The comparative effects of the administration of cortisone, estrogen-progestin, and placebo on the clinical manifestations of the polycystic ovary (Stein-Leventhal) syndrome

To test the use of cortisons administration in treating the polycystic ovary syndrome, 26 patients were treated with placebo tablets for 6 months, followed by 50 mg cortisone acetate daily for 3 months and then 25 mg cortisone acetate daily for 12 months. The patients were then treated with 2.5 mg norethynodrel and .1 mg mestranol daily for 6 months. Basal body temperature, vaginal hormone cytology, glucose tolerance tests, total urinary gonadotropin assays and steroid profile studies were conducted throughout the treatments. The placebo and cortisone therapy failed to regularly induce ovulation, regulate the menstrual cycle, or otherwise improve the patients' condition, and in some of the patients during the cortisone phase, their acne and hirsutism worsened. The estrogen-progestin treatment did cause a considerable improvement in the patients' acne and hirsutism. It is concluded that cortisone administration is not useful in treating the polycystic ovary syndrome and that the syndrome's symptoms are of ovarian rather than adrenal origin.     

Coronary thrombosis in myocardial infarction: Report of a workshop on the role of coronary thrombosis in the pathogenesis of acute myocardial infarction

In recent years the widely held concept that coronary thrombi cause myocardial infarcts has been seriously questioned. On the basis of pathologic studies, several reports have suggested that coronary thrombi do not cause infarcts but instead are the result of infarction. Should these findings become generally substantiated, the antithrombotic approach to the prevention and therapy of ischemic heart disease must be revised. This workshop was organized to examine more closely this issue and to sort out reasons for such divergent views of the role of thrombosis in the pathogenesis of myocardial infarction.     

Linear localized coumarin necrosis

We report a 55-year-old man with coumarin necrosis. This drug eruption is sometimes a devastating gangrenous process in sites with abundant underlying adipose tissue. In our patient, however, it assumed an evanescent limited linear distribution on the skin, prompting this report.     

Corneal Endothelial Transplantation

Patients with visually significant corneal edema, secondary to endothelial dysfunction, before the development of scarring or vascularization, need only have the corneal endothelium replaced to restore corneal clarity. This fact, plus the lack of consistently available donor material, prompted us to evaluate tissue cultured corneal endothelium (TCCE) as a donor source. We have shown that TCCE, when transplanted, can regain normal morphology and physiologic function. To accomplish practical use of autologous stroma, a transparent gelatin membrane which can serve as substrate for endothelial growth in tissue culture, has been developed. This cellular membrane has been transplanted successfully in rabbits with good functional results. It is hoped that ultimately this technique can be developed for routine use in man.