The significance of fetal ventriculomegaly: etiology,short- and long-term outcomes

Fetal cerebral ventriculomegaly (VM) is diagnosed when the width of one or both ventricles, measured at the level of the glomus of the choroid plexus (atrium), is ≥ 10 mm. VM can result from different processes: abnormal turnover of the cerebrospinal fluid (CSF), neuronal migration disorders, and destructive processes. In a high percentage of cases, it is associated with structural malformations of the central nervous system (CNS), but also of other organs and systems. The rate of associated malformations is higher (≥60%) in severe VM (>15 mm) and lower (10–50%) in cases of borderline VM (10–15 mm). When malformations are not present, aneuploidies are found in 3–15% of borderline VM; the percentage is lower in severe VM. The neurodevelopmental outcome of isolated VM is normal in > 90% of cases if the measurement of ventricular width is between 10 and 12 mm; it is less favorable when the measurement is > 12 mm. Copyright © 2009 John Wiley & Sons, Ltd.     

Management of red cell alloimmunisation in pregnancy: the non-invasive monitoring of the disease

Haemolytic disease of the fetus and newborn (HDFN) due to red cell alloimmunization was a significant cause of fetal and neonatal morbidity and mortality until the introduction of anti-D immunoglobulin, which has dramatically changed the incidence of the disease. However, it is still a major problem in affected pregnancies. The emphasis of current clinical management has shifted from an invasive approach to non-invasive monitoring of the disease. The key elements of the modern management are determining which fetuses are at risk of HDFN with the use of cell-free fetal DNA in maternal plasma (fetal RHD genotype) and the follow-up of antigen positive fetuses by Doppler ultrasonography to detect anaemia severe enough to need treatment. When anaemia is suspected, an invasive approach is still required in a timely manner for confirmation of the degree of anaemia and to administer blood transfusions. This non-invasive approach prevents unnecessary administration of human-derived blood products, with the consequent ethical and cost implications and most importantly avoids iatrogenic conversion of mild to severe disease by avoiding need for techniques such as amniocentesis. The potential problem of the non-invasive approach is the reduction in the total number of invasive procedures, with the subsequent difficulty of maintaining the skills required to perform them. Copyright © 2010 John Wiley & Sons, Ltd.     

甲基汞诱导大鼠大脑皮层c-JUN蛋白表达

应用免疫组织化学方法研究了甲基汞对大鼠大脑皮层c-JUN蛋白表达的影响.结果表明,各暴露组极显著诱导大鼠大脑皮层c-JUN蛋白表达,在0.05mg/kg MMC暴露20min时汞在脑中的蓄积量与对照组相比没有显著性差异,平均值均为0.0044mg/kg,而此时大鼠大脑皮层c-JUN蛋白表达与对照组相比有显著差异,甲基汞对大鼠大脑皮层c-JUN蛋白表达与其浓度之间有一定的剂量-效应关系;即刻早期基因(c-jun)参与了甲基汞对大脑皮层损害的毒性过程,大鼠大脑皮层c-JUN蛋白表达可以作为甲基汞神经毒性的早期预报指标.