bluuebunny/crossref_metadata_2025 huggingface dataset:
Varicella Pneumonia Complicating Pregnancy: A Report of Seven Cases
Authors: Schutte Teresa J. , Rogers Louise C. , Copas Pleas R.
Published: March 2007

Background: Pneumonia is the most common complication of varicella‐zoster infection in adults and
has potentially devastating effects when complicating pregnancy. Due to the significant morbidity
and mortality associated with this complication during pregnancy and the small number of reported
cases in the literature, we present this report to help educate physicians who care for pregnant
women.

Cases: Seven patients are presented in this report. These patients presented at various stages in
pregnancy, from 17 to 31 weeks of gestation. Three of the patients had unremarkable hospital
courses. Three of the patients had hospital stays over 21 days in duration. One patient died from
complications of varicella pneumonia after 31 days of hospitalization. The obstetric outcomes of the
7 patients described include 1 non‐viable delivery at 20 weeks gestation, 3 term deliveries, 2 preterm
deliveries, and 1 patient who has not yet delivered. All of the patients presented were treated with
intravenous acyclovir therapy. Of the patients described, 3 required intubation and ventilatory
support. Other complications encountered include disseminated intravascular coagulation (DIC),
adult respiratory distress syndrome (ARDS), metabolic encephalopathy, pneumothorax, superimposed
bacterial pneumonia, and sepsis.

Conclusion: The course and treatment of varicella pneumonia complicating pregnancy are discussed.
Current recommendations regarding the use of varicella‐zoster immune globulin (VZIG)
are also reviewed.
Malaria in Pregnancy
Authors: Hollier Lisa M. , Ericksen April L. , Cox Susan M.
Published: March 2007

This review summarizes the epidemiology, clinical course, and diagnosis of malaria. The influence of infection during pregnancy upon maternal and neonatal anemia, stillbirth, preterm labor, low birth weight, and congenital malaria is discussed. Options for treatment and prophylaxis during pregnancy are presented.
Molecular Mechanisms of Parturition
Authors: Ferré F.
Published: March 2007

The initial signal for triggering human parturition might be fetal but of trophoblastic origin. Concomitantly, this placental signal would have as its target not only the uterus but also the fetus by activating its hypothalamo-pituitary-adrenocortical axis. The latter would represent a second fetal signal which, at the fetomaternal interface, would amplify and define in time the mechanisms responsible for the onset of labor, implying changes in the myometrial and cervical extracellular matrix associated with the accession of the contractile phenotype for myometrial cells. At each phase of these processes in the utero-feto-placental system, the nature of these signals remains to be identified. Is there a single substance, or rather, and more likely, a combination of several?

We appear to be in the presence of dynamic systems of a neuro-immuno-hormonal type which are difficult to describe. Nevertheless, steroid hormones appear to coordinate their successive equilibriums until they become irreversible. Such irreversibility constitutes the essential sign of parturition.
Pathogenesis to Treatment: Preventing Preterm Birth Mediated by Infection
Authors: McGregor James A. , French Janice I.
Published: March 2007

Prevention of preterm birth and subsequent newborn immaturity is a primary goal of obstetrical care worldwide. Accumulated evidence shows that 1) as many as 25–50% of preterm births are caused by common genital tract infections and subsequent maternal/fetal inflammatory responses; 2) microbial and maternal host factors (phospholipases, proteases, etc.) play roles in preterm labor and preterm premature rupture of membranes (pPROM); 3) integrated aspects of maternal and fetal host responses (inflammation, altered immune adaptations, endocrine and paracrine mechanisms) play increasingly understood roles in premature activation of parturition; and 4) identification and systemic treatment of common genitourinary infections, most importantly bacterial vaginosis (BV), reduce the risks of preterm delivery and PROM.
Immunopathogenesis of Toxoplasmosis in Pregnancy
Authors: Dupouy-Camet Jean
Published: March 2007

The immunopathogenesis of toxoplasmosis during pregnancy is not completely understood. This paper will try to discuss the most frequently asked questions about the immunopathogeny of congenital toxoplasmosis: differential virulence of Toxoplasma isolates, genetic susceptibility to infection, facilitation of placental transfer, models of congenital toxoplasmosis, and transmission in seropositive hosts. Most published data suggest a role of the genetic background of the host and of the parasite. Models of congenital toxoplasmosis have been evaluated, but it appears that the conclusion drawn would be barely appropriate to understand the pathogenesis in pregnant women.
Immune Sensitization to the 60 kD Heat Shock Protein and Pregnancy Outcome
Authors: Neuer A. , Spandorfer S. , Giraldo P. , Mele C. , Liu H. C. , Marzusch K. , Kneissl D. , Witkin S. S.
Published: March 2007

Heat shock proteins are highly conserved proteins present in organisms ranging from bacteria to man. They are both dominant microbial immunogens and among the first proteins produced during mammalian embryo development. Since bacterial and human heat shock proteins share a high degree of amino acid sequence homology, it has been suggested that sensitization to bacterial heat shock proteins during an infection may result in autoimmunity to human heat shock proteins. Infertile couples seeking in vitro fertilization (IVF) may have been previously sensitized to bacterial heat shock proteins as a consequence of an asymptomatic upper genital tract infection. Due to daily clinical monitoring and precisely timed fertilization these patients are an ideal study group to investigate the effect of prior sensitization to heat shock proteins on preimplantation embryo development and implantation failure. Immune sensitization at the level of the cervix to the 60 kD heat shock protein (hsp60) has been associated with implantation failure in some IVF patients. Similarly, the highest prevalence of circulating hsp60 antibodies among IVF patients was found in the sera of women whose embryos failed to develop in vitro. To more directly assess whether humoral immunity to hsp60 influenced in vitro embryo development, a mouse embryo culture model was established. Monoclonal antibody to mammalian hsp60 markedly impaired mouse embryo development in vitro. These data suggest that immune sensitization to human hsp60, possibly developed as a consequence of infection, may adversely affect pregnancy outcome in some patients.
Recurrent Fetal Loss and Antiphospholipid Antibodies: Clinical and Therapeutic Aspects
Authors: Blétry O. , Piette A.-M.
Published: March 2007

Recurrent fetal losses indicate screening for antiphospholipid antibodies, especially after the third consecutive fetal loss, or when they occur after 12 weeks gestation or when the mother presents with thrombosis or other ailments of antiphospholipid syndrome. Fetal loss may be caused by thromboses of placental vasculature. There is no agreement concerning the mechanism of thromboses: protein C pathway and/or annexin V are the best candidates. When fetal loss occurs early during gestation, murine models suggest that antiphospholipid antibodies can also act on trophoblasts by inhibiting syncytia formation. Among the high risk patients with more than two fetal
losses, an association of aspirin and heparin given early during gestation is successful in 70–80% of cases.
First Trimester Listeria monocytogenes Septicemia
Authors: Goddijn Mariëtte , Schipper Hans G. , Spanjaard Lodewijk , Wolf Hans
Published: March 2007

Background: Little is known about fetal outcome after Listeria monocytogenes septicemia in the first trimester of pregnancy.

Case: A primigravida with L. monocytogenes septicemia at 9 weeks gestation was treated with amoxicillin. At 40 weeks gestation a healthy female infant was born.

Conclusion: This case shows that fetal outcome can be normal after appropriate treatment of maternal L. monocytogenes septicemia during embryogenesis.
Determining the Maternal and Fetal Cellular Immunologic Contributions in Preterm Deliveries With Clinical or Subclinical Chorioamnionitis
Authors: McNamara M. F. , Wallis T. , Qureshi F. , Jacques S. M. , Gonik B.
Published: March 2007

Objective: Our purpose was to determine the maternal and fetal polymorphonuclear contributions to preterm histologic chorioamnionitis and whether this response differs in clinical chorioamnionitis when compared to cases without clinical chorioamnionitis.

Methods: Paraffin placenta blocks from 19 preterm deliveries with histologic chorioamnionitis, 9 with clinical chorioamnionitis and 10 without clinical chorioamnionitis, were identified. Only placentas from male fetuses were used. Cytospin slides were generated from tissue specimens for fluorescent in situ hybridization (FISH) and labeled with X and Y chromosome probes. Under fluorescent microscopy, polymorphonuclear cells (PMNs) were identified as having two XX signals (maternal) or a single X and Y pair (fetal).

Results: Maternal PMNs comprised 89% and 91% of the cellular response in the groups with and without clinical chorioaminionitis, respectively. This difference in the two groups was not statistically significant.

Conclusions: The dominant contribution of PMNs seen in preterm severe histologic chorioamnionitis is maternal in origin. This response is similar in the presence or absence of clinical chorioamnionitis.
Chlorhexidine Vs. Sterile Vaginal Wash During Labor to Prevent Neonatal Infection
Authors: Eriksen Nancy L. , Sweeten Keri M. , Blanco Jorge D.
Published: March 2007

Objective: The purpose of this study was to determine if a dilute solution of chlorhexidine used as a one‐time vaginal wash intrapartum can reduce the use of postnatal antibiotics and neonatal infection.

Methods: Term pregnant women in labor were prospectively randomized to receive either 20 cc of 0.4% chlorhexidine (n = 481) or 20 cc of sterile water (n = 466) placebo. Exclusion criteria included fetal distress, clinical infection, cervical dilatation >6 cm, and known allergy to chlorhexidine. Outcome variables included the incidence of neonatal pneumonia, culture proven neonatal sepsis, and use of the antibiotics in the neonate. Continuous variables were compared using the Mann‐Whitney U‐test and discrete variables were compared with the chi‐square test.

Results: The length of ruptured membranes (mean ± S.D.) between the chlorhexidine group (408 ± 589 min) and control group (352 ± 318 min) was not significantly different (P = 0.85, 95% confidence interval 354–462). Fifteen neonates (3.2%) in the chlorhexidine group and 9 (1.9%) in the control group received antibiotics in the postnatal period (P = 0.32, 95% confidence interval 0.72–3.72). There was one case of pneumonia in the control group and no cases of sepsis in either group.

Conclusions: A one‐time chlorhexidine vaginal wash does not decrease the use of antibiotics or incidence of neonatal infection in our population.
Interrelationships Within the Bacterial Flora of the Female Genital Tract
Authors: Carson Henry J. , Lapoint Paul G. , Monif Gilles R. G.
Published: March 2007

Analysis of 240 consecutive vaginal swabs using the compatibility profile technique revealed that only 2 bacteria have the ability to be a sole isolate and as such a candidate to be a major aerobic regulator of the bacterial flora of the female genital tract (BFFGT). Compatibility profiles of Lactobacillus and Gardnerella vaginalis have shown that these organisms shared compatibility profiling for the majority of the normal bacterial constituents of the female genital tract. Dominance disruption appears to come from the addition of compatible co‐isolates and presumed loss of numerical superiority. These phenomena appear to be the keys to reregulation of BFFGT. Lactobacillus appears to be the major regulator of both G. vaginalis and anaerobic bacteria. When additional organisms are added to the bacterial flora, they may add to or partially negate the inhibitory influence of Lactobacillus on the BFFGT. Inhibitor interrelationships appear to exist between coagulase‐negative staphylococci and Staphylococcus aureus and the group B streptococci (GBS) and other beta hemolytic streptococci. Facilitating interrelationships appear to exist between S. aureus and the GBS and selected Enterobacteriaceae.
Septic Shock, Adult Respiratory Distress Syndrome, and Disseminated Intravascular Coagulopathy Following Midtrimester Genetic Amniocentesis
Authors: Johnson J. R. , Stubblefield P. G. , Hamid M. A. , Kasznica J.
Published: March 2007

Background: Midtrimester genetic amniocentesis is a commonly performed procedure, with acknowledgment of some risk to mother and fetus.

Case: We present an unusual case of midtrimester genetic amniocentesis with bowel injury and resulting septic shock, adult respiratory distress syndrome, and disseminated intravascular coagulation. A total abdominal hysterectomy and bilateral salpingoophorectomy were required for resolution of sepsis. The patient also required prolonged ventilatory support postoperatively.

Conclusion: Although relatively safe, genetic amniocentesis can result in serious morbidity, and attention to technique should be maintained.
Ovarian Abscess Caused by Peptostreptococcus magnusFollowing Transvaginal Ultrasound‐GuidedAspiration of Ovarian Endometrioma and FixationWith Pure Ethanol
Authors: Mikamo H. , Kawazoe K. , Sato Y. , Itoh M. , Tamaya T.
Published: March 2007

Background: Transvaginal ultrasound‐guided aspiration of ovarian endometrioma has been applied
and emphasized as a safe and simple procedure.

Case: Two 27‐year‐old infertile women, both gravida 0, para 0, underwent medical follow‐up
examinations for cases of ovarian endometrioma. Both had undergone transvaginal ultrasoundguided
aspiration of ovarian endometrioma. Because both were continuously febrile and had abdominal
pain and cysts with tenderness in spite of antibiotic therapies, both underwent laparotomies
for treatment. In both cases, enucleation of the ovarian abscess revealed purulent and malodorous
fluid that demonstrated Peptostreptococcus magnus in culture.

Conclusion: We theorize that following transvaginal ultrasound‐guided aspiration of ovarian endometrioma
and fixation with pure ethanol, anaerobic infection by P. magnus occurred, and a cyst
formed in the abscess.
Initial and Repeat Screening for Chlamydia trachomatisDuring Pregnancy
Authors: Allaire Alexander D. , Huddleston John F. , Graves William L. , Nathan Lawrence
Published: March 2007

Objectives: The objective of this study is to determine the prevalence of Chlamydia trachomatis and
risk factors for positive repeat tests in a high‐risk population presenting for early prenatal care.

Methods: We completed a retrospective cohort study of 2,484 women who initiated prenatal care
prior to 20 weeks gestation, delivered, and received testing for cervical C. trachomatis at Grady
Memorial Hospital or a Grady‐affiliated clinic between July 1, 1993 and December 31, 1994. We
calculated adjusted odds ratios (OR) for selected risk factors for a positive initial test and for a
positive subsequent test after an initial negative test.

Results: The prevalence of C. trachomatis was 14.8%. At initial testing, 10.4% of the women were
positive. If the initial test was negative, 5.7% had a positive subsequent test; but if the initial test was
positive, 32.0% had a positive subsequent test (P<0.001). The variables significantly and independently
associated with a positive initial test were black race/ethnicity, age less than 25, unmarried,
and less than a high‐school education (adjusted OR of 1.66, 3.53, 2.18, and 1.81, respectively).
Variables significantly and independently associated with a positive subsequent test after a negative
initial test were white race/ethnicity, black race/ethnicity, age less than 25, and less than a highschool
education (adjusted OR 8.69, 7.77, 4.12,and 2.27, respectively).

Conclusions: In our inner‐city population, most pregnant women have risk factors suggesting the
need to rescreen for C. trachomatis in the second half of pregnancy. Infect.
Prevalence of Cervicovaginal Infections DuringGestation and Accuracy of Clinical Diagnosis
Authors: Simões J. A. , Giraldo P. C. , Faúndes A.
Published: March 2007

Objectives: The aim of this study was to establish the prevalence of cervicovaginal infections in
normal third‐trimester pregnant women and evaluate the accuracy of clinical diagnosis.

Method: A total of 328 pregnant women were followed at the Prenatal Outpatient Clinic of the
Department of Obstetrics and Gynecology at the School of Medical Sciences, Universidade Estadual
de Campinas (UNICAMP), Brazil, from October 1991 to February 1993. The clinical
diagnosis was based on the characteristics of the vaginal discharge, and the etiological diagnosis was
based on bacterioscopy of the vaginal secretion and direct immunofluorescence for Chlamydia trachomatis
. The data were analyzed statistically, determining the sensitivity, specificity, and positive
and negative predictive value of the clinical diagnosis related to the laboratory diagnosis of the
different infections.

Results: The prevalence of infection was 39.6% (Candida albicans, 19.2%; bacterial vaginosis,
9.5%; intermediate vaginal flora, 6.7%; Chlamydia trachomatis, 2.1%; and vaginal trichomoniasis,
2.1%). The accuracy of clinical diagnosis was low, with sensitivity between 50% and 65% and
specificity around 60%, with the exception of trichomoniasis, which showed a sensitivity of 100%
and chlamydia, with a sensitivity of 0% and a specificity of 100%.

Conclusion: The accuracy of the clinical diagnosis of infections was low, specifically with respect
to the positive predictive value. The results demonstrate the need for specific testing of cervicovaginal
infections at prenatal visits. Reliance on simple vaginal examination results in a low yield for
detection of vaginal infections.
Bilateral Tubo‐Ovarian Abscesses Four Years AfterTotal Abdominal Hysterectomy
Authors: Mendez L. E. , Bhoola S. M. , Horowitz I. R.
Published: March 2007

Background: Pelvic inflammatory disease (PID) is a common gynecologic disorder. One known
complication of PID is tubo‐ovarian abscess (TOA) formation. The predominant theory on TOA
formation postulates that an ascending infection from the cervix through the uterus to the fallopian
tubes and ovaries results in abscess formation. Other theories include seeding via a hematogenous
infection, diverticular disease, and appendicitis.

Case: A 39‐year‐old female patient with abdominal pain was referred to our institution and was
found to have a pelvic mass. After a thorough evaluation, surgical exploration revealed the presence
of TOA. No evidence of gastrointestinal disease was present. The patient’s history was significant
for an uncomplicated total abdominal hysterectomy for benign disease of the uterus four years
prior. Abscess cultures grew Streptococcus intermedius.

Conclusion: This case reports the rare occurrence of TOA in a patient who had undergone an
abdominal hysterectomy four years prior to presentation. If the patient reports a surgical history of
prior hysterectomy, TOA is often stricken from consideration. Although unlikely, adnexal abscess
formation should be considered in the differential diagnosis of a patient with abdominal pain and a
pelvic mass, even with a remote history of hysterectomy.
17‐β‐Estradiol Upregulates the Stress Response inCandida albicans: Implications for Microbial Virulence
Authors: O’Connor C. , Essmann M. , Larsen B.
Published: March 2007

Objective: The influence of 17‐β‐estradiol on the stress response of Candida albicans was studied.

Methods: The survival of clinical isolates of C. albicans treated with 17‐β‐estradiol after heat and oxidative stress was measured by viable plate counts. Cellular proteins were analyzed via SDSPAGE.

Results: The heat stress response induced by 17‐β‐estradiol in C. albicans grown at 25 ℃ protected
the organisms against the lethal temperature of 48.5 ℃, as shown by viable plate counts.
17‐β‐estradiol also enhanced protection of C. albicans against oxidative stress (menadione exposure).
SDS‐PAGE analysis of cytoplasmic extracts revealed proteins induced by 17‐β‐estradiol
were similar to those induced by heat.

Conclusion: 17‐β‐estradiol enhances survival of C. albicans under heat and oxidative stresses. The
proteins induced by 17‐β‐estradiol are probably heat shock proteins. Because heat shock proteins
are considered to be virulence factors, 17‐β‐estradiol may function to promote in vivo survival.
Persistence of Human Papillomavirus DNA inCervical Lesions After Treatment With DiathermicLarge Loop Excision
Authors: Distéfano A. L. , Picconi M. A. , Alonio L. V. , Dalbert D. , Mural J. , Bartt O. , Bazán G. , Cervantes G. , Lizano M. , Carrancá A. G. , Teyssié A.
Published: March 2007

Objective: The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial
neoplasia (CIN) lesions and to evaluate the persistence of viral DNA after diathermic large
loop excision (DLLE) treatment.

Study Design: Biopsies from 36 patients with low‐ and high‐grade CIN lesions were studied
before and after DLLE treatment looking for HPV sequences. DNA was extracted to perform a
radioactive polymerase chain reaction (PCR) using GP 5,6 generic primers. PCR products were
analyzed by the single‐stranded conformational polymorphism (SSCP) which is a simultaneous
detection and typing method. Dot‐blot hybridization with generic and type‐specific biotinylated
oligonucleotide probes was applied in some cases.

Results: HPV DNA was found in all pretreatment samples, and the viral type was identified in
80% of them, HPV 16 being the most prevalent. The viral type coincided with that detected in the
first biopsy in all except one case. Seventy five percent of the patients (27 cases) were negative for
CIN at follow up, but 50% of them remained HPV DNA positive.

Conclusion: DLLE treatment was effective in removing the CIN lesion but not the HPV. This
fact points out the need to asses the presence of HPV in DNA during the follow‐up, since viral
persistence has been considered a high risk factor for recurrence and/or malignant transformation.
The Ex Vivo Human Placental Transfer of theAnti‐HIV Nucleoside Inhibitor Abacavir and theProtease Inhibitor Amprenavir
Authors: Bawdon R. E.
Published: March 2007

Objective: The transfer of abacavir, a new nucleoside inhibitor, and amprenavir, a new protease
inhibitor, used for the treatment of human immunodeficiency virus, has been studied in the ex vivo
human placental model.

Methods: The ex vivo human placental model used C14 antipyrine to determine the transport
fraction and clearance index of these compounds at both the peak and trough serum concentrations.
The clearance index accumulation and tissue concentrations were determined for each drug by high
pressure liquid chromatography.

Results: The clearance index of abacavir was 0.47 ± 0.19 and 0.50 ± 0.07 at peak and trough
concentrations, respectively. The clearance index of amprenavir was 0.38 ± 0.09 and 0.14 ± 0.08 at
peak and trough concentrations, respectively. There was no unusual accumulation of either drug in
the media or tissue when the perfusion system was closed.

Conclusion: Abacavir is the first nueleoside compound studied in the perfusion system with a high
clearance index. The transfer of the protease inhibitor amprenavir had a clearance index 2.75 times
greater than the clearance index of ritonavir at peak concentration determined in a previous study.
At trough concentration the clearance index was much less than at the peak concentration. A
similar result was found with ritonavir.
Assessment of Office‐Based Care of SexuallyTransmitted Diseases and Vaginitis and AntibioticDecision‐Making by Obstetrician‐Gynecologists
Authors: McGregor J. A. , Hager W. D. , Gibbs R. S. , Schmidt L. , Schulkin J.
Published: March 2007

Objective: Survey office‐based obstetric‐gynecologic practitioners regarding their knowledge of infectious
disease care and antibiotic use.

Methods: A survey questionnaire of multiple‐choice questions was mailed to Fellows of the
American College of Obstetricians and Gynecologists about clinical entities for which recommendations
have undergone recent changes or about which there was a lack of consensus in a prior
similar survey (Gibbs RS, McGregor JA, Mead PB, et al.: Obstet Gynecol 83:631–636, 1994).

Results: Respondents indicated that oral metronidazole was their most frequent choice to treat
bacterial vaginosis. Ampicillin (57%) was used more often than penicillin (39%) for intrapartum
group B streptococcus prophylaxis. Azithromycin was preferred (61%) over erythromycin‐base
(38%) for chlamydia treatment during pregnancy. There were several modes of practice that deviated
from accepted care: 27% and 29% did not screen for chlamydia and gonorrhea, respectively,
in pregnancy; 17% used cultures for Gardnerella vaginalis to diagnose bacterial vaginosis; 25%
considered quinolones to be safe in pregnancy; 93% felt metronidazole should never be used in
pregnancy; and the majority (66%) would send a patient treated successfully for pelvic cellulitis
home with an oral antibiotic.

Conclusion: Respondents’ infectious disease knowledge and practices in obstetrics and gynecology
is appropriate in treating sexually transmitted diseases, bacterial vaginosis, and group B streptococcus.
Numerous deficiencies still exist in screening for sexually transmitted diseases in pregnancy
and diagnosing bacterial vaginosis, as well as in the choice of antibiotics to use or avoid for
certain infections.
Heat Shock Proteins and Protection Against Ischemic Injury
Authors: Dillmann W. H.
Published: March 2007

Heat shock proteins present a complex family of proteins exerting chaperone‐like activities that are classified according to their molecular weight. We especially explored protective functions of inducible heat shock protein 70, the mitochondrial heat shock protein 60 and 10, and the small heat shock proteins HSP27 and αB‐crystallin against ischemic, reoxygenation‐mediated injury using transgenic
animals and hearts under in vivo conditions and in isolated cardiac myocyte‐derived cells
using adenoviral vectors. We noted with great interest that differential protective effects are exerted by specific hsps. For example, alpha‐B‐crystallin and constitutive hsp70 markedly protect microtubular structure in cardiac myocytes from ischemia‐induced injury. Inducible hsp70, hsp60 and hspl0 when coexpressed, and hsp27 and αB‐crystallin have an overall protective effect against ischemic injury as determined by the release of enzymes like creatine kinase and LDH. We did not note inflammatory or immune responses elicited by the expression of hsps in transgenic animals and
cardiac myocytes. The specific cell types in which hsps are expressed may contribute to the protective effect of hsps versus their inflammatory and immunogenic effects when expressed in other cell types. Infect. Dis. Obstet. Gynecol. 7:55–57, 1999.
Chlamydial Heat Shock Proteins and Disease Pathology: New Paradigms for Old Problems?
Authors: LaVerda D. , Kalayoglu M. V. , Byrne G. I.
Published: March 2007

The mucosal pathogen Chlamydia trachomatis affects hundreds of millions of people worldwide and is a significant cause of sexually transmitted disease. Although most acute infections can be easily managed, complications often occur that can be especially severe in women. It has been proposed that increased exposure to conserved chlamydial antigens, such as through reinfection or persistent
infection, results in chronic inflammation and tissue scarring and contributes to the pathogenesis of endometrial and fallopian tube damage. This immunopathologic damage is believed to be a principal cause of ectopic pregnancy and tubal factor infertility. The chlamydial heat shock protein Hsp60, a homolog of Escherichia coli GroEL, has been identified as one protein capable of eliciting intense mononuclear inflammation. Furthermore, several studies have revealed a correlation between
Hsp60 responses and the immunopathologic manifestations of human chlamydial disease. The role of additional antigens in the immunopathologic response to chlamydiae is currently undefined. A prime candidate, however, is the chlamydial GroES homolog Hspl0, which is genetically and physiologically linked to Hsp60. Recent studies provide data to suggest that immune reactivity to Hspl0 is significantly associated with tubal infertility in a chlamydiae‐exposed population. Chlamydia pneumoniae is a more recently defined chlamydial species that has been implicated in a variety
of ways with chronic disease processes, such as adult onset asthma and atherosclerosis. Evidence indicates that Hsp60 is present in human atheroma and may play a role in lesion development by direct activation of macrophages. Hsp60 causes the elaboration of inflammatory cytokines, the induction of metalloproteinase, and the oxidation of low density lipoprotein. Each of these events is directly associated with the progress of atherosclerosis. Thus, chlamydial heat shock proteins may function in at least two ways to promote chronic disease: first by direct antigenic stimulation and second as signal transducers that result in macrophage activation. These concepts in disease pathology
are discussed in the context of chlamydial infections. Infect. Dis. Obstet. Gynecol. 7:64–71, 1999.
Heat Shock Protein–Based Therapeutic Strategies Against Human Immunodeficiency Virus Type Infection
Authors: Brenner B. G. , Wainberg M. A.
Published: March 2007

Heat shock proteins (hsps) and cyclophilins (CypA) are intracellular chaperone molecules that facilitate protein folding and assembly. These proteins are selectively expressed in cells following exposure to a range of stress stimuli, including viral infection. Hsp species are highly immunogenic, eliciting humoral, cytotoxic T lymphocyte (CTL), and natural killer (NK) cell responses against viruses, tumours, and infectious diseases. This review discusses the roles of stress proteins in immunity and viral life cycles, vis‐à‐vis the development of Hsp‐based therapeutic strategies against human immunodeficiency virus type‐1 (HIV‐1) infection. Cumulative findings are cited implicating
the requirement of CypA in HIV‐1 replication and formation of infectious virions. Studies by our group show the upregulated expression of hsp27 and hsp70 during single‐cycle HIV infections. These species redistribute to the cell surface following HIV‐infection and heat stress, serving as targets for NK and antibody‐dependent cellular cytotoxicity. Co‐immunoprecipitation and Western blot studies show that hsp27, hsp70, and hsp78 complex with HIV‐1 viral proteins intracellularly. Hsp70, hsp56, and CypA are assembled into HIV‐1 virions. The ability of hsps to interact with HIV‐1 viral proteins, combined with their inherent adjuvant and immunogenic properties, indicates that hsps may serve as vehicles for antigen delivery and the design of vaccines against acquired immunodeficiency syndrome. Infect. Dis. Obstet. Gynecol. 7:80–90, 1999.
Evaluation of Ofloxacin in the Treatment of Laparoscopically Documented Acute Pelvic Inflammatory Disease (Salpingitis)
Authors: Peipert J. F. , Sweet R. L. , Walker C. K. , Kahn J. , Rielly-Gauvin K.
Published: March 2007

Objective: To evaluate the safety and efficacy of intravenous and oral ofloxacin monotherapy in the treatment of laparoscopically documented acute pelvic inflammatory disease (PID).

Methods: This study was conducted as an open‐label, phase‐III, uncontrolled, multicenter study. Patients identified with laparoscopic findings of salpingitis were treated with 400 mg of intravenous ofloxacin every 12 hours followed by 400 mg of oral ofloxacin every 12 hours for 10 to 14 days. Patients were evaluated five times for clinical and microbial efficacy. Since laparoscopy was performed only at admission, pathogens identified laparoscopically were presumed eradicated if they were present on the laparoscopic culture and the patient was clinically cured or improved at final evaluation.

Results: Of the 70 patients evaluable for safety (intent‐to‐treat population), the mean age was 25.6 years. Sixty‐one of 70 patients (87%) were cured, one improved, one did not improve, and seven were unevaluable because they discontinued study participation. Fifty‐one were evaluable for clinical efficacy: 50 (98%) were cured and one did not improve. Sixteen were evaluable for expanded microbiological efficacy: three had documented Neisseria gonorrhoeae; 12, Chlamydia trachomatis; and one, a mixed infection of both organisms. All cervical, laparoscopic, and endometrial cultured pathogens, including N. gonorrhoeae and C. trachomatis, were eradicated or presumed eradicated at the posttherapy visit. No serious or unexpected adverse events occurred.

Conclusions: Ofloxacin monotherapy was effective and well tolerated in the treatment of laparoscopically proven PID in a geographically diverse population. Future studies are necessary to evaluate long‐term outcomes and sequelae of PID treatment with single agent therapy. Infect. Dis. Obstet. Gynecol. 7:138–144, 1999.
Infertility Following Pelvic Inflammatory Disease
Authors: Pavletic A. J. , Wölner-Hanssen P. , Paavonen J. , Hawes S. E. , Eschenbach D. A.
Published: March 2007

Objective: To assess the frequency of infertility after pelvic inflammatory disease (PID) and factors
important in postinfectious tubal damage in an urban population at high risk for sexually transmitted
diseases.

Methods: From a cohort of 213 women with PID documented by laparoscopy and/or endometrial
biopsy, 58 women (27% of the initial cohort) were interviewed by phone 2 to 9 years after an index
episode of PID. Data regarding the initial history, physical examination, microbiology, laparoscopic,
and serologic findings, and data concerning interval contraception, subsequent pregnancy, subsequent
infection, and chronic pelvic pain were compared among those with and without infertility
at follow up.

Results: Nineteen (40%) of the 48 women not using contraception were involuntarily infertile
after the index episode of PID. Compared with those who had an interval pregnancy, infertile
women were older (P = 0.02), more likely to have a history of infertility prior to the index episode
of PID (P = 0.001), and were more likely to have occluded or partially occluded fallopian tubes (P = 0.03), peritubal adhesions (P = 0.007), or perihepatic adhesions (P = 0.02) seen by laparoscopy
performed during the index episode. Surprisingly, recovery of Chlamydia trachomatis was negatively
related to infertility (P = 0.001), although a similar proportion of both groups had chlamydia
immunoglobulin M antibody (40% vs. 31%). Chlamydia heat shock protein was weakly related to
infertility (P = 0.08). The isolation of Neisseria gonorrhoeae was not significantly different between
groups (53% vs. 57%).

Conclusions: The high rate of postinfection infertility found was probably related to a combination
of tubal damage before and during the index episode of PID. Prevention of recurrent PID and better
understanding of the pathophysiology of postinfection tubal damage (which may differ between
chlamydia and gonorrhea) is needed to develop more effective strategies to reduce permanent tubal
damage. Infect. Dis. Obstet. Gynecol. 7:145–152, 1999.
Semiquantitative Bacterial Observations With Group B Streptococcal Vulvovaginitis
Authors: Monif G. R. G.
Published: March 2007

Objective: Group B streptococcal (GBS) vulvovaginitis is a poorly‐delineated clinical entity. The purpose of this study is to report semiquantitative data from four cases of GBS vulvovaginitis and to comment on their significance in terms of the in vitro inhibitory capabilities of GBS.

Methodology: Four patients whose clinical presentations were consistent with GBS vulvovaginitis, from whom GBS was isolated and for whom semi‐quantitative as well as qualitative microbiologic data existed, were identified.

Results: To produce vulvovaginitis, GBS must be at a high multiplicity (108
CFU/g of vaginal fluid). Single coisolates were identified in three of the four cases (two cases of Escherichia coli and one case of Staphylococcus aureus). Group B streptococcus does not inhibit either of these bacteria in vitro.

Conclusion: When the growth requirements for the demonstration of in vitro inhibition for GBS or lack thereof are met in vivo, the in vivo observations are consistent with those projected from the in vitro data. Infect. Dis. Obstet. Gynecol. 7:227–229, 1999.
Human Papillomavirus Cervical Infection and Associated Risk Factors in a Region of Argentina With a High Incidence of Cervical Carcinoma
Authors: Tonon S. A. , Picconi M. A. , Zinovich J. B. , Liotta D. J. , Bos P. D. , Galuppo J. A. , Alonio L. V. , Ferreras J. A. , Teyssié A. R.
Published: March 2007

Objective: To assess the prevalence and potential risk
factors associated with human papillomavirus (HPV) cervical infection among
women residing in a region of northeastern Argentina with a high incidence of
cervical cancer.

Methods: A case‐control study of 330 women participating in a cervical
cytological screening program conducted in Posadas city, Misiones, Argentina,
from February 1997 to November 1998 was carried out. Standardized
questionnaires were administered, and clinical examination including
colposcopy was performed. Fresh endocervical specimens for HPV DNA
detection by generic polymerase chain reaction were collected and the products
typed by dot‐blot hybridization.

Results: Human papillomavirus DNA was found in 61%
of samples analyzed (185/301). Samples with normal cytology had a 43% infection
rate (85/199), while those classified as low‐grade squamous intraepithelial lesion, high‐grade
squamous intraepithelial lesion, and invasive cervical carcinoma had an infection rate of 96%
(53/55), 100% (29/29), and 100% (18/18), respectively. Human papillomavirus typing showed
a 64% (118/185) prevalence of type 16 among all the infected population analyzed; type 16 was
detected among 49% (42/85) of infected samples with normal.cytology and in an average of
74% (74/100) with abnormal cytology. Sexual behavior, residence in southern Paraguay,
and history of a previous sexually transmitted diseases were the main risk factors associated
with high‐grade cervical lesions.

Conclusions: An elevated prevalence of HPV infection was detected in this
population, which also has a high incidence of cervical cancer. The broad distribution of
high‐risk HPV type 16 in women with normal cytology and colposcopy suggests that viral
infection is an important determinant of regional cancer incidence. Infect. Dis. Obstet.
Gynecol. 7:237–243, 1999.
The Lenten Face of Christ in Shusaku Endo’s Silence and Life of Jesus
Authors: Keuss Jeff
Published: March 2007

While much has been written in literary criticism about Shusaku Endo’s various historical and literary novels particularly by William Johnston, SJ and Van C. Gessel who have also served as key translators of Endo into English, this essay builds on their work and provides a necessary theological and phenomenological exploration of Endo’s work through his fluidity of imaging the face of Christ in Silence and Life of Jesus. In particular, Endo’s use of the ‘fumie’ image of Christ provokes a reading of Jean Luc Marion’s notion of idol and icon and creates a compelling reassessment of the dislocating images of Christ found in the Lenten season.
Styrene–Maleic Anhydride Copolymer Foam for Heat Resistant Packaging
Authors: Roberts Robert D. , Kwok John C.
Published: March 2007

Recent developments in direct injection foam processing using styrene–maleic anhydride (SMA) copolymer have resulted in a distinct and significant increase in the performance of foam packaging for food service applications. There are several problems that a consumer could experience when using a traditional polystyrene (PS) foam takeout container. To begin with, the heat of food at serving temperatures can cause warping of the package. In addition, oils and other ingredients from particular foods can quickly weaken a PS foam container making PS foam containers unsuitable for microwave reheating of food. SMA foam packages improve performance in all of these areas. Data are presented on the thermal stability of injection molded samples. Extruded foam sheet flexural properties are studied. Finally, microwave re-heat performances of clamshell containers made from rubber modified SMA copolymers are compared to containers made from PS.
Foamed and Oriented Polypropylene Films
Authors: Dontula Narasimharao , Bomba Richard , Heath Terry , Benson John , Sprinz Peter
Published: March 2007

Foamed polypropylene films that are made by extruding mixtures of polypropylene (PP) and a chemical blowing agent are described in this study. The films are prepared by a cast extrusion process, followed by machine direction orientation. This article describes the structure–property relationships of the resultant foamed PP films and the varied applications of the foamed films.
Mechanism of Strength Improvement of Foamed Plastics Having Fine Cell
Authors: Shimbo Minoru , Higashitani Iku , Miyano Yasushi
Published: March 2007

The influence of cell size on tensile fracture strength of foamed plastics is examined in this study. Foamed specimens having various cell sizes with the same foaming magnification are molded. The tensile fracture strength of foamed plastics is measured and the relationship between the cell size and tensile fracture strength is discussed. It is found that the tensile fracture strength of foamed polyethyleneterephthalate and polypropylene which are crystalline resins increases with decrease in cell size more than the strength presumed from the foam magnification. The decrease in cell size results in an increase in cell density. An increase in cell surface area causes molecular orientation thereby effecting strength improvement.
Fuzzy controller for cement raw material blending
Authors: Bavdaž G. , Kocijan J.
Published: March 2007

The main goal of raw material mill blending control in the cement industry is to maintain the chemical composition of the raw meal near the reference cement modules for the kiln at a desired value with minimum variance despite variations in the raw material composition. Because of the continuous variations in the chemical composition of the raw materials, one cannot work with a fixed blending scheme. The lack of an on-line measurement system, for the raw material chemical composition, additionally complicates the construction of the control algorithms. In this paper, a new type of the Takagi - Sugeno (TS) fuzzy controller based on the incremental algorithm for cement raw material blending purposes is presented. The presented control algorithm was tested on the raw mill simulation model within a Matlab™- Simulink™environment. Parameters of the simulation model were set up based on the measurements from the actual raw mill. Several step tests were carried out to validate the model. The results of the control study indicate that the proposed algorithm can improve cement raw material blending.
Robotic airship mission path-following control based on ANN and human operator’s skill
Authors: Rao Jinjun , Gong Zhenbang , Luo Jun , Jiang Zhen , Xie Shaorong , Liu Wufa
Published: March 2007

Robotic airships have numerous low-speed and low-altitude application potentials. Mission path following is one such application, which, however, presents an autonomy challenge. In this paper, a yawing controller, which is based on artificial neural network (ANN) and human operator skills, is proposed for mission path following of robotic airships. First, the path-following errors based on the operator’s point of view are discussed. Then, a data acquisition system is designed to collect the flight data under manual control, and the data are then processed and used for offline training and validation of a multilayer feed-forward neural network. Finally, the trained neural network is reconstructed in the flight control system for yawing control, and the experimental results confirm the effectiveness of this method. It is also shown that the ANN controller is robust even with wind disturbance.
Design of a robust static output feedback controller in the case of multiple parametric uncertainties
Authors: Toscano R. , Lyonnet P.
Published: March 2007

In this paper, we investigate the problem of robust synthesis of a static output feedback controller, with guaranteed quadratic cost, in the context of multiple parametric uncertainties. To solve this problem, a random optimization technique based on a bisection method is proposed. The principle is as follows: for a given initial stabilizing controller of the nominal system, the proposed approach iteratively generates a sequence of matrices with a decreasing quadratic cost. Using a bisection method, this procedure is stopped when the controller reaches the best possible nominal performance that satisfies a given guaranteed quadratic cost. A numerical example shows the practical applicability of the proposed method.
The Spies Who Came in from the Heat: The International Surveillance of the Anarchists in London
Authors: Di Paola Pietro
Published: March 2007

From the second half of the nineteenth century European governments perceived anarchism as an international threat and regarded the surveillance of colonies established by anarchist refugees as of great importance. The article investigates the service of ‘International Police’ that the Italian Ministry of Interior and the Italian embassies set up for this purpose. By taking as a case study the colony of Italian anarchists who settled in London from 1870 to 1914, it analyses in detail the organizational structure of this intelligence service and it reconstructs the main incidents which informers and spies were involved in. The article examines also the ambivalent attitude of the British police in regard to the surveillance of foreign revolutionaries and the repercussions that these intelligence activities had on the relationship between Italian and British authorities.
Les règles du jeu: The Decline and Fall of Sully, 1610-17
Authors: Dickerman Edmund H. , Walker Anita M.
Published: March 2007

On the eve of Henri IV’s assassination in May 1610 the duke of Sully, the king’s most powerful minister, seemed invincible. Less than a year later he tendered the queen regent, Marie de Medici, his two most important offices, thus ending his political career. In his memoirs Sully claimed he resigned on principle and blamed his enemies for turning Marie against him. These claims have been accepted by most historians. Analysis of his actions in light of the early modern codes which governed social and political noble conduct - ‘the rules of the game’ - demonstrates that although he had enemies, Sully’s own behaviour, especially during 1610-17, was crucial to his political demise.
Catholic Women and the Unmaking of French Nationalism After the Dreyfus Affair
Authors: Fuller Robert L.
Published: March 2007

During the Dreyfus era militant nationalists waged a violent campaign against the Third Republic. The nationalist campaign, led by Republicans like Paul Déroulède of the Ligue des Patriotes, sought to replace the parliamentary regime with a more authoritarian presidential republic. This Republican ‘revisionist’ campaign proved highly appealing to royalists and ‘ rallié’ Catholics, who generously subsidized nationalist organizations and fattened their ranks with hopes of toppling the secular republic. When the ‘Government of Republican Defense’ – formed to end the Dreyfus Affair – used the Associations law of 1901 dramatically to curb Catholic influence within France, conservatives switched funding from nationalist leagues to groups formed specifically to defend the church. Women, in particular, lent crucial weight to reorient many nationalist organizations away from their revisionist goals to a narrower end of defending the church. The flight of women and money away from nationalism and toward the church effectively ended the nationalist challenge to the Republic.