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KMID : 0438219720090010287
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Korea University Medical Journal
1972 Volume.9 No. 1 p.287 ~ p.297
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Biological Intravaginal Assay of Blood Estrogen and its Clinical Use
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Abstract
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Measurement and fractionation of blood estrogen are a key to know the delicate change of estrogen in the body and to study the mechanism of estrogenic action and its metabolism, but they have long been replaced clinically with the determination of urinary estrogen due to minimum amount of estrogen in the blood and more difficulty in sampling much amount of blood. In the present time, many chemical methods are developed to determine the minimum amount of estrogen i. e. thin layer chromatography, colorimetry, fluorometry, gas liquid chromatography, double isotope derivative method, competitive protein binding radiossay and their combination, but these methods require so highly expensive apparatus and efforts that it is still far from the frequent clinical use. In biological means, there are original subcutaneous Allen-Doisy test and rat uterine weight method, but these tests also require even 40cc of blood, many animals and high concentration.
Intravaginal modification of subcutaneous Allen-Doisy test has been paid little attention, though advocated by Berger, Emmens and etc., because of its difficulty in control with the international unit or with a standard weight unit.
However the shortcoming of intravaginal assay can be overcome by its high sensitivity (1, 000 times above as compared with that of subcutaneous test), its rapidity and repeated use of the assay animals without danger of anaphylactic death of the animals under test. Furthermore, to convert the assay values obtained by the intravaginal assay into weight unit, author can use an equation of linear regression representing the dose-response relationship.
Summary and Conclusion
1. Biological intravaginal assay was used to determine the minimum quantity of blood estrogen. In the experimental study, 1 mouse vaginal unit was 0.001μg/0.1cc, 50% glycerol. Dose(μg) response (Estrogen Index) relationship was studied using Estrogen Index(E. I.) in scoring smears, and following equation of linear regression was obtained.
Y (E. I. )=37.8908-1-10.0466 log x(x-amount of estradiol, μg)
but
E .I = 3A+ZB+C X10
n-number of the assay animals(mouse)
A-number of the assay animals showing () response
B- " showing () response
C- " showing () response
2. Clinical studies were performed on 18 cases having regular menses of 28 day cycle, 15 abnormal menses, 36 of normal pregnant women, 2 puerperal women and 22 abnormal pregnant women, totally on 93 cases at Han-il Hospital, and following blood estrogen levels were obtained.
1) Normal menstrual cycle.
At advanced follicular phase: 0.0037μg/0.5cc, serum,
ovulatory phase: 0.01μg/0.5cc, serum,
late luteal phase: 0.0085μg/0.5cc, serum.
2) Abnormal menses.
① Amenorrhea, 7 cases: Lower than the estrogen level of normal menstrual cyclic women.
②Oligohypomenorrhea, 5 cases: Markedly decreased than the estrogen level of normal menstrual cyclic women.
③Dysfunctional uterine bleeding, 3 cases: Higher than the estrogen level of normal menstrual cyclic women.
3) Normal pregnancies, 4 cases at each month of pregnancy, total 36 cases, and 2 cases of puerperal women : At the 2nd month of pregnancy 0.0046μg/0.25cc,serum, thereafter estrogen levels were steadily increased, but at the 4th month of pregnancy its value was markedly increased to the level of 0.009μg/0.25cc, serum, and at the 10th month of pregnancy its value attained the peak, 0.16μg/0.25cc, serum. In the puerperium, blood estrogen value was dropped to the level of non pregnant state.
4) Five cases of threatened abortion at the first trimester, 1 case at the mid-trimester and 2 cases of hydatidiform mole: Within normal range. But 2 cases of missed abortion showed very low level than the estrogen levels of the corresponding months of normal pregnancy.
5) Fetal death in utero, 7 cases: All cases revealed very low levels than those of the corresponding months of normal pregnancy indicating the index of feto placental test.
6) Pre-eclampsia, severe 4 cases and I case of diabetic pregnant women: Lower levels than those of the corresponding months of normal pregnancy.
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KEYWORD
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