bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment with oral estrone sulphate in the female climacteric: II. Hormonal aspects
Authors: Lagrelius A. , Carlström K. , Lunell N. O.
Published: December 2009

Of forty‐three perimenopausal women aged 40.1–56.5 years with climacteric complaints 25 were treated with sodium piperazine estrone sulphate 2.5 mg daily and 18 were given methyl scopolamine. All subjects had initial serum FSH levels in the postmenopausal range (20 U/l). The serum levels of FSH, LH, unconjugated immunoreactive estrogens, total estrone, total dehydroepiandrosterone (DHAS), and the urinary low polar estrogens were followed during 18 months of treatment. In the estrogen treated group serum unconjugated immunoreactive estrogens and total estrone as well as urinary low polar estrogens increased significantly during treatment. The serum levels of FSH decreased significantly during the whole test period; LH only at three months. No effects could be seen on serum DHAS. In the group given methyl scopolamine the only changes found were a decrease in FSH at three months and a positive trend for LH (during the whole treatment period). In the total material, positive correlations were found between pretreatment values of unconjugated immunoreactive estrogens and total estrone and between total estrone and DHAS. A negative correlation was found between unconjugated immunoreactive estrogens and FSH.

It is concluded that the effects of estrogens on the endocrine system in peri‐ and postmenopausal women are influenced by chemical structure, dosage and mode of administration of the estrogen as well as by the endogenous hormone profile.
A comparison of the amniotic fluid cytology, lecithin/sphingomyelin ratio and creatinine in predicting fetal maturity at term
Authors: Tydén O. , Bergström S. , Lindmark G. , Nilsson B. A.
Published: December 2009

The value of three amniotic fluid tests—ratio of lecithin/sphingomyelin, creatinine concentration and the Nile blue cytological test for lipid—carrying cells—in predicting fetal maturity at term was investigated. The cytological test was the best individual test, and a combination of all three seemed to accurately diagnose functional immaturity. A sequential approach for maturity testing is suggested. It is also concluded that maturity testing at term is an appropriate means of preventing iatrogenic prematurity.
Excessive hypertriglyceridemia and pancreatitis in pregnancy: Association with deficiency of lipoprotein lipase
Authors: Lykkesfeldt Gert , Bock Johannes E. , Pedersen Finn Damgaard , Meinertz Hans , Faergeman Ole
Published: December 2009

Acute pancreatitis verified at laparotomy occurred in the 37th week in 1 of 4 women who developed excessive hypertriglyceridemia (type V hyperlipoproteinemia) during pregnancy. The hypertriglyceridemia was associated with and possibly caused by deficiency of lipoprotein lipase, measured as the NaCl sensitive component of post‐heparin lipase activity. A severely fat‐restricted diet controlled the hypertriglyceridemia in 1 of the patients, followed during a second pregnancy.
Prediction of fetal pulmonary maturity from amniotic fluid obtained from the vagina after premature rupture of the membranes: A patient treated with dexamethasone
Authors: Isherwood D. M. , McMurray J. A. , Campbell C. , Jenkins D. M.
Published: December 2009

The case presented illustrates the potential of assessing fetal pulmonary maturity by analysing liquor draining vaginally after premature rupture of the membranes. The necessity of carrying out appropriate biochemical tests to detect contamination with maternal urine is emphasized.
PLASMA AND RED CELL FOLATE IN NEWBORN TWINS AND THEIR MOTHERS IN RELATION TO GESTATIONAL AGE
Authors: Ek Johan
Published: December 2009

Abstract. Plasma and red blood cell folate concentrations (Lactobacillus casei activity) have been studied in 56 newborn twins and in 26 of their mothers, and in a control group consisting of 186 singletons and 155 of their mothers. The duration of the pregnancies ranged from 30–40 weeks. Iron, but no folic acid supplementation was given during pregnancy.

The plasma and red cell folate concentrations in the twin mothers were at all stages of pregnancy similar to those observed in women with single pregnancies having an adequate folate intake. The twins had plasma folate concentrations similar to singletons at all gestational ages. Their red cell folate concentrations were lower than in singletons until 37 weeks of gestation, while the values were similar at term, indicating an increased transfer of folate to the twins during the last week of pregnancy. The smaller of the twins had similar plasma folate concentrations and lower red cell folate concentrations compared to the bigger one. At 30–32 weeks of pregnancy twin mothers had lower Hb, RBC and VPRC‐values than women with single pregnancies. Twin mothers, delivering at 38–40 weeks of pregnancy, had values corresponding to those of single pregnancy women, probably indicating a recovery from a physiological lowering of the blood values. The twins had similar Hb, lower RBC and higher MCV and reticulocyte values compared to singletons, possibly indicating a more active erythropoiesis in the twins.

Folic acid supplementation is not recommended as a routine in twin pregnancies in this population. Twins delivered before term should be ensured an adequate folate intake.
UTERINE ANOMALIES IN DIETHYLSTILBESTROL‐EXPOSED WOMEN WITH FERTILITY DISORDERS
Authors: Ben‐Baruch G. , Menczer J. , Mashiach S. , Serr D. M.
Published: December 2009

Abstract. Uterine anomalies were demonstrated by hystero‐salpingography (HSG) in 4 of 5 diethylstilbestrol (DES) exposed young women with fertility disturbances. The anomalies included malformed uterine cavities and cervical incompetence. It is suggested that HSG in DES exposed women with fertility disturbances be performed early in the process of infertility investigation and cerclage should be considered when uterine anomalies are demonstrated. Tubal pregnancy should be ruled out by ultrasonography early during pregnancy in DES‐exposed women.
CYPROTERONE ACETATE IN THE TREATMENT OF HIRSUTISM
Authors: Ylöstalo Pekka , Laakso Leo , Viinikka Lasse , Ylikorkala Olavi , Vihko Reijo
Published: December 2009

Abstract. Cyproterone acetate (100 mg daily on the 5th‐14th days of the normal cycle) together with ethinyl estradiol (0.05 mg daily on the 5th‐25th days) was used for the treatment of hirsutism in 23 women for six months. This treatment caused a significant decrease in the severity of the hirsutism after only three months, the effect being maximal after six months. Sixty per cent of our patients reported being subjectively satisfied with the results. A relapse occurred, however, within three months of the end of the treatment in half the patients. The serum testosterone was significantly decreased after three months of treatment, but the changes in serum testosterone did not follow the changes in the clinical picture of hirsutism, suggesting that one facet in the favorable action of cyproterone acetate is an inhibition of the action of androgen on target cells. Various side effects, such as nausea, headache, loss of libido and depression, were reported very frequently, which undoubtedly limits the large scale use of this treatment, at least with the doses used in this study.
RELATION OF ESTRIOL IN SALIVA TO SERUM ESTRIOL DURING NORMAL PREGNANCY
Authors: Fischer‐Rasmussen Wiggo , Gabrielsen Martin Vahl , Wisborg Tove
Published: December 2009

Abstract. As saliva is an easily accessible biological material, compared with 24‐hour urine and blood, the salivary concentration of estriol was studied from the 30th to the 41st week of gestation in 268 samples from 124 normal pregnancies. At the same time, venous blood samples were drawn and analyzed for total and unconjugated estriol. The mean values for the concentration of total estriol in saliva in the 30th and 41st weeks were 2.8 and 7.2 nmol/l respectively. The salivary estriol concentration appears to increase in perfect conformity with its serum concentration in the course of gestation. If estriol in saliva also reflects low serum values and an impaired function of the feto‐placental unit, analyses of the saliva may be applicable as a screening procedure in high‐risk pregnancies.
SEVERE OVARIAN HEMORRHAGE IN CONGENITAL AFIBRINOGENEMIA
Authors: Schneider D. , Bukovsky I. , Kaufman S. , Sadovsky G. , Caspi E.
Published: December 2009

Abstract. This is a case report of a patient with congenital afibrinogenemia and massive intra‐abdominal bleeding from a ruptured corpus luteum cyst. None of the previously reported 100 cases mentioned obstetrical or gynecological complications associated with this rare entity.
A NEW VAGINAL OPERATION FOR RECURRENT AND LARGE RECTOCELE USING DERMIS TRANSPLANT
Authors: Øster Solveig , Astrup Aage
Published: December 2009

Abstract. A new operation for large rectocele is described. The operation combines the method of posterior colporrhaphy with the principles of ventral hernia surgery using a submucosal dermis graft to reinforce the vaginal wall.

Fifteen postmenopausal women were examined one to four years after treatment for rectocele with this method.

All fifteen patients were cured of their symptoms. Only in one case was the anatomical result less perfect.

On proper indications this operation is a good alternative to the existing methods of treating rectocele.

The method is not difficult to perform for the surgeon familiar with colporrhaphy, and the operation it no more onerous for the patient than is a simple colporrhaphy.
Severe Cervical Dysplasia: Control by Biopsies or Primary Conization? A Comparative Study
Authors: Westergaard Lars , Nørgaard Mogens
Published: December 2009

During the period 1967–75 severe cervical dysplasia was diagnosed in 87 consecutive cases by means of colposcopically directed biopsies of the portio and by cervical curettage. Thirty‐eight of the patients were treated, 3–6 weeks after diagnostic biopsy, by conization (conization group) and subsequently followed with smears and colposcopy. The remaining 49 patients (the biopsy group) were followed up at regular intervals by colposcopically directed biopsies of the portio and cervical curettage. The follow‐up period for all 87 patients ranged from 9 to 106 months, mean 47.6 months. The groups were comparable with respect to the most important epidemiological factors.

During the follow‐up period progression to carcinoma in situ and to microinvasive carcinoma was found in 57.1% of the biopsy group but in 0% of the conization group. Of the whole material, 69 patients had conization (the 38 patients of the conization group plus 31 of the biopsy group). In 3 cases (4.35%) the cone diagnosis was 1 grade more serious than the biopsy diagnosis. The mean transit time of progression from severe dysplasia to CIS/MIC was 12–15 months.

It is concluded that severe dysplasia is a rapidly progressing state which can be safely diagnosed by colposcopically directed biopsies of the portio and cervical curettage and effectively treated by conization. In view of the fact that not less than 32.7% of the cases with severe dysplasia in the biopsy group regressed during follow‐up, we recommend that the diagnosis be established by portio biopsies and cervical curettage, twice with an interval of 3 months to restrict the number of superfluous conizations.
Bacterial Cultures from Intrauterine Devices Removed from Patients with Pelvic Inflammatory Disease
Authors: Nilsson Carl Gustaf , Vartiainen Eero , Widholm Olof
Published: December 2009

Bacterial cultures were obtained from intrauterine devices (IUD) removed from 274 patients admitted to the Department of Obstetrics and Gynecology of the University Central Hospital of Helsinki because of suspected pelvic inflammatory disease (PID). meno‐metrorrhagia, pain or other conditions potentially caused by an IUD. A diagnosis of serious PID was made in 42 patients, mild PID in 119 patients, while 113 were found to have no infection. An association between positive cultures of β‐hemolytic streptococci and Escherichia coli and PID was found. Positive cultures of Neisseria gonorrhoeae were significantly correlated with PID. The risk of developing PID was significantly greater during the first month after insertion of the IUD than when more than 30 days had elapsed from insertion of the IUD. The significance of the microbes cultured from removed IUDs as causal agents of pelvic inflammatory disease is discussed.
Hormonal and Cytotoxic Chemotherapy for Endometrial Carcinoma: Steroid receptors in the selection of appropriate therapy
Authors: Kauppila Antti , Friberg Lars‐Gösta
Published: December 2009

Progestin therapy yields an objective remission in about one‐third of patients with advanced endometrial carcinoma. Cytotoxic chemotherapy has also clearly proved effective in recent years, and anti‐estrogen therapy to an indicative degree. It is remarkable that both these therapies appear to exert their anti‐neoplastic effect even in patients unresponsive to progestin.

A survey of current knowledge on estrogen (ER) and progestin receptors (PR) demonstrates that they are present simultaneously in 41 ‐ 80% of samples of endometrial carcinoma tissue. The concentration of cytosol ER and PR tends to decrease from well differentiated towards anaplastic carcinomas. This indirect evidence, together with some preliminary clinical observations, suggests that an absence or low concentration of ER and/or PR is suggestive of a poor prognosis.

It is thought that an assay of ER and PR might be of value in predicting the response to chemotherapy in endometrial carcinoma, such as in breast carcinoma. This does indeed seem to be the case, as at least four independent clinical studies have to date confirmed that significant amounts of cytosol ER alone, and especially cytosol PR alone, or both together, in the tumor tissue can predict with reasonable accuracy a good sensitivity to progestin. In like manner, a low cytosol concentration of these steroid receptors appears to predict a good response to cytotoxic chemotherapy, as demonstrated in one study.

Progestin and anti‐estrogen exert their anti‐neoplastic effect via an operative receptor mechanism in different ways, whereas cytotoxic chemotherapy acts by means not involving steroid receptors. It is therefore likely that a detailed characterization of the endocrine relations of the tumor by precise assay of ER and PR from the cytosol and nuclear fractions, together with determination of the end‐product of progestin action, 17β‐hydroxysteroid dehydrogenase, will further enhance the accuracy of individual a priori selection of the most efficacious chemotherapy available.
VAGINAL APPLICATION OF A CHEMOTHERAPEUTIC AGENT BEFORE LEGAL ABORTION
Authors: Meirik Olav , Nilsson Staffan , Nygren Karl‐GÖSta
Published: December 2009

Abstract. In an attempt to reduce the incidence of infectious complications after first trimester legal abortion 199 healthy, early pregnant women were treated with chloro‐quinaldol (SterosanR vaginal jelly) during six days before their vacuum aspiration. A group of 291 women served as control. In the treatment group 18 women (9%) had a postoperative gynecological infection while this condition was found in 37 women (12.8%) in the control group. This difference is not statistically significant. The authors conclude that preoperative prophylactic treatment with Sterosan vaginal jelly does not seem to reduce postoperative infectious complications after first trimester legal abortions.
Complications Following High and Low Dose‐Rate Intracavitary Radiotherapy for St. I‐II Cervical Carcinoma: A Comparison of Remotely Afterloaded CO60 (Cathetron) and Conventional Radium Therapy
Authors: Taina Esko , Taina E.
Published: December 2009

Abstract. A study was made to compare the incidence, quality and aetiology of complications after low and high dose‐rate intracavitary radiotherapy for St. Ia‐IIb cervical carcinoma in 185 patients, of whom 84 were treated with radium (R) and 101 with afterloaded Co60 (Cathetron, C), from 1969 to 1976. the frequency of surgery and external irradiation was similar in both groups. There were more (p=0.01) complications in group C (27.7%) than in group R (13.1%). However, when the single fractions in the Cathetron treatment were lowered from 10 Gy to 7.5 Gy each in 1972, the incidence of complications decreased from 42.4% to 20.6% (p=0.02) and the latter incidence was not statistically different from group R. Intestinal complications were more frequent than urological ones in both groups. Low weight was significantly (p<0.025) correlated with the development of complications and previous laparotomy (p=0.0001) with the development of fistulae in group C.
A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co60 (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma
Authors: Taina Esko , Taina E.
Published: December 2009

Abstract. From 1970 to 1976, 91 patients with St. I‐II endometrial carcinoma associated with a small uterine cavity (≤9 cm) were treated with the Cathetron (C) and 125 with radium (R). Surgery was carried out on 59.3% of the patients in group C and 80.0% in group R two weeks after the intracavitary radiotherapy and 56.0% of the patients in group C and 39.2% in group R received external irradiation with or without an operation. There was no statistical difference in the survival between the two treatment groups, the 5‐year crude survival being 79.4% for group C and 82.4% for group R, and the 3‐year crude survival rates 82.4% and 88.0% respectively. There was no statistically significant difference in the local recurrence of tumour between group C (3.3%) and R (0%); nor were the rates of early complications different, 3.3% in group C against 4.0% in group R. No differences were found in operative difficulties or early postoperative morbidity between the two groups during or after hysterectomies and bilateral salping‐ooophorectomies after intracavitary radiotherapy.
Complications Following High and Low Dose‐Rate Intracavitary Radiotherapy for St. I‐II Endometrial Carcinoma: A Comparison of Remotely Afterloaded CO60 (Cathetron) and Conventional Radium Therapy
Authors: Taina Esko , Grönroos Matti , Taina E.
Published: December 2009

Abstract. Complications after low and high dose‐rate intracavitary radiotherapy for St. I‐II endometrial carcinoma associated with a small (≤9 cm) uterine cavity were analysed, and comparisons of their incidence, quality and aetiology were made. the material comprised 216 patients treated from 1970 to 1976, of whom 125 were treated with radium (R) and 91 with afterloaded Co60 (Cathetron, C). No significant difference was found in the incidence of complications between group C (14.3%) and group R (8.0%). When the single fractions in the Cathetron treatment were lowered from 10 Gy to 7.5 Gy each in 1972, the incidence of complications decreased significantly (p= 0.04) from 33.3% to 11.4%. Intestinal complications occurred more frequently than urological ones both in group C and R. Vascular disease was significantly (p=0.03) correlated with the development of complications in group R, while age, weight or previous laparotomies were not correlated with complications in either group.
Randomized Prospective Studies on Metabolic Effects of Oral Contraceptives
Authors: Briggs M. H. , Briggs Maxine
Published: December 2009

Abstract. The results of two randomized prospective studies on metabolic changes induced in groups of healthy Young women by commercial oral contraceptives (OC) are described. In the first study, four low‐estrogen (30 μg or 35 μg ethinylestradiol) combined products were compared, while in the second, effects of four different formulations, each containing levonorgestrel plus ethinylestradiol, were determined. Results are presented for oral glucose tolerance and plasma insulin responses, serum total cholesterol, HDL‐cholesterol, triglycerides, coagulation factors I, VII, VIII, and X, plasminogen, anti‐thrombin III, and (for study no. two only) renin activity, substrate, and concentration. In the first study, products containing norethisterone or ethynodiol diacetate were associated with significant increases in serum triglycerides and total cholesterol, though HDL cholesterol fell. Coagulation and fibrinolytic factors showed similar changes. The product containing levonorgestrel showed the smallest alteration in all tests.

In study 2, the effects of formulation were investigated. Most tests showed changes approximately in proportion to the dose of both steroidal components, though the estrogen appeared to exert the most pronounced effect. Minimal alterations in most tests occurred in women using the lowest fixed dose formulation (150 μg levonorgestrel + 30 μg ethinylestradiol), or the triphasic product. Significant effects on the renin system were seen with all four formulations; again, the two lowest dose preparations produced the smallest changes.

Most of the biochemical changes observed were established during the first few cycles of oral contraceptive treatment, then remained approximately constant to the end of the present study periods. The effects appear to be determined by the estrogen and progestogen doses of the various products, and to interactions between the two hormones.
Progestogen Effects and their Relationship to Lipoprotein Changes
Authors: Wingrave Sally J.
Published: December 2009

Abstract. The Oral Contraception Study of the Royal College of General Practitioners is a long‐term, controlled, prospective survey which is now in its 14th year. The substantial data accumulated permits assessment of the effects of particular brands upon morbidity. We have shown that the progestogen content of the Pill is associated with the incidence of hypertension, benign breast disease and, more important, of total arterial disease. The data support the findings of other investigators who have shown that progestogens lower HDL‐cholesterol levels and that low HDL‐cholesterol increases the risk of arterial disease. The implications are that the progestogen content of an oral contraceptive and the relative potency of the estrogen and progestogen it contains must be considered carefully not only in terms of present clinical practice, but also in terms of the direction of new Pill formulation development.
Use of β‐Receptor Agonists in Obstetrics
Authors: Ingemarsson Ingemar
Published: December 2009

Abstract. Modern β‐receptor agonists are potent inhibitors of uterine activity, both spontaneous and induced, and there are several indications for therapy, such as preterm labor, abnormal uterine activity during labor (with or without concomitant fetal distress), complicated cesarean sections, and others.

In recent years the widespread use of β‐receptor agonists for preterm labor has been criticized and the efficacy of these drugs has been questioned, since the rate of preterm deliveries (before week 37) has remained unchanged. However, an analysis of preterm births in Sweden from 1973 to 1979 shows that the number of both preterm births before week 32 and of infants with birthweight below 1 500 g is declining, which is more interesting in terms of fetal outcome than is the crude preterm figure (before week 37). The introduction of routine use of β‐receptor agonists for preterm labor coincides with this decrease.

It is concluded that these drugs can be of great value in many obstetrical situations.
Prevention of Prematurity in Twin Pregnancy by Orally Administered Terbutaline
Authors: Skjaerris Johannes , Åberg Anders
Published: December 2009

Abstract. The intention of this study was to evaluate whether perorally administrated terbutaline given prophylactically could reduce prematurity in twin pregnancy. In a double‐blind study, 50 women with twin pregnancies were given either placebo (25) or terbutaline (25). Six in the terbutaline group and 15 in the placebo group went into preterm labor which required intravenous infusion of terbutaline. The difference is statistically significant (p = 0.010). The total number of days in hospital due to preterm labor was 115 in the terbutaline group and 256 in the placebo group. There is a slight difference in prematurity (delivery week < 37th week)—the placebo group gave birth somewhat earlier—but this difference is not statistically significant. When evaluating this, it has to be considered that 15 of the 25 in the placebo group received parenteral treatment with terbutaline because of preterm labor. Birth weights of the twins in relation to gestational age seemed to be the same in the two groups.
Prescription of β‐Receptor Agonists in Maternal Health Care in Sweden
Authors: Lindberg Bo S.
Published: December 2009

Abstract. In 1978–80 about 8 per cent of all pregnant women in Sweden were prescribed β‐stimulants per os because of imminent preterm labor. This did not cause any definite change in the frequency of prematurity (less than 37 weeks' gestation).
Follow‐Up Studies On Preterm Infants After Maternal β‐Receptor Agonist Treatment
Authors: Svenningsen Niels W.
Published: December 2009

Abstract. A review of the existing literature regarding the outcome of infants delivered preterm after antenatal β‐receptor agonist treatment of the mother is presented. Some investigators have reported an increased rate of neonatal and long‐term hazards, while others have not found a higher incidence of such complications after antenatal β‐receptor treatment. In our own material of 54 preterm survivors with follow‐up up to 2 years of age, we found a modest rise in postnatal hypoglycemia rate but no other short‐term or long‐term sequelae. Postnatal monitoring of blood glucose and cardiovascular function is warranted at preterm deliveries after antenatal β‐receptor agonist treatment.
Laboratory and Clinical Assessment of a New Progestational Compound, Desogestrel
Authors: Skouby Sven O.
Published: December 2009

Abstract. The effects of a new progestational compound, desogestrel (17α‐ethinl‐18‐methyl‐11‐methylene‐4‐estrene‐17β‐01), on a range of laboratory and clinical parameters have been studied in three groups of healthy women (n = 2–6) after oral administration of the drug alone (60, 125, or 250 μg) and in combination with 50 μg ethinylestradiol. The time for each group to enter the study was staggered so that any undesirable side effect could be recognized before a higher concentration of desogestrel was given. Tablets were administered for 21 days and, for control reasons, each treatment cycle was preceded by a tablet‐free cycle. Effects on fasting glucose, triglycerides, total cholesterol, thyroxine, total bilirubin, alkaline phosphatase, ala‐nine aminotransferase, total protein, hemoglobin, throm‐bocyte count, body weight, blood pressure and bleeding pattern were studied. In addition any effect on the general physical well‐being of the volunteers was recorded. The results of the study have not revealed any adverse effects on laboratory or clinical parameters and justify further clinical investigations with desogestrel, both alone and in combination with ethinylestradiol.
Ethinylestradiol and a New Progestogen (Desogestrel) in a Low‐Dose Combination
Authors: Cullberg Göran , Knutsson Folke , Lindstedt Göran , Mattsson Lars‐Åke , Steffensen Kjeld
Published: December 2009

Abstract. A combination of 30 μg ethinylestradiol (17α‐ethynyl‐1,3,5(10)‐estratriene‐3,17β‐diol) and 150 μg desogestrel (Org 2969, 17α‐ethynyl‐18‐methyl‐11‐methylene‐4‐estrene‐17β‐ol) was given for 21 days through three consecutive cycles to 5 healthy female volunteers. A detailed study was made in the cycle immediately preceding (‘control’) and the one following the treatment as well as of the first and third treatment cycles. Serum FSH, LH, prolactin, 17β‐estradiol and progesterone were measured by radioimmunoassay. Serum sex‐hormone binding globulin (SHBG) was assayed as dihydrotestosterone binding capacity by the cellulose anion‐exchanger adsorption technique. Cervical mucus was studied with respect to sperm penetration and Spinnbarkeit. Basal body temperature as well as menstrual and intermenstrual bleedings were recorded.

All ten treatment cycles appeared to be anovulatory, in contrast to the control and post‐treatment cycles. Sperm penetration was very weak during treatment, whereas Spinnbarkeit was less suppressed. The SHBG capacity increased about fivefold. The mean duration of the follicular phase of the post‐treatment cycle was slightly longer and that of the luteal phase slightly shorter than in the pretreatment cycle. No evidence was obtained for adverse effects on the secretion of gonadotropins, prolactin, or the main gonadal steroids after withdrawal of treatment. The observed differences in preovulatory concentration of 17β estradiol between the control and post‐treatment cycles may be ascribed to differences in SHBG capacity. Some previously undescribed hormonal findings in the follicular phase of the post‐treatment cycle are discussed.

There was a negative relation between serum SHBG capacity and body weight at the initiation of the study. The 2 volunteers with heaviest body weight and lowest SHBG capacity decreased 9 and 10 kg, respectively, whereas the body weight of the other 3 volunteers remained essentially unchanged during treatment.

Endometrial morphology was also studied; it was highly variable between the subjects.
Computer Description of the Cardiotocogram
Authors: Stigsby Bjarne , Nielsen Peter Vest , Olesen Mogens Brix , Jaszczak Poul , Larsen Jørgen Falck , Lenstrup Carsten
Published: December 2009

Abstract. Principles of calculations used for computer description of the cardiotocogram (CTG) were evaluated. Fetal heart rate (FHR) and intrauterine pressure (IUP) were recorded simultaneously on magnetic tape. Subsequent quantitative analysis was performed on a general purpose digital minicomputer. The program automatically detects decelerations, accelerations and uterine contractions. The following variables are determined automatically: baseline level and variability; duration, amplitude, area, latency time and lagtime of the alterations; uterine resting tone; duration, amplitude and area of uterine contractions. Trends of all variables can be presented graphically. The program can function off‐line, as well as on‐line, using about seven minutes of computational time to describe one hour of CTG.
Diagnostic Value of Ultrasound Scanning and Curettage in Ectopic Pregnancy
Authors: Legarth Jesper , Eriksen Poul Sindberg
Published: December 2009

Abstract. The object of this study was to assess the diagnostic value of ultrasonic scanning alone and of ultrasonic scanning combined with histological examination of endometrial tissue on suspicion of subacute ectopic pregnancy. For the 93 patients comprising the study, ectopic pregnancy was diagnosed in 21 cases. The diagnostic sensitivity of ultrasound scanning alone proved high, there being 97% correct, negative diagnosis, while a correct positive diagnosis was made in 79%. Ultrasound scanning combined with histological examination of endometrial tissue did not improve the diagnostic accuracy. It is concluded that on suspicion of ectopic pregnancy, ultrasound scanning is a valuable screening method for the exclusion of this condition.
Invasive Cancer in the Vulvar Region
Authors: Andreasson Benny , Bock Johannes E. , Weberg Edgar
Published: December 2009

Abstract. During the past 25 years there has been a tenfold increase in the incidence of vulvar cancer in Denmark. For this reason a material of 195 patients treated during the period 1960–77 is reviewed.

There had been a considerable delay in treatment, due partly to the patients and partly to the doctor first seen.

The five‐year survival rate was 63.3%, corrected 84.2%. The prognosis is highly influenced by the size of the tumor, its appearance, the presence of unilateral or bilateral metastasization to the inguinal nodes, the histological type, and localization of the tumor. On the basis of these features, it is possible to single out groups having a particularly poor prognosis in whom the surgical treatment is insufficient and ought to be supplemented.

Clinical assessment of the inguinal lymph nodes carries a considerable uncertainty, yet the FIGO staging is based mainly upon this assessment. This goes some way towards explaining why no prognostic differences were found between stages I, II, and III.

Postoperative staging based upon the histological diagnosis would provide greater prognostic certainty.
A Study of Parental Attitudes after Donor Insemination (AID)
Authors: Milsom Ian , Bergman Per
Published: December 2009

Abstract. Artificial donor insemination (AID) is important in the treatment of infertility when the couples' wish for a family is denied because of male sterility. However, very little is known regarding the continued development of AID families and their attitudes to insemination after the child is born. This study is based on a questionnaire anonymously completed by 92 couples returning to obtain a second child by insemination. None of the parents regretted his or her decision regarding insemination and the majority were prepared to recommend the method to other couples in the same situation. Apart from one couple the parents intended to withhold the truth from the child regarding its origin. The majority of parents chose not to inform anyone else regarding the child's conception. The parents were therefore anxious that case notes and details concerning insemination were treated with the utmost discretion and confidentiality. The parents in this study clearly indicated they preferred insemination to adoption. A large proportion of the parents who already had a child as a result of insemination returned to the clinic for a second child.
Screening for Cancer of the Uterine Cervix in Iceland 1965–1978
Authors: Johannesson G. , Geirsson G. , Day N. , Tulinius H.
Published: December 2009

Abstract. The trends in the mortality and morbidity from cervical cancer in Iceland for the period 1965–1978 are examined in relation to the screening programme that began in 1964. By 1970 over 80% of the female population under the age of 65 had been screened at least once, and by 1977 over 65% of women under the age of 75 had been screened at least twice. Mortality fell by 60% between 1959–1970 and 1975–1978, with a corresponding fall in the incidence of advanced tumors. The mortality rates among the unscreened population are more than ten‐fold greater than among the screened. The greater part of the fall in mortality is attributed to the mass screening programme.
Peripheral and Ovarian Venous Concentrations of Gonadal Steroids and CEA in Women with Ovarian Tumors
Authors: Jeppsson Sten , Kullander Stig , Rannevik Gunnar
Published: December 2009

Abstract. In an effort to improve our knowledge of certain marker substances in human ovarian neoplastic diseases (both benign and malignant) 12 patients with ovarian tumors were studied. Ten of these were postmenopausal.

Venous blood was drawn simultaneously from both ovarian veins and a cubital vein by direct puncture during laparotomy. In cystic tumors, cyst fluid was also collected. 17β‐estradiol and progesterone were analyzed in all samples, as were FSH, LH, and CEA in peripheral venous blood and cyst fluid.

Owing to the physiological variation of gonadal steroid levels in premenopausal women, abnormal production of steroids from the tumors could be detected only in postmenopausal women. The study showed that 4 out of 6 postmenopausal women with benign ovarian tumors had abnormally high peripheral blood levels of estradiol and progesterone emanating from the ovaries harboring the tumors. All 4 postmenopausal women with malignant tumors likewise had an abnormally high production of estradiol, and usually also of progesterone.

High concentrations of estradiol were seen in tumorous ovarian venous blood in one patient in spite of normal concentrations in peripheral venous blood.

Various histological types of tumor could produce similar hormonal profiles.

One case out of 6 of benign ovarian tumor and 2 cases out of 6 of malignant ovarian tumor showed elevated levels of CEA in the peripheral blood. One benign serous and 2 benign mucinous cystomas had elevated CEA values in the cyst fluid.

This preliminary report demonstrates that 8 out of 10 postmenopausal women with ovarian tumors had an abnormal production of gonadal steroids.

The determining of gonadal steroids and other marker substances in ovarian venous blood sampled, i.e. during angio‐catheterization, might improve the early detection of ovarian tumors. Relevant studies are in progress.
Uterine Activity and Placental Histology in Abortion at Mid‐Trimester by Rivanol and Catheter
Authors: Manabe Y. , Manabe A. , Yoshida Y.
Published: December 2009

Abstract. Artificial abortions were performed on 7 patients during mid‐pregnancy by intra‐uterine instillation of 0.1% rivanol and catheters. The changes in uterine contractility during the treatment were monitored continuously by intra‐amniotic pressure recording. Uterine activity developed a gradual but steady increase and abortion was completed within 22 to 47 hours. A significant increase in uterine contractility started after a lag of several hours. Neither hyper‐tonus nor hyperactivity was noted during the treatment. The fetus was delivered unaffected in all cases. The placentas delivered showed normal histological integrity, and an autora‐diographic study established the viability of trophoblasts. These results suggest that the abortive effect of rivanol and catheter on the uterus and placenta is different from that induced by other chemicals.
Single Extra‐Amniotic Injection of Prostaglandin E2 in Tylose Gel to Induce First Trimester Abortion in Young Nullipara
Authors: Djahanbakhch O. , Bassan T. S. , Marshall D. E. , Gardner N. H.
Published: December 2009

Abstract. A single extra‐amniotic injection of 2 or 4 mg of prostaglandin E2 in Tylose gel was administerd to 30 primi‐gravidae between the ages of 14 and 20 years to induce first‐trimester abortion. Twenty‐three patients (76.7%) aborted, though incompletely, within 9 hours, with a mean induction‐abortion interval of 6.3 hours. In the remaining 7 (23.3%) the cervical os was found to be open and no mechanical dilatation was required at the time of vacuum aspiration. The only side effect was vomiting, which occurred in 2 patients. The method was shown to be safe and effective and may be employed in young primigravidae, thus eliminating the cervical complications attending vacuum aspiration.
Serum Lipoprotein and Apolipoprotein Changes During Treatment with a Contraceptive Vaginal Ring Containing Levonorgestrel and Estradiol
Authors: Åhrén T. , Lithell H. , Victor A. , Vessby B. , Johansson E. D. B.
Published: December 2009

Abstract. Contraceptive vaginal rings containing estradiol and levonorgestrel were used by 22 women during 219 cycles. The estrogenicity was low and the daily dose of levonorgestrel was about 290 μg. The triglyceride and cholesterol concentrations decreased in whole serum and, to varying degrees, in the different lipoprotein classes. The most consistent change was a 25% (p <0.001) reduction in the cholesterol content of the high‐density lipoprotein (HDL) fraction. The cholesterol concentration in low‐density lipoprotein decreased by 11% after the first 3 months, but increased during the ensuing 9 months of treatment to regain pretreat‐ment level. Percentagewise, the apolipoprotein B and A‐I concentrations, determined by rocket immunoelectro‐phoresis, were less affected than the LDL‐ and HDL‐cholesterol concentrations. The composition of the LDL and HDL particles seemed thus to alter during the treatment. The pronounced effect on the HDL levels seen is consistent with earlier findings of a dose‐dependent, androgenic effect of gestagens derived from 19‐nortestosterone. However, the low basal level of LDL and its further decrement during treatment alleviate the supposedly unfavorable effect of HDL reduction from the atherogenic point of view.
Plasma and Red Cell Folate in Mothers and Infants in Normal Pregnancies
Authors: Ek Johan
Published: December 2009

Abstract. Plasma and red blood cell folate concentrations (L. casei‐activity) have been studied at term in 166 infants born after normal pregnancies, and in 139 of their mothers. Iron (but not folic acid) supplementation was given during pregnancy. The mothers did not develop folate deficiency during pregnancy as judged from their plasma and red blood cell folate concentrations and peripheral red blood cell pictures. A positive correlation was observed between the red cell folate concentrations in the mothers and the birth weights of the infants (r = 0.18, n = 136, p<0.05). A positive correlation was also observed between the red cell folate concentrations of the infants and the birth weights and lengths (r = 0.16, n = 147, p<0.05 and r = 0.22, n = 147, p<0.01, respectively). The present evidence is insufficient to settle whether these correlations are causal. Hematological parameters in the mothers were correlated to those of the infants. The results suggest a relationship between the maternal and infant erythropoiesis.
Neoplasia in the Vagina Following Hysterectomy for Dysplasia or Carcinoma in Situ of the Uterine Cervix
Authors: Rasmussen Jan , Diernaes Elisabeth
Published: December 2009

Abstract. With a view to establishing some of the factors responsible for an increased risk of neoplasia in the vagina following primary hysterectomy for dysplasia or carcinoma in situ of the cervix, 63 surgical specimens from patients with subsequent neoplasia in the vagina have been compared with specimens from 40 patients without subsequent neoplasia.

We found the frequency of neoplasia in the vagina to be greater when dysplasia or carcinoma in situ could be demonstrated in the vaginal margin. Neither the degree of endo‐cervical glandular involvement, the number of mitoses, nor the inflammatory response of the connective tissue appeared to be significant in this respect.

No significant connection was found between the severity of the preinvasive lesion of the cervix and the subsequent neoplasia in the vagina.
Scanning electron microscopy of maternal blood cells and their surface relationship with the placenta
Authors: Al‐Zuhair A. G. H. , Ibrahim M. E. A. , Mughal S. , Mohammed M. E.
Published: December 2009

Abstract. With the aid of the scanning electron microscope the surface of full‐term human placenta and the maternal blood cells displayed on that surface were examined. The possible site(s) of materno‐fetal transfer of gases were further investigated. Small, fresh pieces of tissue were obtained and processed from at least six regions of central and peripheral parts of the maternal surface. It seemed that there is a firm association between the presence of the maternal red blood cells, the main vehicles for gas transport, and that of the microvilli. Our results clearly confirm the absence of maternal blood cells from the smooth apices of the dome‐shaped protrusions that occur on the tips of some floating villi. However, maternal red blood cells were consistently seen in close contact only with areas covered with microvilli. Direct evidence of the close contact was demonstrated by either red cell adherence to the microvilli or by their lying in recesses on the trophoblastic surfaces. Impressions (“foot prints”) on some surfaces, and the presence of red blood cells with detached microvilli adhering to their surfaces were interpreted as indirect evidence for the adherence. The lack of such evidence regarding the white blood cells or platelets is remarkable. Different types of white blood cells were identified in various shapes, ranging from rounded to flattened. Some of them possessed surface microvilli, while others demonstrated projections and surface folds. Our findings indicate, therefore, that the red cells have a unique and intimate relationship with the trophoblastic surfaces ‐more so than the other blood corpuscles. Thus this would appear to support our previous view that one of the functions of the microvilli is transfer of the gas across the placenta.
Lack of Correlation Between Contraceptive Pills and Down's Syndrome
Authors: Ericson Anders , Källén Bengt , Lindsten Jan
Published: December 2009

Abstract. A case‐control study has been made on the use of oral contraceptives before pregnancy and the birth of an infant with Down's syndrome. Controls were matched for age and parity and selected from the Medical Birth Register. Information on Pill usage was obtained from the Swedish standardized maternity health record which contains dates for when the woman stopped using the Pill and for last menstrual period. There was no indication of any relation between the use of oral contraceptives and Down's syndrome.
Fertility Prognosis after Surgical Treatment of Pelvic Endometriosis
Authors: Rantala M.‐L. , Kahanpää K. V. , Koskimies A. I. , Widholm O.
Published: December 2009

Abstract. A total of 129 infertile patients with endometriosis were treated by surgery. The severity of endometriosis was estimated according to Acosta's classification. The mean pregnancy rate was 51.2%. The pregnancy rate of the patients with primary infertility was 48.9% and, for the secondary infertility group, 56.8%. Two‐thirds of the women who became pregnant conceived within one year. The pregnancy outcome in mild endometriosis was 59.1%, in moderate 56.4% and in severe 40%. Eighteen male partners had deficient sperm in the group of 63 women who did not conceive within the follow‐up period. In addition to the extent of the disease, factors such as duration of infertility prior to surgery and age at the time of surgery seemed to be important in the fertility prognosis.
Premature Rupture of the Membranes and Ritodrine Treatment
Authors: Neldam Steen , Osler Mogens
Published: December 2009

Abstract. The treatment with Ritodrine of 38 women with preterm rupture of the membranes (PROM) and 109 with intact membranes (ITM) was compared. Before the 36th gestational week, parturition could be postponed significan‐ly longer in the ITM group than in the PROM group (p <0.01), whereas there was no difference between the two groups after the 36th week. Parturition could be postponed significantly longer in the PROM group, when Bishop's score was below or equal to 6, than when it was above, while the same was true for ITM, when the score was even 9 or below (p<0.001). Therefore, it seems like that PROM adds 3 points to the Bishop score, when the score is used as a prognostic index for the ability to postpone parturition.

There was no significant difference in the occurrence of RDS between the PROM group and the ITM group, although birth weight was significantly higher in the ITM group (mean 2799.5 g) than in the PROM group (mean 1985.5 g) (p<0.001).

No serious side effects of the treatment given were seen, either in the mothers or in the infants.

It is concluded that all women with preterm labor should be treated with ritodrine and bedrest, if betamethasone treatment of the mothers is indicated, as parturiton could be postponed for at least 24 h in all pregnancies in both groups.
Gastrin and Gastrointestinal Dyspepsia in Pregnancy
Authors: Steen J. , Westergaard L.
Published: December 2009

Abstract. Fasting serum gastrin (SG) concentration and the SG response to a standard protein meal were investigated in 8 women with upper gastrointestinal dyspepsia in the 36th week of pregnancy and again 8 weeks after parturition, when the dyspepsia had disappeared. The fasting SG concentration was significantly higher (p<0.05) during pregnancy than post part urn, whereas no statistically significant difference was found between the SG response to a protein meal stimulation during pregnancy vs. post partum. The demonstrated variations in gastrin secretion during and after pregnancy offer no explanation for the upper gastrointestinal dyspepsia of our patients.