Prenatal diagnosis and treatment of fetal long QT syndrome: a case report

We report a case of a fetus presenting with bradycardia, intermittent atrioventricular (AV) block, ventricular tachycardia (VT) and the signs of fetal congestive heart failure (ascites and scrotal hydrocele) during mid-gestation. Prenatal treatment with β-adrenergic blocker (propranolol) and digitalis glycosides was prescribed because of suspicion of long QT syndrome occurring with fetal congestive heart failure. The male baby was born at 39 weeks of gestation and showed a prolonged QT interval (QTc = 492 ms) and frequent variable AV block or alternating left and right bundle branch block, depending on the atrial rate. Prenatal administration of lidocaine failed to correct the fetal VT. Conversely, propranolol decreased the attack frequency of fetal VT. Postnatal administration of the K⁺ channel opener (nicorandil) successfully shortened the QT interval and improved the outcome. Copyright © 2002 John Wiley & Sons, Ltd.     

Prenatal diagnosis of ventricular aneurysm: a report of two cases and a review

Ventricular aneurysms have rarely been reported prenatally. Their prognosis is variable depending on factors such as early detection, their relative size in comparison to the ventricular cavity, growth on follow-up, and signs of cardiac failure. In view of the fact that it may be useful to report on additional cases in order to make available further information on aetiology, prognosis and neonatal management, we hereby report on two cases of ventricular aneurysm with good mid-term prognosis. One case of apical aneurysm of the left ventricle was associated with a muscular ventricular septal defect, the features of which are compatible with a fetal myocardial infarction and ventricular septal rupture in absence of coronary artery anomalies as demonstrated by catheterisation. Another case of sub-tricuspidal aneurysm of the right ventricle associated with mitral prolapse appears to be a component of diffuse connective dysplasia. Despite the early gestational age at diagnosis, the large size of the aneurysm and the associated defect, both the infants were asymptomatic in infancy prompting a conservative management. Copyright © 2002 John Wiley & Sons, Ltd.     

The ductus venosus in early pregnancy and congenital anomalies

The ductus venosus (DV) is a tiny vessel leading oxygenated blood from the placenta to the fetal heart and its flow assessment has been used as an indicator of fetal acidemia. At 11 to 14 weeks, the fetuses with increased nuchal translucency also showing an abnormal DV blood flow were consistently found to be aneuploid. Early cardiac dysfunction, signaled by abnormal DV blood flow, was suggested as the underlying cause of increased nuchal translucency. Detection rates for aneuploidy with the use of DV blood flow studies range from 59 to 93% with 2 to 21% false-positive rates. In fetuses with normal karyotype, an abnormal DV flow pattern signals cardiac defects or adverse perinatal outcome. Copyright © 2004 John Wiley & Sons, Ltd.     

Cardiotocographic and sonographic findings in two cases of antenatally diagnosed intrauterine fetal brain death

Intrauterine fetal brain death is a rare cause of a fixed fetal heart rate pattern. Seven cases have been previously reported in the literature, but only two of them were diagnosed prenatally and all the newborns died soon after delivery. Two additional cases of antepartum diagnosis of intrauterine fetal brain death, managed expectantly, are reported. We had the unique opportunity to document progressive sonographic cerebral changes during the follow-up period, following the neurological event, while the fetus continued life and growth in utero. The cardiographic and sonographic findings suggesting intrauterine fetal brain death were a prolonged fixed fetal heart rate, even following a vibroacoustic and contraction stress test; an atonic fetus without breathing and body movement; and the appearance of hydramnios and the development of ventriculomegaly.     

The Effects of Local Cooling on Thermophysiological Response in Participants Wearing Dust-Free Garments

This study was designed to find the effects of two kinds of dust-free garments with (A) and without (B) frozen gel strip (FGS), and half-naked clothing (brassiere and shorts; C) on thermophysiological parameters and on temperature and humidity within clothing. The heart rate, rectal, and skin temperatures as well as sweat rate and clothing microclimate were measured during 140 min in 9 healthy females. Inquiries were also made into the subjective rating of thermal, humidity, and comfort sensations. The main findings in our experiments are as follows: (a) Physiological parameters such as rectal and skin temperatures (chest and forehead), heart rate, and sweat rate were clearly lowest in garb C, intermediate in garb A, and highest in garb B throughout the experiment; (b) Temperature and humidity within clothing were lower in garb A than in garb B; (c) More than half of the 9 participants decreased thermal sensation by wearing garb A. These results suggest that the usage of FGS could improve the heat load in lightly working participants wearing dust-free garments.     

Heart Rate Variability in Exposure to High Altitude Hypoxia of Short Duration

Abstract

The objective of the study is to attempt an evaluation of heart rate (HR) and heart rate variability (HRV) regulatory mechanisms in the presence of autonomous nervous system (ANS) components in transient exposure to high altitude hypoxia.

During 24 hrs including a stay in hypobaria, the participants had their HR continuously recorded using the Holter method. The following parameters were calculated at rest and during the stay in a thermobarochamber: spectral power in low frequency bands (LF) 0.04-0.15 Hz and high frequency bands (HF) 0.15-0.5 Hz, and the sympathetic-parasympathetic balance index LF/HF.

Under hypobaric conditions, a decrease in mean spectral power of R-R intervals was noted within both frequency ranges, compared with the study performed in normobaria. The observed differences were larger at daytime.     

2,2’,4,4’-四溴二苯醚(BDE-47)对大型溞(Daphnia magna)的毒性效应

2,2’,4,4’-四溴二苯醚(BDE-47)在水体及各种水生生物(鱼类、海洋哺乳动物以及水生无脊椎动物)中被广泛检出,但BDE-47对水生无脊椎动物毒性效应的研究还处于起步阶段。以大型溞(Daphnia magna)为受试生物,通过急性(48h)和慢性(21d)毒性暴露实验,考察了BDE-47对大型溞活动抑制率、心率、产仔情况和酶活性等指标的影响。结果显示,BDE-47对大型溞活动抑制率的48h-EC50为112.5μg.L-1;高浓度(>100μg.L-1)BDE-47显著诱导提高大型溞的心率。21d慢性暴露实验中,8μg.L-1处理组中大型溞全部死亡;其他各浓度处理组(0.5、1、2、4μg.L-1)中,母溞第1胎产仔时间延后,第1胎子代数量减少,总产仔数量大幅减少,这表明大型溞的繁殖能力受到抑制。BDE-47在一定程度上抑制了母溞胆碱酯酶(ChE)和谷胱甘肽硫转移酶(GST)的活性,大型溞体内的代谢机制没有被诱导,神经活性虽被抑制,但抑制率不高。BDE-47大幅诱导过氧化氢酶(CAT)的活性,并呈现一定的剂量效应关系,相对于ChE和GST,CAT对BDE-47暴露更为敏感,可作为BDE-47对大型溞慢性暴露毒性效应的潜在生物标志物。     

噪声对脑、心脏、肝脏元素影响的研究

采用原子吸收法,试图从元素方面探讨强噪声暴露对机体重要器官的元素代谢的影响。结果发现与对照组相比经强噪声暴露后,脑、心脏、肝脏的元素锌、脑的元素钙及心肌的元素镁均呈极显著减少;而脑、心脏、肝脏的元素铜及心、肝脏的元素钙则呈极显著增加。在停止强噪声暴露后第5d,上述4种元素代谢仍没有恢复正常。结果表明：强噪声使机体重要器官的元素代谢严重障碍。提示强噪声环境是引起心脏病的原因之一,可能与强噪声使心肌元素代谢严重失调有关。     

Contamination in Ontario farmstead domestic wells and its association with agriculture:: 1. Results from drinking water wells

Groundwater provides about 30% of water requirements in Ontario, but farm families depend almost entirely on private wells. Major potential contaminants on farms are nitrate (NO₃⁻), pathogenic microorganisms, pesticides and petroleum derivatives. A survey of farm drinking-water wells was conducted throughout the Province of Ontario, Canada, in 1991 and 1992 and tested for these contaminants. The main objectives of the survey were to determine the quality and safety of drinking water for farm families, and determine the effect of agricultural management on groundwater quality at a provincial scale. Four farm wells were chosen in each township where >50% of the land area was used for agricultural production. Elsewhere one well per township was usually sampled. Within each township the types of farming activity and dominant soils were additional criteria for selection. The network comprised 1292 of the estimated 500,000 water-wells in Ontario, and the study conformed to a stratified random survey. A subset of 160 wells, chosen by farm type, soil, and the presence or absence of a fuel storage tank, was investigated for the presence of petroleum derivatives: benzene, toluene, ethyl benzene, and xylene. About 40% of farm wells tested contained one or more of the target contaminants above the maximum acceptable concentration; 34% of wells had more than the maximum acceptable number of coliform bacteria, 14% contained NO₃⁻-N concentrations above 10 mg l⁻¹ limit and about 7% were contaminated with both bacteria and NO₃⁻. Only six wells contained pesticide residues above the interim maximum acceptable concentration (IMAC), but pesticides were detected in 7% of wells in winter and in 11% in summer. No wells contained detectable petroleum derivatives. These results for NO₃⁻ contamination were not significantly different from those reported for a survey of Ontario wells for the period 1950–1954, but the frequency of contamination by Escherichia coli was greater in the present study. None of the point sources investigated contributed significantly to the NO₃⁻ contamination. The percentage of wells contaminated by coliform bacteria decreased significantly with increasing separation of the well from the feedlot or exercise yard on livestock farms. A full statistical model including the type of well construction, depth, age and soil hydrologic group was developed to describe the frequency of NO₃⁻ contamination.