Toshinobu Tanaka

Nonsurgical therapy to preserve oviduct function in patients with tubal pregnancies.

Surgical treatment for tubal pregnancies greatly impairs the subsequent fertility of patients because of salpingectomy and its complicated adhesions. Nonsurgical methotrexate therapy was developed to avoid such complications. Although early detection was of prime importance, resolution of ectopic pregnancy was obtained in 22 patients (95.7%) with methotrexate administration alone. Patency of the oviducts was evaluated with hysterosalpingography and/or laparoscopy in 19 patients after termination of methotrexate treatment. In 10 of 19 patients (52.6%), complete patency of the involved oviduct confirmed the validity of this regimen. Severe side effects were not observed in any of the 23 patients.

Levels of ritodrine hydrochloride in fetal blood and amniotic fluid following long-term continuous administration in late pregnancy

Placental transfer of ritodrine hydrochloride (ritodrine) was investigated in late-pregnant women following continuous infusion. Five volunteer women undergoing cesarean section received a total dose of 650-5970 mg of ritodrine for 8-49 days. After the infusion was discontinued at cesarean section, maternal and fetal blood and amniotic fluid were collected for later determinations of ritodrine by radioimmunoassay. Maternal serum concentrations of ritodrine were between 99.0-332.4 ng/ml. Serum levels of ritodrine in cord artery and vein were 75.9-250.5 ng/ml and 74.7-213.0 ng/ml, respectively. Ritodrine levels in amniotic fluid ranged from 126.0 to 424.0 ng/ml. The concentration of ritodrine in cord vein to maternal vein (CV/MV) was 0.695 +/- 0.066 (m +/- SE), while the concentration ratio of the amniotic fluid to maternal vein (AF/MV) was 1.719 +/- 0.211. In the present study of continuous administration of ritodrine, remarkably higher concentrations in fetal circulation and amniotic fluid were observed compared to those in cases of short-term infusion.

The determination of choline in human semen by the enzymic method

Studies are reported on the specific enzymic microdetermination of free choline in human semen. The concentration of choline in normal semen was found to be 0.9 - 1.4 mg/ml. The minimum detectable concentration of choline using the method described was 1.5 micrograms. Normal levels of choline in vaginal fluid, saliva, serum and urine could not be detected by this procedure.

Evaluation of the Improvement of Cephems on the Prophylaxis of Pelvic Infection after Radical Hysterectomy

Antibiotics, especially cephems, have been improved remarkably in the last 20 years. In order to evaluate the improvement of antibiotics used for the prophylaxis of infections after radical hysterectomy, two groups of patients (group A, 1978-1979, n = 54; group B, 1985-1987, n = 55) were examined in regard to bacteriological and clinical effects. In spite of the improvement of antibiotics, the positive rate of bacteriological analysis had increased from 44.4 to 76.4%. Obvious decrease of gram-negative bacilli and increase of gram-positive cocci (GPC), e.g. Enterococcus, were observed. In contrast, fever index and febrile morbidity of group B decreased significantly more than those of group A. These results indicate that the improvement of antibiotics has brought more effective prophylaxis in the postoperative infection in spite of the high positive rate of GPC.

Endocrinological environment of polycystic ovarian disease.

Serum levels of androgenic hormones, 17-hydroxyprogesterone and estrone in Japanese patients with polycystic ovarian disease (PCOD) were elevated as compared to normal women. In early follicular phase of all of PCOD patients, serum levels LH were always higher than those of FSH. Serum PRL levels were shown to be significantly (p less than 0.05) higher in PCOD patients than in normal women. Although the cause of both inappropriate gonadotropin secretion and occurrence of mild hyperprolactinemia in PCOD have not been fully elucidated, decrease in numbers of receptor for dopamine is thought to be one of the main causes of them from the present data obtained by metoclopramide injection administered during the continuous infusion of dopamine.

Serial monitoring of serum estradiol and progesterone levels during the HMG‐HCG therapy in six anovulatory women

Serum estradiol (E2) and progesterone (P) levels were radioimmunoassayed every or every other day for monitoring the HMG‐HCG therapy in six anovulatory patients, and the clinical significance of measuring steroid hormones as precautionary counter‐plot against the ovarian hyperstimulation syndrome and multiple pregnancies was evaluated.

The serum pregnancy-specific β1-glycoprotein to betahuman chorionic gonadotrophin ratio as an index of prognosis in patients with choriocarcinoma

Summary. The ratio of serum pregnancy‐specific β1‐glycoprotein (SP1) to the β‐subunit of human chorionic gonadotrophin (β‐hCG) before and after chemotherapy was measured in 12 patients with metastatic choriocarcinoma. The ratios before chemotherapy ranged between 0.03 and 0.75, with a mean value of 0.34 (SD 0.21). The ratio increased to over 1.0 (1.05–53.3) after one or two courses of chemotherapy in seven of the 12 patients. These women achieved complete remission. In the other five patients who died of the disease due to drug resistance of the tumour, the ratio after chemotherapy was low (0.04–0.74) and tended to decline. These data suggest that the serum SPl/β‐hCG ratio can be used to predict the prognosis of patients with choriocarcinoma.