bluuebunny/crossref_metadata_2025 huggingface dataset:
What makes continuing education effective: perspectives of community pharmacists
Authors: Namara Kevin P Mc , Marriott Jennifer L , Duncan Gregory J
Published: November 2007

Objective

To explore how different aspects of the professional environment for Australian community pharmacists are perceived to be influencing the effectiveness of continuing education models in improving practice.

Setting

Australian community pharmacy.

Methods

A convenience sample of practising community pharmacists (n = 15) was recruited using the ‘snowballing’ technique to participate in one of four focus group teleconferences. Each focus group examined continuing education experiences from different professional perspectives and training needs (recent graduates, experienced practitioners, specialist practitioners and rural/remote practitioners).

Key findings

Facilitation of professional development by accreditation bodies, and new challenges resulting from the introduction of cognitive services were seen to promote a favourable environment for continuing education engagement. Complex continuing education delivery models combined with high costs and excessive workloads made it more difficult to engage with continuing education systems or try to apply knowledge to the workplace.

Conclusion

Results support findings from previous research that practice development requires a multifaceted approach with continuing education as just one component. Affordable and integrated models of continuing education are required in order to optimise efficacy for participants.
Reforming the quality use of medicines in Australian aged care facilities: a new pharmacy practice model
Authors: Emmerton Lynne , Bessell Tracey , Marriott Jennifer , Nissen Lisa , Dean Laura
Published: November 2007

Objective

Numerous problems exist with accessing prescription medicines in Australian Residential Aged Care Facilities (RACF). This research aimed to identify the issues surrounding a theoretical model for pharmacists' prescribing in these facilities that had been proposed to address these problems. Specific objectives were to conceptually tailor the model to the RACF setting and qualitatively examine its potential applicability.

Setting

Data were collected from June to September 2004 via 34 semi-structured interviews with representatives of 28 stakeholder organisations, and 12 homogeneous focus groups comprising 25 consumers, 28 pharmacists and 18 medical practitioners representing rural and metropolitan locations. Participants were sourced from four states/territories of Australia.

Method

The so-called ‘Medication Maintenance’ model had previously been developed from the international literature and discussion with an expert steering committee. It proposes a system for pharmacists to continue Pharmaceutical Benefits Scheme prescriptions for patients whose therapy had been stabilised by a medical practitioner, by one month, one repeat or one original pack, as appropriate. The potential benefits, harms, barriers and facilitators were discussed with relevant stakeholders. Data were thematically analysed, and recommendations made for trial of the model.

Key findings

Potential benefits of the ‘Medication Maintenance’ model include improved patient focus, efficiency and interprofessional relationships. Potential harms include increased risk, possible wastage and exploitation. Potential barriers include role conflict, lack of controls, legislative issues and conflict of interest for pharmacists. Facilitators for the model were identified as defined roles and protocols, limitations on supply, regular patient review, communication channels and shared patient records.

Conclusion

A range of benefits, harms, barriers and facilitators of this theoretical model were elucidated from stakeholders. This has led to the proposal of a staged implementation trial of the model, which should involve clinical, humanistic and economic outcome monitoring, and attitudinal, practical and legislative issues to be addressed.
Coptidis Rhizoma attenuates repeated nicotine-induced behavioural sensitization in the rat
Authors: Lee Bombi , Yang Chae Ha , Hahm Dae-Hyun , Lee Hye-Jung , Choe Eun Sang , Pyun Kwang-Ho , Shim Insop
Published: November 2007

Repeated injections of nicotine can produce an increase in locomotor activity and the expression of immediate-early gene, c-fos, in the central dopaminergic areas. Many studies have shown that Coptidis Rhizoma (CR) and its main alkaloid compound, berberine (BER), have a suppressive effect on the central nervous system. We examined the influence of CR or BER on repeated nicotine-induced locomotor activity in rats and the change of c-Fos expression in the brain by using immunohistochemistry. Male Sprague-Dawley rats were given CR and BER before repeated injections of nicotine hydrochloride (0.4 mg kg−1, s.c.) twice daily for 7 days. After 3 days withdrawal, rats received a challenge injection of nicotine. Pretreatment with CR (100 mg kg−1, i.p.) and BER (100 mg kg−1, i.p.) significantly inhibited the nicotine-induced locomotor activity and expression of c-Fos in the striatum and the nucleus accumbens. These results suggest that CR and BER may produce inhibitory effects of nicotine on behavioural sensitization by possibly reducing postsynaptic neuronal activation in the central dopaminergic systems.
Antioxidant properties of phenols
Authors: Foti Mario C
Published: November 2007

The current understanding of the antioxidant properties of phenols (in homogeneous solutions) is reviewed, with particular emphasis on the role of the solvent. Phenols (ArOH) are known to reduce the rates of oxidation of organic matter by transferring a H atom (from their OH groups) to the chain-carrying ROO• radicals, a mechanism that most likely involves a concerted transfer of the hydrogen as a proton and of one electron between the two oxygen atoms, O-H•••O• (proton-coupled electron transfer mechanism). The antioxidant capabilities of phenols are strongly reduced by hydrogen-bond accepting solvents since the hydrogen-bonded molecules ArOH•••S are virtually unreactive toward ROO• radicals. The magnitude of these kinetic solvent effects is determined by the solute acidity α2H of ArOH (range 0 to 1) and solvent basicity β2H (range 0 to 1). Hydroxyl solvents (alcohols) have a double effect on ArOH. On the one hand, they act as hydrogen-bond accepting solvents and reduce the conventional rates of the ArOH + ROO• reaction. On the other hand, these solvents favour the ionization of ArOH into their phenoxide anions ArO−, which may react with ROO• very rapidly by electron transfer (sequential proton loss electron transfer mechanism). The overall effect is therefore determined by the ionization degree of ArOH. Other aspects of the kinetics and thermodynamics of ArOH + ROO• are also discussed.
Peroxynitrite and nitrosoperoxycarbonate, a tightly connected oxidizing-nitrating couple in the reactive nitrogen-oxygen species family: new perspectives for protection from radical-promoted injury by flavonoids
Authors: Pavlovic Radmila , Santaniello Enzo
Published: November 2007

Peroxynitrite is the product of the reaction of nitric oxide with superoxide radical and is implicated in the pathogenesis of a wide variety of human diseases, being responsible for in-vivo oxidation/nitration events. Nitrosoperoxycarbonate anion, formed by the interaction of peroxynitrite with CO2/bicarbonate at physiological concentrations, provides a new interpretation of oxidative/nitrative processes formerly attributed to peroxynitrite. The aim of this review is to summarize the chemistry and biology of peroxynitrite and radical species related to nitrosoperoxycarbonate anion, as well as the information available regarding the molecular mechanisms that determine and regulate radical-promoted injury by the two tightly connected species at physiological concentrations. Interception of carbonate and nitro radicals produced by interaction of peroxynitrite with CO2/bicarbonate, as in-vivo prevention of pathological events, creates new perspectives for the evaluation of safe scavengers of oxidative/nitrative stress at the physiological level. In this respect, natural products such as flavonoids hold a preeminent position among the vast array of compounds endowed with such properties.
Involvement of plasma membrane redox systems in hormone action
Authors: Incerpi Sandra , Fiore Anna Maria , De Vito Paolo , Pedersen Jens Z
Published: November 2007

Reactive oxygen species (ROS) is the common name used to describe the partially reduced forms of molecular oxygen that may be generated in cells during oxidative metabolism. They are normally considered to be toxic, and cells possess various defence systems to protect themselves including antioxidant enzymes and low molecular weight antioxidants like vitamin C and vitamin E. However, it is now clear that small amounts of ROS also act as messenger molecules in cell signal transduction pathways; the plasma membrane of eukaryotic cells in particular contains a variety of different ROS-producing oxidases and reductases, of which the best characterized are the superoxide-producing NADPH oxidases. It has been known for many years that membrane redox activity can be changed rapidly by various hormones and growth factors, but the molecular mechanisms involved and the physiological importance of this phenomenon have only recently begun to be unveiled. This review summarizes the state of the art on plasma membrane-based ROS signalling in the pathways of insulin, steroid and thyroid hormones and growth factors. The apparent paradox of ROS being essential biomolecules in the regulation of cellular functions, but also toxic by-products of metabolism, may be important for the pharmacological application of natural and synthetic antioxidants.
Protective effect of icariin on DNA against radical-induced oxidative damage
Authors: Zhao Feng , Tang You-Zhi , Liu Zai-Qun
Published: November 2007

Icariin (2-(4′-methoxylphenyl)-3-rhamnosido-5-hydroxyl-7-glucosido-8-(3′-methyl-2-butylenyl)-4-chromanone) is a flavonoid with a rhamnose as ligand. It is the major component in Herba epimedii, widely used for the treatment of atherosclerosis and neuropathy in Chinese traditional medicine, and its antioxidative property has attracted much scientific interest. The major objective of this work is to determine the antioxidative effect of icariin against oxidative DNA damage induced by 2,2′-azobis(2-amidinopropane) dihydrochloride (AAPH). The oxidative damage of DNA was followed by measuring the formation of carbonyl compounds that can react with thiobarbituric acid (TBA) to form thiobarbituric acid reactive substance (TBARS). We found that icariin protects DNA against AAPH-induced oxidative damage in a concentration-dependent manner, although it does not affect the rate of AAPH-induced DNA damage. This result indicates that icariin is a concentration-dependent chemopreventor in protecting DNA against radical-induced damage.
Par-complex proteins promote proliferative progenitor divisions in the developing mouse cerebral cortex
Authors: Costa Marcos R. , Wen Gaiping , Lepier Alexandra , Schroeder Timm , Götz Magdalena
Published: November 2007

The size of brain regions depends on the balance between proliferation and differentiation. During development of the mouse cerebral cortex, ventricular zone (VZ) progenitors, neuroepithelial and radial glial cells, enlarge the progenitor pool by proliferative divisions, while basal progenitors located in the subventricular zone (SVZ) mostly divide in a differentiative mode generating two neurons. These differences correlate to the existence of an apico-basal polarity in VZ, but not SVZ, progenitors. Only VZ progenitors possess an apical membrane domain at which proteins of the Par complex are strongly enriched. We describe a prominent decrease in the amount of Par-complex proteins at the apical surface during cortical development and examine the role of these proteins by gain- and loss-of-function experiments. Par3 (Pard3) loss-of-function led to premature cell cycle exit, reflected in reduced clone size in vitro and the restriction of the progeny to the lower cortical layers in vivo. By contrast, Par3 or Par6 (Pard6α)overexpression promoted the generation of Pax6+ self-renewing progenitors in vitro and in vivo and increased the clonal progeny of single progenitors in vitro. Time-lapse video microscopy revealed that a change in the mode of cell division, rather than an alteration of the cell cycle length, causes the Par-complex-mediated increase in progenitors. Taken together, our data demonstrate a key role for the apically located Par-complex proteins in promoting self-renewing progenitor cell divisions at the expense of neurogenic differentiation in the developing cerebral cortex.
Wolverhampton Council for Community Relations: The Pattern of Participation
Authors: Jacobs Brian
Published: November 2007

This paper examines the major factors affecting the pattern of black ethnic minority interest group affiliation to the Wolverhampton Council for Community Relations (WCCR). The study views group affiliation within the general context of the financial and administrative interrelationships between WCCR, the Commission for Racial Equality (CRE) and Wolverhampton Corporation.

The political setting is one in which councillors, local authority officials and community leaders prefer to involve themselves in a policy process where decisions are taken which ensure stability in the political environment. The desirability of maintaining stability, particularly from the point of view of those associated with the more formal aspects of policy-making, is evident to the extent that policy formulation and implementation relies, for its effectiveness upon the consent of the community. This consent in the field of race relations has invariably been difficult to achieve because of the cleavages between the black and white communities and within the black community itself. The resolution of the resulting conflicts provides the rationale for the existence of local community relations councils (CRCs) which actively seek to maintain, and where necessary, restore stable community relations.
Regional Devolution, Administrative Decentralization and Bureaucratic Performance in Italy
Authors: Freddi Gorgio
Published: November 2007

Ten years ago the formal structure of Italian government and administration underwent a momentous and radical change when, for the first time, with the elections of June 7, 1970, regional legislatures and governments were chosen by the people throughout the nation. This step concluded a twenty year long move from centralisation to decentralisation, initiated by the Republican Constitution of 1948. Until then, and from 1859 (the accepted date to designate the completion of national unification), Italy had been governed by a highly centralised and top-heavy administrative structure – modelled after the French example – including a prefectural system that left little or no autonomy to local governments such as municipalities and provinces.

To be sure, between 1860 and 1870, when the new Italian state was being built, some consideration was given to the establishment of autonomous regional governments, but the preoccupation with national unity prevailed. Only after the second World War, with the emergence of democratic politics, and of a generalised revulsion against the stifling centralisation of the Fascist regime, did regional sentiment assert itself again to find recognition in the Constitution, which provided for five ‘special’ regions and fourteen (later fifteen) ‘ordinary’ regions.
Prime Cuts: Public Expenditure and social services planning in a hostile environment
Authors: Glennerster Howard
Published: November 2007

The presumption of growth in a relatively stable economic and political environment is deeply embedded not merely in administrative and budgetary practice but in the framework of ideas that political scientists have used to analyse resource decisions. It is as much a part of the rational comprehensive planning tradition as it is of the incrementalist budgetary literature. The more turbulent economic environment and the era of cuts in public spending call for a re-appraisal of theory and practice.

There have been a series of articles on this theme in the Public Administration Review (1978) and in Maurice Wright’s recently (1980) edited collection of essays and Christopher Hood’s contribution to this Journal (1980). The discussion so far seems to be an extension of the debate between the rational comphrehensive school and the incrementalists.

The theme of some contributors to Maurice Wright’s book and many American writers has been to argue that cuts will be good for the public sector. Faced with a tight financial situation public authorities will be forced to adopt more rational and therefore more efficient appraisals of their spending.

In the Wright volume Professor Stewart suggests that the management process can no longer focus on the increment.
Problems of Steering and Control in Decentralized Public Programmes: Some lessons from the US Manpower Programme
Authors: Richardson J. J. , Lawther Wendell C.
Published: November 2007

As Lewis Gunn has recently pointed out, academics have hitherto been preoccupied with policy formulation, leaving the practical details of policy implementation to administrators. This situation, as he suggests, is rapidly changing. There is now a growing concern with problems of implementation and indeed with policy ‘failures’. We have gradually come to realize that there is considerable truth in the saying that he who implements, decides policy. There is also a greater awareness that the type of system selected to deliver or administer policies may be an important determinant of the ‘success’ or ‘failure’ of many policy programmes. An added complication is that measurement of success or failure is itself difficult and at times impossible. What may seem failure to the central policy-maker (be he politician or civil servant) may be seen as success by the regional or local implementor. The results of evaluation studies of public policies will vary according to whether the evaluator adopts a ‘top down’ or ‘bottom up’ view of the policy process. In any event the researcher must be aware of differing objectives both in terms of the policies themselves and in terms of personnel involved in delivering those policies.
Before Malcolm X, Dessalines: a French tradition of black Atlantic radicalism
Authors: Jenson Deborah
Published: November 2007

This article explores the anticolonial and postcolonial thought of Haitian revolutionary leader Jean-Jacques Dessalines. Dessalines, like Malcolm X, whom Cornel West calls a prophet of Black rage, is part of a black Atlantic radical tradition. Dessaline's secretary Louis-Flix Boisrond
Tonnerre has often been viewed as the author of some of Dessalines' documents, including the Haitian Declaration of Independence, but I argue that Dessalines' voice remains distinctive and that he and his secretaries should be viewed as authorial teams. Dessalines' vision is syncretic, incorporating
African diasporan views of the spiritual world and nature into his decisively anticolonial political ideology. These texts challenge the anglophone identity of the black Atlantic, and invite reconsideration of the diverse beginnings of the postcolonial.
When French-Canadian literature freed itself from the tutelage of Paris
Authors: Parris David
Published: November 2007

Soon after the Second World War, a dispute broke out between a group of French intellectuals and the Montral-based publisher Robert Charbonneau. Charbonneau's views on the grievances of the French are brought together in: La France et nous. Around the same time, Charbonneau's
friend Berthelot Brunet wrote a Histoire de la littrature franaise in which he is critical of French culture. The two texts mark a break with France, a refusal of its hegemony, and at the same time they give an idea of what was to be known as la littrature qubcoise.
Resources, Not Capital: A Case Study of the Gendered Distribution and Productivity of Social Network Ties in Rural Ethiopia*
Authors: Torkelsson Åsa
Published: November 2007

AbstractPoor people make use of a variety of contextually relevant resources to pursue their livelihood strategies, and there is wide empirical evidence that opportunities and contraints for accessing these may vary considerably for women and men, particularly in the rural areas of developing countries. In this article, micro‐evidence from a case study from a village in rural Ethiopia is used to analyze the role that gender plays in the distribution and productivity of social network ties. In the examined case, women and men have access to different social networks: women have access to bonded or relational social resources which can yield economic returns only if and when they are bridged, linked to, and associated with men and their networks. This is a result of the prevailing social structure in which men define social norms and implement these through locally available institutions, combined with women's time poverty. Consequently, for rural development interventions to be successful in building and strengthening women's social network ties, adequate attention needs to be paid to mechanisms that make sure that links and connections are in place as well.
A High Concentration of Epidermal Growth Factor Increases the Growth and Survival of Neurogenic Radial Glial Cells Within Human Neurosphere Cultures
Authors: Nelson Aaron D. , Suzuki Masatoshi , Svendsen Clive N.
Published: November 2007

Human neural progenitor cells (hNPC) isolated from the fetal cortex can be expanded as aggregates of cells termed neurospheres. Traditional methods have used 20 ng/ml epidermal growth factor (EGF) to drive the proliferation of these cells. Here, we show that 100 ng/ml EGF can significantly increase growth rates of hNPC at later passages. This was through increased survival of dividing cells rather than increased proliferation and associated with prolonged activation of ErbB2 and phosphorylated Akt. High EGF also resulted in a larger proportion of elongated “radial glial”-like cells within the growing neurospheres and increased expression of the radial glial markers. The number of new neurons generated from cultures maintained in 100 ng/ml EGF was significantly higher than from 20 ng/ml EGF. Thus, high concentrations of EGF increase the survival of a highly neurogenic human radial glial cell.

Disclosure of potential conflicts of interest is found at the end of this article.
Fibrochondrogenesis in Two Embryonic Stem Cell Lines: Effects of Differentiation Timelines
Authors: Hoben Gwendolyn M. , Koay Eugene J. , Athanasiou Kyriacos A.
Published: November 2007

Human embryonic stem cells (hESCs) are an exciting cell source for fibrocartilage engineering. In this study, the effects of differentiation time and cell line, H9 versus BG01V, were examined. Embryoid bodies (EBs) were fibrochondrogenically differentiated for 1, 3, or 6 weeks and then used to engineer tissue constructs that were grown for an additional 4 weeks. Construct matrix was fibrocartilaginous, containing glycosaminoglycans (GAGs) and collagens I, II, and VI. A differentiation time of 3 or 6 weeks produced homogeneous constructs, with matrix composition varying greatly with cell line and differentiation time: from 2.6 to 17.4 μg of GAG per 106 cells and from 22.3 to 238.4 μg of collagen per 106 cells. Differentiation for 1 week resulted in small constructs with poor structural integrity that could not be mechanically tested. The compressive stiffness of the constructs obtained from EBs differentiated for 3 or 6 weeks did not vary significantly as a function of either differentiation time or cell line. In contrast, the tensile properties were markedly greater with the H9 cell line, 1,562–1,940 versus 32–80 kPa in the BG01V constructs. These results demonstrate the dramatic effects of hESC line and differentiation time on the biochemical and functional properties of tissue-engineered constructs and show progress in fibrocartilage tissue engineering with an exciting new cell source.

Disclosure of potential conflicts of interest is found at the end of this article.
Absence of OCT4 Expression in Somatic Tumor Cell Lines
Authors: Cantz Tobias , Key Göran , Bleidiβel Martina , Gentile Luca , Han Dong Wook , Brenne Alexandra , Schöler Hans R.
Published: November 2007

The POU-domain transcription factor OCT4 is associated with the pluripotent state of cells comprising the inner cell mass of pre-implantation embryos and has been known to play a critical role in the maintenance of pluripotency of embryonic stem cells. Reactivation of OCT4 expression is postulated to occur in differentiated cells that have undergone carcinogenesis, or tumor formation. In contrast to earlier studies, recent reports describe OCT4 expression in several human tumor cell lines. To resolve the apparent discrepancy in OCT4 expression between earlier and recent studies, we determined OCT4 expression in the cervical carcinoma cell line HeLa and the breast cancer cell line MCF7 in comparison with the human teratoma cell line nTera by immunofluorescence, Western blot, and RT-PCR analyses. We were unable to detect staining of the OCT4 transcription factor in the nucleus of HeLa and MCF7 cells by immunofluorescence using two different monoclonal antibodies. Faint cytoplasmic staining in HeLa and MCF7 cells was observed; however, no OCT4 signal could be detected by Western blot analysis. In addition, we were unable to detect significant levels of OCT4 mRNA in HeLa and in MCF7 cells by RT-PCR. Furthermore, the OCT4 promoter region is highly methylated in HeLa and MCF7 cells. We argue that recent reports of OCT4 expression in these and other cancer cell lines could actually be attributed to OCT4 pseudogene expression or misinterpretation of background signals in immunofluorescence experiments. In conclusion, we emphasize the need for adequate controls in investigations of OCT4 expression in somatic cell lines by immunofluorescence and RT-PCR.

Disclosure of potential conflicts of interest is found at the end of this article.
Suitability for Short-Term Cognitive-Behavioral Therapy
Authors: Myhr Gail , Talbot Jeanne , Annable Lawrence , Pinard Gilbert
Published: November 2007

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.
Family History of Diabetes Mellitus and Oral Glucose Tolerance Testing Criteria
Authors: Piscitelli Joanne , Eden Robert D. , Jelovsek Frederick R. , Grandis Arnold S. , Gall Stanley A.
Published: November 2007

A review of 185 obstetrical patients, having a family history of diabetes mellitus without medical history of glucose intolerance in the non‐pregnant state was conducted. A 3‐hour 100‐g oral glucose tolerance test was performed on all patients between 20 and 34 weeks of gestation. According to O'Sullivan's criteria for glucose tolerance testing, normal glucose tolerance occurred in 89.7%, while Class A diabetes was identified in 10.3% of patients tested. 3.8% of the study population fulfilled the O'Sullivan criteria for abnormal glucose intolerance and required insulin treatment during pregnancy.

The Division of Perinatal Medicine at Duke University has traditionally defined the abnormal glucose tolerance test at glucose values lower than O'Sullivan's internationally accepted criteria. An intermediate group, having abnormal glucose values according to the Duke criteria, was classified as “Carbohydriate Intolerance”, comprised 32.4% of the patients tested and were managed identically to O'Sullivan Class A Diabetes. Analysis or perinatal outcome, including macro‐somia, birth trauma and neonatal morbidity, revealed that Carbohydrate Intolerance patients fulfilling O'Sullivan criteria, being similar to patients with ‘normal’ GTT test results. Patients having a family history of diabetes mellitus, appeared as a group to be at increased risk for macro‐somia, fetal distress and cesarean delivery, compared with the general population.
Epidemiology and Pathogenesis of Ureaplasma Urealyticum in Spontaneous Abortion and Early Preterm Labor
Authors: Naessens Anne , Foulon Walter , Cammu Hendrik , Goossens Anita , Lauwers Sabine
Published: November 2007

The role of U. urealyticum in spontaneous and recurrent spontaneous abortion was studied in 633 women. Cervical colonization with U. urealyticum was found in 42.6% of 310 normal pregnant women, in 41.6% of 84 patients who underwent induced abortion, in 41.5% of 41 normal fertile patients, in 53.3% of 122 patients with spontaneous abortion and in 64.5% of 76 patients with recurrent spontaneous abortion. The cervical isolation rate was significantly higher in patients with spontaneous abortion (p<0.05) and recurrent spontaneous abortion (p<0.005) than in normal pregnant women. Endometrial colonization was more frequent in patients with recurrent spontaneous abortion (27.6%) than in normal fertile women (9.7%) (p<0.05). Moreover, in 6 patients with intact membranes and uncontrollable preterm labor resulting in fetal loss (all between the 20th and 28th week of gestation) U. urealyticum was isolated in 5 of them from the cervix, in 4 patients from the placenta and in 2 out of 4 from the amniotic fluid. Histological examination of the placenta showed signs of chorioamnionitis in 5 patients. From this study we conclude that although U. urealyticum is a common inhabitant of the lower genital tract, it may play a role in the etiology of spontaneous abortion and uncontrollable preterm labor.
Induction of Labor: A Prospective, Randomized Study into Amniotomy and Oxcytocin as Induction Methods in a Total Unselected Population
Authors: Bakos Oddvar , Bäckström Torbjörn
Published: November 2007

All women (n =223) scheduled for induction of labor were randomized into start with oxcytocin infusion (O) or amniotomy (A). After 4 h an assessment of the progress and prognosis was made. If the progress was not acceptable O was added to A and A to O.

Oxcytocin alone showed the lowest frequency of delivered patients. The “amniotomy only” group showed the shortest duration of delivery. The frequency of complications was low but somewhat higher when the initial step was oxcytocin.

Oxcytocin alone is not a good method for induction. Early evaluation of the progress and prognosis of the induction is difficult. The combination of amniotomy and oxcytocin seem to be more essential than the choice of initial step. If, however, an infusion of oxcytocin is the first proceeding, amniotomy should be added on a routine basis and without delay.

Bishop score is not a conclusive measure of the readyness of uterus to go into labor. Parity may partly be the explanation but other today unknown factors are probably involved in the inducability.
An Evaluation of Two Inert Gas Clearance Techniques for Measurement of Endometrial Blood Flow in Women
Authors: Fraser Ian S. , McCarron Gay , Hutton Brian , Macey Dan
Published: November 2007

Two methods utilizing inert gas clearance for the measurement of endometrial blood flow in non‐pregnant women have been assessed and compared. A Krypton‐85 re‐breathing technique allowed measurement of superficial flow by means of an intrauterine semiconductor β‐detector probe. Intrauterine instillation of high specific activity Xenon‐133 in small volumes of saline allowed endometrial flow measurement by γ camera recording of the rate of clearance. Both these methods permitted calculation of absolute rates of flow and comparison of cyclical changes. Direct comparison of the techniques in the same women, and repeatability studies have shown good agreement, with calculated rates of absolute endometrial blood flow varying within the range 14 − 60 ml per 100 g tissue per minute. Vaginal blood flow measured simultaneously was always significantly lower (36−64%) than endometrial flow.
Conservative Management of the Abnormal Smear During Pregnancy: A long‐term follow‐up
Authors: Hellberg Dan , Axelsson Ove , Gad Adel , Nilsson Staffan
Published: November 2007

One hundred and thirty‐two pregnant women who had a smear suggestive of cervical intra‐epithelial neoplasia (CIN) II or more during the 10th to 12th gestational week, were followed with repeated smears and colposcopy every month and, when indicated, a colposcopically guided biopsy. Post‐partum follow‐up included cytology, colposcopy, portio biopsies and endocervical curettage. Seventy‐nine women with normal findings post partum were checked once a year in a long‐term study.
Placental Proteins (Pp 5, Pp 12 and Pp 14) in Ovarian Tumors: A Preliminary Report
Authors: Boltenberg Anette , Furgyik Stefan
Published: November 2007

Using a specific radio‐immunoassay, the placental proteins PP 12, PP 14 and PP 5 were studied in serum for 2 patients with ovarian cancer and 7 with benign ovarian tumor. Elevated levels of PP 14, found in one endometroid ovarian cancer, decreased during successful treatment. PP 14 could also be found in the blood of nude mice grafted with this tumor. One patient with serous kystadenocarcino‐ma had a slightly elevated level of PP 14 at diagnosis, increasing as the tumor progressed. PP 14 was demonstrated histochemically in both the original tumor and the grafted. Ascitic fluid was rich in PP 14. Elevated levels of the proteins PP 12 and PP 5 were not found in these patients, however. In seven benign ovarian tumours, low PP 14 serum levels were found. The conclusion drawn from this study is that PP 14 can constitute a tumor marker in ovarian cancer.
Small for Dates: Evaluation of Different Diagnostic Methods
Authors: Fescina Ricardo Horacio , Martell Miguel , Martinez Gerardo , Lastra Lucio , Schwarcz Ricardo
Published: November 2007

Ninety‐four high‐risk pregnancies were studied weekly in a prospective and longitudinal study. Uterine height, biparietal diameter (BPD), cranial perimeter (CrP) and abdominal perimeter (AbP) were measured. Amniotic fluid volume (AFV) was assessed. Of the sample selected, 58 neonates were appropriate for gestational age and 36 were small‐for‐date (17 symmetrical and 19 asymmetrical). The sensitivity values in diagnosis of small‐for‐dates were: 67% for BPD, 42% for CrP, 94% for AbP, 56% for Uterine Height and 28% for AFV. The specificity for the five variables ranged from about 91% to 100%. If we consider symmetrical and asymmetrical retardation separately, the sensitivity values for the former were: 94%, 77%, 100%, 77% and 24% for BPD, CrP, AbP, Uterine Height and AFV respectively. For symmetrical retardation, the sensitivity values were: 43%, 11%, 90%, 37% and 32% for BPD, CrP, AbP, Uterine Height and AFV respectively. The fetal cranial measurements were the only ones to demostrate a different pattern of evolution in symmetrical and asymmetrical small‐for‐dates. This is therefore a useful measurement in making a differential diagnosis between both retardations. The earliest diagnoses were made in the symmetrical small‐for‐date group.
Late Sequelae after Laparoscopic Sterilization in the Pregnant and Non‐Pregnant Woman
Authors: Dueholm Svend , Zingenberg Helle J. , Sandgren Gerd
Published: November 2007

To determine the frequency of late sequelae after laparoscopic sterilization performed at the time of induced abortion, we compared data on 114 women who underwent induced first‐trimester abortion and concurrent laparoscopic sterilization, with 288 women who had sterilization performed at least 3 months after induced abortion. The period of observation was 12–95 months, median 49 months. We found no statistical difference between the groups with respect to failures, low abdominal pain, dyspareunia, change in bleeding pattern, sexual life and regrets. The results of these findings, discussed here, support the practice of performing the combined procedure.
Carpal Tunnel Syndrome in Pregnancy: A Prospective Study
Authors: Ekman‐Ordeberg Gunvor , Salgeback Stig , Ordeberg Gunnar
Published: November 2007

In this prospective study, 56 women (2.3%) of 2 358 (47% nulliparous and 53% multiparous) delivered during a 12‐month period at the Department of Obstetrics and Gynecology, Malmo General Hospital, had symptoms of carpal tunnel syndrome during pregnancy. All (33 nulliparous and 23 multiparous women) were examined, at the outpatient's maternity care unit and within 4–5 weeks from the time of debut of symptoms, by a specialist in hand surgery. At that time the most common symptoms were paresthesia and nocturnal pain. Twenty‐nine had signs of reduced sensibility and 14 of them had a positive two‐point discrimination test. AH had generalized edema. Conservative treatment with splinting of the wrist at night made 46 out of 56 symptom‐free. Of the remaining 10 women, 3 had to be operated on, whereas 7 received only conservative treatment, as the expected time for parturition was very close. One of them had to be operated on after delivery. In conclusion, carpal tunnel syndrome during pregnancy is most common in primiparas with generalized edema. Conservative treatment is sufficient for symptom relief in most women (80%) but a few cases need operative intervention to abolish the severe pain and to avoid disturbances of hand function.
The Effect of Pregnancy on Functions of Inflammatory Cells in Healthy Women and in Patients with Rheumatic Disease
Authors: Østensen Monika , Revhaug Arthur , Volden Gunnar , Berge Lillian , Husby Gunnar , Giercksky Karl‐Erik
Published: November 2007

Chemiluminesence (CL) after zymosan stimulated phagocytosis of polymorphonuclear granulocytes (PMN) and mononuclear cells (MNC), random migration of PMN and intra‐and extracellular activities of nine lysosomal enzymes were assessed serially in 8 healthy women and 10 women with rheumatic disease during and after pregnancy. A gestational increase of lysosomal enzymes in serum and enhancement of PMN random migration was observed in all women. Significant differences between healthy and rheumatic women were found for CL of phagocytic cells. In healthy women, CL of PMN was slightlv enhanced, while it remained unchanged in MNC during pregnancy. In patients, CL of PMN was markedly suppressed, while MNC CL increased during gestation. An inverse relationship between CL and intracellular enzyme activities was noted. Thus, the presence of an inflammatory state seemed to influence the gestational behavior of phagocytic cells.
Sex Hormone Binding Globulin in Clinical Perspective
Authors: Bond Andrew , Davis Collin
Published: November 2007

The plasma steroid‐binding proteins play a fundamental role in the modification and delivery of the steroid “signal” to its target tissue. While their precise function requires further evaluation, the measurement of these proteins, particularly of SHBG, provides clinically useful information.

This article reviews the current theories of sex steroid transport and uptake, and documents the changes in SHBG status relevant to health, disease and drug therapy.
Ultrasound measurement of the ovarian volume
Authors: Andolf Ellika , Jörgensen Connie , Svalenius Elizabeth , Sundén Bertil , Andolf E.
Published: November 2007

The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented.

In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopaus. In the group of women receiving orally administered estrogens for at least a year the p‐values for all parameters were >0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056).

The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for developement of ovarian carcinoma.
A Study of maternal ecg characteristics before and during intravenous tocolysis with β‐sympathicomimetics
Authors: Mulders L. G. M. , Boers G. H. J. , Prickartz‐Wijdeveld M. M.J.F. , Hein P. R.
Published: November 2007

Severe maternal complications during β‐mimetic therapy have been reported. In a study of maternal complications related to intravenous tocolysis, which covering a period of 2 years, we paid special attention to the maternal ECG before and during treatment. There was a high prevalence of pretreatment ECG changes: tachycardia (23.6%), disorders of impulse conduction (43.6%), ST‐depression (14.5%) and disorders of repolarization (43.6%). During intravenous 0‐mimetic therapy there was an increase in the prevalence of tachycardia, prolonged QT‐time and disorders of repolarization. We also studied the course in time of the different ECG characteristics during treatment. With regard to the ST‐depression, a possible physiological adaptation to the β‐mimetic drug is described. We could not find this possible adaptation with regard to the other ECG characteristics. None of the women in the studied group showed clinical signs of myocardial ischemia, notwithstanding the high prevalence of ECG changes. We conclude that the ECG criteria for discontinuation of tocolytic therapy need re‐evaluation.
Intra‐ and inter‐observer variability in the assessment of intrapartum cardiotocograms
Authors: Nielsen P. V. , Stigsby B. , Nickelsen C. , Nim J.
Published: November 2007

The diagnostic value of a test depends on the variability of the test results and the accuracy of the test. The object of this investigation was to estimate the observer variability and the accuracy, when intrapartum CTGs were assessed by experienced obstetricians. Fifty CTGs were evaluated twice by four obstetricians. They were asked to identify the CTGs belonging to the compromised infants. They were told the criteria for a compromised infant and the incidence (one‐ third). Eleven (22%) of the CTGs were assessed in the same way of all the obstetricians in both evaluations. Between the obstetricians, the accuracy ranged from 50 to 66%. We conclude that the considerable observer variability found in this and other investigations must severely impair the clinical value of electronic fetal monitoring (EFM). The variability must be reduced before the “true” predictive value and the cost/benefit of EFM can be estimated.
Immature ovarian teratoma in a postmenopausal woman
Authors: Ørnvold K. , Detlefsen G. U. , Horn T. , Rørth M.
Published: November 2007

We report the first case of immature ovarian teratoma occurring after menopause in a 57‐year‐old, 3 years postmenopausal woman. Within one year after resection of the teratoma she developed peritoneal botryoid rhabdomyosarcoma, which probably originated from initially unrecognized rhabdomyoblasts in the teratoma. The patient died 6 months later from progressive disease after a transient adriamycin‐induced tumor response. The literature on ovarian immature teratoma and ovarian rhabdomyosarcoma is briefly reviewed, and the available treatment is discussed.
Ruptured Episiotomia Resutured Primarily
Authors: Monberg Jørgen , Hammen Søren
Published: November 2007

In a randomized study, 35 patients with ruptured episiotomy were treated in two ways. One group, treated with Clindamycin and primary resuture, did better than the other group, not resutured but spontaneously healed.
Neonatal Retinal Hemorrhages and Neurobehavior Related to Tractive Force in Vacuum Extraction
Authors: Svenningsen Leif , Lindemann Rolf , Eidal Kristin , Jensen Øystein
Published: November 2007

Fifty clinically indicated vacuum extractions were studied to evaluate a possible relationship between neurobe‐havioral abnormality, retinal hemorrhages and the tractive force used for delivery. A Vacuum Extractor Recorder (Type SF 30, Knick), was used to measure the forces necessary for delivery of the head. Infants delivered by the use of extensive tractive force showed no greater incidence of neuropathology than those delivered with less tractive force. The retinal hemorrhages were equally distributed among the infants, irrespective of the tractive force applied or the neurobehavioral assessment. The implication is that retinal hemorrhages cannot be used to evaluate the extent of cerebral influence after birth and that the main cause of neurobehavioral abnormality is the condition leading to the use of the vacuum extractor (VE).
Herpes Gestationis
Authors: Jørgensen Erik Hvidberg , Clemmensen Ole , Anagnostaki Lola
Published: November 2007

A case of clinically typical herpes gestationis is presented. The diagnosis was confirmed by light microscopy and immunofluorescence studies. The symptoms subsided at delivery, but recurred during subsequent oral contraceptive medication. The newborn infant was affected temporarily. The treatment, the fetal risk and the implications of the diagnosis on future pregnancies and contraceptive therapy are discussed.
Placental Teratoma
Authors: Svanholm Hans , Thordsen Christian
Published: November 2007

A case of placental teratoma is presented. This is a rare tumor of disputed histogenesis. Some regard it as a separate entity while others believe it represents the extreme of a fetus amorphus. The tumor is benign and of no clinical significance.
Adenosarcoma Uteri
Authors: Agdal Niels , Wilken‐Jensen Charlotte
Published: November 2007

Adenosarcoma of the uterus is a rare tumor of low‐grade malignancy. It belongs to the family of mixed mesodermal (Müllerian) tumors. It is a biphasic tumor with benign epithelium and malignant stromal components. A case in a 76‐year‐old woman is presented.
A Serous Ovarian Cystadenocarcinoma Metastatic to Both Eyes
Authors: Hauksson Arnar , Bynke Hans , Tropé Claes
Published: November 2007

A patient with a stage IV ovarian cystadenocarci‐noma is described. She seems to constitute the first reported case of this kind of tumour metastasizing to the eyes.
Serum relaxin and steroid hormones in spontaneous abortions
Authors: Seki K. , Uesato T. , Tabei T. , Kato K.
Published: November 2007

To assess the capacity of the corpus luteum to secrete steroid hormones and relaxin during spontaneous abortion, human chorionic gonadotropin (hCG), progesterone, 17α‐hydroxyprogesterone (17‐OHP) and relaxin concentrations were determined in serum samples obtained from 16 spontaneously aborting first‐trimester patients and 5 asymptomatic, apparently normal women who subsequently aborted. hCG and P were subnormal in more than half of aborting patients, and 17‐OHP in half of them. However, relaxin was normal in most of them. No patient with subnormal relaxin levels had hCG values in the normal range. Such a relationship was not found between hCG and 17‐OHP values. Hence, decreases in placental activity seem to precede a decrease in luteal ability to secrete relaxin but not to secrete stereoid hormones. Some aborting patients with subnormal 17‐OHP levels had normal relaxin values. All but 1 woman who aborted subsequently had subnormal 17‐OHP values at a time when relaxin levels were normal. Therefore, in some aborting patients, the ability of the corpus luteum to secrete steroid hormones is impaired at a time when its capacity to secrete relaxin is preserved.