bluuebunny/crossref_metadata_2025_split huggingface dataset:
The changes in magnetic resonance properties of the fetal lungs: a first result and a potential tool for the non‐invasive in utero demonstration of fetal lung maturation
Authors: Duncan Keith R. , Gowland Penny A. , Freeman Alan , Moore Rachel , Baker Philip N. , Johnson Ian R. 
Published: August 2005

Objective
To measure magnetic resonance parameters T1 and T2 of the fetal lungs and investigate the relationship of these parameters to changes in volume and gestation.Design
Prospective cross‐sectional study.Setting
Large teaching hospital in Nottingham and the Magnetic Resonance Centre at the University of Nottingham.Population
Normal pregnancies from 20 weeks to term.Methods
T1, T2, and lung volume were measured in the fetus using echo‐planar magnetic resonance imaging.Main outcome measures
The relationship of T1 and T2 to gestational age and lung volume.Results
Linear regression demonstrated a significant relationship (P < 0.001) between gestational age and lung volume, T1 and T2. There was also a significant relationship between lung volume and T1 and T2 (P < 0.001).Conclusions
Relaxation time measurements give additional information to lung volume estimation in the assessment of lung physiology in utero. We have demonstrated the progressive changes which take place in the fetal lungs between 20 weeks and term. The physiological changes which can be demonstrated with this non‐invasive technique may have an important application in the demonstration of fetal lung maturity in a prospective non‐invasive manner.
Indicators of quality of antenatal care: a pilot study
Authors: Vause Sarah , Maresh Michael 
Published: August 2005

Objective
To pilot a list of indicators of quality of antenatal care across a range of maternity care settings. For each indicator to determine what is achieved in current clinical practice, to facilitate the setting of audit standards and calculation of appropriate sample sizes for audit.Design
A multicentre retrospective observational study.Setting
Nine maternity units in the United Kingdom.Population
20, 771 women with a singleton pregnancy, who were delivered between 1 August 1994 and 31 July 1995.Results
Nine of the eleven suggested indicators were successfully piloted. Two indicators require further development. In seven of the nine hospitals external cephalic version was not commonly performed. There were wide variations in the proportions of women screened for asymptomatic bacteriauria. Screening of women from ethnic minorities for haemoglobinopathy was more likely in hospitals with a large proportion of non‐Caucasian women. A large number of Rhesus negative women did not have a Rhesus antibody check performed after 28 weeks of gestation and did not receive anti‐D immunoglobulin after a potentially sensitising event during pregnancy. As a result of the study appropriate sample sizes for future audit could be calculated.Conclusions
Measuring the extent to which evidence‐based interventions are used in routine clinical practice provides a more detailed picture of the strengths and weaknesses in an antenatal service than traditional outcomes such as perinatal mortality rates. Awareness of an appropriate sample size should prevent waste of time and resources on inconclusive audits.
Misoprostol dose‐related shivering and pyrexia in the third stage of labour
Authors: Lumbiganon Pisake , Hofmeyr Justus , Gülmezoglu A. Metin , Pinol Alain , Villar José ,   For the WHO Collaborative Trial of Misoprostol in the Management of the Third Stage of Labour
Published: August 2005

Objective
To select the misoprostol dose to be used in a large multicentre randomised trial comparing misoprostol with oxytocin in the routine management of the third stage of labour.Design
Randomised pilot trial, double‐blinded with the use of double placebos.Setting
Two of the nine hospitals that will participate in the main multicentre trial. The hospitals werePopulation
Women during second stage of labour about to be delivered vaginally.Methods
located in Johannesburg, South Africa and Khon Kaen, Thailand. The trial had three arms: misoprostol 400 μg versus misoprostol 600 μg versus intramuscular oxytocin 10 IU. Each group received an injection and three tablets immediately after the birth of the baby.Main outcome measures
Shivering and pyrexia rates were the main outcome measures. Data on other side effects and characteristics of the third stage of labour were also collected. Side effects were noted as none, mild, moderate or severe.Results
Both shivering and pyrexia (temperature > 38°C) were most common in the 600 μg misoprostol group (28% and 7.5% for shivering and pyrexia, respectively) compared with 400 μg misoprostol (19% and 2%), and the oxytocin group (12.5% and 3%). The increase in shivering in the misoprostol 600 pg group was due primarily to a higher rate of moderate shivering. None of the women had a temperature > 40°C. There were no increases in severe side effects and other adverse events in the misoprostol 600 μg group.Conclusions
When used in the management of the third stage of labour oral misoprostol is associated with an increase in the rate of moderate shivering and pyrexia which seems to be dose‐related. Based on the results of this pilot trial, the Steering Committee has decided to use 600 μg misoprostol in the main trial, comparing it with oxytocin, in order to achieve higher effectiveness.
Controlled trial of fundal height measurement plotted on customised antenatal growth charts
Authors: Gardosi Jason , Francis Andre 
Published: August 2005

Objective
The purpose of this study was to evaluate the effect of a policy of standard antenatal care which included plotting fundal height measurements on customised antenatal charts in the community.Design
Prospective, non‐randomised, controlled, population‐based study.Population
Two defined and separate referral areas from community to teaching hospital, with similar delivery rates and socioeconomic characteristics. A total of 1272 consecutively booked women with singleton pregnancies and dating ultrasound scans before 22 weeks of gestation.Intervention
In the study area customised fundal height charts were issued to each mother at the routine hospital booking scan, on which regular fundal height measurements were to be plotted by community midwives. The charts adjusted limits according to maternal characteristics including height, weight, parity and ethnic group. Usual management in the control area included fundal height assessment by abdominal palpation and recording on a standard co‐operation card.Outcome measures
Antenatal detection of small and large for gestational age babies; number of antenatal investigations for fetal growth in each group.Results
The study group had a significantly higher antenatal detection rate of small for gestational age babies (48%vs 29%, odds ratio 2.2, 95% confidence interval 1.145) and large for gestational age babies (46%vs 24%, OR 2.6, CI 1.3–5.5). There was no increase in the study group in the overall number of scans per pregnancy done in the ultrasound department (1.2 vs 1.3, P= 0.14), but a slight decrease in repeat (two or more) third trimester scans (OR 0.8, CI 0.6–11.0, P= 0.08). Women in the study group had significantly fewer referrals for investigation in a pregnancy assessment centre (OR 0.7, CI 0.5–0.9; P= 0.01) and fewer admissions to the antenatal ward (OR 0.6, CI 0.4–0.7, P= 0.001). There were no differences in perinatal outcome.Conclusions
Serial measurement of fundal height plotted on customised charts leads to increased antenatal detection of small and large babies. This is accompanied by fewer investigations, which is likely to represent increased confidence in the community to recognise normal fetal growth. With adjustments for physiological variables, fundal height measurements appear to be a cost effective screening method which can result in substantial improvements in the antenatal assessment of fetal growth.
Paracervical anaesthesia in outpatient hysteroscopy: a randomised double‐blind placebo‐controlled trial
Authors: Lau W. C. , Lo W. K. , Tam W. H. , Yuen P. M. 
Published: August 2005

Objective
To evaluate the efficacy and safety of paracervical anaesthesia in reducing pain during outpatient hysteroscopy and endometrial biopsy.Design
Prospective, randomised, placebo‐controlled, double‐blind study.Population
One hundred women undergoing outpatient hysteroscopy and endometrial biopsy for abnormal uterine bleeding.Interventions
Paracervical block using 10 mL of either 2% lignocaine or normal saline before the procedure.Main outcome measures
Evaluation of pain at different stages of hysteroscopy using a visual analogue scale together with blood pressure and heart rate monitoring.Results
Compared with placebo, paracervical anaesthesia significantly reduced the pain only at the time of insertion of the hysteroscope, but not at the subsequent stages of the procedure. However, paracervical injection of lignocaine resulted in a higher incidence of bradycardia and hypotension.Conclusions
Paracervical anaesthesia not only fails to reduce pain during outpatient hysteroscopy and endometrial biopsy, but also carries a risk of inducing bradycardia and hypotension, which is probably a result of inadvertent intravascular injection.
Neutrophil function in women with pre‐eclampsia
Authors: Crocker I. P. , Wellings R. P. , Fletcher J. , Baker P. N. 
Published: August 2005

ObjectiveTo investigate the function of neutrophils in normal pregnancy and pre‐eclampsia.DesignBaseline levels and activated responses of peripheral blood neutrophils were measured in response to the physiological agonists, n‐formyl‐met‐leu‐phe (fMLP) and zymosan activated serum.SampleNeutrophils of 16 pre‐eclamptic, 17 normal pregnant (third trimester) and 15 nonpregnant age‐matched control women were calculated.SettingAntenatal Clinic, City Hospital, Nottingham.MethodsNeutrophil superoxide anion production was determined by lucigenin‐enhanced chemilumi‐nescence; the release of secondary granule lactoferrin by ELISA; and the expression of cell surface adhesion molecules CD1 1b, CD 18 and L‐selectin (CD62L) by flow cytometric analysis.ResultsSuperoxide anion generation was reduced in the pregnant group compared with nonpregnant controls [fMLP by 51 % (P= 0.03) and zymosan activated serum by 56% (P= > 0.01)] but pre‐eclamptic measurements did not show a similar reduction. There were no differences between the three study groups in the plasma levels of lactofenin, or in the stimulated expression and release of CD1 Ib and CD18, or lactoferrin and L‐selectin. The base‐line levels for the production of superoxide anions; the expression of CD11b or CD 18 or L‐selectin; and the release of lactofemn showed no significant differences.ConclusionsCirculating neutrophils in pregnancy and pre‐eclampsia are neither activated nor primedin vivo, however the release of reactive oxygen species is diminished in normal pregnancy. In comparison, an elevation of reactive oxygen generation in pre‐eclampsia may highlight a role for neutrophils in the oxidative stress and pathophysiology of this disease.
A Conceptual Model of Cognitive Deficits in Chronic Heart Failure
Authors: Bennett Susan J. , Sauvé Mary Jane , Shaw Rose Mary 
Published: August 2005

Purpose:

To describe a conceptual model to guide studies of cognitive deficits among patients with heart failure.
Organizing Framework:

The conceptual framework of cognitive deficits in chronic heart failure is based on theoretical and empirical literature about (a) the pathophysiology of heart failure, (b) the pathophysiology of cognitive deficits, and (c) health‐related quality of life. Other variables that may cause or contribute to cognitive deficits include age, the relative contributions of multiple comorbid conditions, hypertension, and depressive symptoms. Covariates that might influence cognitive deficits (medications, gender, and education) are also included in the model. The most prominent cognitive deficits are believed to occur in domains of attention, working memory, memory, learning, executive function, and psychomotor speed. The main outcome variable is health‐related quality of life, which is believed to be influenced by circulatory insufficiency and cognitive deficits.
Conclusions:

The conceptual model described in this paper is a framework for testing cognitive deficits that occur in heart failure. After validation through empirical testing, the model may be useful in developing interventions for patients with heart failure whose care is complicated by cognitive deficits.
Effects of splinted prosthesis supported a wide implant or two implants: a three‐dimensional finite element analysis
Authors: Huang Heng‐Li , Huang Jehn‐Shyun , Ko Ching‐Chang , Hsu Jui‐Ting , Chang Chih‐Han , Chen Michael Y. C. 
Published: August 2005

AbstractObjectives: Three‐dimensional finite element (FE) models of splinted prosthetic crowns were studied and stress analyses were evaluated with different types of implant support, including standard, wide or two implant(s) for partial, posterior edentulous restorations.Material and methods: The FE models were constructed based on a cadaver mandible containing the 2nd premolar and the 1st molar. The crowns of these two teeth were modeled as connected and disconnected to mimic the splinted and non‐splinted designs, respectively. One standard implant was placed at the premolar region, while three types of implant support, one at a time (the standard implant, wide implant and two implants), were used to support the molar crown. A 100 N oblique load was applied to the buccal cusp on each crown. The FE simulation was validated experimentally via strain gauge measurement.Results: The experimental data were well correlated with the FE predictions (r2=0.97). When compared with the standard implant used in the molar area, the wide implant and two implants reduced the peak stress in crestal bone by 29–37% for both splinted and non‐splinted cases. Inserting the standard implant into both the premolar and molar area, the bone stresses were identical for splinted and non‐splinted designs. However, splinting the adjacent crowns has shown to decrease the bone stresses at the premolar region by 25%, while the wide implant or two implants were placed at the molar region.Conclusion: The biomechanical advantages of using the wide implant or two implants are almost identical. The benefit of load sharing by the splinted crowns is notable only when the implants on the premolar and molar regions have different supporting ability.
An evaluation of resonance frequency analysis for the determination of the primary stability of orthodontic palatal implants. A study in human cadavers
Authors: Gedrange T. , Hietschold V. , Mai R. , Wolf P. , Nicklisch M. , Harzer W. 
Published: August 2005

AbstractBackground: The primary stability of short orthodontic implants is important for anchorage.Methods: For this study 14 cadaveric human heads were used. The stability of orthodontic implants (Straumann) with lengths of 4 and 6 mm and different localization (palatal suture or paramedially) were evaluated. The implants with length of 6 mm were only placed in the suture and primary stability was non‐invasively determined with the resonance frequency (Osstell®). The invasive method for the analysis of the morphometric parameters of the implant/bone contact was carried out by means of histological and radiological examinations.Results: The 6 mm implants have significant better primary stability in the palatal suture as 4 mm implants paramedially (P<0.05). No differences were found between 6 and 4 mm implants in the palatal suture and between 4 mm implants in palatal suture to paramedially. The histological and radiological results demonstrate the ability to measure the implant stability by investigation of the bone offer and density around the implant. Bone structure, especially the pore size in the trabecular bone and the precision of placement may influence the stability.Conclusion: This study shows that the short implant gives sufficient bone fixation, independently of placement. The quality of implantation and bone structure are more important than the length of the orthodontic implant.
Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study
Authors: Von Arx Thomas , Häfliger Jörg , Chappuis Vivianne 
Published: August 2005

AbstractObjective: To analyse the occurrence and resolution of neurosensory disturbances following bone harvesting from the symphysis.Material and methods: In 30 patients, skin sensitivity of the chin/lower lip area and pulp sensitivity of all mandibular anterior teeth were assessed preoperatively, at the time of suture removal, at 6 and 12 months postoperatively. In addition, bone defect dimensions of the donor site were measured intraoperatively, and distances from defect margins to adjacent anatomical structures, such as root apices, mental foramen and inferior border of mandible, were assessed postoperatively on a panoramic radiograph.Results: Pulp sensitivity changes were found in 18.6% of adjacent teeth at the time of suture removal. At the 6‐month follow‐up, 8.1% of teeth, and at the 12‐month re‐examination, 0.6% of teeth presented with altered sensitivity. This decrease over time of the number of affected teeth per patients with sensitivity changes was significant (P=2.35e−007). Lower lip hypaesthesia was only observed in one patient postoperatively, with complete resolution at the 6‐month follow‐up. Radiographic measurements of distances between donor defect and adjacent anatomical structures only reached significant difference for one parameter in patients with sensitivity changes compared with patients without sensitivity changes.Conclusions: Patients must be informed about possible transient and long‐term sensitivity changes of adjacent teeth and soft tissues following bone harvesting from the chin. However, by correctly placing mucoperiosteal incisions and bone cuts, the risk of sensitivity changes can be minimized.
UV‐Hauttumoren
Authors: Hönigsmann Herbert , Diepgen Thomas L. 
Published: August 2005

ZusammenfassungDiese Übersicht behandelt die Epidemiologie und pathogenetische Aspekte von UV‐induzierten bösartigen Hauttumoren (Basaliom, Plattenepithelkarzinom und Melanom) an Hand der aktuellen Literatur. Während das gegenwärtige Wissen über das Plattenepithelkarzinom, vor allem aus experimentellen Ergebnissen, wesentliche Rückschlüsse über seine Entstehung gestattet, sind die Verhältnisse bei Basaliom und Melanom noch nicht eindeutig geklärt, da für diese beiden Tumoren keine adäquaten Tiermodelle existieren, die dem biologischen Verhalten beim Menschen genau entsprechen. Der zweifellos sichere Zusammenhang mit Sonnenexposition basiert vorwiegend auf der Extrapolation epidemiologischer Daten.
Incomplete Activation of Macrophage Apoptosis during Intracellular Replication of
Legionella pneumophila
Authors: Abu-Zant Alaeddin , Santic Marina , Molmeret Maelle , Jones Snake , Helbig Jürgen , Abu Kwaik Yousef 
Published: August 2005

ABSTRACT

The ability of the intracellular bacterium
Legionella pneumophila
to cause disease is totally dependent on its ability to modulate the biogenesis of its phagosome and to replicate within alveolar cells. Upon invasion,
L. pneumophila
activates caspase-3 in macrophages, monocytes, and alveolar epithelial cells in a Dot/Icm-dependent manner that is independent of the extrinsic or intrinsic pathway of apoptosis, suggesting a novel mechanism of caspase-3 activation by this intracellular pathogen. We have shown that the inhibition of caspase-3 prior to infection results in altered biogenesis of the
L. pneumophila
-containing phagosome and in an inhibition of intracellular replication. In this report, we show that the preactivation of caspase-3 prior to infection does not rescue the intracellular replication of
L. pneumophila icmS
,
icmR
, and
icmQ
mutant strains. Interestingly, preactivation of caspase-3 through the intrinsic and extrinsic pathways of apoptosis in both human and mouse macrophages inhibits intracellular replication of the parental stain of
L. pneumophila
. Using single-cell analysis, we show that intracellular
L. pneumophila
induces a robust activation of caspase-3 during exponential replication. Surprisingly, despite this robust activation of caspase-3 in the infected cell, the host cell does not undergo apoptosis until late stages of infection. In sharp contrast, the activation of caspase-3 by apoptosis-inducing agents occurs concomitantly with the apoptotic death of all cells that exhibit caspase-3 activation. It is only at a later stage of infection, and concomitant with the termination of intracellular replication, that the
L. pneumophila
-infected cells undergo apoptotic death. We conclude that although a robust activation of caspase-3 is exhibited throughout the exponential intracellular replication of
L. pneumophila
, apoptotic cell death is not executed until late stages of the infection, concomitant with the termination of intracellular replication.
Characterization of MtsR, a New Metal Regulator in Group A Streptococcus, Involved in Iron Acquisition and Virulence
Authors: Bates Christopher S. , Toukoki Chadia , Neely Melody N. , Eichenbaum Zehava 
Published: August 2005

ABSTRACT

Group A streptococcus (GAS) is a common pathogen of the human skin and mucosal surfaces capable of producing a variety of diseases. In this study, we investigated regulation of iron uptake in GAS and the role of a putative transcriptional regulator named MtsR (for Mts repressor) with homology to the DtxR family of metal-dependent regulatory proteins. An
mtsR
mutant was constructed in NZ131 (M49 serotype) and analyzed. Western blot and RNA analysis showed that
mtsR
inactivation results in constitutive transcription of the
sia
(streptococcal iron acquisition) operon, which was negatively regulated by iron in the parent strain. A recombinant MtsR with C-terminal His
6
tag fusion (rMtsR) was cloned and purified. Electrophoretic mobility gel shift assays demonstrated that rMtsR specifically binds to the
sia
promoter region in an iron- and manganese-dependent manner. Together, these observations indicate that MtsR directly represses the
sia
operon during cell growth under conditions of high metal levels. Consistent with deregulation of iron uptake, the
mtsR
mutant is hypersensitive to streptonigrin and hydrogen peroxide, and
55
Fe uptake assays demonstrate that it accumulates 80% ± 22.5% more iron than the wild-type strain during growth in complete medium. Studies with a zebrafish infection model revealed that the
mtsR
mutant is attenuated for virulence in both the intramuscular and the intraperitoneal routes. In conclusion, MtsR, a new regulatory protein in GAS, controls iron homeostasis and has a role in disease production.
Neisseria meningitidis
Lactate Permease Is Required for Nasopharyngeal Colonization
Authors: Exley Rachel M. , Goodwin Linda , Mowe Eva , Shaw Jonathan , Smith Harry , Read Robert C. , Tang Christoph M. 
Published: August 2005

ABSTRACT

Neisseria meningitidis
is a human specific pathogen that is part of the normal nasopharyngeal flora. Little is known about the metabolic constraints on survival of the meningococcus during colonization of the upper airways. Here we show that glucose and lactate, both carbon energy sources for meningococcal growth, are present in millimolar concentrations within nasopharyngeal tissue. We used a mutant defective for the uptake of lactate (C311Δ
lctP
) to investigate the contribution of this energy source during colonization. Explants of nasopharyngeal tissue were inoculated with the wild-type strain (C311) and C311Δ
lctP
; the mutant was recovered at significantly lower levels (
P
= 0.01) than C311 18 h later. This defect was not due to changes in the expression of adhesins or initial adhesion in C311Δ
lctP
to epithelial cells. Instead, lactate appears to be important energy source for the bacterium during colonization and is necessary for growth of the bacterium in nasopharyngeal tissue. Studies with other strains defective for the uptake of specific nutrients should provide valuable information about the environment in which
N. meningitidis
persists during carriage.