摘要:

Experience of 32 cases of symphysiotomy carried out in Mozambique and in Botswana is reviewed. Of all cases only 1 was lost to follow-up. The observation period varied from 7 days to 6 months. Among 31 cases examined at discharge or on return for check-up few complications occurred. Vaginal laceration occurred in 3 cases, haematuria in 1 case and wound infection in 1 case. In 2 cases there was significant postoperative pain causing gait problems, but in no case were there significant problems with pain at discharge or at follow-up. It is concluded that the intervention is seldom complicated by severe sequelae, provided strict adherence to given indications is respected. In rural areas in the third world symphysiotomy is a life-saving and simple surgical intervention, which should be regarded as an adjunct measure in some cases with a moderately contracted pelvic outlet incompatible with normal vaginal delivery.

ISSN:0378-7346    

DOI:10.1159/000292441

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290845

出版商:S. Karger AG    

年代:1913

数据来源: Karger

摘要:

In order to understand the effects of intrauterine growth discordancy (15% or more birth weight difference), birth weight, and gestational age on the neonatal adverse events (including 1- or 5-min Apgar scores < 7, neonatal death, ICU admission, respiratory distress, hypoglycemia, hypocalcemia, perinatal infection, blood transfusion, and hyperbilirubinemia) in third trimester twin gestations, 279 consecutive twin pairs delivered from January 1986 to December 1991 were studied. Univariate anlyses showed discordant twins were smaller than concordant twins in gestational age by 1.4 weeks (35.74 and 37.14 weeks respectively). When birth weight was compared, that of smaller (one with lower birth weight in a pair) discordant twins (1,951 g) was significantly lower than that of smaller concordant twins (2,423 g), while larger (one with higher birth weight in a pair) discordant twins (2,556 g) and concordant twins (2,594 g) showed no significant difference. Univariate analysis indicated there was a tendency for adverse events to occur in discordant twins, especially in the smaller twin. Through logistic regression analysis, it was found that birth weight and gestational age, but not discordancy, are the predictors of the occurrence of adverse events. A smaller twin weighing no more than 2,000 g has a 10 times greater risk to develop an adverse event as compared to a twin with a birth weight over 2,000 g and a similiar gestational age; while a twin with a gestational age of less than 34 weeks has a 5 times greater risk than one 34 weeks or over with a similiar birth weight.

ISSN:0378-7346    

DOI:10.1159/000292442

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Doppler flow studies of the intracranial internal carotid artery and middle cerebral artery performed in 17 women at 30–36 weeks of gestation, referred for evaluation of small for gestational age fetuses, resulted in abnormally low pusatility index values (below 2 SD). These patients were investigated when fasting and 1 h after a 100-gram glucose load. Increase of 20 ml/dl or more was followed by elevation of the mean pulsatility index in the internal carotid artery from 1.03 ± 0.09 to 1.44 ± 0.22 (p < 0.001), and in the middle cerebral artery from 1.12 ± 0.16 to 1.83 ± 0.24 (p < 0.001). Pulsatility index values returned to normal (within 2 SD for gestational age) in 15 of the subjects investigated after glucose load. These findings suggest the importance of standard fasting state or determination of maternal plasma glucose levels in patients undergoing Doppler flow evaluation of growth-retarded fetuses.

ISSN:0378-7346    

DOI:10.1159/000292443

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290846

出版商:S. Karger AG    

年代:1913

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290847

出版商:S. Karger AG    

年代:1913

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290848

出版商:S. Karger AG    

年代:1913

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000290849

出版商:S. Karger AG    

年代:1913

数据来源: Karger

摘要:

The aim of the present study was to optimize the use of serum procollagen type I carboxy-terminal propeptide (PICP) as a possible marker of postmenopaus-al-3761ted changes of bone metabolism. Postmenopausal (n = 20) and healthy fertile young (n = 4) women were studied after informed consent. The postmenopausal women were subdivided in 4 groups: (1) nontreated; (2) treated with estrogen-progestogen replacement therapy; (3) treated with calcitonin, or (4) with kidney or liver diseases. Blood samples were collected at 15-min time intervals for 4, 6 or 8 h. Serum concentration of PICP was measured by radioimmunoassay, in duplicate at two different dilutions. In postmenopausal women mean ± SEM serum PICP levels were slightly but nonsignificantly higher than in fertile women. Serum PICP levels in estrogen-progestogen or calcitonin-treated women were significantly lower than in non-treated postmenopausal women. Episodic changes of circulating PICP level were observed in fertile and postmenopausal women. The pulses of serum PICP levels did not show significant differences among the groups of women studied. The present study showed that the measurement of serum PICP levels is a useful marker for investigating the changes of bone metabolism. In particular, low PICP levels in postmenopausal women under steroid hormone or calcitonin treatment in part reflect the changes of bone turnover. The pulses of serum PICP levels during a time interval suggest that collagen metabolism in women undergoes a rapid turnover

ISSN:0378-7346    

DOI:10.1159/000292448

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

One hundred and eighty-eight patients with epithelial ovarian carcinoma were treated with primary cytoreductive surgery and subsequent combination chemotherapy. The first recurrent findings such as sites and disease-free interval were analyzed in 141 patients who were clinically remitted 6 months after operation or chemotherapy. Fifty-seven cases had a recurrence. Five-year disease-free survival rates were 75, 72, 29, and 0% in stage I, II, III, and IV, respectively. Twenty-one of 22 patients with > 2 cm maximun residual tumor died, although they once achieved clinical remission. Significant differences were observed between histologic types, and the disease-free survival rate was lowest for serous cystadenocarcinoma. Nine of 15 stage IV patients with serous histology experienced remission, but none of the 8 in stage IV with other histologies did so, suggesting that serous adenocarcinoma is sensitive to chemotherapy and conducive to clinical remission. However, all stage IV patients in remission encountered a recurrence. Intra-abdominal cavity and lymph node were frequently the initial recurrent sites (38 and 27%, respectively). On the other hand, the incidence of distant recurrence was as high as 27%, and 8 of 16 cases with distant recurrence were stage I. Survival time after recurrence was not different among initial sites of recurrence and mean survival time was 15 months.

ISSN:0378-7346    

DOI:10.1159/000292449

出版商:S. Karger AG    

年代:1994

数据来源: Karger