bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic Monitoring of the Placenta in Patients with Bleeding during the First and Second Trimesters
Authors: Takeda Satoru , Baba Kazunori , Kojima Toshiyuki , Kinoshita Katsuyuki , Satoh Kazuo , Sakamoto Shoichi
Published: August 2010

Thirteen patients with vaginal bleeding in the first and second trimester, in 730 pregnancies confirmed with live fetuses, were diagnosed as having subchorionic hematoma at the perivillous or periplacental region by a real‐time B‐mode scan device. In 9 of the 13 patients, the hematoma disappeared within 1 to 3 months after detection, while in 2 patients it increased in size.

Seven of the 13 pregnancies progressed to full term (53.8%), 3 ended in premature deliveries (23.1%) and 3 in spontaneous abortions (23.1%). In 5 of the 13 patients, PROM occurred. Pathological examinations revealed 5 circumvallate (38.5%) and 2 circummarginate (15.4%) placentas.

Since our clinical observation indicates that subchorionic hematoma and marginal separation of the placenta may be important causes of bleeding during pregnancy, monitoring of the placenta and fetus by ultrasound was used to obtain precise information in order to manage patients with bleeding. It might be speculated that extrachorial placenta results from subchorionic hematoma or its absorption.
Massive Fetomaternal Hemorrhage: Case Report
Authors: Ishihara Hiroshi , Takahashi Hiroyuki , Takeuchi Yuichiro , Kigawa Junzo , Sawazumi Kazuhide , Ito Takashi , Maeda Kazuo
Published: August 2010

Massive fetomaternal hemorrhage (FMH) is rare. Early diagnosis is important because FMH has a poor prognosis in the antepartum or early postpartum period. A case of massive FMH in which 400 ml blood was lost is presented here. Fetal anemia was suspected from the sinusoidal fetal heart rate pattern. The hemorrhage in the maternal circulation was diagnosed before delivery by using the Kleihauer‐Betke test. An emergency cesarean section was performed. The cord hemoglobin level was 3.7 g/dl. The baby's severe anemia was treated with a neonatal blood transfusion. In this case, the baby had a good clinical course. Early diagnosis and treatment of massive FMH are necessary for a good prognosis.
Cartier Loop Biopsy of the Cervix: A Retrospective Study of 6 Months' Experience with a One‐Year Follow‐Up*
Authors: von Dadelszen Peter , Peddie David J. , Wells J. Elisabeth
Published: August 2010

Ninety‐six women with cervical pathology underwent Cartier loop biopsy at Christchurch Women's Hospital, during the first 6 months of 1987. Eighty‐four (88%) patients had full follow‐up past 11 months, of whom 10 (12%) had dysplasia/CIN. Initial follow‐up (3–8 months) was achieved in 91 (95%) patients, of whom 11 (12%) had dysplasia/CIN. Follow‐up was predominantly by cytology. These rates were not significantly influenced by any single preoperative or operative factor. The implications of these results are discussed.
An Ethical Issue for Reproductive Technologies*
Authors: Poplawski Nicola K.
Published: August 2010

The establishment of “new birth technologies” (such as ovulation induction, in vitro fertilization and gamete intrafallopian transfer) has raised many ethical issues. One such issue is “selective fetal reduction”, a process advocated in the management of excessive multiple pregnancy. The ethics of “selective fetal reduction” involve consideration of not only the efficacy of the process and the destruction of fetuses per se, but more specifically consideration of the moral dilemma of destroying some fetuses for the probable benefit of the remainder. The latter I consider here.

Following from this ethical analysis it is suggested that the law regarding abortion should permit selective reduction in high multiple pregnancies, that is pregnancies of 4 or above. I contend that the law should prohibit deliberate exposure (in an infertility programme) to significant risk of high multiple pregnancy, when there is full intention to reduce any subsequent pregnancy of high multiple size.
Adult Embryonal Rhabdomyosarcoma of the Vagina Complicating Pregnancy: A Case Report and Review of the Literature
Authors: Singhal Sandeep , Sharma Sanjiv , De Sudarshan , Kumar Lalit , Chander Subhash , Rath G. K. , Gupta S. Datta
Published: August 2010

Embryonal rhabdomyosarcoma of the vagina in adults per se is uncommon and pregnancy complicated by such tumors is extremely rare. We wish to report one case of vaginal embryonal rhabdomyosarcoma, diagnosed at the age of 23 years who was carrying at the time of initial presentation. The problem of management of rhabdomyosarcoma in adults, particularly when they are associated with pregnancy is discussed. We advocate the use of multiagent chemotherapy and pelvic radiotherapy in its overall management.
Chemotherapeutic Approach to Uterine Papillary Serous Carcinoma
Authors: Hamaguchi Kinya , Komai Kan , Sakihama Hideki , Okura Naofumi , Nagasue Naoki , Nishida Tadashi , Yakushiji Michiaki
Published: August 2010

Uterine papillary serous carcinoma (UPSC) is a recently recognized histologic variant of endometrial carcinoma with an aggressive clinical course. This study reviews 7 patients with the diagnosis of UPSC treated at the National Kokura Hospital between 1987 and 1989. The mean age was 60 years. Clinically, 4 patients presented as Stage I, one as Stage II, one as Stage III, and one as Stage IV. Surgery upstaged 28.7% (2/7) of these patients. All 7 patients underwent a staging laparotomy followed by chemotherapy. Deep myometrial invasion was found in 5/7 (72%) of the specimens. Four of these 5 specimens demonstrated up to the uterine serosa. Lymph nodal involvement was observed in 1/4 (25%) of the specimens. Furthermore, positive peritoneal washings were obtained in 4/7 (57%) of the specimens. All patients received an adjuvant combination chemotherapy with cisplatin 50 mg/m2 on day 1, adriamycin 50 mg/m2 on day 1, and ifosfamide 1.0 g/m2 on day 1 to day 5 (PAI). Recurrence and relapse of the disease developed in the 2 patients within 6 months. Two patients had a negative second look operation with no evidence of disease (NED) at 18 months after the initial treatment. Serial determination of the serum CA125 was seen to have great value in monitoring treatment in 4 patients. However, additional accural and follow‐up are needed to determine whether or not PAI therapy has an impact on this disease.
Immunohistochemical Localization of CA130 in Fetal Tissues, and in Normal and Neoplastic Tissues of the Female Genital Tract
Authors: Nanbu Yoshihiko , Fujii Shingo , Konishi Ikuo , Nonogaki Hirofumi , Sagawa Norimasa , Kobayashi Fuminori , Mori Takahide , Saga Tsuneo , Endo Keigo
Published: August 2010

A murine monoclonal antibody, 130‐22, produced against a human lung adenocarcinoma cell line (PC‐9) has been suggested as recognizing an antigenic determinant (CA130) which is different from an epitope recognized by OC125 on CA125 glycoprotein molecules. The immunohistochemical reactivity with the 130–22 antibody (anti‐CA130) was examined in human fetal tissues, and normal and neoplastic tissues of female genital tracts, and compared to those using OC125.

Among the fetal tissues, the amnion and the cells of coelomic epithelium and mullerian‐derived epithelia reacted with anti‐CA130. In normal adult tissues, cervical and endometrial gland cells, tubal epithelial cells, and ovarian surface cells reacted with anti‐CA130. In addition, predecidual cells in the late secretory endometrium and decidual cells during gestation were positive. Among the neoplastic tissues, tubal and endometrial adenocarcinomas and epithelial ovarian tumors were positive for anti‐CA130. There were no differences in the respective specimens between the immunohistochemical localization of anti‐CA130 and of OC125.

Therefore, anti‐CA130 is considered to be useful in the immunohistochemical detection of CA125 glycoprotein molecules as well as OC125.
Vaginal Adenosis without Exposure to Diethylstilbesterol: A Case Report
Authors: Pillai Nimish V. , Thye Koh Eng , Kumar Pratap
Published: August 2010

Vaginal adenosis is an unusual condition seen more in females with diethylstilbesterol (DES) exposure in utero, vaginal adenosis in absense of DES exposure is unusual. A case of vaginal adenosis is presented and the literature is reviewed.
Analysis of Cell Cycle Kinetics Using Flow Cytometry from Paraffin‐Embedded Tissues in Endometrial Adenocarcinoma
Authors: Takahashi Yoshiki , Matsumoto Hisanori , Wakuda Koji , Ishiguro Tatsuya , Yoshida Yoshinobu
Published: August 2010

Flow cytometric analysis of cell cycle kinetics from paraffin‐embedded tissues was performed to evaluate the DNA heterogeneity and risk factor of endometrial adenocarcinoma. We studied 54 tumor samples and 6 controls with normal endometrium, and all samples were measured for S‐phase fraction (SPF) and proliferative index (PI). Intratumor variations of SPF and PI values were evaluated at 3 different sites of the tumor; (1) primary endometrial lesion, (2) the site of myometrial invasion, and (3) metastatic lesions. SPF and PI values of endometrial adenocarcinoma were significantly higher than those of normal endometrium. There was a significant correlation between the PI value and the histological grade. SPF and PI values at the primary endometrial lesion had a significant correlation with the prognosis of this cancer at stage III or IV. SPF and PI values which were measured at the site of myometrial invasion tended to be lower than those from other sites. Our results indicate that the SPF and PI values of endometrial lesions are one of the important prognostic factors of endometrial adenocarcinoma at stage III or IV. In addition, DNA syntheses of endometrial adenocarcinoma cells display intratumor heterogeneity.
Camp Laparoscopic Sterilization Deaths in Gujarat State, India, 1978–1980
Authors: Bhatt Rohit V.
Published: August 2010

An early experience of camp laparoscopic sterilization in Gujarat State, India, resulted in 22 deaths among 106,500 women undergoing the operation during 1979 and 1980. Increased risk of death was seen when larger numbers of procedures were performed by year or month of year. The least experienced surgeons had the highest case‐fatality rate. Improvised settings (i.e., school buildings) exacerbated the risk of death, as did advanced age, and, to a lesser extent, high parity. Errors in clinical judgment were identified in some fatal procedures. A system of health audit of large sterilization programs is needed.
Urodynamic Investigation in the Management of Incontinent Women
Authors: Umstad Mark P. , Glenning Peter P.
Published: August 2010

One hundred and sixty‐eight women presenting to a Urinary Incontinence Clinic were studied. Only 52% had a urodynamic diagnosis that supported their clinical signs and symptoms. The response rates to various modalities of treatment for each urinary disorder are described. Fifty‐one percent achieved a complete response with the treatment selected, 27% had a partial response, and 10% did not respond or deteriorated. Twelve percent of patients were lost to follow‐up.
Intra‐Cervical Prostaglandin E2 Gel in Management of Dead Fetus in utero
Authors: Herabutya Yongyoth , O‐Prasertsawat Pratak
Published: August 2010

During a two and a half year period at this institution, prostaglandin E2 gel was administrated intra‐cervically in the treatment of 74 cases of dead fetus in utero. Delivery was achieved in all 74 cases. The mean interval from induction to delivery of the fetus was 17.6 hours with a mean total dosage used of 5.2 mg. Seventy percent of the patients spontaneously expelled the fetus and placenta completely. Gastrointestinal side‐effects were minimal with no medication needed. Oxytocin was used in 17 (23%) patients mainly to expedite the expulsion of the fetus. Intra‐cervical administration appeared to result in fewer side‐effects and was more cost effective than vaginal prostaglandin therapy for the treatment of dead fetus.
Changes in Plasma Levels of Lipid Peroxide and Vitamin E during Pregnancy
Authors: Iioka Hideaki , Akada Shinobu , Hisanaga Hiroyasu , Shimamoto Takako , Yamada Yoshihiko , Moriyama Ikuko S. , Ichijo Motohiko
Published: August 2010

The present study was undertaken in order to determine the changes in blood levels of lipid peroxide and vitamin E during pregnancy. 1. The man plasma level of lipid peroxide was 0.89±0.13 nmole/ml for non‐pregnant women, while in pregnant women it was increased as the progressed pregnancy reaching 2.71±0.29 nmole/ml at full term. 2. The mean plasma, red cell and platelet levels of vitamin E were 6.6±0.9 μg/ml, 3.55±0.38 μg/ml packed cell and 99±25 μg/ml protein for non‐pregnant women, while in pregnant women the levels changed as the progressed pregnancy becoming 15.5±0.9 μg/ml, 2.43±0.24 μg/ml packed cell, and 244±19 μg/g protein at full term.

It was shown in this study that during pregnancy the plasma level of lipid peroxide increased while the levels of vitamin E which inhibited the formation of lipid peroxide, increased in plasma and platelets, but decreased in red cells.
Serial Changes of Serum CA125 Levels during Menstrual Cycles
Authors: Nonogaki Hirofumi , Fujii Shingo , Konishi Ikuo , Nanbu Yoshihiko , Kobayashi Fuminori , Mori Takahide
Published: August 2010

Serial changes of serum CA125 levels during 32 menstrual cycles were examined in 32 healthy young women (19–21 years of age) charting basal body temperature (BBT) and measuring serum estradiol and progesterone levels. Analysis of BBT charts and serum progesterone levels revealed that the 32 menstrual cycles could be classified into either an ovulatory cycle with a sustained BBT temperature increase for at least 10 days (type I: 9 cycles), an ovulatory cycle with a sustained BBT temperature increase for less than 10 days (type II: 17 cycles), or anovulation (type III: 6 cycles). All 32 cycles exhibited basal CA125 levels of less than 35 u/ml throughout the cycle, except during the period of menstruation. At menstruation, 7 of the 9 cycles of type I showed a marked, transient elevation of CA125 levels from previous basal levels (a mean net increase). On the other hand, 12 of 17 cycles of type II showed only a slight elevation of CA125 levels during the period of menstruation. None of the 6 cycles of type III showed any apparent increase in CA125 levels during the period of menstruation. The mean net increase of CA125 levels during the period of menstruation in the cycles of type I was significantly higher than that of the cycles of type II (p<0.05) and type III (p<0.05). These results imply that a transient elevation of serum CA125 levels during the period of menstruation occurs in cycles with ovulation, and the levels of elevation seem to be closely associated with the duration of the sustained BBT temperature increase.
Ectopic Ovary in the Omentum
Authors: Peedicayil Abraham , Sarada Venkateswaran , Jairaj Prabha , Chandi Sushil M.
Published: August 2010

At caesarean section the right ovary of a patient was found to be absent. There was an omental cyst that was excised and this was found to be an ectopic ovary. This case is reported because of its rarity. The nomenclature and embryological aspects of the condition are discussed.
Government‐Funding Program on Reversal of Tubal Sterilization
Authors: Bai Byoung Choo , Park Chan Moo , Kwak Hyun Mo , Whang Young Whan
Published: August 2010

Three hundred and sixty‐one women were provided government‐funded sterilization reversal services with the technique of microsurgery. A large majority of reasons (89.8%) for requesting reversal surgery was a loss of children, and the mean interval between sterilization and reversal was 28.7 months. Two hundred and seven (69.7%) of 297 follow‐up cases have experienced term delivery or intra‐uterine pregnancy and 5 cases were ectopic pregnancy. The largest number of reversal clients (63.3%) were sterilized by the laparoscopic unipolar coagulation technique and the next largest group (24.2%) was sterilized by the laparoscopic banding technique. The highest pregnancy rate (77.8%) was shown in clients who had undergone laparoscopic banding technique while the lowest (65.9%) was the group of laparoscopic unipolar coagulation. A more than 60% of the clients became pregnant within 6 months of their reversal surgery, with the shortest interval being 1 month, the longest 39 months, and the mean 7.6 months. A large majority of the successful cases, 81.6%, were pregnant within 1 year of their reversal surgery.
Origin of Macrophage Colony‐Stimulating Factor (M‐CSF) and Granulocyte Colony‐Stimulating Factor (G‐CSF) in Amniotic Fluid
Authors: Saito Mami , Saito Shigeru , Nakagawa Tomoyoshi , Ichijo Motohiko , Motoyoshi Kazuo
Published: August 2010

A large amount of M‐CSF and G‐CSF exists in human amniotic fluid and both are considered to have some physiological affect on maintaining pregnancy. We therefore examined the source of M‐CSF and G‐CSF found in the amniotic fluid.

The average level of M‐CSF in the amniotic fluid of patients without complications was 17.3±8.5 ng/ml and that of G‐CSF 1.85±1.72 ng/ml, both being high values. In neonatal urine, the average level of M‐CSF was also very high, 144.3 ±97.0 ng/ml, but that of G‐CSF was below the determination limit of 60 pg/ml.

Immunohistochemical staining indicated that production of M‐CSF and G‐CSF was localized in the epithelial cells of fetal membrane.

On the basis of the above observations, M‐CSF was found to derive from neonatal urine and the epithelial cells of fetal membrane, and G‐CSF from the epithelial cells of fetal membrane.
A Sero‐Epidemiological Study on Mother‐to‐Child Transmission of HTLV‐I in Southern Kyushu, Japan*
Authors: Oki Toshitaka , Yoshinaga Mitsuhiro , Otsuka Hirofumi , Miyata Koichiro , Sonoda Shunrdu , Nagata Yukihiro
Published: August 2010

In vertical transmission of HTLV‐I the duration of breast‐feeding seems to be an important risk factor. In this study, we made prospective and retrospective surveys on the rate of vertical transmission of HTLV‐I in infants and their siblings born to HTLV‐I seropositive mothers. The results obtained were as follows.

 In the prospective study, 885 of the 16,283 pregnant women examined were HTLV‐I seropositive, and the seropositive rate was 5.4%. The seroconversion rates of short‐term (>7 months) and long‐term (≥7 months) breast‐feeders were 3.8% (1/ 26 cases) and 25.0% (1/4 cases) respectively, and the rate of bottle‐feeders was 5.6% (10/177 cases). Short‐term breast‐feeding tended to yield a lower seroconversion rate of infants. In addition, the seroconversion rate of short‐term breast‐feeders was nearly equal to that of bottle‐feeders: 3.8% vs. 5.6%.

 In the retrospective study, the seroconversion rates of short‐term and long‐term breast‐feeders in their siblings were 4.5% (3/67 cases) and 14.0% (19/136 cases) respectively. There was a significant difference between the 2 groups (P<0.01).

Thus, the results of our retrospective and prospective studies suggest that short‐term breast‐feeding might lessen the risk of breast‐milk‐borne transmission of HTLV‐I from carrier mothers to their children.
Heterophile Antigens in Serous Cystadenocarcinoma of the Human Ovary
Authors: Kamada Masaharu , Mori Tsuneatsu , Sakamoto Yasuki , Daitoh Toshifumi , Furumoto Hiroyuki , Irahara Minoru , Aono Toshihiro , Mori Takahide
Published: August 2010

As the aberrance of carbohydrate moieties, the appearance of heterophile antigens in human ovarian cancer tissue was studied using various heterophile antigens and antibodies together with antisera raised in rabbits by immunization with extracts of human ovarian cancer tissues. In the immunodiffusion test, rabbit antisera reacted with a heat‐stable, perchloric‐acid extractable antigen that was different from CEA and CA125 and possessed Hanganutziu‐Deicher (HD)‐type specificity in all 4 specimens of serous cystadenocarcinoma of the ovary. Furthermore, a pathologic serum with strong HD‐antibody complex formed a precipitin line with one of them. In the cancer tissue, we also immunochemically demonstrated the presence of rat‐erythrocyte antigens. However, other types of heterophile antigens, such as Paul‐Bunnell and Forssman, were not detected. These results suggest that HD‐type antigens appear in serous cystadenocarcinoma of the human ovary, one in broad distribution and some in specific cases.
Sonographic Prenatal Diagnosis of Congenital Heart Defects in Thoraco‐Omphalopagus
Authors: Sukcharoen Nares , Wannakrairot Pongsak
Published: August 2010

Thoraco‐omphalopagus is the most common variety of conjoined twins. About 90% of the conjoined thoraco‐omphalopagus twins have a common pericardium, and 75% have conjoined hearts. Options for the treatment of thoraco‐omphalopagus are largely dependent on the anatomy of the cardiovascular system. The extent of the conjunction of the heart and the severity of the associated cardiac defects primarily determine the feasibility of successful separation of the infants. Two‐dimensional echocardio‐graphy and color Doppler examination has become the method used to investigate cardiovascular system of conjoined twins with a high degree of confidence. A case of thoraco‐omphalopagus conjoined twins prenatally determined of the extent of cardiac conjunction and diagnosis of associated defects by these methods is presented.
A Case Report on Surgically Managed Elephantoid Vulva Due to Donovanosis
Authors: Suneja Amita , Chaudhry Rama , Ramam M. , Agarwal N. , Talwar V.
Published: August 2010

An unusual case of vulval donovanosis is reported from non endemic part of India, who presented with huge ulcerovegetative growth on the vulva and ultimately required surgical resection in addition to long term therapy with antibiotics.
Changes of Hemorheologic Properties during Normal Human Pregnancy
Authors: Eguchi Katsuto , Mitsui Yukiteru , Yonezawa Masaru , Oguni Nobutsugu , Hiramatsu Yuji
Published: August 2010

To investigate alterations of hemorheologic properties during pregnancy, we measured the hematocrit (Hct) and fibrinogen levels, blood viscosity, and erythrocyte de‐formability in 10 healthy nonpregnant women and in 10 women with uncomplicated pregnancies.

The Hct decreased during pregnancy, while the plasma fibrinogen concentration was elevated. No significant changes in blood viscosity were observed throughout pregnancy. Erythrocyte deformability was significantly decreased in pregnancy when compared to the nonpregnant state, but returned to the nonpregnant level by the 7th postpartum day.

These findings suggest that adequate microcirculation is maintained in the uter‐oplacental unit during gestation by hemodilution, which prevents an elevation of blood viscosity despite the increase in fibrinogen and the decrease of erythrocyte deformability. These changes are thus thought to be among the physiological maternal adaptations to fetal growth and development.
Qualificated Discrimination of Ovarian Malignancy by Diagnostic Ultrasound
Authors: Hirai Takeshi , Akamatsu Nobuo , Sekiba Kaoru , Tsubota Nobutaka , Tsuru Satoko
Published: August 2010

Ultrasonograms of 214 ovarian masses in 184 patients were studied to discriminate ovarian malignancies from benign masses and to help in developing a new scoring system using ultrasonographic findings with weight‐adjusted scores.

The 76 masses that showed cystic patterns only were directly determined to be benign, having an expected success rate of 97.4%. The remaining 138 masses, of which 116 showed mixed patterns and 22 of which showed solid patterns, were analyzed by the Quantification method No. 2 of Hayashi to select the effective ultrasonic findings and to obtain a good discriminant function. Eleven findings (items) expressing 29 categories were selected, and a discriminant function composed with a weight‐adjusted score for each category was obtained as the result of the analysis. Using these functions, the 86.6% of the ovarian masses with mixed or solid patterns were correctly discriminated as being malignant, borderline‐malignant, or benign. According to internal checks of all ovarian masses, the success rate was 90.2%. Then 73 ovarian masses of 65 new patients were discriminated as the external check, and a success rate of 93.2% was obtained.

It is concluded that this newly developed scoring system using ultrasonic findings is useful in discriminating ovarian malignancies from benign ones.
Color and Pulsed Doppler Ultrasonography of Reversed Umbilical Blood Flow in an Acardiac Twin
Authors: Ishimatsu Junji , Nakanami Hiromi , Hamada Teiji , Yakushiji Michiaki
Published: August 2010

Prenatal diagnosis of an acardiac twin pregnancy was performed. At 30 gestational weeks, pulsed color Doppler ultrasound revealed polyhydramnios, reversed‐pulsatile blood flow in the umbilical artery and vein of the acardiac twin, and artery‐artery anastomosis on the placental surface. The total cardiac dimension, maximum blood flow velocity of the ascending aorta and the pulmonary artery in the alive twin were in the normal range.
Prediction of Dystocia by Entanglement (impaction) in Vertex‐Vertex Type Twin Delivery
Authors: Uchino Koichi
Published: August 2010

We studied the fetal position in vertex‐vertex type twins in 6 impaction cases and in 23 cases of vaginal deliveries without impaction. The results obtained were as follows:

(1) In 6 impaction cases, the presenting head of the first fetus was shown to be at the maternal pubic side and the head of the second fetus at the maternal sacral side.

(2) In 23 cases without impaction, the presenting head of the first fetus was shown to be at the maternal sacral side and the head of the second fetus at the maternal pubic side.

(3) There was a statistical significant difference between the 6 impaction cases and the 23 non impaction cases as determined by the Chi‐square test (p<0.001).

Our study suggests that it is possible to predict the occurrence of impaction in vertex‐vertex type twin deliveries by examining the positional relationship of the presenting heads of the first and second fetuses.

There was a higher possibility of impaction when the head and body of twin 1 was located in the maternal‐pubic position, while the head of twin 2 was in the sacral position.

In contrast, impaction never occurred when the head and body of twin 1 was in the maternal‐sacral position and the head of twin 2 was in the pubic position.
A Comparison between the Preoperative and Operative Findings of Peritoneal Cytology in Patients with Endometrial Cancer
Authors: Sagawa Tadashi , Yamada Hideto , Sakuragi Noriaki , Fujimoto Seiichiro
Published: August 2010

Abstract

Laparoscopy and hysteroscopy were simultaneously performed to examine the in‐traperitoneal and intrauterine spread of endometrial cancer prior to surgery. Peritoneal cytology (PC) was examined before and after hysteroscopy and at the time of laparotomy. To elucidate the mechanisms by which endometrial cancer cells spread into the peritoneal cavity, the changes in PC in sequential samples and the association between PC and other prognostic factors were examined.

Of the patients who had negative PC before hysteroscopy, 3 patients exhibited positive PC from their operation materials (12.5%). It was suggested that leakage of endometrial cancer cells into the peritoneal cavity was induced by hysteroscopy in 2 patients and by endometrial biopsy in one patient.

Of those patients with no intraperitoneal lesions, 3 patients had positive PC in the prehysteroscopy samples (11.1%). A statistically significant association was found between pelvic node metastasis and positive PC in the prehysteroscopy samples.
Congenital Diaphragmatic Hernia Treated by Perinatal Stabilization
Authors: Iwanaka Tadashi , Tamura Masanori , Tanaka Kiyoshi , Komuro Hiroaki , Tsuchida Yoshiaki , Okai Takashi
Published: August 2010

The delay of surgery in conjunction with high‐frequency oscillation ventilation combined with preoperative stabilization is a standard treatment for congenital diaphragmatic hernia neonates in the high‐risk group. A new protocol of perinatal stabilization with this preoperative stabilization has been developed at the University of Tokyo Hospital. The most important components of this method of perinatal stabilization are cesarean section and the injection of morphine and pancuronium through the umbilical vein prior to ligation of the umbilical cord. In order to benefit from this treatment, congenital diaphragmatic hernia patients should be diagnosed antenatally by ultrasonography and be delivered by cesarean section. This protocol of perinatal stabilization appears effective in congenital diaphragmatic hernia patients.
A Case Report on Radiotherapy in Choriocarcinoma: A Life Saving Procedure
Authors: Vaid Neelam B. , Kaur Charanjeet , Vidya S. , Bahadur A.K.
Published: August 2010

Radiation therapy was tried to control hemorrhage from uterine cavity in a case of choriocarcinoma in which surgery was not practically possible due to the presence of a large nodule extending from suburethral region up to anterior fornix involving the entire anterior vaginal wall and patient being in a very critical condition. Radiotherapy was found to be successful and life saving.
A Comparison of Enzyme‐Linked Immunosorbent Assay (ELISA) with Sperm Immobilization Test (SIT) in Detection of Antisperm Antibodies in Sera of Infertile Women
Authors: Lin Kuo‐Cherng , Su Jinu‐Huang , Lee Jau‐Nan
Published: August 2010

In the present study, an enzyme‐linked immunosorbent assay (ELISA) for antisperm antibodies was compared with a traditional standard sperm immobilization test (SIT) in sera from 158 infertile women in order to evaluate their clinical usefulness for various causes of infertility. Ten pregnant and unmarried women were used as the control group. There was a higher incidence rate by ELISA (13.9%) compared with that by SIT (10.1%) after examination of overall samples, although the difference was not statistically significant. The unexplained infertility group exhibited the highest incidence among the various causes of infertility in both of these two methods. Fifteen (93.8%) of 16 patients with positive SIT showed positive reaction in ELISA method, indicating that a close correlation exists between the two methods. The positive predictive value (54.5%) of ELISA was significantly (p<0.05) lower than that (87.5%) of SIT, as evaluated with the results of postcoital test (PCT) performed at periovulatory phase. This suggests that the ELISA method for antisperm antibodies is less specific than SIT in view of the PCT results. Nevertheless, no fresh sperms are not required for the ELISA examination. Thus, it seems that the ELISA method may provide a convenient and practical means for mass screening in detecting antisperm antibodies in clinical practice.
Prolactin Response to Suckling in a Group of Fully Breast Feeding Women during the Early Postpartum Period
Authors: Tennekoon Kamani H. , Arulambalam Preetha D. , Karunanayake Eric H. , Seneviratne Harsha R.
Published: August 2010

Prolactin response to suckling was studied in a group of fully breast feeding women (N= 58) between 4–6 weeks postpartum. Basal, suckling stimulated and the increment of prolactin showed wide individual variations. Basal prolactin concentrations varied from 140 to 4,600 mlU/l, suckling stimulated prolactin from 400 to 5,600 mlU/l and the increment of prolactin from 40 to 4,160 mlU/l. Basal (p = 0.0395) and suckling stimulated (p = 0.0423) prolactin concentrations significantly increased as the number of night breast feeds increased and the suckling stimulated (p = 0.0218) prolactin concentrations significantly increased as the number of breast feeds/24 h increased. However, the magnitude of the rise in prolactin in response to suckling was not dependent on basal prolactin concentration. Basal, suckling stimulated or the increment of prolactin were not significantly different between subjects having different breast feeding frequencies, when the subjects were grouped according to the number of breast feeds. These differences may be due to the large individual variation in prolactin concentrations seen in women having similar breast feeding frequencies which may arise from individual variations in hypotha‐lamic — pituitary response to suckling.
Management of an Infected Urachal Cyst during Pregnancy
Authors: Kotsuji Fumikazu , Hosokawa Kumiko , Takeuchi Yuzuru , Kamitani Naoyuki , Tominaga Toshiro
Published: August 2010

An infected urachal cyst complicating a pregnancy is extremely rare, but is considered to present a high risk to both the mother and the fetus. We treated a patient with an infected urachal cyst diagnosed at 29 weeks of gestation. A healthy infant was delivered by cesarean section at 37 weeks of gestation. The patient underwent excision of the unruptured cyst 37 days later. This is the first reported case of an infected urachal cyst complicating a pregnancy, that was diagnosed before rupture and was managed without serious sequelae for either the mother or the fetus. The diagnosis and management of the infected urachal cyst complicating the pregnancy is discussed.
Laparoscopic Surgery and DNA Analysis in Patients with XY Pure Gonadal Dysgenesis
Authors: Tsutsumi Osamu , Iida Taku , Taketani Yuji
Published: August 2010

The sex‐determining region on the Y chromosome (SRY) encodes a gene that has many of the properties expected of the testis‐determining factor. The XY pure gonadal dysgenesis is characterized by streak gonads in phenotypic females who lack the somatic abnormalities and short stature associated with Turner's syndrome. Abnormalities within the SRY have been described in these patients. However, we have experienced several patients with short stature whose SRY are apparently normal. The DNA sequencing of the SRY gene showed a 100% nucleotide sequence identity with the reported cloned sequence. Sex reversal in two of the present cases may be due to mutation at a locus other than SRY in the sex determining pathway, a gene potentially involved in the determination of human constitution. The risk of developing malignancy in the dysgenetic gonads has been reported to be 25%, dictating early prophylactic removal of the streaks. Laparoscopic surgery is recommended because of the amount of the surgery and the rapid postoperative recovery of the patient.
Enhanced Magnetic Resonance Imaging in Monitoring of Conservative Treatment of Cervical Pregnancy
Authors: Takashima Masaki , Yamasaki Mineo , Fujita Ichiro , Ohashi Masanobu , Matsuo Hiroya , Mochizuki Matsuto , Kitagaki Hajime , Kono Michio
Published: August 2010

We report on case of cervical pregnancy successfully treated by two 5‐day courses of etoposide, embryocide with the injection of KCl, the injection of methotrexate into the placenta, and cervical curettage. We evaluated the effects of these treatments by measuring urinary human chorionic gonadotropin (hCG) titers and serial hCGβ‐ carboxy‐terminal peptide (CTP) levels. Moreover, we used ultrasonography and magnetic resonance imaging (MRI) enhanced by gadolinium‐diethylenetriamine‐ pentaacetic acid (Gd‐DTPA) to diagnose and to evaluate the blood supply to the trophoblast. The beneficial outcomes suggest that Gd‐DTPA‐enhanced MRI is useful in detecting the blood supply to the trophoblast, in order to avoid the massive bleeding that results from conservative treatments. This is the first report of the usefulness of Gd‐DTPA‐enhanced MRI for the successful conservative treatment of cervical pregnancy.
A Randomized Study Comparing Suture with Non‐Suture Cold‐Knife Conization
Authors: Tangtrakul Somsak , Srisupundit Somkeart , Linasmita Vasant , Bullangpoti Sunchai , Israngura Nathapong , Wilailak Sarikapan , Panijayanusondthi Orapin
Published: August 2010

Objective: To compare the short‐term outcome of cold‐knife conization between suture and non‐suture (with Monsel's solution pack) methods.

Methods: Between February, 1990 and March, 1992, 142 patients underwent cold‐knife conization were randomly allocated into 2 groups. The hemostasis was done by suture in one group and by Monsel's solution pack without suture in the other group. The patients' and cone specimens' characteristics as well as short‐term outcome were recorded and compared using Chi‐square test, Fisher exact test and t‐ test where appropriate.

Results: The patients' characteristics, cone size, and histologic diagnosis of both groups were comparable. The non‐suture group had shorter operative time (10.69 ± 7.86 vs. 20.04 ± 6.99 minutes) and lesser late hemorrhage (2.9 vs. 15.9%) than the suture group (p < 0.05). There was no statistical difference in the operative blood loss.

Conclusion: The non‐suture method of conization should replace the traditional suture method
The Chromosome Complement of Human Uncleaved Oocytes
Authors: Kumar Rachana M. , Khuranna Ashok
Published: August 2010

Objective: Investigation of human oocyte chromosomes that fail to fertilize may provide data essential to the assessment of reproductive failure. In view of this, 121 uncleaved human oocytes were analyzed cytogenetically to assess the type and frequency of chromosomal abnormality.

Methods: Oocyte recovery was done from patients undergoing in vitro fertilization (IVE) procedures. Then, these oocytes were preincubated and inseminated in vitro. Karyotyping was attempted in 121 oocytes lacking signs fertilization 50 h after insemination.

Results: Sixty‐nine oocytes were adequately karyotyped. The overall frequency of chromosomal aberration was 47.6%. Amongst these, 34.8% were aneuploidy, the frequency of which was significantly higher (p < 0.05) in patients > 35 years of age. Diploidy and hyperploidy was noted in 7.2% and 2.8% respectively. Translocation were noted in 2.8% and in 18.8% of human oocytes sperm chromosome condensation appeared prematurely in the G1 phase. No correlation was a found between specific chromosomal aberrations and type of fertility, stimulation treatment or gonadotrophin levels.

Conclusion: The high rate of chromosomal disorders (47.6%) in human oocytes may contribute significantly towards their failure to fertilize in vitro.
Pregnancy, Labor and Delivery in a Woman with a Damaged Spinal Cord
Authors: Yaginuma Yuji , Kawamura Mitsuhiro , Ishikawa Mutsuo
Published: August 2010

We report here a case involving the pregnancy, labor and delivery of a woman with a damaged spinal cord. In our case, even though the cord was damaged below the Th11, continuous epidural anesthesia was needed to prevent autonomic hyperreflexia. The patient's and infant's subsequent courses were normal.
Sociobiological Risk Factors for Spontaneous Abortion in Malaysia
Authors: Tan Niap H. , Yahya Aziz , Adeeb Nafisah
Published: August 2010

Objective: To evaluate the risk factors of spontaneous abortion.

Methods: A case‐control study was conducted by interviewing 350 women who were admitted to the university gynaecological unit for spontaneous abortion and 350 women who delivered normally at the university obstetric unit. Odds ratios, as the estimators of relative risks, were calculated.

Results: The relative risk for spontaneous abortion among women in the age‐group 30 to 39 years was 1.61 and among women above 40 years of age was 3.68 when compared to those below 30 years of age. In relation to career women, the relative risk of spontaneous abortion for housewives was 0.45. Ethnic group, parity, subfertility, previous induced abortion, ectopic pregnancy, contraception and menarcheal age did not influence the risk of spontaneous abortion.

Conclusion: Increasing age and a woman's career are significant risk factors of spontaneous abortion.
The Vaginal Radical Operation of Cervical Cancer
Authors: Lichtenegger W.
Published: August 2010

Choosing the surgical technique for the cervix carcinoma — vaginal or abdominal — it is particularly necessary to take into account the lymphatic spread of the cervix. As it is not possible to realize a lymphadenectomy in a vaginal procedure, it has to be found a preoperative diagnostic method which enables very surely the exclusion of lymph node involvement.

In summary of the facts stated up to now, one can conclude as follows:

1. The FIGO‐classification is too subjective.

2. There is a significant correlation between tumor volume and lymph node involvement.

3. The tumor markers — as e.g. PCNA, p53, c‐neu, EGF, β1 Integrin etc.— show no correlation with the lymph node involvement.

4. Only MRI allows an exact preoperative measurement of the tumor volume.

5. On account of the above mentioned results, it seems to be possible to extend the indication for the vaginal radical surgery on cases with a small tumor volume.
Perinatal Database in Germany
Authors: Brockerhoff Peter G. , Knapstein Paul G.
Published: August 2010

By collecting standardized data from up to 600,000 deliveries per year in Germany a nation‐wide database has been established in recent years enabling not only regional and overregional quality control, but also the scientific analysis of rare maternal and fetal complication. During the observation period of 10 years the understanding of perinatal risk factors has considerably improved and the perinatal mortality has declined from 9.4 to 6.4 (per 1,000 deliveries).

From the huge amount of calculations typical results are presented.
Prevalence of Hemoglobin S and β‐Thalassemia in Northern Jordan*
Authors: Sunna Elias I. , Gharaibeh Nayef S. , Knapp Dona D. , Bashir Nabil A.
Published: August 2010

Objective: The aim of this study was to determine the incidence of HbS and β‐thalassemia in the Northern Jordan.

Study Design: The investigation targeted 3 areas of Northern Jordan. Blood samples from 2,290 volunteers were evaluated to determine the prevalence of HbS and β‐thalassemia by preparing a hemolysate for cellulose acetate electrophoresis. An additional 568 newborn samples were collected from the umbilical and analyzed for the presence of HbS using electrophoresis.

Results: The overall prevalence of HbS and β‐thalassemia was 4.45% and 5.93%, respectively. The incidence of sickle cell trait in the newborn sample was 3.17%. The prevalence of both HbS and β‐thalassemia was higher in the Al‐Gor area in comparison to Ajloun and Irbid.

Conclusion: A better understanding of the demographics of these diseases has the potential to aid in the more efficient utilization of health care resources and improved planning and provision of health care services.
Mixed Gonadal Dysgenesis with Gonadoblastoma in a Female with Y Chromosome: Case Report
Authors: Sadi Al Muktafi , Toda Takayoshi , Kiyuna Masaya , Miyagi Hiroko
Published: August 2010

A young female with primary amenorrhea and male karyotype (46/XY) is reported. Physical examination and clinical investigation of the patient suggested mixed gonadal dysgenesis (MGD). After gonadectomy, a tumor was found on the left side and histologically diagnosed gonadoblastoma. Postoperative decreased level of testosterone and estradiol reflected the activities of the tumor.
Fetal and Neonatal Haemodilution Associated with Multiple Placental Chorioangioma: Case Report
Authors: Montan Sven , Anandakumar Chinnaiya , Joseph Roy , Arulkumaran Sabaratnam , Ng Soon‐Chye , Ratnam Shan S.
Published: August 2010

A pregnancy with polyhydramnios and abnormal antepartum fetal heart rate pattern was found to have multiple placental haemangiomas. Multiple placental haemangiomas can give rise to fetal cardiac failure due to a hyperdynamic circulation or fetal anaemia either due to haemodilution or possibly destruction of blood cells in the chorioangioma. Whether fluid restriction with or without diuretics or blood transfusion is the correct form of treatment of neonatal cardiac failure in such a case is discussed.
Landry‐Guillain‐Barre‐Strohl Syndrome in Pregnancy
Authors: Yaginuma Yuji , Kawamura Mitsuhiro , Ishikawa Mutsuo
Published: August 2010

We report here a case of Landry‐Guillain‐Barre‐Strohl syndrome (LGBSs) in pregnancy. The patient had rubella viral infection, and the patient's inspiratory ability rapidly weakened. In the end, aggressive plasmapheresis prevented the need for respiratory support and the inherent risk it poses in terms of maternal morbidity and mortality.
In vitro Fertilization of in vitro Matured Oocytes Obtained from the Follicles without hCG Exposure for Prevention of Severe Ovarian Hyperstimulation Syndrome: A Case Report
Authors: Kodama Hideya , Fukuda Jun , Karube Hiroko , Matsui Toshihiko , Shimizu Yasushi , Tanaka Toshinobu
Published: August 2010

We aspirated ovarian follicles of an infertile patient who encountered a great risk of ovarian hyperstimulation (OHSS) during her ovulation‐induction cycle, which had been stimulated with gonadotropins, in order to avoid OHSS without interrupting the treatment. If this action were to yield a considerable number of immature oocytes, some of which were to achieve in vitro maturation and subsequent fertilization, this method could be an alternative to conventional ovulation‐induction methods for patients who repeatedly present imminent signs of hyperstimulation. However, the number of oocytes collected from the patient was disappointingly low, even though a large number of follicles were thoroughly aspirated. One of these oocytes was matured in vitro in a medium containing 30% follicular fluid and granulosa cells of mature follicles, fertilized, cryopreserved, and transferred in a later artificial cycle; but pregnancy was not achieved. A low number of recovered oocytes from patients in this situation might be a factor that greatly limits the clinical applications of this method.
Use of Intravenous Adenosine Triphosphate (ATP) to Terminate Supraventricular Tachycardia in a Pregnant Woman with Wolff‐Parkinson‐White Syndrome
Authors: Kanai Makoto , Shimizu Motohiko , Shiozawa Tanri , Ashida Takashi , Sawaki Shoji , Sasaki Yasuyuki , Fujii Shingo
Published: August 2010

The case of pregnant woman with Wolff‐Parkinson‐White syndrome, whose paroxysmal supraventricular tachycardia was successfully terminated by intravenous administration of 5–10 mg adenosine triphosphate (ATP), is presented.
A Prospective Study on the Relationship between Intrapartum Maternal Group‐B Streptococcal Concentration and Signs of Infection in Neonates*
Authors: Itakura Atsuo , Kurauchi Osamu , Morikawa Shigehiko , Matsuzawa Katsuji , Mizutani Shigehiko , Tomoda Yutaka
Published: August 2010

Objective: Our purpose was to examine the effects of intrapartum vaginal Group‐B streptococcal (GBS) colonization on neonatal signs of infection.

Study Design: We performed a quantitative GBS culture of vaginal specimens in 1,280 pregnancies within 24 hours before delivery and examined signs of neonatal infection within 48 hours after birth. Among them, 287 pregnant women had premature ruptures of membranes.

Results: The rate of vaginal GBS colonization in groups with and without ruptured membranes was 22.0% and 11.3%, respectively. The incidence of neonates with signs of infection born to GBS‐carrier women in each group was 28.6% and 8.8%, respectively. There were significant differences between the groups with regard to both the rate of colonization and the incidence of infection. Signs of neonatal infection increased in proportion to the maternal GBS concentration only in women with ruptured membranes.

Conclusion: This study suggests that there is an important association between maternal GBS concentration and mild neonatal infections after birth, especially in women with premature ruptures of membranes.