bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiological Aspects of Ectopic Pregnancy in Nulliparous Women
Authors: Dhall Kamala , Grover Vimal , Mittal Sushil C. , Dhall Gian I.
Published: August 2010

This presentation gives retrospective analysis of 47 cases of ectopic pregnancy in nulliparous women, admitted in the Gynaecological Emergency services of Nehru Hospital attached to the Postgraduate Institute of Medical Education and Research, Chandigarh. Etiological factors leading to ectopic pregnancy in these patients have been presented. Tubal damage in young patients as a result of ascending infections possibly due to sexually transmitted diseases have been discussed. Preventive measures for reducing the incidence of ectopic pregnancy have been emphasized.
Psychosocial Sequelae of Abortion and Sterilization: A Controlled Study of 200 Women Randomly Allocated to Either a Concurrent or Interval Abortion and Sterilization
Authors: Cheng M.C.E. , Cheong June , Ratnam S.S. , Belsey M.A. , Edstrom K.E. , Pinol A. , Zegers L.
Published: August 2010

Two hundred and one women who sought abortion and sterilization were randomly allocated into two study groups to compare the incidence of psychosocial sequelae. The first group (95 patients) had had abortion and concurrent sterilization and the second (106 patients) had abortion followed by interval sterilization 6 weeks later. Of the 106 patients in the second group 74 had the interval sterilization within 3 months. At 12 months between 2 and 3% of women in both groups expressed regret in having the sterilization. There was no difference in the self‐perceived health status of the women in the 2 groups, nor were there any significant differences in perceived changes in menstrual pattern, marital relationships and libido.
Dysgerminoma of the Ovary Associated with Pregnancy
Authors: Kulenthran A. , Sivanesaratnam V.
Published: August 2010

Two cases of dysgerminoma of the ovary associated with pregnancy are presented. The literature on dysgerminoma in pregnancy is reviewed. It is suggested that in young women, with a unilateral well‐encapsulated tumour, a unilateral salpingo‐oophorectomy is the treatment of choice when further childbearing is desired. A more radical surgery is required in those who have completed their family and in those with evidence of capsular infiltration or breach.
Closed Loop Automatic Infusion System for Induction of Labour Based on External Tocography
Authors: Arulkumaran S. , Ingemarsson I. , Ratnam S.S.
Published: August 2010

A closed loop automatic infusion system for titrating oxytocin to induce labour based on external tocography was evaluated. Fourty‐one nulliparae and 28 multi‐parae were induced with this system. The obstetric outcome was good with only six caesarean sections; two for fetal distress, two for failed induction and two for malposition and failure to progress. Six nulliparae needed assisted vaginal delivery for prolonged second stage, three due to malposition and three due to poor maternal effort. No multiparae had an instrumental vaginal delivery. Five nulliparae and one multipara with poor cervical score (<=5) were transfered to conventional peristaltic infusion system at the end of nine hours due to failure of progress with clinically inadequate uterine contractions. Of the six, two delivered vaginaily whereas 4 required caesarean section.

The neonatal outcome assessed by 1 min and 5 min Agpar scores and umbilical cord arterial pH values was good. The frequency of hypertonic uterine activity was low. With the safety features of alarm and cessation of oxytocin infusion, when uterine hypertonus or abnormal fetal heart rate is encountered, the equipment appears to be an asset for the practice of induction of labour. The adequacy of it's programme for nulliparae with poor score (<=5) has to be further evaluated.
Accuracy of Fetal Weight Estimation by Ultrasound
Authors: Anandakumar C. , Wong Y.C. , Rauff Mary , Ratnam S.S.
Published: August 2010

The main objective of this study was to assess the accuracy of fetal weight estimation by ultrasound. 124 patients were scanned and the estimated fetal weight calculated by the equation of Warsof revised by Shepard was compared with actual fetal weight of the newborns, who were born within one week of the last scan. In 93.3% of the time the estimated weight by ultrasound was within 15% of the actual weight.
Treatment of Drug‐Tolerant Choriocarcinoma in Combination with Bleomycin, Cisplatin and VP16‐213 (Etoposide)
Authors: Yamamoto Takara , Shiroshita Kohe , Tsuji Masamichi , Okada Hiroji
Published: August 2010

A 38‐year‐old patient with choriocarcinoma who was tolerant to MTX and Act‐D and highly refractory to MECA therapy after hysterectomy and bilateral oophorec‐tomy was treated with 4 courses of BCE therapy. One course of BCE therapy consisted of bleomycin (Bleo Inj.®, Nihon Kayaku Co., Ltd., Tokyo Japan. Day 1–5: 5 mg i.v. infusion/day); cisplatin (Briplatin®, Bristol‐Myers Co., Ltd., Tokyo, Japan. Day 1; 50 mg i.v. infusion/m2); and VP16‐213, (Etoposide, Day 1–5: 100 mg i.v. infusion/m2 /day). This treatment was successful in achieving complete remission.
The Clinical Significance of Antibody against Oncofetal Antigen‐I (anti‐OFA‐I) in Patients with Gynecologic Tumors
Authors: Higuchi Masaomi , Takahashi Masaaki , Takeuchi Yutaka , Hando Tamotsu , Takeuchi Shoshichi
Published: August 2010

Oncofetal antigen‐I (OFA‐I) is a membrane antigen of human cancer cells that cross‐reacts with human fetal brain tissues. The antibody profile against this antigen was analyzed in relation to the course of disease.

Fifteen out of 22 patients had persistently stable antibody levels and antibody titer in three of them increased by more than 4‐fold. These patients did not show either recurrence or death, but had a good prognosis. In four patients, antibody levels dropped by more than 4‐fold and was followed by clinical recurrence and death.

These studies show that persistently stable antibody titers are predictive of non‐recurrence, and decreasing titers predictive of recurrence.
Maternal Serum Cholinesterase Levels in Pregnant Women in Healthy and Diseased States
Authors: Satyanarayana M.
Published: August 2010

Maternal serum cholinesterase estimation was done in pregnant women in gesta‐tional‐wise, during labour and pathological states by spectrophotometric method. Sera from non‐pregnant women was used as controls (190 units/ml). During normal pregnancy, cholinesterase levels in maternal serum increased abruptly from 8 weeks (220 units/ml) to 20 weeks (380 units/ml) and fell gradually to low levels (210 units/ ml) at <42 weeks (post‐mature pregnancy). Serum cholinesterase levels were significantly increased during second and third stage of labour. In the post partum period, serum cholinesterase levels in the maternal blood rapidly reached the non‐pregnant levels (180 units/ml) by 2nd day after delivery. Significant variation of maternal serum cholinesterase levels were found in pregnancy with patients undergoing induced abortions, cases of threatened abortions, congenital anomalies of foetus, pre‐eclampsia, eclampsia, nephrotic syndrome, tuberculosis, infectious hepatitis, anaemia, diabetes mellitus, Rh‐incompatibility, placenta praevia, etc. These observations may have an important bearing because this may lead to a better understanding of serum cholinesterase's basic biochemical function and application in clinical medicine.
Differential Diagnosis of Intraperitoneal Fluid by Ultrasound
Authors: Murao Fuminori , Hata Kohkichi , Hata Toshiyuki , Shibukawa Toshihiko , Iwanari Osamu , Kitao Manabu
Published: August 2010

A review of 40 clinical cases of proven intraperitoneal fluid was made to assess the accuracy of ultrasonography for diagnosing the nature or distribution of intraperitoneal fluid and for differentiation between fluid collection and other conditions.

Since the distributions of intraperitoneal fluid depend on the action of gravity, capillary attraction, adhesion and so forth, localized fluid collection or unusual distribution of fluid poses a problem in differential diagnosis. An unusual or irregular collection of fluid may suggest a malignant ascites.

Deviations from a homogenous, echo‐free space suggest an inflammatory, mucinous or malignant fluid.

The smallest amount of fluid identified by ultrasound was thought to be approximately 10 ml.
Steroid Receptors and Histological Types in Cervical Cancer
Authors: Fujimoto Jiro , Tamaya Teruhiko , Watanabe Yoshinobu , Arahori Kenji , Sato Sohei , Okada Hiroji
Published: August 2010

Estrogen receptor (ER), progestin receptor (PR), and androgen receptor (AR) levels in cytosol, nuclear KC1 extract, and nuclear KC1 unextractable fraction were determined in 34 cases by Scatchard analyses, using the dextran‐coated charcoal (DCC) method for the first two receptors and the washing method for the last one. The dissociation constants of ER, PR and AR ranged from 10‐10 to 10‐9 M. The histological types were classified according to the World Health Organization criteria. ER, PR and AR were detected in some cases of cancer of the cervix. Regardless of the histological types of squamous cell carcinoma of the cervix, ER was detected in almost all cases. The detection rate of PR (8/27) was significantly lower (p<0.03) than that of ER (25/ 27), and that of AR (16/27) tended to be lower (p<0.09) than that of ER (25/27) in large cell non‐keratinizing carcinoma, keratinizing carcinoma, and small cell non‐keratinizing carcinoma. PR was not detected in cases of cervical adenocarcinoma, regardless of their histological differentiation.
Steroid Sulfatase Deficiency: Enzymatic Studies Using Placenta and Leucocytes in One Family
Authors: Sakai Sumitaka , Honda Hiroshi , Kawai Nobuhide , Sakurai Norio , Arimoto Kiyoshi
Published: August 2010

Various placcntal and leucocyte enzyme activities were determined in a male newborn whose mother had decreased urinary E3 and serum total E3 levels during the course of pregnancy, suggesting placental sulfatase deficiency (PSD). Tests revealed that both placental steroid sulfatase (SS) and arylsulfatase C (ASC) were deficient but arylsulfatases A and 15 were normal. SS activity, as well as the levels of arylsulfatases A, B and C, were also determined in the newborn and his family members using leucocytes. SS and ASC activities were deficient in the newborn and one of his male cousins. Both cases had cutaneous ichthyosis several weeks after birth. Leucocyte SS and ASC activities in the mother and grandmother of these two cases with steroid sulfatase deficiency (SSD) were 38% to 69% of the mean levels in the control. This, coupled with the results of the family investigation, strongly suggests that the deficiency is a sex‐linked recessive hereditary condition. Control values for SS and ASC were higher in females than in males. These results indicate that the diagnosis of SSD and the screening of carriers can be made using both leucocytic SS and ASC activities. Estrogen E1, E2 and E3 levels were low in maternal and umbilical cord blood.
Cytological Properties of Human Ovarian Carcinoma Cell Lines
Authors: Ishiwata Isamu , Ishiwata Chieko , Nozawa Shiro , Ishikawa Hiroshi
Published: August 2010

Ovarian carcinomas from 30 cases were cultured, and 8 cell lines, including 4 lines of serous cystadenocarcinoma (SCAC), 2 lines of endometrioid adenocarcinoma (EAC), one line of anaplastic carcinoma (AC), and one line of clear cell carcinoma (CCC), were established. Examination of the cytobiological properties (morphology, proliferation, chromosomes, heterotransplantability, etc.) of the cell lines revealed that the cell lines maintain the characteristics of the original tumor in vitro for a long period. HTOA and HUOA, both SCAC lines of a well differentiated type, produce a large amount of CA125 and formed SCACs that were extremely similar to the original tumor in nude mice. HTBOA (AC line) and HUOCA‐II (CCC line, poorly differentiated type) were both easy to transplant to nude mice, and the tumor formed was rich in blood vessels, proliferated rapidly, and showed histology that was similar to that of the original tumor. The HTBOA cells produced granulocyte colony‐stimulating‐factor (G‐CSF) and caused granulocytosis in the mouse.
Plasma Gastrin and Secretin in Neonates
Authors: Nakai Toshiaki , Yamada Ritsuji , Watanabe Hiroshi , Kumasaka Takahiro
Published: August 2010

With a view to investigating the dynamics of gastrointestinal hormones after birth, chronological changes in gastrin and secretin in the blood after birth were determined with radioimmunoassay. At delivery, the gastrin concentration in the umbilical cord plasma was 201 ±10 pg/ml (mean±SEM), significantly higher than that in the maternal vein. In the first 4–48 hours of life, it decreased to the adult level and rose again at 5 days of age. Next, the post‐prandial gastrin responses in both neonates and adults were examined. Percent increase in neonatal plasma gastrin concentration after feeding, as compared with the pre‐feeding level, was significantly higher than that observed in the adults. From these findings, we presumed that the “release setting” of gut endocrine cells differs between neonates and adults and also that enteral feeding might trigger the postnatal increase in the plasma gastrin concentration. The secretin concentration in the arterial cord plasma was 314 ±22 pg/ml. The secretin concentration in the blood also decreased in the first –8 hours of life, this decrease being similar to that of the gastrin level. However, a second rise in the level, as in the case of gastrin, was not observed at 5 days of age. In milk‐fed neonates, secretin did not show a postprandial response as did gastrin.
Diabetes Mellitus and Pregnancy: Management Simplified by a Computer Assisted Home Glucose Meter and Measurement of Glycosylated Protein
Authors: Moses Robert G.
Published: August 2010

This case report describes the use of glycosylated protein measurements and a computer assisted home glucose meter in the management of a diabetic pregnancy.
Diagnoses and Prognoses of Fetal Cardiovascular Anomalies in utero, Assessed Echocardiographically
Authors: Hara Kenji , Koyanagi Takashi , Hori Eiichi , Satoh Shoji , Nakano Hitoo
Published: August 2010

Abstract

This echocardiographic study was designed to determine the accuracy of prenatal diagnoses of fetuses with cardiac anomalies and also to evaluate the manner in which various types of disorders affect the prognoses in utero. In 13 fetuses studied, the following cardiac anomalies were present: ventricular septal defect (VSD), atrial septal defect (ASD), atrio‐ventricular septal defect (AVSD), double outlet of the right ventricle, hypoplastic right (HPRV) and left (HPLV) ventricles, Ebstein's anomaly, endocardial fibroelastosis (EFE), transposition of the great arteries, coarctation of the aorta and cardiac tumor.

These were categorized by the minimum unit of cardiovascular anomalies. According to this criteria, the correct, false positive, false negative, and misinterpretations were estimated to be 71.4, 4.8, 14.3 and 9.5%, respectively. After division of correctly diagnosed cases into 2 groups, 86.7% of heart anomalies and 50.0% of those of great vessels were found to be accurately diagnosed.

Fetal prognoses with cardiovascular anomalies were classified into 3 groups: cardiac failure, intrauterine growth retardation and no sequelae.

The first group was representative of EFE and HPRV, the second group, representative of hypoplastic ventricle and deffective heart diseases complicated by chromosome anomalies or other major malformations. The third group included all anomalies but with no sequelae in utero.
Pelvic Outlet Contraction: A Forgotten Entity
Authors: Fliegner John R. H.
Published: August 2010

Abstract

Pelvic outlet contraction is rare, but should be readily diagnosed at the routine assessment of the pelvis during the prenatal period. When in doubt, accurate measurements of the bony outlet by X‐ray pelvimetry are mandatory. A trial of labor is not applicable if the pelvic outlet is reduced, because the true state of disproportion will not be appreciated until very late in labor. A case is reported in which severe outlet contraction was not recognized in the prenatal period, and only became evident after fetal distress necessitated careful assessment in labor.
Nonimmunologic Hydrops Fetalis and Chromosome Aberration
Authors: Maeda Hirotaka , Shimokawa Hiroshi , Matsuo Toshiko , Hisanaga Sachio , Nakano Hitoo
Published: August 2010

Abstract

In order to evaluate the role of genetic amniocentesis for the management of nonimmunologic hydrops fetalis (NIHF), the present study was performed.

In 29 cases with NIHF, diagnosed antenatally using ultrasound, a genetic amniocentesis was performed. Three cases had chromosome aberration and all were 21 trisomy; one had a heart anomaly and the other 2 cases had no malformations. All 3 cases died during the neonatal period in spite of intensive perinatal management. Among NIHF, the incidence of 21 trisomy is 10%.

Genetic amniocentesis is an invaluable means to detect underlying diseases in NIHF.
Effect of Various C19‐Steroids upon the Production of Progesterone and 17α‐Hydroxyprogesterone by Preovulatory Hamster Follicles in Culture
Authors: Matson Phillip L. , Collins William P.
Published: August 2010

Abstract

Preovulatory follicles (591–740 μm) were isolated from immature golden hamsters 72–78 h after the administration of 40 IU PMSG and cultured for 4 h in the presence or absence of androstenedione, dehydroepiandrosterone, testosterone or 5α‐dihydrotes‐tosterone. Dose‐dependent increases in the output of progesterone and 17α‐hydroxy‐progesterone were caused by each of the C19‐steroids tested and this stimulation was not dependent upon the synthesis of new mRNA or protein.
Recent Changes in the Epidemiology of GTN in Taiwan, ROC: Preliminary Report
Authors: Hsu Chien‐Tien , Jong Hong‐Lin , Wang Tai‐Te , Chang Chung‐Chuan , Roan Cheng‐Hsiung , Lin Yun‐Nan , Chen Ting‐Yao , Lan Chung‐Fu
Published: August 2010

Four hundred and seventy‐four cases of GTN from the Municipal Chunghsing Hospital, the Municipal Maternal and Child Hospital, the Department of Pathology of Taipei Medical College and MacKay Memorial Hospital were collected and statistically analyzed. The present study proves that hospital statistics on the incidence of GTN were inadequate, being subject to change according to the number of hospital deliveries which could be dependent on the socioeconomic status and educational level of the community. There is a highly significant positive correlation between the incidence of GTN and the fertility rate, but no correlation with the total number of live births. There was a highly significant negative correlation between the incidence of GTN and the per capita daily consumption of protein (r = ‐0.7189), calorie intake (r = ‐0.6332) and per capita income (r = ‐0.8420). The gradual decrease of GTN in an earlier period and the acute drop in GTN incidence in the last 10 years reflects Taiwan's progress from the status of a developing country to that of a developed country. The close parallelism between the incidence of GTN (or relative incidence; the percentage of GTN among the total of all surgical specimens) and the fertility rate reflects the Taiwan's successful family planning program. In particular the sharp divergence between the fertility rate and the total number of live birth more definitely indicates the success.

Epidemiological studies would suggest that contrary to reports in the literature, there may be no great difference in the incidence of GTN in China and the USA. Socioeconomic and environmental (nutritional and life style) factors might play a more important role than the racial factor.
Measurement of Placental Blood Flow by the Thermocouple Method in Comparison with the Electromagnetic Flowmeter Method
Authors: Hidaka Atsuo , Komatani Mitsuo , Sugawa Tadashi
Published: August 2010

A comparative study of flow measurements in model experiment by using a thermocouple method and an electromagnetic flowmeter was done, with the result that the flow waves shown by both apparatuses were seen to be quite analogous.

Furthermore, the influence of uterine artery occlusion on placental blood flow was studied using the thermocouple method in comparison with measuring blood flow in a uterine artery by using an electromagnetic flowmeter in 5 late pregnant dogs. Both flows revealed almost the same pattern, however, the placental blood flow changes were more gradual than that of the uterine arterial blood flow.

We found that the thermocouple method is useful to measure placental blood flow on the maternal side.
Fetal Cardiac Hemodynamics Assessed by Two‐Dimensional Doppler Echocardiography
Authors: Hata Toshiyuki , Hata Kohkichi , Ryukoh Kanji , Aoki Showa , Takamori Hisazumi , Nagata Hiroko , Nishigaki Arata , Hirayama Keiko , Takamiya Osamu , Murao Fuminori , Kitao Manabu
Published: August 2010

Forty‐one 2‐dimensional (2‐D) Doppler echocardiographic examinations were performed on 36 fetuses in utero, at 17 to 39 weeks of gestation. Left and right transvalvular, aortic, pulmonary, transforaminal, and inferior vena caval flows were assessed. The rates of detection of left and right transvalvular, aortic, pulmonary, transforaminal, and inferior vena caval flows were 85.4, 73.2, 53.7, 41.5, and 9.8%, respectively. In one fetus with premature atrial contraction, there was a characteristic pattern of intracardiac hemodynamics. The 2‐D Doppler echocardiography is proving to be very useful for assessing in utero fetal cardiac hemodynamics and determining related physiologic and pathologic states.
Bioassay of Cisplatin and Doxorubicin by HeLa Cell Clonogenic Assay
Authors: Yoshimura Takahiro , Iwasaka Tsuyoshi , Kidera Yoshiro , Sugimori Hajime
Published: August 2010

With use of a new bioassay method, HeLa cell clonogenic assay, we examined the pharmacokinetics of cis‐diamminedichloroplatinum (CDDP) and Doxorubicin (DR) in vitro and in patients after administration of these antitumor agents. The in vitro study revealed that the inhibitory effects of both agents on colony growth were not only dose dependent but dependent on treatment time and that the inhibition of colony growth by CDDP decreased with the addition of fetal calf serum or human serum. The plasma samples were obtained from 9 patients with gynecological malignancies after administration of CDDP (35–50 mg/m2) or DR (35–50 mg/m2). The plasma levels of total CDDP and free CDDP were determined by atomic absorption assay, while DR was determined by fluoroassay. Plasma concentration of total CDDP gradually rose during continuous infusion, reaching a maximum at the end of the transfusion and slowly decreased thereafter. On the other hand concentrations of free CDDP increased according to total CDDP during continuous infusion and decreased rapidly after the completion of infusion. Antitumor activities in these plasmas measured by HeLa cell clonogenic assay correlated well with kinetics of free CDDP but not with total CDDP. The conclusion was that protein‐bound CDDP does not contribute to the inhibition of colony growth. Hence a bioassay of CDDP is considered to be important to know its true antitumor effects and to determine appropriate schedules for chemotherapy.
Term Pregnancy in a Rudimentary Horn of a Bicornuate Uterus with Foetal Salvage: A Case Report
Authors: Akhtar Asif Zia
Published: August 2010

A case of pregnancy in the left rudimentary horn of a bicornuate uterus is described. The pregnancy was carried to term without the rupture of the horn and a live infant weighing 3.5 kg was delivered by lower segment caesarean section and thinned out horn of uterus was removed. The case is reported as it is one of the very few documented deliveries of a live‐born infant. Some of the factors associated with pregnancy in a rudimentary horn are discussed.
Role of Surgical Intervention in Severe Grade of Septic Abortions: An Analysis of 14 Cases
Authors: Pai Vidya , Dasan J. , Rao Usha R. , Pai U. S. , Nalini V.
Published: August 2010

Septic induced abortion is still posing a problem in our community. Out of 14 grade III septic induced abortion, 12 required surgical intervention as part of active management for appropriate therapy. Clinical variables like patient characteristics, method of induction, person responsible for induction, the methods, the reason for delay in admission were analysed in detail with a view to obtain a comprehensive idea of this socio‐medical problem and its prevention.
A Morphometric and Ultrastructural Study of the Microvessels of the Functional Zone of Normal Human Endometrium with Some Notions on Possible Secretory Functions of the Endothelial Cells
Authors: Blackwell Peter M. , Fraser Ian S.
Published: August 2010

A comparative analysis of microvessel concentration in 24 specimens of normal human endometrium has been carried out in the mid‐proliferative (n = 12) and mid‐secretory (n = 12) phases of the menstrual cycle, with the finding of a significantly greater vascularity in the mid‐secretory phase (25.0+/‐12.7 microvessels/sq mm compared with 12.2+/‐6.3; mean +/‐SD; p<0.005).

No significant difference was observed between the 2 phases in measurements of maximum luminal diameter, mean luminal diameter or luminal area, but there was a significantly greater mean diameter at the basement membrane in the proliferative compared with the secretory phase. This indicates that the microvessel diameter was larger in the proliferative phase due to greater height of the endothelial cells, while luminal size remained constant. Mean area (+/‐SD) of endothelial cell cytoplasm per transverse microvessel section was 58.5+/‐28.6 sq um in the mid‐proliferative phase and 44.9+/‐26.2 sq um in the mid‐secretory phase (p = 0.001).

In a detailed ultrastructural study made of all the microvessels seen in 12 specimens of normal endometrium (6 mid‐proliferative and 6 mid‐secretory), the morphological appearance of the microvessels varied widely, especially with respect to cytoplasmic density and organelle concentration. Three distinct types of endothelial cell junction were observed each of which would impart a different level of cohesion to the vessel. A proposal is put forward that the presence of very weak junctions may be a factor leading to a propensity for excessive menstrual bleeding in some women.

Endothelial cells have been shown by others to be highly metabolically active and secretory in nature and it has been assumed that they externalise their products by exocytotic secretory mechanisms.

We have described unusual projections from the luminal membranes of human endometrial endothelial cells and free membrane‐bound luminal bodies observed in over a quarter of all endometrial microvessels. The function of these projections and bodies is unknown, but their appearances are consistent with the hypothesis that they represent a form of apocrine secretion with release of cytoplasmic material into the microvessel lumen for local and distant use.
The Effect of an Anti‐Progestin Compound (RU486) on Gonadotropin Release from Rat Anterior Pituitary Cells in vitro
Authors: Arakawa Satoko , Ohkawa Tomi , Kambegaaw Akira , Okinaga Shoichi , Arai Kiyoshi
Published: August 2010

Anterior pituitary cells from castrated female rats were cultured in a medium with or without progesterone (P4), estradiol‐17 β (E2), 17 β‐hydroxy‐11 β‐(4‐dimethylaminophenyl)‐17‐(prop‐1‐ynyl)‐estra‐4,9‐dien‐3‐one (RU486) or norethisterone (NE). Three days later, the media were changed and the cells were incubated further with or without luteinizing hormone releasing hormone (LHRH) (10‐6‐10‐12 M) for 3 hours. LH and FSH released in the media were measured by radioimmunoassay (RIA).

At a high concentration of LHRH (>10‐8 M), E2 (10‐9 M) increased the release of LH and FSH significantly. When P4 (10‐6 M) was combined with E2 for 3 days, the release of LH and FSH by E2 was inhibited.

RU486 had no direct effect on LH and FSH release. However, the effect of P4 against E2, as mentioned above, was nullified by 10‐6 M of RU486.

In the same experimental model, RU486 also inhibited the effect of norethisterone.

By the use of the anti‐progestin compound, RU486, it was confirmed that progestins directly inhibited the action of E2 at the anterior pituitary level.
Premature Ovarian Failure: A Clinical, Histological and Cytogenetic Study
Authors: Tanaka Shoichi , Mizunuma Masahiro , Watanabe Hiroshi , Hata Hiroshi , Shimoya Yasuharu , Hashimoto Masayoshi
Published: August 2010

In this study, 17 cases of primary ovarian failure were studied clinically and endocrinologically. The average age at the beginning of amenorrhea was 23.7 years. The mean levels of serum LH, FSH and estradiol were 102.7 miu/ml, 99.6 miu/ml and 12.5 pg/ml, respectively. Chromosomal analysis was performed in 14 cases. One case was 46XXq– and one case 45X/46XY, while the others were categorized as 46XX karyotype. Ovarian biopsy was performed in 5 cases. In all 5 cases, no primordial follicle was found, but corpora albicantia were present, indicating past ovulation. Induction of ovulation was attempted in 16 cases. After estrogen progesterone cyclic therapy, one patient became pregnant, but gonadotropin therapy was ineffective. Although the etiology of primary ovarian failure remains unknown, pregnancy and ovulation can be achieved in some cases. With regard to treatment, estrogen replacement therapy may prove to be more effective than gonadotropin therapy.
Microinvasive Carcinoma of the Cervix and Colposcopy
Authors: Supreeya Wongtra‐Ngan , MacLean A. B. , Cordiner J. W.
Published: August 2010

The trainee in colposcopy is often taught that the colposcopic appearances of microinvasive carcinoma of the cervix can be distinguished from those due to intraepithelial neoplasia. However, our experience is that the colposcopic features of microinvasive carcinoma are not specific or diagnostic, and that the diagnosis from biopsy material is often unexpected.

Atypical areas of the transformation zone should be biopsied during assessment before planning treatment. Any lesion that extends into the canal must be assessed by cone biopsy (cut by knife or laser). Providing occult invasion and canal involvement can be excluded, the interval between diagnosis and treatment is not prolonged, and the method of selective ablation ensures destruction to a depth of over 5 mm, the failure to recognise microinvasion in an area of intraepithelial neoplasia probably does not have clinical repercussions.
Eisenmenger's Syndrome with Pregnancy: A Rare Obstetrical Problem with Successful Outcome
Authors: Buckshee Kamal , Biswas Arijit , Mittal Suneeta , Agarwal Neera
Published: August 2010

More and more cases of congenital heart disease are reaching reproductive age and conceiving. Some of these do not pose much additional problem to the obstetrician but Eisenmenger's syndrome though rare is associated with a very high maternal mortality. The problem is further aggravated if patient develops pre‐eclampsia. Pregnancy termination is offered by most obstetricians when faced with a patient of Eisenmenger's syndrome with pregnancy. Few cases with successful outcome are reported in literature.
The Urodynamic Effect of Colposuspension Immediately after Surgery for Genuine Stress Incontinence
Authors: Wang Alex C. , Hsieh C. C.
Published: August 2010

Extensive reports on postoperative urodynamic evaluation of female patients with GSI have been published in the current literature. However, urodynamic data from immediate postoperative evaluation has not yet been presented.

Urodynamic study was made in 33 out of 41 patients from 9th–12th postoperative day. Our results indicated that preoperative and postoperative FUL in erect and supine position were 2.90±0.71; 3.72±0.98; P<0.005 and 2.13±0.68; 3.55±1.67; P<0.005 respectively. Preoperative PFR was 23.4±11.2 and postoperative PFR was 8.1±5.2; P<0.001. Preoperative RU was 69.9±83.3 and postoperative RU was 194±179; P<0.005.

On the basis of the foregoing figures and our previous study, the following conclusions can be drawn; edematous swelling, possible hematoma formation and possible damage of the nerve supplying the bladder during dissection may be causes of postoperative voiding difficulty. The results of FUL obtained immediately following operation may serve as a parameter for predicting the outcome of corrective surgery. This may provide a simple way to judge whether or not the proximal urethra has been successfully restored to the intra‐abdominal pressure zone if the medical centers are not equipped with sophisticated instruments for measuring transmission ratios.
Outcome of Epileptic Pregnancy: Neonatal Hemorrhage due to Anticonvulsant Treatment of Mothers during Pregnancy
Authors: Ihara Yoshiyuki , Shimizu Takashi , Kawaguchi Kanetoshi , Inoue Kinya , Ando Nobuya
Published: August 2010

Sixteen neonates were born from epileptic women under anticonvulsant treatment. Most of the mothers were administered phenobarbital and phenytoin. Although no congenital anomaly was observed, 2 neonates showed hemorrhage and one died 25 hours after birth from profuse intra‐abdominal hemorrhage derived from ruptured subcapsular hematoma of the liver.

The cord blood concentration of anticonvulsants correlated well with both maternal daily dose and maternal blood concentration. The ratio of cord blood to maternal blood concentration was approximately 1: 1 with phenobarbital and phenytoin. In the 2 neonates with hemorrhage, both the maternal dose and the cord blood concentration were relatively low.

The cord blood of neonates born from an epileptic mother treated with anticonvulsants (especially phenobarbital and phenytoin), should immediately be submitted to coagulation tests, even if maternal daily dose or blood concentration of the drug is low. Such infants should be closely observed and be transfused with fresh frozen plasma, if bleeding is detected.
Long‐Term Immunoprophylaxis of Hepatitis B Surface Antigen Carrier in Infants Born to Hepatitis B Surface Antigen Positive Mothers Using Plasma Derived Vaccine
Authors: Theppisai Urusa , Thanuntaseth Chalermsri , Chiewsilp Pimol , Siripoonya Praput
Published: August 2010

Immunoprophylaxis of HBV infection using 3 doses (10 μg) of plasma derived HBV vaccine were given to 49 newborn infants of e‐antigen negative HBs Ag carrier mothers at birth, one and 6 months of age. The protective efficacy rate was 100% during first 2 years. At 3 years of age, HBs Ag carrier was 2.63% and 89.48% of infants had anti‐HBs above the protective level. Ten point fifty‐two percent of total infants had anti‐HBs level below 10 mIU/ml and 21.05% had anti‐HBs level between 10–100 mIU/ml. Most infants who had the maximal level of antibody below 100 mIU/ml had lost all antibody within 3 years. The loss of antibody was closely related to the maximal anti‐HBs titer (one year of age) which is highly predictive indicator of the longevity of anti‐HBs.
Grandmultiparity: A Continuing Problem in Developing Countries
Authors: Karim Saadiya Aziz , Memon Abdul M. , Qadri Nighat
Published: August 2010

Four hundred and thirty‐one grandmultiparae and 1,070 less parous women who delivered at Civil Hospital, Karachi over a 2‐year period (Jan. 1982 to Dec. 1983) have been reviewed retrospectively. The purpose was to estimate the incidence of grandmultiparity at this hospital and compare the incidence of obstetric and medical complications in the grandmultiparae with the less parous women. A higher incidence of anaemia, spontaneous abortions, abruptio placentae, postpartum haemorrhage, spontaneous uterine rupture and fetal loss was found in the grandmultiparae compared with other parturients. The grandmultipara continues to be a “high‐risk” obstetric problem.
An Experimental Study on the Effects of Elastase, Bleomycin and Infection on the Growth and Tensile Strength of Elastic Tissue in Rabbit Fetal Membranes
Authors: Chimura Tetsuro , Fujimori Katsuhiko
Published: August 2010

The effects of bleomycin, elastase and infection on the tensile strength of rabbit fetal membranes and the structure of the elastic tissue of rabbit amnion were studied. The experimental subjects were rabbits to which bleomycin (total dose, 20 mg) or elastase (total dose, 60 mg) was administered from 18 days of pregnancy. In addition to the fetal membranes from these treated animals, fetal membranes with amniotic infection induced by injection of Escherichia coli into the amniotic fluid (AF) of rabbits at 22 or 23 days of pregnancy were examined, and those from rabbits administered physiological saline solution were used as controls. The results obtained were as follows.

Determination of tensile strength of the fetal membranes revealed that the infected membranes had minimum rupture pressure (18.67·6.30 mm Hg), followed by the elastase administration group (46.67·3.51 mm Hg). The value in the bleomycin administration group (99.67·12.89 mm Hg) was significantly higher than that in the control group (61.80·6.30 mm Hg). Histological changes in the fibroblast layer of these fetal membranes included elastic fibrosis due to excessive collagen production, which was mostly manifested as fibrosis densa, in the bleomycin administration group. In the elastase administration group, the elastic fibers were eliminated or became minute, as in the infection groups.

The above results showed the adverse effects of elastase and bleomycin and the destructive effect of infection on the growth and properties of elastic tissue in the amnion, suggesting their pathophysiological importance.
Establishment and Characterization of CA 125 Producing Cell Line (OMC‐2) Originating from a Human Endometrial Adenocarcinoma
Authors: Yamada Takashi , Ueda Masatsugu , Maeda Takayoshi , Okamoto Yoshiaki , Miyawaki Yoshitaka , Otsuki Yoshinori , Ueki Minoru , Sugimoto Osamu
Published: August 2010

A new human endometrial carcinoma cell line, designated OMC‐2, was established from the endometrial adenocarcinoma of a 59‐year‐old woman. This cell line has grown well for 51 months and has been subcultured more than 50 times. Monolayer cultured cells are polygonal in shape, showing a pavement‐like arrangement and a piling up tendency without contact inhibition. The chromosomal number shows aneuploidy and the modal chromosomal number is in the diploid range. The cells were transplanted into the subcutis of nude mice and produced tumors resembling the original tumor. 1X105 OMC‐2 cells produced CA 125 (184–682 U) during 19 days in culture media. CA 125 was demonstrated immunohistochemically in the original tumor, heterotransplanted tumor, and OMC‐2 cells. The cells contain no estrogen or progesterone receptors. Twenty‐nine other reports of endometrial carcinoma cell lines are reviewed.
Epidermal Growth Factor‐Like Immunoreactivity in Human Endometrium
Authors: Ishihara Satoko , Taketani Yuji , Mizuno Masahiko
Published: August 2010

Epidermal growth factor (EGF)‐like immunoreactivity was detected in human endometrial tissues. The concentrations of the immunoreactivity fluctuated during the menstrual cycle. The highest levels were observed in the late proliferative phase with the concentrations being 0.50±0.06 ng/mg protein (M±SE, n=5). Considering the presence of EGF receptors in human endometrium, EGF‐like peptides may act in autocrine or paracrine fashions in human endometrium.
Thymidylate Synthase Inhibition as a Predictor of Tumor Sensitivity of Fluorinated Pyrimidines
Authors: Suzuki Mitsuaki , Sekiguchi Isao , Tamada Taro
Published: August 2010

The thymidylate synthase (TS) content of tumor tissue was assayed and the levels of 5‐fluorouracil (5‐Fu) in serum and tumor tissue were determined in 21 patients with cervical cancer who were treated with UFT, a fluorinated pyrimidine. Subrenal capsule assay, a predictive tumor sensitivity test, was conducted concurrently on cervical tumor samples. TS inhibition and serum and tissue 5‐Fu levels widely varied between both samples. Investigation of the relationship between the tumor growth inhibition rate determined by subrenal capsule assay and the above parameters (TS inhibition, serum and tissue 5‐Fu levels) showed that TS inhibition and tumor growth inhibition were well correlated (r=0.73). This suggests that a TS inhibition assay in tumor tissue can be a useful predictive test for tumor sensitivity of fluorinated pyrimidines.
Relationship between the Placental Location and the Flow Velocity Waveforms of Bilateral Uterine Arteries
Authors: Ito Yuji , Shouno Hideaki , Yamasaki Miyoshi , Oga Masayuki , Sugimori Hajime
Published: August 2010

The relationship between the placental location and the resistance index (RI) of the ascending branch of bilateral uterine arteries was examined with continuous Doppler ultrasonography, in 48 healthy pregnant women in the 37th to 40th week of gestation. When the placental location was central, there was little difference in the RI between the right and left uterine artery (fundus; 0.61±0.04 versus 0.58±0.03, NS, body; 0.48±0.04 versus 0.47±0.03, NS, and lower segment; 0.28±0.03 versus 0.30±0.04, NS). The RI became smaller when the level of placental attachment was lower toward the cervix. In cases where the placental location has shifted to the right or left of the uterine body, the RI on the placental side was smaller than that of the contralateral uterine artery (0.39±0.04 versus 0.62±0.03, p<0.01). The physiological and clinical significance of these results are discussed in the following report.
Augmentation of Labour by a Standard Protocol in Papua New Guinea
Authors: Mola Glen , Rageau One
Published: August 2010

A study to investigate a policy of routine augmentation of dystocic labour by standard protocol encompassing definitions of delay in the first and second stages, dosage and administration of oxytocin, specific contra‐indications and monitoring progress of augmented labour.

During the 5 months of the study 3,261 women were confined at Port Moresby General Hospital. In 329 of these labour was augmented by a standard regime. Amongst the 161 primigravidae thus augmented there were 8 (5%) caesarean sections and 34 (21.1%) assisted deliveries. Of the 166 multigravidae augmented there were 4 (2.4%) caesarean sections and 20 (12.1%) assisted deliveries. These figures can be compared against a total caesarean rate of 2.4% and an assisted delivery rate of 3% in 1988.

Analysis of case controls did not show a significant difference in perinatal outcome for those who were augmented.

We conclude that a standard management protocol for augmentation of labour in all cases of delay in the first and second stages of labour, excluding those with specific contra‐indications is safe and substantiates further the ascertion that active management of labour is a reasonable alternative to caesarean section for dystocia.
Immediate Postoperative Oral Hydration after Caesarean Section
Authors: Guedj Pierre , Eldor Joseph , Stark Michael
Published: August 2010

A study was carried out to assess the effects of immediate postoperative oral rehydration in 51 unpremedicated women undergoing caesarean section under epidural anesthesia. The patients were randomly assigned to 2 groups: group 1 (n=22)—fasting at least until 24 hours after the end of the operation, and group 2 (n=29)—receiving immediate oral intake of fluids (water, tea or coffee with sugar) without limitation of quantity. The 2 groups were compared for the occurrence of postoperative nausea and vomiting, onset of peristalsis, rectal gas emission, first bowel movement, and possible complications. The results demonstrate no significant differences between the parturients who drank immediately postoperatively as compared to those in whom oral fluid intake was delayed for 24 hours or more. It is concluded that immediate postoperative oral rehydration had no harmful effect upon peristalsis post‐caesarean section.
Risk Determination in Cases with an Extra Minute Chromosome: Prenatal Diagnosis
Authors: Sago Haruhiko , Iinuma Kazuso , Yoshiwara Sachiko , Takeda Tomoko , Takeda Osamu , Onda Takekazu , Kitagawa Michihiro , Komuro Nobuyoshi , Terashima Yoshiteru , Kinoshita Hideo
Published: August 2010

The interpretation of an extra minute chromosome (EMC) detectedin uteropresents both diagnostic and prognostic problems. Two EMC cases are presented and a flow‐chart guideline is proposed for the determination of developmental risk. A prenatally detected EMC was familially inherited through a normal phenotype father. The pregnancy was continued and a normal baby boy was delivered. At one year his development was within normal ranges. The second EMC case was a mentally retarded girl examined at 4 years and 7 months of age. The EMC was identified with a combination of various staining techniques to be an inversion duplication (15). The importance of differential diagnosis of EMCs by DA/DAPI staining is emphasized.
Cervical Cancer Screening Program in a Muslim Country: Three‐Year Experience at The Aga Khan University Medical Center, Karachi
Authors: Rasul Saadiya , Khan Khalid S. , Rizvi Javaid H. , Hassan Sheema H. , Maniar Siddiqua
Published: August 2010

A systematic cervical cancer screening program was initiated in January 1987 at The Aga Khan University Medical Center, Karachi, Pakistan. The 8,784 cervical smears obtained in 3 subsequent years from 8,412 consecutive women attending the gynecology and antenatal clinics were reviewed. “Positive” smears were found in 111 (1.3%) patients; 107 (1.27%) smears showed squamous epithelial dysplasia and 4 smears showed adenocarcinoma. The highest incidence of abnormal smears was found in the 45–54 years age group. Colposcopy and biopsy was performed on all patients with “positive” smears except on those with atypical or mildly dysplastic ones, in whom only the persistence of the abnormality on repeated smears was considered an indication for tissue evaluation. The histopathologic diagnosis of these biopsy specimens revealed cervical intra‐epithelial neoplasia in 60 patients and invasive cervical cancer in 6 patients.
Pharmacokinetics of Vitamin K in Mothers and Children in the Perinatal Period: Transplacental Transport of Vitamin K2 (MK‐4)
Authors: Iioka Hideaki , Moriyama Ikuko S. , Morimoto Keiko , Akada Shinobu , Hisanaga Hiroyasu , Ishihara Yuki , Ichijo Motohiko
Published: August 2010

In order to examine the pharmacokinetics of vitamin K2, vitamin K2 (MK‐4) was intravenously injected into mothers, and its transfer to placental tissue and the fetuses was examined. While incorporation of vitamin K2 into placental tissue was relatively active, transfer of vitamin K2 to fetal blood (cord blood) was small. So it was indicated that vitamin K2 incorporated into placental tissue from maternal blood is initially stored in the placenta and then gradually released into the fetal blood.

Since vitamin K deficiency has been pointed out, release of vitamin K2 into milk was also examined. When vitamin K2 (MK‐4) was injected into mothers, the release of vitamin K2 into milk increased with time even after the plasma vitamin K2 concentration in maternal blood decreased. So the presence of a vitamin K2 concentrating mechanism in the mammary tissue was indicated.
Reconstruction of Surgical Defects Using the Gluteus Maximus Myocutaneous Flap Following Radical Vulvectomy
Authors: Ogino Masahiro , Sakamoto Takako , Inoue Jun , Dobashi Kazuyoshi , Okinaga Shoichi , Arai Kiyoshi
Published: August 2010

Radical vulvectomy is often complicated by problems associated with insufficient closure of large skin defects involving postoperative necrosis of the suture line over the mons pubis and the inguinal areas. To resolve these problems, the present study compared radical vulvectomy (RV, 7 cases) with radical vulvectomy followed by reconstructive operation using the gluteus maximus myocutaneous flap (RVR, 5 cases). There was no significant difference in operation time and blood loss between the two groups. Three of the 7 RV patients had wound separations requiring reoperation, while only 1 patient in the RVR group did. The average hospital stay was 86 days in the RV group and 38 days in the RVR. Risks of postoperative infection and wound breakdown were reduced with the flap technique, and ambulation and rehabilitation could begin earlier in this group. Surgical wounds were stable and the quality of life after operation was improved dramatically using the flap technique.