Acta obstetrica et gynaecologica Japonica最新文献

Following successful preceding studies, a quantitative analysis of the female pelvic cavity was made using contact compound scanning procedures. The subjects were seventy-seven, 3 day postpartum women and ultrasonic tomograms were obtained concerning the five pelvic transections in each individual. For the quantitative analysis, variables of binary digits were used. Such were based on the standard of "normopelvis" in the polar coordinate system plus the external criteria, normal progress of labor, protraction and arrest disorders. Characteristics of the dystocia pelvis included an abnormal side wall of the small pelvis as well as an increased resistance of the muscles of the pelvic floor. The efficiency of the discrimination was greatest when those variables were adopted from each transection (78.3%). Arrest disorders could be clearly distinguished from the normal cases, however, cases of protraction disorder presented more difficulty as the distribution was wide between normal and the arrest disorder. Here, the pelvic floor muscles contribute significantly. The newly developed numerical system should make feasible an early prediction of dystocia, assist in screening processes and pave the way for accurate assessments of the interaction of anatomical factors related to the mechanics and processes of labor.

For the purpose of analysis of cancer specific immune reactions in gynecological malignancies, Leucocyte Migration Inhibition Test (LMIT: agarose-plate method) has been examined with tumor extract. Tumor extracts as antigens were prepared from 27 cases of cervical cancer, 14 of ovarian cancer, 4 of endometrial cancer, 4 of choriocarcinoma, 3 of vulval cancer and 3 of uterine sarcoma as well as control tissue extracts by hypertonic potassium chloride method (3 M-KCl method). The same antigens were also used for skin reaction test and leucocyte adherence inhibition (LAI) assay. 1. LMIT The positive reaction with autochthonous tumor extracts were 6/27 (22.2%) cases in cervical cancer, 4/14 (28.6%) in ovarian cancer, 1/4 in endometrial cancer, 1/4 in choriocarcinoma, 0/3 in vulval cancer, 1/3 in uterine sarcoma. But their reactions with control tissue extracts were all negative. Only a case of ovarian cancer and another of endometrial cancer with cancer extracts of the same types showed positive reaction. 2. Correlations of among LMIT, LAI and skin reaction--Positive reactions of LAIs and skin reactions which were simultaneously examined using the autochthonous tumor extracts were 0-60% in gynecological malignancies. The results yielded the agreement rate with LAI of 77.8%, and that with skin reaction of 55.6%. 3. The antigeneic localization of tumor extract--We gained 3 fractions from the cervical cancer extract, which was LMIT-positive, by Sephadex G-200 gel column chromatography. The antigenicity of the extract was found to be in the high molecular weight fraction.

Human luteal cells have characteristic organelles, such as well developed smooth endoplasmic reticulum (sER), large mitochondria with tubular cristae, lysosome like granules and lipid droplets. To investigate possible roles of these characteristic organelles, 21 human active corpora lutea, obtained from women aged 32-46, were studied cytochemically on 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), cytochrome c oxidase (CY-O), NADPH diaphorase (NP-DP) and acid phosphatase (ACP) activities, using the methods by Benkoël et al., Ogawa et al., Ago et Ogawa and Barka et Anderson. Subcellular localization of 3 beta-sterol were also examined using the 3 beta-sterol digitonin complex method by Mizuhira et al., 3 beta-HSD and NP-DP activities were demonstrated in the intercrystal and outer space of mitochondria and sER. CY-O activities were demonstrated in mitochondria. ACP activities were demonstrated in lysosomes and Golgi apparatus. Some lipid droplets contained the crystals of 3 beta-sterol digitonin complex. These data suggest that human luteal mitochondria can synthetize progesterone from cholesterol, and that mitochondrial respiratory chain activities in human luteal cells is highly elevated. Human luteal cells probably require much oxygen. Elevated ACP activities indicate that lysosomes play a role in the steroidogenesis. Some lipid droplets may contain cholesterol and other 3 beta-sterols.

The activity of 15-hydroxy prostaglandin dehydrogenase (15 OH-PGDH) was studied in the human placenta by the biochemical determination and enzyme histochemical technique. The placentae of 6-40 weeks of gestation were obtained from artificial abortion, spontaneous abortion and normal delivery. 1) The capability of prostaglandin metabolism in the placenta increased according to gestational age. 2) The relative potency of 15 OH-PGDH activity among different tissues was placenta villi greater than chorion greater than decidua greater than amnion. The enzyme histochemical technique has disclosed the same results. 3) The conversion rate of PGF2 alpha to 15-keto PGF 2 alpha was dominant in the maternal side rather than fetal blood vessel system in the perfusion experiment of placenta. 4) The strong activity of 15 OH-PGDH was mainly localized in the syncytiotrophoblasts of placenta villi. 5) The activity of 15 OH-PGDH decreased in the placenta of abortion. The decrease of this enzyme activity was not detected in the toxemia of pregnancy. It has been postulated that endogenous and exogenous prostaglandin, which possesses strong and multiple biological activity, increases in the pregnancy. The present results suggest that the prostaglandin metabolic system in the placenta has the important role in the continuity of pregnancy.

This paper is concerned with the methods and results of fetal growth assessment by using the real-time ultrasono-tomography under our newly systematized flow of the fetal management. The following results were obtained. 1) At early stage of pregnancy gestational age of the fetus may be corrected more precisely with the measurement of fetal crown-rump length (CRL) than diameter of amniotic space. 2) The correlation coefficient between gestational days by BBT base and CRL was 0.990 and standard deviation was +/- 2.3 mm. The error of estimated gestational days was +/- 3 days. 3) With one parameter such as the biparietal diameter (BPD), or the fetal abdominal circumference (FAC), it seems to be difficult to find out abnormal fetal growth from the normal growth at the last stage of pregnancy. 4) The discriminant function [Z = 0.6012 X (BPD) + 3 . 100 X (FAC) - 45.204] was obtained within seven days of delivery in order to find immature and mature neonates. With this equation, the probability for correct diagnosis was 90.4%, and 9 in 10 cases of IUGR were predicted. 5) Using four parameters (BPD, FAC, Gestational age, Uterine length), the predicted birth weights was computed. The correlation coefficient between the predicted birth weights and the actual birth weights was 0.852 and 1 S.D. was +/- 281 gram.

The purpose of this study is to determine the steroidogenesis of polycystic ovary syndrome (PCO), through the comparison of steroidogenic potential between polycystic and normal ovarian cells harvested from follicles under 6 mm in diameter in vitro. 1) The granulosa cells were cultured by monolayer culture method, while the thecal tissue by explant culture method, at 37 degrees C using 5% CO2 in air for 18 days. 2) The cultured granulosa cells and thecal tissue grew successfully under 20% fetal calf serum with 80% medium 199. 3) The major product secreted by the cultured granulosa cells was progesterone, and the difference of steroidogenic potential between normal ovary and PCO was not significant. 4) The major products of isolated thecal tissue were delta 4-androstenedione and testosterone. Particularly, the cultured thecal tissue from PCO accumulated more androgens, in comparison with that from normal ovary. 5) The secretion of estradiol by the cultured granulosa cells was low in the absence of estrogen substrate and FSH. There was not appreciable difference in the capacity of granulosa cells from normal ovary and PCO to secrete estradiol. These results suggest that steroidogenic potential of isolated granulosa cells from PCO is comparable to that from normal ovary, whereas thecal tissue from PCO has more androgenic capacity than that from normal ovary.

We aimed to measure acid glycosaminoglycans (aGAG) and its composition in nonpregnant and immediately postpartum rabbits uterine cervix and body. aGAG was extracted from the uterine tissues by the modified method of K. Anno (1964) and determined by the carbazole method (Bitter, 1962). Component of aGAG were separated and identified by electrophoresis (0.3 M calcium acetate, veronal buffer, 0.1 M veronal -0.15 M ammonia water, 0.2 M ZnSO4) using acetate cellulose strips. aGAG from uterine cervix and body were separated in three bands which we considered to be hyaluronic acid, heparan sulfate and chondroitin sulfate. Hyaluronic acid was dominant in the cervix, on the other hand the components of aGAG without hyaluronic acid were dominant in the body. This compositional changes were also demonstrated by histochemical digestion test and metachromasia method. We considered these changes as a sign of cervical ripening at term pregnancy.

Morphological and endocrinological studies were performed on a 19-year-old case of an arrhenoblastoma with marked virilization. The tumor was an intermediate type of Meyer's classification. Histochemically, 3 beta-HSD and G-6-PDH activities were demonstrated in Leydig cells. These cells also had ultrastructures typical of steroid-producing cells. Basal blood cells of pregnenolone, dehydroepiandrosterone, testosterone (T), androstenedione (A), progesterone, estradiol, estrone, LH, and FSH were determined pre- and postoperatively. T and A showed a very high level preoperatively, and were markedly decreased immediately after removal of the tumor. Stimulation of tumor cells by HMG-HCG did not show any significant changes in their main products of T and A. These findings suggest that Leydig cells of the present tumor produced mainly A and T independently on gonadotropins, and these hormones had virilized the patient.