bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recombinant expression and characterization of a lysozyme from the midgut of Triatoma brasiliensis (Hemiptera, Reduviidae) in comparison with intestinal muramidase activity
Authors: WANIEK PETER J. , MENDONÇA‐LIMA LEILA , MENEZES GUSTAVO B. , JANSEN ANA M. , ARAÚJO CATARINA A. C. 
Published: August 2009

Abstract.Insect c‐type lysozymes are antibacterial proteins that are synthesized in different organs with high activity against Gram‐positive bacteria. Because lysozymes possess muramidase activity, they also play an important role in the digestion of bacteria in Diptera. Triatomines express lysozyme‐encoding genes constitutively in the anterior region (cardia and stomach) of the midgut and the fat body after injection of bacteria into the haemocoel. The present study describes the overexpression of the Triatoma brasiliensis lysozyme 1 (lys1) in Escherichia coli. Recombinant T. brasiliensis Lys1 (TbLys1) is purified after solubilization of the inclusion bodies. The protein refolds successfully, showing muramidase activity against Micrococcus lysodeikticus lyophilized cells, after enterokinase cleavage of its thioredoxin fusion protein. In in‐gel zymograms and turbidimetric liquid assays TbLys1 is broadly active under alkaline and acid conditions, indicating a possible digestive function in the two physiologically different midgut regions of the bug: the stomach and small intestine. Muramidase activity is shown in the stomach and small intestine content of unfed bugs and bugs at different days after feeding, respectively. Western blot analysis identifies TbLys1 as lysozyme.
Chronic liver disease in children on long‐term parenteral nutrition
Authors: MISRA SUDIPTA , AMENT MARVIN E. , VARGAS JORGE H. , SKOFF CHRISTOPHER , REYEN LAURIE , HERZOG FAY 
Published: August 2009

AbstractUse of long‐term total parenteral nutrition (TPN) is often presumed to be associated with serious hepatic dysfunction. In this retrospective study, we reviewed the complete charts of patients who had received TPN for more than 2.5 years, starting in infancy or childhood, for evidence of liver dysfunction. There were 16 male and 10 female patients with a total of 254.5 patient years on TPN. Seventeen patients have been on TPN since birth or early infancy. Thirteen of 26 patients derive ≧90% of their calorie intake from TPN. Six patients had hepatomegaly; two of them also had splenomegaly. Twenty‐one patients had normal transaminases, nine have had past episodes of raised enzymes ranging from 2.5 to 7.5 times normal. Seventeen patients always had normal bilirubin levels, five had past episodes of hyperbilirubinaemia, while four patients had persistently raised bilirubin levels (range 1.5–20.7 g/dL). Alkaline phosphatase was normal for age in all patients except two. Hepatic synthetic function, as measured by albumin, pre‐albumin levels and prothrombin time, was within the normal range in all patients except one. Liver biopsies were performed in eight patients. Two biopsies showed cirrhosis, one showed chronic active hepatitis (CAH) with cholestasis, two patients had fibrosis, one showed cholestasis and two biopsies were normal. One patient with cirrhosis and one with CAH were positive for hepatitis C antibody. Another asymptomatic patient was positive for hepatitis B. Only the patient with CAH had hepatic decompensation. We conclude that clinical hepatic failure is uncommon in our group of patients on long‐term TPN for 2.5 years or more. Cirrhosis and fibrosis, when found, could not be solely attributed to TPN.
Surgery‐assisted reproductive technology hybrid therapy: A reproductive procedure for an infertile woman of late reproductive age with multiple myomas
Authors: Kuroda Keiji , Takeuchi Hiroyuki , Kitade Mari , Kikuchi Iwaho , Kumakiri Jun , Kobayashi Yuko , Kobori Hiroyuki , Kuroda Masako , Itagaki Kazuko , Machida Mai , Takeda Satoru 
Published: August 2009

AbstractAim:  To produce a successful pregnancy in a 38‐year‐old infertile patient with relapsed myoma using a technique we refer to as ‘surgery‐assisted reproductive technology (ART) hybrid therapy’ because it combines ART for cryopreservation of in vitro fertilized eggs with reproductive surgery.Methods:  A 38‐year‐old nulliparous woman who had undergone abdominal myomectomy and in whom magnetic resonance imaging showed multiple myomas was treated at our University‐affiliated hospital and outpatient clinic. Blastocysts were cryopreserved during the preoperative period. Laparoscopic myomectomy was performed after preoperative treatment with a GnRH agonist. Ten months after the operation, the youngest cryopreserved blastocyst was transferred into the uterus and implanted successfully.Results:  Treatment resulted in successful implantation and pregnancy. In January 2008, the course of pregnancy had been uneventful and the patient gave birth to a male infant weighing 2998 grams by cesarean section at 37 weeks of gestation.Conclusion:  We have treated eight patients using hybrid therapy with encouraging results, and we describe these cases herein briefly.
Efficacy and safety of ormeloxifene in management of menorrhagia: A pilot study
Authors: Kriplani Alka , Kulshrestha Vidushi , Agarwal Nutan 
Published: August 2009

AbstractObjective:  To assess the efficacy and safety of ormeloxifene (centchroman) in the medical management of menorrhagia.Methods:  Forty‐two women with menorrhagia were recruited for the study. Ormeloxifene was given to each patient 60 mg twice a week for 3 months and then once a week for 1 month. Patients were followed up at 2 and 4 months of therapy, then at 3 and 6 months after treatment was stopped. Menstrual blood loss (MBL) was measured objectively by a pictorial blood loss assessment chart (PBAC) score and subjectively by a visual analog scale (VAS).Results:  The pretreatment median PBAC score was 388 (range 169–835). Eighteen patients (42.9%) had amenorrhea with the therapy. Median PBAC reduced to 80 (range 0–730) and 5 (range 0–310) at 2 and 4 months, respectively (P‐value <0.001); thus, the percentage reduction was 97.7% at 4 months. Seven patients (16.7%) had no response and three (7.1%) discontinued treatment before 4 months. During the 10‐month study period, 21% of the patients underwent hysterectomy. Adverse effects included ovarian cyst (7.1%), cervical erosion and discharge (7.1%), gastric dyspepsia (4.8%), vague abdominal pain (4.8%) and headache (4.8%).Conclusion:  Ormeloxifene is an effective and safe therapeutic option for the medical management of menorrhagia.
Emergency contraception: Knowledge, attitude and prescription practice among doctors in different specialties in Hong Kong
Authors: Lo Sue S.T. , Kok Wai‐ming , Fan Susan Y.S. 
Published: August 2009

AbstractAim:  Few studies have evaluated doctors' knowledge, attitudes and practices as regards emergency contraception (EC). Some studies have reported inadequate knowledge, bias and wrong prescriptions by doctors. This article compares the prescription pattern, attitude and knowledge of EC in Hong Kong doctors in different specialties.Methods:  Questionnaires were mailed to family physicians, obstetrician‐gynecologists and doctors working in family planning clinics to ascertain their attitudes to EC. Those who provided EC described the types of EC used, whether drugs were given in advance and answered a 12‐question knowledge test. Those who did not provide EC stated why.Results:  A total of 443 completed questionnaires were analyzed: 70.9% of doctors agreed that the benefits of EC outweigh its risks and 61.2% agreed that doctors should discuss it with clients. Advanced provision was supported by 54.2% of doctors but reduced to 32.5% if the target client was a girl aged 16 or below. Even fewer doctors (40.2%) supported the over‐the‐counter sales of EC pills. In the knowledge test, family planning doctors scored 10.45 out of 12 and obstetrician‐gynecologists in private practice had the lowest score of 6.08. Family planning doctors used levonorgestrel pills while private family physicians and obstetrician‐gynecologists used Yuzpe. Among 352 doctors who provided EC, only 21.7% of private family physicians and 15.9% of private obstetrician‐gynecologists prescribed it in advance.Conclusions:  Only doctors working in family planning clinics were competent in their knowledge of emergency contraception and up to date with current practice. Although half of the doctors supported advanced provision, few implemented it. Most doctors did not support advanced provision to young girls nor the over‐the‐counter sales of EC pills.
Relations between fetal head descent and cervical dilatation during individual uterine contractions in the active stage of labor
Authors: Barnea Ofer , Luria Oded , Jaffa Ariel , Stark Michael , Fox Harold E. , Farine Dan 
Published: August 2009

AbstractThe relationship between instantaneous changes in fetal head station and cervical dilatation within the individual contraction during the active stage of labor were studied and an index of labor progress was suggested. Cervix dilatation and fetal head station were measured continuously in 30 nullipara women (mean age 27.5, standard deviation 4.8). The continuous measurements enabled the analysis of each variable and the analysis of the relations between these two variables. The relationship between the head station and the cervical dilatation were demonstrated by plotting one against the other during a contraction. This led to the definition of a contraction vector that integrates the interaction between the two variables. The angle of this vector, that indicates this relation, was plotted against mean head station to demonstrate change along the delivery process regardless of time to normalize the progress and allow comparison between different women with different labor durations. This plot showed a sharp change from almost zero into a steep curve at about zero head station. A zero angle indicates that the cervix dilates during a contraction with little effect on head station while a steep angle indicates a significant effect of cervical dilatation on head station during the contraction. The contraction‐vector angle reflects the changing intra‐contraction relationship between head station and cervical dilatation. The angle of this vector may serve as an indicator of labor progress.
Pseudocyesis in a rural southeast Nigerian community
Authors: Ouj Umeora 
Published: August 2009

AbstractContext:  Pseudocyesis is uncommon and probably under reported among the African population.Aims and Objectives:  To document the incidence and presentation of false pregnancies in a Nigerian rural population.Methods:  This involved a review of prospectively collected data on all patients who were diagnosed with pseudocyesis over a four‐year period in a Mission hospital.Results:  Pseudocyesis occurred at a frequency of 1 in 344 pregnancies. The mean age was 33.6 years and the condition was found more commonly among poorly educated women. Amenorrhea was common among the subjects and 54% claimed they felt fetal movement. Ultrasound studies confirmed the absence of pregnancies in all cases. Management included counseling and referral to specialist clinical psychologists.Conclusion:  Pseudocyesis is more common among the African population than in developed countries. Gynaecologists in these regions should have a high index of suspicion to diagnose this and assess the mental status of the subject and the precipitating factors.
Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: A preliminary report
Authors: Chin Hung‐Yen , Chiang Chi‐Hsin , Lin Kuan‐Cheng , Wang Chin‐Jung , Lee Chyi‐Long , Soong Yung‐Kuei 
Published: August 2009

AbstractAim:  To evaluate the changes in symptoms of overactive bladder (OAB) on the advanced cystocele after restoration of prolapse using the Perigee system.Methods:  This prospective clinical study recorded 16 women for the Perigee procedure due to advanced cystocele with OAB symptoms. Prolapse assessment was measured according to the pelvic organ prolapse quantization system. Complete urodynamic examination was performed before and six months after the operation. Subjects were also asked to fill in a questionnaire before and after the operation for a quantitative assay of OAB symptoms. Additional pelvic reconstructive surgeries including the Apogee procedure, retropubic tension‐free vaginal tape and posterior colporrhaphy with tension‐free vaginal tape were performed concurrently on 10 patients.Results:  Eleven cases were available for data analysis. Results showed significant improvement at points Aa and Ba after the operation. The Perigee procedure could restore the advanced cystocele adequately, with points Aa and Ba almost back to their normal physiological and anatomical positions. However, urodynamics showed two subjects with motor urgency and one with sensory urgency having objective improvement in urge sensation. Questionnaire results of postoperative subjective symptoms revealed a significant improvement with respect to coping, concern and sleep as compared to preoperative symptoms.Conclusion:  This preliminary report reveals that the Perigee procedure is an efficient and effective surgical approach for the treatment of anterior vaginal wall prolapse. It can also improve the subjective symptoms of OAB.
Outcome of cesarean section in asymptomatic HIV‐1 infection in Kampala, Uganda
Authors: Sekirime Wilberforce K. , Lule John C. 
Published: August 2009

AbstractAim:  Sepsis remains a major cause of morbidity and mortality in Mulago Hospital, Kampala, Uganda, following cesarean section (CS). The present study was designed to assess whether asymptomatic HIV infection could be contributing to the increased morbidity following emergency CS in the form of wound and genital tract infection (GTI) with consequent prolonged stay in the hospital.Methods:  Five hundred patients who had undergone emergency lower segment CS had their blood taken to check for HIV‐1 serostatus on the first postoperative day. The patients were followed up for evidence of wound sepsis, defined as occult pus discharge on compression of the wound or removal of the closing stitches, GTI and duration of stay in the hospital after the operation.Results:  There were 98 (20.5%) HIV‐1 seropositive patients. The incidence of postoperative wound sepsis (P = 0.948, 95% confidence interval [CI] 0.56–1.86), GTI (P = 0.339, 95% CI = 0.74–2.39) as well as hospital stay >8 days (P = 0.327, 0.78–2.09) was not statistically significantly different between the infected and non‐infected groups. Significant predisposing factors to postoperative morbidity were poor general condition on admission, dehydration, preoperative clinical anemia, and ruptured membranes prior to the operation.Conclusion:  Asymptomatic HIV‐1 was not associated with increased postoperative morbidity following emergency lower segment cesarean section.
Acute mesenteric venous thrombosis due to protein S deficiency in a pregnant woman
Authors: Atakan Al Ragıp , Borekci Bunyamin , Ozturk Gurkan , Akcay Mufide N. , Kadanali Sedat 
Published: August 2009

AbstractAcute mesenteric venous thrombosis is a rare and potentially fatal disease, which often occurs in medically compromised elderly patients. Isolated mesenteric venous thrombosis may be encountered in young women who have underlying hypercoagulable disease. We report a case of mesenteric venous thrombosis in a young pregnant woman in whom protein S deficiency was diagnosed at a later stage. The patient underwent extensive bowel resection. On follow‐up she had developed an obstruction on the intestinal anastomosis. The anastomosis was revised, but the patient died of intervening complications 3 months after the operation. Early management of acute mesenteric venous thrombosis relies on early diagnosis, which requires a high index of suspicion. The condition must be considered during evaluation of persistent abdominal pain in pregnant women with hypercoagulable disorder.
Port wound closure assisted by Foley catheter: An easier way to provide fascia security
Authors: Su Wen‐Hsiang , Cheng Ming‐Huei , Tsou Tsung‐Shan , Cheung Sai‐Ming , Chang Sheng‐Ping , Wang Peng‐Hui 
Published: August 2009

AbstractAim:  Specific laparoscopy‐related complications, such as incisional hernia (trocar hernia) or hemorrhage, are worthy of our special attention. Preventing and managing these complications safely and efficiently are important, suggesting that a definite closure of the 10–12 mm port wound after laparoscopy is needed; for this, a newer, simpler method was used.Methods:  Ninety‐six patients with benign ovarian tumor warranting laparoscopic surgery were enrolled into the study. Forty‐eight patients (50%) underwent a Foley catheter‐assisted port wound closure (Foley group) and the remaining patients (50%) underwent a conventional port would closure (control group). The outcome was measured by comparing operative time, the amount of suture material used (difficulty of wound closure), therapeutic efficacy (hernia), postoperative complications (bleeding, hematoma, and wound pain by a self‐reported six‐point verbal numeric rating scale (VNRS‐6)) and anesthesia use as measured by an analgesic usage score (AUS), and dissatisfaction with the cosmetic results, in both groups.Results:  The general characteristics of the patients were similar in both groups. There were no statistical differences in mean operative time, therapeutic efficacy, and postoperative complications between the two groups. However, the amount of extra suture material needed was significantly less in the Foley group compared to the control group (1.04 ± 0.08 vs 1.29 ± 0.44, P = 0.015, and 4.2 vs 25%, P = 0.02, respectively).Conclusion:  Wound closure with the assistance of a Foley catheter offers an easy and secure way to close a 10–12 mm port wound.
Pseudoangiomatous stromal hyperplasia (PASH) of the breast: Intraductal appearance
Authors: Gur Akif Serhat , Unal Bulent , Edington Howard , Kanbour‐Shakir Amal , Soran Atilla 
Published: August 2009

AbstractPseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative lesion of breast stroma. The diagnosis of PASH can be made using imaging techniques such as ultrasound, magnetic resonance or mammography. Ductoscopy is a relatively new technique which is used for imaging the intraductal surface. We report a patient with PASH in whom ductoscopy was performed successfully.
Recurrent pregnancy loss: A disease of inflammation and coagulation
Authors: Kwak‐Kim Joanne , Yang Kwang Moon , Gilman‐Sachs Alice 
Published: August 2009

AbstractRecurrent pregnancy loss (RPL) is one of the most common obstetrical complications. Multiple etiologies, such as endocrine, anatomic, genetic, hematological and immunological causes have been reported for this devastating disease. However, over half of the cases remain unexplained. Thrombotic/inflammatory processes are often observed at the maternal‐fetal interface as the final pathological assault in many cases of RPL, including those of unexplained etiologies. In the present paper, cellular immune responses (T, natural killer [NK], natural killer‐T [NKT], regulatory T [Treg] cells and their cytokines) and autoimmune abnormalities of women with RPL are reviewed. In addition, metabolic diseases and hematological conditions which often lead to thrombotic/inflammatory conditions are discussed in association with RPL. Finally, current therapeutic options for RPL are reviewed.
The Shared Equal Access Regional Cancer Hospital (SEARCH) nomogram for risk stratification in intermediate risk group of men with prostate cancer: validation in the Duke Prostate Center database
Authors: Jayachandran Jayakrishnan , Schroeck Florian , Sun Leon , Gerber Leah , Moreira Daniel M. , Moul Judd W. , Freedland Stephen J. 
Published: August 2009

Study Type – Prognosis (cohort) Level of Evidence 2aOBJECTIVESTo validate the Shared Equal Access Regional Cancer Hospital (SEARCH) nomogram to better risk stratify men with intermediate‐risk pathology after prostatectomy (positive surgical margins, PSM, and/or extracapsular disease, ECE, without seminal vesicle or lymph node involvement) in a tertiary referral centre (the Duke Prostate Center, DPC).PATIENTS AND METHODSWe retrospectively analysed 485 men in the DPC cohort with PSM and/or ECE but without seminal vesicle or lymph node involvement. The predicted risk of biochemical progression‐free probability at 1, 3 and 5 years was estimated by the SEARCH and updated Kattan postoperative nomograms. Calibration plots were generated and accuracy assessed with the concordance index.RESULTSThe SEARCH nomogram appeared to be well calibrated, with the highest‐risk quartile having a predicted <60% progression‐free probability at 5 years, vs >80% for the lowest risk. In comparison, overall external calibration appeared to be similar for the updated Kattan nomogram, although there was less separation between the highest‐ and lowest‐risk quartiles. The SEARCH model had an overall predictive accuracy of 0.65, which compared favourably with the updated Kattan nomogram (0.57).CONCLUSIONIn an external dataset, the SEARCH nomogram to predict progression‐free probability for men at intermediate risk after prostatectomy was well calibrated and performed better than the updated postoperative Kattan nomogram.
Estimated blood loss as a predictor of PSA recurrence after radical prostatectomy: results from the SEARCH database
Authors: Lloyd Jessica C. , Bañez Lionel L. , Aronson William J. , Terris Martha K. , Presti Jr Joseph C. , Amling Christopher L. , Kane Christopher J. , Freedland Stephen J. 
Published: August 2009

Study Type – Diagnosis (exploratory cohort)  Level of Evidence 2bOBJECTIVETo clarify the relationship between estimated blood loss (EBL) and biochemical recurrence, assessed by prostate‐specific antigen (PSA) level, as blood loss is a long‐standing concern associated with radical prostatectomy (RP), and no studies to date have examined the association between blood loss and cancer control.PATIENTS AND METHODSIn all, 1077 patients were identified in the Shared Equal‐Access Regional Cancer Hospital database who underwent retropubic RP (between 1998 and 2008) and had EBL and follow‐up data available. We examined the relationship between EBL and recurrence using multivariate Cox regression analyses.RESULTSIncreased EBL was correlated with PSA recurrence in a multivariate‐adjusted model (P = 0.01). When analysed by 500‐mL EBL categories, those with an EBL of <1500 mL had a similar risk of recurrence. However, the risk of PSA recurrence tended to increase for an EBL of 1500–3499 mL, before decreasing again for patients with an EBL of ≥3500 mL. Men with an EBL of 2500–3499 mL had more than twice the risk of recurrence than men with an EBL of <1500 mL (P = 0.02). EBL was not associated with adverse tumour stage, grade or margin status.CONCLUSIONSThere was a significant correlation between EBL at the time of RP and biochemical recurrence. We hypothesized that this association might be due to transfusion‐related immunosuppression, excessive blood obscuring the operative field, EBL being a marker of aggressive disease, or EBL being a marker of poor surgical technique. However, our data did not completely fit any one of these hypotheses, and thus the ultimate cause for the increased risk of recurrence remains unclear and requires further study.