Adnexal torsion: the contribution of color Doppler sonography to diagnosis and post-operative follow-up.

Ovarian torsion is often difficult to diagnose due to non-specific clinical and clinical and ultrasonographic findings. We demonstrated the use of color Doppler for the early diagnosis of ovarian torsion and for post-operative follow-up until the normalization of the preserved ovary was confirmed by subsequent viable pregnancy. Color Doppler flow assessment can be useful as both a diagnostic tool and for evaluating the recovery of the affected ovary after conservative surgical treatment.

Relationship between embryo morphology and implantation rate after in vitro fertilization treatment in conception cycles.

OBJECTIVE: To investigate the relationship between the embryo number and morphology in conception cycles and the incidence of multiple pregnancies. DESIGN: The study is based on information received from a computerized data base. SETTING: In Vitro Fertilization Unit, Sapir Medical Center, Kfar Saba, Israel. PATIENTS: A total of 117 consecutive pregnancies resulted from replacement of fresh embryos in our IVF-ET program. MAIN OUTCOME MEASURES: The impact of embryo quality, as assessed by morphological parameters, on the multiple pregnancy rate (PR). RESULTS: Implantation rates positively correlated with the number and the quality of transferred embryos. However, no multiple pregnancies occurred when only two embryos were replaced. There were no multiple pregnancies when only embryos of low quality (grades 1 and 2) were transferred. Furthermore, there was no correlation between the number of replaced embryos of poor quality and the rate of implantation. The multiple PR increased from 10% when a mixture of high and low quality embryos were transferred to 30.76% when only embryos of highest quality were transferred. CONCLUSION: The implantation rate of transferred embryos is directly correlated with the morphological scoring. The results of the study suggest that the number of embryos transferred should be balanced against their morphological quality to reduce the rate of multiple pregnancies.

Lack of correlation between hormonal blood levels and endometrial maturation in agonadal women with repeat implantation failure following embryo transfer from donated eggs.

Five women with ovarian failure who repeatedly failed to conceive following embryo transfer from donated eggs underwent endometrial development investigation. One endometrial biopsy was obtained on cycle days 19, 21, and 23 during three consecutive artificially induced cycles. All five patients had only early secretory changes on days 19 and 21. Histological evaluation on cycle day 23 revealed various developmental stages: two women had "in-phase" endometrium, two patients had adequately developed stroma but significantly retarded glandular maturation, and one women showed no progress. The histological findings were conclusive for a significant maturation delay and an impaired endometrial receptivity. There was a lack of correlation between the peripheral hormonal blood levels and the endometrial maturation.

Treatment of male genital condylomatous lesions by carbon dioxide laser after failure of previous nonlaser methods.

Carbon dioxide laser was used to treat 119 male patients with condylomata acuminata after other treatments had failed. In 82.3% of the patients, the treatment resulted in complete disappearance of the lesions, whereas in the others two to three treatments were required. Advantages of the laser treatment are discussed.

Phenoxybenzamine--an effective male contraceptive pill.

Phenoxybenzamine (PBZ), administered in doses up to 20 mg/day, caused aspermia following male orgasm. This led to the development of a male contraceptive pill, PBZ being the active drug. It has been shown that small doses of the drug do not change the hormonal balance of the body, nor do they affect blood pressure. In 2 to 3 days, PBZ blocks ejaculation; this is fully reversed with the cessation of treatment. The drug does not affect semen quality (testicular function), even after a long period of medication. During treatment, the vas deferens, the ampulla and the ejaculatory ducts are probably paralyzed. Cessation of medication brought full recovery of these effects and the reappearance of normal ejaculation. Men complaining of premature ejaculation reported marked improvement in their sexual performance. The recommended regimen for administering PBZ as a male contraceptive is discussed.

The possible use of phenoxybenzamine as a male contraceptive drug: studies on male rats.

Treatment of male rats with phenoxybenzamine hydrochloride (PBZ), 70 micrograms/100 g body weight for 5 weeks, caused infertility of the rats. This effect was fully reversible. Studies on the weights of the testes, epididymides, and male accessory sex glands, revealed increased glandular weights (significantly in the testes, epididymides and seminal vesicles). The number of spermatozoa found in the epididymis and vas deferens was significantly increased in the treated rats. Thus, PBZ caused a temporary cessation of sperm transport and paralysis of the muscles of the accessory glands, leading to the absence of ejaculation. In proestrous females mated with treated rats, this caused pseudopregnancy. No changes were found in the sexual behavior of the treated male rats, which was also supported by the absence of changes in the testosterone levels in serum and in testicular tissue. We recommend the use of PBZ in clinical trials, using this well-known drug as the active material for a future contraceptive pill.

Evaluation of semen quality following kallikrein treatment.

30 asthenozoospermic subfertile men were treated parenterally for 30 months with kallikrein. 20 men showed a significant increase in sperm motility, 66% (responders), while the other 10 men, 34% (non-responders), did not respond to this treatment. A striking decrease in sperm concentration (by 32%) was found in most patients. No latent period was found following kallikrein treatment. Thus, semen quality did not differ if examined immediately following the cessation of treatment or a few weeks afterwards. A poor pregnancy rate was recorded, i.e. 20% among the responders and 10% among the non-responders. In conclusion, kallikrein is a useful drug in the treatment of asthenozoospermia only when the sperm concentration is not decreased below the optimal value.

Nasopharyngeal cancer in a total population: selected clinical and epidemiological aspects.

A nationwide study of nasopharyngeal cancer in Israel, during a 9-year period (1960-68) demonstrated a mean annual incidence rate of 1.0 per 100,000 in males and 0.4 per 100,000 in females. Significantly higher incidence was observed in residents born in North Africa (3.0 in males and 1. 1 in females). Survival was relatively better in females among patients with lymphoepithelioma and in those without neurological complications. The results may support the presence of environmental factors in aetiology, though genetic predisposition cannot be ruled out.