To examine the impact of amenorrhea on bone mineral density in women of reproductive age, bone mineral density in the lumbar spine (L2-L4) was measured by Dual-energy X-ray absorptiometry in 43 amenorrheal women. There was a significant lower bone mineral density in this test group (0.917 +/- 0.121 g/cm2) than in a normally menstruating control group (1.032 +/- 0.095 g/cm2). In premature ovarian failure, we found lower bone mineral density (0.863 +/- 0.112 g/cm2) than in any other subclass. Seven women with premature ovarian failure received cyclic hormone replacement therapy for 12 months (day 1-28, 0.625 mg conjugated estrogen, and on days 14-28, 5 mg medroxyprogesterone, followed by a seven-day pause). After 12 months, bone mineral density had increased significantly (p < 0.05) compared to the initial bone mineral density. We conclude that amenorrhea is a cause of bone loss in young women and that estrogen therapy is effective in preventing bone loss.
In order to clarify the bone metabolism of women during both pregnancy and puerperium, we studied the changes in bone mineral content and bone biochemical parameters. Bone mineral content was measured by ultrasound bone densitometry, and serum calcium (Ca), ionized calcium (i-Ca), intact parathyroid hormone (i-PTH), intact osteocalcine (i-OC), urinary pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) were measured concomitantly. 1. In the 3rd trimester bone stiffness was decreased (p < 0.05) compared the 1st and 2nd trimesters, but was slightly increased in the puerperal group. 2. Serum i-OC was decreased during pregnancy but significantly increased (p < 0.01) in the puerperium. The Pyr/Creatinine (Cre) and D-Pyr/Cre ratios were both increased in pregnant and puerperal women. 3. Serum Ca, i-Ca and i-PTH were within the normal range during pregnancy and the puerperium. These results suggest that in the 2nd and 3rd trimesters bone resorption would be increased, and in the puerperium bone formation would be increased. In pregnant and puerperal women serum Ca, i-Ca and i-PTH are within the normal range, but the turnover rate for Ca metabolism would be relatively increased.
The aim of this study was to determine the influence of cytoreductive surgery followed by chemotherapy on quality of life (QOL) in patients with advanced ovarian cancer. A total of 33 patients, who underwent the treatment after telling the truth and gave us the information on QOL 11 to 42 months after the discharge, were entered into the present study. Survival and length of hospital stay were calculated. QOL including emotional and physical well-being were assessed with a structure questionnaire which gives 110 points as full marks. The estimated 5-year survival rate was 49.6%. The mean survival time and length of hospital stay were 1,257 and 382 days, respectively. The mean QOL score was estimated to be 93.2. THe scores for both sociality and mentality showed a tendency to increase after completion of the treatment. Thirty-two of 33 cases (97.0%) obtained a good response for telling the truth. Alopecia and emesis due to chemotherapy were serious problems for patients. The present study showed that telling the truth was useful for well-informed consent and the QOL of patients with advanced ovarian cancer was not disturbed by cytoreductive surgery or chemotherapy.
In this study, we investigated fluctuations in serum lipoprotein (a) (Lp(a)) levels in normal and toxemic pregnancy. We measured serum total cholesterol (TC), triglyceride (TG), phospholipid (PL), high-density lipoprotein (HDL), apolipoprotein and Lp(a) levels in 33 normal pregnant and 11 toxemic pregnant women at delivery and in 47 normal pregnant women throughout gestation. Lp(a) and apolipoproteins were detected by turbidimetric immunoassay. The levels of serum lipids, HDL and apolipoproteins were all increased in pregnancy. In toxemia of pregnancy, serum TC and PL levels were lower (p < 0.05) and the apolipoprotein C-III level was higher (p < 0.005) than in normal pregnancy. Serum Lp(a) levels increased until the 20th week and reached a value which was 1.5 times higher than at the 10th week. Thereafter Lp(a) levels were constant until the late stage of pregnancy. In contrast, serum TC and TG levels increased steadily throughout gestation. The serum Lp(a) level was 18.1 +/- 27.5mg/dl in normal pregnancy and 17.8 +/- 17.9mg/dl in toxemia of pregnancy. These results revealed changes in serum Lp(a) levels during pregnancy. Further studies will be required to clarify the metabolic control of Lp(a) in pregnancy and the matabolic disorders of lipids and lipoproteins in toxemia of pregnancy.
The purpose of this study was to estimate the risk of heart diseases in pregnancy. A total of 594 patients with heart diseases treated at the National Cardiovascular Center between 1982 and 1993 were evaluated. The heart diseases were classified into eight categories: congenital heart disease with or without pulmonary hypertension (8 cases (1%) and 219 cases (37%), respectively), mitral valve prolapse (38 cases (6%)), valvular heart disease with or without valve replacement (9 cases (2%) and 54 cases (9%), respectively), arrhythmia (222 cases (37%)), cardiomyotitis (15 cases (3%)) and miscellaneous (29 cases (5%)). Maternal risk was estimated from the incidence of maternal mortality and artificial preterm delivery. Maternal death within two years after delivery was observed in 7 cases (1.2%): 4 cases with cardiomyotitis (3 DCM and 1 HCH), 2 cases with heart disease with pulmonary hypertension (1 PPH and 1 PDA), and a single case with valvular heart disease with aortic valve replacement. Artificial preterm delivery was carried out in 32 cases (5.4%), most frequently in cases with congenital heart disease with pulmonary hypertension (6/8, 75%) which follows cardiomyotitis (4/15, 27%) and cases with valvular heart disease with valve replacement (2/9, 22%). Fetal risk was measured by the incidence of fetal death, fetal growth retardation and congential heart disease of the fetus. IUFD because of maternal heart disease was observed in 4 cases: two cases with valvular heart disease with valve replacement, a single case with Marfan's syndrome and a single case with DCM. Fetal growth retardation was observed in 59 cases, most frequently in cases with congenital heart disease with pulmonary hypertension and cases with valvular heart disease with valve replacement (3/8 (38%) and 3/9 (33%), respectively). Neonatal congenital heart disease was found in 8 of 228 neonates (3.5%) whose mothers also had congenital heart disease. It is therefore suggested that intensive medical care be recommended in pregnancies complicated with congenital heart disease with pulmonary hypertension or with valvular heart disease with valve replacement, which increase both maternal and fetal risk, and in pregnancies complicated with cardiomyotitis which significantly increases the maternal risk.
In order to assess the effect of vitamin D receptor (VDR) gene polymorphisms on vitamin D3 therapy for postmenopausal bone loss. Thirty-four Japanese postmenopausal women, administered vitamin D3 (Alfarol 1.0 microgram/day) and Ca (2.0 g/day) for 18 months, were analyzed by RFLP. Bone mineral density (BMD) at the lumbar spine (L2-4) and Os-calcis were measured every 6 months by dual energy X-ray absorptiometry (DXA) and single energy X-ray absorptiometry (SXA). VDR gene allelic polymorphisms were assessed by Bsm 1 endonuclease restriction after specific PCR amplification. Genotypic polymorphism was defined as BB, bb and Bb. The genotypes were BB in 1 (3.1%), Bb in 13 (40.6%), and bb in 18 (56.3%). The women in these two major VDR genotype groups (Bb and bb) were similar in their backgrounds (in terms of age, body mass index, and BMD in premedication), but the VDR genotype was associated with the percent of change in BMD after treatment. In Group-Bb, the mean percent increases in L2-4 BMD were 3.2%, 4.9% and 4.1% at 6, 12 and 18 months. In contrast, in Group-bb they were 0.8%, 1.8% and 1.2% at the same points. Analysis of VDR alleles may prove useful in selecting the vitamin D therapy for osteopenia before treatment.
Simplified avidity assay of rubella IgG antibody with urea was evaluated to distinguish primary rubella from reinfection. In this method urea washing was done once for 10 minutes. The avidity index (AI) was calculated as the optical density percentage for the urea-washed well when compared to that of the non-treated well. We examined 292 sera from 50 patients with primary infection collected 6 to 2,259 days after the rash appeared, 29 sera from 11 patients with rubella reinfection and 69 sera from 68 pregnant women without fetal infection and having a high hemagglutination inhibition (HI) antibody. In primary infection AI increased gradually from 0%, and reached a plateau of about 60% four months after the rash appeared, whereas the mean AIs of patients after reinfection and with high HI antibody were as high as 87.1% and 89.9%, respectively. These results indicate that the simplified avidity assay in rubella IgG antibody is also valuable in diagnosing recent primary rubella in pregnant women with a high HI antibody.
Forty-eight cases of human uterine cervical cancer were examined for the expression of c-myc protein by immunohistochemical staining. The overexpression of c-myc was detected in 17 of 48 cases (35%), which is consistent with previous reports. The frequency of c-myc overexpression was not associated with the clinical stage. Relapse was observed in 7 of 15 cases (47%) which had overexpression of c-myc (mean follow-up period: 35 months), whereas relapse was observed in only 3 of 30 cases (10%) which did not overexpress c-myc (mean follow-up period: 33 months). The five-year survival rate was significantly lower in the cases overexpressing c-myc than in those not overexpressing it. This indicates that the overexpression of c-myc may be associated with a high risk of relapse and poor prognosis. We also analysed the correlation between lymph node metastasis, cervical stromal invasion and c-myc overexpression, and did not find any correlation between them. These results suggest that the overexpression of c-myc in cervical cancer may be a prognostic indicator for predictive testing.
A large number monoclonal antibodies (Mo-Abs) to neoplasms have been utilized as diagnostic tools, but they have not yet been fully characterized from the biological point of view. Antibody-dependent cellular cytotoxicity, complement dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC) were investigated in Mo-Abs OC125 and SH-9 (IgG1) to ovarian tumor cell lines SHIN-3, MN-1, KEN-3 and EC by MTT assay in vitro. OC125, but not SH-9 showed prominent CDC activity against SHIN-3 and MN-1 cell lines. CDC activity was induced against OC125 and SH-9, when a guinea pig complement was used. Furthermore, ADCC, activity was significant against SHIN-3, MN-1, OC125 and SH-9, but not against KEN-3 or EC. In summary, OC125 had both CDC and ADCC activity, but SH-9 did not. We concluded that the epitope on CA125 antigen varied in OC125 and SH-9, and each of epitope in Mo-Abs may have a different biofunction.
