Biomedical subjects
Publications and source records attributed to F Pepe.
Between 1970 and 1984 89 patients under 18 years of age were treated for dysfunctional premenarchal or postmenarchal bleeding. Patients' age varied from 8 to 18 years (average age 12.2 years). 12 cases were of dysfunctional bleeding in menarche and 68 were of menorrhagic or menometorrhagic menstruation after a period of 2 months to 6 years after menarche. Medical therapy was successful in all cases.
The authors report two cases of adnexal torsion. The first case occurred in a 30-year old patient, while the latter was in a woman after induction of ovulation with FSH-LH and hCG. The patient, who had begun a pregnancy was treated with adnexectomy, and delivered at term a normal baby.
Labor was induced via intravenous infusion of 16-phenoxy-prostaglandin-E2-methylsulphonylamide in 13 cases of missed abortion and 19 cases of intrauterine fetal death. In all cases Bishop score was less than 4. Delivery occurred within 24 hours in all cases, with a minimal frequency of side effects (six cases of erythema above the incannulated vein and 1 case of diarrhea). The interval between the beginning of the infusion and delivery was 9.42 minutes. Uterine curettage was performed in 9 cases.
Between 1965 and 1985 28 patients aged between 10 and 18 years (average age 16.3 years) were treated for pelvic tumor, with a frequency of 0.13% of gynecological admissions. Ovarian tumor was the most frequent type (21 cases), followed by paraovarian tumor (5 cases), and uterine tumor (2 cases), 21 of pelvic tumor were neoplastic of which 18 benign. Among the ovarian neoplasias the most prevalent was cystadenoma (9 cases), followed by dermoid tumors (7 cases).
The authors report their studies of 39 lymphoscintigraphies performed on patients with breast cancer. They point out that interpretation of scintigraphic imaging must take into account the morphologic variations of the lymph nodes of the internal mammary chains (i.e. single central chain, single central lymph node) and the morphological difference in the symmetry of lymph nodes considered non-pathologic to avoid false positives. The authors retain that lack of visualization of a chain, conspicuous increase in size of a lymph node, asymmetry of pathologic development, or reduced uptake by one or more lymph nodes of the internal mammary chains must be interpreted as a sign of metastatic spread. The authors recommend lymphoscintigraphy as an effective technique in the screening of breast cancer patients for staging, follow-up, restaging, and planning of radiotherapy.
The Authors studied the frequency of Cesarean section in relation to deliveries in the last trimester of pregnancy, the frequency of repetitive Cesarean section, age and parity of the patients, indication for cesarean section, week of delivery, and perinatal and maternal morbidity and mortality at the First Clinic of Obstetrics and Gynecology, University of Catania, Catania, Italy, from 1972 to 1974 and from 1983 to 1985. The frequency of Cesarean section has increased from 12.07% (735 cases out 6,086 deliveries) to 16.89% (837 cases out of 4,955 deliveries). There was a decrease in frequency of repetitive Cesarean section from 30.47% (224 cases) to 27.95% (234 cases) and in perinatal mortality rate from 4.35% (32 cases out of 735) to 3.19% (27 cases out of 845 newborn). There were no cases of maternal death, while the most common cause of maternal morbidity was uterine atonia. From 1972 to 1974 mechanical causes were the most frequent indication for Cesarean section (28.16% -207 cases), while from 1983 to 1985 previous hysterotomy (32.73% -274 cases) was the main indications for Cesarean section.
Correlation between parity and sexual behavior during pregnancy was studied in 106 pluriparous and 69 primiparous patients. Sexual desire, frequency of coitus, frequency of orgasm, which partner initiated sexual activity, and level of sexual satisfaction were analyzed in the year before pregnancy and during pregnancy. Sexual desire, frequency of coitus, and sexual satisfaction were qualitatively equal in both groups. The frequency of coitus in particular decreased progressively in the three trimesters of pregnancy and more evidently in the pluriparous. The partner who initiated sexual activity most frequently was the male in the pluriparous group.
The Authors report a case of fecal peritonitis caused by perforating appendicitis in a patient in the 16th week of pregnancy. Appendectomy was performed and the patient successfully delivered a normal sibling weighing 2850 grams in the 37th week.
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Between 1965 and 1985 59 paraovarian cystic tumors, were treated at the First Clinic of Obstetrics and Gynecology, Catania University, Catania (Italy). In 45.76% of cases (27 cases) the cyst was localized on the right and in 40.67% (24 cases) on the left parametrium, bilaterally in 6.77% (4 cases) and multiple on the same side in 6.77% (4 cases). In 91.52% (54 cases) the patients were in fertile age and 8.48% (5 cases) were in menopause. The dimensions of the cysts varied between 2 and 20 cms, with higher incidence between 6 and 10 cms (49.16%). In 1.69% there was benign neoplastic degeneration (1 case of cystadenoma). In 6.77% (4 cases) there were no symptoms, while pelvic pain and menstrual disorders occurred in 57.62% (34 cases) and 35.59% (21 cases) of cases respectively. In 5.08% (3 cases) there was torsion of the cyst. Enucleation of the cyst was performed in 44.06% (26 cases), and in the other cases therapy was adopted according to the patient's age, parity, associated gynecological pathology and neoplastic degeneration.
From 1965 to 1984, 105 cases of ovarian dermoid cysts have been diagnosed and treated at the First Clinic of Obstetrics and Gynecology, Catania University, Catania, Italy. The patients were aged between 9 and 70 years, with a higher frequency of dermoid cysts between 26 and 30 years (21.91%, 23 cases). In 0.95% (1 case) the patient was premenarchal, 84.76% (89 cases) in fertile age, and in 14.29 (15 cases) in menopause. 35.22% (37 cases) were nulliparous with an average of 31 years, and 64.76% (68 cases) pluriparous with an average age of 38.9 years. In 4.76% (5 cases) the patients had already been treated for dermoid cysts. The asymptomatic form occurred in 13.33% (14 cases), while in 9.52% (10 cases) of cases there was torsion of the cyst. In 89.53% (95 cases) the cyst was monolateral, double in the same ovary in 0.95% (1 cases), and bilateral in 9.52% (10 cases). Epithelial cancerous degeneration occurred in 1.95% of cases (2 cases). In 11.43% (12 cases) enucleation of the cyst was performed while in the other cases therapy was chosen in relation to age, parity, and associated gynecological pathology of the patients. The Authors compare their data with that in literature.
Five cases of dysgerminoma are reported. All patients underwent unilateral salpingo-oophorectomy for FIGO Stage 1 dysgerminoma; five-year follow-up showed no recurrence of illness. A review of current work-up for staging, prognosis, and controversial therapeutic modalities for FIGO Stage 1 is presented.
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