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Biogenic amines in bovine retina have been identified and quantified by an extraction-derivatisation procedure involving their reaction with 3,5-di(trifluoromethyl)benzoyl chloride (DTFMBCl) in the aqueous phase followed by extraction into an organic solvent, hydrolysis of phenolic esters, and conversion of free hydroxyl groups to trimethylsilyl ethers. Subsequent analysis of these DTFMB-trimethylsilyl derivatives by gas chromatography-negative ion chemical ionisation mass spectrometry revealed that the molecular ion carried most (greater than 60%) of the ion current, which made the method highly specific and gave a potential limit of detection below the picogram level. This method establishes unequivocally that the principal amines in bovine retina are p-tyramine, dopamine, and 5-hydroxytryptamine.

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Possible mechanisms of action of a combination of ethinylestradiol (EE) and dl-norgestrel as a postcoital contraceptive agent were studied in 12 healthy female volunteers. An oral dose of 0.1 mg of EE and 1.0 mg of dl-norgestrel was given at the predicted time of ovulation and again 12 hours later. Serum luteinizing hormone, prolactin, progesterone, 17 alpha-hydroxyprogesterone, and estradiol were measured by specific radioimmunoassays in blood samples obtained daily from the 8th day of the menstrual cycle to the 1st day of menses. Hormone profiles suggested that the medication elicited a range of individual variations in pituitary and/or ovarian responses. Histologic examination of the endometrium consistently showed significant alteration in endometrial development with a dissociation in maturation of glandular and stomal components. This postcoital contraceptive acts either by (1) suppressing ovulation or (2) disrupting luteal function by acting directly on the corpus luteum or by interfering with appropriate endometrial responses to ovarian steroids.

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Numerous well-documented endocrine effects of oral contraceptives (OCs) can be subdivided into two groups: (a) those relating to the hypothalamic and pituitary-ovarian system, the breast and the genital tract of the human female and (b) those related indirectly to laboratory testing of other endocrine glands. Benefits from OC use include marked decreases in the incidence of menorrhagia, benign breast disease, dysmenorrhea, iron deficiency anemia, premenstrual tension and ovarian cyst formation--all of which will be discussed only briefly. Of much concern are two suggested adverse effects of OCs: (a) the development of amenorrhea or menstrual disturbance associated with anovulation after discontinuing OCs, thereby possibly influencing the future fertility of former OC users, and (b) the suggested relationship between hyperprolactinemia and the development of micro- and eventually macropituitary adenomas. A review of the literature, along with our own findings, is presented.

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Most clinical trials to date have demonstrated the effectiveness of 2-bromo-alpha-ergocryptine in suppressing the onset of puerperal lactation and confirmed the postulative mechanism of action by suppression of serum prolactin concentrations during its administration. The present study involving 112 patients was carried out to demonstrate the dose response and the timing of the administration. The drug was administered in two dose schedules of 1 mg t.i.d. and 2.5 mg b.i.d. commencing immediately after delivery and continued for 14 days. A third group of patients had 2.5 mg administered b.i.d. only after acute engorgement became a problem in the post-partum period. The drug was just as effective in the lower dose schedule and almost complete relief of pain and engorgement spared both the patient and the nursing staff many complaints. A dramatic relief was also obtained within 48 h even after engorgement had occurred and an overall incidence of rebound filling of 19% is similar to that reported by others.

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This article is a discussion between two family doctors and three consultants about the problems of consultation from both points of view. Some suggestions are made as to how we might improve the quality of this part of our medical practice.

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The management of prolonged pregnancy still remains controversial, although most now accept that perinatal mortality and possibly morbidity are increased when pregnancy exceeds 42 weeks gestational age. Accurate diagnosis must commence with the first prenatal visit, since retrospective documentation is impossible. Except for elective induction of a few special high risk pregnancies, the problem can be well managed with the use of frequent urinary estriol determinations and selective amniocentesis. Careful monitoring and detection of fetal distress with early intervention are essential in eliminating this problem with elective cesarean section in a selected few. A combination of low estriols and prolonged pregnancy should always be an indication for maternal X-ray to eliminate anencephalic monsters.

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The management of infertility rests on correct diagnosis of the reasons for failure to conceive. Both marriage partners must be examined and an adequate history taken of both. Dealing with infertility in women involves taking complete menstrual history, testing for endometriosis, examination of the cervix, testing for sperm antibody and investigation of the tubal factor. Endocrine disorders deserve special attention, especially those which point to failure to ovulate. Finally, there are many cases where no adequate reason for failure to conceive can be found-for these cases supportive therapy is the only treatment.

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