Diagnosis,surveillance, and treatment of the anemic fetus using middle cerebral artery peak systolic velocity measurement

The in utero course of the anemic fetus has improved dramatically, owing to early diagnosis and cordocentesis transfusion. In utero invasive procedures such as amnio- and cordocentesis have become important modalities in the evaluation and treatment of anemic fetuses. However, they carry risks for both the mother and fetus. A valid and sensitive noninvasive means of following the anemic fetus is the evaluation of changes in the middle cerebral artery peak systolic flow velocity (MCA-PSV). This is a sensitive tool for both the evaluation of fetal anemia and response to treatment. Intracerebral vessels respond earliest to the fetal anemic state, and are readily accessible for ultrasound examination. We describe the methodology and evolving clinical applications of MCA-PSV measurement in the fetus, through an overview of the literature describing the development and application of MCA-PSV measurement in fetuses at risk of fetal anemia of various immune and nonimmune etiologies, illustrated by index cases from our center. MCA-PSV measurement is essential in the diagnosis, evaluation, and management of cases of fetal anemia. The use of this modality lessens the need for invasive procedures. The method is readily accessible and should be integrated into the repertoire of all obstetric ultrasound centers. Copyright © 2006 John Wiley & Sons, Ltd.     

Cryptic 1p36.3/6q25.2 translocation in three generations ascertained through a foetus with IUGR and cerebral malformations

Here we describe a foetus with intrauterine growth retardation (IUGR), cerebral malformations and a 46,XY,der(1),t(1;6)(p36.3;q25.2) karyotype owing to a familial cryptic translocation segregating in three generations. A balanced translocation was present in the mother, the maternal uncle, the aunt and the grandmother. A female first cousin with dysmorphisms, hydrocephalus and mental retardation was a carrier of a partial trisomy 1p and a partial monosomy 6q. Multiple miscarriages were present in the family pedigree. Parents of the foetus had three other pregnancies: a male with a balanced translocation, and two foetuses with 1p36.3–pter monosomy and 6q25.2–qter trisomy. Copyright © 2003 John Wiley & Sons, Ltd.     

除虫菊酯和迷迭香对大鼠大脑突触体ATP酶的活性影响

除虫菊酯越来越广泛地被应用于农业和家庭昆虫防治,主要通过作用于膜结合蛋白而对动物起神经毒性.迷迭香因其抗氧化功能而被应用于很多商业化的除虫菊酯产品中.本实验以大鼠大脑突触体ATP酶为研究对象,对除虫菊酯和迷迭香的药理学进行了研究.用Percoll梯度离心法分离突触体,通过检测无机磷的量来测定总ATP酶和Mg2 -ATP酶活性.结果表明,除虫菊酯在浓度为10 μmol/L时总ATP酶和Mg2 -ATP酶分别降低到对照的80.3%和46.9%.迷迭香在浓度为0.3～30 μmol/L时几乎不影响ATP酶活性,当浓度上升到3 000 μmol/L时,总ATP酶活性降低到66.8%,而Mg2 -ATP酶活性降低到54.5%. 10 μmol/L 除虫菊酯和30 μmol/L迷迭香混合物引起总ATP酶和Mg2 -ATP酶分别降低到72.9%和33.4%.结论: 1) 除虫菊酯能抑制大鼠大脑ATP酶活性; 2) 迷迭香只在高浓度下才对ATP酶有抑制作用; 3) 迷迭香能增强除虫菊酯对ATP酶的抑制作用.图3参19     

重症脑挫伤患者气管切开护理

总结了70例重症脑挫伤行气管切开术后,可出现的相关问题,采取相应的护理措施．重点加强人工道气管导管护理,气道湿化、吸痰护理、气管切口护理等,减少气管切开的并发症,降抵重症脑患者死亡率．参6．     

Fetal gastroschisis associated with monosomy 22 mosaicism and absent cerebral diastolic flow

A case of fetal gastroschisis associated with 45,XY, —22/46.XY mosaicism and absent cerebral diastolic flow is described. This is the third case reported of monosomy 22 mosaicism, and the first one to be diagnosed antenatally.     

Post-natal investigations: management and prognosis for fetuses with CNS anomalies identified in utero excluding neurosurgical problems

The suspicion of an abnormality of the central nervous (CNS) system raises difficult questions for the clinician and the family and will inevitably lead to considerable anxiety. These questions include what it means for the child's future, whether it can be treated and whether it will happen again in subsequent pregnancies. For many disorders accurate prenatal diagnosis remains elusive, as even with fetal magnetic resonance imaging (MRI), early recognition and characterisation are simply not possible because of the immature state of brain development at that stage of pregnancy. The natural history of many prenatally diagnosed CNS disorders remains to be elucidated which means that an accurate prognosis cannot be given in all cases. We review the current state of knowledge regarding the investigation, management and prognosis of the most common and important CNS malformations. We also discuss the post-natal management of these conditions both in the neonate and subsequent pregnancies for the families. Copyright © 2009 John Wiley & Sons, Ltd.