Cervical carcinoma-in-situ in woman exposed to diethylstilboestrol in utero.
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Adult↗
Biomedical subjects
J Dewhurst
Publications and source records attributed to J Dewhurst.
Further clinical experience in the treatment of hirsutism with cyproterone acetate.
Further experience in the treatment of female hirsutism with the anti-androgen cyproterone acetate is reported. Two-thirds of treated patients have shown improvement but relapse occurred within two or three months of stopping treatment. Acne also healed in two patients.
Adolescent↗
Premature menarche without other evidence of precocious puberty.
We describe 4 young girls with recurrent vaginal bleeding in the absence of other signs of precocious sexual development. Investigation showed low oestrogen levels in 2 of them, and basal gonadotrophins were in the upper part of the prepubertal range. We believe that the isolated early menstruation in these patients was possibly related to increased sensitivity of the endometrium to oestrogens.
Child, Preschool↗
The doctor cannot always tell. Medical examination of the "intact" hymen.
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Adolescent↗
Vaginal bleeding in childhood: a review of 51 patients.
A search of the medical records at the Hospital for Sick Children, Great Ormond Street and Chelsea Hospital for Women, London, revealed 51 cases of vaginal bleeding in children under the age of 10 occurring in the years 1962 through 1977. The bleeding was caused by some form of precocious puberty in 37 patients (73 per cent). Eight of these patients had cyclical vaginal bleeding in the absence of secondary sexual development or advanced bone age. Fourteen patients (27 per cent) bled because of a local lesion and six of these had a malignant neoplasm of the genital tract.
Brain Diseases↗
Secretion patterns of plasma-progesterone, 17-hydroxyprogesterone and 20 alpha hydroxypregn-4-en-3-one in early normal pregnancy.
Plasma levels of progesterone, 17-hydroxyprogesterone and 20 alpha hydroxypregn-4-en-3-one were established from 4 to 16 weeks gestation by sampling 15 normal patients twice weekly. Apart from a peak at week 5, the mean levels of progesterone remained constant at about 24 ng/ml until week 10 and then rose progressively to 40 ng/ml at week 16.20 alpha hydroxypregn-4-en-3-one remained within the 7 to 9 ng/ml range apart from a peak at week 5. A significant decrease in mean levels of 17-hydroxy-progesterone was noted from week 5 to a nadir of 3 ng/ml at week 11. It would appear that the main hormone production of progesterones in pregnancy has been taken over by the placental unit by the 10th week.
20-alpha-Dihydroprogesterone↗
Secretion patterns of plasma-progesterone, 17-hydroxyprogesterone, and 20alpha hydroxypregn-4-en-3-one in early abnormal pregnancy.
Plasma progesterone, 17-hydroxyprogesterone, 20alpha hydroxypregn-4-en-3-one levels were determined twice weekly up to 16 weeks gestation, where possible, in a twin pregnancy, in two patients who aborted spontaneously and in three patients who were treated with 'progesterone supplements' because of abnormal vaginal cytology. There was no correlation between vaginal smears and the plasms hormone levels and there was no evidence to suggest that progesterone supplements influenced clinical outcome. Compared with normal mean values the only difference was a significantly rise in progesterone and 20alpha hydroxypregn-4-en-3-one levels in the twin pregnancy after the 12th week and a precipitate fall in all hormone levels just prior to abortion. Plasma hormone levels could not be used to predict outcome.
20-alpha-Dihydroprogesterone↗
Fertility in 47,XXX and 45,X patients.
Female patients with a sex chromosome abnormality may be fertile. In patients with a 47,XXX cell line there appears to be an increased risk of a cytogenetically abnormal child but the extent of this risk cannot yet be determined; it is probably lower in the non-mosaic 47,XXX patient than the mosaic 46,XX/47,XXX one. Patients with a 45,X cell line rarly become pregnant, and when they do they appear to have a high risk of an abnormal child or repeated unsuccessfuly pregnancies; this risk is certainly exaggerated by the method of reporting; when the poor reproductive perforamcne is first identified leading to the recognition of the maternal cytogenetic fault, the reproductive failure rate is naturally high; when the maternal fault is first identified and the reproductive history then established far better results are evident.
Congenital Abnormalities↗
Congenital malformations of the lower urinary tract.
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Bladder Exstrophy↗
Recommendations from the findings by the RCGP oral contraception study on the mortality risks of oral contraceptive users.
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Adult↗
Cervical hostility and antisperm antibodies in the male.
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Autoantibodies↗
Male intersexuality presenting at puberty.
A 15-year-old girl was referred to the Endocrine Unit because of a deep voice and the absence of menstruation. Secondary sex hair showed a male pattern of distribution and there was a phallic clitoris 4 cm long, with the urethral orifice posterior. Plasma testosterone was within the normal male range. The karyotype was 46XY. Gonadectomy and clitoridectomy were performed. Histology suggested a diagnosis of anatomical testicular failure, which, in view of the imperfect attempt at masculinization, was thought to be only partial. Possible causes are discussed.
Adolescent↗
Cosmas and Damian, patron saints of doctors.
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Christianity↗