Masked depressions in obstetrics and gynecology.

The development of psychosomatic symptoms should not be viewed exclusively under the aspect of anxiety or defense against anxiety. In another study, we have shown that affects other than anxiety can lead to functional obstetric disturbances (2). The insight that depressions, above all masked depressions can be the basis of many psychosomatic symptoms in obstetrics and gynecology paves the way for good therapeutic possibilities in many cases that have been resistant to therapy heretofore. Antidepressants often bring prompt relief from symptoms. Psychotherapy is possible in numerous cases following success in prescribing antidepressants.     

Somatization disorders in obstetrics and gynecology

Summary Somatization refers to the phenomenone of physical symptoms not being conditioned by physical structural defects but primarily by mental processes. The basic understanding integrating psychodynamic, cognitive behavioral and systemic views conceptualized the underlying process as a signal processing circle in which the perceptual, interpretative and the effectiv-behavioral part interact in a dysfunctional manner. The clinical entities of this basic mechanism are variable in the localization and intensity of the symptoms which is reflected in the existing classification of ICD 10 and DSM IV. These classifications do not differentiate between gender. In obstetrics and gynecology somatization disorders are quantitatively important and qualitatively distinct. The pathogenetic factors are linked to gender specific biopsychosocial conditions, psychoendocrine interactions and genital organ subjective experiences. Therefore we propose a gender-sensitive classification into three groups of somatization disorders: Somatizing reactions during specific life phases or transitional periods, pychoendocrine disorders and somatoform disorders of the female genital organs. In each group the dysfunction may manifest itself mainly on the perceptual part or the effective-behavioral part of the signal processing circle. The pathogenetic pathways, comorbidities, specific diagnostic and therapeutic interventions for these different groups are summarized. Accepted October 6, 2002; Published online December 9, 2002 Correspondence: Prof. Johannes Bitzer, Department of Social Medicine and Psychosomatics, University Hospital of Gynecology and Obstetrics Basel, Schomzenstrasse 46, CH-4031 Basel, Switzerland; e-mail: jbitzer@uhbs.ch     

Herpes simplex pancreatitis

Lesions of the pancreas induced by viral infection have drawn relatively little attention because of their low incidence, and the histopathologic features of viral pancreatitis have not been fully elucidated. We report the autopsy findings of 2 patients, a 59-year-old woman with allergic granulomatous angiitis and a 73-year-old man with invasive pulmonary aspergillosis who had a disseminated visceral herpes simplex virus (HSV) infection. In both cases, the liver was the organ most severely affected by the viral infection. The pancreas showed multiple small foci of hemorrhagic necrosis, which were not accompanied by fat necrosis of the surrounding adipose tissue. Histopathologically, Cowdry type A intranuclear inclusions and a ground-glass appearance of the nuclei were found in many degenerated acinar cells around the necrotic foci. The gross appearance and histopathologic features of HSV pancreatitis were characteristic and, in particular, distinct from those of the more common acute hemorrhagic pancreatitis. Immunohistochemistry using an anti-HSV antibody revealed immunoreactivity in the intranuclear inclusions and ground-glass nuclei, and polymerase chain reaction analysis disclosed that the causative virus in these 2 cases was HSV-1. Herpes simplex virus pancreatitis constitutes a rare, but distinct pathologic entity among a group of acute pancreatitis diseases with diverse etiopathogenesis.     

Herpes simplex lymphadenitis

Localized herpetic lymphadenitis is an extremely uncommon complication of herpes simplex virus (HSV) infection. The authors report two cases of localized herpetic lymphadenitis, both showing well-circumscribed areas of necrosis containing cells with diagnostic intranuclear inclusions. Electron microscopic studies in both cases revealed characteristic viral particles, and in situ hybridization studies using a herpes simplex genomic probe demonstrated HSV DNA in both specimens. Immunohistochemical studies demonstrated that the cells containing the inclusions were stromal, not lymphoid, cells. Combining the current two cases with the six well-documented cases previously reported in the literature, seven of the eight cases of HSV lymphadenitis have developed in inguinal lymph nodes, with four occurring in patients with previously or subsequently diagnosed hematopoietic malignancies, including both patients in the current series.     

生物止血材料在妇产科手术中的应用

背景：良好的生物敷料或纱布可直接促进凝血过程,不仅可用于广泛渗血创面,且在一些常用的妇产科手术中能有效降低渗血率。 目的：评价不同生物止血敷料及纱布的材料学性能及应用于妇产科切口的生物相容性,寻找符合不同切口创面需要的止血材料。 方法：采用电子检索的方式,在万方数据库(http://www.wanfangdata.com.cn/)中检索1999-01/2011-04有关妇产科生物止血材料应用的研究文章,关键词为“妇产科,生物材料,止血敷料,纱布,胶原/壳聚糖”,排除重复研究、普通综述或Meta分析类文章,筛选纳入30篇文献进行评价。 结果与结论：近几年国内外生物医用可吸收止血材料主要包括纤维蛋白胶、壳聚糖、明胶海绵、氰基丙烯酸酯类组织胶、氧化纤维素和氧化再生纤维素等。各种止血性伤口急救材料都有各自的特点,但在妇产科应用的选择上,应考虑多方面因素,包括手术部位、出血部位、切口形态大小、不同渗/出血情况的填塞要求、不同止血材料的自身性能及与机体的相容性等。但因目前尚无完全符合理想标准的材料,因此开发新的快速止血和与宿主相容性良好的止血材料及复合材料势在必行。     

Herpes simplex oesophagitis

A patient is described with oesophageal ulceration due to herpes simplex virus type I. The endoscopic, light, electron microscopic, and immunohistochemical appearances are described and the literature of this under-diagnosed entity is reviewed.     

妇产科课堂语言的艺术化探讨

课堂教学是一项具有科学性和艺术性的工作[1-3]。作为一名医学教育工作者,现就如何提高妇产科学的课堂教学效果的问题,谈几点体会。1艺术化语言使用医学生面临的一大困难是需要记忆的内容太多,如何使学生记住课堂的教学内容,笔者认为在保证教学的科学性的前提下,使用形象、生动     

Foreign medical apparatus for obstetrics and gynecology

Biomedical Engineering -