bluuebunny/crossref_metadata_2025 huggingface dataset:
Dose–response Relationship between Dose of Clomiphene Citrate and Incidence of Ovulation
Authors: Seki Katsuyoshi , Kato Koichi
Published: August 2010

One hundred and fifty anovulatory, infertile women were treated with clomiphene citrate in an individualized, graduated therapeutic regimen. Women with high serum follicle stimulating hormone or prolactin concentrations were not included. Ovulation was induced in 135 (90.0%) of the 150 women. Of the 55 women who achieved pregnancy, 50 (90.9%) did so at a dose of 150 mg for 5 days or less. Five pregnancies (9.1%) were achieved with higher doses. There was a significant correlation between the total dose of clomiphene citrate administered per cycle and the cumulative incidence of ovulation. There was also a significant relationship between the total dose of clomiphene per cycle and the cumulative incidence of pregnancy.
Mid‐pregnancy Amniocentesis
Authors: Ju Kap Soon , Lee Sun Kyung , Kim Seung Bo , Lee Jae Hyun
Published: August 2010

The follow‐up study on the outcome of mid‐pregnancy performed amniocentesis with or without ultrasound guidance is carried out from a total of 913 cases.

The results are as follows;

Out of 473 pregnancy without ultrasound guidance and 440 with ultrasound guidance, there were observed full term deliveries in 457 (96.6%) and 419 (95.2%), premature deliveries in 8 (1.69%) and 12 (2.72%), immature deliveries in 2 (0.4%) and 3 (0.68%), spontaneous abortions in 3 (0.63%) and 0, and induced abortions in 3 (0.6%) and 6 (1.36%) respectively.

The perinatal mortality was 27.48 in cases of amniocentesis without ultrasound guidance and 13.63 in cases of amniocentesis with ultrasound guidance.

The 0.03 percent of the pregnant women having amniocentesis without ultrasound guidance had spontaneous abortions from 10 to 60 days after amniocentesis. No abortions from the cases with ultrasound guidance was observed.

A total of 9 cases had induced abortion. Seven cases were prenatally diagnosed fetal anomalies. Six were chromosomal anomalies and one anencephalic fetus.

No specific infant diseases were observed and the upper respiratory infections were the most common disease from both groups. An infant died of pneumonia in each group.

Out of a total of 913 pregnancies, 12 cases (1.3%) showed anomalies. Only 5 cases gave births and 2 of them, a cleft palate and a Polydactyly were survived.

The 29 cases (6%) out of 473 cases without ultrasound guidance and the 74 cases (16.8%) out of 440 cases with ultrasound guidance complained after amniocetesis such as abdominal pain in most, amniotic leakage and vaginal spotting. One case with amniotic fluid leakage wanted to be aborted, and two with vaginal spotting were turned out to be placenta previa and hydatidiform mole.
Complications of Laparoscopy
Authors: Patel Dina N. , Parikh Mahendra N. , Nanavati Murai S. , Jussawalla Mehernosh J.
Published: August 2010

This study presents the analysis of 8,600 cases of laparoscopy both diagnostic and operative carried out by the Nowrosjee Wadia Maternity Hospital and Post Graduate Institute, Bombay. Of these, 2,300 cases were performed at the hospital and 6,300 cases at various camps all over India. Variety of complications noted in these cases have been evaluated.
Diagnostic Colposcopy in Adenocarcinoma of the Uterine Cervix
Authors: Ueki Minoru , Maeda Takayoshi , Sano Takashi , Sugimoto Osamu
Published: August 2010

Although the incidence of adenocarcinoma of the cervix is 5% or more of all cases of cervical carcinoma, colposcopical studies of this lesion have never been reported systematically. We observed the colposcopic findings in 52 cases of cervical adenocarcinoma. The findings of cervical adenocarcinoma on colposcopy and of endometrial carcinoma on hysteroscopy were compared to confirm the diagnosis.

In the early stages of cervical adenocarcinoma, papillary findings, transformation zone‐like findings, a combination of these findings, granulation‐like findings, and atypical vessels were observed. The lesions tended to bleed and secrete mucus, and root‐like, wastethread‐like, glomerular, tendril‐like and corkscrew‐like vessels were seen. In advanced stages, the lesion tended to be a necrotic mass with a collapsed surface. In some adenosquamous carcinomas, white epithelium, mosaic, and punctation were observed, but these were not seen in true adenocarcinomas.

These surface and capillary characteristics resemble the hysteroscopic findings of endometrial carcinoma.
Hematemesis Complicating Pregnancy
Authors: Dhall Kamala , Dhall Gian I. , Mapa Manik K.
Published: August 2010

A rare case of bleeding from oesophageal varices complicating pregnanc‐, without an‐ intrahepatic or extra‐hepatic patholog‐ has been reported and the differential diagnosis has been discussed.
Menstrual Disorders in Adolescence
Authors: Mukherji Joydev , Chowdhury N.N. Roy
Published: August 2010

Of 380 adolescents who attended Eden Hospital, Calcutta Medical College, India, over a 9 month period, 215 had some menstrual problem. There were 75 cases with primary amenorrhoea, 28 with secondary amenorrhoea, 42 with oligomenorr‐hoea, and 70 with excessive bleeding.

Primary amenorrhoea stood out as the commonest serious disorder. Leaving aside delayed menarche, majority of its causes including Mullerian Tract abnormalities, Gonadal dysgenesis and chromosomal aberrations are determined in utero. These require only modest skill for diagnosis and are mostly absolute barriers to fertility.

Secondary amenorrhoea although potentially less serious requires more investigations. Nutritional disturbances, polycystic ovarian disease, and genital tuberculosis are important causes.

Oligomenorrhoea', commoner than secondary amenorrhoea may be paraphysi‐ological during early adolescence. However severe oligomenorrhoea may have causes similar to secondary amenorrhoea.

Puberty menorrhagia is the commonest cause for emergency hospital admission in teenagers. Although most cases are dysfunctional, the organic causes should be carefully excluded.
Ultrasonic Evaluation and Classification of Ovarian Tumors
Authors: Vera Ma. Trinidad R. , Okai Takashi , Mukubo Masaaki , Kozuma Shiro , Maeda Tsukio , Mizuno Masahiko
Published: August 2010

Echo pattern classification for ovarian tumors was devised to evaluate ovarian tumors pre‐operatively, distinguishing malignant ones from the benign tumor. The study covered a period of 8 years, for which 182 cases of ovarian tumor were initially evaluated to devise and test the classification, after which another set of 198 cases diagnosed as ovarian tumor by ultrasound was studied to determine its use in the clinics. The classification consisted of 6 patterns and 2 or 3 sub‐groups for each pattern. The probability of the tumor to be benign was high if it fell in patterns I, II, III, and IV‐A and to be malignant if it fell in patterns IV‐B, V, and VI. The percentage of accuracy of diagnosing malignant ovarian tumor was 89.36% with a low rate (0.65%) of false negative diagnosis. Histologic and echo pattern correlation was high. The results suggest the usefulness of the classification in clinical setting.
Demonstration of Immunoreactive LHRH in the Human Ovaries by Peroxidase Immunocytochemistry
Authors: Huang Hung June , Ishimaru Tadayuki , Yamabe Tooru
Published: August 2010

The distribution of immunoreactive LHRH in the human ovary was examined using paraffin sections by peroxidase immunocytochemistry. Immunoreactive LHRH is seen in the granulosa cells of mature follicles, and in the theca interna cells of atretic follicles. But the immunoreactive LHRH is not found in the theca interna cells or stromal components of mature follicles, and in the granulosa cells or stromal components of atretic follicles. There may be a possibility that immunoreactive LHRH serves as a paracrine modulator in follicular maturation.
Lung Surfactant Apoprotein and Phosphatidylglycerol in Amniotic Fluid for Prediction of Respiratory Distress Syndrome
Authors: Dhall Kamala , Majumdar Sidhartha , Narang Anil , Rupinder Raj
Published: August 2010

The proteins (Apoproteins) of adult human lung surface active material were separated by Sephadex G‐200 gel chromatography into four components. Fraction IV showed heterogeneity of three different proteins by disc gel electrophoresis and other fractions provided single proteins.

Immunochemical analysis suggested that the protein of fraction II appeared in the lung tissue of neonate and adult whereas the proteins of fraction IV appeared in only adult lung tissue and of fraction I was present in lung tissue of prematue baby, neonate and adult. Since the protein of fraction II appeared in neonatal lung tissue and was the major component of lung surfactant active material, this protein in amniotic fluid was immunoassayed semiquantitatively to predict the fetal lung maturation in normal and abnormal pregnancy. Using a scoring system for the concentration of this protein in amniotic fluid, fetal lung immaturity was predicted in two cases which later on developed respiratory distress syndrome.

The results of lung apoprotein were statistically compared with PG values and L/S ratio carried out in the same amniotic fluid samples.
A Case of Pelvic Arteriovenous Fistula
Authors: Kigawa Junzo , Makio Akira , Torii Yuuichi , Narita Kiyoji , Aoki Satoru
Published: August 2010

Arteriovenous fistulas in the female pelvis are rare, except in intrautenne cirsoid aneurysma. There are only two cases, including this case, of A‐V fistulas which become evident during the postpartum period in the literature. The patient began to experience left abdominal pain in 6th month after childbirth and an A‐V fistula between the left internal iliac artery and vein was detected by arteriography. Ligature of the left internal artery and left paravaginal vein was followed by an uneventful postoperative course.
In vitro Fertilization Applied for Tubal and Non‐Tubal Causes of Infertility
Authors: Yovich John L. , Yovich Jeanne M. , Tuvik Ann I , Junk Stephen , Bootsma Barbara , PhD Phillip L. Matson
Published: August 2010

A combined service and research program of IVF‐ET was established at PIVET Laboratory, Perth, Western Australia in 1981. By May 1985, 592 couples have had a mean of 1.66 treatment cycles with a total of 140 pregnancies achieved (23.7% per couple). The earliest cases were treated for occlusive tubal disease, but increasingly, a wide range of infertility disorders have been managed by IVF‐ET. The pregnancy rate achieved for tubal disease was 23.3%. Rates are significantly lower in women with endometriosis (9.1%; p<0.01) and significantly higher where the woman has no recognizable factor (including those treated for failed artificial insemination by donor semen) and those with circulating antispermatozoal antibodies (up to 47.6%; p<0.001). With regard to male factors, applying the treatment methods described, pregnancy rates did not vary between groups (mean 23.7%) although donor semen was used where an insufficient number of motile spermatozoa was obtained from husband's semen.
Characteristics of Anticellular Activities of Human Recombinant Interferon γ on Gynecological Malignancies: In vitro Sensitivity
Authors: Iwasaka Tsuyoshi , Yoshimura Takahiro , Sugimori Hajime
Published: August 2010

The anticellular activity of recombinant human interferon γ (RelFN‐γ) against cultured human cell lines established from gynecological malignancies was compared with that of natural human fibroblast interferon‐β (IFN‐β) and the in vitro anticellular action of RelFN‐γ was characterized. The anticellular spectrum of ReIFN‐γ' against 8 gynecological cancer cell lines was basically similar to that of IFN‐β, though RelFN‐γ was more effective in inhibiting the growth of these cell lines. It was also revealed that the inhibitory activity against cell growth induced by ReIFN‐γ was relatively long‐lasting and stable, and that RelFN‐γ but not IFN‐β had cytotoxic activity.
Diagnostic Laparoscopy in Gynecologic Disorders
Authors: Chang Yoon Seok , Lee Jin Yong , Moon Shin Yong , Kim Jung Gu
Published: August 2010

A clinical analysis of 3015 consecutive cases of diagnostic laparoscopy performed from June 1974 to May 1985 was done. Infertility was the leading indication (68.1%). The pelvic abnormalities were found in 84.5% of 2053 infertile patients. Tubal occlusion and pelvic adhesion were the most common abnormalities. With regard to the tubal patency, there was agreement between laparoscopic and hysterosalpingographic findings in 77.5% of 1267 infertile patients. In 54.5% of 244 patients with suspected ectopic pregnancy, the diagnosis was confirmed. The error in prelaparoscopic diagnosis of obscure pelvic mass was 31% and unwarranted surgery was avoided in 18.3% following laparoscopy.
Catheterization of Urinary Bladder before Major Gynaecological Surgery
Authors: Malik Lala Rukh
Published: August 2010

Between 1979 and 1983, 1,292 cases who underwent major gynaecological operations in the Department of Obstetrics and Gynaecology, Khyber Hospital, Peshawar, were studied. One group (777 cases) had catheterization of bladder whereas the other group (515 cases) emptied their bladders immediately before anaesthesia and were not catheterized. There was no significant difference in the number of cases of retention of urine and bladder injury between the 2 groups except that in cases of laparotomy there were significantly fewer cases of retention in the non‐catheterized patients (P = 0.05).
Intrauterine Growth Retardation: A Comparative Study of the Perinatal Outcome
Authors: Nagarkatti Rajendra S. , Pandit R. D.
Published: August 2010

A comparative study of the perinatal outcome, in 60 cases of intrauterine growth retardation (I.U.G.R.) which were antenatally monitored through clinical examinations and investigations, as against 60 cases which were not diagnosed and therefore remained unmonitored, was carried out. Besides epidemiological characteristics like age and parity, special attention was paid to antenatal care received by both groups, etiological factors involved, the time and method of diagnosis and the special investigations used. Only 18% in the unmonitored group, as compared to 33% in the monitored group required operative interference during delivery. The incidence of macerated and fresh stillbirths was 4 times more in the unmonitored group. The incidence of neonatal complications and neonatal deaths also showed a threefold increase in the unmonitored group. Only 53% in the unmonitored group as compared to 90% in the monitored group had a successful perinatal outcome, aptly depicting the value of prompt diagnosis and management of I.U.G.R.
Properties of Ectopic Proteins Synthesis in vitro by Human Cervical Carcinoma Cells
Authors: Chao Kuan‐Chong , Ng Heung‐Tat , Chang Chi‐Ching , Hu Cheng‐Po , Chang Chung‐Ming
Published: August 2010

Two ectopic proteins, carcinoembryonic antigen (CEA) and ferritin, were synthesized in the culture media from a newly established cervical cancer cell line as measured by radioimmunoassay. The cervical cancer cell line, designated CC‐7T, produced CEA and ferritin ectopically in vitro in increasing quantities as cultures proceeded. In control studies, cultured fibroblasts did not have this secreting phenomenon. The amount of CEA and ferritin production by CC‐7T cells depended upon the cell density, nutrient availability, and the accumulation of waste products. Our findings indicate that CEA and ferritin were directly secreted by cervical cancer cells from cell line CC‐7T. This cell line should be a useful tool for studies of the mechanism of re‐expression of the oncodevelopmental genes which are responsible for the proteins' production. We also presume that there is a parallelism between the ectopic protein production and the advancement of the tumor process in positive cervical cancer patients making them excellent tumor markers for clinical monitoring of patients.
Unengaged Foetal Head in Pakistani Primigravida: Frequency and Outcome
Authors: Jafarey Sadiqua N.
Published: August 2010

The frequency of engagement of foetal head in the maternal pelvis at 36 weeks of pregnancy (N = 100) and in early labour (N = 246) were studied in Pakistani primigravida.

The head was engaged in 2 (2%) at 36 weeks. In labour only 50 (20.3%) patients had head engaged. There was no difference in the mean age and mean height of the patients with head engaged and those with head unengaged. The duration of labour was significantly higher (p value = 0.02) in the ‘unengaged’ groups and the rate of operative delivery greater. However, 81% of patients with head not engaged delivered vaginally without increased foetal morbidity. The mean birth weights, head circumference and Apgar score were not different.

A plea for conservative attitude in Pakistani primigravida with unengaged head in early labour is made.
Effect of Medroxyprogesterone Acetate on Peritoneal Adhesion
Authors: Nayel Sayed A. , Habashy Moustafa A. El , Banna Nadia E. , Sehrawy Sayed A.
Published: August 2010

Sixteen albino female non‐pregnant rabbits of the blanc du Bouscat strain are the material of this study. Ten animals received a single intramuscular injection of 20 mg medroxyprogesterone acetate (MPA). The other six received placebo (normal saline). Laparatomy was performed to the animals, both horns of each animal were transected, then repaired by end to end anastomosis 2 weeks later, the animals reexplored and the adhesion formation assessed. It was found that MPA significantly reduced adhesion formation in the treated animals.
Nasal Administration of Prostaglandins for Uterine Stimulation and Induction of Labour
Authors: Toppozada Mokhtar K. , Shaala Said A. , Ismail Ahmed A. A. , Osman Mohamed M. , Ziedan Kamel M. , Hammouda Ahmed A. , Anwar Medhat M.
Published: August 2010

Fifty pregnant women were included in the present work in 3 groups. Group I comprised 24 women with intrauterine fetal death with the objective of screening the effect of various doses of 3 prostaglandins (PGs, E2, F2α and Sulprostone®) administered intranasally with simultaneous recording of uterine activity by intrauterine microballoon. A dose response correlation regarding uterine stimulation was recorded for PGE2 and Sulprostone® but the former induced marked nasal irritation. Group II included 16 normal near term pregnant cases who were given nasal Sulprostone® drops to detect the optimal safe dosage regimen as judged by cardiotocographic recordings. The results indicated that 250–500 μg can be safely given in repeated doses for uterine stimulation. In Group III, 10 primigravidae received intranasal drops of Sulprostone® with an initial dose of 250 μ to induce labour for valid medical indications. Uterine activity and Bishop score increased significantly and labour was successfully induced in 9 cases. No maternal or fetal distress was recorded. This mode of Sulprostone® delivery in relatively low doses appears to have desirable advantages and minimal risks.
The Clinical Usefulness of Umbilical Artery Velocity Waveforms for Early Detection of Intrauterine Growth Retardation
Authors: Sakoda Yoshio , Ito Masaharu , Yunohara Takeo , Aiko Akira , Fujisaki Shunichi , Okamura Hitoshi
Published: August 2010

Umbilical artery velocity waveforms, biparietal diameter (BPD), and abdominal circumference (AC) were examined in 20 pregnant women shown to be carrying infants small for their gestational age (SGA) and in 112 normal pregnant women who were delivered of infants with size and weight appropriate for their gestational age (AGA). The diagnoses of SGA and AGA were confirmed retrospectively. A combination of real‐time scanning and pulsed Doppler was used to obtain blood waveforms from the umbilical arteries. The systolic peak of the velocity wave was divided by the end diastolic value, thereby giving an S/D ratio. The S/D ratio in SGA fetuses was significantly higher than that of AGA fetuses when measured between 21 and 40 weeks gestation. The significant changes of biparietal diameter and abdominal circumference in SGA fetuses was detectable between 33 and 40 weeks gestation. The umbilical artery S/D ratio may be more useful as a parameter for early detection of intrauterine growth retardation (IUGR) than BPD and AC.
Maturity and in vitro Fertilization of Superovulated Human Oocytes in Relation to Various Hormone Levels in Follicular Fluids
Authors: Chang Yoon Seok , Lee Jin Yong , Moon Shin Yong , Kim Jung Gu , Yoon Bo Hyun
Published: August 2010

Follicular fluid (FF) prolactin (PRL), follicle stimulating hormone (FSH), estradiol (E2), progesterone (P), androstenedione (ADD) and testosterone (T) levels were compared in 3 groups of spontaneously ovulatory women undergoing ovulation induction with clomiphene citrate (CC) alone or with human menopausal gonadotropin (hMG) (15 patients), hMG (8 patients), or pure FSH/hMG (9 patients) for the purpose of in vitro fertilization. FF hormone levels measured did not differ significantly according to the maturity of the oocyte. FF FSH and T levels for all three groups were similar, but the PRL concentrations were significantly lower in the CC‐treated group than in the other groups. E2 was highest in FF from CC‐treated group compared to the hMG‐treated or FSH‐treated group. FF P values were highest in CC‐treated group. And hMG‐stimulated follicles contained significantly lower ADD than did the other groups. However, in all treatment groups, FF levels of various hormone measured did not show any close relationship with fertilization and the success of pregnancy after embryo transfer.

In conclusion, follicular development and steroidogenesis differs markedly depending on the agent used for follicular stimulation. But these alterations may not impair oocyte development, successful fertilization and implantation.
Primary Choriocarcinoma in the Uterine Cervix: Report of 4 Cases
Authors: Tsai Yat‐San , Su Shi‐Chiy , Wang Tai‐Te , Hsu Chien‐Tien , Lin Yun‐Nan
Published: August 2010

In our department, 4 cases of choriocarcinoma were considered as primarily developed in the uterine cervix, because of the absence of such lesion in other parts of the genital organ. In one case this developed in the left‐over cervix 2 years after subtotal hysterectomy for hydatidiform mole. In the other cases no definite immediately preceding pregnancy of any type could be traced, and primary ectopic choriocarcinoma developing in the cervix seems most likely. The 2 cases occurring before the advent of chemotherapy died, but the 2 cases occurring after the advent of chemotherapy have survived. It is very interesting to note that in the case occurring at the initial stage of the development of chemotherapy, oral MTX intake alone has successfully resulted in a survival of 31 years even in association with lung and brain metastasis, although the latter is based only on symptomatology. In the literature, no more than 70 cases of choriocarcinoma in the world have primarily arisen in the uterine cervix, and most of these have been reported in Japan. The present 4 cases are considered the first observed in Taiwan, ROC.
Induction of Cervical Intraepithelial Neoplasia in BALB/c Mice by UV‐Inactivated Herpes Simplex Virus Type 2
Authors: Hayashi Yoshinobu , Okabe Nobuo , Mori Ryoichi , Kaku Tsunehisa , Mohri Shirou , Iwasaka Tsuyoshi , Sugimori Hajime
Published: August 2010

The present study was undertaken to investigate the oncogenic potential of herpes simplex virus type 2 (HSV‐2) in the mouse cervix and the effect of tetradecanoyl‐phorbol‐acetate (TPA) on the development of HSV‐2‐induced cervical lesion. Cotton tampons saturated with ultraviolet‐inactivated HSV‐2 were inserted into the vaginas of BALB/c mice twice a week. Histological examination performed at the 48th week revealed cervical intraepithelial neoplasia in a HSV‐2‐exposed mouse and a HSV‐2 plus TPA‐exposed mouse but not in control mice. Although premalignant lesions were induced in the mouse uterine cervices by HSV‐2, there was no evidence of malignancy. These results suggest that HSV‐2 functions as an initiator in the multistep process of cervical carcinogenesis.
The Role of Human Neutrophil Elastase in the Premature Rupture of Membranes
Authors: Kanayama Naohiro , Terao Toshihiko , Horiuchi Kentarou
Published: August 2010

Studies were made as to whether or not human neutrophil elastase is involved in the pathogenesis of some cases of premature rupture of the membranes. Only the disrupted areas of membranes of prematurely ruptured amnions stained with antibodies against human neutrophil elastase. Moreover, the epithelial cells of amnions without premature rupture of the membranes stained strongly with antibodies against α1‐antitrypsin, whereas those of amnions with premature rupture of the membranes stained only weakly. Purified human neutrophil elastase degraded only type III collagen of normal amniotic collagens. These findings suggest that one cause of premature rupture of the amnion membranes is degradation of type III collagen by human neutrophil elastase. The mechanism of premature rupture of the membranes may be similar to that of pulmonary emphysema induced by α1‐antitrypsin deficiency.
Eight Years Experience with Rh Negative Isoimmunised Mothers in a Special Rhesus Clinic
Authors: Gupta I. , Narang A. , Bhakoo O. N. , Jolly J. G. , Dass S. K.
Published: August 2010

In special Rh clinic, data regarding 193 immunised cases over a period of 8 years is analysed. The incidence of Rh negative population was 10% and 13% of Rh negative cases were immunised. Spectrophotometric analysis was used as the mainstay for the management of immunised pregnancies. The corrected perinatal mortality was 16.2% and 27.0% in booked and unbooked cases respectively. Intrauterine transfusion was attempted in 2 cases but babies could not be salvaged. Mismatched transfusion was responsible for immunised state in 9.0% of women.
Colposuspension in Treatment of Genuine Stress Incontinence
Authors: Rizvi Javed H. , Awad Mohammad E. L. , Stobbart David
Published: August 2010

Colposuspension is a popular operation for treatment of genuine stress incontinence (urethral sphincter incompetence). In this study our experience with the use of this operation is described. Sixty‐two patients were selected for colposuspension on the basis of history, clinical findings and urodynamic studies.

The results of this operation were evaluated in the immediate post‐operative period and 6 weeks after surgery. Long term evaluation included urodynamic studies 3–6 months after operation and then yearly follow up for 3 years. The overall cure rate was 88.7%. Twenty patients had previous surgery for incontinence, in this group the cure rate was 80%.

Twenty percent of patients were able to void urine spontaneously on the 4th day. However, 90% of patients were passing urine normally by the 10th post‐operative day. Three percent of patients had long term voiding difficulties with poor flow rates and residual urine of over 100 ml. A similar percentage (3.2%) had developed detrusor instability secondary to the operation. Long term follow up showed that the incidence of development of high rectocele, enterocele and uterine prolapse was 5%.

We confirm that, colposuspension is an effective operation for treatment of genuine stress incontinence; the success rates are high but the selection of patients is critical. They have to be selected carefully in order to avoid immediate complications of retention of urine and late complications of voiding difficulty and appearance of enterocele, high rectocele and uterine prolapse.
Bleomycin, Cisplatin and Etoposide Combination Therapy (BCE) in Drug‐Resistant Gestational Choriocarcinoma
Authors: Yamamoto Takara , Sawada Shigenari , Urabe Mamoru , Tamura Naoya , Suzuki Hidefumi , Iwasaku Kazuhiro , Sasaki Junichi , Naitoh Kazuo , Fukuoka Masaaki , Okada Hiroji
Published: August 2010

A combination of bleomycin, cisplatin and etoposide as a second line chemotherapy was used for 3 cases of drug‐resistant gestational choriocarcinoma. A drop in hCG levels and tumor reduction were confirmed in all cases. One case, however, contracted severe pneumonia despite frequent monitoring of the pulmonary function.
Differences in the Mechanisms of Production and Release of SCC‐Ag and CEA from an Established Uterine Cervical Carcinoma Cell Line (AMCC‐1)
Authors: Yabushita Hiromitsu , Nakagawa Yoshiaki , Sawaguchi Keizo , Noguchi Masayoshi , Ishihara Minoru
Published: August 2010

A 2‐color flow cytometric study indicated a distinct correlation between the SCC‐Ag content and the DNA content of cells, whereas the intracellular CEA content had no relation to the DNA content. Exposure to 1 μg/ml of bleomycin induced the release of SCC‐Ag from AMCC‐1 cells into the culture medium, in proportion to the increase in the cell population with a tetraploid complement of DNA. However, it did not induce the release of CEA from AMCC‐1 cells into the culture medium. After exposure of AMCC‐1 cells to 50 μg/ml of bleomycin, the concentration of both SCC‐Ag and CEA in the culture medium increased markedly. From these findings it was suggested that the production and release of SCC‐Ag are induced by the G2 blockade of AMCC‐1 cells caused by exposure to a low dose of bleomycin, and that the release of CEA from AMCC‐1 cells is induced only by the lysis caused by exposure to concentrated bleomycin.
The Treatment of Eclampsia by Early Interruption of Pregnancy: A 15‐Year Review
Authors: Ji‐qing Luan
Published: August 2010

This study is a result of treatment obtained from 106 patients who had eclampsia over a 15‐year period from January 1973 to December 1987. All patients were treated for eclampsia by delivering infants as early as possible, either transvaginally or by cesarean section. By use of this method, as opposed to the administration of magnesium sulfate, the outcome for both mothers and newborns was acceptable. Of the 106 cases, cesarean sections were performed on 59 cases with antenatal eclampsia. There was no maternal death, while the perinatal mortality rate of infants was 2.78%. This study is a profile of cases where early delivery was chosen as a means of treatment for eclampsia.
Asymptomatic Salpingitis in Intrauterine Contraceptive Device Users
Authors: Ghosh Kusagradhi , Gupta Indu , Gupta Subhas Kumari
Published: August 2010

Serial histological sections of the fallopian tubes of 50 asymptomatic subjects undergoing voluntary tubal ligation were evaluated for morphological evidence of inflammation. Twenty‐five subjects had history of IUD use (the study group) and the rest 25 had never used a device (the control group). Evidence of inflammation was found in 11 out of 25 subjects in the IUD users compared to only 2 out of 25 subjects in the non‐users (p<0.001). The relative risk was 5.5 times. Both acute and chronic inflammation of the oviducts were observed more often in the IUD users, though clinically and at surgery there was no apparent evidence of pelvic inflammatory disease.
The Inhibitory Effect of Synthetic Steroids on Proestrous Gonadotropin Release in theRat
Authors: Ohkawa Tomi , Awata Shoichiro , Arakawa Satoko , Kambegawa Akira , Okinaga Shoichi , Arai Kiyoshi
Published: August 2010

This study was performed to evaluate the inhibitory effect of synthetic steroids on the hypothalamo‐pituitary axis. Six synthetic steroids, used for contraception or other gynecologic indications, were injected to female rats on diestrus 2 (2 mg/kg, sc), and the animals were sacrificed in the afternoon of proestrus. Serum levels of LH, FSH and progesterone, the pituitary contents of LH and FSH, and LH‐RH in the median eminence were measured by radioimmunoassays. Among the synthetic steroids tested in this study, norethisterone, d‐norgestrel, 3‐keto‐desogestrel and gestrinone completely blocked the gonadotropin surge on proestrus, showing stronger antigonado‐tropic activity than progesterone. Desogestrel did not affect proestrous gonadotropin release at this dose. The suppressive effect of danazol could be seen only in a larger dose (20 mg/kg). These findings reconfirmed previously reported results, which demonstrated that the hypothalamo‐pituitary complex was a major site of action of these steroids.
Analgesia and Anesthesia during Labor in Japan and Developed Countries
Authors: Arai Masao , Nishijiam Masahiro , Tatsumi Hideki
Published: August 2010

Analgesia and anesthesia during labor were surveyed by the use of a questionnaire sent to university hospitals in USA, UK, France, FRG, GDR, Japan, and also other types of institutions in Japan.

A rather negative attitude toward analgesia and anesthesia during labor was encountered less often in Japan than in USA, UK, and FRG, but the actual frequency of use was much less in Japan.

Narcotics and/or tranquilizers were most frequently used in the first stage of labor. The only exception was France where lumbar epidural anesthesia was actually used as a method of choice at 70% of the institutions.

Lumbar epidural anesthesia or some other regional block was the method of choice in the second stage except in UK where inhalation of nitrous oxide was the method of choice at 48% of the institutions.

Augmentation of labor was much more frequent and the number of annual deliveries were much less in Japan. Higher c‐section rate was seen in USA.
Clinical Significance of a Solid‐Phase Immunoradiometrical Assay for Sialyl SSEA‐1 Antigen in Obstetrics and Gynecology
Authors: Ota Yoriko , Inaba Noriyuki , Shirotake Shoichi , Fukazawa Ichio , Okajima Yuko , Takamizawa Hiroyoshi
Published: August 2010

The clinical usefulness of sialyl SSEA‐1 antigen was evaluated in obstetrics and gynecology. Serum levels of sialyl SSEA‐1 were measured in patients with benign or malignant gynecologic diseases, and in normal pregnant women. Moreover, in 10 cases of full term delivery, samples of maternal sera immediately prior to delivery, soon after delivery and 5‐day‐puerperium, cord sera from the umbilical artery and vein, and amniotic fluid were taken to measure its concentration. During the course of pregnancy, serum SSEA‐1 levels were within the normal range (below 38 U/ml), showing no significant correlation with gestational weeks. Of patients with gynecologic diseases, those with malignant ovarian neoplasms, uterine cervical carcinoma and benign ovarian neoplasms exhibited elevated (over 38 U/ml) levels in 26%, 15% and 6% of all cases, respectively. In cases of full term delivery, the concentrations of sialyl SSEA‐1 in the maternal and cord sera were within the normal range. Concentrations were extremely high, however, in the amniotic fluid.
Breast Feeding Practices and Maternal Employment
Authors: Monga Deepika , Rai Uma , Kumari Sudarshan
Published: August 2010

Little information exists about the relationship between maternal employment and breast feeding practices and knowledge about lactation. The study was conducted on 318 employed and 299 non‐employed women prospectively.

Lactational practices were significantly influenced by employment status, with 81.9% non‐employed vs. only 49.7% employed going in for exclusive breast feeds in the first 3 months (p<.001). Correspondingly, 46.8% employed women started combined breast and bottle feeds from birth (p<.001). Within the employed group, parity and social class did not significantly alter the infant feeding practices.

Employed women were better informed about feeding and weaning as compared to their non‐employed counterparts (36.8% vs. 18.4% p<.001). Women from higher social class also tended to be more aware (59.8% vs. 7.2%: p<.001). Multiparas had an edge over primiparas with respect to knowledge about lactation (36.1% vs. 20.1% p<.01).
Estrogen Producing Activity in Epithelial Ovarian Tumors and Dermoid Cysts
Authors: Sekiguchi Isao , Suzuki Mitsuaki , Tamada Taro
Published: August 2010

In 28 cases of postmenopausal women with non‐functioning ovarian tumors, the estradiol (E2) level was assayed in peripheral plasma and tumor tissue extract. E2 precursors were also assayed in the tissue extract, and localization of 3β‐hydroxysteroid dehydrogenase (3β‐HSD) in the tissue was investigated. The plasma E2 levels were 153.8±205.9 pg/ml in 15 benign tumor cases, 244.3±336.5 pg/ml in 13 malignant tumor cases, and both of which were significantly higher than 12.3±3.6 pg/ml in normal postmenopausal women (p<0.01). The postoperative plasma E2 level (33.3± 32.7 pg/ml) was significantly lower than the preoperative one (228.3±319.0 pg/ml). Twelve of 19 cases (68.2%) showed a postoperative decline in the E2 level to less than a half of the preoperative level. E2 and its precursors were found in tumor tissue. These findings demonstrate that E2 is produced by the tumor tissue itself. In addition, 3β‐HSD activity was localized in the stroma of ovarian tumors, indicating that E2 synthesis is mainly carried out in stromal cells rather than in epithelial cells.
The Development of Sleep‐Wakefulness Cycle and Its Correlation to Other Behavior in the Human Fetus
Authors: Shinozuka Norio , Okai Takashi , Kuwabara Yoshinori , Mizuno Masahiko
Published: August 2010

Fetal rapid eye movements (REM), breathing movements (BM), and trunk movements (TM) were observed through the use of 3 ultrasonic real‐time scanners. Each movement was recorded with the event marker and quantitatively analyzed in relation to the development of the sleep‐wakefulness cycle by a computer‐assisted system. The results were as follows: The number of REM increased with gestational age. The appearance rate of REM reached a certain level after 32 weeks of gestation. REM— non‐REM rhythm was distinguished after 32 weeks. The relationship between REM and BM increased with gestational age. The occurrence of each TM has no correlation to that of REM when it was analyzed in short‐term units, but the incidence of TM was high in REM periods. These results demonstrate the course of the development of sleep‐wakefulness cycle in human fetuses.
Prospective Study on Premature Labor with Magnesium Sulfate
Authors: Jirapinyo Mayuree , Thuvasethakul Pichai , Leelaphiwat Supatra
Published: August 2010

The efficacy of magnesium sulfate was evaluated as the primary tocolytic agent in the management of patients at risk for premature delivery. Fifteen patients presenting with premature labor between 28 and 35 weeks gestation, given titrated dose intravenously magnesium sulfate till uterine contraction ceased, were prospectively studied. All patients received an additional oral β‐mimetic agent once labor was arrested till 36 weeks gestation. All cases had intact membranes and no contraindications for tocolytic therapy. Tocolysis for more than 72 hours was achieved in 14 cases (93.3%). Delayed tocolysis of more than 7 days was achieved in 13 cases (86.7%). The mean dosage to achieve tocolytic effect was 3.17 g/hr (SD 0.08). The mean serum magnesium level to achieve such effect was 5.38 mg/dl (SD 0.88). Magnesium sulfate was found to be easy to administer and clinically efficacious with minimal adverse effects. It may be used as the first line of tocolytic therapy where β‐sympathomimetic drugs are contraindicated.
Pregnancy Suppression by a Platelet Activating Factor Antagonist, ONO‐6240, in Mice
Authors: Ando Masaaki , Suginami Hiroshi , Matsuura Shumpei
Published: August 2010

Mouse embryos produce an embryo‐derived platelet activating factor (EDPAF) during their early developmental stages. The present study was aimed at investigating the physiological significance of EDPAF by using a specific PAF antagonist, ONO‐6240. EDPAF‐induced platelet decrease was antagonized by ONO‐6240 in a dose‐dependent manner, although this alone did not affect circulating platelet concentrations. ONO‐6240, when administered to maternal mice, increased the proportion of mice conceiving small litter sizes, whereas it did not affect in vivo or in vitro development of embryos. EDPAF was suggested to play an important role in establishing pregnancy in mice by promoting implantation.
A Fetal Case with Midgut Volvulus*
Authors: Suzumori Kaoru , Adachi Ritsuko , Yagami Yoshiaki , Togari Hajime
Published: August 2010

A fetus with midgut volvulus is described. The mother had developed polyhydramnios, and the fetus was found by sonography to have dilated fluid‐filled structures compressing the chest in the upper abdomen. Percutaneous aspiration of the upper abdominal mass was performed to identify the content and know whether decompressing the chest would be beneficial. The removal of meconium‐stained fluid accomplished an improvement of the fetal biophysical profile. The infant was delivered by low transverse cesarean section, and survived with immediate removal of the fluid in the abdominal mass and ventilatory therapy.
A Comparison of Vaginal Ultrasonic‐Guided and Laparoscopic Retrieval of Oocytes for in vitro Fertilization
Authors: Kovacs G. T. , King C. , Cameron I. , Cushnahan L. , Wood E. C. , Leeton J. F. , Renou P. , Shekleton P. , Lenz S. , Baker G.
Published: August 2010

A retrospective analysis was undertaken to compare the less invasive technique of vaginal ultrasonic‐guided oocyte retrieval with the standard laparoscopic technique. We have shown that the outcome of the transvaginal technique with respect to oocytes harvested, fertilization rate, and pregnancy rate is comparable with the laparoscopy technique. We have also shown that 9 clinicians with little previous expertise in ultrasound have been able to incorporate this technique into a busy and successful in vitro fertilization unit.
Plasma Catecholamine Metabolites and Polycystic Ovary Syndrome
Authors: Yoshino Kazuo , Takahashi Kentaro , Nishigaki Arata , Eda Yoshimi , Kitao Manabu
Published: August 2010

It has been postulated that catecholamine metabolism may be altered in cases of polycystic ovary syndrome. To search for possible correlations between catecholamine metabolism and hormonal disturbances, we have studied the serum LH, LH:FSH ratio, testosterone, and plasma catecholamine metabolites in patients with polycystic ovary syndrome and in control subjects with normal ovulatory cycles. The metabolites studied were 3‐methoxy‐4‐hydroxyphenylglycol (MHPG) and 3,4‐dihydroxyphenyl‐acetic acid (DOPAC) as markers of adrenergic activity and dopaminergic activity, respectively. The polycystic ovary was divided into 2 patterns [general cystic pattern (GCP) and peripheral cystic pattern (PCP}] as determined by ultrasound. The results were as follows: 1) Serum LH, LH:FSH ratios, and plasma MHPG levels in patients with polycystic ovary syndrome were significantly higher than in the controls. 2) In cases of polycystic ovary syndrome, serum LH, LH:FSH ratios, and testosterone showed no significant correlations with catecholamine metabolites. 3) Using the ultrasonographical classification, we found that plasma MHPG levels of the GCP group were significantly higher compared with the PCP group in patients with polycystic ovary syndrome. Thus, catecholamine metabolism is altered in patients with polycystic ovary syndrome, and ultrasonography revealed different patterns of catecholamine metabolism.
Chromosomal Studies on 934 Induced Abortuses of Middle‐Aged Pregnant Women
Authors: Hoshi Nobuhiko , Yamagami Yukiko , Hanatani Kaoru , Tanaka Toshinobu , Fujimoto Seiichiro
Published: August 2010

A total of 934 induced abortuses of middle‐aged pregnant women (35–48 years old) were chromosomally surveyed. The mean gestational age was 7.6±2.0 (S.D.) weeks after the first day of the last menstrual period, and the mean maternal age was 39.6±2.7 (S.D.) years. There was a high incidence of chromosomally abnormal fetuses in induced abortions, which markedly increased with the advancing age of the women: 9.6% (40/418) for the 35–39‐year‐old age group, 20.7% (100/484) for the 40–44‐year‐old age group, and 43.8% (14/32) for the 45–48‐year‐old age group, averaging 16.5%.
Flow Cytometric DNA Analysis with Use of Normal Lymph Node Cells as an Internal Reference Standard in Ovarian Cancer
Authors: Takahashi Yoshiki , Chiba Takashi , Matsumoto Hisanori , Ishiguro Tatsuya , Yoshida Yoshinobu
Published: August 2010

Fresh frozen and paraffin‐embedded tumor specimens of 21 patients with ovarian cancer were investigated by means of flow cytometry. In 4 patients, the fresh frozen tumor specimens (fresh tumor specimens) of ovarian tumors were measured for the DNA ploidy and index. We used the paraffin‐embedded normal lymph node tissue specimens which were acquired from retroperitoneal lymphadenectomy as the internal reference standard (IS). In all 21 patients, the paraffin‐embedded tumor specimens mixed with a lymph node specimen as an IS (tumor specimen with IS) were measured. In addition, all 21 paraffin‐embedded tumor specimens without a lymph node tissue specimen (tumor specimens without IS) were measured. In 4 cases which were measured with the fresh tumor specimens, all 4 tumor specimens with IS had the same patterns of DNA ploidy as the fresh tumor specimens. Of 21 patients, 6 patients showed different DNA ploidy patterns between the tumor specimens with and without IS. Furthermore, all of these 6 patients showed diploidy in the tumor specimens without IS while showing aneuploidy in the tumor specimens with IS. Fourteen (66.7%) of 21 tumor specimens with IS were aneuploidy despite aneuploidy of only 8 (38.1%) tumor specimens without IS. All 4 patients with stage I had diploidy in the tumor specimens with IS, and 13 (81.3%) of 16 patients with stage III or IV had aneuploidy. All 8 patients with diploidy in the tumor specimens with IS had survived for 1–2 years. It is possible that the new method of the use of paraffin‐embedded normal lymph node tissue specimens as an internal reference standard accurately shows DNA aneuploidy, as well as being reliable as a predictor for the short term prognosis of patients with ovarian cancer.
Acardius Anceps: Report of 3 Cases
Authors: Ko Tsang‐Ming , Tzeng Shiang‐Jong , Hsieh Fou‐Jou , Chu Jan‐Show
Published: August 2010

Acardius anceps is an uncommon but serious consequence of multiple pregnancy, usually in monozygotic twins. There are great variations in gross appearance and pathologic features. Recently we have encountered 3 cases of acardius anceps in 3 sets of twin pregnancy. The subcutaneous edema was so extensive and severe that no facial structures could be recognized; however, the skull bones could be detected by prenatal ultrasound examination and confirmed by postnatal radiography. The hearts were all severely malformed and many of the visceral organs were also defective. Prenatal blood gas analysis in 2 affected fetuses showed severe hypoxemia. All 3 pregnancies were terminated before the normal co‐twin reached viability. One set of the twins was delivered by hysterotomy because of the potential dystocia caused by bulky fetal mass due to severe hydropic change. Prenatal ultrasound examination is a very useful tool in the diagnosis and management of this anomaly.
A Study of Adult T‐Cell Leukemia Virus (ATLV) Infection in the Field of Obstetrics: Its Epidemiology, Vertical Transmission and Familial Clustering
Authors: Matsumoto Reiko , Inaba Noriyuki , Shimizu Hiroshi , Yamaguchi Harumi , Cho Syuwa , Takamizawa Hiroyoshi
Published: August 2010

Nine hundred and seventy‐one healthy individuals in Iwate Prefecture, 659 pregnant women in Ishigaki Island, 487 pregnant women in Chiba Prefecture and 108 familial members of the ATLA‐Ab‐positive pregnant women (pregnant carrier women) were tested for ATLA‐Ab by the PA, EIA and WB tests. 1) The rate of agreement of EIA with the PA test was 88.4% and there were no false negative sera by both examinations. These results indicate the both tests are available for mass screening. 2) In Iwate and Chiba Prefectures, the ATLA‐Ab‐positive rates of pregnant women were 5.3 and 0.6%, respectively. In addition, the incidences for healthy individuals ranged from 5.3 to 21.1% by age in Iwate Prefecture. Thus, Iwate Prefecture was found to equal Ishigaki Island (7.1%) in ATLA‐Ab detection rates. 3) Forty‐five (41.7%) out of 108 familial members of 15 pregnant carrier women were found to be seropositive for ATLA‐Ab, which confirms a certain familial clustering of ATLV.