Acta obstetrica et gynaecologica Japonica最新文献

To elucidate ultrasound irradiation effect on pre-implantation embryos, its mechanism and safety levels of ultrasound intensity, I had performed ultrasound irradiation and thermal experiments on pre-implantation embryos. The pre-implantation embryos, whose stages were late morula on early blastocyst, were located in the centre of ultrasound beam certainly by using closed microdroplet culture. Experiments were done under various conditions of ultrasound intensity, irradiation time and temperature of circumference. The statistically significant increase of morphological abnormality was observed when 3.0 W/cm2 continuous wave for 60 minutes of 0.65, 1.0 or 1.8 W/cm2 continuous wave for 720 minutes was irradiated. The statistically significant developmental retardation was observed when 2.0 or 3.0 W/cm2 continuous wave for 60 minutes or 0.65, 1.0 or 1.8 W/cm2 continuous wave for 720 minutes was irradiated. Pulsed ultrasound irradiated groups showed neither increase of morphological abnormality nor developmental retardation significantly. The reading of thermistor sonde located in the centre of beam was raised during irradiation. No significant change were observed between warming and irradiated groups, temperature of which were similarly raised. Similar results were seen when 3.0 W/cm2 continuous wave for 60 minutes were irradiated during cool circumference, in which temperature of the centre of ultrasound beam didn't raise more than 37 degrees C. These results suggest that thermal effect of ultrasound is most effective during various effects including cavitation in this study.

Serum levels of DHA, 16 alpha OH-DHA and estriol (E3) were determined in maternal peripheral vein by gas chromatography-mass spectrometry (GC-MS) with application of deuterated steroids as internal standards during late pregnancy and labor. Deuterium labeled 3,4,4-d3-DHA, 3,4,4-d3-16 alpha OH-DHA and 2,4-d2-E3 were newly synthesized and highly specific method for determination of serum DHA, 16 alpha OH-DHA and E3 was developed by GC-MS. The mean total steroid concentrations in the third trimester (III), in the stage when patients had irregular contraction (P) and during the first stage of labor (1st) were as follows; DHA, 612.9 +/- 265.3, 877.5 +/- 365.6 and 1522.5 +/- 580.6, 16 alpha OH-DHA, 30.2 +/- 20.2, 49.4 +/- 21.9 and 161.3 +/- 43.6, E3, 50.9 +/0 25.7, 70.4 +/- 19.8 and 108.6 +/- 44.5 ng/ml (mean +/- S.D.). The values of these three steroids increased significantly from the III to the 1st. Correlation between the levels of total DHA and total E2 measured in ten patients individually in the III was 0.8665 (p less than 0.001) which changed to -0.6650 (p less than 0.01) and -0.5362 (p less than 0.05) in the stage of P and 1st. ACTH was given to eight pregnant women in the third trimester, and response of these steroids to ACTH was studied. In addition to these steroids, cortisol (F) levels were also measured by RIA. Following the administration, F increased significantly whereas no changes of DHA, 16 alpha OH-DHA and E3 levels were noticed suggesting that these steroids may not be influenced by maternal adrenal secretion. From the results obtained above, it is suggested that the endocrinological environment in maternal blood as indicated by correlations between DHA and E3 levels, changes prior to the onset of labor.

The pituitary gonadotropin response of synthesis and release to two step-stimulation at 60 minutes interval by 100 micrograms of luteinizing hormone-releasing factor was studied by radioimmunoassay of hLH-beta, hLH and hFSH in pregnant women. The immunological affinity of hLH-beta antiserum was 7.9% with hCG-beta, 3.4% with hLH-alpha and 0.41% with LER 907 as compared to 100% with hLH-beta. Serum mean levels of hLH in non pregnant women were 248.5 ng/ml serum before the first injection of LH-RF. The first injection caused an increase in the serum hLH level to 2185.0 ng/ml serum. After the second injection of the hormone, serum hLH levels increased further than the first peak, indicating the "self-stimulating" or "priming" effect of the first LH-RF on the second peak. Serum mean values of hLH-beta in normal menstrual women were 2.60 ng/ml before the first injection. The hLH-beta response to the second injection was significantly greater than to the first. The first peak of hLH-beta was 4.30 ng/ml serum and the second peak was 5.07 ng/ml serum. The FSH response to the second injection of LH-RF was not significantly peaked from that after the first injection. The value of the serum mean levels of hLH-beta during pregnancy were between 0.57 and 0.81 ng/ml and showed no significant increase through two LH-RF stimulations, suggesting that pituitary gonadotropins synthesis and release were depressed during gestation. Thus LH-RF two step stimulation was useful to clarify anterior pituitary function in both synthesis and release of gonadotropin.

Maternal blood and milk iron (Fe), folate (FA), vitamin B12 (B12) and serum ferritin (Fr) were determined in four groups of lactating mothers: normal, toxemic, anemic and treated anemic during pregnancy. 1. An increasing blood Fe, Fr and a decreasing milk Fe with time in postpartum were found in each group. A high level of blood Fe, Fr was observed in the treated group. Milk Fe, however, had showed no significant difference in either group. There was no correlation between the blood and milk Fe. 2. There was no demonstrable change of blood FA, but milk FA had significantly increased in each group. Blood FA showed a low level in the toxemic group and a high level in the treated group, but no significant difference of milk FA could be found in either group. No matter how widely the level of blood FA spread, there was a little change in milk FA. 3. An increasing blood B12 and a decreasing milk B12 were found in each group. There was a tendency towards a high level of blood B12 in the treated group, but the level of milk B12 differed widely from one material to the other. There was no correlation between the blood and milk B12.

Here are reported the therapeutic results of ifosfamide on primary ovarian malignancies in 30 cases which were treated at Kurume University Hospital from September 1978 to December 1980. These cases were advanced or recurrent ones, and histologically, they consisted of serous cystadenocarcinoma in 22 cases, mucinous cystadenocarcinoma in 2, unclassified adenocarcinoma in 1, and malignant teratoma in 5. In the ifosfamide therapy, 2 grams or 40 mg/kg per day were given intravenously for 5 consecutive days, and as observing the blood state and the general condition, it was repeated every 3 weeks. The drug was given from 1 to 7 courses, and the average was 3.3 courses. The effect was evaluated by Koyama-Saito's criteria and Karnofsky's criteria; the response rate was 48% in the adenocarcinoma group and 20% in the malignant teratoma by the former criteria, while the rate was 64% and 20%, respectively, by the latter one. As main side effects, there were seen hemorrhagic cystitis, nausea and vomiting, and the myelotoxicity was low.

The assay for hCG is important in gynecological and obstetrical fields and has been performed by RIA and radioreceptor assay (RRA). But these procedures use radioisotope which limits popular use. Recently enzyme immunoassay (EIA) has been developed in which procedure the enzyme has been used for labelling in place of radioisotope. The labelling enzyme is stable and has no adverse effect on human beings and its activity is easily measured. In this study, EIA for hCG has been developed. beta-D-Galactosidase (beta-Gal) is preferred because an infinitesimal amount of beta-Gal is easily measured, and MCAE of conjugating agent is used to prevent self-coupling. As solid phase sheep red blood cells were used at first, but now silicone rods are being used because of easy handling. To remove serum interference, sequential competitive method is carried out and 0.5 mIU/ml to 200 mIU/ml of hCG is measurable in 12 h. Coefficients of variation are satisfied. This newly developed assay has been used clinically in diagnosis of brain metastasis of trophoblastic disease, early diagnosis of pregnancy and prognosis of threatened abortion and is now being tried for follow-up of trophoblastic disease.

Placental and renal cortical blood flow were measured by thermocouple method in 70 cases of late pregnant rabbits, 17 late pregnant dogs and 2 late pregnant monkeys. Intrauterine resting tonus in 148 primigravid and 74 multigravid women tended to increase towards the onset of labor, with maternal mean blood pressure elevating in close relation to the intrauterine pressure. Especially in primigravid women there was a strong tendency and intrauterine resting tonus was higher value in primigravidas than that in multigravidas. The increasing of intrauterine pressure by uterine contraction caused an elevation of maternal blood pressure by about 10% in pregnant women, and caused a decrease of placental blood flow by about 30% respectively, but it did not show any definite pattern in renal cortical blood flow in experimental animals. On the other hand, the increasing of intrauterine resting tonus with intraamniotic saline injection in 47 cases of experimental animals brought about a decrease of placental blood flow by about 30%, at the same time caused a decrease of renal cortical blood flow by about 20% and an elevation of maternal blood pressure by about 10% respectively. These findings support the concept that increasing of uterine resting tonus could play a role in mediating late pregnancy induced hypertension.

We report a histochemical study of alkaline phosphatase (ALP) in normal cells of uterine endometrium and endometrial cancer to ascertain the incidence of ALP and the isoenzyme type. For this purpose, cytological specimens and tissue serial sections were subjected to heat-stability and L-phenylalanine (L-p) inhibition test. The Regan-like isoenzyme, a heat-stable and L-p sensitive ALP, which had been thought to derive only from cancer or the placenta, was found in very limited endometrial luminal surface lining cells. Meanwhile ALP activity in endometrial glandular cells was heat and L-p sensitive. Of 42 cases of endometrial cancer, all cases manifested non-specific ALP activity, and 19 cases (45%) manifested heat stability of slight to high degree. 7 endometrial cancers exhibited the Regan-like isoenzyme with marked heat and L-p sensitivity. These findings indicate that in the course of uterine endometrial carcinogenesis, the ALP isoenzyme of endometrial glandular cells undergo a change and that "enzyme deviation" occurs.

For the purpose of investigating the histogenesis of the yolk sac tumor, 7 cases of the tumor and 9 cases of human yolk sac were used. Histological, ultrastructural investigations together with immunofluorescent antibody examinations revealed the following results. Ultrastructurally yolk sac endodermal cells prior to the 7th week of pregnancy were proved to have microvilli, abundant glycogen which formed rosette, parallel arranged rough endoplasmic reticulum (rER), mitochondria closely associated with rER and ovoid electron dense amorphous granules which showed positive diastase-resistant PAS-reaction. Morphologically endoderm after the 8th week of pregnancy showed degenerative changes. Light microscopically the tumors showed Schiller-Duval body, endodermal sinus structure and clear-cells endoblastic pattern, but ultrastructurally the tumor cells of these three types showed approximately similar appearances. Ultrastructural features of the tumor seem to resemble those of the yolk sac endoderm before the 7th week of pregnancy. The tumor cells which form the epithelial mantling of Schiller-Duval body closely resembled the endodermal cells facing the yolk sac cavity with respect to the presence of abundant glycogen granules, rER, mitochondria, short irregular microvilli on the cell surface and remarkable nucleolus with thread-like nucleolonema. Both the tumor cells facing the endothelial cell and those which form the endodermal sinus structure and clear-cells endoblastic pattern resembled the endodermal cells facing the mesenchyma in view of the features of intracellular organelles, the presence of extracellular basement membrane-like substances and tubular structure.