bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuronal activity enhances aryl hydrocarbon receptor‐mediated gene expression and dioxin neurotoxicity in cortical neurons
Authors: Lin Chun‐Hua , Juan Shu‐Hui , Wang Chen Yu , Sun Yu‐Yo , Chou Chih‐Ming , Chang Shwu‐Fen , Hu Ssu‐Yao , Lee Wen‐Sen , Lee Yi‐Hsuan
Published: February 2008

The aryl hydrocarbon receptor (AhR) is a ligand‐activated transcription factor activated by dioxin and polyaromatic hydrocarbons. Recent studies have revealed that AhR activity in central neurons depends on the NMDA receptor. In this study, we investigated how the neuronal activity influence AhR‐mediated dioxin‐responsive gene expression and neurotoxicity. Our results show that activation of AhR by the selective agonist 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin induced dioxin‐responsive gene expression and calcium entry, which were attenuated by AhR small interfering RNA, the NMDA receptor channel blocker MK801, and the action potential blocker tetrodotoxin (TTX). In addition, AhR‐mediated gene expression was enhanced in neurons during synaptogenesis (10 days in vitro) compared with younger neurons (4 days in vitro), as was sensitivity to TTX and MK801. Furthermore, TTX and MK801 differentially affected the association of AhR and its transcriptional co‐activator cAMP‐responsive‐element binding protein with the cytochrome P450 1A1 (cyp1A1) gene enhancer. Calcium/calmodulin‐dependent protein kinase IV, the cAMP‐responsive‐element binding protein activating enzyme, was also activated by 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin in an activity‐dependent manner. Finally, we found that neuronal susceptibility to dioxin insult was also maturation and activity‐dependent. Together, the results suggest that neuronal activity may facilitate AhR‐mediated calcium signaling, which in turn enhances AhR‐mediated gene regulation and mediated maturation‐dependent dioxin neurotoxicity.
Chronic binge‐like moderate ethanol drinking in rats results in widespread decreases in brain serotonin, dopamine, and norepinephrine turnover rates reversed by ethanol intake
Authors: Smith James E. , Co Conchita , McIntosh Scott , Cunningham Carol C.
Published: February 2008

This research was initiated to assess the turnover rates (TORs) of dopamine (DA), norepinephrine (NA), serotonin (5‐HT), aspartate, glutamate, and GABA in brain regions during rodent ethanol/sucrose (EtOH) and sucrose (SUC) drinking and in animals with a history of EtOH or SUC drinking to further characterize the neuronal systems that underlie compulsive consumption. Groups of five male rats were used, with two trained to drink EtOH solutions, two to drink SUC and one to serve as a non‐drinking control. When stable drinking patterns were obtained, rats were pulse labeled intravenously and killed 60 or 90 min later and the TORs of DA, norepinephrine, 5‐HT, aspartate, glutamate, and GABA determined in brain regions. Changes in the TOR of 5‐HT, DA, and NA were detected specific to EtOH drinking, SUC drinking or a history of EtOH or SUC drinking. An acute EtOH deprivation effect was detected that was mostly reversed with EtOH drinking. These results suggest that binge‐like drinking of moderate amounts of EtOH produces a deficit in neuronal function that could set the stage for the alleviation of anhedonic stimuli with further EtOH intake that strengthen EtOH seeking behaviors which may contribute to increased EtOH use in at risk individuals.
Impact of anaesthesia–surgery on D‐dimer concentration and end‐tidal CO2 and O2 in patients undergoing surgery associated with high risk for pulmonary embolism
Authors: Kline Jeffrey A. , Hogg Melanie M. , Mauerhan David R. , Frick Steven L.
Published: February 2008

Background:  The exhaled end‐tidal CO2/O2 ratio and the D‐dimer concentration are diagnostic markers of pulmonary embolism (PE).

Objective:  To develop a non‐invasive technique to monitor for PE in surgical patients. We examine the change imparted by anaesthesia–surgery on the end‐tidal CO2/O2 compared with the D‐dimer.

Methods:  We enrolled 125 participants undergoing an orthopaedic or oncological operation thought to confer high risk for postoperative PE. We obtained preoperative blood samples in the anaesthesia clinic, and breath samples in the preoperative holding area on the same day of surgery; we repeated blood and breath samples on the postoperative day of discharge. Blood samples were immediately analysed for fibrinogen and D‐dimer (Vidas®; bioMérieux, Durham, NC, USA) concentrations. Breath samples were obtained from 1 min of spontaneous tidal breaths delivered via mouthpiece while the participant breathed room air. All participants had follow‐up at 30 days.

Results:  We enrolled 125 participants and had complete data in 104. No participant developed PE or deep venous thrombosis within 30 days. The mean preoperative D‐dimer was 927 ± 928 ng ml−1, and the mean postoperative D‐dimer was 1879 ± 1263 ng ml−1 and the mean relative change was +234 ± 292%. The mean preoperative end‐tidal CO2/O2 was 0·31 ± 0·05 and the mean postoperative end‐tidal CO2/O2 was 0·32 ± 0·07 and the mean relative change was +1·6 ± 20%. The increase in D‐dimer did not correlate with the increase in fibrinogen (r2 = 0·015).

Conclusions:  The stress impact of anaesthesia–surgery causes less change in end‐tidal CO2/O2 compared with the D‐dimer. Further work will be required to determine if end‐tidal CO2/O2 can be used to monitor for postoperative PE.
A new deal for lone parents? Training lone parents for work in West London
Authors: Smith Fiona , Barker John , Wainwright Emma , Marandet Elodie , Buckingham Sue
Published: February 2008

In this paper we explore the impacts of the training programmes offered to lone mothers with young children on the Government's ‘New Deal for Lone Parents’ in one local labour market: West London. Our research suggests that regulatory workfare policies are (re)producing and reinforcing gendered inequalities in the labour market by encouraging lone mothers to undertake training in feminised occupational areas such as childcare. We will argue that in a local economy such as West London where more childcare workers are desperately needed to enable other more highly skilled workers to take up employment opportunities, such training programmes may be doing little more than exacerbating the already gendered and class‐based polarisation of the labour market – embedding low‐skilled, poorly qualified lone mothers into low‐paid jobs.
A journey in quest of meaning: a hermeneutic‐phenomenological study on living with memories from intensive care
Authors: Storli Sissel L , Lindseth Anders , Asplund Kenneth
Published: February 2008

Background:  In a short‐term perspective, a high incidence of psychological problems linked to memories from intensive care has been found in survivors of critical illness. Little is known about what kinds of memories patients might carry with them and what it is like to live with memories from intensive care as years go by.

Aim:  The aim of this study was to explore the meaning of living with memories from intensive care.

Methods:  A hermeneutic‐phenomenological approach. In‐depth interviews with ten former intensive care patients 10 years after their admission.

Findings:  Memories of bodily sensations and memories containing strong emotions were surprisingly well kept. Memories residing in the body at a prereflective level and that could be awakened without being triggered by will or conscious thought comprised an important segment of the memory spectrum. Complaints such as panic attacks and anxiety were strongly linked to these kinds of memories and experienced as flashbacks of frightening experiences that entailed strong emotions. Some informants still strove to understand experiences and reactions. Living with these memories and flashbacks was interpreted as a journey in quest of meaning. Having someone and something to live for implied strength on the journey. The presence of close relatives at the bedside provided strength to go on and someone with whom to share experiences afterwards.

Conclusion:  A period of critical illness and intensive care stay for treatment may leave durable traces in the patient’s life. Finding meaning of existential and ontological nature seems to be of decisive significance for how people fare in their lives after having lived through intensive care treatment. The identified journey in quest of meaning points to the need for follow‐up programmes, and we must acknowledge close relatives as important resources for the patient both at the bedside and in the subsequent process of discovering meaning in lived experience.
Development in service provision. Making major elective surgery happen. The development of a postoperative surgical unit
Authors: Heller Judy , Murch Phil
Published: February 2008

Background:  Optimizing the provision of elective surgery and reducing waiting list times for elective surgery has been a central theme in this government’s health‐care agenda. The negative impacts of high levels of cancelled surgery have significant implications, for both patient and health‐care resources.

Aims:  To describe the development and initial impact of a postoperative surgical unit (POSU), an innovative strategy to optimize provision of major elective surgery.

Methods:  Data were collected concerning numbers of cancellations of major elective operations during the first year of POSU’s opening and for the previous year when high‐dependency unit held the only available beds for these patients. Data were also collected concerning the outcome of the admission of these patients. All data collection was standardized.

Results:  In the year prior to the opening of POSU, of 503 patients requiring level 2 care postoperatively, 317 underwent elective surgery and 186 patients had their surgery cancelled because of unavailability of level 2 beds. In POSU’s first operational year, of 877 similar patients, 843 had elective surgery and 34 had their surgery cancelled because of unavailability of appropriate dependency beds.

Conclusions:  This small project has illustrated how POSU has had a positive impact on decreasing the waiting list times and led to low levels of cancelled major elective surgery. These outcomes have resulted in improvements in delivery of services to patients and in the utilisation of resources.
Sedation breaks: are they good for the critically ill patient? A review
Authors: Pinder Sally , Christensen Martin
Published: February 2008

Background:  Tradition has led us to believe that a heavily sedated patient is a comfortable, settled, compliant patient for whom sedation will improve outcome. The current move witnessed in clinical practice today of limiting sedation has led health care in recent years to question the benefit and necessity of routine, continuous sedation for all patients requiring mechanical ventilation. However, as a result there has been a rise in the amount of agitation being reported as being experienced by patients with the daily withdrawal of sedation.

Aims:  The purpose of this paper is to review current arguments for and against perserving with agitation versus re‐sedating, when it presents during the daily sedation breaks.

Findings:  Of the literature reviewed, the question to re‐sedate the mechanically ventilated agitated patient during sedation breaks remains an issue of contention. Although there is evidence focusing on the psychological effects of long‐term sedation and sedation breaks specifically, the complex nature of critical illness in some cases means that individualized care is of paramount importance and in‐depth assessment is crucial when deciding to re‐sedate in the face of undetermined agitation. Agitation has been closely linked with several incidents that can be detrimental to patient safety, such as removal of lines and unplanned self‐extubation.

Conclusion:  The recommendations of this review are that nurses should re‐commence sedation if the patient becomes agitated following a sedation break.
Medical emergency team: a review of the literature
Authors: Barbetti Julie , Lee Geraldine
Published: February 2008

Background:  A medical emergency team (MET) comprises of a team of doctors and nurses with advanced life support skills, which are hospital based, who respond to emergency calls following a deterioration in a patient’s clinical condition. The role and contribution of such approaches promoting the early recognition and intervention of these vulnerable patients demands critical appraisal.

Aim:  To investigate the contribution of medical emergency teams and whether there are clinical antecedents evident prior to the triggering the MET system. The paper will also discuss factors influencing effective utilization and implementation strategies to encourage a culture change required to adopt the MET system.

Methods:  A critical review the relevant literature of studies focussed on the MET system.

Results:  The majority of published work relating to MET systems was conducted in single‐centres. The introduction of MET systems appears to be linked to a reported reduction in adverse outcomes and early recognition and intervention in clinically deteriorating patients. Additionally, a consistent observation in the studies reviewed was the reported presence of clinically abnormal physiological observations prior to the clinical events such as the cardiac arrest. The evidence in support of MET or equivalent systems, is not straightforward. Issues such as education, resources (human and financial) and communication are vital to success with implementation. Responding promptly to patients who unexpectedly become acutely ill demands skill and competence; however, more research evaluating the role of early ’response’ systems is warranted.
Clinical Trial of SE 505 … A New Oxytocic Mixture
Authors: Barbaro C. A. , Smith G. O.
Published: February 2008

A clinical trial has been conducted using SE 505, a new oxytocin: ergometrine mixture. Administration was by intramuscular injection after delivery of the foetus. Comparing the results obtained in a similar group of patients given ergometrine by intravenous injection after delivery of the foetus and ergometrine by intramuscular injection after delivery of the placenta, the new Compound was found to be associated with a significantly greater postpartum haemorrhage rate and mean blood loss.
A Study of Congenital Malformations: PART I
Authors: Pitt David B.
Published: February 2008

Four hundred infants with major and minor malformations recognizable at birth have been studied. The incidences were 1.51% and 0.28% respectively (total, 1.79%). The commonest malformations were talipes and congenital heart defects.

No correlation with sex incidence was found, other than a male preponderance in genito‐urinary malformations. No correlations were found with the racial origin of the mothers, maternal blood groups, or antenatal obstetrical emergencies.

The association with prematurity was confirmed, one‐third of the infants with major malformations being 2,500 g. or less in weight. A tendency was shown for the grosser malformations to result in more premature births.

Congenital malformations were a little commoner in the infants of primigravidae; in the infants of mothers over 41 years of age the incidence was increased threefold.

Central nervous system malformations, congenital heart defects and multiple malformations contribute most to the pool of perinatal mortality and infant morbidity.
Relation of Congenital Anomalies of the Central Nervous System to the Blood Group of the Mother
Authors: Collmann R. D. , Stoller A.
Published: February 2008

When percentage distributions by ABO groups or Rh factor were compared, no significant differences were found between the mothers of children with central nervous system malformations, either taken separately or combined, and those of a control group. This result is in accord with the Rhode Island findings. The Dublin result for mothers of anencephalics, however, showed that a statistically significant excess belonged to group O. It might be noted that the incidence of anencephaly in Dublin was very much higher than that for Rhode Island or Melbourne, the rates being 5.9 per 1,000 total hospital births (in one Dublin hospital it was 8.6), 1.93 and 0.66 respectively. It might be said here that the relevant hospital records used in the Melbourne survey were complete and adequate.

Whatever genetic or environmental factors may be involved in the aetiology of these malformations, there does not appear to be any appreciable association between the Rh factor or ABO blood grouping and these malformations of the central nervous system, although Penrose (1957), commenting on the Dublin and Rhode Island percentages of group O mothers of anencephalics, suggests that ABO incompatibility remains a possibility in its causation.
Carcinoma In Situ of the Uterine Cervix:Conservative Management in 84 of 190 Cases
Authors: Green G. H.
Published: February 2008

A series of 190 patients with cervical carcinoma in situ has been presented. All have been followed for at least 1 year, and more than half for at least 2 years.

The definitive treatment was total hysterectomy in 106 patients and local excision in 84. Four of the latter patients ultimately had a hysterectomy.

The method of cone biopsy used, and some of its complications, are described.

Of the patients who underwent hysterectomy one had positive vaginal smears after operation.

Eleven of the conservatively‐treated patients showed evidence of persistent disease and one with incomplete follow‐up is assumed to have it also. The investigation and outcome of these patients are considered in detail; all except one are cytologically free of disease at present.

The relative efficiency of the various types of biopsy, in completely excising a carcinoma in situ, is discussed.
Antidiuretic Effects of Oxytocin, Morphine and Pethidine in Pregnancy and Labour
Authors: Liggins G. C.
Published: February 2008

Diuresis was induced by a constant intravenous water load in women in late pregnancy and early labour. The effects on urine flow and clearance values of synthetic oxytocin (Syntocinon), morphine and pethidine were studied after their intravenous administration.

Oxytocin caused a consistent antidiuretic response when given in doses above 20 mU/min. Morphine and pethidine also caused a marked antidiuresis which persisted for about 7 hours and 2 hours respectively.

The onset of painful uterine contractions was not associated with inhibition of diuresis.
Physiological Metaplasia on the Human Cervix Uteri
Authors: Reid B. L. , Blackwell P. M.
Published: February 2008

Tissue from the columnar‐covered area of the cervix of women, removed at the first postnatal visit (about 6–7 weeks after delivery) was subjected to the following histo‐chemical procedures: the PAS technique for demonstration of the basement membrane and of mucin, the acid phosphatase technique (studied by both light and electron microscopy) and the DDD technique for the demonstration of SH groups.

The variability in structure extending to complete absence of the basement membrane at certain stages of the process of metaplasia is described. The significance of the intimacy of the epithelial and subepithelial tissues at these stages is discussed from the viewpoint of a possible inductive effect analogous to embryonic induction. Columnar cell mucin was noted to be absent in cells of more prominent or superficial situation and toward the vaginal end of the cervical canal.

Acid phosphatase labelling of this tissue is shown to occur in columnar epithelial cells and in plasma cells of the subepithelial tissue. Such epithelial staining is, as with mucin, markedly reduced on prominences, e.g., the tips of villous processes. An hypothesis is developed that lysosomes of columnar cells which are responsible for some of the acid phosphatase stain are ruptured by conditions associated with the alteration of the prevailing pH at the cervico‐vaginal junction. Such rupture may in turn damage the columnar cells, depleting their mucin content, and stimulate the production of new (squamous) cells.

A gradation of staining with the DDD reagent for SH groups in plasma cells, which are plentiful in sites of active metaplasia, suggests that there is a maturation process at these sites where plasma cells are stimulated to produce antibody. Some part of the plasma cell function appears to be production of antibody and the possible reasons for its production are discussed.
Hysterosalpingography and Infertility*
Authors: Cron Roland S.
Published: February 2008

Gas insufflation of the uterus and fallopian tubes was first performed by the author in 1920. Peterson and Cron in 1923 reported 13 pregnancies in 36 infertile couples, and in 1930, the author reported 10 pregnancies in 53 infertile couples. At this period, the writer became interested in the more exact diagnostic procedure of filling the uterine cavity and tubes with radio‐opaque oil, and found that this was also of great diagnostic and therapeutic value.
The Place of Foetal Transfusion in Haemolytic Disease: A Report of 22 Transfusions in 16 Patients
Authors: Green G. H. , Liley A. W. , Liggins G. C.
Published: February 2008

A series of 22 foetal transfusions performed in 16 patients over a period of 12 months is presented.

In infants hydropic at the first transfusion the procedure was of no benefit, all such infants dying in utero. Demonstrable hydrops is at present a contraindication to foetal transfusion.

Of 8 infants not hydropic at the first transfusion, 6 survived and were well at periods of 2 months of age and more. One developed hydrops prior to a second transfusion and one died in the neonatal period at 32 weeks after 3 foetal transfusions.

Amniotic fluid analysis is considered to be of the utmost importance in the selection of cases.

Some points in the technique are briefly discussed. No notable risks to foetuses so treated have yet been demonstrated.

The place of foetal transfusion in the management of pregnancy complicated by rhesus sensitization is discussed. Theoretically it should not be necessary in more than 1 in 2,000 pregnancies. Benefits accruing from the procedure are the saving of some babies poised between the risks of intrauterine death and neonatal death from prematurity, the drawing of attention to the prognostic value of amniotic fluid analysis by spectrophotometry, and an indication of the principle that it is possible to treat an infant in utero.

Any patient with rhesus sensitization whose amniotic fluid shows an optical density for the 450 mμ peak of above 0.20 between 28 and 32 weeks of pregnancy should be considered for foetal transfusion.
Mitotic Activity and Radiation Response in Uterine Malignancy*
Authors: Cox L. W. , Wakonig R. , Harvey N. D.
Published: February 2008

1. Eighteen patients having intracavitary Cobalt 60 treatment in 3 divided doses for cervical carcinoma were assessed for mitotic activity.

2. Two patients who showed active mitosis after 2 cobalt applications had residual carcinoma after a full course of radiation.

3. Five patients who showed active mitosis after 1 cobalt application have no recurrence yet.

4. All patients in whom mitotic activity had ceased after the first cobalt application have remained free from disease (except one where early metastases occurred outside the field of irradiation). The longest period of follow‐up is 2½ years.
Reservations on the Safety of Oxytocin Nasal Spray in Obstetrics*
Authors: Bradfield Alan
Published: February 2008

1. Claims for the safety of oxytocin nasal spray in induction and enhancement of labour were tested in 102 patients. In 44 the pregnancies had been normal; in 58 the pregnancies were complicated by toxaemia, hypertension, post maturity, diabetes and elderly primigravidity.

Foetal heart rate and amniotic fluid pressure were recorded continuously.

2. The efficacy of the spray was confirmed, but in contrast to previous reports significant uterine hyperactivity and hypoxic foetal heart rate changes were observed.

3. In 7 of the 102 patients the spray induced marked uterine hypertonus. Serious foetal bradycardia resulted and was followed by sustained tachycardia as uterine hyperactivity waned.

Hypoxic foetal heart rate changes were more common when pregnancies were complicated. They were seen less frequently when the spray was employed in the induction of labour than in the enchancement of labour.

4. Oxytocin nasal spray lacks precision. The preparation used in this study delivered a higher dose than that reported in similar studies from U.S.A. A metered aerosol pack is undergoing trial.

5. Meanwhile, in complicated pregnancies uterine stimulation is more safely achieved by controlled intravenous infusion.
The Medical Paper
Authors: Mackay E. V.
Published: February 2008

“A man must serve his time to every trade Save censure—critics all are ready made.” Lord Byron.
Acute Puerperal Inversion of the Uterus
Authors: Correy J. F.
Published: February 2008

Two cases of acute puerperal inversion of the uterus are presented and some of the problems encountered in the performance of the hydrostatic method of treatment are described.

The mechanism of correction of the inversion by hydrostatic pressure is suggested.
Advanced Tubal Pregnancy: A Case of Survival of Mother and Baby
Authors: Schokman Christopher M.
Published: February 2008

A case has been reported of advanced tubal pregnancy. It was attended by the survival of the mother and, probably by the very nature of its mode of presentation, by survival of the child.

Some diagnostic features of this unusual condition have been discussed in the light of previous reports of similar cases.

Comment has been made on some clinical and radiographic features of the case.
Vehicular Accidents and Pregnancy
Authors: Elliott Murray
Published: February 2008

A survey of 8 fatal and 31 non‐fatal traffic injuries in pregnant women is presented.

The ability of women to withstand trauma is not greatly influenced by pregnancy, but the hypertrophied and distended pelvic blood vessels are more vulnerable to injury because of the commonness of fractured pelvis and violent movement of the pregnant uterus.

Despite the protuberance of the pregnant uterus, it resists most blunt external trauma and purely obstetric complications are rare.

The foetus seems remarkably safe in its intact amniotic sac. Maternal hypotension and not direct trauma is the commonest cause of foetal death.

Uncontrolled haemorrhage was the usual cause of death in this series. Some of these tragedies may well have been prevented by earlier laparotomy.
Obstetric Acute Yellow Atrophy
Authors: Giles P. F. H.
Published: February 2008

Acute liver failure in pregnancy is rare. Mother and foetus usually die whether liver failure is due to acute viral hepatitis, hepa‐totoxic agents, eclampsia, or whether it is due to “obstetric acute yellow atrophy” in which there is no necrosis but a gross fatty change in the liver. Moore (1956) suggested the term “acute fatty liver of pregnancy” for this unusual appearance. It was, however, Sheehan in 1940 who first recognized “obstetric acute yellow atrophy” as a distinct clinical entity and since then just over 40 cases have been reported.

The case history of a patient who died from obstetric acute yellow atrophy is presented and discussed.
An Unusual Case of Primary Abdominal Pregnancy
Authors: Beischer N. A.
Published: February 2008

Advanced abdominal pregnancy, although infrequently encountered, is a well documented entity because it is one of the most hazardous complications of child‐bearing (Mackay, 1959). The diagnosis may not be made until the time of operation when the surgeon faces the major problem of the management of the placenta (Hibbard, 1957). It is evident that abdominal pregnancies will not be recognized unless they are considered in the differential diagnosis of obstetrical conditions having abnormal signs and symptoms (Cross et al, 1951).

A case of primary abdominal pregnancy is reported.

The placenta was attached to the posterior peritoneum of the pouch of Douglas which was expanded inferiorly and contained most of the gestation sac.

Retroplacental bleeding had resulted in a large haematoma which occluded the vagina in its middle third and displaced the rectum to the right lateral pelvic wall.
Shock and Ureteric Obstruction following Vaginal Repair
Authors: Gudgeon C. W.
Published: February 2008

Partial ureteric obstruction may occur in the course of a vaginal repair. Combined with urinary infection post‐operatively, a characteristic illness with nausea, pyrexia, shock, and oliguria may occur within the first week.

Three patients with ureteric obstruction following vaginal repair are reported.

This complication should be suspected if the post‐operative course is characterised by unexplained and prolonged nausea or pyrexia.

The onset of rigors, oliguria and shock usually indicates the presence of gram‐negative endotoxic shock; the treatment of this condition is briefly discussed.
Brachial Arterial Blood Pressure in the Lateral Recumbent Position during Pregancy
Authors: Trower R. , Walters W.A.W.
Published: February 2008

Brachial arterial blood pressures measured by sphygmomanometry fall significantly in most non‐pregnant and normal pregnant women when they turn from the supine to right or left lateral recumbent positions. These changes are most marked in the second trimester of pregnancy. This finding is in contrast with the rise in brachial arterial blood pressure and relief of adverse symptoms that occur when pregnant women who develop the supine hypotensive syndrome are turned into a lateral position.

Possible mechanisms to account for these blood pressure changes are discussed.
Subarachnoid Haemorrhage Associated with Pregnancy
Authors: Baker J. W.
Published: February 2008

Four cases of subarachnoid haemorrhage associated with pregnancy occurring at the Royal Women's Hospital in the period 1961–1965 have been presented. The only maternal death which occurred in Queensland during this period is also presented. A general review of the literature with regard to incidence, clinical features, angio‐graphy, aetiology, obstetrical management and prognosis is presented.
Antenatal Anaemia and Postpartum Haemorrhage
Authors: Dewar Marion J.
Published: February 2008

Summary and Conclusion

A study was made of the postpartum haemorrhage rates in 170 patients with iron‐deficiency anaemia diagnosed in the last 3 weeks of pregnancy and in 1,743 non‐anaemic patients, both groups being delivered at National Women's Hospital during the period January to August, 1966. No significant difference between the 2 groups was found. It was concluded that urgent methods (blood transfusion and intravenous iron therapy) of overcoming iron‐deficiency anaemia in the last 3 weeks of pregnancy are not justifiable quite apart from their risks.
Interstitial Tubal Pregnancy
Authors: Toongsuwan Sommai
Published: February 2008

The diagnosis and management of 4 cases of interstitial pregnancy (1 in 2,600 deliveries) is presented.
Induction of Labour by Amniotomy and Micro‐infusion of Oxytocin (Syntocinon)
Authors: Townsend Lance , Pepperell Roger J.
Published: February 2008

A method of induction of labour by amniotomy and micro‐infusion of oxytocin (Syntocinon) is described. The micro‐in‐ fusion reduces the amount of intravenous fluid required to effect delivery to less than 500 ml. in most cases.

There were no maternal complications and 96% of patients were delivered on the day of the infusion.

The Caesarean section rate was 3%. There was no perinatal mortality attributed to the method of induction.

The potential risks of the method are emphasized.
Spontaneous Respiratory Rate in First Stage Labour‐Comparison with the Breathing Exercises of Natural‐Childbirth Methods
Authors: Blankfield Adele
Published: February 2008

The spontaneous respiratory rates which occurred in normal labour have been timed during and between contractions, in calm patients. Respiratory rate in early first stage labour is not significantly influenced by contractions. With the progression of normal labour, the rate during contractions increases, particularly in late first stage when it is doubled. The rates of the psychoprophylaxis (Lamaze) method breathing exercises for late labour are very much higher than those which occur in normal, untrained patients at this stage.
Spontaneous Haematoma of the Umbilical Cord
Authors: Ratten Graeme J.
Published: February 2008

A case of haematoma of the umbilical cord is described. Fetal bradycardia occur‐ red during labour and was associated with acidosis (pH 7.13). Caesarean section was performed and a depressed but live infant obtained.
Experiences with Artificial Insemination
Authors: Hill Arthur M.
Published: February 2008

Experiences with 21 patients treated by artificial insemination are presented. The clinical features of the patients– 16 treated by A.I.D. and 5 by A.I.H. are discussed. As a result of insemination, 13 of 16 dedicated patients were delivered of 18 living, healthy children, while those who were casual in approach had no success.
Effect of Maternal Inhalation of 10% Oxygen upon the Human Fetus
Authors: Wood Carl , Hammond Judith , Lumley Judith , Newman Warwick
Published: February 2008

Summary: The effect of material inhalation of 10% oxygen upon the human fetus was studied under careful conditions. Fetal acidosis developed in 1 patient with pre‐eclampsia and significant FHR changes (late dips) in 2 others. Although the study was abandoned for ethical reasons it is thought that the development of an oxygen stress test for the fetus is possible.
The Relationship of Oral Contraception to Depression
Authors: Leeton John , Leinkram C. , Stiglitz J.
Published: February 2008

A single double‐blind trial on a combined contraceptive drug was carried out on a lower socio‐economic group of women between Day 21 and 42 of the puerperium. Their levels of depression were measured before and after taking these drugs by means of a questionnaire. No statistical difference was found between the mean depressive score of the group on the active pill compared with that on the placebo.
The Investigation and Treatment of Patients with Ovulation Failure: with Special Reference to the Problems Arising with the use of Clomiphene
Authors: Schokman F. C. M. , Correy J. F. , Cusick E. T.
Published: February 2008

An analysis has been made of the results of investigation and treatment of patients with anovulation and oligo‐ovulation who attended a gynaecological endocrine clinic.

This has revealed the need for a careful evaluation of the parameters for detecting ovulation and demonstrates the fallacy of using a single parameter as an indicator of ovulation. A scheme of management is proposed which takes into account the value of treatment with placebo and cyclic hormone therapy and which may help to elucidate the problem of failure to achieve pregnancy when the use of clomiphene followed by HCG has presumably resulted in ovulation.
Acute Appendicitis in Pregnancy and the Puerperium
Authors: Taylor John D.
Published: February 2008

Summary: A series of 55 cases of acute appendicitis in pregnancy and the puerperium over the 6‐year period, 1960–1965 is presented. Pregnancy modifies the classical presentation of the disease, partly because of the altered position of the appendix, and partly because of less efficient localization of the infection. Accordingly, the site of maximum tenderness may be above McBurney's point and peritonitis is a frequent complication and this may be associated with abortion and perinatal death. Immediate appendicectomy is the correct treatment; combination with Caesarean section should be avoided whenever possible.
Vasa Praevia
Authors: Quek S. P. , Tan K. L.
Published: February 2008

Seven cases of vasa praevia were encountered in 35,000 deliveries. The diagnosis was made antepartum in 5 cases. One death was directly attributable to this condition, and another may have been related to it.

Although fetal mortality generally has been forbidding, it is stressed that a greater awareness of the condition, coupled with a high index of suspicion, can result in more frequent antepartum diagnosis and an improved fetal prognosis.
Spontaneous Haemoperitoneum Complicating Uterine Fibromyoma
Authors: Buttery Beresford W.
Published: February 2008

Summary: In the case presented, a large haemoperitoneum occurred as a result of spontaneous rupture of a vein on the surface of a uterine fibromyoma. The relevant literature is reviewed.
Oral Contraceptives and Thrombo‐embolism
Authors: McQueen E. G.
Published: February 2008

Oestrogencontaining oral contraceptives increase many of the factors involved in thrombosis, presumably as a result of hepatic enzyme‐induction, Clinical and pathological data suggest a special liability to thrombotic complications and retrospective statistical surveys appear to have confirmed an increased mortality and morbidity. It is possible that the diminished oestrogen content of oral contraceptives now in use may be diminishing the risk.
Fertility Patterns in the South Pacific Communities
Authors: Bonham D. G.
Published: February 2008

Birth rates in South Pacific Island communities are significantly lower in Australia and New Zealand than in the smaller Islands.

In New Zealand the Maori (8% of the population) has a higher birth rate than the European; both are falling, the Maori by a greater percentage.

Fertility rates in the age groups show marked falls over 35 years in both races. With increasing sophistication Maoris and Islanders accept modern family planning methods well, though males less than females.

In Fiji an effective family planning program has shown that the population growth can be fully controlled and that socio‐economic motivation is important.

The acceptability of family planning to help a national economic need appears to be more motivated by personal socio‐economic and educational factors than by racial background.
The Relationship of Oral Contraception to Depressive Symptoms
Authors: Leeton John
Published: February 2008

Summary: A double‐blind cross‐over trial involving 45 patients was carried out to determine the relationship between oral contraception and pharmacologically‐induced depressive symptoms. Oral contraception produced pharmacological symptoms in 15% of women from a selected group, of whom half had previously experienced adverse side‐effects from the contraceptive pill. This depression occurred in 2 forms. Three women had endogenous depression which increased on oral contraception, becoming worse during the second month of therapy. A fourth woman had reactive depression due to associated nausea and vomiting which improved during the second month of therapy. “Scapegoat” depressive symptoms were at least as common as pharmacological effects when taking oral contraception. About half the number of women with a history of depressive ill‐nessness experienced an increase in depression on oral contraception. Oestrogen‐progesterone balance was not important in the development of depressive side‐effects; the latter bore no relationship to the cytohormonal status of the patient, either before treatment or during oral contraceptive therapy.
Subcutaneous Symphysiotomy — Time for a Reappraisal?
Authors: Hartfield V. J.
Published: February 2008

Summary: A series of 138 patients in whom symphysiotomy had been performed is presented. The vicissitudes of this operation are reviewed and an evaluation has been attempted of its role in the management of moderate disproportion. Early and late complications were few and rarely serious if recommended guidelines were adhered to.
Amnioscopy … Is It Worthwhile?
Authors: Barham K. A.
Published: February 2008

Summary:Amnioscopy has been used in late pregnancy to monitor the amniotic fluid of the fetus at risk of intra‐uterine hypoxia. The test has been performed on more than 3,000 patients over a 7‐year period. Properly performed it is a worthwhile clinical procedure since it can improve the quality of antenatal care for the fetus who is at risk. Apart from this it has been of assistance in the induction of labour, the early detection of unsuspected abnormalities and research on membrane cytology.
Donor Insemination — A Substitute for the Infertile Male
Authors: Robertson Struan
Published: February 2008

Summary: Investigation, assessment, and the results of treatment of 114 couples requesting donor insemination (A.I.D.) are reported. Where the male factor for infertility was the only recognisable one, 66% of patients became pregnant in an average of 3 months of treatment; where there was an additional female infertility factor, 32% of patients became pregnant in an average of 9 treatment months.
Scanning Reflection Electron Microscopy of the Fallopian Tube and Vagina
Authors: Alexander I. G. S. , Hunter C. R. , Lopata A. , Wood C.
Published: February 2008

Summary: Scanning electron microscopy was used to study the surface topography of the Fallopian tube and vagina. The microvillous and the ciliated cells of the Fallopian tube formed a regular almost square pattern which may be related to gamete transport. The surface of the lower vaginal cells was similar to that of the bladder, these organs sharing a common embryological origin and the functional property of distensibility.
The Routine Screening of Obstetric and Gynaecological Patients for Gonorrhoea
Authors: Platts W. M. , Cresswell B.
Published: February 2008

Summary: Between 1970 and 1973, 3,389 public hospital patients (both obstetrical and gynaecological) were screened for gonorrhoea. An unexpectedly high figure (2.4%) was obtained in the “single” group (single, separated, divorced, de facto). In the married group, the incidence was 0.7%. Results of other screening programmes throughout the world are reviewed. Relatively few of these have been reported outside North America; in those that have, the yields have been disproportionately low. The reasons for this are thought to be linked to culture methodology.

Greater use of routine screening, particularly of individuals who are not in a stable marital situation, is advocated in city obstetrical and gynaecological clinics, even in areas with a medium incidence of gonorrhoea
Obstetric Outcome in Pregnancies Complicated by Recurrent Anaemia, With Observations on Iron and Folate Metabolism, Bacteriuria and Pre‐eclampsia
Authors: Fleming A. F. , Martin J. D. , Stenhouse N. S.
Published: February 2008

Summary: Three hundred and thirty‐one pregnant women were studied to see whether moderate maternal anaemia or iron and folate deficiency in the absence of anaemia had any adverse effect on the fetus. When results from all subjects were analysed, no correlations between haematological findings and measures of fetal well‐being were apparent, except for a tendency for increased placental weight when the haemoglobin (Hb) concentration was low at the end of pregnancy.

However, haematological and obstetrical complications appeared to be related in 2 sub‐groups, (i) those with a history of anaemia in previous pregnancies, and (ii) those with significant bacteriuria.

Patients who were anaemic in previous pregnancies tended to have persistent hypochromic anaemia in the study pregnancy; their low Hb and red cell hypochromia were associated with a history of past abortions and low birth weight in the present pregnancy. These complications were ascribed to anaemia at the time of conception and in early pregnancy.

Patients with significant bacteriuria were shorter and had lower Hb on average, and the degree of red cell abnormality correlated with premature delivery and low birth weight. Both obstetric and haematological complications were likely to have been direct consequences of underlying renal tract disease, and blood film reports could be of value in assessing pregnancies complicated by bacteriuria.

There was no evidence that pre‐eclampsia or hypertension from other causes was associated with anaemia, but the Hb was significantly higher in this subgroup. There was a tendency to hypersegmentation of the neutrophil polymorphs, but serum and red cell folate levels did not suggest that this was the result of folate deficiency.
Stress Incontinence: A Review of 270 Marchetti Operations
Authors: Giesen J. E.
Published: February 2008

Summary: A series of 270 retropubic vesico‐urethral suspension operations is presented. These have been followed up for periods ranging from 1 to 25 years. There were 17 failures, giving a cure rate of 94%. Indications for the different types of operation are discussed and the failures analysed. It is concluded that uncomplicated stress incontinence can be cured completely and permanently by the Marchetti operation.
Urinary Diversion in Carcinoma of the Cervix
Authors: Kennedy D. R. H.
Published: February 2008

Summary: In the management of carcinoma of the cervix, urinary diversion may be required for the palliation of symptoms, as a preliminary to radiotherapy, or for the complications of treatment. A review of 41 operations in 40 patients is presented, with particular reference to the problems likely to be encountered in each of the above groups. The results confirm that the ileal loop diversion is the most satisfactory method.
Six‐Monthly Depo‐Provera Injection as a Contraceptive Agent: Its Acceptability in Singapore
Authors: Cheng M. C. E. , Lim Y. C. , Ng A. Y. H. , Ratnam S. S.
Published: February 2008

Summary: A prospective study was carried out of the efficacy and acceptance of 6‐monthly Depo‐Provera injections in postpartum patients. Analysis of the results in the first 310 patients showed a low acceptance rate. The cumulative discontinuation rates of 50 per 100 women at 6 months and 75 per 100 women at 12 months are much higher than reported in other series.
Late Toxic Reactions to Intravenous Iron Dextran Therapy
Authors: Ping Wong Wai , Sinnathuray T. A. , Ng Jeannie
Published: February 2008

Summary: Late severe reactions to intravenous iron dextran are uncommon but particularly dangerous. Four such cases are reported and appear to have been due to the administration of a new form of iron dextran.
Surgical Induction of Labour With and Without Oxytocin Infusion: A Prospective Study
Authors: Saleh Y. Z.
Published: February 2008

This study was designed to investigate the efficacy of simultaneous oxytocin infusion in physiological doses in patients in whom amniotomy had been performed to induce labour. One hundred patients were studied and, as far as possible, these were obstetrically homogeneous. In all patients, conditions favourable for induction were present.

All of the 50 patients induced by amniotomy and simultaneous oxytocin infusion delivered within 24 hours (1 patient required a Caesarean section operation for fetal distress), whereas only 34 of the 50 induced by amniotomy alone did so.

The study confirms the generally accepted view that 95% of patients will be delivered vaginally after surgical induction of labour. It also confirms Mac Vicar's study (1971) that 2% of patients induced by amniotomy will require Caesarean section for defective uterine activity alone.

To shorten the induction‐delivery interval, amniotomy should be performed and, immediately thereafter, an oxytocin infusion commenced. In favourable cases, the oxytocin should be given by intravenous infusion in physiological doses. This requires minimal staff supervision.
Placental Sulphatase Deficiency Causing Low Urinary Oestriol Excretion in Pregnancy Complicated by Toxaemia
Authors: Chadwick John M. , Murnain Jeff R.
Published: February 2008

Summary: A patient presenting with pre‐eclampsia in her second pregnancy was found to have persistently low urinary oestriol levels (below 2mg/24 hours) in the last trimester. Plasma progesterone estimation showed that this reading was not due to placental insufficiency, and radiological examination excluded anen‐cephaly. No drugs known to affect the measurement of urinary oestriol were being ingested.

A normal male child was delivered by Caesarean section. Subsequent studies confirmed the presence of a placental sulphatase deficiency.