Prenatal diagnosis of congenital cystic adenomatoid malformation of the lung by fetal lung biopsy

A case of type III congenital cystic adenomatoid malformation of the lung was successfully diagnosed prenatally by fetal lung biopsy. We performed this procedure at 22 weeks of gestation, using a biopsy gun system under ultrasound guidance. The pregnancy was undisturbed by the procedure but as the condition was incompatible with life, an abortion was performed. The diagnosis was confirmed at post-mortem examination. Fetal lung biopsy appears to be a useful method for prenatal diagnosis of fetal lung disorders.     

Neonatal lung function following mid-trimester amniocentesis

Three hundred and fifty-four women who underwent midtrimester genetic amniocentesis were matched for age, parity, indication, and smoking history, with an equivalent number of women who had declined the procedure, for the purpose of comparing the neonatal respiratory status of their offspring. There was no evidence that the infants exposed to genetic amniocentesis were compromised.     

Prenatal interventions for fetal lung lesions

The widespread availability of high resolution ultrasound equipment and almost universal routine anatomy scanning in all pregnant women in the developed world has lead to increased detection of abnormalities in the fetal thorax. Already in the 1980s, large pleural effusions and significant macrocystic lesions in the fetus were easily detected on ultrasound. However, smaller lung tumours were often missed. Nowadays, fetal medicine centres receive many referrals for evaluation of fetal lung lesions, of which the most common are congenital cystic adenomatoid malformation and bronchopulmonary sequestration. Almost invariably, both the parents and the referring physicians experience anxiety after detection of large lung masses in the fetus. However, the vast majority of the currently detected fetal lung lesions have an excellent prognosis without the need for prenatal intervention. In the small group of fetuses in which the prognosis is poor, almost exclusively those with concomitant fetal hydrops and cardiac failure, several options for fetal therapy exist, often with a more than 50% survival rate. Indications, techniques, complications and outcomes of these interventions will be described in this review. Copyright © 2011 John Wiley & Sons, Ltd.     

PFOS暴露对肺癌细胞中信号通路的影响

为探讨全氟辛烷磺酸盐（PFOS）产生肺毒性的分子机制,采用细胞计数试剂盒（CCK-8）方法测定不同浓度PFOS对A549细胞活性的影响,并用二代测序方法测定PFOS暴露对A549细胞中miRNAs表达的影响,预测异常表达miRNAs的靶基因.通过生物信息学分析推断靶基因参与的信号通路及潜在的生物学功能.结果显示,低浓度PFOS（<00μmol/L）促进A549细胞增殖,高浓度PFOS抑制细胞增殖.暴露于300μmol/L PFOS中24h的A549细胞中108个miRNAs表达量显著上调,63个miRNAs表达量显著下调.差异表达miRNAs通过Ras、Rap1、HIF-1、ErbB和VEGF等信号通路参与细胞增殖、代谢和发育等生物学过程.这表明PFOS可通过影响细胞增殖和诱发炎症反应对肺造成威胁.     

Induction of fetal lung maturation with intra-amniotic thyroxine in multiple pregnancy

Two premature triplet pregnancies underwent repeated treatment aimed at acceleration of individual fetal lung maturity while administering intravenous tocolytic treatment. From the early third trimester, repeated amniocenteses were used for intra-amniotic administration of thyroxine to each sac, while the individual fetal lung maturation rate was determined by surfactant microviscosity until lung maturity was achieved.     

宣威肺癌高发区室内PM10对肺泡上皮细胞凋亡的影响

采集云南宣威市肺癌高发区虎头村和肺癌低发区宁家湾村冬季室内PM10样品,利用肺上皮细胞A549建立颗粒物染毒模型,以AnnexinV-FITC/PI双染色流式细胞分析法(FCM)检测PM10染毒后的细胞凋亡情况.AnnexinV-FITC/PI流式细胞分析结果显示,在相同浓度PM10作用下虎头村组肺泡上皮细胞凋亡率、死亡率均比宁家湾组高.宣威肺癌高发区虎头村组室内PM10对人肺泡上皮细胞凋亡的影响大于对照点宁家湾村.     

Mineral lung burden of an urban population

A study was carried out on mineral lung burden in 85 autopsy cases who died accidentally. Subjects of both sexes aged from 15 to 70 years were selected from all the autopsies performed at the Institute of Forensic Medicine in Rome.These subjects were living in an urban area and were not affected by neoplasm diseases. All selected subjects were residing in Rome at the time of their death. Information on years of legal residence in urban areas, smoking habits and occupational history were obtained by interviews with relatives. Lung parenchyma samples were obtained from the right upper lobe. The mineral particulate matter present in the tissue samples was studied by means of analytical transmission electron microscopy (ATEM) techniques: 16 mineral varieties and 22 metallic elements were identified. Smoke, age and residence seem to have influence on the lung burden.     

The prognostic factors in the prenatal diagnosis of the echogenic fetal lung

The prenatal diagnosis of an echogenic fetal lung (EFL) is now often made in the early second trimester using high-resolution ultrasound. This ultrasound appearance is usually caused by a congenital cystic adenomatoid lung malformation (CCAM), an intrapulmonary lung sequestration or obstruction of a major airway. In order to provide prognostic guidelines to parents who may be considering termination of a fetus with these findings, we have analysed a series of 11 cases diagnosed in our centre over the past 2 years in conjunction with 60 cases from major published series. The data suggest that in the absence of non-immune hydrops fetalis (NIHF) or other anomalies, the outcome for the fetuses is excellent, with over 90 per cent survival. Neither early diagnosis (24 weeks) nor the presence of mediastinal shift is a poor prognostic indicator. In addition, it appears that if NIHF is absent at diagnosis, the chance that it will develop as the pregnancy continues is small (6 per cent). Furthermore, there is a significant (up to 30 per cent) chance that this ultrasound finding will resolve in utero. The development of in utero fetal surgical techniques may be the only hope for those hydropic fetuses who appear to have a dismal prognosis.     

Disappearing lung echogenicity in fetal bronchopulmonary malformations: A reassuring sign?

Congenital bronchopulmonary malformations detectable on prenatal ultrasound include cystic adenomatoid malformation (CAM), lobar sequestration, and upper airway atresia. We describe three fetuses with prenatally detected intrathoracic lesions in which the associated pulmonary hyperechogenicity disappeared before delivery. In the first case of pulmonary sequestration, the infant was asymptomatic after birth. However, in a case of CAM and another with laryngeal atresia, respiratory distress developed after delivery, despite recent scans showing apparently normal lung fields. This experience suggests that ultrasonic resolution of hyperechogenic lung lesions in utero does not necessarily indicate resolution of the underlying pathology.     

Cystic lung lesions – prenatal diagnosis and management

With increasing use of fetal ultrasound comes an increase in the detection of clinically silent ‘abnormalities’ which pose diagnostic and management dilemmas for perinatologists and paediatricians. Congenital thoracic malformations (CTMs) (excluding congenital diaphragmatic hernia) are one such example, where a few cases are symptomatic in early life and management options are clear, but the majority are clinically asymptomatic, giving rise to difficulties in defining postnatal management of the well child with a sonographic or radiological lesion. Here, we will outline the prenatal presentation and natural history of CTMs that are not congenital diaphragmatic herniae and briefly discuss the approach to postnatal management, which is covered in more detail in the review by Laje and Liechty in this issue. Copyright © 2008 John Wiley & Sons, Ltd.