The OEIS complex: two case reports that illustrate the spectrum of abnormalities and a review of the literature

We present two cases of OEIS (omphalocele, exstrophy, imperforate anus, spinal defects) complex -MIM 258040 and a review of the literature. Case 1 was a 14-year-old girl who presented at 30 weeks' gestation. An ultrasound examination showed an omphalocele and spina bifida; the bladder was not visualised. She went into spontaneous labour two weeks later and the baby died shortly after birth. A full post-mortem examination was refused, but the mother did agree to an external examination, skin biopsy for fibroblast culture, X rays and MR imaging. The MR imaging showed a pelvic kidney, a large omphalocele containing the other kidney, liver, bowel and a fluid filled structure thought to represent an exstrophy of the bladder (EB). Case 2 was a 30-year-old woman who had an ultrasound examination at 20 weeks' gestation; this showed an omphalocele, but the bladder was not visualised. The pregnancy was subsequently terminated and a post-mortem examination showed a low set umbilical cord associated with a small omphalocele; there was an imperforate anus; a blind ending rectum terminated in the omphalocele. We conclude that these two cases illustrate the variability of the OEIS complex. Copyright © 2006 John Wiley & Sons, Ltd.     

Epidemiological and biomechanical evaluation of airline baggage handling

Objectives. Musculoskeletal disorders (MSDs) are prevalent among airline baggage handlers due to manual materials handling. In this study, the Nordic musculoskeletal questionnaire (NMQ), the revised National Institute for Occupational Safety and Health (NIOSH) lifting equation, and the University of Michigan 3D Static Strength Prediction Program? (3DSSPP) were used to analyze MSDs among baggage handlers. Methods. The NMQ was filled out by 209 baggage handlers and 46 arbitrarily selected baggage handlers were evaluated using the NIOSH method and 3DSSPP. Results. The obtained results showed that the most common MSDs occurred in the lower back region. The next risky regions included knees, neck, and upper back, respectively. The NIOSH results confirmed that the subjects lifted loads heavier than the permitted limit and their lifting postures were inappropriate. The results of the 3DSSPP also indicated that compression forces exceeded the NIOSH limit in these awkward postures. Conclusions. Relying on this study, holding compulsory ergonomic lifting training courses could be proposed for workers and regulations adjusting an upper limit for maximum baggage weight must be also enacted in order to improve occupational health and prevent the prevalence of increasing MSDs.     

浅析某型导爆索组件环境试验中的断裂问题

目的分析某型导爆索组件断裂问题产生的原因。方法采用平板试验件模拟实际使用状态,用于考核导爆索组件的环境适应性及分离功能。结果试验件中导爆索组件均出现了断裂,且存在三处明显磨痕,而且有一发平板试验件的辅助限位板出现了断裂。结论辅助限位板刚度不足,导致导爆索组件出现疲劳断裂,增加辅助限位板厚度,可有效提高其刚度,防止断裂问题产生。     

Pure fetal blood samples obtained by cordocentesis: Technical aspects of 322 cases

Three hundred and twenty-two percutaneous umbilical blood samplings were performed over 4 years in our prenatal diagnostic centre. A 3·5 MHz sector ultrasound transducer was used to guide a 22·5-gauge needle under local anaesthesia. Sampling was performed fcir rapid fetal karyotyping (within 72 h) in 120 cases, for diagnosis of fetal toxoplasmosis in 133 cases, for determination of the severity of Rh immunization in 15 cases, and for diagnosis of congenital rubella in 4 cases. Pure fetal blood was obtained in 98·7 per cent of the cases after two attempts. The approach to the cord was either transamniotic or trans-piacental. Puncturing was preferentially done at the placental insertion of the cord (72·2 per cent of the cases) and the mean blood sample volume was 3·5 ml. The rate of fetal death in utero was 1 9 per cent, including two cases of amnionitis, one trisomy 18, and one severe bradycardia. The failures were due to sampling at an early stage of pregnancy (before gestation week 18), to maternal obesity, oligohydramnios, and the inexperience of the operator.     

Early prenatal sonographic diagnosis of neuropathic arthrogryposis multiplex congenita with osseous heterotopia

A prenatal diagnosis of arthrogryposis multiplex congenita (AMC) has been carried out on a 19-week-old fetus by means of echography. The ultrasonographic characteristics were unnatural position of the four limbs associated with articular anomalies together with absence of active fetal movements. A therapeutic interruption of pregnancy was performed and the diagnosis was confirmed. At autopsy, architectural disorder of the motor neurons of the anterior medullary horn revealed a neuropathic pathogenesis of the arthrogryposis. Moreover, at the lumbar level the spinal cord was progressively replaced by heterotopic bony tissue which caused a more severe deformity of the lower limbs compared with the upper. The aspects of anatomo-pathological, genetic, and differential diagnosis are discussed showing the precocity of the prenatal diagnosis and the peculiarity of the aetiology of our case.     

Umbilical cord pseudocyst in trisomy 18

Prenatal diagnosis of cord defects by means of ultrasound examination is possible and highly accurate. Although this is a rare pathological finding, we report two cases in which umbilical cord pseudocysts were associated with trisomy 18. These observations underscore the need of umbilical blood sampling for establishing the karyotype in fetuses with such umbilical cord anomalies and the importance of careful examination of placentas and infants born with such defects.     

Associations between maternal phthalate exposure and cord sex hormones in human infants

It has been speculated that maternal phthalate exposure may affect reproductive development in human newborns. However, the mechanism awaits further investigation. The aim is to evaluate the association between maternal phthalate exposure and cord sex steroid hormones in pregnant women and their newborns from the general population. A total of 155 maternal and infant pair were recruited and analyzed. Levels of urinary phthalate metabolites and sex steroid hormones were determined using liquid chromatography/electrospray tandem mass spectrometry (LC-ESI-MS/MS) and radioimmunoassay (RIA), respectively. No significant correlation was found between each steroid hormones and phthalate metabolites for male newborns, except MMP was marginally significantly correlated with E₂. After adjusting for maternal age, estradiol (E₂) levels in cord serum from male newborns were not correlated with maternal urinary phthalate metabolites. In female newborns, the maternal urinary levels of mono-(2-ethylhexyl) phthalate (MEHP) and mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP) were negatively correlated with the free testosterone (fT) and fT/E₂ levels in cord serum with Pearson correlation coefficients ranging between −0.24 and −0.29 (p < 0.05). Additionally, after gestational age was adjusted, the maternal urinary level of DEHP was negatively correlated with the free testosterone (fT) and fT/E₂ levels in cord serum. We suggest that maternal exposure to phthalates may affect sex steroid hormones status in fetal and newborn stage.     

Umbilical cord blood mercury levels in China

Mercury (Hg) is a well-known neurotoxicant. Hg exposure at high levels can harm individuals of all ages. Even low level exposure to Hg can damage the brain of fetuses and young children, and affect their central nervous system and cognitive development. The aims of our study were to measure total Hg levels in infant umbilical cord blood and to investigate the risk factors associated with total Hg cord blood levels in various cities in China. Our goal was to provide clues for the prevention of Hg exposure in utero. The results indicated that the average cord blood mercury levels (CBMLs) were (1.81 ± 1.93) μg/L, which were lower than those found in most previous studies. The concentrations also differed according to geographic region. The CBMLs were not only associated with family economic and living conditions, but also with diet in pregnant women, especially the intake of marine fish, shellfish, poultry, formula milk and fruits.