[The place of radioimmunoscintigraphy in the diagnosis and follow-up of ovarian cancer in comparison with computed tomography and second-look surgery]. / Stellenwert der Radioimmunszintigraphie in der Diagnostik und Verlaufskontrolle des Ovarialkarzinoms im Vergleich zur Computertomographie und "Second Look"-Operation.

In this prospective study the diagnostic capability of radioimmunoscintigraphy (RIS) was compared with that of computed tomography (CT) and of "second look" surgery as primary diagnostic procedures in 27 patients and in the follow-up of 52 women suspected of suffering from ovarian cancer. The results were compared with immunohistochemical findings and CA125 serum levels. For primary diagnosis sensitivity, specificity and diagnostic accuracy of RIS was 100%, 60% and 90%, resp. In follow-up, sensitivity for local recurrencies was 75% and specificity 68%. Peritoneal carcinosis in the pelvis and lower abdominal region was better detectable by RIS, but for detection of liver metastases CT showed better results. CT and RIS could not replace "second look" surgery.

[The course of labor in intrauterine fetal death]. / Zum Geburtsverlauf bei intrauterinem Fruchttod.

The results of the course of birth in 71 intrauterine cases of foetal death are presented. There were spontaneous deliveries in 82% of the cases and in 4% a vacuum extraction was performed. The relatively high rate (14%) of Caesarean sections was in most cases, due to maternal indication. The introduction of prostaglandins was a significant progress factor in birth induction of these disturbed pregnancies. All 36 patients (51%) were treated with sulprostone (mostly intravenously). Furthermore, intrapartal, directly postpartal complications and complications of early puerperium are discussed.

[Reduction-plasty of the breast in symmastia]. / Reduktionsplastik der Brust bei Symmastie.

Medial confluence of the breasts, known as symmastia, has received little attention in plastic surgery literature. By reporting on one case, we present our surgical technique. The chosen method of the reduction mammoplasty is considered to be particularly important. Liposuction is integrated into the surgical procedure. Suggestions made by other authors are discussed.

[Complications and correction of augmentation-plasty with cadaver adipose tissue implantation]. / Komplikationen und Korrektur bei Augmentationsplastik mit Leichenfettimplantaten.

The most common complications after augmentation mammoplasty with homologous fat implants could be demonstrated in one patient. We show our subsequent surgical procedure and the experiences of other authors to achieve an immediately acceptable cosmetic result.

[Coexistence of endometroid carcinoma of the ovary and endometrial carcinoma in a 32-year-old woman]. / Koexistenz eines endometroiden Karzinoms des Ovars mit einem Endometriumkarzinom bei einer 32jährigen Frau.

At our hospital a 32 year old patient with a cystic ovarian had been operated. Because sonography was without pathological findings and the patient showed a sterility type, laparoscopy was indicated. Histological findings showed invasive growth of a tubulopapillary carcinoma. Laparotomy with hysterectomy, bilateral adnexa removal, omentectomy as well as pelvic and para-aortic lymphadenectomy was examined. Histologic and immunohistochemical investigations led to coexistence of ovarian endometroid carcinoma and to an endometrial carcinoma, both tumors being of different antigenicity.

[Deliveries in patients with more than 1 cesarean section]. / Entbindungen bei Patientinnen mit mehr als einem Kaiserschnitt.

The mode of delivery in 49 women with two or more previous cesarean sections was examined. In 33 cases (67%) a primary re-cesarean section was performed, in 12 of 16 patients (75%) a vaginal birth was possible. Emphasis was given to the causes leading to the latest cesarean section to the maternal and infant conditions and complications and the relevant factors from earlier cesarean sections. The results were discussed by comparison to related publications. Some fundamental considerations about the mode of delivery in cases of repeated cesarean sections were presented. The justifications for a repeated primary cesarean section based on the previous record to two or more cesarean sections alone seems to be no longer given.

[Ectopic ureteral junction as a cause of chronic pelvic pain and treatment refractory vaginal discharge]. / Ektope Uretermündung als Ursache für chronische Unterbauchschmerzen und therapieresistenten Fluor.

We report on a 22-year old patient with an ectopic ureter ending in the vestibulum of the vagina without genital malformations. Generally, the diagnosis of this anomaly will have already been made in childhood, because of enuresis uretica and therapy-resistant vaginal discharge. The methods of diagnosis leading to this anomaly, which is rare at that age, and the therapeutic requirements are shown.

[Double kidney with ectopic ureteral orifice: a case report]. / Doppelniere mit ektoper Uretermündung: Eine Kasuistik.

An ectopic ureteric opening is a relatively rare malformation, diagnosed mostly in young age because of typical signs and symptoms and more often found in female patients. The diagnosis of this malformation in adults is unusual and can be difficult because of untypical signs and symptoms, as represented in the following case report.

[Clinical experiences in the treatment of endometriosis with the LH-RH analog buserelin with special reference to the post-therapy course]. / Klinische Erfahrungen der Endometriosebehandlung mit dem LH-RH-Analogon Buserelin unter besonderer Berücksichtigung des posttherapeutischen Verlaufs.

The current therapy study with 50 patients showed that a reversible down regulation of the ovaries is possible. Particularly in cases with severe endometriosis a rapid release of pain can usually be achieved. Further development of the disease could be prevented and in two third of the cases even a partial reduction of tumor size. Within 12 weeks after the therapy the cycle is normally stabilized. But in about 70% of the patients the typical complaints of endometriosis were recurrent. The advantage of this treatment is the high acceptance of the patients in comparison to steroid medication. In long term administration it is mandatory to control bone and lipid metabolism.

[Experiences with intravenous sulprostone administration in massive postpartal hemorrhage]. / Erfahrungen mit intravenöser Sulproston-Applikation bei massiven postpartalen Blutungen.

Forty-three patients at the University Gynecology Clinic in Charlottenburg were given the prostaglandin E2 derivative sulprostone for severe postpartal hemorrhage. It was administered intravenously in a dose of 1.7 mcg/min (100 mcg/100 ml/h), with short-term increases to three times this amount in isolated cases. The drug proved highly efficacious (rapid onset and lasting effect). In 80% of the cases there were no side effects. Rises in body temperature occurred in six patients and in one patient a venous irritation developed in the arm into which the drug was infused. An RDS occurred, though it was considered that there was not necessarily a causal connection between this and the sulprostone infusion. In the authors' experience this drug has an established place in the treatment of atonic postpartal hemorrhage emergencies.

[Ovarian function and recurrence in adjuvant chemotherapy of breast cancer]. / Ovarialfunktion und Rezidiv bei adjuvanter Chemotherapie des Mammakarzinoms.

The present paper reports the results of a prospective study of the influence of adjuvant chemotherapy (1) on ovarian function and (2) on recurrence and the patient's endocrine function status. Observation criteria were the endocrine status before, during and after chemotherapy. The follow-up period ranged from 12 to 78 months. The patient population comprised 80 women, of whom 39 were treated with AC and 41 with CMF. Of the 80 women, 56 (70.0%) had hypergonadotropic function at the end of treatment; 31 of these had been treated with AC and 25 with CMF. Significantly more women (p less than 0.1) who had undergone AC therapy were hypergonadotropic than among those treated with CMF; 28 of the patients had recurrences during the follow-up period. Among women with undisturbed ovarian function under chemotherapy (eugonadotropinemia), recurrences occurred more frequently (50.0%) than among chemically castrated patients (28.6%). This effect was especially apparent among patients in the AC group with positive receptor status and chemotherapeutically induced ovarian suppression. CMF therapy produced no difference between eugonadotropic and hypergonadotropic patients with regard to frequency of recurrences, not even when there was a correlation with their receptor status.