Adult granulosa-cell tumor of the ovary: a retrospective study of 45 cases

This study describes 45 cases of adult granulosa-cell tumors seen in our institution between 1976 and 1993. The median age was 46.5 years (12–77) and 18 women were postmenopausal. Vaginal bleeding was present in one-third of cases; other complaints were abdominal pain (28%) and the presence of a pelvic mass (47%). The tumor size was variable (<3 cm to 30 cm, median 11.5 cm). FIGO stages were: stage I: 30 (73%) (19 Ia, seven Ic, four I unknown); stage II: seven (17%) (two IIa, five IIC); stage III: three (7%) (one IIIb, two IIIc). Two adenocarcinomas and 13 cases of hyperplasia were found in 25 endometrial samples available. The initial therapy for all the cases was surgery, consisting in 34 patients of hysterectomy, bilateral salpingo-oophorectomy, ± tumor resection. Sixteen patients received adjuvant therapy as well: chemotherapy (CT) alone for 12, radiotherapy (RT) alone for two, and CT + RT for two patients. Among the 39 patients who achieved a complete response after initial therapy, 15 patients have relapsed (pelvic recurrences) (38.5%) including six stage Ia (three received only conservative surgery). All the recurrent tumors were resected and 14/15 had CT (13/14 with cisplatin). The overall survival rate was 77.2% at 5 years, 66.5% at 10 years, and 41.2% at 20 years. A statistically significant difference was found between the survival of patients with stage Ia disease (75% at 10 and 15 years) and that of other patients (60% at 10 years, and <50% at 15 years). Serum estradiol and serum inhibin were measured in some patients and the results are described.     

Subcutaneous estradiol pellets for endometrial preparation in donor oocyte recipients with a poor endometrial response

Purpose: The purpose of this study was to evaluate the clinical effectiveness of subcutaneous estradiol pellets in donor oocyte recipients with an inadequate endometrial response. Methods: The subjects were 13 women with ovarian failure and a maximal endometrial thickness <10 mm on standard estrogen regimens, as demonstrated during mock and/or prior oocyte donation cycles. They underwent pellet implantation (100–250 mg of estradiol) 6–13 weeks before oocyte donation. Results: Maximal (mean ± SD) endometrial thickness was 8.7±1.5 mm on standard regimens, in contrast to 11.7± 1.8 mm on pellets, while estradiol levels were 674±844 and 815±706 pg/ml, respectively. The estradiol:estrone ratio on pellets was >1. There was 1 pregnancy with early loss during 10 cycles on other estrogen regimens and 12 pregnancies during 19 cycles on pellets. The pregnancy and implantation rates were, respectively, 63 and 27% on pellets and 41 and 14% on standard regimens in historical controls. Conclusions: We conclude that estradiol pellets after a single administration provide constant estradiol levels extending into the first trimester of pregnancy, a physiologic estradiol:estrone ratio, and a better endometrial response than standard estrogen regimens. Implantation and pregnancy rates are higher. This approach may be especially suitable for recipients with a poor endometrial response. Presented at the IXth World Congress on In Vitro Fertilization and Assisted Reproduction, Vienna, Austria, April 3, 1995, and the 51st Annual Meeting of the American Society for Reproductive Medicine, Seattle, Washington, October 7–12, 1995.     

Associations of alcohol, height, and reproductive factors with serum hormone concentrations in postmenopausal Japanese women

We measured serum levels of estradiol (E₂), sex hormone-binding globulin (SHBG), progesterone, and dehydroepiandrosterone sulfate (DHEAS) in 61 postmenopausal women drawn from female residents in a community in Japan to evaluate the relationships between these hormone levels and potential breast cancer risk factors. The information on reproductive history, body size, alcohol use, and physical activity was obtained by means of a self-administered questionnaire. There was a significant trend in increasing E₂ level with increasing height after taking account of age and body mass index (BMI) (p for trend = 0.04). BMI was inversely associated with SHBG level after controlling for age (p for trend = 0.01). Decreasing progesterone with increasing BMI was observed after controlling age and history of hysterectomy (P=0.05). Alcohol consumption was positively associated with E₂ level and there was a strong linear trend after controlling for age, height, and BMI (p for trend=0.001). Trend for increasing DHEAS with alcohol consumption was also statistically significant after controlling for age and history of hysterectomy (p for trend=0.01). Reproductive factors as well as physical activity were not related to any of the hormone levels.     

调坤汤性激素样作用的实验研究

目的：探讨调坤汤对雌二醇（E2）、孕酮（P）等性激素调节的机理。方法：用同龄SD雌性大白鼠30只，随机分为空白对照组、高剂量给药组、低剂量给药组，每组10只，空白对照组不用任何药物，高剂量给药组每天给调坤汤煎液3ml含原生药9g，低剂量给药组每天给调坤汤煎液稀释液3ml含原生药6g，共给药10天（约2个生理周期），用药结束后采血样测性激素。结果：经检验，高剂量给药组、低剂量给药组的E2和P与空白对照组比较差异有显著性（P〈0．05、P〈0．01）。结论：调坤汤有升高血清E2和P的作用。     

17-β雌二醇对缺氧诱导人脐静脉内皮细胞凋亡的影响

流行病学资料[1]提示雌激素对心血管系统有保护作用,其确切机制尚不十分清楚.缺氧能引起血管内皮细胞功能异常:一氧化氮(NO)下降和内皮素(ET-1)上升,同时能够加速血管内皮细胞的凋亡,并参与一系列的临床病理过程[2].本研究拟探讨缺氧对人脐静脉内皮细胞(HUVECs)功能和凋亡的影响,17-β雌二醇(E2)对上述影响是否有保护作用.     

17β-雌二醇增加卵巢切除大鼠心肌内皮型一氧化氮合酶的表达和一氧化氮生成

目的 :观察 17β 雌二醇替代治疗对卵巢切除大鼠心肌组织中一氧化氮 (NO)和内皮源性一氧化氮合酶 (eNOS)的影响。方法 :成年雌性SD大鼠经双侧卵巢切除术 ,假手术组作为对照 ,术后 3周随机分为假手术组 ,模型对照组 ,17β 雌二醇(0 .1mg·kg-1·d-1)和溶媒 (芝麻油 )皮下注射治疗组 ,处理 6周 ,记录大鼠的血压、心率、子宫重量 ;检测血中雌二醇的含量 ;亚硝酸还原酶法检测心肌匀浆中NO含量 ;Westernblot分析心肌中eNOS及eNOS调节蛋白小凹蛋白 1(caveolin 1)的蛋白表达情况。结果 :17β 雌二醇治疗组的心率 (314± 16次 分 )较其他各组低 ,与溶媒对照组比较 ,雌二醇替代治疗组心肌匀浆中NO的含量增加一倍 ,eNOS蛋白表达明显增加 (P <0 .0 1) ,而作为eNOS的内源性抑制物caveolin 1的表达却明显减少 (P <0 .0 5 )。结论 :雌激素替代治疗直接增加卵巢切除大鼠心肌eNOS的表达量以及NO的产生 ,减少抑制eNOS活性的小凹蛋白 1表达。     

PROK1及其受体PROKR1在子宫内膜异位症中的表达和临床意义

目的：探讨前动力蛋白-1(prokineticin 1,PROK 1)及其受体(prokineticin-receptor 1,PROKR 1)在子宫内膜异 位症中的表达水平及意义。方法：采用定量PCR(quantitative PCR,qPCR)和蛋白质印迹法检测PROK 1和PROKR 1在18 例正常对照组和22例子宫内膜异位症患者在位内膜及异位内膜中的表达水平;将6例正常对照组子宫内膜间质细胞分 离、培养,给予雌二醇(estradiol,E2)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)干预后,采用qPCR检测PROK 1 mRNA的表达水平。结果：PROK 1 和PROKR 1 mRNA在子宫内膜异位症患者的异位内膜和在位内膜以及正常对照组 子宫内膜中均有表达,表达最高的为异位内膜组,表达最低的为正常内膜组(P<0.05);PROK 1 和PROKR 1 蛋白在子 宫内膜异位症患者的异位内膜和在位内膜以及正常对照组的子宫内膜中均有表达,在异位内膜中表达最高,在正常 内膜中表达最低(均P<0.05);在正常子宫内膜组及子宫内膜异位症组中PROK 1的蛋白表达水平均为分泌期高于增生期 (均P<0.05);E2对子宫内膜间质细胞PROK 1 mRNA的表达无明显影响,TNF-α能上调子宫内膜间质细胞PROK 1 mRNA 的表达。结论：PROK 1及其受体参与了子宫内膜异位症的发生并对其发展有促进作用,TNF-α可能上调PROK 1的表 达从而促进血管生成。     

超临界CO2萃取鹿茸中的性激素研究

目的：研究超临界CO₂萃取技术提取鹿茸中性激素。方法：超临界CO₂萃取鹿茸中的性激素并采用放射免疫法分析其含量,利用GC-MS,TLC和HPLC分析了萃取物中其他成分。结果：以85%乙醇为夹带剂,夹带剂∶原料=1(mL·g^-1),萃取压力30 MPa,萃取温度65 ℃,总提取率为1.56%,雌二醇和孕酮的质量分数分别为3.07,776.18 ng·g^-1。结论：采用超临界CO2萃取技术提取鹿茸中的性激素是可行的。     

Ethinyl estradiol 20 μg/drospirenone 3 mg 24/4 oral contraceptive for the treatment of functional impairment in women with premenstrual dysphoric disorder

Objective

To determine the effects of ethinyl estradiol (EE)/drospirenone in a 24/4 regimen (24 days of active and 4 days of inactive pills) on functional impairment (affecting work, partnership, and social activities) in women with premenstrual dysphoric disorder (PMDD).

Methods

The present study was a secondary analysis of a double-blind, randomized, parallel-design multicenter trial. Women received EE 20 μg/drospirenone 3 mg (n = 232) or placebo (n = 218) and completed the Daily Record of Severity of Problems (DRSP) scale daily.

Results

The decrease in mean scores for all 3 DRSP functional impairment items (work, partnership, and social activities) from baseline to cycle 3 mirrored changes in the total DRSP symptom score; the greatest decreases were observed in cycle 1 with further small reductions through to cycle 3. The proportional mean decreases from baseline to cycle 1 for the 3 functional items ranged from 47% to 48%. For all 3 functional items, the mean reductions from baseline to cycle 1 (but not from cycle 1 to cycles 2 and 3) were significantly greater with EE/drospirenone than with placebo (P < 0.05).

Conclusion

Ethinyl estradiol 20 μg/drospirenone 3 mg in a 24/4 regimen significantly improved functional impairment in women with PMDD. Symptoms improved in parallel.     

Similar efficacy of low and standard doses of transdermal estradiol in controlling bone turnover in postmenopausal women

Objectives.?To investigate the effects of a low transdermal estradiol dose on bone metabolism and to compare it with both the standard dose and absence of treatment.

Methods.?In this study performed in a third-level academic center, 66 healthy postmenopausal women underwent hormone therapy (HT) with patches containing estradiol at standard (0.050 mg/day, HT50, 33 women) or low dosage (0.025 mg/day, HT25, 33 women) and 70 women were without treatment (NT). The values (mean of three samples) of several bone biochemical parameters were compared between groups after adjusting for confounding factors. Bone mineral density (BMD) was assessed (by dual-energy X-ray absorptiometry) in the spine and hip in all cases, and a second densitometry scan was performed in 44 women.

Results.?Bone turnover markers tended to show lower values in the treated groups, but significance was restricted to total alkaline phosphatase (NT vs. HT25, p < 0.05) and cross-linked N-telopeptides of type I collagen (NTX) (NT vs. HT25, p < 10^?6; NT vs. HT50, p < 10^?5). The loss of BMD observed in NT women, as assessed by the annual percentage change, was blocked in both the HT25 and HT50 women. No significant differences were detected between both HT groups.

Conclusions.?Low and standard dosages of transdermal estradiol were equally effective in controlling bone metabolism, as assessed by turnover markers. Additionally, NTX was confirmed as the most sensitive marker for detecting changes in bone resorption.