[The termination of ovulation in sterility patients].
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Biomedical subjects
Publications and source records attributed to M Link.
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Breech presentation is classed as an abnormality because of the high associated perinatal mortality and morbidity rates and the slightly increased maternal morbidity. A review of 14 years' experience with breech delivery was undertaken to ascertain patterns of care. During this period there were 33 183 births and there were 1271 cases of breech presentation. The method of delivery in the 1271 cases included 91,5 per cent vaginal deliveries and 8,5 per cent cesarean sections. There was an increase to 15,3 per cent during the last 2 years of the review. This review indicates a decline in perinatal mortality rate from 20,3 to 5,4 per cent (unselected). Breech presentation is often associated with premature labor. Premature labor represents the significant clinical problem by contributing to perinatal morbidity and death.
Male infertility is a far more prevalent problem than is perhaps generally realized. The evaluation of testicular biopsies allows various clinical syndromes of hypogonadism to be identified and a rational basis for therapy to be established. The morphological-anatomical classification of male infertility paralleling the clinical-biochemical classification divides the different varieties of male infertility into three categories: those due to pretesticular, testicular, and posttesticular causes. Testicular biopsy is an important method in the diagnosis and management of male infertility. The procedure is simple and safe in competent hands and yields information obtainable in no other way. The increasing use of this procedure permitts a rational classification of the testicular lesions responsible for infertility and provides an intelligent basis for the institution of corrective measures or the withholding of therapy in cases in which the biopsy indicates a hopeless prognosis for fertility.
The course of delivery to patients aged 16 and under during 1957 to 1961 and 1967 to 1971 is reported. The frequency of deliveries has not changed. Vaginal delivery occurred in 140 of 142 patients. The delivery of the young girls was characterized by an uncomplicated course. The incidence of breech, cesarean section and assisted deliveries was low. Neonatal complications and the perinatal mortality rate are attributed to prematurity and malformation. Prematurity might be reduced by an intensive care of pregnancy.
There are many difficulties in the diagnosis of recurrent carcinoma in the lesser pelvis. A second course of radiation carries a high risk of morbidity and mortality. Therefore histological proof of recurrence must be obtained prior to subjecting a patient to radiotherapy. An attempt has been made to demonstrate malignant recurrence on the pelvic side wall by means of needle biopsy. The results of 181 needle biopsies are reviewed and the sources of error in this method are discussed.
Cyclic alterations of the endometrium are known for certain, but similar processes of the mucous membrane of the uterine cervix are vague. In pregancy there is a considerable increase in secretion. The epithelium of surface and glands becomes stratified and the nuclei of cylindrical epithelial cells withdraw from the base of the cells and often originate retronuclear vacuols. From these vacuols one has to distinguish so-called subcylindrical vacuols which only appear during pregnancy. They are seen between epithelium and basal membrane. Electron microscopical investigations show the vacuols lined partly by atrophical partly bysecretory cylindrical cells. Histochemically the contents of the vacuols are similar to the cytoplasm of cylindrical cells and the contents of glands. These alterations of the cervical mucous membrane are dependent on hormonal stimulation and in conclusion it must be possible to demonstrate the hormonal situation andits disturbances by investigations of the mucous membrane of the cervix uteri.
The course of pregnancy to patients aged 16 and under during 1957 to 1961 and 1967 to 1973 is reported. There is an increasing number of pregnancies in these groups of adolescent girls. The frequency of delivery has not changed but the number of abortion has become more important. This fact and the complication by a substantially higher frequency of gestosis and by a tendency to premature delivery causes the pregnancy in young girls as a high risk pregnancy which needs intensive care.
It is reported about an organizational plan for more intensity in the field of medical care and research of sterility and infertility. Diagnosis and therapy of sterility should be carried out within a high specialised centre. General practitioner and gynecologist in general and clinical practice of the territory have to accomplish important problems in prophylaxis and metaphylaxis of sterility and infertility.
The problems in early diagnosis of endometrial cancers are not sufficiently solved. Only atypical bleeding with subsequent curettage will result in success. At this time progredient carcinomas are frequent and the chance of recovery is small. Therefore a screening program of early diagnosis by small biopsy is developed and clinically proved.
As a contribution to the aetiology of insufficiency of placenta carbohydrate-histo-chemical investigations of the kyema were per-formed from the 10 th to 14 th week of pregnancy. The studies were carried out on pregnancy products of women with affection of kidneys, circulatory failures, and under cytostatic therapy. For comparison purposes, cases were used where the pregnancy was without organic diseases of the pregnant women. The investigations performed did not prove evidence of an essential alteration of the regulation of carbohydrates in the kyema by maternal disorders or cytostatic treatment during early gravidity.
It is reported on 21 pregnancies during contraception with IUD, among them one tubal pregnancy, one pregnancy with normal outcome and one pregnancy with a partly perforated IUD. By means of an extra- and intraamnial opaque matter injection one can find out exactly the position of the IUD on the roentgenogram before artificial abortion is carried out. The IUD can be seen above the small pelvis as a result of the changed position and the growth of the uterus during pregnancy. Furthermore it is possible to notice a glide down of the IUD into the cervix uteri or a perforation of the IUD into the uterine wall respectively into the pelvic cavity.
After a review of historical and present opinions about the physiological alterations of the portio vaginalis uteri results on investigations by the author about regeneration are reported. The alterations of reserve cells of the mucous membrane of the cervix during pregnancy demonstrate the hormonal influence on regeneration and allow conclusions on indirect metaplasia under other conditions.
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