[Laparoscopic appendectomy from the gynecologic viewpoint. A report of experiences].

From November 1992 until the middle of 1997 we had 80 laparoscopic appendectomies in our gynaecological department of the district hospital Parchim. These procedures were done with the Semm 3-sling-technique. Recurrent abdominal pain, ovarial tumor, dysmenorrhoea and the wish of sterilisation were the main indications for laparoscopy.

[Disseminated peritoneal leiomyomatosis. A case report].

Leiomyomatosis peritonealis disseminata (LPD) is a rare benign and mostly asymptomatic disease only occurring in women of reproductive age. Because of the disseminated appearance of multiple subperitoneal nodules malignancy is frequently simulated. A report is given on a case of LPD in a 38 year old woman.

[Comparison between ketamine, propanidid, and etomidate in general anaesthesia for caesarean section (author's transl)].

Propanidid, etomidate, and ketamine were compared for their effects on maternal acid-base balance and circulation as well as on postnatal general condition and acid-base balance of the newborn, on the basis of 44 women in advanced pregnancy to whom caesarean section was applied in general anaesthesia. The probands had not been deliberately selected beforehand. Results obtained from the three above anaesthetics were compared with one another as well as with parameters recorded from spontaneously delivered newborns without any medication.

[Postnatal primary therapy of Morbus haemolyticus neonatorum in prematurely born infants, following intra-uterine foetal transfusion (author's transl)].

Intra-uterine foetal transfusion was applied in 63 instances to 44 patients with severe Rh incompatibility in the authors' hospital, between 1967 and 1976. Eighteen of 29 live-born children survived the neonatal period (41 per cent). - Nineteen live-born children with most severe M.

[Experience obtained from intra-uterine foetal transfusion to cope with severe rhesus-caused haemolytic disease of foetus - ten-year report (author's transl)].

Sixty-three intra-uterine transfusions were applied to 44 foetuses with foetohaemolytic disease, in Rostock, between 1967 and 1976. Patients were selected for treatment by means of stepwise prenatal diagnosis. Details of that selection are described together with the technique of intra-uterine transfusion, with reference being made also to risks and complications.

[Comparative blood coagulation studies in PGF2a- and 15-methyl-PGF2a-induced therapeutic abortion].

In 15 pregnant women of the first trimenon of gravidity an interruption was performed by means of extra-amnial application of PGF2a and in 10 pregnant women by means of i. m. application of 15-methyl-PGF2a.

Immunochemical investigations on the problem of the pregnancy zone protein. XII. Serum concentrations of pregnancy-associated alpha-2-glycoprotein in diabetic pregnancy.

The concentration in serum of the pregnancy zone protein (PZ), a high molecular pregnancy-associated alpha 2-glycoprotein, increases during pregnancy, when oral contraceptives are taken and under certain pathological conditions. PZ is probably part of a multifactorial immunological defence system which prevents the premature rejection of the fetus and placenta which together may be regarded as an allograft. Normally, the PZ serum concentration begins to rise during the 6th-12th week of pregnancy and reaches its peak at about the 24th week.

[Immunology of pregnancy -- more recent aspects of immunological mother-child relations (author's transl)].

An account is given of some topical aspects relating to immunology of pregnancy, with reference being made to more recent literature. Included are hypothetical considerations on undisturbed embryonic development, the barrier function of the placenta, the ontogenesis of the immune system, immunosuppressive factors of pregnancy serum, the macrophage function of placental cells, pregnancy proteins, and immunological peculiarities of EPH gestosis.

[Serum concentration of the pregnancy-associated alpha2 glycoprotein (alpha2-PAG, protein of the "pregnancy zone", PZ) in malignant gynecologic diseases].

The concentration of pregnancy-associated alpha2-glycoprotein (alpha2-PAG, PZ) was investigated by means of electroimmunodiffusion and single radial immunodiffusion in sera of 30 patients suffering from malignant genital diseases. Results of electroimmunodiffusion indicate that surgical and/or radiological treatment is followed by a significant decrease of PZ serum level. But few months later values have been measured as detected before therapy.

[The effects of Pavulon (pancuronium bromide) on maternal circulation and metabolism as well as on fetal metabolism and postnatal condition at Caesarean section (author's transl)].

The effects of pancuronium bromide (Pavulon) on maternal circulation and metabolism as well as on fetal metabolism and postnatal conditions were studied in 13 women in late pregnancy (between gestational weeks 33 and 40) requiring Caesarean section in general anaesthesia. A comparison with results of 50 spontaneous deliveries without analgetics was performed. The average dosage of 4 mg did not effect the maternal blood pressure, fetal muscle tonus and cardiorespiratory adaption of the newborn.

[Pregnancy proteins].

Proteins, which are elevated in their blood concentration in pregnant women and patients suffering from malignant tumours, are reported because of their growing significance for the clinical practice. At present mainly are the following "pregnancy" proteins of clinical relevance: human chorionic gonadotrophin (HCG), human placental lactogen (HPL), placental heatstable alkaline phosphatase (HAP), pegnancy-associated alpha2-glycoprotein ("pregnancy zone" protein, PZ), socalled pregnancy-specific beta1-glycoprotein (SP1) and alpha1-fetoprotein (AFP). Applications to the clinical practice may be the surveillance of normal pregnancy, the recognition of dangerous conditions for mother and fetus, the inhibition of graft rejection, the induction of abortion, antibodies against pregnancy proteins as abortifacient and antifertilizer as well as the tumour diagnosis including the control of treatment and recognition of recidives.

The macrophage electrophoretic mobility (MEM) test for the diagnosis of hydatidiform mole and choriocarcinoma. Preliminary report.

In 1970, Field and Caspary reported that lymphocytes from patients with malignant disease can be stimulated by a basic protein from human brain (human encephalitogenic protein--HEP). The stimulated lymphocytes are capable of releasing the macrophage-slowing factor, which reduces the electrophoretic mobility of guinea-pig macrophages. In general, this effect was not found with lymphocytes from patients without malignant disease.

[Immunochemical investigations on the protein of the "pregnancy zone". XI. Serum concentration of the pregnancy-associated alpha2-glycoprotein (Pregnancy Zone protein) in normal pregnancy (author's transl)].

A quantitative study of the pregnancy zone proteins was made in the sera of 383 healthy pregnant women by means of radial immunodiffusion according to Mancini and co-workers. The serum levels related to a pregnancy serum standard were measured from the 6th to 44th week of pregnancy. The serum concentration of the protein showed a considerable individual variation.

Macrophage electrophoretic mobility (MEM) test in malignant gynaecological diseases.

All patients examined [52] with malignant disease of the female genital tract showed lymphocyte reactions to encephalitogenic factor (EF) of more than 10% as measured by the macrophage electrophoretic mobility (MEM) test and its modification (MOD-MEM). Whilst 13 patients with non-malignant disease of the genital tract and 30 normals showed lymphocyte reaction to EF of less than 6%, 4 patients with nonmalignant gynaecological disease gave values above the 10% limit. The lymphocyte reactions of this latter group of patients were discussed with respect to their previous clinical histories.

[Induction of labor by prostaglandin F 2 alpha in the treatment of hydatidiform mole].

Labour was induced by intravenous infusion of prostaglandin F2alpha (PGF2alpha) in 12 patients with hydatidiform mole. After a mean infusion time of 15 h 51 min and a mean dosage of 25,1 mg PGF2alpha, the infusion of 5 to 40 mug PGF2alpha/min led to 1 to 3 cm dilatation of the cervix. In this way, it was possible to perform a mild evacuation of the molar tissue with vacuum curette or fixation forceps and curette.

[Intrauterine extra-amnial administration of prostaglandin F 2 alpha for the induction of abortion in primigravidae and problem cases].

With 529 patients (4 groups) abortion was induced through intermittend extraamniotic application of PGF2alpha. In 97,9 per cent, the hourly instillation of PGF2alpha led to the desired success: 25 (4,7 per cent) complete abortions, 416 (78,6 per cent) incomplete abortions, 77 (14,6 per cent) "missed" abortions with opening of the cervix. In groups I to III (primigravidae betw-en the 6th and 12th weeks of pregnancy), in the mean PGF2alpha dosages there were no significant differences between 6,84 and 6,27 mg.

On the influence of prostaglandin F2alpha-induced labor at term on the metabolism and coagulation of mother and fetus.

11 pregnancies at term were terminated by dilatation of the uterine cervix, low amniotomy, and by intravenous administration of PGF2alpha. The average infusion time was 3 hours 55 minutes, and the average total dose of PGF2alpha amounted to 2.0 mg.

[Immunochemical investigations on the protein of the "pregnancy zone". X. Demonstration of immunosuppressive activities of the pregnancy-associated alpha2-glycoprotein (pregnancy zone protein) by means of the macrophage electrophoretic mobility test (author's transl)].

By means of the macrophage electrophoretic mobility (MEM) test the supposed immunosuppressive activity of the pregnancy-associated alpha2-glycoprotein (pregnancy zone protein) could be demonstrated significantly. Pregnancy sera and sera of nonpregnant women with hormonal contraception containing this pregnancy protein showed an immunosuppresive activity, too. On the contrary, serum of male donors with the blood group AB and human serum albumin had no inhibitory effects.

[The action of prostaglandin E2-induced pains on the metabolic and clotting systems of mother and child during birth (author's transl)].

11 pregnancies at term were terminated by dilatation of the uterine cervix, low amniotomy, and by intravenous administration of PGE2. The average infusion time was 4 hours 20 minutes, and the average total dose of PGE2 amounted to 0.2 mg.

[Immunochemical demonstration of soluble antigens in the protein fractions of placental tissue].

Protein fractions were prepared from placental tissue by homogenization, ammonium sulfate fractionation, gel filtration and ion exchange chromatography. The antigens detected in these fractions by absorbed antisera against placental tissue and pregnancy serum partly occur in the pregnancy and fetal serum too. The other antigens, which are found neither in pregnancy serum nor in fetal serum, could be specific for placental tissue.

[Influence of labor induced by prostaglandins on the metabolism and blood coagulation system of the mother and child during labor].

22 pregnancies at term were terminated by dilatation of the uterine cervix, low amniotomy, and by intravenous administration of PGF2alpha or PGE2. The average infusion time was 4 hours 10 minutes, and the average total dose of PGF2alpha amounted to 2,0 mg and of PGE2 0,2 mg. Parameters of acid-base changes, carbohydrate and energic state changes, gas metabolism, and changes in coagulation and fibrinolysis in mother and in fetus were analyzed during labor and after birth.