Acta obstetrica et gynaecologica Japonica最新文献

Reports are made of the analytical results of 76 cases with ovarian neoplasma under 20 years of age who had been treated at the Kurume University Hospital from January 1952. The incidence of ovarian tumors was 5.5% in all age groups, and the youngest patient was 5 years of age, the mean age being 15 years. Histologically, these tumors comprised 48 cases (63%) of germ cell origin, showing characteristically of ovarian tumors occurring in childhood and adolescence. The total 76 cases included 40 of malignant tumors, which were subdivided into 13 of embryonal carcinoma, 12 of solid teratoma, 9 of dysgerminoma, 5 of simple carcinoma, and 1 case of granulosa cell tumor. In all the cases the clinical stage was important factor for prognosis, and the prognosis of embryonal carcinoma was poorest, with only 4 cases of survival out of 13 cases. But the prognosis of dysgerminoma was comparatively good, with 8 cases of survival out of 9 cases. It is worthy of note that this tumor was highly radiosensitive, since 3 out of 4 cases at stage III and stage IV had been surviving for over 5 years.

Repeatedly, we tried to give an devized treatment of HMG-HCG therapy to the three women who had different degree ovulatory disorder. Throughout the study, we observed BBT, cervical mucus and the changes of blood hormones levels until all three women got pregnant. 1) As much difference was bound in the individual ovarian sensitivity to gonadotropin, we observed the ovarian reaction administering of HMG (150 IU) every day. 2) When we observed some maturity of ovarian follicles, we decreased amount of HMG to the level of FSH in the normal menstrual cycle. 3) Considering the days needed to form follicular maturation, we changed HMG to HCG 4 or 5 days after cervical mucus increased to 0.2 ml. or more and showed 2-grade of crystallization.

We describe 30 patients with Starr-Edwards cardiac valve replacements who underwent pregnancy. Fourteen pregnant women who received anticoagulants gave rise to 3 neonatal anomalies such as congenital heart disease, polydactylia and microphthalmus. And fetal losses were 5 spontaneous abortions. Women with artificial valves can tolerate the hemodynamic load of pregnancy well, but there is an increased fetal wastage in patients taking oral anticoagulants (coumarin: warfarin). Namely, there is probably largely attributable to fetal hemorrhage but there is also a risk of malformation caused by teratogenic effects of warfarin. In contrast, pregnant women who didn't receive anticoagulants had the risk of thrombo-embolismus. It is suggested that the best plan is to use long acting oral anticoagulants during antenatal period and heparin over the periods of labor.

In order to assess the possible sexual transmission of hepatitis B virus (HBV), the occurrence of post-marital acute hepatitis and the prevalence of hepatitis B surface antigen (HBsAg) and antibody (HBsAb) were investigated among the husbands of HBsAg carrier women. The possible infectious routes and influencing factors in the HBV infection of the husbands by their HBsAg carrier wives were also discussed. This study demonstrates: 1. In the husbands examined, the exposure marker of HBV was found to be 32.8 per cent and the occurrence rate of post-marital hepatitis came up to 7.2 per cent. 2. The transmission of HBV from HBsAg carrier women to their husbands was supposed to take place shortly after marriage. E-Ag and e-Ab in ther sera of HBsAg carrier women could serve respectively as indicators of positive and negative HBV transmission. In the husbands with wives whose serum HBsAg-titers by R-PHA were higher than 39, a high exposure marker of HBV (87.5%) was observed. 3. The results of HBsAg detection rates and titers in various kinds of body fluids obtained from HBsAg carrier women suggested that cervical mucus and vaginal discharge might play an important role in the sexual HBV transmission.

The physiological roles of oxytocin in pregnant rats were studied by passive immunization. Oxytocin antibody (A/S OT) was produced to synthetic OT in rabbits by immunizing with OT conjugated to bovine serum albumin by glutaraldehyde method. Then the sera in the rabbits were tested for the potency of antibody to OT by double antibody radioimmunoassay. On the nineteenth day of pregnancy, each of ten rats was daily injected subcutaneously with 1 ml of A/S OT up to parturition. The mean gestation period in the treated rats was 23.1 +/- 0.31 days and in the control rats (normal rabbit serum: NRS treated), 23.2 +/- 0.13 days. The amount, 1 ml of antiserum, was inferred to be capable to sufficiently neutralize the endogenous oxytocin in pregnant rats. This antiserum was proved to inhibit the biological action of OT by Magnus equipment. These data suggest that, the hypothesis that OT may play a primary role of initiation of labor, is necessary to be reevaluated.

In Isojima's sperm immobilization test, the complement is one of the most important factors which influence on sensitivity of the test. Previously we reported that more than 10 CH50 of guinea pig serum complement was necessary in the reaction to obtain the best result for measuring the sperm immobilizing antibody in the serum. This time, the influences of various test specimens on complement activities for the sperm immobilization test were studied and the necessary amounts of complement to detect the sperm immobilizing antibody in serum, cervical mucus and seminal plasma were compared. In the sperm immobilization test, the following results were obtained: 1. The amount of complement (guinea pig serum) added was 11.9 CH50, and after 60 minutes incubation at 32 degrees C in veronal buffer (VB2+), 2.0 +/- 0.3 (M +/- SD) of CH50 was consumed. 2. When human serum, cervical mucus and seminal plasma were added to the reaction as specimens, the complement consumptions (M +/- SD) were more 0.2 +/- 0.3 CH50, 0.2 +/- 0.2 CH50 and 3.3 +/- 0.8 CH50 than that of VB2+ buffer respectively. 3. When the washed human spermatozoa were added, the consumed amounts of complement (M +/- SD) were dose dependent; 3.5 +/- 0.7 CH50 for 100 X 10(4) spermatozoa, 7.3 +/- 0.3 CH50 for 200 X 10(4) spermatozoa and 15.7 +/- 2.2 CH50 for 400 X 10(4) spermatozoa. 4. In our sperm immobilization test, the net consumptions of complement (M +/- SD) were 5.0 +/- 0.7 CH50 for specimen of serum, 4.9 +/- 0.8 CH50 for specimen of cervical mucus and 11.1 +/- 1.2 CH50 for specimen of seminal plasma. 5. Complement doses necessary to obtain the most sensitive sperm immobilization tests were 10 CH50 for both serum and cervical mucus specimens, and 15 CH50 for seminal plasma specimen.

To study the influence of beta 2-stimulants on pregnant woman and fetus from cardiovascular and metabolic viewpoint, tests were conducted on pregnant rats and human clinical cases of threatened premature labor. 1) When terbutaline 800 micrograms was administered to groups of pregnant rats for 4 days and 8 days, body weight, and weight of liver, placenta and heart of both mother and fetus indicated the trend of decrease when compared to the control, but the difference was not statistically significant. 2) Concentration of c-AMP in the fetal serum was found to be less than the control (P less than 0.001) under the above conditions and consequently c-AMP/c-GMP indicated decrease. Concentrations of c-AMP and c-GMP in the maternal, fetal cardiac tissue were in a decreasing tendency in the terbutaline group. In the patholo-histological studies, terbutaline-induced myocardial necrosis was not observed. 3) In the past five years, of the terbutaline treated cases, specifically 15 cases of large dose and long period of administration were analyzed and the prognosis of their children were followed up. The doses were 20.6 mg (iv, im), and 1276 mg (po), arrest less than 37W was noted in four cases, but onset of SFD was not observed. During the administration term, no abnormality of mothers was noted before and after delivery, and unusual phenomenon was not recognized in the prognosis traced on newborns.

The sex steroid hormone receptor levels of uterine cytosol were assayed in the course of experimental induction of endometrial carcinoma in rats. Effects of administration of various hormones on the receptor levels were examined with each histological pattern of endometrium. 1) The dissociation constants for E2 and R5020 bindings with uterine cytosol were almost fixed in spite of various histological patterns of endometrium. 2) The influence of administrated hormones on the receptor assay system could be neglected by the preincubation of uterine cytosol with DCC for five times. 3) By the administration of DES for six weeks, estrogen receptor levels were increased significantly in adenocarcinoma, while progesterone receptor levels did not show the tendency of decreasing. 4) By the administration of MPA combined with DES, estrogen receptor levels were not decreased significantly in both atypical adenomatous hyperplasia and adenocarcinoma; progesterone receptor levels were decreased in all groups. 5) By the administration of MPA, estrogen receptor levels were decreased significantly in adenocarcinoma. These data suggest that receptor levels can be controlled by the administration of sex hormones in the course of development of endometrial carcinoma.

For the study on initiation of labor, a highly sensitive and specific radioimmunoassay for oxytocin (OT) was developed. Investigations were performed on the blood levels of OT and neurophysins in women during labor, lactation as well as in umbilical vessels. The blood was assayed for OT and Estrogen Stimulated Neurophysin (ESN), Nicotine Stimulated Neurophysin (NSN) in each specific radioimmunoassay. The mean value of plasma OT levels of women without labor pains (5 minutes interval) ws 217.3 +/- 36.02 (pg/ml, Mean +/- S.E.) whereas the values at 28 to 40 weeks of gestation was much lower than those. At delivery the OT level in maternal plasma was 176.3 30.92 and 207.5 62.90 in the umbilical vein respectively. There was no statistical difference in the level of OT before and after lactation. ESN level was higher during lactation and NSN level showed the similar pattern. At delivery NSN concentration in the umbilical artery was higher than that in the vein. These data suggest that hypothalamo-pituitary function correlate with labor and lactation.

In usual medical consultation, we have been met a lot of female patients suffering from disturbances of autonomic nervous system such as headache, shoulder-ache and so on. Experiments were designed to elucidate whether or not these disturbances of autonomic nervous system were induced by inflammation and accelerated by stimulant diets. Functions of autonomic nervous system were examined by lipolysis in rat epididymal adipose tissue which was partly controlled by sympathetic nervous system. It was found that free fatty acid release from the epididymal adipose tissue was considerably elevated by inflammation which was formed in abdominal wall or in abdominal cavity or oral administration of stimulant diets such as red pepper and white pepper, and that such elevation of lipolysis was significantly reduced by resection of the autonomic nerve. These results indicated that the inflammation and the stimulant diets induced excitement of sympathetic nerve which controlled the epididymal adipose tissue. Experiments were now in progress to clarify relationship between such excitement of sympathetic nervous system induced by the inflammation or by the stimulant diet and irregular complaints due to disturbances of autonomic nervous system.