGE2 in nonstretched cell medium. 3H-thymidine incorporation into DNA is 211 ± 25 cpm/105 cells in nonstretched groups; that in stretched groups is 582 ± 94 cpm/105 cells. There is a significant difference between the two groups. These results suggest that stretch stimulation facilitates prostaglandin production in fetal membranes, which may contribute to uterine contraction in labor.
40 citations
TL;DR: Elective induction was at least equivalent to awaiting the onset of spontaneous labor and was not associated with higher complication rates due to the method of induction, and fetal outcome was excellent in both groups.
Abstract: In 345 women with a favorable cervical score at due date, labor was either induced by means of intravaginal application of tablets containing 3 mg of prostaglandin E2 or spontaneous onset o
39 citations
TL;DR: The results suggest that the causes of PROM are not correlated to the phases of the moon or to meteorological variations.
Abstract: Over a 2-year period, 1,516 births were investigated to determine whether the onset of parturition could be correlated with the phases of the moon or to barometric height. 1,269 births started spontaneously, and of these, 254 (20%) started with premature rupture of the fetal membranes (PROM). No association was observed between the phases of the moon and deliveries beginning with PROM or with deliveries beginning without PROM. 1,302 of the women had regular menstrual cycles before pregnancy, and among these no specific relationship was found between the phases of the moon and the first day of the last menstruation before pregnancy. No relationship was found between the frequency of PROM and the barometric height. Variations in barometric height up to 9 h before the fetal membranes ruptured did not influence the frequency of PROM. Deliveries with PROM occurred significantly more often among primipara than among multipara. PROM occurred more frequently during night-time in the 8-hour period between 10 p.m. and 6 a.m. These results suggest that the causes of PROM are not correlated to the phases of the moon or to meteorological variations.
39 citations
TL;DR: In a population of 1,050 pregnant women the effect of maternal colonization by group B Streptococcus on premature rupture of membranes (PROM), preterm delivery, and low weight was analyzed.
Abstract: In a population of 1,050 pregnant women the effect of maternal colonization by group B Streptococcus on premature rupture of membranes (PROM), preterm delivery, and low weight was a
39 citations
TL;DR: In this paper, the results of an open randomized trial on women with bacterial vaginosis were examined in an open clinical trial, the aim of which was to define clinical results and the microbiological panorama after topical treatment for 1 week with either an acetic acid jelly (A), an estrogen cream (B), a fermented milk product (C) or metronidazole (D), after exclusion because of chlamydia infection (15 cases) or for other reasons, 61 cases remained for complete evaluation 4 weeks after the start of treatment.
Abstract: Eighty-four patients with bacterial vaginosis were examined in an open randomized trial, the aim of which was to define clinical results and the microbiological panorama after topical treatment for 1 week with either an acetic acid jelly (A), an estrogen cream (B), a fermented milk product (C) or metronidazole (D). After exclusion because of chlamydia infection (15 cases) or for other reasons, 61 cases remained for complete evaluation 4 weeks after the start of treatment. Clinical cure was obtained in 3 cases out of 17 on regimen A, in 1 out of 16 on regimen B, in 1 of 14 on regimen C, and in 13 out of 14 on regimen D. The patients were conclusively either symptomless or symptomatic when examined on 113 occasions. Statistically significant reduction after treatment resulting in relief of symptoms was observed in the numbers of corynebacteria and anaerobic cocci, whereas lactobacilli increased in numbers. The instillation of high numbers of Lactobacillus acidophilus (C) into the vagina cured only 1 patient and did not influence the predominance of lactobacilli in the vagina at the follow-up examination. The difference in microbiological profile of women in symptomatic and asymptomatic conditions becomes still more apparent when the results of the present and previously published studies on the subject by the present group of investigators are combined. The symptomatic woman is significantly more often harboring corynebacteria, Gardnerella vaginalis, peptostreptococci, peptococci, eubacteria and Bacteroides species. Lactobacilli are significantly reduced in numbers. However, only 51% of our previously symptomatic, but now symptomless women show predominant growth of lactobacilli, which is less than expected for healthy women.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: In diagnosing ovarian tumors, bimanual examination, ultrasound, CT scan and tumor markers should all be considered and it was impossible to rule out malignant disease in all cases preoperatively.
Abstract: Tumor markers have proved to be generally useful for diagnosing and monitoring malignancy. In contrast, high levels of tumor markers disturb us for differing benign disease from malignancy. We had 5 cases with benign disease who showed high values of tumor markers (CA 125 and CA 19-9). In this report, we illustrated 3 patients with endometriosis who showed high values of CA 125 and 2 patients with dermoid cyst who showed high values of CA 19-9. It was impossible to rule out malignant disease in all cases preoperatively. In diagnosing ovarian tumors, bimanual examination, ultrasound, CT scan and tumor markers should all be considered.
TL;DR: The main endocrine-metabolic changes associated with the hot flashes were a sharp increase in plasma free fatty acids, norepinephrine and LH levels, and a sharp rise in plasma insulin, glucagon, growth hormone, epinephrine and dopamine levels.
Abstract: Thermocutaneous, vascular, metabolic and hormonal changes were investigated during 11 hot flashes from 6 postmenopausal women. The first detectable change was an increase in finger blood flow with a concomitant enhancement of skin conductance. The increase in skin conductance was followed rapidly by a sharp rise in finger temperature. The main endocrine-metabolic changes associated with the above phenomena were a sharp increase in plasma free fatty acids (∼65%), norepinephrine (∼ 100%) and LH (∼20%) levels. Plasma glucose and cortisol tended to be increased but did not reach statistical significance; on the other hand, plasma insulin, glucagon, growth hormone, epinephrine and dopamine remained unchanged.
TL;DR: Naproxen sodium is a useful and safe drug in the treatment of premenstrual and menstrual pain related symptoms and a significant improvement of pre menstrual 'behavioral changes' which is probably related to the relief of painful symptomatology is obtained.
Abstract: The prostaglandin system is thought to play a role in the etiology of the premenstrual syndrome Many authors describe that prostaglandins are involved in both central and peripheral symptoms To test this hypothesis, we studied the effects of naproxen sodium treatment (550 mg twice daily, from day -7, in relation to next menses, to the 4th day of the cycle) in 34 patients suffering from premenstrual syndrome Six cases dropped out Fourteen women were given placebo for the first three cycles of the trial, followed by active drug The other 14 patients were given naproxen sodium, beginning from the first cycle In order to evaluate premenstrual symptoms, the Moos menstrual distress questionnaire was prospectively applied during the 2-month run-in period and at the 3rd and 6th cycles of treatment During our double-blind naproxen sodium study, both menstrual and premenstrual 'pain' decreased during active drug treatment, while placebo was ineffective We also obtained a significant improvement of premenstrual 'behavioral changes' which is probably related to the relief of painful symptomatology In conclusion, this study indicates that naproxen sodium is a useful and safe drug in the treatment of premenstrual and menstrual pain related symptoms
TL;DR: It is suggested that also during human pregnancy there is a diurnal variation in TSH and cortisol secretion, as well as an episodic secretion of PRL.
Abstract: Diurnal variations in serum concentrations of thyrotropin (TSH), prolactin (PRL) and cortisol were measured in 4 women during late stages of pregnancy (gestational weeks 34–38), in 2 women at an early
TL;DR: Ultrasonographic examinations, done to measure the fetal transverse cerebellar diameter (FCD), were performed in 116 women with regular menstrual cycles, at 17-40 weeks of gestation, and correlated well with gestational age.
Abstract: Ultrasonographic examinations, done to measure the fetal transverse cerebellar diameter (FCD), were performed in 116 women with regular menstrual cycles, at 17-40 weeks of gestation. FCD correlated well with gestational age (r = 0.96, p less than 0.001). The 95% confidence interval of the linear regression was also given. FCD may be a more useful indicator of the accurate gestational age in case of dolichocephaly or brachycephaly, and facilitate antenatal detection of congenital disorders.
TL;DR: None of these antigens is tumor specific, but CEA, TPA, CA125 and CA199, but not CA153, are oncofetalAntigens, the term 'tumor-associated antigen' is more appropriate.
Abstract: The following tumor markers were determined in body fluids associated with pregnancy: carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), neopterin, CA125, CA153 and CA199. CEA levels (cut-off 5.0 ng/ml) were not elevated during gestation, whereas TPA was above cut-off (85 U/l) in 98 out of 107 cases (range 40–408 U/l). TPA was significantly higher during the 3rd trimester of pregnancy than during the 1st and 2nd trimesters. 38.3% of CA125 measurements were slightly above the chosen cut-off of 35 U/ml, and the mean concentration was 33.5 ± 16.2 U/ml. During delivery, 14 out of 21 values (67%) were elevated. Only 9.4% of CA153 values were elevated. CA199 and neopterin were also hardly ever above cut-off. In general, there was a wide scattering of individual values. With the exception of CA153 (neopterin not determined), high concentrations of CEA (maximum: 207 ng/ml), TPA (maximum: 1,565 U/ml), CA125 (maximum: 2,371 U/ml) and also CA199 (maximum: 1,533 U/ml) were found in amniotic fluid. The distribution in mixed cord blood was similar but with more moderate elevations and a lower incidence of levels above cut-off. Thus, none of these antigens is tumor specific. The term ‘tumor-associated antigen’ instead of ‘tumor marker’ is more appropriate. CEA, TPA, CA125 and CA199, but not CA153, are oncofetal antigens. Thus, if a pregnant woman has cancer or is followed up after malignant disease, the use of CEA, CA199 and CA153 can be recommended. TPA will yield a high percentage of false-positive values, whereas a higher cut-off for the CA125 assay in pregnancy (e.g. 90 U/ml) is recommended.
TL;DR: Serum levels of carcinoembryonic antigen (CEA), CA 125 and CA 15-3 levels reflected the clinical course of the disease during chemotherapy and seemed to be useful for monitoring response to treatment.
Abstract: Serum levels of carcinoembryonic antigen (CEA), CA 125 and CA 15–3 were measured in 47 patients with endometrial cancer and 20 with endometrial hyperplasia. Before treatment elevated serum levels of C
TL;DR: This study proves the validity and applicability of microdialysis to the monitoring of chemicals in uterine fluid and especially to follow dynamic changes.
Abstract: Currently used techniques to measure the chemical composition of the rat uterine fluid are accompanied by interference with the physiology of the uterus, and the sampling procedure creates a methodological problem as the amount of uterine fluid is small. The aim of the present study was to investigate the utility of a new in vivo technique, microdialysis. A microdialysis probe, which functions as an ‘artificial blood vessel’ was implanted into the uterine lumen and perfused with a Ringer solution. This perfusion technique makes it possible to study ions and other components in the uterine fluid without withdrawal of any liquid. Compared to previous techniques it offers the advantage of continuous monitoring of the chemical composition of the uterine fluid over time. The sodium and potassium concentrations in the uterine fluid of 10 rats were monitored during oestrous. After 1–2 h of baseline perfusion an intramuscular injection of progesterone was given. The mean sodium concentration was 124.9 ± 2.4 mEq/1 before and increased in all 10 rats to 133.9 ± 2.3 mEq/1 (p < 0.001) after injection. The mean potassium concentration was 22.3 ± 2.4 mEq/1 before and decreased to 17.9 ± 2.1 mEq/1 (p < 0.001) after injection. This study proves the validity and applicability of microdialysis to the monitoring of chemicals in uterine fluid and especially to follow dynamic changes.
TL;DR: The data indicate that the tocolytic action of magnesium most probably results from the inhibition of calcium entry into myometrial cells.
Abstract: High concentrations of magnesium (12 and 24 mM) in the extracellular medium markedly inhibited both spontaneous activity and K+-induced contracture in strips of nonpregnant human myometrium. Net calcium influx measured by the uptake of 45Ca2+ in the myometrium was considerably decreased by high concentrations of magnesium. This was true for both resting (unstimulated) and K+-stimulated uptake of 45Ca2. While calcium uptake in K+-stimulated tissues exposed to 24 mM magnesium was significantly lower than in those exposed to 12 mM, no difference was found in the unstimulated tissues. These data indicate that the tocolytic action of magnesium most probably results from the inhibition of calcium entry into myometrial cells.
TL;DR: Structural and functional changes in the vaginal epithelium during the menstrual cycle may be important for the diagnosis and susceptibility to certain viral infections.
Abstract: Estrogen receptor content in vaginal tissue was quantified in 12 healthy female volunteers during the menstrual cycle. Epithelial biopsies were obtained at cycle days 10 and 21 and investigated by a m
TL;DR: A 52-year-old woman with primary malignant melanoma of the cervix succumbed to widespread metastatic disease 2 years after initial diagnosis after undergoing radiotherapy for metastatic lesions in the pelvis and para-aortic nodes.
Abstract: Primary malignant melanoma of the cervix was diagnosed in a 52-year-old woman. Extended hysterectomy and partial vaginectomy were performed. A vulval recurrence was treated with wide excision and total vaginectomy. She subsequently underwent radiotherapy for metastatic lesions in the pelvis and para-aortic nodes, but succumbed to widespread metastatic disease 2 years after initial diagnosis. Diagnosis, therapy, and prognosis for malignant melanoma are discussed.
TL;DR: One hundred and twenty-one patients with genuine stress urinary incontinence underwent urodynamic examination before and after Burch colposuspension, a surgical procedure which combined the techniques of the Ball and Burch procedures.
Abstract: One hundred and twenty-one patients with genuine stress urinary incontinence underwent urodynamic examination before and after Burch colposuspension. They were divided into two groups, one with preoperative urethral pressure of 20 cm water or less (n = 17), and the other with urethral pressure greater than 20 cm water (n = 104). Success rates at 12 months were significantly lower in women with low urethral pressure as compared with those with normal urethral pressure (65 vs. 88%; p less than 0.01). Starting in January 1987, all patients with low urethral pressure preoperatively underwent a surgical procedure which combined the techniques of the Ball and Burch procedures. Short-term cure rate (at 3 months postoperative follow-up) in women with low urethral pressure was 83% as opposed to 70% with the Burch urethropexy (p less than 0.05).
TL;DR: During treatment with desogestrel, levonorgestrel and norethisterone alone, testosterone displacement could account for a slight increase in free testosterone, though the decrease in serum SHBG following treatment was found to be more important in this respect.
Abstract: The progestogens desogestrel, levonorgestrel, lynestrenol and norethisterone are known to display certain androgenic effects. Apart from direct androgen receptor interaction, binding to sex hormone binding globulin (SHBG) and displacement of testosterone could lead to an increase in free, metabolically active testosterone. The affinities for SHBG binding of some progestogens including levonorgestrel, norethisterone and the active metabolite of desogestrel, 3-keto-desogestrel, were compared using an equilibrium partition method, and the distribution between free and protein-bound testosterone during progestogen therapy was calculated with the use of a computer program. During treatment with desogestrel, levonorgestrel and norethisterone alone, testosterone displacement could account for a slight increase in free testosterone, though the decrease in serum SHBG following treatment was found to be more important in this respect. Also during treatment with combinations of ethinyl estradiol and levonorgestrel for oral contraception, testosterone displacement could theoretically have a slight influence on free testosterone levels. Combinations with ethinyl estradiol and desogestrel or norethisterone, on the other hand, cause an increase in SHBG concentration and as a result a fall in free testosterone which could not be compensated via testosterone displacement.
TL;DR: It is suggested that in the treatment of asymptomatic bacteriuria in pregnancy, a single dose of 3 g amoxicillin is as effective and acceptable as a 4-day course and offers the advantage of a reduction in total dose, lower costs and better patient compliance.
Abstract: A prospective, randomized, controlled comparative clinical trial was carried out with the aim of investigating the efficacy and tolerance of two different dosage regimens of amoxicillin in the treatment of asymptomatic bacteriuria during pregnancy. Patients in group A received a single dose of 3 g amoxicillin, which was compared to a 4-day course of 3 X 750 mg amoxicillin tablets taken every 8 h (group B). Significant bacteriuria (CFU≥105 /ml clean catch midstream urine and CFU ≥ 104/ml urine obtained by bladder catheterization) was diagnosed using the dip-slide method (Uricult®). 91 pregnant women with a mean gestational age of 25 weeks (14–38) were randomly allocated to the two treatment groups. 53 patients were assigned to group A and 38 patients to group B. The treatment groups were comparable in terms of age and duration of pregnancy. Urine culture tests were performed 1 and 4 weeks after completion of therapy. The predominant species was Escherichia coli, which was isolated in 60–65% of the cases. Bacteriological cure rates at 1 and 4 weeks, respectively, were 77 and 74% in group A, and 62 and 62% in group B. These differences were statistically not significant. The incidence of side effects was 4% in group A and 13 % in group B. The results obtained in the present study suggest that in the treatment of asymptomatic bacteriuria in pregnancy, a single dose of 3 g amoxicillin is as effective and acceptable as a 4-day course. In addition, the single-dose regimen offers the advantage of a reduction in total dose, lower costs and better patient compliance.
TL;DR: The maternal and newborn renal function in 84 normal pregnant women delivering at term was investigated and there was no difference between mothers and newborn plasma concentrations of urea.
Abstract: The maternal and newborn renal function in 84 normal pregnant women delivering at term was investigated. There was no difference between maternal and newborn plasma concentrations of urea (3.9 ±
TL;DR: The rabbit model is suitable for studying the influence of endometrial implants on fertility and microsurgical techniques prevented the formation of tubo-ovarian adhesions.
Abstract: Since not all problems in endometriosis can be studied in the human, there is need of an animal model. We transplanted endometrial tissue of the rabbit into the peritoneal cavity and studied the changes after 12 weeks. At that time the endometrial implants in the rabbit had become cystic structures. The macroscopic and histologic appearance was consistent with endometriosis. Hormonal supplementation turned out not to be necessary. Microsurgical techniques prevented the formation of tubo-ovarian adhesions. This makes the rabbit model suitable for studying the influence of endometrial implants on fertility.
TL;DR: Doppler color flow mapping carried out before and after chemotherapy for an invasive mole revealed an abnormal color blood flow within the echo-free space in the uterine myometrium, and pulsed Doppler ultrasound showed a prominent arteriovenous shunt flow.
Abstract: We report here Doppler color flow mapping carried out before and after chemotherapy for an invasive mole. This mapping revealed an abnormal color blood flow within the echo-free space in the uterine myometrium, and pulsed Doppler ultrasound showed a prominent arteriovenous shunt flow. Similar features were obtained by pelvic angiography (PAG). After 4 courses of chemotherapy, the area of abnormal colored flow was reduced and findings on the PAG were supportive. The patient is being closely followed, using Doppler color flow mapping.
TL;DR: The role of human growth hormone (hGH) on placental hormone secretion at term was investigated in two in vitro models: placental explants and cultured trophoblastic cells as discussed by the authors.
Abstract: The role of human growth hormone (hGH) on placental hormone secretion at term was investigated in two in vitro models: placental explants and cultured trophoblastic cells. Physiological concentrations of hGH caused a significant dose-dependent increase in placental lactogen and progesterone secretion. In the explant model it stimulated estradiol secretion. In order to determine whether this stimulatory effect on estradiol is exerted via aromatase, an isolated cell culture was utilized where androstenedione was supplied as substrate. In this model, hGH exerted a mild inhibitory effect. In conclusion, hGH at levels present in the fetal circulation exerts a significant stimulatory effect upon placental function as reflected by both peptide and steroid hormone production and secretion. The effect of estradiol secretion is the end result of an inhibitory effect on androgen aromatization and a stimulatory effect on earlier steps.
TL;DR: The treatment of anaerobic vaginosis with vaginal tinidazole was effective and particularly useful if an IUCD was in concurrent use, and the intrauterine contraceptive device played an important role in the etiology of relapses and also in the decreased cure rates particularly seen in groups A and B.
Abstract: A prospective randomized trial comprising 90 patients was undertaken to evaluate three different regimens of tinidazole in the treatment of anaerobic vaginosis. Each group consisted of 30 women. The three regimens were: (A) oral tinidazole (150 mg X 2) for 7 days, (B) same oral treatment as above but also the partner received 500 mg X 2 for 4 days, and (C) intravaginal tinidazole (500 mg) at bedtime for 2 weeks. After clinical diagnosis and treatment the patients were reassessed at 1 and 3 months. The overall cure rate was significantly (p less than 0.05) higher in group C than in the other groups. After 3 months, 70% of the cases in group C were asymptomatic, while in the other groups the rate was 42 and 43%, respectively. The intrauterine contraceptive device (IUCD) played an important role in the etiology of relapses and also in the decreased cure rates particularly seen in groups A and B. Among the women in group C using an IUCD, 80% were cured, while in groups A and B only 30 and 29% were cured. All regimens were well tolerated. The treatment of anaerobic vaginosis with vaginal tinidazole was effective and particularly useful if an IUCD was in concurrent use.