Early ultrasound diagnosis of Neu–Laxova syndrome

We report the mid-trimester prenatal diagnosis of Neu–Laxova syndrome (NLS) in two at risk families utilizing serial sonographic examinations. Ultrasound and pathologic findings from seven affected pregnancies, the largest case series of NLS to date, are presented. One fetus had anencephaly and incomplete rachischisis, an anomaly that has not been previously reported in association with NLS. Ultrasonographic detection of severe intrauterine growth restriction (IUGR), abnormally postured limbs, microcephaly, and edema allowed prenatal diagnosis of NLS in five of these at risk pregnancies during the mid-trimester. Growth curves derived from serial sonograms reveal abnormalities of all standard biometric measurements. The growth discrepancy was most pronounced in the measurements of the biparietal diameter, which were consistently less than two standard deviations below the mean across all gestational ages. This case series confirms that aberrant growth and anomalies may be detected sufficiently early in gestation to permit prenatal diagnosis of NLS. Copyright © 2001 John Wiley & Sons, Ltd.     

First trimester maternal serum placenta growth factor (PIGF)concentrations in pregnancies with fetal trisomy 21 or trisomy 18

Placenta growth factor (PIGF), an angiogenic factor belonging to the vascular endothelial growth factor family, pregnancy-associated plasma protein A (PAPP-A) and free β-human chorionic gonadotrophin (β-hCG) were measured in maternal serum from 45 pregnancies with trisomy 21, 45 with trisomy 18 and 493 normal controls at 10–13 completed weeks of gestation. In the normal pregnancies maternal serum PIGF levels increased exponentially with gestation. The median multiple of the median (MoM) PIGF concentration in the trisomy 21 group (1.26 MoM) was significantly higher (p<0.0001) than in the control group (1.00 MoM). In the trisomy 18 group the median PIGF was lower (0.889 MoM) but this did not quite reach significance (p=0.064). The corresponding median MoM values for PAPP-A were 1.00 MoM for the controls, 0.49 MoM for trisomy 21 and 0.16 MoM for trisomy 18. The median MoM values for free β-hCG were 1.00 MoM for the controls, 2.05 MoM for trisomy 21 and 0.38 MoM for trisomy 18. In the control group there was a small but significant correlation of PIGF with free β-hCG (r=+0.1024) and PAPP-A (r=+0.2288). In the trisomy 18 group there was a significant association between PIGF and free β-hCG (r=+0.2629) but not with PAPP-A (r=+0.0038). In the trisomy 21 group there was a small but significant association with PAPP-A (r=+0.1028) but not with free β-hCG (r=+0.0339). The separation of affected and unaffected pregnancies in maternal serum PIGF is small, and therefore it is unlikely that measurement of PIGF would improve screening for these abnormalities provided by the combination of fetal nuchal translucency and maternal serum PAPP-A and free β-hCG. Copyright © 2001 John Wiley & Sons, Ltd.     

Fetal renal anomalies and genetic syndromes

Renal abnormalities are some of the commonest and most easily detectable anomalies on ultrasound. Many are an isolated finding but the prognosis may be altered considerably by the detection of other anomalies which could indicate a genetic disorder or syndrome. It is often easier to detect presupposed anomalies and the purpose of this article is to introduce and discuss those syndromes that may present with a renal abnormality on ultrasound. Common renal findings are presented with the range of additional anomalies that should be sought and suggested diagnostic tests. It should be remembered that although for many genetic conditions specific mutation analysis is now available, this usually requires pre‒pregnancy investigations. Furthermore, in some cases the definitive diagnosis may not be suspected until post mortem. By this time it may be too late to establish a cell line to confirm the suspicion using laboratory methods. It is therefore important to take tissue samples antenatally where possible, or at delivery, as postnatal samples may have a high culture failure rate. Copyright © 2001 John Wiley & Sons, Ltd.     

Role of amniotic fluid interphase fluorescence in situ hybridization (FISH) analysis in patient management

We retrospectively reviewed 309 amniotic fluid interphase fluorescence in situ hybridization (FISH) analyses performed from October 1995 to June 1999 to assess the role of interphase FISH in the management of patients at increased risk for fetal aneuploidies. Gestational age and indications for amniocentesis, clinical interventions after FISH results, as well as interventions after final culture reports were analyzed. There were 244 (79%) normal, 50 (16%) abnormal and 15 (5%) inconclusive FISH results. There were no false-positive or false-negative results, but there were nine (3%) clinically significant chromosomal abnormalities not detectable by FISH. Of the 50 women with abnormal FISH results, 26 (52%) elected to terminate the pregnancy prior to the availability of the standard chromosome analysis. In two of the fetuses with trisomy 21 no abnormalities were reported by ultrasound examination. Our experience indicates that interphase FISH results played an important role in decision making, especially for pregnancies close to 24 weeks' gestation. Standard karyotype analysis is still required for detection of chromosome abnormalities not detectable by interphase FISH techniques and for clarification of unusual or inconclusive FISH results. Copyright © 2001 John Wiley & Sons, Ltd.     

Design of policy mechanism to promote cleaner production in China

ＩｎｔｒｏｄｕｃｔｉｏｎＣｌｅａｎｅｒｐｒｏｄｕｃｔｉｏｎ (ＣＰ)ｈｏｌｄｓｇｒｅａｔｐｒｏｍｉｓｅａｓａｎｅｆｆｅｃｔｉｖｅｓｔｒａｔｅｇｙｉｎｔｈｅｆａｃｅｏｆｄｏｕｂｌｅｃｈａｌｌｅｎｇｅｓｏｆｅｎｖｉｒｏｎｍｅｎｔａｌｐｒｏｔｅｃｔｉｏｎａｎｄｅｃｏｎｏｍｉｃｄｅｖｅｌｏｐｍｅｎｔ.Ｉｎ 1993,ａｄｅｍｏｎｓｔｒａｔｉｏｎｐｒｏｊｅｃｔ (Ｂ 4ｐｒｏｊｅｃｔ) ,ｄｅｓｉｇｎｅｄａｎｄｅｘｅｃｕｔｅｄｂｙｔｈｅＳｔａｔｅＥｎｖｉｒｏｎｍｅｎｔａｌＰｒｏｔｅｃｔｉｏｎＡｄｍｉｎｉｓｔｒａｔｉｏｎ (…     

Water solubility enhancements of pyrene by single and mixed surfactant solutions

ＩｎｔｒｏｄｕｃｔｉｏｎＳｕｒｆａｃｔａｎｔｓｅｎｈａｎｃｅｔｈｅｒｅｍｅｄｉａｔｉｏｎｏｆＮＡＰＬ ｃｏｎｔａｍｉｎａｔｅｄｓｉｔｅｓｂｙｉｎｃｒｅａｓｉｎｇｔｈｅａｑｕｅｏｕｓ ｐｈａｓｅｃｏｎｃｅｎｔｒａｔｉｏｎｏｆｔｈｅＮＡＰＬｖｉａｍｉｃｅｌｌｅｆｏｒｍａｔｉｏｎ ,ｍｉｃｒｏｅｍｕｌｓｉｆｉｃａｔｉｏｎ ,ｏｒｍｏｂｉｌｉｚｉｎｇｔｈｅＮＡＰＬｐｈａｓｅ (Ｋｉｌｅ ,1989;Ｅｄｗａｒｄｓ,1991;Ｇｕｈａ ,1998ａ ;Ｋｏ ,1998;Ｚｉｍｍｅｒｍａｎ ,1999;Ｂｅｔｔａｈａｒ,1999;Ｗｉｌｌｓｏｎ ,1999;Ｐａ…     

沙漠绿洲的开发与环境变化的相互影响

干旱区的农业活动、特别是沙漠绿洲的开发,改变了地-气系统的能量交换。几年来的沙漠绿洲气候与防风林的研究、气候资料的分析和实地考察表明,中国西部干旱区最近４３年来的沙漠绿洲开发已改变着那里的局地气候环境,使其向有利于人类和农业的方向发展着。在沙漠绿洲的开发利用与局地环境变化之间,存在着两种截然相反的反馈作用：环境变好→绿洲发展→环境更好→绿洲再发展;环境恶化→绿洲退化→环境更坏→绿洲再退化,甚至消失。决定这两种反馈作用的是大环境的变迁和绿洲开发利用中是否合理利用资源和按自然规律办事。