An investigation on first-week mortality in layers.

The quality of day-old chick placement and management upon arrival have a major impact on first-week mortality (FWM) and subsequent welfare in layers. The present study investigated FWM and causes of FWM in 50 flocks of layers. Post mortem results from 983 chickens showed that 50% died from infections, whereas noninfectious causes, in particular dehydration and nephropathy with visceral gout, made up the remaining causes of mortality. Escherichia coli and Enterococcus faecalis were identified as the most significant bacterial pathogens associated with FWM. Statistical analysis demonstrated a significant correlation between FWM and total mortality during rearing, and a model predicting total mortality in the rearing period based on FWM was established. A statistically significant correlation between FWM and uniformity of the flock was not demonstrated at 1-2 wk of age or at approximately 15 wk of age. Genetic characterization of E. coli and E. faecalis provided evidence for a polyclonal nature of these infections in affected flocks, indicating different sources of infection. Results obtained underline the importance of minimizing FWM to a level less than 1%.

Surgical treatment for distal tubal occlusion. A review of 167 cases.

Surgery was performed on 167 patients for distal tubal occlusion. In 143 cases a terminal microsurgical salpingostomy was performed and in 24, a cuff neostomy. The overall intrauterine pregnancy rate was 20.4%, and 16.8% of the patients had live births. The ectopic gestation rate was 1.8%. None of the patients with a cuff neostomy became pregnant.

Morphological alterations of rabbit oviducts following ligature of the tubal isthmus.

An animal model of tubal sterilisation would be valuable in order to examine the problem of severe damage of the tubal wall and to study the criteria for optimal anastomosis. In a preliminary experimental group the Fallopian tubes of 30 rabbits were ligated at the isthmic segment. Specimens of the ligated portion and other tubal segments have been investigated by light microscopy and scanning and transmission electronmicroscopy one, four and twelve weeks following the ligature. Changes in the Fallopian tubes following the ligature were limited to the ligated portion. The morphological findings consisted of a flattening and decrease of differentiation of the mucous epithelium, and of a slight scarring in the tubal wall and in the subperitoneal tissue within the constricted segment. Tubal ligation at the isthmic segment provides good conditions for refertilisation, following resection of the altered portion and microsurgical anastomosis.

[Reconstruction of fallopian tubes using microsurgical technics (author's transl)]. / Uber die Anwendung mikrochirurgischer Techniken bei rekonstruktiven Operationen an der Tube.

The results of reconstructive tubal surgery improved significantly since microsurgical technics were introduced. Nowadays microsurgery is the procedure of choice for salpingolysis, salpingostomy, reanastomosis reversal of sterilisation and conservative repair of an ectopic pregnancy. Successful reversals of sterilisation demonstrate the advantage of the microsurgical technics in the best way. Tubal sterilisation isn't irreversible any longer but it still should be recommended as a definitive method. Because of the high technical effort reversal of sterilisation can be done in exceptional cases only. In young women the possibility of a reversal must be considered and a sterilisation operation should be done in an adequate and careful way.

[The value of microsurgical techniques in tubal surgery (author's transl)]. / Uber den Stellenwert mikrochirurgischer Techniken bei der operativen Therapie der tubaren Sterilität

Tubal surgery by help of microsurgical techniques was performed in 86 women from January 1976 until December 1978. 70 patients suffered from tubal sterility due to pelvic inflammatory disease. 16 women asked for reversal of sterilization. As result of 83 operations 17 life births respectively undisturbed intrauterine pregnancies were achieved. Two patients had an abortion. Three more pregnancies could not be added to the success rate, because in these women we found only one blocked tube intraoperatively, while the contralateral one seemed to be intact. Up to now we haven't had an ectopic pregnancy. In 39 patients the operation was done within the last half year. The value of microsurgery in the field of tubal reconstructive surgery is discussed in regard to the literature and to our own experiences and operative results.

PIP: Microsurgical techniques were used for tubal reconstruction for sterility due to pelvic infection in 70 patients and for reversal of tubal sterilization in 16 patients. Procedures included tubal reanastomosis following inflammation or ligation, and lysis of adhesions impairing mobility of the tubes and fimbria; many patients had more than 1 procedure. Pregnancies have been reported in 19 patients. Of these, 2 have ended in miscarriages, and 13 in live births; 4 other pregnancies are still in progress. Since 39 patients were treated within the past 6 months, it is expected that more pregnancies will be observed in the group.

Morphology of rabbit oviduct after microsurgical techniques for reanastomosis of the isthmus or ampulla.

Using microsurgical techniques and two layers of sutures, we reanastomosed 66 rabbit oviducts; 35 had been divided in the isthmic region and 31 in the ampullary region. With light microscopy as well as transmission and scanning electron microscopy we studied anastomosed segments and the rest of the oviducts 1 day, 1 week, and 4--12 weeks after operation. -- In the vicinity of the sutures we found slight scarring, some flattening of the mucosal epithelium with loss of differentiation and, most important, displacement of the mucosa into the muscle wall of the tube with the development of irregular diverticuli. The significance of these alterations and their possible relation to the occurrence of tubal ectopic pregnancy is discussed. We recommend that care should be taken to avoid the mucosa during total anastomosis.

[Microsurgical reversal of sterilization: experiences and results in 119 cases]. / Sterilisation--Refertilisierung. Erfahrungen und Ergebnisse bei 119 mikrochirurgisch refertilisierten Frauen.

From January 1976 to March 1982 119 microsurgical reversals were performed. Most of these women were not older than 30 years at the time of sterilization. A new partnership was the main reason for a request of reversal. Up to now 69 patients (58,0%) achieved an intrauterine pregnancy. Ectopic pregnancies occurred in 3 women (2,5%). The prognosis of a reversal depends mainly on the remaining length of the fallopian tube and the site of the anastomosis. For isthmo-isthmic anastomoses the intrauterine pregnancy rate was 80%. Due to today's high divorce rates tubal sterilization in women younger than 30 years should be based on a well founded indication. In younger patients only such sterilization techniques should be performed, which offer the highest chances for reversal.

PIP: Between January 1976-March 1982, 119 microsurgical reversals were performed. Most of these women were not older than 30 years at the time of sterilization. A new partnership was the main reason for the request of reversal. Currently, 69 patients (58%) have achieved an intrauterine pregnancy. Ectopic pregnancies have occurred in 3 women (2.5%). The prognosis of a reversal depends mainly on the remaining length of the fallopian tube and the site of the anastomosis. For isthmo-isthmic anastomoses, the intrauterine pregnancy rate was 80%. Due to a high divorce rate prevalent today, tubal sterilization in women younger than 30 years should be based on serious indications. In younger patients, only such sterilization techniques should be used which offer the highest chances for reversal. (author's modified)