bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Menstrual History and Basal Body Temperature with Early Fetal Growth by Ultrasound in Diabetic Pregnancy
Authors: Hieta‐Heikurainen H. , Teramo K.
Published: November 2007

The time of ovulation and conception of 24 insulin‐dependent (Type I) diabetic women was estimated by monitoring the basal body temperature (BBT). The mean (±SD) duration of the menstrual cycle was 28 (±2) days. Conception occurred, on the average, on the 18th day of the cycle. The fetal crown‐rump length was measured by ultrasound scan every 2 weeks between 6 and 14 weeks of pregnancy. When menstrual history was used for dating, there was an apparent early fetal growth delay by a mean of 4 days. When the dates were corrected by BBT, the fetal growth was identical with the standard mean crown‐rump length diagram by Robinson & Fleming. The findings of our study suggest that early fetal growth delay reported by Pedersen & Melsted‐Pedersen does not exist in diabetic pregnancy. The small fetuses observed could be explained by an error in the gestational age.
Prenatal Diagnosis of Left Ventricular False Tendon
Authors: Morin Luc R.M. , Iselin Michel , Loisel Jean Claude , Feuilly Christian
Published: November 2007

A case of prenatal diagnosis of left ventricular false tendon is reported. The in utero echographic features of false tendon are described, together with their differential diagnosis. The management of neonates with false tendons is described.
Pyosalpinx Subsequent to Tubal Ligation
Authors: Menashe Yehezkel , Ben‐Baruch Gilad , Tamarkin Mordechai , Sarlin Jonathan
Published: November 2007

A case of salpingitis with pyosalpinx subsequent to tubal ligation is described. The procedure was performed at the time of cesarean section 7 years earlier. The pyosalpinx included the distal portion of the ligated tube, with no evidence of infection in the proximal segment. Although pelvic peritonitis, salpingitis and tubo‐ovarian abscess are rare following tubal ligation, they should be suspected in any patient presenting with lower abdominal pain.
Ovarian Metastasis from Squamocellular Cervical Cancer, Stages IB and IIA
Authors: Bouma Joke , Hollema Harry
Published: November 2007

Ovarian metastasis from early stage squamous cervical cancer is rare. In a series of 393 surgically treated patients with squarnous cervical cancer, stages IB and HA, 2 had unsuspected ovarian metastasis. These cases are reported. In younger patients, ovarian extirpation instead of conservation of the ovaries must only be considered in histologically unfavorable tumors extending high up in the endocervix, especially on suspicion of lymph node metastasis.
Treatment with Hachimijiogan, a Non‐Ergot Chinese Herbal Medicine, in two Hyperprolactinemic Infertile Women
Authors: Usuki Satoshi , Kubota Sayuri , Usuki Yoshie
Published: November 2007

Two hyperprolactinemic infertile women, one with and one without a pituitary adenoma, who were resistant to bromocriptine treatment, were treated orally with Hachimijiogan, a Chinese herbal medicine. This treatment reduced the serum prolactin level, resulting in a normal ovulatory cycle and pregnancy, without side effects.
Acta Sixty Years Ago: Evaluation of Radical Treatment of Abortion Peritonitis
Authors: Bergsjø Per
Published: November 2007

In the 1920s, peritonitis following abortion was an extremely serious condition, attended by a high risk of lethal outcome for the unlucky victim. Surgical intervention had been tried, but fallen into disrepute. In the first article in fasciculus I of Acta Obstet‐ricia et Gynecologica Scandinavica in 1930, J. J. Chy‐denius wrote Uber die operative Behandlung der dif‐fusen Abortperitonitiden (1), an account of the change from conservative to operative treatment of the condition. at the University clinic in Helsinki. During eleven years, 1919‐1929, the Department had treated 3221 abortees, of whom 56 (1.7%) were stricken by diffuse peritonitis. Of the latter, 27 were treated conservatively, and only one of these survived. Before 1925, surgical treatment did not seem to matter much one way or the other, as seven out of eight patients who were operated upon also died. However, in 1925 matters seemed to improve. Operative intervention became more frequent, accomplished first by small incision and drainage, later by more radical laparotomy with removal of one or both adnexa and in some cases amputation of the uterus, plus incision and drainage through the vagina. Between 1925 and 1929, nine out of 21 patients so treated survived. The author was quick to point out that the two groups (operated and non‐operated) were not strictly comparable. Both because of small numbers and der untereinander sehr verschie‐denen Eigenart der Falle kann jedoch keine statis‐tische Behandlung des Materiales in Betracht kom‐men. They were not unaware of the golden rule for statistical comparisons even in those days. Take heed, computer converts!
Addin of Exogenous Estrogens To Improve Cervical Mucus Following Clomiphene Citrate Medication: Patient Selection
Authors: Kokia Ehud , Bider David , Lunenfeld Bruno , Blankstein Josef , Mashiach Shlomo , Ben‐Rafael Zion
Published: November 2007

Medication with Clomiphene Citrate and its effects on the quality of cervical mucus and the addition of exogenous estrogens in order to suppress abnormal mucus secretion are controversial issues. We have prospectively studied a group of 19 anovulatory women who were treated with clomiphene citrate in order to characterize those patients most likely to respond to the addition of exogenous estrogens. On day 14 of the cycle, 17 β estradiol and cervical ‐re were measured and 1 mg estradiol benzoate was injected intramuscularly. Cervical scores were below 7 in 12 out of the 19 patients before estradiol benzoate administration. In these patients, 17 β estradiol rose from 751±541 to 1321±648 pg/ml (p<0.03).and cervical scores rose from 3.75±2.1 to 7.1±3.7 (p<0.0l), after estradiol benzoate administration. Patients with cervical scores of 8‐12 did not improve significantly. In the 12 patients with cervical scores below 7, those (n=6) with 17 β estradiol below 600pg/ml experienced a significant improvement in cervical score, in contrast to those (n=6) with 17 8 estradiol above 600pg/ml who had no improvement. The reduction in cervical mucus accomplished with clomiphene citrate can be further improved by adding exogenous estrogens, mainly in patients who have low 17 β estradiol levels concomitant with low cervical score.
Evaluation of Histological and Ultrastructural Aspects of Endometrium During Treatment with Gestrinone in Women with Amenora or Spotting
Authors: Fedele Luigi , Marchini Maurizio , Baglioni Andrea , Dell'antonio Giacomo , Motta Tiziano
Published: November 2007

Nineteen patients with a laparoscopic diagnosis of endometriosis were treated with gestrinone at a dosage of 2.5 mg twice a week for 6 months. In 7 who reported spotting in the first 3 months, the dose was increased to 2.5 mg three times a week during the second trimester. An endometrial sample was obtained from each patient at the time of laparoscopy (basal) and at 3 and 6 months of treatment. Endometrial structure and ultrastructure were studied. Areas of hemorrhage and of loss of surface epithelium and a lesser degree of involution of the surface epithelium were observed in the 3‐month samples of 7 patients with spotting, compared with 12 with amenorrhea. It is hypothesized that incomplete endometrial involution could be due to differences in gestrinone pharrnacokinetics in individual patients, in the quality and/or quantity of endometrial cytosolic receptors for sex steroids, or in endocrine compensation to administration of the drug.
Detection of Human Papilloma Virus in Women Refed for Colposcopy: A comparison between different diagnostic methods
Authors: Bodén Elisabeth , Evander Magnus , Wadell Göran , Bjersing Lars , von Schoultz Bo , Rylander Eva
Published: November 2007

Various methods presently available for the diagnosis of genital Human Papilloma Virus (HPV) were compared regarding their sensitivity in women referred for specific diagnosis and treatment because of atypical Pap smears or clinically suspected neoplasia.

Colposcopic examination was performed in all cases. In addition to taking a second Pap smear, cell suspensions were made from 105 women and analysed by the Filter In Situ Hybridization (FISH) technique and tested for HPV 6+11 and HPV 16+18+31. The FISH technique was also used for the possible detection of HPV‐DNA in a reference material comprising 119 apparently healthy women with normal Pap smears.

Colposcopically directed cervical biopsies in altogether 196 specimens were obtained from 155 women for histopathological examination and also for the detection of HPV‐DNA by the Southern blot hybridization technique. These specimens were tested for the presence of HPV 6, 11, 16, 18, 31 and 33.

Three per cent of the women with and 34% without cytological signs of HPV in Pap smears had cervical intraepithelial neoplasia (CIN) 111 according to histopathology. CIN III was present in 35% of biopsies with and 59% of biopsies without histological signs of HPV in the biopsies.

Altogether 46% of the women were HPV‐DNA positive. Of the women analysed by Southern blot, 39% were HPV‐DNA positive. Of the samples analysed by FISH, 27% with atypical cells were HPV‐DNA positive, compared with 11% of the samples from reference women with normal cytology.

Of the women positive for HPV 16/18, colposcopy revealed HPV signs and or dysplasia in 95%.

The presence of HPV in precancerous epithelium is not easily confirmed, either by cytology, colposcopy, or histopathology.

By using Southern blot technique, it can be established that HPV‐DNA (67%) is frequently present in CIN III lesions. The FISH technique appeared to be as sensitive as Southern blot concerning the possibility of detecting HPV‐DNA in benign tissue and neoplasia of mild to moderate degree.
Second Primary Cancer After Treatment of Invasive Carcinoma of the Uterine Cervix, Compared with Those Arising After Treatment for in Sltu Carcinomas. ‐ An Eft of Irradiation?: A Cancer Registry Study
Authors: Pettersson Folke , Ryberg Marianne , Malker Birgitta
Published: November 2007

A cancer registry cohort of 16,704 cases of invasive carcinoma of the uterine cervix and 56,116 cases of in situ carcinomas of the uterine cervix was followed up and second new primary cancers were recorded. The invasive car cinomas contributed 127,118 woman‐years at risk and the in situ carcinomas contributed 453,362 woman‐years at risk. The main treatment for the invasive carcinomas had been radiotherapy and for the in situ carcinomas, conization and other types of surgical intervention. 767 new primaries occurred after treatment of invasive carcinoma of the uterine cervix, compared with 644.5 expected. O/E is 1.19. After the in situ carcinomas, 1,421 malignant tumors were observed, vs. 1,188.0 expected (O/E 1.19). If, however, cases of invasive carcinoma of the uterine cervix after in situ carcinomas are excluded, the ratio observed/expected is 1.10. For some sites the increased observedlexpected ratios were found after both invasive and in situ carcinomas, which speaks for some common carcinogenic effect other than irradiation (for instance, in bronchus and trachea, pharynx, nose, sinus and larynx, but also in rectum, urinary bladder, other female genital organs, pancreas, lymphosarcoma, as well as acute and non‐lymphatic leukemia). A lower risk than expected ‐ after both in situ and invasive carcinoma of the uterine cervix ‐ is observed for breast cancer, cancer of the corpus uteri and for multiple myeloma. However, analyses based on time since treatment provide evidence of a carcinogenic effect of irradiation, especially in intensively irradiated organs such as bladder, rectum, corpus uteri and ovary, and also for acute and non‐lymphatic leukemia.
Leiomyosarcoma Vulvae
Authors: Maller Lars Bo Krag , Nielsen Majbrit Nygaard , Trolle Carsten , Krag Möller L. B.
Published: November 2007

A case of leiomyosarcoma of the vulva is presented. Differential diagnostic problems, route of metastasis and treatment are discussed. Radical vulvectomy was performed, with no signs of recurrence or metastasis 30 months after the operation.
Serum Half‐Life of the Tumor Marker CA 125 During Induction Chemotherapy as a Prognostic Indicator for Survival in Ovarian Carcinoma
Authors: Hoügberg Thomas , Kagedal Bertil
Published: November 2007

Patients (n=72) with newly diagnosed non‐mucinous ovarian carcinomas, FIGO stages IIC‐IV, and CA 125 levels raised when starting chemotherapy were followed both by serial serum CA 125 tumor marker determinations during induction chemotherapy and by second‐look operation after 4‐6 cycles of chemotherapy. Patients with complete response at the second‐look operation (n=19) had an estimated survival of 75% 59 months after the operation, compared with 22% in the 53 patients with persisting disease (p=0.0004). Patients (n=23) with a serum CA 125 half‐life shorter than 16 days during induction chemotherapy had an estimated survival of 68% 59 months after the second‐look operation as compared with 18% in 49 patients with a CA 125 half‐life of more than 16 days (p=0.003). Thus both second‐look operation and serial CA 125 measurements fairly accurately predicted the patient survival, although the groups of patients identified by the two methods differed slightly. There was a strong correlation between the second‐look results and the residual tumor after the primary operation. Interestingly, this association could not be found for tumor marker pattern, which could mean that this is an independent prognostic factor.
A Large Labial Adhesion following Normal Delivery
Authors: Yoong Ann , Alderman B.
Published: November 2007

Labial adhesions seldom occur following vaginal delivery. We report the case of a large labial adhesion forming after an uneventful pregnancy and normal delivery in a multiparous patient.
Maternal Body Weight And Relation To Birth Weight
Authors: Rössner Stephan , Öhlin Agneta
Published: November 2007

In The Stockholm Pregnancy and Weight Development Study the relationships between birth weight and maternal initial body weight as well as weight increase during pregnancy were analysed in 2,295 subjects. As expected, the most important predictor of birth weight was total maternal weight increase, followed by initial maternal body weight. However, in women with an initial BMI value above 24 kg/m2, birth weight did not increase significantly in tact with maternal weight. The frequency of cesarean sections, 12% overall, was not significantly increased with maternal body weight. These data show that birth weight increases with maternal weight only up to the upper normal body weight.
Magnetic Resonance Imaging Of Unicornuate Uterus
Authors: Fedele Luigi , Dorta Milena , Brioschi Diana , Giudici Maria Natalina , Villa Laura
Published: November 2007

Five patients with a hysterosalpingographic diagnosis of unicornuate uterus underwent magnetic resonance imaging (MRI) and subsequently lapa‐roscopy/laparotomy to evaluate the ability of MRI to identify the various subclasses of this malformation. The method was demonstrated to be valid, since in all 5 cases (one subclass A1b, two subclass A2, two subclass B) were correctly diagnosed. Compared with laparoscopy, MRI is less expensive, less invasive, and can be performed in women in whom laparoscopic examination is risky. However, unlike laparoscopy, MRI can not detect the presence of minimal and mild endometriosis and does not allow assessment of the tubal conditions.
Management Of Urinary Incontinence In Gynecological Practice In Norway
Authors: Eriksen Bjarne C. , Sandvik Hogne , Hunskaar Steinar
Published: November 2007

In order to investigate how Norwegian gynecologists manage female urinary incontinence in their daily practice, a questionnaire about six typical case histories was sent to the members of the Norwegian Gynaecological Association. The questionnaire comprised questions about investigations, use of laboratory tests and treatment options. Of 268 questionnaires sent out, 190 were returned (71%). Frequency‐volume charts were recommended by 42% of the doctors and pad‐weighing tests by 12%. Urodynamic examination was recommended for 55% of the cases, but mainly in mixed incontinence (76 and 77%). Pelvic floor exercises were suggested more often to younger patients than to the elderly. Drugs were infrequently suggested, mainly following appropriate indications. Drugs and pads were recommended especially for the elderly. The recommendation rate for surgical repair was higher for young age and greater degree of stress incontinence. The modest therapeutic ambition on behalf of the elderly women lacks basis in clinical research. A general management program for female urinary incontinence would possibly standardize and improve the quality of incontinence care by gynecologists in Norway.
A 16‐Year‐Old Girl With Invasive Carcinoma Of The Vulva
Authors: Nilsson Thomas , Aim Per , Malmstrom Henric , Simonsen Ernst , Trope Claes
Published: November 2007

We present a 16‐year‐old girl with vulvar squamous cell carcinoma. The patient initially received a radical treatment because of lymph‐node dissemination. However, recurrent disease erupted a little more than one year after the initial treatment, with metastases in the right lung and multiple osteolytic skeletal metastases. Despite aggressive treatments with chemotherapy the patient died about 2 years after the initial diagnosis. An aggressive radical treatment must be chosen for cases of invasive vulvar carcinoma, irrespective of the patient's age.
Acceleration of Fetal Maturation with Intra‐Amniotic Thyroxine in the Presence of Maternal Malignancy
Authors: Romaguera Josefina , Reyes Gloria , Caiseda David , Wallach Robert C. , Adamsons Karlis
Published: November 2007

Acceleration of fetal maturation with intra‐amniotic administration of thyroxine was employed in eight patients in whom preterm delivery was necessary because of malignant disease of the mother. Thyroxine (200 mcg to 500 mcg) was given at weekly intervals starting at the 27th to 32nd week of gestation until the L‐S ratio exceeded 2.0. The fetuses were delivered between the 29.4 and 34.0 week. None of the newborns suffered from respiratory distress syndrome, and three newborns were cared for in the regular nursery.

Thyroxine‐induced acceleration of fetal maturation and pre‐term delivery permits earlier initiation of antineoplastic and radiation therapy without exposing the fetus to the hazards of maternal therapy and those of prematurity.
Radical Surgery Compared with Intracavitary Cesium Followed by Radical Surgery in Cervical Carcinoma Stage Ib
Authors: Tinga Dick J. , Bouma Joke , Hollema Harry , Aalders Jan G.
Published: November 2007

Forty‐nine patients aged ≤ 45 years, with cervical carcinoma stage iB≤ 3 cm) were treated with either primary radical surgery (n = 26). or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium +
Peripheral and Ovarian Venous Concentrations of Estradiol and Progesterone in Postmenopausal Women with “Non‐Endocrine” Ovarian Tumors
Authors: Kitayama Shunya , Nakano Ryosuke
Published: November 2007

Estradiol (E2) and progesterone (P4) levels in peripheral venous blood were measured in 45 postmenopausal (more than 5 years after menopause) women with ovarian neoplasms. The E1 and P4 concentrations in ovarian venous blood were also measured in 26 of these 45 patients. The steroid levels were compared with the values in 10 postmenopausal women without ovarian tumors. In peripheral venous blood, relatively high E, concentrations were found in 24 of the 45 (53%) postmenopausal patients with ovarian tumors, and relatively high P4 concentrations were noted 15 of 45 (33%) of the patients. In ovarian venous blood, relatively hgih values of E2 were found in 18 of 26 (69%) of the postmenopausal patients, and relatively high values of P4 were noted in 11 of these 26 (42%). No differences in the E, and P4 levels in peripheral and ovarian venous blood were noted between the patients with benign tumors and those with malignant tumors.

These results suggest that some of the epithelial ovarian tumors in postmenopausal women have steroid‐producing activity.
Primary Melanoma of the Cervix Uteri, an Avis Rara? A Review of the Literature
Authors: Vleugels M. P. H. , Brölmann H.A.M. , van Beek M.
Published: November 2007

A primary melanoma of the uterine cervix is presented. Diagnostic approaches and therapeutic procedures are discussed following a review of the literature.
Vaginal Administration of PGE2 for Induction of Labor Stimulates Endogenous PGF2a Production
Authors: Greer Ian A. , McLaren Margaret , Calder Andrew A.
Published: November 2007

Prostaglandin E2 is effective for induction of labor but many preparations exist using a variety of vehicles from which the active ingredient may not be equally available. Plasma concentrations of bicyclic PGE2 metabolite (PGEM) and 13, 14‐dihydro, 15‐keto PGF2α (PGFM) were measured following administration of a 3mg PGE2 vaginal tablet or 1mg PGE2 vaginal gel to twenty‐four parous women with favorable induction features, randomly allocated to receive one or other preparation. PGEM increased rapidly following both administration of the 3mg PGE2 vaginal tablet and the 1mg PGE2 vaginal gel, reaching a peak within 40 minutes of PGE2 administration. The maximal rise in PGEM in the gel group correlated directly with the change in cervical score and inversely with the need for augmentation with oxytocin and the induction‐delivery interval. A secondary rise in PGFM was noted in both groups 3–4 hours following PGE2 administration. The magnitude of the increase in PGE2 may be important in the clinical response to PGE2 administration, while PGE2 absorption may switch‐on endogenous PGF2, production, similar to what is seen in spontaneous labor.
Infertility, Technology and the Law':Patients' and Future Doctors' Opinions
Authors: Sundby Johanne , Olsen Anne
Published: November 2007

The rectifying of infertility by application of modern technology has been a topic for debate in modern society over the past decade. Laws regulating the investigation and treatment of infertility have been passed in many countries, for instance in Norway and Sweden, while other nations await future developments. In this paper, some users of the technology ‐female infertility patients and future medical doctors ‐present their attitudes toward controversial issues of infertility, investigated by means of a survey questionnaire issued to them in 1987‐88. Medical students have a more restrictive attitude than former patients, whereas religious beliefs influence the viewpoints of the patients. Both groups seem to have opinions that to a large degree accept the content of the Norwegian law.
Cytobrush in Evaluation of Cervical Dysplasia: Is Cervical Curettage Necessary?
Authors: Frost Lars
Published: November 2007

203 patients suspected of having dysplasia were evaluated by colposcopy, cytologic smear including cytobrush, endocervical curettage, biopsy and conization. The results obtained on the basis of the final cone suggested that directed biopsies and cytological smear by spatula and cytobrush more accurately define the dysplastic lesion than do biopsies and endocervical curettage. Conization seemed necessary for the evaluation of the cervical lesion in patients revealing non‐classified dysplasia at successive examinations.
Acute Massive Pulmonary Embolism Treated with Streptokinase During Labor and the Early Puerperium
Authors: Fagher Birger , Ahlgren Mats , Astedt Birger
Published: November 2007

Acute massive pulmonary embolism occluding 60‐70% of the pulmonary circulation occurred in a young primipara during the 28th week of pregnancy. She was critically ill despite 40 h of heparin infusion and thrombolytic therapy with streptokinase was initiated. After a 10‐h infusion she went into labor and streptokinase treatment was stopped. One hour later she gave birth spontaneously to a preterm infant in footling breech delivery. The infant did well neonatally. Streptokinase infusion was recommenced 8 h after delivery. Because of increasing blood loss on the second day after delivery, streptokinase was withdrawn after a total treatment time of 29 h. Total hemorrhage amounted to 8.9 litres. Serial perfusion lung scans showed complete resolution of the emboli and normal lung function was restored.
Iontophoresis of vasoactive drugs Effect on peripheral blood flow during pregnancy
Authors: Eneroth‐Grimfors Eva , Lindblad Lars‐Erik , Westgren Magnus , Etzell Britt‐Marie , Bevegård Sture
Published: November 2007

The aim of this study was to evaluate whether iontophoretic administration of the vasoactive agents noradrenalin (NA) and angiotensin (AII) combined with measurement of skin blood flow with a laser Doppler technique could serve as a predictive method for pre‐eclampsia.

Nine healthy non‐pregnant women, 9 healthy pregnant women and 9 pre‐eclamptic patients were investigated. A significant reduction of skin blood flow was induced by NA in all three groups and by AII in the non‐pregnant group. There was no significant difference between healthy pregnant and pre‐eclamptic patients in the degree of reduction of blood flow with respect to NA and All administration.
The relationship between granulocyte elastase‐like activity of cervical mucus and cervical maturation
Authors: Kanayama Naohiro , Terao Toshihiko
Published: November 2007

Granulocyte elastase (elastase)‐like activity in 119 samples of cervical mucus from pregnant women was measured. Though elastase‐like activity in normal pregnant women was low in 2nd and 3rd trimesters (less than 20 units), it increased during labor (1st stage of labor: 70±50 U/l; 2nd stage: 72±56). Elastase‐like activity in pregnant women with imminent premature delivery (24‐30 gestational weeks) was also high (78±57). Elastase‐like activity of cervical mucus correlated with Bishop score in both normal term and preterm labor. Elastase‐containing granulocytes were identified by immunohistochemistry in ripened cervix in normal and preterm labor. Some granulocytes degranulate and release elastase into the cervical stroma. Others migrate through the basement membrane of the endocervix to reach the cervical canal. Elastase could not be demonstrated in immature cervix as assessed by Bishop score. The staining intensity of elastase in the cervix correlated closely with elastase‐like activity in cervical mucus. Thus elastase‐like activity in cervical mucus reflects the degree of cervical maturation. These results lead one to speculate that elastase is one of the neutral proteases which depolymerize and degrade collagen in the ripening cervix.
Vacuum aspiration for termination of early second trimester pregnancy after treatment with vaginal prostaglandin
Authors: Gottlieb C. , Lindstedt V. Lundström , Swahn M.‐L , Bygdeman M.
Published: November 2007

Vaginal and intramuscular administration of prostaglandin analogues are routinely used for dilatation of the cervical canal prior to vacuum aspiration in first trimester abortion. Whether the same procedure is also useful during the first weeks of the second trimester has been much less investigated. In the present study, 127 women in the 13th and 14th week of pregnancy were pretreated with 3 mg 9‐deoxo‐16,16‐dimethyl‐9‐methylene PGE, administered vaginally 12 hours before surgery. At surgery the cervical canal was dilated to 9.8 mm ± 2.5 mm (mean ± SD) and the evacuation of the uterus was uneventful. In 21% of the patients vaginal bleeding occurred prior to the operation. The mean blood loss at surgery was 49 ml and exceeded 100 ml in only 6 patients. Gastrointestinal side effects were rare but analgesic injections were demanded by 29% of the patients during the pretreatment period. No subsequent curettage was performed during the follow‐up period but 2 patients (1.6%) were readmitted because of post‐abortion endometritis. It can be concluded that after pretreatment with PG, vacuum aspiration can be safely performed during the first weeks of the second trimester.
Sexual experience, abortion and sexually transmitted diseases among young women at a contraceptive clinic
Authors: Persson Elisabeth , Holtzberg Madeleine , Edgardh Karin
Published: November 2007

All visitors who during one year visited a contraceptive clinic in the Solna district of Stockholm County and were below the age of 26 were asked to fill in a questionnaire and offered a test for C. trachomatis. Three hundred and six women (97%) participated. Ninety percent had at some time used oral contraceptives and 91% had experience of condom use. One‐fifth of the whole group had undergone one or more legal abortions, and one fourth had experience of a sexually transmitted disease (STD). The most common STD experienced was chlamydia, followed by condyloma. The actual prevalence of chlamydia in the group was 6%. Sexual contacts were often made early in on‐going steady relations. Forty‐two percent admitted casual sex, but the number of life‐time partners was five or less among the majority.
Malignant mixed Müllerian tumors of the ovary: Report of 13 cases
Authors: Pfeiffer Per , Hardt‐Madsen Michael , Rex Sven , Hølund Berit , Bertelsen Kamma
Published: November 2007

Thirteen patients with verified malignant mixed Müllerian tumor of the ovary treated in Denmark during the 7‐year period 1981‐87 were reviewed. Two patients had homologous and 11 patients had heterologous tumors. Four patients with early stage disease underwent radical surgery; 9 patients had stage III disease. Median survival for all 13 patients was 12 months. Six patients received platinum‐containing cytotoxic therapy; 2 of these patients without measurable disease became long‐term survivors (survival times 42+ and 92+ months, respectively) and 3 of the 4 remaining patients with evaluable disease obtained an objective remission.
Fetal and infant outcome of pregnancies with very early rupture of membranes
Authors: Montan Sven , Holmquist Peter , Ingesson Karin , Ingemarsson Ingemar
Published: November 2007

Fetal and infant outcome was studied in 38 singleton pregnancies complicated by very early rupture of membranes (PROM), in gestational weeks 19‐29, over a 4‐year period, in a Swedish population. The pregnancies were managed according to a specified protocol, including postponement of delivery until 34 weeks of gestation if possible. Stillbirth occurred in 10 cases (26.3%), all with PROM before 26 completed weeks, while 6 other infants died in the neonatal period. Respiratory distress syndrome was evident in half (50.0%) of the 28 liveborn infants. The surviving 22 infants (57.9%) were followed up to 2 years of age. The rate of neurological sequelae at follow‐up was 22.7 % (5/22). The fetal outcome of the 20 pregnancies with rupture of membranes before 26 completed weeks was poor; only 7 infants of the 10 born alive survived the neonatal period. The short‐term fetal outcome in the group with rupture of membranes in 26‐29 completed weeks was better: 15 of the 18 infants survived, but 4 had neurological sequelae. PROM before 29 completed weeks of gestation is associated with severe short‐term and long‐term fetal complications, in cases where the pregnancy is prolonged for several weeks.
A randomised, double‐blind, placebo‐controlled trial of gemeprost (Cervagem) pessaries for cervical dilatation in non‐pregnant women
Authors: Elder M. G. , Lewis G.
Published: November 2007

In a randomised, double‐blind trial, 75 women received either placebo or a 1‐mg gemeprost (Cervagem) pessary for cervical dilatation prior to gynecological procedures which require mechanical dilatation of the cervix. No significant difference was seen between gemeprost and placebo with respect to preoperative cervical dilatation. The incidence of vaginal bleeding and adverse effects was similar in each group.
Tubulo‐villous adenoma of the female genital tract: A case report and review of literature
Authors: Mortensen Birthe Brøndum , Nielsen Karsten
Published: November 2007

A case is presented of tubulo‐villous adenoma in the vagina of a 43‐year‐old woman. The possible origin of this rare condition is discussed and the need for careful follow‐up is emphasized.
Sarcoidosis of the uterus
Authors: Sandvei Roar , Bang Gisle
Published: November 2007

Sarcoidosis rarely involves the female genital tract. A report is presented of 2 cases of sarcoidosis of the uterus. In the first, the diagnosis was made by biopsy of the portio vaginalis uteri which was amputated during the Manchester operation for genital prolapse. In the second case the diagnosis was made by endometrial curettage for postmenopausal vaginal bleeding. Neither of the women exhibited signs of generalized sarcoidosis.
Prenatal diagnosis of craniopagus
Authors: Loverro Giuseppe , Occhiogrosso Michele , Caruso Gilda , Greco Pantaleo , Selvaggi Luigi
Published: November 2007

The long‐term prognosis of craniopagus, a congenital abnormality of monozygotic twinning, is strictly correlated to the type of shared cerebral structures. Hence, the purpose of prenatal diagnosis is not only to detect this malformation, but also to identify the fused cerebral structures. The authors report a prenatal diagnosis of a craniopagus during the second trimester of pregnancy. Comparison of ultrasound data with the pathological findings underlines that ultrasound is of great value in detecting malformations, but it is not alone sufficient to identify the types of conjoined cerebral structures.
Malignant schwannoma in pregnancy
Authors: Puls Lary E. , Chandler Pamela A.
Published: November 2007

we report a case of maglignant schwannoma on the distal forearm in a pregnant woman with neurofibromatosis. The problems of managing concomitant pregnancy and this particular maternal malignancy are discussed, leading toward a favorable maternal‐fetal outcome.
The effect of various drugs with neuroendocrine activity and transdermal estradiol on plasma gonadotropin concentrations after ovariectomy in reproductive‐aged women
Authors: Nappi Carmine , Petraglia Felice , Maria de Chiara Bianca , Genazzani Alessandro D. , Montemagno Rodolfo , Genazzani Andrea R. , Montemagno Ugo
Published: November 2007

In the present study we compared the effect of different neuroactive drugs with that of estrogen treatment on the ovariectomy‐induced plasma luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) changes. A total of 35 menstruating women undergoing ovariectomy were randomly divided into five groups of 7 patients each, receiving a 4‐week treatment with oral clonidine, lisuride and sodium valproate, transdermal 17β‐estradiol, or placebo. The treatment started the day after ovariectomy. Surgery was done during the early follicular phase of the cycle. Blood samples were collected before and after 3, 5, 7, 14, 21 and 28 days of treatment. During the treatment, hot flushes were subjectively recorded. The placebo‐treated group showed a progressive increase in plasma LH and FSH concentration during the month following ovariectomy. The same changes occurred in the lisuride and sodium valproate treated groups. Plasma LH levels in ovariectomized women treated with clonidine showed an increase which was higher than in placebo‐treated women (p<0.01), while FSH levels were similar to those in the placebo group. In the estradiol‐treated group the increase in both gonadotropins was significantly less (p<0.01) than in the placebo group. The frequency and intensity of hot flushes were high in placebo and sodium valproate treated subjects, being significantly reduced by clonidine, lisuride and estrogen treatment. Our results seem to indicate that clonidine treatment modulates the LH postcastration rise and that both neuroendocrine and gonadal mechanisms influence the changes in the activity of the GnRH‐pituitary axis following ovariectomy.
Incidence of adenomyosis uteri in a Greek population
Authors: Chrysostomou M. , Akalestos G. , Kallistros S. , Papadimitriou V. , Nazar S. , Chronis G.
Published: November 2007

The reported incidence of adenomyosis based on unselected hysterectomies varies so widely that conclusions regarding the influence of any factor on that incidence are difficult to reach, although the relation of adenomyosis uteri to endometrial carcinoma has been the subject of only a few studies.

In a 5‐year period at the General Hospital of Athens, 646 hysterectomies were performed. All data were retrieved from the surgical pathology laboratory files concerning adenomyosis uteri with either simultaneous endometrial carcinoma or endometrial hyperplasia. A control population was selected from patients operated upon for a variety of benign pelvic diseases. Adenomyosis was found in association with endometrial carcinoma in 17.5% of 40 cases, and in association with endometrial hyperplasia in 21.6% of 60 cases. The control series of 546 patients had a 26% incidence of adenomyosis. The results of our study do not indicate any correlation between adenomyosis uteri and endometrial carcinoma.
Reproductive failure and antisperm‐antibody production among prostitutes
Authors: Bahraminejad Roozbeh , Kadanali Sedat , Erten Oktay , Bahar Hakki
Published: November 2007

Reproductive failure and anti‐sperm antibody (ASA) production among prostitutes were investigated. A questionnaire including the subject's age, years of prostitution, date of most recent birth, number of children and contraceptive method used at the beginning of prostitution were asked of 109 prostitutes, but only 53 agreed to complete the questionnaire. ASA was detected by ELISA in the prostitutes (n=109) and in the control group (n=40) sera. The tests revealed a high ASA rate (43.1%) among the prostitutes. The difference in the incidence of ASA between controls (5%) and the prostitutes (43.1%) was highly significant (p < 0.01). It was found that ASA positivity incidence in 27 prostitutes who had never use any contraception method and who became infertile within 9,3 years (average) was 61.3%. These results may be explained by repeatedly inoculations with multiple sperm antigens and/or microorganisms.
Acetyl‐1‐carnitine as possible drug in the treatment of hypothalamic amenorrhea
Authors: Genazzani A. D. , Petraglia F. , Algeri I. , Gastaldi M. , Calvani M. , Botticelli G. , Genazzani A. R.
Published: November 2007

Several neuroendocrine disregulations have been demonstrated in patients with hypothalamic amenorrhea, but a definite therapeutic strategy has not yet been found. Since acetyl‐1‐carnitine (ALC) has been reported to have a specific effect on central cholinergic, serotoninergic, dopaminergic and opioidergic systems, 20 patients with hypothalamic amenorrhea were treated with ALC (2 g/day, per os). Both the clinical efficacy and the endocrine parameters were evaluated after 6 months. The patients were subdivided in two groups according to their LH plasma levels: A) hypogonadotropic: 10 subjects with plasma LH < 3 mlU/ml, and B) normogonadotropic: 10 subjects with plasma LH > 3 mIU/ml. All subjects underwent: 1) a pulsatility study (4 h sampling every 10 min), 2) GnRH test (two bolus injections of 10 mg at time 0 and ±120), 3) TRH test (200 mg). These parameters were evaluated before and after 6 months of ALC administration. The occurrence of a spontaneous menstruation was observed in 6 out of 10 hypogonadotropinemic and in 4 out of 10 normogonadotropinemic patients. Menstrual bleeding occurred between the 3rd and the 6th month of therapy. Major hormonal changes after ALC administration were observed in the hypogonadotropic subjects. They showed a significant increase in baseline plasma LH levels (from 0.9±0.1 to 3.5±0.7 mIU/ml,p<0.05) (mean ± SEM), a significant increase in LH pulse amplitude (p < 0.01) with no changes in LH pulse frequency, and a significantly increased response of LH to the latter GnRH bolus during the GnRH test. Hypogonadotropic patients also showed a significant increase in both estradiol (from 18.8 ± 2.5 to 48 ± 3.3 pg/ml, p < 0.05) and PRL (from 6±1 to 11.4±1.7 ng/ml, p<0.05). No significant differences were observed in the hormonal parameters of normogonadotropic patients after 6 months of ALC therapy. Thus, ALC treatment was effective in some patients with hypothalamic amenorrhea, inducing a menstrual bleeding and a normal menstrual cycle. Moreover, in patients with hypogonadotropic amenorrhea, ALC treatment raised the LH plasma levels and LH response to exogenous GnRH. These data support the possible use of acetyl‐1‐carnitine as drug for the treatment of some forms of hypothalamic amenorrhea.
Umbilical metastasis (Sister Joseph's nodule) from carcinoma of the vagina
Authors: Bakri Younes N. , Subhi Jamal , Hashim Ebtihaj , Senoussi Mohammed
Published: November 2007

A case is reported of a squamous cell carcinoma of the vagina with metastasis to the umbilicus (Sister Mary Joseph's nodule). Systemic cisplatinum chemotherapy resulted in partial response, however, the “nodule” was a sign of poor prognosis and indicative of short‐term survival. To the best of our knowledge, this is the first report of umbilical metastasis from a primary carcinoma of the vagina.
Air embolism due to pulmonary barotrauma in a patient undergoing cesarean section
Authors: Sadan O. , Adler M. , Ezra S. , Zakut H.
Published: November 2007

Air embolism may occur following criminal abortion, vaginal douching, powder insufflation as treatment for vaginal infections, and orogenital sex. The patient reported in this work deteriorated following pulmonary barotrauma. Diagnosis was made 16 h after the appearance of neurological signs. She was transferred immediately to the hyperbaric unit. The speed and completeness of recovery are directly related to the prompt diagnosis and commencement of therapy. Failure is more likely related to delay.
Experience with GnRH agonists in an in vitro fertilization (IVF) program
Authors: Forsdahl Finn , Holst Nicolai , Hansen Lars Jul , Bertheussen Kjell
Published: November 2007

The experience using pre‐treatment with GnRH‐agonists in an IVF‐program are reported. 55 patients having a ‘poor response’, premature LH surge, or follicular luteinization in previous treatment cycles were treated for a total of 68 cycles. Therapy with GnRH agonists was initiated in the midluteal phase, and given by self‐administration subcutaneously. Stimulation started with exogeneous gonadotropins on a fixed day (Saturday) after pituitary desensitization had first been obtained, and resulted in all folicular punctures being performed on weekdays. Five treatment cycles (7.4%) were cancelled because of ‘poor response’. Where the indication for GnRH‐agonist therapy was previous ‘poor response’, a cancellation rate of 36.4% was observed, whereas a cancellation rate of only 1.8% was found in the other indication groups (p < 0.001). Altogether 26 clinical pregnancies were achieved, five of these ending in a spontaneous abortion. The rate of deliveries was 33% per oocyte retrieval, and 40% per pre‐embryo replacement.
Monochorionic monoamniotic twins—the most precarious of twin pregnancies
Authors: Dørum Anne , Nesheim Britt‐Ingjerd
Published: November 2007

Monochorionic monoamniotic twins have a high perinatal mortality rate. Death usually occurs before 24 weeks' gestation, mainly because of cord entanglement, prematurity, congenital anomalies or twin‐to‐twin transfusion. These possibilities should be taken into account when twin pregnancies are detected at the ultrasound screening between 17 and 20 weeks' pregnancy. We report here a case where monochorionic monoamniotic twins were born at 34 weeks, with massive cord entanglement and we describe the antenatal care at our clinic.
Antenatal Care in Southern Sweden: A Population‐Based Prospective Study Describing the Diagnostic Panorama of Pregnancy
Authors: Håkansson Anders , Åberg Anders , Atterwall Inger , Hagander Barbro , Schersten Bengt
Published: November 2007

All pregnant women from the catchment areas of three health centres in southern Sweden, registered for antenatal care during the calender year 1986, were included in the study population. Four hundred and nine women could be prospectively followed throughout pregnancy. By 15 completed weeks, 95% of the women were registered at an antenatal clinic. Only 2 women had no antenatal care at all. During the course of pregnancy the 409 women made altogether 6,058 (mean 14.8) visits to the health and medical services, most of them (95%) were to an antenatal clinic. Common obstetrical problems were vaginitis, symphysiolysis, threat of preterm labour, and vaginal bleeding; and common non‐obstetrical problems were low back pain and respiratory tract infections. During pregnancy 42% of the women were prescribed some sort of medication, and 53% were sicklisted on one or more occasions. The outcome of pregnancy was comparable to figures for all Sweden.
Sonography‐guided Fetal Blood Sampling for ph and Blood Gases in Premature Fetuses with Abnormal Fetal Heart Rate Traces
Authors: Shalev Eliezer , Dan Uzi , Yanai Nili , Weiner Ehud
Published: November 2007

In nine pregnancies, remote from term, with an abnormal Non‐Stress Test (NST) and Bio‐Physical Profile (BPP) of 3 or above, cordocentesis for fetal blood gas analysis was performed. In seven cases an immediate post‐partum blood sample was taken from the fetal cord for a similar analysis. The two tests gave very similar results. The results showed fetal acidemia (pH 7.09–7.19 and B. E. −10–15) in 4 cases, followed by immediate delivery. In the remaining 5 cases, normal blood gases were evident (pH 7.28–7.35); despite the abnormal NST, pregnancy was allowed to continue for 2 to 7 weeks, under close supervision. At birth, 2 out of 9 newborns were deemed by the neonatologist suffering from asphyxia. Both belonged to the acidemic group of women who were managed by immediate cesarean section. The other 5 fetuses, which were managed expectantly, had normal postpartum blood gases or Apgar score; none had asphyxia. Fetal blood gas analysis, on samples obtained by cordocentesis, provides useful information that can assist in the management of premature fetuses suspected of being distressed, according to their heart traces. Normal fetal blood gases can identify those fetuses falsely identified by the NST as in distress and thereby spare them unnecessary premature birth with its known complications.