bluuebunny/crossref_metadata_2025 huggingface dataset:
Transvaginal Ultrasonographic Evaluation of the Endometrium Related to the Histological Findings in Pre- and Perimenopausal Women
Authors: Bakos Oddvar , Heimer Gun
Published: April 2003

Objective: To evaluate the clinical usefulness of high-resolution transvaginal ultrasonography in pre- and perimenopausal women suspected to have endometrial pathology. Patients and Methods: 196 women, aged between 32 and 57 years, were referred to the outpatient clinic for a dilatation and curettage (D&C). In 81% the clinical indication was irregular vaginal bleedings. Before the D&C an examination with transvaginal ultrasonography was performed, and the endometrial thickness and texture were determined. The ultrasonographic results were later compared with the histological diagnosis obtained from the D&C specimen. Results: Ultrasonographically both normal and pathological endometrial changes could be detected, and 82% of the women had an endometrium characterized as normal. The endometrial phase determination correlated with the histological findings in approximately 50% of the women. Histologically 83% of the women had a normal endometrium. Endometrial hyperplasia was found in 12% and endometrial polyps in 4%. There were no malignancies found in this study. The hormone users (33% of the women) had no higher incidence of hyperplasias than non-users. Conclusion: Our data indicate that transvaginal ultrasonography is as effective as the D&C for depicting the endometrium in pre- and perimenopausal women with irregular bleedings.
Comparison of the Differential Distribution of Leukocytes in Preeclampsia versus Uncomplicated Pregnancy
Authors: Lurie Samuel , Frenkel Eugine , Tuvbin Yosef
Published: April 2003

Objective: To describe leukocyte count and differential distribution in preeclampsia and uncomplicated pregnancy. Study design: Blood samples were obtained from 46 consecutive preeclamptic patients and 46 controls with uncomplicated pregnancy. Thirty met the criteria for mild preeclampsia and 16 for severe. The blood was tested within 1 h of venepuncture. An aliquot of the blood was tested in the Cell-Dyn 2000 for complete blood cell count. Main Results: The absolute neutrophil count was significantly elevated in preeclamptic patients as compared with that of controls with uncomplicated pregnancy (9,410.1 ± 3,066.9 vs. 7,498.6 ± 2,354.0 × 106/l, p < 0.05). In neutrophils, the elevation was more prominent in severe preeclamptic patients as compared with mild preeclamptic patients (10,658.8 ± 3520.4 vs. 8,694.4 ± 2,561.9 × 106/l, p < 0.05). The absolute lymphocyte and eosinophil counts declined in patients with preeclampsia as compared with uncomplicated pregnancy, whereas monocyte and basophil counts did not differ. Conclusion: Our results suggest that preeclampsia is associated with an increase in the absolute neutrophil count.
Plasma Melatonin Profile and Hormonal Interactions in the Menstrual Cycles of Anovulatory Infertile Women Treated with Gonadotropins
Authors: Tang P.L. , Chan T.Y. , Tang G.W.K. , Pang S.F.
Published: April 2003

The patterns of plasma melatonin, gonadotropins, sex steroids and prolactin were studied in anovulatory infertile females undergoing ovulation induction with hMG/hCG. Melatonin levels were found to fluctuate during the menstrual cycle of these subjects with a nadir at mid-cycle and peak occurring at the early follicular/late luteal phases of the cycle (p < 0.05). Melatonin correlated negatively with estradiol during the follicular phase (r = –0.5180, p < 0.05) and positively with LH (5 + 0.6321, p < 0.05) in the luteal phase, respectively. Correlational analyses by partial and multiple correlations suggest that the effects of estradiol and LH on melatonin in the follicular phase are interdependent whereas the effect of LH on melatonin in the luteal phase is independent of the effects of other hormones. The results suggest that hormonal interactions and phases of the cycle are important variables contributing to the fluctuations in melatonin levels during the menstrual cycle.
Comparison of Chemotherapies with Methotrexate, VP-16 and Actinomycin-D in Low-Risk Gestational Trophoblastic Disease
Authors: Matsui Hideo , Iitsuka Yoshinori , Seki Katsuyoshi , Sekiya Souei
Published: April 2003

Objective: To compare the efficiency and toxicity of four chemotherapeutic regimens in low-risk gestational trophoblastic disease. Methods: Since 1974, 247 patients with low-risk gestational trophoblastic disease have been treated with 5-day intramuscular methotrexate (MTX) (conventional MTX), 5-day intravenous drip infusion of VP-16, 5-day intravenous actinomycin-D (Act-D) or 8-day alternating intramuscular MTX-folic acid (MTX-CF) at Chiba University School of Medicine. We compared the primary remission rate, the response of human chorionic gonadotropin and the prevalence of drug toxicities in these 4 regimens. Results: The primary remission rate was 73.6% in the conventional MTX regimen, 90.1% in VP-16, 84.0% in Act-D, and 60.0% in MTX-CF. The primary remission rate was significantly higher in the VP-16 and Act-D regimens than in the conventional MTX and MTX-CF regimens. The response rate was significantly higher in the VP-16 regimen than in the other 3 regimens. The drug toxicity with VP-16 and Act-D was less than that with conventional MTX and MTX-CF regimens. Conclusions: The VP-16 regimen was highly effective and less toxic for gestational trophoblastic disease compared with other chemotherapeutic regimens.
Validation of a Laboratory Method of Measuring Postpartum Blood Loss
Authors: Chua S. , Ho L.M. , Vanaja K. , Nordstrom L. , Roy A.C. , Arulkumaran S.
Published: April 2003

Laboratory methods give more accurate measurement of blood loss in the postpartum period than visual estimation. In order to evaluate a laboratory method used to quantify blood loss postpartum, blood lost at gynecological operations was collected in a measuring bottle. The measured amount of blood (50–1,000 ml) was then poured onto absorbent paper towels and sanitary pads, in order to mimic conditions when measuring blood loss in clinical trials in the postpartum period. The amount of blood absorbed onto the absorbent paper and sanitary pads was measured by a rapid method of automatic extraction and photometric measurement of alkaline hematin. The study shows that the method provides a reliable and accurate means of measuring blood loss. The error in each case was less than 10% with an intraclass correlation coefficient of almost 1.
Endothelin Stimulation of Rat Uterine Segment Contractility Is Estrogen-Dependent
Authors: Gittens Lisa N. , Wojtczuk Andrea , Weiss Gerson , Goldsmith Laura T.
Published: April 2003

To determine whether the effect of endothelin upon in vitro uterine contractility requires estrogen, immature female Long Evans rats were subcutaneously injected daily for 3 days with either estradiol benzoate or vehicle. The uterine contractile response to endothelin (5 or 100 nM) was measured. A response to endothelin in vehicle-treated animals exposed to physiologic (5.6 mM) or high (70.6 mM) potassium levels was also noted. Vehicle-treated uteri did not respond to endothelin; the contractions in estrogen-treated uteri increased by 288%. With high potassium, and without estrogen, no response to endothelin was seen. These data indicate that the contractile effect of endothelin on the uterus requires estrogen.
Prophylaxis of the Occurrence of Hyperbilirubinemia in Relation to Maternal Oxytocin Infusion with Steroid Treatment
Authors: Leylek Ozkan A. , Ergur Ayça , Senocak Feyza , Sencan Mehmet , Bakır Sevtap , Ozdemır Himmet , Songur Selda
Published: April 2003

This study was carried out to investigate the steroid prevention on the occurrence and the severity of red blood cell destruction by the effect of oxytocin usage for labor induction. Venous cord blood was collected from the pregnancies who had oxytocin-induced or augmented labors (20), oxytocin-infused deliveries with steroid use (20), deliveries without oxytocin use (20) and cesarean sections (20). Evaluation of the data showed significant increase in serum bilirubin level, serum lactic dehydrogenase activity, erythrocyte fragility and reticulocyte count (p < 0.0083), and a significant decrease in hemoglobulin concentration, packed red cell volume fraction (p < 0.01) in groups with labor induction or augmentation with oxytocin in comoparison to deliveries with oxytocin plus steroid use and the two other methods of delivery. Moreover, with regard to the above data, no significant difference was observed between the deliveries other than oxytocin-only use. Mean corpuscular volume in the oxytocin group was apparently (not significant) higher than the steroid group. The results of this study suggest that the use of 16 mg dexamethasone 21-phosphate at the beginning of the induction or augmentation of labor with oxytocin, followed by an additional 4-mg dose 4 h later intravenously, is advantageous for the prevention of erythrocyte destruction.
Lipid Peroxidation andVitamin E Level s in Preeclampsia
Authors: Kharb Simmi , Gulati Nirmal , Singh Veena , Singh G.P.
Published: April 2003

Twenty preeclamptic, 25 normotensive pregnant and 25 healthy nonpregnant women were analyzed with regard to serum malonaldehyde (MDA), vitamin E and lipid profile. In preeclampsia, MDA was significantly higher than control. MDA also showed high correlation to the level of blood pressure. Serum cholesterol and triglycerides were increased in normotensive women and still higher in preeclamptic women. A highly significant fall in vitamin E levels in preeclamptic women was noted as compared to control groups. Our study supports the view that an increased lipid peroxidation may be involved in vasoconstriction in preeclampsia.
Preoperative Determination of Several Serum Tumor Markers in Patients with Primary Epithelial Ovarian Carcinoma
Authors: Kudoh Kazuya , Kikuchi Yoshihiro , Kita Tsunekazu , Tode Takehiko , Takano Masashi , Hirata Junko , Mano Yoshinori , Yamamoto Kenji , Nagata Ichiro
Published: April 2003

This study was designed to evaluate the clinical significance of the use of preoperative serum tumor markers in primary epithelial ovarian cancer. Subjects comprised 111 patients with primary epithelial ovarian cancer. Lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (HBDH), carcinoembryonic antigen (CEA), CA19-9, tissue polypeptide antigen (TPA), CA125 and sialyl TN (STN) serum levels were measured within 7 days before surgery. The tumor marker values were compared with the histopathologic diagnosis. The overall agreement between the test results and the actual outcome was calculated using Student’s t test and analysis of variance (ANOVA). Survival curves were constructed according to the Kaplan-Meier method, and differences in survival were assessed with the log-rank test. The prognostic significance of tumor markers for survival was assessed in a multivariate analysis with the Cox proportional hazards model. Of the tumor markers examined in this study, CA125 showed the highest positive rate (77.6%), followed by 63.2% for STN and 55.9% for CA19-9. When the positive rate was compared according to histologic types, serous cystadenocarcinoma, mucinous cystadenocarcinoma, endometrioid adenocarcinoma and clear cell carcinoma showed the highest positive rates for CA125 (94.1%), CA19-9 (76.9%), CA125 (91.7%) and STN (75.0%), respectively. Regarding the distribution of tumor marker levels according to the FIGO stage, LDH, HBDH, TPA and CA125 were correlated with the clinical stage while CEA, CA19-9 and STN did not show any correlation. From analyses of tumor marker levels according to histologic types, all patients with a ratio of CA125 to CEA of >1,000 had serous cystadenocarcinoma and a ratio of CA125 to CA19-9 of >50 showed serous cystadenocarcinoma or endometrioid adenocarcinoma. On the other hand, all patients with a ratio of LDH or HBDH to CA19-9 of <1.0 had mucinous cystadenocarcinoma or clear cell carcinoma. From univariate analysis, the survival time of patients with elevated CA125, TPA or STN was significantly shorter than that of patients with normal CA125, TPA or STN levels. When the Cox’s proportional hazard model was used, we identified age, clinical stage, clear cell carcinoma and serum STN as independent prognostic factors. Serum CA125, TPA or STN may give significant prognostic information in epithelial ovarian carcinoma. It is noteworthy that STN has been identified as an independent prognostic factor and has a high rate of positivity in clear cell carcinoma.
The Complexity of Pregnancy Anemia in Dar-es-Salaam
Authors: Massawe S.N. , Urassa E.N.J. , Mmari M. , Ronquist G. , Lindmark G. , Nystrom L.
Published: April 2003

Objectives: To investigate the main causes of anemia in pregnancy in Dar-es-Salaam and identify appropriate investigations at all levels of care. Materials: All pregnant women booking for antenatal care at 2 clinics (n = 2,235) were screened for anemia. Investigations for etiology of anemia were done in all anemic women (Hb <10.5 g/dl) (n = 361). Methods: Blood cell counts, microscopy of blood films, S-ferritin, C-reactive protein, HIV, stool parasite and bone marrow analysis were performed. Results: Iron deficiency dominated in 86% and malaria in 1/3 of anemia cases. Since 42% had indication of ongoing inflammation, S-ferritin was less useful as indicator of iron deficiency but blood film microscopy identified most cases.
Factors Influencing Vaginal Fetal Fibronectin Concentrations during Pregnancy
Authors: Rossel Goffeng Anette , Holst Elisabet , Milsom Ian , Lindstedt Göran , Lundberg Per-Arne , Andersch Björn
Published: April 2003

In order to evaluate factors influencing fetal fibronectin concentrations during pregnancy a total of 312 vaginal samples for fetal fibronectin measurements and microbiological culture were collected and later included in a stepwise regression analysis. Preterm premature rupture of membranes, a modified Bishop score ≥6 (p < 0.0001), a low vaginal polymorphonuclear leukocyte count (p < 0.002), the presence of Enterococcus faecalis (p < 0.0001), Prevotella species (p < 0.05), a bacterial vaginosis-associated flora (p < 0.05), and a non-lactobacilli-dominated vaginal flora (p < 0.05) were associated with an elevated vaginal fetal fibronectin concentration.
Intermittent Cisplatin Therapy for Stage-III Ovarian Cancer Patients following Clinical Remission
Authors: Umesaki Naohiko , Tanaka Tetsuji , Muso Hiroshi , Kawamura Naoki , Kanaoka Yasushi , Honda Ken-ichi , Deguchi Masaaki , Ishiko Osamu , Ogita Sachio
Published: April 2003

Intermittent cisplatin (CDDP) administration as consolidation therapy for stage-III ovarian cancer was studied. No patients with residual disease at surgery or at second-look operation or patients with <8 U/ml of CA125 after remission induction chemotherapy were enrolled in this study. Fifteen subjects received intermittent chemotherapy, and 10 control patients did not. CDDP of 20 mg/m2 for 5 days was administered every 3–4 months for 5 years. A significant increase in 5-year survival rate was found in the intermittent chemotherapy group when compared with the control group. Side effects from the intermittent chemotherapy were controllable. Intermittent CDDP therapy seems to be an effective consolidation therapy for stage-III ovarian cancer patients.
Fertility Potential of Individual Sperm Donors
Authors: Al-Inany Hesham G. , Dunselman GerardA.J. , Dumoulin JohnC.M. , Maas JacquesW.M. , Evers JohannesL.H.
Published: April 2003

Objective: To study the fertility potential of individual semen donors with ejaculates of optimal as compared to suboptimal quality. Methods: 363 semen donations were obtained from 11 donors between January 1993 and September 1997. 270 samples were cryopreserved and 1,399 straws obtained from 120 ejaculates were used in 495 insemination cycles. Results: 52 pregnancies were achieved in 128 recipients (40.6%). No significant differences were found between donors of high fecundability and those of low fecundability regarding sperm parameters. The mean donor fecundability index was 10.5%. The optimal and suboptimal samples yielded similar results. Donors with suboptimal semen quality had an increased number of samples rejected after thawing. Conclusion: Traditional semen analysis parameters do not differentiate high from low fecundability donors. Suboptimal results of the semen analysis should not exclude potential donors from an artificial insemination donor (AID) program.
Endometrial Morphology and Ultrasound Vascular Findings
Authors: Ragni Guido , Piloni Stefania , Rossi Piero , Carinelli Silvestro , de Lauretis Luciana , Vegetti Walter , Crosignani Pier Giorgio
Published: April 2003

Luteal-phase supplementation has proved necessary in Gn-RH analog and human gonadotropin-stimulated cycles. We studied the effects of vaginally and intramuscularly delivered progesterone on the endometrium. Thirty patients enrolled in an IVF program without embryo transfer due to absence of fertilization were included in the study. Patients were randomly allocated to two treatment groups. Group A (n = 15) was administered 200 mg progesterone b.i.d. by the vaginal route (Esolut, Angelini) starting on the day of oocyte pick up and group B (n = 15) was given 100 mg intramuscular progesterone once daily (Prontogest, Amsa). Six days after HCG administration, biopsies were obtained for endometrial histological maturation and estrogen (ER) and progesterone (PR) receptor analyses. In addition, ultrasound measurements of endometrial thickness were made and uterine and myometrial artery flow was determined. Serum concentrations of estriol and progesterone were measured on the day of HCG, at oocyte pick up and at endometrial biopsy. The two treatment groups were similar in terms of follicular phase parameters during superovulation with Gn-RH analog and gonadotropin. Histologic, receptor and ultrasonographic analyses showed no significant differences between the two treatment groups. Our results indicate that both intramuscular and vaginal progesterone are equally effective on the endometrium.
Cervical Adenoid Cystic Carcinoma Coexisting with Multiple Human Papillomavirus-Associated Genital Lesions
Authors: Yang Yi Jun , Gordon Gerald B.
Published: April 2003

Adenoid cystic carcinoma of the uterine cervix is a rare tumor with unknown etiology. We report a case of adenoid cystic carcinoma occurring in a young woman, associated with multiple human papillomavirus (HPV)-related lesions including condyloma acuminata, vulvar intraepithelial neoplasm, cervical intraepithelial neoplasm and invasive basaloid squamous cell carcinoma. While adenoid cystic carcinoma has previously been found to coexist with squamous cell carcinoma or cervical intraepithelial neoplasia, its association with such a variety of HPV-related lesions in our case has not been previously reported, and raises the speculation that HPV may also be the causative factor for adenoid cystic carcinoma. However, in situ DNA hybridization and polymerase chain reaction in our current study failed to demonstrate the existence of HPV DNA in adenoid cystic carcinoma.
Increased Natural Killer Cell Activities in Patients Treated with Gonadotropin Releasing Hormone Agonist
Authors: Umesaki Naohiko , Tanaka Tetsuji , Miyama Masato , Mizuno Kuniko , Kawamura Naoki , Ogita Sachio
Published: April 2003

Natural killer (NK) cell activity in patients treated with gonadotropin-releasing hormone agonists (GnRH-a) was studied. The subjects were 8 patients with endometriosis (6 with ovarian endometrial cyst, 2 with adenomyosis) and 3 patients with uterine leiomyoma. Changes in serum estradiol (E2) concentration and NK cell activity in peripheral blood were analyzed before and after GnRH-a treatment (buserelin 900 μg/day for 4–5 months). NK cell activity was determined by 51Cr release assay and E2 by radioimmunoassay. NK cell activity before GnRH-a treatment was 37.7 ± 19.0%, and after therapy activity increased significantly to 50.8 ± 18.2%. However, no significant correlation between the increase in NK cell activity and the decrease in E2 concentration was found. Results indicate that the standard GnRH-a treatment for endometriosis and uterine leiomyoma might increase NK cell activity. The etiology of the increase of NK activity with GnRH-a treatment is likely related to factors other than E2 concentration.
Luteal Phase Support with 17α-Hydroxyprogesterone versus Unsupported Cycles in in vitro Fertilization:A Comparative Randomized Study
Authors: Abate A. , Brigandi A. , Abate F.G. , Manti F. , Unfer V. , Perino M.
Published: April 2003

This study was designed to determine the efficacy of 17α-hydroxyprogesterone caproate (17-OHPc) for luteal phase support in in vitro fertilization (IVF). For this purpose, a total of 86 IVF patients undergoing embryo transfer were randomly allocated to two groups as follows: (1) group A, including 43 patients who received the support of luteal phase through the intramuscular administration of 17-OHPc at a dosage of 341 mg every 3 days, and (2) group B, including 43 patients who received the intramuscular administration of a saline solution as placebo every 3 days. In both groups, the treatment was started within 24 h after embryo transfer until β-HCG evaluation. In case of positive β-HCG, it was extended until 12 weeks. Efficacy was assessed using the pregnancy rates, which was, per transfer, statistically significantly higher in group A than in group B (32.5 vs. 18.3% respectively). On the basis of our results, we emphasize the use of 17-OHPc for luteal phase support after IVF and embryo transfer.
Endocrinological Disorders
Authors: Blaicher Wibke , Imhof Martin H. , Gruber Doris M. , Schneeberger Christian , Sator Michael O. , Huber Johannes C.
Published: April 2003

Background: The interaction of melatonin to sterility and anovulation as well as related hormonal disorders has not been sufficiently examined yet. We set out to investigate the interaction between melatonin and hyperprolactinemia, hyperandrogenemia, hypothyreosis and obesity in premenopausal females. Methods: We evaluated the overnight urinary excretion of 6-sulfatoxymelatonin (6-SMT) in a group of 155 women using a radioimmunoassay. Results: Melatonin levels in patients with hyperprolactinemia and hyperandrogenemia with normal body mass index are significantly higher compared to matched controls. Obese females without hormonal disorders showed statistically lower 6-sulfatoxymelatonin levels and in hypothyreotic females we found no difference in 6-sulfatoxymelatonin levels compared to controls. Conclusion: Melatonin plays an important role in patients with hormonal disorders such as hyperprolactinemia and hyperandrogenemia. Melatonin should be prescribed restrictively in all sterile patients. In patients with untreated hypothyreosis or obesity, melatonin seems to play a minor part; in those with hyperprolactinemia and hyperandrogenemia additionally to standard sterility treatment light therapy may improve the outcome.
Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings
Authors: Cohen Ilan , Azaria Ron , Aviram Rami , Bernheim Joelle , Tepper Ron , Cordoba Mario , Beyth Yoram
Published: April 2003

Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal breast cancer patients with tamoxifen treatment (group I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared. This comparison was performed in order to assess whether endometrial pathologies are more frequently diagnosed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological findings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium was significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001). All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 and 11.5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15.0 and 0.4%, respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various endometrial histological findings and of overall positive endometrial histological findings were significantly higher in specimens collected by hysterectomy than in specimens obtained by hysteroscopy.
Discordance between Fetal RhD Typing Using Molecular Methods and Neonatal Typing with Serology
Authors: van den Veyver Ignatia B. , Yankowitz Jerome , Subramanian Stephanie B. , Dorman Karen F. , Moise Jr. Kenneth J.
Published: April 2003

Polymerase chain reaction (PCR)-based genotyping on amniotic fluid in an RhD-negative alloimmunized woman predicted an RhD-negative fetal blood type. The neonate was RhD-positive and developed hemolytic disease. Discrepant results were also observed on paternal testing. PCR analysis with a different set of primers correctly predicted the RhD-positive fetal and paternal blood type. Use of more than one set of primers and parental testing can avoid some of the problems associated with use of PCR genotyping.
A Sensitive, Nonradioactive Method for the Detection of a Low Level of Apoptosis in Rat Ovary and Human Placenta
Authors: Furuta Itsuko , Yamada Hideto , Sakuragi Noriaki , Fujimoto Seiichiro
Published: April 2003

Apoptosis is often characterized by internucleosomal DNA fragmentation, which is classically visualized in standard agarose gel electrophoresis. However, this technique is not sufficiently sensitive for the detection of a modest apoptotic level in intact tissues. We developed a sensitive, nonradioactive method for the qualitative and quantitative analyses of apoptotic DNA fragmentation in intact tissues. An ultrasensitive chemiluminescent substrate, CDP-Star, was used for the visualization of digoxigenin (DIG)-labeled DNA fragments, and banding patterns were densitometrically quantified. Serially diluted DNA samples from rat ovaries were labeled with DIG. As a result, only 1.56 ng of DNA could be analyzed for the presence of apoptotic DNA cleavage. The sum intensity of these bands increased almost linearly by increasing the amount of labeled DNA. In human placental tissues, clear apoptotic DNA ladders were visualized by this method, and the quantification of apoptotic DNA fragmentation was also possible. This new method provides a nonradioactive, highly sensitive and semiquantitative analysis of apoptotic DNA fragmentation and may be highly useful for the study of a low, physiological level of apoptosis.
Xanthogranulomatous Tubo-Ovarian Abscess Resulting from Chronic Diverticulitis
Authors: Mesia Augusto F. , Lam Henry , Wallach Robert C.
Published: April 2003

We report a case of xanthogranulomatous tubo-ovarian abscess which was preoperatively suspected to be an adnexal neoplasm. With foreign body material found in the abscess wall and vegetable fiber in the tubal lumen, a previously treated chronic diverticulitis was the presumed cause. Culture studies showed polymicrobial isolates which included Escherichia coli, an enteric pathogen. After surgery, administration of antibiotics, and revision of delayed subcutaneous wound healing, the patient is reportedly well.
Nitric Oxide Affects Angiotensin II Pressor Response: Possible Mechanism of Attenuated Pressor Response during Pregnancy and Etiology of Pregnancy-Induced Hypertension
Authors: Maeda Takahiro , Yoshimura Toshihiro , Ohshige Akihiro , Koyama Hideki , Ito Masaharu , Okamura Hitoshi
Published: April 2003

Objective: To investigate the mechanism of attenuated pressor responses to several vasoconstrictors during gestation, we sought to characterize the effects of NG-monomethyl-L-arginine (L-NMMA) and L-arginine (L-Arg) on the pressor response to the infusion of angiotensin II in rats. Methods: L-NMMA and L-Arg were infused intraperitoneally into rats at a constant rate by means of an osmotic minipump. The L-NMMA group received an infusion of L-NMMA (3 mg/day) daily for 13 days, whereas the L-NMMA plus L-Arg group received L-NMMA (3 mg/day) daily for 4 days, followed by L-NMMA plus L-Arg (12 mg/day) daily for 9 days. Sham-operated rats served as controls. The animals were anesthetized on day 13, and catheters were placed into the femoral artery and vein. After the animals had recovered from anesthesia, the pressor response to intravenous bolus doses of angiotensin II (50, 100, 200, and 400 ng/kg) were determined after recovery from anesthesia. Results: While the baseline mean arterial blood pressure was not affected by L-NMMA, with or without L-Arg, the pressor response to angiotensin II in the L-NMMA group was significantly increased as compared with that in the control group, at doses of 50, 100, and 200 ng/kg. The response of the L-NMMA plus L-Arg group did not differ significantly from that of the control group. Conclusion: Results indicate that the infusion of a nitric oxide synthase inhibitor, at a dose insufficient to produce hypertension, increases the pressor response to angiotensin II.
High-Risk Pregnancy in Beta-Thalassemia Major Women
Authors: Perniola Roberto , Magliari Francesco , Rosatelli M. Cristina , De Marzi Cristiano A.
Published: April 2003

Reproductive failure is common in β-thalassemia major patients because of endocrine damage resulting from iron overload. Here 3 full-term pregnancies following spontaneous ovulation in 2 splenectomized β-thalassemia major women are reported. The main echocardiographic parameters, such as left ventricular end-diastolic and end-systolic diameters, fractional shortening and ejection fraction, were within the normal range before pregnancy, but worsened during gestation, and 1 patient developed pre-congestive heart failure. Deferoxamine therapy was continued throughout 2 pregnancies, while in the other it was stopped after 8 weeks: no abnormalities were noted in the children. Thanks to the currently applied therapies, an increased number of pregnancies may now be expected in β-thalassemia major women: it is important to find out more about the pregnancy-related problems and their management in these patients.
Accuracy of Frozen Section Diagnosis in Borderline Ovarian Malignancy
Authors: Kayikcioglu Fulya , Pata Özlem , Cengiz Saadet , Tulunay Gökhan , Boran Nurettin , Yalvaç Serdar , Köse M. Faruk
Published: April 2003

This study was conducted to determine the accuracy of frozen section diagnosis in borderline ovarian tumors. Thirty-three patients were evaluated on the basis of frozen sections between February 1992 and December 1997. Frozen section diagnosis and final diagnosis were divided into three categories: for frozen section diagnosis: 1 = benign, 2 = borderline, 3 = ‘at least’ bordeline, and for final diagnosis: 1 = benign, 2 = borderline, 3 = cancer. Three patients with a benign diagnosis according to their frozen sections were reclassified as borderline in the final diagnosis and all of them were of the mucinous type. The frozen section diagnosis of tumors of borderline malignancy was inaccurate in 3 of 23 patients. Four of 7 patients with at least borderline according to their frozen section diagnosis had invasive cancer at the final diagnosis. The correlation between frozen section diagnosis and final pathological examination was 72.7% (24/33). We found 9% (2/22) inaccurate results in the serous type and 36.6% (4/11) in the mucinous type. The sensitivity and specificity of frozen section diagnosis were found to be 86.95 and 57.14%, respectively. We concluded that frozen section evaluation in identifying a borderline ovarian malignancy is accurate enough to exclude the presence of a benign pathology.
Reproductive History in Mothers of Children with Neural Tube Defects
Authors: Rivas Fernando , Dávalos Ingrid P. , Olivares Norma , Dávalos Nory O. , Pérez-Medina Roberto , Gómez-Partida Guillermo , Chakraborty Ranajit
Published: April 2003

The reproductive history of 100 women with at least 1 child with a neural tube defect (NTD) has been studied. The data analyzed correspond to the period previous to their first visit to a genetic counseling service. A total of 204 pregnancies resulted in 205 outcomes. Of the 100 sibships, 14 (14%) had more than 1 affected member. The pregnancy was shorter than 28 weeks in 56/205 (27%) of the total outcomes. Of 104 evaluable previous outcomes, 34 corresponded to short pregnancies, positioned before an affected (23/60, 38%), a healthy (2/18, 11%), or an undiagnosed product (9/26, 35%). Short pregnancies subsequent to affected outcomes were also increased. The inter-gestational interval varied according to diagnosis: it was longer in the affected group than in the healthy one (0.1 > p > 0.05) and the subsequent intervals were shorter for the affected group (p < 0.05). An increased number of abortions adjacent to affected offspring and a changing fertility pattern, depending on the product diagnosis, point to an environmental etiological component in this high-risk NTD group of mothers.
Leiomyoma of the Fallopian Tube
Authors: Misao R. , Niwa K. , Iwagaki S. , Shimokawa K. , Tamaya T.
Published: April 2003

Leiomyomas of the fallopian tube are rare. They are typically incidental findings seen at autopsy or unrelated surgical procedures. A 32-year-old woman presented with lower abdominal pain and mass. Transvaginal sonogram and magnetic resonance imaging showed the solid mass at the outside of the uterus. At surgery, the left fallopian tube contained a firm mass with torsion in the area of the ampullary-isthmic junction. The left tube and the infundibulopelvic ligament were rolled in torsion and showed edematous change. We report a rare case in whom torsion of a pedunculated tubal leiomyoma caused abdominal pain.
Multiple Screening for Fetal Down’s Syndrome with the Classic Triple Test, Dimeric Inhibin A and Ultrasound
Authors: Debiève F. , Bouckaert A. , Hubinont C. , Thomas K.
Published: April 2003

The aim of the study was to determine whether inhibin combined with ultrasound improves the classic second trimester triple test. Eighteen Down’s syndrome and 200 euploid pregnancies were included. Maternal serum α-fetoprotein (AFP), human chorionic gonadotrophin (hCG), and estriol (E3), measured between 15 and 20 weeks’ gestation by radioimmunoassay, were retrieved. Inhibin A was tested with a specific two-monoclonal-antibody ELISA. Ultrasound was performed between 15 and 25 weeks’ gestation: femur length, nuchal thickness and morphological abnormalities were assessed. Statistical analysis used a multivariate discriminant analysis. Except for the classic triple test parameters, only inhibin and the standard deviation score (SDS) for femur length allowed us to make a statistically significant distinction between euploid and Down’s syndrome pregnancies. For a 5% false-positive rate, the classic triple test sensitivity was 61%. When E3 was replaced with inhibin A, the sensitivity increased to 77.8% and to 66.7% with SDS femur length. Combining hCG, AFP, SDS femur length and inhibin A gave a sensitivity of 66.7% for a false-positive rate of 2.5%. In conclusion, the classic triple test can be more significantly improved by replacing E3 with inhibin than by including ultrasound. However, a combination of ultrasound and inhibin enhances both the sensitivity and specificity of the test. In Down’s syndrome screening, the biological parameters improve sensitivity while ultrasound is a better indication of specificity.
Reproductive Outcome after Surgical Treatment of Ectopic Pregnancy
Authors: Kjellberg L. , Lalos A. , Lalos O.
Published: April 2003

Objectives: Reproductive outcome after laparoscopy or laparotomy performed for treatment of ectopic pregnancy. Methods: Data of 104 women were collected by a questionnaire and from medical records. Results: No differences in pregnancy rate were found comparing the two different operative procedures. Women with a normal contralateral fallopian tube had a better pregnancy rate compared with those with a damaged contralateral tube. Conclusions: The crucial factor for future reproductive outcome after surgical treatment of ectopic pregnancy is the status of the contralateral tube.
Comparison of Magnesium and Methyldopa for the Control of Blood Pressure in Pregnancies Complicated with Hypertension
Authors: Rudnicki Martin , Frølich Anne , Pilsgaard Kirsten , Nyrnberg Lone , Møller Mette , Sanchez Manuel , Fischer-Rasmussen Wiggo
Published: April 2003

Objectives: Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. Methods: A total of 33 patients with pregnancy-induced hypertension were randomized to either magnesium or methyldopa treatment. Of these 16 received magnesium and 17 methyldopa. The treatment comprised a 48-hour magnesium infusion followed by oral magnesium tablets until 3 days after delivery or 250 mg methyldopa 4 times a day in a similar period. Results: Patients treated with magnesium had 1 day after inclusion a statistically significantly lower systolic blood pressure compared to the level in the methyldopa group (138.1 ± 11 vs. 147.6 ± 11 mm Hg; p < 0.05), but no difference was observed in diastolic blood pressure (92.0 ± 6.6 vs. 96.0 ± 10.1 mm Hg; NS). From the 5th day of inclusion and until delivery both systolic and diastolic blood pressure were significantly lower in the magnesium group (p < 0.05). Including all blood pressure measurements in a single analysis showed that both systolic (138 ± 13 vs. 148 ± 15 mm Hg; p < 0.0001) and diastolic (92 ± 10 vs. 94 ± 10 mm Hg; p < 0.05) blood pressure were lower in the magnesium group compared to the methyldopa group. There was no difference between the two groups regarding gestational age at delivery, birth weight, Apgar scores and pH in umbilical cord blood. Conclusion: This preliminary study demonstrates that magnesium treatment lowers blood pressure in pregnancies complicated with hypertension. The effect is without any adverse effect on maternal and neonatal well-being.
Menstruum Induces Changes in Mesothelial Cell Morphology
Authors: Koks Carolien A.M. , Demir Weusten Ayşe Y. , Groothuis Patrick G. , Dunselman Gerard A.J. , de Goeij Anton F.P.M. , Evers Johannes L.H.
Published: April 2003

In previous studies, we have shown that menstrual endometrium preferentially adheres to the subepithelial lining of the peritoneum. It remains to be elucidated, however, whether this damage is preexisting or inflicted by the menstrual tissue itself. We hypothesized that the menstrual tissue itself damages the peritoneum. To investigate this, the viability of menstrual endometrial tissue in peritoneal fluid (PF) was evaluated and the morphologic changes in the mesothelial cells were studied by in vitro cocultures of menstruum with mesothelial cell monolayers. Menstruum was collected with a menstrual cup. Endometrial tissue was isolated from the menstruum, resuspended in culture medium or in the cell-free fraction of PF and cultured for 24, 48 or 72 h. A 3(4,5-dimethylthia-zolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) assay was performed to obtain a relative measure of viable adhered endometrial cells. Mesothelial cells isolated from human omental tissue were cultured on Matrigel or uncoated plastic. At confluence, overnight cocultures were performed and scanning electron microscopy was used to evaluate the morphologic changes. The viability of endometrial fragments was 84% (n = 36, p < 0.05), 82% (n = 27, not significant) and 104% (n = 14, not significant) when cultured in the cell-free fraction of PF for 24, 48 and 72 h, respectively, when compared to medium with 10% fetal calf serum. Menstrual endometrial fragments or menstrual serum added to and cocultured with mesothelial cells induced severe morphologic alterations of the latter, including retraction, shrinking and gap formation. Similar morphologic changes were observed when mesothelial cells were cocultured with menstrual endometrial fragments in PF or in culture inserts. Incubation with conditioned medium from cultured menstrual endometrium induced similar but less pronounced changes in morphology. In conclusion, menstrual endometrial fragments remain viable in PF in vitro for at least 72 h. Antegradely shed menstruum induces changes in mesothelial cell morphology, including retraction and shrinking with exposure of the underlying surface. These findings suggest that menstruum is harmful to the peritoneal lining. Therefore, by local destruction of the mesothelial layer, menstrual endometrium is able to create sites for adhesion.
Fetal Binocular Distance
Authors: Jacquemyn Yves , Sys Stanislas U. , Verdonk Paul
Published: April 2003

Objective: The aim of this study was to detect if interethnic differences for fetal binocular distance exist between the autochthonous Belgian population and immigrants from Turkey or Morocco, and to evaluate the need for different reference charts by ethnicity. Methods: A prospective cross-sectional study was performed. In 246 pregnant women who presented for routine prenatal ultrasound between 18 and 40 weeks of gestation age the binocular distance was measured. Polynomial regression was performed for the three ethnic groups. Results: The population consisted of 171 autochthonous Belgian women, 31 women from Turkish origin and 44 women from Moroccan origin. A statistically significant difference for the fetal binocular distance was noted between the Moroccan versus the autochthonous Belgian and Turkish fetuses (F test, p = 0.047). The order of magnitude of this statistical difference is extremely small and does not result in clinical relevance. Conclusion: A small, but statistically significant difference exists for the fetal binocular distance between fetuses of Moroccan origin versus those of autochthonous Belgian or Turkish origin. This difference is of no clinical importance and there is no need to adapt reference charts for ethnicity when studying these three groups.
Transvaginal Sonohysterography for the Evaluation and Treatment of Retained Products of Conception
Authors: Wolman Igal , Gordon David , Yaron Y. , Kupferminc M. , Lessing Joseph B. , Jaffa Ariel J.
Published: April 2003

Diagnosing retained products of conception in a woman presenting with postpartum or postabortion bleeding presents a clinical challenge. Although ultrasonographic examination may be potentially useful in detecting retained products of conception, its accuracy has not yet been established. Saline infusion sonohysterography is a simple ultrasonographic technique for enhanced transvaginal sonographic imaging of the endometrial cavity by the instillation of saline into the uterine cavity during ultrasonographic evaluation. This technique enhanced our ability to diagnose retained products of conception, and we describe our experience in evacuating them under sonographic guidance while performing saline infusion sonohysterography.
5-Hydroxytryptamine Induces Vasoconstriction of the Human Umbilical Artery: Effects of Hypoxia and Nicorandil
Authors: Tiritilli Alberto
Published: April 2003

Human umbilical arteries are known to be modulated by oxygen partial pressure. To further understand the underlying mechanisms, rings were suspended in organ chambers for the measurement of isometric force. The effects of 5-hydroxytryptamine (10–9 to 10–5 M) were first investigated before and after hypoxic conditions (5% O2–5% CO2 in N2). Then after pretreatment, we tested indomethacin (10–5 M), N-nitro-L-arginine (L-NNA, 10–5 M) and nicorandil (10–5 M) each separately, then each of the three substances together with hypoxia. In separate experiments the contractions to 5-hydroxytryptamine (10–9 to 10–5 M) were effectuated in a glucose-free medium, and mitochondrial respiration was inhibited by cyanide (2 mM). Hypoxic conditions significantly reduced the contractive response to 5-hydroxytryptamine. Contractions were enhanced after indomethacin, but remained unchanged after L-NNA. Pretreatment with nicorandil decreased the contraction. Furthermore, hypoxia and nicorandil dramatically decreased the contraction to 5-hydroxytryptamine. In glucose-free medium under normoxia or in hypoxic conditions, 5-hydroxytryptamine did not induce any contraction. Moreover, cyanide (2 mM) remained without effect on the contraction obtained by 5-hydroxytryptamine. These results suggest that hypoxia and nicorandil attenuate vasoconstrictor responses to 5-hydroxytryptamine in human umbilical arteries. Furthermore, these findings suggest that prostacyclin acts as a functional antagonist to vasoconstriction whereas nitric oxide does not. Finally, glycolysis seems to be involved rather than mitochondrial metabolism.
Methylenetetrahydrofolate Reductase Polymorphisms Are Not a Risk Factor for Pre-Eclampsia/Eclampsia in Australian Women
Authors: Kaiser Thomas , Brennecke Shaun P. , Moses Eric K.
Published: April 2003

In European and Japanese but not in Australian, American, and South African women, the C677T methylenetetrahydrofolate reductase (MTHFR) polymorphism has been reported to be a genetic risk factor pre-eclampsia/eclampsia (PE/E). The recently described A1298C MTHFR gene polymorphism also results in reduced MTHFR enzyme activity, although to a lesser extent than the previously described C677T polymorphism. Heterozygotes for both polymorphisms are reported to have an even lower MTHFR enzymatic activity than seen in homozygotes for the C677T genotype. In this current study we determined the allele frequency of the A1298C MTHFR gene polymorphism in an Australian population and examined this polymorphism alone and in combination with the C677T MTHFR polymorphism for an association with PE/E. Neither the A1298C polymorphism alone nor a combination of both polymorphisms showed an association with PE/E in our population of Australian women.
New Cervicoscopy with Toluidine Blue Staining for Superficial Cervical Invasion by Endometrial Carcinoma
Authors: Nishimura Sadako , Ishiko Osamu , Honda Ken-ichi , Hyun Yooji , Ogita Sachio
Published: April 2003

We developed a method of endocervical staining with toluidine blue solution during cervicoscopy that clearly discriminates between the endocervical region and the endometrium and allows easy detection of superficial cervical invasion by endometrial carcinoma. Toluidine blue staining cervicoscopy was used for preoperative histological diagnosis in 10 cases of endometrial carcinoma. The staining permitted a correct diagnosis in 3 cases in which conventional diagnostic methods were practically useless. Endocervical staining with toluidine blue is highly useful for diagnosis of superficial cervical invasion by endometrial carcinoma.
Use of Intramuscular Progesterone versus Intravenous Albumin for the Prevention of Ovarian Hyperstimulation Syndrome
Authors: Costabile Loredana , Unfer Vittorio , Manna Claudio , Gerli Sandro , Rossetti Dario , Di Renzo Gian Carlo
Published: April 2003

This study was designed to compare the effectiveness of intramuscular progesterone with that of intravenous albumin in the prevention of ovarian hyperstimulation syndrome (OHSS). Ninety-six patients at high risk to develop OHSS (estradiol concentration >9,000 pmol/l on the day of hCG administration and over 20 follicles of a diameter larger than 14 mm observed by transvaginal ultrasonography) and undergoing in vitro fertilization-embryo transfer were enrolled. They were randomly treated with intramuscular progesterone (200 mg/day) or 100 ml of 20% intravenous albumin in order to estimate the difference in the incidence of OHSS. A significant difference in the incidence of moderate OHSS and no cases of severe OHSS were observed between the groups. Our data show the effectiveness in preventing OHSS with high doses of progesterone.