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Estrogen receptor (ER) content in myoma and myometrium was determined by radio-receptor assay (RRA), and ER staining was performed by immunocytochemical staining, i.e. the peroxidase-antiperoxidase (PAP) method, in uterine samples from eight patients with uterine leiomyoma. ER content in myoma tended to be hither than that in myometrium, but the difference was not significant. The distribution pattern of ER staining was thought to be an important criterion. When the data were compared on the basis of the number of cells in the site where the largest number of positive cells aggregated, the number for myoma was significantly higher than that for myometrium (P less than 0.05). These results suggest that myoma contains more ER positive cells to obtain estrogen effects than myometrium.

Open laparoscopies were performed on patients with eleven infertilities and one ectopic pregnancy in our gynecology clinic. Eight cases of endometriosis were revealed in eleven severe infertile patients. There were three cases of different findings between preoperative hysterosalpingograms and chromotubations under laparoscopies. One case of ectopic pregnancy was cured by salpingectomy after diagnostic laparoscopy. All 12 patients had N2O gas pneumoperitoneum under endo-tracheal intubated anesthesia. One case with both halothane and N2O anesthesia became temporarily hypothermic during open laparoscopy. Indications of gynecologic laparoscopy, characteristics of open laparoscopy and its comparison with closed laparoscopy are discussed.

Gestrinone (R 2323) is a synthetic progestogen, and noteworthy agent for endometriosis treatment. The effect of this reagent on cultured cells from porcine granulosa, human endometrial and endometrial carcinoma origin was investigated concerning their hormonal activities and cell proliferations. Also, the effect of gestrinone on the serum levels of gonadotropins and gonadal steroids in patients with XY gonadal dysgenesis (Swyer's syndrome) and uterine myoma was studied. The monolayer cell colony established from the endometrial tissue fragments was positively stained by PAS similar to the secretory phase endometrium by 10 ng/ml gestrinone in the culture media. Endometrial carcinoma cells from a 65-year-old patient were proliferated by gestrinone at the concentration of 50 ng/ml in the culture media. The effect of gestrinone on the secretions of progesterone and estradiol-17 beta with or without hCG/testosterone from the cultured porcine granulosa cells was also investigated. Progesterone secretions were stimulated at the 50 ng/ml concentration of gestrinone, especially in association with hCG. Nonetheless, at the concentration of 500 ng/ml, those were inhibited. The secretions of estradiol-17 beta were stimulated by this reagent both with and without testosterone in dose-dependent manners. The effect of 25 mg gestrinone administration for 3 days on the levels of LH, FSH, progesterone and estradiol-17 beta in a patient with XY gonadal dysgenesis was as follows. Both LH and FSH levels gradually decreased, whereas estradiol-17 beta level was increased. The same dosage of this reagent was administered to a patient with uterine myoma on her menstrual days 7, 8, and 9.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors present the statistics of the diagnosis and treatment of infertile patients who visited the outpatient clinic of the Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Japan throughout 1985. The number of primary infertility (78) was greater than that of secondary infertility (63). The average age and the duration of infertility were 30.5 y. old/3.86 y. (primary) and 31.6 y. old/3.59 y. (secondary), respectively. The most frequent cause of infertility was ovarian-endocrine factor both in primary and secondary infertilities. The second cause was the male factor in primary infertility in spite of the idiopathic factor in secondary infertility. Tubal disorder as a cause was relatively few in both infertilities. So-called open laparoscopy was performed on 11 patients, with little hope of cure. In eight of these patients, disorders of tubal patency and endometriosis, which were not found by hysterosalpingography and hydrotubation before laparoscopy, were discovered for the first time. In twenty pregnancies at the day of statistics, the number of secondary infertility (13) was greater than that of primary infertility (7). All pregnant cases were under 35 years of age and under 5-year of infertility duration at the initial visit to our outpatient clinic. The number 1 cause of infertility was ovarian-endocrine factor. In eight pregnant cases, hysterosalpingography was performed in the same or one cycle before the pregnant cycle. According to the summation of the questionnaire of 65 infertile patients, most of infertile patients were affirmative to in-vitro-fertilization and embryo transfer. Depressive and neurotic tendencies were not remarkable at that time by Self-Rating-Depression Scale (SDS) and Cornell Medical Index (CMI) in 42 infertile patients.

It is said the prolactin (PRL) is correlated with fetal lung maturation during late pregnancy. However, there are few reports about PRL during early pregnancy and the period of peri-implantation. Recently, transient hyperprolactinemia at the preovulatory phase or after follicle aspiration for in vitro fertilization has been reported. Nonetheless, the effect of high PRL on the folliculogenesis and the early embryogenesis is still controversial. Moreover, some researchers reported that human fetal umbilical cord sera was good for the development of ova fertilized in vitro. Therefore, we studied the effect of graded concentrations of PRL (10, 30, 100 ng/ml) on the development of embryos fertilized in vivo or in vitro using ddY mice. We concluded that higher PRL levels caused a smaller number of developed embryos, in statistical significance, into blastocysts and hatched blastocysts. In general, embryos fertilized in vivo developed better than those fertilized in vitro.

To evaluate the characteristics of myometrial cells, we studied primary cultures of cells obtained from uterine muscle. The myometrium was cut into small pieces and suspended in a trypsin solution. The primary cell culture, as a monolayer, could be passaged four times. To confirm that the cultured cells were derived from myometrium, both the myometrium and the cells were stained with desmin by the enzyme-labeled antibody method. These were all positive. As a result, we confirmed that the cultured cells were derived from myometrium.