[Show abstract][Hide abstract] ABSTRACT: Pregnancy in patients with Parkinson disease is a rare occurrence. To the best of our knowledge, the effect of pregnancy as well as treatment in genetically confirmed autosomal recessive juvenile parkinsonism (ARJP) has never been reported. Here, we report the first case of pregnancy in a patient with ARJP associated with a parkin gene mutation, ARJP/PARK2.
A 27-year-old woman with ARJP/PARK2 was diagnosed as having a spontaneous dichorionic/diamniotic twin pregnancy. Exacerbation of motor disability was noted between ovulation and menstruation before pregnancy as well as during late pregnancy, suggesting that her parkinsonism might have been influenced by fluctuations in the levels of endogenous sex hormones. During the organogenesis period, she was only treated with levodopa/carbidopa, although she continued to receive inpatient hospital care for assistance in the activities of daily living. After the organogenesis period, she was administered sufficient amounts of antiparkinsonian drugs. She delivered healthy male twins, and psychomotor development of both the babies was normal at the age of 2 years.
Pregnancy may worsen the symptoms of ARJP/PARK2, although appropriate treatments with antiparkinsonian drugs and adequate assistance in the activities of daily living might enable successful pregnancy and birth of healthy children.
[Show abstract][Hide abstract] ABSTRACT: A 27-year-old female patient underwent cesarean section and a postoperative hematoma occurred at the site of the uterine incision. The patient underwent relaparotomy to remove the hematoma. Four days later she developed a fever of over 39 degrees C and an abscess had formed at the site. Despite therapy with several antimicrobial agents, her fever persisted. Consequently, she underwent transvaginal abscess drainage, after which she promptly became afebrile. Mycoplasma hominis was considered to be the primary causative organism. There are two reasons that could explain why the wound infection became serious: (i) M. hominis is resistant to several antimicrobial agents that are usually used to treat obstetric infections; and (ii) a long time is required to identify the pathogen. In conclusion, M. hominis should be considered as a causative organism if an antimicrobial-resistant infection occurs at the surgical site after a cesarean section.
Journal of Obstetrics and Gynaecology Research 07/2009; 35(3):593-6. DOI:10.1111/j.1447-0756.2008.00993.x · 1.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: In this study, we investigated whether or not significant compatibility of human leukocyte antigen (HLA)-class II alleles exists between spouses with severe pre-eclampsia (PE) (including gestational hypertension, GH).
The HLA-class II genotypes were determined using a polymerase chain reaction-restriction fragment length polymorphism method. The number of incompatible alleles in 57 patient couples with severe PE (including GH) were determined, and compared with that in 74 control couples.
The number of patient couples and control couples with each number of mismatched alleles of the HLA-DR, -DQ, and -DP genotypes was as follows. The number of patient couples with zero, one, two, three, and four-allele mismatches was 41 (72.9%), and with five and six-allele mismatches was 16 (27.1%). On the other hand, the number of control couples with zero, one, two, three, and four-allele mismatches was 38 (51.4%), and with five and six-allele mismatches was 36 (48.6%). Thus, the number of patient couples with five and six-allele mismatches was significantly lower compared with that in control couples. The same result was obtained as regards the mismatched alleles of the HLA-DR, -DQ, and -DP phenotypes.
These findings suggest that significant compatibility of HLA-class II alleles between spouses is implicated in the genesis of PE (including GH).
American journal of reproductive immunology (New York, N.Y.: 1989) 08/2008; 60(1):75-84. DOI:10.1111/j.1600-0897.2008.00592.x · 2.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present study was conducted to examine the efficacy of immunotherapy for unexplained primary recurrent aborters using paternal lymphocytes.
Two hundred and twenty-eight recurrent aborters were prospectively followed up regarding immunotherapy. Of the 228 patients, 165 underwent immunotherapy using freshly prepared paternal lymphocytes and pregnancy outcome was analyzed. No mixed lymphocyte culture reaction-blocking antibodies (MLR-BAbs) were observed in these patients prior to vaccinations. Pregnancy outcome was also analyzed in such as those patients positive for MLR-BAbs and who did not undergo immunotherapy, and in patients negative for MLR-BAbs and who had become pregnant without immunotherapy.
Of the 140 newly pregnant patients after immunotherapy, the pregnancy continued successfully in 110 (78.6%), and the pregnancy continued successfully in 24 of 32 patients (75.0%) who were positive for MLR-BAbs. The success rate of pregnancy was 30.0% in 18 non-immunized patients. Thus, the success rate was significantly higher among patients with immunotherapy and patients positive for MLR-BAbs than in non-immunized patients, negative for MLR-BAbs.
Immunotherapy using paternal lymphocytes is considered to be effective for unexplained primary recurrent aborters negative for MLR-BAbs.
American journal of reproductive immunology (New York, N.Y.: 1989) 01/2008; 58(6):530-6. DOI:10.1111/j.1600-0897.2007.00536.x · 2.44 Impact Factor