Summary Although cancer of the cervix is traditionally considered not to be responsive to steroid hormones, an in vitro study has reported that the addition of oestrogen increased cellular proliferation in a cervix cancer cell line that was inhibited by progesterone. We investigated whether the reported in vitro effects of oestrogen and progesterone on cellular proliferation can be replicated in locally advanced cervical cancer in vivo and whether these effects, if any, are related to oestrogen and progesterone receptor (ER and PgR) content of the tumour. One hundred post-menopausal patients with locally advanced cervical cancer were systematically allocated by rotation to the four treatment groups: (1) control group receiving no treatment; (2) ethinyl oestradiol 50 gg; (3) norethisterone 5 mg; (4) a combination of ethinyl oestradiol and norethisterone. Hormone treatment (five doses) was given orally every 12 h. Tissue biopsies were taken before and 12 h after the last hormone treatment. S-phase fraction (SpF) was measured by flow cytometry, and ER and PgR were measured by enzyme immunoassay. Results were analysed using two-factor analysis of variance, the factors being oestrogen -absent or present -and progesterone -absent or present. The main effects of oestrogen were increases in SpF, ER and PgR, which were statistically significant (P= 0.0056, 0.0009 and 0.01 respectively), indicating that there is much greater change in these three parameters in the presence of oestrogen (mean changes 7.808 %, 6.258 fmol mg-' and 12.716 fmol mg-' for SpF, ER and PgR respectively) than in its absence (mean change -1.986 %, -3.041 fmol mg-' and 1.736 fmol mg-' respectively). The progestogen main effect and the oestrogen -progestogen interaction were not significant. The rise in SpF, ER and PgR in the presence of oestrogen had a correlation coefficient with the initial ER values of -0.0565, -0.2863 and -0.1230 respectively, none being statistically significant, suggesting that the oestrogen actions were not strictly related to baseline ER concentrations. The combined median baseline ER and PgR values of the four groups were 1.48 fmol mg-' and 0.80 fmol mg-' respectively. Our results show that oestrogen is capable of increasing SpF in locally advanced cervical cancer in vivo and may help to revive interest in the use of oestrogen as a radiosensitizing agent in the treatment of this disease.Keywords: cervical cancer; S-phase fraction; oestrogen receptor; progesterone receptor; radiosensitisation Carcinoma of the cervix is the commonest cancer in women in the developing world where most patients present at advanced stages when treatment with radiotherapy is not very effective (Hoskins et al, 1993). At least two studies have used adjuvant oestrogen treatment in an attempt to increase sensitivity of squamous cell carcinoma of the cervix to radiation therapy (Runge, 1959;Sugimori et al, 1976). One of these studies reported a significantly better survival in stage III patients in whom oestrogen was administered before and during radi...
Fifty-one patients with proven anovulatory infertility were treated for four months. For two months each, a dose regimen of 50 mg of clomiphene citrate daily for five days and one of 150 mg daily for five days was prescribed. During one month of each of these two regimens, each patient also received 5000 IU of human chorionic gonadotropin intramuscularly. Thirty-three of the 51 patients ovulated at least once during the four months of treatment; the ovulation rate was 64.7%. Sixteen pregnancies occurred during the treatment, for a pregnancy rate of 31.4%. Human chorionic gonadotropin did not appear to increase the ovulation rate.
Ujalambkar AN, Sutaria UD (Dept. of Obstetrits and Gynaecology, BJ &ledical College and Sassoon Genera1 Hospitals, Poona, India). The roll-over test to predict toxemia in pregnancy. /nt J Gynaecol Obstet 19: 327-331, 1981 We performed the roll-over test on 98 primigravid and 10 7 multigravid patients at [28][29][30][31][32] weeks' gestation to predict preeclamptic toxemia. Positive results from the roll-over test correctly predicted preeclamptic toxemia in 71.4% of primigravidae and 23.3% of multigravidae.Negative results were associated with a normal pregnancy in 94.9% of primigravidae and in 98.9% of multigravidae. A mean arterial pressure of 61 mmHg or more when recorded between 28 and 32 weeks' gestation accurately predicted preeclamptic toxemia in 96% of al1 patients.
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