Prenatal diagnosis of congenital cystic adenomatoid malformation of the lung by fetal lung biopsy

A case of type III congenital cystic adenomatoid malformation of the lung was successfully diagnosed prenatally by fetal lung biopsy. We performed this procedure at 22 weeks of gestation, using a biopsy gun system under ultrasound guidance. The pregnancy was undisturbed by the procedure but as the condition was incompatible with life, an abortion was performed. The diagnosis was confirmed at post-mortem examination. Fetal lung biopsy appears to be a useful method for prenatal diagnosis of fetal lung disorders.     

Greening the Fife Economy: Ecological Modernization as a Pathway for Local Economic Development

Progress in the greening of UK local government has been hampered by uncertainty about the relationship between resource use and environmental protection. Ecological modernizationmay offer the most appropriateparadigm to reconcile economic, social and environmentalinterpretationsof sustainability. The transition from corporate to strategic environmental management currently being attempted by some 'green' authorities can be construed as an attempt to promote ecological modernization in the form of institutional learning. Fife Council in Scotland provides an interesting case study. Progress with corporate environmental management has become bound up with a radical devolution of decision making. Efforts to link the authority's Sustainable Development Policy to a Local Agenda 21 programme have been initiated with the piloting of sustainability indicators.     

Site characteristics,growth and nutrition of natural red pine stands in newfoundland

Red pine (Pinus resinosa Ait.) is rare (< 15 000 mature trees) in Newfoundland and is known from only 22 locations in the central region. Red pine occupies 3 major site types in Newfoundland: 1) red pine on medium-textured sands (RP1), 2) red pine on coarse-textured glaciofluvial deposits (RP2), and 3) red pine on Folisols over bedrock (RP3). The succession of red pine site types after cutting is from red pine to Kalmia-black spruce (Picea mariana (Mill.) B.S.P.) for RP1, and to Cladonia-Kalmia-black spruce for types RP2 and RP3. Succession after fire is usually to the pre-fire type, but this depends on the severity of the fire.Although occupying a relatively poor site, red pine at 60–70 years reaches heights in excess of 18 m, dbh in excess of 40 cm, and individual tree volumes greater than 1 m³ were recorded in 75 stemanalyzed fire-killed trees. Black spruce on that same site produces less than one-third that volume in 60 years. Merchantable volume of 140–280 m³ ha^-1 were recorded i.e., Canada Land Inventory (CLI) forest capability class 5 and class 4 ratings. This raises the CLI rating two capability classes if red pine were occupying these poor quality sites over black spruce. In terms of nutrition, even the best growing red pine are nitrogen (N) deficient as shown by foliar analysis. All natural stands have foliar N concentrations below 1.3% which is the critically low level shown in the literature. Immediately after fire, foliar concentrations reach this level but are usually about 1% or less. Most other nutrients are low but are within the generally reported adequate levels in testing for P, K, Ca and Mg.Fire influences soil nutrient availability as pH increases in the RP1 type. Burning temperature also affects soil pH and the understory vegetation. The RP2 type loses more N in hotter burns on this site type and more N is tied up in these ortstein hardpan soils. The pattern of regeneration following wildfire is related to slope, density, age and species mixture of the stand as well as the thickness and composition of the duff layer.     

Effects of clearfelling on stream and soil water aluminium chemistry in three UK forests

Data are presented demonstrating how clearfelling has changed soil and stream water aluminium chemistry. For soil waters, a strong empirical relationship was observed between inorganic aluminium (Al(inorg)) and total inorganic anion (TIA) concentrations. Before felling, chloride and sulphate accounted for the largest proportion of the TIA concentration. After felling, in soils where nitrification was active, nitrate became increasingly important. Where this led to an increase in TIA, Al(inorg) concentrations increased. Over five years, nitrate concentrations have fallen, along with TIA, resulting in a sympathetic decline in Al(inorg). Streams draining clearfelled areas initially became more acid, although chloride and sulphate concentrations decreased. Stream water nitrate concentrations increased soon after felling and remained higher than controls for up to four years. While nitrate concentrations were high, Al(inorg) remained unchanged. Subsequently, as nitrate and TIA decreased, Al(inorg) also declined to concentrations below those in the control stream. Clearfelling upland forests will not necessarily result in immediate improvements in water quality, although long-term benefits may be seen before canopy-closure of the next crop.     

Development of Ecological Land Classification and mapping in support of forest management in northern Newfoundland,Canada

For the sustainable development of forest land, as recently prescribed by the Canadian Forest Strategy, a land classification project in northern Newfoundland was initiated to support the local forest management activities. The method adopted here is a modification of the Canadian Committee for Ecological Land Classification's (CCELC) system, and it applies various levels of mapping to uniform areas based on geomorphology, soils, vegetation, climate, water, and fauna.In this study, all CCELC levels were mapped; resulting maps were digitized and imported into a Geographic Informations System (GIS). The GIS data base contained the following maps: 1) digital terrain model, 2) bedrock geology, 3) surficial geology, 4) forest inventory, and 5) various levels of the ecological land classification, including Vegetation Types at the lowest level. In addition to the mapping, mensurational data were analyzed to provide stand and stock tables for each of the forest types, including growth curves that could be entered into specific forest growth modelling systems to predict wood supply scenarios based upon different management interventions.     

Detecting neural tube defects by amniocentesis between 11 and 15 weeks' gestation

Forty-two open neural tube defects (NTDs) were identified in our series of 7440 amniocenteses tested between 11 and 15 weeks of gestation. Using a cut-off of ≥2.0 MOM, the detection rate for open NTDs was 95 per cent; 100 per cent each for anencephaly and spina bifida; and 78 per cent for encephalocele. Two encephaloceles had AFP levels less than 2.0 MOM and negative AChEs. Thirty-four (81 per cent) of these NTDs were tested between 13 and 15 weeks and 8 (19 per cent) before 13 weeks. There were 0.6 per cent false positives by AFP (excluding serious abnormalities and fetal death) and 0.1 per cent after AChE. The likelihood of an open NTD after an elevated AFP (≥2.0 MOM) was 24 and 77 per cent for any serious abnormality. These results, when combined with an earlier study, indicate that amniotic fluid AFP appears to be as sensitive a test for open NTDs between 13 and 15 weeks as between 16 and 20 weeks. Additional experience is necessary to determine this before 13 weeks.     

Prenatal diagnosis of herlitz junctional epidermolysis bullosa by amniocentesis

Herlitz junctional epidermolysis bullosa (HJEB) is a severe blistering disorder which usually results in death during infancy. We have previously shown that the anchoring filament protein laminin-5 (kalinin/nicein), which mediates keratinocyte attachment and dermal–epidermal cohesion, is abnormally expressed in individuals with HJEB. Laminin-5 was detected by Western blot analysis in amniotic fluid from 44 consecutive normal secondtrimester control pregnancies, but was undetectable in second-trimester amniotic fluid from four pregnancies with fetuses affected by HJEB. In one case of severe non-Herlitz JEB, laminin-5 was detected in both amniotic fluid and skin. In human amniotic fluid, the laminin-5 a3 subunit was processed to a major 165 kD species and a minor 145 kD species and the β2 subunit was partially processed to 105 kD. Although laminin-5 was covalently associated with laminin-6 (K-laminin) in amniotic membrane, no covalent interaction was detected in amniotic fluid. Laminin-5 from amniotic fluid strongly supported keratinocyte attachment. These results suggest that Western blot analysis of second-trimester amniotic fluid is useful in determining the prenatal diagnosis of HJEB and that laminin-5 may serve a physiologically important function in amniotic fluid.     

Prenatal exclusion of stickler syndrome

Stickler syndrome is an autosomal dominant disorder of the connective tissue which includes ocular and systemic manifestations. We report on a large kindred in which we were able to demonstrate very tight linkage between the disease and the type II collagen gene (COL2A1) (LOD score 3·91 at θ=0). In a family in which the father and one of his daughters were severely affected, DNA analysis from a chorionic villus sample demonstrated that the fetus possessed the normal allele of COL2A1. Thereafter a normal child was born.     

Incremental cost-effectiveness of incorporating oestriol evaluation in down syndrome screening programmes

As screening for Down syndrome becomes increasingly sophisticated, it is important to evaluate the newer technologies in terms of their cost-effectiveness. One recent addition to Down syndrome screening programmes is maternal serum unconjugated oestriol (uE₃), especially when used in conjunction with maternal serum α-fetoprotein and human chorionic gonadotropin. Using assumptions used in a California proposal to justify an expanded screening programme for Down syndrome, we calculated both the average and the incremental cost-effectiveness of adding uE₃. Using the base case assumptions, including an $8 fee for the uE₃, the incremental cost-effectiveness of adding uE₃ to the proposed California programme is $119 100 per case detected, a value that compares favourably with other Down syndrome screening programmes. The sensitivity analysis supports this conclusion over a wide range of assumptions. However, because of the uncertainty with some key data, it is still too early to fully support the inclusion of uE₃ in Down syndrome screening programmes.