bluuebunny/crossref_metadata_2025 huggingface dataset:
Preinduction Cervical Ripening with Intravaginal Prostaglandin E1 Methyl Analogue Misoprostol: A Randomized Controlled Trial
Authors: Srisomboon Jatupol , Tongsong Theera , Tosiri Visit
Published: August 2010

Objective: To evaluate the efficacy of intravaginal prostaglandin E1 methyl analogue misoprostol in cervical ripening in patients with unfavorable cervix (Bishop score < 4) requiring labor induction.

Method: A randomized controlled clinical trial of 62 women in the third trimester with various indications for induction of labor were randomly allocated to receive either 100 μg misoprostol inserted vaginally (32) or placebo similarly applied (30). Transvaginal sonography was performed to measure the cervical length before and 12 hrs after insertion.

Results: The mean change in cervical length and Bishop score was significantly greater in the misoprostol group (24 mm and score 8) compared with in the placebo group (2.2 mm and score 1) (p = 0.001). All but one patients receiving misoprostol went into labor while only one in the placebo group did so. The interval from insertion to vaginal delivery was significantly shorter in the misoprostol group (12.0 vs 25.5 hrs, p < 0.001). Delivery occurred within 24 hrs in 75% and 30% of patients in the misoprostol and placebo groups respectively. Uterine tachysystole occurred more frequently in the misoprostol group (38%) than in the placebo group (0%) (p < 0.001). All could be rapidly reversed by tocolytics without apparent untoward intrapartum effects. No significant differences were noted in the 2 groups in terms of perinatal outcomes and mode of delivery.

Conclusion: Intravaginal misoprostol is an effective, cheap and safe method for cervical ripening. The higher frequency of uterine tachysystole in the misoprostol group did not increase the risk of adverse intrapartum and neonatal outcomes.
Bone Mineral Density of the Spine Using Dual Energy X‐Ray Absorptiometry in Patients with Non‐Insulin‐Dependent Diabetes Mellitus
Authors: Kwon Dong‐Jin , Kim Jim‐Hong , Chung Ki‐Wook , Kim Jang‐Heub , Lee Jin‐Woo , Kim Soo‐Pyung , Lee Hun‐Young
Published: August 2010

To evaluate the influence of non‐insulin‐dependent diabetes mellitus (NIDDM) on bone mineral density (BMD), we measured BMD in 185 female patients with NIDDM using dual energy X‐ray absorptiometry (DEXA). BMD was measured in lumbar vertebrae (L2–4). BMD is slightly higher in the diabetic patients compared with control subjects and bone loss related to menopause starts before the onset of menopause. The BMD of postmenopausal women showed a definite decrease with aging and there was abrupt bone loss after 55 years of age (p < 0.05). In relation to the duration of diabetes, the decrease of BMD for 15 years was 10.0%. BMD was negatively correlated with age, years since menopause (YSM), and disease duration (r = ‐ 0.584, r = ‐ 0.470, r = ‐0.186). These results suggest that age, YSM, and the duration of disease appear to be the risk factors for decreased BMD in the diabetic patients.
Clinical Evaluation of Plasma Fibronectin Level as a Biomarker of Preeclampsia
Authors: Yasumizu Takehiko , Kato Junzo
Published: August 2010

Objective: To evaluate the clinical feasibility of plasma fibronectin as a biomarker and predictor for preeclampsia.

Methods: A total of 13 patients who had severe preeclampsia in prior pregnancies were enrolled for longitudinal study, and the profiles of plasma fibronectin were observed throughout their pregnancies. In cross‐sectional study, the correlation between plasma fibronectin within a week before delivery and the grade of preeclampsia were analyzed in 96 pregnant women including tangible preeclampsia.

Results: In the longitudinal study, 5 patients developed severe preeclampsia, in whom plasma fibronectin was elevated over the normal range 2–9 weeks before the onset of preeclampsia. In the cross‐sectional study, plasma fibronectin levels elevated significantly corresponding with the severity of preeclampsia, and the abnormal elevation of fibronectin reflected the existence of preeclampsia with satisfactory sensitivity and specificity.

Conclusion: Increased plasma fibronectin levels may be a highly sensitive and specific diagnostic indicator for preeclampsia.
Effect of Estriol on Bone Loss in Postmenopausal Japanese Women: A Multicenter Prospective Open Study
Authors: Minaguchi Hiroshi , Uemura Tsuguo , Shirasu Kazuhiro , Sato Akira , Tsukikawa Susumu , Ibuki Yoshito , Mizunuma Hideki , Aso Takeshi , Koyama Takao , Nozawa Shiro , Ohta Hiroaki , Ikeda Toshiyuki , Kusuhara Koji , Ochiai Kazuhiko , Kato Junzo , Kinoshita Toshihiko , Tanaka Kenichi , Minagawa Yusuke , Kurabayashi Takumi , Fukunaga Masao
Published: August 2010

Objectives: To assess the effects of oral estriol on the bone mineral density (BMD) and bone metabolism in postmenopausal women.

Methods: Seventy‐five natural postmenopausal women with a BMD of more than 10% below the peak bone density were treated for 50 weeks with 2 mg/day estriol (E3) cyclically and 0.8 g/day of calcium lactate continuously. BMDs at L2‐L4 were measured by dual energy X‐ray absorptiometry (DXA).

Results: The BMD increased 1.79% (p < 0.01 vs. pretreatment) after 50 weeks, accompanied with decrease of biochemical markers of bone turnover. With regard to climacteric symptoms, Kupperman's menopausal index improved (p < 0.01 vs. pre‐treatment) after 5 weeks of treatment. As to the incidence of adverse events genital bleeding was observed in only 8.0% of the subjects. Endometrial histology and cytology showed neither abnormalities nor hyperplasia during and after the treatment.

Conclusions: Estriol prevented postmenopausal bone loss and improved climacteric symptoms effectively with low incidence of genital bleeding.
Gestational Changes in Nitric Oxide Synthase Activity in the Rat Placenta
Authors: Thanda Myat , Saheki Shuichi , Kitagawa Hiroyuki , Yano Juri , Matsuura Shumpei
Published: August 2010

Objective:To assess the importance of nitric oxide (NO) generated in the placenta on pregnancy, nitric oxide synthase (NOS) activities were measured in the rat placentas of different gestational ages.

Materials and Methods:NOS activity was determined by [3H] L‐arginine to [3H]‐citrulline conversion assay on rat placenta of day 5, 10, 15 and 21 of gestation.

Results:NOS activity distributed both in the soluble and particulate fractions. Inhibition of NOS activity by L‐arginine analogs confirmed the substrate specificity. The requirement of calcium/calmodulin for the maximal activity indicated that the rat placenta NOS was of a constitutive calcium/calmodulin dependent isoform. The activities in both fractions were higher in the earlier gestational age placentas, decreasing with progression of gestation, and the lowest in the term placentas.

Conclusion:Although NOS activity was detected in the placenta throughout gestation, it was highest in the early gestational age placenta, suggesting a possible significant role of NO in early gestation.
Anti‐Phospholipid Antibodies in Preeclampsia and Their Binding Ability for Placental Villous Lipid Fractions
Authors: Yamamoto Tatsuo , Takahashi Yuko , Geshi Yumi , Sasamori Yukifumi , Mori Hirouki
Published: August 2010

Objective: In order to investigate the significance of the anti‐phospholipid antibodies (APAs) in preeclampsia, 3 kinds of APAs — namely, the anti‐cardiolipin antibody (ACA), the anti‐phosphatidylserine antibody (APSA), and the anti‐phosphatidylcholine antibody (APCA) — were measured, and the APA‐binding ability for placental villi using villous lipid fractions was studied.

Methods: Serum samples were taken from 70 cases of preeclampsia, including 42 cases of the severe type, and from 45 normal pregnant women. The APAs were measured by an enzyme linked immunoabsorbent assay (ELISA). Placental villous membranes (PVMs) from normal placenta were purified and the lipid fractions were extracted from PVMs. The antibody‐binding ability for PVM lipid fractions was evaluated by the ELISA method.

Results: In IgG‐antibody measurements, the rate of ACA‐positive, APSA‐positive and APCA‐positive cases were 10.0%, 18.1%, and 7.1%, respectively. The presence of APAs was revealed in preeclampsia. Using thin‐layer chromatography, negatively charged phospholipids were found in the lipid fractions obtained from PVMs. Antibody binding for the lipid fractions of PVMs was detected in 9 of 12 APA‐positive cases in preeclampsia.

Conclusion: The results suggest that one cause of preeclampsia is the production of antiphospholipid antibodies that bind to placental villous membrane antigens.
Immunohistochemical Study of c‐erb B‐2 Expression in Malignant Mixed Müllerian Tumors of the Female Genital Tract
Authors: Nasu Kaei , Kawano Yasushi , Hirota Yoshiko , Matsui Naohiko , Hayata Takashi , Miyakawa Isao
Published: August 2010

Objective: To study the expression of c‐erb B‐2 in gynecologic malignancies, especially in malignant mixed müllerian tumors (MMTs).

Methods: Using immunohistochemical techniques, we examined 6 cases of primary MMT, 6 cases of leiomyosarcoma (LMS), 7 cases of endometrial adenocarcinomas, and 10 cases of normal endometria.

Results: The expression of c‐erb B‐2 was observed in the carcinomatous area of all 6 cases of MMT (100%), the sarcomatous area of 5 of 6 cases of MMT (83.3%), in 1 of the 6 cases of LMS (16.7%), in all 7 cases of adenocarcinoma (100%), and in all cases of normal epithelial cells (100%), but was not observed in any of the cases of normal stromal cells (0%).

Conclusion: The results suggest that the carcinomatous and sarcomatous elements of MMT are similar in their expression of c‐erb B‐2. MMT differed immunohistochemically from pure sarcoma cells and normal stromal cells, but resembled pure carcinoma cells and normal epithelial cells of the female genital tract.
The Relation between Body‐Fat Distribution and Lipid Metabolism in Postmenopausal Women
Authors: Douchi Tsutomu , Ijuin Hirofumi , Nakamura Sachiko , Oki Toshimichi , Yamamoto Shinichi , Katanozaka Mari , Nagata Yukihiro
Published: August 2010

Objective: To evaluate the relationship between body‐fat distribution and lipid metabolism in postmenopausal women.

Methods: Fifty‐four women (mean: 61.8 ± 7.8 years old) showing hyperlipidemia and 63 controls were enrolled in this study. Their baseline characteristics and body‐fat indices, as measured by DEXA, were compared. The correlations between the serum‐lipid levels and the variables were evaluated.

Results: The amount of upper‐half‐body fat and the body‐fat ratio were significantly higher in the hyperlipidemia group. In single‐regression analysis, there were low levels of correlation between the serum TC levels and the amount of upper‐half‐ body fat and the upper‐body fat ratio. There was a low level of correlation between the serum TG level and the amount of upper‐half‐body fat, the upper‐lower‐half‐ body‐fat ratios, and the upper‐half‐body‐fat ratio. After adjusting for variables, the serum TC and TG levels best correlated with the amount of upper‐half‐body‐fat (r = 0.458, r = 457, respectively).

Conclusion: In postmenopausal women, lipid metabolism is reflected in the amount of upper‐half‐body fat, irrespective of age and the body‐mass index (BMI).
Urinary 8‐hydroxy‐2‘‐deoxyguanosine (8‐OHdG) Levels in Women with or without Gynecologic Cancer*
Authors: Yamamoto Takara , Hosokawa Ken‐ichi , Tamura Takaya , Kanno Hiroshi , Urabe Mamoru , Honjo Hideo
Published: August 2010

Objective: To detect the level of 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) which is an oxygen‐radical‐forming agent, in the urine of patients with (n = 18) or without (n = 10) carcinoma of the female genitalia. None of the patients had been receiving any treatment before their urinary 8‐OHdG levels were measured.

Methods: Urinary 8‐OHdG was extracted by a solid‐phase technique, and its level was determined by high‐performance liquid chromatography (HPLC) with an electric chemical detector (ECD).

Results: We determined that the urinary 8‐OHdG level decreased with as the age of the patient increased, and was extremely high in advanced cancer and recurrent cancer in a considerable number of patients. The urinary 8‐OHdG level (1,827 ± 1,500 pmol/kg/day, mean ± SEM) in 18 patients with carcinoma was significantly higher (p ≤ 0.05) than that (747 ± 425 pmol/kg/day) in 10 patients without carcinoma.

Conclusion: These results suggest that it might be possible to determine the spread of cancer to some extent by determining a patient's urinary 8‐OHdG level.
Prenatal Diagnosis of an Extensive Haemangioma of the Fetal Leg: A Case Report
Authors: Raman S. , Ramanujam T. , Lim C. T.
Published: August 2010

Extensive haemangioma with platelet consumption (Kasabach‐Merritt syndrome) is rare. The lesion is usually a single cutaneous cavernous haemangioma1similar to that found in our patient. Multiple superficial strawberry naevi were also seen all over the rest of the body. This condition was diagnosed antenatally in this patient with the use of colour Doppler. There is one recent report where the thrombocytopaenia was diagnosed by cordocentesis.2Unfortunately the baby developed heart failure with intractable coagulopathy and died 2 days later.
Outcome of Unplanned Vaginal Deliveries after Two Previous Caesarean Sections
Authors: Jamelle Raana N.
Published: August 2010

Once a caesarean section always a caesarean section may not stand true any more but twice a caesarean section always a caesarean section still stays put because of its high maternal and foetal complications. Jinnah Postgraduate Medical Centre is large tertiary care hospital and has a caesarean section rate of over 18%; 10 patients (3.9%) were picked up in a retrospective study who had vaginal delivery after 2 previous caesarean sections in 2 years. They were admitted late in labour. Only one patient had dehiscence of scar. The aim of the study was to evaluate the outcome and safety of vaginal deliveries after 2 previous caesarean sections even when the trial was not conducted at the hospital.
The Value of Human Growth Hormone as an Adjuvant for Ovarian Stimulation in a Human in vitro Fertilization Program
Authors: Wu Ming‐Yih , Chen Hsin‐Fu , Ho Hong‐Nerng , Chen Shee‐Uan , Chao Kuang‐Han , Huang Su‐Cheng , Lee Tzu‐Yao , Yang Yu‐Shih
Published: August 2010

The purpose of this study was to evaluate whether the combined treatment of growth hormone (GH) and gonadotropins can improve ovulation stimulation in previously poor responders. Twelve patients who, had suboptimal responses in previous in vitro fertilization cycle were enrolled. They underwent 1 cycle with gonadotropin‐releasing hormone analogue (GnRH‐a) and gonadotropins and another cycle with GnRH‐a, gonadotropins, and GH. Serum gonadotropins, insulin‐like growth factor‐1 (IGF‐1), and sex steroids, including estradiol (E2), progesterone (P4), testosterone, and androstenedione were measured on Day 2 and during ovulation induction. The serum IGF‐1 level was higher in the GH cycle. There were no significant differences in the levels of the serum luteinizing hormone, E2, P4, testosterone, and androstenedione between the 2 cycles, so was IGF‐1, E2 and P4 in follicular fluid. Co‐treatment with GH did not improve the ovarian response. However, the GH cycles had better performance in terms of the number of oocytes fertilized and the pregnancy rate.
Sexual Behaviour and Prevalence of HIV Antibodies in Transsexuals
Authors: Chew Stephen , Tham K. F. , Ratnam S. S.
Published: August 2010

Objective: To present data on the social characteristics, sexual behaviour and prevalence of HIV antibodies in 277 transsexuals.

Material and Methods: One hundred fifty‐four male and 123 female transsexuals requesting surgical gender reassignment at the National University Hospital, Singapore were interviewed using a standard questionnaire. Blood samples were also taken at booking and prior to surgery and tested for HIV antibodies using a commercial enzyme immunoassay.

Results: The mean ages of the male and female transsexuals were 26.3 and 28.3 years respectively. The majority of the transsexuals were Singaporean Chinese and had at least a secondary school education. None of the female and 14 (9%) of the male transsexuals were engaged in prostitution. Significantly more female (48%) than male (10.4%) transsexuals were sexually inactive. The sexual behaviour and practices of the transsexuals are also discussed.

Conclusions: Significantly more male transsexuals compared to the female transsexuals, were sexually active, had earlier sexual contact, engaged more often in anal intercourse, and had 7 or more sexual partners. However, none of our transsexuals were positive for HIV antibodies.
Incidence of Postnatal Depression in Malaysian Women
Authors: Kit Lee Kick , Janet Grace , Jegasothy Ravindran
Published: August 2010

Objective: To determine the incidence of postnatal depression of Malaysias women at 6 week postpartum and a survey of their sociocultural practices.

Methods: A hundred and fifty‐four women who were 6 weeks postpartum attending the postnatal clinic between May and July 1995 at Maternal and Child Health Clinic, Seremban, Malaysia.

Maternal socio‐demography, depression by Edinburgh Postnatal Depression Scale (EPDS), postnatal care and practices e.g. pantang larang (prohibited behaviour and practices), diet and partnering were evaluated.

Results: Postnatal depression was 3.9%. Indians had the highest rate at 8.5% as compared to Malays (3.0%) and none in Chinese (p < 0.05). There were no demographic differences in the study groups. Average score of EPDS was 4.05 which ranged from 0 to 20. During the confinement 85.7% of women took special diet; 64.3% followed pantang larang and 78.8% had someone to look after them.

The incidence of postnatal depression is low in Malaysia at 3.9%. Majority of Malaysian women still observed the traditional postnatal beliefs and practices.
Importance of the Transitional Zone between the Cervical Stroma and the Parametrium in the Treatment of Cervical Carcinoma
Authors: Tabata Masaaki , Makinoda Satoru , Yamaguchi Tatsumi , Sakuragi Noriaki , Fujimoto Seiichiro
Published: August 2010

Objectives: Parametrial invasion is an important risk factor in cervical carcinoma. Because the vessels of the parametrium start in the zone between the cervical compact stromal layer and the parametrium, which we have defined as the parametrial initial zone (PIZ) or transitional zone, the invasion of a carcinoma into this part of the cervix is also important. Our objectives in this study were find a characteristic index of the transitional zone and to clarify the relationship between a transitional‐zone invasion and the prognosis in a case.

Methods: Thirty‐three cases of carcinoma in situ were available to use for the morphological examination of the cervix. The cervix was divided into 8–12 sections. In each section, the outer diameters of the short axis of the arteries were measured with a light microscope and a micrometer. Using the arterial diameter as the characteristic index of the transitional zone, we performed epidemiological studies on 312 patients with clinical Stage Ib‐III squamous‐cell carcinoma of uterine cervix.

Results: The arteries with an axis exceeding 300 μm were concentrated in the transitional zone at a rate of 94.6%. Therefore, arteries of this size are used as the characteristic index of the transitional zone. Patients with invasion to transitional zone only had lymph node metastasis at the rate of 28.1%, compared with 0% for patients who had no permeation to the zone (p < 0.001). The 5‐year survival rate of patients with invasion to the transitional zone only was 87.3%, which is significantly lower than those without invasion (99.2%) (p < 0.01).

Conclusions: Measuring the short axis (300 μm ≤) of the artery is the best method by which to pinpoint the transitional zone. The invasion of a carcinoma into the transitional zone in the cervix should be treated as a parametrial involvement.
Effect of Population Density on the Early Post‐Implantation Mouse Embryo Growth in vitro
Authors: Kang Byung Moon , Kim Chung Hoon , Chang Yoon Seok , Mok Jung Eun
Published: August 2010

Objective: To investigate the relationship between embryo population density and embryo development in vitro.

Methods: Swiss Webster albino mice were used and blastocysts were flushed from the uterine horns. Various numbers of blastocysts were randomly assigned to separate 35 mm dishes and cultured for 9 days.

Results: The effect of duration of culture to the mean success rates was different as the number of embryos in the dish was changed. In early egg cylinder (EEC) stage; the mean success rate was a flat function of the number of embryos. But the mean success rate was a decreasing function in late egg cylinder (LEG) stage and the decreasing rate was faster in early somite (ES) stage. Interestingly, the mean success rate to ES stage was nearly constant when more than 10 embryos were cultured in one dish.

Conclusion: The success rate to each developmental stage in vitro decreased as the number of embryos in the dish and the duration of culture increased.
Effects of All‐trans Retinoic Acid on Choriocarcinoma Cells in vitro*
Authors: Yamada Satoru , Okamoto Tomomitsu , Nakanishi Toru , Nomura Seiji , Tomoda Yutaka
Published: August 2010

Objective: To determine the activities of all‐trans retinoic acid (RA) on choriocarcinoma cells in vitro.

Methods: The antiproliferative effect of all‐trans RA on 4 choriocarcinoma cell lines was measured by the MTT assay. The effect of all‐trans RA combined with methotrexate or actinomycin‐D was then examined. The effect of all‐trans RA on hCG secretion was also studied. The gene expression of retinoic acid receptors (RARs) was examined by RT‐PCR.

Results: All‐trans RA inhibited cell proliferation dose‐ and time‐dependently; a 6‐day exposure to 1 μM all‐trans RA suppressed the cell growth by 67.8%‐82.0% compared to the controls. An enhanced effect was observed in the combined administration of all‐trans RA and methotrexate or actinomycin‐D. The secretion of hCG increased 4‐fold to 9‐fold by the addition of 1 μm all‐trans RA. RARs genes were expressed in all cell lines.

Conclusion: The anticancer activity presented here appears to warrant further evaluation of all‐trans RA as adjuvant therapy for choriocarcinoma.
Immunohistochemical Studies on Matrix Metalloproteinase‐9 (MMP‐9) and Type‐IV Collagen in Endometrial Carcinoma
Authors: Inoue Yoshiki , Abe Kunio , Obata Koushiro , Yoshioka Tadaaki , Ohmura Gen , Doh Kunihiko , Yamamoto Kaichiro , Hoshiai Hiroshi , Noda Kiichiro
Published: August 2010

Immunohistochemical staining of MMP‐9 and the type‐IV collagen was performed on paraffin sections of endometrial carcinoma. Immunostaining in 129 cases of endometrial cancer detected MMP‐9 in 19.0% of the cases. MMP‐9 positive was shown in 30% of the cases with vessel invasion, and in 12.7% of the cases without vessell invasion (p < 0.05). MMP‐9 showed positive in many cases with poor differentiation and lymph node metastasis, but still failed to achieve statistical significance. MMP‐9 staining did not correlate with disease outcomes. We can not clarify that MMP‐9 is associated with tumor‐cell invasion and metastasis. Type‐IV collagen deposition at the tumor‐stromal border was studied in 58 cases of endometrial carcinoma in which disruptions were seen in varying degrees. The type‐IV collagen in the primary lesion decreased as the differentiation decreased. Even in the lymph node metastasis lesions, the type‐IV collagen was stained and was almost in agreement with the primary lesions. In the primary lesions, there was no relationship between MMP‐9 staining and the type‐IV collagen. It was suggested that the type‐IV collagen observed in endometrial carcinoma was more concerned with the differentiation of the tumor than with the degradation by MMP‐9.
The Detection of Right‐Sided Congenital Diaphragmatic Hernia in Monozygotic Twins on Prenatal Ultrasonography
Authors: Chao An‐Shine , Cheng Po‐Jen , Hsueh Chuen , Soong Yung‐Kuei
Published: August 2010

The diagnosis of a pair of monozygotic twins with right‐sided diaphragmatic hernia under ultrasound is described. Aspects of heredity, diagnosis and management are discussed.
Preinduction Cervical Ripening: Prostaglandin E2 Gel vs Hygroscopic Mechanical Dilator
Authors: Chua S. , Arulkumaran S. , Vanaja K. , Ratnam S. S.
Published: August 2010

Objectives: To evaluate the efficacy and safety of hygroscopic mechanical dilators (Dilapan™) for ripening the pregnant cervix prior to induction of labour at or near term and to compare it with an intracervical PGE2 gel (Prepidil™).

Methods: One hundred and eighty‐five women (69 nulliparae, 116 multiparae) at term with singleton pregnancies in cephalic presentation, who were scheduled for induction of labour in the labour ward at the National University Hospital, but had an unfavourable cervical score were randomized into 2 groups by random number table. In group 1 (Prepidil), 0.5 mg of PGE2 in 2.5 ml of triacetin gel was inserted into the endocervical canal. In women in group 2 (Dilapan) upto a maximum of 4 hygroscopic dilators were placed in the endocervical canal. If labour did not ensue at the end of 12 hours of ripening, the cervical score was assessed, amniotomy was performed and oxytocin commenced. Neonatal and obstetric outcome was compared, statistical analysis performed using Chi‐square, and t‐tests.

Results: Significantly more women in the group who received Dilapan for cervical ripening required amniotomy and oxytocin for induction of labour > 12 hours after priming compared with the group who received Prepidil (p < 0.001). Operative delivery for no progress and fetal distress respectively was similar in the 2 groups. The number of cases of hyperstimulation were higher in the Prepidil group but did not result in an increased incidence of operative deliveries for fetal distress. There was one neonatal death and one case of neonatal sepsis in the Dilapan group. Uterine rupture occurred in 1 woman who received Prepidil.

Conclusion: Dilapan, a mechanical method of cervical ripening is as effective as the more widely accepted mode of ripening with an endocervical PGE2 gel in achieving vaginal delivery. Dilapan would be useful for cervical priming prior to induction of labour in places where prostaglandins are not available because of cost and the need for a cold chain.
Risk Factors Predictive of Para‐Aortic Lymph Node Metastasis in Endometrial Carcinomas*
Authors: Yokoyama Yoshihito , Maruyama Hidetoshi , Sato Shigemi , Saito Yoshiharu
Published: August 2010

Objective: To identify risk factors predictive of para‐aortic lymph node (PAN); metastasis in endometrial carcinomas.

Methods: Sixty patients with endometrial carcinomas Stage I to III (FIGO, 1988) who each underwent a complete pelvic and para‐aortic lymphadenectomy with a semiradical or radical hysterectomy, bilateral salpingo‐oophorectomy, between April 1988 and March 1996, were included in this study. The relationship between PAN metastasis and clinico‐pathological factors such as histological type, grade, depth of myometrial invasion (MI), vascular space involvement (VSI), cervical invasion (CI), peritoneal cytology, tumor size, pelvic lymph node (PLN) metastasis, and glutathione S‐transferase π (GST‐π) expression was examined using univariate and multivariate analysis.

Results: Seven variables — G3 grade, more than one‐half MI, positive VSI, positive CI, tumor size of more than 2 cm in diameter, positive PLN metastasis, and positive GST‐π — were significantly correlated with PAN metastasis using univariate analysis. Multivariate analysis revealed that of the above 7 variables, 3 were significantly and independently correlated with PAN metastasis: more than one‐half MI, positive PLN, and positive GST‐π. The relative risk of a patient with these 3 factors having PAN metastasis was 18.0 times greater than the risk for a patient without them.

Conclusion: These variables — More than one‐half MI, positive PLN, and positive GST‐π — were significantly related to PAN metastasis.
The Behavior of Endometrial Hyperplasia: A Prospective Study
Authors: Terakawa Naoki , Kigawa Junzo , Taketani Yuji , Yoshikawa Hiroyuki , Yajima Akira , Noda Kiichiro , Okada Hiroji , Kato Junzo , Yakushiji Michiaki , Tanizawa Osamu , Fujimoto Seiichiro , Nozawa Shiro , Takahashi Takeshi , Hasumi Katsuhiko , Furuhashi Nobuyuki , Aono Toshihiro , Sakamoto Atsuhiko , Furusato Masakuni ,   Endometrial Hyperplasia Study Group
Published: August 2010

Objective: To clarify the behavior of endometrial hyperplasia in a prospective study.

Method: Fifty‐one patients with endometrial hyperplasia were followed up for 6 months. Samples of endometrial tissues were taken by uterine endometrial biopsy every 4 weeks during the first 3 months and at the end of follow‐up.

Results:/ In 69% (35/51) of the patients histological picture of the endometrium became normal during the observation period. The lesions persisted in 17% (6/35) of the patients with simple hyperplasia, in 25% (1/4) of those with complex hyperplasia, in 14% (1/7) of those with simple atypical hyperplasia, and in 80% (4/5) of the patients with complex atypical hyperplasia. In the remaining 3 patients with simple hyperplasia, the lesions progressed to complex atypical hyperplasia by the end of follow‐up, after showing a normal endometrium.

Conclusion: Most cases of endometrial hyperplasia, except for complex atypical hyperplasia, disappeared spontaneously within a short period of time.
Outcome of Abruptio Placentae in Normotensive and Hypertensive Patients in Aga Khan University Hospital, Pakistan
Authors: Munim Shama , Chaudhury Nasreen , Jamal Khalid , Khan Fida Ali
Published: August 2010

The aim of our study was to compare the perinatal and maternal outcome in hypertensive women experiencing abruptio placentae with that of normotensive women. We hypothesized that hypertensive women experiencing abruptio had a less favorable outcome than the normotensive women. Ours was a retrospective cohort study, in which the outcome of 33 hypertensive women with abruptio was compared with 138 normotensive women experiencing abruptio placentae. Our results indicate that although higher number of hypertensive women with abruptio had a past history of hypertension and were more likely to have diabetes (p = 0.05) there was no difference found in the grades of abruption or in any other antenatal complications between the 2 groups. The hypertensive women were also more likely to undergo cesarean section. We did not find any difference in the neonatal outcome. Therefore, we conclude that there is no difference in the maternal and perinatal outcome between the hypertensive and normotensive women experiencing abruptio.
Puerperal Inversion of the Uterus in Nepal: Case Reports and Review of Literature
Authors: Dali Sanu Maiya , Rajbhandari S. , Shrestha S.
Published: August 2010

Retrospective study of 6 cases of puerperal inversion of the uterus is being presented from 1975 to 1995 and a review of literature for 20 years of the period 1975–1995 has been summarised. In the present series, one case with acute puerperal inversion of uterus were treated by manual reposition, 2 cases of chronic puerperal inversion of uterus was treated surgically by Kustner's vaginal approach. Two cases with subacute puerperal inversion of uterus, 1 case of chronic puerperal inversion were treated by Haultain and Huntington method. Out of 241 cases of uterine inversion obtained from review of literature for last 20 years, 229 (95%) constituted puerperal and 12 (5%) were non puerperal inversions. Among puerperal inversions, 191 (83.4%) cases were of acute type and only 6 (2.62%) cases were of subacute variety. The chronic puerperal inversion constituted 32 (13.9%). Out of 63 cases of uterine inversions in India, maternal deaths were reported as 6 (9.5%) but there was no maternal death in the present series.
Hypersensitivity Reactions to Cisplatin following Multiple Uncomplicated Courses: A Report on Two Cases
Authors: Onoyama Yoshimichi , Umezu Takashi , Kuriaki Yumiko , Honda Naotoshi
Published: August 2010

Two patients with ovarian cancer who had received multiple courses of cisplatin without complications experienced hypersensitivity reactions to cisplatin: one, involving intrahepatic artery infusion, manifested general erythema, dyspnea, and hypotension; the other, involving intravenous infusion, manifested abdominal pain, general erythema, and fever. When platinum‐containing agents are administered, patients should be closely monitored for hypersensitivity reactions, even in previously uncomplicated cases.
A Comparison of Intravaginal Misoprostol and Intracervical Prostaglandin E2 Gel for Ripening of Unfavorable Cervix and Labor Induction
Authors: Herabutya Yongyoth , O‐Prasertsawat Pratak , Pokpirom Jareeporn
Published: August 2010

Objective: To study the effectiveness of single application of intravaginal misoprostol versus intracervical prostaglandin E2 gel for ripening the unfavorable cervix and labor induction.

Method: One hundred and ten patients with indications for induction of labor with unfavorable cervices were randomized to receive either 100 microgram tablets of misoprostol placed in the posterior vaginal fornix or prostaglandin E2 1.5 mg in gel placed into the endocervix. Those, who were not in active labor after 24 hours, had labor induced with amniotomy and oxytocin.

Results: Among 110 patients recruited, 60 received misoprostol and 50 received prostaglandin E2 gel. The average interval from start of induction to vaginal delivery was 19.14 ± 10.64 hours in misoprostol group and 21.37 ± 13.09 hours in the prostaglandin E2 group (p = 0.33). Five patients (8%) in the misoprostol group had induction of labor after 24 hours of the treatment compared with 13 patients (26%) in the PGE2 group. The difference was significant (p = 0.03). Oxytocin augmentation was 35% in the misoprostol group and 34% in the prostaglandin E2 group (p = 0.86). There were no significant differences between routes of delivery. Nineteen patients (31%) in misoprostol group and 16 patients (32%) in the PGE2 gel group had cesarean deliveries. There was one case (1.7%) of uterine hyperstimulation in the misoprostol group and none in the PGE2 gel group. There were no significant difference in Apgar scores < 7 at 1 and 5 minutes, or admission to the neonatal intensive care unit between the 2 groups.

Conclusion: Vaginal misoprostol is an effective agent for cervical ripening and induction of labor. Complications associated with prostaglandin administration were not statistically different between the 2 groups, but hyperstimulation occurred more in misoprostol group.
Risks Associated with Cesarean Sections in Women with Placenta Previa
Authors: Takayama Takeshi , Minakami Hisanori , Koike Toshimitsu , Watanabe Takashi , Sato Ikuo
Published: August 2010

Objective: To investigate the risks associated with cesarean section performed because of placenta previa.

Methods: We retrospectively reviewed the records of 88 women with singleton pregnancies complicated by placenta previa who underwent cesarean sections and those of 176 (control) women with singleton pregnancies who required cesarean section because of complications other than placenta previa.

Results: The duration of gestation was 35.3 ± 3.6 weeks for subjects with placenta previa and 36.9 ± 3.8 weeks for the control subjects. The mean birth weight was 2,650 g ± 75 g for infants of women with placenta previa and 2,644 g ± 38 g for infants of the control subjects. Blood loss during surgery was greater for women with placenta previa than for the control subjects (1,154 ml ± 924 ml vs 632 ml ± 357 ml, p < 0.001). Blood transfusion was required in 13 of 88 (15%) women with placenta previa, compared with 4 of 176 (2.3%) of the control subjects (p < 0.001). An emergency cesarean hysterectomy was performed on 4 of the 88 (4.5%) women with placenta previa, and in none of the control subjects (p < 0.05). The Apgar score was ≦ 7 at 5 minutes in 17 infants of the 88 (22%) women with placenta previa, compared with 17 infants of the 176 (11%) control subjects among infants born at ≧ 33 weeks' gestation (p < 0.05); among infants with a birth weight ≧ 2,000 g, the corresponding numbers were 15 (21%) and 13 (9.2%), respectively (p < 0.05).

Conclusions: Cesarean section in the women with placenta previa was associated with increased blood loss, resulting in a blood transfusion rate 6.5 times higher than in the control subjects. These findings suggest that placenta previa might adversely affect the neonatal outcome.
Hydatid Cyst of Morgagni: Any Impact on Fertility?
Authors: Abd‐El‐Maeboud Karim H. I.
Published: August 2010

On laparoscopy in 3 patients with primary infertility, the only pathology found was hydatid cysts of Morgagni that were excised. In one patient with monolateral hydatid cyst, pregnancy failed to be achieved. Despite prior failure of repeated trials of ovulation induction and intrauterine insemination in the other 2 patients, a spontaneous pregnancy was achieved within 2–3 months following laparoscopic extirpation of hydatid cysts of Morgagni. The hydatid cysts were bilateral in one case; and monolateral (in relation to the only present tube with a unicornuate uterus) in the other dase. Jt is concluded that hydatids of Morgagni, as a single pelvic pathology, might hinder fertility. Laparoscopic extirpation of these cysts would improve ovum pick‐up and enhance fertility.
Spontaneous Rupture of the Liver in an Uncomplicated Pregnancy
Authors: Matsuda Yoshio , Maeda Takatsugu , Hatae Masayuki
Published: August 2010

Spontaneous liver rupture has been reported during pregnancy secondary to severe pregnancy‐induced hypertension, eclampsia or syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Here we report a case diagnosed using CO2 intra‐arterial digital subtraction angiography in an uncomplicated pregnancy. A 33‐year‐old Chinese woman at 39 weeks' gestation underwent a second caesarean delivery. Her pregnancy course had been uneventful. In the immediate postpartum period, she developed clinical signs of hepatic infarction or hematoma. After a blood transfusion and the use of vasoactive agents, her hemodynamic condition became stable. A hepatic angiography was performed before an emergent laparotomy. CO2 intra‐arterial digital subtraction angiography revealed a small extravasation that was not found by the conventional method using an ionized medium. This disease should be considered when there occur pain in the upper part of the abdomen and signs of hemorrhagic shock, even in the case of an uncomplicated pregnancy.
Effects of Fibrin Glue on Postsurgical Adhesions after Uterine or Ovarian Surgery in Rabbits
Authors: Takeuchi Hiroyuki , Toyonari Yuka , Mitsuhashi Naoki , Kuwabara Yoshinori
Published: August 2010

Objective: To evaluate the prophylaxis with fibrin glue on postoperative adhesions following uterine or ovarian surgery in rabbits.

Study Design: The uterine horns of 10 rabbits were exteriorized and electrocauterized by monopolar coagulation. Fibrin glue was applied to one uterine horn and the other was left untreated as a control (Experiment 1). Multiple ovulation was induced in 12 rabbits with hCG, and wedge resection was performed on both ovaries of each animal. One ovary was treated with fibrin glue and the other was untreated as a control (Experiment 2). Second‐look laparotomy was performed to assess adhesion formation 2 weeks after the initial operation.

Results: The use of fibrin glue resulted in significant decrease in postoperative adhesions compared with the control side, in the uterine horns and the ovaries (p < 0.02 and p < 0.01, respectively).

Conclusion: Fibrin glue was useful in preventing postoperative adhesions of the reproductive organs in rabbits.
THE CLIOMETRICS OF INTERNATIONAL MIGRATION: A SURVEY
Authors: Hatton Timothy J.
Published: August 2010

Abstract This is a survey of some of the key studies in the literature on international migration in history that may be described as cliometric. This literature uses the concepts and approaches of applied economics to investigate a range of historical issues and there are strong parallels with the questions that have been addressed in the literature on contemporary migrations. Here I focus on the period 1850–1940 and chiefly on migration from Europe to the New World. The survey is organized around six themes that include the forces driving migration, over time and across space; the assimilation of migrants and their effects on wages and income distribution in source and destination countries; and the evolution of immigration policy. Although this literature has drawn heavily on the tool kit of applied economists it also provides a wider perspective on many of the issues that concern migration today.
Novel demonstration of RNAi in citrus reveals importance of citrus callose synthase in defence against Xanthomonas citri subsp. citri
Authors: Enrique Ramón , Siciliano Florencia , Favaro María Alejandra , Gerhardt Nadia , Roeschlin Roxana , Rigano Luciano , Sendin Lorena , Castagnaro Atilio , Vojnov Adrian , Marano María Rosa
Published: August 2010

Citrus is an economically important fruit crop that is severely afflicted by citrus canker, a disease caused by the bacterial phytopathogen, Xanthomonas citri subsp. citri (Xcc). GenBank houses a large collection of Expressed Sequence Tags (ESTs) enriched with transcripts generated during the defence response against this pathogen; however, there are currently no strategies in citrus to assess the function of candidate genes. This has greatly limited research as defence signalling genes are often involved in multiple pathways. In this study, we demonstrate the efficacy of RNA interference (RNAi) as a functional genomics tool to assess the function of candidate genes involved in the defence response of Citrus limon against the citrus canker pathogen. Double‐stranded RNA expression vectors, encoding hairpin RNAs for citrus host genes, were delivered to lemon leaves by transient infiltration with transformed Agrobacterium. As proof of principle, we have established silencing of citrus phytoene desaturase (PDS) and callose synthase (CalS1) genes. Phenotypic and molecular analyses showed that silencing vectors were functional not only in lemon plants but also in other species of the Rutaceae family. Using silencing of CalS1, we have demonstrated that plant cell wall‐associated defence is the principal initial barrier against Xanthomonas infection in citrus plants. Additionally, we present here results that suggest that H2O2 accumulation, which is suppressed by xanthan from Xcc during pathogenesis, contributes to inhibition of xanthan‐deficient Xcc mutant growth either in wild‐type or CalS1‐silenced plants. With this work, we have demonstrated that high‐throughput reverse genetic analysis is feasible in citrus.
On the Optimality of Multivariate S‐Estimators
Authors: CROUX CHRISTOPHE , DEHON CATHERINE , YADINE ABDELILAH
Published: August 2010

Abstract.  In this article, we maximize the efficiency of a multivariate S‐estimator under a constraint on the breakdown point. In the linear regression model, it is known that the highest possible efficiency of a maximum breakdown S‐estimator is bounded above by 33 per cent for Gaussian errors. We prove the surprising result that in dimensions larger than one, the efficiency of a maximum breakdown S‐estimator of location and scatter can get arbitrarily close to 100 per cent, by an appropriate selection of the loss function.
Exploring diversity of learning outcomes in e‐learning courses: results of a qualitative study in a French multinational company
Authors: Baudoin Emmanuel
Published: August 2010

The implementation of e‐learning by companies in France is ongoing. One of their issues is to improve the learning experience of their employees. From our point of view, this implies that they must better understand the learning experience of the employees. This paper suggests a qualitative approach to learning in order to identify the diversity of learning outcomes achieved in a given e‐learning course. Four e‐learning courses were studied in a French multinational company. Forty‐two interviews were conducted. Results showed that employees reached different types of learning outcomes even if they completed the same e‐learning course. Finally, eight learning outcomes are identified: procedural information acquisition, declarative information acquisition, skills acquisition, skills automation, content understanding, understanding of the work environment, understanding of oneself and no perceived learning.
Differences in visual perception of age and attractiveness of female facial and body skin
Authors: Fink B. , Matts P. J. , Röder S. , Johnson R. , Burquest M.
Published: August 2010

Synopsis

Perception of age and health is critical in the judgement of attractiveness. The few studies conducted on the significance of apparent skin condition on human physical appearance have studied faces alone or isolated fields of images facial skin. Little is known about whether perception of the face matches that of other body parts or if body skin affects overall age and attractiveness perception when presented in combination with facial skin. We hypothesized that independent presentation of female faces, chests and arms (including hands) – cropped from a full face and upper body image – would result in significant differences in perception of age and attractiveness compared to the corresponding composite. Furthermore, we sought to investigate whether relatively young and attractive looking skin on selected, individual parts of the body affects overall perception. Digital photographs of 52 women aged 45–65 years were collected and processed to yield four derivative sets of images: One set showed the composite of all features, i.e. the face, the chest and the arms, whereas the other three were cropped carefully to show each part of the upper body described above independently. A total of 240 participants judged these faces for perceived age and attractiveness. Our results showed significant differences in perception with the chest and the arms being judged significantly younger than the face or composite image of the same women. Moreover, arms and chest images were perceived as more attractive than face and composite images. Finally, regression analysis indicated that differences between the perceived and chronological values of overall age perception could be predicted by age perception of the face and arms. These results continue to support the significance of facial age perception in assessment of a woman’s age, but highlight that body skin also plays a role in overall age impression.
A rapid High Performance Liquid Chromatographic (HPLC) method for the simultaneous determination of seven UV filters found in sunscreen and cosmetics
Authors: Wharton M. , Geary M. , O’Connor N. , Murphy B.
Published: August 2010

Synopsis

A rapid High Performance Liquid Chromatographic (HPLC) method was developed for the simultaneous determination of seven Ultra Violet (UV) filters most commonly found in cosmetics and sunscreen. The object of the method development was to provide a reliable rapid method, that would simultaneously separate a combination of the UV Filters, most commonly found in cosmetics and sunscreen products, utilizing a minimum of environmentally friendly solvents. The compounds separated were: benzophenone 3 (BZ3), methylbenzildene camphor (MBC), octyl dimethyl PABA (ODP), octocrylene (OCR), octyl methoxycinnamate (OMC), butyl – methoxydibenzoylmethane (BDM) and octyl salicylate (OS). An adjusted mobile phase consisting of ethanol and 1% acetic acid, combined with a Thermo Hypersil C18 BDS 3 micron column resulted in a method, which allowed the analysis of the seven compounds in seven minutes. The proposed method was validated utilising the International Congress on Harmonisation (ICH) and the Food and Drug Administration (FDA) guidelines. All parameters examined were found to be well within the stated guidelines.