Sirenomelia,the mermaid syndrome—detection in the first trimester

The sirenomelia sequence with fusion, rotation, hypotrophy or atrophy of the lower limbs in combination with severe urogenital and gastrointestinal malformations is a rare and usually lethal disorder. We present the case of a 28-year-old woman, who was referred to our department because of an intraabdominal cystic structure in the 9th week of gestation. Subsequent scans confirmed the diagnosis of a sirenomelia sequence with the fusion of the lower extremities without fusion of the bones according to Stocker I classification. The size of the intraabdominal cyst decreased during follow-up. After counseling, termination of pregnancy was induced. The postmortem X-ray confirmed the ultrasound diagnosis. The exact etiological mechanism of this malformation is still unknown. An early alteration of the embryological vascular network damaging the caudal mesoderm is thought to lead to arrested development of the lower limbs and other affected organs. The cyst we saw in the 9th week might fit with this theory, either as an expression of the complex malformation of the lower abdomen or as the sonographic appearance of necrosis. Copyright © 2003 John Wiley & Sons, Ltd.     

Vom Werden zum Sein

In the evolution of the animal kingdom and of Man there have been four striking changes in orientation, each accompanied by (amongst other things) marked changes in the flow rates and distribution of energy. An analysis of the alterations in the turnover and distribution of energy reveals that with each such revolution the role of the individual and his social demands gained in importance as compared to that of the germ line.     

沿海和海洋生态系统与人类人口系统间的相互作用:关于消费如何调解这种相互作用的看法

人口、环境及可持续发展的困境 20世纪的80和90年代,环境工作者和普通公众普遍认为,不加控制的人口增长是造成各类环境退化的根本原因.这种新马尔萨斯人口论的观点最初出现在20世纪60年代Ehrlich所著的<人口炸弹>的文章中,该文以危言耸听的语气解释了那十年空前高的人口增长率[1～3].     

Feto-amniotic shunting—report of the experience of four european centres

Few reports concerning intrauterine shunting are available. We investigated the impact of this method. In order to evaluate intrauterine shunting and the complication rate for different indications, we sent a questionnaire to all German-speaking level 3 centres. In four level 3 centres, 52 intrauterine catheters were inserted in 34 fetuses. The indications were uni- or bilateral hydrothorax in nine cases, cystic adenomatoid malformation of the lung in four cases, infravesical stenosis in 13 cases, and fetal ascites in eight cases. In three cases (6 per cent), difficulties occurred when the drain was inserted. In 15 cases (29 per cent), the function of the drain was reduced by dislocation or occlusion. The mortality rate caused by shunting was as high as eight per cent (four cases). The application of an intrauterine shunt currently represents a rarely performed ultrasound-guided therapeutic intervention in the fetus. In all cases, the indication for shunting is to avoid compression of normal tissue by cystic structures. A high complication rate restricts the application of drainage to selected cases.