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. With an endocervicoscope 5 mm in diameter, and a fibre-optic system, it was possible to biopsy the chorion through the cervical canal, during early human pregnancies from 8 to 20 weeks of duration. 39 patients who applied for legal abortion were examined. Growth in tissue culture, with a sufficient number of mitotic figures for sexing and chromosomal analysis was obtained in 20 out of 41 tests after 2-3 weeks. The karyotypes from the biopsy specimens were found to be normal and agreed with respect to sex with the legally aborted fetuses. 19 cases observed for between 7 and 43 days following the biopsy did not show any disturbance of the pregnancy during that time. The practical usefulness of this technique, which was also tried in two cases of imminent abortion, is discussed. [ABSTRACT FROM AUTHOR]

The distribution and fate of 125I-labelled bovine prolactin, human chorionic gonadotropin and bovine serum albumin was studied and followed by serial gamma camera photographs, scintillation counting of blood and tissues, and autoradiography in normal pro-oestrus rats, in oophorectomized rats and in rats with experimental ovarian tumours developed in intrasplenic ovarian grafts after bilateral oophorectomy. A high affinity for 125I-HCG was found both in ovarian tumours and in normal ovaries. An increased active tumour uptake of 125I-HCG was observed for 3 hours, which permitted tumour depicting with gamma-camera technique. The 125I-prolactin uptake was more moderate both in ovaries and ovarian tumours. 125I-albumin showed no specific affinity. The possible application of these findings in diagnosis and therapy of human ovarian tumours is discussed. [ABSTRACT FROM AUTHOR]

226 patients were subjected to conization (including all cases with positive vaginal cytology and without clinical suspicion of invasion of the uterine cervix) at the Department of Gynaecology and Obstetrics, Malmo General Hospital, in 1963 and 1964. The operative technique was standard throughout the series which was followed up for 5 years. Of the patients subjected to conization alone, nearly 95% showed no signs of recurrence at the end of the 5-year period. Late sequelae were few and mild. Fertility after the operation was high and the course of pregnancies normal. Conization therefore is very valuable not only as a diagnostic method but also as an effective treatment for preinvasive carcinoma of the uterine cervix. [ABSTRACT FROM AUTHOR]

. A fibrinolytic inhibitor AMCA (trans p-aminomethyl cyclohexane carboxylic acid) was given i.v. in a dose of 0.01 g/kg bodyweight to 12 mothers about to be delivered by Caesarean section. Immediately after delivery the concentration of AMCA was determined in the maternal blood and in cord blood. AMCA was determined by a chemical method based on high voltage paper electrophoresis and photometric determination of the ninhydrin complex. It was found that AMCA passes through the placenta and that the concentration of the drug in the cord blood can be fairly high (4-31 μg per ml). The possible value of prophylaxis of the foetus with AMCA by the maternal route to check fibrinolytic bleedings (pulmonary or intracranial) sustained during premature delivery is discussed. [ABSTRACT FROM AUTHOR]

Methods: In a randomized double-blind study, 134 patients were given 500 mg metronidazole as an intravenous infusion immediately before operation for abdominal total hysterectomy and again 8 hours later and 124 patients received placebo., Results: There was more wound infection, postoperative hospitalization was longer and the sedimentation rate on the sixth postoperative day was significantly higher in the placebo group. There was no difference in postoperative temperature. Postoperative wound infections occurred in 12% in the placebo group and 6% in the metronidazole group. Eight percent in the total material had urinary tract infections, the diagnosis was based on urine cultures., Conclusions: Prophylaxis with intravenous infusion of metronidazole is recommended in total hysterectomies.

Two cases of tubal pregnancy are presented. Both were treated successfully with hysteroscopic tubal instillation of prostaglandin F2 alpha.

In a detailed prospective interview study, all newly diagnosed cases of adenocarcinoma corporis uteri at Malmö during a 2-year period (n = 51) were analysed with regard to the occurrence of tumors in first-degree relatives. The families of the proband's male consorts were used as controls. Sisters and mothers of probands had tumors (particularly of the corpus uteri or breast) more often than had controls. Colon and prostate cancer also figured in family histories of proband relatives, more often and with earlier age at onset than in controls. Nine patients (18%) either had additional concomitant malignancies, or had had such malignancies previously. Familial cancer predisposition was associated with poorly differentiated anaplastic cancer of the corpus uteri with poor prognosis. Three cases of familial cancer (CFS) observed at Malmö are also described, in which the probands presented with adenocarcinoma corporis uteri. The findings suggest that a hereditary, cancer predisposing factor (gene) is involved in a significant proportion of cancer corporis uteri, and that it is expressed in a heterogeneous tumor pattern, predominantly at sites sensitive to hormonal influences.

All patients hospitalized in 1982 at the Department of Gynecology in Malmö because of malignancy of the cervix uteri attended an interview study concerning the presence of cervical cancer among their nearest relatives. In addition, these patients were questioned concerning earlier gonorrheal infection. The blood group was determined as also was the secretory status and Gm allotype. As a control group the families of the male consorts were used. Cervical cancer was found significantly more often in mothers of the patients (7.9%) than in the consorts' mothers (1.0%). Sisters, aged 20 or over, of the patients had cervical cancer significantly more often (7.5%) than sisters of the consorts (1.1%). Moreover, cervical cancer in mothers and/or sisters was found in 15.6% of the patients. In cases of invasive cancer or previously operated CIS, this figure was 17.5%. The patients did not differ significantly from the normal population regarding blood group or secretory status. A somewhat lower, although non-significant, frequency of Gm(1) allotype was found in patients with invasive cancer, compared with patients with CIS. Patients with a positive family history of cancer had more often had gonorrhea (24%) than patients with a negative family history (18%). The study indicates a multifactorial etiology for cervical cancer.

Bromocriptine, 2.5 mg twice a day was tested for its effect on premenstrual tension in a random double-blind cross-over trial. 1. The compound tended to lessen the symptoms, especially mastodynia. 2. Serum prolactin levels around the upper limit of the normal range were significantly lowered. Patients with the highest starting prolaction levels had the most severe symptoms and in these patients the fall in the levels was greatest. 3. Serum FSH and LH levels were significantly reciprocally influenced compared with serum prolactin. Serum estradiol-17-beta and progesterone did not change during treatment. 4. The bromocriptine-treated cycles were all ovulatory according to basal temperature levels. The luteal phase was prolonged when serum FSH was raised.

Fibrinolytic activity was histochemically determined in biopsy specimens of the walls of human veins (vv. epigastricae superficiales) obtained from 15 patients after irradiation of the lower abdomen because of malignant genital diseases and compared with non-irradiated controls. The activity was significantly lower (p less than 0.001) after radiotherapy.

The results are presented of a prospective study on drug use during pregnancy involving antibiotics, analgesic drugs and iron and vitamin preparations. The study was conducted in Malmö between 1963 and 1965. No unfavourable effect of the use of antibiotics, mainly penicillin and sulphonamides, could be demonstrated. Among 15 women who had an infant with hypospadias, three had used penicillin during the first trimester, but this may well be coincidental. Analgesic drug use shows a variability which resembles that previously described for psychopharmaca. No effect on the malformation rate or infant survival could be found. A possible lengthening of the mean duration of pregnancy occurred after the use of analgesic drugs during the 2nd or 3rd trimesters. Women who are going to have a dead or malformed infant use iron and/or vitamin preparations less often during late pregnancy than women who prove to have a normal infant. When such drugs were used, the percentage of pregnancies ending in birth before the 38th week is reduced, and the birth weight among term babies is higher. The associations between pregnancy outcome and the use of iron and vitamin preparations is probably indirect, due to social factors associated with drug use.

During the past four years, an attempt has been made in Malmö to reduce the frequency of preterm termination of twin pregnancies. For this purpose, the entire pregnant population of this medium-sized city was subjected to general ultrasonic screening in the second trimester. This detected 88 per cent of the twin pregnancies. The screening has a methodological error of 2 per cent. Eightysix of the women with twin pregnancy were subjected to bedrest in hospital for more than two weeks in the second half of gestation. The incidences of twins born with birth weight below 1 500 g and of twins light-for-gestational-age were reduced compared with those a decade earlier. Also the group of twins born before the 37th week decreased, and the perinatal mortality rate fell to the same level as in singleton pregnancies. Early detection of twin pregnancies followed by rest for the pregnant women seems to contribute to an improved outcome of these gestations.

Specific localization in vivo of marked, 131I-labelled human chorionic gonadotrophin (HCG) was shown by scintillation counting of different tissues to occur in rat ovarian tumor, but not in human Krukenberg tumor heterografts growing subcutaneously in female nude mice. The ovaries of the mice showed an increased uptake. This model system may be useful for studying gonadotrophin receptors and gonadotrophin dependency of human ovarian tumors. A similar study in menstruating women about to be operated upon because of myoma showed a remarkably high uptake in the corpus luteum, but binding also in ovarian follicles. The increased uptake of the radioactivity observed in the ovaries enabled preliminary scanning. This unique specificity of uptake may offer new possibilities in the diagnosis of ovarian tumors. The general turnover of the 131I-HCG in these women is described and applied to a mathematical model. High relative concentrations of 131I were also seen in urine and saliva.

Dihydroergotamine (DHE) was given to 20 gynecological patients, 0.5 mg i.m. preoperatively and again every twelfth hour for 7 days. No cases of thrombosis occurred as judged by the 125I-fibrinogen test. Increased concentrations, but within normal range, were found for fibrinogen factor VIII activity and related antigen, plasminogen and antithrombin III and decreased concentration for alpha 2-macroglobulin. The fibrinolytic activity of the wall of a superficial hand vein was not suppressed, which otherwise occurs postoperatively. Together with the increased concentration of antithrombin III this might explain the potentiating effect of DHE or prophylactic treatment with low-dose heparin.

22 different human ovarian tumours were heterotransplanted subcutaneously to female "nude" mice. When small tissue pieces were used 10 out of 16 tumours grew. Subcutaneous injections of suspended tumour cells were made to 11 mice: all failed. Metastatic or infiltrative growth was never seen in the mice observed for up to 25-40 days. Material from each tumour was transplanted to four separate sites in two mice. The successful grafts largely retained the original morphological features. As measured with H3-thymidine incorporation, DNA-synthesis was also similar in the original tumours and the growing grafts. This animal in vivo model might be highly informative for the study of inter alia fundamental biology, chemotherapy, and irradiation of ovarian tumours.

The concentrations of FSH, LH, 17-beta-estradiol (E2), estrone (E1) and progesterone (P) were measured in peripheral and ovarian vein sera obtained at preoperative pelvic angiography from 5 postmenopausal women with malignant ovarian tumors. In 5 others the concentrations of E2, P and testosterone (T) were also measured in ascitic fluid collected at laparotomy. The investigation showed that most of these patients had increased concentrations of E2 and/or E1 and P as well in the peripheral blood. Significant gradients between the ovarian and peripheral vein concentrations were found for E2 and for P. High levels of E2, P and T were found in the ascitic fluid. FSH and LH levels were often lowered in peripheral blood compared with normal menopausal values and a gradient to ovarian tumor venous blood - with lower concentrations in the blood coming from the tumors, was found. Endometrial histology showed signs of steroid stimulation. These cases indicate that malignant ovarian tumors and/or the ovaries harboring them, are often capable of producing different sex steroids. These steroids may be found in the peripheral blood and in the ascitic fluid compartment and therefore may be used as tumor markers. The steroid production is probably not autonomous, but gonadotropin-dependent.

A prospective study has been performed on the use of psychopharmaca during 6 376 pregnancies and its correlation to certain socio-medical variables and pregnancy outcome. An association between drug use and later miscarriage or legal abortion was demonstrated and is conceivably due to an increased use of such drugs in unwanted pregnancies. No indication of an association between drug use and birth of a dead or defective infant was found. Pregnancies where psychopharmaca were used during the first trimester had, on average, a longer duration than pregnancies where such drugs were not used, but birth weight of full-term infants was not affected.

In a prospective study of anti-emetic drug use during 6 376 pregnancies, the previously demonstrated negative correlation between the use of such drugs and miscarriage was confirmed. It is probably completely due to less frequent and possibly less severe morning sickness complaints in pregnancies ending with a miscarriage. A slight positive correlation is found between the use of anti-emetics and infant malformation. A detailed analysis showed that this was mainly due to a high incidence of drug use (mainly promethazine) among women giving birth to infants with congenital dislocation of the hip. The probable indirect relationship is discussed.

Results froma prospective study in Malmö performed in 1963-65 are used to discuss the possible role of hormonal drugs in human fetal maldevelopment. Appr. 2 per cent of all women had a child born were treated with gestagens during early pregnancy and slightly more had used Primodos as a pregnancy test. No harmful effect on embryonic development can be demonstrated.

Treatment of postmenopausal women with a non-steroid oestrogen (P1496) in a dose of 50 mg a day for 2 ,days before operation for prolapse did not suppress the histochemically determined fibrinolytic activator content of the vessel wall. Neither was any change found in the concentration of P&P-complex (prothrombin, factor VII, factor X), factor VIII, antithrombin III, alpha1-antitrypsin, alpha2-macroglobulin or the inhibitors of urokinase induced plasminogen activation. Nothing suggested a thrombogenic effect of this non-steroidal oestrogenic compound.

474 women in mid-pregnancy, interviewed at ten different hospitals in Sweden, were questioned on a number of social and medical items: e.g., drug use, contraceptive technique used before pregnancy, exposure to possibly deleterious factors in the environment. The study, compared with a similar study made ten years earlier in Sweden, showed little or no difference in the use of iron and/or vitamin preparations, analgesic drugs, antibiotics, or endocrine drugs; but a drastic reduction is noted in the use of psychotropic drugs and of antihistaminic drugs. A marked decrease in frequency of first trimester X-ray exposures can be found, but no marked changes in smoking habits. Appr. 18% of the women used contraceptive pills within 6 months of becoming pregnant---3 had used them during early pregnancy. About 4% (18 women) had used IUD---one became pregnant with a Cu-UID (intra-uterine device inpregnated with copper).This type of study can provide some information on the prevalence of relatively common factors, but it must be considerably extended in order to permit an analysis of rare events, e.g., use of most drugs.