Source:http://linkedlifedata.com/resource/pubmed/otherAbstract
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| pubmed-article:12336567 |
PIP: 2 very early cases of organ transplantation, in this case of sections of healthy ovaries from fertile women to women unintentionally or unknowingly subjected to oophorectomy, are described; the paper concentrates on surgical technique, for the outcome is preliminary at the time of publication. The surgeon involved found donors willing to lose portions of their ovarian tissue, for various reasons, who were proven fertile. In 1 case of transplantation, the recipient was made ready for transplantation concurrently with the donor, and no storage of organs was necessary; in the other, ovarian material was stored in saline for a period of time, and upon reintroduction to a pelvic cavity the material immediately became reinfused and appeared healthy. Neither of the recipients had begun menstruating postsurgery at the time of this article's publication (about 6 months postoperatively), but signs were hopeful. The technique is spelled out in a step-wise manner.
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| pubmed-article:12255534 |
PIP: In a report of 192 cases of examinations of both husband and wife for cause of sterility, the husband was found at fault in 33 cases. In 31, few spermatozoa were present and in 2, none. The morphology of human spermatozoa is described in detail and the results of various staining methods compared. Numerous drawings illustrate observed variations in morphology. The common cause of azoospermia is an obliterating double epididymitis, usually of gonorrheal origin. Permanent obliteration of the tube of the epididymis is exceptional rather than usual. Persistent obstruction is most often only in the tail of the epididymis. Motile spermatozoa may be found above the block. The obstructed area may be bypassed by attaching the vas to any part of the epididymis on the testicular side of the obstruction or to the vasa efferentia. This operation was successfully accomplished first in experiments on dogs. A trial operation was done on a man with a history of bilateral epididymitis of gonorrheal origin followed by aspermia. The cut end of the vas deferens was implanted into an incision in the head of the epididymis and secured with silver-wire sutures. Semen showed many spermatozoa 19 days postoperation. Whether the continuity of the duct will be permanently maintained was not determined.
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| pubmed-article:12334406 |
PIP: A vasectomy technique is described and an argument for the sterilization of mental defectives, based on eugenics and the cost of institutionalizing mental defectives, is presented.
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| pubmed-article:12309849 |
PIP: The ineffectiveness of tubal surgery in rendering a woman sterile is discussed in this review of surgical procedures used for tubal ligation and/or excision. The following methods have been used: tubal ligation, section and resection of tubes between 2 ligatures, resection of tubes between 2 ligatures with burial of the uterine end, cauterization of sectioned tubes, bilateral salpingectomy, and resection of interstitial canal by removal of a wedge-shaped piece of uterine cornu. In a retrospective look at tubal ligation procedures performed at Johns Hopkins, it was noted that 14 of 23 tubal ligations could be traced for follow-up, and of these 5 were over 40 years old at time of operation, but 2 of the remaining 9 cases had become pregnant after surgery. A case history of a patient whose tubes were sectioned and resectioned showed that she too became pregnant after surgery. Hence, until more satisfactory methods are devised, extirpation of the tubes together with excision of a wedge of uterine cornu is the simplest and most effective tubal sterilization procedure.
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| pubmed-article:12264098 |
PIP: Castration of female mice below 6 months of age resulted in a marked reduction of tumor incidence, from between 60-70% in control mice to 9% in castrated mice. Although majority of the tumors appeared during the 1st age period in the controls, they were delayed in the castrated mice to the 2nd age period. Development of neoplasms however cannot be entirely prevented by castration performed at a period between 4-6 months, when the mice have already entered the breeding age. Cancer age is increased in castrated female mice but castration in mice aged 6 months or older does not have any effect on cancer rate or age. Cancer incidence is decreased and cancer age increased when female mice are prevented from breeding, although the effect is not as marked as that of castration. Nonbreeding female mice have a higher cancer age than breeders. Castration is effective in reducing cancer rates because it eliminates the corpora lutea which is responsible for the periodic growth of the mammary gland during pregnancy and in some species, during periods of sexual cycle unaccompanied by pregnancy. Castration allows the mammary gland to remain in an uninterrupted state of rest. The results of this study are the 1st experimental demonstration of internal secretion as an etiological factor in spontaneous cancer development.
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| pubmed-article:12338355 |
PIP: This study concerns the cyclic temperature pattern of sexually mature women and studies normal temperature fluctuations during menstruation, pregnancy, puerperium, and lactation. The study subjects were taken from a delivery room, from private practice, and from febrile women in a tuberculosis sanitorium. Temperature was determined rectally with calibrated thermometers. Early morning temperature represents minimum terperature, maximum terperature was taken between 4 and 6 PM. A typical male temperature curve shows a constant daily fluctuation of about 0.9 degrees Celsius between minimum and maximum from early childhood till old age. Prepubertal girls show this same temperature curve. After puberty the woman's temperature curve becomes cyclic and shows 2 distinct patterns: postmenstrual pattern with low AM temperature (36.8 degrees), average maximum temperature and significant daily fluctuations (0.8-0.9 degrees), and premenstrual temperature with increased AM temperatures (36.9-37.1 degrees), proportionally increased maximum temperature and smaller daily fluctuations (0.5-0.7 degrees). The 1st pregnancy trimester shows a premenstrual pattern followed by a postmenstrual pattern for the rest of pregnancy. Temperature in puerperium is higher in AM, lower in PM than in pregnancy, with diurnal variations less in days 2-5 than after day 5. Temperature curve in lactation shows a postmenstrual pattern; the nonlactating woman soon reverts to the cyclic menstrual pattern. After climacteric the temperature pattern becomes once again prepubertal after an intial irregualr transitional pattern. The causes of these fluctuations are sought in various metabolic activities of the ovary. The corpus luteum, the ovum, the uterus, carbohydrates, and/or proteins. Various animal studies appear to support the theory of protein metabolism. Greater nitrogen excretion is found consistently at higher body temperatures. There is also much support for the theory of carbohydrate metabolism.
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| pubmed-article:12305424 |
PIP: The Nassau County, New York, breast feeding demonstration in 1923 and 1924 was the 1st significant demonstration since Sedgwick proved in Minneapolis that universalizing of breast feeding in a community can be accomplished. Of the 3 essentials necessary to proceed, the New York State Dept. of Health provided the birth records and the nurses trained in techniques of breast feeding and the Brooklyn Pediatric Society supplied physicians interested in the promotion of breast feeding. In this demonstration a case was only accepted after approval was obtained from the physician who signed the birth certificate, and this attending doctor introduced the nurse to the mother she would be visiting and helping. All data evaluated by an impartial and professionally trained statistician. 2815 infants were included in the demonstration. 9/10 of the mothers nursed their infants for 1 month and 2/3 did so for 7 months. The mortality rate of this group of infants was 49/1000. In the years preceding the demonstration, 1920, 1921, and 1922, the infant mortality rate was 70, 67, and 78 respectively. The data show conclusively that there is more sickness among children who have not been breast fed. There have been numerous requests for information on the demonstration and programs similar to Nassau County's have begun. The movement for universalizing breast feeding is growing quickly throughout the state of New York.
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| pubmed-article:12255535 |
PIP: The results of experiments carried out at the Wisconsin Agricultural Experiment Station to test the possibility of controlling sex by artificial insemination with centrifuged spermatozoa in rabbits and swine are presented. Microscopic studies of spermatozoa showed dimorphism in the head lengths but separation by centrifuging was not complete. According to the chromosome theory, if the ovum is fertilized by an X-bearing spermatozoon, the resulting individual will contain 2 X chromosomes in its cells and will be female. If the ovumn is fertilized by a Y-bearing chromoxome spermatozoon, the resulting individual will contain and X and a Y chromosome in its cells and be a male. The Y-containing spermatozoa are thought to have smaller heads than the X-containing ones. Centrifugal separation of male- and female-producing spermatozoa was attempted with liquid recovered by means of a catheter from the vagina and uterus of rabbits. Other rabbits were then artificially inseminated with portions of this liquid and sex of young produced was recorded. Many young were produced from centrifuged spermatozoa and many from spermatozoa exposed to low temperatures for periods up to 24 hours. Modification of sex ratios was not significant. This investigation failed to show a practical method of controlling sex ratios among the offspring of higher animals.
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| pubmed-article:12255683 |
PIP: Injections of 1 or 1 1/2 units of ovarian follicular extract on the 1st or 2nd day of pregnancy sometimes interfered with the course of the pregnancy in rats. When 3 units were given on the 1st day of pregnancy in 4 of 6 animals the pregnancy did not progress to a normal termination. Injection of 3 units of extract on Day 2 of pregnancy prevented continuation of pregnancy in all of the 6 animals tested. After Day 3, larger doses were necessary to produce this effect. With a 20-unit dose, given on Day 3 of pregnancy, the pregnancy was interrupted in all of 5 animals. When 20-unit doses were injected into 6 animals on Day 4 of pregnancy all pregnancies were interrupted. On Day 5 of pregnancy, injection of 20 units of extract interfered with pregnancy in only 1 of 4 animals. Some changes were seen in vaginal smears with amounts of follicular extract large enough to interfere with pregnancy. These changes were often of short duration. Injection of extracts of other tissues were also tried. Pregnancy was interrupted less often than in uninjected animals. From these observations it seems probable that there is a difference in function between the follicular secretion and that of the corpus luteum in rats.
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| pubmed-article:12236137 |
PIP: Improvements to Freund's uterine curettoscope (1924) are described a nd practical applications of the instrument are reported. The lens of the instrument has been placed very close to the end, in order to visualize the tubes, a tube for the introduction of a sound or catheter has been added, a moveable joint was added to control the direction of the catheter, and the currette was eliminated. The resulting instrument, called the "tube hysteroscope," has been used for examinations in 50 patients; physiological data of great interest have been collected, and the instrument's usefulness in the diagnosis of uterine carcinoma, polyps, myoma, and tubal function has been demonstrat ed. Uterine perforation occurred in 1 case, already complicated by tubal and ovarian infection. The author recommends the strictest asepsis, and timing during the intermenstruum.
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| pubmed-article:12332297 |
PIP: To study the time of ovulation in the menstrual cycle, an investigation was planned to recover ova from the uterine tubes, to correlate their condition with the menstrual history and stage of development of the early corpora lutea from which these ova had been extruded, and to quantitatively analyze the ovarian hormone level in tissues of the human ovary. The preliminary report records the recovery of 7 ova from the uterine tubes. 1 case involved twin ova where each ovary contained an early corpus luteum. Another involved internal migration of the ovum from the left ovary to the right tube. One ova was recovered on the 12th, 4 on the 15th, and 2 on the 16th day of the menstrual cycle. The last 2 showed signs of degeneration. The corpora lutea of each ova were examined and described. The ova, uterine tubes, corpora lutea, and some endometrium are being prepared for histologic st udy. A series of analyses of hormone content of human ovarian tissues is also being accumulated.
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| pubmed-article:12305572 |
PIP: Although the author had previously reported that intermenstrual blee ding in the monkey was of ovarian origin, resulting from minute hemorrhages incident to ovulation, subsequent laparotomies have convinced him that the bleeding is of uterine origin. In the Carnegie monkey colony 105 menstrual cycles were studied. The bleeding was observed in 62. This midinterval bleeding was of microscopic amounts only and of brief duration. Proestrous bleeding in the dog has likewise been shown to be of uterin origin. In humans after abdominal operations in which the oviducts are bathed in bloody fluid no red blood cells are recoverable from the vagina. However, in the monkey it has been reported that carbon particles injected into the peritoneal cavity pass into the uterus.
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| pubmed-article:12261469 |
PIP: Surviving Indian codices and inscriptions, reports written down by the Spanish, and continuity of practice from pre-conquest times are the sources of knowledge about obstetrics in Mexico prior to 1600. Antenatal care included avoidance of exposure to heat, no sleep during the day, and plenty of nourishment, although certain dietary precautions were recommended. Moderate intercourse during the first trimester was permitted but prohibited near the time of parturition. In general, midwives counseled the prospective mother to eat well, to rest physically and mentally, and to engage very moderately in manual labor. Massage was given at regular intervals, and vapor baths were taken. Juices of medicinal plants were administered during labor both to expedite it and to relieve pain. Women assumed a squatting position during labor, which was also assisted by abdominal massage and the manual dilation of the vulva. If parturition was prolonged, pressure was applied by the midwife who used her feet for this purpose. The child was bathed immediately after birth. Lactation was prolonged among the Mexicans.
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| pubmed-article:12332362 |
PIP: Lack of uniformity of opinions concerning the development of the vag ina prompted an investigation into the successive stages of the vagina's developmental events. Observations on the material studied indicated: 1) that the upper part of the vagina develops from the mullerian ducts: 2) the lower part of the vagina is formed from the urogenital sinus in an area fromerly occupied by the mullerian tubercle; it is here that the hymen forms; 3) the hymen is formed passively by the invagination of the posterior wall of the sinus attributed to expansion of the vagina's lower end and; 4) formation of the vagina occurs without the participation of the wolffian ducts which involute at 50mm and usually rapidly and entirely disappear from the genital cord. These observations suggest that a caudocranial process occurs in which epithelial cells in the center of the solid cord undergo involution, desquamate and are discharged in part of the hymenal opening thus forming the vaginal canal.
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| pubmed-article:12334433 |
PIP: Surgical technics for vasectomy, salpingectomy, tubal patency tests, electric cauterization of the fallopian tubes, and chemical occlusion of the tubes are reviewed. The use of heat to the testicle and irradiation of the testes and tubes as temporary methods of sterilization are noted.
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| pubmed-article:12305346 |
PIP: A metallic spiral IUD was inserted in 1 region of a rabbit uterus and tied to the uterine wall to test its effectiveness in pregnancy prevention. Within 1 week and after 20 days, pregnancy was hindered in the region where the device was present. The action of the IUD was irrespective of its composition. Changes in the uterine mucous membrane were generally absent, and the uterus was without inflammatory findings and without necrosis or atrophy of the glands. In clinical trials a modification of the Graefenberg ring was used. This was termed the "presear-ring" and consisted of the addition of a flat ball in the center of the ring, thus increasing the surface area. When compared with the Graefenberg ring the efficacy of the modified device was increased (5 pregnancies out of 53 vs. 1 pregnancy out of 73 cases, respectively). Insertion of the device was easy and was performed on an outpatient basis. Some gland proliferation was seen but without inflammation. Pregnancy was possible after the ring was removed. The materials used for the ring were gold or silver plated with gold.
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| pubmed-article:12255346 |
PIP: A suction-curet apparatus for endometrial biopsy is described. The primary application of the apparatus is in the determination of ovulation in cases of infertility. An electric motor suction apparatus is employed instead of suction by syringe. The curved tube cannula is preferred to the straight instrument, and can usually be inserted without dilation of the cervix. The method can also be used for diagnosis of adenocarcinoma of the uterus, hyperplasia of the endometrium, the study of indocrinopathic amenorrhea, and for obtaining fertilized ovum at very early stages of implantation.
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| pubmed-article:12255369 |
PIP: Any contraceptive method acts by producing temporary sterility. Var iations in the time of spontaneous ovulation and variations in the length of the cycle render the date of ovulation relatively unpredictabl e. The safe period, therefore, varies. Hormonal sterilization deals with methods that render the woman sterile for the duration of at least 1 menstrual cycle. This anovulatory cycle is 1 method. No corpus luteum forms although bleeding occurs cyclically. Most cycles during lactation are sterile. Other women sometimes have anovulatory cycles. Prolactin injections have been shown to temporarily suppress ovarian cyclic activity in mice and rats. Prolactin may produce anovulatory cycles in women and thus provide a method of hormonal sterilization. 4 mg progesterone daily inhibits estrus. Studies with estrone show that it has a depressant effect on ovarian response to follicle stimulating hormone. Large doses of estradiol benzoate used to treat dysmenorrhea have altered menstrual rhythm. Injection of gonadotrophic antisera for prevention of ovulation is a possibility. Daily injections of estrone, begun on day of mating, usually have resulted in retention of ova in the fallopian tubes of mice and rabbits. All of these ova showed signs of degeneration by Day 4. Fertilized human ova may be tube locked by an excess of estrone or degeneration of the fertilized ovum may inhibit further development. The potentialities of hormonal sterilization are great. Extensive investigation for humans is warranted.
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| pubmed-article:12255508 |
PIP: Contraception has become an important part of a private general medi cal practice serving mostly suburban middle-class white women. The 884 patients advised were 75% married, mostly Protestant, and generally college educated. 94% were taught the diaphragm and jelly method. Pregnancy rate was 6/100 woman-years of exposure, a reduction of 93-96% over no contraception. 1/2 of the 86 unplanned pregnancies followed errors or omissions that might account for conception. The method had no adverse affect on subsequent planned pregnancies. Of the 136 planned conceptions for which data are available, 1/2 were conceived within 1 month and 3/4 within 3 months.
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| pubmed-article:12332367 |
PIP: A case study of successful anastomosis of the vas 4 years after elective vasectomy is presented. The operation was recommended by reason of emotional depression due to the desire to father children. Anastomosis was accomplished by forcing the freshened, patent ends together with catgut. Live spermatozoa were present in the semen at follow-up examination. The patient's emotional condition improved considerably, and he has subsequently had normal offspring.
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| pubmed-article:12305503 |
PIP: Rats of relatively low susceptibility to spontaneous carcinoma were studied. The estrone used was crystalline folliculin. Experiment 1 inv olved 12 rats, of which half were ovariectomized at the age of 58 days. All animals received daily vaginal application of a solution of estrone in corn oil from the age of 62 days until death. Hysterectomy was done on some to remove pyometra. Some were painted on the interscapular region 3 times a week with tar. In 2 cases, 3 mg of dry kieselguhr were inserted into 1 mammary gland. In this series, 1 rat killed on the 964th day of life had squamous carcinoma of the vagina, a precancerous lesion of the cervix, and a mammary adenofibroma. Another rat, at the age of 751 days, had a large abscess adherent to the descending colon. In the wall of the abscess a squamous cell carcinoma was found. In other rats of this group, a cervical papilloma and an ileo-caecal lymphosarcoma were found. In the 2nd series, 10 rats were ovariectomized at 106 days of age and silk threads placed in 1 or both uterine horns. All of these rats received daily sc injections of 30 gamma of estrone in corn oil. Some also had silk threads or kieselguhr placed in 1 mammary gland. A rat in this group, killed on Day 293 of life, had a precancerous lesion of the cervix and an abdominal lymphosarcoma. Another rat at the age of 624 days had an adenocarcinoma of the breast and 49 days later an abscess in the lower abdomen. In the wall of the abscess squamous pearls of doubtful malignancy were found. In the same rat there was an area of squamous metaplasia in a breast where kieselguhr had been injected. In a control series of 12 rats injected with corn oil alone or not treated, squamous lesions were found in abscesses of uterine horns of 2 at 753 days. A 3rd series consisted of 12 female rats of which 6 were ovariectomized at the age of 116 days. All received daily injections of 30 gamma estrone. Kieselguhr, 15 mg, was placed in the uterine horns of each animal and 35 mg in the peritoneal cavity of some. A malignant breast tumor developed in 1 rat at the age of 553 days. When estrone injections were stopped, the tumor ceased to grow. Another rat in this group died of abdominal lymphosarcoma. Of 12 rats in the 3 series which survived 500 days or longer and were treated with estrone, 4 developed cancer while of 18 control rats from Series 2 and 3 living 500 days or more only 1 had cancer. Fistulas between the uterus or vagina were found only in estrone-treated rats. In this colony of 121 rats kept without treatment, 55 female and 27 males survived 500 or more days. A submaxillary gland cancer was found in 1 but no other malignant tumors occurred among them. It is concluded that rats treated for long periods with estrone, often toghether with various forms of local irritation, developed malignant tumors more frequently than others of the same colony subjected to other procedures or untreated.
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| pubmed-article:12255649 |
PIP: Of 900 biopsies made with a small suction curet 457 from 329 women were analyzed to show the progression of the endometrium from the high-estrogen early-proliferative phase, immediately following menstruation, through the late proliferation occurring about Day 12 foll owing menstruation. Classifications from Days 14 to 27 are much easier to make because the 1st sign of progestin effect causes significant change. On Day 15 vacuolization of the cytoplasm and beginning migration of the nuclei toward the surface of the cells is seen, leaving a lucid zone underlying the nuclei. On Day 17 this zone is well-marked and the nuclei above it are lining up to lie later each beside the other near the middle of the cell. On Day 19 the row of nuclei has sunk distally near to the base of all the cells. On Day 18 a beginning edema of the stroma is seen, first in patches; by Day 21 it is generalized and the last vestige of the zona pellucida has disappeared. On Day 21 the process of secretion, which began about Day 17, is well advanced. From Day 21 on the signs of hormonal action are seen not primarily in the gla nds but in the stroma and vascular system. Edema has become generalized by Day 21; on Day 23 the stroma cells are larger, more thick-walled, and more numerous; by Day 25 the edema is replaced by masses of contiguous large cells with large pale nuclei and much cytoplasm; and on Day 26 size of the stroma cells has extended so that almost all the interglandu lar cells are contiguous. On Day 27 this solidification of the most sup erficial stroma becomes complete, the glands are widely dilated, the epithelium approaches the cuboidal, the vascular system is highly developed, and the arterioles and venules are engorged with blood. Late on Day 27, just before menstruation, lymphocytes and polymorphonuclear leukocytes appear in great numbers and erythrocytes appear in clumps. T he whole predeciduum is infiltrated, the stroma nuclei become pale, neutrophils appear in large numbers, the tissue disintegrates, and menstruation occurs. Understanding of this normal process can aid in clinical diagnosis of menstrual disorders. A series of biopsies taken with a small surgical curet does little tissue damage and can reveal hormonal imbalance, thin stroma associated with menopause or hypoplastic endometrium, and such pathological conditions as tuberculous endometritis and cancer of the endometrium. In the 3 cases in which a woman with unsuspected early pregnancy was biopsied, no harm was done. This study showed amenorrhea is usually due to deficient follicular development but may be present even if a proliferative endometrium shows a high degree of follicle activity; in the absence of pregnancy there is never a persistent corpus aluteum.
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| pubmed-article:12233291 |
PIP: The promotion of sexual maturity in a genitally hypoplastic adult ma le by testosterone propionate (TP) is reported. TP was injected 3 times a week in a dose of 5 mg for about 4 months. The dosage was then increased to 25 mg, 3 times a week. Almost 7 months after the start of treatment, genital size had increased, and live spermatozoa were evident in the ejaculate. The voice became somewhat deeper, but the initial beardlessness and distribution of hair was unchanged. In laboratory studies with TP, stimulation and proliferation of the germinal epithelium was apparent, but maturation of the testes was not accelerated. In the case reported, it is concluded that the increase in dosage caused proliferation of spermatozoa after stimulation of germinal epithelium maturation.
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| pubmed-article:12259097 |
PIP: The effects of estradiol benzoate (EB) injection on sexual development and the pituitary gland were studied in 240 immature rats after 16 weeks of treatment. Treatment resulted in eunuchoid dwarfing. Males showed enlargement of the pituitary after 4 months, while in females it remained normal. After continued treatment for 8 months, enormous hypophyseal tumors were observed in 29 of 35 rats of both sexes; 1 animal died as a result of these tumors. No tumor developed in less than 7 months, which suggests that the duration of treatment, rather than the dose, is of primary importance in tumorigenesis. The amount of gonadotropic hormones in the enlarged pituitaries and tumors was the same as in normal pituitaries of control animals, which indicates that it is the utilization, rather than the production, of gonadotropic hormones that is inhibited by EB-induced eunuchoid dwarfs.
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| pubmed-article:12334491 |
PIP: 47 figures and 2 tables are the core of evidence presented in this discussion of the relatedness of estrogen to breast tumors. A pathologic study of 95 cases of gynecomastia, 25 cases of virginal hypertrophy, and 450 cases of fibroadenoma shows the similarity of these lesions, characterized by a developmentally responsive fibroepithelial growth occurring in both males and females under normal and abnormal conditions. That prolonged (developmental) and uninterrupted stimulation by estrogen rather than brief high concentrations is necessary for production of these conditions is supported by the following: 1) these hypertrophies are easily produced in male animals when pathologic concentrations of estrogen are present; 2) these conditions are prevalent in prepuberty in girls, when small but steady estrogen breast secretions occur for 3-5 years before menstrual onset; 3) these conditions occur or are exacerbated during the latter 2 trimesters of pregnancy; 4) experimental injection of repeated small doses of estrogen into monkeys is more efficacious in reproducing the diseases than high doses given over short periods; and 5) the bio-assay of these pathologic tissues demonstrates that affected tissue has a marked capacity to concentrate the hormone. Cystic disease and fibrosarcoma receive similar histological treatment in the text, and the frozen sections suggest that the involutional changes in fibroadenomatous lesions may give rise to cystic disease and the proliferative changes in fibroadenoma may be responsible for fibrosarcoma development. Nonsurgical attempts to involute these lesions are described, and their advancement is recommended (e.g., treatment of gynecomastia by prolactin).
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| pubmed-article:12310122 |
PIP: This study reports on the length of time needed for spermatozoa to retain normal morphology and migratory power in the female genital tract. The literature on the subject is amply reviewed. From his own investigations the author affirms that in most women conditions most favorable to sustain spermatozoa motility are provided for only a limited part of the menstrual cycle, and that sperm survival at periods of less than 24 hours is a frequent recurrence. On the other hand, a few cases were observed in which migratory sperm cells were found from 36 to 80 hours after coitus, and, in 1 case, even 84 hours after coitus.
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| pubmed-article:12337637 |
PIP: Prostaglandins were extracted from the prostate gland and testicles of sheep in the form of a barium salt and were used in experiments on rabbits and cats. Intravenous injection of prostaglandins caused a decrease in blood pressure; this effect was reduced or absent after hepatic blood vessels were cut off or after the animal had been eviscerated. Intravenous injection or injection into the v. portae caused an increase in the portal blood pressure and a decrease in the right anterior ventricle. No significant effects of prostaglandin on heart-lung preparations were observed. Perfusion of the lung with prostaglandin caused vasoconstriction. Prostaglandin perfusion of the posterior end caused vasodilatation, which was not as marked in the case of the cats. Perfusion of the kidney caused vasoconstriction in cats and vasodilatation in rabbits. A latency period was observed between intraarterial prostaglandin injection and its effects; this period was longer than for other substances with vasodilatory effect. Prostaglandin injections can counteract vasoconstriction caused by adrenalin; prostaglandin was also shown to counteract the effect of adrenalin in the uterus of rabbits.
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| pubmed-article:12264095 |
PIP: This study describes the gradual changes which take place in the epithelium of vagina and cervix of mice from early to advanced age, with and without the stimulation of estrogen and other hormones, and the eventual transition from normal growth processes to precancerous and cancerous proliferation. With advancing age the average depth of the epithelial processes extending from the surface epithelium into the underlying connective tissue in the vagina and cervix of mice increases. Estrogenic substances injected into these animals causes these processes to reach a greater depth (10.7%) than in noninjected controls (0.8%). Injection of estrogenic substances over long periods of time causes these processes to pass into a precancerous and into a carcinoma-like growth. Mechanical factors may lead to partial erosion of the surface epithelium. Under the influence of intense stimulation leading in the end to carcinoma-like growth processes in the vagina and cervix, morphological potentalities of the tissues may be revealed which under ordinary conditions would remain hidden. These observations confirm that the transitions in the epithelial tissue of vagina, cervix, and uterus are gradual. Further research is needed to investigate the occurrence of spontaneous carcinoma, which is a condition analagous to that seen in the mammary gland.
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| pubmed-article:12338106 |
PIP: The growth processes induced by estrogenic hormones which take place in the uterus of the mouse are investigated. The uterus and other sex organs were studied in 501 mice including 177 control mice which were not subjected to sex hormones. 3 different strains of mice of ages ranging from 1-20 months were used. Mice were variously injected with 1-100 rat units of estrogen, estrogen and acid extract of cattle anterior pituitary gland, acid extract alone, estrogen and corpus luteum extract (Proluton), and corpus luteum alone. Changes which may take place in the uterus of mice under the influence of estrogen include: 1) the normal one-layered cylindrical epithelium may change into several rows of cylindrical cells or into a partly cylindrical and partly squamous epithelium, or a typical squamous epithelium; 2) gland ducts may become cystically dilated and filled with colloid material; 3) the uterine glands may proliferate and penetrate into and through the muscle tissue; 4) infection may take place; and 5) parts of the pancreas may become adherent to the uterus. In none of the test cases were cancerous changes or even precancerous proliferations found. Reactivity of the uterine epithelial structures to growth stimulation is less than that of the compounding tissues in the vagina, cervix, and mammary gland. Cancerous transformation depends, among other factors, on the product of the intensity of growth stimuli acting on a tissue and the responsiveness of the affected tissue. In a minority of the mice certain changes were observed such as a penetration of the uterine glands into or through the musculature of the uterus and a metaplasia of the cylindrical surface epithelium. In a considerable number of cases, the squamous epithelium owed its origin to regenerative processes which led to an extension of the cervix epithelium into the uterus. Under the influence of estrogen these changes are produced more readily the greater the dosage used and the more continuous the action.
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| pubmed-article:12338142 |
PIP: 11 castrate female rats were treated with intrauterine injections of a solution of estrone in corn oil; 11 additional castrate female rats were administered with the same solution by daily subcutaneous injections. Vaginal smears in both groups showed continuous estrus, distended uteri and squamous metaplasia of the uterine epithelium, with downgrowth into the stroma. Similar quantities of estrone administered to 12 normal male rats produced marked atrophy of the penis, testes, seminal vesicles, and prostate, but no metaplasia was observed, even when estrone was injected directly into the seminal vesicles. Administration of 1:2:5:6-dibenzanthracene in oil, gas-house tar, or pregnandiol in female rats did not cause metaplasia of the uterine epithelium, although the first 2 preparatoin are known to be carcinogenic.
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| pubmed-article:12264118 |
PIP: Several studies have proven the connection between ovarian activity, or treatment with estrogens, and breast cancer in laboratory animals. This article presents the results of an experiment conducted on 130 male mice of no particular strain, of which 20 had been castrated. The mice were treated with a solution of estrin in benzene for prolonged periods. Only 1 of the mice, a castrated male, developed breast cancer 175 days after the beginning of treatment. The tumor was removed, and an autograft was made in the right groin; 58 days after the autograft the mouse was killed. The grafted tumor had penetrated the abdominal wall and numerous metastases were present. On the other hand, grafts from the original tumor given to 10 young mice did not give rise to any additional tumors.
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| pubmed-article:12311508 |
PIP: In most laboratory animals (e.g. guinea pig, rat, rabbit) the appearance of the cervix is very variable, and is characterized by a glandular differentiation between the vagina and the body of the uterus. The author has tried to provoke variations in the glandular morphology of the cervix by injection of total folliculin, of ovarian lipids, corpus luteum extracts, purified folliculin, and synthetic proluton. In the guinea pig injection of folliculin first thickened the basal layers of the vagina, and then caused desquamation; in the body of the uterus it provoked the growth of glands and the apparition of decidual cells; secretion from the mucosa increased. Placental lipids caused the same effects, while luteinizing products did not. Pure folliculin caused on the cervical glands the same effects as estrogen products, but more quickly. Testicular lipids caused the development of cervical glands and an abundant secretion of mucus; keratinization was induced more rapidly in the castrated female. The same effects, with slight differences, were obtained after injections in the rat and in the rabbit. Further studies are required before the results can be transferred to the clinical field.
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| pubmed-article:12261809 |
PIP: The practice of infibulation, or female circumcision, was carried out in many parts of the ancient world. Today, infibulation and other female mutilations are still practiced in various parts of the world. There are 3 different types of infibulation, involving removal or mutilation of different parts of the female genitalia. Every Sudanese girl is circumcised when she has passed her 6th birthday. The procedure, which is attended and performed solely by females, is described in detail. Complications may arise. The purpose of the practice is usually to preserve virginity until marriage. However, a whole network of other reasons has grown up and interwoven itself in tribal custom. Similar practices involving the female genitalia in other areas are compared to Sudanese infibulation. A table presents ages at which the procedure is carried out in different countries. Reasons cited for the practice in these countries are also listed.
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| pubmed-article:12262232 |
PIP: Scientific investigation on menotoxin, or menstrual toxin, started around 1920. Since then a number of zoopharmacological reactions, and a number of phytotoxic effects of menotoxin have been described. It has been shown, for example, that injections of menotoxin have a markedly depressant effect on albino rats, that large doses of menotixin can depress the muscular contractions of vas deferentia in rats, and that menotoxin solutions, when applied to the sciatic nerves of rats, greatly increase their irritability. Research on the chemical nature of menotoxin have brought it into close touch with the chemistry of toad poisons, closely related in their nature to oxycholestrin and to certain heart drugs.
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| pubmed-article:12311503 |
PIP: This study investigates the effect of nursing on the incidence of breast tumors in mice. The A inbred high-cancer line was used as control and newborn young of A stock mothers were removed and fostered by females of the low-tumor C57 Black or CBA lines. It was apparent that the fostered mice and the progeny of the noncancerous fostered animals lived considerably longer than did mice from the other 2 classes. Controls had a tumor incidence of 83.6% as compared to only 7.4% of the fostered mice. Little variation was observed in the average breast tumor age of the various classes. This experiment demonstrates that the source of milk exerts a decided influence on the development of breast tumors, since mice nursed by low-tumor stock females show a low percentage of tumors, while mice nursed by high-tumor stock females have a high ratio. In general, if the mother had a breast tumor the incidence among its progeny was nearly as high as for the control stock, while young descended from noncancerous mothers usually have a low ratio. These findings, however, do not entail definite conclusions, since exceptions are rather common.
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| pubmed-article:12313287 |
PIP: A study of all infants born in New York State, exclusive of New York City, in 1936 has been made with the intent of investigating the effects of order of birth and age of paretns of neonatal mortality. The study revealed these results. 1) Of the 82,140 infants, 2563 (31.2/1000 livebirths) died before 1 month of age. 2) Firstborn infants, as well as those of higher birth orders, were found to have a considerably higher mortality than the intermediary births. The rate for 1st births was 32.1; for 2nd births it was 26.0. It rose gradually for births of orders 2, 3, and 4, and sharply beginning with 5th births. The rate for infants of order 10 and over was 55.2, more than twice the rate for 2nd births. 3) More than 1/2 of the neonatal deaths (54%) were found to occur among infants born prematurely, while less than 3% of the surviving infants for the 1st month of life were premature. The frequency of prematurity was 42.9/1000 livebirths. 4) The mortality of premature births was extremely high (389.2), and it rose with order of birth. The rate was a minimum for 1st births (329.4) and rose to a rate of 644.4 for infants of order 10 and over. However, the frequency of premature births/1000 livebirths started high for 1st births (49.3), was a minimum for 5th births (36.0), and increased thereafter. 5) The neonatal mortality of infants carried to fullterm was only 15.2/1000 livebirths. Thus, the rate for prematurely born infants was 25 times as high as the rate for fullterm infants. The handicapping of the 1st born is very marked for the latter. The rate for fullterm 1st births was 44% higher than the rate of 2nd births. 6) The neonatal mortality for male infants was consideralby higher for than female infants for every order of birth. 7) Premature births were more frequent in urban communities than in the rural part of the state. However, the mortality among the premature was higher in the rural areas thanin the cities. 8) When stillbirths were added to neonatal deaths, the total loss (late fetal and neonatal mortality) presented the same variation by birth order as neonatal mortality. The rate for the total loss was 58.4 and the frequency of prematurity was 55.5/1000 total births. 9) Neonatal mortality of infants born to very young mothers and to older mothers is considerably higher than that of infants born to mothers ages 20-30. The lowest rate was recorded for mothers ages 27-28. 10) The same trend of mortaltiy by age of mother was observed in practically every order of birth. It started high for young mothers of every birth order, dropped gradually to a minimum, and then rose to very high rates for old mothers. Neonatal mortality seems to be independently correlated with the 2 factors of birth order and maternal age.
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| pubmed-article:12259192 |
PIP: An intensive follow-up study of 230 patients (employees of the Birth Control Clinical Research Bureau) who used contraceptive 'jelly alone' during a 4-year period (1932-1935) was conducted. 12 kinds of 'jellies alone' were used: 98 women were given a CO2 effervescing jelly; 78 were given jellies with chinosol as the main ingredient; 26 had soap-base jelly; 18 had jellies with lactic acid as the main ingredient; 5 were given acetic acid jellies, and the remaining 5 had jellies with varying chemical compounds. Only 151 patients were completely followed up. Women who discontinued use of the jellies did so because of the product's messiness and over-lubrication. Only 63 out of the 151 were able to use jelly successfully. 16 of the 35 women who used the CO2 jelly conceived in spite of regular use. It was suggested that physicians exercise caution in prescribing jellies to patients for contraceptive measures. Further, biochemist's findings regarding the chemical properties of the product should be combined with the clinician's clinical findings for best results.
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| pubmed-article:12332250 |
PIP: Research on the name "condom" is presented. Condoms, as contraceptives and protection against venereal disease, were popularized about 1840. It is surmised that Cundum was an actual man, an Englishman. He was not a doctor, probably an army officer. He popularized the device between 1680 and 1717.
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| pubmed-article:12305416 |
PIP: A study to determine the contraceptive effectiveness of a buffered acid vaginal jelly without the aid of a mechanical device was undertaken in Philadelphia in which 133 women remained active for varying periods u p to 26 months. In the groups of 84 patients who attended the clinic re gularly for 9 months or longer, 77 were "colored" and 7 were white and none had had previous contraceptive experience. The majority of the patients were from a low socioeconomic level and 47 patients were over 25 years of age. 44 patients used the jelly successfully for 8 months or less, and when 1 discontinued its use after 1 month, she promptly conceived. 80 patients were observed for at least 10 months, 20 of whom were observed for at least 20 months. Of the 8 pregnancies occurring in the clinic group, only 4 might be attributed to jelly failure. Complaints of irritation, burning or annoying sensations were absent. The reduction in the pregnancy rate as seen through evidence from this study justifies its continued use. In addition, the jelly method is simple, easily mastered, safe and acceptable to a large percentage of clinic patients.
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| pubmed-article:12305417 |
PIP: An investigation was undertaken in South Carolina to test acceptability and effectiveness of spermicidal jelly under the severest conditions. The majority of patients were Negroes from an exclusively rural area. The majority of pregnancies occurred during the program's first and third 6 months as promoted by inefficiency of a field worker and use irregularity respectively. 41 patients were lost to follow-up. 65 patients (14.3%) refused service leaving 84% of the 452 patients to w hom it was offered accepting the method. There were no voluntary pregna ncies and only 13.1% of those who became pregnant claimed regular use of the contraceptive. An 85% acceptability rate and effectiveness rate of more than 90% reduction in fertility by regular users was observed. Husband objection was based on superstition that interference with natural processes would impair virility. The materials studied were free from harmful or irritating qualities. When compared with the precl inic pregnancy rate, this contraceptive method's usefulness is clearly revealed.
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| pubmed-article:12305459 |
PIP: The immobilizing process, as observed under the microscope, is a lab oratory method of comparing contraceptives. It was found that the resis tance of spermatozoa to spermicides varies with the donor and with diffe rent ejaculations from the same donor. Jellies and creams were tested. Human semen from 25 donors was collected in glass vials and kept at room temperature, with occasional stirring. Measuring was done by Vogue's method in a capillary tube. Each test could be made with only .04 ml of semen. Tests at room temperature were found to give the same results as those done at 37 degrees C. Diluents for the jellies to be tested were egg white, 5% dextrose, .85% sodium chloride, or buffered glucose and saline. Times for immobilization were much longer for egg white but other diluents gave similar results. Mixtures of jelly and semen were placed on slides and viewed by dark-field illumination to observe spermatozoal motility. Of 10 contraceptives tested, Ortho-Gynol was found to be the most rapidly acting, followed by Cooper Creme, Lactikol- B, Vagi-Serol, Marvosan, Clinicol, Jelly-X, Bor-Oxyquin, Cellikol, and Lanteen Blue Jelly in that order. The ability to form an obstruction at the external os was not determined but was considered important. The chemical formula of each compound, as given by the manufacturer, is shown. Oxyquinoline sulfate is the active ingredient in several. Resistance of spermatozoa to spermicides was found to decrease at an average rate of 10-30%/hour during the early hours. Therefore, spermicidal tests must be done simultaneously as well as with portions of the same ejaculate.
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| pubmed-article:12275695 |
PIP: Cases of reestablishment of continuity and patency of the vas deferens most frequently employ end-to-end anastomosis. A 26-year-old man who had been sterilized via ligation and cutting of the spermatic cords underwent vasorrhaphy and anastomosis of the vas deferens in an attempt to be able to conceive. 3 months after the operation a sperm count was 2,500,000 sperm/cc semen indicating a successful patency.
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| pubmed-article:12305469 |
PIP: Condoms were offered to all white farm wives in about half of Watauga County, North Carolina, an Appalachian region. At the time of 1st interview 38% were using some contraceptive technique (including withdrawal), and prevalence of contraception increased with higher educational, occupational, and economic status. 59% of those interviewed accepted the condoms, including about half of those not practicing birth control at the time. Among those who accepted supplies the pregnancy rate dropped to 11 per 100 years of exposure, including cases of irregular use. 73% were still using the condoms after 36 months. The protection approximated that reported in other populations for diaphragm plus jelly. Prescription of condoms for the prevention of dangerous or undesirable pregnancies appears suitable for inclusion in public health programs.
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| pubmed-article:12305580 |
PIP: Papers surveying the fate of spermatozoa in the various regions of the woman's reproductive tract and correlating the cycle of mucus with other cyclic sexual phenomena led to a study on some practical problems associated with variations in cervical mucus. Samples were aspirated fr om the normal external os of sterile, amenorrheic, pregnant, and menopau sal women. Stilbestrol therapy definitely affected the character of cervical mucus in sterile and menopausal women changing it from acid and impenetrable to alkaline and readily penetrable. Upon discontinuation o f stilbestrol, the mucus returned to an impenetrable acid. 14 cervical mucus specimens from pregnant women were observed. In all instances muc us was slightly penetrable but the pH varied from 4.5 to 7.5 making supe rfetation an unlikely possibility. 20 menopausal preestrogenic therapy patients had scant or moderate viscid or crumbly cervical mucus with a pH of 4.5. Mucus was impenetrable to semen in each case. Estrogen ther apy noticeably altered the mucus. These observations indicate that dete rmination of mucus responses will be more exact and simple than the vagi nal smear technique.
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| pubmed-article:12255675 |
PIP: The potential for extensive fertility control in Nashville among indigent white patients selected for high fertility and interest in family limitation was demonstrated in an investigation. However, despite a ready willingness to try the suggested methods, neither diaphragm and jelly nor foam powder and sponge were sufficiently suitable to prevent patients from rapidly dropping out of the program. A comparison of the 2 methods shows that both are similar in their contraceptive skill and interest. However, foam powder was prescribed to patients for whom the diaphragm was unsuitable. Diaphragm and jelly was more acceptable to patients than was foam powder. The protective services offered by diaphragm and jelly (88%) exceeded those obtained from foam powder (63%) by a wide margin. Analysis of factors influencing chance of conception with in each group suggests that the difference lies in the method rather than in the patient.
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| pubmed-article:12275792 |
PIP: A contraceptive service was established in Puerto Rico in 1937. Detailed study of the reproductive history of low income families admitted to the service provides information for the basis of the present high fertility of the population and the likelihood of its continuance. The experience of these families following admission to the contraceptive service shows the impact of the service upon their fertility, testing the view that Puerto Rico might respond to an organized birth control effort. The sample consisted of 1962 families selected not randomly but on the basis of indigence and interest in contraceptive advice. 1/3 of the couples reported some previous effort at contraception, with most of the contraceptive practice depending on withdrawal. Residence, education, occupation, and income are all associated with the marked variation in the proportions who reported contraceptive experience. The percentages are 26 and 52 for rural and urban residence; 21, 27, 44, and 59 for the educational groupings with less than 5 to 7 and 8 or more completed grades. For the low, medium, and high occupational groups, the percentages are 20, 45, and 69, and for the corresponding income classes they are 22, 42, and 66. Women aged 25 to 29 and 30 to 34 report contraceptive practice with much greater relative frequency than younger women. Clearly marked differences are found in the rates for contraceptors of different social and economic classes. Although the reason for high fertility in Puerto Rico is due to lack of cultural and economic pressure to limit families, there is evidence to suggest that use of birth control has begun. It appears that fertility reduction would be implemented if the population possessed better knowledge of birth control measures and readier access to contraceptive materials, particularly condoms. A clinical program to encourage the use of contraception might also prove effective.
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| pubmed-article:12307964 |
PIP: 4 oophorectomized female rhesus monkeys were treated with estradiol in sc implants in an attempt to produce estrogen-induced fibroid reactions. Each tablet weighed 70-112.7 mg. At the time of oophorectomy 2 monkeys were mature and 2 were immature. The period of treatment ranged from 69 to 290 days. 1 monkey died from unknown causes at 69 days. The other 3 were treated from 285 to 290 days. None of the animals showed fibroid tumors of disseminated miliary nodules. A keloid plaque of fibrosis over the stomach was seen in 1 animal and another had pronounced operative adhesions and fibrosis at the site of a laparotomy performed at 264 days of treatment. 2 animals showed a pronounced fibrosis of the myometrium around the cervix uteri.
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| pubmed-article:12259270 |
PIP: Hormonal treatment for women with primary and secondary amenorrhea is described. In secondary amenorrhea of more than 2 years' duration, 50 mg of progesterone is injected for 2-5 days. For secondary amenorrhea of less than 2 years' duration, 25 mg of progesterone with 2.5-5 mg of estradiol benzoate is injected over a 5-days period. This method of treatment may be further simplified by the oral administration of pregnen-in-on-ol instead
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| pubmed-article:12261319 |
PIP: Terracottas from the 6th century B.C.; a description of a delivery written in 1780; and a description of a labor chair used until 1914 give an historical picture of childbirth on the Greek island of Chios. The terracottas establish the fact that women were delivered in an upright perpendicular position in classical times. The upright labor chair seems to have continued in use until 1914. Midwives have historically at deliveries. In Chios, doctors seem to have taken over from midwives only around 1914.
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| pubmed-article:12336540 |
PIP: The principle and the technique of 2-point coagulation in neurosurgery are reviewed. Since it was introduced in 1940, the 2-point coagulation forceps has been used in 257 major neurosurgical procedures, excluding ventriculography, trephining and other minor operations. It is now the only method of coagulation used by this surgeon with rare exceptions. The dangers of the usual method of coagulation include production of excessive heat, shrinkage of the blood vessel or surrounding tissue, explosion of a blood vessel, and production of heat in a blood vessel at a distance from the point of coagulation. In the 2-point coagulation method, there is no connection to the body of the patient; the current flows only between the tips of a small pair of bayonet forceps. Points to be observed in the use of the coagulation forceps include the following: 1) the vessel or point to be coagulated needs to be accurately caught between the tips of the forceps; 2) the forceps should grasp the vessel before the current is turned on; 3) coagulation should be done with a small amount of saline solution running over the area to prevent sticking and to cool the surrounding tissue; 4) the time of coagulation should be minimal; and 5) a coagulation current rather than a cutting current should be used because it is cooler. The advantages of this method are minimal heat production, minimal shrinking and greater speed and safety.
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| pubmed-article:12279175 |
PIP: This study reports on an experiment involving normal female rats, castrates of both sexes, and estrogen-injected castrates to determine whether or not estrogenic hormones are capable of influencing transplanted adenofibroma. A total of 469 normal and castrated rats were given injections of estrogen and testosterone after tumor implantation in the region of the right inguinal mammary gland. The injection of estrogen raised the growth rate of tumors in castrates to 2.0 mm/week. Castration does not appreciably affect the number of successful implants in males, the takes in the normal males being 24.3% and in the castrates 22.2%. Injection of testosterone propionate in a small group of castrate females resulted in successful growth in 40%; in castrated males there was a 46.1% take. These results do not indicate any inhibitory effect of testosterone on adenofibroma. Estrogenic hormone is the important endocrine factor determining the successful transplantation of mammary adenofibroma in rats. The stimulatory effect of estrogenic hormone upon mammary adenofibroma is probably exerted indirectly through the "mammogenic hormone" of the anterior pituitary. The transplantibility and growth rate of adenofibromas may be altered by hormonal means since this tumor responds like the normal mammary gland to the ovarian and pituitary hormones.
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| pubmed-article:12338137 |
PIP: This article studies spontaneous benign mammary tumors in 97 female and male rats. All animals were observed until death and in every instance the tumors were examined and measured. In the 1st series of experiments autotransplants and homotransplants were done on 38 female rats by removing the original tumor and inserting fragments in the axillae and groins of the same animal; such serial autotransplantations were repeated from 2 to 5 times until the animal died. With minor variations such autotransplant tumors retained the structural identity of the original tumor. The 2nd series of experiments comprised 18 female rats injected with estrogen; large, spontaneous tumors showed no changes in morphology, but autotransplants and homotransplants grew more rapidly, and the latent period was reduced. A 3rd series of experiments was carried out with 16 female rats treated with androgens, which appeared to inhibit the epithelial components of adenofibromata. In a last series of experiments on 12 rats treated with estrogens and androgens together or in sequence, estrogen seemed to overcome the inhibiting action of androgens and exerted a stimulating effect on growing specific epithelium. Connective-tissue elements of the tumors did not appear to be directly affected by estrogens and to be moderately inhibited by androgens.
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| pubmed-article:12338434 |
PIP: Data on infant mortality and infant feeding in Puerto Rico were examined. The material studied was the infant and preschool records found in the active and pending files of the public health units. The information tabulated was that of the status of the child at the time of 1st admission to Health Department service, before any specific benefit could have been obtained from that service. A total of 1189 records was tabulated from 3 municipalities: 171 from Ciales; 360 from Guayama; and 658 from Rio Piedras. Results of the 2 sexes were combined. Breastfed means that the sole source of milk was breast. The proportion breastfed declined with advancing age of child. There was a striking difference between Ciales, an area of relatively low infant mortality, and the other 2 municipalities. The proportion breastfed in Ciales was definitely higher than in the other 2 communities in the 2-3 months group. The difference was even greater in the 4-5 months group. The total records from Ciales were only 171, but the differences were statistically significant. Rio Piedras was consistently the lowest in every age group. In the youngest age group of the children there was a decreasing proportion breastfed with the advancing age of the mother. This finding was statistically significant. In the group of children 6 months and older, it appeared that the older mothers had the highest proportion of breastfed children. In this group, the difference according to mother's age only approached significance. In regard to rural-urban differences, there was clearly little difference in the early months of life, but in the older age groups the proportion breastfed was higher for inhabitants of rural areas. These differences were significant and suggest that rural mothers tend to nurse their infants longer. There was no evidence that the rates for older infants in the rural areas were weighted with older mothers tending to have th e highest proportion of infants breastfed at age of 6 months and older. It is essential that the proper technique of breastfeeding be taught to all mothers, particularly to primiparas, as errors in technique may result in unnecessary artificial feeding. Physicians and nurses should become more familiar with the requisites for successful breastfeeding.
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| pubmed-article:12255498 |
PIP: A 12-month analysis of 480 patients of whom 339 used jelly alone and 141 used the jelly with a diaphragm is presented. Many had previously u sed other methods of contraception with varying degrees of success. The simplicity of the jelly-alone method made it more acceptable to patients than other methods. In only 8 instances were there complaints of irritation from the jelly and a few more with the diaphragm-and-jelly me thod. There were a total of 26 unplanned pregnancies, 11 with the jelly -alone and 15 with the diaphragm-and-jelly method. The theoretical adva ntages of the diaphragm-and-jelly method are thought to have been nullif ied by the greater difficulties of use leading to irregular or nonuse. A reduction in estimated fertility of about 85% is thought to have been accomplished by each method.
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| pubmed-article:12233290 |
PIP: The cervical cap whose plastic dome adheres to the vaginal fornices is as effective a contraceptive device as the vaginal diaphragm when self-inserted. It provides continuous harmless protection throughout the menstrual cycle provided patients are properly selected and their tolerance verified. Inflammatory complications and development of cervical carcinoma have been absent in women using these caps. The accumulation of menstrual fluid has been reported causing abdominal discomfort or relapse of old adnexal infections. The best practice is to leave the device in place overnight following coitus or to remove it after coitus and douche immediately. Demand and satisfaction on the part of clientele who choose the cap over other methods indicate that it holds potential for individual acts of coitus, for protracted lengths of time in the vagina and for special indications.
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| pubmed-article:12259049 |
PIP: The contraceptive effectiveness of insufflation of the vagina with a powder composed of quinine sulphate, oxyquinoline sulphate, boric acid, and nitrophenolate of mercury was evaluated in 150 patients reported that they had used the method consistently and as instructed. There were no subjective complaints or objective evidence of irritation.
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| pubmed-article:12259105 |
PIP: Physiologically, proteins and lipoids of anode or cathode sperm differ qualitatively from one another. The proteins are characterized by their isoelectric points. The lipoids have a different hormonal effect. Lipoid hormones from the sperm heads in mammals closely resemble sexual hormones in their effect. The biochemical and physiochemical differences of the biocolloids of both sperm types enable separation of X- and Y-bearing sperm in the electric field (by attraction to the anode or cathode). Thus in the future the sperm electrophoresis procedure may be a suitable method of artificial sex regulation in the offspring of mammals.
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| pubmed-article:12259174 |
PIP: A study was conducted to determine the effects of nicotine on lactation and the nurslings. 55 white volunteers between 18-36 years of age, both multiparas and primiparas, who smoke habitually were studied. Nicotine was found to be present in all milk and urine specimens obtained from smoking mothers. Comparison with nonsmoking mothers showed that no specimen of their urine or milk contained nicotine. 11-17 times more nicotine was contained in the urine than in the milk samples. There was a correlation between the amount of nicotine in either the urine or the milk and the number of cigarettes smoked. 20% of the mothers in the study had insufficient milk to continue lactation, but this was no higher than the usual percentage of women who fail to sustain lactation. The nurslings were apparently unaffected by the nicotine they ingested with their breast milk. It is suggested that a tolerance to nicotine may prevent the nicotine from affecting either the mothers' ability to nurse or the infants.
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| pubmed-article:12308048 |
PIP: Although numerous works have been published on the subject of teaching contraception in the senior year of medical schools, these so-called reference works have been nothing but a "dismal series of opportunistic, propagandist, and sentimental drivel". In teaching contraception courses in medical schools, it is important that better reference works be available; that preconceived notions be scientifically supported, and; that working syllabus and teaching outline be prepared for practical teaching purposes. A syllabus which provides an excellent outline for teaching the theory and practice of contraception to medical students is prepared by William E. Brown of the University of Cincinnati and edited by Abraham Stone of the Planned Parenthood Federation of America. This syllabus presents all available information on contraception with clarity and adequacy, although it is not without fault, particularly with respect to the propagandist treatment of the pros and cons of birth control methods. Other than that, it is the first of its kind.
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| pubmed-article:12313315 |
PIP: The frequency and ease with which planned conception occurred in a private practice are reported. Over the 1925 36 period, 884 white patients from the upper middle class were advised in contraceptive technique. At the time of the 1937 analysis, 662 patients. The incidence of planned conception was higher for premarital patients than for women advised after marriage, and also increased with the length of the follow-up interval. The planned fertility of premarital patients was compared with that of women of comparable age in a population approximately at reproductive equilibrium. By this test their planned fertility was far below the requirements of population replacement. This was also characteristic of the fertility of a control sample of similar socioeconomic status and not selected for contraceptive interest. This result is taken as some evidence for the view that controlled reproduction need not mean voluntary sterility and that the physician's role is less to provide contraception where there is none than to prescribe methods better suited to the needs of his/her patients than ghose otherwise available to them. The physician's advice may have no great effect upon the number of children born to patients and yet make it possible to space those children more advantageously. About half of the planned conceptions were alleged to have been conceived in 1 month and about 3/4 within 3 months after contraceptive precautions had been stopped. Within the age range of 20-41 there was no association between age and months required for planned conception. There was also no relationship between prior gravidity and months to conceive, although the value of this finding was limited by the narrow range of prior gravidity.
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| pubmed-article:12332284 |
PIP: An accurate record of oral basal temperatures, taken every morning b efore beginning any activity, can provide pertinent data on ovarian acti vity and ovulation. Oral temperatures are just as reliable as rectal or ovarian temperatures and are more acceptable to the patient. Basal temperature graphs collected from 500 patients over a 2-year period show a definite temperature drop followed by a pronounced rise at time of ovulation; in many cases vaginal smears, endometrial biopsies, and operative material confirmed this phenomena. The higher level continues through the later half of the cycle, dropping sharply just before menstruation. When pregnancy occurs the basal temperature remains at the postovulatory level through the 1st few months of gestation. It then drops but does not return to the preovulatory level until after delivery. Postpartum basal temperature curves indicate that the 1st bleeding period is rarely ovulatory while the 2nd menstrual period is associated with ovulation in about 1/2 the patients. A basal temperature curve should be part of every sterility study; it is the simplest device for ascertaining ovarian activity and dating ovulation. In 75% of sterility cases determining time of ovulation has resulted in conception. Basal body temperatures which continue elevated provide the most accurate early data concerning pregnancy. During the 1st week of a missed menstrual period the failure of the temperature to drop strongly indicates possible pregnancy. Patients with characteristically irregular periods will not yield as much information through temperature curves. Basal temperatures are reliable indexes of ovarian activity in at least 3 out of 4 women. In the 4th the curve is so atypical with irregular readings at intervals that no accurate interpretation of physiological changes can be made. In addition to fertility studies and indications of pregnancy, basal temperatures can aid in conception control by pinpointing time of ovulation. The woman is to refrain from intercourse from the preovulatory drop until 36-48 hours after the ovulatory rise has reached a plateau. This system has also helped women avoid conception in the menopausal period. 1 group followed their basal temperatures during the climacteric. Fewer and fewer periods were associated with ovulation and when bleeding ceases entirely the curve assumes the typical diurnal pattern seen in the male for ovarian activity is at a low ebb.
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| pubmed-article:12305597 |
PIP: Studies have indicated that when Vitamin-C is administered the amount exceeding bodily requirements is excreted in the urine; this amount is lowest on the day presumed to be the day of ovulation. A test involving ingestion of 200 mg of Vitamin-C per day revealed the following: 1) in men, in anovulatory cycles in women and during illness a pronounced peak is absent; 2) in multiovulatory cycles 2 or more peaks may be seen; 3) administration of estradiol results in lower amounts of Vitamin-C excretion; the opposite of this action occurs in early pregnancy and pituitary hypofunction; and 4) injection of estradiol can produce artificial peaks. These observations suggest that ovulation frequently occurs 15 days before the next menses, but it occasionally occurs 1 or 2 days earlier or later. The causes for the peak and the correlation between sex activity and ovulation need to be studied.
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| pubmed-article:12334535 |
PIP: A causal link between prolonged estrogen (E) therapy and endometrial cancer is argued for in this report of a case who was treated with large amounts of estrogenic substances almost continuously for an 8-year period. In 1919 a 25-year-old woman was admitted with asthma of 1-year duration. Asthma onset had been very severe, requiring administration of epinephrine hydrochloride every few hours and frequent hospital observation. In 1928, the patient was amenorrheic for 8 months; in 1936, she experienced amenorrhea for 4 months. In 1937 (patient now 45 years old), the relationship between amenorrhea and increased severity of asthma was suspected. At this time, the patient also complained of hot flashes and sweats. Treatment with estrogenic substances was begun in 1937 and continued through 1945. 3 unusual features were noted during therapy: 1) persistence of hot flashes; 2) persistence of high urine titers of follicle stimulating hormone (FSH) despite adequate E doses; and 3) absence of bleeding when E was temporarily withdrawn. By 1945, endometrial cancer had been identified by vaginal smear and verified by biopsy. Because of the previous absence of respose of FSH to prolonged E therapy, Es were omitted for 4 weeks, and after this period the vaginal smear showed complete absence of intrinsic estrogenic stimulation, and the urine titer of FSH was high. E given for 10 days caused moderate pituitary inhibition. Determination of 17-keto-steroids made before and after therapy was abnormally low. Except for the state of chronic illness and the continuous administration of asthma medication (chronic alarm reaction?), there is no explanation of carcinoma grade 2.
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| pubmed-article:12255545 |
PIP: The People's League of Health (England) appointed a special committee in July 1935 to study the influence of the nutrition of expectant and nursing mothers on maternal and infant mortality and morbidity. The primary investigation was conducted from March 1938 to t he end of 1929 and was planned to reveal whether additions of vitamins and minerals to the food would be beneficial to the course of pregnancy and labor and to the newborn infant. 5022 pregnant women participated in the investigation. These women were patients at the antenatal clinic s of participating hospitals from the initiation of the study, exclusive of those women whose pregnancy was beyond the 24th week and those suffering from any physical disease or abnormality. The women were divided into experimental and control groups with the experimental group receiving the vitamin supplements. Within each of these groups women we re classified into women pregnant for the 1st time and women with a history of 1 or more pregnancies as well as a division of women under 25, women between 25 and 30 years, and women who were older than 30. It was found that for all ages the percentage of toxemia in the treated primiparae is significantly lower than among the controls, 27.1% in contrast to 31.7%. For sepsis there is no satisfactory evidence that supports treatment with vitamin supplements. A smaller incidence of prematurity was revealed among the treated women, and this is particularly significant since about 50% of infant deaths under 1 month are due to prematurity. Although the percentage of children breast-fed increased with extended treatment, it is only when the mother had taken the supplementary diet for 24 weeks and over that their ability to breast-feed was slightly better than that of the controls. It might be expected that as the infants of the treated mothers had the more positiv e experience in regard to prematurity and birth weight they would show lower rates of stillbirth and neonatal mortality. This was found to be the case in regard to stillbirth but not in regard to neonatal mortality which is notably higher in infants born to treated primiparae and slightly higher in treated multiparae.
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| pubmed-article:12278355 |
PIP: Circumcision, or the circular abscission of the foreskin, is a medical practice which has been performed over a wide area of the world. Only the Indo-Germanic peoples, the Mongols, and the Finno-Ugrian-speaking peoples did not ever practice circumcision. The original reason for this practice varies and is generally lost in history. The practice was almost universally performed at or before puberty. The method of performance and reasons, where known, in various parts of the world are discussed. The operation was often of fundamental importance in establishing the social position, rights, and duties of members of the community. Only the Jews are believed to have originated the practice as an hygienic measure. Practices similar to circumcison among males were incision and subincision. Common to all of the mutilatory practices was the evocation of bleeding. A type of circumcision was also practiced on girls at puberty. Incision, artificial defloration and infibulation are in the same category of mutilatory operations.
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| pubmed-article:12307896 |
PIP: A questionnaire was sent in October 1944 to 15,000 physicians to determine their attitudes and practices toward contraception. Of these 6000 were gynecological and obstetrical specialists and 9000 were general practitioners from a geographical cross section. 3381 questionnaires were returned, and after careful study it was concluded that the sample was representative. 90% of the graduates before 1920 had no teaching in contraception; 27% of those who graduated in 1935 or later had some instruction. 93% of the physicians were requested by patients for contraceptive advice, 62.2% frequently and 30.5% occasionally. The 3 main reasons the patients requested contraceptive advice were: child spacing, economic, and family limitation. 98% of the doctors approved of contraception for at least some medical reason. More than 80% approved for child spacing. The average minimum interval between children considered safe was 23 months. The physicians approved of economic reasons for contraception as much as for medical reasons. 51.5% of the respondents frequently prescribe contraceptive methods and another 31.7 prescribe them occasionally. The 1st choice method was diaphragm with jelly or cream, and the condom was 2nd choice. The method prescribed is a compromise between patient acceptability and trustworthiness.
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| pubmed-article:12305487 |
PIP: A case study of testosterone-induced spermatogenesis in a "pan-hypop ituitary" eunochoid is presented. The patient, age 24, exhibited relative dwarfism and complete sexual infanitilism. The patient was treated with testosterone pellets for a period of 5 months. The treatment resulted in significant spermatogenesis and sexual development. Since urinary gonadotropin excretion prior to and during therapy was consistently negative for 4 or less mouse units per 24 hours, it is assumed that testosterone directly affects the seminiferous tubules without mediation by gonadotropins.
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| pubmed-article:12255556 |
PIP: Development of spermatogenesis in hypogonadism is discussed. Case r eports are presented of 4 patients in whom spermatogenesis appeared to have been the result of treatment and 1 patient in which it seemed likel y that fertility might have been present but after disappearing, was not restored a 2nd time during the period of observation. An excess of follicle stimulating hormone (FSH) was not found in any of the patients, therefore it was assumed that the primary disturbance was not in the testis, at least not in the tubular portions. It is concluded that treatment with testosterone alone may bring about development of secondary sex characteristics and spermatogenesis in some cases of hypogonadotropic eunchoidism or panhypopituitarism in the male. Chorionic gonadotropin with varying quantities of FSH may bring about development of secondary sex characteristics and nitrogen retention through stimulation of the Leydig cells. Apparently once these developments have occurred, continued treatment is not always necessary.
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| pubmed-article:12336576 |
PIP: Guidelines for developing effective programs of mass persuasion were provided. These guidelines were derived from the findings of studies, undertaken by the Division of Program Surveys of the Department of Agriculture for the War Finance Division of the U.S. Treasury Department, for the purpose of evaluating the U.S. Government's efforts to promote the sale of war bonds during the 2nd World War. The evaluation studies demonstrated how difficult it was to induce mass behavioral changes. Effective programs of mass persuasion must 1) change the cognitive structures of individuals; 2) change the motivational structures of individuals; and 3) activate new forms of behavior. In order to promote cognitive change it is necessary to insure that the sense organs receive the media messages and that the messages are relatively compatible with the existing cognitive structures of the individuals receiving the messages. If the messages are too deviant, they will be rejected or distorted by the receiver. To promote individuals toward a specific action, the individuals must be convinced that the action, being induced, will lead to the fulfillment of personal goals; however, even motivated persons frequently fail to perform the actual behavioral patterns which is being promoted. Individuals must also be provided with a specific path of action and a specific time for action. Only if all 3 of these processual changes are induced will a program of mass persuasion effectively accomplish its goal.
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| pubmed-article:12339641 |
PIP: Certain features of a group of 1309 diabetics were studied. The group was considered representative of Scottish diabetics since the sex distribution of cases corresponded to the sex distribution of deaths from diabetes recorded in the official mortality statistics for Scotland. Evidence is presented which justifies the use of Scottish mortality statistics for this purpose. A study of the incidence of diabetes in 413,110 Scottish recruits (male and female) suggested that in the general population the sex distribution of persons with undiagnosed diabetes might not be the same as that of persons known to have the disease. In both sexes, the disease began most frequently after age 40; sex incidence was equal up to age 40 and thereafter, female diabetics were more common than male diabetics. The high frequency of diabetes in women of middle age was confined to married women and appeared to be related, at least in part, to previous childbearing. The age at onset and the severity of the disease in this group of women were apparently uninfluenced by marriage and childbearing. Adult diabetics were no taller than the controls (hospital visitors). In the case of women diabetics, the maximum weight was significantly greater than that of the control from age 20 onwards, and in the case of male diabetics, from age 40 onwards. In both groups, married women were heavier than single women. The mean blood pressure was significantly higher in female diabetics after age 30 than in the corresponding control group. This hypertension could not be adequately explained on the grounds of obesity; it was not related to previous childbearing. Of 923 diabetics questioned, 23.2% had a family history of diabetes. As age at onset of the disease increased, positive family histories decreased. There was no relationship between presence of a positive family history and severity of the disease. The frequency of a positive family history in obese and hypertensive patients did not differ from that of a group of diabetics as a whole. In the group of middle aged married women, those with the largest families gave the fewest positive family histories. It was considered that there was no proof of parital sex linkage of the hereditary factor, and no convincing evidence that age at onset is determined by heredity. Thyrotoxicosis was present in 1% of the cases. Age at onset in these cases was similar to that of diabetics in general. Sepsis was associated with onset of diabetes in 6% of the cases, but average age at onset was that of diabetics in general and a family history of diabetes was obtained in 18% of the cases. After examining these data, it was concluded that etiologic factors in human diabetes could be divided into hereditary factor(s) fundamental to almost all cases or factors increasing the susceptibility of those persons predisposed to diabetes by a hereditary factor such as abesity, factor(s) associated with childbearing, and minor factors such as sepsis, thyrotoxicosis, or acromegaly.
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| pubmed-article:12279705 |
PIP: This analysis covers 156 case histories of women fitted with cervical caps in an attempt to encourage further research on a larger patient group. The contraceptive prescribed for almost all women was a plastic cervical cap imported from abroad. Observations with a new American made plastic cap were begun a short time ago and will be published in the near future. After the absence of any cervical pathology was ascertained during routine gynecological examination, the size of the cervical cap was determined by rough estimation as "large," "medium," or "small." The cervical cap is cleansed with water and soap, dried, and lubricated with jelly and then the cap is filled with spermicidal cream or jelly. The woman is placed in the lithotomy position, 2 fingers of the left hand separate the labia. The cervical cap is held between index and middle fingers of the right hand and inserted into the vagina, following the posterior wall to the posterior fornix. Here the cap is released and will slip almost automatically over the cervix. For self insertion the woman is taught to feel her own cervix, and then she is directed to follow this same technique. For removal of the cap, index and middle finger are inserted into the vagina, reaching high up in the fornix. As the rim of the cap is reached it is tilted away from the cervix. Thereafter the cap is grasped between the 2 fingers and removed. The objection most often raised against the cervical cap is that the technique is too difficult for the women to learn, but Marie Stope and Hannah Stone experienced no difficulty in teaching thousands of women the technique. Only 13 of the 156 women encountered difficulties in learning self insertion. The most frequent side effect of the use of the cap was discharge, especially in cases where it was left in for the 24 days between 2 menstruations. In no case did the discharge amount to a major disturbance. The plastic cap has less tendency to induce discharge than other firm caps. Increased discharge in the presence of an erosion was observed in 9 cases. Acute and subacute pelvic inflammatory disease are an absolute contraindication for the cervical cap. There is no large group of statistics which attest one way or the other as to the reliability of this method. Histories are cited to demonstrate the effectiveness and harmlessness of the cervical cap as a contraceptive method. Of 90 observations of the cervical cap in the clinic group, 49 were chosen to evaluate the reliability factor. There were 7 pregnancies in this group. Of 40 women seen in private practice, 7 experienced unwanted pregnancies.
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| pubmed-article:12255323 |
PIP: In this survey of 2000 private obstetric patients regarding their contraceptive history and practice the attempt was made to determine the following: 1) what percentage of the deliveries of this group were the result of planned pregnancies; 2) what methods of contraception had the patients used; 3) what is the relative effectiveness of the methods used; and 4) how long did it take for the patients to become pregnant after discontinuing contraceptive use. The data was collected on a 33 column code sheet with the information taken from the 2000 consecutive obstetric histories taken at the initial office visit, usually at the 8th or 9th week of pregnancy. Over 99% of the patients were white. Over 85% of the women were between the ages of 20 and 35 and 60% were Jewish. About 30% of the husbands were professional men; 23% were business owners or executives; 38% were white collar workers; and 10% were manual workers. Of the 2000 pregnant women 64% had stopped using contraception with the plan of becoming pregnant; 18.7% became pregnant while still using contraception; and 17.4% became pregnant without using contraception and without indicating an intention to become pregnant. The condom and diaphragm represented 85% of the total contraceptives used, and the relative effectiveness of these methods as used by this group was approximately the same and more effective than the other methods used. 3/5 of the planned pregnancies occurred within 3 months and more than 9/10 within 1 year from the time contraception was discontinued. On the basis of this data it appears that physicians should change their practice and become concerned with a couple's reproductive problems at 1 year, rather than waiting until inability to conceive has continued for 2 years.
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| pubmed-article:12332354 |
PIP: Data from the Annual Reports of the Registrar-General for England an d Wales (1939-1947) and for Scotland (1939-1947) were examined to determine the relationship of sex ratio to maternal age. Sex ratios of total births and live births decrease with maternal age; sex ratios of stillbirths increase. The increase in the sex ratio of stillbirths with maternal age accounts for the difference between live births and total births. The decrease in the sex ratio of total births with maternal age may be explained by changes in the sex ratios of abortions earlier than the 28th week. A trend in the sex ratio at conception would then be absent with regard to maternal age. Data from the Annual Reports of the Registrar-General for Scotland (1939-1946), which give the causes of stillbirth were used to investigate the increase of the sex ratio with maternal age. There were 4 main classes of stillbirth described and each class has a different sex ratio. Changes in the sex ratio of all stillbirths with maternal age were in part attributable to changes in the relative proportions of these classes in each age group. The class which exhibits the most definite age trend - anomalies of fetus, placenta, or cord - was examined. Results indicate that each class is influenced by individual causes within the class. Trends of stillbriths with maternal age for any single cause were absent. It is suggested that the reported trend of the sex ratio in association with birth order may also be explained by changes in the composition of stillbirths and abortions with parity.
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| pubmed-article:12332365 |
PIP: In an effort to encourage contraceptive use it was beneficial to offer a simple, reliable, and satisfactory contraceptive method needing no special skill for its adoption. Among a group of 1023 patients, 871 (85%) used the vaginal jelly. Of those 436 patients offered both jelly and cream, 273 (64%) preferred the jelly and 153 (36%) the cream. Among those using only jelly, 71 (8%) became pregnant resulting in a 2.2% failure and a 97.8% effectiveness rate. Of those patients using only cream 7% became pregnant yielding a 2.4% failure and 97.6% effectiveness rate. 5 women in the total group were sterilized. Evidence indicating pruritus or vaginal irritation was absent in the entire group. This study showed that the cream is as efficient as the jelly - when used alone without the diaphragm and according to instructions both provdie simple, reliable, and satisfactory contraception.
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| pubmed-article:12233288 |
PIP: A study was undertaken in January 1941 to determine the contraceptive effectiveness of Ortho-Gynol, a buffered acid jelly, when used without a mechanical occlusive device. Patients were selected by voluntary participation when they returned for postnatal follow-up at 4-6 weeks postpartum. Each patient was given a tube of jelly and a dose applicator and instructed in their use. Subsequent examinations and resupply were at monthly intervals. By January 1943, there were 188 patients. Of these, 55 had failed to cooperate leaving 133 to be reported on. Of these, 49 had been observed for 8 months or less and 84 for 9 months or longer. Pregnancies occurred in 9 of the 133 patients but in only 4 following correct and regular use of the jelly. Only 8 patients were primipara. Of patients under observation, 112 had used the jelly for 1 year or longer, 48 for over 2 years, and 25 for over 4 years. In 6 instances, the pregnancies had occurred before the 9th month of observation. Ortho-Gynol was acceptable to most patients. None complained of irritation or of annoying sensation. A reduction of pregnancy rate from an anticipated 99/100 woman-years to 1.3/100 woman-years is claimed. Results justify the continued use of this metho d of contraception.
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| pubmed-article:12255527 |
PIP: Information of the extent of breast-feeding in Great Britain in 1946 , with special reference to the health and survival of children is provided from a 2nd maternity survey in 1948, of 4669 women, 2 years after the birth of their babies. The average mother in 1946 breast-fed her baby 4.2 plus or minus .06 months. Average duration of breast-feeding was the same for each birth order. There were only small social class differences in the maintenance of breast-feeding although in the 9th month the rate of weaning was significantly lower among babies in bad home conditions (p less than .05). The risk of conception was lower among women breast-feeding. Failure to establish lactation was more frequent in nursing homes but those confined there were more successful at maintaining it. Breast infections were more frequent after hospital confinements (7%) compared to home confinements (4.6%). Babies taken to welfare centers had higher weaning rate during the first 6 months of life. Differences between the mortality of bottle-fed and breast-fed infants were insignificant. However, serious infection of the gastrointestinal tract was more frequently seen among bottle-fed bab ies (primarily among babies of extreme birth weight), and babies were more likely to have mild attacks of diarrhea during the switch from breast to bottle. Bottle-fed babies were more liable to lower respirato ry diseases, bronchitis, and pneumonia during the first 9 months. Immunity to measles developed in babies breast-fed in the early months which lasted throughout the 2nd year. At 2 years of age bottle-fed babies tended to be slightly heavier than breast-fed babies and tended to walk at a later date.
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| pubmed-article:12305452 |
PIP: 50 mentally normal men who had been vasectomized in the years 1941-1949 were interviewed from 3 to 129 months after the operation (median = 55 months). Average time lost from work was less than 1 day. Few patients reported sexual changes. 5 reported a decrease in libido, but 9 reported an increase. Likewise, 4 reported lesser frequency of intercourse, but 8 reported greater frequency. 47 said they were satisfied with the results and "would do it again."
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| pubmed-article:12332212 |
PIP: A response to a query on the treatment of moniliasis vulvae is presented. Methylrosalinine chloride is recommended as the treatment of choice. The drug can be administered in several ways: 1) liberal coating of the vagina with a 2% aqueous solution; 2) the insertion of methylrosaniline chloride jelly individual dose applicators; and 3) the use of methylrosaniline chloride suppositories. It should be ascertained that a mixed infestation is not present. If overtreatment should occur, all treatment should be stopped and weak vinegar or lactic acid douches should be given.
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| pubmed-article:12255316 |
PIP: The spermatogenic rebound effect was studied in 5 oligospermic males after testosterone-induced azoospermia. The subjects received 3 weekly doses (50 mcg) of testosterone propionate for 2 1/2 - 4 1/2 months. Seminal fluid analysis was conducted every 6-8 weeks after treatment was terminated. In each case, spermatogenic activity gradually increased after the last treatment until the production of mature spermatozoa exceeded pretreatment levels. A marked improvement was also seen in the posttreatment histologic picture when compared with pretreatment specimens. It is not known whether the rebound response is peculiar to androgenic substances.
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| pubmed-article:12255441 |
PIP: The advantages of postpartum sterilization and indications for steri lization are discussed. Postpartum sterilization is a safe procedure that has the advantages of: 1) circumventing caserean section or hysterotomy, 2) does not require a 2nd hospital visit, 3) prevents furth er pregnancy, and 4) is technically easy to perform during the puerperium. Factors in the decision to perform sterilization for medical indications, excessive multiparity and socioeconomic reasons, psychiatric indications, or eugenic reasons are discussed. Careful study of women of low socioeconomic status with many children and possible medical and psychiatric disorders is recommended.
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| pubmed-article:12255260 |
PIP: The postpartum return of menstruation was studied in 834 obstetric patients. 23.5% of the women were lactating, 42.7% were partly-lactating, and 33.8% were nonlactating. All but 32 of the women were between the ages of 20-40. Menstruation was reestablished in 25.7% of the lactating women at 6-12 weeks, in 20% at 12-18 weeks, and 14.3% at 18-24 weeks. Menstruation was reestablished in 35.5% of the partly-lactating women within 6 weeks, and in 51.3% at 6-12 weeks. Menstruation was reestablished in 47.3% of the nonlactating women within 6 weeks, and in 45.4% at 6-12 weeks. It appeared that the earlier the return of menstruation, the more irregular it was. The results are analyzed for the factors of age and parity.
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| pubmed-article:12275629 |
PIP: Statistical analyses of seasonal variations in the birthrate in cities and regions of India are critically reviewed, and the major factors accounting for the variation are discussed. Review of previous studies reveals that a standard Indian birthrate curve does not exist. Problems in the interpretation of often inaccurate and incomplete records and the compilation of data are discussed. It is suggested that urban variations in the birthrate are primarily due to changes in weather conditions, whereas rural variations are related to the harvest season. A periodic regression equation for analysis of live births is developed and applied to the cities of Bombay and Poona.
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| pubmed-article:12275712 |
PIP: Patients are becoming aware that sterilization can be performed without morbidity or mortality, and elective sterilization is more and more requested, often for social and economic reasons. There is no law in Texas governing this procedure. Clarification is in order, and physicians should initiate this clarification through their legal counsel. It is suggested that a consultation procedure such as is used in cases of therapeutic abortion be adopted.
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| pubmed-article:12275628 |
PIP: This study examined birthweight and gestation time in relationship to maternal age, parity, and infant survival in 13,730 (7037 male, 6693 female) births at an obstetric hospital in 1935-46. Preliminary analysis of the data indicated that nonsurvivors were significantly lighter at birth with shorter mean gestation times and older maternal ages than survivors. Parity in the 2 groups was similar. When infants who died in the 1st 28 days of life were excluded, the association between birthweight and parity was significant. Children of the 1st 3 parities showed a definite decrease in weight with increasing maternal age, but this effect was not present in higher parities. Mean gestation times were shorter by 1-2 days for parities 5 and above. Parabolas gave a good fit to the logarithm of odds on survival for a given birthweight. Survival was greatest among infants in the 7.5-8.5 lb weight group, which was close to the mean value. A 275-89 day gestation period was associated with the highest rates of infant survival, with periods under 260 days less favorable than periods of 305 days or more. The articla also provides tables for estimating infant survival for given weights and gestation times.
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| pubmed-article:12307934 |
PIP: The technic of posterior colpotomy is described. The patient is put in the lithotomy position and conditions for possible contraindications are determined. The incision in the cul-de-sac is made well posterior in the fold between the uterosacral ligaments. The fascia is pushed downward with the index finger, displacing the rectum and exposing a widearea of thin peritoneum. The peritoneum is then opened without danger of injury to the bowel. The ovary is palpated with the index finger and grasped with a ring forceps bringing it up and medial, exposing the tube. When the uterus is anterior, gentle pressure is made over the fundus abdominally and the lateral aspect of the incision is elevated exposing the ovary. Lifting the ovary anterior and medial with pressure over the fundus abdominally facilitates exposure of the cornual portion of the tube. The incision is closed with interrupted mattress sutures including all layers. Colpotomy is a safe, certain method of confirming the diagnosis of tubal pregnancy. It is more accurate than needle aspiration of the cul-de-sac. Contraindications of this method include severe hemorrhage, shock, previous pelvic operations with extensive adhesions, endometriosis of the rectovaginal septum, fixed pelvic pathology and acute vaginitis.
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| pubmed-article:12255243 |
PIP: A postcoital examination made after the use of the contraceptive Experimental Jelly "P" by 200 women was used to evaluate the longevity of spermatozao, and the value of the experimental jelly as a contraceptive. 158 of the women (95% black, 5% white) returned to the clinic for 1 or more visits over a period of 3-18 months. 37 patients had used other contraceptive measures previously. After a medical history and physical examination each patient was instructed in the proper use of the method. With an applicator, 5 cc of the jelly was to be placed in the upper vagina, close to the cervix, 5-10 minutes prior to coitus. A douche could be taken after a minimum of 6 hours. Whenever possible, the examination was made a few hours after coitus. Vaginal and cervical contents were examined for spermatozoa, leukocytes, trichomonads, monilia, and spinnbarkeit of mucus. Occasionally uterine samples were aspirated. At the phase of maximum spinnbarkeit the longevity of spermatozoa was optimal and the need for an active contraceptive greatest. Therefore, the efficacy of the Experimental Jelly P at this time and at the estimated menstrual calendar ovulation time was especially noted. A total of 289 postcoital tests were done on the 158 patients at 2-72 hours postcoitus. Of the 289 tests 173 (59.8%) revealted no spermatozoa, 110 (38.1%) showed nonmotile sperm, and motile sperm were found in only 6 (2.1%). Effect of the jelly on cervical mucus did not penetrate to the endocervix. 30 pregnancies occurred. However, 23 of these women admitted to incorrect or inconstant use of the method. 83 women were followed for 3-18 months. 18 of them became pregnant but in only 7 instances was failure of the correctly used method thought to be the reason. The rate for jelly failure was 17.46 pregnancies per 100 woman-years of exposure. The reduction in fertility was estimated to be 83.17%. Of side effects, 49 patients complained of local burning. In some instances both partners complained. 12 of these women were found to have monilial vaginitis. The burning ceased when this condition was treated. Many complained of the messiness of the method. The postcoital test is considered an accurate method in the evaluation of spermicidal preparations used as contraceptives.
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| pubmed-article:12255302 |
PIP: Blood levels of 17-hydroxycorticosteroids in 124 pregnant women, in 37 women immediately after delivery, in 10 women 6 days after delivery and in 21 normal healthy women were studied. The 17-hydroxycorticosteroids were determined by the method of Nelson and Samuels. 17-hydroxycroticosteroids increased during pregnancy with a positive correlation between the level of these steroids and the duration of pregnancy. The levels increased to about 4 times the normal value during the last trimester. Immediately after delivery the levels increased to about 7 times the normal value but by the 6th day postdelivery, the levels had dropped to normal levels. The fetal cortex may contribute to the increased levels during the latter part of pregnancy but it remains to be explained why there is an increase in early pregnancy and just after delivery.
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| pubmed-article:12233285 |
PIP: 3 consecutive successful operations for restoration of fertility by repair after vasectomies and a review of the literature are presented. An article in the "Journal of the American Medical Association" is quoted as stating that successful repair cannot be obtained if the vasectomy operation had been properly done. The entire American literature has contained only an occasional isolated article describing successful vas reunion operations. There were also a few European reports of success. Of 1240 questionnaires sent out by an investigator, less than 18% of urologists replying had even attempted this operation. Of those having performed the operations, 45% claimed some successful results. To reestablish continuity of the severed vas, either direct anastomosis or production of a fistulous tract between the 2 ends is necessary. No single technique has proven best. In the 3 successful cases reported an intraluminal bridge of plain catgut has been inserted. General or spinal anethesia was needed. The intraluminal splint was passed 2 cm into each end of the vas after the ends had been freed of surrounding tissues and the fibrous scars of previous surgery removed. After drawing the 2 ends together, the suture was secured by a knot in either end. Meticulous handling of tissues and of hemostatis was considered important. The procedure was done bilaterally. In 3 consecutive cases so treated, subsequent sperm counts have become normal after several months, and 2 pregnancies have already occured in wives. The operation is recommended when home conditions have changed and more children are desired. Several techniques are available. 'An intralumina l splint may be of plain catgut, stainless steel, or tantalum as preferred.
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| pubmed-article:12259050 |
PIP: A study of 123 patients who had complete azoospermia and in whom either exploration of the scrotal content or corrective sugery was performed is reported. Azoospermia was caused by a variety of factors (incomplete or improper development of the ductal system, obstruction in the epididymis or in the vas as a result of postinflammatory constriction, occlusion of the lumen or the ejaculatory ducts, and inadvertent or purposeful division of the vasa). Operation to relieve vasoepididymal obstruction is indicated only the presence of a normally functioning testicle. There are 4 types of operations for the correction of sterility. If these operations are unsuccessful it is possible to bring the free and cut ends of the vas into the midline of the scrotum and then allow them to empty continuously into and inverted skin pouch to create a reservoir of sperm for artificial insemination. In this series there were 61 patients in whom there was sufficiently hopeful indication for success to warrent bilateral or unilateral epididymovas anastomosis. In only 23 of these could it be said that there was complete success. Only 5 of these men were able to effect pregnancy. Reanastomosis of the vas after prior voluntary sterilization resulted in a 70% success rate for surgery.
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| pubmed-article:12261921 |
PIP: During the '20's, after many hard and inconceivable difficulties, Miss M.E. Wolff and her sister developed and organized what became the Midwifery Service of the Sudan. Miss Wolff spent a whole month persuading some old practicing midwives to come in for training but was only laughed at for her offer to teach women old enough to be her grandmother. At that time, the midwives of Sudan were untrained and old, very conservative, completely ignorant, and extremely dirty. In addition, the women resented any innovation which was not in accord with their customs, and particularly any change which demanded of them a higher standard of performance and special training. By 1924, it was possible to train all the existing old midwives of both Khartoum and Omdurman. A training program was started with very satisfactory results. The trained midwives became, in a minor way, missionaries in the cause of cleanliness and simple hygiene in the home. They were also used to combat the almost universal, but barbaric and dangerous, custom of complete female circumcision. The standard of midwifery has been raised to a higher level at Omdurman and Khartoum, but it will take time before this level can be achieved in the provinces. In 1930, Miss Wolff and her sister started the first Ante-Natal Clinic in the Sudan, at the Midwifery Training School. The Clinic, with some great opposition at first, even actually became very successful and popular. Since 1921, 624 midwives have been trained, of which 40 were trained nurses and 12 were health visitors. The standard of training is gradually being raised as the younger and more educated women come forward.
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| pubmed-article:12275609 |
PIP: Menstruation and conception during lactation are discussed. 943 postpartum patients were observed during lactation for the frequency of menstruation. Of mothers who at 4 months after birth were breast-feeding, breast and artificially feedings, or artificially feeding their children, 39.8, 56.8, and 95.3%, respectively, had menstruated. It is suggested that ovarian activity does not interfere with lactation and failure of lactation leads to a return of the cycle only indirectly because it results in a reduction of the suckling stimulus. Of 1227 postpartum women, 87 became pregnant within a year of delivery and 10 conceived while their children were being wholly or partially breast-fed. 4 of the 10 women became pregnant before menstruation was reestablished.
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| pubmed-article:12255499 |
PIP: Syn-A-gen, a new vaginal contraceptive which does not contain either murcurial compounds or quinoline derivates was used by 18 fertile women during a total of 165 cycles to avoid a medically contraindicated pregna ncy. In 89 cycles the suppositories were used only during fertile phase s as shown by the curve of basal temperature. In 76 cycles application occurred during the whole cycle without basal temperature control. Despite the occurrence of sexual intercourse during the period of the highest fertility no case of conception was reported. Complaints of vaginitis or disagreeable secondary effects were absent following regular suppository use. These results indicate that Syn-A-gen is an innocuous and reliable contraceptive.
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| pubmed-article:12233286 |
PIP: Sterilizaton can be defined as therapeutic, voluntary, or statutory. An investigation involving 659 cases of therapeutic sterilization showed an incidence on the combined obstetrical and gynecological service of .5%, 64% on the obstetrical division alone and .38% on the gynecological, division. Indications and contraindications were based on the patient's medical and social histories. 20 different operations were classified as to uterine and tubal procedures. An increasing preference for tubal and for puerperal sterilizations was observed. 2 failures occurred resulting in an incidence of .3%. Advantages to the procedure include performance under local anesthesia, prevention of fistulas and recanalization, and a virtually bloodless procedure. Disadvantages include irreversibility, postop morbidity, and complications. 3 deaths following sterilization were apparently indirectly attributable to the sterilization.
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| pubmed-article:12336086 |
PIP: In this paper, the etiological factors affecting infertility among the Azande tribe of Central Africa are reviewed. Of those factors reviewed, including venereal disease, leprosy, sleeping sickness, endemic goitre, nutrition, voluntary contraception, and malaria none is sufficient to account for a lowering in the fertility rate. The data collected is estimated to be accurate but very limited. The author, however, concludes that there is 1) a low child/adult ratio; 2) a marked female preponderance; and 3) a high infant and child mortality rate. Finally, the people of the tribe are reproducing themselves, though not so prolifically as their former preponderance in this region, or comparison with fertility levels in neighboring tribes, would lead one to expect.
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| pubmed-article:12255379 |
PIP: Pregnancy, delivery, and neonatal records of mentally defective chil dren born in Baltimore, Maryland, between 1935 and 1952 were compared wi th records of a control group to determine the effects of complications during these 3 phases on eventual mental disorders. The mental defectives had a greater amount of recorded complications of pregnancy and delivery, prematurity, and abnormal neonatal experiences. Nonmechanical pregnancy complications, i.e., bleeding or toxemia, seemed more significant in this association than the mechanical factors of delivery. Neither duration of labor nor operative procedures performed at delivery was related with the development of mental deficiency. The associations that did show were not as strong for nonwhites. Various reasons for this fact are considered. It seems possible that reproductive casualty can occur during pregnancy, delivery, and the neonatal period. In its most serious form, it causes spontaneous abortion, stillbirth, neonatal deaths. Lesser brain damage during these periods will cause, in the following order, cerebral palsy, epilepsy, mental retardation, and behavioral disorders.
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| pubmed-article:12255395 |
PIP: Laboratory tests designed to measure the spermicidal effectiveness of contraceptive jellies and creams after dilution and mixing were carried out. 87 materials were tested. The number of minutes during which motion of the sperm continued in a column of human semen 2 mm in diameter and 5 mm long in contact with a contraceptive material was computed. The average spermicidal activity of the 51 jellies tested was higher than for the 16 suppositories and still greater than for the 20 creams. The immobilization times were measured of rice flour jellies containing sodium chloride in concentrations of 10%, 20%, and 30% of the water present. The 30% sodium chloride jelly showed the shortest immobilization time of any of the preparations, 41 minutes, whereas the time of the 10% mixture, 12 minutes, was shorter than that of 90% of the commercial preparations tested in 1951 and of 80% of those tested in 1953 (the present study). Based on the 87 commercial contraceptive mate rials reviewed, the data indicate a maximum diffusion spermicidal time of 195 minutes for desirable materials.
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| pubmed-article:12307916 |
PIP: Preliminary results on the diagnosis of sex in utero by analysis of cells from amniotic fluid are reported. Amniotic fluid was extracted from 20 subjects and was found to contain an adequate number of cells for diagnosis. Correct diagnosis of fetal sex was made in all cases. The only possibility of error with this technique is in rare cases of intersex, providing that the sample is not contaminated with maternal cells. The diagnosis can be made from the 12th week of gestation until term. Diagnosis of an aborted human fetus is also possible.
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| pubmed-article:12305195 |
PIP: This paper reviewed indications for cesarian section and the development and use of total or complete hysterectomy as an elective means of sterilization in an open staff general hospital. Case reports of patients so treated during the previous 12 years and follow-up studies were included. Of 22,832 patients delivered at the Santa Monica (California) Hospital, 1188 (5.1%) were delivered by cesarean section. Hysterectomy was done in 84 of these: 62 of the subtotal variety and 22 total. No maternal deaths resulted. Spinal anesthesia was used in 1170 of the cesarean sections. In 42.8% of the cesarean cases, a previous cesarean section had been done. In 24.1% of the cases under study the cesarean was done for cephalopelvic disproportion in 14.8% for hemorrhages complicating pregnancy, in 6.5% for soft part dystocia, and in 3.7% for toxemia. Of the 62 subtotal hysterectomies, 15 patients were seriously ill on admission. Of the 22 total hysterectomy cases 17 were elective. In the series of 84 hysterectomies there were 11 fetal deaths of which 8 were still born or nonviable. Abruptio placenta was the most frequent cause. There were no postoperative complications in 62 cases; all but 1 of the serious complications occurred in patients who were extremely ill on admission. 32 of the cesarean hysterectomy patients have been followed: 14 of the total cases and 18 subtotal cases. With total hysterectomy granulation tissue formation frequently required treatment. In the subtotal cases cervicitis required subsequent treatment in 6; vaginal removal of the cervical stump was later done in 3 of these. In 6 operated on as an emergency measure there were serious emotional disturbances. Postoperative follow-up of elective cases revealed excellent adjustment. Total cesarean hysterectomy is gradually replacing subtotal. In younger patients the operation should be limited to those with a primary indication for hysterectomy.
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| pubmed-article:12334405 |
PIP: A reevaluation of the interpretation of findings on the number and types of genes influencing the fate of skin homografts of mice is presented. Continuing observation of 149 grafts revealed 103 successful procedures. The breakdown of successful grafts between strains is given. Except for intrastrain grafting of A/Jax mice, male-to-female grafts generally failed, whereas male-to-male, female-to-female and female-to-male grafts almost always succeeded. The disparity in results and the genetic implications of the data remain to be elucidated.
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| pubmed-article:12275461 |
PIP: A study of 1830 puerperal tubal ligations performed from 1936-1950 at the John Hopkins Hospital is reported. Major indications for the sterilization were great multiparity, chronic hypertension, and repeated cesarean section or hysterotomy. The Pomeroy technique was used most frequently (80.8%). 17 of the operations failed to prevent pregnancy;y Early puerperal sterilization by the Pomeroy technique resulted in 3 pregnancies and sterilization by the same method accompanied by cesarean section or hysterotomy resulted in 7 failures;y A death rate of .3% was observed for the Pomeroy technique. As a result, the Irving technique was substituted in cases of cesarean section or hysterotomy. It is concluded that the hazards of the Pomeroy technique approximate those of undisturbed fertility and that sterilization on the grounds of multiparity alone cannot be justified.
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