Accuracy of amniotic fluid testing before 21 weeks' gestation in prenatal diagnosis of congenital cytomegalovirus infection

Cytomegalovirus (CMV) is the most common cause of intrauterine infection. Recent publications show amniocentesis to have an 81–100 per cent sensitivity in antenatal diagnosis after 21 weeks' gestation. Testing before 21 weeks' gestation is less well documented. We performed 36 amniocenteses between 14 and 20 weeks' gestation. The sensitivity was 45 per cent and the specificity 100 per cent. Implications and possible causes of this low sensitivity are discussed.     

Attitudes of women of childbearing age towards prenatal diagnosis in Southeastern France

The objective of this study was to explore women's attitudes towards prenatal diagnosis of trisomy 21 and to examine some of the factors possibly responsible for these attitudes before implementing in real practice serological screening of pregnant women at risk for trisomy 21. We carried out a telephone survey on a representative sample of women who had recently had a normal livebirth delivery in the Marseille district in 1990. The participation rate was 80 per cent and the average age of the mothers was 28-9 years. Among the 514 women interviewed, 78 per cent stated that they would ask for an amniocentesis for a 1 per cent risk of trisomy 21 at their next pregnancy. When adjusting for confounding factors, the decision to have or not to have an amniocentesis was found to depend not only on the women's attitude towards induced abortion, but also on their understanding of the risk involved and on the social context (knowing a handicapped child, discussion with the father). It also depended on the women's age and on what they knew about amniocentesis from the medical point of view. The risk of miscarriage can influence a woman's choice but this objection was not found to affect the women's decisions significantly in our survey. The data showed the existence of a high potential demand for fetal karyotyping.     

Prenatal diagnosis of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency by steroid analysis in the amniotic fluid of mid-pregnancy: Comparison with HLA typing in 17 pregnancies at risk for CAH

Amniotic fluid (AF) levels of 17-hydroxyprogesterone (17OHP) and testosterone (T) were determined at 16–17 weeks in 17 pregnancies at risk for CAH and results compared to 75 normal controls. The fetus was predicted to be unaffected in 12 cases on the findings of normal AF levels of both 17OHP and T and the latter allowed a correct prediction of fetal sex in all instances. HLA typing confirmed normality in 12 cases revealing 5 carriers, 5 homozygous normal and 2 indeterminate. Steroid levels of the 2 groups were similar. Three fetuses were predicted to be CAH affected on unambiguously high levels of 17OHP and T (in female only). HLA typing was in agreement, and the diagnosis was confirmed in 2 abortuses and a female newborn by physical and hormonal studies. In the last 2 cases AF levels of OHP and T were normal but HLA (A/B/C) genotypes were identical to the CAH affected siblings. Normal physical and hormonal findings in the 2 aborted fetuses would exclude the possibility of an in utero virilizing form of CAH. The discrepancy could be explained on the basis that the fetuses had an allelic form of 21-hydroxylase deficiency or on the basis of recombination (not fully tested). It is concluded that a fully informative prenatal diagnosis of CAH should not rely entirely on HLA typing but on hormonal studies.     

英国塘鹅蛋中多氯联苯同类物的时空变化趋势

1977～1998年间,在苏格兰西部的艾尔萨克雷格对收集到的塘鹅蛋中的多氯联苯(PCB)同类物进行了回顾性分析.对一些年份所收集的塘鹅蛋中每年选择8～10个对其PCB同类物浓度范围分别进行了分析.所有的同类物在几年之内浓度都降在低,但不同的同类物降解速率不同.     

Climate anomalies, Indonesian vegetation fires and terrestrial carbon emissions

There was a widespread misconception about the causes of vegetation and land fires in Indonesia. At a certain point, the public perceived that fires and the associated haze pollution were primarily caused by smallholders' agricultural activities. In fact, there was a variety of land-use activities including large-scale land clearing following deforestation for further land development. El Niño events and the associated dry weather were sometimes quoted by officials and the media as the cause of fires. The fire episodes from 1980 to 2000 were analysed in connection with climate anomalies and the implementation of land-use policies related to forest conversions. The analysis employs long-term climatic and sea surface temperature data to reconstruct climate distributions and anomalies including Southern Oscillation Index (SOI), Sea Surface Temperature (SST) and Outgoing Long-wave Radiation (OLR). In this study, the terrestrial carbon emissions from vegetation fires were estimated based on official statistical data on area burnt. The possible incentives for sustainable land management were discussed in the light of fire prevention. The underlying cause neglected in the discussion of Indonesian vegetation fires was forest and land development policy. Legitimated in the early 1980s, it drove massive forest conversions and the use of fires for land clearing. El Niño Southern Oscillation (ENSO) provided dry weather suitable for biomass burning and widespread fire, but it was hardly the cause of fires. The estimate of area burnt in the big fires in 1997 was about 11.6 Mha, resulting in carbon release of 1.45 Gt, equivalent to 0.73 ppmv of CO₂, or almost half the annual global atmospheric CO₂ growth. Based on the current carbon market price such emissions by the 1997 fire episode were worth around US$ 3.6 billion.     

First-trimester free beta (hCG) screening for Down syndrome

Maternal serum free beta (hCG) levels are elevated (median 2·20 MOM) in the first trimester of pregnancy in 38 Down syndrome cases as compared with appropriate controls. This observation may form the basis for its use as a marker in screening for Down syndrome in the first trimester. Altered levels of the free beta analyte are observed in pregnancy conditions or complications other than Down syndrome.     

氯乙酰苯胺除草剂及其降解产物在肯尼亚Nzoia流域的演变

采用气相色谱法对肯尼亚沿Nzoia河9个地点的水样和沉积物样中草不绿(也称杂草锁)(α'-氯-N-(2,6-二乙基苯基)-N-(甲氧基甲基)乙酰胺)、甲氧毒草安(α-氯6'-乙基-N-(2甲氧基-1-甲基乙基)乙酰邻甲苯胺)及它们各自环境稳定的苯胺类降解物2,6-二乙基苯胺、2-乙基-6-甲基苯胺进行分析.降解物在90%以上的沉积物样和水样中检出,而母体化合物只在不到14%的水样中检出.沉积物中的杀虫剂和它们的降解物比在水中浓度高很多(1.4～10 800倍),显示出化合物在沉积物中的积累.在研究时间内沉积物中降解物的普遍存在意味着这些化合物的持续性.可以假定在热带气候为主的条件下,促使杀虫剂快速分解为环境稳定的降解物,从而在研究区域内使后者成为比其母体更重要的污染物.