Patients' attitudes following chorionic villus sampling

The attitudes of 190 patients who had undergone chorionic villus sampling (CVS) were assessed by means of a questionnaire. One hundred and fifty-two patients replied of whom 68 (45 per cent) were referred because of increased maternal age and in the other 84 cases the indications included previous chromosomal abnormalities, fetal sexing, DNA analysis, and biochemical analysis. One hundred and twenty-two patients had a transcervical procedure, 24 had a transabdominal, and six patients required both procedures. One hundred and forty-one patients (93 per cent) reported CVS to be a satisfactory procedure, and the same percentage thought earlier diagnosis was beneficial. Thirty-nine patients (81 per cent) reported a better experience with CVS than with a previous amniocentesis. A majority of patients (93 per cent) wished a CVS in a future pregnancy and 137 patients (97 per cent) would accept a risk of miscarriage from the procedure of twice that quoted for amniocentesis (1 per cent).     

Comparative audit of booking and mid-trimester ultrasound scans in the prenatal diagnosis of congenital anomalies

During 1988 and 1989, 3565 women booked under consultants who performed an ultrasound scan at booking, whilst 4984 booked under consultants who performed a formal mid-trimester scan between 16 and 18 weeks. All significant anomalies diagnosed prenatally and in the neonatal period were recorded, the incidence in each group being 12.9/1000 and 9.83/1000, respectively (NS). The sensitivity of diagnosis before 20 weeks was 45 per cent in the ‘mid-trimester’ group (kappa 0.62) compared with 30 per cent in the ‘booking’ group (kappa 0.46), overall sensitivity of prenatal diagnosis, however, being similar in both groups (63 vs. 65 per cent, kappa 0.77 vs. 0.79). Cardiac anomalies were the single largest group which were not detected equally prenatally in both groups. This study shows that formal mid-trimester scanning leads to anomalies being detected significantly earlier in the antenatal period. Although not statistically significant, three lethal anomalies were missed prenatally in the ‘booking’ group which we would have expected to diagnose on a mid-trimester scan. These figures are discussed in the light of previous reports.     

Clinical and pathological factors in spontaneous abortion following chorionic villus sampling

Twenty-nine cases of spontaneous abortion following first-trimester chorionic villus sampling (CVS) were reviewed out of a series of 722 patients. Of the 29 cases, there were only four abnormal CVS results. Pathological examination was performed in 79 per cent of cases, and this did not identify any characteristic pathological feature associated with spontaneous abortion after CVS. There was no obvious difference in the pathological features following the transabdominal (TA) or the transcervical (TC) methods. The majority of miscarriages occurred within 4 weeks of the procedure, but 38 per cent of cases aborted between 7 and 14 weeks after CVS. The TC method was used in 22 patients; the TA in 6; and both methods in 1 patient. The TA method was associated with a significantly lower fetal loss rate than the TC method (TA 2 per cent, TC 9 per cent, p < 0.001).     

Dioxins and furans in emissions from medical waste incinerators

Dioxins and furans were detected in emissions from eight medical waste incinerators tested in California. Total uncontrolled emissions ranged from 363 to 11, 811 nanograms per dry standard cubic meter. The most effective of three wet scrubbers achieved an emissions control efficiency of 95 percent for total PCDD and PCDF. A baghouse was less than 30 percent efficient in removing PCDD and PCDF from the incinerator emissions.     

Persistence, distribution, and emission of Telone C35 injected into a Florida sandy soil as affected by moisture, organic matter, and plastic film cover

With the phase-out of methyl bromide scheduled for 2005, alternative fumigants are being sought. This study of Telone C35, a mixture of (Z)- and (E)-1,3-dichloropropene (1,3-D) with chloropicirin (CP), focuses on its emissions, distribution, and persistence in Florida sandy soil in microplots with different soil-water and organic matter carbon (C) content with and without two different plastic film mulches. The addition of CP did not affect the physical behavior of the isomers of 1,3-D. Slower subsurface dispersion and longer residence time of the mixed fumigant occurred at higher water content. An increase in the percent organic carbon in the soil led to a more rapid decrease for chloropicirin than for 1,3-dichloropene isomers. The use of a virtually impermeable film (VIF) for soil cover provided a more even distribution and longer persistence under all the conditions studied in comparison to polyethylene (PE) film cover or no cover. The conditions of near field capacity water content, low organic matter, and a virtually impermeable film cover yielded optimum conditions for the distribution, emission control, and persistence of Telone C35 in a Florida sandy soil.     

Tolerance of transgenic canola plants (Brassica napus) amended with plant growth-promoting bacteria to flooding stress at a metal-contaminated field site

The growth of transgenic canola (Brassica napus) expressing a gene for the enzyme 1-aminocyclopropane-1-carboxylate (ACC) deaminase was compared to non-transformed canola exposed to flooding and elevated soil Ni concentration, in situ. In addition, the ability of the plant growth-promoting bacterium Pseudomonas putida UW4, which also expresses ACC deaminase, to facilitate the growth of non-transformed and transgenic canola under the above mentioned conditions was examined. Transgenic canola and/or canola treated with P. putida UW4 had greater shoot biomass compared to non-transformed canola under low flood-stress conditions. Under high flood-stress conditions, shoot biomass was reduced and Ni accumulation was increased in all instances relative to low flood-stress conditions. This is the first field study to document the increase in plant tolerance utilizing transgenic plants and plant growth-promoting bacteria exposed to multiple stressors.     

Legislating soil reconstruction on surface-mined land in the United States

The author, who participated with an interdepartmental team in advising the US Congress in writing the Surface Mining Control and Reclamation Act, outlines the often conflicting requirements which determined the genesis of the Act. The paper also discusses the criteria for judging the effectiveness of restoring soil productivity and the emphasis on the restoration of prime farmland. It also notes that the nature of the balance between environmental protection, farmland productivity and the needs of coal are still uncertain and that there is a contradiction in US attempts to alleviate hunger while national soil resources are being destroyed.From 1972 to 1977, the author participated with an interdepartmental tcam that assisted the U.S., Congress in writing the Surface Mining Control and Reelamation Act.     

Fumarylacetoacetase activity in cultured and non-cultured chorionic villus cells,and assay in two high-risk pregnancies

We describe further development of the fumarylacetoacetase (FAA) assay for the prenatal diagnosis of tyrosinaemia type 1 using chorionic villus sampling (CVS). We have established a reference range for FAA activity in cultured villus cells and have confirmed previously reported data on the FAA activity in uncultured chorionic villus cells. This should allow confirmation of results using CVS, without the need for further invasive procedures. We report the FAA enzyme stability at −70°C, +4°C, and at room temperature, and we have shown no obvious difference in enzyme activity with gestational age. We have analysed cultured and non-cultured CVS activity of FAA in two pregnancies at risk of tyrosinaemia type 1. In both, the fetus was designated unaffected, and these results were confirmed postnatally.