bluuebunny/crossref_metadata_2025 huggingface dataset:
Dimeric Inhibin A as a Fourth Marker for Down's Syndrome Maternal Serum Screening in Native Japanese Women
Authors: Yoshida Koyo , Kuwabara Yoshinori , Tanaka Tadao , Onda Takekazu , Kudo Ryuichi , Yamamoto Hiroyuki , Sato Akira , Yanagida Kaoru , Okai Takashi , Sakai Masato , Takai Yasushi , Uemura Hiraku , Hoshi Kazuhiko , Fukada Yukihito , Aono Toshihiro , Maeda Kazuhisa , Ogita Sachio , Ishiko Osamu , Murata Yuji , Kanzaki Toru , Myrick Faye , Grier Robert E.
Published: May 2010

Objective: This study was conducted to assess the usefulness of dimeric inhibin A as a fourth marker for Down's syndrome screening in addition to AFP, hCG and uE3 markers for native Japanese women.

Methods: Serum specimens from 367 native Japanese women in the second trimester were assayed for dimeric inhibin A levels. Day specific dimeric inhibin A medians were established for gestational ages 15.0–21.9. Weekly median values for the native Japanese were compared with those of a U.S. population. Selected Japanese specimens from 15 diagnosed Down's syndrome and 3 trisomy 18 cases were also assayed for dimeric inhibin A.

Results: Dimeric inhibin A levels did not vary greatly over the gestational age range as expected. Median value comparison showed that native Japanese dimeric inhibin A medians are higher than the U.S. population medians by an average of 7.95%. Native Japanese dimeric inhibin A median values in this study are 1.77 times higher in Down's syndrome cases than in unaffected pregnancies. Trisomy 18 dimeric inhibin A levels show no significant difference from the unaffected pregnancies.

Conclusions: This report shows for the first time that dimeric inhibin A can be informative as a fourth marker for Down's syndrome screening in native Japanese women. We expect the addition of dimeric inhibin A to a triple marker protocol will increase the accuracy of predicted risk for all pregnancies screened and increase the detection rate of Down's syndrome affected pregnancies.
Reasons for Improper Simple Hysterectomy in Patients with Invasive Cervical Cancer in the Northern Region of Thailand
Authors: Srisomboon Jatupol , Pantusart Aree , Phongnarisorn Chailert , Suprasert Prapaporn
Published: May 2010

Objective: To determine the reasons for improper simple hysterectomy in the presence of invasive cervical cancer.

Methods: The medical records of 70 patients who had undergone simple hysterectomy in the presence of invasive cervical cancer and were referred to Chiang Mai University Hospital between January 1991 and December 1998 were reviewed.

Results: Approximately half of the patients presented with abnormal vaginal bleeding. Failure to perform a Papanicolaou smear before the operation accounted for 35.4%. Normal pelvic examination in which no gross invasive tumor was observed accounted for 59%. The most common indications for inappropriate operation was cervical dysplasia. The reasons for inappropriate simple hysterectomy included lack of preoperative cervical cytology (22.8%), incomplete evaluation of cervical dysplasia or microinvasion on biopsy (21.4%), false‐negative cervical cytology (18.6%), failure to perform an endocervical curettage following conization (8.6%), emergency hysterectomy (8.6%), failure to perform indicated conization (5.6%), errors in colposcopic examination (4.3%), incomplete evaluation of an abnormal cervical cytology (1.4%), failure to perform endocervical currettage following loop conization (1.4%), failure to review slide (1.4%), failure to check the pathology report (1.4%), failure to biopsy a gross cervical lesion, and skipped lesion in upper part of the endocervix (1.4%). One case of invasive disease was missed for unknown reason.

Conclusion: Most cases of inappropriate hysterectomy resulted from deviation from guideline for cervical cancer detection. Preoperative Papanicolaou smear and strict adherence to the well‐established diagnostic protocol for patients with an abnormal smear are advised to prevent such occurrence.
Chemotherapy in Recurrent Epithelial Ovarian Cancer (EOC): An Analysis of Prognostic Factors
Authors: Shamsunder S. , Kumar Lalit , Gupta S. , Kumar S. , Bhatla N. , Singh R. , Kochupillai V.
Published: May 2010

Objective: Prognosis of patients with recurrent epithelial ovarian cancer (EOC) is generally poor. Cisplatin is the most effective drug. We used three cisplatin based chemotherapeutic (CT) regimens and retrospectively analyzed the data to determine the response rate, toxicity, survival and the impact of various prognostic factors on the outcome.

Patients and Methods: Between August, 1989 and September, 1997, 102 patients were diagnosed to have recurrent EOC. Sixty‐five of 102 patients received CT every 3 weeks using cisplatin 75 mg/m2 IV day 1 plus cyclophosphamide 750 mg/m2 IV day 1 (CP, Group A, n = 29), cisplatin 75 mg/m2 IV day 1, plus adriamycin 40 mg/m2 IV day 1 and cyclophosphamide (CAP, Group B, n = 22) and paclitaxel 135 mg/m2 IV day 1 plus cisplatin 75 mg/m2 IV day 1 (TP, Group C, n = 14). Twelve patients received single agent CT and were not analyzed. Remaining 25 patients refused CT treatment and were followed for survival.

Results: The overall response rate (complete and partial) was 59.2% for patients receiving CP (Group A), 45% for CAP (Group B) and 76.9% for those receiving TP (Group C), p = ns. Response rate was significantly higher for patients with platinum sensitive disease compared to those with platinum resistant disease; 55.76 vs 39%, p < 0.007. CT was generally tolerated well; 2 patients died of CT toxicity, one each in Group A (CP) and C (TP), respectively. The median survival from the date of relapse for patients receiving chemotherapy was 15 months compared to 4 months for those who did not receive chemotherapy, p < 0.001.

Chemotherapy responders had a significantly higher median survival than chemotherapy non‐responders, 24 months vs 10 months, p < 0.01. The median overall survival was not significantly different in the 3 groups; Group A‐15 months, Group B‐12 months and 15 months in Group C, p = 0.738. On univariate analysis — time since last CT (< 6 months vs > 6 months, p < 0.037, response to previous CT, p < 0.0183, cisplatinum sensitivity vs resistance, p < 0.032, number of sites (< 2 vs > 2) of recurrence, p < 0.004 and response to salvage CT, p < 0.01 were associated with survival benefit. On multivariate analysis, 2 factors — platinum sensitivity and response to salvage CT attained significance.

Conclusions: Our study confirms the benefit of platinum based chemotherapy in recurrent EOC. Patients with platinum sensitive disease, and those responding to salvage chemotherapy benefit most.
Prenatal Diagnosis of Severe Tricuspid Insufficiency in Ebstein's Anomaly with Pulmonary Atresia and Intact Ventricular Septum: A Case Report
Authors: Song Tae‐Bok , Lee Jee‐Young , Kim Yoon‐Ha , Oh Bong‐Suk , Kim Eun‐Kyung
Published: May 2010

Pulmonary atresia with intact ventricular septum is an uncommon congenital cardiac anomaly which very often present varying degrees of downward displacement and dysplasia of the tricuspid valve.

A 23‐year‐old woman was referred at 23 weeks' gestation because of fetal cardiomegaly detected by routine ultrasonography. Ebstein's anomaly with pulmonary atresia was diagnosed by fetal echocardiography. On pulsed Doppler examination, a severe tricuspid regurgitation was detected. Pulmonary atresia was suspected, as forward flow was not detected into pulmonary artery. The fetus was terminated at 25 weeks. At the postmorterm examination Ebstein's anomaly with pulmonary atresia and intact ventricular septum were confirmed.

The finding of right atrial enlargement on an early sonogram should prompt the search for tricuspid valve abnormalities with tricuspid regurgitation and the presence or development of pulmonary atresia or stenosis. With the information provided, early detection of tricupid valve disease should be possible so that the option of therapeutic abortion can be offered.
Surgical Management of Genital Prolapse: Is Chain Cystourethrography Useful for Evaluating Anatomical Corrections and Urinary Symptoms after Surgery?
Authors: Baba Tsuyoshi , Koizumi Motoiki , Tanaka Ryoichi , Yamashita Satoko , Noda Masanari , Yamanaka Ikuhito , Suzuki Takahiro , Ito Eiki , Kudo Ryuichi
Published: May 2010

Objective: To evaluate the relationship between chain cystourethrography and surgery for genital prolapse and urinary symptoms.

Methods: A retrospective study of women with genital prolapse was conducted from January 1991 through December 1997. To assess the preoperative and postoperative anatomical situations objectively, chain cystourethrography was performed.

Results: Fifty‐seven patients underwent surgical repairs for genital prolapse. All of them recovered from the genital prolapse both subjectively and objectively after surgery. Chain cystourethrography is useful for evaluating postoperative anatomical corrections. However, 6 patients (12%) suffered from a recurrent feeling of genital prolapse, and 14 patients (28%) had urinary symptoms postoperatively.

Conclusions: Our treatment showed good anatomical corrections based on chain cystourethrography, and there were no prognostic differences among the surgical procedures. However, anatomical correction does not always mean improvement of urinary symptoms. Further studies are needed to clarify what factors contribute to the prognosis in such cases.
Clinical Applications of Serum Placental Protein 14 (PP14) Measurement in the IVF‐ET Cycle
Authors: Suzuki Yoshichika , Sugiyama Rikikazu , Fukumine Noritaka , Usuda Saburo , Itoh Hiroe , Isaka Keiichi , Takayama Masaomi , Teisner Borge
Published: May 2010

Objective: Placental protein 14 (PP14) is known to be one of the endometrial proteins that reflect endometrial functioning throughout the menstrual cycle. In this study, we examined PP14 as a marker for human endometrial receptivity in order to predict the outcome of in vitro fertilization and the embryo‐transfer (IVF‐ET) cycle.

Patients and Methods: The subjects were 72 women who had 96 IVF‐ET cycles and who were examined at Tokyo Medical University Hospital during the period of January 1998 to June 1998 because of mechanical or unexplained infertility for a duration of at least 2 years. Serum samples were collected from all patients during treatment cycles, and serum PPI4 concentrations were measured by a newly established enzyme‐linked immunosorbent assay (ELISA).

Results: In the pregnant group, serum PP14 concentrations were markedly increased after ET, and a significant difference between the pregnant group and the nonpregnant group was observed 8 days following ET (p < 0.01). PP14 concentrations were higher in patients with endometria that exhibited homogenous patterns and that were more than 7 mm thicker than in other patients, as determined by ultrasound on the day of oocyte collection (p < 0.005). The pregnancy rates of patients with homogeneous patterns were lower than those of patients showing a trilaminar pattern. No pregnancies were observed when serum PP14 concentrations were greater than 6.85 U/l on the day of oocyte collection.

Conclusion: PP14 might be a useful marker for human endometrial receptivity to predict the outcome of IVF‐ET cycles.
Emergency Postpartum Hysterectomy in Obstetric Practice
Authors: Yamamoto Hiroyuki , Sagae Satoru , Nishikawa Satoshi , Kudo Ryuichi
Published: May 2010

Objectives: To review cases of emergency postpartum hysterectomies performed in the setting of life‐threatening hemorrhaging.

Methods: A retrospective study of 17 patients who underwent postpartum hysterectomies during January 1, 1985‐December 31, 1998 was undertaken. Maternal characteristics, method of delivery, antenatal complications for hysterectomy, obstetric history, placental location, blood loss before hysterectomy and during operation, intraoperative and postoperative complications, and operative procedures were investigated, as was whether prostaglandin F2α and/or oxytocin were administrated during labor. The operative procedures also were examined.

Results: The incidence was 1 in 6,978 deliveries (0.014%). All patients were transported from affiliated clinics. The leading cause for a hysterectomy was uterine rupture (35.3%), followed by disseminated intravascular coagulation (DIC) due to placental abruption (29.4%), and uterine atony (23.5%). Failure of internal iliac‐artery ligation occurred in 7 patients.

Conclusions: Internal iliac‐artery ligation is not effective for patients with massive blood loss. In such cases, it is desirable for the private physician to make an early decision for maternal transport.
Is There a Relationship between Uterine Activity and the Length of the Cervix in the Second Trimester?
Authors: Cook Colleen‐Maree , Ellwood David A.
Published: May 2010

Objective: The purpose of this study was to determine if a relationship could be detected between uterine activity and cervical change in the second trimester.

Methods: Ten women with evidence of cervical change and 10 women with no cervical change (controls) were studied between 20 and 28 weeks gestation. Uterine activity was recorded using home uterine activity monitoring units. Cervical assessment was performed using transvaginal ultrasound.

Results: There was no statistically significant difference in the contractions per hour in the cervical change group (1.26 + 0.38; mean + SEM) compared to the controls (1.13 + 0.48) (p 0.48; Mann‐Whitney U test). There were significant differences in closed endocervical length (p < 0.001) and internal os dilatation (p 0.004), the cervical change group demonstrating a shorter closed endocervical length and greater internal os dilatation.

Conclusions: This preliminary study shows no evidence of a relationship between uterine activity and endocervical canal length in the second trimester.
Gonadotropin‐Releasing Hormone Analogue Therapy for Peritoneal Inclusion Cysts after Gynecological Surgery
Authors: Nozawa Shiro , Iwata Takashi , Yamashita Hiroshi , Banno Koji , Kubushiro Kaneyuki , Aoki Rui , Tsukazaki Katsumi
Published: May 2010

Objective: The purpose of this report is to estimate the effectiveness of gonadotropin‐releasing hormone analogue (Gn‐RHa) therapy for peritoneal inclusion cysts.

Methods: Patients who had cystic masses that developed after gynecological surgery and were strongly suspected of being peritoneal inclusion cysts based on the results of ultrasound, magnetic resonance imaging (MRI), and tumor marker studies, were treated with a Gn‐RHa (buserelin acetate or leuprorelin acetate). Buserelin acetate was administered at a dose of 900 μg/day, and leuprorelin acetate at a dose of 3.75 mg/month. Ultrasonography was performed in the outpatient clinic every 2 weeks after the start of administration to measure the diameter of cysts.

Results: We treated 8 patients with peritoneal inclusion cysts conservatively with a Gn‐RHa. The cysts resolved in 7 of the patients. Two of them developed a recurrence, but further Gn‐RHa therapy was followed by complete resolution of the cysts in one patient and we resume Gn‐RHa therapy to the other patient. The peritoneal inclusion cysts failed to shrink in only one patient.

Conclusion: It is suggested that Gn‐RHa therapy is effective in some cases of peritoneal inclusion cysts.
A Report on More than 10,000 Vaginal Hysterectomies Performed Without Ligation of the Paracervical Ligaments
Authors: Kudo Ryuichi , Sagae Satoru , Itoh Eiki , Hayakawa Osamu , Koizumi Motoiki , Ishioka Shin‐ichi
Published: May 2010

Objective: To review 10,016 cases of total vaginal hysterectomy (TVH) performed in our department by a method without ligation of the paracervical ligaments.

Methods: From 1955 to 1997, a total of 10,016 TVHs without ligation of the paracervical ligaments were performed at the Department of Obstetrics and Gynecology, Sapporo Medical University Hospital.

Results: Of all 22,509 gynecological operations, 44.5% were TVHs, and 8.7% were total abdominal hysterectomies (TAHs). The operative time of our TVHs ranged from 31–60 minutes in 44.1% of the cases, and from 61–90 minutes in 35.3% of the cases. Blood loss was less than 300 ml in 85% of the cases. Abdominal conversion from the vaginal approach occurred in 110 cases (1%). Operative complications also occurred only in 0.7% (69) of the cases.

Conclusion: TVH without ligation of the paracervical ligaments is a safe and convenient method that has very few complications and that can be utilized by many gynecologists.
A Case of Uterine Endometrial Carcinoma 15 Months Post‐Partum
Authors: Ishioka Shin‐ichi , Sagae Satoru , Saito Tsuyoshi , Sugimura Masaki , Akutagawa Noriyuki , Nishimura Makoto , Ezaka Yoshiaki , Kudo Ryuichi
Published: May 2010

A case of uterine endometrial carcinoma 15 months post‐partum, who did have none of typical risk factors of uterine endometrial carcinoma, is presented. The occurrence of postpartum uterine endometrial carcinoma is extremely rare condition probably due to anti‐carcinogenic effects of progesterone. Progesterone refractory cells in the uterine endometrium, which could be an origin of the endometrial carcinoma, might have existed.
Body Fat Distribution as a Risk Factor of Endometrial Cancer
Authors: Iemura Akiko , Douchi Tsutomu , Yamamoto1 Shinako , Yoshimitsu Nobuyuki , Nagata Yukihiro
Published: May 2010

Objective: To investigate the relative contributions of upper body fat distribution and overall adiposity to endometrial cancer risk.

Methods: Subjects were 63 postmenopausal women with endometrial cancer aged less than 70 years and 201 age‐matched controls. Age, age at menopause, years since menopause, height, weight, and body mass index were recorded at the time of admission. The trunk‐leg fat ratio, body fat mass, trunk fat mass, and the percentage of body fat were measured by dual‐energy X‐ray absorptiometry.

Results:Trunk‐leg fat ratio was higher in endometrial cancer patients than in controls (1.40 + 0.59 vs 1.23 + 0.39, p < 0.05). Whereas, other variables including age at menopause, percentage of body fat, body fat mass, and body mass index did not differ between the 2 groups. On stepwise multiple regression analysis, the trunk‐leg fat ratio was still correlated with the presence of endometrial cancer (p < 0.05).

Conclusions: Upper body fat distribution rather than overall adiposity is associated with endometrial cancer risk.
Development and Clinical Application of a Telemedicine Support System in the Field of Perinatal Patient Management
Authors: Kitagawa Michihiro , Akiyama Yoshiaki , Omi Hiroko , Sago Haruhiko , Natori Michiya
Published: May 2010

In recent years, perinatal patient management has been greatly improved due to the advance of medical technologies in various fields. The primary objectives of perinatal patient management are to discover signs and symptoms of fetal asphyxia and threatened premature delivery at an early stage and to initiate treatment as soon as possible. For this purpose, continuous monitoring of the fetal heart rate and uterine contractions is most effective.

We developed a telemedicine support system for pregnant women and evaluated it to see if that makes it possible 1) to manage pregnant women monitored at home in the same way as those who visit hospitals on an ambulatory basis, and 2) to prevent adverse events in women in a high‐risk pregnancy. The findings obtained in the present study showed that this system is useful for both purposes.

Perinatal telemedicine is expected to progress significantly in the next few years, although there are a number of issues that need to be resolved in this area.
Changes in Uterine and Ovarian Arterial Impedance during the Periovulatory Period in Conception and Nonconception Cycles
Authors: Yokota Akishige , Nakai Akihito , Oya Atsuko , Koshino Tatsuo , Araki Tsutomu
Published: May 2010

Objective: To evaluate whether the Doppler velocimetry of uterine and ovarian arteries during the periovulatory period in conception cycles differs from that in nonconception cycles.

Design: Transvaginal color Doppler sonography was used to assess uterine and ovarian perfusion in 63 infertile women during the periovulatory period.

Results: In the conception cycles (n = 16), the PI values of uterine arteries at the day of ovulation were significantly less than those in nonconception cycles (n = 47). There were no significant differences in the PI values of ovarian arteries between the conception and nonconception cycles.

Conclusions: In the present study, the conception cycles showed lower vascular impedance in the uterine during the periovulatory period than did the nonconception cycles. This endometrial perfusion presents an accurate noninvasive assay of uterine receptivity that can be used to predict the successful outcome of implantation and to reveal unexplained infertility problems.
Antenatal Diagnosis of Prune Belly Syndrome at 11 Weeks of Gestation
Authors: Yamamoto Hiroyuki , Nishikawa Satoshi , Hayashi Takuhiro , Sagae Satoru , Kudo Ryuichi
Published: May 2010

We present a case of prune belly syndrome diagnosed by ultrasonography at 11 weeks of gestation. We believe this case to be the earliest detection of this syndrome.
Metastatic Placental Site Trophoblastic Tumor: A Case Report
Authors: Aggarwal Neelam , Sawhney Harjeet , Vasishta Kala , Pathak Naina , Saran R. K. , Nijhawan Raje
Published: May 2010

Placental site trophoblastic tumor (PSTT) is very rare. It is an unusual variant of gestational trophoblastic neoplasia usually confined to the uterus, although 10% of patients have metastases. The clinical behaviour of PSTT varies and despite knowledge of its histology, diagnosis of this rare form of trophoblastic disease and prediction of its biological behaviour remains difficult due to only a few cases reported in literature.
Nitric Oxide Mediates Inhibitory Effect of Interleukin‐1β on Estrogen Production in Human Granulosa‐Luteal Cells
Authors: Tobai Hisako , Nishiya Iwao
Published: May 2010

Objective:To investigate the effect of IL‐1β on NO production and steroidogenesis in human granulosa‐luteal cells obtained from women undergoingin vitrofertilization procedures.

Subjects and Methods:To investigate the effect of IL‐1β, granulosa‐luteal cells were cultured with various doses of IL‐1β (0, 0.05, 0.5, 5, 50, 100 ng/ml), IL‐1β (5 ng/ml) withNG‐nitro‐L‐arginine‐methyl ester (l‐NAME), selective inhibitors of NOS, sodium nitroprusside (SNP), NO donors and Genistain, a tyrosine kinase inhibitor.

Results:IL‐1β induced a dose‐dependent stimulation of NO production and inhibited the production of estradiol in a significant way in a dose‐dependent manner. l‐NAME significantly decreased NO production and increased the production of estradiol and progesterone. SNP significantly increased NO production and caused decreases in the production of both estradiol and progesterone. Genistain decreased NO production and significantly increased the production of estradiol and progesterone. Inducible NOS (iNOS) messenger RNA was present in granulosa‐luteal cells before treatment with IL‐1β.

Conclusions:IL‐1β stimulated NO production, and NO inhibited the production of estradiol.
Gravid Uterus in an Incisional Hernia
Authors: Banerjee Neelam , Deka Deepika , Sinha Alka , Prasrad Rajinder , Takkar Deep
Published: May 2010

A case of gravid uterus in an incisional hernia is reported. The pregnancy was further complicated by intrauterine growth restriction, oligohydramnios and pregnancy induced hypertension. The management of the case is discussed.
The Relationship of Human Papillomavirus (HPV) Detection to Pap Smear Classification of Cervical‐Scraped Cells in Asymptomatic Women in Northeast Thailand
Authors: Ekalaksananan Tipaya , Pientong Chamsai , Kotimanusvanij Daroon , Kongyingyoes Bunkerd , Sriamporn Supannee , Jintakanon Darunee
Published: May 2010

Objective: To correlate the detection of human papillomavirus (HPV) with the Pap smear classification of cervical‐scraped cells from asymptomatic women living in northeast Thailand.

Methods: A total of 260 asymptomatic women attending the Obstetrics and Gynecology's Outpatient Clinic, Srinagarind Hospital, Thailand, were interviewed for risk factors and cervical scrapes were taken. The cells were examined by Pap smear for cytological changes and by PCR for HPV DNAs – nononcogenic (HPVs 6 and 11) and oncogenic (HPVs 16, 18 and 33) types. Cervical biopsies were taken from women with abnormal Pap smears for histological examination.

Results: Of the 260 cervical smear samples, the cervical cells were classified as normal and abnormal in 174 and 86, respectively. Twenty‐three percent of all samples were positive for overall HPV DNA. HPV DNAs (mostly HPVs 6 and 11) were detected in 21% of normal cells, and the higher detection rate (27%) for HPV DNA in abnormal cells gradually increased in severity from 16% in Class 3 to 35 and 60% in Classes 4 and 5, respectively. Histologically 46, 90 and 100% of HPV detection was associated with CIS, SCC and adenocarcinoma, respectively. Almost all of the HPV DNAs detected were types 16, 18 or 33. There was no significant association between HPV infection and reproduction history, sexual behavior and demographic variables.

Conclusion: We speculated that an abnormal Pap smear and the detection of an oncogenic type HPV may indicate the presence of neoplastic cells in asymptomatic woman who might be at risk for the development of cervical cancer.
Management of Pregnancy with Congenital Antithrombin III Deficiency: Two Case Reports and a Review of the Literature
Authors: Yamada Takahiro , Yamada Hideto , Morikawa Mamoru , Kato Emi H. , Kishida Tatsuro , Ohnaka Yoshito , Nikaido Hiroki , Ozawa Tetsuo , Fujimoto Seiichiro
Published: May 2010

Women with antithrombin (AT) III deficiency are prone to pregnancy‐associated venous thromboembolism. We report 2 cases with genetically confirmed ATIII deficiency, one with a mutation in exon 3A and the other with an exon 4 deletion, in whom the pregnancies were successfully managed with prophylactic therapies for thrombosis. A 35‐year‐old pregnant woman was treated with intravenous infusions of ATIII concentrate alone, and the other 22‐year‐old pregnant woman was mainly treated with subcutaneous injections of heparin and oral low‐dose aspirin therapy. Both pregnancies resulted in vaginal deliveries of healthy neonates. The literature concerning prophylactic therapies for thrombosis in ATIII deficiency‐complicated pregnancy is reviewed, and the clinical problems, including the adverse effects of the therapies, are discussed.
Maternal Transmission of Helicobacter pylori in the Perinatal Period
Authors: Kitagawa Michihiro , Natori Michiya , Katoh Makoto , Sugimoto Kouhei , Omi Hiroko , Akiyama Yoshiaki , Sago Haruhiko
Published: May 2010

Objectives: Studies indicate that Helicobacter pylori (HP) infection is closely related to gastric mucosa lesions and well‐differentiated gastric cancer. In Japan, the HP‐positive rate in childhood is 5–6%, which is similar to other developed countries, and in regard to the infection route, oral infection is considered important. To our knowledge there have been no reports on mother‐to‐child transmission and in this study we investigated maternal HP infection status to determine the potential of mother‐to‐child transmission in the perinatal period.

Methods: After obtaining informed consent from 1,588 pregnant women, mother's blood and cord blood were collected at delivery to measure HP antibody (Helico‐G). Gastric contents from the neonates were cultured to isolate H. pylori (Skirrow medium). Vaginal discharge (73 women) and dental plaque scraping swabs (48 women) were collected before delivery, and milk (66 women) was collected after delivery from 212 HP antibody‐positive pregnant women to detect H. pylori by PCR.

Results: The HP antibody‐positive rate for the pregnant women was 29.2%. H. pylori was not detected in the vaginal discharge from HP antibody‐positive pregnant women, but dental plaque scraping swabs from 4 women and milk from 4 women was positive.

Conclusion: We considered that vertical infection during pregnancy or at delivery is unlikely as a route of mother‐to‐child HP antibody infection. However, horizontal infection through breast‐feeding may occur.
The Effect of Estradiol Vaginal Tablet and Conjugated Estrogen Cream on Urogenital Symptoms in Postmenopausal Women: A Comparative Study
Authors: Manonai Jittima , Theppisai Urusa , Suthutvoravut Somsak , Udomsubpayakul Umaporn , Chittacharoen Apichart
Published: May 2010

Objectives: To compare the effects of estradiol vaginal tablet with conjugated estrogen cream on urogenital symptoms, vaginal health index, vaginal cytology, endometrial thickness, and plasma estradiol level in postmenopausal women.

Methods: Fifty‐three women with urogenital symptoms were randomized to local vaginal treatment of 25 μg estradiol tablet or 1 g of conjugated estrogen cream for 12 weeks. They were assessed for urogenital symptoms, vaginal health index, vaginal cytology, endometrial thickness and estradiol level.

Results: Forty‐eight women completed the treatment. Both groups showed improvement of urogenital symptoms, vaginal health index, and vaginal cytology after the first 4 weeks of treatment. Conjugated estrogen cream showed superior efficacy in alleviating vaginal dryness and dyspareunia. Two cases of endometrial proliferation were noted.

Conclusions: Estradiol vaginal tablet and conjugated estrogen cream were effective in treating urogenital symptoms, the restoration of normal vaginal epithelium and reduction of vaginal pH in postmenopausal women. However, 2 cases of endometrial proliferation were noted.
Clinical Factors and Biomarkers Which Affect a New Universal Grading System for Ovarian Epithelial Carcinoma
Authors: Ishioka Shin‐ichi , Sagae Satoru , Sugimura Masaki , Nishioka Yoshihiro , Kobayashi Kanji , Kudo Ryuichi
Published: May 2010

Objective: To detect clinical factors and biomarkers which affect a new grading system for ovarian epithelial cancer that was proposed by Shimizu et al. and to analyze the impact of those factors on malignant behaviors of the tumor.

Methods: Review and scoring of specimens of paraffin embedded tissues of epithelial ovarian cancer were carried out according to the new universal grading system in 110 women who underwent initial treatments including the primary operation in our university hospital between January 1990 and June 1999. As biomarkers, expression of Bcl‐2, Bax, Bcl‐X, and the accumulation of P53 protein were also studied immunohistochemically.

Results: This grading system functioned as a prognostic indicator. Five‐year survivals of the patients was 77.6, 36.3, and 17.4%, for Grade 1, Grade 2, and Grade 3, respectively. The grade was also correlated with clinical stages, histologic subtypes, operative completeness, para‐aortic lymph nodes metastasis, and the expression of Bax protein, with univariate analysis. Multivariate analysis revealed histological subtypes and para‐aortic lymph nodes metastasis to be important factors which affected the grading system.

Conclusion: These results demonstrate that the new universal grading system is useful, and that this grading system might reflect potential of metastasis or dissemination of the ovarian cancer.
Liver Dysfunction in Late Pregnancy: Cytomegalovirus‐Induced Hepatitis or the HELLP Syndrome?
Authors: Ohkuchi Akihide , Minakami Hisanori , Suzuki Izumi , Ayustawati  , Izumi Akio , Sato Ikuo
Published: May 2010

A 27‐year‐old primiparous preeclamptic woman developed a skin rash in late pregnancy and was persistently febrile for 10 days after giving birth. Blood tests suggested that she developed the HELLP syndrome and had concomitant cytomegalovirus (CMV) infection. Hemolysis, slightly impaired liver function, and thrombocytopenia were explainable by either only the CMV infection or only the HELLP syndrome. A literature review of a limited number of such cases and our case suggests that laboratory data in patients with CMV infection can mimic those of the HELLP syndrome. Thus, it may be important to consider CMV infection as a possible cause of abnormal laboratory data similar to the HELLP syndrome.
Severe and extensive neonatal hearing loss in cats results in auditory cortex plasticity that differentiates into two regions
Authors: Rajan R. , Irvine D. R. F.
Published: May 2010

We examined the response characteristics of primary auditory cortex (A1) neurons in adult cats partially but extensively deafened by ototoxic drugs 2–8 days after birth. The damage evoked extensive A1 topographic map reorganization as also found by others, but a novel finding was that in the majority of cats with low‐frequency edges to the cochlear lesion, the area of reorganization segregated into two areas expressing the same novel frequency inputs but differentiated by neuronal sensitivity and responsiveness. Immediately adjacent to normal A1 is an approximately 1.2‐mm‐wide area of reorganization in which sensitivity and responsiveness to sound are similar to that in normal A1 in the same animals and in unlesioned adult animals. Extending further into deprived A1 is a more extensive area of reorganization where neurons have poorer sensitivity and responsiveness to new inputs. These two areas did not differ in response‐area bandwidth and response latency. We interpret these novel changes as the cortical consequences of severe receptor organ lesions extending to low‐frequency cochlear regions. We speculate that the two areas of A1 reorganization may reflect differences in the transcortical spatial distribution of thalamo‐cortical and horizontal intracortical connections. Qualitatively similar changes in response properties have been seen after retinal lesions producing large areas of visual cortical reorganization, suggesting they might be a general consequence of receptor lesions that deprive large regions of cortex of normal input. These effects may have perceptual implications for the use of cochlear implants in patients with residual low‐frequency hearing.
INNOVATION IN VERTICALLY RELATED MARKETS*
Authors: CHEN YONGMIN , SAPPINGTON DAVID E. M.
Published: May 2010

We examine the impact of vertical industry structure on upstream process innovation. We find that vertical integration (VI) generally enhances innovation under downstream Cournot competition, but can diminish innovation under downstream Bertrand competition. We also find that under Bertrand competition, VI can increase innovation when the direct incentives for innovation are limited, but can reduce innovation when the direct incentives are pronounced.
NON‐COOPERATIVE ENTRY DETERRENCE IN LICENSE AUCTIONS: DYNAMIC VERSUS SEALED BID*
Authors: VARMA GOPAL DAS , LOPOMO GIUSEPPE
Published: May 2010

We examine the impact of potential entry on incumbent bidding behavior in license auctions, in both dynamic and sealed bid formats. Unlike sealed bid auctions, dynamic auctions reveal information about the identities of potential winners and allow bidders to revise their bids. This helps incumbents to coordinate their entry deterrence efforts. If entry is sufficiently costly for each incumbent, only the dynamic auction has an equilibrium where entry is deterred for sure. Numerical calculations suggest that, regardless of how costly entry is for each incumbent, sealed bid auctions can generate a higher probability of entry as well as a more efficient allocation.
The impact of the global economic crisis on sovereign wealth funds
Authors: Balin Bryan J.
Published: May 2010

This paper analyses the effects of the recent global economic crisis upon sovereign wealth funds (SWFs). Since mid‐2007, SWFs have experienced significant portfolio losses, a decline in fund inflows, and enhanced scrutiny from their own governments. SWFs have been utilised for sovereign stabilisation programs and have helped finance troubled Western banks. SWFs and the IMF have also created a set of best practices known as the Santiago Principles. From these developments, many SWFs have moved to relatively shorter investment time horizons and more liquid holdings, revamped their transparency and management, experienced a temporary improvement in their images, begun to hold controlling stakes in major Western corporations, and have improved their coordination with institutional investors and other SWFs. Going forward, these changes, alongside the relatively strong post‐crisis asset position held by SWFs in comparison to other asset vehicles, make SWFs well‐positioned to play an even more prominent role in global finance.
Achieving mutual understanding in world Englishes
Authors: KAUR JAGDISH
Published: May 2010

ABSTRACT:  Given the rapid growth in international contacts worldwide, English is increasingly becoming the chosen medium to facilitate communication among people of diverse linguistic and cultural backgrounds. However, the question remains as to how non‐native speakers of English of varying levels of proficiency, using different varieties of English, are able to arrive at mutual understanding in this medium. The paper addresses this question by offering some insights into the process of negotiating understanding in English as a lingua franca and the interactional procedures used in this regard. Fifteen hours of transcribed audio recordings of naturally occurring spoken interactions in English as a lingua franca (ELF), between participants of a range of first language and cultural backgrounds, were examined using conversation analytic procedures. Several interactional practices were identified as the ones utilized in the process of constructing shared understanding, namely repetition, paraphrase and various confirmation and clarification procedures. These procedures are strategically employed by both speaker and recipient as warranted by the local context to address problems of understanding when they occur. Thus, regardless of the participants’ use of different varieties of English at varying levels of competency, communication is successful as the participants make skilful and adept use of common, shared interactional practices to arrive at mutual understanding.
Chinese perceptions of Inner Circle varieties of English
Authors: EVANS BETSY E.
Published: May 2010

ABSTRACT:  Research from populations around the world on attitudes to varieties of English is essential in order to have a better understanding of how the complexities of globalization play a role in the form of English as a world language. To that end, university students in China were asked to name countries around the world where they believe English is spoken and indicate what kind of impression they have of those varieties without the presentation of voice stimuli. This type of data elicitation enables the participants themselves to provide the researcher with evaluative categories and avoids problems associated with using voice stimuli. The results indicate that the effect of the cultural hegemony of US English as a variety is complex, and that, contrary to assumptions, US English is unlikely to be a model for a ‘standard’ variety of world English in the traditional sense.
A Zealous Evangelical Missionary. Mary Ann Greaves in Europe 1814–1824
Authors: LATHAM JACKIE E. M.
Published: May 2010

Mary Ann Greaves (1779–1846), a zealous unmarried evangelical Anglican, travelled and then lived in Europe as an unofficial representative of the British and Foreign Bible Society. Her unpublished travel journal covering the years 1814–1815 shows both her missionary zeal to bring all Christians to true religion and her keen secular interest in the Grand Tour's works of art. In 1815, settled in Lausanne in the Canton de Vaud, she continued her determined work of reforming the reformed until banished from the Canton in 1822 as subversive; she then moved to near Geneva. As a single woman, Greaves faced (and usually ignored) the constrictions of what was appropriate for women imposed by both secular and evangelical convention. Her journal reveals how much her own determined and confident character differed from the ideal and illuminates both her partial success and her ultimate disappointment in her missionary work among the Calvinists of Switzerland.
Infrastructure Investment and Rural Economic Development: An Evaluation of USDA's Broadband Loan Program
Authors: KANDILOV IVAN T. , RENKOW MITCH
Published: May 2010

We empirically evaluate whether participation in the U.S. Department of Agriculture's Broadband Loan Program, which began making loans in 2002, has had measurable positive impacts on zip code‐level economic outcomes. Using difference in differences and propensity score matching program evaluation techniques, we find that loans made in 2002 and 2003 under the Pilot Broadband Loan Program have had a substantial positive impact on employment, annual payroll, and the number of business establishments in recipient communities. However, a more spatially disaggregated analysis reveals that the positive economic impacts of the pilot program are driven primarily by the outcomes in communities located closest to urban areas. Finally, we find no evidence that loans received as part of the current Broadband Loan Program have had a measurable positive impact on recipient communities, possibly because not enough time has elapsed for the impacts of the current Broadband Loan Program to have emerged.
Accelerated hemolysis and neurotoxicity in neuron‐glia‐blood clot co‐cultures
Authors: Jaremko Kellie M. , Chen‐Roetling Jing , Chen Lifen , Regan Raymond F.
Published: May 2010

J. Neurochem. (2010) 114, 1063–1073.

A growing body of experimental evidence suggests that an intracerebral hematoma is toxic to neighboring cells. However, injury mechanisms remain largely undefined, due in part to conflicting results from in vivo studies. In order to investigate blood toxicity in a more controlled environment, murine clots were co‐cultured on porous membrane inserts with primary neurons and glia. Erythrocyte lysis was apparent within 48 h, but was reduced by almost 80% in cultures lacking neurons, and by over 90% in the absence of both neurons and glial cells. By 72 h, most released hemoglobin had oxidized to methemoglobin or its hemichrome degradation products. At this time point, approximately 50% of neurons were non‐viable, as detected by propidium iodide staining; glia were not injured. Deferoxamine, Trolox and the NMDA receptor antagonist MK‐801 prevented most neuronal death, but had no effect on hemolysis at neuroprotective concentrations. The 27‐fold increase in culture malondialdehyde and 5.8‐fold increase in heme oxygenase‐1 expression were also attenuated by deferoxamine and Trolox, but not by MK‐801. These results suggest that hemoglobin release from clotted blood is accelerated by adjacent neurons and glia. Subsequent neurotoxicity is mediated by both iron‐dependent and excitotoxic injury pathways.
Distinguished Fellow: Ross Garnaut*
Authors: HILL HAL
Published: May 2010

This paper surveys the contribution of Ross Garnaut to the Australian economics profession, in the fields of Asia–Pacific economic integration, Australia’s economic relations with the Asia–Pacific region, the economic development of Papua New Guinea and China, and climate change. It particularly draws attention to his major contribution to economic policy‐making in Australia and the region.
Capability, Quality, and Performance of Offshore IS Vendors: A Theoretical Framework and Empirical Investigation
Authors: Palvia Prashant C. , King Ruth C. , Xia Weidong , Palvia Shailendra C. Jain
Published: May 2010

Information systems (IS) offshoring has become a widespread practice and a strategic sourcing choice for many firms. While much has been written by researchers about the factors that lead to successful offshoring arrangements from the client's viewpoint, the vendor's perspective has been largely scarce. The vendor perspective is equally important as offshore IS vendors need to make important decisions in terms of delivering operational and strategic performance and aligning their resources and processes in order to meet or exceed targeted outcomes. In this article, we propose and test a three‐level capability–quality–performance (CQP) theoretical framework to understand vendor outcomes and their antecedents. The first level of the framework represents three vendor capabilities: relationship management, contract management, and information technology management. The second level has three mediating variables representing process quality: partnership, service, and deliverable quality. The third level has three dependent variables representing vendor outcomes: operational performance, strategic performance, and satisfaction. The model was tested with 188 vendor firms from India and China, the two most popular destinations for IS offshoring. Results support the CQP framework; vendor capabilities are significant predictors of intermediate quality measures, which in turn affect vendor outcomes. Implications of the study findings to both theory development and IS offshore vendor strategic decision making are discussed.
Managing Product Rollovers
Authors: Koca Eylem , Souza Gilvan C. , Druehl Cheryl T.
Published: May 2010

We study the product rollover strategy decision, where a firm decides whether to phase out an old generation of a product to be replaced by a new with either a dual or single roll. Our model considers a final build of the old product and preannouncement of the new, and incorporates dynamic pricing and inventory decisions. We find that the optimal price path closely follows changes in reservation price curves for the two products over time. We also identify the drivers of the rollover strategy decision, finding that lower market risk (faster diffusion, higher market responsiveness to preannouncements) and higher performance improvement for the new generation are associated with the single roll strategy.
Fusion Product Planning: A Market Offering Perspective*
Authors: Chen Yuwen , Carrillo Janice E. , Vakharia Asoo J. , Sin Peter
Published: May 2010

Devices that integrate multiple functions together are popular in consumer electronic markets. We describe these multifunction devices as fusion products as they fuse together products that traditionally stand alone in the marketplace. In this article, we investigate the manufacturer's fusion product planning decision, adopting a market offering perspective that allows us to address the design and product portfolio decisions simultaneously. The general approach adopted is to develop and analyze a profit‐maximizing model for a single firm that integrates product substitution effects in identifying an optimal market offering. In the general model, we demonstrate that the product design and portfolio decisions are analytically difficult to characterize because the number of possible portfolios can be extremely large. The managerial insight from a stylized all‐in‐one model and numerical analysis is that the manufacturer should, in most cases, select only a subset of fusion and single‐function products to satisfy the market's multidimension needs. This may explain why the function compositions available in certain product markets are limited. In particular, one of the key factors driving the product portfolio decision is the margin associated with the fusion products. If a single all‐in‐one fusion product has relatively high margins, then this product likely dominates the product portfolio. Also, the congruency of the constituent single‐function products is an important factor. When substitution effects are relatively high (i.e., the product set is more congruent), a portfolio containing a smaller number of products is more likely to be optimal.