Amniotic fluid accumulation in the first trimester.

Amniotic fluid volume was estimated sonographically in 507 of 977 first trimester pregnancies with living fetuses and in 99 of 227 instances of missed abortion. Volume is correlated with fetal length, cross referenced by average heart rate for living fetuses. Fluid volume increases exponentially after 9 weeks, consistent with the onset of renal function.

Immunologic aspects of IUD action.

Embryo implantation has been demonstrated to depend on specific lymphocyte populations within the uterine cavity. Intrauterine devices (IUD) exert their contraceptive action by prevention of embryo implantation via presently still unknown mechanisms. Therefore, mononuclear cell populations from mice uteri which either contained silastic or copper (Cu) IUD fragments or were sham-operated were evaluated, utilizing monoclonal antibodies against specific cell markers.

Comparison of human chorionic gonadotropin measurements by radioimmunoassay and in vitro bioassay.

A sensitive, accurate, and reproducible in vitro bioassay was developed for measuring human chorionic gonadotropin (hCG), based on testosterone production by collagenase-dispersed interstitial cells of rat testes in response to hCG. The results were compared to those obtained by established beta hCG radioimmunoassay. The assay sensitivity was 25 pg hCG-CR119/ml (65 microIU second IRP/ml).

Laser applications in gynecology.

Laser technology is now applied to many medical fields and has found wide applications in gynecology. Future developments in laser applications in gynecology will probably involve extension of current indications for its use, and the development of other, more sophisticated laser instruments such as the laser hysteroscope that will soon be applied to clinical trials. Familiarity with its mechanics and physical properties can help us safely harness this potentially distractive force and use it effectively as a surgical tool.

Danazol.

Danazol, approved 5 years ago for the treatment of pelvic endometriosis, has recently been approved for treating cystic disease of the breast. As the mechanisms of action of this drug are made clear, the clinical syndromes that can be treated by this impeded androgen have increased dramatically. Results of controlled prospective clinical studies on the drug have increased our understanding of the pathophysiology of several poorly understood diseases.

Removal of a presacral tumor via a Schuchardt incision.

Presacral tumors have been traditionally approached either abdominally or via a transsacral incision. We describe a perineal approach to these tumors. A patient with a presacral benign cystic teratoma is described.

Asymmetric hyperthecosis ovarii.

Testosterone and delta4-androstenedione concentrations, in venous blood obtained by percutaneous retrograde femoral catheterization of the ovarian and adrenal veins bilaterally, demonstrated the left ovary to be the predominant secretory source of androgens in an 18-year-old virilized female. Histologic examination of the excised ovarian tissue revealed asymmetric hyperthecosis ovarii and confirmed the biochemical data. This study demonstrates the accuracy of the venous catheterization method in locating preoperatively the hypersecretory source of androgens in virilized women.