[A case with non-gestational choriocarcinoma of the uterus].
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Biomedical subjects
Publications and source records attributed to S Hachiya.
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Cefpiramide (CPM) was administrated intramuscularly to 27 cases of gynecological infections to evaluate its clinical efficacy and safety and the following results wee obtained. CPM was effective to all the cases of gynecological infections, and excellent was seen in 14 cases and good was seen in 13 cases. CPM eliminated 75% of clinical isolates. Laboratory tests were performed to blood samples and functions of liver and kidney before and after CPM treatment. Elevation of GPT was observed in 2 cases but required no treatment.
Efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) was studied on gynecological infections. The results obtained are as follows: In the treatment of 31 cases of gynecological infections, the clinical efficacy of SBT/CPZ was assessed as excellent in 9 cases and effective in 22 cases. As for the bacteriological effects of SBT/CPZ, clinically isolated organisms were completely (100%) eradicated. In comparison with MICs of CPZ, SBT/CPZ was found to show a combined effect on Gram-negative and Gram-positive organisms in the order mentioned, but this effect was not observed against anaerobes. The combined effect of SBT/CPZ on beta-lactamase producing bacteria was also investigated in the same manner. As a result, SBT/CPZ was found to exert a combined effect on beta-lactamase strains of S. aureus, S. epidermidis, E. coli, B. catarrhalis and B. fragilis. The laboratory tests performed before and after administration of SBT/CPZ revealed rise in GOT and GPT values in 1 case, GPT values in 2 cases and eosinophil in 1 case. However, these rises were all mild and required no particular measures.
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Ceftazidime (CAZ) was studied for its transference into adnexa uteri and uterine tissues as well as for its effects and safety on gynecological infections. The results obtained are as follows: Peak levels of CAZ were obtained in the tissues of adnexa uteri and uteri at 15--30 minutes after one shot intravenous injection of CAZ 1 g, and relatively high concentrations were maintained for several hours. In the treatment of 33 cases of gynecological infections, the clinical efficacy of CAZ was assessed as excellent in 13 cases and effective in 20 cases. As for the bacteriological effects of CAZ, 95.5% of clinically isolated organisms were eradicated. The laboratory tests performed before and after administration of CAZ revealed rise in GOT, GPT values in 2 cases and eosinophilia in 1 case. However, these cases were all mild and required no particular measures.
A new cephamycin antibiotic, cefotetan, was administered intramuscularly to 45 patients with female genital infections including 2 cases with abscess of Bartholin's gland, 14 cases with endometritis, 23 cases with adnexitis and 6 cases with pelvic peritonitis. The daily doses of the drug were 1 to 3 g, with 2 g daily being the most frequent regimen. The treatment was given twice daily in most patients. All cases responded to the drug, and marked response was seen in 22 cases and moderate response in 23. The eradication rate for causative organisms was 64.3%. In 16 cases of S. faecalis, it was rather low at 37.5%. Neither side effects nor abnormalities in clinical laboratory findings attributable to the drug were seen.
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The following trial was conducted as a fundamental study in the application of piperacillin (PIPC) in the field of obstetrics and gynecology. A dose of 1 g was administered to 10 patients by intravenous injection and the concentrations of PIPC in the serum and the various tissues of the uterus were measured. This data was analyzed by the computer. 1. These concentrations were analyzed based on a two- or three-compartment model. We obtained the pharmacokinetic parameters and described the simulation curves. Correspondence was observed between the calculated and the actually determined concentrations. 2. PIPC was rapidly distributed to the tissues of the uterus and exhibited high concentrations. Transfer to these tissues correlated well with serum concentrations.
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The malignant ovarian cancer cells removed on operation were cultured and exposed to the anticancer drug (either 5-fluorouracil or mitomycin C) for 30 minutes or 24 hours respectively. The activity of the LDH and LDH isozyme in the culture medium was measured. Also the activity of the LDH and its isozyme was determined in the patients undergoing chemotherapy with either 5-fluorouracil or mitomycin C. The results are summarized as follows: 1) The LDH isozyme pattern of the culture medium prior to exposure of malignant cells to the anticancer drugs was classified into 2 types i.e., M type which is characterized by a predominance of LDH4,5 (referred hereinafter to as group M) and H type with a predominance of LDH1,2 (referred to as group H). 2) Of 11 cases studied, 7 were classified as group M and 4 were categorized as group H. there was no distinct relationship between histological type and LDH isozyme pattern. 3) In the group with exposure to anticancer drugs the total LDH activity in both group H and group M was lower than in the control group. Control specimens in group H showed increased total LDH activity. 4) The H/M ratio based on subunits of LDH isozyme was virtually unchanged by exposure to anticancer drugs in group M, while rapidly lowered by the same treatment in group H. 5) The death rate of malignant cells as estimated by dye exclusion methods was higher with exposure to anticancer drugs than without it. 6) The serum LDH was more markedly lowered after treatment in group H than in group M. However, there was no substantial difference between the two groups in M/H ratio before and after treatment.
The cellular origin and the mechanism of steroidogenesis were investigated on one case of recurrent type of granulosa cell tumor. Light and electron microscopic findings indicated the cell component was non-luteinized granulosal element and neither fibroblastic nor thecal ones. These tumor cells were cultured as monolayers and steroids (estradiol-17 beta, dehydroepiandrosterone, progesterone and 17-hydroxyprogesterone) secreted in the medium were measured by radioimmunoassay. Despite low level of estrogen, progesterone or testosterone in the serum or urine preoperatively, the estradiol-17B level in the culture medium after three days of cultivation reached over 900 pg/ml. In both light and electron microscopic observations of the cultured cells, morphological characteristics of activation of steroidogenesis were noted. It is concluded that this type of granulosa cell tumor consisting exclusively of the granulosa element without thecal one has the activity of estrogen production.
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