Prenatal overgrowth and mosaic trisomy 15q25-qter including the IGF1 receptor gene

Overgrowth is rarely associated with chromosomal imbalances. Here, we report on a male foetus presenting with overgrowth and additional material on the short arm of one of the chromosome 15 in 12% of lymphocytes and 50% of amniotic cells. Parents' karyotypes were normal, indicating a de novo origin for this unbalanced rearrangement. Complementary studies using cytogenetic and FISH studies showed that this additional material resulted in a 15q25-qter trisomy and confirmed the presence of three copies of the insulin-like growth factor 1 receptor (IGF1R) gene, included in the trisomic region. Autopsy performed after termination of pregnancy revealed isolated overgrowth and absence of visceral malformations. The possible mechanisms and origins for the formation of this mosaic pure trisomy are complex. The present observation emphasises the hypothesis that the overgrowth phenotype, frequently reported in patients with trisomy including the 15q26 region, might be causally related to a dosage effect of the IGF1R gene, as well as the importance of chromosome analysis in patients with overgrowth. It also confirms that the overgrowth is of prenatal onset in those observations. Copyright © 2004 John Wiley & Sons, Ltd.     

Risk of amniocentesis in women screened positive for Down syndrome with second trimester maternal serum markers

In routine obstetrical practice, prior to offering invasive prenatal diagnosis, it is crucial to weigh the risks attendant on amniocentesis against the individual's risk of aneuploidy. We took advantage of a policy of follow-up of patients undergoing Down syndrome maternal serum screening to compare the rates of fetal loss before 24 weeks and of early premature delivery at 24–28 weeks between women who underwent amniocentesis and women who did not. A total of 54 902 patients entered the study, of whom 4039 (7.35%) were lost to follow-up and 387 were excluded because of a severe fetal abnormality. Of the 50 476 remaining patients, 3472 had an amniocentesis whereas 47 004 had not and served as controls. In the amniocentesis group, the fetal loss rate before 24 weeks was 1.12% (95% CI=1.08–1.15) and the 24–28 weeks premature delivery rate was 0.40% (95% CI=0.39–0.41) which was significantly higher than in controls (0.42% with 95% CI 0.41–0.43 and 0.24% with 95% CI 0.23–0.25, respectively). The 0.86% difference in adverse outcome rates between the amniocentesis and control groups may be attributable to amniocentesis and compares favourably with the positive predictive value of maternal serum markers (1.70%) observed in the present study. Copyright © 2002 John Wiley & Sons, Ltd.     

Prenatal diagnosis of partial trisomy 12q: clinical presentations and outcome

We present a pregnant woman with a fetus prenatally diagnosed as 46, XY,der(4) t(4;12) (q35.1; q21.2). This defect resulted from the unbalanced segregation of a paternal balanced translocation, t(4;12) (q35.1; q21.2). Prenatal ultrasound revealed borderline ventriculomegaly, a thick nuchal fold, pericardial effusion, arthrogryposis, a single umbilical artery, and micropenis. Fluorescence in situ hybridization (FISH) with whole chromosome painting probe and microarray-based comparative genomic hybridization analysis further confirmed chromosomal gain of terminal 12q. The woman had her pregnancy terminated at 20 weeks of gestational age. When compared with previously reported cases, the proband had characteristics common to the phenotypes of partial trisomy 12q, including an abnormal facial appearance and multiple anomalies. Additionally, this case had previously unreported phenotypes, such as arthrogryposis, a single umbilical artery, and a micropenis. Regarding the outcome of partial trisomy 12q, the fetuses carrying trisomies distal to 12q24 have a good chance of extended postnatal survival. In contrast, the cases with trisomies involving a larger amount of 12q likely die prenatally or within a few days after birth. Copyright © 2005 John Wiley & Sons, Ltd.     

Congenital heart disease and aneuploidy

Congenital heart disease (CHD) is one of the commonest prenatal diagnoses made on routine ultrasound screening. Overall, up to 33% of CHD are associated with fetal aneuploidy. However, some specific cardiac lesions have a significantly greater association with particular chromosomal abnormalities. The majority of fetuses with CHD and aneuploidy also have extra-cardiac anomalies and are best managed by a multidisciplinary team where the management and prognosis of the cardiac defect can be discussed in the context of the baby as a whole. It is therefore important for clinicians involved in the management of fetuses with CHD to be aware of the association of aneuploidy as well as the prognosis and management of these cases, so that they can appropriately counsel the parents. In this chapter, we review the frequency and types of aneuploidy associated with the commonly diagnosed CHD and discuss their management. Copyright © 2004 John Wiley & Sons, Ltd.     

A CFD based explosion risk analysis methodology using time varying release rates in dispersion simulations

A full probabilistic Explosion Risk Analysis (ERA) is commonly used to establish overpressure exceedance curves for offshore facilities. This involves modelling a large number of gas dispersion and explosion scenarios. Capturing the time dependant build up and decay of a flammable gas cloud size along with its shape and location are important parameters that can govern the results of an ERA. Dispersion simulations using Computational Fluid Dynamics (CFD) are generally carried out in detailed ERA studies to obtain these pieces of information. However, these dispersion simulations are typically modelled with constant release rates leading to steady state results. The basic assumption used here is that the flammable gas cloud build up rate from these constant release rate dispersion simulations would mimic the actual transient cloud build up rate from a time varying release rate. This assumption does not correctly capture the physical phenomena of transient gas releases and their subsequent dispersion and may lead to very conservative results. This in turn results in potential over design of facilities with implications on time, materials and cost of a project.In the current work, an ERA methodology is proposed that uses time varying release rates as an input in the CFD dispersion simulations to obtain the fully transient flammable gas cloud build-up and decay, while ensuring the total time required to perform the ERA study is also reduced. It was found that the proposed ERA methodology leads to improved accuracy in dispersion results, steeper overpressure exceedance curves and a significant reduction in the Design Accidental Load (DAL) values whilst still maintaining some conservatism and also reducing the total time required to perform an ERA study.     

五氟苄基羟胺衍生与GC/MS联用分析大气中的单羰基化合物和多羰基化合物

利用涂布五氟苄基羟胺（PFBHA）的Tenax-TA作为固体吸附剂,采取主动采样的方式采集大气中羰基化合物,再经溶剂洗脱和氮吹浓缩后用气相色谱/质谱（GC/MS）分析,成功检测到14种单羰基化合物和2种二羰基化合物（乙二醛与甲基乙二醛）.研究表明：在吸附剂的装载量为50mg的前提下,当衍生剂的涂布量为260nmol,采集流速为50mL·min^-1时,采集效果最佳.羰基化合物的检测限、平行样的相对标准偏差和样品的加标回收率范围分别为0.54～3.83ng·m^-3、1.0%～14.2%、89.2%～113.8%.该方法在实际大气样品中合适的采样时间为0.5～8.0h.利用此法对上海市宝山区大气中羰基化合物进行了检测,成功检测到16种羰基化合物,且具有明显的日变化趋势.