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V. Jaschke, R.: Circulatory Apparatus and Myomata
ABSTRACTS
177
Randa.ao, M.: Sterility and Uterine Fibroids, Monatsch. f. Geburtsh. u. Gyniik. 98: 270, 1935. The relationship between uterine fibroids and sterility is a double one. Thtre is no doubt that uterine .fibroids can cause sterility. On the other hand, there is no unity of opinion among gynecologists that sterility may be the cause of the development of myomas. We know that fibroids frequently oecur in elderly, unmarried women and in nuns, i. e., among women whos<: reproductive function~ are not exercised. The author attempts to solve the connection between sterility and the development of myomas. He first shows that tl e ovaries stimulate the growth of the .fibroids. From a study of 358 eases of fibroids he tries to .~how that the sterility which is associated "l'lrith .fibroids is due only in small part to the presence of the myomas. He found that in 60 per c•mt of the cases the 1n, terval of time which elapsed between the last pregnancy and the discovery of the fibroids was more than six years. He feels justified, therefore, in assuming tl:at the sterility was not only the possible but the actual cause of the growth of the .fibroids. He adds that there must be, of course, a predisposition to the development of the tumors. The sterile or slightly fertile woman develops a fibroid as if a biologic law of woman punishes her because ~hP either wilfully or involuntarily does not propagate. .T. P. GREENHILL.
v.
Jaschke, R.: 1933.
Circulatory Apparatus and Myomata, Arch. f. Gynfi.k. 155: 6,
In 962 patients with fibroids, 601 (62 per cent) had an absolutely normal circulatory apparatus. Only 77 patients (8 per cent) s:t10wed cardiae changes which might be related to the presence of the tumors. The remainder had arrhythmias, functional murmurs, valvular disease, thyroid hearts, etc. In 21 of the 77, the heart muscle damage could be attributed to emphysema, malnutrition, previous infectious diseases, etc. The remaining 56 women showed definite myocarditis and the e:ffeets of prolonged secondary anemia. These cardiae changes must be attributed to the protracted bleeding and the severe secondary anemia rather than to the presence of the myomas since the same type of changes are found following the hemorrhages of carcinoma, metropathia hemorrhagiea and in all other forms of severe secondary anemia. The term '' myomaheart'' is a misnomer. Myomas per se have no effect upon the heart or the eir,•ulatory ap·· paratus. RALPH A. REil:l.
Cotte, G., and Mathieu, J.: Some Cases of SpontaD.eous :PhlebitiS During the Evolution of Uterine Myomas, Gynec. et obst. 30: 209, 1934. In the opinion of Cotte and Mathieu, the appearance of phlebitis during the evolution of a myoma should always be considered as a serious complication, since, in addition to accidents which may arise from the phlebitis itself, it may be followed by an infarct or an embolus. In cases where there are no complica· tions it is not necessary to interfere. However, where it is urgent to operate, as for example in a case of an infected myoma with gangrene, one may ligate the hypogastric veins before removing the tumor. This necessity is rare. After spontaneous cure of phlebitis it is unwise to wait for a spontaneous cure of the myoma. It is best to remove the tumor by myomectomy or hysterectomy. By these procedures not only accidents due to the myomas but also the recurrence of phlebitis are prevented. J. P. GREENHILL.
177
Randa.ao, M.: Sterility and Uterine Fibroids, Monatsch. f. Geburtsh. u. Gyniik. 98: 270, 1935. The relationship between uterine fibroids and sterility is a double one. Thtre is no doubt that uterine .fibroids can cause sterility. On the other hand, there is no unity of opinion among gynecologists that sterility may be the cause of the development of myomas. We know that fibroids frequently oecur in elderly, unmarried women and in nuns, i. e., among women whos<: reproductive function~ are not exercised. The author attempts to solve the connection between sterility and the development of myomas. He first shows that tl e ovaries stimulate the growth of the .fibroids. From a study of 358 eases of fibroids he tries to .~how that the sterility which is associated "l'lrith .fibroids is due only in small part to the presence of the myomas. He found that in 60 per c•mt of the cases the 1n, terval of time which elapsed between the last pregnancy and the discovery of the fibroids was more than six years. He feels justified, therefore, in assuming tl:at the sterility was not only the possible but the actual cause of the growth of the .fibroids. He adds that there must be, of course, a predisposition to the development of the tumors. The sterile or slightly fertile woman develops a fibroid as if a biologic law of woman punishes her because ~hP either wilfully or involuntarily does not propagate. .T. P. GREENHILL.
v.
Jaschke, R.: 1933.
Circulatory Apparatus and Myomata, Arch. f. Gynfi.k. 155: 6,
In 962 patients with fibroids, 601 (62 per cent) had an absolutely normal circulatory apparatus. Only 77 patients (8 per cent) s:t10wed cardiae changes which might be related to the presence of the tumors. The remainder had arrhythmias, functional murmurs, valvular disease, thyroid hearts, etc. In 21 of the 77, the heart muscle damage could be attributed to emphysema, malnutrition, previous infectious diseases, etc. The remaining 56 women showed definite myocarditis and the e:ffeets of prolonged secondary anemia. These cardiae changes must be attributed to the protracted bleeding and the severe secondary anemia rather than to the presence of the myomas since the same type of changes are found following the hemorrhages of carcinoma, metropathia hemorrhagiea and in all other forms of severe secondary anemia. The term '' myomaheart'' is a misnomer. Myomas per se have no effect upon the heart or the eir,•ulatory ap·· paratus. RALPH A. REil:l.
Cotte, G., and Mathieu, J.: Some Cases of SpontaD.eous :PhlebitiS During the Evolution of Uterine Myomas, Gynec. et obst. 30: 209, 1934. In the opinion of Cotte and Mathieu, the appearance of phlebitis during the evolution of a myoma should always be considered as a serious complication, since, in addition to accidents which may arise from the phlebitis itself, it may be followed by an infarct or an embolus. In cases where there are no complica· tions it is not necessary to interfere. However, where it is urgent to operate, as for example in a case of an infected myoma with gangrene, one may ligate the hypogastric veins before removing the tumor. This necessity is rare. After spontaneous cure of phlebitis it is unwise to wait for a spontaneous cure of the myoma. It is best to remove the tumor by myomectomy or hysterectomy. By these procedures not only accidents due to the myomas but also the recurrence of phlebitis are prevented. J. P. GREENHILL.