Fallgeschichte einer Patientin, die in der 28. Schwangerschaftswoche ihrer ersten Graviditat die Klinik einer Praeklampsie entwickelte. Innerhalb eines Tages trat eine schwere Hamolyse und eine diffuse Gerinnungsstorung auf, so das eine Notfall-Sectio durchgefuhrt wurde. Im weiteren Verlauf wurde eine kontrollierte Beatmung wegen einer diffusen streifigen Verdichtung der Lunge notwendig. Die Laborwerte waren beweisend fur eine thrombotisch-thrombozytopenische Purpura (Moschcowitz-Syndrom), so das eine Plasmaaustauschtherapie 7 Tage lang durchgefuhrt wurde: Diese Therapie fuhrte zu einer schnellen und vollstandigen Heilung und zur Normalisierung der Laborwerte. Die Fallgeschichte wird anhand der betreffenden Literatur und der speziellen Perspektive einer pathophysiologischen Identitat zwischen den zwei Syndromen HELLP (hemolysis, elevated liver enzymes, low platelets) und Moschcowitz-Syndrom (Thrombotische thrombozytopenische Purpura) diskutiert; dieser Aspekt erscheint von speziellem Interesse wegen der adaquaten Plasmaaustauschtherapie. Case history of a patient is reported who developed signs of preeclampsia in 28th week of her first gravidity. Within one day severe haemolysis and diffuse haemorrhage occurred and an emergency section was performed. Subsequently, supported respiration became necessary because of diffuse infiltrations of the lung. Laboratory data then were conclusive for a thrombotic thrombocytopenic purpura (Mosehcowitz's disease) and therefore the patient was subjected to plasma exchange during seven days: this measure induced rapid and full clinical and laboratory remission. The case history is discussed on the background of the pertinent literature and the special perspective of a pathophysiological identity between the two syndromes: HELLP (haemolysis, elevated liver enzymes, low platelets) and Moschcowitz's disease (thrombotic thrombocytopenic purpura); this seems to be of special interest for an adequate therapy by plasma exchange.

Case history of a patient is reported who developed signs of preeclampsia in 28th week of her first gravidity. Within one day severe haemolysis and diffuse haemorrhage occurred and an emergency section was performed. Subsequently, supported respiration became necessary because of diffuse infiltrations of the lung. Laboratory data then were conclusive for a thrombotic thrombocytopenic purpura (Moschcowitz's disease) and therefore the patient was subjected to plasma exchange during seven days: this measure induced rapid and full clinical and laboratory remission. The case history is discussed on the background of the pertinent literature and the special perspective of a pathophysiological identity between the two syndromes: HELLP (haemolysis, elevated liver enzymes, low platelets) and Moschcowitz's disease (thrombotic thrombocytopenic purpura); this seems to be of special interest for an adequate therapy by plasma exchange.

Radiographic examination during pregnancy and pelvimetry before pregnancy are still required for particular indications. The use of digital radiography (lateral topogram on CT) reduces the radiation dose to the foetus and ovaries by a factor of 10 to 100, as compared with conventional pelvimetry, as described by Guthmann. The accuracy of this method is satisfactory, the technique is simple, it is rapid and is easy for the patient, particularly for pregnant women. As long as pelvimetry is not possible without ionising radiation, we consider pelvimetry with digital radiography, when strictly indicated, to be acceptable. In order to determine the transverse diameter of the pelvis, a single additional CT cut through the narrowest part of the pelvis is suggested.

In the following up of the diagnosis of the female sterility we practised 123 hysterosalpingographies (HSG) from 1972--1978. Presupposition was the proof of the ovulation by base temperature. The HSG is the beginning of the diagnosis to recognize the intracanalicular changes of the uterus and to avoid senseless treatment with hormones. 34.9% of the patients showed absolutely normal uteri or tubes. Pathological results were be found in 17.7% by the uterus and 47.4% by the tubes. Without any treatment we have had a success of pregnancy after HSG in 26.8%. Further pregnancies we got by operative intervention or medicamentous treatment in only 4,8%. 23 patients = 18,7% could not be evaluated because they were missing. The HSG is an important and supplementary method for a diagnosis of the female sterility and it does not compete with the method of the useful pelviscopy.

Within the period of 4 years 35 patients with urinary incontinence relapses have been treated surgically using modified Marshall-Marchetti-Krantz method and Lyodura-snare operation. In the group of patients who have been treated with the Lyodura-snare, 13 uterus had to be extirpated vaginally and two times by abdominal approach. 22 patients have been additionally treated by anterior colporrhaphy. In 10 patients with urinary incontinence relapse and simultaneous intraabdominal pathological changes, a laparotomy and abdominal suspension of paraurethral tissue were performed according to the modified Marshall-Marchetti-Krantz method. After an observation period of 4-1 years all patients were continent.

Within the period of 4 years 35 patients with urinary incontinence relapses have been treated surgically using modified Marshall-Marchetti-Krantz method and Lyodura-snare operation. In the group of patients who have been treated with the Lyodura-snare, 13 uterus had to be extirpated vaginally and two times by abdominal approach. 22 patients have been additionally treated by anterior colporrhaphy. In 10 patients with urinary incontinence relapse and simultaneous intraabdominal pathological changes, a laparotomy and abdominal suspension of paraurethral tissue were performed according to the modified Marshall-Marchetti-Krantz method. After an observation period of 4-1 years all patients were continent.

Within the period of 4 years 35 patients with urinary incontinence relapses have been treated surgically using modified Marshall-Marchetti-Krantz method and Lyodura-snare operation. In the group of patients who have been treated with the Lyodura-snare, 13 uterus had to be extirpated vaginally and two times by abdominal approach. 22 patients have been additionally treated by anterior colporrhaphy. In 10 patients with urinary incontinence relapse and simultaneous intraabdominal pathological changes, a laparotomy and abdominal suspension of paraurethral tissue were performed according to the modified Marshall-Marchetti-Krantz method. After an observation period of 4-1 years all patients were continent.

We report about a woman, 20 years old, who get a chorionepitheliom with pulmonary metastasis. We treated not by operation but by cytostatics Methotrexat and Actinomycin D over 40 days. The remission of the tumor was significant but accompanied by considerable toxic sideeffects.--18 months after this, we finished a new pregnancy by sectio caesarea without any complications for wife or child.

Es wird über autoradiographische Untersuchung zum Aufschluß des Proliferationsverhaltens der Placenta unter normalen und pathologischen Bedingungen berichtet. Gewebsproben von 39 Placenten normaler und 31 pathologischer Schwangerschaften (Diabetes mellitus, Erythroblastose, EPH-Gestose und Blasenmole) der 10.–43. Schwangerschaftswoche wurden in3H-Thymidin inkubiert.

To determine the effect of the 2-phase (mestrenol-lynestrol) ovulation inhibitor on the condition and proliferative activity of the human endometrium in different phases of the cycle and after different durations of therapy, 28 females (25-48 years old) on the sequential preparation were studied during 305 cycles. 97 biopsies were examined by light microscopy for morphological changes, and DNA-synthesis was investigated by radiography. In contrast to other studies, it was concluded that the sequential therapy does not imitate the usual endometrium alterations of a normal cycle. With estrogen administration up to Day 10, a proliferating endometrium was observed without glandular secretion. With subsequent combined application of gestagen-estrogen from Day 10, retronuclear secretory vacuoles appeared. The condition resembled abortive (undatable) secretion with suppressed glands, rather than the normal situation. At the end of the cycle atrophic cells and regressive alterations were observed. With prolongation of treatment the condition remained essentially the same with no increase in atrophy. This type of endometrium is unsuitable for nidation, and a nidation-inhibiting effect of the sequential preparation is assumed. Concerning DNA synthesis, intensified DNA synthesis activity was detected in the proliferation phase in the gland and surface epithelium with a sharp decrease in the secretion phase. Thymoid incorporation was observed during all cyclic phases in the stroma.