Does ovarian blood flow distinguish between ovulatory and anovulatory patients with polycystic ovary syndrome?

OBJECTIVE: The purpose of this study was to determine whether parameters of ovarian blood flow distinguish between women with polycystic ovary syndrome (PCOS) who ovulate and those who are anovulatory. STUDY DESIGN: This was a prospectively enrolled trial, carried out as a cross-sectional comparison of 12 ovulatory patients with PCOS and 20 matched subjects with classic PCOS and 10 healthy control subjects. Hormonal parameters and ovarian blood flow by color flow Doppler imaging were obtained in the early follicular phase. RESULTS: Characteristic elevations in luteinizing hormone (LH) and androgens were found in both groups with PCOS compared with control groups. Women with anovulatory PCOS had high insulin levels and lower Quantitative Insulin-Sensitivity Check Index (QUICKI) values compared with women with ovulatory PCOS, although both groups had values that were different from healthy control subjects (P<.01). Ovarian volume was similar in the two groups with PCOS, but pulsatility and resistance indices were lower in anovulatory PCOS (P<.01) compared with ovulatory PCOS and control subjects, who had similar findings. Insulin correlated negatively with the resistance index and QUICKI correlated positively (r=0.653, P<.01). There was a negative correlation between the resistance index and unbound testosterone (r=-0.5, P<.05). CONCLUSION: These data suggest that differences in ovarian blood flow in anovulatory versus ovulatory women with PCOS and that hormonal factors, including insulin resistance, may influence this relationship. The alterations in blood flow in anovulatory PCOS may contribute toward or result from anovulation.

[Surgical treatment of extracranial carotid aneurysms]. / Il trattamento chirurgico degli aneurismi delle arterie carotidi extracraniche.

The incidence of aneurysm ranges from 0.1 to 3.7 of all carotid artery diseases requiring surgery. The aim of the study was to describe our personal experience with the surgical therapy of aneurysms of the carotid artery. Over the period from 1980 to 2000 we observed 19 aneurysms of the extracranial carotid tract in 17 patients. Eleven patients were subjected to surgical treatment (M/F: 2:1; mean age: 59 years). The sizes of the lesion ranged from 2 to 5.5 cm. The locations of the lesions were: common carotid 5; internal carotid 4; bifurcation 4. A shunt was utilised in one patient. No mortality was recorded. In 2 patients there was a transitory central neurological deficit, and in 4 patients a transitory peripheral neurological deficit. A definitive peripheral deficit was recorded in one patient (9%). The authors recommend prompt surgical treatment, in view of the low morbidity and almost total absence of mortality.