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PubMed2000

Sex, reproduction, and gynecological disease in young adults with a history of juvenile chronic arthritis.

OBJECTIVE: To study the effect of chronic disease of childhood on aspects of reproduction in young adults with a history of juvenile chronic arthritis (JCA). METHODS: Demographic data, clinical features of JCA, previous medical treatment, reproductive events, contraception, wish for children, sexuality, and gynecological disease were evaluated by means of a questionnaire in 126 women and 35 men with JCA and their age matched healthy counterparts. RESULTS: Median age of patients and controls was 24 years. Median age at menarche was 13 years in female patients and controls. Female patients who shared characteristics of marital status with their healthy counterparts showed a similar attitude to sexual activity, contraception, wish for children, age at first child, and duration of lactation. Fertility was not impaired in JCA, but fecundity was significantly reduced. Also, pregnancy outcome was less successful in women with JCA, shown by a significantly increased rate of miscarriage. When analyzing the occurrence of gynecological disease, a higher proportion of patients had metrorrhagia, pelvic inflammatory disease, and surgery for ovarian cysts. Males with JCA had greater difficulties than both healthy males and female patients in establishing a permanent relationship to the opposite sex. CONCLUSION: Our study shows that a history of JCA in young men and women can influence several aspects of reproductive behavior and health. Health care providers counseling adolescents with JCA need to be aware of these problems.

Adolescent↗
PubMed1992

[Incidence of gynecologic diseases in multiparae during the climacteric period].

The structure and incidence of gynecologic diseases were studied in 796 women aged 40 to 60. The results were computer-processed. A significant (by 3.5 times) increase of the incidence of atrophic changes of the vagina and vulva and genital dystopia were revealed in multiparae, which fact evidenced unqualified labor management and neglect of hygienic measures in the postpartum period. Cervix uteri abnormalities were also more often detected in multiparae. A direct correlation between the number of pregnancies, deliveries, and abortions, on the one hand, and incidence of diseases of the cervix uteri, on the other, was revealed; uterine myoma was more frequently found in multiparae than in women who had one or two deliveries. A direct relationship was established between the duration of lactation period and incidence of ovarian tumors. Mammary diseases were more frequently detected in women with a history of one or two deliveries.

Adult↗
PubMed1983

Immunoreactive pancreatic secretory trypsin inhibitor in gynecological diseases.

Serum immunoreactive pancreatic secretory trypsin inhibitor in 45 patients with various gynecological diseases was measured by a radioimmunoassay. In normal serum of healthy individuals, the concentration was 11.7 +/- 2.3 ng/ml (mean +/- SD). Elevated levels (above control mean plus 3 S.D.) were observed in sera of 5 patients (50%) with ovarian cancer, and serum of one patient (4.7%) with uterine cancer. Only one tumor extract of ovarian cancer contained a significant level of immunoreactive PSTI. PSTI-containing mucin was detected in a mucin-producing ovarian adenocarcinoma.

Amylases↗
PubMed1995

[Expert assessment of gynecologic diseases].

Medical reports in Gynecology have to consider the evaluation of organic diagnosis as well as connected psychical disorders. It has to be examined if psychical insults have led to dysfunction in the genital system. A typical example is hypothalamic amenorrhea as a sequel of extreme stress or chance of surroundings. Frequent lesions in the urinary system due to endometriosis, change of site, tumours and chronic inflammation of the female genital system often require a urological as well as a gynecological examination. Severity and duration of complaint, tendency to recur and the necessity of clinical treatment are essential factors in the assessment of the degree of disability. Examples of medical reports are shown and the limits of modified professional discretion are pointed out.

Adult↗
PubMed1990

[Prospects of the use of neoplasm antigens as markers of gynecologic diseases].

CA-125 antigen was assayed in 108 patients with the most prevalent gynecologic diseases by enzyme immunoassay. Its blood levels were found to be under 35 U/ml in the patients with inflammatory diseases. In endometriosis and benign ovarian tumors CA-125 concentrations in the blood were elevated. Malignant tumors of the ovaries were detected in 80 percent of the examinees. CA-125 levels reduced after surgical treatment in 72 percent of patients. These data permit a conclusion that CA-125 diagnostic agent may be used to monitor the course of the postoperative period and assess the late results of treatment.

Adolescent↗
PubMed1988

Relation between serum levels of tissue polypeptide antigen (TPA) and cancer antigen 125 (CA125) and their immunohistochemical identification in benign and malignant gynecological disease.

We studied immunohistochemical stains for TPA and CA125 in patients with benign and malignant gynecologic diseases. The results were as follows: (1) CA125 was not found in ovarian mucinous cystadenocarcinoma but was demonstrated immunohistochemically in 82% of ovarian serous cystadenocarcinomas and 83% of Krukenberg's tumors. (2) TPA was demonstrated in 65% of ovarian serous and 75% of ovarian mucinous cystadenocarcinomas, and in 58% of endometrial carcinomas. (3) TPA was found in all trophoblastic tumors examined, while CA125 was found in none. Eighty-three percent of patients with trophoblastic diseases had raised serum TPA levels. (4) When serum CA125 levels were raised CA125 was demonstrated immunohistochemically in 71% of patients with ovarian serous cystadenocarcinomas, 67% of patients with Krukenberg's tumors and 100% of patients with tubal carcinomas. (5) Despite elevated serum levels, CA125 and TPA were not identified by immunohistochemistry in 64% cases of benign ovarian disease and in 80% of patients with uterine myomata. (6) It would seem that CA125 was more easily released from tumor cells than TPA.

Antigens, Neoplasm↗
PubMed1994

Chromosome aberrations in lymphocytes from women irradiated for benign and malignant gynecological disease.

Excess leukemias have occurred after partial-body radiotherapy for cervical cancer and benign gynecological disease (BGD). However, the level of risk is nearly the same in both groups, about twofold, despite a tenfold difference in average dose to active bone marrow (8 Gy vs 0.7 Gy, respectively). High-dose cell killing has been postulated as one explanation for this apparent inconsistency. To examine whether chromosome aberration rates observed in lymphocytes many years after exposure might serve as population markers of cancer risk, blood samples were taken from 60 women treated for BGD (34 with radiation) and cytogenetic data compared with previous results from 96 women irradiated for cervical cancer. Remarkably, the rate of stable aberrations, which reflects nonlethal damage in surviving stem cells, was only slightly higher among the cancer patients. Thus the lower-dose regimens to treat benign disorders resulted in much higher aberration yields per unit dose than those for cervical cancer. Assuming that the fraction of cytogenetically aberrant stem cells that survive radiotherapy contributes to the leukemogenic process, these data are then consistent with the epidemiological observations of comparable overall leukemia risks seen in these two irradiated populations. Accordingly, for patient populations given partial-body radiotherapy, stable aberrations at a long time after exposure appear to serve as biomarkers of effective risk rather than as biomarkers of radiation dose received.

Aged↗
PubMed2002

Isoflavones for prevention of cancer, cardiovascular diseases, gynecological problems and possible immune potentiation.

Japanese women show low incidence of and mortality from breast cancer, cardiovascular disease and climacteric symptoms compared to Caucasians. High soy bean intake is considered to attribute to that, but it is not clear whether soy protein itself or isoflavones (IFs) mixed in the soy protein has such effects. Presence of IFs in soy beans was varied by site, so we made IF-rich tablets from daidzein-rich soy germ (hypocotyl) for intervention studies. Our intervention study on young women by using the IF-rich tablet (20 and 40 mg/day) showed slight elongation of the menstrual cycle, but no adverse effects occurred. Intervention study on climacteric women showed improvement of bone density, hypertension and climacteric symptoms. Health effects of IFs on cancer occurrence, cardiovascular diseases, gynecological problems and possible immune potentiation are reviewed from functional aspects.

Adjuvants, Immunologic↗
PubMed1990

A prospective comparison of transabdominal and transvaginal ultrasound with surgical findings in gynecologic disease.

Eighty-five patients underwent transabdominal (TAU) and transvaginal ultrasound (TVU) 24 hours before elective surgery for gynecologic disease. No obstetric cases were included. The diagnostic outcome of TVU was not significantly better than that of TAU in spite of a better image quality. The evaluation of large ovarian cysts and sizeable fibroids was difficult with TVU due to the limited field of view. Endometrial pathology was clearly diagnosed by TVU. We recommend using TVU in combination with TAU, especially in cases of unclear pelvic pathology or when larger masses are present.

Abdomen↗
PubMedDate not supplied

Cytohistologic correlation of peritoneal washing cytology in gynecologic disease.

The peritoneal washings and cul de sac aspirates from 204 patients undergoing 217 procedures for the evaluation of gynecologic disease were examined retrospectively and correlated with the histologic diagnoses. Of the 73 washings from patients with histologically benign genital disease, cytology diagnosed 64 (87.7%) as negative, 6 (8.2%) as inconclusive and 3 as malignant. One malignant washing was a true positive from a nongenital primary. False positives thus occurred in 2.7% of the benign cases on blind review. Of 144 cytologic examinations of washings from patients with histologically confirmed malignant disease of the female genital tract, 38 (26.4%) were considered positive after cytohistologic correlation. Four malignant cases (2.1%) were undercalled on blind review while 3 (2.0%) were considered overcalls. Eleven of 47 cases (23.4%) with biopsy-proven peritoneal disease had negative cytology after histologic correlation. Recurring problems in interpreting peritoneal washings included: (1) the differential diagnosis of the spectrum encompassed by reactive mesothelium, endosalpingiosis, borderline serous tumors and well-differentiated serous cystadenocarcinoma; (2) morphologic similarities between some tumor cells and mesothelial cells associated with treatment effects; and (3) a paucity of malignant cells in some washings, resulting in false-negative interpretations. Ineffective cytopreparation, particularly of bloody specimens, hampered interpretation of some specimens. Correlation with previous histology and cytology enhanced the accuracy of peritoneal washing cytology in this study.

Adult↗
PubMed1997

[Diagnosis of chlamydia and gardnerella infection in patients with acute gynecological diseases].

Chlamydial infection was diagnosed by indirect immunofluorescence in 26.3% and Gardnerella infection in 28.7% of patients with acute gynecological diseases. The degree of vaginal contamination in patients with chlamydiasis was virtually the same as in all other examinees, whereas in patients with gardnerellosis the third and fourth degrees of purity predominated. Hence, assessment of the vaginal contamination (purity) is an additional criterion for screening for gardnerellosis but providing no clinically significant information for the detection of chlamydiasis.

Acute Disease↗
PubMed2001

Major complications of operative and diagnostic laparoscopy for gynecologic disease.

STUDY OBJECTIVE: To compare complication rates of diagnostic and operative laparoscopy. Design. Retrospective study (Canadian Task Force classification II-2). SETTING: One medical center and three teaching hospitals. PATIENTS: Six thousand four hundred fifty-one women with various indications for laparoscopic diagnosis and/or laparoscopic surgery from January 1994 through June 1999. INTERVENTION: Diagnostic and operative laparoscopies. MEASUREMENTS AND MAIN RESULTS: Forty-two major complications occurred that directly resulted in one death. One patient had stomach injury, 3 had major vessel injuries, 5 had ureter injuries, 10 had intestinal injuries, and 23 had bladder injuries. The overall complication rate for all laparoscopies was 0.65% (42/6451); however, it rose to 0.80% (39/4865) for operative laparoscopy compared with 0.19% for diagnostic laparoscopy (3/1586; p <0.001, Fisher's exact test). CONCLUSION: Laparoscopic surgery is appropriate for managing various gynecologic diseases and has an acceptable complication rate. However, operative laparoscopy should be performed carefully because its rate of complications is significantly higher than that of diagnostic laparoscopy, especially for laparoscopic-assisted vaginal hysterectomy. (J Am Assoc Gynecol Laparosc 8(1):68-73, 2001)

Catheterization↗