bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of upper aerodigestive tract cancers in a case-cohort study of autoworkers exposed to metalworking fluids
Authors: Zeka A , Eisen E A , Kriebel D , Gore R , Wegman D H
Published: April 2004

Aims:To re-examine aerodigestive cancer risk in a cohort of autoworkers exposed to metal working fluids (MWF), using improved case definition and more recently diagnosed cases.

Methods:The autoworker cohort included 31 100 hourly workers alive on 1 January 1985 who worked at three automobile plants in Michigan. A case-cohort design was carried out that included incident cases of cancers of the larynx, oesophagus, and stomach, and a 10% sample of the cohort. A Cox proportional hazards model was used to estimate MWF exposure effects. The smoothing method of penalised splines was used to explore the shape of the underlying exposure-response curves.

Results:The most important finding was the association between larynx cancer incidence and cumulative straight MWF exposure. The results for oesophageal cancer were less consistent. For stomach cancer there was no evidence of excess risk.

Conclusion:This association between larynx cancer and straight MWF exposures was consistent with a previous finding in this cohort, providing further support for a causal relation.
Antisense expression of a ω-3 fatty acid desaturase gene in tobacco plants enhances susceptibility against pathogens
Authors: Im Yang Ju , Kim Mi Seong , Yang Kwang Yeol , Kim Yong Hwan , Back Kyoungwhan , Cho Baik Ho
Published: April 2004

Membrane lipids in higher plants contain a high proportion of trienoic fatty acids. ω-3 Fatty acid desaturases act on membrane lipids to catalyze the formation of trienoic acids. We isolated a wound-inducible Arabidopsis plastid ω-3 fatty acid desaturase (fad7) gene, and generated transgenic tobacco plants constitutively expressing the antisense fad7 RNA. Selected transgenic lines showed significant reductions in the content of trienoic fatty acids compared with control plants. The transgenic lines showed enhanced susceptibility against Tobacco mosaic virus infection, where necrotic lesions with brown halos developed much earlier and were larger in the transgenic lines than in control plants. After Tobacco mosaic virus infection, expression and protein accumulations of the wound-inducible protein kinase WIPK, as well as defense-response gene expressions such as lipoxygenase (lox) and defensin (pdf1.2), were retarded in the transgenic lines compared with control plants. Increased susceptibility of the transgenic lines was also demonstrated by infections with Pseudomonas syringae pv. tabaci (van Hall) Ash et al., which caused wildfire disease, and with a powdery mildew fungus (Erysiphe cichoracearum DC). These findings support the concept that trienoic fatty acids are involved in plant defense signaling.Key words: ω-3 fatty acid desaturase, linolenic acid, Nicotiana tabacum 'Xanthi', Pseudomonas syringae pv. tabaci, powdery mildew fungus, Tobacco mosaic virus.
Biological control of Pythium damping-off of pea and sugar beet by Rhizobium leguminosarum bv. viceae
Authors: Bardin Sylvie D , Huang Hung-Chang , Pinto Joanna , Amundsen Eric J , Erickson R Scott
Published: April 2004

Rhizobium leguminosarum Jordan bv. viceae strains from pea and lentil root nodules were tested for control of damping-off of pea (Pisum sativum L., host) and sugar beet (Beta vulgaris L., nonhost) crops caused by Pythium sp. "group G". Of the 18 Rhizobium isolates tested, only strain R5 inhibited mycelial growth of Pythium sp. "group G". None of the strains showed any protease activity. Results of indoor experiments in soil artificially infested with Pythium sp. "group G" showed that 10 strains of R. leguminosarum bv. viceae were effective in increasing sugar beet emergence compared with the untreated control, when bacteria were coated onto seeds. Three of the most promising strains, R12, R20, and R21, were further tested for control of damping-off of field pea and sugar beet in a field naturally infested with Pythium spp. R12 and R20 significantly increased seedling emergence of field pea in the two field tests, compared with the untreated control. The efficacy of strains R12 and R20 was similar to that of Pseudomonas fluorescens Migula 708, a biological control agent of Pythium sp. "group G". Rhizobium leguminosarum bv. viceae strains R12 and R21 were the most effective biological control agents for control of sugar beet damping-off in the field experiments. They were as effective as seed treatment with the fungicide ThiramTM in one field experiment. The present study reveals that some R. leguminosarum bv. viceae strains, in addition to their use as biofertilizer, also have the potential to be used for biological control of Pythium damping-off of field pea and sugar beet.Key words: Rhizobium leguminosarum bv. viceae, Pythium sp. "group G", damping-off, biological control, sugar beet, pea.
Herbivory has a greater impact in shade than in sun: response of Quercus pyrenaica seedlings to multifactorial environmental variation
Authors: Baraza Elena , Gómez José M , Hódar José A , Zamora Regino
Published: April 2004

Many biotic and abiotic factors affect seedling establishment in woody plants. In Mediterranean environments, the major factors affecting tree regeneration are light, water, and herbivory. We investigated the response of some morphological and chemical traits of Quercus pyrenaica Willd. seedlings to simulated herbivory (hand removal of 50% of the aerial mass) and two levels of light (sun vs. shade) and water (one vs. two waterings). Water had no appreciable direct effect on morphological or chemical traits. Shaded seedlings grew less but had greater total leaf area. Simulated herbivory decreased the total leaf area, and root and aerial mass. Among the chemical characteristics, shaded seedlings had higher levels of nitrogen and lower levels of condensed tannins. In colorimetric assays of tannins, clipped seedlings had lower absorbances than did unclipped plants, and this effect was more pronounced in the sun than in the shade. Our experiment shows that light availability and herbivory affect the development and defence of Q. pyrenaica seedlings. Although Q. pyrenaica tolerated shade and simulated herbivory, both factors decreased biomass and chemical defence, which could affect the seedlings' future performance.Key words: environmental context, light, mammal herbivory, oak seedlings, Quercus pyrenaica, secondary compounds.
Seasonal variation in reproductive traits in Ipomopsis longiflora (Polemoniaceae), a desert annual
Authors: LeBuhn Gretchen
Published: April 2004

Seasonal variation in reproductive traits is commonly documented in flowering plants. This variation is critical because it is the material for evolution by natural selection. Understanding the mechanisms that maintain that variation is important, because it can tell us about the ecological and evolutionary forces acting on populations. Using Ipomopsis longiflora (Torr.) V. Grant subsp. australis, a Chihuahuan desert annual that has two discrete flowering seasons, I studied the relative influence of seasonality, variation in the individuals present in the population, and prior reproduction on reproductive traits. I found that traits that represent the allocation of resources within a plant (ovule number, flower number, and flower size) were influenced by seasonality and the individuals present in the population, whereas traits that represent the efficiency of reproduction (seeds/ovule, fruits/flower, and seeds/fruit) were influenced only by seasonality.Key words: iteroparity, semelparity, efficiency, phenology.
Genetic variation in Trillium erectum (Melanthiaceae), a widespread forest herb in eastern North America
Authors: Griffin Steven R , Barrett Spencer CH
Published: April 2004

Trillium erectum L. is an insect-pollinated understory herb widespread in forests of eastern North America. Marker gene studies indicate that the species has a mixed mating system, but aspects of population genetic structure have not been investigated. Using 10 allozyme loci, we measured genetic variation within and among 23 populations sampled from throughout the species' range. Overall, T. erectum displayed moderate levels of genetic diversity in comparison with other herbaceous plants. The percentage of loci that were polymorphic was 52%, with average values (±SE) of 1.20 ± 0.02, 0.08 ± 0.01, and 0.13 ± 0.01 for the number of alleles per locus (A), observed heterozygosity (Ho), and expected heterozygosity (He), respectively. There was evidence of inbreeding within populations (Fis = 0.39, 95% CI 0.260.55) and significant population differentiation (Fst = 0.16, 0.050.24). Analysis of genetic data provided no evidence of isolation by distance, and together with the occurrence of population subdivision, this suggests that there is relatively limited contemporary gene flow among populations. Northern populations of T. erectum tended to have less genetic variability than southern populations, probably as a result of historical factors associated with post glacial migration. Limited opportunities for gene dispersal as a result of low plant densities, the capacity for self-fertilization, and local seed dispersal by ants are likely to be the main factors maintaining contemporary patterns of genetic variation in T. erectum. Key words: allozymes, genetic diversity, gene flow, population genetic structure, Trillium.
DEEP INELASTIC LEPTON-NUCLEON SCATTERING AT HERA
Authors: NEWMAN P.
Published: April 2004

Data from the HERA collider experiments, H1 and ZEUS, have been fundamental to the rapid recent development of our understanding of the partonic composition of the proton and of QCD. This report focuses on inclusive measurements of neutral and charged current cross sections at HERA, using the full available data taken to date. The present precision on the proton parton densities and the further requirements for future measurements at the Tevatron and LHC are explored. Emphasis is also placed on the region of very low Bjorken-x and Q2. In this region, the 'confinement' transition takes place from partons to hadrons as the relevant degrees of freedom and novel or exotic QCD effects associated with large parton densities are most likely to be observed. Finally, prospects for the second phase of HERA running are discussed.
DIFFRACTION AND VECTOR MESON PRODUCTION
Authors: YAMAZAKI Y.
Published: April 2004

A review is given of the measurements of the diffractive process in recent years from two high-energy colliders, the HERA ep collider and the Tevatron [Formula: see text] collider. The energy dependence of the cross sections and the factorisation properties of diffractive processes are discussed.
ASTROPARTICLE THEORY: SOME NEW INSIGHTS INTO HIGH ENERGY COSMIC RAYS
Authors: ROULET E.
Published: April 2004

Some new developments obtained in the last few years concerning the propagation of high energy cosmic rays are discussed. In particular, it is shown how the inclusion of drift effects in the transport diffusion equations leads naturally to an explanation for the knee, for the second knee and for the observed behavior of the composition and anisotropies between the knee and the ankle. It is shown that the trend towards a heavier composition above the knee has significant impact on the predicted neutrino fluxes above 1014 eV. The effects of magnetic lensing on the cosmic rays with energies above the ankle are also discussed, analyzing the main features of the different regimes that appear between the diffusive behavior that takes place at lower energies and the regime of small deflections present at the highest ones.
ABSENCE OF APPARENT HORIZONS IN TRANSLATIONALLY-INVARIANT EINSTEIN–MAXWELL SPACETIMES
Authors: GONÇALVES SÉRGIO M. C. V.
Published: April 2004

We show that (3+1) Einstein–Maxwell spacetimes admitting a global, spacelike, one-parameter Lie group of isometries of translational type cannot contain apparent horizons. The only assumption made is that of the existence of a global spacelike Killing vector field with infinite open orbits; the four-dimensional spacetime metric is otherwise completely arbitrary. We discuss the implications of this result for the hoop and cosmic censorship conjectures.
Genetic characterization of theDrosophilahomologue ofcoronin
Authors: Bharathi V. , Pallavi S. K. , Bajpai R. , Emerald B. S. , Shashidhara L. S.
Published: April 2004

We report cloning and characterization of coro, which codes for the Drosophila homologue of the F-actin binding protein coronin. Viable alleles of coro produce a variety of phenotypes in leg, wing and eye development, which are similar to the phenotypes observed as a result of mutations in genes associated with the actin cytoskeleton and/or membrane trafficking. Homozygous lethal mutations in coro results in the disruption of the actin cytoskeleton in wing imaginal discs. Formation of both basolateral septate junctions and apical adherens junctions are also adversely affected in epithelial cells. Both viable and lethal alleles of coro show genetic interactions with syntaxin1A, a gene required for membrane trafficking. They also show enhanced response to over-expression of Decapentaplegic (Dpp) and its receptor Thick vein. Tracing of Dpp morphogen using a Dpp::GFP fusion construct suggested defects in the endocytic pathway, which resulted in uniform distribution of Dpp along the AP axis rather than a gradient from the AP boundary. Our results provide a genetic link between endocytosis/exocytosis events involving F actin-coated vesicles and the establishment of morphogen gradient.
Human keratin 8 mutations that disturb filament assembly observed in inflammatory bowel disease patients
Authors: Owens D. W. , Wilson N. J. , Hill A. J. M. , Rugg E. L. , Porter R. M. , Hutcheson A. M. , Quinlan R. A. , van Heel D. , Parkes M. , Jewell D. P. , Campbell S. S. , Ghosh S. , Satsangi J. , Lane E. B.
Published: April 2004

We have identified miss-sense mutations in keratin 8 in a subset of patients with inflammatory bowel disease (Crohn disease and ulcerative colitis). Inflammatory bowel diseases are a group of disorders that are polygenic in origin and involve intestinal epithelial breakdown. We investigated the possibility that these keratin mutations might contribute to the course of the disease by adversely affecting the keratin filament network that provides mechanical support to cells in epithelia. The mutations (Gly62 to Cys, Ile63 to Val and Lys464 to Asn) all lie outside the major mutation hotspots associated with severe disease in epidermal keratins, but using a combination of in vitro and cell culture assays we show that they all have detrimental effects on K8/K18 filament assembly in vitro and in cultured cells. The G62C mutation also gives rise to homodimer formation on oxidative stress to cultured intestinal epithelial cells, and homodimers are known to be polymerization incompetent. Impaired keratin assembly resulting from the K8 mutations found in some inflammatory bowel disease patients would be predicted to affect the maintenance and re-establishment of mechanical resilience in vivo, as required during keratin cytoskeleton remodeling in cell division and differentiation, which may lead to epithelial fragility in the gut. Simple epithelial keratins may thus be considered as candidates for genes contributing to a risk of inflammatory bowel disease.
Unconventional myosin VIIa and vezatin, two proteins crucial forListeriaentry into epithelial cells
Authors: Sousa Sandra , Cabanes Didier , El-Amraoui Aziz , Petit Christine , Lecuit Marc , Cossart Pascale
Published: April 2004

Listeria monocytogenes is a bacterial pathogen with the capacity to invade non-phagocytic cells. This dynamic process involves coordinated membrane remodelling and actin cytoskeleton rearrangements. Although some of the molecular factors promoting these events have been identified, the driving force allowing internalization is unknown. One of the receptors for L. monocytogenes on epithelial cells is E-cadherin, a transmembrane protein normally involved in homophilic interactions that allow cell-cell contacts at the adherens junctions. E-cadherin has to be connected to the actin cytoskeleton to mediate strong cell-cell adhesion and to trigger Listeria entry; α- and β-catenins play key roles in these processes. We have recently identified an unconventional myosin, myosin VIIa and its ligand vezatin, at the adherens junctions of polarized epithelial cells. Here, we demonstrate by pharmacological and genetic approaches that both myosin VIIa and vezatin are crucial for Listeria internalization. These results provide the first evidence for the role of an unconventional myosin in bacterial internalization and a novel example of the exploitation of mammalian proteins, by a pathogen, to establish a successful infection.
Micro-organization and visco-elasticity of the interphase nucleus revealed by particle nanotracking
Authors: Tseng Yiider , Lee Jerry S. H. , Kole Thomas P. , Jiang Ingjye , Wirtz Denis
Published: April 2004

The microstructure of the nucleus, one of the most studied but least understood cellular organelles, is the subject of much debate. Through the use of particle nanotracking, we detect and quantify the micro-organization as well as the viscoelastic properties of the intranuclear region in single, live, interphase somatic cells. We find that the intranuclear region is much stiffer than the cytoplasm; it is also more elastic than viscous, which reveals that the intranuclear region displays an unexpectedly strong solid-like behavior. The mean shear viscosity and elasticity of the intranuclear region of Swiss 3T3 fibroblasts are 520 Poise (P) and 180 dyn/cm2, respectively. These measurements determine a lower bound of the propulsive forces (3-15 picoNewton) required for nuclear organelles such as promyelocytic-leukemia bodies to undergo processive transport within the nucleus by overcoming friction forces set by the intranuclear viscosity. Dynamic analysis of the spontaneous movements of nanospheres embedded in the nucleus reveals the presence of putative transient nuclear microdomains of mean size 290±50 nm, which are mostly absent in the cytoplasm. The strong elastic character and micro-organization of the intranuclear region revealed by particle nanotracking analysis may help the nucleus to preserve its structural coherence. These studies also highlight the difference between the low interstitial nucleoplasmic viscosity, which controls the transport of nuclear proteins and molecules, and the much higher mesoscale viscosity, which affects the diffusion and directed transport of nuclear organelles and re-organization of interphase chromosomes.
Unlocking the code of 14-3-3
Authors: Dougherty Michele K. , Morrison Deborah K.
Published: April 2004

One of the most striking `rags to riches' stories in the protein world is that of 14-3-3, originally identified in 1967 as merely an abundant brain protein. The first clues that 14-3-3 would play an important role in cell biology came almost 25 years later when it was found to interact with various proto-oncogene proteins and signaling proteins. The subsequent identification of 14-3-3 as a phosphoserine/phosphothreonine-binding protein firmly established its importance in cell signaling. 14-3-3 family members are found in all eukaryotes – from plants to mammals – and more than 100 binding partners have been identified to date. The targets of 14-3-3 are found in all subcellular compartments and their functional diversity is overwhelming – they include transcription factors, biosynthetic enzymes, cytoskeletal proteins, signaling molecules, apoptosis factors and tumor suppressors. 14-3-3 binding can alter the localization, stability, phosphorylation state, activity and/or molecular interactions of a target protein. Recent studies now indicate that the serine/threonine protein phosphatases PP1 and PP2A are important regulators of 14-3-3 binding interactions, and demonstrate a role for 14-3-3 in controlling the translocation of certain proteins from the cytoplasmic and endoplasmic reticulum to the plasma membrane. New reports also link 14-3-3 to several neoplastic and neurological disorders, where it might contribute to the pathogenesis and progression of these diseases.
Temporal Separation and Self-Rating of Alertness as Indicators of Driver Fatigue in Commercial Motor Vehicle Operators
Authors: Belz Steven M. , Robinson Gary S. , Casali John G.
Published: April 2004

This on-road field investigation employed, for the first time, a completely automated trigger-based data collection system capable of evaluating driver performance in an extended-duration real-world commercial motor vehicle environment. The study examined the use of self-assessment of fatigue (Karolinska Sleepiness Scale) and temporal separation (minimum time to collision, minimum headway, and mean headway) as indicators of driver fatigue. Without exception, the correlation analyses for both the self-rating of alertness and temporal separation yielded models low in associative ability; neither metric was found to be a valid indicator of driver fatigue. In addition, based upon the data collected for this research, preliminary evidence suggests that driver fatigue onset within a real-world driving environment does not appear to follow the standard progression of events associated with the onset of fatigue within a simulated driving environment. Application of this research includes the development of an on-board driver performance/fatigue monitoring system that could potentially assist drivers in identifying the onset of fatigue.
Influence of Fatigue in Neuromuscular Control of Spinal Stability
Authors: Granata Kevin P. , Slota Greg P. , Wilson Sara E.
Published: April 2004

Lifting-induced fatigue may influence neuromuscular control of spinal stability. Stability is primarily controlled by muscle recruitment, active muscle stiffness, and reflex response. Fatigue has been observed to affect each of these neuromuscular parameters and may therefore affect spinal stability. A biomechanical model of spinal stability was implemented to evaluate the effects of fatigue on spinal stability. The model included a 6-degree-of-freedom representation of the spine controlled by 12 deformable muscles from which muscle recruitment was determined to simultaneously achieve equilibrium and stability. Fatigue-induced reduction in active muscle stiffness necessitated increased antagonistic cocontraction to maintain stability resulting in increased spinal compression with fatigue. Fatigue induced reduction in force-generating capacity limited the feasible set of muscle recruitment patterns, thereby restricting the estimated stability of the spine. Electromyographic and trunk kinematics from 21 healthy participants were recorded during sudden-load trials in fatigued and unfatigued states. Empirical data supported the model predictions, demonstrating increased antagonistic cocontraction during fatigued exertions. Results suggest that biomechanical factors including spinal load and stability should be considered when performing ergonomic assessments of fatiguing lifting tasks. Potential applications of this research include a biomechanical tool for the design of administrative ergonomic controls in manual materials handling industries.
Pilot Ability to Anticipate the Consequences of Flight Actions as a Function of Expertise
Authors: Doane Stephanie M. , Sohn Young Woo , Jodlowski Mark T.
Published: April 2004

The study offers insights into pilot ability to anticipate consequences of actions and how this ability changes with experience. Novice and expert pilots completed trials in which 3 screens depicted a control movement (or control movements), a cockpit flight situation, or a change in flight situation. Changes depicted in the 3rd screen of each trial were consistent, inconsistent with the mental model of the effect of the control movement or movements, or inconsistent with the application of the control movement(s) to the current flight situation. Pilots indicated whether the depicted change was inconsistent or consistent with their expectations, and accuracy of consistency judgments was greater for mental-model than for situation-model inconsistent statements. Experts are more accurate than novices, particularly for trials that involve multiple, meaningfully related control movements. Expert ability to organize information into meaningful units appears to facilitate future flight state projections, and projection failures appear to result from situation- rather than mental-model failures. Actual or potential applications of this research include analysis of flight situation awareness and flight performance errors.
Oral contraceptive exposure of amenorrheic women with and without prolactinomas
Authors: Jones James R. , Kemmann Ekkehard , Norwood Paula K.
Published: April 2004

The purpose of this study was to determine the extent of oral contraceptive (OC) exposure of women with secondary amenorrhea of hypothalamic‐pituitary etiology. In 93 of 126 women with secondary amenorrhea sufficient data were obtained regarding menstrual history and OC exposure: 26 patients had evidence of a prolactinoma, an additional 26 patients had idiopathic hyperprolactinemia without evidence of a pituitary tumor, and 41 had “pure” dysfunction hypothalamicpituitary amenorrhea. After stratification by age at diagnosis and parity the estimated odds ratio for past oral contraceptive usage showed no differences among the three groups (odds ratios between 0.74 and 1.48). Using the chisquare test the proportion of subjects who had regular menses before oral contraceptive intake and developed anovulation immediately after discontinuance (“post pill amenorrhea”) in the three groups also showed no difference (χ2 = 0.60, P = 0.74). These data indicate that non‐ovulatory patients are likely to have been exposed to OC, and do not indicate that patients with prolactinomas differ in the extent of their OC exposure from other specified groups of patients with secondary amenorrhea.
Pituitary and placental hormone levels in pseudocyesis
Authors: Osotimehin B.O. , Ladipo O.A , Adejuwon C.A. , Otolorin E.O.
Published: April 2004

Twelve patients with clinical features of pseudocyesis were divided into two groups according to the presence or absence of galactorrhea. The mean serum prolactin level of patients with galactorrhea was significantly higher than the normal values of the patients without galactorrhea. The mean serum levels of luteinizing hormone and follicle‐stimulating hormone were markedly elevated in patients without galactorrhea. This was especially true of luteinizing hormone. Serum levels of human chorionic gonadotropin were undetectable in all patients. The significance of these observations is discussed.
Cesarean section in four Rio de Janeiro hospitals
Authors: Lins Fernando Estellita , Fortney Judith A.
Published: April 2004

Data collected on maternity patients at four hospitals in Rio de Janeiro, Brazil, show that their rates of cesarean section vary considerably, ranging from less than 15% of all deliveries at the hospital serving women from the lowest socioeconomic group to over 80% at the one restricted to private patients. Virtually none of the conditions usually considered as indication for cesarean delivery were universally managed in this manner. On the other hand, in many instances, there was no recorded indication for abdominal delivery. While mortality and morbidity rates were low, exposure of mothers and infants to the additional risks associated with surgery for no apparently valid reason is unwarranted.
Simultaneous in situ squamous cell carcinoma and microinvasive adenocarcinoma of the cervix
Authors: Wolk Barry M. , Kime Warson , Albites Victor
Published: April 2004

A case of simultaneously occurring carcinoma in situ of the cervix, and adenocarcinoma of the endometrium is presented. The diagnosis was made by examination of the pathological specimen, but was suspected pre‐operatively because of Pap smear findings. A review of the recent literature is discussed.
The first abortion ‐ and the last? A study of the personality factors underlying repeated failure of contraception
Authors: Niemelä Pirkko , Lehtinen Päivi , Rauramo Lauri , Hermansson Ralf , Karjalainen Rauni , Mäki Hannele , StorÅ Clas‐Åke
Published: April 2004

The causes leading to a second abortion were outlined in a psychological study comparing 30 women expecting a second abortion with 29 women who had successfully prevented conception after a first abortion. It was found that both groups improved their contraceptive practices after the first abortion. However, while the latter group continued with their improved practices, the former group went back to the earlier inefficient or non‐existent contraceptive behavior. The inability to improve contraception in the long run was not related to differences in educational level or knowledge about contraceptive techniques but to the developmental level of personality structures. The women expecting their second abortion rated lower in control of impulsivity, emotional balance, realism, self‐esteem and stability of life as well as capacity for more integrated personal relationships. The differences in personality development and consequently in the capacity for long‐term contraception were found to be due to growth conditions in childhood.
Postpartum sterilization by operating‐room nurses in Thailand
Authors: Koetsawang Suporn , Varakamin Somsak , Satayapan Suvanee , Srisupandit Suwanee , Apimas Supanee J.
Published: April 2004

A training project to assess the performance of experienced operating room nurses as operators in postpartum sterilization was conducted in 1977–1978. The results for over 1000 nurse‐operated clients and a comparison group of approximately 300 physician‐sterilized clients show that nurses achieved comparable success with physicians in postpartum sterilization, as judged by clinical and attitudinal follow‐up. No serious complications were recorded in either group. Minor infections in both groups were treated routinely. A stitch obcess for one nurse‐operated client resulted in hospitalization; the client was released after 3 days. The clients in both groups returned to routine chores at home rapidly, and client satisfaction with the procedure was virtually unanimous in each group. This study lends support to the use of nurses in performing contraceptive surgery. The need for increased service coverage in this area is of high priority, and nurses provide a readily available and easily trained cadre of support staff.
Ultrastructural alterations in human endometrium caused by intrauterine contraceptive devices
Authors: Verma Vinod
Published: April 2004

Biopsies of endometrium from women using intrauterine contraceptive devices (IUDs) were examined by electron microscopy to elucidate the possible cause of IUD‐associated uterine hemorrhage. The findings reveal the presence of degenerated, shrunken cells in the endometrial glands of IUD users. These cells, termed pyknotic or apoptotic, are more prevalent in tissue from women with complaints of excessive bleeding than in cases without such complaints. The pyknotic cells often show discontinuities of the plasma membrane at their luminal pole, from which cell contents stream into the lumen. Sometimes erythrocytes are also observed in the lumen. A second alteration in the ultrastructure of the endometrium is an abnormal increase in microfilaments in the epithelial cells.

These two changes, a large number of pyknotic cells on the one hand and increase in microfilaments on the other, are correlated with excessive bleeding but they do not explain in simple terms the outflow of erythrocytes. Probably some inflammatory mechanism is involved. The increased number of microfilaments might be helping the movement of fluid from healthy to pyknotic cells.
Endocrinologic and psychologic aspects of galactorrhea associated with normal menstrual cycles
Authors: Naguib Y.A. , Darwish N.A. , Shaarawy M. , Nagui A.R. , Thabet S.M. , Abdel Azim S.
Published: April 2004

Twelve cases of galactorrhea in women with normal menstrual cycles who were radiologically free of any pituitary adenomas were investigated. Determinations were made for serum thyroid‐stimulating hormone (TSH), T3 resin uptake (T3RU), total thyroxine by radioimmunoassay (T4), free thyroxine index (FT4I), norepinephrine, epinephrine, prolactin and urinary luteinizing hormone, total estrogens, pregnanediol and total catecholamines. Psychologic evaluation and assessment were also done using the Middlesex Hospital Questionnaire and the Eysenk, manual dexterity. Bender Gestalt and trial‐making scales. Hypothyroidism associated with moderate hyperprolactinemia and anovulation were the main features in eight cases. Associated psychologic disturbances were reported. The other four cases showed significant elevations in serum epinephrine, norepinephrine and urinary total catecholamines with concomitant pathologic scales of anxiety and neuroticism. Thyroxine replacement and psychotherapy are recommended in the treatment of such cases.
Triplet pregnancy in Nigeria: Socio‐biologic aspects
Authors: Sogbanmu M.O.
Published: April 2004

A retrospective analysis of 20 triplet pregnancies not stimulated by clomiphene or gonadotrophins revealed a perinatal mortality of 26.3%. There were greater losses recorded in the case of mothers who had received no antenatal care than for those who had been seen before the babies' births. Triplet pregnancy in this series was associated with anemia, hypertension, postpartum hemorrhage and hydramnios. In Nigeria, where there is a high incidence of such pregnancy, it should be suspected more often than elsewhere. The authors recommend amnioscopy, amniocentesis and early resort to cesarean section as part of the antenatal regimen, with careful management of the third stage of labor to prevent postpartum hemorrhage.
Laparoscopic sterilizations (16,803) without vaginal manipulation
Authors: Mehta P.V.
Published: April 2004

Laparoscopic sterilization is usually done after viewing the fallopian tubes brought into the laparoscopic field by a uterine manipulator introduced through the vagina. The orthodox rural Indian women, however, resent vaginal manipulation exposing their genitalia. Therefore, the author developed a single‐puncture technique for performing laparoscopic sterilization with a Falope‐Ring®, which dispenses with a uterine manipulator. Experience with 16,803 cases is presented. This technique is recommended for mass sterilizations because it eliminates the risks involved in vaginal manipulation and enhances acceptability and popularity of the procedure. Nonetheless, the risks of bowel injury are augmented, and the method is not for the inexperienced or occasional operator.
Sinusoidal fetal heart rate pattern in severe fetal anemia from feto‐maternal transfusion
Authors: Treisser A. , Vige P. , Maria B. , Lebrun F. , Sureau C.
Published: April 2004

A case is reported where a sinusoidal fetal heart rate pattern was found in a fetus at 34 weeks. This pattern, at first isolated and later persistent for several hours, during a normal pregnancy became progressively transformed into a silent pattern. Cesarean delivery then performed resulted in the birth of an infant affected by a severe anemia due to a major feto‐maternal transfusion and it died aged 36 h. The authors enquire into the significance of this pattern when found in apparently normal pregnancies, not involving rhesus iso‐immunization, and they suggest a possible management when confronted with a sinusoidal fetal heart pattern.
Laparoscopy on patients with previous lower abdominal surgery: A new technique
Authors: Serour G.I. , Kandil O. , Askalani H. , Younis N. , Hefnawi F.
Published: April 2004

During the period June 1979–May 1981, 1582 diagnostic and operative laparoscopic procedures were performed at Al‐Azhar University Endoscopy Unit and during field visits to several hospitals in Egypt, Sudan and Mauritania. Ninety‐nine of these had had previous lower abdominal surgery. Laparoscopy was performed on 93 of these patients using a modified technique of laparoscopy. The modified technique involves direct visualization of the previous peritoneal scar with the scope before its careful puncturing with the trocar and cannula. The paper describes the technique, findings, complications, limitations of the procedure and its application.
Simultaneous pregnancy in each cavity of a double uterus. A case report
Authors: Hochner‐Celnikier D. , Yagel S. , Beller U. , Milwidsky A.
Published: April 2004

A case of twin pregnancy in an anovulatory woman with uterus didelphys who conceived after ovulation induction is described. The management and possible complications of such cases are discussed.
Preliminary report on a postpartum CuT 200 study, Santiago, Chile
Authors: Lavin Pablo , Waszak Cynthia , Bravo Carmen
Published: April 2004

An analysis is presented of a study of the Copper‐T 200 (CuT 200) intrauterine device at the Barros Luco Hospital in Santiago, Chile. The devices were inserted in 1142 postpartum patients. The expulsion rate was high, 32.1% at 3 months. Of the 372 women who expelled devices, 349 received a replacement CuT 200. The expulsion rate for these reinsertions was 7.7% at 12 months with a continuation rate of 86.4%
Fetal tachycardia and meconium staining: A sign of fetal infection
Authors: Blot P. , Milliez J. , Breart G. , Vige P. , Nessmann C. , Onufryk J.P. , Dendrinos S. , Sureau C.
Published: April 2004

A retrospective study was carried out on 72 liveborn babies in whom perinatal infection was suspected. Twenty‐nine of the 72 neonates were effectively infected. Analysis of intrapartum FHR recordings showed that tachycardia (base line FHR above 160 beats/min) during labor, occurred more often among infected babies (P < 0.001). When fetal tachycardia is associated with meconium stained amniotic fluid (MSAF), the relative risk of fetal infection is 51 times as great as in babies without MSAF. Fetal tachycardia is not related to maternal fever nor to prematurity. It is not a sign of limited placental or amniotic fluid infection, but implies infection of the fetus itself. Since most infected babies displayed infectious diarrhea immediately at birth, it is suggested that MSAF may eventually be due to antenatal intestinal infection and intrauterine emission of infected stools. Although great caution is advocated for the management of labor in the presence of fetal tachycardia, MSAF should not be always regarded as a sign of acute fetal distress when antenatal infection of the fetus is suspected.
Velamentous insertion of the umbilical cord and vasa previa
Authors: Paavonen J. , Jouttunpää K. , Kangasluoma P. , Aro P. , Heinonen P.K.
Published: April 2004

We report 31 cases with velamentous insertion of the umbilical cord of whom two had coexistent vasa previa. The prevalence of the former was 0.22% and of the latter 0.014%. Perinatal mortality was low, 3.2%, but there was a high rate of complications during pregnancy, such as threatened abortion, antepartum and intrapartum bleeding, premature delivery and fetal distress. Fifteen patients underwent caesarean section. Four of the term infants were small for gestational age. One infant had congenital malformations. The two cases with vasa previa are described in detail. We conclude that velamentous insertion of the umbilical cord should be kept in mind in the differential diagnosis of fetal distress accompanied with antepartum or intrapartum vaginal bleeding.
Clinical and pathologic evaluation of 342 benign ovarian tumors
Authors: Portuondo JoséA. , Gimenez Borja , Rivera JoséM. , Garriga J. , Alegre Alfonso
Published: April 2004

A series of 289 patients who were diagnosed with 342 benign ovarian tumors (BOT) at laparotomy have been reviewed. Mean age was 36.7 years (S.D. ± 13.9), mean parity was 1.5 (S.D. ± 1.6); 236 (81.7%) patients had a single unilateral ovarian tumor; 29 (10%) patients had bilateral ovarian tumors. Benign cyst teratoma was diagnosed in 89 (26%) tumors, and it was the most frequent histological type. In eight patients (2.8%) the post‐operative pathologic report was compatible with malignancy, despite the lack of suspicion at laparotomy. Mean maximal diameter of BOT was 9.1 cm, and almost 60% of the mucinous cystoadenomas were larger than 16 cm. Benign cyst teratoma and serous cytoadenoma had a medium size, about 6–10 cm. Lower abdominal‐pelvic pain was the symptom most frequently reported by patients with BOT. Calcifications were most frequently seen in benign cyst teratoma. Tumors of 11–15 cm in size were the tumors most frequently torsioned. Twenty four (8.3%) patients had their surgical operation done during pregnancy; benign cyst teratoma was the tumor most frequently associated with pregnancy.
Clinical evaluation of intramuscular injection of microencapsulated compound megestrol acetate
Authors: Ziyan Han , Ruiqiu Xiao
Published: April 2004

A comparative clinical study was undertaken by the Sichuan Cooperative Research Group for Microencapsulated Contraceptives to assess the efficacy of intramuscular microencapsulated egestrol compound as a long‐acting contraceptive and to find the optimal dosage as regards efficacy, side effects and menstrual irregularities. Eight hundred twenty eight women were divided into four groups and injected monthly with four different dosage combinations that consisted of megestrol acetate and estradiol valerate. In all, 5298 dosage cycles were observed. The investigation indicated that microencapsulation effectively prolonged contraceptive effect of the short‐acting agents, reduced the required dosage and lowered the incidence of side effects. A combination of 15 mg megestrol acetate and 5 mg estradiol valerate, as compared to the other three regimens, was found to be clinically most acceptable because of the lower incidence of menstrual irregularities.
Teh Allen Masters syndrome revisited. Successful treatment by laparoscopy
Authors: Glezerman M.
Published: April 2004

The main underlying pathology of the Allen Masters syndrome is based on lacerations of the broad ligament. This sometimes incapacitating disease is expressed by persistent pelvic pain, dyspareunia and menstrual disturbances. Treatment modes employed hitherto consisted of either suturing the peritoneal defect or of hysterectomy. We have treated four patients by simple fulguration of the peritoneal laceration, performed during laparoscopy. Results were excellent. It is suggested that this treatment mode may replace more extensive surgery.
The challenges of vaginal atresia and stenosis: Nigerian experience
Authors: Unuigbe J.A. , Ojobo S. , Oronsaye A.U.
Published: April 2004

From July 1973 to December 1980, 6942 patients were admitted to the Gynaecology unit of the University of Benin Teaching Hospital, Benin City, Nigeria. Fifty‐nine patients presented with gynatresia (vaginal atresia and stenosis), an incidence of 8.5 1000. The most common causes of this condition were caustic vaginitis, secondary to local herb pessary insertion, and circumcision. The resulting vaginal adhesions were effectively treated surgically by simple adhesiolysis. There was a low incidence of congenital gynatresia. As the large proportion of cases of acquired gynatresia were preventable, improvement in health education should further reduce incidence of this condition in our community.
Fetal heart rate in maternal hypoglycemic coma
Authors: Confino Edmond , Ismajovich Bernardo , David Menachem P. , Gleicher Norbert
Published: April 2004

In pregnancies complicated by diabetes mellitus fetal heart rate (FHR) monitoring is widely utilized to detect early fetal compromise. Never, however, was the fetal heart rate monitored during a maternal hypoglycemic coma. Such a case is here presented.
Maternal mortality — a world wide problem
Authors: Högberg Ulf
Published: April 2004

Death during pregnancy and delivery is one of the leading causes of death among women in the developing countries. A review of literature, and a comparison of the decline of the maternal mortality in Sweden, concludes that maternal mortality is a sensitive socioeconomic index of health in the society, but also that this death cause is one of the few that it is really possible to prevent by the impact of medical services — antenatal and delivery care.
The role of obstetric factors in perinatal mortality trends
Authors: Iffy Leslie , Bilenki Irene , Apuzzio Joseph J. , Ganesh Vijaya , Sun Shyan C. , Thomas Hermoine , Erian Makram , Kaminetzky Harold A.
Published: April 2004

In the Perinatal Unit of the New Jersey Medical School, Newark the combined neonatal mortality and stillbirth rates declined from more than 51 per 1000 to less than 17 per 1000 between 1971 and 1983. This change is comparable to the reduction of perinatal mortality rates nationwide since the Second World War. Because the improvement in the fetal and neonatal survival rates occurred in a static population and against well identifiable changes in the structure, equipment, policies and management patterns of the obstetric unit, it was possible to assess the impact of various factors upon perinatal outcome.

In the environment of this institution adherence to conservative concepts of obstetric management, avoidance of manipulative and extraction procedures, an increase of the rate of cesarean sections from about 7 to 15% and emphasis upon infection control appeared to be the crucially important factors. Antepartum sonography and fetal stress and non‐stress testing significantly impacted upon the results. The role of intrapartum electronic monitoring was less clearly definable and seemed to be effective only in the hands of experienced physicians. The results did not seem to be adversely affected by the fact that the program de‐emphasized invasive procedures, including fetal scalp pH sampling.
In‐hospital maternal mortality risk by cesarean and vaginal deliveries in two less developed countries—a descriptive study
Authors: Chi I‐Cheng , Whatley Anne , Wilkens Lynne , Potts Malcolm
Published: April 2004

Cesarean deliveries are increasing in both developed countries and less developed countries (LDCs). Recent studies in the U.S. have revealed a significantly higher mortality risk for women who delivered abdominally than for those who delivered vaginally, even when the effect of the conditions which necessitated cesarean delivery was taken into account. We chose for study from an international maternity monitoring network, five centers from two LDCs that reported an in‐hospital maternal mortality rate (MMR) of around 10 per 1000 parturient women. The pooled data revealed an MMR of 5.1 per 1000 women with vaginal deliveries. For women with cesarean delivery, the total MMR was 36.2 and the MMR attributable to cesarean section was estimated to be 12.8; both rates were per 1000 procedures. The leading cause of death was eclampsia for the vaginal deliveries and sepsis for the cesarean deliveries. The risk of maternal mortality inherent with the cesarean section procedure per se (not counting the risk associated with the labor and delivery complications that necessitated cesarean section) as well as the practical avoidability of maternal deaths for either mode of delivery in these LDC hospitals are discussed.
Indications and results of metroplasty in uterine malformations
Authors: Kessler I. , Lancet M. , Appelman Z. , Borenstein R.
Published: April 2004

During 14 years, 430 women with some type of congenital uterine malformation were discovered by different methods, with a rate of 1 in 137 deliveries. In only 17 was metroplasty indicated, because of very poor reproductive performance; out of 42 desired pregnancies, only 14.3% live births resulted. The abortion rate was 65.2%, and there were 13% premature deliveries. The operations performed included the Strassmann type in 13, the Tompkins technique in three and the Jones operation in one. After the metroplasty, out of 27 completed pregnancies the rate of abortions fell in 14.8% (P<0.00003) and the rate of live births rose to 85.2% (P< 0.00003). There is no doubt that when the indication for metroplasty is strictly imposed, the staff is well versed in the different types of operations and the treatment is done in a center which has acquired competence, the improvement in reproductive performance can be quite impressive.