Junnosuke Minagawa

Congenital malformations of newborn infants after clomiphene-induced ovulation

The effect of clomiphene citrate (CC) on the incidence of congenital malformations in newborn infants was assessed from the outcome of 1034 pregnancies after CC-induced ovulation recorded at nine university hospitals in a 5-year period. Of these pregnancies, 14.2% ended in abortion, 0.5% in ectopic pregnancy, 0.1% in molar pregnancy, and 1.6% in stillbirth. In all, 935 infants were born, and 21 (2.3%) showed visible malformations. This incidence of malformations was not significantly different from that in 30,033 infants (1.7%) after spontaneous ovulation (spontaneous ovulation group), and the types of malformations after CC treatment were similar to e those in the spontaneous ovulation group. These data indicate that CC has no teratogenic effect.

The diagnostic significance of LH-releasing hormone test in patients with amenorrhea

Abstract Serum levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) following intravenous injection of 100 μg of synthetic LH-releasing hormone (LH-RH) in 10 normal women in the follicular phase and in 80 amenorrheic women were determined by radioimmunoassay. The low or normal basal levels of LH and FSH with good response to LH-RH were observed in patients with galactorrhea, secondary amenorrhea responding to progestin with bleeding, and in some of the patients with anorexia nervosa. Low resting levels with little or no increase of LH and FSH following LH-RH were experienced in patients with Sheehans syndrome, postoperative patients with chromophobe pituitary adenoma, and in some of the patients with amenorrhea responding to progestin plus estrogen with bleeding. Elevated basal LH and FSH levels with further increase following LH-RH were seen in patients with Turners syndrome and in some of the patients with amenorrhea responding to progestin plus estrogen with bleeding. The three typical patterns stated above may indicate that the cause of anovulation lies in the hypothalamus, pituitary, or ovaries. It is concluded that the LH-RH test is useful in clarifying the pathophysiology of anovulatory conditions.

Response of pituitary LH and FSH to synthetic LH-releasing hormone in normal subjects and patients with Sheehan's syndrome.

Abstract Serum levels of LH and FSH were determined by radioimmunoassay in seven patients with Sheehans syndrome, eight women with normal menstrual cycles, and five normal men following intravenous injection of synthetic luteinizing hormone-releasing hormone (LH-RH) in a dose of 100 μg. The mean maximum increases of LH (M. ± S.E. mI.U./ml.) were in the following order: 279.4 ± 87.6 at the preovulatory phase, 69.2 ± 12.6 in normal males, 48.2 ± 3.5 at the midluteal phase, and 29.9 ± 4.9 at the early follicular phase. The response of serum levels of FSH was found to parallel the change in the levels of LH, but these changes were less pronounced. No response of LH and FSH to LH-RH was observed in five patients with Sheehans syndrome while the remaining two patients showed an increase of LH around normal lower limits. These findings seem to indicate that LH-RH test is useful for the evaluation of pituitary reserve function of gonadotropin secretion.

Improvement of long-term prognosis in patients with ovarian cancers by adjuvant sizofiran immunotherapy: a prospective randomized controlled study.

The effect of immunotherapy using sizofiran (SPG) on the prognosis of patients with ovarian cancers was prospectively studied in a total of 68 patients, who were randomly assigned to either a cisplatin, adriamycin and cyclophosphamide (PAC) therapy group or a PAC plus SPG combination therapy group.The survival rate was significantly higher in patients with stage Ic, II or III cancers treated with the PAC plus SPG combination, compared with the patients treated with PAC alone. In the SPG-receiving patients with stage Ic or more advanced cancers who were treated with four cycles or more of PAC, the outcome was improved (Cox-Mantel, p=0.074; generalized Kruskal-Wallis, p=0.032). Similar improvement was also observed in the patients with non-serous adenocarcinomas (Cox-Mantel, p-0.076; generalized Krukal-Wallis, p=0.045). No side effects attributable to SPG were recorded.The present results suggest that the use of SPG in combination with long-term chemotherapy improves the postoperative prognosis in ovarian cancer patients.

LEPRECHAUNISM (DONOHUE'S SYNDROME) – TWO AUTOPSY CASES

Two autopsy cases of female newborns with numerous morphologic and metabolic abnormalities were reported. These were considered Identical with a disorder which has been called leprechaunism or Donohues syndrome, and were believed to be the first and second autopsy cases reported in this country. Although it has been presumed that these might be abnormalities of endocrine system or of metabolism, the authors could not find any factors which caused the disorder in spite of minute analysis of steroid hormones In urine, investigation of laboratory data as well as autopsy findings.

Cervical carcinoid associated with adenocarcinoma and squamous cell carcinoma.

子宮頸部のsmallcellcarcinomaは従来よりsquamous cell carcinomaの1亜型に分類されているが, 最近はAPUD系腫瘍との関連性が注目され, carcinoidとして報告されつつある.われわれは, 40歳3経妊1経産婦に発生し, 電顕的にneuro-secretory granuleを有する子宮頸部carcinoidの1例を経験した.組織学的には, 腫瘍の大部分はsmall cell carcinomaで占められるが, 一部にwell-differentiated adenocarcinomaおよび1argecellnon-keratinizing squamous cellcarcinoma成分を伴っており, smallcellcarcinomaと連続的移行像も認められる. ほかにsquamousdysplasiaも存在する.本腫瘍のhistogenesisとして, 多分化能を有する未熟上皮細胞由来の可能性が示唆される.剥離細胞像の特徴としては, 大部分を占めるsmallcellcarcinoma由来細胞のみで, 多数の小型腫瘍細胞を主として散在性に認める. 腫瘍細胞質は極めて乏しく, 核は円形ないし卵円型で一様である. 核クロマチンは増量し, 粗大穎粒状で, 核小体は不明瞭である.膣細胞診におけるこれらの小型腫瘍細胞はリンパ球と混同されやすく, また本腫瘍は極めて予後不良であることからも, 細胞診に際しては特別の注意を要する.