Neuromyopathy in venous insufficiency.

Since July, 1985, the authors have studied 23 patients with history and physical findings of venous insufficiency syndrome (VIS) confirmed by venous pressure, muscle biopsy, ascending and descending venography, electromyography, and nerve conduction velocity studies. Clinically, swelling appears to be the most important symptom, along with high venous pressure, particularly ambulatory venous pressure, correlated with venography findings. Muscle atrophy was present in 18 cases. Electromyography and nerve conduction velocity studies yielded abnormal findings in 20 of 23 cases. The authors suggest that nerve conduction velocity and EMG studies could perhaps be used as noninvasive tests for diagnosis and follow-up of cases with VIS.

A comparative study of the estrogenic potential of two synthetic estrogens (mestranol and ethinylestradiol).

PIP: The purpose of this study was to establish the relative estrogenicity of ethinylestradiol and mestranol and to establish .05 and .1 mg of mestranol as standard reference preparations for the comparative study of other compounds. Patients were selected from a large group of primary amenorrhea, secondary amenorrhea, and postmenopausal women. All required hormonal replacement therapy. Patients with chromosomal abnormalities or those with diminished or abnormal response were excluded. Vaginal cytology was used as the main method for the assessment of the response. Before treatment all had either an atrophic pattern (Maturation Index = 50-50-0) or a hypertrophic pattern (MI=5-95-0) with a mean value of 10-87-3 for patients with primary amenorrhea and 18-79-3 in the other 2 groups. Patients with a proliferative intermediate cell pattern and postmenopausal women thought to have continuing endogenous estrogen activity were omitted. Ethinylestradiol or mestranol were given orally in doses of .025, .05, and .1 mg for a period of 10 days during which frequent vaginal smears were made. When cell patterns showed extremely marked cytolysis of the glycogen-containing intermediate cells and a low percentage of karyopyknotic superficial cells these patients were excluded. 40 women were finally included. The effects of estrogen on the vaginal epithelium in all 40 women after 10 days therapy were quite uniform. In those cases showing delayed regression of estrogenic effects 4 mg of chlormadinone acetate was given daily for 10 days. These patients then showed a reduction in the superficial cell percentage accompanied by a shift to the left in the maturation index such as 0-40-60 before to 0-95-5 after treatment. A few women had an insignificant reduction in the superficial cell percentages. Changes in the percentages of the intermediate type of cells were not significant. The regression was considered to be complete when the smear contained mainly small intermediate cells and parabasal cells with numerous leukocytes and some necrotic debris. Both estrogen preparations produced the same vaginal response at .05 mg doses. Tablets of .05 and .1 mg mestranol were chosen for further study. The increase in the superficial cell index to 30 (SD plus or minus 18.5) following treatment with .05 mg and the increase to 54.1 (SD plus or minus 26.7) following .1 mg have been adopted as standard vaginal responses. The term estrogenic effect used in vaginal cytology is taken to mean the local vaginal effect induced by estrogens.^ieng

[Urinary estrogen profile in consecutive phases of menstrual cycle in young healthy women]. / Profile estrogenów w moczu w kolejnych fazach cyklu zdrowych kobiet

PIP: Urinary estrogen profiles were made on 6 women, aged 26-30 years. Mean values of excreted estrone (E1) were the highest values in the 1st half of the cycle: 10.15 in the follicular phase and 10.23 mcg/24 hours in midcycle. In the 2nd half of the cycle the level of E1 decreased: 8.78 in the early luteal phase and 8.36 in the late luteal phase. Estradiol (E2) showed its highest mean level in the midcycle, 4.53 mcg, 2.80 in the follicular phase, 3.95 mcg in the early luteal phase, and 3.38 mcg in the late luteal phase. Estriol (E3) showed its lowest levels in the follicular phase at 13.78 mcg and in the late luteal phase at 14.12 mcg/24 hours. The highest E3 levels were 17.59 mcg in midcycle and 17.33 mcg/24 hours in the early luteal phase. The mean quotient ratio of E3/E1+E2 (R) showed high estriol proportions of 1.1, 1.2, 1.4, and 1.2 in all consecutive cycle phases. These are noted to be higher than those of English women (.70 and 1.21 in the 1st and 2nd phases). The racial and geographical factors involved in this are examined.^ieng

[Comparative studies of the estrogenic potency of mestranol and stilbestrol]. / Porównawcze badania estrogennych potencji mestranolu i stilboestrolu.

PIP: 90 women with absent or deficient estrogenic activity were administered by means of normal substitution therapy in a routine 10-day cycle mestranol in doses of .02, .05, and .1 mg, and stilbestrol in doses of 1.0 and 2.0 mg. Estrogen potency was measured through changes in the vaginal epithelium. Cytohormonal vaginal smears were taken before and after therapy; evaluation was made on the basis of maturation index, superficial cells index, and maturation value. With the value of ''100'' given to the estrogenic activity of 1 mg of stilbestrol, with an identical effect observed with .5 mg of mestranol, a value of ''180.3'' was given for .1 mg of mestranol, and ''163'' for 2.0 mg of stilbestrol. The dose of .02 mg of stilbestrol showed the lowest value of ''34.7.''^ieng

[Uncommonly high concentration of estrone of adrenal origin in a case of androgenic obesity, anovulation and amenorrhea]. / Niezwykle wysokie wartosci estronu pochodzenia nadnerczowego w przypadku androgennej otylosci,braku owulacji i miesiaczki.

PIP: The case of a 35-year-old woman who demonstrated androgenic obesity, absence of ovulation, and amenorrhea is examined. This patient showed arterial hypertension, diabetes mellitus, hirsutism, and anovulatory cycles. A very high concentration of estrone was noted in the urine, originating in the adrenal glands. These indications are generally considered during evaluation of breast or uterine cancer threat. Administration of dexamethasone led to a decrease in urinary estrone to insignificant levels. Stimulation with human chorionic gonadotropin caused an increase in ovarian activity. The disruptions this patient suffered were attributed to hormonal imbalances attributed to her obesity, primarily in regard to estrogen metabolism.^ieng