摘要:

Background. The purpose of this study was to evaluate the attitudes and opinions among donor insemination recipient couples with respect to the informing of offspring and relatives, the effects of donor insemination on sexual life and marital status, and their concerns about the risk of getting a sexually transmitted disease.Methods. Aquestionnaire study design. Three hundred and sixteen (194 Danish and 122 Swedish) couples were included.Results. Answering rate among the Danish couples was 89% and among the Swedes 75%, (p<0.01).Fifty percent of the Danish couples and 66% of the Swedes were of the opinion that the treatments should be kept secret from good friends, (p<0.05). Sixty‐seven percent of the Danes and 87% of the Swedes found it important that knowledge about the inseminations was not made common knowledge to all interested parties, (p<0.005).Parameters in which there were no differences between Danes and Swedes: Fifty‐one percent of the couples would withhold information about the insemination from the child even when it was old enough to understand this information.Seventy percent of the couples would prefer not to know themselves, whether they had been conceived by donor insemination.Nineteen percent of the Danish couples would not have accepted donor insemination if the legislation guaranteeing donor anonymity had not been in existence.Eighty percent thought that their sexual life was unaffected during the course of the treatment. When asked, 95% were still married to the same partner with whom they began the treatment. Eighty‐five percent of the couples were worried about getting a sexually transmitted disease through the treatment.Conclusion. The results suggest that secrecy about the treatment and donor anonymity have a high priority among Danish and Swedish recipient couples, irrespective of the different legislation in the two coun

ISSN:0001-6349    

DOI:10.3109/00016349509009943

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In a consecutive series, 30 women were interviewed and gynecologically examined after pelvic pouch operation because of inflammatory bowel disease. The examination displayed: colpitis in two. bacterial vaginosis in one and cervical cancerin situin one of the women. Unwanted infertility was reported by five women, probably due to female factors in three. Sixteen women had felt sexually unattractive by the temporary ileostomy. At follow‐up, after closure of the ileostomy, 23 women experienced a considerable sexual desire, 28 could experience orgasm and 20 nearly always had orgasm at intercourse. Insufficient vaginal lubrication during intercourse was reported by seven women. This could be explained by hormonal or other factors in four women and might be owing to side‐effects of the operation in three. Four women reported slight deep dyspareunia and one superficial dyspareunia. The result indicated a low frequency of sexual problems after pelvic pouch operat

ISSN:0001-6349    

DOI:10.3109/00016349509009944

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The effects of an oral contraceptive pill containing cyproterone acetate on lipid metabolism in women with polycystic ovary syndrome (PCOS) was studied.Materials and methods. Seventy‐two women with PCOS were treated for 36 consecutive cycles with an oral contraceptive containing 0.035 mg of ethinylestradiol and 2 mg of cyproterone acetate. Hormonal. lipid and glucose profiles were studied before and after 12 and 36 cycles of treatment. Lipid, lipo‐and apolipoprotein values were compared to a healthy control group. Statistical analysis was by one way analysis of variance and Bonferroni'sttests.Results. The treatment suppressed gonadotropin and androgen values and increased the levels of sex hormone binding globulin. After 12 and 36 cycles a significant increase in triglycerides, high density lipoprotein (HDL) cholesterol system, and apoprotein B levels was seen. Low density lipoprotein (LDL) cholesterol and LDL cholesterol/HDL cholesterol ratio were reduced. Insulin and glucose plasma concentrations did not change. During treatment triglycerides, total cholesterol and apoprotein B values were higher than in the control group. There were no differences in plasma levels of LDL‐C and HDL‐C in PCOS and in the control group.Conclusion. Lipid and lipoprotein changes observed after treatment could be due to the estrogen dominance of the treatment. The plasma concentration of triglycerides and total cholesterol during treatment does not change appreciably and the LDL‐CIHDL‐C rat

ISSN:0001-6349    

DOI:10.3109/00016349509009945

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Background. The accuracy of clinical staging is known to be insufficient in stage II endometrial carcinoma. Also the optimal management of this disease is controversial. In this study we evaluate diagnostic accuracy and prognostic factors with special reference to treatment modalities of stage II endometrial carcinoma.Methods, Of 1297 patients with endometrial adenocarcinoma (EAC) treated between 1970 and 1980 at Departments of Obstetrics and Gynecology, Helsinki University Central Hospital, 140 (11%) cases represented clinical stage II and were retrospectively analyzed.Results. Median age of the patients was 63.5 years (range 40–85 years). Accuracy of Papanico‐laou smear was 50%, and that of endocervical curettage 51%. Most of the tumors were histopathologically pure adenocarcinomas (88%), well differentiated (43%), and superficially invaded to inyometrium (44%). Thirty‐four (24%) of the patients developed a recurrent disease during the first five years afterwards. Median time of recurrency was 17 months (range 4–35 months). The disease free 5‐ or 10‐year survival were 72% and 67%. Survival was significantly correlated with menopausal state (p<0.01), tumor grade (p<0.05), myometrial invasion (p<0.001), surgical stage (p<0.0001), and mode of treatment, i.e. operation done or not (p<0.05). Survival was not affected by the radical nature of the operation (radical vs. simple hysterectomy). When all prognostic variables were analyzed by Cox's regression model (multi‐variate analysis) in 10‐years follow‐up, only menopausal state, myometrial invasion, and mode of treatment. i.e. operation done or not (p<0.01), were independent prognostic factors.Conclusions. The only relevant staging procedure is the histological examination of cervix without the preoperative irradiation. According to our results it seems that simple hysterectomy instead of radical (Wertheim operation) hysterectomy may be a sufficient operative treatment of stage II endo

ISSN:0001-6349    

DOI:10.3109/00016349509009946

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In a prospective study of 107 women, bacterial vaginosis was clinically diagnosed in 34 women. Compared with clinical diagnosis of bacterial vaginosis, detection of clue cells in Papanicolaou stained vaginal smears showed a sensitivity of 88.2%, a specificity of 98.6%, a positive predictive value of 96.8% and a negative predictive value of 94.7%. The corresponding values for detection of bacterial vaginosis in Gram stained smears compared with the clinical diagnosis were 100%, 97.3%, 94.4% and 100%, respectively. Compared with clue cells in wet smears, identification of clue cells in Papanicolaou stained vaginal smears showed a Kappa index of 0.87 and compared with Gram stain criteria a Kappa index of 0.94. The correlation between Gram stain and Papanicolaou stained vaginal smears showed a Kappa index of 0.89. In contrast to the results of earlier investigators our studies indicate that the demonstration of clue cells in Papanicolaou stained vaginal smears correlate reasonably well with the conventional clinical criteria. However, the Gram stain method may be more reliable than the Papanicolaou method.

ISSN:0001-6349    

DOI:10.3109/00016349509009947

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Aim of the study. To examine intracranial blood flow during major laparoscopic gynecologic operation and the effects of a deep Trendelenburg position and pneumoperitoneum on the flow.Material. Fifteen patients scheduled for laparoscopic hysterectomy.Methods. Trans‐cranial Doppler examination of blood flow velocity waveforms in the middle cerebral artery during operation.Results. Trendelenburg position and pneumoperitoneum were followed by a decrease in cardiac output and an increase of central venous pressure and pulmonary capillary wedge pressure. No significant changes in the pulsatility index or maximal or mean blood flow velocities in the middle cerebral artery occurred during operations. A negative correlation between percentual changes in the pulsatility index and mean arterial pressure existed.Conclusions. Uncomplicated laparoscopic hysterectomy is not associated with harmful changes in intracranial circulation in spite of a Trendelenburg position, pneumoperitoneum and changes in the patient's extracranial hemodynamic

ISSN:0001-6349    

DOI:10.3109/00016349509009948

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A 39 year‐old patient with long‐standing diagnosis of pelvic endometriosis had been treated for over twenty years with oral contraceptives (OCs). A year prior to admission to the gynecological ward. an ultrasonographic examination revealed three hepatic lesions, which were not reported in previous liver sonography. These lesions progressed during OC use, over the next six months. Liver function tests were normal. Liver scan, CT and ultrasound imaging techniques supported the diagnosis of solid hepatic tumors. These lesions developed concomitantly to long‐term use of OCs, therefore discontinuation of therapy was mandatory. Six months later, the patient was hospitalized due to pelvic pain. She underwent total abdominal hysterectomy and left salpingo‐oophorectomy (the right adnexa had been removed years before). Due to the patient's young age, hormone replacement therapy was indicated. The preferred preparation was transdermal estradiol due to the fact that systemic absorption has no hepatic first‐pass effect and therefore exerts minimal influence on liver enzymes and functions. Serial ultrasonographic examinations, performed while under treatment with transdermal estradiol, showed complete regression of the hepatic lesions over a period of two years. Our report demonstrates regression of multifocal hepatic tumors despite transdermal estradiol replacemen

ISSN:0001-6349    

DOI:10.3109/00016349509009949

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

A case of adenoid cystic carcinoma of the Bartholin's gland, a rare vulval tumor, is reviewed with respect to clinical and pathological characteristics. Histological transition from normal Bartholin gland to adenoid cystic carcinoma was evident in this case. Local recurrences are common and often precede distant metastases. The recommended primary treatment is vulvectomy, obtaining clear margins and bilateral inguinofemoral node dissection.

ISSN:0001-6349    

DOI:10.3109/00016349509009950

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Cases of coexisting ovarian hyperstimulation and ectopic pregnancy are rare, and pose a difficult diagnostic problem. The routine attempts at laparoscopic diagnosis and treatment of these pregnancies may prove to be hazardous. Such cases may be better managed nonsur‐gically either by methotrexate or, in selected cases, by expectant management while monitoring the p‐hCG level and clinical sta

ISSN:0001-6349    

DOI:10.3109/00016349509009951

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349509009952

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY