187 patients with atrophic, hypertrophic and mixed vulvar dystrophy were treated with 2% testosterone propionate ointment from 18 months to 7 years. Symptoms, macroscopic, and histologic picture were evaluated before and during treatment. About 75% of the patients achieved good and excellent symptom relief. Treatment efficacy differentiates according to the type of dystrophy, and in relation to the lesion's extension and the duration of symptoms, which consist mostly of pruritus. Side effects from therapy were negligible.

In confronting the problem of prevention and early diagnosis of vulvar lesions at risk, the diagnostic methodology for their recognition and the therapeutic measures best taken are discussed. Through the use of routine, ambulatory screening tests, it is possible to detect and recognize those pathological situations which may evolve towards neoplasia. Among these, the vulvar dystrophies, some viral infections and sexually-transmitted diseases are particularly at risk. Patients with oncologic precedents are also at risk as well as patients receiving immunosuppressive therapy.

Hormone receptor assays for testosterone, estrogens and androgens were performed on 53 biopsy specimens of vulva from 40 patients, consisting of 6 with normal tissue, 14 with atrophic type dystrophy, 13 with hypertrophic type dystrophy, and 20 with malignancy. Atrophic and hypertrophic forms showed a different receptor pattern; hypertrophic forms were characterized by consistently higher levels of progesterone receptors not correlated with estrogen receptors. Neoplastic tissue showed no significant changes in values compared to normal or dystrophic forms, but range of variability was high. The bond between neoplastic forms and hormone activity seems without doubt less important than in the corresponding endometrial and mammary forms. The study of dystrophic forms, instead, should be further explored with a larger number of cases.

The increased incidence of multiple primary tumors of genital-breast district has been evaluated, with the possibility of early diagnosis which consent greater survival in cancer patients. We found a particular high incidence of second neoplasia associated with vulval tumors (7.4%). With regard to pathogenetic factors, the oncogenic role of certain treatments is undoubtedly important, especially if they are protracted in time. It is necessary that these patients undergo complete gynecological screening for a time period that is much longer than that held sufficient to consider a patient cured.

The presence of second neoplasia in association with vulvar neoplasia is significant. We confirm the usefulness of including a screening procedure for vulvar neoplasia in the follow-up of patients with gynecological cancer, especially those with carcinoma of the portio. Patients with a first gynecological neoplasia who present vulvar viral infection, or dystrophies, or who have undergone radiotherapy or immunosuppressive treatment are considered at high risk.

The case-series of the Institute of Obstetrics and Gynaecology were examined to evaluate the suitability of urinary estriol, total plasma estriol, unconjugated plasma estriol, unconjugated plasma estetrol, plasma placental lactogen, plasma S.P.-1 glycoprotein, plasma alphafetoprotein and biparietal diameter in correctly forecasting the perinatal risk, when performed after the 25th week of pregnancy. In high-risk pregnancies, according to our results, S.P.-1 glycoprotein and urinary estriol are the most sensitive tests, while S.P.-1 glycoprotein, placental lactogen and biparietal diameter are found to have the highest predictive value. The repetition of the considered tests increases their sensitivity, but not their predictive value. In pregnancy mass screening the most suitable tests, on the basis of the "relative risk" are S.P.-1 glycoprotein (or even placental lactogen), estriol and biparietal diameter. For the last one a single measurement seems to be enough during the third trimester.

Plain films of the abdomen taken during pregnancy at term from 1971 to 1981 at the Radiology Service of the Obstetric and Gynecological Clinic of the University of Padua are summarized and analysed. The average frequency of X-ray investigation is 0.5%, ranging from 0.06% (in 1980) to 2.11% (in 1977), compared to Carmichael's data which range from 11 to 30%. Indications have remained fairly constant over the years, in view of the very low incidence of this examination. The most significant finding is the greater incidence of fetal malformation in recent years, and is explained by a more efficacious program of pregnancy screening. X-ray examination may be still employed in some cases to obtain superior information regarding the best definition of gestational age, some fetal malformation, and in rare cases, hemolytic disease.

The Authors report a new technique of employing mammary echotomography. The patient, in prone position, is tested with her breasts immersed in water, using a linear array of 2.8 MHz.

Physiological and pathological echograms of the female genital tract are examined. Following a rapid review of the literature, the role of echography in gynecology is evaluated on their decennial experience.