Isao Matsunaga

Precise day of ovulation determined by real-time ultrasound evidence of graafian follicular development

Real‐time ultrasonic scanning was performed in 21 infertile Japanese women during 37 menstrual cycles. The maximum diameter prior to ovulation was 23.3 ± 2.9 mm in spontaneous ovulation cycles, 29.6 ± 5.2 mm in case of clomiphene therapies, and 26.7 ± 3.9 mm in HMG‐HCG therapies, respectively. Size of the graafian follicles was maximum at almost the same time as the LH peak in the plasma and urine, respectively. The LH peak in the urine was determined by the hemagglutination inhibition assay, the results of which were obtainable within 2 h. Four patients became pregnant (19.0%). There was no statistical correlation between the diameter of the largest follicle and the plasma estradiols (r = 0.28, 0.2 < P < 0.3) or between the diameter of the largest follicle and the peak luteinising hormone level (r = 0.27, 0.3 < P < 0.4). Therefore, the combination of the real‐time ultrasound and a hemagglutination inhibition assay for LH in urine can be clinically applied to detect the precise day of the ovulation.

Clinical usefulness and false-positive results of CA 125 as a tumor marker of ovarian cancer —A study on 674 patients—

To study the clinical usefulness and false-positive results of CA 125 as a tumor marker of ovarian cancer, we measured serum CA 125 levels in 197 patients with gynecological diseases, 274 normal, pregnant and postpartum women, 14 patients with abnormal pregnancy, 82 healthy women with a normal ovulatory menstrual cycle and 107 healthy non-pregnant subjects, using RIA kits. A level below 34 U/ml was considered the normal CA 125 range. The positive ratio of serum CA 125 in patients with malignant ovarian tumor was 81.3 per cent, and in those with serous cystadenocarcinoma the rate was 100 per cent. On the other hand, only one patient with benign ovarian tumor had a positive CA 125 value. Therefore, we suggest that CA 125 is useful for differentiation between benign ovarian tumor and ovarian cancer. However, because the positive ratio of CA 125 level is high in patients with recurrences of uterine cervical adenocarcinoma, those with tubal cancer, endometriosis, early pregnancy, abnormal pregnancy plus intrauterine fetal death and menstruating women, such situations must be given due attention when CA 125 is used as a tumor marker of ovarian cancer.

Endometrial Cyst, Dermoid Cyst and Mucinous Cystadenoma Sonographically Evidenced in the Same Ovary

We treated a patient with an ovarian tumor histologically consisting of an endometrial cyst, dermoid cyst and mucinous cystadenoma, in the same ovary. A comparative study between ultrasonic and histological findings was done. The usefulness, drawbacks and limitations in the ultrasonic evaluation of ovarian tumors are discussed.