Satoru Makinoda

Intimate Partner Violence Against Women: Is Women Empowerment a Reducing Factor? A Study from a National Bangladeshi Sample

This article explores how women empowerment affects Intimate Partner Violence (IPV) in Bangladesh using a cross-sectional investigation of currently married women (n = 4,181) sampled via the Bangladesh Demographic Health Survey (BDHS), 2007. About one-fourth (24%) of currently married Bangladeshi women experienced both physical and/or sexual IPV in the past year. Prevalence of physical and sexual violence was 19.4% and 10.5%, respectively. Younger generation (age 15–24), illiterate, rural, and the poorest household wealth categorized women were much victimized. Current employment status predicted intimate partner violence. Household decision-making pattern also emerged as a predictor of IPV. Likelihood of all forms of IPV increases with increase of number of participation in household decision-making. Promoting women empowerment in the household without men’s support may put women at more risk of IPV.

Transarterial embolization of the uterine arteries, patient reactions and effects on uterine vasculature

BACKGROUND Therapeutic embolization of the uterine arteries has been successfully used to manage profuse gynecological hemorrhage. In the present study we aimed to investigate whether embolization of uterine arteries may serve as a safe and effective alternative treatment in cases of menorrhagia in fertile and perimenopausal women. As a first step, we have evaluated the methodology, patient reactions and effects on the uterine vasculature. METHODS The distal part of the uterine artery was embolized with polyvinyl alcohol particles via catheterization of the right femoral artery. Total abdominal hysterectomy was performed the next day. RESULTS Bilateral embolization in two patients resulted in considerable pain that required morphine analgesic medication and epidural analgesia. One patient was embolized unilaterally and experienced only slight discomfort with no need for analgesic medication at all, indicating that unilateral embolization is a well-tolerated method. After embolization, angiography showed stagnant flow in embolized vessels without contrast filling of distal branches. Angiography of the specimen showed normal vascular architecture in non-treated vessels. In treated vessels the main arterial trunks were patent but all smaller branches were occluded. Histology showed that most of the particles lodged in small arteries and that arterioles never showed injected material. CONCLUSION The study indicates that the procedure involves an efficient occlusion of uterine vessels and that unilateral embolization of uterine arteries is well tolerated.

Intimate Partner Violence and Unintended Pregnancy Among Bangladeshi Women

This study examined the relationship between intimate partner violence (IPV) and unintended pregnancy using data from women reporting IPV in the 2007 Bangladesh Demographic Health Survey. The analysis included 4,695 married women, aged 15 to 40 years, who had at least one birth in the last 5 years. Bivariate and multiple logistic regression analyses were performed to assess the relationship between IPV and pregnancy. About one third (30.4%) of women were abused physically and/or sexually and about one third (30.9%) of their births in the last 5 years were unintended. Compared with women who suffered no IPV, women who were abused sexually had a 1.64-fold increased risk of unintended pregnancy, which is higher than those who suffered physical abuse only (odds ratio: 1.35). The prevalence of unintended pregnancy among those who experienced severe physical violence was 1.60 times higher than those who reported no abuse. The findings indicate a significant relationship between IPV and unintended pregnancy among Bangladeshi women.

Association between adolescent marriage and intimate partner violence : a study of young adult women in Bangladesh

This study explores the association between adolescent marriage and intimate partner violence (IPV) among young adult women using 2007 Bangladesh Demographic Health Survey data. The analyses are restricted to young women 20 to 24 years old. Logistic regression analyses are constructed to estimate the odds ratios and 95% confidence intervals for the association between adolescent marriage and IPV in the past year. Results show that there is a strong significant relationship between adolescent marriage and experience of physical IPV in the past year among this population. Association between sexual IPV and adolescent marriage is insignificant. Adolescent marriage puts women at increased risk of physical IPV into their young adult period. Government agencies need to enforce existing law on the minimum age at marriage to reduce IPV among adolescent and young adult girls.

High prevalence of intermediate‐risk human papillomavirus infection in uterine cervices of kenyan women infected with human immunodeficiency virus

The aim of this study was to investigate an association between certain human papillomavirus (HPV) types and human immunodeficiency virus (HIV) infections. Sexually active females (n = 487; 19–61 years old) were enrolled in the study. Subjects underwent Pap testing and evaluations of HIV and HPV infection status on uterine cervical cell samples. HPV genotyping was performed using a Kurabo GeneSQUARE DNA microarray test. Overall, 23 HPV genotypes were detected, and the most prevalent HPV genotype was HPV‐52, followed by HPV‐39, ‐54, ‐45, ‐56, ‐53, ‐31, ‐42, ‐16, ‐68, and ‐51. HPV‐30, ‐53, ‐54, ‐61, and ‐66, which are associated with abnormal cytology, are categorized as intermediate‐risk in this study. Detection of both high‐ and intermediate‐risk HPV types was significantly associated with cervical abnormality and HIV infection. Multivariate analysis revealed that some high‐risk HPV types (HPV‐31, ‐45, ‐51, ‐56, and ‐59) and most intermediate‐risk HPV types were associated with HIV infection, while the high‐risk types (HPV‐16, ‐18, ‐33, ‐35, ‐39, ‐52, ‐58, and ‐68) were not. The oncogenic effect of the most malignant HPV types (e.g., HPV‐16 and ‐18) appear to be lower, while that of intermediate‐risk types are greater, in areas with a high prevalence of HIV infection. J. Med. Virol. 83:1988–1996, 2011.

Analysis of Renal Artery Hemodynamics in Normal Fetuses Using the Color Doppler Method

Objective: From analysis of fetal renal artery hemodynamics, we attempted to reveal renal glomerular and tubular function in normal fetuses during pregnancy. Design: The study included 36 cases of normal fetuses from the 20th to the 40th week of gestation; Vmax (the systolic peak velocity of main renal artery), Vmean (time averages of trace of peak velocity) blood flow were initially measured between 20 and 24 weeks of gestation and every 4 weeks thereafter. The measurement was performed a total of five times in a longitudinal study. In addition, the blood flow waveform was concurrently examined. Results: The Vmax was 22.02 ± 0.50 cm/s at 20–24 weeks of gestation. This standard value (100%) was found to increase for each group as follows: 125.2, 149.1, 156.1, and 181.5%. Furthermore, using 20–24weeks of gestation as the standard, the Vmean increased after the 37th week of gestation: 186.7%, respectively. At 20–24 weeks of gestation, the blood flow wave forms consisted of 43.2% type I (only systolic waveforms), and 56.8% type II (both systolic and diastolic waveforms). Type III waveforms (waveforms that extended beyond the diastolic to the next systolic component) were not recognized. In the 33- to 36-week group, 82.6% of the waveforms were type II, and in the 37- to 40-week group, 76.2% of the waveforms were type III. Conclusions: The Vmax and Vmean of the renal artery in normal fetuses exhibit a similar rate increase when 20–24 weeks of gestation is compared to 37–40 weeks of gestation. The blood flow waveforms changed as pregnancy progresses; thus, it was inferred that this finding was related to the development of the renal glomerular and renal tubular function.

Prenatal diagnosis of fetal respiratory function: evaluation of fetal lung maturity using lung-to-liver signal intensity ratio at magnetic resonance imaging

The purpose of this retrospective study is to determine the fetal lung‐to‐liver signal intensity ratio (LLSIR) on T2‐weighted images for the prediction of neonatal respiratory outcome.

Hemodynamic analysis of cephalothoracopagus by the color doppler method : A comparison to normal fetuses via a longitudinal study

In a case of cephalothoracopagus, the umbilical artery (UA) was observed with color Doppler method, and the findings were compared with the hemodynamics of 46 normal fetuses. The patient was a 25-year-old primigravida who had appeared for routine prenatal visits since her 6th week of pregnancy. At a later time, the patient was examined after an interval of 4 weeks. Although an ultrasonography was also conducted, unfortunately, any findings of cephalothoracopagus were not detected. In the 25th week of gestation, we hospitalized her for marked polyhydramnios (amniotic fluid index: 280 mm), at which time an ultrasound examination revealed cephalothoracopagus. In the UA, the Vmax was 30.3 cm/s (normal fetus at 25–28 weeks: 33.5 ± 3.9 cm/s). The UA hemodynamics fell below the normal range. At 26 weeks, the UA Vmax was 56.5 cm/sec, a level which significantly exceeded the normal range. The patient underwent a cesarean section at 27 weeks of gestation; the indication was fetal distress. This is caused by the condition in which the fetal heart beats decreases to 90 beats per minute 3 times during a 10-min period as measured on the cardiotocograms. She delivered a 1,392-gram female with an Apgar score of 2 points (respiratory 1 point and heart rate 1 point). The infant was a cephalothoracopagus, with one head, two hearts, four upper limbs, and four lower limbs. The neonate died from circulatory failure 56 min after birth.

Hemodynamics of the renal artery and descending aorta in fetuses with renal disease using color Doppler ultrasound--longitudinal comparison to normal fetuses.

Abstract Objective: To examine the hemodynamic values of the renal artery (RA) and descending aorta (DA) in normal fetuses, and to compare these values to those of fetuses with renal disease, thus evaluating the usefulness of hemodynamic analysis for the diagnosis of fetal renal disease. Materials and methods: We examined 46 normal fetuses and 15 fetuses with renal disease (six cases of polycystic kidney (PCK) and nine cases of hydronephrosis). We measured the maximum systolic velocity (Vmax) of the RA and DA using color Doppler. Measurements were made five times, from the 20th to the 40th week, in both the control and the renal disease group. Results: In the fetuses with PCK (Potters syndrome) that died postpartum from non-functional kidneys, the Vmax of the RA and DA in the 35th week were 13 cm/s and 25.4 cm/s, respectively. In the fetus with PCK (Trisomy 9) that died due to non-functional kidneys in the 34th week, the values were 13.3 cm/s and 29.6 cm/s, respectively. These values were well below those of the normal group: more than 1.5 SD below the mean. In two fetuses from the nine with hydronephrosis that had a unilateral non-functional kidney, the RA did not clearly show identifiable blood flow. Conclusions: The Vmax of the RA and DA in fetuses with renal disease correlates with fetal kidney function, particularly the RA Vmax. Vmax of 1.5 SD below the mean should be the lower normal limit.

Hemodynamic response of ovarian artery after hCG injection

We have analyzed ovarian hemodynamics immediately after human chorionic gonadotropin (hCG) administration in patients treated by clomiphene-hCG and human menopausal gonadotropin-hCG. This study involved 40 infertile women who signed consents to participate in this study. After intramuscular injection of 10000 IU hCG, the change of ovarian arterial blood flow (BF) was evaluated by color Doppler. Pulsatility index, resistance index, maximum velocity (V(max)), mean velocity, minimum velocity, cross-sectional area of ovarian artery (Area) and BF were measured before and 15-180 min after hCG administration. In the 36 subjects in which ovulation was induced successfully, V(max) and BF increased significantly even at 15 min after hCG administration and thereafter. In the 4 non-ovulatory subjects, no significant changes in any of indices at any of measured time points were observed. Comparative study of non-ovulatory and ovulatory subjects suggested that ovulation may be predicted by the ovarian hemodynamic analysis immediately after hCG administration.