We report a successful pregnancy in a woman who at the age of 31years received chemotherapy for mucinous cystadenocarcinoma of the right ovary. She was treated with multiple chemotherapy including cis-platinum, cyclophosphamide, adriamycin, and oral melphalan. She had microscopic residual cancer at the opposite ovary at second-look laparotomy. She developed secondary amenorrhea with symptoms of menopause after commencing treatment which persisted on its completion. Biochemical investigations were consistent with ovarian failure, which was assumed to be chemotherapy-induced. She was given hormonal replacement therapy with a conjugated equine estrogen/medroxyprogesterone acetate combination, resulting in regular withdrawal bleeding. The patient conceived 5 years after completing chemotherapy and gave birth a normal infant at term.
Amenorrhea ; Cisplatin ; Cyclophosphamide ; Cystadenocarcinoma, Mucinous ; Doxorubicin ; Drug Therapy* ; Female ; Hemorrhage ; Humans ; Infant ; Laparotomy ; Melphalan ; Menopause ; Neoplasm, Residual ; Ovarian Neoplasms ; Ovary ; Parturition ; Pregnancy*

This study was undertaken to investigate an involvement of nitroxergic innervation in gastric smooth muscle of rat. Isometric tension study, the measurement of single cell length, NADPH diaphorase stain of smooth muscle layers and neuronal nitric oxide synthase (nNOS) western blotting were performed. Sodium nitroprusside (SNP), a nitric oxide donor, relaxed the muscle strips precontracted by acetylcholine (ACh) in a concentration-dependent manner. Pretreatment of L-arginine decreased the contraction induced by electric field stimulation (EFS). Pretreatment of NG-nitro-L-arginine methyl ester (L-NAME), a NOS inhibitor, increased the EFS-induced contractions. LY 83583, a guanylate cyclase (GC) inhibitor, reversed the inhibitory actions of L-arginine on the muscle contractions. The effects of L-Arginine, L-NAME and LY 83583 on ACh-induced contractions were not significant. L-arginine reduced the EFS-induced contraction in circular muscle, whereas L-NAME enhanced the EFS-induced contraction in longitudinal strips. By EFS, the phasic contractions appeared approximately 20~25 seconds later. L-NAME significantly shortened the delay time to about 2~3 seconds. In single cell study, ACh contracted gastric smooth muscle cells, SNP relaxed the cells, and the latter also inhibited the ACh-induced contraction. LY 83583 enhanced the ACh-induced contraction and antagonized SNP-induced relaxation. NADPH diaphorase activity was assessed by a histochemistry, nitroblue tetrazolium (NTB) staining. Positive staining was observed in both circular and longitudinal muscle layers. L-arginine increased the staining, while L-NAME decreased the staining. Western blotting for nNOS proved the presence of nNOS in rat gastric smooth muscle. EFS and additional Ca2+ increased nNOS protein expression. These results suggest that in rat stomach, both circular and longitudinal muscle layers are innervated with nitroxergic nerves which relax the gastric smooth muscle via NO-cGMP pathway.
Acetylcholine ; Animals ; Arginine ; Blotting, Western ; Guanylate Cyclase ; Humans ; Muscle Contraction ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; NADPH Dehydrogenase ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase Type I ; Nitroblue Tetrazolium ; Nitroprusside ; Rats* ; Relaxation ; Stomach ; Tissue Donors

OBJECTIVE: Our purpose was to determine the effect of epidural analgesia on the first phase of labor and mode of delivery of nulliparous women. METHODS: We studied 170 nulliparous women at near-term who underwent spontaneous and induced labor at the Department of Obstetrics and Gynecology, Hanyang University Hospital from January 1999 to May 2000 prospectively. Eighty women who were received epidural analgesia for pain relief were compared to ninety women as control group. Cesarean delivery was performed when indicated. RESULTS: The demographic characteristics of the two groups were similar with respect to age, height, weight, gestational weeks, and gravida. The two groups had the same cervical dilatation at the time of analgesia. There were no statistically significant difference between two groups. The length of the first phase of labor was same between two groups(558.4+/-50.4 min. vs 452.1+/-46.7 min.). There were statistically significant differences in the instrument delivery and cesarean section rate between two groups(43 vs. 32, 8 vs. 16 respectively). CONCLUSIONS: Epidural analgesia provides safe and effective intrapartum pain control and may be administered without undesirable effects on the first phase of labor and delivery.
Analgesia ; Analgesia, Epidural* ; Cesarean Section ; Female ; Gynecology ; Humans ; Labor Stage, First ; Labor, Induced ; Obstetrics ; Pregnancy ; Prospective Studies