摘要:

The effective half-life of prostacyclin in human serum is highly dependent on binding to serum proteins. Abnormalities in prostacyclin binding appear to be important in some patients with thrombotic thrombocytopenic purpura. We investigated prostacyclin binding and half-life in normotensive and hypertensive pregnant women and in nonpregnant controls. Pregnancy was associated with a decrease in serum prostacyclin binding and a shorter prostacyclin half-life. This decrease was even greater in women with hypertensive disorders. The decrease in prostacyclin half-life in hypertensive disorders may play an important role in the pathogenesis of these disorders. Measurement of both production and metabolism, however, will be required to adequately assess the role of prostacyclin in normal and abnormal gestation

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

High dietary protein intake is known to increase glomerular filtration rate in the nonpregnant state. The effects of dietary protein on renal function in human pregnancy are not well known. We studied 392 patients with singleton uncomplicated pregnancies at gestational ages of 7-40 weeks. Creatinine clearance was correlated with protein intake estimated from 24-hour dietary recall during the same period. Creatinine clearances were significantly higher when dietary protein was more than 50 g than when it was less than 50 g (P<.005). The short- or long-term significance of this finding is unclear

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

To characterize the flora of early postpartum endometritis and the clinical features of women with specific organisms, endometrial cultures for facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis were taken with a triple-lumen sampling device. More than one organism was recovered from 80% of the women. Over 60% of the women had Gardnerella vaginalis and/or anaerobes associated with bacterial vaginosis isolated from the endometrium; these women were more likely to have severe illness and to develop a wound infection than were other women. Genital mycoplasmas were isolated frequently, but specific antibiotic therapy was not required for clinical cure in the 10% of patients who had Ureaplasma urealyticum only. Chlamydia trachomatis was infrequently isolated, but C trachomatis commonly remained after therapy

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Thirty-six patients with epithelial ovarian cancer, incompletely resected at primary laparotomy, were treated with one of two intensive cis-platinum-based combination chemotherapy regimens. The intention was to perform further surgical debulking (intervention debulking surgery) after three cycles in patients responding to treatment. Intervention debulking surgery was carried Out in 28 of 36 patients (78%) at a median interval of 12.7 weeks from primary diagnosis. Omentectomy and total abdominal hysterectomy were the most commonly performed procedures at intervention debulking. As a result of such surgery, 16 of the 28 women (57%) were left with no macroscopic residual disease, five (18%) had less than 1 cm, four (14%) less than 2 cm residuum, and three (11%) remained with more extensive disease. Post-intervention debulking surgical complications were few, with a median postoperative hospital stay of 10 days and a median interval of 21 days from debulking surgery to resumption of chemotherapy. Neoadjuvant (cytoreductive) chemotherapy combined with early secondary surgical debulking is feasible, with little severe morbidity, and can leave a high proportion of patients free of macroscopic disease. The effect of such a program on patient survival is now being tested in a randomized study

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Follicle regulatory protein immunoreactivity and biologic activity were measured in ascites from a patient with juvenile granulosa cell tumor. Microscopic examination of immunohistochemical staining of a juvenile granulosa cell tumor with anti-follicle regulatory protein antisera showed homogeneous cytosolic expression of follicle regulatory protein throughout the tumor. Tumor cells were injected subcutaneously into nude mice. Partially purified follicle regulatory protein (50 µg/day) was then injected daily for 10 days, or for 25 days once the tumor became palpable. Treatment with follicle regulatory protein significantly slowed the rate of tumor growth with both treatments. To test the tissue specificity of the effect, a metastatic, welldifferentiated endometrial adenocarcinoma was also grown in nude mice. Follicle regulatory protein treatment did not alter the rate of tumor growth. An in vitro clonigenic assay confirmed these in vivo results. Partially purified follicle regulatory protein had a biphasic effect on the proliferation of juvenile granulosa tumor cell but did not affect the proliferation of endometrial adenocarcinoma cells. Clonigenic assays were performed on five ovarian adenocarcinomas passaged in vitro, and these tumor cells exhibited a biphasic response to follicle regulatory protein. Immunoneutralization studies showed that this biphasic response was due to impurities in the follicle regulatory protein preparations. The longer the exposure of the tumor cells to follicle regulatory protein, the greater the degree of inhibition of proliferation. In summary, administration of follicle regulatory protein slowed tumor growth through a direct effect on the tumor cell rather than an indirect effect on the hormonal or immune status of the host

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The estrogen receptor content, determined immunohistochemically by staining with monoclonal antibodies, was studied in seven consecutive cases of endometrial stromal sarcoma. In addition, the mitotic rate and immunohistochemical patterns (vimentin, desmin, actin, cytokeratins) were determined. Five of seven cases contained estrogen receptors, three low-grade (fewer than 10 mitoses/10 highpower fields [hpf]) and two high-grade (10 or more mitoses/ 10 hpf), the latter having a relatively low mitotic rate. The two negative cases were high-grade with a very high number of mitoses. Tumor cells were positive only to vimentin. Based on these results, we postulate that estrogen receptors are undetectable only in highly proliferating neoplasms. Thus, immunohistochemically determined estrogen receptor levels may indicate the aggressiveness of endometrial stromal sarcoma, and might be a guideline in selecting patients for hormonal therapy. The presence of positive immunostaining to vimentin confirms the mesenchymal origin of endometrial stromal sarcoma

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Sialyl Lewis-Xi antigen was measured by sandwich radioimmunoassay in sera from patients with various gynecologic tumors: 27 uterine myomas, 117 cervical cancers, 46 endometrial cancers, 54 benign ovarian cysts, and 47 ovarian cancers. Among the patients with uterine malignancies, only a few cases showed serum sialyl Lewis-Xi antigen values in excess of the cutoff limit. On the other hand, among the patients with ovarian cancers, serum sialyl Lewis-Xi antigen was elevated significantly in the following order: clinical stage I (44%), stage II (50%), and stage III (62%). The antigen level also correlated with the effect of treatment. However, serum sialyl Lewis-Xi antigen was elevated in 9% of patients with benign ovarian cysts and in 1.4% of normal volunteers. The lack of tumor specificity of sialyl Lewis-Xi antigen limits its diagnostic value for gynecologic malignancies, but serial measurement of this antigen may be useful in evaluating therapy and monitoring patients

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A double-blind, placebo-controlled study was undertaken to evaluate the long-term efficacy and safety of oral acyclovir suppressive therapy over a 1-year period. Results from the multicenter trials, based on a total of 261 patients with frequently recurring genital herpes, were analyzed. Of the patients enrolled in the study, 131 received oral acyclovir capsules (800 mg) daily and 130 received placebo capsules. Medication was taken twice daily. Analysis of data from patients who completed a full year of therapy demonstrated that only 5% of patients receiving placebo were free from recurrences, as compared with 46% of acyclovir recipients. The mean number of recurrences for patients on acyclovir therapy was 1.8, as compared with a rate of 8.7 recurrences for the placebo group over the course of the year. The mean time to the first recurrent herpes outbreaks was 19 days for the placebo group and 274 days for the acyclovir-treated patients. There were no significant differences between the two groups in laboratory data or in the frequency or nature of side effects reported. Daily administration of acyclovir capsules for 1 year is a safe and effective therapy for control of frequent recurrences of genital herpes.

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Dating of maturity of the endometrium by histologic examination was correlated with four methods of ovulation detection in 13 cycling parous women. Histologic dating was assessed independently by two pathologists and correlated with the postovulatory duration as determined by daily transvaginal ultrasound scanning, serum LH measurements, basal body temperature (BBT), and subtraction of 14 days from the onset of menses. In addition, progesterone and estradiol (E2) were measured in daily serum samples. Dating of the endometrial biopsy was highly correlated (P<.002) with the day of ovulation as determined by ultrasound, and was found to be within 2 days of the correct postovulatory day on evaluation of 25 of 26 (96.1%) of the interpretations. The accuracy of dating using the LH surge was 84.6% (22 of 26 interpretations), and with the BBT thermogenic shift was 76.9% (20 of 26 interpretations). However, dating of the endometrium was within 2 days of the correct day in only 17 of the 26 interpretations as determined by subtracting 14 days from the onset of the subsequent menses. The accuracy of dating was significantly better correlated (P<.025) with days from ovulation as determined by ultrasound than as calculated from the onset of menses. There was a significant correlation between endometrial dating and the amount of progesterone (P<.01) and E2 (P<.01) secreted from the day of ovulation, as determined by transvaginal ultrasound, to the day of biopsy. These data confirm a strong correlation between endometrial dating and ovarian hormone secretion during the postovulatory phase. If histologic dating of the endometrium is used to diagnose luteal insufficiency, it must be correlated with days since ovulation as determined by an accurate method rather than as calculated by subtracting 14 days from the onset of menses

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The concentrations of serum albumin and albumin reserve for bilirubin binding were studied in 24 healthy women during and after pregnancy, using monoacetyl-4,4'-diaminodiphenylsulphone as a deputy ligand for bilirubin. In the first trimester, the serum albumin concentration was already diminished. Likewise, the serum reserve albumin for bilirubin binding was reduced gradually during pregnancy. These reductions were evident as early as the 20th week of gestation, and at delivery the level averaged 53% of the nonpregnant level. The reduction in bilirubin binding capacity was partly dependent on the decreasing serum albumin concentration, but a reduction in the albumin molecule's binding capability was also shown. This binding defect, which is also present in neonates, is not fully explained. The reduction in bilirubin binding capability probably reflects a reduced degree of protein binding for many protein-bound drugs during pregnancy, which may contribute to pharmacokinetic alterations in pregnancy

ISSN:0029-7844    

出版商:OVID    

年代:1989

数据来源: OVID