bluuebunny/crossref_metadata_2025 huggingface dataset:
Three‐dimensional passive seismic waveform imaging around the SAFOD site, California, using the generalized Radon transform
Authors: Zhang Haijiang , Wang Ping , van der Hilst Robert D. , Toksoz M. Nafi , Thurber Clifford , Zhu Lupei
Published: December 2009

We apply a three‐dimensional (3D) generalized Radon transform (GRT) to scattered P‐waves from 575 local earthquakes recorded at 68 temporary network stations for passive‐source imaging of (near‐vertical) structures close to the San Andreas Fault Observatory at Depth (SAFOD) site. The GRT image profiles through or close by the SAFOD site reveal near‐vertical reflectors close to the fault zone as well as in the granite to the southwest and the Franciscan mélange to the northeast of the main fault. Although slightly lower in resolution, these structures are generally similar to features in 2D images produced with steep‐dip prestack seismic migration of data from active source seismic reflection and refraction surveys. Our GRT images, however, also reveal several vertical reflectors to the northeast of the SAF that do not appear in the migration images but which are consistent with local geology. These results suggest that in a seismically active area, inverse scattering of earthquake data (for instance with the GRT) can be a viable and, in 3D, economic alternative to an active source survey.
Nonlinear shallow water tropical instability waves on the equatorial β‐plane: Genesis of two distinct types of waves
Authors: Zhou C. , Boyd J. P.
Published: December 2009

The nonlinearity of Tropical Instability Waves (TIWs) is studied using shallow‐water equations with various mean states from the equatorial Pacific Ocean. In the early linear stage, unstable TIWs, centered near 5°N with a wavelength about 1000 km and a period about one month, dominate the whole domain. However neutral Yanai waves with periods about 15–22 days emerge near the equator when the unstable TIWs grow into fully nonlinear vortices and begin to rotate, which stabilizes the mean states substantially. The strength of these Yanai waves are sensitive to the instability of the initial mean flow. Meanwhile the TIWs centered near 5°N are slowed down and weakened. The external forcing terms are found to be important for them to retain their dominance from 3°N to 7°N and also be able to suppress the late emerging Yanai waves if strong enough.
Earth oblateness changes reveal land ice contribution to interannual sea level variability
Authors: Marcus Steven L. , Dickey Jean O. , Willis Josh K. , Seitz Florian
Published: December 2009

A broad consensus has emerged regarding the importance of both ocean mass and heat content changes for global sea level (GSL) rise, but their respective contributions to interannual GSL variability are less certain. Here, we use changes in the Earth's dynamic oblateness (J2) to infer land ice contributions to GSL variability during a 10.5‐year period encompassing the intense 1997–98 ENSO event. By accounting for heat content and water mass distribution changes in the oceans, atmosphere and land hydrology using observational and model results, we isolate unexplained residuals in J2 and GSL that are well‐correlated with each other and with melt‐season temperature and mass balance anomalies in Alaska, a particularly active and well‐studied glaciated region. The close agreement between residual GSL and oblateness variations found in our results indicates that the latter can provide a useful proxy for changes in high‐latitude land ice when corrections for other sources are applied.
Equatorial and low‐latitude ionosphere‐thermosphere system response to the space weather event of August 2005
Authors: Sreeja V. , Ravindran Sudha , Pant Tarun Kumar , Devasia C. V. , Paxton L. J.
Published: December 2009

The response of the equatorial and low‐latitude ionosphere‐thermosphere system to the geomagnetic storm during 23–26 August 2005 is investigated. The study is carried out using the vertical total electron content (VTEC) measured by GPS receivers along the 77–78°E longitude and the O/N2 ratio obtained from the Global Ultraviolet Imager instrument on board the TIMED satellite. The equatorial ionization anomaly (EIA) shows a poleward latitudinal expansion on 24 August, probably associated with an eastward prompt‐penetration electric field. The equatorial and low latitudes show an increase in VTEC during the main phase of the storm on 24 August. The prompt‐penetration eastward electric field, along with an increase in the O/N2 ratio, could be responsible for this observed positive phase. The VTEC variations on 24 August also reveal the signature of a large‐scale acoustic gravity wave/traveling atmospheric disturbance propagating with a horizontal velocity of ∼750 m/s. Suppression of the EIA is observed during the storm recovery phase on 25 August, which probably is associated with the westward disturbance dynamo electric field and the equatorward expansion of the neutral composition changes (O/N2 depletion).
Strong postmidnight equatorial ionospheric anomaly observations during magnetically quiet periods
Authors: Yizengaw Endawoke , Moldwin Mark B. , Sahai Yogeshwar , de Jesus Rodolfo
Published: December 2009

We have examined the quiet time equatorial electrodynamics of the ionosphere in the postmidnight sector using satellite, GPS total electron content (TEC) and ionosonde data. ROCSAT‐1 vertical drift data are used to estimate the equatorial ionosphere electrodynamics, TOPEX altimeter and GPS TEC are used to obtain the density structure of the ionosphere. Ionosonde data measure the postmidnight F layer height as function of local time. We analyzed 4 years (2001–2004) of quiet time (Kp ≤ 3) observations in the postmidnight sector. We found that very strong equatorial ionospheric anomalies (EIAs) in the postmidnight (0100–0500 LT) sector during magnetically quiet periods are common and are capable of disrupting satellite communication and navigation systems. The coordinated multi‐instrument observations clearly demonstrate that these strong EIAs are not simply the EIAs observed in earlier local time sectors that have corotated into the postmidnight sector as has been suggested by previous studies. We demonstrate that they are triggered by a reversed vertically upward drift, which is suggested to be generated by thermospheric neutral wind through F region dynamo. This clearly demonstrates that the Earth's postmidnight ionosphere is dynamic even in magnetically quiet periods contrary to simple theoretical model predictions.
Interseismic deformation associated with three‐dimensional faults in the greater Los Angeles region, California
Authors: Marshall Scott T. , Cooke Michele L. , Owen Susan E.
Published: December 2009

Existing interseismic models are not well‐suited to simulate deformation within the network of finite, intersecting, nonplanar faults observed in the greater Los Angeles region. Instead of applying fault slip rates to a model a priori, we allow three‐dimensional fault surfaces to interact and accumulate mechanically viable slip distributions and then use the deep nonseismogenic portion of slip to calculate interseismic deformation. We apply this approach to the Los Angeles region and find that the geologic timescale model results match well geologic slip rate data and the interseismic timescale model results match well the heterogeneous GPS velocity pattern in the Los Angeles region. Model results suggest that localized geodetic convergence in the San Gabriel basin can be achieved with slip on multiple active fault surfaces in the Los Angeles region including relatively fast slip on the Sierra Madre fault and slow slip on the Puente Hills thrusts, in agreement with geologic data. The ability of the three‐dimensional model to reproduce well both geologic slip rates and interseismic geodetic velocity patterns suggests that current day contraction rates in the greater Los Angeles region are compatible with long‐term geologic deformation rates and disputes suggestions of significant temporal variations in fault slip rates inferred from existing investigations.
Lagrangian modeling of advection‐diffusion transport in open channel flow
Authors: Devkota Bishnu H. , Imberger Jörg
Published: December 2009

A fully Lagrangian method is presented for the accurate simulation of advection‐diffusion transport in both steady and unsteady open channel flows. Numerical results are presented for Gaussian tracer distributions, top hat tracer distributions, and steep tracer fronts (step function) profiles in a uniform flow and are compared against analytical solutions and against the results obtained with an Eulerian Quadratic Upstream Interpolation for Convective Kinematics with Estimated Streaming Terms (QUICKEST) method. It is demonstrated that the Lagrangian scheme can totally eliminate numerical diffusion and oscillations including those normally observed in steep frontal regions in most Eulerian schemes. In steady, uniform flow, the scheme allowed a large time step to be used and provides exact solutions for a wide range of Courant numbers (results are presented for Cr from 0 to 20) and for an entire range of grid Peclet numbers (from 0 to infinity). These simulation results for a uniform flow were extended to flows due to simple waves, solitary waves, and undular bores; again, the scheme produced excellent results. It is shown that the simple Lagrangian model is an efficient and accurate tool to predict transport in advection dominated systems, and when it is coupled with the new Lagrangian river model, the dynamic river model, it can be an ideal model for long‐term and large‐scale simulation of transport for water quality in river systems and for transport with steep frontal regions.
PPAR‐γ agonist inhibits Ang II‐induced activation of dendritic cells via the MAPK and NF‐κB pathways
Authors: Wei‐guo Zhu , Hui Yan , Shan Li , Yun Zhang , Wen‐cheng Nie , Fu‐lin Yu , Fang‐yan Fan , Jun‐hua Ge , Jian‐hua Zhu
Published: December 2009

The renin‐angiotensin system exerts a profound regulatory effect on the functional features of dendritic cells (DCs), thus suggesting a new target of angiotensin II (Ang II) action in the immune system. This study analyzed whether peroxisome proliferator‐activated receptor‐gamma (PPAR‐γ) activation in DCs regulated Ang II‐induced activation of DCs and exploited the possible molecular mechanisms, especially focused on the signaling pathways of mitogen‐activated protein kinase (MAPK) and nuclear factor‐kappa B (NF‐κB). Ang II stimulation of human monocyte‐derived DCs resulted in an intermediate state of DC maturation and function via modulating the balance of the negative or positive regulation of the signaling pathways of extracellular regulated kinase (ERK), p38 MAPK and NF‐κB, but not c‐Jun N‐terminal kinase (JNK). Moreover, pretreatment of DCs with the PPAR‐γ agonist pioglitazone reverted these effects of Ang II on DCs via suppression of the MAPK and NF‐κB signaling pathways at least in part. Collectively, our data support the notion that PPAR‐γ activation in human DCs inhibits the activation of DCs induced by Ang II, with which involves the regulation of MAPK and NF‐κB signaling pathways. These findings may support the important role of these mediators in the regulation of DC‐mediated inflammatory and immunologic processes.
Paclitaxel inhibits killing by murine cytotoxic T lymphocytes in vivo but not in vitro
Authors: Robinson Marcus James , Ronchese Franca , Miller John H , La Flamme Anne Camille
Published: December 2009

To kill antigen‐specific target cells (TCs), cytotoxic T lymphocytes (CTLs) reorganise their microtubule cytoskeleton to deliver lytic granules to the TCs. We used two drugs that stabilise microtubules, paclitaxel and peloruside, to determine how the stabilising microtubule network affects CTL function in vitro and in vivo. In vitro, neither paclitaxel nor peloruside inhibited antigen‐specific killing, lytic granule delivery to the cell surface, nor interferon‐γ release by murine CTLs. In contrast, in an in vivo murine model of antigen‐induced killing, a single dose of paclitaxel had a significant inhibitory effect on killing by CTLs. Furthermore, the inhibitory effect of paclitaxel was not caused by specific deletion of the effector CTL population in drug‐treated mice. The findings reveal that microtubule‐stabilising drug treatment can lead to immediate impairment of CTL function without affecting lytic granule release. The results also suggest that patients undergoing taxane anti‐cancer therapy may be impaired in their ability to fight infection before the anti‐mitotic effects of paclitaxel are apparent.
Deligne–Beilinson cohomology and Abelian link invariants: Torsion case
Authors: Thuillier F.
Published: December 2009

For the Abelian Chern–Simons field theory, we consider the quantum functional integration over the Deligne–Beilinson cohomology classes and present an explicit path-integral nonperturbative computation of the Chern–Simons link invariants in SO(3)≃RP3, a toy example of a 3-manifold with torsion.
Amorphous silicon as electron transport layer for colloidal semiconductor nanocrystals light emitting diode
Authors: Song Tao , Zhang Fute , Shen Xiaojuan , Zhang Xiaohong , Zhu Xiulin , Sun Baoquan
Published: December 2009

We demonstrate the fabrication of light-emitting diodes (LEDs) made from all-inorganic colloidal semiconducting nanocrystals (NCs). The diode utilizes a sandwich structure formed by placing CdSe/CdS NCs between two layers of Si and AgxO, which act as electron- and hole-transporting materials, respectively. The photoluminescence properties of NCs are rendered less dependent upon surface chemistry and chemical environment by growing a thick CdS shell. It also enhances stability of the NCs during the process of magnetron sputtering for silicon deposition. The resulting LED device exhibits a low turn-on voltage of 2.5 V and the maximum external quantum efficiency of nearly 0.08%.
Interactions of charged particles on surfaces
Authors: Lawandy Nabil M.
Published: December 2009

Charges of the same polarity bound to a surface with a large dielectric contrast exhibit an attractive long-range Coulomb interaction, which leads to a two-particle bound state. Ensembles of like charges experience a collective long-range interaction, which results in compacted structures with interparticle separations that can be orders of magnitude smaller than the equilibrium separation of the pair potential minimum. Simulations indicate that ensembles of surface bound nuclei, such as D or T, exhibit separations small enough to result in significant rates of fusion.
Nanosize confinement induced enhancement of spontaneous polarization in a ferroelectric nanowire
Authors: Cai M. Q. , Zheng Y. , Wang B. , Yang G. W.
Published: December 2009

We theoretically showed that the spontaneous polarization in ferroelectric (FE) nanowires (NWs) can be considerably enhanced due to the nanosize confinement by the first-principles calculations. The spontaneous polarization along the wire direction in a fully relaxed PbTiO3 NW with 1.8 nm diameter is 1.26 times higher than that of bulk counterpart. The tension induced by NW surface curvature counteracts the near-surface depolarizing effect and meanwhile leads to the unusual enhancement of spontaneous polarization. These findings indicated that FE NWs can be promising in the applications of nanodevices.
Soft mode behavior in SrTiO3/DyScO3 thin films: Evidence of ferroelectric and antiferrodistortive phase transitions
Authors: Nuzhnyy D. , Petzelt J. , Kamba S. , Kužel P. , Kadlec C. , Bovtun V. , Kempa M. , Schubert J. , Brooks C. M. , Schlom D. G.
Published: December 2009

Infrared reflectance, terahertz transmittance, and microwave resonance measurements show that SrTiO3 films, strained by ∼1% in biaxial tension by growing them on (110) DyScO3 substrates, undergo a pronounced phonon softening near 270 K. This in-plane soft-mode drives the ferroelectric transition. The appearance of two new low-frequency modes and splitting of the high-frequency TO4 mode provide evidence of an antiferrodistortive phase below ∼180 K.
Room temperature piezoelectric displacement detection via a silicon field effect transistor
Authors: Mahboob I. , Nishiguchi K. , Fujiwara A. , Yamaguchi H.
Published: December 2009

An electromechanical oscillator embedded with a two dimensional electron gas is capacitively coupled to a silicon field effect transistor (Si-FET). The piezovoltage induced by the mechanical motion modulates the current passing through the Si-FET enabling the electromechanical oscillator’s position to be monitored. When the Si-FET is biased at its optimal point, the motion induced piezovoltage can be amplified resulting in a displacement sensitivity of 6×10−12 mHz−1/2 for a 131 kHz GaAs resonator which is among the highest recorded for an all-electrical room temperature detection scheme.
Tbx4/5
gene duplication and the origin of vertebrate paired appendages
Authors: Minguillon Carolina , Gibson-Brown Jeremy J. , Logan Malcolm P.
Published: December 2009

Paired fins/limbs are one of the most successful vertebrate innovations, since they are used for numerous fundamental activities, including locomotion, feeding, and breeding. Gene duplication events generate new genes with the potential to acquire novel functions, and two rounds of genome duplication took place during vertebrate evolution. The cephalochordate amphioxus diverged from other chordates before these events and is widely used to deduce the functions of ancestral genes, present in single copy in amphioxus, compared to the functions of their duplicated vertebrate orthologues. The T-box genes
Tbx5
and
Tbx4
encode two closely related transcription factors that are the earliest factors required to initiate forelimb and hind limb outgrowth, respectively. Since the genetic components proposed to be responsible for acquiring a trait during evolution are likely to be involved in the formation of that same trait in living organisms, we investigated whether the duplication of an ancestral, single
Tbx4/5
gene to give rise to distinct
Tbx4
and
Tbx5
genes has been instrumental in the acquisition of limbs during vertebrate evolution. We analyzed whether the amphioxus
Tbx4/5
gene is able to initiate limb outgrowth, and assayed the amphioxus locus for the presence of limb-forming regulatory regions. We show that
AmphiTbx4/5
is able to initiate limb outgrowth and, in contrast, that the genomic locus lacks the regulatory modules required for expression that would result in limb formation. We propose that changes at the level of
Tbx5
and
Tbx4
expression, rather than the generation of novel protein function, have been necessary for the acquisition of paired appendages during vertebrate evolution.
Transvaginal repair of enterocele and vaginal vault prolapse using autologous fascia lata graft
Authors: Mølsted‐Pedersen Lars , Rudnicki Martin , Lose Gunnar
Published: December 2009

Background. The aim was to describe the operative technique of transvaginal repair of enterocele and apical prolapse using autologous fascia lata and report intra‐ and postoperative complications and long‐term outcome.

Methods. A retrospective chart review of 74 consecutive patients who had repair of a symptomatic enterocele and vaginal vault prolapse or uterine prolapse from January 1987 to August 1999. All patients were followed for a minimum of 3 months and 61 were available for long‐term evaluation at 18–106 months (median 52 months).

Results. Intra‐ and postoperative complications were few. Pelvic examination at long‐term follow‐up disclosed a recurrence rate for enterocele of 1.7%, vaginal vault prolapse of 8.3%, and cystocele of 15%. Ninety‐one per cent were subjectively satisfied with the relief of mechanical vaginal symptoms. Only 35% (6/17) were cured of constipation. Out of the 22 women who were sexually active after the procedure, 12 (54%) experienced improved quality.

Conclusion. Repair of the posterior compartment defect and suspension of the vaginal vault using autologous fascia lata graft provides acceptable intra‐ and postoperative complication and long‐term results.
Analysis of two polymorphisms in the promoter region of matrix metalloproteinase 1 and 3 genes in women with endometriosis
Authors: FERRARI MARIA MADDALENA , BIONDI MARIA LUISA , ROSSI GABRIELA , GRIJUELA BARBARA , GAITA SARA , PERUGINO GIUSEPPE , VIGANÒ PAOLA
Published: December 2009

Background. Matrix metalloproteinases are a family of proteolytic enzymes that can degrade extracellular matrix components and have been implicated in connective tissue remodeling associated with cancer invasion and metastasis. These proteins are also involved in the invasive events underlying endometriotic lesion formation and aggressive behavior. Given the established genetic background of endometriosis, the aim of this study was to examine the potential impact of two polymorphisms in the gene promoter region of two of these enzymes, matrix metalloproteinases 1 and 3, on predisposition and severity of the disease. Methods. Genomic DNA was obtained from 56 Italian Caucasian women with a surgical diagnosis of endometriosis and a control group of 71 age‐matched Caucasian healthy female blood donors. In control women, endometriosis was ruled out by evaluation of the medical history, gynecologic examinations, and ultrasound scanning. Two polymorphisms have been specifically investigated: 1. a single insertion polymorphism (2G) in the matrix metalloproteinase‐1 promoter region known to elevate transcriptional level of matrix metalloproteinase‐1; and 2. a single insertion/deletion polymorphism (5A/6A) located in the promoter of the matrix metalloproteinase‐3 gene with functional significance in the regulation of its expression. Genotypes were determined by PCR amplification and sequence analysis. Results. Allele and genotype frequencies of both polymorphisms did not significantly differ between endometriosis and control groups. Moreover, no significant difference for both polymorphisms was observed in relation to the clinical stage and recurrence status of the disease. Conclusions. This is the first study that has evaluated the possibility that gene variants of matrix metalloproteinases might be involved in the susceptibility to endometriosis. However, these results suggest that matrix metalloproteinases 1 and 3 promoter polymorphisms do not constitute an important factor for the genetic predisposition to endometriosis and its invasive behavior in the Italian population.
Serum levels of activin A and inhibin A are not related to the increased susceptibility to pre‐eclampsia in type I diabetic pregnancies
Authors: EKBOM PIA , DAMM PETER , ANDERSSON ANNA‐MARIA , SKAKKEBÆK NIELS ERIK , FELDT‐RASMUSSEN ULLA , MATHIESEN ELISABETH R.
Published: December 2009

Background. Activin A and inhibin A have been found to be elevated in women without diabetes subsequently developing pre‐eclampsia. The aim was to investigate whether activin A and inhibin A in serum were elevated in type I diabetic women after developing pre‐eclampsia and, if so, were they clinically useful as predictors of pre‐eclampsia. Methods. In a prospective study, maternal serum was analyzed for activin A and inhibin A in 115 women with type 1 diabetes at 10, 14, 22, 28, and 33 weeks of gestation. Results. Fourteen women (12%) developed pre‐eclampsia (26–37 weeks of gestation) and 101 did not. The two groups were comparable regarding age, body mass index, and diabetes duration. There was no difference between serum concentrations of activin A and inhibin A in women developing pre‐eclampsia and women who did not at any gestational period. Conclusions. Serum concentrations of activin A and inhibin A could not predict pre‐eclampsia in type I diabetes.
What can be learned from the levormeloxifene experience?
Authors: RAVN PERNILLE , NIELSEN THERESE F. , CHRISTIANSEN CLAUS
Published: December 2009

Levormeloxifene is a selective estrogen receptor modulator that was developed as an alternative to estrogen replacement therapy for the treatment and prevention of postmenopausal bone loss. In animal models, levormeloxifene prevented increased bone turnover and vertebral bone loss following ovariectomy. Studies of healthy postmenopausal women showed that levormeloxifene 1.25–20 mg/day decreased bone turnover and increased bone mineral density to a comparable extent to that observed during conventional hormone replacement therapy. However, in the phase II and III studies, the effect on bone turnover and bone mineral density was similar for each dose of levormeloxifene and the minimal effective dose was never established. The development of levormeloxifene was discontinued during the phase III trial due to a significant incidence of gynecologic adverse events in the levormeloxifene‐treated groups. This article reviews the preclinical and clinical studies of levormeloxifene and the circumstances for the premature termination of the development of the drug. Other selective estrogen receptor modulators such as tamoxifen and raloxifene and the perspectives for selective estrogen receptor modulators in development are furthermore discussed.
Feminine life‐course of Estonian women born in 1937–47: A questionnaire survey
Authors: KIRSS FRED , LANG KATRIN , TUIMALA RISTO
Published: December 2009

Background. This study describes reproductive health, use of contraception, age at menopause, the prevalence of climacteric complaints, and hormone replacement therapy among Estonian women born in 1937–47. Methods. A sample of 800 Estonian women born in 1937–47 was composed at random from the Estonian population registry in 1997. A postal questionnaire was sent to all participants. Results. Curettage before menopause (16.6%, 95%CI = 13.5–20.0) and hysterectomy (11.7, 95%CI = 9.0–14.8) were the most common gynecological operations. 66.7% (95%CI = 62.5–70.6) of women had never used contraception, with the most popular method of contraception being intrauterine device (19.9%, 95%CI = 16.6–23.6). About three quarters of the respondents had had induced abortions, with 30.4% (95%CI = 26.5–34.4) having had three or more abortions. After exclusion of women with surgical menopause (57 cases, 10.6%, 95%CI = 8.1–13.5), women who were unable to assess the time of menopause (17 cases, 3.2%, 95%CI = 1.8–5.0), and those who were still menstruating (73 cases, 13.6%, 95%CI = 10.8–16.8), the average age of menopause (based on 388 study subjects) was 50.3 (95%CI = 49.9–50.6) years. The prevalence of climacteric complaints was as follows: hot flushes 51.0% (95%CI = 46.7–55.3), night sweats 44.1% (95%CI = 39.9–48.4%), depression/irritability 35.6% (95%CI = 31.5–39.8), bleeding problems 10.1% (95%CI = 7.6–12.9). Hormone replacement therapy was currently being used by 8 respondents (1.5%, 95%CI = 0.6–2.9). Previous hormone replacement therapy use was reported by 4 (0.7%, 95%CI = 0.2–2.9) of the women. Conclusions. The feminine life‐course of women born in Estonia in 1937–47 is characterized by a high number of induced abortions and hysterectomies, and relatively little contraceptive use. Hormone replacement therapy use is very low.
Validation of a test model of induced dysmenorrhea
Authors: LIEDMAN RAGNER , SKILLERN LAURENCE , JAMES IAN , MCLEOD ALISON , GRANT LEE , ÅKERLUND MATS
Published: December 2009

Background. The myometrial hyperactivity and reduced uterine blood flow of primary dysmenorrhea is to a large extent caused by increased vasopressin secretion. A new therapeutic approach for this condition is to develop antagonists of uterine vasopressin V1a receptors. We studied a test model of vasopressin‐induced dysmenorrhea in healthy, sterilized women and compared responses against those in dysmenorrheic subjects. Methods. Eight women with primary dysmenorrhea and eight sterilized, healthy women participated in recordings of intrauterine pressure and experienced pain on days 1–2 of two menstruations. We tried to identify biochemical markers in plasma of uterine ischemia. Furthermore, the effects of repeated bolus injections of 10 pmol/kg b w of vasopressin or placebo on these parameters were assessed. Results. The vasopressin injections caused statistically significant increases in the area under the intrauterine pressure curve (AUC) in both healthy volunteers and patients with dysmenorrhea, the overall responses being greater in healthy volunteers. The experienced pain measured by visual analog scale in individual dysmenorrheic subjects tended to show higher maximal post‐dose scores for the vasopressin injections than for placebo. Maximum visual analog scale scores and maximum AUCs in individual subjects tended to be related. Mean creatine kinase MB levels were higher in women with dysmenorrhea than in healthy subjects both before and after vasopressin administration, the converse being observed for C‐reactive protein levels. Conclusions. The present model appears to be useful for evaluating new drugs for the treatment of primary dysmenorrhea.
Longitudinal trends in cervical cytological lesions and the effect of risk factors. A 30‐year overview
Authors: SIGURDSSON KRISTJAN , SIGVALDASON HELGI
Published: December 2009

Background. Cytological preinvasive changes are important precursors in cervical cancer, therefore variations in their trends affect screening guidelines. Methods. Trends in cytological preinvasive changes following the 1st to 5th screening visits in the 20–34 and 35–69 year age groups were analyzed for the period 1979–2002: a) the incidence rate (absolute risk) of higher grade cytology and the relative risk of risk factors on this rate; b) the cumulative incidence of low‐grade and higher grade smears after normal and abnormal screening results; c) the cumulative incidence of higher grade cytology at a fixed risk level after normal screening results; and d) the prevalence of higher grade smears at first screening visit in the 20–24/25–29 year age groups during 1971–2002. Results. An increased trend in the prevalence of higher‐grade smears was observed at the first screening visit after 1980. The main risk variables for higher‐grade smears in both age groups were low‐grade changes and inflammation followed in the younger age group by calendar year. However, age correlated with a decreased risk ratio. After normal screening the cumulative incidence rate of low and higher‐grade smears increased almost linearly with time. The screening interval before diagnosis of higher‐grade smears increased with both age and number of normal visits, but leveled out after the age of 35–40. Conclusions. Trends in higher‐grade smears indicate that screening should preferably start before age 25 with a maximum interval of 3 years. The interval can be extended after age 35–40. Low‐grade smears or inflammation need closer follow‐up.
Factors influencing laparoconversions during the learning curve of laparoscopic myomectomy
Authors: MARRET H. , CHEVILLOT M. , GIRAUDEAU B. , LALITHA K.
Published: December 2009

Background. To assess the probability of conversion of a laparoscopic myomectomy to an open procedure, we only found the score developed by Dubuisson et al. (2001) based on four preoperative risk factors. Routinely this score is not appropriate, as realized by the most skilled laparoscopic surgeons. Methods. The aim of this study was to identify the preoperative factors affecting the risk of conversion in data collected in different centers among a population of surgeons at the beginning of their experience in laparoscopic myomectomy. We collected preoperative clinical and ultrasonography data for all laparoscopic myomectomies performed in 11 hospital centers between January 1996 and December 2000. Data were available for 116 patients. Multiple logistic regression was use to develop a simple predictive model based on available preoperative risk factors of laparoconversion. Results. We encountered 33 laparoconversions (28%) compared to an expected number of 7.8 using Dubuisson's score. We confirmed the importance of two of the four risk factors in Dubuisson's model: biggest myoma size at ultrasonography (↑ 1 mm) (OR: 1.06) and intramural type (OR: 3.25) of the dominant myoma. However, we also identified another risk factors: surgeon's experience (OR: 0.15). Simple score was calculated and used to provide an estimated risk of conversion. Conclusion. Our model is a useful tool to predict laparoconversion for surgeons beginning in laparoscopic myomectomy. Ultrasound evaluation is essential before performing the procedure. Skilled surgeons in laparoscopy and in laparoscopic myomectomy must help their trainees during their learning curve in order to reduce laparoconversion rate.
Female patients report on health care staff's disobedience of ethical principles
Authors: Swahnberg Katarina , Wijma Barbro , Liss Per‐Erik
Published: December 2009

Background.Earlier studies have shown a high prevalence of abuse in health care (AHC). We hypothesized that patients might easily feel abused when staff do not follow prevailing ethical principles. Therefore we developed the Violations of Ethical Principles Questionnaire (ViolEP), with 30 examples of situations in health care where four ethical principles are disobeyed (autonomy, nonmaleficence, justice, and integrity). Respondents reported whether or not they had ever experienced each of the situations, and whether or not they had perceived that event as a violation. Research questions: 1. What proportion of female patients have ever experienced staff disobeying ethical principles in health care? 2. To what extent are such events perceived as violations? and 3. How well do perceived violations of ethical principles correspond to experiences of AHC?

Method.Our sample was 661 consecutive female patients at the Department of Obstetrics and Gynecology in Linköping, Sweden. They completed ViolEP and NorVold Abuse Questionnaire (NorAQ) at home and returned them by post.

Results.20/661 (64%) women answered the ViolEP and 426/661 (64%) returned the NorAQ. The majority (73%) (306/420) had experienced staff disobeying ethical principles. More than every second woman had perceived those events as violations (68%) (209/306). The prevalence of AHC was 23%. ViolEP had good sensitivity but low specificity when we used AHC according to NorAQ as the “gold standard”.

Conclusion.The majority of the patients had experienced health care staff disobeying prevailing ethical principles. These events were not always perceived as violations. The reason for this discrepancy needs to be explored.
Endoscopic treatment of deep infiltrating endometriosis (DIE) involving the bladder and rectosigmoid colon
Authors: Langebrekke Anton , Istre Olav , Busund Bjørn , Johannessen Hans‐Olaf , Qvigstad Erik
Published: December 2009

Background. To study the feasibility, complications and symptom relief of laparoscopic treatment in patients with deep infiltrating endometriosis.

Methods. From January 2004 to March 2005, 24 patients with deep infiltrating endometriosis were treated with laparoscopic techniques. Preoperative symptoms, staging, involvement of the disease, and surgical procedures were recorded. Operating time and perioperative complications were also registered, as well as follow‐up of the patients.

Results. The surgical treatment was individualized with removal of deep infiltrating endometriosis in all 24 patients, additional bladder resection in five patients and colorectal resection in eight patients. In two cases laparoconversion was performed, and one patient had a temporary loop ileostomy. We observed no major peri‐ or postoperative complications. Median operating time was 3.4 h (range 1.4–8.0 h). All patients with bladder involvement were relieved of their urinary dysfunction, while all except three patients were successfully treated for their pain problems, and also these three patients had symptom relief.

Conclusions. Patients with deep infiltrating endometriosis represent a challenge to surgical procedures. Our results show that radical laparoscopic surgery including colorectal and bladder resection is feasible, safe, and effective in almost all patients.
Primary surgery of genital prolapse: a shift in treatment tradition
Authors: Crafoord Kristina , Sydsjö Adam , Nilsson Kerstin , Kjølhede Preben
Published: December 2009

Background. The use of complete repairs in genital prolapse surgery has been questioned because of the possible adverse effects of the surgery on the urogenital and sexual function and selective repairs have been advocated. The aims of this study were to establish information about genital prolapse surgery and to analyze whether a shift from extensive prolapse surgery with complete repairs to selective repairs occurred during a 10‐year period. Methods. A retrospective study of 610 consecutive patients operated upon for genital prolapse during 1983 (Period I) and 1993 (Period II) in a sample of three Swedish hospitals was conducted. Data were obtained from the patient records. 542 women had primary surgery and were analyzed with emphasis on demographic, clinical, and surgical data. Results. The demographic and clinical data of the patients showed no significant differences between the two periods. In Period I, 69% of the patients underwent complete repair compared with 37% in Period II (p<0.001). The proportion of prolapse operations without posterior colporrhaphy increased significantly from the first to the second period from 14 to 43% (p<0.001). Conclusion. The surgery for genital prolapse seems to have changed from complete repairs towards selective repairs and posterior colporrhaphy was more often avoided in the second period. The implication of this shift in surgical treatment on pelvic floor function is not known. Further studies are needed to disclose the effect of the surgery on pelvic floor function and dysfunction in the long term.
Risk factors for forceps delivery in nulliparous patients
Authors: MAZOUNI CHAFIKA , PORCU GÉRALDINE , BRETELLE FLORENCE , LOUNDOU ANDERSON , HECKENROTH HÉLÈNE , GAMERRE MARC
Published: December 2009

Objective. To identify risk factors for forceps delivery during first pregnancy. Materials and methods. A retrospective case–control study was carried out in a tertiary maternity ward between January 2001 and December 2003. A total of 582 nulliparous women, with full‐term (>37 weeks gestation), singleton, cephalic pregnancies, who delivered by the vaginal route with or without instrumental assistance were evaluated. Results. The strongest risk factors for forceps delivery were birth weight greater than 4000 g (OR: 6.5; 95% CI: 1.6, 26.9), the occiput posterior position of the fetal head (OR: 5.8; 95% CI: 2.5, 13.8), and epidural analgesia (OR: 7.7; 95% CI: 4.1, 14.7). Other significant risk factors for forceps delivery were age over 35 years (OR: 2.4; 95% CI: 1.1, 5.1), induction of labor (OR: 2.1; 95% CI: 1.4, 3.1), first stage of labor longer than 420 min (OR: 2.3, 95% CI: 1.3,4.2), and a prolonged second stage of labor (OR: 1.6, 95% CI: 1.1, 2.4). Conclusion. Age over 35 years and induction of labor are risk factors for forceps delivery at admission. Epidural use, fetal head in occiput posterior position, and birth weight >4000 g are strong intrapartum risk factors for instrumental delivery in nulliparous women.
Fetal heart rate patterns and neurodevelopmental outcome in very low birth weight infants
Authors: Nisenblat Vicki , Alon Eran , Barak Shlomi , Gonen Ron , Bader David , Ohel Gonen
Published: December 2009

Background. To evaluate the validity of fetal heart rate monitoring during the last hour prior to birth, as a predictor of long term neurodevelopmental outcome of very low birth weight infants. Methods. A total of 111 very low birth weight infants were included in the study. Fetal heart rate tracings were obtained during the last hour prior to delivery. A perinatologist, blinded to the neonatal outcome, evaluated the tracings and divided them into three groups: reassuring, nonreassuring, and pathological. Neurodevelopmental status was evaluated at age 2 years. The relationship between fetal heart rate monitoring results and the neurodevelopmental outcome at 2 years of age was assessed with a chi‐square test and the Student's t‐test. Results. At 2 years of age 97 (87.4%) of the children had normal neurodevelopmental function, while 14 (12.6%) had variable degrees of neurodevelopmental impairment. The fetal heart rate monitoring results were classified as reassuring (normal) in 35 cases (31.5%), nonreassuring in 56 cases (50.5%), and pathological in 20 cases (18.0%). Both normal and pathological fetal heart rate patterns were associated with similar incidence of abnormal neurodevelopmental outcome, 14.3% and 15.0% of cases, respectively (p=0.778). Pathological fetal heart rate patterns as a predictor of neurodevelopmental outcome had a sensitivity of 27%, specificity of 74%, positive predictive value of 15%, and negative predictive value of 86%. Conclusion. Electronic fetal heart rate monitoring prior to delivery is not a reliable tool for the prediction of neurodevelopmental impairment in premature infants of very low birth weight, at 2 years of age.
Choosing fertilization method by analyzing sperm morphology or by performing swim‐up preparation
Authors: SÖDERLUND BRITA , LUNDIN KERSTI
Published: December 2009

Background. Evaluation of sperm morphology has been used as a screening method for choosing between intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (IVF). However, sperm morphology analysis is a time‐consuming and often subjective scoring method, and may lead to an unnecessarily large proportion of invasive and costly ICSI treatments. The aim of this study was to evaluate if the yield after swim‐up preparation could be of advantage over sperm morphology evaluation for choosing fertilization method. Material and methods. In the first part of the study 53 split cycles with less than 5% normal forms in the ejaculate were retrospectively evaluated. Part 2 is a prospective evaluation including 357 cycles where the number of sperm available after a standardized swim‐up procedure was used for choosing fertilization method. In all cycles where ≤1 million sperm were obtained after swim‐up, conventional IVF was performed. Results. In the first part no statistically significant difference in fertilization rates was found for IVF and ICSI respectively (59.2% versus 64.7%). Four IVF cycles ended up in total fertilization failure (TFF) while in no ICSI cycle was TFF obtained. In the second part 8.9% TFF was obtained in the poor sperm morphology group compared to 1.3% in the good morphology group. These TFF corresponded to 1% of all our treatment cycles. Conclusion. The present strategy reduced ICSI treatments by 10%, thereby reducing the cost and workload. It can be discussed if an increase of TFF in absolute number of eight is balanced by a reduced workload of 100 ICSI treatments.
Preserved microcirculatory response to acute estrogen not reflected by exercise capacity
Authors: Fogelberg Monika , Löfman Ida , Carlström Kjell , Freyschuss Anna , Henriksson Peter
Published: December 2009

Background. To assess the acute effect of a single dose of 10 mg oral micronized 17β‐estradiol on microcirculation in postmenopausal women with and without coronary artery disease and its potential influence on exercise capacity. Methods. Postmenopausal women (n=11) with coronary artery disease had symptoms of ischemic heart disease and at least 1 mm ST depression at exercise. Microcirculation was examined by vital microscopy, with and without the acute administration of estrogen in a placebo‐controlled cross‐over design. Exercise test was performed on bicycle. The microcirculatory findings were contrasted to those in 14 healthy postmenopausal women. Results. 17β‐Estradiol in serum and blood flow velocity increased significantly after acute oral estrogen administration both in women with coronary artery disease (p<0.001) and in healthy women (p<0.0001), with no significant difference between the two groups. No effect on exercise capacity or ST depression at exercise was detected. Conclusions. Previously reported data that a single dose of estrogen administered to postmenopausal women results in positive effects on exercise was not reproduced. An increased peripheral microvascular flow velocity was detected in women with coronary artery disease and this increase was not accompanied by an increased exercise capacity.
No difference in length of hospital stay between laparoscopic and abdominal supravaginal hysterectomy – a preliminary study
Authors: Oscarsson Ulf , Sundström Poromaa Inger , Nüssler Emil , Löfgren Mats
Published: December 2009

Background. Although a number of well‐designed studies have concluded that laparoscopic hysterectomy is associated with less postoperative pain, reduced hospital stay, and shorter periods of sick leave, thus far, studies on the perioperative and postoperative outcomes of laparoscopic supravaginal hysterectomy (LSH) versus abdominal supravaginal hysterectomy (ASH) are lacking. By applying multimodal intervention program for the postoperative care of patients, the primary aim of the current study was to compare length of hospital stay, time to convalescence, and long‐term patient satisfaction between LSH and ASH. Method. The study was conducted at the departments of Obstetrics and Gynecology, Skellefteå Hospital and Lycksele Hospital. Forty‐seven consecutive women scheduled for supravaginal hysterectomy were randomly assigned to LSH or ASH. Perioperative and postoperative parameters were compared between the two groups. Results. The length of the postoperative hospital stay did not differ between patients undergoing LSH and ASH, but the number of disability days was greater in the ASH group. The operating time was significantly longer in the LSH group compared with the ASH group, whereas the estimated perioperative bleeding was greater in the ASH group. At the 6‐month follow‐up, 87.0% of patients in the ASH group and 91.3% in the LSH group were satisfied or very satisfied with the overall result of the surgical procedure. Conclusion. The present study has indicated that by applying a multimodal intervention program for the postoperative care of patients undergoing supravaginal hysterectomy, the surgical procedure per se is of less importance than generally considered for the length of postoperative hospital stay and long‐term patient satisfaction.
Laparoscopic‐assisted vaginal vs. abdominal surgery in patients with endometrial cancer stage 1
Authors: Tollund Lisbeth , Hansen Birgit , Jørgen Kjer Jens
Published: December 2009

Background. The development of new diagnostic and surgical methods has brought a differentiated approach to the surgery of endometrial cancer. The aim of this study was to verify the peri‐ and postoperative differences between laparoscopic and open procedures. Methods. In the period from January 1995 to August 2001 a total of 86 patients were treated for endometrial cancer stage 1. Of these, 28 patients were treated by laparoscopic‐assisted vaginal hysterectomy (LAVH) and bilateral salpingo‐oophorectomy (BSO), while 58 patients were treated by total abdominal hysterectomy (TAH) and BSO. The two patient groups were comparable in all aspects. Results. The average hospital stay in the LAVH group was 2.7 days compared to 5.4 days for the TAH group. There were fewer complications in the LAVH group (7%) compared to the laparotomy group (14%). Conclusions. Laparoscopic‐assisted vaginal hysterectomy seems to be acceptable in the treatment of stage 1 endometrial carcinoma.