Management of fetofetal transfusion syndrome

Feto-fetal transfusion syndrome contributes heavily to high rates of perinatal mortality and morbidity in monochorionic multiple pregnancies. Its prenatal management has been controversial for at least 25 years. We review the recent literature in order to present the basis for a pragmatic reappraisal of the management of this condition. Laser surgery of the chorionic plate inter-twin anastomoses is the best first-line treatment when the syndrome develops before 26 weeks' gestation. Survival (including quality of survival) and gestational age at delivery are improved when compared to serial amnioreduction. Second-line treatment options include repeat-laser, intra-uterine blood transfusion, serial amnioreduction, selective feticide using bipolar cord coagulation or elective delivery, depending upon gestational age and the severity of the disease and its complications. We have found that fetoscopic placental surgery has proven itself over simplicity of amnioreduction. There is no evidence that treatment should be customized according to the stage of the disease at diagnosis. Early recognition of the syndrome through fortnightly serial ultrasound follow-up of all monochorionic pregnancies should ensure timely referral and make up for geographical constraints. Laser surgery should now be available in fetal medicine units that are managing at least 20 cases per year. Copyright © 2005 John Wiley & Sons, Ltd.     

Herbicide Roundup® and its main constituents cause oxidative stress and inhibit acetylcholinesterase in liver of Carassius auratus

Roundup® is a glyphosate-based herbicide containing a mixture of surfactants. This paper evaluates the toxic effects of Roundup® and its main constituents on the goldfish, Carassius auratus, after 7 days exposure. Fish were exposed to 0.16, 0.032 and 0.0064 mg/L of Roundup® [containing 41% isopropylamine salt of glyphosate (G.I.S) and 18% polyoxyethylene amine (POEA)], G.I.S, and POEA. Their livers were taken for determining reactive oxygen species (ROS), superoxide dismutase (SOD) activity, malondialdehye (MDA) content and acetylcholinesterase (AChE) activity. Hydroxyl radical (·OH) could be induced by exposing Roundup® at a rate of 43%–111%, G.I.S at 90%–124% and POEA at142%–157%. A decreased SOD activity was observed in fish exposed to G.I.S and POEA. The contents of MDA significantly increased when exposed to Roundup® at all concentrations, 0.16 mg/L G.I.S and 0.032 mg/L POEA. The exposure led to an inhibition of AChE in livers overall during the experimental periods. POEA was more toxic than Roundup® or G.I.S during this experiment. AChE and ·OH are supposed to be sensitive biomarkers of the exposure of Roundup® and its main constituents to C. auratus.     

Proliferation of nonconforming land uses in agricultural envelope of urban Hong Kong

Until the late 1960s rural Hong Kong had an attractive rustic landscape and a small but active farming population. The recent widespread agricultural decline provided opportunities for urban-oriented activities to invade, mainly as open storage and workshops unsuitable in city areas. Rapid container-port expansion and cross-border China trade generate demands for cheap and accessible land for non-conforming uses (NCU). Rural development control and land-use planning are inherently weak, and formal provision for such uses is lacking. An unfavorable landmark court judgement allows landowners to degrade the countryside. The activities have caused acute environmental problems, telescoped into a small territory, including visual blight, pollution, drainage blockage, loss of wetland habitats, and increased flooding hazard. The distinction between urban and rural has been blurred in the destruction of the valuable countryside heritage. An interim legislative amendment fails to stop unauthorized conversion of farmland. In the long term, an integrated and comprehensive rural planning strategy to conserve inherent elements, as well as accommodating selected urban spillover in properly located and serviced sites, is needed.     

Codisposal of municipal refuse, sewage sludge and marine dredgings for methane production

As marine disposal of sewage sludge and dredged sediments may impose serious adverse effects to marine ecosystems, landfilling seems to be the most feasible method for the final disposal of these wastes. A batch experiment was conducted to study waste degradation and gas production after sewage sludge and marine dredgings were mixed with municipal refuse at 13 different ratios for 36 days. The addition of sludge and dredgings to municipal refuse enhanced gas production, compared with the degradation of refuse or sludge alone. A proper mixing ratio of wastes can also shorten the time to reach the final phase of anaerobiosis. The highest gas production was obtained from the ratio of 75-20-5 (refuse-sludge-dredgings) (wet weight basis). Its average daily gas production rate was 1.42 l kg(-1) waste mixture; methane content was 68.3%. The results indicated that codisposal of the three wastes would be beneficial for energy recovery from landfill gas.     

Characterisation of workers' exposure in a Russian nickel refinery

In support of a feasibility study of reproductive and developmental health among females employed in the Monchegorsk (Russia) nickel refinery, personal exposure and biological monitoring assessments were conducted. The inhalable aerosol fraction was measured and characterised by chemical speciation and particle-size distribution measurements. Unexpected findings were that: (i), pyrometallurgical working environments had significant levels of water-soluble nickel; (ii), significant exposure to cobalt occurred for the nickel workers; (iii), particles of size corresponding to the thoracic and respirable fractions appeared to be virtually absent in most of the areas surveyed. The water-soluble fraction is judged to be primarily responsible for the observed urinary nickel and cobalt concentrations. It is concluded relative to current international occupational-exposure limits for nickel in air, and because of the high nickel concentrations observed in urine, that the Monchegorsk nickel workers are heavily exposed. The implication of this finding for follow-up epidemiological work is alluded to.