Detection of helminth infections in dogs and soil contamination in rural and urban areas.

A study was conducted to determine the helminthes in dog's feces and soil samples from urban and rural areas. Six species of nematodes (Toxocara sp, an undetermined nematode larvae, Strongyloides sp larvae, Ascaris sp ova, hookworm ova, Trichuris sp ova) and one species of Cestode (Taenia sp) were found in 175 stool samples. Seventy-eight point nine percent of stool samples were positive for helminthes.

Diagnosis of pituitary gonadotroph adenomas in reproductive-aged women.

Objective: To describe the clinical symptoms associated with the diagnosis of pituitary gonadotroph adenoma in premenopausal women.

Design: Report of three separate cases.

Setting: University medical center.

Patient selection for laparoscopic myomectomy.

Study Objective: To determine if preoperative criteria could select patients who were likely to be managed successfully by laparoscopic myomectomy.

Design: Prospective.

Setting: Two community hospitals.

Patient Selection for Myomectomy via Operative Laparoscopy.

Removal of uterine myomas via operative laparoscopy is controversial. The ability to select patients who are likely to be successfully managed by this approach would eliminate unnecessary morbidity and extended operative times. We studied the ability of clinical examination, ultrasound evaluation, hysteroscopy, and laparoscopic assessment of the uterus to select appropriate candidates for operative laparoscopy.

Utility of an algorithm to diagnose ectopic pregnancy.

In recent years, algorithms have been proposed to evaluate ectopic gestations. To determine the usefulness of an algorithm for a large county hospital, a surveillance project was initiated. During 2 years, 4045 women were screened in the emergency room for pregnancy.

Reliability of ultrasound in predicting uterine leiomyoma volume.

Recently ultrasound has been used to size and track individual myoma volumes for patients undergoing medical therapy. However, little is known about the specific performance characteristics and limitations of this technique with respect to volume measurements. We performed and prospectively interpreted serial ultrasound examinations on myoma patients and confirmed the location, size and number of myomas in the surgical specimens.

Corpus luteum activity in tubal pregnancy.

Corpus luteum activity was monitored in 20 women undergoing nonsurgical management of ectopic pregnancy with methotrexate and citrovorum factor (N = 15) or observation (N = 5). The functional integrity of the corpus luteum was assessed by measuring progesterone and 17-hydroxyprogesterone. Trophoblastic viability was assessed by measuring the immunoreactive beta subunit of human chorionic gonadotropin.

Survey of attitudes regarding the use of siblings for gamete donation.

We conclude that the acceptability of using a sister for gamete donation is high among couples desiring ovum donation. On the contrary, couples undergoing AID generally rejected the concept of using the husband's brother as a known donor. Thus, although similar in concept, disparity exists regarding the use of siblings for gamete donation.

Nonsurgical management of unruptured isthmic ectopic pregnancy: preliminary experience.

Five unruptured isthmic tubal pregnancies diagnosed at laparoscopy were treated with either methotrexate/citrovorum factor rescue (MTX/CF) (n = 4) or observation alone (n = 1). Entry criteria required that the ectopic be fully visualized, no greater than 3 cm in diameter, with intact serosa, and without active bleeding. Treatment selection was based upon preoperative levels of beta-hCG with MTX/CF given to subjects exhibiting a plateaued or rising pattern and observation alone given those with falling levels.

Timely diagnosis of early ectopic pregnancy using a single blood progesterone measurement.

We obtained a single serum P measurement in 70 subjects at risk for an EP. Retrospectively, a P less than 15 ng/ml was 100% predictive of either an EP or otherwise nonviable IUP, while P greater than 15 ng/ml would have ruled out an EP in all cases. Because of this high degree of diagnostic accuracy, we speculated on the clinical utility of an outpatient D and C for those patients in our series having a P less than 15 ng/ml.

In-vivo blastocyst production and ovum yield among fertile women.

We evaluated ova recovered from 13 fertile women undergoing uterine lavage for purposes of embryo donation, and assessed differences in blastocyst production and ovum yield among subjects. Six women produced 10 blastocysts during 31 insemination cycles (32%). Yet, despite undergoing at least four insemination cycles apiece, seven women produced no blastocysts in 52 lavage attempts.

Nonsurgical management of unruptured ectopic pregnancy: an extended clinical trial.

Unruptured tubal pregnancies diagnosed at laparoscopy were treated with either methotrexate/citrovorum factor (MTX/CF) (n = 21) or observation (n = 5). Entry criteria required that the ectopic pregnancy be visualized, less than or equal to 3 cm in diameter, with intact serosa and no active bleeding. Treatment selection was based upon preoperative levels of beta-human chorionic gonadotropin (beta-hCG), with MTX/CF given to subjects exhibiting a plateaued or rising pattern and observation alone given to those with falling levels.

Scanning electron microscopy of the endometrium in functionally agonadal women receiving steroid replacement therapy with polysiloxane vaginal rings and cylinders.

We prepared a group of five agonadal women to receive donated embryos by delivering physiologic concentrations of 17 beta-estradiol (E2) and progesterone (P4) through a polysiloxane vaginal ring and cylinder delivery system. In order to detect endometrial surface ultrastructural asynchrony that might reduce prospects for successful embryo transfer, we performed scanning electron microscopy (SEM) on biopsies obtained from these five women and compared them against those from four normal, spontaneously ovulating controls. Light microscopy revealed all nine women to be in the late luteal phase (day 26 +/- 2) and with glandular-stromal synchrony.

Establishing early pregnancy levels of serum progesterone in functionally agonadal women using polysiloxane vaginal rings and cylinders.

Using a polysiloxane cylinder impregnated with crystalline progesterone (P4), combined with a 17 beta-oestradiol (E2) and P4 vaginal ring, we produced first trimester pregnancy levels of serum P4 in six functionally agonadal women scheduled for transfer of donated embryos. With this 4 g P4 cylinder worn from cycle day 15 to day 30, overall mean serum P4 concentrations were 15.03 +/- 1.

The medical treatment of unruptured ectopic pregnancy with methotrexate and citrovorum rescue: preliminary experience.

Seven women with unruptured tubal pregnancies diagnosed on laparoscopy were treated with methotrexate and citrovorum rescue. Criteria for inclusion in the study were that the level of human chorionic gonadotropin (hCG) be plateaued or rising, that the ectopic pregnancy not exceed 3 X 3 cm, that the tubal serosa be intact, and that there be no active bleeding. The women were followed with serial measurements of hCG, complete blood counts, and liver function tests.

Polysiloxane vaginal rings and cylinders for physiologic endometrial priming in functionally agonadal women.

17 beta-estradiol (E2)-and/or crystalline progesterone (P)-impregnated polysiloxane vaginal rings and cylinders were tested as a system for endometrial priming in functionally agonadal women awaiting donor embryo transfer. Endometrial tissue was obtained by a transcervical biopsy procedure on simulated cycle day 26. The adequacy of the replacement regimen was judged by endometrial histologic dating, scanning electron micrographs, receptor content, and circulating E2 and P serum concentrations.

Unilateral vulvar edema after intraperitoneal Hyskon administration.

Two patients are presented who developed vulvar edema after intraperitoneal instillation of Hyskon. Regardless of the route of extravasation, Hyskon's high molecular weight and osmotic effects may lead to further soft tissue swelling. Correct diagnosis warrants the exclusion of wound infection, hematoma, or seroma.

Biologic and morphologic development of donated human ova recovered by nonsurgical uterine lavage.

Using uterine lavage performed 5 days after the luteinizing hormone peak, we collected 25 uterine ova from five fertile donors who had had a single, periovular artificial insemination. After examination, all recovered ova were transferred to recipient uteri and resulted in three intrauterine and one tubal pregnancy. Morphologic development ranged from degenerating single-cell ova to mature blastocysts.