Physiomorphology of twin transfusion syndrome. A study of 86 twin gestations.

The placentas of 86 pairs of twins were examined and correlated with the clinical characteristics of the neonate. The incidence of twin pregnancy in this group was 1 : 108 deliveries. Fetal prematurity and associated complications in twin pregnancy were the cause of increased perinatal and neonatal mortality.

Spermiation and epididymal maturation of spermatozoa in the bonnet macaque (Macaca radiata) as viewed by scanning electron microscopy.

Spermiation and epididymal maturation of spermatozoa were studied in the bonnet monkey (Macaca radiata) by light and scanning electron microscopy. The morphology, location, and release of residual body were observed during spermiation. Along the epididymal duct, the shape of spermatozoa changed, the constriction at the anulus disappeared, the marginal thickening diminished in length, and the cytoplasmic droplet regressed and moved toward the posterior end of the middle piece. Mature spermatozoa were very similar to those of other Cercopithecidae, and they showed a forward motility and a drop in eosin stainability.

Sperm transport and distribution in the reproductive tract of the female rabbit after intraperitoneal insemination.

PIP: Both live and dead spermatozoa were used to study the transport and distribution of sperm in the reporductive tract of 3 groups of rabbits. The female rabbits studied were: 1) rabbits in estrus and not treated, 2) rabbits injected with 25 IU of human chorionic gonadotrophin (HCG) 12 hours before intraperitoneal insemination, and 3) rabbits injected with HCG 96 hours before insemination. Upon autopsy, it was found that spermatozoa were transported in an abovarian and adovarian direction in the oviduct. Motile spermatozoa were more consistently recovered from the reproductive tract than immotile. Fewer spermatozoa were recovered from the reproductive tracts of pseudopregnant rabbits than rabbits in estrus or at ovulation. Sperm motility and oviduct contraction affect the pickup of spermatozoa by the fimbriae. Since most of the spermatozoa recovered from the oviduct were found in the ampulla, it is suggested that their abundance over those found in the isthmus was due to anatomical barriers in the oviduct created by the isthmus. Oviductal contractility is also seen to affect the distribution of sperm in the oviduct.^ieng

Gonadotropin binding sites in human postmenopausal ovaries.

Glucose-6-phosphate dehydrogenase (G6PD) activity and gonadotropin binding sites were localized within seven postmenopausal ovaries. G6PD was localized in the cells of cortical stroma and hilus using a histochemical technique for the reduction of the tetrazolium salt, Nitro-Blue tetrazolium. Gonadotropin binding sites were localized by autoradiography following incubation of ovarian sections with (125I-hLH) and 125I-labeled follicle-stimulating hormone (125I-hFSH) were identified in the cortical stroma and hilus cells. Since these cells contain G6PD and other enzymes necessary for steroidogenesis and also have the capacity to bind both hLH and hFSH, steroidogenesis in postmenopausal ovaries appears to be controlled by circulating gonadotropins. Blood vessels within postmenopausal ovaries also bound both gonadotropins, but 125I-hFSH binding was often more intense than 125I-hLH binding.

In vitro response of rabbit utero-ovarian ligament to catecholamines.

The response of the rabbit utero-ovarian ligament to catecholamines has been studied in vitro, with contractile activity being recorded isometrically from whole rabbit ligaments obtained under various hormonal conditions. Both the catecholamines norepinephrine (NE) and epinephrine (EPI) produced dose-dependent (10(-2) mug/ml threshold; 10(2) mug/ml maximum) tetanic contractions of rabbit ligament. There was no difference (P less than 0.05) between estrous and ovulatory ligaments either in terms of the dose-response curves or maximal force of contraction. Both agonists were 100% antagonized by the alpha-blockers, phentolamine and phenoxybenzamine. The beta-agonist, isoproterenol, had little effect on ligament tonus but did inhibit spontaneous activity and attenuated the response to both NE and EPI. Propranolol, a beta-blocker, slightly (less than 10%) potentiated the stimulatory effects of NE and EPI. It is concluded that the utero-ovarian ligament of the rabbit contains predominately alpha-stimulatory and possibly weak beta-inhibitory receptors analogous to receptors in ovarian and oviductal smooth muscles.

Ureaplasma urealyticum (T-mycoplasma) in vaginal fluid and cervical mucus from fertile and infertile women.

Ureaplasma urealyticum (T-mycoplasma) was isolated more frequently and in heavier growth from cervical mucus (49%) than from vaginal fluid (34%). It was isolated in 24% of vaginal fluid samples and in 35% of cervical mucus samples from fertile women, and in 29% of vaginal fluid samples and in 47% of cervical mucus samples from infertile women. The incidence of infection was high following abortion or total hysterectomy and during pregnancy or oral contraceptive use. T-mycoplasma was also isolated from the vaginal fluid and cervical mucus of a woman with tubo-ovarian abscess, but was not present in women with Trichomonas vaginalis infection. U. urealyticum did not alter the physiophysiologic characteristics of vaginal fluid and cervical mucus or the sperm penetration and sperm viability in cervical mucus. Treatment with tetracycline eradicated the organism in 88% of the infected women. Pregnancies were recorded during a 6-month follow-up in 1 of 19 infertile women who were treated with tetracycline.

Ultrastructural changes in human endometrium with copper and nonmedicated IUDs in utero.

Scanning and transmission electron microscopy were used for a study of the surface and glandular ultrastructure of human endometrium in the presence of different types of IUDs at comparable phases of the menstrual cycle. The aim of the study was to compare the effect of the nonmedicated with the copper and multiload copper devices to further explain the differences in their contraceptive potencies and their mechanism of action. The endometrium was evaluated at and away from the IUD; emphasis was put on the ultrastructure of endometrial gland openings, secretory activity, cellular glycogen content, ciliated cells, microvillous pattern, and kinocilia. The changes of the surface ultrastructure of the endometrium in the presence of copper IUDs were more extensive in this study than those previously reported. There seems to be a direct relationship between the amount of copper incorporated in the device, the degree of ultrastructure changes, and the area of endometrium involved. Copper devices affect the endometrial cells away from the IUD. The altered secretory function with disturbed macroapocrine secretion, the abnormality of ciliated cells, and the defective microvillous growth seem to interfere with the physiologic and functional integrity of the endometrium, reducing the chances of contraception in the presence of copper IUDs.

Surface ultrastructure of preimplantation baboon embryos.

Scanning and transmission electron microscopy were used to study baboon preimplantation embryos 3 to 5 days E.F.A. (estimated fertilization age), ranging from about 16 to more than 60 cells. The peripheral blastomers were covered with microvilli scattered on the convex outer surface and along the borders of the intercellular furrows. In younger morulae, some longer microvilli may bridge over the furrow separating contiguous blastomeres. A few blastomeres showed poorly developed microvilli. Blastomeres of smaller diameter than the others may arise from more recent cleavage. Cell junctions as well as small intercellular spaces were noted at the apposition of the blastomere plasma membranes whereas surface intercellular ridges were not observed.

Maternal malnutrition, low birthweight and related phenomena in man. Physiological and behavioral interactions.

The variables producing lowered birthweight include prematurity, maternal genetic tendencies, low prepregnancy weight, low weight gain during pregnancy, pathologies of pregnancy, multiple births, maternal malnutrition, and intrauterine growth retardation. Reductions in intelligence related to low birthweight are distributed equally among different socioeconomic groups. However, when mental subnormality is used as the criterion of impairment, low socioeconomic status is a better predictor of poor outcome than low birthweight. Even when general intelligence is not impaired, low birthweight children show specific cognitive, perceptual and behavioral signs of organic brain damage. In the absence of frank congenital abnormality, absolute birthweight is a better predictor of impaired intelligence than intrauterine growth retardation. Maternal malnutrition during the period of pregnancy does not influence offspring intelligence. Malnutrition throughout the maternal and offspring lifespan does impair intelligence, especially when surrounding social conditions are counterproductive to its development.

The human semen and fertility regulation in the male. International Conference in Andrology.

An international conference in andrology was held on April 24, 25 and 26, 1975, at the C. S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, Michigan. Eighty-five papers were presented by 165 contributors from Austria, Argentina, Belgium, Canada, Denmark, Finland, France, Germany, Japan, Netherlands, Norway, South africa, Spain, Sweden, Switzerland, Thailand, the United Kingdom and the U.S.A. Eleven sessions of the conference dealt with testicular and epididymal physiology; functional anatomy of spermatozoa; sperm motility and migration; seminal plasma; seminal proteinases and their inhibitors; endocrine-andrology; immunoandrology; neuro-andrology; clinical andrology (diagnostic, endocrine, therapy and surgical); artificial insemination and male contraception.

Egg transport and postcoital isthmic contractility in the rabbit.

Both pre- and postcoital isthmic contractility were recorded in vivo in the rabbit by using balloon-ended catheters, filled with fluid and placed in the isthmic lumen of the oviduct. Autopsy was performed at 12, 24, 48 and 72 hours postcoitum (PC). Segmental flushing of the contralateral oviducts correlated isthmic contractility with egg transport. At 12 and 24 hours PC, when the majority of eggs reached the ampulla, the isthmic activity increased, involving both active contractions and resting pressure fluctuation. This active pattern caused an increase in the isthmic intraluminal pressure on occlusion of the isthmus and retention of the eggs at the ampullary-isthmic junction. At 48 hours PC, when the majority of eggs were in the distal isthmus, there were a uniformly low amplitude and highly frequent resting pressure fluctuations without any active contractions. Such a pattern reduced the isthmic luminal diameter, with subsequent isthmic egg locking. At 72 hours PC, when the eggs were transported to the uterus, complete cessation of the isthmic contractility, including resting pressure fluctuations, was associated with abrupt and remarkable alterations in the resting baseline. Since the estimated diameter of the egg, with its mucin coat, was bigger than that of the resting isthmus, the eggs initiated their own transport through the isthmus by stretching the adjacent walls.

Scanning electron microscopy of nonfunctional human ovaries.

Samples of ovaries taken from fertile and infertile patients, 23 to 32 years of age, were fixed in 2.5% buffered glutaraldehyde, processed by critical point drying, sputter coated with gold palladium and viewed by scanning electron microscopy. Cell cores proliferating from the tunica albuginea into the stroma were made up of an epithelium similar to that covering the ovarian surface. Ovarian papillae, arising from the ovarian surface, were covered with typical polyhedral superficial cells. The oocyte and granulosa cells were connected by means of microvilli, desmosomes and gap junctions. After ovulation the stigma was occupied by a mass of connective tissue to which were attached red blood cells (coagulated blood) and residual follicle cells. In the postovulatory follicle the adjacent superficial epithelium underwent extensive proliferation to repair the rupture point. The anovulatory ovaries were completely covered with superficial epithelium, which was packed tightly and exhibited dense microvilli, blebs, solitary cilia, ruffles, filopodia and different types of cytoplasmic projections. This was in contrast to the ovulatory ovary, in which the superficial epithelium seemed to be localized only in certain areas and the site of the follicular rupture was not completely repaired by superficial epithelium.

Rapid transport of alien eggs transplanted 66 hours post coitum in the oviduct of the rabbit.

Alien (fixed and stained) rabbit ova were transferred into the oviduct of recipient rabbits 24, 48, 60, and 66 hours post-coitum and were observed at 48, 72, 72, and 72 hours post-coitum respectively, using a clearing technique. In all cases the transport of alien eggs was accelerated, so they caught up with native eggs. Alien eggs, transferred to the ampulla 66 hours post-coitum were transported to the uterus within six hours.

Symposium on scanning electron microscopy of fertility and infertility, Eighth Congress of Fertility and Sterility, Buenos Aires, Argentina, November 1974. Human vaginal adenosis and adenocarcinoma.

PIP: Samples of vaginal tissue were obtained from patients with a recorded history of exposure to nonsteroidal estrogens such as diethylstilbestrol (DES) in utero as well as from patients not exposed to DES but undergoing vaginal operations for other reasons. The tissue was removed from various sites within the vagina and divided into 2 segments, 1 fixed in 10% formalin and the other in 3.5% glutaraldehyde. The formalin series received routine histological analysis. The glutaraldehyde series was further prepared for scanning electron microscopy. As a result of exposure to DES several cervico-vaginal aberrations were noted, the most striking of which were those seen histologically. These have been classified into 5 groups: 1) complete epidermidization - complete replacement by metaplasia; 2) surface epidermidization - residual glands beneath and surface; 3) incomplete epidermidization - mixture of columnar epithelium on surface including crypts and glandlike elements; in-situ or invasive: and 5) squamous cell dysplasia. The differentiation of the early embryonic vaginal epithelium to that of the mature squamous epithelium of the newborn seems to be interfered with by the in utero exposure to nonsteroidal estrogens. It is not known whether this is due to inhibition with steroid estrogens or to some other enzymatic process. As a result of this exposure, vaginal adenosis develops. There is a natural tendency of the body to convert this adenosis to normal squamous epithelium through the process of metaplasia and the 5 states observed represent all phases of this process. In the group of patients in which the metaplastic process is incomplete or in a state of transition both columnar cells and squamous cells exist adjacent to each other and between them cells with variable degrees of metaplastic change. In a few patients these abnormal embryonic cell nests lead to the development of a malignancy, usually a mesonephromal clear-cell adenocarcinoma. Furthermore, within the areas of metaplastically converted squamous epithelium, anaplastic and dysplastic cellular changes also occur, with the potential danger of developing intraepithelial and possibly invasive squamous cell carcinomas of athe vagina.^ieng