bluuebunny/crossref_metadata_2025 huggingface dataset:
On the use of Plasma Proteins as Indicators of the Metabolic Effects of Combined Oral Contraceptives
Authors: Cullberg Göran , Dovré Per‐Arne , Lindstedt Göran , Steffensen Kjeld
Published: December 2009

Abstract. Ethinylestradiol (EE, 17α‐ethynyl‐1,3,5(10)‐es‐tratriene‐3,17β‐diol) 30 μg daily, in combination with 150μg per day of desogestrel (Org 2969,17α‐ethynyl‐18‐methyl‐11‐methylene‐4‐estrene‐17β‐ol) or levonorgestrel (17α‐ethynyl‐18‐methyl‐4‐estrene‐17β‐ol‐3‐one), was administered to two groups of 10 healthy human women who had been without hormonal treatment during 3 months prior to the study. The preparations were given for three 21‐day cycles with 7‐day intervals. Blood samples were taken before treatment and at the end of the third treatment period. Serum sex‐hormone binding globulin (SHBG), ceruloplasmin, ornsomucoid, C1‐esterase inhibitor and C4 were analyzed by electroimmunoassay and transcortin was assayed as cortisol‐binding capacity. Serum testosterone was assayed by radioimmunoassay of methylenedichloride extracts using an antiserum with about 20% cross‐reactivity for dihydrotestosterone (DHT).

The increases in serum ceruloplasmin and transcortin concentrations were the same in both groups (about 80% and 100‐140%, respectively), whereas no significant change was noted for the orosomucoid, C1‐esterase inhibitor or C4 concentrations. The SHBG concentration, however, increased by about 220% when EE + desogestrel was used, whereas with EE + levonorgestrel there was no significant change. For both groups there was a significant correlation between post‐ and pretreatment SHBG concentrations. The results indicate that individuals with low SHBG concentrations are at risk of developing a further reduction as a result of EE+levonorgestrel administration at the dosages used.

Serum testosterone (+DHT) decreased in all women but one in each group. A decrease in testosterone/SHBG ratio was observed in both groups; the decrease was most pronounced in the EE + desogestrel group. One woman in the EE+levonorgestrel group, the only individual who exhibited signs of androgenic side effects, had low values for SHBG concentration and high for the testosterone/SHBG ratio. She was then treated with 25 μg EE and 125 μg desogestrel daily for three cycles, resulting in a threefold increase in SHBG concentration, normalization of the testosterone/SHBG ratio and disappearance of androgenic side effects.

The results are discussed in relation to published information on the influence of hormones on plasma protein homeostasis.
Study on Effect of 30 μg Ethinylestradiol (Ee)+150 μg Desogestrel on Lipid and Lipoprotein Metabolism in Healthy Volunteers, Also in Comparison with 30 μg Ee + 150 μg Levonorgestrel
Authors: Samsioe Göran
Published: December 2009

Abstract. In a cross‐over design study, 15 healthy young volunteers were randomly allocated an oral contraceptive containing 30 μg EE. Preparation A contained in addition 150 μg of a new progestogenic compound, desogestrel, and preparation B 150 μg levonorgestrel. Subjective side effects were few during use of any of the preparations.

Preparations A and B induced similar changes in most of the serum lipid and lipoprotein‐lipid parameters. Body weight, triglycerides, VLDL‐triglycerides and LDL‐free cholesterol, total cholesterol and triglycerides were significantly lower and HDL‐total cholesterol and triglycerides significantly higher with preparation A than preparation B.

The relative fatty acid composition of lecithin revealed with preparation B (as compared with preparation A), higher levels of palmitic and linoleic acids which could be interpreted as an enhancement of pathway I for liver lecithin synthesis which in turn is usually coupled to a reduced capacity of liver excretory function.

The present data regarding preparation B are in agreement with those reported by others, while preparation A has not been studied before. The differences observed between preparation A and B are ascribed to the more marked androgen‐like effects of preparation B.
Two Cases of Goblet Cell Carcinoid Tumor of the Appendix with Bilateral Ovarian Metastases
Authors: Heisterberg Lars , Wåhlin Anne , Nielsen Kim S.
Published: December 2009

Abstract. Two cases of a primary goblet cell carcinoid tumor of the appendix with bilateral ovarian metastases are reported. These tumors are extremely rare, but may be found when the appendix is removed in cases of metastatic ovarian tumor with uncertain primary origin.
Hydrops Fetalis Caused by Maternal Indomethacin Treatment
Authors: Mogilner B. M. , Ashkenazy M. , Borenstein R. , Lancet M.
Published: December 2009

Abstract. Hydrops fetalis was diagnosed in one of two twins, while the other suffered from cardiac failure. Indomethacin, administered to the mother to arrest premature labor, seemed to be the predisposing factor resulting in the hydrops fetalis. The possible relationship between intrauterine closure of the ductus arteriosus and the pathogenesis of hydrops fetalis is discussed.
Metronidazole Prophylaxis in Abdominal Hysterectomy
Authors: Manthorpe T. , Justesen T.
Published: December 2009

Abstract. The use of prophylactic metronidazole in elective total abdominal hysterectomy was evaluated in a prospective, double‐blind randomized study. The rate of complicated wound healing was 18% in the metronidazole group and 13% in the placebo group. The bacteriologically confirmed wound infection rate was 3.9% in both the metronidazole and the placebo group. Only one of the infections was anaerobic and it appeared in the placebo group. No pelvic infections were observed in either of the groups and hospital stay was the same in both. Peroperative investigations of the vaginal flora showed significantly fewer anaerobic strains in the metronidazole group than in the placebo group.
Antibiotic Levels in Plasma and Peritoneal Fluid after Amoxycillin, Ampicillin, and Bacampicillin Treatment for Pelvic Inflammatory Disease
Authors: Onsrud Mathias , Bergan Tom , Gjønnæss Halvard
Published: December 2009

Abstract. Fifteen patients with pelvic inflammatory disease had a thin polyethylene catheter inserted through the abdominal wall into the pouch of Douglas for sampling of peritoneal fluid. At hourly intervals peritoneal fluid and capillary blood were collected. Five patients each received a single oral dose of either 0.5 g of ampicillin or amoxycillin, or 0.8 g of bacampicillin (approximately equimolar doses). The highest median peak plasma level was observed after bacampicillin. Bacampicillin also showed less variation in individual plasma concentration. The area below the plasma curve was similar for amoxycillin and bacampicillin, whereas that of ampicillin was significantly smaller (p<0.01). The rate of penetration into peritoneal fluid was slower for amoxycillin than for bacampicillin, even though the area below the peritoneal fluid curve was similar for the two drugs. Therapeutic levels were maintained for 5–8 hours, longer after amoxycillin than after bacampicillin.
Extragenital Endometrioid Cystadenofibroma
Authors: Ortega I. , Nogales F. , Gonzalez‐Campora R. , Matilla A. , Galera H.
Published: December 2009

Abstract. We present a case of extragenital endometrioid cystadenofibroma, whose rare pelvic localization is the motive for its publication, as no similar case has been described previously. Its possible histogenesis from a pelvic mesothelium, as well as the differential diagnosis from pelvic endometriosis is discussed.
Effect of Oral Medroxyprogesterone Acetate on Menopausal Symptoms in Patients with Endometrial Carcinoma
Authors: Aslaksen K. , Frankendal B.
Published: December 2009

Abstract. A double‐blind cross‐over study was performed on 21 patients treated for endometrial carcinomas who had severe menopausal symptoms. The patients were randomized into two groups and received medroxyprogesterone acetate (MPA) 100 mg twice daily per os for 12 weeks and a placebo for 12 weeks. A significantly better effect on hot flushes and sweating was obtained with MPA than with the placebo. On average the maximum effect was achieved by MPA after 4—6 weeks. Six patients had a weight gain of more than 3 kg during the MPA administration, compared with none during the placebo administration. No significant difference was found in the blood pressure increase above 160/90 mmHg between MPA and placebo groups. Patients with endometrial carcinoma may risk exacerbation of their disease by undergoing therapy with exogenous estrogen. In contrast, MPA has been found of value in the treatment of disseminated endometrial carcinomas. In this study oral MPA was effective in the treatment of vasomotor menopausal symptoms and may be an alternative in women for whom estrogens might be hazardous.
Interactions Between Psychosomatic Conflicts and Gonadotropin Secretion
Authors: Peters F. , Richter D. , Breckwoldt M.
Published: December 2009

Abstract. This present paper represents an attempt to correlate hormonal patterns and psychoanalytical data in 30 patients with secondary amenorrhea. Based on psychoanalytical data and the maximal LH response to GnRH, which were obtained independently, the patients were divided into two groups presenting differing psychosomatic symptomatologies. Patients with severe psychosomatic disease (group A) complaining predominantly of somatic discomfort, exhibited a weak pituitary response to GnRH. Patients presenting mainly mental symptoms were found to be less affected by the psychosomatic disease (group B). The LH responses to GnRH were only moderately impaired in these patients. Seven patients of group A underwent psychotherapy, resulting in a resumption of regular menses in 4 patients. Eight untreated controls of this group who remained amenorrheic exhibited unaltered gonadotropin in levels. All patients of group B being treated by psychotherapy resumed regular menses, while 5 of 7 control patients developed spontaneous menstruation. The progress of sexual maturation in these patients is correlated with increasing pituitary LH response to GnRH. The present study provides evidence that the degree of a psychosomatic disturbance resulting in secondary amenorrhea is reflected by the pattern of plasma LH after GnRH stimulation.
The Importance of Gestagen, Tamoxifen and Steroid Receptors in the Therapy of Endometrial Cancer: Report of an experiment
Authors: Kleine W. , Fuchs A. , Pfleiderer A.
Published: December 2009

Abstract. Six human endometrial cancers in different clinical stages were xenotransplanted into thymusaplastic nude mice. Estrogen and progesterone receptors in the tumor tissue were determined in each case. Two carcinomas with both estrogen and progesterone receptors showed a better clinical course and grew more slowly in nude mice than the four carcinomas with no receptors at all. Treatment with the antiestrogen Tamoxifen in the carcinoma with positive estrogen receptors showed a significant growth retardation compared with the control group. Estrogen treatment gave accelerated growth, whereas gestagen treatment showed no significant effect. The progesterone receptor content of the receptor‐positive tumor tissue might have been too small. None of the four receptor‐negative carcinomas showed any influence of tumor growth during endocrine therapy. The results demonstrate the importance of receptor determination as a prognostic sign and, further, allow the endocrine therapy of endometrial carcinomas to be complemented with Tamoxifen in estrogen‐receptor‐positive tumor tissue.
Coagulation and Fibrinolysis in Pregnancy Complicated by Intrauterine Growth Retardation
Authors: Persson B. L. , Holmberg L. , Åstedt B. , Nilsson I. M.
Published: December 2009

Abstract. In a prospective study, blood from women in the 19th and 32nd week of pregnancy was analyzed for fibrin‐ogen, prothrombin complex (P & P), F V, F VIII:C, F VIIIR: Ag, the VIIIR: Ag/VIII:C ratio, F IX, F XII, F XIII, antithrombin III, α2 ‐macroglobulin, aj‐antitrypsin, α2‐antiplasmin, the inhibitor of plasminogen activation and fi‐brinogen degradation products. In normal pregnancies all the coagulation factors except F XIII were markedly increased, as were α1‐antitrypsin and the inhibitor of plasminogen activation. Pregnancy did not influence the levels of antithrombin III, α2‐macroglöbulin or α2‐antiPlasmm‐ Pe‐ripheral blood from women with growth retarded fetuses differed in that the levels of P & P, F XII (in the 19th week) and the inhibitor of plasminogen activation (in the 19th and 32nd weeks) were lower. The level of F XIII was higher in the 32nd week. A low grade activation of the coagulation system is suggested as one possible factor in the pathogene‐sis of intrauterine growth retardation, which emphasized the value of heparin treatment in certain cases with this syndrome.
Regression of Hemangioma ‐ Thrombocytopenia Syndrome
Authors: Ástedt B. , Henriksson P. , Nilsson I. M. , Svanberg L.
Published: December 2009

Abstract. Kassabach & Merritt in 1940 first described hem‐angioma associated with thrombocytopenia and bleeding tendency. This was followed by several case reports, in which most of the tumors were localized to the extremities. Evidence of consumption coagulo‐pathy and also enhanced fibrinolytic activity with release of plasminogen activator has been presented (1, 2).
Primary Surgical Treatment of Carcinoma stage I of the Uterine Cervix
Authors: Falk V. , Lundgren N. , Quarfordt L. , Årström K.
Published: December 2009

Abstract. 476 cases of Stage I —IV invasive carcinoma of the uterine cervix were treated at the Gynecology Departments in Karlstad and Örebro in 1965‐75. 232 (48.7%) were classified Stage I, 198 (85.3%) of them were treated with primary surgery (57 Stage IA and 141 Stage IB). Thirty‐four were given primary radiotherapy because of advanced age or co‐existing conditions contra‐indicating surgery. Of the 141 patients with primary surgery for Stage IB, squamous epithelial carcinoma was established in 88.7% and adenocarcinoma in 11.3%. Surgery revealed lymph node metastases in 13 (9.2%). Postoperative radiotherapy was given to all patients with lymph node metastases, to 3 patients with tumor thrombi in the parametrial vessels, and to 6 in whom surgery had conceivably not been radical. Urinary tract complications requiring reconstructive surgery occurred in 8 (4.0%). The 5‐year survival rate with Stage IB was 91.5%, corrected for intercurrent diseases, 5‐year survival was 92.8%. Of the 13 with lymph node metastases, 7 were still alive after 5 years. The 5‐year survival rate for those without demonstrable lymph node metastases was 94.5%, corrected 96.0%.
Tuberculous Peritonitis Simulating Peritoneal Carcinosis
Authors: Kiilholma P. , Punnonen R. , Meurman L. , Tala E.
Published: December 2009

Abstract. Two cases are reported exemplifying the difficulties faced in the clinical diagnosis of peritoneal tuberculosis. Two fertile‐aged nulliparous females were admitted with symptoms and signs of an acute abdomen. Both showed a relative intenstinal obstruction, abdominal mass and ascitic fluid. A malignant disease was suspected and laparotomy was performed. Tuberculous peritonitis was demonstrated histologically in biopsy and later confirmed by positive culture for tubercle bacilli. In the first case the correct diagnosis was disclosed during operation by frozen section, although the histological picture also indicated possible car‐cinosis because of a heavy mesothelial hyperplasia. A 9‐month chemotherapy with isoniazide and rifampicin, supplemented during the first 2 months by streptomycin or ethambutol, was successful in both cases.
Lactate Dehydrogenase Isoenzymes in Human Myometrium During Pregnancy and Labor
Authors: Makkonen Maija , Puhakainen Eino , Hänninen Osmo , Castrén Olli
Published: December 2009

Abstract. Myometrial lactate dehydrogenase isoenzymes were investigated in 32 pregnant women and in 21 women during labor. During pregnancy and labor the H‐type LDH isoenzymes were found to preponderate in contrast to M‐type LDH isoenzymes. Both H‐LDH and M‐LDH isoenzyme activities showed a tendency to increase in normal pregnancy. In severe pre‐eclampsia and in chronic hypertension, the uterine M‐LDH level decreased. In normal labor, M‐LDH activity declined in both the uterine and the rectus abdominis muscles.
The Effect of Maternal Hypercapnia and Hyperoxia on Breathing Movements in the Normal and Growth‐Retarded Fetus
Authors: van Weering H. K. , Wladimiroff J. W.
Published: December 2009

Abstract. Fifteen normal pregnant subjects inhaled a 7% CO2 mixture over a period of 5 min, resulting in a markedly increased rate of fetal breathing. In a further 15 normal pregnant subjects, an 80% O2 mixture was administered over a period of 10 min; during the second half of this stimulation period a significant increase in fetal breathing rate was noted. Finally, a 7% CO2 mixture was administered during a 5‐min period to a total of 26 pregnant patients with fetal growth retardation. Seventeen of these 26 patients were subsequently administered an 80% O2 mixture during a 10‐min period, immediately followed by a mixture of 80% O2 and 7% CO2 over a 5‐min period. During both maternal hypercapnia and hyperoxia a marked increase in fetal breathing rate was noted, which was not essentially different from that seen in normal pregnancy. Administration of a mixture of O2 and CO2 did not result in any significant change in fetal breathing activity. At birth, all growth‐retarded infants had an Apgar score of 6 or more at one minute. It can be concluded that respiration in both the normal and the clinically non‐hypoxic growth‐retarded fetus shows a similar reaction pattern towards alterations in maternal gaseous exchange.
Constriction of the Umbilical Cord by an Amniotic Band After Midtrimester Amniocentesis
Authors: Ashkenazy M. , Borenstein R. , Katz Z. , Segal M.
Published: December 2009

Abstract. Constriction of the umbilical cord by an amniotic band after previous midtrimester amniocentesis is an extremely rare entity. A case report of fetal asphyxia caused by partial occlusion of the umbilical cord by an amniotic band is presented. Clinical and experimental evidence strongly suggests that the pathogenesis of this defect is related to early rupture of the membranes during gestation with subsequent encirclement and ligation of fetal umbilical cord, or extremities. In this case, formation of the amniotic band caused by midtrimester amniocentesis is strongly suggested. Obstetricians should be aware of this hazardous complication during pregnancy and labor in women who had had a midtrimester amniocentesis.
Placental transfer of aromatic amino acids in non‐human primates
Authors: Pueschel Siegfried M. , Boylan Joan M. , Jackson Benjamin T. , Piasecki George J. , Cha Chung‐Ja
Published: December 2009

Abstract. Macaca fascicularis (crab‐eating monkeys) underwent an operative procedure at 120 to 130 days of pregnancy that allowed fetal blood sampling. During subsequent experiments L‐phenylalanine and p‐chlorophenylalanine were injected into the maternal circulation. Blood obtained from mother and fetus revealed that phenylalanine is actively transported across the placenta and hence is markedly increased in the fetus if the maternal blood phenylalanine concentration is below the “saturation” level of 1.82 mM to 2.12 mM. The results of these studies which provide a better understanding of placental transport mechanisms of aromatic amino acids will be of assistance in future management of pregnant phenylketonuric females.
HSV 2‐associated antigens in human cervical tissues before and after grafting in nude mice
Authors: Christenson Brith , Furgyik Stefan
Published: December 2009

Abstract. Biopsy material from human invasive cervical carcinoma, carcinoma in situ (CIS) and normal uterine cervix was transplanted into nude mice, some of which were then injected with estrogen or progesterone during a follow‐up of 1 —4 weeks. The cervical cells were analysed prior to and after passage in nude mice by the anticomplement im‐munofluorescence (ACIF) assay for the presence of herpes virus associated antigens. Such antigens were found in a few cells in three out of seven transplanted cervical cancers prior to the grafting and in one out of 3 cases with normal tissue. After the grafting period HSV‐related antigen was found in 6 out of 7 cases of cervical cancer in grafting material from estrogen‐stimulated mice. Without hormonal stimulation, 5 out of 7 showed a positive reaction. Hence the expression of the HSV‐related antigen seemed enhanced after grafting in nude mice.
Measurement of cardiac stroke volume by impedance cardiography in the last trimester of pregnancy
Authors: Milsom I. , Forssman L. , Sivertsson R. , Dottori O.
Published: December 2009

Abstract. Simultaneous determination of cardiac stroke volume by impedance cardiography and the dye dilution technique was compared in 10 women during the last trimester of pregnancy. Measurements were performed in different body positions to investigate the influence of body position on stroke volume.

The correlation coefficient for all measurements was 0.87. Mean stroke volume determined by impedance cardiography was significantly (p<001) lower than mean stroke volume calculated by the dye dilution technique. There was no significant difference between the mean change in stroke volume determined by the two techniques during serial measurements. The reproducibility of individual impedance‐determined stroke volumes (6.1 ml) did not differ significantly from individual values obtained by dye dilution (9.3 ml).

Maximum mean impedance‐determined stroke volume was recorded in the left lateral position (83.8 ±4.0 ml). Mean stroke volume was significantly (p<0.01) reduced in the supine position (17.9%). A smaller (14.4%) reduction was registered in the right lateral position. These changes in stroke volume according to body position were equally evident by both methods.

Impedance cardiography is a safe, reliable, non‐invasive technique for the measurement of changes in stroke volume during late pregnancy. The ability of impedance cardiography to determine changes in stroke volume was unaffected by changes in body position.
Cytoplasmic Progestin Receptors in Myomal and Myometrial Tissues
Authors: Büchi K. A. , Keller P. J.
Published: December 2009

Abstract. Cytoplasmic progestin receptors in human myo‐metrium and myomata of uteri, both with and without tumors, were determined. The same concentration was found in all tissues when expressed in terms of tissue weight or DNA content. However, tumors had slightly more receptors when calculated per mg of soluble protein. This was due to the fact that myomata contained considerably less soluble protein than the normal myometrium.

The receptors present were dependent upon the serum concentration of estradiol. Increasing values were accompanied by an increase in the number of receptors. At estradiol levels exceeding 300 pmoles/1 their number reached a plateau and became independent of the hormone concentration. Progesterone had no influence except at very high levels where it depressed the number of receptors significantly.

The investigation did not reveal any difference in the number of or the hormonal regulation of cytoplasmic progesterone receptors present in the various tissues. However, it showed that tumors contained considerably less soluble protein than normal myometrium.
Outcome of Delivery Subsequent to Vacuum ‐ Aspiration Abortion in Nulliparous Women
Authors: Meirik Olav , Bergstöm Reinhold
Published: December 2009

Abstract. Altogether 4719 women who had had a legally induced abortion in Uppsala County during 1970 — 75 were followed by means of computerized record linkage, and deliveries during 1970 — 78 after abortion were noted. Out of 1 364 deliveries traced, 670 were to primiparas who had had a previous vacuum‐aspiration (VA) abortion. The outcome of the delivery for the 670 women was compared with that of matched controls, 622 primiparas and 626 secundiparas. Confounding variables were checked for by multiple regression analysis using the infant's birthweight and gestational duration as dependent variables. This analysis showed that the abortion did not have a statistically significant effect on the outcome. Low birth weight infants and preterm delivery did not occur more often after a previous VA abortion.
Treatment of urinary tract infections in gynecological patients
Authors: Iosif Constantin S. , Laurin Jan , Möller Eva‐Brita , Bauer Carl‐Axel
Published: December 2009

Abstract. Eighty‐two gynecological patients with clinical signs of a lower urinary tract infection (UTI) were randomized to 10 days' treatment with either a fixed combination of pivampicillin‐pivmecillinam (PAPM) or trimethoprim‐sulphamethoxazole (TMPS). The effect of treatment could be evaluated in 25 patients on PAPM and in 19 on TMPS, who had bacteriologically verified UTI and who completed treatment and check‐ups. All strains were sensitive in vitro to the respective antibiotic combination used. Treatment eradicated the original pathogen in 75 — 80% of the cases, 64% of the patients on PAPM and 47% on TMPS having sterile urine 3 weeks after end of treatment. Side effects could be evaluated in 76 patients. Two patients on PAPM and 8 on TMPS had to discontinue treatment due to side effects. Including abnormal values for hematology, liver and renal parameters, significantly fewer side effects (p = 0.038) were noted on PAPM (7/40) than on TMPS (15/36).
Metabolism of Estrone Sulfate in Human Endometrium
Authors: Carlström K. , von Uexküll A.‐K. , Einhorn N. , Fredricsson B. , Lunell N.‐O. , Sundelin P.
Published: December 2009

Abstract. The metabolism of [3H] estrone sulfate was studied in endometrial tissue obtained from postmenopausal women with atrophic endometrium (I), benign endometrial proliferative changes (II) and endometrial carcinoma (III) and in perimenopausal women with proliferative (IV) and secretory (V) endometrium. Total hydrolysis (i.e. formation of [3H] estrone+ [3H] estradiol‐17β) of [3H] estrone sulfate as well as formation of [3H] estradiol‐17β only was significantly less in group I than in the other groups. The formation of [3H] estradiol‐17β was greater in group V than in the other groups. It is speculated that formation of estradiol‐17β in the endometrium from estrone sulfate may be of importance in the genesis of endometrial disorders in the postmenopausal woman.
Termination of second‐trimester pregnancy by laminaria and intramuscular injections of 15‐methyl PGF2α or 16‐phenoxy‐ω‐17, 18, 19, 20‐tetranor PGE2 methyl sulfonylamide
Authors: Bygdeman M. , Christensen N. J.
Published: December 2009

Abstract. The present study included 120 second‐trimester patients admitted to the hospital for termination of pregnancy. In all patients, one medium‐size laminaria tent was introduced into the cervical canal. The laminaria was withdrawn 12 hours later and the patients randomly allocated to either i.m. injection of 15‐methyl PGF2α, 0.25 mg every second hour, or 16‐phenoxy‐ω‐17,18,19,20‐tetranor PGE2 methyl sulfonyl‐amide, 0.5 mg every fourth hour. Both treatment scedules were equally effective. All patients but 2 (98.3%), one in each group, aborted within 24 hours of pro‐staglandin treatment. Both methods seem far more effective than other methods at present in use for termination of second‐trimester pregnancy. With the E analogue, the frequency of gastro‐intestinal side effects was significantly lower than with the F analogue and not more common than following hypertonic saline. The use of laminaria tent was normally uneventful and seemed to reduce the risk of cervical laceration significantly.
Estriol Screening in Pregnancy
Authors: Nielsen Peter Vest
Published: December 2009

Abstract. One thousand six hundred and sixty pregnancies were recorded in this investigation. In 1042 women with singleton pregnancies and known term, measurements of the total serum estriol (E3) were made exclusively for the present study. The study was prospective, and the clinicians had no knowledge of the E3 values.

Within the screened group a low E3 value entailed a 42% risk of delivering an infant with perinatal complications and a 27% risk of an infant small for gestational age (SGA). 7% of the infants with perinatal complications and 19% of the SGA infants were detected at the screening. In a sub‐group of 800 pregnancies considered normal according to given criteria, a low E3 level involved a 27% risk of perinatal complications and a 15% risk of an SGA infant. Of these cases 4% and 14% respectively had been detected at the screening.

It is concluded that the E3 level should be measured on wide indications, but that this test is of little value in pregnancies that are clinically quite normal. Thus, the benefit of screening all apparently normal pregnancies depends upon the extent and thoroughness of the clinical antenatal care.
Maternal and Fetal Serum Prolactin Levels in Cases of Premature Rupture of Membranes
Authors: Ron M. , Beller U. , Ori J. , Ben‐David M. , Palti Z.
Published: December 2009

Abstract. Serum prolactin levels were measured in maternal and fetal sera immediately post delivery in 20 cases of premature rupture of the membranes and in 20 controls. Fetal serum prolactin levels were 781 ±265 ng/ml in cases of PRM and 737±314 ng/ml in controls. Maternal serum prolactin levels were 504±264 ng/ml in cases of PRM and 731±361 ng/ml in controls. This difference is statistically significant (t=1.81, p<0.05).

A probable role of prolactin in maintaining fetal membrane integrity and the probable effect of the difference in maternal serum prolactin concentration in the two groups on the membrans' viscoelastic properties is discussed.
Percutaneous Estrogen Replacement Therapy
Authors: Hoist J. , Cajander S. , Carlström K. , Damber M‐G. , von Schoultz B.
Published: December 2009

Abstract. A percutaneous gel containing 0.6 mg/g of estra‐diol‐17β was used for cyclic replacement therapy in 19 post‐menopausal women. Significantly increased serum concentrations of estradiol‐17β, unconjugated estrone, and total estrone were recorded during 6 months of treatment. In contrast to oral treatment the quotient of estrone/estradiol‐17β was maintained and even reduced during therapy. Significant gonadotropin inhibition was recorded and the es‐trogenic potency of 3 mg percutaneous estradiol‐17β was similar to that of oral estradiol‐17β 2 mg and 2.5 mg oral estrone sulphate. Prolactin levels remained constant during treatment. Therapy was effective in abolishing hot flushes in 17 out of the 19 women treated. The therapy was well accepted by the volunteers. Seventeen out of 19 women stated that the gel was easy to use in everyday life. Topic application may develop into an alternative treatment for climacteric complaints and may even have some metabolic advantages over oral treatment.
Long‐Term Clinical Effects of Ovarian Wedge Resection in Polycystic Ovarian Syndrome
Authors: Hjortrup A. , Kehlet H. , Lockwood K. , Hasner E.
Published: December 2009

Abstract. Twenty‐nine consecutive patients with polycystic ovary (PCO) syndrome (defined as hirsutism plus oligomen‐orrhea or secondary amenorrhea, and excluding Cushing's syndrome, an androgen‐secreting adrenal or ovarian tumor or adrenocortical hyperplasia) were treated with ovarian wedge resection leaving normal‐sized ovaries. Long‐term follow‐up from 2.3 — 9.5 years (mean 5.7 years) showed that 26 of 29 patients (90%) had established normal menstrual cycles. Fertility and normal pregnancies were achieved in all 10 patients (100%) with normal postoperative menstrual cycles who desired to conceive, but not in the 3 patients with remaining postoperative oligomenorrhea. Eight of 9 patients who were obese preoperatively and who had normal postoperative menstrual cycles showed a major weight loss after wedge resection. In contrast, none of the preoperatively obese patients, who remained oligomenorrheic after surgery, lost weight. Hirsutism was not cured by wedge resection. It is concluded that ovarian wedge resection should still be considered useful in patients with PCO.
Spontaneous Uterine Rupture in Late Pregnancy Caused by Placenta Percreta
Authors: Moldin Per , Nielsen Thorkild F.
Published: December 2009

Abstract. Placenta percreta is a very uncommon but serious complication of pregnancy. A case of spontaneous rupture of the uterus in the third trimester of pregnancy, due to placenta percreta, is described. The etiology of placenta percreta and therapeutic aspects of this obstetric complication are discussed.
Transient Post‐Partum Hypothyroidism
Authors: Kaplinsky Naomi , Pines Amos , Olchovsky David , Frankl Otto
Published: December 2009

Abstract. Transient hypothyroidism was observed in two young women a few months following childbirth. It is suggested that throughout their pregnancy they had already suffered from auto‐immune thyroiditis, the symptoms of which were suppressed at that time, as found in many other auto‐immune diseases. Being transient, post‐partum hypothyroidism is an exception to the rule that treatment by thyroid hormone replacement should never be stopped in hypothyroidism. Post‐partum hypothyroidism has to be considered in every suspected case of post‐partum depression, because of the possible similarity in the clinical presentation.
Endometrial Response Following Percutaneous Estrogen Replacement Therapy
Authors: Cajander Stefan , Hoist Juhani , Carlström Kjell , Damber Mats‐Göran , von Schoultz Bo
Published: December 2009

Abstract. The endometrial response in 10 postmenopausal women receiving estrogen replacement therapy was evaluated morphologically and quantified by morphometric analysis. During 6 months of cyclic treatment with percutaneous estradiol‐17β, 3 mg daily, the mean relative endometrial gland volume increased from 10% to 40%. In each individual woman this morphometric parameter was significantly correlated to the serum concentration of estradiol‐17β. The decline in FSH level during treatment showed no significant correlation to the endometrial response or the estrogen level. In some endometrial samples from women during treatment, glands with incomplete epithelial lining and rows of glandular epithelial cells were observed. It is suggested that these phenomena represent early forms of glandular development.
Laparoscopic Sterilization with the Falope‐RingR
Authors: Larsen K.‐E. , Jensen H. Kaalund
Published: December 2009

Abstract. Following 189 laparoscopic sterilizations with the Falope‐ringR, 33 cases of peroperative complications were registered. Laparotomy was required in one case. Sterilization undertaken in connection with termination of pregnancy was not associated with more peroperative complications than sterilization performed during an interval phase. In a randomized trial comprising 100 women it was not possible to demonstrate that application of lidocaine to the tube reduced the incidence of immediate postoperative abdominal pain which occurred in 18% of the women in the control group. A follow‐up investigation of 91 women revealed change in bleeding pattern in 32% and low abdominal pain de novo in 40%. The frequencies of changes in bleeding pattern and of low abdominal pain were greater in women who had previously employed oral contraception than in women who had not done so. A questionnaire investigation comprising 169 women revealed that 38% had developed one or more of the following symptoms: hot flushes, tendency to depression and irritability, and tachycardia. Alterations in libido were found in 26%. 2% regretted the sterilization. One pregnancy occurred in 172 sterilized women after an average observation period of 13 months.
Fetal Activity Acceleration During Early Labor
Authors: Nyholm H. Chr. , Hansen T. , Neldam S.
Published: December 2009

Abstract. Altogether 59 women (53 normal and 6 high‐risk pregnancies) underwent a fetal activity acceleration determination (FAD) during the first stage of labor. 52 FAD were considered reactive, while 5 were non‐reactive and 2 technically inadequate. Four of the 5 fetuses with a non‐reactive FAD showed signs of fetal compromise during labor and 1 died intra‐uterinely. There were significantly more normal births and non‐compromised fetuses in the FAD reactive group than in the non‐reactive (p< 0.002, χ2‐test), while there were significantly more acute cesarean sections in the non‐reactive group (p<0.001, χ2‐test). Of the 12 vacuum extractions (all in the FAD reactive group) 4 were performed because of prolonged 2nd stage and 8 because of suspected intra‐uterine asphyxia, but all infants did well after delivery, and the umbilical arterial pH was in all cases above 7.15.

It is concluded that when a FAD test is reactive in the first stage of labor, one can expect a positive outcome of the birth, whereas a non‐reactive test arouses suspicion of fetal compromise and implies that one must carefully monitor the progress of the birth so that the fetus can be delivered promptly if any sign of late decelerations should appear. A reactive FAD is, on the other hand, rather reassuring for the fetal state.
Cimethidine Pre‐Anesthetic
Authors: Qvist Niels , Storm Kirsten
Published: December 2009

Abstract. Twenty patients undergoing cesarean section received cimethidine 400 mg intramuscularly as pre‐anesthetic approximately 70 minutes prior to gastric aspiration. The average pH was 5.05, as against 2.97 in the control group (p<0.01). No significant reduction in the aspirated volumes was observed. In the cimethidine group the proportion of patients at risk of developing Mendelson's syndrome (pH<2.5 and volume > 25 ml) was significantly reduced, viz. 5% as against 42% in the control group (P = 0.014). No perinatal effects attributable to cimethidine were observed in the infants. Hence, cimethidine is a safe and useful pre‐anesthetic for patients undergoing cesarean section, irrespective of indication and, consequently, much to be preferred to oral antacids.
Fibromyomas and Uterine Activity
Authors: Iosif Constantin Serafim , Åkerlund Mats
Published: December 2009

Abstract. Intra‐uterine pressure was recorded with a triple‐channelled microtransducer catheter in women with fibro‐myomas prior to hysterectomy or myomectomy and in women due to undergo hysterectomy because of other gynecological disorders. In most of the patients with myomas the uterine activity differed from that in the women without myomas and from findings in previous studies on uterine activity in healthy subjects. Thus, small and irregular contractions were frequently seen in the pressure recordings from the receptors placed in the vicinity of myomas. In women with dysmenorrhea secondary to the development of myomas, increased uterine activity was registered. It is concluded that myomas may have a clinically significant effect on uterine activity.
Prevention of Fetal Alcohol Effects
Authors: Larsson Gunilla
Published: December 2009

Abstract. The increased consumption of alcoholic beverages by young people must be viewed with great concern, particularly as regards prospective parents. A study was therefore started at four Maternal Health Clinics to develop methods for the early detection of maternal alcohol abuse and for treatment of the women concerned. The study involved 464 consecutive pregnant women. A systematic drinking anamnesis was obtained from all patients. Attention was also paid to additional indicators of maternal alcohol abuse. Four per cent of the women were classified as alcohol abusers, and a further 7% as excessive drinkers. The majority of the mothers reduced their drinking altogether or stopped after receiving information about alcohol. The alcoholic women, on the other hand, needed intensive counselling. Most women welcomed the opportunity to obtain an accurate assessment of the risks of alcohol consumption during pregnancy. One infant was given a diagnosis of fetal alcohol syndrome at birth and another neonate had a partial fetal alcohol syndrome. The antenatal staff identified significantly more women with excessive alcohol consumption, compared with the situation the year prior to starting the program. Family guidance provided by a multi‐disciplinary team in pregnancy may result in lifelong benefits to both the mother and her child.
Effect of Segmental Epidural Analgesia on Neonatal Serum Bilirubin Concentration and Incidence of Neonatal Hyperbilirubinemia
Authors: Jouppilal Riitta , Larval Leena , Jouppilaz Pentti , Koivisto Maila , Pakarinen Arto
Published: December 2009

Abstract. Neonatal serum bilirubin levels were determined at the ages of 12 hrs, 2 days, 3 days, 4 days and 5 days in 80 infants. Forty‐three mothers had received segmental epidural analgesia at the height of Th 10‐ 12 for pain relief during the first stage of labor. The analgesic agent used was 0.5% bupivacaine. The individual doses were of 4 ml. Thirty‐seven mothers served as a control group. The groups were further divided into smaller groups according to whether oxytocin was used for induction or acceleration of labor ‐ or not. The results showed no statistically significant differences in the neonatal serum bilirubin levels at different times between the epidural and the control groups, whether oxytocin was used or not. Nor did the incidence of neonatal hyperbilirubinemia cases differ between the groups.
A Rare Case of Iud Expulsion Through the Fallopian Tube
Authors: Wikland Matts , Wilhelmsson Lennart
Published: December 2009

Abstract. This case report describes the expulsion of an IUD (Gravigard) through the Fallopian tube. Such a phenomenon has been suggested earlier but never reported. It is concluded that the shape of the IUD is of importance for such a route of expulsion.
The Role of Estradiol and Progesterone in the Regulation of Myometrial Activity for the Onset of Labor
Authors: Batra S. , Bengtsson L. Ph. , Ingemarsson I.
Published: December 2009

Abstract. The concentrations of estradiol (E2) and progesterone (P) were measured in peripheral plasma and myomet‐rium from women in the 35th to 42nd week of pregnancy. On the basis of the subjective symptoms and objective signs of labor, judged by tocography and cervical status, the women were divided into two groups, one in labor and the other not. There were no significant inter‐group differences in the concentrations of E2 or P in either plasma or the myo‐metrium. The plasma P/E2 ratio, however, differed significantly, being lower in the women in labor. A similar tendency was found in the P/E2 ratio in the myometrium but due to a wide variation, the inter‐group difference did not attain statistical significance. The results suggest that a lower P/E2 ratio at term would facilitate the action of an, as yet unknown, physiological stimulus to the onset of labor.
Vaginal Cleansing at Vacuum Aspiration Abortion does not Reduce the Risk of Postoperative Infection
Authors: Lundh Christer , Meirik Olav , Nygren Karl‐Gösta
Published: December 2009

Abstract. Does a thorough vaginal cleansing with bactericidal solutions prior to induced first‐trimester vacuum aspiration abortion reduce the frequency of postabortal pelvic inflammatory disease (PID)? To answer this question we compared the frequency of PID in 372 women where a thorough preoperative vaginal cleansing with a bactericidal solution was undertaken at abortion with that in 350 women where the upper part of the vagina was swabbed with a pad moistened with a 0.9% saline solution. A postoperative PID was recorded in 25 (6.7%) of the former women and in 23 (6.6%) of the latter women.
Collection of Human Oocytes for in Vitro Fertilization
Authors: Lauritsen J. G.
Published: December 2009

Abstract. By laparoscopy or laparotomy, oocytes were recovered from 42 (90%) of 47 patients. A total of 185 follicles containing 138 oocytes were aspirated by means of a specially constructed aspiration unit. The patients followed two different schemes pre‐operatively. In the unstimulated patients an average of 1.3 pre‐ovulatory oocytes per patient was collected, while treatment with 600‐900 IU human menopausal gonadotropin + 6000‐12000 IU human cho‐rionic gonadotropin resulted in an average of 2.0 pre‐ovulatory oocytes per patient. It is concluded that laparoscopy in combination with the described aspiration technique seems to be a clinically suitable method for collection of human oocytes for in vitro fertilization.
Prevention of Post‐Hysterectomy Urinary Retention by Alpha‐Adrenergic Blocker
Authors: Livne Pinhas M. , Kaplan Boris , Ovadia Yardena , Servadio Ciro
Published: December 2009

Abstract. Micturition difficulties and urinary retention are common complications after abdominal or vaginal hysterectomy. Adrenergic receptors are located in the bladder neck and proximal urethra, and blocking these receptors with al‐pha‐blockers such as phenoxybenzamine (Dibenzyline) may improve micturition and prevent postoperative urinary retention. In a randomized clinical trial, 51 patients who underwent total abdominal hysterectomy, received a prophylactic dose of Dibenzyline 10 μg orally 6‐8 hours after operation and again the next day about 18 hours later. Only 2 of the 51 patients were found to have urinary retention, in comparison with 9 of 48 patients in the control group (p>0.05). Another group of patients who underwent vaginal hysterectomy were treated according to the same protocol. Eight of the 30 patients in this study group required catheterization to drain the overdistended bladder, in comparison with 16 of 26 patients in the control group (p>0.025). It seems from this clinical trial that prophylactic treatment with Dibenzyline is recommended after abdominal hysterectomy or vaginal operation in order to improve micturition and prevent urinary retention.
Choice of Substrate in Determining Peroxidase Activity in the Amniotic Fluid
Authors: Armstrong Donald , Kelley Kathleen
Published: December 2009

Abstract. Peroxidase activity in the amniotic fluid has been measured with two different chromogens, O‐dianisidine and p‐phenylenediamine. No activity was demonstrable with the former substrate but was present with the latter. These results show that choice of substrate is important in determining peroxidase activity, especially in the amniotic fluid.
“Morning‐After Pill” and Antithrombin III
Authors: Weenink G. H. , ten Cate J. W. , Kahle L. H. , Lamping R. J. , Treffers P. E.
Published: December 2009

Abstract. Plasma antithrombin III (AT III) was studied longitudinally in 15 subjects (13 patients and 2 volunteers), who used the “morning‐after pill” (5 mg ethinylestradiol daily for 5 days). The mean decrease in AT III level in the 13 patients was 17% of the pre‐treatment value. From additional observations made in 2 of the patients and in the 2 volunteers it is concluded that this decrease is caused by hemodilution due to salt and water retention rather than by a decreased synthesis or increased consumption.
Preinvasive Carcinoma of the Cervix Uteri and Smoking
Authors: Berggren G. , Sjöstedt S.
Published: December 2009

Abstract. The occurrence of smoking among 609 women with preinvasive cervical uterine cancer has been examined. Of these women, 66.3% were smokers. For 6090 controls the figure was 41.9%. The difference is statistically significant (p>0.001). In all the age groups the proportion of smokers was greater among the women with cancer. These also started smoking at an earlier age, and the number of cigarettes smoked daily was greater than for the controls.
Bacteriological study of Amniotic fluid During labor
Authors: Maye D. P. , Filthuth I. , Pugin P. , Waldvogel F. , Herrman W. L.
Published: December 2009

Abstract. Amniotic fluid from 207 women in labor was analysed at the time of artificial rupture of membranes or by amniocentesis. The following organisms were identified in concentrations of more than 1000/ml: Staphylococcus aureus (1), Propionibacterium (1), E. coli (1), group B Streptococci (3), Lactobacilli (16). The 6 patient‐carriers of pathogens became infected as did 4 of their babies. Leukocyte counts and LDH levels performed on amniotic fluid did not correlate with the appearance of symptoms of infection. Quantitative bacteriology of amniotic fluid seems to be of value in identifying patients at high risk of developing endo‐metritis and/or neonatal sepsis.