John A. Board

Hemangiopericytoma of the uterus: An ultrastructural study

Abstract A hemangiopericytoma of the uterus, which presented as a polypoid mass protruding into the vagina, was studied by light and electron microscopy. The appearance of the tumor was identical to that of hemangiopericytomas of other sites that have been reported, and the tumor cells did not ultrastructurally resemble endometrial stromal cells or uterine smooth-muscle cells. These findings confirm the existence of hemangiopericytoma of the uterus as an entity distinct from both stromal myosis and vascular leiomyoma, with which it has been confused. The treatment and prognosis of this rare tumor are also discussed—it should be considered a low-grade malignancy until proved otherwise.

Continuous norethindrone, 0.35 mg., as an oral contraceptive agent

Abstract Norethindrone 0.35 mg. was taken daily by 154 women for a total of 1,888 months in a study of continuous low-dosage progestin as an oral contraceptive method. Pregnancy rates of 0.6 per 100 woman-years for correct use and 1.3 per 100 woman-years for total use were obtained. A high incidence of menstrual irregularity and/or amenorrhea was noted but the incidence of nausea and weight gain was low. There was no significant difference in oral glucose tolerance tests done in 18 women before and after taking norethindrone for 6+ months, and other serum determinations done in 19 women showed a significant rise in alkaline phosphatase and albumin along with a significant decrease in SGOT.

Nocturnal Prolactin Levels in Infertility

Since serum prolactin rises during sleep in normal women, nocturnal serum prolactin concentrations were determined every 30 minutes in follicular phase and again in luteal phase in 13 regularly menstruating infertile women with daytime normoprolactinemia, 8 of whom had luteal phase defects. When compared with controls, there was an increased serum prolactin elevation in 7 women. Six of the women with nocturnal hyperprolactinemia took bromocriptine for two menstrual cycles. This treatment eliminated the excessive nocturnal prolactin rise but did not result in consistent improvement in endometrial development. Polytomographic findings compatible with a pituitary microadenoma were seen in 5 of 7 women with nocturnal hyperprolactinemia. Random daytime prolactin levels may be normal in infertile women who have nocturnal hyperprolactinemia associated with x-ray evidence of pituitary microadenoma.

Effect of Oral Diethylstilbestrol on Plasma Progesterone

6 regularly ovulating women volunteered to receive oral diethylstilb estrol under conditions simulating the occurrence of unprotected coitus at midcycle. They each received 25 mg of the drug for 5 days beginning on the day of basal body temperature rise. Levels of plasma progesterone were lower in the cycle in which treatment was received when compared to control cycles in the same women. The comparisons were significant at the p less than .01 p less than .01 and p less than .05 levels for Days 3-4 5-6 and 7-8 post-LH peak respectively.

Carbonic anhydrase concentration in endometrium after oral progestins.

Abstract Endometrial biopsies were performed on 28 women who were taking sequential oral contraceptive tablets which employed mestranol as the estrogen and either norethindrone or DMAP (3-desoxy-6α-methyl-17α-acetoxyprogesterone) as the progestin. Endometrial carbonic anhydrase concentration was determined by a colorimetric method, and found to vary directly with the amount of progestin which had been taken.

Plasma human growth hormone in the puerperium

Human growth hormone and prolactin share many characteristics. Plasma HGH levels were measured during the first 5 postpartum days in women who were nursing, in women who were not nursing and received androgen-estrogen medication for suppression of lactation, and in women who were not nursing and received no such medication. No difference in plasma HGH levels was detected among these three groups.

Effects of α- and β-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea

Abstract The effects of α- and β-adrenergic blocking agents on the serum prolactin levels of six women with hyperprolactinemia and galactorrhea were investigated. There was no indication that pituitary adenomas were etiologic agents for the hyperprolactinemia. Serum prolactin could be lowered with oral l -dopa. When intravenous phentolamine (an α-adrenergic blocking agent) or intravenous propranolol (a β-adrenergic blocking agent) were administered for 1 hour, there was no significant change in serum prolactin levels.

Sequential Oral Contraception Using DMAP

A synthetic steroid, 3-desoxy-6-alpha-methyl-17-alpha-acetoxy progesterone (DMAP), was used as the progestin in a program of sequential oral administration of contraceptive tablets; indigent patients attending the postpartum clinic at the Medical College of Virginia were studied. No pregnancies occurred in 561 cycles of use. Withdrawal bleeding incidences usually occurred every 27 days, lasted 5 days, and were associated with moderate flow. The incidence of breakthrough bleeding was 3%; intermenstrual spotting, 2.4%; and nausea or vomiting, 9.5%. The endometrial changes more closely resembled those in a normal ovulatory cycle than those associated with oral contraceptive methods which utilize an estrogen-progestin mixture started on Cycle Day 5.

Effect of cyproheptadine on chlorpromazine stimulation of prolactin in women

In five normal women, the expected chlorpromazine-induced rise in serum prolactin was inhibited by pretreatment with a serotonin antagonist, cyproheptadine. This indicated that the serotoninergic system has an excitatory effect on the release of prolactin. When similar studies were done in nine women with hyperprolactinemia and galactorrhea, the administration of chlorpromazine did not consistently produce a rise in serum prolactin, and pretreatment with cyproheptadine did not have a predictable effect. In most cases, this chlorpromazine-induced reduction in the prolactin inhibitory factor could not further increase the secretion of prolactin, so that there was no rise to inhibit.

Serum prolactin levels in galactorrhea

Some patients with galactorrhea will have normal serum prolactin levels but many will have elevated serum prolactin levels. The galactorrhea may be due to drug ingestion, nipple afferent nerve stimulation, nonneoplastic disease or injury, and intracranial tumors. Serum prolactin levels were measured by radioimmunoassay in 17 women with galactorrhea. Levels 5 and 6 times normal values were found in two women who had proved pituitary adenomas. The latter conditions must be strongly considered and functional tests may help in diagnosis prior to enlargement of a prolactin-secreting tumor to the size where changes in the sella are seen on x-ray or visual field changes occur. If galactorrhea persists when no evidence of tumor can be found, the patient must be periodically re-evaluated, as the tumor may have been too small for detection at the time of the previous examination.