Of 154 Chinese patients who underwent gynaecological operations, four showed a positive 125I fibrinogen leg scan for venous thrombosis, and overall incidence of 2 . 6%. In those who were on oral contraceptives and had major pelvic surgery for benign conditions, the incidence was 10 . 5%; in those who had Wertheim hysterectomy for carcinoma of cervix, it was 6 . 7%. This confirms the rarity of post-operative thromboembolism in the Chinese. Fragment E showed a biphasic rise after major operation due to tissue injury and venous thrombosis. In patients with malignancy, the postoperative 'fibrinolytic shutdown', represented by decreased plasminogen activator together with increased alpha 1 antitrypsin and C1- inhibitor levels, was more marked. In addition, alpha 2 macroglobulin level was lower and fell significantly after operation. In patients on oral contraceptives, fragment E levels were higher after surgery and there was no decrease in plasminogen activator levels. Antithrombin III levels did not fall except in three of the four patients with venous thrombosis. A marked increase in fragment E level and a decrease in antithrombin III level might be useful diagnostic markers for postoperative venous thrombosis.

Sixty patients who developed persistent or metastatic gestational trophoblastic disease (GTD) received primary oral etoposide therapy (VP 16-213). Twelve patients had metastatic GTD. Fifty-nine patients achieved biochemical remission. One patient had marked nausea and vomiting and the therapy was switched to a methotrexate/folinic acid regimen. Three patients developed relapse of GTD, giving a relapse rate of 5.1%. Etoposide is an active drug against choriocarcinoma. Its use should not be restricted to drug-resistant GTD.

One hundred fourteen semen samples from Chinese males were analyzed for routine semen parameters including the semen volume, sperm count, percentage motility, and percentage normal morphology. Of these 114 samples, 54 also had movement characteristics of seminal and swim-up sperm evaluated by the computer image analyzer system (Cellsoft; Cryo Resources Co., New York). All semen samples were subjected to the swim-up procedure to harvest the motile sperm before inseminations of human oocytes. Fertilization was considered to have occurred when at least one oocyte was observed with two or more pronuclei. Semen samples were classified as infertile (0% fertilization rate; N = 32) or fertile (greater than 0% fertilization rate; N = 82) before statistical analyses. There was a significant difference (P less than 0.005) in percentage normal morphology of seminal sperm between the fertile (mean +/- SE; 67.3 +/- 1.2%) and the infertile (59.3 +/- 2.2%) samples. The percentage normal morphology of seminal sperm correlated (r = 0.3049; P less than 0.002) with the fertilization rate and this parameter was selected by the multivariate stepwise discriminant analysis as the discriminator capable of predicting the fertilization rate with 57.9% accuracy. Statistical analyses of samples where sperm movement was also evaluated demonstrated that there was significant differences (P less than 0.01) between the fertile (N = 38) and the infertile (N = 16) samples in percentage normal morphology of seminal sperm (67.8 +/- 1.8% vs 56.2 +/- 2.6%) and curvilinear velocity of swim-up sperm (89.2 +/- 3.5 vs 68.2 +/- 7.2 microns/sec).(ABSTRACT TRUNCATED AT 250 WORDS)

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