bluuebunny/crossref_metadata_2025_split huggingface dataset:
Half-Life of Estradiol in Postmenopausal Women
Authors: Ginsburg Elizabeth S. , Gao Xiaoying , Shea Brian F. , Barbieri Robert L. 
Published: April 2003

Estrogen replacement is often advised for postmenopausal women to prevent menopausal symptoms, osteoporosis and heart disease. However, little information is available concerning the half-life of estradiol (E<sub>2</sub>) in postmenopausal women. This study was designed to determine the half-life and metabolism of transdermal E<sub>2</sub>. A prospective clinical study of 8 healthy postmenopausal women was performed in the Clinical Research Center of the Brigham and Women’s Hospital. A transdermal E<sub>2</sub> patch 0.10 mg was placed on the abdominal wall. Thirteen hours later, after an overnight fast, the E<sub>2</sub> patch was removed and frequent blood sampling was performed over 6 h. Serum samples were assayed for E<sub>2</sub>, estrone (E<sub>1</sub>) and estrone sulfate (E<sub>1</sub>S). Serum samples were taken before E<sub>2</sub> patch placement, for 30 min before patch removal, and for 6 h after patch removal. The basal E<sub>2</sub> level of women prior to use of transdermal E<sub>2</sub> was 19 ± 2 pg/ml (mean ± SE). Thirteen hours after transdermal E<sub>2</sub> placement, steady state levels had been reached, with a mean E<sub>2</sub> of 112 ± 6 pg/ml. The mean half-life of E<sub>2</sub> after removal of transdermal E<sub>2</sub> was 161 min (range 107–221 min). There was a direct relationship between the subjects’ weight and the half-life of E<sub>2</sub> (r = 0.79, p = 0.02). Mean basal E<sub>1</sub> levels were 23 ± 5 pg/ml and mean E<sub>1</sub> steady-state levels after E<sub>2</sub> patch placement were 39 ± 0.6 pg/ml. E<sub>1</sub>S levels rose from mean basal levels of 1.5 ± 0.3 ng/ml to mean steady-state levels of 3.1 ± 0.1 ng/ml after placement of the E<sub>2</sub> patch. The apparent half-life of E<sub>2</sub> after discontinuing a transdermal E<sub>2</sub> patch is 2.7 h or 161 min.
Antepartum Risks of Shoulder Dystocia and Brachial Plexus Injury for Infants Weighing 4,200 g or More
Authors: Blickstein Isaac , Ben-Arie Alon , Hagay Zion J. 
Published: April 2003

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

Elastase is produced and released by polymorphonuclear leukocytes (PNMs) during inflammatory processes. Thus, elastase is assumed to be a sensitive marker of infections similar to the well-established C-reactive protein (CRP). It is deactivated predominantly in tissues by α<sub>1</sub>-proteinase inhibitor which forms stable complexes with the elastase molecule (EAPI) that can be detected for several hours. Premature rupture of membranes is often correlated with an early increase in elastase, occurring earlier than the increase in leukocyte count or CRP. Elastase might be a sensitive marker of beginning amnion infection syndrome after premature rupture of membranes. For the present study, plasma EAPI levels of 335 healthy pregnant women as well as 47 healthy nonpregnant pre- and postmenopausal women were analyzed. No significant differences were found in the latter group or in pregnant women until the beginning of labor. Women at the beginning of labor but without rupture of membranes showed a significant increase in plasma EAPI from 97.7 to 338.3 ng/ml (p < 0.001). With opening of the os uteri to more than 2 cm, elastase concentrations decreased to values comparable to those before the beginning of labor (p < 0.001). The use of elastase as a marker for a rupture of membranes or beginning amnion infection syndrome as suggested by a number of studies might need some restriction. As a consequence, serial monitoring of plasma elastase to detect a persisting increase might give more reliable results. The increase in plasma elastase during beginning of labor may be explained by the role of PMNs in the physiology of delivery. However, serial monitoring to detect a persisting increase in plasma EAPI may be more helpful.
Perinatal Outcome of Oligohydramnios without Associated Premature Rupture of Membranes and Fetal Anomalies
Authors: Hsieh T’sang-T’ang , Hung Tai-Ho , Chen Kuang-Chao , Hsieh Ching-Chang , Lo Liang-Ming , Chiu Tsung-Hong 
Published: April 2003

To investigate the perinatal outcome of patients with oligohydramnios (amniotic fluid index ≤5 cm), but without premature rupture of membranes and fetal congenital anomalies, data from 245 singleton pregnancies were analyzed and compared to those with normal amniotic fluid volumes (5 < amniotic fluid index < 24 cm, n = 27,261). Significantly higher incidences of primiparity, pregnancy-induced hypertension, premature separation of placenta, past history of intrauterine fetal death, past history of preterm delivery, postterm pregnancy, and advanced maternal age were noted to be associated with the occurrence of oligohydramnios. Pregnancies complicated by a markedly diminished amniotic fluid volume assessed antenatally by ultrasound were significantly more frequently associated with adverse perinatal outcomes such as preterm delivery, low or very low birth weight, low Apgar scores, intrauterine fetal death, small-for-gestational-age newborns, meconium staining, cesarean delivery, neonatal intensive care, and neonatal death.
Role of Serum Ceruloplasmin and Its Ferroxidase Activity on Preterm Labor
Authors: Vitoratos N. , Botsis D. , Christodoulacos C. , Contoravdis A. , Dalamaga A. , Chryssicopoulos A. 
Published: April 2003

The role of serum ceruloplasmin and its ferroxidase activity on preterm labor with or without rupture of the membranes was studied. Thirty-seven primigravid women between 31 and 35 weeks of gestation were investigated. Our material is divided into 3 groups. Group A consisted of 12 patients with premature rupture of the membranes; group B consisted of 10 patients with preterm labor but intact membranes, and group C consisted of 15 non-laboring patients. Patients with rupture of the membranes presented with statistically significantly higher serum ceruloplasmin levels compared to those with preterm labor but intact membranes (p < 0.05) as well as to non-laboring patients (p < 0.01). On the contrary, the mean ferroxidase activity level or ceruloplasmin was 518.2 ± 183.42, 460.9 ± 198.8 and 517.5 ± 142.01 µmol/l/min in groups A, B and C, respectively. These values were not significantly different. Our results show a loss of ferroxidase activity of ceruloplasmin in patients with rupture of the membranes and probably suggest a defect in the maternal defense mechanisms.
Interleukin-6 Concentrations in Cervical Secretions in the Prediction of Intrauterine Infection in Preterm Premature Rupture of the Membranes
Authors: Rizzo Giuseppe , Capponi Alessandra , Vlachopoulou Anastasia , Angelini Emanuela , Grassi Carmen , Romanini Carlo 
Published: April 2003

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

The electric activity of the ovary was studied in 13 female mongrel dogs aiming at characterizing a normal electro-oophorogram (EOOG). Two monopolar silver-silver chloride electrodes were sutured under anesthesia to the ovary of the bitches which were in the anestrus phase of the estrous cycle. A daily recording session of 60 min was performed for 10 days. Furthermore, the effect of ovarian vessels’ clamping, of oophorectomy and of ovarian insult by irradiation on the electric activity, was studied. Electric waves were recorded from the two electrodes. Each wave consisted of a negative followed by a positive deflection with a mean amplitude of 52.6 ± 10.7 µV and frequency of 9.2 ± 1.6 cycles per second. The waves showed the same amplitude and frequency from the two electrodes and were reproducible when the test was repeated in the same animal. Fast activity spikes were not encountered. Temporary clamping of the ovarian vessels caused diminution of the normal ovarian electric activity which returned to the preclamping state after clamp release. A ‘silent’ EOOG was obtained after oophorectomy. Two EOOG patterns were recorded from the irradiated ovary: silent and dysrhythmic. To conclude, an EOOG could be characterized for the bitches in the anestrus phase which is a quiescent phase of the estrous cycle. Further studies are required to record the EOOG in the other phases of the estrous cycle and in the various pathologic conditions of the ovary.
Estrogen and Progesterone Receptors in Benign Ovarian Tumors of Menopausal Breast Cancer Patients Treated with Tamoxifen
Authors: Cohen Ilan , Bernheim Joelle , Fishman Amiram , Shapira Jeremiah , Tepper Ron , Beyth Yoram , Cordoba Mario , Yigael Dror , Altaras Marco M. 
Published: April 2003

In order to assess possible ovarian cell potential for interaction with tamoxifen, thus demonstrating possible effects of this agent on the development of ovarian pathologies through growth stimulation and cell proliferation, we measured estrogen receptors (ER) and progesterone receptors (PR) by immunohistochemical method in 16 benign ovarian tumors removed from 11 postmenopausal breast cancer patients treated with tamoxifen (study group). The results were compared with those measured in 7 similar ovarian tumors obtained from 5 similar patients without tamoxifen treatment (control group I), and in 9 similar tumors removed from 9 age-matched postmenopausal women (control group II). There were no significant differences with regard to ER or PR expression between the study group and control group I and II (ER = 18.75, 0.0 and 11%, respectively; PR = 43.75, 28.5 and 44%, respectively; p = NS). There were also no significant statistical differences between the three groups when subdividing the ovarian pathologies according to different histological types. From the results obtained in this study, it seems that tamoxifen probably does not have any direct influence on the ovaries of menopausal breast cancer patients.
Reproducibility of Transvaginal Ultrasonographic Measurements of Endometrial Thickness in Patients with Postmenopausal Bleeding
Authors: Wolman Igal , Amster Reuben , Hartoov Joseph , Gull Ilan , Kupfermintz Michael , Lessing Joseph B. , Jaffa Ariel J. 
Published: April 2003

The aim of the study was to establish the reproducibility of transvaginal sonographic measurements of endometrial thickness in patients with postmenopausal bleeding (PMB). In a prospective blind study, two examiners measured the endometrial thickness in 48 patients presenting with PMB by transvaginal sonography on two separate occasions, 30 min apart. The analysis of variance performed at each endometrial thickness measured by the two examiners revealed no statistical difference. However, it was shown that the most accurate measurements are up to the level of 4 mm (mean deviation of 0.1 ± 0.2 mm, range 0.7). Once the endometrial thickness reaches 5–6 mm the mean deviation becomes 0.3 ± 1.2 mm with a range of variation of 4 mm. In conclusion, measurements of endometrial thickness in patients presenting with PMB can be repeated quite accurately up to a level of 4 mm thickness.
Proton NMR Spectroscopy of the Phospholipids in Human Uterine Smooth Muscle and Placenta
Authors: Pulkkinen Martti O. , Nyman Samuel , Hämäläinen Mauri M. , Mattinen Jorma 
Published: April 2003

The parameters regulating the fluidity of myometrial and placental phospholipids include double bonds, fatty acid chain lenght and the cholesterol/phospholipid ratio. The transformation of these parameters was studied during pregnancy and labor. Myometrial and placental tissue samples were collected from 24 patients: 6 were nonpregnant, 6 early-pregnant, 6 late-pregnant not in labor and 6 in labor. After butanol extraction, tissue cholesterol and lipid phosphorus were determined. Proton NMR spectroscopy of the phospholipids was performed at 500 MHz. The myometrial cholesterol/phospholipid ratio was slightly elevated in pregnant patients not in labor. The uterine muscle of the nonpregnant patients contained more CH=CH groups in the phospholipids than that of the late-pregnant patients. There were 29 more double bonds in placental than in uterine tissue per 100 fatty acid molecules. The average fatty acid chain length varied from 14.0 to 18.8. The placenta has longer fatty acid chains than the uterine smooth muscle. The myometrial carbon chain was shortened on the average by 1.4 and the placental by 1.0 carbon atoms, when the patient went into clinical labor. These findings suggest fluidity changes in myometrial and placental phospholipids during human pregnancy and labor.
Ultrasonographic Blood Flow Measurement in the Carotid Arteries in Postmenopausal Women
Authors: Darj Elisabeth , Bakos Oddvar , Naessen Tord , Persson Ingemar 
Published: April 2003

<i>Objectives:</i> The aim of the present study was to evaluate blood flow in postmenopausal women on hormone replacement therapy (HRT) compared to controls. Blood flow was ultrasonographically measured in the great arteries of the neck instead of in the vessels of the internal genital organs. <i>Methods:</i> Fifty healthy women with climacteric complaints, at least 6 months postmenopausal, participated in the study. They were randomly divided into two groups. One group received 2 mg estradiol (E<sub>2</sub>) for 12 days, continued with 2 mg E<sub>2</sub> and 1 mg norethisterone acetate for 10 days, followed by 1 mg E<sub>2</sub> for 6 days, cyclically during 6 months. The other group received placebo tablets the first 3 months and the same HRT as the first group for the last 3 months. Blood flow was measured ultrasonographically by color flow pulsed Doppler in the common (CCA), internal (ICA) and external (ECA) carotid arteries, before the start of the study, after 3 and 6 months of therapy. <i>Results:</i> CCA and ICA, both low resistance vessels, and ECA, a high resistance vessel, and their waveforms were identified. Pulsatility index did not decrease statistically significant (p > 0.05) in any of the great vessels during 6 months of HRT in this study. There were no differences in blood flow between the HRT-treated group compared to control group during 3 months of therapy, except for the right ECA (p = 0.04). <i>Conclusion:</i> The difference in blood flow and wave-forms of the major arteries of the neck were clearly shown, but HRT did not have any important impact on the blood flow in this study. No difference was shown concerning blood flow between the two groups of postmenopausal women, on active therapy or placebo.
Endometrial Response to Unopposed Estrogens Remains Unaltered in Patients with Chronic Renal Failure Receiving Hemodialysis
Authors: Ergeneli Mehmet H. , Duran E. Hakan , Zeyneloglu Hulusi B. , Demirhan Beyhan , Erdogan Mithat 
Published: April 2003

Most patients with chronic renal failure who are on maintenance hemodialysis are anovulatory and have menstrual abnormalities. This study was designed to determine the prevalence of organic causes of abnormal uterine bleeding in this group of patients exposed to unopposed estrogens. Eighteen patients with chronic renal failure and abnormal uterine bleeding underwent vacuum curettage. The histopathologic findings were compared with a group of 154 premenopausal women who had abnormal uterine bleeding without detectable organic causes. Excluding patients with secretory and atrophic endometrium, only 2 of 8 patients (25%) with chronic renal failure had endometrial lesions while 44 of 131 patients (33.6%) had either endometrial polyp, simple or atypical endometrial hyperplasia or endometrial carcinoma (p > 0.05). The uremic environment caused by chronic renal failure does not alter the endometrial responsiveness to unopposed estrogens and may lead to the development of endometrial lesions.
The Role of Oxytocin in Relation to Female Sexual Arousal
Authors: Blaicher Wibke , Gruber Doris , Bieglmayer Christian , Blaicher Alex M. , Knogler Wolfgang , Huber Johannes C. 
Published: April 2003

Oxytocin is clearly involved in human reproduction and serves an important role in sexual arousal. Oxytocin serum levels were measured before and after sexual stimulation in 12 healthy women. Values of oxytocin 1 min after orgasm were significantly higher (p < 0.05) than baseline levels. This finding supports the hypothesis that oxytocin plays a major part in human sexual response both in neuroendocrine function and postcoital behavior.
Umbilical Artery Waveforms in Triplet and Quadruplet Pregnancies
Authors: Ezra Yossef , Jones Julia , Farine Dan 
Published: April 2003

The incidence of abnormal umbilical waveforms in triplet and quadruplet pregnancies and its correlation with adverse pregnancy outcome was studied by a retrospective review of all our triplet and quadruplet pregnancies (1986–1993) with documented Doppler flow assessment. Obstetrical outcomes were analyzed in relation to abnormal umbilical artery waveforms. Nineteen triplet and 4 quadruplet pregnancies were studied. Of 73 fetuses, 6 had abnormal umbilical artery waveforms (8.2%). All abnormal waveforms were characterized by persistent absence of the end-diastolic velocities (AEDV). In comparing the abnormal and normal groups, significant differences were found in birth weights (910 ± 433 vs. 1,724±434 g; p = 0.0004), small for gestational age rate [5/6 (83%) vs. 5/67 (7.5%); p = 0.0003], and perinatal mortality rate [3/6 (50%) vs. 2/67(3%); p = 0.001]. There were no differences in congenital anomalies, gestational age at birth, and neonatal intensive care admission. In conclusion, it seems that Doppler umbilical artery waveforms in multiple pregnancies were either normal or extremely abnormal (e.g. AEDV). AEDV was associated with adverse perinatal outcomes such as low birth weight, growth restriction and perinatal mortality.
The Severity of Polyhydramnios, Estimated Fetal Weight and Preterm Delivery Are Independent Risk Factors for the Presenceof Congenital Malformation s
Authors: Lazebnik Noam , Many Ariel 
Published: April 2003

<i>Objective:</i> To evaluate maternal and fetal factors associated with congenital malformations in patients with polyhydramnios. <i>Study Design:</i> The study group consisted of 275 singleton pregnancies with an amniotic fluid index (AFI) >25.0 cm. An equal number of controls were matched for maternal age, gravidity, parity and gestational age. The proportion of cases and controls with malformations was compared. Polyhydramnios cases were categorized into three groups by severity: mild (AFI 25–30 cm), moderate (AFI: 30.1–35.0 cm) and severe (AFI >35.1 cm). Among cases, logistic regression analysis was utilized to estimate the risk for fetal congenital malformations in relation to severity of polyhydramnios, estimated fetal weight, maternal diabetic status and gestational age at delivery. <i>Results:</i> Congenital malformations were detected in 40 of 275 cases (14.5%) with polyhydramnios and in 9 cases (3.3%) of the control group (p < 0.01). The relative risks of congenital malformations increased with the severity of polyhydramnios: 3.2 (95% CI 1.5–6.8), 5.7 (95% CI 2.4–13.3) and 13.1 (95% CI 5.8–29.5) for mild, moderate and severe polyhydramnios, respectively. Congenital malformations among polyhydramnios cases were present in 54.5% of small-for-gestational age fetuses, in contrast to 12.7% for average-for-gestational age fetuses and 10.8% for large-for-gestational age fetuses (p < 0.001). Maternal diabetic status did not significantly affect the fetal anomaly rate once polyhydramnios was detected. Premature newborns in the polyhydramnios group had a higher malformation rate (24%) than did term newborns (11.3%) (p < 0.02). In the study group, multiple logistic analysis confirmed the significance of severe polyhydramnios, small-for-gestational age status and preterm delivery as independent contributors to the malformation risk. <i>Conclusions:</i> Polyhydramnios (AFI >35 cm), small-for-gestational age fetus and preterm delivery are independent risk factors for congenital malformations.
Glutathione S-Transferase Alpha Levels in Epileptic and Healthy Women Preconceptionally and throughout Pregnancy
Authors: Zusterzeel Petra L.M. , Knapen Maarten F.C.M. , Roes Eva Maria , Steegers-Theunissen Régine P.M. , Peters Wilbert H.M. , Merkus Hans M.W.M. , Steegers Eric A.P. 
Published: April 2003

We studied plasma GSTA1-1 concentrations in preconceptionally recruited epileptic women who received antiepileptic drugs (n = 99) and a control group of healthy women (n = 106). Mean plasma GSTA1-1 concentrations in the control group did not show significant changes preconceptionally and throughout pregnancy. Six weeks postpartum, however, a significant increase in the mean plasma GSTA1-1 concentration (p < 0.001) was found as compared to preconceptional levels and levels during pregnancy. The mean plasma GSTA1-1 concentration in epileptic women was significantly higher in the 4th gestational week compared to those determined in healthy pregnant women (1.68 versus 1.08 μg/l, p < 0.001). Values between the groups in the second and third trimester and postpartum period showed no significant differences.