Biomedical subjects

A Chryssikopoulos

Publications and source records attributed to A Chryssikopoulos.

32 records · Page 2Linked to original sources

PubMed1995

New reliable biochemical marker for screening 21 alpha-hydroxylase deficiency without index person among hirsute women in agreement with HLA-haplotyping.

Late onset congenital adrenal hyperplasia due to 21 alpha-hydroxylase deficiency (LO21OH def), as many other diseases, is the cause of hirsutism, menstrual disorders, infertility (PCO-like symptoms). We evaluated the reliability of a new biochemical marker for screening LO-21OH def in 47 women with PCO-like symptoms and 11 men, members of their families, comparing the results of separation using this new marker with those of HLA-haplotyping in 21 members of the patient population. All subjects were stimulated with 0.25 mg synthetic ACTH iv. Serum progesterone (P), 17-hydroxyprogesterone (17-OHP) and cortisol (F) at 0, 15, 30, 45 and 60 min following ACTH administration were determined and the new marker, namely the difference between 60min and 0min of the ratio F/17-OHP [delta F/17-OHP (60 min -0 min)] was calculated. According to the established biochemical criteria for the detection of LO-21OH def cases, (Gutai 30 min > or = 12 ng/dl/min and 17-OHP 60 min > or = 12 ng/ml for severe 21-OH def and Gutai 30 min < 6.5 ng/dl/min and 17-OHP 60 min < 5 ng/ml for "healthy" individuals regarding 21-OH def) two groups, A and B respectively, were separated from the patient population. In group A (n = 8), with LO-21OH def, the new marker showed negative values in all cases, while in group B (n = 9), without LO-21OH def, this marker was positive. The remaining subjects, depending on the results of the new marker were separated in 2 subgroups, Cneg (n = 28), with negative values, composed, consequently, of members with 21-OH def and Cpos (n = 13), with positive values, composed, consequently, of subjects with absence of LO-21OH def. HLA-typing was in agreement with the results of screening by the new marker, in 20 out of 21 cases, while there was only one false negative result. In conclusion, the proposed biochemical marker delta F/17-OHP (60 min-0 min) seems to be a reliable parameter for the LO-21OH def detection among young women with PCO-like symptoms as well as males suspected for congenital adrenal hyperplasia.

17-alpha-Hydroxyprogesterone↗

PubMed1995

A contribution to the classification of cases of non-classic 21-hydroxylase-deficient congenital adrenal hyperplasia.

The aim of this study was to classify the degree of 21 alpha-hydroxylase deficiency in patients suspected for non-classic 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH). In 66 selected subjects (45 young women with polycystic ovary (PCO)-like symptoms and members of their families, of whom 12 were men), progesterone, 17-hydroxyprogesterone (17-OHP) and cortisol were measured at 0, 15, 30, 45 and 60 min after adrenocorticotropic hormone (ACTH) stimulation. The markers [(17-OHP at 30 min--17-OHP at 0 min) + (progesterone at 30 min--progesterone at 0 min)]/30 proposed by Gutai and the ratio of cortisol to 17-OHP at 30 min (cortisol30/17-OHP30) were calculated and cluster analysis was performed using the above two markers and 17-OHP at 60 min (17-OHP60). Our patients were grouped by cluster analysis into four Groups: I, II, III and IV (n = 3, 11, 35 and 16, respectively) with (1) Gutai (mean +/- SE) 107.0 +/- 21.7, 29.9 +/- 4.4, 10.5 +/- 0.54 and 4.0 +/- 0.37 ng/dl per min, respectively, (2) 17-OHP60 169.7 +/- 28.3, 10.8 +/- 1.3, 4.6 +/- 0.2 and 3.7 +/- 0.4 ng/ml, respectively, and (3) cortisol/17-OHP30 0.97 +/- 0.28, 38.5 +/- 6.9, 82.3 +/- 5.5 and 112.0 +/- 8.9, respectively. All three markers showed highly significant differences between the four groups (p < 0.0001). The patterns of 17-OHP, cortisol and cortisol/17-OHP ratio following ACTH testing revealed the degree of 21-hydroxylase deficiency in every group. HLA typing effected in 20 studied individuals confirmed the classification derived from cluster analysis. Thus, it seems that Groups I, II and III include, respectively, patients with severe, mild and minimal forms of non-classic 21-hydroxylase-deficient CAH, while in patients of Group IV the hyperandrogenemic symptoms are of different etiology. In conclusion, the concurrent evaluation of the three markers together with the variations of 17-OHP, cortisol and the cortisol/17-OHP ratio after ACTH testing enhance the accurate identification of a patient suspected for non-classic 21-hydroxylase-deficient CAH in relation to the severity of the enzymatic defect.

17-alpha-Hydroxyprogesterone↗

PubMed1991

Hormonal patterns in a successful pregnancy of a patient with late-onset 21-OH deficiency taking methylprednisolone; a case report.

A successful pregnancy of a young woman with late-onset congenital adrenal hyperplasia (LOCAH) is reported. Exogenous glucocorticoids are the most commonly used regimen in such cases both for suppression of adrenal overstimulation and avoiding masculinization of a female fetus. In our LOCAH patient methylprednisolone has been used for treatment. We present the management and the outcome of this pregnancy, as well as the hormonal follow-up.

17-alpha-Hydroxyprogesterone↗

PubMed1990

The diagnosis of luteal phase defect using different diagnostic criteria.

We evaluated the real incidence of the luteal phase defect (LPD) syndrome in 149 women who previously had been diagnosed by four independent researchers as having it, by the use of a combination of 3 criteria: basal body temperature (BBt), the histological appearance of the endometrium (EB) and the serum level of progesterone (P). The women had been divided according to etiological factors of the LPD syndrome into 4 groups (A, B, C and D). When the 3 criteria were used simultaneously (category II), the incidence of LPD among the patients was 41%; when P and EB (category III) and P and BBt (category V) criteria were used, the incidence was the same in each case (45%). On the contrary, with the use of BBt and EB (category IV) criteria the incidence was 65%. Furthermore, when the above-mentioned categories were used in each of the groups separately, the smallest deviation between the initial and final diagnosis of LPD was found in groups A and B, whereas the largest deviation was found in groups C and D. We conclude that the highest incidence of patients who remained with the diagnosis of LPD was observed after utilization of category IV (EB and BBt) criteria and we recommend that, in cases where LPD is diagnosed based on P levels, only higher serum levels be accepted as indicative of the syndrome.

Adult↗

PubMed1988

Cervical incompetence: a 24-year review.

Three hundred nineteen cervical cerclages performed in 264 pregnant women were retrospectively studied. The diagnosis of cervical incompetence was established by the obstetrical history, hysterosalpingography, ultrasound screening and vaginal examination. All cervical cerclages were applied between 14 and 17 weeks gestation according to Shirodkar's technique except 49 emergency cases between 18 and 26 weeks gestation for which other techniques were chosen. The incidence of preterm deliveries (26-37 weeks gestation) decreased from 39.7% to 14.23% (P less than 0.001) and that of full term pregnancies increased from 20.04% to 75.74% (P less than 0.001). The number of neonates weighing less than or equal to 2000 g decreased from 44.20% to 11.38% (P less than 0.001) and those weighing greater than or equal to 2500 g increased from 44.83% to 75.82% (P less than 0.001). Perinatal mortality after cerclage declined from 28.21% to 5.52% (P less than 0.001). There was no increase in congenital defects. An increased rate of breech presentation (5.32%) and cesarean section (20.38%) was noticed. The repeated cerclage in consequent pregnancies did not seem to influence the duration of gestation. In emergency cases the rate of preterm deliveries was 53.06%, of full term pregnancies 12.25%, of newborns with birthweight less than or equal to 2500 g 31.77% and of those with birthweight greater than 2500 g 19.23%. Perinatal mortality in emergency cases was 42.3%. An increase in aerobic and anaerobic pathological flora was noticed in postoperative cervical cultures.

Abortion, Spontaneous↗

PubMed1988

The influence of different amounts of clomiphene citrate on follicle-stimulating hormone, luteinizing hormone and estradiol levels and on the number and maturation of follicles.

Sixty-eight anovulatory women were divided into three groups according to the administered doses of clomiphene citrate (CC) (A 250 mg, B 500 mg, C 750 mg). Daily follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) measurements were performed. Follicular maturation was monitored by ultrasound. In the high-CC dose group, a statistically significant FSH rise was noted. As a result, earlier selection of the dominant follicle (DF), faster increase in the DF diameter and increased E2 production was found.

Adult↗

PubMed1988

[Beta-HCG concentration in maternal serum and in amniotic fluid of patients in labor with physiologic pregnancies].

A comparison was made of beta-hCG concentrations in maternal serum (MS) as well as in amniotic fluid (AF) in 30 healthy pregnant women, intra partum in correlation with parity, fetal sex and maternal age. In all cases, the differences in the average values of beta-hCG in MS and in AF were statistically significant. In pregnancies with female fetuses the average values of beta-hCG was higher than the corresponding values of those with male fetuses. Especially in cases of multiparous women, this difference was statistically significant. On the contrary, in AF a reversal of this relationship was observed. The average values of beta-hCG in pregnancies with male newborns were higher than those with female newborns.

Amniotic Fluid↗

PubMed1986

[Dynamic tests in females with Kallmann syndrome].

Three patients with Kallmann's syndrome (one of whom had undergone eight-year therapy with sex steroids) were studied with many dynamic tests. The progesterone and clomiphene tests were negative. An insulin test and TRH stimulation test showed a normal pool of GH and TSH in the hypophysis. A double stimulation with 100 micrograms LH-RH led to an inadequate gonadotropin response with a dominant FSH secretion, while the patient who had previously received sex steroids gave better results. The other two patients received 100 micrograms LH-RH i.m. daily for 20 days and the double LH-RH stimulation test was repeated. A satisfactory gonadotropin response with a predominance of LH secretion was noted. A TRH stimulation test revealed normal PRL secretion, while after a chlorpromazine test only one patient showed a satisfactory PRL secretion. Under combined HMG-HCG therapy, one of the patients conceived and had a normal outcome of her pregnancy.

Adolescent↗

PubMed1978

[Endometrial chondroma].

A case of ectopic cartilage formation is reported in the endometrium of woman suffering from tuberculosis of the internal genitalia. The possibilities as far as the theories relating to the explanation of cartilage formation are analysed.

Aged↗

PubMedDate not supplied

Hypothalamic-pituitary-thyroidal axis dysfunction and cortisol secretion in patients with nonclassical congenital adrenal hyperplasia.

OBJECTIVE: The purpose of this study was to evaluate thyroid function and TSH and cortisol (F) secretion in hyperandrogenemic women with nonclassical congenital adrenal hyperplasia (NC-CAH) due to 21-hydroxylase deficiency (Group A) when compared with women with hyperandrogenemic symptoms (menstrual irregularities, hirsutism, acne, seborrhea and sterility) of other etiologies (Group B). METHODS: Seventy-two women were subjected to stimulation of the adrenal cortex with i.v. ACTH administration in the early proliferative phase of the menstrual cycle. Basal plasma TSH, T3, T4, and FTI as well as basal and ACTH-stimulated plasma F and 17-hydroxyprogesterone levels were determined. RESULTS: According to internationally accepted criteria and HLA haplotyping, we diagnosed 28 NC-CAH patients as well as affected heterozygotes of the disease. No significant difference was found in the plasma T3, T4, or FTI or F concentrations between the women of the two groups. On the contrary, plasma TSH levels were significantly lower in patients with 21-hydroxylase deficiency when compared to the women with hyperandrogenemic symptoms of other etiologies. CONCLUSION: The results of this study support a dysfunction of the hypothalamic-pituitary-thyroidal axis due to altered ACTH secretion patterns.

17-alpha-Hydroxyprogesterone↗

PubMedDate not supplied

The etiology in 77 primary amenorrhea patients.

This study is based upon an analysis of 77 cases of primary amenorrhea. The work-up included a complete endocrinological study, cytogenetics, laparoscopy, and gonadal biopsy. Of the total number of patients, 31 had a completely developed female phenotype, 22 had an insufficiently developed one, and the remaining 24 patients were characterized by infantilism. A positive sex chromatin was obtained in 59 patients, and negative in 18. Out of 77 patients, 25 had an abnormal karyotype or one corresponding to the opposite sex. In six patients, the existence of a Y chromosome in the karyotype was found in spite of the female phenotype. Five patients had the testicular feminisation syndrome.

Adolescent↗

PubMedDate not supplied

Indications and results of total hysterectomy.

During a 16 year period, 3,410 total hysterectomies were performed. The abdominal approach was preferred in 2,910 cases (85.33%) and the vaginal in 500 (14.67%). About 3/4 (74.77%) of the patients subjected to abdominal hysterectomy (AH) were aged 36 to 55, and 70.6% of the women subjected to vaginal hysterectomy (VH) were aged 56 to 75. The indications were 85.75% for benign and 14.25% for malignant diseases. Among benign diseases, the main indications were 54.6% for uterine myomas, 13.51% for uterine prolapse and 5.46% for benign ovarian tumors. Indications due to malignant diseases rated 5.01% for malignant ovarian tumors, 4.94%, for Ca of corpus uteri and 3.02% for in situ cervical Ca. In almost one out of every three patients the condition was aggravated by a chronic disease or pathological situation. More than 1 in 4 patients had one postoperative complication. In hysterectomies due to benign diseases the complication rate was 24.21%, while those with malignant disease presented a two-fold complication rate. The complication rate for both routes of operation was similar, with fever complications in middle aged patients (25.98%), while patients of young or advanced age presented higher complication rates (29.71% and 31.28% respectively). The overall mortality rate up to the fourth postoperative day was 0.652%, 0.645% for AH and 0.60% for VH. Operations due to benign disease had a 0.20% mortality rate while those with malignant etiology rated 2.966%.

Adult↗

PubMedDate not supplied

Cytokines in gynecological cancer.

BACKGROUND: Cytokines are considered as part of host defence to infection or injury. MATERIAL AND METHODS: Pretreatment values of TNF and sIL-2R were measured in 132 women with a) ovarian carcinoma (n = 25), b) breast cancer (n = 20), c) endometrial cancer (n = 15), d) cervical squamous cell carcinoma (n = 19), e) cervical adenocarcinoma (n = 11) and f) benign gynecological diseases (n = 42) in order to evaluate whether these cytokines could be useful in the discrimination of malignant from benign gynecological diseases. RESULTS: Both TNF and sIL-2R were significantly higher in all cancer groups together (mean +/- SD: 30 +/- 11 pg/mL and 1293 +/- 465 U/mL respectively), than those in the benign group (16.0 +/- 6 pg/mL and 626 +/- 233 U/mL, respectively; p < 0.0001), while no significant differences were found for TNF and sIL-2R values in the five cancer groups. Significantly higher cytokine values were measured in the advanced stage diseases (33 +/- 11 pg/mL and 1705 +/- 192 U/mL), than those in the limited cancer (26 +/- 12 pg/mL, p < 0.05 and 916(521 U/mL, p < 0.0001). CONCLUSIONS: Our results suggest that, cytokines may be useful in the discrimination of malignant from benign gynecological diseases and in monitoring tumor activity in patients early in the malignancy process.

Breast Neoplasms↗

PubMedDate not supplied

The predictive value of double Gn-RH provocation test in unprimed Gn-RH-primed and steroid-primed female patients with Kallmann's syndrome.

OBJECTIVE: To determine the degree of hypophyseal deficiency in Kallmann's syndrome, and the effects of Gn-RH priming and HRT. PATIENTS AND METHODS: Seven female patients with complete Kallmann's syndrome were subjected to dynamic tests (chlorpromazine, TRH and double Gn-RH provocation test) immediately after their first admission to the hospital. In five patients the diagnosis was established for the first time (unprimed patients), while in the other two cases the diagnosis has been established earlier and the patients were already receiving hormonal replacement therapy (HRT-primed patients). In the 5 unprimed patients, 100 microg Gn-RH s.c. were administered daily for 28-32 days and the double Gn-RH test was repeated immediately after. RESULTS: The gonadotropic response of the unprimed patients in the administration of Gn-RH was insufficient, mainly in the second stimulation, with secretory dominance of FSH (ratio LH/FSH <1), while after the monthly Gn-RH priming, the gonadotropic response to Gn-RH had improved, with a considerable increase in the peak values of plasma FSH and LH after both stimulations, and the LH/FSH ratio was reversed to >1. In the two primed patients, the gonadotropic response to Gn-RH administration was better in both stimulations than that of the unprimed patients. CONCLUSIONS: Both the short-term Gn-RH and the long-term HRT priming improve the secretory promptitude of the hypophyseal cells for both gonadotropins, while after long-term Gn-RH priming the LH-secreting cells are capable of both release and synthesis of the hormone, as can be seen by the results of the second stimulation in the Gn-RH primed patients. Consequently, for women with Kallmann's syndrome who wish to become pregnant, ovulation induction and conception can be achieved sooner and with less cost if they are previously primed.

Adolescent↗