摘要:

A series is presented of 830 patients in whom elective appendectomy was performed at the time of laparotomy for other intraabdominal disease. Special emphasis is given to 490 such procedures among 1042 patients with abdominal hysterectomy, an incidence of 47%. This increases to 57% by exclusion of patients with previous appendectomy. The contraindications to elective appendectomy are discussed, as well as its morbidity, mortality, and complications. The author concludes that an elective appendectomy should be performed with abdominal and pelvic surgery whenever the opportunity is presented, provided that the procedure is not prohibited by the contraindications discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The use of conservative pelvic surgery combined with intra- and postoperative antibiotic peritoneal lavage has been evaluated in 113 women with generalized peritonitis due to ruptured tuboovarian abscess. Mortality was 7.1% and hysterectomy was only required in 3% of cases. Hormonal and menstrual functions were retained in 73.5% and the potential for future pregnancy in 42.5%. Further surgery was required in 17.5% of the patients. These results are contrasted with recent series of comparable size in which the mortality and morbidity were similar but the frequency of hysterectomy ranged from 70-100%. It is concluded that hysterectomy is not necessary in the management of ruptured tuboovarian abscess if the major source of sepsis is removed and adequate peritoneal drainage is provided by the use of lavage.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The fever index measured the responses of 102 women with serious pelvic infections who had received either chloramphenicol or clindamycin, in combination with other antibiotics. There was no statistical difference in the number of degree hours in the two populations. Patients with salpingo-oophoritis had significantly more fever than those with a septic abortion. Bacteremia did not delineate a group of women with a markedly elevated febrile response. Within the population with salpingo-oophoritis, neither black women nor women with an intrauterine device in place had significantly more fever, but patients requiring operation had more fever while those with an endocervical culture positive for the gonococcus at the time of admission had the most favorable clinical response. The significance of these findings is discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Laparoscopic ovarian biopsies performed on 11 patients with congenital absence of the uterus revealed the presence of follicles at different stages of development, with corpora lutea in 2 patients and cystic follicles in 1 patient who had cyclic patterns of serum gonadotropins and plasma progesterone.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A review of all newly diagnosed cases of cervical and endometrial carcinoma in Israel during the S-year period of 1961-1965 yielded mean annual incidence rates of 4.9/100,000 and 7.4/100,000, respectively. Cervical cancer was more prevalent in Moroccan-born women and among divorcees, while the risk of endometrial cancer was highest in older age, among the European born, and the single; it also appeared earlier in life; Postmenopausal bleeding constituted the most frequent first symptom in both sites. Fifty percent of the patients of both groups were diagnosed within 1 month, but the delay was somewhat longer in the endometrial group. Median survival was 5 years in patients with cervical cancer and above 12 years in those with cancer of the corpus. Five-year survival was 50 and 75%, respectively. Survival tended to be better in younger patients in both groups. It is expected that the gradual disappearance of intraethhic differences in Israel would lead to a decrease in the incidence of invasive cervical cancer, coupled with an increased incidence of the endometrial category.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Eight patients who required prolonged estrogen replacement therapy were implanted with two 25-mg pellets of estradiol-17β and were followed with serial measurements of serum estradiol, estrone, follicle stimulating hormone, luteinizing hormone, and maturation index of the vaginal smears. There was a significant increase in estrogen levels within 24 hours after pellet implantation, and this level was maintained in physiologic premenopausal range during the rest of the period of followup. Gonadotropins were suppressed to a greater degree in gonadal dysgenesis patients as compared to postmenopausal patients. There was rapid relief of vasomotor symptoms within 4-10 days even though the gonadotropin levels were high. Implantation of 50 mg of estradiol pellets and periodic withdrawal bleeding with a progestational agent seems to he an effective method of long-term replacement therapy.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Two case reports of intraabdominal pregnancy and review of 9 others which have been seen at the Indiana University Hospital arc presented. An incidence of one intraabdominal pregnancy in 7931 deliveries at Indiana University is compared to 1 in 3372 deliveries from a large series at another institution. A perinatal mortality of 91% and a maternal mortality of 18% from our series are contrasted to 90% and 6%, respectively, from the world literature. The diagnosis, management, arid outcome of this rare form of extrauterine pregnancy are discussed. Recurrent abdominal pain in the gravid patient may signal abdominal pregnancy. The role of ultrasound in diagnosis and the importance of early surgical intervention with minimal disturbance of the placenta are stressed. In cases of intraabdominal pregnancy, (he infant rarely survives and congential malformations are frequent.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Over half the patients with proven ectopic pregnancies have negative urinary slide or tube pregnancy tests at the time they present with symptoms. Because of the morbidity and mortality associated with unrecognized ectopic pregnancy, the need for an accurate, rapid, sensitive, and specific method for measuring low levels of human chorionic gonadotropin (hCG) is apparent. A three-hour radioimmunoassay (RIA) for serum hCG with a sensitivity of 5 mlU/ml was developed which utilizes an antiserum generated against the beta suhunit of hCG,125I-hCG for tracer purposes, a highly purified hCG standard, and dioxane for separation of hound from free hormone. Blood samples were obtained from 52 patients with suspected ectopic pregnancies. Twentyfour of these patients had a surgically proven ectopic gestation. The blood samples were analyzed in the above described RIA, and in the standard (24-hour) double antibody beta-hCG RIA. There were no false positive or false negative results by either assay. These results indicate that the dioxane modification of the beta-hCG RIA is an accurate and rapid method for confirming the diagnosis of ectopic pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Scrum prolactin values in normal pregnant women showed a progressive increase from a mean value of 50 ng/ml in the 12th week to 270 ng/ml at term, with the range at term being 100-600 ng/ml. There was a fairly good correlation (r=0.7) between the values of 24-hour urine estriol in 138 determinations and in the serum prolactin in 133 pregnant women. The regression lines of serum hPRL values with time of gestation in cases of intrauterine growth retardation (IUGR) and diabetes mellitus were less steep than those seen in normal pregnancy. The serum hPRL value of patients with preeclamptic toxemia, latent diabetes, premature rupture of membranes, or multiple pregnancies were found not to differ significantly from the values observed in normal pregnancy. The results indicate that prolactin determinations in pathologic pregnancies are not useful as an aid in their evaluation.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

To understand the effects of uterine compression on the abdominal aorta in pregnant women, the abdominal aorta in pregnant animals was experimentally constricted. This procedure produced symptoms identical to toxemia in humans. A physical model simulating the human aorta with blood flowing under physiologic pressure, and a “term uterus” pressing on it showed that blood flow reduction thus produced easily could be within the range observed in the toxemic human. Experimental constriction or compression of the abdominal aorta in pregnant animals produced a parallel drop in the femoral artery pulse pressure and uterine artery blood flow. This observation is applicable to pregnant women in the supine position. When the pregnant uterus presses on the abdominal aorta, reduced uterine artery blood flow was noted by following femoral or popliteal artery pulse pressure reduction. In 379 pregnant patients studied, 40% showed a drop in popliteal artery pulse pressure during uterine contraction and 11% during uterine relaxation. During relaxation, this was observed in 16% of primiparous patients and in 6% of multiparous patients.

ISSN:0029-7844    

出版商:OVID    

年代:1977

数据来源: OVID