Biomedical subjects
Publications and source records attributed to S Trotnow.
A case of bilateral tubal pregnancy resulting from in vitro fertilization and the transfer of two embryos is reported. Because the husband had retrograde ejaculation after surgical treatment of a malignant testicular tumour, cryopreserved semen was used.
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Using basal body temperature and repeated radioimmunological plasma progesterone estimations we monitored the luteal phase in seven patients after the administration of Clomid/hCG, oocyte recovery, in vitro fertilization and embryo transfer. In six of these women, the transferred embryos did not implant, and they bled 13--16 days after oocyte recovery. Neither the basal body temperature charts nor the plasma progesterone levels provided any indication of a luteal phase defect, being indistinguishable from those obtained in a control group of healthy women during the natural cycle. In the seventh woman, transfer of an eight-cell stage embryo resulted in implantation and a pregnancy which, to date (37th week) is developing normally.
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Rabbit embryos were successfully frozen at the 8-cell stage, employing a rapid and a slow freezing-thawing program. They were then stored at -196 degrees C (liquid nitrogen) for 10 to 60 days. After thawing the embryos were examined for viability in vitro and in vivo. Using the slow program B 82.5% were morphologically intact, compared to only 69.3% after the rapid procedure (program A). 88.8% of the group first mentioned above, and 56.8% of the latter developed to the blastocyst stage after 4 to 5 days in culture. The implantation rate was 18.1%, when embryos were transferred to minus 18 hours asynchronous recipients, after thawing. With 40%, a significantly higher implantation rate could be achieved, when the embryos were transferred to minus 24 hours asynchronous foster mothers. 18 viable young were born 30 to 32 days after transfer.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Using a standardised questionnaire, 7356 women, patients at the Erlanger Universitäts-Frauenklinik, were interviewed. Women with cervical cancer or carcinoma in situ of the cervix were compared with the remaining patients. Social factors are described which are more frequent with women with cervical cancer than with other women. The more such individual factors are added together, the greater the risk of developing a cervical cancer. Further, social factors are investigated which prevent women from going to prophylactic examinations. The more such factors are encountered, the greater the probability that a woman will not go to prophylactic examinations. Both results were to be expected from common-sense, but until now confirmation by empirical investigation was lacking. The greater the risk of getting cervical cancer, the greater the probability that screening will be avoided. This result show that cervical cancer is to be expected in the greater proportion of about 70% of women over the age of 30 who do not go for prophylactic examination, compared with the 30% who undergo prophylactic examination anually.
Gynecologists prefer the vaginal route for closure of vesicovaginal fistulae. Urologists, however, have some doubts as to the long-term results as far as proper function is concerned. The purpose of this investigation was to discover the limits of the vaginal fistula operations with reference to patients at the Department of Gynecology and Obstetrics, University Erlangen-Nürnberg. From 1962 to 1976, 40 women with vesicovaginal, urethrovaginal and vesicocervicovaginal fistulae were treated. Forty-five operations were necessary. In one patient, surgery in two sessions was planned from the beginning. Besides 4 obstetric fistulae, gynecological operations were the original cause of the fistulae in 34 cases. Two women had actinic fistulae (overdosage of intracavitary radium application). Attempts to close the fistulae here failed utterly. The Latzko technique was used in 27 women. Füth's method, in 7. In the remaining cases various vaginal procedures were chosen, for example, interposition of the bulbocavernosus muscle or interposition of the uterus. Three late complecations with recess formation (in 2 cases with concrements) after the Latzko operation could be treated trans-urethrally. Ten years after a Füth's operation one patient had to undergo vaginal surgery for an urethral diverticulum with concrement. The precedure of choice in the typical post-hysterectomy fistula is the Latzko operation. For fistulae patients who still have a uterus, other vaginal procedures are preferable. No attempt should be made to close a radiogenic fistula--usually following inadequate radiation therapy--by a vaginal operation. Details of our indications are fully dealt with in the discussion.
Breast diseases in 792 women were studied by biopsy and histological evaluation. In all subjects glucose tolerance was examined by OGTT (100 g glucose). The diabetes frequency of 22% in 326 women with breast cancer was compared with the frequency in women with fibroadenoma (n = 101), papilloma (n = 80), fibrocystic disease (n = 107), lipoma, granuloma, fibrosis (n = 88), papilloma with proliferation (n = 32), mastopathy with proliferation (n = 33) and carcinoma in situ lobulare (n = 11). The statistical evaluation was done with an electronic data processing system. We used matched pairs according to age, height and weight. Diabetogenic factors like age and overweight were thus allowed for. These comparative statistics showed a frequency of diabetes twice or three times higher in women with breast cancer. This result cannot be regarded as a consequence of age, overweight and menopause. In groups with fibroadenoma, fibrocystic disease and lipoma, we found glucose tolerance in 1-3%, whereas the group with proliferation (including carcinoma in situ) showed an incidence of 7%. The remarkably high incidence rate of 14% in women with papilloma can be explained by the higher age and the more frequent obesity in this collective.
With a standard questionnaire 7356 lying-in patients at the Department of Obstetrics and Gynecology, University Erlangen-Nürnberg, were asked about their social background and their sexual habits. First of all some statistical facts concerning the frequency of distribution: 20% of all women questioned had their first cohabitation before the age of seventeen. 53% had sexual intercourse with one man, 23% with two, the remainder with more than two men. Quite a number of social characteristics influenced the sexual behavior of women. Thus it was shown that women have their first cohabitation before the age of eighteen the sooner the lower their social status is and the more partners they had. Insufficient contraceptive precautions or the neglect of any contraception were mainly met with women of lower social status. The same correlation could be found between contraceptive behavior on the one hand and the parameters education and strong religious commitment on the other hand. In rural aereas contraceptive measures were used insufficiently or less often then in urban communities.
The relation between the parity of the mother and the birth-weight as well as the size of the new-born child, taking into account the sex, were examined as follows: From the patients needing obstretical care during the period of 1966 to 1971 those 3441 women were chosen who had born twice or more times during this time. By means of an electronic data processing system the weight and size differences of the children were correlated with the parity of the mother taking again into account the order of male and female births. Births with uncertain gestational age, non-cephalic presentations, and premature births were excluded (WHO definition or gestational age less than or equal to 266 days counted from last menstruation). 1. The average birth-weight increases by 105 g from the first to the second child, by 39 g from the second to the third, and by 12 g from the third to the fourth child. Obviously, there is no linear link between the increase of the birth-weight and the increasing parity. The major weight-increase is to be observed from the first to the second child. 2. A corresponding statement concerning the size of the new-born children cannot be made which is partly due to the relative inaccuracy of the method applied. 3. On the average boys weigh between 130 g to 150 g more than girls according to the parity.
In a prospective study at the Department of Obstetrics and Gynecology, University Erlangen-Nürnberg, covering the period from January 1st 1971 til December 31st 1973 the incidence of pathological glucose tolerance was examined in 837 women with breast cancer, benign tumours and conditions requiring excision or air cystography and/or mammography because of suspicion of tumour. The glucose tolerance was tested in all patients by oral ingestion with 100 g glucose of i.v. by means of intravenous injection of 0.33 g glucose/kg body weight. The results in 327 women with breast cancer were compared with those in 510 women with benign breast affections. Using matched pairs, the evaluation was done with an electronic data processing system. Diabetogenic factors like age and body weight were thus allowed for. In the total collective 22.3% out of 327 women with breast cancer were manifestly and 6.7% subclinically diabetic. Our findings allow the following conclusions. 1. Manifest diabetes mellitus is found twice as frequently in women with breast cancer compared to women with benign breast affections. 2. In the collective of pairs matched according to age, height and weight (n = 217) 21% of the women with breast cancer have a pathological glucose tolerance, compared with 10% of the women with benign breast affections. 3. Only 25 out of 73 manifestly diabetic women with breast cancer were aware of their metabolic disorder before admission to hospital, whereas 75% of the diabetic women with benign histological findings did know of it.
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