bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy after Chemotherapy for Trophoblastic Diseases and Psychosomatic Developmentin the Progeny*
Authors: Suzuki Itsuko , Goto Setsuko , Yamada Ayako , Tomoda Yutaka
Published: August 2010

We treated 542 patients with trophoblastic diseases from 1965 through 1988, and succeeded in preserving fertility in 269 of them (240 cases of invasive mole and 29 cases of choriocarcinoma).

Of the 269 patients, 198 (79.5%) conceived after completing treatment. A total of 396 pregnancies in these women resulted in 295 term live births (74.5%), 51 spontaneous abortions (12.9%), and 4 recurrences of moles (1.0%). Four cases (1.32%) of malformations were discovered. The growth conditions of 101 children born in 1976 or later were followed up until the age of 18 months. Their heights or weights did not differ significantly from those of children measured in national infantile‐growth surveys. The psychoneurological development of 54 children up to the age of 7 years who were studied by using infantile mental‐development questionnaires showed no marked mental retardation. Our results provide strong evidence of the safety of chemotherapy for the treatment of trophoblastic diseases.
Prostaglandins Biosynthesis in the Rabbit Uterine Cervix at Various Stages of Pregnancy
Authors: Okawa Toshiaki , Suzuki Yosuke , Hoshi Kazuhiko , Endo Chikara , Sato Akira , Nakanishi Hironori
Published: August 2010

The accumulation of prostaglandins (PGs: 6‐keto PGF1α, PGE2, PGF2α, and TXB2) elicited by A‐23187, a Ca2+‐ionophore, was studied in the uterine cervical tissue taken from non‐pregnant and pregnant (10th, 20th and 30th day of pregnancy) rabbits in vitro.

At every stage of pregnancy, the accumulation of PGs levels increased as follows; 6‐keto PGF1α, PGE2, PGF2α and TXB2. Biosynthesis of each began to increase from the 20th day of pregnancy, and was significantly elevated at the 30th day. Especially, 6‐keto PGF1α and PGE2 were remarkably higher than PGF2α and TXB2 at term, and so they are thought to play a more important role in cervical dilation and ripening than the other PGs. Six‐keto PGF1α was significantly elevated on the 20th day, when other PGs had not yet began to increase. It is thus conceivable that PGI2 plays an important role in the predispositing of cervical ripening.
The Application of Immunotargeting into Cancer Chemotherapy with Carboplatin:in vitroandin vivoStudies
Authors: Ota Yoriko , Oehr Peter , Inaba Noriyuki , Takamizawa Hiroyoshi
Published: August 2010

Anti‐tumor effects of the following 2 cis‐diammin (1, 1‐cyclobutandicarboxylato) platin II (carboplatin, Bristol‐Myers‐Squibb) conjugates were evaluated through bothin vitroand in vivo experiments: (1) carboplatin coupled with anti‐cytokeratin monoclonal antibody (MAb), TS1 via carboxymethyl dextran (carboplatin‐carboxymethyl dextran‐TSl), and (2) carboplatin‐carboxymethyl dextran‐avidin targeted to biotiny‐lated TS1. Using l‐ethyl‐3(3‐dimethylaminopropyl)‐carbodiimide andN‐hydro‐xysuccinimide, carboplatin was conjugated to carboxymethyl dextran, TS1, or avidin, at high molar ratios. The staining positivity of carboplatin‐carboxymethyl dextran‐TSl in indirect immunofluorescence was almost identical to that of the original MAb. The average dose of carboplatin given in each treatment was about 60% of a clinical dose. Regarding cytotoxicity, the free drug showed the strongest effect and the best dose‐dependency in cell lines: HeLa and ZR‐75‐1. Anin vivostudy giving carbo‐platin‐MAb conjugates or free drug to HeLa tumor bearing nude rats proved that the efficacy of carboplatin‐carboxymethyl dextran‐TSl in HeLa tumor was not greater than that of the free carboplatin.
Emergency Hysterectomy in Obstetrics: Review of 15 Years
Authors: Gupta U. , Ganesh K.
Published: August 2010

Abstract

A total of 140 patients underwent emergency obstetric hysterectomy at Smt Sucheta Kriplani Hospital, New Delhi, India, over a 15‐year period between 1976 to 1990. Rupture of uterus and obstetric hemorrhage were two major indications for obstetric hysterectomy. Maternal mortality occurred in 18 i.e. 12.8% of the cases. Hemorrhage was leading cause of maternal death. While major degree of placenta praevia was responsible for 39.3% of obstetric hemorrhage, it contributed to nearly 40% of maternal deaths. Fifty percent of placenta praevia cases had morbid adhesions of placenta, associated with previous cesarean section. Hence patients of previous cesarean section with placenta praevia should be operated by experienced obstetricians keeping plenty of blood ready.
Combined Intrauterine and Ovarian Pregnancy: A Case Report
Authors: Hirose Masaya , Nomura Tetsuya , Wakuda Kohji , Ishiguro Tatsuya , Yoshida Yoshinobu
Published: August 2010

Abstract

A case of combined intrauterine and ovarian pregnancy diagnosed by postoperative microscopic observations is reported in this paper. The patient was a 23‐year‐old, Japanese nulligravid female. On the 32 day after a previous D & C when normal chorionic tissues of very early gestation were obtained, she complained of severe lower abdominal pain. Immediate laparotomy revealed hemorrhaging from a hema‐toma‐like region on the surface of the left ovary, and partial resection of the left ovary was performed.

The resected ovary was composed of an intact corpus luteum and another thin corpus luteum around a hematoma‐like region containing chorionic villi, confirming this case to be an ovarian pregnancy. Histological findings of chorionic villi of the ovary indicated that ovarian pregnancy took place during the same menstrual period as intrauterine pregnancy, and not after the prior D & C. From these observations, this case was diagnosed as a combined intrauterine and ovarian pregnancy.
Primary Clear Cell Adenocarcinoma of the Fallopian Tube with Brain Metastasis: A Case Report
Authors: Ryuko Kanji , Iwanari Osamu , Abu‐Musa Antoine , Fujiwaki Ritsuto , Kitao Manabu
Published: August 2010

The first reported case of cerebellar metastasis from primary clear cell adenocarcinoma of the fallopian tube is presented. Initially diagnosed as stage la, the patient underwent total abdominal hysterectomy, bilateral salpingo‐oophorectomy and omentectomy, followed by cisplatin‐based chemotherapy and whole pelvic irradiation. Thirty six months later multiple pulmonary metastases were detected that did not respond to chemotherapy. Later the patient presented with cerebellar metastasis. She received whole brain radiotherapy and steroids. The brain lesion partially responded and the patient's neurologic symptoms improved. Throughout there was no evidence of local recurrence. This case suggests that with the prolonged survival achieved by aggressive treatment occult brain metastases might become apparent.
Neonatal Narcotic Withdrawal in Hong Kong Chinese
Authors: Lam S. K. , To W. K.
Published: August 2010

A retrospective case controlled study was carried out to study the neonatal characteristics, outcome and narcotic withdrawal syndrome in 51 neonates exposed to narcotic antenatally. The birth weight, head circumference and body length were significantly smaller in the study group while the incidence of prematurity (41%) and small‐for‐gestational age babies was increased (27.5%). Narcotic withdrawal occurred in 83% of narcotic exposed neonates. About half of them had onset of withdrawal symptoms within the first 24 hours. All of these newborns were treated by either phenobarbitone (45%), chlorpromazine (9.5%) or both (40.5%). The average duration of treatment was 15.7 days. There was one neonatal death due to in utero withdrawal and hypoxia, and another post‐neonatal death due to sudden infant death. Neonatal jaundice, necrotising enterocolitis, clinical sepsis and congenital syphilis were more common in the drug‐addicted group.
Extra Gonadal Germ Cell Tumours: Report of Two Cases
Authors: Kumar Lalit , Kumar Sunesh , Kamble R.M. , Sharma Suash
Published: August 2010

Extra gonadal germ cell tumours (EGGCT) in women are rare. We report here two such patients. The clinical and laboratory features were — young age, 25 and 22 years, midline location (mediastinum, scalp), elevated tumour marker and normal ovaries on CAT scan. The histological subtype was embryonal carcinoma in both cases. Complete response (CR) was achieved with cisplatin based chemotherapy (CT). Both patients had return of normal ovarian functions and have delivered normal babies (1st patient one, 2nd patient 2 babies). Both remain asymptomatic and disease‐free at 30 + and 55 + months follow‐up.

We conclude that patients with EGGCT after treatment with cisplatin based CT achieve CR with return of normal ovarian functions and prolonged survival.
Trabecular Bone in Long‐Term Depot‐Medroxyprogesterone Acetate Users
Authors: Virutamasen Pramuan , Wangsuphachart Somjai , Reinprayoon Damrong , Kriengsinyot Rosalin , Leepipatpaiboon Smai , Gua Chonticha
Published: August 2010

A cross‐sectional study was designed to determine trabecular bone density in 75 long‐term depot‐medroxyprogesterone acetate (DMPA) users (> 3 yr) matched with non‐DMPA users by age, body mass index (18–25), limitation of age (< 45 yr), and body weight (< 60 kg). The long‐term DMPA cases were divided into 3 groups according to duration of injectable contraceptive use. Neither cases nor controls had a smoking or chronic alcohol consumption history. Cases and controls were matched by age. Trabecular bone of the femoral neck were assessed by X‐ray and interpreted by a single‐blinded radiologist. Trabecular bone patterns were graded according to Singh's Index. Blood collection for determination of estradiol, prolactin, calcium, phosphorus, and medroxyprogesterone acetate were performed in cases and controls. Venous blood was taken at twelfth week of injection of DMPA and within 5 days after menstrual bleeding cessation in the controls. Mean trabecular bone in the cases was 5.5 ± 0.6 (range 4–6). It was not statistically different from that in the controls (mean 5.5 ± 0.6, range 2—6). No statistically significant difference of serum, calcium, phosphorus, prolactin, and estradiol was seen in the cases when compared to controls at mid follicular phase of normal menstrual cycle. Serum MPA of individual case at twelfth week of injection was 4.1 ± 1.1 nmol/l. In conclusion, trabecular bone density in long‐term DMPA users were not statistically different from normal menstruating women who have not received injectable DMPA.
Successful Pregnancy after Heart‐Lung Transplantation: A Case Report
Authors: Chinayon Pratharn , Sakornpant Pantpis
Published: August 2010

A successful pregnancy outcome in a patient with previous heart‐lung transplantation is reported. A 22‐year‐old primigravid woman received heart‐lung transplantation for Eisenmenger's ASD and conceived 22 months postoperatively. She had been continuously treated with cyclosporine, azathioprine and prednisone during pregnancy. Her antenatal course was uneventful. At 39 weeks' gestation, she developed leakage of amniotic fluid and went into spontaneous labor. She vaginally delivered a 2,550 g male infant by elective forceps extraction, with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Mother and baby had an uneventful postpartum course.
A Prospective Study of the Treatment of Cervical Intraepithelial Neoplasia by Loop Electrosurgical Excision Procedure (LEEP) in Hong Kong Population
Authors: Wong Shu Pong , Fung Yun Mei Hedy , Wong Wu Shun Felix
Published: August 2010

From May to December 1990, 72 patients suffering from cervical intraepithelial neoplasia confirmed with guided biopsy were treated with loop electrosurgical excision procedure (LEEP) as outpatients under local anaesthesia. Overall success rate of a single treatment at 6 weeks follow‐up was 88.9%. All the specimens obtained from the procedure were of good quality for histological examination. The overall significant complication rate of the procedure was 4.2% during treatment and 8.4% after treatment. The results suggested that LEEP is an effective and safe outpatient treatment for CIN lesions. It is easy to use and readily acceptable to patients. It also has the advantage of providing histological confirmation and more economical than the use of laser.
Choriocarcinoma in a Term Placenta with Pulmonary Metastasis
Authors: Kodama Shoji , Yoshiya Norio , Honma Shigeru , Yasuda Masahiro , Ikarashi Hirokazu , Tanaka Kenichi
Published: August 2010

This is a case report of choriocarcinoma in the placenta of a patient who had a term delivery at the 38th week of pregnancy. The pregnant woman had hemoptysis at the 26th week of pregnancy, and a chest X‐ray revealed a tumor in the left lung. She had suffered from a hydatidiform mole in a previous pregnancy in 1989. The patient's serum level of β‐human chorionic gonadotropin (hCG) had been below the normal level before the present pregnancy. Choriocarcinoma was histologically found at 3 sites in the placenta. Her urine hCG levels decreased rapidly after delivery. A partial lobectomy was performed after 2 courses of chemotherapy, and no choriocarcinoma was recognized histologically, because the lesions were hemorrhagic and necrotic. At present, the mother is free of disease, and the baby is growing normally.

The placenta should be examined in a detail in post‐molar pregnancy.
Pregnancy Outcome and Mitral Valve Prolapse
Authors: Chia Y. T. , Yeoh S. C. , Lim M.C.L. , Viegas O. A. , Ratnam S. S.
Published: August 2010

Mitral valve prolapse (MVP) comprises a large proportion of obstetric cardiac problems and has a general prevalence of 4%. We examined the obstetric outcome of patients with MVP delivered between 1988—1991 at the National University Hospital, Singapore. During this interval, deliveries totalled 16,755 of which 85 (0.51%) had maternal cardiac disease. Of these, 28 (32.9%) had echocardiographic evidence of non‐myxomatous MVP. Ten patients (37.5%) had demonstrable mitral regurgitation and 4 (14.3%) had benign ventricular ectopics.

All patients remained well throughout pregnancy. Gestation at delivery and use of analgesia did not differ significantly from non‐cardiac patients. However, the labour induction rate was twice the department average at 17.9%. Twenty‐four (85.7%) patients achieved vaginal delivery and 4 (14.3%) patients were delivered abdominally. All babies were liveborn. Eight patients (28.6%) did not receive antibiotic prophylaxis during labour and postpartum period and remained afebrile. The role of antibiotics in this category of patients is discussed. Patients with MVP without myxomatous valve changes may expect excellent pregnancy outcome.
A Quality Study of a Computerized Medical Birth Registry
Authors: Lu Jen‐Her , Hung Jeng‐Hsiu , Lin Fu‐Mei , Shen Wen‐Yung , Chen Shu‐Jen , Hwang Betau , Wu Shiow‐Ing , Chao Yuh‐Mei Yu
Published: August 2010

Processed by a computerized medical birth registry system, the birth records of 20,103 deliveries, from February 1992 to February 1993, were digitized with medium registry. From January 1, to February 28, 1993, the original records (n = 2,840 cases) of all 10 collaborative hospitals were requested for assessment of the data quality. Thirty‐six items were scored, data of poor quality was found in 8 items; acceptable quality in 4 items; and good quality in 28 items. The feasibility of data transfer by floppy disc and per modem was evaluated. This registry system had shortened data processing time effectively and improved mutual feedback between data center and delivery units. Errors resulting from technical faults originating in preparation of the data for computerizing at hospital level could be effectively reduced. The validity of diagnosis remained as the major source of errors.
Autoimmune Premature Ovarian Failure
Authors: Kim Jung Gu , Moon Shin Yong , Chang Yoon Seok , Lee Jin Yong
Published: August 2010

Premature ovarian failure (POF) may be caused by a variety of factors that result in the depletion of responsive ovarian follicles. There is a increasing body of evidence that suggests an autoimmune etiology in some POF patients. Data in support of an autoimmune etiology include: (1) lymphocytic and plasma cell infiltration of the ovary and alteration of T cell subsets; (2) circulating autoantibodies to ovarian antigens; (3) association with other “autoimmune” disorders; (4) recovery of ovarian function after regression of autoimmune status. The mechanism for ovarian autoimmunity is unknown. Genetic or environmental factor might be involved in the stimuli inducing immune response. The possibility that major histocompatibility complex antigen and cytokines are implicated in human autoimmune POF has been proposed. The relative contribution of cell‐mediated immunity and antibody‐mediated immunity remains obscure in animal models and in POF patients. Currently, in vitro fertilization and/or gamete intrafallopian transfer with donated oocytes are the best therapeutic options to achieve pregnancy although ovulation induction and immunosuppressive treatment might be used in approved experimental protocols. A newly developed double bridged enzyme linked immunosorbent assay (ELISA) might be useful in screening POF patients to identify those for whom temporary treatments may improve fertility.
Female Aging and Superovulation Induction for IVF
Authors: Kim Sun‐Haeng
Published: August 2010

The success of in vitro fertilization (IVF) has been reported to be adversely affected by increasing women's age. The main reason being that older women more frequently show a poorer response to stimulation. Information about such variability in ovarian responsiveness to stimulation is important for assessing the chances for successful pregnancy in older women undergoing assisted reproduction, because those with limited ovarian reserve should be counseled to consider other therapeutic options without delay.

I present results demonstrating the ovarian response to gonadotropin stimulation and the success rate in 746 IVF cycles. A brief overview on current methods of evaluating ovarian reserve as a means to identify the poor responder, and a discussion on the efficacy of several stimulation regimens for old women with limited ovarian reserve is also provided.
Zona Manipulation in an Assisted Reproductive Technologies (ART) Programme
Authors: Odawara Yasushi , Matsumoto Kazunori , Shinozuka Shoichi , Kusuhara Koji , Terashima Yoshiteru
Published: August 2010

Abstracts

We investigated whether the aged oocytes maintain the ability to fuse with spermatozoa when the oocyte investment is removed. In the first study, 87 two‐days‐old oocytes provided from IVF‐ET programme were treated with pronase to dissolve the zona pellucida. The oocytes were then inseminated with 100, 10 or 1 per μl sperm and the incidence of monospermic and polyspermic fertilization was determined. In the second study 100 one‐day‐old unfertilized oocytes obtained from 18 IVF patients with “zero fertilization” at initial insemination were treated in the same way to either remove or thinning of the zona pelucida. They were then re‐inseminated with 10 motile sperm per μl of the husband. The incidence of monospermic and polyspermic fertilization were 0.0% (0/13) and 61.6% (8/14), respectively, with a sperm count of 100/μl, 7.3% (3/41) and 31.6% (13/41) with 10/μl, and 14.2% and 11.9% (5/33) with 1/μl. The incidence of monospermic and polyspermic fertilization with reinsemination of one day old oocytes were 12.5% (3/24) and 25.0% (6/24) after zona removal and were 18.3% (9/49) and 10.2% (5/49) after zona thinning. The incidence of fertilization by zona removal was significantly higher than the results of conventional reinsemination (p < 0.001). It appeared that human aged oocytes maintain the ability to fuse spermatozoa after even two days. A higher rate of monospermic fertilization was obtained by carefully controlling the number of spermatozoa for insemination. We concluded that zona manipulation might improve fertilization in vitro in case of severe male factor infertility.
Clinical Trial of Daily Low‐Dose Oral Etoposide for Patients with Residual or Recurrent Cancer of the Ovary or Uterus
Authors: Yasumizu Takehiko , Kato Junzo
Published: August 2010

Objective: To determine the efficacy of long‐term therapy of oral etoposide in patients with residual or recurrent gynecologic malignancies.

Methods: Twenty‐five Japanese patients with resistant or recurrent carcinoma of the uterus or ovary were treated with oral etoposide at a dose of 25 mg/day/body for 21 consecutive days, and cycles were repeated every 4 weeks. The residual or recurrent lesion could be objectively evaluated in all patients by measuring it directly.

Results: The response rate after 6 cycles of therapy was 40% for the group of all patients, and 42.8%, 28.6%, and 50% for those with ovarian carcinoma, cervical carcinoma, and endometrial carcinoma, respectively. Side effects of etoposide treatment included gastrointestinal discomfort in 14 patients and leukopenia of grade 3 or higher in 2 patients. However, these side effects were mild, and all patients could continue treatment.

Conclusion: These findings indicate that long‐term, low‐dose oral etoposide was effective for and well‐tolerated by patients with refractory or recurrent carcinoma of the ovary or uterus.
Affect on Neonatal Thyroid Function of Povidone‐Iodine Used on Mothers during Perinatal Period
Authors: Koga Yasutsugu , Sano Hitomi , Kikukawa Yoshiichi , Ishigouoka Tetsuro , Kawamura Mitsuhiro
Published: August 2010

Objective: Our objective was to evaluate the affect on the neonatal thyroid function of povidone‐iodine (PVP‐I) used on mothers during the perinatal period.

Methods: Eighty consecutive‐term pregnant women were randomly separated into 4 groups. Either PVP‐I or benzethonium chloride (BC) was used to disinfect both maternal skin during labor and vaginal lacerations after delivery in Group I and IV; and PVP‐I or BC was supplied to either skin or lacerations in Groups II and III. On day 5, we measured the iodide concentrations in breast milk and random urine of neonates, and the levels of neonatal thyroid‐stimulating hormone (TSH) and free thyroxine.

Results: The TSH levels in Group I and the breast‐milk iodide concentrations in Groups I and II were significantly higher than those in Group IV (p < 0.05). Dietary iodide intake from breast milk correlated significantly with urinary iodide concentrations (r = 0.52, p < 0.001). In our clinic, the recall rate at the time of screening for congenital hypothyroidism was significantly decreased by discontinuing the use of PVP‐I (4.47% vs 0.74%, p < 0.001).

Conclusions: These findings suggest that the use of PVP‐I on mothers is associated with transient neonatal hyperthyrotropinemia, in which breast milk might play an important role. Therefore, we recommend that the use of PVP‐I be avoided during labor.
Immunohistochemical Detection of p53 Overexpression in Formalin‐Fixed, Paraffin‐Embedded Sections of Endometrial Carcinoma
Authors: Iwai Kyouko , Hachisuga Toru , Iwasaka Tsuyoshi , Sugimori Hajime
Published: August 2010

Objective: In the part, immunohistochemical detection of p53 has been possible only in the case of fresh‐frozen tissues. However using CM1 and an enhanced method based on microwave heating and protease digestion enabled the immunohistochemical detection of p53 overexpression in formalin‐fixed, paraffin‐embedded sections of endometrial carcinoma, although very few positive stainings were obtained without such an enhanced treatment. To evaluate the enhancement method, a comparative study was performed on frozen materials and paraffin‐enbedded samples.

Methods: Fifty‐three frozen materials, including normal endometrial glands, endometrial hyperplasias and carcinomas, and paraffin‐embedded samples from the same patients were used in this study. PAb1801 (mouse monoclonal antibody) was used to analyse p53 overexpression in the frozen sections, while CM1 (rabbit polyclonal anti‐p53 antibody) was used for the paraffin sections.

Results: PAb1801 and CM1 staining on normal endometriums and endometrial lesions showed a significant degree of concordance between frozen and paraffin‐embedded materials.

Conclusion: Enhanced immunodetection of p53 in paraffin‐embedded tissues will provide a useful alternative to the usual fresh‐tissue assay.
Allelic Deletion Mapping of Putative Tumor Suppressor Genes on 17q in Sporadic Ovarian Cancer
Authors: Chen Kuang‐Chao , Hsieh T'sang‐T'ang , Schwartz Peter E. , Yang‐Feng Teresa L.
Published: August 2010

Objectives: 1) To study whether the same or different chromosome 17q genes may be involved in the oncogenesis of familial and sporadic ovarian malignancies. 2) To localize the candidate gene in the sporadic ovarian cancers.

Methods (Study design): Using DNA extracted from ovarian tumors and corresponding peripheral leukocyte, we examined the status of loss of heterozygosity (LOH) at 12 loci spanning chromosome 17q12–q25 by Southern hybridization and polymerase chain reaction.

Results: Comparison of the extent of LOH among 25 epithelial ovarian tumors showing allele loss at one or more loci on 17q, the smallest overlapping region of allelic deletion is between D17S579 and GIP, with a genetic distance of approximate 2cM.

Conclusions: From our allelic deletion analysis of chromosome 17q loci, it indicates that there are more than one ovarian cancer candidate genes on chromosome 17q.
Production of Complete Heart Block and Utero Cardiac Pacing in Fetal Lambs
Authors: Murotsuki Jun , Okamura Kunihiro , Watanabe Takanori , Kimura Yoshitaka , Yajima Akira
Published: August 2010

We produced a complete heart block in 5 fetal lambs at 120 to 135 days of gestation by injecting 10% formaldehyde into the His bundle. We obtained acute experimental data in 5 fetuses and chronic experimental data in 2 fetuses. Immediately after production of the complete heart block, cardiac output was acutely reduced to 43 ± 9% when compared with the cardiac output at sinus rhythm. It was possible to restore the cardiac output to 80 ± 7% of the preoperative levels by atrioventricular pacing at the same rate as had been present before the heart block was produced. When the heart rate decreased below 100 beats per minute, further increase of stroke volume did not occur, and output was markedly diminished. This model allows us to study the pathophysiological response of a complete heart block, and offers basic information useful for understanding fetal cardiac functioning.
Intravenous Leiomyomatosis: Three Case‐Reports
Authors: Ogino Masahiro , Urushibata Hironobu , Takada Hiroyuki , Okinaga Shoichi , Mori Hiroyuki , Tanaka Fumihiko , Imamura Tetsuo
Published: August 2010

In the 3 cases of intravenous leiomyomatosis presented here, the retroperitoneal, pelvic, and vaginal veins were completely removed. Two of the cases were diagnosed by a gynecologist at surgery, and 1 was diagnosed by the pathologist performing a histological examination on excised tissue. These 3 cases were asymptomatic in spite of the intravenous invasive leiomyomatosis.
Pregnancy Following Renal Transplantation: The Experience in Hong Kong
Authors: To William W. K. , Lam Kenneth S. K. , Chan Y. M.
Published: August 2010

Objective: To assess the outcome of pregnancies occurring after renal transplantation, and to review the factors conductive to a favourable outcome.

Method: A retrospective review of 8 pregnancies occurring after renal transplantation from 1988 to 1992 in a tertiary referral centre in Hong Kong.

Result: A very high successful pregnancy rate was achieved with minimal maternal and perinatal morbidity in the cases reviewed.

Conclusion: Good prepregnancy counselling and stringent criteria for pregnancy assessment appears to be crucial factors for a favourable pregnancy outcome.
Two Cases of Monozygotic Twins, in Each of Which One Fetus Was Prenatally Diagnosed as Having a Heart Anomaly
Authors: Negishi Hiroaki , Okuyama Kazuhiko , Sagawa Tadashi , Makinoda Satoru , Fujimoto Seiichiro
Published: August 2010

In each of the 2 cases of monozygotic twins reported here, 1 of the fetuses was suspected, as a result of a prenatal ultrasonographic examination, of having congenital heart disease (CHD). One of twins (Case 1) had a hypoplastic left heart (HPLH), coarctation of the aorta (CoA), mitral stenosis (MS), and an atrial septal defect (ASD). Of the other twins (Case 2), 1 fetus had pure pulmonary atresia (PPA) and tricuspid regurgitation (TR). In Case 1, the fetus with CHD had a single umbilical artery, the other had otherwise. In Case 2, the fetus with CHD had a velamentous insertion and an accessory placenta, and the other fetus had a marginal insertion. These findings suggest that environmental factors such as blood flow, blood pressure and so on have a role in the etiology of CHD.
Immunohistochemical Expression of Glutathione S‐Transferase π (GST‐π) and Chemotherapy Response in Malignant Ovarian Tumors
Authors: Hirazono Kenichi , Shinozuka Takao , Kuroshima Yoshio , Itoh Hitoshi , Kawai Kenji
Published: August 2010

Objectives:To clarify the relationship between the expression of GST‐π and the therapeutic effects of high‐dose combination chemotherapy with support by autologous bone‐marrow transplantation (ABMT).

Methods:Expression of GST‐π in tissue specimen were analyzed by indirect immunoperoxidase methods using anti‐GST‐π polyclonal antibody.

Results:(1) Eighteen of 36 cases (50%) tested prior to administration of any chemotherapeutic agents were found to be positive in terms of immunohistochemical expression of GST‐π in the cancer cells. (2) The rate of GST‐π expression was elevated following administration of cisplatin, adriamycin, and cyclophosphamide, which suggests that administration of such anti‐cancer agents is capable of inducing expression of GST‐π in cancer cells. (3) GST‐π negative patients exhibit better survival rates than do GST‐π positive patients (Kaplan Meier method: p < 0.05‐0.001).

Conclusions:Analysis of GST‐π obtained at primary surgery can serve as a valid marker in anticipating chemotherapeutic effects and long‐term prognoses.
Pregnancy Outcome of Threatened Abortion with Demonstrable Fetal Cardiac Activity: A Cohort Study
Authors: Tongsong Theera , Srisomboon Jatupol , Wanapirak Chanane , Sirichotiyakul Supatra , Pongsatha Saipin , Polsrisuthikul Thongchai
Published: August 2010

Pregnancy with visible fetal heart beat complicated by first trimester threatened abortion had significant increased risk of subsequent spontaneous abortion compared with normal pregnancy.

Objective: To compare pregnancy outcomes in cases complicated by first trimester threatened abortion with those that were not.

Methods: Prospective cohort study of 255 cases of first trimester threatened abortions but with visible heart beat and 265 other normal pregnancies.

Results: Spontaneous abortion rates of 5.5% (with relative abortal risk of 2.91) was found for study group, compared to 1.88% for controls (p < 0.05). Preterm delivery was also higher, but was not statistically significant.

Conclusions: First trimester bleeding with visible fetal heart beat appears to associate significantly with higher subsequent spontaneous abortion rate than those without.
Breast Cancer Metastatic to Uterine Leiomyoma: A Case Report
Authors: Sugiyama Takashi , Toyoda Nagayasu , Nose Junko , Kihira Norihisa , Ando Yoshiyuki , Ishihara Akinori
Published: August 2010

A case is reported of a 51‐year‐old woman who had a hysterectomy and bilateral salpingo‐oophorectomy in the same year, following a radical mastoidectomy for breast cancer with metastases to the axillary lymph nodes. Histological examination showed breast cancer metastatic to uterine leiomyoma. The literature about metastasis of extragenital cancer to a leiomyoma is reviewed, and the possible mechanism involved is discussed.
Prelabour Rupture of Membranes to Delivery Interval Related to the Incidence of Maternal and Neonatal Infection
Authors: Chua S. , Arulkumaran S. , Kumar S. Sailesh , Selamat N. , Ratnam S. S.
Published: August 2010

Objective: To assess the infectious morbidity associated with prelabour rupture of membranes (PROM) to delivery interval, and the incidence of maternal and neonatal infection in a population managed by either immediate stimulation or by overnight conservatism.

Method: A retrospective study of 117 women admitted with PROM to the labour ward in the National University Hospital, Singapore, in the period between June 1990 and May 1991, and who were managed by immediate stimulation or by stimulation after overnight conservatism. Statistical analysis was performed using Chi‐square and Student's t‐test.

Results: More than one third of infants whose mothers had ruptured membranes for > 48 hrs had signs of neonatal infection, compared with an incidence of 8.8% and 8.9%, respectively for those with an interval of < 12 hrs and 12–24 hrs between PROM to delivery. Group B streptococcal infection was a major cause of neonatal infectious morbidity. Clinical evidence of maternal infection occurred in 3 of the 117 women; these patients had an interval between rupture of membranes and delivery of between 24–76 hrs.

Conclusions: Prolongation of PROM to delivery interval for > 48 hrs increases the incidence of infection. Conservative policy of management of PROM at term should aim to deliver the babies < 48 hrs after PROM. The difference in maternal and neonatal infection rates were not significant in the group treated with a policy of overnight conservatism compared with the group in whom labour was stimulated immediately on admission.
Xanthogranulomatous Oophoritis: An Unusual Complication of Typhoid
Authors: Singh Usha R. , Revathi G. , Gita R.
Published: August 2010

The association of xanthogranulomatous oophoritis with ovarian endometriosis and typhoid is described in a 25 years unmarried female who underwent laparotomy after one year of enteric fever.
Carcinoma of the Uterine Cervix Presenting as Superior Vena Cava Syndrome: Report of Three Cases and a Review of Literature
Authors: Biswal Biswa M. , Sandhu Manavjit S. , Mohanti Bidhu. K. , Rath Gaura K.
Published: August 2010

We present three cases of superior vena cava syndrome secondary to carcinoma of the uterine cervix which manifested 2 to 7 years after the initial diagnosis and primary therapy. In two of these patients, tissue diagnosis could be obtained. Two patients expired within two months of presentation despite timely radiotherapy, and one case died after six months of diagnosis.
A Case of Ovarian Serous Adenocarcinoma Suggestive of Transformation to an AFP‐Producing Tumor during Chemotherapy
Authors: Kataoka Akio , Nishida Takashi , Sugiyama Toru , Yakushiji Michiaki
Published: August 2010

Ovarian serous adenocarcinoma with AFP production is very rare. A case involving a 66‐year‐old woman with an elevated serum AFP level without detectable hepatic involvement. AFP‐positive cells were seen in the tumor at the second surgery. Fifty‐seven percent of serum AFP from the patient bound Con A, whereas 43% did not. Similarly, 54% of the tumor fluid also bound Con A. These suggest that the serum AFP was similar to that of gastrointestinal tumors and yolk‐sac tumors.
Posthemorrhagic Hydrocephalus in a Fetus with Severe Tachycardia
Authors: Matsui Hiroshi , Chaki Osamu , Yanagisawa Takashi , Nakayama Masaki , Hirahara Fumiki , Takahashi Tsuneo , Taga Michiyoshi , Minaguchi Hiroshi , Kawataki Motoyoshi
Published: August 2010

Although posthemorrhagic hydrocephalus has been observed in premature infants, few cases of its intrauterine occurrence in fetuses have been reported. We report a case of posthemorrhagic hydrocephalus in a fetus with severe tachycardia. This case indicates that its possible occurrence should be considered in a case of a preterm fetus with distress.
Magnetic Resonance Imaging of Autosomal Recessive Polycystic Kidney Disease in utero
Authors: Nishi Takenori
Published: August 2010

Objective: To assess the efficacy of ultrasonography (USG) and magnetic resonance imaging (MRI) in diagnosing a particular urologic disease, autosomal recessive polycystic kidney disease (ARPKD).

Subject: A patient with a case of ARPKD, as diagnosed by USG and MRI.

Result: USG revealed features typical of ARPKD; the kidneys were enlarged and echogenic, with a loss of normal renal architecture. MRI revealed anatomical features similar to those demonstrated by USG. Furthermore, MRI showed clearer delineation and tissue specificity of the affected kidneys.

Conclusion: USG and MRI were useful in diagnosing ARPKD. MRI can serve as an adjunctive method for diagnosing certain fetal anomalies.
Risk Factors for Wolfe's Dysplasia of Mammograms in Postmenopausal Turkish Women
Authors: Uslu Turhan , Topuz Atakan , Erçal Tijen , Acar Berrins
Published: August 2010

Objective: The aim was to ascertain whether menstrual, reproductive and hormonal risk factors for breast cancer are present in women with dysplastic mammographic patterns and to investigate possible trends towards breast cancer.

Method: This prospective case‐control study was designed in a university hospital. Thirty‐two turkish postmenopausal women were evaluated for the associations between obesity, parity, age, age at menarche, age at menopause, total lactation period and dysplasic mammographic patterns.

Results: We found an increasing trend of dysplasia with increasing age at menarche. This association contradicts the well established one for breast cancer. The effects of parity and total lactation period on dysplasia were similar. Although nulliparity had some protective effects on dysplasia, relative risk (RR) increased to some extent with an increase in parity and lactation period. Later menopause and older age were associated with an increase risk of dysplasia, whereas an apparent protection was given by greater body mass index.

Conclusion: Onset of the menopause increases the risk of dysplasia and the estrogenic milieu may have some role in the initiation and progression of dysplasia.
Prediction of Histopathologic Features and Proliferative Activity of Uterine Leiomyoma by Magnetic Resonance Imaging Prior to GnRH Analogue Therapy: Correlation between T2‐Weighted Images and Effect of GnRH Analogue
Authors: Oguchi Osamu , Mori Atsushi , Kobayashi Yaeko , Horiuchi Akiko , Nikaido Toshio , Fujii Shingo
Published: August 2010

To predict the histological features and proliferative activity of leiomyomas and to evaluate the effect of GnRH analogues (GnRHa) by MR images, the correlation between MR images and histopathologic findings was studied on 137 leiomyomatous nodules from 79 patients. The correlation among cellularity, proliferative activity and MR images was studied on sections of 42 leiomyomatous, nodules stained with hematoxylin‐eosin and immunohistochemistry for proliferating cell nuclear antigen. The utility of MR imaging in assessing response to therapy with a GnRHa (buserelin 900 μg/day, intranasal for 16 weeks) was studied on 62 leiomyomatous nodules from 29 patients.

On T2‐weighted MR images, we encountered five major images. According to the increase of signal intensity relative to that of the myometrium and/or the endometrium, the images were classified as Type 1, Type 2, Type 3, Type 4, and Type 5. Histopathologically, the majority of Type 1, Type 2 and Type 3 images had features of typical leiomyoma. Almost all cellular leiomyomas and bizarre leiomyomas had Type 4 images. Variable degenerative features were observed in the nodules with Type 5 images. According to the increase of signal intensity, leiomyomas had a tendency to show a high degree of both cellularity and proliferative activity. Moreover, the reduction rate of leiomyomatous nodules after GnRHa therapy correlated with the tumor signal intensity on T2‐weighted images before therapy. The reduction rate was the lowest in Type 1 images (20.9%) and the highest in Type 4 images (50.7%).

These results suggest that increased the signal intensity on T2‐weighted MR images correlates with the cellularity and proliferative activity of leiomyomas, and with tumor response to GnRHa treatment. MR imaging enables quantitative monitoring of GnRHa therapy in patients with leiomyomatous nodules, and allows us to predict the histopathology, cellularity, proliferative activity, and shrinkage rate of nodules before GnRHa treatment.
External Cephalic Version from 34 Weeks under Tocolysis: Factors Influencing Success
Authors: Foote Andrew J.
Published: August 2010

External cephalic version (ECV) was performed on 72 patients from 34 weeks of gestation under tocolysis, with ultrasound control and cardiotocograph surveillance. Successful ECV was associated with multiparity, decreased lower segment caesarean section (LSCS) rate, and earlier discharge home. ECV was successful in 51.4% of patients overall, with the success rate being 35% in primigravidas and 71.4% in multiparas (p<0.005). The LSCS rate was reduced from 91.4% to 0% (p < 0.0001) on comparing the unsuccessful and the successful ECV groups, while breech presentation was reduced from 94.3% to 0% (p < 0.0001). There were no significant fetal complications.
Toxoplasmosis as a Cause of Repeated Abortion
Authors: Sahwi Samir Y. , Zaki Magda S. , Haiba Nassr Y. , Elsaid Omar K. , Anwar Medhat Y. , AbdRabbo Salah A.
Published: August 2010

The extent to which toxoplasmosis causes habitual abortion is still controversial. The present study was carried out on 100 cases of repeated abortions, and 40 multiparous pregnant women at 20th week gestation as a control.

Tests for the presence of toxoplasma IgG and/or IgM antibodies were done for both groups. It was found that 19% of the selected cases, and 7.5% of the control were seropositive for IgM. The difference was statistically insignificant, therefore acute toxoplasmosis, most probably, is not related to habitual abortions, whereas 37% of the selected cases and only 10% of the control group were seropositive at high dilution for IgG antibody, this statistical significant difference indicates that chronic toxoplasmosis, most probably is a significant cause of repeated abortion. Also it has been found that toxoplasmosis has a significant relation to abortion at first trimester.
Association of Multiple Human Papillomavirus Types with Vulvar Neoplasias
Authors: Nagano Hiroaki , Yoshikawa Hiroyuki , Kawana Takashi , Yokota Harushige , Taketani Yuji , Igarashi Hiroko , Yoshikura Hiroshi , Iwamoto Aikichi
Published: August 2010

Objective: The purpose of this study was to clarify the association of multiple genital human papillomavirus (HPV) types with vulvar neoplasias.

Methods: We examined vulvar neoplasias by the polymerase chain reaction (PCR) method, which can detect almost all genital HPV types sensitively (L1‐PCR).

Results: Eight HPV types (types 6, 11, 16, 18, 52, 53, 56, and 68) were detected in 52 of 53 (98.1%) vulvar condylomas; 2 HPV types (types 16 and 18) were detected in all 6 Grade‐3 vulvar intraepithelial neoplasias; and 5 HPV types (types 6, 16, 18, 51, and 56) were detected in 8 of 11 (72.7%) invasive vulvar carcinomas. Detection of HPV types 52, 53, 56, and 68 in vulvar condylomas and detection of HPV types 51 and 56 in vulvar carcinomas are the first examples ever reported.

Conclusion: This study suggests that more HPV types are associated with the generation of vulvar neoplasias than was thought to be the case up to now.
A Case of Vulvar Schwannoma
Authors: Yamashita Yoshiki , Yamada Takashi , Ueki Ken , Ueki Minoru , Sugimoto Osamu
Published: August 2010

Schwannoma is generally a solitary, nodular, benign tumor of a peripheral nerve sheath, and it rarely affects the external female genitalia. Its most‐common locations are the head, neck, upper and lower extremities, posterior mediastinum, and retroperitoneum. We treated a 29‐year‐old woman with a vulvar schwannoma. A tumor of 2.5 cm in diameter was resected for treatment and biopsy. It was a capsulate tumor with a smooth surface, and was elastic in consistency. A histological examination revealed a swirling pattern with some palisading of spindle‐shaped cells in H.E. stains. Immunohistochemical studies showed the tumor to be positive for S‐100 protein and negative for desmin. As a result, the mass proved to be schwannoma originating from the vulva.
Gonadoblastoma in Patient with Turner's Syndrome
Authors: Lo Keith W. K. , Lam S. K. , Cheung T. H. , Wong S. P. , Chang Allan , Chow John H. S.
Published: August 2010

A 15‐year‐old phenotypic female referred for the investigation of primary ammenorrhea, was found to have a 45 XO karyotype and an ovarian cyst. She demonstrated some of the features of Turner's syndrome, as well as virilization. On laparotomy, she was found to have bilateral gonadoblastomas. She was treated with total abdominal hysterectomy and bilateral salpingo‐oophorectomy. Subsequently, repeated chromosomal analysis detected the presence of Y chromosomes, which was confirmed by the use of polymerase chain reaction (PCR). The difficulties encountered in searching for the Y chromosome in patients with gonadoblastoma are discussed. Prophylactic gonadectomy is suggested in those cases associated with atypical features.
Ovarian Mucinous Cystadenocarcinoma with Sarcoma‐Like Mural Nodules
Authors: Kataoka Akio , Nishida Takashi , Ueyama Takako , Okina Hideto , Yakushiji Michiaki
Published: August 2010

We present a rare case of a 31‐year‐old woman with a mucinous ovarian tumor with sarcoma‐like mural nodules. The epithelial elements consisted of a mixture of benign, borderline‐malignant, and mucinous adenocarcinoma; the sarcoma‐like mural nodules consisted of pleomorphic and epulis‐like cells. The lesion was resected for an ovarian tumor. In an immunohistochemical study, these cells stained for lysozyme and vimentin. The patient received 2 courses of cisplatin (100 mg/m2). There was no evidence of disease at a second‐look laparotomy after 1 year, and none upon examination 6 years after the initial operation. The mural nodules might be of non‐epithelial origin. The prognosis of patients with this rare lesion appears favorable, according to this and previous reports.
Two Cases of Twisted Fetal Ovarian Cysts
Authors: Yokoyama Yoshihito , Kagiya Akifumi , Ozaki Takashi , Ogasawara Tomoka , Saito Yoshiharu , Sugai Michihiro
Published: August 2010

Two twisted fetal ovarian cysts were detected antenatally by routine ultrasonographic examination. Serial changes of twisted ovarian cysts can be monitored by ultrasonic observation. If signs of torsion appear, obstetricians should consider prompt delivery in order to preserve the patient's fertility.
Case Report: Torsion of a Gravid Horn of a Didelphic Uterus
Authors: Achanna Siva , Monga Deepika , Hassan M. Suhaimi
Published: August 2010

Acute abdominal pain during pregnancy presents a dilemma as signs and symptoms are often modified. Abdominal massage by traditional birth attendants (TBAs') during early labour is a common practice in the rural population, as it is perceived to give a soothening effect to the labouring mother. Many instances of abruptio placentae were reported in the past by this procedure, and in this case, the clinical picture presented as an abruptio placenta. Malpresentation and failure to progress were the indications for caesarean section despite the fetal demise. Severe post partum haemorrhage and failure to contract despite massive oxytocics resulted in the hysterectomy of the gravid horn, leaving the other horn intact.