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  • 1
    ISSN: 1432-0428
    Keywords: Keywords Endothelium ; VE-cadherin ; β-catenin ; occludin ; ZO ; 1 ; gestational diabetes ; placenta
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. The aim of this study was to investigate whether gestational diabetes mellitus, which occurs in the microvascular remodelling phase of placental development, causes alterations in surface expression of tight and adherens junctional molecules involved in endothelial barrier function and angiogenesis. Methods. Term placenta, delivered by elective Caesarian section, from normal pregnancy (n = 5) and those complicated by gestational diabetes (n = 5) were perfusion-fixed and analysed by indirect immunofluorescence and confocal scanning microscopy. Using systematic random sampling, the surface expression of endothelial junctional proteins and the relative incidences of immunostained vessels were compared between the two study groups. Total vessel lengths were measured by stereological techniques. Results. The adherens junctional molecules, vascular-endothelial cadherin and β-catenin, and the tight junctional molecules, occludin and zonula occludens-1 were localised to paracellular clefts in both study groups. The diabetic placentae showed pronounced reductions in the intensity of immunofluorescence and in the number of immuno-positive vessels. A corresponding statistically significant increase (from 19 % to 56 %) in the percentage of vessels showing junctional anti-phosphotyrosine immunoreactivity was found. The differences observed represented real changes in the absolute lengths of immunostained regions along the vessels. The stereological measurements failed to detect any statistically significant change in the combined length of fetal vessels in gestational diabetic placenta. Conclusion/interpretation. Our results suggest that even short duration diabetic insult, alters the surface expression of placental junctional proteins. This alteration could be mediated by the tyrosine-phosphorylation pathway. The changes suggest impaired barrier function rather than accelerated vascular growth. [Diabetologia (2000) 43: 1185–1196]
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine whether maternal influenza virus infection in the second and third trimesters of pregnancy results in transplacental transmission of infection, maternal auto-antibody production or an increase in complications of pregnancy.Design Case-control cohort study.Population Study and control cohorts were derived from 3975 women who were consecutively delivered at two Nottingham teaching hospitals between May 1993 and July 1994. A complete set of three sera was available for 1659 women.Methods Paired maternal ante- and postnatal sera were screened for a rise in anti-influenza virus antibody titre by single radial haemolysis and haemagglutination inhibition. Routine obstetric data collected during and after pregnancy were retrieved from the Nottingham obstetric database. Cord samples were tested for the presence of IgM anti-influenza antibodies, and postnatal infant sera were tested for the persistence of influenza-virus specific IgG. Paired antenatal and postnatal sera were tested against a standard range of auto-antigens by immunofluorescence.Main outcome measures Classification of women as having definite serological evidence of an influenza virus infection in pregnancy (cases) or as controls.Results Intercurrent influenza virus infections were identified in 182/1659 (11.0%) pregnancies. None of 138 cord sera from maternal influenza cases was positive for influenza A virus specific IgM. IgG anti-influenza antibodies did not persist in any of 12 infant sera taken at age 6–12 months. Six of 172 postnatal maternal sera from cases of influenza were positive for auto-antibodies. In all cases the corresponding antenatal serum was also positive for the same auto-antibody. There were no significant differences in pregnancy outcome measures between cases and controls. Overall, there were significantly more complications of pregnancy in the cases versus the controls, but no single type of complication achieved statistical significance.Influenza infection in the second and third trimesters of pregnancy is a relatively common event. We found no evidence for transplacental transmission of influenza virus or auto-antibody production in pregnancies complicated by influenza infections. There was an increase in the complications of pregnancy in our influenza cohort.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To compare reagent strip testing (RST) with microscopy and culture in identifying significant bacteriuria, and secondly, to consider potential cost savings if RST screening proved to be reliable.Design Prospective descriptive study.Setting Antenatal Clinic, Bristol Maternity Hospital.Subjects Eight hundred and ninety-eight women having urine testing in pregnancy for microscopy and culture either routinely or because of a clinical indication.Interventions The midstream specimens of urine had RST examination using Ames Multistix 8SG prior to being sent to the laboratory.Main outcome measure Significant culture (〉105 colonies/ml) of a single organism in culture.Results The highest predictive value for a negative result of the urine culture (99.7%) was obtained when using four RSTs in combination. The RST for nitrite had a high predictive value for a positive urine culture (90%). The samples which gave a false negative result with RST screening were mainly infected with low grade urinary pathogens or genital tract contaminants.Conclusion RST screening for bacteriuria provides a reliable and cheap alternative to culture of all urine specimens.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 106 (1999), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate fetal behaviour in breech and cephalic fetuses at term, using a computerised fetal behaviour program.Design An observational study.Setting Pregnancy Assessment Centre, University Hospital, Nottingham.Sample Twenty-six breech and 58 cephalic fetuses between 36 and 41 weeks.Methods Behaviour (fetal heart rate and activity) was recorded with the use of Doppler ultrasound. The duration of recording was 60 minutes or more in all but four recordings (minimum 49 minutes).Main outcome measures Behavioural criteria studied were 1. the relative percentage time spent in low and high variation fetal heart rate patterns; 2. the duration and recurrence of fetal activity; 3. the number of accelerations in low and high fetal heart rate variation; and 4. the number of fetal behavioural state transitions.Results Breech fetuses differed from the cephalic group in that they were lighter than the cephalic fetuses (median 3105 g vs 3400 g; P 〈 0.01) and were born to older mothers (median maternal age 30 years vs 28 years; P 〈 0.01). No significant differences were found in rates of movement, numbers of accelerations and time exhibiting low and high fetal heart rate variation. However, breech fetuses exhibited significantly more state transitions (median 5.2h vs 3.69h; P= 0.01).Conclusions This study shows that breech fetuses are neurologically different from their cephalic counterparts in otherwise healthy pregnancies, and that subtle behavioural differences can be demonstrated in utero using this computerised method.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 99 (1992), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fifty babies were born at ≤ 37 weeks to mothers with diabetes. Delivery was undertaken in all patients with the reassurance that the L/S ratio was ≥2.0 within the preceding 72 h. Five babies (10%) developed respiratory distress syndrome (RDS). Prediction of fetal lung maturity was improved dramatically by measuring amniotic fluid concentrations of phosphatidylcholine (PC), phosphatidylinositol (PI) and phosphatidyl-glycerol (PG). Fourteen babies were predicted as having ‘no surfactant’ (PC 〈 20 mg/1, PI 〈 2 mg/1 and PG 〈 2 mg/1), five developed RDS. None of the remaining 36 babies developed the illness: they were predicted as having either ‘early surfactant’ (PC ≥ 20 mg/1, PI ≥ 2 mg/1 but PG 〈 2 mg/1) or ‘late surfactant’ (PC ≥ 20 mg/1, PI ≥ 2 mg/1 and PG ≥ 2 mg/1). Measurement of PC levels alone was the most accurate method of predicting RDS. There was a significant association between low surfactant phospholipid concentrations and the development of transient tachypnoea of the newborn.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 90 (1983), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The lecithin/sphingomyelin (L/S) ratio in amniotic fluid is an excellent predictor of fetal lung maturity in most pregnancies but today its value is limited. A review of the use of the L/S ratio service in Manchester from 1975 to 1981 (inclusive) shows a dramatic and consistent fall in the number of requests made over the last 18 months of this period resulting in inconvenience and inefficiency in the laboratory service. Possible explanations for the declining use of the L/S ratio service are discussed with particular reference to St Mary's Hospital, Manchester and a regional re-organization of laboratory assessment of fetal lung maturity is proposed.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The phospholipid composition of amniotic fluid samples from 30 normal patients and 44 diabetic patients over the last 10 weeks of pregnancy was studied. Higher levels of phosphatidylcholine (PC) and phosphatidylinositol (PI) were found in diabetic pregnancies where there was excellent glucose control. These differences were statistically significant at 34–36 weeks. Phosphatidylglycerol (PG) aeared significantly earlier in the well controlled diabetic pregnancies. but even in the poorly controlled diabetics the levels of PC, PI and PG were comparable to those in normal pregnancies. There was no evidence of delayed aearance of fetal surfactant phospholipids in either the well or poorly controlled diabetic pregnancies. The absolute lecithin (PC)/sphingomyelin (SM) ratio in diabetic pregnancies was generally greater for any given gestational age than those in normal pregnancies. Whilst in most cases this was due to a higher PC concentration, in a few poorly controlled diabetics it was the result of a lower concentration of SM.
    Type of Medium: Electronic Resource
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