[Use of neurotransplantation in the treatment of Parkinson's disease]. / Ispol'zovanie neirotransplantatsii v lechenii bolezni parkinsona.

The outcomes of transplantation of the human embryonal mid-brain into the striatum of patients with Parkinson's disease are presented. For this, a procedure for obtaining, isolating, preparing the human embryonic midbrain, as well as a method for stereotactic administration of embryonal nerve tissue suspension having high dopaminergic neuron levels into the patients' striatum are specified. Patients underwent neurological examinations by the international protocol Core Assessment Program for Intracerebral Transplantation including monthly video recording within 3 months before and 3-24 months after surgery. Electrophysiological, neuropsychological, and immunological examinations were made at the same intervals. Most patients had positive dynamics: diminution of the severity of main disease symptoms, reduction in the efficiency of a single dose of DOPA-containing drugs, decrease in the magnitude of side effects of drug therapy.

[Hypogonadotropic form of amenorrhea. Features of the functional state of hypothalamo-hypophyseal structures and the endocrine status]. / Gipogonadotropnaia forma amenorei. Osobennosti funktsional'nogo sostoianiia gipotalamo-gipofizarnykh struktur i éndokrinnyi status.

Study of the function of the hypothalamopituitary system in patients with hypogonadotrophic amenorrhea showed the activity of its structures which manifested by the presence of pulsed LH secretion in 70% of women; however, the parameters of pulsed secretion of gonadotropins were disordered: the pulses were chaotic and low-amplitude. Adenohypophyseal gonadotrophs were capable of reacting to the administered gonadotrophin-releasing hormone, but the parameters of this reaction differed from the normal. The endocrine status of patients with hypogonadotrophic amenorrhea was changed vs. that in health: prolactin level was reduced, growth hormone level increased, thyroid and adrenocortical function changed; the pattern of secretion of some adenohypophyseal trophic hormones (prolactin, STH, TTH) was also changed. The results permit a hypothesis that impairment of the common central mechanisms regulating the endocrine system underlies the development of this disease; basing on their findings, the authors propose new approaches to the correction of this abnormality.

[Hypogonadotropic form of amenorrhea. Principles of ovulation induction]. / Gipogonadotropnaia forma amenorei. Printsipy induktsii ovuliatsii.

Analysis of the clinico-anamnestic and endocrine parameters of the reproductive system of 45 patients with hypogonadotropic amenorrhea helped single out three types of this condition. Drug doses and schemes of their administration to induce ovulation were selected individually with due consideration for the initial functional status of the reproductive system. The authors defined the basic principles of ovulation induction in patients with hypogonadotropic amenorrhea: the patients should be carefully selected according to WHO classification, with due regard for their clinico-anamnestic data and the function of the reproductive system (hormonal functional test); drug doses for substitution therapy and protocols of their administration should be selected individually, with consideration for the degree of hypophyseal-gonadal insufficiency; daily double (ultrasonic and hormonal) monitoring is needed for the correction of ovulation induction protocols; the choice of the optimal time of administration of the "ovulatory" dose should be based on the findings of double monitoring indicating follicle size 19-20 mm and the maximal activity of steroidogenesis (350 to 400 pmol/liter estradiol per follicle). The possibility of using lutrelef, an analog of gonadotropin releasing hormone, for ovulation induction in patients with the hypothalamic form of gonadotropic amenorrhea was studied. The drug was administered in a pulsed mode using Zykloma+ device (Ferring, Germany). The advantages of a physiological principle of substitution therapy were demonstrated, although the induction of cycles was not appreciably improved by this method as against substitution therapy with human menopausal gonadotropin.

[The course of pregnancy induced by ovulation stimulation in patients with the hypogonadotropic form of amenorrhea]. / Techenie beremennosti, indutsirovannoi stimuliatsiei ovuliatsii u patsientok s gipogonadotropnoi formoi amenorei.

The course of 60 pregnancies induced by ovulation stimulation with pergonal (in 46 cases) and lutrelef, an LHRF agonist (in 10 cases) was followed up. The authors emphasize the importance of the first therapeutic course as a preparative one, because pregnancies occurred in only 15 and 20% of patients treated with the two drugs, respectively, after it, and 25% of them failed to develop. The major pregnancy complications were due to multiple fetuses (23.4 and 20%, respectively). Stimulated pregnancy should be regarded as a high risk one in respect of spontaneous abortions; indications for abdominal delivery should be extended in such cases.

[The characteristics of hypophyseal gonadotropic function in patients with hypogonadotropic amenorrhea against a background of pergonal ovulation stimulation]. / Osobennosti gonadotropnoi funktsii gipofiza u patsientok s gipogonadotropnoi amenoreei na fone stimuliatsii ovuliatsii pergonalom.

Forty-three ovulation cycles stimulated with human menopausal gonadotropin were examined in 31 patients with hypogonadotropic amenorrhea. Peripheral blood estradiol and luteinizing hormone were radioimmunoassayed. The findings indicate the possibility of recovery of adenohypophyseal gonadotropin autosecretion in the presence of human menopausal gonadotropin administration.

[Sexual and reproductive behavior as seen in the results of a randomized study]. / Nekotorye aspekty seksual'nogo i reproduktivnogo povedeniia po rezul'tatam vyborochnogo issledovaniia.

The authors present the results of analysis of the sexual and reproductive behavior of 1010 girls aged 15 to 19, living in regions with various birth rates, who responded to questionnaires. The authors claim that adolescent girls should be regarded as a group of risk as regards unplanned pregnancy. Induced abortions rank first among the possible pregnancy outcomes in adolescents. A low level of the use of effective contraceptive means or agents is explained by poor knowledge of the young girls, which fact necessitates prompt charges in the system of sexual education and medical consultations for adolescents, with special emphasis on contraception.

[The acceptability of current contraceptive methods to adolescents]. / Priemlemost' sovremennykh metodov kontratseptsii u podrostkov.

The authors analyze the admissibility of present-day contraception methods in 107 adolescent girls who used oral anteovin and trisiston and in 128 ones who used copper-containing IUDs. Analysis has not revealed noticeable differences in the incidence of side effects in adolescents and a control group of women of a reproductive age. Spontaneous menses recovery occurred in all young patients within 26 to 36 days after the drugs were discontinued, and basal temperature biphasic pattern recovered in 70.2% of girls by the third month after IUD contraception discontinuation. Short courses (up to 6-12 months) of hormonal contraception are advisable for adolescents. IUD contraception complications presenting as expulsions and menstrual cycle disorders were 1.5-2 times more incident in the adolescents than in control women despite the preventive measures taken.

PIP: A total of 235 adolescents aged 15-20 years were investigated, of whom 107 (Group I) were using oral contraceptives (OCs) (Trisiston and Anteovin) and 128 (Group II) were using IUDs containing copper: Cu 7-mini, Medusa, and T Cu 200. In addition, 215 women aged 20-35 years were studied in two more groups: 115 were using the OCs Anteovin and Trikvilar (Group III) and 100 were using the IUDs T Cu 200, Cu 7-Standard, and Medusa 1, 2, and 3 (Group IV). The reliability of OCs proved to be complete without even one unplanned pregnancy, while there were 4 such cases in Group II and 3 cases in Group IV. Side effects affected 9.3% among women using OCs in Groups I and III compared to only 7.5% in women at the midpoint of reproductive age. Group I experienced dyspepsia, reduction of work performance, and change in libido, while Group III experienced mammary tension and intermenstrual bleeding. 94.4% of patients in Group I and 94.6% of women in Group III had a menstrual cycle of 28.1 +or- 0.6 days at the beginning of OC use; compared to 27-29 days after the first cycle under OC treatment. Premenstrual syndrome and oligomenorrhea were found in 46.7% of adolescents using OCs and 12.3% of adult OC users at the beginning of treatment; however, by the third month of use menstrual disorders disappeared in all patients, and premenstrual syndrome as well as mammary tension occurred 2-5 days before menstruation in only 2.6% of women in Group III. Among IUD users complications were reported in 9.4% of Group II and 6.3% of Group IV. The frequency of expulsion was around 1.2-2.2 (mean 1.53) per 100 women in the course of 1 year in the adolescent users and 0.67 in Group IV patients. After 4 months of IUD use 73% of adolescents and 80% of women in Group IV experienced bleeding, while IUD removal because of hyperpolymenorrhea had to be done in 1.2% of Group II and 0.7% of Group IV users.

[Epidemiology of induced abortion and contraception]. / Epidemiologiia iskusstvennogo aborta i kontratseptsii.

This article describes prevalence and distribution patterns of induced abortion and contraception in various regions of the USSR. Selective studies have elucidated a spectrum of factors of abortion and contraception prevalence, their roles in birth control and priorities in implementation of updated methods of induced abortion prevention.

[Effects of hormonal contraceptives on menstrual and reproductive function of women]. / Vliianie gormonal'nykh kontratseptivov na menstrual'nuiu i generativnuiu funktsii zhenshchiny.

Results of a 2-year follow-up have been summarized in 220 normal women of 19 to 38 years of age who had been using hormonal contraceptives Ovidon, Non-ovolon, Rigevidon and Triquilar for 6 to 12 months. Regular menstrual cycles established within 1-5 months after withdrawal of oral contraceptives (OC) in 97.3% and by 3 months in 99.1% of the patients. The use of OC significantly reduced the incidence of oligomenorrheic menstrual dysfunctions. Planned pregnancy within the first 6 months following OC withdrawal occurred in 94.7% of the women. No adverse effects of OC on pregnancy were seen in women who received within 3 months. Contraception within 1-2 months is not recommendable due to an increased risk of complications. Mechanical and chemical contraception should be used in this period.

[Comparative analysis of fertile and infertile cycles during stimulation of ovulation with pergonal in patients with hypo- gonadotropic amenorrhea]. / Sravnite'lnyi analiz ferti'lnykh i neferti'lnykh tsiklov pri stimuliatsii ovuliatsii pergonalom u patsientok s gipogonado- tropnoi amenoreei.

A comparative assessment of variations in sex hormone levels and echographic parameters of fertile and infertile cycles was carried out in patients with gonadotrophic deficiency during pergonal induction of the ovulation. It was demonstrated that 83% of the infertile cycles were the first stimulation cycles. Basic differences were identified in the variation of sex hormone levels and echographic parameters of target organs between the fertile and infertile cycles. It is concluded that the first ovulation-induction course should be regarded as a preventive or preparatory one, where an optimum drug dosage is adjusted while the gonads and target organs are getting ready for the ovulation.

[Placental scintigraphy--a diagnostic method for evaluating indications for hyperbaric oxygenation in pregnant women with high risk of perinatal pathology]. / Stsintigrafiia platsenty--diagnosticheskii metod, pozvoliaiushchii opredeli't pokazaniia k giperbaricheskoi oksigenatsii u beremennykh gruppy vysokogo riska perinata'lnoi patologii.

At most, 40 pregnant females at a high risk for fetal perinatal pathology underwent clinical investigation, ultrasonic scanning of the placenta, recording of the fetal electro- and phonocardiography, the evaluation of the placental levels of lactogen and estradiol and thermoresistant alkaline phosphatase changes of the values considered who were then treated with hyperbaric oxygenation (HBO) under the control of dynamic placental scintigraphy. Based on the placentographic findings, the authors distinguished from the whole of the risk-group the patients whose pattern of uteroplacental blood flow response to the treatment was beneficial and therefore the HBO treatment for fetoplacental insufficiency was advisable.

Short and long-term results of pregnancy termination by different methods.

Different methods of pregnancy termination such as curettage, prostaglandins and vacuum aspiration have been compared with respect to the subsequent reproductive function in 560 patients. The first year of the 5 year follow-up was characterized by inflammation changes. A high rate of ovarian dysfunction was found in the first post-abortion menstrual cycles. The post-abortion period is considered a high risk condition.

PIP: The frequency of short and long term complications of artificial pregnancy termination were studied to identify a group of high risk patients in relation to the development of postabortion complications. The goal was to determine the optimum time for conducting rehabilitative measures. Group 1 was composed of 250 women whose pregnancy was terminated by curettage (n=100), prostaglandins (n=100), and vacuum aspiration (n=50). Reproductive function was assessed in this group for 12 months after artificial abortion (1, 3, 6, 12 cycles). Group 2 consisted of 400 women: pregnancy was terminated instrumentally in 250 of the women, and it was done by prostaglandins in 150 women. The assessment of reproductive function was conducted 5 years after artificial abortion. Gynecological diseases were observed in 16 patients of group 1 (6.4%): in 12 of 100 women with instrumental abortion (12%), in 2 of 100 women with prostaglandin-induced abortion (2%), and in 2 of 50 women with vacuum aspiration (4%). In most of the women complications were expressed in the form of uterine subinvolution (2.4%), metroendometriosis, salpingoophoritis (2.4%), and in the form of metrorrhagia (1.6%). Followup of group 1 revealed no regularity in the time of development of the disorders since their rate of appearance was equal 1, 3, 6, and 12 months after abortion. The 1st menstrual cycle after both surgical and prostaglandin abortion was biphasic in 88% (220 of the 250 women). Yet, an insufficient luteal phase in the 1st menstrual cycle developed in 20% of women with surgical abortion and in only 10% of the subgroup with prostaglandin-induced abortion. The 2nd menstrual cycle was characterized by the recovery of hormonal parameters and tests of functional diagnosis. Examination of the 2nd group revealed reproductive dysfunction in 131 of the 400 women studied (32.7%). The primary complaint was infertility. 3 groups of disorders were identified: hypothalamopituitary dysfunction expressed in anovulation (33 women); hypothalamopituitary dysfunction manifested by insufficient luteal phase (80 women); and adnexitis (18 women). The rate of postabortion complications in the long term increased by more than 3-fold. Postabortion complications were more frequent in women with a late menarche and with a history of genital inflammation. Investigation of the menstrual pattern in women suffering from secondary infertility after artificial abortion showed that 36.6% of the patients preserved the regular menstrual pattern, yet an insufficient luteal phase revealed by functional tests led to infertility. Impairment of the ovulatory process was the leading symptom in the women with secondary infertility. Ovarian dysfunction was expressed as an insufficient luteal phase 2.4 times more often than anovulation.

[Medical genetic study of the population of Turkmenia. VI. Intrapopulation variability from an analysis of marriage migrations and ABO and Hp marker systems]. / Mediko-geneticheskoe izuchenie naseleniia Turkmenii. Soobshchenie VI. Vnutripopuliatsionnaia izmenchivost' pri analize brachnykh migratsii i markernykh sistem ABO i Hp.

By the sampling procedure, the distribution of phenotypic and genotypic frequencies of ABO and Hp systems and the structure of intermarriage migration in Turkmen population was studied. The geographical subdivision of the Turkmen population coincided with its ethnic divergency. The main Turkmen tribes are highly isolated (the gametic index is 0.965 to 1.0) and the differences in gene frequencies between tribes are significant. The mean gene frequencies for the ABO system in the Turkmen population are: I0-0.5373, IA-0.2601, IB-0.2025, these being Hp1-0.284, Hp2-0.716 for the Hp system.

[Treatment of hyperplastic processes in the endometrium of women of child-bearing age using different types of synthetic progestins]. / Lechenie giperplasticheskikh protsessov éndometriia u zhenshchin detorodnogo vozrasta razlichnymi vidami sinteticheskikh progestinov.

PIP: It has been proved that a prolonged use of synthetic progestins in patients with hyperplastic processes may provoke an atrophy of the endometrium and anovulation and amenorrhea. The authors studied the effectiveness of an administration of combined and pure gestagens for the treatment of hyperplastic processes of the endometrium. Taking into consideration the ability of estrogen-gestagen preparations to provoke a stimulating action on the hypothalamo-hypophysis-ovarian system and to cause ovulation, the authors studied 105 patients with dysfunctional bleeding. The patients were aged 19 to 42. The duration of the disturbance was over 5 years on the average. All patients were suffering from anovulation. Functional diagnostic tests and the measurement of the steroid hormone level in the urine and the plasma revealed in all patients an estrogen saturation in the organism. Histological studies showed hyperplastic processes with the absence of secretion changes in the endometrium in 85 women. The study of the gonadotropic function of the hypophysis, based on the luteinizing and follicle stimulating hormones, showed a disturbance of the corrective gonadotropin secretion rythm with a disappearance of the peak in the middle of the menstrual cycle. The authors believe that these results are of primary importance for the endocrine aspect of cancerogenesis in the endometrium.^ieng