Plasma and peritoneal fluid levels of CA 125 in women with endometriosis

Determined by a sandwich, solid-phase radioimmunoassay with mouse monoclonal antibody, OC 125, plasma CA 125 levels were significantly elevated in stage III (mean +/- SEM = 32.7 +/- 5.2 U/ml, n = 17, p = less than 0.01) and stage IV endometriosis (37.2 +/- 10.5 U/ml, n = 6, p = less than 0.005) compared with levels during the follicular (15.9 +/- 1.5 U/ml, n = 12) and secretory phases (15.8 +/- 1.3 U/ml, n = 15) of control women and users of oral contraceptives (15.5 +/- 1.2 U/ml n = 10). However, CA 125 levels were not significantly elevated in women with stage I (16.6 +/- 2.0 U/ml, n = 28) or stage II endometriosis (17.9 +/- 2.1 U/ml, n = 13). Peritoneal fluid levels of CA 125 (n = 14) were significantly higher (2 to 9.3 times) than the corresponding paired plasma levels in participants with stage I, II, or III endometriosis. In patients treated with danazol (n = 10) or buserelin (n = 17), plasma CA 125 levels decreased significantly by midtherapy, remained suppressed at the end of therapy, but rebounded to near pretreatment levels 6 months after treatment was completed. With gestrinone therapy a similar decline was observed but became significant only at the end of therapy. Our findings indicate that elevated plasma CA 125 levels may prove useful in the management of endometriosis.     

Neonatal morbidity in pregnancy complicated by diabetes mellitus: predictive value of maternal glycemic profiles

The relationship between glycemic control and perinatal outcome was assessed in a relatively uniform population of 75 White Class B through D pregnant diabetic women. All patients used glucose reflectance meter self-monitoring and performed a minimum of four determinations daily. Mean capillary blood glucose was calculated from a minimum of 16 weeks of determinations. Regression analysis confirmed a correlation between these values and third-trimester hemoglobin A1 (p less than 0.001). The study population was divided into two groups on the basis of mean capillary blood glucose values: group I, mean capillary blood glucose less than 110 mg/dl (43 patients) (mean = 96.8 +/- 7.1); group II, mean capillary blood glucose greater than 110 mg/dl (32 patients) (mean = 126 +/- 9.0). Of the 32 patients in group II, eight had mean capillary blood glucose greater than or equal to 130 mg/dl. The degree of maternal glycemic control appeared to affect perinatal outcome. At least one form of infant morbidity was present in 33% of group I infants compared with 53% of group II. Significant differences were observed for the incidence of hypoglycemia (p less than 0.05), macrosomia (p less than 0.05), and respiratory distress syndrome (p less than 0.01). One of six group I infants delivered at 35 to 36 weeks developed respiratory distress syndrome, compared with four of seven group II patients. The appearance of phosphatidylglycerol in amniotic fluid appeared delayed in group II patients at term. These data suggest that maintaining mean capillary blood glucose values less than 110 mg/dl may serve to reduce several major forms of morbidity in the infant of the diabetic mother. This information is helpful in establishing objectives for glycemic control in pregnant women using self-monitoring techniques.     

Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes

We studied the impact of a training program on glucose tolerance in gestational diabetes mellitus. Women with gestational diabetes mellitus (N = 19) were randomized into either group I, a 6-week diet alone group (24 to 30 kcal/kg/24 hours; 20% protein, 40% carbohydrate, 40% fat), or group II, which followed the same diet plus exercise (20 minutes three times a week for 6 weeks). An arm ergometer was used to maintain heart rate in the training range. Glycemic response was monitored by glycosylated hemoglobin, a 50 gm oral glucose challenge with a fasting and 1-hour plasma glucose, and blood glucose self-monitoring, fasting and 1 hour after meals. Week 1 glycemic parameters were the same for both groups. Week 6 data (mean +/- SD) were as follows: group I glycosylated hemoglobin, 4.7% + 0.2% versus group II, 4.2% +/- 0.2%; p less than 0.001. The group I glucose challenge fasting value was 87.6 +/- 6.2 versus 70.1 +/- 6.6 mg/dl, p less than 0.001 for group II. The group I 1-hour plasma glucose challenge result was 187.5 +/- 12.9 mg/dl versus 105.9 +/- 18.9 mg/dl for group II, p less than 0.001. The glycemic levels diverged between the groups at week 4. We conclude that arm ergometer training is feasible in women with gestational diabetes mellitus and results in lower glycosylated hemoglobin, fasting, and 1-hour plasma glucose concentrations than diet alone. Arm ergometer training may provide a useful treatment option for women with gestational diabetes mellitus and may obviate insulin treatment.     

Significance of serum immunosuppressive substance (IS) levels in the field of gyneco-obstetrics

To investigate the immune responses of patients with cancer, we assayed a newly found immunosuppressive substance (IS) by the single radial immunodiffusion method. This substance is extracted from ascites of colon cancer. The IS average level in 46 healthy women was 555.4 +/- 112.1 micrograms/ml. The normal upper limit should be 800 micrograms/ml. Seventy cases with uterine cervical cancer had a significantly higher IS level (667.0 +/- 189.8 micrograms/ml) than healthy women (t=3.57, p less than 0.001), especially in Stages III & IV. All 28 patients except one with recurrent cancer showed an IS level higher than 800 micrograms/ml. (1431.7 +/- 480. 9 micrograms/ml). Before recurrence was found clinically, the IS level became higher. In ovarian tumors, assay of the IS level yielded an interesting result: In 16 cases with benign tumors the level was 568.8 +/- 109.7 micrograms/ml. On the other hand, nine patients with ovarian cancer had levels over 800 micrograms/ml. These data suggest that the assay of IS substance may be useful for the staging of uterine cervical cancer, early detection of the recurrence, differentiation between benign and malignant ovarian tumors and so on.     

The increase in fetal hemoglobin synthesis in the fetal lamb during hyperglycemic hypoxemia

To determine whether fetal hypoxemia induced by hyperglycemia has any effect on the proportions of fetal and adult hemoglobin synthesized during fetal development, hemoglobin synthesis was determined after a period of hyperglycemic hypoxemia in the fetal lamb. These experiments were carried out at a time in gestation during the switch from fetal to adult hemoglobin. Twelve catheterized fetal sheep were included in this study. Seven were made hyperglycemic by glucose infusions during 5 days (group I) and five were control animals (group II) that received saline solution infusions (0.45 gm/dl). In group I, glycemia increased from 14.7 +/- 5.0 to 54.6 +/- 16.4 mg/dl (p less than 0.001), whereas oxygen content decreased from 8.5 +/- 1.7 to 6.4 +/- 2.2 ml/dl (p less than 0.01). Red blood cells obtained before and after 5 days of glucose or saline solution infusions were incubated in an amino acid mixture containing 14C-leucine. The hemoglobins were then subjected to polypeptide chain elution with carboxymethyl cellulose chromatography. The amount of fetal hemoglobin synthesized was determined by the ratio of radioactive gamma-chain to total of radioactive non-alpha-chains. The data demonstrated that the hyperglycemic fetus synthesizes more fetal hemoglobin than expected for the period of fetal development (78.0% +/- 10.9% versus 59.8% +/- 11.3%, p less than 0.02).     

The effects of maternally administered magnesium sulfate on the neonate

The effects of parenterally administered magnesium sulfate on maternal and neonatal calcium and magnesium metabolism in nonasphyxiated, term pregnancies complicated by pregnancy-induced hypertension were studied prospectively. In addition, the neurobehavioral effects of neonatal hypermagnesemia were investigated by means of a neonatal assessment scale that specifically measures reflex activity and both passive and active muscle tone. Maternal magnesium sulfate infusion was associated with maternal and neonatal hypermagnesemia when compared with that of control subjects (1.8 +/- 0.10 to 3.6 +/- 0.5 mg/dl, p less than 0.001, and 1.75 +/- 0.2 to 3.6 +/- 0.5 mg/dl, p less than 0.005, respectively). Maternal serum calcium levels fell with magnesium therapy (9.3 +/- 0.18 to 7.9 +/- 0.1 mg/dl, p less than 0.001), while neonatal calcium levels were unaffected (10.8 +/- 0.44 to 10.5 +/- 0.38 mg/dl, p less than 0.05). Neurological status examinations in the neonate were similar in both the control and treatment groups. In addition, neurological performance of the neonate did not correlate with cord magnesium levels or to the total dose of magnesium administered.     

Serum sialyl stage-specific embryonic antigen levels in adenocarcinoma of the lung.

The serum levels of sialyl stage-specific embryonic antigen (SSEA-1) in 67 patients with adenocarcinoma of the lung were studied to assess their values for diagnosis. A solid-phase immunoradiometric sandwich assay with an FH6 monoclonal antibody was used. Another 49 healthy adults, 52 patients with benign pulmonary diseases, and 142 lung cancer cases with cell types other than adenocarcinoma were evaluated for comparison. The mean (+/- S.D.) levels (U/mL) for adenocarcinoma of the lung, lung cancer other than adenocarcinoma, benign pulmonary diseases and normal subjects were 182.9 +/- 309.7, 53.5 +/- 22.6, 38.9 +/- 17.1 and 30.5 +/- 6.5, respectively. The mean serum sialyl SSEA-1 level was significantly higher in adenocarcinoma of the lung, compared with lung cancer other than adenocarcinoma (p < 0.001), benign pulmonary diseases (p < 0.001), or normal subjects (p < 0.001). For late stage (Stages III and IV, n = 58) adenocarcinoma of the lung, the mean (+/- S.D.) serum sialyl SSEA-1 level (204.3 +/- 327.6 U/mL) was significantly higher than that of earlier stage (Stages I and II, n = 9) adenocarcinoma of the lung (39.9 +/- 19.3), p < 0.001. There was no statistical difference among the mean serum levels of various histologic types of lung cancer other than adenocarcinoma (p > 0.05). In the lower range of values, considerable overlap existed between adenocarcinoma of the lung and lung cancer other than adenocarcinoma. However, very high sialyl SSEA-1 levels (> 140 U/mL) were only encountered in late stage adenocarcinoma of the lung (22/58).(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of some hemostatic parameters in patients with cervical carcinoma

It is well known that cancer induces changes in hemostasis. Plasma levels of Fibrinopeptide A (FPA), D-Dimer (DD), von Willebrand Factor (FvW) and fibrinogen were-assayed at diagnosis in 66 patients with cervical carcinoma and in 67 healthy women as controls. FPA, DD and fibrinogen levels were significantly higher in patients with FIGO stage I b-IIa cervical carcinoma than in controls (2.25 +/- 0.25 vs 1.19 +/- 0.15 p less than 0.001; 307 +/- 35 vs 112 +/- 8 p less than 0.001; 375 +/- 23 vs 280 +/- 17 p less than 0.001 respectively). A further increase of DD, FPA but not of fibrinogen concentrations was observed in advanced stages of disease (3.52 +/- 0.81 vs 2.25 +/- 0.25 p less than 0.1; 943 +/- 98 vs 307 +/- 35 p less than 0.001; 407 +/- 26 vs 375 +/- 23 p = NS respectively). FvW levels in patients with early stage cervical carcinoma were in the normal range, while in patients with advanced cancer, they were significantly higher (175 +/- 8 vs 104 +/- 2 p less than 0.001). A significant correlation was found between plasmatic levels of FPA and DD, FPA and FvW, DD and FvW (r = 0.57 p less than 0.01; r = 0.76 p less than 0.01; r = 0.54 p less than 0.01 respectively). Our data seem to indicate that in patients with cervical carcinoma, and in particular in those with advanced cancer, there is an activation of blood coagulation and fibrinolysis.     

Fetal responses to maternal infusions of angiotensin II

It is unclear whether the fetus is affected by maternal infusions of angiotensin II; therefore we studied maternal and fetal responses (n = 9) to angiotensin II (1.15, 2.29, 11.5 micrograms/min) infused 5 minutes into the vena cava of chronically instrumented sheep (129 to 137 days of gestation) while monitoring PO2, PCO2, pH, heart rate, uterine blood flow, and arterial and umbilical venous pressures. Pregnant sheep demonstrated expected dose-related increases in mean arterial pressure and decreases in uterine blood flow (p less than 0.05). Increases in fetal mean arterial pressure also correlated with the maternal dose of angiotensin II (r = 0.77, p less than 0.001). Fetal heart rate appeared to increase with 2.29 micrograms/min; however, bradycardia was observed with 11.5 micrograms/min (p less than 0.05) and was associated with decreased PaO2, 19.0 +/- 1.0 to 14.3 +/- 1.4 mm Hg (p less than 0.05), increased PaO2 (p less than 0.05), and decreased umbilical venous PO2, 31.4 +/- 2.3 to 27.0 +/- 1.9 mm Hg. The decreases in PO2 correlated with decreases in uterine blood flow (r = 0.60, p less than 0.002, and r = 0.75, p less than 0.005, respectively). Nevertheless, changes in fetal mean arterial pressure also occurred in the absence of altered fetal oxygenation; thus decreased uterine blood flow and fetal oxygenation alone cannot explain the fetal cardiovascular responses. It is suggested that angiotensin II or an active metabolite may cross the ovine placenta.     

Urinary kallikrein quantity and activity of normal pregnant women and toxemia patients in third trimester

In this study, urinary kallikrein quantity and activity were measured by the kallikrein direct RIA and kininogenase activity with human low molecular weight kininogen in 32 non pregnant healthy women, 20 normal 3rd trimester pregnant women and 18 3rd trimester hypertension type toxemia patients. There was no significant difference in urinary kallikrein quantity between non pregnant women (n = 32, 64.0 +/- 6.3 micrograms/day, mean +/- SE) and normal pregnant women (n = 20, 68.1 +/- 10.1 micrograms/day). There was a significant difference (p less than 0.001) between non pregnant women and toxemia patients (n = 18, 22.5 +/- 3.3 micrograms/day). There was a significant difference (p less than 0.001) between toxemia patients and normal pregnant women. There was a significant difference (p less than 0.05) in urinary kallikrein activity between non pregnant women (n = 32, 496.2 +/- 57.2 micrograms kinin/day) and normal pregnant women (n = 20, 319.5 +/- 48.1 micrograms kinin/day). There was a significant difference (p less than 0.0001) between non pregnant women and toxemia patients (n = 18, 82.6 +/- 13.6 micrograms kinin/day). There was a significant difference (p less than 0.01) between normal pregnant women and toxemia patients. There were no correlation in both urinary kallikrein quantity and activity between severe type toxemia patients (systolic blood pressure greater than or equal to 160mmHg or diastolic blood pressure greater than or equal to 110mmHg) and mild type toxemia patients (160mmHg greater than systolic blood pressure greater than or equal to 140mmHg and 110mmHg greater than diastolic blood pressure greater than or equal to 90mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)     

Changes in lipids and lipoproteins with long-term estrogen deficiency and hormone replacement therapy

Cross-sectional data of the long-term effects of estrogens, androgens, and progestogens on lipids and lipoproteins were obtained in 556 postmenopausal women aged 24 to 85 years with follow-up for 1 to 44 years. Baseline values were obtained in 155 women from less than 1 year up to 30 years after menopause. Total cholesterol and low-density lipoprotein cholesterol tended to rise during the early postmenopausal years while high-density lipoprotein cholesterol did not change. Triglycerides were related to weight and were significantly different only between untreated women of normal weight (128.3 +/- 7.80 mg/dl) and hormone users weighing greater than 200 pounds (252.9 +/- 9.44 mg/dl), p less than or equal to 0.001. Although mean high-density lipoprotein cholesterol was lower with both C-21 progestogens (64.5 +/- 4.16 mg/dl) and C-19 progestogens (61.9 +/- 3.84 mg/dl), there were no statistically significant differences on comparison with levels in the unopposed estrogen users (67.0 +/- 3.94 mg/dl). Smoking significantly depressed high-density lipoprotein cholesterol in both hormone users (p less than or equal to 0.001) and untreated women (p less than or equal to 0.001). Added progestogens do not adversely affect lipids and lipoproteins over the long term when adequate dosages of estrogens are used.     

Prenatal screening for gestational diabetes throughout office hours

A group of 1666 consecutive pregnant women attending our prenatal clinic was screened for gestational diabetes (GD). Patients with risk factors (155) underwent a classical 50 g OGTT, while 1511 patients without risk factors for GD were submitted at random throughout the day to a simplified OGTT, consisting of a single blood glucose determination 1 h after the glucose ingestion. In these patients, plasma glucose 1 h after the glucose load averaged 104 +/- 1 mg/dl and exceeded 135 mg/dl in 315 patients. In the latter group, retested with a standard 50 g OGTT, 48 out of 1511 patients (3.2%) finally met the criteria for GD, while 25 patients had an abnormal OGTT in the group with risk factors. The blood glucose levels after simplified 50 g glucose load were significantly higher in the third (vs. first) trimester of pregnancy (113 +/- 1 vs. 96 +/- 1 mg/dl, p less than 0.001). A significant increase in mean glucose concentrations was also observed for those patients tested after 11 a.m. (107 +/- 1 mg/dl vs. 99 +/- 1 mg/dl prior to 11 a.m. p less than 0.001) and for the women with an ideal body weight (IBW) greater than or equal to 150% at the beginning of pregnancy (124 +/- 7 mg/dl vs. 104 +/- 1 mg/dl for less than 150% IBW, p less than 0.001). These variations in glucose tolerance, related to the time of the day, the gestational age and the body weight, are of limited amplitude and should not be considered in the determination of the cut-off point of the screening test. Glucose loading at random throughout the day is a simple and useful tool for the routine detection of unsuspected GD in pregnant patients attending prenatal clinics.     

Clinical usefulness of estimation of serum fructosamine concentration as screening test for gestational diabetes

Serum fructosamine levels and fructosamine/protein ratios were measured in 100 pregnant women who underwent glucose tolerance tests because of clinical risk. Compared with normal pregnant women, the 13 study participants with gestational diabetes had higher fructosamine/protein levels (39 +/- 3.9 mumol/gm versus 37 +/- 3.2 mumol/gm, p less than 0.05), fasting serum glucose levels (107 +/- 13.7 mg/dl versus 82 +/- 8.6 mg/dl, p less than 0.001), and area under curve of glucose tolerance test (36 +/- 5 gm x min x dl-1 versus 22 +/- 3.6 gm x min x dl-1, p less than 0.001). The serum fructosamine levels were not significantly different between the two groups of participants (2.3 +/- 0.26 mmol/L versus 2.2 +/- 0.17 mmol/L); 10 of the 13 women with diabetes had a fructosamine/protein ratio within 2 SD of the mean of the groups of normal pregnant women. Spontaneous caloric intakes (r = 0.72, p less than 0.005) and the hospital mean daily capillary glucose levels during diabetic diet (r = 0.72, p less than 0.005) correlated better with the fructosamine/protein ratio than with fasting serum glucose levels (r = 0.58, p less than 0.05) and area under curve (r = 0.57, p less than 0.05). Consequently, serum fructosamine and fructosamine/protein ratio levels should be considered insensitive as a screening test in pregnant patients with clinical risk of gestational diabetes.     

Surgical treatment for ductal adenocarcinoma of the pancreas

A ten year community hospital experience of 124 patients with ductal adenocarcinoma of the pancreas proved at biopsy is reported. All patients underwent a celiotomy, and 94 per cent were observed until death. All of the patients were stratified by stage (I, 9 per cent; II, 30 per cent; III, 18 per cent, and IV, 43 per cent). Nine of the patients with Stage I disease underwent resection with a high postoperative mortality rate of 44 per cent and only one five year survivor. Fifty-nine patients with Stages II and III disease underwent biliary bypass with a low postoperative mortality rate of 2 per cent. Bypass of the common bile duct (N = 24) provided more permanent palliation against recurrent jaundice or cholangitis (p less than 0.05), but did not improve the survival time when compared with bypass of the gallbladder (N = 20). This was not true for those with Stage IV disease in whom recurrent jaundice did not develop in those with either bypass of the gallbladder or common duct. Adding prophylactic gastroenterostomy (GE) to biliary bypass (N = 25) conferred no survival benefit, but did protect against subsequent duodenal obstruction (p less than 0.05). Thirty-seven per cent of the 38 patients in whom a GE was not performed had duodenal obstruction develop. Adjuvant radiation and chemotherapy in 22 patients with unresectable Stages II and III disease resulted in a significant prolongation of survival time compared with 15 untreated patients in the control group (p less than 0.05). Fifty-one patients with Stage IV disease underwent biliary bypass or biopsy of the tumor resulting in a 14 per cent postoperative mortality rate and a median survival time of four months. Nine per cent of the 44 survivors with Stage IV disease lived at least one year. The implications of these findings to clinical practice are discussed.     

The ovarian renin-angiotensin system: renin-like activity and angiotensin II/III immunoreactivity in gonadotropin-stimulated and unstimulated human follicular fluid

Renin-like activity and angiotensin II/III immunoreactivity in follicular fluids from 34 women stimulated with human menopausal gonadotropin and human chorionic gonadotropin (56.8 +/- 6.5 ng angiotensin I per milliliter per hour and 187 +/- 21 pg/ml [mean +/- SEM], respectively) were much higher (p less than 0.001) than in follicular fluids from 12 unstimulated preovulatory women (1.41 +/- 0.37 ng angiotensin I per milliliter per hour and 58.5 +/- 13.7 pg/ml) and in simultaneously drawn plasma (4.47 +/- 0.73 ng angiotensin I per milliliter per hour and 31.8 +/- 11.6 pg/ml, respectively; p less than 0.001). Plasma renin-like activity and angiotensin II/III immunoreactivity in stimulated cycles did not differ from unstimulated cycles. Follicular fluid angiotensin II/III immunoreactivity correlated significantly with follicular fluid renin-like activity in stimulated (r = 0.72; p less than 0.01) and in unstimulated samples (r = 0.86; p less than 0.01). Significant correlation was found also between follicular fluid renin-like activity and estradiol. A sharp preovulatory rise of renin-like activity and angiotensin II/III immunoreactivity was noted in unstimulated follicular fluid samples collected on cycle days 13 and 14 compared to days 9 through 12 (p less than 0.01). The findings that follicular fluid renin-like activity and angiotensin II/III immunoreactivity are correlated, and that gonadotropins have a stimulatory effect on follicular fluid concentrations support our concept of a physiologic intrinsic ovarian renin-angiotensin system.     

The role of D-dimer in diagnosis of ovarian cancer

One of fibrin degradation products, D-dimer was measured in ovarian cancer (N = 28), benign ovarian tumors (N = 26), benign uterine tumors (N = 15) and normal controls (N = 66). The D-dimer value for ovarian cancers was 721 +/- 423 ng/ml, benign ovarian tumors; 299 +/- 248, benign uterine tumors; 248 +/- 141, and normal controls; 237 +/- 212, respectively. There was a significant difference between the ovarian cancer group and the other groups (p less than 0.01). When the cut off level of D-dimer was less than 400 ng/ml, the positive rate for D-dimer was 50% in stage I of ovarian cancer, 88% in stage II, 86% in stage III and 80% in stage IV. Overall, 82% of ovarian cancer patients were positive. D-dimer provides good sensitivity compared with other ovarian cancer markers such as TPA, SLX and CEA. The coefficient correlation between D-dimer and CA125, TPA, SLX or CEA was 0.476, 0.376, 0.226, -0.292, respectively. This suggest that the measurement of D-dimer is useful in diagnosing ovarian cancer.     

Influence of the degree of carbohydrate metabolism imbalance in gestational diabetes on pregnancy and newborns condition

The aim of our study was the evaluation of the correlation between carbohydrate metabolism imbalance at the moment of gestational diabetes mellitus (GDM) diagnosis and regulation of glycemia during pregnancy, pregnancy complications, time and mode of delivery and conditions of the newborns. MATERIAL: 231 women with GDM delivered in our hospital between 1993-1996 were investigated. This population was divided into 6 groups, according to glycemia levels. METHOD: The term of diagnosis of the GDM, medical treatment (diet or diet and insulin), the degree of metabolic regulation archived, mode and time of delivery, as well as state of newborns were analysed. RESULTS: In groups I and VI we noticed the greatest percentage of patients treated with insulin (68%, 67%), versus 26% in group II and 17% in group III. In group VI in all cases treated with insulin we begun this therapy shortly after marking GDM. Glycemia in 24 hrs period after GDM diagnosis in group I were 122.7 +/- 28.6 mg/dl, in group VI 112.0 +/- 23.6 mg/dl, while we noticed 90.3 +/- 15.6 mg/dl in group II and 87.7 +/- 15.9 mg/dl in group III. Blood glucose level < 100 mg/dl in first determination of 24 hrs profiles we noticed in 5% in group I, 2% in group VI while 20% in group II and 51% in group III. Average levels of glycemia in last 24 hrs profiles before delivery in group I were 93.0 +/- 15.8 mg/dl, in group VI 96.2 +/- 21.1 mg/dl while 87.8 +/- 13.5 mg/dl in group II and 86.8 +/- 14.1 mg/dl in group III. Blood glucose level < 100 mg/dl of daily profile before the end of pregnancy was discovered in 8% in group I, 47% in group III. The greatest amount of complications (pregnancy induced hypertension and imminent premature delivery) was diagnosed in group VI-75% and in group III-55%. Surgical delivery took place in group I in 50%, in group V in 46%, in group VI in 67% while 17% in group II, 35% in group III and 30% in group IV. Macrosomy of newborns (> 4000 g) was diagnosed in group I in 36% in group V in 23% and in group VI in 42% while 9%, 6% and 15% in groups, II, III and IV respectively. The condition of newborns in the 1st minute of life was determined as good (8-10 points in Apgar scale) in significant percentage, in 87%, 75%, 70% in groups II, III, IV while only 59%, 62%, 58% in groups I, V, VI respectively. CONCLUSION: Serious intensification of carbohydrates metabolism disorders at the moment of diagnosing GDM, such as fasting glycemia > 140 mg/dl and the result after 2 hours > 200 mg/dl in 75 g OGTT more often requires insulin treating connect with numerous difficulties both in pregnancy monitoring and also has inadventageous influence on obstetrics outcomes-increasing percentage of surgery deliveries and macrosomies, that change the condition of newborns for worse.     

Influence of pregnancy on human immunodeficiency virus disease

Over a period of 3 years (mean 16, extremes 3 and 36 months), we compared clinical and laboratory parameters of 128 female, human immunodeficiency virus (HIV)-infected patients, all in clinical stage II or III (CDC classification). 34 patients were pregnant and delivered a viable infant after at least 28 weeks of amenorrhea (group I), 29 patients were pregnant and had a spontaneous or induced abortion during the first or second trimester (group II), and 64 were non-pregnant female control patients (group III). The changes in the clinical stages over time were not statistically significant between the groups. The only laboratory parameters that were significantly higher in group I at the time of the delivery were: leucocyte count (p less than 0.001), lymphocyte count (p less than 0.05), and sedimentation rate (p less than 0.001). These changes are known to be related to pregnancy and not to HIV disease. All other laboratory parameters showed no significant differences within and between the groups. We conclude, that pregnancy--carried to term or interrupted--does not aggravate the natural evolution of HIV infection in clinical stage II and III patients.     

妊娠高血压综合征患者血清可溶性白细胞介素6受体和可溶性糖蛋白的检测

目的　观察妊娠高血压综合征（妊高征）患者血清可溶性白细胞介素6受体（sIL-6R）和可溶性糖蛋白(sgp130)的变化。方法　应用酶联免疫吸附法（ELISA）检测40例妊高征患者（妊高征组）和20例正常非孕妇女（对照组I）、20例正常妊娠妇女（对照组II）血清sIL-6R和sgp130水平。结果妊高征组血清sIL-6R为(196.7±12.9)μg/L,sgp130为(379.4±79.3)μg/L;对照组I血清sIL-6R为(174.8±46.2)μg/L,sgp130为(273.6±28.3)μg/L;对照组II血清sIL-6R为(174.4±48.3)μg/L,sgp130为(254.4±34.7)μg/L。妊高征组血清sIL-6R和sgp130水平均高于对照组I和对照组II,差异有极显著性（P<0.01）。妊高征组中,随病情加重,血清sIL-6R、sgp130水平逐渐升高。差异有极显著性（P<0.01）。对照组II血清sIL-6R和sgp130水平与对照组I比较,差异无显著性（P>0.05）。结论　血清sIL-6R和sgp130水平变化与妊高征的病情发展有关。     

Elevated serum concentrations of CA-125 in patients with advanced endometriosis

CA-125 is a high-molecular-weight glycoprotein that is expressed on the cell surface of some derivatives of embryonic coelomic epithelium. Based on results of an immunoradiometric assay developed to detect CA-125 in peripheral blood, 82% of patients with ovarian cancer and less than 1% of apparently healthy controls have elevated peripheral blood levels of CA-125. Because endometriotic lesions are likely to be derivatives of embryonic coelomic epithelium, the authors investigated serum CA-125 levels in patients with endometriosis. Preoperative serum CA-125 concentrations were measured in 147 patients undergoing diagnostic laparoscopy or laparotomy. Serum CA-125 concentrations were elevated in patients with stage III or IV endometriosis, compared with controls with negative diagnostic laparoscopies (66.5 +/- 14.5 versus 8.20 +/- 0.59 U/ml, mean +/- standard error of the mean; P less than 0.001). Fifty-four percent of patients with stage III or IV endometriosis and 0% of the controls had CA-125 levels greater than 35 U/ml. Occasional patients with stage II endometriosis (13%), leiomyomata uteri (14%), and chronic pelvic inflammatory disease (5%) also had serum CA-125 concentrations greater than 35 U/ml. Immunocytochemical techniques demonstrated the presence of CA-125 on the cell surface of endometriotic lesions.