bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy in Diagnosis of Ectopic Pregnancy by Transvaginal Ultrasonography
Authors: Anandakumar C. , Lee Colin S. S. , Wong Yee Chee , Chia Dawn , Rodenburg A. , Ratnam S. S.
Published: August 2010

Forty patients suspected to have ectopic pregnancy by transvaginal ultrasonography had surgery. 77.5% were confirmed to have ectopic pregnancy and 10% had other abnormal pelvic findings.

The transvaginal approach appears to enable us to diagnose ectopic pregnancy at an earlier date, with the earliest diagnosis made at 4 weeks 0 days of amenorrhoea. In cases of confirmed ectopic pregnancy, the presence of a complex adnexal mass was the most common feature seen on transvaginal ultrasound and its predictability of ectopic pregnancy is enhanced by a concomitant finding of an empty uterus (95%) or free fluid in the Pouch of Douglas (94%) in the presence of a positive hCG test.

The significance of transvaginal ultrasound features, and the advantages of transvaginal over transabdominal ultrasound, are discussed.
Outcome of 143 Pregnancies Conceived by Assisted Reproductive Techniques
Authors: Yang Mary H. M. , Ng Soon‐Chye , Ratnam Shan S. , Devendra Sharath , Marshall Barry , Anandakumar C. , Wong Yee‐Chee , Bongso Ariff
Published: August 2010

One hundred and forty‐three pregnancies conceived by assisted reproductive techniques (ART) from October 1985 to June 1989 in the National University Hospital, Singapore, resulted in 66 deliveries and 89 babies. There were 27 (18.7%) biochemical pregnancies, 44 (30.7%) clinical miscarriages and 6 (4.2%) ectopic pregnancies when total pregnancies were considered. Of those who continued pregnancy to second trimester multiple births occurred in 20 (13.3%) patients. A high incidence of vaginal bleeding and hypertension in pregnancy was noted in 32 (48.5%) patients and 18 (27.3%) patients, respectively. Caesarean section was the method of delivery in 48.5% of patients. Twenty‐six (29.2%) babies required admission to the neonatal intensive care unit. All babies except one set of twins delivered at 24 weeks of amen‐orrhoea survived. Fetal abnormality was noted in 2 cases.
Analysis of 20,119 Deliveries in Dhaka Medical College Hospital
Authors: Begum Kohinoor
Published: August 2010

Data of 20,119 deliveries in Dhaka Medical College Hospital are presented. Dhaka Medical College Hospital is the chief referral hospital in Dhaka city. The 15% of patient were 18 years of age or below and 18% were above 35 years of age or above. The 48.22% were primaegravida and 51.78% were multigravida, of these 28% were grandmultigravida. The 89% had no previous antenatal checkup. The 92.72% had cephalic presentation, 65.52% had normal vaginal delivery, 21.07% had caesarean section, 11.18% had forceps delivery. Perinatal mortality during hospital stay was 143/1,000 deliveries, maternal mortality 2,510/100,000, mainly due to eclampsia. Complications during delivery were mainly in the form of ruptured uterus (1.10%), P.P.H. (1.06%), and retained placenta (3.88%).
A Case of Successful Pregnancy and Delivery after Brain Metastasis of Choriocarcinoma
Authors: Yokota Hideo , Mabuchi Yoshiya , Hosomichi Taro , Kimura Masanori , Imai Hideaki , Sutou Kenji
Published: August 2010

This is report regarding a 28‐year‐old woman who conceived and delivered a healthy child following treatment for brain metastasis of choriocarcinoma in 1980 and a prolonged postoperative disease‐free period. The patient had delivered a hydatidiform mole. Eight months afterwards she was admitted to our hospital with occipital pain, vomiting and stupor, and upon CT examination was found to have a brain tumor. The surgically removed tumor was pathologically diagnosed as choriocarcinoma. Postoperative methotrexate chemotherapy rapidly lowered the preoperative urinary human chorionic gonadotrophin (19 IU/ml), and allowed restoration of the preoperative LH level, consciousness, ambulation, and manifest ovulation. Occasional mild cramps were received by continuous use of anticonvulsants which did not affect her daily life. Four and one‐half years postoperatively she conceived, and had a healthy boy weighing 2,294 g at the 39th week of gestation in June 1985. Both mother and baby have been doing well for 7 postpartum years.
Pregnancy in Association with Mitral Valve Prolapse
Authors: Jana Narayan , Vasishta Kala , Khunnu Bhawani , Dhall G. I. , Grover Anil
Published: August 2010

Mitral valve prolapse (MVP) is considered to be the most common valvular heart lesion in adult females of reproductive age. Our report reviews the obstetrical performance and outcome of 34 pregnancies in 15 women with MVP. In 12 (80%) patients cardiac lesion was suspected due to enigmatic dyspnoea and palpitation during antenatal period. Four mothers required propranolol for cardiac arrhythmias. However, all of them tolerated pregnancy and labour well. Four pregnancies (11.8%) ended in spontaneous abortion and 1 mother had intrauterine fetal death due to severe pregnancy‐induced hypertension. There were 25 (73.5%) term and 3 (8.8%) preterm neo‐nates without congenital abnormality. One preterm neonate had tracheo‐oesophageal fistula and died 6 hours after corrective surgery. The mean birth weight of 2.8 kg was appropriate for mean gestation of 38.5 weeks when compared to the Institute's reference neonatal weight curve. Infective endocarditis prophylaxis was recommended in cases having mitral regurgitation and complicated delivery. Awareness of this common cardiac lesion, thorough cardiovascular examination during pregnancy, early detection and treatment of cardiac arrhythmias if any, are the essential steps to prevent rare but dreaded maternal complications.
The Impact of Autologous Bone Marrow Transplantation on Hematopoietic Recovery after High‐Dose Cyclophosphamide, Doxorubicin and Cisplatin Chemotherapy for Patients with Gynecological Malignancies*
Authors: Murakami Masaru , Shinozuka Takao , Miyamoto Tsuyoshi , Fujii Akikazu , Tokuda Yutaka
Published: August 2010

Twenty‐six patients with gynecological malignancies (21 ovarian and 5 uterine malignant tumors) who were treated 42 times with high‐dose cyclophosphamide, doxorubicin and cisplatin (CAP) chemotherapy with autologous bone marrow transplantation (ABMT) were assessed for the impact of predictive parameters on hematopoietic recovery. An inverse correlation was observed between the number of infused nucleated marrow cells (NMC)/kg or colony‐forming units of granulocyte‐macrophage (CFU‐GM)/kg and the leukopenic duration <1X103/μl; the correlation coefficients were r=‐0.54 and ‐0.49, respectively (p<0.001). The recovery time of platelet count to achieve more than 5times104/μl without transfusion was inversely correlated with CFU‐GM/kg (r=‐0.33, p<0.05) but not with NMC/kg. Neither the episodes of fever nor the number of chemotherapy courses performed on the patients influenced the hematopoietic recovery. The numbers of infused CFU‐GM and NMC were useful parameters of leukopoietic recovery after ABMT and high‐dose CAP chemotherapy.
Colposcopic Index of HPV and CIN Patients
Authors: Roy M.H. Sianturi
Published: August 2010

There were 115 patients who had atypical transformation zone on colposcopic examination which attended this study. This prospective study was held in the author's private colposcopy clinic from July 1, 1989 until December 31, 1991. The colposcopic index was used to describe the colposcopic sign of those lesions and histopathology results were adopted as the gold standard of diagnosis. This colposcopic index had an accuration rate of 95.7% compared to histopathology diagnosis.
Successful Pregnancy in a Woman with Premature Ovarian Failure
Authors: Fujii Shunsaku , Ikeda Shiroh , Tachizaki Tatsuo , Kagiya Akifumi , Saito Yoshiharu
Published: August 2010

A case of a patient with premature ovarian failure (POF) is discussed. Ovulation failed to occur for 5 years by gonadotropin‐releasing hormone agonist (GnRHa) and human menopausal gonadotropin (hMG) treatment following estrogen‐progesterone replacement therapy. After laparoscopic ovarian biopsy, ovulation was successfully induced by hMG, although gonadotropins were not suppressed enough, and the patient achieved pregnancy.
Postpartum Hemorrhage Producing Acute Ischemic Optic Neuropathy
Authors: Sharma Ranjana , Desai Sanjiv
Published: August 2010

A rare case of bilateral peripartum blindness due to acute ischemic optic neuropathy (AION) occurring after an episode of postpartum hemorrhage is described. Massive blood loss and the resultant hypotension was instrumental in reducing the perfusion pressure at the optic nerve head and producing ischemic damage to it.
Neoadjuvant Chemotherapy Using a Platinum, Vincristine and Peplomycin (CVP) Combination in Patients with Carcinoma of the Uterine Cervix
Authors: Shimamoto Tomihiro , Tateyama Hiromichi , Kohso Toshihiko , HamActa Masao
Published: August 2010

Neoadjuvant chemotherapy consisting of a cis‐platinum, vincristine and peplomycin (CVP) combination has been used to treat patients with carcinoma of the uterine cervix at our departments since 1983. Twenty‐one patients are reviewed in this study. A high response rate (71.4%) was obtained with 19.0% complete and 52.4% partial responses prior to radical therapy. Survival times and the progression free interval for stage I and III disease treated with CVP show improvement compared to patients not treated with CVP. No life‐threatening toxicity related to chemotherapy was noted. This combination chemotherapy used in neoadjuvant setting warrants further study.
Tubo‐Ovarian Abscess Containing Tapeworm Proglottids and Ova: A Case Report
Authors: Pairwuti Sunsri , Ratanawichitrasin Adune , Koetsawang Amorn , Robertson Donald Ian
Published: August 2010

We report a case of pelvic inflammatory disease complicated by a tubo‐ovarian abscess containing Taenia spp. proglottids and ova which migrated through a fistula with the sigmoid colon.
Analysis of Jmmunosuppressive Mechanism to Cytotoxic T Lymphocyte Generation in Patients with Advanced Cancer
Authors: Maeda Nagamasa , Sagara Yusuke
Published: August 2010

In vitro activation of cytotoxic T lymphocytes (CTLs) in peripheral blood mono‐nuclear cells (PBMCs) of patients with advanced cancer is extremely difficult. The proportion of monocytes among PBMCs is high in this type of patient. We investigated monocytosis and the mechanism of suppression of CTL generation and obtained the following findings.

1. The cell fraction ratios of PBMCs were divided into two groups: those with a higher proportion of T cells (Group I), and those with a rapid increase in monocytes and a decrease in T cells (Group II).

2. CTL generation occured in Group I, but was either extremely low or not observed in Group II.

3. Supernatant from the culture of monocytes obtained from Group II remarkably suppressed CTL generation.

4. Statistical analysis revealed that the cancer recurrence rate over a 2‐year period was significantly higher in Group II than in Group I.

These findings show that monocytes are associated with the recurrence and worsening of cancer. Furthermore, the monocytes exert this effect by releasing a humoral factor that suppresses CTL activation.
The Development of an Enzyme Immunoassay for Placental Tissue Protein 17 (PP17) and Its Clinical Significance
Authors: Maekawa Iwao , Inaba Noriyuki , Ota Yoriko , Takamizawa Hiroyoshi , Bohn Hans
Published: August 2010

We developed an enzyme immunoassay (EIA) for placental protein 17 (PP17) using avidin biotin binding, and measured the serum‐PP17 levels of 37 healthy men, 103 nonpregnant women, 48 pregnant women, and 86 patients with gynecologic malignancies. The mean level was 12.8 ng/m/ in healthy men and 44.2 ng/m/ in nonpregnant women (p<.05). The calculated upper limit of normal was 97.8 ng/m/ (mean + 2σ). The serum PP17 concentration was remarkedly reduced postmenopausally. Pregnant women showed a mean serum level of 19.2 ng/m/, which was significantly lower than that of nonpregnant women. Immunoserological results strongly suggest that PP17 is produced far more in the normal endometrium than in the placentae and decidua. Patients with gynecologic malignancies had obviously lower mean serum PP17 levels (8.3 —19.9 ng/m/) than those found in healthy nonpregnant women. Measurement of the serum PP17 concentration might be useful in distinguishing gynecologic malignancies from various normal conditions.
The Sources and Biochemical Characteristics of Cobalamin‐Binders in Human Amniotic Fluid*
Authors: Nakamura Kousaku , Sagawa Norimasa , Mori Takahide
Published: August 2010

The sources and biochemical characteristics of cobalamin‐binders in amniotic fluid were investigated. Using gel‐permeation chromatography, cobalamin‐binder, extracted from amniotic fluid at term, was recovered in a single peak with the molecular size of haptocorrin. Neonatal saliva also contained only haptocorrin. However, neonatal gastric juice contained two types of cobalamin‐binders: haptocorrin and intrinsic factor. Amniotic fluid in midtrimester contained three types of cobalamin‐binders: haptocorrin, intrinsic factor, and transcobalamin II. The cultured amnion cells secreted mainly apo‐transcobalamin II. Concentrations of both apo‐haptocorrin and salivary amylase in amniotic fluid increased as gestation advanced.

These results suggest that cobalamin‐binder in amniotic fluid in midtrimester originates from the fetal salivary gland, fetal gastric mucosa, and amnion cells, and that the contribution by the fetal salivary gland increases at term, when almost all cobalamin‐binders in amniotic fluid are haptocorrin.
Maximal Cytoreductive Surgery and High Dose Cisplatin Chemotherapy for Advanced Ovarian Cancer
Authors: Ochiai Kazunori , Takakura Satoshi , Isonishi Seiji , Sasaki Hiroshi , Terashima Yoshiteru
Published: August 2010

Fifty‐eight stage III patients treated at The Jikei University Hospital were analysed retrospectively, in order to clarify the combination effect of maximal cytoreductive surgery and high dose cisplatin based chemotherapy in advanced ovarian cancer. They were divided into 4 groups by treatment they received which was as follows: Group A (n=25); total abdominal hysterectomy (TAH), bilateral salpingooophorectomy (BSO) and omentectomy (OMTX) done at primary surgery and followed by 5 courses of “low dose” CAP therapy (cyclophosphamide 200 mg/sq m, adriamycin 20 mg/sq m, cisplatin 35 mg/sq m every 4 weeks for 5 courses). Group B (n=4); TAH, BSO and OMTX carried out at primary surgery and followed by “high dose” CAP therapy (cyclophosphamide 200 mg/sq m, adriamycin 20 mg/sq m, cisplatin 70 mg/sq m, every 4 weeks for 5 courses and every 8–12 weeks for 5 courses thereafter). Group C (n=13) received TAH, BSO and OMTX at the primary operation and paraaortic and pelvic lymphadenectomy (LNX) at the second look operation (SLO) with “high dose” CAP therapy as did Group B. Group D (n=16), TAH, BSO, OMTX, LNX with maximal efforts made to reduce the size of the residual tumor to less than 2 cm at the primary surgery followed by “high dose” CAP therapy. The 3 year and 5 year survival rate of each group were as follows: Group A 15.6%, 15.6%, Group B 25.0%, 0%, Group C 81.8%, 0% and Group D 50.8%, 38.1%, respectively. Results indicate that a combination of maximal cytoreductive surgery and high dose cisplatin based chemotherapy contributes to the prognosis of advanced ovarian cancer patients.
Changes of Perinatal Statistics in a Semiurban Setup between Two Time Periods in Malaysia
Authors: Al‐Mohdzar Syed Abdullah , Haque Md. Enamul , Abdullah Wan Ariffin
Published: August 2010

Hospital University Sains Malaysia (HUSM) functions as the state referral centre and the only hospital for the state of Kelantan that can offer neonatal intensive care service. The deliveries in HUSM with grand multiparity, late booking and problems of late referrals resembles a hospital serving a semiurban rather than an urban community. A comparison between the year 1989 and 1991 showed marked improvement of perinatal mortality rate from 41.32 to 24.88, which is significantly better than the improvement achieved from 1987 to 1989 (46.0 to 41.32). This was possible due to a marked fall in the early neonatal mortality rate from 10.02 in 1989 to 5.45 in 1991 and fall in the stillbirth rate from 31.61 to 19.53.
Complications Associated with CDDP Intraperitoneal Chemotherapy
Authors: Adachi Susumu , Noda Tsuneo , Ito Kimihiko , Kiyozuka Yasuhiko , Itani Yoshio , Shintani Masashi , Hisanaga Hiroyasu , Umekage Hideshi , Nakayama Masahiro , Fujita Masayuki
Published: August 2010

Abstract

As CDDP‐ip is known to affect intraperitoneal tumors directly, and reduce CDDP associated adverse reactions, it has been used not only for ovarian cancer but other intraperitoneal tumors. However ip chemotherapy requires catheter placement at the time of laparotomy. We investigated the complications of catheters as an intraperitoneal administration route. The subjects were 84 patients, 39 with temporary catheters and 45 with an implantable port and catheter system. Twenty‐seven percent of the temporary catheter patients experienced complications‐infection 8%, inflow obstruction 3%, leakage 5%, extrusion 8%, and severe pain 3%. Furthermore, a total of 22% of patients with an implantable port and catheter system experienced complications‐inflow obstruction 9%, infection 2%, leakage 4%, and extrusion 7%. Fortunately, no serious complications were observed at our institutions, and the complication incidence seemed lower compared to that of other institutions.
Comparative Assessment of the Effects of Subdermal Levonorgestrel Implant System and Long Acting Progestogen Injection Method on Lipid Metabolism
Authors: Anwar Mochamad , Soejono Sri Kadarsih , Maruo Takeshi , Abdullah Nadir
Published: August 2010

Abstract

In order to compare the effects of two type of long‐acting progestogen contraceptive methods with subdermal levonorgestrel (LNG) implants and depot‐medroxy‐progesterone acetate (DMPA) injections on lipid metabolism, a clinical cohort study was performed by requiring 25 women in each group adopting either LNG implant or DMPA injection method voluntarily. After 6 months of use, serum levels of trigly‐cerides, total cholesterol, HDL‐cholesterol and LDL‐cholesterol were determined and compared between the two groups of acceptors. The mean of total cholesterol in LNG implant acceptors was significantly lower than that in DMPA injection acceptors. The mean values of HDL‐cholesterol in LNG implant acceptors (41.7± 7.7 mg/dl) and in DMPA injection acceptors (45.0±9.0 mg/dl) were in the normal range without significant difference between the two groups. The mean value of triglycerides did not differ significantly between LNG implant acceptors (77.6 ± 25.1 mg/dl) and DMPA injection acceptors (91.0±30.3 mg/dl). Serum concentrations of lipid fractions such as HDL‐cholesterol and LDL‐cholesterol in LNG implant acceptors were relatively low compared to those in DMPA injection acceptors. Since there was a comparable reduction in both total‐and HDL‐cholesterol levels in the LNG implant group, the ratio of total‐to HDL‐cholesterol, which is thought to be a factor in determining the risk of coronary artery disease, remained in the normal range (2±4.5). This suggests that the use of these two contraceptive methods with proge‐stogens does not alter the risk of development of coronary artery disease.
Risk Weighing in Twin Pregnancy
Authors: Casper Fritz W. , Seufert Rudolf J. , Brockerhoff Peter
Published: August 2010

Multiple pregnancies are more often associated with complications than singleton pregnancies. In our retrospective study of 613 twin pregnancies the most important risk factors in twin pregnancies were premature labour before the 37th week of gestation and the premature rupture of the membrane. The increase of perinatal mortality and morbidity for twins might be primary the result of premature delivery.
Adenosquamous Carcinoma Arising in a Mature Cystic Teratoma of the Ovary: A Case Report and Review of the Literature
Authors: Iwaoki Yasuhisa , Katsube Yasuhiro , Toyota Nobutaka
Published: August 2010

A 57‐year‐old woman with Stage la adenosquamous carcinoma arising in a mature cystic teratoma was presented. Pathologically, poorly differentiated squamous cell carcinoma and mucoepidermoid carcinoma were intermingled in the solitary nodule inside of the cyst. She received chemotherapy after operation (total abdominal hysterectomy, bilateral salpingo‐oophorectomy, and omentectomy). She is living without evidence of disease 3 years post‐treatment.

Adenosquamous carcinoma is a rare malignant component in mature cystic teratomas. We reviewed 7 cases of this cancer arising in mature cystic teratomas, including this case. Three cases with Stage la were living and well for 9 months to 5 years. Three other cases with Stage Ic, II, and IIIc died of their disease at 6, 13 and 2 postoperative months, respectively. These results might suggest that the prognosis of the tumor is worse in advanced stages than that of squamous cell carcinoma in mature cystic teratomas.
Development of an Effective and Simple Insemination Method for the in vitro Fertilization of Patients with Male‐Factor Infertility
Authors: Inagaki Shiro , Suganuma Nobuhiko , Kitagawa Takeshi , Fukugaki Hiroyuki , Nakamur Kiyoshi , Kondo Ikuyo , Tomoda Yutaka
Published: August 2010

An insemination method involving mechanical removal of the cumulus and multiple oocytes per dish (MRC‐MOPD) was applied to achieve in vitro fertilization (IVF) of patients with male‐factor infertility, and the prognosis of IVF and embryo transfer was evaluated. Although the fertilization rate of patients with male‐factor infertility was only 41.4% (12/29) using standard insemination methods, a 73.0% (27/ 37) fertilization rate was achieved with the MRC‐MOPD method. Moreover, 10 patients with male‐factor infertility who were treated with the MRC‐MOPD method achieved clinical pregnancy. A comparison of the results in the 10 patients who were treated with both methods in common reveals that the MRC‐MOPD method also increased the fertilization rate per oocyte. The rate of occurrence of polyploid fertilization did not increase, although large numbers of sperm were inseminated via the MRC‐MOPD method. These results indicate that the MRC‐MOPD method is an effective and simple insemination technique to achieve successful IVF of patients with male‐factor infertility.
The Predictive Value of Extremes of Birth Weight, Mother's Height and Ethnic Origin on the Likelihood of Emergency Caesarean Section
Authors: Hin L.Y. , Khairuddin Y. , Ng K.B.
Published: August 2010

We reviewed the deliveries in a teaching hospital in a multiracial community over the period of one year (1988), and investigated the relationship between maternal height, ethnic origin, and the extremes of birth weight with the likelihood of emergency lower segment caesarean section (LSCS). After excluding patients with obvious indications for LSCS, 5,050 patients were entered in the study. Chi‐square analysis showed that the risk of emergency LSCS is significantly higher in the Indians compared to Chinese and Malays, but does not differ significantly between the latter two groups. Logistic regression analysis showed that birth weight of less than 2,500 g or greater than 3,500 g is the most significant association with emergency LSCS rate. Conditional logistic regression showed that, provided the individuals conformed to the characteristics of the cohort in this study, risk of emergency LSCS for a 150 cm (25th centile) tall Indian pregnant lady is almost twice that of a 158 cm (75th centile) tall non‐Indian.
Causes and Factors Affecting Perinatal Mortality at Princess Basma Teaching Hospital in North Jordan
Authors: Abu‐Heija Adel T.
Published: August 2010

This is the first study about the perinatal mortality in North Jordan. Between 1st June 1991 and 31st May 1992, 8,146 deliveries took place at Princess Basma Teaching Hospital. There were 250 perinatal deaths comprised of 124 stillbirths and 126 early neonatal deaths. The perinatal mortality rate was 30.6 per 1,000. The factors which might have affected this rate were mainly prematurity, low birth weight, unexplained intrauterine fetal death, and congenital malformations. The possible ways of improving the results are discussed.
Effects of Progesterone on the Metabolism of Cancellous Bone in Young Oophorectomized Rats
Authors: Fujimaki T. , Kurabayashi T. , Yamamoto Y. , Yasuda M. , Tojo Y. , Yahata T. , Tanaka K.
Published: August 2010

The effects of progesterone on cancellous bone in young rats were evaluated. Fifty female rats aged 90 days were divided into 5 groups: (1) Sham‐operated controls (SHAM); (2) oophorectomized (OVX) rats; (3) OVX rats treated with estrogen (OVX + E); (4) OVX rats treated with progesterone (OVX + P); and (5) OVX rats treated with estrogen and progesterone (OVX + EP). After surgery, some animals were treated subcutaneously (s.c.) with 0.5 mg of estradiol dipropionate depot, with 5 mg of hydroxyprogesterone capronate depot, or with both hormones, at intervals of 7 days. After 180 days, the bone mineral density (BMD) and bone histomorphometry of their lumbar vertebrae and serological parameters were measured.

In the OVX + P group, the BMD and the bone volume as shown by bone histomorphometry were slightly higher than in the OVX group, but not significantly. These parameters in the OVX + E and OVX + EP groups were significantly higher than in the OVX group. The OVX + P group showed a significant increase in the labeled surface and a decrease of the osteoclast number, compared to the OVX group. The OVX + P group showed increases of serum alkarine phosphatase and osteocalcin.

From these results, it can be concluded that progesterone treatment might intensify bone formation and suppress bone resorption on cancellous bone in oophorectomized rats, although progesterone alone does not have a positive effect on BMD and bone volume.
A Case of Laparoscopic Complication: Injury of the Left Common Iliac Vessels and Subsequent Acute Compartment Syndrome of the Left Leg
Authors: Honda Tetsuro , Tokushige Makoto , Uda Satoko , Egawa Haruto , Suginami Hiroshi
Published: August 2010

A 45‐year‐old Japanese woman underwent a laparoscopy‐assisted vaginal hysterectomy. Insertion of a trocar injured the left common iliac artery and vein, which were repaired within 2.5 hours. Postoperatively the patient presented an acute compartment syndrome of the left leg. Fasciotomy and rehabilitation rescued her from functional disturbances.
Prevention of Pregnancy‐Induced Hypertension by Calcium Dietary Supplement: A Preliminary Report
Authors: Tomoda Shoji , Kitanaka Takashi , Ogita Sachio , Hidaka Atsuo
Published: August 2010

Objective: The purpose of this study is to clarify whether the taking of a calcium dietary supplement is able to prevent the development of pregnancy‐induced hypertension (PIH) in Japanese people.

Study Design: Forty‐five nulliparous women (Ca‐group) with various high‐risk factors for PIH started to take a calcium supplement (1 g/day in the form of calcium salts) from the 12th gestational week (GW). Obstetrical outcome of Ca‐group was compared to that of the nullipara (n = 453) who did not take a calcium supplement during pregnancy (Non‐Ca Group) and that of the nullipara (n = 413) who did not develop PIH among Non‐Ca group (normotensive group).

Results: The incidence of PIH in the Ca‐group was 2.2%, compared to 8.8% of Non‐Ca group. The decrease in blood pressure after taking calcium during the first half of the pregnancy was much greater in Ca‐group than in the normotensive group. The urinary excretion of sodium and calcium and serum free calcium at the 28th GW were much lower in a woman with PIH, despite of the taking of a calcium supplement, than in the normotensive calcium group. Also, the parathyroid hormone level at the 28th GW was higher in the calcium‐taking woman with PIH than in the normotensive calcium group.

Conclusion: Our preliminary study suggests that among the possible effects of taking a calcium supplement are a decrease in blood pressure and the prevention of PIH in Japanese people, and that calcium metabolism might be related to the development of PIH. However, more study is needed before it will be possible to reach a final conclusion.
The Possibility of Clinical Application of the Thromboxane A2 Synthase Inhibitor, Ozagrel, for the Treatment and Prevention of Preeclampsia: A Preliminary Report
Authors: Seki Hiroyuki , Kuromaki Ken‐ichi , Takeda Satoru , Kinoshita Katsuyuki , Satoh Kazuo
Published: August 2010

Objectives: This study was performed to investigate whether the TXA2 synthase inhibitor, ozagrel, was effective in the treatment and prevention of preeclampsia.

Study Design: Ozagrel was administrated therapeutically to 4 severely preeclamptic women, and prophylactically to 5 pregnant women with histories of severe preeclampsia and complications.

Results: The therapeutic administration (TA) of ozagrel improved hypertension and proteinuria. Two patients delivered appropriate‐for‐date (AFD) infants, whereas the other 2 patients delivered light‐for‐date (LFD) infants. Mean plasma concentrations of TXB2 (plasma TXB2) decreased, whereas plasma 6‐keto PGF1α were almost unchanged. The prophylactic administration (PA) of ozagrel prevented the occurence of preeclampsia in 3 of the 5 patients. All delivered AFD infants. The duration of pregnancy was prolonged more than that of previous pregnancies in all patients. Plasma TXB2 decreased, whereas plasma 6‐keto PGF1α increased.

Conclusions: PA prevented preeclampsia and intrauterine growth retardation, whereas TA improved only maternal symptoms. These results might justify a large prospective study to determine whether ozagrel is an effective prophylactic.
Gestational Herpes: 3 Cases
Authors: Uncu Gürkan , Ozan Hakan , Tathkazan Serhat , Kimya Yalçin , Cengiz Candan
Published: August 2010

Three histologically proven gestational herpes cases were presented. All were complaining of itching and vesiculobullous skin lesions. The diagnosis was confirmed by skin biopsies and they all gave a complete response to 1 mg/kg‐day oral prednisolone therapy. No neonatal morbidity was observed.
Dopaminergic System Mediation of Stimulatory Effect of Melatonin on Secretion of Prolactin
Authors: Okada Masataka
Published: August 2010

Objective: The purpose of the present study was to clarify the mechanism of the stimulatory effect of melatonin on the secretion of prolactin.

Methods: Determination was made of the levels of dopamine (DA), 3,4‐dihydroxyphenylacetic acid (DOPAC), serotonin (5‐HT), and 5‐hydroxyindoleacetic acid (5‐HIAA) in the median eminence of rats following intravenous melatonin (100 μg) administration.

Results: Administration of 100μg of melatonin to rats resulted in a significant increase in prolactin secretion (p < 0.01, analysis of variance). Administration of melatonin also resulted in significant decreases in the DOPAC content (p < 0.05) and in the DOPAC/DA ratio (p < 0.05) in the median eminence 1 hour after melatonin administration, at which time serum prolactin was maximal. However, no significant changes were detected in the content of 5‐HT or 5‐HIAA or in the 5‐HIAA/5‐HT ratio in the median eminence.

Conclusion: These results suggest that the stimulatory effect of melatonin on the secretion of prolactin might be mediated by dopaminergic mechanisms.
Rapid Chromosome Analysis and Prenatal Diagnosis Using Fluid from the Cystic Hygroma, Hydrothorax and Isolated Ascites: New Source for Chromosome Analysis
Authors: Yang Young Ho , Cho Jae Sung , Min Hae Won , Lee Chang Hoon , Song Chan Ho
Published: August 2010

Objective: To determine whether abnormally collected fetal body fluid could be used as alternative cell sources for cytogenetic assessment.

Method: Using modified lymphocyte culture, the abnormal fetal body fluids obtained from the five fetal anomaly cases (3 cystic hygromas, 1 hydrothorax, and 1 isolated ascites) were analyzed in order to determine their karyotypes.

Results: Two cases showed 45, X and 46, XX/45, X and the other three showed a normal karyotype.

Conclusion: The cytogenetic analysis from body fluid aspiration yields a rapid and accurate result within 96 hours. This method could be helpful when cordocentesis or placental biopsy is not feasible or when time requirement for amniotic fluid cell culture is burdensome to patient management.
A New Approach to Methotrexate and Lipiodol Suspensions for Ectopic Pregnancy: Preliminary in vitro and Animal Experiments
Authors: Fujishita Akira , Ishimaru Tadayuki , Masuzaki Hideaki , Matsuwaki Takahiro , Chavez Raul Ortega , Yamabe Tooru , Ogasawara Masayoshi
Published: August 2010

Objectives: To measure and evaluate the in vitro release of MTX from suspensions of methotrexate (MTX) and lipiodol (LPD), and to investigate the MTX concentration and fertility rate using an animal model.

Methods: This study was divided into three components: a) An in vitro Release Study, b) Animal Study No. 1 (concentration of tissue and plasma levels), and c) Animal Study No. 2 (fertility rate after MTX suspension).

Result: The releasing rate in vitro was more rapid with MTX‐S (MTX dissolved in saline) than with either MTX‐LPD (MTX dissolved in lipiodol) or MTX‐LPD‐PC (MTX suspended in lipiodol and phosphatidylcholin, i.e., MTX suspension). The tissue concentration tended to be higher with an MTX suspension than with MTX‐S. There was no significant difference in the fertility rate or the nidation index among the 3 groups (Groups 1, 2, and 3).

Conclusion: The injection of an MTX suspension is useful for increasing the tissue concentration and maintaining the long‐term effectiveness of MTX, and this technique might offer a new approach in the treatment of ectopic pregnancy (EP) or in second‐line therapy for persistent EP.
Biochemical Events in Cervical Ripening Dilatation during Pregnancy and Parturition
Authors: Osmers R. G. W. , Adelmann‐Grill B. C. , Rath W. , Stuhlsatz H. W. , Tschesche H. , Kuhn W.
Published: August 2010

In specimens taken from the posterior lip of the cervix uteri we determined the collagenase activity and the glycosaminoglycan concentration. In biopsies obtained from the lower uterine segment during cesarian section we measured cytokines (IL‐ 8, IL‐2, TNFα) and matrix metalloproteinases (MMP‐8, MMP‐9). We found that the release of collagenases is critically involved in the process of cervical dilatation. The glycosaminoglycan concentration increases during pregnancy and shows remarkable changes of the distribution patterns of the different glycosaminoglycans. The parturition is characterized by a dramatic loss of most of the glycosaminoglycans. Furthermore, the IL‐8 shows a close correlation to the clinical feature of cervical ripening and is closely associated with the release of MMP‐8 and MMP‐9.

Summarizing the process of cervical maturation and dilatation is a complex enzymatic controlled process with substantial remodelling of the cervical extracellular matrix. The cytokines IL‐8 seems to play an essential role in triggering the process of cervical dilatation.
The Prevention of Mechanical Birth Trauma by Means of Computer Aided Simulation of Delivery by Means of Nuclear Magnetic Resonance Imaging and Finite Element Analysis
Authors: Melchert Frank , Wischnik Arthur , Nalepa Ernst
Published: August 2010

Anatomic disproportion gains an increasing interest in obstetrics. Imaging procedures (radiologic pelvimetry, computed or magnetic resonance imaging (MRI) fail to reflect the dynamics of delivery including deformations of the birth channel as well as of fetal structures. To validate findings of imaging procedures in this respect a method has been developed to perform a dynamic, biomechanical postprocessing of the static informations obtained from MRI. Using an especially developped software MRI pixel matrices of maternal pelvis and fetal head were color‐coded and — according to the principle of same density — line data were created. After sectional attribution of the resulting polygones a three‐dimensional mesh of so called Finite elements (FE) was created, which then can be used for deformation analysis. Fetal head was then moved through the birth channel by means of computed simulation. This allows not only ongoing deformations to be visualized but also resulting forces to be calculated for at any time of the delivery process for any point of the anatomical model. Performing these simulations assuming various anatomic and physiologic conditions an obstetrical‐biomechanical data basis could be obtained, that was implemented in a PC‐based expert system. This allows interpretation of pelvimetric data with regard to birth dynamics.
Triple Test for Prenatal Detection of Edwards Syndrome (Trisomy 18)
Authors: Sinosich M. J. , Cameron B. , Robertson R. D. , Saunders D. M.
Published: August 2010

Objective(s): To demonstrate the limitation of complete reliance on computer generated interpretations and to highlight the need for understanding of pregnancyrelated biochemistry when offering prenatal screening.

Methods: Four cases of cytogenetically confirmed trisomy 18 pregnancies are presented. All four cases underwent prenatal screening (Triple Test‐AFP, uE3, tβ‐hCG) at midgestation and risk assessment by the alpha algorithm.

Results: All four cases of trisomy 18 were assessed as being at low risk for DS and/or open NTD. Although marker levels were not consistent with either of these clinical situations, they were indicative of a compromised pregnancy. Circulating levels of trophoblast‐derived antigens (uE3, tβ‐hCG) were depressed ( 0.5 MoM) in all four cases. Further investigations (ultrasonography, amniocentesis) confirmed a trisomy 18 fetus.

Conclusions: Risk assessment by computer based algorithms relies on maternal factors and specific DS/NTD marker profiles. Aberrant marker profiles are not distinguished from normal. Therefore, it is essential that prenatal screening is offered only by those competent in pregnancy biochemistry and able to identify these abnormal situations.
Ascitic Positive Cytology and Intraperitoneal Metastasis in Ovarian Dysgerminoma
Authors: Mandai Masaki , Konishi Ikuo , Koshiyama Masafumi , Komatsu Takayuki , Yamamoto Shinichi , Nanbu Kanako , Mori Takahide , Fujii Shingo
Published: August 2010

Objectives: To verify the pattern of the spread of tumors in ovarian dysgerminoma, with special reference to intraperitoneal metastasis, and to assess clinicopathologic factors for predicting tumor extension.

Methods: Detailed data regarding ascitic cytology, macroscopical findings at surgery, and the histopathology of the surgical specimens were retrospectively reviewed in 12 patients with dysgerminoma who were treated at Kyoto University Hospital. The relationships between the tumor extension and the period of symptoms, the serum lactic dehydrogenase (LDH) level, and the operative findings also were analyzed.

Results: Ascitic cytology revealed a high incidence of positivity in 6 of the 10 (60%) cases examined. Extraovarian metastases were present in 4 of the 6 (67%) cases with positive cytology, and in 1 of the 4 (25%) cases with negative cytology. Intraperitoneal metastatic nodules were detected in 5 of the 12 (42%) patients either by inspection during surgery or by postsurgical histological examination. In addition, these metastatic lesions were 5 or fewer in number and 7 mm or less in diameter, except in 1 patient with widespread disease. The presence or absence of extraovarian spread of the tumor was not significantly correlated with the period of symptom, the serum LDH level, the size of the primary tumor, or the volume of the ascitic fluid.

Conclusion: The incidence of intraperitoneal spillage and/or metastases of dysgerminoma cells might be higher than previously reported. These findings indicate the importance of ascitic cytology and careful inspection at the time of operation, as well as the rationale of postsurgical chemotherapy for dysgerminoma of an apparently early stage.
Multilocular Peritoneal Inclusion Cysts (Benign Cystic Mesothelioma): A Case Report
Authors: Yaegashi Nobuo , Yajima Akira
Published: August 2010

We report a case of a rare lesion, a multilocular peritoneal inclusion cyst (MPIC), and describe in detail its appearance on MRI. A young woman with pain of the lower abdomen underwent surgical removal of a mass that was histologically diagnosed as an MPIC. The characteristic MRI features were a multilocular cystic mass with thin septa in the pelvic cavity, located both anterior and posterior to the uterus and the adnexa, showing hypointensity of the cyst contents on T1 images and variable hyperintense signals on T2 images.
Assessment of Fetal Health Should Be Based on Maternal Perception of Clusters Rather Than Episodes of Fetal Movements
Authors: Fai Fong Yoke , Singh Kuldip , Malcus Peter , Biswas Arijit , Arulkumaran S. , Ratnam S. S.
Published: August 2010

Objective: To determine the level of correlation between mother and machine detected episodes and clusters of fetal movements and their association with fetal heart rate acceleration.

Methodology: An observational study conducted on health pregnant women between 29–40 weeks gestation who were admitted in spurious labour to the Department of Obstetrics and Gynaecology, National University Hospital, Republic of Singapore. A continuous record of fetal heart rate and fetal movement was obtained using the fetal actocardiograph. Fetal movements felt by mother were also noted. If a continuous series of fetal movements were perceived over a period of 15 secs on more it was termed clusters of fetal movement. The presence or absence of acceleration in relation to these movements were noted.

Results: There was a highly significant correlation between mother and machine in detection of clusters of fetal movements (r = 0.77, p < 0.001); for episodes of fetal movements, the correlation was weaker (r = 0.23, p < 0.05). All clusters of fetal movements perceived by the mother were recorded by the machine and were associated with fetal heart rate accelerations. Two or more accelerations within 3 minutes of the fetal movements were seen with 87.8% of clusters felt by mother compared with 66.7% detected by the machine (p = 0.01). In the 2,263 minutes of recording in 42 women, a cluster of fetal movements was felt at least every 25 minutes by the mother.

Conclusion: Maternal perception of 1 or 2 clusters of fetal movements in 30 to 60 minutes may be as reliable as a non‐stress test in reassuring good health. It would be less time consuming than the traditional count to 10 fetal movement chart and a more reliable indicator of fetal health than counting episodes of fetal movements. Thus, our study suggests that clusters rather than episodes of fetal movements should be considered for evaluating fetal health based on fetal movements.
The Prevalence of Hemoglobin S and Glucose‐6‐Phosphate Dehydrogenase Deficiency in Jordanian Newborn
Authors: Talafih Khalid , Hunaiti Abdelrahim A. , Gharaibeh Nayef , Gharaibeh Mohammad , Jaradat Saied
Published: August 2010

Objective: The aim of this study was to determine the incidence of HbS and glucose‐6‐phosphate dehydrogenase (G6PD) deficiency in Jordanian newborn.

Study Design: A total of 181 male and female babies born at Princess Basma Teaching Hospital, randomly selected, and cord blood samples were collected, and the erythrocyte G6PD activity was measured, and the hemoglobin electrophoresis for blood lysate was conducted and scanned for HbS scanning.

Results: The frequencies of two major red cell genetic defects, sickle hemoglobin (HbS) and deficiency G6PD was determined, of the studied subjects 10 (11%) females and 11 (12%) males were found to be deficient in the G6PD gene. The frequency of HbS carriers among the females was 4% while it was 6% among males. The coincidence of both G6PD deficiency and sickle cell hemoglobin in the samples was 1%. No coincidence was found between G6PD deficiency and hyperbilirubinemia.

Conclusion: A better understanding of the distributions of these genetic disorders has the potential to aid in the more efficient utilization of health care resources and improved planning.
Pulmonary Embolism Associated with Sjögren's Syndrome in Pregnancy
Authors: Kikuchi Akihiko , Okai Takashi , Taketani Yuji
Published: August 2010

The occurrence of pulmonary embolisms in patients having circulating lupus anticoagulant has been reported.1–3) Lupus anticoagulant has been noticed in association with autoimmune diseases1,4–6) and early‐onset severe preeclampsia.7–10) We report a case of Sjögren's syndrome with circulating lupus anticoagulant in a patient who developed a pulmonary embolism and severe preeclampsia at 29 weeks of gestation.
Assessment of Tubal Patency by Transvaginal Sonographic Hydrotubation with Color Doppler Flow
Authors: Taechakraichana Nimit , Wisawasukmongchol Wirach , Uerpairojkij Boonchai , Suwajanakorn Somchai , Limpaphayom Kobchitt , Phaosawasdi Sukhit
Published: August 2010

Objective: To assess the value of transvaginal sonographic hydrotubation with color Doppler flow (TSH) as a test of tubal patency.

Methods: Thirty‐nine women undergoing infertility investigation at Chulalongkorn Hospital participated in this prospective, blind comparative study. Before diagnostic laparoscopy (DL) with chromopertubation, TSH was performed using the SSD 680, 5 MHz vaginal ultrasound probe and 20–50 ml of saline was injected into the uterine cavity.

Results: Nine cases could not be evaluated properly. Of the 30 cases, there were complete agreements between TSH and DL in 24 (80%), partial agreement in 5 (16.67%) and non‐agreement in 1 (3.33%). TSH had sensitivity 100%; specificity 84.62%, positive predictive value 50%, negative predictive value 100%, false positive rate 15.38%, but no false negative rate.

Conclusion: TSH is a simple diagnostic procedure for screening of tubal patency. However, other confirmatory test is needed if tubal occlusion is suspected.
Regulation of Neutrophil Superoxide Generation by Alpha‐Tocopherol in Human Peripheral and Umbilical‐Cord Blood
Authors: Ando Masaki , Yoshioka Tamotsu , Akiyama Jitsuo , Kudo Takafumi
Published: August 2010

Objectives: Alfa‐tocopherol (VE) inhibits protein phosphorylation and affects protein kinase C (PKC)‐dependent superoxide (O2‐) generation of phagocytic cells. Because umbilical‐cord blood contains low concentrations of VE, we studied the effects of VE on stimulation‐dependent O2 generation of neutrophils derived from the healthy human peripheral circulation (HPMNs) and the umbilical cord (UCBNs).

Methods: O2‐ generation and VE content were assayed by reduction of ferricytochrome c and by HPLC with an electrochemical detector, respectively. Neutrophil‐specific annexin protein was identified by an immunological method.

Results: Both types of neutrophils generate significant amounts of PKC‐dependent O2‐ generation, but weak PKC‐independent O2‐ generation, except for opsonized zymosan‐stimulated O2‐ generation in UCBNs. The VE content of UCBNs was similar to that of HPMNs although umbilical‐cord blood contains a low concentration of VE. A neutrophil‐specific annexin protein was also found in the UCBNs

Conclusion: UCBNs have a greater ability to incorporate VE than HPMNs do, but have similar general characteristics of stimulation‐dependent O2‐ generation to those of HPMNs.