bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric liver transplantation: A 10 year experience in Taiwan
Authors: CHEN CHAO‐LONG , CHEN YAW‐SEN , CHIANG YUAN‐CHENG , CHENG YU‐FAN , HUANG TUNG‐LIANG , ENG HOCK‐LIEW 
Published: August 2009

AbstractBetween March 1984 and August 1994, 13 orthotopic liver transplantations were performed in 13 patients ≦ 25 years of age. The indications included Wilson's disease (n= 7), biliary atresia (n= 4), choledochal cyst (n=1) and hepatitis C cirrhosis (n=1). Technical variants included full‐size (n=11), reduced‐size (n=1) and living‐related (n=1) liver transplantation. These recent technical innovations have offered an expanded donor pool for earlier transplantation, shorter waiting times and excellent quality grafts. Surgical complications occurred in six patients; all required additional surgery. Biliary complications were encountered more commonly in our earlier patients. Our actuarial patient and graft survival rate is 92% at 2 years. The long‐term follow‐up of our liver‐transplanted Wilson's disease patients provides confirmatory evidence that orthotopic liver transplantation cures the underlying metabolic defect with complete normalization of biochemical abnormalities of copper metabolism, reversal of neurological impairments and the disappearance of Kayser‐Fleischer corneal rings. The high rate of patient survival and excellent rehabilitation indicate that with prudent clinical judgement, liver transplantation can be achieved with an acceptable rate of morbidity, mortality and cost in a setting where manpower and donor organs are very limited.
Pre‐ and postoperative nutritional care in liver transplantation in children
Authors: SHEPHERD ROSS W. 
Published: August 2009

AbstractOrthotopic liver transplantation (OLT) is now a definitive treatment option for most cases of endstage liver disease (ESLD) in children. Efforts now focus on active supportive treatment to maintain, if not improve, the patient's clinical status before OLT and to ensure normal patterns of growth and development after OLT. Malnutrition adversely affects the outcome of OLT and is probably the single area in pre‐operative management where the largest potential improvement can be made. Our studies indicate significant abnormalities of protein energy metabolism and body composition in children referred for OLT. We have shown that the use of enteral formulae, enriched with branched‐chain amino acids, have significant advantages. Other adjunctive therapy, such as growth hormone, is the subject of current investigation. Following transplantation, catch‐up weight and growth does occur with the advent of normal liver functioning, but patients at continuing risk for undernutrition, such as those with rejection and/or chronic infection, need to be targeted for specific nutritional therapy.
Hypovolemic shock due to massive edema of a pedunculated uterine myoma after delivery
Authors: Koide Keiko , Sekizawa Akihiko , Nakamura Masamitsu , Matsuoka Ryu , Okai Takashi 
Published: August 2009

AbstractAlthough most patients with uterine myomas are asymptomatic during pregnancy, profound enlargement of a pedunculated myoma has serious consequences. In the present case, gradual enlargement of a pedunculated myoma was observed throughout a woman's pregnancy, worsening after delivery and causing hypovolemic shock, without evidence of external or intra‐abdominal hemorrhage. Laparotomy revealed a severely edematous myoma containing a large amount of blood. It is speculated that partial occlusion had obstructed venous return, but not arterial blood flow, which caused rapid enlargement of the myoma.
High‐risk human papillomavirus testing for monitoring patients treated for high‐grade cervical intraepithelial neoplasia
Authors: Jeong Nan Hee , Lee Nak Woo , Kim Hai Joong , Kim Tak , Lee Kyu Wan 
Published: August 2009

AbstractAim:  The aim of the present study was to examine the accuracy of high‐risk human papillomavirus (HR‐HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high‐grade CIN.Methods:  Ninety‐five women treated by conization and loop electrosurgical excision procedure (LEEP) for high‐grade CIN were followed‐up with HR‐HPV DNA testing (Hybrid Capture II test, Digene Diagnostics, Gaithersburg, MD, USA) and cytology at 3, 6, 12, 18 and 24 months after treatment. The outcome of our study was to detect the presence of CIN using colposcopy‐directed biopsy within 24 months after treatment.Results:  Women with recurrent or residual disease did not differ from women who were cured within clinicopathologic parameters at treatment. Pre‐treatment HR‐HPV testing was positive in all cases. In the recurrent pre‐treatment group HR‐HPV loads were significantly higher than in the group with no recurrence (1065.5 ± 852.3 vs 527.7 ± 669.6, P = 0.003). Residual or recurrent disease was identified in 17 patients (17.9%) during a 24‐month period. A Pap smear significantly predicted disease recurrence at the first follow‐up visit only. At the 6‐month visit, HR‐HPV testing showed 100% sensitivity and negative predictive value (NPV). When both a Pap smear and a HR‐HPV test were used together, 82% sensitivity, 76% specificity and 95% NPV was noted. Performance of resection margins (odds ratio (OR) 9.8; 95% confidence interval (CI), 3.0–32.7) and post‐treatment HR‐HPV load >100 RLU (OR 9.3; 95% CI, 2.2–38.2) were also significant.Conclusion:  HR‐HPV testing in conjunction with Pap smear offers clear advantages over single cytology when monitoring women treated for high‐grade CIN.
McGill Pain Questionnaire: A multi‐dimensional verbal scale assessing postoperative changes in pain symptoms associated with severe endometriosis
Authors: Fabbri Elena , Villa Gioia , Mabrouk Mohamed , Guerrini Manuela , Montanari Giulia , Paradisi Roberto , Venturoli Stefano , Seracchioli Renato 
Published: August 2009

AbstractBackground:  Objective evaluation of pelvic pain symptoms using a standard pain questionnaire is essential to assessing the treatment of endometriosis and related pain.Aim:  To evaluate the McGill Pain Questionnaire (MPQ) as a multi‐dimensional verbal scale in providing information about chronic pelvic pain associated with endometriosis, before and after laparoscopic surgery.Methods:  Fifty‐five women undergoing laparoscopy for severe endometriosis were asked to complete the MPQ before surgery and at the 6‐month follow up. All patients presented with preoperative pain symptoms of variable severity. We obtained the pain indexes and studied their relation with: patients' characteristics (age, body mass index, parity, qualification, occupation); operative findings (number, site and size of endometriotic lesions and presence of pelvic adhesions); and postoperative evolution of variable MPQ pain indexes at the 6‐month follow up.Results:  Median present pain index (PPI) (index of pain intensity), before surgical treatment was 3 (2–4): preoperative PPI was <2 in 25% of patients while 25% of patients had PPI > 4. Overall median PPI after surgical treatment was 1 (0–2): postoperative index of pain intensity was <1 in 50% of patients, >2 in 25% of patients while 25% of patients did not experience postoperative pain. Overall pain intensity significantly decreased after laparoscopic treatment of endometriosis (Wilcoxon test P < 0.0005). None of the patients' characteristics were found to be significantly correlated with the severity or improvement of preoperative pain at postoperative follow up (P > 0.05), and the intensity of preoperative pain was not correlated to any of the operative variables. There was a significant reduction in all individual MPQ pain indexes; however 18.2% of women did not show improvement of pain symptoms after laparoscopic surgery. An increasing endometrioma diameter was associated with a significant decrease in the difference in evaluative rank score of pain rating index between pain indexes at the 6‐month follow up and preoperatively (P = 0.04, Spearman's rank correlation Rho = −0.277).Conclusions:  MPQ appears to be useful as a multi‐dimensional scale in describing patients' pain semiology and evaluating pain evolution after surgical treatment. However, due to the extreme variability of pain experience, MPQ results don't clarify the relationship between pain intensity and the severity of endometriosis.
Urine leakage related to physical fatigue in women with urinary stress incontinence
Authors: Deffieux Xavier , Hubeaux Katelyne , Dick John , Ismael Samer Sheikh , Raibaut Patrick , Amarenco Gérard 
Published: August 2009

AbstractObjective:  To evaluate the frequency of urine leakage related to physical fatigue in women presenting with urinary stress incontinence using a specific questionnaire, and to assess its association with the Bristol Female Lower Urinary Tract Symptoms questionnaire and urodynamic findings.Design:  Prospective observational descriptive study.Setting:  University hospital (urodynamics laboratory).Participants:  Sixty‐one women presenting with urinary stress incontinence and 10 continent women.Interventions:  Not applicable.Main Outcome Measures:  The participants underwent urethral pressure profile measurement and completed a Bristol Female Lower Urinary Tract Symptoms questionnaire and a specific questionnaire focused on urine leakage related to physical fatigue.Results:  Twenty‐three (37%) women with urinary stress incontinence claimed to exhibit urine leakage related to physical fatigue more often than one third of the time and 47% claimed to exhibit urinary leakage only after more than one cough. There was a positive correlation between the findings of the specific questionnaire and the presence of a sharp decrease in urethral pressure following repeated cough efforts: question #1 (P = 0.02); question #2 (P = 0.00002); question #3 (P = 0.04).Conclusion:  There is a strong association between this questionnaire focused on urine leakage related to fatigue and the presence of a decrease in urethral pressure following repeated coughs.
Use of Chinese herbal medicine ‘meizitanc’ in pregnancy: Report of three cases
Authors: Çayan Filiz , Dilek Umut , Akbay Esen , Gen Ramazan , Dilek Saffet 
Published: August 2009

AbstractThe Chinese herbal medicine ‘meizitanc’, known as ‘LiDa Dai Dai Hua Jiao Nang’ (Kunming Dali Industry and Trade, Kunming, Yunnan, China) has been used by many women to support weight loss, even though life‐threatening side‐effects and deaths have been reported. We report the outcomes of three cases of exposure to ‘meizitanc’ during early pregnancy. In the first case, the pregnancy continued after the patient stopped taking the drug and at 38 weeks of gestation, the patient delivered a healthy infant. However, in the second and third cases fetal cardiac activities were not detected on obstetric follow‐up and both pregnancies were terminated due to missed abortion. To our knowledge, this is the first report of exposure to meizitanc during pregnancy. Although herbal medicines are presumed to be safe because of their natural origin, consumption of such products may be dangerous due to the content of undeclared drugs, adulteration with multiple substances and contamination with toxic metals.
Unilateral ovarian metastasis in a case of squamous cervical carcinoma IA1
Authors: Kang Woo D. , Kim Cheol H. , Cho Moon K. , Kim Jong W. , Kim Yoon H. , Choi Ho S. , Kim Seok M. 
Published: August 2009

AbstractOvarian metastasis from early‐stage squamous cervical cancer is rare. We report a case of unilateral ovarian metastasis from squamous cervical cancer IA1. Although ovarian metastasis from early‐stage squamous cervical cancer is rare, gynecological oncologists should not overlook its possibility.
Evaluation of D‐dimer during pregnancy
Authors: Nishii Ayano , Noda Yoshito , Nemoto Reiko , Ushiro Ken , Ohno Tsutomu , Mochizuki Yoshio , Yoshihara Hajime , Taguchi Akira , Uchino Naoki , Ohkawara Satoshi 
Published: August 2009

AbstractAim:  The purpose of the present study was to elucidate the change of D‐dimer and the possibility of deep vein thrombosis screening by D‐dimer during pregnancy.Methods:  One thousand, one hundred and thirty‐one pregnant women were enrolled in the study from April 2006 to March 2007. D‐dimer was measured by latex immunoassay at 6 to 14 and 30 to 36 weeks of gestation, respectively, and the veins of the lower extremities were examined by ultrasound at 30 to 36 weeks of gestation.Results:  The mean and standard error of D‐dimer was 1.1 ± 1.0 µg/mL in the first trimester and 2.2 ± 1.1 µg/mL in the third trimester, and both values were significantly higher than adult values. In addition, D‐dimer significantly increased during pregnancy.D‐dimer was not significantly different between singleton and twin pregnancies in the first trimester, but in the third trimester, the values of twin pregnancies were higher than singleton pregnancies (2.2 ± 1.6 vs 3.7 ± 2.5 µg/mL).The mean value of D‐dimer of ultrasonographically positive women was 2.6 ± 2.0 µg/mL, which was significantly higher than the value for negative woman during the third trimester (2.2 ± 1.6 µg/mL). The positive predictive value was 7.4% and negative predictive value was 95.5% for ultrasonographically positive women when D‐dimer was set at 3.2 µg/mL.Conclusion:  We clearly found a change of D‐dimer during pregnancy. When D‐dimer was higher than 3.2 µg/mL, the percentage of ultrasonographically positive women was high. We propose that women with D‐dimer higher than 3.2 µg/mL are closely monitored for prevention of pulmonary thromboembolism.
Uterine compression suture against impending recurrence of uterine inversion immediately after laparotomy repositioning
Authors: Matsubara Shigeki , Yano Hitoshi , Taneichi Akiyo , Suzuki Mitsuaki 
Published: August 2009

AbstractUterine compression suture to prevent impending recurrence of uterine inversion after laparotomy repositioning has not been reported previously. A 28‐year‐old primigravid woman demonstrated uterine inversion. Although Huntington's procedure had successfully repositioned the uterus, acute recurrence of inversion with uterine atony appeared to be impending during the surgery. We applied modified uterine compression sutures, which prevented the recurrence of inversion and achieved complete hemostasis. Three years later, the patient became pregnant and vaginally delivered a term infant. Thereafter, uterine inversion recurred, and was repositioned manually. Uterine compression suture may be of use not only for hemostasis for postpartum hemorrhage, but also for prophylaxis against acute recurrence of uterine inversion.
Chlamydia trachomatis infections and the risk of ectopic pregnancy in Khon Kaen women
Authors: Pientong Chamsai , Ekalaksananan Tipaya , Wonglikitpanya Naroemit , Swadpanich Ussanee , Kongyingyoes Bunkerd , Kleebkaow Pilaiwan 
Published: August 2009

AbstractAim:  To determine the prevalence of Chlamydia trachomatis infection and to evaluate the relation of previous and persistent chlamydial infection to ectopic pregnancy (EP) among women in Khon Kaen, Thailand.Methods:  We enrolled 32 EP patients in the case group. Control subjects were 57 women undergoing tubal ligation after normal labor. Serum immunoglobulin (Ig)G and IgA antibodies to C. trachomatis were determined using ELISA. Chlamydial DNA was investigated using polymerase chain reaction.Results:  The prevalence of chlamydial DNA in fallopian tube tissue was 34.38% of EP patients whereas none was detected in controls. In cervical cells, however, no significant difference in chlamydial DNA between cases (3.13%) and controls (3.51%) was detected. Serum‐specific IgG was found more in the EP group than in the control group (21.88% and 5.26%, respectively; P < 0.05). Serum‐specific IgA was detected in 5.26% of the control women but not in the EP group. Analysis by multivariate conditional logistic regression revealed a significant association between EP and the various risk factors. Among these, abortion, previous EP and age at first intercourse <15 years were strong predictors of EP. However, the association between specific IgG and EP became non‐significant in this analysis.Conclusions:  No strong independent association was shown between chlamydial antibodies and the EP risk in Thai women despite DNA detection in fallopian tube tissue. In contrast, factors including abortion, previous EP, and age at first intercourse <15 years were the significant predictors of EP. Efforts to address these other variables will help more in reducing the EP burden in Thai women compared to eliminating C. trachomatis.
Neonatal C‐reactive protein value in prediction of Outcome of Preterm Premature Rupture of Membranes: Comparison of Singleton and Twin Pregnancies
Authors: Taghavi Simin , Melli Manijeh Sayyah , Barband Alireza , Atashkhoui Simin , Sheikhvatan Mehrdad 
Published: August 2009

AbstractAim:  The clinical importance of preterm premature rupture of the membranes (PPROM) is its relationship to maternal and neonatal mortality and morbidity, especially in twin pregnancies. The aim of this study was to determine and compare the role of inflammatory factors as predictors of the PPROM outcome between singleton and twin pregnancies.Methods:  The medical records of 22 twins delivered between 28 and 34 weeks and complicated by PPROM were reviewed at the Al‐Zahra Hospital in Tabriz, Iran. Also among singletons, 55 cases of matched gestational age were randomly selected as a control group. Three laboratory indices of neonatal white blood cell (WBC) count and C‐reactive protein (CRP) in the two groups were measured immediately after delivery and the effects of two factors on neonatal outcome were assessed.Results:  In singletons, there was adverse relationship between the mean of WBC count and duration of latency (P = 0.007). Also, a positive relationship between the means of ventilation time and WBC count in second twins was found (P = 0.034). Positive CRP was the main predictor of neonatal intensive care unit admission in both singletons (odds ratio: 4.929, P = 0.042) and first twins (odds ratio: 9.000, P = 0.005). However, positive CRP did not influence the existence of metabolic acidosis or duration of latency in either of the two groups.Conclusion:  Neonatal WBC count was a predictor for the duration of latency in singletons and for ventilation time in twins. Positive neonatal CRP was an important factor for the prediction of neonatal intensive care unit admission in both types of pregnancy; its role in twins is clearer than in singletons.
Fetal arrhythmia: Prenatal diagnosis and perinatal management
Authors: Maeno Yasuki , Hirose Akiko , Kanbe Taro , Hori Daizo 
Published: August 2009

AbstractThe importance of managing fetal arrhythmia has increased over the past three decades. Although most fetal arrhythmias are benign, some types cause fetal hydrops and can lead to fetal death. With the aim of improving the outcome in such cases, various studies for prenatal diagnosis and perinatal management have been published. Detailed analysis of the type of arrhythmia in utero is possible using M‐mode and Doppler echocardiography. In particular, a simultaneous record of Doppler waveform at the superior venous cava and the ascending aorta has become an important and useful method of assessing the interval between atrial and ventricular contractions. Common causes of fetal tachycardia (ventricular heart rate faster than 180 bpm), are paroxysmal supraventricular tachycardia (SVT) with 1:1 atrioventricular (AV) relation and atrial flutter with 2:1 AV relation. Of fetal SVT, short ventriculo‐atrial (VA) interval tachycardia due to atrioventricular reentrant tachycardia is more common than long VA interval. Most fetuses with tachycardia are successfully treated in utero by transplacental administration of antiarrhythmic drugs. Digoxin is widely accepted as a first‐line antiarrhythmic drug. Sotalol, flecainide and amiodarone are used as second‐line drugs when digoxin fails to achieve conversion to sinus rhythm. Fetal bradycardia is diagnosed when the fetal ventricular heart rate is slower than 100 bpm, mainly due to AV block. Approximately half of all cases are caused by associated congenital heart disease, and the remaining cases that have normal cardiac structure are often caused by maternal SS‐A antibody. The efficacy of prenatal treatment for fetal AV block is limited compared with treatment for fetal tachycardia. Beta stimulants and steroids have been reported as effective transplacental treatments for fetal AV block. Perinatal management based on prospective clinical study protocol rather than individual experience is crucial for further improvement of outcome in fetuses with tachycardia and bradycardia.
Effects of corticosterone and the β‐agonist isoproterenol on glutamate receptor‐mediated synaptic currents in the rat basolateral amygdala
Authors: Liebmann Lutz , Karst Henk , Joëls Marian 
Published: August 2009

AbstractBehavioral and field potential studies suggest that – shortly after stress – noradrenaline and corticosterone interact to affect the function of basolateral amygdala (BLA) neurons. Here, we tested, at the single‐cell level, to what extent α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate (AMPA) receptor‐mediated and N‐methyl‐d‐aspartate (NMDA) receptor‐mediated synaptic responses of identified BLA neurons are affected by relatively low concentrations of the β‐agonist isoproterenol, how this is influenced by concomitant application of corticosterone, and how isoproterenol effects are influenced by corticosterone given several hours in advance. We observed that isoproterenol concentration‐dependently enhances AMPA receptor‐mediated (but not NMDA receptor‐mediated) responses; near‐maximal effects were induced by 1 μm isoproterenol. Corticosterone alone did not rapidly affect AMPA and NMDA‐mediated responses. NMDA‐mediated responses were also not affected by the hormone in a delayed manner; AMPA‐mediated responses were slowly suppressed by corticosterone, but only with high stimulation intensities. If corticosterone was co‐applied with isoproterenol (0.4 or 1 μm), facilitation of AMPA‐mediated responses was comparable to that seen with isoproterenol alone. However, if corticosterone was applied several hours in advance of the β‐agonist, the effect of 0.4 μm isoproterenol on AMPA‐mediated responses was reduced. This supports the notion that, in the BLA, isoproterenol facilitates synaptic transmission, a process that can be suppressed by corticosterone in a slow manner. Overall, the data suggest that, despite the previously reported ability of corticosterone to cause long‐term increases in excitability in the BLA, the hormone still retains some capacity to slowly exert a normalizing action on local activity.