bluuebunny/crossref_metadata_2025 huggingface dataset:
Perivitelline space: Does it play a role in blocking polyspermy in mammals?
Authors: Talbot P. , Dandekar Pramila
Published: June 2003

The perivitelline space of mammalian oocytes changes in size and composition during preimplantation development. Often overlooked in the past, this space contains a hyaluronan‐rich extracellular matrix prior to fertilization and a cortical granule envelope following release of the cortical granules at fertilization. The hyaluronan‐containing matrix of unfertilized oocytes is well developed in some species such as opossums and humans but is scant in rodents including the hamster and mouse. The significance of the hyaluronan‐rich matrix, which attaches to the plasma membrane of the oocytes, is not fully understood. However, hyaluronan, which can inhibit membrane fusion, is present in the perivitelline space (PVS) of unfertilized oocytes and must be negotiated by the fertilizing sperm. Following fertilization, the cortical granule envelope forms as the cortical granules disperse, thereby causing the PVS to increase significantly in size. Calcium is important in the dispersion of the cortical granules following exocytosis. Once formed, the cortical granule envelope in some species is about the same thickness as the zona pellucida, but it is not readily visualized unless it is stained with fluorescent probes or examined ultrastructurally after following stabilization with ruthenium red. The envelope contains proteins that remain in the PVS until the time of blastocyst hatching. Although little work has been done on the functions of the cortical granule envelope, several studies are consistent with the idea that it plays a role in blocking polyspermy. While nicotine increases polyspermy in sea urchins, its effects on polyspermy in human smokers have not been characterized, but could be addressed in human in vitro fertilization labs. Microsc. Res. Tech. 61:349–357, 2003. © 2003 Wiley‐Liss, Inc.
Isometric cycles, cutsets, and crowning of bridged graphs
Authors: Jiang Tao , Kim Seog‐Jin , West Douglas B.
Published: June 2003

A graph G is bridged if every cycle C of length at least 4 has vertices x,y such that dG(x,y) < dC(x,y). A cycle C is isometric if dG(x,y) = dC(x,y) for all x,y ∈ V(C). We show that every graph contractible to a graph with girth g has an isometric cycle of length at least g. We use this to show that every minimal cutset S in a bridged graph G induces a connected subgraph. We introduce a “crowning” construction to enlarge bridged graphs. We use this to construct examples showing that for every connected simple graph H with girth at least 6 (including trees), there exists a bridged graph G such that G has a unique minimum cutset S and that G[S] = H. This provides counterexamples to Hahn's conjecture that dG(u,v) ≤ 2 when u and v lie in a minimum cutset in a bridged graph G. We also study the convexity of cutsets in bridged graphs. © 2003 Wiley Periodicals, Inc. J Graph Theory 43: 161–170, 2003
On Moore bipartite digraphs
Authors: Fiol M. A. , Gimbert J. , Gómez J. , Wu Y.
Published: June 2003

In the context of the degree/diameter problem for directed graphs, it is known that the number of vertices of a strongly connected bipartite digraph satisfies a Moore‐like bound in terms of its diameter k and the maximum out‐degrees (d1, d2) of its partite sets of vertices. It has been proved that, when d1d2 > 1, the digraphs attaining such a bound, called Moore bipartite digraphs, only exist when 2 ≤ k ≤ 4. This paper deals with the problem of their enumeration. In this context, using the theory of circulant matrices and the so‐called De Bruijn near‐factorizations of cyclic groups, we present some new constructions of Moore bipartite digraphs of diameter three and composite out‐degrees. By applying the iterated line digraph technique, such constructions also provide new families of dense bipartite digraphs with arbitrary diameter. Moreover, we show that the line digraph structure is inherent in any Moore bipartite digraph G of diameter k = 4, which means that G = L G′, where G′ is a Moore bipartite digraph of diameter k = 3. © 2003 Wiley Periodicals, Inc. J Graph Theory 43: 171–187, 2003
Two‐factors each component of which contains a specified vertex
Authors: Egawa Yoshimi , Enomoto Hikoe , Faudree Ralph J. , Li Hao , Schiermeyer Ingo
Published: June 2003

It is shown that if G is a graph of order n with minimum degree δ(G), then for any set of k specified vertices {v1,v2,…,vk} ⊂ V(G), there is a 2‐factor of G with precisely k cycles {C1,C2,…,Ck} such that vi ∈ V(Ci) for (1 ≤ i ≤ k) if $n = 3K,\delta(G)\ge\,{{7k-2}\over {3}}$ or 3k + 1 ≤ n ≤ 4k, $\delta (G)\,\ge\,{{2n+k-3}\over {3}}$ or 4k ≤ n ≤ 6k − 3,δ(G) ≥ 3k − 1 or n ≥ 6k − 3, $\delta(G)\ge {{n}\over {2}}$. Examples are described that indicate this result is sharp. © 2003 Wiley Periodicals, Inc. J Graph Theory 43: 188–198, 2003
A newly recognized intrinsically knotted graph
Authors: Foisy Joel
Published: June 2003

In [Adams, 1994; The Knot Book], Colin Adams states as an open question whether removing a vertex and all edges incident to that vertex from an intrinsically knotted graph must yield an intrinsically linked graph. In this paper, we exhibit an intrinsically knotted graph for which there is a vertex that can be removed, and the resulting graph is not intrinsically linked. We further show that this graph is minor minimal with respect to being intrinsically knotted. © 2003 Wiley Periodicals, Inc. J Graph Theory 43: 199–209, 2003
Study of molecular structures for arylidene derivatives of 3R‐methylcyclohexanone by 1H NMR and molecular simulation
Authors: Pivnenko Nikolay S. , Krivoshey Alexander I. , Kutulya Lidiya A.
Published: June 2003

Conformational states of the cyclohexanone ring were established for 3R‐methyl‐6‐(4‐phenylbenzylidene)cyclohexanone and several 2,6‐bis(4‐X‐benzylidene)‐3R‐methylcyclohexanones (X = Br, OCOCH3 and C6H5) by 1H NMR spectroscopy combined with molecular simulation using the semi‐empirical methods AM1 and PM3. The first compound studied contains only one arylidene group, and exists predominantly in a chair conformation of the cyclohexanone ring with an equatorial orientation of the methyl substituent in C6D6 and CDCl3 solutions at room temperature (22–23 °C). In contrast, the 2,6‐bis(arylidene) derivatives of 3R‐methylcyclohexanone preferentially adopt conformations with an axially oriented methyl group. The extent of twisting of enone fragments was also characterized for the compounds studied based on simulation results and comparison of chemical shifts for the arylidene protons of appropriate model compounds. Copyright © 2003 John Wiley & Sons, Ltd.
Nitroxide spin probe study of probe size, hydrogen bonding and polymer matrix rigidity effects on poly(acrylic acid)/poly(ethylene oxide) complexes
Authors: Tan Li , Chen Shiming , Ping Zhenghua , Shen Yimin
Published: June 2003

An electron spin resonance (ESR) spin probe study was performed on 1 : 1 by weight poly(acrylic acid) (PAA)/poly(ethylene oxide) (PEO) complex over the 100–450 K temperature range with a series of tetramethylpiperidyloxy‐based spin probes. Measurements of the parameters T5mT, Ta and Td demonstrated the effects of probe size and the strength of hydrogen bonding. The probes in the series Tempone, Tempo, Tempol and Tamine (respectively 4‐oxo‐, unsubstituted, 4‐hydroxy‐ and 4‐amino‐2,2,6,6,‐tetramethylpiperidine ‐1‐oxyl) displayed noticeable increases in the hydrogen‐bonding effect, as indicated by Ta and Td. These increases correlated with increasing hydrogen bond acceptor strength. On the other hand, as the probe size became larger, T5mT gradually increased due to the free volume decrease. These effects were analyzed using the established theoretical relationship of T5mT to probe volume expressed by f. Meanwhile, in order to investigate the effect of polymer matrix rigidity, a similar study was performed with a nitroxide spin probe, 2,2,6,6‐tetramethyl‐1‐piperidine‐1‐oxyl (Tempo), on PAA/PEO complexes of different weight compositions. The quantitative fast motion fraction in the composite ESR spectrum was calculated. The influence of changes in the composition of PAA on the molecular mobility was characterized by changes of the spectral parameters $2A^{'}_{zz}$ and τc. The molecular mobility was shown to diminish with increasing content of PAA in PAA/PEO blends duo to the restriction of the polymer matrix rigidity increase. Copyright © 2003 John Wiley & Sons, Ltd.
Combined use of nuclear magnetic resonance and infrared spectroscopy for studying recognition processes between amphenicolic antibiotics and albumin
Authors: Martini Silvia , Bonechi Claudia , Magnani Agnese , Marchettini Nadia , Corti Piero , Corbini Gianfranco , Rossi Claudio
Published: June 2003

Biological reactions are mostly concerned with selective interactions between small ligands and macromolecular receptors. The same ligands may activate responses of different intensities and/or effects in the presence of different receptors. Many approaches based on spectroscopic and non‐spectroscopic methods have been used to study interactions between small ligands and macromolecular receptors, including methods based on NMR and IR spectroscopic analysis of the solution behaviour of the ligand in the presence of receptors. In this work, we investigated the interaction between ovine serum albumin with two amphenicolic antibiotics [chloramphenicol (CAP) and thiamphenicol (TAP)], using a combined approach based on NMR and IR methodologies, furnishing complementary information about the recognition process occurring within the two systems. The two ligands, despite their similar structures, showed different affinities towards albumin. NMR methodology is based on the comparison of selective ($R_{1}^{SE}$) and non‐selective ($R_{1}^{NS}$) spin–lattice relaxation rates of the ligands in the presence and absence of macromolecular receptors and$R_{1}^{NS}$and$R_{1}^{SE}$temperature dependence analysis. From these studies, the ligand–receptor binding strength was evaluated on the basis of the ‘affinity index.’ The derivation of the affinity index from chemical equilibrium kinetics for both the CAP–albumin and TAP–albumin systems allowed a comparison of the abilities of the two amphenicolic antibiotics to interact with the protein. IR methodology is based on the comparison of the ligand–protein ‘complex’ spectra with those of the non‐interacting systems. On the basis of the differences revealed, a more thorough IR analysis was performed in order to understand the structural changes which occurred on both ligand and protein molecules within the interacting system. Copyright © 2003 John Wiley & Sons, Ltd.
Conformational analysis of trinucleotides containing a single abasic residue; mimics of DNA damage
Authors: Baker John M. , Arnold John R. P. , Fisher Julie
Published: June 2003

The conformations of three deoxytrinucleotide analogues [d(TpXpT), where X = T, tetrahydrofuran (THF) or propyl (Pr)] were investigated using 1H NMR spectroscopy as part of our studies of DNA‐base damage. The phosphorus‐decoupled 1H NMR spectrum of each compound was simulated and values for the vicinal proton–proton coupling constants of the sugar ring hydrogens were extracted at several different temperatures, for use in conformational analyses. It was found that the south‐pucker preference of the sugar 3′ to the modification is increased whereas that of the 5′ is decreased relative to the puckers observed for the non‐modified system. The conformational change is <25%. This subtle effect may be sufficient for recognition by DNA repair enzymes. Copyright © 2003 John Wiley & Sons, Ltd.
1H, 13C and 15N NMR investigation of a new, condensed hexahydro‐1,3,5‐triazine
Authors: Simon A. , Tóth G. , Librera C. P. , Adam W.
Published: June 2003

Treatment of 2‐acetyl‐2‐methylcyclopentanone with hydrazine hydrate yielded a new condensed hexahydro‐1,3,5‐triazine (3b), which is the first example of the ketimine‐type trimers. A complete 1H, 13C and 15N NMR assignment of the compound was achieved. Copyright © 2003 John Wiley & Sons, Ltd.
Flow injection analysis NMR (FIA–NMR): a novel flow NMR technique that complements LC–NMR and direct injection NMR (DI–NMR)
Authors: Keifer Paul A.
Published: June 2003

Details of a new flow NMR technique, flow injection analysis NMR (FIA–NMR), are presented for the first time. This method blends some aspects of both liquid chromatography–NMR and direct injection NMR, and complements both. FIA‐NMR is shown to be useful as an analytical technique, especially for repetitive analyses, and may also prove useful in the analysis of combinatorial chemistry libraries. The feasibility of FIA‐NMR is demonstrated by the quantitative analysis of an over‐the‐counter pharmaceutical. Copyright © 2003 John Wiley & Sons, Ltd.
Prediction of proton NMR couplings in flexible ring systems: application to the stereochemical analysis of synthetic β‐substituted tryptophans
Authors: Augé Franck , Laronze Jean‐Yves , Nuzillard Jean‐Marc
Published: June 2003

The stereochemical analysis of synthetic β‐substituted tryptohans was achieved through the study of their conformationally constrained 1,2,3,4‐tetrahydro‐β‐carboline derivatives. The relative configuration of the contiguous asymmetric centers of interest was determined by analysis of the vicinal proton–proton coupling constant values J. Two compounds presenting intermediate J values led to the assessment of both coupling and energy evaluation methods. Energy was found to be adequately calculated by the semi‐empirical AM1 method on a set of lowest energy conformations. The latter were generated by molecular dynamics, based on the empirical force field CFF91. Compounds that led to ambiguous J values were shown to undergo conformational exchange due to steric repulsions between bulky trans‐oriented substituents. Copyright © 2003 John Wiley & Sons, Ltd.
Saturated amine oxides: Part 5. Hydroacridines: Part 24.13C NMR chemical shifts of N‐epimeric saturated six‐membered azaheterocyclic amine oxides
Authors: Potmischil Francisc , Cîmpeanu Valentin , Herzog Helmut , Buddrus Joachim , Duddeck Helmut
Published: June 2003

The 13C NMR spectra of 22 piperidine‐, tropine‐ and tetradecahydroacridine‐derived saturated amine oxides were measured. The chemical shifts were assigned on the basis of APT and 2D‐INADEQUATE spectra, and are briefly discussed. Copyright © 2003 John Wiley & Sons, Ltd.
Ulnar neuropathy in the forearm: A possible complication of diabetes mellitus
Authors: Acosta Juan A. , Hoffman Stuart N. , Raynor Elizabeth M. , Nardin Rachel A. , Rutkove Seward B.
Published: June 2003

Ulnar neuropathy in the forearm is an unusual cause of hand weakness and sensory loss that is most often attributed to compression of the nerve distally within the humero‐ulnar arcade (cubital tunnel). An association with diabetes mellitus, however, has not been reported. We identified four patients with type I diabetes mellitus and clinical findings suggestive of ulnar neuropathy in whom electrophysiologic testing revealed partial conduction block or abnormal temporal dispersion within the forearm segment of the ulnar nerve. Although evidence for a mild underlying polyneuropathy was present in three patients, the ulnar nerve abnormalities were disproportionately severe. In all cases, a Martin‐Grüber anastomosis was excluded. Whether this lesion is due to an increased propensity to focal compression of the ulnar nerve within the humero‐ulnar arcade or whether it represents a localized manifestation of the generalized polyneuropathy remains to be determined. Muscle Nerve 28: 40–45, 2003
Viscous flow in three‐dimensional reconstructed porous media
Authors: Pilotti Marco
Published: June 2003

In a recent paper Masad et al. (Int. J. Numer. Methods Eng. 2000; 26: 53–74) have shown the possibility of numerically studying fluid flow within two‐dimensional microscopic images of granular materials. In this paper we investigate the possibility of computing the flow field at the pore scale within numerically reconstructed three dimensional porous media, by coupling a physically based sedimentation algorithm for porous media generation and a Lattice Boltzmann Technique for solving Navier equations for the monophasic flow of a newtonian fluid inside the intergranular space. Since the adopted sedimentation algorithm can produce porous media with a controlled level of complexity, we believe that this type of approach provides an ideal numerical laboratory to probe the effect of void space topology and geometry on the flow field. This should allow to understand the fluid‐dynamic implications of processes such as compaction and cementation. After showing that the Lattice Boltzmann Technique is effective in solving Navier equations in porous media also at moderately high Reynolds, where Darcy's flow does not strictly hold anymore, we investigate the distribution of velocity components within porous media of growing complexity, starting from two different periodic arrangements of spheres up to a mixture of log‐normally distributed spheres. We observe that the distribution of velocity components is conditioned by the medium complexity and tends to an exponential pattern. Copyright © 2003 John Wiley & Sons, Ltd.
A hybrid Bayesian back‐propagation neural network approach to multivariate modelling
Authors: Chua C. G. , Goh A. T. C.
Published: June 2003

There is growing interest in the use of back‐propagation neural networks to model non‐linear multivariate problems in geotehnical engineering. To overcome the shortcomings of the conventional back‐propagation neural network, such as overfitting, where the neural network learns the spurious details and noise in the training examples, a hybrid back‐propagation algorithm has been developed. The method utilizes the genetic algorithms search technique and the Bayesian neural network methodology. The genetic algorithms enhance the stochastic search to locate the global minima for the neural network model. The Bayesian inference procedures essentially provide better generalization and a statistical approach to deal with data uncertainty in comparison with the conventional back‐propagation. The uncertainty of data can be indicated using error bars. Two examples are presented to demonstrate the convergence and generalization capabilities of this hybrid algorithm. Copyright © 2003 John Wiley & Sons, Ltd.
Simplified estimation of seismically induced settlements
Authors: Vincens E. , Labbé P. , Cambou B.
Published: June 2003

This paper proposes a predictive expression of settlements for a dry sand deposit overlying a bedrock and subjected to a seismic motion. The proposed formula combines geometrical and mechanical properties of the soil profile with classical characteristics of the input motion. One of the main concepts developed herein consists in regarding the input motion and the dynamical response as samples of random processes; another key concept consists in the common densification curve from Sawicki. The model introduces a parameter k identified by means of an extensive set of accelerograms. The main advantage of the proposed method consists in allowing fast comparisons of earthquake induced settlements for different soil and motion characteristics and therefore quantifying the damage power of a time‐history input motion. Copyright © 2003 John Wiley & Sons, Ltd.
Impact of urinary incontinence after stroke: Results from a prospective population‐based stroke register
Authors: Kolominsky‐Rabas Peter L. , Hilz Max‐Josef , Neundoerfer Bernhard , Heuschmann Peter U.
Published: June 2003

Aim

The purpose of this study was to investigate, in a community‐based population, the frequency of stroke‐related urinary incontinence (UI) and to analyse the long‐term impact of UI on prognosis and institutional care.

Methods

Included were 752 acute stroke patients admitted consecutively during a 4‐year period. We evaluated the UI by using the Barthel Index during the first 7 days and at 12‐months follow‐up.

Results

During the acute stage, the proportions of patients with full UI, partial UI, and no UI were 41%, 12%, and 47%, respectively (16%, 16%, and 68% at 12‐months follow‐up). A total of 45% of patients with UI at 12 months were institutionalised compared with 5% of patients without UI. In a multivariate logistic regression model, age, urinary incontinence at day 7, and severe disability at 12 months were demonstrated to be independent factors for a higher frequency of institutional care 12 months after stroke.

Conclusions

On admission in the acute stage, more than 50% of an unselected stroke population have UI. The proportion declines to one third of the surviving patients at 12 months. Stroke survivors who are incontinent in the acute stage have an fourfold higher risk to be institutionalised after 1 year. Neurourol. Urodynam. 22:322–327, 2003. © 2003 Wiley‐Liss, Inc.
Ascending and descending brainstem neuronal activity during cystometry in decerebrate cats
Authors: Sugaya Kimio , Ogawa Yoshihide , Hatano Tadashi , Nishijima Saori , Matsuyama Kiyoji , Mori Shigemi
Published: June 2003

Aims

This study was undertaken to examine the distribution of pontomedullary neurons related to micturition or urine storage, as well as the connections between the pontine micturition center (PMC), medullary neurons, and the spinal cord.

Methods

In decerebrate cats, extracellular recording of the rostral pontine and rostral medullary neurons was performed. Firing of each neuron was quantitated during cystometry. Connections between the PMC, medullary neurons, and the spinal cord (L1) were also examined electrophysiologically.

Results

Ninety‐four neurons showed an increase or decrease of the firing rate during micturition. Units with an antidromic response to L1 stimulation and an increased firing rate were located in the nucleus locus coeruleus alpha (LCa; n = 8) corresponding to the PMC, and in the medial reticular formation (MRF) of the medulla (n = 14). Units showing a decreased firing rate were located in the nucleus reticularis pontis oralis (PoO; n = 26) and in the MRF (n = 11). The latencies of antidromic and orthodromic responses of the LCa units were longer than those of the PoO units. MRF neurons responded antidromically and/or orthodromically to stimulation of the PMC or L1.

Conclusions

These results suggest that the pathway concerned with urine storage has a faster spinobulbospinal loop than the micturition reflex pathway and that rostral medullary neurons also play an important role in micturition and urine storage. There may be two descending pathways between the PMC and the spinal cord: both a direct pathway and one by means of medullary neurons. Neurourol. Urodynam. 22:343–350, 2003. © 2003 Wiley‐Liss, Inc.
Predicting urethral area from video‐urodynamics in women with voiding dysfunction
Authors: Rao Soujanya G. , Walter James S. , Jamnia Ali , Wheeler John S. , Damaser Margot S.
Published: June 2003

Aims

Mathematical models are useful for developing predictive parameters for characterizing the biomechanics of voiding dysfunction. The goal of this project was to test a one‐dimensional steady flow model used to predict the minimum cross‐sectional urethral area from urodynamic data.

Methods

Nine adult female subjects underwent video‐urodynamic testing. By using Bernoulli's formula and the Torricelli theorem, the minimum urethral area was predicted from pressure and flow rate at the moment of maximum flow rate during voiding. This prediction was compared with the minimum cross‐sectional area of the urethra, which was calculated from minimum urethral diameter as measured from fluoroscopy, assuming a circular cross‐section.

Results

The maximum flow rate during voiding was 14.4 ± 3.0 mL/sec. Mean bladder, abdominal, and detrusor pressures simultaneous with maximum flow rate were 63 ± 7, 29 ± 6, and 33 ± 6 cm H2O, respectively. Mean minimum cross‐sectional area of the urethra from fluoroscopy was 8.0 ± 2.0 mm2. Mean minimum cross‐sectional area of the urethra predicted by the mathematical model was 5.0 ± 1.0 mm2 using bladder pressure and 7.0 ± 2.0 mm2 using detrusor pressure. There were no significant differences between the three cross‐sectional area measures. However, when area predictions were expressed as percentage of fluoroscopic measurements, the estimate from detrusor pressure (97 ± 13%) was significantly larger than the estimate from bladder pressure (69 ± 7%).

Conclusions

A steady flow model is accurate enough on average to describe urine flow in the urethra. However, it may not be sufficiently accurate to aid in diagnosis of individuals. Neurourol. Urodynam. 22:277–283, 2003. Published 2003 Wiley‐Liss, Inc.
Clinical and urodynamic features of intrinsic sphincter deficiency
Authors: Pajoncini Cinzia , Costantini Elisabetta , Guercini Federico , Bini Vittorio , Porena Massimo
Published: June 2003

Aims

A prospective analysis of 92 patients with genuine stress incontinence was performed to identify the clinical and urodynamic features of intrinsic sphincter deficiency (ISD).

Methods

We divided the patients into two categories: 50 patients affected by pure ISD as they had severe stress incontinence and no urethral mobility; 42 patients suffering from stress urinary incontinence without ISD as they had mild stress incontinence and marked urethral hypermobility. Cystometry was normal in all patients. The presence/absence of ISD was considered the dependent variable and was correlated against the following independent variables: age, vaginal deliveries, menopause, previous urogynecological surgery and/or hysterectomy, supine stress test, irritative and/or obstructive symptoms, Valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), urethral functional length (UFL), and leakage during cystometry.

Results

The statistical analysis showed close correlations between ISD and age (P < 0.001), menopausal status (P < 0.001), previous surgery (P < 0.0001), supine stress test (P < 0.0001), leakage during cystometry (P < 0.001), and UFL (P < 0.01). The VLPP was below the cut‐off value (≤60 cm H2O) in 70% of ISD patients (P < 0.0001), whereas the MUCP in 50% of ISD patients (P < 0.0001). Multiple logistic analysis showed that lower VLPP, lower MUCP, and previous surgery correlate more significantly with ISD. After backward conditional stepwise logistic regression, the odds ratio of having ISD were VLPP = 2.3, MUCP = 7.7, VLPP + MUCP = 62.8.

Conclusions

ISD is related to the presence of a more severe clinical picture and case history, but the most significant independent variables are the VLPP and MUCP. Neurourol. Urodynam. 22:264–268, 2003. © 2003 Wiley‐Liss, Inc.
Effectiveness of pelvic floor muscle exercise therapy supplemented with a health education program to promote long‐term adherence among women with urinary incontinence
Authors: Alewijnse Dianne , Metsemakers Job F.M. , Mesters Ilse E.P.E. , van den Borne Bart
Published: June 2003

Aims

A longitudinal randomized controlled trial (RCT) was conducted to evaluate the effectiveness of physiotherapeutic pelvic floor muscle exercise (PFME) therapy supplemented with a health education program to promote long‐term adherence among women with stress, mixed, and urge urinary incontinence (UI).

Methods

Women (n = 129) were evaluated by their general practitioner (GP) and randomized in either the control group (PFME therapy alone) or one of the three experimental groups (PFME therapy with one of the three health education program versions). Therapy consisted of 9–18 individual 30 min sessions with a specialized physiotherapist, over 14–22 weeks. Outcome measures were weekly frequency of wet episodes and adherence behavior. Women were assessed up to 1 year after therapy.

Results

The health education program had no additional impact to individual contact during PFME therapy on treatment outcome, nor on adherence. However, the individual physiotherapeutic treatment protocol was very effective in reducing weekly frequency of wet episodes from 23 to 8 times a week immediately after therapy, and effects were maintained during the 1‐year follow‐up period. Adherence was very high; most women followed the behavioral advice on average 6 days/week at posttest and still 4–5 days 1 year after therapy. Results were not different between incontinence types. Women who had relatively frequent wet episodes before and 1 year after therapy had higher adherence levels compared to women who had fewer weekly losses.

Conclusions

Results suggest that a standardized protocol checklist for physiotherapists covering all treatment aspects of PFME therapy, may optimize long‐term treatment outcome and adherence behavior among patients, and outshines the addition of a health education program. Neurourol. Urodynam. 22:284–295, 2003. © 2003 Wiley‐Liss, Inc.
Clinical value of combined electrophysiological and urodynamic recordings to assess sexual disorders in spinal cord injured men
Authors: Schmid D.M. , Curt A. , Hauri D. , Schurch B.
Published: June 2003

Aims

To assess the significance of combined neurophysiological and neurourological examinations for diagnosis of neurogenic male sexual dysfunction.

Methods

This is a prospective study of 32 spinal cord injured men. Each underwent clinical and neurophysiological examinations (sympathetic skin responses (SSR), pudendal somato‐sensory evoked potentials (P‐SSEP), bulbocavernosus reflex (BCR)) and neuro‐urological measurements (urodynamic examination (UE), reflex erections (RE), psychogenic erections (PE) and nocturnal penile tumescence recordings (NPTR)).

Results

Erectile dysfunction due to impairment of RE was associated with loss of BCR and detrusor areflexia (P > 0.001), whereas that due to impairment of PE was associated with loss of perineal SSR (P < 0.001). P‐SSEP corresponded in 94% with impairment of penile sensibility and duration of erections in NPTR. The NPTRs were less related to functional sexual impairment. NPTRs in complete and incomplete suprasacral (level > T10) spinal lesion showed sufficient erections despite strongly disturbed PE. NPTRs in lumbosacral lesion revealed significant reduction in or absent erections and underestimated the presence of well excitable PE.

Conclusions

Combined neurophysiologic and neurourologic testing provides highly relevant diagnostic informations about sexual dysfunction in men with spinal cord injury. Loss of the BCR and detrusor areflexia imply loss of somatic and parasympathetic reflex activity and correlate with loss of RE. Loss of PE correlates with loss of perineal SSR (sympathetic denervation). Neurourol. Urodynam. 22:314–321, 2003. © 2003 Wiley‐Liss, Inc.
Inter‐observer agreement in the estimation of bladder pressure using a penile cuff
Authors: Drinnan Michael J. , McIntosh Stuart L. , Robson Wendy A. , Pickard Robert S. , Ramsden Peter D. , Griffiths Clive J.
Published: June 2003

Aims

Objective data are useful in quantifying a patient's lower urinary tract symptoms (LUTS). We are investigating the use of an inflatable penile cuff to obstruct flow progressively during voiding, and thereby determine the pressure pcuff,int at which flow is interrupted. The aim of this study was to determine the agreement between experienced observers in their estimates of pcuff,int.

Methods

We recorded 486 cuff inflation cycles during 142 voids from 42 subjects recruited from urology out‐patient's and prostate assessment clinics. Each inflation cycle was assessed independently by three experienced observers, a total of 1,458 ratings. According to our standard assessment procedure, the observers (i) indicated whether the inflation should be analyzed, (ii) estimated pcuff,int for those inflation cycles judged suitable for analysis, and (iii) discarded measurements that were clearly inconsistent with others from the same voiding cycle.

Results

Overall, 689 of the 1,458 ratings (45%) were excluded, with just 4% of all ratings discarded for inconsistency. For 385 of the 486 inflation cycles (79%) there was complete agreement that the cycle should or should not be analyzed. Thereafter, for the 262 inflation cycles analyzed by two or three observers, the overall SD error in measurements of pcuff,int was 4.6 cm H2O.

Conclusions

We conclude that there is good agreement between experienced observers in their interpretation of data from the cuff test. For practical purposes, there is no need for multiple observers in the clinical application of the cuff method. Neurourol. Urodynam. 22:296–300, 2003. © 2003 Wiley‐Liss, Inc.
The amyloid‐β (Aβ) peptide pattern in cerebrospinal fluid in Alzheimer's disease: evidence of a novel carboxyterminally elongated Aβ peptide
Authors: Lewczuk Piotr , Esselmann Hermann , Meyer Markus , Wollscheid Volker , Neumann Manuela , Otto Markus , Maler Juan Manuel , Rüther Eckart , Kornhuber Johannes , Wiltfang Jens
Published: June 2003

The patterns of amyloid β (Aβ) peptides in human cerebrospinal fluid (CSF) and brain homogenates were studied by surface‐enhanced laser desorption/ionization (SELDI) time‐of‐flight (TOF) mass spectrometry, and the results were compared with those obtained by Aβ‐SDS‐PAGE/immunoblot. Apart from the peptides known in the literature to occur in the CSF, we postulate the existence of a novel, previously not described peptide, either Aβ1–45 or Aβ2–46. This peptide was observed exclusively in a pool of samples originating from patients with AD, i.e. CSF and postmortem brain homogenates, but not in either the pooled CSF samples nor the pooled brain homogenates of the non‐demented controls. Similarly to our previous results, Aβ1–42 was decreased in the CSF in AD. Expectedly, brain homogenates of the control subjects did not show the presence of Aβ peptides. Compared with Aβ‐SDS‐PAGE/immunoblot, SELDI‐TOF enabled more precise analysis of Aβ peptides in the human material. We conclude that SELDI‐TOF offers a promising tool for dementia expression pattern profiling using a minute amount of a biological sample. Copyright © 2003 John Wiley & Sons, Ltd.
Feasibility of atmospheric pressure desorption/ionization on silicon mass spectrometry in analysis of drugs
Authors: Huikko K. , Östman P. , Sauber C. , Mandel F. , Grigoras K. , Franssila S. , Kotiaho T. , Kostiainen R.
Published: June 2003

The feasibility of atmospheric pressure desorption/ionization on silicon mass spectrometry (AP‐DIOS‐MS) for drug analysis was investigated. It was observed that only compounds with relative high proton affinity are efficiently ionized under AP‐DIOS conditions. The limits of detection (LODs) achieved in MS mode with midazolam, propranolol, and angiotensin II were 80 fmol, 20 pmol, and 1 pmol, respectively. In MS/MS mode the LODs for midazolam and propranolol were 10 fmol and 5 pmol, respectively. The good linearity (r2 > 0.991), linear dynamic range of 3 orders of magnitude, and reasonable repeatability showed that the method is suitable for quantitative analysis. Copyright © 2003 John Wiley & Sons, Ltd.
Understanding and control of a simple dynamic system
Authors: Jensen Eva , Brehmer Berndt
Published: June 2003

This study examined laypeople's understanding of a simple dynamic system, expressed in reasoning and strategies used by the subjects, and how it affected performance. Participants were 15 undergraduate psychology students, 4 male and 11 female; median age was 24 years, ranging from 21 to 31 years. The subjects' task was to establish equilibrium in a simple predator‐and‐prey system. A task analysis was performed to identify the problem structure, the vital aspects of the task, and the ideal strategies to perform the task. The subjects' actual performance was compared to these strategies. The results revealed that, even though the task was structurally simple, it was still difficult. Much of these difficulties seemed to stem from a low ability to apply indirect reasoning and thinking in terms of discrete time steps instead of in terms of continuous time. Copyright © 2003 John Wiley & Sons, Ltd.
A system dynamics analysis of the Westray mine disaster
Authors: Cooke David L.
Published: June 2003

This article describes a system dynamics analysis of the 1992 Westray mine disaster in Nova Scotia, Canada. It examines the causal structure of the Westray system, including relationships that could have led to conditions that caused the fatal explosion at the mine. The value of simulation is its ability to capture a “mental model” of the safety system, which can stimulate discussion among safety experts as to the systemic causes of a disaster. By taking into account feedback loops and non‐linear relationships, which is not possible with conventional root‐cause analysis, a dynamic model of the system provides insights into the complex web of causes that can lead to disaster and valuable lessons for organizational learning. Copyright © 2003 John Wiley & Sons, Ltd.
Prenatal diagnosis of dysmorphic syndromes by routine fetal ultrasound examination across Europe
Authors: Stoll C. , Clementi M. ,   The Euroscan Study Group
Published: June 2003

Objectives

Ultrasound scan in the mid‐trimester of pregnancy is now a routine part of prenatal care in most European countries. The objective of this study was to evaluate the prenatal diagnosis of dysmorphic syndromes by fetal ultrasound examination.

Methods

Data from 20 registries of congenital malformations in 12 European countries were included in the study.

Results

There were 2454 cases with congenital heart diseases, 479 of which were recognized syndromes, including 375 chromosomal anomalies and 104 syndromes without chromosomal anomalies. Fifty‐one of the 104 were detected prenatally (49.0%). One hundred and ninety‐two of 1130 cases with renal anomalies were recognized syndromes, including 128 chromosomal anomalies and 64 syndromes without chromosomal anomalies; 162 of them (84.4%) were diagnosed prenatally, including 109 chromosomal anomalies and 53 non‐chromosomal syndromes. Fifty‐four of the 250 cases with limb defects were recognized syndromes, including 16 chromosomal syndromes and 38 syndromes without chromosomal anomalies; 21 of these 54 syndromes were diagnosed prenatally (38.9%), including 9 chromosomal syndromes. There were 243 cases of abdominal wall defects including 57 recognizable syndromes, 48 with omphalocele and 9 with gastroschisis; 48 were diagnosed prenatally (84.2%). Twenty‐six of the 187 cases with diaphragmatic hernia had recognized syndromes, including 20 chromosomal aberrations and 6 syndromes without chromosomal anomalies. Twenty‐two of them (84.6%) were detected prenatally. Sixty‐four of 349 cases with intestinal anomalies were recognized syndromes; 24 were diagnosed prenatally (37.5%). There were 553 cases of cleft lip and palate (CL(P)) and 198 of cleft palate (CP) including 74 chromosomal anomalies and 73 recognized non‐chromosomal syndromes. Prenatal diagnosis was made in 51 cases of CL(P) (53.7%) and 7 of CP (13.7%). Twenty‐two of 188 anencephalic cases were syndromic and all were diagnosed prenatally. Of 290 cases with spina bifida, 18 were recognized syndromes, and of them 17 were diagnosed prenatally. All 11 syndromic encephaloceles were diagnosed prenatally.

Conclusions

Around 50% of the recognized syndromes which are associated with major congenital anomalies (cardiac, renal, intestinal, limb defects, abdominal wall defects and oral clefts) can be detected prenatally by the anomaly scan. However the detection rate varies with the type of syndrome and with the different countries' policies of prenatal screening. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Reproducibility of three‐dimensional ultrasound diagnosis of congenital uterine anomalies
Authors: Salim R. , Woelfer B. , Backos M. , Regan L. , Jurkovic D.
Published: June 2003

Objective

To examine the reproducibility of the diagnosis of congenital uterine anomalies and the repeatability of measurements of uterine cavity dimensions using three‐dimensional (3D) ultrasound.

Methods

The reproducibility of diagnosis of congenital uterine anomalies was examined by re‐slicing stored 3D ultrasound volumes. Each data set was evaluated by two independent observers. Assessment of uterine morphology was performed in a standardized plane, with the interstitial portions of the Fallopian tubes used as reference points. Additionally, in 35 cases of congenital uterine anomalies the width of the uterine cavity (W), fundal distortion (F) and the length of unaffected uterine cavity (C) were measured. Intraobserver and interobserver variabilities were evaluated by each observer performing all three measurements twice.

Results

Eighty‐three 3D ultrasound volumes were examined. Both operators classified 27 uteri as normal, 33 as arcuate, 19 as subseptate and three as unicornuate. A single case of uterine anomaly was described as arcuate uterus by one operator and subseptate by another (kappa 0.97). The intraobserver variability for each of the three measurements (W, F and C) was satisfactory with limits of agreement ranging from ±1.43 to ±2.51 mm. The examination of the interobserver variability showed no significant differences between the two observers (F = 0.484, P > 0.05).

Conclusion

3D ultrasound is a reproducible method for the diagnosis of congenital uterine anomalies and for the measurement of uterine cavity dimensions. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound assessment of cervical length in threatened preterm labor
Authors: Tsoi E. , Akmal S. , Rane S. , Otigbah C. , Nicolaides K. H.
Published: June 2003

Objective

More than 70% of women presenting with threatened preterm labor do not progress to active labor and delivery. The aim of this study was to investigate the hypothesis that in women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor.

Methods

We examined 216 women with singleton pregnancies presenting with regular and painful uterine contractions at 24–36 (mean, 32) weeks of gestation. Women in active labor, defined by the presence of cervical dilatation ≥ 3 cm, and those with ruptured membranes were excluded. On admission to the hospital a transvaginal scan was performed to measure the cervical length. The subsequent management was determined by the attending obstetrician. The primary outcome was delivery within 7 days of presentation.

Results

In 173 cases the cervical length was ≥ 15 mm and only one of these women delivered within 7 days. In the 43 cases with cervical length < 15 mm delivery within 7 days of presentation occurred in 16 (37%) including 6/14 (42%) treated with tocolytics and 10/29 (35%) managed expectantly. Logistic regression analysis demonstrated that the only significant contributor in the prediction of delivery within 7 days was cervical length < 15 mm (odds ratio = 101, 95% CI 12–800, P < 0.0001) with no significant contribution from ethnic group, maternal age, gestational age, body mass index, parity, previous history of preterm delivery, cigarette smoking, contraction frequency or use of tocolytics.

Conclusions

In women with threatened preterm labor, sonographic measurement of cervical length helps distinguish between true and false labor. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Abnormal cardiac function in fetuses with increased nuchal translucency
Authors: Rizzo G. , Muscatello A. , Angelini E. , Capponi A.
Published: June 2003

Objective

To evaluate cardiac function in structurally and chromosomally normal fetuses with increased nuchal translucency (NT).

Methods

Forty‐two structurally and chromosomally normal fetuses with increased NT at 11–14 weeks of gestation underwent fetal echocardiographic examination at 20–23 weeks. Fifty fetuses with normal NT values were considered as controls. Pulmonary and aortic peak velocity and time to peak velocities were measured as indices of ventricular systolic function. The ratios between the E‐wave and A‐wave (E/A) and the ratios between the E‐wave and time velocity integral (E/TVI) at the level of both atrioventricular valves were evaluated as indices of ventricular diastolic function.

Results

In fetuses with increased NT the E/A ratios were significantly decreased when compared to control fetuses at the level of both the mitral (0.52 ± 0.09 vs. 0.60 ± 0.10, P = 0.0002) and tricuspid (0.51 ± 0.09 vs. 0.61 ± 0.09, P < 0.0001) valves. Similar results were found for the E/TVI ratios (mitral valve 4.79 ± 1.03 vs. 5.63 ± 1.23, P = 0.0007 and tricuspid valve 4.40 ± 0.88 vs. 5.19 ± 0.82, P < 0.0001). No significant relationship was found between the degree of NT and the abnormalities in Doppler indices. There were no significant differences in Doppler systolic indices.

Conclusion

Structurally and chromosomally normal fetuses with increased NT have low E/A and E/TVI ratios at 20–23 weeks of gestation. These findings might indicate cardiac diastolic dysfunction. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
First‐trimester diagnosis of micrognathia as a presentation of Pierre Robin syndrome
Authors: Teoh M. , Meagher S.
Published: June 2003

We describe a case of first‐trimester diagnosis of micrognathia. A transvaginal ultrasound scan performed at 13 weeks' gestation revealed an abnormal fetal facial profile consisting of a small mandible and a receding chin. A subsequent amniocentesis at 15 weeks' gestation revealed a normal karyotype. A morphology scan and subsequent postmortem examination at 19 weeks confirmed the first‐trimester findings and revealed, in addition to the facial pathology, a complex cardiac abnormality and unilateral talipes equinovarus. These findings are consistent with the diagnosis of Pierre Robin syndrome. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Endometrial blood flow mapping using transvaginal power Doppler sonography in women with postmenopausal bleeding and thickened endometrium
Authors: Alcázar J. L. , Castillo G. , Mínguez J. Á. , Galán M. J.
Published: June 2003

Objective

To evaluate the role of transvaginal power Doppler sonography to discriminate between benign and malignant endometrial conditions in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography.

Methods

Ninety‐one postmenopausal women (median age, 58 years; range, 47–83 years) presenting with uterine bleeding and a thickened endometrium (≥ 5‐mm double‐layer endometrial thickness) on transvaginal sonography were included in this prospective study. Endometrial blood flow distribution was assessed in all patients by power Doppler immediately after B‐mode transvaginal sonography. Three different vascular patterns were defined: Pattern A: multiple‐vessel pattern, Pattern B: single‐vessel pattern and Pattern C: scattered‐vessel pattern. Histological diagnoses were obtained in all cases. No patient taking tamoxifen citrate or receiving hormone replacement therapy was included.

Results

Histological diagnoses were as follows: endometrial cancer: 33 (36%), endometrial polyp: 37 (41%), endometrial hyperplasia: 14 (15%), endometrial cystic atrophy: 7 (8%). Blood flow was found in 97%, 92%, 79% and 85% of cases of carcinoma, polyp, hyperplasia and endometrial cystic atrophy, respectively. A total of 81.3% of vascularized endometrial cancers showed Pattern A, 97.1% of vascularized polyps exhibited Pattern B and 72.7% of vascularized hyperplasias showed Pattern C. Sensitivity and specificity for endometrial cancer were 78.8% and 100%. For endometrial polyp these respective values were 89.2% and 87% and for hyperplasia they were 57.1% and 88.3%.

Conclusions

Transvaginal power Doppler blood flow mapping is useful to differentiate benign from malignant endometrial pathology in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.