bluuebunny/crossref_metadata_2025 huggingface dataset:
Antenatal Cardiotocography and Intrauterine Death
Authors: Solum Thore , Sjöberg Nils‐Otto
Published: December 2009

The purpose of the present study was to elucidate The reliability of antenatal cardiotocography (CTG) in predicting fetal death. During a 4‐year period, 1 455 patients with risk pregnancies have been routinely monitored with antenatal CTG. The total number of tracings amounted to inore than 10 000. Five cases of fetal death occurred, in all of which pathological CTG patterns were found. Our experience in the present study indicates that antenatal CTG is a reliable technique for the predicting of fetal death and its use should reduce fetal mortality rates.
Hydrop Degeneration: A Histopathological Investigation of 260 Early Abortions
Authors: Ladefoged Christian
Published: December 2009

Placental tissue from 160 abortions provoked during the 6th–12th weeks, and 100 spontaneous abortions between weeks 5 and 16, were studied histopathologically in respect of a comparison and quantitation of hydrop degeneration.

Significantly more cases of severe hydrop degeneration were observed among the spontaneous abortions (p> 0.001). Of these abortions, 87 per cent were hydrop degenerated to varying degrees; 41 per cent were severely hydrop degenerated. Among the provoked abortions, approximately 81 per cent were hydrop degenerated to varying degrees but only 6.9 per cent were severely hydrop degenerated. The relationship between severe hydrop degeneration and chromosome abnormality is discussed.
Infertility Factors: Their Relative Importance and Share in an Unselected Material of Infertility Patients
Authors: Sørensen SØRen Stampe
Published: December 2009

A 7‐year material of 196 infertile couples is presented. 1.5–8.5 years after investigation and/or treatment for infertility rather more than 48 per cent of the women had conceived, and of these pregnancies 19 per cent ended in abortion.

Various factors, such as duration of infertility, age, history of pelvic inflammatory disease, and previous use of oral contraceptives are analyzed for their relative share in the material and relative importance for the chances of pregnancy.—Unlike age, the duration of infertility was an important prognostic factor, also when it exceeded 2 years. Previous operations on the internal genitalia reduced the chances of conceiving essentially more than a history of one episode of pelvic inflammation, whereas several episodes of pelvic inflammation seemed to spell an equally unfavorable prognosis. As expected, infertility caused by oral contraceptive‐conditioned oligo‐amenorrhea was considerably easier to treat than other forms of infertility. Oligo‐amenorrhea was significantly more common among patients who had used oral contraception for 1–6 years than among those who had used it for less than 1 year.—The incidence of abortion in patients with secondary infertility was about three times higher before than after the infertility investigations.

Lastly, the individual infertility diagnoses were analyzed in the same way, as regards relative share and importance. About 42 per cent of the operated patients succeeded in conceiving. It is remarkable that 8 patients had a bicornuate uterus, and of them 7 had oligo‐ and/or hypomenorrhea.
Monoamniotic Twins Diagnosed by Ultrasound in the First Trimester
Authors: Mantoni Margit , Pedersen Jan Fog
Published: December 2009

A case of monoamniotic twins was diagnosed by ultrasonic scanning in the first trimester through the presence of two fetuses in one gestation sac. The fetuses died in utero in weeks 17 and 25. The possible ultrasound appearance of the various types of monozygotic and of dizygotic twins in early pregnancy is discussed and a scheme is suggested which allows some differentation.
Liver Cell Carcinoma in Young Women Possibly Induced by Oral Contraceptives
Authors: Amtrup Flemming , Slottved JØRgen , Svanholm Hans
Published: December 2009

Two cases of liver cell carcinoma in young women ingesting oral contraceptives have been found within a few months in the county of Vejle, Denmark. Including these two patients 22 cases of liver cell carcinoma in young women have been published since 1973, 19 of whom have used oral contraception. The possible effects of oral contraceptives in inducing liver tumors is discussed, and it is pointed out that no statistical proof of such an effect exists at present.
STUDIES IN NORMAL PREGNANCY — SERUM LIPIDS, LIPOPROTEINS, AND URIC ACID (II)
Authors: Skryten A. , Johnson P. , Gustafson A.
Published: December 2009

Abstract.Three different series of healthy pregnant women without any history or symptoms of metabolic disorder have been studied for serum lipids (cholesterol), triglycerides and phospholipids) as well as for cholesterol and triglyceride content in lipoprotein fractions in the 1st, 2nd and 3rd trimesters. Two other series of non‐pregnant healthy women, previously studied for serum lipids, are presented for comparison.

In the 1st trimester, serum cholesterol decreased (p<0·01) as compared to non‐pregnant values. In the 2nd and 3rd trimester all serum lipids increased successively with maximum values during 3rd trimester all serum lipids increased successively with maximum values during 3rd trimester. The changes were most pronounced in serum triglycerides.

Among lipoproteins, cholesterol content increased in all fractions during the 2nd trimester and was most pronounced in very‐low‐density lipoproteins (VLDL) (in the 2nd trimester by 78 per cent and in the 3rd trimester by an additional 94 per cent). The increase in triglycerides in the 1st and 2nd trimester was most pronounced in infranatant (LDL + HDL), while in the 3rd trimester the triglyceride content was more evenly distributed among infranatant and supernatant (VLDL) at density 1 006 g/ml. It is suggested that the increase in triglycerides is due to increased liver synthesis in the 1st and 2nd trimester concomitant with an enhanced removal, i.e. by increased lipoprotein lipase activity (LPLA). In the 3rd trimester, however, LPLA is possibly inhibated by subclinical cholestatic changes in the liver causing a maximum triglyceride accumulation preferentially located in VLDL.

In an earlier study dealing with serum lipid changes in diabetic pregnancy, marked hyperlipidemia in ihe 3rd trimester was a characteristic feature (23). Furthermore, elevated serum triglycerides in the mother appeared to be related to an increased birth weight of her infant.

A long parallel study was needed in normal pregnancy to allow a comparison with the serlim lipid variables in diabetes. The aim of the present investigation was to study serum lipids and lipoprotein, distribution in normal pregnancy.
PERIHEPATITIS IN PELVIC INFLAMMATORY DISEASE — ASSOCIATION WITH INTRAUTERINE CONTRACEPTION
Authors: Onsrud Mathias
Published: December 2009

Abstract. The Fitz‐Hugh‐Curtis syndrome (FHCS), or perihepatitis as a complication of pelvic inflammatory disease (PID), is readily diagnosed by laparoscopy. Among 274 non‐selected cases of acute PID verified laparoscopically, FHCS was found in 38 (13.8 per cent). Twenty‐four of the patients presented right‐upper‐quadrant pain and tenderness, while 14 experienced no local symptoms. Perihepatitis was found in a slightly higher frequency in PID cases of low age and in those using intrauterine contraception (IUCD) but the differences lack statistical significance. However, acute PID occurring within 6 weeks after IUCD insertion was associated significantly more often with FHCS (p < 0.01). It is suggested that the traumatizing effect of IUCD insertion facilitates the spread of pelvic inflammatory material to the perihepatic region.
MÜULLERIAN MALFORMATIONS AND SIMULTANEOUS PREGNANCIES IN DIDELPHYS UTERI
Authors: Leiberman J. R. , Schuster M. , Piura B. , Chaim W. , Cohen A.
Published: December 2009

Abstract. Congenital anomalies originating in the mullerian ducts are among the causes of gynecological and obstetrical disturbances that are commonly overlooked. These cases reach the rate of 1, 1‐3.5 per cent in hysterographic examinations. Some authors have stressed the need to keep this type of lesion in mind and to try to diagnose these conditions correctly, especially when the patients are examined for trivial complaints in the non‐pregnant state, as well as during the prenatal period, or after delivery. The case presented is a multiparous Beduin woman with simultaneous pregnancies in both cavities of an unexpected didelphys uteri. The first twin, female 2000 gram, was born at home, and the second, female 2250 gram by cesarean section, following unsuccessful attempts at vaginal delivery. The decision to undertake surgery was taken for common obstetrical reasons like inertia uteri and high presentation. Proper early diagnosis should result in adequate management and the earlier end of labor.
Treatment with oral estrone sulphate in the female climacteric: I. Influence on lipids
Authors: Lagrelius A. , Johnson P. , Lunell N. O. , Samsioe G.
Published: December 2009

Twenty women in the perimenopause were studied for 12 months during which sodium‐piperazine‐estronesulphate 2.5 mg/day was given for 3 weeks out of 4 as a hormone replacement therapy.

Blood samples were drawn at the start of therapy, then after 3, 6 and 12 months and analyzed for serum triglyceride, total cholesterol, cholesterol content of high density lipoprotein (HDL) fraction and the relative fatty acid composition of serum lecithin.

Triglyceride levels were increased after 3 months (p <0.01). After that there was a gradual decline to almost pretreatment levels. Total cholesterol decreased during the latter period of treatment and became virtually normal; significantly lower levels (p <0.01) were found at 12 months. The HDL‐cholesterol, which constitutes most of the high density lipoprotein fraction, showed a continuous increase and reached statistical significance at 12 months (p <0.01). This type of lipoprotein pattern is associated with a reduced risk of ischemic cardiovascular disease.

After 3 and 6 months of treatment an increase in the relative content of palmitic acid in serum lecithin was seen, an increase that might indicate an altered liver lecithin synthesis, usually seen in cholestasis. However, after 12 months the palmitic acid level declined and was not significantly altered from the pretreatment value, indicating that the change was transitory.
Urological complications of okabayashi's operation for cervical cancer
Authors: Bostofte E. , Serup J.
Published: December 2009

It has been suggested that the Okabayashi technique for radical hysterectomy in cervical cancer results in fewer urological complications as compared with the Wertheim‐Meigs technique. Of 479 women with cervical cancer operated on consecutively during the period 1963 to 1978 by the Okabayashi operation, 52 (10.8 per cent) had urological complications (17 bladder and ureter injuries, 35 fistulae and strictures). Thirty‐five elective urological operations were required (Table IV). Operative mortality related to urological complications was 1/479.

Compared with an earlier series of 397 women operated on in our department, mainly by the Wertheim‐Meigs operation, the Okabayashi operation did not result in significantly fewer urological complications. However, because of technical advantages and possibly better radicality the Okabayashi operation for cervical cancer is still prefered.
Fibrinolytic activity of human uterine fluid
Authors: Casslén B. , Åstedt B.
Published: December 2009

Normal biochemical composition of uterine fluid is essential for survival and successful implantation of the blastocyst. Fibrinolytic enzymes are involved in the implantation process. The variation of the fibrinolytic activity of uterine fluid with the phase of the normal menstrual cycle was investigated with the aid of radial enzyme diffusion on fibrin plates. The lytic activity increased during the pro‐liferative phase, reached a maximum in midcycle and then fell to its lowest level during the luteal phase. It increased again in the premenstruum.
PRE‐AND POSTOPERATIVE BEAD CHAIN URETHROCYSTOGRAPHY IN FEMALE STRESS URINARY INCONTINENCE
Authors: Ala‐Ketola Lasse , Kauppila Antti , Jouppila Pentti , Ylikorkala Olavi
Published: December 2009

Abstract. The effects of suprapubic Marshall‐Marchetti‐Krantz (MMK) operation or vaginal Kelly's operation on roentgenographic anatomy of the lower urinary tract were elucidated by means of chain urethrocystography (UCG). A selected series of 30 postoperatively continent and 70 incontinent patients were examined both preoperatively and 3–4 years after operation.

Both the urethral inclination (UI) and the posterior urethrovesical (PUV) angle decreased after the operation. The decrease was more marked after successful than unsuccessful operations. The MMK operation reduced the UI and the PUV angle significantly more than did Kelly's operation in both successful and unsuccessful cases. The position of the bladder base or the PUV junction was not altered significantly by either of the operations, whether successful or unsuccessful. The patients with postoperative detrusor instability had roentgen‐anatomical findings similar to those of continent patients.
RADIOIMMUNOASSAY OF HUMAN CHORIONIC GONADOTROPIN β‐SUBUNIT AS AN EARLY DIAGNOSTIC TEST IN ECTOPIC PREGNANCY
Authors: Sandvei R. , Støa K. F. , Ulstein M.
Published: December 2009

Abstract. Serum HCG‐β has been assayed in 100 cases of ectopic pregnancy. Results above 10 IU/I were considered positive. Positive values were found in 97 cases, of which 23 were within the range of a normal pregnancy, one was above and 73 below the normal range.

In the 3 cases with a negative HCG‐β value, devitalized ectopic pregnancies were found at operation.

The routine urine pregnancy test was negative in 53, positive in 29 and not performed in 18 cases.
INDUCTION OF LABOR WITH ORAL PROSTAGLANDIN E2 AND BUCCAL DEMOXYTOCIN WITHOUT AMNIOTOMY
Authors: Lykkesfeldt G. , Osler M.
Published: December 2009

Abstract. The results of labor induction without primary amniotomy in 132 primi‐parae are presented. Prostaglandin E2 was given orally to 40 patients, 45 were treated buccally with demoxytocin and 47 were given a combination consisting of demoxytocin on the first day and prostaglandin E2 on the second day. All patients had Bishop < 7.

No significant difference in the efficiency of induction between the three types of treatment was detected. The delivery rates 48 hours after the start of treatment were 45.0 per cent, 37.8 per cent and 46.8 per cent respectively. The incidence of complications was not increased in the group which received the combined treatment.
BONE MINERAL CONTENT DURING PREGNANCY IN EPILEPTICS ON ANTICONVULSANT DRUGS AND IN THEIR NEWBORNS
Authors: Christiansen C. , Brandt N. J. , Ebbesen F. , Sardemann H. , Trolle D.
Published: December 2009

Abstract.Bone mineral content (BMC) in the long bones was measured by photon absorptiometry in epileptic pregnant and normal pregnant women an in their newborns. The BMC (highly related to total body calcium) was completely unchanged during pregnancy in both groups. The BMC was of virtually the same order in the newborns of the epileptic mothers as in the newborns of the normal mothers. Furthermore, the development state, estimated from BMC, weight and length, was identical in the two groups of newborns. These results show that anticonvulsant osteomalacia can be held at a constant level during pregnancy, and infants born to epileptic mothers have no demonstrable demineralization of bone.
DIRECT CURRENT CONVERSION OF MATERNAL SUPRAVENTRICULAR TACHYCARDIA DEVELOPED DURING THE TREATMENT OF A PREGNANT HEROIN ADDICT WITH RITODRINE
Authors: Fink B. J. , Weber T.
Published: December 2009

Abstract. During ritodrine (UtoparR) treatment for premature labor, a chronic heroin‐addicted patient developed supraventricular tachycardia which was treated by direct current (d.c.) conversion. d.c. conversion did not affect the fetus, as judged by the cardiotocogram. As heroin addicts run an increased risk of developing cardiac arrhythmia, caution is advised when treating these patients with beta‐mimetics.
SYMPTOMATIC POSTMENOPAUSAL ENDOMETRIOSIS
Authors: Djursing Henning , Petersen Kaj , Weberg Edgar
Published: December 2009

Abstract. This paper is a case report describing active extensive abdominal endometriosis in a postmenopausal woman without signs of estrogen activity.
Premenstrual Complaints: II. Influence of Oral Contraceptives
Authors: Andersch B. , Hahn L.
Published: December 2009

The prevalence of individual premenstrual symptoms was studied in a randomly selected group of 217 women taking oral contraceptives (OC). The results were compared with corresponding data from 595 women not using the pill. The analyses included six different mental and somatic symptoms defined and graded in severity and related to age. It was found that OC had a beneficial effect on the premenstrual tension symptoms (PMT) in all age groups except in the youngest group (18 years), in which the tendency was rather the opposite. Within the total sample of women, users of OC were significantly less frequently absent from work. The present results are in agreement with those of most earlier studies, provided that age is taken into account.
Ante—Natal Pulmonary Edema and Metabolic Acidosis: Postpartum Pulmonary Embolism in a Non—Diabetic Patient Associated with Ritodrine and Betamethasone Administration in Premature Labor
Authors: Felding Christine , Hasselbach Hans
Published: December 2009

A case is reported of ante‐natal pulmonary edema and metabolic acidosis complicated post partum by pulmonary embolism in a non‐diabetic woman receiving ritodrine and betamethasone treatment in premature labor. The possible relationship between the treatment and the severe outcome is discussed and a comparison is made with recent reports from the literature.
Investigations on Hormone Dependency of Human Mammary Carcinomas Transplanted into Nude Mice
Authors: Brünner Nils , Spang‐Thomsen Mogens
Published: December 2009

Since human mammary cancer can be transplanted into nude mice, this makes possible the in vivo study of relations between hormone dependency and the steroid hormone receptor content of the tumors. The macroscopic growth curve of the transplanted tumors during endocrine therapy will reflect the hormone dependency. The results can be compared with successive steroid hormone receptor determinations in the tumor tissue.
Treatment of Advanced Breast Cancer with Progestins: A review
Authors: Løber J. , Rose C. , Salimtschik M. , Mouridsen H. T.
Published: December 2009

This paper reviews the theoretical background for the use of progestins in advanced breast cancer and the clinical experience obtained from 13 major studies.

The average rate of response is about 30%, with somewhat higher rates when the dominant site of disease is localized to soft tissue and to bones, compared with viscera. Furthermore it seems that cross resistance between progestin therapy and other endocrine therapies is only partial. However, response rates related to previous therapy and to important prognostic variables such as age of the patient, disease‐free interval and hormone receptor content of the tumor tissue are poorly elucidated. Only limited data are available concerning response rate in relation to dose and route of administration and data from prospective randomized trials to analyze these relations are still lacking.

Considering the only modest side effects of treatment with progestins and the clinical and theoretical evidence favoring a mode of action different from that of other endocrine therapies, progestins are drugs with interesting qualities. Therefore future controlled studies with progestins alone or in combination with other systemic therapies should be carried out to establish the therapeutic efficacy of progestin therapy in primary and advanced disease.
Pharmacokinetics of Medroxyprogesterone Acetate Administered by Oral and Intramuscular Route
Authors: Lørber J. , Mouridsen H. T. , Salimtschik M. , Johansson E.
Published: December 2009

The present study was undertaken to elucidate: 1) The relationship between plasma concentration of medroxyprogesterone‐acetate (MPA, ClinovirR, Depo‐Provera, Upjohn) administered both orally and intramuscularly. 2) The relation between dose and plasma concentration of MPA.

Nineteen patients entered the study. In each patient the plasma concentration was monitored after the administration of a single oral and one intramuscular dose of MPA at the following dosage levels: 100 mg (5 patients), 400 mg (5 patients), 800 mg (5 patients) and 1 200 mg (4 patients). The interval between the oral and i.m. administration was 1 week.

The results show: 1) A very large interindividual variation in plasma concentration. 2) An increase in plasma concentration after both oral and i.m. dose. 3) After the i.m. administration, plasma levels remained steady or increased slightly throughout the test period. 4) After the oral administration the concentration increased rapidly to reach a peak by 2‐7 hours, subsequently decreasing. Peak concentrations were 2‐ 10 times higher than after i.m. administration. 5) Over the test period, the plasma concentration x time (0‐168 h) is similar in the two modes of administration.
IN VITRO RELEASE OF STEROIDS FROM THE HUMAN FETAL ADRENAL TISSUE
Authors: Yanaihara Takumi , Arai Kiyoshi
Published: December 2009

Abstract. Human fetal adrenal glands obtained at mid‐gestation were incubated in vitro, and steroids in the incubation media and tissues were measured by radioim‐munoassay. During two consecutive one‐hour incubation periods, mean concentrations of 2.23±0.45 and 2.77±0.60 ng/h/mg tissue (±SE) of combined pregnenolone and pregnenolone‐sulfate were found in the media of the control group. When adrenocorticotropin (ACTH) was added in the second half of incubation, the total pregnenolone level rose from an average of 1.90±0.42 to 5.89±2.00 ng/h/mg tissue (p<0.05). The dehydroepiandrosterone (DHA) and DHA‐sulfate levels in the control media remained almost unchanged, while the addition of ACTH caused a significant increase, from 6.26±1.48 to 15.49±4.08 ng/h/mg tissue (p>0.05). The tissue content of these steroids increased slightly but not significantly in the ACTH group. Lesser amounts of 16α‐hydroxy‐DHA and 16α‐hydroxy‐DHA‐sulfate, progesterone and cortisol were also measured in both incubation media and tissue. Concentrations of these steroids did not change significantly upon the addition of ACTH in vitro. This in vitro study further supports the hypothesis that the fetal pituitary‐adrenal axis has the potential to respond to stress‐induced ACTH release and secretes steroids which are the precursors of sex steroids in pregnancy.
INDUCTION OF LABOR WITH AND WITHOUT PRIMARY AMNIOTOMY
Authors: Secher N. J. , Lange A. P. , Nielsen F. Hassing , Pedersen G. Thomsen , Westergaard J. G.
Published: December 2009

Abstract. A comparative study of labor induction has been performed on 471 consecutive patients. Primary amniotomy was performed in 227 cases, and 103 of these patients were stimulated, 57 patients with PGE2 tablets and 46 with oxytocin. In the remaining 124 cases labor was induced within 4 hours without medical stimulation. Primary amniotomy was omitted in 244 cases, as the head was not engaged and the cervix was unripe. After random allocation to the treatment groups 125 patients received PGE2 tablets (ProstinR), and 119 patients received oxytocin intravenously. After 2 days of stimulation without primary amniotomy, delivery was induced in 83 per cent of the patients receiving PGE2 and in 84 per cent of the patients receiving oxytocin. All patients on whom primary amniotomy had been performed were delivered on the first day. There was no difference in the success rate between PGE2 and oxytocin treatments in patients with the same Bishop score. The performance of amniotomy at the beginning of induction led to a significantly lower total dose as well as a lower maximal dose of PGE2 and oxytocin. There was no difference in the duration of active labor in patients receiving PGE2 or oxytocin.

There were no differences in the incidence of fetal distress and low Apgar scores between the different groups. No serious side effects occurred. Vomiting and diarrhea in 14 patients (8 per cent) receiving PGE2 was in contrast to 3 patients with these symptoms (2 per cent) in the oxytocin group.

Oral administration of PGE2 is a convenient, effective and safe alternative to oxytocin for the induction of labor; however, PGE2 was not found superior to oxytocin in cases with a low Bishop score.
ASSESSMENT OF PLACENTAL FUNCTION BY ESTIMATION OF TESTOSTERONE IN PLASMA AFTER AN INTRAVENOUS INJECTION OF DEHYDROEPIANDROSTERONE SULPHATE (DHAS)
Authors: Axelsson Ove , Johansson Elof D. B.
Published: December 2009

Abstract. The response of plasma testosterone to an intravenous injection of 50 mg dehydroepiandrosterone sulphate (DHAS) was measured in 22 pregnant women. In 15 women with uncomplicated pregnancies a rapid and steep increase of plasma testosterone was observed, most women having their maximum testosterone value recorded as soon as 5 minutes after the injection. Three women with pre‐eclampsia had delayed maximum values. They delivered infants of low birth‐weight or with low Apgar scores. One woman with pre‐eclampsia had a normal response and gave birth to a healthy infant of normal birth‐weight. Out of 3 women with intrauterine growth retardation (IUGR) 2 had an abnormal and 1 a normal response. It is concluded that the plasma response of testosterone to an injection of DHAS is a reflection of placental function.
UTERINE CELLULAR STROMAL INFILTRATION
Authors: Larsen J. , Bock J. , Visfeldt J.
Published: December 2009

Abstract. Extreme pleomorphic stromal cellular infiltration of the cervix and the corpus uteri was demonstrated by curettage in a 29‐year‐old woman with menorrhagia. The histological classification was not decisive and a hysterectomy was performed. The histological picture may be compatible with a malignant disease such as a stromal sarcoma or a lymphoma of Hodgkin or non‐Hodgkin type, or with an inflammatory or immunologic disease. The clinical course, however, indicates a benign disease.
HYPERPROLACTINEMIC AMENORRHEA INDUCED BY METOCLOPAMID (PRIMPERANR)
Authors: Andersen Ole Peter , Hansen Per , Madsen Hans
Published: December 2009

Abstract. Secondary amenorrhea, elicited by metoclopamid (PrimperanR) induced hyperprolactinemia, was found in a 24‐year‐old woman. Withdrawal of the drug was followed by normalization of the hyperprolactinemia, as well as the menses.

For many years metoclopamid (PrimperanR) has been used for various dyspeptic inconveniences, such as gastroesophageal reflux, ventricular rentention and postoperative tarm‐atom. Well‐known secondary effects are reported to be drowsiness, uneasiness, restlessness and extra‐pyramidal secondary effects in the form of acute dystom.

The present case of secondary amenorrhea caused by metoclopamid (PrimperanR) induced hyperprolactinemia has been verified clinically, serologically and by treatment.
Effects in Postmenopausal Women of Natural and Synthetic Estrogens on Calcitonin and Calcium‐Regulating Hormone Secretion
Authors: Whitehead M. I. , Lane G. , Townsend P. T. , Abeyasekera G. , Hillyard C. J. , Stevenson J. C.
Published: December 2009

Abstract. The major function of calcitonin in man appears to be the prevention of excessive or unwanted bone resorption. There is a marked sex difference in circulating levels, with a relative deficiency in women. As calcitonin secretion in young women is known to be increased by estrogens, long periods of estrogen lack—such as the postmenopause—are possibly associated with a more pronounced calcitonin deficiency. This exaggerated deficiency could be an important factor in the pathogenesis of postmenopausal bone loss, especially as the latter is believed to be due to excessive bone resorption.

We have studied the effects of three exogenous estrogens on the circulating levels in postmenopausal women of calcitonin, parathyroid hormone, the vitamin D metabolites 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D, and calcium and phosphate. The most striking finding was a sharp rise in the plasma levels of calcitonin. Estrogens are known to prevent postmenopausal bone loss but the mechanism of action remains obscure. We suggest that the beneficial effects of estrogens could be mediated, at least in part, through control of calcitonin secretion. Thus calcitonin may prove effective in the prevention of postmenopausal bone loss and its role in the treatment of established osteoporosis warrants further evaluation.
Some β‐Adrenoceptor Functions of Therapeutic Interest
Authors: Persson Carl G. A.
Published: December 2009

Abstract.The availability of selective β‐receptor agonists such as terbutaline is a stimulus to research dealing with various β‐receptor functions. The aim of such work is to demonstrate the physiological importance of the hormonal or nervous activation of receptors and to establish a scientific basis for therapeutic trials with β‐receptor active drugs. A brief account is given of the therapeutic possibilities as related to certain β‐receptor functions in the biliary tract, the urinary tract, the lung and the uterus. It is concluded that many β‐receptor functions can be described as therapeutically interesting. The practical importance of β‐agonist therapy is at present confined to relatively few organs, in particular the lung and the uterus.
Pharmacological Inhibition of Uterine Activity
Authors: Andersson Karl‐Erik
Published: December 2009

Abstract.Several drugs have been used clinically to inhibit uterine activity in preterm labor, e.g. prostaglandin synthetase inhibitors, β‐receptor agonists, ethanol, calcium antagonists, magnesium sulfate and progesterone. A short review is given of the excitation‐contraction‐relaxation processes in uterine smooth muscle, and the effects and possible modes of action of these drugs are briefly discussed.
A Computerized Perinatal Data System
Authors: Jennett Raymond J. , Warford Harry S.
Published: December 2009

Abstract.The development of a regional data system was one of the major objectives of the Arizona Perinatal Program funded by the Robert Wood Johnson Foundation. To achieve this objective, a decision was made to adopt and expand a perinatal data system under development at St. Joseph's Hospital in Phoenix. This shift from what was planned as a highly sophisticated single hospital system, which would include real‐time data storage as well as paper acquired data, required certain sacrifices and resulted in certain problems as well as significant gains for the region. The data system is made up of two major components — (1) a paper record system in which the documents completed by physician or nurse serve both as the official medical record and a computer‐input document and (2) a computer using the Meditech Interpretive Information System (MIIS) version of the MUMPS operating system and language. Programs to achieve the goals and objectives established for the system are described; Lessons learned from this experience which may be helpful to others interested in similar developments are described.
Levels of Trimethoprim and Sulfamethoxazole in Human Oviduct Mucosa and Plasma
Authors: Brihmer Christina , Brundin Jan , Dornbusch Katrin
Published: December 2009

Abstract. The oviductal and plasma levels of trimethoprim (TMP) and sulfamethoxazole (SMZ) were studied in 9 women after oral and i.v. administration of a drug combination (EusaprimR, Wellcome Foundation Ltd.). The concentration of TMP in a healthy endosalpinx was found to be twice as high (4.7 μg/g, range 2.8–8.3) as in plasma (2.6 μg/ml, range 2.1–3.6). Conversely, the endosalpingeal level of SMZ (38 μg/g, range 12–65) was about half that in plasma (77 μg/ml, range 58–95). The agar well diffusion method was used for the concentration determinations. The specimens were collected during surgery for non‐infectious genital diseases. The implication of treatment by the given drugs is discussed.
Residual Carcinoma after Intracavitary Irradiation of Endometrial Carcinoma, Stage I
Authors: Gröntoft O. , Risberg B. , Sténson S. , Westholm B.
Published: December 2009

Abstract. Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole‐organ sectioning technique. Re‐examination of the curettage material showed cancer stage 0 in 8 (9%) and carcinoma stage I in 79 cases (91%). In the stage I cases 57% showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae. Histological changes in the carcinoma were unevenly distributed, but tumors growing close to the external uterine surface were well preserved. In 40.5%, no carcinoma was present, and in 2.5% the changes found could not be classified.

Correlated to disparity in irradiation technique, no significant difference could be demonstrated in the incidence or localization of residual carcinoma.

The most important single pretreatment factor combined with the presence of residual carcinoma was myometrial fragments with infiltrating carcinoma in the curettage material (MICC). Computerized analysis of combinations of factors showed that all patients aged over 60 years with a uterine‐sound length exceeding 8 cm had residual carcinoma.

Only 2 patients with infiltration of the myometrium had a completely destroyed carcinoma.

The findings indicate that it is unlikely that endometrial carcinoma stage I with myometrial invasion will be eradicated by intracavitary irradiation.
Irradiation and Bleomycin in the Treatment of Inoperable Vulval Carcinoma
Authors: Iversen T.
Published: December 2009

Abstract. Fifteen patients with inoperable squamous cell carcinoma of the vulva were treated with Bleomycin and irradiation. Only 2 patients were also treated with vulvectomy and bilateral lymphadenectomy 2 weeks later. One patient survived more than 4 years without signs of recurrence, another survived 2½ years and 2 more 18 and 12 months respectively. The rest died less than 6 months after the treatment. Three patients developed signs of lung fibrosis. Bleomycin and irradiation may render a tumor operable, but in most cases this regime merely aims at palliation.
Effect of Prostaglandin E2and F2αon the Systemic and Pulmonary Circulation in Pregnant Anesthetized Women
Authors: Secher N. J. , Thayssen P. , Arnsbo P. , Olsen J.
Published: December 2009

Abstract.The hemodynamic effect of prostaglandin F2α(PGF2α) and of prostaglandin E2(PGE2) was studied in 12 healthy volunteers admitted for suction abortion at 10–12 weeks of gestation. They were anesthetized using natrium thiomebumal, pethidine and pancuronium bromide. PGF2αwas given as an intravenous infusion of 100 μg/min, the dose being increased by 100 μg every 10 min to a maximum of 300 μg/min. PGE2was administered with 5 μg/min, the dose being increased by 5 μg every 10 min to a maximum of 15 μg/min.

During infusion of 300 μg PGF2αa significant increase in cardiac output and femoral arterial pressure of 40% and 25% respectively was measured together with an increase in the pulmonary arterial pressure (125%). Pulmonary vascular resistance was doubled, with a concomitant decrease in systemic resistance (11%). These changes were followed by a significant decrease in pH and PaO2, whereas an increase in PaCO2was found.

During infusion of PGE2a significant, 36% increase in cardiac output was measured during infusion of 15 μg/min PGE2, together with a decrease in systemic blood pressure (31%) and resistance (33%). Heart rate rose significantly, while stroke volume showed only a small increase, and pulmonary pressure was unchanged. These changes were followed by an increase in PaO2.

PGF2αseems to have a positive inotropic effect on the heart, whereas its response to PGE2seems to be a result of the peripheral vasodilatation. The slight decrease in systemic blood pressure without change in pulmonary hemodynamics makes PGE2suitable for induction in patients with cardiopulmonary diseases.
Diagnosis of Endometrial Carcinoma Using the Mi‐MarkR Helix Sampling Technique
Authors: Linden Margareta , Roger Vivi
Published: December 2009

Abstract. The traditional Papanicolaou smear achieves only 20–60% diagnostic accuracy when applied to endometrial carcinoma. Consequently, various specially designed methods for the early detection of endometrial carcinoma have been tried out. The present study was a comparison of conventional curettage with a new technique, the Milan‐Markley helix method (Mi‐MarkR) for the obtaining of material from the uterine cavity for both cytological and histological evaluation. The material included 474 samples from 401 patients.

The method is designed as an office procedure and is not intended to replace diagnostic curettage. It should be used as an additional diagnostic procedure in high‐risk groups and in the follow‐up of such patients.

With cytological examination of the material the specificity was found to be 97.6% and the sensitivity 85.7%.
Effects of Two Years' Estrogen‐Gestagen Replacement on Climacteric Symptoms and Gonadotropins in the Early Postmenopausal Period
Authors: Hagen C. , Christensen M. S. , Christiansen C. , Stocklund K. E. , Transbøl I.
Published: December 2009

Abstract. The effects of estrogen/gestagen (e/g) treatment given in a 28‐day cycle (Trisequens forteR, Novo) on menopausal symptoms and plasma concentrations of follicle‐stimulating hormone (FSH) and luteinizing hormone (LH) were studied in a placebo trial. 119 normal women in the early postmenopausal period with mild to moderate climacteric complaints were included. At 3‐month intervals for 2 years the participants were examined and filled in questionnaires containing the 11 symptoms of the Kupperman index (10). For each symptom a score was given. In the e/g group 77% (43/56) completed the trial compared with 83% (54/63) in the control group.

A total of 61% of the women complained of hot flushes and from 9% to 44% complained of the remaining 10 Kupperman symptoms. At all eight examinations e/g treatment was found to have reduced the symptom score as well as the proportion of women with hot flushes, paresthesia, insomnia, nervousness, vertigo and formication. The symptom score of hot flushes and insomnia declined significantly (p<0.01). In the 24 women with hot flushes and in the 19 without, e/g caused similar reduction in the mean score of the other 10 symptoms. No placebo effect was seen.

E/g caused a significant (p<0.01) fall in the elevated plasma concentrations of FSH and LH. Vaginal bleeding was regular in 38/43 and irregular in 4/43 women during hormone treatment. No serious side effects were attributed to e/g therapy.

It is concluded that e/g treatment, in addition to its beneficial effects on hot flushes and insomnia, also alleviates several other climacteric symptoms.
Colposcopic Pattern of Cervicitis, Dysplasia and Previnvasive Cancer of the Uterine Cervix
Authors: Rubinstein Eli
Published: December 2009

Abstract. The great majority of cervical neoplasia begin in the transformation zone between the squamous and the columnar epithelium, i.e. within the area in which metaplasia takes place. This process, both normal and atypical, can be studied colposcopically. Colposcopy increases the diagnostic accuracy and therapeutic success in cervical neoplasia as it is the only method that permits a topographical study of cervical lesions, and indicates the location of neoplastic epithelial proliferation.
Scanning Electron Microscopic Studies on Stigmas in Rat Ovaries
Authors: Tsujimoto D. , Katayama K. , Tojo S. , Mizoguti H.
Published: December 2009

Abstract. Ultrastructural observations on stigmas in rat ovarian follicles have been performed by scanning electron microscopy. Stigmas were classified into two types under a dissecting microscope; extensively bulging vesicles (bleb‐type stigmas) and small, flat avascular areas (flat‐type stigmas). The bleb‐type stigma had lost its surface epithelial cells extensively, and the flattened and densely arranged fibroblasts without fibrous structures were exposed. These fibroblasts had short, serrate, cytoplasmic projections where multivesicular structure‐like granules were seen. By contrast, on the flat‐type stigma a small region of exposed stroma was covered with fibrous structures. Removal of the fibrous structures by the HCl‐collagenase method revealed that the exposed stroma consisted of stellate fibroblasts surrounding a small opening through which a few granulosa cells were about to discharge. When the cumulus mass was protruding, it was surrounded by the fibrous structures. These findings indicate that both the stellate fibroblast formation and the presence of fibrous structures are needed for the release of ova through the stigma.
Persistent Supraventricular Tachycardia Following Infusion with Ritodrine Hydrochloride
Authors: Kjer Jens Jørgen , Pedersen Kirsten Hervert
Published: December 2009

Abstract. A rare side effect is reported following treatment of preterm labor with ritodrine hydrochloride. The patient developed persistent supraventricular tachycardia, which had to be changed to normal sinus rhythm by cardioconversion.
Infertility and Metroplasty
Authors: Kusuda Masahiko
Published: December 2009

Abstract. Various techniques of metroplasty were performed in 32 cases of double uterus. In these patients the fetal survival rate before the operation was nil, whereas post‐operatively it reached as high as 92.6%.

Strassmann's operation was carried out in 16 cases, Jones & Jones's modified method in 12 cases and Tompkins's operation in 4 cases. The merits and demerits and the applicability of each technique and the various types of uterine malformation are discussed. It is concluded that a correct diagnosis of uterine malformation can only be established by a combination of precise HSG with direct macroscopical observation of uterine body. The Strassmann transverse incision is well suited for a bicornuate uterus, and Jones & Jones's wedge‐shaped fundal resection for a partial septate uterus. The postoperative deformation in the fundus uteri is most frequently seen after the application of Strassmann's method, and is much less common with the modified method of Jones & Jones.

Metroplasty can be applied in such cases of uterine malformation as when primary sterility is complained of but where any other cause for sterility is ruled out or is deemed to be corrected.

Maximum care should be taken to prevent postoperative adhesion. Three months is considered to be a sufficient period for postoperative contraception. The mode of delivery depends on the individual case, though cesarean section is recommended.
Oxytocin, Prostaglandins, and Contractility of the Human Uterus at Term Pregnancy
Authors: Wikland M. , Lindblom B. , Wilhelmsson L. , Wiqvist N.
Published: December 2009

Abstract. The contractile properties of myometrial “mini‐strips” from the upper and lower uterine segments were studied by a superfusion technique. These samples of myo‐metrium were taken from women delivered by elective ce‐sarean section in the 39th week of pregnancy.

The frequency of spontaneous contractions was significantly higher in isthmic myometrial specimens than in corpus specimens, whereas amplitude and duration of contractions did not differ. Both isthmic and corpus myometrium were stimulated by prostaglandin E2 at low concentrations and inhibited at high concentrations. PGF2α induced an ex‐citory response in the isthmic strips but surprisingly not in preparations from the corpus. However, PGF2α restored normal spontaneous activity following inhibition of the contractility with indomethacin. Oxytocin caused an ex‐citory response over a wide concentration range in both types of specimen and this response was not reduced by pretreatment with indomethacin. These findings suggest that endogenous prostaglandin synthesis is a necessary prerequisite for spontaneous myometrial activity at term pregnancy and that prostaglandins are not essential for the excitatory effect of oxytocin.
Transabdominal Isthmic Cerclage for the Treatment of Incompetent Cervix
Authors: Olsen S. , Tobiassen T.
Published: December 2009

Abstract. During the period from 1973 to 1980 transabdominal isthmic cerclage was performed on 32 patients. Twenty‐nine patients experienced 35 pregnancies. In 23 cases (79%) the diagnosis was based on one or several second‐trimester abortions. In the remaining 6 cases the diagnosis was based on clinical findings of an abnormal cervix. Both groups had fetal loss in first and third trimester. The operation was performed before pregnancy or during pregnancy up to the 14th week. The fetal salvage rate rose from 12% to 91.4%, and the prematurity rate was 6.7% after operation. Only one pregnancy was terminated prematurely, due to forcible labor.
Interindividual Variation in Vaginal Examination Findings During Labor
Authors: Bergsjø P. , Koss K. S.
Published: December 2009

Abstract. A series of 99 paired vaginal examinations before or during labor were analysed. For each single comparison two observers recorded his or her findings independently. In about 90% there was either complete agreement or a difference of 1 cm, both for the dilatation of the cervix and the station of the presenting fetal part along the pelvic axis.
Uterus Didelphys
Authors: Legarth J. , Hansen B.
Published: December 2009

Abstract. In a 30‐year‐old primigravida with uterus didel‐phys there occurred, during labor, mutual torsion of the inferior lower uterine segments, the cervix of the pregnant right uterus crossing in front of the lower segment of the non‐pregnant left uterus. This blocked the birth canal, and the patient had to be delivered by cesarean section. The frequency of major uterine malformations, their diagnosis, and role in the obstetric prognosis are discussed.
Pain Relief in Labor by Transcutaneous Electrical Nerve Stimulation
Authors: Bundsen Peter , Ericson Klas
Published: December 2009

Abstract. A current density standard for current shapes used in transcutaneous electrical nerve stimulation (TNS) must be established in order to avoid harmful effects. This is especially important when stimulating near vital structures such as the fetal heart. In the absence of an applicable standard, a preliminary safety norm is proposed, based on clinical experience during delivery and experimental measurements in the female bladder. Current densities due to TNS not exceeding 0.5 μA/mm2 are safe for the fetal heart. A stimulator and electrodes fulfilling the safety criteria proposed in this study have been tested. A filter which suppresses the electrical disturbances occurring during TNS, thereby permitting recording of the fetal heart rate during birth, has also been tested. TNS was given over both the low‐back and suprapubic region. Results of clinical tests of the equipment during 15 supervised births are reported. No adverse effect in the mother or newborn infant were observed.
Low LH (Hcg) Receptor Concentration in Ovarian Follicles in Endometriosis
Authors: Kauppila Antti , Rajaniemi Hannu , Rönnberg Lars
Published: December 2009

Abstract. The concentration of LH (hCG) receptors in the granulosa cells of ovarian follicles was assayed in 20 patients with histologically proven endometriosis and in 6 control patients.

The levels of receptors in 15 patients with ovarian endometriosis (0.48±0.46 fmol/mg protein) and in 5 patients with endometriosis without ovarian involvement (0.51±0.52 fmol/mg protein) were lower (p<0.01 and p<0.05, respectively) than in control patients (1.32<0.61 fmol/mg protein). The severity of the disease was not reflected in the results. The low receptor concentration in endometriosis suggests a failure in the mechanism mediating LH action in the follicle.