Filling of cavities in the uterine wall during hysterography was observed in 54 of 320 surgically excised specimens in which metal threads had been inserted at different levels for identification. Adenomyosis may have accounted for these cavities in 24%. Cavities secondary to adenomyosis in one part of the uterus coexisted when cavities not etiologically related to the disease in another part. Adenomyosis is generally not involved in the pathogenesis of cavities in the lower half of the uterus and does not account for cavities of more than 5 mm in diameter.
A large single dose (94 000 to 131 000 IU) of human chorionic gonadotrophin (HCG) was administered intravenously to three amenorrhoeic women and the plasma levels and urinary elimination of HCG were followed by a bioassay method and a radioimmunoassay procedure in parallel.
There was a close agreement between the estimates of HCG obtained by the two methods in the urine, but not in the plasma, where bioassays gave significantly (P < 0.001) higher estimates of potency than immunoassays. The disappearance rate of the injected HCG from the plasma was calculated on the assumption that the logarithm of the plasma concentration of HCG is linearly related to the time elapsed following its administration. There was a satisfactory parallelism between the regression lines obtained by the two methods. The half-life time of administered HCG in circulating plasma varied between 6 and 10 hours, with a mean value of 8 hours.
From the relationship of the initial plasma concentration and dose administered, the plasma distribution volume of the hormone was tentatively calculated. The calculated plasma volumes (1664 ml from bioassays and 3680 ml from immunoassays) suggested that the bioassays gave most probably an overestimate and the immunoassays an underestimate of the HCG present in the plasma. On the basis of different assumptions it was calculated that the metabolic clearance rate of HCG was around 4 ml/min. The urinary excretion of the administered HCG by the three subjects amounted to 21 to 22 per cent of the injected material, estimated both by the bioassay and immunoassay methods. The renal clearance of the injected hormone was 0.36 ml/min when calculated from the bioassay data and 0.70 ml/min on the basis of immunoassays.
Since the half-life time of circulating HCG is considerably longer than that reported for human luteinising hormone of pituitary origin, it should be realized that repeated daily injections of HCG will result in a progressive accumulation of the hormone in the circulation.
Three male patients with testicular dysgenesis are described. In all three patients testicular histology showed advanced tubular sclerosis and Leydig cell hyperplasia. Two were of short stature and none had gynaecomastia. They were all euthyroid with normal PBI, but two of them showed decreased thyroid uptake of 131I and a decreased »TSH reserve«.
In all three cases cells from several tissues had 46 chromosomes and an XX sex chromosome constitution. In one mosaicism was indicated by the presence of a very small proportion of cells with 47 chromosomes. Some of these cells seemed to contain three X chromosomes whereas the others had two X chromosomes and possibly a Y. No evidence of mosaicism was found in the other two. There were no signs of structural chromosome abnormalities.
Direct wound closure with or without flap-plasty after vulvectomy gives satisfactory cosmetic and functional results. Split thickness skin-grafts seem to be of limited value in the repair of the defects.
A low chiasma count, asymmetrical bivalents, multivalents and univalents as well as fragments were found at first meiosis in two 46, XY patients with spermatogenic arrest at the first spermatocyte level. Such meiotic irregularities have not been previously described in man. The two patients were the only ones with this histologic and meiotic picture in a series of 51 consecutive infertile men investigated because of severe oligospermia or azoospermia. One of them was the offspring of a first cousin marriage and had a sister with secondary sterility, which might indicate a primary genetic cause for this characteristic type of meiotic failure.
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