bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Body Composition and Fat Distribution in Long-Term Users of Hormone Replacement Therapy
Authors: Perrone G. , Liu Y. , Capri O. , Critelli C. , Barillaro F. , Galoppi P. , Zichella L.
Published: April 2003

The aim of the study was to evaluate the body composition and fat distribution in long-term users of hormonal replacement therapy (HRT). 18 healthy menopausal women, long-term users of HRT (transdermal estradiol 50 μg continuously administered and 10 mg/day of medroxyprogesterone acetate for 12 days/month) and 18 healthy menopausal women, who had never used HRT were included in the study. Age, menopausal age, parity, weight and height (body mass index, weight/height2), and lifestyle habits were similar. Waist and hip circumference, body composition and waist/hip ratio were measured and the results were analyzed. No significant difference was demonstrated in fat and water percentage, and waist/hip ratio. Nevertheless, the waist circumference of long-term HRT users was significantly lower than that of non-users. In conclusion, abdominal fat in long-term HRT users is lower than that of non-users of similar age, menopausal age and body mass index.
Clinical Use of Serum c-erbB-2 in Patients with Ovarian Masses
Authors: Cheung T.H. , Wong Y.F. , Chung T.K.H. , Maimonis P. , Chang A.M.Z.
Published: April 2003

The c-erbB-2 (Her-2/neu) gene product has a large extracellular domain (ECD) and part of which could be identified in the serum. We measured the serum level of c-erbB-2 ECD in 93 patients, who presented with ovarian masses, with an enzyme immunoassay test and an elevated level was found in 5.5, 16.7 and 38% of patients with benign, borderline and malignant ovarian neoplasms, respectively. This serum marker may reflect the overexpression of c-erbB-2 gene in tumor tissues, which is associated with poor prognosis. However, measurement of c-erbB-2 ECD when used alone or in combination with CA 125 is not useful in differentiating benign from malignant ovarian tumors.
Investigation of Kinetic of Lead during Pregnancy and Lactation
Authors: Nashashibi Nabil , Cardamakis Emmanuel , Bolbos George , Tzingounis Vassilios
Published: April 2003

Lead concentration was estimated in peripheral blood, milk as well as in cord blood in 47 women and their infants, using atomic absorption spectrophotometry. Mean maternal blood lead concentration was 14.9 ± 4.1 μg/dl, while in milk a mean level of 2.0 ± 0.5 μg/dl was estimated. Mean lead concentration in cord blood was 13.1 ± 3.7 μg/dl. Analysis of these data showed a statistically significant correlation between lead maternal and cord blood concentration (r = 0.413, p = 0.01) or maternal blood and milk (r = 0.543, p < 0.01). The difference between maternal and cord blood might be indicative of a small filtering effect of placental tissue on lead transfer to the fetus. Placenta can determine 57.4% of the level of lead transferred to the fetus in a dynamic modus, while 42.6% depends on the pollution’s level of mothers.
The Predictive Power of Endocrine Tests for the Diagnosis of Polycystic Ovaries in Women with Oligoamenorrhea
Authors: Turhan Nilgün Öztürk , Toppare Mete Fuad , Seçkin Neslihan Carda , Dilmen Gülçin
Published: April 2003

Various hormonal parameters and the best logistic regression model to predict disease probability were evaluated in women with polycystic ovary syndrome (PCOS). Concentrations of LH, FSH, LH/FSH ratio, testosterone, free testosterone, SHBG and insulin in serum were recorded in 32 women with PCOS and in 25 controls. A model including LH/FSH ratio, insulin and testosterone measurements yielded the best goodness of fit for classification of women with and without PCOS in the logistic regression analysis. Only LH/FSH ratio and insulin were retained as significant variables. The diagnostic characteristics of LH/FSH ratio and insulin for PCOS when compared by receiver-operator characteristic analysis were found to be equally effective. By combining these two variables a higher area under curve was obtained. LH/FSH ratio, insulin or the combination of these two can predict the disease probability in women with PCOS.
Plasma Nitric Oxide Metabolites and Lipid Peroxide Levels in Preeclamptic Pregnant Women before and after Delivery
Authors: Mutlu-Türkoglu Ü. , Aykaç-Toker G. , Ibrahimoglu L. , Ademoglu E. , Uysal M.
Published: April 2003

It has been suggested that oxidative stress may cause endothelial dysfunction and that endothelial dysfunction may lead to hypertension by reduced release of vasodilating agents such as nitric oxide (NO). In this study, we investigated the relationship between serum NO and lipid peroxides in preeclamptic and normal pregnant women before and after delivery. Plasma from women with preeclampsia had significantly lower nitrate/nitrite concentrations and significantly higher lipid peroxide levels than normal pregnant women before the delivery. Lipid peroxide levels were significantly elevated in preeclamptic placenta. After delivery in the preeclamptic group the plasma concentration of nitrate/nitrite was increased and plasma thiobarbituric acid reactive substance levels decreased, while these parameters remained unchanged in the normal pregnants women. These results indicate that high levels of lipid peroxides in the circulation may be the cause of lowered NO synthesis and hypertension observed in preeclamptic women.
A Three-Year Postoperative Evaluation of Tension-Free Vaginal Tape
Authors: Olsson I. , Kroon U.-B.
Published: April 2003

The aim of this study was to evaluate the outcome of tension-free vaginal tape (TVT) 3 years after surgery. Fifty-one women (mean age 52.9) with a genuine stress incontinence underwent the TVT operation. In 10 patients, a prolapse repair was also done simultaneously. The majority of the patients were operated under local anesthesia. All patients were evaluated 3 years after the procedure using a protocol for objective and subjective assessment of the outcome including an evaluation of quality of life related to urinary incontinence. According to the protocol, 46 women (90%) were successfully cured, another 3 patients (6%) were improved, whereas 2 patients (4%) were classified as failures. Few complications occurred. We conclude that TVT is a simple and well-accepted minimal invasive surgery for treatment of female urinary stress incontinence. The outcome 3 years after the operation showed no signs of deterioration compared to the results shortly after surgery. The cure rate of 90% is comparable with the best results of other surgical treatments for female urinary incontinence.
Therapeutic Value of Selective Salpingography for Infertile Women with Patent Fallopian Tubes: The Impact on Pregnancy Rate
Authors: Kamiyama Shigeru , Miyagi Hiroko , Kanazawa Koji
Published: April 2003

Objective: To determine the therapeutic value of selective salpingography (SSG) for infertile women with patent fallopian tubes. Design: Retrospective, case-control analysis. Setting: University Hospital, infertility clinic. Patients: Infertile cases with patent tubes documented by hysterosalpingography (HSG) or by HSG followed by laparoscopic examination (n = 80). Intervention(s): Hysteroscopic SSG. Main Outcome Measure(s): Patency rate of tubes by SSG. Pregnancy rate following SSG. Result(s): Eighty cases were divided into the study group (SSG performed, 37 cases) and the case-control group (SSG not performed, 43 cases). Successful SSG of at least one tube was obtained in all of 37 cases (100%) in whom SSG was attempted. A patency rate of 95.9% was documented in the 73 cannulated tubes of these cases. The total subsequent pregnancy rate (48.6%) within 12 months of follow-up after SSG was significantly higher than that (11.6%) obtained in the control group (p < 0.001). The cumulative pregnancy rate in the study group was also significantly higher than that in the control group (p < 0.001). Conclusion(s): The findings of the present study encourage the application of SSG to infertile women, either as a sole therapeutic approach or in association with other methods of assisted reproductive technology, even if their fallopian tubes are shown to be patent by HSG.
Accuracy of Intraoperative Frozen-Section Diagnosis in Stage I Endometrial Adenocarcinoma
Authors: Kucera E. , Kainz Ch. , Reinthaller A. , Sliutz G. , Leodolter S. , Kucera H. , Breitenecker G.
Published: April 2003

The purpose of our study was to determine if frozen-section diagnosis accurately identified patients suffering from endometrial adenocarcinoma FIGO stage I for surgical staging consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal cytology, and complete bilateral pelvic lymphadenectomy in moderately differentiated tumors with myometrial invasion. In all poorly differentiated tumors, and in all tumors with deep myometrial invasion (more than 50%) surgical staging included additional para-aortic lymphadenectomy. We performed a retrospective study including 70 patients. Frozen-section diagnosis of myometrial invasion and tumor grade was compared with permanent-section diagnosis. The accuracy rates were determined, and compared with accuracy rates of frozen-section diagnosis in the literature, and a total accuracy rate for 624 patients suffering from stage I endometrial adenocarcinoma was evaluated. In our patient collective, the overall accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade was 80 and 84%, respectively. In the five comparable studies, the mean accuracy rate for myometrial invasion and tumor grade was 89 and 84%, respectively. In combination with the five comparable studies our recent study produced an accuracy rate of frozen-section diagnosis for myometrial invasion and tumor grade of 88 and 84% in 624 patients, respectively. Despite an accuracy level of frozen-section diagnosis for myometrial invasion of 80 and 84% for tumor grade in our patient collective, all patients who required surgical staging were accurately identified.
Effect of Danazol and Ovariectomy on Matrix Metalloproteinases in Rat Uteri
Authors: Willingham Allan K.
Published: April 2003

The experiments described in this report were designed to study the effects of danazol on matrix metalloproteinases in the rat uterus. Proteinases were analyzed by zymography in gels copolymerized with either gelatin or transferrin. There were no apparent effects of danazol on proteinases from rat uteri when analyzed in gelatin gels. However, in transferrin gels, not only did more bands appear in control samples but also there was a clear negative effect of danazol on the production of these proteinases. Similar results were obtained from uteri of ovariectomized rats. Again no differences were observed in gelatin gels but the control bands which appeared only on transferrin gels were missing in transferrin gels as a result of ovariectomy. These results indicate that there is an effect of estrogen on the synthesis of specific matrix metalloproteinases in the rat uterus and that these proteinases are only observed by zymography when gels are developed in transferrin but not collagen.
Placental Levels of Human Decidua- Associated Protein 200 in Normal Pregnancy and Missed Abortion
Authors: Halperin Reuvit , Hadas Eran , Bukovsky Ian , Schneider David
Published: April 2003

Levels of human decidua-associated protein (hDP)200 were measured in homogenized placental tissue samples obtained from 26 induced and 24 missed abortions at 8–23 weeks of pregnancy. No significant difference in the level of placental hDP200 was observed comparing normal pregnancies and missed abortions. Moreover, no significant change in the level of placental hDP200 was demonstrated throughout normal pregnancies and those ending with missed abortions. Our results show that the level of hDP200 in placental tissue, measured by double-site ELISA, is probably incompatible with the normal continuation of pregnancy.
Alterations in the Immune System of Patients with Imminent Preterm Labour
Authors: Oleszczuk Jan , Darmochwal-Kolarz Dorota , Leszczynska-Gorzelak Bozena , Rolinski Jacek
Published: April 2003

Premature labour is the major cause of perinatal morbidity and mortality. The aetiology of most cases of preterm labour remains unknown. We tried to estimate whether immunological changes are present in patients with preterm labour. Fourteen patients with imminent preterm labour and 12 healthy women with uncomplicated pregnancies were included in the study. The specific lymphocyte antigens were determined using direct staining with monoclonal antibodies and analysed by flow cytometry. We observed that CD8+ lymphocyte percentage was significantly lower in the group of patients with preterm labour when compared to controls (p < 0.001). This deficit was related to T CD8+11b+ suppressor lymphocytes, while the percentage of T CD8+11b– cytotoxic lymphocytes did not differ in both studied groups. Furthermore, the percentage of T CD3+ lymphocytes was significantly lower and that of B CD19+ cells higher in the study group when compared to controls. Similarly, the percentage of CD4+45RA naive cells was higher in the group of patients with imminent preterm labour, while the percentage of memory CD4+45RO+ cells was lower in the study group in comparison with the control group. These observations suggest that alterations in maternal immunological parameters can be associated with the mechanisms mediating preterm labour.
Relative Abundance of Placental Pro-Atrial Natriuretic Factor mRNA in Normal Pregnancy and Pre-Eclampsia
Authors: Gude N.M. , Stebbing P.N. , Wang L.-M. , Xue J.-R. , Brennecke S.P. , Lim A.T.
Published: April 2003

Atrial natriuretic factor (ANF), produced by cytotrophoblast cells of the human placenta, may be involved in the regulation of uteroplacental blood flow. Pre-eclampsia is associated with maternal hypertension and reduced uteroplacental perfusion. The relationship between pre-eclampsia and placental production of ANF is not known. This study measured pro-ANF mRNA levels by Northern blot analysis in placentae delivered by caesarean section at preterm and term gestations from women with normotensive and pre-eclamptic pregnancies and found no significant difference between pre-eclampsia and normal pregnancy at either gestation. This result suggests that placental production of ANF is not altered at the pretranslational level during pre-eclampsia.
Prolonged Labour Attributed to Large Fetus
Authors: Högberg Ulf , Lekås Berg Marie-Louise
Published: April 2003

The aim of this study is to assess the interactive dynamics of power, passenger and passage in relation to an adverse course of labour. The design was a community-based follow-up of all women with singleton pregnancies experiencing spontaneous term labour. Median of first stage was 2.6 h for multiparas and 3.7 h for primiparas. Median of second stage was 20 min for multiparas and 91 min for primiparas. Heavy birth weight significantly influenced a prolonged late first stage OR 6.6 (CI 2.1–21) and second stage of labour OR 4.5 (CI 1.5–14) among primiparas. The attributable proportions of heavy birth weight for prolonged labour were 19–21%. Large paediatric head circumference showed a positive correlation to prolonged late first stage OR 3.2 (CI 1.2–9) and intervention OR 7.2 (CI 1.8–35), with an attributable proportion of 22%. For multiparas no significant association were found. To conclude, this study indicates that heavy birth weight and large head circumference contribute to 1/5th of the prolongation of labour and interventions among primiparas.
Stress Vulnerability and Climacteric Symptoms: Life Events, Coping Behavior, and Severity of Symptoms
Authors: Igarashi Miyuki , Saito Hidekazu , Morioka Yukiko , Oiji Arata , Nadaoka Toshihide , Kashiwakura Masaki
Published: April 2003

To explore a possible association between climacteric symptoms and ways of coping with stress, a comparative study was conducted among 19 menopausal women who sought treatment for climacteric symptoms (the study group) and 44 healthy menopausal women (the control group). Life stress was assessed using a life event method in which factor analysis extracted four ways that women cope with stress: avoidance-oriented coping, consultation-oriented coping, aggression-expression coping, and problem-solving coping. The study group had a higher symptom score and was more prone to avoidance-oriented coping than the control group despite experiencing the same number of undesirable life events. The severity of climacteric symptoms correlated positively with the number of undesirable life events and the degree of avoidance-oriented coping and correlated negatively with the degree of aggression- expression coping for the study group. These results suggest that vulnerability to stress contributes to worsening climacteric symptoms caused by stress.
Development and Therapeutic Effect of Adoptively Transferred T Cells Primed by Tumor Lysate-Pulsed Autologous Dendritic Cells in a Patient with Metastatic Endometrial Cancer
Authors: Santin A.D. , Hermonat P.L. , Ravaggi A. , Bellone S. , Cowan C. , Coke C. , Pecorelli S. , Cannon M.J. , Parham G.P.
Published: April 2003

We describe a 65-year-old woman with a large surgically unresectable and chemoresistant liver metastasis of endometrial carcinoma who was treated by infusion with peripheral blood T cells stimulated with tumor lysate-pulsed autologous dendritic cells (DC). Extensive in vitro characterization of the DC-activated T cells included phenotypic analysis, cytotoxicity, and intracellular cytokine secretion. High cytotoxicity was observed against autologous tumor cells, but not against NK-sensitive K562 cells, autologous Con-A lymphoblasts, or autologous Epstein-Barr virus-transformed lymphoblastoid cells. Blocking studies demonstrated that lytic activity was HLA class I restricted. Two-color flow cytometric analysis revealed that a significant proportion of CD8+ T cells was also CD56+, and analysis of intracellular IFN-γ and IL-4 expression suggested a type 1 cytokine bias. The patient was treated by three infusions of tumor-specific T cells at 3- to 4-week intervals, and in vivo distribution of the T cells was followed by 111In oxine labeling and serial gamma camera imaging. Tumor localization and accumulation of labeled lymphocytes was consistently detected at serial time points following each injection. However, deep infiltration of the large tumor mass by activated T cells was minimal, as evaluated in 3 dimensions by single photon emission computerized tomography (SPECT) imaging. Transient serum increases of the tumor marker lactate dehydrogenase (LDH), were detectable after each injection. Similar posttreatment elevations were seen for serum uric acid and potassium. Clinically, stabilization of the large liver metastasis was obtained during treatment. Collectively, these results indicate that tumor-specific CD8+ cytotoxic T-cell responses can be generated in patients with endometrial cancer, and suggest that T-cell immunotherapy may be of therapeutic value in patients harboring metastatic disease.
Excellent Results of Postoperative Radiotherapy for Endometrial Stromal Sarcoma of Low-Grade Malignancy
Authors: Ishiko Osamu , Wakasa Ken-ichi , Honda Ken-ichi , Nakajima Satoko , Ogita Sachio
Published: April 2003

Endometrial stromal sarcoma of low-grade malignancy (ESSL) is a rare neoplasm, and neither preoperative diagnostic procedures nor standard therapy have yet been established. We treated 3 cases of ESSL in the past 27 years, and we report here one of these cases that was classified as stage III (according to the FIGO classification of endometrial carcinoma). Postoperative radiotherapy was used to treat a residual tumor, and the patient showed a complete response.
Congenital Fiber-Type Disproportion Presenting Antenatally with Clubfoot and Hydramnios
Authors: Bigner Dori R. , Rijhsinghani Asha , Yankowitz Jerome
Published: April 2003

This is a case of congenital fiber-type disproportion that presented prenatally with bilateral clubfoot, hydramnios, and reduced fetal movements. Although prognosis is generally good for this condition, the neonate presenting at birth may have a more severe form of congenital fiber-type disproportion with a high rate of mortality.
Subclassification of Small-for-Gestational-Age Fetus Using Fetal Doppler Velocimetry
Authors: Hata Toshiyuki , Aoki Showa , Manabe Atsushi , Kanenishi Kenji , Yamashiro Chizu , Tanaka Hirokazu , Yanagihara Toshihiro
Published: April 2003

Our purpose was to determine whether small-for-gestational-age (SGA) fetus can be divided to subclassified groups using fetal Doppler velocimetry. Fifty-four pregnant women with SGA infant delivered after 37 weeks of gestation were studied. After 24 weeks of gestation, fetal middle cerebral artery puslatility index (MCAPI) and umbilical artery pulsatility index (UAPI) were measured at 2- to 3-week intervals using Doppler ultrasound. Perinatal outcomes [operative delivery due to fetal distress, abnormal fetal heart rate (FHR) pattern, meconium staining, low Apgar score (<7), neonatal acidosis (umbilical artery blood pH <7.15), neonatal intensive care unit (NICU) admission due to neonatal asphyxia, and decreased amniotic fluid] were compared in subclassified SGA groups using fetal Doppler velocimetry. The number of SGA fetuses with normal MCAPI and UAPI (normal SGA group) was 39, and those with significantly low MCAPI but normal UAPI (eventful SGA group) 15, respectively. Birth age and birth weights in the eventful SGA group were significantly earlier and lower than those in the normal SGA group, respectively (p < 0.05, and p < 0.005). There were significant increases in operative deliveries, abnormal FHR patterns and decreased amniotic fluid in eventful SGA group, when compared with events related to normal SGA group. However, there were no significant differences in meconium staining of amniotic fluid, low Apgar score, neonatal acidosis, and NICU admission between the two groups. These results suggest that SGA fetus with abnormally low MCAPI but normal UAPI has more poor perinatal outcomes, compared with that with normal MCAPI and UAPI.
Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women
Authors: Salamalekis E. , Vitoratos N. , Kassanos D. , Loghis C. , Batalias L. , Panayotopoulos N. , Creatsas G.
Published: April 2003

The aim of this study was to evaluate whether sweeping of the membranes at term could shorten the length of pregnancy and reduce the incidence of postterm pregnancies. We randomly selected 104 nulliparas with uncomplicated pregnancy and gestational age between 281 and 287 days. Our patients were divided into three groups. Group A consisted of 34 women who were subjected to sweeping of the membranes. Uterine stimulation with oxytocin was applied in 35 women (group B), and 35 women (group C) were used as a control group. We had no significant reduction of the time interval from sweeping of the membranes until delivery (1.9 ± 1.2 days), compared to that of group B (2.1 ± 0.8 days) as well as that of the control group (2.5 ± 0.9 days). The incidence of spontaneous labor in patients after sweeping of the membranes was greater (67.6%) when compared with oxytocin-stimulated patients and the control group (p < 0.05). Furthermore, a better Bishop score was noted in patients of group A. No statistically significant difference was noted in the mode of delivery between the groups, but sweeping of the membranes significantly decreased the incidence of postterm pregnancies (p < 0.05). We concluded that sweeping of the membranes is an effective method for initiating labor in women with a gestational age between 40 and 41 weeks, thus reducing the need for induction.
Laparoscopically Assisted Vaginal Hysterectomy Using the Light-Endorsed Transvaginal Section Technique versus the Conventional Method: A Preliminary Study
Authors: Lee J.N. , Tsai E.M.
Published: April 2003

Laparoscopically assisted vaginal hysterectomy (LAVH) is now being used by an increasing number of gynecologists. However, problems, such as the long operating time, the inherent difficulty of the technique, and limitations of the skills of the surgeons, still exist. Pelvic adhesion, especially in the vesicouterine reflection, may increase the difficulty and morbidity of the operation. We here describe a simple technique, called light-endorsed transvaginal section (LETS), which can facilitate the effectiveness and safety of LAVH. We have designed prospective studies to compare results obtained in 50 cases treated using LAVH plus LETS (study group) with those obtained in 50 cases treated by conventional LAVH (control group). We further divided the study group into 25 ‘complicated’ cases (with pelvic adhesion) and 25 ‘easy’ cases (without pelvic adhesion). The results show that the LETS technique is a simple, safe, and easy way of increasing the efficacy of LAVH, especially as a supplement to LAVH in the presence of pelvic adhesions.
Comparison of Vaginal Shapes in Afro-American, Caucasian and Hispanic Women as Seen with Vinyl Polysiloxane Casting
Authors: Pendergrass Paula B. , Reeves Cornelia A. , Belovicz Meyer W. , Molter Darron J. , White Janet H.
Published: April 2003

Full vinyl polysiloxane casts of the vagina were obtained from 23 Afro-American, 39 Caucasian and 15 Hispanic women in lying, sitting and standing positions. A new shape, the pumpkin seed, was found in 40% of Afro-American women, but not in Caucasians or Hispanics. Analyses of cast and introital measurements revealed: (1) posterior cast length is significantly longer, anterior cast length is significantly shorter and cast width is significantly larger in Hispanics than in the other two groups and (2) the Caucasian introitus is significantly greater than that of the Afro-American subject.
Primary Vaginal Stone in an 11-Year-Old Recumbent Girl
Authors: Yoshimura Toshihiro , Nagata Yasushi , Matsuura Kohei , Okamura Hitoshi
Published: April 2003

Primary vaginal stones are extremely rare, particularly in young women. We describe the occurrence of a primary vaginal calculus in a severely retarded 11-year-old girl who was not diagnosed until she was examined using computerized tomography. We postulate that the calculus was formed as a consequence of urinary contamination of the vagina in association with incontinence and prolonged maintenance in a recumbent posture.
Placental Apoptosis in Normal and Abnormal Pregnancies
Authors: Halperin R. , Peller S. , Rotschild M. , Bukovsky I. , Schneider D.
Published: April 2003

The aim of this study was to demonstrate apoptosis in the human placenta in normal and abnormal pregnancies. The percentage of apoptotic cells in placental samples was quantified by analyzing the cell cycle of nuclei stained with propidium iodide using a flow cytometer. No significant difference in the percentage of apoptotic cells was obseved comparing the group of normal pregnancies (first and second trimesters) with those of missed abortions. There was also no difference in the incidence of apoptosis comparing placental samples obtained from chromosomally normal and abnormal pregnancies. Yet, there was a significant increase in the incidence of apoptosis in placental samples obtained from second and third trimesters as compared with those obtained from the first trimester (p < 0.04 and p < 0.01, respectively). There was also a significant increase in the incidence of placental apoptosis in the third as compared with the second trimester (p < 0.03).
The Outcome of Triplet versus Twin Pregnancies
Authors: Ziadeh Saed M.
Published: April 2003

Objective: The purpose of this study was to examine and to determine whether triplet pregnancies are associated with a significantly greater risk of adverse outcome than are twin pregnancies. Methods: Maternal and perinatal outcomes were evaluated retrospectively in 41 sets of triplets and twin pregnancies that were matched for maternal age, parity, mode of delivery, preterm delivery, mode of conception, and antepartum complications. Main Outcome Measures: Perinatal outcome in triplet versus twin gestation. Results: Triplets had a significantly lower mean average birth weight than in twin gestation (1,596 vs. 2,317 g, p < 0.018) and gestational age at delivery (32.9 vs. 35.9 weeks; p < 0.03). Preterm labour occurred significantly more often in triplet than in twin gestation (80.5 vs. 41.5%) as did preterm delivery (87.8 vs. 46.2%). Triplets required a longer hospital stay than did twins (25 vs. 9 days; p < 0.04). There were no significant differences between the groups in number of administrations to the Special Care Baby Unit (32.5 vs. 30.5%). Apgar score <7 at 5 min was significantly more in triplet as compared with twin gestation (17 vs. 6%; p < 0.0015). Neonatal deaths occurred significantly more in triplets than in twins (26 vs. 8.5%; p < 0.0001). There were no significant differences between the groups in maternal antepartum or neonatal complications such as anaemia, pregnancy-induced hypertension, placental abruption, respiratory distress syndrome or intraventricular haemorrhage. Preterm labour was the only complication that occurred significantly more often in the triplet than in the twin gestation. Conclusions: We concluded that this information could be useful in counseling patients with respect to the anticipated perinatal outcome of triplet pregnancies.
Perinatal Outcome of Pregnancies Complicated by Diabetes and by Maternal Daily Hyperglycemia Not Related to Diabetes
Authors: Rudge Marilza Vieira Cunha , Calderon Iracema de Mattos Paranhos , Ramos Maria Delgi , Abbade Joelcio Francisco , Rugolo Lígia M.S. Souza
Published: April 2003

We analyzed the perinatal outcome of 1,086 pregnancies classified according to the response to the 3-hour 100-gram glucose tolerance test and the diurnal glycemic profile into the Rudge groups corresponding to control pregnant women, class A gestational diabetic women, class A/B to FRH pregnant women and women with daily hyperglycemia. Despite treatment, the diabetic pregnant women and those with daily hyperglycemia presented higher mean blood glucose levels compared to controls (76.6 ± 10.2 mg/dl). The pregnancies complicated by diabetes and by daily hyperglycemia were characterized by a high incidence of prematurity, macrosomia, large for gestational age newborn infants, malformation and fetal and neonatal death, with consequent perinatal mortality. The perinatal mortality of women with daily hyperglycemia was 10 times higher than that of the controls and was similar to that of the diabetic patients. These adverse perinatal results emphasize the need for the diagnosis and control of intrauterine hyperglycemia both in diabetic pregnant women and in women with an altered diurnal glycemic profile.
Serum Group II Phospholipase A2 Levels during Menstrual Cycle and Pregnancy
Authors: Hayashi Keiji , Kawamura Takae , Endo Shigeatsu , Hata Toshiyuki
Published: April 2003

The purpose of this study was to evaluate the circulating group II phospholipase A2 (PLA2-II) levels during normal menstrual cycle and to assess alterations in maternal circulating PLA2-II concentrations during pregnancy and at puerperium. Circulating serum PLA2-II concentrations were compared between 38 nonpregnant women with normal menstrual cycle (15 at menstrual phase, 11 at follicular phase, and 12 at luteal phase), 61 normal pregnant women (13 in the first trimester, 12 in the second trimester, and 36 in the third trimester), and 14 normal postpartum women at 5th puerperal day. Serum PLA2-II concentrations were also measured in 11 patients with threatened premature labor. Maternal and fetal serum PLA2-II levels before and after delivery were made to determine differences in 11 neonates delivered vaginally and 11 neonates delivered by elective cesarean section. Serum PLA2-II level was measured with an immunoradiometric assay. Serum PLA2-II concentrations at luteal phase were significantly lower than those at menstrual or follicular phase (p < 0.05). There was no significant difference for PLA2-II levels between first trimester and menstrual phase or follicular phase. There were no significant differences among three trimesters during pregnancy. There was no significant difference in serum PLA2-II levels between normal pregnant women and patients with threatened premature labor. Labor stress did not affect both maternal and fetal serum PLA2-II concentrations. There was also no significant difference for circulating PLA2-II levels between maternal and fetal serum. Interestingly, serum PLA2-II concentrations in postpartum women were significantly higher than those in normal pregnant women (p < 0.05). These results suggest that a regulatory mechanism of PLA2-II may exist during the normal menstrual cycle and at puerperium.
Uterine Rupture Associated with Vaginal Birth after Cesarean Section: A Complication of Intravaginal Misoprostol?
Authors: Gherman Robert B. , McBrayer Susan , Browning Joseph
Published: April 2003

Intravaginal misoprostol has become increasingly employed for labor induction among patients with an unfavorable Bishop’s score. Almost all of the reported studies have specifically excluded patients with prior uterine surgery. There has been, therefore, very little information concerning its usage among patients attempting vaginal birth after cesarean section. We report a patient with two prior low transverse uterine incisions who experienced uterine rupture after having received a single 25-μg intravaginal dose of misoprostol.
Use of Prostaglandin E2 for Cervical Ripening in Pregnancies with Oligohydramnios
Authors: Stefos Theodor , Mouzakioti Elena , Sotiriadis Alexandros , Andronikou Styliani , Adamidis Konstantinos , Lolis Dimitrios
Published: April 2003

The effectiveness of intracervical prostaglandin E2 (PGE2) was studied in 96 primigravidas with unfavorable cervix and need for induction of labor. Group A consisted of 49 oligohydramnios and group B of 47 cases with normal amniotic fluid volume (controls). A single dose of 0.5 mg PGE2 gel was applied intracervically and several parameters were recorded during the next hours. The mean number of uterine contractions increased during the first 2 h in both groups, decreased during the next one and did not change significantly afterwards. The mean fetal heart rate (FHR) in group A decreased during the first 2 h and then increased, staying always within normal limits. The mean FHR in group B increased for 2 h, decreased during the next hour and did not change significantly afterwards. No significant differences were found between the two groups regarding mode of delivery, Apgar score and neonatal acidosis. Intracervical PGE2 appeared to effectively stimulate cervical ripening and labor induction in oligohydramnios, without causing side effects to the uterus and fetus.
Perinatal Outcome in 41 Sets of Triplets
Authors: Ziadeh Saed M.
Published: April 2003

Objective: To determine the perinatal outcome associated with triplet pregnancies and to compare abdominal delivery with vaginal delivery. Methods: Retrospective analysis of maternal and neonatal medical records of 41 triplets. 21 were delivered vaginally and 20 were delivered by cesarean section. Main Outcome: To measure perinatal mortality and early neonatal complications. Results: Between January 1, 1994, and June 30, 1999, there were 41 triplets delivered at our institution. Of these 21 triplets were delivered vaginally and 20 triplets were delivered abdominally. The perinatal mortality rate was 32/123 (26.0%), primarily due to the respiratory distress syndrome. The perinatal deaths are mainly at a birth weight of 500–1,500 g (29/32; 90.6%). Breech presentation was associated with a significantly higher perinatal mortality rate than vertex presentation (62.5 vs. 37.5%). Cesarean delivery was associated with a higher perinatal mortality rate than vaginal delivery (30.0 vs. 22.2%). Conclusions: Abdominal delivery in triplets is not superior to vaginal delivery in terms of fetal and early neonatal outcome. The perinatal deaths are increased with low birth weight (500–1,500 g) and with breech presentation. The main cause of neonatal mortality is the respiratory distress syndrome.
A Study to Determine if Certain Sonographic Uterine Parameters Are Associated with Multiple Gestation
Authors: Dietterich Carole , Check Jerome H. , Lurie Deborah , Choe Jung K. , Nazari Ahmad
Published: April 2003

The objective was to determine if lower uterine artery vascular impedance is associated with a greater likelihood of multiple gestation. Color Doppler parameters of pulsatility index, resistance index, endometrial thickness and echo patterns were measured in oocyte/retrieval cycles on days of human chorionic gonadotropin injection, oocyte retrieval, and mid-luteal phase in cycles where at least 3 embryos were transferred. Comparisons of these parameters were made in patients with single versus multiple gestations. There was no association between uterine environment as measured by vascular impedance and endometrial thickness and number of embryos implanted. Thus, a more ideal uterine environment, at least as determined by these sonographic parameters, does not seem to facilitate multiple embryo implantations.
Variability in CD34+ Cell Counts in Umbilical Cord Blood:Implications for Cord Blood Transplants
Authors: Yap C. , Loh M.T. , Heng K.K. , Tan P. , Yu S.L. , Chan S.H. , Ren E.C.
Published: April 2003

Objective: To determine if total nucleated cell counts alone are sufficient for predicting the efficacy of cord blood units for transplant from neonatal umbilical cord blood samples. Methods: Umbilical cord blood samples were collected from 200 mothers at delivery and the cord blood units processed. The total nucleated cells and CD34+ cells were enumerated and compared for each sample. Results: Despite an apparent linear correlation between total nucleated cell counts and CD34+ cell counts, each group of total nucleated cell counts demonstrated a high degree of variation in CD34+ cell counts and could be as low as 0.1% of total nucleated cell counts. Conclusions: Large variations in CD34+ cell counts per total nucleated cell count are present for cord blood units from neonatal umbilical cord samples. Hence a CD34+ cell count for each cord blood unit would improve selection of samples for transplant.
Age-Related Survival in Non-Hodgkin’s Lymphoma
Authors: Salminen E.
Published: April 2003

Purpose: Non-Hodgkin lymphoma (NHL) occurs in patients in all age groups and its incidence in Finland has constantly increased since the 1950s. In this study the change in the incidence rate and the effect of age on the survival of NHL patients was investigated. The aim of the study was to determine the relative survival by age during follow-up through a cancer registry. Patients and Methods: The data base of the Finnish Cancer Registry was used to collect information of all NHL cases registered in Finland in 1960–1992. A total of 2,824 newly diagnosed cases of NHL were included. Of them 1,414 (50%) were diagnosed in men and 1,410 (50%) in women. Results: The age-specific incidence rates in both sexes indicated a significant increase (p < 0.0001) in incidence for patients from 1960 to 1992. The 1- and 5-year relative survival rates were best for patients diagnosed at the age of 40–44 years. During 10 years’ survival two peaks were observed, in the age group of 20–24 and 40–44 years. The relative survival rate was found to deteriorate with an increase in the age of the patients. Patients with local NHL lymphoma had a similar survival regardless of their age at diagnosis. Relative survival of patients aged over 65 years with extensive lymphoma was 36% of the survival observed for younger patients. Conclusion: There is a trend for an increase in the incidence of NHL. Because NHL is more common in patients over 60 years of age than in the younger age groups, an increasing incidence indicates that more elderly patients will need treatment in the years to come.
Plasmacytoma of the Gastrointestinal Tract in Korea: Higher Incidence than in Japan and Epstein-Barr Virus Association
Authors: Tomita Yasuhiko , Ohsawa Masahiko , Hashimoto Michiko , Qiu Ke , Yang Woo-Ick , Park Chan-IL , Aozasa Katsuyuki
Published: April 2003

As a result of a systematic review of non-Hodgkin’s lymphoma of the gastrointestinal tract (GI) at the Yonsei University, Seoul, Korea and the Osaka University, Osaka, Japan, we found an extramedullary plasmacytoma in 5 of a total of 78 cases (6.4%) in Korea and 1 of 136 cases (0.7%) in Osaka, which represents an approximately 9-fold difference in frequency. The presence of the Epstein-Barr virus (EBV) genome was examined in paraffin-embedded specimens from the 5 cases with GI plasmacytoma from Korea together with 17 patients collected by a nationwide study in Japan. There were no clinical findings suggestive of the presence of immunodeficiency in these Korean and Japanese patients. There were no prominent differences in the age distribution or sex ratio between the patients of the two countries. Histologically, the proliferation of mature plasma cells was almost monomorphous with occasional bi- or multinucleated forms. The immunohistochemistry revealed a restricted cytoplasmic expression of immunoglobulin light chain, kappa type in 8 cases and lambda type in 14. A polymerase chain reaction of preserved DNA from 4 Korean and 16 Japanese patients found that only 2, both Korean, were positive for EBV of subtype A. The difference in the frequency of EBV positivity between Korean and Japanese cases was significant (p < 0.05). In situ hybridization revealed positive signals in the nucleus of the tumor cells. IHC revealed that the tumor cells in these two cases were positive for latent membrane protein-1 and EB nuclear antigen-2, showing latent infection of EBV. These findings suggest a close association of EBV and Korean GI plasmacytoma, and might partly explain the remarkable number of cases in this country.
Bile Acid Load on the DNA Distribution Pattern of Bile Ductules and Cholangiocarcinoma Induced by Diisopropanolnitrosamine in Hamsters
Authors: Kinami Yoshio , Miyakoshi Minoru , Fujikawa Kosaburo
Published: April 2003

This study evaluated the influence of bile acid load on the DNA distribution pattern of proliferated bile ductules and cholangiocarcinoma induced by diisopropanolnitrosamine. Ninety hamsters were separated into control, tauro- and deoxycholic acid (DCA) groups. The DNA distribution pattern of intrahepatic lesions at 15–25 weeks was measured by cytofluorometry and classified into three types: I (-A, -B), II and III, according to the degree of dispersion on the DNA histogram. Regarding proliferated bile ductule lesions, all groups showed an increase in cell populations, indicating the dispersion of nuclear DNA content from the 4C to 6C ranges over the course of 25 weeks, and two groups with bile acids, especially the DCA group, revealed significant high incidences of lesions with type I-B plus II compared with those in the control group (p < 0.05, 0.01). Changes in carcinoma types were similar to those of bile ductule lesions, and the tumors in the DCA group had a significant high frequency of type II plus III (p < 0.05). In addition, heterogeneity of the DNA distribution pattern was observed within individual lesions of not only carcinoma but also bile ductules. These results suggest that bile acid load, especially DCA, promotes an increase in nuclear DNA content or DNA polyploidization and enhances the distribution of the DNA pattern of proliferating bile ductules and carcinoma. Furthermore, a bile ductule-carcinoma sequence may be present in the development of cholangiocarcinoma.
Cyclin D1 Overexpression and Prognosis in Colorectal Adenocarcinoma
Authors: Maeda Kiyoshi , Chung Yong-suk , Kang Soon-myoung , Ogawa Masafumi , Onoda Naoyoshi , Nishiguchi Yukio , Ikehara Teruyuki , Nakata Bunzo , Okuno Masahiro , Sowa Michio
Published: April 2003

Recently, it has been reported that cyclin D1 plays a major role in oncogenesis in various cancers; however, there have been few studies on the association of cyclin D1 overexpression and prognosis of patients with malignant tumors. We evaluated the prognostic significance of cyclin D1 overexpression in colorectal adenocarcinoma. One hundred twenty-three specimens resected from patients with colorectal adenocarcinomas were investigated by staining with a monoclonal antibody against cyclin D1. As a result, both overall survival and disease-free survival were significantly poorer in the patients with tumors strongly positive for cyclin D1 than in those with cyclin-D1-negative or weakly positive tumors. The 5-year survival rate of the patients with tumors strongly positive for cyclin D1 was 53.3%, while the 5-year survival rates of patients with cyclin-D1-negative and weakly positive tumors were 96.2 and 78.8%, respectively. Moreover, multivariate analysis indicated that cyclin D1 overexpression is an independent predictor of disease recurrence in our patients. In conclusion, cyclin D1 overexpression may be useful as a predictor of disease recurrence in colorectal adenocarcinoma.
Hemolytic Uremic Syndrome in Prostatic Carcinoma
Authors: Müller Nicolas J. , Pestalozzi Bernhard C.
Published: April 2003

Background: Disseminated intravascular coagulation is a well-known complication of adenocarcinoma of the prostate, while hemolytic uremic syndrome (HUS) is not. Case Report: We describe the unusual case of a 61-year-old patient with adenocarcinoma of the prostate. Prior to any systemic therapy he developed hemolytic uremic syndrome (HUS) necessitating dialysis. Renal function has fully recovered and he is alive and well 7 years later. Conclusion: HUS is a rare complication of adenocarcinoma of the prostate and has a far better prognosis than chemotherapy-associated HUS.
Mediastinal Large Cell Lymphoma: Prognostic Significance ofCT Findings at Presentation and after Treatment
Authors: Smith Darrell , Shaffer Kitt , Kirn David , Canellos George P. , Mauch Peter M. , Shulman Lawrence N.
Published: April 2003

Objective: Primary mediastinal large cell lymphoma is a distinctive subtype of non-Hodgkin’s lymphoma. Computed tomography (CT) has become an integral part of the evaluation of these patients at presentation and after completion of therapy. The purpose of this study is to identify CT features that predict increased risk of relapse. Methods: A retrospective study of patients with primary mediastinal large cell lymphoma who underwent CT scans of the thorax. Results: Tumor volume greater than 100 ml after completion of therapy was a statistically significant predictor of increased risk of relapse (p = 0.02, Fisher exact test). Other measurements (obtained at presentation and after completion of treatment) were not statistically significant in predicting relapse. Conclusion: CT plays an important role in predicting outcome in primary mediastinal large cell lymphoma. Large residual tumor volume after completion of treatment predicts an increased risk of relapse.
Rare Pulmonary Tumors –A Review of 32 Cases
Authors: Sekine Ikuo , Kodama Tetsuro , Yokose Tomoyuki , Nishiwaki Yutaka , Suzuki Kenji , Goto Koichi , Nagai Kanji , Kuriyama Takayuki
Published: April 2003

In a review of pulmonary tumors diagnosed at our institute from 1976 to 1995, we found 20 malignant and 12 benign rare tumors, which accounted for 0.57 and 0.34% of all pulmonary tumors, respectively. The histological types of these rare malignant tumors were malignant lymphoma (6/20), carcinosarcoma (3/20), mucoepidermoid carcinoma (2/20), bronchial gland mixed tumor (2/20), adenocystic carcinoma (1/20), myoepithelioma (1/20), leiomyosarcoma (1/20), epitheloid hemangioendothelioma (1/20), hemangiopericytoma (1/20), malignant melanoma (1/20) and choriocarcinoma (1/20). Benign rare tumors involved papilloma (3/12), lipoma (3/12), leiomyoma (3/12), adenoma (1/12), fibroma (1/12), and meningioma (1/12). The clinical and pathological features of malignant tumors were roughly the same as those of common pulmonary carcinomas. In contrast, benign tumors were never larger than 3 cm and were more commonly located in the central parts of the lung, which explained the relatively frequent symptoms of wheezing and fever associated with obstructive pneumonia.