Biomedical subjects
Publications and source records attributed to H Ruf.
The value of the assay of the sub-units of human chorionic gonadotrophin in the diagnosis and follow-up of trophoblastic disease is generally recognised. The authors stress that this follow-up allows a maximal preservation of the genital tract of the patients and an evaluation of the real effectiveness of treatment.
Atypical and severe hyperplasia of the endometrium is often associated with a carcinoma and, on their own, present a malignant potential which requires a specific treatment, involving an extension of the indications for hysterectomy after the menopause.
Sterility in North African immigrants does not differ greatly from the sterility observed in French women. The authors emphasise one particular difference: the frequency of genital tuberculosis present in 1/3 of cases compared with 6 per cent of the general population.
Gynaecological arteriovenous fistulae are a difficult diagnosis and their aetiology is often difficult to determine. The surgical treatment is not always satisfactory and the prognosis can be transformed by means of embolisation.
The authors study all of the possible forms of foeto-maternal immunisation (ABO system, D antigen and other antigens). They present a general review of the course of allo-immunisations since the establishment of prophylaxis against anti-D allo-immunisations and they define the current situation.
The features of the gypsy population, including the conditions of their lifestyle, are very unusual and medical follow-up is very irregular, resulting in obstetric and neonatal pathology. On the basis of a series of 1571 pregnancies, the authors describe the disadvantages of these features which can only be improved by a reciprocal confidence between gypsies and the medical profession.
The obstetric pathology of North African women, which used to be fairly different from that of French women, is now tending to resemble that of the French population, as the customs of the immigrants tend to coincide with those of the local population, especially in the context of information and antenatal care.
On the basis of a series of 220 operated cases of genital prolapse, the authors describe the complications and classify the various elementary components of the prolapse (120 complete prolapses) and the associated lesions. The operative techniques are classified by category and the results are presented with a follow-up of two and three years. This homogeneous series demonstrates that the vaginal techniques are generally more effective.
Two series of trials of labour are compared: the first series without any particular analgesia and the second under epidural analgesia. The caesarian rate was significantly less in the second series because the trial of labour was able to be pursued for a longer period of time without any danger to the foetus. The authors consider that, provided cases of mechanical dystocia and maternal agitation are eliminated, trial of labour under epidural anaesthesia can result in a real cephalopelvic engagement.
A study was carried out on 599 pregnant women from whom 2,991 levels were estimated of HCS and beta SP1 to determine their variations. The control group was of 400 normal pregnancies (1,770 couples of levels of HCS and beta SP1. The pathological population was in two groups: - non-complicated pathological pregnancies, from whom 510 coupled levels were estimated in 77 women, and - complicated pregnancies, from whom 711 coupled levels were estimated in 122 patients. This pathological group was compared with the control population statistically. The results conform to those that have already been published. This work shows two original features: - very high levels of beta SP1 and HCS ;are an index of the severity of the prognosis of fetuses and hydramnios, - a drop in the level of beta SP1 towards the end of pregnancies is a warning that fetal distress may occur in labour.
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A radiochemical assay was used to measure the triacylglycerol lipase activity found in normal human amniotic fluid at term. Enzyme activity was characterized in a partially purified extract of amniotic fluid and was found to be optimal at pH 8.0 +/- 0.2 in the presence of 5mM sodium taurocholate, with the use of emulsified tri-[3H]oleoyl glycerol as the substrate. The assay described made it possible to determine the lipase activity in as little as 25 microliters of a 12,000 x g supernatent of whole amniotic fluid as the source of enzyme. The lipase appeared to be distinct from another triacylglycerol lipase measurable in fetal membranes. In turn, it was shown that the amniotic fluid enzyme exhibited several catalytic properties which resembled those of pancreatic lipase. i.e., its substrate specificity, the bimodal effect of bile salt, and the influence of authentic pancreatic colipase on the catalytic process. The results suggest that the assay of triacylglycerol lipase activity may be clinically useful in the detection of enzyme abnormalities in human amniotic fluid.
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The authors have come to the conclusion that the ideal time to start female contraception is when the periods return following delivery. They arrived at this conclusion after studying the disadvantages of the various methods of hormone contraception and of mechanical female contraception immediately following delivery. Directly after delivery contraception should be in the hands of the man and not the woman. If better information is given to the couple during pregnancy and in the postnatal period it should direct them towards such formations of contraception. The problem, however, of grand multipara who are feckless, ignorant and of low social class, still remains. Medroxyprogesterone, if it is used at all immediately after delivery, should be given in a dose of 150 mg. As far as tubal ligation by mini-laparotomy after delivery goes this is permanent contraception and its indications should be considered with very great care.
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