bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moyamoya‐disease‐related ischemic stroke in the postpartum period
Authors: Miyakoshi Kei , Matsuoka Misugi , Yasutomi Daisuke , Tanaka Mamoru , Yakubo Kazumi , Fukuiya Tatsuro , Yoshimura Yasunori 
Published: October 2009

AbstractStroke during pregnancy or the puerperium is an extremely rare yet serious cause of perinatal morbidity and mortality. Moyamoya disease, a cerebrovascular occlusive pathology with a female predominance, may become symptomatic for the first time in association with pregnancy. A 36‐year‐old woman with postpartum pre‐eclampsia suddenly developed hemiparesis in the left arm with dysarthria after the initiation of antihypertensive measures. Cranial magnetic resonance imaging and angiography revealed acute ischemic lesions in the right hemisphere along with the steno‐occlusive lesions of bilateral terminal portions of the internal carotid artery, indicating Moyamoya disease. With anti‐platelet medication, the patient recovered gradually and was diagnosed as having Moyamoya disease using conventional angiography 3 months postpartum. In this case, the fluctuations in blood pressure in association with pre‐eclampsia appear to have exacerbated the clinical symptoms of Moyamoya disease. As such, Moyamoya disease should be considered as an underlying disease of ischemic stroke associated with pregnancy.
A survey of the knowledge and attitudes of pregnant Thai women towards Down syndrome screening
Authors: Pruksanusak Ninlapa , Suwanrath Chitkasaem , Kor‐anantakul Ounjai , Prasartwanakit Visit , Leetanaporn Roengsak , Suntharasaj Thitima , Hanprasertpong Tharangrut 
Published: October 2009

AbstractAim:  To determine the knowledge and attitudes of pregnant Thai women towards Down syndrome screening.Methods:  A total of 714 pregnant women were recruited attending antenatal clinics in Songklanagarind Hospital from February through June 2007. Their knowledge and attitudes concerning Down syndrome screening were evaluated through self‐administered questionnaires. The data were analyzed using SPSS version 12.0.Results:  The mean age of the respondents was 29.9 ± 6.4 years. Regarding their knowledge of Down syndrome and its screening test, the mean scores were 43.6% and 20.6%, respectively. Most pregnant women (77.6%) had a positive attitude to Down syndrome screening. In addition, 92.2% of cases would accept a Down syndrome screening test. Multivariate logistic regression analysis showed that levels of education and types of health insurance were factors associated with knowledge of Down syndrome screening. Maternal age was the only factor affecting attitudes.Conclusion:  Most pregnant women had inadequate knowledge of Down syndrome and the screening test. However, they did have a positive attitude and were willing to accept the test. Providing knowledge on Down syndrome and the screening test for pregnant women should be implemented in our antenatal care services and community.
Maternal plasma soluble fms‐like tyrosine kinase‐1 and placental growth factor levels as biochemical markers of gestational hypertension for Malaysian mothers
Authors: Nadarajah Vishna D. , Min Richard G. L. Y. , Judson John P. , Jegasothy Ravindran , Ling Elena H. P. 
Published: October 2009

AbstractAims:  To establish baseline levels of maternal plasma soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) among normotensive Malaysian mothers and to compare the marker levels between normotensives and mothers with gestational hypertension (GH).Methods:  Plasma sFlt‐1 and PlGF were measured by enzyme‐linked immunosorbent assay in an unmatched, case–control study. The results were subjected to normality testing and analyzed by Mann–Whitney U‐tests.Results:  Among normotensive mothers, both sFlt‐1and PlGF showed a general increase in levels from the 24th to 32nd weeks of pregnancy. PlGF levels in normotensive mothers with gestational diabetes mellitus were reduced compared to those without the disease, while levels of sFlt‐1 were elevated. Mothers with GH had reduced levels of PlGF with increased levels of sFlt‐1 when compared to normotensive mothers. Among the normotensive mothers followed up until delivery, the inversed pattern of reduced PlGF and increased sFlt‐1 marker levels was found in 40% of those who developed GH later in pregnancy.Conclusions:  Plasma levels of sFlt‐1and PlGF in normotensive mothers may be influenced by gestational diabetes mellitus and GH. GH mothers show an inversed pattern of marker levels compared to normotensive mothers.
Two cases of reversal of twin‐twin transfusion syndrome diagnosed by measuring hourly fetal urine production
Authors: Sumie Masahiro , Nakata Masahiko , Murata Susumu , Miwa Ichiro , Sugino Norihiro 
Published: October 2009

AbstractReversal of twin‐twin transfusion syndrome (TTTS) is a rare complication of monochorionic pregnancy. Diagnostic criteria and satisfactory therapeutic options have not been reported. We make a suggestion of diagnosis and therapy for reversal of TTTS. We report two cases of reversal of TTTS. Measurement of the fetal urine production rate was useful for management and better comprehension of the cases. In case 1, double intrauterine fetal demise occurred before the criteria for TTTS were fulfilled, in which each fetal urine production rate reversed prior to the change of amniotic fluid volume. In case 2, elevated urine production was noted prior to progressive polyhydroamnios and congestive heart failure in the new recipient and the fetoscopic laser photocoagulation of the placental communicating vessels was performed successfully before the criteria for TTTS were fulfilled. Both infants required intensive care, but developed normally and showed no neurologic complications at 2 years after birth. Hourly fetal urine production rate was useful for immediate diagnosis of reversal of TTTS, and laser photocoagulation of the placental communicating vessels is thus a method for the correction of the fetal blood flow imbalance in cases of reversal of the donor‐recipient phenotype in TTTS.
Oral hydration therapy in oligohydramnios
Authors: Ghafarnejad Marzieh , Tehrani Mehrnaz Barzi , Anaraki Fatemeh Baradaran , Mood Narges Izadi , Nasehi Leyla 
Published: October 2009

AbstractAim:  Oligohydramnios is a threatening condition to fetal health, for which some treatments are available, or are under evaluation. We aimed to assess the effect of acute oral hydration on maternal amniotic fluid index (AFI).Methods:  An randomized controlled trial was conducted on 44 pregnant women diagnosed by sonography to have oligohydramnios (2.1 < AFI < 6 cm).Results:  The mean AFI before intervention was 50.8 in the intervention group and 52.1 in the control group. After intervention, the mean AFI was 67.2 and 52.5 in the intervention and control groups, respectively, (P < 0.001, t‐test = 3.827). The mean urinary specific gravity (USG) change was 13.4 after oral hydration in the intervention group and 1.68 in the control group (P < 0.001, t‐test = 3.954).Conclusion:  Acute oral hydration is a noninvasive, easily accessible and cheap intervention, and an effective way of increasing AFI.
Luteoma‐induced fetal virilization
Authors: Ugaki Hiromi , Enomoto Takayuki , Tokugawa Yoshihiro , Kimura Tadashi 
Published: October 2009

AbstractA pregnancy luteoma represents an unusual response of ovarian stromal cells to the altered hormonal levels of pregnancy. It is a distinctive non‐neoplastic lesion characterized by solid proliferations of luteinized cells resulting in a tumor‐like ovarian enlargement. Most patients are asymptomatic; the ovarian enlargement is usually discovered incidentally at cesarean section or during postpartum tubal ligation. We report a typical case that we found at cesarean section to be associated with a virilized infant who manifested clitoromegaly and labial fusion. We detected an increased level of testosterone in the maternal patient. We concluded that the ovarian luteoma induced the fetal virilization.
Effect of human chorionic gonadotrophin on in vitro contractions of stimulated detrusor muscle strips of female rats
Authors: Rizk Diaa E. E. , Osman Nawal A. , Shafiullah Mohammed M. , Nagelkerke Nicolaas J. D. , Fahim Mohammed A. 
Published: October 2009

AbstractAims:  We studied the effect of human chorionic gonadotrophin (hCG) on the in vitro detrusor muscle contractions in female rats.Methods:  Two adjacent detrusor muscle strips from the bladder dome of 18 female Wistar rats (230–250 gm) were mounted in an organ bath for the recording of isometric tension. Carbachol (10−9–10−3 M), α,β methylene adenosine 5′‐triphosphate (ATP) (10−9–10−3 M) and potassium chloride (KCl) (10−4–10−3 M) were applied (n = 6 × 3 groups). Concentration‐response curves, before and after the addition of hCG (100 iu/mL) or oxybutynin (10−5 M) to either muscle strip, were compared.Results:  All curves were displaced to the right by hCG in a concentration‐dependent manner with significant inhibition of contractions induced by carbachol (P < 0.001) and KCl (P = 0.016) but not those induced by α,β‐methylene ATP (P = 0.4). Estimated order of potency of inhibition was carbachol>KCl>α,β‐methylene ATP. The overall inhibitory effect of hCG was significantly less than oxybutynin (P < 0.001).Conclusions:  hCG significantly inhibited in vitro detrusor contractions induced by depolarization (KCl) and cholinergic (carbachol) but not purinergic (α,β‐methylene ATP) stimulation in a dose‐dependent manner in female rats.
Relevance of declines in serum human chorionic gonadotropin levels to the management of persistent ectopic pregnancy
Authors: Abe Takashi , Akira Shigeo , Negishi Yasuyuki , Ichikawa Masao , Nakai Akihito , Takeshita Toshiyuki 
Published: October 2009

AbstractAim:  To evaluate postoperative declines in serum human chorionic gonadotropin (hCG) levels (percentages of preoperative hCG levels) to rule out persistent ectopic pregnancy (PEP).Methods:  A retrospective study was conducted on 50 patients who underwent laparoscopic salpingotomy between April 1995 and March 2008. The postoperative course was divided into four periods: (period A: days 1–2; period B: days 3–4; period C: days 5–6; and period D: days 7–8), and the postoperative serum hCG declines in the PEP and control groups (successfully treated patients) were compared. A cutoff value of serum hCG decline to rule out PEP was established by receiver operating characteristic (ROC) analysis.Results:  Ten of the 50 patients (20%) were diagnosed with PEP. There were no differences in clinical findings or preoperative serum hCG levels between the two groups. From period C, the serum hCG decline in the control group was significantly greater than in the PEP group, and all individual serum hCG declines in the PEP group were outside the 95% confidence interval of the control group. Furthermore, analysis by ROC using a 14% decline in postoperative serum hCG as a cutoff revealed that the specificity and sensitivity of the test were equal to 100% from period C.Conclusion:  Declines in serum hCG during period C (days 5–6) constitute an important marker of the presence or absence of PEP. Decisions regarding a second intervention for PEP should be made by this time postoperatively.
The prevalence of hereditary breast/ovarian cancer risk in patients with a history of breast or ovarian cancer in Japanese subjects
Authors: Komata Dai , Yahata Tetsuro , Kodama Shoji , Koyama Yu , Takeda Nobuo , Tajima Kenzo , Makino Haruhiko , Sato Nobuaki , Muto Ichiro , Hatakeyama Katsuyoshi , Tanaka Kenichi 
Published: October 2009

AbstractAim:  Women at high risk for hereditary breast/ovarian cancer require specific management strategies for cancer prevention and early detection. The authors sought to determine the prevalence of family histories suggestive of a hereditary breast/ovarian cancer syndrome in patients with a personal history of breast or ovarian cancer in Japanese women.Methods:  Family history (first‐ and second‐degree relatives) data were collected by a self‐administered questionnaire for women with a history of breast or ovarian cancer in six major cancer treating hospitals in Niigata prefecture, Japan.Results:  Data were obtained from 1463 women: 626 women with a history of breast cancer, 289 women with a history of ovarian cancer and 548 women without a history of any cancer as controls. Women with a family history of breast and/or ovarian cancer had OR of breast cancer of 2.3 (95% confidential interval [CI] 1.5–3.7) and ovarian cancer of 2.2 (95% CI 1.3–3.8). The risk was higher when the proband was younger or when two or more relatives were affected. Among women with a history of breast or ovarian cancer, 7.5% met the criteria for a 10% risk of a BRCA1 or BRCA2 mutation according to the Myriad model.Conclusion:  Obtaining a detailed breast and ovarian cancer family history and the application of the Myriad model is useful for identifying women at an elevated genetic risk of breast and ovarian cancer. The estimation for the prevalence of hereditary breast/ovarian cancer syndrome has significant implications for a patient's management, as well as for the capacity for risk assessment and testing.
Reduced‐dose rocuronium for day‐case tonsillectomy in children where volatile anaesthetics are not used: operating room time saving
Authors: BARTOLEK DUBRAVKA , JAKOBOVIĆ JASMINKA , BARTOLEK FRANJO , FINCI DIJANA , MUNJIZA ALEKSANDRA 
Published: October 2009

SummaryObjectives:  Mivacurium, rocuronium, and vecuronium are neuromuscular blocking agents (NMB) commonly used in pediatric day‐case anesthesia. Mivacurium is the most appropriate NMB for short surgical procedures where NMB drugs were required but is not available in all countries.Aim:  We evaluated the operating room time minimization after reduced‐dose rocuronium (0.45 mg·kg−1) during elective day‐case tonsillectomy in children.Methods/Materials:  One hundred and five children (6–9 years, ASA I/II status) scheduled for day‐case tonsillectomy were included in prospective, double blind clinical study. Children were randomly divided in three equal groups. All children were premedicated (midazolam 0.25 mg·kg−1 orally, EMLA). Anesthesia was induced (2.5 mg·kg−1) and maintained (0.1 mg·kg−1·min−2) by propofol and alfentanil (0.0015 mg·kg−1·min−1) and supplemented by inhalation mixture of 50% of O2/Air. Neuromuscular block was achieved by vecuronium (0.1 mg·kg−1) (V) or rocuronium in standard (0.6 mg·kg−1) (R) or reduced dose (0.45 mg·kg−1) (LD). Neuromuscular transmission was monitored by acceleromyography. Time analysis of NMB drugs action was performed.Results:  Time difference from the end of tonsillectomy to T90 neuromuscular block recovery was significantly shorter in LD Group (7.3 ± 0.41 min), (V = 15.9 ± 1.06, R = 16.0 ± 1.7 min) (P = 0.0011). The onset time of neuromuscular block was prolonged in LD Group (LD=3.1 ± 0.4, R = 1.3 ± 0.4, V = 2.2 ± 0.2 min) (P = 0.0039) without changing the intubating conditions. The maximum operation room time saving per each tonsillectomy was 37% in LD Group (Group V 21%, Group R 17%) (P = 0.0001). Low incidence of postoperative nausea and vomiting (PONV) 3–6% (0.4577) and good visual analog scale (VAS) score (≤2) (0.5969) were found in all study groups 12 h after surgery.Conclusions:  Reduced‐dose rocuronium in addition with propofol and alfentanil in children where volatile anesthetics are not used effectively saves the operating room time during short elective surgical procedures, avoids delays in patient recovery, allows high level of acceptable intubating conditions, and improves the optimal surgical work. Low incidences of PONV as VAS score may achieved successfully.
The comparative prevalence and demographic impact of two pathogens in swarming Ips typographus adults: a quantitative analysis of long term trapping data
Authors: Wegensteiner Rudolf , Dedryver Charles‐Antoine , Pierre Jean‐Sébastien 
Published: October 2009

Adult Ips typographus were collected using pheromone traps at a locality in the eastern part of Austria between 1995 and 2004. The occurrence of two pathogens, Gregarina typographi and Chytridiopsis typographi, was determined throughout the period of beetle swarming activities. Weekly and annual data sets were then analysed by smoothing statistical techniques and epidemiological models.
The pathogens spread differently within the beetle population with respect to their biological characteristics: infectious forms of C. typographi were immediately available after their development in the insect's gut, but not those of G. typographi.
Both of the pathogens had a low prevalence in swarming beetles, especially C. typographi, and there was no evidence of a between‐year or within‐year epidemiological process. Conversely, it was shown that G. typographi has a positive effect on the rate of increase of trapped beetles.
Fitting a nonlinear model to the data suggested that: (i) this was due to a higher catch ability of beetles infected with G. typographi than of healthy beetles; (ii) when this effect is taken into account, G. typographi induces a specific within‐year low mortality in beetle populations; and (iii) beetle populations increase naturally within a year, despite their infection by both pathogens. No clear effect of C. typographi was detected in the trapped data set when the prevalence of this species was high in beetle populations collected from trees.
It is hypothesized that both pathogens induce different behavioural effects on their host, resulting in: (i) favouring the trapping of G. typographi‐infected beetles and (ii) hindering the capture of C. typographi‐infected individuals. This could be the result of both of the pathogens having an opposite effect on the flight abilities of beetles and/or on the beetles' response to the aggregation pheromones used in the traps.
−509C>T polymorphism in the TGF‐β1 gene promoter is not associated with susceptibility to and progression of colorectal cancer in Chinese
Authors: Qi P. , Ruan C.‐P. , Wang H. , Zhou F.‐G. , Zhao Y.‐P. , Gu X. , Gao C.‐F. 
Published: October 2009

AbstractAim  Colorectal cancer is common, accounting for nearly 10% of all cancers. Transforming growth factor‐β1 (TGF‐β1) is a pleiotropic cytokine that has been implicated in the pathogenesis of colorectal neoplasia. The most studied −509C>T polymorphism of TGF‐β1 gene has been associated with various kinds of cancer. This study investigated the association between this genetic variant and the risk and/or progression of colorectal cancer.Method  A case–control study was carried out of 150 colorectal cancer cases and 503 healthy controls. DNA was extracted from blood cell nuclear materials, and −509C>T polymorphism in the TGF‐β1 gene promoter was genotyped by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Colorectal cancer tissues (n = 70) were obtained from the studied cases for measurement of TGF‐β1 mRNA expression levels. We also assessed the plasma TGF‐β1 levels of cases (n = 88) and healthy subjects (n = 120).Results  The TGF‐β1 producer genotype, −509TT, was not associated with an increased risk of colorectal cancer compared with other genotypes. Colorectal cancer patients especially those with a more aggressive disease behaviour were more frequently associated with C allele.Conclusion  The results suggest that TGF‐β1 −509C>T polymorphism is not associated with either an increased risk or progression of colorectal cancer.
Association between interleukin‐4R and TGF‐β1 gene polymorphisms and the risk of colorectal cancer in a Korean population
Authors: Lee Y. S. , Choi H. B. , Lee I. K. , Kim T. G. , Oh S. T. 
Published: October 2009

AbstractAim  Colorectal cancer is associated with inflammatory bowel disease. The mechanisms of how different genetic make‐ups of cytokines might influence the individual susceptibility to develop particular types of tumours are still unknown. The authors analysed the association between genetic polymorphisms in cytokine/cytokine receptor genes and the risk of colorectal cancer in a Korean population.Method  The authors assessed polymorphisms of the interleukin: IL‐1, IL‐1R, IL‐2, IL‐4, IL‐4R, IL‐10, transforming growth factor (TGF)‐β1, IFN‐γ genes in Korean patients with colorectal cancer (n = 170) and in a normal healthy control group (n = 130) to investigate the association between theses cytokine gene polymorphisms and the risk of colorectal cancer.Results  The IL‐4R 1902*T allele was found to be associated with an increased risk of colon cancer (P < 0.01, OR = 2.0) and rectal cancer (P < 0.05, OR = 1.8). The IL‐4R 1902*C allele was associated with a decreased risk of both colon cancer (P < 0.01, OR = 0.51) and rectal cancer (P < 0.05, OR = 0.5). The TFG‐β1 10*T allele was found to be associated with an increased risk of colon cancer (P < 0.00, OR = 2.3) and the TFG‐β1 10*C allele with a decreased risk of colon cancer (P < 0.00, OR = 0.43).Conclusion  These results suggest that the genetic polymorphisms of IL‐4R and TGF‐β1 are associated with the risk of colorectal cancer in a Korean population.
Hygiene and urinary tract infections after cystectomy in 452 Swedish survivors of bladder cancer
Authors: Thulin Helena , Steineck Gunnar , Kreicbergs Ulrika , Onelöv Erik , Ahlstrand Christer , Carringer Malcolm , Holmäng Sten , Ljungberg Börje , Malmström Per‐Uno , Robinsson David , Wijkström Hans , Wiklund N. Peter , Henningsohn Lars 
Published: October 2009

Study Type – Symptom prevalence (retrospective cohort) Level of Evidence 2bOBJECTIVESTo determine whether or not an improved hygiene can lessen the incidence of symptomatic urinary tract infections (UTIs) in patients treated by cystectomy for urinary bladder cancer.PATIENTS AND METHODSWe attempted to contact during their follow‐up all men and women aged 30–80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified hygienic measures and included them in a study‐specific questionnaire. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results presented as relative risks (RR) with 95% confidence interval.RESULTSWe received the questionnaire from 452 (92%) of 491 identified patients. The proportion of patients who had a symptomatic UTI in the previous year was 22% for orthotopic neobladder and cutaneous continent reservoir, and 23% for non‐continent urostomy diversion. The RR for a UTI was 1.1 (0.5–2.5) for ‘never washing hands’ before handling with catheters or ostomy material. Patients with diabetes mellitus had a RR of 2.1 (1.4–3.2) for having a symptomatic UTI.CONCLUSIONSWe could not confirm lack of hygiene measures as a cause of UTI for men and women who had a cystectomy with urinary diversion. Patients with diabetes mellitus have a greater risk of contracting a UTI.