ADVANCES IN OBSTETRICS AND GYNECOLOGY

Immunohistochemical studies were performed on laminin, type IV collagen, cathepsin-D and matrix metalloproteinase-9 (MMP-9) in adenomyosis compared with endometrial carcinomas and endometrial hyperplasia. The rate of staining for laminin in the basement membrane was 36.3% in well differentiated adenocarcinomas(G1), 28.9% in moderately differentiated lesions(G2), and 22.8% in poorly differentiated lesions(G3). Lack of basement membrane was observed even in endometrial hyperplasia (EH). The rate of staining was 96.5% in EH, and 69.3++% in atypical endometrial hyperplasia (AEH). Furthermore, lack or loss of staining for laminin was seen in adenomyosis with a rate of 32.9%. The rate of staining for type IV collagen was the same as that for laminin in endometrial carcinoma and endometrial hyperplasia, but in adenomyosis, the rate for type IV collagen was 43.9%, which was higher than that for laminin (p<0.05). Cathepsin-D was positive in 41.5% of G1, 51.6% of G2, 83.3% of G3 and 46.7% of adenomyosis. The positive rate of MMP-9 was 20.0% in G1, 25.0% in G2, 40.0% in G3 and 80.0% in adenomyosis. It was suggested that adenomyosis was similar to neoplastic disease with respect to basement membrane or extracellular matrix proteinase. [Adv. Obstet. Gynecol., 54 (2) : 71-79, 2002 (H.14.3)]

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We evaluated the clinical efficacy of Kyuki-chouketsu-in, a Japanese traditional herbal medicine, on restration of postpartum psycho-physical condition. We enrolled 171 women with normal delivery in Osaka Medical College Hospital and connected clinics. We randomly assigned them to two groups: a Kyuki-chouketsu-in treatment group (85 subjects; Kyuki-chouketsu-in 6.0 g/day) or an Ergometrine treatment group (86 subjects; Methylergometrine maleate 0.375 mg/day). We measured the uterine height, blood hemoglobin concentration, and total volume of milk secretion untill 6 day postpartum. Furthermore, we evaluated psychological condition using a questionnale. Kyuki-chouketsu-in significantly reduced the height of uterine fundus (8.9±2.4cm) compared with ergometrine (10.5±2.7 cm) at 5 days postpartum (p=0.0071). There was a significant difference (p=0.0025) in the change of blood hemoglobin concentration at 6 days from that of 1 day postpartum between the patients with kyuki-chouketsu-in therapy (+4.6±7.2%) and those with ergometrine (-1.57±7.3%). In volume of milk secretion, there were significant differences at 4, 5, and 6 day postpartum (p<0.05) between the patients with kyuki-chouketsu-in therapy and those with ergometrine. We observed higher incidence 2.1 times and 1.6 times of depressive mood and anxiety, respectively, after delivery in the ergometrine therapy group compared with kyuki-chouketsu-in therapy group. No adverse effect was observed. The results of our study demonstrate the beneficial effects of kyuki-chouketsu-in on the restration of postpartum physical condition and on stabilization of psychological status. Effects on well-being with this herbal medicine should be expected in the postpartum period. To further explore the properties of Kyuki-chouketsu-in, bio-pharmacological research and clinical trials are warranted. [Adv. Obstet. Gynecol., 54 (2) : 80-86, 2002 (H.14.3)]

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