摘要:

The association of unilateral tubo-ovarian abscess and the presence or use of an intrauterine contraceptive device(IUD) appears to be a definite clinical entity. Four cases of unilateral tubo-ovarian abscess in patients using the IUD are presented. Three patients had a Dalkon Shield IUD and one had a Lippes Loop. Two patients had unilateral salpingo-oophorectomy while the other 2 had total abdominal hysterectomy and bilateral salpingo-oophorectomy. The differential diagnosis, possible etiology, route and mode of infection, and management are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Exenteration for Stage IV cancer of the vulva is feasible and desirable, with expected 5-year survival rates of 34–57%. A team of gynecologic oncologists operating simultaneously has the cohesion to reduce operating time, surgical fatigue, and perhaps morbidity and mortality. Data indicate that ultraradical surgery in the 71-year and over age group is nonproductive of salvage and should be individualized critically. Patient selection, attention to detail, and use of the proper surgical procedure are all important in improving results.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Eighty-eight cases of Stage I and Stage II carcinoma of the cervix treated with radiotherapy at the University of North Carolina Memorial Hospital between April 1969 and July 1971 are reviewed. The question of whether the radiation time-dose-fraction relationship can be applied to the combination of external beam and intracavitary therapy used in the treatment of cervical carcinoma is studied. Formulas are outlined which enable one to calculate a total Rad Equivalent Therapy (RET) value, including the contribution from both the fractionated external beam and intracavitary therapy. Both the calculated RET value and the rad dose to Point A show good correlation with control of local disease in this retrospective analysis; however, the RET value may be more applicable when deviations from the standard time-dose-fraction relationship have occurred.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

A surgical technique for para-aortic lymph node evaluation for metastatic tumor by the extraperitoneal approach is described. The procedure is devised to avoid gastrointestinal complications frequently found after transperitoncal evaluation of the para-aortic area followed by extended field irradiation. The surgical procedure was performed in 20 patients. Nine patients treated with 6000 rads extended field irradiation remained without gastrointestinal complications after 3 to 16 months of follow-up.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The Gambee single-layer, through-and-through, catgut suture anastomosis of the gastrointestinal tract has been in use from 1969 to 1974. Sixty-four anastomoses have been performed on 56 patients with gastrointestinal involvement or pelvic malignancy. There were no operative deaths, and no patients required reoperation for correction of intestinal anastomotic leaks or rupture of the suture line. This experience suggests that the Gambee intestinal single-layer anastomosis may be useful in the management of gastrointestinal complications of pelvic surgery and malignancy.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The serum concentration of immunoreactive follicle-stimulating hormone (FSH) and FSH response to synthetic luteinizing-hormone-releasing hormone (LHRH) were investigated in 9 patients with intact hydatidiform moles and 3 patients with aborted moles. The serum concentration of FSH before and after intravenous administration of 200 μg of synthetic LHRH was measured by double antibody radioimmunoassay. Seram FSH was detectable but relatively low compared with the levels seen in the follicular phase of the normal menstrual cycle in all 12 patients. Furthermore, the 12 patients did not respond, or responded subnormally, to exogenously administered LHRH, and there was no significant elevation in serum FSH levels after LHRH injection. The result of the current study is in accord with that of our previous report on the serum concentration of FSH and FSH response to synthetic LHRH during normal pregnancy. Thus, it might be concluded that the follicle-stimulating activity of the anterior pituitary is suppressed by an unknown mechanism during molar pregnancy as well as normal pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Levels of progesterone, estradiol, LH, and FSH were measured in daily serum samples obtained from 4 subjects during a control cycle and during the first and fourth menstrual cycles after insertion of an intrauterine device (IUD). In addition, progesterone and estradiol were measured in serum samples obtained from 6 women 3, 4, or 5 months after IUD insertion, and from 6 women more than 1 year after IUD insertion. These measurements were compared to the data obtained from study of a large group of normal cycles. The results indicated that the IUD does not influence follicular maturation, time of ovulation, or corpus luteum function. The IUD did exert a local effect on the endometrium. causing the onset of menses to take place when steroid levels were higher than in control cycles.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

Benign hepatocellular neoplasis has been found in 23 patients receiving oral contraceptives of various types. Because primary liver tumors are rare, this marked increase in incidence within 5 years suggests a cause-and-effect relationship. Since progestogens are enzyme inducers it is possible that they accelerate oncogenesis by increasing toxic metabolites which cannot be excreted due to the cholestatic effect of estrogens. Vascular changes and the hypercoagulation state of pill users may act synergistically to produce hemorrhagie necrosis and tumor rupture. Liver scans, celiac arteriography, and standard liver function tests are impractical and ineffective in the identification of the patient at risk. Management of the suspect patient with an intact liver should consist of biopsy at laparotomy so that the entire liver can be inspected. Observation, discontinuance of oral contraceptives, avoidance of similar steroids, and pregnancy should provide adequate prophylaxis against liver rupture. However, if a large blood-filled sinus lake or an area of coagulation necrosis is encountered, resection is imperative to prevent later rupture.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The efficacy of intramuscular 15-me-PGF2αas an abortifacient was evaluated in 40 women between 14 and 20 weeks of gestation and 6 patients with missed abortions. Pregnancy was successfully terminated in all the cases. The injection-abortion interval was significantly lower in 20 patients (Group II) who had intracervical laminaria insertion prior to treatment with 15-me-PGF2αthan in 10 women (Group I) without laminaria insertion (t= 7.2;P< .001). Abortion was also accomplished in 10 women with ruptured membranes and 6 patients with missed abortions. Gastrointestinal side effects were minimal and acceptable when premedication with antiemetics and an antidiarrheal was used. This study demonstrates the availability of the intramuscular route—a simple, safe, and reliable means of terminating pregnancy, especially during the early midtrimester period.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID

摘要:

The relation between oral contraceptive (OC) use, ABO blood groups, and in vitro fibrin formation, as measured by thrombo-elastography, was investigated in 4315 women. The thrombo-elastogram (TEG) measures the speed of fibrin formation (R, K) and clot firmness (Ma). More rapid fibrin formation and increased clot firmness were associated with current OC use, but not to the extent seen in pathologic states. This relation was not related to dose, estrogen-progestin type, or duration of exposure. Past and “never” OC users had similar TEG values, suggesting reversibility, and noncontraceptive estrogens had a minimal effect on the TEG. ABO blood groups were found to have only a slight association with TEG values. Subjects with blood group O showed a somewhat prolonged speed of fibrin formation as compared to all other subjects. A decreased clot firmness was found in AB subjects, but this did not persist among OC users.

ISSN:0029-7844    

出版商:OVID    

年代:1975

数据来源: OVID