Isolated follicle-stimulating hormone deficiency in a woman with X chromosomal mosaicism

Primary amenorrhea was observed in a 40-year-old woman with a proportionate female habitus. Serum levels of luteinizing hormone (LH) (71 to 97 mIU/ml) and estradiol (less than 10 pg/ml) were in the postmenopausal range, while follicle-stimulating hormone (FSH) remained at the lower limit of detection (1 to 6 mIU/ml). LH was found to be biologically active in a mouse Leydig cell testosterone production assay. Chromosomal analysis revealed three major cell lines: 5% 45,X; 83% 46,XX; and 3% 47,XXX. The remaining cells showed apparently random aneuploidy and chromosome rearrangements. Intravenous administration of 150 micrograms of gonadotropin-releasing hormone produced a threefold elevation in LH but did not alter FSH levels. Review of ovarian biopsies performed at age 22 revealed a multitude of primordial follicles and one follicle with antrum formation. There was no evidence of recent or past ovulation. An insulin tolerance test evoked normal responses in serum growth hormone, prolactin, and cortisol. This is the first reported case of an isolated deficiency of FSH associated with mosaicism of the X chromosome. This coexistence of functional and genetic aberrations suggests that the differential secretion of LH and FSH may be related to specific independent loci on the X chromosome.

Steroid effects on relaxin secretion in the rat

These studies were performed to determine if estrogen and/or androgens are involved in the regulation of relaxin secretion in the pregnant rat. Animals were hysterectomized at Day 15 of pregnancy and either untreated or given a) a subcutaneous Silastic capsule containing crystalline testosterone, b) a subcutaneous Silastic capsule containing crystalline dihydrotestosterone, or c) daily subcutaneous injections of 100 micrograms estradiol. A group of sham-operated animals served as controls. Serum samples taken at Days 14, 16, and 18 of pregnancy were assayed for relaxin and progesterone. Treatment with either estradiol or testosterone attenuated the decline in serum relaxin and progesterone concentrations observed following hysterectomy, whereas dihydrotestosterone (a nonaromatizable androgen) had no effect upon either relaxin or progesterone levels. These results suggest that estradiol and testosterone, previously implicated in the control of luteal progesterone production, also stimulate luteal relaxin secretion. The mechanism by which testosterone stimulates relaxin secretion is probably via its aromatization to estradiol within the corpus luteum.

Stimulation of human sperm motility by relaxin

Relaxin has recently been identified in human seminal plasma (SP). This investigation was undertaken to determine the effect of relaxin on sperm motility. Washed ejaculated human sperm were incubated with or without porcine relaxin. In a series of 37 normal specimens (motility greater than or equal to 60%) relaxin attenuated the decline in grade of forward progression and percentage of motile sperm. Relaxin had a similar effect on a series of 47 subfertile specimens (motility 30% to 40%). Endogenous relaxin may play a role in delaying declines of motility and grade of forward progress in ejaculated sperm.

Food fantasies of incarcerated drug users

In a 1966 survey of food preference associations to narcotics, 47 incarcerated male addicts' actual as well as fantasied oral behaviour was studied. A significant preference was expressed for liquid and solid sweets in both the actual and fantasied experience during periods of abstinence. Retrospective, anecdotal reports indicate that the subjects' food preferences are psychologically determined and are chiefly related to infantile components in their personality makeup. The preference for sweets has the quality of a craving, and the substances consumed are thought of as yielding pleasurable effects resembling those of the drug. The hypothesis was substantiated that infantile hunger is the prototype of the adult's morbid craving and that food preferences reflect his type of early psychosexual need.

Hearing and middle ear function in osteogenesis imperfecta

Fifty-five patients with osteogenesis imperfecta (OI) were studied to determine the extent to which the peripheral auditory mechanisms share in the connective tissue lesion. Ninety-two unaffected relatives and 43 control subjects were also studied. Subjects were divided into age groups younger than and older than 30 years. Hearing loss, most frequently sensorineural, occurred in 49% (younger than 30 years) and 94% (older than 30 years) of patients with OI. A sensorineural pattern of hearing loss, here considered characteristic of OI, was observed in 47% of OI subjects irrespective of age, in 42% of relatives, and 5% of controls. Middle ear analysis by tympanometry and acoustic reflex analysis indicates that, although some patients with OI have a still middle ear system similar to that seen in otosclerosis, the majority display absent acoustic reflexes and increased compliance of the middle ear with notched tympanograms suggestive of anomalous ossicular articulation. Similar findings in otherwise uninvolved relatives suggest a genetic basis for these defects.

Synergistic effect of human relaxin and progesterone on human myometrial contractions

In an in vitro human myometrial strip system, both relaxin and progesterone can independently decrease the amplitude of spontaneous myometrial contractions. However, progesterone and relaxin synergize in this action. Doses of relaxin and progesterone which independently are ineffective, together inhibit myometrial contraction amplitude. Relaxin and progesterone are both products of the corpus luteum, a structure necessary for early pregnancy maintenance. The synergistic action of relaxin and progesterone in vitro suggests a similar in vivo physiologic effect in establishing uterine quiescence.

Relaxin in normal and pathogenic pregnancies

Serum relaxin concentrations were quantitated throughout pregnancy. Relaxin levels were higher in the first than in either succeeding trimester of pregnancy. Relaxin concentrations in third-trimester twin pregnancies were not significantly different from those in singleton pregnancies. Relaxin levels in toxemic pregnancies were similar to those of normal pregnancy. In contrast, relaxin concentrations in pregnancies beyond 43 weeks' gestation and in women with premature labor were significantly lower than levels in normal women in the third trimester of pregnancy.

Controversial issues of the pharmacotherapy of the hyperactive child

This paper, which forms part of a symposium on Paediatric Psychopharmacology, selects for discussion certain practical and theoretical issues related to the use of Stimulant Therapy for Hyperactive Children. The particular issues selected relate to important clinical questions, most of which have been the focus of recent research. Amongst the controversial issues chosen for discussion is the fact that while the short term effect of stimulants on symptoms of the hyperactive syndrome is well established, the long term efficacy and the effect of stimulants on improving the prognosis of this syndrome remains uncertain. It is concluded that the large body of research on the use of stimulants for hyperactive children has finally answered some long standing questions, but many gaps of knowledge remain and further research is required.

Accessory cervix: an unusual congenital malformation

A woman with a septate vagina and two cervices was observed. One of the cervices ended blindly. The other cervix communicated with a normal corpus and two normally positioned patent fallopian tubes. Two explanations for the origin of this accessory cervix are offered: (1) that it originated from a fusion failure of the lower portions of the müllerian ducts, and (2) that it arose from the urogenital sinus.

Hormone secretion by monolayer cultures of human luteal cells

To be able to study the control mechanisms for human luteal function, a system was designed to maintain human luteal cells in culture. Collagenase dispersed cells of human corpora lutea of the menstrual cycle and pregnancy were maintained as monolayer cultures for 26 days. Progesterone (P) and relaxin (R) in culture media were measured by radioimmunoassay. Both menstrual cycle and pregnancy luteal cells secreted P for 26 days. hCG increased P secretion by menstrual cycle luteal cells, but not by pregnancy luteal cells. R was not detected in media of menstrual cycle luteal cell controls, nor in media of cells incubated with hCG. R was detected in media of pregnancy luteal cells for 6 days. Addition of hCG caused a significant increase in media R levels only on day 2 of culture. These studies show that human luteal cells can be maintained as viable monolayer cultures for at least 26 days and these cultures can be used to study control of human luteal function.

Pituitary response to LHRH stimulation in women on oral contraceptives: a followup dose response study

Gonadotropic response to bolus intravenous injection of LHRH was measured in 36 women. Thirty of them were taking five different oral contraceptive preparations with six women in each category, and the remaining six served as controls. 150 micrograms LHRH was given during cycle days 20-25. Serum samples were obtained prior to the bolus injection and at 20 minute intervals for two hours. Five different oral contraceptive agents were selected to compare different progestins with same type and dose of estrogen, and different type or dose of estrogen with same type and dose of progestins. Significant suppression of LH response to LHRH stimulation ws observed in the agents containing 50 mcg of ethinyl estradiol or mestranol. No such suppression was noted in the product containing only 20 mcg of ethinyl estradiol. In comparing the different type of estrogenic or progestational components, no statistically significant differences in LH response were demonstrated. This finding suggests that it is not the individual component alone, but the combined action of estrogenic and progestational components which determines the potency of an oral contraceptive agent.

Placental control of ovarian immunoreactive relaxin secretion in the pregnant rat

To investigate the control mechanisms for the secretion of relaxin in pregnant rats, the effects of the fetus, placenta, and uterus were studied. Plasma immunoreactive relaxin and progesterone were measured in pregnant rats, from days 8--1 post partum. On day 16 of pregnancy, groups of animals were subjected to removal of the fetuses, conceptuses (fetuses and placentae), or uteri. To determine whether there are extraovarian sources of circulating relaxin, a group of pregnant rats was ovariectomized on day 16. Immunoreactive relaxin was undetectable in the plasma of pregnant rats before day 10, and increased to a mean concentration of 0.52 +/- 0.01 (SEM) ng/ml on day 13. In control animals, immunoreactive relaxin levels remained at about this concentration throughout the remainder of pregnancy and declined rapidly post partum. The pattern of secretion of relaxin in fetectomized animals was similar to that in controls. In contrast, a significant decline in immunoreactive relaxin was seen, within 24 h after surgery, in those animals in which removal of the conceptuses or hysterectomy was performed. In these animals, immunoreactive relaxin was undetectable within 48 h after surgery and remained undetectable throughout the experimental period. In animals that were ovariectomized, immunoreactive relaxin was undetectable 24 h after surgery. Progesterone secretion in animals that had fetectomy or removal of the conceptuses performed was similar to that in controls. These groups showed a significant decline in progesterone on day 17 of pregnancy, and progesterone continued to decline until day 1 post partum. Progesterone in hysterectomized animals declined more abruptly than in either controls or other experimental groups. Ovariectomy resulted in a prompt fall in plasma progesterone. These results indicate that in the rat, the fetus is not needed for the maintenance of relaxin secretion throughout pregnancy, the placenta controls the ovarian secretion of relaxin. The uterus does not exert a tropic effect upon relaxin secretion, no extraovarian sources of circulating relaxin exist in the rat, and there is a divergence between progesterone and relaxin secretion during rat pregnancy.

Infected endometriotic cysts: clinical characterization and pathogenesis

Although endometriotic cysts are common, the occurrence of infection in these lesions has not been reported. Of 510 consecutive endometriotic cysts diagnosed at New York University Medical Center between 1965 and 1979, eleven had pathologically confirmed evidence of infection. These patients were nulliparous and had a mean age of 34.7 years at time of diagnosis and without long histories of endometriosis or pelvic infection. All were anemic. Six patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and five patients were treated with conservative surgery. The morbidity of both groups was similar. The latter had a poor prognosis for fertility. Infected endometriotic cysts demonstrate a strong association with concomitant tubal infection and a weaker association with antecedent hysterosalpingography.