Monitoring of ovulation induction with human menopausal gonadotropin and human chorionic gonadotropin by ultrasonography : prevention of ovarian hyperstiumulation Syndrome

We monitored follicular development by ultrasonography on 40 anovulatory women on the day when we switched from HMG to HCG, and measured the maximum follicular diameter (mFD) and the sum total of follicular cross sectional area (FA) and examined the correlations of both mFD and FA with ovulation or OHSS. The ovulatory rate with mFD of more than 18mm was 100%. The correlation coefficients between mFD and serum estradiol level and moreover, FA and estradiol level were 0.3817 and 0.8099, respectively. From the above results, it is concluded taht in order to induce ovulation without the hazard of causing OHSS, it is best to switch from HMG to hCG when the patients have FA less than 7.0cm and mFD more than 18mm, respectively

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

Results of Postoperative Treatments in View of the Surgical Stage of Uterine Endometrial Carcinoma

Background : The indications for and the optimal mode of adjuvant therapy in surgically operated endometrial cancer patients have not yet been established. We studied the indications for the postoperative treatment of endometrial carcinoma patients based on their surgical stages (FIGO, 1988) . Methods : We retrospectively restaged the cases of 178 endometrial carcinoma patients who underwent hysterectomy with pelvic lymphadenectomy between 1965 and 1992 and who were followed-up longer than 3 years. The patients were subdivided into low- and high-risk groups, and we investigated the relation between their postoperative treatment and recurrence rates. Postoperative treatment was divided into the three groups of no/incomplete, external whole-pelvic irradiation (EWPI) and chemotherapy. Results : The 79 patients in Stage Ia or Ib had no/incomplete postoperative treatment, but only 1 (1.3%) had a recurrence. Four Stage IIa patients had no recurrence and all 3 low-risk patients had no postoperative treatment. Of the 5 Stage IIb, low-risk patients, 1 of the no postoperativetreatment group had a recurrence. The recurrence rate among the Stage IIb patients of the high-risk group was 40% (2/5) in the incomplete postoperative treatment group. The six Stage IIIa patients with EWPI. had no recurrence. In contrast, 14 of the 15 Stage IIIb and IIIc patients underwent postoperative EWPI, and 11 of them (78.6%) had a recurrence including 8 (81.8%) with a recurrence in distant regions. Conclusion : Postoperative treatment may be well omitted for many patients at Stage Ia or Ib and the low-risk group at Stage IIa based on surgical staging criteria. Patients in other surgical stages seemed to require to identify best postoperative treatment , but further randomized prospective studies will be required to identift the best mode of treatment

BEHAVIORAL PATTERN OF THE NEWBORN Earliest timing for iniciating attachment behavior in the infants.

The behavioral pattern during the first hour of life of 10 term neonate are reported by the study of minute by minute observation. The term newborn spent 65.5% of the first hour in the quiet alert state, 30.1% in the crying state and the rest 4.4% in the other states. The mean time spent in the dominant state of quiet alertness was 39.3 minutes. A sexual difference amongst the newborn was that the males spent 72.7% and the females spent 58.4% of the first hour in the quiet alert state. The predominant quiet alert state was analized for the time spent during the first 30 minutes and from 30 to 60 minutes. And it was found that 58.7% of the first 30 minutes and 76.4% of the second 30 minutes was spent in the quiet alert state. So it is suggested that during the time interval between 30 to 60 minutes after birth, the infants should be brought into physical contact with mothers for the first imprintation of the attachment-behavior in them, when they are in the state of maximum receptivity and the level of responses and reciprocation is at the optimum for promoting the attachment-behavior in the infants to be more deepening and long-lasting

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