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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.

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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.

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Primary therapy of advanced ovarian cancer is standardized, the therapy in relapsed ovarian cancer however is still controversial. In a prospective study the benefit of secondary surgery and/or second-line chemotherapy were evaluated. 139 patients with relapsed ovarian cancer were stratified according to a treatment plan: patients with early relapse (recurrence-free interval 12 months) or primary progression during chemotherapy (n=43) were treated chemotherapeutically with etoposide (p.o. vs. i.v.). Patients with late relapse (recurrence-free interval >12 months, n=96) were referred, if possible, to a secondary debulking operation, followed by a platinum-based chemotherapy. Remission-rate, toxicity and survival time were analyzed. Median survival time in the group was 15 months compared to 30 months in patients with late relapse (p=0.0004). Within the group patients with secondary debulking and chemotherapy (n=59) had a statistically significant survival advantage compared to patients who had only chemotherapy (n=37) (38 vs. 12 months, p<0.0001). The unfavorable group of patients with early relapse should be treated chemotherapeutically, whereas in patients with late relapse a secondary debulking seems to improve prognosis.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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".

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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.

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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.

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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.

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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.

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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.

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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.

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