David B. Weiss

Alveolar soft-part sarcoma of the female genital tract

SummaryAn alveolar soft-part sarcoma of the uterine cervix observed in a 26-year-old women is described. One year after extended radical hysterectomy there was no evidence of tumor recurrence. To the best of our knowledge, this is the second reported case of alveolar soft-part sarcoma arising in the female genital tract and the first description of this tumor in the uterine cervix.

Does preejaculatory penile secretion originating from Cowper's gland contain sperm?

AbstractPurpose: To determine if spermatozoa are present in the preejaculatory penile secretion, originating from Cowpers gland. Methods:Design: Prospective clinical and laboratory study. Setting: Andrology and Sex Counseling Unit, Department of Obstetrics and Gynecology, Academic Teaching Hospital. Patients: Five patients referred for premature ejaculation, three for excessive fluid secreted during foreplay and four normal healthy volunteers. Intervention: Glass slide smears of preejaculatory Cowpers gland secretion obtained during foreplay from at least two different occasions, and semen samples after masturbation. Main Outcome Measures: Microscopic examination of air-dried smears, and routine semen analyses. Results: None of the preejaculatory samples contained sperm. All the patients had sperm in routine sperm analyses. Conclusions: Preejaculatory fluid secreted at the tip of the urethra from Cowpers gland during sexual stimulation did not contain sperm and therefore cannot be responsible for pregnancies during coitus interruptus.

Erythrocytosis due to erythropoietin-producing uterine fibromyoma

Erythrocytosis has been observed to occur infrequently in association with uterine fibromyomas. Study of this case revealed erythrocytosis prior to surgery and a remission was noted after myomectomy. Elevated erythropoietin activity in this patients serum was demonstrated. The erythropoietin activity in the tumor tissue extract was 10 times higher than in the control tissue extract. We postulate that the tumor itself was responsible for the erythrocytosis observed. The mechanisms proposed to explain polycythemia in such a tumor were revised and our conclusion is that the tumor produced the erythropoietin autonomously and is not subjected to feedback control mechanism.

Anti-PP1Pk (Anti-Tja) and Habitual Abortion

Blood group incompatibility as a cause of early or habitual abortion has been a matter of much debate. However, the abortion rate in such cases is much higher than that found in the general population. Two sisters having the rare genotype pp and anti-PP1Pk (anti-Tja) in their serum were reported as having habitual abortions; a third sister, with a normal P group, had a normal obstetric history. The relationship of anti-PP1Pk (anti-Tja) to the high rate of habitual abortion was discussed and added support was given to the existing evidence that certain maternal blood group antibodies can affect embryos early in uterine life.

A Possible Mechanism for the Detrimental Effect of Varicocele on Testicular Function in Man**Supported in part by National Institutes of Health Center Grant 5 P50 HD08338 and by departmental funds.

Seminiferous epithelium histology, Leydig cell density, and in vitro testosterone synthesis were quantitated in bilateral testicular biopsies from men with varying degrees of unilateral or bilateral varicoceles. Results were correlated with plasma levels of gonadotropins (follicle-stimulating hormone [FSH], luteinizing hormone [LH]) and testosterone (T), as well as with semen quality. In patients with bilateral varicoceles, spermatogenesis, Leydig cell density, plasma T levels, and in vitro T synthesis were significantly lower than in patients with unilateral varicoceles. Varicoceles appeared to affect maximally the latest stages of spermatogenesis. A negative correlation between FSH and LH levels and spermatogenesis was observed; however, a dissociation between the two gonadotropins occurred when spermatogenesis declined. Plasma T levels were within the normal range in all patients. The T:LH ratio was significantly correlated with spermatogenesis and sperm motility. Leydig cell density was abnormally low in oligospermic patients, and it was significantly correlated with in vitro T synthesis, spermatogenesis, sperm motility, and semen volume. Sperm count and motility were significantly correlated in this group of patients, suggesting a common pathophysiology for the effect of varicocele on spermatogenesis and sperm motility. This common pathophysiology appears to be disturbed Leydig cell function resulting in decreased testicular androgen production, in turn causing inadequate spermatogenesis and epididymal function.

Quantitative Analysis of The Seminiferous Epithelium In Human Testicular Biopsies, and The Relation of Spermatogenesis to Sperm Density**Supported in part by National Institutes of Health Center Grant 5 P50 HD08338.

Quantitative analysis of the seminiferous epithelium was performed in bilateral testicular biopsy specimens from 14 patients with sperm counts ranging from 0 to 89 million/ml. All Sertoli cells and germ cells within each seminiferous tubule cross-section were counted in all biopsies. Results were expressed either as number of cells per unit length of seminiferous tubule circumference or as number of cells per Sertoli cell. Results were correlated with sperm count (millions per milliliter), total sperm count (millions per ejaculate), and age. A significant correlation between sperm density and germ cell counts was demonstrated. Coefficients of correlation were higher when results were expressed per unit of tubular wall length than when expressed per Sertoli cell. In men with sperm counts below 5 million/ml the number of germ cells in the biopsy was lower than in men with higher sperm counts. Spermiogenesis appeared to be most affected. In this group of patients an adverse effect of age on spermatogenesis was noted.

Mixed Mullerian Tumour of the Fallopian Tube Presenting as a Hydrosalpinx

Summary: Primary tumours of the Fallopian tube are rare and this is particularly true of the mixed Müllerian variety. Such a tumour developing in association with chronic follicular salpingitis and hydrosalpinx is reported.