[The antifertility effect of gossypol plus testosterone and estrogen]

In order to reduce the side effect of gossypol, gossypol was used in combination with steroid hormones so that the dose of both drugs can be reduced. Silastic capsules containing testosterone (T) + estradiol (E) were implanted under the skin male wister rats for 8 weeks. After removing the implants, testosterone was given orally at the dose of 15 mg.kg-1 which is only 50% of the usual antifertility dose. Mating tests showed that the male rats became infertile. Microscopic examination of the heart, liver and kidneys showed no pathologic changes. The treated rats gained body weight as well as the controls. The fertility of the treated rats recovered four to five weeks after treatment. Thus, gossypol in combination with testosterone and estrogen exhibited a low degree of side effect and high antifertility activity.

Ethnic differences in causes of infant mortality: Texas births, 1989 through 1991

The mortality rate of African-American infants in Texas is about twice those of Anglo and Hispanic infants, due at least partly to their increased risk of preterm and low-weight birth. We examined the underlying causes of infant deaths from 1989 through 1991 for specific causes that accounted for the racial difference and for those that were associated with those adverse pregnancy outcomes. The overall infant mortality rate was 8.27 per 1000 live births (6.80 for Anglo, 7.72 for Hispanic, and 15.32 for African-American infants). About 37% of all infant deaths (but 48% of African-American deaths) were associated with adverse pregnancy outcomes; excluding these deaths reduced the overall rate to 5.20 per 1000 (4.59 for Anglo, 5.03 for Hispanic, and 8.05 for African-American infants). Accordingly, reducing adverse pregnancy outcomes in African-American women will reduce but not resolve the discrepancy in racial infant mortality rates. Infant mortality rates for 30 of the top 59 causes of death were at least 1.5 times higher in African-American than in Anglo and Hispanic infants, while a comparable excess in Hispanic infants was noted only for anencephaly; Anglo infants did not have an excessive mortality rate for any of the 59 causes. Reduction of the racial infant mortality rate discrepancy in Texas will require clarification and correction of factors that place pregnancies of African-American women at increased risk for adverse pregnancy outcomes and those that place their infants at increased risk for death from a wide range of causes.

Proportional differences in births and infant mortality rates among the triethnic population in Texas from 1984 through 1986

Birth at preterm gestation and/or with low birth weight is a major predictor of the infant mortality rate, which is twice as high in African-American as in Anglo and Hispanic infants in Texas. This study examined the relative proportions of Anglo, African-American, and Hispanic births that occurred in Texas at specific gestational ages and birth weights, and the neonatal, postneonatal, and infant mortality rates associated with those births. African-American infants showed a systematic tendency to be born at earlier gestational ages and with lower birth weights than did Anglo infants, while Hispanic-Anglo differences were limited to a small excess of preterm but not low weight Hispanic births. Preterm and low-birth-weight African-American infants had neonatal and infant mortality rates that were lower than those of Anglo infants, but that benefit was inadequate to compensate for the greater proportion of African-American births that were at risk. No consistent difference could be identified between Hispanic and Anglo infant mortality rates. We conclude that the birth weight and gestational age predictors of infant mortality reflect the combined effects of two ethnic-specific factors: the mortality rates at specific birth weights and gestational ages, and the proportions of births that are at risk. The biological and/or sociological causes for these ethnic differences in pregnancy outcomes and mortality risk need to be identified if the mortality rate of African-American infants in Texas is to be reduced.

Patterns of infant mortality in relation to birth weight, gestational and maternal age, parity, and prenatal care in Texas' triethnic population, 1984 through 1986

Neonatal, postneonatal, and infant mortality rates were determined in Texas' triethnic populations from 1984 through 1986 with relation to gestational age, birth weight, maternal age, parity, and prenatal care. All mortality rates were increased in the black population. Preterm birth and low birth weight were both strong predictors of mortality. The neonatal mortality rate of preterm black infants was actually lower than those of the other ethnic groups, but the increased proportion of black pregnancies that resulted in preterm and low-birth-weight births, together with their elevated postneonatal mortality rates, produced an infant mortality rate that was twice as high in black as in Anglo and Hispanic infants. The infant mortality rate was highest in infants born to mothers younger than 18 years, of high multiparity, and with inadequate or no prenatal care. Recognition of these associations should enable improved planning of care for all Texas women and their infants.

Patterns of birth weight in relation to gestational age, maternal age, parity, and prenatal care in Texas' triethnic population, 1984 through 1986

This study investigated the distribution of birth weights in Texas' triethnic populations for the years 1984 through 1986 (more than 900,000 births) with regard to gestational age, maternal age, parity, and visits for prenatal care. African-American infants had a systematic tendency to be born earlier and smaller than Anglo and Hispanic infants. Among the maternal age categories, mothers younger than 18 years had the highest rates of preterm birth (less than 37 completed weeks), very low birth weight (less than 1500 g), and low birth weight (less than 2500 g). High multiparity and inadequate visits for prenatal care were associated with increased rates for the same adverse pregnancy outcomes, and the risks were always much higher in African-American than in Anglo and Hispanic women of the same age, parity, and prenatal care categories. The predictive values of these associations for individual pregnancies were limited, but their recognition may improve the planning of prenatal care for Texas women and of the anticipatory care for their infants.

Four years' experience with the treatment of all-trans retinoic acid in acute promyelocytic leukemia

A retrospective analysis was done on 43 patients with acute promyelocytic leukemia (APL) at our hospital from June 1987 to August 1992. All-trans retinoic acid was used to induce these patients to differentiation. In the early period of induction there were risks of severe hemorrhage, which was the main cause of early death. Treatments combined with platelets and heparin or aminomethylbenzoic (PAMBA) were given to patients with abnormal coagulation. As a result only 4 out of 43 patients died of intracranial bleeding at 4-12 days when their white blood cell (WBC) counts peaked. The combination of retinoic acid (RA) and HA chemotherapy could reduce hyperleukocytosis during the RA induction course. None of 7 patients died at early stage with this treatment combination. Our studies showed that it could predict the onset of remission at early stage through observations on the successive changes of karyotypes and morphology of the bone marrow and peripheral blood cells. Our studies also showed that the growth of CFU-F could be inhibited by RA. We think that it may play a role in the RA-induced differentiation. In 4 years of follow-up the overall leukemia-free survival (LFS) was 80% with a relapse rate of 45%. Thirty-five patients out of 43 cases were still alive in remission, and one was alive in relapse. All 11 out of 43 patients relapsed within 3 years, but the relapses occurred later, after 3 years duration of remission (P < .01). Retinoic acid failed to induce 5 patients who relapsed with the continuation treatment of RA and chemotherapy alternatively. In order to overcome the resistance to RA, the continuation treatment of simple chemotherapy had been administered following CR. Two cases achieved remission in this way. The difference of resistant events to RA reached significance between these 2 groups of different continuation treatment.