bluuebunny/crossref_metadata_2025 huggingface dataset:
II The age of menarche in Finnish girls in 1969
Authors: Kantero Riitta‐Liisa , Widbolm Olof
Published: December 2009

The material consisted of data on 8,111 girls from primary and secondary schools in different districts of Finland. The investigation was carried out during 1969 and the girls were from 10 to 20 years of age.

By means of the probit analysis method it was found that the mean value of the menarcheal age for the whole country was 13.16 ± 0.02 years and standard deviation 1.13 years. With few exceptions, menarche occurred between 10 and 16 years of age.

The trend towards a lower menarcheal age since the late 19th century was found to continue. The rate of decline in the age of menarche was estimated, on the basis of earlier studies, to be about 6 months per decade. The causes of this trend were discussed and the conclusion drawn was that its pace corresponds to that of the rise in the general standard of living.

The comparison of constitutional types calculated according to the height/weight ratio showed that the menarche of asthenic girls occurred 11.4 months later than that of girls with a normal height/weight ratio, and that the pyknic type started menstruation 4.8 months later than the normal. The age at menarche of the girls with an ordinary body build was just under 13 years.

Dependence upon geographical environments could be shown in that the menarcheal age of the girls living in the capital was 5.2 months lower than that of girls living in the inland districts. The menarcheal age of the girls living in the coastal districts and representing small‐town dwellers did not differ significantly from the girls resident in the capital.

A comparison between the social groups revealed an almost significant difference of 2.2 months in the age of menarche between the girls of groups I and II.

The menarcheal age of the primary school pupils was 5.5 months higher than that of secondary school pupils.

The mean menarcheal age of the mothers, whose mean age was 40 years at the time of the investigation, was 13.88 ± 0.02 calculated on the basis of recollected data. Comparisons by constitutional types, geographical place of residence and social groups revealed the same differences among the mothers as among the girls.
IV Correlations of menstrual traits between adolescent girls and their mothers
Authors: Kantero Riitta‐Liisa , Widholm Olof
Published: December 2009

It has been claimed that daughters mimic the menstrual patterns of their mothers. For the present report the menstrual patterns of c. 5,000 menstruating girls and their mothers were studied.

Comparisons were made under the following headings: constitution, age of menarche, cycle, duration, regularity of menstruation, premenstrual tension, and dysmenorrhoea.

The correlations between the patterns of menstruation of mothers and daughters were highly significant. The highest correlation coefficients were found for the age at menarche, for premenstrual tension, duration of flow and dysmenorrhoea, and the lowest for the regularity of menstruation.

The question as to whether the genetic constitution or whether an acquired behaviour plays the more important role in these correlations is still unclear.
The Use of Ultrasonic Biparietal Diameter Measurement Of The Fetus In Assessing Gestational Age
Authors: Levi Salvator
Published: December 2009

In 178 pregnant patients there was either inability to recall the date of the last menstrual period, or there was a clinical discrepancy between uterine growth and calculated duration of pregnancy. The author attempts to forecast the expected date of delivery by ultrasonic measurement of fetal biparietal diameter. When the 40th week was considered as a mean value, 96% of the patients delivered between the 37th and the 43rd week in the control group versus 84% in the study group. If the 41st week is taken as the mean value the corresponding figures are 94% and 91% respectively.
Marfan Syndrome, Pregnancy, and Fatal Dissection of Aorta
Authors: Sutinen Seppo , Piiroinen Olli
Published: December 2009

A case of sudden death during early labour is reported from a small hospital. The patient had an incomplete Marfan syndrome and death resulted from rupture into the pericardium of a dissecting aneurysm of the aorta. No other similar cases with this combination of the MS, pregnancy and fatal aortic dissection were found among the records of 46 maternal deaths in 75 087 deliveries at two larger hospitals in Southwestern Finland. The case here reported and 12 others previously described showed a median age of 25 years at death. The dissection of the aorta, typically with a rupture into the pericardium and tamponade, usually occurred after the 8th month of gestation or in the puerperium. If the pregnancy continued to at least 8 months a healthy infant was obtained in most cases. No infants showed signs of the MS. Mostly the anatomical basis of the aortic dissection seemed to be typical cystics medionecrosis with small initial haemorrhages from the vasa vasorum.
Progesterone Levels in Amniotic Fluid and Plasma from Women: II. Levels during Pregnancies Complicated by Rh‐Immunization or Hepatosis Gravidarum
Authors: Jonasson L.‐E. , Johansson E. D. B.
Published: December 2009

Using a protein binding technique, levels of progesterone were determined in 195 samples of amniotic fluid collected from 114 women. Most of the pregnancies were complicated by Rh‐immunization and parallel estimations of progesterone were performed in plasma or serum. The results show small variations between the various clinical groups. There was a significant rise in amniotic fluid progesterone concentration in pregnancies with very severe fetal erythroblastosis. Patients with hepatosis gravidarum showed a tendency towards high values both in amniotic fluid and in plasma. Progesterone determinations in amniotic fluid would be of limited practical value in the management of pregnancies complicated by Rh‐immunization.
Mechanics of Human Myometrium Studied with Dynamic Tests in Vivo
Authors: Joelsson Ingemar
Published: December 2009

A technique for dynamic studies of the mechanics of the uterine musculature in vivo is described, based on the registration of pressure responses to sinusoidally imposed changes in volume. The final amplitudes are varied between 1 and 9 ml and the frequency of volume changes is selected between 0.005 and 0.1 Hz. Having defined the frequency of the spontaneous activity of the uterus, end pressure, area of hysteresis and distance between the limbs of the loop are used as parameters to characterize the mechanical properties of the myometrium. The potential of the method includes the study of the effect upon the myometrium of pharmacologic agents with oxytocic and relaxant effects.
Plasma Oestriol in Prolonged Pregnancy
Authors: Fischer‐Rasmussen Wiggo , Ægidius Jørgen
Published: December 2009

Plasma oestriol concentrations were studied in 48 women with prolonged pregnancies. In all, 177 studies were made from the 40th to 46th weeks. There was a significant fall in plasma concentration from the 40th to 46th weeks contrasting with the significant rise from the 24th to 42nd weeks of normal pregnancy. There was a correlation between the plasma concentration and urinary excretion of oestriol, as there is in normal pregnancy from the 24th to 42nd weeks, but there was a significant difference in the correlations (at these two stages) pointing to an increased renal clearance of oestriol during prolonged pregnancy. It is postulated that this phenomenon might depend on a proportionate increase in the production of the conjugate oestriol‐16‐glucosiduronate, which is more rapidly excreted by the kidneys than oestriol‐3‐sulphate, and which reflects a reduced metabolic activity. Urinary oestriol excretion, however, falls during prolonged pregnancy, despite the postulated increased clearance. It is concluded, therefore, that oestriol production, which reflects the function of the feto‐placental unit, is, in fact, reduced during prolonged pregnancy. Plasma oestriol studies would appear, therefore, to give a better physiological control of prolonged pregnancy than urinary oestriol studies.
Phospholipid Composition of Human Amniotic Fluid During Gestation and at Term
Authors: Arvidson Gosta , Ekelund Hans , åstedt Birger
Published: December 2009

The concentration, composition and fatty acid components of amniotic fluid phospholipids were determined in samples obtained at term and during the second trimester of gestation. The mean concentration of total phospholipids was significantly higher at term than during the second trimester. There was also a highly significant increase in the ratio phosphatidylcholine/sphingomyelin at term. Concomitantly the proportion of palmitic acid in the phosphatidylcholines rose to very high levels. Changes in the same direction were recorded in the fatty acid composition of the phosphatidylethanolamines. The present results indicate that analysis of amniotic fluid phospholipids may be of clinical significance in determining the pulmonary maturity of the foetus.
The Effect of Oestradiol on the Arterial Diameter in Mice, as Studied by Angiography
Authors: Strömberg B. , Westin B.
Published: December 2009

Ten spayed female mice received a subcutaneous injection of 1 μg of ocstradiol‐benzoate. Whole body angiography was performed on the oestrogen‐treated and untreated controls. The diameters of the arteries supplying the head, neck, fore limbs, pelvis and posterior limbs were measured with an optical micrometer. The arteries of the head, neck and fore limbs in the oestrogen‐treated group were smaller in diameter, while the diameter of the internal iliac artery (hypogastric trunk) was larger when compared with controls. The results are discussed in relation to recent findings in humans.
Fibrin Degradation Products During Postoperative Radiotherapy of Ovarian Carcinoma
Authors: Svanberg Lars , Åstedt Birger , Gynning Inge , Nilsson Inga Marie
Published: December 2009

Determinations were made of fibrin degradation products (FDP) in serum from 19 patients who were receiving radiotherapy after the surgical treatment of malignant ovarian tumours. FDP decreased or disappeared in association with operation and radiotherapy but increased or re‐appeared with recurrences. Possible explanations of this phenomenon are discussed.
Toxaemia and Cigarette Smoking During Pregnancy
Authors: Palmgren Bertil , Wahlén Tore , Wallander Bo
Published: December 2009

Toxaemia of pregnancy occurs in 1 out of every 10 pregnant non‐smokers, compared with 1 out of every 20 smokers. This might be due to the abortifacient effect of smoking, especially in the first trimester, with consequent exclusion of presumptive candidates for toxaemia. Another interesting possibility is that the cyanides included in tobacco smoke are converted to thiocyanates and, theoretically, might offer a certain protection against thrombosis in the placenta and against toxaemia. The perinatal mortality among low‐weight newborns (< 2500 g) is much higher among infants of non‐smokers, as is the frequency of bleeding and infarction of the placenta. This suggests that the perinatal mortality among low‐weight newborns of mothers who are non‐smokers is to a larger extent due to toxaemia than is that among infants of smokers.
Intra‐Uterine Fetal Growth Studied by Ultrasonic Biparietal Measurements
Authors: Levi S. , Smets P.
Published: December 2009

Abstract. Fetal biparietal diameter was measured in utero with ultrasonic techniques, in 1 Oil patients with 3 032 measurements at gestational ages ranging from 15 to 43 weeks. The distribution of these values, the mean weekly increments, together with the 5th to 95th percentiles are presented in tabular and graphic forms. The mean values correspond to those quoted in other investigations.
The Effects of an Oral Comblned Contraceptive on Plasma Levels of Glucose, Free Fatty Acids, Glycerol, β‐8 Hydroxybutyrate and Triglycerides
Authors: Lunell N. O. , Persson B. , Öhqvist G.
Published: December 2009

Abstract. The effects of an oral combined contraceptive (OC) (norethisterone + mestranol) on plasma levels of glucose, free fatty acids (FFA), glycerol, D‐β‐hydroxy‐ butyrate and triglycerides in 39 healthy women were followed. Plasma samples were collected before and during the end of the first and second cycles of OC administration. OC caused a significant increase in triglycerides while the levels of glucose, FFA, glycerol and β‐B‐ hydroxybutyrate were unaffected.
Purification of the “Pregnancy Zone” Protein
Authors: von Schoultz Bo , Stigbrand Torgny
Published: December 2009

Abstract. The “pregnancy zone” protein is a serum protein found in pregnancy and after administration of oral contraceptives. It has hitherto not been isolated and therefore practically nothing is known about its structure and function. Purification of this protein was achieved in three steps: 1) Gel filtration on Sephadex G‐200; 2) Chromatography on DEAE‐Sephadex; 3) Preparative polyacrylamide electrophoresis. After the third step a protein was obtained which was found to be pure judged by the behaviour in polyacrylamide electrophoresis and ultra‐centrifugation. The molecular weight was estimated to be 326000, the sedimentation coefficient 12 S and the isoelectric point 4.7.
Continuous Drip Lumbar Epidural Anaesthesia with Lidocaine for Vaginal Delivery
Authors: Zador Göran , Willdeck‐Lund Gunilla , Nilsson Bo A.
Published: December 2009

Abstract. A total of 22 parturients with uncomplicated pregnancies were given continuous epidural block using a 0.4 per cent, lidocaine drip solution without epinephrine (series I), or with epinephrine (II). The mean total dose of lidocaine administered in series I was 591 mg, and 293 mg in series II. The mean total dose per kg body weight in series I was 8.33 mg, and 4.17 mg in series II. According to the results of a specially designed scoring system adequate pain relief was achieved and maintained in both series trough‐out labour and delivery. For the second stage an additional dose of lidocaine was necessary in some mothers in series I, whereas in the second series acceptable analgesia was maintained by a continuation of the initially started low drip rate. The lidocaine concentrations in foetal capillary blood and in maternal venous blood were low in series II. These values were about 40‐60 per cent higher in series I, but mean maternal values were never in excess of 1.2 mcg/ml. The highest mean foetal value was 0.7 mcg/ml and the highest individual foetal value 1.0 mcg/ml. In none of the cases were higher lidocaine levels found in foetal blood than in maternal venous blood at corresponding sampling occasions. Differences in lidocaine concentrations found in blood from maternal artery and vein were, under the existing circumstances with the exception of an initial peak, only slight, thus clinically negligible.
Serum Triglyceride in Women with and without a Predisposition to Diabetes During Short‐Term Administration of a Combined Oral Contraceptive
Authors: Nielsen F. Hassing
Published: December 2009

Abstract. A group of 17 healthy women, of whom 9 had a predisposition to diabetes, were studied for five consecutive menstrual cycles with regard to the effect of an oral combined contraceptive containing 0.5 mg norgestrel and 0.05 mg ethinylestradiol (Eugynon®). The fasting concentration in the serum of triglycerides, free fatty acids and insulin together with the respone values during i.v. glucose toleracne for free fatty acids and insulin were estiamted. The tests were performed at midcyle n the cycle prior to, in two ycles during and in the second cycle after cessation of the drug administratino. The drug was administered daily from the fifth to twentyfifth day of the cycle in the two cycles. Thus each subject served as her own control. Statistical analysis of the results showed a significant increase in the fasting values of teh serum triglycerides during hormonal administration in those predisposed to diabetes, but unchanged values in those not so predisposed. The fasting values of the serum free fatty acids were, for the series as a whole, significantly lower in the second cycle of administration. There was no significant difference with regard to the predisposition to diabetes, but a tendeny to unchanged values in those predisposed to diabetes and lower values in those not predisposed. The fasting values of the serum insulin showed no changes and no difference with regard to predisposition to diabetes. The response to i.v. glucose injection showed, for the free fatty acids, no significant changes during hormonal administration, but the fasting values also had a tendency to unchanged values for thsoe predisposed and lower values for those not predisposed to diabetes, during hormonal administratino. The response values of serum insulin were, for the series as a whole, significantly higher during hormonal administration, those predisposed to diabetes showed 60 min after glucose injection significantly higher values than those not so predisposed during hormonal administration. The results are discussed and compared to the findings of other investigators. Possible modes of action with regard to the increase in triglycerides in thsoe predisposed to diabetes are discussed. The study indicates, but does not prove, that in women predisposed to diabetes there is an increased risk of the development of hypertriglyceridaemia and consequent disease with the administration of the oral contraceptive studied.
Amniotic Fluid Oestriol Concentration During the Last Trimester of Pregnancy: II Perinatal Mortality and Morbidity
Authors: Jørgensen P. I.
Published: December 2009

Abstract. In the present study the amniotic fluid oestriol concentration was correlated to the condition of the foetus and newborn in pathological pregnancies and compared with the urinary excretion of oestriol. by transabdominal amniocentesis in 58 pregnant women 83 specimens of amniotic fluid were collected. Our method and normal concentration area has been described in a previous report. the results and conclusions were as follows: 1) in pregnancies complicated by perinatal death of the foetus or newborn the amniotic fluid oestriol levels were low. However, when the amniotic fluid was contaminated with meconium, the urinary oestriol assay reflected the condition of the foetus in a better way. 2) in connexion with anencephalia of a living foetus the amniotic fluid oestriol concentration was very low. 3) Amniotic fluid oestriol assays reflected perinatal morbidity such as asphyxia and respiratory distress of the newborn, remarkably well and better than urinary oestriol assays. 4) Amniotic fluid oestriol assays predicted signs of intrauterine malnutrition (»small for dates» and/or dysmaturitas of the newborn) just as well as urinary oestriol assays. 5) Fourteen out of seventeen women with pregnancy complications such as preecclampsia or hypertension, but giving birth to healthy infants presented normal oestriol concentrations in amniotic fluid. in this group too there was a good correlation between the condition of the newborn and the concentration of oestriol in amniotic fluid as well as the urinary excretion of oestriol.—It seems reasonable to conclude that the amniotic fluid oestriol assay has its advantages in preference to urinary oestriol assay. However, it was our impression that the two assays were complementary to one another in a favourable way. Thus the findings of the present study speak in favour of a more widespread combined use of the two oestriol assays.
A Semiquantitative Hemagglutination Inhibition Assay For Human Placental Lactogen (Hpl) in the Late Part of Pregnancy
Authors: Gæde Preben , Nørgaard‐Pedersen B.
Published: December 2009

Abstract. A hemagglutination‐inhibition reaction (HAIR) for semiquantitative determination of human placenta lactogen hormone (HPL) in serum or whole blood from pregnant women is presented.

The lower level of HPL concentration in serum for a positiv reaction of the test was found to be 2,3 mg/liter, making it suitable for determinations after the 32nd week of pregnancy.

A microtechnique for combined sampling and dilution of capillary blood makes the assay suitable as a screening procedure in places with limited laboratory facilities.
Effect of Estrogen Therapy on Climacteric Symptoms and Tissue Changes
Authors: Punnonen Reijo , Rauramo Lauri
Published: December 2009

Abstract. Estrogen substitution for 50 castrated women consisted of estriol succinate and for another 50 women of estradiol valerate. The daily dose in both groups was 2 mg, given for six months starting one month after castration. The patients generally developed strong vegetative symptoms after oophorectomy. Five patients failed to respond to estriol succinate and one to estradiol valerate. The effect of estrogen therapy on the vaginal smear and the skin was also studied in these six cases. An estrogen effect, though often fairly weak, in the vaginal smear was observed. Total urinary estrogens were high in all the cases after three and six months of estrogen therapy. The epidermis was significantly thickened after three months of estrogen except in one case. There was generally no significant difference between the 3‐month and 6‐month skin specimens. Ostensibly ineffective estrogen subsitution may thus play a role in the prevention of postmenopausal degenerative changes. The effect of estrogen therapy on the vegetative symptoms alone should not be regarded as the yardstick of its efficacy.
Studies in Cholestasis of Pregnancy
Authors: Johnson P. , Samsioe G. , Gustafson A.
Published: December 2009

Abstract. Forty‐one pregnant women with pruritus, in whom cholestasis was verified by the presence in their serum of an abnormal lipoprotein, lipoprotein‐X (LP‐X), were divided into two clinical groups, pruritus gravidarum (PG) (n=20) and hepatosis of pregnancy (HP) (n=21) in relation to serum bilirubin (below and above 1.2 mg/100 ml, respectively) and/or SGOT, SGPT (below and above 50 units/1, respectively). In HP, but not in PG, serum lipids, i.e. cholesterol, phospholipids, triglycerides, pre‐β‐lipoproteins (very‐low‐density lipoproteins), and low‐density lipoproteins were increased and high‐density lipoproteins decreased when compared with suitable controls. Serum lipids were elevated in proportion to the derangement in the liver function tests, alkaline phosphatase, SGOT, and SGPT. The occurrence of LP‐X was inversely related to HDL cholesterol, suggesting a causal relationship between HDL lipid metabolism and the presence of LP‐X. Serum TIBC, Simplastin A, and serum iron were elevated in HP in relation to the degree of deterioration of liver function tests. Some of these changes in serum in cholestatic pregnancy may partially (serum triglycerides and pre‐β‐lipoproteins) or completely (TIBC and Simplastin A) be explained by an enhanced estrogen influence in promoting increased liver lipid/protein metabolism.
Simultaneous Urethrocystometry and Urethra Pressure Profile Measurement with a new Technique
Authors: Asmussen Mogens , Ulmsten Ulf
Published: December 2009

Abstract. A new technique for simultaneous recording of the pressures within the urethra and urinary bladder is described. The pressures are recorded by microtransducers enclosed in a semiflexible dacron catheter. The recording system has a high frequency response (2000 Hz) and is free of motion‐induced artefacts, which makes it possible to measure the urethra pressure profile with a high degree of precision.
Enzymatic Studies of Glycogen Metabolism in Nonmalignant and Malignant Biopsies from the Human Uterine Cervix
Authors: Pedersen S. Nødskov
Published: December 2009

Abstract. The glycogen metabolism of the human uterine cervix has been investigated in tissue specimens from 147 women with gynaecological diseases: 64 with cervical carcinomas, 6 with carcinoma in situ and 77 with nonmalignant cervical diseases. The glycogen content of the normal uterine cervix was found to be fairly constant and apparently not regulated by steroid hormones. The low content of glycogen in malignant cervical tumours was confirmed by the present investigation. The present investigation also showed that this abnormality was not only characteristic of invasive carcinoma but also of carcinoma in situ. A particularly low glycogen content was found in tissue samples from patients with relapse. Concerning the enzyme involved in glycogen metabolism, a significantly high activity of glycogen synthetase was found in malignant cervical biopsies, while the activity of glycogen phosphorylase did not differ significantly when comparing normal to malignant tissue.
Endocrine Changes Before and After the Menarche
Authors: Kantero R. L. , Wide L. , Widholm O.
Published: December 2009

Abstract. The study was carried out on healthy girls before and after the menarche in order to investigate the behaviour of certain hormones apparently affecting the growth spurt in puberty. It was desired to study the normal variation and to discover at what point of time the adult level is attained. The serum levels of growth hormone and alkaline phosphatase, and the urinary excreation of 17‐ketosteroids and 17‐hydroxycorticosteroids in a total of 146 healthy pre‐ and postmenarcheal girls were studied. The blood samples, one per girl, were collected in the afternoon after a moderate fast. The results were calculated for groups based on skeletal age, the so‐called gynecological age, and the stage of puberty. A review of the total group showed that alkaline phosphatase had a highly significant negative correlation to the skeletal age, height, weight and stage of puberty (r about −0.4). The 17‐ketosteroids and 17‐hydroxycorticosteroids were highly significantly positively correlated to the same variables (r about 0.4–0.5). The growth hormone correlation coefficients did not differ significantly from zero in this review. The alkaline phosphatase means were at their maximum at a skeletal age of 11 years and before secondary sex characters had appeared. After appearance of the latter the alkaline phosphatase values soon fell to the adult level. The growth hormone level was generally found to be significantly higher than in adult women. Girls with a bone age of 11–13 years had mean values significantly higher than the younger and the older girls. In groups based on the stage of puberty, the mean values were highest for the pubic hair stage 2 and breast stage 3, that is to say, before the menarche. The 17‐KS means were found to rise as the skeletal age increased. However, one year before and one year after the menarche the mean values were practically the same. The finding may suggest that there is a steady phase in the steroid production of the adrenal about the time of the menarche. Later the 17‐KS level showed a rise which seemed to continue even 5 years after the menarche. The values of 17‐OHCS in the pre‐menarcheal groups increased with skeletal age. The adult level was reached in the group with a skeletal age of 12 and puberty stage 3. The results suggest that, at the time of the growth spurt, the steroid secretion increases and the serum GH level rises. The high GH values accompany high alkaline phosphatase values but in a somewhat later phase of growth. In the 17‐ketosteroid excretion, a smooth increase continues until the menarche and, after a possible steady phase, the increase continues for years after menarche. For 17‐OHCS the adult level is reached before the menarche.
Occurrence of Genital Herpes Simplex and Cytomegalovirus Infections in Pregnancy
Authors: Vesterinen Ervo , Savolainen Eeva‐Riitta , Purola Esko , Saksela Eero , Leinikki Pauli
Published: December 2009

Abstract. A total of 244 pregnant women, 172 in the first and 72 in the third trimester, were screened for genital herpes simplex (HSV) and cytomegalovirus (CMV) infections using virus isolation, cytological examination and serological studies. in addition, immuno‐fluorescence staining of exfoliated cervical cells was used for the detection of HSV infections. Herpes simplex virus (HSV) could not be isolated and no characteristic HSV altered cells were found in cytological (PAPA) smears. Cytomegalovirus was isolated four times but PAPA smears obtained from these patients were also normal. in 34 (14%) patients HSV antiserum detected immunofluorescence positive exfoliated cervical cells. Overall, 14% of patients had HSV‐2 antibodies and 71% CMV antibodies. No differences between the first or third trimesters in these respects were noted.
Ultrasonic Diagnosis of Placenta Praevia
Authors: Sand Hanne
Published: December 2009

Abstract. 741 women suspected of placenta praevia were submitted to ultrasonic scanning during the second and/or third trimesters of pregnancy. in 61 an abnormal placental site was diagnosed. During Caesarean section, carried out in 46 of these cases, the location was compared with the ultrasound findings. the scanning diagnosis during the last trimester correlated with the findings at delivery. At scanning after the 35th week the diagnosis differed in only 4 cases. in all 4 there was a question of a low‐lying placenta versus partial placenta praevia. During the second trimester diagnoses of low‐lying placenta were revised in several cases at later scans. It is discussed whether these early diagnoses of an abnormal placental site, which later becomes normal, indicate a migrating placenta and/or an uncertainty of the scanning method. Early diagnosis of low‐lying placentae should be checked by repeat scans.
Negative Smears in Women Developing Invasive Cervical Cancer
Authors: Rylander Eva
Published: December 2009

Abstract. Fifty‐six cervical smears originally classified as Pap. I, from women in whom cervical cancer of stage I to IV was detected within 4 to 5 years after the cytological check, were re‐examined in order to estimate the screening error and sampling failure. At the review, 35 smears were classified as Pap. II to V. the incidence of changed classification of the smears obtained from population screening was 70% and that of the smears taken at private specialists or at hospitals was about 50%. the influence of sampling failure on the evaluation of the smears classified as Pap. II should be considered. On 14 slides, correctly interpreted as negative, there were no columnar cells present, a fact that may indicate inefficient sampling of cells from the squamo‐columnar junction.
VAGINAL BLEEDING IN THE LAST TWO TRIMESTERS OF PREGNANCY A CLINICAL AND ULTRASONIC STUDY
Authors: Jouppila Pentti
Published: December 2009

Abstract. Ninety‐seven cases of vaginal bleeding during the second and third trimesters of pregnancy are presented with special reference to the follow‐up observations and perinatal parameters after the first bleeding and ultrasonic determination of placental site. The perinatal mortality rate was 11 per cent and the rate of premature deliveries 23 per cent. In the cases of recurrent bleeding episodes (N=33), the corresponding frequencies were 22 and 35 per cent. Placenta previa of some degree was diagnosed by ultrasound during the first episode of bleeding in 36 cases. Although the placenta was observed to “move” upwards from the internal os of cervix in 20 of these patients during the last few weeks of pregnancy, final placenta previa (N=16) was the most common definite etiological factor behind the bleeding. The high frequency of perinatal complications associated with these pregnancies emphasizes, despite reliable localization of the placenta, the importance of a careful follow‐up until delivery.
The Treatment of Postmenopausal Syndrome by Monthly Oral Doses of Quinestrol
Authors: Jaschevatzky Oscar E. , Anderman Shmuel , Shalit Amos , Kampf David , Griinstein Stephan
Published: December 2009

Abstract. Seventy patients between the ages of 37 and 59 suffering from the menopausal syndrome were included in a clinical trial and treated for a period of 6 to 18 months. Out of the seventy, 43 were suffering from spontaneous and 27 from surgical menopause. Forty of them were given 1 mg of quinestrol and 30 received placebo. The drug was administered orally in a one‐tablet dose once a month. An improvement took place in 35 (87.5%) of the women receiving quinestrol but in only 15 (50%) of those receiving placebo. Among the patients with spontaneous menopause an improvement was seen in 22 out of 25 (88%) receiving quinestrol, compared with 9 out of 18 (50%) receiving placebo. Tolerance of the drug was good and most of the laboratory tests as well as blood pressure and body weight showed statistically non‐significant changes. This kind of treatment is especially suitable when daily intake is undesirable.
RIPENING OF THE CERVIX BY INTRACERVICAL APPLICATION OF PGE2‐GEL BEFORE TERMINATION OF PREGNANCY WITH DILATATIONU AND EVACUATION
Authors: Wingerup Lars , Ulmsten Ulf , Andersson Karl‐Erik
Published: December 2009

Abstract. In a randomized double‐blind study a viscous gel, containing 0.25 mg prostaglandin E2 (PGE2‐gel) or without prostaglandin (placebo gel), was applied intracervically in twenty‐two nulliparous patients just before termination of early pregnancy by dilatation and evacuation (D & E). Within twelve hours a marked ripening of the cervix was found in all the eleven patients receiving PGE2‐gel. Thus, a significant change in cervical dilatation from mean 5.4 mm to mean 10.7 mm occurred. Furthermore, a considerable softening of the cervix was registered. In the eleven patients receiving placebo gel, no significant changes in cervical dilatation or consistency were found. The subsequent D & E was easily performed in all patients treated with PGE2‐gel. However, in three of the patients given placebo gel, D & E was difficult to carry out because of an unfavorable cervical state.

To eliminate or decrease myometrial activity the calcium antagonist nifedipine was given orally to eight patients at application and five hours after application of 0.25 mg PGE2‐gel. None of the patients recognized uterine contractions. However, also in these patients significant changes in cervical consistency and dilatation occurred within twelve hours. No side effects of the treatment were observed.

It is concluded, that a preoperative, intracervical single application of 0.25 mg PGE2 seems to be useful to ripen the unfavorable cervix before subsequent termination of early pregnancy by D & E.
PROSTAGLANDINS AND DYSMENORRHEA
Authors: Pickles Vernon R.
Published: December 2009

Abstract. This survey traces the development of the main ideas and experimental findings on the function of endometrial prostaglandins in stimulating the expulsive contractions of the myometrium during normal menstruation, and the effect of excessive action of this nature in producing dysmenorrhea. Some observations are also given on the ‘menotoxin’, an unidentified substance which is toxic to certain plants and which may or may not prove relevant to gynecology.

Areas where further fundamental work is needed are suggested. The survey is not a complete review of the topic, which would need a much longer paper.
PROSTAGLANDIN SYNTHETASE INHIBITORS
Authors: Whittle Brendan J. R.
Published: December 2009

Abstract. Drugs may alter prostaglandin production by acting on the various pathways of arachidonic acid metabolism. The liberation of arachidonic acid from membrane‐bound phospholipids, induced by the enzyme phospholipase A2, may be inhibited by mepacrine and the steroidal anti‐inflammatory agents. The bio‐transformation of the free arachidonic acid, by the enzyme cyclo‐oxygenase, to the unstable endoperoxide intermediates is inhibited by non‐steroidal anti‐inflammatory agents. Thus, the generation of all the prostaglandin products is prevented. This action can explain the anti‐inflammatory, analgesic, antipyretic actions as well as the ulcerogenic properties of these aspirin‐like compounds. An alternative metabolic pathway of arachidonic acid, via the lipoxygenase system, can be inhibited by an acetylenic analogue and a newer compound, phenidone. The unstable endoperoxide intermediates can be transformed by blood platelets into the pro‐aggregating products, thromboxanes. This pathway can be selectively inhibited by a variety of experimental compounds. Prostacyclin, a potent vasodilator and inhibitor of platelet aggregation is the major product of endoperoxide transformation in blood vessels. Its formation can be inhibited by lipid peroxides. Selective actions on one or more steps in arachidonic acid metabolism can lead to a different profile of the products subsequently generated. Such a diversion of biosynthetic pathways may be an underlying mechanism in certain pathological conditions, perhaps even in dysmenorrhea.
PROSTAGLANDIN SYNTHETASE INHIBITORS AND DYSMENORRHEA
Authors: Jacobson Jan , Cavalli‐Björkman Karin , Lundström Viveca , Nilsson Berit , Norbeck Mimmi
Published: December 2009

Abstract. A survey of earlier published studies on treatment of dysmenorrhea with prostaglandin synthetase inhibitors is given and personal clinical experiences are presented. The time when treatment should start in relation to the onset of bleeding is also discussed.

A survey of studies published in English and Scandinavian literature yielded 532 patients. Pain relief was experienced in 64 to 100 per cent of the patients in these studies. The incidence of side‐effects has generally been low but in a few studies a high incidence was reported.

In the current study 34 patients with primary dysmenorrhea completed the double‐blind, placebo controlled study on naproxen. The patients were treated for two cycles, 16 with naproxen and 18 with placebo. The mean relief score indicated a “slight to good” pain relief in the naproxen group and “no alleviation” in the placebo group. The difference is statistically significant (p = 0.003). Supplementary medication was much more used in the placebo group compared to the naproxen group (p = 0.01). In the placebo group no change whatsoever was demonstrated in alleviation of interference with every‐day life, whereas there was a statistically significant improvement in the naproxen group. No major side‐effect was registered. Thus none of the subjects withdrew from the study.
NAPROXEN AND INDOMETHACIN IN THE TREATMENT OF PRIMARY DYSMENORRHEA
Authors: Kajanoja Pauli , Vesanto Tuulikki
Published: December 2009

Abstract. The efficacy of naproxen and indomethacin in the treatment of dysmenorrhea was compared in a double‐blind, cross‐over study. Both drugs were given to 24 female undergraduates with severe primary dysmenorrhea in four consecutive cycles in a randomized schedule. Both drugs were equally effective. Good or moderate overall relief was achieved in 73% of 48 cycles treated with indomethacin and in 61% of the 48 cycles treated with naproxen. The difference was not statistically significant.

Gastrointestinal side‐effects occurred in 5 and 7 patients during naproxen and indomethacin treatment respectively. Central nervous system side‐effects, dizziness, headache, tiredness, were more common with indomethacin than with naproxen (p<0.02). The most important and frequent of these side‐effects, dizziness, was complained of by six patients in association with indomethacin but by none with naproxen (p<0.05). Only one patient discontinued the treatment because of side‐effects.
Posterior Bladder Suspension Defects in the Female: A Radiological Classification with Urodynamic and Clinical Evaluation
Authors: Olesen Knud P. , Walter Steen , Hald Tage
Published: December 2009

Of 420 female patients examined by means of colpo‐cysto‐urethrography 51 patients presented posterior bladder suspension defects. Two distinct forms were seen

1. Trigonocele (22 patients)—a downward herniation of the trigone between the postero‐inferiorly displaced vagina and the bladder neck, which is retained in a nearly normal position by muscle fibres from the pubococcygeal muscle and the pubovesical ligaments. Symptoms were mostly those associated with prolapse. Stress incontinence was rare, while urge incontinence, cystitis and retention of urine were seen. The morphology varied from cases where the herniation disappeared during detrusor contraction (compensated trigonocele) through typical forms to transitional forms between trigonocele and posterior bladder descent.

2. Posterior bladder descent (29 patients) comprises postero‐inferior displacement of the vagina and bladder base together. Two subgroups are discernible: A. Bladder descent even at rest (16 patients). B. Bladder descent only during micturition (13 patients). Symptoms were varied, but stress incontinence was found in 31 per cent in group A, and 62 per cent in group B. Morphological forms varied from two cases that were normalized in position during detrusor contraction (compensated descent) to total prolapse during micturition.
EARLY DIAGNOSTIC SIGNS IN THE DEVELOPMENT OF A FALLOPIAN TUBE CARCINOMA
Authors: Niklasson O. , Henriksson L. , Stormby N. , Ulmsten U.
Published: December 2009

Abstract. A woman is presented in whom cellular atypia and signs of abnormal fibrinolysis in a jet washing caused persistent suspicion of malignancy after a benign curettage. Nearly 3 years later a fallopian tube carcinoma was diagnosed. The value of determination of biological markers of neoplasia in addition to the cytologic interpretation of uterine fluid is emphasized.
The use of transcutaneous nerve stimulation for pain relief during labor: A controlled clinical study
Authors: Nesheim Britt Ingjerd
Published: December 2009

Seventy parturient women were randomized into two groups, one receiving transcutaneous nerve stimulation, the other mock stimulation with an identical looking apparatus. The patients' assessment of pain relief and the use of analgesics during labor were recorded. There was no difference between the two groups in the degree of pain relief. There was no reduction in the need for analgesics which could be ascribed to the use of nerve stimulation. The use of analgesics in each patient was correlated to the duration of labor.
TREATMENT WITH ORAL ESTRONE SULPHATE IN THE FEMALE CLIMACTERIC
Authors: Lagrelius A.
Published: December 2009

Abstract. Thirty‐eight women were treated with estrone sulphate over a period of 30 months for climacteric problems. A random control group of 29 women were given methyl scopolamine.

Bone mineral assays were performed by means of dual photon absorptiometry before the start of treatment and after 6, 12, 18, and 30 months. There was a difference in the mineral loss of trabecular bone between the two groups after 30 months of treatment, that of the control group being significantly higher (p>0.001).

In the estrogen‐treated group there was a decrease in serum phosphorus (p>0.01), alkaline phosphatase activity (p>0.001), and albumin (p>0.001). In the control group, serum albumin showed the same decrease, while the other factors either showed no difference or even increased. The urinary excretion of calcium was not significantly reduced in the estrogen group, whereas there was an increase in the control group (p>0.01). There was an increase in hematocrit in both groups.

Positive correlation was found between parity and loss of trabecular bone mineral (p>0.01).
MENSTRUAL STATUS AND MENOPAUSAL AGE OF MIDDLE‐AGED SWEDISH WOMEN
Authors: Bengtsson Calle , Lindquist Olof , Redvall Lars
Published: December 2009

Abstract. A population study of women in Göteborg, Sweden, was carried out in 1968‐69. Altogether 1462 women participated (participation rate 90.1 per cent). Five age strata were studied: 38, 46, 50, 54 and 60 (women born in 1930, 1922, 1918, 1914 and 1908, respectively). The same women were re‐studied in 1974‐75. At this time 1302 women participated, corresponding to 89.1 per cent of those studied in 1968‐69 and 80.3 per cent of those initially sampled. The vast majority of the women had a natural menopause. The median age at the menopause was found to be about 50. The criteria for definition of menopause are discussed. No support was found for the theory of increased menopausal age with time. Estrogen therapy of postmeno‐pausal women was found to be much more common in 1974–75 than in 1968–69.
Uterine Bizarre Leiomyoma
Authors: Klünder Kurt Bjørnø , Svanholm Hans , Frimodt‐Møller Poul Chr.
Published: December 2009

Abstract. On the basis of two new cases of uterine bizarre leiomyoma and a short review of the literature, the clinical aspects and pathology of this neoplasm are described. The problems of classifying atypical smooth muscle tumors and predicting malignancy according to morphologic criteria are discussed. The need to follow‐up these patients is emphasized.
Detrusor Instability Score in the Evaluation of Stress Urinary Incontinence
Authors: Kauppila Antti , Alavaikko Pirkko , Kujansuu Erkki
Published: December 2009

Abstract. The major cause of failure in the surgical treatment of stress urinary incontinence (SUI) in women is an occult detrusor instability. In order to detect detrusor instability and its degree, urological histories were standardized by scoring the replies to ten specific questions with 0 (indicative of SUI), 1 or 2 (slightly and markedly indicative of detrusor instability, respectively). The sum of the scores was termed the “detrusor instability score” (DIS).

The DIS was calculated for 134 patients both preoperatively and 2 years after operation, and 112 of these women were also evaluated by bead‐chain urethrocystography (UCG) before operation. The 10% failure rate among the 72 patients with a DIS of 0–7 (exclusive or nearly exclusive detrusor instability) was significantly less than the 32% rate in the 62 women with a DIS of 8–16 (SUI complicated by marked detrusor instability). The 38% failure rate in 47 women of peri‐ or post‐menopausal age and having a DIS of 8–16 was higher than the 10% in the other 87 women. An increased risk of failure was also found in patients who had a DIS of 8–16 together with either a urethral inclination angle of 80° or less (46% failure rate in 28 women) or a posterior urethrovesical angle of 160° or less (43% failure rate in 30 women) in lateral bead‐chain UCG during straining. The mean DIS decreased after successful surgery, but remained constant in cases of failure. The scored urological data facilitate the detection of patients with detrusor instability. This is potentiated by those lateral bead‐chain UCG findings which indicate a low motility of the proximal urethra or bladder neck.
Total Estriol in Capillary and Venous Serum During Late Pregnancy
Authors: Stånge Lars , Carlström Kjell , Nilsson Bo A.
Published: December 2009

Abstract. The choice between urine and serum/plasma estriol assays in obstetric practice is still a matter of discussion and the advantages and disadvantages of the different sampling techniques are well known. Concerning serum analysis, frequent venipuncture may be uncomfortable for some patients and in certain cases venous blood samples are difficult to obtain. In such cases capillary blood collected from the finger tip may be an alternative to blood sampling. Excellent correlations between values obtained in venous and capillary blood have recently been demonstrated for unconjugated immunoreactive estrogens (estradiol‐17β3 + estrone) by Sankolli et al. (4) and for unconjugated estriol by Axelsson and co‐workers (1). In obstetric practice, determination of total (conjugated + unconjugated) estriol is used at least as frequently as determination of the unconjugated steroid. We therefore considered it of interest to evaluate the capillary sampling technique for this steroid. Since a comparison between capillary blood and urinary estrogen values does not seem to have been reported, such a comparison was included in the study.