Decrease in human plasma prolactin levels by oral prostaglandin E2 in early puerperium.

Eight milligrams of prostaglandin E2 (PGE2; 2 mg every 30 min) were given orally to 12 puerperal women on day 4 after delivery. Plasma levels of prolactin showed a significant decrease in comparison with basal levels and with those of controls sampled over a similar period. The same dose of PGE2 was ineffective in modifying the plasma prolactin levels in four puerperal women on day 30 after delivery and in four non-pregnant women with normal levels of prolactin. It is suggested that a PGE2-induced decrease in prolactin could be mediated by hypothalamic dopaminergic neurones.

Uterine leiomyoma cytogenetics. II. Report of forty cases.

Chromosome analysis of 40 cultured uterine leiomyomas revealed the presence of clonal changes in 32.5% of them, confirming the cytogenetic heterogeneity within this type of tumor, mostly referable to a few cytogenetic subgroups. Preferential involvement of 12q14-15 and 14q23-24 bands in reciprocal and complex translocations was most commonly observed. Deletions of chromosome 7 and changes of chromosomes 1, 2, and to a lesser extent, chromosomes 19 and 22 were also found. Constitutional karyotype of patients bearing tumors with karyotypic abnormalities was examined. In one patient, two cells were found with t(12;14)(q14-15;q23-24) translocation and two with del(14)(q13q23-24). The latter rearrangement was also present as a clonal change in the tumor.

Uterine leiomyoma cytogenetics. I. Rearrangements of chromosome 12.

Cytogenetic investigation on 19 benign tumors of uterine smooth muscle was carried out after short-term cultures. Clonal chromosome abnormalities were present in four cases; 15 had normal karyotypes. All four cases with abnormal karyotype showed changes of chromosome 12. In three cases, chromosome 12 was involved in structural rearrangements with chromosome X, 1, and 4, respectively. Breakpoints on this chromosome occurred in different regions. The fourth case had trisomy 12 and an extra deleted chromosome 2, del(2)(p22). These findings confirm the involvement of chromosome 12 in uterine leiomyoma.

Uterine leiomyoma cytogenetics. III. Interphase cytogenetic analysis of karyotypically normal uterine leiomyoma excludes possibility of undetected trisomy 12.

Uterine leiomyoma, a benign tumor that histopathologically is rather homogeneous, was recently characterized cytogenetically. About 40% of the investigated tumors are associated with clonal chromosome abnormalities and five different subgroups have been identified, characterized by trisomy 12, t(12;14)(q14-15;q23-24), del(7q), t(1;2)(p36;p24), and 6p rearrangements. In our survey of 76 cases, trisomy 12 was observed in 10% of the abnormal cases. To exclude a possible underscoring of this abnormality, we reexamined 15 of the cases with normal karyotype by interphase cytogenetics using a chromosome 12 alphoid DNA probe.

A specific translocation, t(12;14)(q14-15;q23-24), characterizes a subgroup of uterine leiomyomas.

We have cytogenetically investigated short-term cultures initiated from 34 uterine leiomyomas, all of which were histologically completely benign. Clonal chromosome abnormalities were detected in five cases, a normal female complement in 22, whereas, in the remaining seven tumors no karyotype could be established. Apparently identical reciprocal translocations, t(12;14)(q14-15;q23-24), were found as the sole abnormality in four tumors. The fifth abnormal case contained a t(2;14)(p11;p11). We conclude that chromosome aberrations may be found in myomas of the uterus, and that t(12;14)(q14-15;q23-24) characterizes a subset of these tumors.

Antigenic and cytochemical characterization of cells adhering to intrauterine contraceptive devices.

Eighteen copper intrauterine devices (IUDs), removed after 25 months of use, were examined to evaluate cells adhering to them (IAC). By means of monoclonal antibodies, the antigenic phenotype of IAC was studied, along with some IAC cytochemical properties. Sixty percent of IAC were identified as granulocytes based on morphological, cytochemical, and antigenic characteristics. A small proportion of IAC were shaped like large foreign-body macrophages, with multiple picnotic nuclei, and diffused alpha naphthyl acetate esterase (ANAE) activity. Some IAC identified as macrophages from a morphological view point also showed dipeptidyl-diaminopeptidase IV (DAPIV) reactivity, previously described only in T-helper lymphocytes. Most IAC identified as macrophages reacted with the monoclonal antibodies OKM1 and HLA-DR, and showed ANAE activity in the form of small multiple granules. The hypothesis that IUD-adhering macrophages with an ANAE+, DAPIV+, OKM1+, and HLA-DR+ phenotype could play a role in the inactivation of spermatozoa can be proposed.

Embryonal carcinoma in two cases of androgen insensitivity syndrome: clinical, endocrinological and pathological features.

Embryonal carcinoma in two cases of complete androgen insensitivity syndrome (CAIS) is reported. In both cases gonadectomy carried out for prophylactic purposes led to the discovery of a localized embryonal carcinoma with areas of anaplastic seminoma in one case. In non-neoplastic tissue, gonad morphology in both cases was typical of AIS. Prevalently hypotrophic aspects, especially in the interstitial gland, were found in case 2. This may explain the different endocrine profile in the two cases before gonadectomy. Our study, aside from series of psycho-sexual problems, shows, according to all Authors, that the most serious complication is the high risk of malignancy after puberty in patients with AIS.

Carcinoma IB of the endometrium: spread and prognostic factors.

The prognostic factors and their intercorrelation in 47 patients with IB endometrial cancer are presented. The data reveal the particular behaviour of the lymphatic involvement: five patients (10.6%) showed metastases to pelvic lymph nodes and six patients (12.8%) had paraaortic node metastases; altogether two women (4.2%) had histological evidence of involvement of pelvic and paraaortic nodes. Both histological grade and depth of myometrial invasion showed a characteristic relationship with the lymphatic spread: the percentage of lymph node metastases seems to bear relation to progression of myometrial penetration (M2-M3) and to histological differentiation (G2-G3).

Activity of interferon beta in condylomata with dysplastic lesion of the uterine cervix.

The effectiveness of interferon beta in the treatment of condylomata of the cervico-vaginal tract associated with CINs was evaluated in 25 patients. Human fibroblastic interferon (IFN beta) was administered by intra and perilesional infiltration at a dosage of 3 x 10(6) IU/day for 5 consecutive days the first week and every other day the second. The treatment showed: complete regression in 61.76% of CIN I and 58.69% of CIN II; partial regression in 26.47% of CIN I and 21.73% of CIN II. The picture remained unvaried in 11.76% of CIN I and 19.56% of CIN II.

Variations of plasma CEA levels in gynecologic malignancies: incidence, significance and changes occurring in response to therapy.

Serial carcinoembryonic antigen (CEA) radioimmunoassay were performed on 84 patients with primary gynecologic malignancies using the double antibody method. A positive correlation between the marker levels and tumor stage was found in the subjects with invasive disease: the incidence of positive values is appreciably higher in the advanced stages of malignancies. The surgical resection normalized the pretreatment elevated levels: fluctuating CEA values were observed during chemio or radiotherapy. The findings of this investigation support the theory of the limited usefulness of the CEA levels as a diagnostic test in patients with gynecologic cancer. The determination would appear to be helpful only in case with an elevated plasma values at the time of diagnosis. The CEA test seems to indicate that serial plasma assays can be of large interest in the follow-up of this women and for the second-look surgery, chemio and radiant therapy.

Immunoperoxidase localization of HSV2 antigens in cervical dysplasia and carcinoma.

The AA. have evaluated by means of the immunohistochemical technique the incidence of herpetic phlogosis in 76 women with neoplastic pathologies of the uterine cervix. The patients were submitted to cytologic, colposcopic and histologic examination for CIN. The HSV2 positivity by immunohistochemical method was demonstrated in 53 (35.3%) cases of CIN and invasive carcinoma. The results confirm the frequent association between HSV2 and cervical carcinoma and they support a specific therapeutic approach to be made in the prevention and clinical management of the carcinoma.

Hormonal profile and androgen status during the menstrual cycle in women with acne.

The androgen excess in women with acne can play an important role in gynecological endocrinology. LH, FSH, PRL, Testosterone (T), Androstenedione (A), Deydroepiandrosterone sulphate (DHEA-S) and Progesterone (P) were investigated in 21 women with uncomplicated idiopathic acne during the menstrual cycle. LF/FSH ratio greater than 3 was found in 7 cases (36.8%). Total T values were high in 90.4% of the whole group of women with acne (mean +/- SD 618.6 +/- 253.6, normal range 92-352 pg/ml). An ovulatory pattern of P was found in 66.65% of women with acne. Hyperprolactinemia was found in 23.6% of cases. The common denominator for ovulatory dysfunction in these women seems to be elevated LH levels, rather than elevated T levels.

HSV2 and cervical intraepithelial neoplasia: cytological, histological and serological features.

An epidemiological investigation on the incidence of HSV2 infection in 1216 women with acute or recurrent vulvovaginitis was performed. HSV2 research was carried out by means of clinical, cytological, colposcopic, histologic examinations and vaginal pad cultures and antibody titration. Of the patients examined, 12.6% presented signs of genital herpes; among the diagnostic techniques used, the most reliable proved to be the serological method. Incidence of HSV2 was higher among women in the under privileged social classes, those who had sexual relations with different partners and those who were multiparous. A higher percentage of dysplastic and/or neoplastic lesions of the uterine cervix among HSV2 positive (P less than 0.025) with respect to controls was also found. A higher incidence of neoplastic pathologies among women who are positive for HSV2 was therefore confirmed.

Effect of thyrotropin-releasing hormone in pituitary-thyroid system function infertile women after surgical castration.

The Authors evaluate the effect of surgical castration on thyroid function of fertile women, and the response of TSH to TRH before and 30 days after castration.

Management, therapy and outcome of treatment in women with pelvic endometriosis.

Sixty-four cases of endometriosis treated between 1980 and 1985 were reclassified according to the R-A.F.S. Twenty-eight of the patients (43.7%) were followed for 24-39 months: in this group we evaluated the efficiency of medical treatment (Danazol), combined medical and conservative surgical or definitive surgical treatment on the basis of the persistence, complete or partial regression of the symptoms. In this group of patients the symptoms regressed completely in 39.28% of the cases; in 28.57% there was a partial regression and persistence or recurrence of the symptoms were reported in 32.14%. These results suggest that the classification system is a key to interpreting treatment.

Short term treatment with ketoconazole: effects on gonadal and adrenal steroidogenesis in women.

Ketoconazole, an imidazole derivative, is a large spectrum antifungal agent. The drug is known to cause a decrease in plasma androgens and adrenal steroids in normal men; it is also an active drug in the treatment of malignant tumors of the prostate. To examine the antiandrogenic action of this drug in women, we measured several gonadal and adrenal steroids in 21 normally menstruating women before and after receiving oral ketoconazole (200 mg twice daily) for 5 days. Plasma testosterone (T) decreased from a basal level of 0.35 to 0.25 ng/ml (+/- SEM) (P less than 0.001); dihydrotestosterone (DHT) from a basal level of 190.62 +/- 23.2 to 159.75 +/- 19.43 pg/ml (P less than 0.02); dehydroepiandrosterone sulphate (DHEA-S) from 1.42 +/- 0.44 to 1.15 +/- 0.19 micron/ml (P less than 0.02). Plasma 17 beta-estradiol (E2) decreased from a basal level of 97.42 +/- 29.37 to 54.32 +/- 9.9 pg/ml (P less than 0.05). In contrast, plasma 17-OH-progesterone (17-OHP) levels increased from a basal level of 44.81 +/- 8.21 to 71.81 +/- 15.81 ng/100 ml (P less than 0.05). These results confirm that the ketoconazole blocks the conversion of progestins into androgens. The decrease in the plasma concentration of E2 suggest a direct effect of the ketoconazole on the ovary. It is likely that the effect of the drug, both at the level of the ovaries and of the adrenal gland, is dose-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

5-(2-bromoethyl)-2'-deoxyuridine: a selective inhibitor of herpes simplex viruses in vitro.

A new pyrimidine analog, 5-(2-bromoethyl)-2'-deoxyuridine (BEUdR), was tested in vitro for antiviral activity on Herpes simplex virus types 1 and 2. As reference compounds, ACG, BVUdR and PAA were used. Compared to ACG and BVUdR, BEUdR resulted less potent on both HSV-1 and HSV-2. However, a 50% inhibition of the multiplication of uninfected cells could be obtained only at very high BEUdR concentration (ID50 = 8500 microM). This makes BEUdR the least toxic analog known and gives it a selective index comparable to, if not better, than of ACG and BVUdR.