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Aim: To improve the outcomes in children with ovarian torsion., Material and Methods: Three clinical observations of patients with ovarian torsion are presented. Duration of the disease was 3-4 days. All children underwent organ-sparing surgery including untwisting followed by ovariopexy., Results: All children were examined in early and late postoperative period (up to 5 years) after organ-sparing procedures. Ultrasonic picture of the ovaries including structure and dimensions corresponded to age, the follicles were determined., Conclusion: 'Conservative' approach allows to preserve anatomical structure and potential for reproductive function.

The authors report the first attempt to develop the treatment strategy for patients with primary "empty" sella turcica syndrome based at a health resort facility. It is shown that combined therapy including radon baths and acupuncture at specific auricular points makes it possible to improve functioning of the pituitary-ovarian system, decrease body weight, normalize blood prolactin level, eliminate visceral obesity, enhance tissue sensitivity to insulin, reduce hyperinsulimenia and fertility problems (anovulation, hyperandrogenism, and hypoluteinism) associated with insulin resistance.

Transvaginal hydrolaparoscopy (THL) is considered as a first-line endoscopic method in the investigation of infertility. During the last period it has played important role in the rehabilitation of the natural fertility. The rapid development of this method in the operative settings is very attractive by it's low-invasiveness. Coagulation of endometrial cysts using THL method is very effective. In this case operation can be performed on an outpatient basis. The detection of small endometriomas that are not seen during THL is not a problem only for fertiloscopy. We offered method detecting the location of ovarian small endometrial cysts, which are not discovered by THL. For this purpose we suggest to perform aspiration drainage of small cysts under ultrasound control before THL. This routine manipulation allows not only the determination of the amount of endometrial cysts, but also leaves the aspiration hole on the ovarian surface which indicates on the localization of endometrial inversion. Thus it helps to determine, without any difficulties, the site of coagulation during THL.

Glandular cystic ovarian endometriosis (OE) is characterized by a more intensive blood supply than cystic OE. This type of OE is characterized by a high proliferative glandular epithelial activity detected by an immunohistochemical study using antibodies to PCNA and CA-125. Moreover, a positive correlation is found between the serum concentration of CA-125 and the expression of this antigen in the epitheliocytes of an endometrioid cyst in both glandular-cystic and cystic OE. Thus, the findings permit the determination of the morphofunctional activity of a type of OE and its aptness to the progression of the disease and to the development of recurrences.

Ferritin was assayed by immunoradiometrical procedure in peritoneal fluid (26 patients with various ovarian pathologies) and gastric juice (18 patients with stomach cancer and 28 cases of gastric ulcer disease). It was found that diagnostic significance of ferritin measurements in peritoneal fluid in ovarian pathology is compromised by inflammation. Therefore, this marker cannot be used to differentiate between malignant and benign ovarian tumor. Single measurements of ferritin for detecting stomach ulcers were also diagnostically irrelevant since the data for stomach cancer and gastric ulcer exacerbation showed no significant difference.

Laparoscopic studies have been done in 42 patients after laparotomic ovarian wedge resection (group 1), 12 women after laparoscopic ovarian thermocauterization (group 2) and 24 patients after laparoscopic ovarian wedge resection (group 3). Prominent adhesions were found out in the pelvis in group 1 women and milder ones in group 2 patients. The incidence of adhesions was significantly lower in group 3. It suggests that wedge resection using laparoscopy represents a method of choice for surgical ovarian correction.

Resistant ovary syndrome has been confirmed in 42 women using clinical, roentgenologic (craniography, hysterosalpingography, pneumogynecography, electroencephalography), genetic, sonographic, endoscopic and histologic studies. Fibrocystic breast disease was identified in 64% and normal ovarian size in 74% of the patients with resistant ovary syndrome. Progesterone test was positive in 84% of the patients. Resistant ovary syndrome was associated with higher serum estradiol levels as compared with ovarian dystrophy and pure gonadal dysgenesis. Diagnosis confirmation requires ovarian biopsy with a histological examination of ovarian specimen, but its outcome is not always significant.

The study has been done in 30 women with the resistant ovary syndrome diagnosed by laparoscopy, laparotomy and histologic examination of ovarian biopsy samples. Genetic study identified the feminine phenotype and genotype (46,XX). Estradiol levels corresponded to those seen in the follicular menstrual phase, prolactin levels were normal, and gonadotropin levels were above basal values and were several fold above the ovulatory peak, when tested with luteinizing hormone-releasing factor in 7 patients and after estrogen challenge in 5 patients. The tests indicated an adequate adenohypophyseal response and intact feedback mechanisms between the hypothalamic pituitary system and gonadal steroids, as confirmed by electroencephalography.

This study included 62 women with hypergonadotropic amenorrhea. Clinical, hormonal, genetic, laparoscopic and histologic studies revealed three types of the disease: resistant ovary syndrome, dystrophic ovary syndrome, and "pure" gonadal dysgenesis. Mammary function and architectonics were correlated with gynecologic conditions. Fibrocystic breast disease was identified in 64.9% of patients with resistant ovary syndrome, and fatty glandular degeneration was seen in dystrophic ovary syndrome; pure gonadal dysgenesis was associated with breast hypoplasia, poor structural differentiation and prevalence of adipose tissue in the mammary glands.

Ovarian apoplexy was established in 41 (2.6%) of 1581 women operated upon with diagnosis "acute appendicitis". Apoplexy of the right ovary was found in 26 women, of the left one--in 7 women. Seven patients had bilateral ovarian apoplexy associated with acute appendicitis. In ovarian apoplexy urgent operations are indicated. In 29 women operations were started by the Volkovich-Diakonova incision, in 12 cases median laparotomy was used. Appendectomy is necessary when inflammation of the vermiform process is suspected.

Ultrasonic examination was applied to 149 female patients with active genital tuberculosis, late aftereffects of clinically cured tuberculosis and different nonspecific diseases of the internal genitalia. In all the three groups the ultrasonic examination revealed fibromyomas, adenomyosis, hypoplasia of the womb body, tubo-ovarian inflammations, cysts and cystic degeneration of the ovary. The examination made it possible to detect small fibromyomas, small ovary cysts and hydrosalpinx in the three groups. This extended the diagnostic possibilities.

The observation and surgical treatment of 122 women aged from 16 to 44 with acute appendicitis associated with acute diseases of uterine appendages have shown the differential diagnosis to be rather difficult. In such cases the true character of the pathologic condition can be established during operation only. The histological examinations of "unaltered" vermiform processes ablated during the operations have revealed signs of acute inflammation in most of them which speaks in favour of appendectomy in acute diseases of uterine appendages.