bluuebunny/crossref_metadata_2025 huggingface dataset:
Mini‐Catheter Used for Bladder Drainage Following Stress‐Incontinence Surgery and the Factors Relating to Drainage Failure
Authors: Su Tsung‐Hsien , Yang Jenn‐Ming , Chen Chie‐Pein , Wei Hsiao‐Jui , Hwu Yuh‐Ming , Yang Yuh‐Cheng
Published: August 2010

Objectives: To determine the most effective length for the mini‐catheter and to discuss factors relating to drainage failure.

Methods: Prospective study of a No. 8 silastic feeding tube for bladder drainage omits the necessity of additional catheterization for measuring residual urine. This two‐part study in which 146 patients took part, first, determined the suitable length for insertions for the perforated portion and the imperforated portion; then, gauged the effectiveness of the mini‐catheter with desired proportions.

Results: Drainage is better when the imperforated portion is at least 5 cm in length (p = 0.0129). The length of the perforated portion, on the other hand, has less impact of the resultant drainage provided that its length does not exceed 5 cm. Beyond this length, an obstruction often occurs. There were 2 obstructions (1.3%) induced by blood clot as well as 9 patients (5.8%) who suffered from one, or more, complications attributed to the mini‐catheter for reasons other than the length of insertion.

Conclusions: When care is taken in creating a mini‐catheter of the proper proportions, it offers many advantages and very few complications to gynecologists and patients alike.
Papillary Serous Carcinoma of the Peritoneum
Authors: Chew S. , Tham K. F. , Lim F. K. , Ratnam S. S.
Published: August 2010

Objective: To describe the clinical features of papillary serous carcinoma of the peritoneum followed by a short review of the literature.

Methods: From January 1986 to May 1994, six patients with papillary serous carcinoma of the peritoneum were treated at our institution. Their presenting features, sites of disease at the time of staging laparotomy, subsequent treatment and follow‐up were reviewed.

Results: The mean age was 53.3 years (range 46–59). The most common presenting features were abdominal pain, distention and the presence of ascites. Common sites of disease at the time of laparotomy were the peritoneal and subdiaphragmatic surfaces, omentum, serosa of bowel and superficial involvement of the ovaries. Patients were treated with cytoreductive surgery and platinum — based chemotherapy.

Conclusion: Although experience is scant and more data is needed, for the time being, management for primary peritoneal carcinoma is as for ovarian cancer.
Investigation on Breastfeeding and Lactational Amenorrhoeic Women in Mountainous Areas of Pengxian County, Southwest China
Authors: Cui Nian , Yang Xiaofeng , Tang Guanghua , Li Minxiang , Zhang Zhiyong
Published: August 2010

Objective: To determine the distributions of the duration of postpartum breastfeeding, amenorrhoea, and contraceptive use, a community‐based epidemiological investigation was carried out in Pengxian County, Southwest China in March 1992.

Methods: 1,040 women who had given live births during the reference period were interviewed. A current‐status life table analysis was used.

Results: At 1 month postpartum, 100% infants were breastfed, at 6 months 95%, and at 12 months 82%. The level of amenorrhoea at 1 month postpartum was 90%, at 3 months 74%, at 6 months 62%, and at 12 months 36%. Contraceptive use was initiated at the second month postpartum with 19% of users, at 6 months 48%, and at 12 months 91%.

Conclusion: The results indicate that at population level advising women to begin using contraceptives in 3 months postpartum is fairly reasonable, and the non‐medicated IUD is recommended to be the first choice for the lactating women.
The Role of Superoxide Dismutase in the Human Ovary and Fallopian Tube*
Authors: Tamate Kenichi , Sengoku Kazuo , Ishikawa Mutsuo
Published: August 2010

Objectives: To investigate the localization of manganese superoxide dismutase (Mn‐SOD) and copper‐zinc superoxide dismutase (Cu, Zn‐SOD) in the human ovary and fallopian tube, and to examine the role of superoxide radicals and SODs in the human ovulatory process.

Methods: Using immunohistochemical methods, we studied the localization of SODs in 22 human ovaries, in 18 fallopian tubes, and in aspirated granulosa cells. We measured, by enzyme‐linked immunosorbent assay, the concentrations of SODs in follicular fluid taken from 94 IVF patients.

Results: Mn‐SOD was found in granulosa, in theca and luteal cells, and in fallopian tubes. Cu, Zn‐SOD was localized in theca and luteal cells.

The concentration of Cu, Zn‐SOD in follicular fluid in the high‐progesterone group (11.3 + 4.2 ng/ml) was significantly less than in the low‐progesterone group (24.5 + 19.5) (p < 0.05).

Conclusion: Mn‐SOD and Cu, Zn‐SOD have different localizations and actions in human ovaries and fallopian tubes. The superoxide radical‐SOD system might play an important role in ovulation and in the luteal function of the human ovary.
The Value of Doppler Study of the Umbilical Artery in Predicting Perinatal Outcome in Pre‐Eclamptic Patients
Authors: Rocca Mohamed M. , Said Mohamed S. , Khamis Mohamed Y. , Ghanem Ibrahim A. , Karkour Tarek A.
Published: August 2010

Objective: To test the value of routine Doppler study of the umbilical artery to predict the perinatal outcome in pre‐eclamptic patients.

Methods: Fetal wellbeing was assessed in 113 women with pre‐eclampsia by weekly performed biophysical profile score (BPP) and Doppler study of the umbilical artery starting early in the third trimester till delivery.

Results: The last Doppler result before delivery was normal in 82 cases and abnormal in 31 cases. The group with abnormal Doppler had significantly higher blood pressure and serum uric acid level, and significantly lower platelet count than the group with normal Doppler. The incidence of IUGR, low Apgar score at 5 minutes, perinatal deaths and operative delivery for fetal distress was significantly higher in the group with abnormal Doppler.

Conclusions: The abnormal Doppler result usually precedes the appearance of abnormal BPP. The abnormal Doppler result helps to identify the fetus at risk that needs further surveillance.
Progression of Vulvar Intraepithelial Neoplasia III to Invasive Carcinoma in a Young Woman
Authors: Tan A. L. , Jones R. W. , White J. E. T.
Published: August 2010

This case documents the progression of untreated vulvar intraepithelial neoplasia to invasion in a young woman over a four and a half year period. Conflicting views with regards to the natural history of VIN III are discussed.
Mid‐Second Trimester Organic Acids in Severe Open Neural Tube Defects
Authors: Legge Michael
Published: August 2010

Objective: To investigate amnioic fluid organic concentrations at 16 weeks gestation from normal fetuses and those affected by severe neural tube defects.

Methods: Amniotic fluid collected from normal, anencephalic and severe open spina bifida fetuses was analysed for upto 24 organic acids by gas liquid chromatography.

Results: Significant increase in organic acids similar to those observed in defects of phenylalanine and tyrosine metabolism were identified when compared with the normal fetuses. Significant differences in organic acid concentrations were also identified within the two neural tube defect groups.

Conclusion: A relationship between phenylalanine and tyrosine metabolism, closure rate of the neural tube and folate metabolism is proposed.
Thyroid Hormone in Hyperemesis Gravidarum
Authors: Tareen Asal Khan , Baseer Abdul , Jaffry Hassan Fatima , Shafiq Muhammad
Published: August 2010

Objective: Several studies have suggested that nausea and vomiting in early pregnancy are related to the levels of thyroid hormones and human chorionic gonadotropin (hCG). To ascertain this relationship, we investigated 60 pregnant women (30 subjects each with morning sickness and hyperemesis gravidarum) and compared them with 30 control subjects (by enzyme immunoassay method).

Methods: Serum T3, T4 and TSH were determined in all the subjects while serum hCG was assayed in pregnant women only. Group comparison was done by applying Student's t‐test and the relationship between various parameters was evaluated by calculating coefficient of correlation, “r''.

Results: Serum T4 and hCG levels were significantly increased in hyperemesis gravidarum while TSH demonstrated a significant decline in the same group. Correlation analysis showed a direct relationship between serum T4 and hCG and an inverse relationship between serum TSH and hCG in pregnancy with morning sickness.

Conclusion: Our results are suggestive of the involvement of these variables in the pathogenesis of morning sickness and hyperemesis gravidarum not only because their levels were significantly altered but the extent of increase or decrease in their level correlated well with the severity of symptoms in the study subjects.
A Series of 1000 Consecutive Out‐patient Diagnostic Hysteroscopies
Authors: Cooper M. J. W. , Broadbent J. A. M. , Molnár B. G. , Richardson R. , Magos A. L.
Published: August 2010

Objective: To review the success of out‐patient diagnostic hysteroscopy.

Method: Retrospective review of 1000 consecutive out‐patient hysteroscopies.

Results: Hysteroscopy was successfully performed in 96%. Cervical dilatation was required in 15.0% and local anaesthesia was administered in 31.4%; 77.3% of those requiring cervical dilatation received local anaesthesia. Intrauterine pathology was noted in 49.3%. The procedure failed in 40 (4%) patients for the following reasons: pain or anxiety in 23, cervical stenosis in 11, equipment failure in 4, and extreme uterine retroversion and inadvertent false cavity formation in one case each.

Conclusion: Out‐patient diagnostic hysteroscopy is a safe, well tolerated and successful investigation procedure in the majority of patients and should be the procedure of choice for suspected intrauterine pathology.
A Case of True Hermaphroditism with Androgen Insensitivity
Authors: Takeuchi Hiroyuki , Hatta Mariko , Fukuda Masaru , Mitsuhashi Naoki , Kuwabara Yoshinori
Published: August 2010

A phenotypically normal woman with a 46, XY karyotype was found to have a testis, an ovotestis, bilateral rudimentary uteri, and bilateral fallopian tubes. The endocrinological and pathological aspects of these findings are discussed.
Combination Treatment with Cisplatin and Schizophyllan for 7,12‐dimethylbenz(a)anthracene‐Induced Rat Ovarian Adenocarcinoma
Authors: Sugiyama Toru , Nishida Takashi , Kumagai Seisuke , Imaishi Kiyohisa , Ushijima Kimio , Kataoka Akio , Yakushiji Michiaki
Published: August 2010

Objective: Experimental chemotherapy was conducted to investigate the combined effect of Schizophyllan (SPG) and Cisplatin (CDDP).

Methods: Rats with 7,12‐dimethylbenz(a)anthracene (DMBA)‐induced ovarian adenocarcinoma received SPG and/or CDDP, were observed for the anti‐tumor effect of the drugs and were subjected to immunohistochemical study.

Results: 1Tumor reduction was enhanced by the combined use of SPG and CDDP; 2The survival rate of rats given SPG alone was significantly higher than that of the control rats, and treatment with SPG combined with CDDP tended to improve the survival rate; 3Immunohistochemically, an infiltrative increase in cytotoxic T‐lymphocytes (CTL) was induced, although the development of helper T‐cells and macrophages was immunohistochemically weak at the tumor site.

Conclusion: The administration of SPG enhanced the anti‐tumor effect of CDDP.
Successful Pregnancy after Intracytoplasmic Injection of a Single Testicular Spermatozoon into a Human Oocyte: A Case Report
Authors: Suganuma Nobuhiko , Asada Yoshimasa , Yamamoto Masanori , Moriwaki Takayuki , Kitagawa Takeshi , Tomoda Yutaka , Mishima Atsushi , Miyake Koji
Published: August 2010

Testicular sperm was retrieved from a man with an epididymal obstruction, and an intracytoplasmic sperm injection was made into his wife's oocytes. In 4 mature oocytes treated, 2 fertilized eggs were obtained, and a clinical pregnancy was established with embryo transfers. Our experience demonstrated the possibility of fertilization and conception with testicular sperm.
A True Hermaphrodite with Bilateral Ovotestes: A Case Report
Authors: Sadi Al Muktafi , Toda Takayoshi , Kiyuna Masaya
Published: August 2010

A 20‐month‐old phenotypically male child with ambiguous external genitalia came to this hospital. Chromosomal and DNA analyses revealed 46/XX karyotype and absence of SRY gene, respectively. Two gonadal masses in the labioscrotal folds histologically showed both ovarian and testicular tissues. Clinicopathological features of the patient suggested true hermaphroditism with bilateral ovotestes.
Changes in Glycoconjugate‐Lectin Binding Characteristics of in vitro and in vivo Mouse Blastocysts
Authors: Legge Michael
Published: August 2010

Objective: To investigate the influence of embryo culture, on blastocysts cultured from the zygote stage, on blastocyst cell surface glycoconjugates as an indicator of cellular metabolism.

Method: Eleven fluorescein isothiocyanate (FITC)‐labelled lectins, which recognize different oligosaccharide structures, were applied to zona pellucida intact and zona pellucida free blastocysts which had developed either in vivo or in vitro. The differential binding patterns for the zona pellucida, trophectoderm and inner cell mass were determined using fluorescence microscopy.

Results: With the exception of wheat germ agglutinin (WGA) and Limax flavus agglutinin (LFA) the remaining nine lectins bound less intensely to the zona pellucida of the in vitro blastocysts compared with the in vivo blastocysts. The trophectoderm from both groups bound seven lectins with equal intensity, of the remaining four Lotus tetragonolbus agglutinin (LTA), Bandeiraea simplicifolia 4 (BSB4), Phaseolus vulgaris agglutinin P (PHA‐P) and Limulus polyphemus agglutinin (LPA) demonstrated differential binding. The inner cell mass from the two blastocyst groups bound only three lectins identically, peanut agglutinin (PNA), Bandeiraea simplicifolia 4 (BSB4) and Dolichos biflorus agglutinin (DBA).

Conclusion: Oviductal glycoproteins contribute to the zona pellucida glycoprotein content during early development, however embryo culture from the zygote stage may not provide adequate substrates for normal inner cell mass glycoconjugate biosynthesis.
The Association of Chlamydia trachomatis / Gonococcal Infection and Tubal Factor Infertility
Authors: Swasdio K. , Rugpao S. , Tansathit T. , Uttavichai C. , Jongusuk P. , Vutayavanich T. , Oranratanachai A. , Pruthitada N. , Peerakom S. , Ittipunkul W. , Rowe P. J. , Ward M. E.
Published: August 2010

Objective: To determine the association of past Chlamydia trachomatis and past Neisseria gonorrhoeae infection with tubal factor infertility.

Methods: A cross‐sectional study was conducted. Cases consisted of 55 primary infertile women with laparoscopy confirmed tubal damage (group A) and their husbands, consecutively attending the Infertility Unit at Maharaj Nakorn Chiang Mai Hospital between 1990 and 1992; and 58 primary infertile women with laparoscopy confirmed normal tubes (group B) and their husbands, consecutively attending the same hospital over the same period. Controls consisted of 59 postpartum women (group C) and their husbands omitted to the same hospital over the same period as cases. Past chlamydial and gonococcal infections were assessed by measuring serum IgG antibodies by enzyme immunoassay (EIA). The EIA antigens consisted of purified elementary bodies of C. trachomatis serovar L1, or purified alpha pili of N. gonorrhoeae strain P9.

Results: The prevalence of positive IgG antibody to gonococcal pili in sera from group A was 29.1%, significantly higher than the prevalence of 5.2% in group B or 3.4% in group C (p = 0.000). The husbands of women in group A had a significantly higher prevalence of IgG antibody to gonococcal pili (36.4%) than the husbands of women in group B (8.6%) or group C (18.6%) (p = 0.002). There was no significant difference in positive IgA antibody between case and control groups. After controlling for age, group A showed significantly higher prevalences of past gonorrhea (OR = 32.4, 95% CI 4.3, 242.2) and past chlamydial infection (OR = 3.2, 95% CI 1.2, 8.5) than group C. The husbands of women in group A also had higher prevalences of both types of infection than the husbands of women in group C; the odds ratios for past gonorrhea or chlamydial infections were 2.8 (95% CI 1.1, 6.9) and 2.9 (95% CI 1.2, 7.1), respectively. Neither infertile women with normal tubes (group B) nor their husbands showed any difference when compared with controls.

Conclusion: These results suggest that in this region of northern Thailand there is an association between past gonorrhea and past chlamydial infection and tubal factor infertility.
Uterine Cervical Clear‐Cell Adenocarcinoma with a Choriocarcinomatous Component: A Case Report
Authors: Morimura Yutaka , Yazawa Mihoko , Hoshi Kazuhiko , Takano Yoshimasa , Hang Xiang Li , Honda Tsuyoshi , Sato Akira
Published: August 2010

A 55‐year‐old woman presented with vaginal bleeding. A tumor was found in the cervix; it was composed of 2 distinctive elements: a clear‐cell adenocarcinoma and a choriocarcinoma. Histologic findings suggested that the choriocarcinomatous element was derived from a preexisting clear‐cell adenocarcinoma through a metaplastic process.
The Role of Transvaginal Ultrasonography and Colour Doppler Imaging in the Detection of Ectopic Pregnancy
Authors: Chew S. , Anandakumar C. , Vanaja K. , Wong Y. C. , Chia D. , Ratnam S. S.
Published: August 2010

Objective: To assess the use of transvaginal ultrasound and colour Doppler imaging in the detection of ectopic pregnancy.

Materials and Methods: Seventy‐one patients with suspected ectopic pregnancies had transvaginal sonography and colour Doppler imaging performed and 61 ectopic pregnancies were confirmed at surgery. Various ultrasound features on transvaginal B mode scanning were noted and the resistance index of peritrophoblastic flow in the adnexal masses computed.

Results: The use of transvaginal B mode imaging alone in the diagnosis of ectopic pregnancy achieved a sensitivity of 98% and a positive predictive value of 86%. The mean gestational age at time of diagnosis was 6 weeks 5 days (range 4 weeks to 13 weeks 2 days). The use of transvaginal colour flow imaging did not increase detection rates of ectopic pregnancy. The mean RI values for patients with or without ectopic pregnancy were almost identical.

Conclusion: Colour Doppler imaging failed to improve on the results of transvaginal B mode sonography in the detection of ectopic pregnancy.
Genital Chlamydia trachomatis Infection in Egyptian Women: Incidence among Different Clinical Risk Groups
Authors: El‐Shourbagy Mahmoud , Abd‐El‐Maeboud Karim , Diab Khaled M. , El‐Ghannam Alaa , Nabegh Lila , Ammar Samia
Published: August 2010

Objective: To investigate genital Chlamydial infection incidence among high risk clinical conditions in Egyptian women.

Methods: A case control study in Ain Shams University Hospital involving 501 patients with cervicitis (n = 58), abnormal cervical smear (n = 256), tubal infertility (n = 85), ectopic pregnancy (n = 22), preterm labour (n = 80) and 192 controls. Active cervical Chlamydial infection was diagnosed using direct immunofluorescent technique. Data were analyzed by Chi‐square (X2 and Z tests.

Results: Significant increase of Chlamydial infection among different clinical conditions compared to controls. The percentage of positive chlamydial infection was 79.3% among cervicitis group, 33.3% among subjects with inflammatory smear, 75.2% among those with cervical condyloma, 82.6% among those with cervical intraepithelial neoplasia, 51.8% among tubal infertility subjects, 77.2% among ectopic patients and 56.3% among subjects with preterm labour.

Conclusion: The incidence of Chlamydial infection in these high risk Egyptian patients is relatively high. Emperical treatment is recommended as the diagnosis is costly and usually not available.
Cytokines Concentrations in the Cervical Mucus of Pregnant Women
Authors: Sagawa Tadashi , Furuta Itsuko , Negishi Hiroaki , Kishida Tatsuro , Begum Sayeda , Fujimoto Seiichiro
Published: August 2010

Objective: Interleukin‐1α, interleukin‐1β, interleukin‐6 and interleukin‐8 in specimens of cervical mucus were assayed to assess defense mechanisms against infection in the cervical canal during pregnancy.

Methods: Two hundred and thirty‐nine pregnant women who attended the obstetrics outpatient clinic in our hospital were included as subjects. Cervical mucus was collected with a newly developed collection swab, and cytokines and granulocyte elastase in the samples of cervical mucus were quantified using enzyme immunoassay kits. The 1‐factor ANOVA, the Kruskal‐Wallis test, and scheffé's F were used for statistical analysis.

Results: Interleukin‐1α, interleukin‐1β and interleukin‐8 levels rose significantly as the concentrations of granulocyte elastase increased. High concentrations of interleukin‐1α (75.36 ± 19.93 pg/ml) and inteukin‐1β (1005.29 ± 238.75 pg/ml) and interleukin‐8 (4822.4 ± 633.2 pg/ml) were found in the specimens from the group of high granulocyte elastase levels.

Conclusions: These cytokines might be involved in defense mechanisms against ascending infection from the vagina.
Comparative Cytogenetic Studies of Benign, Borderline, and Malignant Epithelial Ovarian Tumors
Authors: Izutsu Toshihiko , Kudo Tomohiko , Shoji Tadahiro , Nishiya Iwao
Published: August 2010

Comparative cytogenetic studies were performed in 40 cases of untreated epithelial ovarian tumors. Of these 40 tumors, 13 were classified as benign, 3 as borderline, and 24 as malignant, according to the WHO classification for ovarian tumors. Of 13 benign ovarian tumors, 4 (30.8%) showed chromosomal abnormalities. Of 4 ovarian tumors, 3 (75%) had single chromosomal abnormalities, and the remaining tumor (25%) retained multiple chromosomal abnormalities.

Of 3 borderline‐malignant ovarian tumors, 2 (66.7%) showed chromosomal abnormalities. Of 2 ovarian tumors, 1 (50%) indicated single chromosomal abnormalities, and the remaining tumor (50%) revealed multiple chromosomal abnormalities.

Of 24 malignant ovarian tumors, 20 (83.3%) showed chromosomal abnormalities. Of these 20 ovarian tumors, 3 (15%) had single chromosomal abnormalities, and the other 17 (85%) exhibited multiple chromosomal abnormalities.

These data indicate that the rate of chromosomal abnormalities, especially multiple abnormalities, increases following the progression of malignancy in epithelial ovarian tumors.
A Study on Fetal Urinary Tract Anomaly: Antenatal Ultrasonographic Diagnosis and Postnatal Follow‐Up*
Authors: Kim Eun‐Kyung , Song Tae‐Bok
Published: August 2010

Objective: To evaluate the incidence, associated anomalies, and the type of congenital urinary tract anomaly and to know the cause of congenital hydronephrosis.

Methods: In 4.5 years, 5,442 fetuses had ultrasonography and 48 cases of fetal urinary tract anomaly were detected. Ultrasonogram was done after delivery with further examination as necessary.

Results: The incidence of all types of anomaly was 4.3% (236/5,442) and the incidence of urinary tract anomaly was 0.9% (48/5,442, 8.8/1,000 births) of all babies born and 20.3% (48/236) of entire anomaly. Types of urinary tract anomaly were as follows; hydronephrosis (37 cases), multicystic dysplastic kidney (5 cases), polycystic kidney disease (2 cases), renal agenesis (2 cases), ectopic kidney (1 case) and hypoplastic kidney (1 case). Associated anomalies were found in 8 cases (16.7%) among 48. Causes of hydronephrosis were ureteropelvic obstruction in 13 cases, ureterovesical obstruction in 4 cases, vesicoureteral reflux in 2 cases, proximal ureteral obstruction in 2 cases, and no specific causes in 16 cases.

Conclusions: Antenatal ultrasonography is a very useful diagnostic tool in the detection of urinary tract anomaly and a careful search for other anomalies is indicated when urinary tract anomaly is found.
A Rapid Serological Detection Method for Squamous Cell Carcinoma
Authors: Yoshizawa Hiroyuki , Yamauchi Susumu , Kenjo Takiko , Kuroshima Yoshio , Makino Tsunehisa
Published: August 2010

Objective: We conjugated the squamous cell carcinoma (CA)‐associated antibody (anti‐YM antibody) with gelatin particles. We found that these particles reacted specifically with the tumor‐associated antigen (YM antigen) in serum samples from patients with squamous cell CA of the uterine cervix and various organs (GPA reaction).

Methods: 1) We performed immunohistochemical studies of the YM antigen in dysplasia and invasive squamous cell CA of the uterine cervix; 2) We measured the GPA reaction in various malignant and non‐malignant gynecologic diseases.

Results: 1) Immunohistochemical localization of the YM antigen was over 75% in cases of dysplasia and invasive squamous cell CA of the uterine cervix, and was 21% in normal squamous epithelium of the uterine cervix. 2) The GPA reaction in gynecologic diseases was positive in 57.1% of the dysplasia cases; in CIS cases, 69.2%; in cervical CA, 83.0%; in corpus CA, 25.0%; in leiomyoma 16.7%; and in pregnant serum samples, 66.7%. 3) GPA reactions in non‐ob‐gyn cases were positive in 68.8% of the cases of squamous cell CA of the head and neck; 66.7% in cases of squamous cell CA of the lung; and 25.0% in adenoCA of the lungs whereas the sera of patients with benign tumors and of healthy persons were free of the YM antigen.

Conclusion: We concluded that this newly developed GPA‐reaction measurement is a simple and reliable serologic test for detecting the initial stage of squamous cell CA of various organs and for monitoring its postoperative status.
Simultaneous Intra‐ and Extra‐Uterine Pregnancy with Ovarian Hyperstimulation Syndrome after Induction of Ovulation: A Case Report
Authors: Fujii Miho , Mori Satoko , Goto Taeko , Kiya Tamotu , Yamamoto Hiroshi , Ito Eiki , Kudo Ryuichi
Published: August 2010

We present a case of polycystic ovary syndrome (PCOS) that developed simultaneous intra‐ and extra‐uterine pregnancy with ovarian hyperstimulation syndrome (OHSS) after induction of ovulation with pure FSH‐HCG. At 9 weeks of pregnancy, the bilateral tubal pregnancy caused an imminent spontaneous abortion, and both Fallopian tubes were resected. After the laparotomy, the pregnancy progressed without problems until 31 weeks and 5 days of pregnancy, when signs of spontaneous abortion appeared, and healthy twin female babies were delivered by cesarian section. The incidence of heterotopic pregnancy is increasing in cases in which inducers of ovulation or ART, such as IVF‐ET and GIFT, have been employed. One must be well aware that the danger of heterotopic pregnancy following induction of ovulation is imminent, particularly in cases with risk factors of multiple and/or extrauterine pregnancy, such as PCOS, a history of tubal restoration, and sexually transmitted disease(s).
Immunotherapy with Husband's Leukocytes to Primary Habitual Aborters and Autoantibodies in Their Sera
Authors: Takesako Shunji , Fujino Toshinori , Shiokawa Hironobu , Iwamoto Ichiro , Ikeda Toshiro , Nagata Yukihiro
Published: August 2010

Objective: This study was performed to determine whether primary habitual aborters have an autoimmunological tendency and whether immunotherapy with leukocytes induces autoantibodies in their sera.

Methods: We measured the levels of antiphospholipid antibodies (APAs) and antinuclear antibodies (ANAs) in the sera of 65 primary habitual aborters. Among them, 8 primary habitual aborters received immunotherapy with their respective husband's leukocytes; these 8 patients were followed up for autoantibodies in their sera before immunotherapy, at the time of pregnancy permission, during the first trimester of pregnancy, at delivery, and postpartum.

Results: Sixty‐nine percent of the 65 primary habitual aborters were positive for IgG or IgM antibodies to at least 1 of 6 phospholipids, and 29% of them were positive for ANAs. Although the pregnancy outcomes of the 8 primary habitural aborters after immunotherapy were good, their APAs and ANAs converted to positive after the immunotherapy.

Conclusion: Immunotherapy with leukocytes should be performed after checking and confirming the absence of autoantibodies in the sera of a habitual aborter.
Pregnancy with Scrub Typhus and Vertical Transmission: A Case Report
Authors: Suntharasaj T. , Janjindamai W. , Krisanapan S.
Published: August 2010

Scrub typhus is a rickettsian disease which is seldom found in pregnancy. A 31‐year‐old, 34 weeks pregnant woman presented with fever, chill and cough for 6 weeks. Fetal jeopardy was found then a cesarean section was performed to deliver a 2,200 g male with hepatosplenomegaly. The mother's diagnosis was confirmed by positive Weil‐Felix (OXK titer 1: 320) and scrub typhus (titer 1: 1600) tests. Vertical transmission was also demonstrated by a positive scrub typhus IgM in her child.
Dense Acetowhite: A High Grade Lesion?
Authors: Sianturi M. H. Roy
Published: August 2010

To describe the ability of colposcopy in predicting the high grade squamous intraepithelial lesion (SIL) a retrospective, descriptive study was undertaken from January 1, 1993 until November 30, 1995. Agreement between colposcopy and histology results was described in unweighted Kappa. Agreement between colposcopy diagnosis and histology results taken from the dense acetowhitening areas was poor (Kappa 0.5). This agreement will be higher in areas of acetowhite that has an abrupt peeling margin in 72/74 cases. It seems that dense acetowhite areas showed high grade lesions in most of cases observed especially if they had also abrupt peeling margin.
Pregnancy Rates Using CC/hMG or hMG Alone
Authors: Ziadeh Saed M. , Zakaria Muhannad R. , Abu‐Hieja Adel
Published: August 2010

Objective: The purpose of our study was to determine which of the two drug regimens is more successful in achieving conception in the infertile couple.

Subjects: One hundred and sixty women with primary infertility were included in this study. Group A, consisted of 102 patients were treated with clomiphene citrate (CC) and human menopausal gonadotrophin (hMG). Group B, consisted of 58 patients were treated with hMG alone.

Methods: This retrospective study was performed between April 1993 and March 1996, to compare the pregnancy rates in women using two drug regimens with ultrasound scan and serum E2 to monitor ovulation induction.

Results: The pregnancy rate per patient in Group A was significantly higher than in Group B (46% vs 25.9%) as was the pregnancy rate per treatment cycle (31.3% vs 15.8%) pregnancy loss was lower in Group A than in Group B (17% vs 33.3%).

The incidence of multiple pregnancy was 8.5% in Group A, and 13.3% in Group B. While the incidence of ovarian hyperstimulation syndrome was 3% in Group A, and 6.9% in Group B.

Conclusions: We concluded that the use of CC + hMG in an assisted conception programme gives a better pregnancy rate 46% than in the hMG alone 25.9%. These data with the use of U/S scan and serum E2 clearly showed that the use of CC + hMG is a successful and safe method for the treatment of infertile patients.
Characterization of Macrophages Isolated from the Maternal Surface of Human Term Placenta by a New Method of Urokinase Treatment*
Authors: Shiokawa Hironobu , Fujino Toshinori , Yashiki Shinji , Nagata Yukihiro , Sonoda Shunrou
Published: August 2010

Objectives: This study was performed to establish a new method for isolating macrophages from the maternal surface of human term placenta by urokinase treatment and to characterize their immunological functions.

Methods: Macrophages were recovered from the maternal surface of 6 human term placentas by urokinase treatment, adherence to plastic, and density gradient centrifugation using Percoll. The cells retrieved were tested for their surface markers by immunofluorescent staining. Their antigen‐presenting capacity was examined by use of a mixed lymphocytes culture (MLC) test. In 2 cases, human leucocyte antigen (HLA) typing was performed.

Results: An average of 4 × 106 macrophage‐like cells were obtained per whole placenta. More than 90% of them were positive for CD14, HLA‐DR, and DQ surface antigens. An MLC test revealed that they had antigen‐presenting capacity. Of the 6 cases, 2 showed positive MLC test results with maternal peripheral‐blood mononuclear cells. In 1 of the 2 cases, macrophages with paternal HLA phenotypes were identified.

Conclusion: The urokinase treatment is a new useful method for isolating macrophages from the maternal surface of human term placenta. Using this method, we obtained macrophages of paternal HLA phenotypes (fetal origin) that might have migrated to the maternal surface of human term placenta.
Pregnancy in a Patient of Glanzmann's Thrombasthenia with Antiplatelet Antibodies
Authors: Kashyap Rajesh , Kriplani Alka , Saxena Renu , Takkar D. , Choudhry V. P.
Published: August 2010

Glanzmann's thrombasthenia is an autosomal recessive, inherited platelet function disorder. There is an absence of glycoprotein (GP) IIb/IIIa on the platelet membrane which causes reduced platelet aggregation with a defective platelet haemostatic plug formation. The management of bleeding episodes in these patients with platelet transfusions may result in alloimmunization and make the successive transfusions less effective. Pregnancy and delivery is rare in these patients and is associated with a high risk of severe haemorrhage. We describe a primigravida with Glanzmann's thrombasthenia and alloimmunization who developed secondary postpartum haemorrhage and was successfully treated with oral prednisolone.
Granulocytic Sarcoma of Uterine Cervix as Presentation of Acute Myeloid Leukemia: A Case Report and Review of Literature
Authors: Ramble R. , Kochupillai V. , Sharma A. , Kumar L. , Thulkar S. , Sharma M.C. , Mittal S.
Published: August 2010

Localized extramedulary collection of leukemic cells is termed as granulocytic sarcoma. Incidences of 2–8% in acute myeloid leukemia have been reported in various autopsy studies. In female it usually involves ovary. Since most of such tumors are asymptomatic, they are detected only at autopsy. We report here a case who manifested as abnormal vaginal bleeding, large cervical mass, renal failure, and aspergillous fungaemia. The patient died before she could be treated. From the present report it would appear that granulocytic sarcoma at times may precede other manifestations of leukemia.
A Study of γ‐Aminobutyric Acid (GABA) in Amniotic Fluid
Authors: Kobayashi Keiko , Sekizawa Akihiko , Morimoto Taro , Suzuki Akira , Saito Hiroshi , Yanaihara Takumi
Published: August 2010

Objective: The purpose of the study was to evaluate the role of gamma aminobutyric acid (GABA), an inhibitory neurotransmitter, in amniotic fluid (AF) during fetal distress, because it has been reported that several neurotransmitters, e.g. norepinephrine, are affected by GABA.

Methods: AF was obtained during elective cesarean section (CS,n= 11) and cesarean section due to fetal distress without labor pain (FD,n= 7). Maternal and umbilical‐cord blood, as well as the first urine of the neonates, also were collected. GABA, norepinephrine (NE), and epinephrine (EP) concentrations were measured using HPLC.

Results: The GABA concentration was higher in the AF than in either maternal or fetal circulation, or in the first urine of neonates. The GABA concentrations in the AF and in the first urine of neonates were significantly higher in the FD group than in the CS group (p < 0.05). Furthermore, significant positive correlations were observed between the NE and GABA concentrations and between the EP and GABA concentrations in the AF. GABA was produced in a time‐dependent manner in cultured amnion cells.

Conclusion: The highest concentration of GABA was found in the AF. The GABA in the AF appeared to be derived from both the amniotic membrane and the fetal urine. The increase in the GABA concentration in cases of fetal distress might be partially derived from the fetus via fetal urine. The positive correlations between the concentrations of GABA and those of NE and EP in the AF, suggest that GABA, NE, and EP might play important roles during fetal distress.
Uterine Cervical Adenocarcinomas and Squamous Carcinomas in Bombay: 1965–1990*
Authors: Krishnamurthy Sarala , Yecole Balkrishna B. , Jussawalla Darab J.
Published: August 2010

Objective: To learn if the increased incidence of uterine cervical adenocarcinomas in developed populations exists in developing ones.

Methods: We studied age‐adjusted (world) incidence rates of pathologic types of cervical cancer from 1965 through 1990 in the population‐based Bombay Cancer Registry and in the National Cancer Registry's hospital‐based frequencies of 1985–1987. The t‐test was used to measure the statistical significance of change. International comparisons were made.

Results: In Bombay, the incidence rates of adenocarcinoma per 106 women rose from 5.0 in 1965 to 12.9 in 1990 (p < 0.05). However, cervical cancers overall declined, from 244 per 106 in 1965 to 176 in 1990 (p < 0.001), squamous carcinomas declined from 167 to 129 per 106 (p < 0.05), other types of cervical cancers declined from 10.9 to 2.9 per 106 women (ns), and nonpathologically diagnosed cervical cancers declined from 61 to 31 per 106 (p < 0.05). Adenocarcinomas were 2.5% of all cervical cancers in Bombay's overall population in 1965, and were 7.0% in 1990; they were only 3.3% in 5 Indian hospital registries but were a higher percent in the Tata Hospital Bombay and internationally. The peak age of adenocarcinoma patients was 50–55 years in Bombay, unlike a younger peak age in the West, and 60–65 years for squamous carcinomas.

Conclusion: These Occidental‐type trends might be due to increased awareness of cervical adenocarcinomas and/or changes associated with industrialization. Such trends might occur in other developing countries in the future. Greater awareness of cervical adenocarcinoma and its early diagnosis by endocervical brush cytology are needed in such populations.
Association between Body Composition and Menstrual Dysfunction in Collegiate Dance Students
Authors: To W. W. K. , Wong M. W. N. , Chan K. M.
Published: August 2010

Objective: To evaluate the relationship between body mass index, body fat composition and fat distribution and menstrual dysfunction in collegiate dancing students.

Method: A total of 64 dancing students from a collegiate school of dancing were studied; through interview by a structured questionnaire to elicit details of menstrual history, and these were correlated to anthropometric measurements obtained by physical examination.

Results: There were 22 ballerinas, 16 classic Chinese dancers, and 26 modern or theatrical dancers. Ten (15.6%) had oligomenorrhoea and 12 (18.7%) had amenorrhoea, with a slight, but statistically non‐significant preponderance of ballerinas in the amenorrhoeic group. There was no difference in the body mass index among the eumenorrhoeic, oligomenorrhoeic or amenorrhoeic group, but amenorrhoeic dancers had a significantly lower percentage of total body fat as calculated by a 4 site skinfold thickness formula when compared to eumenorrhoeic ones (15.72% vs 17.95%, p < 0.05). Amenorrhoeic dancers also had lower waist to hip (p < 0.001) and waist to thigh circumference ratios (p < 0.001), indicating that they had more feminine figures favoured aesthetically for dancers.

Conclusion: The data suggests that estimation of percentage of body fat gave a better correlation to menstrual status than either weight or body mass index. Thus, proper nutritional advice based on such evaluation should be an essential component in treating menstrual dysfunction in these dancers.
Accident Compensation Reform
Authors: Craigie Rowen , Cumpston Richard , Sams Dennis
Published: August 2010

The aim of the article is to provide a survey of the major issues involved in the reform of accident Compensation schemes. The article outlines the economic and social pressures for reform of existing accident compensation schemes, discusses the major reform issues and raises the major challenges facing the reform process. The article focuses on the experience of the Victorian Government in developing and implementing its reform of workers compensation (Workcare) and on its proposed reform of the existing compulsory third party motor accidents scheme to illustrate the key issues.
The Economics and Financing of Hospitals in Australia
Authors: Palmer George R.
Published: August 2010

The Australian hospital industry is described and it is noted that the term ‘hospital’ is applied to a wide range of institutions. The main problems and issues associated with hospitals are discussed, including the lack of adequate methods of measuring their ‘products’ and of allocating funds to them. The role of the medical staff in influencing the ‘demand’ for hospital beds and in resource allocation is emphasised as a major influence on hospital behaviour. In a study of the determinants of the costs of Victorian public hospitals it was found that the complexity of the case‐mix as measured by diagnosis related groups (DRGs) was a major determinant of teaching hospital costs but not of those of other large hospitals. DRG‐based funding and costing of hospitals is recommended as a strategy for achieving increased efficiency.
ON ACKNOWLEDGEMENT AND CAVELL'S UNACKNOWLEDGED THEOLOGICAL VOICE
Authors: DAHL ESPEN
Published: August 2010

This article argues that Cavell's key concept of acknowledgement is of great theological significance. Acknowledgement is meant as a particular interpretation of knowledge, which emphasises the personal responsiveness and responsibility to the human other and to the world. As Cavell himself indicates, acknowledgement also overlaps with faith. However, what such acknowledgement of God amounts to, is not yet satisfactorily understood in the growing literature on Cavell. This article argues that Cavell's treatment of confessions (Augustine, Wittgenstein) and acceptance of promise (Luther) provides important clues to a more elaborate understanding of acknowledgement in general, and of acknowledging God in particular.
Expert opinion and review article: The timing of comedone extraction in the treatment of premenstrual acne – a proposed therapeutic approach
Authors: Steventon K.
Published: August 2010

Synopsis

The face is the most exposed part of our body, and deterioration of facial appearance, through disease or ageing, causes psychological distress. Acne lesions and subsequent pigmentation changes contribute to the unevenness of skin colour that is detrimental to facial attractiveness and leads to rejection and stigmatization in our society. The purpose of this review is to look at the root causes of premenstrual acne and, for the first time ever, propose that the specific timing of treatment can, at least in part, resolve the acne lesions. We postulate that it is the timing of the manual extraction that matters in resolving premenstrual acne and that the effectiveness of this therapy could be improved. Based on the reviewed evidence, we propose that it is important to remove the comedones at the time of ovulation, prior to the reduction of the size of the sebaceous orifice and epidermal barrier function, to counteract the onset of increased sebum production, prevent blockage of the pores and subsequent bacterial colonization and inflammation. If performed successfully, the extraction may contribute to a reduction in inflamed acne lesions and thus benefit women by increasing their facial attractiveness, well‐being, social function and thereby decrease psychological stress.
Developmental regulation of glucose transporters GLUT3, GLUT4 and GLUT8 in the mouse cerebellar cortex
Authors: Gómez Olga , Ballester‐Lurbe Begoña , Poch Enric , Mesonero José E. , Terrado José
Published: August 2010

Glucose uptake into the mammalian nervous system is mediated by the family of facilitative glucose transporter proteins (GLUT). In this work we investigate how the expression of the main neuronal glucose transporters (GLUT3, GLUT4 and GLUT8) is modified during cerebellar cortex maturation. Our results reveal that the levels of the three transporters increase during the postnatal development of the cerebellum. GLUT3 localizes in the growing molecular layer and in the internal granule cell layer. However, the external granule cell layer, Purkinje cell cytoplasm and cytoplasm of the other cerebellar cells lack GLUT3 expression. GLUT4 and GLUT8 have partially overlapping patterns, which are detected in the cytoplasm and dendrites of Purkinje cells, and also in the internal granule cell layer where GLUT8 displays a more diffuse pattern. The differential localization of the transporters suggests that they play different roles in the cerebellum, although GLUT4 and GLUT8 could also perform some compensatory or redundant functions. In addition, the increase in the levels and the area expressing the three transporters suggests that these roles become more important as development advances. Interestingly, the external granule cells, which have been shown to express the monocarboxylate transporter MCT2, express none of the three main neuronal GLUTs. However, when these cells migrate inwardly to differentiate in the internal granule cells, they begin to produce GLUT3, GLUT4 and GLUT8, suggesting that the maturation of the cerebellar granule cells involves a switch in their metabolism in such a way that they start using glucose as they mature.
Neuronal over‐expression of chromogranin A accelerates disease onset in a mouse model of ALS
Authors: Ezzi Samer Abou , Larivière Roxanne , Urushitani Makoto , Julien Jean‐Pierre
Published: August 2010

J. Neurochem. (2010) 115, 1102–1111.

Recent studies provided evidence that chromogranins can interact with mutant superoxide dismutase 1 (SOD1) and that chromogranin B (CgB) may act as a susceptibility gene and modifier of onset in amyotrophic lateral sclerosis (ALS). To further investigate the role of chromogranins in ALS pathogenesis, we generated SOD1G37R mice that over‐express CgA under the control of Thy1 promoter. Here, we report that neuronal over‐expression of CgA in SOD1G37R mice caused acceleration of onset of motor impairment and exacerbation of motor neuron degeneration. The use of monoclonal antibody specific to misfolded mutant SOD1 demonstrated a higher level of misfolded SOD1 species in double transgenic mice compared to SOD1G37R mice, suggesting a stabilization of pathogenic SOD1 species by excess CgA. These results suggest a role of chromogranins as modulators of disease onset in ALS pathogenesis.
Are current disease‐modifying therapeutics in multiple sclerosis justified on the basis of studies in experimental autoimmune encephalomyelitis?
Authors: Farooqi Nasr , Gran Bruno , Constantinescu Cris S.
Published: August 2010

J. Neurochem. (2010) 115, 829–844.

The precise aetio‐pathology of multiple sclerosis remains elusive. However, important recent advances have been made and several therapies have been licensed for clinical use. Many of these were developed, validated or tested in the animal model, experimental autoimmune encephalomyelitis (EAE). This systematic review aims to assess whether the current disease modifying treatments and those that are the closest to the clinic are justified on the basis of the results of EAE studies. We discuss some aspects of the utility and caveats of EAE as a model for multiple sclerosis drug development.