bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antepartum Evaluation of Monochorionic Diamniotic (MD) Twins; MD‐Twin Score: A New Scoring Method for Perinatal Outcome
Authors: Kaneko Masatoki , Sameshima Hiroshi , Ikeda Tomoaki , Kodama Yuki , Ikenoue Tsuyomu 
Published: May 2010

AbstractObjective: Our purpose was to establish a new scoring method to survey monochorionic diamniotic (MD) twins during antepartum periods.Study Design: A retrospective study was performed regarding MD twins delivered between January 1992 and July 1996. Maternal and neonatal records were assessed for the following 5 perinatal variables; birth‐weight discordance, amniotic‐fluid discordance, hydrops fetalis, umbilical‐cord insertion, and fetal‐heart‐rate monitoring. Each variable was coded as normal or abnormal and then assigned an arbitrary weight of 0 if normal and 1 if abnormal, yielding a range of scores from 0 (all normal) to 5 (all abnormal). The relationships between individual variables and their combinations and the outcome of pregnancy was determined. A poor pregnancy outcome consisted of intrauterine death, neonatal death, or neurological sequelae of at least one twin. The 5‐variable combination was termed as the MD‐twin score. A chi‐square test and logistic regression analysis were used to determine statistical significance.Results: There were 59 MD pregnancies, of which 13 pregnancies resulted in a poor outcome. The single variable that most likely contributed to a poor outcome was amniotic‐fluid discordance. All 35 pregnancies with an MD‐twin score of ≤ 2 had a good outcome. There were 14 pregnancies with a score of 3, and 21% of them had a poor outcome. All of the pregnancies with a score of ≥ 4 had a poor outcome. When we chose the MD‐twin score of 3 as the critical point for a poor outcome, the likelihood ratio statistics became the highest of any single variable or any combination of variables.Conclusion: The MD‐twin score predicted poor outcomes better than did any single variable or combination of variables.
Profile of Maternal Smokers and Their Pregnancy Outcomes in South Western Sydney
Authors: Bai Jun , Wong Felix W. S. , Gyaneshwar Rajanishwar , Stewart Helen C. 
Published: May 2010

AbstractObjective: The prevalence of maternal smoking remains high in New South Wales. In order to better understand the profile of maternal smokers, a study has been conducted to examine the social and demographic characteristics and pregnancy outcomes of women who smoked during their pregnancy in south western Sydney.Methods: Women and babies of a retrospective cohort of 7,191 singleton births between March 1996 and December 1998, at Liverpool Hospital were analyzed.Results: The prevalence of maternal smoking for the study population was 18.8%. The study found that the sociodemographic factors, such as marital status, ethnic origin, English speaking background, working status during pregnancy, and private health insurance status were independent risk factors for maternal smoking, but maternal age was not. Women who smoked during their pregnancy had higher rates of abruptio placenta, threatened premature labour, and premature labour. The adverse neonatal outcomes due to maternal smoking were low birth weight and increased neonatal morbidity. Smoking appears to have a protective effect on pregnancy induced hypertension.Conclusion: The findings of this study suggests that future smoking cessation programs should pay more attention to addressing sociodemographic and cultural factors that influence the behaviour of maternal smokers.
A Case of Stage‐IVb Cervical Adenocarcinoma Successfully Treated by Combination Chemotherapy: Case Report
Authors: Takehara Masaki , Nishioka Yoshihiro , Saito Tsuyoshi , Baba Tsuyoshi , Suzuki Takahiro , Ito Eiki , Kudo Ryuichi 
Published: May 2010

AbstractA 54‐year‐old patient with a Stage IVb adenocarcinoma of the cervix was treated with combination chemotherapy. This regimen consisted of intravenous cisplatin (70 mg/m2) and aclacinomycin A (30 mg/m2) on Day 1, followed by mitomycin C (5 mg/m2) on Day 2 and 3. A pathologically complete response was achieved by this regimen. The patient is well and has been free of symptoms for 66 months.
Gynaecology in the New Millennium
Authors: Fong Yoke‐Fai , Singh Kuldip , Ratnam S. S. 
Published: May 2010

AbstractGreat challenges await the gynaecologist in the 21st century. While advances in medical technology necessitate that gynaecology move more towards a medical discipline than a surgical one, gynaecologists will be expected to play an increasingly important role in the modern woman's life. This fundamental change is influenced by four main factors, namely, the world's aging population, spread of information technology, advances in molecular based medical therapy, and the changing lifestyle of the woman in the next century. Our role cannot get any lesser as we continue to advise, educate and facilitate the lives of women, and we must aspire a new generation of responsible gynaecologists to continue this ambition.
Laparoscopic Management of Heterotopic Pregnancy: A Review
Authors: Pschera Helmut , Gatterer Achim 
Published: May 2010

AbstractLaparoscopic management of ectopic pregnancies is becoming more common. Having recently successfully treated one case of heterotopic pregnancy by laparoscopy in our department, the object of the present paper is to review the literature regarding laparoscopically treated cases of heterotopic pregnancy in order to assess benefits, complications and safety of this procedure. A Medline search yielded 10 additional cases with ampullary, interstitional or cornual tubal pregnancy, respectively. All surgical procedures were uncomplicated and all in utero pregnancies progressed normally. Despite a small number of cases, lack of complications in these reports is encouraging feasibility of laparoscopic management of heterotopic pregnancy.
Dimeric Inhibin A as a Fourth Marker for Down's Syndrome Maternal Serum Screening in Native Japanese Women
Authors: Yoshida Koyo , Kuwabara Yoshinori , Tanaka Tadao , Onda Takekazu , Kudo Ryuichi , Yamamoto Hiroyuki , Sato Akira , Yanagida Kaoru , Okai Takashi , Sakai Masato , Takai Yasushi , Uemura Hiraku , Hoshi Kazuhiko , Fukada Yukihito , Aono Toshihiro , Maeda Kazuhisa , Ogita Sachio , Ishiko Osamu , Murata Yuji , Kanzaki Toru , Myrick Faye , Grier Robert E. 
Published: May 2010

AbstractObjective: This study was conducted to assess the usefulness of dimeric inhibin A as a fourth marker for Down's syndrome screening in addition to AFP, hCG and uE3 markers for native Japanese women.Methods: Serum specimens from 367 native Japanese women in the second trimester were assayed for dimeric inhibin A levels. Day specific dimeric inhibin A medians were established for gestational ages 15.0–21.9. Weekly median values for the native Japanese were compared with those of a U.S. population. Selected Japanese specimens from 15 diagnosed Down's syndrome and 3 trisomy 18 cases were also assayed for dimeric inhibin A.Results: Dimeric inhibin A levels did not vary greatly over the gestational age range as expected. Median value comparison showed that native Japanese dimeric inhibin A medians are higher than the U.S. population medians by an average of 7.95%. Native Japanese dimeric inhibin A median values in this study are 1.77 times higher in Down's syndrome cases than in unaffected pregnancies. Trisomy 18 dimeric inhibin A levels show no significant difference from the unaffected pregnancies.Conclusions: This report shows for the first time that dimeric inhibin A can be informative as a fourth marker for Down's syndrome screening in native Japanese women. We expect the addition of dimeric inhibin A to a triple marker protocol will increase the accuracy of predicted risk for all pregnancies screened and increase the detection rate of Down's syndrome affected pregnancies.
Reasons for Improper Simple Hysterectomy in Patients with Invasive Cervical Cancer in the Northern Region of Thailand
Authors: Srisomboon Jatupol , Pantusart Aree , Phongnarisorn Chailert , Suprasert Prapaporn 
Published: May 2010

AbstractObjective: To determine the reasons for improper simple hysterectomy in the presence of invasive cervical cancer.Methods: The medical records of 70 patients who had undergone simple hysterectomy in the presence of invasive cervical cancer and were referred to Chiang Mai University Hospital between January 1991 and December 1998 were reviewed.Results: Approximately half of the patients presented with abnormal vaginal bleeding. Failure to perform a Papanicolaou smear before the operation accounted for 35.4%. Normal pelvic examination in which no gross invasive tumor was observed accounted for 59%. The most common indications for inappropriate operation was cervical dysplasia. The reasons for inappropriate simple hysterectomy included lack of preoperative cervical cytology (22.8%), incomplete evaluation of cervical dysplasia or microinvasion on biopsy (21.4%), false‐negative cervical cytology (18.6%), failure to perform an endocervical curettage following conization (8.6%), emergency hysterectomy (8.6%), failure to perform indicated conization (5.6%), errors in colposcopic examination (4.3%), incomplete evaluation of an abnormal cervical cytology (1.4%), failure to perform endocervical currettage following loop conization (1.4%), failure to review slide (1.4%), failure to check the pathology report (1.4%), failure to biopsy a gross cervical lesion, and skipped lesion in upper part of the endocervix (1.4%). One case of invasive disease was missed for unknown reason.Conclusion: Most cases of inappropriate hysterectomy resulted from deviation from guideline for cervical cancer detection. Preoperative Papanicolaou smear and strict adherence to the well‐established diagnostic protocol for patients with an abnormal smear are advised to prevent such occurrence.
Chemotherapy in Recurrent Epithelial Ovarian Cancer (EOC): An Analysis of Prognostic Factors
Authors: Shamsunder S. , Kumar Lalit , Gupta S. , Kumar S. , Bhatla N. , Singh R. , Kochupillai V. 
Published: May 2010

AbstractObjective: Prognosis of patients with recurrent epithelial ovarian cancer (EOC) is generally poor. Cisplatin is the most effective drug. We used three cisplatin based chemotherapeutic (CT) regimens and retrospectively analyzed the data to determine the response rate, toxicity, survival and the impact of various prognostic factors on the outcome.Patients and Methods: Between August, 1989 and September, 1997, 102 patients were diagnosed to have recurrent EOC. Sixty‐five of 102 patients received CT every 3 weeks using cisplatin 75 mg/m2 IV day 1 plus cyclophosphamide 750 mg/m2 IV day 1 (CP, Group A, n = 29), cisplatin 75 mg/m2 IV day 1, plus adriamycin 40 mg/m2 IV day 1 and cyclophosphamide (CAP, Group B, n = 22) and paclitaxel 135 mg/m2 IV day 1 plus cisplatin 75 mg/m2 IV day 1 (TP, Group C, n = 14). Twelve patients received single agent CT and were not analyzed. Remaining 25 patients refused CT treatment and were followed for survival.Results: The overall response rate (complete and partial) was 59.2% for patients receiving CP (Group A), 45% for CAP (Group B) and 76.9% for those receiving TP (Group C), p = ns. Response rate was significantly higher for patients with platinum sensitive disease compared to those with platinum resistant disease; 55.76 vs 39%, p < 0.007. CT was generally tolerated well; 2 patients died of CT toxicity, one each in Group A (CP) and C (TP), respectively. The median survival from the date of relapse for patients receiving chemotherapy was 15 months compared to 4 months for those who did not receive chemotherapy, p < 0.001.Chemotherapy responders had a significantly higher median survival than chemotherapy non‐responders, 24 months vs 10 months, p < 0.01. The median overall survival was not significantly different in the 3 groups; Group A‐15 months, Group B‐12 months and 15 months in Group C, p = 0.738. On univariate analysis — time since last CT (< 6 months vs > 6 months, p < 0.037, response to previous CT, p < 0.0183, cisplatinum sensitivity vs resistance, p < 0.032, number of sites (< 2 vs > 2) of recurrence, p < 0.004 and response to salvage CT, p < 0.01 were associated with survival benefit. On multivariate analysis, 2 factors — platinum sensitivity and response to salvage CT attained significance.Conclusions: Our study confirms the benefit of platinum based chemotherapy in recurrent EOC. Patients with platinum sensitive disease, and those responding to salvage chemotherapy benefit most.
Prenatal Diagnosis of Severe Tricuspid Insufficiency in Ebstein's Anomaly with Pulmonary Atresia and Intact Ventricular Septum: A Case Report
Authors: Song Tae‐Bok , Lee Jee‐Young , Kim Yoon‐Ha , Oh Bong‐Suk , Kim Eun‐Kyung 
Published: May 2010

AbstractPulmonary atresia with intact ventricular septum is an uncommon congenital cardiac anomaly which very often present varying degrees of downward displacement and dysplasia of the tricuspid valve.A 23‐year‐old woman was referred at 23 weeks' gestation because of fetal cardiomegaly detected by routine ultrasonography. Ebstein's anomaly with pulmonary atresia was diagnosed by fetal echocardiography. On pulsed Doppler examination, a severe tricuspid regurgitation was detected. Pulmonary atresia was suspected, as forward flow was not detected into pulmonary artery. The fetus was terminated at 25 weeks. At the postmorterm examination Ebstein's anomaly with pulmonary atresia and intact ventricular septum were confirmed.The finding of right atrial enlargement on an early sonogram should prompt the search for tricuspid valve abnormalities with tricuspid regurgitation and the presence or development of pulmonary atresia or stenosis. With the information provided, early detection of tricupid valve disease should be possible so that the option of therapeutic abortion can be offered.
Surgical Management of Genital Prolapse: Is Chain Cystourethrography Useful for Evaluating Anatomical Corrections and Urinary Symptoms after Surgery?
Authors: Baba Tsuyoshi , Koizumi Motoiki , Tanaka Ryoichi , Yamashita Satoko , Noda Masanari , Yamanaka Ikuhito , Suzuki Takahiro , Ito Eiki , Kudo Ryuichi 
Published: May 2010

AbstractObjective: To evaluate the relationship between chain cystourethrography and surgery for genital prolapse and urinary symptoms.Methods: A retrospective study of women with genital prolapse was conducted from January 1991 through December 1997. To assess the preoperative and postoperative anatomical situations objectively, chain cystourethrography was performed.Results: Fifty‐seven patients underwent surgical repairs for genital prolapse. All of them recovered from the genital prolapse both subjectively and objectively after surgery. Chain cystourethrography is useful for evaluating postoperative anatomical corrections. However, 6 patients (12%) suffered from a recurrent feeling of genital prolapse, and 14 patients (28%) had urinary symptoms postoperatively.Conclusions: Our treatment showed good anatomical corrections based on chain cystourethrography, and there were no prognostic differences among the surgical procedures. However, anatomical correction does not always mean improvement of urinary symptoms. Further studies are needed to clarify what factors contribute to the prognosis in such cases.
Clinical Applications of Serum Placental Protein 14 (PP14) Measurement in the IVF‐ET Cycle
Authors: Suzuki Yoshichika , Sugiyama Rikikazu , Fukumine Noritaka , Usuda Saburo , Itoh Hiroe , Isaka Keiichi , Takayama Masaomi , Teisner Borge 
Published: May 2010

AbstractObjective: Placental protein 14 (PP14) is known to be one of the endometrial proteins that reflect endometrial functioning throughout the menstrual cycle. In this study, we examined PP14 as a marker for human endometrial receptivity in order to predict the outcome of in vitro fertilization and the embryo‐transfer (IVF‐ET) cycle.Patients and Methods: The subjects were 72 women who had 96 IVF‐ET cycles and who were examined at Tokyo Medical University Hospital during the period of January 1998 to June 1998 because of mechanical or unexplained infertility for a duration of at least 2 years. Serum samples were collected from all patients during treatment cycles, and serum PPI4 concentrations were measured by a newly established enzyme‐linked immunosorbent assay (ELISA).Results: In the pregnant group, serum PP14 concentrations were markedly increased after ET, and a significant difference between the pregnant group and the nonpregnant group was observed 8 days following ET (p < 0.01). PP14 concentrations were higher in patients with endometria that exhibited homogenous patterns and that were more than 7 mm thicker than in other patients, as determined by ultrasound on the day of oocyte collection (p < 0.005). The pregnancy rates of patients with homogeneous patterns were lower than those of patients showing a trilaminar pattern. No pregnancies were observed when serum PP14 concentrations were greater than 6.85 U/l on the day of oocyte collection.Conclusion: PP14 might be a useful marker for human endometrial receptivity to predict the outcome of IVF‐ET cycles.
Emergency Postpartum Hysterectomy in Obstetric Practice
Authors: Yamamoto Hiroyuki , Sagae Satoru , Nishikawa Satoshi , Kudo Ryuichi 
Published: May 2010

AbstractObjectives: To review cases of emergency postpartum hysterectomies performed in the setting of life‐threatening hemorrhaging.Methods: A retrospective study of 17 patients who underwent postpartum hysterectomies during January 1, 1985‐December 31, 1998 was undertaken. Maternal characteristics, method of delivery, antenatal complications for hysterectomy, obstetric history, placental location, blood loss before hysterectomy and during operation, intraoperative and postoperative complications, and operative procedures were investigated, as was whether prostaglandin F2α and/or oxytocin were administrated during labor. The operative procedures also were examined.Results: The incidence was 1 in 6,978 deliveries (0.014%). All patients were transported from affiliated clinics. The leading cause for a hysterectomy was uterine rupture (35.3%), followed by disseminated intravascular coagulation (DIC) due to placental abruption (29.4%), and uterine atony (23.5%). Failure of internal iliac‐artery ligation occurred in 7 patients.Conclusions: Internal iliac‐artery ligation is not effective for patients with massive blood loss. In such cases, it is desirable for the private physician to make an early decision for maternal transport.
Is There a Relationship between Uterine Activity and the Length of the Cervix in the Second Trimester?
Authors: Cook Colleen‐Maree , Ellwood David A. 
Published: May 2010

AbstractObjective: The purpose of this study was to determine if a relationship could be detected between uterine activity and cervical change in the second trimester.Methods: Ten women with evidence of cervical change and 10 women with no cervical change (controls) were studied between 20 and 28 weeks gestation. Uterine activity was recorded using home uterine activity monitoring units. Cervical assessment was performed using transvaginal ultrasound.Results: There was no statistically significant difference in the contractions per hour in the cervical change group (1.26 + 0.38; mean + SEM) compared to the controls (1.13 + 0.48) (p 0.48; Mann‐Whitney U test). There were significant differences in closed endocervical length (p < 0.001) and internal os dilatation (p 0.004), the cervical change group demonstrating a shorter closed endocervical length and greater internal os dilatation.Conclusions: This preliminary study shows no evidence of a relationship between uterine activity and endocervical canal length in the second trimester.
Gonadotropin‐Releasing Hormone Analogue Therapy for Peritoneal Inclusion Cysts after Gynecological Surgery
Authors: Nozawa Shiro , Iwata Takashi , Yamashita Hiroshi , Banno Koji , Kubushiro Kaneyuki , Aoki Rui , Tsukazaki Katsumi 
Published: May 2010

AbstractObjective: The purpose of this report is to estimate the effectiveness of gonadotropin‐releasing hormone analogue (Gn‐RHa) therapy for peritoneal inclusion cysts.Methods: Patients who had cystic masses that developed after gynecological surgery and were strongly suspected of being peritoneal inclusion cysts based on the results of ultrasound, magnetic resonance imaging (MRI), and tumor marker studies, were treated with a Gn‐RHa (buserelin acetate or leuprorelin acetate). Buserelin acetate was administered at a dose of 900 μg/day, and leuprorelin acetate at a dose of 3.75 mg/month. Ultrasonography was performed in the outpatient clinic every 2 weeks after the start of administration to measure the diameter of cysts.Results: We treated 8 patients with peritoneal inclusion cysts conservatively with a Gn‐RHa. The cysts resolved in 7 of the patients. Two of them developed a recurrence, but further Gn‐RHa therapy was followed by complete resolution of the cysts in one patient and we resume Gn‐RHa therapy to the other patient. The peritoneal inclusion cysts failed to shrink in only one patient.Conclusion: It is suggested that Gn‐RHa therapy is effective in some cases of peritoneal inclusion cysts.
A Report on More than 10,000 Vaginal Hysterectomies Performed Without Ligation of the Paracervical Ligaments
Authors: Kudo Ryuichi , Sagae Satoru , Itoh Eiki , Hayakawa Osamu , Koizumi Motoiki , Ishioka Shin‐ichi 
Published: May 2010

AbstractObjective: To review 10,016 cases of total vaginal hysterectomy (TVH) performed in our department by a method without ligation of the paracervical ligaments.Methods: From 1955 to 1997, a total of 10,016 TVHs without ligation of the paracervical ligaments were performed at the Department of Obstetrics and Gynecology, Sapporo Medical University Hospital.Results: Of all 22,509 gynecological operations, 44.5% were TVHs, and 8.7% were total abdominal hysterectomies (TAHs). The operative time of our TVHs ranged from 31–60 minutes in 44.1% of the cases, and from 61–90 minutes in 35.3% of the cases. Blood loss was less than 300 ml in 85% of the cases. Abdominal conversion from the vaginal approach occurred in 110 cases (1%). Operative complications also occurred only in 0.7% (69) of the cases.Conclusion: TVH without ligation of the paracervical ligaments is a safe and convenient method that has very few complications and that can be utilized by many gynecologists.
A Case of Uterine Endometrial Carcinoma 15 Months Post‐Partum
Authors: Ishioka Shin‐ichi , Sagae Satoru , Saito Tsuyoshi , Sugimura Masaki , Akutagawa Noriyuki , Nishimura Makoto , Ezaka Yoshiaki , Kudo Ryuichi 
Published: May 2010

AbstractA case of uterine endometrial carcinoma 15 months post‐partum, who did have none of typical risk factors of uterine endometrial carcinoma, is presented. The occurrence of postpartum uterine endometrial carcinoma is extremely rare condition probably due to anti‐carcinogenic effects of progesterone. Progesterone refractory cells in the uterine endometrium, which could be an origin of the endometrial carcinoma, might have existed.
Body Fat Distribution as a Risk Factor of Endometrial Cancer
Authors: Iemura Akiko , Douchi Tsutomu , Yamamoto1 Shinako , Yoshimitsu Nobuyuki , Nagata Yukihiro 
Published: May 2010

AbstractObjective: To investigate the relative contributions of upper body fat distribution and overall adiposity to endometrial cancer risk.Methods: Subjects were 63 postmenopausal women with endometrial cancer aged less than 70 years and 201 age‐matched controls. Age, age at menopause, years since menopause, height, weight, and body mass index were recorded at the time of admission. The trunk‐leg fat ratio, body fat mass, trunk fat mass, and the percentage of body fat were measured by dual‐energy X‐ray absorptiometry.Results:Trunk‐leg fat ratio was higher in endometrial cancer patients than in controls (1.40 + 0.59 vs 1.23 + 0.39, p < 0.05). Whereas, other variables including age at menopause, percentage of body fat, body fat mass, and body mass index did not differ between the 2 groups. On stepwise multiple regression analysis, the trunk‐leg fat ratio was still correlated with the presence of endometrial cancer (p < 0.05).Conclusions: Upper body fat distribution rather than overall adiposity is associated with endometrial cancer risk.