bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Glucose Intolerance in Pregnancy Using Biochemical Markers of Fetal Hyperinsulinemia
Authors: Roach Vijay J. , Fung Hedy , Cockram Clive S. , Lau T.K. , Rogers Michael S. 
Published: April 2003

We aimed to evaluate gestational impaired glucose tolerance (GIGT) in untreated patients using umbilical cord blood insulin and connecting peptide (C-peptide) concentrations to indicate fetal hyperinsulinemia. A 75 g, 2-hour oral glucose tolerance test, evaluated using WHO criteria, was performed in 722 antenatal patients. Cord C-peptide (p = 0.001) and insulin (p = 0.008) concentrations were significantly higher in patients with GIGT in comparison to those with normal glucose tolerance. The WHO test failed to identify abnormal C-peptide concentrations (p = 0.057), but did identify abnormal insulin concentrations (p = 0.006) and cases where either or both were raised (p = 0.002), with a low Youden’s index (range 8.1–11.3) in all 3 cases. A significant biochemical difference exists in patients with GIGT. The WHO criteria for GIGT predict abnormal biochemical outcomes, but they do so poorly.
Prophylaxis of the Occurrence of Hyperbilirubinemia in Relation to Maternal Oxytocin Infusion with Steroid Treatment
Authors: Leylek Ozkan A. , Ergur Ayça , Senocak Feyza , Sencan Mehmet , Bakır Sevtap , Ozdemır Himmet , Songur Selda 
Published: April 2003

This study was carried out to investigate the steroid prevention on the occurrence and the severity of red blood cell destruction by the effect of oxytocin usage for labor induction. Venous cord blood was collected from the pregnancies who had oxytocin-induced or augmented labors (20), oxytocin-infused deliveries with steroid use (20), deliveries without oxytocin use (20) and cesarean sections (20). Evaluation of the data showed significant increase in serum bilirubin level, serum lactic dehydrogenase activity, erythrocyte fragility and reticulocyte count (p < 0.0083), and a significant decrease in hemoglobulin concentration, packed red cell volume fraction (p < 0.01) in groups with labor induction or augmentation with oxytocin in comoparison to deliveries with oxytocin plus steroid use and the two other methods of delivery. Moreover, with regard to the above data, no significant difference was observed between the deliveries other than oxytocin-only use. Mean corpuscular volume in the oxytocin group was apparently (not significant) higher than the steroid group. The results of this study suggest that the use of 16 mg dexamethasone 21-phosphate at the beginning of the induction or augmentation of labor with oxytocin, followed by an additional 4-mg dose 4 h later intravenously, is advantageous for the prevention of erythrocyte destruction.
The Complexity of Pregnancy Anemia in Dar-es-Salaam
Authors: Massawe S.N. , Urassa E.N.J. , Mmari M. , Ronquist G. , Lindmark G. , Nystrom L. 
Published: April 2003

<i>Objectives:</i> To investigate the main causes of anemia in pregnancy in Dar-es-Salaam and identify appropriate investigations at all levels of care. <i>Materials:</i> All pregnant women booking for antenatal care at 2 clinics (n = 2,235) were screened for anemia. Investigations for etiology of anemia were done in all anemic women (Hb <10.5 g/dl) (n = 361). <i>Methods:</i> Blood cell counts, microscopy of blood films, S-ferritin, C-reactive protein, HIV, stool parasite and bone marrow analysis were performed. <i>Results:</i> Iron deficiency dominated in 86% and malaria in 1/3 of anemia cases. Since 42% had indication of ongoing inflammation, S-ferritin was less useful as indicator of iron deficiency but blood film microscopy identified most cases.
Endometrial Morphology and Ultrasound Vascular Findings
Authors: Ragni Guido , Piloni Stefania , Rossi Piero , Carinelli Silvestro , de Lauretis Luciana , Vegetti Walter , Crosignani Pier Giorgio 
Published: April 2003

Luteal-phase supplementation has proved necessary in Gn-RH analog and human gonadotropin-stimulated cycles. We studied the effects of vaginally and intramuscularly delivered progesterone on the endometrium. Thirty patients enrolled in an IVF program without embryo transfer due to absence of fertilization were included in the study. Patients were randomly allocated to two treatment groups. Group A (n = 15) was administered 200 mg progesterone b.i.d. by the vaginal route (Esolut, Angelini) starting on the day of oocyte pick up and group B (n = 15) was given 100 mg intramuscular progesterone once daily (Prontogest, Amsa). Six days after HCG administration, biopsies were obtained for endometrial histological maturation and estrogen (ER) and progesterone (PR) receptor analyses. In addition, ultrasound measurements of endometrial thickness were made and uterine and myometrial artery flow was determined. Serum concentrations of estriol and progesterone were measured on the day of HCG, at oocyte pick up and at endometrial biopsy. The two treatment groups were similar in terms of follicular phase parameters during superovulation with Gn-RH analog and gonadotropin. Histologic, receptor and ultrasonographic analyses showed no significant differences between the two treatment groups. Our results indicate that both intramuscular and vaginal progesterone are equally effective on the endometrium.
Postmenopausal Endometrial Pathologies with Tamoxifen Treatment: Comparison between Hysteroscopic and Hysterectomy Findings
Authors: Cohen Ilan , Azaria Ron , Aviram Rami , Bernheim Joelle , Tepper Ron , Cordoba Mario , Beyth Yoram 
Published: April 2003

Histological findings of endometrial specimens collected by hysteroscopy from 261 postmenopausal breast cancer patients with tamoxifen treatment (group I) and from endometrial specimens obtained following hysterectomy from 40 similar patients (group II) were compared. This comparison was performed in order to assess whether endometrial pathologies are more frequently diagnosed in specimens collected by hysterectomy than by those collected during hysteroscopy in such patients. Overall positive endometrial histological findings were significantly more common in group II patients than in group I patients (82.5 and 24.5%, respectively; p < 0.0001). Atrophic endometrium was significantly more common in group I patients than in group II patients (75.5 and 15.0%, respectively; p < 0.0001). All other different endometrial pathologies, except for proliferative endometrium, were significantly more common in group II patients than in group I patients (endometrial hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial polyps = 30.0 and 11.5%, respectively; p < 0.006; endometrial polyps with hyperplasia = 17.5 and 4.2%, respectively; p < 0.0003; endometrial carcinoma = 15.0 and 0.4%, respectively; p < 0.0001). These findings suggest that in postmenopausal breast cancer patients treated with tamoxifen, the frequency of various endometrial histological findings and of overall positive endometrial histological findings were significantly higher in specimens collected by hysterectomy than in specimens obtained by hysteroscopy.
Nitric Oxide Affects Angiotensin II Pressor Response: Possible Mechanism of Attenuated Pressor Response during Pregnancy and Etiology of Pregnancy-Induced Hypertension
Authors: Maeda Takahiro , Yoshimura Toshihiro , Ohshige Akihiro , Koyama Hideki , Ito Masaharu , Okamura Hitoshi 
Published: April 2003

<i>Objective:</i> To investigate the mechanism of attenuated pressor responses to several vasoconstrictors during gestation, we sought to characterize the effects of N<sup>G</sup>-monomethyl-<i>L</i>-arginine (<i>L</i>-NMMA) and <i>L</i>-arginine (<i>L</i>-Arg) on the pressor response to the infusion of angiotensin II in rats. <i>Methods:</i> <i>L</i>-NMMA and <i>L</i>-Arg were infused intraperitoneally into rats at a constant rate by means of an osmotic minipump. The <i>L</i>-NMMA group received an infusion of <i>L</i>-NMMA (3 mg/day) daily for 13 days, whereas the <i>L</i>-NMMA plus <i>L</i>-Arg group received <i>L</i>-NMMA (3 mg/day) daily for 4 days, followed by <i>L</i>-NMMA plus <i>L</i>-Arg (12 mg/day) daily for 9 days. Sham-operated rats served as controls. The animals were anesthetized on day 13, and catheters were placed into the femoral artery and vein. After the animals had recovered from anesthesia, the pressor response to intravenous bolus doses of angiotensin II (50, 100, 200, and 400 ng/kg) were determined after recovery from anesthesia. <i>Results:</i> While the baseline mean arterial blood pressure was not affected by <i>L</i>-NMMA, with or without <i>L</i>-Arg, the pressor response to angiotensin II in the <i>L</i>-NMMA group was significantly increased as compared with that in the control group, at doses of 50, 100, and 200 ng/kg. The response of the <i>L</i>-NMMA plus <i>L</i>-Arg group did not differ significantly from that of the control group. <i>Conclusion:</i> Results indicate that the infusion of a nitric oxide synthase inhibitor, at a dose insufficient to produce hypertension, increases the pressor response to angiotensin II.
Comparison of Magnesium and Methyldopa for the Control of Blood Pressure in Pregnancies Complicated with Hypertension
Authors: Rudnicki Martin , Frølich Anne , Pilsgaard Kirsten , Nyrnberg Lone , Møller Mette , Sanchez Manuel , Fischer-Rasmussen Wiggo 
Published: April 2003

<i>Objectives:</i> Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. <i>Methods:</i> A total of 33 patients with pregnancy-induced hypertension were randomized to either magnesium or methyldopa treatment. Of these 16 received magnesium and 17 methyldopa. The treatment comprised a 48-hour magnesium infusion followed by oral magnesium tablets until 3 days after delivery or 250 mg methyldopa 4 times a day in a similar period. <i>Results:</i> Patients treated with magnesium had 1 day after inclusion a statistically significantly lower systolic blood pressure compared to the level in the methyldopa group (138.1 ± 11 vs. 147.6 ± 11 mm Hg; p < 0.05), but no difference was observed in diastolic blood pressure (92.0 ± 6.6 vs. 96.0 ± 10.1 mm Hg; NS). From the 5th day of inclusion and until delivery both systolic and diastolic blood pressure were significantly lower in the magnesium group (p < 0.05). Including all blood pressure measurements in a single analysis showed that both systolic (138 ± 13 vs. 148 ± 15 mm Hg; p < 0.0001) and diastolic (92 ± 10 vs. 94 ± 10 mm Hg; p < 0.05) blood pressure were lower in the magnesium group compared to the methyldopa group. There was no difference between the two groups regarding gestational age at delivery, birth weight, Apgar scores and pH in umbilical cord blood. <i>Conclusion:</i> This preliminary study demonstrates that magnesium treatment lowers blood pressure in pregnancies complicated with hypertension. The effect is without any adverse effect on maternal and neonatal well-being.
Transarterial Chemotherapy with Zinostatin Stimalamer for Hepatocellular Carcinoma
Authors: Okusaka Takuji , Okada Shuichi , Ishii Hiroshi , Ikeda Masafumi , Nakasuka Hidekazu , Nagahama Hiroyasu , Iwata Ryoko , Furukawa Hiroyoshi , Takayasu Kenichi , Nakanishi Yukihiro , Sakamoto Michiie , Hirohashi Setsuo , Yoshimori Masayoshi 
Published: April 2003

Zinostatin stimalamer (SMANCS) is a lipophilic intra-arterial chemotherapeutic agent for hepatocellular carcinoma (HCC). Thirty HCC patients underwent transcatheter arterial injection of 4 mg SMANCS-lipiodol emulsion. Their responses were evaluated by computed tomography 1 month after treatment. Complete response (CR) was defined as disappearance or 100% necrosis of all tumors. Partial response (PR) was defined as ≧50% reduction and/or ≧50% necrosis. We regarded the lipiodol accumulation in tumors as being necrotic. CR and PR were observed in 8 patients (27%) and 4 patients (13%), respectively, and the overall response rate (CR + PR/all patients) was 40% (12/30). Of 12 patients whose serum α-fetoprotein levels had been more than 200 ng/ml before treatment, 5 patients (42%) showed more than 50% reduction in this level within 1 month after treatment. Toxicity was quite acceptable, although grade 4 toxicity (WHO) was observed as liver dysfunction in 1 patient. Transarterial chemotherapy with SMANCS, which is well tolerated, appears to have moderate antitumor effect in patients with HCC.
Prognostic Value of nm23 Protein Expression in Renal Cell Carcinomas
Authors: Nakagawa Yoshinori , Tsumatani Kenichi , Kurumatani Norio , Cho Masaki , Kitahori Yoshiteru , Konishi Noboru , Ozono Seiichiro , Okajima Eigoro , Hirao Yoshihiko , Hiasa Yoshio 
Published: April 2003

In the present study, an analysis of whether expression of <i>nm</i>23-H1 and <i>nm</i>23-H2 proteins has prognostic significance was performed. A series of 95 renal cell carcinomas was analyzed for nuclear grade, tumor size (larger than 50 mm or not), staging in the Robson system and expression of <i>nm</i>23-H1 and <i>nm</i>23-H2, as well as patient survival. Immunohistochemical staining of <i>nm</i>23-H1 and <i>nm</i>23-H2 was found in 68.4 and 50.5% of the cases, respectively. Significant differences in <i>nm</i>23-H1, but not <i>nm</i>23-H2 expression were noted with regard to nuclear grade and tumor size. The patients with <i>nm</i>23-H1-expression-negative tumors sized ≤50 mm had a significantly poorer prognosis than their positive counterparts. Multivariate analysis using the Cox proportional hazards regression model indicated that the staging in the Robson system and expression of <i>nm</i>23-H1 were significant and independent prognostic factors for survival. However, no significant correlation between the incidence of metastasis and expression of <i>nm</i>23-H1 or <i>nm</i>23-H2 was found. The results imply that reduced expression of <i>nm</i>23-H1 influences the prognosis of patients with renal cell carcinomas, but not the likelihood of metastasis. In small tumors sized ≤50 mm, reduced expression of <i>nm</i>23-H1 protein was suggested to be an especially strong predictor of a poor prognosis.
Combination Regimen with Carboplatin, Epirubicin and Etoposide in Metastatic Carcinomas of Unknown Primary Site: A Hellenic Co-Operative Oncology Group Phase II Study
Authors: Briasoulis Evangelos , Tsavaris Nicholas , Fountzilas George , Athanasiadis Athanasios , Kosmidis Paris , Bafaloukos Dimitris , Skarlos Dimosthenis , Samantas Epaminondas , Pavlidis Nicholas 
Published: April 2003

The encouraging results that have been reported for cisplatin combination chemotherapy in a minority of patients with cancer of unknown primary (CUP) together with the previously shown equal activity of carboplatin in this setting, prompted us to investigate the effectiveness of a carboplatin-containing regimen in a phase II clinical trial.Sixty-two evaluable CUP patients entered the protocol. The chemotherapy regimen consisted of carboplatin 300 mg/m<sup>2</sup> IV D<sub>1</sub>, epirubicin 45 mg/m<sup>2</sup> IV D<sub>1</sub> and etoposide 120 mg/m<sup>2</sup> IV D<sub>1–3</sub> (CEE regimen) administered every 3 weeks. The median age of the patients was 61 years and 36 were male. Thirty-one diagnosed as poorly differentiated carcinomas (pdc) and the rest as adenocarcinomas. By clinicopathological criteria, 14 patients had a predominately nodal disease with pdc or poorly differentiated adenocarcinomas (pda), 3 women peritoneal carcinomatosis, and the remaining 46 patients had a predominately splanchnic involvement (24 pdc, 22 pda). Twenty-three patients responded to chemotherapy with 4 (6.5%) complete and 19 (30.5%) partial responders (RR 37%, 95% CI 25–49%). An equal activity of the regimen was observed between the two major histopathological types, the pdc and the adenocarcinomas. Nevertheless, significant differences were seen when the CEE regimen was assessed for its activity in the distinct clinicopathological subsets of CUP. Patients with predominately nodal disease of midline distribution with pdc or pda, and women with peritoneal carcinomatosis, achieved a response rate of 64 and 62% respectively, as compared with a 26% response rate for those with predominately splanchnic involvement. Overall median survival was 10 months and for patients with midline distribution 15 months. The regimen was well tolerated. It is concluded that CEE is a relatively nontoxic chemotherapy regimen and easily administered on an outpatient basis. This prospective phase II study confirmed the activity of carboplatin in the chemosensitive subsets of the predominately nodal disease of midline distribution and peritoneal carcinomatosis in women in the CUP syndrome.
Topotecan – A Novel Topoisomerase I Inhibitor: Pharmacology and Clinical Experience
Authors: Kollmannsberger C. , Mross K. , Jakob A. , Kanz L. , Bokemeyer C. 
Published: April 2003

Topotecan, a water-soluble analogue of camptothecin, is a newly available cytotoxic agent which acts as an inhibitor of topoisomerase I, an enzyme necessary for DNA replication. Topotecan is a semisynthetic product derived from camptothecin, which was discovered during a National Cancer Institute cytotoxic drug screening program almost 30 years ago. It acts by forming a stable covalent complex with the DNA/topoisomerase I aggregate, the so-called ‘cleavable complex’. This process leads to breaks in the DNA strand resulting in apoptosis and cell death. Topotecan possesses a serum half-life of approximately 3 h, a high volume of distribution with high tissue uptake and a low protein binding. The chemical structure is based on a lactone ring. Topotecan undergoes reversible hydrolysis from its biologically active lactone form to the open ring inactive carboxylate form. It is also able to penetrate the intact blood-brain barrier. Since most of the agent is excreted by the kidneys, dose adjustment is necessary when renal function is impaired. In contrast, pharmacokinetic behavior is unchanged in patients with limited hepatic function. The principal toxicity of topotecan when administered at standard doses is neutropenia, but thrombocytopenia and anemia occur as well, while the nonhematological toxicities are usually mild. Alopecia is frequently observed and some patients may suffer from pronounced fatigue. Most clinical data available are based on the following schedule: 1.5 mg/m<sup>2</sup> topotecan given as a 30-min infusion, days 1–5. There are currently only minimal data available regarding a dose–antitumor activity relationship. Other topotecan administration schedules are currently being investigated. Preclinical data suggest that continuous-infusion schedules may be a better application form in terms of both, toxicity and antitumor activity. However, clinical trials could not confirm these results to date. Results of phase II studies suggest considerable antitumor activity of single agent topotecan in small cell lung cancer and ovarian cancer patients. A randomized phase III trial of topotecan versus paclitaxel in ovarian cancer patients pretreated with cisplatin/cyclophosphamide has demonstrated that topotecan is as effective as paclitaxel in the second-line treatment of these patients. Activity of topotecan was also observed in non-small-cell lung cancer, refractory leukemias/myelodysplastic syndromes and in childhood sarcomas. Due to its unique mechanism of action and lack of cross-resistance, cisplatin, etoposide, cytarabine and paclitaxel are potential interacting partners for combination chemotherapy regimens. However, the best combination regimen as well as the optimal combination schedule have yet to be conclusively determined. The potential of topotecan in a variety of solid tumors, as well as its use in combination regimens for ovarian and small cell lung cancer is currently being investigated.
A Phase II Study of Concomitant Chemoradiotherapy for Laryngeal Carcinoma Using Carboplatin
Authors: Nishioka Takeshi , Shirato Hiroki , Fukuda Satoshi , Arimoto Takuro , Kamada Tadashi , Furuta Yasushi , Nishino Shigeo , Hosokawa Yoichiro , Kitahara Toshihiro , Kagei Kenji , Inuyama Yukio , Miyasaka Kazuo 
Published: April 2003

<i>Purpose:</i> We conducted a phase II study of concomitant chemoradiotherapy with carboplatin for laryngeal carcinoma. <i>Materials and Methods:</i> Sixty-four patients with stage II–IV (stage II, 36; III, 19; IV 9) laryngeal carcinoma were treated with concomitant administration of carboplatin (CBDCA) during radiotherapy (CRT group) between 1991 and 1994. There were 36 supraglottic, 25 glottic, and 3 subglottic carcinomas. Patients with stage II and stage III–IV received intravenous CBDCA of 100 mg/m<sup>2</sup> and 120 mg/m<sup>2</sup> once a week, respectively. Tumor response was assessed at 40 Gy in 16 fractions to select the patients suitable for total laryngectomy or radical radiotherapy of 65 Gy in 26 fractions in 6.5 weeks. The treatment results were compared with the historical control consisting of 56 patients consecutively treated from 1988 to 1990 without chemotherapy (RT group). The two studies were comparable with regard to patient characteristics, including age distribution, gender, tumor location, size, and clinical stage. <i>Results:</i> The actuarial 5-year survival rate was 80.3% for the CRT group and 81.3% for the RT group. A favorable response (complete response or partial response) at 40 Gy was observed in 87.5% of the patients of the CRT group and in 62.5% of the patients of the RT group (χ<sup>2</sup> = 7.566, p < 0.01). The actuarial 5-year larynx preservation rate for the CRT group (75%) was significantly higher than that for the RT group (57%) in patients with T<sub>2</sub> supraglottic carcinoma (p < 0.05). There was no difference in the larynx preservation rate between the two treatment arms for any T stage of glottic carcinomas. <i>Conclusion:</i> CRT using carboplatin improved the tumor response at 40 Gy and consequently achieved a higher larynx preservation rate for T<sub>2</sub> supraglottic carcinoma. A clinical randomized trial is indicated to certify the findings of this phase II study.
Intensified Adjuvant Cyclophosphamide, Methotrexate and 5-Fluorouracil Therapy: A Dose-Finding Study for Ambulatory Patients with Breast Cancer
Authors: Hietanen P. , Teerenhovi L. , Joensuu H. 
Published: April 2003

Escalating doses of cyclophosphamide were given every 3 weeks as adjuvant treatment for women operated for breast cancer to determine the maximum tolerated dose of cyclophosphamide that can be given with constant doses of methotrexate (40 mg/m<sup>2</sup>) and 5-FU (600 mg/m<sup>2</sup>; CMF) as an outpatient treatment without the routine use of granulocyte colony-stimulating growth factor (G-CSF). The dose of cyclophosphamide was increased by 250 mg/m<sup>2</sup> starting from the dose of 1,000 mg/m<sup>2</sup>. Mesna was given to prevent cystitis. The criteria for dose-limiting toxicity were grade IV granulocytopenia lasting for longer than 48 h, granulocytopenic infection or other grade IV toxicities. G-CSF and ofloxacin were used if grade IV granulocytopenia continued for longer than 48 h or if granulocytopenic infection occurred. At the dose level of 1,500 mg/m<sup>2</sup> (500 mg/m<sup>2</sup>/week) 22 (92%) of the 24 patients had grade IV granulocytopenia during the 6 CMF cycles given, but only 3 (13%) had granulocytopenic fever. G-CSF was used in 28% of the cycles at this dose level. Other toxicities included complete alopecia (79%), nausea and vomiting. Sixteen (80%) of the premenopausal women became postmenopausal. At the dose level of 1,750 mg/m<sup>2</sup> all 3 patients treated had to be hospitalized after the first cycle due to neutropenic infection (n = 2) or intractable vomiting even though prophylactic G-CSF was used. We conclude that intravenous CMF with a cyclophosphamide dose of 1,500 mg/m<sup>2</sup> given at 3-week intervals with the selective use of prophylactic G-CSF is feasible as adjuvant treatment for patients with breast cancer.