bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical implications of emerging pathogens in haemophilia: the variant Creutzfeldt–Jakob disease experience
Authors: DOLAN G.
Published: January 2006

Summary. The impact of variant Creutzfeldt–Jakob disease (vCJD) on the clinical practice of haemophilia in the UK is coloured by the haemophilia community's experience of hepatitis C virus and human immunodeficiency virus (HIV) transmission via plasma‐derived therapies in the 1980s, when the delay in recognizing and acting on the potential risks cost many patients their lives and left others to manage another chronic disease. This crisis prompted organisations such as the United Kingdom Haemophilia Centre Doctors’ Organisation to advocate for the introduction of haemophilia therapies that would not be susceptible to contamination with blood‐borne pathogens. After the identification of vCJD in 1996, a number of public health measures were taken in response to a government‐sponsored vCJD risk assessment, and following reports of transfusion‐transmission of vCJD, additional guidelines have been developed to prevent person‐to‐person transmission, some of which may impact the quality and availability of medical and surgical care. Variant CJD has had a significant negative effect on the UK haemophilia community, shaking patient confidence in the therapies they have received over the last 21 years, affecting the quality of care and creating the risk of stigmatizing the community as it was in the 1980s. As with HIV and vCJD, emerging blood‐borne infectious agents will likely affect blood and blood‐derived therapies well before we become aware of its presence. As a result, only therapies with the lowest level of risk should be used for care of patients with haemophilia.
The physician's role in selecting a factor replacement therapy
Authors: PIPE S. W.
Published: January 2006

Summary.  Over the past 20 years, transmissions of human immunodeficiency virus (HIV), hepatitis B virus or hepatitis C virus have been virtually eliminated from plasma‐derived or recombinant therapy in the USA, a record that can be largely attributed to the use of effective screening and inactivation technologies for known pathogens. The next significant threat will likely come from the emergence of a new, blood‐borne infectious disease, perhaps one transmitted by a non‐lipid‐enveloped virus or prion, for which current inactivation methods are ineffective. Following the HIV crisis of the 1980s, government, patient advocacy groups, medical and scientific communities and the manufacturers of clotting therapies can learn from the past and approach potential threats from emerging pathogens in a proactive and productive manner. For clinicians, this includes actively engaging patients in a dialogue about all the factors that may influence their choice of clotting factor therapies, including emerging pathogens, patient convenience, consistency and reliability of supply, relative cost/benefit ratios, reimbursement issues (where applicable), patient preference and brand loyalty. It is our obligation as healthcare providers to understand potential risks and help make proactive decisions with our patients, decisions that often must be made in an environment of scientific uncertainty. Threats from infectious agents that were once deemed theoretical can, and often do, ultimately become real, with serious implications for morbidity and mortality.
Qualitative meta‐synthesis: a question of dialoguing with texts
Authors: Zimmer Lela
Published: January 2006

Aims.  This paper discusses whether useful synthesis of research reports across different qualitative methodologies is possible, and whether qualitative meta‐synthesis violates the tenets of the interpretive paradigm.

Background.  Qualitative meta‐synthesis is a recent development in qualitative inquiry that offers a means of enhancing the contribution of qualitative findings to the development of more formalized knowledge. However, there are a number of unanswered questions and areas that require debate.

Discussion.  A brief overview of qualitative meta‐synthesis as a method of inquiry is presented. The assumptions of phenomenology, ethnography and grounded theory are explored for their amenability to meta‐synthesis and the possibility of coherent synthesis of findings across these methodologies. In addition, a summary of major philosophical commitments common to the interpretive paradigm is presented. Qualitative meta‐synthesis as a methodology is then explored for its fit within this paradigm. An argument is made, with some caveats, for synthesis across qualitative methodologies. Gadamer's concepts of the hermeneutic circle, the fusion of horizons, and dialogue with the text are explored for the insight they provide into the place of qualitative meta‐synthesis in inquiry.

Conclusion.  It is important for researchers to bring hermeneutic skill to the process of meta‐synthesis in order to develop a comprehensive understanding of the various philosophical assumptions in which qualitative approaches are based. The particular challenge of combining analysis and interpretation from studies with markedly different approaches and intentions may prompt synthesists to create new and innovative approaches to the presentation of meta‐synthesis.
Prehospital care pathway delays: gender and myocardial infarction
Authors: O'Donnell Sharon , Condell Sarah , Begley Cecily , Fitzgerald Tony
Published: January 2006

Aim.  This paper reports the findings of a study that identified gender specific prehospital care pathway delays amongst Irish women and men with myocardial infarction.

Background.  Women are more likely to experience a poorer prognosis than their male counterparts following hospitalization for myocardial infarction, yet research shows that women continue to experience prehospital care pathway delays.

Methods.  A 1‐year prospective census was carried in six major academic teaching hospitals in Dublin, Ireland in 2001–2002. A total of 277 (31%) female and 613 (69%) male patients with confirmed myocardial infarction were included in the study.

Results.  Women were more likely to experience prolonged ‘initial symptom‐onset to A&E delays’ (14 hours vs. 2·8 hours P < 0·0001), and ‘intense symptom‐onset to A&E delays’ (3·1 hours vs. 1·8 hours , P < 0·0001), i.e. arrival at a hospital accident and emergency department. Advancing age was associated with greater prehospital delays (P < 0·0001), whilst patients with private health insurance had shorter delays than public patients (without private health insurance) or those with medical cards (entitling them to means‐tested medical benefits) (P = 0·001). Patients who drove themselves by car to hospital had shorter median prehospital times than those arriving by any other admission mode (P < 0·0001), whilst those referred by their general practitioner had longer delays than those who were self‐referred (5 hours vs. 1·7 hours, P < 0·0001).

Conclusions.  Female gender, advancing age, referral source, insurance status and mode of transport to hospital are independent factors contributing to prehospital patient delays. Nurses who care for patients with coronary artery disease have a unique opportunity to educate people about the most appropriate action to be taken in the event of experiencing symptoms.
The psychological effects of organizational restructuring on nurses
Authors: Brown Hilary , Zijlstra Fred , Lyons Evanthia
Published: January 2006

Aim.  This paper reports a comparison of nurses affected by the restructuring associated with healthcare organization mergers (1998–2000) in the United Kingdom and those of non‐affected nurses in the UK.

Background.  Restructuring, a feature of healthcare organizations for decades, has been associated internationally with negative outcomes for nurses. Despite this, no model to evaluate management of change factors and psychological stress processes has been operationalized and tested.

Method.  A sample of 351 Registered Nurses was recruited from southern England. Participants either worked in organizations that were within 6 months of merging or were not affected by mergers. On two occasions, 6 months apart, all were sent a questionnaire that had been formulated for the study. Questions related to the parts of the model being tested: restructuring initiatives (i.e. stressors) information and participation, coping action, and coping effectiveness (i.e. outcomes). The data were collected between 1998 and 2000.

Findings.  Nurses affected by mergers reported statistically significantly higher restructuring initiatives before and after an event than non‐affected nurses. Moreover, up to 12 months after an event some affected nurses reported lower information and participation, and lower coping effectiveness (i.e. higher job insecurity, job stress, job pressure, lower job satisfaction, physical, psychological, and environmental quality of life) than non‐affected nurses, which was consistent with the model's proposals. However, there was no difference between affected and non‐affected nurses’ coping action.

Conclusion.  The psychological effects of restructuring are linked with perceptions of low information and participation, and with negative outcomes for nurses. Managers, therefore, need to communicate information and encourage staff to participate in decisions about restructuring events.
Monitoring child and parent refusals to enrol in clinical research protocols
Authors: Gattuso Jami , Hinds Pamela , Tong Xin , Srivastava Kumar
Published: January 2006

Aims.  The aim of this paper is to report the rates and reasons for refusal given by 817 eligible participants from 10 completed and ongoing nursing and behavioural medicine studies in paediatric oncology from 1994 to 2004.

Background.  Eligible participants have the right to accept or decline participation in research studies. Information about rates of refusal and reasons for refusal could be useful in determining participant‐perceived burden related to study participation, in accurately estimating the time needed to accrue an adequate number of participants to achieve the study aims, and in interpreting study findings from certain groups of participants.

Methods.  A 13‐item survey form about study characteristics was completed prospectively for each study included in this report; categories of reasons for refusal were inductively identified and defined using a semantic content analytic technique.

Results.  The overall rate of refusal was 23·6% (range: 6·7–46·7%). The studies that involved blood sampling or end‐of‐life decision‐making had the highest refusal rates and an instrumentation study had the lowest. Eligible male participants had consistently higher rates of refusal than did females across the 10 studies. Nine categories of refusal were inductively identified, with the most commonly reported reason being the burden of the research methods.

Conclusion.  A careful informed consent process will still result in some refusals. The refusal rates reported here can be used to help future researchers more accurately estimate accrual periods for studies involving blood sampling or investigating sensitive topics in paediatric oncology.
Establishing a definition for a nurse‐led clinic: structure, process, and outcome
Authors: Wong Frances K.Y. , Chung Loretta C.Y.
Published: January 2006

Aim.  This paper reports a study to define a nurse‐led clinic by exploring the domains of structure, process and outcome.

Background.  Nurse clinics have been introduced as a measure to support intermediate care after the acute phase of disease. Previous studies have been mainly descriptive, or have only addressed a particular aspect of clinic service.

Methods.  This exploratory study was conducted in two phases. In the first phase, nurses from 34 clinics were interviewed. In the second phase, 162 clinic sessions were observed, and 162 patients and 16 physicians were interviewed. The data were collected in 2001–2003.

Results.  The nurses who ran the clinics were very experienced, and resources were available to support their work. Over 80% of their work was independent or interdependent, involving skills such as adjusting medications, and initiating therapies and diagnostic tests according to protocols. The principal interventions were assessments and evaluations, and health counselling. The nurses rated ‘management of symptoms’, ‘prevention of complications’, and ‘client satisfaction’ as the top three key indicators of their success. All patients studied showed improvement after the nurse clinic consultation, but the best rates were found in wound and continence clinics. Satisfaction scores for both nurses and clients were high. Physicians valued their partnership in care with the nurses, but were concerned about possible legal liability resulting from the advanced roles assumed by these nurses.

Conclusions.  A nurse clinic is an effective alternative model of ambulatory healthcare delivery that uses a holistic framework.
A novel regulatory circuit specifies cell fate in the Arabidopsis root epidermis
Authors: Schiefelbein John , Lee Myeong Min
Published: January 2006

The specification of distinct cell fates in multicellular organisms is a fundamental process in developmental biology. The Arabidopsis root epidermis, which consists of root‐hair cells and non‐hair cells, provides a useful model system for studying cell fate specification. In this tissue, the cell fates are determined by their relative position to the underlying cortical cells, and many genes have been identified that regulate this position‐dependent cell fate specification. Recent studies using genetic, molecular, and biochemical approaches have shed new light on this process and revealed a complex network of interacting and interdependent components. In particular, a novel regulatory circuit has recently been identified, which includes a lateral inhibition pathway and a feedback loop that enables intercellular communication and ensures that two distinct cell types arise in an appropriate pattern. This regulatory circuit is also influenced by a positional signaling pathway which includes the SCRAMBLED leucine‐rich repeat receptor kinase. The studies of cell fate specification in the Arabidopsis root epidermis provide new insights into the molecular strategies used to define distinct cell types in plants.
Development of an interspecific Vigna linkage map between Vigna umbellata (Thunb.) Ohwi & Ohashi and V. nakashimae (Ohwi) Ohwi & Ohashi and its use in analysis of bruchid resistance and comparative genomics
Authors: Somta P. , Kaga A. , Tomooka N. , Kashiwaba K. , Isemura T. , Chaitieng B. , Srinives P. , Vaughan D. A.
Published: January 2006

To facilitate transfer of bruchid resistance to azuki bean (Vigna angularis) from its relatives an interspecific mapping population was made between rice bean, V. umbellata, and the related wild species V. nakashimae. The V. umbellata parent is completely resistant and V. nakashimae is completely susceptible to the bruchid beetle pests, azuki bean weevil (Callosobruchus chinensis) and cowpea weevil (C. maculatus). There is very low cross compatibility between V. umbellata and azuki bean. Therefore, V. nakashimae, that crosses with both V. umbellata and V. angularis without the need for embryo rescue, is used as a bridging species. A genetic linkage map was constructed based on an interspecific F2 mapping population between V. umbellata and V. nakashimae consisting of 74 plants. A total of 175 DNA marker loci (74 RFLPs and 101 SSRs) were mapped on to 11 linkage groups spanning a total length of 652 cM. Segregation distortion was observed but only three markers were not linked to any linkage group due to severe segregation distortion. This interspecific genome map was compared with the genome map of azuki bean. Of 121 common markers on the two maps, 114 (94.2%) were located on the same linkage groups in both maps. The marker order was highly conserved between the two genome maps. Fifty F2 plants that produced sufficient seeds were used for quantitative trait locus (QTL) analysis and locating gene(s) for C. chinensis and C. maculatus resistance in V. umbellata. The resistance reaction of these F2 plants differed between C. chinensis and C. maculatus. Both resistances were quantitatively inherited with no F2 plants completely susceptible to C. chinensis or C. maculatus. One putative QTL for resistance to each of these bruchid species was located on different linkage groups. Other putative QTLs associated with resistance to both C. chinensis and C. maculatus were localized on the same linkage group 1. Linked markers associated with the bruchid‐resistant QTL will facilitate their transfer to azuki bean breeding lines.
Distribution of the wheat–rye translocation 1RS.1BL among bread wheat varieties of Bulgaria
Authors: Landjeva S. , Korzun V. , Tsanev V. , Vladova R. , Ganeva G.
Published: January 2006

The distribution of the wheat–rye translocation 1RS.1BL was studied in 31 winter wheat varieties from Bulgaria. The presence of the translocation was verified in 17 varieties using chromosome N‐banding analysis, PAGE‐analysis of grain storage proteins and DNA‐marker analysis. The 1RS.1BL has been transmitted in 54% of varieties with a known source of the translocation in their pedigree.
Cloning, genetic and physical mapping of resistance gene analogs in barley (Hordeum vulgare L.)
Authors: Mammadov J. A. , Liu Z. , Biyashev R. M. , Muehlbauer G. J. , Saghai Maroof M. A.
Published: January 2006

The majority of verified plant disease resistance genes isolated to date belong to the NBS‐LRR class, encoding proteins with a predicted nucleotide binding site (NBS) and a leucine‐rich repeat (LRR) region. Using degenerate primers, designed from the conserved motifs of the NBS region in tobacco N and Arabidopsis RPS2 genes, we isolated 190 resistance gene analogs (RGA) clones from barley genomic DNA. A total of 13 single‐ and low‐copy RGAs were genetically mapped onto chromosomes 1H–7H (except 5H) using three barley double haploid (DH) mapping populations: Steptoe × Morex, Harrington × TR306 and LUGC × Bowman. Sequence analysis of the RGAs showed that they are members of a diverse group. As a result of BLAST searches, one RGA proved unique as it did not detect any significant hit. Another RGA is putatively functional, because it detected several barley expressed sequence tag (EST) matches. To physically map the RGAs, 13 sequences were used to screen a 6.3 × cv. ‘Morex’ bacterial artificial chromosome (BAC) library. After fingerprint analysis, eight contigs were constructed incorporating 62 BAC clones. These BAC contigs are of great value for positional cloning of disease resistance genes, because they span the regions where various barley R genes have been genetically mapped.
Expression profiling of Italian ryegrass (Lolium multiflorum Lam.) during infection with the bacterial wilt inducing pathogen Xanthomonas translucens pv. graminis
Authors: Rechsteiner M. P. , Widmer F. , Kölliker R.
Published: January 2006

Bacterial wilt caused by Xanthomonas translucens pv. graminis (Xtg) may lead to severe damage and substantial yield losses in Italian ryegrass, Lolium multiflorum Lam. To identify candidate genes for marker‐assisted breeding and to investigate the molecular basis of the host‐pathogen interaction, this study focused on searching the ryegrass genome for resistance genes and key signal transduction elements in the defence response. cDNA‐amplified fragment length polymorphism (AFLP) was used to analyse differentially expressed genes at six time‐points after infection in a partially resistant genotype of L. multiflorum infected with Xtg. A total of 87 selective primer combinations resulted in 173 differentially expressed transcript‐derived fragments (TDF) out of which 37 TDFs were isolated. Database searches revealed sequence homologies of various TDFs to sequences such as ERBP‐transcription factors, an TGF‐β receptor interacting protein, a terpene synthase and various other genes expressed in response to bacterial and fungal infection. Reverse transcription‐polymerase chain reaction (RT‐PCR) and quantitative RT‐PCR (qRT‐PCR) confirmed the expression patterns found by cDNA‐AFLP. The TDFs identified represent candidate genes for the identification of quantitative trait loci (QTLs) involved in resistance to bacterial wilt. These TDFs may also allow for the identification and analysis of avirulence genes expressed by Xtg. The results of this study provide a valuable basis not only for a better understanding of the genetic control of resistance to bacterial wilt in Italian ryegrass, but primarily for the development of molecular tools to improve resistance breeding.
Selection for Fusarium head blight resistance in early generations reduces the deoxynivalenol (DON) content in grain of winter and spring wheat
Authors: Wilde F. , Miedaner T.
Published: January 2006

Fusarium head blight (FHB) results in yield losses and contamination of kernels by mycotoxins, particularly deoxynivalenol (DON). For minimizing DON content in grain, indirect selection methods would increase gains from selection compared to the costly and time‐consuming DON analysis. The aim of this study was to examine whether an early selection for fewer FHB symptoms would lead to a reduced DON content in grain after inoculation with Fusarium culmorum. Starting with a double‐cross derived population of about 1,100 genotypes, 30 F1:3 genotypes were selected for FHB rating in a two‐step selection in spring wheat with the non‐adapted resistance sources CM82036 and ‘Frontana’. In winter wheat, 30 F1:2 genotypes were selected out of a double‐cross derived population of about 600 F1 plants from crosses with German resistance sources (‘Dream’, G16‐92). Selected genotypes were grouped in three categories according to their FHB rating (low, moderate and high) and analysed afterwards for grain DON content. The three groups differed in their DON content illustrating that indirect selection should already be feasible in the earliest generations. Because of the wide genotypic ranges for DON contents within one grouping, a final DON analysis for selected materials is advisable to achieve full selection gain.
Characterization of high‐molecular‐weight glutenin subunit genes fromElytrigia elongata
Authors: Wang J. R. , Yan Z. H. , Wei Y. M. , Zheng Y. L.
Published: January 2006

Three high‐molecular‐weight glutenin subunit (HMW‐GS) genes fromElytrigia elongata(Host) Nevski were characterized by determining the coding sequences of two x‐type subunit genesEe2.1andEe1.9, and one y‐type subunit geneEe1.8with 2082, 1938 and 1788 bp, respectively. The numbers of amino acids in the central repeat domains of Ee2.1, Ee1.9 and Ee1.8 were considerably fewer than the other known HMW‐GSs with substitutions, insertions and/or deletions involving a single or more amino acid residues. Moreover, an extra cysteine (Cys) was found in the repeated domain of x‐type subunit Ee2.1. The difference in the number and position of Cys residues might be associated with the good dough quality. The extra Cys in the good‐quality subunit Dx5 was at the beginning of the repetitive domain, while the extra Cys in Ee2.1 was at the central repetitive domain. Evolutionary relationships between the HMW‐GSs fromE. elongataand the known HMW‐GSs were estimated. It transpired that Ee1.9, Ee2.1 and Bx7 were clustered into one subgroup with high bootstrap values, while Ee1.8 was closely related to Ay.
Improved plant regeneration and in vitro somatic embryogenesis of St Augustinegrass [Stenotaphrum secundatum (Walt.) Kuntze]
Authors: Li R. , Bruneau A. H. , Qu R.
Published: January 2006

St Augustinegrass [Stenotaphrum secundatum (Walt.) Kuntze] is an important warm season turf and pasture grass. In vitro tissue culture of St Augustinegrass could serve as an important mean for its improvement through genetic transformation as well as induced somaclonal variation. To optimize tissue culture conditions for plant regeneration of St Augustinegrass, tissue culture responses of 11 explant tissues and four callus induction/subculture media have been examined. Embryogenic calli with regeneration potential were observed on cultures of early immature embryo [3 days after pollination (DAP)], immature embryo (7–14 DAP), and shoot base of young seedlings. The addition of benzyladenine (BA) in the callus induction/subculture medium enhances callus regeneration ability and does not harm callus induction for immature embryos. The best response came from 7 to 14 DAP immature embryo on MS medium containing 1 mg/l 2,4‐dichlorophenoxyacetic acid and 0.5 mg/l BA. The callus induction and regeneration rates were 97.7% and 47.6% respectively. However, BA supplement reduced callus formation and failed to enhance regeneration for young leaf bases. Scanning electron microscopy revealed that plant regeneration of St Augustinegrass is via somatic embryogenesis.
Changes in plasma levels of hepatocyte growth factor and its associated factors during pregnancy
Authors: Watanabe Takashi , Sakata Yoichi , Matsubara Shigeki , Yamagishi Toshiya , Nagaike Kazuhiro , Kuwata Tomoyuki , Suzuki Mitsuaki
Published: January 2006

Aim:  Hepatocyte growth factor (HGF) was originally identified as a factor that stimulates the mitogenesis of hepatocyte, and also plays a role in maintaining pregnancy. We conducted this study to evaluate the changes in plasma concentrations of HGF and its associated factors during normal pregnancy.

Methods:  Blood specimens were obtained from 14 healthy non‐pregnant and 175 healthy pregnant and post‐partum women (189 women in all). The women's plasma concentrations of total HGF, active HGF, active HGF activator (HGFA), HGF activator inhibitor type 1 (HAI‐1) and HGF activator inhibitor type 2 (HAI‐2) were determined by enzyme‐linked immunosorbent assay.

Results:  The levels of active HGF and HGF activator were significantly lower in pregnant women compared with those of non‐pregnant women. The level of plasma HAI‐1 significantly increased as pregnancy progressed, while it fell post‐partum. Also, there were no differences in the concentrations of total HGF and HAI‐2 in non‐pregnant and pregnant women.

Conclusion:  A high concentration of HAI‐1 during pregnancy may decrease the plasma level of active HGFA. This may in turn inhibit the activation of the precursor form of HGF, leading to a decrease in the level of plasma active HGF.
Influence of α‐tumor necrosis factor and β‐interleukin‐1 on production of angiogenetic factors and thymidine phosphorylase activity in immortalized human decidual fibroblasts in vitro
Authors: Hayashi Takashi , Matsuoka Kikumi , Saitoh Masahiro , Takeda Satoru , Kimura Masayuki
Published: January 2006

Aim:  The aim of the present study was to investigate regulatory mechanisms of angiogenesis in the decidua using immortalized human decidual fibroblasts.

Methods:  A sample of decidual fibroblasts was taken from a woman in early pregnancy. A cell line, DE‐1, was established by infecting the decidual fibroblasts with the simian virus 40 large T antigen. Using this cell line, the ability to produce vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), β‐transforming growth factor (TGF‐β), and thymidine phosphorylase (TP) activity was investigated using immunohistochemistry, and the influences of β‐interleukin‐1 (IL‐1β) and α‐tumor necrosis factor (TNF‐α) on these angiogenetic factors was investigated using enzyme‐linked immunosorbent assays. Furthermore, the effects of TNF‐α on proliferative capacity and apoptosis induction in DE‐1 were studied.

Results:  It was demonstrated that DE‐1 produced all of these angiogenetic factors. The production of VEGF, bFGF and TGF‐β respectively was enhanced by both IL‐1β and TNF‐α. TP activity was increased by TNF‐α, but no increase was observed as a result of IL‐1β. It was shown that TNF‐α suppressed the proliferation of DE‐1 cells and significantly increased the percentage of apoptotic cells.

Conclusion:  It is suggested that IL‐1β and TNF‐α stimulate decidual fibroblasts to up‐regulate angiogenesis in the human decidua.
Total peroxyl radical‐trapping ability and anti‐oxidant vitamins of the umbilical venous plasma and the placenta in pre‐eclampsia
Authors: Kim Yoon Ha , Kim Cheol Hong , Cho Moon Kyoung , Kim Ki Min , Lee So Yoon , Ahn Bong Whan , Yang Sung Yeul , Kim Seok Mo , Song Tae Bog
Published: January 2006

Aim:  Our purpose was to investigate lipid peroxide levels, total peroxyl radical‐trapping anti‐oxidative parameter (TRAP) values, and anti‐oxidant vitamin levels in umbilical venous plasma and placental tissues, and to evaluate their roles in the pathophysiology of pre‐eclampsia.

Methods:  Samples of umbilical venous plasma and placental tissue homogenates were obtained from 23 normal and 18 pre‐eclamptic women at between 33 and 40 weeks’ gestation. The enzyme‐linked immunosorbent assay method was used to assay α‐tumor necrosis factor (TNF‐α), and lipid peroxide levels were measured by thiobarbituric acid reaction. The TRAP values were measured using the modified Wayner's method. Ascorbic acid, retinol α‐tocopherol and γ‐tocopherol were measured by high performance liquid chromatography.

Results:  Levels of TNF‐α in placental tissue homogenates of women with pre‐eclampsia were significantly higher than those of women with normal pregnancy (21.4 ± 3.39 v. 10.3 ± 1.06 pg/mL, P < 0.05). Lipid peroxide levels in umbilical venous plasma and placental tissue homogenates of women with pre‐eclampsia were significantly higher than those of women with normal pregnancy (10.3 ± 1.1 v. 5.85 ± 0.53, P < 0.01, 5.14 ± 0.40 v. 3.99 ± 0.33 nmol/mg protein, P < 0.05, respectively). The TRAP values in umbilical venous plasma and placental tissue homogenates of women with pre‐eclampsia were significantly lower than those of women with normal pregnancy (0.39 ± 0.02 v. 0.45 ± 0.02, P < 0.05, 0.27 ± 0.02 v. 0.34 ± 0.03 mM, P < 0.05, respectively). Ascorbic acid levels in umbilical venous plasma and placental tissue homogenates of women with pre‐eclampsia were significantly lower than those of women with normal pregnancy (325.4 ± 50.4 v. 543 ± 73.8, P < 0.05, 219.0 ± 21.0 v. 333.3 ± 32.6 nmol/mL, P < 0.05, respectively).

Conclusions:  The above results suggest that increased oxidative stress in the placenta is involved in the pathophysiology of pre‐eclampsia, and ascorbic acid may act as an important preventative factor in the development of pre‐eclampsia.
Giant hemangioma of the fetal neck, mimicking a teratoma
Authors: Yoshida Shiro , Kikuchi Akihiko , Naito Sachie , Nakamura Hisaki , Hayashi Akiko , Noguchi Masahiko , Kondo Yoshiaki , Nakamura Tomohiko
Published: January 2006

We present a case involving a giant hemangioma of the fetal neck, prenatal diagnosis of which was a teratoma. A 32‐year‐old pregnant woman was referred to our hospital at 31 weeks’ gestation owing to a giant solid mass of the fetal neck and excessive amniotic fluid. The mass seemed to be occupying the neck almost entirely, extending to the nasopharyngeal cavity, the mandible, the surface of the left orbit and the left shoulder. Based on sonographic and magnetic resonance imaging (MRI) findings, diagnosis of a giant teratoma was made. Cesarean section was performed at 35.5 weeks’ gestation, and a female infant weighing 2826 g was delivered. Purpurae were observed on the neck of the infant, and the tumor turned out to be a hemangioma. Postnatal MRI findings, in which the tumor's signal intensity differed from that of the prenatal findings, were quite compatible with the diagnosis of a typical hemangioma. Laser and corticosteroid treatment successfully decreased the volume of the mass. Although it may not always be possible to make a prenatal differential diagnosis between a hemangioma and a teratoma in the neck of the fetus, serial ultrasound and MRI examination are mandatory to evaluate the prognosis and to plan suitable treatment. Moreover, possible postnatal changes to the tumor characteristics have to be taken into consideration when evaluating the findings of prenatal diagnostic imaging.
Complications and myoma recurrence after laparoscopic uterine artery occlusion for symptomatic myomas
Authors: Holub Zdenek , Eim Josef , Jabor Antonin , Hendl Antonin , Lukac Jan , Kliment Lev
Published: January 2006

Aim:  To determine the frequency and severity of complications and the recurrence of fibroids as a result of laparoscopic occlusion of the uterine artery (LOUA) in women with symptomatic fibroids.

Methods:  One hundred and fourteen women with symptomatic fibroids were treated using ultrasonically activated shears, clips or electrosurgery. A retrospective evaluation of the complications and recurrence rate was carried out. For each patient, the analysis took place at least 3 months after the procedure was performed. Each complication was categorized using the complication classifications developed by the Czech Society of Gynecologic Endoscopy and a modified set of the classifications of the American College of Obstetricians and Gynecologists. All adverse events that occurred during the follow‐up period were included, in addition to those that occurred after the 3 months minimum interval.

Results:  A total of eight women (7.1%, 95% confidence intervals [CI], 3.3–14.4) experienced complications; one of these women had two complications, resulting in a total of nine adverse events. There were no intraoperative complications and no permanent injuries. Two women required supracervical hysterectomy and myomectomy, respectively, as a result of fibroid necrosis. One patient had an undiagnosed endometrial stromal sarcoma after 12 months of LOUA. The rate of fibroid recurrence was 9.0% (10 patients). The recurrence‐free survival interval rate (no clinical failure, no recurrence) at 23.6 months (median) follow‐up was 88.3% (CI 84.9–93.5).

Conclusion:  The rate of complications and fibroid recurrence was low in patients undergoing LOUA.
Is there a correlation between vaginal chlamydia infection and cervical smear abnormalities? A community‐based study in the Al‐Ain district, United Arab Emirates
Authors: Ghazal‐Aswad Saad , Badrinath Padmanabhan , Osman Nawal Ahmed , Abdul‐Khalik Samar , Raasclou Tove
Published: January 2006

Aim:  The purpose of this study was to determine the correlation between vaginal chlamydia infection and cervical abnormalities. The data on the prevalence of chlamydia infection and cervical abnormalities have been presented elsewhere and in this article we provide the results of a correlation analysis.

Methods:  In this cross‐sectional, community‐based survey, women attending primary and secondary care in the Al‐Ain medical district, United Arab Emirates, were offered cervical screening using the Papanicolaou smear, and chlamydia testing. A total of 793 women underwent cervical screening and 728 were tested for chlamydia. A commercially available kit was used to determine the prevalence of chlamydia. The correlation between cervical abnormalities and chlamydia infection was tested using the chi‐squared test or Fisher's exact test, as appropriate.

Results:  The prevalence of abnormal smears was 1.51% (95% confidence interval [CI], 0.66–2.4). Twelve subjects had abnormal smears, including smears showing atypical squamous cells of undetermined significance. The prevalence of chlamydia infection in this population was 2.5% (95% CI, 1.2–3.3). Statistical analysis showed no association (χ2 0.6, P = 0.4) between the prevalence of chlamydia infection and cervical abnormalities.

Conclusion:  Although there have been earlier reports of an association between vaginal chlamydia and cervical abnormalities, our study does not provide evidence to support this association.
Intrapartum late deceleration develops more frequently in pre‐eclamptic women with severe proteinuria
Authors: Furukawa Seishi , Sameshima Hiroshi , Ikenoue Tsuyomu
Published: January 2006

Aim:  Our purpose was to investigate the effect of proteinuria associated with pre‐eclampsia on intrapartum fetal heart rate patterns.

Methods:  A retrospective study was performed involving 79 pregnant women with pre‐eclampsia and 19 pregnant women with gestational hypertension (GH). Pre‐eclampsia was then classified into two groups according to the degree of proteinuria (≥ or <3+ dipstick), which was classified as severe urinary protein (UP; n = 35) and mild UP (n = 44) at delivery. Intrapartum fetal heart rate (FHR) monitoring was classified as either no deceleration, moderate variable deceleration, severe variable deceleration (sVD), prolonged deceleration (PD), occasional deceleration or recurrent late deceleration (rLD). We evaluated the prevalence of non‐reassuring FHR (sVD, PD or rLD), the prevalence of intrauterine growth restriction (IUGR), and cord blood gas status in the three groups. The prevalence of non‐reassuring FHR and cord blood gas status of these three groups was also compared with their prevalence in 65 women with low‐risk pregnancies. Multiple logistic regression analysis was performed to determine the association between rLD and maternal–fetal parameters.

Results:  Levels of systolic and diastolic blood pressure were similar among the three groups. Severe UP was diagnosed significantly earlier, was associated with significantly lower gestational age, and infants with lighter birth weight (P < 0.05) compared with GH and mild UP. The prevalence of IUGR in severe UP was higher than in GH (54%v. 21%, P < 0.05); however, no differences were found in the prevalence of IUGR between mild and severe UP (43%v. 54%, P = 0.33). The prevalence of non‐reassuring FHR in GH was not statistically significant in the low‐risk pregnancies (5%v. 9%, P = 0.58). In mild and severe UP, the non‐reassuring FHRs were more predominant (30% and 43%, respectively) than in low‐risk pregnancies and GH (P < 0.05). The rLD was more common in the group with severe UP and accounted for 40% of all FHR patterns. There was no difference in the incidence of low pH among the groups. However, fetuses in pregnancies involving severe UP were significantly hypoxemic when compared with others. Multiple logistic regression analysis showed that worsening proteinuria (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.4–12.9) and IUGR (OR, 3.8; 95% CI, 1.2–11.5) increased the risk of rLD. Rates of preterm birth at less than 32 weeks (OR, 0.7; 95% CI, 0.2–2.5) and severe hypertension (OR, 0.5; 95% CI, 0.2–1.3) were not significant.

Conclusion:  In pre‐eclampsia, the presence of severe proteinuria is associated with an increased likelihood of rLD.
Increase in serum concentrations of inhibin in early onset pre‐eclampsia with intrauterine growth restriction
Authors: Itoh Yoshiyasu , Suzuki Yoshikatsu , Yamamoto Tamao , Kojima Kazuhisa , Murakami Isamu , Suzumori Nobuhiro
Published: January 2006

Aim:  Recently, it has been hypothesized that reduced placental blood flow in early pregnancy causes changes in endothelial function, leading to pre‐eclampsia. To clarify this clinically, we assessed serum concentrations of inhibin and uric acid in pre‐eclamptic women compared with those of normotensive pregnant women.

Methods:  One hundred and forty normotensive pregnant women (at 20–41 weeks’ gestation) and 50 women with pre‐eclampsia (at 24–41 weeks’ gestation) were the study subjects. Pre‐eclamptic women were classified according to the new criteria for pregnancy‐induced hypertension produced by the Japanese Society of Obstetrics and Gynecology (JSOG). Serum concentrations of uric acid and inhibin were measured enzymatically and by radioimmunoassay, respectively.

Results:  Serum concentrations of inhibin and uric acid in the pre‐eclamptic women were significantly higher than in gestational age‐matched normotensive pregnant women. There were significant correlations among inhibin and uric acid, blood pressure and birth weight. According to JSOG criteria, of the 50 pre‐eclamptic women, 18 were early onset (EO), including 16 cases complicated by intrauterine growth restriction (IUGR), and 32 cases were late onset, including 12 cases complicated by IUGR. In the patients with EO and IUGR, serum concentrations of inhibin, but not uric acid, were significantly elevated as compared with those of the other pre‐eclamptic women.

Conclusion:  The results suggest that an increase in the serum concentration of inhibin seen in EO pre‐eclampsia, together with IUGR, might be a cause of reduced placental blood flow.
Bilateral pleural endometriosis
Authors: Dhanaworavibul Kriengsak , Hanprasertpong Jitti , Cheewadhanaraks Sopon , Buhachat Rakchai
Published: January 2006

The patient was a 40‐year‐old woman with a 1‐year history of catamenial chest pain and a recent bilateral hemothorax. She underwent a left thoracotomy for surgical pleurodesis, and a pleural biopsy. Subsequently, she had a hysterectomy in conjunction with an oophorectomy. The pathologic investigation of the pleura revealed an endometrial implant. The postoperative course was uneventful with no recurrence of hemothorax and chest pain during the first 6 months and at the patient's follow‐up. This is a very rare case of a patient with thoracic endometriosis presenting with bilateral hemothorax.
Prenatal diagnosis of bilateral diaphragmatic hernia by fetal sonography
Authors: Eroglu Derya , Yanik Filiz , Sakallioglu Ayse Ebru , Arikan Unser , Varan Birgul , Kuscu Esra
Published: January 2006

This report describes a case of prenatally diagnosed bilateral diaphragmatic hernia. At 22 weeks’ gestation, ultrasound revealed a cystic structure behind the fetus's heart on the axial image at the level of the cardiac four‐chamber view. This suggested a left‐sided congenital diaphragmatic hernia with herniation of the stomach into the left hemithorax. However, the left‐to‐right midline shift of the heart was minimal, which is not typical of left‐sided congenital diaphragmatic hernia. Throughout the 30th week of gestation, the right and left branches of the pulmonary artery were hypoplastic compared with the values in normal fetuses of the same gestational age. The presumptive diagnosis was bilateral congenital diaphragmatic hernia. A female newborn weighing 2900 g was delivered at 37 weeks’ gestation, and she died at 7 h of age. An autopsy revealed large defects on both sides of the diaphragm. In conclusion, prenatal diagnosis of bilateral diaphragmatic hernia is possible with fetal sonography.
Effects of KUR‐1246, a selective uterine relaxant, on transplacental passage and transmigration to milk
Authors: Furihata Yoshio , Kobayashi Mamoru , Kojima Masami , Kobayashi Kaoru , Kawarabayashi Tatsuhiko , Yamamoto Toshinori
Published: January 2006

Aim: To evaluate the safety of KUR‐1246 as a tocolytic agent, we determined the effects of its constant infusion on efficacy, transplacental passage, and transmigration to milk in pregnant or puerperal animals and compared them to the effects of ritodrine hydrochloride.

Methods: A balloon method was used to evaluate the inhibitory effects of KUR‐1246 constant infusion on spontaneous uterine motility in pregnant rats. We also measured transplacental passage and transmigration to milk of KUR‐1246 in pregnant and/or puerperal animals. KUR‐1246 and ritodrine hydrochloride concentrations were quantified using a liquid chromatography‐tandem mass spectrometry method.

Results: Constant infusion of KUR‐1246 and ritodrine hydrochloride clearly inhibited spontaneous uterine motilityin vivo. The ED50value for KUR‐1246 was 1.1 mg/kg/min, a potency which was approximately 40‐fold greater than that of ritodrine hydrochloride. Transplacental passage (proportions of fetal plasma/maternal plasma) of KUR‐1246 in pregnant rats and/or guinea pigs were approximately one‐half to one‐third of that of ritodrine hydrochloride. Transmigration of KUR‐1246 to milk in puerperal rats disappeared by 48 h after injection.

Conclusions: KUR‐1246 is a promising drug for the treatment of preterm labor in obstetric practice because it is as efficacious as currently used agents yet less likely to produce direct effects on the fetus.
Natural nutrient mixture effectively reduces collagen matrix contraction driven by human uterine smooth muscle cells
Authors: Ivanov Vadim , Roomi M. Waheed , Kalinovsky Tatiana , Niedzwiecki Aleksandra , Rath Matthias
Published: January 2006

Aim:  Abnormal uterine myometrial contractility causes preterm delivery, contributing to perinatal morbidity and mortality. Disturbances in hormonal regulation and inflammation‐related processes have been attributed a role in the pathophysiological mechanisms of uterine contractility. We investigated the effects of natural nutrients on uterine tissue contractility in vitro.

Methods:  We used an in vitro model of collagen I gel contraction driven by embedded cultured human uterine smooth muscle cells (SMC). The effects of tested compounds were evaluated using their capacity to affect gel contraction (measured by reduction in gel area during 24‐h incubation in serum free medium). Cellular expression of matrix metalloproteinases (MMP) was followed by gel zymography.

Results:  Collagen gel contraction driven by uterine SMC was significantly stimulated by potassium chloride, pituitary hormone oxytocin and by inflammatory cytokine α‐tumor necrosis factor (TNF‐α). Accelerated gel contraction was accompanied by elevated secretion of MMP‐2 and MMP‐9 into cell culture media. Among a variety of purified bioflavonoids and polyphenol‐enriched plant extracts tested for their ability to counteract uterine SMC‐dependent collagen gel contraction, the strongest effects were demonstrated by epigallocatechin gallate and green tea leaf extract, respectively. The addition of ascorbic acid and the amino acids lysine, arginine, cysteine and proline to green tea extract further increased its effectiveness. A reduction in gel contraction correlated with decreased MMP expression.

Conclusion:  Based on these findings, we found that nutrients can effectively counteract uterine myometrial contraction and MMP activity in vitro, suggesting that pathophysiological mechanisms of abnormal uterine myometrial contractility can be counteracted by a combination of naturally occurring nutrients. These mechanisms might involve extracellular matrix remodeling.
A method for the determination of N‐nitrosodiethanolamine in personal care products – collaboratively evaluated by the CTPA Nitrosamines Working Group
Authors: Flower C. , Carter S. , Earls A. , Fowler R. , Hewlins S. , Lalljie S. , Lefebvre M. , Mavro J. , Small D. , Volpe N.
Published: January 2006

Synopsis

A procedure for the determination of N‐nitrosodiethanolamine (NDELA) in personal care products was evaluated in collaborative studies by member organizations of the United Kingdom's Cosmetic Toiletry and Perfumery Association (CTPA) and LGC Limited, formerly known as the Laboratory of the Government Chemist (LGC). Samples were prepared depending on the matrix of the cosmetic product: aqueous samples were prepared by diluting in water followed by solid‐phase extraction; emulsions, oils and solid materials were dissolved in dichloromethane and extracted with water. NDELA was separated from the sample matrix using reverse‐phase liquid chromatography. The N‐nitroso bond was cleaved by photolysis to give nitrite, which was colorimetrically quantified. The nitrite functional group reacted with sulphanilamide in an acid medium to form a diazonium ion which was then coupled with N‐(1‐naphthyl)ethylenediamine dihydrochloride according to the Griess reaction to give a purple‐coloured azo dye that absorbed at 540 nm. Compared with other published methods for NDELA, the method described here is quick and easy to use. It has the required sensitivity and specificity, and can accurately and reliably quantify NDELA in a wide range of personal care product matrices.