bluuebunny/crossref_metadata_2025 huggingface dataset:
Uterine Malignancy Developing after Long Term Use of IUCD Additional Report of 2 Cases: Endometrial Stromal Sarcoma and Leiomyosarcoma
Authors: Hsu Chien‐Tien , Hsu Mei‐Lien , Hsieh Tung‐Ming , Lin Chung‐Tsung , Wang Tai‐Te , Lin Yun‐Nan
Published: August 2010

In our 2 previous papers published in this Journal, we had 5 cases of uterine malignancies developing after long term use of IUCD's. In the present paper 2 cases of such association are to be added. One case ATH with right adnexectomy was performed for persisting vaginal bleeding after 22 years of Lippes Loop application and recurrence 8 years after the first operation. Pathological diagnosis is endometrial stromal sarcoma. The other case is a leiomyosarcoma developing after 25 years of Lippes Loop application. Although no cause and effect relationship between IUCD use and uterine malignancy in human beings has been proved, the increase in such cases suggests to us that long term application should be avoided, particularly in view of the positive animal experiments. The successive detection of such cases in a relatively short period of time prompts us to make further studies to gain a deeper insight into such associations.
The Attitudes of Doctors and Students Towards a Genetic Service in an Asian Country: Sri Lanka
Authors: Jayasekara Rohan W.
Published: August 2010

A study comparing the views on the acceptance of a genetic service of 302 doctors and 143 final year medical students from Colombo, Sri Lanka, showed both groups have strong positive views on the provision and use of genetic counselling, prenatal diagnosis of genetic disorders and therapeutic abortion. The students responded with greater restraint possibly due to being a younger cohort with less clinical experience. Both groups, however, showed little support for the use of prenatal diagnosis purely to determine fetal sex.
RU 486 Mediated Leukocytic Inflammatory Reaction at the Utero‐Placental Interface
Authors: Sinosich Michael J. , Wolf Jean P. , Williams Robert F. , Hodgen Gary D.
Published: August 2010

Placentae obtained from RU 486 treated cynomolgus monkeys, with successful pregnancy outcome, could not be distinguished, by microscopic or macroscopic examination, from normal placental morphology of untreated females. However, circulating PAPP‐A levels were markedly depressed in RU 486 treated (114.8±13.1 IU/l) than in control animals (477.2±150 IU/l), suggesting compromised placental physiology. Microscopic examination of placental tissue obtained from animals with fetal demise, after RU 486 administration, revealed pathological changes. When fetal demise occurred recently (<24 h), active villus destruction by infiltrating polymorphonuclear leukocytes was readily observed. Whereas aqueous extracts of placentae, whether obtained by cesarean section or spontaneous delivery, inhibited neutrophil elastase (HGE) activity, extracts of placenta being degraded by host phagocytic‐proteolytic defense system were rich in HGE activity. Thus suggesting that parturition was not mediated by leukocyte lysosomal proteases, such as HGE, and that hemochorrially implanted placentae produce PAPP‐A, a specific inhibitor of HGE. Administration of RU 486 decreased placental PAPP‐A production and secretion, culminating with a neutrophilic infiltration into placental intervillous blood spaces, destruction of villus structure and fetal demise.
Lectin Binding in Tissues from Hydatidiform Mole, Invasive Mole and Choriocarcinoma to Concanavalin‐A, Wheat Germ Agglutinin and Peanut Agglutinin
Authors: Juan Filomena T. Santiago‐San , Hoshina Makoto , Manalo Augusto M. , Mochizuki Matsuto
Published: August 2010

A light microscopic analysis of lectin receptors in normal placenta and trophoblastic disease was performed utilizing biotinylated Concanavalin‐A (Con‐A), wheat germ agglutinin (WGA), and peanut agglutinin (PNA), in conjunction with an avidin‐biotin peroxidase complex. Hydatidiform mole, invasive mole and choriocarcinoma exhibited increased receptors to Con‐A and WGA compared to normal placenta. Increased reactivity to Con‐A and WGA was associated merely with increased growth and proliferation of trophoblasts rather than a malignant transformation. Normal placenta, partial and complete mole generally showed moderate to strong binding with PNA after neuramidase treatment, while invasive mole and choriocarcinoma (11 of 15 cases) generally showed minimal to absent reaction with PNA. Heterogeneity of PNA binding in choriocarcinoma was manifested by the presence of PNA reactivity in the trophoblast membrane in 2 cases wherein no prior neuramidase treatment was given. This suggests that in some malignant trophoblasts, there is absence of sialic acid in the terminal cell surface carbohydrate groups resulting in the exposure of N‐acetylgalactoseamine.
Fitz‐Hugh‐Curtis Syndrome: Three Cases Confirmed by Laparoscopy
Authors: Toki Toshihiko , Hoshiai Hiroshi , Chan Wai‐Ip , Yajima Akira
Published: August 2010

There were 3 cases of Fitz‐Hugh‐Curtis syndrome,—pelvic inflammatory disease (PID) complications and perihepatitis,—caused by Chlamydia trachomatis infection. All 3 patients complained of sudden right upper quadrant pain in addition to PID symptoms. Enzyme immunoassay of uterine cervical specimens revealed that the positive chlamydial antigen and serum antibody titer against anti‐Chlamydia trachomatis were also high. In all cases the laparoscopy revealed findings of perihepatitis on the anterior surface of the right hepatic lobe. In 2 cases, typical violin‐string adhesions were also observed between the liver capsule and parietal peritoneum. In both cases, adhesiolysis was conducted during the laparoscopy.
Non‐Hodgkin's Lymphoma of the Ovaries and Appendix: A Case Report
Authors: Chawla Nirja , Dhaliwal Lakhbir Kaur , Gopalan Sarala , Rajwanshi Arvind
Published: August 2010

Involvement of the female genital tract by non‐Hodgkin's lymphoma is extremely rare. Here is the report of a patient who presented as a bilateral malignant ovarian tumour and was diagnosed by laparotomy and subsequent histopathology to have non‐Hodgkin's lymphoma of both ovaries and appendix. The patient had radical surgery followed by multiagent chemotherapy and is alive without disease at one year of follow‐up.
Excessive Physical Work during Pregnancy and Birth Weight
Authors: Hassan Talat J. , Ibrahim Khushnaseeb , Jabarey Sadiqua N.
Published: August 2010

The effect of excessive physical work during pregnancy on birth weight was studied in 329 full term pregnant mothers with no complication of pregnancy and no associated disease delivering at Jinnah Postgraduate Medical Centre, Karachi. Birth weight was influenced by excessive physical work amongst mothers on diet defecient in calories according to calorie allowance recommended by WHO2 but not in mothers on recommended calories.
Pseudo‐Meigs' Syndrome Secondary to Broad Ligament Leiomyoma: A Case Report
Authors: Buckshee Kamal , Dhond Abhay J. , Mittal Suneeta , Bose Shikha
Published: August 2010

An unusual and rare case of broad ligament leiomyoma with massive ascites and bilateral pleural effusion is described. The ascites and pleural effusion resolved dramatically following removal of the tumor. Patients with pseudo‐Meigs' syndrome may present a diagnostic problem as they masquerade as carcinoma with malignant effusions. Thus they should always be considered for exploratory laparotomy.
Maternal Mortality: A Report from a University Hospital in Ankara
Authors: Ayhan Ali , Tuncer Z. Selçuk , Bilgin Filiz , Gürgan Timur
Published: August 2010

Maternal mortality was found to be 140 deaths per 100,000 live births in Hacettepe University Hospital. Infection, hemorrhage and cardiac disease were still the leading causes of maternal deaths. It is possible to reduce the maternal mortality due to these largely preventable causes if standards of care and treatment are raised to a higher level throughout the country.
Is Mucaine an Appropriate Medication for the Relief of Heartburn during Pregnancy?
Authors: Kovacs Gabor T. , Campbell John , Francis David , Hill David , Adena Michael A.
Published: August 2010

A double blind comparative study comparing Mucaine, Mucaine without oxethazaine, and placebo was carried out with 50 patients with symptoms of heartburn during late pregnancy.

We found that the 2 active treatments were more effective than placebo for the relief of heartburn, but there was no statistically significant difference between groups for the relief of nausea and regurgitation.

There was a significant difference in the percentage of days of use of each medication, with the placebo being used least frequently. Although not statistically significant, for the 3 measures for which placebo differed from the active treatments, patients showed a better response to mucaine. This suggests that the addition of oxethazaine may be of benefit. The lack of statistical significance may be due to the relatively small number of cases, and the findings are promising.

No side effects were recorded for any treatment.
Clinicostatistical Study of Low Potential Malignancy Ovarian Cystadenoma (Borderline Cases)
Authors: Shiromizu Kenji , Kawana Takashi , Sugase Motoyasu , Izumi Rikuichi , Mizuno Masahiko
Published: August 2010

The number of ovarian cystadenoma of low potential malignancy (abbreviation: LPM) was 31 (5.7%) among common epithelial tumors [benign cystadenoma=400 (74.0%), carcinoma=110 (20.3%)]. Their mean ages, bilaterality, frequency of ascites and nulligravidity were situated intermediately between those of benign cystadenoma and carcinoma. Abdominal tumor, distention, pain and metromenorrhagia were the main symptoms, although gastrointestinal complaints were rare in LPM cystadenoma. With LPM cystadenoma, 19 (61.3%) patients were at stage I, 7 (22.6%) at stage II and 5 (16.1%) at stage III, but with carcinoma, 44 (40.0%) were at stage III‐IV [33 (30.0%) at stage I, and 31 (28,2%) at stage II]. The 5‐year actuarial survival rate was 90% for LPM cystadenoma, but 43% for carcinoma. These results suggest that the clinical and biological features as well as the histological definition of LPM cystadenoma are situated intermediately between those of benign cystadenoma and carcinoma.
Postmenopausal Sexuality in Thai Women*
Authors: Tungphaisal Somchai , Chandeying Verapol , Sutthijumroon Sonthit , Krisanapan Oermporn , Udomratn Pichet
Published: August 2010

We evaluate sexuality in 100 natural menopausal women as pertains to hormones, symptoms related to intercourse, and marital relationship with sexual desire, orgasm and coital frequency. The mean age was 56.8 years while menopausal age was 50.3 years. The postmenopausal syndrome presented 55.0% occurring 1 to 7 years after menopause (mean 3.4 years). The common sexual problems after menopause were loss of libido, orgasmic dysfunction, and dyspareunia. Both sexual desire and activity decreased when compared with premenopausal period. Ninety percent of the subjects had sexual desire less than once a month. Only 14% of the subjects occasionally reached orgasm while the other 86% never had orgasm after menopause. The levels of FSH, LH, estradiol and testosterone were also reported. There was no correlation of hormone estradiol and testosterone, symptoms related to intercourse and marital relationship with sexual desire, orgasm, or coital frequency.
Plasma Vitamin A and Carotene in Maternal and Cord Blood
Authors: Ibrahim Khushnaseeb , Hassan Talat J. , Jafarey Sadiqua N.
Published: August 2010

Mean plasma vitamin A and carotene levels in 200 pregnant women at term were 30.3 mcg% and 43.6 mcg%. Sixty‐four percent of women had vitamin A in lower limit of normal (<33 mcg%) and 26% had deficient and low levels of carotene.

Mean values of plasma vitamin A and carotene in cord blood was 13.7 mcg% and 16.5 mcg%, respectively, and lower than that of maternal blood at term.

Women who had adequate levels of vitamin A (>33 mcg%) in blood had significantlyhigher intake of vitamin A. Similarly the newborn babies of those mothers who had adequate levels of vitamin A had significantly higher levels of vitamin A than those of mothers who had inadequate levels (<33 mcg%).
Local Thermo‐Radiotherapy in Carcinoma Cervix: Improved Local Control versus Increased Incidence of Distant Metastasis
Authors: Sharma Sanjiv , Singhal Sandeep , Sandhu A.P.S. , Ghoshal Sushmita , Gupta B. D. , Yadav N. S.
Published: August 2010

In 1986, 50 patients with stages II and III carcinoma of the cervix were entered into this prospective randomized study. Twenty‐five cases (Group I) were treated only by radical radiation whereas remaining 25 cases (Group II) received local hyperthermia in addition to radical radiation. Hyperthermia was delivered by intracavitary brachyhyperthermia approach using an endotract applicator. Both the groups were followed up for a minimum period of 18 months. Group II patients achieved better local control (14 out of 20 evaluable cases) than the Group I patients (11 out of 22 evaluable cases). A disturbing observation was the increased incidence of distant metastasis in Group II (4 out of 23 cases) as compared to Group I (1 out of 23 cases), though most of them remained disease free locally. The increasing use of hyperthermia in the management of various cancers needs to be reviewed in this context.
Clinicostatistical Study of Ovarian Tumors of Germ Cell Origin
Authors: Shiromizu Kenji , Kawana Takashi , Sugase Motoyasu , Izumi Rikuichi , Mizuno Masahiko
Published: August 2010

Ovarian tumors of germ cell origin consisted of 440 dermoid cysts, 5 struma ovariis, 3 immature teratomas (G1, G2), 2 carcinoids, 8 dysgerminoma, 3 yolk sac tumors, one choriocarcinoma, 4 dermoid cysts with malignant transformation, and one immature teratoma (G3) of a total of 1,387 ovarian tumors. The patients' mean ages ranged between 17.3 years to 31.9 years, but the mean ages of those with carcinoid and dermoid cyst with malignant transformation were 46.0 and 53.0 years, respectively. In dermoid cyst bilaterality was 17.3% and occurrence during pregnancy or puerperium was 19.6%. In benign tumors, torsion of pedicle and association with pregnancy or puerperium were frequent unlike common epithelial carcinoma, but ascites was rare. Abdominal tumor, pain and metromenorrphagia were the main symptoms, but abdominal distension was scarce with dermoid cysts. The rate of malignant transformation of dermoid cysts was 0.9% overall but 4.3% in patients over 40 years. The prognosis for borderline germ cell tumors was good.
Vitamin A Status of Pregnant Women in Five Districts of Sri Lanka
Authors: Jayasekera J.P.D.J.S. , Atukorala T. M. Sunethra , Seneviratne H. R.
Published: August 2010

Vitamin A status was assessed in early and late stages of pregnancy in 496 pregnant women living in Colombo, Kurunegala, Kegalle, Badulla and Galle districts, using clinical, dietary and biochemical parameters. Serum vitamin A concentration was determined by a fluorometric method and the retinol binding protein concentration by radial immunodiffusion.

The serum vitamin A levels of subjects in the lowest socioeconomic group in Galle and Kegalle districts were significantly lower than those living in Colombo. The percentage of subjects having serum vitamin A levels less than 20 μg/dl, increased in late pregnancy in all areas, with the highest value (27.8%) in the Galle district. None of the subjects had severe ocular manifestations of vitamin A deficiency. The higher incidence of subclinical vitamin A deficiency noted among subjects in Galle and Kegalle districts could be attributed at least in part to a low dietary intake of vitamin A and carotenoids.
Depressed Skull Fracture in a Newborn Successfully Managed Conservatively: A Case Report
Authors: Lim C. T. , Koh M. T. , Sivanesaratnam V.
Published: August 2010

A preterm baby was born to a multiparous mother by emergency caesarean section at 36 weeks of gestation. Apart from a depression on the right temporo‐parietal region measuring 3 cm × 3 cm × 0.5 cm, no other abnormality was noted. A CT scan of the brain excluded the presence of intracranial haematoma and pressure effect on the brain. Spontaneous reduction of the fracture without any adverse neurological sequelae suggests that these fractures can be managed conservatively in some instances.
Ovarian Tumors in the Second Decade of Life
Authors: Vani Ramkumar , Kuntal Rao , Rao P.L.N.G.
Published: August 2010

A study of 28 adolescents aged 10–20 years admitted with ovarian tumors during a 5‐year period revealed that 75% had malignant ovarian tumors, with germ cell tumors being most frequent. The high incidence of malignancy was due to our hospital being a referral centre. One case of mixed germ cell tumor (mainly choriocarcinoma) presented with precocious puberty, and one case of arrhenoblastoma showed signs of virilization. Tumor markers were found useful in diagnosing choriocarcinoma and endodermal sinus tumor. Amongst the malignant ovarian tumors, the best prognosis was noted with dysgerminomas. Tumors were found more frequently on the right side. Optimal surgery at initial laparotomy, followed by adjuvant chemotherapy or radiotherapy were found to offer the best chance of cure.
Translaparoscopic Tubal Embryo Transfer: Preliminary Experience at National Taiwan University Hospital
Authors: Yang Yu‐Shih , Hwang Jiann‐Loung , Ho Hong‐Nerng , Lien Yih‐Ron , Lin Heng‐Ru , Chiu Yu‐Ho , Lee Tzu‐Yao
Published: August 2010

Forty‐six couples with various causes of infertility were treated by tubal embryo transfer. Oocyte retrievals were carried out under ultrasound guidance transvaginally and embryos were transferred 48 hours later by laparoscopy into fallopian tubes. Totally 52 cycles were stimulated and 45 retrievals were performed with an average of 8.1 oocytes per retrieval. The average fertilization rate was 54.8%. The implantation rate was 23.8% and the pregnancy rate was 53.5% per transfer. The pregnancy rate per transfer was comparable whether 3 or 4 embryos were transferred. Nine (39.1%) of the 23 pregnancies had multiple pregnancies. Six cases (26.1%) aborted in the first trimester and the remaining 17 were ongoing or term delivery.
Effects of Oxytocin Antagonist (dTVT) and Ritodrine on Spontaneous and Oxytocics‐Induced Uterine Contractions in Pregnant Rats
Authors: Chimura Tetsuro
Published: August 2010

The effect of a recently developed oxytocin antagonist dTVT, i.e. deamino‐[2‐D‐tyrosine(OEt)‐4‐threonine‐8‐ornithine] oxytocin on uterine contraction of pregnant rats was studied in vitro. The following results were obtained.

1. dTVT treatment did not affect spontaneous PGE2‐ or PGF2α‐stimulated contraction, while it slightly suppressed PGE1 analogue (Gemeprost)‐stimulated contraction of the uterus.

2. Following treatment with dTVT (5–50 μg/ml), oxytocin‐stimulated uterine contraction was gradually and slowly suppressed, resulting in an attenuation curve. Ritodrine treatment, on the other hand, rapidly suppressed spontaneous uterine contraction as well as contraction stimulated by various oxytocics. Suppression of oxytocin‐stimulated uterine contraction by dTVT took much longer (14.8±1.1 min) to take effect than that by ritodrine (<1 min).
Idiopathic Pulmonary Fibrosis (IPF) Necessitating Therapeutic Midtrimester Abortion: A Case Report
Authors: Sholapurkar Shashikant L. , Vasishta Kala , Dhall Gian I. , Jindal Surinder K.
Published: August 2010

A 35‐year old multiparous lady was admitted at 19 weeks of pregnancy with rapid onset of dyspnoea which progressed to grade III in 2 months. She was diagnosed as a case of idiopathic pulmonary fibrosis (IPF). She had a vital capacity of 1.25 l, 46.5% of predicted and PaO2 of 60 mmHg at rest, dropping to 35 mmHg on mild exercise testing. She did not respond to prednisolone 40 mg daily given orally for one month. In view of lack of improvement, therapeutic abortion was carried out at 24 weeks by abdominal hysterotomy combined with tubal ligation. Subsequent to termination of pregnancy, her clinical status and pulmonary function improved markedly and she had only grade I dyspnoea 30 months later without corticosteroids. Effect of pregnancy on interstitial lung disorders especially IPF is not yet clear beacuse of extreme rarity of their association. Therapeutic abortion should be seriously considered in patients who cannot increase their oxygen consumption 3 times normal without uncorrectable hypoxaemia.
Obstetric Performance in the Elderly Malaysian Primigravida
Authors: Urquhart D. Rennie , Tai Christina
Published: August 2010

The obstetric performance of 240 elderly primigravida delivering at the University Hospital, Kuala Lumpur, Malaysia between January 1987 and February 1990 was compared with a random group of 250 young primigravida delivering during the same time period. The incidence of impaired glucose tolerance, diabetes mellitus, preterm delivery, antepartum haemorrhage and malpresentation was all increased in the elderly primigravida group. The incidence of caesarean section in the older group was 40.4% compared with 6.8% in the younger (p<0.001). Recent studies suggest that the perinatal mortality in women who delay having their first baby until after the age of 35 is not significantly different from the rest of the obstetric population. However, in our own population of elderly primigravida, although not quite reaching statistical significance the perinatal mortality rate of 46 per 1,000 is three times that of primigravida aged 20–25. This may reflect our low induction rate (7.5%) and assisted vaginal delivery rate (8.3%) in those women in this high risk group who are allowed to labour. The implications of these findings are discussed.
Role of Antenatal Care in Reducing Maternal Mortality
Authors: Pandit Ramesh D.
Published: August 2010

Maternal mortality in the developed nations has been considerably reduced, but it still is very high in developing nations. I carried out an indepth study of maternal mortality at N. Wadia Maternity Hospital, Bombay. India, from 1929 to 1988, which revealed that the MMR which was 1920 per 100,000 live births during 1929–1939 period has declined to 82 per 100,000 live births during 1980–1988 period. This achievement in reduction of maternal mortality over the decades was due to multiple factors like increased and effective antenatal, intranatal, and postnatal care. This study shows the apathy of pregnant women to come forward to avail of antenatal care though available even free of charge nearby. To give maximum benefits to pregnant women specially in the developing nations, we have to carry the antenatal care at the doorsteps of the community.
Chorionic Villus Sampling: Evaluation of Obstetric Performance
Authors: Ng Ngee‐Keng , Liu David T. Y.
Published: August 2010

Chorionic villus sampling is frequently utilised in the Nottingham region as a means of early prenatal diagnosis of genetic problems. Its relative safety in the early antenatal period is well established but there has been some concern that perinatal mortality may be greater in the chorionic villus sampling group as compared to am‐niocentesis. We have in response studied our own data and report the obstetric outcome in 144 cases where the pregnancy has progressed beyond 28 weeks gestation. We have selected a procedure free control group matched for parity.

We have found no significant difference in the perinatal outcome and obstetric performance and conclude that at this juncture we should continue to offer our services as chorionic villus sampling offers significant advantages in the first trimester over amniocentesis.
Immunohistochemical Assessment of the Growth Fraction in Cervical Cancers Using the Monoclonal Antibody Ki‐67; Relationship to the Clinical Stage, Histologic Type and DNA Content
Authors: Masuda Tomoyuki , Yabushita Hiromitsu , Sawaguchi Keizo , Noguchi Masayoshi , Nakanishi Masami
Published: August 2010

To assess the growth potential of cervical cancer, cell populations in proliferating cycle (%PC) were examined by an immunohistochemical technique using the monoclonal antibody Ki‐67. The %PC was 31.63+16.61% in 36 cervical cancers and was significantly higher when compared to the 7.8±3.81% found in 24 samples of normal ectocervical tissues. In cervical cancer tissues, the %PC increased in accordance with progression of the clinical stage of the disease, however, the %PC was not different among the various histologic types of invasive cervical cancers. The DNA index also increased in accordance with progression of the clinical stage of cervical cancer, however, there was no correlation between the %PC and the DNA index. These results suggest that the value of %PC obtained using the monoclonal antibody Ki‐67 can be used as a parameter for evaluating the growth activity of cervical cancer and for predicting biological heterogeneity in a tumor.
The Israel Perinatal Census
Authors: Mor‐Yosef Shlomo , Samueloff Arnon , Schenker Joseph G.
Published: August 2010

A nation‐wide perinatal census which included 22,815 deliveries was carried out. The cesarean section rate was 9.6% and the perinatal mortality rate was 13.5/1000. Using a logistic regression analysis the risk factors for cesarean section and for perinatal mortality were ranked. Breech presentation and one uterine scar were found to be the most important risk factors for cesarean section and breech presentation, maternal disease and multiple pregnancy for perinatal mortality.

Low birth weight rate was 6.9% with nonsignificant differences between the various ethnic groups. The national cesarean section rate in breech presentation was 57.8%. It was performed mainly at the extremes of birth weight.

From those with one previous cesarean section 55.1% delivered vaginally and 44.9% abdominally. The chance for vaginal delivery is higher (67.2%) providing the woman had delivered vaginally in the past.

Comparison between primiparae and multiparae showed that preeclampsia, hypertension and diabetes mellitus were all significantly more frequent among older parturients and among primiparae.
Elastase Activity of Endocervical Mucus in Normal Pregnancy*
Authors: Limvarapuss Chainarong , Kanayama Naohiro , Terao Toshihiko
Published: August 2010

Elastase activity of 294 samples of endocervical mucus taken from 125 normal pregnant women during the visits to antenatal clinic were measured. Activity of the enzyme increased gradually with the advance of gestational age. Steep rising of the enzyme was seen between 34–35 weeks of gestation and the peak was achieved at 37 week since then the enzyme activity sustained at relatively high level until deliveries. Average activity of the enzyme after 34 weeks of gestation showed significant difference over that of earlier period. To use delivery date as a referent point, the peak was reached in the last fourth week of pregnancies and then sustained until deliveries. Significantly higher average activity was also seen in these last 4 weeks of gesation. These correlated very well to the fact that cervical maturation progresses most rapidly during last month of pregnancy. Immunohistochemical staining for elastase demonstrated elas‐tase‐containing granules in polymorphonuclear leukocytes. These cells found in cervical tissue taken from immediately postpartal women were much more than in those of early pregnant women. These findings may be the evidences support roles of granulocyte elastase in the process of cervical maturation preceding spontaneous labors in normal pregnancies.
Changes in cAMP‐Dependent Phosphorylation of Specific Cytosol Protein in the Peri‐ and Postmenopausal Ovary
Authors: Ushiroyama Takahisa , Tanigawa Yoshinori , Sugimoto Osamu
Published: August 2010

Changes in cAMP‐dependent phosphorylation of 53 kDa protein in a human ovary with respect to the aging process were studied. The phosphorylation of endogenous proteins in ovarian cytosol decreased with aging. However, ovarian aging was accompanied by an increase in the cAMP‐dependent phosphorylation of 53 kDa specific protein while the amount of this protein decreased with aging.

The plasma gonadotropin levels of women with regular menstrual periods were significantly different from those of women whose menstrual periods had in the recent past become irregular (FSH: p<0.01; LH: p<0.05); however, there was no significant difference in the plasma estradiol levels between these two groups.

Our data show the possible correlations between the non‐steroidal ovarian factor (53 kDa protein) and/or its phosphorylation by cAMP‐dependent protein kinase and the ovarian aging process.
A Case Report: Vesico‐Rectal Fistula with Ano‐Urethral Atresia
Authors: Anandakumar C. , Wong Y. C. , Biswas A. , Venkat A. , Chia D. , Arulkumaran S. , Ratnam S. S.
Published: August 2010

Vesico‐rectal fistula is a rare congenital abnormality causing severe early second trimester oligohydramnios. Prenatal diagnosis of such a case is reported here. Ultrasound diagnosis could be aided by transabdominal amnio‐infusion and, if necessary, fetal intraperitoneal saline instillation. In a karyotypically normal fetus with normal somatic growth, demonstration of normal fetal kidneys together with a functioning urinary bladder, in presence of severe oligohydramnios, is very suggestive of the diagnosis. Since pulmonary hypoplasia is the major cause of neonatal mortality in these cases, restoration of normal amniotic fluid volume by serial amnio‐infusion was attempted. Although amnio‐infusion is an important diagnostic aid in the evaluation of severe midtrimester oligohydramnios, the role of multiple therapeutic amnio‐infusion in improving lung growth remains to be evaluated.
Acute Abdomen Due to Adenomyosis of the Uterus: A Case Report
Authors: Fujino Toshinori , Watanabe Tomoko , Shinmura Ryoji , Hahn Liangping , Nagata Yukihiro , Hasui Kazuhisa
Published: August 2010

A Japanese woman with severe abdominal pain underwent an emergent exploratory laparotomy. Intraperitoneal bleeding from the uterine serosal surface was observed, and a pathologic examination showed that the bleeding was caused by an exudative hemorrhage from the endometrial tissues in the myometrium close to the uterine serosal surface.
Measurement of Serum Rubella Antibody Titers in Korean Children, Female Adolescents, and Pregnant Women
Authors: Lee Im‐Soon , Kim Chang‐Hwi , Lee Sang‐Jhoo , Cho Tai‐Ho
Published: August 2010

IgG antibody titers to rubella virus in serum of 322 nuchal cord blood, 1,473 children, and 1,103 reproductive and pregnant women were detected in Soonchunhyang University Hospital in Korea.

Positive rate of IgG antibody to rubella virus was 86.3% (278/322) in nuchal cord blood, 68.0% (991/1,458) in children. The IgG antibody from the mother disappeared between the 7th to 11th month after birth, and then the positive rate increased as age increased.

In the reproductive age group including pregnant women, positive rate of IgG antibody was 81.8% (894/1,103). Therefore, it was known that there was a possibility that 18.9% of this group would be attacked with rubella in Korea.
The Effects of Glucose Concentration on Early Embryogenesis Using the Whole Embryo Culture System on Rats
Authors: Katase Tsuyoshi , Tetsuo Masahiro , Hamada Teiji , Yakushiji Michiaki
Published: August 2010

In order to investigate the effect of hyperglycemia on fetal teratogenesis, rat embryo culture was performed according to the method of New et al. The effect of hyperglycemia was then studied at glucose concentrations of 300, 600, 900 and 1,200 mg/dl in the medium. The embryos from the high glucose medium (600 mg/dl) had significantly shorter CRLs and fewer somites. Major anomalies characterized by neural lesions and minor anomalies characterized by extraneural lesions increased as the glucose concentration increased. However, fetal growth was promoted with statistical significance in the medium with 300 mg/dl of glucose, where the incidence of malformations remained unchanged as compared to the control group. The findings indicate that the glucose is one of the substantial compounds which influences embryo growth, development and abnormalities, but glucose alone appears to have no major effect on early embryogenesis in diabetic pregnancy.
Thymidylate Synthase Activity in Normal and Malignant Gynecologic Tissues
Authors: Suzuki M. , Ohwada M. , Tamada T.
Published: August 2010

We assayed thymidylate synthase (TS) activity in normal and malignant gynecologic tissues. TS activity in the normal cervix, secretory endometrium, and ovaries from a total of 61 patients was 1.00±0.52pmol/g tissue (mean±SD). Thus the upper limit (mean+2SD) of TS activity in normal gynecologic tissue was 2.00 pmol/g tissue. TS activity was generally higher in malignant tissue than in normal tissue, and particularly high activity was detected in cervical cancer. TS activity in endo‐metrial cancer was relatively low, but activity in poorly and moderately differentiated tumors was significantly elevated compared to well differentiated tumors. These findings suggest that cervical cancer is a highly proliferative tumor and that in endo‐metrial cancer, cell proliferation is more rapid in poorly differentiated tumors than in well differentiated ones.
Combined Examination of Middle Cerebral Artery and Umbilical Artery Flow Velocity Waveforms in Growth‐Retarded Fetuses
Authors: Sekizuka Naoto
Published: August 2010

The resistance index (RI) of middle cerebral artery (MCA) and umbilical artery (UA) flow velocity waveforms (FVWs) were characterized retrospectively in 60 growth‐retarded fetuses in the third trimester of gestation. Reference ranges of MCA‐RI, UA‐RI, and the UA‐RI/MCA‐RI ratio to gestational age were obtained from a cross‐sectional study of 150 healthy fetuses. Growth‐retarded fetuses that developed fetal distress had lower MCA‐RIs, higher UA‐RIs, and higher UA‐RI/MCA‐RI ratios than growth‐retarded fetuses that had good outcomes. The highest sensitivity for fetal distress was observed in the UA‐RI/MCA‐RI ratio (UA‐RI/MCA‐RI 94.1%, MCA‐RI 79.4%, UA‐RI 61.8%), and the highest specificity was in MCA‐RI (MCA‐RI 92.3%, UA‐RI 84.6%, UA‐RI/MCA‐RI 76.9%). In growth‐retarded fetuses, the combined examination of MCA FVWs and UA FVWs was more useful in assessing fetal well‐being than examination of UA FVWs alone.
Outcome of Pregnancy in Patients with Organic Heart Disease in Taiwan
Authors: Hsieh T'sang‐T'ang , Chen Kuang‐Chao , Soong Jin‐Hong
Published: August 2010

A total of 122 pregnancies in 101 women with organic heart disease were reviewed. The incidence of organic heart disease in pregnant women was 0.25%. The ratio of rheumatic to congenital heart disease was 1.0 to 1.5. In the congenital heart disease group, IUGR was more frequent in the cyanotic group as were preterm births. Patients with cyanotic lesions had a significantly higher maternal mortality rate than those with acyanotic lesions. The cyanotic group without surgical correction had a significantly higher maternal mortality rate and more IUGR than those with correction. Congestive heart failure was the most common maternal complication, with a rate of 38.1%. The patients with good cardiac status control during pregnancy developed less IUGR, had fewer preterm births, less maternal morbidity and less maternal mortality than those in poor condition. Patients in functional classes I and II before pregnancy carried less risk of maternal morbidity than those in classes III and IV.
Y Ghromosome Analysis and Laparoscopic Surgery in XY Pure Gonadal Dysgenesis: A Case Report and a Review of Literature
Authors: Tsutsumi Osamu , Iida Taku , Hakuno Naomi , Sadatsuki Miyuki , Okai Takashi , Taketani Yuji , Nagafuchi Shigeo , Nakahori Yutaka
Published: August 2010

DNA analysis and laparoscopic surgery were performed on a patient with 46, XY pure gonadal dysgenesis. Southern‐blot and polymerase chain‐reaction analyses revealed that she had no apparent deletion of the Y chromosome, including the SRY gene (sex‐determining region Y), suggesting that the patient might have some other abnormality. Since the risk of gonadal neoplasia in XY gonadal dysplasia is high, operative laparoscopy was performed to ensure that there was no malignancy in the patient. Laparoscopic surgery is recommended because of the amount of the surgery and the rapid postoperative recovery of the patient.
Synchronous Secretion of LH and Prolactin during the Normal Menstrual Cycle
Authors: Tennekoon Kamani H. , Lenton Elizabeth A.
Published: August 2010

Integrated hourly concentrations of day‐time prolactin and LH showed significant positive correlations (p<0.05‐0.001) on the day of the pre‐ovulatory mid cycle LH surge (n=3) and during the mid luteal phase (n=6) in a group of regularly cyclic women. No correlations between these two hormones were seen during any other stage of the cycle. Consistent significant correlations were not evident between prolactin and oestradiol, prolactin and progesterone, LH and oestradiol or LH and progesterone during any other stage of the cycle.
New Schedule of Intramuscular Iron Administration for Pregnant Women
Authors: Mahale Arun R. , Shah Suni] H.
Published: August 2010

Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group received iron with folic acid orally, other group was given 5 injections of iron dextran spaced 4 weekly. Mean haemoglobin was same for both the groups at the begining (p>0.05). At 36 weeks intramuscular group has shown statistically more haemoglobin rise than oral group (p<0.001). This new intramuscular schedule is found to be convenient, cheap and acceptable to pregnant women. It also assures atleast 5 antenatal checkups to a pregnant woman.
Luteinizing Hormone (LH) Surge in Patients Using Buserelin Spray during Ovarian Stimulation for Assisted Reproduction
Authors: Ho Pak‐Chung , Chan Yuen‐Fai , So Wai‐Ki , Yeung William S. B. , Chan Samuel T. H.
Published: August 2010

The incidence of luteinizing hormone surge was studied in patients who were downregulated with a short protocol of gonadotrophin releasing hormone agonist before ovarian stimulation for assisted reproduction. Buserelin nasal spray 100 μg was given 5 times daily from day 2 of the cycle, followed by ovarian stimulation with human menopausal gonadotrophin and follicle stimulating hormone from day 3 onwards. Of the 159 cycles studied, luteinizing hormone surge was detected in 9 cycles (5.7%). The occurrence of LH surge was usually (67%) but not always associated with a fall in serum oestradiol level before administration of human chorionic gonadotrophin. None of the patients developed luteinizing hormone surge after day 10. Even in patients without luteinizing hormone surge the serum luteinizing hormone levels on the day of administration of hCG were significantly higher than those on day 2 before administration of buserelin. It is concluded that a short protocol with intranasal buserelin 500 μg per day is inadequate to suppress endogenous luteinizing hormone surge.
Origin of CA125 and SCC Antigen in Human Amniotic Fluid*
Authors: Takeshima Nobuhiro , Suminami Yoshinori , Takeda Osamu , Abe Hiroaki , Kato Hiroshi
Published: August 2010

Levels of CA125 and SCC antigen in amniotic fluids were examined in 26 cases. All samples showed high levels of CA125 and SCC antigen. Statistically significant decreases in CA125 (p<0.05) and increases in SCC antigen (p<0.01) from the second to the third trimesters were recognized.

We focused on amnion cells as likely sources of the 2 tumor markers in amniotic fluid. Analysis of in vitro culture of amnion cells and amniotic membranes revealed an accumulation of CA125 and no accumulation of SCC antigen in the culture supernatant. A Northern blot analysis using a cDNA probe of SCC antigen ensured that there was no mRNA expression of SCC antigen in the amnion, the cord or the placenta. It is likely that the amnion is a major source of CA125 in amniotic fluid, and that the fetus is the origin of SCC antigen.
The Effect of Antenatal Administration of Solcoseryl on Hepatic Glycogen Synthesis in Rat Fetuses with Intrauterine Growth Retardation
Authors: Takahashi Hidehiko , Cheng Kuang‐Ming , Araki Tsutomu
Published: August 2010

The effect of antenatal solcoseryl administration on hepatic glycogen synthesis and storage was studied in normal developing and intrauterine growth‐retarded (IUGR) rat fetuses using biochemical analyses.

The maximal effect of solcoseryl occurred 2 hours after administration. The glycogen content of the liver showed a significant increase in normal and IUGR fetuses with antenatal solcoseryl administration compared to their non‐solcoseryl counterparts (p<0.05). The activities of glycogen synthase enzymes, total and active forms, showed significant increases, at p<0.05 and p<0.005, respectively, in IUGR fetuses with antenatal solcoseryl administration. Active synthase also increased in normal fetuses with antenatal solcoseryl administration (p<0.05). There were no significant changes in the activities of glycogen phosphorylase enzyme.

These findings suggest that antenatal solcoseryl administration stimulates hepatic glycogen synthesis and storage in IUGR rat fetuses, and thus might favorably influence the development of neonatal hypoglycemia.
Effects of Epidermal Growth Factor on Mouse Fetal Growth
Authors: Odaka Koji , Hiramatsu Yuji , Eguchi Katsuto , Kudo Takafumi
Published: August 2010

The effects of epidermal growth factor (EGF) on fetal growth were examined in mice. EGF is synthesized in large amounts by the mouse submandibular glands. On the 18th day of gestation, the body weight of fetuses whose mothers had undergone sialoadenectomy (excision of the submandibular glands) was significantly lower than that of controls. However, the maternal‐plasma EGF concentration was not significantly affected by sialoadenectomy. The body weight of fetuses whose mothers were injected with EGF for 7 days during pregnancy was significantly higher than that of controls. Sialoadenectomy altered the blood amino acid concentrations in adult female animals, especially the levels of leucine and isoleucine.

These results suggest that EGF influences fetal growth mainly by regulating maternal nutrition.
The Influence of Semen Quality on the Kinetics of the Acrosome Reaction in Human Spermatozoa in vitro
Authors: Takahashi Kentaro , Kitao Manabu
Published: August 2010

Spontaneous sperm acrosome‐reaction (AR) was examined in washed semen samples of 12 donors with proven fertility and 16 infertile patients who visited the Infertility Clinic of Shimane Medical University Hospital, using fluorescein‐labeled Concan‐avalin A lectin during incubation (37d̀C, 5% CO2) of up to 24 hours. In the fertile‐semen samples, a significant (p<0.05) increase of %AR was observed, with maximum values at 6 hours (or longer) of incubation. In the abnormal‐semen samples, 2 reaction patterns of %AR were observed: (1) a rapid significant (p<0.05) increase of %AR, with a maximum value at 3 hours of incubation; and (2) %AR<10% after 24 hours.

The results are discussed and a new value (the GAR rate), which expresses the rate of spermatozoa getting acrosome reaction, is introduced. We conclude that abnormal semen quality leads to alterations in the pattern of the AR.
Endometriosis and Social Class: An Asian Experience
Authors: Arumugam Kulenthran , Welluppilai Sivanesh
Published: August 2010

The social class distribution in 147 patients confirmed to have endometriosis at laparoscopy was done to see if the disease was associated with affluence. Two hundred and eighty‐one patients confirmed not to have endometriosis was used as controls. The patients were derived from a background population for which the social class characteristics was known. Endometriosis was significantly (p<0.001) associated with social class 1 and 2. However there was no association between social class distribution and the severity of the disease developed.
Diagnostic Problems Relating to Uterine Cervical Polyps with Malignancy
Authors: Shiromizu Kenji , Ryou Eiji , Tsukagoshi Toshio , Nishimura Toshinobu , Takahashi Michiko , Matsuzawa Masumi
Published: August 2010

In order to clarify the diagnostic problems relating to, and the proper treatment of, uterine cervical polyps, 951 polyps were analyzed clinicopathologically. All polyps were examined histopathologically and divided into 2 groups: benign polyps (Group‐1), and polyps with neoplastic or malignant lesions (Group‐2). Polyp size and cervical cytology are not always reliable for predicting the correct diagnosis of neoplastic or malignant lesions. Colposcopic diagnostic accuracy was 56.3%, but increased to 75.0% when combined with cytology. Neoplastic or malignant lesions were found at both the cervical polyp and the cervix in 21 out of 24 Group‐2 patients (87.5%). These results suggest that in order not to miss rare neoplastic or malignant lesions in polyps and/or cervices, histopathological examinations of all polyps, aided by cervical cytology and colposcopic observation, are necessary.
Shared Antenatal Care between Family Health Services and Hospital (Consultant) Services for Low Risk Women
Authors: Chan F. Y. , Pun T. C. , Tse L. Y. , Lai P. , Ma H. K.
Published: August 2010

Four thousand four hundred and seventy‐two patients were recruited into a project to test the efficacy of a Shared Care System in the management of low risk antenatal patients. The patients were scored according to a simple point scoring system. Three thousand three hundred and fourty‐seven (74.8%) were scored as low risk. Fifty point two percent (1,682) of these low risk patients received the conventional system of care and acted as controls; while 49.8% (1,665) received shared care, where they were seen jointly by midwives, general doctors and hospital specialists.

It was found that with the use of shared care, there was a significant decrease in workload to the hospital specialty clinics. Not only was the antenatal diagnostic rate of intrauterine growth retardation (IUGR) significantly improved, but the mean gestations at which IUGR, malpresentations, and pregnancy induced hypertension were diagnosed were also significantly earlier. The number of antenatal cardiotocographs performed, as well as the number of hospital admissions and mean duration of stay were decreased in the study group. The overall cost savings to the hospital was calculated if the shared care system was generally adopted.
Relationship between the Prognosis of Conception and the Location of Pelvic Involvement in Endometriosis: Significance of the TOP (Tube, Ovary, Peritoneum) Classification
Authors: Kurata Suwako , Ishimaru Tadayuki , Masuzaki Hideaki , Yamabe Tooru
Published: August 2010

To determine the main factors that affect the prognosis for conception in endome‐triosis‐associated infertility, 99 infertile patients with laparoscopically confirmed endometriosis were classified according to the new TOP classification, which we have developed to evaluate the severity of endometriosis by site, i.e., fallopian tubes (T), ovaries (O) and the peritoneum (P). According to the TOP classification, a negative correlation between the pregnancy rate after treatment and the severity of lesions was noted in case of tubal and peritoneal involvement, but not when the ovaries were involved. If there was no tubal involvement or only unilateral tubal involvement, high pregnancy rates were achieved for patients with ovarian endometrioma (87%) and for those with partial or complete posterior cul‐de‐sac obliteration (83%). The results suggest that for endometriosis‐associated infertility, the treatment modality should be selected according to the severity of tubal involvement, which is considered to contribute to infertility more than ovarian or peritoneal lesions.