Epidemiology and the prevention of peripartal mycoses.

About 30% of all pregnant women are affected by antepartal vaginal yeast contamination. During the past 40 years this incidence has remained unchanged throughout the world. Due to the close contact of the baby with the contaminated area during parturition, yeasts are transmitted to the skin surface of the newborn. Yeasts are still demonstrable in more than 10% of all newborn on the 5th day of life. All newborn presenting yeast contamination on the 7th day of life are likely to develop a clinically manifest thrush by the end of the 2nd week of life. If the yeast contamination is acquired at a later stage, the risk of infection is much lower. Extensive mycological examinations of the newborn nursing staff and of the environment of newborn have not indicated any causal relationship to contamination. The yeast reservoir of the maternal vagina may therefore, in the majority of cases, be regarded as the cause of perinatal thrush which affects about 13% of all newborn by the 4th week of life. A prophylaxis of neonatal thrush should thus be carried out before parturition. Both the incidence of vaginal and neonatal yeast contamination can be reduced by more than 60% by a general mycological examination of all pregnant women between the 34th and 36th week of pregnancy and treatment of a possible yeast contamination with a local antifungal.

[The influence of radium therapie on the yeast contamination of the vagina (author's transl)]. / Der Einfluss der Radium-Kontaktbestrahlung auf den vaginalen Hefebefall.

Before the beginning of radium therapy a vaginal yeast contamination of 9,7% was found of 113 patients with different genital carcinomas. However, the incidence of vaginal yeast contamination increased suddenly to 30,9% under the contac irradiation therapy with radium. The radiation effect of radium is not sufficient for a "selfsterilisation" of the radium-carrier in the case of yeast contamination. Therefore, a chemic desinfection of the radium-carriers is principly necessary. The significance of radium therapy with respect to vaginal yeast contamination is discussed and the recommendation is made that routine mycological supervision be carried out on all patients with gynaecological carcinomas and appropriate antimycotic therapy initiated where necessary.

Are yeasts in vaginal smears intracellular or extracellular?

Using light microscopic cytodiagnosis the only thing that can be said about the position of the yeast cells in relation to the epithelial cells is that the epithelial cells and the parasite are very close to one another. It is not possible to say whether both elements are only temporarily projected above one another or in direct contact. This question can only be answered unequivocally with the aid of the electron microscope. It is possible to verify that the yeast cells, despite their size, are able to invade intact epithelial cells and are capable of reproduction within these same cells.

[Phasecontrast cytology for intraoperative diagnosis of malignant breast lesions (author's transl)]. / Die Phasenkontrastzytologie bei der intraoperativen Diagnose des Mammakarzinoms

The efficacy of a cytodiagnostic method using a wet preparation of freshly exstirpated suspected tumorous breast tissue and phasecontrast microscopy has been evaluated in 430 cases. 95% of the carcinomas present were found with this method. The rate of wrongly positive cytological findings was less than 1%. It is discussed what advantages of this method can be achieved by a well trained cytologist for the patient and the surgical organisation. Further this new method is a means to check the frozen section findings.