Carcinoma of the vulva arising in condylomata acuminata.

A case of carcinoma of the vulva arising in condylomata acuminata is presented. The patient was much younger than is classically reported for carcinoma of the vulva. The vulvar growth was first noted during pregnancy, and it continued to grow and enlarge following delivery. Malignancy appeared to develop after a relatively short time. It is sometimes difficult to distinguish vulvar condylomata acuminata from carcinoma from clinical evidence alone. It is, therefore, mandatory in doubtful cases to take multiple biopsies from the lesion before treatment is instituted.

The hysterographic diagnosis of stromal endometriosis.

The hysterographic appearances in three histologically verified cases of stromal endometrosis are presented. Interpretation of the unusual radiographic findings on the basis of uterine pathology is attempted. Little is known about the preoperative diagnosis of the disease. A triad of uterine enlargement, endometrial stromal hyperplasia with few or no glands in the curettings and unusual hysterographic findings strongly suggests a diagnosis of stromal endometriosis.

Subdermal levonorgestrel implants and pituitary function.

This study was designed to report changes in circulating FSH, LH, and prolactin levels in women users of subdermal levonorgestrel implants. The subjects comprised 21 women implanted with 6 silastic rods, each containing 34 mg levonorgestrel, between days M0 and M+4 of the menstrual cycle. Blood samples were drawn prior to, 1 month and 6 months after implantation, during the early follicular phase in menstruating (n=12), and randomly in amenorrheic (n=9) subjects. No significant differences were noted between the mean values of estimated hormones at the 3 intervals of estimation in both regularly menstruating and amenorrheic groups.

Chronic pelvic pain in Lippes IUD users. Laparoscopic and venographic evaluation.

PIP: 39 women using the Lippes loop C, and complaining of chronic pelvic pain dating from after insertion of the IUD, were investigated by laparoscopy and transuterine pelvic venography in the premenstrual period of the cycle. Patients complaining only of cramp-like pain similar to spasmodic dysmenorrhea were not included. Other types of pain noticed were dull aching low abdomen, deep seated pelvic pain with associated dyspareunia, and low backache mainly on the sacrum. Pain was attributed to the presence of pelvic variocele diagnosed by laparoscopy (52%), and venography (95%), chronic pelvic inflammatory disease (28%), and pelvic adhesions (8%). The sites of maximum pain correlated well with the sites of maximum varicosities and/or venous stasis. Menorrhagia was associated with pain in one-third of the cases and was explained on the basis of increased pelvic vascularity, chronic pelvic inflammatory disease, and cystic changes in the ovaries. The possible factors predisposing to uterine perforation during venography in 3 cases are discussed.^ieng

Amniotic fluid proteins and lipids in normal and high-risk pregnancies and their relation to foetal outcome.

Amniotic fluid total lipids (T.L.), lipid phosphorus (L.Ph.), phospholipids (Ph.L.), total cholesterol (T.Ch.), total proteins (T.P.) and inorganic phosphorus (I.Ph) were determined in a number of high risk pregnancies and compared to parallel data obtained for full term normal pregnancies. Amniotic fluid T.L., L.Ph., Ph.L. and T.Ch. were significantly decreased in diabetic and toxaemic cases. The decrement in L.Ph. and Ph.L. was more pronounced in diabetic and toxaemic mothers who delivered either still-births or neonates suffering from RDS or in cases of intrapartum death. The L.Ph. and Ph.L. were increased in case of toxaemic mothers who delivered living neonates with no RDS. In spite of the increase in T.Ch. in the same cases; the ratio of T.Ch to T.L. was constant except in cases with prolonged intrauterine foetal death where it was increased.