bluuebunny/crossref_metadata_2025 huggingface dataset:
Chorionic Villus Sampling: Clinical Experience of the Initial 750 Cases
Authors: Yang Young H. , Park Yong W. , Kim Sei K. , Cho Jae S. , Jeong Mee J. , Kim Haeng S. , Song Chan H.
Published: August 2010

Objective: To assess the factors that might influence the success rate, safety and reliability of chorionic villus sampling (CVS) and to evaluate the relationship between CVS and other congenital anomalies.

Design: Analysis of the outcome of 750 cases of CVS (730 cases with transcervical and 20 cases with transabdominal).

Setting: The outpatient prenatal genetic clinic of a university tertiary care center.

Subjects: Seven hundred and fifty pregnant women that underwent CVS for prenatal genetic diagnosis from 7 to 12 weeks of gestation.

Results: Advanced maternal age was the most common indication for CVS (32.8%). The overall sampling success rate was 98.0% (735/750), representing 93.9% at 7 to 8 weeks, 98.1% at 9 to 10 weeks, and 98.3% at 11 to 12 weeks of gestation. The majority of cases (93.1%) required one or two aspirations. Cytogenetic analysis routinely included direct overnight and long‐term culture methods which revealed 16 abnormalities (2.2%). Of 735 cases in which CVS was successful, 700 advanced to normal offspring, 17 had therapeutic termination, and 18 resulted in spontaneous abortions; there was an overall fetal loss rate of 2.4% (18/750).

Conclusion: CVS in early pregnancy is a relatively safe and reliable method of prenatal genetic diagnosis capable of replacing genetic amniocentesis. However, it must be done by experienced personnel. No congenital anomalies were found to be related to CVS in this series.
Abdomino Perineal Repair of Pulsion Enterocele
Authors: Brieger Geoffrey M. , Korda Andrew R. , Houghton C. Roger S.
Published: August 2010

Objectives: To review the techniques, results and complications of the combined abdomino perineal repair and mersilene mesh sacrocolpopexy.

Methods: From March 1988 to December 1993; 45 cases of pulsion enterocele were treated by a combination of the Zacharin type abdomino perineal repair and mersilene mesh sacrocolpopexy. Forty cases were followed from between 1 month and 18 months (mean 5.95 months). The notes were reviewed retrospectively.

Results: There were 3 recurrences (7.5%). Complications were not insignificant: wound infection in 3, urinary tract infection in 6, bowel dysfunction in 8, ventral hernia, vaginal stricture necessitating surgical release, and brachial nerve plexus injury occurred once. In one patient a peritoneal cyst developed necessitating laparoscopic aspiration.

Conclusion: The combined abdomino perineal and sacrocolpopexy procedure offers the restoration of normal anatomy and the relief of the symptoms of prolapse in 92.5% of patients. The complication rate is significant and it should be undertaken as a secondary procedure.
HER‐2/neu Gene Amplification in Cervical Cancer in Chinese Women of Hong Kong and China
Authors: Wong Y. F. , Chung Tony K. H. , Cheung T. H. , Lam S. K. , Tam O. S. , Lu H. J. , Xu F. D. , Chang Allan M. Z.
Published: August 2010

Objective: To determine the amplification of proto‐oncogene HER‐2/neu in invasive cervical cancer and its relationship with the stage of disease, grade of tumor and prognosis of patients.

Methods: In this retrospective study 70 women with invasive cervical squamous cell carcinoma were included. DNA was extracted from the paraffin‐embedded tumor tissue. The amplification of HER‐2/neu was studied using a differential polymerase reaction (PCR) technique. Assessment of significance was performed using Peason's Chi‐square test and Fisher's exact test.

Results: Eleven of the 70 cases (16%) showed an amplification of HER‐2/neu but there was no relation between amplification and tumor histologic grading (p = 0.408) or clinical staging (p = 0.180). Follow‐up information in 67 patients was available. The incidence of amplification in the patients who were alive with disease was not statistically different from that in the patients who were alive with no evidence of disease (p = 0.315). The incidence of amplification in the patients who died of disease was higher than that in the patients who were still alive, but statistical significance did not reached (p = 0.062).

Conclusion: The results suggest that HER‐2/neu amplification does exist in a subgroup of invasive cervical cancer and may play a role in cervical carcinogenesis. The role as independent prognostic factor has to be evaluated by further prospective studies.
HLA Sharing, Anti‐Paternal Cytotoxic Antibodies and MLR Blocking Factors in Women with Recurrent Spontaneous Abortion
Authors: Kishore Raj , Agarwal Suraksha , Halder A. , Das V. , Shukla B. R. K. , Agarwal S. S.
Published: August 2010

Objective: To study the prevalence of HLA sharing between spouses and its correlation with presence of antipaternal cytotoxic antibody (APCA) and mixed lymphocyte reaction (MLR) blocking factors in recurrent spontaneous aborters (RSA).

Design: Study was carried out at Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, from 1988–1992. Hundred coupes with 3 or more consecutive recurrent spontaneous abortions and equal number of age, parity and ethinically matched normal controls were selected for studying HLA, APCA and MLR blocking factors. Meta‐analysis was performed using standard formula and significance was tested by Chi‐square analysis.

Results: Significant HLA sharing was observed in couples with RSA at A and DR loci compared to normal controls (p < 0.001). Twenty‐seven point eight percent of couples with RSA were positive for APCA compared to 49% of controls (p < 0.01). MLR blocking factors were detected in 26% couples with RSA compared to 78% in controls (p < 0.001). An inverse correlation between HLA sharing and APCA and MLR positivity was demonstrated.

Conclusion: The study supports that greater HLA sharing between spouses, associated with lack of an appropriate immune response to them could be responsible for RSA.
Analysis of 23 Cases of Primary Carcinoma of the Fallopian Tube over 50 Years
Authors: Huber‐Buchholz Marie‐Madeleine , Buchholz Niels‐Peter , Staehelin Jody
Published: August 2010

The authors report on 23 cases of primary Fallopian tube carcinoma occurring over the past 50 years. In addition, the literature of the past 30 years was reviewed. The 5‐year survival rate was 40%, increasing considerably with lower tumor stage or better tumor differentiation. The adjuvant therapies used did not prolong survival. Results were compared to other studies, and diagnostic and therapeutic trends are pointed out. Due to the rareness of the tumor, there are no controlled studies as to the effectiveness of therapeutic regimens. Therapy is purely empiric and usually follows the guidelines for ovarian cancer. There are no established tools for a safe preoperative diagnosis. The tumor is highly aggressive and quickly spreading. Initial tumor stage and differentiation are determinants for the prognosis. Therefore, a radical approach is indicated whenever a tubular malignancy cannot be excluded.
Use of Recombinant Tissue‐Type Plasminogen Activator to Treat Massive Pulmonary Embolism after Cesarean Section: A Case Report
Authors: Onoyama Yoshimichi , Minamitani Makoto , Takeuchi Hajime , Sakai Sunao , Eguchi Hiroyuki
Published: August 2010

A 30‐year‐old primigravida, delivering by cesarean section, went into shock with cardiac arrest due to pulmonary thromboembolism. Thrombolytic therapy with recombinant‐tissue‐type plasminogen activator (rt‐PA) induced a rapid improvement in both the hemodynamic and respiratory conditions. This case shows the marked efficacy of rt‐PA in treating massive pulmonary thromboembolism. Close attension must be given to the patient in such a case, however, because the risk of hemorrhagic complication exists.
Micronutrient Status of Plantation Workers in Sri Lanka during Pregnancy and Postpartum
Authors: de Silva L. Dilip R. , Atukorala T. M. Sunethra
Published: August 2010

Iron, zinc and vitamin A status was assessed in 309 plantation workers during pregnancy and in a sub‐sample of 108 subjects at 20 to 36 weeks postpartum and the birth weights of their newborn were noted. A significant positive correlation was noted between haemoglobin concentration at 10–26 weeks of gestation of anaemic mothers (n = 180) and birth weights of their new born. Depleted iron stores (serum ferritin < 12 μg/l) were noted in 33.3% of subjects at 10–26 weeks of gestation. There was no significant change in serum ferritin concentration at > 32 weeks of gestation. Iron deficiency persisted at 20–36 weeks postpartum. Marginal vitamin A deficiency was also noted, as, 46.2% and 15.6% of the subjects respectively, had low serum vitamin A levels in pregnancy and postpartum. Low serum zinc levels were noted only in pregnancy. Iron supplementation during pregnancy was only effective in preventing further deterioration in iron status and it should be continued for about 12 weeks after delivery.
Serum Levels of Squamous Cell Carcinoma Antigen and Carcinoembryonic Antigen as Tumor Markers of Vulvar Cancer
Authors: Yamawaki Takaharu , Takeshima Nobuhiro , Shimizu Yoshio , Teshima Hideo , Hasumi Katsuhiko
Published: August 2010

Objective: To assess whether squamous cell carcinoma (SCC) antigen and carcinoembryonic antigen (CEA) are useful as tumor markers of vulvar cancer.

Methods: The serum levels of SCC antigen and CEA were determined for 30 patients with invasive vulvar carcinoma.

Results: There was a significant difference not only between tumor sizes of 2 cm or larger and those of less than 2 cm (p < 0.001), but also between patients with lymph node metastasis and patients free from it (p < 0.001). Tumor marker levels well reflected the response to neoadjuvant chemotherapy. The sensitivity to recurrence was 63%, and the specificity was 94%. In 2 of 8 recurrent cases, it was only the re‐increase in tumor markers that indicated the recurrence.

Conclusion: The measurement of serum levels of SCC antigen and CEA is useful not only for preoperative evaluation of the risk of lymph node metastasis, but also for the detection of recurrence.
Case Report: An Exaggerated Placental Site with a Cervical Pregnancy
Authors: Kase Hiroaki , Kodama Shoji , Yahata Tetsuro , Aoki Yoichi , Tanaka Kenichi
Published: August 2010

An exaggerated placental site (EXPS) is an exuberant nonneoplastic proliferation of the intermediate trophoblast at the implantation site. We had a case of an EXPS with a cervical pregnancy. We report on this case, including the patient's clinical course and immunohistological findings.
Laparoscopic Assisted Vecchietti Procedure for the Creation of a Neovagina
Authors: Cooper Michael J. W. , Fleming Sue , Murray John
Published: August 2010

A case report of a 21‐year‐old patient with Mayer‐von Rokitansky‐Küster‐Hauser syndrome is presented. A neovagina was created by drawing an olive into the vaginal grove and applying continuous tension via sutures passed at laparoscopy to a tensioning device on the anterior abdominal wall.
Outcome of External Cephalic Version: Our Experience
Authors: Teoh Terence
Published: August 2010

The aim is to assess the outcome of external cephalic version (ECV) for term breech in our clinical setting and the factors involved. Patients with no contraindications and who consented to ECV were recruited into this prospective study. Terbutalin infusion was used. There were 42 ECV attempts of which 21 (50%) were successful. Seventeen of the patients with successful ECV delivered vaginally and 4 had cesarean section for various indications. Only 5 of the 21 unsuccessful ECV delivered vaginally. Thirteen had elective cesarean section and 2 had emergency cesarean during trial of breech. One patient from the unsuccessful ECV group was lost to follow‐up. There were 31 (74%) primipara. The birth weight of the babies was not a significant factor in the outcome of ECV. The type of breech and parity did influence the success rate. External cephalic version should be included in the routine management of our breech presentation.
A Multicentre Study to Investigate the Prevalence of Abnormal Carbohydrate Metabolism in Chinese Pregnant Women
Authors: Lee C. P. , Wang Z. Q. , Duthie S. J. , Ma H. K. , Zhang J. Z. , Zhou S. M. , Li D. F. H.
Published: August 2010

Objectives: To determine the prevalence of abnormal carbohydrate metabolism in Chinese pregnant women. To study the inter‐relationship between maternal body habitus, maternal serum glucose and birth weight of the baby.

Methods: Multicentre observational study involving 713 pregnant Chinese women, attending antenatal clinics in Beijing, Shanghai, Guangzhou and Hong Kong.

Results and Conclusion: The overall prevalence of abnormal glucose tolerance was 6.9%. The prevalence was 6.8%, 5.5%, 7.2% and 8.1% in Beijing, Shanghai, Guangzhou and Hong Kong, respectively. The differences among the centres did not reach statistical significance (p = 0.9). The mean ponderal index of women with abnormal glucose tolerance was significantly higher than that of women with normal glucose tolerance (15.2 vs 14.3, p < 0.01). The birth weight ratio of the babies was positively correlated with the maternal height (correlation coefficient 0.23, 95% C.I. 0.15–0.30), weight (0.32, 95% C.I. 0.25–0.39) and to a lesser extent, the fasting level of serum glucose (0.10, 95% C.I. 0.02–0.28) but not with the 2 hour level of serum glucose.
Absence of Vagina and Hypoplasia of the Urethra and Ectopia of the Ureter
Authors: Nasu Kaei , Yoshimatsu Jun , Miyakawa Isao , Nakagawa Masahisa , Nomura Yoshio
Published: August 2010

A 16‐year‐old Japanese girl was admitted for evaluation of complaints of primary amenorrhea, cyclic lower abdominal pain, and urinary incontinence. Her vaginal introitus appeared rudimentary with a depth of 0.5 cm and hypoplasia of the hymenal ring. A hypoplastic urethra (diameter: 1 cm; length: 0.5 cm) and 1 of 2 right ectopic ureters opened into the introitus. Transabdominal ultrasonography demonstrated fluid distending the uterus, the proximal 1/3 of the vagina, and the pouch of Douglas. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of hematometrocolpos and fluid collection in the pouch of Douglas. These associated anomalies can be due to faulty growth of the urogenital sinus. In addition to the transabdominal ultrasonography and CT, MRI was useful in the diagnosis and evaluation of vaginal agenesis.
Mucinous Cystadenocarcinoma with Sarcoma‐like Mural Nodules Arising in a Mature Cystic Teratoma of the Ovary: A Case Report
Authors: Mizuno Kaoruko , Hirata Shuji , Kasai Tsuyoshi , Yasumizu Takehiko , Kato Junzo
Published: August 2010

Almost all cases with malignant transformation of a mature cystic teratoma of the ovary have been reported to be associated with squamous cell carcinoma. We describe a very rare case of mucinous cystadenocarcinoma with sarcoma‐like mural nodules arising in an ovarian teratoma.
A Method of Measuring Dipalmitoylphosphatidylcholine (DPPC) by High‐Performance Liquid Chromatography (HPLC): Effect of Dexamethasone on DPPC Secretion in Fetal Rat Alveolar Type II Cell Culture*
Authors: Suzuki Rika , Ichikawa Fumitaka , Endo Chikara , Hoshi Kazuhiko , Sato Akira
Published: August 2010

Objectives: To establish a method by which to measure dipalmitoylphosphati‐dylcholine (DPPC), which is the most prevalent phospholipid in lung surfactant, by high‐performance liquid chromatography (HPLC), and to measure DPPC secretion in type‐II alveolar cell culture to determine whether glucocorticoid has a direct accerelating effect.

Method: Type‐II alveolar cell suspensions were made with fetal rat lungs and then cultured. Dexamethasone (10‐9, 10‐8 M) was added to some of the culture dishes. DPPC was extracted from the culture medium, purified, and measured by high‐performance liquid chromatography (HPLC).

Results: In the measurements of DPPC, the specificity of isolation and measurement parity were excellent [coefficient of variation: intraassay; 5.66% (0.005 mg/ ml), 25.37% (0.05 mg/ml)): interassay; 8.35% (0.005 mg/ml)), 0.08% (0.05 mg/ml))]. The DPPC concentration in the culture dishes of the dexamethasone was not significantly different than that of the control dishes (Student's t)‐test).

Conclusion: The above results prove that dexamethasone does not directly stimulate lung alveolar type‐II cells.
Doppler‐Velocity Waveforms in Ductus Venosus in Normal and Small‐for‐Gestational‐Age Fetuses
Authors: Nakata Masahiko
Published: August 2010

Objective: To investigate blood‐flow patterns in ductus venosus in growth‐retarded fetuses.

Methods: Reference ranges of ductus venosus flow velocities were constructed from a cross‐sectional study of 179 normal fetuses between 16 to 38 weeks' gestation, and the ductus venosus flow‐velocity waveforms in 11 small‐for‐gestational‐age (SGA) fetuses were compared with normal patterns.

Results: Of 179 pregnant women who were possible subjects, 175 were employed for the analysis, and ductus venosus flow‐velocity waveforms were obtained in 197 out of 211 examinations (success rate = 93.4%). The peak forward velocities during (a) ventricular systoles, (b) the lowest forward velocities during atrial contractions, and (c) the time‐averaged velocities all linearly increased as gestational ages increased [respectively: (a) slope, 1.135; constant, 31.720; (b) slope, 1.154; constant, 1.557; (c) slope, 1.240; constant, 19.386]. Peak forward velocities during ventricular systoles and time‐averaged velocities in the SGA group did not differ from those of the normal group. Three SGA fetuses with abnormal flow in the umbilical artery showed a marked reduction of the lowest velocities during atrial contractions in the ductus venosus, and two of them showed no forward velocity at all.

Conclusion: The Doppler‐velocity waveforms of ductus venosus showed a marked reduction of the end diastolic flow, especially in SGA fetuses with abnormal umbilical artery flows.
Chromosomal Analysis in 894 Induced Abortuses from Women of Advanced Maternal Age in Relation to Gestational Weeks and Fetal Sex Ratio
Authors: Hoshi Nobuhiko , Hanatani Kaoru , Kishida Tatsuro , Sagawa Tadashi , Fujimoto Seiichiro
Published: August 2010

Objective: To clarify the prenatal sex ratio, and types and frequencies of chromosome anomalies in relation to gestational weeks in women of advanced maternal age.

Methods: Chromosomal analysis was performed in 894 induced abortuses derived from elderly pregnant women 35 or more years of age.

Results: The embryonic sex ratio in the chromosomally normal (abnormal) gave a preponderance of females over males in lower gestational weeks [366/458 (63/73); 79.9 to 100 (86.3 to 100) in 4–10 weeks]; the reversal of dominancy in those from females to males occurred in the 11th gestational week [41/29(5/4); 141.4 to 100 (125.0 to 100) in 11–20 weeks]. The frequency of trisomy in females at 10 weeks of gestation was significantly high (7/28; 25%).

Conclusions: This study showed that the existence of a difference of and a reversal of the sex ratio in gestational weeks. It was considered that there might be a lower viability of genetically handicapped males as compared to such females. However, the reversal of the sex ratio, such as that observed between 9th and 10th gestational weeks, might reflect events occurring after implantation.
An Interesting Unusual Case of Endometrial Stromal Sarcoma
Authors: Mittal Suneeta , Sharma Rohit , Kriplani Alka , Buckshee Kamal
Published: August 2010

An interesting case with an unusual presentation of endometrial sarcoma is described. This patient presented with a history of continuous vaginal bleeding 3 months following a full term caesarean section and perception of an enlarging abdominal mass. The physical examination revealed an enlarged uterus with a leiomyoma though there was no evidence of the same at the time of the caesarean section. A laparotomy was undertaken and the patient was found to have a large tumor with multiple polypoidal growths invading the myometrium through to the serosa. This was proven to be an endometrial stromal sarcoma on histopathology.
Amniotic Fluid Volume in Spurious Labour
Authors: Biswas Arijit , Chew Stephen C. L. , Anandakumar Chinnaya , Chua Selina P. K. , Arulkumaran Sabaratnam
Published: August 2010

Objective: A prospective study was undertaken to assess the amniotic fluid index (AFI) in women with spurious labour and its possible role in management.

Methods: Eight hundred and ninety‐three women in early labour, who had uncomplicated pregnancy, were recruited for the study. Of these, 133 were later diagnosed to have had spurious labour, while 760 were in true labour. An admission cardiotocography and determination of AFI was done for all patients at the time of their admission to the labour ward. Labour was induced within 24 hours for those women in spurious labour who had severe oligohydramnios.

Results: The incidence of severe oligohydramnios (AFI < 5) was significantly higher in the patients later diagnosed to have had spurious labour (15.7%) compared with those in true labour (2.1%). With this management protocol, the obstetric and the neonatal outcome was similar in the spurious labour and the true labour groups.

Conclusion: The assessment of AFI could be a simple and useful screening tool to avoid adverse perinatal outcome in women who experience spurious labour.
Effects of Hormone Replacement Therapy on Sexuality in Postmenopausal Women in a Mideast Country
Authors: Omu Alexander E. , Al‐Qattan Najeeba
Published: August 2010

Objective: During the postmenopausal period, sexual interest and activity seem to decline, as part of the menopausal effect of oestrogen deficiency. The aim of this study was to evaluate other factors that could contribute to sexual dysfunction and the effect of hormone replacement therapy among postmenopausal women in Kuwait.

Method: Between June 1992, and June 1994, details of sexual history were compiled from 261 postmenopausal women that attended the Menopause Clinic at the Maternity Hospital, Kuwait. The effect of hormone replacement was analysed from the sexual history and the bacteriology of the lower genital tract.

Results: About 71% of the 261 postmenopausal women were still sexually active. Among those not sexually active, 38% had loss of interest, 22% because of divorce or death of husband, 20% from loss of interest by husband, and in 13% because the husbands had impotence from medical problems. Of the sexually active women, 41.1% had reduced libido. Contributing factors included vaginal symptoms like dyspareunia and vaginal dryness, vaginal infection, disturbances in the premenopausal menstrual pattern and disharmony with husbands. About 23 to 45% of the postmenopausal women with oestrogen replacement therapy, had significant relief of their symptoms of sexual dysfunction. Vasomotor symptoms had better response compared to sexual dysfunction (p < 0.01). Natural oestrogen gave slightly better relief of symptoms of sexual dysfunction than other forms of oestrogen therapy. Livial gave complete relief of dyspareunia and vaginal dryness in 9.1% and 3.9% respectively, but none of those with libido and vaginal discharge had any relief.

Conclusion: There is a decline in sexual response and activity in postmenopausal women in Kuwait. This is however, multifactorial in origin. Although oestrogen replacement therapy gives significant relief in symptoms of sexual dysfunction, other contributory factors should always be evaluated.
The Effect of Prolonged Cycles of Chemotherapy on Quality of Life in Gynaecologic Cancer Patients
Authors: Carter Jonathan R. , Chen M. Dwight , Fowler Jeffrey M. , Carson Linda F. , Twiggs Leo B.
Published: August 2010

Objective: The aim of this study was to determine if the prescription of prolonged cycles of chemotherapy to patients with a variety of gynaecologic cancers has an adverse effect on quality of life (QOL).

Methods: Patients attending a single gynaecologic oncology clinic who received greater than 6 cycles of chemotherapy were identified. Prior to each chemotherapy cycle, patients were asked to complete a modified Functional Assessment Cancer Therapy‐General (FACT‐G) quality of life form. QOL scores were compared to their baseline or pretreatment score (cycle 1 score), as well as to their score representing the completion of primary therapy (cycle 6 score).

Results: Seventeen patients were identified as having received greater than 6 cycles of systemic cytotoxic chemotherapy. The total number of chemotherapy cycles analyzed was 95. Comparing QOL scores for cycle 1 and 6 to cycles 7–16, we found no significant alteration (improvement or deterioration) in the following subscale scores: physical well being (PWB), social well being (SWB), and functional well being (FWB). Similarly, overall QOL as represented by the summed individual scores was also not affected by the prescription of up to 16 cycles of chemotherapy. Analysis of the emotional well being (EWB) subscale scores revealed a significant downward trend after the 12th cycle of therapy as compared to the 6th cycle (p = 0.04), however this trend was not significant when compared to the pretreatment or cycle 1 scores (p = 0. 16). There was however a statistically significant progressive deterioration in the subscale score of the relationship with the doctor (RWD). This was most marked after the 10th cycle of therapy (p < 0.0001). When split by disease status, we again found no statistically significant alteration in PWB, SWB, RWD, EWB, FWB and overall QOL for cycle 1 and 6 as compared to cycles 7–17. However, those patients who were able to attain a complete clinical response (CCR) disease status, achieved a higher SWB (p = 0.003), RWD (p = 0.02), EWB (p = 0.03), and overall QOL scores (p = 0.04) while their PWB scores were not statistically different from patients with stable (p = 0.7) or progressive disease (p = 0.6).

Conclusion: In conclusion, the prescription of prolonged cycles of chemotherapy to patients with gynaecologic cancers does not result in an overall deterioration of QOL. Further more an improvement in subscale and overall QOL was demonstrated in those patients able to attain a complete clinical response (CCR).
Pheochromocytoma during Pregnancy: Case Report
Authors: Chittacharoen Apichart , Phuapradit Winit
Published: August 2010

Pheochromocytoma during pregnancy is rare. Only a few hundred cases have been published in the literature. We report patients with pheochromocytoma diagnosed at antepartum period. Manifestation include hypertension with various clinical presentation, possibly resembling those of pregnancy‐induced hypertension. Confirmation necessitates special biochemical examination and the use of different radiological imaging tool. Treatment combines medical procedures with surgical exploration, mandating a team approach of diverse medical expertise. In the first and second trimesters, tumor resection has a good fetal outcome; in later pregnancy, delivery by elective cesarean section followed by tumor resection is recommended. The overall prognosis is mainly affected early diagnosis and multidisciplinarian management.
Effect of Maternal Exercise on Fetal Umbilical Artery Waveforms: The Comparison of IUGR and AFD Fetuses
Authors: Nabeshima Yuichi , Sasaki Junichi , Mesaki Noboru , Sohda Satoshi , Kubo Takeshi
Published: August 2010

Objective: To determine the effect of maternal exercise on the fetal blood flow of normal and growth‐retarded fetuses.

Methods: The effect of maternal exercise on fetal blood flow was investigated with 24 pregnant women between 36 and 42 weeks' gestation. Seventeen pregnancies were uncomplicated (normal group) and the other 7 were complicated with growth‐retarded fetuses (IUGR group). They underwent graded walking on a treadmill with an upper limit of 150 bpm for the maternal heart rate. The systolic over diastolic velocity ratio (S/D ratio) of the umbilical artery was measured before exercise, and at 3, 5, 10, and 15 minutes after exercise.

Results: The mean S/D ratio of the IUGR group before exercise was significantly higher than that of the normal group (p < 0.05). The S/D ratio did not change significantly after exercise, in either the normal group or the IUGR group.

Conclusion: This study suggests that maternal exercise at this level of intensity and duration does not have any harmful effect, even on growth‐retarded fetuses that might have placental dysfunctions.
DNA Analysis of the Androgen Receptor Gene in Two Cases with Complete Androgen Insensitivity Syndrome
Authors: Komori Shinji , Sakata Kazuko , Tanaka Hiroyuki , Shima Hiroki , Koyama Koji
Published: August 2010

Objective: Androgen insensitivity syndrome is an X‐linked disorder of sexual differentiation resulting from abnormalities of the androgen receptor gene. In this study, we analyzed the androgen receptor gene in 2 cases with complete androgen insensitivity syndrome (CAIS).

Methods: DNAs were isolated from patients with CAIS, and the androgen receptor gene was amplified by a polymerase chain reaction. Sequence analysis of the androgen receptor gene was performed.

Results: In Patient 1, one substitutional mutation [glutamine (CAA) to arginine (CGA) at position 194] was identified in exon A, and the premature termination of the androgen receptor gene was also demonstrated due to the deletion of one nucleotide at the codon in exon C (position 597). In Patient 2, one substitutional mutation [arginine (CGC) to cysteine (TGC) at position 855] in exon G was identified. This position was located in the hormone‐binding domain and appeared to be a hot spot of mutations because the mutations at the same position have been reported before in several unrelated cases.

Conclusion: The results of this study suggest that these abnormalities might be related to the pathogenesis of complete androgen insensitivity syndrome.
Hypertension in Pregnancy: A Study of the Asia‐Oceania Region
Authors: Spurrett Brian R. , Cook Colleen‐M.
Published: August 2010

A review of the management practices and problems surrounding hypertension in pregnancy in the Asia‐Oceania region was made. This review was achieved by surveying institutions in the region. Sixteen countries responded to this survey and the results were analysed. Both rural and city hospitals were involved in the survey. The centres were selected by members of the Maternal Perinatal Committee of the Asia‐Oceania Federation of Obstetrics and Gynaecology (AOFOG) under whose patronage the survey was performed.

Analysis of the survey revealed a number of problems which could be addressed by appropriate educational interventions, these included drug therapies and protocols, deficiencies in governmental support especially in transport and centralised intensive care facilities. Public awareness was also a priority to be addressed.

The role of the traditional birth attendant has been increasingly recognised as a resource which could be utilised. This is highlighted in this survey where there are countries who will be dependant on these carers for the next 10 years at least. Their place in the management of hypertension is discussed.
Obstetric Outcome after One Previous Ceasarean Section
Authors: Perveen F. , Shah Q.
Published: August 2010

Objective: A prospective study was undertaken to evaluate the outcome of trial of labour (TOL) after one previous ceasarean section.

Methods: A total of 2,447 deliveries were conducted during this study period over 22 months. Out of these patients 167 women had one previous ceasarean birth, 112 (67.1%) of whom underwent trial of labour.

Results: Seventy‐two (64.28%) of these patients achieved vaginal delivery. This success rate would be much higher if fixed protocol could be applied to all the patients. Fourty‐six point fifteen percent of patients with past indication for ceasarean section due to cephalopelvic disproportion also delivered vaginally. This advocates that each patient should be selected on individual merits and the past indication for ceasarean section should be reviewed. One maternal death occurred in this study which was due to anaesthetic complication while the perinatal mortality rate in this group was slightly higher as compared to national perinatal mortality rate, reason discussed in the text.

Conclusion: It is safe to offer TOL provided patient is carefully selected and monitored.
Detection of Pregnant Women at Risk of Cervical Incompetence by Transvaginal Sonography during Straining
Authors: Sherif Lotfy Sh. , Shalan Hesham M.
Published: August 2010

Objective: To evaluate the ability of transvaginal sonography (TVS) undertaken, during straining to detect incompetent cervix in pregnant women at risk.

Method; Forty‐seven pregnant women with risk factor(s) for cervical incompetence and 22 pregnant women (control) were evaluated for cervical changes detected by TVS during rest, transfundal pressure and during the stress induced by straining.

Results: The control group demonstrated no cervical changes. The changes were more significant during straining than with transfundal pressure. In the group with risk factor(s), 48.9% showed negative response and 51.1% demonstrated positive response. The pregnancy outcome was more favourable in the group with negative response (full term pregnancy 82.6% vs 70.8%, preterm delivery 13% vs 16.7% and pregnancy loss 4.4% vs 12.5%).

Conclusion: TVS during straining can be applied as a stress test in women at risk for cervical incompetence.
Cystic Teratoma of the Greater Omentum: A Case Report and Review of the Literature
Authors: Furuhashi Madoka , Katsumata Yoshinari , Oda Hiroyuki , Imai Nobuaki
Published: August 2010

Cystic teratoma in the greater omentum remains one of gynecology's rarest entities. A 28‐year‐old woman presented with a goose‐egg‐sized mass in the right lower quadrant. At laparotomy, the mass proved to be a cystic teratoma of the greater omentum. To our knowledge, this report documents the first case where an omental pedicle was torsioned.
Prenatal Diagnosis of Pulmonary Atresia by Fetal Echocardiography
Authors: Uerpairojkit Boonchai , Charoenvidhya Dhiraphongs , Tannirandorn Yuen , Chottivittayatanakorn Pairoj , Witoonpanich Pairoj , Phaosavasdi Sukhit
Published: August 2010

With an improvement in cardiac imaging during the past 20 years, fetal echocardiography has progressively altered the practice of obstetricians and become a principle armamentarium for the diagnosis of fetal heart diseases. We presented a case of pulmonary atresia with intact ventricular septum diagnosed prenatally using fetal echocardiography.
Effects of Gonadotropin, Estrogen, and Progesterone on c‐mos Gene Expression in Mouse Oocytes in vivo and in vitro
Authors: Hanai Kazuo , Suganuma Nobuhiko , Kikkawa Fumitaka , Furuhashi Madoka , Tomoda Yutaka
Published: August 2010

Objective: To analyze the effects of gonadotropin and ovarian steroid hormones on the gene expression of c‐mos in mouse oocytes.

Methods: The changes of c‐mos messenger RNA (mRNA) levels in oocytes were examined after the administration of pregnant mare's serum gonadotropin (PMSG) in vivo, or after incubation with estrogen and/or progesterone in vitro. Five IU PMSG was injected intraperitoneally to female immature mice, and human chorionic gonadotropin was also injected intraperitoneally 48 hours after the PMSG injection, with or without mating with male mice. The oocytes were collected from follicles or oviducts at 24, 30, 36, 42, 48, 60, 72, and 84 hours after the injection. The RNAs were extracted from 5 oocytes at each time point, and a reverse‐transcription polymerase chain reaction using specific primers to c‐mos DNA was performed to measure the relative amount of c‐mos mRNA.

Results: The c‐mos mRNA in oocytes at 36 hours after the injection was 2.7 times higher than that at 24 hours. The c‐mos mRNA level gradually decreased thereafter, and after ovulation the level was only 1/10 of the peak level. When the oocytes that were retrieved 24 hours after PMSG injection were incubated with 800 ng/ml estradiol 17‐β or 600 ng/ml progesterone for 120 minutes, the c‐mos gene expression was significantly suppressed or stimulated, respectively, in comparison with the absence of these substances.

Conclusion: Although the regulatory mechanism of c‐mos gene expression in oocytes is still unclear because the result obtained from the in vitro study, that estrogen suppressed the c‐mos gene expression directly, was inconsistent with the result of the in vivo study, that increases of both c‐mos mRNA and estrogen occurred simultaneously with PMSG stimulation in the early phase of preovulatory oocytes, our present study revealed that gonadotropin and steroid hormones might affect c‐mos gene expression in mouse oocytes indirectly and/or directly.
Prenatal Diagnosis of Duchenne Muscular Dystrophy in the Japanese Population by Fluorescent CA Repeat Polymorphisms Analysis
Authors: Shiroshita Yoshiko , Katayama Susumu
Published: August 2010

Objective: To investigate the efficacy of CA repeat analysis using fluorescence‐labeled primers in the prenatal diagnosis of Duchenne muscular dystrophy in the Japanese population.

Methods: Allelic frequencies of polymorphic loci in the Duchenne muscular dystrophy gene were ascertained, and the polymorphic information content (PIC) was calculated. CA repeat analysis of 21 Japanese families with Duchenne muscular dystrophy was then performed.

Results: The STR 49 locus had the highest PIC, followed in decreasing order by the loci of STR 44, STR 45, STR 50, DYS III, DYS II, DYS I, and 3′ CA. The diagnostic applicability increased to 0.999 when the PICs of all 8 loci were combined. When the highest PIC from each of the 5′ end, exons near the 3′ end and the 3′ end were combined, the diagnostic applicability increased to 0.988. Of the 7 males examined prenatally, 1 was diagnosed as normal, and 6 were affected, while of the 9 females examined, 5 were diagnosed as carriers, and 4 as non‐carriers.

Conclusion: CA repeat analysis using fluorescence‐labeled primers is useful in the prenatal diagnosis of Duchenne muscular dystrophy in the Japanese population.
Emergence of an Irreversible Differentiated Subclone from the Poorly Differentiated Ovarian Adenocarcinoma Cell Line AMOC‐2 Treated with Sodium Butyrate
Authors: Yabushita Hiromitsu , Noguchi Masayoshi , Nakanishi Masami
Published: August 2010

Objective: To cast light on the capacity of an ovarian adenocarcinoma to undergo irreversible cellular differentiation, we established clonal cell lines from cultured ovarian carcinoma cells treated with sodium butyrate and examined their phenotypic changes.

Methods: The poorly differentiated ovarian carcinoma cell line AMOC‐2 was exposed to 2 mm sodium butyrate for 30 days, and clonal cell lines were established by a dilution plating technique.

Results: Five clonal cell lines were established. One of them had a longer doubling time and lower plating efficiency than the parental clone, also demonstrating stronger expression of vimentin and 56 kD cytokeratin. This clone became columnar with pronounced polarity, formed gland‐like structures when cultured in collagen gels, and exhibited no tumorigenicity, in contrast to the parental clone.

Conclusion: Sodium butyrate treatment of AMOC‐2 cells can cause phenotypic changes reminiscent of maturation in the Müllerian duct, endocervix, and/or endometrium.
Malignant Melanoma of the Uterine Cervix: A Case Report
Authors: Miyagi Yasunari , Yamada Shinako , Miyagi Yuji , Yamamoto Junko , Kawanishi Kunihiro , Yoshinouchi Mitsuo , Kodama Junichi , Kamimura Shigehito , Takamoto Norio , Kudo Takafumi , Taguchi Kohji
Published: August 2010

We present case of a 57‐year‐old Japanese woman a 9 cm‐size primary malignant melanoma of the uterine cervix. MRI demonstrated a low‐signal T1‐weighted spin echo image and hyperperfusion indicated by Gd‐DTPA enhancement. The sequence! analysis of the MTS1/CDK4I gene revealed no deletion or mutation. The results of cytological, pathological, and electron microscopy tests are also presented.
Postnatal Depression: A Prospective Study of Its Prevalence, Incidence and Psychosocial Determinants in an Israeli Sample
Authors: Fisch R. Z. , Tadmor O. P. , Dankner R. , Diamant Y. Z.
Published: August 2010

Objective: To assess the prevalence and incidence of postnatal depression and its relation to certain psychosocial factors.

Method: A questionnaire was administered to 327 randomly selected pregnant women on the first or second postpartum day A and again 6 to 12 weeks later B. The questionnaire comprised a psychosocial and demographic self‐report, and the 10‐item Edinburgh Postnatal Depression Scale (EPDS).

Results: At time A the prevalence of postnatal depression was 9.9–22.3%, and at time B it was 5.2–12.4% (p < 0.0001). Four of the psychosocial determinants examined correlated significantly with depression at times A and B. These factors were: a positive psychiatric history, Oriental ethnic origin, being foreign born, inconvenient timing of pregnancy.

Conclusion: Postnatal depression was less common than in most reported series. It was related to marital and social support, the circumstances of the pregnancy, and the degree of religious observance. Postnatal depression is a specific disorder, not equivalent to depression in the prenatal period.
A novel light‐dependent selection marker system in plants
Authors: Koh Serry , Kim Hongsup , Kim Jinwoo , Goo Eunhye , Kim Yun‐Jung , Choi Okhee , Jwa Nam‐Soo , Ma Jun , Nagamatsu Tomohisa , Moon Jae Sun , Hwang Ingyu
Published: August 2010

Photosensitizers are common in nature and play diverse roles as defense compounds and pathogenicity determinants and as important molecules in many biological processes. Toxoflavin, a photosensitizer produced by Burkholderia glumae, has been implicated as an essential virulence factor causing bacterial rice grain rot. Toxoflavin produces superoxide and H2O2 during redox cycles under oxygen and light, and these reactive oxygen species cause phytotoxic effects. To utilize toxoflavin as a selection agent in plant transformation, we identified a gene, tflA, which encodes a toxoflavin‐degrading enzyme in the Paenibacillus polymyxa JH2 strain. TflA was estimated as 24.56 kDa in size based on the amino acid sequence and is similar to a ring‐cleavage extradiol dioxygenase in the Exiguobacterium sp. 255‐15; however, unlike other extradiol dioxygenases, Mn2+and dithiothreitol were required for toxoflavin degradation by TflA. Here, our results suggested toxoflavin is a photosensitizer and its degradation by TflA serves as a light‐dependent selection marker system in diverse plant species. We examined the efficiencies of two different plant selection systems, toxoflavin/tflA and hygromycin/hygromycin phosphotransferase (hpt) in both rice and Arabidopsis. The toxoflavin/tflA selection was more remarkable than hygromycin/hpt selection in the high‐density screening of transgenic Arabidopsis seeds. Based on these results, we propose the toxoflavin/tflA selection system, which is based on the degradation of the photosensitizer, provides a new robust nonantibiotic selection marker system for diverse plants.
Taking post‐development theory to the field: Issues in development research, Northern Thailand
Authors: McKinnon Katharine
Published: August 2010

Emerging post‐development literatures consider how post‐structural and post‐colonial critiques of development could form the basis for new kinds of development practices. Much of the search for such post‐development possibilities draws on new theories of discourse. This paper considers the challenges of bringing together empirical research and the experience of doing development with the often ethereal and deeply speculative work of discourse theorists. I reflect on the course taken by my own research in Northern Thailand, and discuss the possibilities that can emerge as theory confronts empirics, and conceptual frameworks are transformed through the daily politics of fieldwork.
Power over, power to, power with: Shifting perceptions of power for local economic development in the Philippines
Authors: Cahill Amanda
Published: August 2010

Power has long been recognised as crucial to the sustainability of community development interventions; however, the way in which space affects power relations within such interventions has remained relatively under‐theorised in the development literature. Many practitioners continue to regard power as located centrally and as embedded in particular institutions, networks, knowledge and resources. According to this logic, processes of empowerment involve the redistribution of these resources to marginalised groups through their participation in development interventions such as microfinance and sustainable livelihood initiatives. The danger inherent in such development approaches is that they can discourage the potential for participants to use their own agency by overemphasising an existing lack of resources locally and inadvertently feeding a sense of dependency on formal development interventions initiated by external agencies. This paper suggests that a post‐structural conceptualisation of power as dynamic, multiple and mediated at the local level offers a more productive starting point for thinking about approaches to empowerment. Drawing on data from an action research project designed to initiate community enterprises in a small rural municipality in the Philippines, I suggest how a post‐structural approach to power can be enacted by building on the existing local resources and practices of everyday life.
Dutiful tourism: Encountering the Cambodian genocide
Authors: Hughes Rachel
Published: August 2010

This paper considers contemporary international tourism to a genocide museum in Phnom Penh, Cambodia. It argues that existing theorisations of ‘dark tourism’ are inadequate for the task of understanding the motivations, actions and experiences of visitors in such a place, or of such sites as contested international institutions. The paper is concerned with the ways in which visiting practices encouraged at the Tuol Sleng Museum of Genocide Crimes in the immediate post‐genocide period (the 1980s) continue to affect visiting practices in the present. Moreover, the absence of familiar curatorial practices and technologies of interpretation leads contemporary visitors to conceive of the space of the museum and their visit in unexpected ways. The dutiful comportment of visitors at Tuol Sleng both supports and challenges the moral geographies enacted by contemporary travel.
Geographic imaginations: Exploring divergent notions of identity, power, and place meaning on Pha‐ngan Island, Southern Thailand
Authors: Malam Linda
Published: August 2010

This paper explores contrasting narratives of place meaning in a tourism site in Southern Thailand. Specifically, I analyse the parallel discourses of community change through tourism development embedded in international backpacker narratives, and those of the local Thai elite. By configuring identity and power around binary oppositional categories such as West as economically powerful and dominant/non‐West as economically weak and subordinated, ‘traditional’ tourism studies often locate the dynamics of change in the international tourism industry. To date, there is little research on the very real and important ways that people working in tourism assert agency and understand their own identities in everyday contexts. I argue that local communities can, and often do, shape the changes that tourism development initiates in very creative and adaptive ways.