혈중 Estrogen의 생물학적 미량측정법과 이상월경에 대한 임상적 검토 = Bioassay of Blood Estrogen in Women with Abnormal Menstruation using Intravaginal Method

다국어 초록 (Multilingual Abstract)

Blood estrogen level is an excellent indicator for the evaluation of the ovarian function in women, but the measurement of urinary extrogen has been generally applied. However, this is not a reasonable method because the uninary excretion of metabolic products of steroid hormones is influenced by the collection rate in the process of extraction and function of liver or kidney. Several chemico-physical methods and available for the measurement of blood estrogen, but these methods require blood sampling of large amount, highly expensive apparatus and complexity in isolation and purification in clinical application. Even in bioassay, Allen-Doisy or Astwood`s method which are generally used requires a large volume and high concentration of blood. Besides, intravaginal modification of the original Allen-Doisy method introduced by Berger and Emmens has been paid little attention because of a difficulty in coverting into standard weight unit or international unit. But as compared with other biological methods, advantages claimed for this intravaginal method are requirement of the small amount of blood, repeated use of test animal without a danger of anaphylactic shock, higher sensitivity(more than 1,000 times as compared with that of subcutaneous injection), and shortening of test duration. With the above advantages, the author applied this intravaginal method using mouse, and obtained an equation of linear regression (Y=37.9677=9.9702 log X) respresenting dose- response relationship to convert estrogen index by vaginal smear to weight unit. Clinical studies were performed on 14 cases with normal menstrual cycle, 8 cases of primary or secondary amenorrhea, 7 cases of hypomenorrhea, 6 cases of gypermenorrhea, 4 cases or polymenorrhea, 4 cases of oligomenorrhea and 5 cases of functional uterine bleeding, and the following results were obtained. 1) In the preliminary dose-response experiment, it was disclosed that one mouse vaginal unit was 0.001㎍ of estradiol per 0.1 ml of standard solution. 2) In normal menstrual cycle, blood estrogen level was cyclically changed with two peaks at the ovulatory and premenstrual phases. Estrogen Amount(㎍)/Serum Volume(ml) Menstrual phase : 0.001/0.1 Postmenstrual phase : 0.008/0.1 Ovulatory phase : 0.051/0.1 Postovulatory phase : 0.010/0.1 Premenstrual phase : 0.016/0.1 3) The average level of blood estrogen in amenorrhea, 0.006㎍/0.1 ml, was very low. 4) The average level of blood estrogen in oligomenorrhea, 0.010㎍/0.1ml, was low. 5) The average level of blood estrogen in hypomenorrhea, 0.006㎍/0.1ml, was very low. 6) In hypermenorrhea or polymenorrhea, there was little difference as compared with the average level of the ovulatory and premenstrual phases of normal menstrual cycle. 7) The average level of blood estrogen in functional uterine bleeding, 0.047㎍/0.1ml, was very high.