Cystic hygroma and congenital diaphragmatic hernia: Early prenatal sonographic evaluation of Fryns' syndrome

We report a case of cystic hygroma and diffuse lymphangiectasia detected by sonogram at 12 weeks' gestation. Fetal karyotype was normal. At 20 weeks' gestation, herniation of the bowel into the chest was noted. At delivery, the infant was diagnosed as having Fryns' syndrome. This is the first reported case of Fryns' syndrome presenting with cystic hygroma.     

An infant with trisomy 9 mosaicism presenting as a complete trisomy 9 by amniocentesis

We present a case in which amniocentesis performed at 33 weeks' gestation because of symmetrical intrauterine growth retardation and decreased amniotic fluid volume led to the prenatal diagnosis of a fetus with a karyotype of 47,XX,+9, t(1;20)(q42;p11.2) pat, i.e., with an extra chromosome 9 and a balanced translocation between chromosomes 1 and 20. At delivery, the baby showed clinical features of trisomy 9, yet chromosome analysis of the cord blood revealed no trisomy 9 cells, a finding confirmed by neonatal blood karyotyping. The balanced translocation was present in all cells. A skin biopsy confirmed trisomy 9 mosaicism with 10 per cent trisomy 9 cells. The baby died at 6 weeks and an autopsy was obtained. Chromosome analysis of different organs demonstrated different frequencies of the mosaicism of trisomy 9. The possible underlying mechanism for the discrepancy between the karyotype results by amniocentesis and those of other tissues is discussed.     

Amiodarone treatment in pregnancy for dilatative cardiomyopathy with ventricular malignant extrasystole and normal maternal and neonatal outcome

Amiodarone treatment in pregnancy might be difficult to handle because of the long half-life of the drug (14–28 days up to 2 months) and because it reduces maternal and neonatal thyroid activity. Although short-term use in pregnancy has been described in cases of fetal supraventricular tachycardia, there are few reports on the chronic use of the drug. In this paper we describe our experience with amiodarone treatment in two pregnant sisters with familial dilatative cardiomyopathy and ventricular malignant extrasystole. Prolonged administration of amiodarone (400–200 mg/die) since the beginning of pregnancy did not have any adverse effects; maternal and neonatal thyroid function was normal, as was the neurological and motor development of the neonates.     

Field Study of Wind and Traffic to Test a Street Canyon Pollution Model

In the U.K., local authorities have new duties to review and assess air quality. Dispersion models are important tools in this process. The performance of a street canyon model, AEOLIUS, in calculating carbon monoxide (CO) concentrations in urban areas is discussed. A field experiment was conducted in a busy street canyon in Leek, Staffordshire. Wind speed and direction were measured at three heights adjacent to the street. The canyon's CO concentrations and traffic counts were recorded. Predicted concentrations of CO, calculated using AEOLIUS, were compared with the observed values. The concept of a roof-top wind is discussed, as are the consequences of using wind measurements from outside the town. Choice of wind measurement location and height of the anemometer above the canyon had a pronounced effect on calculating the roof-top wind. Two methods of deriving a street level wind speed from a roof-top wind speed gave results that differ by up to a factor of two. AEOLIUS had variable skill at predicting CO concentrations depending on the roof-top wind direction: possible reasons for this variability are explored. A sensitivity study of the model showed that vehicle emissions have the greatest impact on predicted concentrations. Implications for local air quality management are discussed.     

Combining state and transition models with dynamic Bayesian networks

Bashari et al. (2009) propose combining state and transition models (STMs) with Bayesian networks for decision support tools where the focus is on modelling the system dynamics. There is already an extension of Bayesian networks - so-called dynamic Bayesian networks (DBNs) - for explicitly modelling systems that change over time, that has also been applied in ecological modelling. In this paper we propose a combination of STMs and DBNs that overcome some of the limitations of Bashari et al.’s approach including providing an explicit representation of the next state, while retaining its advantages, such an the explicit representation of transitions. We then show that the new model can be applied iteratively to predict into the future consistently with different time frames. We use Bashari et al.’s rangeland management problem as an illustrative case study. We present a comparative complexity analysis of the different approaches, based on the structure inherent in the problem being modelled. This analysis showed that any models that explicitly represent all the transitions only remain tractable when there are natural constraints in the domain. Thus we recommend modellers should analyse these aspects of their problem before deciding whether to use the framework.     

Thinking,feeling and deciding: The influence of emotions on the decision making and performance of traders

We report on a qualitative investigation of the influence of emotions on the decision making of traders in four City of London investment banks, a setting where work has been predominantly theorized as dominated by rational analysis. We conclude that emotions and their regulation play a central role in traders' decision making. We find differences between high and low performing traders in how they engage with their intuitions, and that different strategies for emotion regulation have material consequences for trader behavior and performance. Traders deploying antecedent‐focused emotional regulation strategies achieve a performance advantage over those employing primarily response‐focused strategies. We argue that, in particular, response‐focused approaches incur a performance penalty, in part because of the reduced opportunity to combine analysis with the use of affective cues in making intuitive judgments. We discuss the implications for our understanding of emotion and decision making, and for traders' practice. Copyright © 2010 John Wiley & Sons, Ltd.     

The first world conservation lecture

Summary This, The First World Conservation Lecture, was presented at the Royal Institution, London, UK, on 12 March 1981. The Lecture celebrated the 20th anniversary of the World Wildlife Fund, and the first anniversary of the World Conservation Strategy. The Lecture was organized by the World Wildlife Fund, UK.Published with the kind permission of the World Wildlife Fund, UK.Edward Max Nicholson, CB, CVO, Commandeur (Netherlands), Order of the Golden Ark, holds honorary doctorates from the University of Aberdeen, and The Royal College of Art London. He was educated at the University of Oxford, and was a member of the University's expeditions to Greenland (1928) and to British Guiana (1929). He was General Secretary (until 1940), later Chairman of PEP (Political and Economic Planning): now Vice-President of its successor body, the Policy Studies Institute. From 1945 to 1952 he was Secretary of the Office of the Lord President of the Council, then Deputy Prime Minister of the United Kingdom. He was member of the Advisory Council on Scientific Policy from 1948–1964. In 1952 he was leader of the joint UN/FAO Development Team in Baluchistan. Charter Member from 1949, and Director-General (1952–1966) of the Nature Conservancy, London, UK. From 1963 to 1974 he was Convenor of the Conservation Section of the International Council of Scientific Unions' International Biological Programme. President of the IUCN Technical Meeting in Edinburgh in 1956, concerned with rehabilitation of areas biologically devastated by human disturbance, and relation of ecology to landscape planning. Member, Panel on Landscape Action Program, The White House Conference (USA) on Natural Beauty (1965). Secretary, HRH The Duke of Edinburgh's Study Conference on The Countryside in 1970 (1963 and 1965). Council and Board Member of IIED. Godman-Salvin Medallist British Ornithologist Unions. Phillips Medallist and Member of Honour IUCN, Geoffroy St. Hilaire Gold Medal, Société Nationale de Protection de Nature de France, Premio Europeo Cortina-Ulisse (1971), Europa Preis für Landespflege (1972), Hon Member of World Wildlife Fund, Chairman Ecological Parks Trust, President RSPB, 1980. Principal Consultant and Chairman of Land Use Consultants Ltd (London) since 1966. Author of many books,Birds and Men (1951);Britain's Nature Reserves (1958),The System (1967);The Environmental Revolution (1970).     

Diagnosis of polyhydramnios in early gestation: Indication for prenatal diagnosis?

Previously published reports have indicated that idiopathic polyhydramnios may be associated with trisomies 18 and 21 and that chromosomal analysis is indicated. Furthermore, the natural history and fetal outcome of polyhydramnios diagnosed in early gestation have not been well delineated. We identified 138 pregnancies with polyhydramnios prior to 26 weeks' gestation. Of 131 complete cases, 21 were diagnosed as severe, 18 as moderate, and 92 as mild polyhydramnios. Congenital abnormalities were noted in 18 of 21 severe cases (86 per cent). Two of the remaining three cases were twin-to-twin transfusion. Thirteen of 18 cases with moderate polyhydramnios (72 per cent) were associated with anomalies; six of the remaining cases were twin-to-twin transfusion. Sixteen of 92 cases of mild polyhydramnios (17 per cent) were associated with congenital abnormalities. In 69 of 76 cases of mild hydramnios not associated with anomalies (91 per cent), the hydramnios resolved prior to delivery. Only 2 of 16 (13 per cent) associated with anomalies resolved. In 4 of 5 cases (80 per cent) with moderate hydramnios and no anomalies, the amniotic fluid volume was normal on subsequent ultrasound. No case of moderate polyhydramnios associated with anomalies or maternal conditions nor any case of severe polyhydramnios resolved. There were seven cases of chromosomal abnormalities in this series; all were associated with sonographic findings in addition to the presence of polyhydramnios. On the basis of these data, we doubt the benefit of amniocentesis following the early diagnosis of idiopathic polyhydramnios in the absence of other ultrasound findings.     

The normal fetus of an acardiac twin pregnancy: Perinatal management based on echocardiographic and sonographic evaluation

Experience with three prenatally diagnosed pregnancies complicated by an acardiac twin reveals that ultrasonography and echocardiography are helpful in detecting early signs of in-utero congestive heart failure in the normal twin. The use of Doppler blood flow analysis to determine direction of blood flow, post-mortem placental and fetal angiography, and umbilical cord blood gas determination provided proof that retrograde arterial perfusion occurs in the acardiac fetus. In a fourth pregnancy, an experimental approach to occlude the acardiac twin's umbilical cord was attempted, but was unsuccessful.     

First-trimester ultrasonic diagnosis of twin reversed arterial perfusion sequence

Twin reversed arterial perfusion (TRAP) syndrome sequence is a rare specific anomaly of twin gestation with fused placentae and umbilical anastomosis. This syndrome occurs once in very 35 000–48 000 births and has been described in the second trimester (23-29 weeks of gestation). We report on early sonographic diagnosis (10 and 12 weeks' gestation) of two cases of TRAP sequence, together with their umbilical cord Doppler studies.