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International Journal of Gynecology & Obstetrics | 1994

Gynecologic tumors and symptoms in childhood and adolescence; 10-years' experience

A. Imai; Tatsuro Furui; Teruhiko Tamaya

OBJECTIVES: The advancement of diagnostic imaging evaluations and the earlier occurrence of secondary sexual development prompted us to review our recent experience with genital tract tumors in children. METHODS: We analyzed data for 1938 patients aged less than 18 years who were referred to Gifu University School of Medicine‐affiliated Hospitals for the years 1984 through 1993. RESULTS: Of the patients, 145 underwent surgical treatment. Vaginal tumor was seen in 5 patients; 1 endodermal sinus tumor, 1 sarcoma botryoides and 3 Gartners duct cysts. Two patients with malignant tumor presented only with bloody vaginal discharge; recurrent abdominal pain due to vaginal obstruction was noted in 1 patient with the cyst. Ten had benign tumors in the vulva, presenting with a genital mass. Of 114 ovarian tumors, 3 were diagnosed by antenatal ultrasonographic examinations. Fifty‐five had germ cell tumors, 33 had epithelial tumors, and 18 had stromal tumors. The most common symptom was abdominal pain and approximately one‐third of girls who complained of abdominal pain had an ovarian tumor. Precocious puberty was noted in 4 girls with stromal tumor. Two of the 23 malignant tumors developed in the vagina and the others originated in the ovary. In 19 patients unilateral salpingo‐oophorectomy or local excision was done in an attempt for reproductive organ conservation; 4 cases of advanced stage disease were treated with hysterectomy and/or bilateral salpingo‐oophorectomy. Only 3 of the 23 patients with malignant tumor died within 4 years and others are free from disease. CONCLUSIONS: Genital symptoms, even common, alert us to the posibility of a genital tract tumor. The prompt and precise detection of either benign or malignant tumors in children may lead to cure and preservation of fertility with conservative surgery.


International Journal of Gynecology & Obstetrics | 1994

Acute myelogenous leukemia in pregnancy: Fetal blood sampling and early effects of chemotherapy

Shigeo Morishita; A. Imai; Ichiro Kawabata; Teruhiko Tamaya

This report documents the acute toxicity of anti‐leukemic chemotherapy on the fetus in utero by umbilical blood sampling. A patient with acute myelocytic leukemia diagnosed at the 23rd week of gestation received combination chemotherapy, and carried the pregnancy to successful delivery at the 34th week. During the course of pregnancy, the fetal condition was evaluated by serial real time sonograms and umbilical blood sampling through cordocentesis. Fetal hemotopoiesis was preserved against maternal chemotherapeutic agents, and no developmental abnormalities were observed. This is the first attempt to evaluate the acute effects of chemotherapeutic agents on the fetus in utero by real time umbilical cord sampling.


International Journal of Gynecology & Obstetrics | 1994

HYPOKALEMIA IN A PREGNANT WOMAN WITH LONG-TERM HEAVY COLA CONSUMPTION

K. Matsunami; A. Imai; Teruhiko Tamaya

References Bendsen J, Maller-Ernst K, Povery G: Bladder tumor as apparent cause of vagina1 bleeding in pregnancy. Acts Obstet Gynecol Stand 64: 329, 1985. Gonzalez-Blanco S, Mador DR, Vickar DB, McPhee MS: Primary bladder carcinoma presenting during pregnancy in 3 cases. J Urol 141: 613, 1989. Weinreb JC, Brown CE, Lowe TW, Cohen JM, Erdman WA: Pelvic masses in pregnant patients: MR and US imaging. Radiology 159: 717, 1986.


Journal of Obstetrics and Gynaecology | 2010

Uterovaginal duplication with blind hemivagina and ipsilateral renal agenesis: Review of unusual presentation

H Takagi; K Matsunami; A. Imai

Congenital abnormalities of the Müllerian duct system can result in various urogenital anomalies, including uterus didelphys with blind hemivagina and ipsilateral renal agenesis (Herlyn–Werner–Wunderlich syndrome). It usually presents after the menarche with progressive pelvic pain during periods secondary to haematocolpos. However, rarely presentation is unusual with consequent diagnostic delay. This paper attempts to review the medical literature for rare presentations that make diagnosis and treatment difficult, including our cases. Clinicians must be aware of the importance of this rare congenital anomaly of the female genital tract, especially many years after the menarche. This condition should be considered to prevent misdiagnosis or suboptimal treatment.


Journal of Obstetrics and Gynaecology | 2003

Gonadotrophin-releasing hormones agonist therapy increases peritoneal fibrinolytic activity and prevents adhesion formation after myomectomy

A. Imai; Michiyo Sugiyama; Tatsuro Furui; Seiji Takahashi; Teruhiko Tamaya

The aim of this study was to evaluate uterine adhesions after myomectomy and peritoneal fibrinolytic capacity in women treated with gonadotrophin-releasing hormone agonist (GnRHa) before surgery. A prospective observational study comprised 15 infertile women who underwent myomectomy. Before surgery, 10 were treated with buserelin acetate (900 μg/day) for 10 – 12 weeks followed by additional postoperative treatment with GnRHa for 4 weeks (GnRHa group) and five received no treatment (control group). Peritoneal fluid specimens were taken at the beginning of myomectomy and the adhesions were estimated by second-look surgery (caesarean section or laparoscopy). Levels of plasminogen activator (PA) and PA inhibitor (PAI) were determined by enzyme-immunosorbent assays. Pre- and postoperative GnRHa therapy significantly reduced adhesion formation compared with control groups (adhesion scores; 0.2 ± 0.4 vs. 2 ± 1, P < 0.0001). GnRHa group showed a significant decrease in PAI level (P < 0.0001) but no significant change in PA level, suggesting increased fibrinolytic capacity in peritoneal fluid from GnRHa-treated patients. These data suggest that GnRHa therapy is successful in preventing adhesion formation after myomectomy. GnRHa-induced shift to more fibrinolytic activity, mainly because of a decreased level of PAI, may play a critical role in the mechanism of the GnRHas action on postoperative adhesion development.


Archives of Gynecology and Obstetrics | 1991

Elevated CA125 serum levels in a patient with tuberculous peritonitis

A. Imai; T. Itoh; Kenji Niwa; Teruhiko Tamaya

SummaryWe report a case of tuberculous peritonitis in a 59-year-old postmenopausal woman. Her serum CA125 level was raised and fell in response to antituberculous therapy.


Journal of Obstetrics and Gynaecology | 2007

Chemotherapy-induced female infertility and protective action of gonadotropin-releasing hormone analogues

A. Imai; Tatsuro Furui

Summary This review aimed to critically discuss the current protocols using gonadotropin-releasing hormone analogue (GnRHa) for the management of chemotherapy-induced premature ovarian failure. In in-vitro experiments, GnRHa retards doxorubicin-induced granulosa cell damage, suggesting an additional GnRHs activity to protect the gonads during chemotherapy through GnRH receptor-mediated mechanism(s). GnRHa acts to protect the gonads during radiation and/or chemotherapy by preferentially steering cells into cell cycle arrest with a decline in response to the chemotherapeutic agents. The ovarian protection by GnRHa co-treatment against chemotherapy can enable the preservation of future fertility in survivors and prevent the bone demineralisation and osteoporosis associated with hypooestrogenism and ovarian failure.


Archives of Gynecology and Obstetrics | 1991

A dermoid cyst of the paravaginal space

Reiko Hirose; A. Imai; Hiroshi Kondo; K. Itoh; Teruhiko Tamaya

SummaryWe describes a patient with a dermoid cyst in the paravaginal space. The cyst recurred after repeated drainage procedures and became infected. The cyst was ultimately excised.


Archives of Gynecology and Obstetrics | 1991

The use of peritoneum for vaginoplasty in 24 patients with congenital absence of the vagina.

Teruhiko Tamaya; A. Imai

SummaryVaginoplasty using pelvic peritoneum (Rothmans method) was used in 24 patients with congenital absence of the vagina. The results are presented. Rothman (1972) described vaginoplasty using pelvic peritoneum. We have operated on 24 patients with the anomaly. In this report, the better technique for this operation and the results of treatment are evaluated using data from these 24 cases.


International Journal of Gynecology & Obstetrics | 2006

Cesarean section scar pregnancy may be the cause of serious hemorrhage after first-trimester abortion by dilatation and curettage

M. Nonaka; H. Toyoki; A. Imai

Implantation within the fibrous tissue of a cesarean scar is considered to be the rarest form of ectopic pregnancy and constitutes a life-threatening condition [1,2]. The literature warns that implantation in the uterine scar can cause serious bleeding after otherwise uncomplicated dilatation and evacuation procedures [3,4]. A 36-year-old woman, gravida 4, para 3, was referred to the Department of Obstetrics and Gynecology of the Gifu University School of Medicine, Gifu, Japan, for further management of a missed abortion. Her obstetrics history revealed 3 lower transverse cesarean sections performed 7, 5,

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