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Ramos, Alberto Peralta: Membranous Dysmenorrhea as a Factor in Sterility
578
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Ramos, Alberto Peralta.: Membranous Dysmenorrhea as a Factor in Sterility, Obstet. y ginec. Latino- Americanas 1: 117-131, H\43. As emphasized by Alberto Peralta Ramos (Buenos Aires) membranous dysmenorrhea is important not only because it produceR pain at the time of the menstrual :!low but also because it causes sterility. Histologic study of the endometrium obtained in cases of membranous dysmenorrhea reveals that it is identical with that which is present during the last few days of the cycle except that it has not undergone autolysis. This is due to insufficient action of the physio· logic, proteolytic and anticoagulating ferments. The greatest pain in eases of membranous dysmenorrhea oeeurs just before and during menstruation when there is present the greatest amount of estrogen and the smallest amount of progesterone. The treatment recommended by the author is the use of gonadotropic hormones assisted by progesterone. In the future he intends to employ dehydrated plasma of pregnant women because this substance has yielded good results in some cases of menstrual irregularities.
J.P.
GREENHILL.
Westm.a.n, A.: The Mecha.nism of the Transit of Ova. in Women Observed During Laparotomy, Schweiz. med. Wchnschr. 73: 145-148, 1943. Only a few operators have been fortunate enough to observe rhythmic contrac· tions of the Fallopian tubes at the time of operation. However, as the author points out, with the Rubin apparatus tubal activity is, of course, registered on a kymograph. Mickulicz-Radecki studied the behavior of the tubes and ovaries in various phases of the menstrual cycle and found that at the time of ovulation the abdominal ends of the tubes came into intimate contact with the ovaries by means of activity of the tubes. Westman had previously shown that such a phenomenon takes place in many of the lower and higher mammals. This author also studied the mechanism of the transport of ova in women. At the time of operation he injected drops of Jipiodol into the tunica albuginea and subsequently studied the position of the ovaries by roentgenography. He performed hysterosalpingography and thereby was able to study the 1·elationship of the tubes to the ovaries. Serial roentgenograms showed that not only do the tubes possess motility but also the ovaries. 'l'he latter can move not only cranialward and caudalward but also on their long axis. This motility is brought about by contraction and relaxation of the smooth muscle in the ovarian ligaments and in the walls of the ovarian blood vessels. Roentgenograms showed that periodically the tubes bend around and encircle the ovaries. By means of this mechanism the expelled ovum is transported directly and quickly into the Fallopian tube. J. P.
GREENHII,L.
Rochat, R. L.: Sterility of Ovarian Origin, Schweiz. med. Wchnschr. 73: 208-210, 1943. According to the author the causes of sterility in the female may be divided into three groups: (1) Incapacity of the ovaries to produce ova or at least fertili· zable ova; (2) FuJ1ctional or chemical abnormalities in the genital tract which cause the death of spermatozoa or which prevent their union with ova; and, (3) Mechanical obstacles which prevent the union of sperm with ova. The second and third causes are easy to determine but the :first is not. Likewise, whereas it is easy to detect abnormalities of spermatozoa by direct examination, this cannot be done with ova. To determine the ovulatory function of the ovaries, two pro\ledures are avail· able namely, biopsy of the endometrium during the premenstrual phase, and a study of the temperature curve.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Ramos, Alberto Peralta.: Membranous Dysmenorrhea as a Factor in Sterility, Obstet. y ginec. Latino- Americanas 1: 117-131, H\43. As emphasized by Alberto Peralta Ramos (Buenos Aires) membranous dysmenorrhea is important not only because it produceR pain at the time of the menstrual :!low but also because it causes sterility. Histologic study of the endometrium obtained in cases of membranous dysmenorrhea reveals that it is identical with that which is present during the last few days of the cycle except that it has not undergone autolysis. This is due to insufficient action of the physio· logic, proteolytic and anticoagulating ferments. The greatest pain in eases of membranous dysmenorrhea oeeurs just before and during menstruation when there is present the greatest amount of estrogen and the smallest amount of progesterone. The treatment recommended by the author is the use of gonadotropic hormones assisted by progesterone. In the future he intends to employ dehydrated plasma of pregnant women because this substance has yielded good results in some cases of menstrual irregularities.
J.P.
GREENHILL.
Westm.a.n, A.: The Mecha.nism of the Transit of Ova. in Women Observed During Laparotomy, Schweiz. med. Wchnschr. 73: 145-148, 1943. Only a few operators have been fortunate enough to observe rhythmic contrac· tions of the Fallopian tubes at the time of operation. However, as the author points out, with the Rubin apparatus tubal activity is, of course, registered on a kymograph. Mickulicz-Radecki studied the behavior of the tubes and ovaries in various phases of the menstrual cycle and found that at the time of ovulation the abdominal ends of the tubes came into intimate contact with the ovaries by means of activity of the tubes. Westman had previously shown that such a phenomenon takes place in many of the lower and higher mammals. This author also studied the mechanism of the transport of ova in women. At the time of operation he injected drops of Jipiodol into the tunica albuginea and subsequently studied the position of the ovaries by roentgenography. He performed hysterosalpingography and thereby was able to study the 1·elationship of the tubes to the ovaries. Serial roentgenograms showed that not only do the tubes possess motility but also the ovaries. 'l'he latter can move not only cranialward and caudalward but also on their long axis. This motility is brought about by contraction and relaxation of the smooth muscle in the ovarian ligaments and in the walls of the ovarian blood vessels. Roentgenograms showed that periodically the tubes bend around and encircle the ovaries. By means of this mechanism the expelled ovum is transported directly and quickly into the Fallopian tube. J. P.
GREENHII,L.
Rochat, R. L.: Sterility of Ovarian Origin, Schweiz. med. Wchnschr. 73: 208-210, 1943. According to the author the causes of sterility in the female may be divided into three groups: (1) Incapacity of the ovaries to produce ova or at least fertili· zable ova; (2) FuJ1ctional or chemical abnormalities in the genital tract which cause the death of spermatozoa or which prevent their union with ova; and, (3) Mechanical obstacles which prevent the union of sperm with ova. The second and third causes are easy to determine but the :first is not. Likewise, whereas it is easy to detect abnormalities of spermatozoa by direct examination, this cannot be done with ova. To determine the ovulatory function of the ovaries, two pro\ledures are avail· able namely, biopsy of the endometrium during the premenstrual phase, and a study of the temperature curve.