Nihon Sanka Fujinka Gakkai zasshi最新文献

Specimens of ovarian cancers, which were obtained through laparotomy from 17 patients who received no preoperative chemotherapy and were examined histopathologically, were immunohistologically stained with anti-PCNA antibody to examine the ability to proliferate. The percent age of stained tumor cells per 1,000 cells was used as a PCNA-labeled rate. This rate was analyzed in relation to the clinical stage/histological type and the presence or absence of lymph node metastasis. 1. Tissue specimens were stained with anti-PCNA antibody in all cases, and the PCNA-labeled rate was 49.5 +/- 13.3%. 2. There were no significant differences in PCNA-labeled rates between different histological types or between clinical stages. 3. The PCNA-labeled rates was significantly higher in cases with metastasis than in those without metastasis (p < 0.01). 4. No metastasis was detected in the cases showing a PCNA-labeled rate of 50% or below. It was indicated that this PCNA-labeled rate, which can be determined with formalin-fixed specimens, is useful for evaluating the degree of biological malignancy of ovarian cancer.

The aim of this study was to elucidate the roles of free estradiol and free progesterone in endometrial development and the outcome of IVF-ET. Ovarian hyperstimulation with long GnRHa-hMG protocol was performed for IVF-ET. Proliferation and maturation in endometrium was evaluated by transvaginal sonography. Total steroid hormone levels in serum were determined by EIA and free steroid hormone levels were determined by ultrafiltration dialysis. Total estradiol and total progesterone levels were significantly higher in conception cycles than that in non-conception cycles after Day 14 (Day 0 is the day of hCG administration). In the case of free estradiol and free progesterone, the difference was seen as early as Day 11. The hyperechoic endometrial area ratios, which represent endometrial maturation, evaluated by sonography on Day 2 in conception cycles (75%) were higher than those in non-conception cycles (56%), although there was no difference in total estradiol and total progesterone levels on Day -2, 1, 2, but the percentage of free progesterone in conception cycles (2.5%) was higher after Day 1 than that in non-conception cycles (2.0%). These results suggest that the percentage of free progesterone played an important role in successful conception and could be an indicator to estimate conception.

Calcaneum bone stiffness in 222 young women was investigated by using an ultra-sound bone densitometer (Achilles). Their exercise experiences, amounts of dairy products (including foods which contain a lot of calcium) consumed and 24 questions on their eating attitudes were also analysed. Stiffness showed a significant (p < 0.05) positive correlation with age, BMI and the onset of menarche by polynomial (2) regressions. Using these three variables, expected stiffness was calculated by multiple regression, and according to the differences between the real and expected stiffness, the subjects were divided into three subgroups. Group H which showed higher stiffness, showed significantly (p < 0.05) higher exercise experiences and had the habit of consuming more dairy products and small fish than the other two groups. In all of the subjects, the most important variable which increased the stiffness was the exercise experience at junior high school and the next was the habit of eating small fish. The subjects who customarily ate their meals with their families were more likely to eat small fish. These findings suggest that family eating habits should be noticed not only in post-menopausal women, but also in young girls.

The obstetric course and neonatal outcome were studied in 35 pregnant women with neuropsychiatric disorders who were admitted to Toho University Ohmori Hospital between 1981 and 1990. The rate of live births associated with psychiatric disease was 0.49% (40 of 8.191 deliveries). These were schizophrenia (N = 17), epilepsy (N = 12), depression (N = 2), neurosis (N = 3) and psychogenic response (N = 1). Iron deficiency anemia was observed in 8 of 16 epileptic women. Cesarean section or vacuum extraction were performed in 15 of 40 cases (37.5%). The indications for these procedures were uncontrollable psychotic symptoms in all of 6 schizophrenic women, while those in all 7 epileptic women were obstetrical. Symptoms of schizophrenia became worse in 33.3% and 50% of the patients during and after birth, respectively. The incidence of preterm delivery was 15%, and 25% of newborn infants were of low birthweight. Drug withdrawal symptoms were observed in 4 of 16 infants (25%) born to epileptic mothers. Three of 10 offspring of epileptic mothers were affected by febrile convulsions within 6 years of age. Although a relatively higher incidence of obstetric complications has recognized, there seem to be no specific complications in epileptic or psychiatric women. Our results also suggest the importance and need for close cooperation between the obstetrician and psychiatrist, and a follow-up program for offspring.

Ovarian folliculogenesis is a dynamic process during which follicles undergo growth and differentiation. It is now evident that various growth factors interact with FSH to modify follicular growth and function. In the present study, the effects of tumor necrosis factor alpha (TNF alpha) on the proliferative potential and steroidogenic ability of granulosa cells were examined in vitro as a function of follicular growth by using a porcine model. Porcine granulosa cells obtained from small (1-2mm), medium (3-5mm) and large (6-12 mm) follicles were cultured under serum-free conditions in the presence or absence of FSH (100 ng/ml) and IGF-1 (100 ng/ml), with or without various concentrations of TNF alpha. The proliferative activity of cultured granulosa cells was assessed by immunocytochemical techniques with a monoclonal antibody to proliferating cell nuclear antigen (PCNA) and by [3H]-thymidine uptake, while differentiated functions of granulosa cells were assessed by determining the ability to secrete progesterone and 17 beta-estradiol. The addition of FSH and IGF-I augmented the proliferative activity and steroidogenic ability of cultured granulosa cells. The increases in proliferative activity and steroidogenic ability caused by treatment with FSH and IGF-I were significantly reduced by the concomitant treatment with TNF alpha in culture of granulosa cells. The inhibitory effect of TNF alpha on the proliferative activity was prominent in small follicle granulosa cells, whereas the inhibitory effect of TNF alpha on estradiol secretion was very strong in large follicle granulosa cells. The inhibitory effect of TNF alpha on progesterone secretion was apparent regardless of the stage of follicular growth. These results suggest TNF alpha participation in regulating the proliferation and differentiation of granulosa cells. In appears that the biological action of TNF alpha on granulosa cells may shift from the inhibition of proliferative activity in immature follicles to the inhibition of differentiated function in mature follicles during the course of follicular growth.

In order to investigate the role of local immune response in uterine cervical carcinogenesis, lymphocyte phenotypes infiltrating the cervical region were studied by indirect immunoperoxidase staining for natural killer (NK) cells, macrophages. Langerhans cells (LC), memory T cells, CD4-positive cells and CD8-positive cells. The specimens used in this study were 9 normal ectocervical epithelium samples, 28 with mild dysplasia, 28 with moderate dysplasia, 31 with severe dysplasia and 9 with carcinoma in situ (CIS). A quantitative study was conducted in 23 patients with persistent cervical dysplasia and a comparable control group of 17 patients with regressive dysplasia. Human papillomavirus (HPV) types 16 and 18 DNA was analyzed by using polymerase chain reaction techniques, and differences in local immune responses between cases with and others without HPV types 16 and 18 were studied. The results are as follows. 1) The numbers, of NK cells and macrophages increased as the grade of cervical dysplasia increased and the numbers of these cells in cases of cervical dysplasia were greater than in normal ectocervical epithelium and CIS. 2) The numbers of LC, memory T cells and CD4-positive cells also increased with the grade of cervical dysplasia. The number of memory T cells was significantly greater in severe cervical dysplasia than in normal ectocervical epithelium or mild dysplasia (p < 0.05). 3) There were statistically significant correlations between the number of white blood cells and those of stroma-infiltrating memory T cells (r = 0.98) and CD4-positive cells (r = 0.88). A positive correlation was found between the numbers of lymphocytes in epithelium and in subepithelium. 4) A significant reduction in CD4-positive cells was founded in persistent dysplasia compared with regressive dysplasia (p < 0.05). 5) Cases with and without HPV types 16 and 18 did not differ significantly with respect to local immune responses. It is therefore considered that the increased number of lymphocytes in cervical dysplasia and the decreased number in CIS might reflect active local immunosurveillance in the process of carcinogenesis. Lymphocytes, especially CD4-positive cells, may play an important role in surveillance against the development and progression of cervical cancer.

To analyze the association between the potential risk factors and ovarian cancer, we conducted a case-control study from October, 1994 to January, 1996 in northern Kyushu. We interviewed 78 patients whose ovarian cancer was histologically confirmed, and 346 controls, selected from women at mass screening, who had not ever suffered from a cancer or an ovarian disorder. An odds ratio (OR) and its 95% confidence interval (95% CI) were estimated by the conditional logistic regression method. As a result, it was found that the risk was significantly increased for a family history of ovarian cancer in a mother or a sister (OR = 2.85, 95% CI 1.01-8.08), for heavier maximum body weight in the past (trend, OR = 1.31, 95% CI 1.06-1.63), and for larger maximum body mass index (trend, OR = 1.30, 95% CI 1.06-1.60). Conversely, the risk was significantly decreased with the number of parities (trend, OR = 0.57, 95% CI 0.39-0.83), and with experience in having ever taken oral contraceptive pills (OR could not be calculated, p < 0.05). The positive relationship of maximum body weight or maximum body mass index to the ovarian cancer risk may in part explain the recent increase in the incidence of ovarian cancer in Japan.

To clarify the pattern of cytokeratin and vimentin expression in mixed adenocarcinoma and squamous cell carcinoma of the uterine cervix, twenty-three cases of formalin-fixed paraffin-embedded specimen were examined immunohistochemically using a panel of four different monoclonal anti-cytokeratin antibodies and anti-vimentin antibody. Fifty-seven cases of benign or malignant tissue were selected for controls. The results were summarized as follows. 1) In four cases of co-existing adenocarcinoma and squamous cell carcinoma, their immunostaining patterns were compatible with original histological cell type. 2) In four cases of adenoacanthoma, high molecular weight-cytokeratin (HCK) was positive in each acanthomatous component and only a small part of one adenocarcinomatous component. 3) In twelve cases of cervical adenosquamous carcinoma, HCK were positive in four adenocarcinomatous components. Out of eight cases with non-stained adenocarcinomatous components, six cases showed negativity for HCK even in the squamous cell carcinomatous component. 4) Though vimentin was negative in all cases of mixed type of cervical carcinoma, some cases of mixed type endometrial carcinoma were stained positively for vimentin. It was indicated from our study that adenosquamous carcinoma of the cervix could originate either in reserve cells or columunar epithelium and that vimentin positive cases could originate in the endometorial gland.