摘要:

A study was undertaken to investigate changing trends in the microscopic patterns of endometrial carcinoma and to compare the biologic characteristics of those cases associated with and without estrogen usage. After each case was reviewed independently and in a random order by at least 2 pathologists, a diagnosis of cancer was agreed on in 274 patients who had been treated by 5 gynecologists at the Massachusetts General Hospital between 1940 and 1971. Six microscopic patterns were identified (adenocarcinoma, adenoacanthoma, atypical adenoacanthoma, adenosquamous carcinoma, clear-cell adenocarcinoma, and undifferentiated carcinoma). The frequency of each pattern relative to the other 5 changed only slightly during the 30-year interval. The tumors that developed in estrogen users were more highly differentiated than those that developed in nonusers (P< 0.005) and were found at an earlier average age (P< 0.02). That the adenoacanthoma was associated with estrogen usage more frequently (51%) than any other tumor type (P< 0.02) may reflect, in part, a similar and lower mean age of estrogen users (56 years) and patients with adenoacanthoma (55 years) compared with that of nonusers with the other forms of tumors (60–67 years). Although the overall 5− and 10-year survival rates of the estrogen users were higher than those of the nonusers, the differences between the 2 groups disappeared when the grade of the neoplasm was considered.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Twelve cases of transverse vaginal septum were clinically and pathologically evaluated. Seven cases were treated with electrosurgical excision of the septum with encouraging results. Histologic findings in the patients in this study support the view that the epithelium of the vagina and the transverse septum are of mesonephroid origin.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A retrospective analysis was conducted of 668 consecutive cases using T-tube suction drainage and/or prophylactic antibiotics as infection prophylaxis for hysterectomy. The data are analyzed for the incidence of minor febrile morbidity (temperature > 100.4 for 2 days) and for major infection (hospital stay more than 14 days, reoperation or readmission for the management of pelvic abcess or pelvic thrombophlebitis). The study also compares a minor febrile and major infection group with a noninfected group by measuring parameters of patient discomfort, medical staff effort, and financial costs. It is concluded that 1) minor febrile morbidity frequently follows abdominal (20–30%) and vaginal (30–50%) hysterectomy; 2) minor febrile morbidity has temporary but significant consequences in the form of increased patient discomfort, medical staff effort, and financial costs; 3) major infections are rare following abdominal hysterectomy (< 0.5%) and uncommon following vaginal hysterectomy (1–4%); 4) suction drainage used alone, prophylactic antibiotics used alone, or a combination of suction drainage and antibiotic prophylaxis is each associated with a statistically significant reduction in the incidence of minor febrile morbidity following both abdominal and vaginal hysterectomy (P= < 0.01); and 5) such infection prophylaxis may also reduce the incidence of major infection following vaginal hysterectomy.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Of 177 gynecologic outpatients with cervical dysplasia studied, 29 (16%) were found to excrete Chlamydia trachomatis from their urogenital tract. Sera collected from 93 of these patients were significantly more often positive for and showed higher levels of antichlamydial micro-complement fixation (CF) and immunofluorescence (IF) antibodies than sera obtained from the controls. However, when the sera were tested for anti-herpesvirus type II (HSV-II) and cytomegalovirus (CMV) antibodies, no difference between the cases and the controls were encountered.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Perineal cellulitis originating from an episiotomy incision resulted in 20% of the maternal mortality in King County, Washington, between 1969 and 1977. Necrotizing fasciitis was present in 2 of the cases, and clostridial myonecrosis was present in 1. These fatalities occurred because the practitioners were not aware that necrotizing fasciitis can occur in the fatty superficial fascia of the perineum and that resection of the necrotic tissue is necessary for successful therapy.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Electronic measurements of compression, using a hydrostatic technique, were made during 44 normal deliveries and compared with the values obtained during 32 deliveries using Kielland's forceps, 21 using Neville Barnes' forceps, 48 using Moolgaoker's adjustable forceps, and 26 using Malmstrom's vacuum extractor. Electronic recordings of traction, using strain gauges, were made simultaneously during all the instrumental deliveries except those with Kielland's forceps. By exercising suitable controls over most of the multiple factors operating at the time of any delivery the authors were able to compare objectively the efficiency of the different methods of instrumental delivery. Smaller forces of compression and traction were exerted and better Apgar scores were recorded in infants delivered with the adjustable forceps than in infants delivered with the other instruments. The superiority of the adjustable forceps was most noticeable during midcavity deliveries of the malrotated head.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In a paired, controlled, retrospective study, 44 low birth weight breech fetuses delivered vaginally were compared with 44 breech fetuses delivered by cesarean section. Seven deaths occurred in the vaginal delivery group, compared with only 1 in the abdominal delivery group. Asphyxia, trauma, and intracranial hemorrhage were also found more frequently among vaginally delivered fetuses. The authors conclude that for the low birth weight breech fetus, delivery by cesarean section is preferable.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Serum human placental lactogen (hPL) levels were studied in 806 women in late pregnancy. The hPL levels were positively correlated with birth weight but were unrelated to maternal age, parity, socioeconomic status, or the sex of the newborn. The hPL levels peaked at 37 weeks' gestation and then declined moderately. An individual's hPL levels in late pregnancy are quite constant week to week. Patients with severe chronic hypertension have low hPL values; those carrying twins have high values.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In a prospective study of 100 consecutive diabetic pregnancies, 1 was complicated by hyperthyroidism and 4 by hypothyroidism. The association of hypothyroidism with diabetes mellitus merits special attention as this combination of diseases affected 4 of 20 (20%) White's class D and F diabetics. Hydramnios and/or spontaneous premature labor were features of diabetic pregnancies complicated by compensated hypothyroidism. Delayed diagnosis of hypothyroidism may have contributed to the fatal congenital malformations in one of these fetuses, but the remaining infants survived, including 1 infant suffering from severe respiratory distress syndrome (RDS).

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Glycosylated hemoglobins (HbA1) were measured in 23 nonpregnant women, 53 normal pregnant women, and 22 Class A diabetics; the results were 6.1 ± 0.7%, 5.8 ± 1.0%, and 7.0 ± 1.3% in the 3 groups, respectively. The decrease in normal pregnancy was insignificant, whereas the increase of HbA1in Class A diabetics over the other 2 groups was statistically significant (P< 0.05). HbA1did not correlate with maternal age, gravidity, or gestational age at the time of sampling. There was no difference in HbA, between whites and blacks [patients with sickle hemoglobin (HbS) were excluded] (P= 0.35), nor between primigrav-idas and multigravidas (P= 0.8). HbA, levels did not correlate with the birth weight ratios in either normal pregnancies (r= 0.06,P= 0.7) or in Class A diabetics (r= −0.4,P= 0.09). This is probably due to the long interval between HbA, determination and delivery (9.9 weeks).

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID