摘要:

Five hundred and twenty-eight female patients with urinary incontinence were studied and treated over a 10-year period. Details of management are given, including a description of a vaginal method of reconstruction of the anatomically incompetent bladder neck. The results of treatment of each group are discussed, and the importance of initial clinical recognition of the urinary outflow obstruction syndrome is stressed in order to institute correct treatment.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Seventy-six patients with primary or secondary amenorrhea who wished to conceive were treated with clomiphene citrate, 2-Br-α-ergocryptine, and/or human menopausal gonadotropins (hMG). Of these 71 patients who received clomiphene citrate, 39 (55%) ovulated. Of these 71 patients, 52 had withdrawal uterine bleeding following IM progesterone, and 38 (73%) ovulated; only 1 of the 19 who did not bleed ovulated (P< 0.001). Ovulation occurred in the former group of patients whether or not they had galactorrhea. Of the 32 patients who failed to ovulate despite treatment with the maximal dose of clomiphene, 250 mg/ day for 5 days, 26 received hMG-hCG. All 26 ovulated and 15 conceived. All 8 patients with amenorrhea-galactorrhea who were treated either primarily or secondarily with bromergocryptine ovulated, and 4 conceived. Therefore, the drug of choice for ovulation induction in amenorrheic patients depends on 1) the presence of withdrawal bleeding after progesterone and 2) the presence of galactorrhea. In all patients with progesterone withdrawal bleeding with or without galactorrhea, the initial treatment of choice is clomiphene citrate. In the absence of withdrawal bleeding, hMG should be administered if galactorrhea is absent, and bromergocryptine should be administered if galactorrhea is present

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Channel formation in dried cervical mucus and the presence or absence of fern formation are correlated. The mean number of channels was 9.2 when the fern was negative, 42.8 when the fern was poor positive, and 73.9 when the fern was good positive. The difference between the means in the 3 groups was statistically significant. The channel number in dried cervical mucus and the presence or absence of fern formation arc correlated with the day of the menstrual cycle in which the specimens were obtained and with the woman's observation of the PEAK mucus symptom while using the ovulation method of natural family planning. The data organized itself more clearly when it was related to the woman's observation of the PEAK symptom. This has been explained by the fact that the PEAK mucus symptom is essentially an ovulatory event. The reliability of the woman's vulvar observations while using the ovulation method was tested against observations of cervical mucus obtained from the level of the endocervix. In those vulvar observations that are considered fertile by the method, the channel number and the frequency of good positive ferning were higher than in those observations that are considered infertile. When the vulvar observations that indicate fertility were compared with those vulvar observations that indicate infertility, the difference was statistically significant. Finally, a practical model of human fertility is described using practical experience with the ovulation method, the woman's vulvar observations while using the method, and the channel and fern formation of endocervical mucus. A progressively declining index of fertility is described that is statistically significant.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One objection occasionally raised against the use of routine antibiotic prophylaxis for pelvic surgery is the concern that the flora of treated patients will be altered, thus favoring the emergence of different, potentially more resistant organisms. This report summarizes experience with 100 women undergoing elective hysterectomy who were subjected to short-term cefazolin, penicillin, or placebo prophylaxis. The changes in preoperative versus postoperative flora were similar among antibiotic-treated and placebo-treated groups. In general, postoperative isolation of gram-negative aerobes and Bacteroides sp increased, and isolation of gram-positive aerobes (except group D streptococci) decreased in antibiotic-treated and placebo-treated groups. The clinical implications of these findings arc discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Cervical abnormalities accompanied by Papanicolaou Class II or Class III cytologic results are commonly encountered in gynecologic office practice. Chlamydiae are a common cause of genital tract infection, with or without manifest symptoms or signs. An immunofluorescence method was used to determine the presence of antichlamydial antibodies in cervical secretions. Eleven of 15 patients in whom such antibodies were found (73.3%) had Papanicolaou Class II or Class III smears, in contrast to only 3 of IS patients (16.7%) without antichlamydial antibodies. The determination of antichlamydial antibodies in cervical mucus was highly reproducible, and specimens were readily collected in the office, without the need of prompt laboratory procedures. In selected patients, tetracycline treatment of early chlamydial infection resulted both in the disappearance of the antibody from cervical secretions and in the reversion of the Papanicolaou smear from Class II or Class III to Class I.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The administration of cephradine prophylactically to patients who were undergoing vaginal hysterectomies resulted in a marked and significant reduction in the incidence of postoperative infections when compared to a placebo group. Cephradine was the cephalosporin studied because of its unique pharmacodynamic properties, which result in high uterine tissue levels. The protective effect was similar whether I g was given preoperatively followed by 500 mg IV q. 6 hours for 4 doses, or a single dose of 2 g IV given approximately 1 hour before surgery. Uterine tissue and serum levels of antibiotic were high and correlated with the degree of protection noted.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The ovarian-peripheral gradients of various Δ4 and Δ5 steroids were determined for a patient with virilizing arrhenoblastoma. The high peripheral testosterone level accompanying this tumor results from increased precursor supply from both the Δ4 and Δ5 pathways, with the Δ5 pathway predominating, and from negligible aromatase activity. A review of 45 cases of androgen-producing ovarian tumors with measurement of peripheral venous testosterone, and of 24 cases with measurement of ovarian venous testosterone, and a comparison with findings in 159 patients with hirsutism of functional origin reveal the following: 1) An androgen-producing tumor must be ruled out when peripheral testosterone exceeds 2 ng/ml; 2) an ovarian venous testosterone level exceeding 20 ng/ml generally accompanies a tumor, particularly when the tumor is less than 5 cm in diameter; and 3) virtually all (98%) of the tumors reviewed were accompanied by virilization, regardless of the peripheral concentration of testosterone.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Recently, the testicular regression syndrome has been reported as being representative of a clinical range of XY agonadal persons. A patient with aberrant fetal sexual development is described. Of particular interest is that all of the tissues examined—the rudimentary uterine horn and the 2 fallopian tubes—displayed an XY chromosome complement. Correlation was made between the known temporal events of embryogenesis of the testes and the apparent time of regression of the testes. In this patient, the insult to testicular development, with subsequent testicular regression, occurred between 48 and 60 days after fertilization. This review supports the previously reported thesis that in certain XY persons the testes are irreparably damaged at a critical stage in fetal development, and that this critical stage is represented by a range of abnormalities of genital development. Possible causes and simplified nomenclature for such gonadal damage are presented.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Because a few ovarian adenocarcinomas respond favorably to endocrine therapy, we tested the hypothesis that some ovarian adenocarcinomas have functional similarity with sex-hormone-sensitive endometrial and breast tumors. Cytosols from 23 ovarian adenocarcinomas and 27 control tissues were examined for receptorlike estrogen and/or progestin binding. Eight of 16 primary ovarian adenocarcinomas had estrogen and/or progestin receptorlike components; among the metastases tested, one third retained estrogen binding. No correlations were found between binding characteristics and histopathologic grade. The presence of estrogen binding in a lung lesion helped confirm recurrent ovarian disease. Estrogen binding occurred in specimens from women with no histories of exposure to exogenous estrogen. Because tamoxifen and nafoxidine could inhibit estradiol binding, it is likely that anti-estrogens will prove beneficial against some ovarian cancers.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Trophoblast-“specific” proteins in the plasma of 37 patients with primary epithelial carcinoma of the ovary were measured. Circulating pregnancy-specific β-glycoprotein (SP,) was detected in 5 subjects, human chorionic gonadotrophin (hCG) was found in 2 subjects, and human placental lactogen (hPL) was detected in 8 subjects.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID