bluuebunny/crossref_metadata_2025 huggingface dataset:
Imbalance between Lipid Peroxidation and Antioxidant Status in Preeclampsia
Authors: Mutlu-Türkoglu Ü. , Ademoglu E. , Ibrahimoglu L. , Aykaç-Toker G. , Uysal M.
Published: April 2003

Lipid peroxidation and the antioxidant system were investigated in the plasma and placenta of normal and preeclamptic pregnant women. A significant increase in thiobarbituric acid reactive substance (TBARS), significant decreases in total thiol (t-SH) content and superoxide dismutase (SOD) activity, and unchanged vitamin C levels and glutathione peroxidase (GPx) activity were observed in the plasma of preeclamptic women compared to women with normal pregnancies. In placentas from preeclamptic women TBARS levels were significantly elevated, while glutathione and vitamin C levels and GPx, glutathione S-transferase and SOD activities were decreased. After delivery, the elevated TBARS values decreased significantly and the reduced SOD activity and t-SH contents increased significantly. We concluded that preeclampsia is associated with an imbalance between lipid peroxides and the antioxidant system.
Influence of 5-Lipoxygenase on in vitro Growth of Human Mammary Carcinoma Cell Line MCF-7
Authors: Przylipiak A. , Hafner J. , Przylipiak J. , Köhn F.-M. , Runnebaum B. , Rabe T.
Published: April 2003

The aim of this study was to investigate the direct effect of 5-lipoxygenase (5-LO) on the growth of human mammary cancer cells MCF-7 in vitro. Cell growth was measured according to the level of 3H-thymidine incorporation. 5-LO was shown to inhibit 3H-thymidine incorporation. The inhibitory effect was 19, 42 and 78% when administered at concentrations of 0.1, 0.2 or 0.5 U/ml, respectively. Its effect was time- and dose-dependent and was statistically significant at concentrations of 0.2 and 0.5 U/ml. We have also shown that the specific 5-LO inhibitor MK-886 (1 µM) lifts the inhibitory effect of 5-LO (0.2 U/ml). Moreover, when treated with an activator of 5-lipoxygenase calcium ionophore A23187 (10 µM) MCF-7 cells synthesize LTB4. The results of this study are evidence of the role of 5-lipoxygenase in the regulation of human mammary cancer cells growth in vitro.
Supernumerary Ovary Found by Ultrasonogram and FSH Measurement after an Extensive Operation for a Yolk Sac Tumor of the Ovary
Authors: Fujiwara Keiichi , Shirotani Takako , Kohno Ichiro
Published: April 2003

A rare case of supernumerary ovary found by a transvaginal ultrasonogram and follicle-stimulating hormone (FSH) measurement is presented. The patient was a 32-year-old female who underwent an extensive operation for a yolk sac tumor of the ovary. An asymptomatic cystic tumor was found during follow-up. There was no evidence of recurrence or metastasis of the yolk sac tumor. Although histological confirmation was not possible because the patient refused removal of the mass, a diagnosis of supernumerary ovary was made because changes in the shape of the cystic mass completely correlated with changes in the serum FSH level.
Characterization of Subclonal Cell Lines Showing High Motility Derived from an Undifferentiated Human Endometrial Cancer Cell Line
Authors: Koizumi Motoiki , Ito Eiki , Yamashita Satoko , Baba Tsuyoshi , Yamanaka Ikuhito , Suzuki Takahiro , Kudo Ryuichi
Published: April 2003

To examine the relationship between the morphology and the motility of cancer cells, we studied the difference between human endometrial undifferentiated cancer cell lines with different motilities, using light and electron microscopy, immunocytochemistry and RT-PCR. In a transplanted tumor of a cell line with high motility, many connective tissues and microvessels were observed and there were few intercellular spaces, which were ultrastructurally full of extracellular matrix. In the high-motility cell line only cytokeratin 19 was observed, and the level of cytokeratin 19 mRNA was elevated. Thus, motility is suggested to be related to the induction of connective tissues and cytoskeleton.
Gene Expression in Primary, Metastatic and Recurrent Lesions of Endometrial Cancer
Authors: Sakamoto Hideki , Kinoshita Kazuya , Nakayama Yasuo , Takami Takeshi , Ohtani Kaori , Izuka Sadao , Satoh Kazuo
Published: April 2003

Seventeen patients with endometrial cancer were studied. Tissues of primary (P) and metastatic (M) lesions were obtained from 8 patients and complete sets of P, M and Recurrent (R) lesions were obtained from 9 patients during a follow-up period of 1–10 years. Expressions of estrogen receptors, progesterone receptors, multidrug resistance protein-1, multidrug resistance-related protein, c-erbB-2, membrane-type metalloproteinase, human telomerase RNA, human telomerase reverse transcriptase RNA, E-cadherin and autocrine motility factor receptor were studied by RT-PCR. Also, telomeric restriction fragment length (TRFL) and microsatellite instability were determined between P, M and R. The results indicate that there are significant differences in the gene expression frequency during tumor progression. The mismatch rate ranged from 0 to 47.1% between P and M and from 14.3% to 66.7% between P and R, respectively. The TRFL analysis showed a marked reduction in P and M (P vs. M: 8.2 ± 0.9 vs. 5.6 ± 0.4 kb, mean ±SEM, n = 9, p = 0.002 by paired Student’s t test). The length further decreased in R (P vs. R: 8.2 ± 0.9 vs. 3.2 ± 0.7, p = 0.01, M vs. R: 5.6 ± 0.4 vs. 3.2 ± 0.7, p = 0.005). The genomic instability/replication error was tested by AluI arbitrary primed polymerase chain reaction (AP-PCR). Five out of 17 patients showed an altered replication error pattern (29.4%). The mean number of abnormal AluI AP-PCR patterns in M and R compared to the P was 1.5 (M) and 4 (R). The difference between the P and R was statistically significant (p < 0.04). The present data indicate that biological behavior of cancer cells in P, M and R may differ significantly.
Interferon Gamma Expression during Human Pregnancy and in Association with Labour
Authors: Veith Gaylene L. , Rice Gregory E.
Published: April 2003

In this study, the expression of the type 1 cytokine, interferon gamma (IFNγ) during human gestation and in association with labour was assessed. Immunoreactive (ir) IFNγ concentrations (ng/ml) were quantified in maternal plasma (n = 136) and amniotic fluid (n = 68). In addition, irlFNγ content (pg/mg protein) was determined in term gestational tissues (placenta, amnion and choriodecidua, n = 39). In peripheral plasma, irlFNγ was detected in 34% of all samples assayed. Where detected, the concentration averaged 0.19 ± 0.03 ng IFNγ/ml plasma (mean ± SEM). During pregnancy, irlFNγ concentrations in maternal plasma declined significantly (p < 0.05). irlFNγ was identified in all gestational tissues examined and content increased significantly with labour status (p < 0.01). irlFNγ was not detectable in amniotic fluid (assay sensitivity = 0.02 ng/ml) at any stage of pregnancy. The data obtained are consistent with the hypothesis that, during pregnancy, cell-mediated immunity is suppressed. At term and in association with labour and delivery, lower plasma IFNγ concentrations and high tissue content may indicate a contributing role for IFNγ in parturition.
Three-Dimensional Sonographic Features of Hydrops fetalis
Authors: Hata Toshiyuki , Yanagihara Toshihiro , Matsumoto Minako , Hanaoka Uiko , Maesato Taeko , Tanaka Yasuko , Kuno Atsushi , Akiyama Masashi , Yamashiro Chizu , Ohnishi Yohichi , Tanaka Hirokazu , Hayashi Keiji , Yamada Yohko
Published: April 2003

Objective: To describe three-dimensional (3–D) sonographic features of hydrops fetalis. Methods: A total of 6 cases with hydrops fetalis from 15 to 32 weeks of gestation were studied with transabdominal 3-D sonography (3.5 MHz). Results: Before around 20 weeks of gestation, the skin becomes a transparent-like structure, so internal organs can be clearly identified. After 25 weeks, skin edema, pleural effusion, and ascites were well depicted. In the case with pleural effusion, hypoplastic lungs were clearly recognized. Conclusion: These results suggest that 3-D sonography provides a novel means of visualizing hydrops fetalis in utero.
Mortality following Laparoscopic Surgery
Authors: Lo Keith Wing-Kit , Yuen Pong-Mo
Published: April 2003

The rapid advance in laparoscopic surgery in different surgical specialities has raised concerns about its safety, especially when the procedures are now being performed by less-experienced surgeons. The use of electrosurgery further increases the possibility of unrecognized organ injury and requires a good understanding of the basic principles. Despite the fact that the use of electrosurgery is frequently emphasized and discussed in most of laparoscopic surgery conferences, this is seldom taught in in-house residence programs. We describe a case of death as a result of unrecognized thermal damage and would like to stress the importance of awareness of this potential lethal complication.
Timing of Subsequent Pregnancy following Treatment of Molar Pregnancy
Authors: Young Ronald L. , Sangi-Haghpeykar Haleh , Thomakos Nikolaos , Miller Harold J.
Published: April 2003

Objective: To assess the practice habits and recommendations of members of American Society of Gynecologic Oncologists (ASGO) dealing with follow-up management of molar pregnancy. Materials and Methods: A questionnaire was mailed to ASGO members requesting their recommended waiting period for subsequent pregnancy following treatment of molar pregnancy. Year of Fellowship completion was determined for each respondent. Results: Only 36.8% still recommended the traditionally accepted 12-month waiting period, and 31.3% recommended 6 months. The trend was toward shorter waiting periods among younger, more recently trained oncologists, although differences were not statistically significant. Conclusion: It appears time to review the recommendation of a 12-month waiting period. A reduction of at least down to 6 months may be appropriate, but needs further investigation.
Neurochemical Characterization of the Vestibular Nerves in Women with Vulvar Vestibulitis Syndrome
Authors: Bohm-Starke Nina , Hilliges Marita , Falconer Christian , Rylander Eva
Published: April 2003

Women with vulvar vestibulitis syndrome (VVS) have a distinct burning pain provoked by almost any stimuli in the area around the vaginal introitus. In a previous study we observed an increased number of intraepithelial free nerve endings in women with VVS. The aim of the present study was to neurochemically characterize the superficial nerves in the vulvar vestibular mucosa of women with VVS. Immunohistochemical methods were used to detect neuropeptides normally found in various types of nerve fibers. Calcitonin gene-related peptide, which is known to exist in nociceptive afferent nerves, was the only neuropeptide detected in the superficial nerves of the vestibular mucosa. These findings confirm our previous theory that the free nerve endings within the epithelium are nociceptors.
GnRH Analogues and Uterine Leiomyomas
Authors: Rintala Sirpa , Kujansuu Erkki , Teisala Klaus , Rantala Immo , Kivinen Seppo , Tuimala Risto
Published: April 2003

Cell proliferation in uterine leiomyomas treated preoperatively with either nafarelin (400 μg/day) for 3 months (7 patients) or nafarelin plus hormone (oestradiol + norethisterone) add-back therapy (6 patients) was investigated by automatic image analysis of frozen tissue sections using immunohistochemistry with anti-proliferating cell nuclear antigen antibody. GnRHa therapy decreased cell proliferation in leiomyomas to a level corresponding to the situation previously seen in postmenopausal leiomyomas. However, there was no consistent correlation between cell proliferation and shrinkage of leiomyomal size. The hormone add-back therapy moderated the influence of GnRHa on cell proliferation and completely blocked a decrease in size of leiomyomas in our patients.
Granulocyte Colony-Stimulating Factor on the Growth of Human Ovarian Carcinoma Cells in vitro
Authors: Chao Kuan-Chong , Chang Chi-Ching , Yen Ming-Shyen , Wang Peng-Hui , Ng Heung-Tat
Published: April 2003

Granulocyte colony-stimulating factor (GCSF) is a member of a family of glycoprotein hormones that stimulates the proliferation and differentiation of hematopoietic cells in vivo and in vitro. In ovarian cancer chemotherapy, GCSF is used clinically to build up bone marrow function after severe cytotoxicity to granulocytes by chemotherapy. Little is known about the effects of these cytokines on the growth of cancer cells. To study the influence of GCSF on the proliferation of ovarian cancer cells in vitro, five established ovarian cancer cell lines (OC-89-VGH, OC-117-VGH, OCPC-2-VGH, NIH-OVCAR-3, and NIH-SK-OV-3) were treated with the concentration ranging from 0.1 pg to 10 ng GCSF for 5 days and compared with vehicle control. In addition, we also examined the effect of GCSF (0.01–1.0 ng) on eight primary cultures of fresh ovarian cancer tissues. Cell viability after treatment was measured by Cell Titer AQueous assay and expressed as a percentage of untreated control cultures. A decrease in cell growth (75–85%) was observed in OC-89-VGH, OC-117-VGH and OCPC-2-VGH cell lines while NIH-OVCAR-3 and NIH-SK-OV-3 cells showed minimal growth stimulation. However, all dose-response curves were nonsignificant, suggesting indirect effects. In the eight fresh tumor primary cultures treated with GCSF, no statistical significant difference in growth was observed. In conclusion, our data suggest that GCSF has little or no growth-modulatory effect on human ovarian carcinoma in vitro. Therefore, the clinical use of GCSF is unlikely to have a direct effect on tumor growth.
Leiomyomas in Uterine Remnants Associated with Vaginal Agenesis
Authors: Maeda Kyoko , Ishiko Osamu , Honda Ken-ichi , Wakasa Kenichi , Kawamura Naoki , Ogita Sachio
Published: April 2003

A premenopausal woman with vaginal agenesis underwent surgery for leiomyomas in rudimentary uterine horns. Immunohistochemical study of surgical specimens revealed that progesterone receptors are distributed in the nuclei of a majority of the leiomyoma cells and in the nuclei of a minority of the myometrial cells. Estrogen receptors are not detected in the surgical specimens.
Management of Heparin-Associated Thrombocytopenia in Pregnancy with Subcutaneous r-Hirudin
Authors: Huhle G. , Geberth M. , Hoffmann U. , Heene D. L. , Harenberg J.
Published: April 2003

Heparin-induced thrombocytopenia type II is a serious, immune-mediated complication of heparin therapy. Due to its low cross-reactivity with heparin-associated antibodies (10–20%), danaparoid has successfully been administered in these patients. In recent studies, r-hirudin as a potent and specific thrombin inhibitor, was demonstrated to be a safe and effective anticoagulant. We report a pregnant woman with systemic lupus erythematosus and recurrent venous thromboembolism who suffered from heparin-induced thrombocytopenia type II while treated with dalteparin sodium. Positive cross-reactivities with danaparoid were found. Anticoagulation with 15 mg subcutaneous r-hirudin was performed twice daily from the 25th week of pregnancy until delivery. No thromboembolism or bleeding or fetal toxicity of r-hirudin was detected. Recombinant hirudin is a potent and specific thrombin inhibitor that can be used as a safe and effective anticoagulant in pregnancy.
The Incidence of Pregnancy Rhinitis
Authors: Ellegård Eva , Hellgren Margareta , Torén Kjell , Karlsson Göran
Published: April 2003

The purpose of this study was to define the cumulative incidence of pregnancy rhinitis, and to study whether smoking, asthma, hayfever or month of conception are risk factors. A questionnaire was delivered during 1 year in 10 antenatal care centers in one Swedish county. Questions were asked by midwives on the ordinary check-up visits throughout pregnancy. Five centers with response rates of 70% or more, including 599 women, were evaluated. The cumulative incidence of pregnancy rhinitis was 22%. Smokers had a significantly increased incidence with a relative risk enhancement of 69%, whereas hayfever, asthma, and month of conception had no statistically significant influence on incidence. Pregnancy rhinitis was shown to appear at any time during gestation.
Aspiration of Simple Pelvic Cysts during Pregnancy
Authors: Caspi B. , Ben-Arie A. , Appelman Z. , Or Y. , Hagay Z.
Published: April 2003

Traditional management of persistent ovarian cysts in pregnancy is explorative laparotomy at 16–20 weeks of gestation and resection of the tumor. Scheduling surgery to this time of pregnancy is accepted in order to prevent abortions that are common whenever surgery is done in the first trimester, without delaying treatment of ovarian tumors which harbor a malignant potential. In the following article we report of 10 cases where simple ovarian cysts diagnosed during pregnancy were successfully treated by sonographically guided cyst aspiration. This new approach is justified with no fear of missing a malignant ovarian tumor due to strict ultrasonic characteristics of benign cysts that include unilocular simple appearing cyst with no solid echogenic parts, septations or papillary structures. For 5 of the 10 women undergoing aspiration, this constituted the definitive treatment, while the remaining 5 were later operated. We conclude that aspiration of simple cysts during pregnancy is safe, may save surgical intervention and in some cases this will be the definitive treatment.
Type of Human Papillomavirus and Expression of p53 in Elderly Women with Cervical Cancer
Authors: Saito J. , Hoshiai H. , Noda K.
Published: April 2003

To clarify the age-related genetic events in cervical cancer in elderly (≧65 years) women, 66 tissue specimens obtained from patients with stage Ib–IIb cervical carcinoma among two groups of women, 64 years of age or younger and 65 years of age and older, were analyzed for human papillomavirus (HPV) typing via polymerase chain reaction, the expression of p53 via immunohistochemical study, and clinical behavior. The prevalence of HPV DNA was higher in the younger group than in the older group (84.0 vs. 50.0%) as was the detection rate of HPV 16 (44.0 vs. 6.3%). In contrast, HPV 18, 33, 52, 58, and X were frequently detected in older patients. The positive rate of p53 overexpression in the older group was similar to that in the younger group (46.7 vs. 48.8%). There was no significant difference in the incidence of lymph node metastasis, histology, and the distribution of clinical stage between the two groups. Thus, in elderly Japanese women with stage Ib–IIb, the association of HPV of types other than HPV 16 is suggested to influence the progression of cervical cancer.
Amniotic Fluid Index and Labor Length of Pregnancies Induced Beyond 41 Weeks of Gestation with Unfavorable Cervix
Authors: Rizzo Nicola , Farina Antonio , Santarsiero Giuseppe , Di Luzio Luisa , Vitarelli Marisa , Bovicelli Alessandro , Carinci Paolo , Bovicelli Luciano
Published: April 2003

We evaluated if the response to prostaglandin E2 (PGE2) induction, in pregnancies completing 41 gestational weeks, is correlated to amniotic fluid index (AFI) values. A follow-up was performed from the time of the induction to the time of delivery of 63 pregnancies resulting in a spontaneous delivery showing unfavorable cervical examination at 41 weeks of gestation. This was induced by means of intracervical administration of PGE2 gel (Dinoprostone 0.5 mg). If the cervix was still unfavorable after 12 h, another gel administration followed. The number of PGE2 administration and AFI were both used as variables to correlate the time remaining before the delivery and the probability of delivery (Kaplan-Meier and Cox algorithms). Gestational age, parity, neonatal weight, and APGAR 5′ were used as covariates. A cut-off of AFI >6 better discriminates two groups regarding the probability of delivery at paired hours from the beginning of the induction. A statistically significant difference was demonstrated in only those patients which did not deliver within 12 h (44 cases). Multivariate analysis (Cox regression) yielded an adjusted odds ratio associated to the probability of delivery of 0.47 (0.23–0.95, 95% CI, p value = 0.0354) for AFI≤6 vs. AFI >6.
Serum Angiogenin Levels during Menstrual Cycle and Pregnancy
Authors: Hayashi Keiji , Yanagihara Toshihiro , Hata Toshiyuki
Published: April 2003

Objective: To evaluate alterations in maternal circulating angiogenin levels with advancing gestation and to assess the effect of labor stress on serum angiogenin levels in neonates delivered vaginally and by cesarean section. Methods: The maternal circulating angiogenin concentrations were compared in 37 normotensive nonpregnant women, in 60 normotensive pregnant women from 7 to 41 weeks of gestation, and in 12 normotensive postpartum women on the 3rd puerperal day. The serum angiogenin concentrations were also measured in 12 patients with threatened premature labor. Moreover, maternal and fetal serum angiogenin samples before and after delivery were used to determine differences in 12 neonates delivered vaginally and in 11 neonates delivered by elective cesarean section. The serum angiogenin level was measured using an enzyme-linked immunosorbent assay. Results: There was no significant difference in serum angiogenin levels during each phase of the menstrual cycle. The serum angiogenin levels were decreaseing until 15 weeks of gestation and increasing thereafter. There was no significant difference in serum angiogenin levels between normal pregnant women and in patients with threatened premature labor. Labor stress did not affect either maternal or fetal serum angiogenin concentrations. The serum angiogenin levels of the neonates were significantly lower than those in maternal serum after both vaginal delivery and delivery by cesarean section. Conclusion: These results suggest that regulatory mechanisms of angiogenin may exist during pregnancy.
Urinary Orotic Acid Levels in Normal Pregnancy and Pregnancy-Induced Hypertension
Authors: Furutani Kouichi , Ochi Hiroshi , Matsubara Keiichi , Ito Masaharu , Togari Hajime
Published: April 2003

Our objective was to study the urinary levels of orotic acid in normal pregnancy and in pregnancy-induced hypertension. Such levels were measured using high-performance liquid chromatography with column-switching. The levels of urinary orotic acid (μmol/g creatinine) in normal pregnancy (n = 14) were 6.9 ± 2.3 (first trimester), 10.1 ± 2.4 (20 weeks) and 12.0 ± 3.7 (30 weeks). In pregnancy-induced hypertension (n = 14), the corresponding levels were 6.5 ± 1.7, 7.8 ± 2.7 and 7.6 ± 2.3, respectively. Normal pregnant subjects individually showed a significant elevation at 20 and 30 weeks of gestation as compared with those in the first trimester (p < 0.01). A high consumption of arginine in nitric oxide production during normal pregnancy may cause a physiological elevation of urinary orotic acid. The absence of an elevation in pregnancy-induced hypertension may be associated with a decrease in nitric oxide production.
Endometrial Response to Sexual Steroids as Assessed by Prostaglandin F2α Output in Explant Culture and Hormone Receptor Expression
Authors: Illouz Séverine , Boubli Léon , Lavaut Marie-Noëlle , Allasia Claude , Charpin Colette
Published: April 2003

The objective of this study was to evaluate the endometrial response to sexual steroids in organ culture using two means: prostaglandin (PG) F2α output in medium culture and steroid receptor immunoexpression in tissue. Human endometrium samples were classified in homogeneous and heterogeneous proliferative or secretory subsets. In proliferative endometrium explant culture, progesterone (10–7 M) induced a significant decrease in PGF2α output, but this was not the case in secretory endometrium, whereas no significant effect of estradiol (10–8 M) was observed. Before culture, homogeneous and heterogeneous proliferative endometrium presented the same pattern of estradiol receptor (ER) and progesterone receptor (PR) expression evaluated by quantitative immunocytochemistry. After culture, immunoreactive ER and PR were detected on the explant. PR immunoexpression rates after culture were lower than before culture in glands on homogeneous proliferative and in stroma on heterogeneous proliferative endometrium explants without in vitro steroid addition. In secretory endometrium, no significant difference was observed between ER or PR immunoexpression rates before culture and after culture. These results provided the hormonal receptivity status of endometrium after culture and will thus serve as a reference for evaluating in vitro steroid effects on endometrium explants. Our preliminary results suggest that cultures of endometrium explants are a valid model for studying the effects of hormonal treatment on homogeneous as well as heterogeneous endometrium. These data could be particularly relevant for evaluating the potential response to hormone stimulation and treatment of endometria sampled in perimenopausal patients.
Chronic Intrauterine Bleeding and Fetal Growth at Less than 32 Weeks of Gestation
Authors: Sherer David M. , Salafia Carolyn M.
Published: April 2003

Placental hemosiderin deposition representing intrauterine bleeding at least 24–48 h before delivery is detected frequently in prematurity. The objective of this study was to assess incidence and site of histologic evidence of intrauterine bleeding in association with fetal growth in prematurity. Placentas of consecutive nonanomalous singleton liveborns delivered <32 weeks of gestation were studied for the presence of hemosiderin in decidua of the placental basal plate or extraplacental membranes (confirmed by Prussian blue stain). Cases of placenta previa, clinical abruption, or coagulopathy and cases in whom obstetric and neonatal gestational age assessment differed by >2 weeks were excluded. A single reviewer blinded to clinical data except for gestational age at delivery assessed the presence of decidual hemosiderin. Statistical analysis included ANOVA, and Mann-Whitney U test with p < 0.05 considered significant. The study included 352 patients delivered for principal indication of premature rupture of membranes (PROM) or preterm labor (PTL) and 78 patients delivered for preeclampsia between 1989 and 1994. Mean birth weight percentiles for neonates delivered following PROM/PTL versus preeclampsia were: no decidual hemosiderin 42 ± 25 versus 17.4 ± 25, extraplacental membrane hemosiderin 42 ± 25 versus 9.2 ± 10, placental basal plate hemosiderin 42 ± 25 versus 17 ± 24, and hemosiderin in both sites 27 ± 21 versus 6.4 ± 10 (p = 0.02). Hemosiderin deposition in both placental basal plate and extraplacental decidua is associated with significantly lower mean birth weight percentiles in PROM/PTL at less than 32 weeks of gestation. We postulate that in these patients placental disruption which accompanies decidual bleeding may explain the relatively impaired fetal growth. In preeclampsia, hemosiderin depositions are not associated with further impaired fetal growth.
A 22-Week Cervical Pregnancy
Authors: Has Recep , Ermiş Hayri , Ibrahimoglu Lem’i , Yildirim Alkan
Published: April 2003

We report on a cervical pregnancy at advanced gestational age. Misdiagnosis allowed pregnancy to proceed until the 22nd week of gestation and made its management more complicated. An abdominal hysterectomy with preservation of the adnexa was performed.
A Clinicohysteroscopic Scoring System of Intrauterine Adhesions
Authors: Nasr Ahmed L. Aboul , Al-Inany Hesham G. , Thabet Saaed M. , Aboulghar Mouhamed
Published: April 2003

We propose a new scoring system for intrauterine adhesions (IUA) that may predict the prognosis after hysteroscopic adhesiolysis. We analyzed hysteroscopic findings and clinical data of patients diagnosed as having IUA by reviewing previously published hysteroscopic classifications of IUA. The data were subjected to evaluation according to the most popular classifications in addition to the proposed classification using a scoring system for different parameters. The results obtained by the proposed scoring system matched well with other classifications regarding grade I and III IUA. But in the cases with moderate IUA (grade II), there was overlap between the classifications (sensitivity 58.3%) which can be attributed to considering the menstrual and reproductive history. Further studies are needed to assess its prognostic value.
Changes in Plasma Adenosine Concentrations during Normal Pregnancy
Authors: Yoneyama Yoshio , Suzuki Shunji , Sawa Rintaro , Takeuchi Tsutomu , Kobayashi Hajime , Takei Rintaro , Kiyokawa Yasuko , Otsubo Yasuo , Hayashi Zuisei , Araki Tsutomu
Published: April 2003

The aim of this study was to measure changes in plasma adenosine concentration [ADO] during a normal pregnancy and to evaluate the possible role of platelets and red blood cells (RBC) as causes of changes in plasma [ADO]. We measured the plasma [ADO] in normal pregnant women (n = 11) during the first, second and third trimesters. The mean plasma [ADO] in the third trimester was 0.41 ± 0.08 μM (means ± SEM), significantly higher than in the first and second trimesters (p < 0.05). In pregnant women, platelet and RBC counts, hematocrit and hemoglobin concentration decreased slightly throughout the pregnancy. The elevation in the plasma [ADO] correlated inversely with the platelet count (r = –0.43, p < 0.05). These results suggest that an increase in the plasma [ADO] in the third trimester may be attributed to the enhanced adenosine release from activated platelets.
Gamma-Delta T Cells in Midgestation Human Placental Villi
Authors: Bonney Elizabeth A. , Pudney Jeffrey , Anderson Deborah J. , Hill Joseph A.
Published: April 2003

One question that remains is how the immune system at the maternal-fetal interface supports tolerance of the fetus while at the same time protecting it from infection. A potential answer is that local innate immunity is augmented while adaptive immunity is downregulated. In this study, we focus on T cells of the γ-δ lineage, thought to be important in certain innate responses. Using tissue from normal pregnancies, we documented the presence of γ-δ T cells and their counterpart, α-β T cells, in midgestation human placental villi. The variable presence of these two T cell lineages in this anatomic site may suggest differential regulation, and herein we describe potential mechanisms for this phenomenon.
A Case of XY Pure Gonadal Dysgenesis with 46,XYp–/47,XXYp– Karyotype Whose Gonadoblastoma Was Removed Laparoscopically
Authors: Takai Yasushi , Tsutsumi Osamu , Harada Ikuko , Morita Yutaka , Momoeda Mikio , Fukushima Yoshimitsu , Taketani Yuji
Published: April 2003

A case of pure gonadal dysgenesis was investigated. The patient was an 18-year-old Japanese woman with a history of primary amenorrhea. She had poorly developed breasts, a hypoplastic uterus, a normal vagina and infantile genitalia. The patient’s karyotype was 46,XYp–/ 47,XXYp–. Microsatellite analysis revealed that the X chromosomes of this patient originated from one of the two maternal X chromosomes. DNA analysis of the Y chromosome revealed that she had a deletion of SRY (the sex-determining region on the Y chromosome). She underwent laparoscopic gonadectomies with a final pathology consistent with gonadoblastoma. Laparoscopic surgery is recommended as it is much less invasive and associated with rapid postoperative recovery.
Prophylactic Therapy in a Pregnant Woman with Severe Factor VII Deficiency
Authors: De Leo V. , Ditto A. , Morgante G. , La Marca A. , Massafra C. , Guidoni C.G.
Published: April 2003

This paper reports a case of factor VII deficiency, a very rare autosomal recessive disorder, in a primipara at 37 weeks of gestation in whom we administered prophylactic therapy with factor VII every 12 h until 24 h after delivery. The prophylactic use of factor VII enabled the woman to deliver without hemorrhagic complications.
Prognostic Factors in Metastatic Malignant Melanoma
Authors: Falkson Carla I. , Falkson Hendre C.
Published: April 2003

Prognostic factors in 236 patients with metastatic malignant melanoma were analyzed. The patients were all entered on clinical research studies at a single institution. Univariate and multivariate analyses were performed on data which was prospectively collected. Seven independent variables were analyzed for effect on response, time to treatment failure (TTF) and survival. Univariate analysis identified four factors which significantly effected response, TTF and survival: PS, dominant site of disease, number of sites of disease and treatment. In multivariate analyses dominant site of disease and treatment remained significant factors influencing response rates, but performance status (PS) and number of sites of metastases lost statistical significance. Treatment and number of sites were significant for TTF and treatment, PS and disease-free interval were significant for survival. The identification of prognostic factors may lead to identification of subgroups of patients who may benefit from existing treatment programs, and may allow for new treatment programs to be designed with greater insight, logic and rationale.
Mitomycin C, Epirubicin and Cisplatin versus Mitomycin C Alone as Therapy for Carcinoma of Unknown Primary Origin
Authors: Falkson Carla I. , Cohen G.L.
Published: April 2003

Carcinoma of unknown primary (CUP) site accounts for approximately 6.5% of all cancers. Optimal therapy for patients with CUP has not yet been delineated. The current study was undertaken to evaluate response, time to treatment failure and survival in patients with CUP treated with a combination regimen comprising mitomycin C, epirubicin and cisplatin (MEP) versus mitomycin C alone (MITOC). Eighty-four patients with CUP were randomised to receive either the combination (MEP) or MITOC. Both treatment arms were well matched for age, gender, performance status, dominant site and number of disease sites. Eighty of the above patients were evaluable. Twenty patients (50%) treated with MEP responded to treatment compared with 7 (17%) who received MITOC. Grade III–IV hemopoietic toxicity was documented in 2 patients treated with MEP and no patients treated with MITOC. A single patient treated with MEP developed grade I peripheral neuropathy. Median time to treatment failure was 4.5 months for patients receiving MEP as opposed to 2 months for those receiving MITOC (p = 0.05). Median survival was 9.4 months in patients treated with MEP compared to 5.4 months in those receiving MITOC (p = 0.05). This study indicates that the addition of cisplatin and epirubicin to MITOC results in a significant improvement in the response rate, time to treatment failure and survival in patients with adenocarcinoma of unknown primary site.
Heated Intraoperative Intraperitoneal Mitomycin C and Early Postoperative Intraperitoneal 5-Fluorouracil: Pharmacokinetic Studies
Authors: Jacquet Pierre , Averbach Andrew , Stephens Arvil D. , Stuart O. Anthony , Chang David , Sugarbaker Paul H.
Published: April 2003

Purpose: The purpose of this study was to report the pharmacokinetics of heated intraoperative intraperitoneal mitomycin C (MMC) and to analyze the impact of heat, extent of peritoneal resections, and effect of intraoperative hyperthermic chemotherapy on the pharmacological properties of the peritoneal plasma barrier. Methods: Sixty patients with peritoneal carcinomatosis were included in a phase I/II study combining cytoreductive surgery with 2 h of heated intraperitoneal mitomycin C in an intraoperative lavage technique and one cycle of early postoperative 5-fluorouracil (5-FU) given on postoperative days 1–5. Three pharmacokinetic analyses were performed: (1) pharmacokinetics of heated intraoperative intraperitoneal MMC was determined for 18 patients by sampling peritoneal fluid, plasma, and urine during the 2-h procedure; (2) impact of peritoneal resections on MMC pharmacokinetics was assessed by comparing a group of patients who underwent ≤1 peritonectomy procedure (minimal surgery) to a group of patients who underwent ≥2 peritonectomy procedures (extensive surgery), and (3) effects of heated intraoperative intraperitoneal chemotherapy on the pharmacokinetics of early postoperative intraperitoneal 5-FU by comparing a group of patients treated with heated intraoperative intraperitoneal MMC to a control group who did not receive heated intraoperative intraperitoneal chemotherapy. Results: The mean dose of heated intraoperative intraperitoneal MMC per patient was 22.5 ± 7.1 mg (12.9 ± 3.8 mg/m2). Drug absorption from perfusate was 14.3 ± 2.7 mg. The mean aeras under the curve (AUC) for perfusate and plasma were, respectively, 340 ± 138 and 15 ± 4 µg/ml × min. The mean AUC peritoneal fluid/plasma ratio was 23.5 ± 5.8. Patients who underwent extensive peritoneal resections exhibited a significantly (p = 0.037; Wilcoxon rank test) increased peak plasma concentration of MMC, a significantly (p = 0.029) increased AUC of plasma concentrations and a significantly (p = 0.034) decreased peritoneal fluid/plasma AUC ratio. Pharmacokinetic studies of early postoperative intraperitoneal 5-FU showed no significant difference in plasma AUC, perfusate AUC and AUC ratio between patients who received and those who did not receive heated intraoperative intraperitoneal MMC. Conclusions: Heated intraoperative intraperitoneal chemotherapy achieves high peritoneal concentrations of MMC with limited systemic absorption. Systemic drug absorption during heated intraoperative intraperitoneal chemotherapy is increased when extensive peritoneal resections are performed, but such slight increases are unlikely to change the risk of systemic drug toxicities. Heated intraoperative intraperitoneal chemotherapy does not alter the pharmacokinetics of early postoperative intraperitoneal 5-FU.
Chemotherapy with Methotrexate, Carboplatin, Mitoxantrone (Novantrone) and Vincristine (Oncovin) in Transitional-Cell Urothelial Cancer
Authors: Pectasides D. , Mylonakis A. , Antoniou F. , Kostopoulou M. , Triantaphyllis D. , Papadopoulou M. , Varthalitis J. , Dimitriadis M. , Athanassiou A.
Published: April 2003

Forty-four patients with either metastatic or locally advanced transitional cell carcinoma of the bladder were treated with the MCNO regimen (methotrexate 300 mg/m2 in 1,000 ml normal saline as a 4-hour infusion on days 1 and 14 with leucovorin rescue 15 mg 6-hourly for 6 doses; carboplatin 300 mg/m2 in 250 ml 5% distilled water as a 1-hour infusion on day 1; mitoxantrone (Novantrone) 10 mg/m2 in 100 ml 5% distilled water as a 30-min infusion on day 1, and vincristine (Oncovin) 1 mg/m2 as an intravenous bolus on days 1 and 14. Patients with metastatic disease were treated with 6 cycles, while patients with locally advanced disease were treated with 4 cycles of induction chemotherapy followed by cystectomy or radiotherapy. The overall response rate was 40%, with 15% complete response (CR). The responses were better for patients with locally advanced disease (CR 25%, partial response, PR, 31.25%, response rate, RR, 56.25%) than for those with metastatic disease (CR 8.3%, PR 20.83%, RR 29.1%). The differences in these results were probably due to the bad performance status and the presence of visceral metastases in patients with generalized disease. The overall median survival was 14 months, with responders living longer (median survival 28.8 months in patients with locally advanced disease and 22.9 months in patients with metastatic disease) than non-responders (median survival 16 months in patients with locally advanced disease and 8.9 months in patients with metastatic disease). The difference in survival between responders and non-responders was statistically significant in both groups of patients. Toxicity was moderate, but manageable. The MCNO regimen appears to have a lower efficacy than that obtained with cisplatin-based regimens for the treatment of metastatic disease and rather similar efficacy for the treatment of locally advanced urothelial-cell cancer. Therapy with this regimen, though less toxic, may not be a reliable alternative in elderly patients with visceral metastases and a performance status of ≥2.
Overexpression of c-erbB-3 in Various Stages of Human Squamous Cell Carcinomas
Authors: Funayama Takaaki , Nakanishi Tohru , Takahashi Korjiro , Taniguchi Shigehiko , Takigawa Masaharu , Matsumura Tomohiro
Published: April 2003

Amplification of the c-erbB-3 gene and the expression of its mRNA and protein in human squamous cell carcinomas (SCC) were analyzed. Although no amplification of the c-erbB-3 gene was observed, overexpression of its mRNA was observed in SCC by RT-PCR. The expression of this gene in SCC was 15–50 times higher than in normal fibroblasts. Overexpression of the secreted type of erbB-3 mRNA was also observed in all SCC. Moreover, overproduction of the c-erbB-3 protein was also detected in SCC by dot blot analysis using anti-c-erbB-3 monoclonal antibodies. In nude mice, the expression of c-erbB-3 mRNA was higher in metastatic tumors compared with primary tumors. These results suggest that both the transmembrane and secreted types of c-erbB-3 play a significant role in the formation and development of SCC.
Mortality from Cancer of the Male Reproductive Tract and Environmental Exposure to the Anti-Androgen p,p′-Dichlorodiphenyldichloroethylene in the United States
Authors: Cocco Pierluigi , Benichou Jacques
Published: April 2003

The association of prostate cancer mortality and testicular cancer mortality with environmental exposure to the antiandrogen dichlorodiphenyltrichloroethane (DDT) derivative p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE) in the USA was explored in the period 1971–1994 using multiple linear regression analysis. Environmental p,p′-DDE contamination by state was estimated by p,p′-DDE concentrations in the subcutaneous fat of population samples and by measurements of p,p′-DDE in tree bark. On average, African Americans had adipose p,p′-DDE levels 74% higher than Whites (8.49 vs. 4.88 µg/g; p < 0.001). Neither prostate cancer mortality nor testicular cancer mortality showed a positive association with either indicator of p,p′-DDE environmental contamination. On the contrary, the regression coefficient for prostate cancer was constantly inverse for adipose p,p′-DDE along the period of study, although it approached statistical significance only for African Americans in 1981–1985 (β = –0.755; 0.10 > p > 0.05). This ecologic study does not provide support to the hypothesis of a link between environmental exposure to DDT derivatives and cancer of the male reproductive tract.
Paclitaxel-Induced Cell-Mediated Hypersensitivity Pneumonitis
Authors: Fujimori K. , Yokoyama A. , Kurita Y. , Uno K. , Saijo N.
Published: April 2003

A 73-year-old man with mild inactive interstitial pneumonitis and non-small cell bronchogenic carcinoma developed a cell-mediated hypersensitivity pneumonitis within 15 days following a second exposure to paclitaxel. Histological features of transbronchial lung biopsy were consistent with interstitial pneumonitis. Bronchoalveolar lavage showed increased lymphocytes and eosinophils, and decreased helper/suppressor T lymphocyte ratio. Leukocyte migration inhibitory test was positive for paclitaxel. These results support the possibility that paclitaxel-induced pneumonitis is due to delayed type hypersensitivity; they also support the hypothesis of a central role of T lymphocytes in drug-induced pneumonitis.
Increased Cyclin D1 in Human Pancreatic Cancer Is Associated with Decreased Postoperative Survival
Authors: Kornmann Marko , Ishiwata Toshiyuki , Itakura Jun , Tangvoranuntakul Pam , Beger Hans G. , Korc Murray
Published: April 2003

Cyclin D1 belongs to a family of protein kinases that have been implicated in cell cycle regulation. In the present study we characterized cyclin D1 expression in 6 cultured human pancreatic cancer cell lines and in normal and cancerous human pancreatic tissues. A 4.4-kb cyclin D1 mRNA transcript was present in all cell lines and in all pancreatic tissues. Cyclin D1 mRNA levels were 2.1-fold higher in the pancreatic cancers than in normal pancreatic tissues (p < 0.0002). Cancer patients with lower cyclin D1 levels (n = 16) had a median survival of 15.5 months whereas patients with higher levels (n = 16) had a median survival of 6.5 months (p < 0.007). These data indicate that cyclin D1 expression may serve as a predictor of postoperative survival in pancreatic cancer patients, and raise the possibility that treatment modalities blocking cyclin D1 activity may have a future role in the therapy of these patients.
Diffuse Large Cell Lymphomas: Identification of Prognostic Factors and Validation of the International Non-Hodgkin’s Lymphoma Prognostic Index
Authors: Nicolaides C. , Fountzilas G. , Zoumbos N. , Skarlos D. , Kosmidis P. , Pectasides D. , Karabelis A. , Giannakakis T. , Symeonidis A. , Papadopoulos A. , Antoniou F. , Pavlidis N.
Published: April 2003

Several clinical prognostic factors have been identified that predict treatment outcome in patients with diffuse large cell lymphomas. An International Non-Hodgkin’s Lymphoma Prognostic Index (IPI) has been recently formulated. We tried to identify the clinical prognostic factors that predict treatment outcome in Greek patients with diffuse large cell lymphomas and validated the IPI in these patients. The possible prognostic variables for tumor response, relapse-free (RFS) and overall survival (OS) were analyzed in 239 consecutive patients treated with anthracycline-based chemotherapy regimens. In univariate analysis, factors associated with poor response were stages III–IV, performance status (PS) ≥2, spleen and bone marrow involvement, more than one extranodal site involved, increased lactate dehydrogenase (LDH) value, hemoglobin (Hb) <12 g/dl, albumin <3.5 g/dl, erythrocyte sedimentation rate (ESR) >50 mm/h. Multivariate analysis identified stage, PS, more than one extranodal site involved, increased LDH level, and ESR > 50 mm/h as the factors more predictive of poor response. For RFS, multiple Cox analysis found stages III–IV and bone marrow involvement to be statistically significant. For OS, multiple Cox analysis identified stage III–IV, PS ≥2, bone marrow involvement, more than one extranodal site involved, increased LDH level and ESR > 50 mm/h as negative prognostic factors. Patients stratified in the different risk groups of the IPI had a significantly different outcome regarding complete response (CR) rate, RFS and OS. In conclusion, although age >60 years was not recognized as an adverse factor in this analysis, our patients stratified in the different groups of the IPI had significant differences in CR rate, 2-year RFS and OS verifying the prognostic significance of the index. Bone marrow involvement and ESR > 50 mm/h, parameters that are not included in the IPI, adversely affected survival.