Synchronous primary tumors: appendiceal and ovarian cancer--case report.

A 64-year-old women was operated on for acute abdomen and both appendiceal and ovarian tumors were found. Histology revealed synchronous adenocarcinoma of the appendix and serous pappillary carcinoma of the right ovary. The patient was given adjuvant chemotherapy and received six cycles of cisplatinum. Regular follow-up showed no recurrence of the two synchronous primary tumors. A rare case of synchronous primary tumors of appendiceal and ovarian origin is reported. The tumors proved to be difficult to treat requiring several combined medical therapies, including surgery, chemo- and radiotherapy.

[Drug therapy of Graves' disease in pregnancy]. / Medikamentozna terapija Gravesove bolesti u graviditetu.

An analysis was made of 75 pregnant patients who received medicamentous therapy for Graves' disease before the investigated pregnancy and 20 healthy pregnant women with normal pregnancies and term delivery. A severe form of hyperthyreosis was found in 35 examined persons. A separate analysis was made of the patients who had no previous therapy (17) and pregnant patients who were treated with antithyroid drugs (18), with the aim to investigate their effect on the course and outcome of pregnancy and the condition of the newborn infant. In all examined pregnant women the median values with standard deviations for TSH, T4 and T3 in each trimester of pregnancy, the dynamics of their trends, as well as the correlation of values in treated and untreated pregnant women were recorded. The analysis of the pregnancy course in patients with hyperthyreosis indicated a significantly higher incidence of gestational diabetes and EPH gestoses (p less than 0.001). A separate analysis indicated that hyperthyreoidism is one of the risk factors in the occurrence of gestational diabetes. There were 90% of pregnant women who were delivered in an euthyroid condition achieved before pregnancy and maintained during pregnancy, 85% with mild and 77.1% with severe hyperthyreosis. The comparison of treated and untreated patients indicated that the percentage of delivered patients is similar (77.8:76.4), while the incidence of spontaneous abortions was higher (16.7:11.8) and of fetal deaths lower (5.5:11.8). There was one stillbirth in an untreated patient, while the remaining infants were healthy. The authors are of the opinion that it is necessary to achieve remission before pregnancy. In patients with severe hyperthyreosis the authors suggest the administration of antithyreoid drugs.

[Cervical clefts as a possible etiologic factor in sterility]. / Rascepi grlica materice kao moguci etioloski faktor steriliteta i infertiliteta.

Follow-up gynecological and colposcopic examinations performed in 81 patients after the puerperium have shown that out of 15 sutured ruptures only 9 (60%) healed. The follow-up colposcopic examination revealed 19 unstitched clefts of which 13 did not heal and 6 healed leaving a scar (31.5%). The ectopy of the cervical mucosa was found 5 times (33.3) in the group of stitched clefts and 8 times (47.3%) in the group of unstitched clefts, among which there was also leukoplakia in one case. In the group without the injury of the cervix, ectopia was observed in 11 cases (23.4%). In the course of 1979, at the Gynecology Department, cerclage was performed 474 times. Out of these cases, 20 women (4.2%) underwent cerclage owing to the cleft of the uterine cervix and previous spontaneous abortions. The authors recommend a careful surgical treatment of the cleft and consider the revision of the cervix after each delivery absolutely necessary, both these measures being meant to serve as prevention against sterility and infertility.