bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between self‐esteem and psychological adjustment in young adolescents
Authors: Schweitzer Robert D. , Seth‐Smith Mary , Callan Victor
Published: April 2004

The study adopts a multi‐dimensional construct of self‐esteem to examine the relationship between self‐perception and psychological adjustment in order to identify specific dimensions that discriminate between disturbed and non‐disturbed groups. The disturbed group (n = 33) is derived from a clinical sample and are matched with a non‐disturbed group (n = 33) of adolescents. Results indicate that dimensional self‐concept scores are significantly lower for clinical subjects while there are no significant differences between groups on the mathematics, honesty, and physical ability dimensions. These findings provide a more fine grained understanding of the relationship between self‐esteem and psychological adjustment and emphasize the need to examine self‐esteem in terms of its particular dimensions.
Sex education: more is not enough
Authors: Mellanby Alex , Phelps Fran , Tripp John
Published: April 2004

Increasing demands for sex education have been associated with a plethora of recommendations, regulations and resources with resulting variability of content, strategy, quality and outcome. While numerous studies confirm that the health behaviour of teenagers is not altered by the teaching of facts alone, other data suggest that appreciation of personal risk and learned assertiveness skills are associated with changes in population behaviours. Peer led teaching is a powerful and probably essential component of school health and sex education. Evaluated interventions with agreed purpose and acceptable methodologies are essential if there is to be any real expectation of health benefit from sex education.
Clinical experience in non‐stressed antepartum cardiotocography in high‐risk pregnancies
Authors: Varma T.R.
Published: April 2004

A “ten‐point” scoring system for antenatal cardiotocography based on base line fetal heart rate, fetal movement, base line variability and fetal heart rate response to fetal movements and Braxton‐Hicks contractions has been used in 1100 patients to assess the fetal status in pregnancies complicated by suspected fetoplacental insufficiency. The incidence of fetal distress in labor, of operative deliveries, of low Apgar score (0–5), of infants with intrauterine growth retardation, of perinatal mortality rate, and of fetal abnormalities was significantly higher when the CTG score was 6 or below. The method of scoring was simple to use and could standardize reporting.
Abruptio placentae
Authors: Clemetson C. Alan B. , Cafaro Virginia
Published: April 2004

Analysis of blood samples from pregnant women has shown that the mean histamine level starts to rise when the plasma ascorbic acid level falls below 1.0 mg/100 ml; it is doubled when the ascorbate level falls to 0.5 mg/100 ml and quadrupled when it falls below 0.2 mg/100 ml. The incidence of abruptio placentae was found to be seven out of 355 (or 2.0%) in women who had plasma ascorbic acid levels above 0.4 mg/100 ml and six out of 31 (19.4%) in women with plasma ascorbate levels below 0.4 mg/100 ml. This difference is highly significant. It is suggested that ascorbic acid deficiency and histamine excess play leading roles in the etiology of abruptio placentae.
Decreased fetal activity and fetal heart rate changes after amniocentesis complicated by fetal hemorrhage
Authors: Sodavsky Eliahu , Eyal Fabian G. , Perlman Max , Beyth Yoram
Published: April 2004

A case is described in which aminocentesis caused placental injury, abruptic placenta, and fetal hemorrhage which caused fetal distress. This was primarily manifested by reduction of fetal movements and later by fetal heart rate deceleration. Emergency cesarean section was performed and a live infant was born. The importance of monitoring the fetus after amniocentesis by assessment of fetal movements is stressed.
Postpartum contraception
Authors: Edelman David A. , Goldsmith Alfredo , Shelton James D.
Published: April 2004

In a previous report, we reviewed the safety of initiating different contraceptive methods immediately postabortion [11]. In the time since the report was written, there have been no significant or new developments concerning contraception immediately following either elective or spontaneous abortion. This report will examine issues relating to contraception immediately following a term delivery, and the safety and effectiveness of different contraceptive methods immediately postpartum.
Endometrial cancer in Israel, 1969–1975
Authors: Schenker J.G. , Birkenfeld A. , Schwartz S.
Published: April 2004

Epidemiological data on 1017 cases of primary cancer of endometrium in Israel diagnosed over a 7‐year period are presented. Incidence of corpus cancer in Israel has not changed in the last decade; the mean incidence for the current study is 18.73/100,000 women above the age of 25. Eight percent of patients were above the age of 51, with a steep increase of incidence being found above the age of 35. Endometrial carcinoma was four to five times more prevalent in Jewish women of European‐American origin than in those of Asian‐African background. In 85% of the patients diagnosis was made while the disease was in Stage I. A strong correlation was found between endometrial cancer and infertility, but no correlation was found with diabetes and hypertension. The five‐year survival rate in the present survey was 65.0%. Factors affecting prognosis and clinical stage of the disease at diagnosis, degree of myometrial invasion, tumor differentiation, age of the patient and type of treatment are discussed.
Small cell anaplastic lung cancer presenting as an ovarian metastasis
Authors: Malviya Vinay K. , Bansal Manjula , Chahinian Philippe , Deppe Gunter , Lauersen Niels , Gordon Ronald E.
Published: April 2004

An unusual case of small cell anaplastic carcinoma of the lung, presenting as a pelvic mass, is presented. Histochemical and electron microscopic findings confirmed the diagnosis. The pathologic features and unique clinical characteristics are discussed with comments on the topic of metastatic ovarian tumors.
Menstrual therapies in commonwealth Asian law
Authors: Bhiwandiwala Pouru P. , Cook Rebecca J. , Dickens Bernard M. , Potts Malcolm
Published: April 2004

Under English law, acting with the intention to procure an abortion whether a woman is pregnant or not is a crime. Laws in Commonwealth Asia governing abortion apply only in cases where a woman is clearly pregnant. Accordingly, menstrual therapies are available without violating abortion laws, or having to comply to their conditions. This permits doctors under such laws to exercise considerable discretion in recourse to menstrual therapies.
Fetal heart rate decelerations following the administration of meperidine‐promethazine during labor
Authors: Ron M. , Menashe M. , Scherer D. , Palti Z.
Published: April 2004

A deceleration response lasting up to 7 min was observed in 53 fetuses (out of 1910 studied) following the administration of 75 mg meperidine and 25 mg promethazine intravenously to the mothers during labor. Thirty‐six of these fetuses reacted with baseline tachycardia following the deceleration with or without loss of baseline variability. Seven fetuses showed a variable deceleration pattern and six fetuses reacted with a late deceleration pattern following the first deceleration. Two newborns from the group showing a late deceleration patten were delivered with an apgar score below 7 in 5 min. The probable mechanisms and significance of these changes are discussed.
Objective demonstration of cervical softening with a prostaglandin F2α gel during first trimester abortion
Authors: Rath Werner , Kühnle Henning , Theobald Peter , Kuhn Walther
Published: April 2004

In a prospective study the cervix softening and dilating effects of intracervically applied prostaglandin F2α gel were investigated in 100 patients during induced abortion in the 7–12th week of pregnancy. A specially designed tonometer was used to measure the resistance of the cervical canal before as well as 6–8 h, 4 days and 5–6 weeks after gel application. The cervix of 99 patients proved to be freely passable without use of undue force for at least Hegar 8 after treatment. Measurements in 96 patients 5–6 weeks after the operation showed good general agreement with those values obtained before gel application. No spontaneous or operation‐induced lesions of the cervix occurred. Intracervical prostaglandin gel application proved itself to be a safe, practicable and gentle method for avoiding dilation‐induced complications during first trimester abortions.
Early vaginal delivery of hydrocephalus after transabdominal encephalocentesis
Authors: Samberg I. , Gonen R. , Levitan Z. , Sharf M.
Published: April 2004

Simple and easy transabdominal encephalocentesis with ultrasound control, should be the procedure of choice in huge hydrocephalus, in order to minimize maternal trauma.
Oral contraceptives and mortality from circulatory system diseases: An epidemiologic study in Taiwan
Authors: Chow L.P. , Lin C.C. , Keyvan‐Larijani E. , Chang K.K.
Published: April 2004

An epidemiological study on the association between oral contraceptive (OC) use and circulatory system disease (CSD) mortality undertaken in Taiwan by proxy interview of closest family members of 306 deceased cases, 305 deceased controls, and 611 healty neighborhood controls indicated that the relative risk between the cases and health controls was 0.98 (0.62–1.54) and that between cases and health controls was 0.82 (0.56–1.21). Use of OC by Taiwanese women has not produced any overwhelming adverse effects on CSD mortality.
Fetal movements and intrauterine growth retardation
Authors: Mor‐Yosef Shlomo , Sadovsky Eliahu , Brzezinski Amnon , Levinsky Reuven , Ohel Gonen
Published: April 2004

Fetal Movement (FM) rate was evaluated in cases of symmetrical and asymmetrical intrauterine growth retardation (IUGR) and was compared to the FM rate in normal pregnancy. In the 25–36th week of gestation there was a significant decrease of FM rate in both groups of IUGR which was more pronounced in the symmetrical group. Also shown, was a gradual trend of increase of the FM rate with advancing gestational age in both groups of IUGR. Cases of asymmetrical IUGR were noted, who had markedly decreased FM until cessation. In this group of IUGR decreased FM demands prompt hospitalization and fetal heart rate monitoring so that possible respiratory failure and impending fetal death can be detected.
Methoxyflurane hepatitis: Two cases following obstetric analgesia
Authors: Delia Julian E. , Maxson Wayne S. , Breen James L.
Published: April 2004

Methoxyflurane is utilized in obstetrics for analgesia during labor. It has been recognized as an unpredictable hepatotoxin. Although hepatitis has been seen after its use in anesthesia, only one case of hepatitis has been reported after its use for analgesia in labor. Two more cases of hepatitis following methoxyflurane analgesia are reported. Direct toxic effects of its metabolites and host idiosyncracy may underlie the hepatic injury from methoxyflurane.
Reproductive hormone profiles in regularly menstruating sundanese women
Authors: El Sheikh M.A.A. , Molloy B.G. , Chapman C. , Glass M.R.
Published: April 2004

Venous blood samples were taken daily from 21 regularly menstruating Sudanese women throughout one complete menstrual cycle. FSH, LH, estradiol‐17β and progesterone were assayed in all plasma samples and normal reference ranges were thus established. Fifteen subjects had a luteal phase of more than 12 days whilst in 3 subjects it was shorter. Two subjects were found to be hyperprolactinemic and one had an anovulatory cycle with an elevated LH. The plasma concentrations of estradiol‐17β in the follicular phase and progesterone in the luteal phase were significantly lower in subjects with short luteal phase than in those with a luteal phase of more than 12 days. The hormonal profile of FSH, LH, estradiol‐17β and progesterone throughout a normal menstrual cycle in regularly menstruating Sudanese women was similar to what has been reported in the literature for other ethnic groups.
Menstrual pattern changes following minilap/pomeroy, minilap/ring and laparoscopy/ring sterilization: A review of 5982 cases
Authors: Bhiwandiwala Pouru P. , Mumford Stephen D. , Feldblum Paul J.
Published: April 2004

Menstrual pattern changes experienced by 5982 women subsequent to sterilization by the techniques of minilap/Pomeroy, minilap/tubal ring and laparoscopy/tubal ring were tabulated. Controlling for prior contraceptive use, we examined data on the following six menstrual parameters at the time of sterilization compared to reports at follow‐up visits 6 and 12 months after surgery: cycle regularity, cycle length, menstrual flow duration, amount of flow, dysmenorrhea and intermenstrual bleeding. Our findings suggest that minilap sterilization does not cause menstrual pattern changes.
Treatment of fibrocystic disease of the breast with gestrinone, a new trienic synthetic steroid with anti‐estrogen, anti‐progesterone properties
Authors: Coutinho E.M. , Azadian‐Boulanger G.
Published: April 2004

Twenty‐eight patients with radiologically diagnosed fibrocystic disease were given twice weekly 5 mg tablets of Gestrinone, a synthetic contraceptive steroid with potent anti‐estrogen, anti‐progesterone properties, for periods ranging from 3 to 9 months. Treatment was discontinued when the nodularity disappeared and the patient became asymptomatic. Twelve patients had palpable nodules or masses in both breasts, while the remaining 16 had a single nodule or lump. In 12 patients, all with small nodules or lumps, complete elimination of nodularity occurred at the end of the first 3 months of treatment. In a further eight patients, five of whom had small nodules and three of whom had large ones, an additional 3 months of therapy were required to achieve complete elimination of nodularity. In two subjects, nodularity was eliminated at the end of 9 months of therapy, and in the remaining six subjects, although a reduction in nodularity greater than 50% occurred, masses remained palpable at the end of 9 months. Pain and tenderness were eliminated during the first 2 weeks of therapy in most cases. The most common complaints were acne and seborrhea (70% of patients) and a weight gain of between 2 and 5 kg in patients treated for 9 months. Main side effects encountered were acne and seborrhea.
Menstrual regulation with prostaglandin (Pg ONO 802) in Indonesia
Authors: Agoestina T. , Sastrawinata Sulaiman , Prayitno Wasis , Gonta Pim
Published: April 2004

This study was conducted to evaluate the safety, efficacy and acceptability of PGE1 vaginal suppositories (Pg ONO 802) in menstrual regulation. Each vaginal suppository contains 1 mg of 16,16 dimethyl‐trans‐Δ2 PGE1 methyl ester. Five suppositories were inserted as high as possible into the fornix posterior of the vagina at intervals of 3 h. Five hundred thirty four subjects with delay of menses mostly of up to 14 days were included in the study. Blood chemistry was evaluated and urine analysis performed in all subjects. Success of treatment was assessed on two alternative groups of criteria: (A) induction of bleeding by Pg ONO 802; (B) induction of bleeding achieved by Pg ONO 802 and not followed by surgical intervention. The success rate based on criteria A was 98.9%, and on criteria B 86%. If heavy bleeding occurred and signs of pregnancy were found during the trial period, intervention was made by vacuum aspiration or curettage when necessary. If bleeding did not occur and/or pregnancy continued, treatment was declared a failure and pregnancy was terminated by vacuum extraction or curettage. For non‐pregnant subjects no intervention was made but careful re‐evaluation was carried out. Mean duration of bleeding after Pg ONO 802 treatment was 6.7 days. Side‐effects were generally mild. The incidence of diarrhea was 8.8%, nausea 7.8%, headache 5.8%, vomiting 2.8%; abdominal cramp occurred in as many as 66% of subjects. No treatment was given for these side‐effects as they were within acceptable limits. The onset of side‐effects mostly occurred between insertion of the 1st and 2nd (46.7%) suppositories and onset of bleeding at the time of insertion of the 2nd suppository (41.6%).
Carcinoembryonic antigen in high risk pregnancies
Authors: Lolis D. , Baltoyiannis P. , Messinis I.E.
Published: April 2004

The significance of carcinoembryonic antigen (CEA) measurement was evaluated in 25 pregnant women with diabetes mellitus, 15 Rh negative sensitized and nine prolonged pregnancies. Another 114 women with normal pregnancy served as controls. Values in maternal and umbilical cord serum and in amniotic fluid did not change appreciably through 24–42 weeks' gestation. No significant difference in maternal serum, cord serum and amniotic fluid CEA values was found between diabetic, Rh negative sensitized and normal pregnancies at the corresponding weeks. Similar findings were obtained in prolonged pregnancies, except the values in amniotic fluid which were significantly higher than in normal pregnancies due to the presence of meconium. These results suggest that the measurement of CEA in high risk pregnancies is not useful in predicting fetal condition.
Human chorionic gonadotropin in the ectopic gestation
Authors: Golan Abraham , Van Der Walt Andree L. , Wexler Shraga , Kort Hilton
Published: April 2004

The ectopic pregnancy is a relatively common condition in the south African black patients. The beta‐specific subunit radioimmunoassay for human chorionic gonadotrophin (HCG) was utilized in procuring information in our series of 30 patients. Levels of the hormone were significantly lower when compared to normal gestation of similar duration, never exceeding 2000 mIU/ml. The clearance rate of HCG following normal vaginal delivery was about 24 h and less variable than that of ectopic gestation. The half‐life clearance rate of HCG in the ectopics could be divided into three phases, suggestive of HCG compartmentalization. The possible buffering effect of this hormone in the maintenance of the receptor‐saturated pregnancy is discussed. The possibility that the HCG produced by the normal pregnancy is dissimilar to that of ectopic is speculated upon.
The effects of cyclofenil on the cervical mucus score (Insler)
Authors: Bhathena R.K. , Patel R.H. , Varma T.R.
Published: April 2004

Daily simultaneous cervical mucus evaluation and ultrasonography of the Graafian follicular growth an ovulation were studied (in the mid‐cycle) in 8 infertile British women during 30 Cyclofenil‐stimulated cycles, and compared with 18 non‐stimulated normal ovulatory cycles in 12 subjects (controls). In the 16 Cyclofenil‐induced ovulatory cycles, there was an early (5 days prior to the day of ultrasonic ovulation) Full Cervical Mucus Score (Insler) in 69% of the cycles, and the Full Cervical Mucus Score lasted for 7 days or more in 63% of the cycles. In 38%, there was persistence of the Full Cervical Mucus Score on the third day after ultrasonic ovulation. In the 14 Cyclofenil‐treated an ovulatory cycles, a Full Cervical Mucus Score was recorded on one or more occasions in the mid‐cycle in 29% of the cycles. The classical teaching of prediction of the probable timing of ovulation by Cervical Mucus Scoring is not applicable to Cyclofenil‐stimulated cycles.
Effect of hormone replacement therapy on anti‐thrombin III activity in post menopausal women
Authors: Varma T.R. , Patel R.H. , Rosenberg D.
Published: April 2004

Anti‐thrombin III is the major inhibitor of activated blood clotting factors. We studied 320 patients with climacteric symptoms who received estrogen replacement therapy to assess the effect of hormone therapy on Anti‐thrombin III (AT‐III) activity). Of the 320 patients 80 patients received Prempak C (0.625 mg) for 2 years, 82 patients received Prempak C (1.25 mg) for 2 years, 78 patients received Cycloprogynova (1 mg) for 2 years and the remaining 80 patients received Cycloprogynova (2 mg) for 2 years. The mean AT‐III activity before, during and 3 months after treatment showed no significant difference in all the four groups of patients. There was no incidence of myocardial infarction or stroke or thrombo‐embolic disease in this group of 320 patients receiving estrogen replacement therapy.
Life threatening complications of endometriosis
Authors: Marineau E.J. , Deppe G. , Sokol R.J. , Malviya V.K. , Adel S.K.
Published: April 2004

Endometriosis affects 5–20% of menstruating women and occurs primarily within the pelvis. Although histologically benign, ectopic endometrial tissue possesses the ability to grow, infiltrate and disseminate with life threatening results/consequences. This is illustrated by a case of asymptomatic endometriosis involving the ureters and rectum. The importance of evaluating the integrity of the urinary tract in endometriosis, especially cases involving the uterosacral ligaments, is stressed. Appropriate therapy followed by periodic surveillance for progression of the disease is discussed.
Fatal heart monitoring and ultrasound in the management of placental abruption
Authors: Ito M. , Kawasaki N. , Matsui K. , Fujisaki S.
Published: April 2004

Three cases of placental abruption with the “pseudosinusoidal” fetal heart rate (FHR) pattern, a periodic late deceleration related to frequent uterine contractions are reported. This ‘pseudosinusoidal’ pattern is clearly not a true sinusoidal pattern. The fetal monitoring patterns of these patients are presented and discussed along with the use of ultrasound in the management of this condition. All infants were delivered by cesarean section with low Apgar scores at birth, but they soon recovered completely.
Elevated intravesicular fluid thyroid‐stimulating hormone concentration in hydratidiform mole
Authors: Gunasegaram R. , Peh K.L. , Loganath A. , Kottegoda S.R. , Ratnam S.S.
Published: April 2004

In an attempt to explain hyperthyroidism in hydatidiform mole, concentrations of immunoreactive thyroid‐stimulating hormone (TSH) together with human‐chorionic gonadotrophin (β‐hCG) were measured in the serous fluid obtained from 43 patients aged 15–45 years and with amenorrhea 11–31 weeks. Elevated concentrations of these two hormones were found in all samples. It is probable that hyperthyroidism could stem from TSH immunologically similar to pituitary TSH and distinct from hCG and luteinizing hormone (LH) that we have identified in hydatid vesicles.
Reproductive performance after eclampsia
Authors: Adelusi Babatunde , Ojengbebe O.A.
Published: April 2004

Eclampsia is a common complication of pregnancy in Ibadan, although its long term effects on subsequent pregnancies is unknown. In a prospective study of 64 women who had eclampsia in their previous pregnancies and were followed up in their current pregnancies, 15.6% of them had recurrent eclampsia, in spite of optimal antenatal care. Of the 18 patients with diastolic blood pressure of 80 mmHg 22.2% or over at booking had antepartum or intrapartum eclampsia as compared with only 2.2% of 46 patients with diastolic blood pressure of less than 80 mmHg at booking. This finding was statistically significant (P < 0.01), showing that the diastolic blood pressure at booking can be a measure of the potential for developing eclampsia because of the possibility of residual hypertension on which pre‐eclampsia may be superimposed. Similarly, there was a significant association (P < 0.05) between the birthweight of the babies and the diastolic blood pressure at booking, and may be a measure of the effect of vascular effect of pre‐eclampsia on the placenta. However, there was no difference in the perinatal mortality rate in this study and the overall hospital figures in spite of the high risk pregnancies being managed. It was concluded, therefore, that the outcome of these pregnancies would depend much on the standard of antenatal care provided for the patients.
Viral hepatitis as a major cause of maternal mortality in Addis Ababa, Ethiopia
Authors: Kwast B.E. , Stevens J.A.
Published: April 2004

Causes of maternal mortality were investigated in Addis Ababa, Ethiopia, from September 1981 to September 1983. Viral hepatitis ranked third among the leading causes of maternal mortality behind septic abortion and puerperal sepsis. There were 26 deaths from viral hepatitis during the 2‐year study period for a hospital maternal mortality rate of 91.0 per 100,000 live births. Although 30% of women who died of all maternal causes received antenatal care in Addis Ababa, only 13% of women who died from viral hepatitis in our hospital study received antenatal care. Low socio‐economic status (SES) has been shown to be associated with low antenatal care utilization and with an increased risk of protein malnutrition. Malnutrition is considered a predisposing factor for liver damage. Suggestions for reducing hepatitis transmission and maternal mortality through education, better hygiene, and improved sanitation are discussed.
Estrogen receptors in breast cancer ‐ therapeutic response to the treatment of recurrences
Authors: Pinotti J.A. , Teixeira L.C. , Pisani R.C.B. , Bastos S.R.
Published: April 2004

The authors analyze estrogen receptors in 501 cases of breast cancer and the therapeutic response achieved with treatment of patients who relapsed. The method utilized to determine the presence of estrogen receptor was cytosol protein‐counting and Dextran coated charcoal (DCC) saturation analysis. Patients were treated with chemotherapy when the primary tumor was estrogen‐receptor negative. If receptor was present, anti‐estrogen drug (Tamoxifen) was added. Patients previously treated with the anti‐estrogen presented a better response to anti‐estrogen therapy and a lower recurrence rate. Recurrences were more frequent in estrogen receptor negative cases and better responses to treatment were found in estrogen receptor positive ones.
Prophylactic topical cefamandole in radical hysterectomy
Authors: Miyazawa K. , Hernandez E. , Dillon M.B.
Published: April 2004

From July 1, 1978 to June 30, 1984, 45 radical abdominal hysterectomies were performed by the authors at Tripler Army Medical Center. Management was uniform except for the use of prophylactic antibiotics. Three patterns of practice were identified: Group I, no antibiotics were used; Group II, intravenous (i.v.) antibiotics were given in the induction room and for less than 48 h post‐surgery; Group III, prophylactic i.v. antibiotics were given and the surgical site was also irrigated with a cefamandole and saline solution. The three groups were found to be similar with regard to age, parity, weight‐height index, pre‐ and postoperative hematocrit, pre‐operative white blood cell count, operative and anesthesia times, estimated blood loss, and amount of blood transfused. Groups I and II had a higher surgical site infection rate (87.5% and 63.6%, respectively) than Group III (3.8%). The mean 10‐day fever index in degree hours was 109 for Group I, 71 for Group II, and 30 for Group III (P < 0.001). Irrigation of the surgical site with a cefamandole and saline solution in addition to i.v. antibiotics decreases the infectious morbidity of radical hysterectomy.
In vitro studies on the control of human myometrial gap junctions
Authors: Garfield R.E. , Hayashi R.H. , Harper M.J.K.
Published: April 2004

In this study human myometrial tissues were examined for the presence of gap junctions by quantitative electron microscopy before and after incubation in tissue culture media with and without indomethacin. The area of gap junctions was very low in tissues from pregnant women at term but not labor, before incubation. After 24 and 48 h incubation without any treatment, segments of some of the same tissues developed many gap junctions and other tissues contained few junctions. Prostaglandin E (PGE), prostaglandin F (PGF) and prostaglandin F metabolite (PGF metabolite) levels in the media at various times were measured by radioimmunoassay. The prostaglandins increased progressively during the incubation period. Treatment of tissues with indomethacin decreased prostaglandin levels in the media and increased the numbers of gap junctions in those control tissues that developed few junctions over the same incubation interval. We conclude that the capacity of human myometrial tissues to develop gap junctions in vitro may depend upon a maturational stage in preparation for labor. Furthermore, our results suggest that products of the cyclo‐oxygenase or lipoxygenase pathways may control the presence of gap junctions in the human myometrium and that changes in synthesis in these patterns may occur as part of the maturational process.
Ultrasonically guided follicle aspiration for oocyte retrieval in an in vitro fertilization program: Further simplification
Authors: Sterzik K. , Jonatha W. , Keckstein G. , Rossmanith W. , Traub E. , Wolf A.
Published: April 2004

Transabdominal, transvesical aspiration of oocytes was performed in 58 infertility patients under ultrasound guidance. In contrast to other groups, no particular guiding instruments were used. Wider bore needles and general anesthesia improved the oocyte recovery rate from 44% to 80%, thus approaching the one achieved by laparoscopy.
The use effectiveness of the copper T‐200 in Matlab, Bangladesh
Authors: Rob U. , Phillips J.F. , Chakraborty J. , Koenig M.A.
Published: April 2004

Using a unique record keeping system, the use effectiveness of the Copper T‐200 is examined in rural Bangladesh. In Matlab the Copper T‐200 is a highly effective contraceptive modality. The adopters are typically low to medium parity women under 30 years of age. The most important cause of termination among women in the study was voluntary removal of the device. The complaint most often reported was bleeding followed by pain and weakness. The Matlab experience suggests that sustained motivation and regular resupply are the two key components of this highly successful family planning program.
Antepartal fetal death of one twin
Authors: Lumme R. , Saarikoski S.
Published: April 2004

Twenty‐four cases with antepartal fetal death of one twin are reported. Of the still‐born fetuses 5 were delivered as a fetus papyraceus, 13 had severe and 6 no maceration. The cesarean section rate was 25%. The placenta was monochorionic in 12 cases. Structural defects were found in one monochorionic co‐twin of a fetus papyraceus. Otherwise the neonatal morbidity of the liveborn co‐twins was not increased if the low gestational age averaging 34 weeks, was taken into account. No manifestations of defective hemostasis were observed in the mothers.
The epidemiology of cancer of the uterine corpus in Canada: 1950–1985
Authors: Ayiomamitis A.
Published: April 2004

Morbidity and mortality patterns in Canada from malignancies of the corpus uteri, were analyzed for the periods 1970–1980 and 1950–1985, respectively. Although rates of morbidity have fluctuated between 15.0 and 19.6 new cases per 100,000 population per year, age‐specific rates for women aged 35–44 have declined significantly (0.26 fewer new cases per 100,000 population per year; P < 0.05). Mortality rates have declined by approximately 50% between 1950 and 1985 (P < 0.0001) with age‐specific rates for women aged 35–44, 45–54, 55–64, 65–74 and 75–84 also exhibiting significant declines (P < 0.02).
Clearance pattern of maternal serum pregnancy specific β1‐glycoprotein after treatment in active and regressed tubal pregnancy
Authors: Phocas I. , Sarandakou A. , Kontoravdis A. , Chryssicopoulos A.
Published: April 2004

The clearance pattern of maternal serum pregnancy specific β1‐glycoprotein (SP1) was studied in 16 cases of tubal pregnancy (9 active and 7 regressed) after 12, 24, 48, 72, 96, 120 and 192 h following surgery. The mean values of the hormone in both groups showed a statistically highly significant difference in all measurements before and after treatment (P < 0.001), but they followed the same exponential regression pattern. The half‐life of SP1 in active tubal pregnancies after salpingectomy was 36.2 h and in regressed tubal pregnancies after salpingostomy was 37.5 h.
Maternity care in developing countries: Relevance of new technological advances
Authors: Faundes A. , Rosenfield A. , Pinotti J.A.
Published: April 2004

It is suggested that improved maternity care in the developing world depends primarily on the increased provision of cos‐effective basic, easily accessible maternity care services. Expensive new technologies should be judged by their effectiveness, safety, technical feasibility, cost (including operating and maintenance expenses) and local need. After identifying the major causes of morbidity and mortality, priority should be given to interventions applicable at the local level and which do not require highly or specially trained educated personnel.
Four‐year follow‐up of electrocoagulation and tubal ring sterilizations in Costa Rica
Authors: Cilenti D. , Solano A. , Aranda C. , Feldblum P.J. , Lamptey P.R.
Published: April 2004

An earlier analysis of 299 laparoscopic sterilizations comparing electrocoagulation and tubal ring occlusion techniques found no significant differences in rates of surgical complications. The risk of potentially serious complications, such as bowel/bladder burns, was considered higher with electrocoagulation suggesting that tubal rings might be the preferred technique. Examination of the same women through 48 months poststerilization showed no significant difference between the two techniques with respect to the incidence of gynecologic surgery performed subsequent to sterilization. Gynecologic abnormalities were similar for women in both groups. The rate of pregnancy was higher for tubal rings than for electrocoagulation (2.1 compared to 0.7 at 48 months) but this difference was not statistically significant.
A clinico‐pathologic study of ovarian neoplasm
Authors: Gopeesingh T.D. , Rahaman J. , Charran D.
Published: April 2004

A series of 96 patients who were diagnosed with 120 ovarian neoplasms at surgery have been reviewed. Nine types of benign ovarian cysts were encountered. Benign cystic teratoma with an incidence of 30% was the commonest tumor. The majority of these were in the 20–30 year age range. The mean age of the patients with mucinous cyst adenoma and benign cystic teratoma was significantly less (P < 0.05) than those with serous cyst adenoma. The incidence of ovarian malignancies of 8.3% was low, and none of the malignancies was bilateral. There was a high incidence of 8.3% of malignant change in benign cystic teratomas. Abdominal pain and swelling were the symptoms most frequently experienced in patients with benign ovarian neoplasms.
Countrywide perinatal surveillance in Czechoslovakia
Authors: Štembera Z.
Published: April 2004

Countrywide perinatal surveillance in four 10‐year periods of Maternal Child Health (MCH) care development in Czechoslovakia is described. During this time maternal mortality decreased from 137 to 17/100,000 live births, and perinatal mortality (PMR) from 51 to 12/1000. On the basis of study results, countrywide intervention strategies concerning organization as well as medical measures were gradually drawn up. The greatest decrease in PMR was found through basic perinatal care for all; greatest efficiency followed employment of a risk approach.
The role of confidential enquiries in the reduction of maternal mortality and alternatives to this approach
Authors: Cook R.
Published: April 2004

The aim of confidential enquiries into maternal deaths is to identify weaknesses in the maternal health care system with a view to remedying them. The method of confidential enquiry is explained using the British system as an example. The reasons why this apparently useful practice is not more widely adopted can in some countries include fears of litigation or lack of trust in confidentiality. Alternative approaches to maternal death audit are discussed.
Reproductive health of adolescents in Bangladesh
Authors: Rahman S. , Nessa F. , Rahman S. , Ali R. , Ara Ali H.
Published: April 2004

The health and social effects of pregnancy in married women 13–23 years of age were studied among a population of 175,000 in rural Bangladesh. Data collected by a structured questionnaire identified pregnant women who were followed twice during pregnancy and twice postpartum. Maternal mortality for the 13–17 age group was 5.8/1000 compared to 1.8/1000 for the 18–23 year olds. Major causes of death in the younger group were obstructed labor and toxemia. The neonatal death rate was 80/1000 for the younger group and 43/1000 for the older group. The major cause of death of infants born to the younger mothers was birth injury. In infants born to older mothers, it was tetanus. Perinatal death rate was 66.4/1000. All deliveries occurred at home, and 89% of births were attended by relatives, neighbors or an untrained birth attendant. Only 13% of the women had ever used contraceptives. Use varied from 2.9% at 16 years to 24.7% at 23 years. Suggestions are made for improving maternal and child health care in rural Bangladesh.
Vaginal sonographic visualisation of a cervical carcinoma
Authors: Osmers R. , Bergholz M. , Kuhn W.
Published: April 2004

In the present case, the vaginal sonographic picture of a cervical (collum) carcinoma, which was clinically non‐apparent, but was histologically established through a fractionated curettage, led to a change in the surgical procedure in the sense that a primary operation according to Wertheim—Meigs instead of a knife conisation was performed. The postoperative histology showed a good correlation between sonographic tumor boundaries and the actual expansion of the carcinoma.
Successful hemisterilization in a patient with uterus didelphus
Authors: Børlum K.‐G. , Blom R.
Published: April 2004

Women with uterine malformations frequently present with reproductive impairment. This case addresses the opposite problem, a woman with uterus didelphus who conceived with ease. Following three consecutive cesarean sections in the left uterine horn, she was offered sterilization for medical reasons, but refused on religious grounds. As a compromise, she accepted unilateral tubal closure in order to force future pregnancies to the right uterine horn. She has now had three pregnancies with two cesarean sections on that side.
Embolization therapy in patients with severe arterial bleeding after hysterectomy
Authors: Teichmann A.T. , Körber H.J. , Schuster R. , Romatowski H.‐J.v.
Published: April 2004

The case history of a patient aged 41 years, who suffered recurrent hemorrhages following vaginal hysterectomy is reported. After several surgical interventions complete hemostasis was finally achieved by selective embolization of the internal iliacal artery. The application of this procedure is recommended in case of recurrent bleeding complications caused by pelvic surgery or neoplasms.
Amniotic fluid prolactin levels in Rhesus isoimmunized patients
Authors: Baxi L.V. , Fairne D. , Frantz A.G. , Freda V. , Stark R.
Published: April 2004

The concentration of prolactin in the amniotic fluid (AFPRL) was measured in 75 samples obtained in the third trimester of 14 isoimmunized women. There was a uniform decline in prolactin levels with advancing gestation in each pregnancy (r = −0.89 to −0.99). The decline in AFPRL was similar in uncomplicated pregnancies. AFPRL levels were not predictive of umbilical cord hemoglobin or bilirubin levels and amniotic fluid lecithin/sphingomyelin ratio.
A new method for measurement of surfactant specific apoprotein in amniotic fluid
Authors: Kashiwabara Y. , Onoyama Y. , Shimokawa H. , Hisanaga S. , Nakano H.
Published: April 2004

A simple and rapid method for the quantitative measurement of surfactant specific apoprotein concentration in amniotic fluid was developed using the measurement of immunological reactions by the nephelometric technique. Use of this method made it possible to measure 0.5–8.0 μg apoproteins per ml within approximately 70 min. Surfactant specific apoproteins in 54 samples of amniotic fluid were measured using the method. The surfactant specific apoprotein concentration in amniotic fluid increased from 1.03 ± 0.51 μg/ml (mean ± S.D.) at 26–30 weeks of gestation to 4.45 ± 2.08 μg/ml at 36 weeks of gestation or more. Among premature infants, who were delivered within 24 h after amniocentesis, surfactant specific apoprotein concentration was less than 1.5 μg/ml in three infants with respiratory distress syndrome (RDS), and more than 2.1 μg/ml in six without RDS. The results indicated that the quantitative measurement of surfactant specific apoprotein in amniotic fluid is effective in predicting the fetal lung maturity, and that simplicity and rapidity make our method useful for clinical application.
Peritonitis and empyema following the use of dextran in tubal operations
Authors: Zamir O. , Rosenn B. , Udassin R. , Nissan S. , Palti Z.
Published: April 2004

Two patients developed severe bacterial sepsis with peritonitis and pleural empyema following tubal surgery. Intraperitoneal low‐molecular dextran was used in both patients and hydrocortisone was administered perioperatively. The use of dextran in tubal surgery probably increases the risk of severe postoperative infection and should be avoided in susceptible patients. Prophylactic antibiotics may be indicated when dextran is administered.
Repeated contralateral interstitial pregnancy
Authors: Petersen L.K. , Clausen I.
Published: April 2004

A case of repeated contralateral interstitial pregnancy is presented in a woman with previous sterility. Biopsies from both uterine corners have later shown salpingitis isthmica nodosa. The etiology, symptoms and treatment are discussed based on the literature.
Rupture of the gravid uterus following a road traffic accident
Authors: Onwudiegwu U. , Okonofua F.E. , Omole‐Ohonsi A.
Published: April 2004

A case of rupture of the uterus at 34 weeks of pregnancy due to a road traffic accident is presented. Emergency laparotomy and total abdominal hysterectomy were done with good maternal outcome. This is a rare cause of rupture of the uterus in this population.
Surgical control of obstetric hemorrhage: hypogastric artery ligation or hysterectomy?
Authors: Chattopadhyay S.K. , Deb Roy B. , Edrees Y.B.
Published: April 2004

Sixty‐four patients with severe postpartum hemorrhage (PPH) required surgical intervention during the years 1983 to 1987. Bilateral hypogastric artery ligation (HAL) was the initial surgical approach in 45% (29/64) and hysterectomy in 55% (35/64). HAL successfully controlled hemorrhage in 65% (19/29), and failed in 35% (10/29) where hysterectomy was required as a life saving procedure. Failure of HAL was more evident in atonic PPH than in other situations. Complications were more following hysterectomy; six (6/45) patients required re‐exploration for intraperitoneal hemorrhage and two (2/45) patients died following hysterectomy. HAL was found to be a relatively easy, safe and successful procedure to be attempted as an initial surgical approach for all severe PPH, specially where uterine conservation was desired.
The relationship between beta‐endorphin levels and uterine muscle contractions during labor
Authors: Weissberg N. , Algur N. , Schwartz G. , Shemesh O. , Eylath U. , Abraham A.S.
Published: April 2004

Plasma β‐endorphin (BE) levels (8.6 ± 0.8 pmol/l) (mean ± SE) were lower in the third trimester than in non‐pregnant controls (14.8 ± 1.1 pmol/l) (P < 0.001), increased during labor, to 29.3 ± 4.4 pmol/l (P < 0.005) and decreased, 72 h after delivery, to 3.5 ± 0.4 pmol/l (P < 0.001). BE levels were found to correlate significantly with uterine muscle contraction (r = 0.966, P < 0.05) and with cervical effacement (r = 0.974, P < 0.05) during labor.
Blood pressure profiles and perinatal outcome in pregnant black women in Pelonomi Hospital, Bloemfontein, South Africa
Authors: Schoon M.G. , Van der Walt W.J. , Fourie J. , Kruger H.
Published: April 2004

In a retrospective study, the antenatal records of 241 consecutive patients were analyzed. Maternal gravidity, age, blood pressure recordings, and fetal gestational age at birth, weight and perinatal deaths were recorded. Blood pressure recordings were done by the clinic staff with the patient in the supine position tilted 15° to the right. Hypertension was defined as a diastolic pressure (Korotkoff phase 4) of 90 mmHg or more. Forty‐one percent were classified as hypertensive. Hypertension before 33 weeks had a perinatal mortality of 264/1000.
The prognostic significance of augmentation of urethral closure pressure and functional length
Authors: Sand P.K. , Bowen L.W. , Ostergard D.R.
Published: April 2004

Sixty‐one women with genuine stress incontinence undergoing preoperative and postoperative multichannel urodynamic investigation were tested with augmenting urethral closure pressure profiles during contraction of the pelvic floor muscles to assess voluntary control of the urethral “sphincter.” Increases of 20% or more above resting functional length and closure pressure were selected as indicators of augmentation. The presence or absence of augmentation of functional urethral length and/or closure pressure during pelvic floor contraction allowed for the grouping of these patients into six subgroups which were compared for urinary symptoms, prior anti‐incontinence procedures and the presence of low urethral pressure, detrusor instability and genuine stress incontinence both pre‐ and postoperatively. Evaluation of the patient's ability to augment functional length and closure pressure did not affect surgical success nor did its presence or absence correspond to the presence of a low pressure urethra, detrusor instability, or specific urinary symptoms. Evaluation of augmentation of functional length and closure pressure was therefore felt to be of no prognostic value during the performance of multichannel urodynamic testing in incontinent females.
Effectiveness of phenol‐atabrine‐paste (PAP) instillation for female sterilization
Authors: Kang X.P. , Wan H.Z. , Wang P. , Wang S.X. , Chow L.P.
Published: April 2004

Two groups of sterilized women, 3307 by phenol‐atabrine‐paste (PAP) instillation and 1026 by mini‐lap technique, were follow‐up interviewed to determine their relative effectiveness. PAP, if successfully performed, was as effective as the mini‐lap. The life table pregnancy rates among successful PAP women were 0.21 and 0.28 at 12 and 24 months, respectively. The rates among the unsuccessful PAP women, however, were high: 15.1 and 30.5 at 12 and 24 months, respectively. In spite of its distinctive advantage of being non‐surgical, wider promotion of PAP sterilization procedure deserves caution.