A Comparative Study between Vaginal and Rectal Routs of Bromocriptine Administration

To assess the efficacy and possible potential side effects of alternate routes of treatment, 2.5mg bromocriptine was administered vaginally or rectally to five normoprolactinemic and four idiopathic hyperprolactinemic women. Serum bromocriptine and prolactin (PRL) levels were measured hourly for the first 12 hours, then every 2 hours for the following 12 hours. The mean peak bromocriptine levels were 641.0 ± 200.1 pg/ml and 386.5 ± 134.8 pg/ml in the normoprolactinemic and hyperprolactinemic groups, respectively. Maximum PRL reduction rate was 67.7 ± 3.4% at 11.3 ± 1.1 hours and 44.8 ± 0.7% at 21.5 ± 1.5 hours after vaginal administration in the normoprolactinemic and hyperprolactinemic groups, respectively. In contrast, in the rectal treatment group the mean peak values of serum bromocriptine were 364 pg/ml and 314.5 ± 3.9 pg/ml in the normoprolactinemic and hyperprolactinemic groups, respectively. Maximum PRL reduction rate was 38.1% at 8 hours and 21.0 ± 10.4% at 17.0 ± 3.5 hours in the normoprolactinemic and hyperprolactinemic gryoups, respectively. In conclusion, we suggest that the vaginal route of administration is as effective and has fewer side effects than by the oral route. Furthermore, the rectal route is an alternate method of treatment for patients who cannot be administered bromocriptine by vaginal route

Results of Postoperative Treatments in View of the Surgical Stage of Uterine Endometrial Carcinoma

Background : The indications for and the optimal mode of adjuvant therapy in surgically operated endometrial cancer patients have not yet been established. We studied the indications for the postoperative treatment of endometrial carcinoma patients based on their surgical stages (FIGO, 1988) . Methods : We retrospectively restaged the cases of 178 endometrial carcinoma patients who underwent hysterectomy with pelvic lymphadenectomy between 1965 and 1992 and who were followed-up longer than 3 years. The patients were subdivided into low- and high-risk groups, and we investigated the relation between their postoperative treatment and recurrence rates. Postoperative treatment was divided into the three groups of no/incomplete, external whole-pelvic irradiation (EWPI) and chemotherapy. Results : The 79 patients in Stage Ia or Ib had no/incomplete postoperative treatment, but only 1 (1.3%) had a recurrence. Four Stage IIa patients had no recurrence and all 3 low-risk patients had no postoperative treatment. Of the 5 Stage IIb, low-risk patients, 1 of the no postoperativetreatment group had a recurrence. The recurrence rate among the Stage IIb patients of the high-risk group was 40% (2/5) in the incomplete postoperative treatment group. The six Stage IIIa patients with EWPI. had no recurrence. In contrast, 14 of the 15 Stage IIIb and IIIc patients underwent postoperative EWPI, and 11 of them (78.6%) had a recurrence including 8 (81.8%) with a recurrence in distant regions. Conclusion : Postoperative treatment may be well omitted for many patients at Stage Ia or Ib and the low-risk group at Stage IIa based on surgical staging criteria. Patients in other surgical stages seemed to require to identify best postoperative treatment , but further randomized prospective studies will be required to identift the best mode of treatment

BEHAVIORAL PATTERN OF THE NEWBORN Earliest timing for iniciating attachment behavior in the infants.

The behavioral pattern during the first hour of life of 10 term neonate are reported by the study of minute by minute observation. The term newborn spent 65.5% of the first hour in the quiet alert state, 30.1% in the crying state and the rest 4.4% in the other states. The mean time spent in the dominant state of quiet alertness was 39.3 minutes. A sexual difference amongst the newborn was that the males spent 72.7% and the females spent 58.4% of the first hour in the quiet alert state. The predominant quiet alert state was analized for the time spent during the first 30 minutes and from 30 to 60 minutes. And it was found that 58.7% of the first 30 minutes and 76.4% of the second 30 minutes was spent in the quiet alert state. So it is suggested that during the time interval between 30 to 60 minutes after birth, the infants should be brought into physical contact with mothers for the first imprintation of the attachment-behavior in them, when they are in the state of maximum receptivity and the level of responses and reciprocation is at the optimum for promoting the attachment-behavior in the infants to be more deepening and long-lasting

Immunohistochemical Studies on Sex Steroid Hormones In Sex Cord-Stromal Tumors of the Ovary

Estradion, progesterone and testosterone were examined immunohistochemically in formalin fixed paraffin embedded tissue specimens of 15 sex cord-stromal tumors [6 granulosa cell tumors (GCT), 2 thecomas, 5 fibromas, 1 sclerosing stromal tumor and 1 Sertoli-Leydig cell tumor] or ovary using ABC method. In the granulosa cell tumor, estradiol, progesterone and testosterone were demonstrated in the granulosa cells, Clinical evidence of increased estradiol was found in 4/6 cases (66.7%) of GCT, being consistent with the steroid localization. In the thecomas, progesterone and testosterone were weakly positive in the Iuteinized theca cells, where immunoreactivity of estradiol was not observed. Progesterone and testosterone were weakly positive in the vacuolated and polygonal tumor cells but not the fibroblastic cells of sclerosing stromal tumor. Estradiol was weakly and testosterone were weakly or moderately positive in both the Sertoli and Leydig cells of Sertoli-Leydig cell tumor. The patient had clinical evidences of increased androgen production, manifested by virilization and increased serum hormone level of androgens. No hormone immunoreactivity was observed in any of the fibromas. From the results of this study it may be concluded that specific types of hormonally active cells i these ovarian tumors can produce estradiol, progesterone and testosterone, except fibroma