bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of four candidate strategies to detect cervical cancer in different health care settings
Authors: Kamal Meherbano M. , Sapkal Rekha U. , Sarodey Chhaya S. , Munshi Maitreyee M. , Alsi Yamini D. , Chande Mrudul A. , Hingway Sneha R. , Dandige Seema , Kane Utpala S. , Kshirsagar Ragini , Tangsale Madhvi , Zodpey Sanjay , Patel Archana B. , Mamtani Manju , Kulkarni Hemant 
Published: August 2007

AbstractAim:  Considering the differing but potentially supplementary properties of visual inspection of the cervix with acetic acid (VIA) and the cytological examination (CYTO) of cervical smears for the screening of cervical cancers, we examined the performance of these two tests and their combinations for the screening of cervical cancer in different health care settings.Methods:  In this cross‐sectional diagnostic test performance evaluation study of 4235 female subjects in the reproductive age group, we assessed the screening performance of four strategies: VIA alone, CYTO alone, VIA and CYTO combined in a parallel fashion, and VIA and CYTO combined in tandem. Subjects were recruited from three settings: Hospital, Urban Community and Rural Community. Colposcopy was used as the reference standard. Screening performance was assessed using sensitivity, specificity, post‐test probabilities and likelihood ratios (LR), diagnostic odds, area under receiver operating characteristic curve and LR χ2.Results:  Both VIA and CYTO when used alone had a low sensitivity but high specificity, especially in the Rural Community setting. A combination of the results of VIA and CYTO improved the diagnostic accuracy but the strategy using a parallel combination of VIA and CYTO was the most accurate. In general, all screening strategies using VIA and CYTO showed a modest screening performance.Conclusions:  In the settings of varying levels of health care and low resources, caution is needed for a generalized use of VIA for cervical cancer screening. Further evaluation of the cost‐effective ways of combining VIA and CYTO is needed in these circumstances.
Does a change in obstetric management influence the incidence of traumatic birth lesions in mature, otherwise healthy newborn infants?
Authors: Zeck Willibald , Haas Josef , Rossegger Helfried , Bjelic Vesna , Schöll Wolfgang 
Published: August 2007

AbstractAim:  The incidence of lesions due to birth trauma can be generally regarded as a characteristic of obstetric management; since obstetric management has changed through the years, one might expect a decrease or increase of lesions due to birth trauma in mature newborn infants.Methods:  In a retrospective study, the incidence of lesions due to birth trauma was recorded in the year 2000. In 1989, an identical study had already been carried out in the same department, employing the same criteria. The new findings were compared with the historical data.Results:  In the year 1989 24.6% and in 2000 13.2% showed lesions due to obstetric trauma. The episiotomy rate and lesions due to birth trauma had significantly decreased. A decline regarding the traumas per se was noticed in caput succedaneum traumas, in hematomas due to birth trauma and in clavicle fracture. The cesarean section rate among the study group increased. The cesarean section rate among the traumatized newborns decreased.Conclusion:  Episiotomy does not prevent newborns from traumatic lesions. Gestational age and birthweight have not significantly changed throughout the years; therefore an increase in the cesarean section rate must have contributed to the decrease of birth traumas. Even during abdominal operative delivery, obstetric traumas in newborns do occur. However, an increase in cesarean sections alone can not thoroughly explain the reduction of birth lesion among newborns. Improvement in prenatal diagnostic tools and procedures, respectively, and a goal‐oriented use of labor induction might also play a major role.
Surgical morbidity associated with total laparoscopic hysterectomy in women with prior diagnostic excision of the cervix
Authors: Phongnarisorn Chailert , Srisomboon Jatupol 
Published: August 2007

AbstractAims:  To evaluate the feasibility, safety, and complications of total laparoscopic hysterectomy (TLH) in women undergoing prior diagnostic excision of the cervix.Methods:  A retrospective study (Canadian Task Force classification II‐2) was conducted in a tertiary care university hospital. The medical records of women undergoing TLH between June 2003 and September 2004 were reviewed.Results:  Twenty‐six women with stage IA1 cervical cancer (19) and persistent high grade cervical neoplasia (7) underwent TLH after diagnostic cervical excision. The operation was successfully performed in all cases without conversion to laparotomy. The mean age of the patients was 47.0 ± 8.64 years (95% CI 43.5–50.5). 19 patients had previous loop electrosurgical excision procedure (LEEP), one had cold knife conization. Six patients underwent repeated LEEP for positive endocervical margin. The mean operating time was 253.0 ± 66.7 min (95% CI 226.0–279.9). The median blood loss was 300 mL (range 50–1000 mL). Only one patient needed 1 unit of blood transfusion. The median post‐operative hospital stay was 3 days (range 2–6 days). All hysterectomy specimens had negative surgical margins. Two patients had major complications, one with bladder injury requiring laparoscopic repair. The remaining one had ureteral injury detected 9 days after the operation requiring subsequent ureteroneocystostomy. Both complications occurred in the first four cases of this series. No significant morbidity was noted in 2 years of follow‐up.Conclusion:  TLH appears to be feasible and safe in patients with prior diagnostic excision of the cervix. Careful separation of the bladder from the cervix and identification of both ureters are recommended to minimize morbidity associated with this operation.
Cytokine profiles in serum and peritoneal fluid from infertile women with and without endometriosis
Authors: Kalu Emmanuel , Sumar Nazira , Giannopoulos Theodoros , Patel Pinika , Croucher Carolyn , Sherriff Elizabeth , Bansal Amolak 
Published: August 2007

AbstractObjective:  To study the serum and peritoneal fluid cytokine profiles in infertile women with minimal/mild active endometriosis.Methods:  Fifty‐seven consecutive infertile women undergoing laparoscopy for unexplained infertility had peritoneal fluid and serum samples obtained at the time of laparoscopy. The levels of interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), interleukin‐1 beta (IL‐1 β), vascular endothelial growth factor (VEGF), tumor necrosis factor‐alpha (TNF‐α), monocyte chemotatic protein‐1 (MCP‐1), RANTES, platelet derived growth factor (PDGF), soluble Fas (sFas), and soluble Fas Ligand (sFasL) in peritoneal fluid and serum were measured to compare the concentration in both biological fluids, in women who have minimal/mild red endometriosis using women with no endometriosis as controls.Results:  Peritoneal fluid levels of MCP‐1, IL‐8 and IL‐6 were significantly higher in the endometriosis group (P < 0.012, P = 0.003, and P = 0.015, respectively). There was no significant difference in the peritoneal fluid levels of IL‐1 β, TNF‐α, RANTES, VEGF, PDGF, sFas and sFasL in the two groups. Although serum levels of IL‐8 were higher in women with endometriosis, the difference was not significant (P = 0.07). Serum levels of PDGF, IL‐6, RANTES, IL‐1 β, TNF‐α, and sFas, were not significantly different in the two groups.Conclusion:  The elevated levels of MCP‐1, IL‐6, and IL‐8 in peritoneal fluid but not serum may indicate the importance of local macrophage activating factors in the pathogenesis of endometriosis.
Massive pericardial effusion in an early gestational fetus having intrapericardial diaphragmatic hernia
Authors: Hara Kikue , Kikuchi Akihiko , Takagi Kimiyo , Kaneko Sachie , Yasukochi Satoshi , Ogiso Yoshifumi 
Published: August 2007

AbstractIntrapericardial diaphragmatic hernia is a very rare phenotype of congenital diaphragmatic hernia. Twelve cases of this condition have been reported under the age of 1 year since 1981, and in only four cases were abnormal findings observed antenatally. We report a case of a fetus with this disease in which pericardial effusion was noted in an earlier gestational age than any other previously reported cases. A 35‐year‐old pregnant woman was referred to our center at 16 weeks' gestation. Ultrasound revealed that the bilateral lungs of the fetus were very small due to the compression by massive pericardial effusion. Pregnancy was terminated at 18 weeks, and autopsy of the stillborn baby revealed intrapericardial diaphragmatic hernia and cardiac aneurysm of the right ventricle. In conclusion, when pericardial effusion is observed in a fetus, intrapericardial diaphragmatic hernia, a very rare type of congenital diaphragmatic hernia, must be included in a differential diagnosis.
Dichorionic twin fetuses with VACTERL association
Authors: Sunagawa Sorahiro , Kikuchi Akihiko , Yoshida Shiro , Miyashita Susumu , Takagi Kimiyo , Kawame Hiroshi , Kondo Yoshiaki , Nakamura Tomohiko 
Published: August 2007

AbstractAlthough prenatal diagnosis of VACTERL (vertebral defects, anal atresia, cardiac anomaly, tracheal‐esophageal fistula with esophageal atresia, renal defects, and radial limb dysplasia) association is not always possible, ultrasonography and magnetic resonance imaging can visualize some of the characteristic findings of this condition. Because infants with this condition usually require significant surgical treatment and care, prenatal detection with those imaging modalities should assist in proper planning for delivery and anticipated care of the neonate. In this report, we present dichorionic twin fetuses, both of whom were found postnatally to have this condition, and suggest the possible relationship between this disorder and intracytoplasmic sperm injection. As far as we know, this is the first report of twin fetuses affected by VACTERL association.
Nitric oxide donor isosorbide mononitrate for pre‐induction cervical ripening at 41 weeks' gestation: A randomized controlled trial
Authors: Rameez Mohamed Furukan Mohamed , Goonewardene Indra Malik Rodrigo 
Published: August 2007

AbstractObjective:  Nitric oxide donors have been shown to cause cervical ripening. The aim of this study was to determine whether sustained release isosorbide mononitrate (ISMN‐SR) 60 mg administered vaginally is effective for pre induction cervical ripening at 41 weeks' gestation.Methods:  A double‐blind randomised controlled trial was carried out at the University Obstetric Unit, Galle, Sri Lanka for a period of 9 months, commencing 1st August 2003. One hundred and fifty‐six consecutive women with uncomplicated singleton pregnancies at 41 weeks' gestation with a modified Bishop Score <5 were allocated by stratified (primip/multip) block randomization to receive either ISMN‐SR 60 mg (n = 78) or vitamin C 100 mg (n = 78) vaginally. Modified Bishop Score at 41 weeks + 2 days' gestation and the proportions establishing spontaneous labor or becoming favorable for induction of labor (IOL) by 41 weeks + 2 days' gestation were evaluated in each group.Results:  At the commencement of the study there were no differences between the mean age, parity or modified Bishop Score of the two groups. In the ISMN‐SR group, there was a marked increase in the proportion establishing spontaneous labor (28% vs 7.5%, P < 0.01) and being favorable for IOL (40% vs 9% P < 0.001), 2 days after therapy. In the ISMN‐SR group, there was a significantly higher increase in the mean modified Bishop Score (3.8, 95% CI 2.3–5.3 vs 1.3, 95% CI 0.3–2.2, P < 0.01) and a marked decrease in the proportion of subjects requiring further ripening of the cervix with a Foley catheter. (32% vs 79%, P < 0.001). The cesarean section rates were similar in both groups.Conclusion:  Sustained release ISMN administered vaginally is effective for preinduction cervical ripening.
Mixed epithelial and stromal tumor of the kidney in a puerperal woman
Authors: Sharma Jai Bhagwan , Aruna Janaki , Mittal Suneeta , Sharma Meher Chand 
Published: August 2007

AbstractPuerperal pyrexia is still rampant, especially in third world countries, and is usually due to puerperal sepsis, urinary tract infections, upper respiratory infection, and breast infection. Rarely, in third world countries like India, it may be due to tuberculosis, malaria, typhoid, and so on, which are also rampant in the general population. Mixed epithelial and stromal tumor of the kidney (MESTK) is a recently recognized subset of renal tumors composed mainly of smooth muscle cells in which epithelial structures are embedded. It usually occurs in middle aged and older women. In the present case report, a 36‐year‐old woman presented with puerperal pyrexia, possibly due to tuberculosis and with an incidental mixed epithelial and stromal tumor of the kidney causing complex ascitis and fever, which required nephrectomy that was followed by full recovery. This case report highlights the importance of keeping MESTK in mind even in younger women with asymptomatic renal mass. It also highlights the importance of keeping renal tumors in mind as a possibility and to perform proper investigations for adequate treatment and recovery.
Total vaginal reconstruction with combined ‘Split Labia Minora Flaps’ and full‐thickness skin grafts
Authors: Baytekin Caghan , Menderes Adnan , Mola Fahri , Balik Ozan , Tayfur Volkan , Vayvada Haluk 
Published: August 2007

AbstractPurpose:  Vaginal reconstruction with split‐thickness skin grafts is the most common method for total vaginal reconstruction. Although it has disadvantages like contraction of the graft, foreshortening, donor site morbidity and long‐lasting periods of vaginal standing; its easy surgical technique makes it popular. A new method using split labia minora (LM) flaps and full‐thickness skin graft is discussed in this study.Method:  A 19‐year‐old female was presented with amenorrhea. A total absence of vagina was present and the patient underwent a total vaginal reconstruction for possible sexual intercourse.Results:  We observed no contraction and no foreshortening with a patent vaginal cavity up to 11 cm and 4.5 cm width. The need for continuous standing period was as short as 4 weeks and for intermittent standing up to 4 months. Sexual intercourse was encouraged after 4 weeks. During sexual intercourse no external lubrication was reported to be needed. There was no need for further reconstructive intervention.Conclusion:  Vaginal reconstruction in congenital vaginal agenesis with split LM flaps and full‐thickness skin grafts is a simple and effective method, which shortens the standing period and decreases the contraction in neovagina. Total vaginal reconstruction with split LM flaps could also be possible; to achieve this goal, expansion of LM flaps could be a further alternative.
Retrospective study of the success rates and complications associated with total laparoscopic hysterectomy
Authors: Ng Christopher C. M. , Chern Bernard S. M. , Siow Anthony Y. M. 
Published: August 2007

AbstractAims:  Laparoscopic techniques are being used increasingly more in gynecologic surgery and the introduction of modern laparoscopic instruments has allowed complex operations to be performed laparoscopically. The aim of this study is to evaluate our surgical technique with regard to the success of total laparoscopic hysterectomy (TLH) for the removal of the uterus, by analyzing its intraoperative and postoperative surgical outcomes and complications in the hope of reducing their occurrence.Methods:  A retrospective observational study was carried out at KK Hospital, Singapore, based on TLH operations performed from January 2001 to June 2005. The KOH Colpotomizer System and the RUMI Uterine Manipulator were the surgical methods used.Results:  435 women consented for a TLH. 427 women (98.2%) had a successful TLH with three mini‐laparotomy and five laparotomy conversions (1.8% failure rate). Injuries included bowel injury (four), bladder base bleeding (one), uterine perforation (one), uterovaginal fistula (one) and vaginal laceration (four). 21 women (4.8%) encountered major complications (defined as laparotomy conversion, excessive bleeding requiring blood transfusion, hemorrhage ≥1000 mL, ureteric injury, bowel injury and pulmonary embolus), which compares favorably with previous reports (4.0–11.0%) of laparoscopic hysterectomy. Our mean operating time, mean estimated blood loss, mean hospital stay and readmission rate are similarly comparable.Conclusion:  TLH is associated with a high success rate, and low morbidity with few complications.
Hypersensitivity to aeroallergens in patients with recurrent vulvovaginitis of undetermined etiology
Authors: Ozturk Sami , Caliskaner Zafer , Karaayvaz Mehmet , Dede Murat , Gulec Mustafa 
Published: August 2007

AbstractAim:  Recent findings show that the vaginal mucosa can develop an allergic response to environmental allergens and there is a strong association between atopy and some recurrent vulvovaginal infections. In this study, we investigated prospectively the rate of atopy in patients with recurrent vulvovaginitis of undetermined etiology (RVV).Material and Methods:  After being investigated by a gynecologist, 35 patients with RVV who were considered as undetermined etiology formed the study group. The control group consisted of 150 healthy females. Study and control groups were investigated for atopy by means of skin prick test for common aeroallergens. Associated allergic disease and familial atopy history of the subjects were recorded.Results:  The rate of atopy (11/35; 31.4% vs 9/150; 6%) was significantly higher (P < 0.001) in the study group than in the controls. Familial history of atopy was significantly more frequent in the study group than in the controls (10/35; 28.6% vs 8/150; 5.3%, P < 0.05). RVV in atopics is more associated with seasonal rhinitis than in nonatopics (5/11; 45.4% vs 2/24; 8.3%, P < 0.05).Conclusion:  We concluded that a significant number of RVV is associated with atopy. Although the exact mechanism(s) of this relationship remains to be investigated atopy might be a causative and/or contributing factor in the pathogenesis of RVV.
Ligneous inflammation involving the female genital tract
Authors: Karaer Abdullah , Mert Ismail , Akınsu Filiz , Tug Mengu , Tefs Katrin , Schuster Volker , Mollamahmutoglu Leyla 
Published: August 2007

AbstractLigneous inflammation is a rare disease characterized by progressive growth of ligneous plaques on mucosal surfaces. Involvement of the female genital tract is an unusual condition. We present a patient with multifocal ligneous inflammation involving her genital tract, oral mucosa and conjunctiva. Plasminogen functional activity was 18% of normal (reference: 55–145%). Molecular analysis exhibited that her genetic status is homozygous for a combination of three polymorphisms. But no true mutation could be found in all 19 exons of the plasminogen gene. We did not observe any clinical changes, although plasminogen activity has improved in the course of 5 months of oral contraceptive therapy Most gynecologists are unfamiliar with this diagnosis and pathologists with wide experience in gynecology are unaware of this disease. However, the histology of lesions is characteristic and a diagnosis can be made quite easily once it has been considered.
Impact of use of combined oral contraceptive pill on the quality of life of Japanese women
Authors: Matsumoto Yasuyo , Yamabe Shingo , Ideta Kazuhisa , Kawabata Masato 
Published: August 2007

AbstractAim:  To evaluate the impact of combined oral contraceptive pill (OC) use on quality of life (QOL) among Japanese women, we performed a prospective study using the Japanese version of the World Health Organization Quality of Life (WHOQOL) questionnaire.Methods:  Women who consulted Chayamachi Lady's Clinic to get a prescription for OC for the first time were recruited for our questionnaire study and asked to complete the WHOQOL questionnaire twice, before taking OC and more than 3 months after beginning OC use. Two hundred and seventeen women responded to our questionnaire before taking OC and 110 patients completed the questionnaire. The patients were divided into six groups based on the reason they wanted to take OC: contraception, relaxation of dysmenorrhea, regulation of menstrual cycles, improvement of acne, remission of menorrhagia, and improvement of premenstrual tension syndrome (PMS).Results:  WHOQOL scores showed significant improvement in all domains of the dysmenorrhea group, all domains but the social of over all participants, the social and overall domain of the irregular cycle group, physical, environmental, and overall domain of the acne group, and psychological and overall domain of the PMS group. The WHOQOL score worsened in the social domain of the contraception group; however, the score in the overall domain of that group improved.Conclusions:  These results indicate that OC can provide higher QOL for women with problems involving menstrual pain and/or hormonal abnormalities. However, those using OC for contraception only were found to be unsatisfied with taking OC in a relationship with their partners.
Re‐evaluation of the true rate of hepatitis C virus mother‐to‐child transmission and its novel risk factors based on our two prospective studies
Authors: Hayashida Ayako , Inaba Noriyuki , Oshima Kyoko , Nishikawa Masayoshi , Shoda Akiko , Hayashida Shihou , Negishi Masami , Inaba Fujiyuki , Inaba Michiyo , Fukasawa Ichio , Watanabe Hiroshi , Takamizawa Hiroyoshi 
Published: August 2007

AbstractObjective:  To re‐evaluate the true hepatitis C virus (HCV) mother‐to‐child transmission (MTCT) rate and its novel risk factors.Study Design:  A comparative study based on our own two prospective studies done during the two periods, ‘early’ (1989–1994) and ‘recent’ (1995–2004).Results:  All carrier infants became HCV RNA‐positive within 3 months after birth. The MTCT and de‐carrier rates were, respectively, higher (14.2%) and lower (16.7%) in the recent period, although liver dysfunction of carrier infants was found very frequently (66.7%) in both groups. MTCT occurred significantly when the maternal viral load, serum alanine aminotransferase (sALT) levels and blood loss at delivery were, respectively, more than 105 copies/mL, 110 IU/L, and 500 g. No MTCT was found when elective cesarean section was done.Conclusions:  The true HCV MTCT and de‐carrier rates were found to be much higher and lower than those reported previously. The maternal liver dysfunction (sALT ≥110 IU/mL) and blood loss (≥500 g) at delivery are the next risk factors to maternal viral load (≥105 copies/mL) for MTCT.