ADVANCES IN OBSTETRICS AND GYNECOLOGY
Online ISSN : 1347-6742
Print ISSN : 0370-8446
ISSN-L : 0370-8446
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Volume 55, Issue 2
Displaying 1-8 of 8 articles from this issue
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ARTICLES
Original
  • Clinical management of deep fungal infection in obstetrics and gynecology
    Tsugio FUKUNAGA, Satoru MOTOYAMA, Mari CHIJINA, Shinya HAMANA, Masashi ...
    Article type: Original
    Subject area: ARTICLES
    2003 Volume 55 Issue 2 Pages 161-166
    Published: 2003
    Released on J-STAGE: June 24, 2003
    DOIhttps://doi.org/10.11437/sanpunosinpo.55.161
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    Recently, there is an increased incidence of immunocompromised patients in medical fields. Frequent use of antibiotics, oncostatics, immunosuppressants and indwelling catheters lead to the causation of deep fungal infection. Deep fungal infection is fatal hence the proper diagnosis, management and prevention are of utmost importance.
    In the gynecologic department of our institution, we had 109 cases that showed recalcitrant exothermic reaction to antibiotics. CAND-TEC and FUNGI-TEC, which detect fungal antigen in the blood, were utilized. The treatment modality was determined in relation to the degree of severity of fungal infection based on the results obtained. The cut-off values used in this study for CAND-TEC and FUNGI-TEC were (4+) and 11.0 pg/ml, respectively. If the results were above the given values, they were categorized as serum positive indicative of an existing deep fungal infection.
    Comparison was made between serum positive and serum negative groups with regards to age, malignancy or benign disease, catheter use, leukocyte count, and c-reactive protein (CRP) values. In the serum fungus antigen positive group, 8.7% of the cases had benign diseases compared to 32.5% in the serum fungus antigen negative group. The difference was statistically significant (P<0.05). In the serum fungus antigen positive group, leukopenia of --4500/mm3 (52.1%) was significantly higher than that (12.5%) of antigen negative group (P<0.05). Moreover, the rate of death within one month from serum positivity (39.1%) in the serum fungus antigen positive group was higher than that (15.0%) in the serum fungus antigen negative group (P<0.05). This was also statistically significant.
    The investigation of existence of systemic fungal infection with the use of our institution's protocol was noted to increase the efficacy of therapy to 68.0% as compared to 35-50% effectivity of reported conventional therapy.[Adv Obstet Gynecol, 55 (2) 161-166, 2003 (H.15.5)]
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  • New method for estimation of body fat mass in pregnant women using bioelectric impedance analysis with compensation for weight of fetal component
    Yasuo UEDA, Motoyoshi MARUO, Yoshihiko ASHITAKA, Yuko KITAHARA, Yuka H ...
    Article type: Original
    Subject area: ARTICLES
    2003 Volume 55 Issue 2 Pages 167-177
    Published: 2003
    Released on J-STAGE: June 24, 2003
    DOIhttps://doi.org/10.11437/sanpunosinpo.55.167
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    This study investigated the application of bioelectrical impedance analysis (BIA) with a compensation for the fetal component weight to estimate the body composition of pregnant women.
    Methods: The subjects consisted of 487 pregnant women divided into 4 groups and examined as follows : 1) comparison between various compensating methods using the fetal component weight (sum of fetal, placental and amniotic fluid weights) or the fundus length, 2) the influence of non-pregnant maternal constitution and gestational edema, 3) comparison between the estimated fat mass (FM) values obtained by BIA and those by DXA, and 4) the estimation of maternal FM changes during normal pregnancy. The examinations in groups 1) and 2) were performed by estimating the differences between the maternal FM values of immediately before labor and 4 days postpartum. Measurement of the maternal FM was performed using a BIA body fat analyzer (TBF-410) as well using DXA (XR22) in some postpartum cases. Additionally, changes in maternal FM during pregnancy were estimated by measuring the maternal FM in 16 weeks of pregnancy and immediately before labor using BIA.
    Results: In the SFD and HFD groups, the differences between the maternal and puerperal FM were -0.8~+0.6kg when the gestational month, gestational week and the fundus length were used for compensation. The difference was reduced to -0.3~+0.3kg when the fetal weight and a combination of the fetal and amniotic weight were used for compensation. The FM values obtained using BIA were well correlated with those obtained using DXA (r=0.875[p<0.001]) . In the gestational edema group, the same correlation was observed. The regression lines between the values before labor and on postpartum day-4 are described by the equations y=0.97x+0.64 for normal pregnancy, y=0.87x+2.21 for all gestational edema, y=0.74x+3.46 for generalized edema, y=0.55x+8.79 for generalized edema in the obese group and y=1.04x-0.25 for gestational edema other than generalized edema in the obese group. The increase in maternal FM during pregnancy was 3.1±1.7 kg in the underweight group, 2.2±2.1 in the normal-weight group and 0.2±2.4 in the overweight group.
    Conclusion: New method of measuring maternal FM using BIA was established, and our results clearly showed that appropriate values were obtained in all groups except for women with generalized edema in the overweight group. This method may be useful for routine medical check-up of pregnant women as a qualitative method for analyzing maternal weight.[Adv Obstet Gynecol, 55 (2) : 167-177, 2003 (H.15.5)]
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Clinical report
  • Genital chlamydial infection in the female population of Shiga prefecture
    Koji KUMAGAI, Daisuke AKISE, Ryuji HIRAI, Minoru UEKI, Yoshihiko HAYAS ...
    Article type: Clinical report
    Subject area: ARTICLES
    2003 Volume 55 Issue 2 Pages 178-183
    Published: 2003
    Released on J-STAGE: June 24, 2003
    DOIhttps://doi.org/10.11437/sanpunosinpo.55.178
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    A research group, funded by the Ministry of Health, Labor and Welfare, performed a surveillance of sexually transmitted diseases (STDs) in 9 model prefectures in 2001. It reported that genital chlamydial infection (GCI) was the most widespread STD, many cases of which were asymptomatic, and that the incidence of GCI in females was higher than that in males. Between June 2001 and May 2002, we collected cervical secretion specimens from the posterior vaginal vault of 480 women, living in Kohka or Gamoh county, who consulted the Kohka Public Hospital. We performed polymerase chain reaction (PCR) assay for Chlamydia trachomatis (Ct) . Of these 480 women, the highest positivity rate (17.8%) was recorded among subjects aged 15-19 years. Roughly, the younger the group age, the higher the positivity rate. Among all 480 women tested, the positivity rate in different towns ranged between 0.0% and 13.9%. Women who were positive for Ct had several complaints such as vaginal discharge (23.3%), lower abdominal pain (43.3%), atypical genital bleeding (6.7%), or infertility (3.3%). However, some of them (23.3%) did not have any symptoms. Based on these findings, we emphasize that clinicians should conduct Ct detection tests for females under 40 years whenever possible, even if the women has no symptoms. [Adv Obstet Gynecol, 55(2) : 178-183,2003 (H.15.5)]
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  • Pharmacokinetic and clinical evaluations of effectiveness of cefazolin for prevention of early-onset neonatal sepsis
    Hidetoshi YAMASHITA, Kazunori TAMAI, Takahisa USHIROYAMA, Minoru UEKI
    Article type: Clinical report
    Subject area: ARTICLES
    2003 Volume 55 Issue 2 Pages 184-190
    Published: 2003
    Released on J-STAGE: June 24, 2003
    DOIhttps://doi.org/10.11437/sanpunosinpo.55.184
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    We studied the efficacy of treatments for group B streptococcus (GBS) carriers during pregnancy and the utility of cefazolin (CEZ) for prevention of early-onset neonatal sepsis by pharmacokinetics. We carried out screening for GBS during pregnancy, and GBS carriers were treated with oral ampicillins and vaginal disinfection. Forty-one pregnant women with rupture of membranes were administered of drip infusion 1g of CEZ for 60 minutes every 12 hours during labor. The concentrations of CEZ were measured by high performance liquid chromatography (HPLC) . Data were analyzed using simulation curves drawn by the two-compartment open model and calculated with WinNonlin®(Ver. 3.1) . Following rupture of membranes, GBS was isolated in 4 cases (9.8%). One patient in whom GBS was isolated was treated during pregnancy, but GBS was isolated again. The other 3 patients remained free from GBS during pregnancy. The theoretical concentration of CEZ in umbilical cord plasma was higher than 6.25 µg/mL 5.6 hours after administration, and in amniotic fluid (gastric fluid) the level reached 6.25 µg/mL at 1.7 hours and gradually increased over 11hours. This concentration was markedly higher than the reported MIC90's of CEZ against E. coli, including ampicillin-resistant E. coli and GBS. No infectious complications were observed in newborns after the prophylactic use, but the efficacy of GBS screening and prophylactic treatments during pregnancy in preventing GBS infections remains uncertain. Pharmacokinetic analysis demonstrated that prophylactic treatment by CEZ during labor may be a useful regimen for prevention of early-onset neonatal sepsis by GBS and E. coli.[Adv Obstet Gynecol, 55 (2) : 184-190, 2003 (H.15.5) ]
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TRANSACTIONS of SECTIONAL MEETINGS
Endocrinology & Reproduction(in the 107th Meeting of the OBSTETRICAL GYNECOLOGICAL SOCIETY OF KINKI DISTRICT JAPAN)
"Endoscopy in infertility"
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