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Typical Turner's syndrome with 45 XO karyotype and normal menstruation. Cytogenetic and histological findings.

The clinical, laboratory, histological and cytogenic findings in a patient with Turner's syndrome with normal menstruation are presented. Although the phenotype and karyotype were those of Turner's syndrome, normal sexual development and periods occurred at puberty. The endocrine studies revealed onyl a mild diabetic oral glucose tolerance test. At laparotomy, normal uterus, Fallopian tubes and ovaries were seen. Histological examination of the ovaries showed several primordial follicles and a follicle cyst. Tissue cultures of lymphocytes, skin fibroblasts and ovary revealed a single line of cells with the 45 XO karyotype. Although 25 cases of Turner's syndrome with normal sexual development have been reported, most of them were mosaics and only a small number showed the pure 45 XO karyotype.

Adolescent↗

Menstruation in an unusual place: a case of thoracic endometriosis in Kampala, Uganda.

While pelvic endometriosis is relatively common, thoracic menstruation is rare. A report of what is believed to be the first case of thoracic endometriosis in Uganda is given. A 34-year-old female was complaining of on and off chest pain mainly on the right side. Clinically she had signs of pleural effusion and 500 mls of altered blood were tapped from her right pleural space. Worried about a possibility of a malignant process, an urgent chest CT scan was performed. A right posterior pleural mass and pleural effusion were found. A pleural biopsy was taken and confirmed at histology as endometrial tissue. She did well on surgical excision and hormonal therapy. This was a rare case of endometriosis which shows the usefulness of imaging in the patient work up.

Adult↗

Synchronous expression of pinopodes and alpha v beta 3 and alpha 4 beta 1 integrins in the endometrial surface epithelium of normally menstruating women during the implantation window.

OBJECTIVE: To use histology, scanning electron microscopy (SEM) and immunohistochemistry to examine the expression of pinopodes, and alpha v beta 3 and alpha 4 beta 1 integrins in the same endometrial biopsies. STUDY DESIGN: A prospective observational study. Fifteen consecutive regularly menstruating women with normal hormone profiles were followed for detection of ovulation and then biopsied twice, on postovulatory days luteinizing hormone (LH) +6 and LH +8. Measurements included abundance and development stage of pinopodes and a semiquantitative assessment of intensity of antibody staining for integrins. RESULTS: All biopsies observed under light microscopy showed an in-phase endometrium. Pinopodes were found developing mostly on day LH +6 and were fully developed on day LH +8. The expression of alpha v beta 3 dimer increased significantly from day LH +6 to day LH +8, while alpha 4 beta 1 dimer did not show any significant change during the same period. Fully developed pinopodes and strong intensity of alpha v beta 3 integrin were the most common findings. CONCLUSION: These results indicate a coordinated, synchronous change in morphology and adhesion molecule expression of endometrial epithelial cells on day LH +8 of a normal menstrual cycle.

Adult↗

Knowledge about menstruation and practices of nursing students affiliated to University of Alexandria.

All secondary school nursing students enrolled in the Main University Hospital during the scholastic year 1987-1988 were studied for knowledge and practices related to menstruation. Over 85% of the students were acquainted with age of menarche, length of the menstrual cycle, and duration of menstrual bleeding. Only 71.54% gave correct answers about age of menstrual cessation. Students' practices revealed that one quarter of the sample avoid bathing during their bleeding period. About two thirds of the students stated that they use 3-8 sanitary pads per day. First year students significantly used less pads than those at higher grades. Menstrual pains and fear of bleeding were the causes of absenteeism from school among 37.62% of the sample. The higher the grade the more likely that the student carries out her normal daily activities without any difficulties. The main source of knowledge on the topic was the mother. The nursing school education was not mentioned except by minority of students in relation to menstrual hygiene.

Adolescent↗

Knowledge and beliefs about the body interior during early adolescence: the case of menstruations.

Contrasting with the increase of curiosity about sexual matters at the time of puberty, is the paucity and distortion, recognized by many authors, of young adolescents' sex-oriented knowledge. In the present study attention focused on knowledge about the internal mechanisms that cause menstrual bleeding. The study was conducted in a situation where schools do not provide systematic information about sexual matters, as is the case in many parts of Italy. Three hundred forty-eight young adolescents, ages 11 to 14 years, male and female (pre- and post menarcheal) from southern Italy, were interviewed with an open questionnaire method. The results showed consistent lack of correct information regarding menstrual event, in a high percentage of subjects, both male and female. A descriptive content analysis of subjects' explanations of menstruations was made and several categories of explanations were put in evidence.

Adolescent↗

[Yuanhuacin film for menstruation induction and termination of early pregnancy: analysis of 382].

Yuanhuacin Film was used in 382 cases, 26 cases for menstrual induction (successful rate 100%) and 356 for termination of early pregnancy. Among the latter group 336 cases resulted in complete abortion (94.4%), 12 cases in incomplete abortion (3.4%) and 8 cases in failure (2.2%). The embryonic sacs were discharged within 34.66 +/- 33.73 (means +/- s) hours. The amount of vaginal bleeding was less than or equal to that of menstruation, which lasted for 8.18 + 9.14 (means +/- s) days with mild abdominal pains. In the complete abortion group 237 cases (70.5%) were followed up and 236 cases were found to restore their menses within 40 days (99.6%), and 157 cases have decreased amount or the same amount of menstrual flow (66.2%), while in 80 cases the amount was increased (33.8%).

Abortifacient Agents↗

[Usefulness of determining serum levels of prolactin in women with menstruation disorders].

In 173 women with oligomenorrhea or amenorrhea, serum level of prolactin (PRL) was determined by radioimmunoassay method. In 22 cases (12.7%) the concentration of PRL was above 15 ng/ml. From the above women in 9 cases (5.2%) of all examined patients pituitary microadenoma was diagnosed. In 1 patient with pituitary microadenoma, coexisting partially empty sella was diagnosed. The mean basal PRL concentration in women with menstruation disturbances without hyperprolactinemia (group I) was found to be 7.1 +/- 3.1 ng/ml while the women with hyperprolactinemia without pituitary microadenoma (group II) was 32.9 +/- 5.8 ng/ml. In women with diagnosed pituitary microadenoma (group III) PRL concentration was 131.8 +/- 47.7 ng/ml. The group II and III demonstrated statistically significant increase of serum prolactin level in comparison to group I. Moreover in comparison with group I, statistically significant reduction of serum level of FSH, LH and estradiol 17 beta was confirmed in group with pituitary microadenoma. In group II significant decrease of serum concentration of LH and estradiol 17 beta was stated as well as lack of significant difference in serum level of FSH, in comparison to group I.

Adenoma↗

[Menstruation and the woman in Judaism].

Since ancient time subtile cultic regulations have been fundamentals of the habits of jewish people. Women had been affected from these in a considerable degree, consequently pressed into a social exceptional position. The laws of cleanness about behaviour during menstruation have been joined on a large scale. Nevertheless, behind the religious demands are a actual quinding directives of hygiene and timeless ethical principles. The question for prophylactic hints enclosed there cannot be answered.

Female↗

[Influence of body weight on gonadotrophins and steroid hormone levels in menstruating women].

In order to study the effect of obesity or underweight on gonadotropins and steroid hormone levels, serum concentrations of FSH, LH. Testosterone, Estradiol, Estrone, 17-OH-Progesterone and SHBG were measured by RIA in obese, underweight and control women, all menstruating in the follicular phase. Serum concentrations of all parameters measured did not differ significantly in the underweight and control groups. All obese women had higher levels of estrone than the control group, and only obese patients with a body mass index above 39 showed a lower SHBG level than that of the control group. The data suggest that the increased levels of estrone could play a role in the amenorrhea of obese women.

Androgens↗

[The influence of menstruation cycle on human parotid saliva composition (author's transl)].

The influence of different sexual hormone levels during menstrual cycle on the composition of human parotid saliva was investigated. During mid-cycle there were significantly enhanced concentrations of ionized calcium, total calcium, inorganic phosphate and sodium in parotid saliva. The changes in chloride concentrations were parallel to that of sodium and the excretion of postassium was inverse to that of sodium. The maximal out-put of total protein and alpha-amylase was found during midcycle and menstruation.

Fasting↗

[Experimental testing of Pflüger's reflex hypothesis of menstruation in late 19th century].

Pflüger's hypothesis of a nerve reflex as the cause of menstruation published in 1865 and accepted by many, nonetheless did not lead to experimental investigations for 25 years. According to this hypothesis the nerve reflex starts in the ovary by an increase of the intraovarian pressure by the growing follicles. In 1884 Adolph Kehrer proposed a program to test the nerve reflex, but only in 1890, Cohnstein artificially increased the intraovarian pressure in women by bimanual compression from the outside and the vagina. His results were not convincing. Six years later, Strassmann injected fluids into ovaries of animals and obtained changes in the uterus resembling those of oestrus. His results seemed to verify a prognosis derived from Pflüger's hypothesis. Thus, after a long interval, that hypothesis had become a paradigma. Though reasons can be given for the delay, it is little understood, why experimental testing started so late.

Animals↗

Pathogenesis and surgical therapy of migraine attacks caused by weather (Foehn) and menstruation.

This work reports for the first time on the pathological background and the successful definitive surgical treatment of migraine attacks caused by weather (Foehn) changes, menstruation, nutrition (cheese, chocolates, red wines etc), and psychophysical stress. Forty-two patients between the ages of 13 and 48, who were subdivided into an earlier and later treatment group, were surgically treated for migraines caused by the factors mentioned above. In the first group of 15 female patients that was treated, the surgical technique consisted of subperichondral septum correction crushing and partial or total resection of the middle concha and ethmoidal opening. In four of the patients where no septum deviation was observed, a resection of the middle nasal concha and a transnasal opening of the ethmoidal cells in the area of the middle nasal passage was performed. In the later group consisting of 27 patients, the surgical technique was simplified so that only subperichondral septum correction and crushing of the middle concha was performed, without total resection of the concha and ethmoidal cell opening. Up to the present all the 42 patients operated on have been free from migraine attacks, the first operation having been performed seven years ago and the last eight months ago.

Adolescent↗

Depressed mononuclear cell phagocytic activity associated with menstruation.

The peak of the normal distribution curve for pelvic inflammatory disease occurs near the onset of menses. This study was undertaken to determine if there were changes in the cell-mediated immunity of normal menstruating women which could explain the increase in inflammatory disease. The cellular immune response of 8 normal women, measured by number of T- and B-cells and response of mononuclear cells to stimulation with mitogen, was not dependent on the menstrual cycle. However, there was a significant decrease in phagocytic activity of mononuclear cells early in the cycle. The depressed phagocytic activity was not altered by treating the subjects with ibuprofen.

Female↗

Demonstration of human chorionic gonadotropin during the second half of the menstrual cycle in plasma of regularly menstruating women users of copper IUds.

An attempt has been made of demonstrating the beta subunit of HCG in the plasma of 13 regularly menstruating women wearing a copper IUD. Eighteen menstrual cycles were explored with a total of 94 specimens obtained at 3-day intervals starting from the 16th day of the cycle. A cross reaction with LH was excluded by simultaneous assay of this hormone. Progesteron was also assayed so as to exclude anovulatory cycles. Five out of 12 ovulatory cycles yelded positive results with HCG values ranging from 171 to 692 mIU per ml. We therefore agree with the hypothesis according to which copper IUDs do not interfere with fecundation but with subsequent stages, specifically about the time of nidation of the blastocyst in the uterus.

Adult↗

Familial Mediterranean fever associated with menstruation. Efficacy of intermittent colchicine therapy.

The majority of patients with familial Mediterranean fever have a random pattern of attacks without a clear prodrome. Continuous prophylaxis with colchicine has been shown to reduce the frequency of attacks. It is generally considered undesirable, however, to expose young patients to the potential adverse effects of continuous colchicine prophylaxis. The alternative of intermittent short courses of colchicine during acute attacks is often ineffective in patients without a clear prodrome. Case reports of patients with a pattern of attacks occurring 12-24 hours after the onset of menstrual bleeding have appeared. Such patients should be ideal candidates for intermittent colchicine therapy. A review of the literature reveals that a consistent pattern of attacks closely following the onset of menstruation is not uncommon. Such a patient is described who has responded completely to short courses of colchicine begun at the first sign of menstrual bleeding.

Adult↗

Menstruation, menarche, and sexuality in the public school curriculum: school nurses' perceptions.

Nurses employed by schools and health departments have varying responsibilities for curricula related to menstruation, menarche, and sexuality. Nevertheless, the school nurse is usually a source of information on these subjects whether employed full-time in school health or also participating in other nursing roles in the community. This survey examines the involvement of school nurses in curricula related to human reproduction including contraception. Data about their involvement in these classroom topics provides a basis for evaluating their roles and making recommendations for subsequent continuing education programs for school health nurses.

Adolescent↗

Iron balance in menstruating women.

OBJECTIVES: To study factors determining iron balance in menstruating women by examining the relationships between total iron requirements, based on menstrual iron losses and basal iron losses, and serum ferritin concentration, transferrin saturation, blood haemoglobin concentration, bone marrow haemosiderin and absorption of iron from a test dose of ferrous sulphate (0.56 mg Fe). SUBJECTS: The study was made in 203 women all aged 38 years, randomly selected from the census register of Göteborg. The study was originally made in 1968-69. Serum ferritin in frozen sera was first analysed in 1978. Reanalyses, calibrated to the International Standard 80/602, and studies on the effect of storage of sera, were made in 1992. This allowed a complete re-examination of the importance of different determinants of iron balance in women. RESULTS: With increasing iron requirements there was an increase in iron absorption, and a decrease in serum ferritin concentration and transferrin saturation. Above a certain level of iron requirement there was a rather sudden decrease in haemoglobin concentration and in stainable iron in bone marrow smears, indicating the critical level of iron requirements in these women that could be balanced by an increased iron absorption from the present diet. This level represents the maximal adaptation to maintain iron balance in an iron-replete state that can be achieved with this diet and corresponds to a prevalence of iron deficiency of about 25%. CONCLUSIONS: The continuous regulation of iron absorption from iron deficiency to iron repletion has a critical balance point determined by the properties of the diet.

Absorption↗