bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunocytochemical Study of the Placenta of a Twin Pregnancy with a Retained Dead Fetus
Authors: Ikarashi Toshihiko , Takeuchi Shoshichi , Ohnishi Yoshihisa
Published: August 2010

A placenta of a twin pregnancy with a retained dead fetus (RDFt) was studied im‐munohistochemically by comparison with controls consisting of 9 other placentae with a retained dead fetus (RDF) and 20 placentae without an intrauterine fetal death (IUFD) (control placentae without IUFD). By immunohistochemical examination, immunoglobulins were found in villous syncytiotrophoblasts and villous endothelial cells. The positive reactions were, furthermore, diminished by pretreatment with ammonium thiocyanate by immunoelectron microscopy, so that the immunoglobulin binding to chorionic villi were regarded as one of nonspecific bindings. However, a strongly positive immunoreaction for IgG remained in the specimens from the placenta of RDFt after pretreatment with ammonium thiocyanate. The findings indicate that an immunological injury of a placenta is provoked in RDFt.
Interaction between Opioid Peptides and Monoamines in the Regulation of Gonadotropin Secretion in the Female Rat
Authors: Kawagoe Shinnosuke , Hiroi Masahiko
Published: August 2010

Adult female rats were injected with 15 μg β‐endorphin twice, at 12: 00 and 15: 00, on the day of proestrus, with or without pretreatment with the antiserotonergic drugp‐chlorophenylalanine (PCPA, 300 mg/kg) or the anticholinergic drug atropine sulfate (150mg/kg). Administration of β‐endorphin alone caused a slight decrease in pre‐ovulatory LH release and blocked ovulation in 4 of the 10 animals. Pretreatment with PCPA, but not atropine, completely blocked the β‐endorphin action. Injection with naloxone (2 mg/kg) induced a significant increase in serum LH levels 60 minutes later in immature female rats. The naloxone‐induced LH rise was reduced by concomitant intraperitoneal administration of β‐endorphin (200 μg/kg). This β‐endorphin inhibition of naloxone action was, however, completely abolished by pretreatment with PCPA, while PCPA showed a tendency to potentiate the LH response to naloxone alone. These results suggest that serotonergic systems participate in the mechanisms whereby β‐endorphin suppresses LH secretion. In addition, the stimulatory action of naloxone on LH secretion was markedly suppressed when reserpine (2 mg/kg) or phenoxybenzamine (20 mg/kg), all antinoradrenergic drugs, were first administered, suggesting that the naloxone action to promote LH release is mediated in part via hypothalamic noradrenergic systems.
Catecholamine Concentrations of Fetal Blood and Amniotic Fluid during Labor
Authors: Mitsutani Hiroshi , Kudo Takafumi , Kishimoto Yasuo
Published: August 2010

Catecholamine concentrations in the amniotic fluid and in the umbilical arterial plasma obtained from 52 full term deliveries were determined by radioenzymatic assay. Umbilical arterial blood pH and PO2 were also measured. There were significant correlations between umbilical arterial plasma catecholamine concentrations and pH and PO2. Significant correlations were also observed for fetal blood pH and PO2 versus amniotic fluid norepinephrine levels (pH: r = ‐ 0.340, n = 52, p<0.05 PO2: r= ‐0.351, n = 52, p<0.05) but not epinephrine levels. Moreover, there were significant positive correlations between the catecholamine concentrations in the umbilical arterial plasma and in the amniotic fluid (norepinephrine: r = 0.372, n = 52, p<0.05 epinephrine: r = 0.359, n = 52, p<0.05). These results indicate that amniotic fluid catecholamine concentrations, especially norepinephrine, reflect fetal sympathoadrenal activity which responds to acidosis and hypoxia. Amniotic fluid catecholamine levels are an indicator of fetal condition and fetal stress during labor.
Ultrasonically Guided Collection of Preovulatory Oocytes as a Feasible Alternative to Laparoscopic Procedure for Human in vitro Fertilization
Authors: Mao K. , Tam P. , Haines C.
Published: August 2010

Abstract

The laparoscopic procedure has been widely used as the means for the collection of preovulatory oocytes for in vitro fertilization.1,2) The success of in vitro fertilization (IVF) depends largely on the accurate timing and collection of the maximal number of preovulatory oocytes in each treatment cycle. The laparoscopic procedure often achieves a high rate of oocyte recovery, usually at the first aspiration of the follicle, or during the next 3 flushings. The rate on a per follicle basis as reported in the literature varies from 60%3) in the early days of human IVF to about 80% recently.1,2,4–6) An alternative approach to collect preovulatory oocytes by percutaneous aspiration of the follicle via an ultrasonically guided needle has recently been introduced.7′8′ An overall success rate of 52–77% per follicle and 73–91% per treatment cycle was reported9,10) suggesting that the ultrasonic method is an equally efficient method of collection of the oocytes for in vitro fertilization. Both methods were employed in the IVF program offered by the Department of Obstetrics and Gynaecology in the Prince of Wales Hospital. We report here the preliminary results of oocyte collection during the first half‐year of our program. Of particular interest was a case in which a successful ultrasonic collection was made immediately after an aborted laparoscopic attempt.
The Diabetic Pregnancy: Review of Management and Resutls over Seven‐Year Period
Authors: Mittal Suneeta , Agarwal Neera , Buckshee Kamal
Published: August 2010

Abstract

A protocol for the diagnosis and management of diabetes during pregnancy is outlined Improved results have been obtained by strict antepartum surveillance, planned induction and careful monitoring during labour. A close co‐operation between obstetrician, endocrinologist and neonatologist has improved the metabolic control as well as the fetal salvage rate.

Data of 109 patients with diabetes during pregnancy over a 7‐year period has been analysed. In spite of intensive monitoring 21.6% cases developed pre‐eclamptic toxaemia and 5 intrauterine fetal deaths occured. Perinatal salvage rate was better following caesarean section. The caesarean rate was 38.3% and overall perinatal mortality was 16.0%.
An Unusual Presentation of Herpes Gestationis
Authors: Lao Terence T. H. , Chang Allan M. Z.
Published: August 2010

Abstract

A Chinese woman with herpes gestationis is reported Because of the unusual features, the diagnosis was not made until the last trimester. A healthy 3.1 kg baby was delivered at term and there was no postpartum relapse. The various reported incidence of this condition may be related to mild and atypical forms which have been un‐diagnosed. The importance of immunofluorescence staining in skin biopsy is stressed, and the significance of the diagnosis is discussed with a review of the literature.
Eclamptic Pregnancies: The Influence of the Fetus and Antenatal Complications
Authors: Lao T.T.H. , Chin R.K.H. , Leung B.F.H.
Published: August 2010

Abstract

Twenty‐four eclamptic pregnancies over a 6‐year period were studied. These pregnancies were associated with a high incidence of certain antenatal complications, especially hyperemesis gravidarum, vaginal bleeding and urinary tract infection. There was also a high incidence of fetal abnormalities, including 2 cases of hydrops fetalis due to haemoglobin Bart's disease. The occurrence of these complications should alert the obstetrician to monitor these pregnancies carefully for the subsequent development of pre‐eclampsia and eclampsia.
Secondary Syphilis with Extensive Cervical Lesion
Authors: Iwasaka Tsuyoshi , Ikeda Noribumi , Sugimori Hajime
Published: August 2010

Abstract

A case of secondary syphilis which involved the uterine cervix is presented. This case was suspected to be invasive cervical carcinoma by macroscopic and colposcopic examinations, but cytologic and histologic preparations revealed syphilitic granuloma. Clinical process and serologic tests confirmed this. Computer tomography revealed swelling of para‐aortic lymphnodes as well as inguinal lymphnodes.
Seminal Plasma Fructose: Glucose Ratio as an Index of Spermatozoa Motility
Authors: Legge Michael , Hammond Erin M. , Newsome Tina J.
Published: August 2010

Abstract

Seminal plasma from 57 donors was analyzed. Of these 34 were normal, 16 abnormal and 7 had normal motility but other parameters were abnormal. A fructose: glucose ratio performed on each sample indicated a close correlation with motility. The 16 abnormal samples had a significantly lower fructose: glucose ratio than the other 2 groups tested.
Effect of Actinomycin D and Puromycin upon Basal and LH‐Induced Steroidogenesis by Hamster Follicles in Culture
Authors: Matson Phillip L. , Collins W. P.
Published: August 2010

Abstract

The role of protein synthesis in modulating steroid production by preovulatory hamster follicles (591–740 μm) was investigated in vitro using selective inhibitors of transcription (actinomycin D; 8 μg/ml) and translation (puromycin; 80 μg/ml). The results showed:

basal oestradiol production was increased in the presence of either actinomycin D or puromycin, suggesting the existence of a protein inhibitor of oestrogen synthesis;

the initial stimulatory action of LH upon steroidogenesis is abolished by puromycin but not actinomycin D, suggesting that the synthesis of new protein is required but not new mRNA; and

the preovulatory ovarian follicle grown in a defined culture medium is a good model system to study the hormonal regulation of gene expression.
Flow Cytometric Study of Site‐Directed Chemotherapy with Estradiol‐17β as a Drug Carrier to Human Endometrial Adenocarcinoma Cells in vitro
Authors: Nishiya Iwao , Yoshizumi Noboru , Sato Masayuki , Kagabu Teruo , Fujiwara Jun , Yoshizaki Akira
Published: August 2010

Abstract

The effects of Estracyt®, HN2 (nitrogen mustard) derivative of estradiol‐17β, and free HN2 on the cell kinetics of the estrogen receptor (ER) positive human endometrial cancer cell line HEC‐1, were investigated using flow cytometry.

HN2 at 1 μg/ml showed a marked increase in the S phase and a decrease in the G0 + Gi phase. However, with equivalent doses of Estracyt® at 10 μg/ml, the accumulation in the G2 + M phase was even more marked.

Synchronization in the S phase with methotrexate (MTX) showed no increase in sensitivity to these drugs.

The above results suggest that the free HN2 has an effect regardless of the cell cycle phase, whereas the effects of Estracyt® may depend on a fixed population of target cells existing in the G0+G1, S and G2 + M phases.

Synchronization in the G1 phase with sodium n‐butyrate could increase the target effects of Estracyt® in the S phase.
Obstetric Outcome of Large Foetuses in Malaysian Women
Authors: Chuah C. Y. , Raman Subramaniam
Published: August 2010

Abstract

In a retrospective review of all deliveries in the University Hospital, Kuala Lumpur in 1984, 192 infants were found to weigh 4,000 g or more giving an incidence of 3.29%. No antenatal complication was found in the majority of cases (80.2%). Postmaturity and diabetes mellitus were present in 13% of cases. Maternal complications included per‐ineal laceration, difficult labour and a higher caesarean rate. The perinatal morbidity was significantly higher in those who delivered big babies. There were however no fetal deaths. Careful vigilance in labour with recourse to caesarean section in those patients expected to have difficult labour is suggested.
Changing Trends of Maternal Mortality in Developing Countries
Authors: Pandit Ramesh D.
Published: August 2010

Abstract

An indepth study of maternal mortality was carried out by me from 1929 to 1983 at Nowrosjee Wadia Maternity Hospital, Bombay, India. It is revealed that the maternal mortality at N. Wadia Maternity Hospital which was 1,920 per 100,000 live births during 1929–1939 period has come down to 80 per 100,000 live births during 1980–1983 period. The direct obstetric death rate for the period 1929–1939 which was 670 per 100,000 live births has declined to 40 per 100,000 live births for the period 1980–1983, while the indirect obstetric death rate has declined from 690 for period 1929–1939 to 30 for period 1980–1983. Multiple factors were responsible for this. It is emphasised that ideal antenatal, intranatal, and postnatal care is responsible for the decline in the maternal mortality. Confidential maternal mortality committees in various hospitals and institutions, as well as periodic reviews of maternal mortality on a national and international level will help in further reduction of maternal mortality.
Role of Caesarean Section in Low Birth Weight Babies
Authors: Rege Jayant S. , Dastur Nayna A. , Mataliya Manju V. , Pandit Ramesh D.
Published: August 2010

Abstract

The role of caesarean section in babies weighing less than 2,500 g was studied over a period of 6 months. These caesarean section births were studied with respect to their period of gestation, indications for caesarean section; then their Apgar scores, modes of resuscitation, neonatal complications and the perinatal outcome were compared to that of the babies delivered vaginally in the equivalent weight group. Out of the total 335 caesarean sections in the study period, 91 were done in those, where the baby weight was less than 2,500 g giving an incidence of 27%. Placenta praevia and preeclampsia— eclampsia formed the major maternal indications for section in the baby weight group of 1,000–2,000 g. Among the foetal indications, foetal distress was the commonest. Among the babies weighing less than 2,000 g, 27% of the section babies showed 5 minute Apgar (8–10) as compared to 3.2% of the babies in the vaginal delivery group. Sixty‐eight percent of the caesarean babies were discharged alive in below 2,000 g birth weight group, as compared to 41 % in vaginally delivered group.
Ileus due to Extensive Adhesion Formation after Intraperitoneal Chemotherapy Using Cisplatinum
Authors: Takada Shuichi , Azukizawa Sumio , Kubota Yutaka , Masuda Michihiko
Published: August 2010

Abstract

Many reports in the recent literature deal with intraperitoneal chemotherapy. Though quite effective for ovarian cancer, it is accompanied by side effects. Extensive adhesion formation after intraperitoneal chemotherapy is one of the side effects to which clinicians must pay attention.

In this paper, we present a case of ileus due to extensive adhesion formation about 11 months after cessation of intraperitoneal chemotherapy using cisplatinum (CDDP).
Castleman's Disease Associated with Pregnancy: A Case Report
Authors: Yasuda Jinsuke , Sawada Sigenari , Tomioka Megumi , Yamamoto Takao , Okada Hiroji
Published: August 2010

Abstract

A rare case of Castleman's disease is presented. A 26‐year‐old Japanese pregnant woman was found to have an asymptomatic adnexal tumor. Ultrasonography showed a hypoechoic mass with dense central echoes. At laparotomy with presumptive diagnosis of dermoid cyst of the ovary at 15 weeks' gestation, a firm encapsulated retroperi‐toneal mass was resected. Histological examinations identified it as Castleman's disease of the hyaline‐vascular type with focal calcification.

Castleman's disease should be included in the differential diagnosis of low abdominal masses.

This is the first case of Castleman's disease associated with pregnancy in an Asian.
Combination Chemotherapy for Immature (Malignant) Teratomas of the Ovary
Authors: Singh Pritam , Yordan Edgardo L. , Graham James R. , Wilbanks George D. , Slayton Robert E. , Miller Alexander W. , Ratnam S. S.
Published: August 2010

Abstract

Immature (malignant) teratomas of the ovary without combination chemotherapy are highly fatal neoplasms. Within the last decade postoperative adjuvant combination chemotherapy has been shown to be highly effective and produced long term survival in patients with these tumours. The efficacy of a regimen containing vincristine, acti‐nomycin D and cyclophosphamide is reported with several patients alive free of disease at 5 to 10 years. The factors influencing prognosis, duration of therapy and role of second‐look laparotomy in immature teratomas are discussed.
Pregnancies Established by Intrauterine Insemination with Washed Spermatozoa
Authors: Chiu Tony T. Y. , Tarn Patrick P. L. , Mao Kenneth R.
Published: August 2010

Abstract

Intrauterine insemination with washed and capacitated spermatozoa was performed in 11 couples whose primary cause of infertility was poor semen characteristics, i.e. oligospermia, asthenospermia and teratospermia, and in 9 couples with unexplained cause of infertility. A total of 59 cycles were attempted. Four biochemical pregnancies and 2 viable pregnancies were achieved, resulting in the birth of one boy and one girl.
Status of Transferrin Receptors in Benign and Malignant Lesions of the Cervix
Authors: Buckshee K. , Saha D A. , Agarwal N. , Singh G.
Published: August 2010

Abstract

Reactivity for transferrin receptors was studied in 9 cases with benign and 11 cases with malignant lesions of the cervix. Immunostaining reaction for transferrin receptors was positive in 9/11 (81.8%) of the malignant lesions. However, the reactivity was absent (0%) in all of the 9 specimens with benign lesions. The difference in reactivity pattern between benign and malignant lesions was highly remarkable (P< 0.001 Fischer's exact test). Thus the present study denotes that transferrin receptors are associated with active cellular growth (malignant lesions) and virtually absent in the resting tissues (benign lesions).
Peripartum Cardiomyopathy in a Malay Female
Authors: Raman S. , Rachagan S. P. , Marzuki A.
Published: August 2010

A case of peripartum cardiomyopathy occurring in a Malay patient is presented. Diagnosis of this condition can be difficult and is usually one of exclusion. The clinical course of the disease is presented highlighting the points in favour of this rather poorly appreciated and misdiagnosed condition. To our knowledge this is the first report of this condition in a Malay patient.
Primary Malignant Fibrous Histiocytoma of the Uterine Body
Authors: Shiromizu Kenji , Ishihara Osamu , Takahashi Michiko , Matsuzawa Masumi , Nishimura Toshinobu , Takayama Shojiro
Published: August 2010

An extremely rare case of primary malignant fibrous histiocytoma of the uterine body was presented. The patient was a 61‐year‐old woman with deep uterine myometrial invasion and had pulmonary multiple metastases 5 months after total abdominal hysterectomy, and despite intensive chemotherapy died 11 months after diagnosis. Light and electron microscopic observations revealed a tumor composed of characteristic fibroblast‐like and histiocyte‐like cells compatible with the malignant fibrous histiocytoma reported previously.
Laparoscopy as a Diagnostic and Therapeutic Technique in Uterine Perforations during First Trimester Abortions
Authors: Pratap Kumar N. , Padma Rao A.
Published: August 2010

Laparoscopic analysis of uterine perforation during first trimester medical termination of pregnancy was done in 10 cases out of the 12 perforations in 2,967 MTPs. Incidence of uterine perforation was 3 per 1,000. In 9 out of 10 cases, a laparotomy was avoided due to laparoscopic aid and MTP was completed under laparoscopic vision. Fundus was the commonest site of perforation with no relevance of uterine position. The procedure is safe when performed in indicated cases and an exact diagnosis of the extent of perforation injury can be obtained. This procedure avoids an exploratory laparotomy.
Nuclear Steroid Receptors in Endometrial Cancers
Authors: Fujimoto Jiro , Tamaya Teruhiko , Watanabe Yoshinobu , Arahori Kenji , Sato Shohei , Okada Hiroji
Published: August 2010

Estrogen receptor in the cytosol (ERc), in the nuclear KCl extract (ERne), and in the nuclear KCl unextractable fraction (ERnu) of endometrial cancers was detected in all 3 premenopausal cases. In all postmenopausal cases. ERc was detected, but neither ERne nor ERnu were detected in several cases. These results suggest that an ER‐mediated mechanism is present in all endometrial cancers.

In 3 premenopausal cases, progestin receptor (PR) and androgen receptor (AR) were detected in the cytosol, and in the nuclear fractions of one well‐ and one moderately‐differentiated tumor. In some postmenopausal cases, PRne was found but not PRc. ARc levels in endometrial cancers were always low in both pre‐ and postmenopausal cases. These findings indicate the presence of some factor by which the pro‐gesterone‐PRc complex translocates to the nucleus of endometrial cancer cells in some postmenopausal cases, and that the nucleus may have progestin‐specific binding sites.
Presence and Expression of Human Papillomavirus Types 16 and 18 DNA Sequences in Cervical Carcinomas
Authors: Hsieh Chang‐Yao , Lee Sheng‐Chung , Huang Su‐Cheng
Published: August 2010

DNA of human papillomavirus (HPV) types 16 and 18 has been found closely associated with cervical carcinomas. We have analyzed DNA from a larger number of cervical carcinomas, for the state and expression of the HPV 16 and 18 genome. Among 77 samples, HPV 16 genome was found in 35 (45.5%) while HPV 18 in 14 (18.2%). HPV 18 genome was associated more closely with adenocarcinomas than with squamous cell carcinomas. HPV 16 and 18 genomes were mutually exclusive in terms of their tissue existence. The viral DNA was present in the tissue mainly as integrated forms, although in some tissues there was episomal as well as integrated forms. The sites of HPV DNA integration were random. The copy number of HPV sequences varied greatly among different samples. Poly (A)+ RNA ranging from 1.1 kb to more than 5 kb were detected in HPV 16 or HPV 18 positive tissues using HPV 16 or 18 DNA probe.
Effects of RU 486 on the Mechanical Properties of Rabbit Fallopian Tubes
Authors: Nozaki Masahiro , Nakamura Gen‐ichi
Published: August 2010

The effects of RU 486 on the mechanical activities of the circular smooth muscles of the rabbit oviduct were investigated using an isometric tension recording method. Injection of human chorionic gonadotropin (hCG) markedly increased the frequency of the spontaneous contractions but simultaneous treatment with hCG and RU 486 did not increase the frequency. In the animals treated with hCG, the frequencies and amplitudes of the contraction increased, and the concentrations of progesterone in the sera increased. This action of hCG was suppressed when RU 486 was simultaneously injected. In oviductal smooth muscles simultaneously treated with progesterone and RU 486, the frequency of spontaneous contractions was markedly decreased as in the case of the simultaneous injection of hCG and RU 486. Thus, RU 486 alters the mechanical activities of the fallopian tube by preventing the release of progesterone induced by hCG and by acting against progesterone. This is the first report that RU 486 acts directly on tubal motility.
Combination Chemotherapy for Malignant Mixed Germ Cell Tumours of the Ovary: A Prospective Study
Authors: Singh Pritam , Yordan Edgardo L. , Graham James R , Wilbanks George D. , Slayton Robert E. , Miller Alexander W.
Published: August 2010

A prospective study of 10 patients with malignant mixed germ cell tumours of the ovary treated with combination chemotherapy consisting of either vincristine, actinomycin D and cyclophosphamide (VAC) or vinblastine, bleomycin and cisplatin (VBP) is reported. The median age of these patients was 21.5 years and 3 patients had Stage I disease, 4 Stage II and 3 had Stage III disease. A detailed analysis of the pathological and prognostic features of mixed germ cell tumours is presented. Six of these patients are alive and well for periods ranging from 2 to 10 years. Contemporary management of these tumours with chemotherapy including the role of second‐look laparotomy and second‐line chemotherapy is discussed. Optimal therapy of these tumours consists of surgery followed by combination chemotherapy.
Cervical Carcinoma in situ after Incomplete Conisation
Authors: Ueki Minoru , Green G. H.
Published: August 2010

To investigate further the nature and treatment of cervical carcinoma in situ (CIS), 211 conisation specimens reported as showing “incomplete excision of CIS,” obtained at Auckland University's National Women's Hospital were examined and the histological findings correlated with long‐term follow‐up (2 to 16 years); 88.4% were followed for at least 5 years.

There was persistence or recurrence in 34.1% of the total. Recurrence was related to the extent of CIS in the cervix, as judged from the incompletely excised sites and remaining tissue blocks. Micro‐invasive carcinoma was found in 4 patients (1.9%) and invasive carcinoma (Stage Ib “occ”) in 2 (0.9%). It was concluded that when the CIS is small in extent in the cervix, or is incompletely excised only at the exocervix, spontaneous disappearance of any remainder can be expected. The findings suggest that the continued existence of incompletely excised CIS is significantly inhibited by the healing process.
Virilizing Pregnancy Luteoma: A Case Report
Authors: Yasuda Jinsuke , Shiroshita Kohhei , Yamamoto Takao , Okada Hiroji
Published: August 2010

The first case report of virilizing pregnancy luteoma in an Asian is presented. Virilizing symptoms such as a deep voice, a male type of escutcheon, coarse facial hair, severe cystic acne and clitomegaly were found in 25‐year‐old Japanese primigravida during the last trimester of pregnancy. Serum androstenedione and testosterone were much higher than in normal pregnancy. The levels of 17‐ketosteroids in urine were also markedly elevated. In this 17‐KS in the urine, large amounts of 11β‐hydroxy‐androsterone (11β‐hydroxylated metabolites of androgen) were found by gaschromatography‐mass spectrometry (GC‐MS).

Spontaneous labor started at 38 weeks' gestation, and the patient was delivered of a normal male infant. At 3 weeks postpartum, the elevated androgens returned to normal levels, but the enlarged left ovarian tumor did not regress in size. Pathological diagnosis of the tumor at exploratory laparotomy at 4 weeks postpartum was pregnancy luteoma. Virilizing symptoms regressed slowly after delivery, however the deep voice, male type of escutcheon and clitomegaly remained at 5 years postpartum.
A Vaginal Approach to the Treatment of Genital Prolapse
Authors: Tanaka Shoichi , Yamamoto Hiroshi , Shimano Satoshi , Endoh Toshiaki , Hashimoto Masayoshi
Published: August 2010

A series of 84 cases of genital prolapse, operated on at our clinic by way of vaginal hysterectomy with anterior and posterior colporrhaphy during 1976–1985, was clinically analyzed in this study.

The cases included 1 nullipara, 1 primipara, 56 cases from para II to V and 26 cases para VI or more.

Vaginal hysterectomy with anterior colporrhaphy was performed on 58% of the cases and vaginal hysterectomy with anterior and posterior colporrhaphy was carried out in 41% of the cases. Vaginal hysterectomy with posterior colporrhaphy was performed in only 1% of the cases.

Immediate postoperative complications took the form of residual urine in 12 cases of vaginal hysterectomy with anterior colporrhaphy. There was no recurrence in our series after operation.
Pattern of Neonatal Morbidity and Mortality in Infants of Diabetic Mothers
Authors: Faquih Arif M , Mir Nisar A , Kishan J. , Legnain M.
Published: August 2010

The outcome of 145 diabetic pregnancies, seen over a period of 18 months, was analysed. Overall incidence of diabetes in pregnancy was 0.59%, and 70% of the mothers were insulin dependent. Their class distribution was: A‐43 (31%), B‐96 (68%) and C‐6 (4%); 20 (14%) of the mothers had poorly controlled diabetes during the pregnancy. Major maternal complications observed were: toxemia (21), abruptio placentae (7) and polyhydramnios (6). Sixty‐seven (47.8%) mothers delivered at ± 37 weeks of gestation and the cesarean section rate was 39.3%. The mean gestational age and birth weight of infants of diabetic mothers was 37.4 ± 1.7 weeks and 3,898 ± 841 g respectively. The neonatal morbidity observed were: macrosomia (52%), hypoglycemia (46%), asphyxia (38%), polycythemia (36%), hyperbilirubinemia (18%), transient tachypnea of the new born (16%) and hyaline membrane disease (5%). Congenital anomalies were observed in 20 infants. Prematurity, asphyxia, hypoglycemia and birth injuries were more common among infants with macrosomia (p = <0.01).

There were 17 perinatal deaths (5 stillbirths and 12 early neonatal deaths) with a perinatal mortality rate of 117.2 compared with 26.7 per 1,000 births in the general population. Adverse prognostic indices for neonatal mortality were: poor metabolic control of diabetes and presence of severe birth asphyxia, prematurity and/or major congenital anomalies.
A Critical Analysis of the Rates and Indications for Caesarean Section in a Developing Country
Authors: Ojo Vincent A. , Okwerekwu Francis O.
Published: August 2010

A retrospective analysis of 785 cases of caesarean section was performed, over a 2‐year period. The caesarean section rate was 6.96%—primary section rate being 6.14% andrepeat section rate, 0.82%.

The commonest indications for caesarean section were dystocia (2.67%), malpresentation and malposition (1.16%), previous section (0.82%), fetal distress (0.73%) and antepartum haemorrhage (0.63%). A critical discussion on the rates and indications for caesarean section was done. For a reduction in caesarean section rates a re‐appraisal of section for dystocia is essential.
Pattern of Neonatal Mortality in a Government Teaching Institute
Authors: Sangamnerkar M. , Sutaria U. D. , Shrotri A. N.
Published: August 2010

The neonatal mortality during hospital stay of live‐born babies in a large government hospital is assessed in the light of various maternal factors and neonatal problems.

The complete records of every neonatal death along with record of all deliveries over a period of 18 months were maintained prospectively and analysed. Out of total 9,374 deliveries, 8,931 were live births, of which 438 were neonatal deaths. Thus the neonatal mortality was 49.04 per 1,000 live births, of which 89.5% were early neonatal deaths. The main contributors to neonatal mortality were prematurity (22.8%), hyaline membrane disease (20.8%), birth asphyxia (15.7%), sepsis (14.4%), malformations (11.4%), other respiratory problems (8.9%) and birth trauma (3.4%). The main causes of late neonatal deaths were sepsis, respiratory problems and malformations. Of the total live births 13.95% were having birth weight of less than 2 kg and these contributed to 79.6% of neonatal deaths. Of all neonatal deaths, 52.5% were preterm babies.

The various high risk factors and measures to reduce neonatal mortality are discussed.
FSH, LH, PRL and E2 Levels in Follicular Fluid and Serum of Patients Undergoing Follicle Stimulation with Different Protocols for IVF
Authors: Shin Min‐Tsir , Chu Tang‐Yuan , Hsu Chih‐Hsueh , Yu Mu‐Hsien , Chang Jia‐Shyuhn , Sun David , Lao Zen‐Hwa , Wu Kwo‐Tsang , Lee Chia‐Koon , Yang Chi‐Liu , Hsu Chien‐Tien
Published: August 2010

Concentrations of FSH, LH, PRL and E2 in plasma and in follicular fluid were studied by radioimmunoassay in 74 cycles induced for IVF. Three different protocols were used for induction of super‐ovulation: Clomiphene/HCG, clomiphene/HMG/HCG and HMG/HCG.

The results showed that the 2 HMG‐treated groups showed significantly higher serum E2 and PRL, and lower LH levels than the clomiphene‐treated group. Similarly, the HMG‐treated protocols also induced more FSH, PRL and E2 in follicular fluid than the clomiphene‐treated protocol, while LH in the follicular fluid in 3 protocols were very close.

On the basis of the hormone profiles in serum and follicular fluid noted in this study, we concluded that the HMG‐treated protocol produced a more favorable systemic and local environment for oocyte maturation. PRL levels in serum and follicular fluid, like E2, seemed to be an indicator of oocyte maturation. The LH‐surge inhibition effect of HMG was also confirmed in this study.
Pure Rhabdomyosarcoma of the Corpus Uteri: A Case Report with a Review of the Literature
Authors: Teshima Hideo , Narahara Hisashi , Nishida Junichi , Takada Shinichi , Cheng Schin Zon , Mizutani Katsumi , Mori Hiroyuki , Kigawa Tomonori
Published: August 2010

We report on a 52‐year‐old woman with a pure rhabdomyosarcoma of the corpus uteri. Histopathological study revealed that the tumor was composed only of rhabdomyosarcoma (RMS) and it was not associated with carcinoma or other elements of mixed mesodermal tumor. An undifferentiated tumor element was observed. Using the indirect immunoperoxidase technique for myoglobulin, the filaments with striated muscle was stained in the cytoplasm of the undifferentiated tumor cells, which was regarded as a pure rhabdomyosarcoma of the embryonal type arising from the corpus uteri.
Management of Pregnancy Complicated by Diabetes Mellitus: Experience at the University Hospital, Kuala Lumpur
Authors: Dutta R. , Kulenthran A. , Sivanesaratnam V. , Chan S. P. , Zaini A. , Sinnathuray T. A.
Published: August 2010

A retrospective study of 97 patients with pregnancy complicated by Diabetes Mellitus was carried out. An in‐patient management regime was undertaken with combined care by the obstetrician and endocrinologist. Common antenatal complications encountered were urinary tract infections and pre‐eclampsia. A policy of routine induction of labour at 38 weeks gestation was adopted unless delivery was mandated earlier. The caesarean section rate was 41%. There were 2 perinatal deaths, both due to lethal congenital defects.
Long Term Low Dose Pulsatile Luteinizing Hormone Releasing Hormone Therapy for the Treatment of Anovulatory Infertility
Authors: Tan Seang Lin , Thong Pao Wen , Chong Rosalind , Chua Dixie , Tay Beng Choon , Jen Shek Wei , Aw Swee Eng , Salmon Yvonne Marjorie , Chen Christopher
Published: August 2010

Twenty‐seven women who had clomiphene‐resistant anovulation as the only cause of infertility were studied. They were divided into 2 groups on the basis of pre‐treatment endocrine and ultrasound assessment: hypogonadotropic hypogonadism (HH) (N=6) and polycystic ovarian disease (PCOD) (N=21). They were administered pulsatile luteinizing hormone releasing hormone (LHRH) therapy using miniaturized portable infusion pumps at a constant dose 15 ug per pulse every 90 minutes. The patients with HH were treated for a total of 31 cycles and 4 pregnancies were obtained. Twenty‐eight out of 31 cycles of therapy were ovulatory. The patients with PCOD were treated for a total of 65 cycles and, of these, 40 cycles were ovulatory. Ten patients became pregnant. When the patients with PCOD who ovulated were compared with those who failed to ovulate, it was found that the only predictor of successful therapy was the ponderal or body mass index. The mean ponderal index of those who ovulated was 22.20±2.62 (±SD) compared with 26.01±0.81 (±SD) for those who remained anovulatory. We conclude that pulsatile LHRH therapy is efficacious therapy for patients with HH but not as effective for patients with PCOD. In the latter group the ponderal index predicts for the likelihood of successful response to therapy.
Second Stage Fetal Heart Rate Decelerations in Breech Deliveries
Authors: Ohel Gonen , Brjejinski Amnon , Linder Nechama , Navot Daniel
Published: August 2010

Observation of 35 term breech fetuses in the second stage of labor, demonstrated a 77% incidence of periodic fetal heart rate (FHR) decelerations, characterized by brisk onset and quick recovery. As head compression cannot be an important factor in such labors, the FHR changes are most probably caused by cord compression and its associated vagal reflex bradycardia. The high prevalence of such FHR changes underscores the need for continuous FHR monitoring of breech deliveries throughout the second stage of labor.
Comparison of Pharyngeal Aspiration and Amniotic Fluid Surfactant Phospholipids for Prediction of RDS
Authors: Dhall Kamala , Gupta Neelam , Majumdar Siddhartha , Bhakoo Onkar N.
Published: August 2010

Pulmonary surfactant phospholipids in nasopharyngeal aspirate have been compared with the corresponding parameters in amniotic fluid (AF) in 108 cases for prediction of respiratory distress syndrome (RDS) in the newborn. The concentration of phospholipids [lecithin sphingomyelin ratio (L/S) and phosphatidylglycerol (PG)] rises with the rising periods of gestation in both the fluids. When 2 groups of samples were compared, the values of phospholipids were higher in pharyngeal aspirate (PA) than in amniotic fluid (AF). These differences were statistically significant in case of PG but not in case of L/S ratio. Time interval between AF and PA collection, neonatal weight and Apgar score did not influence the concentration of phospholipids in AF and PA. The mature value, i.e. positive test could predict freedom from RDS in 99 to 100% of cases with PG and L/S in both the fluids respectively whereas predictability with negative test though less, was higher with phospholipids in AF than in PA.
Immunogenicity Study of a Plasma‐Derived Heat‐Inactivated Hepatitis‐B Vaccine in Newborn Babies: A Randomised Dose‐Response Study
Authors: Ip Henrietta M. H. , Wong Vivian C. W. , Reesink Henk W. , Lelie P. Nico , Yeung C. Y. , Ma H. K.
Published: August 2010

A double‐blind, randomised dose‐response study was carried out to evaluate the immunogenicity of a plasma‐derived, heat‐inactivated hepatitis‐B vaccine in newborn infants of mothers who were HBsAg‐positive but HBeAg‐negative.

Four groups of 15 babies each were vaccinated at birth and at the age of 1 and 2 months with 0.1, 0.25, 0.6 and 3 μg, respectively. The anti‐HBs conversion rate was 100% at 3 and 6 months in the group immunized with 3 × 3 μg. In comparison with the 3‐μg group, the anti‐HBs conversion rate for the 0.6‐ μg group did not change significantly, but the geometric mean titre was significantly lowered (p<0.005). In the 0.1‐μg and 0.25‐μg groups, however, the anti‐HBs conversion rate was significantly reduced (p<0.05). This implies that the optimum dosage for this vaccine should be between 0.6 to 3 μg. Protective efficacy need to be proven before vaccine dosages are lowered for high risk newborns.
Genital Bleeding during the Administration of Danazol
Authors: Nakamura Gen‐ichi , Yoshimitsu Kiyotaka , Imura Mutsunori , Nakano Hitoo
Published: August 2010

In an effort to reduce undesirable bleeding during danazol treatment, we attempted to see any correlation between the frequency of bleeding and the starting period of danazol treatment during the menstrual cycle. We studied 57 women who were suffering from endometriosis externa and given danazol (400 mg/day) for periods between 16 and 24 weeks.

The patients were divided into 4 groups depending on the day administration of the drug began; 18 patients started on the 1st or 2nd day of the menstrual cycle, 12 on the 3rd day, 20 on the 5th day and 7 after the 10th day.

The rate of bleeding was 6.8±6.3% (M±SD) in the group starting on the 1st or 2nd day. This was significantly smaller than that of other groups starting treatment later in the menstrual cycle.

The number of patients with complete amenorrhea throughout the entire treatment period was significantly higher in the group beginning administration of danazol on the 1st or 2nd day of the menstrual cycle.

Therefore, administration of danazol should be started as early as possible in the menstrual cycle to reduce the frequency of bleeding.
Effects of Catecholestrogen 2‐Monomethyl Ether on Serum Cholesterol and Lipoprotein Levels
Authors: Kono Shinzo , Higa Hiroaki , Sunagawa Hajime
Published: August 2010

The hypocholesterolemic effect of 2‐methoxyestrone (2‐MeOE1), 2‐methoxyestriol (2‐MeOE3) and estradiol‐17β (E2‐17β) was investigated in 2 experimental systems of normocholesterolemic and dietary hypercholesterolemic rats that had been oopho‐rectomized. Each compound was subcutaneously administered for 10 consecutive days at a dose of 10 μg per day in the former, and for 6 consecutive days at a dose of 300 μg per day in the latter.

The hypocholesterolemic effect was as follows; 2‐MeOE3=E2‐17β>2‐MeOE1. In the latter system, the serum total cholesterol level of the individual rats in both 2‐MeOE3‐ and E2‐17β‐administered groups returned to normal.

These hormones caused an increase of α‐lipoprotein, with an inversely proportional decrease of β‐lipoprotein, and the β‐/α‐lipoprotein ratio was in an inverse correlation with the hypocholesterolemic effect.

The uterotrophic activity was detected with neither 2‐MeOE1 nor 2‐MeOE3, while E2‐17β exhibited an anomalous activity.

2‐MeOE1 and 2‐MeOE3 had no effect on body weight, while E2‐17β reduced it slightly.

The results suggest that catecholestrogen 2‐monomethyl ether plays an important role in lipid metabolism through estrogen receptor‐independent mechanisms, and has a pharmacologically important effect on hyperlipidemia and atherosclerosis.
Iron Stores in Maternal and Cord Blood
Authors: Agha Farida , Hasan Talat Jahan , Khan Rafiq Ahmad , Jafarey Sadiqua
Published: August 2010

Serum ferritin concentration was measured in 206 paired maternal and newborn (Umbilical cord sample) blood specimens taken during delivery. Iron deficiency (assessed by serum ferritin assay) was found in 38% pregnant women. The mean serum ferritin was significantly low in pregnant mothers compared to non‐pregnant women, indicating depleted iron stores at term.

Serum ferritin levels in cord blood were higher than those in the maternal blood, indicating that the mother is in a state of iron deficiency with low serum ferritin and the fetus in a state of iron sufficiency with high serum ferritin.

Maternal ferritin had no correlation with cord ferritin and babies born to iron deficient mothers had low but not statistically significant serum ferritin levels. This suggests that iron storage in the mother and iron metabolism in the fetus are not directly related. However, there seemed to be a level of maternal iron stores below which the newborn was endowed with decreased iron stores.
Changes in Neonatal Transcutaneous Bilirubinometer Index following Intravenous Fluid and Oxytocin Infusion during Labour
Authors: Loong E.P.L. , Lao T.T.H. , Chin R.K.H.
Published: August 2010

A survey of 48 Chinese mothers and their babies was made regarding intravenous infusion of fluid and oxytocin during labour and changes in neonatal transcutaneous bilirubinometer (TCB) index. No significant difference was found in cord plasma bilirubin levels at delivery or TCB readings in the first 3 days of life between infants whose mothers had no intravenous infusion and infants whose mothers had infusion of Hartmann's solution or 5% dextrose solution with oxytocin. Administration of intravenous fluid or oxytocin in routine management of labour would not lead to neonatal hyperbilirubinaemia nor contribute to the high incidence of neonatal jaundice in full‐term Chinese newborn infants.
Intravenous Leiomyomatosis: Case Report and Review
Authors: Hughes Phillip F.
Published: August 2010

A case of intravenous leiomyomatosis is presented. The diagnosis and implications are discussed together with the current and probable future approach to treatment.
Ultrasound Directed Oocyte Recovery in an IVF Program
Authors: Wong P. C. , Wong Y. C. , Anandakumar C. , Hamilton M.P.R. , Chan C.L.K. , Ng S. C. , Bongso T. A. , Ratnam S. S.
Published: August 2010

Sixty‐three patients who underwent the IVF program had oocyte recovery done under ultrasound guidance. These patients were previously found to have inaccessible or partially inaccessible ovaries at laparoscopy. Twenty patients had oocyte recovery by the transurethral route while 43 were carried out by the transvaginal approach. In the transurethral group, 96 follicles (4.8 follicles per patient) were aspirated and 55 oocytes were recovered (57.3%) or 2.75 oocytes per patient. In the transvaginal group, 216 follicles (5.0 follicles per patient) were aspirated and 104 oocytes were recovered (48.1%) or 2.41 oocytes per patient. Ultrasound‐guided oocyte recovery is a satisfactory method of oocyte recovery in patients with inaccessible or partially inaccessible ovaries.
Anaerobic Infections in Pregnant Women Undergoing Caesarean Section and Associated Risk Factors
Authors: Dasgupta R. K. , Rao R. Sambasiva , Rajaram P. , Natarajan M. K.
Published: August 2010

From 50 pregnant women who underwent caesarean section on elective or emergency basis (25 each) high vaginal swabs pre‐operatively and post‐operatively and amniotic fluids were cultured for both aerobic and anaerobic organisms. A mixed growth of aerobes and anaerobes was frequently observed; Gram‐positive cocci being predominant. Amniotic fluid from the women undergoing an emergency caesarean section showed significantly higher positivity for anaerobic bacteria. The same patients showed a greater propensity to develop post‐operative febrile morbidity. Absence of antenatal booking, increased duration of labour, prolonged rupture of membranes, more than 7 pelvic examinations and increased duration of surgery were found to be significant risk factors in the aetiopathogenesis of these infections.
Early Pregnancy Support in an in vitro Fertilization Program: Does Human Chorionic Gonadotropin Reduce the Miscarriage Rate?
Authors: Baber Rodney J. , Kuan Richard , Porter Richard N. , Saunders Douglas M.
Published: August 2010

In order to determine the effect of early pregnancy support with intermittent injections of human chorionic gonadotropin (hCG), 60 patients with positive serum pregnancy tests following in vitro fertilization (IVF) or gamete intra‐fallopian transfer (GIFT) were randomly allocated into 2 groups. Those in one group were given 5,000 IU of hCG twice weekly until they reached 12 weeks gestation, or miscarried. Those in the other group acted as controls. There was no difference in the serum progesterone level or in pregnancy outcome noted between the 2 groups. The miscarriage rate in each group was 26.6%. It is concluded that exogenous hCG has no significant role to play once biochemical pregnancy has been achieved in patients with normal hormone profiles on an IVF program.
Glycosylated Haemoglobin in Obstetric Practice
Authors: Dhall Rajiv , Vasishta Kala , Majumdar Siddhartha
Published: August 2010

Forty pregnant non‐diabetics and 35 pregnant diabetics were studied in the antenatal period and followed till confinement. Glycosylated haemoglobin (GHb) and plasma glucose values (fasting and post load) were estimated at specific time periods.

Various analyses showed GHb to have no significant correlation with glucose values (P>0.05). The diagnostic ability of GHb was significant at cut‐off values of 6lt;% and 7% (P< 0.05) but not at 8% (P>0.05). At 7%, sensitivity (65.62%) and specificity (60.71%) were close; the positive predictive value was 65.62%. In pregnant diabetics, monitoring the response to therapy with GHb yielded no significant change in the diabetic status.
Perinatal Mortality in Abnormal Presentations
Authors: Dalal Asha R. , Merchant R. N.
Published: August 2010

Perinatal mortality though on the decline is still alarmingly high in India. When associated with an abnormal presentation it is higher still.

In our hospital, i.e. the B.Y.L., Nair Hospital and the Kamathipura Municipal Hospital, we have observed that out of about 3,000 normal deliveries that we have yearly, in approximately 4–5% of them there is an abnormal presentation.

The perinatal mortality has fallen from around 200 in 1981 to 139 in 1984. It has been observed that 18% of this figure comes from deaths associated with an abnormal presentation. Hence the thorough monitoring of the patients to detect and treat these abnormal presentations adequately will go a long way to reduce the perinatal mortality.