The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality

A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.     

The Relationship Between Exposure to Arsenic Concentrations in Drinking Water and the Development of Skin Lesions in Farmers from Inner Mongolia, China

Associations between the concentration of arsenic naturally occurring in drinking water and the development of skin lesions in people have been documented for some years at various locations around the world. Data on the exposure-response relationship between concentrations of arsenic in drinking water and prevalence of skin lesions in farmers from five locations in Inner Mongolia, China have been collected from the original publications and re-analysed together as a meta-study. The calculated data show a positive linear exposure-response relationship without a threshold. The reasons for this linear correlation are discussed and compared with the data from Xinjiang, another arsenism area located in a different geographical area of China. Here a different relationship was recorded that involved a threshold concentration before skin lesions developed. The significance of these two different exposure-response scenarios is discussed.     

Effects of Selenium Supplementation on Arsenism: An Intervention Trial in Inner Mongolia

This paper reports the effects of a placebo-controlled Se-enriched yeast supplementation trial, conducted for 14 months, on arsenism in adult farmers living in a rural community in Inner Mongolia, China. The farmers had been naturally exposed to elevated concentrations of As in drinking water from tube-wells since 1983 but changed to arsenic-free drinking water when the trial began in June 1996. Blood and hair Se and As concentrations were analysed pre-intervention and at the end of the 3rd, 9th and 14th month, while skin lesions were assessed pre-intervention, as well as at the end of the 14th month, using the Arsenism Clinical Criteria established by the Ministry of Health, China. As the trial was a voluntary one, a number of farmers did not routinely have their blood and hair samples taken for analysis. Consequently, the data have been analysed in two categories. Fifty-four farmers from the Se-group and 29 from the placebo-group who were sampled on each occasion were considered as one group, which has been compared with the second group comprising up to a total of 100 farmers in the Se-group and 86 in the placebo-group. Results calculated for those farmers who were sampled on each occasion, showed that at the end of the trial, blood and hair Se concentrations of the Se-group increased from 0.130 to 0.186 µg ml^–1 and from 0.431 to 0.502 µg g^–1, respectively, while those of the placebo-groups remained constant. Blood and hair As concentrations of the Se-group decreased from 0.051 to 0.015 µg ml^–1 and from 2.57 to 0.680 µg g^–1, respectively, a greater reduction than those in the placebo-group that went from 0.064 to 0.024 µg ml^–1 and from 2.62 to 1.25 µg g^–1, respectively. When the data from all patients were examined, the analytical trends were similar. An evaluation of skin lesions in the category who were sampled for hair and blood on each occasion showed that 41.2% of hyperkeratosis, 50.0% of depigmentation and 44.7% of pigmentation in the Se-group improved one or more degrees, while those in the placebo-group improved by only 7.1, 12.0 and 6.7%, respectively. A total of 61.1% of the adults in Se-group improved in one or more type of skin lesion, but only 17.2% improved in the placebo-group. Comparable results were obtained when all the data from both categories of farmers were examined. Results from the trial showed that Se supplementation was more effective for the improvement of adults who were affected by double or triple skin lesions. In the placebo-group, most of the severely affected adults improved in only one kind of skin lesion, but in the Se-group, more adults improved in two or three kinds of skin lesions. Although the trial was limited by its relatively small size, the results have provided some evidence of the usefulness of Se supplementation for people affected by arsenism.     

Arsenism Clinical Stages and their Relation with Hair Arsenic Concentration of Residents of Bayinmaodao Rural District, Inner Mongolia, China

The clinical skin lesions of arsenism in men and women in Bayinmaodao rural district in Inner Mongolia, Peoples Republic of China, have been examined by doctors, and their hair and drinking water samples analysed for arsenic by hydride generation and ICP-AES. Altogether 311 arsenism patients with a 15.53% prevalence rate for the district were recorded. The disease prevalence rate was positively related to population, age, and their exposure to elevated arsenic concentrations in the drinking water from 1983 when new wells were dug and drinking of surface water was abandoned. Hyperkeratosis was the most serious skin lesion with the highest occurrence rate, then depigmentation and pigmentation in decreasing order. With increasing severity of the disease, ranging from skin lesion with single hyperkeratosis 1° to hyperkeratosis 3° with depigmentation 3° and pigmentation 3°, the results showed that arsenic concentrations in head hair had increased. Arsenic concentrations in hair were positively correlated with the arsenic concentrations in drinking water obtained from local wells.     

Prenatal diagnosis of congenital cystic adenomatoid lung malformation: A report of seven cases

Six cases of macrocystic and one case of microcystic congenital adenomatoid lung malformation were diagnosed by ultrasound between 20 and 31 weeks of gestation. Combined polyhydramnios and fetal hydrops was present in three cases, polyhydramnios alone in one case, and isolated fetal hydrops also in one case. In the remaining two cases, both polyhydramnios and fetal hydrops were absent. Fetal outcome was poor, i.e., two terminations of pregnancy, three early neonatal deaths, and two survivors.     

Prenatal karyotyping in malformed fetuses

Experience with prenatal karyotyping of 237 fetuses with sonographic evidence of malformation is reported. Abnormal karyotype was found in 40 cases (16-8 per cent): chromosomal aberrations were found in 19 of the 178 fetuses with an isolated structural anomaly (10-6 per cent) and in 21 of the 59 fetuses with multiple malformations (35-6 per cent). Detailed cytogenetic and morphological information concerning fetuses affected by omphalocele, duodenal atresia, hydrocephalus, multicystic kidney, unilateral hydronephrosis and cystic hygroma is reported. The need for a very careful ultrasound evaluation of fetal anatomy in these pregnancies is stressed, as the risk of a chromosomal anomaly depends mainly on the existence of more than one ultrasonically diagnosed structural defect.     

Maternal serum alpha-fetoprotein and fetal triploidy

Fetal triploidy is commonly found in early pregnancy. The majority of these pregnancies spontaneously abort in the first trimester. Occasionally, the pregnancy progresses to the second and third trimesters. We reviewed the maternal serum alpha-fetoprotein (MSAFP), amniotic fluid alpha-fetoprotein (AFP), amniotic fluid acetylcholinesterase (ACHE), fetal pathology, and placental pathology in sex second-trimester pregnancies complicated by fetal triploidy. Four of these patients had MSAFP values greater than 7.5 multiples of the median (MoM). Five of six pregnancies had MSAFP values greater than 2.25 MoM. All five of these patients had a partial mole. Four patients had amniotic fluid AFP values greater than 2.0 MoM. Two fetuses had associated neural tube defects. These were the only patients with positive amniotic fluid ACHE. None of the other patients had fetuses with anomalies that are known to be associated with an elevated MSAFP. The elevated MSAFP appeared to be related to the presence of a partial mole. Two of the five cases with an MSAFP greater than 2.25 MoM did not have sonographic evidence of a significant anomaly. Therefore, karyotyping can be of benefit in evaluating patients with elevated MSAFP.     

飞机蒙皮用含氟聚氨酯涂层老化原因分析

选用飞机蒙皮常用的含氟聚氨酯涂层体系为研究对象,结合飞机服役环境的主要特点,开展了实验室模拟加速老化试验研究,并利用电化学阻抗谱对老化试验后的涂层进行了表征.结果表明,紫外线仅对涂层的表面结构产生影响,紫外试验后的涂层电阻下降较慢.在紫外-盐雾循环试验中,紫外线引起涂层表面结构发生变化,涂层的耐水性变差,水更快地进入涂...     

消防服用织物热防护性能测试分析与研究

热防护性能(Thermal protective performance—TPP)是阻燃型服装或织物隔热防护性能重要指标。本文在已研制的一种模拟人体皮肤及体形的高温"圆筒仪"上进行了改进,并用其测试阻燃服装织物的热防护性能。用膜电偶测量模拟皮肤器表面温升率,并结合烧伤积分模型的评价方法来计算达到二级烧伤的防热时间。与其它一维平面测试装置相比,本装置可较为准确评估实际服装热收缩特征对服装热防护性能的影响。     

降温背心人体降温效果评价

本文目的是评价降温背心的降温效果。通过对3名成年人在不同环境条件下,分别穿着降温背心和普通服装,测量人员胸部、上肢、下肢和直肠温度的变化,同时监测心率、呼吸和出汗量等,得出环境温度越高,降温背心的降温效果越明显;体形胖的人耐热能力相对差;耐热与出汗量密切相关等结论,并指出降温背心的降温效果显著,能够满足高温岗位的需要。