摘要:

AbstractObjective(s): To demonstrate the limitation of complete reliance on computer generated interpretations and to highlight the need for understanding of pregnancyrelated biochemistry when offering prenatal screening.Methods: Four cases of cytogenetically confirmed trisomy 18 pregnancies are presented. All four cases underwent prenatal screening (Triple Test‐AFP, uE3, tβ‐hCG) at midgestation and risk assessment by the alpha algorithm.Results: All four cases of trisomy 18 were assessed as being at low risk for DS and/or open NTD. Although marker levels were not consistent with either of these clinical situations, they were indicative of a compromised pregnancy. Circulating levels of trophoblast‐derived antigens (uE3, tβ‐hCG) were depressed ( 0.5 MoM) in all four cases. Further investigations (ultrasonography, amniocentesis) confirmed a trisomy 18 fetus.Conclusions: Risk assessment by computer based algorithms relies on maternal factors and specific DS/NTD marker profiles. Aberrant marker profiles are not distinguished from normal. Therefore, it is essential that prenatal screening is offered only by those competent in pregnancy biochemistry and able to identify these abnormal s

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00937.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe aspirated ovarian follicles of an infertile patient who encountered a great risk of ovarian hyperstimulation (OHSS) during her ovulation‐induction cycle, which had been stimulated with gonadotropins, in order to avoid OHSS without interrupting the treatment. If this action were to yield a considerable number of immature oocytes, some of which were to achievein vitromaturation and subsequent fertilization, this method could be an alternative to conventional ovulation‐induction methods for patients who repeatedly present imminent signs of hyperstimulation. However, the number of oocytes collected from the patient was disappointingly low, even though a large number of follicles were thoroughly aspirated. One of these oocytes was maturedin vitroin a medium containing 30% follicular fluid and granulosa cells of mature follicles, fertilized, cryopreserved, and transferred in a later artificial cycle; but pregnancy was not achieved. A low number of recovered oocytes from patients in this situation might be a factor that greatly limits the clinical applications of this met

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00938.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: To examine the relationship between calculated and measured creatinine clearance, and also to evaluate the clinical utility of calculated creatinine clearance before administration of chemotherapy in patients with gynecologic malignancies.Methods: In 38 patients with gynecologic malignancies, a total‐69 paired creatinine clearance measured by 24‐hour urinary creatinine clearance and calculated were compared.Results: The significant correlation (r = 0.597, p<0.0001) was observed between creatinine clearances determined by both methods. There were 26 (37.7%) 24‐hour urine collections. The correlation between two methods improved when these inaccurate samples were excluded (r = 0.876, p<0.0001). In addition, if a creatinine clearance of 50 ml/min is set as a threshold for dose modification, only 2.9% of the patients would have received reduced doses inappropriately, by using the calculated creatinine clearance alone.Conclusion: These results suggest that in patients with gynecologic malignancies, a calculated creatinine clearance prior to chemotherapy is sufficient for evaluation of renal function and measured creatinine clearance would be determined only when calculated creatinine clearance is below the threshold for dose modific

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00939.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: To determine the effectiveness of a short protocol (SP) of gonadotropin‐releasing hormone agonist (GnRH‐a) administration in patients who already had undergone at least onein vitrofertilization (IVF) and embryo transfer (ET) treatment cycle with the long protocol (LP) and had shown poor results.Methods: One hundred and twelve patients were studied. The E2levels, the number of preovulatory follicles, the number of oocytes retrieved and fertilized, the number of embryos cleaved, the fertilization rate and the number of embryos transferred were calculated.Results: The values for the mentioned parameters were significantly higher in the SP than those in the LP. So were the pregnancy rates per cycle and per ET (23.2% and 24.1%, respectively) in the SP significantly (p<0.0001) higher than those in the LP (12.5% and 13.5%, respectively).Conclusion: In cases who showed poor results to the LP, instead of repeating the same protocol the SP may be substituted. This strategy may not only improve the results, but also decrease the total cost of the IVF‐ET trea

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00940.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjective: To determine the effectiveness and appropriateness of laparoscopic salpingo‐oophorectomy (LSO) versus open salpingo‐oophorectomy (OSO) in developing country.Method: A clinical study with historical control consisted of 31 LSO cases of benign ovarian cysts were compared with 41 OSO cases matched by diagnosis and difficulty.Results: The operative time of the LSO cases was higher (p<0.001), but the morbidity was comparable (p = 0.22). The postoperative hospital stay of the LSO was shorter (p<0.001). Patients who had LSO revealed meaningfully decreased postoperative use of analgesic (p<0.05). The time to full recovery for LSO was shorter (p<0.001), but the hospital charges were higher (p<0.001).Conclusions: LSO is considerable safe and effective alternative to OSO but incurs higher hospital charges. The overall cost effectiveness of LSO, especially in the developing countries, need further evaluat

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00941.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractTwo twisted fetal ovarian cysts were detected antenatally by routine ultrasonographic examination. Serial changes of twisted ovarian cysts can be monitored by ultrasonic observation. If signs of torsion appear, obstetricians should consider prompt delivery in order to preserve the patient's fertility.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00942.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjectives: To verify the pattern of the spread of tumors in ovarian dysgerminoma, with special reference to intraperitoneal metastasis, and to assess clinicopathologic factors for predicting tumor extension.Methods: Detailed data regarding ascitic cytology, macroscopical findings at surgery, and the histopathology of the surgical specimens were retrospectively reviewed in 12 patients with dysgerminoma who were treated at Kyoto University Hospital. The relationships between the tumor extension and the period of symptoms, the serum lactic dehydrogenase (LDH) level, and the operative findings also were analyzed.Results: Ascitic cytology revealed a high incidence of positivity in 6 of the 10 (60%) cases examined. Extraovarian metastases were present in 4 of the 6 (67%) cases with positive cytology, and in 1 of the 4 (25%) cases with negative cytology. Intraperitoneal metastatic nodules were detected in 5 of the 12 (42%) patients either by inspection during surgery or by postsurgical histological examination. In addition, these metastatic lesions were 5 or fewer in number and 7 mm or less in diameter, except in 1 patient with widespread disease. The presence or absence of extraovarian spread of the tumor was not significantly correlated with the period of symptom, the serum LDH level, the size of the primary tumor, or the volume of the ascitic fluid.Conclusion: The incidence of intraperitoneal spillage and/or metastases of dysgerminoma cells might be higher than previously reported. These findings indicate the importance of ascitic cytology and careful inspection at the time of operation, as well as the rationale of postsurgical chemotherapy for dysgerminoma of an apparently early stage.

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00943.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe case of pregnant woman with Wolff‐Parkinson‐White syndrome, whose paroxysmal supraventricular tachycardia was successfully terminated by intravenous administration of 5–10 mg adenosine triphosphate (ATP), is pres

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00944.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:1341-8076    

DOI:10.1111/j.1447-0756.1996.tb00926.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY