scholarly journals Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
René Rodríguez-Gutiérrez ◽  
Jesús Zacarías Villarreal-Pérez ◽  
Felipe Arturo Morales-Martinez ◽  
René Rodríguez-Guajardo ◽  
Gloria González-Saldivar ◽  
...  

Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered.Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM).Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P=0.0001and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78;P≤0.001,r=0.74;  P≤0.001, andr=0.71;  P≤0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001) and free T and DHEA-S declined significantly (P=0.0002and 0.009).Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.

1986 ◽  
Vol 72 (2) ◽  
pp. 205-209
Author(s):  
Franca Vergadoro ◽  
Laura Tabacchi ◽  
Pietro Barbacini ◽  
Laura Vassena ◽  
Flavia Zanaboni ◽  
...  

Thyroid function was assessed in a total of 15 cases, 7 of whom had choriocarcinoma and 8 hydatidiform mole, by measuring free T3, free T4, thyroxin-binding globulin (TBG), basal thyroid-stimulating hormone (TSH) and after the thyrotropin-releasing hormone test (ΔTSH). Free T3, free T4 and TBG were investigated in the same number of healthy women within the first three months of pregnancy. Only 13.4% of the cases presented elevated levels of free T3 and T4 and TBG; TSH and ΔTSH were within normal limits. Both thyroid hormones and TBG returned to within normal limits when β-human chorionic gonadotropin became undetectable. One patient was found to be hypothyroid. Comparison with the control group showed no significant differences except in TBG levels, which were higher in controls. A significant, direct correlation was found between levels of free T3 and T4 and TBG and the pattern of human chorionic gonadotropin.


Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS. Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P<0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.


1962 ◽  
Vol 115 (2) ◽  
pp. 289-294 ◽  
Author(s):  
A. R. Midgley ◽  
G. B. Pierce

Through the use of immunohistochemical techniques, human chorionic gonadotropin has been localized to syncytiotrophoblastic cells of immature placenta, hydatidiform mole, chorioadenoma destruens, and choriocarcinoma. No gonadotropin has been detected in cytotrophoblast. Evidence is discussed which suggests that syncytiotrophoblast is the cell of origin of human chorionic gonadotropin. The observation that formalin fixation did not alter the ability of human chorionic gonadotropin to react with its specific antibody permitted the study of formalin-fixed paraffin-embedded tissues stored in the tissue collection. In addition, the excellence of histologic preparations following formalin fixation facilitated cytologic identification.


2006 ◽  
Vol 21 (1) ◽  
pp. 45-49 ◽  
Author(s):  
H. Ngo Duc ◽  
N.E. van Trommel ◽  
F.C.G.J. Sweep ◽  
L.F.A.G. Massuger ◽  
C.M.G. Thomas

Objective Human chorionic gonadotropin (hCG) is widely used in the management of hydatidiform mole and persistent trophoblastic disease (PTD). Studies on hyperglycosylated human chorionic gonadotropin (invasive trophoblast antigen, ITA) in PTD are limited. In serum samples taken before evacuation of molar pregnancies we measured the concentrations of free hCG β-subunit (free hCGβ), “total” hCG (hCG+hCGβ) and ITA, and determined whether ITA, the two other hCG analytes, or the calculated ratios of hCGβ/hCG+hCGβ, hCGβ/ITA and hCG+hCGβ/ITA could predict the later development of PTD. Design A retrospective study based on blood specimens collected in the Dutch Central Registry for Hydatidiform Moles. The study group comprised 97 patients with hydatidiform moles who did not develop PTD after mole evacuation and 33 patients who did develop PTD. Methods Serum samples from 130 patients with hydatidiform mole with or without PTD were assayed using specific (radio)immunoassays for free hCGβ, total hCG, and ITA. From these analytes we also calculated the ratios hCGβ/hCG+hCGβ, hCGβ/ITA, and hCG+hCGβ/ITA. To predict the development of PTD from these analytes and parameters we performed receiver-operating characteristic (ROC) curve analysis, resulting in areas under the curve (AUCs) that represented the diagnostic accuracy which was rated in a range from excellent (AUC >0.9 or <0.1) to poor (AUC 0.4–0.6). Results The diagnostic accuracy of ITA was moderate (0.618) and not different from that of free hCGβ (0.610) and hCG+hCGβ (0.622). Conclusions ITA as well as the other analytes and parameters in serum taken prior to evacuation from patients with molar pregnancies cannot be used to predict the subsequent development of persistent trophoblastic disease.


Author(s):  
Robabe Hosseinisadat ◽  
Lida Saeed ◽  
Sareh Ashourzadeh ◽  
Sedigheh Safar Heidari ◽  
Victoria Habibzadeh

Background: Several mediators play an important role in implantation. One of these mediators is human chorionic gonadotropin (HCG). Objective: To evaluate the effects of HCG intrauterine injection on the day of oocyte retrieval on the result of assisted reproductive techniques (ART). Materials and Methods: In this randomized clinical trial study, 126 women who were referred to Afzalipour Infertility Center between December 2018 to December 2019 undergoing in vitro fertilization/intracytoplasmic sperm injection cycles were enrolled and assigned to two groups of: a case (n = 62) and a control group (n = 64). The protocols for both groups were the same; except that the case group was injected with the protocols for both groups were the same, except that the case group was injected with 1000 IU of HCG into uterine cavity following the oocyte puncture, while no medication was administered to the control group. The implantation rate, chemical pregnancy, clinical pregnancy, and abortion rates were compared between the two groups. Results: Positive chemical pregnancy was seen in 15 (27.3%) cases of the case group and 14 (25.5%) of the control group. No significant difference was seen in the chemical and clinical pregnancy rates between the groups. The abortion rate was higher in the control group but that was not significant. Conclusion: A 1000 IU of HCG intrauterine injection after oocyte retrieval does not improve implantation, chemical or clinical pregnancy rates in ART cycles. Further studies are needed to clearly understand the role of HCG intrauterine injection in the day of oocyte retrieval in ART outcomes. Key words: Oocyte retrieval, Chorionic gonadotropin, Pregnancy, Assisted reproductive techniques.


2010 ◽  
Vol 76 (10) ◽  
pp. 1112-1114 ◽  
Author(s):  
Bonnie R. Wang ◽  
Vincent L. Rowe ◽  
Sung Wan Ham ◽  
Sukgu Han ◽  
Kaushal Patel ◽  
...  

No standard presently exists for the use of systemic heparin during angioaccess surgery to decrease the incidence of postoperative thrombotic complications. Our objective was to study the effects of intraoperatively administered heparin on 30-day patency and postoperative bleeding complications in patients undergoing autogenous arteriovenous (AV) fistula surgery. A prospective, double-blinded, randomized controlled study was performed on 48 patients undergoing AV fistula creation from April 2007 through November 2009. Of the 48 patients, 22 were randomized to the control group and received no heparin. Twenty-six were randomized to receive heparin (75 units/kg intravenously) before clamping of the artery. There was no significant difference in 30-day patency between the heparin and control groups (92% vs 86%, P = 0.65), respectively. Three patients (12%) developed hematomas in the heparin group compared with one (5%) in the control group; however the difference was not statistically significant ( P = 0.61). The results suggest that intraoperative administration of heparin has no statistically significant effect on 30-day patency rates or postoperative bleeding complications. Larger trials with longer term follow-up and assessment of maturation rates are needed to determine the effect of intraoperative anticoagulation on these outcomes of arteriovenous fistula surgery.


Author(s):  
Uma H. Chourasia ◽  
Mudita Kamlesh Jain ◽  
Juzar I. Fidvi

Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.


2020 ◽  
Vol 36 (5) ◽  
pp. 498-500
Author(s):  
Elliot M. Levine ◽  
Carlos M. Fernandez ◽  
Angela McElwee

Human chorionic gonadotropin is generally used as a biomarker to identify invasive molar pregnancy. The extent of the disease (e.g., its staging) has not, however, relied on its sonographic description. A case is presented that can illustrate some diagnostically useful sonographic features of three-dimensional transvaginal sonography for this condition. The clinical imaging of this case initially suggested it to be a benign hydatidiform mole but ultimately was diagnosed as an invasive molar pregnancy, with human chorionic gonadotropin monitoring. Clinical imaging was used to help manage this patient, with the demonstration of trophoblastic invasion of the uterine wall. Although two-dimensional sonography is commonly used to diagnose molar pregnancy, three-dimensional sonography may offer a clinical advantage for the management of invasive molar pregnancy, which can occur in 15% of benign hydatidiform molar pregnancies.


1988 ◽  
Vol 74 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Giorgio Bolis ◽  
Carlo Belloni ◽  
Cristina Bonazzi ◽  
Giorgia Mangili ◽  
Mauro Presti ◽  
...  

Between 1976 and 1985, at the Obstetrics and Gynecology Department of Milan University, a total of 309 cases of hydatidiform mole, 223 complete moles and 86 partial moles, were monitored with the assay of beta-human chorionic gonadotropin, following a postmolar biochemical surveillance program. Spontaneous remission of the disease occurred in 287 (92.9%) patients. Marker levels were undetectable in 80.4 % of cases within 60 days after evacuation of the mole and in 19.6% between 61 and 140 days. There were 22 (7.1%) patients diagnosed as having gestational trophoblastic tumors (GTT) and treated with chemotherapy: 20 were complete moles and 2 partial moles. Considering these data, the authors suggest different follow-up times for partial and complete moles and confirm the necessity of selection criteria in a diagnosis of GTT.


1981 ◽  
Vol 57 (11) ◽  
pp. 1632-1644
Author(s):  
Ryuichiro NISHIMURA ◽  
Tamotsu HAMAMOTO ◽  
Keizo TANABE ◽  
Masayuki TAKEMORI ◽  
Yoshihiko ASHITAKA ◽  
...  

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