Search

SummaryM-mode echocardiographic studies on 110 human fetuses at 18 to 40 weeks of pregnancy were carried out on Japanese women with a regular menstrual cycle and no complications of pregnancy, in order to evaluate the growth and function of the fetal heart. High correlations of fetal cardiac transverse diameter with the gestational age (r = 0˙93, P < 0˙001), and also with the biparietal diameter(r = 0˙93, p < 0˙001) were noted. Left ventricular diastolic dimension correlated well with the gestational age (r = 0˙69, P < 0˙001), as did left ventricular systolic dimension (r = 0˙64, p < 0˙001). A negative correlation between the left ventricular ejection fraction and gestational age was evident (r = 0˙31, 0˙01

Experimental data on the volumetric liquid-phase mass transfer coefficient kLa in 10 and 19 cm I.D. bubble columns with single-nozzle gas spargers were obtained with several gases and various pure liquids or aqueous non-electrolyte solutions, and the effect of the physical properties of the gas and liquid on kLa was studied. A new dimensionless correlation for kLa was developed and is shown to correlate the experimental data with an average deviation of 2.5%. Data for absorption of oxygen from air into aqueous solutions of various electrolytes were also obtained and the effect of the presence of electrolyte on kLa was investigated.

SummaryIn a fetus with an ostium atrial septal defect, supraventricular and ventricular premature beats were diagnosed antenatally, using simultaneous fetal M-mode echocardiography and electrocardiography. The shape of the QRS complex from the supraventricular premature beat was similar to that of the sinus complex. In case of the ventricular premature beat, a wide bizarre QRS complex was evident. This approach facilitates the antenatal diagnosis of fetal arrhythmia in utero.

A.C. conductivity σac of amorphous As40+xSe60-x and As2Se3 : Ag has been measured. The σac of these materials varies as ωs in the audio frequency range. At room temperature, the exponent s decreases from 1 to 0.7 with increasing x in As40+xSe60-x while s is 0.7 irrespective of Ag content in As2Se3 : Ag. With decreasing temperature, s in As2Se3 : Ag increases. Defect states due to Ag additives are considered to be directly concerned with σac.

Experimental data on the fractional gas hold-up in a 10 cm I.D. bubble column with a single-nozzle gas sparger were obtained with various gases and pure liquids or aqueous solutions of non-electrolytes and the effect of the physical properties of the gas and the liquid on the gas hold-up was studied. A new dimensionless correlation for the fractional gas hold-up was presented and shown to correlate the experimental data with an average deviation of 4.2%. The gas hold-up for air in aqueous solutions of various electrolytes was also measured and the effect of the presence of electrolytes on the gas hold-up was investigated.

SummaryTo search for a possible relationship between gonadotrophin secretion and catecholamines, blood samples were taken from women with normal ovulatory cycles and from those with disturbances of ovulation. Two catecholamine metabolites, 3-methoxy-4-hydroxyphenylglycol (MHPG) as a marker of adrenergic activity and 3,4-dihydroxyphenylacetic acid (DOPAC) of dopaminergic activity, were measured by high performance liquid chromatography. The mean level of MHPG in those with polycystic ovary syndrome was higher than in the group with normal ovulatory cycles. No change was found in MHPG or DOPAC levels after LH-RH administration. The MHPG levels were elevated after oestrogen injection in those with normal ovulatory cycles. Thus, in vivo, catecholamines may have an influence on gonadotrophins.

Electrical conductivity and optical absorption of amorphous As2Se3: Cu are investigated as a function of the copper concentration up to 4 at%. Addition of copper up to 0.5 at% increases the density of localized tail states due to the increase of disorder. It is considered that at a copper content of 0.5 at% and more the Fermi level shifts toward the valence band, and that acceptor like states are produced. At a copper content of 1 at% and more, the optical energy gap decreases with the increase of copper concentration and an alloying effect is supposed to take place in the amorphous As2Se3. Die elektrische Leitakhigkeit und der optische Absorptionskoeffizient von amorphen As2Se3: Cu werden in Abhangigkeit vom Kupfergehalt bis zu 4 At% untersucht. Bei Zusatz von Kupfer biszu 0,5 At% nimmt die Dichte der lokalisierten Auslaufer-Zustande bedingt durch die Zunahme der Unordnung zu. Bei Kupfergehalt von 0,6 At% und daruber kann man annehmen, dast das Fermi - Niveau sich zum Valenzband hin verschiebt, und dast Akzeptor-ahnliche Zustinde erzeugt werden. Bei einem Kupfergehalt von 1 At% und daruber, nimmt die optische Energielucke mit zunehmender Kupferkonzentration ab und ein Legierungseffekt setzt im a- As2Se3 ein.

Real-time two-dimensional and pulsed-wave Doppler ultrasonic examinations were performed on 8 normal volunteers and 97 patients with various gynecologic disorders; the objective was to assess uterine and tumor vascularities. Each arterial blood flow velocity wave-form was classified into two types. The resistance indices of normal and abnormal flows were greater than .7 and less than .7, respectively. In normal volunteers, abnormal flows were nil. In 8 of 44 patients with benign tumors (18.2%), abnormal flows were evident and all proved to be cases of leiomyoma or adenomyosis. Doppler signals were not detected in 18 of 36 patients with cervical carcinoma (50%) and abnormal flows were noted in only 6 (16.7%). In all cases of endometrial carcinoma, ovarian carcinoma, and trophoblastic disease, typically abnormal flows were noted. Moreover, in most subjects a decrease in blood flows was observed after chemotherapy by anticancer drugs or irradiation. Therefore, Doppler ultrasound is a pertinent and noninvasive tool that can be used repeatedly for assessing the tumor vascularity in gynecologic disorders.

Photoconductivity of amorphous As2Se3 is investigated. From the temperature dependence, the activation energy of photoconductivity is found to be about 0.4 eV at high photon energy range and it increases with decreasing photon energy in the energy range less than 1.5 eV. The dependence of photoconductivity on incident light intensity indicates that the slow and fast components of it are concerned with bimolecular and monomolecular characters, respectively. Die Photoleitung von amorphem As2Se3 wird untersucht. Aus der Temperaturabhangigkeit wird gefunden, das im Gebiet hoher Photonenergie der Wert der Aktivierungsenergie der Photoleitung etwa 0,4 eV ist, und das sie im Gebiet unterhalb 1,5 eV mit abnehmender Photonenergie zunimmt. Die Abhangigkeit der Photoleitung von der Beleuchtungsstarke zeigt, das die langsame und schnelle Komponente der Photoleitung mit bimolekularem bzw. monomolekularem Charakter verbunden sind.

Optical absorption coefficient and dc conductivity of amorphous As2Se3Agx system are measured as a function of silver content up to 4 at %. The samples are prepared by various methodes, that is, melt quenching, vacuum evaporation, and bubble blowing technique. The results obtained on different kinds of samples are compared with each other, and reasonable curves of absorption coefficient are found. The activation energy of conductivity decreases with increase of silver content. It decreases rapidly in the lower concentration region but slowly in the higher one. In the latter region, the decrease of the activation energy corresponds to the change in optical gap energy. It is considered, therefore, that silver additive shifts the Fermi level in the lower concentration region and shifts the band edge in the higher one. Der optische Absorptionskoeffizient und die Gleichstrom-Leitfahigkeit des amorphen As2Se3Agx-Systems werden in Abhangigkeit vom Silbergehalt bis zu 4 At % untersucht. Die Proben werden durch verschiedene Methoden, Abschrecken aus der Schmelze, Aufdampfen, und Blasen hergestellt. Die an verschiedenen Proben erzielten Ergebnisse werden miteinander verglichen und vernunftige Kurven fur den Absorptionskoeffizienten erreicht. Die Aktivierungsenergie der Leitfahigkeit nimmt mit zunehmenden Silbergehalt ab, und zwar schnell im Gebiet niedriger Konzentration, jedoch langsam im Gebiet hoherer Konzentration. Diese Abnahme korrespondiert mit der Anderung der optischen Energielucke im letzteren Gebiet. Deshalb kann man annehmen, das das Hinzufugen von Silber das Fermi-Niveau im Gebiet niedrigerer Konzentration verschiebt, und im Gebiet hoherer Konzentration den Bandrand.

The a.c. conductivity of glassy As2Se3 doped with Mn has been investigated at frequencies from 30 Hz to 300 kHz and at temperatures from 77 to 350 K. The frequency dependence of the a.c. conductivity in a sample containing Mn is not represented by the well-known empirical relation σac = Aωs. A sample with Mn exhibits a pronounced peak in the temperature dependence of the a.c. conductivity. The results are interpreted in terms of a simple pair model. It is concluded that Mn introduces localized states deep in the band gap and that they form simple pairs.

Evaluation au moyen d'une cellule galvanique de la conductivite ionique due aux ions Ag + dans le systeme vitreux As 2 Se 3 :Ag. La conductivite ionique dans As 2 Se 3 vitreux contenant 4 at.% Ag est beaucoup plus petite que la conductivite electronique. Par consequent la conduction electrique est interpretee en terme de transport electronique

To differentiate pre-operatively between leiomyomata uteri and adenomyosis, we measured serum levels of an antigen (CA 125) common to most nonmucinous epithelial ovarian carcinoma in patients with benign uterine tumor (11 of leiomyomata uteri, 7 of adenomyosis and 1 of adenomyosis with leiomyomata uteri). CA 125 in serum samples pre and postoperatively were measured using an RIA Kit. The normal range of CA 125 levels was below 35U/ml. The mean CA 125 level (+/- S.D.) was 18.3 +/- 6.1U/ml in patients with leiomyomata uteri and 93.3 +/- 49.4U/ml in those with adenomyosis. Student's t-test showed a significant correlation (0.001 less than p less than 0.01). The mean CA 125 level in patients with adenomyosis was statistically higher than that in disease-free women. Among 7 patients with surgically demonstrable adenomyosis, the CA 125 values were over 35U/ml (87.5%). In all 11 patients with surgically demonstrable leiomyomata uteri, the CA 125 level was below 35U/ml. The CA 125 level in patients with adenomyosis gradually decreased postoperatively and in all was below 35U/ml up to one month postoperatively. Using this approach, leiomyomata uteri and adenomyosis can be differentiated, pre-operatively.

Selective intra arterial hypertensive infusion of CDDP (100 mg) and PEP (40 mg) with angiotensin II was performed in a 64 year-old housewife with inoperable uterine cervical cancer stage IVa and transitional cell cancer of bladder (grade 1-2). PEP at 5 mg/day was also administered for 20 days (total 100 mg) using an implanted Drug Delivery System through the left internal iliac artery combined with irradiation therapy. There were hardly any side effects due to this treatment except for a slight upper digestive tract disturbance and bone marrow suppression, and the cancerous lesion gradually regressed following this treatment. This case suggested the efficacy of intra-arterial infusion using an implanted Drug Delivery System for advanced uterine cervical cancer. There has been no sign of recurrence six months after this treatment.

One hundred and sixteen patients with cervical intraepithelial neoplasia were treated by CO2 laser excisional conization, from 1985 to 1987. All operations in this series were performed in the outpatient unit. 1) In this series, 83.6% (97 out of 116) were patients with CIN and 44.0% (51 out of 116) were patients under the age 39 who can be pregnant. 2) There was no remaining in the 16 materials out of 44 obtained by hysterectomy due to cervical dysplasia and carcinoma in situ (CIS). 3) In our series, 10.3% (6 out of 58) of the women with dysplasia or CIS (surgical margin negative) required two treatments respectively to eradicate their disease from 9 months to 16 months after laser conization. 4) None of 72 women developed postoperative cervical stenosis and cervical infection. 5) Much of the epithelial cover, although originating from columnar cells, became squamous epithelium by 28 days. 6) There were 5 pregnancies in 72 patients, from 5 months to 13 after laser conization. From our studies, a CO2 laser conization for treating CIN preserved the architecture of the cervix, permitting adequate colposcopic and cytological follow-up, and preserved cervical function, so that fertility is not affected and so that there is no interference with pregnancy.

Artificial insemination with husband's semen is one of the treatments in cases of male infertility. A technique for swim-up and washing sperm is described. A special device was used for introduction of sperm into the uterus. Sperm density after treatment by swim-up and washing of sperm was lower than in the pretreatment specimens, but sperm motility, motile sperm count, and conception rate after treatment were higher.

Ninety fetal Doppler echocardiographic examinations were performed on 72 normal fetuses and 5 with congenital heart disease [2 pulmonary stenosis (PS), 1 pulmonary atresia (PA), 1 tetralogy of Fallot (TOF) and 1 endocardial cushion defect (ECD)] at 16 to 40 weeks of gestational age. The maximum transmitral (MVMax), transtricuspid (TVMax), transaortic (AVMax) and transpulmonary blood flow velocity waveforms (PVMax) were assessed. The detection rates for MVMax, TVMax, AVMax and PVMax in normal fetuses were 69.4%, 68.2%, 77.6% and 43.5%, respectively. MVMax, TVMax, AVMax and PVMax correlated well with gestational age, in the normal fetuses. However, there was no correlation between MVMax, TVMax, AVMax, PVMax and heart rate, in the normal fetuses, respectively. The TVMax/MVMax ratio was one and over in 53 of 55 normal fetuses (96.4%), and the PVMax/AVMax ratio was one and over in 11 of 25 normal fetuses (44%). In cases of PS, the TVMax was relatively low, but the PVMax was definitely high. The TVMax/MVMax ratios in cases of PS were 0.8 and 1.0, respectively. AVMax in a fetus with TOF was definitely low and markedly decreased in the case of ECD. Therefore, fetal Doppler echocardiography is a pertinent diagnostic tool which can be used to analyze cardiac hemodynamics in all fetuses, in utero.

To investigate the interrelation among endogenous catecholamines, prolactin and prostaglandin F2 alpha, we measured the plasma levels of dihydroxyphenylalanine (DOPA), norepinephrine (NE), catecholamine metabolites (3,4-dihydroxyphenylacetic acid [DOPAC], 3,4-dihydroxyphenylethyleneglycol [DOPEG], cyclic 3',5'-adenosine-monophosphate (c-AMP), prostaglandin F2 alpha (PGF2 alpha) and prolactin (PRL) in 119 patients, before, during and after a normal labor and delivery, and in the early puerperium. In late pregnancy, DOPAC concentrations were significantly increased, and reached peak values before the onset of labor in the group who went into spontaneous labor. The DOPA, NE and DOPEG levels remained unchanged before labor. The plasma concentrations of NE, c-AMP and PGF2 alpha were significantly increased during labor. There was a positive correlation between plasma NE and c-AMP (r = 0.584, p less than 0.001), and between NE and PGF2 alpha (r = 0.401, p less than 0.001) during labor. In contrast, plasma PRL significantly decreased during labor and immediately after delivery. There was a statistically significant inverse relationship between PRL and NE (r = -0.392, p less than 0.001) and between PRL and PGF2 alpha (r = -0.523, p less than 0.001) during labor, but there was no statistical correlation among PRL, DOPA and DOPAC. In conclusion, these data suggest that the dopaminergic activity in the maternal circulation increases before the onset of labor, and the PRL release from the maternal pituitary gland during labor is probably not controlled primarily by dopaminergic neurons and may be suppressed by other mechanisms, such as the stress of labor and/or the influence of PGF2 alpha.

Transvaginal Doppler color flow mapping was performed on 8 Japanese women (normal, 1; menopause, 2; uterine myoma, 1; endometriosis, 2; pregnant, 2). In all 8, bilateral uterine arteries and branches could be clearly identified in shades of blue and/or red. The color flows were abundant in the pregnant women. Transvaginal Doppler color flow mapping is expected to be an important diagnostic tool for assessing uterine arterial blood flows in physiologic and pathologic conditions of the pelvis.

In 20 infertile Japanese with polycystic ovary syndrome Shakuyaku-Kanzo-To was used to lower plasma testosterone levels and hence to induce pregnancy. The polycystic ovary was classified into two types; general cystic and peripheral cystic patterns. Plasma testosterone was decreased in 18/20 (90%) and 5/20 (25%) became pregnant. The plasma testosterone concentration in the case of the general cystic pattern was significantly higher than that of peripheral cystic pattern, and the pregnancy rate in those with the general cystic pattern was lower. The efficacy of Shakuyaku-Kanzo-To therefore seems to vary according to the type of polycystic ovary syndrome treated.

Ultrasound is an established method of confirming the presence of a hydatidiform mole in utero. However, in agreement with other investigations, we have often noted that the appearance of this entity is less specific than originally reported. To elucidate this, the ultrasonic patterns of 26 patients with trophoblastic disease and 27 with other entities were reviewed. Since there is a paucity of literature with regard to the response of choriocarcinoma to chemotherapy, determined by ultrasound, we simultaneously studied the relationship between findings of the ultrasonograms and the levels of hCG-beta-subunit in sera. We noted variable ultrasonic features in trophoblastic disease, and the sonograms of the choriocarcinoma have occasionally been confused with those of hydatidiform mole. If special attention is directed to the thickness of the placenta-like echoes as well as the sonolucent areas within it, the diagnosis of partial hydatidiform mole may be feasible. We also noted a rough correlation between ultrasonic appearances and the hCG-beta-subunit value, determined during chemotherapy for choriocarcinoma.

Ultrasonographic examinations were performed on 121 normal fetuses between 15 to 40 weeks of gestation to measure the fetal neck. The area (FN-A), circumference (FN-C), anteroposterior diameter (FN-APD) and transverse diameter (FN-TD) of the fetal neck correlated well with the gestational age, respectively. Ultrasonographic measurements of the fetal neck in utero are thus new parameters to evaluate the fetal growth and identify the abnormality of the fetal neck in utero.

The immunological effect has been studied of the non-specific immunopotentiator sizofiran (SPG) on patients with advanced uterine cervical cancer treated with radiation. Ten cases (study group: SPG group) were administered weekly 40 mg of SPG throughout the course of radiation and two weekly 40 mg during 12 months after radiotherapy. Nineteen cases (control group) were treated with irradiation alone. The lymphocyte count, the PHA index and the ratio of CD4 cells/CD8 cells were significantly reduced by radiotherapy, being observed the most remarkable decrease at post-radiotherapy. But in SPG group, these decreasing values were significantly smaller than in control group and the values showed a more progressive rise during the 12 month respectively. There was no significant difference in peripheral T lymphocyte; CD3, CD4, CD8. The NK cytotoxic activity showed a progressive rise during the 12 month period following a minimal change after radiotherapy. These results suggest that the SPG have some enhancing effect on the function of the lymphocytes.

We report a case in which bone metastasis from carcinoma corporis was treated by intra-arterial hypertension chemotherapy. The patient was a 53-year-old female whom we treated by intra-arterial hypertension chemotherapy of CDDP 80 mg and ADM 30 mg with Angiotensin II. Four weeks later she underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy and right common iliac lymph nodes resection. The response of intra-arterial hypertension chemotherapy was charged microscopically. About half (Grade I b) the carcinoma tissue was necrosed.

An accurate preoperative diagnosis of uterine adenomyosis is often difficult. We reviewed our experience with ultrasound evaluation of this pathological entity. Patients with histologically proven adenomyosis were studied to determine the usefulness of ultrasound for the preoperative diagnosis of this entity. In patients with adenomyosis, variable ultrasound patterns are seen, namely, enlargement of the uterus, irregular vesicular spaces within the myometrium, and an acoustically enhanced posterior wall of the uterus. However, leiomyoma had a similar echopattern. Based on five cases of histologically extensive adenomyoasis, an accurate diagnosis of adenomyosis proved feasible when ultrasonography showed all three ultrasonic patterns mentioned above, associated with a retroverted uterus or possible adhesions between the uterus and structures in close proximity, nodule or outgrowth in the region of the uterosacral ligaments or in combination, as frequently found in conjunction with external endometriosis. The ultrasonographical demonstration of endometrial cyst of the ovary may contribute to an accurate diagnosis of adenomyosis.

To confirm the change in serum CA 125 levels in cases of pregnancy, we measured serum CA 125 levels in 234 normal pregnant women, 40 postpartum women and 14 abnormal pregnant women (12 of IUFD and 2 of H. mole), using an RIA kit. The mean CA 125 level (+/- S.D.) and positive ratio (greater than 34U/ml) for pregnant women at 4-11 weeks of gestation were 65.0 +/- 77.3 U/ml and 64.6%, respectively, being the highest values in all the groups. On the contrary, those for pregnant women at 12-23 weeks of gestation were 22.3 +/- 10.6 U/ml and 12.7%, respectively, the lowest in all gestational groups. Changes in serum CA 125 levels in normal pregnant women showed a trend toward decrease, as gestation advanced. But the CA 125 levels for women at postpartum showed a slight trend toward increase. The mean CA 125 level (+/- S.D.) for 12 patients with IUFD was 392.5 +/- 275.8 U/ml and that for 2 patients with H. mole was 65.0 +/- 15.0 U/ml. Serum CA 125 levels for patients with IUFD were higher than that in cases of normal pregnancy. When utilizing CA 125 as a marker for ovarian cancer, the influence of pregnancy must be considered. And it indicates that CA 125 can be used as an aid to the diagnosis of IUFD in serous cases.

Dihydroxyphenylalanine (DOPA), dopamine (DA) and norepinephrine (NE) levels were measured in matched samples of maternal plasma (MV), umbilical arterial (UA) and venous (UV) blood of 25 normal infants born following an uncomplicated vaginal delivery. Levels in maternal plasma in the preterm period (36-40 weeks of gestation) and in 20 non-pregnant control subjects were also determined. DOPA and NE concentrations in the maternal vein at delivery were markedly higher than findings in the preterm period. The levels of DOPA and NE in the umbilical artery were significantly higher than those in the maternal vein at delivery. The DOPA levels in umbilical cord plasma showed arteriovenous differences indicating a net distribution of DOPA from the fetus to the mother. These data strongly suggest that the high DOPA levels in cord blood originate mainly from the fetus.

To investigate the histogenic and cytogenic localization of CA 125 in patients with adenomyosis, sections from 8 adenomyosis cases were expressed with monoclonal anti-CA 125 antibodies. Consequently, CA 125 proved to be present on the glandular epithelium localized in muscle layers of adenomyosis.

Mass screenings for uterine cancer have been done on 200,000 women in Shimane Prefecture, Japan, from 1972-1981. Up to 1978, a cotton-tipped applicator was used for sample procurement and since that time a wooden spatula type instrument has been used. A central, cytological diagnostic system has been used since 1979. The cytology activity index (CAI) was about 90 each year. The rate of second examination performed is about 60% for women requiring an accurate examination. Cancer detection rates increased from 0.05% to 0.12%, the false negative rate decreased, cytological and histological findings were in close parallel and the mortality rates have decreased. These positive results are attributed to the use of the wooden spatula and central diagnostic systems. By the mass screening for uterine cancer during these 10 years, 81 women were detected as having carcinoma in situ and 107 women as having invasive carcinoma in the histological findings. The number of first screenings has decreased gradually, but the number examined 6 times or more has increased. These results include that same women have tended to undergo the mass screening examination. In women over 50 y.o., particularly those 60 or over, the number screened was low, yet the incidence of invasive cancer exceeded that in other groups.

We have been treating advanced cancer of the uterine cervix with intra-arterial cisplatin (CDDP) and pepleomycin (PEP) (injected into the bilateral internal iliac artery), combined with radiotherapy and hysterectomy. Concomitant angiotensin II (AT II) administered by intravenous drip infusion was double the tumoral blood flow and thereby enhanced the efficiency of the intra-arterial chemotherapeutic regimen. But CDDP runs the risk of renal and myelotoxicity, so we studied renal dysfunction after treatment by examining serum and urinary beta 2-microglobulin (beta 2-m), and RBC, Hb, WBC, lymphocyte, and PLT.At 1 week after the treatment, evaluation of the histological effects showed, Grade IIb: 72.7% (8/11 cases). Serum beta 2-m was within normal limit and not changed. Urinary beta 2-m levels increased to abnormal levels at 1 and 2 weeks after treatment, and fell to normal levels at 3 weeks after treatment. RBC, Hb, WBC, lymphocyte, and PLT fell most at 3 weeks after treatment and then increased slowly. This suggests that hypertensive intra-arterial chemotherapy (CDDP) impaired kidney and bone marrow, mildly and reversibly, and its appropriate interval is about 4 weeks.

The hypoosmotic swelling test was done on 74 infertile men, 7 patients who achieved pregnancy by AIH (AIH group) and 10 fertile men and the usefulness of its test was assessed. 1) The rate of total swollen sperm and that of g type swollen sperm from infertile men were significantly lower than rates in the patients in the AIH group and fertile men. 2) There were significant but weak positive correlations between semen analysis (total sperm concentration, motility, motile sperm concentration) and hypoosmotic swelling test results (total swollen sperm, g type swollen sperm). 3) When the cut off value of the rate of total swollen sperm and g type swollen sperm was set at 42% and 14%, respectively, rates were above the cut off value except for g type swollen sperm in patients in the AIH group.

In mass screening tests for uterine cancer carried out Shimane Prefecture, we used three different scraping methods. This summary is a report of a comparison of the findings with each method. Results are as follows: From 1973-1982, 214, 798 Japanese women were examined in mass screening tests. Among the 42, 443 examined using a cotton tipped applicator, there were 15 (0.035%) with mild dysplasia, 8 (0.019%) with severe dysplasia, 6 (0.014%) with carcinoma in situ and 8 (0.019%) with invasive carcinoma. In 38,106 women examined using the spatula, 25 (0.066%) had a mild dysplasia, 10 (0.026%) a severe dysplasia, 18 (0.047%) a carcinoma in situ and 26 (0.068%) an invasive carcinoma. In 134,249 examined using a cotton tipped applicator plus colposcopy, 283 (0.211%) had a mild dysplasia 108 (0.080%) a severe dysplasia, 57 (0.042%) a carcinoma in situ and 78 (0.058%) an invasive carcinoma. Thus, the use of a cotton tipped applicator plus colposcopy leads to higher rates of detection of mild and severe dysplasia. In the group with a negative Papanicolaou smear and for whom the cotton tipped applicator plus colposcopy was used, there were 214 with a mild dysplasia, 65 with a severe dysplasia, 11 with a carcinoma in situ and 7 with an invasive carcinoma. The combination of cotton tipped applicator and colposcopy proved to be the most effective for mass screenings for uterine cancer, as the detection rates for severe dysplasia and carcinoma in situ were higher and there were fewer incidences of false negative results.

The relative frequencies of various sonographic patterns and features of pelvic inflammatory disease (PID) were examined in retrospective analyses of sonograms in 36 proven cases. The original sonographic reports correctly predicted PID in 34/36 patients (sensitivity = 94.4%). Two cases were found to be tubo-ovarian abscess although at first they were reported to be ovarian neoplasia. The most frequent finding was dilatation of the fallopian tube (72.2%). String sign within the dilated tube that would reflect increased interface within the endosalpinx was found in 50.0%, fluid collection in the Douglas' pouch in 47.2%, which was confirmed by the culdocentesis and aspiration in 16 cases, and/or tumor formation at the adnexal region in 38.9%. These findings were characteristic but not specific in PID. Careful sonographic scrutinization should improve the diagnostic accuracy of PID in patients with low abdominal pain, high temperature and low back pain.

Intraoperative and postoperative complications related to CO2 laser conization and cold knife conization were compared. From 1980 to 1984 66 patients were hospitalized for cold knife conization, the mean operative time was 28.1 minutes, all patients had epidural anesthesia, and the mean time of admission was 6.8 days. Three percent of cases had infections, the mean intraoperative hemorrhage was 75 ml, and the rate of remaining foci of neoplasia was 18.2%. Meanwhile there were 116 patients hospitalized for CO2 laser conization from 1985 to 1987. The mean operative time was 15.6 minutes, 15.5% of cases had local anesthesia, the mean time of admission was 0.6 days. Zero percent of cases had infections, 0% of cases had postoperative cervical stenosis, the mean intraoperative hemorrhage was 75 ml, and 29.5% of cases had remaining foci of neoplasia. There was no significant difference in hemorrhage amounts at hysterectomy following conization either method. Thus, in our experience, CO2 laser conization is more effective for clinical diagnosis and treating of cervical intraepithelial neoplasia.