Torsion of the fallopian tube complicating pregnancy.
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A new method of tubal occlusion for sterilization, which is both promising and potentially reversible, is undergoing clinical trials nationwide. At hysteroscopy, a catalyzed silicone rubber compound is instilled in the fallopian tubes where it hardens to form a radiopaque plug. Radiologists may assist the gynecologist in confirming adequate initial formation of the plug and with follow-up radiographs. Radiologists not involved in the procedure may see the radiopaque plugs on radiographs obtained for other clinical purposes, and they should be aware of this new method of sterilization.
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PURPOSE: To determine the efficacy, toxicity, and quality of life of capecitabine (Xeloda), an oral 5-fluorouracil derivative, in patients with chemorefractory recurrent mullerian cancers. PATIENTS AND METHODS: Patients with chemorefractory persistent or recurrent ovarian, fallopian tube, or peritoneal cancer with measurable disease were enrolled. Capecitabine was administered beginning at 2000 mg/m2/day orally in two divided doses with meals on a 21-day cycle: 14 days of capecitabine followed by a 7-day rest period. One dose escalation or reduction was allowed. Response was assessed after cycle 2 and cycle 4 and every third cycle thereafter. Standard evaluation included two-dimensional measurement of evaluable disease. Standard criteria for response were used. Therapy was discontinued if progression occurred after at least two cycles of therapy. Quality of life and symptoms were assessed. RESULTS: Forty-one patients were enrolled. Ninety-two percent of patients had >2 previous chemotherapy regimens. All patients had platinum- and taxane-resistant disease. Thirty-six patients were evaluable for response. Three patients had a partial response, with a median response duration of five cycles. Twenty-two patients had stable disease for 3 to 11 cycles (median, 6 cycles). Eleven had progressive disease. The only grade 4 toxicity was abdominal pain (n = 2). The most common grade 3 toxicities were fatigue (n = 19), hand-foot syndrome (n = 11), abdominal pain (n = 7), and diarrhea (n = 4). One patient had a grade 3 hematologic toxicity (anemia). CONCLUSION: Capecitabine at the dosages used in this study is well tolerated and has minimal hematologic toxicity.
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With 97 female patients who underwent a microsurgical operation of sterility the respectively less damaged tube has been assessed during the diagnostic laparoscopy and during the second-look-laparoscopy with the help of an adhesions-score and a chromopertubation-score. On 92 tubes only one operation was carried out, whereas on five tubes the proximate operation was combined with a distal one. After all methods of operations markedly better adhesions-scores and chromopertubations-scores were achieved. The postoperative adhesions-score was in 79.4% of all cases better than preoperative original value. The chromopertubation-score was postoperatively better in 72.2% of the tubes. 25.8% were macroscopically unobtrusive during the second-look-laparoscopy. After combined distal and proximal operations on one tube favorable postoperative laparoscopic results could be achieved, too.
Clinical data, the findings of biorhythmologic studies and the results of kymographic perturbation evidence the efficacy of early restorative treatment with the use of preformed physical factors early (starting from the first day) after reconstructive microsurgery. Such treatment accelerates the postoperative adaptation of the body, improves the anatomy and function of the uterine tubes and promises a more favorable prognosis for the reproductive function recovery. Criteria for the differentiated application of 3 physical factors are presented, intermittent low-frequency magnetic field, supersonic current, low-frequency monopolar rectangular pulses for electrostimulation of the uterine tubes.