Abnormal knee mobility and meniscal injury.

Stress radiography for anteroposterior mobility of the knees was performed in 17 patients who had undergone medical meniscectomy and 10 patients who had undergone lateral meniscectomy. Sixteen of the patients were also tested for valgus-varus mobility. An increase in varus mobility following medical meniscectomy was primarily attributed to compression of the medical compartment space.

Recognition and treatment of premenstrual syndrome.

Premenstrual syndrome (PMS) is the title applied to a broad range of physical and psychological symptoms that occur cyclically, usually seven to 14 days prior to the onset of a woman's menstruation, and disappear during menstruation. Although the symptoms of premenstrual syndrome were described more than 50 years ago, recognition of PMS by the medical establishment as a discrete condition, which requires attention and treatment, is a fairly recent development. It is estimated that 30 percent of women experience PMS in a debilitating form at some point in their lifetimes from menarche to menopause.

Evaluation of seven- to nine-year-old children exposed to ritodrine in utero.

Twenty children who had been exposed to ritodrine in the management of preterm labor between 24 and 34 weeks' gestational age were examined at seven to nine years of life and compared with matched control subjects. No significant differences were detected in factors of growth, neurologic findings, and psychometric testing.

Preabortion cervical dilatation with a low-dose prostaglandin suppository. A comparison of two analogs.

Vaginal administration of PGE2 and PGF2 alpha suppositories resulted in cervical changes that facilitated suction curettage termination of 46 first-trimester pregnancies. When 30 mg of 9-deoxo-16,16-dimethyl-9 methylene PGE2 was compared with 0.5 mg of 15(S)-methyl PGF2 alpha suppositories, the cervix-ripening properties of these two agents appeared to be equivalent.

Vasectomy and atherosclerosis in Macaca fascicularis. New findings in a controversial issue.

The influence of vasectomy on diet-induced atherosclerosis was studied in ten Macaca fascicularis monkeys. After a six-month control period the monkeys were divided into two groups and matched for cholesterol levels. Five monkeys were given vasectomies and five sham vasectomies, and all animals were placed on a high-cholesterol, atherogenic diet.

Reliability of antenatal testing: estriol levels versus nonstress testing.

During the third trimester of pregnancy, 334 high-risk patients were followed with antenatal fetal heart rate (FHR) evaluation and with serial determinations of unconjugated plasma estriol. The antenatal FHR tests included nonstress testing (NST) and investigation of beat-to-beat variability. Data indicate that the NST was more reliable than estriol analysis in assessing fetal compromise.

133Xenon clearance from amniotic fluid in baboons during administration of oxytocin, prostaglandin F2 alpha and a beta-mimetic agent.

Amniotic fluid clearance of 133xenon was measured in pregnant baboons near term during a control period of spontaneous uterine activity and during induction of contractions with oxytocin or PGF2 alpha and inhibition of activity by a beta-adrenergic agent, berotec. There was no significant change in the clearance of 133xenon from the amniotic fluid during moderate uterine activity induced by oxytocin or PGF2 alpha. The clearance rate decreased five-fold during infusion of berotec, compared with the control infusion periods, simultaneous with a decrease in uterine activity.

Cervical priming prior to dilatation and evacuation: a comparison of methods.

Vaginal administration of prostaglandin analogues resulted in cervical changes that facilitated dilatation and evacuation in 80 patients in the late first trimester and the second trimester of pregnancy. When 0.5 mg and 1.

Small cell anaplastic lung cancer presenting as an ovarian metastasis.

An unusual case of small cell anaplastic carcinoma of the lung, presenting as a pelvic mass, is presented. Histochemical and electron microscopic findings confirmed the diagnosis. The pathologic features and unique clinical characteristics are discussed with comments on the topic of metastatic ovarian tumors.

A new iud insertion technique utilizing cervical priming with prostaglandin.

Cervical priming with the aid of a single 15-ME-PGF2a vaginal suppository prior to IUD insertion resulted in cervical changes which facilitated the procedure. A 0.5 mg 15(S)-15-prostaglandin F2a methyl ester vaginal suppository was administered one hour prior to the IUD insertion in all patients studied.

Microprocessor-controlled doppler. A new fetal heart rate monitoring technique.

A new Doppler fetal heart rate (FHR) monitoring system using microprocessor-controlled ranged directional Doppler (RDD) was developed. The instrumentation was evaluated for accuracy and reproducibility of results by computer measurement and statistical analysis of the difference between FHR simultaneously obtained from Doppler and from fetal scalp electrocardiography (ECG) in 20 high-risk patients during labor. During 90% to 93.

Meperidine-induced sinusoidal fetal heart rate pattern and reversal with naloxone.

A case of sinusoidal fetal heart rate (FHR) pattern in association with maternal intrapartum administration of meperidine is presented. The sinusoidal pattern was reversed after maternal intrapartum administration of naloxone. The significance of this problem and the management of patients with sinusoidal FHR are discussed.

Automatic detection of fetal movement by Doppler ultrasound during non-stress testing.

A new external fetal monitor, using a defocused, wide-area ultrasound transducer has been devised in order to obtain a more accurate representation of fetal movement during antepartum non-stress testing. The fetal activity Doppler signal is easily distinguished from the fetal heart Doppler and provides an automatic record of fetal movement which is objective and reproducible. In several clinical tests, this new monitor was found to be more sensitive and reliable than either reports of fetal movement from the mother or from a physician palpating the abdomen.

The inhibitory effect of ethanol on oxytocin-induced labor at term.

Intravenous ethanol infusion significantly reduced oxytocin-induced uterine activity in pregnant patients at term. The dose response to oxytocin was linear when plotted log2 x in all patients studied, and the line was shifted to the right by alcohol, but the slope remained essentially unchanged. These results suggest that alcohol directly inhibits the effect of oxytocin on the myometrium, although the possibility of some central inhibition of oxytocin release cannot be discounted.

A new modality in nonstress testing: evaluation of beat-to-beat fetal heart rate variability.

Fetal monitoring equipment that provided accurate external measurement of the interval between each fetal heartbeat permitted the evaluation of beat-to-beat fetal heart rate (FHR) variability as part of routine nonstress testing. Nonstress tests (NSTs) were performed on 350 high-risk patients over a 12-month period. The beat-to-beat FHR variability and the reactivity of the last NST within 7 days of labor were analyzed in relation to the appearance of fetal distress during labor as indicated by late decelerations.

A new abortion technique: intravaginal and intramuscular prostaglandin.

The 15-methyl analog of prostaglandin F2 alpha (15-ME-PGF2 alpha), administered in a 3-mg dose via a single vaginal suppository and supplemented at 24 hours by intramuscular injection(s) of 250 micrograms, successfully induced abortion in 80 of 81 patients in the midtrimester of pregnancy. The mean abortion time was 19.6 hours.

Management of intrauterine fetal death with prostaglandin E2 vaginal suppositories.

The recent Food and Drug Administration's approval of prostaglandin E2 (PGE2) vaginal suppositories provides the clinician with a technique for the immediate management of missed abortion and intrauterine fetal death (IUFD). During a 4-year period at our institution, 78 of 80 patients with gestations ranging from 13 to 42 weeks had pregnancy successfully terminated with PGE2 suppositories with a dose schedule of 20 mg every 2 hours. The mean interval from induction to delivery of the fetus was 8.

Early pregnancy interruption with two 15-ME-PGF2a suppositories.

Vaginal administration of 15-ME-PGF2a suppositories successfully terminated pregnancy, as determined by a negative pregnancy test at 14 days following insertion, in 34 of 39 patients with gestations of 34 to 51 days of amenorrhea. Fifteen of 20 patients who received a single long-acting 3-mg suppository had negative pregnancy tests at follow-up, while all 19 patients in whom the 3-mg suppository was preceded by a rapidly acting 1-mg suppository successfully aborted. This two-suppository regimen resulted in a more rapid onset of uterine activity and vaginal bleeding, as well as a slight decrease in gastrointestinal side effects.