[Carl Gustav Carus, the first director of the newly established maternity institute of the Dresden Royal Surgical-Medical Academy 1814-1827]. / Carl Gustav Carus, der erste Direktor des neu eingerichteten Entbindungsinstitutes an der Königlichen Chirurgisch-medicinischen Academie in Dresden 1814-1827.

Carl Gustav Carus was born in 1789 in Leipzig. He studied at the University of Leipzig. His specialization in Gynecology and Obstetrics took place at the Triersches Maternity Hospital. In 1814 he was named Professor for Obstetrics in Dresden at the Royal-Surgical-Medical-Academy. He was the head of the Maternity Hospital till 1827. Under his direction many midwives, students and physicians were educated. He published numerous articles and books on medical and philosophical-psychological topics. He was a talented artist of the Romantic especially in painting landscapes. He was a friend of Caspar David Friedrich and Johann Wolfgang von Goethe. After 1827 he was the physician in ordinary to 3 saxonian kings. He died in 1869. The Medical Academy in Dresden bears his name "Carl Gustav Carus" since its foundation.

[Surgical management of abscessing mastitis and of retromammary abscesses]. / Die chirurgische Behandlung der abszedierenden Mastitis und des retromammären Abszesses.

This paper analyses the frequency of abscess-forming mastitis and retromammary abscess in evaluating patients of 11712 births from 1972 to 1978. In 69 cases we found an abscess-forming mastitis and in 6 cases a retromammary abscess. In differential diagnosis there are discussed the clinical symptoms of both diseases. Whereas in the case of intramammary abscess a radial incision with contra-incision and drainage is made, the retromammary abscess indicates a curved incision according of the retromammary abscess are not so frequent but must be taken into consideration in the differential diagnosis of inflammatory diseases of the mamma during puerperium.

[Principles of prophylaxis, early detection, treatment and follow-up of gestational trophoblastic tumors]. / Grundsätze zur Prophylaxe, Früherfassung, Behandlung und Nachsorge von gestationsbedingten Trophoblasttumoren.

The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of gestational trophoblastic tumours recommended by the Central Institute of Cancer Research as well as the Medical Association of the German Democratic Republic.

[Principles in prevention, early detection, treatment and after care of endometrial cancer]. / Grundsätze zur Prophylaxe, Früherkennung, Behandlung und Nachsorge des Endometriumkarzinoms.

The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of endometrial cancer recommended by the Central Institute of Cancer Research as well as the Medical Associations of the German Democratic Republic.

[Pregnancy course, labor and puerperium in nephrectomized pregnant patients]. / Schwangerschaftsverlauf, Geburt und Wochenbett bei nephrektomierten Graviden.

The coincidence of pregnancy and situation after nephrectomy is rare. Pregnancy, delivery and puerperium of 28 patients with nephrectomy were analysed and compared statistically with a control group from 200 healthy pregnant women. Abortion rate, incidence of gestosis, perinatal mortality and frequency of premature deliveries are not increased. The pregnancy of women after nephrectomy should be controlled in a special prenatal care service. Delivery and puerperium do not need any increased medical expense.

[Principles of prevention, early detection, treatment and after care of ovarian cancer]. / Grundsätze zur Prophylaxe, Früherkennung, Behandlung und Nachsorge des Ovarialkarzinoms.

Principles of prophylaxis and early diagnosis are reviewed and recommendations about therapy and follow-up are given, licensed by an expert committee.

[Principles of prevention, early detection, diagnosis, treatment and after care of malignant neoplasms of the vagina]. / Grundsätze zur Prophylaxe, Früherkennung, Diagnostik, Behandlung und Nachsorge bösartiger Neubildungen der Vagina.

The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of malignant tumours of the vagina recommended by the Central Institute of Cancer Research as well as the Medical Associations of the German Democratic Republic.

[Principles of prevention, early detection, treatment and after care of malignant neoplasms of the fallopian tube]. / Grundsätze zur Prophylaxe, Früherkennung, Behandlung und Nachsorge bösartiger Neubildungen der Tube.

The paper is the summary of a workshop and contains guidelines for prophylaxis, early detection, treatment and follow-up of malignant tumours of the fallopian tube recommended by the Central Institute of Cancer Research as well as the Medical Associations of the German Democratic Republic.

[Principles of prevention, early detection, diagnosis, treatment and after-care of malignant neoplasms of the vulva]. / Grundsätze zur Prophylaxe, Früherkennung, Diagnostik, Behandlung und Nachsorge bösartiger Neubildungen der Vulva.

Screening for malignant tumours of the vulva cannot be proposed, but multiple biopsies from suspicious areas. Histological classification of WHO and ISSVD as well as staging of UICC and FIGO are recommended. Operative therapy should be preferred if possible, in the other cases irradiation with electrons.

[Principles of the prevention, early detection, treatment and aftercare of cervix cancer]. / Grundsätze zur Prophylaxe, Früherfassung, Behandlung und Nachsorge des Zervixkarzinoms.

The WHO classification of epithelial tumors of the uterine cervix is recommended. Cytology is more suitable as colposcopy as screening method. The best method for diagnosis is cone biopsy. Dysplasia and carcinoma in situ may be treated stepwise, whereas invasive carcinoma must be operated on radically by abdominal route or irradiated.

[Principles of prevention, early diagnosis, treatment and after-care of gestational trophoblastic tumors]. / Grundsätze zur Prophylaxe, Früherfassung, Behandlung und Nachsorge von gestationsbedingten Trophoblasttumoren.

Principles for prophylaxis, early diagnosis, therapy and after-care of gestation-caused trophoblast tumors are discussed. With this basis interdisciplinarily co-ordinated recommendations are given for therapy and after-care, which have been elaborated by a group of specialists.

[Postoperative radio- and/or chemotherapy in ovarian stage III cancers. Results of a prospective randomized study]. / Zur Frage einer postoperativen Radio - und/oder Chemotherapie bei Ovarialkarzinomen Stadium III. Ergebnisse einer prospektiv-randomisierten Studie.

In advanced ovarian carcinoma operation alone does not give any change of permanent cure. Therefore an additional treatment is necessary. From 1977 to 1980 we performed a prospective random study about the significance of postoperative radio- and chemotherapy (group A, n = 20) versus combined longterm chemotherapy (group B, n = 24) in ovarian carcinoma stage III. Radical operation was possible in 82% of all cases. 8 of them (18%) occasionally a second-look operation (A = 2, B = 6). Radiotherapy was a whole abdomen irradiation (Co60-teletherapy-40 Gy in two series, pelvis additional 20 Gy) by means of open field technique. Cyclophosphamide, methotrexate, 5-fluorouracile and vinblastine were used for the purpose of chemotherapy. The survival time was not significantly prolonged in group B (20,4 months) compared to group A (13,9 months). 44% (B) survived three years contrary to 36% (A); after four and five years survival rates are equal in both groups (A = 36%, B = 37%). Thus additional radiotherapy does not improve survival rate. On the other hand there are considerable side-effects and tolerance against chemotherapy is diminished. That is why a general radiotherapy is not recommendable in the present modification.

[Intra-arterial chemotherapy in advanced ovarian cancers. 2. Therapeutic results in relation to prognostic factors]. / Intraarterielle Chemotherapie bei fortgeschrittenen Ovarialkarzinomen. 3. Mitteilung: Therapieergebnisse in Abhängigkeit von den Prognosefaktoren.

85 patients with advanced ovarian carcinomas were treated either intra-arterially with MTX and 5-FU, later systemically with the CMFV-combination (therapy arm A) or only systemically (therapy arm B) after randomization. The achieved rates of remission and survival time showed an obvious dependence on the histological type of tumor and on the degree of differentiation. Whereas the results of the treatment were nearly identical in both groups of treatment with badly differentiated carcinomas, a significant improvement could be achieved by the initial local treatment of well and moderately differentiated malignancies. More than one third of the cases of advanced tumors were operable by local chemotherapy. Thus the survival time could be extended. The intra-arterial chemotherapy represents an expensive, but effective method of treatment of advanced ovarian carcinomas.

[Intra-arterial chemotherapy in advanced ovarian cancer. 1. Study conditions and prognostic factors]. / Intraarterielle Chemotherapie bei fortgeschrittenen Ovarialkarzinomen. 1. Mitteilung: Studienbedingungen und prognostische Faktoren.

The significance of intra-arterial chemotherapy in connection with progressive ovarial carcinomas was investigated within a prospective-randomized study. The patients were selected according to strict precaution in consideration of the factors of prognosis. After operative staging 43 patients got an intra-arterial infusion of MTX and 5-FU, later systematically CMFV (therapy arm A). 42 women were only systematically treated with the CMFV combination (therapy arm B). The histological grading proved as most important feature for the judgement of the malignant power of the tumors. A reliable correlation was found between stage, typing and grading of the tumor which is significant for the individual planning of therapy. A significant improvement of the results of survival could be achieved by intra-arterial therapy in a comparable initial state in both particular groups. This comes close to DDP containing combined schedules. Thus second-line drugs were available during repeated tumor progredience.

[Intra-arterial chemotherapy in advanced ovarian cancer. 2. Technic, results, complications]. / Intraarterielle Chemotherapie bei fortgeschrittenen Ovarialkarzinomen 2. Mitteilung: Technik, Ergebnisse, Komplikationen.

Between 1978 and 1984 43 patients with advanced ovarian carcinomas got intra-arterially MTX and 5-FU after being operated, later they received systemically a CMFV chemotherapy (therapy arm A). 42 patients were treated systemically only with a CMFV combination. The results and complications of both types of treatment were evaluated according to theoretical and technical basis of the intraarterial infusion. The intra-arterial chemotherapy led to a significant better rate of remission (74 per cent in therapy arm A compared with 62 per cent in therapy arm B) because of a rapid induction of remission. The cumulative survival time was significantly extended to 27 months compared with 16 months after systemic therapy only.

[Epidemiology and clinical aspects of adenomatous and squamous epithelial cancers of the uterine cervix]. / Epidemiologie und Klinik adenomatöser und plattenepithelialer Karzinome der Cervix uteri.

Compared studies on the epidemiology and clinic of adeno- and squamous-cell carcinoma of the uterine cervix are being carried out by means of a retrospective investigation. 1,481 cervix cancer patients were treated from 1972-1983. Among them were 64 adenocarcinoma patients who were compared with a group of squamous-cell cancer patients equal in number. It could be found out that the number of adenomatous cervical cancer has not become more frequent during the last 20 years - with 4.3% taking only a comparatively small portion within cancer of cervix uteri. There are not any appreciable differences between both cancer groups regarding such epidemiological features like average age, menarche, kohabitarche, number of pregnancies and deliveries as well as high risk behaviour and contraceptive habits. Chronic or frequent occurring cervicitis seems to be a common risk factor. For that reason it is of great importance to pay special attention to diagnosis and therapy of inflammations in the uterine cervix. Although 36% of the women treated took oral contraceptives a causal connection between the taking in of these preparations and the development of neoplasia could not be confirmed. Progress of the disease and healing tendencies have shown that adequate therapy - being in accordance to the respective stages - is effective in the mentioned histological variants of cervical cancer. Adeno- and squamous-cell carcinoma do not differ essentially concerning epidemiological and clinical features. It is assumed that pathological epithelial qualities show similar carcinogeneses.

[Therapy and course in 105 borderline tumors of the ovary]. / Therapie und Verlauf bei 105 Borderline-Tumoren des Ovars.

A report is given on 105 patients with borderline tumours of the ovary who were treated from 1953 till 1984. 78 patients suffered from epithelial, 27 from sex cord stromal or germ cell tumours. The average age of all patients was 47.7 years. 67 patients (63.8%) underwent radical operation, whereas 38 patients (36.2%) only underwent unilateral adnexectomy. Additional treatment was applied in 10 cases. Out of 78 woman with epithelial tumours 69 (88.4%) survived 5 years, 58 (74.4%) 10 years, at which the 10-years survival time is significantly higher after radical operation, which is shown by a percentage of 81.3%, compared with 51.9% after conservative operation. Over 90% of the 27 woman suffering from nonepithelial tumours survived 5 years, 87.5% 10 years, out of whom 91% had undergone conservative and 76% radical operation. Due to the existing risk radical operation is recommended in case of borderline tumours of the ovary, especially of those with epithelial origin. However, in case of young woman wanting to have children a conservative operative approach appears to be justified with observance of strict safety precautions.

[Malignant melanoma of the vagina]. / Das maligne Melanom der Vagina.

The authors present the case of a malignant melanoma of the vagina. Simultaneously was noted a pigmented nodule on the left lower eyelid. This tumour was also diagnosed as a malignant melanoma. On the 38-year-old female patient a radical abdominal hysterectomy with total colpectomy and pelvic lymphadenectomy was performed. Thereafter the tumour of the left eyelid was excised and a bilateral groin dissection was performed. One left inguinal lymph node was pathologically positive involved. In addition the patient was subsequently treated with chemotherapy. She had a disease-free interval of 29 months following the radical surgery. Actual aspects of the therapy of this disease are discussed.

[High-dose progesterone therapy in advanced endometrial cancer]. / Hochdosierte Gestagentherapie fortgeschrittener Endometriumkarzinome.

Since 1973 advanced cases of endometrium carcinoma that cannot be treated by curative therapy have been subjected to high dose gestagen therapy in the gynaecological clinic of the Medical Academy Dresden. With 69 patients, 49.3% complete and 26.1% partial remissions were achieved. A marked improvement of the quality of life could be proved for 73% of the cases. Treatment successes are mainly attributed to the gestagen dose given and to continuous long-term treatment. The wider use of endocrine therapy seems to be justified both in palliative and adjuvant settings. Ten women were chosen at random and subjected to additional chemotherapy with cyclophosphamide, 5-fluorouracile, methotrexate and vinblastin and a complete remission could be achieved in 8 of these cases. Further clinical tests of this therapeutic concept appears to be justified.

[Intra-arterial chemotherapy with methotrexate and 5-fluorouracil in extensive locoregional recurrences of cervix cancer]. / Intraarterielle Chemotherapie mit Methotrexat und 5-Fluorourazil bei ausgedehnten loco-regionalen Rezidiven des Zervixkarzinoms.

The significance of intra-arterial cytostatic drug infusion in connection with histologically confirmed recurrences of squamous carcinomas was investigated within a clinical controlled trial between 1978 and 1985. Patients selection according to strict precaution in consideration of the factors influencing prognosis. After clinical examination, computer-tomographic, sono- and angiographic staging ten patients received MTX and 5FU i.a., completed by intra-venous CMFV-treatment in cases with objective remission of disease (therapy arm A). Six women received FACV-combination only systemically (therapy arm B). One partial (PR) and fife moderate remissions (MR) were achieved by intra-arterial chemotherapy in early time. The median duration of survival was 7.5 month for patients in therapy arm A. Significant prolongation of cumulative survival time (p less than 0.05) was determined only by remission of disease in patients with grade performance status 0-1 WHO. Intra-arterial chemotherapy showed lower toxicity versus systemic FACV- or CMFV-treatment. No complications of using prolonged i.a. infusion by Seldinger's technique were encountered. Further studies for within interdisciplinary scientific research in more chemosensitive malignancies of the female genital tract are warranted.