Adverse outcome in pregnancy following amniotic fluid isolation of Ureaplasma urealyticum

Infections in pregnancy with Ureaplasma urealyticum have been associated with a wide range of adverse outcomes, such as early abortion, stillbirth, prematurity, and neonatal morbidity and mortality. Causality has been difficult to demonstrate secondary to the high prevalence of asymptomatic lower genital tract (LGT) colonization and culture data from inaccessible or potentially contaminated sites. Between 1985 and 1989, 2461 second-trimester genetic amniocenteses were evaluated at the cytogenetics section of the Children's Hospital Medical Center of Akron. All were cultured for the genital mycoplasmas: Mycoplasma hominis and Ureaplasma urealyticum. A total of nine patients were positive, all for Ureaplasma urealyticum, with one patient excluded because of subsequent therapeutic abortion. In addition, complete follow-up data, such as indication for amniocentesis, serum alpha-fetoprotein levels, gestational age at parturition, and out- come of pregnancy, were available on 86 Ureaplasma-negative (U –) patients during an approximate 2-year span within the time-frame of the study. This was in part due to physician response to a questionnaire sent after amniocentesis. Of the eight positive cultures, 100 per cent were associated with an adverse outcome, defined as fetal loss or premature delivery. This was significant compared with the U–group (p<0.001) with a more than eight times greater risk of adverse outcome. Six (75 per cent) resulted in spontaneous miscarriage within 4 weeks of amniocentesis and at less than 21 weeks' gestation. Two (25 per cent) delivered prematurely, with one (12.5 per cent) neonatal death at 24+ weeks. Histological examination of all eight placentae and the seven fetuses revealed a 100 per cent incidence of chorioamnionitis and pneumonia, respectively. In addition, in four of the five cases (80 per cent), cultures were positive for Ureaplasma urealyticum in pure culture from either placenta, fetal lung, or both tissues. The remaining case (20 per cent) was negative for aerobes, anaerobes, and mycoplasmas. The study demonstrates a significant association and supports a causal relationship between isolation of Ureaplasma from mid-trimester amniotic fluid with fetal wastage and premature birth.     

Intrauterine manometry: Technique and application to fetal pathology

A technique is described for measuring pressure within the amniotic cavity and within fetal vessels and/or body compartments. Two saline-filled catheters were connected at one end to needles inserted during indicated invasive procedures and at the other to silicon strain gauge transducers. In 36 pregnancies with normal liquor volume, stable intra-amniotic pressure (IAP, range 1–14 mmHg) increased with gestation (r=0·48, p<0·01). In pregnancies complicated by severe oligohydramnios, IAP was ≤ 1 mm Hg and rose to normal levels with saline amnioinfusion. Raised IAP (range 17–26 mm Hg), found in pregnancies with gross polyhydramnios, fell with drainage of amniotic fluid. Subtraction manometry was used to determine supra-amniotic pressure within the intervillus space, umbilical vein, umbilical artery, abdominal and thoracic cavities, and the urinary tract in normal and/or pathological fetuses. Low intravesical and intrapelvicalyceal pressures (median 6·5, range 2–10 mmHg) were noted in fetuses with obstructive uropathies. Intrauterine subtraction manometry appears to be a useful tool in the understanding of fetal pathophysiology and may be of clinical benefit in the therapeutic drainage and infusion of amniotic fluid and in the assessment of certain fetal disease states.     

Chemistry and physics of amorphous semiconductors

Our understanding of amorphous semiconductors has been greatly clarified by recent theoretical and experimental work. It is now evident that the electrical properties of these materials are generally controlled by intrinsic defects which are either thermodynamically required or induced via strains during the deposition process. The nature of these defects is intimately related to the chemistry of the constituent atoms.     

The use of amniotic fluid AFP action limits in diagnosing open neural tube defects

An analysis is made of alphafetoprotein (AFP) concentrations in 3630 amniotic fluids submitted for prospective prenatal diagnoses over a 7-year period. There were 89 cases of anencephaly, 74 of open spina bifida and 3467 with normal singleton outcomes. The AFP data were expressed in both standard deviations above the mean and multiples of the normal median for individual weeks of gestation. False positive and false negative rates were comparable in the two systems at selected cut-offs. It is concluded that either system may be used in setting action limits for the primary distinction of unaffected pregnancies from those in which an open neural tube defect is present.     

Dystrophin protein and rflp analyis for fetal diagnosis and carrier confirmation of duchenne muscular dystrophy

A pregnant woman with indeterminate Duchenne muscular dystrophy (DMD) carrier status, but with DMD diagnosed in her deceased brother (unavailable for study), presented for prenatal diagnosis, intending to continue the pregnancy only if proven unaffected with DMD with near absolute certainty. Creatine kinase (CK) assays to clarify carrier status were inconclusive. Male sex in the fetus was identified, but DNA restriction fragment length polymorphism (RFLP) analysis was not yet available to this centre to investigate the possible transmission of the DMD gene, and the pregnancy was terminated. Tissue histology and dystrophin protein analysis demonstrated the absence of DMD. In a situation with proven maternal carrier status, future fetal inheritance of the opposite maternal X chromosome would indicate the presence of DMD. However, maternal carrier status remained in doubt through a second pregnancy, even with RFLP studies, and was finally established when dystrophin analysis confirmed the presence of DMD in the second fetus. Histologic findings are presented, contrasting features in the two fetuses. The value of dystrophin analysis for establishing the diagnosis of fetal DMD, in this case proving maternal carrier status in a difficult situation, and for demonstrating DMD gene:RFLP haplotype relationships is illustrated.     

Traceability in low-level radioactivity measurements

Various suggested definitions of the term “traceability” are discussed from the standpoint of proposed adoption and use of the concept by the International Organization of Legal Metrology.     

Threshold and dose response estimation using the “filter model”

The “filter model” has been developed to explain the biologic effects of radiation and chemicals. We have examined nearly 300 sets of dose response data, of which 50 are presented here. Responses (induced by radiation and chemicals) which have been examined include in vitro survival studies on animal and plant tissues, induction of cellular aberrations and time to tumor or death. Similar data from in vivo studies has also been examined. All of the data appear to fit the model R = a lnD + b(lnD)² + c, where R is the response, a and b are parameters fitted by regression to a particular set of data, and c is the response at zero (or lowest) dose. By writing this model in exponential form, it can be seen that the response R results from multistage filtering (by net amounts a and b) of the initial dose, D. The threshold is obtained from this model as the point, $\text{D}\text{?}{}_{\mathrm{T}}$, at which the second derivative becomes zero. This is given by $\text{D}\text{?}{}_{\mathrm{T}}\text{=}\text{exp}\text{(1 ?}\text{a}\text{2b}\text{)}$ when a and b are oppositelt signed.     

WORLD PETROLEUM RESOURCE ESTIMATES AND PRODUCTION FORECASTS: IMPLICATIONS FOR GOVERNMENT POLICY

Resource estimates alone will not give advance warning of encroaching production difficulties. An analysis of the general stages in the evolution of petroleum production and discovery and of industry statistics provides an estimate of when the stage characterised by increasing production in the market economy countries outside the United States and Canada will end. The analysis indicates that the year of maximum production will be in the 1990s. Economic growth aggravates the difficulties accompanying the production decline by advancing the date of peak production and by increasing the adjustments that must be made as oil production declines. Des prévisions de ressources à elles seules ne constituent pas des signes précurseurs de difficultés croissantes de production. Une analyse des étapes générales marquant l'evolution de la découverte et de la production du pétrole ainsi que des statistiques industrielles nous permet de prévoir l'époque à laquelle prendra fin la phase de production accrue dans les pays à économie de marché en dehors des Etats-Unis et du Canada. Cette analyse révèle que l'année de production maximale se situera dans les années 90. La croissance économique accentue les difficultés qui accompagnent le déclin de la production de pétrole en avancant la date à laquelle cell-ci atteindra son plafond et en augmentant le nombre d'ajustements qui s'avèrent nécessaires au fur et à mesure qu'elle baisse. Las evaluaciones de recursos no dan por si solas un aviso anticipado de las dificultades de producción. Un análisis de las etapas principales en la evolución del descubrimiento y producción de petróleo y de las estadísticas industriales provee un estimado de cuando va a terminar la etapa caracterizada por un crecimiento de producción en los paises de economias de mercado otros que Estados Unidos y Canada. El análisis indica que el año de producción máxima se hallará en la década del 90. El crecimiento económico agrava las dificultades debidas a la declinación de la producción al adelantar la fecha de máxima producción (pico) y al aumentar los ajustes que deven hacerse cuando la producción de petróleos disminuye.     

International competitive displacement from environmental control The quantitative gains from methodological refinement

This paper demonstrates empirically the gain from adopting more general equilibrium approaches in projecting the effects on domestic output and international trade of environmental controls. The suggested models include a partial equilibrium case where all industries are treated independently, an intermediate case incorporating effects in supplying industries, and general equilibrium formulations based on alternative macroeconomic conditions. U. S. data is used to evaluate these models. Under both pollutor pays and subsidy financing schemes, moving from the simplest case to the intermediate model results in quite different industry projections. Including macroeconomic factors appears particularly important in the classical setting.