Biomedical subjects
Publications and source records attributed to T B Pokoly.
A unicornuate uterus occurred with an ectopic pregnancy in a noncommunicating tube on the left and a normal tube and ovary with a corpus luteum on the right. In such cases the heterotopic tube should be removed to reduce the risk of ectopic pregnancy and to eliminate competition between the tubes for the transmigrating sperm and oocyte.
Data on cigarette smoking, testicular varicoceles, seminal fluid indexes, and oligospermia were examined in 160 young men without known disease and in 94 husbands in infertile couples. The combination of smoking and testicular varicoceles is strongly related to the incidence of oligospermia, defined as sperm count less than or equal to 20 X 10(6)/ml, in each sample. Smokers with testicular varicoceles, in each sample, had a disproportionately high incidence of oligospermia. In the combined sample of 254 men, the smokers with testicular varicoceles had an incidence of oligospermia approximately ten times greater than that in nonsmokers with testicular varicoceles and approximately five times greater than that in men who smoked but were without testicular varicoceles. This relationship of cigarette smoking and testicular varicoceles to oligospermia has not been previously reported. The pathophysiologic basis of the interaction between smoking and varicoceles was theorized to be due to an increased secretion of catecholamines from the adrenal medulla, induced by cigarette smoking. The elevated catecholamine concentrations in the renal vein would then reach the testes via retrograde flow down the internal spermatic vein in men with testicular varicoceles, resulting in seminiferous tubule damage.
Laparoscopic tubal sterilization utilizing Silastic rings generally has been free of infection except when technical complications occur during the procedure. The development of a unilateral tuboovarian abscess in 2 women who had undergone uncomplicated laparoscopic tubal interruption 1 month earlier is reported. In both patients, the pathogens cultured from abscess and/or blood were common members of vaginal-cervical flora, suggesting the infection occurred after the procedure via the ascending route.
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Estrone, estradiol (E2), progesterone, prostaglandin E (PGE), and prostaglandin F (PGF) were measured simultaneously in uterine and peripheral venous plasma. PGE and PGF were determined in endometrial curettage samples. Prostaglandin levels decreased in the absence of an intact blood supply; therefore, tissue samples were all taken before hysterectomy. The levels of ovarian steroids were found to be higher in uterine venous, compared with peripheral venous plasma. PGF levels were significantly higher (P less than 0.01) in secretory endometrium compared with proliferative endometrium and throughout the cycle PGF levels in the endometrium were linearly related to the log10 concentration of E2 in uterine venous blood (P less than 0.001). PGE levels remained constant throughout the menstrual cycle.
The simultaneous determination of estradiol, estrone, progesterone, and prostaglandins E and F has been made in fetal and maternal compartments in patients with and without the onset of labor. The decidua rather than the fetus or placenta was considered to be the site of prostaglandin synthesis, and prostaglandins present in the amniotic fluid during labor were thought to be a byproduct by myometrial activity rather than the factor initiating the onset of labor. Progesterone levels in the maternal plasma were lower during labor but estradiol levels were elevated. It was concluded that the steroid environment may contribute to the clinical course of labor by facilitating the local uterine production of prostaglandins. Whereas estradiol was high and estrone low in maternal circulation, the ratio was reversed in the fetus. This reversal may serve to protect the fetus from high maternal levels of estradiol.
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