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TFF-peptides (formerly P-domain peptides, trefoil factors) are typical secretory products of mucin-producing cells and are thought to influence the rheological properties of mucous gels. Here, the localization of these peptides in the human uterus was investigated. An analysis of TFF-peptides mRNA by the polymerase chain reaction revealed TFF3 mainly in the endocervix and smaller amounts in the endometrium. TFF1 and TFF2 mRNA was detectable occasionally in the endocervix and very rarely in the endometrium. Western blot analysis detected only TFF3 in tissue extracts of the endocervix and as a constituent of human cervical mucus. Immunofluorescence localized TFF3 in the surface epithelium of the endocervix and in gland-like structures of the cervical epithelium.

Between 09/01/92 and 08/31/95 the Mainz model to register birth defects had been tested in the city of Magdeburg at the same time when the regional register instituted in 1980 was continued. The aim of this hospital-based model for the thorough registry of malformations in neonates is to examine all newborns born in hospitals using clinical and sonographical methods by experienced physicians according to a standardized scheme. Additional medical and social data were recorded. Data on live-and stillborn as well as spontaneous abortions older than the 16th gestational week and induced abortions following prenatal diagnosis were included. During the survey 5255 neonates were examined. The calculated percentage of major birth defects (by definition) was 7.8% and therefore higher than reported before. The experience with the Mainz model in the city of Magdeburg demonstrates, that this model is basically applicable to other centres. It is possible to obtain valid data on malformation frequencies in a defined population. Special attention has to be paid to certain conditions in the composition of hospital populations.

Penetrating head trauma in children causes uncommon and potentially life-threatening injuries. We report on a case of penetrating cranial stab wound to the right parietal region of the head to a 29-week fetus. The child was delivered by emergency Caesarian section. Neurosurgical intervention after birth was necessary. The injury caused a posthaemorrhagic hydrocephalus. Real-time ultrasound examination visualises the brain damage and the development of a hydrocephalus e vacuo.

In the course of six months, the influence of the oral depot contraceptive, Deposiston (3 mg ethinylestradiol sulphonate and 10 mg norethisterone acetate per menstrual cycle) on the pharmacokinetics of caffeine as a model substance was studied in seven women in intraindividual comparison. The first examination began prior to administration of Deposition. The women were subjected to little challenge as saliva was used as the measuring compartment. Deposiston was found markedly delay the elimination half-life life of caffeine (p less than 0.05): t1/2 prior to therapy 4.9 +/- 2.6 h and, after as little as 2 mg ethinylestradiol sulphonate 8.0 +/- 3.5 h. In contrast to the effect observed for preparations containing less estrogen, these longer half-lives persisted throughout the trial. As expected, the AUC values were slightly elevated during this period, whereas clearance values were reduced.

We report about results of growth-inhibiting treatment in Magdeburg between 1976-1986. In 57 girls closed treatment was studied. Side effects are small. The functional state of the hypothalamo-pituitary axis experienced no negative influence.

A rare case of leiomyomatosis peritonealis disseminata is reported in a patient operated on because of fibromyoma with growth tendency and hypermenorrhea.--During the operation a metastazing myomatous tumour was suspected which could not be excluded by frozen-section. Following were abdominal hysterectomy including both adnexa as well as subtotal resection of the omentum majus. Leiomyomatosis peritonealis disseminata was diagnosed by histological examination of the removed specimen. Three years after surgery patient is well.

Pathologic inhibitors of blood coagulation as cause of acquired haemostatic failure are rare. We report about a 23 years old primigravida with a life-threatening haemorrhage post partum. Analysis of coagulation parameters showed the presence of inhibitor to factor VIII. We reacted successfully with cyclophosphamid and cryoprecipitated factor VIII. References to diagnostic and therapy of pathologic clotting factor inhibitors are described.

A decrease of damages to the femoral nerve could be proved clinically, and for a small group electromyographically too, after using leg supports in vaginal surgery. The general use of adjustable legholders is recommended for exact positioning of legs with a flexion angle of 45 degree or more and an abduction angle of 45 degree maximally.

Proliferating papillary serous cystadenomas that seldom occur are classified into the group of ovarian tumours of low malignant potential (borderline tumours). The present study includes 33 cases observed in our clinic since 1955. Even though the five-year survival rate being 88% was substantially higher than that for ovarian carcinomas, the prognosis of individual cases cannot be reliably predicted because of the uncertainty as to the biological behaviour in both clinical and histological terms. Consequently, the trend to predominantly radical surgery appears to be a justified approach. Whenever it is desirable to maintain fertility in younger women, conservative surgery would require a unilateral tumour without a ruptured capsule and normal histological findings to be obtained from wedge excision in the opposite ovary.

A card is introduced, which in addition to essential anamnestic data permits registration of entry of diseases, side effects, smoking habits, additional drug intake and results of examinations during steroid medication. The card to be presented whenever a physician is consulted is intended to convey better pill-taking information to other specialists, while also ensuring follow-up of such patients.

The paper reports on the application of suprapubic bladder drainage in 86 women who had undergone gynecologic operations. After describing the advantages and complications of this method of draining off urine, it is found that, if urine drainage is required over a longer period, in a great number of cases suprapubic urine drainage is to be preferred to the permanent transurethral catheter.

Vaginography is recommended to detect and determine the exact location of uretero-vaginal fistulas and vaginal fistulas extending as far as into the upper intestine. Use of a modified Sengstaken probe for instillation of the contrast medium permits meaningful X-ray photographs to be obtained while ensuring definite sealing of the vagina to the outside.

The effect of postoperative metronidazole prophylaxis was investigated on infection morbidity in childbed. 376 women who have been delivered by caesarean section in the time of three years were divided into the metronidazole group (172) and the control (204) by random selection. In the metronidazole group (n = 36; 21.0%) significantly less cases of febrile course of puerperium were observed than in the control (n = 85; 41.7%). Patients with secondary sections revealed a significant reduction of infection morbidity. The consequences of the risk factors "increased duration (greater than 8 h) of the rupture of the membranes" and "a more than 8 h duration of labor" could be diminished. A metronidazole prophylaxis is recommended in all cases of secondary sections beginning immediately after cutting the umbilical cord.

Technology, evidence as well as indications and contraindications of the suprapubic bladder puncture are shown from a gynecological and obstetrical point of view. The bacteriological result of urine obtained by puncture from 476 women has been compared with that obtained subsequently by midstream voiding. It was proved statistically that bladder puncture yielded less positive results than midstream voiding. In 8.4 per cent of the cases there was a positive voided midstream urine culture with pathogenic bacteria while the samples of bladder puncture were sterile, thus 29.2 per cent of the positive voided midstream urine cultures proving to be "false-positive" concerning an infection of the bladder and of the upper urinary tract. The frequency of pathogenic bacteria, "apathogenic" bacteria and mixed cultures is given, divided into conforming and nonconforming culture results of puncture and midstream urines.

Pregnancy impairment in mice with abortion and fetal resorption was caused by rabbit antibodies to total mitochondrial, mitochondrial membrane and microsomal fractions of mouse placentas injected intraperitoneally at 12-14 days of gestation. Antibodies to cytosol and soluble mitochondrial constituents were ineffective. According to the marker distribution in the biologically active and inactive fractions membrane-bound antigens are thought to be responsible for the abortigenic effect.

The effect of the oral contraceptive, Non-Ovlon, on the pharmacokinetics of the model substance, caffeine, was studied in an intraindividual comparison in the course of seven months, i.e. four and two weeks before as well as 0.5, one, three and six months after the women had begun to take the contraceptive. The study commenced in twelve women of which, after seven months, only five were involved. The measuring compartment chosen was saliva so as to minimize strain on the volunteers by this noninvasive approach. Non-Ovlon delayed the caffeine elimination of 4.0 +/- 1.7 hr to 9.0 +/- 4.5 hr and 11.0 +/- 10.4 hr at the end of the first and third intake cycle, respectively. Markedly successive decreases in clearance and an increase in AUC levels were seen in addition to longer half-lives. Interindividual variations were considerable, a finding that might be relevant to the therapy by other, similarly interacting, drugs. There were no differences observed between the initial phase and the median phase of normal menstrual cycle. In one smoker, the caffeine elimination was highly accelerated compared to the average, throughout the period of investigation.

To examine levonorgestrel as a postcoital contraceptive, 77 women received an oral dose of 0.4 mg per coitus for 1011 cycles and 27 women were administered 0.75 mg per coitus for 226 cycles. In the first dose group seven women became pregnant (Pearl's index 8.3), while two pregnancies resulted in the second group, one of the latter because of faulty drug intake (uncorrected Pearl's index 10.6; corrected Pearl's index 5.3). Menstrual irregularities (chiefly break-through bleedings and oligomenorrhea) were observed in 84.4% and 88.9% of the women, respectively. The number of cycle disorders increased with increasing intake rate and diminished when the drug was applied in excess of six months. The experiments undertaken to test the mechanisms of action indicated an influence on both cervical factor and endometrium, whereas the occurrence of LH-peaks and biphasic basal body temperature patterns suggested the presence of ovulations. Application of levonorgestrel for postcoital contraception failed to be a reliable routine method of hormonal contraception because of insufficient efficacy and considerable menstrual irregularities. The drug should be administered only after unprotected sexual intercourse as might happen, to women with very low frequency of intercourse, or in periods of reduced fertility.

Fifty eight fertile female volunteers between 20 to 45 years were enrolled in a clinical trial to evaluate the efficacy and tolerance of the progestin dienogest (17 alpha-cyanomethyl-17 beta-hydroxyestra-4,9-dien-3-one, VEB Jenapharm Jena GDR) as a postcoital contraceptive. An oral dose of 2 mg dienogest was administered immediately after each coitus. The 58 women reported 872 intercourses during 302 cycles. Frequency of ingestion was on average 3 times per cycle. Pregnancy occurred in 14 women corresponding to a Pearl-index of 55.6. The observed pregnancy rate referring to all intercourses was 1.6 per cent. The incidence of expected pregnancies in relation to the coital exposures was 4.04 per cent. As a result the risk of pregnancy was reduced 2.5 times by dienogest. Menstrual disorders occurred in 18.9 per cent in regard of the total numbers of cycles. The results and an overview of literature suggest that neither dienogest nor other progestins are suitable as a sole contraceptive method when used as a postcoital agent. They are only indicated as a risk-reducing method after so-called "contraceptive emergencies".

Hemotherapy performed in our clinic was investigated in patients operated on in the years 1973 and 1982. A total of 832 operations (638 gynaecological interventions and 194 cesarean sections) were used for evaluation. - Transfusion rates decreased from 72% (1973) to 13% (1982) due to systematic application of crystalloid and colloidal infusions to cases of blood loss of up to 20% of the total blood volume. The percentage of erythrocyte concentrate applied increased from 0.4% (1973) to 42% (1982), while it even reached 80% when related to the total blood transfusions of our clinic. To conclude, strict principles should be adopted in deciding for blood transfusion as well as in purposefully applying blood constituents lost. The advantageous development in the economy of surgery is outlined.

The administration of rabbit antibodies to whole mitochondria, mitochondrial membranes, or microsomes of mice placentas at 12-14 days of gestation resulted in abortion or fetal resorption, whereas antibodies to administered cytosol, mitochondrial matrix, or the mitochondrial intermembrane fraction were ineffective. From the distribution of marker enzymes in the biologically active and inactive fractions the abortigenic antigens are thought to be membrane-associated. Because of insurmountable cross-reactivities of the heterologous antisera, the immunopathogenesis of abortion could not be adequately clarified. However, preliminary experiments with antibodies (immune ascites) from mice immunized with the mitochondrial-microsomal fraction proved successful. A homologous animal model might be more helpful in elucidating the role of antibody-mediated immune mechanisms in human pregnancy impairment.

Sera from 19 patients with EPH gestosis, 22 patients with hypotrophic newborns, and a control group of ten women with normal pregnancy and fetuses were studied for the presence of circulating immune complexes. Both the C1q solid-phase radioimmunoassay and the polyethylene glycol precipitation test revealed significantly higher levels of circulating immune complexes in both groups of patients.

In a female patient with a von Willebrand's disease type II (ristocetin cofactor less than 20%) shortly before and after birth of a son the factor VIII-related antigen and the ristocetin cofactor showed considerable increases, which some weeks later again decreased to the original values. Despite additional thrombocytopenia only on the 4th day post partum an easily controllable uterine haemorrhage was to be established. The risk of haemorrhage in von Willebrand's disease during pregnancy, birth and puerperium seems to be insignificant; nevertheless on the basis of the heterogeneity of this disease a peripartal coagulation-analytic control is regarded necessary.

A report is given on experience gathered in using a new method of postoperative bladder drainage. The advantages and disadvantages of the "mini-catheter", used in 121 women, are detailed.

According to one case of repeated anencephalic pregnancy the etiology of anencephaly has been discussed. The possibilities of prevention of repeated anencephalic pregnancies are described. To determine the alpha-I-fetoprotein in amniotic fluid and the ultrasonic diagnosis are most important in risk pregnancies. The significance of genetic counselling and examination in definitive risk population is advised.

Coumarins administered in early pregnancy can cause malformations. This so-called coumarin embryopathy is characterized by malformations such as those occurring in chondrodysplasia punctata of the Conradi-Hünermann type, i.e. a syndrome which has been known since 1914. A case observed after coumarin administration (Falithrom) in early pregnancy is described with the features considered typical: Hypoplasia of the nasal bridge and stippled calcification of the skeleton, in particular stippled epiphyses of the long bones. According to reports in the literature, the risk of fetal abnormality amounts to some 30 per cent. This entails in practice the requirement for absolute contraindication for coumarins in early pregnancy (first trimester). Finally, possibilities of an acceptable anticoagulant therapy during pregnancy are discussed.

It is reported on the prophylaxis of thromboembolic diseases with acetylsalicylic acid (Micristin) in gynaecological surgery. The number of thromboembolic complications clinically ascertained was diminished from 3,25% (without Micristin) to 0,82% (with Micristin). Side effects were rarely observed, laboratory control was not necessary, Low-dose-heparin-prophylaxis were executed on contraindications and incompatibilities of Micristin. The perioperative use of low doses of heparin combined with postoperative use of oral anticoagulants on patients with increased risk of thromboembolism are discussed.