bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystic Adenomatoid Malformation of the Lung: Prenatal Diagnosis, Prognostic Factors and Fetal Outcome
Authors: Golaszewski T. , Bettelheim D. , Eppel W. , Deutinger J. , Bernaschek G.
Published: April 2003

Aim: To evaluate 14 cases of cystic adenomatoid malformation (CAM) of the lung with regard to antenatal management and fetal outcome. Results: Intrauterine shunts were placed in 3 fetuses to avoid pulmonary hypoplasia. Prenatal sonography showed that the lesions had a tendency to resolve in 4 cases. Of the 9 infants who survived, 5 were treated surgically (lobectomy). Conclusions: The antenatal evolution of these lesions is highly variable; the lesions may even resolve spontaneously, therefore the diagnosis of CAM types II and III should be followed by a period of observation. Intrauterine drainage is recommended in cases of CAM type I if unfavorable prognostic factors are encountered.
Prognostic Implications of Cervical Intraepithelial Neoplasia in a Single Cervical Smear
Authors: Bertelsen Bjørn , Hartveit Flora
Published: April 2003

Our aim was to investigate the prognostic implications of a single cervical smear showing cervical intraepithelial neoplasia (CIN) in a group of women with a previous series of negative smears, and to estimate their risk of developing histologically confirmed CIN 3. A retrospective case-control study was set up. It consisted of 171 cases and 513 age-matched controls, all with at least 3 negative and no positive smears between 1981 and 1988 inclusive. In all cases CIN had been diagnosed on cytology in 1989, while the controls had remained negative. The women were followed up to the end of 1995. The outcome was recorded in terms of regression, progression, persistence or surgical treatment. In women with a single smear showing CIN 1 or 2, the risk of developing histologically proven CIN 3 was 14 and 26 times that in women with negative smears. Negative control smears in the short term did not exclude subsequent progression. Thus women with a single cervical smear indicating CIN 1 had a greatly enhanced risk of producing a lesion that demanded intervention. Such cases should be observed closely with repeat smears over a period of at least 6 years.
A Case Illustrating the Continued Dilemmas in Treating Abdominal Pregnancy and a Potential Explanation for the High Rate of Postsurgical Febrile Morbidity
Authors: Bergstrom Roy , Mueller Glenda , Yankowitz Jerome
Published: April 2003

Background: Abdominal pregnancy is potentially highly morbid and often complicated by postoperative fever. Case: A 29-year-old gravida 2 para 0 presented with a 17-week size-demised abdominal pregnancy. We describe the continued difficulty in determining the timing and type of intervention. In addition, we found that the gestational sac was colonized by group B streptococcus at the time of surgery. Conclusion: This case illustrates that preoperative colonization of the intra-abdominal gestational sac may contribute to postoperative febrile morbidity. We suggest treating patients with prophylactic antibiotics and avoiding spill of gestational sac contents into the peritoneal cavity. Placement of a sterile Foley bulb into the uterine cavity can confirm the extrauterine position of the pregnancy prior to undertaking surgery.
Diurnal Variation in Excretion of N-Acetyl-β-Glucosaminidase during Pregnancy: Implications for the Prediction of Pre-Eclampsia
Authors: Rogers Michael S. , Arumanayagam Mano , Fung Hedy , Lau T.K.
Published: April 2003

Significant differences in urinary excretion of N-acetyl-β-glycosaminidase (NAG) were observed between nulliparous and multiparous patients and between fasted and nonfasted individuals. No significant difference was observed between patients with normal and those with abnormal glucose tolerance. Multiple regression analysis confirmed that the significant independent determinants of NAG/creatinine ratio were age, parity, gestation and fasting state. Significant diurnal variation in urinary NAG/Cr ratio was observed, the highest levels being recorded in early morning fasting specimens, falling in each postprandial specimen and beginning to rise again by midnight. The urinary NAG/Cr ratio is influenced by fasting, parity, gestation and age. More consistent results for prediction of pre-eclampsia are therefore likely to be obtained using fasting (early morning) urine specimens and adjusting cut-off criteria for the other factors.
Ultrasonographic Blood Flow Measurement in the Carotid Arteries in Postmenopausal Women
Authors: Darj Elisabeth , Bakos Oddvar , Naessen Tord , Persson Ingemar
Published: April 2003

Objectives: The aim of the present study was to evaluate blood flow in postmenopausal women on hormone replacement therapy (HRT) compared to controls. Blood flow was ultrasonographically measured in the great arteries of the neck instead of in the vessels of the internal genital organs. Methods: Fifty healthy women with climacteric complaints, at least 6 months postmenopausal, participated in the study. They were randomly divided into two groups. One group received 2 mg estradiol (E2) for 12 days, continued with 2 mg E2 and 1 mg norethisterone acetate for 10 days, followed by 1 mg E2 for 6 days, cyclically during 6 months. The other group received placebo tablets the first 3 months and the same HRT as the first group for the last 3 months. Blood flow was measured ultrasonographically by color flow pulsed Doppler in the common (CCA), internal (ICA) and external (ECA) carotid arteries, before the start of the study, after 3 and 6 months of therapy. Results: CCA and ICA, both low resistance vessels, and ECA, a high resistance vessel, and their waveforms were identified. Pulsatility index did not decrease statistically significant (p > 0.05) in any of the great vessels during 6 months of HRT in this study. There were no differences in blood flow between the HRT-treated group compared to control group during 3 months of therapy, except for the right ECA (p = 0.04). Conclusion: The difference in blood flow and wave-forms of the major arteries of the neck were clearly shown, but HRT did not have any important impact on the blood flow in this study. No difference was shown concerning blood flow between the two groups of postmenopausal women, on active therapy or placebo.
Endometrial Response to Unopposed Estrogens Remains Unaltered in Patients with Chronic Renal Failure Receiving Hemodialysis
Authors: Ergeneli Mehmet H. , Duran E. Hakan , Zeyneloglu Hulusi B. , Demirhan Beyhan , Erdogan Mithat
Published: April 2003

Most patients with chronic renal failure who are on maintenance hemodialysis are anovulatory and have menstrual abnormalities. This study was designed to determine the prevalence of organic causes of abnormal uterine bleeding in this group of patients exposed to unopposed estrogens. Eighteen patients with chronic renal failure and abnormal uterine bleeding underwent vacuum curettage. The histopathologic findings were compared with a group of 154 premenopausal women who had abnormal uterine bleeding without detectable organic causes. Excluding patients with secretory and atrophic endometrium, only 2 of 8 patients (25%) with chronic renal failure had endometrial lesions while 44 of 131 patients (33.6%) had either endometrial polyp, simple or atypical endometrial hyperplasia or endometrial carcinoma (p > 0.05). The uremic environment caused by chronic renal failure does not alter the endometrial responsiveness to unopposed estrogens and may lead to the development of endometrial lesions.
Urinary Bacterial Flora of Women with Urethral Syndrome and Interstitial Cystitis
Authors: Haarala Mervi , Kiilholma Pentti , Lehtonen Olli-Pekka
Published: April 2003

The aerobic and anaerobic bacterial flora in the first voided and in the midstream urine of healthy females (n = 5) and female patients with either urethral syndrome (US) (n = 5) or interstitial cystitis (IC) (n = 14) were studied. Bacteria were grown on media enabling isolation of fastidious and aerobic as well as obligatory anaerobic species. In healthy females only gram-positive rods were found whereas US patients also harbored streptococci. Patients with IC presented also with Enterobacteriae and anaerobic bacteria. Five IC patients with severe symptoms were treated with metronidazole; 2 out of 3 patients with anaerobic bacteria in the pretreatment specimens had no anaerobes after metronidazole therapy and in 1 patient streptococci disappeared after the therapy. One patient with severe symptoms and Bacteroides fragilis in the midstream urine became symptom-free after 2 weeks of metronidazole treatment. Although there is uncertainty whether the US and IC are not related to an infectious etiology, the bacterial flora in urethral and in midstream urine in these conditions differs considerably from that of healthy females.
The Influence of the Maternal Heart Rate on the Uterine Artery Pulsatility Index in the Pregnant Ewe
Authors: Ochi Hiroshi , Matsubara Keiichi , Kusanagi Yasuki , Furutani Kouichi , Katayama Tomihiro , Ito Masaharu
Published: April 2003

We investigated the influence of the maternal heart rate on the uterine artery pulsatility index in pregnant ewes. We used an external pacemaker to alter the heart rate of 5 pregnant ewes at 16–17 weeks of pregnancy and examined the effect of changes in the maternal heart rate on the uterine artery flow velocity waveforms and the pulsatility index, as determined by Doppler velocimetry. The uterine artery pulsatility index showed a significant negative correlation with the maternal heart rate. There were no significant changes in other hemodynamic parameters. The maternal heart rate had a significant influence on the uterine artery pulsatility index.
Characterization of 5-Hydroxytryptamine Receptors Mediating Circular Smooth Muscle Contraction in the Human Umbilical Artery
Authors: Karlsson Caroline , Bodelsson Gunilla , Bodelsson Mikael , Stjernquist Martin
Published: April 2003

The study was performed to characterize pharmacologically the contractile 5-hydroxytryptamine (5-HT) receptors in the circular smooth muscle of the isolated human umbilical artery. Effects of agonists and antagonists for different 5-HT receptor subtypes were studied in intact endothelium vessel segments. All agonists induced concentration-dependent circular smooth muscle contractions. The potency was in declining order 5-HT > α-methyl-5-HT > sumatriptan ≥ 2-methyl-5-HT. The effects of 5-HT and α-methyl-5-HT were antagonized by ketanserin, as well as methiothepin. The contractile effect of sumatriptan was antagonized by methiothepin but not by ketanserin. The 5-HT3 receptor antagonist, MDL 72222, did not affect the contraction by any of the agonists, including 2-methyl-5-HT. It is concluded that the 5-HT-induced contraction in the circular smooth muscle of the human umbilical artery seems to be mediated by a mixed population of 5-HT1-like receptors and 5-HT2 receptors.
The Role of Oxytocin in Relation to Female Sexual Arousal
Authors: Blaicher Wibke , Gruber Doris , Bieglmayer Christian , Blaicher Alex M. , Knogler Wolfgang , Huber Johannes C.
Published: April 2003

Oxytocin is clearly involved in human reproduction and serves an important role in sexual arousal. Oxytocin serum levels were measured before and after sexual stimulation in 12 healthy women. Values of oxytocin 1 min after orgasm were significantly higher (p < 0.05) than baseline levels. This finding supports the hypothesis that oxytocin plays a major part in human sexual response both in neuroendocrine function and postcoital behavior.
Recurrence and Survival Analyses of 1,115 Cervical Cancer Patients Treated with Radical Hysterectomy
Authors: Yuan Chiou-Chung , Wang Peng-Hui , Lai Chiung-Ru , Tsu En-Jie , Yen Ming-Shyen , Ng Heung-Tat
Published: April 2003

Many clinicopathological factors of cervical cancer are still controversial in their prognostic significance. The case records of 1,115 patients who received radical hysterectomy at the Veterans General Hospital, Taipei, from 1980 to 1989 were collected to evaluate prognosis-related factors by univariate and multivariate analyses. The pathology was reviewed retrospectively by one pathologist. Ten parameters known to be prognostic in the literature were included for analysis. Univariate analysis showed that patients with all these factors had higher recurrence rates. However, when the effects of parametrial invasion, progressive stage and stromal invasion were weighed against the presence of lymph node metastasis, their influence on recurrence became unimportant. Nevertheless, these factors still influenced prognosis when there was no lymph node metastasis. Multivariate analysis of both recurrence and survival time in the patients with squamous cell carcinoma shared a consensus that pelvic lymph node metastasis and deep stromal invasion were significant risk factors. We conclude that these simplified and consistent results obtained by multivariate analysis provide a basis for subclassification of patients to predict prognosis and change therapy.
Detection of Small-for-Gestational-Age Infants with Poor Perinatal Outcomes Using Individualized Growth Assessment
Authors: Hata Toshiyuki , Kuno Atsushi Kuno , Akiyama Masashi , Yanagihara Toshihiro , Manabe Atsushi , Miyazaki Kohji
Published: April 2003

Objective: Our objective was to evaluate individualized growth assessment using the Rossavik growth model for detection of small-for-gestational-age (SGA) infants with a poor perinatal outcome. Methods: Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 47 singleton SGA infants. Individual fetal growth curve standards for head and abdominal circumference, and weight were determined from the data of two scans obtained before 25 weeks’ menstrual age and separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index (GPRI) and Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes [mechanical delivery, low Apgar score, abnormal fetal heart rate (FHR) patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit (NICU) admission and maternal complications] were compared between SGA infants with normal NGAS and those with abnormal NGAS. Results: Of the 47 fetuses studied, 27 had normal growth outcomes at birth and 20 showed evidence of intrauterine growth restriction, based on NGAS. There were significant increases in mechanical deliveries, abnormal FHR patterns and meconium staining of amniotic fluid in cases of growth-restricted neonates, determined using the NGAS classification, when compared with events related to normally grown infants. However, there were no significant differences in low Apgar score, neonatal acidosis, NICU admission and maternal complications between the 2 groups. Conclusion: Individualized growth assessment should be useful for detection of SGA infants with poor perinatal outcomes.
Effect of Treatment with GnRH Agonists on New Markers of Bone Metabolism
Authors: Kukuvitis A. , Bildiris J. , Prapas Y. , Tsamis D. , Papadimas J. , Dimitriadou A. , Vlassis G.
Published: April 2003

To assess the utility of new markers in monitoring bone turnover during treatment with GnRH agonists, alkaline phosphatase (total and bone specific) and urinary N-telopeptides were measured. 16 women undergoing treatment with GnRH agonists for endometriosis or leiomyomas were studied before and 3 months after the onset of treatment. N-telopeptide levels increased significantly (44% of baseline, p < 0.05). Bone specific alkaline phosphatase (BALP), measured with a new ELISA assay, was more elevated (40% of baseline, p = 0.001) than total ALP (15% of baseline, p < 0.001). In conclusion, in estrogen deficiency states, urinary N-telopeptide measurements provide a quantitative measure of bone resoption. In the assessment of bone formation, BALP determination is move sensitive than total ALP and this may be clinically useful.
Umbilical Artery Waveforms in Triplet and Quadruplet Pregnancies
Authors: Ezra Yossef , Jones Julia , Farine Dan
Published: April 2003

The incidence of abnormal umbilical waveforms in triplet and quadruplet pregnancies and its correlation with adverse pregnancy outcome was studied by a retrospective review of all our triplet and quadruplet pregnancies (1986–1993) with documented Doppler flow assessment. Obstetrical outcomes were analyzed in relation to abnormal umbilical artery waveforms. Nineteen triplet and 4 quadruplet pregnancies were studied. Of 73 fetuses, 6 had abnormal umbilical artery waveforms (8.2%). All abnormal waveforms were characterized by persistent absence of the end-diastolic velocities (AEDV). In comparing the abnormal and normal groups, significant differences were found in birth weights (910 ± 433 vs. 1,724±434 g; p = 0.0004), small for gestational age rate [5/6 (83%) vs. 5/67 (7.5%); p = 0.0003], and perinatal mortality rate [3/6 (50%) vs. 2/67(3%); p = 0.001]. There were no differences in congenital anomalies, gestational age at birth, and neonatal intensive care admission. In conclusion, it seems that Doppler umbilical artery waveforms in multiple pregnancies were either normal or extremely abnormal (e.g. AEDV). AEDV was associated with adverse perinatal outcomes such as low birth weight, growth restriction and perinatal mortality.
Distribution of Glutathione S-Transferases in the Human Ovary: An Immunohistochemical Study
Authors: Tiltman Andrew J. , Haffajee Zenobia
Published: April 2003

The glutathione S-transferases (GSTs) are a family of isoenzymes with several functions. These include the metabolism of endogenous and exogenous toxic compounds, an isomerase activity in steroidogenesis and intracellular transport. This study has used immunohistochemistry to demonstrate the distribution of the three classes of GST (α, μ and π) in the human ovary at different stages of the menstrual cycle. α-GST was found in cells related to steroid hormone production and probably acts as a δ4–5 isomerase. μ-GST was predominantly found in the non-luteinized stromal cells and its function is obscure. π-GST was found in surface ‘epithelial’ inclusions and the media of arteries where it is thought to play a detoxifying role.
Treatment of Recurrent Bleeding Disorders during Hormone Replacement Therapy by Transcervical Endometrial Ablation
Authors: Römer T.
Published: April 2003

If bleeding disorders, which could not be treated by modification of steroid dosages, occurred during sequential hormone replacement therapy (HRT), most of the patients stopped HRT. In these cases a diagnostic outpatient hysteroscopy with biopsy was carried out. In most of the cases no intrauterine cause for the bleeding disorder was found. In 35 patients we performed an endometrial ablation without intra- or postoperative complications. After this procedure all patients received a combined continuous HRT. In a follow-up of 12 months 34 patients were amenorrheic and satisfied with the treatment. One patient stopped HRT because of suffering from other side effects. Endometrial ablation represents a method of treating patients with bleeding disorders without intrauterine causes with a minimal invasive procedure. A continuous combined HRT is possible after the endometrial ablation in perimenopausal and postmenopausal patients without bleeding disorders. In selected cases endometrial ablation can contribute to the increase of the compliance with HRT.
The Severity of Polyhydramnios, Estimated Fetal Weight and Preterm Delivery Are Independent Risk Factors for the Presenceof Congenital Malformation s
Authors: Lazebnik Noam , Many Ariel
Published: April 2003

Objective: To evaluate maternal and fetal factors associated with congenital malformations in patients with polyhydramnios. Study Design: The study group consisted of 275 singleton pregnancies with an amniotic fluid index (AFI) >25.0 cm. An equal number of controls were matched for maternal age, gravidity, parity and gestational age. The proportion of cases and controls with malformations was compared. Polyhydramnios cases were categorized into three groups by severity: mild (AFI 25–30 cm), moderate (AFI: 30.1–35.0 cm) and severe (AFI >35.1 cm). Among cases, logistic regression analysis was utilized to estimate the risk for fetal congenital malformations in relation to severity of polyhydramnios, estimated fetal weight, maternal diabetic status and gestational age at delivery. Results: Congenital malformations were detected in 40 of 275 cases (14.5%) with polyhydramnios and in 9 cases (3.3%) of the control group (p < 0.01). The relative risks of congenital malformations increased with the severity of polyhydramnios: 3.2 (95% CI 1.5–6.8), 5.7 (95% CI 2.4–13.3) and 13.1 (95% CI 5.8–29.5) for mild, moderate and severe polyhydramnios, respectively. Congenital malformations among polyhydramnios cases were present in 54.5% of small-for-gestational age fetuses, in contrast to 12.7% for average-for-gestational age fetuses and 10.8% for large-for-gestational age fetuses (p < 0.001). Maternal diabetic status did not significantly affect the fetal anomaly rate once polyhydramnios was detected. Premature newborns in the polyhydramnios group had a higher malformation rate (24%) than did term newborns (11.3%) (p < 0.02). In the study group, multiple logistic analysis confirmed the significance of severe polyhydramnios, small-for-gestational age status and preterm delivery as independent contributors to the malformation risk. Conclusions: Polyhydramnios (AFI >35 cm), small-for-gestational age fetus and preterm delivery are independent risk factors for congenital malformations.
Birth-Weight-Specific Perinatal Mortality in Japan, 1989–1993: Singleton versus Multifetal Pregnancies
Authors: Minakami Hisanori , Sato Ikuo
Published: April 2003

Objective: To investigate the relation between birth weight and perinatal mortality in multifetal pregnancies, which is more than 5 times higher than for singleton infants. Methods: We assessed the incidence of perinatal deaths based on birth weight in 89,566 infants of multifetal pregnancies and 6,025,199 infants of singleton pregnancies in Japan. Perinatal death was defined as stillbirth and early neonatal death (death <1 week of age). Results: The incidence of perinatal death was consistently lower for infants of multifetal pregnancies than for infants of singleton pregnancies at birth weights of 500–2,499 g. However, the incidence of infants of multifetal pregnancies with birth weights ≥2,500 g consistently exceeded that in singleton infants weighing ≥2,500 g. The relative risk (95% CI) of perinatal death among infants of multifetal pregnancies compared with singleton infants in the same category of birth weight was 0.88 (0.84–0.93) at 500 g. The relative risk decreased to 0.31 (0.25–0.39) at 1,900 g, increased to >1.0 at 2,500 g, to 3.7 (2.2–6.1) at 3,000 g, and to 14.9 (7.8–28.4) at ≥3,500 g. Conclusions: Japanese infants of multifetal pregnancies reaching ≥2,500 g in body weight have a significantly higher risk of perinatal death than singleton infants in the same category of body weight. Increased monitoring of fetuses of multifetal pregnancies who weigh ≥2,500 g may be helpful in reducing the incidence of perinatal mortality.
Prediction of Oligohydramnios in Prolonged Pregnancy
Authors: Suzuki Shunji , Otsubo Yasuo , Sawa Rintaro , Yoneyama Yoshio , Araki Tsutomu
Published: April 2003

A decrease in amniotic fluid in prolonged pregnancy is associated with increased fetal morbidity. However, few investigations have been reported on the prediction of this condition. Fetal renal arterial pulsatility index (PI), hourly fetal urine production rate (HFUPR) and amniotic fluid index (AFI) at 39 weeks were studied in 51 singleton pregnancies with (n = 14) and without oligohydramnios (AFI < 5, n = 37) in prolonged pregnancy. There was no difference in the average fetal renal arterial PI and HFUPR between the oligohydramnios group and the normal group. However, the average AFI in the oligohydramnios group was 7.5 ± 0.9, which was lower than that in the normal group (p < 0.05). We speculated that AFI value at 39 weeks is useful for predicting the incidence of oligohydramnios in prolonged pregnancy.
Glutathione S-Transferase Alpha Levels in Epileptic and Healthy Women Preconceptionally and throughout Pregnancy
Authors: Zusterzeel Petra L.M. , Knapen Maarten F.C.M. , Roes Eva Maria , Steegers-Theunissen Régine P.M. , Peters Wilbert H.M. , Merkus Hans M.W.M. , Steegers Eric A.P.
Published: April 2003

We studied plasma GSTA1-1 concentrations in preconceptionally recruited epileptic women who received antiepileptic drugs (n = 99) and a control group of healthy women (n = 106). Mean plasma GSTA1-1 concentrations in the control group did not show significant changes preconceptionally and throughout pregnancy. Six weeks postpartum, however, a significant increase in the mean plasma GSTA1-1 concentration (p < 0.001) was found as compared to preconceptional levels and levels during pregnancy. The mean plasma GSTA1-1 concentration in epileptic women was significantly higher in the 4th gestational week compared to those determined in healthy pregnant women (1.68 versus 1.08 μg/l, p < 0.001). Values between the groups in the second and third trimester and postpartum period showed no significant differences.
Biological Implications of Growth Factors on the Mechanism of Invasion in Gynecological Tumor Cells
Authors: Ueda Masatsugu , Ueki Minoru , Terai Yoshito , Ueki Ken , Kumagai Koji , Fujii Hideji , Yoshizawa Keiko , Nakajima Motowo
Published: April 2003

We investigated the effects of epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-α) on migration, invasion and proteinase expression of gynecological cultured cancer cells (SKG-IIIb cervical squamous cell carcinoma, OMC-4 cervical adenocarcinoma, SNG-M endometrial adenocarcinoma and OMC-3 ovarian adenocarcinoma), and whether these growth factors affect thymidine phosphorylase/platelet-derived endothelial cell growth factor expression of tumor cells. Tumor cell migration along a gradient of substratum-bound fibronectin and invasion into reconstituted basement membrane were stimulated by 0.1–10 nM EGF and TGF-α in a concentration-dependent manner. The zymography of tumor-conditioned medium showed that the treatment of tumor cells with EGF and TGF-α resulted in the increase of type IV collagenases, stromelysin and urokinase-type plasminogen activator which was partly confirmed by immunoblot analysis. The expression of thymidine phosphorylase/platelet-derived endothelial cell growth factor which has angiogenic activity, was also upregulated by these growth factors. These results suggest that EGF and TGF-α act as positive regulators on the invasion process of gynecological tumor cells which may be associated with their stimulatory action on the motility of tumor cells, the expression of proteinases secreted by tumor cells and the angiogenic phenotype.
Human Fetal-Placental Weight Ratio in Normal Singleton Near-Term Pregnancies
Authors: Lurie Samuel , Feinstein Michael , Mamet Yaakov
Published: April 2003

Objective: To determine the fetal-placental weight ratio in normal near-term singleton pregnancies. Patients and Methods: 431 consecutive singleton near-term live deliveries following uncomplicated pregnancies were included in a prospective study. Mean maternal age was 28.6 years (range 17–50), mean parity was 2.9 (range 1–16). Mean gestation age at delivery was 39.7 weeks (range 33–42). Results: Mean newborn weight was 3,382.1 ± 486.7 g (range 2,180–4,810). Mean placental weight was 613.0 ± 123.8 g (range 319–1,266). Mean fetal-placental weight ratio was 5.6 ± 0.96 (range 2.9–10.6) with kurtosis of 3.6 and skewness of 1.05. The ratio did not differ significantly between male (n = 253) and female (n = 176) infants, 5.7 ± 0.89 and 5.6 ± 1.04, respectively. There was a progressive increase in the fetal-placental weight ratio with gestational age (r = 0.87): from 5.3 ± 0.90 at 33–36 weeks to 5.9 ± 1.06 at the 41st week and 5.7 ± 0.71 at the 42nd week (p < 0.05) and with birth weight distribution (r = 0.85) from 5.0 ± 1.06 in newborns weighing 2,000–2,499 g to 5.9 ± 0.94 in newborns weighing >4,000 g (p < 0.05). There was a positive relationship between the fetal-placental weight ratio in teenage and elder parturients (r = 0.98): 5.2 ± 0.98 (age 17–19), 5.7 ± 0.88 (age 20–29), 5.6 ± 1.08 (age 30–39), and 5.7 ± 0.96 (age 41–50) (p < 0.05). The most contributing variable was birth weight. Conclusions: The fetal-placental weight ratio tends to be low in teenage women, early near-term gestational age, and low fetal weight. There was a progressive increase in the fetal-placental weight ratio with gestational age and with birth weight distribution.
Correlation of Lipid Peroxidation and Alpha-Tocopherol Supplementation in Patients with Cervical Carcinoma, Receiving Radical Radiotherapy
Authors: Gitanjali G. , Ghalaut V. , Rakshak M. , Hooda H.S.
Published: April 2003

Vitamin E acts as antipromoter of carcinogenesis and MDA is a byproduct of lipid peroxidation inherent in carcinogenesis. Reduced serum levels of vitamin E have been found to be associated with higher risk of oral, gastrointestinal and breast cancers. This study was designed to evaluate status of serum vitamin E levels in carcinoma cervix patients receiving radical radiotherapy (RRT). Material and Methods: Fifty patients with biopsy-proven carcinoma of the cervix were divided into two groups. Group I received vitamin E supplement (100 mg orally daily) in addition to RRT. Group II received RRT only. Serum vitamin E and MDA levels were compared in the two groups pre- and post-RRT using Duggans and Beuges methods, respectively. Results and Conclusion: Serum vitamin E levels were statistically lower in 50 patients than in controls. Post-RRT serum vitamin E levels increased in group I (p < 0.02) and group II (p < 0.01) while serum MDA levels decreased in group I (p < 0.01) and group II (p < 0.05) meaning thereby that oxidative stress and consequent lipid peroxidation was reduced with decrease in tumour mass. Mean post-RRT serum vitamin E levels in the two groups was not statistically different. We found that serum vitamin E levels in the patients did not correlate with oral supplementation of vitamin E.
Evaluation of Treatment of Hyperemesis gravidarum Using Parenteral Fluid with or without Diazepam
Authors: Ditto A. , Morgante G. , la Marca A. , De Leo V.
Published: April 2003

Objective: Hyperemesis gravidarum is a relatively unknown disease, and is generally self-limiting. In some women the symptoms are so severe as to threaten the health of the mother and fetus. Therapies proposed for hyperemesis gravidarum are therefore rather empirical. Medical treatment includes parenteral fluid replacement and nutrition, electrolytes, antiemetics, vitamins, sedation and psychological counseling. Diazepam and benzodiazepins have been widely studied in pregnancy but the results are contradictory. The aim of the present study was to investigate the efficacy of parenteral fluids with vitamins, with or without diazepam sedation. Methods: Fifty women with hyperemesis gravidarum were enrolled in the study. They were treated with infusions of normal saline, glucose, vitamins and randomly with diazepam. Results: The results show that the mean stay in the hospital was shorter in the diazepam group: 4.5 ± 1.9 vs. 6 ± 1.6 days (p < 0.05) and readmission to the hospital was 4% in the diazepam group versus 27% in other group (p < 0.05). There was a significant reduction in nausea in the diazepam group (p < 0.05). A significant reduction in vomiting was observed in both groups. No side effects or congenital neonatal malformations were found in the diazepam group. Conclusions: Intravenous administration of fluids and vitamins is the standard treatment for women hospitalized for hyperemesis gravidarum. The addition of diazepam to the treatment is effective in reducing nausea and does not have teratogenic effects.
Fetal Middle Cerebral Artery Doppler Waveforms in Twin–Twin Transfusion Syndrome
Authors: Suzuki Shunji , Sawa Rintaro , Yoneyama Yoshio , Otsubo Yasuo , Araki Tsutomu
Published: April 2003

The aim of this study was to compare the fetal middle cerebral artery (MCA) Doppler waveforms in growth-retarded twin fetuses with (n = 11) and without (n = 24) twin–twin transfusion syndrome (TTTS). Umbilical artery (UA) and fetal MCA Doppler velocity waveforms were recorded on admission. The mean values of the UA pulsatility index (PI) of smaller twin fetuses with and without TTTS were significantly higher than those of normal singleton pregnancies. The mean values of the MCA PI of smaller twin fetuses in the TTTS group (+0.7 ± 1 SD) were significantly higher than those of normal singleton pregnancies on admission, and these levels did not markedly change following amniocentesis. On the other hand, the values of the MCA of the growth-retarded fetuses without TTTS (–0.9 ± 1 SD) were significantly lower than those of normal singleton pregnancies. Our findings suggest that measurement of fetal MCA PI is a useful method to assess growth-retarded fetuses in monochorionic twin pregnancies.
Is Carbohydrate Metabolism Altered among Women Who Have Undergone a Preeclamptic Pregnancy?
Authors: Nisell Henry , Erikssen Catharina , Persson Bengt , Carlström Kjell
Published: April 2003

Objective: To compare women after a preeclamptic pregnancy with women after a normal pregnancy with respect to androgenic-anabolic status and carbohydrate and lipid profiles. Method: Twenty-one patients and 22 controls were followed up to 26–119 weeks after delivery. Blood was sampled for analyses of insulin, glucose, insulin growth factor-1, lipids, androgens, sex hormone-binding globulin (SHBG) and uric acid. Anthropometric data and blood pressure were recorded. Data are presented as median and ranges (within parentheses) or mean ± SEM where appropriate. Comparisons were made by unpaired t test or Mann-Whitney U test, respectively. Results: Significantly higher values were found in the preeclampsia than in the control group for fasting insulin, fasting glucose, fasting insulin resistance index (FIRI, fasting glucose × fasting insulin/25), serum triglycerides, uric acid and blood pressure. There were no differences in androgen status and IGF-1 levels. Conclusion: Patients with a recent history of preeclampsia demonstrate signs of relative insulin resistance, hypertriglyceridemia and hyperuricemia as well as increased blood pressure as compared with women who had a normal pregnancy. However, in contrast to other women with insulin resistance, they have a normal androgen status.
Correlation between Progesterone Binding Sites on Human Spermatozoa and in vitro Fertilization Outcome
Authors: Fukui Keisuke , Hori Reiko , Yoshimoto Isao , Ochi Hiroshi , Ito Masaharu
Published: April 2003

We investigated whether the expression of progesterone-binding sites on human sperm acrozomal membrane is correlated with in vitro fertilization outcome. In motile sperm we evaluated percentage of progesterone-binding sperm (%PB) and of acrozome-reacted sperm (%AR), collected from 39 male partners undergoing an in vitro fertilization program (IVF), by labeling the sperm with progesterone-conjugated BSA-labeled FITC (P-BSA-FITC) and pisum sativum agglutinin labeled-FITC (PSA-FITC). Mean %PB in 30 fertilized cases was significantly higher than that in 9 fertilization failures (9.0 ± 5.1 vs. 22.3 ± 14.8%, p < 0.01). Furthermore, %PB shows a strong positive correlation with fertilization rate in IVF (r = 0.44) and %AR (r = 0.62), but not with sperm concentration and sperm motility. These results suggest that the expression of progesterone receptor on the sperm was related to the sperm fertilizability, and the evaluation of %PB was useful for predicting the fertilization outcome of IVF.
Women Endurance Runners with Menstrual Dysfunction Have Prolonged Interruption of Training due to Injury
Authors: Beckvid Henriksson G. , Schnell C. , Lindén Hirschberg A.
Published: April 2003

Strenuous exercise by women is associated with menstrual dysfunction, eating disorders and osteoporosis. Intensive training may also increase the susceptibility to infections. In this study, we investigated whether menstrual dysfunction was related to musculoskeletal injuries and/or upper respiratory tract infections in women middle/long-distance runners. A questionnaire was mailed to 127 Swedish female runners of whom 75% answered. This retrospective study showed a higher frequency of menstrual disorders (25%) in runners than in the general population. Furthermore, almost half of the athletes (46%) were classified as at risk of developing eating disorders. Women athletes with menstrual dysfunction were found to have had a longer interruption of training due to musculoskeletal injuries than those with regular cycles (34.1 ± 3.0 vs. 9.0 ± 9.4 days, p < 0.05). However, no relation was found between susceptibility to infections and menstrual status.
Overexpression of p53 and HER-2/neu and c-myc in Primary Fallopian Tube Carcinoma
Authors: Chung T.K.H. , Cheung T.H. , To K.F. , Wong Y.F.
Published: April 2003

Primary fallopian tube carcinoma is a rare form of female cancer and the genetic basis of its carcinogenesis remains unclear. Eighteen cases of primary fallopian tube adenocarcinoma were studied. Immunohistochemical staining for p53, HER-2/neu and c-myc genes were performed. Overexpression of p53 was detected in 12 cases (67%), HER-2/neu in 16 cases (89%), and c-myc in 11 cases (61%). The potential relevance of overexpression of the three genes with clinicopathological features was examined, but no significant correlation was found. The high incidence of p53, HER-2/neu and c-myc overexpression in fallopian tube adenocarcinoma suggests these genes may play a role in its tumorigenesis.
Protective Effect of the Selective Estrogen Receptor Modulator LY117018 on Rat Vaginal Candida albicans Colonization
Authors: Essmann Michael , Larsen Bryan
Published: April 2003

Although we know that estrogen promotes vaginal colonization with Candida albicans in oophorectomized rats, the availability of selective estrogen receptor modulators (SERMs) raises the question of whether these compounds may influence the susceptibility of vaginal epithelium to Candida colonization. We inoculated rats with viable C. albicans 2 days after treatment with oil vehicle (controls), estradiol cypionate or the proprietary SERM, LY117018. LY117018 prevented colonization by a clinical isolate of C. albicans. In contrast, rats treated with estradiol cypionate remained colonized for up to 10 days after initial inoculation with viable yeast. In vitro tests demonstrated that both estradiol-17β and LY117018 promoted growth at a 1 × 10–9 M concentration, whereas both compounds suppressed yeast growth at a higher (1 × 10–6 M) concentration. The effect of LY117018 on vaginal colonization could not be predicted on the basis of in vitro investigation. We conclude that the protective effect of LY117018 resulted from an indirect effect on the host and not from its effect directly on the microorganism.
Factor XII Deficiency in Women with Recurrent Miscarriage
Authors: Yamada Hideto , Kato Emi H. , Ebina Yasuhiko , Kishida Tatsuro , Hoshi Nobuhiko , Kobashi Gen , Sakuragi Noriaki , Fujimoto Seiichiro
Published: April 2003

Congenital thrombophilia is known to cause significant maternal complications, and possibly has an adverse effect on normal fetal development. The aim of this study was to assess the prevalence of factor XII (FXII) deficiency in women with a history of recurrent miscarriage. Two hundred and forty-one consecutive Japanese women with a history of two or more recurrent miscarriages were prospectively assessed for their etiology by conventional screening methods. Seven women were found to have reduced FXII activity (19.2–46.1%) and prolonged activated partial thromboplastin time (33.3–51.3 s). Of these 7 women, 6 had experienced early pregnancy losses, while 1 woman had experienced repeated mid-trimester fetal losses with coincidental gestational thrombocytopenia. In 241 women with a history of recurrent miscarriage, the prevalence of FXII deficiency was 2.9%.
Implications of Asymptomatic Endocervical Leukocytosis in Infertility
Authors: Ou Ming-Cheh , Su Chin-Shu
Published: April 2003

Genital tract infection is a known cause of male and female infertility. In this retrospective study, we investigated the effect of treatment of asymptomatic cervical leukocytosis on pregnancy rates. Twenty-five infertile women with asymptomatic cervical leukocytosis received broad-spectrum antibiotic treatment (100 mg doxycycline, 200 mg ofloxacin, and 500 mg metronidazole twice a day for 7–10 days). Pregnancy rates and resolution of leukocytosis were evaluated 6 months after treatment. Eleven patients (44%) had persistent cervical leukocytosis and 16 (64%) had become pregnant within 6 months after treatment. Successful treatment of cervical leukocytosis resulted in an increase in the pregnancy rate: 13 of the 14 patients (93%) who were cured of leukocytosis became pregnant, while 3 of the 11 (27%) who did not become pregnant were cured (p = 0.002). Patients who did not achieve pregnancy were older (p = 0.002) than those who did. Patients who were not cured were also older than those who were (p = 0.014). Our findings suggest that the treatment for cervical leukocytosis is less effective for older patients than for younger patients. However, treatment of asymptomatic cervical leukocytosis appears to help preserve the fertility of patients with this disease.
Severe Unilateral Hydrothorax as the Only Manifestation of the Ovarian Hyperstimulation Syndrome
Authors: Rabinerson David , Shalev J. , Royburt Moshe , Ben-Rafael Zion , Dekel Arie
Published: April 2003

Background: Unilateral hydrothorax is rarely the sole manifestation of the ovarian hyperstimulation syndrome (OHSS) and is suggestive of the severity of the disease. Case: A 35-year-old woman presented with mild dyspnea 2 weeks after ovarian stimulation with hMG and hCG and IVF-ET. Chest X-ray revealed a large pleural effusion on the right side. Three consecutive thoracocenteses were needed to drain a total of 6,800 cm3 of fluid. Following drainage, the respiratory symptoms disappeared. An uneventful pregnancy is in progress. Conclusions: Thoracocentesis is safe and efficient for the treatment of hydrothorax and may be repeated as often as necessary. Clinicians should be aware of the possibility of unilateral hydrothorax as the sole symptom of OHSS.
Application of Vitrification to Human Embryo Freezing
Authors: Saito Hidekazu , Ishida Gabriela M. , Kaneko Tomoko , Kawachiya Satoshi , Ohta Nobuhiko , Takahashi Toshifumi , Saito Takakazu , Hiroi Masahiko
Published: April 2003

To solve the problem of multiple pregnancies during the in vitro fertilization (IVF) and embryo transfer procedure, excess embryos must be cryopreserved for embryo transfer in future. We applied the vitrification method to cryopreservation of human embryos. A total of 31 frozen-thawed embryo transfer cycles were analyzed at the Yamagata University Hospital, Yamagata, Japan. The patients were introduced to IVF treatment and had an excess of valuable embryos to be frozen after the transfer of three fresh embryos that did not result in establishing a pregnancy. Excess human 8- to 16-cell stage embryos were exposed to vitrification solution and then frozen in liquid nitrogen. The cryoprotectant was removed by washing the embryos in media containing different concentrations of cryoprotectant. Three days after LH surge and/or 2 days after ultrasonographic ovulation the embryos were transferred. The rate of poor quality embryos significantly increased and the rate of good quality embryos decreased after thawing the embryos frozen by the vitrification method. In menstrual cycles with good quality embryo transfer, a higher rate of pregnancies was established than in the cycles in which fair or poor quality embryos were the highest grade of embryos transferred into the uterus. In total, 5 pregnancies were established from 31 embryo tansfers; 4 pregnancies were in cycles associated with the transfer of good quality embryos, and 1 pregnancy was in a cycle in which the highest grade of embryo was fair. When compared with slow embryo freezing methods, vitrification has marked advantages for clinical application in terms of cost and time. Vitrification will be an alternative method for embryo freezing.
Human Uterine Myocytes Retain Their Energy Charge with No Gross Alterations in Morphology for at Least 8 Days when Cultured under Anaerobic Conditions
Authors: Olovsson Matts , Nordling Margareta , Ulmsten Ulf , Lindblom Bo , Waldenström Anders , Ronquist Gunnar
Published: April 2003

Objective: To investigate the ability of human uterine myocytes to grow under anaerobic conditions for a prolonged time period. Methods: Cells were isolated from fundal myometrium and cultured until subconfluency. The cell type was confirmed by immunostaining for the smooth muscle cell-specific cytoskeletal proteins α-actin and desmin. Some cells were further cultured under aerobic conditions and others under anaerobic conditions. Cells were harvested after 0, 4 and 8 days in culture and analyzed for their content of adenylates. Results: Immunostaining revealed that all three preparations contained almost only smooth muscle cells. Energy charge of the myocytes was 0.88 on average at the beginning of the culture experiment. A moderate decrease was noted on day 4 for myocytes grown under both aerobic and anaerobic conditions and no further decrease was noted between days 4 and 8. Morphologically the cells retained their normal appearance and they seemed healthy for at least 8 days in culture under both aerobic and anaerobic conditions. Conclusions: The results of this study suggest that human myometrial cells can survive for an extended period of time under in vitro conditions regardless of oxygen availability for energy metabolism. This means that anaerobic energy metabolism is enough to sustain vital processes during that period of time.
Ultrasound Imaging of Bartholin’s Cysts
Authors: Eppel Wolfgang , Frigo Peter , Worda Christof , Bettelheim Dieter
Published: April 2003

In a prospective, randomized study, Bartholin’s cysts were depicted in 36 patients by means of ultrasound imaging. Patients were requested to return for a follow-up US examination after surgery. We were able to show that Bartholin’s cysts can easily be expressed with ultrasonographic techniques. In clinical practice, this approach may not only help to improve diagnostics, but may also make therapy measurable and, for the first time, objectifiable.
Is Measuring the Posterior Urethrovesical Angle of Clinical Value for Controlling Pelvic Organ Prolapse?
Authors: Sumi Toshiyuki , Ishiko Osamu , Hirai Kouzo , Yoshida Hiroyuki , Ogita Sachio
Published: April 2003

Vaginal total hysterectomy with vaginal plasty was performed in 107 patients with pelvic organ prolapse. The posterior urethrovesical angle (PUVA) was measured by chain urethrocystography. Bladder capacity, residual and incontinence urine volume were measured before and after surgery, and the data obtained were analyzed in relation to postoperative improvement and recurrence of urinary dysfunction. There were no significant differences between the background of patients with dysuria, incontinence, a mixture of dysuria and incontinence, and neither of these symptoms. Postoperative incontinence and residual urine volume decreased in all groups. However there was no correlation between the preoperative PUVA and either incontinence or residual urine volume. Measurement of PUVA was neither helpful in making the diagnosis nor predictive of the recurrence of urinary dysfunction.