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  • 1
    ISSN: 1432-2307
    Keywords: Pituitary adenoma ; Prolactin ; Ultrastructure ; Immunohistochemistry ; Morphometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fifteen cases of pituitary adenoma, 14 of which were associated with hyperprolactinemia, were studied by observation and granule morphometry of electron micrographs, immunohistochemistry and sequential observation of in vitro release with regard to hormone production, storage and secretion. Adenoma cells of 6 cases with marked elevation of plasma prolactin were sparsely granulated, showed characteristic ultrastrucures including the presence of small secretory granules, well developed Golgi and rough membranes, misplaced exocytosis, and positive or negative immunostaining for prolactin. These adenomas also showed vigorous release of the hormone into the circulation and/or culture medium. In vitro studies showed that negative immunostaining of adenoma cells did not preclude the production and secretion of the hormone. One densely granulated adenoma containing cells with numerous lactotroph type granules showed moderate release of prolactin into the circulation. In an acromegalic case associated with both high plasma growth hormone and prolactin, some cells were shown by immunohistochemistry to store both hormones. There were 4 adenomas which could not be shown to produce, store and secrete prolactin by any method available.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: hypercoagulable state ; thrombosis ; medroxyprogesterone acetate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of medroxyprogesterone acetate (MPA) on the mechanism of coagulation in postmenopausal patients were studied and compared with those of tamoxifen by a retrospective analysis. The coagulation test parameters tested included platelet count, bleeding time, clotting time, prothrombin time, activated partial thromboplastin time, and the levels of fibrinogen, fibrin degradation products, factor II, factor V, plasminogen, alpha 2-plasmin inhibitor (alpha 2-PI) and alpha 2-plasmin inhibitor-plasmin complex (alpha 2-PI-P). A shortened APTT was noted and the levels of factors II, V, alpha 2-PI and alpha 2-PI-P were also out of the normal range during treatment in the MPA-treated group. However, these abnormal parameters recovered to within the normal range from 6 months or more after the commencement of treatment without any termination of drug administration. The patients were all asymptomatic. In contrast, a slight prolongation of bleeding time which persisted for more than 6 months was observed in the patients treated with tamoxifen. These data suggest that MPA causes a hypercoagulable state and that any change must be carefully monitored during treatment with either MPA or tamoxifen.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0843
    Keywords: Key words Metastatic breast cancer ; Chemotherapy ; Anthracyclines ; KRN8602 (MX2) ; Phase II trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: KRN8602 (3′-deamino-3′-morpholino-13-deoxo-10-hydroxycarminomycin hydrochloride, MX2 · HCl) is a newly developed anthracycline that has been found to be effective against multidrug-resistant tumor cells in vitro and in vivo. In order to clinically confirm these promising preclinical observations, we performed a phase II trial of KRN8602 in patients with anthracycline-resistant metastatic breast cancer. Methods: Of 41 patients registered with metastatic breast cancer, 37 were eligible and were given at least two cycles of KRN8602 15 mg/m2 per day at 3–4 week intervals by intravenous bolus injection on days 1, 2, and 3. Results: Of the 37 patients, 6 (16.2%, with a 95% confidence interval of 4.3–28.1%) had a partial response (PR). No complete responses (CRs) were observed. The difference between response rates according to prior history of anthracycline administration was not significant. Myelosuppression was moderately severe, with grade 3 or 4 leukopenia occurring in 65%. Severe nausea/vomiting was observed in 44% of the patients. Conclusions: The results indicate that KRN8602 has modest activity in refractory metastatic breast cancer and is associated with relatively severe toxicity. Furthermore, the preclinical finding that KRN8602 overcomes anthracycline resistance was not reliably reproduced in this clinical phase II trial.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-7217
    Keywords: clinical trial ; informed consent ; metastatic breast cancer ; survival ; understanding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To investigate the effect of understanding their own disease by patients with metastatic breast cancer on their survival potential after being informed by their physician. Patientsandmethods: Two hundred and fourteen women with metastatic breast cancer who participated in a multi-institutional, randomized phase III trial (Japan Clinical Oncology Group (JCOG) Study 8808) were asked whether they understood their own disease after being given information about the clinical trial. They were classified into two groups on the basis of whether they understood or not. We estimated their survival after the time of registration and derived relative hazard ratios from Cox's proportional hazards model. Results: There were 190 patients in the ‘better understanding’ group and 24 in the ‘poor understanding’ group. Median survival times after registration were 28.3 and 16.1 months, respectively. The ‘better understanding’ group showed a significant difference from the ‘poor understanding’ group (p=0.016). In multivariate regression analysis, patients who did not understand still showed poorer survival than those who understood (hazard ratio = 2.09; 95% confidence interval (CI) 1.16–3.78; p=0.014)
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1436-2813
    Keywords: color Doppler flow imaging ; deep venous thrombosis ; venography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the ability of color Doppler flow imaging (CDFI) to detect deep venous thrombosis (DVT), which is difficult to diagnose clinically, 67 limbs of 60 patients who presented with clinical signs strongly indicative of DVT during the period between June 1988 and June 1992, were examined. The iliac, common femoral, and superficial femoral veins were assessed with the patient in the supine position, and the popliteal vein was examined with the patient prone. Gentle but firm compression with the transducer probe was used to test for the presence of DVT. Ascending contrast venograms were also obtained within 24 h after the ultrasound procedure, with venography being used as the standard for comparison with CDFI. DVT was identified in 63 limbs by contrast venography and in 62 limbs by CDFI. The sensitivity and specificity of CDFI were 98.4% and 100%, respectively, while the positive and negative predictive values were 100% and 80%, respectively. The thromboses were classified into three patterns: the filling type, the local type, and mural thrombus, detected in 63%, 27%, and 10%, of the limbs respectively, with the filling type being the most common in this series. The results of our study illustrated that CDFI is highly sensitive and specific for detecting symptomatic DVT and that it should be gradually substituted for venography in such patients.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-7217
    Keywords: adjustment disorders ; breast cancer ; first recurrence ; major depressive disorder ; psychological distress
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To investigate the prevalence of, and risk factors for psychological distress following first recurrences of breast cancer. Patients and methods: The sample was drawn consecutively from the inpatient and outpatient populations of the National Cancer Center Hospital in Japan during an 18-month period from July 1996 to December 1997. Of the 56 eligible patients, 55 women aged 30–73 year with recurrent breast cancer participated in the study. The prevalence of psychological distress, including major depressive disorder and adjustment disorders was evaluated according to the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third edition-revised (DSM-III-R). Risk factors for psychological distress were analyzed with a logistic regression model. Results: Of the 55 subjects, 42 met the DSM-III-R criteria for major depressive disorder or adjustment disorders. Major depressive disorder was seen in 4 (7%), and adjustment disorders in 19 (35%). Logistic regression analysis showed that a disease-free interval of less than 24 months significantly predicted a diagnosis of major depressive disorder or adjustment disorders (odds ratio 5.28, 95% confidence interval; 1.28–21.8, p=0.02). Conclusions: These results suggest that it is important for all oncology staff to pay careful attention to the psychological health of patients who have been informed of their cancer recurrence, and that some psychosocial intervention is necessary for preventing distress in patients facing early recurrence.
    Type of Medium: Electronic Resource
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