bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of routine ultrasonography in monitoring the outcome of medical abortion in a clinical setting
Authors: Acharya Ganesh , Haugen Michael , Bråthen Anders , Nilsen Ingard , Maltau Jan Martin 
Published: March 2004

Background.  Clinical methods generally used to evaluate the completeness of medical abortion are not accurate. There are no published reports evaluating the role of routine ultrasonography in monitoring the outcome of medical abortion. The purpose of this study was to investigate whether routine transvaginal ultrasonography (TVS) at the follow‐up visit after medical abortion can accurately identify women who will require surgical intervention.Design.  Retrospective review of medical records and charts of all women undergoing medical abortion in the first trimester of pregnancy between January 1999 and December 2001.Methods.  Medical abortion was performed using oral mifepristone and a vaginal prostaglandin analog before 63 days gestation. All women had an initial TVS to confirm intrauterine pregnancy and gestational age, and another TVS at the follow‐up visit 2–3 weeks later to assess the completeness of abortion. Surgical evacuation of the uterus was allowed as indicated on clinical grounds but not on the basis of ultrasound findings only.Results.  A total of 690 women consented to medical abortion during the study period. Eleven of these women were excluded from the study for various reasons. Of the remaining 679 cases, 95% (645/679) had a documented follow‐up at the hospital. The pregnancy termination rate among these women was 99.2% (640/645) and TVS identified all five cases of continuing pregnancy at the follow‐up. A total of 66 (10.2%) patients had complications. The uterine cavity was empty on TVS at the follow‐up visit in 84.8% (547/645) of cases and only 3.1% (17/547) of them required surgical aspiration/curettage due to excessive or prolonged vaginal bleeding. In the remaining 15.2% (98/645) the uterine cavity was not empty, and 43.9% (43/98) of them had a curettage. The risk of requiring a surgical intervention was significantly higher [odds ratio (OR) 24.4; 95% confidence interval (95% CI) 14.9–39.7] when the uterine cavity was not demonstrated to be empty at the follow‐up visit 2–3 weeks after medical abortion. However, 59.1% (55/93) of women did not require surgical intervention despite ultrasound evidence of thick endometrial echo‐complex.Conclusion.  Routine TVS 2–3 weeks after medical abortion appears to be an efficient means of accurately identifying the cases of ongoing pregnancy and diagnosing a complete abortion. Although TVS could be used as an adjunct to clinical examination to diagnose an incomplete expulsion, it does not accurately differentiate those women who require surgical intervention from those who do not.
Health‐related quality of life and physical ability among pregnant women with and without back pain in late pregnancy
Authors: Christina Olsson  , Lena Nilsson‐Wikmar 
Published: March 2004

Background.  Back pain during late pregnancy is a frequent clinical problem. Very little is known about the impact of this symptom on the quality of life among pregnant women with back pain.Objectives.  To study the influence of back pain and physical ability on quality of life in late pregnancy.Methods.  One hundred and sixty women in the 34th−37th week of pregnancy and attending two different midwife receptions, were asked to fill out questionnaires including: general questions about background factors, the Disability Rating Index (DRI) to score the physical ability, and The Nottingham Health Profile (NHP) for assessing health‐related quality of life. Two groups were defined, with and without back pain.Results.  One hundred and thirty‐six (85%) out of 160 screened women returned the questionnaire for evaluation. The 69 (51%) women with back pain rated significantly (p < 0.05) higher on the DRI; on NHP part I, sub scales sleep, energy, pain, physical functioning and total score; and on NHP part II, aspects occupation, ability to perform jobs around the house, social life and hobbies compared with women without back pain.Conclusions.  Irrespective of back pain the pregnant women studied featured lower quality of life (QOL) compared with published data on healthy women. Among the women with back problems, who had the most impaired QOL, the factors affecting QOL were mostly related to physical ability.
Thrombophilia is not associated with an increase in placental abnormalities in women with intra‐uterine fetal death
Authors: Morssink Leonard P. , Santema Job G. , Willemse Feike 
Published: March 2004

Background.  The aim of this study was to investigate whether women with thrombophilia and intrauterine fetal death have a higher incidence of placental lesions as compared with those without thrombophilia.Method.  In a case–control study comprising 50 women with an obstetrical history of intrauterine fetal death, placental histology comparison was made between those with thrombophilia and those without thrombophilia.Results.  Of the women who had an intrauterine fetal death, eight (16%) had a thrombophilia factor. There were no differences in birth weight, gestational age and parity or in placental volume and weight between the eight women with and the 42 women without thrombophilia. There was no statistically significant difference between placentas of the women with and those without thrombophilia.Conclusion.  In a group of women who had an obstetrical history of intrauterine fetal death, those with thrombophilia do not have a difference in placental histological lesions compared with the women without a thrombophilia factor. Future thrombophilia research should be focused on placental bed specimens.
Uterine contractility and directed sperm transport assessed by hysterosalpingoscintigraphy (HSSG) and intrauterine pressure (IUP) measurement
Authors: Kissler Stefan , Siebzehnruebl Ernst , Kohl Joachim , Mueller Anja , Hamscho Nadja , Gaetje Regine , Ahr Andre , Rody Achim , Kaufmann Manfred 
Published: March 2004

Background.  Uterine peristalsis sustains sperm transport and can be detected by hysterosalpingoscintigraphy (HSSG). This study is the first to be designed to investigate utero‐tubal transport function by HSSG and uterine contractility by intrauterine pressure measurement (IUP) consecutively on the same day in the periovulatory phase.Methods.  Twenty‐one female subjects (mean age 28.4 years) without a gynecologic history were examined sequentially by HSSG and IUP on the same day to evaluate uterine contractility in relation to the utero‐tubal transport function. In HSSG, intact transport function was visualized by the rapid uptake of 99m‐technetium‐marked albumin aggregates through the female genital tract. In IUP, the frequency of uterine contractions (UC/min), amplitude of uterine contractions and basal pressure tone were detected via a intrauterine catheter. HSSG and IUP were embedded in cycle monitoring with measurement of LH and estradiol.Results.  In HSSG, a positive transport of inert particles was assessed in 20 of 21 subjects, in 76% to the side of the dominant follicle or on both sides of the oviduct, and in 19% a strict contralateral transport could be observed. In only one subject (5%), no transport was assessed. The mean value of uterine contractions was 3.4 UC/min (SD ± 0.7), the mean amplitude was 12.0 mmHg (SD ± 4.25 mmHg). Basal pressure tone was 70.7 mmHg. There was a statistically significant correlation with estradiol levels: none of the subjects with less than 3 UC/min showed an estradiol level higher than 100 pg/mL; nearly every patient (one exception) with more than 3 UC/min had an estradiol level higher than 100 pg/mL (p < 0.0001, Fisher's exact test).Conclusions.  Intact periovulatory utero‐tubal transport function can be documented by HSSG and is caused by directed uterine contractility, measured consecutively by IUP. Uterine contractility is influenced by rising estradiol levels. Directed uterine contractility and intact utero‐tubal transport function are considered necessary for intact sperm transport, mainly to the side bearing the dominant follicle to maximize fertility.
Adiponectin is reduced in gestational diabetes mellitus in normal weight women
Authors: Ranheim Trine , Haugen Fred , Staff Anne Cathrine , Braekke Kristin , Harsem Nina K. , Drevon Christian A. 
Published: March 2004

Background.  Adiponectin is an adipose tissue‐derived protein counteracting insulin resistance and inflammation. We have compared women with gestational diabetes mellitus (GDM; n = 22) and normal pregnancies (controls; n = 29) to evaluate whether adiponectin represents a link between endocrine function of adipose tissue and the development of diabetes during pregnancy.Methods.  The participants were categorized according to their prepregnancy body mass index (BMI) into two classes: BMI < 25 and BMI = 25. Plasma concentrations of adiponectin, leptin and insulin were measured by radioimmunoassay (RIA). Total cholesterol, high density lipoprotein (HDL) cholesterol and triacylglycerol were determined by routine enzymatic methods. Expression of adiponectin/glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH) was determined by real‐time reverse transcription polymerase chain reaction (RT‐PCR) in subcutaneous adipose tissues obtained by excision at cesarean delivery.Results.  Among individuals with GDM and BMI < 25 kg/m2 (n = 8), plasma adiponectin concentration was lower than in the controls (n = 20), 8.1 ± 1.2 µg/mL vs. 12.2 ± 1.1 µg/mL; p = 0.04). The mean plasma leptin concentrations did not differ between the GDM and control groups. Plasma concentrations of insulin and C‐peptide were significantly higher among GDM than control individuals independent of BMI. For all the women included in the study, we found that plasma adiponectin only correlated negatively with prepregnancy and third‐trimester (sampling day) BMI (p = 0.03 vs. p = 0.01). In abdominal subcutaneous adipose tissue of pregnant women, adiponectin mRNA levels were lower in GDM than in control subjects (0.77 ± 0.18 vs. 1.39 ± 0.15; p = 0.05).Conclusions.  These results indicate that low plasma adiponectin concentration is associated with GDM. In addition, we found that adiponectin mRNA levels in adipose tissue biopsies from GDM subjects were reduced.
Atypical lymphocytic lobular panniculitis
Authors: Magro Cynthia M. , Neil Crowson A. , Byrd John C. , David Soleymani A. , Shendrik Igor 
Published: March 2004

Background:  Although subcutaneous T‐cell lymphoma (SCTCL) is considered an aggressive form of lymphoma, some patients manifest a long waxing and waning phase unaccompanied by constitutional symptoms.Methods:  Twelve patients were prospectively encountered, presenting with a lymphocytic panniculitis accompanied by lymphoid atypia, although not fulfilling criteria for SCTCL. Clinical, histologic, phenotypic, and genotypic analyses were conducted.Results:  There were five men, one boy, and six women; none had symptoms compatible with lupus erythematosus or aggressive SCTCL. All but two had a waxing and waning course of years. Four patients had periodic cytopenias accompanied by fevers. While responding somewhat to prednisone, the lesions relapsed. In one patient, treatment with alemtuzumab (CAMPATH‐1) led to complete lesional resolution with no recurrence. Light microscopy showed expansion of the interstices of the fat lobule by mildly atypical lymphocytes of the CD4 subset in 10 biopsies from eight patients; in the other four patients, there was an increase in CD8 lymphocytes. There was diminished expression of CD5 and/or CD7 in the majority of biopsies. Ten of 13 biopsies showed clonal T‐cell receptor‐γ rearrangements.Conclusions:  We apply the term atypical lymphocytic lobular panniculitis to this distinctive form of lymphocytic panniculitis manifesting this light microscopic, phenotypic, and genotypic profile.
Milium‐like syringoma: a case study on histogenesis
Authors: Wang Kuo‐Hsien , Chu Jan‐Show , Lin Yun‐Ho , Hu Chung‐Hong , Lee Woan‐Ruoh 
Published: March 2004

Background:  Milium‐like syringoma is a variant of syringoma first described in 1987. Only few cases have been reported in the literature. It may be misleading clinically, and its histogenesis has not been clarified.Case report:  We present a case of periorbital milium‐like syringoma, with studies on the histopathologic, histochemical, and immunohistochemical features.Results:  Histology showed a large keratin‐filled cyst in the upper portion of the lesion approximating the epidermis. Serial sections revealed that the cyst connected with the underlying syringomatous epithelial strands. Melanin was absent in the wall of the cyst, as demonstrated by Fontana–Masson stain. Cytokeratin 7 was expressed neither in the milia nor in the solid epithelial parts. Carcinoembryonic antigen (CEA) reactivity was seen in the luminal cells of the keratinous cysts. However, in the largest keratin‐filled cyst clinically suggesting a milium, only the lower half of the cyst was positive for CEA. These results proved that the milia were part of syringoma with eccrine duct differentiation. Fusion of the upper half of the largest cyst with the epidermis may explain the absence of CEA positivity in this part, analogous with eccrine duct milia. Review of the literature indicated that this variant of syringoma occurs more often in Asians.Conclusion:  We present evidence, and propose the histogenesis of milium‐like syringoma, that it is a variant of syringoma with a prominent cystic component showing features of eccrine duct milia. Recognition of its nature is of therapeutic significance. Further studies are required to verify its clinical characteristics as compared with ordinary syringomas.
Paget's disease of the glans penis secondary to transitional cell carcinoma of the bladder: a report of two cases and review of the literature
Authors: Salamanca J. , Benito A. , García‐Peñalver C. , Azorín D. , Ballestín C. , Rodríguez‐Peralto J. L. 
Published: March 2004

Background:  Extramammary Paget's disease of the glans penis secondary to transitional cell carcinoma (TCC) of the bladder is rare, with only a few cases reported in the literature. We report two new cases, one detected before diagnosing bladder TCC.Methods:  We describe the clinicopathologic features of two patients with intraepithelial spread of glans TCC and the histochemical and immunohistochemical features of the neoplasm.Results:  Light microscopy detected intraepithelial proliferation of neoplastic, large, pale cells located predominantly in the basal and parabasal layers of the epithelium. The pagetoid cells showed positive cytoplasmic staining for mucosubstances and immunoreactivity for CK20. The previously reported cases are reviewed and the differential diagnosis is discussed.Conclusions:  As many benign and malignant glans lesions may be clinically similar, histologic study is necessary to correctly diagnose primary lesions and promptly detect underlying asymptomatic visceral malignancies initially presenting as Paget's disease.
Loss of heterozygosity on chromosome 4q32–35 in sporadic basal cell carcinomas: evidence for the involvement of p33ING2/ING1L and SAP30 genes
Authors: Sironi Elena , Cerri Amilcare , Tomasini Dario , Sirchia Silvia Maria , Porta Giovanni , Rossella Franca , Grati Francesca Romana , Simoni Giuseppe 
Published: March 2004

Background:  Studies on basal cell carcinoma (BCC) have demonstrated that patched gene and p53 gene located at 9q22.3 and 17p13 are the main genes responsible for the onset of this tumor. In order to identify a possible involvement of other tumor suppressor genes, we screened 19 cases of BCCs for loss of heterozygosity (LOH).Methods:  The analysis was performed on tumoral tissue and on corresponding normal tissue by using a panel of 37 polymorphic markers spanning 26 chromosomal regions.Results:  We observed that only four chromosomal regions, 4q32 (30.00%), 4q35 (27.27%), 9q21–22 (28.57%), and 9q22‐qter (35.71%), demonstrated a significative LOH (>20%), even if others show a borderline percentage (15–20%) of imbalance (1q32, 3p24, 10p22.1, and 17q21.3).Conclusions:  Our findings suggest that a new chromosomal region mapping in the long arm of chromosome 4 could be involved in sporadic BCC carcinogenesis. Further analyses indicate that the minimal deleted region in 4q32–35 includes p33ING2/ING1L and SAP30, whose deletion could impair the G1‐phase checkpoint control and favor gene silencing, respectively.
Development of pemphigus herpetiformis in a patient with psoriasis receiving UV‐light treatment
Authors: Sanchez‐Palacios Carla , Chan Lawrence S. 
Published: March 2004

Background:  Pemphigus is an autoimmune blistering disease of the skin and mucous membranes. Pemphigus herpetiformis, a rare variant of pemphigus, is characterized by erythematous, vesicular, bullous, or papular lesions in a herpetiform pattern, often associated with pruritus. Clinical cases documenting the development of pemphigus in patients with a history of psoriasis have been reported in the literature.Methods:  We used immunological methods to study a case in which pemphigus herpetiformis occurred in a woman with a history of psoriasis, shortly after a course of ultraviolet B (UVB) therapy.Results:  Histopathology revealed a subcorneal blister with prominent neutrophilic infiltration. Immunopathology detected in situ bound and circulating immunoglobulin G (IgG) autoantibodies to epithelial cell surfaces and circulating IgG autoantibodies against desmoglein 1. The patient was also found to have Hashimoto's thyroiditis.Conclusions:  This case illuminates a possible role of UV therapy in the induction of pemphigus herpetiformis through an epitope‐spreading mechanism. The patient's autoimmune thyroiditis may also contribute to the predisposition for pemphigus development. The histopathological findings in pemphigus patients with a history of psoriasis may resemble Munro's microabscesses of psoriasis and should therefore alert pathologists and clinicians in considering additional diagnostic methods such as direct and indirect immunofluorescence.
Histological spectrum of cutaneous reactions to aspirin in chronic idiopathic urticaria
Authors: Zembowicz Artur , Mastalerz Lucyna , Setkowicz Malgorzata , Radziszewski Waldemar , Szczeklik Andrzej 
Published: March 2004

Background:  During a clinical trial, we obtained 16 biopsies of skin eruptions induced by aspirin in patients with chronic idiopathic urticaria (CIU). In this setting, aspirin triggers skin eruptions through a well‐established non‐immunological mechanism involving the inhibition of cyclooxygenase type I. This presented the rare opportunity to evaluate histological features of a series of skin eruptions induced by a drug acting through a defined mechanism in a controlled experimantal setting.Objective:  Histological analysis of 16 biopsies of skin eruptions induced by oral aspirin challenge in patients with CIU.Design:  Microscopic analysis of tissue sections.Patients:  16 patients with CIU.Results:  Aspirin (up to 500 mg) induced a restricted range of histological responses with a classic pattern of urticarial tissue reaction occuring in the majority of (12 of 16) cases. Two biopsies showed an interstitial fibrohistiocytic (granuloma annulare‐like) reaction pattern. One case showed only a sparse perivascular lymphocytic infiltrate, and paucicellular dermal mucinosis was observed in one case.Conclusions:  Polymorphism of histological patterns induced by aspirin suggests that in addition to the drug‐specific mechanisms triggering drug eruptions, individual factors also play a role in determining the ultimate histological phenotype of a drug response.
Involvement of BREK, a serine/threonine kinase enriched in brain, in NGF signalling
Authors: Kawa Seiji , Fujimoto Jiro , Tezuka Tohru , Nakazawa Takanobu , Yamamoto Tadashi 
Published: March 2004

We identified AATYK2 (Apoptosis‐Associated Tyrosine Kinase 2) through a database search as a kinase specifically expressed in the brain. After characterization, we renamed it BREK (Brain‐Enriched Kinase). Mouse BREK mRNA is expressed predominantly in brain, especially in olfactory bulb, olfactory tubercle, hippocampus, striatum, cerebellum, and cerebral cortex. Levels of expression and phosphorylation of BREK were high at 0–2 weeks after birth, suggesting that BREK is involved in neural development and functions during the early postnatal period. Phosphoamino acid analysis following in vitro kinase reaction revealed that BREK is a catalytically active, serine/threonine kinase. In PC12 cells, BREK was phosphorylated rapidly upon stimulation with nerve growth factor (NGF) in a protein kinase C‐dependent pathway. In differentiated PC12 cells, BREK was enriched in cell bodies and growth cones, and also present along neurites. Introduction of a kinase‐defective mutant of BREK into PC12 cells enhanced both ERK phosphorylation and neurite outgrowth in response to NGF, suggesting that BREK is a negative regulator of NGF‐induced neuronal differentiation. Thus, we conclude that BREK is a new member of the family of protein serine/threonine kinases and that it plays important roles in NGF‐TrkA signalling.
The dentofacial features of Sanjad–Sakati syndrome: a case report
Authors: Al‐Malik M. I. 
Published: March 2004

Summary. Sanjad–Sakati syndrome is an autosomal recessive disorder that was first reported by Sanjadet al. in 1988. It is characterized by congenital hypoparathyroidism, severe growth failure and dysmorphic features. The clinical features include deep set eyes, microcephaly, thin lips, depressed nasal bridge with beaked nose, external ear anomalies and learning difficulties. This report presents the case of a 4‐year‐old patient who was referred to our dental clinic because of pain in her mouth and poor dental health. Oral findings included micrognathic mandible and maxilla, microdontia, enamel hypoplasia as well as severely decayed teeth. Treatment was carried out under general anaesthesia to extract the most severely affected teeth and restore those which could be conserved. It was concluded that these patients have special dental needs; early diagnosis of the affected children is therefore important in order to commence preventive dental therapy and carry out appropriate dental treatment at the optimum time.
Periodontal management of an adolescent with Down's syndrome – a case report
Authors: Sasaki Y. , Sumi Y. , Miyazaki Y. , Hamachi T. , Nakata M. 
Published: March 2004

Summary.  A case of periodontitis in a young adolescent Japanese girl with Down's syndrome is presented in this report. The patient received a monthly preventive course of dental care consisting of mechanical plaque control and oral hygiene instruction. After 2·5 years she recovered from progression of periodontal disease both clinically and microbiologically. The importance of clinical care for periodontitis in Down's syndrome patients is discussed.