In utero diagnosis and treatment of fetal goitrous hypothyroidism,caused by maternal use of propylthiouracil

A fetal goitre is a potentially dangerous phenomenon because of mechanical obstruction and possible fetal thyroid function disorders. In this report we describe a patient with Graves' disease diagnosed in early pregnancy and treated with propylthiouracil, which resulted in a large fetal goitre and fetal hypothyroidism. The diagnostic problems are discussed and we focus on the need for fetal thyroid hormone serum evaluation. The only reliable way to obtain information about the fetal thyroid status is percutaneous fetal umbilical cord blood sampling, since amniotic fluid levels do not properly represent the fetal thyroid function. Fetal hypothyroidism can thus be diagnosed in utero and treated with intra-amniotic injections of thyroxine. The recommended dose and frequency of injections are only based on a few case reports and for that reason we performed a second fetal blood sampling 1 week later to evaluate our therapy. Weekly intra-amniotic injections of 250 μg of thyroxine seem to be sufficient to reduce a fetal goitre and give a normal thyroid hormone level.     

苯作业对工人血清白细胞介素-6肿瘤坏死因子影响的研究

目的 :探讨苯作业工人血清中细胞因子白细胞介素 -6(IL-6)、肿瘤坏死因子 (TNF)的变化及其意义。方法 :用放射免疫法 ,对不同工龄的苯作业工人血清中IL-6,TNF浓度进行检测 ,并同白细胞变化进行对照比较。结果 :接苯作业工人血清中IL-6 ,TNF较对照组有明显升高 (P<0.05,P<0.01) ,且这些变化在白细胞明显降低前即已发生。结论 :苯作业可致工人血清TNF,IL-6水平的增高 ,这对苯中毒的早期诊断有一定意义。     

Deferoxamine pretreatment inhibits metal neurotoxicity in Caenorhabditis elegans

Neurodegenerative diseases are increasingly common in humans. Alzheimer's disease (AD) is a neurodegenerative disease characterized by the presence of extracellular plaques containing β‐amyloid peptides and neurofibrillary tangles in the brains. Researchers have focused on the elucidation of a correlation between high concentrations of aluminum or iron (in the organism with observed neuropathology). The objective of this study was to evaluate the effects of aluminum and iron on the behavioral parameters (pharyngeal pumping and defecation cycle) of the nematode Caenorhabditis elegans pretreated with deferoxamine (DFX). Acetylcholinesterase (AChE) activity was evaluated as well. DFX is a chelant that is widely used for the treatment of metal toxicity, and it has a high affinity for aluminum and iron. The worms were pretreated with DFX, and then exposed to aluminum and iron. In the absence of DFX, aluminum exposure decreased pharyngeal pumping compared with that in the control group. The defecation cycle of the control was significantly different from that of the worms exposed to aluminum. In contrast, an increased defecation cycle was observed in worms exposed to iron without DFX pretreatment. AChE activity increased in aluminum‐exposed groups that received DFX pretreatment compared with those that did not receive pretreatment. These results suggest that pretreatment with DFX is effective in reducing metal toxicity, particularly with reference to AChE activity, which did not decrease in groups that did not receive DFX pretreatment.     

Organ targeted prenatal gene therapy—how far are we?

Prenatal gene therapy aims to deliver genes to cells and tissues early in prenatal life, allowing correction of a genetic defect, before long-term tissue damage has occurred. In contrast to postnatal gene therapy, prenatal application can target genes to a large population of dividing stem cells, and the smaller fetal size allows a higher vector-to-target cell ratio to be achieved. Early-gestation delivery may allow the development of immune tolerance to the transgenic protein which would facilitate postnatal repeat vector administration if needed. Targeting particular organs will depend on manipulating the vector to achieve selective tropism and on choosing the most appropriate gestational age and injection method for fetal delivery. Intra-amniotic injection reaches the skin, and other organs that are bathed in the fluid however since gene transfer to the lung and gut is usually poor more direct injection methods will be needed. Delivery to the liver and blood can be achieved by systemic delivery via the umbilical vein or peritoneal cavity. Gene transfer to the central nervous system in the fetus is difficult but newer vectors are available that transduce neuronal tissue even after systemic delivery. Copyright © 2011 John Wiley & Sons, Ltd.     

Trophic Cascades Following the Disease‐Induced Decline of an Apex Predator,the Tasmanian Devil

As apex predators disappear worldwide, there is escalating evidence of their importance in maintaining the integrity and diversity of the ecosystems they inhabit. The largest extant marsupial carnivore, the Tasmanian devil (Sarcophilus harrisii) is threatened with extinction from a transmissible cancer, devil facial tumor disease (DFTD). The disease, first observed in 1996, has led to apparent population declines in excess of 95% in some areas and has spread to more than 80% of their range. We analyzed a long‐term Tasmania‐wide data set derived from wildlife spotlighting surveys to assess the effects of DFTD‐induced devil decline on populations of other mammals and to examine the relative strength of top–down and bottom–up control of mesopredators between 2 regions with different environmental conditions. Collection of the data began >10 years before DFTD was first observed. A decrease in devil populations was immediate across diseased regions following DFTD arrival, and there has been no indication of population recovery. Feral cats (Felis catus) increased in areas where the disease was present the longest, and feral cat occurrence was significantly and negatively associated with devils. The smallest mesopredator, the eastern quoll (Dasyurus viverrinus), declined rapidly following DFTD arrival. This result suggests the species was indirectly protected by devils through the suppression of larger predators. Rainfall deficiency was also a significant predictor of their decline. Environmental variables determined the relative importance of top–down control in the population regulation of mesopredators. In landscapes of low rainfall and relatively higher proportions of agriculture and human settlement, top–down forces were dampened and bottom–up forces had the most effect on mesopredators. For herbivore prey species, there was evidence of population differences after DFTD arrival, but undetected environmental factors had greater effects. The unique opportunity to assess population changes over extensive temporal and spatial scales following apex predator loss further demonstrated their role in structuring ecosystems and of productivity in determining the strength of top–down control. Cascadas Tróficas Después de la Declinación Inducida por Enfermedad de un Depredador Apical, el Demonio de Tasmania     

大同市某医院放疗装置环境辐射调查

大同市环境监察支队对大同市某医院医用电子直线加速器及近距离遥控后装机工作场所及其周围环境辐射水平进行了调查。表明，加速器及近距离遥控后装机室内X、γ辐射剂量率，在关机或开机状态下监测结果变化不明显，基本在本底范围内。加速器及近距离遥控后装机室外X、γ辐射剂量率范围接近1987年“全国放射性水平调查”的天然贯穿辐射剂量平均值；屋顶X、γ辐射剂量率监测结果也居正常本底水平。     

Recurrent congenital toxoplasmosis in a woman with lupus erythematosus

We describe the case of a patient with systemic lupus erythematosus, treated by corticosteroids, who presented during two successive pregnancies with serological reactivation of toxoplasmosis associated with fetal lesions. The first infected fetus died in utero with signs of hydrops. The second fetus was treated in utero with a combination of sulfadoxine and pyrimethamine, administered to the mother, and is now well. The increasing number of immunocompromised pregnant patients with immunity to Toxoplasma gondii may lead to a higher risk of reactivation of maternal toxoplasmosis and congenital infection.