bluuebunny/crossref_metadata_2025 huggingface dataset:
Studies of Cardiovascular and Arterial Blood Gas Changes during Carbon Dioxide Pneumoperitoneum for Laparoscopic Sterilization under General Anaesthesia versus Local Anaesthesia
Authors: Subba B. , Gupta I. , Singh H.
Published: August 2010

This study was conducted to evaluate the different change in arterial blood gases and cardiovascular system in 50 healthy females during laparoscopic sterilization procedure performed under general or local anaesthesia.

Women who had laparoscopic sterilization under local anaesthesia, showed an increase in respiratory rate by 17% in response to hypercarbia produced by carbon dioxide insufflation. Subjects undergoing laparoscopic sterilization under general anaesthesia showed significant rise in pulse rate by 6% and systolic and diastolic blood pressure by 8% and 14%, respectively. Also arterial blood gas analysis showed increase in PaO2 by 22.7% which was highly significant. However, PaCO2, pH and base were maintained within normal limits as compared to the other group done under local anaesthesia, where no changes were observed.
Maternal Mortality in Nigerian Women Aged 35 Years and Above
Authors: Okwerekwu Francis E. O.
Published: August 2010

Maternal deaths over a 5‐year period were reviewed retrospectively. The aim was to compare the incidence and causes of maternal deaths and the fetal outcome in women aged 35 years and above with women in the 20–24 age bracket. The classic triad of haemorrhage, sepsis and hypertensive disorders were the major causes of deaths in the 2 groups but were commoner amongst the elderly women. A higher incidence of perinatal mortality was also found in the elderly women's group compared to the younger women's group. Pregnancy and delivery at an advanced age is associated with increased risk and should be prevented by the use of effective contraception.
Solitary Metastatic Ovarian Carcinoma of the Spleen: A Case Report
Authors: Minagawa Yukihisa , Kanamori Yasunobu , Ishihara Hiroshi , Morishita Kaichiro , Kigawa Junzo , Ito Takashi , Maeda Kazuo , Saito Seiichiro
Published: August 2010

Carcinomatous metastatic involvement of the spleen usually indicates a widespread malignant disease. Solitary metastatic lesions in the spleen are exceedingly rare. The literature contains fewer than 16 cases. In this paper we report a case of a solitary metastatic lesion of the spleen arising from a serous cystadenocarcinoma of the ovary 5 years after the initial operation. A splenectomy was performed followed by smooth postoperative course.
The Mechanism of Human Placental Urea Transport: A Study Using Placental Brush Border (Microvillous) Membrane Vesicles
Authors: Hisanaga Hiroyasu , Iioka Hideaki , Moriyama Ikuko , Nabuchi Kaoru , Morimoto Keiko , Ichijo Motohiko
Published: August 2010

To elucidate the mechanism of placental amino acid transport, the transport of amino acids into brush border membrane vesicles was investigated using brush border membrane vesicles (BBMV) separated from the human full‐term placenta.

 The transport of l‐alanine and l‐glutamine into the brush border membrane vesicles prepared from either early gestational placenta or full‐termed placenta disclosed a typical overshooting phenomenon in the presence of H+ concentration gradient (extravesicular pH > intravesicular pH).

 The H+‐dependent overshooting transport of urea into the brush border membrane vesicles disappeared in the presence of H+ ionophore.

 The initial velocity of H+ concentration gradient dependent uptake of urea into the brush border membrane vesicles was regulated by the saturation kinetics determined by the concentration of urea. The values of Km and Vmax, calculated as the kinetic parameters of urea transport by reciprocal plotting of the initial velocity of uptake and the concentration of urea, were 10.8 mM and 410 μmol/mg protein/10 sec, respectively.

The above results indicate that a transport system which transports urea in exchange for H+ exists in human full‐term placental microvillous membrane.
A Comparison between Fibreoptic and Catheter‐Tip Bridge Strain Gauge Transducers for Measurement of Intrauterine Pressure in Labour
Authors: Tham K. F. , Arulkumaran S. , Chua S. , Anandakumar C. , Singh P. , Ratnam S. S.
Published: August 2010

A new fibreoptic pressure transducer was used to measure uterine activity in labour, and the results were compared with those obtained with the catheter‐tip bridge strain gauge transducer. Readings were obtained from 8 patients in spontaneous labour, and a total of 565 contractions were analysed. When all contractions were analysed the coefficient of variation ranged from 11.24 to 42.74. In 2 patients with vast difference in pressure readings one of the catheters had slipped into the lower uterine segment, when these 2 cases were not considered the coefficient of variation ranged from 11.24 to 21.18. Even in the others there were transient periods lasting 5 to 15 minutes when the pressure difference was greater than 10 mmHg between the 2 catheters. When they were excluded from analysis, along with the 2 cases where one of the catheters was displaced, the coefficient of variation ranged from 9.30 to 16.05. The fibreoptic pressure transducer appears to be a safe, convenient and fairly accurate means of assessing uterine activity. But one must be aware that a catheter giving low readings compared with the initial period soon after insertion may be due to displacement of the transducer tip to the uterine lower segment.
The Value of Cordocentesis in Management of Patients with Severe Preeclampsia
Authors: Hsieh T'sang‐T'ang , Kuo Dong‐Ming , Lo Liang‐Ming , Chiu Tsung‐Hong
Published: August 2010

Severe preeclampsia affects placental function and causes fetal compromise. It is necessary to deliver the fetus at an appropriate time in order to minimize fetal mortality and morbidity. Cordocentesis was performed in 9 patients with severe preeclampsia (group 1) and 10 patients with other pregnancy complications (group 2). Intrauterine growth retardation occurred in 5 patients in group 1 and in only one patient in group 2. Blood gas parameters including pH, pO2 and O2 saturation were significantly lower for group 1, while pCO2 was significantly higher, as compared to group 2. For patients in group 1, non‐invasive fetal surveillance successfully identified 5 patients with fetal compromise, who required immediate termination of pregnancy. All 5 of these patients had abnormal fetal blood gas analyses by cordocentesis. Fetal blood gas analysis was abnormal in 2 additional fetuses among the remaining 4 patients who exhibited normal findings by non‐invasive methods of fetal surveillance. These results suggest that cordocentesis is useful in identifying fetal compromise (fetal hypoxia/acidosis) prior to the onset of labor in high‐risk patients, such as preeclampsia associated with intrauterine growth retardation.
Current Concepts of Fetal Therapy
Authors: Kuwabara Yoshinori , Unno Nobuya
Published: August 2010

The development of fetal diagnostic techniques has facilitated the analysis of pathological conditions in abnormal fetuses. This has led to systematic fetal therapy for such diseases as fetal hydronephrosis and fetal struma. In this report, general characteristics and problems of fetal therapy are discussed and several representative diseases that have been treated by surgical and pharmaceutical methods are outlined.
Cervical Incompetence Occurring after Caesarean Section: A Case Report
Authors: Smith David H. , Kirsop Rodney
Published: August 2010

A case of cervical incompetence as a result of caesarean section is presented. The role of caesarean section as an aetiological factor in cervical incompetence is discussed.
A Rare Neural Tube Defect: A Report of Eight Cases in Pakistan
Authors: Haider Parveen , Jafarey Sadiqua
Published: August 2010

Iniencephaly is a rare congenital malformation of central nervous system and axial skeleton. Eight cases were seen in the Department of Obstetrics and Gynaecology, Jinnah Post‐Graduate Medical Centre over a 12 month period constituting 0.1% of all deliveries conducted, the estimated frequency being 1: 850 deliveries.

The purpose of this paper is to describe our cases and to report several considerations which might influence the antenatal diagnosis of this rare anomaly.
An Evaluation of the Pelvic Score by the Quantification Theory for Categorical Data
Authors: Shigemitsu Sadahiko , Kubo Takeshi , Iwasaki Hirokazu
Published: August 2010

The scoring system for pelvic examination used in Tsukuba University Hospital was evaluated by the quantification theory to investigate the precision in predicting the date of labor onset. The objects of this study were 137 nulliparous gravidae and 142 multiparous gravidae who had spontaneous onset of labor at full‐term. In this analysis, we used 15 categories of findings in the examination as independent variables, and as the objective variable we used the interval from the examination to the labor onset. The multiple correlation coefficients in nulliparae was 0.593 and in multiparae 0.598. The following conclusions were reached concerning the assessment of labor onset: (1) The consistency of the cervix and the engagement of the vertex in nulliparous gravidae should be given more consideration. (2) In multiparous gravidae the dilatation of the cervix and the engagement of the vertex are important factors. (3) A different scoring system should be employed for both nulliparae and multiparae.
Endometrial Shedding and Regeneration: An Electron Microscopic Study in the Human Being
Authors: Ollo Mahmoud Ali Abou
Published: August 2010

Whether the stroma of the endometrium, the spongy layer or the deeper parts of the endometrial glands is the origin of the postmenstrual surface epithelium is a matter of different opinions. The endometrium was examined during the second day of the menstrual bleeding in 20 fertile females using the scanning electron microscope (SEM). Proliferative and secretory endometrium were present denoting the onset of regeneration by that time. The superficial parts of the endometrial glands in some areas were projecting on the surface of the remaining spongy layer like worms having nipple like heads and an opening like a mouth. Endometrial regeneration began in the deeper parts of the endometrial glands as columns of rounded cells with central cavities which had everted thick edges on reaching the surface. These everted edges were growing in all directions to cover the remaining spongy layer with surface epithelium containing ciliated and non‐ciliated cells. Exposure of the deeper parts of the glands is essential for regeneration. The delay in shedding the superficial parts of the glands may play an important role in dysfunctional uterine bleeding.
Progestogens: An Occasional Review
Authors: Eden John A.
Published: August 2010

Progestogens are drugs which share the ability to stimulate the progesterone receptor, but differ in many other aspects. Some of their uses include the regulation of menstrual bleeding, protection of oestrogen‐primed endometrium, contraception and as anticancer therapy. However, progesterone physical and psychological side‐effects and potentially adverse metabolic effects including lipoprotein changes must be considered. An understanding of these differences will permit appropriate prescribing of these drugs for gynaecological and medical disorders.
Catecholamines in Experimentally Growth‐Retarded Rat Fetus
Authors: Hiraoka Takanori , Kudo Takafumi , Kishimoto Yasuo
Published: August 2010

This study was designed to evaluate the sympathoadrenal system in rat IUGR fetuses prepared by the Wigglesworth method. Samples were obtained on day 20 of gestation. In the amniotic fluid, concentrations of norepinephrine (NE) and particularly epinephrine (E) were significantly higher in IUGR fetuses than in normally developed fetuses (NE: p<0.05, E: p<0.01).L‐Dopa and three catecholamines in the adrenal glands were decreased in IUGR fetuses. The mol ratios (L‐dopa: dopamine: NE: E) were 1: 4: 35: 63 in IUGR fetuses and 1: 5: 39: 87 in normal fetuses. The ratio for epinephrine toL‐dopa was significantly lower in IUGR fetuses (p<0.05). Adrenal phenylethanolamine‐N‐methyltransferase activities showed no difference between the two groups. From these results, adrenal epinephrine synthesis in IUGR fetuses was thought to be normal. Because of the depletion of adrenal epinephrine in IUGR fetuses, the plasma epinephrine concentrations were significantly lower after acute hemorrhagic shock (p<0.01). However, the plasma concentrations of dopamine and norepinephrine were significantly higher (dopamine: p<0.01, NE: p<0.001) in IUGR fetuses. These findings suggest that the hypersecretion of adrenal epinephrine is a protective response to chronic stress and the decrease of adrenal epinephrine may be a causative factor for the reduced reserves in the defense mechanism of IUGR fetuses.
The Production Mechanism of Amniotic Fluid Dopamine in Rats
Authors: Inoue Kazunori , Kudo Takafumi , Kishimoto Yasuo
Published: August 2010

The production of dopamine in amniotic fluid was studied using Wistar rats. The dopamine concentrations in the amniotic fluid increased significantly between each day of gestation from day 18 to day 21, and a marked increase was observed during the last two days. The concentrations of dopamine in the fetal plasma, however, did not change with the gestational age. There was a significant increase in the fetal plasma L‐dopa, which is the precursor of dopamine, without any changes in maternal plasma L‐dopa levels during late gestation. Dopa decarboxylase (DDC) activity was also measured in the fetal rat kidney from gestation day 17 to day 21. DDC activity, which was low on day 17, increased with advanced gestation. DDC activity on day 21 was 0.68 nmol/mg tissue/h, about 13‐fold higher than on day 17. These results suggest that fetal plasma L‐dopa may be converted to dopamine by fetal kidney DDC, and that the dopamine is voided into the amniotic cavity in fetal urine.
EGF Rapidly Stimulates Tyrosine Phosphorylation in Cultured Endometrial Cells
Authors: Ishihara Satoko , Taketani Yuji , Mizuno Masahiko
Published: August 2010

Recent increasing evidence suggests that EGF has a role in modulating the differentiated functions of human endometrial cells in an autocrine/paracrine fashion. To explore the signal transduction pathway of EGF in endometrial cells, we used cultured human endometrial cells to examine whether EGF induces tyrosine‐phosphorylation. EGF phosphorylated the 175 kDa protein on tyrosine residues within 10 seconds of stimulation. EGF induced tyrosine phosphorylation at as low as 0.1 ng/ml with the maximal effect occurring at 10 ng/ml. Estradiol was shown to enhance the phosphorylation by EGF in this system. These results thus suggest that tyrosinephosphorylation might be an important step in the signal transduction of EGF in human endometrial cells. Furthermore, the observed stimulatory action of estradiol on tyrosine‐phosphorylation by EGF might provide a clue in the elucidation of the cellular mechanism of estrogen action in endometrium.
Meconium Aspiration Syndrome: The Role of Resuscitation and Tracheal Suction in Prevention
Authors: Bhutta Zulfiqar A. , Jalil Sajid
Published: August 2010

We reviewed our experience of meconium staining of liquor and meconium aspiration syndrome over a 33 month period. The clinical and radiological severity of disease was assessed in comparison with tracheal suction and resuscitation. Sixty (27%) of newborns with meconium stained liquor subsequently developed MAS. No association was found between the thickness of meconium or its presence on tracheal aspiration with subsequent severity of respiratory disease. However, the presence of meconium in the trachea was strongly associated with radiological abnormality. The severity of meconium aspiration syndrome and mortality were also related to the clinical stability of the infants at presentation. Our results indicate that intrauterine aspiration and pulmonary maladaptation may play a significant role in meconium aspiration syndrome rather than resuscitative events at delivery.
Significance of the Serum CA125 Level in Recurrent Ovarian Cancer
Authors: Nishimura Haruo , Tashiro Masamichi , Hamaguchi Kinya , Kiyozuka Yasuyuki , Ide Hiroshi , Tateno Nobumasa , Miyoshi Tadashi , Yakushiji Michiaki
Published: August 2010

Thirty‐four recurrent cases of 89 patients with ovarian cancer treated in our department between 1985 and 1989 were examined for changes in serum CA125 level.

 Upon confirmation of recurrence, 17 patients were positive for CA125 and 15 were negative.

 According to the histopathological type, the rate of CA125 positivity in patients with recurrence was high for serous adenocarcinoma, suggesting that determination of CA125 is useful for detection of recurrence. In contrast, all patients with mutinous adenocarcinoma or endometrioid adenocarcinoma were negative for CA125.

 The CA125 positivity rate upon confirmation of recurrence was 9% in patients whose CA125 was less than 1,000 U/ml on initial examination, suggesting that close management of such patients is necessary.

 Elevation of CA125 by 3 steps or more within the normal range (less than 35 U/ml) was useful for predicting recurrence.

 The cut‐off level of CA125 during follow‐up should be set at 16 U/ml.

 It was difficult to evaluate remission with only the serum CA125 level. It is impossible to avoid second look operation at present.

These results indicate that pretreatment values and changes of the parameter within the normal range (less than 35 U/ml) have to be considered when using CA125 as a marker of tumor recurrence.
Perinatal Mortality in High Risk Pregnancy: A Prospective Study of Preventable Factors
Authors: Malik Shahzada J. , Mir Nisar A.
Published: August 2010

The present study was undertaken to identify the preventable factors operative in high fetal and neonatal losses. Over a period of one year, of total of 1,600 consecutive deliveries, 1,107 were considered to be at‐risk: there were 33 fetal and 31 early neonatal deaths with an overall perinatal mortality rate of 40/1,000 births.

Perinatal mortality was higher in mothers who had received inadequate antenatal care and/or with bad obstetric history. Major maternal and obstetric factors associated with a high PMR were: advancing maternal age and parity, antepartum hemorrhage, diabetes, anemia, instrument and vaginal breech delivery. Overall cesarean section rate was 16.9%. Infants with a gestational age of <37 weeks and/or of birth weight of <2,500 g contributed for 56.2% and 68.7% of the total perinatal losses respectively. PMR was three fold higher among twins compared with singleton births. Identifiable causes of perinatal deaths observed were: asphyxia (31%), congenital anomalies (18.7%), sepsis (18.7%) and low birth weight (25%).

It would appear that preventable factors are operative in over two third of the cases of perinatal loss and better maternal health, obstetric and neonatal care can improve the perinatal outcome in majority of the cases.
Expression and Amplification of Cellular Oncogenes in Human Developing Placenta and Neoplastic Trophoblastic Tissue
Authors: Park Jong‐Sup , Namkoong Sung‐Eun , Lee Hun‐Young , Kim Seung‐Jo , Hong Kyong‐Ja , Kim In‐Sook , Kim Kwang‐Un , Shim Bong‐Sop
Published: August 2010

To confirm the expression of cellular oncogenes during normal development, their differential RNA levels in developing human placenta have been studied using radioactive probes such as ?‐abl, ?‐erbA, ?‐fms, ?‐mos, ?‐myc, N‐ras and ?‐src. The c‐tnos and N‐ras genes are expressed and amplified at high levels especially in term placenta, while c‐abl, and c‐erbA are expressed constantly during development. These findings indicate that c‐mos and N‐ras genes may be closely linked to normal differentiation, although c‐abl and c‐erbA may participate in overall developmental processes. In contrast, transcripts of c‐myc and c‐src are enhanced at first trimester and decreased sequentially thereafter, showing that these genes may play a role in early proliferation. Expression patterns of c‐fms gene are same as that of c‐myc and c‐src except reeleva‐tion at term. In addition, to characterize the effect of cellular oncogene expression has been also examined in hydatidiform mole and tumor cells such as BeWo and choriocarcinoma. All cellular oncogenes examined in this study were significantly overexpressed. Thus, our results suggest that cellular oncogene activation may be strongly associated with neoplastic change of trophoblast.
Patterns and Implications of Subclinical Vulval Human Papillomavirus Infection: The Impact of PCR Analysis
Authors: Tay S. K. , Chow V.T.K. , Tham K. M. , Lim‐Tan S. K. , Bernard H. U.
Published: August 2010

This study was performed to elucidate the presence of human papillomavirus (HPV) infection of the vulva by colposcopy, histology and the polymerase chain reaction (PCR). Colposcopy defined 5 patterns of vulval epithelial lesions inconspicuous to the naked eye. Of these 75 subclinical vulval lesions, HPV infection was diagnosed by histology in 20.0% of minor epithelial changes with faint acetowhitening, 52.2% of conspicuous acetowhite lesions, 63.0% of acetowhite areas with satellite lesions, 84.6% of villous lesions, and 85.7% of villous lesions with surrounding acetowhitening. The corresponding HPV DNA positivity rates by PCR were 60.0%, 73.9%, 70.4%, 84.6% and 100% respectively. The oncogenic HPV type 16 was detected by PCR in 37.3% of the samples. These results provide firm evidence for the prevalent existence of subclinical HPV lesions of the vulva. Some of these infections may not produce significant morphologic changes detectable by colposcopy or histology. Subclinical vulval lesions are common and may constitute a reservoir for repeated cervical HPV infections, as well as a source of contamination of cervical samples for HPV DNA detection by sensitive molecular techniques.
BOOK REVIEW
Authors: Arulkumaran S.
Published: August 2010

Contributions to Obstetrics and Gynaecology—Vol. 1 & 2 Edited by S. S. Ratnam, Ng Soon Chye, D. K. Sen, and S. Arulkumaran
Prenatal Diagnosis of Holoprosencephaly by Transvaginal Ultrasonography in the First Trimester
Authors: Hamada Hiromi , Oki Akinori , Tsunoda Hajime , Kubo Takeshi
Published: August 2010

A diamniotic‐monochorionic pregnancy of twins was revealed by transvaginal ultrasonography: one fetus with holoprosencephaly was diagnosed at 11 weeks of gestation. This is the first case of holoprosencephaly diagnosed in the first trimester. Prenatal diagnosis of this anomaly in the first trimester is now possible by transvaginal ultrasonography.
Clinical Course of Early Fetal Loss and Its Chromosomal Characteristics
Authors: Sato Kodo , Kojima Takahisa , Izuta Makoto , Miyakawa Tomoyuki , Takahashi Keiichi , Tametika Shinzi , Kasai Tsuyoshi , Ogawa Keigo , Shioda Kyoko
Published: August 2010

The relationship between types of chromosomal abnormalities and fetal development documented by ultrasonography was discussed in early spontaneous abortions. The subjects were 113 patients who had vaginal ultrasonography at least twice between 6 and 8 weeks of pregnancy, among 167 abortuses with chromosome analyzed. The results were also compared against those for 303 normally developing fetuses. The results obtained in the present study suggested that each fetus with a chromosomal abnormality succumbed at or after a specific stage of fetal development and that the fetal death might be the results of severe fetal growth suppression.
The Immunohistochemical Localization of New Membrane‐Associated Placental Tissue Proteins (MP2 A, B, C, D, and E) in Human and Cynomolgus Monkey Placentae
Authors: Hirai Yasuo , Inaba Noriyuki , Sato Naomi , Fukazawa Kazuo , Yamauchi Kazuhiro , Takamizawa Hiroyoshi , Hasumi Katsuhiko , Masubuchi Kazumasa , Bohn Hans
Published: August 2010

New membrane‐associated placental tissue proteins (MP2 A, B, C, D, and E) were investigated by avidin‐biotin immunoperoxidase technique in the human and cynomolgus monkey placentae, decidua and umbilical cords. In human early placentae, MP2 A, B, C, and E were localized mainly in the membrane of villous syncytiotro‐phoblasts and cytotrophoblasts. Histiocytes in the villous stroma were positive for MP2 A, B, D, and E. In human term placentae, obvious positive staining for MP2 A, B, C, and E was observed in the membrane of villous syncytiotrophoblasts, in the amniotic epithelium, and in the umbilical cord sheath. Histiocytes in the villous stroma were positive for MP2 A, B, C, E, and especially for MP2 D. Importantly, MP2 A, C, and E were positive in polymorphonuclear neutrophils, since most of these common antigens are also carcinoma‐associated, suggesting clinical usage of MP2 proteins as a new tumor marker. In the cynomolgus monkey placentae, similar immuno‐staining results were obtained. The monkey can thus serve as a experimental model for the investigation of the placental proteins.
Cell‐Mediated Immunity in Cervical Intraepithelial Neoplasia
Authors: Park Tchan K. , Kim Soo N. , Choi Dong H. , Lee Chang H.
Published: August 2010

Various immune parameters, i.e., peripheral T and B cell distribution, T cell sub‐population, interleukin 2 (IL‐2) activity and in vitro lymphocyte responses to phytohe‐magglutinin (PHA) and concanavalin A (Con A), were investigated in 24 pretreated patients with cervical intraepithelial neoplasia (CIN) and in 35 normal controls. Of the measured parameters, lymphocyte response to PHA was significantly lower in the CIN than control group (p<0.05). The values of all other measured parameters were similar in both groups.
The Effect of Nifedipine and Dipyridamole on the Doppler Blood Flow Waveforms of Umbilical and Uterine Arteries in Hypertensive Pregnant Women
Authors: Hirose Shougo , Yamada Ayako , Kasugai Masahide , Ishizuka Takao , Tomoda Yutaka
Published: August 2010

In a study of 45 hypertensive pregnant women, the systolic velocity/diastolic velocity ratio and pulsatility index of the umbilical and uterine arteries showed good correlation with the maternal blood pressure, and they appeared to provide a good parameter for the fetoplacental condition.

Using the pulse Doppler method, we studied the effects of the antihypertensive agent nifedipine and of dipyridamole (an agent used to treat proteinuria) on the blood flow of the umbilical and uterine arteries in 16 hypertensive pregnant women. The results proved that both drugs caused a decrease in the vascular resistance of the umbilical artery and suggested that they increased the blood flow volume of this artery and were useful in the treatment of hypertension during pregnancy.
Analysis and Outcome of 502 Cases of Laser Excision Cone (LEC) at the Samaritan Hospital for Women, London
Authors: Yahya Abd. Aziz , Mclndoe G. Angus J. , Mason W. Peter
Published: August 2010

When performed based on cytology, histological accuracy of the laser cone specimen improved with the more severe cytology. The incidence of adenocarcinoma in situ is 1.0%. With and without residual disease, the rate of abnormal cytology after laser excision cone are 0.6% and 1.6% respectively. There is good correlation between colposcopic biopsy and cone specimen in the more severe lesions. Out of 139 cases of incomplete excision, only 3 cases had abnormal cytology at follow‐up. The complication rates are very low.
Study of the Relationship between Abnormalities in Nuclear DNA and Drug Sensitivity of Human Gynecological Cancer Transplanted into Nude Mice
Authors: Arakawa Atsushi
Published: August 2010

The relationship between abnormalities in nuclear DNA and anticancer‐drug sensitivity of human gynecological cancer transplanted into nude mice is reported. Nuclear DNA content was expressed in terms of the DNA index (DI) and heterogeneity index score (HIS) using flow cytometry (FCM). Southern blot analysis was used to examine changes in DNA and in observed abnormal‐size DNA fragments.

Drug sensitivity was carried out according to a procedure described by Battelle Columbus Laboratories.

The results were as follows: (1) Tumors with a high degree of DNA content were more sensitive to anticancer drugs than tumors with less DNA damage. (2) Severe heterogeneity of nuclear DNA caused drug resistance.
The Effects of Cryopreservation on Early Development and Chromosome Constitution in Chinese Hamster Embryos
Authors: Iida Tadashi
Published: August 2010

The effects of cryopreservation on early embryonic development were investigated in Chinese hamster embryos. Embryos were randomly divided into 3 groups, as follows: the control group, embryos which were simply cultured; the DMSO group, embryos which were exposed to dimethyl sulfoxide (DMSO) and then cultured; the cryopreservation group, embryos which were cryopreserved and then cultured. The percentages of embryos which developed into blastocysts after 40 hours of cultivation were high in all groups. However, there were significant differences in the mean number of blastomeres with lower values after an exposure to DMSO and cryopreservation (73.2 in the control group, 62.0 in the DMSO group, and 40.2 in the cryopreservation group). No significant differences in chromosome abnormality rate were evident and there was no distinct tendency for variation in karyotype among the 3 groups. These results indicate that DMSO adversely affects the division of blastomeres, and that cryopreservation with DMSO as a cryoprotectant might aggravate these adverse effects.
Lupus Anticoagulant (LAC) and Its Relation to Pregnancy Outcome: A Report of Five Cases
Authors: Itoh Hiroaki , Ihara Yoshiyuki , Hasegawa Masaaki , Okagaki Atsuhiko , Inamori Kumiko , Sagawa Norimasa , Mori Takahide , Mandai Masaki , Niwa Hayato
Published: August 2010

We examined the relation between the spontaneous remission and prednisolone‐induced suppression of lupus anticoagulant (LAC) or anticardiolipin antibody (ACA) and pregnancy outcome in 5 LAC‐positive women. Two women showed a spontaneous remission of LAC and ACA during the observation period. One of these 2 women became pregnant and delivered healthy twin infants at 36 weeks of pregnancy without any therapy. The other woman became LAC positive again after 1 year of remission, and experienced 2 more fetal losses. Two of the remaining LAC‐positive women received prednisolone and aspirin. Only 1 woman, whose ACA was suppressed by medication, delivered a healthy newborn. The pregnancy of the other woman, whose LAC and ACA remained positive in spite of medication, terminated in an IUFD.

These results suggest that the administration of prednisolone and aspirin is the first choice of therapy for LAC‐positive women, and that encouraging such women to become pregnant while LAC is negative might be an alternative therapy.
Internal Iliac Artery Ligation in Obstetrics and Gynecology Ten Years Experience
Authors: Rajaram P. , Raghavan S. Soundara , Bupathy A. , Balasubramanian S. R. , Habeebullah S. , Umadevi P.
Published: August 2010

Twenty‐two cases of bilateral internal iliac artery ligation done in the Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India over a period of 10 years (1981–1990) were studied. Various indications and complications were analysed. Internal iliac artery ligation is a life‐saving procedure in pelvic hemorrhage. Complications are infre‐quents.
Return of Fertility after the Removal of Intrauterine Devices: A Comparison of Inert and Copper Bearing Devices
Authors: Anwar Mochamad , Widayanto Sri , Maruo Takeshi , Mochizuki Matsuto
Published: August 2010

The use of intrauterine device (IUD) has been suspected to be linked to involuntary infertility due to increased risk of pelvic inflammatory diseases. Nevertheless, it remains unclear whether the overall risk of infertility after discontinuing use of IUD increases with the duration of IUD use. Thus, the present study was designed to evaluate the return of fertility after discontinuing use of copper containing IUDs compared to inert IUD and to determine a possible relationship between the length of IUD use and return of fertility. Ninety women with Lippes Loop type D (LL), 88 women with Copper‐T200 (TCu‐200) and 83 women with Multiload Copper‐250 (MLCu‐250) were included in the analysis. The life table analysis and log rank‐test showed that TCu‐200 and MLCu‐250 acceptors had a more rapid return of fertility compared to LL acceptors, although there was no significant difference in the return of fertility between TCu‐200 and MLCu‐250 acceptors. Compared to LL acceptors, the net cumulative probability of pregnancy after discontinuing use of IUD was 3 times higher in copper containing IUD acceptors in the first 3 months and somewhat higher in the first 4 to 11 months after removal of IUD. The length of use in copper containing IUDs (TCu‐200 and MLCu‐250) acceptors did not influence the return of fertility, whereas the return of fertility after removal of inert IUD (LL) was significantly higher in case of the use for shorter than 48 months compared to the use for longer than 48 months. These results suggest that appropriate selection of a contraceptive IUD and appropriate duration of the IUD use are important for individuals who desire another child.
The Hay's Flexion Rotation Obstetric Forceps: Reestablishing Relevance in Modern Obstetrics
Authors: Sheriar Nozer K. , Mataliya Manju V. , Daftary Shirish N.
Published: August 2010

A prospective evaluation of 140 forceps deliveries with the Hay's flexion rotation obstetric forceps was undertaken over a 5‐year period.

The Hay's forceps was used for a variety of indications and included outlet forceps application in 35.7%, low or midforceps application in 29.3% with forceps rotation in 16.4%, 19.3% of applications for an aftercoming head and 19.3% applications at caesarean section.

Outlet forceps deliveries had maternal and neonatal outcomes comparable with the Wrigley's short obstetric forceps. Midforceps applications were compared to the Simpson's long forceps, with maternal morbidity at 21% being significantly less, blade marks being the only neonatal morbidity and the Apgar scores being significantly higher with the Hay's forceps. Every forceps application at caesarean section resulted in an easy delivery.

Thus the Hay's forceps with innovations such as parallelism and flexion potential could revalidate the role of the forceps in contemporary obstetrics.
Evaluation of Sperm Fertilizing Capacity Using the Determination of Acrosome Reaction
Authors: Takahashi Kentaro , Sakoda Ryouichi , Yamasaki Hiroyuki , Uchida Akihiro , Yoshino Kazuo , Kitao Manabu
Published: August 2010

To evaluate the usefulness of the determination of acrosome reaction (AR) at 2 and 4 hours of incubation for predicting sperm fertilizing capacity in vitro, semen samples obtained from 45 partners of couples participating in the IVF (in vitro fertilization) program were examined. The population was divided into 2 groups, depending on the fertilization rate in the IVF program: Group A, with a good fertilizing capacity (≥50% fertilized oocytes); and Group B, with a poor fertilizing capacity (<50% fertilized oocytes). The rate of acrosome reaction (%AR) was examined using the fluorescein isothiocyanate‐conjugated Concanavalin A lectin method. The efficacy of this procedure was compared with that of the zona‐free hamster oocyte human sperm penetration assay (SPA) and sperm characteristics (SC) that appear in routine semen analysis. The sensitivities in the test of AR, SPA and SC were 91%, 86% and 82%, respectively. However, their specificities were 83%, 48% and 43%, respectively. Therefore, the screening procedure using the determination of acrosome reaction might be a useful tool in predicting IVF results.
Immunohistochemical and Immunoelectron Microscopic Study of Cytochrome P‐450 of Human Fetal Livers (P‐450HFLa): Implications for an Onco‐Feto‐Placental Enzyme
Authors: Okajima Yuko , Inaba Noriyuki , Fukazawa Ichio , Ota Yoriko , Hirai Yasuo , Sato Naomi , Yamamoto Giichi , Itahashi Koshiro , Kitada Mitsukazu , Kamataki Tetsuya , Takamizawa Hiroyoshi
Published: August 2010

Cytochrome P‐450 of human fetal livers (P‐450HFLa) was demonstrated by the avidin‐biotin immunoperoxidase technique in tissue samples as follows: human fetal organs, adult livers, human and cynomolgus placenta, and gynecologic organs which were obtained from 40 patients with gynecologic malignancies and 32 patients with benign diseases.

P‐450HFLa was clearly localized in the cytoplasm and membranes of the hepa‐tocytes, and the fact was confirmed by an immunoelectron microscopic examination. In addition, a semiquantitative assay of staining intensity demonstrated that this enzyme, tended to decrease with advancing age. These findings suggest that hepatic P‐450HFLa synthesis is inversely proportional to age, and that this enzyme is one of the differentiation antigens.

P‐450HFLa was also detected immunohistochemically in other fetal organs. The present study thus confirms that P‐450HFLa is not specific to the liver and is ubiquitous even in the fetus. Marked positive staining for P‐450HFLa was demonstrated in villous syncytiotrophoblasts. In contrast, no positive staining was found in the cynomolgus‐monkey placenta, unlike the case for many other placental antigens. These findings lead to the tentative conclusion that P‐450HFLa is a feto‐placental enzyme peculiar to humans.

P‐450HFLa was demonstrated to occur very frequently in gynecologic malignancies. The mean positivity rate for all gynecologic malignancies was 85%, while the rate was below 25% for benign gynecologic diseases, indicating that P‐450HFLa is one of the onco‐feto‐placental enzymes.

The present study thus suggests that this enzyme could be a promising new tumor marker for gynecologic malignancies.
Association between Human in vitro Fertilization Rate and Pregnancy Outcome: A Possible Involvement of Spermatozoal Quality in Subsequent Embryonic Viability
Authors: Chan Steven Y. W. , Tucker Michael J. , Leung Clement K. M. , Leong Milton K. H.
Published: August 2010

A conventional view of mammalian fertilization is that the active component of the process: the spermatozoon, by virtue of its progressive motility and acrosomal enzymes, penetrates an otherwise passive oocyte. This concept has placed bias on spermatozoal normality as largely determining the outcome of fertilization; once this has been achieved then the contribution of the spermatozoon is often forgotten, and attention switches to the maternally derived “blue‐print” for early embryonic development. Paternal genomic contribution is known to start at the eight‐cell stage in the human, but this is usually after the time when early cleavage stage (2 to 8‐cell stage) embryos are replaced in human assisted reproductive technologies (ART) procedures such as in vitro fertilization and embryo transfer (IVF‐ET). Hence, fundamental abnormal contributions to embryogenesis derived from the fertilizing spermatozoon have often been ignored. Human IVF‐ET has permitted far greater powers of analysis of the fertilization event, and fertilization success appears to be determined in such a system by three main factors: spermatozoal quality, oocyte quality, and quality of in vitro culture conditions (the gamete environment). If the second two factors are more carefully controlled than the first, as is the usual emphasis in routine human IVF practice, then any large variation in fertilization rates that are also significantly related to embryonic viability and ultimately pregnancy outcome, may be thought to be more directly associated with original quality of the fertilizing spermatozoon. An analysis of results of 758 IVF cases provides preliminary evidence to show that there is a close association between human in vitro fertilization rate and subsequent embryo viability following replacement. In accepting this hypothesis as a possibility, we should drastically change our attitude from one of the spermatozoon as a robust, simple initiator of embryonic development, and embrace the idea of the vulnerability of such germ cells both during and after their production, and how detrimental influences on this might profoundly affect embryogenesis after successful fertilization.
Hepatitis C Virus Infection in Pregnant Women: Detection by Different Anti‐HCV Immunoassays and Serum HCV‐RNA
Authors: Lin Ho‐Hsiung , Hsu Hong‐Yuan , Lee Tzu‐Yao , Kao Jia‐Horng , Chen Pei‐Jer , Chen Ding‐Shinn
Published: August 2010

Abstract

To assess the seroepidemiology of hepatitis C virus (HCV) infection in pregnant women and explore the correlation between different anti‐HCV immunoassays, we investigated 2 independent groups in Taipei: 1,687 pregnant women without screening for serum alanine aminotransferase (ALT) (group A) and 260 pregnant women with elevated ALT activity (>45 IU/1) screened from 15,978 cases (group B). In group A, 11 women (0.65%) were found to be anti‐HCV‐positive by first‐generation tests and 21 (1.24%) by second‐generation tests, while 7 (2.69%) and 15 (5.77%) of the group B subjects were positive, respectively. The results of the second‐generation assays, based either on recombinant proteins or synthetic peptides, were identical. Among the 36 second‐generation anti‐HCV‐positive cases, 18 (86%) of the 21 cases in group A and 13 (87%) of the 15 cases in group B contained serum HCV‐RNA by RT‐PCR. We conclude that the prevalence of anti‐HCV in pregnant Taiwanese women is 1.24%, and the prevalence is 5.77% among those with an elevated ALT level. HCV‐RNA is present in 86% of the cases positive for anti‐HCV. The discrepancy between positive anti‐HCV and negative HCV‐RNA in some pregnant women suggests that anti‐HCV positivity in such cases may merely represent a past HCV infection or a fluctuating viremia.
Prenatal Ultrasonographic Diagnosis of Congenital Kyphosis due to Anterior Segmentation Failure
Authors: Song Tae‐Bok , Kim Yoon‐Ha , Oh Sung‐Tack , Byun Ji‐Soo , Kirn Eun‐Kyung
Published: August 2010

Abstract

A few cases of congenital scoliosis due to segmentation failure have so far reported and the antenatal detection of pure congenital kyphosis without scoliosis due to segmentation failure has not been reported. We report the first prenatal identification using ultrasound of a fetus affected with pure congenital kyphosis due to anterior segmentation failure of the vertebral body between the second and third lumbar spine which was associated with ventriculomegaly, cleft palate, and hydramnios.
Macrosomia: Maternal and Fetal Outcome
Authors: Karim Saadiya Aziz , Mastoor M. , Ahmed A. J. , Pasha O. , Qureshi F. , Akhtar S. , Robinson S. C.
Published: August 2010

Abstract

This retrospective case‐control study analyses the prevalence and outcome of macrosomia in a part of the underdeveloped world. Out of 6,093 deliveries at a large tertiary care centre, 234 (3.8%) were macrosomic. Maternal risk factors associated with the condition included age over 35, obesity, grand multiparity, postmaturity and impaired glucose tolerance. Operative deliveries were more common as was shoulder dystocia, birth trauma, fetal distress, the need for neonatal intensive care and perinatal loss.
Serotonin Metabolism in the Fetus in Preeclampsia†
Authors: Taniguchi Katsunori , Okatani Yuji , Sagara Yusuke
Published: August 2010

Abstract

We investigated serotonin (5‐HT) metabolism in the fetus in preeclampsia by measuring free 5‐HT, 5‐hydroxyindoleacetic acid (5‐HIAA) and tryptophan concentrations in umbilical cord plasma and amniotic fluid, and 5‐HT content in platelets by high performance liquid chromatography with electrochemical detection. Free 5‐HT and 5‐HIAA levels in umbilical cord plasma were significantly higher in the severe pre‐eclamptic group (S) than those in the non‐preeclamptic group (N). The plasma 5‐HIAA/5‐HT ratio in group S was significantly lower than that in group N. Platelet 5‐HT content in group S tended to be lower than that in group N. Mean plasma /3‐thromboglobulin concentration in group S was significantly higher than that in group N. There was no significant difference in plasma tryptophan levels between group S and N.

These findings suggest that the higher levels of plasma free 5‐HT in umbilical cord plasma in preeclampsia are attributable to excess release of 5‐HT from platelets as well as lower monoamine oxidase activity.
A Quantitative Approach to the Loss of Heterozygosity in p 53 Allele on Detection of Human Cervical Cancer Using a Biolmaging Analyzer
Authors: Kinoshita Moritoshi , Shin Sadahito , Hirao Tsutomu , Aono Toshihiro
Published: August 2010

Abstract

The presence of HPV16 and HPV18 is believed to be responsible for the tumori‐genesis of cervical cancer. As not all HPV‐infected patients proceed consistently to carcinoma of the uterine cervix, it is important to clarify at the genetic level the mechanism of the disease progression following HPV infection. We recently investigated the loss of heterozygosity (LOH) in p53 gene, using the quantitative Southern hybridization‐incorporated Imaging Plate method with a p53 cDNA probe. According to the detection of heterozygote in p53 allele, 11 (61.1%) out of 18 patients with cervical cancer, and 4 out of 11 heterozygotes cases (36.4%) exhibited a loss of heterozygosity in p53 allele. It could be suggested that the occurrence of LOH is produced through chromosomal alteration in the tumorigenesis of cervical cancer.
Anti‐ssDNA and dsDNA Antibodies in Preeclampsia
Authors: Yamamoto Tatsuo , Yoshimura Sachiko , Geshi Yumi , Sasamori Yukifumi , Mori Hiroyuki , Kobayashi Takuro
Published: August 2010

Abstract

The presence of anti‐ssDNA and anti‐dsDNA antibodies and their clinical significance in preeclampsia were studied. Serum samples were taken from 38 cases of preeclampsia including 19 severe cases, and from 26 normal pregnant women. Anti‐ssDNA and anti‐dsDNA antibodies were measured by using an enzyme‐linked im‐munosorbent assay (ELISA).

Only 1 of the 38 preeclampsia tested positively for the anti‐dsDNA and none of 26 normal pregnant women showed positive results. Although 15 out of the 38 cases (39.4%) of preeclampsia tested positively the anti‐ssDNA antibody, none of the 26 normal pregnant women showed positive results. Five of 19 (26.3%) mild preeclampsia cases tested positively. In severe cases, 10 of 19 (52.6%) tested positively. The frequency of the anti‐ssDNA antibody is related to the severity of such symptoms as hypertension and proteinuria. However, we could not confirm that the presence of the anti‐ssDNA antibody is related to the appearance of intrauterine growth retardation (IUGR) in preeclampsia.

This study demonstrated a high incidence of autoantibodies, such as the anti‐ssDNA antibody, in preeclampsia, and indicates a close relationship between this antibody and the severity of preeclamptic symptom. We concluded that the autoantibodies, such as the anti‐DNA antibody, might be produced in preeclampsia, and that the abnormal B‐cell activation might occur in the pathophysiology of preeclampsia.
An Interesting Case of Intersex: Case Report
Authors: Yang Mary H.M. , Bongso Ariff , Chong S.M. , Ratnam S.S.
Published: August 2010

Intersex is a rare problem. Ambiguous genitalia, a frequent presentation of intersex, is seldom due to true hermaphroditism. This case report describes the findings in such a rare case.
The Prevalence of Adenomyosis and Endometriosis in an Ultra‐Religious Jewish Population
Authors: Bocker Jaron , Tadmor Ofer P. , Gal Michael , Diamant Yoram Z.
Published: August 2010

In view of increasing incidence of adenomyosis and endometriosis reported in recent years, we evaluated the incidence of these disorders in a unique ultra‐orthodox Jewish population over the past 20 years by reviewing 1,434 hysterectomy specimens.

The incidence of adenomyosis among the hysterectomy specimens decreased from 15.14% in the first 10 years of the period studied, to 9.24% in the second decade (p<0.05). The incidence of endometriosis remained unchanged, and was very low (1.12%) compared to published data. Our findings highlight the possible effects of heredity, religious and social behavior on the etiology of endometriosis.
Case Report: Spontaneous Liver Rupture in Pregnancy‐Induced Hypertension
Authors: Morgan Gary J. , Morris David L.
Published: August 2010

The hepatic manifestations of pregnancy‐induced hypertension are common but only occasionally clinically important.

We present a case with both early and late life‐threatening complications.