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Biomedical subjects

David Schneider

Publications and source records attributed to David Schneider.

At least 19 recordsLinked to original sources

Clinical Trial: Phase 3 Trial of Resmetirom Versus Placebo in Metabolic Dysfunction-Associated Steatohepatitis-Reanalysis of Fibrosis Stage 2-3 Subset.

BACKGROUND: Resmetirom is an oral thyroid hormone receptor beta agonist clinically used to treat metabolic dysfunction-associated steatohepatitis (MASH) among adults with stage F2 or F3 fibrosis. AIMS: Because the pivotal, 52-week, randomized, controlled, phase 3 MAESTRO-NASH trial (once-daily oral resmetirom 80 or 100&#x2009;mg or placebo) included patients with F1, F2, or F3 fibrosis, we conducted a post hoc analysis aimed at assessing treatment response in the subset of patients with stages F2 and F3 fibrosis, consistent with the approved label population. METHODS: Co-primary end points were MASH resolution (hepatocellular ballooning score 0, lobular inflammation score &#x2264;&#x2009;1, and &#x2265;&#x2009;2-point nonalcoholic fatty liver disease activity score [NAS] reduction from baseline) with no fibrosis worsening, and &#x2265;&#x2009;1-stage fibrosis improvement with no NAS worsening at Week 52. RESULTS: Among 917 patients with F2 or F3 fibrosis, metabolic risk factor prevalence was high (hypertension, 78.0%; dyslipidemia, 71.1%; type 2 diabetes, 67.0%). MASH resolution was achieved by 25.7% in the 80-mg group, 29.9% in the 100-mg group, and 9.5% in the placebo group (p&#x2009;<&#x2009;0.0001 for both comparisons with placebo). Respective percentages with fibrosis improvement were 26.5%, 28.9%, and 17.3% (p&#x2009;<&#x2009;0.01 for both comparisons). From baseline to Week 24, low-density lipoprotein cholesterol decreased by 11.7% and 13.7% in the 80- and 100-mg resmetirom groups, respectively, and increased by 2.3% with placebo (p&#x2009;<&#x2009;0.0001 for both comparisons). No new safety signals emerged. CONCLUSION: Results among patients with F2 and F3 fibrosis were consistent with the primary MAESTRO-NASH analysis population, demonstrating efficacy and safety of resmetirom after 52&#x2009;weeks.

Humans↗

Toric Implantable Collamer Lens for moderate to high myopic astigmatism.

PURPOSE: To assess the efficacy of the Toric Implantable Collamer Lens (ICL) to treat moderate to high myopic astigmatism. DESIGN: Prospective nonrandomized clinical trial. PARTICIPANTS: Two hundred ten eyes of 124 patients with between 2.38 and 19.5 diopters (D) of myopia (spherical equivalent [SE]) and 1 to 4 D of astigmatism participating in the United States Food and Drug Administration clinical trial of the Toric ICL. INTERVENTION: Implantation of the Toric ICL. MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse events, and postoperative complications. RESULTS: At 12 months postoperatively, the proportion of eyes with 20/20 or better UCVA (83.1%) was identical to the proportion of eyes with preoperative 20/20 or better BSCVA (83.1%); 76.5% had postoperative UCVA better than or equal to preoperative BSCVA. The mean manifest refractive cylinder dropped from 1.93 D (+/-0.84) at baseline to 0.51 D (+/-0.48) postoperatively, a 73.6% decrease in astigmatism. Although only 21.0% of eyes had 1-D refractive cylinder preoperatively (none less), 91.4% of cases had < or =1 D of cylinder postoperatively. Furthermore, 65.6% had < or =0.5 D and 40.9% had < or =0.25 D of refractive cylinder postoperatively. Mean manifest refraction SE (MRSE) improved from -9.36 D (+/-2.66) preoperatively to 0.05 D (+/-0.46) postoperatively. A total of 76.9% of eyes were predicted accurately to within +/-0.5 D, 97.3% to within +/-1.0 D, and 100% to within +/-2.0 D of predicted MRSE. Postoperatively, 37.6% of eyes had a BSCVA of 20/12.5 or better, compared with a preoperative level of 4.8%. Furthermore, BSCVA of 20/20 or better occurred in 96.8% postoperatively, compared with 83.1% preoperatively. Mean improvement in BSCVA was 0.88 lines; there were 3 cases (1.6%) that lost > or =2 lines of BSCVA after 12 months postoperatively, whereas 18.9% of cases improved by > or =2 lines. A total of 76.4% of cases gained > or =1 lines of BSCVA, whereas only 7.5% of cases lost the equivalent amount. Three ICL removals were performed without significant loss of BSCVA, and 1 clinically significant lens opacity was observed. CONCLUSION: The results support the efficacy and predictability of Toric ICL implantation to treat moderate to high myopic astigmatism. Important safety concerns were not identified.

Adult↗

Adnexal torsion involving hydatids of Morgagni: a rare cause of acute abdominal pain in adolescents.

OBJECTIVE: Hydatids of Morgagni are common embryonal remnants of the müllerian duct and among the infrequent causes of adnexal torsion. The purpose of this study was to investigate the occurrence of adnexal torsion involving hydatids of Morgagni, as well as its possible mechanisms. METHODS: A database search was conducted for cases of adnexal torsion treated in our institution from January 2002 to July 2005. These cases were analyzed, focusing on a subgroup of adolescents with adnexal torsion involving the hydatids of Morgagni. RESULTS: There were 76 patients with adnexal torsion. The rate of hydatid of Morgagni torsion was 26% (4 of 15 cases, 95% confidence interval [CI] 0.15-0.51) in the adolescent subgroup (10-19 years old), compared with 0% (0 of 61 cases, 95% CI 0-0.048) in the adult subgroup. The difference between the hydatid torsion rates in the two subgroups was statistically significant (P = .01, 95% CI 0.001-0.532). The four patients with hydatid torsion (postmenarchal girls, aged 13-18 years) were managed with laparoscopic adnexal detorsion and cystectomy of the affected hydatid of Morgagni. At surgery, we noted three different mechanisms of hydatid torsion: torsion of the adnexa together with torsion of the hydatid of Morgagni, torsion of the hydatid of Morgagni with intact adnexa (n = 2), and entanglement of the hydatid's pedicle around the distal fallopian tube. The hydatids of Morgagni were observed on the preoperative transabdominal ultrasonogram in only one patient and appeared as a simple cyst. CONCLUSION: Adnexal torsion involving the hydatids of Morgagni appears to be more common in adolescents than previously thought. LEVEL OF EVIDENCE: III.

Abdominal Pain↗

Hyperemesis gravidarum and nonspecific abnormal EEG findings: a preliminary report.

OBJECTIVE: To evaluate central nervous system abnormalities in a group of otherwise healthy pregnant women with hyperemesis gravidarum (HG) during the first trimester. STUDY DESIGN: In a case-control study, 17 pregnant women with HG during the first trimester (study group) were compared with 18 pregnant women without nausea and vomiting in pregnancy (NVP). The latter group included women who were planning first-trimester termination of pregnancy for reasons other than health (control group). All the pregnant women enrolled in the study answered a questionnaire and underwent a physical examination, blood tests, urinalysis, EEG, and visual evoked potential (VEP) and brainstem auditory evoked response (BAER) tests. RESULTS: An abnormal EEG was found in 5 of the 17 women in the study group (29.4%), whereas none of the 18 women in the control group had an abnormal EEG (p = 0.013). The VEP and BAER tests were normal among the women in both groups. There were no clinically significant differences between the 2 groups with regard to maternal age, gravidity, parity, weeks of gestational age, blood count, renal function, liver function or electrolytes. Low thyroid stimulating hormone levels were found in 6 of the 17 women in the study group (35.3%) as compared to 1 of the 18 in the control group (5.5%) (p = 0.028). None of the women in either group had hyperthyroidism. HG in previous pregnancies was a significant risk factor for HG in the present pregnancy. CONCLUSION: In pregnant women with HG during the first trimester, the frequency of abnormal EEG findings is significantly higher as compared to that in pregnant women without NVP. However, the mechanism and implications of these findings are yet to be clarified.

Adult↗

Clinical inquiries: How should you manage a depressed patient unresponsive to an SSRI?

The best approach among studied alternatives to manage a patient with treatment-resistant depression is not clear from the evidence. All of the options reviewed seem to have about a 25% to 30% success rate. Switching to other antidepressants or augmenting with non-antidepressant drugs has the best supporting evidence (strength of recommendation [SOR]: B).1 Adding additional antidepressants (SOR: B), using psychotherapy (SOR: B), and initiating electroconvulsive therapy (ECT) (SOR: C) are options. Various antidepressants are used as add-on therapy. Psychotherapy is often recommended, though the evidence of benefit after a failed course of initial therapy is sparse. The evidence supporting use of ECT in treatment-resistant depression is weak. Comparison among the options is based on expert opinion (SOR: C). Additional reports from the STAR*D trial may improve the quality of the evidence in the near future.

Antidepressive Agents↗

Sonographic versus clinical evaluation as predictors of residual trophoblastic tissue.

BACKGROUND: The study aims to compare the diagnostic accuracy of sonographic evaluation versus clinical estimation in women suspected to have retained trophoblastic fragments. METHODS: The study group consisted of 68 consecutive patients admitted to our department due to suspected residual trophoblastic tissue. Each woman underwent ultrasound and physical examination by expert clinicians. The clinicians performing the physical examination were not informed of the sonographic findings, and vice versa. RESULTS: Patients were divided into three subgroups: clinical suspicion only of residual trophoblastic tissue (n = 8), sonographic suspicion only (n = 44) and combined sonographic and clinical suspicion of residual trophoblastic tissue (n = 16). In the latter group, in 14 out of 16 women (87.5%) retained trophoblastic tissue was confirmed by histological examination, a significantly higher rate compared to ultrasonographic (45.5%, P < 0.002) or clinical suspicion only (62.5%, P = 0.07). The specificity and positive predictive value of the clinical examination were significantly higher compared to ultrasonographic evaluation (P < 0.05), while the sensitivity of the ultrasonographic evaluation was higher than the clinical estimation (P < 0.05). There was no statistically significant difference in the negative predictive value or in diagnostic accuracy between the two methods. CONCLUSIONS: Based on our current experience, it seems that the combination of both clinical and ultrasonographic evaluation is recommended before uterine curettage is performed, thus lowering the rate of unnecessary invasive procedures.

Abdominal Pain↗

The major histopathologic characteristics in the vulvar vestibulitis syndrome.

OBJECTIVE: In order to better understand the etiology of the vulvar vestibulitis syndrome, we examined the histopathologic parameters in vestibular mucosa, and compared the findings in specimens obtained from women with vulvar vestibulitis with those obtained from the control group. STUDY DESIGN: Specimens of vestibulitis were obtained from 24 patients, undergoing circumferential vestibulectomy under general anesthesia due to the symptoms and signs consistent with vulvar vestibulitis. Control specimens were obtained from 16 women, without symptoms or signs of vulvar vestibulitis, undergoing reconstructive introital surgery due to roomy vagina, rectocele or painful episiotomy. All vestibular tissue specimens were examined for intensity of inflammation, extension of inflammatory cells into the epithelium, vascular proliferation, the presence of mast cells and proliferation of peripheral nerve bundles. RESULTS: No significant difference was found regarding the degree of inflammation, the extension of inflammatory cells into the epithelium, the vascular proliferation and the presence of mast cells while comparing the study and the control groups. The only histopathologic feature, differentiating the patients with vulvar vestibulitis from the control group, was the proliferation of peripheral nerve bundles found in 19 out of 24 (79.1%) specimens expressing vestibulitis and in none of 16 control specimens (p < 0.0001). CONCLUSION: Our results, therefore, support the existence of peripheral nerve hyperplasia in vestibular tissue obtained from patients with vulvar vestibulitis, and exclude the role of active inflammation or mast cells as probable etiologies for the vulvar vestibulitis syndrome.

Adult↗

[Intravenous leiomyomatosis].

Intravenous leiomyomatosis is a rare tumor described only in women, in which benign smooth muscle cells grow into the pelvic venous channels. The tumor may cause life-threatening symptoms if there is involvement of the inferior vena cava or the right atrium. This is a case study of intravenous leiomyomatosis with left ovarian extension in a 42 years old woman. The patient was admitted for total abdominal hysterectomy due to uterus myomatosus and menorrhagia. During the operation a frozen section was sent for examination revealing intravenous leiomyomatosis. Thereupon, bilateral salpingo-oophorectomy was also performed. This article reviews the cause, disease, presentation, diagnosis, treatment and recurrence of intravenous leiomyomatosis.

Adult↗

Termination of multiple pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation.

OBJECTIVE: To compare outcome in women undergoing termination of multiple pregnancy as compared with singleton pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation. STUDY DESIGN: The medical records of 372 consecutive women undergoing does not increase pregnancy termination by Laminaria dilatation and evacuation at 18-24 weeks' gestation between January 1997 and December 2001 were reviewed and divided into a group with multiple pregnancies (38 cases) and a group with singleton pregnancies (334 cases). The 2 groups were then compared for differences in patient characteristics, indications for pregnancy termination and operative outcome. Statistical methods included Student's t and chi2 test. RESULTS: Patients with multiple pregnancies were significantly older (P < .01), and a greater percentage of them were married (P < .001). The percentage of pregnancies following infertility treatment was also significantly higher in the group with multiple pregnancies (P < .0001). Furthermore, significantly more patients with multiple than singleton pregnancy underwent pregnancy termination due to preterm premature rupture of membranes (42.1% vs. 0.3%) (P < .00001), while significantly more singleton pregnancies were terminated due to structural and chromosomal fetal malformations (34.5% vs 10.6%) (P = .03). Operative outcome between the study groups differed mainly regarding blood transfusion; it was significantly greater in the group of patients undergoing multiple, as compared with singleton, termination (7.9% vs. 0.3%) (P < .00001). The group with multiple pregnancy had a longer hospital stay (1.7 +/- 0.9 vs. 1.2 +/- 0.5 days) (P < .001). CONCLUSION: Termination of multiple pregnancies at 18-24 weeks' by dilatation and evacuation appears safe when performed by skilled surgeons. There is an increased need for blood transfusion.

Abortion, Induced↗

[Early stage fallopian tube carcinoma--diagnosis, staging and treatment].

Fallopian tube carcinoma is one of the rarest malignancies of the female genital tract. It is often diagnosed incidentally at an advanced stage. In recent years, an increase was observed in early stage fallopian tube carcinoma diagnosis. Such early diagnosis challenges the current FIGO staging system, as well as treatment recommendations, due to its limitations in precise discrimination between early stages. This is a case study of a 42 year-old woman, admitted for bilateral salpingo-oophorectomy due to bilateral ovarian cysts. Pathological examination incidentally revealed early staged fallopian tube carcinoma, which had invaded the lamina propria only, with no muscularis penetration. Due to the limited data regarding the efficacy of adjuvant chemotherapy at this early stage, only CA-125 levels follow-up was recommended.

Adult↗

Immune activation of NF-kappaB and JNK requires Drosophila TAK1.

Stimulation of the Drosophila immune response activates NF-kappaB and JNK signaling pathways. For example, infection by Gram-negative bacteria induces the Imd signaling pathway, leading to the activation of the NF-kappaB-like transcription factor Relish and the expression of a battery of genes encoding antimicrobial peptides. Bacterial infection also activates the JNK pathway, but the role of this pathway in the immune response has not yet been established. Genetic experiments suggest that the Drosophila homolog of the mammalian MAPK kinase kinase, TAK1 (transforming growth factor beta-activated kinase 1), activates both the JNK and NF-kappaB pathways following immune stimulation. In this report, we demonstrate that Drosophila TAK1 functions as both the Drosophila IkappaB kinase-activating kinase and the JNK kinase-activating kinase. However, we found that JNK signaling is not required for antimicrobial peptide gene expression but is required for the activation of other immune inducible genes, including Punch, sulfated, and malvolio. Thus, JNK signaling appears to play an important role in the cellular immune response and the stress response.

Animals↗

Conservative management of ectopic pregnancy with fetal cardiac activity by combined local (sonographically guided) and systemic injection of methotrexate.

OBJECTIVE: To evaluate the efficacy of conservative management of ectopic pregnancy with fetal cardiac activity by combined local sonographically guided and systemic injection of methotrexate. STUDY DESIGN: The study group included 12 patients with ectopic pregnancy and fetal cardiac activity, treated by combined local and systemic injection of methotrexate in the period from January 1, 2000 to July 1, 2002. The outcome of these patients was compared with the outcome of 53 patients who had ectopic pregnancy without fetal cardiac activity and were being treated only by systemic injection of methotrexate during the same period of time. RESULTS: The success rate was 91.6% (11 out of 12) in the group of patients with ectopic fetal cardiac activity and 90.5% (48 out of 53) in the group of patients with ectopic pregnancy, but without fetal cardiac activity. There was also no significant difference between the two groups comparing the percentage of cases treated by an additional dose of methotrexate (8.3 and 13.2%, respectively), nor comparing the number of days to resolution of beta-human chorionic gonadotrophin (BHCG; 40 +/- 2 and 34 +/- 10 days, respectively). Conversely, there was a significant difference in the initial BHCG level comparing the group of patients treated by combined local and systemic injection of methotrexate (12,616 +/- 9,585 mIU/ml) and the group of patients treated by systemic injection of methotrexate (1,499 +/- 2,065 mIU/ml) (p < 0.00001). Seventy-five percent of patients (6 out of 8) diagnosed with ectopic fetal cardiac activity, who desired to become pregnant, succeeded to conceive within 6 months following the combined local and systemic injection of methotrexate. CONCLUSION: The combined local sonographically guided and systemic injection of methotrexate is associated with a successful outcome in asymptomatic patients presenting with ectopic pregnancy and fetal cardiac activity.

Abortifacient Agents, Nonsteroidal↗

A graph-theoretic approach to comparing and integrating genetic, physical and sequence-based maps.

For many species, multiple maps are available, often constructed independently by different research groups using different sets of markers and different source material. Integration of these maps provides a higher density of markers and greater genome coverage than is possible using a single study. In this article, we describe a novel approach to comparing and integrating maps by using abstract graphs. A map is modeled as a directed graph in which nodes represent mapped markers and edges define the order of adjacent markers. Independently constructed graphs representing corresponding maps from different studies are merged on the basis of their common loci. Absence of a path between two nodes indicates that their order is undetermined. A cycle indicates inconsistency among the mapping studies with regard to the order of the loci involved. The integrated graph thus produced represents a complete picture of all of the mapping studies that comprise it, including all of the ambiguities and inconsistencies among them. The objective of this representation is to guide additional research aimed at interpreting these ambiguities and inconsistencies in locus order rather than presenting a "consensus order" that ignores these problems.

Chromosome Mapping↗

Tubo-ovarian abscess in older women: is the woman's age a risk factor for failed response to conservative treatment?

OBJECTIVE: To assess retrospectively if there is a trend of change in the epidemiology of tubo-ovarian abscess (TOA) and to define the epidemiologic, clinical and laboratory risk factors associated with failed response to conservative antibiotic therapy. STUDY DESIGN: The charts of 60 patients, admitted with clinically and sonographically diagnosed TOA between January 1995 and December 2000, were reviewed. On admission, all patients were treated with broad-spectrum antibiotics, and were divided into two groups according to the response to medical treatment. Forty-three patients, responding to antibiotic therapy, constituted group A, whereas 17 patients who did not respond and were further treated by sonographically guided drainage or surgery, were included in group B. The groups were compared with respect to patient characteristics, clinical and sonographic presentation, laboratory findings, duration of hospital stay and recovery rate of different pathogens from the endocervix. RESULTS: The mean age of patients responding to medical therapy (group A) was significantly lower (39.6 +/- 8.3) than the age of patients who did not respond (group B) (45.3 +/- 6.6) (p = 0.02). The gravidity as well as the percentage of menopausal women were significantly increased in group B (p = 0.03 and p = 0.02, respectively). There was a significantly lower incidence of previous pelvic surgery and past history of PID in group B versus group A (p = 0.02 and p = 0.03, respectively), yet the duration of IUD use was significantly prolonged in group B (p = 0.02). The size of TOA, evaluated clinically and sonographically, was significantly increased in group B compared with group A (p = 0.04 and p = 0.009, respectively). Pelvic peritonitis was observed in 40% of group B patients and in none of group A patients (p = 0.0001). The only laboratory finding differentiating between the two groups was the mean sedimentation rate, being significantly higher in group B than in group A (p = 0.0005). The time interval from admission to afebrile condition as well as the duration of hospitalization were significantly shorter in group A (6.1 +/- 2.3 days) than in group B (10.7 +/- 4.7 days) (p = 0.00003). The incidence of positive culture from the endocervix was significantly higher in group B than in group A (p = 0.007). One hundred percent of patients in group B versus 65.2% of patients in group A were treated with triple agent therapy (p = 0.007). CONCLUSION: The results of the current study strengthen our previous assumption that there is probably a new trend in the epidemiology of TOA, occurring in older women, who do not present the traditional risk factors for pelvic inflammatory disease and TOA.

Abdominal Abscess↗

Long-term follow-up (5-20 years) after uterine ventrosuspension for chronic pelvic pain and deep dyspareunia.

OBJECTIVE: To examine the long-term outcome of patients undergoing uterine ventrosuspension for chronic pelvic pain and deep dyspareunia. METHODS: Eighty-two patients, presenting with retroverted uterus, pelvic pain and deep dyspareunia, underwent uterine ventrosuspension by laparotomy or laparoscopy during the period from 1981 to 1996. Only patients (56) with no pelvic pathologic condition, as identified intraoperatively, participated in the study. At the beginning of the year 2002, 41 out of 56 patients (73.2%) were attained by telephonic questionnaire, and they were asked to refer to the uterine ventrosuspension procedure. RESULTS: Patients' average age was 32.3 years, and the mean duration of preoperative symptoms was 3 years. The mean follow-up period was 12 (range 5-20) years. The initial improvement in preoperative symptoms was observed in 70.7% of patients, whereas the final improvement was observed in 46.3% of patients, with no significant difference comparing the approach of laparotomy versus laparoscopy. Hysterectomy after uterine suspension was performed in 12.1% of patients (4.3% after laparotomy and 22.2% after laparoscopy). Twenty-three patients (56.1%) would recommend this operative procedure to others. CONCLUSION: The long-term outcome of patients undergoing uterine ventrosuspesnion approximates to 50% success rate, with no significant difference comparing the approach of laparotomy versus laparoscopy.

Adult↗

Late midtrimester pregnancy termination in the presence of placenta previa.

OBJECTIVE: To examine the operative outcome in women undergoing late midtrimester pregnancy termination by dilatation and evacuation in the presence of complete placenta previa. STUDY DESIGN: The records of 306 consecutive women undergoing pregnancy termination at 19-24 weeks' gestation from January 1997 to December 2000 were reviewed and divided into those with and without complete placenta previa based on an ultrasound examination before the procedure. These two groups were then compared for differences in patient characteristics, previous gynecologic history and operative outcome, reflected by operative time, need for blood transfusion, discharge time, postoperative bleeding and postoperative fever. RESULTS: Complete placenta previa occurred in 2.6% of patients (8 of 306). Significantly more women with placenta previa were married (P = .04). There was also a significant difference between the two groups considering the indication for pregnancy termination, as all patients with placenta previa underwent late midtrimester termination due to structural and chromosomal fetal malformations, whereas 33.8% of patients without placenta previa demonstrated fetal malformations (P = .005). Furthermore, significantly more women with placenta previa had had previous pelvic surgery (P = .01). However, there was no significant difference between the two groups with regard to age, percentage of smokers, number of previous abortions, parity or number of previous cesarean sections. There was no significant difference in the number of inserted Laminaria, operative time, need for blood transfusion, postoperative morbidity and duration of hospital stay. CONCLUSION: Late midtrimester pregnancy termination by dilatation and evacuation in the presence of placenta previa appears to be safe and apparently does not increase maternal morbidity as compared with the outcome in patients without placenta previa undergoing the same procedure.

Abortion, Induced↗

[Fetal abnormalities leading to termination of pregnancy: the experience at the Assaf Harofeh Medical Center between the years 1999-2000].

OBJECTIVES: To assess the distribution of fetal indications leading to termination of pregnancy. DESIGN: A retrospective study. METHODS: The study included all parturient women with singleton pregnancy, who underwent termination of pregnancy due to fetal abnormalities (structural, chromosomal/genetic, infections). The women were subdivided into two groups according to their gestational age, i.e. early termination (gestational period < 23 weeks) and late termination (gestational period > 23 weeks). RESULTS: A total of 137 terminations of pregnancies were performed, including 102 early terminations and the rest--late terminations. The mean maternal age was 31 +/- 5 years. The termination procedures were performed at a mean gestational age of 20 +/- 5 weeks. The main indications in the early-termination subgroup were structural and chromosomal/genetic (n = 45, 44% for each subgroup). Multiple abnormalities were more common in the early-termination group (18% versus 7%). In the late-termination subgroup the leading indications were structural anomalies (n = 29, 83%) that were subdivided into neurological defects (31%) followed by skeletal deformities (23%). In addition, in the late-termination subgroup there were more cardiac and urinary tract defects (17% versus 11% and 14% versus 9%, respectively). Among the chromosomal aneuploidies, trisomy 21 was diagnosed in 24 cases (53%). Fetal infections were diagnosed in 13 pregnancies (9%), with only one of these detected in advanced gestation. The leading infectious agent was cytomegalovirus. CONCLUSIONS: In the early-termination subgroup the main indications were equally divided between structural and chromosomal/genetic defects while in the late-termination subgroup the leading cause was structural defects.

Abortion, Induced↗

Development and mapping of 2240 new SSR markers for rice (Oryza sativa L.).

A total of 2414 new di-, tri- and tetra-nucleotide non-redundant SSR primer pairs, representing 2240 unique marker loci, have been developed and experimentally validated for rice (Oryza sativa L.). Duplicate primer pairs are reported for 7% (174) of the loci. The majority (92%) of primer pairs were developed in regions flanking perfect repeats > or = 24 bp in length. Using electronic PCR (e-PCR) to align primer pairs against 3284 publicly sequenced rice BAC and PAC clones (representing about 83% of the total rice genome), 65% of the SSR markers hit a BAC or PAC clone containing at least one genetically mapped marker and could be mapped by proxy. Additional information based on genetic mapping and "nearest marker" information provided the basis for locating a total of 1825 (81%) of the newly designed markers along rice chromosomes. Fifty-six SSR markers (2.8%) hit BAC clones on two or more different chromosomes and appeared to be multiple copy. The largest proportion of SSRs in this data set correspond to poly(GA) motifs (36%), followed by poly(AT) (15%) and poly(CCG) (8%) motifs. AT-rich microsatellites had the longest average repeat tracts, while GC-rich motifs were the shortest. In combination with the pool of 500 previously mapped SSR markers, this release makes available a total of 2740 experimentally confirmed SSR markers for rice, or approximately one SSR every 157 kb.

Chromosome Mapping↗