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AIM The aim is to examine the prevalence of low bone mineral density (BMD) (osteoporosis and osteopenia) of lumbar and femoral bones in puerperal women for the prenatal and postnatal care to ensure their optimal bone health. METHODS We analyzed the first scan data of 1079 Japanese puerperal women without bone fracture (mean age 33.5 ± 4.5 years) who had undergone deliveries at Niigata City General Hospital for 10 years. We measured BMDs of the lumbar spine [LS], femoral neck [FN], and total hip [TH] with dual-energy X-ray absorptiometry (DXA) within 30 days after delivery. RESULTS The rates of osteoporosis of LS, FN, TH, and comprehensive diagnosis (CD) were 0.6%, 4.8%, 1.5%, and 5.4%, respectively, and osteopenia were 20.2%, 39.5%, 29.3%, and 44.3%, respectively. The multivariable-adjusted odds ratio (OR) for body mass index (BMI) before pregnancy reflected significant decreases in risk for low BMD with an OR of 0.78 (95% CI: 0.74-0.82) with the 1 kg/m2 increases. In lean women (BMI

This study assessed the relief of uterine bleeding and clinical symptoms during cyclic administration of dienogest for the treatment of endometriosis.In total, 25 patients undergoing ovarian cyst enucleation and given dienogest participated in this study. Dienogest 2 mg/day was administered for 3 weeks, and the drug was then withdrawn for 1 week (cyclic administration of dienogest). This 4-week cycle was repeated six times. Patients' records were prospectively analyzed for the number of days on which any uterine bleeding occurred, as well as menstrual pain before and after the start of dienogest administration were evaluated with a view to using the data obtained herein as the basis.During the period of cyclic administration of dienogest, uterine bleeding occurred on 5.8 to 7.7 days per 4-week period on an average through cycles. Of uterine bleeding episodes, menstruation-like uterine bleeding was present in about 80% of patients. The visual analog scale (VAS) value for menstrual pain significantly decreased from 3.8 before dienogest administration after surgery to 1.5 at the completion of cycle 1, VAS remained low thereafter.These results raise the possibility that cyclic administration of dienogest may relieve lessen uterine bleeding, a major adverse event and menstrual pain.

Objective Taste disturbance is known to occur as one of the adverse events associated with chemotherapy for gynecological cancer, but few studies have attempted to assess it in practical terms. Therefore, a range of taste tests was performed in gynecological cancer patients. Methods The patients were 23 women with gynecological cancer being treated with anticancer agents. Subjective symptoms of altered taste were classified, and objective findings were obtained with the following four gustatory tests: serum trace element (zinc, copper, iron) levels, tongue cultures, electrogustometry, and the filter paper disc tests. Results Of the 23 subjects, 11 perceived taste disturbances. The serum zinc level was consistently below the lower limit of normal. On tongue cultures, indigenous bacteria were seen in all patients during the entire treatment period. Electrogustometry revealed a tendency for the development of hypogeusia in the chorda tympani nerve field. Conversely, hypergeusia tended to develop gradually in the greater petrosal nerve field. The filter paper disc test revealed a tendency for the development of hypergeusia for sweetness, saltiness, and sourness in the chorda tympani nerve field. Hypogeusia for bitterness tended to develop with increasing number of chemotherapy cycles. The glossopharyngeal nerve field exhibited the same tendencies as observed in the chorda tympani nerve field. In the greater petrosal nerve field, there was a tendency for the development of hypergeusia for sweetness, sourness, and bitterness. Conclusions Abnormal test results were seen in half of patients after cancer chemotherapy.

To evaluate the outcomes of patients treated with cyclic administration of dienogest after ovarian endometriotic cystectomy, following the completion of treatment. We retrospectively evaluated 26 patients treated with dienogest (2 mg/day) after cystectomy (revised American Society for Reproductive Medicine [r-ASRM] stage III-IV) in a pilot study. Dienogest was administered cyclically, for a total of six cycles, each comprising three weeks on and one week off. Outcomes of interest included severity of menstrual pain and recurrence of cysts at baseline, during the immediate post-treatment period and at the final outpatient follow-up. The mean outpatient follow-up period was 45.0 months. The visual analog scale score for menstrual pain following 6 cycles of dienogest treatment was significantly lower than that at baseline; it remained low at the final follow-up. The recurrence rates of cysts were 4% and 21% at 24 and 48 months after the completion of dienogest treatment, respectively. Six patients with recurrent disease were all classified as having r-ASRM stage IV. Our results suggest that cyclic dienogest for six months after cystectomy could relieve menstrual pain and reduce the recurrence of cysts, for approximately four years. The necessary treatment period for patients with r-ASRM stage IV disease requires further study.

Although primary carcinoid tumor of the ovary is an extremely rare neoplasm, survival is excellent if the disease is confined to one ovary. Herein, we present a case of primary strumal carcinoid tumor of the ovary, stage IA, borderline malignancy, in a 34-year-old woman. Histological findings of the right ovary indicated higher atypical nuclei, higher mitotic rate and focal necrosis of tumorous cells in some areas, findings that are compatible with atypical carcinoid of the lung. Immunohistochemical staining was positive for synaptophysin, neuron-specific enolase, chromogranin A, Ki-67, topoisomerase IIalpha, peptide YY, and thyroglobulin. Three and a half years postoperatively, multiple bone and breast metastases were found and anticancer chemotherapy was ineffective. The results in the present case indicate that an ovarian carcinoid tumor found to be 'atypical carcinoid' according to pulmonary carcinoid criteria or immunohistochemical staining (i.e. highly positive for topoisomerase IIalpha and Ki-67) may have a poor prognosis.

Calcium transfer from the mother to the infant during pregnancy and lactation plays an extremely important role in the bone health of the mother and neonate. Calcium aids in bone health through all ages but is especially crucial during pregnancy and lactation. Changes in the structure and metabolism of bone during pregnancy and the early stage of postpartum are evaluated by investigating bone mineral density (BMD), bone histomorphometry and bone markers of human or animal models. The bone resorption increased at the end of pregnancy and lactation, and the bone formation increases and the bone structure is almost recovered after cessation of lactating in postpartum. Puerperal BMD remained static over the subsequent 5-10 years. If the women have a low BMD at this stage of their reproductive life, it tends not to improve over this time. Perhaps identification of this at-risk group may lead to effective interventions to reduce fracture risk in later life.

We report a retrospective study of 16 patients with uterine sarcoma from 1986 to 2001 in Niigata City General Hospital. Five-year survival rates in stage I, II, III and IV (FIGO) were 68% (n = 4), 50% (n = 2), 0% (n = 3), and 0% (n = 7), respectively. Overall survival for the patients with incomplete resection of tumor at primary laparotomy (n = 7) was significantly poorer than that with complete resection (n = 8). Patients with a high-LDH (lactic acid dehydrogenase) value tended to have poorer prognoses, but there was no significant difference of overall survival between the high-LDH group (n = 8) and the normal-LDH group (n = 8). Fifteen patients had postsurgical adjuvant chemotherapy. Out of 5 evaluable patients undergoing first-line chemotherapy, there were only 2 partial responders with IAP (ifosfamide, adriamycin, cisplatin) chemotherapy, and out of 11 evaluable patients undergoing second-line chemotherapy, there was only 1 partial responder with IAP. Out of 10 patients who had no evidence of disease after prior therapy, 6 patients had recurrences. Five patients underwent secondary surgery for recurrence and residual tumor. Of them, 3 patients did not have complete resection of residual tumor and died within 1 year after secondary surgery. Although prognosis of advanced uterine sarcoma and recurrence is poor, it is suggested that aggressive resection for recurrence and residual tumor improves prognosis.