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Understanding the hemoglobin switching regulation mechanism in extremely premature infants is particularly important for understanding the extrauterine adaptation of the infants. In this study, we sought to identify factors influencing oxygen affinity in fetal blood and neonatal blood and obtained these results. (1) Aging is required for hemoglobin switching. (2) Switching in premature infants (27 to 32 weeks) is delayed at least 3 weeks in comparison with full-term infants. (3) A delay in the switching of fetal hemoglobin to adult hemoglobin was confirmed in IUGR (intrauterine growth retardation) infants. However, there is a compensatory increase in 2, 3-DPG for adaptation after birth. (4) A delay in 2, 3-DPG increase was observed in RDS (respiratory distress syndrome) infants, and oxygen affinity remained high.

Objective We report a case of combined intra-abdominal and intra-uterine pregnancy from spontaneous conception, diagnosed and treated with laparoscopy in the first trimester. A revision of Studdiford criteria for diagnosis of an intra-abdominal pregnancy in heterotopic pregnancy is proposed for laparoscopic procedures. Case A 20-year-old woman conceived spontaneously and experienced an episode of abdominal pain at 5 weeks of gestation. Combined intra-abdominal and intra-uterine pregnancies were diagnosed and the intra-abdominal pregnancy was treated using a laparoscopic technique, in the first trimester. There were good fetal and maternal outcomes. Conclusion Less invasive diagnostic and therapeutic management of intra-abdominal pregnancy in early pregnancy should be employed to save the intra-uterine gestation of the heterotopic pregnancy. We propose modified Studdiford criteria for probable and definite laparoscopic diagnosis of primary abdominal pregnancy.

In this study, the changes in skin blood flow and skin temperature for healthy subjects and the difference in the distribution of the rhythms of skin temperature between healthy subjects and patients with Raynaud's syndrome were analyzed using laser Doppler flow meters, thermocouples and a thermographic system (thermal rhythmography) which is capable of displaying topograms of the power spectra of an arbitrary frequency range with respect to changes in skin temperature. The results showed that the periodic fluctuations of skin temperature may provide a useful index for autonomic nervous conditions, and thermal rhythmography could become a useful tool for the evaluation of autonomic dysfunction or for the preventive diagnosis of neuro-vascular diseases such as Raynaud's syndrome.

Thrombus occurs frequently in the placental chorionic lumen of patients with Pre-ecclampsia (EPH) gestosis, and participation of platelets is suggested in the pathology of the diseases. In the placental tissues, there is an antiplatelet aggregating factor which plays an important role in the maintenance of microcirculation in the placenta. The brush border membrane of the placental chorioepithe-lium plays the part of the vasoendothelium as it is the point of direct contact with the maternal blood flow in the chorionic lumen. It has already been confirmed that a strong inhibitory action on platelet aggregation is present in the vasoendothelium, and its main active mechanism is shown to be prostacyclin (PG I2) and ADP degrading by an ADPase-like activity which exists in edothelial membrane. Thus, it is quite possible that some inhibitory activity on platelet aggregation exists in the brush border membrane of placental chorioepithelium. We, therefore, investigated the presence of such an inhibitory activity on platelet aggregation as well as its properties using a fraction of the brush border membrane.

To elucidate the human placental L-lactate transport mechanism, we investigated L-lactate uptake by microvillous membrane vesicles (MMV) prepared from full termed human placenta using the rapid filtration technique. 1. The transport of L-lactate into the MMV was not dependent on the Na+ electrochemical gradient (extravesicular greater than intravesicular). 2. The transport of L-lactate into the MMV was dependent on the H+ gradient (extravesicular greater than intravesicular) and this H+ dependent L-lactate uptake showed a tendency to overshoot. This overshoot disappeared with the addition of H+ ionophore (FCCP). 3. The initial rate of this H+ dependent L-lactate transport into the MMV exhibited saturation kinetics with respect to the L-lactate concentration: An apparent Km of 4.35mM and Vmax of 2.78n mol/mg protein/20sec were calculated. These results indicated that there existed a H+ and L-lactate transport system in human placental MMV.

Eleven of 157 twin pregnancies were complicated with polyhydramnios. Chorionicity, vascular anastomosis and insertion of the umbilical cord were analyzed with relation to polyhydramnios. 1. Polyhydramnios was found commonly in monochorionic placentation. 2. Vascular anastomosis was found in 40% of monochorionic polyhydramnotic placentas, which was lower than the anastomosis of monochorionic non-polyhydramniotic placentas. 3. The placentas with hydramnios had a higher incidence of abnormal umbilical insertion (marginal or velamentous insertion). These data indicate that incompetent vascular connections between the two fetoplacental circulations may be the pathogenesis of polyhydramnios.

Cefodizime (THR-221, CDZM), a new antibiotic, was studied pharmacokinetically and clinically. The results obtained are summarized as follows: 1. Concentrations of CDZM in internal genital tissues were quite high after an intravenous infusion. 2. Clinical effects of the therapy with CDZM using intravenous infusion twice daily were evaluated in 1 patient with endometritis, 2 patients with pyometra, 1 patient with extragenital abscess and 1 patient with BARTHOLIN'S gland abscess. Clinical responses were good in all 5 patients. No side effects nor abnormal laboratory test values due to the drug were noted.

To clarify the role of placental brush border in the regulation of placental microcirculation, we investigated the platelet aggregation inhibition activity of placental brush border membrane vesicles (BBMV) and obtained the following results. 1. There was very strong platelet aggregation inhibiting activity in placental BBMV. In the 20-40 micrograms/ml protein concentration, the BBMV almost completely inhibited the platelet aggregation induced by ADP, arachidonic acid and collagen, and in the 100-150 micrograms/ml protein concentration, the BBMV almost completely inhibited the platelet aggregation induced by ristocetin. 2. There existed a very strong ADP degrading activity (ADPase activity) in the placental BBMV. The platelet aggregation activity of ADP was completely lost when ADP was preincubated with the placental BBMV. 3. The placental BBMV inhibited platelet malondialdehyde (MDA) production. With the 20 micrograms/ml and 100 micrograms/ml protein concentrations of placental BBMV, 22% and 65% of platelet MDA production was inhibited respectively.

A case is reported of a 34-year-old female who complained of an adult head-sized tumor in the pelvis and was treated with a high dose of CDDP. On the first look operation, it was found impossible to perform reduction surgery because of severe adhesion and peritonitis carcinomatosa. To introduce a high concentration of an anti-cancer agent into the tumor tissue, we administered CDDP intravenously, intraperitoneally and intra-arterially to the total amount of 1815 mg. After this high dose combination chemotherapy, a second look operation was performed and the tumor was seen to be reduced. The patient is now in remission and is being followed up as an out-patient. The clinical course of this case had decided for us which route would be the most effective and would have the least side effect, also, how much of a dosage can be administered as a maximum adoptive dose of an anti-cancer agent, and what kind of a second-line chemotherapy is effective against resistant cancer cells.