bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryosurgery for Dysplasia of the Uterine Ectocervix
Authors: Schantz Anne , Thormann Lene
Published: December 2009

Abstract. This prospective, randomized study of 142 women with mild or moderate dysplasia of the uterine ectocervix shows that the double‐freeze technique is significantly more effective than the single‐freeze technique, the recurrence rates being, respectively, 6.2% and 16.3%. The highest recurrence rate was found in the group treated with a single freeze and having the most extensive portio involvement. All patients were examined colposcopically before cryosur‐gery in order to exclude patients with lesions extending into the cervical canal and in order to evaluate the size of the lesion. Recurrent lesions were usually diagnosed within the first year (75%) and in only one patient more than 2 years after treatment. None of the patients developed invasive cancer. The mean follow‐up period was 27 months (24‐42 months). We consider cryosurgery to be an acceptable treatment for selected patients. Our criteria for entry were 1) mild or moderate dysplasia of the uterine ectocervix, and 2) colposcopic visualization of the entire transformation zone to ensure that the lesion does not extend into the cervical canal. Our experience from the present study is that the following criteria should be added: 3) the portio involvement must not be too extensive, and 4) the patient must agree to follow‐up examination. When these conditions are fulfilled, future treatment in our department will consist of a double freeze extending 3 mm beyond the lesion, with a thaw interval of 4 min.
Pregnancy and Delivery in Ehlers‐Danlos Syndrome
Authors: Kiilholma P. , Grönroos M. , Näntö V. , Paul R.
Published: December 2009

Abstract. Two pregnancies of a patient with the mitis type of the Ehlers‐Danlos syndrome (EDS) were followed up. The first pregnancy ended at 26 weeks. The second one proceeded to term, but the infant had a low birth weight and the placenta showed dysmaturity. In view of these pregnancies, the authors consider the vaginal route as an alternative to caesarean section for delivery of patients with the mitis type of EDS. In connection with both deliveries, serum zinc and copper levels were determined with the method of particle‐induced X‐ray emission (PIXE); the concentrations of both trace elements were low. The ceruloplasmin levels, on the other hand, were within the normal range. The relevance of these findings is discussed.
Progestin Therapy of Endometrial, Breast and Ovarian Carcinoma
Authors: Kauppila Antti
Published: December 2009

Abstract. A survey of the literature shows that in studies employing standardized criteria to define the response to progestin therapy, an objective remission is achieved in about one‐third of patients with endometrial and breast cancer, and it is much less frequent in ovarian malignancy. The response is seldom complete and it is mostly of a short duration. There is a tendency towards an increased response‐rate with increased dosage of progestin, in both endometrial and breast carcinoma, while the route of administration appears to be of minor importance. The clinical benefit of adjuvant progestin therapy in endometrial cancer is unproven. Simultaneous therapy with progestin and cyto‐toxic drugs seems not to increase the survival figures obtainable by cytotoxic therapy alone. The antiestrogen tamoxifen has an established efficacy in all these malignancies. The spectra of tumors sensitive to tamoxifen and to progestin are not completely identical. The optimal combination of these drugs awaits results from prospective studies. Selection of patients for progestin therapy with a sufficient degree of accuracy is not feasible by use of clinical or histological parameters. On the other hand, estrogen receptor determination already has an established position in the clinical evaluation of the sensitivity of breast cancer to endocrine therapy. The assay of progestin receptors from endometrial carcinoma tissue also seems to give reliable information; correct prediction was observed in 86% when the receptor data from five studies with 105 progestin therapies were correlated with the treatment results.
Analysis of Intrapartum Fetal Deaths: Their decline with increasing electronic fetal monitoring
Authors: Erkkola R. , Grönroos M. , Punnonen R. , Kilkku P.
Published: December 2009

Abstract. Over a 12‐year period, from 1970 to 1981, 30600 babies were born at the Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland. During that period, the use of electronic fetal monitoring increased remarkably, being involved in 9, 12, 33 and 95% of all vaginal deliveries during four consecutive 3‐year periods. The number of intrapartum deaths during the same 12‐year period was 52, giving an overall rate of 1.7 per thousand. When 15 lethally malformed infants are excluded, the rate becomes 1.2 per thousand. In the four consecutive 3‐year periods, the death rates were 1.7, 1.9, 1.0 and 0.3 per thousand. Electronic fetal monitoring was not undertaken in any of the cases leading to fetal death. The main factor leading to fetal death could be considered to be hypoxia in approximately 90% of the deaths of normally formed babies. The most common reasons for hypoxia were placental abruption and cord entanglement, yet in many cases only the decreased placental perfusion could be suggested to have caused the hypoxia. The mean weight of those babies that died intra‐partally decreased significantly, being approximately 1 250 g during the last 3‐year period.
Complications and Short‐Term Consequences of Tubal Sterilization
Authors: Børdahl P. E. , Solberg M. , Langengen H.
Published: December 2009

Abstract. The aim of the present study was to investigate the short‐term complications and consequenses of 216 consecutive female sterilizations. Information was obtained from 211 women (98%) within the first postoperative year. There was one failure (Pomeroy), three skin burns, a vesical lesion and problems with the induction of anesthesia in 2 cases. Thirty‐nine women were bothered by minor complaints for 3 months or more, in most cases by discomfort of the lapa‐rotomy scar. The impact on postoperative marital life was mainly positive. Twenty‐three women expressed doubts whether the sterilization had been sensible, 10 expressed real regret at at least one interview. At one year, 4 stated serious regret. One year after surgery, 68% had told friends about the sterilization; these women were younger than the remainder. Forty‐six percent said they would have preferred an earlier operation.
Boys Born by Forceps and Vacuum Extraction Examined at 18 Years of Age
Authors: Nilsen Stein Tore
Published: December 2009

Abstract.An 18‐year follow‐up study was made of 62 males delivered by forceps and 38 by vacuum extraction in 1962‐63. The obstetrical data are compared with the medical and psychological military draft board examinations. The mortality and morbidity rates were not significantly different from those of the total cohort of Norwegian conscripts, either in the forceps or in the vacuum group. Rotation of the fetal head with Kielland's forceps in midcavity extractions did not adversely affect the late results. A significantly elevated mean intelligence score was found in the forceps group, while the vacuum group did not differ from the national average.
Estriol: Absorption After Long‐Term Vaginal Treatment and Gastrointestinal Absorption as Influenced by a Meal
Authors: Heimer Gun , Englund Doris
Published: December 2009

Abstract. This study was designed to evaluate the vaginal absorption of estriol when given as a 21‐day treatment. Vaginal absorption was compared with the oral absorption of a known estriol preparation (TriovexR, Leo AB, Sweden). One mg of estriol was administered intravaginally once a day for 21 days to 6 menopausal women. Plasma concentrations of unconjugated estriol were measured by a specific RIA‐method at frequent intervals during 24 hours on the first and 21st day of treatment. One month later, 10 mg of estriol was given once orally and plasma estriol concentrations were measured in the same way. At vaginal administration, the absorption of estriol was very effective. When measured on the 21st day, the absorption had declined significantly but was still nearly in the same range as after oral administration of 10 mg of estriol. At oral administration, there was an initial plasma estriol elevation for 3 hours only followed by a second one immediately postprandially. It is concluded that estriol is readily absorbed from the vagina, but the absorption does decline significantly during prolonged treatment. A large single oral dose of estriol provides initially a high plasma estriol concentration but also a second one induced by eating a meal, possibly indicating an enterohepatic recirculation of estriol.
The influence of danazol on pituitary function and on the ovarian follicular hormone secretion in premenopausal women
Authors: Rannevik Gunnar , Thorell Jan I.
Published: December 2009

Abstract. The purpose of this investigation was to study the influence of danazol on the basal levels of luteinizing hormone (LH) and follicle‐stimulating hormone (FSH), on their response to gonadotropin‐releasing hormone (GnRH), as well as the effect of different doses on the serum levels of prolactin, estradiol and progesterone.

Three groups of regularly menstruating women were treated with danazol, 600, 400 and 200 mg a day, respectively. Serum samples were obtained—and in the 600 mg group a GnRH‐test was performed—before, and after one, 3 and 6 months of continuous medication. LH, FSH, prolactin, estradiol and progesterone were measured by radio‐immu‐noassay.

Compared with pretreatment levels in the early follicular phase, basal serum levels of gonadotropins were unchanged during treatment with danazol 600 mg. However, compared with pretreatment levels later on in the menstrual cycle, a slight but significant decrease in LH and increase in FSH were observed. The pituitary responsiveness to GnRH was significantly higher during danazol treatment, than found during the early follicular phase. Serum prolactin levels decreased significantly during treatment with 600 and 400 mg a day, but not with 200 mg a day. The mean estradiol levels on danazol 600 mg a day varied between 15359 (SE) and 161±17 pmol/l, corresponding to the levels in the early follicular phase (100–250 pmol/l). In the lower dose groups, the mean estradiol levels were significantly higher, varying between 265±30 and 321±57 pmol/l in the 400 mg group, and between 279±39 and 405±125 pmol/l in the 200 mg group. There were no significant differences within each dose group between the mean concentrations following one, 3 and 6 months of medication. The serum concentrations of progesterone with danazol 600 mg a day were invariably low (< 5 nmol/l), but with the lower dosages some of the samples showed increased progesterone levels.

Danazol does not appear to exert an overall suppressive effect on production and release of gonadotropins, but follicular development appears to be inhibited consistently with danazol 600 mg a day. With the lower dosages, follicular maturation and ovulation may occur occasionally. The slight decrease in serum prolactin levels with 600 and 400 mg a day may be due to the decreased estradiol levels or to a direct effect on the pituitary.
Vocal effects of danazol therapy
Authors: Nordenskjöld Fredrik , Fex Sören
Published: December 2009

Abstract. Vocal effects of danazol thrapy were studied in 23 women. Before danazol therapy was started the patients were examined by a phonitrician using indirect laryngoscopy and microlaryngoscopy in stroboscopic light. A glottographic frequency indication ad rnodum Kitzing and a tape‐recording were also made. These examinations were carried out again after 3 and 6 months of therapy. The patients mostly received 600 mg danazol daily. One of the patients noticed a very marked change in her voice after 2 weeks of therapy. This patient also had conjunctivitis and the reaction was judged to be an allergic reaction to the drug and not a hormonal side effect. In 4 of the other 22 patients the glottographic frequency indication showed a slight decrease in the mean frequency and in 3 a slight increase within the normal range of interpersonal variation. None of the patients noticed subjectively any virilization of the voice. In this preliminary study we have not found any significant vocal changes in the 23 patients tested that could be attributed to the androgenic properties of danazol.
Treatment of recurrent cyclical mastodynia in patients with fibrocystic breast disease
Authors: Döberl Anton , Tobiassen Tobias , Rasmussen Thorkild
Published: December 2009

Abstract. Thirty premenopausal women with recurrent, pronounced cyclical mastodynia associated with mammographically confirmed fibrocystic disease were studied. All patients had long‐standing symptoms, had undergone one previous course of treatment with danazol, and were recruited during long‐term follow‐up after original treatment, when cyclical mastodynia had again reached similar severity as before the original treatment (mean interval between treatments 9.5±3.9 (SD) months). Fifteen patients each were randomly allocated to double‐blind treatment with either danazol or placebo. During the first month, 2 capsules a day (each containing danazol 100 mg or placebo) were given, thereafter one capsule a day up to 6 months.

Danazol caused a marked and sustained decrease in mastodynia, according to the clinician's assessment and according to each patient's self‐rating on a visual analogue scale. The response to danazol was fairly uniform and statistically significant (p < 0.005 or less), whereas the response to placebo was inconsistent and not statistically significant (p>0.10). Danazol proved significantly more effective than placebo (p<0.05 or less). Changes in palpatory and/or mammographic findings were also found more consistently after danazol treatment than after placebo.

During treatment, there was a modest weight increase, which was statistically significant in the danazol group (p <0.01) but not in the placebo group. A greater frequency in menstrual irregularities was observed in the danazol group than in the placebo group, but not to an extent that would have caused ‘unblinding’ of the study. Other side effects were virtually the same in both groups with regard to type of complaint, total number of complaints (16 on danazol, 18 on placebo) and proportions of patients reporting one or more complaints (10/15 on danazol, 9/15 on placebo).

Thus, unlike placebo, danazol largely abolished the cyclicity and periodicity of breast symptomatology and produced, in most cases, a sustained suppression of mastodynia, which was associated with a decrease in palpable structure and mammographic densityhpread of glandular tissue. These findings demonstrate the therapeutic efficacy of danazol even at these low doses, compared with placebo.

However, a comparison of the response to danazol in this study and the response in the same patients during the original treatment course suggests that the dose of 100 mg a day is not as effective as 200 or 400 mg a day in severe cases.
Risk Grouping of 113 Patients with Hypertensive Disorders During Pregnancy, with Respect to Serum Urate, Proteinuria and Time of Onset of Hypertension
Authors: Liedholm H. , Montan S. , Åberg A.
Published: December 2009

Abstract. In order to describe the outcome of a one‐year material of hypertensive pregnancies, a retrospective analysis was made of the patients with respect to time of onset of hypertension, absence/presence of significant proteinuria, and maxium recorded serum urate values less or greater than 350 μmol/l. The material comprised 113 hypertensive patients, 3.7% of 3036 deliveries in 1980. Of these only 87 could be classified as intended. Twenty‐two patients lacked information on serum urate values, and the remaining 4 did not fulfil the inclusion criteria.

As the type of antihypertensive treatment was almost exclusively restricted to β1‐selective betablockers, alone or in combination with hydralazine, the type of treatment given was analysed with respect to the classification system applied.

From this retrospective study it is evident that most hypertensive patients tend to be older than the average pregnant woman and that they also tend to represent problems arising during recurrent pregnancies. Patients with additive risk factors such as proteinuria and high serum urate values tend to need more vigorous antihypertensive treatment and in that sense seem to be more difficult to treat. In our material, patients with an early rise in high blood pressure and high serum urate values accounted for the entire perinatal mortality of the hypertensive pregnancies. The values of serum urate monitoring and the future detection and monitoring of hypertensive pregnant patients is discussed.
Hypertension in Pregnancy and the Infant
Authors: Svenningsen N. W. , Liedholm H. , Åberg A.
Published: December 2009

Abstract. A one‐year population comprising 119 infants of 113 mothers with hypertension in pregnancy has been studied regarding fetal and neonatal mortality and morbidity. The overall incidence of hypertension in pregnancy was 3.7%, but was higher in preterm deliveries (from 16.6% in gestational weeks 25‐29 to 8.6% in gestational weeks 34‐36). Fetal loss with intra‐uterine death was related to hypertension in pregnancy in 23%.

Auxological parameters in 16 SGA infants of hypertensive parturients showed growth recovery in all infants as regards head circumference and in all but 2 as regards body weight and body length.

A controlled follow‐up study was performed in 104 infants of hypertensive mothers and 104 control infants of similar gestational age and birthweight but without pregnancy complications. There was a significantly higher rate of cesarean section, of low Apgar score at 1 minute, and SGA infants and neonatal morbidity requiring admittance to the neonatal intensive care unit. At 2 years of age the rate of neurodevelopmental handicaps was similar in the study population and in control infants. Stillborn infants all belonged to the group of mothers with hypertension starting before the 21st gestational week and with an increased serum urate level. Three of 4 infants with a handicap at 2 years also belonged to this group of mothers. With modern peri‐and neontal intensive care and appropriate fetal assessment, delivery after 26‐28 weeks of gestation seems to be associated with a slightly increased neonatal morbidity but no increase in long‐term handicaps at 2 years of age.
ASSESSMENT OF GESTATIONAL AGE BY ULTRASONIC MEASUREMENT OF THE FEMUR LENGTH
Authors: Shalev E. , Feldman E. , Weiner E. , Zuckerman H.
Published: December 2009

Abstract. The effectiveness of ultrasonic femur length measurement from 12 to 40 week's gestation, as a means of assessing fetal age, was tested and compared with that of bi‐parietal cephalometry. The femur length and biparietal diameter (BPD) were obtained from 471 measurements, from pregnant women with confirmed datings, using real‐time scanning with a 3,5 mHz transducer frequency. Using a freeze frame and electronic calipers, the mean value of three consecutive measurements of the femur, when vizualized with its characteristic appearance, was recorded. Linear regression analysis with the correlation coefficient of the femur growth‐curve (r = 0.989, p<0.001) and that of the BPD (r = 0.985, p<0.001) showed that the former is as good as the latter. The femur growth‐curve from 12 to 40 week's gestation with a mean ±2 SD was constructed. Estimation of fetal age by femur length measurement was compared with that assessed by the BPD in a further 54 women. A close correlation was found (r = 0.993, p<0.001). Measurement of the fetal femur appears to be a reliable method for assessing gestational age, which can compensate for the limitations of the BPD method.
EFFECTS OF A LOW‐DOSE DESOGESTREL‐ETHINYLESTRADIOL COMBINATION ON HIRSUTISM, ANDROGENS AND SEX HORMONE BINDING GLOBULIN IN WOMEN WITH A POLYCYSTIC OVARY SYNDROME
Authors: Cullberg GÖRan , Hamberger Lars , Mattsson Lars‐Åke , Mobacken HÅKan , Samsioe GÖRan
Published: December 2009

Abstract. Twenty women suffering from a polycystic ovary syndrome (PCO) accompanied by hirsutism were given a low‐dose oral contraceptive combination containing 0.150 mg desogestrel plus 0.030 mg ethinylestradiol for 8 months. The pretreatment situation regarding hair and hormone profiles in the PCO group was compared with that in 22 regularly menstruating women. Serum levels of free and total testosterone and androstenedione were significantly elevated in PCO women, as were body weight, blood pressure, hair diameter and depilation frequency. Sex hormone binding globulin (SHBG) binding capacity was lower. Following treatment of the PCO group for 8 months, total and free testosterone levels were depressed, but androstenedione had not changed significantly. SHBG binding capacity was increased five‐fold. Body weight decreased in the obese women. Hair growth was significantly suppressed and the hair itself was less coarse. Depilation intervals were longer. Acne, present before the treatment had now disappeared. Blood pressure did not change. Few and mild side effects were recorded. After treatment, 3 women succeeded in becoming pregnant and in 8 others spontaneous menstruations had recurred.
CORRELATION OF ANDROGEN RECEPTORS WITH HISTOLOGICAL DIFFERENTIATION IN HUMAN ENDOMETRIAL CARCINOMAS
Authors: Kato J. , Seto T.
Published: December 2009

Abstract. Primary endometrial carcinomas from 35 non‐treated patients were investigated by measurement of andro‐gen receptors in the tumor cytosols. Receptor analysis was done with a labelled synthetic androgen, methyltrienolone 3H‐R1881 and triamcinolone acetonide, and dextran‐coated charcoal absorption. The concentrations of androgen receptors in the endometrial carcinomas were, in decreasing order: highly‐differentiated tumors, 15.7±1.8 (fmol/mg protein, mean±SE) (number of cases, 21); moderately differentiated tumors, 4.6±1.6 (n = 7); poorly differentiated tumors, undetectable in 7 out of 8 cases. Highly‐differentiated tumors contained a much greater concentration of receptors than the two less differentiated ones. One highly‐differentiated endometrial carcinoma with pyometra virtually lacked the receptor. The moderately differentiated endometrial carcinomas contained very low levels of the receptors. The poorly differentiated tumors virtually lacked the receptors. Metastatic lymph nodes from primary endometrial carcinomas with moderate differentiation had a very low receptor level. From these results, it is concluded that human endometrial carcinomas, particularly with histologi‐cally high differentiation, contain a considerable amount of androgen receptor and that the receptor concentrations appear to correlate with the histologic grade of tumor differentiation.
MATERNAL AND FETAL ALPHAFETOPROTEIN (AFP) LEVELS AT TERM
Authors: Obiekwe B. C. , Malek N. , Kitau M. J. , Chard T.
Published: December 2009

Abstract. Serum α‐fetoprotein (AFP) was measured in maternal, cord arterial and venous blood. Samples were collected at the time of vaginal delivery from 105 women at 36–42 weeks' gestation. There was a significant correlation between maternal, cord arterial and venous AFP. Umbilical cord arterial and venous AFP levels were considerably higher in male infants than in females. Umbilical AFP levels declined with lengthening gestation and increasing birth‐weight for both male and female infants and a similar pattern was seen in the mother. Fetal AFP levels were significantly higher in subjects giving birth at 40 weeks whose infants had a birthweight below the population mean vis‐a‐vis those above the mean. It is concluded that the absolute size of the fetus as well as gestational age may play a significant role in determining maternal and fetal AFP concentrations.
COMPARISON OF CELLULAR LEVELS OF STEROID RECEPTORS IN UTERINE LEIOMYOMA AND MYOMETRIUM
Authors: Tamaya T. , Fujimoto J. , Okada H.
Published: December 2009

Abstract. To support the estrogen hypothesis in the patho‐genesis of leiomyoma, total cellular estrogen receptor (ER) levels (the sum of levels in cytosol and nuclear KCl‐extract‐able and nuclear non‐KCl‐extractable fractions) were assayed and compared with levels of progestin (PR) and an‐drogen (AR) receptors in the leiomyoma and the corresponding myometrium. The ratios of ER to PR or AR levels were higher (with statistical significance) in leiomyoma than in the corresponding normal myometrium, both in terms of total cellular levels in' each individual case and nuclear levels. It appears that estrogen sensitivity is higher in the leiomyoma than in the corresponding myometrium, due to the relative increasc in ER.
THE PRECISION AND ACCURACY OF SYMPHYSIS‐FUNDUS DISTANCE MEASUREMENTS DURING PREGNANCY
Authors: Bagger Peter V. , Eriksen Poul Sindberg , Secher Niels Jørgen , Thisted JØRgen , Westergaard Lars
Published: December 2009

Abstract. We studied the precision and accuracy of SF measurements. Five trained obstetricians made three measurements of SF on each of 33 patients in the third trimester. The intraobserver variation varied from 0 cm to 8 cm, and comprised on average 1.5 to 2 cm (95th centiles 2.5 to 4 cm). The interobserver variation varied from 1 to 13 cm, and comprised on average 4 cm (95th centile 8 cm). The accuracy of SF measurements was estimated by comparison with ultrasound‐guided measurements, which showed a very high precision. Two of the investigators differed significantly, by −1.56 cm and −1.97 cm, from the other 3.
SUPRAVAGINAL UTERINE AMPUTATION VERSUS HYSTERECTOMY WITH REFERENCE TO SUBJECTIVE BLADDER SYMPTOMS AND INCONTINENCE
Authors: Kilkku Pentti
Published: December 2009

Abstract. Studies on postoperative symptoms of hysterectomy have devoted scarcely any attention to malfunctioning micturition and pressure sensation in the bladder region. Postoperative occurrence of incontinence is mentioned in some studies. Preoperatively, 33.3% of abdominal hysterectomy patients and 38.3% of patients with supravaginal uterine amputation complained of pressure sensation in the bladder region; one year after operation the corresponding percentages were 9.6 and 10.3. Prior to the operation, a sensation of residual urine after micturition occurred in 28.6% of hysterectomy patients and 35.5% of supravaginal amputation patients; at 1 year postoperatively these figures were 22.1 and 10.3% respectively. The decrease in the supravaginal amputation group is statistically highly significant. Pre‐operative incontinence occurred in 36.2% of hysterectomy and 47.7% of supravaginal amputation patients. Twelve months postoperatively the values were 28.8 and 22.6% respectively, the decrease in the supravaginal amputation group being again statistically highly significant. Development of log‐linear models for both groups gave interactions “earlier urinary tract infections/sensation of residual urine” and “earlier urinary tract infections/incontinence”. Thus the greater reduction in the symptoms in the supravaginal amputation group appears to result rather from the type of operation than from the differences in the two patient groups.
CILIATED ADENOCARCINOMA OF THE ENDOMETRIUM
Authors: Haibach Helmut , Oxenhandler Ronald W. , Luger Alan M.
Published: December 2009

Abstract. Two cases of ciliated endometrial adenocarcino‐ma which came to attention in less than one year are described. This entity deserves emphasis, as its ciliation may distract from its histological malignant features. Association of cilia with atypical nuclear features in the same cell is the diagnostic characteristic which distinguishes it from non‐ciliated adenocarcinoma overrunning non‐malignant ciliated endometrium. The ultrastructural detail of the cilia of malignant cells does not differ from that of non‐malignant endometrial glandular epithelium. Our cases raise the question of a possible association of estrogenic effect with ciliated endometrial adenocarcinoma.
THE DISAPPEARANCE OF HUMAN CHORIONIC GONADOTROPIN FROM PLASMA AND URINE FOLLOWING INDUCED ABORTION
Authors: van der Lugt B. , Drogendijk A. C.
Published: December 2009

Abstract. In 28 females, daily measurement of the HCG concentration in urine and in 15 of them daily measurement of the β‐HCG concentration in plasma was carried out during the first 2 weeks following first‐trimester induced abortion by vacuum aspiration. Plasma β‐HCG concentration fell according to a multi‐exponential curve with a half‐life of 0.63 days in the first 2 days following induced abortion, and of 3.85 days in the subsequent 14 days. The disappearance of HCG from urine is exponential, with a half‐life value of 1.3 days. A urine pregnancy test with a sensitivity of 1 IU/ml wil nearly always be negative in the course of 2 weeks after abortion. A positive test 4 weeks after abortion indicates an incomplete abortion or persistent trophoblast.
EFFECT OF THE NATURALLY OCCURRING PROSTAGLANDINS E2 AND F2α ON THE HUMAN MYOMETRIUM IN VIVO DURING PREGNANCY
Authors: Rydnert Jan , Joelsson Ingemar
Published: December 2009

Abstract. Hysterometry has been used to evaluate the effect on the human myometrium in vivo during early pregnancy of the naturally occurring prostaglandins E2 and F2α. The hystermetric technique is based upon the fact that mechanical distension of smooth muscle induces contraction. According to the analysis of the contractile responses, the effects of the agents have been determined quantitatively.

The drug effects have been characterized by changes in myometrial response between registrations under basic conditions and during the infusion of the active agent, respectively. It was found that when these drugs were given in the doses usually employed in clinical practice, the effect on contractility of the PGF2α compound was more pronounced than that of the PGE2. However, when describing the results on a microgram basis, the PGE2 was confirmed to be more potent than the PGF2α by a factor of up to 7–8.
THE PSYCHOSOCIAL IMPACT OF INFERTILITY TWO YEARS AFTER COMPLETED SURGICAL TREATMENT
Authors: Lalos Ann , Lalos Othon , Jacobsson Lars , von Schoultz Bo
Published: December 2009

Abstract. Twenty‐four infertile couples were interviewed prior to and 2 years after the woman's reconstructive tubal operation. Their marital relationship, social and sexual life, mental health, possible solutions to the infertility problem and need of professional psychosocial counselling were studied. Moreover, various mental symptoms were recorded by means of a ‘symptom checklist’. The personality characteristics were evaluated by the Eysenck Personality Inventory (EPI). The partners feelings for each other were worsening 2 years after the operation. There was also a tendency to a deterioration in the participants' opinion about their marital relationship, but no statistically significant change could be found. The women reported deterioration of sexual life and the men experienced an increased negative influence of the infertility problem on the marital relationship. The negative emotional and social effects of infertility were pronounced both before and 2 years after the surgical treatment. The participants' personality characteristics as regards neuroticism and extroversion had not changed. Most of the infertile couples found it difficult to work on their own towards a solution to the crisis of infertility during the 2 years following the surgical treatment.
A PROSPECTIVE CONTROLLED TRIAL OF METOPROLOL‐HYDRALAZINE TREATMENT IN HYPERTENSION DURING PREGNANCY
Authors: Högstedt Stellan , Lindeberg Solveig , Axelsson Ove , Lindmark Gunilla , Rane Anders , Sandström Bo , Lindberg Bo S.
Published: December 2009

Abstract. in an open, controlled trial, treatment with a combination of metoprolol and hydralazine was compared with non‐pharmacological management of mild and moderate hypertension in pregnancy. One hundred and sixty‐one women participated in the study. the drug‐treated group showed significantly better blood pressure control than the group not given antihypertensives. Induction of labor before term, because of maternal or fetal complications, was somewhat more frequent in the control group. Nine women in the treatment group and 5 in the control group developed albuminuria. Three infants in the drug‐treated group died perinatally, and one in the control group. the outcome for the newborns was similar in both groups concerning birth weight, head circumference and Apgar score and in the frequencies of respiratory distress, bradycardia and hypoglycemia. the better blood pressure control achieved with these drugs makes it possible to treat the patient at home and reduce the risk of emergency delivery, but treatment does not seem to be mandatory for a good outcome of the pregnancy in cases of mild and moderate hypertension during pregnancy.
PLASMA 20α‐OH‐PROGESTERONE IN WOMEN WITH MALIGNANT EPITHELIAL ‘NON‐ENDOCRINE’ OVARIAN TUMORS
Authors: Mählck Carl‐Gustav , Bäckström Torbjörn , Kjellgren Olle , Selstam Gunnar
Published: December 2009

Abstract. the production of 20α‐OH‐progesterone (20α‐OH‐P) in women with malignant epithelial ovarian tumors was investigated. the study material comprised 51 postmenopausal and/or oophorectomized women with ovarian carcinoma, including the histological types Ic, IIc, IIIc and V and F1GO stages I‐IV. Their tumor volumes were evaluated once a month using bimanual recto‐vaginal palpation under anesthesia. Blood samples were drawn for 20α‐OH‐P radio‐immunoassay at monthly intervals for 3 months. the plasma levels were compared with those of a control group of postmenopausal women. the results show a relationship between tumor volume and plasma 20α‐OH‐P level. Another finding is that endometrioid ovarian cancer (histologically IIIc) showed a significantly lower 20α‐OH‐P production than the other types. the reason for this is discussed.
The Clinical Pharmacology of Piroxicam
Authors: Guttadauria Maria
Published: December 2009

Piroxicam, a potent inhibitor of prostaglandins, is effective and well‐tolerated in the treatment of primary dysmenorrhea. A single 40 mg dose has been shown to rapidly reduce the uterine hypercontractility of primary dysmenorrhea. In clinical trials vs placebo, piroxicam in a dose of 40 mg once daily for two days followed by 20 mg once daily thereafter demonstrated superior efficacy. In more than 1400 piroxicam‐treated menstrual cycles and more than 200 placebo‐controlled cycles, a similar incidence of side effects—7% and 8.4% respectively—was observed.
THE RISK OF ENDOMETRIAL AND BREAST CANCER AFTER ESTROGEN TREATMENT
Authors: Persson Ingemar
Published: December 2009

Abstract.Estrogen treatment of climacteric women has been found to be associated with a substantially increased risk of endometrial cancer and a possible slight excess risk of breast cancer. Numerous retrospective case‐control studies, reported mainly in the United States, have provided evidence of a causal link between the use of estrogens and the development of endometrial cancer. The magnitude of the risk increase has been shown to be correlated with characteristics of the exposure, chiefly the duration of treatment and the presence of certain host factors in the patient, e.g. obesity and late menopause. Cases of endometrial cancer occurring after estrogen exposure were shown to have favorable tumor characteristics and excellent survival rates. The early results from a prospective cohort study have indicated that estrogen therapy, as practised in Sweden, is associated only with an excess risk of premalignant endometrial changes and that the addition of progestogens might exert a protective effect. The risk of breast cancer after estrogen therapy has been studied in both retrospective and prospective investigations. In the majority of these studies no evidence of an increased risk has been found. However, in two case‐control and two follow‐up studies the risk estimates were slightly but significantly raised in association with long‐term and high‐dose exposure.
PIROXICAM IN PRIMARY DYSMENORRHEA
Authors: Saltveit Torbjern
Published: December 2009

Abstract. Ninety‐two patients with primary dysmenorrhea were included in a double‐blind randomized crossover trial to study the efficacy of piroxicam on menstrual pain and associated symptoms, with placebo as control.

Ninety patients completed the 4‐month study period. Piroxicam afforded a highly significant relief from menstrual pain and reduced the need for the supplementary analgesic paracetamol. Piroxicam also had a significant effect on associated symptoms. The drug was well tolerated, with only a few side, effects of a mild nature reported and with no difference between the piroxicam and placebo groups in this respect.
ENDOMETRIAL POLYPS AND HYPERPLASIA AS RISK FACTORS FOR ENDOMETRIAL CARCINOMA
Authors: Pettersson Birgitta , Adami Hans‐Olov , Lindgren Anders , Hesselius Inge
Published: December 2009

Abstract. As part of a comprehensive case‐control study, the impact of previous endometrial pathology on the risk of developing endometrial carcinoma was investigated. The study comprised 254 consecutive women with histopatholo‐gically confirmed cancer of the uterine body in a well‐defined population, and their age‐matched controls. Ninety‐eight (39%) of the patients and 81 (32%) of the controls had previously undergone endometrial curettage. More than one previous curettage was positively associated with endometrial carcinoma (odds ratio = 2.5; 95% CL = 1.4–4.5). Endometrial abnormalities in previous curettage specimens occurred significantly more often among carcinoma patients (57%) than among controls (25%) (odds ratio = 4.0; 95% CL = 2.0–8.0). Twelve patients, but no controls, had adenomatous hyperplasia and this hyperplasia antedated the cancer diagnosis by a mean of 4.6 years. Endometrial polyps were present significantly more often in patients (20%) than in controls (10%) (odds ratio = 3.4; 95% CL = 1.3–9.3). The present results suggest that both of thes; conditions are risk factors for endometrial carcinoma. Among women who had undergone endometrial curettage more than 4 years after the menopause, 19 out of 30 patients, but none out of 7 controls, showed abnormality in the curettage specimens. Postmenopausal women with endometrial abnormality should thus be regarded as being at risk of developing endometrial carcinoma.
PRENATAL DIAGNOSIS OF CONJOINED TWINS (DIPROSOPUS) WITH MYELOMENINGOCELE
Authors: Rydnert J. , Holmgren G. , Nielsen K. , Bergman F. , Joelsson I.
Published: December 2009

Abstract. Conjoined twins (diprosopus) with a neural tube defect were diagnosed by ultrasound, alphafetoprotein and acetylcholinesterase in the 18th week of gestation.
Conization by Carbon Dioxide Laser or Cold Knife in the Treatment of Cervical Intra‐Epithelial Neoplasia
Authors: Bostofte E. , Berget A. , Larsen J. Falck , Pedersen P. Hjortkjær , Rank F.
Published: December 2009

In a randomized trial concerning 123 women with CIN, 59 were treated with laser conization under colposcope without further hemostatic remedy and 64 with cold knife conization guided by Schiller's iodine dyeing supported by side sutures, vaginal packing and postoperative oral administration of tranexam acid. Follow‐up with colposcopy and cytology was done 3 and 12 weeks post‐conization and then every 6 months. The average follow‐up period was 36 months (28–48). Peroperative bleeding was rather less pronounced in the laser group. Postoperatively, however, bleeding requiring treatment was significantly less common in the laser group (5%) than in the cold knife group (17%).

The recurrence rate of CIN was 7% in the laser group and 10% in the knife group. Stenosis of the cervical canal developed in 7% of the patients in the laser group and in 3.5% in the knife group. After 12 weeks the squamocolumnar junction was visible in its full extent in 66% of the laser treated patients compared with 38% of the cold knife treated patients. It is concluded that laser conization is a safe procedure even without hemostatic procedures other than the coagulation abilities of the laser beam itself, as used in this work.
Does the Hygroscopic Property of the Laminaria Tent Imply a Risk for Ascending Infection in Legal Abortions?: A microbiological study
Authors: Evaldson G. R. , Fianu S. , Jonasson A. , Larsson B. , Nord C. E. , Ölund A.R.
Published: December 2009

In 53 women admitted for first‐trimester abortion, the cervical canal was dilated with laminaria tents prior to vacuum aspiration. Before insertion of the tents, endocervical specimens were taken for microbiological investigations, including Chlamydia trachomatis, and both aerobic and anaerobic microorganisms. The laminaria tents, widened by their hygroscopic properties, were removed just before the vacuum aspiration and sent for cultivation of aerobic and anaerobic microorganisms. The Grampositive aerobic cocci, Staph. epidermidis, Strept. faecalis and Strept. agalactiae as well as Escherichia coli and Klebsiella/Enterobacter were the most frequent microorganism among the aerobic isolates from the endocervices as well as from the laminaria tents. These microorganisms were identified on the tents in greater numbers than in the cervices. Staph. aureus was isolated from three laminaria tents, but only one of these 3 women was proved to be primarily colonized endocervically. Among the anaerobes, Bacteroidaceae followed by peptococci and peptostreptococci were the predominant genera found in the cervix as well as on the removed laminaria tents. These three groups of anaerobic microorganisms were found markedly less frequently on the laminaria tents than in the endocervix. On the other hand, Strept. intermedius, another anaerobe of possible enteric origin, was recovered from 9 laminaria tents but not in the cervices. Since no cases of clinically verified endometritis/salpingitis were registered in the present study it is concluded that the risk of a pelvic inflammatory disease (PID) due to the laminaria tent is negligible as long as the laminaria treatment does not exceed 24 hours.
Genital Mycoplasma Colonization in Neonatal Girls
Authors: Iwasaka T. , Wada T. , Kidera Y. , Sugimori H.
Published: December 2009

Specimens obtained from the genital tract of 90 pairs of mothers and their female infants were cultured for Ureaplasma urealyticum (Ureaplasma) and Mycoplasma hominis (M. hominis). Ureaplasma and M. hominis were isolated from 80% and 17% of pregnant women, and 41% and 4.4% of female infants, respectively. Fifty nine per cent of infants were positive for Ureaplasma when they were borne per vaginam by Ureaplasma‐positive mothers. However, Ureaplasma was not isolated from any of 11 infants delivered by cesarean section before rupture of the fetal membranes, in spite of positive colonization by Ureaplasma in the mothers. Quantitation of Ureaplasma revealed that neonatal colonization was closely associated with the colonization number of this microorganism in the cervical canal of mothers. Prolonged interval between rupture of fetal membranes and delivery caused a slightly increased frequency of isolation of this organism, but it was less significant. A study of mean birth weight revealed that there was no correlation between maternal or neonatal colonization by Ureaplasma and low birth weight.
Intestinal bypass operation and pregnancy outcome
Authors: Knudsen Lisbeth B. , Kallen Bengt
Published: December 2009

With the aid of the national Medical Birth Registries and Discharge Registries in Denmark and Sweden it was possible to identify and study delivery outcome in 77 women who, prior to pregnancy, had undergone an intestinal bypass operation for obesity. Analysis of birth weight and pregnancy length distribution showed that infants borne by these women had an increased rate of low birth weight, short gestation, and also growth retardation. There were no distinct differences between those infants that were conceived less than 24 months or more than 24 months after operation. Only two infants had congenital malformations, none died perinatally.
Ectopic pregnancy combined with intra‐uterine twin pregnancy
Authors: Udesen Margrethe , Hald Finn
Published: December 2009

A case of ectopic conception complicating simultaneous intra‐uterine twin pregnancy is described. Predisposition factors are discussed.
Cyproterone Acetate Versus Levonorgestrel Combined with Ethinyl Estradiol in the Treatment of Acne: Results of a multicenter study*
Authors: Carlborg Lars
Published: December 2009

In spite of an abundant literature on antiandrogen treatment with cyproterone acetate (CA) there have been no objectively measured results to prove statistically the possible superiority of CA over combined oral contraceptive pills in the treatment of acne vulgaris. A multicenter study was therefore done, in which two preparations containing CA in combination with ethinylestradiol (EE) were compared with a marketed combined oral contraceptive pill. The preparations studied were: 1) CA 2 mg + EE 50μg (DianeR), 2) CA 2 mg + EE 35 μg (DianeR mite), 3) Levonorgestrel 150 μg + EE 30 μg (NeovlettaR). A woman was eligible for the study if she was found by a dermatologist to have at least eight acne lesions (sum of papules, pustules, cysts and nodules) on her face, was otherwise healthy and without medication. After a primary assessment of the number of acne lesions by the dermatologist the woman was referred to a gynecologist and given one of the three test preparations double‐blind and at random. The treatment was to continue for 6 months. 133 women were recruited at eight different centers. The groups thus constituted were of similar size and comparable with regard to age, degree of acne, and menstrual and contraceptive histories. As the number of acne lesions varied considerably between patients all data were converted into percentage change during treatment before they were processed in a computer. After only 4 months of treatment the patients on DianeR and DianeR mite had a significantly greater reduction in the number of acne lesions compared with those on NeovlettaR. This difference was more pronounced at the end of the sixth treatment cycle, where there was an average reduction of acne lesions by 70% in the DianeR and DianeR mite groups, compared with 35% in the NeovlettaR group. Furthermore, the data scatter was less for the two DianeR groups. Among women taking DianeR or DianeR mite, only 4% were found to have deteriorated, as compared with 18% for NeovlettaR. The data support the previously unproven concept that regular oral contraceptive pills may improve acne in some women, whereas in others the condition was exacerbated. Bleeding patterns and contraceptive efficacy were excellent for all three preparations. Side effects were few and comparable to reports on other low‐dose oral contraceptives. DianeR mite had a tendency towards less pronounced “estrogenic” side effects and was equally effective in the treatment of acne as DianeR. DianeR mite is therefore suggested as the treatment of choice in women with acne who are otherwise willing to use an oral contraceptive.
Interaction Between Prostaglandin E2 and Noradrenalin on Collagen Synthesis in Human Cervical Tissue During Pregnancy
Authors: Norström A. , Tjugum J. , Wilhelmsson L. , Hamberger L.
Published: December 2009

The effects of prostaglandin E2 (PGE2) and noradrenalin (NA) on the incorporation of [3H]proline in cervical tissue of pregnant women were investigated. NA inhibited the incorporation in early as well as in term pregnancy. PGE2 counteracted the NA‐effect in the former group of patients but did not affect the influence of NA at term. the results demonstrate an interaction between PGE2 and NA and point to a hitherto unknown effect of NA in the regulation of cervical connective tissue metabolism.