bluuebunny/crossref_metadata_2025 huggingface dataset:
Chlamydia trachomatis infection in mothers with preterm delivery and in their newborn infantsNote
Authors: GENCAY MESUT , KOSKINIEMI MARJALEENA , FELLMAN VINETA , ÄMMÄLÄ PIRKKO , VAHERI ANTTI , PUOLAKKAINEN MIRJA
Published: October 2003

We studied Chlamydia trachomatis infection in mothers with preterm delivery and intrauterine transmission of the infection to their offspring. Forty‐one mothers with preterm labour and their newborn infants (n=50) were studied for the presence of C. trachomatis infection using microimmunofluorescence test for detection of serum antibodies against C. trachomatis and polymerase chain reaction for detection of C. trachomatis‐specific DNA in mucosal swabs. Antibodies to C. trachomatis were found in serum of 12 mothers (29%). Five of fourteen mothers had C. trachomatis DNA in cervical specimens. Eighteen neonates were born to the 14 mothers with positive serology and/or C. trachomatis DNA. C. trachomatis DNA was detected in specimens from 10 of the 18 neonates (55.5%). Three of the available cord blood samples contained C. trachomatis IgM antibodies. Our results strongly suggest that mothers and their preterm babies may benefit from screening for active C. trachomatis infection.
Influence of different curette insertion depths on the outcome of non‐surgical periodontal treatment
Authors: Izumi Y. , Hiwatashi‐Horinouchi K. , Furuichi Y. , Sueda T.
Published: October 2003

Abstract. This study was undertaken to compare the effects of scaling and root planing (Sc/RP) performed from approximately 1 mm coronal to (test Sc/RP) or at the bottom of (control Sc/RP) the probeable pocket to the gingival margin. 2 male and 5 female patients with moderate to severe periodontitis participated in the study. Initial examination was performed with respect to probing pocket depth (PPD) and probing attachment level (PAL) using a pressure‐controlled periodontal probe and stents. The patients received repeated instruction in oral hygiene, and their plaque control reached an excellent level. Baseline examination including PPD and PAL measurements was then performed. Following the baseline examination, single‐rooted teeth in 1 quadrant of each dentition were randomly selected and subjected to the test Sc/RP (test teeth) or control Sc/RP (control teeth). The PPD and PAL were measured 1 and 3 months following Sc/RP. It was demonstrated that: (i) the PPD reduction following Sc/RP was larger at the sites with initially deep pockets than at the sites with shallow pockets; (ii) the mean PPD reduction at the sites with an initial PPD ≥3.5 mm was significantly larger in the control teeth than in the test teeth; (iii) there was a significant PAL gain in the initially deep pockets but not in the initially shallow pockets; (iv) the PAL gain in the initially shallow pockets was significantly larger in the control teeth than in the test teeth. In the treatment of periodontitis, trauma caused by Sc/ RP to the most coronal part of the connective tissue attachment seems to be of minor importance compared to the effective removal of subgingival deposits.
Androgen metabolism in response to oestradiol‐17b and progesterone in human gingival fibroblasts (HGF) in culture
Authors: Tilakaratne A. , Soory M.
Published: October 2003

Abstract. The modulation of androgen metabolism by oestrogen and progesterone in HGF has been investigated, to elucidate hormone modulatory mechanisms, in periodontal disease presentation and healing responses. Duplicate incubations of HGF were performed in Eagle's MEM for 24 h with either 14Ctestosterone/ 14C‐4‐androstenedione as substrate and serial concentrations of oestradiol‐17β, or progesterone (0.01–50 μg/ml). The effect of the anti‐ oestrogen tamoxifen on the action of oestradiol in HGF was also investigated. The medium was analysed and quantified for steroid metabolites. When 14C‐testosterone was used as substrate, oestradiol stimulated the synthesis of 5σ‐dihydrotestosterone (DHT), 4‐ androstenedione (4‐A) and the diols by 35%, 25% and 2–10‐fold respectively (n=4; p<0.01), at optimal concentrations. Tamoxifen inhibited the stimulatory effects of oestradiol. Similarly, when 14C‐4‐androstenedione was used as substrate, there were 60% and 2‐fold increases in the yields of DHT and testosterone respectively, with significant increases in the formation of the diols in response to oestradiol (n=4; p<0.001). Progesterone inhibited the formation of DHT and 4‐A by 10‐fold and 3‐5‐fold at effective inhibitory concentrations (n=4; p<0.001), when 14C‐testosterone was used as substrate. Similarly, when 14C‐4‐androstenedione was used as substrate, progesterone decreased the yields of testosterone, DHT and the diols substantially. These results reinforce the potentially anabolic and catabolic roles of oestradiol and progesterone, respectively. This may partly explain the modulatory mechanisms involved, in periodontal disease presentation during altered hormonal states and healing responses in the inflamed periodontium.
Clinical effects of root instrumentation using conventional steel or non‐tooth substance removing plastic curettes during supportive periodontal therapy (SPT)
Authors: Bardet Philippe , Suvan Jean , Lang Niklaus P.
Published: October 2003

Abstract. Although root instrumentation has been accepted as the most important cause‐related treatment of periodontal diseases, repeated scaling and root planing may over time result in substantive loss of tooth substance and increased sensitivity of the teeth. In an effort to minimize these side effects of therapy, non‐root substance removing curettes have been developed. However, the clinical effects of such plastic curettes with regard to the control of the periodontal infection has not yet been established. The aims of this study were, therefore, to compare the effects of root instrumentation using plastic curettes (Universal Perio Soft Scaler®, Hawe‐Neos Dental, Bioggio, TI, Switzerland) versus conventional steel curettes on the periodontal conditions during supportive periodontal therapy. 40 subjects participated in this parallel, randomized, double blind, prospective longitudinal clinical study following active peridontal therapy. 20 subjects served as a control group and were treated with conventional steel curettes during a supportive periodontal care visit (SPT). The other 20 subjects, the experimental group, were treated using plastic curettes during a similar SPT visit. Clinical parameters, such as bleeding on probing (BOP) and probing pocket depth (PPD), were assessed at baseline and 3‐6 months later at the next regular SPT visit. In addition, the BOP percentage was determined 10 days following baseline. The results showed that there were no statistically significant differences between the 2 treatment modalities regarding BOP and PPD at any observation time. Both treatments were effective in reducing the BOP percentage which ranged from 17–42% at baseline by about 40% after 10 days (mean BOP baseline: 26%, mean BOP after 10 days: 16%). This clinical study suggests that non‐root stance removing curettes may be valuable instruments for periodontally treated patients during maintenance care, thus minimizing trauma on the hard structures of the teeth.
Estradiol enhances the production of mineralized nodules by human periodontal ligament cells
Authors: Morishita Masayuki , Yamamura Tatsuji , Shimazu Atsushi , Bachchu Afzal Hossain , Iwamoto Yoshifumi
Published: October 2003

Abstract. A primary objective in the treatment of periodontal disease is the regeneration of the mineralized and soft connective tissue. PDL cells produce mineralized nodules in vitro which is one of the important functions of PDL cells for regenerative therapy. The purpose of this study was to investigate the effects of estradiol on mineralized nodule formation by human PDL cells. PDL cells were obtained from healthy donors and maintained in DMEM with 10% fetal bovine serum. Serum‐free medium was used when the effects of estradiol were tested. ALP activity in the supernatant of cells disrupted by sonication was analyzed spectrophotometrically. The formation of mineralized nodules was assessed by staining the PDL cells with alizarine red and counting the number of nodules. at Estradiol 20 ng/ml significantly enhanced the ALP activity and mineralized nodule formation compared to the control. These results suggested that estrogen status may modify the regenerative activity of periodontal tissue.
Comparison of video and written instructions for plaque removal by an oscillating/rotating/reciprocating electric toothbrush
Authors: Renton‐Harper P. , Addy M. , Warren P. , Newcombe R. G.
Published: October 2003

Abstract. A previous crossover study showed that a watch‐and‐follow instructional video improved plaque removal by an electric toothbrush compared to the use of the instructional leaflet. This study employed a parallel design to assess the value of an instructional video for plaque removal by a new model oscillating/rotating/reciprocating electric toothbrush. 2 groups of 26 dentate subjects with average oral hygiene, who had never used an electric toothbrush, participated in this single blind, randomised parallel group designed study. On day 1 of the study, subjects received a professional prophylaxis to remove all plaque. Oral hygiene measures were then suspended and subjects returned on day 3 when a prebrushing plaque score was recorded by plaque index and area. Subjects withdrew and either read the manufacturers instructional leaflet (group L) or observed the instructional video (group V). Groups L and V then performed toothbrushing with toothpaste for 2 minutes and with group V brushing in time with the instructional video. Post‐brushing plaque indices and areas were then recorded. Whole mouth, lingual, upper, lower, anterior and posterior but not buccal % reductions in plaque index and area were significantly greater in group V compared to group L. % plaque removal was also significantly greater by area at mid and distal sites but not mesial sites. Whole‐mouth plaque reductions were 10% greater in group V but reached >15% at lingual surfaces. Within group differences in plaque removal at paired sites e.g., buccal/lingual, remained similar, suggesting that further improvement could be achieved by modifying the video to devote more time to the difficult‐to‐clean areas. In conclusion, in the early period of learning the use of an electric toothbrush, plaque removal can be improved by using an instructional video. Such watch‐and‐follow video routines could be extended to other areas of oral hygiene practices.
GCF levels of MMP‐3 and MMP‐8 following placement of bioresorbable membranes
Authors: Said S. , Mohd Haji , Sander L. , Rönkä H. , Sorsa T. , Kinane D. F.
Published: October 2003

Abstract. Matrix metalloproteinases (MMPs) are responsible for remodeling and degrading extracellular matrix and basement membrane components. MMP‐3 and ‐8 levels were assessed in this study during the early healing phase following a guided tissue regeneration (GTR) procedure. 32 patients, having 2 or 3 walled intrabony defects of PD≥6 mm, were stratified into 2 groups on the basis of age, sex, smoking status and disease severity. All intrabony defects were treated using the resorbable Guidor® membrane but only 1 group of patients was given a pre‐operative dosage of antibiotic (3 g amoxycillin). GCF samples for the quantification of MMP‐3 and ‐8 levels were obtained from the intrabony site where a membrane was placed (membrane site), from the non‐adjacent site on the adjacent tooth which was involved in the surgical flap (surgical control site), and from a healthy site (healthy) on the contralateral side. The GCF samples taken at baseline, 1 week, 4 weeks and 3 months after surgery were analyzed using an enzyme linked immunoabsorbent essay (ELISA) for MMP‐3 and using a time‐resolved immunofluorescence assay (IFMA) for MMP‐8. MMP‐3 was detected in a very low % of sites at baseline while relatively high levels of MMP‐8 were detected at all 3 types of sites at baseline. MMP‐8 levels increased for all sites at week 1, and this was statistically significant for the membrane site, but at week 4, the levels decreased for both the membrane and the surgical sites. There was no statistically significant difference between the levels of MMP‐3 and ‐8 in the antibiotic and non‐antibiotic group. Collagen remodelling occurs during the early wound healing period following surgical and regenerative procedures. The levels of MMP‐3 and ‐8 in GCF appear to reflect these processes.Interestingly, the presence of the membranes appeared to increase the levels of MMP‐3 and ‐8 and may relate to the resorption of the resorbable membrane by host systems.
IL‐1β and IL‐8 in Human Fetal Membranes: Changes with Gestational Age, Labor, and Culture Conditions
Authors: ELLIOTT C.L. , LOUDON J.A.Z. , BROWN N. , SLATER D.M. , BENNETT P.R. , SULLIVAN M.H.F.
Published: October 2003

PROBLEM: Interleukin (IL)‐1β and IL‐8 are associated with labor. This study aimed to characterize their concentrations in fetal membranes and any changes in these with advancing gestation and to define as to whether there are interactions between the membranes in their expression.  METHOD OF STUDY: mRNA and protein content of amnion and choriodecidua at increasing gestations and before and after labor at term were quantified. Membranes were also collected before and after labor, separated, and cultured. Protein production was measured by ELISA.  RESULTS: IL‐1β and IL‐8 concentration increased in third trimester amnion and choriodecidua. Further increased expression of mRNA of both cytokines was found after labor in both membranes except IL‐8 production by amnion. Choriodecidua produced more of each cytokine than amnion, however, no interaction between the membranes was demonstrated by culture.  CONCLUSIONS: Increasing expression of IL‐1β and IL‐8 in amnion and choriodecidua in the third trimester and after labor supports a role for these cytokines in the establishment of labor.
Risk Factors Associated with Fetal Losses in Treated Antiphospholipid Syndrome Pregnancies: A Multivariate Analysis
Authors: CARMONA FRANCISCO , AZULAY MARCOS , CREUS MONTSERRAT , FÁBREGUES FRANCISCO , PUERTO BIENVENIDO , BALASCH JUAN , FONT JOSÉ , CERVERA RICARDO
Published: October 2003

PROBLEM: Pregnancies in women with antiphospholipid syndrome (APS) are associated with obstetric complications despite treatment. The present study analyzes risk factors and evaluates fetal outcome in a large sample of treated APS pregnancies.  METHOD OF STUDY: Seventy‐seven pregnancies in 56 women were included. Twelve selected variables potentially related to the outcome of treated pregnancies were analyzed in a multivariate logistic regression model.  RESULTS: Treated women delivered 65 live infants at 24–41 weeks gestation (mean 36.7±0.5) but two neonatal deaths occurred. There were seven first‐trimester miscarriages (9%) and five intrauterine fetal demises (6.5%). Thus, the probability of having a live baby under treatment was 82% (95% CI 71.3–89.6%), a figure significantly greater (P<0.001) than that observed before therapy (25.7%; 95% CI 18.7–33.7%). Variables related with fetal outcome in the multivariate model were: preconceptional use of aspirin and abnormal umbilical artery Doppler velocimetry at 23–26 weeks gestation.  CONCLUSIONS: The present report shows that in treated APS pregnancies: i) aspirin treatment started preconceptionally is an independent and significant prognostic factor associated with favorable fetal outcome; and ii) abnormal velocity waveforms in the umbilical artery predict adverse outcome of pregnancy.
The Role of the Fas/Fas Ligand System in Estrogen‐Induced Thymic Alteration
Authors: MOR GIL , MUÑOZ AMANDA , REDLINGER JR. RICH , SILVA IVALDO , SONG JOON , LIM CHUNGHYUN , KOHEN FORTUNE
Published: October 2003

PROBLEM: Estrogen induces atrophy in the thymus by an unknown mechanism. Since the Fas/FasL system is one of the main pathways in T cell apoptosis, we tested the hypothesis that estrogen‐induced thymic atrophy is mediated by the Fas/FasL system.  METHODS OF STUDY: In vivo experiments were done using ovariectomized female rats treated with estrogen or saline. In vitro experiments were performed using isolated thymocytes. Estrogen receptor (ER) α and β expression was characterized using flow cytometry, RT‐PCR and immunofluorescence. Fas and FasL mRNA and protein expression was evaluated using RT‐PCR and Western blot analysis respectively. 
RESULTS: ERα and ERβ are present in thymocytes and stromal cells. ER expression is mainly localized in the Double Positive CD4+CD8+ thymocytes. Estrogen treatment decreases thymus size and increase FasL expression. 
CONCLUSION: CD4+CD8+ thymocytes and thymic stroma cells express ERα and ERβ. In vivo and in vitro we showed that estrogen treatment increases FasL expression while decreasing thymus cell number. These findings support the hypothesis that estrogen‐induced thymic atrophy occurs as a result of apoptosis and is mediated by estrogen‐induced FasL expression.
Increased Natural Killer‐Cell Activity is Associated with Infertile Women
Authors: MATSUBAYASHI HIDEHIKO , SUZUKI TAKAHIRO , ARAI TADASHI , KONDO AKANE , SUGI TOSHITAKA , IZUMI SHUN‐ICHIRO , MAKINO TSUNEHISA , HOSAKA TAKASHI , SUGIYAMA YOKO
Published: October 2003

PROBLEM: An increase in natural killer (NK)‐cell activity has been observed in women with unexplained recurrent miscarriages. Because of the many similarities between infertility and early pregnancy loss patients, we investigated whether infertile women had raised NK‐cell activity.  METHOD OF STUDY: We tested 94 infertile women who, in spite of treatment, were unable to conceive for 6 or more months. NK‐cell activity was measured by using a chromium‐51 release cytotoxicity assay, with K562 human myeloid leukemia cells as targets.  RESULTS: NK‐cell activity of the infertile group (mean±SD; 40.2%±14.7) was significantly higher than the control group (31.5%±11.9, P<0.0001). The increased NK‐cell activity was not associated with age, infertile duration, depression scores, treated hyperprolactinemia, or treated endometriosis.  CONCLUSIONS: In certain patients, elevated NK‐cell activity may be considered an independent risk factor for infertility.
Biological Activity of the Suppressor Cells Inducer Factor Secreted by the Jeg‐3 Choriocarcinoma Cell Line
Authors: MARKERT U.R. , MARKERT U.R. , CHAOUAT G.
Published: October 2003

PROBLEM: We wanted to further study the mechanisms of immune suppression and suppression inducing capacities by choriocarcinoma products, e.g. both crude human choriocarcinoma supernatant (HCS) and especially an active fraction obtained by high performance liquid chromatography (HPLC) from the culture supernatant of the Jeg‐3 human choriocarcinoma cell line, since it appeared by weight and charge criteria to be a different molecular species than the low molecular weight fraction previously isolated from mouse and human term placenta. It was important to know whether the purified material was active in vivo as it was in vitro. Therefore, we tested the effects of HCS in vivo in three systems: prevention of fetal demise in the CBA/J×DBA/2 abortion prone murine mating combination, where the effects of the HPLC purified fraction were also monitored as well as by a cell transfer system, where the suppression is revealed by a local GVH/HVG assay, and finally enhancement the survival of a mildly immunogenic tumor allograft. 
METHODS: An active fraction was isolated from HCS by ion exchange HPLC. Female CBA/J were mated with DBA/2 and the influence of 3 intraperitoneal injections of both crude HCS and the active fraction was evaluated by monitoring the percentage of fetal resorptions. Simultaneously, on the day when resorptions were counted, maternal splenocytes from these females were harvested and were injected by the subcutaneous way in C3H/HEJ hind feet. The lymph node reactivity (HVG+GVH) was assessed by [3H]thymidine intake by cells harvested from the draining popliteal lymph nodes. For assessment of influence of HCS on allograft rejection, BALB/b (H‐2b) mice received a subcutaneous injection of allogeneic P815 tumor cells (H‐2d). The influence of HCS injections on tumor survival was analyzed by regular measurements of the mean tumor diameter. 
RESULTS: Intraperitoneal injection of HCS reduced fetal resorptions from 24.7 to 13%. Injection of the in vitro active fraction induced the same rate of reduction. The mean intensity of HvG/GvH reaction was 13 400 cpm per lymph node when splenocytes from the control group were injected compared to 2900 cpm when splenocytes from treated mice were used. P815 tumor allografts were completely rejected in all cases after 21 days. Weekly subcutaneous injections of HCS prolonged tumor survival in all cases up to at least 30 days.  CONCLUSION: The fraction isolated from HCS increased very efficiently the survival of allografts as well as those of allogeneic fetuses in a resorption prone murine mating. The choriocarcinoma cell line might prove to be a useful source of immunosuppressive materials, which could otherwise be important for the fetal–maternal tolerance and a successful pregnancy.
Expression of Interleukin‐18 and its Receptor in Mouse Ovary
Authors: TSUJI YOSHIYUKI , ADACHI SUSUMU , KOYAMA KOJI , TAMAOKI TOMOKO HASHIMOTO , IEMOTO ATSUKO , FURUYAMA JUN‐ICHI , TAMAOKI TOMOKO HASHIMOTO , HASEGAWA AKIKO , FURUYAMA JUN‐ICHI , KOYAMA KOJI , TAMAOKI TOMOKO HASHIMOTO , KASHIWAMURA SHIN‐ICHIRO , UEDA HARUYASU , MURANAKA JUNKO , FURUYAMA JUN‐ICHI , OKAMURA HARUKI
Published: October 2003

PROBLEM: Interleukin‐18 (IL‐18) strongly induces interferon‐gamma production and is produced not only by types of immune cells but also by types of non‐immune cells. Ovulation is thought to be an inflammation‐like reaction in which many pro‐inflammatory cytokines are involved. We investigated whether IL‐18 is involved in the functions of ovary.  METHOD OF STUDY: The 4‐week‐old immature female mice were examined for IL‐18 and IL‐18 receptor (IL‐18R) expression on their ovaries under stimulation with pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) by immunohistochemical staining, Western blotting and reverse transcript‐polymerase chain reaction. The IL‐18R was blocked by the injection of anti‐IL‐18R monoclonal antibody to immature mice during PMSG‐hCG stimulation, and the number of ovulated ova was counted.  RESULTS: The expression of both proteins and mRNA of IL‐18 and IL‐18R were very low in immature ovaries before stimulation, but after PMSG injection both IL‐18 and IL‐18R increased dramatically in theca cells and reached a maximum level at the peri‐ovulatory phase then slightly lowered, but still kept a high level during the luteal phase in the corpus luteum.  The treatment of IL‐18R monoclonal antibody to the mice during ovarian stimulation reduced the number of ovulated ova and inhibited the expansion of cumulus cells surrounding the ovum.  CONCLUSION: IL‐18 and IL‐18R play roles in various kinds of function of ovary.
Successful Ovulation Induction, Conception, and Normal Delivery after Chronic Therapy with Etanercept: A Recombinant Fusion Anti‐cytokine Treatment for Rheumatoid Arthritis
Authors: SILLS E.S. , PERLOE MARK , TUCKER MICHAEL J. , KAPLAN CAROLYN R. , PALERMO GIANPIERO D.
Published: October 2003

Etanercept (Enbrel®; Wyeth‐Ayerst/Immunex Inc, Seattle, WA, USA) is a subcutaneously administered novel fusion protein consisting of the extracellular ligand‐binding domain of the 75 kD receptor for tumor necrosis factor‐alpha (anti‐TNFα) and the FC portion of human IgG1. The agent is synthesized by plasmid transfection of a Chinese hamster ovary cell line, utilizing recombinant DNA technology. Etanercept was approved by the US FDA for treatment of multi‐drug resistant rheumatoid arthritis in 1998, but no human data exist regarding the impact of anti‐TNFα therapy on human reproductive function or its use before ovulation induction. As TNFα potentiates collagenolysis via matrix metalloproteinase gene expression (thereby facilitating ovulation), there exists a theoretical risk that TNFα‐inhibition could exert an undesirable effect on ovulation and pregnancy. In this report, we describe the first case of ovulation induction, intrauterine insemination, normal pregnancy and singleton delivery of a healthy infant following chronic (>1 year) pre‐ovulatory TNFα‐inhibitor therapy for rheumatoid arthritis. Reproductive endocrinologists and obstetrician‐gynecologists should be familiar with etanercept therapy in the context of severe rheumatic disease, and offer appropriate reassurance regarding its safe use for infertility patients planning ovulation induction.
Activation of the Novel Prothrombinase, fgl2, as a Basis for the Pregnancy Complications Spontaneous Abortion and Pre‐eclampsia
Authors: KNACKSTEDT M. , DING J.W. , GORCZYNSKI R.M. , LEVY G.A. , CLARK D.A. , KNACKSTEDT M. , ARCK P.C. , HERTWIG K. , DUDENHAUSEN J.W. , COULAM C.B. , AUGUST C. , LEA R. , CLARK D.A. , DING J.W.
Published: October 2003

PROBLEM: Impaired trophoblast invasion during the first trimester of pregnancy is linked to spontaneous abortion, and defective invasion in the second trimester to hypertension+proteinuria (pre‐eclampsia). Hypertension developing during the third trimester of human pregnancy represents, in part, a corrective response in the mother to provide adequate placental perfusion for fetal growth when trophoblast has not to invaded and converted the myometrial porprtion of maternal spiral arteries into to low resistance‐high capacitance conduits. Deportation of vesicles from hypoxemic trophoblast is thought to cause hypertension plus proteinuria, vascular damage and a systemic coagulopathy. Trophoblast invasion may be inhibited by local cytokines, such as TGF‐βs but Th1‐type cytokines associated with pre‐eclapmsia and spontaneous abortions (e.g., IL‐1, TNF‐α, IFN‐γ) are not known to inhibit migration at in situ concentrations. Trophoblast invasion is also inhibited by the binding of surface integrins to fibronectin and fibrin, and fibrin production is stimulated by these Th1 cytokines via up‐regulation of prothrombinases(s) such as fgl2 which directly and via TNF‐α‐facilitated inflamation compromise trophoblast cell integrity. We, therefore, asked if fgl2 expression and TNF‐α are increased in first trimester human miscarriage and in third trimester pre‐eclampsia. 
METHODS: fgl2 mRNA was detected using in situ hybridization and fgl2 protein by immunohistochemistry. TNF‐α mRNA and protein were similarly tested. The techniques were validated using uterine sections from day 8.5 of CBA×DBA/2 pregnancies, and then were applied to sections of placentae from normal and pre‐eclamptic pregnancies with and without intrauterine fetal growth restriction (IUGR). Fibrin was detectectd by immunohistochemistry.  RESULTS: Expression of fgl2 protein correlated with fgl2 mRNA expression in mouse uteri and in placentae from normal human pregnancies. Increased expression of fgl2 and TNF‐α mRNA and protein, and increased fibrin deposition was detected in placental trophoblast.  CONCLUSIONS: Activation of fgl2 prothrombinase by Th1‐type cytokines in pregnancy may lead to spontaneous abortion, or in ongoing pregnancy, to pre‐eclampsia and/or IUGR.
Effect of IL‐1β and IL‐6 on Oxytocin Secretion in Human Uterine Smooth Muscle Cells
Authors: FRIEBE‐HOFFMANN ULRIKE , CHIAO JYE‐PING , RAUK PHILLIP N.
Published: October 2003

PROBLEM: Infection‐mediated preterm labor results in the production of inflammatory cytokines, including interleukin‐1β (IL‐1β) and interleukin‐6 (IL‐6). Oxytocin (OT) plays a key role in the process of labor. This study investigates the effect of IL‐1β and IL‐6 on intra‐and extracellular OT in human smooth muscle cells and evaluates IL‐1β induced changes in IL‐6 production.  METHOD OF STUDY: Primary cultures of human myometrium, obtained from term pregnant women (n=7) were incubated with either IL‐1β or IL‐6 for 0–24 hr. Intra‐ and extracellular OT peptide concentrations were measured by radioimmunoassay and IL‐6 mRNA and protein were evaluated by reverse transcription polymerase chain reaction and enzyme‐linked immunosorbent assay. 
RESULTS: Both, IL‐1β and IL‐6 led to an increase in OT secretion, which was accompanied by a reduction of the intracellular OT peptide pool. IL‐1β significantly induced IL‐6 mRNA expression and protein secretion, which did not further enhance IL‐1β induced OT secretion. 
CONCLUSIONS: The induction of OT secretion by proinflammatory cytokines in human myometrium in vitro, supports the concept of a thus regulated infection‐triggered preterm labor process in vivo.
Anti‐Phosphatidylserine/Prothrombin Antibodies are not Frequently Found in Patients with Unexplained Recurrent Miscarriages
Authors: TSUTSUMI AKITO , ATSUMI TATSUYA , ICHIKAWA KENJI , YAMADA HIDETO , HIRAYAMA KATO EMI , FUJIMOTO SEIICHIRO , KOIKE TAKAO
Published: October 2003

OBJECTIVE: To determine whether the presence of anti‐phosphatidylserine/prothrombin antibodies (anti‐PS/PT) can be a major factor in otherwise unexplained recurrent miscarriages.  PATIENTS AND METHODS: Eighty‐one consecutive patients with history of 2 or more recurrent miscarriages were studied. Patients with history of overt thrombotic events were not included. Patients were examined for plausible causes of miscarriages, and titer of IgG, IgM and IgA anti‐PS/PT were measured by enzyme‐linked immunosorbent assay (ELISA).  RESULTS: Thirty‐five patients had one or more plausible causes of recurrent miscarriages, including 12 positive for well‐established anti‐phospholipid antibodies, such as anti‐β2‐glycoprotein I. None of the patients included in this study was found to be positive for anti‐PS/PT.  CONCLUSION: Detection of anti‐PS/PT in addition to other anti‐phospholipid antibodies does not seem to aid in the evaluation of patients with unexplained recurrent miscarriages.
Impact of intrapartum epidural analgesia on breast‐feeding duration
Authors: Henderson Jennifer J. , Dickinson Jan E. , Evans Sharon F. , McDonald Susan J. , Paech Michael J.
Published: October 2003

Background:  Although the labour and delivery outcomes of epidural analgesia have been investigated extensively, the effects on breast‐feeding success are not clearly identified.

Aim: To investigate the effects of intrapartum epidural analgesia on breast‐feeding duration.

Methods: Nulliparous women enrolled in a randomised trial investigating labour and delivery outcomes of intrapartum epidural analgesia were asked about breast‐feeding outcomes. Breast‐feeding duration was ascertained by a self‐report at 2 and 6 months post‐partum. Breast‐feeding outcomes were analysed as a prospective observational study because of high cross‐over rates (43.4%) in the original randomised controlled trial.

Results: A total of 992 women were recruited to the trial with 690 (69.6%) receiving epidural analgesia in labour. Breast‐feeding was initiated by 95% (n = 946). At 2 and 6 months, 625 (63.5%) and 401 (40.7%), respectively, were still breast‐feeding. Intrapartum analgesia (trend P‐value = 0.036), mode of delivery (P < 0.001), age (P < 0.001), education (P < 0.001), and smoking in pregnancy (P < 0.001) showed univariate associations with breast‐feeding duration. In the subgroup of women with spontaneous onset of labour and vaginal deliveries, after controlling for other obstetric and demographic factors, epidural analgesia but not narcotic analgesia was significantly associated with reduced breast‐feeding duration (adjusted hazard ratio 1.44, 95% confidence interval 1.04–1.99).

Conclusions: Nulliparous women have a high use of epidural analgesia in labour. Nulliparous women who choose epidural analgesia are more likely to breast‐feed for shorter durations. Further exploration of the factors underlying this association should be undertaken.
Trust and Distress in Three Generations of Rural Australians
Authors: Berry Helen , Rodgers Bryan
Published: October 2003

Objectives: Social connectedness has been associated with mental health outcomes. One study proposed that social connectedness influences mental health only indirectly because it is associated with a protective factor–trust. Trust is typically measured using the one-item measure in the World Values Survey (WVS). There are methodological difficulties associated with this measure and thus with interpreting findings. The aims of this study are to evaluate two approaches to measuring trust and to elaborate on the relationship between trust and distress.

Methods: A random sample of 969 members of a rural community completed an anonymous self-report postal questionnaire including the Organisational Trust Inventory (OTI), the World Values Survey measure and the K10 as a measure of general psychological distress.

Results: The OTI produced the more powerful and richer explanation of the relationship between trust and distress. Overall, women reported greater trust than men, and older Australians reported less distress and greater trust than younger people. Greater trust was associated with less distress, but the patterns of association differed between age generations.

Conclusions: This research highlights the importance of trust for mental health. Generational differences in the extent and meaning of trust have implications for social policy and planning.
Motivations of Catholic Missionaries Working with Australian Aborigines
Authors: Girola Stefano
Published: October 2003

Objective: To investigate the cultural and theological presuppositions that have influenced the attitudes of Catholic missionaries towards Australian Indigenous people.

Methods: Analysis of missionary literature and Papal missionary encyclicals.

Findings: ‘Charitable institutions’ such as hospitals, orphanages and schools, were seen as instrumental to the diffusion of Catholicism. In extreme cases, this brought an interpretation of disease as a ‘providential gift’. More often, it fostered the idea that spiritual rewards — better achieved in an ‘artificial’ context of isolation — were more important than the fulfilment of material needs. Missionaries decided priorities in advance, in accordance with the assumption that ‘savages’ were children, and had to be treated as such.

Conclusions: The Vatican has recently reaffirmed the superiority of Catholicism over other religions. There is a need for the Catholic Church to move towards a greater acceptance of religious pluralism.
The Aboriginal Concept of Time and its Mental Health Implications
Authors: Janca Aleksandar , Bullen Clothilde
Published: October 2003

Objective: To explore the Aboriginal concept of time and discuss its impact on the assessment and management of Indigenous mental health problems in Australia.

Conclusions: The Aboriginal concept of time differs from the Judeo-Christian perception of time in that Aboriginal people do not perceive time as an exclusively ‘linear’ category (i.e. past-present-future) and often place events in a ‘circular’ pattern of time according to which an individual is in the centre of ‘time-circles’ and events are placed in time according to their relative importance for the individual and his or her respective community (i.e. the more important events are perceived as being ‘closer in time’). Such an important difference in perception of time contributes to the limited applicability of standard assessment procedures in psychiatry and creates numerous difficulties in providing culturally appropriate mental health services to Aboriginal people in Australia.
Healing Traditions: Culture, Community and Mental Health Promotion with Canadian Aboriginal Peoples
Authors: Kirmayer Laurence , Simpson Cori , Cargo Margaret
Published: October 2003

Objective: To identify issues and concepts to guide the development of culturally appropriate mental health promotion strategies with Aboriginal populations and communities in Canada.

Methods: We review recent literature examining the links between the history of colonialism and government interventions (including the residential school system, out-adoption, and centralised bureaucratic control) and the mental health of Canadian Aboriginal peoples.

Results: There are high rates of social problems, demoralisation, depression, substance abuse, suicide and other mental health problems in many, though not all, Aboriginal communities. Although direct causal links are difficult to demonstrate with quantitative methods, there is clear and compelling evidence that the long history of cultural oppression and marginalisation has contributed to the high levels of mental health problems found in many communities. There is evidence that strengthening ethnocultural identity, community integration and political empowerment can contribute to improving mental health in this population.

Conclusions: The social origins of mental health problems in Aboriginal communities demand social and political solutions. Research on variations in the prevalence of mental health disorders across communities may provide important information about community-level variables to supplement literature that focuses primarily on individual-level factors. Mental health promotion that emphasises youth and community empowerment is likely to have broad effects on mental health and wellbeing in Aboriginal communities.
Emotional and Social Wellbeing: National Policy Context
Authors: Roxbee Lesley , Wallace Clinton
Published: October 2003

Objectives: This paper provides an overview of the national policy in relation to Aboriginal and Torres Strait Islander mental health and emotional and social wellbeing.

Conclusions: The limited available evidence suggests that mental health disorders are more prevalent in Aboriginal and Torres Strait Islander communities, a situation related to the unique historical, cultural and social situation of Aboriginal and Torres Strait Islander peoples in Australia. Community-based mental health services are not adequately available, while Aboriginal and Torres Strait Islander people are over-represented in inpatient mental health care. A range of program and policy initiatives have been undertaken to address this situation, including both the development of specific Aboriginal community controlled emotional and social wellbeing services and the reform of specialist mental health services. These initiatives have been supported by a range of policy initiatives at Commonwealth, State and Territory levels. Inadequate coordination between sectors in implementing programs and policies has hampered delivery of services. The current development of a national strategic framework for emotional and social wellbeing aims to increase partnerships between the sectors, and to motivate governments to provide more resources to address the issue. Support from the Royal Australian and New Zealand College of Psychiatrists is valuable in moving this agenda forward.
Towards an Outcome-Based Mental Health Policy for New Zealand
Authors: Krieble Todd
Published: October 2003

Objective: This paper outlines efforts to shift New Zealand's mental health policy from a service input based strategy to an outcome based strategy.

Methods: A New Zealand mental health outcome framework has been created as the basis for the development of outcome philosophies and outcome measurement from (i) cultural, (ii) consumer, (iii) clinical, and (iv) public investment perspectives.

Results: A full medium/long-term program of outcome development and implementation is underway within the new framework.

Conclusions: New Zealand has had unprecedented levels of service development in the last decade. These gains are being consolidated but considerable work is required to ensure greater emphasis on outcomes. Current and future strategies are being aligned to support the move to an outcome based strategy.
Social Determinants of Health, the ‘Control Factor’ and the Family Wellbeing Empowerment Program
Authors: Tsey Komla , Whiteside Mary , Deemal Audrey , Gibson Teresa
Published: October 2003

Objective: To explore links between the social determinants of health, the ‘control factor’, and an Aboriginal empowerment program.

Methods: The evidence that rank or social status is one of the most important determinants of health is briefly presented. This is followed by a critique of the Australian policy and intervention framework for tackling and reducing social inequalities. The concept of ‘control’ as an important element in addressing social determinants of health is examined next and the Family Wellbeing empowerment program is analysed to illustrate how the concept of control might be operationalised at program or intervention level. Implications for health practitioners are identified.

Results: By providing a safe group environment for participants to explore sets of critical questions about themselves, their families and communities, through the process of participatory action research, Family Wellbeing has demonstrated its potential to ‘enable’ Indigenous people to take greater control and responsibility for their situation. While program participants first address personal and immediate family issues, evidence is emerging of a ripple effect of increasing harmony and capacity to address issues within the wider community

Conclusions: The social determinants of health are complex and multi-layered and so addressing them needs to involve multilevel thinking and action. The control factor is only one element, albeit an important one, and Family Wellbeing is providing evidence that ‘control’ can be addressed in Indigenous settings. For empowerment programs to achieve their full potential, however, there is a need to ensure that such programs reach a critical mass of the target group. It is also imperative that policy-makers and practitioners take a longer-term approach, including properly resourced longitudinal studies to document and enhance the evidence base for such interventions. As health practitioners it is vital we consider our work within this broader context, creatively seek to enhance linkages between services and programs, and support processes for change or intervention at other levels.
What's Driving Involuntary Treatment in the Community? The Social, Policy, Legal and Ethical Context
Authors: Brophy Lisa , McDermott Fiona
Published: October 2003

Objective:Involuntary treatment in the community has become an increasing and accepted part of the landscape of mental health service delivery. Community Treatment Orders (CTOs) or Outpatient Commitment (OPC) may be understood to be an inevitable consequence of the process of deinstitutionalisation and an acceptance that many clients are at constant risk in the community and may require long-term involuntary treatment. However, there are important social, economic and political imperatives influencing CTOs; this article explores these driving forces and identifies the concerns of the critics of involuntary treatment in the community.

Methods:Using the concept of force field analysis, the driving and restraining forces surrounding the development and implementation of CTOs are identified.

Results: All Australian states and territories now have provision for involuntary community treatment. However, despite an increasing reliance on, and to some extent, acceptance of, the validity of involuntary community treatment in mental health, these developments are not uncontested. Consumer groups, legal advocates and service providers have questioned the use of involuntary treatment in the community and identified various concerns, including the potential for human rights abuses, ethical dilemmas and doubts regarding effectiveness.

Conclusions: The paper concludes by arguing for stronger evidence base to support the use of CTOs. In doing so it focuses on the social, policy, legal and ethical context within which CTOs are implemented.
Refuge or Retrauma? The Impact of Asylum Seeker Status on the Wellbeing of East Timorese Women Asylum Seekers Residing in the Australian Community
Authors: Reesp Susan
Published: October 2003

Objective: To summarise findings from interdisciplinary research into the experiences of East Timorese women asylum seekers residing in the Australian community, and specifically to highlight the effects of prolonged asylum seeker status on wellbeing. ‘Wellbeing’ was defined as a holistic state that includes psychological, physical, spiritual, social and cultural welfare and contentment.

Methods: A qualitative multimethod data collection tool comprised semi-structured interviewing of East Timorese women asylum seekers, questionnaires to professional workers assisting East Timorese asylum seekers at the community level, and an analysis of secondary source material.

Results: Insecurity of tenure and living with the fear of forced removal from Australia was found to have significantly affected and dangerously compromised the wellbeing of the asylum seekers. The findings further revealed a flaw in current social policy with respect to the length of time asylum seekers could reside in the community without adequate supports, services and avenues for social inclusion.

Conclusions: The research illustrated the necessity for faster processing of claims for asylum seeker status, recognition of the effects of torture and trauma on asylum seekers in policy, and consequently immediate access for asylum seekers to essential and gender specific supports and services. The research provides evidence to support the East Timorese asylum seekers’ claim to permanent status in Australia on humanitarian grounds.
Effects of the spin trap‐α‐phenyl‐N‐tert‐butyl nitrone (PBN) in transient forebrain ischaemia in the rat
Authors: PAHLMARK K. , SIESJÖ B. K.
Published: October 2003

The free radical spin trap α‐phenyl‐N‐tert‐butyl nitrone (PBN) has previously been shown markedly to reduce infarct size in permanent or transient focal ischaemia in rats. The mechanisms of action have not been clearly defined, but data obtained in focal ischaemia suggest microvessels or mitochondria as targets. Since microvascular dysfunction and/or mitochondrial failure are probably not the immediate causes of delayed neuronal damage following forebrain ischaemia in rats, we induced 15 min of two‐vessel occlusion ischaemia in anaesthetized rats, and assessed brain damage by histopathological techniques 7 days later. Animals were treated either before (30 min) or after ischaemia (30 min or 6 h) with PBN or its vehicle. Other animals received a more soluble PBN analogue (2′‐sulfonyl PBN), and received the drug 30 min prior to 12 or 15 min of ischaemia.

PBN reduced neuronal necrosis in the neocortex when given 30 min post‐treatment, but not when given before or 6 h after ischaemia, and it failed to reduce damage to the CA 1 sector of the hippocampus, or the caudoputamen. The sulphonyl derivative of PBN failed to reduce damage in any region.

The results provide important hints as to the action of PBN. It is tentatively concluded that the nitrones ameliorate either the microvascular dysfunction or the mitochondrial failure, which could be the crucial events leading to infarction in focal ischaemia, but that they have only a weak effect on the mechanisms that yield selective neuronal necrosis in transient ischaemia of brief duration.