[Results of fertility preserving operations in malignant ovarian tumors].

Indication for fertility preserving surgery results from the patient's age, the histologic tumor type and the stage of the ovarian malignancy. Approximately 80-85 % of these lesions are ovarian cancers. 10-15 % tumors with low malignant potential (LMP) and approx.

[Efficacy of various methods for preoperative vaginal antisepsis].

In a prospective clinical study we investigated 115 patients prior to vaginal surgical interventions to determine the antimicrobial efficacy of six different procedures for vaginal antisepsis. To sample the microorganisms we used a cotton swab moistened with a neutralising fluid. Immediately after the time of action of the antiseptic procedures (3 minutes), providone-iodine solution, applied undiluted or diluted 1:10, yielded the strongest median reduction of the vaginal flora (log RF 3.

[Topical administration of oxybutynin hydrochloride in women with urge incontinence. Results of a prospective randomized double-blind study].

Detrusor instability is the second most common cause of femal urinary incontinence. Oxybutynin chloride anticholinergic action with direct muscle-relaxant properties. 39 women with persistent-urgeincontinence participated in a pilot study of intravesical oxybutynin application.

[Morbidity and mortality of retarded and normal weight premature infants].

Differences of fetal outcome between appropriate for gestational age (AGA) and small for gestational age (SGA) preterm newborns with birth weight below 2500 g and gestational age ranging from 27 to 36 weeks have been evaluated. As described by Rohrer SGA have been divided into symmetrical retarded and asymmetrical retarded newborns using ponderal index. Therefore distribution of ponderal index on our local population has been analysed.

[Modified endocervical vaginal smear for diagnosis of endocervical microinvasive cervix carcinoma].

We report about a case of a highly intracervical located microcarcinoma of the cervix uteri, which could solely be diagnosed by a sufficient sampling technique using cyto-brush. The same case could not be diagnosed without the presence of endocervical cells in the endocervical smear either.

[Rupture of a splenic artery aneurysm intra partum].

The rupture of a splenic artery aneurysm in pregnancy and during labour is a rare event with a high maternal and fetal mortality rate. This report is, in view of previously reported cases, on the thirteenth case of a ruptured splenic artery aneurysm reporting survival of both mother and fetus. The etiology, clinical signs, diagnosis and therapy are discussed with reference to consideration of the literature.

[Control of labor onset in the human].

While the mechanism of the initiation of labor in humans has not been clarified satisfactorily, it is of major clinical interest, particularly with a view to understanding and avoiding preterm labor. Progesterone, whose role can now be determined in greater detail by the use of newly developed progesterone antagonists, and estrogens both play a role. Recently, attention has focused not only on contraction-stimulating substances such as oxytocin and prostaglandins, but also on cytokines, which have been implicated in the pathogenesis of preterm labor related to intrauterine infection.

[When may, should, must the ovary by removed--with which technique?].

The growing demand for minimally invasive operative processes and the unmistakable progress in pelviscopy, have led to an extension of the indications for minimally invasive surgery. At the same time, the operative treatment of ovarian cysts is the third most frequently performed pelviscopic operation. The indication for ovarectomy depends, above all, on anamnestic factors, the clinical findings and the results of pre-operative vaginal sonography.

[Intrauterine pregnancy after conservative treatment of ectopic pregnancy with contralateral removal of the adnexa].

Laparoscopic injection has become an important tool in tubal pregnancy. Intratubal injection of 5 mg of prostaglandin F2 alpha (PG F2 alpha) was successful at a serum human chorionic gonadotropin (hCG) level of more than 2500 mlU/ml. Intrauterine pregnancy occurred 112 days after laparoscopic treatment, during earlier removal of the contralateral tube.

[Urogynecologic follow-up after conservative therapy of stress incontinence with a vaginal cone (Femcon)].

The conservative treatment of women suffering from stress incontinence is very often highly successful. Vaginal cones (Femcon) are widely used for training the pelvic floor muscles. We investigated 60 women (mean age 50.

[Ovarian hyperstimulation syndrome].

Techniques of assisted fertilization are usually preceded by ovarian stimulation therapies. This implies the risk of development of an ovarian hyperstimulation syndrome (OHS). With this article, clinical relevance, possible pathogenetic mechanisms, diagnosis, therapy and prevention of OHS are discussed.

[Actinomycosis and intrauterine spiral. 4 case reports].

Genital actinomycotic infections are relatively rare and show a strong coincidence with long term IUD application. Two patients without symptoms, where diagnosis was made by means of Papanicolaou smears, were compared with two patients, where removal of a tubovarian mass led to diagnosis. A general agreement about diagnosis and especially screening tests are still missing, but there seems to be a consensus regarding the types of IUD, the duration of use, and the sexual behaviour of the patients.

[The value of the "vascular invasion" factor for prognosis of breast cancer].

The histological sections of 106 patients, who underwent a primary breast cancer operation in the years 1986 and 1987, were inspected for the presence of tumour vascular invasion. With immunohistochemical methods, tumour vessels were tomographed and the paraffin sections were stained with an antibody, which is sensitive to factor VIII-antigen. A tumour embolus was considered present, if a malignant cell was established within a positively stained lumen.

[Growth rate of breast cancer, implication for early detection and therapeutic effects].

Numerous trials have shown, that breast cancer have highly variable rates of growth. It is assumed, that the rates (relative growth rates) decelerate with increasing tumour size. The Universities of Heidelberg and Louisville carried out a retrospective statistical analysis of the mammographically measured growth rates of 448 screening patients until breast cancer diagnosis.

[Abdominal hysterectomy without internal peritonealization: primary vaginal closure with stapler or open and drained vagina].

The purpose of this study was to compare the postoperative course in 127 patients undergoing abdominal hysterectomy without closure of the visceral peritoneum, who were assigned to either staple closure of the vaginal cuff or drain use. In 31 patients, the vaginal cuff was closed with absorbable staples, and in the 96 patients of the control group, vaginal drain was used. Both, the rate of postoperative complications requiring antibiotic treatment and febrile morbidity were significantly lower in the staple group.

[CIN in pregnancy: incidence, diagnosis and therapy].

Over a period of 5 1/2 years, 71 cases of CIN in pregnancy were analysed. In this report, biological tumour behaviour, diagnostic procedures and therapy are discussed. In our study, there was a higher rate of remissions of light to moderate cervical intra-epithelial neoplasia (CIN I-II) in pregnancy than observed in non-pregnant women.

[Disorders of bladder emptying after labor. Study of 511 puerperal patients regarding the incidence and risk of residual urine post partum].

In a Study of 500 unselected women in childbed interested the incidence and risk factors of residual urine over 50 ml (RH), sonographically proven in the first days after birth. The incidence after vaginal birth was 17% and after C-section 13%, 7% and 1% suffered from a urinary tract infection respectively. The RH-phenomenon lasted approximately 3 days.

[Ultrasonographic determination of amniotic fluid--comparison of two methods].

A study was performed in order to find a suitable ultrasonographic method of determining amniotic fluid volumes. Volumes were measured in 398 gravidae with no fetal or maternal pathology. The Depot V method described by Chamberlain et al.

[Drug information in hormone substitution drugs].

The package leaflets of hormone preparations used for Hormone Replacement Therapy (HRT) in hypoestrogenaemic women contain contraindications, which are taken from the package insert of oral contraceptives: Clots in the blood vessels (thrombotic disorders), high blood fats, severe diabetes, abnormal red blood cells, deterioration of inherited deafness and jaundice not explained by infections, disturbances of the liver function and of existing or treated hormone-dependent tumours of the breast or of the lining of the womb. Numerous epidemiologic, animal-experimental and also clinical studies proved that the cardiovascular risk, hepatic discomfort and the influence on the blood system of oestradiol 17-beta have to be evaluated completely differently compared to the ethinyloestradiol used in oral contraceptives; therefore, many of the listed contraindications must be reconsidered. In our review we try to emphasise this postulation by scrutinizing recent publications.

[L-carnitine-betamethasone combination therapy versus betamethasone therapy alone in prevention of respiratory distress syndrome].

In this prospective randomised study the effects of antenatal treatment with a low dose betamethasone (2 mg/1 day)-L-carnitine (4 g/5 days) combination were compared with those of a high dose betamethasone, given alone (8 mg/2 days) on the prevention of respiratory distress syndrome (RDS) and mortality in preterm infants. One-hundred women entering the trial gave birth to 109 liveborn infants, 55 in the betamethasone group (A), 54 in the betamethasone-L-carnitine combination group (B). Eight of the 55 (14.

[Pregnancy and spontaneous delivery 13 months after heart transplantation].

This case report is on a 23-year old female patient, who underwent cardiac transplantation because of dilatative cardiomyopathy. Four months after transplantation she became pregnant. 13 months postoperatively, the patient had spontaneous vaginal delivery and gave birth to a healthy newborn in good physical condition.

Twenty-four hours hormone secretion profiles of cortisol and estradiol in preterm labour.

We investigated the 24 hour hormone secretion profiles in women with preterm labour. Although estradiol secretion seems to be unaffected, we found an variable estradiol-cortisol-shift due to a cortisol increase. Cortisol circadian secretion persists in preterm labour, but maximum secretion is moved to midday.

[Doppler ultrasound in high grade multiple pregnancies].

From 1987 until 1992, 16 triplets and 2 quadruplets were studied by pulsed Doppler ultrasound between 17 and 36 weeks of gestation. A resistance index (RI) of the foetal aorta and umbilical artery above the 95th percentile was considered pathological. Elevated RI-values of the umbilical artery as compared to the A.

[Breech presentation in nulliparous women--vaginal delivery or indications for primary section?].

The strategy of primary Caesarean section (I. UFK) was compared to the strategy of conservative vaginal delivery (SFK) in nulliparous women with singleton breech presentation. 160 women of the I.