Problemstellung: Die Sonographie ist neben der Mammographie und der Palpation der Brust ein wichtiges Diagnostikum in der Früherkennung des Mammakarzinoms. Durch stetige Weiterentwicklung der Ultraschallgeräte und verbesserte Auflösungsvermögen werden zunehmend Läsionen in der Mamma sichtbar gemacht, die in der Mammographie oder bei der Tastuntersuchung nicht zu erfassen oder aufgrund strahlendichter Mammae nicht darstellbar sind. Dieser Vorteil in der Früherkennungsdiagnostik führt häufig zu unnötigen operativen Eingriffen an der weiblichen Brust. Die sonographisch gesteuerte Vakuumbiopsie in Lokalanästhesie ermöglicht nach nur einem Einstich die Entnahme von mehreren Stanzzylindern, was mit den herkömmlichen Stanzbiopsien bisher nicht möglich war.

BACKGROUND:Primary hyperparathyroidism during pregnancy is rare. The incidence of primary hyperparathyroidism in women of child-bearing age is estimated to be approximately 8 cases per 100,000 population per year.CASE REPORT:We provide a case report of a 33-year old pregnant woman, in whom primary hyperparathyroidism was diagnosed because of neonatal hypocalcemia two days after delivery. There was a history of recurrent urinary tract infections with hydronephrosis on the left side. The woman had been treated on an outpatient basis by an urologist, nephrostomy had been performed. After delivery, nephrolithiasis was diagnosed by x-ray and treated endoscopically. Parathyroid adenoma was found and removed successfully.DISCUSSION:Due to physiological changes of calcium metabolism primary hyperparathyroidism is often without symptoms during pregnancy. Operative elimination of adenoma as a frequent cause of primary hyperparathyroidism reduces maternal and fetal morbidity and mortality.CONCLUSIONS:In pregnant women with hydronephrosis on the left side primary hyperparathyroidism should be considered. If undetected, hyperparathyroidism causes considerable morbidity, not only for the mother but also for the child.

BACKGROUND Incidence of malignant melanoma has more than doubled in the past 10 years. Two thirds of malignant melanoma arise from melanocytes, the pigmented cells of epidermis and dermis, in one third of the cases from preexisting nevi. CASE REPORT We report on a 39 year-old pregnant woman with liver metastases after surgical removal of a malignant melanoma two years before. The mother died in the course of progredient liver insufficiency, a male baby had been delivered with a gestational age of 26 weeks + 4 days via cesarean section 11 days before and developed normally. RESULTS Early diagnosis and operative excision are decisive for survival, in advanced stages chemotherapy does not prolong survival. CONCLUSIONS Interdisciplinary co-operation of the pediatrician, obstetrician, and oncologist is of utmost importance. DISCUSSION Melanoma and pregnancy represent a difficult situation for the patient, her partner and the treating physicians. Here the wish to have a child meets the potentially deadly cancer disease.

Analysis of estrogen and progesterone receptor (ER, PR) status was performed in pre-, peri- and postmenopausal women at the time of surgery in 60 women with breast cancer and 19 women with benign breast disease by comparative use of the dextrose coated charcoal method and the immunohistochemical assay (peroxidase-antiperoxidase technique). In premenopausal women we furthermore differentiated depending on the menstrual cycle at the time of surgery. The retrospective study shows sufficiently consistent results in both analytical procedures. There was no difference in the expression of ER and PR in pre- and postmenopausal women, furthermore, ER and PR expression was not significantly different during the follicular phase compared to luteal phase.

In insgesamt neun Kurzvorträgen wurde der Bezug von Umwelt und sozialem Umfeld auf die Frauenheilkunde gezogen.

Beim Mammakarzinomen wird die Bedeutung der Zyklusphase zur Zeit der Brustoperation auf die Prognose und Überlebenszeit prämenopausaler Patientinnen kontrovers diskutiert. Karzinomzellen sollen unter reinem Östrogeneinfluß eine größere Potenz zeige, zu proliferieren und Mikrometastasen zu bilden als bei Anwesenheit von Progesteron (1).

Unsere Untersuchungen zeigen somit sowohl auf licht- als auch auf elektronenmikroskopischer Ebene, daß die gefundenen Varationen in der Expression der Steroidrezeptoren als Ausdruch einer zum Teil reversiblen Zellschädigung zu verstehen sind, die mit einer Funktionsbeeinträchtigung während des Eitransportes einhergehen. Unsere Ergebnisse weisen auf eine Mitbeteiligung der Steroide und ihrer Rezeptoren bei der komplexen und im einzelnen noch wenig verstandenen Regulation des Eitransportes hin.

We characterized the expression pattern of estrogen receptor α (ERα) gene in two regions of the oviduct, ampullae and isthmus, of the rabbit (Oryctolagus cuniculus) during early pregnancy (1–4 days) by RT-PCR and immunohistochemistry. In both regions of the oviduct, ERα mRNA was increased (P < 0.01) in pregnant rabbits as compared with non-pregnant animals (NG). In the ampullae, the greatest amount of ERα mRNA was detected on the third day of pregnancy (1.01 ± 0.02 relative amount), followed by a decrease on Day 4. In the isthmus, an increase in ERα mRNA was observed during the first 4 days of pregnancy, with the greatest amount on Day 3 (1.49 ± 0.3 relative amount). A marked ERα immunostaining was detected in epithelial, stromal and smooth muscle cells of the ampullae on the second and third days of pregnancy as compared with the NG group. In contrast, a significant increase in ERα immunostaining was observed on the first and second days of pregnancy with a reduction on the third and fourth days in the epithelial, stromal and smooth muscle cells of the isthmus. The overall results suggest there is differential expression pattern for the ERα gene in the ampullae and isthmus during early pregnancy of the rabbit, and that these variations are related to specific functions of ERα in the reproductive tract during early pregnancy.

In this double blind cross-over study, 20 infertile men, who had sperm antibodies detected by the mixed antiglobulin reaction (MAR test) in the ejaculate and by the tray agglutination test (TAT) in serum, were treated with 40 mg/day prednisolone or placebo from days 1 to 10 of the partners' menstrual cycle. Patients were randomly allocated to different treatment groups. While group 1 started with placebo followed by verum for three consecutive cycles, group 2 began with verum and continued with placebo. All patients had regular intercourse (n = 19) or intra-cervical insemination at ovulation (n = 1). A post-coital test or a sperm penetration test was performed during verum and placebo regimes. Blood samples were drawn from the male partner at this time to control the efficacy of prednisolone treatment by checking the TAT titre. No pregnancy occurred during prednisolone or placebo treatment. In eight of 12 patients, post-coital testing showed little improvement and antibody titres decreased in seven of 16 patients. Side-effects from medication were reported by eight patients (seven verum and one placebo cycle) and caused treatment to be discontinued in two cases. Five patients' partners conceived at a later stage by intrauterine insemination with spermatozoa prepared by 'swim up' (n = 3) or by in-vitro fertilization (IVF n = 2). Thus high dose corticosteroid therapy was ineffective in achieving pregnancies induced by infertile men positive for antisperm antibodies. Since side-effects of corticosteroids should not be underestimated in otherwise healthy men, other reproductive techniques such as intrauterine insemination or IVF should be offered to such couples.

Der Eitransport durch die Tube ist durch ein Zeitprofil des Transportes mit Ruhephasen vor dem Eintritt in den Tubenisthmus und dem Übertritt in den Uterus gekennzeichnet. Speziesspezifisch ist das Entwicklungsstadium bei Eintritt in den Uterus sowie die Geschwindigkeit des Eitransportes in den einzelnen Tubenabschnitten. Der Eitransport folgt einer komplexen und noch wenig verstandenen Interaktion von Muskelaktivität einerseits sowie Zilien- und sekretorischer Aktivität andererseits (Haibert et al., 1976). Angenommen wird eine synergistische Wirkung, wobei sowohl Muskelaktivität als auch Zilienbewegung nach selektiver Ausschaltung den regelrechten Eitransport garantieren können (Verdugo et al. 1980). Sekretion und Zilienschlag der Endosalpinx sowie die Kontraktilität der Myosalpinx werden durch Östrogene gefördert und Progesteron antagonisiert.

Noch immer stellt die chronische Plazentainsuffizienz mit ihren schwerwiegenden Folgen wie fetaler Hypoxie, Wachstumsretardierung oder intrauterinem Fruchttod eine Herausforderung an den Geburtshelfer dar. Die Grundüberlegung zur Entwicklung eines wirksamen Therapiekonzeptes bei chronischer Plazentainsuffizienz ist, die uteroplazentare Durchblutung zu verbessern. Neben der Ausschaltung möglicher ursächlicher Noxen wie Nikotin, Alkohol oder Mangelernährung der Mutter haben Bettruhe und Entlastung der Patientin von beruflichen und familiären Streßfaktoren positive Auswirkungen (2, 20). Beta-2-Sympathikomimetika werden eingesetzt, um den Tonus des Myometriums zu senken und durch die so erzielte Vasodilatation die uteroplazentare Perfusion zu fördern (15, 20). Durch den Einsatz gerinnungshemmender Substanzen wie Heparin sollen Thrombosen der uteroplazentaren Gefäße und des intervillösen Raumes vermindert werden (1, 3, 5, 12). Bisher gibt es kein einheitliches Therapiekonzept bei der Langzeittherapie der chronischen Plazentainsuffizienz.

Annals of the New York Academy of SciencesVolume 598, Issue 1 p. 561-563 Alterations in Prostaglandin Metabolism in Cultured Human Umbilical Vein Endothelial Cells Affected by Atherogenic Risk Factors during Pregnancy H.-J. BAUCH, H.-J. BAUCH Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorW. ERDBRÜGGER, W. ERDBRÜGGER Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorB. KARBOWSKI, B. KARBOWSKI Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorB. KEHREL, B. KEHREL Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorW. H. HAUSS, W. H. HAUSS Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this author H.-J. BAUCH, H.-J. BAUCH Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorW. ERDBRÜGGER, W. ERDBRÜGGER Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorB. KARBOWSKI, B. KARBOWSKI Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorB. KEHREL, B. KEHREL Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this authorW. H. HAUSS, W. H. HAUSS Institut für Arterioskleroseforschung an der Universität Domagkstrasse 3, D–4400 Münster, Federal Republic of GermanySearch for more papers by this author First published: August 1990 https://doi.org/10.1111/j.1749-6632.1990.tb42348.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume598, Issue1Atherosclerosis II: Recent Progress in Atherosclerosis ResearchAugust 1990Pages 561-563 RelatedInformation

Endothelial cell functions regulating fetal hemodynamics and placental perfusion are modulated by metabolites of arachidonic acid, in particular derivatives of cyclooxygenase such as prostaglandins. We utilized an in vitro system to study the possible role of the vascular endothelium in the pathogenesis of chronic placental insufficiency. Cellular growth and prostaglandin metabolism were investigated in cultured umbilical vein endothelial cells from mothers exposed to risk factors such as smoking and diabetes mellitus during pregnancy. The study comprised cells from smoking (n = 18) and diabetic mothers (n = 5) compared to non-smoking, non-diabetic controls (n = 20). Endothelial cells from smoking and diabetic mothers grew less readily than did control cells. The synthesis of the prostaglandins PGI2 and PGE2, both potent vasodilators and platelet aggregation inhibitors, was significantly reduced in endothelial cells from smoking mothers and from mothers suffering from diabetes of various stages. Thus, reduced prostaglandin synthesis may be a cause of impaired placental perfusion in high risk pregnancies. Our data suggest that prostaglandins may play an important role in the etiology and pathogenesis of chronic placental insufficiency.

Bei maternalem Diabetes mellitus, aber auch Nikotinabusus führt das Versagen der materno-fetalen hämodynamischen Funktionseinheit zu einer chronischen Plazentainsuffizienz.