Circulating blood levels of gonadotropins and prolactin in the normal menstrual cycle

Circulating blood levels of luteinizing hormone, follicle-stimulating hormone and prolactin are reported in 17 normally menstruating Nigerian women. The profiles of the secretion of these pituitary hormones are similar to those reported in other ethnic groups. A significant midcycle peak of prolactin, coinciding with the peaks of luteinizing hormone and follicle stimulating hormone was also observed.     

Estrogen biosynthesis in breast adipose tissue during menstrual cycle in women with and without breast cancer

Abstract

Circulating estrogens fluctuate during the menstrual cycle but it is not known whether this fluctuation is related to local hormone levels in adipose tissue. We analyzed estrogen concentrations and gene expression of estrogen-regulating enzymes in breast subcutaneous adipose tissue in premenopausal women with (n?=?11) and without (n?=?17) estrogen receptor-positive breast cancer. Estrone (E₁) was the predominant estrogen in premenopausal breast adipose tissue, and E₁ and mRNA expression of CYP19A1 in adipose tissue correlated positively with BMI. Adipose tissue estradiol (E₂) concentrations fluctuated during the menstrual cycle, similarly to the serum concentrations. In women with breast cancer median adipose tissue E₁ (1519 vs. 3244, p?<?.05) and E₂ (404 vs. 889?pmol/kg, p?<?.05) levels were lower in the follicular than in the luteal phase whereas in control women no significant differences were observed. In the follicular phase, mRNA expressions of HSD17B1 (median 0.06; interquartile range 0.05–0.07 vs. 0.17; 0.03–0.2, p?=?.010) and CYP19A1 (0.08; 0.07–0.14 vs. 0.22; 0.09–0.54, p?=?.025) were lower in women with breast cancer than in controls. In conclusion, the changes in adipose tissue E₁ and E₂ concentrations and the estrogen-regulating CYP19A1 and HSD17B1 during the menstrual cycle may be related to dysfunctional local estrogen metabolism in women with breast cancer.     

Levels of immunoreactive inhibin-like material in urine during the menstrual cycle

Using a specific and sensitive radioimmunoassay, the authors determined levels of inhibin-like material in the urine of eight healthy women with normal menstrual cycle length of 28 ± 4 days. The results revealed a cyclic variation in urinary immunoreactive inhibin levels during the menstrual cycles, with a sharp rise in levels three to four days prior to luteinizing hormone (LH) and follicle-stimulating hormone (FSH) peaks. These levels of immunoreactive inhibin may thus serve as a parameter to detect impending LH surge.     

Postpartum magnetic resonance imaging in a case of placenta accreta with intrauterine abscess formation

The postpartum magnetic resonance imaging (MRI) appearance of a patient with placenta accreta and abscess formation is presented here and compared to the ultrasound and CT findings. The diagnosis was confirmed on histopathologic examination and cultures of the hysterectomy specimen. On MRI, the T1-weighted acquisitions showed an enlarged uterus of mildly heterogeneous but predominantly low signal intensity. The T2-weighted images demonstrated a heterogenous area of predominantly bright signal within the uterine body and fundus. In this case, MRI was more informative than ultrasound and non-contrast CT scan in the postpartum diagnosis of placenta accreta with abscess formation. Received: 10 March 1998 / Accepted: 14 April 1998     

磁共振成像在子宫内膜癌诊断和分期中的价值

应用磁共振成像对４３例临床可疑子宫内膜癌患者和７例正常妇女进行了对照研究，以观察ＭＲＩ在子宫内膜癌诊断、估计肌层浸润深度和分期中的应用价值。４３例患者，ＭＲＩ测得内膜厚度均超过正常标准。     

动态磁共振成像测量骨盆耻尾线评估盆腔器官脱垂程度的临床价值

目的 初步了解动态磁共振成像(MRI)测量骨盆耻尾线(PCL)评估盆腔器官脱垂(POP)程度的临床价值.方法 对20例POP患者分别进行POP定量(POP-Q)分度法测量,同时行动态MRI检查,用梯度回波二维快速小角度激发成像(FLASH)T1加权快速扫描序列,获得静息和用力屏气期间盆底矢状面MRI影像,分别测量骨盆PCL以评仙阴道前壁脱垂、子宫脱垂和阴道后壁脱垂的程度,并与POP-Q分度法的结果进行比较.结果 20例POP-Q分度法诊断为阴道前壁脱垂的患者,在最大屏气用力时,17例患者的膀胱颈或膀胱最低点位于PCL以下,与POP-Q分度法的符合率为85%(17/20).19例POP-Q分度法诊断为阴道后壁脱垂的患者,最大屏气用力时,4例患者的肛直肠连接部下降至PCL下2.5 cm之下,与POP-Q分度法的符合率为4/19.14例POP-Q分度法诊断为子宫脱垂的患者,最大屏气用力时,宫颈最低点均位于PCL上l cm以下,与POP-Q分度法的符合率为14/14,但有5例POP-Q分度法未诊断子宫脱垂的患者,宫颈最低点位置在最大屏气用力时位于PCL上1 cm以下.结论 与POP-Q分度法相比,采用动态MRI检查中的骨盆PCL作为标志线,可以准确判定子宫脱垂的程度,对阴道前壁脱垂也有一定的临床参考价值,而对阴道后壁脱垂则有一定的局限性.因此,动态MRI测量骨盆PCL评估POP程度的临床价值有待进一步研究.     

17 Beta-estradiol, progesterone and testosterone in the normal menstrual cycle of Nigerians

Circulating blood levels of estradiol, progesterone and testosterone are reported in 17 normally menstruating Nigerian women. The pattern of secretion and the range of levels of estradiol and progesterone are similar to those reported in other ethnic groups. Testosterone levels were, in general, higher than corresponding values in Caucasian or Asian women, but were of the same order of magnitude as previously reported in Zambian African women.     

A comparison of uterine peristalsis in women with normal uteri and uterine leiomyoma by cine magnetic resonance imaging

Objective

The non-pregnant uterus shows wave-like activity (uterine peristalsis). This pilot study was intended to determine: (1) whether uterine peristalsis during the menstrual cycle is detectable by cine magnetic resonance imaging (MRI); (2) the effects of leiomyoma on uterine peristalsis.

Study design

Mid-sagittal MRI was performed sequentially with T2-weighted single-shot fast spin-echo (SSFSE) in 3 normal ovulatory volunteers and 19 premenopausal women with uterine leiomyoma. Direction and frequency of movement of the junctional zone were evaluated using a cine mode display.

Results

Junctional zone movement was identified in all subjects. Direction of uterine peristalsis in normal volunteers was fundus-to-cervix during menstruation, cervix-to-fundus during the periovulatory phase, and isthmical during the mid- and late-luteal phases. Abnormal peristaltic patterns were detected in three of five patients with uterine leiomyoma during menstruation and in the mid-luteal phase of the cycle, respectively.

Conclusion

Cine MRI is a novel method for evaluation of uterine peristalsis. Results of this pilot study suggest that abnormal uterine peristalsis during menstruation and the mid-luteal phase might be one of the causes of hypermenorrhea and infertility associated with uterine leiomyoma.     

Increased cerebral blood flow in preeclampsia with magnetic resonance imaging

OBJECTIVE: The purpose of this study was to compare third trimester and nonpregnant cerebral blood flow of women with preeclampsia to normotensive control subjects with the use of magnetic resonance imaging techniques. STUDY DESIGN: Nine normotensive pregnant women and 12 untreated women with preeclampsia underwent velocity-encoded phase contrast magnetic resonance imaging of the bilateral middle and posterior cerebral arteries in the third trimester and at 6 to 8 weeks after delivery. The Student t test was used for comparison, with a probability value of <.05 considered significant. RESULTS: Third-trimester large cerebral artery blood flow was significantly higher in preeclampsia. Mean vessel diameter was unchanged, except for the left posterior cerebral artery. There was no difference in mean vessel diameter or cerebral blood flow between the 2 groups while the women were not pregnant. CONCLUSION: Cerebral blood flow is increased significantly in preeclampsia. We hypothesize that increased cerebral blood flow ultimately could lead to eclampsia through hyperperfusion and the development of vasogenic edema.     

Changes in copper and zinc plasma concentrations during the normal menstrual cycle in women

Objective.?To investigate whether there is a fluctuation of the copper and zinc plasma levels during the menstrual cycle and if this correlates to the physiological fluctuations of estradiol and progesterone plasma concentrations in eumenorrhoic women.

Methods.?We studied 14 eumenorrhoic women. Copper (Cu), zinc (Zn), estradiol (E2) and progesterone (Prg) plasma concentrations, during time of menstruation (time 1), midfollicular phase (time 2), time of ovulation (time 3) and midluteal phase (time 4) were determined.

Results.?We observed significant changes in both copper plasma concentrations and zinc plasma concentrations during the four times studied (p?<?0.05). The changes of Cu during the various phases correlated negatively with the changes in E2 (r?>?0.5, p?<?0.05), whereas the changes of Zn correlated positively with those of E2 (r?>?0.8, p?<?0.05). We were unable to demonstrate any statistically significant correlation between Cu and Prg or Zn and Prg.

Conclusions.?This study indicates that there is a cyclic fluctuation of Cu and Zn concentrations in plasma during the menstrual cycle, in healthy eumenorrhoic women. This cyclic fluctuation might be due to the cyclic fluctuation of plasma levels of E2.     

Changes in cervical neutrophil elastase levels during the menstrual cycle

Purpose  

Cervical mucus plays an important role in host defense mechanisms and is involved in the ascendance of sperm. To determine the change of neutrophil mediators contained in cervical mucus, we measured total neutrophil elastase (NE) levels throughout the menstrual cycle.     

Placental perfusion in normal pregnancy and early and late preeclampsia: A magnetic resonance imaging study

Objective

Our primary aim was to investigate if women with early or late preeclampsia have different placental perfusion compared with normal pregnancies. A secondary aim was to investigate if placental perfusion changes with increasing gestational age in normal pregnancy.

Methods

The study population included thirteen women with preeclampsia (five with early and eight with late preeclampsia) and nineteen women with normal pregnancy (ten with early and nine with late pregnancy). Early was defined as <34 weeks and late as ≥34 weeks gestation. All women underwent a magnetic resonance imaging (MRI) examination including a diffusion weighted sequence at 1.5 T. The perfusion fraction was calculated.

Results

Women with early preeclampsia had a smaller placental perfusion fraction (p = 0.001) and women with late preeclampsia had a larger placental perfusion fraction (p = 0.011), compared to women with normal pregnancies at the corresponding gestational age. The placental perfusion fraction decreased with increasing gestational age in normal pregnancies (p = 0.001).

Conclusion

Both early and late preeclampsia differ in placental perfusion from normal pregnant women. Observed differences are however in the opposite direction, suggesting differences in pathophysiology. Placental perfusion decreases with increasing gestational age in normal pregnancy.     

Serum HE4 concentration is not dependent on menstrual cycle or hormonal treatment among endometriosis patients and healthy premenopausal women

Objective

Human epididymal secretory protein E4 (HE4) is a new promising tumor marker developed for the diagnostics and follow up of ovarian cancer. It has yet to become widely accepted in clinical practice, and its biological properties have not been inclusively studied. The aim of this study was to investigate whether serum HE4 concentration varies within the normal menstrual cycle and whether common gynecological hormonal treatments have an effect on HE4 values.

Methods

Our study population consisted of 180 women, including 126 endometriosis patients and 54 healthy women. We measured their serum HE4 and CA125 concentrations and evaluated the effect of the menstrual cycle and the possible hormonal medication on these marker concentrations.

Results

We found no significant variation in serum HE4 concentrations in samples taken at different phases of the menstrual cycle. The median HE4 concentrations in proliferative, secretory and menstrual phase were 41.5, 45.1 and 35.3 pM in healthy women, and 43.4, 44.3 and 43.0 pM in endometriosis patients, respectively. The use of combined estrogen and progestin contraceptives did not affect serum HE4 levels significantly.

Conclusions

The present study shows that the HE4 measurement in healthy premenopausal women as well as in women with endometriosis can be carried out at any phase of the menstrual cycle, and irrespective of hormonal medication, extending the benefits of HE4 use in clinical practice.     

激光多普勒血流成像技术检测月经周期指甲微循环血流量的初步研究

目的观察女性月经周期3个阶段的指甲微循环血流量的变化,探讨月经周期对女性指甲微循环血流量的影响。方法采用激光多普勒动态血流成像仪对2011年8月至2011年10月浙江中医药大学药学院招募的20例月经正常女性月经周期3个阶段的指甲微循环血流量进行测定,同时在月经周期第1天、第14天,第23天进行手背动态血流成像扫描。结果月经周期的月经期、增殖期和分泌期拇指指甲微循环血流量分别为（540.5±81.1）PU、（546.4±94.9）PU和（607.1±97.4）PU,三者比较,差异有统计学意义（P〈0.01）,其他手指指甲微循环血流量测定结果相似。手背动态血流成像图显示,月经周期第23天血流灌注量较月经第1天及第14天明显增加。结论健康女性的指甲微循环血流量随月经周期呈动态变化。激光多普勒动态血流成像可简便、快速地测定体表微循环血流。     

Urinary excretion of catecholestrogens, 2-methoxyestrogens and “classical estrogens” throughout the normal menstrual cycle

Summary Catecholestrogens, 2-methoxyestrogens and “classical” estrogens (estrone, estradiol, estriol) were measured simultaneously in urine samples of healthy women during the menstrual cycle. All estrogen values reach a preovulatory maximum at the time of the LH peak and show a marked increase during the luteal phase as compared to the follicular phase. Catecholestrogens and estrone seem to behave similarly supporting the assumption that catecholestrogens are predominantly metabolites of estrone. Daily measurements of urinary estrogens show large interindividual variations of 2- and 4-hydroxyestrogens as well as very differing 2-hydroxy-/2-methoxyestrogen ratios. The results obtained support the assumption, that catecholestrogens and their methylethers are excretory products with no additional regulatory functions.     

Dynamic assessment of pelvic floor and bony pelvis morphologic condition with the use of magnetic resonance imaging in a multiethnic, nulliparous, and healthy female population

OBJECTIVE: The purpose of this study was to determine dynamic pelvic floor and bony pelvis morphologic condition in asymptomatic multiethnic women. STUDY DESIGN: Pelvic floor anthropometry, at rest and after the Valsalva maneuver, and pelvimetry were compared with the use of magnetic resonance imaging in nulliparous young volunteers from 5 ethnic groups (n=11 x 5 volunteers: Emirati, other Arab, Filipino, Indian/Pakistani, and European/white volunteers), with the white volunteers as the reference group. RESULTS: The white volunteers were significantly taller (P <.0001) than the other women. Their levator hiatus was significantly longer than the Emirati women (P=.03) and wider than the Filipino women (P=.04). The bladder neck descent on straining was also significantly greater than the other groups (P <.00001). The white women also had the longest transverse diameter of the pelvic inlet (P=.002). Their sagittal outlet diameter was significantly longer than the Emirati and Arab women (P=.02), and their interspinous diameter was significantly longer than the Arab women (P=.002). CONCLUSION: Nulliparous, healthy white women have larger levator hiatus and bony pelvis with greater bladder neck descent on straining than non-white women.     

Comparison of magnetic resonance imaging to ultrasound in the estimation of birth weight at term

OBJECTIVE: This study was undertaken to compare magnetic resonance (MR) and ultrasound (US) fetal weight estimates obtained immediately before delivery with birth weight. STUDY DESIGN: Eighty women scheduled for a cesarean delivery underwent a fast acquisition MR and US for fetal weight estimation within 3 hours of delivery. Prospective MR calculation was based on the equation 0.12+1.031 g/mLxfetal volume (mL)=MR weight (g). US fetal weight estimation was calculated by the formula by Hadlock et al. Estimations were compared with birth weight. RESULTS: Correlation (95% CI) between birth weight and MR weight is 0.95 with a mean absolute error of 129 g (105-155) compared with the correlation between birth weight and US of 0.85 with a mean absolute error of 225 g (186-264). The correlation for birth weight and MR imaging is significantly greater than that of birth weight and US, P<.001. CONCLUSION: Birth weight estimation is more accurate by MR imaging than by US in term infants.     

Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging

OBJECTIVE: Enlargement of the junctional zone (JZ) on T2-weighted resonance imaging of the uterus has recently been established as the major criterion for adenomyosis in patients with endometriosis. This study was conducted to analyse the extent of adenomyosis using magnetic resonance imaging (MRI) and relate it to the duration of dysmenorrhoea. STUDY DESIGN: This was a prospective study of 70 patients presenting with the complaint of severe dysmenorrhoea. Forty patients (57%) reported dysmenorrhoea as their major complaint and 30 patients (43%) suffered additionally from infertility. Group I (n=40) consisted of patients with dysmenorrhoea of between 1 and 10 years' duration, group II (n=30) consisted of patients with dysmenorrhoea of longer than 11 years' duration. All patients underwent laparoscopy to detect the presence and degree of endometriosis, and all patients underwent T2-weighted resonance imaging of the uterus to detect the extent of adenomyosis by measurement of the "junctional zone". RESULTS: In group I, adenomyosis could be detected via MRI in 21 patients (52.5%), while 19 patients (47.5%) showed no signs of adenomyosis. By contrast, in group II a distinct enlargement of the JZ, as the major radiological criterion of adenomyosis, could be observed in 26 patients (87%), while only 4 patients (13%) revealed no signs of adenomyosis (p=0.04). The mean thickness of the JZ was significantly enlarged in group II (11.07 mm) compared with group I (6.38 mm; p<0.0001). The prevalence of adenomyosis in endometriosis after dysmenorrhoea of more than 11 years' duration was 87%. CONCLUSIONS: In deep infiltrating endometriosis, a correlation between a specific localisation and dysmenorrhoea can often not be found. Recently, endometriosis and adenomyosis have been believed to result from a common uterine disease, the dislocation of the basal endometrium. Our data clearly show that dysmenorrhoea of long duration in patients who have had endometriosis for over a threshold value of 11 years is significantly related to adenomyosis of the uterus. Hence, evaluation of adenomyosis using MRI should become a standard procedure in cases of dysmenorrhoea and endometriosis. Severe dysmenorrhoea of long duration should always focus clinical interest on adenomyosis of the uterus.     

应用MRI评价宫颈癌分期的临床研究

目的探讨应用磁共振成像(MRI)指导宫颈癌分期的价值。方法对64例宫颈癌患者在手术前行MRI,均依临床分期结果制定治疗计划。以术后病理诊断为金标准,采用病例自身对照法将临床、MRI分期中癌浸润的部位和范围、淋巴结转移,尤其是宫旁浸润情况与手术病理所见对比,评价宫颈癌分期。结果MRI对浸润性宫颈癌判断的准确率为93.7%,特异性为95.7%,敏感性为88.9%。MRI预测宫颈癌总的分期的准确率为75.1%。在区分局限性和宫旁浸润中MRI的准确率为93.7%。MRI对宫颈癌侵犯部位和范围判断的准确率达88.5%。MRI对淋巴结转移预测的准确性为90.6%。结论MRI可多方位成像清楚显示宫颈肿瘤病变范围,MRI对区分局限性和浸润性病灶、淋巴结转移有着较高的准确性。临床引入MRI技术,有利于合理制定治疗计划,应成为宫颈癌术前常规的影像检查方法。