bluuebunny/crossref_metadata_2025 huggingface dataset:
Vertical Transmission of Herpes Simplex Virus Acquired After Primary Outbreak in SecondTrimester of a Dichorionic Twin Gestation
Authors: Joffe G. M. , Olson K. , Merlin T. L. , Brown A.
Published: March 2007

Background: The incidence of genital herpes simplex virus (HSV) has increased in recent years, particularly among women of reproductive age. This places more neonates at risk for severe morbidity and mortality. Treatment recommendations for primary disease in pregnancy are lacking, particularly for those who acquire. HSV remote from term.

Case: A patient at 17 weeks of gestation carrying dichorionic twins developed primary herpes with subsequent vertical transmission of the virus and significant neonatal morbidity.

Conclusion: Data regarding risks and benefits of treatments such as acyclovir and immunoprophylaxis are lacking at a time when the incidence of HSV infection is on the rise.
A Review of Famciclovir in the Management of Genital Herpes
Authors: Faro S.
Published: March 2007

The frequent occurrence of genital herpes continues to be a serious clinical problem. Although not life threatening, the physical symptoms of the disease, and the ensuing psychosocial complications, can be overwhelming to patients. The life cycle of the herpes simplex virus is complex, comprising multiple stages. Following infection, the virus establishes life-long latency in its host and can reactivate at any time as a recurrent infection. Successful management of genital herpes simplex infections involves patient education and psychological support, as well as antiviral agents. The antiviral agent famciclovir has been shown to shorten the course and decrease the severity of episodes of recurrent genital herpes. In addition, famciclovir has been shown to be effective in suppressing recurrent genital herpes. A review of the clinical experience with famciclovir in the treatment of genital herpes is presented.
Female Genital Tract Bacterial Coisolates WithCandida albicans in Patients Without Clinical Vaginitis
Authors: Monif G. R. G. , Carson H. J.
Published: March 2007

Objective: In vitro, Candida albicans has demonstrated the ability to inhibit replication of selected
bacteria. Little information exists on the impact of C. albicans on the vaginal bacterial flora in vivo.
The purpose of this study is to identify the coexisting bacterial flora when C. albicans is isolated from
vaginal cultures submitted to a hospital‐based testing facility for reasons other than vulvovaginitis.

Methodology: All specimens (240) received from ambulatory care clinics over a six‐month period
were cultured for aerobic and anaerobic bacteria and Candida species. Those specimens submitted
for cervicitis, vaginitis, or vaginal discharge and those from which yeasts other than C. albicans
were isolated were eliminated. To control for sample biases, a subgroup composed of all pregnant
women for whom cultures were done as screening procedures was similarly studied. Chi‐square
analyses, comparing the prevalence of individual bacteria isolated with and without the presence of
C. albicans, were done for all study populations using SPSS for Windows software (1994).

Results: Two hundred and forty consecutive specimens were bacteriologically analyzed. Of the
220 vaginal samples used in the study, C. albicans was isolated in 44 instances (20%). Neither the
presence of the lactobacilli nor the presence of Gardnerella vaginalis markedly influenced the isolation
rate of C. albicans. The group B streptococci had a greater probability of coisolation when
C. albicans was present (27.3%) verses 16%), but this was not statistically significant (P < 0.8).
Dissociation between the presence of C. albicans and the coisolation of Peptostreptococcus species
and anaerobic gram‐positive cocci and/or bacilli was noted (P < 0.0819). while the incidence of
gram‐positive aerobic bacilli was reduced in the presence of C. albicans (30/176 [17.1%] versus 6/44
[13.6%]), this reduced incidence was not statistically significant. Isolation data of the subgroup of
pregnant women supported these observations.

Conclusion: Within the limitations of the study, statistically, the data suggests that an inverse
relationship exists between the presence of C. albicans and recovery of Peptostreptococcus and anaerobic
gram‐positive cocci and bacilli.
A Comparison of Ligase Chain Reaction toPolymerase Chain Reaction in the Detection ofChlamydia trachomatis Endocervical Infections
Authors: Davis J. D. , Riley P. K. , Peters C. W. , Rand K. H.
Published: March 2007

Objective: To compare the reliability of ligase chain reaction (LCR) to polymerase chain
reaction (PCR) in detecting Chlamydia trachomatis endocervical infections.

Methods: We conducted a prospective study of 486 patients at risk for chlamydial infection of the
endocervix. We obtained two endocervical specimens from each patient and used LCR and PCR to
detect C. trachomatis. Discrepant results between the two techniques were resolved by repeat testing
and by testing for the major outer membrane protein (MOMP) gene, if necessary. We determined
the sensitivity, specificity, positive predictive value, and negative predictive value for each test, using
concordant results or MOMP gene results as the “gold standard”.

Results: Of the 486 patients, 42 (8.6%) had evidence of C. trachomatis infection after resolution of
discrepant results. Of the 42 true positive specimens, 41 were positive by initial LCR and 38 were
positive by initial PCR. Of the 444 true negative specimens, none had a positive initial LCR result,
while 2 had a positive initial PCR test. Therefore, compared to the gold standard, LCR had a
sensitivity of 97.6% and specificity of 100%, while PCR had a sensitivity of 90% and a specificity of
99.5%. The positive and negative predictive values of LCR were 100% and 99.8%, respectively.
PCR had a positive predictive value of 95% and a negative predictive value of 99.1%. The difference
in sensitivity of LCR versus PCR was not statistically significant (P = .125).

Conclusion: LCR and PCR perform equally well in detecting C. trachomatis endocervical infections.
Studies on the Pathogenicity of Anaerobes, EspeciallyPrevotella bivia, in a Rat Pyometra Model
Authors: Mikamo H. , Kawazoe K. , Izumi K. , Watanabe K. , Ueno K. , Tamaya T.
Published: March 2007

Objective: Prevotella bivia is one of the anaerobic bacteria that resides in the flora of the female
genital tract. We studied the pathogenicity of P. bivia in a rat pyometra model.

Methods: The experimental animial (rat) model of pyometra was developed to investigate the
pathogenicity of P. bivia in a rat pyometra model.

Results: In the groups inoculated with aerobes alone, the infection rate was 10% (1/10) in the
Staphylococcus aureus‐ or Staphylococcus agalactiae ‐inoculated group and 20% (2/10) in the
Escherichia coli‐inoculated group. Infection Was not established in the groups inoculated with anaerobes
alone. High infection rates were observed in all the mixed‐infection groups. In the S. agalactiae‐ and
Bacteroides fragilis‐, S. agalactiae‐ and P. bivia -, E. coli-
and B. fragilis‐, and E. coli‐ and P. biviai‐ inoculated
groups, an infection rate of 100% (10/10) was demonstrated. The efficacy of antibiotics
such as flomoxef (FMOX) could be determined using a rat pyometra model. In relation to the
alteration of vaginal microbial flora during the menstrual cycle, estrogen increased the growth of P. bivia.

Conclusion: Mixture of aerobic bacteria and P. bivia increased the pathogenicity of P. bivia.
Estrogen would be useful for raising up the inflammatory change of the uterus in experimental
models of genital tract infection due to P. bivia.
Vulvar Myiasis
Authors: Passos M. R. L. , Carvalho A. V. V. , Dutra A. L. , Goulart Filho R. A. , Barreto N. A. , Salles R. S. , Santos C. C. C. , Tibúrcio A. S. , Monteiro A. C. S. , Tavares R. R.
Published: March 2007

Myiasis is a parasitic infestation caused by larvae of several fly species. Diagnosis and treatment are simple. This infestation is, however, rarely seen in the vulvar area. We present a short review of the disease and the case of a 19-year-old pregnant girl with vulvar myiasis and concomitant syphilis, vaginal trichomoniasis and genital candidiasis. The patient was also positive for human immunodeficiency virus.
Daily Oral Grepafloxacin vs. Twice Daily OralDoxycycline in the Treatment of Chlamydia trachomatisEndocervical Infection
Authors: McCormack W. M. , Martin D. H. , Hook E. W. , Jones R. B.
Published: March 2007

Objective: To compare the efficacy and safety of a 7‐day course of treatment with oral grepafloxacin,
400 mg once daily, and oral doxycycline, 100 mg twice daily, in patients with chlamydial cervicitis.

Methods: Women aged 18 years or older attending 17 sexually transmitted disease clinics in the
United States who had clinical signs of mucopurulent cervicitis or who had a recent positive culture
or nonculture test for Chlamydia trachomatis or who had contact with a male partner with a positive
culture for C. trachomatis were enrolled into this randomized, double‐blind, active‐controlled clinical
study. The diagnosis of chlamydial cervicitis was based on culture for C. trachomatis. Patients were
randomized to receive a 7‐day course of treatment with either oral grepafloxacin, 400 mg once daily,
or oral doxycycline, 100 mg twice daily. Response to therapy was assessed 3–8 days and 21–28 days
after completion of treatment. The primary measure of efficacy was eradication of C. trachomatis at
the 21–28 day follow‐up visit. Clinical success, defined as improvement or complete resolution of the
signs and symptoms of cervicitis, was a secondary measure of efficacy.

Results: Of the 451 female patients enrolled, 228 received grepafloxacin and 223 received doxycycline.
In all, 154/451 (35%) patients were evaluable at the 21–28 day follow‐up (81 who received
grepafloxacin and 73 who received doxycycline). Microbiologic and clinical success rates demonstrated
the equivalence of the two treatments. The C. trachomatis eradication rates were 96.3%
(78/81) and 98.6% (72/73) for patients receiving grepafloxacin or doxycycline, respectively. The two
study drugs were also equivalent in resolving clinical signs and symptoms, with clinical success
rates of 88.9% (64/72) and 89.5% (51/57) for patients treated with grepafloxacin and doxycycline,
respectively. Both drugs were well tolerated, with 47% of patients receiving grepafloxacin and 46%
of patients receiving doxycycline experiencing drug‐related adverse events, none of which was
serious.

Conclusions: Seven days of treatment with oral grepafloxacin, 400 mg once daily, was as effective
as 7 days of treatment with oral doxycycline, 100 mg twice daily, in patients with cervicitis caused
by C. trachomatis. Both agents were well tolerated and had comparable safety profiles. Grepafloxacin’s
once‐daily dosing regimen may offer advantages in terms of patient compliance.
The Pharmacokinetics of Once‐Daily Dosing WithGentamicin in Women WithPostpartum Endometritis
Authors: Sunyecz J. A. , Wiesenfeld H. C. , Heine R. P.
Published: March 2007

Objective: To evaluate the pharmacokinetics and cost of once‐daily dosing with gentamicin in
women with postpartum endometritis.

Methods: Gentamicin in a single daily dose of 4.5 mg/kg was administered intravenously to10
women with postpartum endometritis. Peak and trough gentamicin levels were measured, and
nephrotoxicity and clinical ototoxicity were monitored. Pharmacokinetic data were analyzed, and
a cost analysis of once‐daily gentamicin administration was performed.

Results: The mean elimination conslant was 0.105 ± 0.008 L/h, and the mean volume of distribution
was 0.34 ± 0.07 L/kg. Mean peak gentamicin levels exceeded 11 mg/L, and all trough levels
were <0.3 mg/L. Cost savings of 44% were achieved with once‐daily dosing of gentamicin, compared
with traditional thrice‐daily dosing.

Conclusions: Once‐daily dosing with gentamicin in women with postpartum endometritis achieves
therapeutic peak levels without drug accumulation. Substantial cost savings are realized with this
dosing regimen.
Antibodies to the Chlamydial 60 Kilodalton Heat Shock Protein in Women With Tubal Factor Infertility
Authors: Ault K. A. , Statland B. D. , King M. M. Smith , Dozier D. I. L. , Joachims M. L. , Gunter J.
Published: March 2007

Introduction:Fallopian tube damage and subsequent infertility are common sequelae of upper genital tract infection withChlamydia trachomatis. This fallopian tube damage is thought to be immune mediated. The 60 kilodalton chlamydial heat shock protein (hsp) may be the key antigen associated with this pathogenic response. Our objective was to study the relationship between antibody response to 60 kilodalton chlamydial hsp and tubal factor infertility (TFI).

Subjects and Methods:Twenty-three women with TFI and 33 women with male factor infertility (controls) were studied. Tubal factor infertility was defined as infertility for one year with hydrosalpinx or distal tubal occlusion. Patients’ sera were tested for antibodies to the chlamydial hsp using an enzyme-linked immunosorbent assay (ELISA). A stepwise logistic regression was performed by each patient’s age, race/ethnicity, self-reported history of chlamydia infection, gonorrhea, or pelvic inflammatory disease (PID), history of ectopic pregnancy, and antibodies to the chlamydial hsp.

Results:Eighteen of the 23 women with TFI had a positive result on the hsp ELISA (78.6%) versus 23.4% of controls. Risk factors for TFI were a history of PID (P= 0.022), “nonwhite” race (P= 0.004), history of ectopic pregnancy (P = 0.027), and antibodies to the 60 kilodalton chlamydial hsp (P< 0.001).

Conclusions:Antibodies to 60 kilodalton chlamydial hsp are strongly associated with TFI.
Clinical Utility of CA125 Levels in PredictingLaparoscopically Confirmed Salpingitis in PatientsWith Clinically Diagnosed PelvicInflammatory Disease
Authors: Moore E. , Soper D. E.
Published: March 2007

Objective: The purpose of this study was to determine the utility of serum CA125 determinations in
diagnosing acute salpingitis.

Methods: CA125 levels were determined for 34 women with the clinical diagnosis of pelvic
inflammatory disease (PID). Acute salpingitis was confirmed laparoscopically in 28 women (82.3%).

Results: Twenty patients (71.4%) with laparoscopically confirmed acute salpingitis had CA125
levels greater than 7.5 units, compared with no patients (0/6) with laparoscopically normal tubes (P = 0.002). The degree of elevation of CA125 levels correlated with the severity of tubal inflammation
noted at laparoscopy. All patients with levels above 16 units had laparoscopically severe salpingitis.

Conclusions: We conclude that while CA125 levels above 7.5 units may modestly improve the
ability of the clinical diagnosis of PID to accurately reflect visually confirmed acute salpingitis,
limitations of the test make its clinical utility questionable.
Heat Shock Protein Expression During Gametogenesis and Embryogenesis
Authors: Neuer A. , Spandorfer S. D. , Giraldo P. , Jeremias J. , Dieterle S. , Korneeva I. , Liu H.-C. , Rosenwaks Z. , Witkin S. S.
Published: March 2007

When cells are subjected to various stress factors, they increase the production of a group of proteins called heat shock proteins (hsp). Heat shock proteins are highly conserved proteins present in organisms ranging from bacteria to man. Heat shock proteins enable cells to survive adverse environmental conditions by preventing protein denaturation. Thus the physiological and pathological potential of hsps is enormous and has been studied widely over the past two decades. The presence or absence of hsps influences almost every aspect of reproduction. They are among the first proteins produced during mammalian embryo development. In this report, the production of
hsps in gametogenesis and early embryo development is described. It has been suggested that prolonged and asymptomatic infections trigger immunity to microbial hsp epitopes that are also expressed in man. This may be relevant for human reproduction, since many couples with fertility problems have had a previous genital tract infection. Antibodies to bacterial and human hsps are present at high titers in sera of many patients undergoing in vitro fertilization. In a mouse embryo culture model, these antibodies impaired the mouse embryo development at unique developmental stages. The gross morphology of these embryos resembled cells undergoing apoptosis. The TUNEL (terminal deoxynucleotidyl transferase‐mediated X‐dUTP nick end labeling) staining pattern, which is a common marker of apoptosis, revealed that embryos cultured in the presence of hsp antibodies stained TUNEL‐positive more often than unexposed embryos. These data extend preexisting
findings showing the detrimental effect of immune sensitization to hsps on embryo development. Infect. Dis. Obstet. Gynecol. 7:10–16, 1999.
[Retracted] Induction of Heat Shock Protein Expression in Cervical Epithelial Cells by Human Semen
Authors: Jeremias J. C. , Bongiovanni A. M. , Witkin S. S.
Published: March 2007

Objective: The 70kD heat shock protein (Hsp70), induced when cells are subjected to environmental stress, prevents the denaturation and incorrect folding of polypeptides and may expedite replication and transmission of DNA and RNA viruses. We analyzed whether messenger RNA (mRNA) for Hsp70 was expressed following exposure of a cultured human cervical cell line (HeLa cells) to human semen or in cervical cells from sexually active women.

Study Design: HeLa cells were co‐cultured with a 1:50 dilution of semen from four men or with purified spermatozoa or cell‐free seminal fluid. Endocervical swabs were acquired at mid‐cycle from 53 women. Heat shock protein 70 mRNA was detected by a reverse transcriptase‐polymerase chain reaction utilizing specific primer pairs and analysis on agarose gels. In cervical cells Hsp70 mRNA was measured identically followed by hybridization with an Hsp70‐specific internal probe and detection by enzyme‐linked immunosorbent assay (ELISA). Cervical immunoglobulin A (IgA) antibodies to the human Hsp70 were determined by ELISA.

Results: HeLa cell‐semen co‐culture resulted in the induction of Hsp70 mRNA. In addition, cell‐free seminal plasma and motile sperm incubated individually with HeLa cells also induced this mRNA. Heat shock protein 70 mRNA was detected in 28 (52.8%) of 53 endocervical samples obtained from women at various time points following intercourse. The percentage of samples expressing this mRNA was 37.5% at less than 10 hours, 64.3% at 10 hours, 70% at 11 hours, and
between 36% and 50% at later times after semen exposure. The detection of cervical IgA antibodies to the Hsp70 was highly associated with Hsp70 gene transcription.

Conclusion: Human semen induces transcription of Hsp70 in cervical epithelial cells. Infect. Dis. Obstet. Gynecol. 7:17–22, 1999.
Detection of the Human 70‐kD and 60‐kD Heat Shock Proteins in the Vagina: Relation to Microbial Flora, Vaginal pH, and Method of Contraception
Authors: Giraldo P. , Neuer A. , Ribeiro-Filho A. , Linhares I. , Witkin S. S.
Published: March 2007

The expression of the 60‐kD and 70‐kD heat shock proteins (hsp60 and hsp70) in the vaginas of 43 asymptomatic women of reproductive age with or without a history of recurrent vulvovaginitis (RVV) were compared. Vaginal wash samples were obtained and assayed by enzyme‐linked immunosorbent assay (ELISA) for human hsp60 and hsp70. Heat shock protein 70 was not detected in any of the 19 women with no history of RVV, and hsp60 was present in only one woman in this group. In contrast, in the RVV group, 11 (45.8%) were hsp60‐positive and eight (33.3%) were hsp70‐positive. The presence of either heat shock protein in the vagina was associated with an elevated vaginal pH (>4.5). Bacterial vaginosis or Candida was identified in some of the asymptomatic subjects; their occurrence was significantly higher in women with vaginal hsp70 than in women with no heat shock proteins. Oral contraceptives were used by 35.7% of subjects who were negative for vaginal heat shock proteins, as opposed to only 12.5% of women who were positive for hsp70 and 8.3% who were positive for hsp60. Expression of heat shock proteins in the vagina may indicate an altered vaginal environment and a susceptibility to vulvovaginal symptoms. Infect. Dis. Obstet. Gynecol. 7:23–25, 1999.
Characterization of Mild Whole‐Body Hyperthermia Protocols Using Human Breast, Ovarian, and Colon Tumors Grown in Severe Combined Immunodeficient Mice
Authors: Repasky E. A. , Tims E. , Pritchard M. , Burd R.
Published: March 2007

Objective: We have shown that one treatment of fever‐like whole body hyperthermia (WBH) on mice bearing human breast tumors results in a tumor growth delay. Our goal was to repeat this study in mice bearing human ovarian or colon tumors. We further evaluated this WBH protocol by performing multiple and interrupted WBH treatments.

Methods: Human tumors were grown in severe combined immunodeficient (SCID) mice. For WBH, core body temperatures were maintained at 39.8±0.2℃ for 6–8 hours. Multiple treatments were given 6–7 days apart. Interrupted WBH consisted of three 2‐hour heatings, 15 minutes apart.
Tumor growth time (TGT) was the number of days to grow 1.5 or 2 times in volume.

Results: For WBH‐treated ovarian tumors, TGT was 12±1.2d, compared with 5.0±0.1d for untreated mice (P < 0.05). For colon tumors with one WBH treatment TGT was 4.4± 1.1d. Two and three treatments had TGTs of 9±2.3d and 8±1.6d. For the untreated tumors, TGT was 2±0.7d
(P < 0.01 for one, two, and three treatments). Histological examination indicated that one and two treatments were associated with cellular damage within the tumors. With a slower growing colon tumor, the TGT was 24±3.3d with three WBH treatments, compared with 14±1.8d for controls (P < 0.01). The TGT of breast tumors treated with interrupted WBH was not significantly different than the noninterrupted, with TGT of 7.3±0.8d and 6.2±1.0d, respectively.

Conclusions: These data illustrate thatWBH causes a tumor growth delay in mice bearing human ovarian and colon tumors. This response is enhanced with a second treatment ofWBH. Interrupted and noninterrupted WBH give comparable anti‐tumor results. We will continue to evaluate WBH in various animal models to optimize its potential for clinical administration and maximize the anti‐tumor response. Infect. Dis. Obstet. Gynecol. 7:91–97, 1999.
Circulating Heat Shock Proteins in Women With a History of Recurrent Vulvovaginitis
Authors: Giraldo P. C. , Ribeiro-Filho A. D. , Simões J. A. , Neuer A. , Feitosa S. B. N. , Witkin S. S.
Published: March 2007

Objective: Predisposing factors influencing recurrences of bacterial vaginosis (BV) or vaginitis from Candida remain unidentified for most women. As a component of studies to determine host susceptibility
factors to genital tractiiafeetions in women, we measured expression of the 60‐kDa and
70‐kDa heat shock proteins (hsp60 and hsp70, respectively) in the circulation of women with or without a history of recurrent BV or candidal vaginitis and with or without a current lower genital tract infection. Heat shock protein expression is associated with a down‐regulation of proinflammatory immune responses that would inhibit microbial infection.

Method: The investigators measured hsp60 and hsp70, antibodies to these proteins, the proinflammatory cytokine tumor necrosis factor‐α (TNF‐α), and the anti‐inflammatory cytokine interleukin‐ 10 (IL‐10) in sera by ELISA. The study population consisted of 100 women who attended a gynecology clinic in Campinas, Brazil. Of those, 55 had a history of recurrent vulvovaginitis (RV), while 45 were controls with no such history. Only women who were asymptomatic for at least 1 month were studied.

Results: Although all were asymptomatic, clinical and microbiological examination revealed that five of the women with a history of RV and two controls had a current candidal vaginal infection; 16 RV patients and 12 controls had BV; and six RV patients had both BV and candidiasis. Twenty‐eight RV patients and 31 controls had no clinical or microbiological detectable vaginal infection. Among the RV patients, hsp60 and hsp70 were more prevalent in those with current BV (40.9% and 50.0%, respectively) or a candidal infection (45.5% and 54.5%) than in women with no
current infection (21.4% and 17.9%). In the women with no history of RV, BV was not associated with a high prevalence of hsp60 (8.3%) or hsp70 (8.3%). Interleukin‐10 and TNF were not more prevalent in vaginitis patients or controls with a current candidal infection or BV than in uninfected subjects.

Conclusion: The high prevalence of circulating hsp60 and hsp70 in women with a history of RV and current BV or vaginal candidiasis, but not in women with no history of RV, suggests that differences in heat shock protein induction may be related to susceptibility to recurrent vaginal infections. Infect. Dis. Obstet. Gynecol. 7:128–132, 1999.
Prophylactic Cefazolin in Amnioinfusions Administered for Meconium‐Stained Amniotic Fluid
Authors: Edwards R. K. , Duff P.
Published: March 2007

Objective: To determine if amnioinfusion with an antibiotic solution decreased the rate of clinical chorioamnionitis and puerperal endometritis in patients with meconium‐stained amniotic fluid.

Methods: Patients in labor at 36 weeks of gestation or greater with singleton pregnancies and meconium‐stained amniotic fluid were randomized to receive either cefazolin, 1 g/l,000 mL, of normal saline (n = 90) or normal saline (n = 93) amnioinfusion. Rates of clinically diagnosed chorioamnionitis and endometritis and of suspected and culture‐proven neonatal infection were determined.

Results: Between the study and control groups, the incidences of clinical chorioamnionitis (7.8% vs. 8.6%), endometritis (2.4% vs. 3.5%), aggregate intrauterine infection (10.0% vs. 11.8%), suspected neonatal infection (17.8% vs. 21.5%), and proven neonatal infection (0.0% vs. 2.2%) were not significantly different.

Conclusions: Prophylactic use of cefazolin in amnioinfusions did not significantly reduce rates of maternal or neonatal infection in patients with meconium‐stained amniotic fluid. Infect. Dis. Obstet. Gynecol. 7:153–157, 1999.
A Matched Prospective Study of Human Immunodeficiency Virus Serostatus, Human Papillomavirus DNA, and Cervical Lesions Detected by Cytology and Colposcopy
Authors: Eckert L. O. , Watts D. H. , Koutsky L. A. , Hawes S. E. , Stevens C. E. , Kuypers J. , Kiviat N. B.
Published: March 2007

Objective: To compare the prevalence and type of human papillomavirus (HPV) infections in the genital tract of human‐immunodeficiency‐virus‐ (HIV) seropositive and ‐seronegative women
matched for cytology and to examine prospectively the relationship of HPV DNA, colposcopic findings and cervical squamous intraepithelial lesions (SIL) in these matched seropositive and seronegative cohorts.

Methods: A matched prospective study of HIV‐seropositive and ‐seronegative women undergoing cytologic screening, colposcopy, and testing for HPV DNA and other infections at each visit.

Results: Twenty‐three HIV‐seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow‐up length. Fourteen pairs of these women had follow‐up visits every 4 months, for 56 and 53 total visits in seropositive and seronegative women, respectively. After matching, the groups had a similar overall prevalence ofHPV DNA and ofHPV oncogenic (high risk) types at baseline. On follow up, HIV‐seropositive women were more likely than seronegative women to develop SIL (38% vs. 10%), less likely to have negative cytology (34% vs. 60%, overall P = 0.03), more visits with HPV DNA detected (68% vs. 40% P = 0.04), and more visits with multiple HPV DNA types detected (18% vs. 0%, P = 0.02).
Colposcopic lesions in the seropositive women were more likely to have sharp borders or mosaicism or to be thick white (P = 0.009).

Conclusions: After matching for baseline Papanicolaou smear readings, these data suggest that over time seropositive women have more visits that yield abnormal cytology, more persistent HPV DNA detection, and more colposcopic abnormalities than seronegative women. Infect. Dis. Obstet. Gynecol. 7:158–164, 1999.
Heat Shock Proteins and Heat Shock Protein‐Antibody Complexes in Placental Tissues
Authors: Ziegert M. , Witkin S. S. , Sziller I. , Alexander H. , Brylla E. , Härtig W.
Published: March 2007

Objective: The relationship between pregnancy outcome and expression of the heat shock proteins
(hsps) or hsp‐antibody complexes of 60kD (hsp60), 70kD (hsp70), and 90kD (hsp90) in placental tissue and circulating antibodies to hsps was evaluated.

Method: Expression of hsp60, hsp70, and hsp90 in placentae from 12 women with preterm birth, eight with intrauterine growth restriction (IUGR), and 10 with term birth, as well as the presence of the corresponding antibodies, was investigated by a new carbocyanine double fluorescence technique. Results were compared with microbiological findings and circulating antibodies to hsps in sera.

Results: In each placental specimen examined, hsp60, hsp70, and hsp90 were identified. However, hsp70‐antibody complexes were detected in only four of the preterm labor cases. Similarly, hsp60‐antibody complexes were detected in only five preterm labor patients and in one patient with IUGR. None of the placentae contained hsp90‐antibody complexes. In the preterm birth group, all patients with hsp60‐antibody complexes were also positive for circulating antibodies to hsp60. The presence of hsp70‐antibody complexes also correlated with hsp70 antibody in sera.

Conclusions: Formation of hsp60‐ and hsp70‐antibody complexes in the placenta may contribute to the induction of preterm birth. Women sensitized to these antibodies may be at increased risk for adverse pregnancy outcome. Infect. Dis. Obstet. Gynecol. 7:180–185, 1999.
Bacterial Isolates From Patients With Preterm Labor With and Without Preterm Rupture of the Fetal Membranes
Authors: Mikamo H. , Sato Y. , Hayasaki Y. , Kawazoe K. , Hua Y. X. , Tamaya T.
Published: March 2007

Objective: The aim of this study is to describe the bacterial flora of women in preterm labor with or without premature rupture of membranes.

Methods: Retrospective studies of 239 patients with preterm labor were performed.

Results: One hundred and twenty‐three of 239 patients with preterm labor (51.5%) had bacterial vaginosis. Seventy of the 239 patients with preterm labor (29.3 %) developed premature rupture of the membranes (preterm PROM). Ofthe 70 patients with preterm PROM, 51 (72.9%) had bacterial vaginosis. Therefore, 51 of the 123 patients with bacterial vaginosis (41.5%) developed preterm PROM. An increased number of organisms detected from the vaginal discharge in patients with preterm labor was associated with preterm PROM by Cochran‐Armitage test. An increased number of organisms detected from the vaginal discharge in patients with preterm labor complicated with bacterial vaginosis was significantly associated with preterm PROM by Cochran‐Armitage test.

Conclusions: In preterm labor, the number of different species detected in the vagina provide sensitive and specific prediction of preterm PROM in patients with preterm labor. Infect. Dis. Obstet. Gynecol. 7:190–194, 1999.
Increased Susceptibility to Helicobacter pylori Infectionin Pregnancy
Authors: Lanciers S. , Despinasse B. , Mehta D. I. , Blecker U.
Published: March 2007

Objective: Helicobacter pylori plays, a major role in abdominal symptoms and gastroduodenal pathology, including gastric cancer. Pregnancy has been associated with changes in both humoral and cell‐mediated immunity. These changes include alterations in the various classes of antibodies during different gestational periods. It has been previously suggested that these alterations may
expose pregnant women to an increased risk of infection with this microorganism.

Methods: To further investigate this hypothesis, we assayed sera from 229 asymptomatic pregnant women for the presence of H.-pylori‐specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies by means of a commercially available serum ELISA test (Malakit™, Biolab, Belgium). Both tests were previously validated in large series of H.-pylori‐positive and ‐negative subjects. While the presence of H.-pylori‐specific IgG antibodies is only a marker for a “chronic” infection with this bacterium and therefore no indicator of the time of acquisition of the infection,
specific IgM antibodies are a more specific marker for a recently acquired infection
with H. pylori. Results were compared with those previously obtained in asymptomatic, healthy, nonpregnant individuals.

Results: One hundred twenty of 229 women (52.4%) and 55/118 nonpregnant subjects (46.6%) were seropositive for H.-pylori‐specific IgG antibodies (P > 0.3). Out of these 120 IgG‐antibodypositive women, 36 (30%) were positive for H.-pylori‐specific IgM antibodies, as were 25/109 (22.9%) in the IgG‐antibody‐negative group (P > 0.3). Overall, 61/229 (26.6%) of the pregnant women had recently been infected with H. pylori, compared with 11% of the healthy, nonpregnant population (P > 0.01).

Conclusions: Our observations confirm the possibility of an increased susceptibility to H. pylori infection in pregnancy. Additional studies are necessary to further understand the immune response to H. pylori in pregnancy. Infect. Dis. Obstet. Gynecol. 7:195–198, 1999.
Germ Tube Formation Changes Surface Hydrophobicity of Candida Cells
Authors: Rodrigues A. G. , Mårdh P.-A. , Pina-Vaz C. , Martinez-de-Oliveira J. , Fonseca A. F.
Published: March 2007

Hydrophobic interaction is generally considered to play an important role in the adherence of
microorganisms to eukaryotic cells and also to certain inert surfaces. Using a microbe adhesion
assay to hydrocarbons (n‐hexadecane), 68 strains of Candida albicans and 30 non‐albicans strains
were studied. Influence of source of isolate, age of the culture, and percentage of germ tube formation
on adhesion were studied. C: albicans blastoconidia were found to be hydrophilic; conversely,
blastoconidia of non‐albicans strains were slightly more hydrophobic. Germ tube formation
was associated with a significant rise in cell surface hydrophobicity. Infect. Dis. Obstet. Gynecol.
7:222–226, 1999.
Peritoneal Tuberculosis: Diagnostic Options
Authors: Lal N. , Soto-Wright V.
Published: March 2007

Background: Extrapulmonary tuberculosis has vague symptoms and few signs. It is essential to recognize and diagnose this curable disease prior to performing definitive surgery. Newer tests such as DNA or RNA amplification allow for early diagnosis but have limitations.

Case: We report a case of peritoneal tuberculosis in an immigrant woman. She had vague symptoms of low‐grade fever, mild abdominal pain, obstipation, and bloating. Diagnostic laparoscopy was performed to establish the diagnosis. Tuberculosis was confirmed by DNA extraction from the frozen section specimen with subsequent analysis using polymerase chain reaction.

Conclusion: Peritoneal tuberculosis is a disease that often simulates malignancies. With the increasing prevalence of human immunodeficiency virus in developed countries, tuberculosis is also on the rise and should be considered in the differential diagnosis of a patient with an abdominal/ pelvic mass and ascites. Infect. Dis. Obstet. Gynecol. 7:244–247, 1999.
Question Answering in Restricted Domains: An Overview
Authors: Mollá Diego , Vicedo José Luis
Published: March 2007

Automated question answering has been a topic of research and development since the earliest AI applications. Computing power has increased since the first such systems were developed, and the general methodology has changed from the use of hand-encoded knowledge bases about simple domains to the use of text collections as the main knowledge source over more complex domains. Still, many research issues remain. The focus of this article is on the use of restricted domains for automated question answering. The article contains a historical perspective on question answering over restricted domains and an overview of the current methods and applications used in restricted domains. A main characteristic of question answering in restricted domains is the integration of domain-specific information that is either developed for question answering or that has been developed for other purposes. We explore the main methods developed to leverage this domain-specific information.
Answering Clinical Questions with Knowledge-Based and Statistical Techniques
Authors: Demner-Fushman Dina , Lin Jimmy
Published: March 2007

The combination of recent developments in question-answering research and the availability of unparalleled resources developed specifically for automatic semantic processing of text in the medical domain provides a unique opportunity to explore complex question answering in the domain of clinical medicine. This article presents a system designed to satisfy the information needs of physicians practicing evidence-based medicine. We have developed a series of knowledge extractors, which employ a combination of knowledge-based and statistical techniques, for automatically identifying clinically relevant aspects of MEDLINE abstracts. These extracted elements serve as the input to an algorithm that scores the relevance of citations with respect to structured representations of information needs, in accordance with the principles of evidence-based medicine. Starting with an initial list of citations retrieved by PubMed, our system can bring relevant abstracts into higher ranking positions, and from these abstracts generate responses that directly answer physicians' questions. We describe three separate evaluations: one focused on the accuracy of the knowledge extractors, one conceptualized as a document reranking task, and finally, an evaluation of answers by two physicians. Experiments on a collection of real-world clinical questions show that our approach significantly outperforms the already competitive PubMed baseline.
Word-Level Confidence Estimation for Machine Translation
Authors: Ueffing Nicola , Ney Hermann
Published: March 2007

This article introduces and evaluates several different word-level confidence measures for machine translation. These measures provide a method for labeling each word in an automatically generated translation as correct or incorrect. All approaches to confidence estimation presented here are based on word posterior probabilities. Different concepts of word posterior probabilities as well as different ways of calculating them will be introduced and compared. They can be divided into two categories: System-based methods that explore knowledge provided by the translation system that generated the translations, and direct methods that are independent of the translation system. The system-based techniques make use of system output, such as word graphs or N-best lists. The word posterior probability is determined by summing the probabilities of the sentences in the translation hypothesis space that contains the target word. The direct confidence measures take other knowledge sources, such as word or phrase lexica, into account. They can be applied to output from nonstatistical machine translation systems as well.

Experimental assessment of the different confidence measures on various translation tasks and in several language pairs will be presented. Moreover,the application of confidence measures for rescoring of translation hypotheses will be investigated.
Papyrus Egerton 2 - the ‘Unknown Gospel’
Authors: Nicklas Tobias
Published: March 2007

This article deals with the so-called ‘unknown Gospel’ of P.Egerton 2 , one of the oldest extant Christian manuscripts (dating to around 200 CE ). Presented here is a short interpretation of the five fragmentary scenes of the text, followed by questions about the theological profile of the text, the date of the text and its literary dependency on the canonical Gospels.
The Nature of Preaching and the Gospel of John
Authors: Paddison Angus
Published: March 2007

This article explores a positive ontology of the preaching act. What is preaching? Answering this question with the Fourth Gospel open on the desk I put forward a proposal for how preaching ‘works’ by matching it up to the revealing activity of the triune God. Two theses are advanced: (1) the power of preaching is the presence of the ascended and ruling Christ, and (2) preaching is an occasion through which the Spirit draws us into the conversation of the Trinity.
Effect of Nanoclay and Foaming Conditions on the Mechanical Properties of HDPE–Clay Nanocomposite Foams
Authors: Jo Choonghee , Naguib Hani E.
Published: March 2007

The effects of nanoclay and foaming conditions on the foam morphology and mechanical properties of microcellular high density polyethylene (HDPE)–clay nanocomposite foams are investigated. Clay loadings of 0.5, 1.0, and 2.0 wt.% are used and the microcellular HDPE–clay nanocomposite foams are prepared by batch foaming process using CO2. Uniaxial tensile tests are performed with the nanocomposites and its foams. It is demonstrated that nanoclays in HDPE, with proper clay contents, have a role to improve the mechanical properties, such as elastic modulus and tensile strength. In addition, tensile properties of HDPE–clay foams are reinforced when compared to that of pure HDPE foams. In the case of both nanocomposites and nanocomposite foams, the mechanical properties are improved most at 0.5 wt.% clay loadings.
Thin Microcellular Plastic Sheet Incorporating Designed Foaming Patterns Made by Photochemical Foaming Technology
Authors: Kojima Junya , Takada Tomoyuki , Jinno Fumio
Published: March 2007

A novel chemical foaming technology is proposed to manufacture microcellular plastic sheet with a thickness of 100 μm or less. A foamable plastic consisting of a polymer with t-butyl ester groups and a photoacid generator has been developed. Upon ultraviolet irradiation, the photoacid generator releases protons. The protons transform the t-butyl ester group attached to the polymer into isobutene gas upon heating, which leads to controlled microcellular formation in the plastic film. The cell size and the cell density of the microcellular plastic are controlled by ultraviolet irradiation and the heating temperature. By adjusting these two parameters, the optical properties of the resulting microcellular plastic can be predetermined. A thin microcellular sheet that has a micron-order foaming pattern exhibiting different transparencies has been produced by using a pattern mask.
Low-dimensional model-based boundary control of 2D heat flow utilizing root locus
Authors: Efe Mehmet Önder
Published: March 2007

Control of systems governed by Partial Differential Equations (PDEs) is an interesting subject area, as the classical tools of control theory are not directly applicable and PDEs can display enormously rich behaviour spatiotemporally. This paper considers the boundary control of a 2D heat flow problem. A solution to the control problem is obtained after a suitable model reduction. The considered PDE system is subject to Dirichlet boundary conditions of generic type f(x)γ(t). The separation of these boundary excitations after Proper Orthogonal Decomposition yields an autonomous Ordinary Differential Equation (ODE) set in which the boundary excitations are implicit. The main contribution of this paper is to describe a mathematical treatment based on the numerical observations such that the implicit excitation terms explicitly appear in the ODE set. With such an ODE model, standard tools of feedback control theory can be applied. A measurement point has been chosen, and the desired behaviour is forced to emerge at the chosen point. A root locus technique is used to obtain the controller. It is seen that the results obtained are in good compliance with the theoretical claims.
Histoires croisées: François Furet, Ernst Nolte and a Comparative History of Totalitarian Movements
Authors: Schönpflug Daniel
Published: March 2007

The global political avalanche that accompanied the breakdown of the Soviet Union swept away the European discursive landscape, with its strict right-left divisions. In its wake, a renaissance and reorientation of debates about totalitarianism can be observed. First, more emphasis is placed on the utopian content and other elements of totalitarian ideologies, which explain the enthusiasm they evoked. Second, there has been a shift of interest from totalitarian regimes to total-itarian movements. Third, recent research has been marked by an expansion of the comparative apparatus, which allows the analysis of reciprocal perceptions, imitations and learning processes between totalitarian movements. François Furet and Ernst Nolte have been among the most prominent combatants in the arena of historical politics. There can be no doubt that their stances in the debate on totalitarianism were deeply influenced by the Cold War. Nevertheless, it is argued in this article that they also contributed to the recent reorientation of these debates. The impulses towards a comparative history of totalitarian movements yielded by Furet and Nolte were particularly intense in the second half of the 1990s, when the two historians met and influenced one another. The article starts with Furet’s interpretation of Jacobinism, which can be understood as a paradigmatic analysis of a totalitarian movement. The second section compares Furet’s and Nolte’s vision of the Russian Revolution. While the French historian sees 1917 as a re-enactment of the French Revolution, his German colleague’s chief concern is to interpret the Russian Revolution as something wholly novel. The last section of the article focuses on Furet’s and Nolte’s view of National Socialism. In this context, the mutual influences but also the fundamental differences between the two are most obvious. In ‘Le passé d’une illusion’, Furet adopts Nolte’s history of interactions between communism and National Socialism without sharing Nolte’s provocative assumption of a ‘causal nexus’. It is above all Furet’s critical and creative reading of Nolte’s ‘Der europäische Bürgerkrieg’ that points the way towards a comparative cultural history of totalitarian movements.
Palliative care in patients with severe multiple sclerosis: two case reports and a survey among German MS neurologists
Authors: Kümpfel T , Hoffmann L A , Pöllmann W , Rieckmann P , Zettl U K , Kühnbach R , Borasio G D , Voltz R
Published: March 2007

Due to its chronic and fluctuating time course, multiple sclerosis (MS), thus far, has not been regarded as a focus of palliative care. However, sometimes we are confronted with severely affected MS patients, who suffer from complex medical, physical and psychosocial problems, which are not fully covered by the current health care services.

We present two cases of severely affected MS patients we saw in our outpatient MS clinic, and who, we believe, are candidates for palliative care. The first patient, with primary chronic progressive (pcP) MS for many years (Expanded Disability Status Scale (EDSS): 8.0) presented with complex painful dysaesthesias and a depressive syndrome. He refused any treatment, and finally committed suicide with the help of a euthanasia group in Switzerland. The second patient was also severely affected by a secondary chronic progressive (scP) MS (EDSS: 9.0) and was finally admitted to our palliative care unit due to a complex pain syndrome associated with panic attacks and anxiety. She spent three weeks on the palliative care unit and her symptoms improved gradually after changing and optimising her pain medication. The patient was discharged with home care and is seen regularly on the palliative care unit.

Additionally, as a first step, a questionnaire was sent to 53 German MS specialists regarding their general view on the needs for palliative care in MS. Our two cases and the results of the questionnaire demonstrated that MS patients and their caregivers are confronted with a variety of symptoms which are difficult to treat, and are a cause of great suffering for the patients, including ataxia, depression and fatigue. The data of the questionnaire also showed that neurologists usually do not deal with end-of-life care issues in MS.

More research is needed to define the role of palliative care in MS and establish appropriate interventions to improve the quality of life in advanced stage MS patients and their relatives.