[Infections during pregnancy in the puerperium].
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Biomedical subjects
Publications and source records attributed to J Zander.
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In order to prove that non-palpable lesions of the breast that have been removed after suspicion from mammography have been removed completely it is appropriate to X-ray during the operation of biopsy in order to make a diagnosis. Tests carried out with the X Faxitron X-ray apparatus on 369 patients show that even X-ray departments that carry out mammography and do not have specialised equipment can with quite modest means use this reliable technique for diagnosis.
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1,092 patients were operated for carcinoma of the uterine cervix according to a standardized radical abdominal hysterectomy with obligatory pelvic lymphadenectomy. The operative specimen showed metastases of the lymph nodes in 45,6% of the cases. In 15% of the cases embolization of tumor cells was found. In 8.7% of the specimes micro-metastases were seen and in 21.9% gross metastases were found. Postoperatively 1.5% of the cases developed bleeding. Ileus occured in 0.7% of the cases. A vesicovaginal fistula occurred in 0.3% of the patients. 1.4% of the patients developed a uretero-vaginal fistula. The operative mortality up to the 30th post-operative day was 1%.
Women with uremia are usually infertile. Following successful renal transplants ovarian function resumes and conception becomes possible. Two cases of pregnancy following renal transplants are reported. The first patient had a Caesarean section at 33 weeks gestation for maternal indications, the second patient had a Caesarean section at 36 weeks gestation because of premature spontaneous rupture of the membranes. Both mothers and infants are in satisfactory condition. The problems of pregnancies following renal transplants are discussed and the literature since 1963 is reviewed. Pregnancy following renal transplantation is a high risk pregnancy for both the mother and the fetus. These high risks are acceptable if close supervision of the pregnancy by the nephrologist, gynaecologist and paediatrician are possible and if co-operation of the mother is satisfactory.
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Out of a total of 1092 women operated because of cervical carcinoma, 4.8% had an adenocarcinoma of the cervix. Compared with patients with squamous cell carcinoma, there was no difference in signs and clinical pattern with those patients who had adenocarcinoma of the cervix. Treatment results, too, corresponded with those of patients with squamous cell carcinoma of the cervix.
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Primary bilateral malignant lymphoma of the breast was diagnosed in these women. All were of the lymphoblastic type of high malignancy. Two patients were pregnant and all died of generalised malignant lymphoma. Survival time between initial or early manifestation in the breast and death was two to four months.
The clinical course of a 26-year-old primigravid woman with a virilizing luteoma of pregnancy is described. It was demonstrated by endocrine studies that the tumor secreted an excessive amount of testosterone. After removal of the luteoma in week 32 of pregnancy, the virilizing symptoms of the mother completely regressed. A normal male infant was delivered in week 39. From 100 luteomas of pregnancy described in the literature, 26 cases have been cited to elicit endocrine virilizing activity. An evaluative synopsis indicates that including the case described in this paper only 13 can be regarded as a clinical, morphologic, and functional entity. This entity should be differentiated from the inhomogeneous group of luteomas as the "androluteoma syndrome of pregnancy." It is characterized by the following major criteria: virilization, beginning with the second trimester of pregnancy; histologic criteria of a luteoma of pregnancy; production of testosterone, leading to excessive plasma levels (exceeding the concentration of androstenedione), and masculinization of female fetuses.
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