Since harmful effects of estrogens in murine lupus are well established, we studied the influence of oral contraceptive therapy on systemic lupus erythematosus activity in 26 female patients with lupus nephropathy. Combined preparations containing either 50 pg (14 patients) or 30 pg (7 patients) of ethinyl-estradiol were used in 21 courses in 20 patients. Initial manifestations or exacerbations of systemic lupus activity appeared within 3 months of beginning hormonal therapy in 9 patients, an overall incidence of lupus flare-up of 43%; there was major renal involvement in 4 patients. Conversely, evidence of lupus exacerbation did not develop in any of 11 patients who received pure progestogen oral contraceptive therapy with either continuous low-dose norsteroids (6 patients) or discontinuous progestogens at normal dosage (5 patients). These patients were followed for 5-30 months. Our data indicated that oral contraceptive therapy that used estrogens, even at From the

Data of 22,691 observations on parturition related problems (dystocia, calf mortality, milk fever, retained placenta, and mastitis) were collected from 27 cooperating California dairy herds. Age at first calving did not affect calving difficulty; thus, an optimal age for first calving was not identified. Decisions on breeding virgin heifers should be based on size of cow because of the effect of size of cow on difficulty at first parity. Small calves experienced greatest mortality at parities greater than one; however, large calves had greater mortality at first parity. Greater mortality for large calves at first parity was partially due to the increased difficulty associated with larger calves. Calving difficulty resulted in impaired reproductive performance (more days open, more services, and more days to first breeding) and decreased 30-day milk production but had no effect on 90-day milk production and 305-day mature-equivalent milk production. Dystocia, milk fever, and retained placenta occurred as a complex. Incidence of dystocia and calf mortality decreased with parity, and all other problems increased with parity.

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Because women comprise the majority of patients with systemic lupus erythematosus (SLE) (1) and androgens confer protective effects in murine lupus (2-5), it seems possible that sex-linked hormonal factors may modulate the expression of the disease. Serum testosterone levels have already been studied in men who have SLE (6,7), but data on androgen metabolism in women who have SLE are still lacking. We assessed plasma androgen levels in female SLE patients. Preliminary results in the quiescent phase of the disease showed low plasma androgen levels (8); now we have completed our tests and also studied patients during the active phase of their disease. PATIENTS AND METHODS Patients. Thirteen female SLE patients between 18and 42 years of age were studied. All had regular menses, none of them had received oral contraceptive therapy, nor had any been previously treated with cyclophosphamide; liver enzymes were normal in all at the time of study.The patients were divided into two groups (Table I), according to the disease activity defined on a clinical basis From the Departments of Nephrology and Gynecologyendocrinology and Inserm U 25, Necker Hospital, 75015 Paris, and from the Fondation de Recherche en Hormonologie,