Anti-implantation action of a medicated intrauterine delivery system (MIDS)

The effect of a silastic implant made of polydimethyl siloxane tubing and containing 40 mg of norethindrone acetate has been studied in relation to its effect on the subcutaneous tissue of fifty women. Clinically, induration over the implant was detected in only one of them. The histopathology revealed connective tissue response to the silastic implant. The connective tissue showed progressive condensation and maturation of collagen and was associated with chronic inflammatory cell reaction,mainly mononuclear cells and foreign body giant cells. New capillary formation was also seen. However, no anaplastic changes of the fibroblasts were observed.     

Endometrial histology and progesterone levels in women using norethindrone acetate implants for contraception

The effect of a single implant-D containing 40 mg of norethindrone acetate on the endometrium and serum progesterone, and its mode of contraceptive action was investigated. 20 women aged 20-40 (parity 1-5) had used implant-D for periods of 7-27 months. Endometrial biopsies and peripheral venous bloods were collected between the 16th-28th days of the menstrual cycle. Endometrial dating was done according to the criteria of Noyes et al. 19 of the 20 biopsies taken showed the endometrium in the secretory phase, and serum progesterone levels above 3 ng/ml confirming that ovulation had occurred. The biopsy of the remaining woman showed proliferative endometrium and serum progesterone of 2.15 ng/ml. The dating of the endometrium revealed disparity between stromal, glandular, and vascular components of the specimens; thus, only approximate dates could be assigned to a particular specimen. In the dating of the endometrium, 5 women showed retardation by more than 3 days and 4 women showed enhancement of 3 or more days. The results show that the norethindrone-acetate-containing silastic implant-D does not inhibit ovulation and 1 mode of its interaction in fertility control is by bringing about an imbalance in endometrial maturation during the luteal phase.     

The cytologic history of 245 patients developing invasive cervical carcinoma

A review was made of the cytologic history of 245 patients who developed invasive carcinoma of the cervix, and three groups of patients were identified. Group 1 included 149 patients (60.8%) who had never had a cervical cytologic examination, group 2 included 26 patients (10.6%) whose cytologic history in terms of frequency of examination and or timing was considered to be unsatisfactory, and group 3 included 70 patients (28.6%) whose cytologic history was considered to be satisfactory. Only 53 (35.6%) of the patients in group 1 had Stage I disease. Stage I disease was present in 16 patients (61.5%) of group 2 and in 54 patients (78.6%) of group 3. There was no significant difference between the three groups with respect to site of residence or access to the health care system. Of the patients in group 3, 20 (28.6%) had normal cytologic findings and 50 (71.4%) had abnormal cytologic findings. Of the 50 patients with abnormal cytologic findings, 31 (62.0%) did not have further examination for 6 months or longer after identification of the abnormal smear. The majority of these patients had minor degrees of cytologic abnormalities. A review of 299 original cervical smears revealed that 52 (17.4%) had been significantly undercalled, but only 21 (7.0%) had been undercalled as normal. In this study, 28 patients (11.4%) developed adenocarcinoma. In these patients, staging was unrelated to screening.     

Placental ultrasonographic biochemical and histochemical studies in human fetuses affected with Niemann-Pick disease type A

Placental ultrasonographic, bio- and histochemical studies were performed on four unrelated fetuses affected with Niemann-Pick disease Type A, following prostaglandin-induced abortion at about the 19th week of gestation. An accumulation of sphingomyelin in the placentae of affected fetuses indicates the essential role of the enzyme sphingomyelinase, even during the early stages of gestation. A fair correlation between histochemical localization of sphingomyelin in the placentae and ultrasonographic findings was found, indicating the value of ultrasonic echo wave information in the diagnosis of metabolic disorders.     

Microanalysis of lipids in discrete brain areas of the rabbit following intramuscular administration of steroid contraceptive

The effects of 60- and 90-day administration of a pill containing 0.05 mg ethinylestradiol and 0.5 mg norgestrel on the regional lipid levels of female albino rabbit brains have been investigated. Decreared levels of total lipids, phospholipids, cholosterol, free fatty acids and esterified fatty acids were observed in hypothalamus, hippocampus, amygdaloid nucleus, midline nuclei of thalamus and gyrus cinguli. However, the levels of esterified fatty acids only in the amygdaloid nucleus and that of cholosterol in hypothalamus were significantly increased.     

Free cholesterol levels in plasma from the maternal, placental and fetal circulations during human pregnancy

A sensitive, precise assay for free plasma cholesterol has been developed and used to measure the levels of free cholesterol in plasma samples from sites in the maternal, placental and fetal circulations during human pregnancy. These results demonstrate the removal, during passage through the placenta, of sufficient free cholesterol from the maternal circulation for use as the biosynthetic precursor of placental neutral steroid hormones. There is a suggestion from preliminary data on the arterio-venous differences in the umbilical circulation that a de novo fetal synthesis of cholesterol occurs.     

The effect of cone biopsy on subsequent pregnancy outcome

One hundred and thirty-one pregnancies occurring in 97 patients following cone biopsy were reviewed. Excluding therapeutic abortions, 27.1% of the remaining pregnancies terminated in spontaneous abortions and 11.3% in labor prior to 36 weeks. However, because of other abnormal preceding factors in many of these cases, in only a few could cone biopsy be implicated as a likely etiological factor. The majority of viable pregnancies and labors were uncomplicated. Nonetheless, it would seem advisable to minimize the risk of complications with the use of colposcopy and a “shallow” cone or by the use of cryosurgery in the treatment of preclinical carcinoma of the cervix.     

A study of the lecithin/sphingomyelin ratio of amniotic fluid.

1. There is a significant correlation between lecithin/sphingomyelin (L/S) ratios based on densitometry (L/S)D and L/S ratios based on phosphorus determinations ((L/S)P). 2. The fetal lung is mature when the (L/S)D, determined according to Verhoeven, A.G.J. and Merkus, H.M.W.M. (1974) Clin. Chim. Acta 53, 229--232, is 1.2. This value is equivalent to an (L/S)P of 1.8. 3. The acetone precipitation procedure, introduced by Gluck, L., Kulovich, M.V., Borer, R.C. and Keidel, W.N. (1974) Am. J. Obstet. Gynecol. 120, 142--155, is a necessary step for isolating surface-active lecithin. 4. Standardization of the (L/S)D test is feasible and should permit different laboratories to use the same transition point.     

Evaluation of two dose schedules of 15(S)15 methyl PGF2α methyl ester vaginal suppositories for dilatation of cervix prior to vacuum aspiration for late first trimester abortions

15(S)15 methyl PGF₂α methyl ester was used in the form of vaginal suppositories to evaluate its effect as a cervical dilator prior to vacuum aspiration in 49 women seeking medical termination of pregnancy between 9–12 weeks of gestation. Two dose schedules comprising of 1.0 mg and 1.5 mg vaginal suppositories, inserted three hourly for four times, were used in 25 and 23 women, respectively. At the time of vacuum aspiration which was planned 18 hours after the initiation of treatment, cervical dilatation of 10 mm was observed in all the subjects. The incidence of vomiting was significantly higher in the 1.5 mg dose group as compared to the 1.0 mg group. Serum progesterone levels were measured by radioimmuno-assays before insertion of the 15-me-PGF₂α suppositories and after 18 hours, i.e. just before vacuum aspiration. A significant fall in the progesterone level was observed in all cases.