[Study on management of low potential malignancy ovarian tumors].

Thirty-six patients with low potential malignancy ovarian tumors were treated at our hospital from 1972 to 1986. Of these, 80.6% were classified as stage I, 5.6% as stage II, and 13.9% as stage III. Sixteen patients were treated by simple total hysterectomy and bilateral salpingo-oophorectomy, 15 patients by unilateral salpingo-oophorectomy, 2 patients by enucleation of the tumor, and 3 patients by exploratory laparotomy. In stage I no difference between the survival rates for the conservative therapy group and the radical therapy group was seen. Postoperative radiation therapy was given to 4 patients with dysgerminoma, and chemotherapy was given to 13 other patients. The five-year survival rate for stage I was 91.7%, better than for stage I malignant ovarian tumors, which was 78.9%. But the five-year survival rate for stage II and stage III was 0%. Analysis indicated that: 1. Prognosis of stage I patients is so good that treatments may be done in consideration of the patient's fertility. 2. The importance of adequate postoperative treatment and of strict follow up to guard against recurrence of malignancy is important in patients with stage II or stage III disease.

[Effect of nicotine on uterine blood flow and antagonistic effect of prostaglandin I2 derivative (OP-41483) in pregnant ewes].

In order to elucidate the mechanism of the detrimental effect of smoking on uteroplacental circulation in pregnant women, and to confirm the protective effect of PGI2 derivative (OP-41483) against the effect, hemodynamic responses to various doses of nicotine infusion (0.25-1.0 mg/min) were measured before and during the OP-41483 infusion in chronically instrumented pregnant ewes. Moreover, the isometric tension responses of spiral strips of sow uterine arteries to the nicotine and norepinephrine perfusion were also measured using an in vitro technique. The results were as follows: Maternal mean arterial blood pressure (MAP) and the cardiac output were increased by the intravenous infusion of various doses of nicotine; however the uterine blood flow (UBF) decreased consistently in a dose-dependent fashion, and it decreased 20.4% from the control level following the infusion of 1.0 mg/min nicotine, suggesting a detrimental effect on the fetus. During the infusion of OP-41483 (25 micrograms/min), nicotine induced MAP increases were suppressed at all test doses and the decrease in UBF was lessened by 22% of control delta UBF on doses of 1.0 mg/min nicotine. In the muscle chamber, the tension increase in uterine artery strips of nonpregnant sows to various nicotine concentrations (10(-7)-10(-4) M) were suppressed by the preliminary treatment with phentolamine (0.1 mg/min), and the responses to norepinephrine were also suppressed by the preliminary treatment with a low concentration of nicotine (10(-6) M) in the buffer bath.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of sex steroid hormones in relative refractoriness to angiotensin II during pregnancy.

Normal human pregnancy is associated with significant vascular refractoriness to the pressor effects of infused angiotensin II, and in women destined to develop pregnancy-induced hypertension, this refractoriness is lost several weeks before the onset of hypertension. The plasma concentrations of sex steroid hormones gradually increase throughout pregnancy. In the present study, the effect of infusion of 17 beta-estradiol (E2), progesterone, or 5 alpha-dihydroprogesterone on the pressor response to infused angiotensin II (0.002 to 0.1 micrograms X min-1 X kg-1) was evaluated in eight unanesthetized and chronically instrumented nonpregnant ewes. Pressor response to infused angiotensin II (0.02 to 0.1 micrograms X min-1 X kg-1) was significantly suppressed by a 60-minute infusion of E2 (0.8 micrograms X kg-1), whereas infusion of progesterone (4 micrograms X min-1 X kg-1) or 5 alpha-dihydroprogesterone (0.8 micrograms X min-1 X kg-1) did not affect the pressor response. Neither the acid-base status, plasma renin activity, nor serum electrolytes were altered by the administration of E2 or progesterone. These results indicate that E2 may play an important role in the refractoriness to infused angiotensin II during pregnancy, and that this refractoriness by E2 is not mediated by changes in chemoreceptor reflex, renin-angiotensin system, or serum electrolytes, but more likely by the changes in the characteristics of the vascular wall.

IgG subclasses of anti-A and anti-B antibodies bound to the cord red cells in ABO incompatible pregnancies.

IgG subclasses were determined in 138 A or B infants weighing over 2,500g, born to O mothers. Direct antiglobulin test (DAT) was positive in 43 infants and negative in 95 with anti-A and/or anti-B antibodies detected by heat elution test. In 59 out of 131 infants without ABO hemolytic disease (ABO-HDN), no IgG subclass was detectable. In the 72 others, IgG1 was found in 29/72, IgG2 in 63/72, and IgG3 was not detected. In 7 infants with ABO-HDN, DAT was positive in 4 and negative in 3. In conclusion, in DAT-positive infants without HDN, IgG1 or IgG2 may be bound to erythrocytes, but the amount of IgG1 is too small to cause hemolysis. In DAT-positive ABO-HDN the amount of IgG1 is sufficient to cause hemolysis. In DAT-negative ABO-HDN, IgG3 is responsible for hemolysis, even though undetectable by DAT.

[The responses of isolated uterine arteries from pregnant sows to vasoconstrictive agents].

Isometric contractions of isolated uterine arteries, mesenteric arteries and the thoracic aortae of nonpregnant and pregnant sows were measured in a modified Krebs-Henseleit solution in order to investigate the characteristics of the uterine artery responsiveness to vasopressor substances during pregnancy. Contractile response (delta T) of the uterine artery from pregnant sow to angiotensin II(A II) was significantly smaller than that from nonpregnant animal. On the other hand, delta T of uterine artery from pregnant sow to norepinephrine (NE) was greater than that from nonpregnant animal. NE-induced delta T of preparations from both pregnant and nonpregnant sow were suppressed nearly to the same level following the treatment of phentolamine, or verapamil in the incubation medium of 2.5mM Ca2+. In the Ca2+-free (EDTA 1mM) incubation medium, the responses decreased to the minimum degree. These results imply that conspicuous refractoriness of the uterine artery to A II during pregnancy is due to the changes in the characteristics of the uterine vascular wall, and the enhanced responsiveness to NE of the uterine artery may be due to the increased sensitivity in alpha-adrenergic receptor on the vasculature with the increase in Ca ion influx.