ABSTRACT
Deficiency of factor XI (plasma thromboplastin antecedent) can result in severe bleeding in women undergoing obstetric or gynecologic procedures, with the highest risk in women of Ashkenazi Jewish background. Most patients do not bleed if treated with sufficient fresh frozen plasma to maintain a factor XI level of 30% or more but occasionally patients may require higher levels. Plasma infusion should be continued for several days, even if bleeding does not seem excessive, since delayed bleeding is not uncommon. The use of hepatitis B vaccine and of plasma from a single donor, may reduce the risk of hepatitis.
Subject(s)
Blood Transfusion , Factor XI Deficiency/therapy , Hemorrhage/therapy , Postoperative Complications/therapy , Postpartum Hemorrhage/therapy , Pregnancy Complications, Hematologic/therapy , Adult , Cervix Uteri/surgery , Female , Hemorrhage/etiology , Humans , Plasma , Postpartum Hemorrhage/etiology , Pregnancy , Risk , Sterilization, TubalABSTRACT
The colposcopic management of patients with abnormal Papanicolaou smears relies on correlating the examination findings with the cytology and biopsy results. Failure to adequately sample the endocervical canal introduces a possible source of error and could allow an invasive lesion to be missed. In 300 patients subjected to both endocervical curettage and RO-TAGE biopsy (Proto Med Incorporated, Boulder, Colorado), significantly fewer inadequate samples were obtained with RO-TAGE biopsy (1%) or the use of both methods (0.3%) than with curettage alone (4.3%). Therefore, we conclude that RO-TAGE biopsy should be added to every colposcopic examination.
Subject(s)
Biopsy/instrumentation , Carcinoma in Situ/pathology , Cervix Uteri/pathology , Uterine Cervical Dysplasia/pathology , Uterine Cervical Neoplasms/pathology , Biopsy/methods , Colposcopy , Curettage , Female , Humans , Papanicolaou Test , Vaginal SmearsABSTRACT
The capacity of aromatization in 15 neoplastic human endometrial specimens was investigated. Viable tissue fragments were incubated with [3H]testosterone (10 nM) at 37C for 20 hours. Various estrogens were isolated from the incubated tissues and medium. The mean value of estrogen synthesized in 12 cases of endometrial adenocarcinoma (16.0 +/- 11, means +/- SD fmol/mg protein), is approximately two and five times higher than that of proliferative and secretory endometria, respectively. The highest capacity was found in three mixed mullerian tumors (means = 145 fmol/mg protein). These findings indicate that the malignant endometria, in particular the mixed mullerian tumors, are able to synthesize estrogen in a capacity higher than that in normal endometria. Endometrial aromatase may play an important role in promoting cell growth in estrogen-sensitive tumors.
Subject(s)
Adenocarcinoma/enzymology , Aromatase/metabolism , Endometrium/enzymology , Oxidoreductases/metabolism , Uterine Neoplasms/enzymology , Adult , Aged , Estrogens/biosynthesis , Estrogens/metabolism , Female , Humans , In Vitro Techniques , Middle Aged , Testosterone/metabolismABSTRACT
Vaginograms were done on 20 normal women to determine the exact axis, length, and direction of the normal vagina. The vagina was found to be a curved organ with a distinct upper portion that has an axis between the third and fourth sacral vetebrae. The importance of restoring this axis in pelvic surgery, especially for vault prolapse, is discussed.
Subject(s)
Vagina/anatomy & histology , Adolescent , Adult , Female , Humans , Uterine Prolapse/surgeryABSTRACT
Nine hundred and twenty-two patients who had one or both adnexa conserved at the time of abdominal hysterectomy for benign diseases are presented. Thirteen patients (1.4%) have required subsequent re-exploration for adnexal pathology. Corpus luteum cysts were found in 10 (77%) of these patients. The primary pathology was found in the Fallopian tube in five patients (38%). No patient was found to have an ovarian malignancy in the short period of follow-up. Conservation of ovarian function is recommended in patients who have not undergone menopause.
