bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic origin analysis of hydatidiform mole and non‐molar abortion using the polymerase chain reaction method
Authors: Fujita Noriko , Tamura Shozo , Shimizu Nobuyoshi , Nozawa Shlro 
Published: November 2007

Objective. The study attempts to determine the genetic origin of hydatidiform mole and non‐molar abortion using the polymerase chain reaction (PCR) method, and reevaluates this method;IS a possible diagnostic tool for hydatidiform mole.Material and Methods. A total of 71 cases which consists of 21 complete hydatidiform moles, three partial hydatidiform moles, and 47 non‐molar abortions were investigated. The genetic origin Was analyzed by the PCR method applied to the variable number of tandem repeat regions of the Apolipoprotein B gene. the human type‐II collagen gene. and the probe YNZ22. Chromosomal analysis was also performed.Results. Genetic origin was determined in 58 out of 71 cases (83.1%). All of the complete hydatidiform moles were androgenic. having only paternal alleles. On the other hand, all the partial hydatidiform moles and non‐molar abortions revealed clear biparental contribution. Besides triploid partial hydatidiform moles, one non‐molar abortion showed two paternal and one Paternal complements.Conclusion. Our results were compatible with the classical theory of androgenic origin of complete hydatidiform mole; only complete hydatidiform mole is caused by androgenesis. We also found no complete hydatidiform mole of biparental origin. In conclusion, this PCR method brings a new aspect of genetic origin in the diagnosis of trophoblastic disease. It would be interesting to explore how morphologic subgrouping and genetic origin relate to the prognosis of trophoblastic disease.
Cervical fetal fibronectin correlates to cervical ripening
Authors: Ekman Gunvor , Granström Lena , Malmström Anders , Sennström Maria , Svensson Jan 
Published: November 2007

Aim of study. It is well established that the cervical ripeness is of great prognostic value at labor induction. The available methods of measuring the cervical ripeness are not satisfactory. This study was therefore initiated to investigate if there is any correlation between cervical fetal fibronectin and cervical ripening at term.Method. Three groups were included in this study: women with unripe cervices, women with spontaneous cervical ripening and those with PGE2‐induced cervical ripening. Fetal fibronectin was measured by ELIZA after sampling from the cervical canal.Results. The cervical fetal fibronectin was low in women with unripe cervices. In women with favorable cervices a ten fold higher level was found. The fibronectin level was even higher after PGE2‐induced ripening.Conclusion. Conclusively an increased amount of cervical fetal fibronectin is registered during the cervical ripening process. A level of > 0.80 μg/ml of cervical fetal fibronectin seems to indicate a favorable cervix.
Simulated intraperitoneal absorption of irrigating fluid
Authors: Olsson Joel , Hahn Robert G. 
Published: November 2007

Background. Intraperitoneal absorption of electrolyte‐free irrigating fluid may occur secondary to uterine perforation during endometrial resection, but the clinical course of this complication is known from only a few case reports.Methods. We studied symptoms, biochemical changes and the kinetics of solute equilibration over the peritoneal membrane in 10 healthy awake women who were subjected to an experimental absorption situation by receiving an intraperitoneal infusion of 25 ml/kg of a solution containing glycine 1.5% and ethanol 1% over 20 min. We also compared the use of breath ethanol and serum sodium samples to indicate the presence of irrigating fluid in the peritoneal cavity.Results. All infusions caused lower abdominal pain. The solute gradients between the peritoneal pool and plasma were reduced according to mono‐exponential functions with a half‐time of 33±5 min for ethanol, 92±9 min for sodium, 103±9 min for potassium, and 124±10 min for amino acids (mean±s.e.mean). Twenty minutes after infusion, the breath ethanol level reached a plateau which could be used to predict the infused volume within ±15% of the true value. In contrast, the serum sodium concentration decreased slowly and was only 3.0±0.7 mmol/l below baseline at 2 hours after infusion.Conclusions. The calculated rates of transperitoneal solute equilibration can be used to assess the need for substitution of electrolytes in patients who absorb irrigating fluid into the peritoneal cavity. Measurement of ethanol in the expired breath is more useful than serum sodium to indicate the existence of such a pool.
Oral contraceptives and low back pain
Authors: Brynhildsen Jan , Ekblad Sara , Hammar Mats 
Published: November 2007

Background. Only few indications have appeared in the literature concerning a possible relationship between the use of oral contraceptives and low back pain. In our daily work we often meet women who have been recommended to abandon their use of oral contraceptives depending on coexisting low back pain. In order to assess the opinions of a possible relationship between oral contraceptives and low back pain this study was undertaken.Methods. A validated questionnaire was sent out to physicians, physiotherapists and midwives dealing with either contraceptive counselling or low back pain. A modified questionnaire was sent to medical‐and physiotherapist students to assess whether the opinions were a result of the education or the working experience.Results. A total of 225 questionnaires were sent out and 206 (91%) were returned. Sixteen percent thought there was a relationship between the use of oral contraceptives and risk of low back pain. Thirty percent had seen patients with low back pain that was interpreted as being affected by use of oral contraceptives. Twenty‐five percent recommended at least some patients with low back pain to change their contraceptive method. Among the students there was a difference in opinion between the first and the last year students indicating that their opinions had been influenced by their education.Conclusions. Evidently many professionals dealing with oral contraceptives and low back pain believe that there is a relationship between oral contraceptives and low back pain, despite the lack of scientific evidence. These recommendations might influence the contraceptive safety for the individual woman and the possible relationship between use of oral contraceptives and low back pain should therefore be more thoroughly investigated before general recommendations are given.
Nodal immune reactivity in FIGO Stage I endometrial carcinoma: relationship with myometrial invasion
Authors: Garzetti Giuseppe Gioele , Ciavattini Andrea , Goteri Gaia , Romanini Carlo 
Published: November 2007

Background. To evaluate T lymphocyte subsets in pelvic and paraortic lymph nodes, in patients with FIGO stage I endometrial carcinoma at different degrees of myometrial invasion and with lymphovascular space invasion. The aim was to define an eventual modulation of regional immune reactivity useful in the therapeutic approach of the disease.Methods. Twenty‐two women with FIGO stage I endometroid adenocarcinoma were consecutively recruited and selected for immunological study. All the patients underwent primary surgery characterized by radical hysterectomy (Piver's type III) with bilateral salpingo‐oophorectomy and systematic pelvic plus paraaortic lymphadenectomy. Lymphocyte tipization was performed by Beckton Dickinson monoclonal antibodies (CD4, CD8, CD56 and CD16) immunohistochemically in frozen‐sections (immune assay on lymph nodes). For statistical evaluations, Student's t test and one way analysis of variance were used.Results. Significantly higher percentages of CD4+ lymphocytes were found in pelvic than in paraaortic lymph nodes; however, by analyzing T lymphocyte content in the different pelvic nodal groups, we also observed significantly higher percentages of CD16 + and CD56 + cells in obturator nodes when compared to iliac stations. A significant increase of CD16 + and CD56+ cell percentages was then defined with respect to myometrial involvement and lymphovascular space invasion, in pelvic nodes.Conclusions. From our results, we could not define any clinical importance of nodal lymphocyte distribution in patients with early stage endometrial carcinoma; however, the observed nodal immune reactivity in presence of myometrial invasion seems interesting, with or without lymph vascular space involvement as possible expression of neoplastic systemic diffusion.
Hypertensive disorders of pregnancy and stillbirth in North Carolina, 1988 to 1991
Authors: Ananth Cande V. , Savitz David A. , Bowes Watson A. 
Published: November 2007

Background. The objectives of this study were (i) to assess the effect of hypertensive disorders of pregnancy on the risk of stillbirth, and (ii) to characterize the relationship between hypertension and stillbirth separately by gravidity, race, ‘explained’ versus ‘unexplained’ causes of stillbirth, and antepartum versus intrapartum stillbirths.Methods. The study was based on a retrospective cohort of approximately 400,000 pregnancies identified through the birth and fetal death certificates in North Carolina, USA, between 1988 and 1991. Multivariable polytomous logistic regression was used to generate odds ratios comparing stillbirth risk in hypertensive compared to non‐hypertensive mothers, adjusted for potential confounders.Results. The risk of chronic hypertension was 7.6 per 1000 pregnancies, while pregnancy‐induced hypertension (PIH) and eclampsia were reported in 36.6 and 6.0 per 1000 pregnancies, respectively. Pregnancies among chronic hypertensives were more likely to result in losses after 28 weeks gestation (RR=3.29, 95% CI: 2.43–4.43), while the risk ratio was 2.16 (95% CI: 1.45–3.22) for losses prior to 28 weeks' gestation. Pregnancies to patients with PIH were at 1.42 (95% CI: 1.15–1.79) times greater risk of terminating in late stillbirth, while the risk ratio for eclampsia was 2.23 (95% CI: 1.51–3.30). The risk ratio for ‘explained’ antepartum stillbirth was higher than intrapartum stillbirth for all of the hypertensive diseases.Conclusions. Hypertensive disorders were found to have a strong adverse impact on stillbirth suggesting that early diagnosis of hypertension during pregnancy and adequate medical intervention may help reduce the risk of stillbirth.
Prenatal diagnosis of omphalocele associated with umbilical cord cyst
Authors: Chen Chih‐Ping , Jan Sheau‐Wen , Liu Fen‐Fen , Chiang Sheng , Huang Shih‐Hung , Sheu Jin‐Cherng , Wang Kuogon , Lan Chung‐Chi 
Published: November 2007

Background. To study the cytogenetics, ultrasound findings, biochemical screening, perinatal outcome, and associated abnormalities in cases of omphaloceles associated with umbilical cord cysts.Methods. From 1988 to 1994, three cases of omphaloceles with umbilical cord cysts were identified at Mackay Memorial Hospital. We compared the clinical data of our three cases with six other cases in the published literature.Results. Two cases of omphaloceles with umbilical cord cysts were affected with trisomy 18. One had bilateral choroid plexus cyst, intrauterine growth retardation, low levels of maternal serum alpha‐fetoprotein and free beta‐human chorionic gonadotropin, and the other had cleft lip and palate, single umbilical artery and intrauterine growth retardation. An elevated level of maternal serum alpha‐fetoprotein was found in the case with normal karyotype. Elevated levels of amniotic fluid alpha‐fetoprotein were found in two cases. Rupture of the umbilical cord cyst and disruption of the umbilical cord occurred in one case at delivery. Based on the gross and microscopic examinations, the cord cysts we observed are likely to be pseudocysts.Conclusion. The umbilical cord cysts most commonly associated with omphaloceles are pseudocysts and allantoic cysts. Among our three cases and the six other cases published in the literature, four out of these nine cases were trisomy 18. Prenatal diagnosis of omphaloceles or umbilical cord cysts by ultrasound warrants cytogenetic analysis and detailed sonogram to rule out the possible combination of both abnormalities and trisomy 18. If an omphalocele is associated with a large umbilical cord cyst and a normal karyotype, cesarean section is recommended to prevent the dilemma of intrauterine vascular compromise of umbilical blood flow during labor.
The effect of nimesulide and naproxen on the uterine and ovarian arterial blood flow velocity. A Doppler study
Authors: Pirhonen Jouko , Pulkkinen Martti 
Published: November 2007

Background. To measure the effect of oral naproxen and nimesulide treatments on the uterine and ovarian arterial blood flow velocity in both eumenorrheic and dysmenorrheic women.Methods. The double‐blind, placebo‐controlled, study comprised six eumenorrheic women receiving either placebo or nimesulide (100 mg, single oral dose) during two consecutive cycles. Six women with moderate to severe dysmenorrhea were treated with placebo, nimesulide or naproxen (500 mg, single oral dose) during three consecutive cycles. Uterine impedance (pulsatile index, PI) was measured during the cycle day 1 at four different levels of the uterus and in the ovarian branch of the uterine artery at 0, 30, 60, and 120‐140 min, with a color Doppler ultrasonograph for orientation and with pulsatile Doppler for recording waveforms.Results. In the eumenorrheic women no significant changes were found with any treatment. In dysmenorrheic patients, nimesulide relieved symptoms and caused a decrease in uterine artery PI earlier than naproxen. Both treatments reduced the elevated uterine impedance in dysmenorrhea close to the normal level. When analyzing the PIs of the uterine artery at 4 different levels, the most prominent changes were observed in the fundus. The ovarian branch remained unaffected.Conclusions. Color Doppler ultrasonography and pulsatile Doppler are good methods for investigating disease‐ or drug‐induced changes in uterine and ovarian blood flow velocities. Nimesulide induced a slightly faster and more complete decrease of the elevated uterine vascular resistance in dysmenorrhea, towards normal eumenorrheic levels, than naproxen. The fundal part of the uterus appears to be an important site of the pathogenesis in primary dysmenorrhea.
Trial of routine gonadotropin releasing hormone agonist treatment before abdominal hysterectomy for leiomyoma
Authors: Balasch Juan , Manau Dolors , Mimó Jaime , Duran Magda , Puerto Bienvenido , Vanrell Juan A. 
Published: November 2007

Objective. To investigate the usefulness of a routine short term treatment with gonadotropin releasing hormone agonist (D‐Trp‐6‐LHRH depot) before abdominal hysterectomy for leiomyoma.Study Design. Prospective, comparative, randomized study.Setting. A teaching hospital of Barcelona University.Patients. Fifty premenopausal women requiring hysterectomy as treatment for symptomatic leiomyomas. Twenty‐three patients were randomized to receive gonadotropin releasing hormone agonist treatment before hysterectomy (cases), and 27 patients were randomized to immediate hysterectomy (controls).Main outcome measures. Type of abdominal incision, operating time, operative hemoglobin and hematocrit decrease, postoperative morbidity, and days in hospital.Results. In the agonist treated group mean uterine volume decreased and mean hemoglobin and hematocrit significantly rose after 8 weeks of treatment. Operative time was similar in both groups of patients but the number of women having Pfannenstiel incision was significantly higher in the cases. Mean operative hemoglobin and hematocrit decrease and postoperative morbidity were lower in the cases. There was a trend for shorter postoperative hospital stays in the agonist treated group.Conclusions. Our results favor the routine use of a short term gonadotropin releasing hormone agonist treatment before abdominal hysterectomy for leiomyoma in order to decrease operative blood loss and postoperative morbidity.
Malignant germ cell tumors of the ovary: Hacettepe hospital experience
Authors: Ayhan Ali , Tuncer Z. Selçuk , Yanik Filiz , Bükülmez Orhan , Yanik Ali , Küçükali TÜRkan 
Published: November 2007

Background. To determine the most important prognostic factors in patients with malignant germ cell tumors of the ovary.Methods. Age, histologic type, tumor size, stage, treatment mode, type of surgery of 67 patients with malignant germ cell tumors managed consecutively were evaluated retrospectively using multivariate analysis.Results. The overall survival rate was 60.6%. This figure was 78.5% for dysgerminoma, 53.3% for immature teratoma, 12.0% for endodermal sinus tumor, 33.3% for mixed germ cell tumor and 100.0% for others. The patients with endodermal sinus tumor had significantly poorer survival than other groups. Among the factors analyzed for survival histologic type was found to be the most significant predictor for survival.Conclusions. Finding of histologic type as the strongest independent risk factor may be evaluated in correlation with the literature that these tumors have historically been investigated as dysgerminomatous and nondysgerminomatous tumors. Furthermore, endodermal sinus tumors had long been known for poor survival. Based on this data, despite advent of staging and effective chemotherapy, prognosis still is basically related to histologic type and histology of tumor should be taken into account while comparing results.
Variations in serum relaxin (hRLX‐2) concentrations during human pregnancy
Authors: Petersen Lone Kjeld , Vogel Ida , Agger Anders Ole , Westergård Jes , Nils Milman , Uldbjerg Niels 
Published: November 2007

Study objective. To study variations in serum relaxin concentrations during normal and abnormal human pregnancy and parturition and in umbilical cord blood.Design and patients. Diurnal variations were determined in samples collected every 2 hours for 24 hours (n=4). Variations during pregnancy were studied in samples taken every 4th week from normal pregnant women (n=26). Additionally samples were collected once a week from the 37th week of pregnancy and until spontaneous delivery (n= 5). Changes in relaxin during early pregnancy (gestational age: 30 to 97 days) were studied in serum from 12 normal pregnant women, 13 with spontaneous abortion and 38 with an ectopic pregnancy. Fetal serum was obtained at delivery from the umbilical vein (n=20). All samples were analysed for relaxin by an ELISA based on human relaxin antibodies.Main results. No diurnal variation in relaxin concentrations were found. In normal pregnant women relaxin concentrations increased during the first 14 weeks of pregnancy. From week 14 to 24 a gradual decrease was found and the concentrations remained constant during the last part of pregnancy. No changes in concentrations were found immediately before or during spontaneous delivery. Women with abnormal pregnancies had lower serum relaxin values than normal early pregnant women. The relaxin concentration was significantly correlated to the serum HCG concentration in early pregnancy but not to the serum HPL levels after week 28. In the umbilical vein relaxin concentrations were low.Conclusion. The variation in circulating levels of relaxin during human pregnancy differs markedly from those found in other species. This suggests a different role for relaxin in human pregnancy.
Maternal serum alpha‐fetoprotein screening for neural tube defects
Authors: Candenas M. , Villa R. , Collar R. Fernandez , Moina M. J. , Pintado S. , Saez F. Garcia , Alvarez F. V. 
Published: November 2007

Maternal serum alphafetoprotein (MSAFP) screening has been set up in Asturias, in the north of Spain, in 1987 in order to make possible the prenatal diagnosis of neural tube defects (NTD) to overall pregnancy population.This large study shows the high sensitivity and specificity of MSAFP screening when it is done with absolute control of all variables such as gestational age, pregnant woman's weight, diabetes, etc. On the other hand, this study also shows a poor sensitivity second level ultrasound for the early diagnosis of NTD in the presence of spina bifidas with no bulge. We have also observed that the incidence of NTD in Asturias remained constant in the last six years, around 1.5‐1.6 per 1000 pregnancies. However, due to MSAFP screening, there has been a decline in the prevalence of children born with these defects. We conclude that MSAFP screening is the best tool to identify and reduce NTD in our Region (Spain).
An oocyte donation program with goserelin down‐regulation of voluntary donors
Authors: Söderstrom‐Anttila Viveca , Hovatta Outi 
Published: November 2007

Background. In ovum donation programs oocytes can be requested from infertile women going through an in vitro fertilization cycle. Currently, when embryos can be cryopreserved, these donors have virtually disappeared. Instead, most donors have been healthy fertile volunteers willing to go through an IVF attempt solely for the purpose of donating all oocytes.Methods. Sixty‐four patients had 93 started cycles of oocyte donation from 59 donors. Twenty recipients had primary ovarian failure, 24 had secondary ovarian failure, 15 had had repeated failures in earlier IVF attempts and five were carriers of genetic diseases. The donors were 51 healthy volunteers recruited through the press. Eight patients from an IVF program donated excess oocytes. Donors were not paid and their mean age was 30 years. To minimize discomfort of the treatment, a long‐acting GnRH‐agonist, goserelin, was used for down‐regulation.Results. The pregnancy rate per transfer with fresh embryos was 28.4% (23/81) and with frozen‐thawed embryos, 17% (3/18). Twenty‐one healthy infants have been born including one set of triplets and three sets of twins. Nine pregnancies ended in abortion and one in intrauterine fetal death. The most common complications of pregnancy were pre‐eclampsia and pregnancy‐induced hypertension (41.2%, 7/17). Ten of 17 patients delivered by cesarean section (58.8%).Conclusion. It was possible, through the press, to obtain highly motivated oocyte donors, who go through IVF treatment solely for altruistic reasons. Oocyte recipients appear to have many complications in their pregnancies. Until more data are available, these patients need a high standard of obstetric care.
Births by younger and older mothers in a population with late and regulated childbearing: Finland 1991
Authors: Hemminki Elina , Gissler Mika 
Published: November 2007

Purposes. The aims of this study were: first, to ascertain the characteristics of younger and older mothers in the Finnish population; second, to assess the health conditions pertaining to births and newborns according to maternal age groups.Methods. The data, 26 373 primiparous and 38 895 multiparous women, came from the 1991 nationwide Finnish birth register, and was completed using death and education registers. The younger (<18 and 18‐19 year olds) and older (35‐39 and 40 and over) mothers were compared to 20‐34 year olds. Infant outcomes were studied by adjusting for mothers' social and obstetric background characteristics by using stepwise logistic regression.Results. Births were rare among women younger than 18 years or 40 years or older. Younger primiparous mothers (less than 20 years) were less often married, more often had a lower social class background, and tended to live in Northern Finland and used antenatal care somewhat less. Their pregnancies, giving birth and infant outcomes were similar to those of 20‐34 years old mothers. Most older mothers were women having their families late, rather than having big families. Older primiparas (35 years or older) were less likely to be married, were more often highly educated and lived in urban areas and in the most southern county. Older mothers had more problems during pregnancy and labor, and their infant outcomes were worse.Conclusions. Our study supports the notion that for young mothers giving birth is a social rather than a medical problem, whereas the reverse is true for older mothers. However, perinatal results for most older mothers are good.