Background Estrogen is vasoprotective in animal models of vascular injury, yet the mechanisms involved are incompletely understood. The role of inducible nitric oxide synthase (iNOS) in vascular repair is controversial, but many lines of... more
Background Estrogen is vasoprotective in animal models of vascular injury, yet the mechanisms involved are incompletely understood. The role of inducible nitric oxide synthase (iNOS) in vascular repair is controversial, but many lines of evidence indicate that it plays a role in neointima formation after arterial injury and that 17β-estradiol (E 2 ) modulates iNOS expression. This study tested the hypothesis that E 2 reduces neointima formation after vascular injury via a mechanism that is dependent on modulation of iNOS expression. Methods and Results Male and female wild-type (iNOS +/+ ) mice and mice with homozygous deletion of the iNOS gene (iNOS −/− ) were studied intact (INT) or after ovariectomy (OVX) and implantation of E 2 or vehicle (V) pellets. Mice were randomized to 8 groups based on sex, iNOS status, OVX, and treatment with E 2 or V. Twenty-eight days after carotid artery ligation, mice were euthanized, and occluded vessels were evaluated for neointima formation by mor...
Research Interests: Endocrinology, Medicine, Internal Medicine, Mice, Nitric oxide, and 15 moreFemale, Animals, Male, Clinical Sciences, Estrogens, Nitric Oxide Synthase, Circulation, Body Weight, Estradiol, CAROTID ARTERY INJURIES, Neointima, Ovariectomy, Ligation, Cardiovascular medicine and haematology, and Nitric oxide synthase type II
Research Interests: Endocrinology, Kinetics, Biology, Medicine, Biological Sciences, and 14 moreAdenosine, Molecular and cellular biology, Progesterone, Internal Medicine, Female, Animals, Adenylate Kinase, Guanosine Triphosphate, Rabbits, Forskolin, Adenosine Triphosphate, Myometrium, Uterine contraction, and Medical and Health Sciences
Guideline advice of many societies on the management of subclinical hypothyroidism in pregnancy suggests treatment when TSH serum levels exceed 2.5 mU/l. Justification of this procedure is based on limited experience, mainly from studies... more
Guideline advice of many societies on the management of subclinical hypothyroidism in pregnancy suggests treatment when TSH serum levels exceed 2.5 mU/l. Justification of this procedure is based on limited experience, mainly from studies carried out in patients with positive thyroid-specific antibodies and higher TSH levels that classically define the condition in the non-pregnant state. Taking into account a lack of clear understanding of the regulation of thyroid hormone transport through the utero-placental unit and in the absence of foetal markers to monitor the adequacy of thyroxine treatment, this review attempts to discuss currently available data and suggests a more cautious approach.
Research Interests: Medicine, Pregnancy, Humans, Female, Thyroid Hormones, and 13 moreHypothyroidism, Clinical Sciences, Newborn Infant, Homeostasis, Adult, Hormone, GuideLine, Maternal-fetal exchange, Subclinical Infection, guidelines as topic, Pregnancy complications, Paediatrics and reproductive medicine, and In Utero
Twenty five double kidney-pancreas transplantations were performed according to the total pancreas transplantation technique with drainage of exocrine secretions into the bladder via a vesicoduodenostomy. 72% of kidney-pancreas grafts... more
Twenty five double kidney-pancreas transplantations were performed according to the total pancreas transplantation technique with drainage of exocrine secretions into the bladder via a vesicoduodenostomy. 72% of kidney-pancreas grafts were functional at one year and 59% were functional at four years. The authors observed a slightly higher rejection rate (0.56 versus 0.34) and a higher incidence of urinary tract infection (60% versus 35%) following double pancreas and renal transplantation than after isolated renal transplantation. Complications were rare: two venous thromboses and two cases of urethritis requiring of rediversion of the duodenum into the intestine. These good results, comparable to those reported in the international registry, reflect the value of the pancreatic and renal transplantation technique using a total pancreas drained into the bladder. It would probably be preferable to transplant patients earlier, when chronic renal failure secondary to insulin-dependent d...
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According to demographic provision, the world population will soon reach 6 billions. It is therefore urgent to increase women's access to well tolerated, efficient, low cost contraceptives. The primary goal is to inform women on their... more
According to demographic provision, the world population will soon reach 6 billions. It is therefore urgent to increase women's access to well tolerated, efficient, low cost contraceptives. The primary goal is to inform women on their reproductive health and on the use of contraceptives. Secondly, new molecules should be shortly available: low dose estroprogestins containing new non androgenic progestins and 17 beta-estradiol, RU 486 as a post-coïtal pill, levonorgestrel or desogestrel containing IUDs. The daily intake of low dose antiprogestins to interfere with endometrial maturation is also currently studied. In the future, anti-FSH molecules or tissue-specific steroids could be designed.
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ABSTRACT This review focuses on advances in the medical termination of pregnancy during the early period of the first trimester, when most abortions are performed. The drugs are used to terminate pregnancy act by inhibiting the synthesis... more
ABSTRACT This review focuses on advances in the medical termination of pregnancy during the early period of the first trimester, when most abortions are performed. The drugs are used to terminate pregnancy act by inhibiting the synthesis of progesterone, inducing myometrial contractions, antagonizing the action of progesterone, or inhibiting trophoblast development. Among the drugs used in medical abortion are epostane, prostaglandins (including misoprostol and gameprost), combined methotrexate and misoprostol, tamoxifen-misoprostol regimen, mifepristone and prostaglandin, and antiprogestin and prostaglandins. The efficacy, side effects, and contraindications of these drugs in the medical termination of pregnancy are discussed. In general, medical abortion is associated with higher rates of prolonged bleeding, nausea, vomiting, and pain as compared to surgical abortion. However, medical termination of pregnancy has a high rate of efficacy in women with early pregnancies. In addition, medical abortion is safe and acceptable to women, and it does not require anesthesia. Lastly, women who choose medical abortion must have access to a center where suction curettage is available, should heavy bleeding occur and blood transfusion is required.
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Research Interests: Genetics, Biology, Medicine, Neuropeptides, Humans, and 15 moreInternal Medicine, Mutation, Circadian Rhythm, Female, Clinical, Male, Body Mass Index, Cryptorchidism, Phenotype, Clinical Sciences, Kallmann Syndrome, alleles, hydrocortisone, G Protein Coupled Receptors, and Paediatrics and reproductive medicine
Research Interests: Biology, Adolescent, Medicine, DNA, Humans, and 15 moreChild, Internal Medicine, Female, Clinical, Male, Disorders of sex development, Infant, Clinical Sciences, Genotype, Androgen Insensitivity Syndrome, Amino Acid Substitution Rates, Dihydrotestosterone, Cohort Studies, Child preschool, and alleles
In primates, the LH surge that triggers ovulation is induced by an increase in circulating estradiol (E2) levels. Although several studies suggest that E2 acts on the pituitary, it is still not clear whether GnRH is involved. We... more
In primates, the LH surge that triggers ovulation is induced by an increase in circulating estradiol (E2) levels. Although several studies suggest that E2 acts on the pituitary, it is still not clear whether GnRH is involved. We investigated the role of GnRH during the periovulatory period in normal women by treating them with the GnRH antagonist Nal-Glu ([Ac-D2Nal1,D4-ClPhe2,D3Pal3,Arg5,DGlu6 (AA),DAla10] when E2 levels exceeded 550 pmol/L. In the first study (A), Nal-Glu was administered in five regimens (n = 4 in each group): a single sc injection of 10 mg (group 1), a single injection of 20 mg (group 2), and an injection of 10 mg, sc, on 2 (group 3), 3 (group 4), and 5 consecutive days (group 5). In the second study (B; n = 4), Nal-Glu (10 mg, sc, on 3 consecutive days) was coadministered with E2 benzoate (EB; 0.5 mg, im, every 12 h on 3 consecutive days). Controls (n = 4) were treated with EB alone at the same stage of the cycle. In the third study (C), three women received 10 mg/day Nal-Glu, sc, on 3 consecutive days together with pulsatile GnRH therapy (25 micrograms/pulse, one pulse every 90 min, sc, for 3 days); the first pulse was given 12 h after the first Nal-Glu injection. In study A, gonadotropin suppression resulted in a transient decline in E2 in groups 1 and 2. Relative to control cycles, the LH surge occurred with a delay of 24-48 h in group 1 and 24-120 h in group 2. In groups 3, 4, and 5, Nal-Glu administration resulted in the demise of the dominant follicle in half of the women in each group. The remaining women showed a profile similar to that of groups 1 and 2, i.e. a transient decline in E2 levels followed by a recovery, and a LH surge occurring 4 +/- 0.3 days after the last Nal-Glu injection. In study B, simultaneous administration of Nal-Glu and EB induced a rise in E2 levels from 951.3 +/- 79.6 to 4000.1 +/- 772.5 pmol/L 24 h after the beginning of treatment. Serum LH and FSH levels both decreased and remained low throughout Nal-Glu treatment. None of the women showed a LH rise in response to the EB injection. In controls, however, EB administration was followed by a significant gonadotropin discharge 48 h after the first EB injection.(ABSTRACT TRUNCATED AT 400 WORDS)
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We have studied a kindred with three siblings with isolated hypogonadotropic hypogonadism caused by compound heterozygote mutations in the GnRH receptor gene. The disorder was transmitted as an autosomal recessive trait. The R262Q... more
We have studied a kindred with three siblings with isolated hypogonadotropic hypogonadism caused by compound heterozygote mutations in the GnRH receptor gene. The disorder was transmitted as an autosomal recessive trait. The R262Q mutation in intracellular loop 3 of the receptor was associated with a mutation in the third transmembrane domain of the receptor, A129D, that has never been described before. This A129D mutation results in a complete loss of function, indicated by the lack of inositol triphosphate (TP3) 3 production by transfected Chinese hamster ovary (CHO) cells after GnRH stimulation. The two brothers had microphallus and bilateral cryptorchidism and were referred for lack of puberty, whereas their sister had primary amenorrhea and a complete lack of puberty. Their basal gonadotropin concentrations were below the reference range, and their endogenous LH secretory patterns were abnormal, with a low-normal frequency of small pulses or no apparent LH pulse. Pulsatile GnRH...
Research Interests: Endocrinology, Biology, Adolescent, DNA, Humans, and 15 moreInternal Medicine, Haplotypes, Female, Animals, Clinical, Drug Resistance, Clinical Sciences, Late onset hypogonadism, Adult, Gonadotropin Releasing Hormone, Amino Acid Sequence, hypogonadism, CHO cells, Hypogonadotropic hypogonadism, and Cricetinae
Research Interests: Human, Pregnancy, Progesterone, Humans, In Vitro Fertilisation, and 15 moreFemale, In Vitro Fertilization, Male, Embryo Transfer, Pilot study, Human reproduction, Adult, Gonadotropin Releasing Hormone, Fertilization in Vitro, Luteinizing Hormone, Estradiol, Follicle stimulating hormone, Follicular phase, Medical and Health Sciences, and Chorionic gonadotropin
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Research Interests: Quality of life, Treatment Outcome, Medicine, Humans, Europe, and 15 moreFertility and Sterility, Female, Uterine Fibroids, Clinical Sciences, Middle Aged, Adult, Public health systems and services research, Time Factors, Pelvic Pain, Endometrium, Leiomyoma, Ulipristal acetate, Amenorrhea, Menorrhagia, and Paediatrics and reproductive medicine
Research Interests: Evidence Based Medicine, Reproduction, Treatment Outcome, Medicine, Pregnancy, and 10 moreHumans, Fertility and Sterility, Female, Animals, Clinical Sciences, Public health systems and services research, Endometriosis, Progesterone receptor expression, Leiomyoma, and Paediatrics and reproductive medicine
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To study increases of serum FSH and gonadal response in gonadotropin-deficient men treated with recombinant FSH (Puregon; NV Organon, Oss, The Netherlands). An open, prospective, multiple rising dose study in which volunteers received... more
To study increases of serum FSH and gonadal response in gonadotropin-deficient men treated with recombinant FSH (Puregon; NV Organon, Oss, The Netherlands). An open, prospective, multiple rising dose study in which volunteers received single daily IM doses of recombinant FSH for 3 weeks. The dose administered was increased at weekly intervals: the first 7 days, 75 IU/d; the subsequent 7 days, 150 IU/d; and the last 7 days, 225 IU/d. Nine men suffering from isolated gonadotropin deficiency or panhypopituitarism. Immunoreactive FSH, LH, inhibin, T, and androstenedione. Serum immunoreactive FSH (median) rose in accordance with the recombinant FSH doses administered from 0.5 mIU/mL (range < 0.05 to 1.9 mIU/mL) at baseline to 4.3 mIU/mL (range 2.0 to 8.5 mIU/mL), 8.4 mIU/mL (range 4.9 to 17.8 mIU/mL), and 13.6 mIU/mL (5.6 to 28.4 mIU/mL) after 1, 2, and 3 weeks of medication, respectively. The elimination half-life of recombinant FSH was 48 +/- 5 hours (mean +/- SD), which was slightly longer than that reported after single dose administration of recombinant FSH (32 +/- 12 hours). The bioactivity of recombinant FSH was reflected by serum inhibin levels, which rose from 116 U/L (range 34 to 356 U/L) at baseline to 350 U/L (range 63 to 1,109 U/L) at day 22. However, serum FSH and inhibin levels did not correlate when compared after 1, 2, and 3 weeks of recombinant FSH administration. Serum immunoreactive LH, T, androstenedione, and E2 were 0.2 mIU/mL (range < 0.05 to 0.7 mIU/mL [conversion factor to SI unit, 1.0]), 58 ng/dL (range < 12 to 222 ng/dL [conversion factor to SI unit, 0.0347]), 14 ng/dL (range 6 to 115 ng/dL [conversion factor to SI unit, 0.0349]), and 14 pg/mL (range < 14 to 16 pg/mL [conversion factor to SI unit, 3.67]), respectively, at baseline and remained unchanged during the entire treatment period. These data indicate that recombinant FSH treatment increases serum FSH in a dose-proportional fashion, increases inhibin secretion, and lacks intrinsic LH activity.
Research Interests: Endocrinology, Medicine, Prospective studies, Humans, Internal Medicine, and 14 moreFertility and Sterility, Male, Clinical Sciences, Middle Aged, Late onset hypogonadism, Adult, Public health systems and services research, Hormone, Recombinant Proteins, Gonadotropins, Follicle stimulating hormone, hypogonadism, Hypogonadotropic hypogonadism, and Paediatrics and reproductive medicine(Fertility and Sterility, Male, Clinical Sciences, Middle Aged, Late onset hypogonadism, Adult, Public health systems and services research, Hormone, Recombinant Proteins, Gonadotropins, Follicle stimulating hormone, hypogonadism, Hypogonadotropic hypogonadism, and Paediatrics and reproductive medicine)
(Fertility and Sterility, Male, Clinical Sciences, Middle Aged, Late onset hypogonadism, Adult, Public health systems and services research, Hormone, Recombinant Proteins, Gonadotropins, Follicle stimulating hormone, hypogonadism, Hypogonadotropic hypogonadism, and Paediatrics and reproductive medicine)
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Currently, the synthetic steroid ethinylestradiol (EE) is the preferred estrogen in combined oral contraceptives. The aim of the present study was to evaluate the effectiveness of the natural steroid estetrol (E(4)) as an ovulation... more
Currently, the synthetic steroid ethinylestradiol (EE) is the preferred estrogen in combined oral contraceptives. The aim of the present study was to evaluate the effectiveness of the natural steroid estetrol (E(4)) as an ovulation inhibitor in rats when compared to EE. Regularly cycling female rats were treated orally twice daily for four consecutive days, starting on the day of estrus, with E(4) (0.03, 0.1, 0.3, 1.0 or 3.0 mg/kg), EE (0.0003, 0.001, 0.003, 0.01 or 0.03 mg/kg) or vehicle control (eight animals per group). In a second experiment conducted under the same experimental protocol, 2.0 mg/kg of E(4) was administered as a single daily dose or as a dose of 1.0 mg/kg twice daily. In both studies, the primary end point was the number of ovulated oocytes in the genital tract. Estetrol at the twice daily dose of 0.3 mg/kg and above inhibited ovulation. This effect was statistically significant (p<.05). The comparator, EE, significantly inhibited ovulation (p<.05) at the highest dose (0.03 mg/kg) administered twice daily. An E4 dose of 2.0 mg/kg administered once daily for four consecutive days inhibited ovulation in four of eight rats. In contrast, when the same dose was administered in two separate doses, that is, 1.0 mg/kg twice daily, ovulation was inhibited in eight of eight rats. The ED(50) for the EE and the E(4) dose response curves shows that EE is 18 times more potent than E(4). Twice daily administration of E(4) effectively inhibits ovulation in cycling rats. The effect is dose-dependent. The relative potency of E(4) is about 18 times less compared to that of EE. We conclude that based on these data, combined with available pharmacological and clinical data on the safety and efficacy of E(4), the human fetal estrogenic steroid estetrol is a potential candidate to replace EE in combined oral contraceptives.
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To determine if GnRH-agonist (GnRH-a) could induce a LH surge in patients where a GnRH antagonist was used to prevent premature spontaneous LH surge. Pilot study. Five patients treated with ovarian stimulation and IUI for idiopathic... more
To determine if GnRH-agonist (GnRH-a) could induce a LH surge in patients where a GnRH antagonist was used to prevent premature spontaneous LH surge. Pilot study. Five patients treated with ovarian stimulation and IUI for idiopathic infertility. Luteinizing hormone, FSH, and P plasma levels. A LH and FSH surge as well as a P rise were obtained in the five patients studied. A GnRH-a successfully can induce an LH surge after GnRH antagonist administration. The effect of the antagonist on the quality of the GnRH-a-induced LH surge as well as the oocyte quality remain to be evaluated.
Research Interests: Fertility, Medicine, Progesterone, Humans, Fertility and Sterility, and 9 moreFemale, Ovulation Induction, Clinical Sciences, Public health systems and services research, Gonadotropin Releasing Hormone, Pilot Projects, Luteinizing Hormone, Follicle stimulating hormone, and Paediatrics and reproductive medicine
Research Interests: Medicine, Progesterone, Humans, Female, Menstrual Cycle, and 3 moreOvary, Endometrium, and Progestins
Recent development of transdermal therapy permits application of estrogen, usually produced in the ovaries, in physiological dosage by means of continuous release from either an epidermal patch or dermal application of a gel. Transdermal... more
Recent development of transdermal therapy permits application of estrogen, usually produced in the ovaries, in physiological dosage by means of continuous release from either an epidermal patch or dermal application of a gel. Transdermal therapy with progesterone, however is impossible due to poor dermal absorption and high dose requirements (release from corpora lutea: 25 mg/24 hours). Two other possibilities have been proposed. On one hand it is possible to apply norethisterone-acetate (NETA), another gestagen, epicutaneously. This mode of administration carries the same problems as oral application thus allowing for a dose reduction. On the other hand progesterone can be applied vaginally. This mode leads to significantly higher plasmatic concentrations of progesterone and has effects on the uterine mucosa similar to those in a normal cycle. This modality thus permits application of estradiol and progesterone in a physiological manner by a non oral route. It appears particularly ...
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To assess in a pilot study the ability of a single injection of a GnRH antagonist (Cetrorelix) to prevent premature luteinizing hormone (LH) surges in an in-vitro fertilization (IVF) embryo transfer programme when administered on a fixed... more
To assess in a pilot study the ability of a single injection of a GnRH antagonist (Cetrorelix) to prevent premature luteinizing hormone (LH) surges in an in-vitro fertilization (IVF) embryo transfer programme when administered on a fixed day in the late follicular phase, ovarian stimulation was carried out in 11 women with two ampoules of human menopausal gonadotrophin per day beginning on day 2 of the menstrual cycle. A 3 mg dose of Cetrorelix was administered on day 8 of the stimulation cycle. A second injection was administered 72 h later if ovulation was not triggered in the meantime. We did not observe a premature LH surge in any of the cycles studied. The injection of 3 mg Cetrorelix was capable of preventing LH surge in all the patients studied, introducing a very simple treatment protocol. Among the patients who received two injections (n = 3), the day of the first administration was delayed in two subjects due to slow follicular maturation kinetics. Out of 11 patients, 10 h...
Research Interests: Treatment Outcome, Pregnancy, Humans, Female, Ovulation Induction, and 14 moreAnimals, Embryo Transfer, Human reproduction, Rats, Adult, Analysis of Variance, Gonadotropin Releasing Hormone, Fertilization in Vitro, Rabbits, Amino Acid Sequence, Pilot Projects, Luteinizing Hormone, Molecular Sequence Data, and Medical and Health Sciences
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Among the remarkable progress made in the treatment of hormone-dependent diseases, recently selective steroid receptor modulators (SPRM) have been remarkable tools to improve the prognosis of multiple hormone-dependent cancers (breast,... more
Among the remarkable progress made in the treatment of hormone-dependent diseases, recently selective steroid receptor modulators (SPRM) have been remarkable tools to improve the prognosis of multiple hormone-dependent cancers (breast, prostate). Because of their remarkable properties, both agonistic and mainly antagonistic, to modulate progesterone action. They have allowed a better understanding of progesterone action and progress in contraception and treatment of abnormal uterine bleeding as well as in the medical treatment of uterine fibroids.
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Because of the microheterogeneities of gonadotropins, immunoreactive measurements of gonadotropins do not necessarily reflect their bioactivity. Follicle-stimulating hormone (FSH) bioassays have relied on measurement of aromatase activity... more
Because of the microheterogeneities of gonadotropins, immunoreactive measurements of gonadotropins do not necessarily reflect their bioactivity. Follicle-stimulating hormone (FSH) bioassays have relied on measurement of aromatase activity in primary cultures of immature rat Sertoli cells or rat granulosa cells (GAB assay). Luteinizing hormone (LH) bioassays have relied on measurement of androgen production in primary cultures of rat interstitial testicular cells (RICT) or mouse Leydig cells. Those bioassays are cumbersome because they rely on primary culture and on indirect measurement of estradiol or testosterone by RIAs. The cloning of the cDNAs of FSH and LH receptors has allowed the establishment of cell lines expressing human receptors. The cotransfection of the recombinant gonadotropin receptor with a cAMP reporter gene allows a nonisotopic measurement of gonadotropin bioactivity. Furthermore, patient serum can be tested directly without prior extraction. We and other groups have developed a CHO cell line expressing the human FSH receptor and a luciferase reporter gene (CHO-FSHR). The CHO-FSHR assays is specific for FSH and free of serum interference up to a final concentration of 20%. The clinical sensitivity is 3 IU/l, the interCV 16%, the intraCV 8%. Studies were performed in normal women (n = 11) during the menstrual cycle using the CHO-FSHR cells. The ratio of bioactive to immunoactive FSH (B/I) equals 1.1 +/- 0.04 across the follicular and early luteal phase. During the mid to late luteal phase the mean B/I rises significantly to 1.65 +/- 0.07 (P < 0.001). Gonadotropin bioassays based on cloned receptors have been used to search for immunoglobulins, directed against the FSH or the LH receptors in premature ovarian failure patients. No blocking antibodies were found among the 38 women studied. A recent study of FSH bioactivity in patients with FSH secreting pituitary adenomas shows increased values of the B/I ratio. In summary, cell lines expressing the LH and the FSH human receptors are now available. Those homologous systems enable clinicians to study potential forms of mutated FSH or antibodies directed against gonadotropin receptors. Furthermore, bioassays based on cloned receptors are interesting tools to test anti-LH or anti-FSH molecules mainly in contraceptive research.
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To investigate the efficacy of the different routes of luteinizing hormone releasing hormone (LHRH) administration upon pituitary responsiveness, we compared plasma LHRH concentrations and pituitary LH responses in four patients with... more
To investigate the efficacy of the different routes of luteinizing hormone releasing hormone (LHRH) administration upon pituitary responsiveness, we compared plasma LHRH concentrations and pituitary LH responses in four patients with hypothalamic amenorrhea treated with pulsatile LHRH. A portable computerized infusion pump delivered sc or iv LHRH pulses of 5, 10 or 20 micrograms every 90 min. Comparison of the two modes of LHRH delivery was performed using radioimmunoassay of exogenous LHRH and studying its pharmacokinetics for a 3 pulses period. With 10 micrograms of LHRH given iv, plasma LHRH levels increased between 700 and 1000 pg/ml within 3 min and returned to basal levels in 30 min. When given sc (10 micrograms), plasma LHRH levels peaked between 80 and 100 pg/ml in 15 min and returned to basal levels 60 min later. In one patient treated with 5 micrograms per pulse iv or sc, plasma LHRH increased to 380 and 60 pg/ml respectively. In all patients, computerized analysis of LH pulses was performed during sc and iv LHRH administration. LH pulsatile release displayed a similar rhythm period with both routes. However, for the same dose of LHRH (10 micrograms), the adjusted mean of LH plasma levels was lower with the sc route. In conclusions, the pharmacokinetics of LHRH administered sc or iv displayed a similar pattern but, with equivalent doses, higher plasma LHRH levels are attained with the iv route. Concomitantly, the mean LH levels were also greater after iv administration. Ovulation can be successfully induced by both pulsatile iv and sc LHRH therapy. However, with the sc route, a higher dose of LHRH should be used to prevent a delay of ovulation or a luteal deficiency.
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Endometrial progesterone and estrogen receptors were studied by immunocytochemistry using monoclonal antibodies during the menstrual cycle in normal women. We initially compared immunocytochemical staining of progesterone and estradiol... more
Endometrial progesterone and estrogen receptors were studied by immunocytochemistry using monoclonal antibodies during the menstrual cycle in normal women. We initially compared immunocytochemical staining of progesterone and estradiol receptors on endometrial fragments obtained by either aspiration or endometrial biopsy and found that immunocytochemistry could be performed easily on tissue obtained in either way. The immunocytochemical studies showed that the concentration and distribution of receptors changed markedly during the normal menstrual cycle. These changes were distributed in three characteristic phases. During phase I, corresponding to the midfollicular period (days 7-8), a small proportion (25%) of stromal and glandular cells stained positively for the progesterone receptor, whereas estrogen receptor staining was more intense and more frequent (50% of cells). Phase II, which included both the late follicular and early luteal periods (days 9-19), was characterized by a marked staining of progesterone receptors in the majority of glandular cells (75%) and somewhat less abundant and less frequent staining in stromal cells (50%). Estrogen receptor staining was present in about half of the glandular and stromal cells. Phase III, the mid- and late luteal period (days 21-27), was characterized by the disappearance of estrogen and progesterone receptor staining in glandular cells, although faint staining for both receptors was found in stromal cells. These variations in progesterone receptor staining are potentially useful for determining the effect of progesterone on endometrial maturation.
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. Metabolic clearance rate (MCR) and daily production rate (DPR) of 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) were measured in 7 hyperthyroid patients and 8 control subjects after a single injection of tritiated 1,25(OH)2D3. Using a... more
. Metabolic clearance rate (MCR) and daily production rate (DPR) of 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) were measured in 7 hyperthyroid patients and 8 control subjects after a single injection of tritiated 1,25(OH)2D3. Using a bicompartmental analysis, MCR of 1,25(OH)2D3 was found to be significantly higher in hyperthyroid than in control subjects (11.5 ± 4.4 vs 5.9 ± 2.4 ml/min (sd), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). No significant difference in plasma 1,25(OH)2D and DPR of 1,25(OH)2D3 was demonstrated. MCR was again measured 1 month after initiation of treatment in 4 hyperthyroid patients and remained elevated. In 2 of these patients, MCR was once more determined 6 months later and had declined towards normal. No correlation was found between MCR and DPR and either plasma calcium, phosphate, immunoreactive PTH, 1,25(OH)D and T3 values. In conclusion, MCR of 1,25(OH)2D3 is elevated in hyperthyroidism, but this finding is probably unrelated to the effect of thyroid hormones on bone metabolism.
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Research Interests: Treatment, Treatment Outcome, Medicine, Humans, Female, and 6 moreAnalog, Clinical Sciences, Adult, Chest, Octreotide, and Carcinoid tumor
Research Interests: Treatment, Treatment Outcome, Medicine, Humans, Female, and 6 moreAnalog, Clinical Sciences, Adult, Chest, Octreotide, and Carcinoid tumor
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OBJECTIVE: To determine if GnRH-agonist (GnRH-a) could induce a LH surge in patients where a GnRH antagonist was used to prevent premature spontaneous LH surge. DESIGN: Pilot study. PATIENTS: Five patients treated with ovarian stimulation... more
OBJECTIVE: To determine if GnRH-agonist (GnRH-a) could induce a LH surge in patients where a GnRH antagonist was used to prevent premature spontaneous LH surge. DESIGN: Pilot study. PATIENTS: Five patients treated with ovarian stimulation and IUI for idiopathic ...