bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Recurrent Intramural Uterine Stromal Tumor with Epithelial Differentiation Effectively Treated with Oral Low‐Dose Administration of Etoposide
Authors: Seki Hiroyuki , Takagi Akiyoshi , Takada Shinichi , Takeda Satoru , Kinoshita Katsuyuki , Masunaga Atsuko , Sugawara Isamu , Itoyama Shinji
Published: August 2010

Abstract

A 66‐year‐old woman was diagnosed as having myoma of the uterus and total hysterectomy with bilateral salpingo‐oophorectomy was performed. The histopathological findings were puzzling, and the case was finally diagnosed as intramural uterine stromal tumor with epithelial differentiation. Three years after the operation, a firm tumor developed in the pelvic cavity. Laparotomy failed to remove the tumor and neither CAP (cyclophosphamide 500 mg, adriamycin 50 mg, CDDP 70 mg) therapy nor radiation therapy was effective. Oral administration of etoposide (25 mg/day), however, showed PR (50% decrease) as determined by CT scanning, and ultrasonography, and no me‐tastatic lesions were found.

This tumor was coincident with the endometrial stromal tumor with epithelial elements classified by Clement and Scully. The histological feature of the tumors and the efficacy of oral etoposide therapy are discussed in this study.
Autologous Blood Transfusion Using Recombinant Human Erythropoietin in Radical Hysterectomy
Authors: Yamawaki Takaharu , Tanaka Hirohiko , Takeuchi Shigeto , Yanase Hitoshi , Taniguchi Haruki , Toyoda Nagayasu
Published: August 2010

The possibility of serious complications of infection and GVHD and adverse prognosis in cancer patients resulting from homologous blood transfusions has been reported. We used recombinant human erythropoietin (rHuEPO) in autologous blood transfusions for radical hysterectomies to avoid the risks associated with transfusions.

rHuEPO efficacy, stability and influence on hemodynamics were investigated. All patients were able to donate 1,200 ml of autologous blood prior to surgery, and anemia did not result despite phlebotomy three times each week. Elevation in Hb concentration was calculated at 0.78±0.37 g/dl over the first 7 days, and 2.12±0.35 g/dl over the first 14 days. No adverse side effects were observed in any patient. The serum EPO level was measured by RIA, and compared to the homologous blood transfusion group. rHuEPO did not influence postoperative EPO secretion. Autologous blood transfusion with rHuEPO in radical hysterectomy was extremely effective in mitigating the risks associated with homologous blood transfusions.
Secondary Abdominal Pregnancy
Authors: Rani P. Reddi , Pandiarajan T. , Raghavan S. Soundara , Rajaram P.
Published: August 2010

Advanced abdominal pregnancy is a rare event with a high fetal and maternal morbidity and mortality. We present 3 cases of abdominal pregnancy seen at our hospital. The perinatal mortality was 100% with no maternal deaths. Literature has been reviewed and management of abdominal pregnancy is discussed. Awareness of this condition and its clinical features is important in preventing abdominal pregnancy related morbidity, mortality. Careful clinical examination coupled with investigatory aids like X‐rays and ultrasound will clinch the diagnosis. Most of the patients require early laparotomy following diagnosis and the morbidity and mortality are high particularly for the fetus.
Congenital Listeriosis: Case Reports and Review of Literature
Authors: Leung Tse Ngong , Cheung Kam Lau , Wong Felix
Published: August 2010

Four babies with congenital listeriosis were diagnosed in the Prince of Wales Hospital in Hong Kong in 1990—1991. Two died in the early neonatal period. The remaining 2 survived and recovered with no sequelae. The clinical and pathological features of these babies, together with those reported in the recent literature are highlighted so as to raise a high index of suspicion toward this disease and hopefully prompt treatment can be offered.
Long Term Results of Colposuspension Operation for Genuine Stress Incontinence
Authors: Abu‐Heija Adel T.
Published: August 2010

A series of 88 patients were treated by a technique of modified Burch technique (colposuspension), in which the vaginal vault on each side is sutured to the iliopectineal ligament on the ipsilateral side using a pair of Dexon 1 sutures on each side. Those patients reviewed 4 years later after the operation, 88% of them were continent. There were 10 failures. The main factors associated with recurrence were previous vaginal repair (70%), pregnancy and vaginal birth after surgery (30%).

This confirm that colposuspension is an effective operation for treatment of genuine stress incontinence, the success rate is high, but the selection of patients is essential, also it is important to have Cystometrogram done before surgery to avoid surgery for those patients who will not benifit from it, like those patients with detrusor muscle instability.
Pregnancy Outcome Data in a United Arab Emirates Population: What Can They Tell Us?
Authors: Hughes Phillip F. , Morrison John
Published: August 2010

A cross‐sectional study of pregnancy outcome in a national Arabic population is presented to highlight a unique reproductive environment compared with many other obstetric populations. A high pro‐natal intensity is evident with significant numbers of grandmultipara (36.7%) and mature gravida (22.2%). These groups did not show any significant increase in adverse antenatal or intrapartum events apart from an increasing rate of gestational diabetes with maternal age. There was an average induction/augmentation rate of 10.2% with a low rate of instrumental delivery (2.3%) and a mean caesarean section rate of 6.9%. A major antenatal complication noted was the prevalance of 17.3% for a haemoglobin <10 g/dl together with overall increased rates of pre‐existing and gestational diabetes. In addition the incidence of preterm labour increased over each of the 3 years studied and is of concern.
A Study on the Hemostatic Effect of Sodium Alginate on Uterocervical Hemorrhage
Authors: Nishiya Masashi , Hareyama Hitoshi , Makinoda Satoru , Fujimoto Seiichiro
Published: August 2010

We examined a sodium alginate preparation (Alto®) to determine its hemostatic effect, in comparison with other topical drugs, on hemorrhages in the uterocervical area. A total of 149 patients with hemorrhage from cervical erosion or after‐treatment bleeding of the cervix uteri were subjects in this trial, and 84 (79%) of 106 patients treated with this preparation experienced a hemostatic effect.

A significant positive correlation (p<0.001) was noted between the degree of tissue adhesiveness and the hemostatic effect in all the drugs tested. As for the tissue adhesiveness, Alto was significantly more favorable (p<0.001) than both Thrombin and Francetin T powder. Because Alto was softened by tissue moisture, its topical adhesiveness could be increased, which suggested that Alto was superior in hemostatis.
Breast Metastasis from Primary Cervical Cancer
Authors: Kumar Lalit , Tanwar Rajendra Kumar , Karak Prasant Kumar , Shukla Nootan Kumar
Published: August 2010

Metastasis to the breast from primary cervical cancer is rare. A 52‐year‐old woman developed breast metastasis 6 months after the diagnosis of primary cervical cancer. The mammography showed discrete well defined nodules without microcalcification. Fine needle aspiration cytology confirmed the diagnosis. Treatment with cis‐platinum chemotherapy and local radiotherapy resulted in complete response. The patient continues to be alive and disease‐free 18 months since the diagnosis of breast metastasis.
Hepatitis‐B Vaccination in Pregnancy: Safety and Immunogenic Response in Mothers and Antibody Transfer to Neonates
Authors: Reddy Pranathi A. , Gupta Indu , Ganguly N.K.
Published: August 2010

Hepatitis B infection during pregnancy causes increased, maternal morbidity and perinatal mortality. No specific therapy is available, hence neonatal immuno‐prophylaxis is recommended by WHO. However, the advantages of maternal immunization are manifold. Therefore, 15 pregnant HBsAg negative women were studied after 3 dozes of hepatitis B specific vaccine. No untoward effects of vaccine were observed and a good immunogenic response with very high antibody titres 178 IU/ l and 184 IU/l at delivery and 3 months post delivery respectively were noted. Passive transfer of antibodies to the neonates was 100% at birth but these levels declined rapidly. Hence hepatitis B specific vaccine is safe and immunogenic in pregnant women and protects their babies in the immediate neonatal period.
Determinants of Birth Weight in Vietnamese Detainees in Hong Kong
Authors: Rogers M.S. , Rogers Kay
Published: August 2010

Five hundred and fifty singleton pregnancies amongst Vietnamese Boat People delivering between January and December 1993 were studied post‐natally. Multiple regression analysis showed no direct effect of ethnic origin on birth weight. When analyses were repeated on the two main ethnic subgroups we found that, amongst Anamese patients, both gestation at delivery and birth weight independently increased with longer duration of stay in Hong Kong. This relationship was not seen in Vietnamese patients of Chinese ethnic origin. Possible reasons for these different relationships are discussed.
Macrophage Activation Factors and Cytokines in Peritoneal Fluid from Patients with Endometriosis
Authors: Ueki Minoru , Tsurunaga Takemitsu , Ushiroyama Takahisa , Ueda Masatsugu
Published: August 2010

Endometriosis is often associated with infertility, which might be a consequence of intraperitoneal macrophage activation and various immunological events related to it. To determine what triggers macrophage activation and what immunologic conditions occur in the peritoneal cavity of a patient with endometriosis, we measured the amounts of phospholipase A2, cholesterol fractions (HDL, LDL, and VLDL), interleukins (IL)‐l and 6, granulocyte‐macrophage‐colony stimulating factor (GM‐CSF), and phosphatidylserine in peritoneal fluid. Peritoneal‐fluid samples were collected during laparoscopy or laparotomy from 14 patients with endometriosis and from 11 patients with other diseases (5 with myoma uteri, 5 with benign ovarian cysts and 1 with a double uterus) as controls. With regard to phospholipase A2, there were no significant differences between the endometriosis group and the control group. LDL was significantly lower in the endometriosis group than in the control (p < 0.05). The levels of IL‐1 and GM‐CSF were similar in both groups; IL‐6, however, was higher in 7 endometriosis patients with associated infertility than in the 9 non‐endometriosis fertile patients. These findings suggest that inflammatory tissues are not related to the activation of intraperitoneal macrophages in endometriosis patients. Cholesterol fractions (HDL or LDL) might participate in macrophage activation in these patients, but this remains to be clarified. The high IL‐6 levels observed in infertile endometriosis suggest that some immunological events that prevent patients from becoming pregnant take place in women with endometriosis‐associated infertility.
Vasospastic Action of Serotonin on the Umbilical Artery in Normal and Preeclamptic Patients
Authors: Taniguchi Katsunori
Published: August 2010

The purpose of this study was to determine whether elevated plasma‐free‐serototnin (5‐HT) levels in preeclampsia could evoke abnormal vasoconstriction in the umbilical artery (UmA). Threshold concentrations of 5‐HT in the UmA from 12 normal pregnant (NP) women were 5 ng/ml. Plasma‐free 5‐HT levels in the UmA (14.38 ± 5.68 ng/ml) in severe preeclampsia (SP) were higher than the threshold value. Plasma‐free 5‐HT levels in UmA blood (1.6 ± 1.2 ng/ml) in NP women were lower than the threshold value. There were significant increases in sensitivity to 5‐HT in the UmA from SP; the threshold value of 5‐HT was low (1.0 ng/ml), and the EC50 value (5.2 ± 2.4 ng/ml) was significantly lower than that of NP women (13.9 ± 3.0 ng/ml, p < 0.001). These results strongly suggest that increased plasma‐free 5‐HT and vascular hypersensitivity to 5‐HT in preeclampsia can cause vasospasms and a disturbance of the feto‐placental circulation.
Early Oral Hydration: A Novel Regimen for Management after Elective Cesarean Section
Authors: Rabbo Salah A. Abd
Published: August 2010

Objective: To compare early oral hydration versus the conventional intravenous fluid replacement after elective cesarean section.

Methods: Two hundred women performed elective cesarean section were selected and randomized to: Regimen I (n = 100): early oral hydration (sips of fruit juices sweetened with honey once the women felt thirst immediately after the operation, then solid food 24 hours later, the amounts of juice or food were determined by the patient herself, i.e. she would regulate her physiological needs) versus regimen II (n = 100): conventional intravenous hydration (2–3 L of dextrose saline/24 hours and solid food thereafter).

Biochemical, metabolic values, postoperative nausea and vomiting, propulsive bowel movements, tolerance of solid food, hospital stay and successful continuation of breast feeding were compared in both groups.

Results: The two regimens were equally effective in maintaining fluid balance and normal plasma and urinary electrolytes without any observed differences in biochemical or metabolic values. The return of bowel sounds, first occurrence of flatus and tolerance of solid food were achieved in regimen I at time periods significantly shorter than those attained with regimen II (p < 0.0001). The incidence of nausea and vomiting, ileus and deep vein thrombosis was higher in regimen II than in regimen I but the difference is statistically insignificant (p > 0.05). Patients in regimen II were hospitalized for significantly longer times than those on regimen I (p < 0.0001). Successful continuation of breast feeding was significantly more in regimen I than in regimen II (p < 0.01).

Conclusion: Early oral hydration after elective cesarean section effectively maintained fluid balance and it was associated with rapid return of propulsive bowel movements, successful breast feeding, less side effects and shorter hospital stay than the conventional intravenous hydration. So, it should be used in most cases after elective cesarean section.
Anaphylactic Reaction to Cefazolin in Pregnancy
Authors: Konno Ryo , Nagase Satoru
Published: August 2010

Anaphylaxis is a rare event in pregnancy, but is one that can have serious implications for both the mother and fetus. We report a case of severe anaphylactic reaction to intravenous (IV) cefazolin (CEZ) given during labor with premature rupture of membranes. Maternal shock and prolonged fetal bradycardia occurred. Both the maternal and fetal outcomes were good following treatment with ephedrine, glucocorticoids, and emergency caesarean section.
Antibodies Prevalence against HPV‐6b and ‐16 Recombinant Fusion Proteins in Korean Patients with Cervical Neoplasia*
Authors: Park Sue Nie , Yoon Hee Shick , Choi Yong Kyung , Choe In Seong , Chung Roh Pal , Chee Yong Hun , Namkoong Sung Eun , Kim Seung Jo , Park Jong Sup
Published: August 2010

Objectives: This study was to investigate the adjunctive diagnostic utility of HPV fusion proteins from the sera in the patients with cervical neoplasia. Immunologic researches on host factors in HPV infection could contribute to better understanding of patho‐physiologic mechanisms of cervical carcinogenesis, and provide valuable informations for HPV vaccine development.

Methods: Prevalence of antibodies against human papillomavirus (HPV) in sera of the patients with carcinomas (n = 81), precancers (n = 25) of uterine cervix and normal controls (n = 40) in Korean women were investigated by Western blot immunoassay using partially purified TrpE fusion recombinant proteins for HPV‐6b and HPV‐16.

Results: In 81 patients with cervical cancer, 15 (19%) and 54 (67%) patients were positive for antibodies to at least one of the tested recombinant proteins related to HPV‐6b or HPV‐16, respectively. And in 25 patients with HPV‐related squamous intraepithelial lesion (SIL) of cervix, 10 were positive for at least one of the tested antibodies for HPV‐6b gene products (40%) and 11 were positive for HPV‐16 related antibodies (44%). The prevalence rates of antibodies for HPV‐6b in the sera of SIL patients were significantly higher than those from the sera of cervical cancer patients (p < 0.05). There was an inverse correlation between increasing the positivity against HPV‐16 E6 protein and progression of cervical lesions, but there was no significant correlation between the positivities of the other antibodies to HPV‐16 and the severity of disease.

Conclusion: These results suggest that the recombinant proteins related to HPV‐6b and HPV‐16 could be useful in evaluation of the patients with HPV‐related cervical lesions and these might play an adjunctive role in diagnosis and management of cervical neoplasia.
Purification and Characterization of 1,25(OH)2D3 Receptor from Human Placenta
Authors: Tanamura Atsushi , Nomura Seiji , Kurauchi Osamu , Furui Toshimitsu , Mizutani Shigehiko , Tomoda Yutaka
Published: August 2010

Objective: To characterize the receptor for 1,25‐dihydroxycholecalciferol [1,25‐(OH)2D3], we purified it from nuclear fractions of human placentae.

Methods: Human placental fractions were concentrated with ammonium sulfate, extracted from hydroxylapatite, and then chromatographed on Sephacryl S‐200 and DEAE‐cellulose.

Results: The receptor for [1,25‐(OH)2D3] was purified approximately 1,500‐fold. The molecular weight of the receptor was estimated to be 55 K dalton by gel filtration. The receptor fractions showed a dissociation constant (Kd) of 3.0 × 10−10 mol/l, and adsorbed to the DNA cellulose column. D3 analogs, estradiol, and progesterone had almost no effect on 1,25‐(OH)2D3 binding.

Conclusion: These properties of the 1,25‐(OH)2D3 receptor in human placenta are similar to those of the chicken intestinal 1,25‐(OH)2D3 receptor.
Cytogenetic Effects of Cryopreservation on Human Sperm: Assessment Using an Improved Method for Analyzing Human Sperm Chromosomes
Authors: Okada Setsuo , Suzumori Kaoru , Yagami Yoshiaki
Published: August 2010

Objective: To evaluate any cytogenetic effects of cryopreservation on human sperm by comparing the frequencies of sperm chromosome anomalies and sex ratios before and after freezing.

Methods: Using in vitro fertilization of zona‐free hamster oocytes, analysis of sperm chromosomes was first performed on portions of fresh human semen samples. The residual semen was then analyzed for sperm chromosomes after cryopreservation for several weeks. Sperm donors were 5 healthy men aged 26–38 years.

Results: A total of 166 sperm karyotypes were analyzed, 94 before freezing and 72 after freezing. The results indicated no significant differences between fresh and frozen sperm in either frequencies of aneuploidy (fresh: 0%, frozen: 2.8%) or structural anomalies (fresh: 7.5%, frozen: 9.7%). The sex ratios did not differ from the expected 1 : 1 ratio under either condition.

Conclusions: The results of these studies indicate that cryopreservation does not exert any cytogenetic mutagenicity on human spermatozoa or alter X/Y ratio of human sperm.
Coexistent Complete and Partial Hydatidiform Moles in a Twin Pregnancy
Authors: Dalrymple Christopher , Russell Peter , Murray John
Published: August 2010

A case of twin pregnancy with complete and partial molar disease is presented. Aspects of diagnosis, ploidy studies and management are discussed.
In vitro Fertilization in a Spontaneous Cycle: A Successful Simple Protocol
Authors: Aboulghar Mohamed A. , Mansour Ragaa T. , Serour Gamal A. , Amin Yehya M. , Sattar Mehanny A. , Ramzy Abdel Megid
Published: August 2010

Objective: To study the efficacy of a simple protocol of in vitro fertilization in the spontaneous natural cycle.

Method: A prospective study using in vitro fertilization in a natural cycle for the treatment of infertility due to tubal factor.

Results: Fifty‐eight patients were monitored by vaginal ultrasound and LH in urine for 229 cycles. In 49.8% of the cycles the pick‐up was canceled because of the early LH rise or failure to visualize a dominant follicle. Ovum pick‐up was performed in 112 cycles and oocyte retrieval rate was 87.5%. Embryo transfer was performed in 86 cycles, pregnancy rate per pick‐up was 10.2%, and there was no pregnancy wastage.

Conclusion: IVF in a spontaneous cycle is a simple, low cost and safe treatment, which yields reasonable PR, for young regularly menstruating women with tubal factors of infertility.
A New Computer Network System for Communicating Perinatal Decision Support Information via a Telephone Line*
Authors: Kubo Takahiko , Sagara Yusuke
Published: August 2010

Objective: For fetal monitoring and assessment of high risk mother and fetus at regional hospitals, we developed a new computer network system.

Methods: The system incorporates a notebook‐type personal computer (PC‐9801nv) at regional hospital for communication in with 3 servers (IBM5580‐YOC) connected via 2 Ethernet LANs to 2 host computers (IBM3080, IBM3174) and 5 workstations (IBM5521 V2b), and transmits the compressed data by telephone. When the data arrive, the doctor in perinatal center can immediately display and interpret the data on his workstation and give appropriate advice to the doctor at the regional hospital.

Results: The rate of reliable data transmission was 100%. Each 1 hour recording session and characteristic perinatal information was transmitted in less than 2 minutes. Regional medical institutions can easily access the center, and thereby can receive both simplified automatic diagnosis by fetal cardiotocography and pregnancy‐risk evaluation.

Conclusions: Because this system uses telephone circuits, it can be accessed from all regions of the country. Thus, our system is useful for perinatal management of high risk mother and fetus.
Changes of Bone Mineral Density in Pregnant and Postpartum Women
Authors: Matsumoto Isamu , Kosha Shoichiro , Noguchi Shin‐ichi , Kojima Nobuko , Oki Toshimichi , Douchi Tsutomu , Nagata Yukihiro
Published: August 2010

Objective: To explore the effects of pregnancy and postpartal lactation on bone mineral density (BMD).

Methods: In this study, the BMD of 22 pregnant women in a longitudinal study, and of 75 pregnant and 111 puerperant women in a cross‐sectional study was estimated at the distal radius of the forearm by dual energy X‐ray absorptiometry. BMD was measured on 8 separate occasions from the first trimester of pregnancy to 24 months' postpartum.

Results: In none of 22 pregnant women was there any noticeable change in BMD during pregnancy. Whereas no significant change in BMD occurred during the 12‐month postpartum period in 11 non‐lactating women, 11 women who breastfed had a significant decrease in BMD at 1, 3, and 6 months' postpartum, with all of them showing a further decrease in BMD at 12 months' postpartum. The BMD of the radius was significantly lower in the breast‐feeders than in the formula‐feeders at all postpartal times of evaluation except at 24 months' postpartum.

Conclusion: It can be recommended that lactating women receive appropriate treatments for saving BMD during lactation.
Second and Early Third Trimester Atrial Natriuretic Peptide (ANP) Levels in Pregnancies Subsequently Complicated by Hypertension
Authors: Chung Tony K. H. , Rogers Michael S. , Baldwin Sally , Chang Allan M. S. , Nicholls M. Gary
Published: August 2010

Objective: To explore the clinical utility of measuring atrial natriuretic peptide (ANP) in the second and early third trimesters of pregnancy in order to predict pregnancy induced hypertension (PIH).

Methods and Materials: The study was done in a University Teaching Hospital. A prospective study of 200 women in their first pregnancy was conducted. ANP was measured at 2 gestational windows, 20–26 weeks and 30–34 weeks. This was correlated with pregnancy outcomes, in particular PIH. Student's t‐test was used to compare ANP levels between women who developed PIH and those who did not. The receiver operator curve (ROC) was used to determine its clinical utility.

Results: ANP levels were lower at 20–26 weeks in women who subsequently developed PIH but there was no significant difference at 30–34 weeks between women who had normotensive pregnancies and those who later developed PIH. The character of the ROC would indicate that it is not useful for prediction.

Conclusion: ANP levels in the second and early third trimesters has limited clinical utility for the prediction of PIH.
Laparoscopic Assisted Vaginal Hysterectomy: An Audit Plus a Word of Caution
Authors: Jones Ian S. C. , Flynn Michael , Hall Barbara , Perrin Lewis , Howland John
Published: August 2010

Laparoscopic assisted vaginal hysterectomy (LAVH) performed in 109 cases has been reviewed. In this series the mean operative time was 89 minutes and mean inpatient hospitalization was 3.7 days. Throughout the review, 6 patients were considered to have major complications and each is discussed. The association of previous caesarean section and bladder damage is noted. LAVH widens the indications available for vaginal hysterectomy in younger women in whom the abdominal approach would previously be indicated, but extra caution is advised when this technique is first introduced to a gynaecological service.
Use of Bromodeoxyuridine, Proliferating Cell Nuclear Antigen, and Nucleolar Organizer Regions in the Multiparametric Assessment of Proliferating Potency in Cervical Intraepithelial Neoplasia
Authors: Kaneko Shigenobu , Izutsu Toshihiko
Published: August 2010

The authors analysed of the proliferative activity of intraepithelial neoplasia of the cervix utilizing the labeling index of monoclonal antibody to Bromodeoxyuridine (BrdU) or proliferating cell nuclear antigen (PCNA), and the number of Nucleolar organizer regions (Ag‐NOR). The BrdU labeling index (B.L.I.) for normal squamous epithelium, mild dysplasia, and moderate dysplasia were significantly lower than for severe dysplasia or carcinomain situ.The PCNA labeling index (P.L.I.) for normal squamous epithelium, mild dysplasia, and moderate dysplasia were significantly lower than for severe dysolasia or carcinomain situ.The number of Ag‐NOR dots of normal squamous epithelium and mild dysplasia were lower than those of severe dysplasia or carcinomain situ.There are significantly positive correlations of the B.L.I., P.L.I., and the number of Ag‐NORs in cervical intraepithelial neoplasia.
EGF‐R and Overexpression of the Oncogene c‐erbB‐2 in Ovarian Cancer: Immunohistochemical Findings and Prognostic Value
Authors: Meden H. , Marx D. , Raab T. , Kron M. , Schauer A. , Kuhn W.
Published: August 2010

Purpose: The purpose of this study was to investigate the prognostic value of EGF‐R (c‐erbB‐1) compared to the overexpression of the c‐erbB‐2 oncogene product p185 in ovarian cancer.

Patients and methods: The study was conducted on 266 previously untreated ovarian cancer patients with FIGO stage I–IV disease. EGF‐R and c‐erbB‐2 oncogene product p185 have been evaluated using immunohistochemistry. Survival times were analyzed according to the method described by Kaplan and Meier. For the simultaneous evaluation of the prognostic relevance of the analyzed factors, a Cox proportional hazards regression was performed.

Results: EGF‐R was detected in 13%, and c‐erbB‐2 oncogene product p185 in 18% of primary tumors. EGF‐R showed no significant impact on the survival time, whereas c‐erbB‐2 oncogene product p185 positive patients had a significantly worse prognosis compared to p185 negative cases (p = 0.002). In the multivariate analysis, c‐erbB‐2 oncogene product p185, like tumor stage, histological grade and age, was found to be a significant prognostic factor.

Conclusion: These data confirm the prognostic importance of the c‐erbB‐2; oncogene product p185 in ovarian cancer at the time of primary surgery, while EGF‐ R does not seem to have prognostic relevance.
Sublingual Nifedipine Compared with Intravenous Hydrallazine in the Acute Treatment of Severe Hypertension in Pregnancy: Potential for Use in Rural Practice
Authors: Jegasothy Ravindran , Paranthaman Sri
Published: August 2010

Objectives: The purposes of this study were to compare the efficacy of sublingual nifedipine with intravenous hydrallazine in the control of acute hypertension of pregnancy and to make a preliminary assesment whether sublingual nifedipine could be recommended for use by midwives faced with severe hypertension in pregnancy in a rural setting.

Methods: Subjects were 200 consecutive patients admitted to Kuala Terengganu General Hospital, Malaysia with severe hypertension in pregnancy between August 1989 and June 1990.

Admission criteria were an ongoing viable pregnancy more than 28 weeks and diastolic blood pressure (DBP) more than 120 mmHg.

The patients were randomly divided into 2 groups. In group I, sublingual nifedipine 5 mg was administered and repeated after 15 minutes if DBP > 120 mmHg; and in group II hydrallazine 5 mg was intravenously injected and repeated after 15 minutes if DBP > 120 mmHg. Both groups were put on hydrallazine infusion if DBP > 120 mmHg after 30 minutes. The Chi‐square test was used for analysis with significance at p < 0.05.

Results: There was no statistical difference in the efficacy of therapy for decreasing blood pressure between the 2 groups. The groups were comparable by age, parity, gestational age at presentation, birth weight of infants, incidence of postpartum haemorrhage and fetal distress. Caesarian section rates were similar. In the observational studies on nurses administering the drugs, no significant difficulties were observed.

Conclusion: Sublingual nifedipine was comparable to IV hydrallazine in the treatment of acute hypertension of pregnancy. Nurses were able to administer sublingual nifedipine without difficulty.
A Comparative Study of Outcome of Laparoscopic Salpingo‐Oophorectomy versus Open Salpingo‐Oophorectomy
Authors: Leetanaporn Roengsak , Tintara Hatern
Published: August 2010

Objective: To determine the effectiveness and appropriateness of laparoscopic salpingo‐oophorectomy (LSO) versus open salpingo‐oophorectomy (OSO) in developing country.

Method: A clinical study with historical control consisted of 31 LSO cases of benign ovarian cysts were compared with 41 OSO cases matched by diagnosis and difficulty.

Results: The operative time of the LSO cases was higher (p < 0.001), but the morbidity was comparable (p = 0.22). The postoperative hospital stay of the LSO was shorter (p < 0.001). Patients who had LSO revealed meaningfully decreased postoperative use of analgesic (p < 0.05). The time to full recovery for LSO was shorter (p < 0.001), but the hospital charges were higher (p < 0.001).

Conclusions: LSO is considerable safe and effective alternative to OSO but incurs higher hospital charges. The overall cost effectiveness of LSO, especially in the developing countries, need further evaluation.
The Evaluation of a New 7‐Day Gonadotropin‐Releasing Hormone Agonist Protocol in the Controlled Ovarian Hyperstimulation for in vitro Fertilization
Authors: Yang Tzay‐Shing , Tsan Shun‐Hwa , Wang Bao‐Chiang , Chang Sheng‐Ping , Ng Heung‐Tat
Published: August 2010

Objective: Gonadotropin‐releasing hormone agonist (GnRHa) was used in the controlled ovarian hyperstimulation (COH) for the in vitro fertilization program. However, the traditional long protocol demanded more human menopause gonadotropin (hMG) and sometimes causes unnecessary delay in the procedure. A new 7‐ day GnRHa/hMG protocol required to conserve cost and time is thus evaluated for better outcome.

Methods: Sixty consecutive IVF candidates less than 40 years of age were recruited for the study. Cases with severe male factor or polycystic ovarian disease were excluded. The perspective candidates were divided into two groups, one received the traditional, GnRHa/hMG protocol and the other received the new 7‐day regimen.

Results: When comparing the results in pregnancy rate (33.3% vs 30%), cleavage rate (75.7% vs 75.5%), and the number of oocyte obtained (5.96 ± 0.91 vs 6.63 ± 0.90), the 7‐day GnRHa/hMG protocol is as good as those of the traditional regimen. The amount of hMG used nevertheless was significantly less (21.48 ± 0.78 vs 50.59 ± 2.07).

Conclusion: The new regimen will surely reduce the cost to relieve patient's financial burden and to increase patient's comfort.
Cervical Cytology by Means of Fluorescence in situ Hybridization with a Set of Chromosome‐Specific DNA Probes*
Authors: Hariu Hideki , Matsuta Morimasa
Published: August 2010

Objective: To reveal the numerical aberration of chromosome 1 and chromosome 17 in cervical neoplasia.

Methods: Fluorescence in situ hybridization (FISH) with chromosome‐specific repetitive DNA probes was applied on cervical smears of cervical intraepithelial neoplasia (CIN) I, CIN II, and CIN III, and of invasive carcinoma cases, to detect numerical aberrations of chromosome 1 (#1) and chromosome 17 (#17). The cases were histologically classified as CIN I (n = 9), CIN II (n = 12), CIN III [severe dysplasia (n = 14), carcinoma in situ (CIS) (n = 14)], and invasive carcinoma (IC) squamous‐cell carcinoma, large‐cell nonkeratinizing type (n = 12). FISH was applied on the same cervical smears of these cases after Papanicolaou's staining, and copies in marked atypical cells were counted using a fluorescence microscope.

Results: The 9.49 ± 2.59%/9.72 ± 1.40% (#1/#17) cells showed an aneuploid pattern in CIN I, 22.5 ± 3.98%/15.5 ± 3.02% (#1/#17) in CIN II, 44.3 ± 7.18%/ 45.01 ± 5.61% (#1/#17) in severe dysplasia, 52.66 ± 6.32/48.9 ± 7.55% (#1/#17) in CIS, and 66.22 ± 3.20%/57.38 ± 5.35% in IC. The loss of a chromosome in CIN III cases and the gain of a chromosome in CIS and IC cases should be noted (p < 0.01).

Conclusion: Because FISH has revealed the numerical aberrations of chromosome 1 and 17 in cervical neoplasia, this is an especially useful method for biological dosimetry and cancer biology.
Maternal Congenital Heart Disease and Pregnancy Outcome
Authors: Chia Y. T. , Yeoh S. C. , Viegas O. A. C. , Lim M. , Ratnam S. S.
Published: August 2010

Objective: To study the obstetrics and neonatal outcome of women with congenital heart disease.

Method: This is a retrospective study of 85 women with congenital cardiac disease. Data collected include maternal characteristics, New York Heart Association Class, cardiac complications and obstetric and neonatal outcome.

Results: The maternal and neonatal outcomes were excellent with no maternal and perinatal mortality. The main cardiac lesions were mitral valve prolapse (60.8%), atrial septal defect (8.6%), ventricle septal defect (6.5%) and aortic regurgitation (4.3%) and 2.1% each of tricuspid regurgitation, pulmonary regurgitation, Ebstein's anomaly, coarctation of aorta, patent ductus arteriosus, and Eisenmenger's syndrome. Six deliveries were associated with New York Heart Association deterioration. Compared to the general obstetric population, more women in the study group were primigravida, had pregnancy induced hypertension, underwent instrumental vaginal deliveries and caesarean sections and had more babies with lower birth weights.

Conclusion: Despite potential difficulties and complications associated with congenital heart disease, careful cardiac and obstetric management in a tertiary referral centre resulted in good maternal and fetal outcomes.
Obstetric Uterine Rupture in North Jordan
Authors: Ziadeh Saed M. , Zakaria Mohannad R. , Sunna Elias I.
Published: August 2010

Objective: The purpose of our study was to determine the aetiological factors of uterine rupture during labour, and propose preventive measures.

Methods: This retrospective study was performed between February 1989 and July 1994, to analyze the cases of rupture uterus in relation to causes, age, parity, maternal and fetal mortality and morbidity.

Results: There were 37 cases of uterine rupture at our institutions. Obstructed labour by malpresentation and disproportion was the main cause. The presence of previous caesarean section scar, dysfunctional labour, injudicious use of uterine stimulant, were the other causes. There was no maternal death and the fetal loss was 17(46%).

Conclusions: The high incidence of uterine rupture is attributed to lack of prenatal care, labour in high risk patients outside the hospital because of declining economy, and more patients with 2 or more previously scarred uterus with many of them labouring more than 14 hours. Maternal and neonatal complications have remained very high in the developing countries.
The Effect of Sperm‐Mucus Interaction Test on the Outcome of in vitro Fertilization and Ovulation Induction Combined with Intrauterin Insemination
Authors: Abu‐Heija A. T. , Fleming R. , Jamieson M. E. , Yates R. W. S. , Coutts J. R. T.
Published: August 2010

Objective: To investigate the effect of sperm mucus penetration tests (SPT) on the fertilization rate (FR) and pregnancy rate (PR) in patients treated with either in vitro fertilization (IVF) or ovulation induction combined with intrauterine insemination (OI + IUI).

Methods: Retrospective analysis of a regional Infertility Unit database. Infertile couples where the women had normal ovarian function and a normal pelvis at laparoscopy and her partner had normal seminology who had failed at least two SPTs who were treated with either IVF or OI + IUI. These patients were compared with similar couples in whom SPTs were satisfactory (SPT + ve).

Group A (SPT + ve) consisted of 46 patients who underwent 78 treatment cycles of IVF and Group B (SPT ‐ ve) comprised 31 patients who underwent 35 IVF cycles. Group C (SPT + ve) consisted of 39 patients who underwent 84 treatment cycles with OI + IUI, and Group D (SPT ‐ ve) consisted of 15 patients who underwent 37 cycles with the same treatment.

Results: In patients treated with IVF, the FR and PR per embryo transfer were 77.0% and 20.0%, respectively in Group A, and 64.0% and 22.6%, respectively in Group B. The differences in FRs were statistically significant (p < 0.001) but there was no difference in the PRs. In patients treated with OI + IUI, the PR per cycle were 22.0% in Group C and 16.2% in Group D.

Conclusion: The results indicate that SPT failure was associated with a lower FR in IVF but this did not affect the PRs. Similarly there was no difference in PRs following OI + IUI.
Effects of Weight Loss on Bone Mineral Density in Rats
Authors: Douchi Tsutomu , Oki Toshimichi , Kosha Shouichirou , Nakamura Sachiko , Ijuin Hirofumi , Yamamoto Shinichi , Noguchi Shinichi , Nagata Yukihiro
Published: August 2010

Objective: To evaluate the effects of weight loss on bone mineral density (BMD).

Methods: Eight‐week‐old female rats were divided into 4 groups: Those in Group A received a restricted diet for 4 weeks; those in Group B received a restricted diet and were treated with estrogen; those in Group C were castrated; and those in Group D underwent sham operations. The rat's body weight (BW) and vaginal smears were checked, and their femoral BMD was measured.

Results: The BW and BMD at 12 weeks were lower in Groups A and B than in Groups C and D; thereafter, however, these values increased for Groups A and B, but were still lower than those in Group D even at 20 weeks. In Group C, the BMD did not decrease, but it was significantly lower than that in Group D at 16 and 20 weeks. Group A showed continuous diestrus 2 weeks after dietary restriction began, but recovered to a 4‐day cycle 2 weeks after the initiation of free food consumption.

Conclusion: Weight loss had a greater effect on BMD than hypoestrogenism.
Current Status of Assisted Reproductive Technology in Asia and Oceania
Authors: Chang Yoon‐Seok , Kim Seok‐Hyun , Moon Shin‐Yong , Lee Jin‐Yong
Published: August 2010

Objective: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in Asia‐Oceanic region in 1992 and 1993.

Design: Data were collected on an annual summary form and submitted to the Reproductive Biology Committee of AOFOG.

Participants: Twelve member countries of AOFOG submitted data on ART procedures performed in 1992 and 1993 — Australia, Egypt, Hong Kong, India, Indonesia, Japan, Korea, New Zealand, Pakistan, Singapore, Taiwan, and Thailand. Data were collected in 1995 so that the outcomes of all pregnancies established would be known.

Main Outcome Measures: Clinical characteristics of patients, causes of infertility, protocols and outcomes of controlled ovarian hyperstimulation (COH), and outcomes of clinical pregnancy including abortion, ectopic pregnancy, multiple pregnancy, and congenital malformation were measured in each ART procedure.

Results: In 1992, 23,872 cycles of IVF‐ET were performed with 21.8% clinical pregnancy rate (PR) per ET, 4,840 cycles of GIFT with 29.5% PR per transfer, 1,136 cycles of simultaneous IVF‐ET and GIFT with 29.9% PR, and 1,563 cycles of ZIFT with 23.1% PR. Total 575 clinical pregnancies were achieved in cryopreserved ET program, 96 pregnancies in oocyte donation program, and 87 pregnancies in microassisted fertilization (MAF) program. In 1993, 24,571 cycles of IVF‐ET were performed with 21.6% clinical PR per ET, 5,240 cycles of GIFT with 28.2% PR per transfer, 1,063 cycles of simultaneous IVF‐ET and GIFT with 32.0% PR, 1,005 cycles of ZIFT with 21.6% PR, 5,562 cycles of cryopreserved ET program with 12.8% PR, and 2,198 cycles of MAF program with 11.6% PR. Total 117 clinical pregnancies were achieved in oocyte donation program.

Conclusions: Although the concepts as well as the status and results of ART are continuously changing, this report may be helpful in planning the future of ART in Asia‐Oceania by analyzing the past history.
Early Asymmetric IUGR and Aneuploidy
Authors: Anandakumar C. , Chew S. , Wong Y. C. , Malarvishy G. , Po L. U. , Ratnam S. S.
Published: August 2010

Objective: To determine the incidence of chromosomal abnormalities in fetuses with asymmetric growth retardation in the second and early third trimesters of pregnancy.

Methods: From November 1989 to December 1993, 71 singleton pregnancies with asymmetrical growth retardation diagnosed at 15 to 35 weeks gestation had detailed ultrasonographic examination for structural malformations and fetal karyotyping done.

Results: The fetal karyotype was abnormal in 7 (9.9%) of the cases. There were 19 growth retarded fetuses with concomitant structural defects. The incidence of chromosomal abnormalities in asymmetrical growth retarded fetuses with structural defects was 21% (4/19). The incidence of fetal aneuploidy in structurally normal fetuses with asymmetrical growth retardation detected before 23 weeks gestation was 20% (3/15); while for those presenting between 23–29 weeks gestation, no abnormal karyotypes were found.

Conclusion: Although more prospective data is needed, our data seems to suggest that fetal karyotyping may be unnecessary in structurally normal fetuses with early onset intrauterine growth retardation occurring between 23–29 weeks of gestation.
Choriocarcinoma Complicated by Splenic Rupture: An Unusual Presentation
Authors: Challis Daniel E. , Rew Kenneth J. , Steigrad Stephen J.
Published: August 2010

A patient with choriocarcinoma presenting with acute abdominal pain due to splenic rupture from secondary deposits is reported. This rare case exhibited several other unusual features including coexisting bilateral ovarian teratomas and the absence of any evidence of a primary lesion. Several hemangiomata in the liver initially confused the clinic picture.
The Clinical Efficacy of Gamete Intrafallopian Transfer by Minilaparotomy versus in vitro Fertilization and Embryo Transfer
Authors: Sayama Masaaki , Araki Shigeo , Motoyama Mitsuhiro , Tamada Taro , Sato Ikuo
Published: August 2010

Objective: To evaluate the clinical performance of gamete intrafallopian transfer (GIFT) and in vitro fertilization and embryo transfer (IVF‐ET).

Methods: Infertile women were divided into 2 groups: for GIFT, 239 patients (326 cycles) with at least 1 patent tube; and, for IVF‐ET, 125 patients (210 cycles) with bilateral tubal occlusion. A specially designed retractor was developed to replace the gametes into an appropriate section of the Fallopian tube accurately and safely. Several parameters, including the pregnancy and delivery rates of each group, were compared.

Results: The success rate per trial in the GIFT group was approximately 1.5 times higher than that in the IVF group (pregnancy rate: 44.2% vs. 31.0%, p < 0.01; delivery rate: 33.4% vs. 22.9%, p < 0.01). The pregnancy and delivery rates of GIFT decreased steadily with the number of trials. These apparent decreases were not observed up to the 3rd trial in IVF‐ET cases.

Conclusions: GIFT with a minilaparotomy procedure yielded significantly higher success rates than IVF‐ET. Accordingly, GIFT is considered to be the first treatment choice in infertility cases with at least 1 patent Fallopian tube.
Calcium Supplementation and Prevention of Pregnancy Induced Hypertension
Authors: Purwar Manorama , Kulkarni Hemant , Motghare Vijay , Dhole Sangita
Published: August 2010

In a randomized controlled trial 201 healthy nulliparous women were randomly allocated by means of a computer generated randomization list. From 20 weeks of gestation until delivery they received either 2 g of oral elemental calcium (n = 103) per day or an identical placebo (n = 98). Eleven women (5.47%) were lost to follow‐up after randomization. The study groups were very similar at the time of randomization; with respect to several clinical and demographic variables. Treatment compliance was very similar in both groups as was determined by pill count.1 The rate of pregnancy induced hypertension was lower in the calcium group than in the placebo group 8.24%; vs 29.03%; (RR = 0.28; 95% CI 0.14–0.59). The incidence of gestational hypertension was 6.18% in the calcium group and 17.20% in the placebo group (RR = 0.28; 95% CI 0.08–0.80), and the incidence of preeclampsia was 2.06% in the calcium group and 11.82% in the placebo group (RR = 0.13; 95% CI 0.01–0.64). In conclusion calcium supplementation given in pregnancy to nulliparous women reduces the incidence of pregnancy induced hypertension.
Correlation between the Stimulatory Effect of Oxytocin on the Formation of Inositol Phosphates and the Oxytocin Receptor Level in the Pregnant Rabbit Myometrium
Authors: Hirata Junko , Kikuchi Yoshihiro , Imaizumi Eiji , Furuya Kenichi , Nagata Ichiro
Published: August 2010

Objective: In order to elucidate the roles of inositol trisphosphate (IP3) and oxytocin (OT) receptors in rabbit parturition, the concentration of IP3induced by OT and the OT receptor levels were determined in rabbit myometria before and after parturition.

Methods: The effects of OT on IP3formation and OT receptor levels were determined in the myometria of non‐pregnant rabbits, Days 26, 28 and 30 of pregnancy rabbits, postpartum rabbits within 12 hours and steroid‐treated ovariectomized rabbits. Prostaglandins (PGs) levels were also measured in the myometrial and decidual tissues.

Results: OT receptors were not detectable in the myometria of non‐pregnant rabbits, and OT had no effect on the formation of inositol phosphates (IPs). On Day 28 of pregnancy, OT receptors became detectable, and then OT could induce the formation of IPs. Thereafter, the stimulatory effects of OT on IPs formation and the OT receptor levels dramatically increased toward the end of pregnancy and reduced rapidly after parturition. When the ovariectomized pregnant rabbits were treated with estrogen, OT receptors in the myometrium were induced, and OT acquired the ability to stimulate IP3formation. However, OT had no effect on the production of cAMP, cGMP, prostaglandin (PG) E2and F2αin the myometria, even if receptors existed, although PGE2production in the decidual tissues was markedly stimulated. In addition, an OT receptor antagonist inhibited the stimulatory effects of OT on IP3formation.

Conclusions: These results suggest that the formation of IPs by OT, the OT receptor levels in the myometrium, and the production of PGE2in the decidua might play crucial roles in parturition.