bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Ischemic Injury during Liver Procurement from Non-Heart-Beating Donors
Authors: García-Valdecasas J.C. , Tabet Jeanine , Valero R. , Deulofeu R. , Taurá Pilar , Rull R. , Capdevila L. , Cifuentes A. , González F.X. , Net M. , Beltran J. , López-Boado M.A. , Palacin J. , García F. , Visa J.
Published: April 2003

The aim of this study was to assess liver viability after different periods of cardiac arrest and the predictive value of two markers of ischemia-reperfusion injury. Methods: A pig liver transplantation model of non-heart-beating donors was studied. Four donor groups were designed; three groups were submitted to different periods of cardiac arrest (20, 30 and 40 min), and the fourth group served as the control group (without cardiac arrest). In the non-heart-beating donor groups, normothermic recirculation was established 30 min prior to total body cooling. Aminotransferase, α-glutathione-S-transferase, and hyaluronic acid determinations as well as liver biopsies, were serially performed. Results: Although hepatocellular function could be preserved after 40 min of cardiac arrest, histological lesions at 5 days were considered irreversible due to the presence of a necrotic biliary tract. An overall significant relationship was found between the time period of cardiac arrest (20, 30 or 40 min) and the levels of hyaluronic acid (p = 0.004) or α-glutathione-S-transferase (p = 0.01) obtained during liver procurement and transplantation. Conclusions: The period of cardiac arrest is the determinant factor of liver viability after liver transplantation from non-heart-beating donors. As early markers of endothelial or hepatocellular damage, hyaluronic acid or α-glutathione-S-transferase levels may help to evaluate the ischemic injury of a potential donor.
New Method for the Detection of Bacterial Translocation Using Intestinal Permeability with Polyethylene Glycol 4000
Authors: Ameno H. , Tani T. , Hanasawa K. , Kodama M.
Published: April 2003

Background: Currently, there is no method of accurately diagnosing bacterial translocation (BT) in humans. BT may be related to changes in intestinal permeability. In this study, we examined the correlation between intestinal permeability using polyethylene glycol (PEG) 4000 and BT. Materials and Methods: Under general anesthesia, laparotomy was done in rats, and PEG4000 was administered to the small intestine. We prepared models of invasive stimulation in which lipopolysaccharide (LPS) was intravenously administered, and a hemorrhagic shock model in which blood pressure was decreased to 30 mm Hg. Blood PEG4000 levels were measured. We also measured blood PEG levels in a model in which oxygen was administered to treat hemorrhagic shock. In all models, the presence or absence of BT development was evaluated. Results: In groups given LPS, mean blood PEG levels were significant higher than in the group treated with saline solution. In the hemorrhagic shock group, the mean PEG level was increased but was slightly inhibited by oxygen administration. In the LPS and hemorrhagic shock groups, the incidene of BT was significantly greater than in the control group. In the hemorrhagic shock group, the incidence of BT was 0% after oxygen administration. There was a correlation between the incidence of BT and changes in the intestinal permeability of PEG4000 (R2 = 0.824). Conclusions: LPS stimulation enhanced intestinal permeability in a dose-dependent manner. An increase in intestinal permeability was correlated with the incidence of BT. Blood PEG4000 levels correlated positively with the grade of invasion and the incidence of BT.
Effect of Ibuprofen and Diethylcarbamazine on the Hemodynamic and Inflammatory Response to Endotoxin in the Dog
Authors: Pinsky M.R. , Roman A. , Buurman W. , Content J. , Vincent J.-L.
Published: April 2003

We studied the effects of pretreatment with either ibuprofen (15 mg/kg), diethylcarbamazine (DEC, 15 mg/kg), or vehicle, on the hemodynamic, hematologic, and serum tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 responses to a bolus Escherichia coli endotoxin infusion (2 mg/kg) in 21 pentobarbital-anesthetized dogs (n = 7 each group). Hematologic and cytokine data were collected before and 0.5, 1, and 3 h after endotoxin infusion. Endotoxin decreased arterial pressure (Pa), cardiac output (CO), total leukocyte (WBC) and platelet counts, and increased lactate, TNF-α, and IL-6. TNF-α levels peaked at 1 h and decreased by 3 h, whereas IL-6 remained elevated. Ibuprofen abolished the endotoxin-induced changes in Pa and lactate, but did not alter the initial decrease in CO, WBC, and platelets or the increase in TNF-α and IL-6. DEC did not alter the response to endotoxin, although the DEC group had higher TNF-α and IL-6 levels before endotoxin infusion compared to controls. We conclude that the cardiovascular effects of ibuprofen in the canine model of acute endotoxemia are not due to suppression of the systemic inflammatory response.
Platelet-Derived Growth Factor and Epidermal Growth Factor Play a Major Role in Human Colonic Fibroblast Repair Activities
Authors: Piazuelo Elena , Jimenez Pilar , Lanas A. , García Asunción , Esteva F. , Sainz R.
Published: April 2003

Background and Aims: Ulceration is a common feature of inflammatory bowel diseases, where subepithelial cell growth is frequently necessary for resolution. In order to further understand the role of colonic fibroblasts in this process, we have used an in vitro model of wound repair to study the response of human colonic fibroblasts to several growth factors expressed in colonic tissues. Methods: Proliferation was determined by [3H]thymidine incorporation into DNA in subconfluent fibroblast cultures. In vitro wound repair was determined in confluent fibroblast monolayers after mechanical denudation. The presence of growth factors secreted by fibroblasts was studied in conditioned medium by heparin affinity chromatography and immunodetection with specific antibodies. Results: Serum and platelet-derived growth factor (PDGF-BB) induced a dramatic increase in both colonic fibroblast proliferation and closure of wounded cell monolayers. Epidermal growth factor (EGF) stimulated both fibroblast activities, but the effect was less potent. However, colonic fibroblasts did not respond to transforming growth factor-β1. Conditioned medium stimulated fibroblast proliferation and wound repair activity, which was reverted by the addition of suramin. Furthermore, a PDGF-like factor was isolated from colonic fibroblast-conditioned medium. Conclusions: EGF and PDGF-BB promote human colonic fibroblast-dependent wound repair activities. Human colonic fibroblasts may exert an autocrine regulation via the production of growth factors.
Dual Effect of Laparoscopy on Cell-Mediated Immunity
Authors: Hajri A. , Mutter D. , Wack S. , Bastien C. , Gury J.F. , Marescaux J. , Aprahamian M.
Published: April 2003

Laparoscopic influence on cell-mediated immunity and tumour evolution is controversial. The objective of the present study was to assess tumour growth and immune patterns after laparoscopy on an experimental study. Lewis rats, bearing an intrapancreatic ductal carcinoma randomly underwent one of the following 2-hour procedures: anaesthesia, laparotomy or CO2 pneumoperitoneum. Cell-mediated immunity was investigated through determination of serum IL1β concentrations by ELISA and TNFα, IL6 and iNOS gene transcriptions in blood white cells and peritoneal cells by RT-PCR 1 day after operation. Tumour growth and spread patterns were assessed on anatomopathological examination 2 weeks after surgery. Tumour growth and spread were unaffected no matter what procedure was applied, but port-site seeding occurred in half of the cases undergoing laparoscopy. No significant change in acute-phase protein response, represented by IL1β serum concentration, was found after laparoscopy. TNFα, IL6 and inducible NO synthase gene transcriptions were enhanced in blood white cells and depressed in peritoneal immune cells after laparoscopy. In our experimental conditions, cell-mediated immune response to CO2 pneumoperitoneum seems to be a good systemic immune activation and a less acute peritoneal immune response as opposed to control laparoscopy. This early impairment of peritoneal macrophage immune activity, observed after a long-lasting CO2 pneumoperitoneum, might be responsible for the high rate of port site recurrence.
Urinary Gonadotropin Peptide Levels in Preeclamptic and Normotensive Pregnant Women
Authors: Williams Michelle A. , Luthy David A. , Zingheim Rosalee W. , Zebelman Arthur M. , Sorensen Tanya K. , Resta Robert G.
Published: April 2003

Objective: Elevated maternal serum human chorionic gonadotropin (hCG) is an important marker of Down syndrome. Notably, women with unexplained elevated serum hCG in the second trimester experience a 2- to 5-fold increase risk of preeclampsia. Urinary gonadotropin peptide (UGP), thought to be a metabolite of hCG that is excreted into urine, has recently been shown to be elevated in Down syndrome pregnancies. We sought to examine urinary UGP levels in preeclamptic and normotensive pregnant women. Methods: We measured UGP levels in urine collected during the third trimester from 18 women with preeclampsia and 20 normotensive controls. UGP levels were determined using enzyme immunoassay and were corrected for dilution using urinary creatinine. Statistical significance testing was done using the Wilcoxon-Mann-Whitney Rank Sum test and Student t test statistics. Results: There was a statistically significant elevation in urinary UGP levels among preeclamptic cases as compared to normotensive control subjects (p = 0.013). Mean urinary UGP levels were 80.7 and 31.3 pmol/mg creatinine for preeclampsia cases and controls, respectively. Elevations in UGP levels among women with preeclampsia as compared with normotensive control subjects persisted after adjustments for possible confounding factors. Conclusion: These early findings suggest that elevations in urinary UGP may be a risk marker for preeclampsia. Prospective studies should further clarify the relation between urinary UGP levels and adverse pregnancy outcomes. These results are consistent with results suggesting a role of placental hypoperfusion in the etiology of preeclampsia.
Half-Life of Estradiol in Postmenopausal Women
Authors: Ginsburg Elizabeth S. , Gao Xiaoying , Shea Brian F. , Barbieri Robert L.
Published: April 2003

Estrogen replacement is often advised for postmenopausal women to prevent menopausal symptoms, osteoporosis and heart disease. However, little information is available concerning the half-life of estradiol (E2) in postmenopausal women. This study was designed to determine the half-life and metabolism of transdermal E2. A prospective clinical study of 8 healthy postmenopausal women was performed in the Clinical Research Center of the Brigham and Women’s Hospital. A transdermal E2 patch 0.10 mg was placed on the abdominal wall. Thirteen hours later, after an overnight fast, the E2 patch was removed and frequent blood sampling was performed over 6 h. Serum samples were assayed for E2, estrone (E1) and estrone sulfate (E1S). Serum samples were taken before E2 patch placement, for 30 min before patch removal, and for 6 h after patch removal. The basal E2 level of women prior to use of transdermal E2 was 19 ± 2 pg/ml (mean ± SE). Thirteen hours after transdermal E2 placement, steady state levels had been reached, with a mean E2 of 112 ± 6 pg/ml. The mean half-life of E2 after removal of transdermal E2 was 161 min (range 107–221 min). There was a direct relationship between the subjects’ weight and the half-life of E2 (r = 0.79, p = 0.02). Mean basal E1 levels were 23 ± 5 pg/ml and mean E1 steady-state levels after E2 patch placement were 39 ± 0.6 pg/ml. E1S levels rose from mean basal levels of 1.5 ± 0.3 ng/ml to mean steady-state levels of 3.1 ± 0.1 ng/ml after placement of the E2 patch. The apparent half-life of E2 after discontinuing a transdermal E2 patch is 2.7 h or 161 min.
Antepartum Risks of Shoulder Dystocia and Brachial Plexus Injury for Infants Weighing 4,200 g or More
Authors: Blickstein Isaac , Ben-Arie Alon , Hagay Zion J.
Published: April 2003

A cohort of 236 vaginally delivered neonates weighing ≥4,200 g was evaluated. Shoulder dystocia was encountered in 27 deliveries (11.4%) and brachial plexus injury was diagnosed in 3 infants (1.3%). The ‘traditional’ antepartum risk factors could not be associated with shoulder dystocia. In this cohort, primiparity was significantly more frequent among the dystocia cases (OR = 8.58, 99% CI = 1.35–54.35, p = 0.021). Shoulder dystocia could not be attributed to a particular difference between the current and the previous heaviest birth weight. A policy of cesarean section for all infants weighing ≥4,200 g would result in at least 5- to 6-fold increase in cesarean rate in this group of patients. Our data reconfirm that shoulder dystocia and brachial plexus injury are unpredictable, even in macrosomic infants. It is a matter of policy whether to accept the expected 1:9 and 1:79 respective risks associated with vaginal births.
Changes in Plasma Elastase during Pregnancy and sub partu
Authors: Cunze T. , Osmers R. , Herzog S. , Speer Ch. , Kuhn W.
Published: April 2003

Elastase is produced and released by polymorphonuclear leukocytes (PNMs) during inflammatory processes. Thus, elastase is assumed to be a sensitive marker of infections similar to the well-established C-reactive protein (CRP). It is deactivated predominantly in tissues by α1-proteinase inhibitor which forms stable complexes with the elastase molecule (EAPI) that can be detected for several hours. Premature rupture of membranes is often correlated with an early increase in elastase, occurring earlier than the increase in leukocyte count or CRP. Elastase might be a sensitive marker of beginning amnion infection syndrome after premature rupture of membranes. For the present study, plasma EAPI levels of 335 healthy pregnant women as well as 47 healthy nonpregnant pre- and postmenopausal women were analyzed. No significant differences were found in the latter group or in pregnant women until the beginning of labor. Women at the beginning of labor but without rupture of membranes showed a significant increase in plasma EAPI from 97.7 to 338.3 ng/ml (p < 0.001). With opening of the os uteri to more than 2 cm, elastase concentrations decreased to values comparable to those before the beginning of labor (p < 0.001). The use of elastase as a marker for a rupture of membranes or beginning amnion infection syndrome as suggested by a number of studies might need some restriction. As a consequence, serial monitoring of plasma elastase to detect a persisting increase might give more reliable results. The increase in plasma elastase during beginning of labor may be explained by the role of PMNs in the physiology of delivery. However, serial monitoring to detect a persisting increase in plasma EAPI may be more helpful.
Management of Malignant Ovarian Tumors in Young Women
Authors: Koshiyama Masafumi , Yoshida Masumi , Takemura Maki , Konishi Mitsunaga , Yura Yasuichirou , Matsushita Katsuko , Hayashi Michiharu , Tauchi Kunihiko
Published: April 2003

To evaluate the management of malignant ovarian tumors in young women who wish to maintain fertility, we retrospectively reviewed ovarian malignancies in 21 young women who were both nulliparous and under 40 years of age. With stage 1a disease, all 9 patients were treated with conservative surgical therapies, and all of them are still alive, irrespective of histological type. With stage 1c disease, 5 (83%) of 6 patients were treated with conservative surgical therapies. Among them, 2 patients with epithelial tumors, who were treated with conservative surgical therapies and potent cis-diamminedichloroplatinum (CDDP)-based combined chemotherapies, are still alive. Furthermore, one of them had a successful pregnancy. On the other hand, 3 out of 4 patients with nonepithelial tumors were treated with conservative surgical therapies. However, 2 (67%) out of 3 died; both of them were treated with non-CDDP-based chemotherapy. In 6 patients with disease beyond stage 2, 4 (67%) were treated with radical surgical therapies, but 2 (33%) were treated with conservative surgery and CDDP-based combined chemotherapy, one of which was followed by a successful pregnancy in spite of nonepithelial tumor. As above, we could obtain some successful pregnancies in cases beyond stage 1c after conservative surgery by adding definite CDDP-based combined chemotherapy. However, we must carefully select the patients with nonepithelial tumors for conservative therapy by adding definite CDDP-based combined chemotherapy and inform them of the risks of therapy.
Preeclampsia and Maternal Heart Rate Variability
Authors: Eneroth Eva , Storck Nicklas
Published: April 2003

Maternal heart rate variability was evaluated by means of 24-hour Holter ECG monitoring in three groups of patients (15 preeclamptic, 15 women hospitalized due to other complications and 15 normal ambulatory pregnant women) in the 28th–33rd week of gestation. Heart rate variability was estimated by time and frequency domain measures. Patients with preeclampsia had significantly longer NN intervals during daytime compared to the other groups studied. With regard to frequency domain measures such as very-low-frequency, low-frequency and high-frequency power, the groups did not differ. Nor did they differ with regard to day and nighttime. We conclude that during pregnancy, the power of the maternal heart rate spectrum is markedly depressed, which affects the power of the method to separate normal pregnancies from pregnancies affected by preeclampsia.
Childbirth as a Biological Model for Stress?
Authors: Bergant Anton M. , Kirchler Harald , Heim Kurt , Daxenbichler Günther , Herold Manfred , Schröcksnadel Hans
Published: April 2003

Objective: The aims of this investigation were to measure corticotropin-releasing hormone (CRH), corticotropin (ACTH) and cortisol before, during and after delivery searching for an endocrine intercorrelation of the hypothalamic-pituitary-adrenal (HPA) axis and to correlate these findings with obstetrical variables. Methods: Blood was sampled from 50 women with singleton pregnancies at term without uterine contractions, during delivery (after full cervical dilatation) and on the 4th postnatal day. Hormones were measured by radioimmunoassay (RIA). The correlation between obstetric variables, sociodemographic and endocrine data were evaluated using the Spearman rank coefficient. Group comparisons for continuous variables were calculated using the Mann-Whitney U test and Kruskal-Wallis test. Results: Maternal plasma ACTH and cortisol increased significantly during labor, declining toward the 4th postnatal day (p < 0.001) and showing a significant intercorrelation (p < 0.01). Compared to women without uterine contractions CRH rose during labor (p < 0.05) and decreased rapidly to the 4th postnatal day (p < 0.001). No correlations between CRH and ACTH or cortisol were observed. None of the obstetrical variables (parity, newborn’s weight, duration of delivery) revealed any significant correlation with ACTH. Analgetic medication (pethidine hydrochloride) was not able to influence the endocrine response to labor stress. Conclusions: Stressful experience during childbirth has an impact on endocrine response. However, this is not fully evident along the HPA axis in a simple biological model with monocausal dependencies. This ‘biological stress model’ is not sensitive enough to detect different childbirth conditions and the hormones in the maternal compartment have partially fetal (placental) origin.
How Alarming Is Post-Coital Bleeding – A Cytologic, Colposcopic and Histopathologic Evaluation
Authors: Shalini Rajaram , Amita Suneja , Neera Mahishee Agarwal
Published: April 2003

This retrospective analysis studies post-coital bleeding (PCB) in 110 patients presenting to the colposcopy clinic of the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, and covers a 2-year period from March 1994 to February 1996. All the patients were evaluated by cytology and colposcopy. Colposcopy-positive patients underwent a directed biopsy. Age, parity and duration of PCB were correlated with histopathologic findings, i.e. benign changes, viral HPV changes and cervical intra-epithelial neoplasia (CIN) 1, CIN 2 and 3 and invasive cancer for risk assessment. 85.5% of the patients had benign findings, 5.6% viral HPV and CIN 1, 3.6% CIN 2 and 3 and 5.5% invasive cancer. Vascular ectopy was the commonest benign colposcopic finding. Cytology had a sensitivity and specificity of 56% and 90%, respectively. The mean age of patients with invasive cancer was 41.3 years versus 32.9 years in patients with benign pathology, the difference being statistically significant (p < 0.05). Mean parity was 4.2 in patients with invasive cancer against 2.8 in benign cases (NS). There was no correlation between duration of bleeding and pathology.
Perinatal Outcome of Oligohydramnios without Associated Premature Rupture of Membranes and Fetal Anomalies
Authors: Hsieh T’sang-T’ang , Hung Tai-Ho , Chen Kuang-Chao , Hsieh Ching-Chang , Lo Liang-Ming , Chiu Tsung-Hong
Published: April 2003

To investigate the perinatal outcome of patients with oligohydramnios (amniotic fluid index ≤5 cm), but without premature rupture of membranes and fetal congenital anomalies, data from 245 singleton pregnancies were analyzed and compared to those with normal amniotic fluid volumes (5 < amniotic fluid index < 24 cm, n = 27,261). Significantly higher incidences of primiparity, pregnancy-induced hypertension, premature separation of placenta, past history of intrauterine fetal death, past history of preterm delivery, postterm pregnancy, and advanced maternal age were noted to be associated with the occurrence of oligohydramnios. Pregnancies complicated by a markedly diminished amniotic fluid volume assessed antenatally by ultrasound were significantly more frequently associated with adverse perinatal outcomes such as preterm delivery, low or very low birth weight, low Apgar scores, intrauterine fetal death, small-for-gestational-age newborns, meconium staining, cesarean delivery, neonatal intensive care, and neonatal death.
Increased Serum Concentrations of Soluble Vascular Cell Adhesion Molecule-1 in Uterine Cervical Cancer
Authors: Nasu Kaei , Etoh Yasuko , Narahara Hisashi , Tanaka Yuuichiro , Miyakawa Isao
Published: April 2003

The purpose of this investigation was to determine the serum concentration of soluble vascular cell adhesion molecule-1 (sVCAM-1) in women with squamous cell carcinoma of the cervix. Serum samples were obtained from 38 Japanese women with squamous cell carcinoma of the cervix before initial treatment (12 in stage 0, 7 in stage I, 5 in stage II, 9 in stage III and 5 in stage IV), 7 patients with a recurrence of this cancer, and 18 healthy female volunteers. Serum sVCAM-1 was measured with a sandwich enzyme-linked immunosorbent assay. Serum concentrations (means ± SD) of sVCAM-1 in the healthy volunteers, the patients with cervical cancer in stages 0–IV and in the patients with recurrent tumors were 597.2 ± 151.4, 690.1 ± 214.2, 1,234.8 ± 466.1, 1,159.8 ± 825.8, 1,529.6 ± 662.0, 1,053.0 ± 228.8, and 1,134.8 ± 211.3 ng/ml, respectively. Values for patients with stages I–IV or recurrent cervical cancer were significantly increased compared to those for healthy volunteers (p < 0.05). Results suggest that sVCAM-1 is shed from endothelial cells in the cancerous tissue.
MTAP Gene Deletion in Endometrial Cancer
Authors: Wong Y.F. , Chung T.K.H. , Cheung T.H. , Nobori T. , Chang A.M.Z.
Published: April 2003

A gene (MTAP) that encodes the enzyme 5′-deoxy-5′-methylthioadenosine (MTA) phosphorylase has been identified on chromosome 9p21 and cloned. The substrate of this enzyme, MTA, inhibits aminopropyltransferases that synthesize polyamines from putrescine and decarboxylated S-adenosylmethionine. This enzyme normally cleaves MTA to adenine and 5′-methylthioribose-1-phosphate, which are recycled to adenine nucleotides and methionine, respectively. Cancers with deletions of the MTAP gene may be especially susceptible to chemotherapeutic regimes which interfere with purine or methionine utilization. The purpose of this study was to determine deletion of the MTAP gene in endometrial cancer using a polymerase chain reaction-based method. Therefore, 50 endometrial adenocarcinomas were studied. Partial or total deletions of the MTAP gene were detected in 7 (14%) of these cancers. There were no significant relationships between gene deletion and patient age, pathological grade or clinical stage (p > 0.05). The findings indicate that deletion of the MTAP gene does occur in a subgroup of endometrial cancer. The present work may be extended to the development of molecular diagnosis of MTAP gene deletion in other cancers and assist in selecting appropriate chemotherapy.
Role of Serum Ceruloplasmin and Its Ferroxidase Activity on Preterm Labor
Authors: Vitoratos N. , Botsis D. , Christodoulacos C. , Contoravdis A. , Dalamaga A. , Chryssicopoulos A.
Published: April 2003

The role of serum ceruloplasmin and its ferroxidase activity on preterm labor with or without rupture of the membranes was studied. Thirty-seven primigravid women between 31 and 35 weeks of gestation were investigated. Our material is divided into 3 groups. Group A consisted of 12 patients with premature rupture of the membranes; group B consisted of 10 patients with preterm labor but intact membranes, and group C consisted of 15 non-laboring patients. Patients with rupture of the membranes presented with statistically significantly higher serum ceruloplasmin levels compared to those with preterm labor but intact membranes (p < 0.05) as well as to non-laboring patients (p < 0.01). On the contrary, the mean ferroxidase activity level or ceruloplasmin was 518.2 ± 183.42, 460.9 ± 198.8 and 517.5 ± 142.01 µmol/l/min in groups A, B and C, respectively. These values were not significantly different. Our results show a loss of ferroxidase activity of ceruloplasmin in patients with rupture of the membranes and probably suggest a defect in the maternal defense mechanisms.
Treatment of Recurrent Genital Herpes with Interferon Alpha-2α
Authors: Cardamakis E. , Relakis K. , Kotoulas I.-G. , Michopoulos J. , Metallinos K. , Mantouvalos H. , Tzingounis V.
Published: April 2003

The purpose of the present study was to evaluate the efficacy and safety of parenteral administration of interferon alpha-2α in the treatment of recurrent herpes genitalis. A total of 97 patients (66 males, 31 females, mean age 34.86 ± 16.74 years), who had at least five recurrences of genital herpes during the previous 12 months, participated in a prospective open study on the effects of treatment with interferon alpha-2α (Roferon-A; Roche). The patients were treated with interferon alpha-2α (3 × 106 IU) by subcutaneous injection, three times weekly for 4 weeks, and the same schedule was repeated after 3 and 6 months. All patients were asymptomatic at the start of the study. After initiation of treatment, all patients reported to the clinic every 3 months for 2 years (the males were submitted to peoscopy and the females to Pap test and colposcopy) at the time of their recurrences. Comparison was made of the number of recurrences, duration of lesions, duration and severity of pain, and itching and burning. Prophylactic administration of interferon alpha-2α prevented recurrences of genital herpes virus infection in 51 patients (20 males and 31 females). Interferon administration shortened the healing time from 8.5 days before treatment to 2.5 days after treatment (p < 0.001). There was a significant reduction in the number of recurrences during the study period, from 7.46 before treatment to 2.64 after treatment (p < 0.001). On the basis of the overall efficacy and adverse effects, this regimen may be of value in the routine treatment of recurrent herpes.
Breast-Feeding, Pain and Infection
Authors: Thomassen Peter , Johansson Vivi-Anne , Wassberg Christina , Petrini Björn
Published: April 2003

A syndrome of deep pain in the breast during and immediately after lactation has been ascribed to an infection with Candida albicans. A series of 20 patients with deep pain, another 20 with superficial infection and 20 healthy women were compared with respect to the growth of bacteria and fungi. C. albicans was found twice as often in the milk of women with superficial lesions compared to those with deep pain. Bacteria were often found on the nipple and in the milk of those complaining of deep pain. Thus, if the deep pain syndrome is caused by microbes, this study points to a pathogenic role of bacteria rather than fungi.
Interleukin-6 Concentrations in Cervical Secretions in the Prediction of Intrauterine Infection in Preterm Premature Rupture of the Membranes
Authors: Rizzo Giuseppe , Capponi Alessandra , Vlachopoulou Anastasia , Angelini Emanuela , Grassi Carmen , Romanini Carlo
Published: April 2003

The objective of this study was to determine the value of interleukin-6 (IL-6) in cervical secretion to diagnose microbial invasion of the amniotic cavity in patients with premature rupture of the membranes. Cervical secretions were sampled immediately before amniocentesis in 124 patients with singleton pregnancies and preterm premature rupture of the membranes. Gestational age ranged between 24 and 32 weeks. Amniotic fluid was cultured and IL-6 measured in amniotic fluid and cervical secretions. A total of 33.8% (21/124) of the amniotic fluid cultures had positive results. In cervical secretions the median concentration of IL-6 was 672 pg/ml (range 5–1,250) in the presence of intra-amniotic infection in contrast to 95.5 pg/ml (range 12–640) in women with negative amniotic fluid culture (p ≤0.001). There were no differences between IL-6 concentrations in the cervical secretions of patients with or without obvious leakage of amniotic fluid. A significant relationship was found between IL-6 levels in amniotic fluid and in cervical secretions (ρ = 0.74, p ≤0.001). An IL-6 level in cervical secretions >200 pg/ml had a sensitivity of 78.5%, a specificity of 73.1% and a relative risk of 4.6 for intra-amniotic infection. Receiver-operator characteristics curve analysis showed that IL-6 assay in cervical secretions is comparable to IL-6 assay in amniotic fluid in predicting intra-amniotic infection (p = 0.468).In conclusion, intra-amniotic infection is associated with increased levels of IL-6 and concentrations in cervical secretions are related to amniotic levels. The measurement of IL-6 in cervical secretions may help to noninvasively identify intra-amniotic infection among pregnancies with preterm premature rupture of membranes.
Placenta praevia and accreta: Analysis of a Two-Year Experience
Authors: Zaideh Saed M. , Abu-Heija Adel T. , El-Jallad Mohammad F.
Published: April 2003

Objective: Our purpose was to determine the relationship between previous caesarean section and subsequent development of placenta praevia and placenta praevia with accreta. Method: A retrospective review of the case records of all women delivered with the diagnosis of placenta praevia during the 2-year period from January 1, 1995, to December 31, 1996, at the tertiary referral centre, Princess Badeea Teaching Hospital, in north Jordan. Results: There were 18,651 deliveries in the study period. 65 (0.35%) had placenta praevia, 21 (32.3%) of whom had a history of previous caesarean section. The incidence of placenta praevia was significantly increased in those with a previous caesarean section (1.87%) compared with those with an unscarred uterus (0.25%); p < 0.0001). This risk increased as the number of previous caesarean sections increased: 1.78% for one previous section; 2.4% for two, and 2.8% for three or more. The incidence of anterior placenta praevia and placenta accreta was significantly increased in those with previous caesarean scars. In the group without antecedent of caesarean section, accretism risk was 9%, with one section or more 40.8% (p < 0.005). Conclusion: There is a high association between anterior placenta praevia, placenta accreta and previous caesarean section. This was enhanced with the increasing number of previous caesarean sections. Patients with an antepartum diagnosis of placenta praevia who have had a previous caesarean section should be considered at high risk of developing placenta praevia and accreta.
Electro-Oophorogram: A Preliminary Study of the Electric Activity of the Ovary
Authors: Shafik Ahmed
Published: April 2003

The electric activity of the ovary was studied in 13 female mongrel dogs aiming at characterizing a normal electro-oophorogram (EOOG). Two monopolar silver-silver chloride electrodes were sutured under anesthesia to the ovary of the bitches which were in the anestrus phase of the estrous cycle. A daily recording session of 60 min was performed for 10 days. Furthermore, the effect of ovarian vessels’ clamping, of oophorectomy and of ovarian insult by irradiation on the electric activity, was studied. Electric waves were recorded from the two electrodes. Each wave consisted of a negative followed by a positive deflection with a mean amplitude of 52.6 ± 10.7 µV and frequency of 9.2 ± 1.6 cycles per second. The waves showed the same amplitude and frequency from the two electrodes and were reproducible when the test was repeated in the same animal. Fast activity spikes were not encountered. Temporary clamping of the ovarian vessels caused diminution of the normal ovarian electric activity which returned to the preclamping state after clamp release. A ‘silent’ EOOG was obtained after oophorectomy. Two EOOG patterns were recorded from the irradiated ovary: silent and dysrhythmic. To conclude, an EOOG could be characterized for the bitches in the anestrus phase which is a quiescent phase of the estrous cycle. Further studies are required to record the EOOG in the other phases of the estrous cycle and in the various pathologic conditions of the ovary.
Angiogenesis in Endometriosis
Authors: Matsuzaki S. , Canis M. , Darcha C. , Dechelotte P. , Pouly J.L. , Bruhat M.A.
Published: April 2003

We evaluated angiogenesis in eutopic endometrium and ectopic endometrium from patients with endometriosis. Microvessels were identified by immunohistochemistry using anti-von-Willebrand factor antibody and vascular parameters were measured using a computerized image analysis system. No relationship was observed between vascular density and type of endometriotic lesion. Heterogeneity in vascular density was observed in different lesions within the same patient. Between red and black peritoneal lesions a significant difference was observed in the frequency distribution of luminal diameter. In black lesions the variability of luminal diameter was decreased and most microvessels were less than 20 mm in diameter. We suggest that the frequency distribution of microvessel luminal diameter of red and black peritoneal lesions may be different and should be important when studying the regulation of angiogenesis in endometriotic implants.
Estrogen and Progesterone Receptors in Benign Ovarian Tumors of Menopausal Breast Cancer Patients Treated with Tamoxifen
Authors: Cohen Ilan , Bernheim Joelle , Fishman Amiram , Shapira Jeremiah , Tepper Ron , Beyth Yoram , Cordoba Mario , Yigael Dror , Altaras Marco M.
Published: April 2003

In order to assess possible ovarian cell potential for interaction with tamoxifen, thus demonstrating possible effects of this agent on the development of ovarian pathologies through growth stimulation and cell proliferation, we measured estrogen receptors (ER) and progesterone receptors (PR) by immunohistochemical method in 16 benign ovarian tumors removed from 11 postmenopausal breast cancer patients treated with tamoxifen (study group). The results were compared with those measured in 7 similar ovarian tumors obtained from 5 similar patients without tamoxifen treatment (control group I), and in 9 similar tumors removed from 9 age-matched postmenopausal women (control group II). There were no significant differences with regard to ER or PR expression between the study group and control group I and II (ER = 18.75, 0.0 and 11%, respectively; PR = 43.75, 28.5 and 44%, respectively; p = NS). There were also no significant statistical differences between the three groups when subdividing the ovarian pathologies according to different histological types. From the results obtained in this study, it seems that tamoxifen probably does not have any direct influence on the ovaries of menopausal breast cancer patients.
Transient Increase in Thrombin Generation during Radiotherapy of Uterine Carcinoma: A Preliminary Study using Thrombin-Antithrombin III Complex Measurements
Authors: Uszýnski Mieczysław , Miodónska Janina , Żekanowska Ewa
Published: April 2003

The question of the study was whether irradiation therapy applied to women with cervical or endometrial carcinoma leads to increased thrombin generation. The study group consisted of 42 women with cervical carcinoma (22 cases) and endometrial carcinoma (20 cases). Irradiation (brachytherapy or/and teletherapy) was applied as follows: 200 cGy/day, 5 days a week, therapeutic dose of 4,500–5,000 cGy. Complexes of thrombin-antithrombin III in blood plasma were measured (ELISA method) before radiotherapy and 4–5 times during therapy. A transient increase in thrombin generation was noticed in 16 of 42 patients: the median value of all ‘peaks’ was 19.25 (range 3.20–30.00 µg/l) in cases of cervical carcinoma, and 14.50 (range 5.25–27.75 µg/l) in cases of endometrial carcinoma. It was concluded that therapeutic doses of ionic energy cause only a transient increase in thrombin generation.
Intrauterine Levels of Human Decidua-Associated Protein (hDP) 200 in Normal Pregnancy and Missed Abortion
Authors: Halperin Reuvit , Halpern Doron , Hadas Eran , Bukovsky Ian , Schneider David
Published: April 2003

Levels of human decidua-associated protein (hDP) 200 were measured in amniotic fluid samples, obtained from 32 induced and 21 missed abortions at 9–20 weeks of pregnancy. A 3-fold decrease in the hDP 200 level was observed between 9 and 20 weeks of normal pregnancy. Moreover, no significant difference was observed comparing the level of hDP 200 and the pattern of its decrease in missed and induced abortions. Thus, according to our results, hDP 200, being a monoclonal rheumatoid factor, is probably not required for the continuation of normal pregnancy.
Plasma and Membrane Ca2+ and Mg2+ Concentrations in Normal Pregnancy and in Preeclampsia
Authors: Kisters Klaus , Körner Jens , Louwen Frank , Witteler Ralph , Jackisch Christian , Zidek Walter , Ott Stephanie , Westermann Gerald , Barenbrock Michael , Rahn Karl H.
Published: April 2003

Objective: Changes in intracellular Ca2+ and Mg2+ concentrations seem to be involved in the pathogenesis of preeclampsia, whereas the role of cell membranes has not been studied in detail yet. To investigate the changes in Ca2+ and Mg2+ metabolism in normal pregnancy and preeclampsia, plasma and membrane Ca2+ and Mg2+ concentrations were determined in a clinical study as compared to healthy subjects. Study Design: 25 healthy female subjects, 22 untreated healthy pregnant and 20 preeclamptic women were investigated. In each patient, plasma and membrane Ca2+ and Mg2+ content were measured. Ca2+ and Mg2+ concentrations were measured by atomic absorption spectroscopy. Erythrocyte membranes were chosen for membranous Ca2+ and Mg2+ determination. Results: Plasma Mg2+ concentrations were significantly lowered in the healthy pregnant group and the preeclamptic group as compared to contols (p < 0.0001). In erythrocyte membranes, Mg2+ content was found significantly decreased in the preeclamptic women as compared to healthy subjects (p < 0.001). In plasma Ca2+ concentrations there was a significant decrease in the preeclamptic group as compared to controls or healthy pregnant women (p < 0.05). Membranous Ca2+ content was significantly increased in the preeclamptic group versus controls or healthy pregnant women (p < 0.001). Conclusion: Lowered plasma and membrane Mg2+ concentrations in preeclampsia may contribute to the development of hypertension in pregnancy. Additionally, a disturbed Ca2+ homeostasis is observed in preeclampsia.
Changes of Maternal Serum Leptin Levels during Pregnancy
Authors: Tamás Peter , Sulyok Endre , Szabó István , Vizer Miklós , Ertl Tibor , Rascher Wolfgang , Blum Werner F.
Published: April 2003

Maternal leptin levels in serum and urine, their relations to maternal weight and body mass index, were examined in 9 healthy pregnant women from the 12th week of gestation until term. Serum leptin concentration was found to increase progressively during the first two trimesters followed by a slight decline thereafter. The peak value of 27.6 ± 15.3 ng/ml (mean ± SD) concentration was reached at the 28th week. Serum leptin levels during the first two trimesters correlated significantly with maternal weight (p = 0.002) and body mass index (p = 0.002) but such a relationship was absent during the third trimester. Leptin could be detected only in about half of urine samples; its concentrations proved to be independent of serum values. No correlation was found between maternal serum leptin levels and the birth weight of neonates. Maternal leptin levels appear to refer to alterations in maternal fat tissue mass that occur during pregnancy.
Insulin Sensitivity and Sex Steroid Hormone Levels during the Menstrual Cycle in Healthy Women with Non-Insulin-Dependent Diabetic Parents
Authors: González-Ortiz Manuel , Martínez-Abundis Esperanza , Lifshitz Alberto
Published: April 2003

Objective: To identify the effect of the menstrual cycle and sex steroid hormone levels on insulin sensitivity in healthy women with non-insulin-dependent diabetic parents. Methods: A clinical trial was realized in 6 healthy women with non-insulin-dependent diabetic parents and in 6 control subjects. In both phases of the menstrual cycle the following tests were made: insulin tolerance test, metabolic profile, and sex steroid hormone levels. Results: Insulin sensitivity was significantly lower in the follicular (p = 0.004) and luteal (p = 0.01) phases of the menstrual cycle in probands compared with controls. In the luteal phase dehydroepiandrosterone was higher in probands than in controls (p = 0.009). Conclusions: Healthy women with non-insulin-dependent diabetic parents had a lower insulin sensitivity in both phases of the menstrual cycle compared with the control group. Dehydroepiandrosterone was higher in the luteal phase in probands than controls.
Reproducibility of Transvaginal Ultrasonographic Measurements of Endometrial Thickness in Patients with Postmenopausal Bleeding
Authors: Wolman Igal , Amster Reuben , Hartoov Joseph , Gull Ilan , Kupfermintz Michael , Lessing Joseph B. , Jaffa Ariel J.
Published: April 2003

The aim of the study was to establish the reproducibility of transvaginal sonographic measurements of endometrial thickness in patients with postmenopausal bleeding (PMB). In a prospective blind study, two examiners measured the endometrial thickness in 48 patients presenting with PMB by transvaginal sonography on two separate occasions, 30 min apart. The analysis of variance performed at each endometrial thickness measured by the two examiners revealed no statistical difference. However, it was shown that the most accurate measurements are up to the level of 4 mm (mean deviation of 0.1 ± 0.2 mm, range 0.7). Once the endometrial thickness reaches 5–6 mm the mean deviation becomes 0.3 ± 1.2 mm with a range of variation of 4 mm. In conclusion, measurements of endometrial thickness in patients presenting with PMB can be repeated quite accurately up to a level of 4 mm thickness.
Impact of Calcitonin on Urinary Excretion of Prostaglandins during Menopause
Authors: Akgül Cemil , Vural Pervin , Canbaz Mukaddes
Published: April 2003

The aim of this study was to investigate the effects of calcitonin as an antiresorptive agent in postmenopausal osteoporosis in prostaglandin metabolism. Urinary prostaglandin E2 (PGE2) concentrations were determined by PGE2 (125I) RIA kit in a total number of 37 patients in postmenopause; 27 in study group with established osteoporosis (WEO) and 10 in another group without osteoporosis (WO). An additional group of 12 patients in the premenopausal period were selected as controls (PreM). Data were given as mean ± SD and statistical analysis was performed by Student’s t test for paired and unpaired values. A significant decrease in urinary PGE2 concentrations was observed in WEO (7.91 ± 3.08 vs. 3.79 ± 3.01 ng/l) (p < 0.001), WO (9.06 ± 6.76 vs. 6.06 ± 3.90 ng/l) (p < 0.05) and PreM (7.14 ± 1.68 vs. 5.16 ± 1.91 ng/l) (p < 0.01). As a conclusion, calcitonin seems to exert a negative effect on prostaglandin metabolism resulting in reduced new prostaglandin formation.
Development and Sexual Difference in Embryonic Heart Rates in Pregnancies Resulting from in vitro Fertilization
Authors: Tezuka Naohiro , Sato Satoshi , Banzai Michio , Saito Hidekazu , Hiroi Masahiko
Published: April 2003

The purpose of this study was to investigate the gestational change of embryonic heart rates (EHRs) and to estimate the influence of embryonic sex on the EHR in pregnancies resulting from in vitro fertilization in the early first trimester. With transvaginal ultrasonography, we performed 92 and 105 examinations, on 27 male and 30 female embryos, respectively. The EHR increased gradually from 87 beats per min at 38 days of gestation to 189 beats per min at 62 days of gestation. The relationship between gestational age and EHR was explored by regression analysis: male EHR (beats per min) = 3.78 × gestational age (days) – 51.30 (r = 0.95), female EHR = 3.65 × gestational age – 44.56 (r = 0.95). These regression lines were mutually included in the 95% confidence intervals for each other. Our results indicate both a close positive correlation between the EHR and gestational age and no statistically significant difference in the EHR between male and female embryos. These findings suggest that the EHR measurement is a novel method for very early ultrasound dating with the identical EHR criterion without regard to embryonic sex.
Proton NMR Spectroscopy of the Phospholipids in Human Uterine Smooth Muscle and Placenta
Authors: Pulkkinen Martti O. , Nyman Samuel , Hämäläinen Mauri M. , Mattinen Jorma
Published: April 2003

The parameters regulating the fluidity of myometrial and placental phospholipids include double bonds, fatty acid chain lenght and the cholesterol/phospholipid ratio. The transformation of these parameters was studied during pregnancy and labor. Myometrial and placental tissue samples were collected from 24 patients: 6 were nonpregnant, 6 early-pregnant, 6 late-pregnant not in labor and 6 in labor. After butanol extraction, tissue cholesterol and lipid phosphorus were determined. Proton NMR spectroscopy of the phospholipids was performed at 500 MHz. The myometrial cholesterol/phospholipid ratio was slightly elevated in pregnant patients not in labor. The uterine muscle of the nonpregnant patients contained more CH=CH groups in the phospholipids than that of the late-pregnant patients. There were 29 more double bonds in placental than in uterine tissue per 100 fatty acid molecules. The average fatty acid chain length varied from 14.0 to 18.8. The placenta has longer fatty acid chains than the uterine smooth muscle. The myometrial carbon chain was shortened on the average by 1.4 and the placental by 1.0 carbon atoms, when the patient went into clinical labor. These findings suggest fluidity changes in myometrial and placental phospholipids during human pregnancy and labor.