New combinations and a complete list of Asparagus species in southern Africa (Asparagaceae)

With only flower sexuality differing. Protasparagus can not be separated from  Asparagus, neither at generic nor at subgeneric level. No significant differences in the degree to which filaments were connivent were observed between species placed under  Myrsiphyllum and those under  Protasparagus/Asparagus. All southern African species of Asparagaceae are therefore reinstated under Asparagus and listed here without recognition of subgenera. Several new combinations are made.

Gestational diabetes: postpartum glucose tolerance testing

OBJECTIVE

Our purpose was to determine the incidence of and evaluate risk factors for postpartum glucose intolerance among predominantly black gestational diabetic women.

STUDY DESIGN

One hundred forty-five gestational diabetics underwent a standard 2-hour glucose tolerance test in the early puerperium according to the criteria of the National Diabetes Data Group.

RESULTS

Fourteen patients (10%) were diabetic and eight (5%) showed impaired glucose tolerance. Maternal age, race, or obesity did not predict abnormal postpartum glucose tolerance testing. The requirement of insulin for glucose control during gestation and gestational age at diagnosis were significantly associated with abnormal postpartum glucose tolerance (p < 0.0001 and p = 0.012, respectively). Multivariate analysis showed that only a requirement for insulin for glucose control was significant (p < 0.001).

CONCLUSION

Pregnancies complicated by gestational diabetes are at increased risk of glucose intolerance during the early postpartum period. Abnormal glucose tolerance occurs predominantly among those patients requiring insulin therapy during gestation or those diagnosed before 24 weeks' gestation.

Ureteral injury during elective pregnancy termination. A case report

This case is the sixth reported one of ureteral injury following elective pregnancy termination. It reemphasizes that the anatomic relationship of the ureter to the lower genital tract can predispose to surgical injury.

Urinary dipstick protein: a poor predictor of absent or severe proteinuria

OBJECTIVE

Our purpose was to compare urinary protein dipstick values with standard 24-hour urinary protein excretion in women with hypertension in pregnancy.

STUDY DESIGN

Urinary protein dipstick determinations and concurrent 24-hour urinary protein excretion measurements were compared by review of 300 urine samples obtained from women with hypertension in pregnancy.

RESULTS

One hundred twenty-three samples had negative to trace protein on dipstick on two occasions at least 6 hours apart. Eight-one (66%) of these patients had significant proteinuria (> or = 300 mg per 24 hours). Seventy-six samples revealed 3+ to 4+ protein on dipstick in at least two samples. Of these, 27 (36%) had heavy proteinuria (> or = 5 gm per 24 hours), and 42 (55%) had nephrotic range proteinuria of > or = 3.5 gm per 24 hours. One hundred one patients had urine dipstick values of 1+ to 2+, of whom 89 (88%) had significant proteinuria.

CONCLUSION

Urinary protein dipstick values > or = 1+ have a positive predictive value of 92% (162/177) for predicting > or = 300 mg per 24 hours. In contrast, a dipstick of negative to trace should not be used to rule out significant proteinuria because its negative predictive value is only 34% (42/123) in hypertensive patients. Moreover, urine dipstick values of 3+ to 4+ should not be used to diagnose severe preeclampsia because their positive predictive value is only 36% (27/76).

Positive serum screening for fetal Down syndrome does not predict adverse pregnancy outcome in absence of fetal aneuploidy

OBJECTIVE

The purpose of this study was to determine whether false-positive maternal serum screening for fetal Down syndrome is predictive of poor pregnancy outcome.

METHODS

The pregnancy outcomes of 99 women having positive serum screening for fetal Down syndrome (study group)--based upon maternal serum alpha-fetoprotein (MSAFP), unconjugated estriol (uE3), hCG, and maternal age--were compared to the outcomes of matched control patients having negative serum screening results (control group). The outcome indices analyzed were fetal death, intrauterine growth retardation (IUGR), preeclampsia, and fetal anomalies.

RESULTS

Between the study group and the control group, there were no statistically significant differences in pregnancy outcome with respect to fetal death, IUGR, preeclampsia, or fetal anomalies.

CONCLUSIONS

Our findings demonstrate no apparent increase in the adverse perinatal outcomes analyzed in women having unexplained positive serum screening for fetal Down syndrome. Although further investigation is needed, these results provide no evidence to support increased antepartum surveillance in such patients.

Adhesion formation associated with the use of absorbable staples in comparison to other types of peritoneal injury

Adhesion formation was assessed after inducing peritoneal injury with absorbable staples, absorbable suture, surgical excision or thermal injury. In addition, adhesion formation was assessed in the presence of Hyskon. Absorbable staples were associated with increased adhesion formation when compared to the other methods of injury. Hyskon appears to significantly reduce the formation of peritoneal adhesions at sites of peritoneal suturing, excision, and thermal injury, but did not reduce adhesion formation in the area of stapling.

A histologic evaluation of peritoneal injury and repair: implications for adhesion formation

A study of peritoneal healing after specific types of peritoneal injury was conducted in rabbits. Histologic specimens were examined at four, eight, 12, 24, and 48 hours, and at five, seven, and 14 days postperitoneal injury. Comparison of types of injury and attempts at peritoneal repair revealed differences in healing mechanisms. Histologic evidence of rapid reperitonealization was associated with those types of repair that involved minimal tissue necrosis and absence of foreign body reaction.

Cytological events associated with in vitro aged and fertilized rabbit eggs

The morphogenetic events associated with rabbit eggs aged in vitro for 12 to 50 hours prior to mixing with sperm have been examined by light and electron microscopy. After 12 hours in culture, morphological alterations of the meiotic spindle and the cortex of unfertilized eggs were evident. By 24 to 50 hours in culture, unfertilized eggs contained subnuclei, structures which formed when individual and/or groups of meiotic chromosomes dispersed and becmae invested by a double-laminated structure reminiscent of a nuclear envelope. Although most eggs obtained 11.5 to 12 hours after induced ovulation and in vitro fertilized displayed morphogenetic patterns similar to those described for in vivo fertilized ova, some (10%) contained three pronuclei. Many eggs obtained 13 to 15 hours after induced ovulation and subsequently mixed with sperm in vitro appeared to undergo processes of fertilization typical of in vivo fertilized eggs, however, approximately 30% contained subnuclei in association with the male pronucleus. Few eggs (15%) aged 12 hours prior to in vitro fertilization displayed patterns of pronuclear development and association typical of fertilized unaged ova. Subnuclei developed in many of the fertilized ova. Supernumerary sperm nuclei, which did not develop into male pronuclei, were observed in some zygotes. Cleavage of eggs aged 12 hours prior to fertilization was abnormal or retarded. After 24 hours in culture approximately 16% of the eggs fertilized. Seventy percent of the fertilized eggs failed to support the development of a male or female pronucleus.