bluuebunny/crossref_metadata_2025 huggingface dataset:
A movable gestational sac in association with a myometrial defect
Authors: Uemura H. , Unno N. , Osuga Y. , Momoeda M. , Ando K. , Marumo G. , Kikuchi A. , Fujii T. , Kozuma S. , Matsuoka R. , Taketani Y.
Published: March 2003

An ultrasound examination in a woman at 9 weeks' gestation demonstrated a gestational sac with a live fetus in the left uterine horn which was surrounded by an extremely thin outer lining. An interstitial pregnancy was suspected and laparoscopy was performed. During laparoscopy the purple bulge in the left horn gradually reduced in size and eventually disappeared following the external pressure by the tip of the forceps. We believe this pressure caused contraction of the superficial myometrial fibers resulting in a shift in the location of the gestational sac to the central area of the uterus. The pregnancy continued and on Cesarean section at 34 weeks' gestation, a membranous protrusion of the uterine wall in the left horn was noticed. A myometrial defect caused by an intrauterine intervention in the patient's previous pregnancy was suspected to be the cause of this ‘movable gestational sac’ phenomenon.Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound diagnosis of postpartum ovarian vein thrombosis: case report
Authors: Lee E.‐H. , Im C. Y. , Kim J. W.
Published: March 2003

Postpartum ultrasound investigation of a woman with unremitting fever and right flank pain after Cesarean section revealed an extensive thrombosis of the right ovarian vein which extended into the inferior vena cava. Computed tomography was required to substantiate the diagnosis. Medical treatment with intravenous urokinase and heparin and antibiotics was successfully performed. During the postpartum period, the possibility of ovarian vein thrombosis should be considered in febrile patients with abdominal pain who are not responding to antibiotics, and imaging studies such as ultrasound and computed tomography should be performed early for prompt diagnosis and therapy. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
The importance of quality management in fetal measurement
Authors: Dudley N. J. , Chapman E.
Published: March 2003

Objectives

The aims of this study were to evaluate factors contributing to inaccuracy in fetal measurements and to assess the clinical importance of measurement quality.

Methods

One hundred images of biparietal diameter (BPD), head circumference (HC) and abdominal circumference (AC) measurements were collected from six centers (1800 measurements); the proportion meeting quality criteria was assessed. Four hundred images of AC were collected from one center, each image measured by ellipse fitting and tracing methods; clinical agreement between the methods was assessed. Fetal weight estimation (EFW) errors were compared between quality controlled and non‐quality controlled studies. Images of three ACs on each of 400 fetuses were collected; where one measurement failed to meet quality criteria, it was compared with an optimal measurement on the same fetus.

Results

Eighty‐nine percent, 87% and 60% of BPD, HC and AC, respectively, met all quality criteria. Limits of agreement between ellipse and traced AC were –4.7 mm to 12.5 mm; 22% of sections were non‐elliptical. EFW errors were significantly different but were confounded by differences in time to delivery. Limits of agreement between optimal and suboptimal AC measurements were –15.1 mm to 7.7 mm.

Conclusions

AC quality criteria are less easily recognized and obtained than those for head measurements; training, adherence to protocols and audit are important. Differences between ellipse and traced AC may not justify the use of separate charts; the number of non‐elliptical sections suggests that ellipse fitting is not appropriate. Comparison between EFW errors is not a suitable tool for audit. Failure to meet quality criteria results in clinically significant errors. Copyright © 2002 ISUOG
Preinduction sonographic measurement of cervical length in the prediction of successful induction of labor
Authors: Pandis G. K. , Papageorghiou A. T. , Ramanathan V. G. , Thompson M. O. , Nicolaides K. H.
Published: March 2003

Background

Induction of labor is carried out in approximately 20% of pregnancies. However, approximately 20% of women having induction of labor end up having a Cesarean delivery. The traditional method of predicting whether an induced labor will result in successful vaginal delivery is based on the preinduction ‘favorability’ of the cervix as assessed by the Bishop score. However, this assessment is subjective and several studies have shown a poor predictive value for the outcome of induction.

Objectives

To examine the relationship between preinduction sonographically measured cervical length and the Bishop score and to compare the two measurements in the prediction of successful vaginal delivery within 24 h of induction.

Methods

In this multicenter study, preinduction cervical assessment was undertaken in 240 women with singleton pregnancies at 37–42 weeks of gestation. The Bishop score was assessed by digital examination and the cervical length was measured by transvaginal sonography.

Results

Multiple regression analysis demonstrated that cervical length, Bishop score and parity provided independent contribution in the prediction of the likelihood of delivering vaginally within 24 h. Further examination of the different components of the Bishop score showed that only cervical length provided a significant contribution in the prediction of the likelihood of vaginal delivery within 24 h. In the receiver operating characteristic curves, the best cut‐off point for the prediction of successful induction was 28 mm for cervical length and 3 for the Bishop score. However, cervical length appears to be a better predictor than the Bishop score, with a sensitivity of 0.87 and a specificity of 0.71 compared to 0.58 and 0.77, respectively. Similarly, the Kaplan–Meier survival curves indicate that better discriminatory results in the prediction of vaginal delivery within 24 h are achieved using cervical length rather than the Bishop score.

Conclusion

Transvaginal sonographic measurement of cervical length provides a useful prediction of the likelihood of vaginal delivery within 24 h of induction.Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Randomized study of vaginal misoprostol (PGE1) and dinoprostone gel (PGE2) for induction of labor at term
Authors: Pandis G. K. , Papageorghiou A. T. , Otigbah C. M. , Howard R. J. , Nicolaides K. H.
Published: March 2003

Objectives

To investigate the efficacy and safety of misoprostol in the induction of labor at term by comparing this agent with the commonly used dinoprostone gel.

Patients and methods

A randomized clinical trial of vaginal misoprostol, 50 µg 6‐hourly, and dinoprostone gel, 1–2 mg 6‐hourly, in 435 women undergoing induction of labor at term. The women, 210 in the misoprostol group and 225 in the dinoprostone group, were compared to determine whether there was a significant difference in achieving vaginal delivery within 24 h, the incidence of hyperstimulation syndrome, Cesarean section rate and adverse neonatal outcome. They were also offered the option of preinduction sonographic cervical assessment.

Results

Misoprostol, compared to dinoprostone gel, was associated with a significantly shorter median induction‐to‐delivery interval (14.6 h vs. 19.0 h; P = 0.0014), a higher incidence of vaginal delivery within 24 h of induction (65.7% vs. 54.2%; P = 0.019) and a reduced need for oxytocin augmentation during labor (20.5% vs. 29.8%; P = 0.034). The groups did not differ significantly in the rates of Cesarean section (18.1% vs. 19.1%; P = 0.88) and hyperstimulation syndrome (2.4% vs. 0.9%; P = 0.27). None of the cases of hyperstimulation required treatment with tocolysis. All nine cases of excessive uterine contractility occurred after the first dose of the drug. There were no significant differences in maternal and neonatal morbidity between the two groups. There was a significant association between preinduction cervical length and the induction‐to‐delivery interval in both those receiving misoprostol and those treated with dinoprostone.

Conclusions

The use of misoprostol is associated with a shorter duration of labor and a higher rate of vaginal delivery within 24 h from induction without an increase in maternal and neonatal morbidity. Transvaginal sonographic measurement of cervical length is useful in the prediction of the likelihood of vaginal delivery within 24 h of induction and of the induction‐to‐delivery interval and may be useful in the stratification of patients participating in randomized studies that examine the effectiveness of inducing agents.Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of sacrococcygeal teratomas by two‐ and three‐dimensional ultrasound
Authors: Bonilia‐Musoles F. , Machado L. E. , Raga F. , Osborne N. G. , Bonilla F.
Published: March 2003

We suspected two fetuses of having sacrococcygeal teratomas following initial two‐dimensional ultrasound scanning at 18 and 22 weeks' gestation. The fetuses were then scanned with three‐dimensional multiplanar surface and three‐dimensional orthogonal planar ultrasound to establish a definitive diagnosis. Although we made a presumptive diagnosis in both cases after initial two‐dimensional scanning, with three‐dimensional ultrasound we were better able to define the degree of involvement of the sacrum and other pelvic structures of prognostic importance. Copyright © 2002 ISUOG
The fetal mandible: a 2D and 3D sonographic approach to the diagnosis of retrognathia and micrognathia
Authors: Rotten D. , Levaillant J. M. , Martinez H. , Le pointe H. Ducoule , Vicaut É.
Published: March 2003

Objective

To define parameters that enable the objective diagnosis of anomalies of the position and/or size of the fetal mandible in utero.

Design

Fetuses at 18–28 gestational weeks were examined by two‐ and three‐dimensional ultrasound. The study included normal fetuses and fetuses with syndromes associated with known mandible pathology: Pierre Robin sequence or complex (n = 8); hemifacial microsomia (Treacher–Collins syndrome, n = 3); postaxial acrofacial dysostosis (n = 1). Fetuses with Down syndrome (n = 8) and cleft lip and palate without Pierre Robin sequence or complex (n = 18) were also studied. Retrognathia was assessed through the measurement of the inferior facial angle, defined on a mid‐sagittal view, by the crossing of: 1) the line orthogonal to the vertical part of the forehead at the level of the synostosis of the nasal bones (reference line); 2) the line joining the tip of the mentum and the anterior border of the more protruding lip (profile line). Micrognathia was assessed through the calculation of the mandible width/maxilla width ratio on axial views obtained at the alveolar level. Mandible and maxilla widths were measured 10 mm posteriorly to the anterior osteous border.

Results

In normal fetuses, the inferior facial angle was constant over the time span studied. The mean (standard deviation) value of the inferior facial angle was 65.5 (8.13)°. Consequently, an inferior facial angle value below 49.2° (mean—2 standard deviations) defined retrognathism. All the fetuses with syndromes associated with mandible pathology had inferior facial angle values below the cut‐off value. Using 49.2° or the rounded‐up value of 50° as a cut‐off point, the inferior facial angle had a sensitivity of 1.0, a specificity of 0.989, a positive predictive value of 0.750 and a negative predictive value of 1.0 to predict retrognathia. In normal fetuses, the mandible width/maxilla width ratio was constant over the time interval studied. The mean (standard deviation) value was 1.017 (0.116). Consequently, a mandible width/maxilla width ratio <0.785 defined micrognathism. Mandible width/maxilla width ratio values were below this cut‐off point in eight and in the normal range in four fetuses with syndromes associated with mandible pathology.

Conclusions

Retrognathia and micrognathia are conditions that can be separately assessed. The use of inferior facial angle and mandible width/maxilla width ratio should help sonographic recognition and characterization of fetal retrognathic and micrognathic mandibles in utero. Copyright © 2002 ISUOG
Islands on the plains: metapopulation dynamics and female biased dispersal in hyraxes (Hyracoidea) in the Serengeti National Park
Authors: Gerlach G. , Hoeck H. N.
Published: March 2003

Two species of hyrax,Heterohyrax bruceiandProcavia johnstoni,inhabit rock outcrops, or kopjes, in the Serengeti National Park, Tanzania. Such distinct ‘island’ habitats provide an excellent model to investigate natural metapopulation dynamics with distinct small populations with extinction and colonization events, as well as migration between populations. Allele frequencies, genetic variability and genetic distances between populations were calculated based on DNA microsatellite markers. The genetic diversity in both species of hyrax, especiallyP. johnstoni, was surprisingly low: allelic diversity ranged from 2 to 7 alleles per locus. This may have been induced by colonization by a small number of individuals from single source populations.F‐statistics, assignment tests and calculations of pairwise relatedness all indicated female‐biased dispersal inH. bruceibut notP. johnstoni. Values ofFISinP. johnstonishowed an excess of homozygotes indicative of high rates of inbreeding; evidence for inbreeding could not be detected inH. brucei. Although female dispersal patterns inH. bruceiseem to prevent inbreeding and consequently reduce risk of local extinction, this seems not to be the case inP. johnstoni.
Population structure, history and gene flow in a group of closely related land snails: genetic variation in Partula from the Society Islands of the Pacific
Authors: Goodacre Sara L
Published: March 2003

Previous studies of Partula land snails from the Society Islands, French Polynesia, have shown that populations within species are highly differentiated in terms of their morphology, behaviour, ecology and molecular genetic variation. Despite this level of variability, differences between species are sometimes small, possibly reflecting the fact that reproductive isolation is not always complete and there exists the opportunity for genetic exchange between taxa through hybridization. The present study uses sequence data from a mitochondrial gene to further investigate genetic variation in Society Island Partula. Most populations are found in this study to be highly differentiated, but within individual species there seems to be no simple relationship either between genetic distance and geographical proximity, or between variation in mitochondria and that in allozymes or morphological characteristics. Among species there appears to be no simple correlation between degrees of reproductive isolation and genetic relatedness according to mitochondrial DNA. The results suggest that past events as well as ongoing drift and selection may have been important in affecting patterns of variation. Similarities among species at specific localities suggest that there must have been some genetic exchange in the past, although this may not necessarily reflect ongoing rates of hybridization. The discrepancy between results for different markers probably reflects the differential effects of drift and selection on mitochondrial and nuclear genes.
The usefulness of amplified fragment length polymorphism markers for taxon discrimination across graduated fine evolutionary levels in CaribbeanAnolislizards
Authors: Ogden R. , Thorpe R. S.
Published: March 2003

Fine‐level taxon discrimination is important in biodiversity assessment and ecogeographical research. Genomic markers are often required for studies on closely related taxa, however, most existing mitochondrial and nuclear markers require prior knowledge of the genome and are impractical for use in small conservation projects. This study describes the application of amplified fragment length polymorphism (AFLP) to discriminate at four progressively finer evolutionary levels of CaribbeanAnolislizards from the central Lesser Antilles. AFLP is shown to be a rapid and effective method for discriminating between species. Separation increases with primer pair number and choice of primer combination appears to be noncritical. Initial population‐level results show markedly less discriminatory power. A screening technique for the identification of population informative markers combining principal component and principal coordinate analyses is presented and assessed. Subsequent results show selected conspecific AFLP data to be remarkably congruent with those of mitochondrial DNA, microsatellite and morphological markers. The use of AFLP as a low‐cost nuclear marker in species‐level taxon discrimination is supported, whereas population level application demands further consideration.
Fine‐level mycorrhizal specificity in the Monotropoideae (Ericaceae): specificity for fungal species groups
Authors: Bidartondo M. I. , Bruns T. D.
Published: March 2003

The Monotropoideae (Ericaceae) are nonphotosynthetic angiosperms that obtain fixed carbon from basidiomycete ectomycorrhizal fungi. In previous work, we showed that each plant species is associated with a single genus or a set of closely related genera of ectomycorrhizal fungi. Here we show that the level of specificity is much higher. We used a molecular phylogenetic approach to contrast specificity patterns among eight plant lineages and three fungal genera. We relied on fungal nuclear internal transcribed spacer (nrITS) sequence data obtained from 161 basidiocarps and 85 monotropoid roots representing 286 sampled plants screened using restriction length polymorphisms. From the phylogenetic placement of fungal symbionts in fungal phylograms, we found that three basal (Sarcodes, Pterospora, Pleuricospora) and one derived lineage (Allotropa) of plants target narrow clades of closely related species groups of fungi, and four derived lineages (Monotropa hypopithys species group, Pityopus) target more distant species groups. Within most plant lineages, geography and photobiont association constrain specificity. Specificity extended further in Pterospora andromedea, in which sequence haplotypes at the plastid trn L–F region of 73 plants were significantly associated with different fungal species groups even in sympatry. These results indicate that both the macro‐ and microevolution of the Monotropoideae are tightly coupled to their mycorrhizal symbionts.
Allozyme heterozygosity, date of first feeding and life history strategy in Atlantic salmon
Authors: McCarthy I. D. , Sánchez J. A. , Blanco G.
Published: March 2003

The relations between allozyme heterozygosity, relative date of first feeding and life history strategy in juvenile Atlantic salmon Salmo salar were examined using eggs obtained from a 400 family cross (20 male × 20 female adult Atlantic salmon). Multilocus heterozygosity, through its positive associations with the timing of first feeding and growth rate, was correlated with life history strategy in juvenile Atlantic salmon, albeit under genotype × environmental (temperature, food availability) regulation. Under hatchery conditions, a 10 day difference was observed in the relative date of first feeding between early and late first feeding Atlantic salmon. Early first feeding Atlantic salmon exhibited a significantly higher mean heterozygosity, grew faster at ambient water temperature (April to November) and a significantly higher proportion adopted the early freshwater maturation (age 0+ years, male fish) or early migrant (age 1+ years, mainly female fish) strategies compared to late first feeding Atlantic salmon. Elevated water temperatures over the winter (December to April, >10·5° C) provided additional growth opportunity allowing previously mature male parr (mainly early first feeders) and lower modal group parr (mainly late first feeders) to adopt the early migrant strategy by the following spring.
A mechanism for social inhibition of sexual maturation in bluegill
Authors: Aday D. D. , Wahl D. H. , Philipp D. P.
Published: March 2003

Social control of maturation is a common phenomenon in fishes, yet associated mechanisms are often unidentified. An examination of interactions between mature and juvenile male bluegill Lepomis macrochirus in mesocosms, isolating visual, chemical and physical interactions, suggested that chemical cues are responsible for inhibiting maturation of juvenile males.
Allometric constraints on stability and maximum size in flying fishes: implications for their evolution
Authors: Davenport J.
Published: March 2003

Flying fish wing area and wing‐loading both rise in strongly negative allometric fashion with increasing body length and mass. Evidence is presented to show that this occurs because: (1) the leading edge of the pectoral fin ‘wing’ is fixed at 24% of standard length ( LS) from the snout, (2) the wing length cannot exceed 76% of LS or the tips will interfere with propulsive tail beat and (3) increased mass demands faster flying and wings with better lift : drag ratios; this selects for tapered, higher aspect ratio wing shapes. A consequence of this situation is that larger flying fishes have centres of mass increasingly further behind the centre of wing pressure. Resultant longitudinal instability restricts the maximum size of the two‐winged design and the pelvic fins of four‐wingers act as a stabilizing tailplane. These data indicate that the accepted model of evolution of flight in flying fishes (by extension of ballistic leaps) is flawed; it is proposed that evolution of lift‐supported surface taxiing in half‐beaks with enlarged pectoral fins (enhanced by ground effect) was an essential preliminary; subsequent forward migration of the centre of mass to within the wing chord permitted effective gliding.
Retinal neurodevelopmental assessment with electroretinogram in patients with biliary atresia
Authors: Igarashi Jun , Shimizu Toshiaki , Oguchi Satoshi , Yamashiro Yuichiro , Miyano Tekeshi , Hayakawa MUtsUko
Published: March 2003

Background
: To evaluate the effect of n‐3 polyunsaturated fatty acid (PUFA) deficiency on the development of retinal function in children with biliary atresia (BA), we examined serum fatty acid levels and performed electororetinogram (ERG) in patients with BA.

Methods
: The study group was composed of one male and four female BA patients (8−14 years) with serum bilirubin levels ranging from 0.40 to 1.48 mg/dL. All of the subjects were born as full‐term infants. The fatty acid composition of total lipids in serum was analyzed by gas chromatography before the Kasai operation, approximately 10 months after the Kasai operation, and at the time of the ERG study. The ERG was recorded using corneal contact lens electrodes.

Results
: Two of the five patients showed decreased levels of arachidonic acid and docosahexaenoic acid (DHA) before and after the operation, but no abnormal findings on ERG were detected in these patients. The other three patients had decreased levels of α‐linolenic acid or DHA after the operation, but again, no abnormalities were found on ERG.

Conclusion
: These results suggest that insufficiencies of DHA and other n‐3 PUFA in full‐term infants might not have an influence on later ERG results.
Psychosomatic disorders in children: An emerging challenge to health care in Japan
Authors: Takahashi Takao , Watanabe Hisako , Matsuo Nobutake
Published: March 2003

Background
: Japan has been witnessing a considerable rise in the number of children presenting with psychosomatic disorders. Thus, there is a mounting demand for pediatricians to be trained in the caring of children with psychosomatic disorders.

Method
: A questionnaire based‐survey was conducted to investigate the average number of working hours for the first year (Postgraduate Year 1 (PGY1)) pediatric residents at Keio University Hospital. The same survey was conducted retrospectively with doctors with at least 10 years of experience in child health care. Another survey was conducted at our 27 affiliated hospitals with respect to the number of outpatients and patients presenting with psychosomatic disorders.

Results
: The survey showed that, in the ward for preschool and school‐age children, PGY1 residents spent on average 78.9 h per week. Time required for care of psychosomatic disorders was more than 30% of the total amount of time allotted for information acquisition, interviews and consultations, as well as conferences and discussions. There was virtually no time spent on the care for psychosomatic disorders in our pediatric residency program 10 years ago. It is an implication of the survey that the apparent number of patients with psychosomatic problems is not dependent on the size or location of the hospital.

Conclusion
: General pediatricians will be spending more time than ever before in the caring of children with psychosomatic disorders. Moreover, pediatricians trained for child health care for psychosomatic disorders are short of supply or non‐existent, even in the major affiliated hospitals.
Unique Doppler velocimetry findings in heart failure of a fetus with giant cardiac rhabdomyoma
Authors: Ogawa Masaki , Sato Naoki , Tsuda Akira , Tanaka Toshinobu
Published: March 2003

Herein, we report a case showing unique Doppler velocimetry findings, just before intrauterine death, in the heart failure of a fetus with cardiac rhabdomyoma located in the interventricular septum. Specific blood flow of only the inferior vena cava was observed when acute fetal heart failure occurred.
Value of humerus length shortening for prenatal detection of Down syndrome in a Thai population
Authors: Tannirandorn Yuen , Manotaya Saknan , Uerpairojkit Boonchai , Tanawattanacharoen Somchai , Wacharaprechanont Teera , Charoenvidhya Dhiraphongs
Published: March 2003

Objective:

To assess the value of humerus length shortening for prenatal detection of Down syndrome in a Thai population.

Methods:

A prospective study was performed on 3053 women undergoing second‐trimester amniocentesis, between 16 and 24 weeks gestation, for the indications of advanced maternal age and a past history of chromosomal abnormality. Biparietal diameter (BPD) and humerus length measurements were obtained before the procedures. Regression equations relating BPD to humerus length were used to calculate observed humerus length/expected humerus length ratio in chromosomally normal and Down syndrome fetuses. Sensitivity, specificity, false‐positive rate and likelihood ratio of a positive test result at various observed humerus length/expected humerus length ratios for detection of Down syndrome were calculated. A receiver–operator characteristic curve was used to determine the threshold screening ratio.

Results:

There were 3003 chromosomally normal pregnancies and 24 fetuses with Down syndrome. The relationship between humerus length and BPD was: expected humerus length = 0.7403BPD – 5.1057, R2 = 0.77, P < 0.001. Humerus length in Down syndrome fetuses was significantly
shorter than in normal fetuses (P < 0.001). A ratio of 0.91 for observed humerus length/expected humerus length yielded a sensitivity of 41.7%, specificity of 88.3%, a false‐positive rate of 11.7% and likelihood ratio of a positive test result of 3.63 (95% confidence interval 2.24–5.88) for detection of Down syndrome.

Conclusions

Humerus length shortening in the second trimester appears to be a useful adjunctive screening parameter for fetal Down syndrome in a Thai population.
Usefulness of percutaneous intracardiac administration of colored microspheres in measuring blood flow distribution to the brain in 7‐day‐old rats
Authors: Xia Yi Xin , Sameshima Hiroshi , Ota Arturo , Xia Xiao Yan , Ikeda Tomoaki , Ikenoue Tsuyomu
Published: March 2003

Objective:
 By using colored microsphere (CMS) technique in newborn rats, we explored the relationship between injection sites and blood flow distribution patterns in open‐chest and in closed‐chest models, with hopes that percutaneous left ventricle injection can be applicable to measure relative blood flow distribution to the brain.

Methods:
 Seven‐day‐old Wistar rats were used. In open‐chest models (n = 30), we exposed the heart and injected CMS (15 mm diameter, 125 000 spheres in 0.05 mL) to left and right ventricles, respectively. In closed‐chest models (n = 12), we percutaneously punctured the left ventricle to administer microspheres to see the difference in blood flow distribution between the right and left side of organs. Microsphere counts were compared between the left and right side of each organ by unpaired t‐test (mean ± SD).

Results:
 Open‐chest showed that right ventricle injection resulted in exclusive entrapment in the lungs, while left ventricle injection resulted in systemic distribution. According to this, one of 12 injections in the closed‐chest was judged as right ventricle injection. The other 11 showed insignificant differences between the right and left side in the cortex, lung, and kidney.

Conclusion:
 Right ventricle injection is differentiated from left ventricle injection and microsphere counts are the same between right and left side of the organs, suggesting that percutaneous microsphere injection is applicable for relative blood flow distribution in 7‐day‐old rat models.
Management of vaginal birth after cesarean
Authors: Mizunoya Fujio , Nakata Megumi , Kondo Tokumasa , Yamashita Sadao , Inoue AndShigeo
Published: March 2003

Objective:
 To raise the success rate of vaginal birth after cesarean (VBAC) without increasing maternal or perinatal morbidity and mortality rates.

Methods:
 Of 468 women with a prior scar, 365 gave valid informed consent for our management of VBAC at Akashi Municipal Hospital during 1986–1999. Trials of labor (TOL) were attempted in 322 cases principally by waiting for spontaneous labor onset and teaching the patients a breathing method to avoid straining until expulsion by vacuum extraction become possible, controlling the intrauterine pressure. Our selection criteria for TOL changed during the trial; from 1991–1999 patients with a prior scar extending into fundus were excluded.

Results:
 Of the 322 TOL, 88.2% were successful, and VBAC was successful in 77.8% (284 of the 365 patients). Uterine rupture was observed in 2 cases (0.62%). Fetal death occurred in 1 case. Three women gave birth to neonates with a 1‐minute Apgar score ≤6.

Conclusion:
 The rate of VBAC was 77.8% in all women with a prior scar. During our management of VBAC, maternal or perinatal morbidity and mortality rates did not increase significantly.
Thromboprophylaxis with low molecular weight heparin in thrombophilia‐complicated pregnancy
Authors: Ebina Yasuhiko , Yamada Hideto , Kato Emi H. , Yamamoto Ritsu , Sakuragi Noriaki , Fujimoto Seiichiro
Published: March 2003

We treated three thrombophilia‐complicated pregnant women (two antiphospholipid antibody syndrome, one protein C deficiency) with low molecular weight heparin (dalteparin). All three pregnancies including one twin pregnancy ended in live births without a decrease in bone mineral density. This treatment modality was effective and safe preventing thrombosis during their pregnancies.
Situation analysis of atypical squamous cells of undetermined significance smears in Songklanagarind Hospital
Authors: Chichareon Saibua B. , Tocharoenvanich Sathana T.
Published: March 2003

Objective:
 To review the incidence, management, follow‐up rate and colposcopic diagnosis of atypical squamous cells of undetermined significance (ASCUS) detected on cervical smears in Songklanagarind Hospital, Thailand.

Methods:
 A retrospective study of ASCUS smears taken during January 2000 to March 2001 at Songklanagarind Hospital was performe. The type of management was classified and the follow‐up rate was detected. Cases with colposcopy, tissue biopsy, endocervical curettage, conization and hysterectomy specimen were reviewed. In the cases without tissue biopsy, the final diagnoses were based on the colposcopic examination.

Results:
 Among the 25 068 Pap smears examined, the incidence of ASCUS was 0.62%. Of these, only 56.13% received the further evaluation. The non‐compliance rate was 18.71%. The incidences of cervical intraepithelial neoplasia (CIN) and invasive cancer among the cases who received colposcopy were 15.96% and 2.13%, respectively. The incidence of CIN or invasive cancer in ASCUS favor reactive and ASCUS favor neoplasia were not different statistically significant.

Conclusions:
 Management of ASCUS smears by follow‐up may be inappropriate. A practice guideline which consists of active management, intensive follow‐up system and well‐organized data management should be used to improve the situation.
Evaluation of a Combination Study of a Noninvasive Scoring System and Transrectal Ultrasonography to Detect Deeply Infiltrating Endometriosis
Authors: Tajima Tomotaka , Ohba Takashi , Tanaka Nobuyuki , Matsuura Kohei , Okamura Hitoshi
Published: March 2003

Objective:
 Noninvasive evaluation must be required for deeply infiltrating endometriosis, typically accompanied by pelvic pain, dyspareunia, and bowel retraction. To explore noninvasive diagnostic methods for deeply infiltrating endometriosis, we employed a combination study of a diagnostic scoring system and transrectal ultrasonography.

Methods:
 A prospective diagnostic study was designed for deeply infiltrating endometriosis by noninvasive diagnostic scoring and transrectal ultrasonography (n = 40).

Results:
 Sixteen out of twenty‐four women with positive points in the diagnostic scoring had deeply infiltrating endometriosis on uterosacral ligaments. Uterosacral ligaments were thickened in 83.3% of patients with deeply infiltrating endometriosis on uterosacral ligaments. The patients who had both thickened uterosacral ligaments and a positive diagnostic score were limited to patients with deeply infiltrating endometriosis on uterosacral ligaments.

Conclusion:
 Our findings showed that thick uterosacral ligaments associated with a positive diagnostic score strongly designated that the women were affected by deeply infiltrating endometriosis. It is concluded that this combination study has clinical diagnostic value for deeply infiltrating endometriosis at the outpatient department.

ACTA OBST GYNAEC JPN Vol. 54, No. 7, pp. 919–924, 2002
Immunohistochemical Study of Steroid Sulfatase in Minimal Deviation Adenocarcinoma of the Uterine Cervix
Authors: Ohtsuka Yukiko , Toma Yoshiro , Saito Hiroshi , Yanaihara Atsushi , Yokoyama Kazuhiko , Ichizuka Kiyotake , Suzuki Akira , OKAI Takashi , Kushima Miki
Published: March 2003

Objective: Minimal deviation adenocarcinoma of the uterine cervix (adenoma malignum : MDA) is a unique neoplasm whose prognosis is poor in spite of the deceptively benign appearance of the tumor cells. The pathogenesis of MDA is unknown. To gain a better understanding of its pathogenesis, the present study was undertaken to explore the immunohistochemical expression of steroid sulfatase (STS), steroid receptors and gastric mucin in MDA and the expression was compared with that in non‐neoplastic cervical glands (NC) and pyloric glands(PG).

Methods: Histopathological specimens of MDA (typical lesion n = 3, less well‐differentiated lesion n = 1) obtained at gynecological operation were subjected and the immunohistochemical staining for STS, estrogen receptor (ER), progesterone receptor (PR) and gastric mucin was performed. NC tissue (n = 5) and PG (n = 2) were also subjected.

Results: The expression of STS was found in all cases of MDA with a typical lesions, but not in a less well‐differentiated cases. All cases of MDA expressed strong staining for gastric mucin. On the other hand, they did not show ER or PR staining. NC expressed positive staining for STS, ER and PR, but not for gastric mucin. PG strongly expressed gastric mucin, but ER, PR and STS did not.

Conclusions: The immunohistochemical expression of STS in typical lesions indicates that MDA partially retained the characteristics of the cervical gland with regulational function of steroid hormones. This suggests that MDA might be malignancy transformed not from ectopic gastric mucosa, but from the endocervical gland by way of gastric metaplasia.
Fiction, poetry and mental health: expressive and therapeutic uses of literature
Authors: Mcardle S. , Byrt R.
Published: March 2003

People with experience as mental health clients, mental health nurses, writers and other professionals have used literature to benefit mental health service users in various ways. These include expressive writing, as well as applications in psychotherapy and counselling and to deal with specific problems and symptoms. In addition, therapeutic storytelling, bibliotherapy and poetry therapy have been used. Various benefits have been described, but some accounts do not include evidence of clinical effectiveness. However, positive treatment outcomes have been reported in research papers and other literature, with particular evidence of clinical effectiveness in some studies of bibliotherapy, therapeutic writing and poetry therapy. Further work is needed to clarify and measure the effectiveness of various expressive and therapeutic uses of literature. The authors also recommend collaboration among practitioners and the need for supporting evidence for proposals for increased resources in this field.
An action research project in a night shelter for rough sleepers
Authors: Payne J.
Published: March 2003

From October 1999 to June 2000, an action research project was undertaken in a homeless night shelter called Jimmy’s. This project was grounded in user‐consultation and sought the involvement of staff and management to institute tangible improvements in service delivery using the Power Audit. A brief overview of Jimmy’s is given, then this research is placed in local and national context by describing policy development in homelessness. A brief description is given of the research methodology and a short description of the Power Audit. Following this, the lives and experiences of the guests (Jimmy’s residents) are conveyed using ethnography. This tells of the development of relationships with guests, staff and management without which the project could not have succeeded. Finally, an overview is provided of the interview content and the practical changes made.
Antitumoral activity of a new series of 5,6‐dihydrobenzo( a)carbazoles
Authors: Martin Gabriela , Cocca Claudia , Rivera Elena , Cricco Graciela , Caro Ricardo , Segall Adriana , Pappa Horacio , Casaubon Raul , Pizzorno María T. , Bergoc Rosa M.
Published: March 2003

The overlapping of three‐dimensional structures of 5,6‐dihydrobenzo( a)carbazole (DHBC) derivatives over the structure of 4‐hydroxytamoxifen (4‐OH‐TAM), by means of the MDL CHEMLAB 11.0 computational program, shows a reasonable structural and spatial resemblance. This finding raised the hypothesis of their possible antitumoral activity, similar to that of tamoxifen (TAM). A number of DHBCs with an alkyl chain and a second basic nitrogen as substituent were synthesized in our laboratory and their possible antitumoral activity was tested by means of: 1) competitive radioligand assays to determine relative drug affinity for the estrogen receptor (ER); 2) in vivo studies, giving the synthetic drugs subcutaneously (1 mg kg

−1 day

−1) to Sprague–Dawley rats with

N‐nitroso‐

N‐methylurea (NMU)‐induced mammary tumors; and 3) in vitro cell proliferation experiments employing the soft agar clonogenic technique. Besides, studies on toxicity and histopathological analyses of organs and tumors from treated animals were performed. Results obtained showed that: 1) relative binding affinities (RBA) for the ER were similar to that of TAM; 2) some structures showed significant antitumoral activity and induced tumoral regression similar to TAM; and 3) these compounds had in vitro inhibitory effect on cell proliferation. Even though all the compounds of the series of synthesized DHBCs showed affinity for the ER similar to TAM, the results of in vivo experiments confirmed the crucial role of hydroxyl groups in the molecule and of the interatomic distance between them, similar to that of estradiol, as well as the necessary presence of the aminoalkyl chain on the annular N atom. However, the effect of alkyl chain enlargement in the nitrogen substituent on the biological activity of those drugs is as yet unclear.
In vivo antitumor activity of F 11782, a non‐intercalating dual catalytic inhibitor of topoisomerases I and II, against a panel of human tumor xenografts
Authors: Kruczynski A. , Ricome C. , Waud W.R. , Hill B.T.
Published: March 2003

The marked in vivo antitumor activity of F 11782 against murine experimental tumors (Kruczynski et al., Br J Cancer 83: 1516–24, 2000) has now been confirmed in a panel of human tumor xenografts. Using an intermittent schedule of six administrations over 2 weeks, F 11782 showed major activity in four of eight xenograft models. Excellent activity was noted versus the CAKI‐1 (renal) model, with regressions at the two highest doses, and marked activity against DLD‐1 (colon) xenografts, also resulting in regressions at the MTD. Marked antitumor activity was also observed against DU 145 (prostate) and GLC4 (small‐cell lung) tumors. At optimal doses, significant T/C values ranged from 3 to 29%, with significant growth delays of 1.5–5.6, without major body weight loss. This tumor growth inhibition induced by F 11782 was sustained with time for ≥6 weeks post implant. In contrast, no real activity was recorded against NCI‐H460 (non small‐cell lung) tumors and only minor responses, with optimal T/C values of <42%, noted in the rapidly proliferating SF‐295 (CNS) and LOX IMVI (melanoma) xenografts or the chemo‐refractory LoVo (colon) model. Overall, this study showing a 50% response rate with definite antitumor activity across a broad spectrum, coupled with its unique mechanistic profile, has prompted the further development of F 11782.
Mutational analysis of Turnip crinkle virus movement protein p8
Authors: Akgoz Muslum , Nguyen Que N. , Talmadge Ann E. , Drainville Katherine E. , Wobbe Kristin K.
Published: March 2003

Turnip crinkle virus encodes two proteins, p8 and p9, that are both required for cell‐to‐cell movement. The p8 movement protein has been demonstrated to bind RNA in a cooperative manner, although, similar to many other plant virus movement proteins, it contains no canonical RNA binding domain(s). However, three positively charged regions of p8 may potentially form ionic interactions with the RNA backbone. To identify functional regions of p8, a series of alanine and deletion scanning mutations were produced. The effects of these mutations were analysed using both in vitro RNA binding assays and in vivo infections of susceptible (Di‐3) and resistant (Di‐17) Arabidopsis thaliana plants. Several mutants that have reduced RNA binding ability were also demonstrated to be movement deficient and replication competent. Based on these results, there appear to be two regions, located between amino acids 18 and 31, and 50 and 72, that are required for RNA binding. Furthermore, additional regions (amino acids 12–15, and 34–37) appear to play a role in vivo unrelated to in vitro RNA binding activity.
Determination of relative proportions of Globodera species in mixed populations of potato cyst nematodes using PCR product melting peak analysis
Authors: Bates Jayne A. , Taylor Emily J. A. , Gans Paul T. , Thomas Jane E.
Published: March 2003

Using a novel approach based on melting peak analysis of PCR products, we have developed a semi‐quantitative assay to measure the relative proportions of Globodera pallida and Globodera rostochiensis in a sample of potato cyst nematodes (PCN). The method depends on a competitive multiplex PCR where the products of each species can be separated by their distinct melting temperatures (Tm). The melting curves of the products are measured by continual fluorescence monitoring in the presence of the intercalating dye SYBR Green I whilst gradually increasing the temperature. Varying the proportion of cysts of each PCN species gave rise to melting curves with different peak heights, which reflected the relative amounts of each DNA in the sample. By calculating the ratio of the melting peak heights at the Tm of each product and comparing it with standards run under the same conditions, it was possible to estimate the proportion of each product in the mixture. Sensitivity was such that 2% of G. pallida cysts in a mixture could be detected. All results predicted by the analysis were confirmed by agarose gel electrophoresis of the PCR products. The method is rapid, reproducible and following DNA extraction, up to 25 samples can be analysed in an hour.
Time for a blast: genomics of Magnaporthe grisea
Authors: Xu Jin‐Rong , Xue Chaoyang
Published: March 2003

The rice blast fungus Magnaporthe grisea causes one of the most destructive diseases of rice. Genetic studies of this important pathogen during the past decade have made it an excellent system for investigating fungal–plant interactions. Recently, the well coordinated efforts by the rice blast community have also made significant progresses in genomics studies of M. grisea. BAC contigs were assembled and integrated with the high density genetic map, and 12 674 BAC‐ends were sequenced as genome survey sequences. Over ten BAC clones have been sequenced by the shot‐gun approach. Preliminary analysis with one completely sequenced BAC clone indicated that M. grisea may have a gene density of 4.2 kb/gene and contain ≈ 9000 genes. In addition, > 10 000 ESTs have been sequenced from several cDNA libraries representing different stages of fungal growth, differentiation and plant infection. Currently, there are ongoing projects to sequence additional ESTs, telomeres, and 6X coverage of the M. grisea genome. A large‐scale functional genomics project on M. grisea and its interaction with rice is also underway. It is an exciting time for genomics studies in M. grisea, and the resources generated in these studies will certainly enhance our understanding of fungal pathogenicity.
Primary structure and tissue‐specific expression of the pathogenesis‐related protein PR‐1b in potato†
Authors: Hoegen Erika , Strömberg Anita , Pihlgren Ulla , Kombrink Erich
Published: March 2003

The infection of potato (Solanum tuberosum) leaves with the late blight pathogen Phytophthora infestans, or treatment with fungal elicitor, leads to the massive accumulation of pathogenesis‐related (PR) proteins in the extracellular leaf space. The most abundant of these proteins was purified to apparent homogeneity and identified as a new, basic member of the PR‐1 family of defence proteins, designated PR‐1b. Antibodies raised against the protein and a cDNA isolated by differential screening were used to study the temporal and spatial patterns of PR‐1b protein and mRNA distribution in healthy and infected potato tissues. PR‐1b was present in old leaves and at low levels also in the carpels of flowers. In leaves, strong accumulation of PR‐1b mRNA and protein occurred in response to infection by the oomycete pathogen Phytophthora infestans or the bacterial pathogen Pseudomonas syringae pv. maculicola. PR‐1b mRNA and protein accumulation was clearly initiated at the infection site, but a delayed and sustained accumulation was also observed in neighbouring, uninfected leaves of potato plants. Tissue‐ and cell type‐specific expression of PR‐1b was analysed by immunohistochemical and in situ RNA hybridization techniques. Appreciable amounts of PR‐1b protein and mRNA were localized in epidermal cells, guard cells of the stomata, glandular trichomes, crystal idioblasts, and cells of the vascular system of infected leaves. However, no significant differences in the amounts and distribution patterns of PR‐1b could be observed between compatible and incompatible interactions of potato and Phytophthora infestans, indicating that PR‐1b expression is not involved in determining cultivar/race‐specific resistance in potato.