We utilized an ultrasensitive recombinant cell bioassay to measure serum estradiol in 800 normal children from birth through puberty. 105 children had repeat samples every 4 months as they approached puberty. We measured estradiol levels every hour for 24 hours in 55 children. Estradiol increased with age and pubertal stage in girls and boys, and was higher in girls than boys at each stage. Prepubertal girls have estradiol levels of 1.6 +/- 2.6 pg/ml. Prepubertal boys have estradiol levels of 0.4 + 1.1 pg/ml. Estradiol had a diurnal variation in girls and boys, with the trough occurring 08.00-20.00 h in girls, and 12.00-20.00 h in boys. We confirm that estradiol levels are higher in girls than boys even before physical signs of puberty, and that estradiol increases throughout puberty in girls and boys. This 10-year experience in 800 children shows the range and variability of estradiol by an ultrasensitive bioassay.

These preliminary data demonstrate promising short-term outcomes for high-risk complex hernias repaired with biologic mesh, particularly SurgiMend, but the long-term durability of these biological materials is yet to be determined.

One of the most important issues in women's health concerns the risks and benefits of estrogen replacement therapy. Continual uncertainty and lack of consensus regarding estrogen replacement therapy has driven many women to seek alternative sources of estrogen, including herbal remedies. We adapted a recombinant cell bioassay to measure estrogen bioactivity in herbs. We studied, in vitro, estrogen bioactivity in red clover, dong quai, black cohosh, soy, licorice, chaste tree berry, fo-ti, and hops. Soy, clover, licorice, and hops have a large amount of measurable estrogen bioactivity, as suspected, based on previous reports using other methods. We discovered surprisingly high estrogen activity in extracts of fo-ti not previously reported. Chaste tree berry, black cohosh, and dong quai did not have measurable activity with this method. We also discovered that removal of a glycone group from soy increases its estrogen bioactivity significantly. We conclude that this recombinant cell bioassay for estradiol can be used to measure bioactivity in herbal products. The preparations of fo-ti studied had estrogen activity of 409 +/- 55 pmol/liter estradiol equivalents per microgram of herb, which is 1/300 the activity of 17 beta-estradiol. Clinical studies are underway to determine the estrogen bioactivity in women using dietary supplements containing these herbs.

Variable dosing of leuprolide acetate is needed to achieve similar amounts of hormonal suppression, yet small changes in dose did not significantly change LH or estradiol levels or predicted height.