bluuebunny/crossref_metadata_2025 huggingface dataset:
Presence, richness and extinction of birds of prey in the Mediterranean and Macaronesian islands
Authors: Donázar J. A. , Gangoso L. , Forero M. G. , Juste J.
Published: September 2005

Aim We analyse modern patterns of richness, presence and extinction of birds of prey (Accipitriforms and Falconiforms) in the Mediterranean and Macaronesian islands, using an integrated approach involving both biogeographical and human‐induced factors.

Location Forty‐three islands grouped into nine Mediterranean and Macaronesian archipelagos.

Methods Information about 25 species breeding during the past century and their fate (permanence or extinction) was compiled from the literature and regional reports. Jaccard's similarity index and cluster analyses were applied to define island assemblages. In order to detect the factors driving richness, presence and extinction, generalized linear models (GLM) were applied to 32 explanatory variables, evaluating location, physiography, isolation of island, taxonomic affinities and life‐history patterns of the raptor species.

Results Islands belonging to the same archipelago clustered when raptor assemblages were compared, revealing a marked biogeographical signal. Species richness was influenced by island area and accessibility from the continent (explained deviance of 51% in the GLM). Models of the probability of presence (explained deviance of 32%) revealed positive influences of migratory patterns (maximum for partial migrants), size of distribution areas and proximity to main migration routes. The model for probability of extinction explained only 8% of the deviance. It revealed that populations living on islands with a high density of human population were more prone to disappear. Also, raptors depending on human resources had more risk of extinction.

Main conclusions Basic predictions of island biogeography can explain current patterns of raptor richness in the study area despite millennia of intense humanization processes. Colonization success appears to depend on life‐history traits linked to migratory and dispersal strategies, whereas body‐size constraints are not influential. Additionally, our results reveal the importance of species‐based analyses in studies of island biogeography.
Geographic distribution, virologic and clinical characteristics of hepatitis B virus genotypes in China
Authors: Zeng G. , Wang Z. , Wen S. , Jiang J. , Wang L. , Cheng J. , Tan D. , Xiao F. , Ma S. , Li W. , Luo K. , Naoumov N. V. , Hou J.
Published: September 2005

Summary.  The significance of hepatitis B virus (HBV) genotypes for the heterogeneity of chronic HBV infection and severity of liver disease is not well understood. The aim of this study was to determine the distribution and virologic characteristics of HBV genotypes in China and possible association with the diversity of liver disease. The study includes 1096 chronic HBV carriers from nine provinces in China. We collected clinical and laboratory data and analysed the HBV strains in sera by polymerase chain reaction–restriction fragment length polymorphism (PCR‐RFLP) and nucleotide sequencing techniques. The most common HBV genotypes were B (41%) and C (53%), while genotypes A and D were also found. A North–South divide was identified in genotype B and C distribution – genotype C was predominant in northern China, while genotype B was more prevalent in southern provinces. Patients with genotype B were younger than those with genotype C, and had a lower prevalence of HBeAg – 65%vs 72%, respectively (P = 0.03). However, the severity of liver disease did not differ significantly between patients infected with genotype B or C – neither when comparing liver function tests (1024 patients), nor hepatic inflammation and fibrosis (264 patients). Amongst 47 patients with genotype D (by PCR‐RFLP), 37 (79%) were infected with a new subtype (designated Dc), having a recombination fragment from genotype C precore/core region. This is the first large‐scale HBV genotype study from China and convincing documentation of the North‐to‐South gradient of genotypes C vs B in this country. HBV DNA recombination over the surface and precore/core genes increases the diversity of HBV strains and may have diagnostic and clinical implications.
Cell cycle‐dependent proteolysis and ectopic overexpression of cyclin B1 in tobacco BY2 cells
Authors: Criqui Marie Claire , Parmentier Yves , Derevier Aude , Shen Wen‐Hui , Dong Aiwu , Genschik Pascal
Published: September 2005

Activation of cyclin B/Cdc2 kinase complex triggers entry into mitosis in all eukaryotic cells. Although cyclin gene expression has been extensively studied in plants, not much is known at the level of the protein stability and function. Here, we demonstrated by using the highly synchronizable tobacco BY2 cell culture, that endogenous cyclin B1 protein undergoes cell cycle‐dependent proteolysis and is stabilized when the spindle checkpoint has been activated. Furthermore, we established transgenic tobacco BY2 cell cultures expressing under the control of an inducible promoter, cyclin B1 protein as well as its non‐degradable form as fusion proteins with GFP and found that the ectopic expression of these proteins did not dramatically disturb the cell cycle progression. These results indicate that, to a certain extent, cell cycle exit is possible without cyclin B1 proteolysis.
Two new species of Colpoma on trees from China
Authors: Hou C.‐L. , Piepenbring M.
Published: September 2005

Two new species of Colpoma are described from China. Colpoma intermedium on Pinus armandii is macroscopically similar to species of Colpoma while asci and ascospores are similar to those of species of Therrya. Colpoma sinense on Rhododendron sp. differs from other Colpoma species by conspicuous lip cells embedded in a gelatinous matrix.
Mutualistic symbiosis betweenBursaphelenchus xylophilusand bacteria of the genusPseudomonas
Authors: Zhao B. G. , Lin F.
Published: September 2005

Interactions between the pine wood nematode (PWN),Bursaphelenchus xylophilus, and bacteria of the genusPseudomonaswere examined by cultivating axenic PWN and bacterial strains using callus ofPinus thunbergii. Ten (Pseudomonas fluorescens,Pseudomonas putida,Pseudomonas cepaciaandPseudomonasspp.) of the 29 bacterial strains tested, significantly increased the reproduction of PWN. The rest of the bacteria (19 strains of 10 species) inhibited the reproduction of PWN completely. The growth of 18 of the 29 bacterial strains tested, including the 10 strains promoting PWN reproduction, was significantly increased by the presence of PWN. It indicated a mutualistic symbiotic relationship between PWN and the 10 bacterial strains in the genusPseudomonas.The bacterial mutualistic symbionts are organisms, which may have co‐evolved with PWN rather than being accidentally associated. The finding provides further evidence for our hypothesis that pine wilt disease is complex, induced by both PWN and associated phytotoxin‐producing bacteria.
Bursaphelenchus fungivorus (Nematoda: Aphelenchida) associated with Orthotomicus erosus (Coleoptera: Scolitydae) in Spain
Authors: Arias M. , Robertson L. , Garcia‐Alvarez A. , Arcos S. C. , Escuer M. , Sanz R. , Mansilla J. P.
Published: September 2005

A survey of the xylophagous insects in the conifer forests, mainly Pinus pinaster woodlands, in Spain was carried out in order to study the phoretic vectors of nematodes of the genus Bursaphelenchus. Fifteen environmental sites were characterized on the bases of altitude, rainfall, temperature and conifer species. Specimens of Orthotomicus erosus (n = 3476) were captured of which 59% carried nematodes under their elytrous, most of them were aphelenchid fungal‐feeding nematodes, but B. fungivorus was found on the beetles from Las Cumbres, Villa Blanca, (Huelva), southern Spain, which represent the first record of O. erosus as vector of a Bursaphelenchus sp. The nematode is characterized by morphometric and biomolecular techniques and distribution and ecology of the insect is discussed.
Xylem dysfunction in Yezo spruce (Picea jezoensis) after inoculation with the blue‐stain fungus Ceratocystis polonica
Authors: Kuroda K.
Published: September 2005

The blue‐stain fungus Ceratocystis polonica is pathogenic to Norway spruce (Picea abies) in Europe, as well as to Yezo spruce (Picea jezoensis) and Sachalin spruce (Picea glehnii) in Japan. The wilting mechanism in P. jezoensis saplings after inoculation with C. polonica was examined based on anatomical studies of the phloem and xylem of periodically harvested trees. In addition, the course of sap ascent in the trunks was traced by injection of acid fuchsin solution at harvest. As an initial external symptom, needle discolouration was observed. In dye conduction tests, xylem dysfunction in the xylem of inoculated trees became obvious. The dehydrated xylem area (dry zone) had extended more than 20 cm above the inoculation wounds, within 1 month after inoculation. When the sap flow to the branches had nearly stopped, the leaves began to discolour. Hyphae of C. polonica colonized the ray tissue around the inoculation wounds, but were absent at the front of the dry zones. Defence reactions occurred in ray parenchyma cells adjacent to the penetrating hyphae. It is suggested that secondary metabolites, which are formed by the ray cells and epithelial cells of resin canals, are involved in the obstruction of sap flow. Limited necrotic lesions of the phloem and cambium were not associated with foliar symptoms. It is proposed that the dry zone formation caused by C. polonica is the main mechanism leading to tree death.
Achilles tendinopathy after treatment with fluoroquinolone
Authors: Yu C , Giuffre BM
Published: September 2005

Fluoroquinolone antibiotic therapy is a recognized but poorly understood cause for Achilles tendinopathy. We report here a patient who developed bilateral partial Achilles tendon tears as a result of fluoroquinolone therapy. Ultrasound and MRI were both useful in identifying and distinguishing between Achilles tendinosis and tendon rupture. The current published literature on this problem was also reviewed.
Lung bullae and pulmonary fibrosis associated with marijuana smoking
Authors: Phan TD , Lau KKP , Li X
Published: September 2005

A 26‐year‐old man with a history of heavy marijuana and minimal tobacco use was found to have extensive bilateral lung bullae and interstitial fibrosis, heavily infiltrated by pigmented macrophages. These features can be associated with marijuana smoking. The differential diagnoses in this patient are also discussed.
Bouveret's syndrome: A rare complication of cholecystolithiasis
Authors: O'Dwyer JC , O'Dwyer HM , Lee MJ
Published: September 2005

Bouveret's syndrome is obstruction of the stomach or the duodenum from a gallstone that has migrated through a biliogastric or bilioduodenal fistula. This rare syndrome has been described in a number of case reports
Agony of the ecstasy: Report of five cases of MDMA smuggling
Authors: Low VHS , Dillon EK
Published: September 2005

The international smuggling of illicit drugs by the ingestion or rectal insertion of drug‐filled packages is recognized in the trafficking of heroin and cocaine. Customs authorities, with suspicion of such activities, presented five subjects. The legally allowed radiological examination comprising one supine abdominal radiograph was performed. Radiographic findings demonstrated the presence of multiple enteric oval, capsule‐shaped packages of soft tissue density. This was confirmed following supervised evacuation of bowel contents induced by the administration of laxatives. Analysis of the concealed material identified ecstasy (methylenedioxymethamphetamine (MDMA)), a substance not previously reported as transported by this route.
TECHNICAL TIPS FOR STENT PLACEMENT IN THE PROXIMAL COLON USING KNITTED NITINOL ESOPHAGEAL STENT
Authors: Maetani Iruru , Seike Masahiro , Ikeda Masaki , Tada Tomoko , Ukita Takeo , Sakai Yoshihiro
Published: September 2005

Self‐expandable metallic stents (SEMS) have recently become widely used. A dedicated stent such as the through‐the‐scope (TTS) stent has enabled easier placement of SEMS by endoscopists for colorectal obstructions. In Japan, however, the TTS stent is not yet available. Therefore, we have to perform non‐TTS placement using esophageal, tracheal or vascular stents for colorectal obstructions. We have developed some modifications which aid the placement of esophageal stents, including increasing the length of the delivery system, and the use of a splinting tube or a double splinting tube. These technical modifications allow markedly better placement of a knitted nitinol Ultraflex esophageal stent for a colorectal obstruction. They allowed us to even place SEMS in the proximal colon without difficulty, and in all patients we treated. Therefore, with some technical modifications, it is feasible to use an esophageal stent for proximal colonic obstruction.
SURVEILLANCE BY MAGNIFYING ENDOSCOPY IN PATIENTS WITH ULCERATIVE COLITIS
Authors: Sada Miwa , Igarashi Masahiro , Yoshizawa Shigeru , Kobayashi Kiyonori , Katsumata Tomoe , Saigenji Katsunori , Otani Yoshimasa , Okayasu Isao
Published: September 2005

Background:  Patients with total or left‐sided ulcerative colitis (UC) for more than 10 years have an increased risk of colon cancer. We studied usefulness of magnifying chromoendoscopy for the surveillance of dysplasia and colitic cancer associated with UC.

Methods:  From April 2003 through February 2004, 39 patients who had total or left‐sided UC for at least 7 years were prospectively enrolled in an endoscopic surveillance program, including target biopsy. All patients were examined by chromoendoscopy and magnifying endoscopy. Sites showing abnormal mucosal surface patterns or pit patterns suggestive of dysplasia underwent biopsy.

Results:  Of the 39 patients, 26 had total UC and 13 left‐sided UC. The mean time elapsed since the onset of UC was 16.2 ± 5.9 years. Disease activity at examination was remission in 22 patients, mild in 15, and moderate in two. Dysplasia was diagnosed in two patients (three lesions), dysplastic changes were suspected in two (two lesions), and sporadic adenoma was diagnosed in four (five lesions). On endoscopic examination, dysplasia appeared as flat elevated lesions with types IIIl and IV pit patterns. Resected specimens showed low‐to‐high‐grade dysplasia. The four patients presenting with a type III to IV mucosal pit pattern during remission were evaluated as sporadic adenoma on pathological findings.

Conclusions:  A combination of chromoendoscopy and magnifying endoscopy is useful for the detection of dysplasia and colitic cancer in patients with UC.
JUXTAPAPILLARY DIVERTICULA AND ENDOSCOPIC TREATMENT OF BILE DUCT STONES
Authors: Horaguchi Jun , Fujita Naotaka , Noda Yutaka , Kobayashi Go , Kimura Katsumi , Ito Kei , Takasawa Osamu
Published: September 2005

Aim:  To assess the influence of juxtapapillary diverticula on endoscopic treatment of bile duct stones.

Methods:  Two hundred and fifty‐eight consecutive patients with bile duct stones who had undergone endoscopic treatment at our department were included in this study. Comparison was done between a group that had a juxtapapillary diverticulum (Group D) and a group that did not (Group N).

Results:  Deep cannulation was achieved in 98% and 100% of Group D and Group N, respectively. The time required for cannulation was 18 min in both groups. Deep cannulation of the bile duct tended to be difficult in cases with the papilla located at the edge of or in the diverticulum in Group D. Complete removal of stones was achieved in 97.7% and 96.9% of the respective groups. The number of sessions and the total time required for removal of stones in Group D and Group N were 1.6 and 47 min, and 1.5 and 47 min, respectively (n.s.). The occurrence rate of complications was not statistically different (12.4%vs 10.1%); however, it was higher (50%) in those who had a papilla inside the diverticulum.

Conclusions:  Although the presence of juxtapapillary diverticula has only a subtle influence on endoscopic treatment of bile duct stones, caution is necessary when treating patients with a papilla in a diverticulum because of the high incidence of complications in such patients.
ENDOSCOPIC ULTRASONOGRAPHY FINDINGS AND CLINICAL BACKGROUNDS IN CASES WITH EARLY RECURRENCE OF ESOPHAGEAL VARICES AFTER ENDOSCOPIC INJECTION SCLEROTHERAPY
Authors: Ishii Shunya , Kakemura Tadayoshi , Fujinuma Sumio , Sakai Yoshihiro
Published: September 2005

Aims:  To investigate the factors affecting early recurrence of esophageal varices after endoscopic injection sclerotherapy (EIS).

Subjects and Methods:  Forty‐four cases with esophageal varices were examined by esophagogastroscopy and endoscopic ultrasonography (EUS) 2 months after EIS. Cases with and without red color (RC) signs evaluated within 1 year after EIS were classified as Early Recurrent Group (ERG) and Non‐Early Recurrent Group (N‐ERG), respectively, and compared with EUS images and clinical backgrounds.

Results:  Compared with ERG (17 cases), N‐ERG (27 cases) had significantly higher detection rates of cardiac intramural veins (CV) and esophageal intramural veins (EV), larger maximum diameters of CV and EV, and higher numbers of CV (P < 0.05). The detection rates of gastric perforating veins (GPV)—but not esophageal perforating veins (EPV), paragastric veins (PGV), or paraesophageal veins (PEV)—correlated with recurrence of varices (P < 0.05). ERG differed in age, gender, γ‐glutamyltranspeptidase (GTP), and detection rates of portosystemic (PS) shunts from N‐ERG (P < 0.05). Age, serum alanine aminotransferase (ALT) and γ‐GTP level, detection rates of PS shunt, maximum diameters of CV and EV, numbers of CV, and GPV‐positive case differed (P < 0.10) by univariate analysis, and maximum diameters (hazard ratio (HR)), 7.16: 95% CI [1.45–35.33]; P = 0.016) and numbers (HR, 1.96: 95% CI, [1.02–3.75]; P = 0.043) of CV differed significantly between the two groups by multivariate analysis.

Conclusions:  EUS is useful in predicting recurrence of esophageal varices after EIS, and the degree of the development of CV is the most important critical factor for early recurrences.
A CASE OF SIALADENOMA PAPILLIFERUM OF THE ESOPHAGUS
Authors: Shirahige Akinori , Mizushima Takaaki , Ohbayashi Chiho , Matsushita Koki , Tanioka Hiroaki , Hanahusa Sumihiro , Soda Mitsuhiro , Ochi Koji , Koide Norio , Tanimoto Mitsune
Published: September 2005

Sialadenoma papilliferum of the esophagus is an extremely rare benign tumor that derives from the submucosal gland duct of the minor salivary gland. A 45‐year‐old man underwent upper gastrointestinal series. A 13 mm diameter esophageal polyp was suspected in the mid esophagus. Endoscopy examination revealed a pedunculated polyp arising from the posterior wall of the esophagus. The head of the polyp was covered with exudate and was slightly nodular but the pedicle had normal mucosa. We performed endoscopic mucosal resection (EMR) and the histological examination of the polyp showed that it was compatible with sialadenoma papilliferum of the esophagus.
DIFFUSE ANTRAL VASCULAR ECTASIA OF THE STOMACH EFFECTIVELY TREATED BY ESTROGEN‐PROGESTERONE THERAPY
Authors: Yoshino Sohei , Matsumoto Takayuki , Esaki Motohiro , Yada Shinichiro , Iida Mitsuo
Published: September 2005

A 68‐year‐old woman had been diagnosed with diffuse antral vascular ectasia (DAVE) about 2 years previously. Despite endoscopic treatments with heater probe, she had manifested repeated anemia, which required blood transfusion. We thus applied hormone therapy to the patient. During the subsequent 3 months, she did not manifest anemia. In addition, her DAVE had dramatically improved under endoscopy. Our case suggests that hormone therapy is one of the strategies for intractable DAVE.
THERAPEUTIC FISTULOSCOPY FOR THE MANAGEMENT OF PROLONGED POSTOPERATIVE INTRA‐ABDOMINAL ABSCESS CAUSED BY SMALL INTESTINAL PINHOLE PERFORATION
Authors: Saida Yoshihisa , Sumiyama Yoshinobu , Nagao Jiro , Nakamura Yasushi , Nakamura Yoichi , Katagiri Miwa , Watanabe Manabu , Kusachi Shinya
Published: September 2005

Fistuloscopy is an effective treatment for intractable fistula, a sometimes difficult to manage postoperative intra‐abdominal complication. A case of a 69‐year‐old male with an abdominal abscess after he underwent right hemi‐colectomy for cecum cancer with invasions into the ileum and sigmoid colon is reported. A re‐operation for lavage and drainage was performed 2 weeks after surgery. However, no obvious origin for the pus was located. Although physiological saline lavage was repeatedly performed, the effusion of pus persisted in the drain at the midline incision about 7 months after surgery. Then, fistuloscopy with an upper gastrointestinal endoscope was performed through the hole of the tube. A pinhole that produced a bubble just below the midline incision was observed. Then, an endoscopic retrograde cholangiopancreatography (ERCP) tube was inserted to obtain images of the small intestine by fluorography and findings suggested a diagnosis of perforation of the small intestine, which appeared to explain why resolution of the abscess was prolonged. After direct drainage to the small intestine with a 40‐cm‐long 7 Fr percutaneous transhepatic cholangio drainage (PTCD) balloon catheter, pus from the tube notably decreased. After confirming that the abscess cavity had disappeared by abdominal computed tomography scan, the PTCD catheter was extracted about 8 months after primary surgery. Since then, no recurrence of cancer or abscess has been observed. In cases of intractable postoperative intra‐abdominal abscess, fistuloscopy using smaller diameter gastrointestinal endoscopy appears to be a valuable diagnostic tool.
The Visual Aura Rating Scale (VARS) for Migraine Aura Diagnosis
Authors: Eriksen MK , Thomsen LL , Olesen J
Published: September 2005

To supplement the traditional ICHD-2 diagnosis for migraine with aura (MA) we developed a diagnostic scale for migraine aura that quantifies the importance of the cardinal characteristics of MA. Since more than 99% of MA patients have visual aura, we developed for simplicity a Visual Aura Rating Scale (VARS). In total 427 patients with MA (ICHD-2) or nonaura visual disturbances were diagnosed in a validated semistructured interview by a trained physician. The patients were separated into a derivation sample and a validation sample. By regression analysis we identified the visual aura characteristics associated with MA in the derivation sample. Based on the identified characteristics we developed VARS and derived a predictive VARS score which was tested in the validation sample. The VARS score is the weighted sum of the presence of five visual symptom characteristics: duration 5-60 min (3 points), develops gradually ≤5 min (2 points), scotoma (2 points), zig-zag lines (2 points), and unilateral (1 point). The maximum score is 10 points. A VARS score of 5 or more diagnosed MA with a sensitivity of 96% (95% CI 92-99%) and a specificity of 98%(95% CI 95-100%) in the derivation sample, and a sensitivity of 91% (95% CI 86-95%) and a specificity of 96% (95% CI 91-100%) in the validation sample. VARS adds evidence based weights to a number of clearly specified characteristics; it is easy to learn, apply and teach and may therefore be a valuable addition to traditional ICHD-2 diagnosis.
Chronic Daily Headache in Children and Adolescents: A Clinic Based Study from India
Authors: Chakravarty A
Published: September 2005

Chronic Daily Headache (CDH) is uncommon in Indian children compared to their adult counterpart. This is a retrospective study looking at the headache phenomenology of CDH in Indian children and adolescents. The validity of the case definitions of subtypes of chronic primary headaches mentioned in the HIS 2004 classification have been evaluated. 22 children (age range 8-15 years; M : F-16 : 6) diagnosed as having primary CDH using a modified definition seen between 2002 and 2003 have been studied. CDH has been defined as daily or near daily headaches > 15d/month for > 6 weeks. The rationale for this modified definition has been discussed. Majority of children (15/22) had a more or loss specified time of onset of regular headache spells resembling New Daily Persistent Headache (NDPH) but did not fulfil totally the diagnostic criteria of NDPH as laid down by IHS 2004. In all cases headache phenomenology included a significant vascular component. Headache phenomenology closely resembled Chronic Tension Type Headache (CTTH) in 4 patients and Chronic Migraine in 3 patients. However, in no patient in these groups, a history of evolution from the episodic forms of the diseases could be elicited. Heightened level of anxiety mostly related to academic stress and achievement was noted in the majority (19/22). Only a minority of patients (3/22) had anxiety and depression related to interpersonal relationships in the family. Medication overuse was not implicated in any patient. CDH in children in India is very much different from CDH in adults with the vast majority of patients exhibiting overlapping features of migraine and tension-type headache. There is need for a modified diagnostic criteria and terminology for chronic primary headaches in children.
Seasonal Variation in Migraine
Authors: Alstadhaug KB , Salvesen R , Bekkelund SI
Published: September 2005

Our group has previously shown that migraineurs, as opposed to individuals with other headaches, are more likely to have headache during the bright arctic summer than during the polar night season. We set out to investigate the impact of seasonal light exposure in migraine with and without aura. We performed a questionnaire-based study of 169 female volunteer migraineurs in an arctic area where light conditions during summer and winter seasons are extreme. We included 98 patients with migraine with aura (MA) and 71 with migraine without aura (MoA). One hundred and seven patients (63%) reported seasonal variation in migraine attack frequency. Close to half (47%) of patients with aura, but only 17% of patients without aura, reported more frequent attacks during the light season ( P < 0.001). Patients with MA reported interictal light hypersensitivity and light exposure as an attack precipitating factor significantly more often than individuals with MoA. They also reported significantly more frequent use of sunglasses to prevent attacks. We found no significant differences between MA and MoA as regards sleep disturbances, use of oral contraceptives, impact of headache or circadian variations. Seasonal periodicity of migraine in an arctic population with more frequent attacks during the light season is a convincing phenomenon in MA but not in MoA. The amount of light exposure seems to be pivotal to this variation.
Transobturator tape for stress incontinence: The North Queensland experience
Authors: NAIDU Aruku , LIM Yik Nyok , BARRY Christopher , GOODWIN Samuel , CORSTIAANS Audrey , RANE Ajay
Published: September 2005

A prospective observational study of 96 patients undergoing insertion of the MONARC transobturator tape (American Medical Systems, Minnetonka, USA) for treatment of urodynamic stress incontinence was conducted to investigate its’ the safety and efficacy. Although there were no major intraoperative complications, sling protrusion was observed in 11/91 patients (12.1%) at early follow up visits. At these visits, 80 women (87.9%) were either completely or substantially continent and 74 women (81.3%) were satisfied with the operation. Objectively, 74 women (81.3%) were cured on urodynamic assessment and only one woman (1.1%) was found to have voiding dysfunction. As a conclusion, it would appear that this new technique is effective for the treatment of stress incontinence; but further studies are needed to investigate its long‐term results and complications.
An anonymous survey of provincial, rural and remote obstetricians’ long‐term practice intentions; Implications for the provision of specialist obstetric services outside metropolitan areas in Australia
Authors: ROBSON Stephen , BLAND Peter , BUNTING Michael
Published: September 2005

Background:  Objective data and anecdotal reports suggest that non‐metropolitan Australia may face a severe shortage of specialist obstetricians in the near future.

Aims:  To assess the workload and practice intentions of specialist obstetricians working in provincial, rural and remote areas of Australia.

Methods:  1. A structured questionnaire posted to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) who undertake part or all of their work in provincial, rural or remote areas of Australia. 2. A telephone survey of all non‐metropolitan hospitals in Australia.

Main outcome measures:  Demographic data (e.g. age, sex); length of time working in the area; practice characteristics; professional supports; workload; intentions for future practice; factors that might improve practice satisfaction.

Results:  Approximately 30% of Australia's births occur in non‐metropolitan hospitals, of which 57% do not currently have specialist obstetric cover. Survey response rate of 73%. The rural workforce is older than the metropolitan demographic, and almost half of respondents intended to cease obstetric practice within 5 years.

Conclusions:  These data may presage a major public health crisis for rural Australia.
Uptake of HIV screening in an antenatal clinic
Authors: GROVER Sonia , PETTERSON Claire
Published: September 2005

Objective:  To assess the uptake of HIV screening in pregnant women attending a tertiary hospital antenatal clinic.

Methods:  An audit was undertaken in an antenatal clinic where HIV screening was routinely offered to all women following counselling. For the women offered HIV testing, note was taken whether the woman agreed to testing or refused, and if so, the reason for refusal.

Results:  Sixty eight percent of women who were offered testing opted to have the test performed. Thirty two percent of women decided against testing, with half of these reporting a recent (negative) HIV test result.

Conclusions:  Over 80% of pregnant women were willing to have HIV testing.

Implications:  With the introduction of recommendations that all pregnant women be given the opportunity for HIV screening, a high participation rate can be expected from women who are offered testing, with the potential for minimisation of vertical transmission by identification of HIV positive women.
Tissue Fixation System posterior sling for repair of uterine/vault prolapse – A preliminary report
Authors: PETROS Peter E. P. , RICHARDSON Peter A.
Published: September 2005

Aims:  To assess the posterior Tissue Fixation System (TFS) sling for repair of uterine/vault prolapse.

Patients and methods:  The TFS comprises of two small polypropylene soft tissue anchors connected to an adjustable polypropylene tape. The posterior TFS sling works much like a McCall procedure. The anchors are inserted just lateral to the uterosacral ligaments. Tightening the sling elevates the prolapsed uterus/vaginal vault. The study group comprised 67 patients who were assessed with a 24‐h urinary diary, structured questionnaire, transperineal ultrasound, urodynamics, cough stress test, and 24‐h pad test, pre and postoperatively.

Results:  Sixty‐seven patients, mean age 65 years (35–87), mean weight 71 kg (38–117 kg), mean 1.6 previous pelvic operations, underwent posterior sling (level 1) repair for uterine/vault prolapse (fourth degree: n = 2; third degree: n = 17; second degree: n = 20; symptomatic first degree: n = 28). Level 2 (n = 18) and level 3 repairs (n = 18) were also performed as required. One patient was lost to the study. At mean 9 months’ review (3–15 months), the prolapse repair had been successful in all but one patient. There were however, 14 de novo herniations postoperatively (20%), cystocoele 12, enterocoele 1, rectocoele 1. Operating time for the sling only was 5–10 min, and mean hospital stay was 1.5 days. Minimal analgesia was required.

Conclusions:  The preliminary results indicate that the TFS posterior sling appears to work well in patients with uterine/vault prolapse. Longer term follow up and studies by other surgeons are required to fully evaluate this procedure.
Maternal and neonatal morbidity after first vaginal delivery using Thierry's spatulas
Authors: MAZOUNI Chafika , BRETELLE Florence , COLLETTE Emmanuelle , HECKENROTH Hélène , BONNIER Pascal , GAMERRE Marc
Published: September 2005

Objective:  To analyse maternal and neonatal morbidity associated with instrumental delivery using Thierry's spatulas.

Methods:  Between January 2001 and December 2003, 570 nulliparous women with term, singleton, cephalic pregnancies gave birth by either instrumental (n = 279) or spontaneous vaginal delivery (n = 291) and were studied in a retrospective case‐control study. Maternal and neonatal morbidity were compared in the instrumental vs. spontaneous delivery groups.

Results:  Women who underwent instrumental delivery using Thierry's spatula were more likely to have severe perineal tears (ORa 7.5, 95% CI 1.5, 32.3), urinary retention (OR 2.7, 95% CI 1.3, 5.6), postpartum blood loss (ORa 3.4, 2.4, 4.9) and extended hospital stay (OR 3.21, 95% CI 2.3, 4.6) than women having a spontaneous vaginal birth. Regarding the infant, one case of subgaleal haematoma was noted. No significant difference was noted in neonatal period.

Conclusion:  This data support the safety of Thierry's spatula on infant outcome. Maternal morbidity observed with Thierry spatulas was similar to that reported in the literature for other modes of instrumental delivery but the risk for perineal morbidity was higher than for spontaneous delivery. Neonatal morbidity appeared to be limited.
Oronasopharyngeal suction versus no suction in normal, term and vaginally born infants: A prospective randomised controlled trial
Authors: GUNGOR Sadettin , TEKSOZ Ertan , CEYHAN Temel , KURT Ercan , GOKTOLGA Umit , BASER İskender
Published: September 2005

This prospective randomised controlled trial aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term and vaginally born infants and was performed at a Turkish tertiary hospital from June 2003 to January 2004. A total of 140 newborns were enrolled in the trial (n = 70 per group). The no suction group showed lower mean heart rates through the 3rd and 6th minutes and higher SaO2 values through the first 6 mins of life (P < 0.001). The maximum time to reach SaO2 of ≥ 92% (6 vs. 11 min) and ≥ 86% (5 vs. 8 min) were shorter in the no suction group (P < 0.001).
Prevalence of rectocele in young nulliparous women
Authors: DIETZ Hans P. , CLARKE Barton
Published: September 2005

Background:  It is generally assumed that fascial defects in the rectovaginal septum are the result of childbirth. However, rectoceles do occur in women who have never delivered vaginally.

Aims:  To determine the incidence of rectocele in a cohort of asymptomatic, young nulliparous women.

Methods:  Observational cohort study on 178 nulliparous caucasian women (aged 18–24) recruited for a twin study of pelvic floor dysfunction. All women were interviewed and examined by translabial ultrasound, supine and after voiding. In 52 women, 3D imaging was obtained and 171 datasets were complete and available for analysis. Ultrasound findings were reviewed for rectovaginal septal integrity by an assessor blinded against interview and demographic data for rectovaginal septal integrity.

Results:  A discontinuity of the anterior rectal wall with extrusion of rectal mucosa or contents (depth of ≥ 10 mm) was observed in 21/171 (12%). The depth of this herniation ranged from 10 to 25 mm and was filled with stool (n = 10) or rectal mucosa (n = 11). Defects were associated with a higher BMI (P = 0.049), with the complaint of constipation (P = 0.049) and non‐significantly with straining at stool (P = 0.09). Descent of the ampulla to beyond the level of the symphysis pubis without fascial defect, that is, significant perineal relaxation, was observed in 23/171 (13%).

Conclusions:  Twelve percent of 171 young nulligravid caucasian women showed a defect of the rectovaginal septum. Associations were observed with higher body mass index and a history of constipation. It is hypothesised that in some women defects of the rectovaginal septum and perineal hypermobility may be congenital in nature.
A preliminary survey of Atopobium vaginae in women attending the Dunedin gynaecology out‐patients clinic: Is the contribution of the hard‐to‐culture microbiota overlooked in gynaecological disorders?
Authors: BURTON Jeremy P. , CHILCOTT Chris N. , AL‐QUMBER Mohammed , BROOKS Heather J. L. , WILSON Don , TAGG John R. , DEVENISH Celia
Published: September 2005

Preliminary studies have indicated that the recently described bacterium Atopobium vaginae may have an association with bacterial vaginosis (BV). Fifty‐five women attending the gynaecology out‐patient's clinic were tested for the presence of this micro‐organism, Gardnerella vaginalis, Mobiluncus and Bacteroides species by polymerase chain reaction (PCR)‐based assays. The frequency of detection was 40%. PCR detection of Gardnerella vaginalis with A. vaginae, occurred in 50% of A. vaginae‐positive cases. Due to the high detection rate of A. vaginae we believe that it is important to determine whether this and other hard‐to‐culture microorganisms have a role in gynaecological disorders.
Foetal response to music and voice
Authors: AL‐QAHTANI Noura H.
Published: September 2005

Objective:  To examine whether prenatal exposure to music and voice alters foetal behaviour and whether foetal response to music differs from human voice.

Subjects and methods:  A prospective observational study was conducted in 20 normal term pregnant mothers. Ten foetuses were exposed to music and voice for 15 s at different sound pressure levels to find out the optimal setting for the auditory stimulation. Music, voice and sham were played to another 10 foetuses via a headphone on the maternal abdomen. The sound pressure level was 105 db and 94 db for music and voice, respectively. Computerised assessment of foetal heart rate and activity were recorded. 90 actocardiograms were obtained for the whole group. One way anova followed by posthoc (Student‐Newman‐Keuls method) analysis was used to find if there is significant difference in foetal response to music and voice versus sham.

Results:  Foetuses responded with heart rate acceleration and motor response to both music and voice. This was statistically significant compared to sham. There was no significant difference between the foetal heart rate acceleration to music and voice.

Conclusion:  Prenatal exposure to music and voice alters the foetal behaviour. No difference was detected in foetal response to music and voice.
Abdominal sacral colpopexy: an independent prospective long‐term follow‐up study
Authors: HIGGS Peta , GOH Judith , KRAUSE Hannah , SLOANE Kate , CAREY Marcus
Published: September 2005

Aims:  The aim of the study was to provide a long‐term follow up of subjective and objective outcomes following sacral colpopexy.

Methods:  A cohort of 148 women who had undergone sacral colpopexy in a tertiary unit between 1998 and 2001 were contacted for follow‐up. Women were questioned about current symptoms including patient determined subjective measures and the Baden‐Walker site specific examination for vaginal prolapse was performed.

Results:  Ninety‐three women were able to be contacted for review. Of these, 64 were available for clinical examination and a further 29 were available for telephone interview. Of those women examined 62 had good vault support. Therefore, recurrent vault prolapse was uncommon at 3%. Recurrent prolapse was present in other vaginal compartments in 40.6% of women. Subjectively 78% of women felt that their prolapse symptoms had resolved and 65% had a visual analogue score (VAS) ≥ 80, indicating satisfaction with the surgery. Stress urinary incontinence symptoms decreased at this long‐term review, however, 24% of women required further incontinence surgery.

Conclusions:  Abdominal sacral colpopexy is an effective technique for the management of vaginal vault prolapse, with a two‐year successful outcome in excess of 90%. Further study is required to investigate recurrent prolapse in other vaginal compartments and the functional aspects following surgery.
Prediction of laparoscopic surgery outcomes in tubal infertility
Authors: KUDAIBERDIEVA Anara , KANGELDIEVA Aygul
Published: September 2005

This study aimed to elucidate the predictive value of hysterosalpingography (HSG) and laparoscopy (LS) scores for spontaneous pregnancy after laparoscopic surgery in 50 patients with tubal infertility. During a 1‐year follow‐up period, 28% of these patients became pregnant. Both scores were informative in prediction of pregnancy with the area under the ROC curve being 0.80 (95% CI 0.67–0.93) and 0.74 (95% CI 0.58–0.89) for LS and HSG scores, respectively.
Bleeding disorders in teenagers presenting with menorrhagia
Authors: JAYASINGHE Yasmin , MOORE Patricia , DONATH Susan , CAMPBELL Janine , MONAGLE Paul , GROVER Sonia
Published: September 2005

Objective:  To assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women.

Design:  A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia.

Setting:  Inpatient and outpatients of a tertiary adolescent gynaecology service.

Patients:  Subjects aged 9–19 years with menorrhagia who had coagulation tests performed, and who did not have a known bleeding disorder prior to presentation were included.

Outcome measures:  A bleeding screen was performed to assess prevalence of bleeding disorders in the population. Variables that were investigated as predictive of a bleeding disorder included clinical history, family history, and haematological indices of blood loss.

Results:  The prevalence of an inherited bleeding disorder was 10.4%. The only statistically significant predictor was a family history of bruising and bleeding. Menstrual history was not predictive.

Conclusion:  Severity of menstrual loss was not predictive of a bleeding disorder, as a significant cause of teenage metrostaxis is due to anovulatory dysfunctional uterine bleeding. The authors recommend that a careful personal and family history of bruising and bleeding be taken in all teenagers who present de novo with menorrhagia. Routine screening in a primary care setting is impractical, but should be mandatory in all patients with a positive family history.
Treatment of Helicobacter pylori
Authors: Bytzer Peter , O'Morain Colm
Published: September 2005

The efficacy of established Helicobacter pylori regimes needs to be reviewed. In view of drug resistance, side effects, and compliance and expense of therapy, treatment failure is increasing and second‐line treatment strategies need to be developed. A simulation model suggested by the Cochrane review group showed that H. pylori eradication is cost‐effective for duodenal and gastric ulcer long‐term. The duration of eradication therapy continues to be controversial. In Europe and other parts of the world, 7‐day triple regimes are used, whereas guidelines from the United States recommend 10–14 days of therapy. Antibiotic resistance is a major factor affecting the outcome of eradication therapy. New modified eradication regimes involve substitution of antibiotics used in conjunction with other drugs. The newer generation fluoroquinolones have shown some promise as part of an eradication regimen. Quadruple therapy (bismuth, proton pump inhibitor [PPI] and two antibiotics and sequential treatment [PPI with three antibiotics]) are promising first‐line treatments. Novel agents have been tried, but with disappointing results. New drugs and administration forms have been reported but their efficacy needs confirmation.
Helicobacter pylori and Extragastric Diseases – Other Helicobacters
Authors: Nilsson Hans‐Olof , Pietroiusti Antonio , Gabrielli Maurizio , Zocco Maria Assunta , Gasbarrini Giovanni , Gasbarrini Antonio
Published: September 2005

The involvement of Helicobacter pylori in the pathogenesis of extragastric diseases continues to be an interesting topic in the field of Helicobacter‐related pathology.

Although conflicting findings have been reported for most of the disorders, a role of H. pylori seems to be important especially for the development of cardiovascular and hematologic disorders.

Previously isolated human and animal Helicobacter sp. flexispira and “Helicobacter heilmannii” strains have been validated using polyphasic taxonomy. A novel enterohepatic Helicobacter has been isolated from mastomys and mice, adding to the list of helicobacters that colonize the liver. Genetic targets that may aid the classification of novel Helicobacter species have emerged. Animal models of Helicobacter‐induced gastric and hepatobiliary diseases have offered insights to the mechanisms associated with premalignant transformation.
Epidemiology of Helicobacter pylori Infection
Authors: Kikuchi Shogo , Dore Maria P.
Published: September 2005

This review summarizes epidemiologic studies published between April 2004 and March 2005. DNA of Helicobacter pylori was detected in river water, but the culture was unsuccessful. H. pylori infection was associated with Shigella infection. Despite many studies, predominant infection routes of H. pylori have not yet been clearly identified. In some limited populations in developing countries, H. pylori infection was rare or with strange distributions. Trials to reduce the H. pylori infection rate were performed including H. pylori eradication in total family units and fly control.

The hypothesis of a causal role of Helicobacter species and H. pylori infection in cancer of the hepatobiliary tract was indeed confirmed.
Diagnosis of Helicobacter pylori Infection
Authors: Krogfelt Karen A. , Lehours Philippe , Mégraud Francis
Published: September 2005

A large number of studies on diagnostic tests have been published this year. New tests were proposed for the detection of Helicobacter pylori antigens in stools and new molecular methods (real‐time polymerase chain reaction) to look for antimicrobial susceptibility. The other standard tests have been applied in different situations to improve the diagnosis of the infection.
Widespread Electroanatomic Alterations of Right Cardiac Chambers in Patients with Myotonic Dystrophy Type 1
Authors: RUSSO ANTONIO DELLO , PELARGONIO GEMMA , PARISI QUINTINO , SANTAMARIA MATTEO , MESSANO LOREDANA , SANNA TOMMASO , CASELLA MICHELA , DE MARTINO GIUSEPPE , DE PONTI ROBERTO , PACE MANUELA , GIGLIO VINCENZO , IERARDI CAROLINA , ZECCHI PAOLO , CREA FILIPPO , BELLOCCI FULVIO
Published: September 2005

Introduction: Conduction disturbances and arrhythmias characterize the cardiac feature of myotonic dystrophy type 1 (MD1); a myocardial involvement has been suggested as part of the cardiac disease. The aim of our study was to investigate the underlying myocardial alterations using electroanatomic mapping (CARTO) and their possible correlation with genetic and neurological findings.

Methods and Results: Right atrial and ventricular CARTO maps were obtained in 13 MD1 patients. Thirteen age‐matched patients with paroxysmal supraventricular tachycardia and normal heart served as controls. Unipolar voltage (UNI‐v), bipolar voltage (BI‐v) amplitudes, bipolar potential duration (Bi‐dur), and atrial propagation time (A‐pt) were measured. UNI‐v and BI‐v in interatrial septum, anterolateral atrial wall, and right ventricle outflow tract were lower in MD1 patients than controls (P < 0.001). Bi‐dur and A‐pt were longer in MD1 patients than controls (P < 0.001, P = 0.046, respectively). A significant relationship was documented between CTG triplets and the percentage of Bi‐v <0.5 mV in the atrial anteroseptal region (r = 0.6, P = 0.02).

Conclusions: Altered electroanatomic patterns are present in the right cardiac chambers in MD1 patients. Widespread myocardial alterations, not necessarily limited to the conduction system, may support the presence of a cardiac myopathy as part of the disease.