bluuebunny/crossref_metadata_2025 huggingface dataset:
Importance of Ocean Heat Uptake Efficacy to Transient Climate Change
Authors: Winton Michael , Takahashi Ken , Held Isaac M.
Published: December 2009

This article proposes a modification to the standard forcing–feedback diagnostic energy balance model to account for 1) differences between effective and equilibrium climate sensitivities and 2) the variation of effective sensitivity over time in climate change experiments with coupled atmosphere–ocean climate models. In the spirit of Hansen et al. an efficacy factor is applied to the ocean heat uptake. Comparing the time evolution of the surface warming in high and low efficacy models demonstrates the role of this efficacy in the transient response to CO2 forcing. Abrupt CO2 increase experiments show that the large efficacy of the Geophysical Fluid Dynamics Laboratory’s Climate Model version 2.1 (CM2.1) sets up in the first two decades following the increase in forcing. The use of an efficacy is necessary to fit this model’s global mean temperature evolution in periods with both increasing and stable forcing. The intermodel correlation of transient climate response with ocean heat uptake efficacy is greater than its correlation with equilibrium climate sensitivity in an ensemble of climate models used for the third and fourth Intergovernmental Panel on Climate Change (IPCC) assessments. When computed at the time of doubling in the standard experiment with 1% yr−1 increase in CO2, the efficacy is variable amongst the models but is generally greater than 1, averages between 1.3 and 1.4, and is as large as 1.75 in several models.
Design of Intelligent Garment with Transcutaneous Electrical Nerve Stimulation Function Based on the Intarsia Knitting Technique
Authors: Li Li  , Wai Man Au  , Yi Li  , Kam Man Wan  , Sai Ho Wan  , Kwok Shing Wong
Published: December 2009

This paper describes the work that was carried out on the design for intelligent wearable garment with transcutaneous electrical nerve stimulation (TENS) function from a knitwear design perspective. It is perceived that good design is essential for the development of textile-related products for medical function. The knitwear technique, garment design skill, Chinese acupuncture therapeutic method and TENS technology were integrated interactively in an intelligent TENS garment. The garment was observed to have more advantages than ones incorporating TENS device, such as it readily, quickly and easily targeted the back of the body; it was more flexible in the treatment by accommodating different numbers and locations of acupuncture points; it was light, washable, flexible, inexpensive and relatively simple to manufacture. This work aimed to develop a knitwear design based on intarsia knitting technique by using proposed textile electrode and conductive yarn to create a novel therapeutic method for healthcare through dressing. Experimental results revealed that the knitwear could achieve better results in performance than those incorporating the TENS therapeutic method.
The State and Political Instability in Africa
Authors: Kieh George Klay
Published: December 2009

Political instability has been an enduring feature of the post-colonial landscape in Africa. The scholarly literature has offered various reasons for this phenomenon – the Cold War, ethnic antagonisms and rent-seeking behaviour, among others. However, this article argues that the peripheral capitalist African state is the primary source of political instability on the continent. Specifically, the peripheral capitalist state has generated various crises such as poor regime performance that occasion political instability. Also, since the peripheral capitalist African state is a product and appendage of the global capitalist system, the latter contributes to instability in the former. Hence, in order to tackle the vagaries of political stability, the peripheral capitalist African state must be democratically reconstituted, and fundamental changes must be made in the global capitalist political economy.
Effects of immunomodulatory treatment with subcutaneous interferon beta-1a oncognitive decline in mildly disabled patients with relapsing—remitting multiple sclerosis
Authors: Patti F. , Amato MP , Bastianello S. , Caniatti L. , Di Monte E. , Ferrazza P. , Goretti B. , Gallo P. , Brescia Morra V. , Lo Fermo S. , Picconi O. , Tola MR , Trojano M. ,   COGIMUS Study Group
Published: December 2009

The objective of this study was to assess the effects of subcutaneous (sc) interferon beta-1a (IFNβ-1a) on cognition in mildly disabled patients with relapsing—remitting multiple sclerosis (RRMS). Patients aged 18—50 years with RRMS (McDonald criteria; Expanded Disability Status Scale score ≤4.0) were assigned IFNβ therapy at the physician’s discretion and underwent standardized magnetic resonance imaging, neurological examination and neuropsychological testing at the baseline and regular intervals for up to three years.

This analysis included 459 patients who received sc IFNβ-1a (44 mcg: n = 236; 22 mcg: n = 223; three-year follow up was available for 318 patients). The hazard ratio for cognitive impairment over three years (44 mcg versus 22 mcg) was 0.68 (95% confidence interval [CI]: 0.480—0.972), suggesting a 32% lower risk with the higher dose treatment. At year 3, the proportion of patients who were cognitively impaired increased slightly from 23.5% at the baseline to 24.8% in the IFNβ-1a 22 mcg treatment group, but remained stable at 15.2% in the IFNβ-1a 44 mcg treatment group. The proportion of patients with cognitive impairment at year 3 was significantly higher in the 22 mcg group than in the 44 mcg group (P = 0.03), although a trend was also seen at the baseline (P = 0.058). Multivariate logistic regression (corrected for baseline cognitive deficits) indicated that treatment with the higher dose of IFNβ-1a was predictive of lower cognitive impairment at three years (odds ratio: 0.51, 95% CI: 0.26—0.99) compared with the lower dose of IFNβ-1a.

These findings suggest that sc IFNβ-1a may have dose-dependent cognitive benefits in mildly disabled patients with RRMS, and may support early initiation of high-dose IFNβ-1a treatment.
HLA-DRB association in neuromyelitis optica is different from that observed in multiple sclerosis
Authors: Guimaraães Brum Doralina , Barreira Amilton Antunes , dos Santos Antonio Carlos , Kaimen-Maciel Damacio Ramon , Matiello Marcelo , Costa Roberta Martins , Saloun Deghaide Neifi Hassan , Silva Costa Laudo , Louzada-Junior Paulo , Beserra Diniz Paula Rejane , Comini-Frota Elizabeth Regina , Mendes-Junior Celso Teixeira , Donadi Eduardo Antonio
Published: December 2009

Until recently, neuromyelitis optica (NMO) was considered to be a sub-type of multiple sclerosis (MS), which has a strong predilection for Caucasian populations, whereas NMO is more frequent in non-Caucasian individuals. The objective of this study was to compare the HLA-DRB profile in Brazilian Mulatto patients with NMO spectrum disorders (NMOSDs) with that observed for Mulatto MS patients and healthy Mulatto controls. Twenty seven NMOSD patients (20 women), all seropositive for NMO-IgG, 29 MS patients and 28 Mulatto healthy blood donors were evaluated for HLA-DRB allele groups. HLA-DRB1*03 allele group was overrepresented in NMO patients compared with healthy controls (p = 0.0401; OR = 3.23, 95%CI: 1.07—9.82). In contrast, the HLA-DRB1*15 allele group was overrepresented in Brazilian MS patients (OR = 15.89, 95%CI: 3.51—71.85; p < 0.0001). DRB3 was overrepresented in NMO (p = 0.0064), and DRB5 overrepresented in MS patients (p = 0.0001). The low frequency of HLA-DRB1*15 alleles was associated with the presence of long and central cord lesions at magnetic resonance. In addition, DRB1*15 alleles were associated with the fulfillment of the Barkhof criteria. In conclusion, these results indicate that the DRB profile of NMO patients is different from that observed for MS patients, further corroborating the distinction between NMO and MS.
Neutralizing antibodies to 500 μg interferon beta-1b: 28-month results of the IDEAS extension trial
Authors: Gottesman MH , Friedman-Urevich S. , Boylan E. , Cheng D.
Published: December 2009

The Interferon Dose Escalation Assessment of Safety extension trial monitored neutralizing antibodies to interferon beta-1b in patients who currently or had previously received the double dose (500 μg) for up to 28 months. Fifteen patients entered the extension trial; five patients were neutralizing antibody-positive at the start of the trial. The present study demonstrates that when neutralizing antibodies develop in patients receiving higher doses of interferon beta-1b they tend to persist for a prolonged period, although neutralizing antibody titers tend to decrease over time and some patients may revert to neutralizing antibody-negative status.
Family Mealtimes
Authors: Hamilton Susan K. , Hamilton Wilson Jane
Published: December 2009

Family mealtimes are an important opportunity to develop strong parent and child relationships and a sense of family connectedness and belonging. Research focusing on the importance of family meals affirms the positive outcomes learned from time spent around the family dinner table. This simple family activity has a significant impact on family communication and functioning, the development of healthy eating patterns in children, and improved literacy and school performance in school-age and teen students, and it also acts as a significant protective factor in reducing the risk for adolescent mental health problems and addiction. This article will review the recent published literature on family mealtimes to ascertain and affirm the role they play in childhood and adolescent development, family functioning, and nutritional choices. The article will conclude with recommendations for families to be creative in making time for family meals. These recommendations will also be of benefit to dietitians and other health care professionals who work with families with children.
Kinome-wide RNAi studies in human multiple myeloma identify vulnerable kinase targets, including a lymphoid-restricted kinase, GRK6
Authors: Tiedemann Rodger E. , Zhu Yuan Xiao , Schmidt Jessica , Yin Hongwei , Shi Chang-Xin , Que Qiang , Basu Gargi , Azorsa David , Perkins Louise M. , Braggio Esteban , Fonseca Rafael , Bergsagel P. Leif , Mousses Spyro , Stewart A. Keith
Published: December 2009

A paucity of validated kinase targets in human multiple myeloma has delayed clinical deployment of kinase inhibitors in treatment strategies. We therefore conducted a kinome-wide small interfering RNA (siRNA) lethality study in myeloma tumor lines bearing common t(4;14), t(14;16), and t(11;14) translocations to identify critically vulnerable kinases in myeloma tumor cells without regard to preconceived mechanistic notions. Fifteen kinases were repeatedly vulnerable in myeloma cells, including AKT1, AK3L1, AURKA, AURKB, CDC2L1, CDK5R2, FES, FLT4, GAK, GRK6, HK1, PKN1, PLK1, SMG1, and TNK2. Whereas several kinases (PLK1, HK1) were equally vulnerable in epithelial cells, others and particularly G protein–coupled receptor kinase, GRK6, appeared selectively vulnerable in myeloma. GRK6 inhibition was lethal to 6 of 7 myeloma tumor lines but was tolerated in 7 of 7 human cell lines. GRK6 exhibits lymphoid-restricted expression, and from coimmunoprecipitation studies we demonstrate that expression in myeloma cells is regulated via direct association with the heat shock protein 90 (HSP90) chaperone. GRK6 silencing causes suppression of signal transducer and activator of transcription 3 (STAT3) phosphorylation associated with reduction in MCL1 levels and phosphorylation, illustrating a potent mechanism for the cytotoxicity of GRK6 inhibition in multiple myeloma (MM) tumor cells. As mice that lack GRK6 are healthy, inhibition of GRK6 represents a uniquely targeted novel therapeutic strategy in human multiple myeloma.
Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis
Authors: De Cicco Luigi , Cella Laura , Liuzzi Raffaele , Solla Raffaele , Farella Antonio , Punzo Giorgio , Tranfa Fausto , Strianese Diego , Conson Manuel , Bonavolontà Giulio , Salvatore Marco , Pacelli Roberto
Published: December 2009

Background

Primary orbital lymphoma is a rare disease that accounts for 10% of all orbital tumors. Radiotherapy on the orbital cavity is the treatment of choice for this unusual presentation of localized non-Hodgkin's lymphoma (NHL). The aim of this study is to retrospectively evaluate the effectiveness and the toxicity of radiation treatment in patients with primary orbital lymphoma.

Methods

Forty-seven consecutive patients having primary orbital lymphoma treated in our department between May 1983 and September 2006 were investigated in a retrospective study. Either 60Co γ rays or 6 MV X rays were used to deliver daily fractions of 1.8 or 2.0 Gy, 5 times/week, with total doses ranging from 34.2 to 50 Gy. Forty-three patients had stage IE, three had stage II and one stage IV disease. Thirty-eight patients had marginal zone B-cell lymphoma, 5 diffuse large B cell lymphoma, 3 mantle cell lymphoma and 1 Burkitt lymphoma. Local control (LC), disease free survival (DFS), overall survival (OS) and late side effects were evaluated in all patients.

Results

With a median follow up of 45 months, LC was obtained in 100% of patients. The estimated 5- and 7-year DFS rates were 75.8% and 55.3%, and the 5- and 7-year OS rates were 88.7% and 79.9% respectively. Acute toxicity was minimal. Late toxicity such as cataract, keratitis, retinopathy and xerophthalmia occurred respectively in 12 (25.5%), 5 (10.6%), 1 (2.1%), and 9 (19.1%) patients.

Conclusion

Radiotherapy is an effective and at the same time well tolerated treatment for primary orbital lymphoma.
Footing the bill: the introduction of Medicare Benefits Schedule rebates for podiatry services in Australia
Authors: Short Anthony J
Published: December 2009

The introduction of Medicare Benefits Schedule items for allied health professionals in 2004 was a pivotal event in the public funding of non‐medical primary care services. This commentary seeks to provide supplementary discussion of the article by Menz (Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004‐2008 Journal of Foot and Ankle Research 2009, 2:30), by placing these findings within the context of the podiatry profession, clinical decision making and the broader health workforce and government policy.
High-resolution surface NMR tomography of shallow aquifers based on multioffset measurements
Authors: Hertrich Marian , Green Alan G. , Braun Martina , Yaramanci Ugur
Published: December 2009

Conventional surface nuclear magnetic resonance (NMR) surveying based on 1D inversions of data recorded using a common (coincidence) transmitter and receiver loop provides only limited or distorted water-concentration information in regions characterized by strong lateral heterogeneity. We introduce a combined field-acquisition and tomographic-inversion strategy suitable for 2D surface NMR investigations of free (i.e., unbound) water stored in hydrogeologically complex regions. Using combinations of coincident and multioffset loops, we take advantage of the range of sensitivities offered by different loop configurations to variations in subsurface free-water concentration. The new tomographic scheme can invert data acquired with diverse loop configurations. Tests of the combined acquisition and inversion strategy on complicated synthetic and observed data demonstrate the substantially higher resolution information provided by combinations of loop configurations vis-à-vis that supplied by a standard coincident loop. A combination of coincident and half-overlapping loop data sets yields tomograms rich in detail, comparable to tomograms derived from a combination of all considered loop configurations. If resources are limited, surface NMR practitioners should consider the half-overlapping loop configuration as an alternative to the standard coincident loop configuration. For a four-station data recording campaign, the half-overlapping loop configuration with 50% more measurements and equal number of loop deployments and retrievals provides significantly higher resolution tomograms than a coincident loop configuration.
LettingEscherichia coliTeach Me About Genome Engineering
Authors: Shapiro James A
Published: December 2009

A career of following unplanned observations has serendipitously led to a deep appreciation of the capacity that bacterial cells have for restructuring their genomes in a biologically responsive manner. Routine characterization of spontaneous mutations in the gal operon guided the discovery that bacteria transpose DNA segments into new genome sites. A failed project to fuse λ sequences to a lacZ reporter ultimately made it possible to demonstrate how readily Escherichia coli generated rearrangements necessary for in vivo cloning of chromosomal fragments into phage genomes. Thinking about the molecular mechanism of IS1 and phage Mu transposition unexpectedly clarified how transposable elements mediate large-scale rearrangements of the bacterial genome. Following up on lab lore about long delays needed to obtain Mu-mediated lacZ protein fusions revealed a striking connection between physiological stress and activation of DNA rearrangement functions. Examining the fate of Mudlac DNA in sectored colonies showed that these same functions are subject to developmental control, like controlling elements in maize. All these experiences confirmed Barbara McClintock's view that cells frequently respond to stimuli by restructuring their genomes and provided novel insights into the natural genetic engineering processes involved in evolution.
Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma
Authors: Pierce Mary Clyde , Kaczor Kim , Aldridge Sara , O'Flynn Justine , Lorenz Douglas J.
Published: December 2009

OBJECTIVE: Our objective was to conduct a pilot study to identify discriminating bruising characteristics and to model those findings into a decision tool for screening children at high risk for abuse.

METHODS: A case-control study of children 0 to 48 months of age who were admitted to a PICU because of trauma was performed. Case subjects (N = 42) were victims of physical abuse, and control subjects (N = 53) were children admitted because of accidental trauma during the same time period. Bruising characteristics (total number and body region) and patient age were compared for children with abusive versus accidental trauma. The development of a decision rule for predicting abusive trauma was accomplished with the fitting of a classification and regression tree through binary recursive partitioning.

RESULTS: Ninety-five patients were studied. Seventy-one (33 of 42 patients in the abuse group and 38 of 53 in the accident group) were found to have bruising, and the characteristics were modeled. Characteristics predictive of abuse were bruising on the torso, ear, or neck for a child ≤4 years of age and bruising in any region for an infant <4 months of age. A bruising clinical decision rule was derived, with a sensitivity of 97% and a specificity of 84% for predicting abuse.

CONCLUSIONS: Discriminating differences exist in bruising characteristics for abusive versus accidental trauma. The body region- and age-based bruising clinical decision rule model functions as a clinically sensible screening tool to identify young children who require further evaluation for abuse.
A Duopoly Model of Political Agency with Applications to Anti-Corruption Reform
Authors: Evrenk Haldun
Published: December 2009

Using a theoretical model of political competition between two candidates who could differ in their (unverifiable) ability to produce public good, popularity, and ethics, I study the effectiveness of three commonly discussed anti-corruption reforms (higher salaries, higher penalties, and constitutional constraints on fiscal policy). In the model, each candidate proposes an income tax rate and a public good level. The difference between the collected taxes and the cost of public good is stolen by the elected politician. The voting decision is probabilistic. I show that under certain conditions each reform could increase the level of corruption or reduce the voter's welfare through other channels.
Development of the cardinality principle in Macedonian preschool children
Authors: Nikoloska Ana
Published: December 2009

Cardinality principle refers to the fact that the last number tag used in counting determines the cardinality of a set. Macedonian kindergarten children were tested with the give-a-number task for understanding of this principle. It was found that Macedonian children, unlike their western counterparts, pass through an additional stage, 5-knowers, before they master the cardinality principle. Also, the age at which they pass through the individual stages is somewhat higher than the age of children coming from western samples. Possible explanations are offered and discussed.
Endoscopic resection of inflammatory gastric fibroid polyp: A case report
Authors: Grgov Sasa , Katic Vuka , Hattori Takanori
Published: December 2009

Introduction An inflammatory fibroid polyp is a rare condition with frequent localization in the antrum of the stomach. Because of the localization in the bottom parts of the mucosa and submucosa, a histological diagnosis is difficult to establish at endoscopic biopsies. So, a correct diagnosis is histologically possible after surgical excision which is a common manner of treatment. Many authors have shown that endoscopic removal of an inflammatory fibroid polyp is possible. Case outline We are presenting a case of complete endoscopic resection of an inflammatory fibroid polyp of the stomach antrum in a 72-year-old patient. He complained of nausea, vomiting and loss of appetite. The polyp endoscopically looked like flat elevation with central umbilication, 16 mm in diameter and it was localized praepylorically. Pathohistologically, areas of severe epithelial dysplasia were verified at endoscopic biopsies which suggested early gastric cancer. Helicobacter pylori (H. pylori) infection was verified histologically and with rapid urease test. The patient was treated with triple eradication H. pylori therapy. Two months after the therapy, we decided to perform endoscopic resection of the polyp. We applied a suction technique of mucosal resection by which the polyp was completely resected. After complete endoscopic removal, the final diagnosis of an inflammatory fibroid polyp localised in the submucosa and mucosa of the antrum of the stomach was histologically made. On follow-ups, after 3, 6 and 12 months, there were no endoscopic and histological signs of either inflammatory fibroid polyp relapse, or recurrence of H. pylori infection. The patient had no dyspeptic symptoms. Conclusion We recommend an endoscopic method of resection as a therapy of choice for an inflammatory fibroid polyp of the stomach.
Cholestatic hepatitis associated with nimesulide: A case report
Authors: Lukic Snezana , Krstic Miodrag , Damjanov Nemanja , Boricic Ivan , Popovic Dragan , Djuranovic Srdjan , Kovacevic Nada , Tomanovic Nada
Published: December 2009

Introduction A toxic effect of drugs, including non-steroidal anti-inflammatory drugs, may be one of aetiological factors for the occurrence of acute hepatitis. Nimesulide is a selective cyclooxygenase-2 inhibitor, whose adverse effects on the liver range from acute hepatitis to more serious conditions, involving the development of acute liver failure and fatal outcome. Case Outline A female patient, aged 73, was admitted to the Gastroenterology and Hepatology Clinic of the Clinical Centre of Serbia in Belgrade because of liver failure. Due to the pain in the right knee, she received a therapy of 100 mg nimesulide in tablets, two times a day, for two months before admission to the Clinic. The analysis of the results of clinical, laboratory and radiographic examinations, and of histopathological findings of the liver biopsy showed that acute hepatitis was associated with the administration of nimesulide. Once the patient discontinued the intake of this drug, she fully convalesced. Conclusion The patient who received nimesulide over a period of two months developed acute hepatitis. In view of the similar cases described in literature and the fact that the use of nimesulide has been discontinued in a number of European countries and restricted by the European Medicines Agency, restriction or ban on the use of nimesulide on the Serbian market should be considered.
Dichotomized Metaphors and Young People's Educational Routes
Authors: Lahelma Elina
Published: December 2009

Drawing from an ethnographically grounded longitudinal study on educational transitions, the aim of this article is to analyse young people's reflections about their educational choices at different ages. Consistencies and breaks in their plans and actual choices are explored and reflected in relation to the economic, social, cultural and emotional resources they possess. In particular, the author explores taken-for-granted dichotomous metaphors that seem to open up certain educational routes and close others, such as ‘the head’ and ‘the hand’ for routes to academic and vocational education. In the first section of the article, the author demonstrates how metaphors appear in ethnographic accounts of lower secondary schools. The author then suggests how they are activated when young people reflect on their post-compulsory choices. Finally, the author presents the educational routes of two young people, drawing from their hopes, dreams and actual choices, as they relate them in interviews when they were 13, 18, 20 and 24 years old.
Effects of environmental factors on weed species composition of cereal and stubble fields in western Hungary
Authors: Pinke Gyula , Pál Robert , Botta-Dukát Zoltán
Published: December 2009

Multivariate analysis of data obtained from 184 cereal and stubble fields in low-input agricultural systems located in western Hungary was undertaken in order to asses environmental factors affecting weed species composition. For each variable, the gross and net effect on weed species composition was calculated. All variables considered in this study had a significant effect on weed species composition and explained 26.99% of the total variation. Most variation in species composition was explained by the aspect (cereal vs. stubble), followed by soil pH, mean annual precipitation, soil texture, mean annual temperature, and altitude. Separating the cereals and stubbles soil pH became the most important factor. Our results suggest that during the long vegetation period, cereal weed communities dominated by winter annuals are replaced by stubble-field weed communities dominated by summer annuals. This seasonal change may also have the same important effect on weed species composition as crop types.
Test and evaluation of reference-based nonuniformity correction methods for microbolometer infrared detectors
Authors: Orżanowski T. , Madura H.
Published: December 2009

In the paper, reference-based nonuniformity correction methods for microbolometer infrared detectors are discussed and tested. In order to evaluate their effectiveness, a complete readout circuit for amorphous silicon microbolometer focal plane array has been designed. The tests were carried out on a developed stand including several extended blackbodies. Some modification of standard two-point correction algorithm incorporating detectors response at external shutter to compensate offset drift is also proposed. The obtained results are presented.
Preoperative Anticoagulant Treatment in Gynaecological Surgery
Authors: Pyörälä Tapani , Lampinen Väinö
Published: December 2009

Abstract. The feasibility of preoperative anticoagulant treatment in connection with gynaecological surgery was studied in a series of 59 patients who were considered to have a predisposition to thromboembolic complications. The anticoagulant drug used was warfarin sodium (Marevan®) and Owren's Thrombotest (TT) method was employed in the control of the treatment. Clinically detectable venous thrombosis or pulmonary embolism did not occur in the series. In 1 case a non‐fatal myocardial infarction was diagnosed postoperatively. There were no deaths in the series. Clinically significant haemorrhagic complications occurred in 5 cases, but could be controlled in all instances. Our experience indicates that preoperative anticoagulant treatment is feasible in connection with gynaecological surgery. If the anticoagulant treatment is supervised carefully, it does not cause any undue increase in the risk of bleeding complications. However, careful haemostasis during surgery is imperative in patients receiving preoperative anticoagulant treatment. A TT level of 10–20% seems to be suitable in preoperative anticoagulant treatment.
Radical Surgery and Radiotherapy in the Management of 173 Cases of Carcinoma of CERVIX Uteri
Authors: Nieminen Usko , Pöllänen Leo , Saarikoski Seppo
Published: December 2009

A total of 173 surgically treated cases of carcinoma of the cervix uteri are presented. Wertheim's radical hysterectomy with lymphadenectomy was performed on 137 patients. 158 patients were also given radiotherapy. The 5 year cure rate for the series as a whole was 82.1%. The operative mortality was 0.6%. Fistulae of various types were encountered in 9.8%. During the same period, 467 patients with carcinoma of the uterine cervix were treated by radiotherapy. The 5 year cure rate was distinctly better for the surgically‐treated patients with Stage I carcinoma and slightly better for those with Stage II carcinoma. The incidence of fistula was the same in both groups. Complications of different degrees were more numerous on the whole in ths casss treated by radiotherapy alone.
Gamma Camera Examination of Pregnant Uterus and Placental Perfusion
Authors: Laakso L. , Kivikoski A. , Mäkelä S. , Paasio J.‐P.
Published: December 2009

Radioactive oomTc (300 μCi) tracer and a gamma camera were used to study placental function between the 34th and 40th weeks of pregnancy in 10 women with a normal pregnancy, 34 with mild and two with severe pre‐eclampsia. The placenta was first localised by the Doppler method and then the gamma camera was aimed at right angles to the site. After the injection the radioactivity over the placenta was counted and a series of radiographs was made at intervals of 30 sec for up to 12 min. The two values correlated. When the material was grouped according to the week of pregnancy, perfusion was fastest in the 34th week (3.1 ± 0.87 min) and slowest in the 40th week (5.5 ± 1.27 min). The difference was significant. There was no significant difference when the material was divided into groups on the basis of normal and toxaemic pregnancies.
Diverticula of the Walls of the Fallopian Tubes
Authors: Troell Staffan
Published: December 2009

Abstract. The part played by genital tuberculosis, salpingitis isthmica nodosa and endometriosis tubae interna in the formation of diverticula of the Fallopian tube is discussed. The author supports the view that a radiographic differential diagnosis between the latter two conditions is not possible. A case is described in which a diverticulum of the middle portion of the Fallopian tube was revealed by hysterosalpingography in a patient, aged 28 years. She had a history of two episodes of salpingitis, two spontaneous abortions and of a tubal pregnancy on the right side which was treated by excision of the fimbriated end of the right tube. The radiographic appearance of the lesion did not resemble those of the diverticula seen in salpingitis isthmica nodosa, endometriosis tubae interna or genital tuberculosis. The genesis of the lesion could not be determined with certainty.
Microbodies in Tissue Cultures from Human Cervical Carcinomas
Authors: Kurz Laura
Published: December 2009

Abstract. Tissue from 35 patients with invasive squamouscell cancer of the cervix uteri at different clinical stages was transplanted intraperitoneally, in 300 diffusion chambers into 300 castrated and non‐castrated female rats.

The chambers were removed within 10 days. The contents of the chambers were fixed in 5% formalin and subjected to the usual methods of histological preparation, with staining by haematoxylin‐eosin. Filters with tissue cultures were fixed in 95% ethanol and then stained with haematoxylin‐eosin.

The cultures were found to contain growth of epithelial and stroma elements. The epithelial proliferation was found to be increased in the neighbourhood of the fibroblasts. The rate of proliferation did not depend on the clinical stage of the cancer.

Microbodies or blebs were found around the cell nucleus in varying numbers. The greatest number was found in cancer from clinically advanced cases. The nature of these microbodies has not been clarified, but they are in the course of being investigated.
Monoamniotic Twins
Authors: Moestrup J. K.
Published: December 2009

Abstract. A case of monoamniotic twins is reported where both children survived without demonstrable malformations. One twin had aplasia of one umbilical artery. Upon a study of the literature this anomaly in liveborn, healthy monoamniotic twins is found to have been described only once before.
Threatened and Spontaneous Abortion
Authors: Johannsen A.
Published: December 2009

Abstract. A survey has been made of the case histories of 271 patients admitted to hospital because of threatened abortion and 436 patients admitted because of spontaneous abortion. The object of the study was to find some factor in the history that could explain why a number of patients are admitted to hospital at a time when abortion threatens and others at a time when the abortion is in process, as judged by the initial diagnosis.

It was found that patients with threatened abortion were hospitalized earlier in pregnancy than patients with spontaneous abortion. In addition it was seen that admission because of threatened abortion was most frequent among younger patients (below 30 years of age), among primigravidae and among patients from the upper social groups, while admission because of spontaneous abortion was most frequent among the older patients (above 35 years of age), multigravidae, unmarried women, patients that had a previous legal abortion and, finally, among patients from the lowest social groups. Possible reasons for these findings are discussed.

It is concluded that a number of abortions could possibly be avoided if patients with symptoms of abortion were admitted to hospital for effective treatment as early as possible after the symptoms became manifest.
A comparative Study on the Influence of Prostaglandin E1, Oxytocin and Ergometrin on the Pregnant Human Uterus
Authors: Roth‐Brandel U. , Bygdeman M. , Wiqvist N.
Published: December 2009

The influence of prostaglandin E1(PGE1), oxytocin and methyl ergometrin maleate (Mether‐gin®) on the contractility of the pregnant human uterus was compared in in vivo experiments on 8 early pregnant and 14 midpregnant women. The substances were administered intravenously in separate injections. With the doses used PGE1and oxytocin caused a marked elevation of tone whereas Methergin® had a less significant effect. The duration of the elevation of tone after PGE1was approximately three times longer than that after oxytocin but considerably shorter than after Methergin®. The motility pattern following Methergin® was characterized by small irregular contractions which differed completely from that after PGE1and oxytocin. The pharmacological effect of PGE1on the midpregnant uterus suggests that this substance might reduce blood loss and shorten the period of time for placental separation during the third stage of labour. However, this assumption could not be confirmed as judged from a small clinical pilot study carried out on 188 women.
A Case of Hydatidiform Mole with Severe Preeclampsia and Severe Disturbances in Thyroid Function
Authors: Kristoffersen K. , Jørgensen F. Schønau
Published: December 2009

Abstract. A case is reported of a hydatidiform mole accompanied by a serious degree of toxaemia and severe disturbances in the function of the thyroid gland in a 20‐year‐old primigravida, who was admitted to the department in the 20th week of pregnancy. Clinically the patient showed severe toxaemia with gross oedema, congestion of the lungs, hypertension to approximately 200/ 130 mm Hg and proteinuria of 4.4 g/1000 ml, but no signs of thyrotoxicosis. The toxaemia disappeared within 14 days after treatment by evacuation, blood transfusion, albumin infusion, digitalization, diuretics and antihypertensive agents. Eight hours after removal of the mole an extremely high PBI (24.2 μg/100 ml) and a low serum cholesterol (97 mg/100 ml) were found. Both of these values returned to normal within the course of 14 days. Triiodothyronine uptake on Sephadex G 25 (T3 test) was found to be 101% and fell simultaneously with the changes in the other values to 48%. I131 uptake in the thyroid gland showed increased values 3 weeks after the operation but was normal again 5 weeks later. The values for the thyroid function tests which were found are compared with similar values reported in literature and it is concluded that the changes must be due to the usual effects on thyroid function of a normal pregnancy plus an extra factor, which must be produced by the molar tissue, and which must either be TSH or some other thyroid stimulator. It is recommended that in future TSH activity be determined in plasma and molar tissue in patients with hydatidiform mole and that various thyroid parameters be studied with regard to their possible diagnostic value in cases of hydatidiform mole.
Membrane‐Like Structures in the Uterine Cavity
Authors: Borell U. , Fernström I. , Ohlson L.
Published: December 2009

Abstract. (1) In a series of 6 000 hysterograms 23 cases of thin regular membrane‐like structures in the uterine cavity were found. They were situated either in the upper or lower part of the cavity and were 1–2 mm thick. (2) The membranes were found mostly in the secretory phase. They were in some cases present on one examination but absent on the following, with no intervening surgery. They were also found to disappear spontaneously during one examination. (3) Two cases of extensive irregular filling defects in the uterine cavity seen at hysterography are described. These defects had the characteristics generally ascribed to adhesions, yet in 1 case they were seen to disappear during the course of a single examination, and in the other case they were found to have disappeared from one examination to the next without intervening surgery. (4) It is stated that these defects are of functional and not organic nature. The diagnosis of adhesions cannot, therefore, be based on one hysterography alone, but requires confirmation of some kind.
Renal Angiography in the Follow‐Up Examination of Toxaemia of Late Pregnancy
Authors: Koskela Osmo , Kaski Pertti
Published: December 2009

A series of 35 patients with toxaemia of pregnancy is presented. These patients were subjected to renal angiography in order to diagnose any renal artery changes. The patients formed part of a series of 139 toxaemic patients, all of whom had been followed up by intravenous pyelography with normal renal findings. One patient showed a unilateral obstruction of the main branch of the renal artery, obviously of importance. Another patient was found to have a saccular aneurysm in the abdominal aorta. These changes were recorded in the group of patients with a history of hypertension preceding pregnancy, and with superimposed toxaemia of late pregnancy. The groups with pure preeclampsia showed no pathological findings, and renal angiography in these groups shed no additional light on the aetiology of toxaemia.
Prognostic Value of Quantitative Determination of Rhesus Antibody (Anti‐D) In Maternal Serum and Amniotic Fluid
Authors: Jørgensen Jan , Rebbe Heinrich
Published: December 2009

Quantitative determinations of anti‐D in sera and amniotic fluids were performed simultaneously in 63 pregnant Rh‐immunized women with Rh‐positive foetuses. It was demonstrated that the ratio of serum antibody to amniotic fluid antibody as a rule is the same.

A quantitative analysis of the serum antibody enabled us to identify the foetuses with good prognoses. For ths remaining cases, it was possible to distinguish between moderate to severe cases and very severe cases of erythroblastosis by determining also the concentration or titre of amniotic fluid antibody. Where specimens were taken less than a fortnight before birth, the titre values alone made it possible to prognosticate correctly in 80% cases. Correlation of amniotic fluid antibody and bilirubin levels led to correct prognoses in 92% of the cases.

With this background a plan for the control of pregnant Rh‐immunized women is suggested.
Studies on Fibrinolytic Inhibitors During Pregnancy
Authors: Hedner Ulla , Astedt Birger
Published: December 2009

Individual fibrinolytic inhibitors (α2‐macroglobulin, antiplasmin, plasminogen activation inhibitors), their relative values and the variation of such values as well as that of plasminogen were measured in 120 women during normal pregnancy (40 in each trimester).

α2‐macroglobulin and antiplasmin were increased throughout pregnancy. The inhibitors of plasminogen activation were determined by means of both a clot method and a caseinolytic method. The level remained largely unchanged during pregnancy. These findings were confirmed by the results obtained after gel filtration on Sephadex G‐200 of sera from 25 pregnant women. The level of plasminogen was found to be high during the whole of pregnancy. Our findings suggest that the reduced fibrinolytic activity during pregnancy is due to a decreased production and/or a defective release of plasminogen activators from the vessel walls.
Forty‐Five Operations for Sterility
Authors: Jessen Helge
Published: December 2009

The literature concerning operations for sterility is reviewed and a personal series of 45 women, subjected to surgical treatment for sterility is presented. Traditional techniques have been employed, without the use of prophylactic antibiotics or steroids. The relevant data of all the women is summarised. In the 45 patients treated, there were 23 pregnancies, 21 intrauterine and 2 extrauterine. Seventeen women had the 23 intrauterine pregnancies. In the 25 patient where salpingostomy alone was performed, there were 13 pregnancies, 11 intrauterine and 2 extrauterine or, calculated by the number of women who conceived, there were 36% with ultimate intrauterine pregnancies. The results are found to be satisfactory and surprising. The material is too small to make an assessment concerning the factors which influence the prognosis, but the prognosis appears to be best in young women who have not had previous surgery in the lower abdomen and who have few adhesions. The duration of sterility or occurrence of previous pregnancies does not seem to have any prognostic significance. It is concluded that plastic operations continue to have their place in the treatment of sterility, and that the prognosis is somewhat better than usually considered.
Feto‐Maternal Transfusion and Free Bleeding from the Umbilical Cord
Authors: Johansen J. Kjersgaard , Schacke E. , Stürup A. G.
Published: December 2009

The incidence of feto‐maternal transfusion in 200 normal women was determined from blood samples taken when labour had become established, with contractions occurring approximately every 5 minutes, and again 30 minutes after delivery.

In 90 instances, after cessation of umbilical artery pulsation, the umbilical cord was ligated and cut, allowing free flow from the placenta. In the remaining 110 instances the cord was cut between two pairs of forceps.

No difference in feto‐maternal transfusion in the two groups could be demonstrated.
Utero‐Vaginal Differential Pressure During the First Stage of Labour
Authors: Westin Björn , Söderberg Göran
Published: December 2009

Intra‐abdominal (vesical), intra‐uterine and intra‐vaginal pressures were measured in 12 healthy women early in the first stage of labour. Ten subjects were primigravidae and two gravidae‐2.

Seven subjects exhibited no significant change of intraabdominal or intra‐vaginal pressures during uterine contractions.

Five subjects (4 primigravidae) exhibited no significant change of intra‐abdominal pressure but a large and significant increase of intra‐vaginal pressure concomitant with uterine contractions. In spite of having higher intrauterine peak pressures during contractions, these subjects exhibited significantly smaller expulsive uterine pressures than the former group because of high vaginal counterpressures. It is believed that increased tension of pelvic floor muscles contributes to the elevated vaginal pressure during contraction.

Our findings may offer a better understanding of why pain relief in selected patients will aid in accelerating labour and make the birth process less hazardous for the fetus.
Experience of the Use of Desamino‐Oxytocin Buccal Tablets as a Method of Inducing Labour, and of a Scoring System for Evaluation of Readiness for Labour
Authors: Laine Jarno
Published: December 2009

Induction of labour was performed on 259 parturients by means of desamino‐oxytocin (ODA 914) buccal tablets. The maximal dose was small (350 I.U.). Primary induction was successful in 64% of the cases. The incidence of maternal complications was small.

Neonatal asphyxia was diagnosed in 12 newborn in‐fants (4.6%). Asphyxia was more common in those cases in which toxaemia was the indication for induction. Intra partum and neonatal mortality were nil.

An endeavour was made to predict the success of in‐duction by using a scoring system for evaluation of readiness for labour. The experience gained suggests that a scoring table of this kind may, when amplified and refined, be useful in deciding the best time for the performance of induction.
Peptic Ulcer in Pregnancy Report of Two Cases of Surgically Treated Bleeding Duodenal Ulcer
Authors: Becker‐Andersen Henning , Husfeldt Vibeke
Published: December 2009

31 perforations and 28 cases of haemorrhage from proved peptic ulcer which occurred during pregnancy have been reported. The authors add 2 cases of bleeding duodenal ulcer near to term. These were treated in one case by Caesarean section plus partial gastrectomy at the same time and in the other case by partial gastrectomy during the puerperium. The oestrogen level and the greatly elevated histaminase concentration afford part of the explanation why symptoms, and especially complications, from peptic ulcer are so rare during pregnancy.
Placental Haemangiomatosis and Severe Maternal Eclampsia
Authors: Seppälä Markku , Saksela Eero
Published: December 2009

A case report is presented of an association of diffuse placental haemangiomatosis with severe maternal eclampsia. Eclampsia occurred at the 35th week of an otherwise uncomplicated pregnancy in a 20‐year old previously healthy woman. An 1800 g dysmature boy was born by caesarean section, and died in 12 hours from an apparent Klebsiella pneumonia. No organic malformations were found at autopsy. The placenta weighed 420 g an J contained, on microscopic examination, a characteristic diffuse placental haemangiomatosis without signs of infection or malignancy. The possible role of the placental lesion in relation to the acute eclamptic period is considered briefly.
Pregnancy in Non‐Communicating Rudimentary Uterine Horn
Authors: Wahlén Tore
Published: December 2009

Three cases in which pregnancy occurred in a non‐communicating rudimentary uterine horn are reported. Prior to operation in two of the cases a false diagnosis of ovarian cyst complicating the pregnancy was made. In the third case an uncomplicated missed abortion was assumed at first, but with the experience of the first two reported cases the correct diagnosis was made pre‐operatively. The functioning of the rudimentary horn before the pregnancy and the migration of the sperm, and the transport and nidation of the fertilized ovum are discussed.