Congenital or acquired uterine defects remain important considerations in the investigation of recurrent pregnancy loss. When repeated first or second trimester losses, preterm delivery, or abnormal fetal presentations are documented, the suspicion of a structural uterine abnormality should be high. The diagnosis of uterine defects is no longer elusive. The combination of radiologic imaging techniques, hysteroscopy, and laparoscopy enables an accurate diagnosis in nearly every case. The optimal treatment for uterine malformations is still a matter of considerable controversy. Therefore, when a uterine defect is diagnosed, tough clinical decisions must be made. When alternate causes of pregnancy loss are excluded, pregnancy potential will depend primarily on the specific type of uterine anomaly that is detected. It is important to recognize that not all uterine defects are amenable to therapy, but in carefully selected patients, reparative surgery may be rewarding.
Interview with Phillip Patton, an aircraft mechanic in the US Marine Corps during WWII. He answers questions about life before the war, his experiences overseas, and returning home post-war.
Objective: To study the differential effects of subcutaneous E, alone or in combination with P on the susceptibility of low-density lipoprotein (LDL) cholesterol to oxidation in naturally postmenopausal diet-controlled rhesus monkeys. Design: Prospective, longitudinal controlled study. Setting: Oregon Health Sciences University, Portland, Oregon, and Oregon Regional Primate Research Center, Beaver-ton, Oregon. Patient(s): Five naturally postmenopausal rhesus monkeys. Intervention(s): Estradiol was administered subcutaneously for the first 4 weeks, followed by Ez plus P for 4 weeks, followed by a third 4-week washout period. Main Outcome Measure(s): Changes in plasma lipoprotein levels and oxidation of LDL and serum concentrations of Ez and P. Result(s): Levels of LDL cholesterol fell after 4 weeks of treatment with Ez, compared with baseline. The lag time to half maximal light absorbancy after 4 weeks of Ez treatment was significantly increased compared with baseline. The maximal absorbance values and the slope of the propagation phase after 4 weeks of treatment with Ez were decreased compared with baseline. After 4 weeks of combined Ez and P treatment, all values were comparable to baseline. Conclusion(s): These results suggest that subcutaneous Ez therapy appears to enhance LDL resistance to oxidation and that this effect is attenuated by the addition of the P. (Fertil Sterile 1997;68:525-30.
A rabbit model for testing the safety and effectiveness of diagnostic and interventional techniques of fallopian tube catheterization is presented. Hysterography with injection into the terminal portion of the uterine horn visualized the fallopian tube in only 6% of cases; however, this increased from 33% to 50% by pretreatment with progesterone, administration of glucagon or phentolamine, or increased pressure of injection with balloon obstruction of the uterine horn. Salpingography with a catheter introduced in the tubal ostium or directly inside the tube was most effective and resulted in a consistent (100%) visualization of the fallopian tube. The technique also allowed coaxial introduction of small diameter guidewires and catheters deep into the fallopian tube.
