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STEROID HORMONES: Title and subTitle BreakMetabolic Studies in Dermatomyositis, Lupus Erythematosus and Polymorphic Light-Sensitive Eruptions

JOHN H. LAMB, M.D.; EVERETT S. LAIN, M.D.; CORINNE KEATY, Ph.D; ARTHUR HELLBAUM, M.D., Ph.D.
[+] Author Affiliations

Read at the Sixty-Seventh Annual Meeting of the American Dermatological Association, Inc., Murray Bay, Quebec, Canada, June 2, 1947.

This study has been aided in part by grants from the Oklahoma Medical Research Foundation and the National Research Council.


OKLAHOMA CITY

From the Departments of Dermatology and Syphilology and Pharmacology, School of Medicine of the University of Oklahoma, Oklahoma City.


Arch Dermatol. 1948;57(5):785-801. doi:10.1001/archderm.1948.01520180002001
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Published online

NUMEROUS observations point to a relationship between the steroid hormones and certain dermatologic disorders. This is particularly true in certain conditions associated with profound systemic and metabolic changes. Significant sex incidences are common.1 Cutaneous sensitivity to allergens has been reported to have its peak at the time of greatest estrogen deprivations in women.2 Furthermore, the correlation of the time of onset of certain cutaneous diseases, exacerbations or remissions with epochs of life during which hormonal balances are undergoing change is significant. Sterilization in women is known to affect the course of some of these diseases.3

Hormonal determinations have been largely confined to the study of acne.4 Various methods have been employed in these determinations, in most instances making it difficult to compare the results quantitatively. Methods in use at the present time for estrogen determinations do not consider quantitatively or qualitatively the various types of estrogens and,

REFERENCES

Rose, E., and Pillsbury, D. N.:  Lupus Erythematosus (Erythematodes) and Ovarian Function: Observations on Possible Relationship, with Report of Six Cases , Ann. Int. Med. 21:1022, 1944;.
Sarateanu, F.:  Sommer Prurigo Hutchinson , Zentralbl. f. Haut- u. Geschlechtskr. 60:240, 1938;.
Hansen-Prüss, O. C., and Raymond, R.:  Skin, Reactivity During the Menstrual Cycle , J. Clin. Endocrinol. 2:161, 1942;.
Cedarcreutz, A.:  Impetigo Herpetiformis: Serious Case Definitely Cured After Radiographic Castration , Acta dermat. venereol. 20:430, 1939;.
Johnson, J. B., and Mazique, E. C.:  Disseminate Lupus Erythematodes Unsuccessfully Treated with Penicillin: Roentgen Ray Castration and Serum Albumin , Ann. Int. Med. 25:559, 1946;.
Wile, U. J.; Snow, J. S., and Bradbury, J. T.:  Studies on Sex Hormones in Acne: II. Urinary Excretion of Androgenic and Estrogenic Substances , Arch. Dermat. & Syph. 39:200 ( (Feb.) ) 1939;.
Cornbleet, T., and Barnes, B.:  The Hormones and Acne Vulgaris: I. Urinary Assay and Therapeutic Use of Androgen , & Syph. 40:249 ( (Aug) ) 1939;.
McCarthy, L., and Hunter, O. B.:  Failure of Therapy with Grandular Preparations in Acne Vulgaris , & Syph. 35:211 ( (Feb.) ) 1937;.
Hamblen, E. C.:  A Syndrome Characterized by Premenstrual Dermatosis, Polyhypermenorrhea, Dysmenorrhea, Menstrual Headache and an Increased Urinary Excretion of Sodium Pregnandiol Glucuronide , Endocrinology 28:269, 1939;.
Gilman, R. L., in discussion on Stokes, J. H.:  Herpes Gestationis , Arch. Dermat. & Syph. 27:1003 ( (June) ) 1933;.
Sechi, E.:  Herpes gestationis , Gior. ital. di dermat. e sif. 73:1353, 1932;.
Turner, S. J., and Zakon, S. J.:  Herpes Gestationis , Am. J. Obst. & Gynec. 41:525, 1941;.
Semon, H. C.:  Lichen Simplex Controlled by Stilbestrol , Brit. J. Dermat. 54:181, 1942;.
Lynch, W. F.:  Keratodermia Climactericum (Haxthausen) , Arch. Dermat. & Syph. 48:270 ( (Sept.) ) 1943;.
Goldberg, N. M.:  Climacteric Hypersensitiveness to Sun and Effort: Treatment with Follicular Hormone (Theelin) , J. Allergy 6:298, 1935;.
Lancaster, A. H.:  Estrogenic Hormone Therapy in Sunlight Eruptions of the Female , South. M. J. 32:495, 1939;.
Selisky, A. B.:  Neue Behandlungsmethode von Lichtdermatosen , Dermat. Wchnschr. 101:299, 1935;.
Epstein, S.:  I. Studies in Abnormal Human Sensitivity to Light , J. Invest. Dermat. 5:187, 1942;.
Hadley, H.:  Urticaria Solaris , Urol. & Cutan. Rev. 45:406, 1941;.
Zugerman, I., and Gross, P. P.:  A Case Report of Bullous Lichen Planus with Recovery Following the Use of Estrogenic Hormone , Pennsylvania M. J. 47: 571, 1944;.
Dowling, G. B., and Griffiths, W. J.:  Dermatomyositis and Progressive Scleroderma , Lancet 1:1424, 1939;.
Jaeger, B. V., and Grossman, L. A.:  Dermatomyositis , Arch. Int. Merl 73:271 ( (April) ) 1944;.
O'Leary, P. A., and Waisman, M.:  Dermatomyositis: A Study of Forty Cases , Arch. Dermat. & Syph. 41:1001 ( (June) ) 1940;.
Richardson, H. B., and Shorr, E.:  The Relation of the Thyroid Gland to Graves' Disease , M. Clin. North America , 18:791, 1934;.
Robbie, W. A., and Gibson, R. B.:  Rapid Clinical Determination of Urinary 17-Ketosteroids , J. Clin. Endocrinol. 3:200, 1943;.
Swartz, J. H., in Discussion of Dermatomyositis at the Sixty-Fifth Annual Meeting of the American Dermatological Association, Inc., June 21, 1944 .
The Maltine Company, Mead Johnson and Company and Eli Lilly and Company supplied the protein hydrolysates used in these studies.
The Schering Corporation supplied the pellets of testosterone propionate as well as testosterone propionate ("oretone"), and progesterone ("prolution").
Contratto, A. V., and Levine, S. A.:  Subacute Lupus Disseminatus , New England J. Med. 221:602, 1939;.
Curtis, A. C., in discussion on Shaffer, L., and others:  Discoid and Disseminate Lupus Erythematosus , Arch. Dermat. & Syph. 54:467 ( (Sept.) ) 1946;.
Dr. Zola Cooper has given valuable assistance in histologic studies of the photosensitive group of patients.
Krause, R. A.:  On Age and Metabolism and on the Significance of the Excretion of Creatine , Quart. J. Exper. Physiol. 7:87, 1914;.
Duckworth, D. A.:  Creatine Retention Capacity of Boys in Relation to Androgenic Function , J. Clin. Endocrinal. 2:13, 1942;.
Nathanson, I. T.; Miller, R. B.; Towne, L. E., and Aub, J. C.;  The Close Correlation of Androgen and Creatinine Excretion in Normal Children , Endocrinology 28:866, 1941;.
Remen, L.:  Ueber den Abbau parenteral Zugeführten Kreatins-bei Erwachsenen mit erloschener Geschlechtsfunktion , Ztschr. f. d. ges. exper. Med. 86:288, 1932;
 Kreatinurie and Ovarialfunktion , RemenZtschr. f. d. ges. exper. Med. 81:223, 1932;.
Sutton, M. M.:  Creatine-Creatinine Metabolism in Older Patients with Prostatic Enlargement , J. Clin. Endocrinol. 1:882, 1941;.
Read, B. E.:  The Metabolism of the Eunuch , J. Biol. Chem. 46:281, 1921;.
Buhler, F.:  Ueber den Einfluss der Sexualhormone auf den Kreatinstoffwechsel , Ztschr. f. d. ges. exper. Med. 86:638, 1933;.
Schittenhelm, A., and Bühler, F.:  Die Spontankreatinurie bei innersekretorischen Störungen, ihr Vorkommen und ihr diagnostischer Wert , Ztschr. f. d. ges. exper. Med. 95:18, 1934;.
Kenyon, A. T.; Sandiford, I; Bryan, A. H.; Knowlton, K. and Koch, F. C.:  The Effects of Testosterone Proprionate on Nitrogen, Electrolyte, Water Balance and Energy Metabolism in Eunuchoidism , Endocrinology 23:135, 1938;.
Kenyon, A. T.; Knowlton, K.; Sandiford, I.; Koch, F. C., and Lowtwin, G.:  A Comparative Study of the Metabolic Effects of Testosterone Propionate in Normal Men and Women in Eunuchoidism , Endocrinology 26:26, 1940;.
Beard, H. H.; Espenan, J. K.; Koren, A. L., and Pizzolato, P.:  Creatine-Creatinine Metabolism and the Hormones , Endocrinology 29:762, 1941;.
Kenyon, A. T.; Knowlton, K.; Lotwin, G.; Munson, P. L.; Johnson, C. D., and Koch, F. C.:  A Comparison of the Metabolic Effects of Testosterone Propionate with Those of Chorionic Gonadotropin , J. Clin. Endocrinol. 2:685, 1942;.
Coffman, J. R., and Koch, F. C.:  Effect of Testosterone Propionate on Creatinuria , Proc. Soc. Exper. Biol. & Med. 42:779, 1946;.
von Steinach, E.; Kuhn, H., and Pecznik, O.:  Diagnosticher Test für hormonobedingte Störungen der männlicher Sexual Funktion und seine klinische Anwendung , Wien. klin. Wchschr. 49:388, 1936;.
Wohlbach, S. B.:  Vitamin Deficiency Experimentation as a Research Method in Biology , Science 86:569, 1937;.
Hass, G., and McDonald, F.:  I. The Production of Collagen in Vitro Under Variable Experimental Conditions , Am. J. Path. 16:525, 1940;.
Robertson, W. v. B.; Ropes, M. W., and Bauer, W.:  Action of Ascorbic Acid and Hydrogen Peroxide on Collagen and Thymonucleohistone , Proc. Soc. Exper. Biol. & Med. 49:697, 1942;
 The Degradation of Mucins and Polysaccharides by Ascorbic Acid and Hydrogen Peroxide , Biochem. J. 35:903, 1941;.
Edlbacher. S., and Leuthardt, F.:  Die Chemie , Klin. Wchnschr. 12:1843, 1933;.
Junowicz-Kocholaty, R., and Kocholaty, W.:  Arginase , Science 94:144, 1941;.
Klemperer, P. and Pollack, A. D.:  Pathology of Disseminated Lupus Erythematosus , Arch. Path. 32:569 ( (Oct.) ) 1941;.
Richter, C. P., and Barelare, B., Jr.:  Further Observations on the Carbohydrate, Fat, and Protein Appetite of Vitamin B Deficient Rats , Am. J. Physiol. 127:199, 1939;.
Richter, C. P., and Richter, C. D.:  The Dependence of the Carbohydrate, Fat and Protein Intake of Rats on the Various Components of the Vitamin B. Complex , Am. J. Physiol. 131:639, 1941;.
Elsom, M. C., and Machella, T. E.:  Studies of the Vitamins B in the Human Subject: I. The Intake of Thiamine and Its Relation to Other Dietary Constituents in Foods Selected by the Normal Subject , Am. J. Sc. 202:502, 1941;.
Kensler, C. J.; Sugiura, K. L.; Young, N. F.; Halter, C. R. and Rhoades, C. P.:  Partial Protection of Rats by Riboflavin with Casein Against Liver Cancer Caused by Dimethylaminoazobenzene , Science 92:300, 1941;.
Sarett, H. P.; Klein, J. R., and Perlzweig, W. A.:  The Effect of Variations in Protein Intake on Urinary Excretion of Riboflavin, Nicotinic Acid, Pyridoxine and Thiamine in Dogs , Federation Proc. 1:132, 1942;.
Basile, B., and Pecorella, F.:  The Effect of Vitamins on the Renewal of Creatine Compounds in Infants , Pediatria 47:475, 1939;
Chem. Abstr. 35 (pt. (1) .): 779, 1940;.
Edwards, E. A.; Hamilton, J. B.; Duntley, S. C., and Hubert, G.:  Cutaneous Vascular and Pigmentary Changes in Castrate and Eunuchoid Men , Endocrinology 28:119, 1941;.
Reynolds, S. R. M.; di Palma, J.; Hubert, G., and Foster, I.:  Dermovascular Actions of Certain Steroid Hormones in Castrate, Eunuchoid and Normal Men , J. Clin. Endocrinol. 2:228, 1942;.
Reynolds, S. R. M., and Foster, I.:  Peripheral Vascular Action of Estrogen in the Human Male , J. Clin. Investigation 18:649, 1939;.
Carloni, E.:  L'azione degli estratti ovarici sull'atteggiamento dei capillari e sulla loro pressione, nelle varie fasi de la rivoluzione funzionale utero ovarica , Arch. di ostet. e ginec. 17:327, 1930;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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Rose, E., and Pillsbury, D. N.:  Lupus Erythematosus (Erythematodes) and Ovarian Function: Observations on Possible Relationship, with Report of Six Cases , Ann. Int. Med. 21:1022, 1944;.
Sarateanu, F.:  Sommer Prurigo Hutchinson , Zentralbl. f. Haut- u. Geschlechtskr. 60:240, 1938;.
Hansen-Prüss, O. C., and Raymond, R.:  Skin, Reactivity During the Menstrual Cycle , J. Clin. Endocrinol. 2:161, 1942;.
Cedarcreutz, A.:  Impetigo Herpetiformis: Serious Case Definitely Cured After Radiographic Castration , Acta dermat. venereol. 20:430, 1939;.
Johnson, J. B., and Mazique, E. C.:  Disseminate Lupus Erythematodes Unsuccessfully Treated with Penicillin: Roentgen Ray Castration and Serum Albumin , Ann. Int. Med. 25:559, 1946;.
Wile, U. J.; Snow, J. S., and Bradbury, J. T.:  Studies on Sex Hormones in Acne: II. Urinary Excretion of Androgenic and Estrogenic Substances , Arch. Dermat. & Syph. 39:200 ( (Feb.) ) 1939;.
Cornbleet, T., and Barnes, B.:  The Hormones and Acne Vulgaris: I. Urinary Assay and Therapeutic Use of Androgen , & Syph. 40:249 ( (Aug) ) 1939;.
McCarthy, L., and Hunter, O. B.:  Failure of Therapy with Grandular Preparations in Acne Vulgaris , & Syph. 35:211 ( (Feb.) ) 1937;.
Hamblen, E. C.:  A Syndrome Characterized by Premenstrual Dermatosis, Polyhypermenorrhea, Dysmenorrhea, Menstrual Headache and an Increased Urinary Excretion of Sodium Pregnandiol Glucuronide , Endocrinology 28:269, 1939;.
Gilman, R. L., in discussion on Stokes, J. H.:  Herpes Gestationis , Arch. Dermat. & Syph. 27:1003 ( (June) ) 1933;.
Sechi, E.:  Herpes gestationis , Gior. ital. di dermat. e sif. 73:1353, 1932;.
Turner, S. J., and Zakon, S. J.:  Herpes Gestationis , Am. J. Obst. & Gynec. 41:525, 1941;.
Semon, H. C.:  Lichen Simplex Controlled by Stilbestrol , Brit. J. Dermat. 54:181, 1942;.
Lynch, W. F.:  Keratodermia Climactericum (Haxthausen) , Arch. Dermat. & Syph. 48:270 ( (Sept.) ) 1943;.
Goldberg, N. M.:  Climacteric Hypersensitiveness to Sun and Effort: Treatment with Follicular Hormone (Theelin) , J. Allergy 6:298, 1935;.
Lancaster, A. H.:  Estrogenic Hormone Therapy in Sunlight Eruptions of the Female , South. M. J. 32:495, 1939;.
Selisky, A. B.:  Neue Behandlungsmethode von Lichtdermatosen , Dermat. Wchnschr. 101:299, 1935;.
Epstein, S.:  I. Studies in Abnormal Human Sensitivity to Light , J. Invest. Dermat. 5:187, 1942;.
Hadley, H.:  Urticaria Solaris , Urol. & Cutan. Rev. 45:406, 1941;.
Zugerman, I., and Gross, P. P.:  A Case Report of Bullous Lichen Planus with Recovery Following the Use of Estrogenic Hormone , Pennsylvania M. J. 47: 571, 1944;.
Dowling, G. B., and Griffiths, W. J.:  Dermatomyositis and Progressive Scleroderma , Lancet 1:1424, 1939;.
Jaeger, B. V., and Grossman, L. A.:  Dermatomyositis , Arch. Int. Merl 73:271 ( (April) ) 1944;.
O'Leary, P. A., and Waisman, M.:  Dermatomyositis: A Study of Forty Cases , Arch. Dermat. & Syph. 41:1001 ( (June) ) 1940;.
Richardson, H. B., and Shorr, E.:  The Relation of the Thyroid Gland to Graves' Disease , M. Clin. North America , 18:791, 1934;.
Robbie, W. A., and Gibson, R. B.:  Rapid Clinical Determination of Urinary 17-Ketosteroids , J. Clin. Endocrinol. 3:200, 1943;.
Swartz, J. H., in Discussion of Dermatomyositis at the Sixty-Fifth Annual Meeting of the American Dermatological Association, Inc., June 21, 1944 .
The Maltine Company, Mead Johnson and Company and Eli Lilly and Company supplied the protein hydrolysates used in these studies.
The Schering Corporation supplied the pellets of testosterone propionate as well as testosterone propionate ("oretone"), and progesterone ("prolution").
Contratto, A. V., and Levine, S. A.:  Subacute Lupus Disseminatus , New England J. Med. 221:602, 1939;.
Curtis, A. C., in discussion on Shaffer, L., and others:  Discoid and Disseminate Lupus Erythematosus , Arch. Dermat. & Syph. 54:467 ( (Sept.) ) 1946;.
Dr. Zola Cooper has given valuable assistance in histologic studies of the photosensitive group of patients.
Krause, R. A.:  On Age and Metabolism and on the Significance of the Excretion of Creatine , Quart. J. Exper. Physiol. 7:87, 1914;.
Duckworth, D. A.:  Creatine Retention Capacity of Boys in Relation to Androgenic Function , J. Clin. Endocrinal. 2:13, 1942;.
Nathanson, I. T.; Miller, R. B.; Towne, L. E., and Aub, J. C.;  The Close Correlation of Androgen and Creatinine Excretion in Normal Children , Endocrinology 28:866, 1941;.
Remen, L.:  Ueber den Abbau parenteral Zugeführten Kreatins-bei Erwachsenen mit erloschener Geschlechtsfunktion , Ztschr. f. d. ges. exper. Med. 86:288, 1932;
 Kreatinurie and Ovarialfunktion , RemenZtschr. f. d. ges. exper. Med. 81:223, 1932;.
Sutton, M. M.:  Creatine-Creatinine Metabolism in Older Patients with Prostatic Enlargement , J. Clin. Endocrinol. 1:882, 1941;.
Read, B. E.:  The Metabolism of the Eunuch , J. Biol. Chem. 46:281, 1921;.
Buhler, F.:  Ueber den Einfluss der Sexualhormone auf den Kreatinstoffwechsel , Ztschr. f. d. ges. exper. Med. 86:638, 1933;.
Schittenhelm, A., and Bühler, F.:  Die Spontankreatinurie bei innersekretorischen Störungen, ihr Vorkommen und ihr diagnostischer Wert , Ztschr. f. d. ges. exper. Med. 95:18, 1934;.
Kenyon, A. T.; Sandiford, I; Bryan, A. H.; Knowlton, K. and Koch, F. C.:  The Effects of Testosterone Proprionate on Nitrogen, Electrolyte, Water Balance and Energy Metabolism in Eunuchoidism , Endocrinology 23:135, 1938;.
Kenyon, A. T.; Knowlton, K.; Sandiford, I.; Koch, F. C., and Lowtwin, G.:  A Comparative Study of the Metabolic Effects of Testosterone Propionate in Normal Men and Women in Eunuchoidism , Endocrinology 26:26, 1940;.
Beard, H. H.; Espenan, J. K.; Koren, A. L., and Pizzolato, P.:  Creatine-Creatinine Metabolism and the Hormones , Endocrinology 29:762, 1941;.
Kenyon, A. T.; Knowlton, K.; Lotwin, G.; Munson, P. L.; Johnson, C. D., and Koch, F. C.:  A Comparison of the Metabolic Effects of Testosterone Propionate with Those of Chorionic Gonadotropin , J. Clin. Endocrinol. 2:685, 1942;.
Coffman, J. R., and Koch, F. C.:  Effect of Testosterone Propionate on Creatinuria , Proc. Soc. Exper. Biol. & Med. 42:779, 1946;.
von Steinach, E.; Kuhn, H., and Pecznik, O.:  Diagnosticher Test für hormonobedingte Störungen der männlicher Sexual Funktion und seine klinische Anwendung , Wien. klin. Wchschr. 49:388, 1936;.
Wohlbach, S. B.:  Vitamin Deficiency Experimentation as a Research Method in Biology , Science 86:569, 1937;.
Hass, G., and McDonald, F.:  I. The Production of Collagen in Vitro Under Variable Experimental Conditions , Am. J. Path. 16:525, 1940;.
Robertson, W. v. B.; Ropes, M. W., and Bauer, W.:  Action of Ascorbic Acid and Hydrogen Peroxide on Collagen and Thymonucleohistone , Proc. Soc. Exper. Biol. & Med. 49:697, 1942;
 The Degradation of Mucins and Polysaccharides by Ascorbic Acid and Hydrogen Peroxide , Biochem. J. 35:903, 1941;.
Edlbacher. S., and Leuthardt, F.:  Die Chemie , Klin. Wchnschr. 12:1843, 1933;.
Junowicz-Kocholaty, R., and Kocholaty, W.:  Arginase , Science 94:144, 1941;.
Klemperer, P. and Pollack, A. D.:  Pathology of Disseminated Lupus Erythematosus , Arch. Path. 32:569 ( (Oct.) ) 1941;.
Richter, C. P., and Barelare, B., Jr.:  Further Observations on the Carbohydrate, Fat, and Protein Appetite of Vitamin B Deficient Rats , Am. J. Physiol. 127:199, 1939;.
Richter, C. P., and Richter, C. D.:  The Dependence of the Carbohydrate, Fat and Protein Intake of Rats on the Various Components of the Vitamin B. Complex , Am. J. Physiol. 131:639, 1941;.
Elsom, M. C., and Machella, T. E.:  Studies of the Vitamins B in the Human Subject: I. The Intake of Thiamine and Its Relation to Other Dietary Constituents in Foods Selected by the Normal Subject , Am. J. Sc. 202:502, 1941;.
Kensler, C. J.; Sugiura, K. L.; Young, N. F.; Halter, C. R. and Rhoades, C. P.:  Partial Protection of Rats by Riboflavin with Casein Against Liver Cancer Caused by Dimethylaminoazobenzene , Science 92:300, 1941;.
Sarett, H. P.; Klein, J. R., and Perlzweig, W. A.:  The Effect of Variations in Protein Intake on Urinary Excretion of Riboflavin, Nicotinic Acid, Pyridoxine and Thiamine in Dogs , Federation Proc. 1:132, 1942;.
Basile, B., and Pecorella, F.:  The Effect of Vitamins on the Renewal of Creatine Compounds in Infants , Pediatria 47:475, 1939;
Chem. Abstr. 35 (pt. (1) .): 779, 1940;.
Edwards, E. A.; Hamilton, J. B.; Duntley, S. C., and Hubert, G.:  Cutaneous Vascular and Pigmentary Changes in Castrate and Eunuchoid Men , Endocrinology 28:119, 1941;.
Reynolds, S. R. M.; di Palma, J.; Hubert, G., and Foster, I.:  Dermovascular Actions of Certain Steroid Hormones in Castrate, Eunuchoid and Normal Men , J. Clin. Endocrinol. 2:228, 1942;.
Reynolds, S. R. M., and Foster, I.:  Peripheral Vascular Action of Estrogen in the Human Male , J. Clin. Investigation 18:649, 1939;.
Carloni, E.:  L'azione degli estratti ovarici sull'atteggiamento dei capillari e sulla loro pressione, nelle varie fasi de la rivoluzione funzionale utero ovarica , Arch. di ostet. e ginec. 17:327, 1930;.

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