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Background: Uterovaginal agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome; MRKH) is a congenital nonformation of the vagina and the uterus, but with normal ovaries., Objective: The authors investigated the psychological impact of this disorder, about which very little is known., Method: A group of 66 women with MRKH were compared with 31 control-group women on a range of self-rating scales assessing psychological distress and self-esteem., Results: Women with MRKH had significantly more pathological scores on some of the scales and subscales, such as phobic anxiety and psychoticism (interpersonal alienation), with a similar trend for subscales measuring depression and anxiety., Conclusion: MRKH has a lasting negative impact on affected women's level of psychological distress and self-esteem.

Objective: The purpose of this study was to report pregnancy outcome and complication rates for women with recurrent late pregnancy loss who were treated with preconception transabdominal cervicoisthmic cerclage., Study Design: This was a case note review of 19 women at high risk for second trimester loss and early preterm delivery who were treated with preconception transabdominal cervicoisthmic cerclage at Queen Charlotte's and Chelsea Hospital from 1994 to 2003., Results: Preconception transabdominal cervicoisthmic cerclage was associated with a postoperative fetal survival rate of 100% for pregnancies that reached >12 weeks of gestation, compared with a preoperative fetal survival rate of 12%. There were no significant intraoperative, antenatal, intrapartum or neonatal complications., Conclusion: Within this case series, preconception transabdominal cervicoisthmic cerclage was a safe alternative to transabdominal cervicoisthmic cerclage that was performed in pregnancy with no risk to a fetus. It should be considered in appropriate cases in women seen for prepregnancy counseling.

While congenital malformations of the genital tract are not common, the sequelae of their presence can be serious. The practising gynaecologist must be aware of the range of congenital abnormalities that may occur and the symptoms that may result from them. Failure to manage these patients correctly may have long-term sequelae for their psychological, sexual and reproductive health. The involvement of a multi-disciplinary team in dealing with these patients is imperative, and preparation for surgery-particularly in congenital malformations of the vulva and the vagina-is imperative if the long-term sexual function in these patients is to be fulfilled. Surgical correction of vulval abnormalities in adolescence is related solely to sexual function as most of the reconstructive surgery is done in childhood. For the management of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, the recommendation is now that passive dilatation by Franks' technique is the treatment of first choice and only if that fails should surgical approaches be embarked upon. The results of the surgery are similar in all techniques and the particular surgical centre will have its own preference of which technique it adopts. Congenital absence of the cervix is a complex surgical problem and should be dealt with solely in centres with expertise.

Current models for the action of linear biological motors may be grouped in two main categories. The conventional "bind and bend" models rely for their power stroke upon a structural change in the myosin headgroup (S1 fragment) which follows the binding of myosin to the F-actin filament. The more recent ratchet models demonstrate that directional motion of a particle along an asymmetrical ratchet is possible with a symmetrical but time-correlated stochastic drive. In this paper a new type of model is introduced which is deterministic like the "bind and bend" model but it requires no molecular structural changes to power the stroke. Like the ratchet models the motor is driven along the linear stator by tangential forces at the interface but the forces are electrostatic and controlled by the hydrolysis of ATP to ADP.

The obstetric outcome following the elective use of oxytocin infusion was determined in a randomised, double-blind placebo-controlled trial. 93 nulliparous women in a London hospital, who had requested epidural analgesia in labour (

Because of the low dielectric constant of most proteins and lipids, the electric field of an ion passing through a narrow pore is long range and will interact with neighbouring ionizable residues of the channel protein. The electrical structure of the channel may thus change transiently in response to an ion passing through the pore. Model calculations then reveal that the ratio of the unidirectional ion fluxes may approach 1 as expected for a carrier or shuttling ionophore rather than the Ussing ratio expected for a pore. Saturation behaviour also becomes carrier-like. Computer simulation is reported showing a continuous variation between pore-like and carrier-like behaviour as the parameters of the system are allowed to change smoothly.

After cryopreservation of semen from men with testicular tumours or Hodgkin's disease the success rate of artificial insemination of their partners was analysed. The cumulative probability of pregnancy at 6 months was 45%. The chance of pregnancy was greater when timing of ovulation was predicted with measurements of urinary luteinising hormone. Sperm density and sperm motility were also important in predicting the likelihood of pregnancy.

Intrapartum continuous fetal heart rate monitoring has been routinely performed at the Jessop Hospital for Women for some years. However, no controlled trials had ever been performed to show its advantages over intermittent auscultation in low-risk patients. A prospective randomized study of 504 patients compared continuous fetal heart rate monitoring with intermittent auscultation. There was no significant difference between the two groups in neonatal deaths, Apgar scores, maternal and neonatal morbidity, and cord blood gases. The cesarean section rate was significantly increased (p less than 0.05) in the monitored patients but this did not seem attributable to fetal monitoring. No beneficial or deleterious effects of continuous fetal heart rate monitoring in labor were shown.

A technique for differentiating high-resolution NMR signals from different regions of small objects is outlined and some initial results on model systems are given. This method uses inorganic paramagnetic or diamagnetic ions to create magnetic field gradients at phase boundaries.