57 couples who attended our outpatient department for artificial insemination with donor sperm (AID) had a detailed semistandardized interview prior to treatment. The Giessen Test was used as personality test, as well as a questionnaire concerning the sexual and partner relationship. We found that it was the woman who had to bear the major part of the intrapsychic burden and who primarily suffered because of the problem which was actually caused by male sterility. However, 54 of 57 couples had no psychological difficulties to overcome the sterility problem. These couples developed individual and partnership strategies to deal with the burden of unwanted childlessness. They preferred AID rather than adoption, because for the woman this alternative offers the chance of real parenthood. AID seems to provide a medico-technical solution for couples with sterility problems: the reproductive process at the biological level was regarded as distinctly separated from their future role as parents which they considered to be a social task.
This is a report on a young patient with dysgerminoma of the right ovary. Right-side adnexectomy and hysterectomy were performed initially. Due to the clearly elevated tumour marker levels, indicating an involvement of other germ cell elements, we opted for postoperative chemotherapy instead of radiotherapy. The follow-up included regular monitoring of the tumour markers. To date, there has been no indication towards tumour recurrence.
Burning pain and autonomic disorders, such as change of skin color, hyperhidrosis, edema and stiffness in joints of extremities were first described in 1864 by Silas W. Mitchell. The German expression "Morbus Sudeck" takes its name from the surgeon Paul Sudeck from Hamburg who described spotty decalcification in x-rays in 1900. In the Anglo-Saxon world, the theory that the sympathetic nervous system was involved in the generation and sustention of these alterations was based on the observations of the French surgeon René Leriche and in 1846 James A. Evans introduced the expression sympathetic reflex dystrophy. As doubts arose that the sympathetic nervous system could not be the sole culprit, the descriptive phrase of complex regional pain syndrome was introduced to substitute for more than 60 synonyms focusing on the fact that the disease develops after minor trauma or nerve lesions and does not correlate with the severity of the trauma. Diagnosing this syndrome is still hampered by the fact that no specific laboratory or radiological marker has yet been identified. Multidisciplinary and interdisciplinary approaches to therapy seem to be inevitable. Since Sudeck first described the disease, 110 years have passed. The underlying hypothesis and theories as well as the development during this time period are summarized.
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