Limited diagnostic value of lymphocytic karyotype in primary amenorrhea with streak gonads

Cytogenetic data represent a first line diagnostic aid in gonadal dysgenesis. Generally, the results of a peripheral blood examination reflect the genotypic alteration of the patient. Nevertheless, on occasion one may encounter cases in which clinical and hormonal evidence suggestive of dysgenesis is not accompanied by an anomalous chromosomal finding, upon cytogenetic analysis of the peripheral blood. In these cases, a cytogenetic alteration may be present in cellular components of the ovary and the cutis. In the light of the above, two patients presenting with primary hypergonadotropic amenorrhea, streak gonads and normal peripheral karyotype are described. In one patient presenting with phenotype alterations, ovarian wedge biopsy via laparotomy followed by cytogenetic analysis of ovarian tissue and tissue from the cutis revealed a 45,X/46,XX-type mosaicism. In the other patient, the ovarian cytogenetic findings were unremarkable. Extending chromosomal analysis to several tissues, beyond the peripheral level, in selected cases, is discussed.

Non-mosaic isodicentric X-chromosome in a patient with secondary amenorrhea

An isodicentric X-chromosome idic(X) (pter----q26.1::q26.1----pter) was found in lymphocytes and ovarian tissue of a 40-year-old female patient with secondary amenorrhea. No mosaicism was observed. The phenotype-karyotype correlation of our case and of previously described non-mosaic cases of idic(X) (q::q) with different breakpoints is discussed.

[Anesthesia and resuscitation in major interventions in gynecologic surgery]

A number of biohumoral parameters have been looked at pre-, intra- and post-operatively in patients subjected to radical hysterectomy according to Wertheim, with lymphadenectomy according to Meigs or Valle, in the Obstetric and Gynaecology Clinic of Turin University. Patients' ages were between 26 and 60. On the basis of the premise that during and after every surgical operation metabolic type changes relating to the quality and quantity of organic fluids, serous proteins and electrolytes, haemoglobin, clotting times and bilirubin production are observed, a treatment that enables prophylaxis to be carried out and cuts complications to the minimum is recommended.

[Hormonal regulation of uterine contraction]

A personal method has been used to study spontaneous kinetic activity of the uterus in 50 women during puerperium following miscarriage between the VIIIth and XIIth weeks. Modifications induced were evaluated in several sessions (510 recordings) and at various periods of time, following administration of: 50 mg of 17B oestradiol, 200 mg natural progesterone, 500 mg of natural progesterone, 250 mg of 17 hydroxyprogesterone caproate and 500 mg of 17 hydroxyprogesterone caproate. In the case of some of the patients, hysterotonometry was evaluated following intravenous oxytocin loading. The results pointed to an activation of the uterine pacemaker after oestrogenic loading, and a clear-cut progestinic block of contractile activity.