Ovarian dysgenesis and chromosome abnormalities.

The association of ovarian hypoplasia with trisomy 18 in 6 infants and trisomy 13 in 5 infants and 1 fetus is reported. Three infants also had thymic hypoplasia. The possible etiology of ovarian dysgenesis is discussed in relation to a variety of clinical and experimental associations.

Carcinoma of the cervix and sexual function.

Forty-six patients were interviewed more than a year after treatment for carcinoma of the cervix to establish the effects of radiation therapy and of surgical therapy on sexual feelings and performance. Group 1 consisted of 22 patients who had undergone radiation therapy for stage I, II, or III cancer of the cervix. Group 2 consisted of 20 patients who had undergone hysterectomy with or without partial vaginectomy for carcinoma in situ. The irradiated patients experienced statistically significant decreases in sexual enjoyment, ability to attain orgasm, libido, frequency of intercourse, opportunity, and sexual dreams. The surgically treated group had no significant change in sexual function after treatment. Both groups experienced a change in self-image but did not feel that their partners or family viewed them differently. Myths about cancer and the actual effects of pelvic irradiation were found to have disrupted the sexual-marital relationships of many women. Therapeutic programs are discussed through which women can be helped through this difficult time in their lives.

Fibrin sealant in breast surgery.

Recent research has investigated the use of fibrin sealant (FS) in axillary lymph-node dissections performed for staging carcinoma of the breast. The majority of complications of axillary dissections in breast surgery stem from the two factors that influence the formation of seromas, hematomas, and lymphedema: the oozing of small transected vessels and the creation of a reservoir due to the removal of tissue. An effective surgical adhesive could improve hemostasis and tissue adherence, thereby decreasing the frequency of these postoperative problems. This paper reviews the use of fibrin sealant in breast surgery to reduce postoperative serous drainage by improving hemostasis and tissue adherence.

The effect of legalized abortion on morbidity resulting from criminal abortion.

In order to examine the effect of legalized abortion on the complications of criminal abortion, a surveillance system was established at a large urban hospital in Atlanta, Georgia. Between 1969 and 1973, legally induced abortions at this hospital increased logarithmically from 8 to 498 per quarter year. The number of women admitting to attempts at illegal abortion decreased significantly, but the decline began only after three years of increasing numbers of legal abortions. A slight decrease in the number of septic "spontaneous" abortions also occurred. Making legal abortion services available can result in a decrease in morbidity associated with illegal abortions, but the availability of legal abortion must be sufficiently broad to obviate having to resort to criminal means.

Sexual function after surgical and radiation therapy for cervical carcinoma.

One hundred women treated for carcinoma of the cervix were interviewed more than one year later to establish the effects of radiation or surgical therapy on sexual function. Forty-three had received irradiation, 44 nonradical surgery, six combined surgery and irradiation, and seven radical surgery. The irradiation and nonradical surgery groups were each further subdivided into subgroups of patients aged 30 to 49 for age-controlled comparison. Patients in the irradiation group had statistically significant decreases in sexual enjoyment, ability to attain orgasm, coital opportunity, frequency of intercourse, and coital desire. The group who had nonradical surgical procedures had no significant change in sexual function after treatment. Similar results were found in both age-controlled subgroups, eliminating age as a major etiologic factor. Marked vaginal alterations were recorded in the majority of irradiated patients, but were not present among the groups treated with nonradical surgery. The vaginal changes alone could not be held accountable for the significant decrease in sexual function among women who received pelvic irradiation. The origin of decreased sexual desire after radiation therapy is complex, and not yet completely understood. We propose therapeutic programs to help women deal with the emotional and physical consequences of pelvic irradiation.