bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma lipoproteins during and after danazol treatment
Authors: Fåhraeus Lars , Larsson‐Cohn Ulf , Ljungberg Sten , Wallentin Lars
Published: December 2009

Abstract. Twelve women with pelvic endometriosis were treated with danazol, at a dose of 200 mg three times daily, over a 24‐week period. The concentrations of cholesterol and triglycerides were determined in plasma and in the lipoprotein fractions. After only 2 weeks the mean high density lipoprotein (HDL) cholesterol had already decreased by 49% and 6 weeks later the reduction was 59%. The low density lipoprotein (LDL) cholesterol concentration increased by 14% after 2 weeks and by 34% after 8 weeks. The triglycerides increased by 20% after 2 weeks. Eight weeks after cessation of treatment the lipoprotein fractions had returned to the pretreatment levels.
Is fibrocystic breast disease a pre‐malignant state?
Authors: Myhre Eivind
Published: December 2009

Abstract. Fibrocystic disease is the most frequent lesion of the breast. When considered as a single diagnostic entity, benign breast disease has generally been reported to be associated with a relative risk of from 1.5 to 3.0 for breast cancer. Few studies have failed to find any association between fibrocystic breast disease and breast cancer. However, the term fibrocystic breast disease encompasses a variety of histologic changes and accordingly a variety of disignations. This lack of a clear classification may account for the divergent results in studies on the relationship between cystic disease and breast cancer. Some investigators have in fact examined the risk of breast cancer among women with various forms Of fibrocystic disease. Particularly high risks have been associated with atypical epithelial hyperplasia. There is disagreement among pathologists as to whether ductal papillomas are ‘precancerous’ or cancerous.
KOILOCYTOTIC METAPLASIA AND INTRA‐EPITHELIAL NEOPLASIA OF THE UTERINE CERVIX
Authors: Rubinstein Eli
Published: December 2009

Abstract. It is emphasized that both metaplasia and CIN (cervical intra‐epithelial neoplasia) must be defined with great precision in order to optimize an individualized treatment. In addition, if the metaplasia or CIN is classified as koilocytotic, the koilocytes must necessarily be found in the same cell layers as the metaplastic and/or the neoplastic cells. In a material of 335 unselected, consecutively treated women evaluated colposcopically, a marked difference between dysplasia (CIN 1–2) and preinvasive cancer (CIN 3) was found cytologically and histologically, in that the incidence of koilocytotic atypia in CIN 3 lesions was only half of that in CIN 1–2 lesions. The diagnostic accuracy of cer‐vicovaginal cytology in koilocytotic metaplasia and koilocytotic CIN was poor: exfoliated koilocytotic cells were found in only 25% of the cases with histologically proven koilocytotic atypia, even when the cytological smears were re‐examined. Furthermore, no characteristic colposcopic picture of koilocytotic metaplasia or CIN was found. It seems probable that koilocytotic dysplasia does not necessarily behave in the same way as classical CIN, which has been thought to progress continuously from mild dysplasia (CIN 1) to preinvasive cancer (CIN 3), since rapid progression of koilocytotic CIN 2 lesion directly into invasive cancer has been demonstrated. The CO2‐laser has been used to treat koilocytotic cervical intra‐epithelial neoplasias. In 49 of the 52 cases so treated in this series, complete eradication of the disease was noted at two postoperative colposcopic and cytological examinations, 3 and 6 months after treatment, respectively.
LASER VAPORIZATION OF CERVICAL INTRA‐EPITHELIAL NEOPLASIA
Authors: Rylander Eva , Lsberg Assar , Joelsson Ingemar
Published: December 2009

Abstract. 300 patients, 18–43 years of age, with CIN I‐III were treated between 1979 and 1983 with laser vaporization. The follow‐up for 12–60 months has been analysed. The healing rate after one treatment session was 91%. Residual disease was discovered without delay using colposcopy and vaginal cytology and retreatment could easily be arranged.

Eight cases of recurrent disease (out of 137 patients followed for 19–60 months) were diagnosed using the following criteria: cytological and/or histological evidence for atypia/dysplasia after a period of minimum 18 months during which time two or more examinations with negative cytology had been performed.

Laser vaporization is a sufficiently safe method for the treatment of CIN I–III. It can be performed as an outpatient procedure. Early as well as late complications are rare.

Both residual disease and recurrences can be detected without delay using colposcopy and vaginal cytology as diagnostic tools.
Pre‐Eclampsia: A Hypothesis for its Pathogenesis
Authors: Enhorning Goran
Published: December 2009

Abstract. A hypothesis is presented according to which the pathogenesis of pregnancy‐induced hypertension can be attributed to disturbances in renal function caused by the upright posture of the human. In pregnancy, glomerular filtration rate (GFR) and tubular reabsorption, the latter stimulated by aldosterone, are working in high gear. A diminished GFR with continued stimulation of tubular re‐absorption would lead to sodium retention. That situation could result, particularly in the primigravida, from the enlarged uterus of late pregnancy exerting pressure on and interfering with venous return, arterial blood flow to kidneys, and/or ability of ureters to transport urine and maintain low pressure in the kidney pelvis. At an early stage, pre‐eclampsia can be controlled by bed rest, quite likely by removing dangerous uterine compression. Animal studies are required to test the hypothesis.
Sympatho‐Adrenal Activity in Different Hypertensive Disorders in Pregnancy: A short review
Authors: Nisell H. , Lunell N.‐O.
Published: December 2009

Abstract. The sympathetic nervous system is involved in blood pressure regulation in normal and hypertensive man via postganglionic nerve transmission mediated by norepinephrine, acting mainly on the α‐receptor to cause vaso‐constriction, and also via adrenomedullary secretion by epinephrine, acting mainly on the β‐receptors which will give rise to increased cardiac output and vasodilation in the muscular beds. Conflicting results regarding the role of the sympathoadrenal system in hypertension of pregnancy have been reported. This may be attributed partly to the varying methods that have been used to study this system. Specific measurement of the the activity of the sympathetic nerves is difficult, although direct recording of their activity has been performed (15). At present, plasma norepinephrine is considered to be an index of sympathoneural activity, reflecting the rate of release at the postganglionic nerve endings (5, 11) and plasma epinephrine is considered to be a marker of adrenal activity, since it is derived almost exclusively from the adrenal glands (5).
The Incidence of Hypertensive Disease in Pregnancy
Authors: Lindmark Gunilla , Lindberg Bo , Högstedt Stellan
Published: December 2009

Abstract. Incidence figures for hypertensive disease in pregnancy (HDP) vary widely in epidemiological studies due to variations in definitions, the occurrence of risk factors and differing methods of data collection. In Uppsala county all pregnant women with a diastolic blood pressure of 90 mmHg or more were prospectively registered within a 2‐year‐period. The incidence of hypertension noted in the antenatal clinics was found to be 7.2%. In 56% of the cases hypertension was first noted after 37 weeks of gestation. The group of patients presenting before term with hypertension not normalized by bed rest in hospital and without complicating factors was only 14% of the whole material. The implications of the findings for discussions on therapy and complications in HDP are discussed.
Methodological Problems in Studies on Hypertension Therapy During Pregnancy
Authors: Högstedt Stellan , Lindmark Gunilla , Lindberg Bo
Published: December 2009

Abstract. As yet, no distinct aetiological factor underlying hypertension in pregnancy has been disclosed, and there is therefore no clearcut treatment for this condition. The lack of well‐defined end‐points makes it difficult to plan and evaluate the results of studies on the treatment of hypertension during pregnancy. However, we cannot await the solution to the puzzle of pre‐eclampsia before providing treatment for this hypertension. Well‐designed investigations to determine the most effective form of such treatment are therefore of great value and must be carried out in spite of the many problems associated with these studies. If given due consideration, as discussed in this paper, this problem can be alleviated.
Drug Selection in the Treatment of Pregnancy Hypertension: A survey
Authors: Liedholm H. , Melander A.
Published: December 2009

Abstract. Effective blood pressure treatment has only been available during the last 20‐25 years. Most antihypertensive drugs employed for other hypertensive conditions have also been used in hypertensive states of pregnancy. In this survey, most of the drugs already in use and some new ones are discussed. No special emphasis is placed on the use of drugs in emergency situations. As β‐adrenoceptor blocking drugs are widely used nowadays, the principal differences between some β‐blockers are discussed in detail. A discussion of future requirements in order to get a better picture of the value of antihypertensive drugs completes this survey.
Fetal Heart Rate During Treatment of Maternal Hypertension with Beta‐Adrenergic Antagonists: A preliminary report
Authors: Ingemarsson Ingemar , Liedholm Hans , Montan Sven , Westgren Magnus , Melander Arne
Published: December 2009

Abstract. The effects of two different β‐adrenergic antagonists on maternal arterial pressure and fetal heart rate were studied in 8 pregnant women with pregnancy hypertension. The fetal heart rate was monitored by abdominal ECG recording under standardized conditions. Basal heart rate, long‐term variability and short‐term variability were calculated in a computer. Four patients received 50–100 mg atenolol once daily; the other 4 received pindolol 10 mg b.i.d. Reduction in mean arterial blood pressure was seen in both groups of patients. The basal fetal heart rate was decreased in atenolol‐exposed fetuses but not in pindolol‐exposed fetuses. In this preliminary study there was no apparent effect on the fetal heart rate variability.
Influence of the β1‐Adrenoceptor Blocker Atenolol on Antenatal Cardiotocography
Authors: Montan Sven , Solum Thore , Sjöberg Nils‐Otto
Published: December 2009

Abstract. Forty term patients with pregnancy‐induced hypertension were treated with the β1‐adrenoceptor blocker atenolol (TenorminR; ICI) for at least 7 days prior to parturition. The antenatal cardiotocography (CTG) was visually analysed before and during treatment. The mean basal fetal heart rate (FHR) decreased from 143±7 beats per minute (bpm) to 13328 bpm. In 13.1% of the recordings in treated patients there was a decrease in long‐term variability for a period of more than 20 minutes; this was observed in only 2.3% prior to treatment. The amplitude of the accelerations was reduced from 23±6 bpm to 18±4 bpm. It was demonstrated that atenolol affected antenatal CTG, and this has to be taken into consideration when interpreting antenatal CTG as one parameter for evaluation of fetal well‐being.
Causes and Consequences of Maternal and Fetal Sympathoadrenal Activation During Parturition
Authors: Irestedt Lars , Lagercrantz Hugo , Belfrage Patrick
Published: December 2009

Abstract. The sympathoadrenal system is activated in both the mother and fetus during parturition. The fetal plasma catecholamines may reach extremely high levels during deliveries complicated by asphyxia.

Increased maternal sympathoadrenal activity during labour or caesarean section may negatively affect utero‐placental blood flow with possible adverse effects on the fetus. Such an increase may be avoided by adequate maternal pain relief and by the sympathetic blockade which follows epidural anaesthesia.

Fetal sympathoadrenal activation during parturition seems on the contrary to be of positive functional importance both for fetal circulatory regulation in utero a well as for the neonatal adaptation in terms of pulmonary function and metabolic stimulation.
CONTRACTION STRESS TEST BY BREAST STIMULATION AS PART OF ANTEPARTUM MONITORING
Authors: Chayen Benjamin , Scott Edna , Cheng Chau‐Chie , Perera Chitra , Śchiffer Morton A.
Published: December 2009

Abstract. Non‐stress tests (NSTs) and oxytocin challenge tests (OCTs) are widely used in most prenatal units for the assessment and monitoring of patients with high risk pregnancies. The contraction stress test is considered to be one of the best tests for evaluating fetal wellbeing in indicated cases. For this purpose, the OCT is usually used. It is a time‐consuming test. An intravenous i.v. and oxytocin are both required, and it is therefore relatively costly. In this study, a non‐invasive technique—breast stimulation—was used to induce uterine contractions for the purpose of contraction stress testing. Sixty‐six patients were studied, and a total of 95 breast stimulation tests (BSTs) were done. 91 tests were successful contraction stress tests (95.78%). The high success rate, the fact that this is a non‐invasive method, its easy application and the fact that this test is less expensive and much less time consuming make it a good test for the assessment of fetuses at risk.
INTENSIVE PLASMA EXCHANGE AS AN ADJUNCT TO MANAGEMENT OF SEVERE RHESUS DISEASE
Authors: Eklund Jarl
Published: December 2009

Abstract. Large‐volume plasma exchange was used to reduce the maternal anti‐D concentration in a case of severe rhesus disease. The treatment commenced at 19 weeks' gestation and continued until the infant was successfully delivered at 35.2 weeks' gestation. The initial anti‐D level of 30 IU/ml was lowered to 10 and was maintained below that level, with few exceptions throughout the program. The volume of plasma exchanged each week varied between 6.8 and 13.4 liters, a total of 154 1. Three IUTs were accomplished, starting from 31 weeks' gestation. The patient's OD values remained far below those recorded in her previous pregnancy which terminated in neonatal death. The replacement fluids consisted of 98 1 PPS with FFP added to equilibrate the patient at the end of each procedure, altogether 33 1. At 33 weeks' gestation she developed a transient non‐A, non‐B hepatitis probably caused by the use of FFP. However, she later made a complete recovery. Large‐volume plasma exchanges commenced early in high‐risk pregnancy must be individually designed and based on the kinetics of anti‐D production. The replacement fluids should preferably consist of pasteurized albumin solutions and intravenous immune globulin.
ULTRASONIC STUDY OF FOLLICULAR MATURATION, OVULATION AND DEVELOPMENT OF CORPUS LUTEUM DURING NORMAL MENSTRUAL CYCLES
Authors: Lenz Suzan
Published: December 2009

Abstract. Ovarian follicular growth, ovulation and development of corpus luteum was monitored with ultrasound in 29 normal menstrual cycles in 14 women. Results were correlated to changes in serum estradiol, LH and progesterone levels. The follicles reached a maximum diameter of 20.5±2.70 mm (mean±SD) with an intercycle variation of 16 to 25 mm, and growth rates ranged between —2 and 6 mm from the day before the LH peak to the day of the LH peak. Cumulus echoes were observed in all follicles with a maximum diameter of more than 17 mm and the cumulus appeared from 1 to 3 days before ovulation. On the day after the LH peak, the follicle was still present in two cycles and had disappeared from 15 cycles. In 11 cases different morphologic patterns could be visualized at the former sites of the follicles. In the middle of the luteal phase the mature corpus luteum was seen as an echogenic area in 16 cases and as a cyst in 1 case.
MALIGNANT HEMANGIOPERICYTOMA OF THE OVARY
Authors: Nørgaard Mogens , Hansborg Niels , Fischer‐Rasmussen Wiggo
Published: December 2009

Abstract. Tumors originating from the blood vessels seldom occur in the ovaries, and primary hemangiopericytoma localized to the ovaries has not previously been described. In the case reported here a bilateral ovarian tumor was found, with one metastasis to the terminal ileum. It was not possible to perform a radical operation, and the patient was after‐treated with external irradiation therapy and chemotherapy. For 9½ months the tumor receded, whereafter it appeared to be stationary for 13 months, to the death of the patient. At autopsy the tumor was in evident regression and there were no signs of metastases.
ON THE VALUE OF PLACENTAL ALKALINE PHOSPHATASE AS A MARKER FOR GYNECOLOGICAL MALIGNANCY
Authors: Stigbrand T. , Holmgren P. Å. , Jeppsson A. , Damber M. G. , von Schoultz B.
Published: December 2009

Abstract. A sensitive catalytic assay for placental alkaline phosphatase (PLAP) was used to quantify enzyme levels in sera from women with malignant gynecological tumors, i.e. cervical carcinoma, ovarian carcinoma and carcinoma of the breast. Values were compared with those of a reference group of 155 healthy individuals. In this group, basic mean levels of the enzyme amounted to 0.06±0.08μmoles × min−1 × 1−1 (mean±SD), which corresponds to 0.3±0.4 ng/ml (mean±SD) purified placental alkaline phosphatase. Enzyme levels were not significantly affected by age, whereas sex gave slightly higher values for women in all age groups. This difference was statistically significant (p< 0.001). The discriminating capacity of PLAP as a tumor marker was analysed with this assay and compared in sensitivity with a radio‐immunoassay. A cut‐off level of 0.2 μmoles × min−1 × 1−1, corresponding to 1 ng/ml enzyme protein as measured by the radio‐immunoassay, detected 23‐68% of the tumor patients, giving false‐positive results from the control group in the order of 5%. Corresponding values at a cut‐off level of 0.3 μmolesxmin−1 × 1−1 (1.5 ng/ml) gave values 20‐44% and 2%, respectively. The present investigation emphasizes that sensitivity in assays of placental alkaline phosphatase, whether catalytic or immu‐nological, must not exceed ng‐level.
EFFECT OF NATURAL ESTROGEN ON THE SERUM LEVEL OF FOLLICLE‐STIMULATING HORMONE (FSH), ESTRADIOL AND ESTRONE IN POST‐MENOPAUSAL WOMEN AND ITS EFFECT ON ENDOMETRIUM
Authors: Varma T. R. , Everard D. , Hole D.
Published: December 2009

Abstract. Serum FSH, estradiol and estrone levels were assayed in 35 post‐menopausal women who received the three commonly available estrogen preparations Premarin, Pro‐gynova and Harmogen. The results were compared with the levels during treatment with Dixarit. Hormone levels did not change when Dixarit was used. The levels of estrone and estradiol increased significantly (p<0.01) when estrogen preparations were used. There was no abnormality in the endometrium at the end of the treatment period.
VITAMIN B12 BINDING PROTEINS IN AMNIOTIC FLUID
Authors: Gimsing P. , Toft L. , Felbo M. , Hippe E.
Published: December 2009

Abstract. The cobalamin‐binding proteins in amniotic fluid are determined by assaying the unsaturated cobalamin‐binding capacity of haptocorrin (R‐proteins, cobalophilin, or transcobalamin I‐like protein and any coexisting intrinsic factor) and non‐haptocorrin. Forty‐five specimens obtained by amniocentesis, and ninety‐two obtained at parturition are analysed. The haptocorrin cobalamin‐binding capacity increases rapidly after a gestational age of about 15 weeks. At parturition the concentration varies from 1.4 to 26.8 nmol/1. The non‐haptocorrin cobalamin‐binding capacity is less than 1% of the total binding capacity. The unsaturated cobalamin‐binding capacities do not correlate significantly with birth weight, placental weight, or total protein concentration of the amniotic fluid. The ratio between haptocorrin concentration in amniotic fluid and maternal plasma is about 3:1. The unsaturated cobalamin‐binding capacity of haptocorrin in amniotic fluid is significantly higher in pregnancies with female than with male fetuses, and is relatively high in one case of twins. It is suggested that haptocorrin in amniotic fluid originates mainly from the fetus, and may have a bacteriostatic effect.
TREATMENT OF VAGINAL CANDIDOSIS WITH TIOCONAZOLE 2% VAGINAL CREAM
Authors: Leegaard Merete
Published: December 2009

Abstract.Six hundred and three women in a contraceptive clinic were examined for the presence ofC. albicansin the vagina and questioned about symptoms. Twenty‐nine women withC. albicansaccompanied by symptoms were treated with tioconazole 2% in a vaginal cream for 3 days, repeated once after an interval of 1 week. The mycological cure rate was 88.5%. At the same time, 34 women with vaginalC. albicansbut without symptoms were examined. The spontaneous cure rate in these patients was 58.8%. In the symptomatic group, rectalC. albicanswas observed in 56.5% of patients before treatment. After vaginal treatment, a rectal cure rate of 100% was achieved, but with a recurrency frequency after 2 —4 weeks of 17.4%. Comparative vaginal re‐currency frequency was 10.3%. Three were not cured. The method used has shown itself to be very acceptable for the patient and to have a cure frequency that is fully equal to previously used, longer lasting treatments.
PREDICTIVE VALUE OF ANTEPARTUM FETAL HEART RATE NON‐STRESS TEST IN HIGH‐RISK PREGNANCY
Authors: Lenstrup Carsten , Haase Niels
Published: December 2009

Abstract. For antepartum evaluation of high‐risk pregnancies the non‐stress test (NST) was performed in order to predict favorable or adverse fetal outcome. Between January 1, 1980 and December 31, 1980, 4078 NSTs were performed on 454 women with high‐risk pregnancies. The NSTs were evaluated for pathology by a CTG pathology score. The NST interpretation were normal 95%, slight pathological 4% and severe pathological 1%. The group of women in whom all NST results were normal gave birth to healthy babies. In tact with an increasing number of pathologica‐NSTs and with worsening CTG pathology score, a significant increase was found for cesarean section rate, acute operative delivery, low Apgar score, low umbilical cord artery pH and infants born small for gestational age or clinically dysmature. The frequence of perinatal morbidity was almost the same, irrespective of whether the NSTs showed accelarations or not on one or more occasions. To identify fetuses suffering from retarded intra‐uterine growth the predictive value of normal NST was 97.3% and the predictive value of pathological NST was 34.8%. To identify perinatal morbidity the predictive values were 87.4% and 55.1% respectively. The NST appears to be a realiable test for antepartum assessment of fetal well‐being in high‐risk pregnancies.
EXPERIMENTAL MASTITIS IN MICE INDUCED BY COAGULASE‐NEGATIVE STAPHYLOCOCCI ISOLATED FROM CASES OF MASTITIS IN NURSING WOMEN
Authors: Thomsen A. C. , Mogensen S. C. , Jepsen F. Løve
Published: December 2009

Abstract. Coagulase‐negative staphylococci are frequently isolated from the milk of women with signs of puerperal mastitis. In order to evaluate the pathogenicity of these bacteria, strains of S. epidermidis and S. saprophyticus isolated from cases of mastitis in nursing women were inoculated into the mammary glands of lactating mice. Although clinical signs of mastitis were absent, by histological examination, mastitis was demonstrated in 78‐93% of the glands. Abscesses were found in a few cases only. The inoculated bacteria were re‐isolated in 41‐61 % of the cases, and when inoculated in numbers of 102 to 104 c.f.u. the bacteria multiplied above input levels in several cases. It is concluded that coagulase‐negative staphylococci isolated from the milk of women with puerperal mastitis can produce mastitis in mice and should be considered as a possible etiologic agent of mastitis in nursing women.
SUPRA VAGINAL UTERINE AMPUTATION WITH PEROPERATIVE ELECTROCOAGULATION OF ENDOCERVICAL MUCOSA
Authors: Kilkku P. , Grönroos M. , Rauramo L.
Published: December 2009

Abstract. Discussion on the advantages of abdominal hysterectomy versus supravaginal uterine amputation has concentrated on the incidence of carcinoma in the remaining stump, mortality, and other serious complications. During the period 1952‐78 we have performed 2712 supravaginal amputations with peroperative electrocoagulation of en‐docervical mucosa. The incidence of stump carcinoma was 0.11% in this material. In our prospective studies we have shown that supravaginal amputation has certain advantages over abdominal hysterectomy as regards long‐term morbidity. In this paper we describe the method we are using when performing supravaginal uterine amputation.
COMPARISON OF INTERVAL AND POSTABORTAL/PUERPERAL LAPAROSCOPIC STERILIZATION WITH THE TUBAL RING PROCEDURE
Authors: Heisterberg Lars , Jessen Poul , Schroeder Erik , Wøhlk Per , Pedersen Lars Møisted
Published: December 2009

Abstract. During a 5‐year period, 344 women underwent la‐paroscopic sterilization with the tubal ring. Complications and failure rates were compared in intervals and postabor‐tal/puerperal procedures. Only 9% were lost to follow‐up, and 50% underwent a hysterosalpingoghraphy (HSG). The comparison of interval and postabortal/puerperal procedures showed no significant differences in complication rates, but postabortal/puerperal laparoscopy had a significantly lower failure rate than interval procedures (p< 0.01). It was found that women whose laparoscopy was carried out despite peroperative complications had a significantly higher risk of sterilization failure (p < 0.005). It is concluded that postabortal/puerperal laparoscopic sterilization with the tubal ring procedure is as safe as interval sterilization, and it is strongly recommended that peroperative complications with tubal ring sterilization should result in a reversion of the laparoscopy to a laparotomy and, if not, that the women be referred for HSG.
ACUTE URINARY RETENTION IN FIRST TRIMESTER OF PREGNANCY
Authors: Hansen J. H. , Asmussen M.
Published: December 2009

Abstract. A 34‐year‐old pregnant woman with retroverted uterus and suffering from acute attacks of urinary retention in the first trimester of pregnancy is described. The attacks of retention were caused by the enlarged retroverted uterus associated with a 1 × 1 cm, well differentiated papilliferous carcinoma in the right side of the trigone. The urinary symptom disappeared after resection of the tumor.
SCREENING IN PREGNANCY WITH UNCONJUGATED ESTRIOL COMPARED WITH TOTAL ESTRIOL
Authors: Nielsen Peter Vest , Schultz‐Larsen Peter , Schioeler Vibeke
Published: December 2009

Abstract. An obstetric population was screened ‘blind’ by measuring unconjugated estriol (ucE3) and total estriol (tE3) in serum. The purpose was firstly to ascertain the predictive values of ucE3 for the prediction of low birth weight and distressed neonates (perinatal deaths included), and secondly to compare the predictive values of ucE3 and tE3. The main material consisted of 1018 singleton pregnancies with known term, who would not have undergone estriol (E3) measurement had it not been for this investigation. The study was carried out prospectively, and the obstetricians had no knowledge of the E3 values in the screened pregnancies. When at least one of the ucE3 values was low, the risk of having a small for gestational age (SGA) infant was 22%. Low tE3 implied a 27% risk. When both were low, the risk of a SGA infant was 54%. The percentages of SGA infants found were 18, 19, and 12%, when ucE3, tE3, or both respectively, were low. ucE3 does not appear to be superior to tE3. From the predictive values found in this study, screening of a total obstetric population with ucE3 and/or tE3 cannot be recommended.
PIROXICAM IN THE TREATMENT OF PRIMARY DYSMENORRHEA
Authors: Wilhelmsson L. , Jonsson K. , Hailing L. , Hermann M. , Jäderling J. , Lindell C. , Nilsson B. , Sannum F. , Haglund A.
Published: December 2009

Abstract. In double‐blind, crossover studies, piroxicam was compared with naproxen sodium and with placebo. The different parameters studied were pain intensity, patient's opinion of the drugs tested, complementary pharmacological treatment, ability to work, overall effect, treatment preference, and side effects. It was concluded that piroxicam was comparable to naproxen sodium and that piroxicam was significantly better than placebo, as regards these parameters. It was also concluded that piroxicam has an effect equivalent to that of naproxen sodium, an accepted treatment for dysmenorrhea.
INTRA‐UTERINE FETAL DEATH AND THROMBOSIS OF THE UMBILICAL VESSELS
Authors: Kristiansen Frank Vous , Nielsen Vibeke Thue
Published: December 2009

Abstract. Intra‐uterine fetal death associated with thrombosis of the umbilical cord vessels is a rarely described condition. Three cases are now reported and the possible genesis of the thrombosis is discussed, with particular regard to the significance of disturbances in the fetal circulation.
A PROSPECTIVE STUDY OF DRUG USE, SMOKING AND CONTRACEPTIVES DURING EARLY PREGNANCY
Authors: Sandahl BjøRn
Published: December 2009

Abstract. In a prospective study, 2436 women were interviewed regarding contraceptive technique used before pregnancy, on drug use, exposure to X‐rays, smoking habits, and vaginal bleeding during the first 17 weeks of pregnancy. The study was conducted in Malmö during 1979 and early 1980. The study, compared with two similar Swedish studies made in 1963–65 in Malmö and a multicenter study from 1973–74, shows a drastic reduction of psychotropic drug use, from 13.5% to 3.0% and of hormone use from 3.7% to 1.1%. The use of analgetics, however, shows an increase, from 27% to 60.7%. For antibiotic and antihistamine use there is little or no difference. The study shows no connection between drug use and fetal malformation. Smoking habits have changed – the number of non‐smokers is the same but the proportion of heavy smokers (more than 10 cigs/day) has decreased from 8.9% to 1.5%. 18 (0.8%) women become pregnant while using oral contraceptives and 13 (0.5%) with an IUD in place.
HISTOMETRY OF THE PLACENTAL STRUCTURES INVOLVED IN THE RESPIRATORY INTERCHANGE
Authors: Cabezón C. , De la Fuente F. , Jurado M. , López G.
Published: December 2009

Abstract. Employing a stereometric technique, we determined the following parameters in six normal term placentae: respiratory area (total surface area of vasculo‐syncytial membranes); total villous surface area; proportion of respiratory area (percentage fraction of villous surface that corresponds to the respiratory area). The value of each of these parameters was studied in each placental sample, as well as their distribution in the different placental zones, considered according to their distance from the placental rim. All parameters were distributed heterogeneously throughout the peripheral, intermediate and central zones of the placentae studied.

The same parameters were also measured along the full thickness of the placenta, considering subchorial, middle and basal levels. All parameters were homogeneously distributed along the thickness of the placenta. We discuss the functional implications of our findings.

Villous surface area values ranged from 8.6 to 13.3 m2 (mean = 10.9 m2). Respiratory areas ranged from 0.97 to 2.43 m2 (mean = 1.57 m2). Between 1:10 and 1:5 of the villous surface area corresponded to the respiratory area.
PSYCHOGENIC STRESS IN WOMEN DURING FETAL MONITORING (HORMONAL PROFILE)
Authors: Shalev Eliezer , Eran Ahron , Harpaz‐Kerpel Shmuel , Zuckerman Henryk
Published: December 2009

Abstract. The influence of fetal heart rate monitoring on endocrinological parameters (growth hormone, insulin, cor‐tisol, dopamine, epinephrine and norepinephrine) for stress was tested in women during pregnancy and in labor. Significant increases in the levels of all hormones except dopamine were found during monitoring in women with the non‐stress test in comparison with the control group. Increases of more than 50% in the level of all hormones were found during labor with or without monitoring, reflecting stress during labor. The implication of fetal heart rate monitoring on the emotional state of the pregnant woman must be taken seriously.
ELEVATED SERUM α‐HYDROXYBUTYRATE DEHYDROGENASE IN PATIENTS WITH OVARIAN CARCINOMA
Authors: Kikuchi Yoshihiro , Momose Eiko , Kizawa Isao , Kuki Eiichi , Kato Koichi
Published: December 2009

Abstract. To differentiate between ovarian carcinoma and benign ovarian tumor, we compared a‐hydroxybutyrate de‐hydrogenase (HBD), lactate dehydrogenase (LDH) and its isoenzyme activities in serum in 115 patients with ovarian carcinoma and benign ovarian tumor. Both serum HBD activity and total LDH activity in ovarian cancer patients were significantly (p< 0.001) higher than that in patients with benign ovarian tumor. From analysis of serum LDH isoen‐zymes, a significant decrease in LDH‐1, and significant increases in LDH‐4 and LDH‐5 in ovarian cancer patients were observed, when compared with those in patients with benign ovarian tumor. When the ovarian cancer mass could be removed surgically, a significant decrease in the HBD was observed, suggesting that the HBD might fairly reflect the tumor burden. Serum HBD activities in a half of ovarian cancer patients were higher than the mean + 2 SD of those in benign control subjects.
PREDISPOSING AND RISK FACTORS OF UMBILICAL CORD PROLAPSE
Authors: Ylä‐Outinen Ari , Heinonen Pentti K. , Tuimala Risto
Published: December 2009

Abstract. Altogether 117 deliveries (0.14%) out of 82 308 were complicated by umbilical cord prolapse (UCP) in the obstetrical department of Tampere University Central Hospital in the period 1962–81. The gross perinatal mortality rate in the present study was 16.2%, but during the last 5‐year period the incidence of UCP (0.09%) as well as the perinatal mortality rate (5.9%) declined significantly. UCP seemed to be more prevalent during the first half of the year. The most prominent precipitating factors for the occurrence of UCP seemed to be abnormal presentation, multiple pregnancy, low birth weight, and multiparity. Amnio‐tomy seemed not to increase the risk for UCP. Diminished perinatal mortality figures were closely associated with increased cesarean section rates in the management of deliveries complicated by UCP. Cesarean section is therefore recommended as the treatment of choice for deliveries complicated by UCP.
THE DECLINE IN MATERNAL MORTALITY IN SWEDEN, 1931–1980
Authors: Högberg Ulf , Joelsson Ingemar
Published: December 2009

Abstract. Maternal mortality in Sweden has declined steeply over the past 50 years. The reasons for this gratifying trend have been analysed. A decreasing incidence of complications during pregnancy and delivery, together with a lower case fatality rate from complications have been found to account for the the major part of the reduction in maternal mortality in Sweden. This has been achieved by improvements in obstetrical and antenatal care, by the introduction of antibiotics and blood transfusion, and by a favorable shift to more appropriate ages for reproduction.
RELIEF OF PRIMARY DYSMENORRHEA BY TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION
Authors: Lundeberg T. , Bondesson L. , Lundströom V.
Published: December 2009

Abstract. in this study we describe the use of high‐frequency transcutaneous electrical nerve stimulation (TENS) (100 Hz) and low‐frequency TENS (lf‐TENS) (2 Hz trains) as compared with placebo‐TENS (p‐TENS) in a group of 21 patients suffering from primary dysmenorrhea. Naloxone, a relatively pure opiate antagonist, was an additional test administered to 6 volunteer patients who had experienced an alleviation of pain with TENS. As will be seen, 14 out of 21 patients receiving high‐frequency TENS (hf‐TENS) experienced a pain reduction exceeding 50% of its original intensity. During lf‐TENS or p‐TENS, only 7 and 5 patients, respectively, obtained pain relief exceeding 50%. in 4 out of 6 volunteer patients, the relief of pain obtained with lf‐TENS was counteracted by naloxone, whereas the relief experienced with hf‐TENS in the same patients was, in general, unaffected by naloxone.
MATERNAL‐SERUM‐ALPHAFETOPROTEIN SCREENING FOR FETAL MALFORMATIONS IN 28062 PREGNANCIES
Authors: Norgaard‐Pedersen Bent , Bagger Peter , Bang Jens , Fischer‐Rasmussen Wiggo , Gad Claus , Hasch Ernst , Helkjær Poul‐Erik , Jacobsen Jens Christian , Kjeldsen Jens , Kjærsgaard Erik , Petersen Peter Lund , Philip John , Thisted Jørgen , Toftager‐Larsen Kim
Published: December 2009

Abstract. From 1st March, 1980 and up to 29th February 1984 a multicenter serum α‐fetoprotein (S‐AFP) screening project was carried out for the detection of severe fetal malformations. S‐AFP was determined by a radio‐immunoas‐say in 28062 pregnant women between the 16th and 20th week of gestation. Patients with elevated S‐AFP values, e.g. above 95 percentile, were examined further with a second S‐AFP and by ultrasound scan. 244 amniocenteses (0.9%) were carried out to detect 62 malformations (21 anen‐cephalies, 14 spina bifidas, 2 encephaloceles, 7 omphaloceles, 5 gastroschises, 4 chromosome abnormalities and 9 other malformations). Fifteen of the 16 cases of spina bifida could not be verified by ultrasound scan, whereas all other malformations except chromosome abnormalities were confirmed by ultrasonography. Two cases of spina bifida and one case of skin‐covered encephalocele had normal S‐AFP concentrations and were therefore not detected. There were no definitive false‐positives, e.g. therapeutic abortion of a normal fetus. Our conclusion is that a nationwide S‐AFP screening should be recommended.
DOXYCYCLINE IN HUMAN OVIDUCT MUCOSA AND PLASMA 24–30 HOURS AFTER AN ORAL DOSE OF 100 MG
Authors: Brihmer Christina , Brundin Jan
Published: December 2009

Abstract. Oviductal and peripheral plasma concentrations 24 hours after the last dose of Doxycycline (DC) were studied in 17 patients. the concentration of DC in healthy oviduct raucosa was 1.3 μg/g (range 0.6–1.7) and 1.1 μg/ml (range 0.6– 1.7) in plasma. One patient with severe chronic salpingitis in acute exacerbation showed 3.6 μg/g in tissue and 2.4 μg/ml in plasma in proliferative phase.
AMNIOCENTESIS IN TREATMENT OF ACUTE POLYHYDRAMNIOSIS IN TWIN PREGNANCIES
Authors: Montan Sven , Jörgensen Connie , Sjöberg Nils‐Otto
Published: December 2009

Abstract. A rare complication in twin pregnancy is acute polyhydramniosis. If left untreated, the perinatal mortality is 100%. the clinical courses of two cases treated with ultrasound‐guided amniocentesis are presented. in the first case altogether 4 87S ml amniotic fluid was drained. Both twins died within the first 24 hours of life after delivery in gestational week 26. in the second case 2 150 ml amniotic fluid was drained. Both twins survived and were delivered in good condition in gestational week 35. We recommend ultrasound‐guided amniocentesis to be performed in twin pregnancy affected by acute polyhydramniosis.
A Comparative Crossover Study of Piroxicam vs. Mefenamic Acid and Diclofenac in France
Authors: Serfaty David
Published: December 2009

A multicenter open crossover study compared piroxicam and mefenamic acid and piroxicam and diclofenac in the treatment of primary dysmenorrhea in 91 patients. Piroxicam 40 mg/day for two days followed by 20 mg/day was compared with mefenamic acid 500 mg t.i.d. and diclofenac 50 mg b.i.d. for two menstrual cycles on each drug. Assessment of efficacy found that piroxicam was more effective than either comparative drug. All three agents were well tolerated. It is concluded that piroxicam is a safe and effective drug for the treatment of primary dysmenorrhea.
MENOPAUSAL AGE AND RISK OF CARDIOVASCULAR DISEASE AND DEATH
Authors: Lapidus Leif , Bengtsson Calle , Lindquist Olof
Published: December 2009

Abstract. A longitudinal population study of 1 462 women initially aged 38‐60 has been proceeding in Gothenburg, Sweden since 1968. The results presented in this paper deal with menopausal age in relation to cardiovascular disease and overall mortality and refer to the initial 12‐year follow‐up period. The risk ratios concerning early menopausal age for all the various cardiovascular end‐points studied were increased, except for new events of ECG changes suggestive of ischaemic heart disease. However, none of the risk ratios studied between menopausal age on the one hand and the 12‐year incidences of myocardial infarction, angina pectoris, or stroke, on the other, was significantly increased when women who had reached the menopause at the age of 40, 45, or 50 were compared with the rest of the participants in the population study. When early menopause was related to the overall mortality, the risk ratio was increased only for women who had reached the menopause at the age of 50, but not sufficiently to be statistically significant. When reviewing the literature, it is obvious that the results from previous studies are discrepant and do not permit of any generalized conclusion as to whether there is a correlation between early menopause and ischaemic heart disease or not. Nor is our longitudinal study conclusive in this respect.
RELATIONSHIPS BETWEEN THE MENOPAUSE AND RISK FACTORS FOR ISCHAEMIC HEART DISEASE
Authors: Lindquist Olof , Bengtsson Calle , Lapidus Leif
Published: December 2009

Abstract. There are still contradictory opinions as to whether there is an association between menopausal age and ischaemic heart disease or not. There is, however, no doubt about the existence of a number of relationships between menstrual status and different risk factors for ischaemic heart disease. Thus, smoking will give rise to an earlier menopause, while the menopause will give rise to increased serum cholesterol and serum triglyceride levels but seems to influence arterial blood pressure and body weight in the opposite way. The relationships between the menopause and risk factors for ischaemic heart disease are complex, which may be one reason for the contradictory results when relating menopausal age to the incidence of ischaemic heart disease.
ON THE ROLE OF ESTRADIOL AND PROGESTERONE IN PARTURITION
Authors: Batra Satish
Published: December 2009

Abstract. Ever since Csapo (1) presented his progesterone block theory the plasma concentration of progesterone and estradiol has been rigorously studied by a series of investigators. Although some experimental evidence in animals supports this hypothesis, the results of studies in man do not (2, 3, 4). On the other hand it is more reasonable to think that the biological activity of the hormones will be governed by the concentrations in the tissue. Recent data from studies in man, rabbit and guinea‐pig in this laboratory clearly showed that plasma concentrations of estradiol and progesterone were poorly reflected in the myometrium (see 5 for reference). Another interesting feature that was revealed by this comparative analysis was that during pregnancy the concentration of progesterone in the human myometrium was 50 to 100 times greater than that in the guinea‐pig myometrium in spite of similar concentrations in the plasma in the two species (5). These observations led us to read‐dress the question of the role of progesterone in the maintenance of pregnancy.

On the basis of extensive data obtained in the past few years mainly in this laboratory (see 5, 6, 7), I propose that the major function of progesterone in pregnancy is to lower estradiol concentration in the myometrium, leading to a higher progesterone/estradiol (P/E2) ratio which in turn is required for the maintenance of pregnancy. The regulation or rather the lowering of estradiol concentration in the myometrium by progesterone is probably achieved by an inhibitory action of progesterone on estrogen receptor synthesis (7, 8, 9). In the guinea‐pig and also to a great extent in the rabbit, uterine estradiol during pregnancy is low due to a low estradiol concentration in the plasma (5). The need for inhibition of estradiol receptor synthesis in these species in contrast to man therefore does not arise. It may not seem surprising then that almost all of the plasma progesterone in the pregnant guinea‐pig is prevented from entering the uterus by virtue of its complete binding to the progesterone‐binding globulin (5). This may in fact be an added but important function of progesterone‐binding globulin which to my knowledge is found specifically in the pregnant guinea‐pig circulation (5).
PERITONEAL TUBERCULOSIS IMITATING OVARIAN CARCINOMA “SPECIAL CATEGORY”
Authors: Lachman E. , Moodley J. , Pitsoe S. B.
Published: December 2009

Abstract. A case report, of a patient with peritoneal tuberculosis in whom the provisional diagnosis of ovarian carcinoma—“special category” was made is presented. As most gynecologists see hardly any cases of peritoneal tuberculosis nowadays, this possible diagnosis—which should always be considered—is reviewed. It illustrates the importance of a definite histopathological diagnosis.
Menstruation Span – a Time‐Limited Risk Factor for Endometrial Carcinoma
Authors: Pettersson Birgitta , Adami Hans‐Olov , Bergström Reinhold , Johansson Elof D. B.
Published: December 2009

A case‐control study was undertaken to investigate the influence of reproductive factors on the risk of developing endometrial carcinoma. The study comprised 254 women with newly diagnosed endometrial carcinoma, resident in a defined geographical area, and 254 age‐matched population controls. Nulliparity and late menopause were positively associated with endometrial carcinoma. Each additional full‐term pregnancy resulted in a decrease in the risk by 16%. The importance of parity and menopausal age decreased with increasing life span, and in women older than 69 years these two variables did not discriminate significantly between cases and controls. The calculated number of years of menstruation (the “menstruation span”) was used as a combined measure of the impact of parity, age at menarche and age at menopause on the risk of developing endometrial carcinoma. The patients had a significantly longer mean menstruation span than the controls (33.6 versus 31.2 years; p<0.001) and a longer span than 39 years gave a 4.2 times higher risk than one shorter than 25 years. It is suggested that the total length of time for which a woman is exposed to unopposed estrogen is important and that the effect of this hormonal influence is time‐limited.
Postmenopausal Tuberculous Cervicitis
Authors: Tang Lawrence C.H.
Published: December 2009

A patient with tuberculosis of the cervix who presented with postmenopausal bleeding is reported and the literature is reviewed.
Inhibition by plant herb extracts of steroid bindings in uterus, liver and serum of the rabbit
Authors: Tamaya T. , Sato S. , Okada H.
Published: December 2009

To assess the action of herb extracts, glycyrrhizin and paeoniflorin, upon steroids, their binding to several classes of intracellular and serum steroid‐binding proteins was studied in the rabbit. Glycyrrhizin and paeoniflorin exhibited similar binding behaviors. They bound minimally to estrogen and androgen receptors, but not to the progesterone receptor in uterine cytosol, and exhibited a moderate binding activity to glucocorticoid receptors in liver cytosol. They also exhibited weak binding activity to both cortico‐steroid‐binding globulin and sex‐hormone‐binding globulin.
Relationships among maternal and fetal amino acid blood concentrations and amniotic fluid amino acid levels in pregnant rhesus monkeys
Authors: Pueschel S. M. , Boylan J. M. , Jackson B. T. , Piasecki G. J. , Cha C‐J.
Published: December 2009

This study was designed to explore relationships among maternal and fetal amino acid blood concentrations and amniotic fluid amino acid levels in pregnant rhesus monkeys. Although there was no constant pattern for all amino acids in the three body fluids, we observed specific patterns for most neutral amino acids, imino acids, and acidic amino acids relative to their concentrations in maternal blood, fetal blood, and amniotic fluid. Moreover, there was no correlation between fetal phenylalanine blood levels and phenylalanine concentrations in amniotic fluid indicating that amniotic fluid phenylalanine levels would not be useful to monitor fetal phenylalanine blood concentrations during pregnancy.