Prolonged in utero meconium exposure impairs spatial learning in the adult rat : Central Prize Award

Objective

The purpose of this study was to examine the effects of prolonged in utero meconium exposure on adult learning and memory, as measured by the Morris water maze.

Study design

Timed pregnant Long-Evans rats were studied. On gestational day 20 (term, 21 days of gestation), laparotomy was performed, and each maternal animal received an injection of clear amniotic fluid or meconium-stained amniotic fluid into each gestational sac. The laparotomy incision was closed, and the animals received postoperative monitoring through delivery. On postnatal days 145 to 148, the offspring underwent Morris water maze testing. The mean (±SEM) for the latency time was reported for each day's trial and compared between groups.

Results

There were significant differences between meconium-stained amniotic fluid group and clear amniotic fluid group in the mean time to platform on day 1 (82.7 ± 1.8 seconds vs 75.9 ± 3.0 seconds; P = .04), day 2 (60.5 ± 3.5 seconds vs 47. 8 ± 4.6 seconds; P = .03), and day 3 (56.5 ± 4.5 seconds vs 34.7 ± 4.4 seconds; P = .001). However, there were no differences on days 4 and 5. There were also no differences between recall and response learning trials that were done after a 12-day retention period.

Conclusion

In the absence of hypoxia or infection, prolonged in utero meconium exposure is associated with a delay of spatial learning in the adult rat.     

Pathological characteristics of ovarian cancer occurring after hysterectomy

OBJECTIVE: The aim of the current study was to examine the pathological characteristics of ovarian cancer occurring in women with previous hysterectomy. METHODS: Newly diagnosed cases of ovarian primary epithelial or primary peritoneal cancer, operated on in our department between January 2000 and December 2002, were included in this retrospective study. The patients were divided into two groups, group I included eight patients with ovarian cancer and previous hysterectomy, and group II comprised 70 patients with ovarian or primary peritoneal cancer, but without previous hysterectomy. RESULTS: There was no significant difference between the eight patients with ovarian cancer and previous hysterectomy and the 70 patients without previous hysterectomy considering the patients' characteristics. Conversely, there was a difference between the two study groups regarding the histology of the tumor, its grade and the stage of the disease. All patients with ovarian cancer and previous hysterectomy had poorly differentiated mixed epithelial or undifferentiated tumors. Nevertheless, only 25% of these patients were diagnosed in Stage IIIC. CONCLUSION: It seems that besides reducing the risk of further ovarian cancer, hysterectomy also causes a change in the main histological sub-group of ovarian cancer, that develops in patients with previous hysterectomy. The greatest protective effect was observed for serous ovarian tumors.     

Inflammatory pseudotumor (plasma cell granuloma) of the pelvic cavity. A case report

BACKGROUND: Inflammatory pseudotumor (IPT), also called plasma cell granuloma, is a rare, benign, tumorlike lesion composed of proliferating spindle cells admixed with an inflammatory infiltrate and usually affecting the lungs. Other locations can also be affected. CASE: An 18-year-old woman complained of abdominal pain and discomfort. Sonographic evaluation revealed a hyperechogenic mass measuring 32 x 36 mm and located between the right ovary and uterus. CBC showed mild leukocytosis. Laparoscopic resection of the mass revealed histologically an inflammatory pseudotumor. CONCLUSION: IPT may occur at any age and affects both sexes equally. The clinical presentation usually includes fever, leukocytosis and weight loss, although many cases are asymptomatic, especially in the pelvis. The lesion usually presents with distinct borders and a firm consistency and is tan to white. The course of IPT is usually benign and self-limited. Surgical resection is the most common therapy, whereas corticosteroids and, in rare cases, chemotherapy are used. Recurrences have been described. Because of the rarity of this condition, it is unusual for the diagnosis to be made preoperatively.     

Risk factors and outcome of failure to progress during the first stage of labor: a population-based study

BACKGROUND: One of the major indications for Cesarean section (CS) is failure of labor to progress. This study was aimed at defining obstetric risk factors for failure of labor to progress during the first stage, and to determine pregnancy outcome. METHODS: A population-based study comparing all singleton, vertex, term deliveries between the years 1988 and 1999 with an unscarred uterus, complicated with failure of labor to progress during the first stage with deliveries without non-progressive labor (NPL). Multiple logistic regression analysis was performed to investigate independent obstetric risk factors associated with failure of labor to progress during the first stage. RESULTS: Failure to progress during the first stage of labor complicated 1.3% (n = 1197) of all deliveries included in the study (n = 92 918), and resulted in CS. Independent risk factors for failure of labor to progress during the first stage, using a multivariable analysis, were premature rupture of membranes (PROM; OR = 3.8, 95% CI 3.2-4.5), nulliparity (OR = 3.8, 95% CI 3.3-4.3), labor induction (OR = 3.3, 95% CI 2.9-3.7), maternal age > 35 years (OR = 3.0, 95% CI 2.6-3.6), birth weight > 4 kg (OR = 2.2, 95% CI 1.8-2.7), hypertensive disorders (OR = 2.1, 95% CI 1.8-2.6), hydramnios (OR = 1.9, 95% CI 1.5-2.3), fertility treatment (OR = 1.8, 95% CI 1.4-2.4), epidural analgesia (OR = 1.6, 95% CI 1.4-1.8) and gestational diabetes (OR = 1.4, 95% CI 1.1-1.7). Although newborns delivered after failure of labor to progress during the first stage had significantly higher rates of Apgar scores lower than 7 at 1 and 5 min as compared with the controls (18.2% vs. 2.1%; P < 0.001 and 1.3% vs. 0.2%; P < 0.001, respectively), no significant differences were noted between the groups regarding perinatal mortality (0.3% vs. 0.4%; P = O.329). Maternal anemia and accordingly packed cells transfusion (47.4% vs. 22.8%; P < 0.001 and 5.6% vs. 1.0%; P < 0.001, respectively) were higher among pregnancies complicated with failure of labor to progress during the first stage as compared with the controls. CONCLUSIONS: Major risk factors for failure of labor to progress during the first stage were PROM, nulliparity, induction of labor and older maternal age. Indications for labor induction should be carefully evaluated in order to decrease the rate of operative deliveries.     

Colonization rate of bacteria in the throat of healthy infants

OBJECTIVE: the human throat is a major ecological site for various bacteria that can reach neighbouring sterile sites and cause mild infections or invasive diseases. The aim of this study was to investigate the carriage rate of several potential pathogens in the throat of healthy children under the age of 2 years. METHODS: cultures were taken from the tonsils of 1000 healthy infants aged 1-24 months attending well-baby clinics, who had not received antibiotic therapy during the preceding 14 days. RESULTS: one hundred and ninety-eight (19.8%) cultures were positive. Thirteen (1.3%) cultures were positive for beta-haemolytic Streptococcus group A, 23 (2.3%) for Streptococcus pneumoniae. In 28 (2.8%) and 24 (2.4%) cultures, respectively, Haemophilus influenzae Type b and non-typeable Haemophilus influenzae were recovered. The commonest bacterium found was Staphylococcus aureus (99 positive cultures). Eleven children carried two species of bacteria and from one 6-month-old child three species were isolated concurrently. CONCLUSIONS: it is concluded that children younger than 2 years of age can be carriers of several types of pathogenic bacteria. In contrast to many other studies, in this study beta-haemolytic Streptococcus group A was isolated from the tonsils of children younger than 1 year of age.