bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking, Hemoglobin Concentration and Pregnancy-Induced Hypertension
Authors: Rasmussen Svein , Øian Pål 
Published: April 2003

The aim of the study was to assess the effect of cigarette smoking on first- to second-trimester change in hemoglobin (Hb) concentration and the presence of pregnancy-induced hypertension (PIH). In smokers and non-smokers the mean difference between the first- and second-trimester Hb concentration was 1.5–1.6 and 1.3 g/dl, respectively (p < 0.0001). The incidence of PIH among smokers and non-smokers was 4.0 and 7.5%, respectively (p < 0.0001). The risk of PIH increased with increasing second-trimester Hb. After adjustment for factors including previous pregnancies, maternal age and weight gain by logistic regression analysis, the increased Hb declined and the decreased incidence of PIH in smokers persisted.
Upper Body Obesity and Hyperinsulinemia Are Associated with Anovulation
Authors: Morán Carlos , Hernández Eugenia , Ruíz Julia E. , Fonseca María E. , Bermúdez José A. , Zárate Arturo 
Published: April 2003

The objective of this study was to determine the effect of body fat distribution and hyperinsulinemia on the occurrence of ovulation. Fifty-six women (20–35 years old) either with overweight or obesity (body mass index ≥25) were studied. They were classified in two groups according to waist/hip ratio (WHR); one with predominance of adiposity in the upper body segment (n = 29, WHR >0.85) and the other with predominant adiposity in the lower body segment (n = 27, WHR ≤0.85). Basal body temperature and serum progesterone were determined in each cycle during 6 months. Serum insulin levels were measured at baseline and 30, 60, 90, 120 and 180 min after a 75-gram oral glucose load. The mean insulin values in response to oral glucose load in patients with upper body segment obesity were significantly higher than those corresponding to women with lower body segment obesity. Furthermore, the ratio between ovulated cycles and all the cycles studied in patients with upper body segment obesity was significantly lower than that observed in patients with lower body segment obesity. Upper body obesity seems to affect the ovulatory process and this may be related to the presence of hyperinsulinemia.
Endothelial Cell Lesion in Preeclampsia
Authors: Gilabert Rosa , Bellart Jordi , Jové Montserrat , Miralles Ramón M. , Piera Verónica 
Published: April 2003

Morphofunctional study of umbilical cords from pregnancies complicated by preeclampsia shows both activation and lesion of endothelium. The cellular findings in umbilical cords from pregnancies complicated by preeclampsia can be summarized as: (i) higher number of cells with secretion bladders and increase in the number and size of both secretion bladders and microvilli-like protrusions; (ii) increase in collagen, fibrin, fibronectin and lipidic vesicles in the vessel wall; (iii) vacuolization of endothelial cells; (iv) presence of lipidic vacuoles and lipophages in the vessel wall; (v) erosion and disorganisation of the endothelium that exposes extracellular proteins to the blood flow. Endothelial cell cultures from preeclamptic pregnancies show kinetic disorders and cell detachment. The results confirm that an endothelial cell lesion occurs in preeclampsia and this cellular disorder can be reproduced in vitro.
Fetal Size as a Determinant of Obstetrical Outcome of Post-Term Pregnancy
Authors: Ryo Eiji , Kozuma Shiro , Sultana Jafreen , Kikuchi Akihiko , Fujii Tomoyuki , Unno Nobuya , Okai Takashi , Taketani Yuji 
Published: April 2003

<i>Hypothesis:</i> We hypothesized that there might be differences in the outcomes of post-term pregnancy according to fetal size. <i>Methods:</i> A retrospective analysis of 143 women with uncomplicated pregnancy that persisted beyond 42 weeks was conducted. Ultrasound dating was performed between 8 and 14 weeks in all cases. The obstetrical outcomes were compared between the cases in which neonatal birth weight was <3,600 g (non-large group) and ≥ 3,600 g (large group). <i>Results:</i> In primiparous women, there was no significant difference between the non-large and large groups in terms of the rate of cesarean section, but the rate of cesarean section for fetal distress in the non-large group was significantly higher than that found in the large group. In addition, the non-large group showed a significantly higher incidence of low pH (<7.20) compared with the large group (14/58 vs. 0/22, p < 0.01). In contrast, the rate of prolonged labor (>24 h) and induction failure in the non-large group were significantly lower than that in the large group. In multiparous women, there was no significant difference in obstetrical outcomes between the non-large and large groups. <i>Conclusions:</i> Primiparous women who were delivered of fetuses weighing not less than 3,600 g at post-term periods were at lower risk of fetal distress on the one hand and at higher risk of induction failure associated with infavorable cervix on the other. This study suggests that post-term pregnancy should be dealt with differently based on fetal weight.
25 mg or 50 mg of Oral Methotrexate Followed by Vaginal Misoprostol 7 Days after for Early Abortion
Authors: Carbonell Esteve J.L. , Varela L. , Velazco A. , Tanda R. , Sánchez C. 
Published: April 2003

<i>Background:</i> Several combinations of oral or intravenous methotrexate plus vaginal misoprostol have been used for early abortion with success rates varying widely. So far, any study has evaluated the efficacy and safety of lower doses of oral methotrexate followed by vaginal misoprostol for early abortion. <i>Objectives:</i> To evaluate the efficacy and safety of methotrexate 25 or 50 mg orally and 800 μg of misoprostol vaginally 7 days after the methotrexate for abortion at ≤56 days of gestation. <i>Study Design:</i> Three-hundred and ten pregnant women seeking elective abortion were randomly allocated to receive 25 mg (group I) or 50 mg (group II) of methotrexate orally and 800 μg of misoprostol vaginally 7 days after the methotrexate. The misoprostol dose was repeated 48 and 96 h later if the abortion did not occur. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side effects and vaginal bleeding. Relative risks were used for the comparison between the outcomes from both treatment regimens. <i>Results:</i> In group I aborted 135/148 cases (91%, 95% CI 85, 95%), and 139/154 cases (90%, 95% CI 84, 94%) aborted in group II (relative risk [RR] = 1.01, RR 95% CI 0.94, 1.09). <i>Conclusions:</i> The two treatment regimens showed the same efficacy and safety, so it would be advisable at least to use the smaller methotrexate dose, i.e. 25 mg.
Pharmacokinetics of Fem7<sup>®</sup>, a Once-Weekly, Transdermal Oestrogen Replacement System in Healthy, Postmenopausal Women
Authors: Geyer D. , Gerrits M.G.F. , Renoux A. , Uhl W. 
Published: April 2003

This open-label, randomized study in 36 healthy postmenopausal women, investigated the pharmacokinetics of Fem7<sup>®</sup> (an oestradiol matrix-type patch), at doses of 25, 50, 75 and 100 μg/24 h, applied once weekly. Maximum plasma concentrations of oestradiol and oestrone were observed 14–20 h after patch application, remaining within the therapeutic range until removal, and returning to baseline within 12 h thereafter. Plasma oestradiol concentrations increased in a dose-dependent manner for all four doses, and plasma oestrone increased for the three highest doses. Fem7 treatment was well tolerated at all four doses and no severe adverse reactions were reported. Fem7 is a convenient and well-tolerated form of hormone-replacement therapy that delivers oestradiol in a consistent and predictable manner.
A Controlled Study for Gender Selection Using Swim-Up Separation
Authors: Khatamee Masood A. , Horn Scott R. , Weseley Alvin , Farooq Tahir , Jaffe Sharon B. , Jewelewicz Raphael 
Published: April 2003

<i>Objective:</i> To evaluate the success for gender selection using a sample of semen separated by a modified swim-up technique. <i>Design:</i> We retrospectively compared the gender outcome of two treatments (A and B) for either a male or female offspring with those who conceived spontaneously. <i>Setting:</i> Private practice of one author (M.A.K.). <i>Patients, Participants:</i> The treatment groups consisted of 52 total pregnancies for couples who conceived by the separation technique. Of these 52 participants, 15 desired a female offspring and were placed into treatment A and 37 desired a male offspring and were placed into treatment B. The control groups consisted of 162 women who were presented with initial consultation for gender selection and conceived spontaneously. Control group A consisted of 80 women who initially chose a female offspring, and control group B consisted of 82 participants who initially chose a male. <i>Interventions:</i> In treatment group A, one timed intrauterine insemination (IUI) was carried out with the bottom 0.5 ml of the separated semen on cycle days 12–14, when the follicle was 18–22 mm. Patients in this group were also administered clomiphene citrate and human chorionic gonadotropin. In treatment group B, one timed IUI was done with the top 0.5 ml of the separated semen, when the follicle was 18–22 mm. <i>Main Outcome Measure:</i> The gender outcome of the pregnancies of two treatment and control groups was evaluated based on the known desired gender. <i>Results:</i> The success rate for conceiving a female child after intervention (treatment group A) was 86.7% effective (p = 0.002) as compared to the control group A. Couples seeking a male child (treatment group B) were 89.2% effective (p = 0.0002) as compared to the control group B. <i>Conclusions:</i> This study reveals that the modified swim-up method with additional monitoring results in statistically significant gender preselection.
Krukenberg Tumors:Can Management Be Improved?<sup> 1</sup>
Authors: McGill Frances M. , Ritter Diane B. , Rickard Caroline S. , Kaleya Ronald N. , Wadler Scott , Greston Wilma Markus , O’Hanlan Katherine A. 
Published: April 2003

<i>Objective:</i> The Montefiore Medical Center experience with women with gastrointestinal (GI) cancer was reviewed to: (1) evaluate clinical parameters in patients with Krukenberg tumor (GI cancer metastatic to the ovaries) and (2) evaluate oophorectomy in GI cancer patients. <i>Methods:</i> (1) Charts of all female patients admitted between 1985 and 1996 with gastric or colon cancer were reviewed. <i>Results:</i> The frequency of Krukenberg tumor was 7/1,021 (0.7%). The median age at presentation was 39.5 years (range 35–80); 5 were premenopausal, 2 of whom were postpartum. Krukenberg tumor was significantly more common in the premenopausal patients with gastric cancer (p = 0.002), colon cancer (p = 0.001), and in both sites combined (p < 0.001). Our rate of pregnancy-associated Krukenberg tumors (28.6%) was significantly higher (p < 0.05) than that found in 4 of 5 large studies. The average survival of our 7 patients was 12.3 months (range 4 days to 26 months), with secondary debulking and chemotherapy offering 1 patient the longest longevity. Only 19/788 (2.4%) women had oophorectomy during their colon cancer surgery revealing 2 (10.5%) Krukenberg tumors, 6 (31.6%) benign solid or cystic ovarian tumors, and 11 (57.9%) normal or atrophic ovaries. <i>Conclusions:</i> Krukenberg tumors are rare. There is no uniformity of data reported in the literature. Krukenberg tumors were more common in premenopausal women with gastric or colon cancer compared to postmenopausal women. Our rate of pregnancy-associated Krukenberg tumors appeared to be higher compared to other studies. Prophylactic oophorectomy in pre- and postmenopausal women should be considered at the time of GI cancer surgery, and requires further study. A national registry combined with prospective, multisite studies are needed to gather data and evaluate treatment.
Prenatal Diagnosis of Nonmosaic Trisomy 9 in a Fetus with Severe Renal Disease
Authors: Sandoval R. , Sepulveda W. , Gutierrez J. , Be C. , Altieri E. 
Published: April 2003

We report a case of nonmosaic trisomy 9 presenting at 21 weeks of gestation with polycystic, echogenic horseshoe kidney, collapsed bladder, absent amniotic fluid, and intrauterine growth restriction. Color Doppler imaging demonstrated no blood flow signals from renal vessels. Fetal blood sampling confirmed a 47,XX,+9 karyotype, with no evidence of mosaicism, and increased serum β<sub>2</sub>-microglobulin levels of 10.7 mg/l, consistent with severe renal failure. A repeat scan at 23 weeks also revealed a dysmorphic face, bilateral microphthalmia, and a cerebellar vermian defect. Follow-up examinations showed progressive growth restriction leading to fetal death at 33 weeks of gestation. This report demonstrates that fetuses with nonmosaic trisomy 9 may present with severe renal abnormalities and confirms that cases seen in the second and third trimesters usually have a dismal outcome.
Elevated Second-Trimester Serum Homocyst(e)ine Levels and Subsequent Risk of Preeclampsia
Authors: Sorensen Tanya K. , Malinow M. Rene , Williams Michelle A. , King Irena B. , Luthy David A. 
Published: April 2003

<i>Objective: </i>Elevated plasma homocyst(e)ine is a risk factor for endothelial dysfunction and vascular disease. In late gestation, levels of homocyst(e)ine are higher in preeclamptics, as compared with normotensive pregnant women. Our objective was to determine whether homocyst(e)ine elevations precede the development of preeclampsia. <i>Study Design: </i>We used a prospective nested case-control study design to compare second trimester maternal serum homocyst(e)ine concentrations in 52 patients who developed preeclampsia (pregnancy-induced hypertension with proteinuria) compared with 56 women who remained normotensive throughout pregnancy. Study subjects were selected from a base population of 3,042 women who provided blood samples at an average gestational age of 16 weeks and later delivered at our center. Serum homocyst(e)ine was measured by high-performance liquid chromatography and electrochemical detection. <i>Results: </i>Approximately 29% of preeclamptics, as compared to 13% of controls had homocyst(e)ine levels ≥5.5 μmol/l (upper decile of distribution of control values). Adjusted for maternal age, parity, and body mass-index, a second trimester elevation of homocyst(e)ine was associated with a 3.2-fold increased risk of preeclampsia (adjusted OR = 3.2; 95% CI 1.1–9.2; p = 0.030). There was evidence of a interaction between maternal adiposity (as indicated by her prepregnancy body mass index) and parity with second trimester elevations in serum homocyst(e)ine. Nulliparous women with elevated homocyst(e)ine levels experienced a 9.7-fold increased risk of preeclampsia as compared with multiparous women without homocyst(e)ine elevations (95% CI 2.1–14.1; p = 0.003). Women with a higher prepregnancy body mass index (≥21.4 kg/m<sup>2</sup>, or upper 50th percentile) and who also had elevated homocyst(e)ine levels, as compared with leaner women without homocyst(e)ine elevations were 6.9 times more likely to later develop preeclampsia (95% CI 1.4–32.1; p = 0.016). <i>Conclusion: </i>Our findings are consistent with other indications of vascular endothelial dysfunction predating clinical preeclampsia. Studies designed to examine the effect of dietary and/or pharmacological mediators of homocyst(e)ine metabolism in preeclampsia are warranted.
Use of Chlorhexidine-Releasing Nylon Fibres to Reduce Device-Related Uterine Infections
Authors: Gard P.R. , Reynolds J.P. , Hanlon G.W. 
Published: April 2003

Implantation of intrauterine devices (IUDs) is associated with an increased incidence of uterine infection, probably as a result of vaginal bacteria entering the uterus at the time of insertion. To reduce the incidence of IUD-related infections, the incorporation of antimicrobial agents into the tail of the device was studied. Chlorhexidine was shown to be released from within nylon hollow fibres at a rate of approximately 114 μg·day<sup>–1</sup> for 10 days. This rate of release was sufficient to exhibit a biocidal effect on bacteria embedded within a mucus gel in vitro. When these devices were implanted transcervically into the guinea-pig uterus they significantly reduced the extent of uterine bacterial contamination within 24 h. These findings indicate that chlorhexidine-releasing devices are potentially useful in the reduction of device-related infections.
Association between Helicobacter pylori Infection and Pancreatic Cancer
Authors: Raderer Markus , Wrba Friedrich , Kornek Gabriela , Maca Thomas , Koller Dieter Y. , Weinlaender Georg , Hejna Michael , Scheithauer Werner 
Published: April 2003

<b>Purpose:</b> In order to determine whether infection with <i>Helicobacter pylori</i> might be associated with pancreatic adenocarcinoma, we performed a study to compare the <i>H. pylori</i> seroprevalence rate between patients with pancreatic carcinoma and matched control subjects. <b>Patients and Methods:</b> Blood samples from 92 patients with histologically confirmed diagnosis of pancreatic adenocarcinoma admitted to our hospital between January 1994 and July 1995 were analyzed for the presence of IgG antibodies against <i>H. pylori</i> by a commercially available enzyme-linked immunosorbent assay. Thirty patients with gastric cancer, 35 patients with colorectal cancer, and 27 healthy volunteers served as controls. In addition to these serological analyses, tumor specimens from 20 patients with pancreatic adenocarcinoma were microscopically investigated for the presence of <i>H. pylori.</i> <b>Results:</b> 65% of pancreatic cancer patients and 69% of those with gastric cancer were found to be seropositive, while only 45% of the other controls tested positive. Statistical analysis revealed no difference in seropositivity between the cohort of patients suffering from pancreatic and gastric cancer. The rate of seropositivity was more prominent, however, in pancreatic cancer patients when compared with those suffering from colorectal cancer combined with normal controls (p = 0.035), with an odds ratio of 2.1 (1.1–4.1). Microscopic evaluation of human pancreatic cancer specimens showed no evidence for the presence of <i>H. pylori.</i> <b>Conclusion:</b> Our data suggest an association between <i>H. pylori</i> infection and pancreatic cancer. Despite demonstration of a positive relationship and its physiological plausibility, larger prospective studies are needed to confirm our preliminary findings and to assess <i>H. pylori</i> as a potential carcinogenic risk factor.
Clinical Pilot Study of Intrahepatic Arterial Chemotherapy with Methotrexate, 5-Fluorouracil, Cisplatin and Subcutaneous Interferon-Alpha-2b for Patients with Locally Advanced Hepatocellular Carcinoma
Authors: Urabe Takeshi , Kaneko Shuichi , Matsushita Eiki , Unoura Masashi , Kobayashi Kenichi 
Published: April 2003

To evaluate the efficacy of methotrexate (MTX)-5-fluorouracil (5-FU), cisplatin (CDDP), and interferon-α-2b(IFNα-2b) combination therapy, we conducted a clinical pilot study in patients with locally advanced hepatocellular carcinoma (HCC). Sixteen patients, who had received no prior treatment for the HCC, with portal tumor thrombosis in the main trunk or in the major branch were enrolled in the study. IFNα-2b (3 × 10<sup>6</sup> units) was injected subcutaneously 3 times per week. After a bolus administration of MTX (30 mg/m<sup>2</sup>), CDDP (75 mg/m<sup>2</sup>) and thereafter 5-FU (750 mg/m<sup>2</sup>) were given weekly by intrahepatic arterial infusion. In 15 eligible patients, there were 1 complete response (CR) and 6 partial responses (PR) with a response rate of 46.7%. Median survival of the 15 patients was 7 months, and the 2-year survival rate of CR and PR patients was 57.1%. There was severe transient hematologic toxicity. More than grade 2 nausea/vomiting was noted in >50%. In conclusion, the IFNα-2b combination chemotherapy demonstrated good response in patients with locally advanced HCC. This treatment should be tried in a controlled study.
Is Continuous 24-Hour Infusion of 5-Fluorouracil plus High-Dose Folinic Acid Effective in Patients with Progressive or Recurrent Colorectal Cancer?
Authors: Hartmann J.T. , Köhne C.-H. , Schmoll H.-J. , Daikeler T. , Kanz L. , Bokemeyer C. 
Published: April 2003

<b>Background:</b> To evaluate the therapeutic activity of 24-hour continuously infused 5-fluorouracil (5-FU) modulated by high-dose folinic acid in patients with metastatic colorectal cancer who had recurred or progressed following mainly bolus 5-FU/folinic acid chemotherapy. <b>Patients and Methods:</b> Forty-two patients with a median age of 59 years (45–76) were enrolled. Karnosfky status was 90% (80–100), previous chemotherapy regimen bolus 5-FU/folinic acid (n = 33, 79%) or 24-hour continuous 5-FU ± interferon α<sub>2</sub> (n = 9, 21%). Chemotherapy was given as a weekly infusion of 500 mg/m<sup>2</sup> folinic acid over 2 h followed by a 24-hour continuous infusion of 2,600 mg/m<sup>2</sup> 5-FU for 6 consecutive weeks followed by a 2-week rest period. <b>Results:</b> No complete but 6 partial responses were observed (ORR: 14%, CI<sub>95%</sub>: 3.5–25.1%) with a median response duration of 7.3 months (range: 1.4–10.6). The median survival from the start of continuous infusion of 5-FU was 11.6 months (range: 2–27, CI<sub>95%</sub>: 9.4–13.8) and the 1-year survival rate was 46%. Disease stabilization and minor responses were achieved in another 25 patients (61%). WHO grade III/IV diarrhea occurred in 26% of patients, mucositis, nausea/vomiting and hand-foot syndrome in 5% each. Two cases of WHO grade III anemia and leukocytopenia were observed (5% each). Dose reductions had to be performed in 11 patients because of unacceptable diarrhea with subsequent stop of treatment in 2 patients. Progressive disease while receiving previous bolus 5-FU chemotherapy was associated with a lower response rate, shorter progression-free interval and overall survival compared to response and survival of patients who had achieved temporary disease stabilization during previous bolus 5-FU therapy. <b>Conclusions:</b> Continuous infusion of 5-FU/folinic acid displays activity in pretreated and refractory colorectal cancer with acceptable toxicity. Patients who had achieved disease stabilization or objective remission with previous 5-FU bolus therapy appear to be more likely to benefit from second-line treatment. Questions remaining to be addressed include the optimal starting dose of continuously infused 5-FU and whether the dose of folinic acid can be reduced or completely eliminated with respect to toxicity and health economics.
Effects of Doxorubicin and/or Cilostazol on Cancer Cells during Liver Regeneration after Two-Thirds Hepatectomy in Rats
Authors: Ikeda Yasuharu , Matsumata Takashi , Takenaka Kenji , Yamagata Motoyuki , Sugimachi Keizo 
Published: April 2003

A rat model of liver metastases generated by intraportal injection of syngeneic tumor cells after two-thirds hepatectomy to determine the optimal benefit of doxorubicin and/or cilostazol for early hepatic metastases. Four groups of WKA rats had viable tumor cells injected directly into the portal vein after two-thirds hepatectomy. Group A underwent to further treatment. Group B had doxorubicin injected 24 h post-operatively. Group C had cilostazol administered prior to two-thirds hepatectomy. Group D received cilostazol, and doxorubicin injections. The mean survival period in each group was 22.2, 20.0, 28.8, and 22.8 days, respectively. The mean survival was significantly longer in group C than in groups A, B and D (p < 0.05). Based on these findings, we believe that during the phase of liver regeneration adjuvant chemotherapy is not recommended. Cilostazol exerts an important antiproliferative effect on liver metastases after hepatectomy.