Ovarian epithelial dysplasia in relation to ovulation induction and nulliparity.

OBJECTIVE: The goal of this study was to assess the relationship between ovulation induction, nulliparity, and ovarian epithelial dysplasia. METHODS: This retrospective cohort study was performed in one teaching and one district general hospital in London. The subjects, 83 women who had undergone hysterectomy and bilateral oophorectomy and whose ovaries were reported as "normal," were divided into three groups: ovulation induction (13), nulliparity (20), and fertile controls (50). These ovaries were independently reviewed by two pathologists who assigned a score of 0, 1, or 2 to nine epithelial cytological and architectural features. The main outcome measure was the total dysplasia score, which was used to quantify the degree of ovarian epithelial abnormality in the three groups. RESULTS: The mean dysplasia score was significantly higher in the women who had undergone ovulation induction than in the fertile controls (7.92 vs 5.70, P = 0.012). The magnitude of the difference between the ovulation induction group and controls remained similar after adjusting for age, parity, and duration of oral contraceptive use (2.17, 95% CI: -0.11-4.44). However, the statistical significance of this difference was reduced (P = 0.062). We did not find any evidence of a difference in dysplasia score between nulliparous women and controls, neither before (P = 0.85) nor after adjusting for age and duration of oral contraceptive use (P = 0.87). CONCLUSIONS: These results suggest a possible association between ovarian epithelial dysplasia and ovulation induction therapy, in accord with previous reports of increased risk of ovarian cancer in women with a history of fertility treatment. The higher dysplasia score could be attributable to the drugs used to induce ovulation or to a genetic susceptibility to ovarian cancer.

Investigation of ethnic neutropenia by assessment of bone marrow colony-forming cells.

Healthy individuals with African ancestry have lower neutrophil counts than Caucasians. It has previously been postulated that this was consequent on either a diminished bone marrow granulocyte reserve or an altered distribution of neutrophils between the circulating and marginated granulocyte pools. Recent indirect evidence supports the former hypothesis. In this study we have compared the number of granulocyte plus granulocyte-macrophage colony-forming units (CFUs) in the bone marrow of healthy African and Afro-Caribbean subjects with the number of CFUs in the bone marrow of healthy age and sex-matched Caucasians. We found the group with African ancestry to have significantly fewer CFUs than the Caucasian group. There was no evidence of any qualitative difference between the CFUs of the two ethnic groups: they showed similar sensitivity to granulocyte-monocyte colony stimulating factor and similar enhancement of growth when cultured with a larger range of cytokines. These observations suggest that ethnic neutropenia observed in those with African ancestry is likely to result from reduced numbers of bone marrow progenitor cells in comparison with numbers present in Caucasians.

Internal carotid-artery response to 5% carbon dioxide in women with polycystic ovaries.

Although polycystic ovary syndrome is associated with hypertension, hyperlipidaemia, and insulin resistance, mortality from cerebrovascular disease is not increased. We previously reported lower downstream resistance in the internal carotid artery in women with polycystic ovary syndrome. This study was designed to assess vascular reactivity by measuring the response to inhalation of 5% carbon dioxide. We studied 34 young women with polycystic ovary syndrome, 15 with symptomless polycystic ovaries, and 18 controls.

Internal carotid artery haemodynamics in women with polycystic ovaries.

Although polycystic ovarian syndrome (PCOS) is associated with risk factors for cerebrovascular disease, the available evidence does not demonstrate increased stroke mortality, and it has been suggested that some protective mechanisms must be operating in these women. Haemodynamic changes have been demonstrated in the pelvic vessels and aorta in this syndrome, but there have been no studies of the cerebral circulation. Since insulin resistance is a central feature of PCOS, it is of interest that cerebral blood flow may be altered in diabetic subjects. The present study was designed to assess internal carotid artery haemodynamics in women with PCOS, asymptomatic women with polycystic ovaries (PCO women) and healthy controls. Mean internal carotid pulsatility index, measured using pulsed Doppler ultrasound under standardized conditions, was significantly lower in 35 PCOS and 15 PCO women than in the 18 controls. This was also shown on multiple regression analyses. Peak systolic velocity did not differ between groups. In view of the difficulty of interpreting pulsatility index in low-impedance vascular beds, the 'back' pressure was calculated and found to be lower in women with polycystic ovaries. This is the first demonstration of lower pulsatility index and back pressure (suggestive of reduced vascular tone) in the cerebral circulation of these women, independent of blood pressure, insulin resistance and other endocrine or metabolic factors. Changes in internal carotid haemodynamics may offset the risk of cerebrovascular disease commonly associated with polycystic ovaries.

[Single-dose administration in the treatment with penicillin G (PG) and metronidazole (Me) in primary pulmonary abscesses (a preliminary study)]. / Administrarea în priza unica a tratamentului cu penicilina G (PG) si metronidazol (Me) în abcesele pulmonare primitive (studiu preliminar).

The anaerobic bacteria play the main role in the etiology of the lung abscesses (Finegold, 1989). From this reason, the administration of the association PG and Me (endovenously or per os) gives a high healing rate in our country; 90.5%. The objective of this work was to study the influence of the drug-administration rhythm on the therapeutical results. The drugs were given once daily, several times daily, or in a combination of those 2 modalities. A lot of 38 patients hospitalized between 1.01.94-31.12.95 in the Institute of Pneumophthisiology, was divided in 3 groups: U (11 cases--28.9%), treated with PG: 5-10 mill and Me: 1.5-2 g in one endovenous perfusion, daily: M (18 cases--47.3%), treated with PG: 5-10 mill, one endovenous perfusion daily and Me: 1.5-2 g, 2-4 times daily: F (9 cases--23.8%), treated with both PG: 5-10 mill and Me: 1.5-2 g, 2-4 times daily. Cases with lung abscess and advanced neoplasia, hepato-renal or cardio-pulmonary insufficiencies, were excluded. The hospitalization period was 15-77 days, with an average of 38.3 +/- 26. The proportion of the therapeutical successes, estimated as the disparition of the clinical suppurative symptomatology and the reduction > or = 90% of the lesions and cavity surfaces on the chest X-ray, was for the group U: 90.9% (10 from 11 cases), for M: 94.4% (17 from 18 cases) and for F: 88.9% (8 from 9 cases), the difference being statistical non-significant.