[Clinical evaluation of beta 2-microglobulin levels in serum and urine in normal and abnormal pregnancies (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Maeyama.
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Hormone levels in patients with threatened abortion were compared with those of women with normal pregnancies to determine the relationship between these hormone patterns and patient prognoses. Plasma progesterone, plasma unconjugated estradiol-17beta (estradiol), and plasma human chorionic somato-mammotropin (HCS) were measured serially in 27 patients with threatened abortion. Twelve of these patients were able to continue their pregnancies, and 15 patients aborted. Of the 3 indices tested, 2 (plasma estradiol and HCS levels) showed marked differences in women who were able to continue their pregnancies and women whose pregnancies ended in abortions; moreover, these findings indicated that these 2 levels could be used as indices for the evaluation of a pregnant patient's prognosis.
An enzymic method using alpha-glucosidases was adapted for measuring glycogen in very small samples (3 mg) of human endometrium. The method is useful as a clinical test of the physiologic function of human endometrium. The glycogen content of the endometrium of normal and infertile patients was measured during the menstrual cycle. The maximal content in both groups was observed between the 16th and 23rd days of the cycle, but the glycogen content of the infertile group was significantly lower (P less than 0.005). These results confirm the reports of others. Endometrial glycogen and urinary pregnanediol levels in 32 infertile patients were measured on day 7 after ovulation. The glycogen content of the endometrium of 21 of these patients, who showed normal excretion of urinary pregnanediol (greater than or equal to 2 mg/day), was significantly higher than that of the other 11 patients who showed low excretion of urinary pregnanediol (less than 2 mg/day) (P less than 0.005). This finding suggests that there is a high correlation between the function of the corpus luteum and endometrial glycogen deposition.
Glycogen content, glycogen synthetase, and glycogen phosphorylase were studied in placental tissue of normal pregnancy and in vesicles of hydatidiform mole. The glycogen content of placental tissue of normal pregnancy decreased significantly with increased gestational age: 6 to 10 weeks, 716.6 +/- 55.7 mg/100 gm wet weight (mean +/- standard error of the mean); 15 to 20 weeks, 216.1 +/- 11.2 mg/100 gm; and 37 to 41 weeks, 176.1 +/- 18.1 mg/100 gm. The decrease in placental glycogen content was accompanied by a corresponding decrease in the placental glycogen synthetase enzyme levels, whereas no remarkable change was found in the glycogen phosphorylase enzyme levels. The glycogen content of hydatidiform mole tissue from 10 patients (13 to 20 weeks of gestation) was 507.0 +/- 58.0 mg/100 gm and was significantly (P less than 0.005) higher than that of normal placental tissue with a corresponding period of gestation. A possible cause of this phenomenon may be the marked decrease in the glycogen phosphorylase enzyme level in hydatidiform mole tissue, which was about one-third that of the normal placental tissue.
Human chorionic somatomammotrophin (HCS), progesterone, and unconjugated oestradiol and oestriol were measured in the plasma of 13 patients with intact hydatidiform moles from week 9 to 19 of pregnancy and in 89 normal women from week 5 to 20 of pregnancy. Plasma alpha-foetoprotein (AFP) was also measured in 9 out of 13 patients and in 23 of the normal women from week 13 to 20 of pregnancy. All the compounds were measured by radioimmunoassay. The plasma HCS concentration in 35 samples from 13 patients with hydatidiform moles ranged from 10 to 910 ng/ml; this was lower than that in normal pregnancy of corresponding duration in eight patients; within the normal range in four patients and high in one patient. The plasma progesterone concentration ranged from 17-5 to 79-2 ng/ml; it was higher than that in normal pregnancy in eight patients and within the normal range in five patients. The plasma unconjugated oestradiol concentration ranged from 1-82 to 8-10 ng/ml; it was higher than normal in six patients and within the normal range in seven patients. The plasma unconjugated oestriol concentration ranged from 0-168 to 1-37 ng/ml, the levels at 15-19 weeks of gestation being significantly lower than those in normal pregnancy at this time (P less than 0-005). Plasma AFP was not detectable in the nine patients (less than 10 ng/ml) whereas it ranged from 10 to 80 ng/ml in 18 out of 23 women in week 13-20 of normal pregnancy. The present results suggest that both plasma oestriol and AFP could be helpful in the diagnosis of hydatidiform mole at about 12-14 weeks though diagnosis could not be made with absolute certainty.
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Dehydroepiandrosterone sulphate (DHAS) was injected intravenously or intra-amniotically into eight volunteers carrying live anencephalic foetuses (including one microcephalic foetus). Urinary and unconjugated serum oestrone, oestradiol and oestriol were measured before and after DHAS administration. In seven pregnant women with live anencephalic foetuses the urinary excretion of oestriol was very low, and the ratio of oestriol to oestrone + oestradiol was much less than that during normal pregnancy. Increases of urinary oestrone and oestradiol but no significant change in the ratio of oestriol to oestrone + oestradiol were observed 24 h after i.v. administration of DHAS to five patients. In three patients, between 1 and 12 h after i.v. administration of DHAS (100-200 mg), the concentrations of serum oestrone, oestradiol and oestriol increased to 13-5, 6-8 and 3-1 times the control values, respectively. After injection of DHAS (200 mg) intra-amniotically into two patients, the urinary excretion of all three oestrogens increased much more on day 2 than on day 1, and the ratio of urinary oestriol to oestrone + oestradiol rose greatly. On the other hand, the concentrations of unconjugated serum oestrogens in these patients increased progressively between 1 and 12 h or more after DHAS administration, and the maximal level of serum oestriol was 9-8 times the control value while those of oestrone and oestradiol were 4-6 times and 5-0 times the control values, respectively. These results suggest that in late human pregnancy DHAS in the circulation of the mother is converted to oestriol largely via the phenolic pathway (DHAS leads to oestrone leads to oestriol), whereas DHAS circulating within the foeto-placental compartment is converted to oestriol via both the phenolic and the neutral intermediates.
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Homogenates of cerebral metastatic chorionepithelioma tissue were incubated with labelled dehydroepiandrosterone, pregnenolone or 20alpha-hydroxypregn-4-en-3-one. The metabolites of dehydroepiandrosterone which were isolated and identified were androstenedione, testosterone, oestrone, and oestradiol; no oestriol was detected. The only metabolite of pregnenolone and 20alpha-hydroxypregn-4-en-3-one isolated and identified was progesterone. No conversion of C-21 to C-19 steroids occurred in the metastatic chorionepithelioma tissue.
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