Investigation on the Mode of HMG Administration -especially on the prevention of side effects -

In HMG-HCG therapy, the FSH level in serum increases gradually by administering HMG every day. Such an unphysiological phenomenon develops and matures many follicles simultaneously, leading to OHSS and multiple pregnancy. Contrarily in the every-other-day administration, the FSH level in serum remains almost unchanged or increases only slightly and less mature follicles are developed. The risk of causing OHSS and multiple pregnancy is lowered in this way. The every-other-day administration is therfore considered to be a valuable method causing less side effects. The demerit of lower ovulation rate in the every-other-day administration could be amended by some methodological improvement. It is concluded that this a promising therapy

Radioimmunoassay of Plasma 17α-Hydroxyprogesterone

A radioimmunoassay for the measurement of 17α-hydroxyprogesterone (17α-OHP) in plasma was investigated utilizing antiserum produced by the introduction of 17α-hydroxyproges- terone-3-oxim BSA. Accuracy was such that within-assay variance was 16.2% and between-assay variance 18.3%. The 17α-OHP mean plasma levels were 930±201 pg/ml(n=8)for normal adult males and 402±186 pg/ml(n=11)in the follicular phase and 1,190±662 pg/ml(n=12)in the luteal phase of females with a normal menstrual cycle. The 17α-OHP levels in some tissues and tissue fluid also were measured, being 18.06±12.91 ng/ml(n=6) in the normal trophoblastic tissue, 1.7±0.5 ng/ml(n=17) in the trophoblastic tissue of a hydatidiform mole and 855.5±507.4 ng/ml(n=5)in lutein cyst fluid

Laparoscopic Diagnosis of Adenomyosis : a Case Report

Usually, Adenomyosis is diagnosed after surgery. Laparoscopic diagnosis may have advantages over other surgical procedures, especially for infertility patients undergoing expectant therapy. We successfully diagnosed adenomyosis using a laparoscopic needle biopsy technique in an infertility patient

A Comparative Study between Vaginal and Rectal Routs of Bromocriptine Administration

To assess the efficacy and possible potential side effects of alternate routes of treatment, 2.5mg bromocriptine was administered vaginally or rectally to five normoprolactinemic and four idiopathic hyperprolactinemic women. Serum bromocriptine and prolactin (PRL) levels were measured hourly for the first 12 hours, then every 2 hours for the following 12 hours. The mean peak bromocriptine levels were 641.0 ± 200.1 pg/ml and 386.5 ± 134.8 pg/ml in the normoprolactinemic and hyperprolactinemic groups, respectively. Maximum PRL reduction rate was 67.7 ± 3.4% at 11.3 ± 1.1 hours and 44.8 ± 0.7% at 21.5 ± 1.5 hours after vaginal administration in the normoprolactinemic and hyperprolactinemic groups, respectively. In contrast, in the rectal treatment group the mean peak values of serum bromocriptine were 364 pg/ml and 314.5 ± 3.9 pg/ml in the normoprolactinemic and hyperprolactinemic groups, respectively. Maximum PRL reduction rate was 38.1% at 8 hours and 21.0 ± 10.4% at 17.0 ± 3.5 hours in the normoprolactinemic and hyperprolactinemic gryoups, respectively. In conclusion, we suggest that the vaginal route of administration is as effective and has fewer side effects than by the oral route. Furthermore, the rectal route is an alternate method of treatment for patients who cannot be administered bromocriptine by vaginal route

Special Report A Genetic Counseling System in Nagasaki Prefecture: The Course and Current Status of the Genetic Counseling Unit in Nagasaki University Hospital

Recent progress in genetic medicine is remarkable and seems to be getting ahead of the general population. For a proper application of genetic medicine to people, genetic counseling is essential. There are few institutions that can provide sufficient genetic counseling in Japan. In response to a proposal by the Ministry of Health, Labour and Welfare to establish a genetic counseling system, Nagasaki prefecture started the genetic counseling model project in 1999 and entrusted Nagasaki University Hospital to become its core, a genetic counseling center. At the same time, Nagasaki University Hospital set up the Genetic Counseling Unit as an independent clinical division to respond the social needs. We describe here the course and current status of the trial to establish a district-adhered genetic counseling system in recent two years in Nagasaki prefecture

Prenatal Vitamin E Treatment Improves Lung Growth in Fetal Rats with Congenital Diaphragmatic Hernia

The aim of this study was to test the effects of vitamin E on fetal lung growth in rats with congenital diaphragmatic hernia (CDH). Experimental congenital diaphragmatic hernia (CDH) was induced in rat fetuses by maternal administration of 100 mg nitrofen by gastric gavage on day 9.5 of gestation. Vitamin E was provided at days 16-20 of gestation, at 30 IU/day. Cesarean section was performed at day 21 of gestation. Immunohistochemistry was performed using anti-surfactant protein A (SP-A) and anti-SP-B polyclonal antibodies. RT-PCR evaluated SP-A and SP-B mRNA expressions. The lung weight/body weight ratio in rats with CDH was lower than the control (p<0.01). The number of type II pneumocytes positive for SP-A in untreated CDH rats (n=20) was lower than the control (n=20). The relative amounts of SP-A and SP-B were significantly higher in vitamin Etreated CDH rats (n=20) than untreated CDH rats (p<0.05). Our results suggest that antenatal vitamin E treatment increases the production of surfactant proteins in hypoplastic lung of rats with the CDH

Histological and Immunohistochemical Analysis of Fetal Hypoplastic Lungs: Preliminary Study

To investigate cellular growth and differentiation of the airway epithelium of the human fetal lung using immunohistochemistry, with a particular focus on cases of pulmonary hypoplasia. A total of 25 autopsy cases of stillbirth and early neonatal death were examined at Nagasaki University Hospital from 1986 to 1997. Using immunohistochemistry, we determined the expression of a variety of growth factors (EGFR, HGFR, GRP and SAPA) in lung tissues with or without pulmonary hypoplasia. A significant decrease in radial alveolar count was detected in hypoplastic lungs compared with normal lungs. The expressions of EGFR, HGFR and GRP in tissues from hypoplastic lungs were significantly lower than in tissues from normal lungs, but the expression of SAPA was not different between the two groups. Our results indicated that significant abnormalities of cellular growth and differentiation are present in pulmonary hypoplasia. However, lung maturation in pulmonary hypoplasia was not significantly different to that in normal lungs

Adenocarcinoma of the Uterine Cervix Detected Over Long-Term Mass Screening in Japan

We retrospectively reviewed the history, records of detailed examination and/or treatment, and cytologic/histologic specimens of 32 adenocarcinoma cases (0.006%) detected among 482,451 examinees in a mass screening for cervical cancer conducted over a 20-year period (1975-1994). The detection rate of adenocarcinoma had increased gradually until 1989 with the increase of total examinees but became markedly lower in the last five-year period (p = 0.0227), probably because of the significant decrease in the number of initial examinees (p<0.0001). The frequency of early-stage adenocarcinoma (stage 0 or Ia) was 37.5% (12/ 32), markedly higher than the 8.4% (7/83) of the adenocarcinoma cases treated at our institution during the same period (p = 0.0004). Glandular epithelial neoplasms were suggested by cervical smears at detection in only 5/12 (41.7%) of the early-stage adenocarcinoma cases and in 17/ 20 (85.0%) of the frankly invasive adenocarcinoma cases (p= 0.0184). Atypical glandular epithelial cells could not be found in the smears at detection from the remaining 10 cases. Atypical cells from coexisting squamous cell neoplasms were found. The rate of the histologic coexistence of squamous cell neoplasms was 9/12 (75.0%) in the earlystage group and 6/20 (30.0%) in the frankly invasive group (p = 0.0269). This rate tended to decrease with the progress of the stage. Mass screening can detect early-stage adenocarcinoma in cervical smears, but half or more of the cases are discovered in smears with atypical cells from coexisting squamous cell neoplasms and incidentally found later in histologic specimens. To improve the accuracy of detecting cervical adenocarcinomas, we should investigate the cytologic features of atypical glandular epithelial cells obtained from early-stage adenocarcinomas. The its epidemiologic profile of this cancer should be furthur delineated for efficient mass screening programs