bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastrointestinaler Stroma-Tumor (GIST): Radiologische Bildgebung und Differentialdiagnosen
Authors: Zubler  , Fahrni  , Komminoth  , Kocher  , Kubik-Huch
Published: May 2007

Wir berichten über die präoperative radiologische Bildgebung bei einem 75-jährigen Patienten mit grossem Unterbauchtumor. Die Computertomographie zeigte eine grosse, scharf begrenzte, inhomogene mesenteriale Raumforderung im linken Unter- und Mittelbauch mit Einbezug der umliegenden Darmschlingen. Die Differentialdiagnose umfasste einen grossen Primärtumor (GIST, Lymphom), eine Metastase eines noch unbekannten Primärtumors oder einer komplizierten Mesenterialzyste. Die Histologie bestätigte einen gastrointestinalen Stroma-Tumor (GIST).
Products of trace methane oxidation during nonmethyltrophic growth by Methanosarcina
Authors: Moran James J. , House Christopher H. , Thomas B. , Freeman Katherine H.
Published: May 2007

Our understanding of the metabolic pathways involved in the anaerobic oxidation of methane (AOM) is challenged by not having an isolated anaerobic methanotroph. Fortunately, trace methane oxidation (TMO) is carried out by isolated organisms closely related to anaerobic methanotrophs. As TMO likely shares metabolic similarities with the AOM metabolism, studies of TMO in culture experiments can serve to enhance our understanding of AOM. Here we explored TMO in cultures of Methanosarcina acetivorans grown separately on acetate and carbon monoxide. We observed no methane oxidation to carbon dioxide in the cultures grown on acetate, but did observe methane oxidation to acetate (1.1 × 10−6 ± 3.5 × 10−8 moles CH4 oxidized, 0.10% of the CH4 produced). Methane was exclusively converted to the methyl position. Because AOM lipids exhibit strong 13C depletion in nature, our results imply acetate does not play a major role as an AOM intermediate. The carbon monoxide cultures showed little or no methane conversion to carbon dioxide (1.9 × 10−7 ± 2.0 × 10−7 moles CH4 oxidized), moderate methane oxidation to acetate (1.8 × 10−7 ± 7.3 × 10−8 moles CH4 oxidized, 0.14% of biogenic CH4 production), and high methane conversion to the methyl groups of product methyl sulfides (4.0 × 10−6 ± 7.7 × 10−7 moles CH4 oxidized, 3.1% of biogenic CH4 production). Taken together, our results identify methyl sulfides as more likely intermediates in natural AOM than acetate.
Transmissivity upscaling in numerical aquifer models of steady well flow: Unconditional statistics
Authors: Dagan G. , Lessoff S. C.
Published: May 2007

Numerical solution of regional‐scale aquifer flow requires discretizing the transmissivity T. Typically, the numerical element scale R and the transmissivity integral scale I are both of the order of hundreds of meters. Then the upscaled block transmissivity is random, and its statistical moments depend on those of T, on flow conditions, and on R/I. Modeling Y = ln T as a two‐dimensional normally distributed stationary random field, we derive unconditional statistics of the upscaled = ln accurate to the first order in σY2 for strongly nonuniform flow in a circular block of radius R centered on a well of radius rw in an unbounded domain. After a proper definition, it was found that the ensemble mean 〈〉 is approximately but not exactly equal to ln TG (the geometric mean) and that the variance ratio 2/σY2, which depends on rw/I and the shape of the correlation ρ, drops slowly from unity for R/I = 0 to approximately 0.6 for R/I = 10. Hence the variance of the upscaled transmissivity in radial flow is larger than that determined previously for uniform flow. Additionally, defining the equivalent Teq as a deterministic value for which the solution of the flow problem renders directly the mean upscaled head drop and specific discharge, we find that in radial flow Teq ≅ TH the harmonic mean and grows slowly with increasing R/I, whereas for mean uniform flow Teq = TG. Application of the procedure is illustrated for an example of aquifer with selected values of parameters.
Relation between fractional flow models and fractal or long‐range 2‐D permeability fields
Authors: de Dreuzy Jean‐Raynald , Davy Philippe
Published: May 2007

Fractional flow models introduced by Barker (1988) have been increasingly popular as means of interpreting nonclassical drawdown curves obtained from well tests. Fractional flow models are intrinsically isotropic scaling models depending to first order on two exponents n and dw expressing the dimension of the structure available to flow and the flow slowdown, respectively. We study the fractional flow induced either by geometrically scaling structures such as Sierpinski‐ and percolation‐like fractal media or by hydraulically scaling media such as long‐range continuous correlated media. First, percolation and Sierpinski structures have two well‐separated dw values in the range [2.6, 3] and [1.9, 2.5], respectively. The bottlenecks, characteristic of percolation, induce a more anomalous transport (larger dw values) than the impervious zones present at all scales of Sierpinskis. Second, the realization‐based values of n and dw depend both on global and on local characteristics like the fractal dimension and the permeability around the well, respectively. Finally, solving the inverse problem on anomalous transient well test responses consists in comparing the (n, dw) realization‐based values with field data. Indeed, well tests performed from a unique pumping well must be taken as realization‐based results. For the site of Ploemeur (Brittany, France), from which n and dw have been previously determined (Le Borgne et al., 2004), the only consistent model is given by the continuous multifractals. However, the values obtained from continuous multifractals cover most of the (n, dw) plane, and realization‐based results are not selective in terms of model. So this should be replaced by the comparison of (n, dw) values averaged over different pumping well locations, which however requires a significantly larger quantity of field tests.
Chylomicron remnants: mediators of endothelial dysfunction?
Authors: Wheeler-Jones C.P.D.
Published: May 2007

Vascular disease is initiated by activation of the endothelium characterized by the predominance of pro-inflammatory and pro-coagulant changes in endothelial cells (ECs) referred to collectively as ‘endothelial dysfunction’. There is increasing evidence that lipoproteins of dietary origin modulate EC function and the use of artificial chylomicron remnant-like particles (CRLPs) in vitro is now beginning to shed light on the molecular mechanisms through which these particles influence cell behaviour. CRLPs enriched in n−6 PUFAs (polyunsaturated fatty acids) influence the production of vasoactive mediators by ECs in a pro-inflammatory manner. Thus CRLPs reduce the synthesis and release of nitric oxide and alter the balance of release of vasodilator versus vasoconstrictor eicosanoids. These changes are accompanied by induction of cyclo-oxygenase-2 expression and activity as well as increased expression of adhesion molecules and the antioxidant defence enzyme haem oxygenase-1. CRLPs also activate a number of intracellular signalling pathways, including NF-κB (nuclear factor κB) and MAPKs (mitogen-activated protein kinases), which may be involved in mediating their effects on gene expression. The effects of CRLPs on EC behaviour can also be modulated by the type of fat/oxidation status of the particles. These findings support the hypothesis that lipoproteins of dietary origin directly regulate molecular events in the vascular wall.
Postprandial inflammation and endothelial dysfuction
Authors: Alipour A. , Elte J.W.F. , van Zaanen H.C.T. , Rietveld A.P. , Cabezas M. Castro
Published: May 2007

Postprandial hyperlipidaemia is a common metabolic disturbance in atherosclerosis. During the postprandial phase, chylomicrons and their remnants can penetrate the intact endothelium and cause foam cell formation. These particles are highly atherogenic after modification. People in the Western world are non-fasting for most of the day, which consequently leads to a continuous challenge of the endothelium by atherogenic lipoproteins and their remnants. Furthermore, atherosclerosis is considered a low-grade chronic inflammatory disease. Many studies have shown that the process of atherogenesis in part starts with the interaction between the activated leucocytes and activated endothelium. Postprandial lipoproteins can activate leucocytes in the blood and up-regulate the expression of leucocyte adhesion molecules on the endothelium, facilitating adhesion and migration of inflammatory cells into the subendothelial space. Another inflammatory process associated with postprandial lipaemia is the activation of the complement system. Its central component C3 has been associated with obesity, coronary sclerosis, the metabolic syndrome and fasting and postprandial TAGs (triacylglycerols). Moreover, chylomicrons are the strongest stimulators of adipocyte C3 production via activation of the alternative complement cascade. A postprandial C3 increment has been shown in healthy subjects and in patients with CAD (coronary artery disease) and with FCHL (familial combined hyperlipidaemia). Postprandial lipaemia has been related to TAG and free fatty acid metabolism. All of these mechanisms provide an alternative explanation for the atherogenicity of the postprandial period.
Self-assembly in the carboxysome: a viral capsid-like protein shell in bacterial cells
Authors: Yeates T.O. , Tsai Y. , Tanaka S. , Sawaya M.R. , Kerfeld C.A.
Published: May 2007

Many proteins self-assemble to form large supramolecular complexes. Numerous examples of these structures have been characterized, ranging from spherical viruses to tubular protein assemblies. Some new kinds of supramolecular structures are just coming to light, while it is likely there are others that have not yet been discovered. The carboxysome is a subcellular structure that has been known for more than 40 years, but whose structural and functional details are just now emerging. This giant polyhedral body is constructed as a closed shell assembled from several thousand protein subunits. Within this protein shell, the carboxysome encapsulates the CO2-fixing enzymes, Rubisco (ribulose-1,5-bisphosphate carboxylase/oxygenase) and carbonic anhydrase; this arrangement enhances the efficiency of cellular CO2 fixation. The carboxysome is present in many photosynthetic and chemoautotrophic bacteria, and so plays an important role in the global carbon cycle. It also serves as the prototypical member of what appears to be a large class of primitive protein-based organelles in bacteria. A series of crystal structures is beginning to reveal the secrets of how the carboxysome is assembled and how it enhances the efficiency of CO2 fixation. Some of the assembly principles revealed in the carboxysome are reminiscent of those seen in icosahedral viral capsids. In addition, the shell appears to be perforated by pores for metabolite transport into and out of the carboxysome, suggesting comparisons to the pores through oligomeric transmembrane proteins, which serve to transport small molecules across the membrane bilayers of cells and eukaryotic organelles.
The emerging role of serine proteases in apoptosis
Authors: Moffitt K.L. , Martin S.L. , Walker B.
Published: May 2007

Unregulated apoptosis can be due to a disruption in the balance and control of both intra- and inter-cellular proteolytic activities leading to various disease states. Many proteases involved in apoptotic processes are yet to be identified; however, several are already well characterized. Caspases traditionally held the predominant role as prime mediators of execution. However, latterly, evidence has accumulated that non-caspases, including calpains, cathepsins, granzymes and the proteasome have roles in mediating and promoting cell death. Increasingly, research is implicating serine proteases within apoptotic processing, particularly in the generation of nuclear events such as condensation, fragmentation and DNA degradation observed in late-stage apoptosis. Serine proteases therefore are emerging as providing additional or alternative therapeutic targets.
New opportunities for protease ligand-binding site comparisons using SitesBase
Authors: Gold N.D. , Deville K. , Jackson R.M.
Published: May 2007

The rapid expansion of structural information for protein ligand-binding sites is potentially an important source of information in structure-based drug design and in understanding ligand cross-reactivity and toxicity. We have developed SitesBase, a comprehensive database of ligand-binding sites extracted automatically from the Macromolecular Structure Database. SitesBase is an easily accessible database which is simple to use and holds pre-calculated information about structural similarities between known ligand-binding sites. These similarities are presented to the wider community enabling binding-site comparisons for therapeutically interesting protein families, such as the proteases and for new proteins to enable the discovery of interesting new structure–function relationships. The database is available from http://www.modelling.leeds.ac.uk/sb/.
Inheritance of an epigenetic change in the mouse: a new role for RNA
Authors: Rassoulzadegan M. , Grandjean V. , Gounon P. , Cuzin F.
Published: May 2007

Hereditary epigenetic variation, initially recognized and studied extensively in plants, had not been reported in mammals until recently. We have now identified the Kit locus as the first example of a paramutable gene of the mouse. Kit+/+ homozygotes born from Kittm1Alf/+ heterozygotes maintain and transmit to their progeny the white-spotted phenotype characteristic of the mutant heterozygote. Our observation of unusual amounts of RNA in the sperm of the paramutated (Kit*) males had led us to consider the possibility of RNA-mediated inheritance. A role for RNA was supported further by the efficient establishment of the epigenetic modification following microinjection in one-cell embryos of either sperm RNA of the paramutated males or of the Kit-specific microRNAs miR-221 and -222. In this article, we describe the phenotypes associated with the wild-type genome in the Kit* paramutated animals. Paramutation may be considered to be one possibility of epigenetic modification in the case of familial disease predispositions that are not fully accounted for by Mendelian analysis.
RNA dynamics of fertile and infertile spermatozoa
Authors: Carreau S. , Lambard S. , Said L. , Saad A. , Galeraud-Denis I.
Published: May 2007

The presence of a complex population of mRNAs in human mature spermatozoa is well documented; among them, transcripts of aromatase and ERs (oestrogen receptors) have been described but their significance is not clear. Therefore, to clarify the role of this complex population of mRNAs in human ejaculated sperm, we have isolated on discontinuous density gradients two main fractions from the same sample: high- and low-motile spermatozoa. The levels of different transcripts coding for molecules involved in nuclear condensation [Prm-1 (protamine 1) and Prm-2], capacitation [eNOS (endothelial nitric oxide synthase), nNOS (neuronal nitric oxide synthase), c-myc], motility and sperm survival (aromatase) have been assessed using semi-quantitative RT (reverse transcriptase)–PCR. The viability of sperm as well as the percentage of apoptosis were identical in high- and low-motile fractions. No significant change in the c-myc/Prm-2 ratio between the two populations of spermatozoa was observed. Conversely the amount of Prm-1 mRNA was significantly higher in low-motile than in high-motile fraction; in most of the high-motile sperm samples analysed, eNOS and nNOS transcripts were undetectable, whereas they were observed in low-motile sperm. Moreover, a partial or complete disappearance of c-myc transcripts was observed after capacitation. As to the aromatase expression, a significant decrease in the amount of transcripts in immotile sperm fraction was recorded in all samples studied. To conclude, analysing mRNA profiles in humans could be helpful either as a diagnostic tool to evaluate male fertility, since they reflect spermatogenesis gene expression, and/or a prognosis value for fertilization, since these RNAs are delivered to oocytes.
Density effect on proton acceleration from carbon-containing high-density thin foils irradiated by high-intensity laser pulses
Authors: Zhou C. T. , Yu M. Y. , He X. T.
Published: May 2007

The acceleration of protons in dense plastic foils irradiated by ultrahigh intensity laser pulses is simulated using a two-dimensional hybrid particle-in-cell scheme. For the chosen parameters of the overdense foils of densities ρ=0.2, 1, and 3 g∕cm3 and of an ultrahigh intensity (2×1020 W∕cm2) laser pulse, our simulations illustrate that a high-density target is favorable to high collimation of the target-normal-sheath acceleration protons but less energy for a short acceleration time (<100 fs). In particular, the difference of strong local heating of the carbon ion for different plasma densities is clearly observed at both the front and rear surfaces of thin solid targets, suggesting that the effect of the density and composition of the targets are also important for correctly simulating energetic ion generation in ultraintense laser-solid interactions.
Millimeter wave carbon nanotube gas sensor
Authors: Dragoman M. , Grenier K. , Dubuc D. , Bary L. , Plana R. , Fourn E. , Flahaut E.
Published: May 2007

This Letter reports experimental observations regarding the significant changes in the transmission modulus and phase of the propagating microwave signals up to 110 GHz in a micromachined coplanar waveguide supported on a dielectric membrane with a thickness of 1.4 μm filled with a mixture of carbon nanotubes when exposed to nitrogen gas. These large shifts of amplitude and phase of microwave signals due to gas absorption represent the experimental basis on which a miniature wireless gas sensor could be implemented.
Work function variation of nickel silicide using an ytterbium buffer layer for Schottky barrier metal-oxide-semiconductor field-effect transistors
Authors: Lee Won-Jae , Kim Do-Woo , Oh Soon-Young , Kim Yong-Jin , Zhang Ying-Ying , Zhong Zhun , Li Shi-Guang , Jung Soon-Yen , Han In-Sik , Gu Tae-kyu , Bae Tae-Sung , Lee Ga-Won , Wang Jin-Suk , Lee Hi-Deok
Published: May 2007

In this article, incorporating ytterbium into Ni-silicide using an Yb interlayer is proposed to reduce the work function of Ni-silicide for a Ni-silicided Schottky barrier diode. The proposed Ni-silicide exhibited good Schottky barrier diode characteristics owing to the reduced work function of about 0.15−0.38 eV. Even though the ytterbium layer was deposited below nickel, a ternary phase (YbxNi1−x)Si is formed at the top region of the Ni-silicide, which is believed to reduce the work function.
Ab initio potential energy surface and spectrum of the B(Π3) state of the HeI2 complex
Authors: Valdés Álvaro , Prosmiti Rita , Villarreal Pablo , Delgado-Barrio Gerardo , Werner Hans-Joachim
Published: May 2007

The three-dimensional interaction potential for I2(BΠ0u+3)+He is computed using accurate ab initio methods and a large basis set. Scalar relativistic effects are accounted for by large-core relativistic pseudopotentials for the iodine atoms. Using multireference configuration interaction calculations with subsequent treatment of spin-orbit coupling, it is shown for linear and perpendicular structures of the complex that the interaction potential for I2(BΠ0u+3)+He is very well approximated by the average of the A′3 and A″3 interaction potentials obtained without spin-orbit coupling. The three-dimensional A′3 and A″3 interaction potentials are computed at the unrestricted open-shell coupled-cluster level of theory using large basis sets. Bound state calculations based on the averaged surface are carried out and binding energies, vibrationally averaged structures, and frequencies are determined. These results are found to be in excellent accord with recent experimental measurements from laser-induced fluorescence and action spectra of HeI2. Furthermore, in combination with a recent X-state potential, the spectral blueshift is obtained and compared with available experimental values.
Dislocation reduction in GaN with multiple MgxNy∕GaN buffer layers by metal organic chemical vapor deposition
Authors: Tun C. J. , Kuo C. H. , Fu Y. K. , Kuo C. W. , Pan C. J. , Chi G. C.
Published: May 2007

Unintentionally doped GaN epitaxial layers with a conventional single low temperature (LT) GaN buffer layer and with multiple MgxNy∕GaN buffer layers were grown on sapphire substrates by metal organic chemical vapor deposition. The multiple MgxNy∕GaN buffer layers exhibit a low nuclei density, increasing the volume of defect-free regions and reducing the dislocations associated with the grain boundaries. Therefore, the GaN with multiple MgxNy∕GaN buffer layers reveals an asymmetrical reflection (102) with a small full width at half maximum, and a higher mobility, lower background concentration, and lower etching pit density than the GaN with the LT GaN buffer layer.
Prevalence of Chlamydia trachomatis in a public colposcopy clinic population
Authors: Petersen Rodney W. , Tabrizi Sepehr N. , Garland Suzanne , Quinlivan Julie A.
Published: May 2007

Background: Chlamydia trachomatis is a major public health issue, with notifications of this sexually transmitted disease continuing to rise in Australia. Women attending colposcopy clinics are referred for treatment of cervical abnormalities often associated with human papilloma virus (HPV) infection. There is evidence that women who have acquired one sexually transmitted infection, such as HPV, are at higher risk of acquiring another. Women attending colposcopy clinics may therefore be at risk of undiagnosed infection with C. trachomatis. Aim: To determine the prevalence of C. trachomatis in women attending a public metropolitan colposcopy clinic in Victoria. Methods: A cross-sectional study was performed. Institutional ethics committee approval and informed consent were obtained. Consecutive women attending the colposcopy clinic completed a questionnaire and had a swab collected from the endocervix for analysis by polymerase chain reaction for C. trachomatis. Positive screens were treated in accordance with best practice. Data were analysed with Minitab Version 2004 (Minitab Inc, State College, PA, USA). Results: Of 581 women approached to participate in the trial, consent was obtained from 568 women (98%) and final outcome data was available on 560 women (99%). The overall rate of chlamydial infection was 2.1% (95% CI 1.5–2.7%). However, in women aged 25 years or less the rate was 5.8% (95% CI 3.8–7.8%) and in women over 25 years it was only 0.9% (95% CI 0.4–1.4%). Apart from age, no other demographic factor was significantly associated with chlamydial infection. Conclusion: Although the prevalence of chlamydial infection in the colposcopy clinic population as a whole does not warrant a policy for routine screening, screening directed at women aged 25 years or less would gain the greatest yields in terms of cost efficacy. Such a policy should be implemented as standard practice.
Up-regulation of heat shock proteins is essential for cold survival during insect diapause
Authors: Rinehart Joseph P. , Li Aiqing , Yocum George D. , Robich Rebecca M. , Hayward Scott A. L. , Denlinger David L.
Published: May 2007

Diapause, the dormancy common to overwintering insects, evokes a unique pattern of gene expression. In the flesh fly, most, but not all, of the fly's heat shock proteins (Hsps) are up-regulated. The diapause up-regulated Hsps include two members of the Hsp70 family, one member of the Hsp60 family (TCP-1), at least four members of the small Hsp family, and a small Hsp pseudogene. Expression of an Hsp70 cognate,
Hsc70
, is uninfluenced by diapause, and
Hsp90
is actually down-regulated during diapause, thus diapause differs from common stress responses that elicit synchronous up-regulation of all Hsps. Up-regulation of the Hsps begins at the onset of diapause, persists throughout the overwintering period, and ceases within hours after the fly receives the signal to reinitiate development. The up-regulation of Hsps appears to be common to diapause in species representing diverse insect orders including Diptera, Lepidoptera, Coleoptera, and Hymenoptera as well as in diapauses that occur in different developmental stages (embryo, larva, pupa, adult). Suppressing expression of
Hsp23
and
Hsp70
in flies by using RNAi did not alter the decision to enter diapause or the duration of diapause, but it had a profound effect on the pupa's ability to survive low temperatures. We thus propose that up-regulation of Hsps during diapause is a major factor contributing to cold-hardiness of overwintering insects.
A1 adenosine receptors play an essential role in protecting the embryo against hypoxia
Authors: Wendler Christopher C. , Amatya Salina , McClaskey Carolyn , Ghatpande Satish , Fredholm Bertil B. , Rivkees Scott A.
Published: May 2007

Embryos can be exposed to environmental factors that induce hypoxia. Currently, our understanding of the effects of hypoxia on early mammalian development is modest. Potential mediators of hypoxia action include the nucleoside adenosine, which acts through A
1
adenosine receptors (A
1
ARs) and mediates adverse effects of hypoxia on the neonatal brain. We hypothesized that A
1
ARs may also play a role in mediating effects of hypoxia on the embryo. When pregnant dams were exposed to hypoxia (10% O
2
) beginning at embryonic day (E) 7.5 or 8.5 and continued for 24–96 h, A
1
AR+/+ embryos manifested growth inhibition and a disproportionate reduction in heart size, including thinner ventricular walls. Yet, when dams were exposed to hypoxia, embryos lacking A
1
ARs (A
1
AR−/−) had much more severe growth retardation than A
1
AR+/+ or +/− embryos. When levels of hypoxia-inducible factor 1α (HIF1α) were examined, A
1
AR−/− embryos had less stabilized HIF1α protein than A
1
AR+/− littermates. Normal patterns of cardiac gene expression were also disturbed in A
1
AR−/− embryos exposed to hypoxia. These results show that short periods of hypoxia during early embryogenesis can result in intrauterine growth retardation. We identify adenosine and A
1
ARs as playing an essential role in protecting the embryo from hypoxia.
Feasibility study of using fetal DNA in maternal plasma for non‐invasive prenatal diagnosis
Authors: LIU FU‐MIN , WANG XIU‐YING , FENG XIA , WANG WEN , YE YUE‐XIAN , CHEN HONG
Published: May 2007

Background. The discovery of the presence of fetal genetic material in maternal blood has opened up a new approach to prenatal diagnosis. One approach that has been extensively investigated over the past few decades is the isolation of fetal cells from maternal blood (Herzenberg et al. Proc Natl Acad Sci USA. 1979;76:1453–5; Bianchi et al. Proc Natl Acad Sci USA. 1990;87:3279–83; Cha et al. Prenat Diagn. 2005;25:586–91). As the fetal cells are scarce and the enrichment is of low efficiency, the technique could not be implemented in clinics. In 1997, Lo et al. (Lancet 1997;350(9076):485–7) discovered that cell‐free fetal DNA is present in the plasma and serum of pregnant women. This discovery suggests that maternal plasma/serum DNA may be a useful source of material for non‐invasive prenatal diagnosis. The objective of our study was to investigate the feasibility of using fetal DNA in maternal plasma for prenatal diagnosis. Methods. Plasma DNA in 277 blood samples of 40 pregnant women at the gestational period from 5 to 40 weeks and 24 h after delivery were extracted by column separation. FQ‐PCR was used to amplify the SRY sequence in 237 plasma samples of 30 pregnant women. Fluorescent PCR was used to amplify 9 short tandem repeat loci simultaneously in 40 plasma samples of 10 pregnant women, and genomic DNA samples from their husbands were amplified by the same method. Results. The fetal SRY sequence could be detected from the 7th week of gestation, with a concentration that increased with progressing gestational age, attaining its highest peak before delivery. Twenty‐four hours after delivery, fetal SRY sequence could not be detected in the maternal plasma. The concordance rate of the SRY sequence amplification results of plasma‐free DNA, with real fetal gender was 100%. Analysis of maternal plasma samples collected during pregnancy revealed the presence of paternally inherited fetal‐specific alleles. Among the 30 collected plasma samples, fetal‐specific alleles were detected in 23 plasma DNA samples. The rate of positive results was 76% (23/30), and the frequency of positive results was 6/10 in early pregnancy, 8/10 in middle pregnancy, and 9/10 in late pregnancy. Short tandem repeats could not be detected from the maternal plasma 24 h after delivery. Conclusion. Fluorescent PCR can be used for amplification of fetal SRY sequence and STRs in maternal plasma to obtain fetal genetic information, which may have implications for non‐invasive prenatal diagnosis of certain hereditary diseases.
Upright position during the first stage of labor: a randomised controlled trial
Authors: MIQUELUTTI MARIA AMELIA , CECATTI JOSE GUILHERME , MAKUCH MARIA YOLANDA
Published: May 2007

Background. Evaluation of the upright position during the first stage of labor on pain, patient satisfaction, obstetrical and perinatal outcomes in nullipara women. Methods. This prospective, randomised, controlled trial included a group of 54 women who were informed and encouraged to adopt the upright position, and a control group of 53 women who were not given this information. The difference between groups was evaluated using the χ2, Wilcoxon and Fisher's Exact tests. Significance was defined as p<0.05. Risk ratios and 95% confidence intervals were calculated. Results. No statistically significant differences were found between the groups in baseline characteristics, obstetrical and perinatal outcomes; however, there was a preference among women in both groups for the upright position. Conclusions. The upright position during the first stage of labor did not contribute towards a shorter duration of labor; however, it proved to be a safe and well‐accepted option for the women of this study.
An exploratory, descriptive study of women's experiences of hospital admission during pre‐term labor
Authors: BARLOW JULIE H , HAINSWORTH JENNY M , THORNTON STEVEN
Published: May 2007

Background. Rarely have women's experiences of admission to hospital during pre‐term labor (PTL) been described from their own perspective. This study aimed to address this issue using qualitative methods. Methods. The views of 8 women admitted to hospital with PTL were obtained through semi‐structured interviews. Issues explored included understanding of their condition, expectations concerning delivery, and their views about hospital admission. Results. A key aspect of women's experiences concerned their search for meaning to help them make sense of their sudden and unexpected hospital admission. Several women continued to feel anxious despite assurances from staff that everything was ‘OK’, whereas others had overcome initial anxiety and were excited about the imminent birth. There was consensus that the information received whilst in hospital was inconsistent, and some women believed that their concerns were being ‘ignored’. Some women attributed PTL to daily stress, such as working long hours. Social support from women's mothers and other patients appeared important. Several women had been ambivalent about their pregnancy in the early stages, but were now in a place of acceptance. Two women reported previous childbirth experiences that were viewed as distressing. PTL had motivated some women to re‐evaluate their lifestyle. Conclusions. Women admitted to hospital in PTL could be assisted in their search for meaning by provision of consistent information, having their views acknowledged, satisfactory social support, and dealing with any previous history of perceived traumatic birth experiences.
Pregnancy‐related deaths due to pulmonary embolism in Sweden
Authors: SAMUELSSON EVA , HELLGREN MARGARETA , HÖGBERG ULF
Published: May 2007

Background. The objective of this study was to report deaths from amniotic fluid embolism (AFE) and pregnancy‐related venous thromboembolism (VTE), to study contributing factors, and to analyse mortality trends. Methods. Using the Swedish Cause of Death Register (CDR), we identified all women aged 15–44, who died during 1990–1999, with VTE or AFE coded as the underlying or contributory cause of death. We scrutinised medical records, and women who had died during pregnancy or within 6 weeks of terminated pregnancy were included. We also used data from the Medical Birth Register (MBR) on incident and fatal cases. Mortality data from the 1970s and 1980s were based on previous studies, in which cases were identified through register linkage (CDR and MBR). Results. Five women died of AFE and 10 of VTE – 6 in early pregnancy – during the 1990s. Five of the cases were not registered as maternal deaths. Only 4 cases were reported as pregnancy‐related deaths from pulmonary embolism (PE). Cesarean section/surgery without thromboprophylaxis, overweight, severe intercurrent disease, delays in seeking health care, and verbal miscommunication were contributing factors in the VTE cases. VTE mortality rates (pregnancy >28 weeks and/or a registered birth) were 1.0 (0.5–1.8), 0.8 (0.3–1.6), and 0.4 (0.1–1.0) per 100,000 live births during the 1970s, 1980s and 1990s, respectively; the corresponding respective figures for AFE were 1.0 (0.5–1.8), 1.1 (0.6–2.1), and 0.5 (0.2–1.1) per 100,000 live births. The case fatality rate for VTE decreased from 4.5% in the 1970s, to 0.6% in the 1990s, paralleled with quadrupled incidence. The case fatality rate for AFE was unaltered and high, around 45%, during those 3 decades. Conclusions. Mortality from pregnancy‐related PE in Sweden is in the lowest range ever reported, and shows a downward trend during the 1990s, with a shift towards early pregnancy. In order to monitor mortality trends, death certificate quality must improve, and registers must be linked routinely.
Abnormal fetal growth is associated with gestational diabetes mellitus later in life: population‐based register study
Authors: CLAESSON RICHARD , ÅBERG ANDERS , MARŠÁL KAREL
Published: May 2007

Background. Increasing evidence has been collected that intrauterine growth restriction is associated with development of type‐2 diabetes mellitus in adult life. The present study was designed to test the hypothesis that abnormal intrauterine growth of female fetuses correlates with their future risk of developing gestational diabetes mellitus (GDM). Methods. Population‐based register study of the data from the Swedish Medical Birth Registry; perinatal data from 1973 to 1983 were linked with the diagnosis of GDM during 1987–2001. 421 women with GDM diagnosis were compared to 60,890 controls with regard to maternal age and parity, maternal education (data from the Education Register of Statistics Sweden), maternal diagnosis of diabetes, gestational duration, birth weight, and gestational age‐related birth weight. Results. There was a significant association between low (odds ratio (OR): 2.15, 95% confidence interval (CI): 1.29–3.50), as well as high (OR: 1.97, 95% CI: 1.12–3.45) birth weight and later development of GDM. There was a U‐shaped relation between the gestational age‐related birth weight and risk of developing GDM. A young mother and prematurity increased the risk of the offspring developing GDM. Nine of the 421 women (2.1%) with GDM were born to mothers who had a diagnosis of diabetes. The corresponding figures for the controls were 205 of 60,890 (0.3%). Conclusion. Intrauterine conditions and/or genetic disposition, which affect prenatal growth, increase the future risk of the female fetus developing GDM.
Is there a correlation between tumor marker panel and tumor size and histopathology in well staged patients with borderline ovarian tumors?
Authors: AYHAN ALI , GUVEN SULEYMAN , GUVENDAG GUVEN EMINE SEDA , KUCUKALI TURKAN
Published: May 2007

Aims. To investigate whether there is a correlation between serum tumor markers panel (CA 125, CA 19‐9, CA 15‐3, and carcinoembryonic antigen (CEA)) and tumor size and histopathology in well staged patients with borderline ovarian tumors (BOTs). Methods. Four tumor markers (CA 125, CA 19‐9, CA 15‐3, and CEA) were analysed clinically in 60 well staged patients with borderline ovarian tumor, for this retrospective observational study. Results. Most patients had serous histology and early stage disease, and the mean age at the time of diagnosis was 40.70 years (range: 19–73). Twenty‐nine patients (48.3%) had high CA 125 levels (>35 U/l), 15 patients (25%) had high levels of CEA (>4 ng/ml), 12 patients (20%) had high levels of CA 19‐9 (>37 U/ml), and 9 patients (15%) had high levels of CA 15‐3 (>30 ng/ml) at the time of initial surgery. The positive rate of CA 125, CA 19‐9, CA 15‐3, and CEA in serous tumor were 57.9, 7.9, 7.9 and 15.8%, respectively. These figures were 31.8, 40.9, 27.3 and 40.9% in mucinous tumor. The positive rate of CA 125 in the serous group was statistically significantly higher than that in the mucinous group, while the positive rates for CA 19‐9 and CEA in mucinous histology was significantly higher than those in serous tumors. In case of grouping the tumor size as <4, 4.1‐10 and >10 cm, the mean serum levels of tumor markers had significantly increased by increasing tumor size (p<0.05 for CA 125, and CA 19‐9, p>0.05 for CA 15‐3, and CEA). Conclusion. The high levels of tumor markers, especially for CA 125 and CA 19‐9, may indicate the larger tumor size. The elevation of serum CA 125 may suggest serous tumors, while the high level of serum CA 19‐9 and CEA may indicate mucinous BOTs.
Ultrasound screening for fetal major abnormalities at 11–14 weeks
Authors: DANE BANU , DANE CEM , SIVRI DERYA , KIRAY MURAT , CETIN AHMET , YAYLA MURAT
Published: May 2007

Background. This study was planned to evaluate the efficiency of the 11–14 week scan in detecting fetuses with major fetal structural abnormalities. Methods. Some 1,290 pregnant women were submitted to a routine ultrasound scan between the 11th and 14th week after the detection of the fetal viability. The fetal anatomy was examined transabdominally, and in suspected cases transvaginally. Following the scans, the patients were examined in the second or third trimester of pregnancy. Fetal structural abnormalities classified as major and early onset were noted. Isolated choroid plexus cysts, cardiac defects not requiring treatment, mild ventriculomegaly, and mild renal pelviectasis in second trimester were not included. Results. Twenty‐four (1.86%) fetuses with various defects were identified, and 17 of these were diagnosed at the 11–14 week scan. The antenatal ultrasound detection rate of the fetuses with major anomalies was 95%, and 70% were detected in the first‐trimester assessment. Four cardiac defects associated with genetic syndromes or requiring operation were included (0.31%) in this series. Two of the fetuses with cardiac defects (50%) had an increased nuchal translucency thickness. In this group, none of the fetuses with karyotype anomalies was born alive. Conclusions. The first‐trimester scan is important in routine antenatal care for early detection of fetal defects, and determination of the fetuses at risk of cardiac anomalies and genetic syndromes.
Loop electrosurgical excision of the cervix and the subsequent risk of preterm delivery
Authors: NØHR BUGGE , TABOR ANN , FREDERIKSEN KIRSTEN , KRÜGER KJÆR SUSANNE
Published: May 2007

Objectives. To investigate the association between loop electrosurgical excision procedure (LEEP) and other potential risk factors, and subsequent preterm delivery (<37 weeks), using data from a large cohort study of Danish women. Methods. The Danish prospective cohort study was initiated in 1991, with the original aim of investigating the role of human papillomavirus in the natural history of cervical neoplasia. The study included 11,088 women aged 20–29. The cohort was invited for 2 follow‐up examinations in 1993–1995 and 1999–2000, respectively. At all 3 examinations, the women answered questions about a number of different lifestyle variables. We assessed the relationship between preterm delivery and potential risk factors, such as previous LEEP treatments, smoking during pregnancy, age, parity and previous preterm delivery. The cohort was followed until 2004, through linkages with the nationwide Pathology Data Bank and the Medical Birth Registry. Results. Of the 14,982 deliveries in the cohort during follow up, 542 were preterm (21–37 weeks). Among deliveries with no previous LEEP, 3.5% ended as a preterm delivery, whereas this applied to 6.6% among deliveries following a LEEP, yielding a significantly increased risk of preterm birth after LEEP (OR = 1.8; 95% CI: 1.1–2.9). The strongest risk factor for preterm delivery was a previous preterm delivery (OR = 2.3; 95% CI: 1.4–3.7). Other significant risk factors were smoking during pregnancy and low educational status. Conclusion. Our study showed an almost 2‐fold increase in the risk of preterm delivery after LEEP treatment. Thus, women in their reproductive age should be informed about the increased risk of preterm delivery, if treated with LEEP.
Good accuracy of ultrasound estimations of fetal weight performed by midwives
Authors: MATTSSON NINA , ROSENDAHL HENRIK , LUUKKAALA TIINA
Published: May 2007

Background. This study was undertaken to evaluate the quality of ultrasound estimation of fetal weight when performed by midwives experienced in ultrasound examinations. We also examined whether the accuracy was affected by fetal presentation, twin pregnancy or birth weight category. The results of 5 different formulas were compared to determine which was most accurate in our study population. Methods. The study population consisted of 620 fetuses in 607 pregnancies, on whom fetal weight estimations had been performed within 3 days prior to delivery. The group of twins (n = 27) was analysed separately. Results achieved by Hadlock 2 formula used in our unit were compared with 4 other widely used formulas for estimation of fetal weight. Results. With Hadlock 2 formula, mean absolute percent error was 6.2% and SD of error was 7.6% of mean birth weight. A total of 81% of estimates were within 10% of the actual birth weight. All the formulas tended to overestimate the weight of twins and fetuses weighing <2,500 g, and underestimate the weight of fetuses >4,000 g. Presentation of the fetus did not significantly influence the accuracy. The formula Hadlock 2, using 3 parameters (biparietal diameter, abdominal circumference and femur length) gave the highest ICC of 0.910. Conclusions. Ultrasound estimation of fetal weight performed by midwives is feasible and of similar accuracy as in the original studies. Major errors may occur both in small and large birth weight groups.
Vaginal sacrospinous colpopexy and laparoscopic sacral colpopexy for vaginal vault prolapse
Authors: MARCICKIEWICZ J. , KJÖLLESDAL M. , ELLSTRÖM ENGH M. , EKLIND S. , AXÉN C. , BRÄNNSTRÖM M. , STJERNDAHL J.‐H.
Published: May 2007

Background. Vaginal sacrospinous colpopexy (VSC) and laparoscopic sacral colpopexy (LSC) both correct vault prolapse. The present study compares the perioperative course and long‐term results of VSC and LSC. Methods. This retrospective study of post‐hysterectomy vault prolapse involved 111 patients operated with either VSC (n = 51) or LSC (n = 60). The median time for the postoperative follow‐up visit was 33.6 (range: 13–60) months for the LSC group and 38.4 (range: 7–108) months for the VSC group. Prolapse grade as well as the patient's satisfaction was recorded at the follow‐up visit. Results. Operation time was significantly shorter in the VSC group (median: 62 min) compared to the LSC group (median: 129 min). The rate of perioperative complications was low in both groups. There were 3 laparotomies in the LSC group, due to perioperative complications. The inpatients days were similar, with 3.7 days (1–18) and 4.0 days (2–21) in the VSC and the LSC group, respectively. Surgery for the recurrence of vault prolapse at any time before the follow‐up visit did not occur in the VSC group, but occurred in 7 patients in the LSC group. At the follow‐up visit, there was no recurrence of vault prolapse in either group. The subjective success rate was 82% in the VSC and 78% in the LSC group. Conclusions. This study indicates that VSC and LSC are two equally effective surgical procedures to correct vaginal vault prolapse, but the LSC technique requires a longer operating time.
The cervical cancer screening program from a midwife's perspective
Authors: IDESTRÖM MONICA , MILSOM IAN , ANDERSSON‐ELLSTRÖM AGNETA
Published: May 2007

Background. Midwives in Sweden are responsible for taking Papanicolaou (Pap) smears as part of the cervical cancer screening program. The aim of this study was to investigate midwives knowledge, experience and management of the cervical cancer screening program, and their apprehension of women's knowledge about Pap‐smear screening. Methods. A postal questionnaire was sent to midwives working in primary health care in 3 different areas in Sweden. A total of 156 (77%) out of 201 midwives completed the questionnaire. Results. Four of 5 midwives considered themselves to have the education they needed to manage the screening program. However, the study indicated that midwives lacked a basic structure when giving information. As many as every third midwife refrained from or had an irrelevant answer to the proposed question, what is meant by a cellular atypia? Almost all midwives saw themselves as the main informant about Pap‐smear screening. At the same time, the midwives perceived that women lacked knowledge about cellular atypia, and thought it was the same as cancer. Some 38% of the midwives expressed a wish to terminate the ‘assembly line‐like’ screening system. The remaining midwives were completely satisfied with the organisation. Conclusions. Many midwives lacked time and a structured guidance when discussing screening and cervical atypia. Improvement in the organisation and certified education for Pap‐smear screening with access to recent research, could develop a more empowering exchange between the midwives and the women participating in cervical screening.
Quality of Life of Chinese Schizophrenia Outpatients in Hong Kong: Relationship to Sociodemographic Factors and Symptomatology
Authors: Xiang Yu-Tao , Weng Yong-Zhen , Leung Chi-Ming , Tang Wai-Kwong , Ungvari Gabor S.
Published: May 2007

Objective: To explore the relationships between sociodemographic and clinical factors and quality of life (QOL) in a cohort of Chinese schizophrenia outpatients.

Method:Two hundred subjects with a diagnosis of DSM-IV schizophrenia aged 18–60 years were randomly selected, and their sociodemographic and clinical characteristics including psychotic and depressive symptoms, extrapyramidal symptoms (EPS), and quality of life were assessed. Correlation and multiple regression analyses were used to evaluate the relationships of sociodemographic, clinical data and QOL.

Results: Compared to normative data obtained for the general population in Hong Kong, significantly lower scores in physical, psychological, and social QOL domains were found in the patient group. History of suicidal attempts and the presence of positive, negative, depressive, anxiety and EPS symptoms were all significantly correlated with QOL in schizophrenia patients. After controlling for the effects of variables that were significantly correlated with QOL in the correlation analysis, however, only depressive symptoms were still significantly correlated with each QOL domain. Multiple regression analysis showed that depressive symptoms predicted all QOL domains, while positive symptoms predicted overall and physical QOL domains.

Conclusions: Chinese outpatients with schizophrenia had poorer QOL than the general population. In this patient population, QOL was more strongly related to the severity of depressive symptoms and was independent of sociodemographic factors.