Intrauterine growth retardation and fetal transverse cerebellar diameter

In 103 small-for-gestational age (SGA) fetuses, the transverse cerebellar diameter (TCD), abdominal circumference (AC), head circumference (HC), and femur length (FL) were measured and their ratios calculated. In addition, umbilical venous blood samples were obtained by cordocentesis for measurements of fetal blood pH and erythroblast count. Compared with the AC, HC, and FL, the TCD was relatively mildly reduced. However, in the 28 fetuses with TCD >2 SDs (standard deviations) below the normal mean, the degrees of growth retardation, acidaemia, and erythroblastosis were more severe, and the incidence of perinatal death was higher than in the group with a normal sized TCD. Although in the group with TCD >2 SDs below the normal mean the TCD/AC ratio was increased, in the most severely growth-retarded fetuses this ratio was usually within the normal range. Thus, in intrauterine growth retardation (IUGR), cerebellar size is reduced in proportion to the severity of the disease and therefore the TCD cannot be used to obtain reliable information on the gestational age of small fetuses and the TCD/AC ratio does not provide reliable information as to whether or not fetuses are growth-retarded.     

The development of the fetal eye: In utero ultrasonographic measurements of the vitreous and lens

Our objective was to establish nomograms for fetal eye measurements from 12 weeks' gestation by using transvaginal and transabdominal high-resolution ultrasound techniques. A prospective cross-sectional study was performed on 450 normal singleton pregnancies between 12 and 37 weeks' gestation. Vitreous and lens circumferences were measured by transvaginal ultrasonography until 17 weeks, and by abdominal ultrasound between 18 and 37 weeks' gestation. Regression analyses were used to create nomograms, and several transformations were done to obtain linearity. Eye measurements of 12 fetuses at risk for ocular disturbances were plotted on the constructed nomograms. Linear relationships were fitted between vitreous (r²=0.79) and lens (r²=0.88) circumferences and gestational age. In addition, there was a significant correlation between these measurements and the biparietal diameter. Data of the fetuses at risk showed that disturbances in ocular growth were associated mainly with abnormal cerebral development. These normative data may be helpful in the prenatal diagnosis of suspected congenital syndromes that include, among their manifestations, ocular growth disturbances such as microphthalmos and anophthalmos.     

Ultrasound evaluation of pregnancies at risk for homozygous α-thalassaemia-1

Twenty-six pregnant Chinese women who were at risk of giving birth to a fetus affected with homozygous α-thalassaemia-1 were examined serially by ultrasound. Six of these 26 pregnancies were affected. In one third of the affected pregnancies progressive fetal ascites appeared before 24 weeks gestation and these pregnancies were terminated. In the remaining two thirds abnormal estimated fetal weight-placental volume (EFW-PV) ratio and fetal growth retardation as evidenced by a falling biparietal diameter (BPD), femur length (FL) but a normal abdominal circumference (AC) was apparent by 28 weeks gestation. Increased transverse cardiac (TC) diameter was another consistent finding but appeared late. All these features appeared before the onset of fetal ascites. A normal EFW-PV ratio and fetal growth until 28 weeks gestation was a reassuring sign of normality. Abnormal EFW-PV ratio was the earliest sign to appear in affected pregnancies and a normal ratio until 28 weeks gestation had a 100 per cent predictive value.     

X-linked pyruvate dehydrogenase complex deficiency due to a novel PDHA1 variant associated with structural brain abnormalities in a fetus

We report a case of pyruvate dehydrogenase E1 alpha subunit deficiency associated with a novel hemizygous PDHA1 variant presenting prenatally as multiple structural brain abnormalities in a male fetus. A healthy Finnish couple was initially referred to the Fetomaternal Medical Center because of suspected fetal choroid plexus cyst at 11 + 2 weeks of pregnancy. At 20 + 0 weeks, multiple abnormalities were observed with ultrasound including narrow thorax, slightly enlarged heart, hypoplastic cerebellum, absent cerebellar vermis and ventriculomegaly. Autopsy and genetic analyses were performed after the termination of pregnancy. The findings of macroscopic examination included cleft palate, abnormally overlapping position of fingers and toes and dysmorphic facial features. Neuropathological examination confirmed the absence of corpus callosum, cerebellar hypoplasia and ventriculomegaly. Nodular neuronal heterotopia was also observed. Trio exome sequencing revealed a novel hemizygous de novo variant c.1144C>T p.(Gln382*) in the PDHA1 gene, classified as likely pathogenic. We suggest that inherited metabolic disorders should be kept in mind as differential diagnoses in fetuses with structural brain abnormalities.     

Can gestational dates routinely derived from very early ultrasound be used to interpret maternal serum alpha-fetoprotein measurements?

This study assesses the reliability of estimating gestational age via crown-rump or gestational sac measurements obtained at 8 weeks' gestation or earlier as part of routine physician office practice. To accomplish this, we studied 88 pregnancies managed at 45 different sites in which both an early first-trimester ultrasonically-derived gestational age estimate and a second-trimester biparietal diameter (BPD) estimate were available. The first-and second-trimester determinations were highly correlated, but the first-trimester determinations were, on average, 0.43 weeks earlier than the second. The first-trimester estimates were satisfactory for use in interpreting maternal serum alpha-fetoprotein (MSAFP) screening measurements, but second-trimester BPD measurements obtained prior to MSAFP screening should be the method of choice for interpreting MSAFP values, due to the increased sensitivity for detecting open spina bifida.     

First-trimester assessment of placenta function and the prediction of preeclampsia and intrauterine growth restriction

Preeclampsia and intrauterine growth restriction (IUGR) are major contributors to perinatal mortality and morbidity worldwide. Both are characterized by impaired trophoblastic invasion of the maternal spiral arteries and their conversion from narrow muscular vessels to wide non-muscular channels. Despite improvement in the understanding of the pathophysiology of these conditions, ability to accurately identify pregnant woman who will develop them is limited. This greatly impairs the development and testing of preventive interventions. While different measures of placental dysfunction have been associated with increased risk for adverse pregnancy outcomes, the ability of any single one to accurately predict these outcomes is poor. Developing predictive tests is further challenged by difficulty in the timing of the measurements, as both the structural and biochemical characteristics of the placenta change with increasing gestational age. The ideal screening test would accurately predict the development of adverse pregnancy outcomes early enough to provide a window for preventive interventions. Improvement in ultrasound technology provides potentially useful novel tools for evaluating placental structure, but measuresments need to be standardized in order to be useful. Maternal serum analyte screening is a noninvasive test of placental biochemical function, but present serum marker alone is not sufficiently accurate to suggest its routine use in clinical practice. The use of first trimester biochemical markers in combination with uterine artery Doppler screening is promising as a potential screening tool. Prospective longitudinal studies using standardized methodology are necessary to further evaluate the choice of parameters and strategies of combination to achieve the best predictive models. Copyright © 2010 John Wiley & Sons, Ltd.     

The prenatal diagnosis of joubert's syndrome of familial agenesis of the cerebellar vermis

The prenatal diagnosis by ultrasound examination of Joubert's syndrome of familial agenesis of the cerebellar vermis is described allowing termination of pregnancy ai 26 weeks gestation. The diagnosis was made by a comparison of the prenatal ultrasound examination with computerized axial tomography obtained from the siblings with the same condition.     

实施简易工况法排气检测若干问题探讨

国标GB18285-2005和GB3847-2005规定在用机动车的排气检测方法选择与简易工况法标准限值的制定均由地方根据实际情况确定,虽增强了地方排气监管工作灵活性,但困难也增加了.各地在推动实施简易工况法时,检测方法的选择应重点从地方管理、地方经济、技术条件和机动车排气监督管理发展方向进行综合考虑,条件许可的地方选用简易瞬态工况法.简易工况法的初始标准限值可以先选用HJ/T 240-2005和HJ/T241-2005两个行业标准中的最松限值,然后在推进简易工况法的过程中逐步收集检测数据,并重新确定地方的排放限值.     

The fetal cerebellum. Pitfalls in diagnosis and management

Prenatal diagnosis of congenital and acquired cerebellar disorders is possible by the use of ultrasound (US) and magnetic resonance imaging (MRI). Although numerous studies have been conducted in this field, diagnostic uncertainties are still common in daily clinical practice. This review outlines five possible pitfalls in the diagnosis of fetal cerebellar disorders: confusion between different entities describing vermian pathologies (Dandy–Walker variant, vermian hypoplasia and vermian agenesis); premature diagnosis of abnormal vermian formation; difficulties in the ultrasonographic differentiation between the cerebellar hemispheres and the vermis; late development of cerebellar hypoplasia/atrophy and differential diagnosis of unilateral cerebellar findings. Copyright © 2009 John Wiley & Sons, Ltd.     

Fetal de novo heterozygous variant in the isocitrate dehydrogenase 1 gene associated with growth restriction,skeletal, cerebral and vascular anomalies

Germline pathogenic variants in isocitrate dehydrogenase 1 (IDH1) can lead to a rare neurodevelopmental disorder called metaphyseal chondromatosis with D-2-hydroxyglutaric aciduria, including severe skeletal and cerebral anomalies. To the best of our knowledge, no prenatal case of an IDH1 pathogenic variant has been reported in literature. Somatic sequence variants in IDH1/2 genes are described in distinct cancers, premalignant diseases and rare inherited metabolic disorders. Amniocentesis and further genetic testing including trio exome sequencing were performed due to suspicious findings on a second trimester routine prenatal ultrasound examination. The fetus was found to have growth restriction, cerebral abnormalities (ex vacuo hydrocephalus, cerebellar and vermian hypoplasia, corpus callosum dysgenesis), brachycephaly, narrow chest, persistent left superior vena cava, liver calcifications, hyperechogenic bowel, short tubular bones and joint contractures. A de novo heterozygous variant in the IDH1 gene was detected via trio exome sequencing. The prenatal diagnosis of a de novo pathogenic variant in IDH1 in a fetus with the described phenotype, obtained through trio exome sequencing, helped parents and providers with an informed decision making about pregnancy management.     

Considerations on air pollution monitoring network design in the light of spatio-temporal variations of data

Spatial and temporal variations of air pollution data obtained from ambient air monitoring stations are studied. Spatial correlation fields and spatial distributions of long-term averages are subject to yearly and seasonal changes for NO₂ and SO₂ concentrations. Many previous works for monitoring network design did not pay much attention to these changes. Fundamental policies for a rational network design are proposed: (1) optimality should be pursued within the accuracy limits ensured by the model fields, (2) network designs should be based on features of the air pollution fields, especially yearly and seasonal fluctuations evaluated from actual monitoring data, and (3) some redundancy is necessary in a network to examine whether or not the required accuracy representing the air pollution field is attained.     

The use of magnetic resonance imaging in the prediction of birthweight

Extremes of fetal growth can increase adverse pregnancy outcomes, and this is equally applicable to single and multiple gestations. Traditionally, these cases have been identified using simple two-dimensional ultrasound which is quite limited by its low precision. Magnetic resonance imaging (MRI) has now been used for many years in obstetrics, mainly as an adjunct to ultrasound for congenital abnormalities and increasingly as part of the post-mortem examination. However, MRI can also be used to accurately assess fetal weight as first demonstrated by Baker et al in 1994, using body volumes rather than standard biometric measurements. This publication was followed by several others, all of which confirmed the superiority of MRI; however, despite this initial promise, the technique has never been successfully integrated into clinical practice. In this review, we provide an overview of the literature, detail the various techniques and formulas currently available, discuss the applicability to specific high-risk groups and present our vision for the future of MRI within clinical obstetrics.     

Dwarfism associated with prenatal ventriculomegaly

Two infants with ventriculomegaly diagnosed by ultrasound during the third trimester of pregnancy were noted to have lethal short-limbed dwarfing syndromes at birth. In one instance, a clinical suspicion of hydramnios and in the other follow-up scan for placental localization revealed ventriculomegaly as an unexpected finding. These observations suggest that when ventriculomegaly is detected during prenatal ultrasound evaluation, limb measurements should be included to exclude a dwarfing syndrome as part of the differential diagnosis.     

Measurements of wind speed and plume rise with a rapid-scanning Lidar

A series of 30-min means of plume rise and dispersion parameters were measured at Fawley power station on Southampton Water between May and December 1989 using a rapid-scanning Lidar. Where possible, plume parameters were determined at three distances, typically 250, 750 and 1500 m, from the stack. Simultaneous measurements of temperature profiles were made using model aircraft and of wind speed and direction using a cup anemometer and wind vane at a height of 44 m on a transmission tower. By matching time series of plume heights at different distances, absolute measurements of wind speed at plume height could be made. These measurements gave a more reliable estimate of plume rise than did surface wind speeds. It was found that, for travel distances out to 1.5 km, the Briggs formula gave a robust prediction of plume heights with C₁ = 1.38±0.07 (95% confidence limits). At Fawley, the standard error in the predicted plume height at 500 m was then 21.0 m, or 19% of the 30-min mean plume rise. For plume-level winds of less than 20 m s⁻¹, analysis of the dependence of plume height on distance, wind speed and power-station load gave a virtual source height of 195.2±10.3 m (95% confidence limits). This is identical with the physical stack height of 198.1 m.     

科技期刊如何走向市场

科技期刊作为一种专业性较强的学术性刊物,不同于其他通俗性时尚刊物,它的受众面较为狭窄,读者群也受到相应的限制,而要在社会主义市场经济体制下求得生存与发展,必须走向市场、适应新形势,在市场竞争中取得社会效益与经济效益的统一,开拓出新的局面。     

基于最小路集求可靠度函数的系统Bayes置信限评估

阐述了复杂系统的Bayes置信限评估原理,并将其与最小路集求可靠度函数的方法相结合,对已知系统可靠性框图或可靠度函数的复杂系统进行可靠度置信限评估.该方法便于工程应用,对于大型复杂系统可靠性评定,具有重要的参考价值.     

Brain cortical assessment by MRI in fetuses with left congenital diaphragmatic hernia

Objective

To evaluate fetal brain development using MRI (magnetic resonance imaging) in CDH (congenital diaphragmatic hernia).

Methods

52 isolated left CDH and 104 control fetuses were imaged using MRI. Brain morphometry (Biparietal diameter—BPD, brain fronto-occipital diameter—BFOD, third ventricle, posterior ventricles, transcerebellar diameter—TCD, anteroposterior and craniocaudal cerebellar vermis diameter—AP and CC) and cortical structures (bilateral cingulate fissure—CF, insular fissure—IF, insular depth - ID) were compared with controls using Mann–Whitney test.

Results

Median gestational age at MRI (p = 0.95)and the median biparietal diameter (p = 0.737) were comparable. Among morphometric parameters, only the brain fronto-occipital diameter was significantly smaller in CDH (p = 0.001) and the third ventricle was significantly greater in CDH (<0.0001). Among cortical structures, the cingulate and insular fissures were significantly deeper in CDH fetuses (p < 0.0001) as the insular depth ID was smaller in CDH (p < 0.03).

Conclusions

CDH fetuses have a smaller fronto-occipital diameter, reduced insular depth, deeper cingulate and insular fissure, and greater third ventricle width as compared to controls. These findings suggest that left CDH may have an impact on fetal brain development with an overall reduction in brain volume.     

Fetal curarization for prenatal magnetic resonance imaging

Fetal magnetic resonance (MR) imaging was performed at 33 weeks of gestation for investigation of a posterior fossa abnormality found at ultrasound screening. Fetal movements were abolished by vecuronium injected under ultrasound guidance into the umbilical vein. MR images showed atrophy of the left cerebellar lobe with cisternal dilatation. These were confirmed postnatally by CT scan.     

The Importance of Human Ecology at the Threshold of the Next Millennium: How Can Population Growth Be Stopped?

 Ecology is defined as the set of complex interactions between the biotic and abiotic environments. Human ecology concerns principally the population ecology "only" of Homo sapiens, but it also includes all aspects of global ecology because humans are the most important species. Human demography is characterized by a recent decline in mortality and fertility rates. These demographic transitions have largely been completed in industrialized countries, but not in the 140 developing countries. Approximately 100 countries are following the same demographic pattern as industrialized countries, however with a time delay of several generations. China has effectively reduced its population increase by means that would be unacceptable in Western democracies. Some 44 developing countries still show increasing population growth and no detectable demographic transition in birth rate. Thus one part of the world shows limited (and, in the long run, shrinking) population growth, and another continues with a strong increase. All populations are limited in their development by their sustainability by their environment, for example, food and energy resources, and the extent of pollution which the use of these resources produces. It is argued that in the case of human population the limits of sustainability have already been reached with the 6 billion humans alive today, since at least 20% of these suffer from hunger, natural resources are overexploited, and biodiversity is threatened. In the coming 200 years it is more likely that the total population will substantially oscillate rather than approach the predicted 12 billion. The most important goal of human ecology should therefore be to slow population growth as far as possible.     

Prenatal diagnosis of spina bifida aperta after first-trimester valproate exposure

In the context of a prospective study on the adverse effects of anti-epileptic drugs on fetal outcome, we evaluated our experience with prenatal diagnosis by ultrasonography and α- fetoprotein (AFP) determination in amniotic fluid. We compared these results with AFP values in maternal serum obtained prior to amniocentesis. From November 1985 to July 1990, amniocentesis at 16–18 weeks of gestation was performed in 267 pregnancies of 237 different women using anti-epileptic drugs. Among 92 pregnancies with maternal valproic acid use, five (including one concordantly affected monozygotic twin-pair) were terminated because of a spina bifida aperta, all prenatally diagnosed by AFP determination and acetylcholinesterase electrophoresis in amniotic fluid. The maternal serum AFP level was raised (⩾ 2.5 multiples of the median (MOM) for singleton pregnancies and ⩾ 4.5 MOM for twin pregnancies) in only two of these five affected pregnancies. We emphasize that maternal serum AFP levels may be unreliable for prenatal screening for fetal neural tube defects in women taking valproate and recommend that amniocentesis and fetal ultrasound examination should be offered directly.