Louis H. Honoré

Combined Adrenorenal Fusion and Adrenohepatic Adhesion: A Case Report with Review of the Literature and Discussion of Pathogenesis

The second case of combined adrenorenal fusion and adrenohepatic adhesion on the right side is reported. It is hypothesized that the basic lesion underlying this innocuous anomaly rests in the periadrenal mesenchyme. In the case of fusion of adrenal with kidney or liver the mesenchymal defect causes 1) retardation of capsule formation with parenchymal mixing and 2) failure of local differentiation into fetal and later adult fat cells. In the case of adhesion of adrenal to kidney or liver there is no retardation of capsule formation with parenchymal mixing but only failure to differentiate locally into fat cells. Consequently, there is no physical separation of these organs by interposition of fat cells and there is variable party-wall sharing of the capsule.

Salpingitis Isthmica Nodosa in Female Infertility and Ectopic Tubal Pregnancy

Salpingitis isthmica nodosa has been studied in relation to female infertility and tubal ectopic pregnancy. The incidence of this lesion in a control Caucasian population was 0.6%, as compared with incidences of 2.86% in an ectopic group and 50% in a small infertility group undergoing tuboplasty. It is suggested that salpingitis isthmica nodosa should be considered as an etiologic factor in these reproductive disorders. Chronic tubal spasm is suggested as the underlying process.

Menorrhagia, diffuse myometrial hypertrophy and the intrauterine contraceptive device: A report of fourteen cases

Abstract. Fourteen uteri, removed for IUD‐associated menorrhagia, were studied. Twelve of these IUD‐bearing uteri showed pure diffuse myometrial hypertrophy; the other two uteri were enlarged as a result of multiple leiomyomas in one case and extensive deep adenomyosis in the other. The incidence of pure myometrial hypertrophy in the IUD group was far in excess of that observed in a control non‐IUD‐bearing menorrhagia series, where leiomyomas and/or deep adenomyosis were mostly responsible for the uterine enlargement.

Partial hydatidiform moles have impaired differentiated function (human chorionic gonadotropin and human placental lactogen secretion) in response to epidermal growth factor and 8-bromo-cyclic adenosine monophosphate*

OBJECTIVE The null hypothesis is that partial hydatidiform moles have normal differentiated function (human chorionic gonadotropin and human placental lactogen secretion) in response to epidermal growth factor and 8-bromo-cyclic adenosine monophosphate. STUDY DESIGN Two complete moles, 10 partial hydatidiform moles, and 19 normal first-trimester placentas in monolayer culture were exposed to 10 ng/ml epidermal growth factor, 1 mmol/L 8-bromo-cyclic adenosine monophosphate plus 1 mmol/L theophylline, or control. Human chorionic gonadotropin and human placental lactogen secretion was measured. Frequency of response to stimuli was compared by chi 2 analysis, and hormone secretion was compared by analysis of variance. RESULTS Partial moles demonstrated reduced frequencies of response of human chorionic gonadotropin and human placental lactogen to epidermal growth factor (partial moles 2/8 and 2/8, respectively; normal placentas 16/19 and 7/18, respectively; p less than 0.025) and of human chorionic gonadotropin to 8-bromo-cyclic adenosine monophosphate (partial moles 3/5, normal placentas 13/16; p less than 0.005). CONCLUSION Partial hydatidiform moles demonstrate impaired human chorionic gonadotropin and human placental lactogen secretory responsiveness to epidermal growth factor and cyclic nucleotides in comparison with normal first-trimester trophoblast.

Recurrent partial hydatidiform mole: Report of a case

The first case of recurrent partial hydatidiform mole is reported. Despite worsening of the associated embryopathy, there was no worsening of the histologic characteristics in terms of trophoblastic hyperplasia or behavior. More cases are needed to define the natural history of this recurrent form of trophoblastic neoplasia.

Malignant Germ Cell Tumor of the Testis: Spontaneous Regression Of Pulmonary Metastases with 7-year Survival

A case of a malignant germ cell tumor of the testis in a 28-year-old man is reported. The patient showed spontaneous regression of pulmonary metastasis and is well 7 years after orchiectomy and irradiation of abdominal lymph nodes. A plea is made for further documentation of such cases.

Postpubertal Untreated Cryptorchidism

A histological study of the postpubertal untreated cryptorchid testis establishes a direct anatomical relationship between Leydig cells and tubular sclerosis, an age-related process ranging from mild fibrosis of the tubular tunica propria to complete tubular hyalinization. Two separate processes are involved. Mild or moderate tunical fibrosis is related to pretubular hyperplastic Leydig cell nodules, while severe tubular sclerosis and hyalinization depends on the development of intratunical Leydig cells, a finding hitherto undescribed. More probing studies are needed to define the mechanisms whereby these abnormal Leydig cells cause tubular tunical fibrosis.

Midtrimester prostaglandin-induced abortion: Gross and light microscopic findings in the placenta

A systematic gross and light microscopic study was done of 60 placentas, spontaneously delivered following induction by intra-amniotic PGF2alpha administration. The main findings were: high incidence of marginal and basal decidual hemorrhage, widespread degenerative changes in the decidua and chorionic villi, intervillous congestion and thrombosis and significant underfilling of the fetal vasculature. These changes are discussed in terms of the possible factors underlying the mechanism of prostaglandin-induced abortion.

The mechanism of midtrimester abortion induced by intra-amniotic instillation of hypertonic saline: A modification of Gustavii's lysosomal hypothesis

This modification of Gustaviis hypothesis recognizes the central role of saline-induced decidual cell necrosis and secondary prostaglandin release in the initiation of myometrial activity. In the absence of significant necrosis in the decidua basalis, passive stretching of the subplacental myometrium is considered to activate this region leading to secondary intervillous stasis and the reduction in progesterone delivery to the myometrium and systemic circulation. This drop in progesterone further sensitizes the myometrium to PGF2alpha stimulation and helps the self-sustaining process of myometrial activity culminating in clinical abortion. A third hypothetical contributing factor may be the loss of some myometrial inhibitor normally present in the amniotic fluid.