Pericardial teratoma complicated by hydrops: successful fetal therapy by thoracoamniotic shunting

Pericardial teratoma is a potentially curable lesion that may become life threatening when it induces mediastinal compression and fetal hydrops. So far, cases with fetal hydrops have been managed by elective delivery or pericardial needle decompression. We report a case in which pericardial teratoma resulted in fetal hydrops. Following transpleural needling of the fetal pericardium at 29 weeks and 6 days, pericardial effusion decreased but hydrops persisted, while major unilateral pleural effusion appeared. A thoracoamniotic shunt was placed at 30 weeks and 5 days. Hydrops resolved, although incompletely. The baby was delivered at 32 weeks and was operated upon on day 3. This observation suggests that fetal hydrops associated with pericardial teratoma may improve following thoracoamniotic shunting. Fetal therapy may limit the risks of respiratory distress arising from the combined effect of airways compression and lung immaturity. Copyright © 2003 John Wiley & Sons, Ltd.     

Rapid Mapping and Prioritisation of Wetland Sites in the Manawatu–Wanganui Region,New Zealand

The extent of wetland in New Zealand has decreased by approximately 90% since European settlement began in 1840. Remaining wetlands continue to be threatened by drainage, weeds, and pest invasion. This article presents a rapid method for broad-scale mapping and prioritising palustrine and estuarine wetlands for conservation. Classes of wetland (lacustrine, estuarine, riverine, marine, and palustrine) were mapped using Landsat ETM+ imagery and centre-points of palustrine and estuarine sites as ancillary data. The results shown are for the Manawatu–Wanganui region, which was found to have 3060 ha of palustrine and 250 ha of estuarine wetlands. To set conservation priorities, landscape indicators were computed from a land-cover map and a digital terrain model. Four global indicators were used (representativeness, area, surrounding naturalness, and connectivity), and each was assigned a value to score wetland sites in the region. The final score is an additive function that weights the relative importance of each indicator (i.e., multicriteria decision analysis). The whole process of mapping and ranking wetlands in the Manawatu–Wanganui region took only 6 weeks. The rapid methodology means that consistent wetland inventories and ranking can now actually be produced at reasonable cost, and conservation resources may therefore be better targeted. With complete inventories and priority lists of wetlands, managers will be able to plan for conservation without having to wait for the collection of detailed biologic information, which may now also be prioritised.     

First-trimester diagnosis of osteogenesis imperfecta associated with encephalocele by conventional and three-dimensional ultrasound

To illustrate the three-dimensional sonographic features of a rare genetic disorder, we report on prenatal diagnosis of osteogenesis imperfecta congenita associated with encephalocele at 13 weeks of gestation, using conventional and three-dimensional ultrasound. Because the parents were first-degree cousins and on the basis of the family history, a recessive autosomal inheritance was suspected. Of seven previous pregnancies, five were unaffected and two had been terminated in the second trimester owing to a similar abnormality (one affected boy and one affected girl). In the case we present, the diagnosis was made on the basis of two-dimensional ultrasound performed by physicians aware of the history; the quality of three-dimensional ultrasound imaging suggests that this technique might have contributed toward establishing a precise diagnosis in the absence of a positive family history. Besides, the global view provided by three-dimensional surface-rendering images made the parents more confident of the accuracy of the diagnosis. Although osteogenesis imperfecta congenita is generally considered as autosomal dominant, the case we report suggests that it may be inherited in a recessive autosomal fashion at least when associated with encephalocele. Three-dimensional ultrasound confirmed the conventional two-dimensional examination and was helpful in convincing the parents of the accuracy of the diagnosis. Copyright © 2003 John Wiley & Sons, Ltd.     

Sonography in prenatal diagnosis of congenital adrenal hyperplasia

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder with an incidence of 1/15 000. More than 90% of CAH cases result from mutations of CYP21, leading to 21-hydroxylase deficiency. In its classical form, CAH is severe and consists of the virilizing (increase of androgens) and salt-wasting (lack of aldosterone) phenotype. When a proband exists, early prenatal diagnosis for CAH can be performed by direct molecular analysis in the first trimester. We describe herein two cases suggesting that the prenatal diagnosis of CAH can be initiated by the sonographic appearance of the adrenal gland at the second-trimester scan in the absence of a family history. Copyright © 2004 John Wiley & Sons, Ltd.     

Tradeoffs between soil, water, and carbon -- a national scale analysis from New Zealand

The tradeoffs between the regulation of soil erosion, provision of fresh water, and climate regulation associated with new Pinus radiata forests in New Zealand are explored using national models. These three ecosystem services for which there is strong demand are monetised as commodities (avoided soil erosion is NZ $1 per tonne; water is NZ $1 per cubic metre; and sequestered carbon is assumed to be NZ?$73 per tonne). This permits their summation on a spatial basis to produce a national map of the net benefit of these ecosystem services. Net benefit is spatially variable depending primarily on the relative mix of forest growth rates and demand for irrigation water. New P.?radiata forests (once mature) generally reduce mass-movement erosion by an order of magnitude. This provides significant benefits for erosion control where there are high natural rates of erosion. Benefits are especially large in catchments where high sedimentation is increasing flood risk and degrading aquatic ecosystems. The generally high growth rates of P.?radiata in New Zealand (8.5 tonnesCha(-1)yr(-1) on average for existing forest) add significant environmental benefits of carbon sinks to climate regulation. However, the reduction of water yield associated with new forests (between 30% and 50%) can neutralise these benefits in catchments where there is demand for irrigation water, such as the eastern foothills of the Southern Alps and the tussock grasslands in the South Island.