Subject(s)
Genital Diseases, Female/diagnostic imaging , Genital Diseases, Female/surgery , Peritoneal Diseases/diagnostic imaging , Peritoneal Diseases/surgery , Ultrasonic Therapy/instrumentation , Adult , Broad Ligament/pathology , Douglas' Pouch/pathology , Female , Genital Diseases, Female/pathology , Humans , Laparoscopy , Myocytes, Smooth Muscle/pathology , Pelvic Pain/etiology , Peritoneal Diseases/complications , Peritoneal Diseases/pathology , UltrasonographyABSTRACT
Hyperandrogenism in females usually results from ovarian or adrenal pathology. We present a case of virilizaton due to very rare bilateral ovarian diffuse interstitial proliferation of Leydig cells with no tumour or hilar cell hyperplasia identified. Interestingly, the case was further complicated by the finding of high levels of testosterone in one adrenal vein on selective venous sampling (SVS), resulting in an unnecessary unilateral adrenalectomy. Further sampling found high levels also in the ovarian veins, and the condition was finally cured by bilateral oophorectomy.
ABSTRACT
Forty-six previously untreated patients with advanced ovarian cancer were treated with combination chemotherapy comprising cisplatin 80 mg m-2 i.v. and cyclophosphamide 1 gm-2 i.v. every 28 days for 5 cycles. Eighty-five percent of patients received more than 75% of the calculated doses, and of 43 evaluable patients, a complete response was achieved in 31 (72%), a partial response in 4 (9.3%) and 8 patients had static or progressive disease. The actuarial survival of the whole group is 60% at a median follow-up of 2 years. Twenty-four patients in complete clinical or pathological remission were then treated with whole abdominal radiotherapy 2,500 cGy followed by a pelvic boost of 2,000 cGy. The pelvic boost was omitted in 3 patients, and the overall radiotherapy treatment time extended in a further 4 patients on account of myelosuppression. The actuarial survival of the 24 patients receiving both treatments at a median of 30 months follow-up is 75%. In the 10 patients with negative second-look procedures completing both treatments there have been no tumour related deaths at a median follow-up of 33 months.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/therapy , Ovarian Neoplasms/therapy , Abdomen , Adult , Aged , Carcinoma/drug therapy , Carcinoma/radiotherapy , Cisplatin/administration & dosage , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Female , Humans , Middle Aged , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/radiotherapy , PelvisABSTRACT
In a comparative trial, ethanol effectively arrested preterm labor for 48 hours for more in 32% of cases, a beta-adrenergic agent (salbutamol) in 60% of cases (not statistically significant), and a combination of ethanol and indomethacin in 70% of cases (statistically significant, P less than 0.5). Labor was delayed for 14 days or more in 36, 60, and 50%, respectively (not statistically significant). The numbers studied were small, and tests of statistical significance were of doubtful value. Salbutamol was more acceptable to patients and the staff than ethanol. The trial was suspended and eventually abandoned due to reports of prostaglandin synthetase inhibitors causing premature closure of the ductus arteriosus. In this series no problems were encountered with the use of indomethacin.
Subject(s)
Albuterol/therapeutic use , Ethanol/therapeutic use , Indomethacin/therapeutic use , Obstetric Labor, Premature/prevention & control , Birth Weight , Drug Therapy, Combination , Female , Fetal Membranes, Premature Rupture/prevention & control , Humans , Indomethacin/adverse effects , Pregnancy , Time FactorsABSTRACT
A case of uterine sacculation is reported in which a classic cesarean section was required for safe delivery. The definition and diagnosis of the condition and some difficulties in management are discussed.
Subject(s)
Pregnancy Complications/surgery , Uterine Diseases/surgery , Cesarean Section , Female , Humans , Infant, Newborn , Pregnancy , Vagina/abnormalitiesABSTRACT
Diabetes, while at one time a rarity in pregnancy, is now one of the more common medical problems encountered by the obstetrician. Immaculate control is essential and can only be accomplished by close co-operation between the patient and all her medical attendants. The patient can then anticipate an almost trouble free pregnancy and should deliver a baby of normal weight with none of the usual stigmata associated with babies of diabetic mothers.
