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Transvaginal ultrasonography and endometrial histology in peri- and postmenopausal women on hormone replacement therapy

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BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1999年第5期106卷 421-426页

作者： Lindgren, R Mattsson, LÅ Andersson, K Lagrelius, A Sandin, K Karlsson, K Risberg, B Organon AB Gothenburg Sweden Sahlgrens Univ Hosp E Gothenburg Sweden Huddinge Univ Hosp Stockholm Sweden Astra Hassle AB Gothenburg Sweden Astra Lakemedel Sodertalje Sweden Norwegian Radium Hosp Oslo Norway

Objective To determine the association between endometrial thickness and endometrial histology in a large sample of women using HRT. Design Results from three multi-centre studies were combined. Participants Five hundred and sixty-four climacteric women were treated with either sequential, continuous combined or long-cycle therapy. Main outcome measures The women underwent 717 examinations with both transvaginal ultrasonography and histological examination of the endometrium. Endometrial thickness was measured and associated with the histological findings. Results Eight cases of endometrial hyperplasia were diagnosed. All the hyperplasias were simple without atypia. Two cases had an endometrial thickness < 4 mm and two a thickness > 8 mm. The > 4 mm threshold for abnormal endometrium had a sensitivity of 75%, a specificity of 47%, a positive predictive value of 2% and a negative predictive value of 99%. Conclusion No association could be found between the endometrial thickness measured by transvaginal ultrasonography and endometrial pathology. In six out of eight women with simple hyperplasia the endometrium measured > 4 mm.

关键词：投药皮肤子宫内膜增生/诊断显像子宫内膜增生/病理学雌二醇/治疗应用激素替代疗法/方法绝经期炔诺酮/治疗应用敏感性与特异性超声检查女(雌)性人类中年人

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Changes in regional fat redistribution and the effects of estrogen during spontaneous weight gain in women with anorexia nervosa

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AMERICAN JOURNAL OF CLINICAL NUTRITION 2001年第5期73卷 865-869页

作者： Grinspoon, S Thomas, L Miller, K Pitts, S Herzog, D Klibanski, A Massachusetts Gen Hosp Neuroendocrine Unit Bulfinch 457B Boston MA 02114 USA Massachusetts Gen Hosp Eating Disorders Unit Boston MA 02114 USA Harvard Univ Sch Med Boston MA 02115 USA

Background: Anorexia nervosa is a disease of severe acquired undernutrition with a high and increasing prevalence among young women in the United States, Objective: The objective was to investigate the effects of spontaneous outpatient weight recovery and estrogen administration on fat distribution in patients with anorexia nervosa. Design: Twenty-seven amenorrheic women aged 26.6 +/- 1.2 y with anorexia nervosa were identified through an outpatient study of bone loss and were randomly assigned to receive or not receive estrogen without any dietary intervention other than calcium and multivitamin supplements. Body composition was measured at baseline and at 6 and 9 mo and was compared with cross-sectional values obtained in 20 healthy, eumenorrheic, age-matched (25.4 +/- 0.5 y) control subjects. Results: Twenty of the 27 patients with anorexia aged 27.0 +/- 1.3 y spontaneously gained weight (4.1 +/- 0.9 kg);body mass index (in kg/m(2)) increased from 16.1 +/- 0.3 to 17.5 +/- 0.4, Fat mass and lean mass accounted for 68% and 32% of the gain in total body mass, respectively With spontaneous weight gain, there was a significant increase in the percentage of trunk far from 32.4 +/- 1.3% at baseline to 36.5 +/- 1.0% at 9 mo (P = 0.03), which correlated with urinary free cortisol (r = 0.66, P = 0.003), Estrogen treatment was not protective against the gain in trunk fat with spontaneous weight gain. Conclusions: ln women with anorexia nervosa, spontaneous weight gain is associated with a significant increase in trunk adiposity, and estrogen administration may not protect against the accumulation of central far with weight gain.

关键词：脂肪组织/解剖学和组织学脂肪组织/药物作用脂肪组织/病理生理学神经性厌食/药物疗法神经性厌食/病理生理学身体成分/药物作用身体成分/生理学人体质量指数钙/治疗应用避孕药口服复合/治疗应用营养保健品炔雌醇/治疗应用随访研究氢化可的松/血液炔诺酮/治疗应用时间因素维生素类/治疗应用体重增长/药物作用体重增长/生理学成年人女(雌)性人类

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EARLY AND LATE BREAST-CANCER - UNIFIED CONCEPT FOR TREATMENT

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CLINICAL RADIOLOGY 1976年第4期27卷 455-462页

作者： EDELSTYN, GA MACRAE, KD NORTHERN IRELAND RADIOTHERAPY CTR BELFASTNORTH IRELAND QUEENS UNIV BELFAST DEPT MED STATISTICSBELFAST BT7 1NNNORTH IRELAND HUME ST HOSP DUBLINIRELAND

Most women with "early" breast cancer have distant metastases by the time the primary growth comes to diagnosis. This observation is based upon the fact that these frequently appear despite successful removal of the primary growth, and given that they originate from the now no longer present tumour, the inescapable conclusion is that dissemination must have taken place prior to initial treatment. Failure to appreciate this rather obvious point results from shortcomings in available diagnostic technology, and inadequate usage of that which is available. Whether detected early or late, treatment of this disseminated cancer poses a common problem, and the various systemic methods are reviewed. Androgens, oestrogens, progestogens and single drug chemotherapy can, from time to time, produce useful results. By careful selection of patients with appropriate metastatic patterns, these methods may yield improved response rates up to 50% but, by and large, experience remains disappointing with across the board representative figures of perhaps 25% response being commonplace. Additionally, these methods are not without their side effects which can be distressing, and indeed on occasion life-threatening. Their short-comings have led to the development of cyclical combination chemotherapy as here reported. Cyclophosphamide, vincristine, 5-fluorouracil and methotrexate are administered for five consecutive days per month. The results obtained in 100 patients treated with this technique are compared with the authors' previous experience with norethisterone acetate and hypophysectomy. Whether the results are considered in total or broken down into prognostic categories such as predominant metastatic pattern, disease-free interval, or age, combination chemotherapy has a clear advantage over other techniques. Whilst this experience does not constitute a randomised trial, it is considered that the results are so superior to previous treatment techniques as to render such a study unne

关键词：乳腺肿瘤/药物疗法乳腺肿瘤/治疗环磷酰胺/治疗应用药物疗法联合氟尿嘧啶/治疗应用垂体切除术甲氨蝶呤/治疗应用肿瘤转移炔诺酮/类似物和衍生物炔诺酮/治疗应用时间因素长春新碱/治疗应用

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倍美力联合炔诺酮治疗围绝经期功能失调性子宫出血的临床研究

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中国医师杂志 2008年第5期10卷 710-711页

作者：王海荣孙广琴高金瑜张慕玲江苏省淮安市第一人民医院妇产科江苏淮安223300

目的探讨围绝经期功能失调性子宫出血（围绝经期功血）与子宫内膜变化的关系及疗效。方法采用B超对180例围绝经期功血患者的子宫内膜厚度进行监测，按子宫内膜厚度分为A组和B组。每组再随机分为两亚组：A1、A2和B1、B2。其中A1和B2为观... 详细信息

目的探讨围绝经期功能失调性子宫出血（围绝经期功血）与子宫内膜变化的关系及疗效。方法采用B超对180例围绝经期功血患者的子宫内膜厚度进行监测，按子宫内膜厚度分为A组和B组。每组再随机分为两亚组：A1、A2和B1、B2。其中A1和B2为观察组，A2和B2为对照组。观察组给予炔若酮和倍美力治疗，对照组常规给予炔若酮治疗，观察患者症状、用药前后血清激素水平及子宫内膜厚度。结果治疗前后A2组与B2组无论在其临床症状改善还是激素水平的改变均无统计学意义（P〉0．05）；Al与A2比较差异无统计学意义（P〉0，05），A1组与B1组差异有统计学意义；B1与B2比较差异亦有统计学意义（P〈0，01）。结论在B超检测下行激素替代治疗对于围绝经期功血的治疗具有指导意义。

关键词：雌二醇/治疗应用炔诺酮/治疗应用功能性子宫出血/治疗

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炔诺酮联合氨甲环酸治疗围绝经期异常子宫出血患者的疗效观察

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医学临床研究 2021年第2期38卷 286-288页

作者：刘瑾华吴娟兵器工业五二一医院妇科陕西西安710065

【目的】探讨炔诺酮联合氨甲环酸治疗围绝经期异常子宫出血患者的临床疗效。【方法】选取2016年5月至2019年10月在本院诊治的64例围绝经期异常子宫出血患者,按照随机数表法分为观察组及对照组,每组32例。对照组患者采用炔诺酮治疗.观察... 详细信息

【目的】探讨炔诺酮联合氨甲环酸治疗围绝经期异常子宫出血患者的临床疗效。【方法】选取2016年5月至2019年10月在本院诊治的64例围绝经期异常子宫出血患者,按照随机数表法分为观察组及对照组,每组32例。对照组患者采用炔诺酮治疗.观察组患者在对照组基础上加用氨甲环酸治疗,比较两组患者治疗前后激素[促卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)及孕酮(P)]水平、治疗后止血时间和血红蛋白水平等。【结果】治疗前两组患者激素水平比较无统计学意义(P>0.05);治疗后,观察组患者FSH及LH水平显著低于治疗前,E2、P水平显著高于治疗前,其差异均具有统计学意义(P<0.05);对照组治疗后P水平显著高于治疗前(P<0.05),而其他3个指标比较差异无统计学意义(P>0.05);治疗后,两组患者FSH、LH KE2水平比较差异均具有统计学意义(P<0.05)。与对照组相比,观察组止血时间明显缩短,血红蛋白水平明显升高(P<0.05)。治疗后3个月后,观察组总有效率为81.25%(26/32),显著高于对照组的56.25%(18/32),其差异具有统计学意义(χ^(2)=4.655,P=0.031)。观察组患者治疗期间并发症发生率为9.38%(3/32),显著低于对照组的31.25%(10/32),其差异具有统计学意义(χ^(2)=4.730,P=0.030)。【结论】炔诺酮联合氨甲环酸治疗围绝经期异常子宫出血患者的临床疗效显著,可缩短止血时间,降低并发症发生率,值得临床推广应用。

关键词：子宫出血/治疗子宫疾病/预防和控制炔诺酮/治疗应用氨甲环酸/治疗应用

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The effectiveness of two oral contraceptives in suppressing plasma androstenedione, testosterone, LH, and FSH, and in stimulating plasma testosterone-binding capacity in hirsute women

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American Journal of Obstetrics and Gynecology 1976年第4期124卷 333-339页

作者： Givens, James R. Andersen, Richard N. Wiser, Winfred L. Umstot, Edward S. Fish, Stewart A. Division of Reproductive Medicine Department of Obstetrics and Gynecology University of Tennessee Center For the Health Sciences Memphis TN United States

The effectiveness of two oral contraceptives in suppressing plasma androstenedione (A), testosterone (T), LH, and FSH and in stimulating testosterone-estradiol-binding globulin TeBG) was evaluated in 39 hirsute women. Twenty-seven hirsute women received norethindrone 2 mg.-mestranol 0.1 mg. (Group I) and 12 received norgestrel 0.5 mg.-ethinyl estradiol 0.05 mg. (Group II). Hormone assays were performed before treatment and at the end of 3 weeks of therapy. Ninety per cent of the women in both groups had an elevated plasma A and/or T. During treatment, plasma A, T, LH, and FSH were significantly reduced in both groups (p < 0.01). In Group II, 78 per cent of the women had a normal plasma A and T during treatment. In Group II, 83 per cent of the women had a normal A and T during treatment. There was a greater increase in TeBG in Group I (p < 0.01). It is concluded that these two oral contraceptives effectively suppressed the hyperandrogenism of most of the hirsute women. © 1976.

关键词：雄烯二酮/血液避孕药口服/药理学避孕药口服复合/药理学炔雌醇/治疗应用卵泡刺激素/血液多毛症/血液多毛症/药物疗法促黄体激素/血液美雌醇/治疗应用炔诺酮/治疗应用甲基炔诺酮/治疗应用蛋白质结合血清球蛋白类/代谢睾酮/血液睾酮/代谢青少年成年人女(雌)性人类

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Diagnostic and therapeutic options in obscure gastrointestinal blood loss.

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Current gastroenterology reports 2000年第5期2卷 395-398页

作者： Amaro, R. Barkin, J.S. Division of Gastroenterology University of Miami School of Medicine/ Mount Sinai Medical Center 4300 Alton Road Miami Beach 33140 FL United States

Obscure gastrointestinal bleeding is defined as an intermittent or chronic loss of blood manifested by iron deficiency anemia or overt bleeding the source of which has not been identified in upper endoscopy, colonoscopy, and barium studies. The diagnostic work-up includes repeat upper endoscopy and colonoscopy, push enteroscopy, radionuclide bleeding scan, angiography, and exploratory laparotomy with intra-operative enteroscopy. Recent publications regarding these and new diagnostic modalities, as well as advances in therapy, including combination hormonal therapy, are reviewed.

关键词：贫血缺铁性/诊断贫血缺铁性/病因学贫血缺铁性/治疗血管发育不良/并发症输血避孕药口服复合/治疗应用诊断鉴别内窥镜检查胃肠道/方法胃肠出血/诊断胃肠出血/病因学胃肠出血/治疗美雌醇/治疗应用炔诺酮/治疗应用潜血人类

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