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Biomedical subjects

T Y Kobara

Publications and source records attributed to T Y Kobara.

6 recordsLinked to original sources

Persistent ectopic pregnancy.

From 1982-1986, 625 tubal ectopic pregnancies were treated at the University of Hawaii School of Medicine Affiliated Hospitals. The percentage of cases in which the involved tube was preserved increased from 7% in 1982 to 26% in 1986. The presence of persistent trophoblastic tissue was diagnosed by elevated serum levels of the beta subunit of human chorionic gonadotropin (beta-hCG) after conservative surgery in four patients. Three of the four patients developed intra-abdominal hemorrhage and required laparotomy. One patient remained asymptomatic despite elevated beta-hCG levels, which disappeared 60 days after surgery. Evaluation of histologic slides demonstrated persistent intraluminal trophoblastic tissue without invasion in two patients, and extraluminal invasion into the tubal wall in one patient. The use of postoperative serial beta-hCG titers might facilitate recognition of this complication in time to prevent further tubal damage and hemorrhage.

Adult

Primary squamous cell carcinoma with its spindle cell variant in the endometrium. A case report and review of literature.

A case of squamous cell carcinoma of the endometrium in a 72-year-old woman is presented. A review of the previous 28 cases of endometrial squamous cell carcinoma (ESCC) that are adequately substantiated in the literature revealed several misconceptions about this rare tumor: the association with pyometra is not as frequent; the lesion does occur in premenopausal women; squamous metaplasia of the endometrium is not always coexistent; and malignant transformation of squamous metaplasia to ESCC has never been convincingly demonstrated. In the current case, a focal sarcomatoid spindle-cell tumor was associated with typical ESCC; however, light and electron microscopic examinations provided convincing evidence that the tumor was composed solely of ESCC. Ultrastructure of the spindle-cell tumor revealed it to be essentially identical to that of a spindle-cell variant of squamous cell carcinoma reported previously.

Aged

Office termination of pregnancy by "menstrual aspiration".

A program of office menstrual aspiration was initiated in our institution in 1972. Since that time 1,443 patients have been admitted into the study. These patients were evaluated by age, marital status, gravidity, repeat pregnancy terminations, complications, and detailed tissue analysis as well as contraception utilized at the time of conception and following counseling after the procedure. A majority of these patients were less than 25 years old and single; 28% had had a previous termination and 51% a previous pregnancy. Pathologic evaluations revealed Arias-Stella reaction in 78%. When these data were compared to those of a similar group of women whose pregnancies were terminated in the hospital by suction curettage, it was found that the office procedure is comparatively safe and should therefore be the therapy of choice.

Abortion, Induced

Rapid hCG-specific radioimmunoassay for menstrual aspiration.

Fifty-one women with missed periods ranging from 5 to 14 days who suspected a pregnancy underwent an aspiration curettage with a flexible soft-tipped cannula attached to a Karman-type syringe. Sera from these women were measured for human chorionic gonadotropin (hCG) by a rapid 2-hour solid phase radioimmunoassay using an antibody with a specificity for the beta subunit of hCG. The sensitivity and specificity of this assay insured detection of bCG with 100% accuracy at the time of the missed period. Of the 51 women, 33 (64.7%) were found to have hCG in their serum, and 29 (56.8%) had histologic evidence diagnostic of pregnancy.

Abortion, Induced