bluuebunny/crossref_metadata_2025 huggingface dataset:
Ovarian Stimulation for Disordered Ovulatory Cycles
Authors: FRACOG John L. Yovich , Tuvik Ann I , Matson Phillip L. , Willcox David L.
Published: August 2010

A total of 391 “ovulatory” women with unexplained infertility had 1,071 treatment cycles (2.74 treatments per patient) with clomiphene citrate (C), human menopausal gonadotrophin (hMG) or a combination of C/hMG; each regimen combined with human chorionic gonadotrophin in the luteal phase. Pre‐treatment monitoring of serum hormones, cervical mucus and ovarian follicle dimensions by ultrasound delineated a relatively narrow range of measurements for “conception” cycles and the term “disordered ovulatory cycles” with follicular or luteal phase defects was applied for those outside the range. At least 70% of treatment cycles responded appropriately and 119 patients conceived (31%) during treatment, showing that “ovulatory” women can benefit by ovarian stimulation. The data also implies that treatment is more likely to be effective for defined ovulatory disorders rather than when given empirically (p>0.05 for clomiphene treatment of follicular phase disorders). However, cervical mucus scores were adversely affected in 22%, of clomiphene treated patients (p> 0.001). This was improved in the C/hMG group and virtually resolved by treatment with hMG alone.
Indication and Outcome of Forceps Deliveries in Lagos: A Study of 553 Cases
Authors: Giwa‐Osagie Osato F. , Ogunyemi Dotun O. , MRCOG Bomi K. Ogedengbe
Published: August 2010

Of 14,982 deliveries between 1976–1981 at LUTH, 553 (3.7%) were by forceps of which 88.4% were mid‐forceps and 11.6% were outlet forceps deliveries. The commonest indication was pre‐eclampsia/eclampsia (34.2%) followed by prolonged second‐stage of labour 23.3%,‐ Fetal distress (6.9%,) and prematurity (2.9%,) were uncommon indications. Seventy‐four (13%,) babies had Apgar >5 at 5 minutes. There were 64 perinatal deaths ‐31 fresh stillbirths, 20 macerated stillbirths and 13 neonatal deaths. Sixty‐three of the perinatal deaths were in cases with pre‐existing maternal, obstetrical or fetal complication, the corrected perinatal mortality rate (PNMR) for this was 184.5/1000 while for the uncomplicated elective cases it was 7.7/1000. Pre‐eclampsia/eclampsia was associated with 30 (47.6%) of the perinatal deaths. PNMR was lowest for babies weighing 3.1–4 kg. There were 7 maternal deaths, 6 from eclampsia. There was morbidity in 14.1% cases, the commonest being P.P.H. (9.1%,).
Identification of Immunosuppressive Factors in Normal Pregnant Serum Affecting Antibody Dependent Cell‐Mediated Cytotoxicity
Authors: Yabushita Hiromitsu , Sawaguchi Keizo , Ishihara Minoru , Itoh Yusei
Published: August 2010

The antibody dependent cell‐mediated cytotoxicity (ADCC) activity of peripheral blood lymphocytes was found to be lower in women experiencing normal pregnancy than in nonpregnant females. This decrease was especially striking during the early stage of pregnancy. It was determined that this decrease is caused by two suppressive factors contained in the pregnant serum. One was a high‐molecular‐weight substance with strong suppressive activity, which was not reduced even when the effector cells were washed. This factor showed binding to IgG Fc‐receptors on the lymphocyte surface and to Protein A. Its ability to suppress ADCC activity was eliminated when precipitation was performed with 4% polyethylene glycol. On the basis of these characteristics, it was surmised that this suppressive factor is an IgG‐immune complexlike substance. The suppressive mechanism of this substance is speculated to be competitive binding to the IgG Fc‐receptors of effector cells, which thereby inhibits the binding of specific antibody to these cells. The second suppressive factor was of low molecular weight, and its activity was lost when the effector cells were washed. This factor did not bind to IgG Fc‐receptors, and it is speculated that the action mechanism of this substance must involve direct action against the ADCC reaction system, thereby inhibiting the cellular metabolism of the effector cells.

Moreover, it was demonstrated that in normal pregnancy there is a positive correlation between the circulating immune complex concentration in the serum and the serum's suppressive effect on the ADCC activity. This finding suggests that the immune complex‐like substance is the principal factor in the suppression of the ADCC activity.
The Effect of Epidural Analgesia on Labour and Delivery in Chinese Women: A Preliminary Experience
Authors: Lao Terence T. H. , So Arthur P. C. , Cheung Y. T.
Published: August 2010

The preliminary experience with the introduction of epidural analgesia as a routine service on cephalic‐presenting vaginal deliveries in a new hospital is reported. The incidence of instrumental deliveries is significantly increased in this group of women. However, further analysis suggests that women with instrumental delivery following epidural analgesia probably had an abnormal dystocic labour to begin with, in contrast to those who delivered spontaneously.
Cardiac Failure Associated with the Use of Salbutamol for Inhibition of Premature Labour
Authors: Tan Seang Lin , Lui Pao Shun , Marjorie Yvonne
Published: August 2010

An unusual case of congestive cardiac failure precipitated by the use of intravenous salbutamol to inhibit premature labour is reported in a patient with no pre‐existing cardiac disease. The vehicle of administration was 5% dextrose and not normal saline as in most other reports and no dexamethasone was given.
Scanning Electron Microscopy of the Human Endometrium in Pill Users
Authors: Nayel Sayed A. , Gawad AH A. , Sibai Farouk A. , Ghanem Ali A. , Olio Mahmoud M. Abo , Shams Ahmed T. , Hebaish Nadia A.
Published: August 2010

Twenty premenstrual endometrial biopsies were examined in 20 fertile women using combined conventional oral contraceptive pills (Anovlar‐1) for periods from 1–15 years using both SEM and light microscopy. Three types of endometria were detected. These were, irregular secretory, suppressed and atrophic endometria. Using scanning electron microscopy the first type showed few ciliated cells with weak cilia as well as collapsed non‐ciliated cells. The second type showed non‐ciliated cells with few signs of secretion. The third type showed rarely ciliated cells, flat secretory cells with no signs of secretions. The longer the duration of pill usage the more were the atrophic changes. Focal glandular proliferation was also detected.
Hyperemesis Gravidarum in Chinese Women
Authors: Chin Robert K. H. , Lao Terence T. H. , Kong Amy M. Y.
Published: August 2010

Abstract

Eighty‐two cases of hyperemesis gravidarum managed in a regional hospital in Hong Kong were reviewed. In contrast to the literature, the incidence of hyperemesis gravidarum in the Chinese population fall within the range reported in the European countries. Most of the women were nulliparous, and women who had 2 or more successful pregnancies seldom have this condition.

The possible role of human chorionic gonadotrophin in hyperemesis gravidarum is discussed.
Screening for Diabetes in Pregnancy in a Nigerian Population with a High Perinatal Mortality Rate
Authors: Abudu O. O. , Kuti J. A.
Published: August 2010

Abstract

Random blood glucose values in pregnancy were determined in normal pregnant Nigerian women at different stages of pregnancy. There was no significant difference between the random blood glucose values in the first trimester (mean 3.23±0.64 Mtnol/l; n = 99) or second trimester (mean 3.1 ±0.63 Mmol/l; n=129) or third trimester (mean 3.2±0.79 Mmol/l; n = 143). The mean random blood glucose value of 3.9± 0.79 Mmol/l in 90 non‐pregnant Nigerian women was significantly higher (p<0.001) than the mean values found in the 3 trimesters of pregnancy.

Using a one hour blood glucose test after a 50g glucose load we screened for diabetes in pregnancy in 336 Nigerian women. Fifteen (4.5%) had blood glucose values of ≥7.2 Mmol/l. Five of these 15 (33%) women had abnormal oral glucose tolerance test (OGTT); an incidence of about 15 undiagnosed diabetic women per 1,000 antenatal population studied. The perinatal mortality in the study group was 15.5/1000 total birth.
Clinical Significance of CA125 and Its Assessement with an Enzyme Immunoassay
Authors: Shi Qui Ying , Sakawaki Tazu , Kasamatsu Tatsuhiro , Ohkura Hisanao
Published: August 2010

Abstract

An enzyme immunoassay (EIA) for CA125 has been developed in Japan with a solid‐phase, sandwich, three‐step assay. A high correlation was observed between CA125 levels assayed by EIA and RIA (r = 0.993) in 256 patients. The cut off value was set at 38 U/ml for healthy females. In patients with non‐gynecological, gynecological but non‐ovarian, and ovarian malignant tumors, the positive rates of CA125 were 17%, 16% and 63%, with mean values of S3 U/ml, 183 U/ml and 1042 U/ml, respectively. In patients with non‐gynecological, gynecological but non‐ovarian, and ovarian benign diseases, the positive rates were 0%, 13% and 31% with mean values of 13 U/ml, 21 U/ml and 30 U/ml, respectively. There is a good correlation between stage and level of serum CA125 in ovarian cancer and CA125 levels correlate with the clinical course of ovarian cancer. Thus CA125 EIA is useful in diagnosis and monitoring of malignant ovarian diseases.
An Immunohistochemical, Scanning, and Transmission Electron Microscopical Study of Intervillous Thrombus
Authors: Ikarashi Toshihiko , Takeuchi Shoshichi , Ohnishi Yoshihisa
Published: August 2010

Abstract

Twenty‐one placentae were examined by light microscopic immunohistochemistry, scanning electron microscopy, transmission electron microscopy, and immunoelectron microscopy for the histogenesis of intervillous thrombus formation. Two possible mechanisms were investigated to explain the structural initiation of intervillous thrombus formation. Either the thrombus occurs precisely on the intravillous stromal fibril or the basal lamina, directly facing the intervillous space, and is derived from the degenerated trophoblastic epithelium in a similar fashion to conventional intravascular thrombus formation, or the thrombus is formed on the degenerated trophoblastic epithelium without any trophoblastic epithelial defects. The villous trophoblastic epithelium is, furthermore, thought to behave in the process of thrombus formation as the endothe‐lium in conventional intravascular thrombosis because the villous trophoblastic epithelium had the same stainability as the endothelium in ultrastructural localization of Factor VIII.
Intravenous Leiomyomatosis of the Uterus: A Light and Electron Microscopic Study
Authors: Konishi Ikuo , Fujii Shingo , Takakura Kenji , Ukita Masahiko , Mori Takahide
Published: August 2010

Abstract

A 45‐year‐old woman with intravenous leiomyomatosis of the uterus underwent total hysterectomy with bilateral salpingo‐oophorectomy and stripping of intravascular cord‐like nodules from within uterine and ovarian veins. Light and electron microscopic studies showed the tumor to possess both extra‐ and intra‐vascular growths, both of which had the same angiomatous features characterized by a palisaded arrangement of smooth muscle‐like cells around the lumina of many small blood vessels. Ultrastructurally, the main tumor cells were those having smooth muscle features. They surrounded endothelial cells and pericytes. The identification of both mature and immature smooth muscle cells in these tumors suggests that multi‐potential mes‐enchymal cells are the source of the tumor. The pattern of palisaded cells arranged around blood vessels, as well as the intra‐ and extra‐vascular growth, suggests an origin in the vascular wall.
Intestinal Parasitism: A Survey of Patients Attending an Antenatal Clinic in the New Territories of Hong Kong
Authors: Rogers Michael S. , Chang Allan M. Z. , French Gary L.
Published: August 2010

Abstract

A prospective survey of patients booking for antenatal care at the Prince of Wales Hosptial was performed, to ascertain the prevalence of intestinal parasitism in such patients, to assess the socio‐demographic factors which may contribute to infestation and to estimate the contribution of intestinal parasites to anemia of pregnancy in the New Territories of Hong Kong.

Parasites were found in 19% of stools of all patients but the prevalence in the immigrant population from the Chinese mainland was 40% compared to only 7% in those women born in Hong Kong. The incidence of anemia was no different in patients with parasitic infestation than those without.
Development of Urine Production and Urination in the Human Fetus Assessed by Real‐Time Ultrasound
Authors: Shin Takeshi , Koyanagi Takashi , Hara Kenji , Kubota Shiroo , Nakano Hitoo
Published: August 2010

Abstract

To evaluate the physiological profile of fetal urine production with advance in gesta‐tional age, we observed the volume of urine retained in the bladder, using real‐time ultrasound. Here, the parameters of maximum urine volume, periodicity of urination and the urine production rate were analyzed. Urine volume can be measured by 3 orthogonal diameters of the bladder, provided that the stereognostic image of the bladder is assumed to be an ellipsoidal configuration. Investigated were 1,261 normal fetuses between 12 and 42 weeks of gestation. Three critical ages were noted, with respect to development of urine production and urination: 12, 18–20, and approximately 37–38 weeks of gestation. The first and the second indicate the onset of urine production and the start of alternating changes in urinary retention and urination, respectively. From the third period toward the end of the pregnancy, the urine production rate begins to decline.
Size‐at‐Birth Standards for a Melanesian Population
Authors: Burrows R. F.
Published: August 2010

By sampling all singleton births occurring to clinic‐attending Nivanuatu over an 18‐month period, the percentile distributions of the newborn infant's weight, length and head and chest circumferences were determined. The mean values for males and females respectively were: birth weight 3,162 and 3,085 g, crown‐heel length 50.6 and 50.1 cm, head circumference 34.3 and 33.7 cm, and chest circumference 31.6 and 31.5 cm. The resulting standards may be used in the clinical evaluation of size for gestational age.
Struma Ovarii: A Case Report
Authors: Salvi Vinita S. , Rao Reshma R. , Shroff Rekha R. , Walvekar Vandana R. , Pandit Ramesh D.
Published: August 2010

Small amounts of thyroid tissue are found infrequently in ovarian teratomas. Rarely, the thyroid tissue dominates, and such tumors are called struma ovarri. We record a case of struma ovarri in a 26‐year‐old patient who presented with a lump in the abdomen and primary infertility. A left oophorectomy with omentectomy was performed.
The Role of Peripheral Blood Monocyte on Cell‐Mediated Immunity in Pregnant Women
Authors: Umesaki Naohiko , Kawabata Masami , Sugawa Tadashi
Published: August 2010

In this work, we studied the monocyte function as accessory cells to T‐cells during and after pregnancy. The function tended to decrease in the 1st trimester, but showed a significant increase in the 3rd trimester (p<0.01). After parturition, it returned to normal. Next, the effect of pregnant serum on the monocyte function was studied. Pregnant serum was found to enhance the monocyte function, and this was most apparent in the samples obtained in the 3rd trimester. These facts led us to study the roles of a number of hormones whose serum levels change dynamically during pregnancy. We found that the monocyte function was enhanced 41% when estrogen was added in concentrations equivalent to the in vivo level during the 3rd trimester, and inhibited 40% by cortisol.

These observations suggest that monocytes play an important role in cell‐mediated immunity during pregnancy and that pregnant serum, especially hormones, influence the monocyte function.
Stimulatory Action of Progesterone on the Synthesis of Glycogen in Primary Cell Culture of Human Endometrium
Authors: Ishihara Satoko , Taketani Yuji , Mizuno Masahiko
Published: August 2010

The effects of progesterone and its antagonist, RU486, on the synthesis of glycogen were investigated using a primary cell culture of human endometrium. Progesterone stimulated the glycogen synthesis in a dose‐dependent manner. The minimal effective dose of progesterone is 10‐9 M with maximal effect occurring at 10‐7 M. Stimulation of glycogen synthesis was apparent as early as after 6 hours of incubation. Progesterone induced the activity of glycogen synthetase and reduced the activity of glycogen phosphorylase. The addition of RU486 with progesterone completely eliminated the action of progesterone in both the synthesis of glycogen and the activity of glycogen synthetase. These results clearly demonstrate the stimulatory action of progesterone in glycogen synthesis in cultured human endometrial cells. Moreover, the antiprogesterone, RU486, is shown to counteract the progesterone action in glycogen synthesis in vitro.
Pregnancy in a Woman with Wilson's Disease Treated with Zinc
Authors: Lao Terence T. H. , Chin Robert K. H. , Cockram Clive S. , Leung Nancy W. Y.
Published: August 2010

A 29‐year‐old Chinese housewife with a 7‐year history of Wilson's disease complicated by severe ataxia, hepatic cirrhosis, splenectomy, allergy to penicillamine and 2 spontaneous abortions, was referred at 23 weeks gestation in her fourth pregnancy which was conceived within a month of a 3‐month course of treatment with zinc sulphate 450 mg daily. She delivered at 37 weeks of a 2,700 g female baby. As zinc has been used successfully as an alternative to chelating agents in non‐pregnant patients, it may become a useful drug for treating pregnancy patients with Wilson's disease in place of penicillamine.
Recurrent Tetra‐Amelia: Ultrasonographic Diagnosis in Early Pregnancy
Authors: Miyakawa Isao , Yasuda Hiroshi , Yanagita Kenichi , Yamaguchi Masatoshi , Mori Norimasa
Published: August 2010

A woman who had previously given birth to a child with tetra‐amelia was sonographically diagnosed to have again conceived a fetus with the same anomaly. Although recurrent tetra‐amelia is extremely rare, ultrasonographic imaging proved to be very useful in detecting this limb reduction defect in early pregnancy.
Intrauterine Diagnosis of Epignathus Using Ultrasonic Tomography
Authors: Shouno Hideaki , Matsuo Norihito , Miyabara Shinichi , Yamasaki Miyoshi , Kuriyama Kazufumi , Sugimori Hajime
Published: August 2010

A case of fetal epignathus was evaluated by 2 new approaches (morphological and functional) using ultrasonic tomography. In the morphological study, serial interval tomograms were converted using a microcomputer into 3‐dimensional images for easier and more accurate diagnosis. In respect to function of cardiovascular system, not only placental enlargement and overswelling of the internal jugular vein were observed, but elevated function in the fetal left ventricle and hypofunction in the right ventricle were revealed by M‐mode ultrasonography. The evidence from these examination and the autopsy seemed to support the double monster theory for the origin of epignathus.
Prenatal Diagnosis of Exstrophy of the Cloaca with Ectopia Cordis
Authors: Nishi Takenori , Yamoto Mareo , Nakano Ryosuke
Published: August 2010

Ultrasonic techniques allow for noninvasive detection of prenatal abnormalities. The management of a delivered baby and the subsequent course are strongly influenced by intrauterine detection. A case of exstrophy of the cloaca with ectopia cordis was prenatally diagnosed by ultrasonography. Ectopia cordis and exstrophy of the cloaca are both rare anomalies. Ectopia cordis can be detected when the heart is outside the thoracic cage and a small thorax is seen on the ultrasonography. Exstrophy of the cloaca can be suspected when omphalocele and meningomyelocele are present, the urinary bladder is absent, and internal and/or external genitalia are abnormal by ultrasonography. Careful and repeated ultrasound study will confirm the combined anomalies of ectopia cordis and exstrophy of the cloaca.
Efficacy of γ‐Globulin Infusion Followed by Platelet Transfusion in Patient with Aplastic Anemia during Pregnancy: A Case
Authors: Mano Takafumi , Takeshima Nobuhiro , Miyake Teruhiko
Published: August 2010

A case of aplastic anemia with positive antiplatelet antibody during pregnancy is summarized.

A single 400 mg/kg dose of γ‐globulin was given intravenously, on August 9, at 35 weeks' gestation, soon after spontaneous rupture of the membranes. During injection of γ‐globulin, labor began spontaneously and a viable 1,980 g infant was delivered by spontaneous vaginal delivery. After parturition, vaginal hematoma developed. Following the γ‐globulin injection, a 13‐unit platelet concentrate, 250 ml of platelet concentrate produced at the Shuto Hospital and 1,000 ml of fresh blood were injected. After these blood transfusions, bleeding from vagina subsided. Twelve hours later the platelet count was 33,000/mm3.

It is suggested that γ‐globulin infusion followed by platelet transfusions may be a practical way to control hemorrhage during parturition in women with positive antiplatelet antibodies and aplastic anemia.
The Determination of CA‐50 Antigen in Women with Cervical Cancer
Authors: Dodd J. K. , Henry R.J.W. , Tyler J.P.P. , Houghton C.R.S.
Published: August 2010

Serum from 97 women with histologically proven squamous cell cervical carcinoma were analysed for the presence of tumour marker CA‐50 using a commercially available assay (DELFIA). Although values ranged between 0.5–573.3 U/ml the majority of cases (75%) fell below 21.2 U/ml. There was no relationship between CA‐50 antigen values and clinical stage of the disease as defined by FIGO, or prognosis. Furthermore the high false negative rate of this marker (51.5%) in patients with proven disease, and the lack of response following treatment, would preclude its use as a diagnostic screen.
Evidence Suggesting the Trophoblastic Origin of Follicle‐Stimulating Hormone, Luteinizing Hormone and Prolactin in Hydatidiform Mole
Authors: Loganath A. , Peh K. L. , Gunasegaram R. , Ratnam S. S.
Published: August 2010

Our previous finding that the intravesicular fluid of hydatidiform mole contains high concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) suggested to us that the molar trophoblast may be able to synthesize polypeptide hormones just as it produces human chorionic gonadotrophin (hCG). Using radioimmunoassay, we examined the plasma concentrations of these hormones before and after evacuation of the molar tissues, because we believed that this procedure might identify the source of increased FSH, LH and PRL synthesis in hydatidiform moles. Our 4 subjects had markedly elevated pre‐evacuation plasma levels of FSH (9.0–12.5 IU/l), LH (135,000–340,000 IU/l), PRL (1,300–3,800 mIU/l) and β‐hCG (550,000–4,500,000 IU/l). Their liver and kidney function tests were normal. After molar evacuation, serial concentrations of FSH, LH and PRL progressively declined to near normal levels by 9–16 weeks. As expected, the changes in FSH, LH and PRL levels closely resembled the typical pattern of changes in β‐hCG levels and decreased to the lower limits of sensitivity of the assay (<2.5 IU/l at 9–12 weeks). The pattern and magnitude of the changes strongly suggest that the diseased trophoblast makes a significant contribution to circulating levels of the 4 hormones.
The Value of Cervical Punch Biopsy in the Assessment of Histopathological Prognostic Factors in Carcinoma of the Cervix
Authors: Ngan Hextan Y. S. , Hsu Chih , Wong Ling C. , Ma Ho K.
Published: August 2010

From 1976 to 1980, 88 patients with stage Ib and early stage II squamous cell carcinoma of the cervix had the histological slides of their pretreatment cervical biopsies reviewed. Histological features of the biopsied tissue like cell type, cell differentiation, lymphatic or vascular permeation and stromal inflammatory cell reactions were assessed. In contrary to previous studies, the present study failed to show any significant correlations between these various histological features and the survival rate except in patients with moderate to severe plasma cell infiltration who had a better survival rate than those with absent to minimal plasma cell infiltration. Cervical punch biospy is of no value in the prediction of the prognosis of patients with squamous cell carcinoma of the cervix.
Fetal Growth and Glucose Metabolism in Diabetic Pregnant Rats
Authors: Murata Kazuhira , Ichio Takao , Yoshimura Kouichi , Toyoda Nagayasu , Sugiyama Youichi
Published: August 2010

We have studied the effects of diabetes on fetal growth, glucose metabolism, lung maturation, and bone development in rats. Fetuses in diabetic rats showed decreased body weights and increased placental weights. A morphological study of the fetal pancreas suggested that the area of the islets was increased. Plasma insulin levels and pancreatic levels of insulin and somatostatin were decreased, while plasma glucagon levels were unchanged. The levels of glycogen, glycogen synthase activity and somatomedin‐C were increased in the fetal liver. The serum transferrin levels were decreased and correlated with the reduced body weights. The levels of insulin and cortisol in the amniotic fluid and the weights of lungs were decreased. Levels of phosphatidylcholine (PC) in the lung and the abilities to synthesize PC and phosphatidylglycerol (PG) from glucose were decreased. The incidence of lumbar and cervical ribs was about 2–5 times higher than normal. Evidence of decreased ossification was also present. The fetuses of insulin‐treated diabetic rats, in which blood glucose concentrations before and during pregnancy were rigidly controlled, showed dramatic improvement in all these parameters to values near to those of the controls.
Pathological State of the Coagulatory and Fibrinolytic System in Preeclampsia and thePossibility of Its Treatment with AT III Concentrate
Authors: Terao Toshihiko , Kobayashi Takao , Imai Nobuaki , Oda Hiroyuki , Karasawa Tetsuro
Published: August 2010

Forty patients with preeclampsia were collected, and 27 of these cases were treated with AT III concentrate (1,000–2,000 units/day) for 7 days. According to an evaluation of objective clinical efficacy by the degree of improvement of GI scores in patients with preeclampsia, the number of effective cases was significantly greater among the treated groups than among the untreated groups (p<0.05). The rate of efficacy of the treated groups was 40%, compared with 0% in the untreated groups. In severe preeclampsia, a decrease in AT III activity was noted in 56.7%, a decrease in platelet count in 62.1%, and an increase in plasma FDP in 46.2%, A significant correlation was found between the GI score and the AT III activity. The anticoagulation therapy using AT III may normalize the chronic coagulation accelerated state in preeclampsia, and a good influence on the fetus may be expected.
Measurement of α‐Fetoprotein and Fetal Erythrocyte Levels for Detecting Fetomaternal Hemorrhage
Authors: Hida Shuji
Published: August 2010

This study was designed to measure changes in AFP levels and increases in fetal red cells in maternal blood before and after delivery to detect fetomaternal hemorrhaging in 41 full‐term singleton deliveries. Discrepancy was noted between the increase in fetal red cells and the elevation of AFP levels. Six cases (14.6%) showed both elevation of AFP levels and an increase in fetal red cells. Six showed elevation of HbF concentration with stable AFP levels, and another 6 showed an increase in maternal serum AFP levels with stable HbF concentration. The measurements of maternal serum AFP levels seem highly useful for detecting FMH in the presence of fetomaternal blood incompatibility.
Fourteen Years' Experience of Management and Use of the Perinatal Data‐Base System
Authors: Shinozuka Norio , Okai Takashi , Mukubo Masaaki , Baba Kazunori , Kuwabara Yoshinori , Mizuno Masahiko
Published: August 2010

Since 1973, we have been recording the data of all obstetric cases in our department in our original data‐base system, which was created on the mainframe computer at the Tokyo University Hospital Computer Center. The purposes of this system are mainly for making summaries of patients, for retrieving information of cases to provide data for clinical investigations, and for collecting statistics. The data records consist of 225 items, including different kinds of perinatal information. Our data‐base system has been useful in improving perinatal medicine, in clinical investigations, and in our daily work. But after 14 years of experience with it, we recognize the system has problems, namely: 1) How to summarize perinatal data to be used as a substitute for a patient history chart, and 2) How to update the data‐base with a little change in format according to improvements of perinatal medicines.
Serological Screening for Syphilis during Pregnancy in a Multiethnic Asian Population
Authors: Goh Tai H. , Ngeow Y. F.
Published: August 2010

Out of 14,841 women who were serologically examined for syphilis at the antenatal booking clinic, University Hospital, Kuala Lumpur in Malaysia, 1.78% were VDRL positive and 1.05% TPHA positive with significant differences between the Malays, Indians and Chinese. These rates are higher than published series and were attributed to childhood yaws infection among the Malays. As differentiation between yaws and syphilitic infection in the clinic is difficult, all TPHA‐reactive women were treated as for syphilis. Congenital syphilis was not diagnosed in those women who had been effectively treated before delivery.
Successful Treatment of Cervical Pregnancy by Cervical Evacuation after Use of Methotrexate
Authors: Kim Doo‐Sang , Hwang Youn‐Yeoung , Park Moon‐Il
Published: August 2010

A case is described with cervical pregnancy successfully treated by two 8‐day courses of methotrexate and leucovorin rescue with cervical evacuation. The apparent beneficial outcome suggests that cervical evacuation after the use of methotrexate and leucovorin rescue will be considered for treatment of cervical pregnancy whenever uterine preservation is desirable.
The Problem of Hemoglobin Switching in Premature Infants and IUGR Infants
Authors: Moriyama Ikuko , Hino Koji , Ninomiya Yuko , Nabuchi Kaoru , Kato Yumiko , Tsuji Yoshimasa , Ichijo Motohiko
Published: August 2010

Understanding the hemoglobin switching regulation mechanism in extremely premature infants is particularly important for understanding the extrauterine adaptation of the infants. In this study, we sought to identify factors influencing oxygen affinity in fetal blood and neonatal blood and obtained these results.

(1) Aging is required for hemoglobin switching.

(2) Switching in premature infants (27 to 32 weeks) is delayed at least 3 weeks in comparison with full‐term infants.

(3) A delay in the switching of fetal hemoglobin to adult hemoglobin was confirmed in IUGR (intrauterine growth retardation) infants. However, there is a compensatory increase in 2, 3‐DPG for adaptation after birth.

(4) A delay in 2, 3‐DPG increase was observed in RDS (respiratory distress syndrome) infants, and oxygen affinity remained high.
Effects of Pre‐Ovulatory X‐Irradiation on Fertilization, Initial Cleavage and Post‐Nidation Development in the Chinese Hamster
Authors: Imaizumi Katsuhide
Published: August 2010

In order to investigate the effects of pre‐ovulation X‐ray radiation on fertilization, initial cleavage and post‐nidation development, Chinese hamster dams were mated with normal males after exposure to 200 rads of radiation during the primary maturation period, and cytogenetic studies were performed at 2.5, 3.5 and 10 days after fertilization; comparison studies were also performed on an untreated control group.

The results indicated that: (1) The ovarian ova with chromosomal anomalies induced by X‐ray radiation had the ability to be fertilized and transmit the abnormality to the 2‐celled stage, but most of them deceased by the 8‐celled stage. (2) The embryos attaining the 8‐celled stage with normal chromosomes were implanted and survived, but showed remarkable hypoplasia on day 10 of gestation.
Cervical Mucus Prolactin Levels in Normal Fertile and Infertile Women
Authors: Shaarawy Mohamed , Darwish Nabil A. , Nagui Abdel‐Rehim , Ezzat Rawia A.
Published: August 2010

Cervical mucus and serum samples were obtained from 42 anovular women and 20 normal ovular fertile women (controls) for the determination of prolactin concentration by a solid phase radioimmunoassay. The former group was subgrouped into 14 galactorrhoeic (9 with oligohypomenorrhea and 5 with amenorrhea) and 28 non‐galactorrhoeic (19 with oligohypomenorrhea and 9 with amenorrhea). The level of prolactin in cervical mucus of normally menstruating women was significantly higher than that of serum at P<0.0125 (11.68·0.77 ng/ml and 16.09·1.65 ng/ml, mean SE, respectively).

Serum prolactin level in galactorrhoeic amenorrhea cases was 8.2 times that of controls, while cervical mucus prolactin amounted to 32 times its control value. The rise of cervical mucus prolactin in cases of galactorrhea oligohypomenorrhea was 21 times its control value which is markedly higher than that of serum (1.9 times). The average rise of serum prolactin in the whole group of galactorrhea with abnormal menstrual function was about 4 times the control value, while the average rise of cervical mucus prolactin was about 41 times the corresponding control value.

In the cases of galactorrhea with menstrual dysfunction, serum prolactin level may be normal in 50% of cases, while cervical mucus prolactin is strikingly elevated in 100% of cases. The possibility of pituitary adenoma should be considered if the level of serum or cervical mucus prolactin exceeds 100 ng/ml and 600 ng/ml respectively. The possible physiological role of cervical mucus prolactin and its source are discussed.
A Study of Drug Efficacy in the Treatment of Ovarian Cancer
Authors: Nishimura Haruo , Hamaguchi Kinya , Miyahara Kenichi , Miyoshi Tadashi , Higashijima Hiroshi , Yakushiji Michiaki
Published: August 2010

One hundred and nine cases of common epithelial ovarian cancer treated in our department during the past decade were entered into this study, which dealt with direct therapeutic effects and prognosis, comparing the groups administered cisplatin with those administered other anticancer drugs.

In 38 patients with measurable lesions, high response rates were achieved through the administration of anticancer drugs containing cisplatin in both the primary cancer and recurrent cancer groups.

Preventive chemotherapy was performed in patients in whom complete surgery was achieved at the initial operation. No significant difference in prognosis was observed through the administration of cisplatin and other anticancer drugs.

In patients in whom reduction surgery was carried out to the maximum possible degree at the initial operation, an improvement in prognosis was observed through the administration of cisplatin.

These results imply that a cisplatin‐based regimen should be aggressively used, except in cases that underwent complete debulking surgery.
Adenoid Cystic Carcinoma of the Cervix: A Report and Review of 3 Cases
Authors: Yokoyama Yasuhiro , Tamaya Teruhiko
Published: August 2010

Adenoid cystic carcinoma was reported in 3 Japanese women. In all cases, the condition followed the same rapid pattern of deterioration described in previous literature. The characteristic cribriform pattern was observed in all patients under a microscope, even in small parts of the tumor. This finding of this tumor may indicate that the adenoid cystic carcinoma is not identical to, but a variation of an undifferentiated carcinoma derived from the reserve cell.
Contragestive Effects of the Antigestagenic Agent, RU486, in Rats and Rabbits
Authors: Tsujii Takashi , Kambegaaw Akira , Kobayashi Miwako , Arakawa Satoko , Okinaga Shoichi , Arai Kiyoshi
Published: August 2010

The contragestive effect of the antiprogesterone RU486 in pregnant rats and rabbits were investigated. Administrations of increasing doses of RU486 in intact or castrated pregnant rats induced abortion in a dose dependent manner. RU486 had less effect when administered on the 16th day of gestation. Antiestrogens (tamoxifen, clomiphene citrate), an inhibition of 3 β‐hydroxysteroid dehydrogenase (epostane) showed a synergistic effect when used in combination with RU486. A decrease in serum progesterone levels was observed after RU486 administration. A larger dose of RU486 was necessary to induce abortion in pregnant rabbits compared to rats. The maximum blood concentration was greater and the area under the plasma level curve was larger in rats than in rabbits following administration of RU486.
Localization and Significance of Fibronectin in Peri‐Implantation Mouse Embryos
Authors: Takeuchi Kazuhiro , Nagata Yukihiro
Published: August 2010

This study was performed with the aim of clarifying differences in the localization of fibronectin between embryos developed in vivo and in vitro together with the significance of fibronectin in embryos at implantation.

Localization of fibronectin in the embryos was first found in the inner cell mass of the early blastocyst in utero (in vivo group). In contrast, when embryos were cultured in vitro from the 2‐cell to the blastocyst stage (in vitro group), fibronectin could not be observed in the late blastocyst.

When the blastocysts developed either in vivo or in vitro were further culture for 3 days in Dulbecco's Modified Eagle Medium (D'MEM) containing 10% newborn calf serum, the in vitro implantation (trophoblastic outgrowth in vitro) rates were 90% and 37%, respectively. If the blastocysts developed in vivo were cultured in D'MEM alone, the in vitro implantation rate was as low as 29%. However, if fibronectin was added to the D'MEM, instead of newborn calf serum, the in vitro implantation rates were improved.

These results led to the conclusion that fibronectin is necessary for the implantation of blastocysts.
Induction of Endogenous Cytokines in Ascites of Patients with Ovarian Cancer by OK‐432, A Streptococcal Preparation
Authors: Mori Hidehiro , Itoh Naoki , Yamada Yoshitaka , Tamaya Teruhiko
Published: August 2010

To clarify the action mechanism of OK‐432, OK‐432 was intraperitoneally (i.p.) administered to 4 ovarian cancer patients with malignant ascites. In 2 of the 4 patients, 4 types of cytokines (tumor necrosis factor, interleukin 1 β, interleukin 2, and interferon γ) were induced in ascites after intraperitoneal injection of OK‐432 (i.p. OK‐432). In one of these patients, the ascitic supernatant after i.p. OK‐432 significantly inhibited colony formation of autologous ascitic tumor cells; the amount of ascites decreased markedly, and the ascitic cytology became negative. In the other 2 patients, only interferon γ was induced in ascites after i.p. OK‐432. In these 2, ascitic supernatant did not inhibit colony formation of autologous ascitic tumor cells.

These results indicated that i.p. OK‐432 can induce various endogenous cytokines in malignant ascites and that these induced cytokines may contribute to the antitumor effect of i.p. OK‐432.
Amniotic Rupture Sequence: Report of Five Cases
Authors: Lin Ho‐Hsiung , Wu Chih‐Cheng , Hsieh Fon‐Jou , Hsieh Chang‐Yao , Lee Tzu‐Yao
Published: August 2010

Amniotic rupture sequence or amniotic band syndrome is a rare, non‐recurrent disease complex. We preferred the former term because its wide spectra of fetal malformation appear to depend on the timing and the consequent changes following a single event of amniotic rupture. However, the exact etiology and pathogenesis still remain obscure; and the disease is often mis‐ or under‐diagnosed, thus leading to inappropriate genetic counselling. Prenatal diagnosis is sometimes possible with the aid of ultrasound. We reported our experience of 5 cases of amniotic rupture sequence with special emphasis on different clinical pictures, possible pathogenesis and pathologic findings. Hopefully this will aid in the recognition of this disorder, thus offer appropriate genetic counselling to the patients.
Cryopreservation of Human Embryos as a Useful Tool for Infertile Couples
Authors: Katayama K. Paul , Stehlik Ed , Roesler Mark , Pentimalli Concetta , Gunnarson Cindy , Jagusch Susan , Meyer Matthew
Published: August 2010

In order to improve the pregnancy rate per oocyte retrieval while reducing the chance of multiple‐gestations, a technique of cryopreservation of human embryos was used for our initial study consisting of 100 infertile patients undergoing in vitro fertilization (IVF) procedure. These patients combined a “fresh” embryo transfer with cryopreservation. The embryos were cryopreserved with 1,2‐propanediol. Twenty‐nine (29%) patients achieved ongoing pregnancies from the fresh embryo transfer. Thirty patients received a transfer of thawed embryos in a natural cycle. Nine of these patients achieved ongoing pregnancies. Combining these 2 transfers results in a 38% ongoing pregnancy rate. Forty‐one patients have yet to receive their frozen embryos. The current success rate in this study indicates that over 50% of the patients in this group can expect to become pregnant by the time all the cryopreserved embryos have been transferred.
Maternal Mortality from Infection at a University Hospital in Nigeria
Authors: Adetoro Olalekan O.
Published: August 2010

This study analyzed 89 cases of maternal death following infections. The overall maternal mortality rate in infection was 5.9%. The maternal death rate is significantly related to parity but higher age group mothers survived better. Septicaemic shock and cardiopulmonary arrest were the major terminal causes of maternal death. The risk factors for the high maternal death following infections were examined and preventive measures recommended.
Case Report: Pregnant Woman with a Ventriculoperitoneal Shunt to Treat Hydrocephalus
Authors: Okagaki Atsuhiko , Kanzaki Hideharu , Moritake Kouzo , Mori Takahide
Published: August 2010

A pregnant woman with hydrocephalus who required multiple revisions of a ventriculoperitoneal shunt is discussed. Her symptoms improved after the replacement of the ventriculoperitoneal (VP) shunt with a ventriculoatrial (VA) shunt, suggesting the benefits of ventriculoatrial shunting during pregnancy.
Vaginal Metastases in Gestational Trophoblastic Disease
Authors: Wong L. C. , Ngan H.Y.S. , Collins R. J. , Ma H. K.
Published: August 2010

From 1976 to 1988, 320 patients with gestational trophoblastic disease were treated in the Department of Obstetrics and Gynaecology, University of Hong Kong. Eighteen patients had vaginal metastases. The clinical features and behaviour of the disease were analysed. The prognosis depends mainly on the extent of the disease. Similar favourable response to chemotherapy was observed in low‐risk patients with vaginal metastases.
In vitro and in vivo Induction of Squamous Cell Carcinoma Antigen (SCC) in a Uterine Cervical Cancer Cell Line (SKG‐IIIa) with Peplomycin and Sodium Butyrate
Authors: Nozawa Shiro , Kojima Masahiko , Tukazaki Katsumi , Sakayor Motoko , Iizuka Rihachi , Kagiyama Naoko
Published: August 2010

In order to investigate the effect of an antisquamous cell carcinoma drug, peplomycin, the new analogue of bleomycin, on the production of a squamous cell carcinoma‐associated tumor marker termed “SCC” (or TA‐4), we carried out in vitro and in vivo experiments using the uterine cervical epidermoid cancer cell line SKG‐IIIa, together with the investigation of the effect of sodium butyrate which was reported to be one of the representative gene modulators. In vitro production of SCC was biochemically and immunocytochemically confirmed in SKG‐IIIa cells. Immunocytochemistry using anti‐SCC antibody revealed that the total number of SCC‐positive cells increased after the treatment with peplomycin (1.6 fold) or sodium butyrate (1.5 fold). The total amount of SCC in cultured medium, intracellular SCC, and cell debris during 5 days of culturation also increased with peplomycin (1.8 fold) and sodium butyrate (1.4 fold). These data strongly suggest that SCC production of SKG‐IIIa cells is stimulated by peplomycin and sodium butyrate in vitro. In vivo experiments were also performed by administering peplomycin to nude rats with hetero‐transplanted tumors of SKG‐IIIa, and transient elevations of serum SCC level (113% to 238% of the initial values) were observed, suggesting that SCC production of cancer cells is also stimulated by peplomycin in vivo.
The Experience of Termination of Second Trimester Pregnancies Using Gemeprost Vaginal Pessaries in a District General Hospital
Authors: Lim B. H. , Mahmood T. A. , Lees D.A.R.
Published: August 2010

Experience with the use of Gemeprost pessaries (prostaglandin E1 analogue), in a group of 60 consecutive patients for second trimester termination in a Scottish District General Hospital, is presented. Gestation ranged from 12 to 20 weeks; there were 29 nulliparous (48%) and 31 (52%) multiparous women. Fifty‐seven (95%) aborted within 36 hours; 29 (48%) aborted completely and did not require further uterine curettage. Nulliparous patients required more pessaries and the abortion was more often incomplete. Side effects were minimal. There were no serious problems; and antiemetics were required by 17% and parenteral analgesics by 13% of patients.
A Highly Sensitive and Specific Sandwich Enzyme Immunoassay for Detection of Human Chorionic Gonadotropin in Trophoblastic Disease
Authors: Ibuki Yoshito , Yazaki Katsumi , Igarashi Masao
Published: August 2010

A highly sensitive and specific two‐site enzyme immunoassay (EIA) kit for human chorionic gonadotropin (hCG) has been examined and applied to the detection of hormones in the serum of normal individuals and patients with trophoblastic disease.

This EIA uses a solid phase coupled antibody to the unique COOH terminal peptide region of the hCG β‐subunit (β‐CTP) and an enzyme conjugated monoclonal antibody to the hCG β‐subunit. The overnight 2 step assay measured as little as 0.2 mIU/ml serum without hLH interference and a rapid one step assay was newly developed in our laboratory. Assays of serum from normal men and nonpregnant women of reproductive age indicated that most individuals did not have detectable serum levels of hCG immunoreactivity, although a minority had minute amounts. In contrast, women with non‐functional ovaries had detectable levels of hCG immunoreactivity with a mean value of 0.86 mIU/ml serum.

The extremely high sensitivity and specificity of the EIA in detecting hCG provides substantial advantages for the detection of early pregnancy and for monitoring trophoblastic tumors.
Analysis of False Negative Cytology by a Chromosome Study
Authors: Katayama K. Paul , Stafl Adolf , Woodruff J. Danald , Masukawa Teruo , Jones Howard W.
Published: August 2010

Forty‐two cases of pre‐invasive and invasive cancer of the cervix diagnosed by histology were studied cytologically and cytogenetically. Preinvasive lesions showed a good correlation between the cytologic impression and the histologic diagnosis. However, among 17 patients with invasive cancer, there were 2 completely negative cytologic impressions. These were in cases having modal chromosome counts of 47 and 48, respectively. This study demonstrates that some invasive cancers of the cervix are resistant to cytologic diagnosis because of their peridiploid chromosome counts and lack of anisokaryosis.
Oocyte Donation Program Using a Simplified Hormonal Regimen
Authors: Chang Yoon Seok , Kim Seok Hyun , Choi Young Min , Moon Shin Yong , Lee Jin Yong
Published: August 2010

It has been well recognized that both the synchronization of luteinizing hormone (LH) surge between the donor and the recipient for normally cycling women and the complex steroid replacement regimen given on a sequential and incremental basis for women with primary or secondary ovarian failure are two important aspects in oocyte donation. In oocyte donation program at SNUH, a simplified hormonal regimen applicable both to normally cycling women and to those with ovarian failure which consisted of administering 2 mg estradiol (E2) valerate orally 3 times a day augmented with 100 mg progesterone (P) in oil intramuscularly daily starting on the day preceding the oocyte retrieval from the donor was utilized. From July 1988 to December 1989 at SNUH, 11 cycles of oocyte donation program in 10 infertile patients were undertaken and 5 patients succeeded in pregnancy.