Our aim was to evaluate hemodynamic and respiratory responses to different levels of hypoxia and hypercapnia in conscious intact or carotid body-denervated rats.

METHODS: Male Wistar rats were submitted to bilateral ligature of carotid body arteries (or sham-operation) and received catheters into the left femoral artery and vein. After two days, each animal was placed into a plethysmographic chamber and, after baseline measurements of respiratory parameters and arterial pressure, each animal was subjected to three levels of hypoxia (15, 10 and 6% O-2) and hypercapnia (10% CO2).

RESULTS: The results indicated that 15% O-2 decreased the mean arterial pressure and increased the heart rate (HR)

in both intact Bafilomycin A1 order IWR-1-endo ic95 (n=8) and carotid body-denervated (n=7) rats. In contrast, 10% O-2 did not change the mean arterial pressure but still increased the HR in intact rats, and it decreased the mean arterial pressure and increased

the heart rate in carotid body-denervated rats. Furthermore, 6% O-2 increased the mean arterial pressure and decreased the HR in intact rats, but it decreased the mean arterial pressure and did not change the HR in carotid body-denervated rats. The 3 levels of hypoxia increased pulmonary ventilation in both groups, with attenuated responses in carotid body-denervated rats. Hypercapnia with 10% CO2 increased the mean arterial pressure and decreased HR similarly in both groups. Hypercapnia also increased pulmonary ventilation in both groups to the same extent.

CONCLUSION: This study demonstrates that the hemodynamic and ventilatory responses varied according to the level of hypoxia. Nevertheless, the hemodynamic and ventilatory responses to hypercapnia did not depend

on the activation of the peripheral carotid chemoreceptors.”
“Contents This paper reviews recent data and concepts on the development of inflammation in the reproductive tract of dairy cows during the first 2 months after calving. The incidence of metritis is typically 10-20%, with 5-15% of LCL161 cows having purulent vaginal discharge (PVD), 15-40% having cervicitis approximately 1 month after calving, and 10-30% having cytological endometritis between 1 and 2 months after calving. Endometritis, cervicitis and PVD are distinct conditions, each of which is associated with significantly increased time to pregnancy, and affected cows often have more than one of these conditions. Cumulatively, 35-50% of cows have at least one form of pathological reproductive tract inflammation between 3 and 7 weeks postpartum. It is hypothesized that reproductive tract disease represents a failure of the immune system to switch fast enough or far enough from the down-regulated state necessary for maintenance of pregnancy to a heightened state of function for postpartum clearance of bacteria and tissue debris and then to a ‘quiet’ state 3-4 weeks later.

In addition, it serves as a unique reference material for research purposes. (C) 2010 Elsevier Ltd. All rights reserved.”
“BACKGROUND: buy CX-6258 No standard index based

on donor factors exists for predicting mortality after orthotopic heart transplantation (OHT). We utilized United Network for Organ Sharing (UNOS) data to develop a quantitative donor risk score for OHT.

METHODS: We examined a prospectively collected open cohort of 22,252 patients who underwent primary OHT (1996 to 2007). Of the 284 donor-specific variables, those associated with 1-year (year) mortality (exploratory p-value < 0.2) were incorporated into a multivariate (MV) logistic regression model. The final model contained donor factors that improved the explanatory power (by pseudo-R2, area under

the curve and likelihood ratio test). A quantitative donor risk score was created using odds ratios (ORs) from the final model. For BVD-523 research buy external validity, a cross-validation strategy was employed whereby the score was generated using a randomly generated subset of cases (n = 17,788) and then independently validated on the remaining patients (n = 4,464).

RESULTS: A 15-point scoring system incorporated 4 variables: ischemic time; donor age; race mismatching; and blood urea nitrogen (BUN)/creatinine ratio. Derivation and validation cohort scores ranged from 1 to 15 and 1 to 12, respectively (mean 4.0 +/- 2.1 for each). Each increase of 1 point increased the risk of 1-year death by 9% (OR = 0.09 [1.07 to 0.12]) in the derivation cohort and 13% (OR = 0.13 [1.08 to 0.18]) in the validation cohort (each p < 0.001). The odds of 1-year mortality by increments of 3 points were: 0 to 2 points (reference); 3 to 5 points (OR = 0.25 [1.12 to 0.40], p < 0.001); 6

to 8 pts (OR = 0.77 [1.56 to 2.02], p < 0.001); and 9 to 15 points (OR = 1.92 [1.54 to 2.39], p < 0.001). Donor risk score was predictive for 30-day mortality (OR 0.11 [1.08 to 0.14],p < 0.001) and 5-year cumulative mortality (OR = 0.11 [1.09 to KU-55933 in vivo 0.13], p < 0.001).

CONCLUSIONS: We present a novel donor risk index for OUT predicting short- and long-term mortality. This donor risk score may prove valuable for donor heart allocation and prognosis after OHT. J Heart Lung Transplant 2012;31:266-73 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved.”
“Microalbuminuria (amount greater than 30-300 mg/day) reflects an abnormal glomerular capillary permeability to protein. It is usually dependent upon three mechanisms. First, loss of negatively charged surface of the glomerular capillary wall secondary to circulating toxic substances injurynamely, oxidative stress and proinflammatory cytokinesallows the albumin with negatively charged surface to freely escape into the urine.

The systemic failure of CaM degradation, and thus of Ca2+/CaM-dependent signaling pathways, may be important in the etiopathogenesis of AD.”
“The unparalleled accumulation of biological and contextual data is currently revolutionizing the way environmental microbiologists

address ecological questions. Here, we briefly review the likely causes that may explain this remarkable scientific revolution and present a synthesized view about how to describe microbial communities in their complex environmental context.”
“We demonstrate-both experimentally and theoretically-that the finite size of the current leads does not allow neglecting the role of these leads in the four-probes transport measurements if the properties LDK378 mouse of these leads are modified in the course of the experiment. We also give a short critical review of other publications, where, to our opinion, a possible role of the current leads was underestimated. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3622146]“
“Hypertension selleck kinase inhibitor causes cognitive impairment, involving mainly executive functions, but the effect of blood pressure (BP) control on the different cognitive domains is still debated. We correlated executive function, attention and memory with BP control and cerebrovascular damage in 60 undemented middle-aged hypertensives at baseline and

after 6-year follow-up. At first evaluation, the patients with poor BP control had higher score of white matter lesions, reduced cerebrovascular reserve capacity and

greater carotid intima-media thickness (IMT) than those with good BP control. Performance on executive tests correlated with IMT and with performance on attention tests, which was impaired by low diastolic BP. At long-term follow-up, performance in attention and executive tests improved in spite of the minor improvement of BP control, increased IMT and worse memory. Low diastolic BP has a negative effect on attention, which affects executive performance at first cross-sectional examination. This confounding effect has to be taken into consideration when planning studies on cognitive function. Longitudinal studies are required to unravel the effect of BP Dinaciclib purchase control on cognitive function, as only long-term antihypertensive treatment improves both attention and executive performance. Journal of Human Hypertension (2011) 25, 80-87; doi: 10.1038/jhh.2010.28; published online 18 March 2010″
“Neurogenesis in the hippocampus is actively involved in neural circuit plasticity and learning function of mammals, but it may decrease dramatically with aging and aging-related neurodegenerative disorder Alzheimer’s disease. Accumulating studies have indicated that Wnt/beta-catenin signaling is critical in control of proliferation and differentiation fate of neural stem cells or progenitors in the hippocampus.

We genotype 12 inbred M. truncatula lines sampled from four wild Tunisian populations and find polymorphisms at approximately 7% of features, comprising 31 419 probes. Only approximately 3% of these markers assort by population, and of these only 10% differentiate between populations from saline and non-saline sites. Fifty-two differentiated probes with unique genome locations correspond to 18 distinct genome regions. Sanger resequencing was used to characterize a subset of maker loci and develop a single nucleotide polymorphism (SNP)-typing assay that confirmed marker assortment by habitat in an independent

sample of 33 individuals from the four populations. Genome-wide linkage disequilibrium (LD) extends on average for approximately 10 kb, falling to background levels by approximately 500 kb. A similar range of LD decay Selleckchem CP-456773 was observed in the 18 genome regions that assort by habitat; PRIMA-1MET purchase these LD blocks delimit candidate genes for

local adaptation, many of which encode proteins with predicted functions in abiotic stress tolerance and are targets for functional genomic studies. Tunisian M. truncatula populations contain substantial amounts of genetic variation that is structured in relatively small LD blocks, suggesting a history of migration and recombination. These populations provide a strong resource for genome-wide association studies.”
“To investigate the influence Trichostatin A order of different kinds of endometriotic lesions, especially peritoneal endometriotic implants in pain generation and the pain reduction after surgical excision in a prospective study.

Fifty-one pre-menopausal patients underwent surgical laparoscopy due to chronic pelvic pain, dysmenorrhoea and/or for ovarian cysts. In 44 patients, endometriosis was diagnosed. The pre- and post-operative pain score was determined using a standardized

questionnaire with a visual analogue scale. Patients with peritoneal endometriosis were divided into two different groups depending on their pre-operative pain score: group A had a pain score of 3 or more, while group B a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C, and patients without endometriosis were classified as group D. The pre- and post-operative pelvic pain and/or dysmenorrhoea was analysed according to the different types of endometriotic lesions.

In groups A and C, the post-operative pain score decreased by at least 2 grades or more (p < 0.0). In group D, the post-operative pain score showed no significant reduction.

The present study suggests that the surgical excision of endometriotic lesions-including peritoneal implants-is an effective treatment of endometriosis-associated pelvic pain and/or dysmenorrhoea.

Samples of ZrO2:Er3+, ZrO2:Er3+/Yb3+, and HfO2:Er3+/Yb3+ were prepared by the sol-gel technique and characterized using x-ray diffraction and electron microscopy. A study of the infrared-to-green and infrared-to-red UC processes was performed including the analysis of the spectral and the temporal behavior. The mechanisms contributing to the UC luminescence were SHP099 smiles identified as excited state absorption and energy transfer among rare-earth ions. (C) 2010 American Institute of Physics. [doi:10.1063/1.3428478]“
“A

4-year-old boy presented with pneumonia. Computed tomography demonstrated a multicystic mass at the posteromedial bilateral lower lobe segments, which were connected by a bronchus behind the heart. Enhanced computed tomography revealed that an anomalous artery arose from

the left gastric artery and inserted into the left sequestrated lung and branched to the right one. The diagnosis of bilateral intralobar sequestration (ILS) with a bridging isthmus was made. After removal of the bilateral ILS, radiologic and pathologic approaches were undertaken to reconstruct the vascular and bronchial architectures. The following observations check details were made: (1) histologically, the region near the anomalous artery insertion site contained bronchial structures, which looked like an ectopic pulmonary hilus. This bronchial structure was continuously observed in the isthmus and its opening of the right sequestrated lung; (2) radiologically, the shape and course of the bronchi within the ILS indicated a distinct bronchial origin that arose from the pulmonary hilus-like structure, and the anomalous artery that ran along with those bronchi, resembled a pulmonary artery. These features suggested that this bilateral ILS might have originated from an accessory lung tissue.”
“Poly(3-hydroxybutyrate-co-3-hydroxyvalerate)(PHBV)/poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3/4HB) blend www.selleckchem.com/products/acy-738.html films were prepared by solvent-cast method. The nonisothermal crystallization results showed that PHBV and P3/4HB are miscible due to a single glass transition temperature (T(g)), which is dependent on blend composition. The isothermal crystallization results demonstrate

that the crystallization rate of PHBV becomes slower after adding amorphous P3/4HB with 19.2 mol%, 4HB, which could be proved through depression of equilibrium melt point (T(m)(o)) from 183.7 degrees C to 177.6 degrees C. For pure PHBV and PHBV/P3/4HB (80/20) blend, the maximum crystalli-zation rate appeared at 88 degrees C and 84 degrees C, respectively. FTIR analysis showed that PHBV/P3/4HB blend films would maintain the helical structure, similar to pure PHBV. Meanwhile, with increasing P3/4HB content, the inter- and intra-interactions of PHBV and P3/4HB decrease gradually. Besides, a lower elastic modulus and a higher elongation at break were obtained, which show that the addition of P3/4HB would make the brittle PHBV to ductile materials.

Results: Torsadogenic drugs known to delay repolarization during slow stimulation prolonged CLIC and dramatically limited the ability to respond to progressively rapid stimulation. The recognized proarrhythmic compounds E-4031, cisapride, grepafloxacin, and haloperidol rapidly prolonged CLIC at and above therapeutic concentrations in a concentration-dependent manner, while negative controls (captopril, indomethacin, and loratidine) do not affect rate-adaptation.

Discussion: Ventricular rate adaptation represents a novel approach for rapidly detecting drugs with torsadogenic risk using rapid rhythms that are typically not employed when evaluating proarrhythmic risk. This

method is well suited for detecting and avoiding PU-H71 cell line potential cardiac liabilities early in drug Selleck LDN-193189 discovery (“”frontloading”") prior to final selection of candidate drugs. (C) 2011 Elsevier Inc. All rights reserved.”
“The purpose of this study was to determine whether a clampless facilitating device (CFD) to perform proximal aortocoronary anastomoses would result in a lower incidence of cerebral embolic events compared with a partial clamping strategy during off-pump

coronary artery bypass (OPCAB). After epiaortic ultrasound confirmed the mild aortic disease (Grades I and II), 57 patients were randomly assigned to have proximal anastonnoses using a partial-occluding clamp (CL, n = 28) or a CFD [Heartstring (HS), n = 29] (Maquet Cardiovascular LLC, San Jose, CA). Solid and gaseous emboli in the middle cerebral arteries were detected using transcranial Doppler ultrasonography. Y-27632 The mean number of proximal anastomoses was similar between groups 1.93 +/- 0.72 (CL) and 1.72 +/- 0.70 (HS) (P = 0.28). The mean number of gaseous plus solid emboli was greater in the CL group than the HS group (90.0

+/- 64.0 vs. 50.8 +/- 36.6, P = 0.01). Emboli were fewest in patients undergoing HS anastomoses using the suction device. The number of intraoperative cerebral emboli was proportional to the number of proximal anastomoses in the HS groups, but independent of the number of proximal anastomoses in the CL groups. Among patients with a low burden of aortic atherosclerosis, partial clamping of the ascending aorta during OPCAB was associated with more cerebral embolic events compared with an anastomosis with a CFD.”
“Hydroa vacciniforme-like lymphoma and extranodal-type natural killer (NK)/T-cell lymphoma are prototypes of Epstein-Barr virus (EBV)-associated cutaneous T- or NK-cell lymphomas. Hydroa vacciniforme-like lymphoma with systemic spread and extranodal-type NK/T-cell lymphoma are characterized by aggressive clinical course. We describe 2 patients with primary cutaneous EBV-associated T- cell lymphomas who did not satisfy the criteria for well-defined entities and showed unusual, prolonged clinical course. They presented with skin ulcerations and mass lesions confined to the extremities without systemic involvement.

(Obstet Gynecol 2011;118:824-30) DOI: 10.1097/AOG.0b013e31822f1713″
“Body weight changes in HCV patients on interferon therapy are well documented. However, the underlying mechanism involved in these changes is poorly understood and rarely reported. The PXD101 chemical structure main objectives of this review are to 1) discuss changes in body weight and other compartments

of body composition, particularly, body fat, and 2) to discuss the underlying mechanism for these changes. The literature review suggests weight loss (12-29%) as a function of interferon therapy is common, affecting up to 90% of HCV patients. Whilst, loss in weight means proportionate loss in other body compartments (lean body mass and body fat, in particular) data on changes in segmented body composition are fragmentary. The possible mechanisms underlying weight loss or changes in other body composition have been reported and these include suppressed appetite due to induction of TNF by TEN, a decrease in serum leptin level, and importantly mitochondrial damage induced by the therapy. It is, therefore, suggested that close monitoring of chronic HCV patients receiving PEG-IFN and/or ribavirin for side effects of these drugs, particularly those related to weight loss, is vitally important from clinical point of view.”
“Objectives: Nonresponse

to patient-reported outcome (PRO) questionnaires after surgery might bias the results. Our aim was to gauge the potential impact of nonresponse bias by comparing the outcomes of early and late responders.

Study Design and Setting: This study compares 59,565 early and 20,735 late responders who underwent a hip or knee replacement, selleck compound hernia repair, or varicose vein (VV) surgery. The association between timeliness of response and three outcomes (the mean

postoperative disease-specific PRO and generic PRO scores and the proportion reporting a fair or poor result) was examined by regression analysis.

Results: Late responders were slightly more likely to be young, nonwhite, deprived, and have a more severe preoperative condition with poorer quality of life. Late response was associated with a slightly poorer outcome in all four procedures although not statistically significant (P < 0.05) for VV surgery. Adjusting for Staurosporine clinical trial preoperative characteristics reduced the strength of the associations, but they remained statistically significant.

Conclusion: As nonresponse to PRO questionnaires introduces slight bias, differences in response rates between hospitals should be taken into account when making comparisons so as to avoid overestimating the performance of those with lower response rates and failing to detect poor performing hospitals. (C) 2013 Elsevier Inc. All rights reserved.”
“Background: There are several reports of lymphomas arising in the nasal cavity, either T cell/NK cell or B cell type. We studied several cases of lymphoma involving the nasal cavity or paranasal sinuses.

Uncompromised neonates were compared to neonates in need of resuscitation.

Results: Out of 224 eligible neonates 31 uncompromised and 15 in need of respiratory support were included. Uncompromised neonates showed higher values for V-min in the third minute and higher values for V-max in the third and fourth minute compared to the tenth minute post-partum. In uncompromised neonates rSO(2) values during the first 6 min after birth were lower compared to minute ten. Neonates in need of respiratory support had lower rSO(2) values over the first 8 min after birth compared to minute ten.

Conclusions:

This is the first study demonstrating that monitoring 5-Fluoracil mouse of aEEG and NIRS to measure cerebral activity and oxygenation during immediate postpartum transition is feasible. During transition compromised neonates requiring resuscitation showed a different cerebral activity pattern compared to uncompromised neonates. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Methylmercury (MeHg) is an important environmental pollutant that causes severe disorders of the central nervous system, but the mechanism underlying its toxicity and the corresponding

biological defense mechanisms remain largely unknown. Saccharomyces cerevisiae (S. cererisiae) yeast cells were used to elucidate SN-38 solubility dmso the defense mechanisms against MeHg toxicity and to search for novel genes involved in MeHg resistance. S. cerevisiae is a eukaryotic organism that possesses many gene products that are functionally similar to those of mammals such as humans.

We have previously reported that Cdc34 and Rad23 confer MeHg resistance to yeast cells. Interestingly, the both proteins are related to ubiquitin-proteasome system (UP system) that is involved in the intracellular degradation of proteins. In our detailed experiments, we found that the UP system might play an important role in lending protection against MeHg toxicity. This review summarizes the results of our studies on the role of the UP system as a defense mechanism against MeHg toxicity in yeast cells.”
“Purpose: To develop floating matrix tablets of salbutamol sulphate using ethyl cellulose and acrycoat S-100 as SN-38 purchase polymers, and sodium bicarbonate, citric acid and tartaric acid as gas generating agents.

Methods: Twenty four formulations were prepared and segregated into four major categories, A to D. The floating tablets were prepared by wet granulation technique, and the granules were compressed at a pressure of 50 kg/cm(2). The tablets contained drug, ethyl cellulose and Acrycoat S-100 (as release-retarding polymers), sodium bicarbonate, citric acid and tartaric acid (as gas formers) as well as various additives. The tablets were made by wet granulation technique. The formulations were evaluated for in vitro buoyancy, dissolution and in vitro drug release.

Results: All the formulations fulfilled the essential requirements for good floating systems.

Magnetic resonance imaging (MRI) revealed right thrombophlebitis extending from the sigmoid sinus to the jugular vein.

Interventions: Systemic administration of adrenocortical steroid hormone after intravenous antibiotic therapy.

Main Outcome Measures: Radiologic features and patient symptoms.

Results: Intravenous antibiotic therapy was ineffective, but selleck products the patient’s symptoms were relieved less than 1 day after the initiation of prednisolone treatment (30 mg/d for 5 d). MRI performed 3 days after treatment revealed that thrombophlebitis of the head and neck had disappeared.

Conclusion: Adrenocortical steroid hormone therapy may be an effective

treatment for thrombophlebitis with EOM. Chemoattractants activated by EOM might be

associated with the pathogenesis of thrombophlebitis of the head and neck.”
“Purpose: To evaluate the effect of a w/o cream of turmeric (Curcuma longa Zingiberaceae) extract on skin sebum secretion in human volunteers.

Methods: Two w/o cream formulations were prepared – one contained 5% extract prepared from the rhizomes of the plant, turmeric, and the second was similar except that it did not contain the extract and served as control. The antioxidant activity of the extract was determined by using the DPPH method. Evaluation of the effect of the creams Liproxstatin 1 on skin sebum secretion was conducted with the aid of a sebumeter. Initial sebum measurements on the face of thirteen human volunteers were taken with the sebumeter prior to application of cream, and then fortnightly after twice daily application of cream (on the right and left cheeks for control and extract creams, respectively) over a period of three months.

Results: Significant increase (p < 0.05) in the sebum values was observed from the 6th week onwards after control cream application. Maximum increase of 6.2% was observed on the 10th

week of the study. On the other hand, following extract cream application, a significant decrease (p < 0.05) in sebum secretion occurred from the 4th week onwards, reaching a maximum of 24.8% at the end of the study period. The antioxidant activity of the extract was 88.5% of selleck inhibitor the standard.

Conclusion: The study demonstrates that the extract obtained from the rhizomes of turmeric plant can be used in skin preparations to regulate excessive sebum secretion in persons suffering from acne and related problems.”
“Objective. To characterize the pharmacokinetics of nifedipine when used for tocolysis in preterm labor and to determine the impact of genetics on these parameters.

Study design. Pharmacokinetic study performed on women given tocolytic nifedipine. Over one dosing interval, drug concentrations, clinical data, and genotype for Cytochrome P450 (CYP)3A5 polymorphisms were obtained. Non-compartmental pharmacokinetic analysis was used to estimate nifedipine exposure at steady state.

Results. The mean nifedipine area under the curve in 20 pregnant women was 86.1 +/- 61.1 ng/ml/h.

Setting: Tertiary referral center.

Patients: Thirty-two subjects with severe to profound hearing loss that developed before the age of 4.

Interventions: Subjects were implanted at a mean age of 24.8 years (range, 16-44) with Nucleus CI24 (n = 18, 56%), Clarion HiRes 90K(n = 11, 34%), and Medel PULSA(n = 3, 10%) device. Details of etiology, duration of deafness,

hearing aid history, hearing thresholds before operation, communication mode, and educational environment were investigated. Speech perception tests were performed preoperatively and 12 months after the operation.

Main ABT-737 datasheet Outcome Measures: Postoperative speech perception test scores between different options within patient group.

Results: The results showed significant improvement in

open set speech perception (sentence) scores after the implantation (mean scores from 7.0 to 46.7, p G 0.05). Preoperative hearing of better ear and preoperative speech perception scores correlated with postoperative performances (r = -0.70 and r = 0.46, respectively, p G 0.05). Education and communication mode were also closely related to postoperative performances. In the group with poorer performances, preoperative hearing thresholds were significantly worse than those with better performances, and a larger portion of those patients attended special schools and used sign language.

Conclusion: We found that residual auditory capacity in the better ear is an important factor in predicting outcomes after cochlear implantation in patients with NSC23766 concentration prelingual hearing loss.”
“Objective. We sought to determine whether placement of laminaria tents improve time to delivery compared with misoprostol alone in second trimester labor induction.

Methods. We retrospectively reviewed all patients undergoing second trimester labor induction. Patients with ruptured membranes, abruption, cervical dilation and chorioamnionitis at presentation were excluded. Complications were defined as chorioamnionitis,

retained placenta or other surgical procedures. Patients who received laminaria and vaginal misoprostol, 200 mu g every 12 h, were compared to those who received BIBF 1120 cell line misoprostol without laminaria.

Results. Forty-three patients met inclusion criteria, 19 underwent induction with misoprostol alone and 24 with laminaria and misoprostol. The median times to fetal and placenta deliveries were 16.4 and 0.0 h in the misoprostol group, and 20.6 and 0.2 h in the laminaria group. There was no difference in complications. Post-hoc power analysis revealed > 80% power to detect a difference in time to delivery of > 12 h, and > 90% power to detect a difference in time to placental delivery of >= 30 min.

Conclusions. Placement of laminaria does not improve fetal or placental delivery times in patients undergoing second trimester pregnancy termination by labor induction.