bluuebunny/crossref_metadata_2025 huggingface dataset:
GUANIDINE HYDROCHLORIDE AND THE CIRCULAR DICHROISM OF RANDOM COIL POLYPEPTIDES
Authors: Cortijo M. , Panijpan B. , Gratzer W. B.
Published: May 2010

The circular dichroism of a series of disulphide‐free proteins in 6 M guanidine hydrochloride was measured. Despite qualitative similarity, the quantitative spread of molar residue ellipticities was considerable, and not explicable in terms of side chain chromophore contributions. It seems likely that composition‐dependence of the distribution of backbone dihedral angles is responsible for the variation. Chains with intact disulphide bonds have larger negative ellipticities. In the case of insulin, evidence is given to suggest that this arises from intra‐chain interactions, rather than the intrinsic optical activity of the disulphide chromophores. Whereas uncharged poly‐L‐lysine and poly‐L‐glutamic acid are not converted to the fully random state in 6 M guanidine hydrochloride, the much more weakly helical polyornithine and polyaspartic acid appear to be completely randomised in this solvent. This provides two uncharged random coil polymers, the CD of which is in the range of those of disordered proteins. The positive feature found in the circular dichroism of charged random poly‐L‐lysine, poly‐L‐ornithine and poly‐L‐glutamic acid (though not poly‐L‐aspartic acid) is absent in the randomly coiled uncharged polymers. In the fully charged polypeptides, 6 M guanidine hydrochloride provokes a change in circular dichroism, similar to that induced by salts at high concentration, and indicative of the appearance of some α‐helical structure. This effect is enhanced by increasing temperature, suggesting a solvent exchange effect.
Accumulation of WCS120 protein in wheat cultivars grown at 9°C or 17°C in relation to their winter survival
Authors: Vítámvás P. , Kosová K. , Prášilová P. , Prášil I. T.
Published: May 2010

With 4 figures and 1 table

We studied how temperature treatments, at 9°C or 17°C during plant growth under controlled conditions, affected the accumulation of the cold‐regulated dehydrin WCS120 in 21 wheat cultivars which had different winter survival rates. Cultivar survival was established using the provocation pot method over three winters. The levels of WCS120 were determined by immunoblot analyses. There was a good correlation between winter survival and the accumulation of WCS120 in the different cultivars of wheat grown under either 9°C or 17°C. Those plants grown at 9°C accumulated higher amounts of WCS120 than did those grown at 17°C. However, all cultivars tested, including the spring variety, accumulated the WCS120 protein at 17°C. These results indicate that the wheat cultivars with higher levels of frost tolerance can be differentiated from the less‐tolerant ones by the evaluation of WCS120 protein content in the plants, when grown at temperatures higher than those that are normally used in cold‐acclimation treatments.
Effects of the angiotensin II receptor blocker losartan on the monocyte expression of biglycan in hypertensive patients
Authors: Sardo Maria A , Mandraffino Giuseppe , Riggio Stefania , D’Ascola Angela , Alibrandi Angela , Saitta Carlo , Imbalzano Egidio , Castaldo Maria , Cinquegrani Maurizio , Saitta Antonino
Published: May 2010

1. Recently, we demonstrated that biglycan (BGN) is increased in circulating monocyte cells from hypertensive patients and that angiotensin (Ang) II is able to increase BGN expression. The present study was designed to investigate the effects of treatment with the angiotensin AT1 receptor antagonist losartan on monocyte BGN mRNA and protein expression in essential hypertension.

2. One hundred and twenty‐six newly diagnosed hypertensive patients without additional risk factors for atherosclerosis and cardiovascular disease were treated with 100 mg losartan once daily for 6 months. Biglycan mRNA and protein expression was determined in monocytes isolated from peripheral blood before (T0) and after (T1) therapy. Plasma levels of interleukin (IL)‐6, tumour necrosis factor (TNF)‐α and high sensitivity C‐reactive protein (hs‐CRP) were also determined. In addition, BGN mRNA and protein expression was determined after the ex vivo addition of 1 μmol/L AngII to monocytes isolated from 20 randomly selected hypertensive patients.

3. Biglycan mRNA and protein expression, blood pressure and plasma levels of fibrinogen, IL‐6, TNF‐α and CRP were significantly lower at T1 than at T0. Variations in BGN expression were associated with inflammatory markers, but not directly with blood pressure. In AngII‐stimulated monocytes, BGN mRNA and protein expression was significantly lower at T1 that at T0. Moreover, mean BGN mRNA expression in AngII‐stimulated monocytes isolated from losartan‐treated patients was similar to baseline expression in unstimulated monocytes from untreated patients.

4. The results of the present study show that losartan can reduce BGN expression in monocytes from hypertensive patients, without any linear association with blood pressure, suggesting that the effects of AngII on BGN expression in monocytes may be modulated, in part, by an AT1 receptor blocker.
Evidence for functional ghrelin receptors on parasympathetic preganglionic neurons of micturition control pathways in the rat
Authors: Ferens Dorota M , Yin Lei , Ohashi‐Doi Katsuyo , Habgood Mark , Bron Romke , Brock James A , Gale Jeremy D , Furness John B
Published: May 2010

1. Previous work indicates that agonists of ghrelin receptors can act within the spinal cord to stimulate autonomic outputs to the colorectum and to blood vessels. Because of the close relationship between colorectal and urinary bladder control, we have investigated whether ghrelin receptor agonists also stimulate spinal centres that influence the bladder.

2. The ghrelin receptor agonist capromorelin (10 mg/kg), injected intravenously in anaesthetized male rats, disrupted the ongoing cycle of micturition reflexes and caused phasic oscillations in pressure that averaged approximately 20 mmHg. Fluid output from the bladder was diminished. The effects of capromorelin were inhibited by hexamethonium (10 mg/kg bolus followed by 4 mg/kg per h infusion, i.v.) and were further reduced by atropine (5 mg/kg bolus followed by 2.5 mg/kg per h infusion, i.v.). Capromorelin (250 μg) injected directly into the spinal cord at the lumbosacral level also increased contractile activity of the bladder. However, capromorelin, up to 0.1 mmol/L, had no effect on the tension of isolated muscle strips from the bladder. Effects of intravenous capromorelin (10 mg/kg) on bladder pressure were still observed after the descending pathways in the spinal cord were disrupted at the thoracic level.

3. In situ hybridization studies revealed ghrelin receptor gene expression in neurons of the autonomic intermediolateral (IML) cell columns. Following a series of micturition reflexes elicited by infusion of saline into the bladder, the immediate early gene product c‐Fos was observed in neurons of the lumbosacral IML and approximately 20% of these also expressed ghrelin receptor gene transcripts.

4. It is concluded that ghrelin receptors are expressed by lumbosacral autonomic preganglionic neurons of the micturition reflex pathways and that ghrelin receptor agonists stimulate these neurons.
Enhancing patient safety: The importance of direct supervision for avoiding medication errors and near misses by undergraduate nursing students
Authors: Reid‐Searl Kerry , Moxham Lorna , Happell Brenda
Published: May 2010

Reid‐Searl K, Moxham L, Happell B. International Journal of Nursing Practice 2010; 16: 225–232 Enhancing patient safety: The importance of direct supervision for avoiding medication errors and near misses by undergraduate nursing students

Medication errors have been the focus of considerable research attention in nursing; however, the extent to which nursing students might contribute to errors has not been researched. Using a grounded theory approach, in‐depth semi‐structured interviews were conducted with undergraduate nursing students based in a university in Queensland to explore their experiences of administering medication in the clinical setting. Almost a third of the participants reported making an actual medication error or a near miss. Where medication errors occurred, participants described not receiving direct and appropriate supervision by a registered nurse. Medication errors by nursing students have the potential to impact significantly on patient safety, quality of health care, and on nursing students' perceptions of their professional competence. Ensuring direct supervision is provided at all times must become an urgent priority for undergraduate nursing education.
Education outcomes related to including genomics activities in nursing practice in Singapore
Authors: Pestka Elizabeth , Lim Swee Hia , Png Hong Hock
Published: May 2010

Pestka E, Lim SH, Png HH. International Journal of Nursing Practice 2010; 16: 282–288 Education outcomes related to including genomics activities in nursing practice in Singapore

The purpose of this study was to describe the impact of a genomic educational intervention by measuring the extent participants could apply the class content to practice. A sample of 76 nurses employed by Singapore Health Services, Singapore, participated in a nursing genomics seminar in 2008 and completed a survey form with a response rate of 89%. Every respondent was able to identify use of a genomic assessment or intervention item with a patient from their clinical practice. The mean use of genomic assessment and intervention items was 5.8 out of a possible 10. The most frequently used items were assessment of family history information, environmental factors and genomic physical findings. Findings provide evidence that nurses are able to include genomic assessments and interventions in their practice following targeted education. This study highlights how informed nurses are able to apply genomic assessments and interventions to individualize patient care.
Pressure‐temperature history of titanite‐bearing eclogite from the Western Iratsu body, Sanbagawa Metamorphic Belt, Japan
Authors: Endo Shunsuke
Published: May 2010

Evidence for eclogite‐facies metamorphism is widespread in the Western Iratsu body of the oceanic subduction type Sanbagawa Belt, Southwest Japan. Previous studies in this region focused on typical mafic eclogites and have revealed the presence of an early epidote‐amphibolite facies metamorphism overprinted by a phase of eclogite facies metamorphism. Ca‐rich and titanite‐bearing eclogite, which probably originated from a mixture of basaltic and calc‐siliceous sediments, is also relatively common in the Western Iratsu body, but there has been no detailed petrological study of this lithology. Detailed petrographic observations reveal the presence of a relic early epidote‐amphibolite facies metamorphism preserved in the cores of garnet and titanite in good agreement with studies of mafic eclogite in the area. Thermobarometric calculations for the eclogitic assemblage garnet + omphacite + epidote + quartz + titanite ± rutile ± phengite give peak‐P of 18.5–20.5 kbar at 525–565°C and subsequent peak‐T conditions of about 635°C at 14–16 kbar. This eclogite metamorphism initiated at about 445°C/11–15 kbar, implying a significantly lower thermal gradient than the earlier epidote‐amphibolite facies metamorphism (∼650°C/12 kbar). These results define a P–T path with early counter‐clockwise and later clockwise trajectories. The overall P–T path may be related to two distinct phases in the tectono‐thermal evolution in the Sanbagawa subduction zone. The early counter‐clockwise path may record the inception of subduction. The later clockwise path is compatible with previously reported P–T paths from the other eclogitic bodies in the Sanbagawa Belt and supports the tectonic model that these eclogitic bodies were exhumed as a large‐scale coherent unit shortly before ridge subduction.
Prevalence of overlaps between GERD, FD and IBS and impact on health‐related quality of life
Authors: Kaji Makiko , Fujiwara Yasuhiro , Shiba Masatsugu , Kohata Yukie , Yamagami Hirokazu , Tanigawa Tetsuya , Watanabe Kenji , Watanabe Toshio , Tominaga Kazunari , Arakawa Tetsuo
Published: May 2010

Objective:  Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and irritable bowel syndrome (IBS) are common, and have negative impacts on health‐related quality of life (HR‐QOL). Several studies demonstrated a significant overlap between two of these three diseases. The purpose of this study was to examine the prevalence of GERD, FD, and IBS, their overlap rates, and HR‐QOL for each disease and each overlap compared with healthy controls in the Japanese general population.

Methods:  We performed a cross‐sectional study of Japanese workers who visited a clinic for a routine health check‐up, and asked them to fill out a self‐report questionnaire. Prevalence and overlap rate of GERD defined as heartburn and/or acid regurgitation at least weekly, FD and IBS based on Rome III criteria, and HR‐QOL by SF‐8 were examined.

Results:  Of the 2680 eligible subjects, 207 (7.7%) were diagnosed as having GERD, 269 (10.0%) as FD, and 381 (14.2%) as IBS. Overlaps were found in 46.9% in GERD, 47.6% in FD, and 34.4% in IBS. Prevalence of overlaps in subjects with IBS was significantly lower compared with those among GERD or FD. Sufferers from GERD, FD, or IBS reported significantly poorer HR‐QOL across all domains compared with controls. Overlaps significantly worsened HR‐QOL in most domains except in the ‘role emotional’ domain. HR‐QOL was particularly poor in the physical component summary for overlapping GERD and in the mental component summary for overlapping IBS.

Conclusion:  Overlaps among GERD, FD and IBS were common and worsened HR‐QOL in Japanese general population.
Bioactive sphingolipids in the biliary tract: Relevance for cholesterol gallstone disease
Authors: Kuver Rahul
Published: May 2010

See article in J. Gastroenterol. Hepatol. 2010; 25: 1105–1110
Efficacy of Intracervicovaginal Misoprostol in Second‐Trimester Pregnancy Termination: A Comparison between Live and Dead Fetuses
Authors: Srisomboon Jatupol , Pongpisuttinun Sureeratana
Published: May 2010

Objective: To study the complications and compare the success rate and abortion time between the live and the dead fetuses in second‐trimester pregnancy termination with intracervicovaginal misoprostol.

Design: A prospective comparative study.

Subjects and methods: A total of 89 pregnant women between 14 and 28 weeks of gestation with obstetric, medical, or genetic reasons for termination of pregnancy were recruited to receive 200 μg misoprostol inserted intracervicovagi‐nally every 12 hours.

Results: The rates of successful abortions within 12, 24 and 48 hours in live fetuses were 15.1%, 54.7% and 92.5%, respectively, while in dead fetuses were 50.0%, 83.3% and 97.2%, respectively. The success rates within 12 and 24 hours in live‐fetus group were significantly lower than those of the dead‐fetus group (p = 0.0009 and p = 0.01, respectively). The mean abortion time of the live‐fetus group (27.1 hours) was significantly more than that of the dead‐fetus group (15 hours, p = 0.001). No serious complications occurred in terms of hemorrhage, febrile morbidity diarrhea, nausea and vomiting

Conclusion: Intracervicovaginal misoprostol is an effective and safe method for second‐trimester pregnancy termination. The success rate is higher and the abortion time is less in dead‐fetus pregnancy than those in the live‐fetus pregnancy.
A Case of a Malignant Mixed Tumor in the Vagina
Authors: Takehara Masaki , Hayakawa Osamu , Itoh Eiki , Sagae Satoru , Suzuki Takahiro , Kudo Ryuichi
Published: May 2010

Malignant mixed tumors in the vagina are extremely rare. We experienced a case of a malignant mixed tumor (synovioid variant). Surgical treatment was performed, followed by 3 courses of chemotherapy. Up to the present time, 4 years after the first treatment, no signs of recurrence have been observed.
A Case of Concurrent Uterine Cervical Adenocarcinoma and Renal‐Cell Carcinoma, and Subsequent Vaginal Metastasis from the Renal‐Cell Carcinoma
Authors: Yokoyama Yoshihito , Sato Shigemi , Kawaguchi Toshiaki , Saito Yoshiharu
Published: May 2010

We report a case of concurrent uterine cervical adenocarcinoma and renal‐cell carcinoma and a subsequent vaginal metastasis from the renal‐cell carcinoma. The renal‐cell carcinoma, which was located in the upper pole of the right kidney, was detected incidentally by preoperative CT scanning. We simultaneously performed in a timely manner radical hysterectomy, pelvic and paraaortic lymphadenectomies, and a right nephrectomy. Subsequently, however, the patient suffered from vaginal metastasis arising from the renal‐cell carcinoma. As a result of this case, we emphasize the importance of making a thorough preoperative assessment prior to performing any definitive surgery for a gynecologic malignancy.
Ovarian Pregnancy Associated with Microscopic Decidualized Endometriosis of the Ovary: Report of a Case
Authors: Toki Toshihiko , Obinata Miyuki , Nakayama Kuniaki , Oguchi Osamu , Fujii Shingo
Published: May 2010

A case of ovarian pregnancy associated with microscopic endometriosis is described. The case satisfied Spiegelberg's four criteria. The associated endometriotic lesion histologically showed prominent decidual change.
The Relationship between Maternity Blues and Thyroid Dysfunction
Authors: Ijuin Tomu , Douchi Tsutomu , Yamamoto Shinichi , Ijuin Yasuhiro , Nagata Yukihiro
Published: May 2010

Objective: To investigate whether there is evidence of thyroid dysfunction in women with maternity blues.

Methods: Twenty women with maternity blues and 20 age‐matched normal controls were enrolled in our study. The serum levels of 6 kinds of thyroid hormones, cortisol, and prolactin (PRL) of the 2 groups were compared, and obstetric variables were recorded for each subject. In addition, significant variables correlating with the development of maternity blues were determined by stepwise regression analysis.

Results: The serum‐free triiodothyronine (FT3) level at 5 days puerperium was lower in the maternity blues group (p < 0.05) than in the control group. In the maternity blues group, the FT3 level at 5 days puerperium was lower than that at 37 weeks of pregnancy and at 1 month puerperium (p < 0.05). The reverse T3 levels and TSH levels at 5 days postpartum were higher in women with maternity blues than among the controls (p < 0.05). The proportion of primiparous women was higher in the maternity blues group (p < 0.01). Stepwise regression analysis revealed that the low FT3 level and primiparity were significantly correlated with the development of maternity blues (R2 = 0.281, p < 0.001).

Conclusion: Thyroid dysfunction might be associated with the development of maternity blues.
Vertical Transmission of Hepatitis C Virus: Risk Factors and Infantile Prognosis*
Authors: Xiong Shu Kang , Okajima Yuko , Ishikawa Kazuaki , Watanabe Hiroshi , Inaba Noriyuki
Published: May 2010

Objectives: To clarify the incidence and risk factors of the vertical transmission of hepatitis C virus (HCV) and to determine the prognosis of the carrier infants.

Methods: At our hospital, 1,941 non‐pathological (non‐HIV carriers) Japanese pregnant women were screened for anti‐HCV antibodies. Sera of the antibody‐positive women were examined by the reverse transcription polymerase chain reaction (RT‐PCR) method, and the positive women and their infants were followed by testing HCV‐related markers.

Results: The HCV carrier rate among the pregnant women was 3.5% (68/ 1,941). Four among the 65 infants (6.2%) who were successfully followed for more than 6 months developed the HCV carrier‐state. Of all the risk factors examined, only the elevation (≤ 110 IU/l of maternal serum alanine aminotransferase (ALT) was found to be significant for HCV vertical transmission. Seventy‐five and 50% of the carrier infants manifested chemical hepatitis and seroconverted to an HCV‐RNA‐negative status, respectively, during the follow‐up period.

Conclusions: The frequency of HCV vertical transmission was 6.2%. Half of the carrier infants became seronegative for HCV‐RNA. HCV vertical transmission was significantly affected by the maternal serum ALT level prior to delivery.
Seroprevalence of Toxoplasma Antibodies among the Antenatal Population in Bangladesh*
Authors: Dr. Ashrafunnessa  , Khatun Shahla , Islam M. Nazrul , Huq Tahmina
Published: May 2010

Objective: To determine the seroprevalence of toxoplasma antibodies (toxoplasma IgG and toxoplasma IgM) among an antenatal population in a hospital of Bangladesh.

Methods:Sera from 286 pregnant women were tested for toxoplasma IgG antibody by applying enzyme linked immunosorbent assay (ELISA) technique. Among the 286 sera, 88 sera were randomly selected and tested for toxoplasma IgM applying ELISA.

Results:Among 286 patients 110 (38.5%) were positive for toxoplasma IgG antibody and among 88 patients only one (1.1%) was positive for toxoplasma IgM. The seroprevalence gradually increased with age and parity. The seroprevalence of antibody was higher among the women in poor (53.0%) than the upper socio‐economic class (22.0%) and among the women with jobs (55.0%) than the housewife group (35.0%).

Conclusion:This study shows that toxoplasmosis is endemic in Bangladesh and also affecting pregnant women. There is need for further detailed studies on toxoplasmosis and its influence on perinatal morbidity and mortality.
Vaginal Birth after Cesarean Delivery: Results in 310 Pregnancies
Authors: Obara Hiromi , Minakami Hisanori , Koike Toshimitsu , Takamizawa Satoru , Matsubar Shigeki , Sato Ikuo
Published: May 2010

Objective: To assess and compare the risk associated with a trial of vaginal birth after cesarean section (VBAC) with the risk of an elective repeat cesarean section.

Methods:A retrospective review of the records of 310 consecutive women who, at the Jichi Medical School Hospital in the 6‐year period of 1990 through 1995, had previously undergone a primary cesarean section and gave birth to a singleton infant weighing ≥ 2,000 g at ≥ 36 weeks of gestation in a subsequent pregnancy.

Results:Elective cesarean sections were performed on 96 (31%) of 310 women, and VBACs were attempted by 214 women (69%). Vaginal deliveries were successful in 132 (43%) of the 310 pregnancies. No maternal deaths or perinatal deaths occurred in either group. A uterine rupture occurred in 2 (0.9%) of the 214 women who attempted a VBAC, and 5 women (2.3%) gave birth to neonates with a 1‐minute Apgar score ≤ 6. None of the 96 women who underwent an elective cesarean section had such complications, although the difference in these complication rates did not reach a significant level.

Conclusions: A trial of a VBAC significantly reduced the rate of cesarean sections. Although the rates of uterine rupture and neonatal asphyxia were slightly higher in women who attempted a VBAC than in women who underwent an elective cesarean section, obstetricians should offer the option of a trial of labor, because more than one‐half of the women with a previous cesarean delivery might have successful vaginal deliveries, and the VBAC‐related maternal mortality rate does not reportedly differ between women undergoing a trial of labor and women undergoing an elective repeat cesarean section.
Ovarian Endometrioid Adenocarcinoma Coexistent with Benign and Borderline Endometrioid Adenofibroma: A Case Report
Authors: Ushijima Kimio , Nishida Takashi , Muraoka Yasunori , Sugiyama Torn , Okura Naofumi , Shinagawa Atsuhiko , Imaishi Kiyohisa , Yakushiji Michiaki
Published: May 2010

A well‐differentiated endometrioid adenocarcinoma coexistent with benign and borderline‐malignant endometrioid adenofibroma was found in the ovary of a 64‐year‐old woman. She had vaginal bleeding caused by simple hyperplasia of the endo‐metrium due to high levels of sex steroid hormones. A FIGO stage la solid ovarian tumor was identified. It was composed of irregularly shaped endometriotic glands with benign and borderline malignant cytologic features embedded in abundant fibromatous stroma. Well‐differentiated malignant epithelium was adjacent to these areas, but fibromatous stroma was not predominant. She was treated by surgery and three cycles of chemotherapy. This paper describes this unusual tumor and reviews the literature.
Sarcoma Botryoides of the Uterine Cervix: A Case Report
Authors: Qiang Ji Xin , Takahashi Osamu , Hatazawa Junichi , Karube Akihiro , Ohyama Noriaki , Sato Hirokazu , Ota Hirotaka , Sageshima Masato , Tanaka Toshinobu
Published: May 2010

Rhabdomyosarcoma of the uterine cervix is a very rare disease. We present a case of rhabdomyosarcoma (botryoide type) arising from the introitus of the uterine cervix, and make a discussion on the diagnosis, treatment and involving factors of prognosis.
Spontaneous Rupture of the Uterus Caused by Placenta Percreta at 28 Weeks of Gestation: A Case Report
Authors: Moriya Mitsuhiko , Kusaka Hideto , Shimizu Katsuhiko , Toyoda Nagayasu
Published: May 2010

Placenta percreta is a rare complication of pregnancy. Rupture of the uterus due to placenta percreta is one of the most urgent obstetrical catastrophes. Recently, we observed a patient who developed placenta percreta accompanied by spontaneous uterine rupture at 28 weeks of gestation. A 29‐year‐old gravida 3, para 1, who had a history of one cesarean section and one miscarriage with dilatation and curetage, was seen at 28 weeks of gestation. An acute abdomen and shock were diagnosed. Immediate laparotomy revealed a transverse rupture on the fundus of the uterus. A hysterectomy was performed. Pathological examination of the uterus showed placenta percreta. Rupture of the uterus due to placenta percreta before the onset of labor is extremely rare.
Maternal Sociocultural Status: A Novel Assessment of Risk for the Birth of Small for Gestational Age, Low Birth Weight Infants
Authors: Arif Manzoor A. , Qureshi Aslam H. , Jafarey Sadiqa N. , Alam Syed E. , Arif Khuram
Published: May 2010

Objectives: We assessed the significance of maternal sociocultural status within the family as a risk factor for low birth weight‐small for gestational age (LBW‐SGA) births using a novel scoring system and also isolated related medical risk factors.

Methods: A prospective matched pairs case control study of 396 LBW‐SGA infants (cases) and 396 term, appropriate for gestational age infants (controls) was set up.

Results: Low maternal sociocultural status (p = 0.02) was significantly associated with LBW‐SGA births as were nonregistration for antenatal care (p < 0.001), maternal weight at delivery < 50 kg (p < 0.0001), antepartum hemorrhage/ preeclampsia (p < 0.01), primigravidity and previous small baby (p < 0.001). Other risk factors included birth interval < 24 m (p < 0.001) and poor maternal or paternal education (p < 0.05).

Conditional logistic regression identified maternal weight at delivery < 50 kg (OR 4.8, 95% C.I. 3.0–7.6), lack of antenatal care (OR 2.0, 95% C.I. 1.4‐2.9), antepartum hemorrhage/preeclampsia (OR 4.3, 95% C.I. 1.7–10.8) and previous small baby (OR 4.3, 95% C.I. 2.1–8.9) as independent risk factors.

Conclusions: Low sociocultural status of the mother within the family is significantly associated with having a LBW‐SGA baby. Further studies are warranted to study this risk factor.
Case Report: A Mixed Tumor of the Vagina
Authors: Kawauchi Shigeto , Fukuda Toshiro , Tsuneyoshi Masazumi
Published: May 2010

We report a case of a mixed tumor arising in the vagina of a 64‐year‐old woman. Microscopically, the tumor was composed of stromal‐type spindle cells and nests of mature squamous cells embedded in myxomatous stroma. We examined the tumor immunohistochemically, ultrastructurally, and cytogenetically. Based on the results, we discuss the histogenesis of this rare tumor.
Use of Transvaginal Color Doppler Ultrasound in the Diagnosis of Ovarian Bleeding: A Report of 10 Cases
Authors: Emoto Makoto , Tamura Riko , Kawarabayashi Tatsuhiko
Published: May 2010

Ten patients with ovarian bleeding, who were surgically treated, had been preoperatively evaluated using transvaginal color Doppler ultrasound. The blood‐flow velocity waveforms of the bleeding also were analyzed. The bleeding artery of the ovary was clearly detected in 9 of 10 (90%) patients by transvaginal color Doppler ultrasound and was later confirmed by either a laparotomy or laparoscopic surgery. Either a corpus luteum cyst or a ruptured corpus luteum was associated with the bleeding in the 9 of the 10 patients. The resistance‐index value in each bleeding artery examined in the 9 cases was relatively low, ranging from 0.46 to 0.59 (mean: 0.51). Based on our findings, transvaginal color Doppler ultrasound is useful for preoperatively detecting bleeding arteries in clinically severe cases of ovarian bleeding.
Admission Test: A Predictive Test for Fetal Distress in High Risk Labour
Authors: Kulkarni Ashwini Achyut , Shrotri Aparna Nishikant
Published: May 2010

Objective: To study predictive utility of admission test (AT) for perinatal outcome in high risk labours.

Method: A hundred patients at risk of fetal jeopardy due to uteroplacental insufficiency were screened by admission test. The traces were classified as per the criteria suggested by Ingemarsson and Arulkumaran (1986). The perinatal outcome was correlated with the initial FHR pattern and Chi square test was applied to the results.

Results: Fifty‐eight patients had reactive, 35 had equivocal and 7 had ominous tracing. The incidence of operative delivery for fetal distress showed a progressive rise from reactive (5.17%) to ominous (28.5%) pattern group. The perinatal morbidity also showed a rise from 6.89% in the reactive to 31.42% in the equivocal (p < 0.01) and 85.71% in the ominous group (p < 0.02). The reactive pattern was assuring of the fetal well being for next 5 hours. Presence of late decelerations and decelerations of 60 beats or more below the baseline were additional ominous characteristics, associated with a significant increase in perinatal morbidity.

Conclusion: Reactive AT appears to be predictive of fetal well being in high risk labours also. Repeat tracing 4 to 5 hours apart may improve the predictive accuracy. Equivocal and ominous patterns require vigilant monitoring.
The Pregnancy Outcome of Acyanotic Heart Disease
Authors: Chig Patrick , Raman Subramaniam , Tham Seng Woh
Published: May 2010

Objective: To study the pregnancy outcome of women with acyanotic heart disease.

Method: This is a retrospective study from a tertiary referral centre in a developing country over a period of 3 years.

Results: There were a total of 19,151 deliveries where 143 cases had heart disease in pregnancy, all of which were acyanotic, giving an incidence of 0.7%. Fifty‐one (38.4%) of these were congenital whereas 82 (61.6%) were acquired. There was no cyanotic heart lesion during this study period. The fetal and maternal outcome of the women with heart disease (study group) was compared with the general obstetric population in the Unit (control group) using the Chi‐squared test. Ninety‐two percent in the study group were asymptomatic (NYHA Class I). The age distribution were no different except in the < 20 years interval where there were significantly fewer in the study group. More women with heart disease were primiparous and fewer were multiparous as compared with the controls. There was no significant difference in the rate of induction of labour (9.8% vs 11.8%). The use of epidural analgesia was significantly higher in the study group (49% vs 13%) as was the instrumental delivery rates (35.7% vs 5.7%) when compared with the controls. The cae‐sarean section rate was no different. The mean gestation of babies born to mothers with heart disease was 38.2 weeks. Significantly fewer babies were in the 3.0–3.5 kg weight interval and more in the 2.5‐3.0 kg interval. However, this did not alter the perinatal mortality rates which was not significantly different (15.3 vs 14.0 per thousand).

Conclusion: The fetal and maternal outcome in women with acyanotic heart disease was favourable. It is advocated that the management of these cases should be multidisciplinary to optimise care for these patients.
Effect of Daily Vaginal Disinfection on Duration of Gestation after Premature Rupture of the Membranes and on Infant Outcome
Authors: Watanabe Takashi , Minakami Hisanori , Matsubara Shigeki , Honma Yoko , Uchida Akira , Sato Ikuo
Published: May 2010

Objectives: We examined the effects of daily vaginal disinfection on the interval between premature rupture of the membranes (PROM) and delivery and on infant outcome.

Methods: Daily vaginal disinfection with povidone iodine was performed on 43 women with PROM. The control group consisted of 59 women with PROM who did not undergo vaginal disinfection. In both groups, the infants born to these women were followed until 1 year of corrected age.

Results: The degree of cervical dilatation, the leukocyte count, and the serum C‐reactive protein level on admission did not differ between the 2 groups. Although there was no difference in the gestational week at delivery between the groups, the interval between PROM and delivery was significantly longer in the disinfectant group than among the control subjects (9.5 ±14.9 days vs. 3.9 ±5.1 days, p < 0.01). There was no difference in infant outcome between the 2 groups.

Conclusions: These findings suggest that daily vaginal disinfection with povidone iodine prolongs the duration of gestation in women with PROM and dose not have an adverse effect on the fetus.
13‐cis‐Retinoic Acid and Interferon‐α2a Therapy in Locally Advanced Squamous Cell Carcinoma of the Cervix: p53 Alteration, Proliferating Cell Nuclear Antigen Expression and Angiogenesis Response*
Authors: Charuruks Navapun , Voravud Narin , Termrungruanglert Wichai , Lertsanguansinchai Prasert , Tresukosol Damrong , Niruthisard Somchai , Sirisabya Nakorn
Published: May 2010

Objective:To evaluate prognostic importance of p53, PCNA and vasculariza‐tion alteration in patients with locally advanced cervical squamous cell carcinoma (SCC) after combination therapy with 13‐cis‐retinoic acid (13cRA) and interferon‐α2a (IFN‐α2a).

Methods: 13cRA and IFN‐α2a were administered to patients with locally advanced cervical SCC. Formalin fixed, paraffin embedded tissues sections obtained at pre‐ and post‐therapy, respectively, were stained immunohistochemically with anti‐p53, anti‐PCNA and anti CD31.

Results:p53 alteration was demonstrated in 5/10 patients and 3/10 patients pre‐ and post‐therapy, respectively. There was no correlation between p53 alteration and prognosis. After therapy, two patients with complete response had lower PCNA expression whereas the non‐responders demonstrated the opposite result. The vas‐cularization showed a correlation with PCNA and prognosis. In the response group, patients had lower microvessel count while the metastatic group exhibited higher count.

Conclusions: The present study suggests that p53 alteration is neither related to the prognosis of cervical SCC nor is it influenced by the combination therapy while PCNA expression and vascularization might be constitute potential markers for tumorigenesis, prognosis and responsiveness to this novel regimen.
Rational Type of Laparoscopic Hysterectomy and Safety in Anesthetic Profiles*
Authors: Song Joon , Kim Sun Haeng , Cho Sung Jin , Park Chang Seo , Ku Pyong Sahm
Published: May 2010

Objective: To evaluate what type of surgery would be more reasonable among 3 types of laparoscopic hysterectomy and to evaluate the safety of cardio‐pulmonary changes on these patients during these operations.

Method: A retrospective study was carried out in 215 women who underwent laparoscopic hysterectomy including laparoscopic‐assisted vaginal hysterectomy (LAVH), laparoscopic hysterectomy (LH), total laparoscopic hysterectomy (TLH). Blood gas analysis, end‐tidal CO2 levels and vital signs were checked and compared with control and preceding values.

Results: The average duration of operation was 102.5 min, 83.8 min and 118.3 min for LAVH (n = 97), LH (n = 75) and TLH (n = 43), respectively (p < 0.05). The average amount of bleeding was 297.5 ml, 152.3 ml and 149.2 ml for each type of hysterectomy, respectively. Hemoglobin decreased by an average of 1.6 g/100 ml, 0.9 g/100 ml and 0.8 g/100 ml, respectively. There was a lesser amount of bleeding for LH and TLH than for LAVH (p < 0.05). Profiles of blood gas analysis and expiratory CO2 varied significantly according to the operative stages under controlled anesthesia (p < 0.05), but were within the normal range.

Conclusion: These results demonstrate that laparoscopic procedures advancing below the uterine vasculature can be considered effective for hysterctomies and that proper anesthesia can safely control the cardio‐pulmonary changes during laparoscopic hysterectomy.
Umbilical Doppler Velocimetry Prediction of Discordant Twins
Authors: Chittacharoen Apichart , Leelapattana Piboon , Phuapradit Winit
Published: May 2010

Objective: To evaluate the role of umbilical Doppler velocimetry as a comprehensive test for the prediction of discordant twins.

Methods: The sets of twins were studied with duplex Doppler velocimetry for umbilical artery in third trimester. A systolic/diastolic ratio was measured for each twin. The average difference in the ratios between each twin ≥ 0.4 was used to indicate abnormal test. Discordancy was identified when the birth weight difference of > 25%.

Results: Among the 52 sets of twin pregnancies studied, 40 sets of twins fulfilled the study criteria. Eight sets of twins were discordant (20%). The mean gestational age at delivery was 37.15 ± 2.24 weeks (range 28 to 41 weeks). The test correctly identified 6 of the 8 growth discordant twins which had a sensitivity of 75%, specificity of 68.75%, and accuracy of 70%.

Conclusion: Umbilical Doppler velocimetry is useful in prediction of discordant twins.
Previous Cesarean Section and Abortion as Risk Factors for Developing Placenta Previa
Authors: Hendricks Marianne S. , Chow Y. H. , Bhagavath B. , Singh Kuldip
Published: May 2010

Objective: To determine the risk of subsequent occurrence of placenta previa in women with a history of previous cesarean sections and/or spontaneous and induced abortions.

Method: A retrospective analysis of all single gestation deliveries at National University Hospital of Singapore from 1993–1997 was done. Women with placenta previa were identified by clinical or ultrasonographic diagnosis.

Results: Of the 16,169 singleton deliveries, 164 women (1.0%) had placenta previa. Women with placenta previa had a significantly higher incidence of previous cesarean sections (p < 0.001). Among the 164 women with placenta previa, women with 1, 2, and 3 previous cesarean sections had 2.2 (95% CI 1.4, 3.4), 4.1 (95% CI 1.9, 8.8) and 22.4 (95%, CI 6.4, 78.3) times increased risk of developing placenta previa respectively. Similarly, women with 2 or more previous abortions had a 2.1 (95% CI 1.2,3.5) times increased risk of subsequently developing placenta previa.

Conclusion: There is a strong association between previous cesarean section and risk of subsequent development of placenta previa. This risk increased with the number of previous cesarean sections. Increasing frequency of abortions was also found to predispose a woman to placenta previa.
Emergency Peripartum Hysterectomy at the Princess Badeea Teaching Hospital in North Jordan
Authors: Abu‐Heija Adel T. , Jallad Fayez F.
Published: May 2010

Objectives: To study the prevalence, indications and outcome of emergency peripartum hysterectomy in women delivered at the Princess Badeea Teaching Hospital in North Jordan.

Method: This is a retrospective study of all cases of emergency peripartum hysterectomy performed between 1st of January 1994 and 31 August 1998.

Results: During the study period there were a total of 21 emergency peripartum hysterectomy were performed. The overall incidence was 0.5/1,000 deliveries. The mean age of patients was 34.7 ± 3.9 years, the median parity was 6 and the mean gestational age was 36.9 ± 2.01 weeks.

There were 19 cases of caesarean hysterectomy. The leading indication for caesarean section was previous caesarean section (89.5%), placenta previa alone (10.5%). It should be noted that 7 cases with previous caesarean section also had placenta previa (41.2%). The main indications for emergency hysterectomy were, abnormally adherent placenta was the leading indication (38.1%), followed by rupture uterus (33.3%), haemorrhage and uterine atony occurred in 14.3% of cases each, maternal complications occurred in 42.9% of cases postoperatively. There were 4 cases of stillbirths and 2 cases of neonatal deaths.

Conclusion: Peripartum hysterectomy remains a necessary procedure for life saving during abdominal and vaginal deliveries. The procedure itself is usually associated considerable perioperative morbidity. Obstetricians should identify patients at risk and anticipate the procedure and complications.
Effect of Vaginal Delivery on the Q‐Tc Interval in a Patient with the Long Q‐T (Romano‐Ward) Syndrome
Authors: Minakami Hisanori , Nakayama Toshio , Ohno Takashi , Kuroki Shigehiro , Sato Ikuo
Published: May 2010

Twelve ECG leads were monitored continuously during peripartum in a 23‐year‐old Japanese woman diagnosed as having the long Q‐T (Romano‐Ward) syndrome. Corrected Q‐T (Q‐Tc) intervals determined by 2 investigators blinded from the clinical informations disclosed that the Q‐Tc interval increased during labor, suggesting that physical and/or emotional stress during labor might cause prolonged Q‐Tc intervals in women with the long QT syndrome.
High‐Risk Types of Human Papillomavirus Associated with the Progression of Cervical Dysplasia to Carcinoma
Authors: Saito Junko , Fukuda Takehiko , Hoshiai Hiroshi , Noda Kiichiro
Published: May 2010

Objectives: In the past several years, much evidence has accumulated that strongly implicates human papillomavirus (HPV) as an etiological agent of cervical cancer. However, the natural history of HPV infection is not yet completely understood, and at present there is no good marker to predict progression to invasive cancer in individual patients with dysplasia.

Methods: Tissue specimens from 45 patients with cervical dysplasia were classified as showing progression to carcinoma (progression group; 26 women), spontaneous regression (regression group; 16 women), and persistence (persistence group; 3 women). The presence of HPV 16, 18, 33, and 52 DNA was examined in 90 formalin‐fixed, paraffin‐embedded surgical and biopsy specimens of dysplasia using the PCR method, and the relationship between the presence of HPV and cervical carcinogenesis was analyzed. The mean follow‐up period was 25.8 months in the progressed group and 34.0 months in both the persistent and regressed groups. The mean ages were 46.4 in the progressed group and 46.8 in the persistent and regressed groups.

Results: HPV 16, 18, 33, and 52 DNA were detected in 19 of the 26 patients (73.1%) in the progressed group. All patients with HPV 16, 18, or 52 DNA showed progression to carcinoma. The HPV 33 DNA was detected in 5 of the 16 patients (31.3%) in the regressed group and in 2 of the 3 patients (66.7%) in the persistent group, while HPV 16, 18, and 52 DNA were not detected in the 19 patients that comprised the regressed and persistent groups.

Conclusion: This retrospective study suggests that cervical dysplasia in patients with high‐risk types of HPV possessed the potential to progress to carcinoma in situ and eventually to invasive carcinoma as well.
Low‐Dose GnRH Agonist Therapy for the Management of Endometriosis
Authors: Uemura Tsuguo , Shirasu Kazuhiro , Katagiri Nobuyuki , Asukai Kunio , Suzuki Takeshi , Suzuki Naoyuki , Osada Hisafumi , Hiroshi Minaguchi
Published: May 2010

Objective: In order to examine whether treatment with a GnRH agonist alone can maintain estrogen levels within the “estrogen window” that inhibits endometriosis without influencing bone‐mineral density, we studied the effects of GnRH agonist therapy and changes in bone‐mineral density.

Methods: Buserelin acetate nasal spray was administered 3 times a day for 8 weeks (daily dose, 900 μg) to 21 women with endometriosis. The drug was then given twice a day for 16 weeks (daily dose, 600 μg). The total duration of treatment was 24 weeks. The bone‐mineral density of the lumbar vertebrae was measured by dual‐energy X‐ray absorptiometry before treatment (baseline), at the end of treatment, and 24 weeks after the end of treatment.

Results: The bone‐mineral density of the lumbar vertebrae at the end of treatment was 2.44% + 0.46% (mean + standard error) lower than the baseline value. The value at 24 weeks after the end of treatment was 1.10% + 0.64% lower than the baseline value. More than 80% of the patients had serum‐estradiol levels of 45 pg/ml or less. During treatment, more than 90% of the patients had serum‐estradiol levels of 60 pg/ml or less. Genital bleeding was inhibited in 90% of the patients. After 8 weeks of treatment, the clinical symptoms improved in 75% of the patients; such improvement persisted for the duration of the treatment.

Conclusion: Decreasing the dose of GnRH agonist during treatment can minimize the loss of bone‐mineral density without lessening the beneficial effects on endometriosis. This technique might be useful in the management of endometriosis.
Recent Management of Malignant Ovarian Germ Cell Tumors: A Study of 34 Cases
Authors: Linasmita Vasant , Srisupundit Somkeart , Wilailak Sarikapan , Tangtrakul Somsak , Israngura Nathapong , Bullangpoti Sunchai
Published: May 2010

Objective: To review the outcome of the treatment in patients with malignant ovarian Germ cell tumors with respect to survival and surgical management at a single institution during 1990–1996.

Methods: Thirty‐four patients with malignant ovarian Germ cell tumors were studied retrospectively for their surgical management. Fourteen patients had pure dysgerminoma, 11 endodermal sinus tumor, 6 immature teratoma, and 3 mixed Germ cell tumors. Nine patients had stage IA, 8 stage IC, 2 stage IIC, 8 stage III, 3 stage IV, and 4 referred patients with recurrent diseases.

Results: Nineteen patients underwent primary conservative surgery, 11 had primary nonconservative surgery. Twenty‐two patients were treated with chemotherapy (BEP or EP or PVB regimen). Five patients with pure dysgerminoma received adjuvant radiotherapy. Persistent remission was achieved in 26 patients. Two patients (7.4%) had recurrence after remission. Seven patients had died of the diseases. Patients with complete clinical remission did not undergo second‐look surgery. The overall survival was 78.8%, 100% for immature teratoma, 84.6% for pure dysgerminoma, 72.8% for endodermal sinus tumor, and 33.3% for mixed Germ cell tumors, with median follow‐up time 31 (3–93) months.

Conclusion: Patients with limited diseases regardless of histologic types can be safely managed by unilateral salpingo‐oophorectomy followed by, if indicated, 3–4 courses of cisplatin‐based chemotherapy. For advanced diseases, conservative surgery is advisable in patients with endodermal sinus tumor.
Hyperbaric Oxygenation for Rectovaginal Fistula: A Report of Two Cases
Authors: Dohgomori Hiroshi , Arikawa Kazuhiro , Nobori Masuo , Tonari Masaharu
Published: May 2010

A rectovaginal fistula after delivery is a rare complication, and its management can become difficult if infection occurs. In two such cases, we administered hyperbaric oxygenation (HBO) treatment against complicated infections, and we obtained a good outcome in each case.