Relationship of reported clinical features of pre-eclampsia and postpartum haemorrhage to demographic and other variables

BACKGROUND

Maternal death and disability remain significant problems in developing countries and are predominantly caused by preeclampsia and postpartum haemorrhage. The diagnostic criteria for preeclampsia and postpartum haemorrhage require medical technologies not readily available in underdeveloped areas.

OBJECTIVE

To determine the correlates of pre-eclampsia and postpartum haemorrhage using symptoms in a rural setting.

METHODS

This was a cross-sectional study in which 577 women from the Kwahu South District of the Eastern Region of Ghana completed questionnaires that sought for signs and symptoms of pre-eclampsia and postpartum haemorrhage in their current or prior pregnancies. The study was conducted over a period of two months, symptoms of pre-eclampsia assessed included headache, visual disturbance, urination, breathing, leg swelling and seizures. For postpartum haemorrhage, the following features were assessed: placenta delivery, length of labour, difficult delivery of placenta, lacerations associated with delivery, size of newborn, headache, visual disturbance and amount of vaginal bleeding.

RESULTS

There was a significant association between education and the number of signs and symptoms of preeclampsia, (Χ² =9.059, =0.018; OR no education vs >7 years=6.8). Mothers with no education were about seven times more likely to have all six signs and symptoms of preeclampsia than those with seven or more years of education. There was no significant association between education and postpartum haemorrhage, (Χ² = 1.835, = 0.400). However, the OR of 1.59, indicated an inverse association between the two variables.

CONCLUSION

The high number of symptoms associated with preeclampsia among women with no formal education strongly supports the need for educational outreach and basic prenatal care in rural Ghana.

Phase I dose-finding study of epirubicin, oxaliplatin, and S-1 (EOS) in patients with previously untreated advanced gastric cancer (AGC)

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Background: To determine the recommended dose (RD) and dose-limiting toxicity (DLT) of EOS combination in patients with previously untreated AGC.

Methods: Previously untreated patients with histologically proven metastatic or recurrent AGC and ECOG performance status 0-2 were enrolled. Fixed dose of epirubicin (50 mg/m2) and oxaliplatin (130 mg/m2) was administered i.v. on day 1. The dose of S-1 was escalated as following schedule: Level I: 30 mg/m2, Level II: 40 mg/m2, Level III: 45 mg/m2, Level IV: 50 mg/m2. S-1 was administered orally twice a day on days 1-14. Each cycle was repeated every 21 days. DLTs were evaluated during the first two cycles of treatment.

Results: Nineteen patients were enrolled: 13 patients in dose-escalation phase and 6 patients in the extension at the RD. Median age was 53 years (range, 40-71 years). At dose level II, 1 DLT (grade 4 neutropenia lasting more than 5 days) was found among 6 patients while at dose level III, 2 DLTs (grade 3 diarrhea and nausea) were observed among 4 patients. Therefore, the dose level II was determined as RD. Cumulative (all cycles) grade 3/4 toxicity included neuropenia (58%), leucopenia (32%), thrombocytopenia (11%), diarrhea (11%), and nausea (5%). Of 13 patients with measurable lesions, 8 achieved partial response and 3 showed stable diseases, and the objective response rate was 62% (95% CI, 36-88%). The median progression-free survival was 6.5 months (95% CI, 4.7-8.2 months).

Conclusions: The RD of the EOS regimen in patients with previously untreated AGC was epirubicin 50 mg/m2 and oxaliplatin 130 mg/m2 on day 1 and S-1 40 mg/m2 twice a day on days 1-14 of every 21-day cycle. This regimen seems to have promising preliminary activity.

No significant financial relationships to disclose.

Prognostic impact of immunohistochemical expression of Ki-67 in patients with advanced gastric cancer who underwent curative resection

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Background: Ki-67, tumor proliferation marker, is an important prognostic factor in a variety of cancers. In the present study, we investigated the prognostic value of immunoexpression of Ki-67 in patient with gastric cancer who underwent curative resection.

Methods: We retrospectively analyzed 241 patients who had undergone curative gastrectomy at Gachon University Gil Hospital between January 2008 and July 2009. Ki-67 proliferation index (PI) by immunohistochemistry on formalin-fixed, paraffin-embedded material and the other clinicopathologic variables were evaluated by univariate and mulvariate analysis.

Results: The median follow-up from surgery was 12 months (range, 0.5-26.7 months) and mean recurrence-free survival was 23 months (95% confidence interval, 21.8-24.1 months). The mean Ki-67 PI was 40% (range, 5-90%). No significant correlation was found between Ki-67 PI and other clinicopathologic variables including histologic grade and pathologic TNM (pTNM) stage. Univariate analysis revealed that significant prognostic factors of recurrence-free survival included age, preoperative serum albumin, pre-operative hemoglobin, surgery type, pTNM, histologic grade, lymphatic vessel invasion, peri-neural invasion, and Ki-67 PI. In the multivariate analysis besides pTNM (p=0.046), lymphatic vessel invasion (p=0.024), and surgery type (p=0.047), Ki-67 PI (p=0.005) also remained as an independent prognostic factor of recurrence, whereas the other factors lost its prognostic value.

Conclusions: Our results suggest that high Ki-67 PI is independent, poor prognostic factor of recurrence in patient with gastric cancer who underwent curative resection.

No significant financial relationships to disclose.

Design and fabrication of label-free biochip using a guided mode resonance filter with nano grating structures by injection molding process

This paper introduces technology to fabricate a guided mode resonance filter biochip using injection molding. Of the various nanofabrication processes that exist, injection molding is the most suitable for the mass production of polymer nanostructures. Fabrication of a nanograting pattern for guided mode resonance filters by injection molding requires a durable metal stamp, because of the high injection temperature and pressure. Careful consideration of the optimized process parameters is also required to achieve uniform sub-wavelength gratings with high fidelity. In this study, a metallic nanostructure pattern to be used as the stamp for the injection molding process was fabricated using electron beam lithography, a UV nanoimprinting process, and an electroforming process. A one-dimensional nanograting substrate was replicated by injection molding, during which the process parameters were controlled. To evaluate the geometric quality of the injection molded nanograting patterns, the surface profile of the fabricated nanograting for different processing conditions was analyzed using an atomic force microscope and a scanning electron microscope. Finally, to demonstrate the feasibility of the proposed process for fabricating guided mode resonance filter biochips, a high-refractive-index material was deposited on the polymer nanograting and its guided mode resonance characteristics were analyzed.

Atomic and electronic structures of amorphous Ge(2)Sb(2)Te(5); melt-quenched versus ideal glasses

To investigate an amorphous structure of Ge(2)Sb(2)Te(5) that satisfies the 8-N rule (so-called 'ideal glass'), we perform alternative melt-quench simulations on Si(2)As(2)Se(5) and replace atoms in the final structure with Ge-Sb-Te. The resulting structures have salient features of the 8-N rule such as the tetrahedral configuration for all Ge atoms and the localized Te lone pairs at the valence top. In addition, the average Ge-Te and Sb-Te distances are in good agreement with experiment. The energetic stability of the ideal glass supports the existence of this amorphous structure that is distinct from the melt-quenched glass. From the analysis of electronic structures and optical dielectric constants, it is concluded that the electronic character of the melt-quenched amorphous Ge(2)Sb(2)Te(5) lies in between the resonant p-bonding of the crystalline phase and the covalent bonding of the ideal glass.

Elasticity transition and loop formation in vibrated bead chains: a simulation of polymer chains

By measuring the distribution function of the end-to-end distance, we find that strongly shaken bead chains exhibit many properties, such as the rigid-rod-to-Gaussian chain transition, scaling, fast drop of loop formation probability in the short-chain regime, and enhancement of loop formation probability for kinked chains, of long-chain polymers. Though there is difference in local details between our chains and the worm-like chains, our results are consistent with recent calculations based on the worm-like chain model in many respects.

Pemetrexed versus gefitinib versus erlotinib in previously treated non-small cell lung cancer by retrospective analysis

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Background: The standards in 2nd-line therapy with advanced non-small cell lung cancer (NSCLC) were erlotinib or pemetrexed as well as docetaxel. To evaluate the efficacies and safeties of pemetrexed, gefitinib, and erlotinib in previously treated NSCLC we analyzed the datas retrospectively. Methods: Eligible patents were 1) histologically confirmed pretreated advanced (stage IIIB or IV) NSCLC, 2) with at least one measurable lesion, 3) age over 18 years, 4) performance status (PS) 0–2, and 5) should never experience other two drugs as previous therapy. Patients of pemetrexed group received IV infusion of 500mg/m2 pemetrexed mixed with normal saline every 3 weeks with vitamin B12 and folate supplementation. Patients of gefitinib group received gefitinib 250mg PO daily and of erlotinib took erlotinib 150mg PO daily. Cycles of IV pemetrexed or taking PO drugs were continued until disease progression or unacceptable toxicity. Results: we analyzed 57 patients (pemetrexed; 20, gefitnib; 20, and erlotinib; 17). The response rates were 5.3%, 25.0%, and 12.5% (P=0.22), and the disease control rate were 5.3%, 40.0%, and 50.0% respectively (P<0.01). Median progression-free survival (PFS) of pemetrexed, gefitinib, and erlotinib were 1.7, 3.5 and 4.4 months (P<0.01) and median overall survival (OS) were 5.6, 21.8 and 21.5 months respectively (P=0.04). In subgroup analysis, patients with non-squamous carcinoma, smokers and good PS (0 or 1) showed longer PFS and OS in gefitinib and erlotinib compared with in pemetrexed. All of these agents showed mild and tolerable toxicity. Conclusions: In retrospective analysis, the patients with gefitinib or erlotinib had longer PFS and OS than pemetrexed, eventhough there was no significant difference for response rate in three group. These results have to confirm by large randomized prospective study because the sample size was small and it was not randomized.

No significant financial relationships to disclose.

Detection of human papillomavirus DNA from the breast carcinomas and the cervix: Are they correlated?

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Background: The association between human papillomavirus (HPV) and cervical cancer is well known. However, it remains unclear whether there is also a correlation between HPV infection and human breast cancer. The aim of this study is to investigate the hypothetic association between HPV infection and breast carcinoma through the comparison of the type of HPV infection in the breast and cervix. Methods: From April to December 2008, 106 patients who were diagnosed as breast cancer and underwent mastectomy were analyzed. Their breast tissue (tumor, normal parenchyme, and nipple-areolar complex) and cervix smear were analyzed for HPV infection with DNA chip microarray method. Results: 24 patients (23.1%) showed HPV infection in their cervix smear; high-risk type of HPV was found in 12 patients. But only six patients (5.8%) revealed the HPV infection in breast cancer; half of them were high-risk group (HPV-16, 31); the same types of HPV was found at the normal breast tissue in two patients of them. However, there were no patients with HPV infection in both breast and cervix concurrently. Conclusions: There were no positive results for HPV infection of cervix in HPV-infected breast cancer patients. Also, we cannot find that the presence of high-risk HPV in the breast might be related to the breast carcinogenesis. We concluded that HPV infection is not correlated to the carcinogenesis of breast.

No significant financial relationships to disclose.