{"title":"29th Congress of the Federation of Scandinavian Societies of Obstetrics and Gynecology. Oulu, Finland, 7-11 August 1994. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"161 ","pages":"17-132"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18912141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endometriosis classification for infertility.","authors":"R S Schenken","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The American Fertility Society (AFS) classification for endometriosis is a widely-used system for categorizing the severity of pelvic endometriosis. Although this classification represents a detailed description of the location and extent of disease, it has limitations when used to predict fecundity following treatment of the different stages of endometriosis. Concern regarding the inability of the AFS classification to discriminate between mild, moderate and severe disease in terms of pregnancy outcome is related to arbitrary assignment of point scores for each pathologic observation, and to arbitrary assignment of total scores to patients divided into severity categories. Establishment of empirically-derived scores for individual pathologic observations and identification of cut-off scores based on pregnancy outcome for each category would offer a reliable, clinically useful classification system for endometriosis in infertile women.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"41-4"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19199100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of cell-mediated immunity in pathogenesis of endometriosis.","authors":"W P Dmowski, H M Gebel, D P Braun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is well recognized that cell-mediated immune responses contribute to the elimination of foreign antigens and cells from the invading organism. It is also likely that the immune system can recognize and eliminate altered or misplaced autologous cells such as ectopic endometrial cells. This mechanism may be operative in most women, preventing the development of endometriosis. Recent studies in women with endometriosis demonstrate functional changes in cells of the immune system including monocytes/macrophages, natural killer cells, cytotoxic T-lymphocytes and B cells. These changes suggest decreased surveillance, recognition and destruction of the misplaced endometrial cells and possible facilitation of their implantation and development of endometriosis. Peripheral blood monocytes (PBM) and peritoneal macrophages (PM) may play a key role in this respect, and may control the function of other immune cells. We have demonstrated that in normal fertile women without endometriosis, PBM and PM suppress endometrial cell proliferation in vitro. In endometriosis, PBM stimulate and PM inhibit endometrial cell proliferation and the cytotoxic effect of PM is inversely correlated with the stage of the disease. The decrease in PM cytotoxic function is controlled by prostaglandin synthesis. In infertile women without endometriosis, the effects of PM and PBM are variable. In about one third of patients, the effects of PM and PBM suggest subclinical endometriosis; in the remaining two thirds of patients the effects of PM and PBM are similar to those of fertile controls. Interestingly, endometrial cells in women with endometriosis are more sensitive to the stimulatory effect of PBM, and more resistant to the cytotoxicity of the immune cells.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19199101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perinatal and infant mortality: trends and risk factors in Norway 1967-90.","authors":"S Agdestein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neither the infant nor the under 24 hours mortality rates in Norway improved in the 1980s. The late neonatal mortality rate did not improve significantly in either the 1980s or the 1970s. The postneonatal mortality rate rose steadily throughout the last 15 years. The major mortality declines for all age groups took place in the 1970s. In the 1980s, only the 1-7-day mortality improved significantly. As a result, Norway fell behind in the international ranking of perinatal and infant mortality. Disparities among the perinatal mortality rates of Norwegian counties diminished throughout the 1970s. In the 1980s, the county disparities intermittently increased. Postneonatal deaths represented an increasing proportion; in the late 1980s, they amounted to half of the infant deaths and one-third of the total perinatal and infant deaths. In 1988, the postneonatal mortality rate was about twice as high in Norway as in Finland, Iceland, or Sweden. Birth injuries and infections almost disappeared as causes of perinatal and infant death. Other perinatal causes also diminished substantially. The incidence of congenital anomalies remained stable. The incidence of sudden infant death syndrome (SIDS), the single cause with continuous rate rise, more than doubled. In the late 1980s, SIDS caused one-quarter of the infant and more than half of the postneonatal deaths. The share of perinatal deaths from placentoumbilical causes (mostly placenta previa and abruptio placentae) and maternal diseases increased substantially. The affluence of Norway surged in the late 1970s and the 1980s, but health care was not given a higher priority. About 80% of fertile women used contraceptives. The use of modern methods increased substantially; oral contraceptives, in particular. About 60,000 confinements and 15,000 legally induced abortions took place in Norway each year. The number of induced abortions increased in women in their twenties, but decreased in all other age groups. As the total fertility decreased, each woman, on average, gave birth to 1.9 children and experienced 0.5 legally induced abortion. Maternal mortality was reduced to nil. Fewer marriages were contracted, and the divorce rate more than doubled. As a result, more than 35% of all births now occur out of wedlock, as compared with 5% in the late 1960s. The individual importance of birth out of wedlock as a risk factor has been reduced substantially. The mean maternal age increased from 26 to 28 years. The proportion of births by teenage mothers dropped from 8 to 3%.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"160 ","pages":"1-30"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19199102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New principles in the management of endometriosis.","authors":"I A Brosens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The current management of endometriosis includes expectant, medical, surgical and combined therapies and the selection is based on the staging of the disease proposed by the American Fertility Society (AFS). This approach, however, has proven to be inadequate for the selection of medical treatment. Peritoneal endometriosis represents a range of lesions of different activity and stage of evolution. Surgical resection carries a risk of adhesion formation. Two to three months of medical therapy can induce inactivation and regression of active lesions. These factors should be taken into account in the selection of therapy. Ovarian endometrial cysts are indications for reconstructive surgery. The extent of adhesions and fibrosis, rather than the size of the cyst, determine the surgical outcome. The invaginated cortex explains the frequent association with lutein cysts. Large cysts can be conservatively treated at laparoscopy in a three-step procedure with a 3-month medical therapy between the first and second laparoscopy. Deep nodular endometriosis presents different lesions varying from fibrosis to adenomyosis. The effect of a therapeutic medical trial can be evaluated within 2 months. Different modalities are available for long-term medical therapy. Surgical resection is the treatment of choice for the adenomyosis type.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"159 ","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19200613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estrogens and the urogenital tract. Studies on steroid hormone receptors and a clinical study on a new estradiol-releasing vaginal ring.","authors":"P Smith","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Estrogen receptors and progesterone receptors were detected and quantified in female pelvic floor muscles, urogenital ligaments and in uterus (myometrium) by use of monoclonal antibody assay techniques. Qualitative assessment with immunohistochemical methods further localized the estrogen receptors and progesterone receptors to the nuclei of connective tissue cells and striated muscle cells in the levator ani muscle, and to the cell nuclei of smooth muscle cells in the round ligament. These findings fulfil a prerequisite for viewing the pelvic floor and the round ligament as target organs for estrogens. The results also contribute to the understanding of the etiological role the reduction in estrogen levels has on the increased incidence of prolapse and urinary incontinence after the menopause. For treatment of urogenital mucosal atrophy a new vaginal silicone ring releasing 5-10 micrograms estradiol/24 h for a minimum of 90 days has been developed. The efficacy, safety and acceptability of the ring were studied in 222 postmenopausal women with symptoms and signs of atrophic vaginal mucosa. The maturation of the vaginal epithelium, as measured by cytological parameters, was significantly improved during treatment. There were significant decreases in vaginal pH, and these changes correlated well with the cytological evaluation. No proliferation of the endometrium was encountered. The therapy had a significant effect on symptoms and on signs of atrophic vaginitis, with cure/improvement registered in > or = 90%. The patient acceptability was high. It is concluded that a vaginal silicone ring giving a continuous release of an ultra-low dose of estradiol is an effective and safe treatment for urogenital estrogen deficiency. No addition of progestogen is needed.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"157 ","pages":"1-26"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19377604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of carboplatin in ovarian cancer. Current results and thoughts for the future.","authors":"R F Ozols","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carboplatin is a cisplatin analog that causes less nephrotoxicity, neurotoxicity and nausea and vomiting than its parent compound. In prospective clinical trials, carboplatin has been shown to be as active, but less toxic, than cisplatin in previously untreated patients with advanced ovarian cancer. However, carboplatin has not led to improved survival, compared with cisplatin. Studies are in progress to reduce the dose-limiting myelo-suppression of carboplatin in order to increase the dose intensity. In addition, new carboplatin combinations are also to be evaluated in clinical trials. The molecular basis for resistance to platinum compounds is also undergoing study and future clinical trials will evaluate modulations of resistance.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"155 ","pages":"75-7"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12672070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ovarian cancer, a prevailing challenge. Proceedings of a nordic symposium. Stenungsbaden, May 10-11, 1991.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"155 ","pages":"5-111"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12527717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The controversial 'second-look' laparotomy.","authors":"Bokhman YaV, V L Vinokurov, E I Gulo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To determine optimal indications for and clinical assessment of the significance of relaparotomy, the data of 304 women with malignant ovarian tumours (of epithelial origin, predominantly, 72%) who had undergone a 'second-look' operation were analysed. 'Second-look' relaparotomies were performed 10-22 months after the initial operation, on the following clinical indications: 1) clinical remission after initial combined treatment (surgery + chemotherapy) in cases where malignant cells are found at systematically performed cytological examinations of ??? or lavage from peritoneal surfaces of the Douglas cul-de-sac plus high levels of CA 125 in blood serum (8 patients with stages I and II, FIGO classification); 2) remission after adequate combined treatment and following 6-10 cycles of polychemotherapy, in order to decide whether to abandon or continue with treatment (13 patients with stages III and IV); 3) clinical remission following initial operation which was voluminously non-radical (117 patients); 4) suspicion of tumour recurrence after adequate combined treatment (114 patients); 5) no suspicion of cancer recurrence, though with ventral hernia or other pathology requiring relaparotomy (22 patients). Complications arising at the 'second-look' operation or during the postoperative period were observed in 29 of the 304 patients (9.5%), giving a postoperative mortality of 0.9%. According to experience, the positive significance of 'second-look' operations to optimize treatment of patients with malignant ovarian tumours is obvious.</p>","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"155 ","pages":"79-83"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12672071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The next generation of oral contraceptives. Proceedings of a symposium held at the XII World Congress of the International Federation of Gynecology and Obstetrics. Rio de Janeiro, October 26, 1988.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75400,"journal":{"name":"Acta obstetricia et gynecologica Scandinavica. Supplement","volume":"152 ","pages":"1-46"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13494637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}