CO 2 laser conization for cervical intraepithelial neoplasia: a comparison with cold knife conization during pregnancy.

Intraoperative and postoperative complications related to CO2 laser conization and cold knife conization were compared. From 1980 to 1984, 66 patients were hospitalized for cold knife conization. The mean operative time was 28.1 minutes, all patients had epidural anesthesia, and the mean time of admission was 6.8 days. Three percent of cases had infections, the mean intraoperative hemorrhage was 66 ml, and the rate of remaining foci of neoplasia was 18.2%. There were 116 patients hospitalized for CO2 laser conization from 1985 to 1987. The mean operative time was 15.6 minutes, 15.5% of patients had local anesthesia, and the mean time of admission was 0.6 days. No patients had infection or postoperative stenosis, the mean intraoperative hemorrhage was 75 ml, and 29.5% of patients had remaining foci of neoplasia. There was no significant difference in hemorrhage amounts at hysterectomy after conization using either method. In the 2 pregnant patients, CO2 laser conization could be performed safely and did not affect pregnancy or delivery. Thus in our experience, CO2 laser conization is more effective for clinical diagnosis and treating of cervical intraepithelial neoplasia.

[Metastatic endometrial stromal sarcoma successfully treated by intra-arterial hypertension chemotherapy with CDDP and ADM].

We report a long-term survival case of metastatic endometrial stromal sarcoma. A 45-year-old woman with acute abdomen was operated at another hospital. Her uterine histology was endometrial stromal sarcoma. She came to our hospital to treat a metastatic endometrial stromal sarcoma. Endometrial stromal sarcomas were found in liver, spleen and lung. Intra-arterial hypertension chemotherapy was repeatedly performed. After this therapy, metastatic legion in the liver and the spleen disappeared on image studies and metastatic lesions in the lung grew smaller.

Clinical application of the swim-up and washing of human spermatozoa.

Artificial insemination with husband's semen is one of the treatments in cases of male infertility. A technique for swim-up and washing sperm is described. A special device was used for introduction of sperm into the uterus. Sperm density after treatment by swim-up and washing of sperm was lower than in the pretreatment specimens, but sperm motility, motile sperm count, and conception rate after treatment were higher.

[Effects and side effects of hypertensive intra-arterial chemotherapy (CDDP, PEP) in advanced cancer of the uterine cervix].

UNLABELLED: We have been treating advanced cancer of the uterine cervix with intra-arterial cisplatin (CDDP) and pepleomycin (PEP) (injected into the bilateral internal iliac artery), combined with radiotherapy and hysterectomy. Concomitant angiotensin II (AT II) administered by intravenous drip infusion was double the tumoral blood flow and thereby enhanced the efficiency of the intra-arterial chemotherapeutic regimen. But CDDP runs the risk of renal and myelotoxicity, so we studied renal dysfunction after treatment by examining serum and urinary beta 2-microglobulin (beta 2-m), and RBC, Hb, WBC, lymphocyte, and PLT. RESULTS: At 1 week after the treatment, evaluation of the histological effects showed, Grade IIb: 72.7% (8/11 cases). Serum beta 2-m was within normal limit and not changed. Urinary beta 2-m levels increased to abnormal levels at 1 and 2 weeks after treatment, and fell to normal levels at 3 weeks after treatment. RBC, Hb, WBC, lymphocyte, and PLT fell most at 3 weeks after treatment and then increased slowly. This suggests that hypertensive intra-arterial chemotherapy (CDDP) impaired kidney and bone marrow, mildly and reversibly, and its appropriate interval is about 4 weeks.

[A case of advanced uterine cervical cancer responsive to continuous intra-arterial chemotherapy using an implanted drug delivery system].

Selective intra arterial hypertensive infusion of CDDP (100 mg) and PEP (40 mg) with angiotensin II was performed in a 64 year-old housewife with inoperable uterine cervical cancer stage IVa and transitional cell cancer of bladder (grade 1-2). PEP at 5 mg/day was also administered for 20 days (total 100 mg) using an implanted Drug Delivery System through the left internal iliac artery combined with irradiation therapy. There were hardly any side effects due to this treatment except for a slight upper digestive tract disturbance and bone marrow suppression, and the cancerous lesion gradually regressed following this treatment. This case suggested the efficacy of intra-arterial infusion using an implanted Drug Delivery System for advanced uterine cervical cancer. There has been no sign of recurrence six months after this treatment.

[A case of carcinoma corporis by intra-arterial hypertension chemotherapy].

We report a case in which bone metastasis from carcinoma corporis was treated by intra-arterial hypertension chemotherapy. The patient was a 53-year-old female whom we treated by intra-arterial hypertension chemotherapy of CDDP 80 mg and ADM 30 mg with Angiotensin II. Four weeks later she underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy and right common iliac lymph nodes resection. The response of intra-arterial hypertension chemotherapy was charged microscopically. About half (Grade I b) the carcinoma tissue was necrosed.