Season of birth of chronic alcoholics.

Season of birth has been well studied in mental illnesses, such as schizophrenia and affective disorders; however, only a few studies have been done for alcoholism. Recently Modestin et al. (1995) found, in a sample from Switzerland, excess birth of male alcoholics in March to July, compared to the general population. The present study attempted to replicate their finding in two independent Japanese samples which comprised a total of 1,947 men with chronic alcoholism. In our study, no birth rate excess in March to July was observed in either sample, while a non-significant birth rate excess (12%) in August to October was noted. It is concluded that there is no consistent trend in season of birth of alcoholics across countries.

Effect of LC9018 combined with radiation therapy on carcinoma of the uterine cervix. A phase III, multicenter, randomized, controlled study.

BACKGROUND: The failure rate with radiation therapy alone for Stage III cervical cancer is quite high, and therefore other modalities are being pursued as adjuvants to radiation therapy in hopes of improving the results. METHODS: A randomized, controlled, comparative study on the efficacy and safety of radiation therapy combined with LC9018 (a biologic response modifier prepared from heat-killed Lactobacillus casei YIT9018) was conducted using 228 patients with Stage IIIB cervical cancer. RESULTS: LC9018 enhanced tumor regression (P < 0.1) by radiation after both 30 Gy of external radiation and at the completion of radiation therapy. The combination therapy also prolonged survival and the relapse-free interval (P < 0.05) compared to radiation alone. Analysis of survival using the Cox proportional hazard model indicated that use of LC9018 was a significant factor related to survival duration. Major side effects of combined LC9018 included fever and skin lesions at the injection site, but no severe symptoms were noted. Radiation-induced leukopenia was significantly less severe (P < 0.05) in the LC9018-combined group than in the radiation-alone group, suggesting that this agent might help to prevent leukopenia during radiation therapy. CONCLUSIONS: LC9018 was shown to be an effective agent for adjuvant immunotherapy when combined with radiation therapy.

Qualificated discrimination of ovarian malignancy by diagnostic ultrasound.

Ultrasonograms of 214 ovarian masses in 184 patients were studied to discriminate ovarian malignancies from benign masses and to help in developing a new scoring system using ultrasonographic findings with weight-adjusted scores. The 76 masses that showed cystic patterns only were directly determined to be benign, having an expected success rate of 97.4%. The remaining 138 masses, of which 116 showed mixed patterns and 22 of which showed solid patterns, were analyzed by the Quantification method No. 2 of Hayashi to select the effective ultrasonic findings and to obtain a good discriminant function. Eleven findings (items) expressing 29 categories were selected, and a discriminant function composed with a weight-adjusted score for each category was obtained as the result of the analysis. Using these functions, the 86.6% of the ovarian masses with mixed or solid patterns were correctly discriminated as being malignant, borderline-malignant, or benign. According to internal checks of all ovarian masses, the success rate was 90.2%. Then 73 ovarian masses of 65 new patients were discriminated as the external check, and a success rate of 93.2% was obtained. It is concluded that this newly developed scoring system using ultrasonic findings is useful in discriminating ovarian malignancies from benign ones.

Rat liver epidermal growth factor receptors in intrauterine growth retarded and heavy-for-date fetuses.

We recently reported that epidermal growth factor (EGF) levels in the first urine to be voided by intrauterine growth retardation (IUGR) and heavy-for-dates (HFD) infants were lower than control infants (8). In this study, we analyzed EGF receptors to reveal the mechanisms controlling EGF levels. EGF binding to fetal rat liver increased markedly from day 19-21 of gestation. Fetal rats were divided into IUGR, control and HFD groups. EGF binding to the liver in each group was as follows, IUGR; 380 +/- 57 fmol/mg protein, control; 258 +/- 47, and HFD; 545 +/- 112. The binding to IUGR and HFD rat liver was significantly greater than in the control group (p < 0.05). These data suggest that IUGR rats compensate for a lack of EGF by increased receptor expression and that HFD rats consume more EGF and have decreased urinary EGF excretion. These data also suggest that EGF is closely related to fetal growth and may play some important roles in fetal growth.

Fetal and neonatal excretion of free and conjugated ritodrine.

The ability of the human fetus and neonate to conjugate and excrete ritodrine, a beta 2-sympathomimetic drug, was investigated. Free and conjugated ritodrine concentrations in the plasma, amniotic fluid and urine were measured in 11 mother-infant pairs, to whom intravenous ritodrine had been administered before elective cesarean section at term. Ritodrine was determined by HPLC with electrochemical detection. At delivery, conjugated ritodrine values were significantly higher than those for the free form in maternal and fetal plasma. There were significant positive correlations between the concentrations in the maternal and umbilical vein plasma for both free and conjugated ritodrine. In the amniotic fluid, the total ritodrine concentrations were much higher than those in the fetal plasma, the conjugated form accounting for 90.2% of the total. Furthermore, the percentages of conjugated ritodrine in the amniotic fluid and neonatal urine were significantly higher than the percentage in the maternal urine on the day of birth. In the neonatal urine, the concentrations of free and conjugated ritodrine decreased rapidly after birth as did those in the maternal urine, on day 3 postpartum being less than 2% of the values on the day of parturition. These results indicate that the fetus at term is capable of forming conjugated metabolites of ritodrine and of excreting free and conjugated ritodrine in its urine.

[Primary effect of preoperative intra-arterial infusion chemotherapy in cervical cancer].

In order to obtain better prognoses for cervical cancer, we conducted preoperative intra-arterial (i.a.) infusion chemotherapy of CDDP in combination with AT-II pressor. Two courses of i.a. chemotherapy were performed for 67 patients with cervical cancer in stage IIb containing 54 squamous cell carcinomas and 13 adenocarcinomas before operation every 3 weeks. A histologically desirable effect in cervical lesion was obtained. A group given preoperative i.a. chemotherapy had a significantly lower rate of infiltration beyond uterus in comparison with 156 patients with 145 squamous cell carcinomas and 11 adenocarcinomas treated by surgery alone as the control group. Further, the rate of histological infiltration to parametrial edges after i.a. chemotherapy tended to be lower than the control group. From the above, it was considered that preoperative i.a. infusion chemotherapy of CDDP in combination with AT-II pressor for cervical cancer was effective as a neo-adjuvant chemotherapy.

Effect of taurine concentration on platelet aggregation in gestosis patients with edema, proteinuria and hypertension.

To elucidate the relationship between the high concentration of taurine in platelets and platelet aggregation in patients with EPH gestosis (gestosis with edema, proteinuria and hypertension), platelet aggregation and the platelet release response (release of ATP and beta-thromboglobulin) were studied in the washed platelet suspension (PS) obtained from normal pregnant or non-pregnant women and EPH gestosis patients. Platelet aggregation and platelet release response were significantly lower in EPH gestosis patients than in normal pregnant and non-pregnant women. Platelet aggregation, platelet release response induced by ADP and collagen and the aggregation induced by A23187 were inhibited in taurine-loaded PS from non-pregnant women. These results suggest that the decrease of platelet aggregation in EPH gestosis patients was caused by high concentrations of taurine in platelets, which may inhibit the intracellular Ca2+ movement and platelet release response. Therefore, taurine appears to have a protective effect against the hyper-coagulative state in EPH gestosis.

[Congenital lobar emphysema successfully treated by right upper lobectomy at five hours after delivery: a case report].

Lobar emphysema is a rare disease and one of the causes of respiratory disturbance in the newborn and infancy. A case report is presented and compared with related data in the literature in Japan. Maternal echographic findings indicated the cystic lung disease of the fetus. The cystic space was punctured and aspirated three times. The baby was delivered by caesarean section after having taken sufficient precaution to prevent respiratory failure. Since the baby developed dyspnea gradually, at five hours following the delivery, right upper lobectomy was performed and the major symptoms were eliminated. The pathological diagnosis was congenital lobar emphysema and the etiology was concluded to be bronchiectasis.

Concentration and uptake of taurine in umbilical blood platelets.

The concentration and uptake of taurine in the umbilical and adult blood platelets were studied. Taurine was the most abundant free amino acid in both umbilical and adult blood platelets. The taurine concentration in umbilical blood platelets (2.30 pmoles/10(4) cells) was significantly lower than that of adult blood platelets (3.27 pmoles/10(4) cells) in contrast to the reverse relationship in taurine concentrations in umbilical and adult blood plasma. No other amino acid showed such significant difference in the concentrations between umbilical and adult blood platelets. Taurine uptake into umbilical blood platelets was temperature sensitive and sodium-dependent in a manner similar to that of adult blood platelets. The uptake conformed well to Hanes-plot. The Vmax of the uptake into adult blood platelets was about 3.6 times higher than that of umbilical blood platelets, but no significant difference was seen in the Km value between the two groups.

Proliferative activity in normal endometrium and endometrial carcinoma measured by immunohistochemistry using Ki-67 and anti-DNA polymerase alpha antibody, and by flow cytometry.

The proliferative activity of various parts of normal and malignant endometrium was evaluated using an immunohistochemical approach and flow cytometry (FCM). The two monoclonal antibodies, Ki-67 and anti-DNA polymerase alpha antibody (anti-poly alpha antibody) were used to detect the proliferative activity of cells, and the percentage of the Ki-67 and anti-poly alpha positive cells were measured. Proliferative indices (PI; percentage of S and G2M phase) and DNA ploidy were measured by FCM. Normal endometrial specimens from 29 patients with benign diseases were used and three different parts (fundus, middle, and low part of the uterus) were examined. In the proliferative phase of normal endometrium, there was no significant difference in the proliferative activity in the three parts. In 20 patients with endometrial carcinomas with myometrial invasion, tissues were taken from the myometrial invasive site and the central part of the tumor tissue. In the cases of endometrial carcinoma, the myometrial invasive site had a higher proliferative activity than central part of the tissue. The proliferative activity measured by the immunohistochemistry was correlated with the histological grade of malignancy, but it was not consistent with PI by FCM. This suggests that the proliferative activity measured by the immunohistochemistry is independent of flow cytometric PI.

Changes in plasma human atrial natriuretic peptide (hANP) level in normal pregnancy and pregnancy induced hypertension.

We determined plasma human atrial natriuretic peptide (hANP) levels in normal pregnancy and pregnancy induced hypertension (PIH). The plasma hANP levels slightly decreased in the first trimester of normal pregnancy and tended to recover as pregnancy advanced, although these changes were slight. However, the plasma hANP level in puerperium was higher than that in the third trimester of normal pregnancy. The plasma hANP level in mild PIH was not significantly higher than that in the third trimester of normal pregnancy. In contrast, the plasma hANP level in three cases of severe PIH was approximately 200% higher than those in the normal third trimester and mild PIH.

Use of Interceed(TC7) absorbable adhesion barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. The Obstetrics and Gynecology Adhesion Prevention Committee.

Interceed(TC7) is a fabric composed of oxidized, regenerated cellulose that was designed to reduce the formation of postsurgical adhesions. We evaluated Interceed(TC7) in a randomized, multicenter clinical study. Sixty-three infertility patients had bilateral pelvic sidewall adhesions removed at laparotomy. One pelvic sidewall was covered by Interceed(TC7) and the other was left uncovered. The deperitonealized areas (N = 205) of all sidewalls were divided into three groups: less than 100 mm2, N = 72; 100-1000 mm2, N = 95; and more than 1000 mm2, N = 38. The effectiveness of Interceed(TC7) was evaluated at laparoscopy 10-98 days after laparotomy. Significantly more adhesions were observed at laparoscopy on the control pelvic sidewalls (48 of 63, 76%) than on the treated sides (26 of 63, 41%) (P less than .0001). The Interceed(TC7)-treated sidewalls also had significantly less area involved with adhesions at laparoscopy (P less than .05, P less than .001, and P less than .001 in the three groups, respectively). Twenty-eight women with severe endometriosis also had significantly more adhesions on the control side (23 of 28, 82%) than on the treated side (14 of 28, 50%) (P less than .05). We conclude that Interceed(TC7) effectively reduced the incidence and extent of postoperative adhesions, even in patients with severe endometriosis.

Clinical effect of sizofiran combined with irradiation in cervical cancer patients: a randomized controlled study. Cooperative Study Group on SPG for Gynecological Cancer.

To evaluate the clinical effect of a biological response modifier (BRM), sizofiran (SPG), combined with irradiation, a randomized controlled study was performed in patients with stage II or III cervical cancer involving the collaboration of 52 institutes throughout Japan. Patients were randomly allocated to the control group (radiotherapy only) and the SPG group (radiotherapy + SPG). SPG was given intramuscularly, 40 mg once and 20 mg twice, a week concomitantly with radiotherapy. A total 315 patients were enrolled for the study but 23 were excluded from analysis. Of the remaining 292 patients, 121 were of stage II (43 controls and 78 SPG) and 171 of stage III (49 controls and 122 SPG). The results were as follows. (1) The complete response (CR) rate among stage II patients was higher in the SPG group (91.0%) than in the control group (79.1%); also the CR rate among stage III patients was significantly higher in the SPG group (77.9%) than in the control group (61.2%). (2) The SPG group showed a significantly rapid recovery from the decreased lymphocyte counts due to radiotherapy (P less than 0.05). (3) Side effects, probably associated with SPG administration, were observed in 11 cases (5.2%).

Platelet taurine concentration and uptake in gestosis patients with edema, proteinuria and hypertension.

The taurine concentration and uptake in platelets obtained from normal pregnant women and gestosis patients with edema, proteinuria and hypertension (EPH gestosis) were investigated. The taurine concentration in platelets showed a marked increase in severe EPH gestosis compared with normal pregnancy or mild and moderate EPH gestosis, while the plasma taurine concentration did not change significantly. Taurine uptake in platelets paralleled the severity of EPH gestosis. The Vmax of the uptake in severe EPH gestosis was about 2.4 times higher than that in normal pregnancy or mild and moderate EPH gestosis, but no significant difference was seen in the Km value among these groups.

Quantitative ultrasound diagnosis of endometrial cysts.

We measured the ultrasonic frequency dependent attenuation of ovarian cysts using the spectral difference method to find the difference in the characteristics of attenuation of the endometrial cyst and other ovarian cysts. We investigated an analytical method to measure the ultrasonic frequency dependent attenuation of ovarian cysts and we called this method the boundary echo spectrum method. The endometrial cyst had an attenuation slope of 0.67 +/- 0.27 dB/cm/MHz, and attenuation value was 1.85 +/- 1.27 dB/cm, and it had significantly higher attenuation slope and attenuation value compared with those of serous cystadenoma and mucinous cystadenoma, but no significant difference compared with those of dermoid cyst (fat component). Compared with attenuation slope and attenuation value, attenuation slope is superior because of smaller standard deviation and better linearity between water immersion and transabdominal method.

[A study on the proliferation of the uterine endometrium].

UNLABELLED: A proliferative activity study of the endometrium was evaluated in three different parts by means of an immunohistochemical approach and flow cytometry (FCM). The materials were 29 cases of hysterectomies due to uterine myoma. Twenty-one cases were in the proliferative phase, and 8 cases were in the secretory phase. The three parts of the endometrium obtained from the upper, middle and lower part of the uterine body were investigated by an immunohistochemical technique with Ki-67 and anti-DNA polymerase alpha antibody. Single staining with Propidium Iodide (PI) was used for cell cycle analysis in FCM. RESULTS: (1) The rate of positive Ki-67 cells was 25.9 +/- 6.3% in the upper part, 26.0 +/- 3.3% in the middle part, and 25.5 +/- 5.8% in the lower part. And the rate of positive DNA polymerase alpha cell was 27.2 +/- 5.8% in the upper part, 24.0 +/- 2.9% in the middle part, and 24.8 +/- 4.0% in the lower part. The growth potential of each part was not significant. (2) FCM did not detect a significant difference among the three parts of the endometrium in cell cycle analysis. (3) Hematoxylin-eosin staining showed that the upper part was thicker than the lower part and the number of glands in the upper part was more abundant than in the lower part. This difference was significant (p less than 0.01). (4) Ki-67 was recognized even in the early secretory phase. (5) And each segment of the endometrium proliferated evenly, not focussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Development of a three-dimensional color Doppler system.

An unprecedented assembly of a three-dimensional (3D) color Doppler system was arranged for the purpose of producing and displaying precisely calculated and recorded 3D color flow mapping images of fetal and umbilical vessels. Data accuracy and quality were enhanced by a computer controlled probe positioner. Scanning was across any of three perpendicular planes to collect serial slice images in any position and interval width. The series of parallel images was digitized in a color imaging processor by a 3D reconstruction program. Analyzed data were transferred to work stations for immediate processing into 3D form and display. The resulting 3D display was a solid model image of umbilical vessels which could be rotated in real time. In addition to the clear information about the vessel's structure, hemodynamics were apparent.

Urinary and plasma epidermal growth factor levels are decreased in neonates with intrauterine growth retardation and in their mothers.

Epidermal growth factor (EGF) concentrations in urine and plasma samples collected from pregnant women and neonates were measured by RIA. The EGF concentration of the first voided urine was higher in appropriate-for-date (AFD) neonates (33.9 +/- 23.0 ng/mg creatinine) than in those with intrauterine growth retardation (IUGR; 23.5 +/- 7.7 ng/mg creatinine, p less than 0.05) and heavy-for-date (19.8 +/- 5.2 ng/mg creatinine, p less than 0.05) neonates. The urinary EGF concentration of pregnant women showed no marked changes throughout pregnancy. Urinary EGF concentrations of women with AFD fetuses (45.9 +/- 31.2 ng/mg creatinine) did not differ significantly from those of women with diabetes (39.9 +/- 26.8 ng/mg creatinine) or women with multiple fetuses (44.6 +/- 30.6 ng/mg creatinine). However, women with IUGR fetuses showed lower urinary EGF concentrations (13.8 +/- 7.4 ng/mg creatinine, p less than 0.05) than women with AFD fetuses. Maternal and fetal platelet-poor plasma EGF concentrations at delivery were lower in the IUGR group (mother: 2.62 +/- 0.38 ng/ml, fetus: 2.16 +/- 0.07 ng/ml, respectively, p less than 0.05 and p less than 0.005) than in the AFD group (mother: 3.34 +/- 0.64 ng/ml, fetus: 3.24 +/- 0.93 ng/ml). In the IUGR group, the EGF concentration in fetal blood was always lower than that in maternal blood (p less than 0.05), although the AFD groups showed no such difference. These data suggest that EGF levels are closely related to fetal growth.