bluuebunny/crossref_metadata_2025 huggingface dataset:
Transport of nucleosides across the Plasmodium falciparum parasite plasma membrane has characteristics of PfENT1
Authors: Downie Megan J. , Saliba Kevin J. , Howitt Susan M. , Bröer Stefan , Kirk Kiaran
Published: March 2006

Like all parasitic protozoa, the human malaria parasite Plasmodium falciparum lacks the enzymes required for de novo synthesis of purines and it is therefore reliant upon the salvage of these compounds from the external environment. P. falciparum equilibrative nucleoside transporter 1 (PfENT1) is a nucleoside transporter that has been localized to the plasma membrane of the intraerythrocytic form of the parasite. In this study we have characterized the transport of purine and pyrimidine nucleosides across the plasma membrane of ‘isolated’ trophozoite‐stage P. falciparum parasites and compared the transport characteristics of the parasite with those of PfENT1 expressed in Xenopus oocytes. The transport of nucleosides into the parasite: (i) was, in the case of adenosine, inosine and thymidine, very fast, equilibrating within a few seconds; (ii) was of low affinity [Km (adenosine) = 1.45 ± 0.25 mM; Km (thymidine) = 1.11 ± 0.09 mM]; and (iii) showed ‘cross‐competition’ for adenosine, inosine and thymidine, but not cytidine. The kinetic characteristics of nucleoside transport in intact parasites matched very closely those of PfENT1 expressed in Xenopus oocytes [Km (adenosine) = 1.86 ± 0.28 mM; Km (thymidine) = 1.33 ± 0.17 mM]. Furthermore, PfENT1 transported adenosine, inosine and thymidine, with a cross‐competition profile the same as that seen for isolated parasites. The data are consistent with PfENT1 serving as a major route for the uptake of nucleosides across the parasite plasma membrane.
On the effect of moisture bonding forces in air‐dry soils on threshold friction velocity of wind erosion
Authors: RAVI SUJITH , ZOBECK TED M. , OVER THOMAS M. , OKIN GREGORY S. , D'ODORICO PAOLO
Published: March 2006

Wind erosion is a dominant geomorphological process in arid and semi‐arid regions with major impacts on regional climate and desertification. The erosion process occurs when the wind speed exceeds a certain threshold value, which depends on a number of factors including surface soil moisture. The understanding and modelling of aeolian erosion requires a better understanding of the soil erodibility associated with different moisture conditions. In arid regions during the dry season, the atmospheric humidity plays an important role in determining the surface moisture content and the threshold shear velocity. By a series of wind tunnel tests and theoretical analyses, this dependence of threshold velocity on near surface air humidity is shown for three soils of different textures: sand, sandy loam, and clay loam. The results show that the threshold shear velocity decreases with increasing values of relative humidity for values of relative humidity between about 40% and 65%, while above and below this range the threshold shear velocity increases with air humidity. A theoretical framework is developed to explain these dependencies assuming an equilibrium between the surface soil moisture and the humidity of the overlying atmosphere. The conditions under which soil‐atmosphere equilibrium occurs were tested experimentally in the laboratory for different soils in order to determine the effect of grain surface area and texture on the time required to reach equilibrium starting from different initial conditions.
Microbial primary dolomite from a Norian carbonate platform: northern Calabria, southern Italy
Authors: MASTANDREA ADELAIDE , PERRI EDOARDO , RUSSO FRANCO , SPADAFORA ALESSANDRA , TUCKER MAURICE
Published: March 2006

The origin of fine‐grained dolomite in peritidal rocks has been the subject of much debate recently and evidence is presented here for a microbial origin of this dolomite type in the Norian Dolomia Principale of northern Calabria (southern Italy). Microbial carbonates there consist of stromatolites, thrombolites, and aphanitic dolomites. High‐relief thrombolites and stromatolites characterize sub‐tidal facies, and low‐relief and planar stromatolites, with local oncoids, typify the inter‐supratidal facies. Skeletal remains are very rare in the latter, whereas a relatively rich biota of skeletal cyanophycea, red algae and foraminifera is present in the sub‐tidal facies. Some 75% of the succession consists of fabric‐preserving dolomite, especially within the microbial facies, whereas the rest is composed of coarse dolomite with little fabric preservation. Three end‐members of dolomite replacement fabric are distinguished: type 1 and type 2, fabric retentive, with crystal size <5 and 5–60 μm, respectively; and type 3, fabric destructive, with larger crystals, from 60 to several hundred microns. In addition, there are dolomite cements, precipitated in the central parts of primary cavities during later diagenesis. Microbialite textures in stromatolites are generally composed of thin, dark micritic laminae of type 1 dolomite, alternating with thicker lighter‐coloured laminae of the coarser type 2 dolomite. Thrombolites are composed of dark, micritic clotted fabrics with peloids, composed of type 1 dolomite, surrounded by coarser type 2 dolomite. Marine fibrous cement crusts are also present, now composed of type 2 dolomite. Scanning electron microscope observations of the organic‐rich micritic laminae and clots of the inter‐supratidal microbialites reveal the presence of spherical structures which are interpreted as mineralized bacterial remains. These probably derived from the fossilization of micron‐sized coccoid bacteria and spheroidal–ovoidal nanometre‐scale dwarf‐type bacterial forms. Furthermore, there are traces of degraded organic matter, probably also of bacterial origin. The microbial dolomites were precipitated in a hypersaline environment, most likely through evaporative dolomitization, as suggested by the excess Ca in the dolomites, the small crystal size, and the positive δ18O values. The occurrence of fossilized bacteria and organic matter in the fabric‐preserving dolomite of the microbialites could indicate an involvement of bacteria and organic matter degradation in the precipitation of syn‐sedimentary dolomite.
Central venous catheter infections at a county hospital in Sweden: a prospective analysis of colonization, incidence of infection and risk factors
Authors: Hammarskjöld F. , Wallén G. , Malmvall B. E.
Published: March 2006

Background:  Catheter‐related infection (CRI) is one of the most serious complications of the use of central venous catheters (CVCs), with an incidence of 2–30/1000 days in different studies. No major prospective study has evaluated the rate of CRI in Scandinavia. Since 1999, we have had a thorough programme for the insertion and care of all CVCs used at our hospital and its outpatient clinics. The purpose of this survey was to study the incidence of catheter tip colonization and CRI and their risk factors, and to compare these data with previous non‐Scandinavian studies.

Methods:  We studied prospectively 605 CVCs in 456 patients in relation to insertion data, patient and catheter characteristics, catheterization time and microbiological cultures. Risk factors were analysed by multivariate analysis.

Results:  Four hundred and ninety‐five (82%) of all CVCs were assessed completely. The total catheterization time was 9010 days. The incidence of positive tip culture was 7.66/1000 days, and the predominant microorganism was coagulase‐negative staphylococci. The incidence of CRI was 1.55/1000 days, and the only significant risk factor was the duration of catheterization with a relative risk of 1.009 per day [95% confidence interval (CI), 1.003–1.015]. Of the 14 cases with CRI, six were associated with candida species, and five of these were diagnosed in the intensive care unit.

Conclusion:  In comparison with non‐Scandinavian studies, our practice of strict basic hygiene routines for CVC insertion and care is associated with a low incidence of CRI. However, there was a high proportion of candida species amongst these infections. The only risk factor for CRI was the duration of catheterization.
Pre‐oxygenation enhances induction with sevoflurane as assessed using bispectral index monitoring
Authors: Fassoulaki A. , Petropoulos G. , Kottis G. , Sarantopoulos C.
Published: March 2006

Background:  Several methods may enhance the inhalational induction of anesthesia. In this randomized double‐blind study, we evaluated the speed of induction of anesthesia with sevoflurane with or without pre‐oxygenation.

Methods:  Fifty‐four patients scheduled for hysteroscopy received for 10 min air or 100% oxygen via a facemask followed by ≥ 7% sevoflurane in 100% oxygen. During the first 300 s of sevoflurane administration, bispectral index (BIS) values were recorded every 30 s in all patients. In 14 patients, seven in each group, BIS, endtidal CO2, tidal volume, respiratory rate, SpO2, and heart rate were recorded every minute during the pre‐induction period and every 30 s during the first 5 min of sevoflurane administration.

Results:  The BIS, endtidal CO2, tidal volume and respiratory rate did not differ between the oxygen or air breathing groups (P = 0.696, P = 0.999, P = 0.388, and P = 0.875, respectively), though the oxygen group exhibited lower tidal volumes by 16–20%. The SpO2 and heart rates were higher in the oxygen breathing group (P < 0.001 and P = 0.042, respectively). During sevoflurane administration, BIS values were lower in the oxygen group vs. the group breathing air, in particular at 90, 120, 150, 180 and 210 s (P = 0.001, P = 0.001, P = 0.001, P = 0.001 and P = 0.030, respectively). The endtidal CO2 and the tidal volumes between the groups did not differ. The two groups differed in the SpO2 and the heart rates during induction (P = 0.004 and 0.003, respectively).

Conclusions:  Before sevoflurane administration, breathing 100% oxygen for 10 min enhances induction of anesthesia with sevoflurane.
Reliability of continuous cardiac output determination by pulse‐contour analysis in porcine septic shock
Authors: Schuerholz T. , Meyer M. Cobas , Friedrich L. , Przemeck M. , Sümpelmann R. , Marx G.
Published: March 2006

Background:  Pulse‐contour analysis represents a technique for cardiac output (CO)‐measurement and allows continuously monitoring trends in CO. We evaluated reliability of pulse‐contour CO (COpc) in septic shock.

Methods:  Seventeen anaesthetized and mechanically ventilated pigs were investigated. After baseline measurements, 14 animals received 0.75 g/kg body weight faeces into the abdominal cavity to induce sepsis and were observed over 9 h, three animals served as controls. A central venous catheter was inserted into the jugular vein and an arterial catheter for thermodilution was inserted into the femoral artery. Two bedside computers were used for COpc. After induction of sepsis, COpc‐computer No. 1 (COpcCAL) was recalibrated hourly. No further calibrations were performed in computer No. 2 (COpcNoCAL). We directly compared COpcCAL hourly before recalibration with COpcNoCAL. One hundred and seventy parallel triplicate determinations of CO were analysed using the method of Bland–Altman.

Results:  Three hours after sepsis induction, correlation between recalibrated and non‐recalibrated CO was r = 0.74, P < 0.01, at 5 h r = 0.59, P < 0.05 and 9 h r = 0.02, NS. Three hours after sepsis induction, bias ± SD (limits of agreement) between both groups was 1.6 ± 15.5 (−29.4–32.6) ml/kg/min, at 5 h −15.0 ± 24.3 (−63.6–33.7) ml/kg/min and at 9 h −87.0 ± 90.8 (−268.5–94.6) ml/kg/min.

Conclusion:  Continuous CO determination using pulse‐contour analysis is a reliable method of assessing CO up to 5 h without recalibration in porcine septic shock. Thus, COpc may be a useful tool for assessment of unpredictable haemodynamic changes in sepsis.
Volatile anesthetics evoke prolonged changes in the proteome of the left ventricule myocardium: defining a molecular basis of cardioprotection?
Authors: Kalenka A. , Maurer M. H. , Feldmann R. E. , Kuschinsky W. , Waschke K. F.
Published: March 2006

Background:  Volatile anesthetics can alter cardiac gene and protein expression. Of those underlying molecular changes in gene and protein expression in the myocardium after exposure to volatile anesthetics that have been identified, some of them have been related to cardioprotection.

Methods:  We used two‐dimensional gel electrophoresis and mass spectrometry to identify changes in the protein expression of the left ventricle myocardium of anesthesized rats. We maintained anesthesia for 3 h using isoflurane, sevoflurane or desflurane, respectively, at 1.0 minimum alveolar concentration (MAC) and dissected the left ventricular myocardium either immediately or 72 h after the end of anesthesia.

Results:  We found changes of at least twofold in 106 proteins of the more than 1.600 protein spots discriminated in each gel. These differentially expressed proteins are associated with functions in glycolysis, mitochondrial respiration and stress response. No obvious difference could be observed between the patterns of differential expression of the three volatile anesthetics.

Conclusion:  We provide the first study of post‐anesthetic protein expression profiles associated with three common volatile anesthetics. These volatile anesthetics promote a distinct change in the myocardial protein expression profile, whereby changes in the expression pattern still exist 72 h after anesthesia. These proteome changes are closely related to cardioprotection and ischemic preconditioning, indicating a common functional signaling of volatile anesthestics.
Effects of heparin, haemodilution and aprotinin on kaolin‐based activated clotting time: in vitro comparison of two different point of care devices
Authors: Dalbert S. , Ganter M. T. , Furrer L. , Klaghofer R. , Zollinger A. , Hofer C. K.
Published: March 2006

Background:  During cardiopulmonary bypass (CPB), measurement of kaolin‐based activated clotting time (kACT) is a standard practice in monitoring heparin‐induced anticoagulation. Despite the fact that the kACT test from the Sonoclot Analyzer (SkACT) has been commercially available for several years, no published data on the performance of SkACT are available. Thus, the aim of this in vitro study was to compare SkACT with an established kACT from Hemochron (HkACT).

Methods:  Blood was withdrawn from 25 patients before elective cardiac surgery. SkACT and HkACT were measured in duplicate after in vitro administration of heparin (0, 1, 2 and 3 U/ml), calcium‐free lactated Ringer's solution (25% and 50% haemodilution) and aprotinin (200 kIU/ml).

Results:  A total of 600 duplicate kACT measurements were obtained from 25 cardiac surgery patients. Overall, mean bias ± SD between SkACT and HkACT was 7 ± 70 s (1.3% ± 14.1%). Administration of heparin, haemodilution and aprotinin induced a comparable effect on both activated clotting time (ACT) tests. Mean bias ranged from −4 ± 39 s (−1.7% ± 12.9%) to 4 ± 78 s (3.2% ± 15.6%) for heparinzed blood samples after haemodilution or aprotinin application and increased after combined aprotinin administration and haemodilution. After haemodilution and administration of aprotinin, both ACT tests were less reliable for values >480 s in heparinized blood samples.

Conclusion:  Accuracy and performance of SkACT and HkACT were comparable after in vitro administration of heparin, aprotinin and haemodilution. Both ACT tests were considerably affected by aprotinin and haemodilution.
Blastocyst development of 4‐cell mouse embryos after laser destruction of one blastomere with or without its microsurgical removal
Authors: Vutyavanich Teraporn , Amatyakul Patcharada , Piromlertamorn Waraporn
Published: March 2006

Aim:  To study the rate of blastocyst formation in 4‐cell mouse embryos after laser destruction of one blastomere, with or without microsurgical removal of the destroyed blastomere.

Methods:  Mouse embryos were randomly allocated to two control and two experimented groups. Control embryos were either non‐manipulated (117 embryos) or underwent laser ablation of zona only (114 embryos). Experimented embryos had laser destruction of zona and the adjacent blastomeres. Destroyed blastomeres were either left in situ (115 embryos) or were microsurgically removed (107 embryos). They were cultured in sequential media for 72 h and were assessed for cleavage/morula arrest and blastocyst formation rates.

Results:  Embryos arrested at cleavage/morula stages were higher when destroyed blastomeres remained in situ (30.4%) than when they were immediately removed (15.0%, P < 0.05). Blastocysts in the group with immediate removal of the destroyed blastomeres (85%) were significantly higher than when destroyed blastomeres were left in situ (69.6%, P < 0.05). Blastocyst formation in the repaired embryos was significantly lower than the non‐manipulated (91.5%) and the manipulated controls (94.8%, P < 0.05). Hatching blastocysts were highest in control embryos with zonal ablation (72.8%). Proportions of hatching/hatched blastocysts in embryos, with or without removal of destroyed blastomeres, were not significantly different (39.3% and 33.9%, respectively). The percentage of embryonic loss during an attempt at microsurgical repair was 6.1%.

Conclusion:  Microsurgical removal of destroyed blastomere was effective in restoring blastocyst development. It could reduce the rate of cleavage/morula arrest.
Sporadic fetal heart rate decelerations associated with electrocortical changes in fetal lambs
Authors: Fujimori Keiya , Murata Yuji , Sato Akira
Published: March 2006

Aim:  The purpose of this study was to determine a relationship between sporadic fetal heart rate (FHR) decelerations and fetal electrocortical changes in physiologically normal sheep fetuses.

Materials and Methods:  A total of 20 experimental observations were conducted on eight chronically instrumented fetal lambs. For electrocorticogram (ECoG) recording, two stainless steel electrodes were implanted bilaterally on the fetal parietal skull. Classifications of ECoG tracings were visually divided into periods of low, high, intermediate and transitional voltage. During day and night observations, sporadic FHR decelerations related to fetal ECoG changes were counted.

Results:  We found that 65% of the total sporadic FHR decelerations occurred in relation to fetal ECoG changes. The largest number of sporadic FHR decelerations was associated with a switch from low voltage to high voltage ECoG (37%). However, the greatest frequency of sporadic FHR decelerations occurred during intermediate ECoG periods (34%).

Conclusion:  The majority of sporadic FHR decelerations observed in physiologically normal sheep fetuses were associated with fetal ECoG changes.
Immunological factors and their role in the genesis and development of endometriosis  ARTICLE HAS BEEN RETRACTED
Authors: Siristatidis Charalambos , Nissotakis Christos , Chrelias Charalambos , Iacovidou Helen , Salamalekis Emmanuel
Published: March 2006

The article presents an overview of immunological factors and their role in the genesis and development of endometriosis, with emphasis on inflammatory cytokines and growth and adhesion factors. Although retrograde menstruation is a common phenomenon among women of reproductive age, not all women with retrograde menstruation suffer the disease. Development of endometriosis seems to be a complex process, facilitated by several factors, including quantity and quality of endometrial cells in peritoneal fluid (PF), increased inflammatory activity in PF, increased endometrial–peritoneal adhesion and angiogenesis, reduced immune surveillance and clearance of endometrial cells, and increased production of autoantibodies against endometrial cells. Potential biomarkers like cytokines and autoantibodies, upregulated during development of endometriosis, seem useful in the development of a non‐surgical diagnostic tool. In this review work, the immune role in endometriosis is examined through the role of immunological factors in the genesis and development of the disease. Furthermore, it could be concluded that, although endometriosis can be treated using hormonal suppression, there is a need today for non‐hormonal drugs, probably to modulate immune function, in order to confront the disease and alleviate pain or infertility without inhibition of ovulation.
Ranking the contributing risk factors in venous thrombosis in terms of therapeutic potential: Virchow's triad revisited
Authors: Kiyomura Masaki , Katayama Tomihiro , Kusanagi Yasuki , Ito Masaharu
Published: March 2006

Aim:  Thromboemoblism is an attendant feature of a variety of pathological conditions. We reconsidered Virchow's pathogenetic triad of stasis, humoral factors and vascular wall pathologies in the light of platelet behavior in vivo.

Methods:  Rat mesenteric microcirculation was examined by intravital microscopy. After isolated rat platelets had been injected i.v. into rats, their behavior in venules was examined under the following conditions: stasis from pressure, hemoconcentration from erythropoietin injections, or endothelial damage from tumor necrosis factor‐α.

Results:  In the endothelial damage group, platelets displayed transient adhesion and rolling, while some platelets exhibited stationary adhesion to venular endothelium. The stasis and hemoconcentration groups exhibited only a slight change in adhesive response.

Conclusion:  Endothelial dysfunction appears to be the most important contributing factor in the development of venous thrombosis. As such, targeting this dysfunction is suggested for therapeutic intervention.
Effectiveness of microlaparoscopy in the diagnosis of premature ovarian failure
Authors: Abe Noriko , Takeuchi Hiroyuki , Kikuchi Iwaho , Kinoshita Katsuyuki
Published: March 2006

Aim:  Premature ovarian failure (POF) cases contain a mixture of cases possessing follicles (type A) and those depleted of follicles (type B). Differentiation between the two types is important because the treatment policy and pregnancy prognosis vary greatly. The objective of this study was to examine the usefulness of microlaparoscopy in the differentiation of types A and B.

Methods:  Among 66 patient with POF diagnosed at our department between May 1996 and April 2004, 47 patients who gave informed consent and underwent microlaparoscopy were studied. The cases were divided into four groups based on the laparoscopic ovarian morphology. These groups were analyzed with respect to patient background, blood hormone levels, antinuclear antibody positive rate, visualization of the ovary on transvaginal ultrasonography, presence or absence of follicles in biopsy specimen, and number of follicles.

Result:  No significant differences in patient background and serum hormone levels were observed between groups. There was a tendency of increase in antinuclear antibody positive rate, increase in proportion of cases with follicles, and increase in number of follicles as the ovarian morphology approached normal. Transvaginal ultrasonography failed to identify the ovary in all the patients.

Conclusion:  Microlaparoscopy is useful in the differentiation between type A and B POF, and is further expected to become an indicator of response to treatment.
Analysis of ovarian tumors for the presence of human papillomavirus DNA
Authors: Quirk Jeffrey T. , Kupinski John M. , DiCioccio Richard A.
Published: March 2006

Aim:  The role of human papillomavirus (HPV) infection in ovarian tumorigenesis is uncertain. The objective of this study was to screen a collection of ovarian tumors for the presence of high‐risk oncogenic HPV types 16, 18 and 33.

Methods:  Twenty benign and malignant ovarian tumors were obtained from women undergoing pelvic surgery at a regional comprehensive cancer institution in North America. DNA was isolated from the snap‐frozen tumors, and commercial polymerase chain reaction (PCR) detection sets were used to analyze the tumor DNA samples for the presence of DNA from HPV types 16, 18 and 33.

Results:  The DNA from HPV types 16, 18 and 33 was not detected in any of the ovarian tumors.

Conclusions:  Our findings do not support an association between infection with HPV types 16, 18 and 33 and ovarian neoplasia in this patient population.
Fetal pulse oximetry and wavelet analysis of the fetal heart rate in the evaluation of abnormal cardiotocography tracings
Authors: Salamalekis Emmanuel , Siristatidis Charalambos , Vasios George , Saloum John , Giannaris Dimitrios , Chrelias Charalambos , Prentza Antonia , Koutsouris Demetrios
Published: March 2006

Aim:  Previous studies indicate that the addition of wavelet analysis of the fetal pulse oximetry tracings (FSPO2) and fetal heart rate (FHR) variability to cardiotocography (CTG), for intrapartum fetal monitoring, provides useful information on the fetal response to hypoxia. We applied the new procedure in non‐reassuring CTG patterns, in which cesarean section was performed, and tested its accuracy in the diagnosis of the intrapartum fetal compromise.

Methods:  At the ‘Aretaieion’ University Hospital labor ward, 318 women with term fetuses in the cephalic presentation entered the trial during labor. They all were monitored with external CTG and fetal pulse oximetry. In the cases that cesarean section was applied, because of abnormal CTG tracings, we applied a method based on the multiresolution wavelet analysis and a self‐organized map neural network on the first and second stage of labor. The main outcome parameter was the rate of cord metabolic acidosis at birth (pH < 7.05). Secondary outcomes included Apgar scores at 5 min, fetal transmission to neonatal intensive care unit (NICU) and neonatal encephalopathy.

Results:  Fifty out of 318 cases delivered operatively because of abnormal CTG patterns (rate 15.72%). In 30 cases, cord pH was >7.05, while in 11 Apgar scores at 5 min were <7, while none of those neonates were transferred to NICU. In the rest 20 cases cord pH was <7.05; in all of these cases Apgar scores at 5 min were <7, while four neonates were transferred to NICU. In one of them, neonatal encephalopathy was diagnosed. After the offline application of wavelet analysis and neural networks to the pulse oximetry and FHR variability readings of the 50 cases, statistics calculated that the system showed a sensitivity of 85% and a specificity of 93%, while false negative and false positive rates were 15% and 7%, respectively.

Conclusion:  Computerized FHR and FSPO2 monitoring shows an excellent efficacy and reliability in interpreting non‐reassuring FHR recordings.
Differences in urodynamic study, perineal sonography and treatment outcome according to urethrovesical junction hypermobility in stress urinary incontinence
Authors: Bai Sang Wook , Kwon Ja Young , Chung Da Jung , Park Joo Hyun , Kim Sei Kwang
Published: March 2006

Aims:  To evaluate the differences in urodynamic study (UDS) and the perineal ultrasonography parameters between stress urinary incontinence (SUI) patients with or without urethrovesical junction (UVJ) hypermobility. Treatment outcomes following a retropubic urethropexy were also compared.

Methods:  The records of 164 SUI patients (≤stage II), treated with retropubic urethropexy at our department between January 2001 and February 2004 were reviewed. The patients were categorized into a hypermobility group when the measured Q‐tip angle was ≥30, and a non‐hypermobility group when <30. All patients underwent UDS and perineal ultrasonography (US) preoperatively. A Burch urethropexy was performed regardless of the Q‐tip result. All patients were reevaluated at 1 month and 3 months, postoperatively, and every 3 months thereafter.

Results:  Ninety‐eight patients (60%) had an accompanying UVJ hypermobility and 66 (40%) did not. No significant differences regarding age, parity, body mass index (BMI), menopausal status, hormone replacement status, history of previous gynecologic surgery, or other medico‐surgical illness were noted. UDS parameters demonstrated a significant difference between the groups, but were in the normal range. The significant difference noted in the perineal US was the bladder neck descent (BND). Following retropubic urethropexy, the success rates after 1 year were 94% and 91% for the hypermobility group and the non‐hypermobility group, respectively, showing no statistical significance.

Conclusion:  The success rates of Burch urethropexy in the two groups were similar. This result suggests that either the Q‐tip is an inaccurate method of evaluating UVJ hypermobility or the presence of UVJ hypermobility does not negatively affect the treatment outcome of a Burch urethropexy.
Giant paraovarian myxoma
Authors: Habek Dubravko , Dmitrovic Branko , Popovic Zoran , Karša Matija , Blažicvic Valerija , Rupcic Branko , Vlahovic Mirna Erman , Marjanovic Ksenija
Published: March 2006

We present an extremely rare case of a successfully operated giant (6700 g) paraovarian myxoma and uterus myomatosus in a 49‐year‐old woman. Preoperative examination (biochemical investigations, ultrasound and computed tomography scan) and perioperative findings did not identify a malignant tumor so that total abdominal hysterectomy/bilateral salpingo‐oophorectomy and tumorectomy was chosen to treat the patient. Histologically, the tumor was clearly differentiated from the surrounding tissue. In solid regions there were spindle‐shaped cells arranged in sheaves and within the profuse, well‐vascularized myxomatous stroma there were star‐shaped cells. Immunohistochemical analysis showed that tumor cells were positive to vimentin and smooth muscle actin. Electron microscopic analysis showed that tumor cells had ultrastructural characteristics that corresponded to cells in fibroma and thecoma in a profuse intercellular matrix, which confirmed the result of light microscopy.
Basic study of healing of injuries to the myometrium and amniotic membrane using photocrosslinkable chitosan
Authors: Suzuki Keitaro , Shinya Masaru , Kitagawa Michihiro
Published: March 2006

Aim:  We performed in vivo and in vitro adhesion experiments on the use of photocrosslinkable chitosan (PC) for healing of the myometrium and the amniotic membrane to test its usefulness in the perinatal field.

Methods:  To determine the adhesion conditions of PC in the healing of the myometrium and amniotic membrane, we applied two concentrations (30 and 50 mg/mL) of PC to the postpartum amniotic membrane, and radiated it with ultraviolet (UV) light for 10, 20, 30 or 60 s. Next, we created incisions of three sizes (pinhole, 5 mm and 10 mm), and performed PC adhesion followed by pressure application experiments. Subsequently, we laparotomized 12‐day‐pregnant rats under anesthesia, created a 5‐mm incision, applied PC and closed the abdomen. We removed the uterus at 20 days of pregnancy, and histologically examined the site of PC application.

Results:  The optimal adhesion conditions of PC were 50 mg/mL, and the optimal time of UV irradiation was 30 s or longer. In pressure application experiments, the bonding strength of PC was so high that even 10‐mm incisions withstood a mean pressure of 92 mmH2O. The bonding strength of PC was significantly higher than that of fibrin glue that was tested in parallel. Histological examination of the rat myometrium showed a mild foreign body reaction with no inflammatory findings, confirming the usefulness of PC.

Conclusions:  PC is a wound‐healing drug, an improvement on the naturally occurring polysaccharide chitosan, and is safer and has a higher bonding strength than biological adhesives including fibrin, making it promising for fetal surgical and perinatal applications.
Preoperative diagnosis of ovarian tumors, focusing on the solid area based on diagnostic imaging
Authors: Umemoto Masahiko , Shiota Mitsuru , Shimono Taro , Hoshiai Hiroshi
Published: March 2006

Aim:  The objectives were to attempt to differentiate between benignancy and malignancy by focusing not on macroscopic finding of tumor sections, but on the solid areas by diagnostic imaging. To investigate the usefulness of diagnostic imaging for ovarian tumors, we examined the solid areas in the tumor and their shape and analyzed the relationship between these factors and the malignant potential.

Methods:  Subjects were 921 surgical cases (1074 tumors) over a period of 7 years. Diagnostic images (ultrasonography, computed tomography and magnetic resonance imaging) were reread, focusing on the solid area. Tumors were classified into four groups according to the prominence of the solid area, and the findings were compared with the postoperative diagnosis.

Results:  Of the cases, 718 indicated benign, borderline malignancy in 29 and malignancy in 174. The malignant potential of tumors with solid areas was significantly higher than those with no solid area. However, upon comparison among the different groups with solid areas, no significant differences were detected in terms of the frequency at which malignancies were detected, despite the differences between the groups with respect to size and shape.

Conclusion:  It is important for the treatment strategy that solid areas, even if small, should not be neglected, and that malignancies are found at high frequency regardless of shape, size and prominence.
Small bowel perforation without tumor recurrence after radiotherapy for cervical carcinoma: Report of seven cases
Authors: Yamashita Hideomi , Nakagawa Keiichi , Tago Masao , Igaki Hiroshi , Shiraishi Kenshirou , Nakamura Naoki , Sasano Nakashi , Yamakawa Sen , Ohtomo Kuni
Published: March 2006

Aim:  We describe the clinical presentation, evaluation, management and outcome of patients experiencing small bowel perforation following radiation therapy for cervical cancer.

Methods and Materials:  A database consisting of 95 Japanese women with stage 0–4 A cervix cancer treated between 1991 and 2004 contained seven patients (7.4%) with small bowel perforation.

Results:  The median age at the time of perforation was 72.5 years (range 62–78). The median time from completion of radiotherapy to perforation was 6 months (range 2–58). Surgery (one small bowel resection and anastomosis with diversion; six small bowel resection and anastomosis) was performed immediately in all seven patients. One of seven patients died of small bowel perforation (i.e. mortality rate was 14%). Bowel adhesion was detected during the operation in only three cases (43%). Signs of peritonitis were absent in six cases (86%). Severe abdominal pain was seen in all seven patients. The perforation site was ileum in all seven cases. In all patients, pathological changes were compatible with postirradiation injury of the gastrointestinal tract.

Conclusions:  The presenting complaints of patients with bowel perforation following radiotherapy vary, and signs of peritonitis may be absent. Emergency physicians must be alert for these complications in patients who have been treated with radiotherapy.
Metronidazole with Lactacyd vaginal gel in bacterial vaginosis
Authors: Decena Ditas Cristina D. , Co Jennifer T. , Manalastas Ricardo M. , Palaypayon Evelyn P. , Padolina Christia S. , Sison Judith M. , Dancel Louella A. , Lelis Marievi A.
Published: March 2006

Aim:  To assess the efficacy and tolerability of lactic acid (Lactacyd vaginal gel; LVG) when given as an adjunct to metronidazole in the treatment of bacterial vaginosis (BV) among Filipino patients.

Methods:  A multicenter, open‐labeled, controlled, randomized, three‐arm comparative study on 90 women aged 18 years or over with clinically and microbiologically proven BV.

Results:  The lactobacilli colony count significantly increased over time in all three arms. At day 14, growth of lactobacilli was significantly higher among patients in the lactic acid gel and combination treatment arms. Significant reduction of malodorous vaginal discharge (whiff test) and lowest recurrence of BV were noted in the metronidazole plus lactic acid gel arm. Regarding disappearance of signs of BV, there was significant decrease in the pH level and frequency of clue cell positive patients across time but was not significantly different across treatment groups. Only one patient (3%, 1/60) among those who received lactic acid gel complained of increased curd‐like discharge. Six patients (10%, 6/60) who received metronidazole complained of epigastric pain/discomfort, dizziness and dyspnea.

Conclusions:  Lactic acid gel (LVG) is safe and as efficacious as metronidazole in the treatment of BV. There is evidence that LVG when combined with metronidazole is superior to metronidazole alone in promoting lactobacilli colonization. LVG as an adjunct to metronidazole, having the least number of recurrent BV, appears to result in better long‐term treatment effect on bacterial vaginosis.
Difference in the relative contribution of lean and fat mass components to bone mineral density with generation
Authors: Mizuma Nobuhisa , Mizuma Mari , Yoshinaga Mitsuhiro , Iwamoto Ichiro , Matsuo Takashi , Douchi Tsutomu , Osame Mitsuhiro
Published: March 2006

Aim:  To investigate whether the relative contribution of body composition (lean and fat mass component) to bone mineral density (BMD) differs depending on generation or menopause.

Methods:  Subjects were 302 premenopausal women aged 30–49 years old and 197 postmenopausal women aged 50–69 years old. They were classified into four subgroups with 10‐year increments. Age, height, weight and years since menopause (YSM) were recorded. Lumbar spine (L2–4), total body BMD, body fat mass, lean body mass (LBM), and the percentage of body fat (%fat) were measured using dual‐energy X‐ray absorptiometry. The correlation of body composition with BMD was investigated.

Results:  The mean age at menopause was 50.2 ± 4.1 years old. On Pearson's correlation test, LBM was positively correlated with BMD of the two sites in all groups. In a group aged 60–69 years, both the %fat and body fat mass were correlated with BMD. On multiple regression analysis, LBM was the principal BMD determinant in women aged less than 60 years, while body fat mass and percentage fat were the principal BMD determinants in women aged 60–69 years. Mean %fat in the group aged 60–69 years was 35.5 ± 7.3%, which was significantly higher than that in the group aged 50–59 years (33.0 ± 6.7%, P < 0.05).

Conclusion:  Although LBM still influences BMD up to 10 years after menopause, the body fat mass initially influences BMD after 60 years of age. These difference may be attributable to certain aging‐related factor(s).
Spontaneous ectopic pregnancy occurring in the isthmic portion of the remnant tube after ipsilateral adnexectomy: Report of two cases
Authors: Takeda Akihiro , Manabe Shuichi , Mitsui Takashi , Nakamura Hiromi
Published: March 2006

Two cases of spontaneous ectopic pregnancy occurring in the isthmic portion of the remnant tube after previous ipsilateral adnexectomy are presented. Laparoscopic observation and postoperative histopathological examination suggested intrauterine transmigration of the fertilized egg as the etiology. Laparoscopic excision of the remnant tube was performed and the postoperative course was uneventful in both cases. Attention should be paid to this unusual type of ectopic pregnancy while examining patients with previous history of adnexal surgery.
Vitamin K2 treatment for postmenopausal osteoporosis in Indonesia
Authors: Purwosunu Yuditiya ,   Muharram, Rachman Ichramsyah A. , Reksoprodjo Soelarto , Sekizawa Akihiko
Published: March 2006

Aim:  To investigate the effect of vitamin K2 (menatetrenone) treatment on bone mineral density (BMD) and a bone metabolic marker (osteocalcin) in postmenopausal women with osteoporosis living in Indonesia.

Methods:  A double‐blind randomized placebo‐controlled study of 63 postmenopausal women with osteoporosis. The vitamin K2 group (n = 33) received 45 mg menatetrenone and 1500 mg calcium carbonate per day and the control group (n = 30) received placebo and 1500 mg calcium carbonate per day for 48 weeks. BMD of lumbal spine (L2–L4), osteocalcin (OC) and undercarboxylated OC were measured before, 24 and 48 weeks after initiation of the treatment.

Results:  After 48 weeks of treatment, the mean percentage change of lumbar BMD in the vitamin K2 group was significantly higher (P < 0.05) than that of the control group. The undercarboxylated OC level decreased by 55.9% in the menatetrenone group and 9.3% in the control group compared with the baseline level. The difference between the two groups was significant (P < 0.01). The adverse events were three minor gastrointestinal cases, which subsided after temporary cessation of therapy.

Conclusions:  Treatment with 45 mg vitamin K2 with 1500 mg calcium per day for postmenopausal women with osteoporosis for 48 weeks resulted in a significant increase in lumbar BMD and a significant decrease in undercarboxylated OC levels.
Fetal aortic distension waveforms for evaluating cardiac function and changes in blood pressure: Fetal lamb validation
Authors: Fujita Yasuyuki , Satoh Shoji , Yumoto Yasuo , Koga Tsuyoshi , Kinukawa Naoko , Nakano Hitoo
Published: March 2006

Aim:  To investigate which part of the fetal aortic distension waveform is mainly influenced by changes in fetal cardiac contractility and aortic blood pressure.

Methods:  In acute preparation, aortic distension waveforms were recorded using an echo‐tracking system, and aortic and left ventricular pressure waveforms were obtained from six late‐gestation catheterized fetal lambs. Dobutamine and angiotensin II were separately infused and the correlations between the maximum value in the first derivative of left ventricle pressure waveforms (Max dP/dt) and fetal blood pressure, and the parameters obtained from aortic distension waveforms were analyzed using linear regression analysis.

Results:  With a change in cardiac contractility, the maximum value of first derivative of the systolic rising slope in the aortic distension waveform had a positive correlation with Max dP/dt (r = 0.93, P < 0.0001). With changes in fetal blood pressure, both the amplitude and the ratio of increase from the end diastolic diameter obtained from the aortic distension waveform had a significant positive correlation with aortic blood pressure amplitude (r = 0.60, P < 0.01; r = 0.61, P < 0.01, respectively).

Conclusion:  The maximum first derivative of the systolic rising slope in the aortic distension waveform and the amplitude in the aortic distension waveform enable us to non‐invasively substitute for fetal cardiac contractility and aortic blood pressure amplitude, respectively.
Inhibition of matrix metalloproteinase‐2 secretion and invasion by human ovarian cancer cell line SK‐OV‐3 with lysine, proline, arginine, ascorbic acid and green tea extract
Authors: Roomi M. Waheed , Ivanov Vadim , Kalinovsky Tatiana , Niedzwiecki Aleksandra , Rath Matthias
Published: March 2006

Aims:  Based on the poor prognosis associated with ovarian cancer and reported anticancer properties of specific nutrients, we investigated the effect of a nutrient mixture (NM) containing lysine, proline, arginine, ascorbic acid and epigallocatechin gallate on human ovarian cancer cells SK‐OV‐3 by measuring: cell proliferation, modulation of matrix metalloproteinase (MMP)‐2 and ‐9 expression, and cancer cell invasive potential.

Methods:  Cell proliferation was evaluated by MTT assay, MMP activity by gelatinase zymography, and invasion through Matrigel.

Results:  Human ovarian cancer cell growth was not significantly affected by the NM. Zymography demonstrated inhibition of MMP‐2 secretion in a dose‐dependent fashion with virtual total inhibition at 50 µg/mL NM concentration. Invasion of human ovarian cancer cells through Matrigel decreased in a dose‐dependent fashion, with 90% inhibition at 500 µg/mL NM and 100% inhibition at 1000 µg/mL NM (P < 0.0001).

Conclusion:  The combination of lysine, proline, arginine, ascorbic acid and green tea extract tested inhibited critical steps in cancer development and spread, such as MMP expression and invasion, indicating its potential as a treatment modality against ovarian cancer.
An evaluation of the economic costs and patient‐related consequences of treatments for benign prostatic hyperplasia
Authors: DISANTOSTEFANO RACHAEL L. , BIDDLE ANDREA K. , LAVELLE JOHN P.
Published: March 2006

OBJECTIVE

To compare the costs and effectiveness of treatments for benign prostatic hyperplasia (BPH), including watchful waiting, pharmaceuticals (α‐blockers, 5‐α‐reductase inhibitors, combined therapy), transurethral microwave thermotherapy (TUMT), and transurethral resection of the prostate (TURP).

PATIENTS AND METHODS

This study used a Markov model over a 20‐year period and the societal perspective to evaluate the costs of treatment alternatives for BPH. Markov states include urinary symptom improvement, symptom improvement with adverse effects, or no urinary symptom improvement. For the analysis, patients could remain on their initial treatment, change to a different treatment, have treatment failure that required TURP, or die (all‐cause mortality). We used published data for outcomes, including systematic reviews when possible. Costs were estimated using a managed‐care claims database and Medicare fee schedules. Costs and effectiveness outcomes were discounted at 3%/year where appropriate. Men (aged ≥ 45 years) with moderate‐to‐severe lower urinary tract symptoms and uncomplicated BPH were included in the analysis, and results were stratified by age. Outcomes include costs, disease progression, surgery, hospitalization, and catheterization time.

RESULTS

What is the ‘best’ treatment depends on the value that an individual and society place on costs and consequences. α−Blockers are less expensive than the alternatives, and are effective at relieving patient‐reported symptoms. Unfortunately, they have little effect on clinical outcomes and have the highest BPH progression rate. Other treatments have lower disease progression and better clinical outcomes, but are more expensive and entail more invasive treatments, and/or more uncertainty.

CONCLUSIONS

Treatment decisions are made using a variety of information, including the cost and consequences of treatment. The best treatment depends on the patient's preference and the outcome considered most important. α‐Blockers are very effective at treating urinary symptoms but do not improve clinical outcomes, including disease progression, relative to other treatments. TURP remains the ‘gold standard’ for surgical procedures. The desire to avoid TURP or the 2 weeks of catheterization associated with TUMT might affect a patient's treatment decision when symptoms are severe. Therefore, more information about patient preferences and risk aversion is needed to inform treatment decision‐making for BPH.