bluuebunny/crossref_metadata_2025 huggingface dataset:
A pulsed electric field procedure for promoting Maillard reaction in an asparagine–glucose model system
Authors: Guan Yong‐Guang , Wang Jun , Yu Shu‐Juan , Zeng Xin‐An , Han Zhong , Liu Yan‐Yan
Published: May 2010

Effects of pulsed electric field (PEF) on pH, intermediate products, asparagine and glucose content, browning value, reducing power as well as antioxidant activity of an asparagine–glucose solution were explored in this paper. Results showed that the solution’s UV–Vis absorbance at 294 nm and 420 nm was significantly increased from 0 to approximately 1.14 and 0.74, respectively, at PEF intensity of 40 kV cm−1 for 7.35 ms treatment. The temperature of PEF treated samples were overall lower than 40 °C. It was also detected that the antioxidant activity of treated sample was correspondingly increased by 20.33%. Meanwhile, 14% reduction of asparagine content and 66% reduction of glucose content were observed. It was demonstrated from high performance liquid chromatography analysis that Maillard reaction in the model system had been enhanced by PEF treatment as no 5‐hydroxymethyl‐2‐furaldehyde was generated. This study indicates that pulsed electric field treatment, especially with higher intensities, is a means to significantly promote the Maillard reaction in an asparagine–glucose solution.
A new deletion mutation of fragrant gene and the development of three molecular markers for fragrance in rice
Authors: Shao G. N. , Tang A. , Tang S. Q. , Luo J. , Jiao G. A. , Wu J. L. , Hu P. S.
Published: May 2010

With 3 figures and 3 tables

Fragrance is an important quality trait of rice, which is mainly controlled by loss‐function of the betaine aldehyde dehydrogenase gene (badh2) on rice chromosome 8. Two deletion mutations of Badh2 have been reported to associate with fragrance in rice. Allelic test showed that the fragrant gene of ‘Zaimiaoxiangnuo’ is allelic to badh2‐E7 (8 bp deletion in exon 7 of Badh2). Sequencing and BLAST analysis showed that the allele in ‘Zaimiaoxiangnuo’ is a new mutation, i.e. deletion of 803 bp between exons 4 and 5. A marker FMbadh2‐E4‐5 was developed for the detection of the new deletion site of fragrant gene. FMbadh2‐E4‐5 and the two previously reported functional markers were used to genotype the fragrant genes of four non‐fragrant and 22 fragrant rice varieties. The deletions were absent in all non‐fragrant rice varieties, but present in all fragrant rice varieties. Eight fragrant rice varieties were positive for the FMbadh2‐E4‐5 marker. These findings are useful in the breeding of fragrant rice varieties.
Are Australian rural women aware of coronary heart disease?
Authors: Crouch Rosanne , Wilson Anne
Published: May 2010

Crouch R, Wilson A. International Journal of Nursing Practice 2010; 16: 295–300 Are Australian rural women aware of coronary heart disease?

Heart disease is the leading cause of morbidity and mortality in Australian women. In 2005, 109 000 women died of heart disease and 27 000 women died of breast cancer. The reported study sought to assess rural women's level of awareness of heart disease as the leading cause of death. A self‐enumerated questionnaire designed to collect information on rural women's perception and awareness of heart disease was distributed to women attending a women's health clinic in a regional hospital. Of 65 participants, 13% (n = 8) identified heart disease as the most significant health problem. Sixty‐four per cent of women participating in the study reported that breast cancer claims more lives than heart disease. The authors concluded that women do not perceive heart disease as a substantial health concern. Programmes directed at young women to improve their perception of risk for heart disease and to encourage them to make healthy lifestyle choices are required to reduce overall heart disease morbidity and mortality.
Viral bronchiolitis for the clinician
Authors: Fitzgerald Dominic A
Published: May 2010

Viral bronchiolitis is common, and about 98–99% of infants are managed in the home. Because about 95% of infants <2 years old are infected with respiratory syncytial virus, however, bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It is usually a self‐limiting condition lasting around a week in previously well children. About 1% of infants are admitted to hospital, and about 10% of hospitalised infants will require admission to the intensive care unit. Respiratory syncytial virus is isolated from about 70% of infants hospitalised with bronchiolitis. The emphasis of hospital treatment is to ensure adequate hydration and oxygenation. Other than supplemental oxygen, little in the way of pharmacological treatment has been demonstrated to alter the course of the illness or the risk of wheezing in the months following bronchiolitis.
Adolescents seeking weight management: Who is putting their hand up and what are they looking for?
Authors: Truby Helen , Baxter Kim , Elliott Sarah , Warren Janet , Davies Peter , Batch Jennifer
Published: May 2010

We describe the characteristics of adolescents seeking treatment for obesity via the ‘Eat Smart’ feasibility study; an intensive 12 week dietitian‐led weight management programme with an emphasis on lifestyle change. It was designed to test the feasibility of a structured low‐fat diet compared with a semi‐structured reduced carbohydrate plan compared with a model of ‘standard care’– an unstructured low fat approach. When compared with non‐participants, participants were predominantly female and lived in lower socioeconomic areas. When given the choice of dietary approach, 50% elected reduced dietary carbohydrate, 43% structured low fat and 7% chose ‘standard care’. Modest weight loss was achieved over 12 weeks, with both the structured low fat and reduced carbohydrate formats. Families showed a strong preference for structured eating plans, in particular seeking assistance with correct portion size. The current standard model of unstructured advice was both unpopular and relatively unsuccessful.
Superior vena cava obstruction: Dangers of a missed diagnosis
Authors: Holme Harriet , Nanduri Vasanta
Published: May 2010

We report the case of a 7 year old girl who presented to the Children's Emergency Department with a 6 week history of bilateral facial and neck swelling. She had felt generally unwell, tired, with a recent onset of dry cough, and had presented multiple times to her general practitioner (GP) who after initially unsuccessfully trying an antihistamine, had given her five courses of soluble Betamethasone (corticosteroid) over six weeks, for presumed allergy; this temporarily relieved her symptoms for a couple of days each time. On subsequent referral to Accident and Emergency she was found to have a superior mediastinal mass, with a left pleural effusion and mediastinal deviation to the right. Further investigation confirmed the diagnosis of a T‐cell lymphoma causing superior vena cava obstruction of blood flow through the SVC to the right atrium and is a classical oncological emergency. This case report highlights the importance of recognizing superior vena cava obstruction and the need for awareness of malignancy as a differential diagnosis when initially presented with a child with non‐specific respiratory findings. We highlight that acute tumour lysis syndrome, a life threatening metabolic emergency that results from massive cytolysis of malignant cells, may occur after a single dose of corticosteroids and one should be aware of this potentially life‐threatening complication.
Ubiquitin‐positive tau‐negative intraneuronal inclusions in dementia with motor neuron disease
Authors: Okamoto Koichi
Published: May 2010

We first reported ubiquitin‐positive tau‐negative intraneuronal inclusions in the hippocampal granular cell layer and entorhinal cortices in patients with amyotrophic lateral sclerosis (ALS). We then found that those inclusions occur frequently in patients with presenile dementia and motor neuron disease. The ultrastructure of the inclusions consists mainly of granules with a few filaments. In 2006, TDP‐43 was identified as a major component of the inclusions specific for frontotemporal lobar degeneration and ALS. Here, we review the current knowledge regarding ubiquitin‐positive tau‐negative intraneuronal inclusions.
The first autopsied case of diffuse Lewy body disease (DLBD): re‐examination by recent immunostaining methods
Authors: Kosaka Kenji , Manabe Yuta
Published: May 2010

Materials from our first autopsied case of diffuse Lewy body disease (DLBD), that was originally reported in 1976, were re‐examined using recent immunohistochemical methods. Lewy pathology consisting of Lewy bodies and Lewy neurites appeared much more marked with alpha‐synuclein immunostaining than had been detected with classical stainings. This case and our other similar cases prompted us to propose the terms “Lewy body disease” in 1980 and “diffuse Lewy body disease” in 1984. We also reported in 1990 that DLBD was classified into two forms: a pure form and a common form. Based on these studies the term “dementia with Lewy bodies (DLB)” was proposed in 1996. Since 1980, we have insisted that DLB, Parkinson disease (PD), and PD with dementia (PDD) should be understood within the spectrum of Lewy body disease. This insistence has been recently accepted by the International Workshop and the International Working Group on DLB and PDD in 2005 and in 2006, respectively.
Hyperperfusion in primary somatosensory region related to somatic hallucination in the elderly
Authors: Nemoto Kiyotaka , Mizukami Katsuyoshi , Hori Takafumi , Tachikawa Hirokazu , Ota Miho , Takeda Tohoru , Ohnishi Takashi , Matsuda Hiroshi , Asada Takashi
Published: May 2010

Aim:  The purpose of the present study was to investigate the regional cerebral blood flow (rCBF) of patients with delusional disorder, somatic type (DDST) exhibiting somatic hallucination.

Methods:  Five patients diagnosed with DDST, as well as 20 control subjects, were examined. All subjects underwent technetium‐99m ethyl cysteinate dimer brain perfusion single‐photon emission computed tomography. Statistical analysis was performed with SPM5, using a two‐sample t‐test model to test the regional population effect on rCBF.

Results:  Patients with DDST had a significant increase in perfusion in the left post‐central gyrus and the right paracentral lobule, both of which are involved in somatic sensory processing.

Conclusion:  Somatic hallucination might be associated with increased perfusion in the primary somatosensory regions.
Synchronous radiation‐induced orbital meningioma and multiple cavernomas
Authors: Paramanathan Nirosha , Ooi Kenneth Gek‐Jin , Reeves Dianne , Wilcsek Geoff A
Published: May 2010

Abstract

Synchronous radiation‐induced tumours are extremely rare. We present the first reported case of synchronous radiation‐induced orbital meningioma and cavernomas of the cerebellum and bilateral basal ganglia, presenting 16 years after ionizing radiation therapy for parietal anaplastic ependymoma, at the age of five. This case again underscores the risks of radiotherapy to children.
The Usefulness of Screaning for Chlamydial Trachomatis Infection with Cervical Mucus Leukocyte Esterase
Authors: El‐Shourbagy Mahmoud , Diab Khaled M. , Abdalla Mahmoud Y. , El‐Salam Magda Abd , Mohasb Shadia H.
Published: May 2010

Objective: To evaluate the ability of leukocyte esterase dipstick test (LET) performed in cervical mucus to predict direct immunofluorescent (DIF)‐verified Chlamydia trachomatis (Ct) cervical infection.

Method: Eighty women with inflammatory cervico‐vaginal smear were submitted to both an endocervical smear, to verify Ct cervicitis by DIF technique; and a cervical mucus sample to perform LET. Results of LET and DIF were matched.

Results: Among 30 Chlamydial positive subjects, cervical mucus esterase test was positive in 28 (93.3%); while among 50 Chlamydial negative controls, esterase test was negative in 43 subject (86%). The sensitivity, specificity, positive and negative predictive values for LET were 93.3%, 86%, 80% and 95% respectively.

Conclusion: Cervical mucus LET is a simple, cost effective screening test, with promising accuracy, for Ct cervical infection among women with inflammatory cervico‐vaginal smears.
Early Invasive Adenocarcinoma of the Fallopian Tube: A Case Report and Review of the Literature
Authors: Kurisu Miho , Konishi Ikuo , Mandai Masaki , Kuroda Hideki , Tsuruta Yuko , Yura Yasuichiro , Nanbu Kanako , Hamid Atia A.
Published: May 2010

We present an early invasive adenocarcinoma of the fallopian tube, which was incidentally found in a 45‐year‐old woman undergoing a laparotomy for uterine myoma. Histological examination of the hydropic tubes revealed widespread endosalpingeal hyperplasia without atypia in both tubes. In addition, the left tube contained 3 scattered lesions of carcinoma in situ, one of which was accompanied by a microfocus of definite stromal invasion confined within the endosalpingeal mucosa. Such a case seems extremely rare, and it might represent the histological appearance of an early invasive feature of tubal carcinoma. We reviewed previously reported cases of in situ and/or early invasive carcinomas of the fallopian tube with respect to the pathological diagnosis and histogenesis of primary tubal adenocarcinomas.
Primary Term Ovarian Pregnancy Superimposed by Intrauterine Pregnancy: A Case Report
Authors: Shahabuddin A. K. M. , Chowdhury Sameena
Published: May 2010

A case of primary ovarian pregnancy proceeding upto term superimposed by another intrauterine pregnancy is presented. Compound extrauterine and intrauterine pregnancy is a rare obstetric phenomenon and still rarer is a primary ovarian pregnancy proceeding upto the term. The condition was diagnosed at laparotomy during the second trimester of current pregnancy. Diagnostic laparotomy was done because the ovarian pregnancy was mimicking an ovarian tumur. The ovarian pregnancy was successfully managed by surgery. Normal vaginal delivery of a term intrauterine pregnancy occurred in due time. The difficulty of diagnosing the heterotopic pregnancy is discussed and the clinico‐pathological eatures of primary term ovarian pregnancy is emphasized, as it is a very rare condition.
Intrauterine Therapy of Fetal Atrial Flutter
Authors: Uerpairojkit B. , Tanawattanacharoen S. , Manotaya S. , Wisawasukmongchol W. , Chottivittayatarakorn P. , Charoenvidhya D.
Published: May 2010

An increased awareness of fetal arrhythmias by obstetricians has resulted in a growing number of diagnosed cases of fetal cardiac problems. A fetus with atrial flutter diagnosed at 31 weeks of gestation was successfully converted to normal sinus rhythm in utero by maternal administration with digitalis. The fetal heart rate stayed in a normarhythm with a maintenance dose of 0.5 mg/day. The fetus was delivered spontaneously at term and the neonatal heart rate has been in normal rhythm without any medical treatment.
Abruptio Placentae: Risk Factors and Perinatal Outcome
Authors: Abu‐Heija Adel , Al‐Chalabi Haifa , El‐lloubani Nahar
Published: May 2010

Objective: It is a case control study, conducted in order to determine the risk factors, and to find out the perinatal outcome of abruptio placentae in women delivered at the Princess Badeea Teaching Hospital in North Jordan.

Methods:We reviewed all cases of placental abruption delivered between 15th April 1994 till 26 November 1995 and to compare that with pregnancies and deliveries not complicated by abruptio placentae.

Results:During the study period there were 108 cases of abruptio placentae and 108 cases of the control group. The total number of women delivered were 18,256, so the incidence of abruptio placentae was 5.9 per 1000 births. When compared to the control group, abruptio placentae occurred more in parous women (para ≥ 5) (p < 0.0005), more preterm deliveries (p < 0.0001) with more birth weight < 2,500 g (p < 0.0001). Preeclampsia and pregnancy induced hypertension, intrauterine growth retardation, caesarean delivery, and intrauterine fetal death occurred more in patients with abruptio placentae.

Conclusion:High parity, preeclampsia and hypertension are significant etio‐logical determinants of abruptio placentae.
Two Uterine Arterial Management Methods in Laparoscopic Hysterectomy*
Authors: Song Joon , Cho Sung Jin , Park Chang Seo , Kim Sun Haeng , Ku Pyong Sahm , Lee Myung Ah
Published: May 2010

Objective: The purpose of this study was to evaluate whether laparoscopic separation with coagulation of the uterine arteries and uterosacral ligaments can be used in an attempt to improve the operative procedure when hysterectomy is carried out by laparoscopic and vaginal method.

Method: A prospective study was carried out in 70 women who underwent laparoscopic hysterectomy excluding total laparoscopic hysterectomy. Laparoscopic uterine arterial separation with coagulation (include laparoscopic reperitonization) was performed after laparoscopic detachment of the bladder and resection of the broad ligament (or adnexa) in 39 cases (Group 1). Uterine artery was coagulated by bipolar electrocoagulator and separated from the uterine side wall by scissors. Endoloop tie was applied to the arterial pedicle, if bleeding occurred. Uterine arterial management was performed through the vaginal route (include vaginal reperitonization) after laparoscopic procedure which was finished at the lower part of broad ligament with bladder detachment in 31 cases (Group 2).

Results:The average duration of operation was 84.0 min and 101.8 min in Groups 1 and 2, respectively (p < 0.05). The average amount of bleeding was 154.8 ml and 298.4 ml in Groups 1 and 2, respectively (p < 0.05). Hemoglobin decreased in average by 0.9 g/100 ml and 1.6 g/100 ml in Groups 1 and 2, respectively (p < 0.05).

Conclusion:These results demonstrate that laparoscopic management of uterine arterial pedicles after bladder detachment could reduce the duration of operation time and amount of bleeding in laparoscopic hysterectomy.
Non‐Hodgkin's Lymphoma Presenting as a Primary Lesion in Uterine Cervix:Case Report
Authors: Chandy Lata , Kumar Lalit , Dawar Ramesh
Published: May 2010

Non‐Hodgkin's lymphoma (NHL) arising from extra nodal tissue and staying localized to that region is rare. Rarer still is primary NHL of the uterine cervix. We describe a patient with primary extra nodal NHL of the uterine cervix and vagina who was treated successfully with chemotherapy and radiotherapy. She is free of disease 17 months after treatment. Data of 52 patients collected from the literature (Medline, National Library of Medicine, Bethesda, MD) is reviewed.
Triplet Pregnancy Complicated by a Gradual Decline in Antithrombin‐IH Activity and HELLP Syndrome: A Case Report
Authors: Izumi Akio , Minakami Hisanori , Matsubara Shigeki , Sato Ikuo
Published: May 2010

We prospectively evaluated the antenatal changes in antithrombin‐III (AT‐III) activity and liver enzymes in a woman with a triplet pregnancy. A gradual decline in AT‐III activity occurred in the absence of clinical signs of preeclampsia and preceded the onset of the typical HELLP syndrome in this patient. Monitoring of AT‐III activity might help to avoid the development of severe HELLP syndrome.
Differences of IgG and IgM Antibodies to Phospholipids and APTT among Non‐Pregnant and Pregnant Women
Authors: Shimano Satoshi , Kurosu Takaji , Hayama Kenji , Aoki Sigeo , Ishida Yuiti , Komae Yoshio
Published: May 2010

Objective: The objective of our study was to assess the difference in IgG and IgM antibodies to cardiolipin(CL), phosphatidylserine(PS), and APTT among non‐pregnant and pregnant women.

Methods: IgG and IgM antibodies to CL and PS among 102 healthy non‐pregnant women and 154 healthy pregnant women were measured by an ELISA. The activated partial thromboplastin time(APTT) was measured in 67 healthy non‐pregnant women, in 67 healthy women at 10—14 weeks of gestation, and in 67 healthy women at 30–32 weeks of gestation. We compared the titer of + 2SD in each group.

Results: The titers + 2SD of IgG antibodies to CL and PS in pregnant women were lower than in non‐pregnant women (p < 0.05), whereas the values of the IgM antibody to CL and PS were the same in pregnant and non‐pregnant women. The APTT in pregnant women was significantly shorter than in non‐pregnant women (p = 0.0001).

Conclusion: Standard criteria for the positivity of the IgG antibody to CL and PS and the prolongation of APTT in pregnancy should employ the values of normal pregnant women rather than those of non‐pregnant women.
Book Review
Authors: Soonawala R. P. , Damania K. R.
Published: May 2010

Books Reviewed in this article

Endometriosis (Obstetrics and Gynecology Perspective Series) Edited by N. D. Motashaw and Svati Dave
Detection of Numerical Chromosome Abnormalities in Human Spermatozoa by Three‐Color Fluorescence in situ Hybridization
Authors: Li Ping , Hoshiai Hiroshi
Published: May 2010

Three‐color fluorescence in situ hybridization (FISH) was used to detect numerical X, Y, and 17 chromosomal aberrations in human sperm nuclei. Digoxigenin‐labeled alpha satellite chromosome X‐specific probe DXZ1, biotin‐labeled classical satellite chromosome Y‐specific probe DYZ1, and biotin plus digoxigenin‐labeled alpha satellite chromosome 17‐specific probe D17Z1 were simultaneously hybridized to sperm preparations from donors with normal semen (group A) and abnormal semen (group B) characteristics. The proportions of haploid X, Y, 17 and disomy, diploidy of them before and after swim‐up were determined. At least 3,000 sperm were analyzed for each sample. Overall, up to 98% of sperm were labeled with the probes, and all statistical analyses were performed using χ2 tests. A significant difference was observed between group A and group B in frequency of sex chromosome disomy (p < 0.05). In group B, there were significant differences in frequencies of sex chromosomes disomy (p < 0.05) and diploidy (p < 0.01) before to after swim‐up. There was no significant difference in frequency of disomy 17 between the 2 groups. In group A and B, the ratios of X‐ to Y‐bearing sperm were 1:1 (neat semen), but in both groups there was a significant increase in Y‐bearing sperm after swim‐up. The results of this study demonstrated that abnormal semen has sex chromosome disomy more frequently than does normal semen and that portion of sex chromosome di‐somic and diploid sperm is removed by swim‐up, especially for abnormal semen. These findings suggest that we should be careful in using abnormal semen for IVF, especially for ICSI, and should perform swim‐up if possible.
Single Agent Versus Combination Chemotherapy in Recurrent Cervical Cancer
Authors: Kumar Lalit , Pokharel Y. H. , Kumar S. , Singh Rajveer , Rath G. K. , Kochupillai V.
Published: May 2010

Objective:Cisplatin and ifosfamide are two most active agents in patients with recurrent and metastatic cervical cancer. Combination of bleomycin, ifosfamide and cisplatinum (BIP) was compared with cisplatinum alone.

Patients and Methods: One hundred and six patients with recurrent/persistent and metastatic cervical cancer received either a combination of bleomycin, ifosfamide and cisplatinum, (Group A, n = 50) or cisplatinum alone (Group B, n = 56) every 3 weeks for up to 6 courses. Ninety‐seven patients were evaluable and were analysed for response and survival.

Results:Patients receiving BIP (Group A) had a higher response rate (complete and partial responses), 52.2% vs 29.4%, p < 0.01 with overall median survival, 8 months (1 to 92+ months) vs 6 months (1 to 40+ months), p = 0.18. Chemotherapy responders had a significantly higher survival in both groups compared to the non‐responders (Group A: 17 vs 6 months, p< 0.001, Group B: 20.5 months vs 5 months, p < 0.001). Patients in good performance status (ECOG, 0—2) had a significantly higher response rate to chemotherapy (Group A: 70.3% vs 26.3%, p < 0.01, Group B: 38.2% vs 11.7%, p < 0.05). In Group A, patients with extrapelvic disease responded better compared to pelvic disease (83.3% vs 34.5%, p < 0.01).

Chemotherapy side effects were mainly nausea/vomiting, alopecia, myelosuppres‐sion, reversible encephalopathy (in Group A), and impaired renal functions. Chemotherapy toxicity was higher for patients receiving BIP, 2 patients died of BIP toxic‐ity. Currently, in ‘Group A’ 8 patients are alive, 7 disease‐free and one with disease at a median interval of 51 months after chemotherapy treatment. While in Group B, 3 patients are alive, 2 disease‐free and one with disease.

Conclusions:Bleomycin, ifosfamide and cisplatin improved the response rate in recurrent and metastatic cervical cancer compared with cisplatinum alone. However, the toxicity was moderate and survival was not significantly improved. These results need to be confirmed in a phase III, randomized study in larger number of patients.
The Necessity for a Progressing Dialog between Basic Science and Clinical Research in Obstetrics and Gynecology*
Authors: Graeff Henner
Published: May 2010

Scientific breakthroughs and basic research are frequently published in prestigious journals and praised for their impact. However, progress in clinical medicine is tedious and slow. There is still a distinct and even widening gap between basic science and clinical application. The dialog between basic science and clinical research has therefore to be intensified and a new culture of cooperation between basic and physician‐scientists will become necessary to accelerate the transfer of new drugs into clinical practice.
Psychological and Obstetrical Responses of Mothers Following Antenatal Fetal Sex Identification
Authors: Kamel Hassan S. , Ahmed Hamdy N. , Eissa Mohammed A. , Abol‐Oyoun Al‐Sayed M.
Published: May 2010

This work was designed to study the impact of prenatal knowledge of fetal sex both on the psychological and obstetrical aspects of the expectant mothers during pregnancy and labour. One hundred pregnant women attending the outpatient antenatal clinic of Assiut University Hospital were recruited. All were in the third trimester, parous, with normal pregnancy and having no past or present psychiatric disorders. The desired sex of the expected child was registered. Symptom checklist 90 (SCL‐90) was applied before, and 2 weeks after sonographic fetal sex determination. Women who desired male sex scored significantly higher depressive symptoms than those who desired female sex. Women who were proven sonographically to have the undesired fetal sex showed significantly higher scores of depression, somatization, anxiety, hostility and phobia scales of SCL‐90 than women whose desired fetal sex was confirmed. The second part of the study to evaluate the effect of knowing the fetal sex on the progress of labour was designed as a case control study including 57 women previously informed about their fetal sex and 40 women ignorant of their fetal sex as controls. Women delivering a baby with undesired sex showed more obstetric difficulties. In the first stage of labour, they had significant reduction in frequency of uterine contractions and rate of cervical dilatation. They also needed much more sedation, analgesia and oxytocin augmentation.
Pregnancy‐Associated Osteoporosis with Elevated Levels of Circulating Parathyroid Hormone‐Related Protein: A Report of Two Cases
Authors: Anai Takanobu , Tomiyasu Toshiko , Arima Kazuyo , Miyakawa Isao
Published: May 2010

Two lactating women who had complained of back pain developed spontaneous vertebral fractures with low bone mineral density (BMD) several months postpartum. The back pain and biochemical abnormalities presented as hypercalcemia and elevated plasma levels of the parathyroid hormone‐related protein (PTH‐rP) that returned to normal indices with increasing BMD after weaning. The increased circulating PTH‐rP might contribute to the pregnancy‐associated osteoporosis in women who probably are already osteopenic.
Primary Malignant Melanoma of the Uterine Cervix: A Case Report
Authors: Takehara Masaki , Ito Eiki , Saito Tsuyoshi , Nishioka Yoshihiro , Kudo Ryuichi
Published: May 2010

We report on a case of a malignant melanoma of the uterine cervix. Histological and immunohistological examinations of a postsurgical specimen revealed malignant melanoma. The junctional activities did not occur due to extensive superficial ulceration. Radical surgery was performed. The patient is doing well and free of symptoms at this time, 2 1/2 year later.
A Prospective Study on the Effects of Reformulated 2‐rod Norplant Implant on Haemostasis after Five Years of Use
Authors: Koh Stephen C. L. , Viegas O. A. C. , Ratnam S. S.
Published: May 2010

Objective: To evaluate the long‐term effects of the new reformulated 2‐rod Norplantr̀ implant on haemostasis in a prospective group of subjects who have completed 5 years of use.

Methods: Data from 11 women who have completed 5 years' use of the new reformulated 2‐rod subdermal implant from the original 16 women who were recruited and randomized to receive this new improved implant in a comparative study were analysed. Clinical assessment and serial blood sampling were done prior to insertion of implant and after 1, 3, 12, 18, 24, 36, 48 and 60 months of implant use. Each subject served as its own control and Analysis of Variance with Student‐Newman‐Kuels test was used for statistical analysis. The following parameters were determined: plasminogen activators (t‐PA, u‐PA), plasminogen activator inhibitor‐1 (PAI‐1), D‐dimer, β‐thromboglobulin (β‐TG), thrombin‐antithrombin (TAT)‐complex, fibrinogen, Factor VII, platelets, haematocrit and haemoglobin levels.

Results: No significant change was observed for t‐PA levels in prolonged implant use. u‐PA antigen showed a significant decrease whilst D‐dimer were significantly elevated at only 24 months of implant use compared to pre‐implant level. PAI‐1 levels were not significantly changed but fibrinogen and FVII levels increased at 36 months and 42 months of use with enhanced platelet activation shown by β‐TG levels at 24 months. Platelet numbers were not affected by prolonged implant use. Haemoglobin concentration and haematocrit level showed significant fluctuations and then return to pre‐implant level by 54 and 60 months.

Conclusion: Enhanced fibrinolysis with platelet activation at 24 months of implant use were seen during the 60 months of 2‐rod reformulated Norplantr̀ implant use. Hypercoagu‐lable state was not observed although fibrinogen and FVII levels remain above the pre‐implant levels as coagulation activation was not enhanced. The increased haemoglobin and haematocrit levels seen indicate enhanced bone marrow activity. There was no association between the use of reformulated 2‐rod Norplantr̀ implant over 60 months of use and prothrombotic state.
Choriocarcinoma Co‐Existent with an Intact Pregnancy: Case Report and Review of the Literature
Authors: Steigrad Stephen J. , Cheung Anthony P. , Osborn Robert A.
Published: May 2010

A patient presenting with antepartum haemorrhage due to a vaginal metastasis of choriocarcinoma is reported. Following delivery she was successfully treated with chemotherapy and surgery. This report details this unusual presentation and reviews the literature on this rare condition.
Sonographically Guided Intralesional Antibiotic Injection for Treatment of a Recalcitrant Pelvic Abscess: A Case Report*
Authors: Ou Ming‐Cheh , Ng Heung‐Tat , Tzeng Chii‐Ruey
Published: May 2010

A pelvic abscess occurred in an infertile woman with an endocervical gonococcal infection after hysterosalpingographical examination. The pelvic abscess was not cured despite rigorous antimicrobial chemotherapy until two intra‐abscess ceftriaxone injections were administered. This shows that antibiotics administered systemically may not reach therapeutic concentration in an abscess and an intra‐abscess antibiotic injection may help to cure it.
Efficacy of Selective Venous Sampling to Localize a Small Ovarian Androgen‐Producing Tumor
Authors: Inoue Yoshihito , Kamura Toshiharu , Okuma Akiko , Shigematsu Toshiyuki , Amada Satoshi , Ogata Rika , Koga Miho , Nozaki Masahiro , Nakano Hitoo
Published: May 2010

Two cases of androgen‐producing tumors, including a Sertoli‐Leydig cell tumor in a woman of reproductive age and a Leydig cell tumor in a postmenopausal woman, are reported herein. In both cases, only selective venous sampling was able to detect the presence of the androgen‐producing ovarian tumors.
Remission of Idiopathic Hypoparathyroidism during Lactation: A Case Report
Authors: Anai Takanobu , Tomiyasu Toshiko , Takai Noriyuki , Miyakawa Isao
Published: May 2010

A 35‐year‐old woman with idiopathic hypoparathyroidism achieved a spontaneous remission during lactation even though 1‐α‐hydroxyvitamin D3 therapy was discontinued after delivery. Urinary excretion of cyclic adenosine 3′,5′‐monophosphate and phosphate was significantly increased during lactation, probably in response to the increased levels of circulating parathyroid hormone‐related protein derived from the breast tissue.
A Case of Huge Ovarian Cyst of 21‐Year‐Old Young Woman
Authors: Kim Young Tae , Kim Jae Wook , Choe Byung Hoon
Published: May 2010

Huge ovarian tumors are rarely seen in modern surgical practice. As health care education and access to hospitals have improved over the past 30 years, the number of these reports have become almost negligible. However, these huge ovarian tumors still present many challenge, even life‐threatening risks due to severe cardiovascular, pulmonary, and circulatory problems, including technical difficulties of surgery, massive hemorrhage, and postoperative complications. A knowledge of the deranged physiology and its management may avert these complications. We present the case of a 21‐year‐old woman with huge ovarian tumor. The total weight of the tumor was 136 pounds (62 kg). She was treated surgically with good results.
Uterine Leiomyoma in Pregnancy: Its Influence on Obstetric Performance
Authors: Koike Toshimitsu , Minakami Hisanori , Kosuge Shuichi , Usui Rie , Matsubara Shigeki , Izumi Akio , Sato Ikuo
Published: May 2010

Objective: To assess the effects of uterine leiomyoma on obstetrical performance.

Methods: We reviewed the medical records of 102 women with singleton pregnancies who were found ultrasonographically to have uterine leiomyomas during the first half of their pregnancy and who gave birth at our hospital at ≥ 22 weeks of gestation between January 1990 and December 1997.

Results: The 102 women gave birth to 101 healthy infants, weighing 2,974 + 579 g at 38.8 + 2.6 weeks of pregnancy. One woman experienced an unexplained antepartum fetal death at 24 weeks of gestation. Bleeding at the first trimester occurred in 16% of the women. Pain localized in the lower abdomen and requiring relief occurred in 28% of the women during the first or second trimester. Tocolytic treatment was required in 25% of the pregnancies, and preterm delivery occurred in 12% thereof. A cesarean section was performed in 39% of the pregnancies. Bleeding ≥ 500 ml occurred at delivery in 48% of the cases. The largest fibroid, > 6 cm in diameter, which was seen in 51 women, was associated with higher frequencies of tocolytic treatment (41%), preterm delivery (24%), bleeding ≥ 500 ml at delivery (59%), and cesarean delivery (51%). In 76 women (75%) who attempted vaginal delivery, the obstetrical outcome was comparable to that of 115 control women who were matched regarding age, parity, and gestational week.

Conclusions: Although pain in the lower abdomen, the requirement of tocolytic treatment, preterm delivery, and cesarean delivery were common, the neonatal outcome was fairly good in women with uterine leiomyomas. The present data might be encouraging to pregnant women with uterine leiomyomas.
Prenatal Diagnosis of Meckel Syndrome: A Case Report
Authors: Tongsong Theera , Piyamongkol Wirawit , Pongsatha Saipin
Published: May 2010

Objective: To demonstrate the major sonographic findings associated with Meckel syndrome and to emphasize the importance of prenatal sonography in helping to establish the correct diagnosis.

Subjects: Two fetuses with prenatal diagnosis of Meckel syndrome were sonographically evaluated.

Results: Both fetuses were demonstrated to have evidence of renal cystic dysplasia, occipital cephalocele and postaxial polydactyly. One case was diagnosed at 16 weeks of gestation whereas the other was detected at 36 weeks. Of interest, the first case had only unilateral renal cystic dysplasia and contralateral renal agenesis and mild degree of oligohydramnios. The other related anomalies which were not detected prenatally included cerebellar hypoplasia in case 1 and micrognathia in case 2.

Conclusion: The main sonographic findings included renal cystic dysplasia, occipital cephalocele and postaxial polydactyly.
Microsatellite Instability and hMSH2 Gene Mutation in a Triple Cancer (Colon Cancer, Endometrial Cancer, Ovarian Cancer) Patient in Hereditary Non‐Polyposis Colorectal Cancer (HNPCC) Kindred
Authors: Shigemasa Kazushi , Yokozaki Hiroshi , Honda Nao , Sakata Kenichirou , Oshita Takafumi , Nagai Nobutaka , Ohama Koso
Published: May 2010

A patient who had triple cancer (colon cancer, endometrial cancer, and ovarian cancer) in HNPCC kindred is reported. Her family history revealed the occurrence of colon cancer in her paternal aunt and in two cousins, fulfilling the minimum HNPCC criteria. Microsatellite instability analysis revealed replication error (RER)' in all cancer lesions at 2 microsatellite loci (D1S191, BAT 40). SSCP analysis suggested germline mutation in exon 2 of the hMSH2 gene. This case showed the importance of complete family‐history investigations to identify HNPCC patients. In the near future, definitive diagnosis of HNPCC will be possible on the basis of DNA studies.
Effect of Labour and Delivery on Plasma Hepatic Enzymes in the Newborn
Authors: Mongelli Max , Kwan Yiu , Kay Law Lap , Hjelm Magnus , Rogers M. S.
Published: May 2010

Objective: To study the relationship between cord blood hepatic enzymes and obstetric and neonatal outcome in a Chinese population.

Materials and Methods: The study group consisted of 288 low‐risk Chinese women with singleton term pregnancies. The following enzymes were assayed in cord blood: lactate dehydrogenase (LDH), glutamyl transferase (GGT), aspartate aminotransferase (AST) and alanine transferase (ALT). These were correlated to maternal and neonatal characteristics.

Results: A strong correlation was noted between cord blood AST and LDH (R = 0.582, p < 0.01), which was absent amongst those infants delivered by elective cesarean section. LDH, AST and ALT were negatively correlated with cord arterial pH and base excess (BE). GGT was inversely related only to gestational age (R = ‐ 0.18, p < 0.01). Both LDH and AST were weakly correlated with the duration of the first and second stages of labour. LDH was most closely linked to arterial pH, whereas AST was related to both arterial BE and duration of the second stage.

Conclusions: The reference values are comparable to those published for Caucasian populations. There are moderate elevations in LDH and AST associated with the onset of labour and changes in acid‐base status.
The Fimbrio‐Ovarian Relation and Its Role on Ovum Picking in Unexplained Infertility: The Fimbrio‐Ovarian Accessibility Tests*
Authors: Ahmad‐Thabet Saeed Mohamad
Published: May 2010

Objective: To study the ovum pickup mechanism and the fimbrio‐ovarian relation in fertile women and cases of unexplained infertility and to design a method for investigation and anticipation of the state of ovum pickup.

Design: Prospective clinical study.

Setting: Department of obstetrics and gynecology Kasr El Aini Hospital, Cairo University, Egypt.

Patients: Fifty fertile and 25 cases of unexplained infertility.

Interventions: In all of cases the fimbrio‐ovarian relation is studied by determining the length of the free ovarian border between the ovarian ligament and the fimbria ovarica that contains the corpus luteum (the ovulation border), the site of ovulation on that border and the length of the fimbria ovarica. It is also determined by a simple test “The fimbrio‐ovarian accessibility test.” The fimbriae are held by non‐traumatizing grasper and their ability to reach and/or to cover the ovulation site are taken as a prove for successful ovum pickup.

In addition, cases having suspected failed ovum picking are treated by controlled supero‐vulation, also by drilling of the ovary at an accessible site to the fimbria ovarica and by freeing short fimbria ovarica with or without its advancement on the ovulation border.

Results: The ovulation site is found to be usually accessible to the fimbrial end of the tube (94%) in the fertile cases and not accessible (92%) in the infertile cases. Correction of the fimbrio‐ovarian relation in the infertile cases was associated with a cumulative ongoing pregnancy rate of 68%.

Conclusion: Failed ovum pickup should be considered one of the important causes of unexplained infertility. The suggested “fimbrio‐ovarian accessiblity” test may be useful for the elucidation of the state of ovum pickup in infertile cases. Correction of the fimbrio‐ovarian relation, to make ovum pickup possible, should be considered a method for treating such cases.
Bartter's Syndrome in Pregnancy: A Case Report and Review
Authors: Li Ivy C. F. , To William W. K.
Published: May 2010

Bartter's syndrome is a rare renal tubular disorder, involving juxtaglomerular cells hyperplasia, characterized by normotensive hyper‐reninism and secondary hyperaldosteronism, marked renal loss of potassium and profound hypokalaemia. Both clinical and biochemical features are heterogeneous, ranging from the incidental finding in an asymptomatic patient to marked clinical features of hypokalaemia. Inheritance is likely to be an autosomal recessive. We present a case of Bartter's syndrome complicating pregnancy in a Chinese woman. We documented an increasing demand for potassium supplement during pregnancy which stabilized by mid‐trimester. The absence of pregnancy complications such as polyhydramnios indicated that the fetus was unlikely to be affected by the condition.
Relationship between Endometrial Estrogen and Progesterone Receptors, and Sonographic Endometrial Appearance in the Preovulatory Phase
Authors: Kim Chung‐Hoon , Chae Hee‐Dong , Huh Jooryung , Kang Byung‐Moon , Chang Yoon Seok , Nam Joo‐Hyun
Published: May 2010

Objectives: The purpose of the present study is to evaluate the relationship between endometrial concentrations of estrogen receptor (ER) and progesterone receptor (PR), and sonographic endometrial findings in the preovulatory phase of menstrual cycle.

Study Design: In 45 cycles of 45 infertile women with tubal factor only, transvaginal sonographic assessments and biopsy for immunohistochemical staining of the endometrium were made in the preovulatory phase of unstimulated, normal menstrual cycle. Immunohistochemical localization of ER and PR was scored according to intensity of staining and proportion of cells specifically stained in glandular epithelium and stroma, and the results were analysed according to the sonographic endometrial thickness (< 6 mm, 6–10 mm, or > 10 mm) and patterns. Endometrial patterns were classified as A, centrally hyperechogenic triple‐line pattern or non‐A, not triple‐line.

Results: There were no significant differences in the endometrial thickness, serum estradiol level and serum progesterone level between A and non‐A groups. The receptor scores of epithelial and stromal ER and epithelial PR were comparable in A and non‐A groups. However, the receptor score of stromal PR was significantly higher in A group, with 4.8 ± 1.4 compared with 2.7 + 1.7 in non‐A group (p < 0.001). There were no differences in the receptor scores of epithelial ER, epithelial PR, stromal ER and stromal PR among the 3 groups according to the endometrial thickness.

Conclusions: This study suggests that high PR expression in endometrial stroma could be related to the sonographic triple‐line or multilayered pattern of endometrium in the preovulatory period.
A Survey of the Current Practice of Obstetric Anaesthesia and Analgesia in Malaysis
Authors: Chan Y. K. , Ng K. P.
Published: May 2010

Objective: A survey covering 30% of the deliveries in Malaysia was done to determine the practice of obstetric anaesthesia and analgesia for 1996.

Results: From the survey, it was found that the regional anaesthesia rate for caesarean section was 46% in the government hospitals compared to 29.2% in the private hospitals, with spinal anaesthesia being the most common regional anaesthetic technique used in both types of hospitals. The epidural rate for labour analgesia was only 1.5% overall for the country. Epidural analgesia services were available in all private hospitals whereas 17.6% of government hospitals surveyed did not offer this service at all.

Conclusions: Although the use of epidural analgesia for labour was low in Malaysia, the overall rate of regional anaesthesia for caesarean section (41.9%) is very much in keeping with the standards of safe practice recommended by the United Kingdom.
Heavy‐for‐Date Infants: Their Backgrounds and Relationship with Gestational Diabetes
Authors: Hiramatsu Yuji , Masuyama Hisashi , Mizutani Yasushi , Kudo Takafumi , Oguni Nobutugu , Oguni Yoshitane
Published: May 2010

Objective: Gestational diabetes (GDM) is closely related to birth weight. Heavy‐for‐date (HFD) infants, especially those with macrosomia, cause many perinatal complications. This study was performed to examine the backgrounds of HFD infants and to determine such infants' relationship with GDM.

Method: Eighty cases of HFD infants who were delivered from 1996 through 1998 were analyzed. The random blood‐glucose level was used for screening for GDM.

Results: Maternal body weight and the body‐mass index before pregnancy and at delivery and the blood glucose level at the second trimester were positively correlated with birth weight. However, only 8.8% of HFD cases were detected by this screening method in the first trimester, and 11.3% of HFD cases were detected in the second trimester and only 1 case of borderline‐type was detected by subsequent 75‐g OGTT.

Conclusions: Maternal obesity is an independent and more important risk factor for HFD infants than glucose intolerance.
Adverse Pregnancy Outcome Following Post‐Chorionic Villus Sampling Amniocentesis Compared to Chorionic Villus Sampling
Authors: Kim Sei K. , Cho Dong J. , Kim Jae W. , Chung Jae E. , Yang Young H.
Published: May 2010

Objective: To assess the adverse pregnancy outcome of post‐chorionic villus sampling (CVS) amniocentesis and chorionic villus sampling.

Methods: Adverse pregnancy outcomes of 32 post‐CVS amniocentesis cases and 264 CVS only cases were compared. The base‐line characteristics were comparable in the 2 groups.

Results: One (3.1%) chromosomal abnormality was detected in the post‐CVS amniocentesis group, compared to 5 (1.8%) in the CVS only group (p > 0.05). The fetal loss rate (spontaneous abortions and stillbirths) among continuing pregnancies was 3.2% in the post‐CVS amniocentesis group and 3.5% in the CVS only group (p > 0.05). No statistically significant difference was found in the incidence of neonatal death, preterm delivery, fetal growth restriction, or congenital anomalies between the 2 groups.

Conclusion: Adverse pregnancy outcome occurred at a similar frequency in the post‐CVS amniocentesis group as in the CVS only group. Therefore, a subsequent amniocentesis after CVS can be considered as a safe procedure that does not introduce any additional adverse pregnancy outcome compared to that of CVS only.