The history of the second-trimester sonographic markers for detecting fetal Down syndrome,and their current role in obstetric practice

This review summarizes the development, history and use of second-trimester sonographic markers for the detection of fetal Down syndrome over three decades. Starting with the nuchal fold thickening in 1985 and culminating in the genetic sonogram in the 1990s. The combination of second-trimester serum screening with the ultrasound markers improved the detection rate of affected fetuses but also allowed patients to decrease their risk of carrying a fetus with Down syndrome if the genetic sonogram was normal. More recently the role of the genetic sonogram and its markers have changed with the wide spread use of first-trimester screening. This prior screening ultimately decreases the prevalence of fetal Down syndrome in the second trimester to less than 85% of what it was in the first-trimester as most fetuses with Down syndrome are now identified early. Current interpretation of the second-trimester Down syndrome markers must be based on the result of the first trimester and combined screening to achieve the most accurate risk estimate of an affected fetus. Copyright © 2010 John Wiley & Sons, Ltd.     

Short femur length associated with severe intrauterine growth retardation

Four fetuses with a femur measuring greater than two standard deviations below the mean compared with the biparietal diameter are presented. These four fetuses were subsequently determined to have severe intrauterine growth retardation and no evidence of skeletal dysplasias.     

The causes and natural history of fetal ascites

The purpose of this study was to examine the natural history and differential diagnosis of ultrasound-detected, isolated fetal ascites. Retrospective review of our patient data base, from 1989 to 1993, revealed 18 patients with fetal ascites diagnosed sonographically. Fetuses presenting with generalized hydrops were excluded. One of the 18 fetuses with ascites had a chromosomal abnormality (trisomy 21), four fetuses had intrauterine infections, seven had gastrointestinal processes, two had genitourinary tract abnormalities, and four were labelled as ‘idiopathic’ (all four resulting in normal neonates). Seventeen of 18 fetuses survived; there was one fetal demise secondary to active syphilis. One fetus with parvovirus infection required intrauterine transfusion and did well. Two infants are developmentally retarded, including one with trisomy 21 and one with microcephaly secondary to cytomegalovirus infection. Fourteen of 18 fetuses had documented in-utero resolution of the ascites. Eleven of the 18 were associated with polyhydramnios sometime during fetal life. None of the fetuses developed hydrops. In conclusion, fetal ascites can result from many different aetiologies, including gastrointestinal and genitourinary anomalies. Chromosomal abnormalities and viral aetiologies must also be considered. Fetuses who have isolated ascites can have a good outcome with resolution of the ascites antenatally.     

Unique phenotypes in the sperm of the earthworm Eudrilus eugeniae for assessing radiation hazards

The earthworm, Eudrilus eugeniae is a segmented worm. It has two pairs of testes whose cells are highly proliferative. It was found that the earthworm, which is irradiated with X-ray, shows the following phenotypic changes in its sperm: fragmented acrosome in the head, break in the tail, and the appearance of zigzag sperm tail. Sperm morphology can be used as a tool to study radiation hazards in local areas. These three phenotypes were not observed in the sperm of worms exposed to different concentration of toxic chemicals such as sodium arsenate, lead acetate, and mercuric chloride. In contrast, exposure of worms to ethidium bromide caused fragmented acrosome in the head of their sperm cells.     

Job and non-job activities,job satisfaction and mental health among veterinarians

This study examines the relationship between dimensions of job and non-job activity, job satisfaction and mental health among veterinary professionals and tests specific predictions arising from the work of Broad bent (1985) and Karasek (1979). Results are based on an analysis of 411 questionnaires returned in a postal survey. Job and non-job activities contributed a significant proportion of unique variance in total mental health as measured, and related differently to anxiety and depression. Support for Broadbent's (1985) predictions was mixed. Pacing related distinctively to anxiety, but depression showed no relationship to social aspects of activity. Both lack of control over the speed of activities and discretion were related to mental health indices, but support was found for the role of discretion as a buffer in an interactive sense on one outcome measure only. Results are discussed in terms of ideas arising from the clinical literature, and suggestions offered for the potential use of carefully chosen activity in controlling levels of anxiety, depression and well-being.     

Market-based approaches and tools for improving water and air quality

Nitrogen (N) losses from agriculture are negatively impacting groundwater, air, and surface water quality. National, state, and local policies and procedures that can mitigate these problems are needed. Market-based approaches where waste treatment plants (point sources) can purchase nutrient credits from upstream agricultural operations (non-point sources) to meet their National Pollutant Discharge Elimination System permit requirements within the Clean Water Act are being explored. This paper reviews these market-based approaches for enhancing air and water quality at a lower cost than simple command-and-control regulation, and describes new tools that are being developed, such as Nitrogen Trading Tool (NTT), that can be used to assess nitrogen losses to the environment under different management scenarios. The USDA-NRCS, EPA and several other state and local agencies are interested in these new tools. The NTT, though primarily designed for water quality markets, also estimates savings in nitrous oxide (N₂O) emissions that can be traded in carbon markets. For example, an analysis using NTT shows that for 100 ha of crop land, a C sequestration equivalent of approximately 25–38 Mg C y^?1 for a farm in Ohio, and 13–21 Mg C y^?1 for a farm in Virginia could be achieved with better nitrogen management practices. These numbers across a watershed could be much larger with improved N and conservation management practices that contribute to better water quality and lower global warming potential. There is a need to further develop, calibrate, and validate these tools to facilitate nitrogen and carbon trading future markets around the globe to increase environmental conservation across agro-ecosystems worldwide.     

Prenatal diagnosis of lissencephaly

We report two cases of prenatal detection of lissencephaly by high-resolution ultrasound. The first case studied was referred for high-risk obstetrical management and serial antenatal ultrasounds because of a family history of lissencephaly in an unresolved chromosomal abnormality. Diagnosis of a smooth gyral pattern consistent with lissencephaly was made at 32 weeks' gestation. The second case was referred for prenatal ultrasound because of a size versus dates discrepancy. The ultrasound examination showed a smooth gyral pattern at 31.5 weeks. In light of this ultrasound finding, a fetal blood sample was obtained and a chromosomal abnormality reported, confirming the diagnosis. To our knowledge, these cases represent the first report of the sonographic prenatal diagnosis of cerebral agyria or lissencephaly.