Fetal fibronectin as a predictor of spontaneous preterm labour in asymptomatic women with a cervical cerclage

Objective  To assess the accuracy of fetal fibronectin (fFN) testing for prediction of preterm labour in asymptomatic high-risk women with a cervical cerclage.
Design  Retrospective observational study.
Setting  United Kingdom.
Population  Nine hundred and ten asymptomatic women at high-risk of Preterm birth referred to specialist antenatal clinics and undergoing fFN testing between November 1997 and December 2007.
Methods  Women had fFN tests taken between 23⁺⁰ and 27⁺⁶ weeks' gestation, on one or more occasions.
Main outcome measures  Sensitivity, specificity, positive predictive values and negative predictive values of fFN testing for predicting delivery <30 and <37 weeks were compared in those with and without cerclage.
Results  For delivery <30 weeks' gestation, the specificity of fFN testing was significantly lower in women with cervical cerclage (77% vs 90%; P  ≤ 0.00001). The sensitivity of the test was similar between the groups (78.6 (no-cerclage) vs 60% (cerclage); P  > 0.4). The negative predictive value of the fFN test for delivery <30 weeks was high in both groups (>98%).
Conclusions  Asymptomatic high-risk women with cerclage in situ are more likely to have a false positive fFN test. The negative predictive value is similar.     

Subcellular targeting domains of Abutilon mosaic geminivirus movement protein BC1

Summary.  Abutilon mosaic geminivirus (AbMV) encodes two movement proteins, BV1 and BC1, which mediate the intra- and intercellular transport of viral DNA in plants cooperatively. It has been shown previously that singly expressed BC1, fused to green fluorescent protein (GFP), accumulates preferentially either at the cell periphery or around the nucleus in separate plant cells. To define the BC1 domains responsible for understanding the subcellular sorting, deletion mutants were fused to GFP and expressed transiently in epidermal cells of non-host (Allium cepa) as well as of host (Nicotiana benthamiana) plants with basically the same results in both species. BC1-mediated intracellular sorting was dependent on two protein domains, an “anchor domain” (amino acids 117 to 180) which is necessary and sufficient to fix GFP:BC1 at the cell periphery and the nuclear environment, and a “pilot domain” (amino acids 1 to 49) in the absence of which the fusion proteins were found at both sites in the same cell simultaneously. Received March 13, 2002; accepted July 1, 2002     

MRI versus CT in the diagnosis of Nelson's syndrome

The purpose of the study was to evaluate the utility of MRI and CT in the diagnosis of Nelson's syndrome, i. e. pituitary tumours in patients bilaterally adrenalectomized for Cushing's disease. Thirteen patients, followed up for 5–29 years after adrenalectomy, were studied. In 6 of them CT and MRI revealed no changes in the pituitary gland. In the remaining 7 patients only three CT scans were suggestive of a pituitary adenoma. MRI studies with administration of gadodiamide confirmed the CT diagnosis of Nelson’s tumour in 3 patients and disclosed microadenomas in a further 4 patients. Neurosurgical treatment in 4 patients confirmed the MRI findings. Additionally CT and MRI examinations were performed in 5 patients suspected of a recurrent Nelson's tumour 3–11 years after neurosurgery. MRI visualized recurrent adenomas in 3 patients that were not well seen by CT scans. In our experience MRI was more effective than CT in the diagnosis of Nelson's syndrome. Received 17 October 1995; Revision received 25 January 1996; Accepted 31 January 1996     

Extraadrenal pheochromocytoma: detection during pregnancy using MR imaging

This case report demonstrates the usefulness of magnetic resonance (MR) imaging to demonstrate an abdominal mass during pregnancy. A pregnant woman presented in midgestation with symptoms and chemical evidence of a pheochromocytoma. The use of MR imaging permitted early localization of a retrouterine tumor when it would have been undesirable for the woman to undergo computed tomography because of radiation exposure. Evaluation of the MR images formed the basis of the therapeutic strategy used by the patient's physicians.     

Transdermal 17 beta-estradiol combined with oral progestogen increases plasma levels of insulin-like growth factor-I in postmenopausal women.

In order to evaluate the effect of postmenopausal estrogen replacement therapy on the plasma levels of the insulin-like growth factor-I (IGF-I) 12 postmenopausal women aged 44 to 59 years were studied. The control group consisted of 15 healthy premenopausal women aged 20-44 years. In the postmenopausal women the plasma levels of IGF-I, gonadotrophins and sex hormones were determined before and after 3 and 6 months cyclic replacement therapy with transdermal 17 beta-estradiol (E2 100 micrograms patches applied twice weekly) combined with oral chlormadinone acetate (2 mg daily for 7 days in each cycle). Basal levels of estradiol (E2), IGF-I, dehydroepiandrosterone sulphate (DHEA-S), testosterone and androstenedione were lower, but gonadotropin levels were higher in postmenopausal than in premenopausal women. In all the women studied age was inversely correlated with IGF-I levels (r = -0.793, p less than 0.001) and with DHEA-S concentrations (r = -0.435, p less than 0.02). In postmenopausal women transdermal estradiol administration restored the circulating E2 levels to the early follicular range and increased the IGF-I levels (from 76.4 +/- 9.2 micrograms/l to 141.8 +/- 20.8 micrograms/l; p less than 0.01). Transdermal estradiol decreased gonadotrophin levels without changes in concentration of DHEA-S, testosterone, androstenedione and SHBG. In postmenopausal women before and during replacement therapy a positive correlation was found between estradiol and IGF-I concentrations (r = -0.439, p less than 0.01). These results suggest that cyclic replacement therapy with transdermal 17 beta-estradiol in combination with chlormadinone acetate given orally increase the plasma levels of IGF-I in postmenopausal women.