Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels

Endovaginal sonography results were compared with quantitatively determined human chorionic gonadotropin (hCG) levels in 84 women referred for early pregnancy complications. Of the 27 with normal intrauterine pregnancies, an intrauterine gestational sac was prospectively identified in one of five cases (20%) in which hCG levels were below 500 IU/L (Second International Standard), four of five (80%) with hCG levels of 500-1,000 IU/L, and all 17 with hCG levels above 1,000 IU/L. In comparison, 17 of the 26 women with ectopic pregnancies (65%) had hCG levels greater than 1,000 IU/L, and none of the 26 had an intrauterine gestational sac. Endovaginal sonography demonstrated an adnexal mass and/or a gestational sac-like structure in 16 of the 17 cases (94%) in which hCG levels were above 1,000 IU/L, compared with only three of the nine (33%) with lower hCG levels (P less than .01). These findings indicate that an intrauterine gestational sac should be normally visualized with endovaginal sonography when the hCG level exceeds 1,000 IU/L, and that visualization of an extrauterine gestational sac and/or adnexal mass is significantly more likely in ectopic pregnancies when the hCG level exceeds 1,000 IU/L.     

Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women.

The prevalence and associated cytologic manifestations of cervical infection with human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 were studied among 500 consecutive women attending the Harborview Medical Center Sexually Transmitted Diseases (STD) Clinic in Seattle, WA. Using radiolabeled-probes without prior amplification of DNA, HPV DNA was detected in cervical specimens from 120 (24%) of the women and was found to be more prevalent than Chlamydia trachomatis (13%), Neisseria gonorrhoeae (12%), or mucopurulent cervicitis (20%). High-risk HPV types 16 or 18 were present alone in 5% of the women; intermediate-risk types 31, 33, 35, 45, 51, 52, or 56 in 3%; and low-risk types 6, 11, 42, 43, and 44 in 5%. In an additional 8% HPV DNA was detected but could be characterized only as being type 6, 11, 16, 18, 31, 33, or 35. Each grouping of HPV types was equally associated with squamous intraepithelial lesions (SILs) of the cervix. In the absence of SIL and koilocytosis, the cytologic changes associated with HPV infection included frequent binucleation and variation in nuclear size and chromatin distribution. Parakeratosis and hyperkeratosis without nuclear atypia were not associated with HPV DNA. The natural history and clinical significance of these HPV-associated lesions remain to be defined.     

Thymic cysts in mediastinal Hodgkin disease

Three cases of proved thymic cysts associated with mediastinal Hodgkin disease are presented. Two illustrate regression of lymphoma with chemotherapy but persistence of thymic cysts. The third case demonstrates a thymic cyst in untreated Hodgkin disease. These cases suggest that such cysts are probably neither coincidental with nor a consequence of therapy but are probably related to initial thymic involvement by Hodgkin disease.     

Studies on Reproduction in Rats with Meclofenamate Sodium, a Nonsteroidal Anti-inflammatory Agent

Studies on Reproduction in Rats with Meclofenamate Sodium, aNonsteroidal Anti-inflammatory Agent. PETRERE, J. A., HUMPHREY,R. R., ANDERSON, J. A., FITZGERALD, J. E., AND DE LA IGLESIA,F. A. (1985). Fundam. Appl. Toxicol. 5, 665–671. Reproductionand teratology studies were performed in rats given meclofenamatesodium, a nonsteroidal anti-inflammatory agent. Dosages of 0,3, 6, and 9 mg/kg were administered orally as dietary admixturesin the Fertility and Perinatal-Postnatal studies. In the Teratologystudy, dosages of 10, 12, 15, and 20 mg/kg were administeredby intragastric intubation. In the Male-Fertility study no adverseeffects on fertility or litter and offspring parameters wereobserved in two generations. In the Female-Fertility and Perinatal-Postnatalstudies, maternal toxicity (death associated with intestinalulceration and adhesions) was particularly evident during lactation.Prolonged gestation periods, decreased weanling weights, andincreased weanling mortality were evident at dosages of 6 and9 mg/kg. Increased postimplantation loss occurred at 6 and 9mg/kg in the Term Sacrifice subgroup of the Female-Fertilitystudy. Fertility rates were unaffected and all other litterand offspring parameters of the F₁ and F₂ generations appearednormal. In the Teratology study no adverse effects on embryonicor fetal development were evident at maternally toxic dosagesup to 20 mg/kg. © 1985 Society of Texicology.