ISSN:0001-6349    

DOI:10.3109/00016349409013408

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0001-6349    

DOI:10.3109/00016349409013409

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Direct intracellular microinjection of a fluorescent dye (Lucifer Yellow) was performed on ex‐situ muscle strips from term pregnant women not in labor. The aim was to characterize the intracellular distribution of LY to obtain criteria for an intracellular injection in whole mounts and ultimately to study the gap junctional communication between myometrial cells in those tissues. Fifteen injections performed on biopsies from ten cases snowed a well‐bordered fusiform shape and were considered to be intracellular. The intercellular spread of the dye into an adjacent cell was observed in three injections (three cases). The average cell dimension was 284 ± 95 μm for length and 5±1.5 μrn for width (n=17). The intracellular injection was confirmed by light microscopy of cross sections. It is concluded that limited coupling exists between myometrial cells of women prior t

ISSN:0001-6349    

DOI:10.3109/00016349409013410

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Histological evaluation of sections from the human fallopian tube revealed an inflammatory reaction in 21 of 31 women using an intrauterine contraceptive device (IUCD) and in four of 29 controls (non‐IUCD users). The inflammatory cells were mainly localized at the epithelium‐lamina propria interface and at the center of the mucosal folds.The immunohistochemical study revealed leukocytes (CD45+), T lymphocytes (CD3+), T helper cells (CD4+), T suppressor/cytotoxic cells (CD8+), B lymphocytes (CD22+, CD19+), granulocytes, monocytes and null cells (CDllb+) mainly localized at the lamina propria in both groups. T lymphocytes were the predominant cell type, and the ratio between T helper and T suppressor/cytotoxic cells was fairly close to one both in IUCD‐users and controls. B lymphocytes were the least frequent cell type identified. In IUCD users, the numbers of the different leukocytes were increased.In both groups, IgA‐, IgG‐ and IgM‐positive cells were demonstrated and were predominantly located at the lamina propria of the mucosal folds. The IgA‐positive cells dominated in both groups, whereas IgG‐ and IgM‐positive cells were less frequent. Cell positive for IgA, IgG or IgM were significantly increased in number in the IUCD users.The data confirm the presence of an immune system in the normal human fallopian tube and indicate that the IUCD can induce a prominent recruitment of inflammatory cells, with a tubal inflammation as the result. The IUCD may disturb the immunological function of the fallopian tube and its role

ISSN:0001-6349    

DOI:10.3109/00016349409013411

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Study objective.Evaluation of the precision of routine ultrasound term prediction.Design.Population based follow‐up without intervention.Setting.Ultrasound screening in routine clinical practice.Material.1650 women residing in one Norwegian county giving birth during a 12‐month period. All pregnancies were singleton with spontaneous onset of labor, all records contained a term predicted with routine ultrasound in the second trimester.Outcome measure.Difference between actual and predicted day of delivery, and difference between ultrasound predicted term and term calculated from last menstrual period.Main results.More women delivered within two weeks of ultrasound term than two weeks of term calculated from the last menstrual period (87.5% and 79.3%,p<0.001). Deliveries were significantly closer to the ultrasound predicted term than the term calculated from the last menstrual period, with the exception of deliveries in the 39th week after LMP where no significant difference was found between ultrasound term and LMP‐term. No difference was found in the mean performance of 14 different ultrasound operators.Conclusions.In a population representative of deliveries in one county, routine ultrasound term prediction performed in three medium sized hospitals more accurately predicted day of delivery than term calculated from the date of last menstrual p

ISSN:0001-6349    

DOI:10.3109/00016349409013412

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Chromosomal mosaicism presents one of the most difficult problems in prenatal cytogenetic diagnosis, requiring the differentiation of true mosaicism from pseudomosaicism. To overcome associated problems and to prevent termination of normal pregnancies, we investigated 23 pregnancies in which true mosaicism has been found in amniotic fluid cell culture. A fetal blood sample was obtained by cordocentesis for rapid karyotyping, and meticulous sonographic examinations were carried out for detecting fetal abnormalities. The 23 cases in which mosaicisms were found in amniocytes involved five cases with sex chromosomal abnormalities, twelve with autosomal trisomy, four with autosomal structural defects, one with a supernumerary marker and one with tetraploidy. The karyotype from fetal leukocytes confirmed the diagnosis of mosaicism in only three out of 23 cases. These three included: two autosomal trisomies (47,XY+ 13/47,XY + 21 and 46,XY/47,XY + 21) and one sex chromosome mosaicism (45,X/46,XY). These were all selected for elective termination of pregnancies by the parents’ request. Post abortion karyotype re‐confirmed previous karyotype. The other twenty lymphocyte karyotypes were normal, and of these, 19 patients gave birth at term, and one delivered prematurely due to premature rupture of membranes. All 20 born infants were found normal by both neonatal examination and re‐karyotypes.We conclude that finding of mosaicism in amniotic fluid culture requires further investigation. Furthermore, in the presence of amniotic fluid cell true mosaicism and normal karyotype in fetal blood, continuation of the pregnancy is safe and to be recomm

ISSN:0001-6349    

DOI:10.3109/00016349409013413

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective.Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications for CS in twin pregnancies was made between two Danish counties, one with a high and one with a low overall CS rate in twin deliveries, taking into account the distribution of parity, mother's age, gestational age at birth, and birth weight.Design.A population based, historic follow‐up study based on antecedent data.Setting.Two Danish counties, with a CS rate in twin pregnancies of 57% and 28%, respectively.Subjects.All women with twin pregnancies who delivered in 1989 in the two counties.Main outcome measures.Comparison of the CS rates in the two counties according to indications and fetal presentation.Secondary measures.Perinatal and maternal outcome.Results.The difference in CS rates between the two counties could not be explained by different distributions of background characteristics. Different attitudes were found towards CS in cases with previous CS, with twin A in breech presentation and in cases with vertex‐breech deliveries. These differences could explain less than two thirds of the overall 29% (CI: 12‐46%) difference in risk of CS between the two counties, indicating more subtle reasons for the discrepancy. No difference between the two counties in perinatal morbidity and mortality was seen.Conclusion.In order to understand and discuss regional variations in the use of CSs in twin deliveries the subjects must be addressed in different ways: the unequivocal indications related to fetal presentations and previous CS can be subjected to randomised controlled trials or large scaled follow‐up studies regarding maternal and perinatal morbidity and mortality. Other more subtle determinants of the physicians’ and the pregnant women's attitude towards CS, however, seem quantitatively important, and these can only be evaluated in observational studies and through di

ISSN:0001-6349    

DOI:10.3109/00016349409013414

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Objective.To compare the clinical indications for delivery by cesarean section (CS) in singleton pregnancies in two Danish counties with different CS rates, and to describe the relation between CS in the two counties and parity, mother's age, type of delivery department, gestational age at birth, and birthweight.Design.A population‐based, follow‐up study based on antecedent data.Setting.Two Danish counties, where women deliver in obstetric as well as surgical departments, with a CS rate of 8.3% and 15.2%, respectively.Subjects.All pregnant women in the two counties who delivered in 1989.Main outcome measures.Comparison of the rates of CS in the two counties carried out for five well‐defined clinical indications: Previous cesarean section, breech presentation, dystocia, fetal distress, and other.Secondary measures.Neonatal and maternal outcomes.Results.In the county with the higher frequency of CS, all indications for CS were used significantly more often, except from ‘fetal distress’ in primiparous women. In this county ‘breech presentation’ was the commonest indication among primiparous women, whereas ‘fetal distress’ was the most common in the county with the lower CS rate. For multiparous women the highest CS rates in both counties were found among women who had had a previous CS. The major difference between the two counties was the threefold greater risk of CS indicated by ‘dystocia’ among multiparous women in the county with the higher CS rate.Conclusion.The regional differences in CS could not be explained by differences between the two populations or by an increased rate of a single indication, but could be due to differences in obstetric practice or expectations or demands fr

ISSN:0001-6349    

DOI:10.3109/00016349409013415

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The effect of two oral contraceptive (OC) pills, both containing 150 μg of desogestrel, but with 20 (Mercilon®) or 30 μg (Marvelon®/Desolett®) of ethinyl estradiol on plasma levels of lipids, lipoproteins and sex hormone binding globulin (SHBG), total and free testosterone were compared in a double‐blind, randomized, two‐center study in a total of 60 women over one year. A significant rise with Marvelon® but not with Mercilon® was seen in total cholesterol, HDL cholesterol, HDL‐3 and apolipoprotein B, whereas LDL cholesterol decreased with Mercilon® only. These effects resulted in significant differences between the two groups in the magnitude of responses in all these parameters except HDL‐3. HDL‐2, apolipoprotein A‐1 and total phospholipids were elevated with both pills after treatment and with no difference in the degree of response between groups. The HDL/LDL cholesterol ratio tended to increase in both groups and that of apolipoproteins A‐1/B in the women on Mercilon®. Total triglycerides increased in both groups, but more in the women on Marvelon®. Total testosterone decreased, particularly in the Marvelon® group, whereas the two pills caused a similar increase in SHBG and decrease in free testosterone. It is concluded that the direction of changes in plasma lipids and lipoproteins with both these pills may as a whole be interpreted as beneficial, and that the differences in effect on LDL cholesterol and apolipoprotein B may suggest a slightly advantageous effect of Mercilon® in this aspect. However, the clinical significance of these changes is uncertain. The results indicate a lack of an

ISSN:0001-6349    

DOI:10.3109/00016349409013416

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Twenty‐five women with regular menstruation and laparoscopically confirmed endometriosis received 100 meg nafarelin intranasally twice daily for six months in an open study. American Fertility Society (AFS) laparoscopic scores pre‐ and post‐treatment, symptom severity, hormonal status, bone density and biochemical indices of bone turnover were studied. Five patients were still menstruating at three months and nafarelin was increased to 400 mcg daily. At the end of treatment, the median serum estradiol was 57 pmol/1 and all patients were amenorrhoeic. AFS scores for endometriosis improved significantly in 19/23 (82.6%) patients (p= 0.001). Adhesions were not affected. Symptom severity scores were markedly decreased (p<0.0001) and remained so six months after the end of treatment. Biochemical indices of bone activation were increased but bone loss was insignificant. During treatment, 23/25 patients reported hot flushes. Nafarelin 200 meg daily significantly reduced signs and symptoms of endometriosis, although five patients needed a dosage increase before menses stopped. The study suggests that lower doses of nafarelin may be efficacious, although symptomatic changes should be treated with caution due to the open and non‐comparative nature of th

ISSN:0001-6349    

DOI:10.3109/00016349409013417

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY