bToxoplasmosis is a zoonosis caused by infection with Toxoplasma gondii and is prevalent worldwide under various climatic conditions. It is usually asymptomatic, but infection in pregnant women can pose serious health problems for the fetus. However, epidemiological information regarding toxoplasmosis in Japanese pregnant women is limited. This study aimed to determine the prevalence of anti-Toxoplasma antibodies, the primary infection rate, and the risk factors for toxoplasmosis in Japanese pregnant women. We measured anti-Toxoplasma antibody titers in 4,466 pregnant women over a period of 7.5 years and simultaneously conducted interviews to identify the risk factors for toxoplasmosis. The overall prevalence of anti-Toxoplasma antibodies was 10.3%, and it was significantly higher in women aged above 35 years. The rate of primary Toxoplasma infection during pregnancy was estimated to be 0.25%. A possibility of infection in the later stages of pregnancy was identified for those women who were not infected in the early stages. A history of raw meat intake was identified to be a risk factor related to toxoplasmosis. Therefore, to lower the risk of toxoplasmosis, pregnant women should refrain from eating raw and undercooked meat and maintain personal hygiene.
The purpose of our study was to examine the feasibility of long-term extrauterine incubation of an isolated premature fetus in artificial amniotic fluid with arteriovenous extracorporeal circulation. Two premature goat fetuses (age 120 and 128 days) were incubated in an isothermal artificial amniotic fluid incubator with arteriovenous extracorporeal membrane oxygenation via the umbilical vessels. We administered pancuronium bromide to suppress fetal movement and swallowing because movement and swallowing have been implicated in fetal deterioration during extrauterine fetal incubation. The fetuses maintained stable circulatory and respiratory parameters. The total incubation time was 494 and 543 h. The animals were then removed from the incubator and stimulated to initiate lung respiration. With ventilator support, both animals maintained stable blood-gas exchange and survived for more than 1 week. These results clearly indicate that umbilical arteriovenous extracorporeal membrane can effectively support extended extrauterine incubation of an isolated premature fetus.
The hypoestrogenic state induced by gonadotropin-releasing hormone agonists (GnRHa) has been shown to be effective in the treatment of uterine leiomyomas but to induce bone loss. Estriol has been described to be a weak and short-acting estrogen without an increased risk of endometrial proliferation and hyperplasia. The purpose of this study was to evaluate whether treatment of uterine leiomyomata with GnRHa plus oral estriol add-back therapy could prevent bone loss, without deteriorating the therapeutic effect of GnRHa. Twelve premenopausal women with symptomatic uterine leiomyomas were randomized to receive either leuprolide acetate depot alone at a dose of 3.75 mg s.c. every month for 6 months (non add-back group; n = 6), or GnRHa for 6 months plus oral estriol 4 mg/day for 4 months commencing with the third GnRHa injection (add-back group; n = 6). In the add-back group, leiomyoma volume, as measured by transvaginal ultrasound, decreased to 59.1% of baseline at 2 months of GnRHa therapy with no significant change in size during the remaining treatment period. In contrast, it decreased to 31.3% of pretreatment size at the end of treatment in the non add-back group. The levels of bone metabolic markers such as CrossLaps, deoxypyridinoline, osteocalcin and bone-specific alkaline phosphatase, increased significantly throughout the treatment in the non add-back group, whereas they were suppressed by the add-back therapy. The bone mineral density of lumbar spine (L2-L4) as measured by dual-energy X-ray absorptiometry decreased significantly by 7.5% at the end of treatment in the non add-back group, but did not change significantly in the add-back group. In conclusion, GnRHa plus estriol add-back therapy might be considered for long-term treatment of uterine leiomyomata.
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