bluuebunny/crossref_metadata_2025_split huggingface dataset:
OUTCOMES OF LAPAROSCOPIC ADRENALECTOMY FOR HYPERLADOSTERONISM
Authors: Pang Tony C. , Bambach Chris , Monaghan Judith C. , Sidhu Stan B. , Bune Alex , Delbridge Leigh W. , Sywak Mark S. 
Published: August 2007

Background:  Primary hyperaldosteronism is a frequent cause of resistant hypertension and is amenable to surgical intervention when caused by a unilateral aldosterone‐producing adenoma. The aim of this study was to investigate the long‐term results of laparoscopic adrenalectomy in the control of hypertension caused by primary hyperaldosteronism.Methods:  A prospective case series of patients undergoing laparoscopic adrenalectomy for hyperaldosteronism was studied. Blood pressure (BP), serum aldosterone levels, plasma renin activity, serum potassium and antihypertensive requirement were measured before and after adrenalectomy.Results:  Sixty‐two patients with hyperaldosteronism underwent laparascopic adrenalectomy in the period from December 1995 to August 2005. The median follow up was 59 months. There was a significant decrease in both systolic blood pressure and diastolic blood pressure at final follow up compared with that before operation. Systolic blood pressure decreased from 149 mmHg to 129 mmHg at final follow up (P < 0.0001). Diastolic blood pressure decreased from 89 mmHg to 80 mmHg (P < 0.0001). Antihypertensive requirement was decreased from an average of 2.6 separate medications preoperatively to 1.4 medications at final follow up (P < 0.0001). Serum aldosterone levels were significantly lower (698 (confidence interval 534–862) pg/mL vs 181 (confidence interval 139–225) pg/mL, P < 0.0001). Overall, 34% of patients had cure of hypertension and did not require any antihypertensive agent. A further 51% had improvement in BP control, whereas 5% had no change or had worsening hypertension. Multivariate regression analysis showed that age and gland size were independent factors predicting sustained hypertension after surgery.Conclusion:  In appropriately selected patients with primary hyperaldosteronism, laparoscopic adrenalectomy is effective in improving long‐term BP control. Larger adrenal gland size and older age at time of surgery are predictors of persisting hypertension.
IS LAPAROSCOPIC COLECTOMY FOR CANCER COST‐EFFECTIVE RELATIVE TO OPEN COLECTOMY?
Authors: Hayes Julian L. , Hansen P. 
Published: August 2007

Background: Laparoscopic‐assisted colectomy (LAC) for cancer has been shown to be safe, with equivalent long‐term survival rates to conventional open colectomy (OC) and better short‐term patient outcomes. However, LAC tends to require more operating theatre time and disposable equipment. This study investigated, in the context of the New Zealand public hospital system, the extent to which LAC for cancer is cost‐effective relative to OC.Methods: Estimates of the hospital resources used and patient recovery times for LAC and OC for colorectal cancer were obtained from a meta‐analysis of published international randomized controlled trials. Using prices from a representative New Zealand public hospital, the additional resources for LAC (relative to OC) were summed to obtain an estimate of LAC’s total incremental (additional) cost. The recovery time savings from LAC were also represented in quality‐adjusted life years (QALY), enabling a cost‐utility analysis of LAC, which was subjected to a one‐way sensitivity analysis.Results: On average, a LAC costs New Zealand public hospitals $1267 (range: $259–$3808; all dollars referred to are New Zealand dollars) more than an OC. Average recovery time savings of 12 and 33 days (from two randomized controlled trials) translate into QALY gains of 0.018 and 0.049. Thus, relative to an OC, an LAC costs $38 and $106 per recovery day saved, or $70 389 and $25 857 (combined range: $14 389–$211 556) per QALY gained.Conclusion: LAC for cancer appears to be cost‐effective relative to OC (per recovery day saved and QALY gained, respectively) for the lower of the average cost estimates and is probably not cost‐effective for the higher estimate. Expected future reductions in operating times, conversion rates and postoperative stays will further improve cost‐effectiveness.
MINIMALLY INVASIVE APPROACH IN THE MANAGEMENT OF CHILDHOOD INTUSSUSCEPTION
Authors: Cheung Sing T. , Lee Kim H. , Yeung Tse H. , Tse Cheong Y. , Tam Yuk H. , Chan Kin W. , Yeung Chung K. 
Published: August 2007

Background:  Intussusception is one of the most common causes of intestinal obstruction in infancy. Non‐operative reduction using air enema or other hydrostatic reduction methods has been the standard treatment in most cases. However, if the non‐operative method is not indicated or fails, open surgery is still necessary. With the tremendous development of the minimally invasive approach in handling surgical conditions in children in the last decade, this has been applied recently for the reduction of intussusception in children. We herein reviewed our experience of using the combined approach, namely, pneumatic reduction and, if failed, laparoscopic reduction in the management of childhood intussusception.Methods:  We carried out a retrospective analysis of all children with intussusception managed at Prince of Wales Hospital between December 1998 and December 2004. The minimally invasive approach was used as far as possible. The method of reduction, success rate and the incidence of complication were analysed.Results:  Over a 6‐year period, there were 146 patients with 167 episodes of intussusception. Pneumatic reduction was carried out in 160 occasions and was successful in 134 (83.8%). In 33 patients, operative reduction was required. Of these, laparoscopic reduction was attempted in 15 and was successful in 13 (86.7%). In those with either pneumatic or laparoscopic reduction, no procedure‐related complication was encountered and they had a significant shorter hospital stay (median 3.0 day) than those requiring laparotomy (median 8.0 day) (t‐test, P < 0.0001).Conclusion:  The minimally invasive approach, that is, pneumatic and/or laparoscopic reduction, was successful in reducing intussusception in 88% of patients with minimal morbidity and shorter hospital stay.
Sperm retention site and its influence on pronucleus stage evaluation following intracytoplasmic sperm injection
Authors: NEGISHI MOMOKO , YANAIHARA ATSUSHI , IWASAKI SHINJI , SUZUKI NORIO , HASEGAWA JUNICHI , YORIMITSU TAKESHI , OKAI TAKASHI 
Published: August 2007

Aim:  It has been suggested that the position of the sperm after intracytoplasmic sperm injection (ICSI) has an effect on the development and quality of the embryo. In this study, we retrospectively examined whether pronucleus stage evaluation used through clinical studies in recent years has relevance with regard to sperm location.Methods:  From 2003 to 2005, 1285 oocytes from 459 patients (average age: 36 years) were retrospectively analyzed. The 459 patients underwent ICSI because of fertilization disorders and oligozoospermia. Follicle stimulation was via either Clomid or the long protocol. Human chorionic gonadotropin was administered to induce ovulation and oocyte retrieval was conducted 35 h later. After confirming the presence of a polar body, we immobilized the ovum at the 6 o’clock position, introduced the injection pipette at the 3 o’clock position and carried out ICSI.Results:  When a sperm was located at a position that was opposite to the polar body, both classifications of Scott and Tesarik regarding embryo quality were distinctly low. Furthermore, a good embryo classification ensued when the sperm was located adjacent to the polar body.Conclusion:  The zone in which the sperm was located did not always correlate with embryo quality; however, our study suggested that sperm location affects the synchronization of the nucleolus. When carrying out ICSI, it is important to take into consideration the insertion point of the sperm. (Reprod Med Biol 2007; 6: 171–174)
Uterine rupture during pregnancy soon after a laparoscopic adenomyomectomy
Authors: MORIMATSU YUKAKO , MATSUBARA SHIGEKI , HIGASHIYAMA NOBUHIKO , KUWATA TOMOYUKI , OHKUCHI AKIHIDE , IZUMI AKIO , SHIBAHARA HIROAKI , SUZUKI MITSUAKI 
Published: August 2007

Although laparoscopic adenomyomectomy may be a possible risk factor for uterine rupture in subsequent pregnancy, few reports have described it. A 35‐year‐old woman became pregnant 1 month after laparoscopic adenomyomectomy. At the 28th week, uterine contraction occurred, leading to intravenous ritodrine infusion. Severe abdominal pain and a non‐reassuring fetal heart rate occurred abruptly and an emergency cesarean section was carried out. The uterus ruptured at the site of previous surgery of the uterine body, which was reconstructed. The mother and the infant did well postoperatively. We report the second case of uterine rupture during pregnancy subsequent to laparoscopic adenomyomectomy. A history of adenomyomectomy and a short interval to subsequent pregnancy may be risk factors for uterine rupture. (Reprod Med Biol 2007; 6: 175–177)
Single inherited thrombophilias and adverse pregnancy outcomes
Authors: Larciprete Giovanni , Gioia Stefano , Angelucci Piero A. , Brosio Federica , Barbati Giulia , Angelucci Giulio P. , Frigo Maria G. , Baiocco Federico , Romanini Maria Elisabetta , Arduini Domenico , Cirese Elio 
Published: August 2007

AbstractIntroduction:  Inherited thrombophilia is believed to be a multiple gene disease with more than one defect. We aimed to determine the association between single thrombophilic patterns and a variety of pregnancy diseases.Methods:  284 pregnant women were recruited for the present study and were divided in two groups: A group (176 controls) and B group (108 cases). Patients belonging to the B group had one of the following: severe pre‐eclampsia, hemolysis, hepatic enzymes increase, hypertension and low platelet count (HELLP) syndrome, gestational hypertension, fetal growth restriction, intrauterine death, abruptio placentae and disseminated intravascular coagulopathy. To detect methylenetetrahydrofolate reductase (MTHFR) A1298C, MTHFR C677T, factor V Leiden, PAI‐1, mutant prothrombin G20210A, an inverse hybridization technology was used. Plasma homocysteine, antithrombin (AT) III and protein S were determined. A modified functional activated protein C resistance was detected.Results:  MTHFR C677T and hyperhomocysteinemia were more prevalent than other thrombophilias. Deficiency in AT III was significantly linked with pre‐eclampsia (relative risk 0.88; 95% CI 0.83–0.94). Activated protein C resistance (APCR) was significantly related to the abruptio placentae (relative risk 0.71; 95% CI 0.61–0.82).Comments:  Apart from the linkage between AT III deficiency and the occurrence of pre‐eclampsia, and apart from the increased risk of abruptio placentae in pregnant women with altered APCR, we obtained findings in contrast with some of the published literature. In our case series, no association of pre‐eclampsia with factor V Leiden or with prothrombin gene mutation was found.
TNF‐α from monocyte of patients with pre‐eclampsia‐induced apoptosis in human trophoblast cell line
Authors: Seki Hiroyuki , Matuoka Kikumi , Inooku Hiroki , Takeda Satoru 
Published: August 2007

AbstractObjective:  In pre‐eclampsia, fetal growth restriction is frequently observed, and the possible involvement of inhibitory substances on trophoblast cell proliferation and differentiation has been suggested. The objective of this study was to investigate the effects humoral factors, such as cytokines, produced in immune cells on proliferation of an immortalized trophoblastic cell line (TCL) that we established.Methods:  Serum and lymphocyte layers were isolated from the blood of normal pregnant and preeclamptic women. The lymphocyte layer was further fractionated into different immune cell populations by the Stem Sep method. Immortalized trophoblastic cells were cultured with the sera diluted. The cytokine concentrations in the supernatants of lymphocyte cultures were compared between normal pregnancy and pre‐eclampsia. The number, DNA content and induced apoptosis were examined on the immortalized trophoblastic cells at the end of culture.Results:  The sera from preeclamptic women significantly inhibited the immortalized trophoblastic cell proliferation in comparison with those from normal pregnancy. Among the lymphocyte fractions, monocytes significantly inhibited the immortalized trophoblastic cell proliferation. The monocytes from preeclamptic women were found to produce higher levels of tumor necrosis factor‐α (TNF‐α) in the culture supernatant than those from normal pregnant women. The coculture with the monocytes from preeclamptic women increased the frequency of TUNEL‐positive TCL cells. TNF‐α inhibited immortalized trophoblastic cell proliferation in a dose‐dependent manner and induced apoptosis.Conclusion:  The present results suggest that monocytes are activated and that cytokines, such as TNF‐α, which is produced by monocytes, induce apoptosis and inhibit proliferation of trophoblast cells in pre‐eclampsia.
Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clinical indicators of hyperemesis severity
Authors: Tan Peng C. , Jacob Reena , Quek Kia F. , Omar Siti Z. 
Published: August 2007

AbstractObjective:  To determine pregnancy outcome in hyperemesis gravidarum and the effect of metabolic, biochemical, hematological and clinical indicators of disease severity on outcome.Study Design:  A retrospective study based on 166 women hospitalized for confirmed hyperemesis gravidarum from January 2004 to January 2005. For each woman, three controls matched for age, parity and ethnicity were obtained from our 2004 birth register. The effects of laboratory indicators of hyperemesis severity were separately analyzed within the hyperemesis gravidarum study group. Outcome measures include stillbirths, Apgar score, mode of delivery, low birthweight, preterm delivery, labor induction, pregnancy induced hypertension and gestational diabetes. Analysis was by t‐test, Fisher's exact test and multivariable logistic regression analysis.Results:  Women with hyperemesis had similar pregnancy outcome compared to controls. In the analysis of laboratory indicators of hyperemesis severity and pregnancy outcomes, hypokalemia (adjusted odds ratio [AOR] 2.7: 95% confidence interval [CI] 1.0–6.8) was associated with emergency operative delivery, high creatinine (odds ratio 4.4: 95% CI 1.3–15) with labor induction and raised gamma glutamyltransferase (AOR 7.5: 95% CI 1.2–46) with the development of gestational diabetes.Conclusions:  Hyperemesis gravidarum per se was not associated adverse pregnancy outcome. Hypokalemia, high creatinine and raised gamma glutamyltransferase in women with hyperemesis gravidarum were associated with adverse pregnancy outcome.
Cervical varix with placenta previa totalis
Authors: Kumazawa Yukiyo , Shimizu Dai , Hosoya Naoko , Hirano Hideto , Ishiyama Koichi , Tanaka Toshinobu 
Published: August 2007

AbstractA cervical varix during pregnancy is a very rare complication. It can lead to hemorrhage and may result in significant morbidity. Furthermore, appropriate management has not yet been established. We present a case of a cervical varix with placenta previa totalis. A 30‐year‐old woman with placenta previa totalis also had a cervical varix without bleeding. At 32 weeks' gestation, massive hemorrhage from the cervical varix occurred. A vaginal pack controlled the bleeding, and a cesarean section was subsequently carried out because of uncontrollable uterine contractions. A 1655 g female infant was delivered; the estimated blood loss was 1814 mL. The cervical varix decreased dramatically in size. In conclusion, presented herein is a rare case of a cervical varix, which had a successful outcome.
Metastasis of lobular breast carcinoma to the cervix
Authors: Perišić Dragan , Jančić Snežana , Kalinović Dragoslav , Čekerevac Milica 
Published: August 2007

AbstractBreast cancers without previous dissemination occasionally result in hematogenous metastases in gynecologic organs, particularly in the cervix. This case report examines a multimodally treated lobular breast cancer patient who was 52 months later diagnosed with malignancy in the uterus. After a tumor was detected at the endocervical and isthmic part of the uterus, a complete hysterectomy with bilateral salpingo‐oophorectomy was carried out. The malignant cells were highly positive for carcino‐embrional antigen and gross cystic disease fluid protein‐15, sensitive breast cancer markers. In conclusion, as breast carcinoma can metastasize to atypical places (cervix, endometrium, etc.), regular surveillance of patients should include gynecologic control.
Decrease and dysfunction of endothelial progenitor cells in umbilical cord blood with maternal pre‐eclampsia
Authors: Xia Liang , Zhou Xin P. , Zhu Jun H. , Xie Xu D. , Zhang Hao , Wang Xing X. , Chen Jun Z. , Jian Sun 
Published: August 2007

AbstractBackground:  The pre‐eclampsia is characterized by placental defective angiogenesis and maternal vascular/endothelial dysfunction. Recently, the decrease and senescence of endothelial progenitor cells (EPC) has been observed in maternal circulation with pre‐eclampsia. Given the essential involvement of EPC in neovascularization and reendothelialization, we investigate whether or not the depletion of EPC is existent in placental/fetal circulation with maternal pre‐eclampsia.Methods:  Samples of venous cord blood were collected during the labor of preeclamptic mothers (n = 14) and normotensive controls (n = 10). Circulating EPC were enumerated as AC133+/KDR+ cells via fluorescence‐activated cell sorting (FACS) analysis. Additionally, EPC were expanded in vitro and identified by DiI‐acLDL uptake and lectin staining by direct fluorescent staining under a laser scanning confocal microscope. EPC proliferation, migration and vasculogenesis activities were determined by MTT, modified Boyden chamber assay and in vitro vasculogenensis assay.Result:  The placental/fetal circulating EPC numbers were significantly decreased in the pre‐eclampsia group compared with the control (median, 200; range, 100–440 cells/mL vs 390; 270–440 cells/mL, P < 0.001), and after in vitro cultivation the numbers of EPC also decreased in pre‐eclampsia group (19.5; 5.0–32.0 vs 39.5; 31.2–52.0 EPC/×200 field; P < 0.001). Both circulating EPC and cultivated EPC were inversely correlated with cord blood level of soluble fms‐like tyrosine kinase 1 (sFlt‐1). In addition, the EPC from patients with pre‐eclampsia were significantly impaired in their proliferation, migration and vasculogenesis capacities.Conclusion:  The present study documented the decrease and dysfunction of placental/fetal circulating EPC in patients with pre‐eclampsia. The alteration is probably associated with the increased sFlt‐1 levels in the umbilical cord blood.
Iniencephaly: Prenatal diagnosis with postmortem findings
Authors: Tugrul Semih , Uludoğan Mehmet , Pekin Oya , Uslu Hüsamettin , Çelik Cem , Ersan Fırat 
Published: August 2007

AbstractIniencephaly is a rare but almost always lethal neural tube defect with the following cardinal features: occipital bone defect, partial or total absence of cervicothoracal vertebrae and fetal retroflexion. Iniencephaly is associated with malformations of the central nervous system, gastrointestinal and cardiovascular system. Prenatally diagnosed cases of iniencephaly are rare because careful and early ultrasonographic evaluation is necessary. The present cases of iniencephaly were found to carry associated malformations such as atrioventricular septal defect and club foot. We present an iniencephaly prenatally diagnosed by sonography, in which therapeutic abortion was induced, with a review of the published literature.
Severe ovarian hyperstimulation syndrome in a twin pregnancy after intracytoplasmic sperm injection
Authors: Cupisti Susanne , Mueller Andreas , Strauss Richard , Dittrich Ralf , Beckmann Matthias W. , Binder Helge 
Published: August 2007

AbstractA 35‐year‐old woman developed bilateral jugular thrombosis in the seventh gestational week in a twin pregnancy after severe ovarian hyperstimulation syndrome (OHSS) and intracytoplasmic sperm injection (ICSI). Due to progressive thrombosis and further complications despite anticoagulation therapy, the pregnancy was terminated in the ninth gestational week. Thromboembolic events are a serious complication associated with OHSS after assisted reproduction techniques. In these cases, a pregnancy can usually be protected by administering anticoagulation therapy, but our case shows that there may be exceptions to this. Screening for thrombophilia should be considered in patients who are at risk for OHSS and deep vein thrombosis.
Definitive diagnosis of primary adenocarcinoma of the appendix by laparoscopic appendectomy
Authors: Umemoto Masahiko , Shiota Mitsuru , Shimaoka Masao , Hoshiai Hiroshi 
Published: August 2007

AbstractWe report a 62‐year‐old woman with a primary adenocarcinoma of the appendix mimicking ovarian tumor. We had diagnosed it definitively by laparoscopic appendectomy, and additional surgery was required in this case. However, the present case suggests that, in some cases, if cancer of the appendix can be diagnosed early, laparotomy can be avoided and the cancer treated with minimally invasive laparoscopic surgery alone.
Mechanical ileus in a pregnant woman at term pregnancy accompanied by labor pains
Authors: Kuwahata Tomoki , Iwamoto Ichiro , Fujino Toshinori , Douchi Tsutomu 
Published: August 2007

AbstractIntestinal obstruction in pregnancy is a rare, but serious complication of pregnancy with significant maternal and fetal mortality. We herein report a case of intestinal strangulation in a pregnant woman with a history of pelvic surgery due to an ectopic pregnancy. Epigastric pain occurred at term pregnancy with concomitant onset of labor pains. The epigastric pain disappeared transiently, and she gave a birth to a healthy child. However, the pain appeared again after the vaginal delivery. She immediately underwent ileo‐ileostomy with a diagnosis of mechanical ileus, and the postoperative course was uneventful. Mechanical ileus should be considered when examining epigastric pain in a pregnant woman with a history of abdominal or pelvic surgery even after the onset of labor pains.