Percutaneous laser ablation under ultrasound guidance for fetal hyperechogenic microcystic lung lesions with hydrops: a single center cohort and a literature review

Objective To evaluate the perinatal outcomes in hydropic fetuses with congenital microcystic pulmonary lesions that underwent percutaneous, invasive, laser therapy. Method This retrospective study reviews the literature and our experience between 2004 and 2010. Characteristics of the cystic lung lesions, liquor volume (presence of polyhydramnios or not), localization of ablation (vascular vs interstitial) and gestational age at which the procedure was performed were related to outcome (survival). Results In total, 16 fetuses with congenital lung lesions underwent invasive percutaneous laser ablation, seven performed in our center and nine published cases. Survival rate was higher in fetuses with a subsequent postnatal diagnosis of bronchopulmonary sequestration (87.5%) compared with congenital adenomatoid malformation (28.6%; p?=?0.04). The technique of vascular ablation was more successful (100%) than interstitial ablation (25.0%, p?<?0.01). Conclusion Percutaneous vascular laser ablation seems to be effective for bronchopulmonary sequestration in hydropic fetuses. Outcomes were worst following interstitial ablation for microcystic congenital adenomatoid with hydrops. (C) 2012 John Wiley & Sons, Ltd.

Perforated corneal hydrops treated with sulfur hexafluoride (SF6) gas and tissue adhesive

Purpose: To report a case of a perforated acute hydrops in a mentally retarded patient that was successfully managed with intracameral sulfur hexafluoride gas and cyanoacrylate tissue adhesive. Methods: Interventional case report. Results: A 14-year-old mentally retarded male patient with keratoconus presented with a perforated acute hydrops. A bandage contact lens was applied. However, following a large emesis 2 days later, the aqueous leak worsened with shallowing of the anterior chamber. Under general anesthesia, sulfur hexafluoride was injected to reform the anterior chamber and cyanoacrylate tissue adhesive was applied to the perforated site and covered by a bandage contact lens and temporary tarsorrhaphy. A follow-up examination at 1 month showed a formed anterior chamber with tissue adhesive in situ and no aqueous leak. Conclusions: The successful use of intracameral sulfur hexafluoride and tissue adhesive in the management of perforated acute hydrops may avoid emergency tectonic penetrating keratoplasty and reduce potential complications in the poorly cooperative patient.

Human parvovirus infections during pregnancy : Special reference to the child-care employees

Human parvovirus B19 (B19V) is known to cause anemia, hydrops fetalis, and fetal death especially during the first half of pregnancy. Women who are in occupational contact with young children are at increased risk of B19V infection. The role of the recently discovered human parvovirus, human bocavirus (HBoV), in reproduction is unknown. The aim of this research project was to establish a scientific basis for assessing the work safety of pregnant women and for issuing special maternity leave regulations during B19V epidemics in Finland. The impact of HBoV infection on the pregnant woman and her fetus was also defined. B19V DNA was found in 0.8% of the miscarriages and in 2.4% of the intrauterine fetal death (IUFD; fetal death after completed 22 gestational weeks). All control fetuses (from induced abortions) were B19V-DNA negative. The findings on hydropic B19V DNA-positive IUFDs with evidence of acute or recent maternal B19V infection are in line with those of previous Swedish studies. However, the high prevalence of B19V-related nonhydropic IUFDs noted in the Swedish studies was mostly without evidence of maternal B19V infection and was not found during the third trimester. HBoV was not associated with miscarriages or IUFDs. Almost all of the studied pregnant women were HboV-IgG positive, and thus most probably immune to HBoV. All preterm births, perinatal deaths, smallness for gestational age (SGA) and congenital anomaly were recorded among the infants of child-care employees in a nationwide register-based cohort study over a period of 14 years. Little or no differences in the results were found between the infants of the child-care employees and those of the comparison group. The annual B19V seroconversion rate was over two-fold among the child-care employees, compared to the women in the comparison group. The seropositivity of the child-care employees increased with age, and years from qualification/joining the trade union. In general, the child-care employees are not at increased risk for adverse pregnancy outcome. However, at the population level, the risk of rare events, such as adverse pregnancy outcomes attributed to infections, could not be determined. According to previous studies, seronegative women had a 5 10% excess risk of losing the fetus during the first half of their pregnancy, but thereafter the risk was very low. Therefore, an over two-fold increased risk of B19V infection among child-care employees is considerable, and should be taken into account in the assessment of the occupational safety of pregnant women, especially during the first half of their pregnancy.

Resultado postnatal de fetos con malformación adenomatoide quística pulmonar en la unidad maternofetal Clínica Colombia

Introducción La Malformación Adenomatoide Quística Pulmonar es una patología que se desarrolla durante estadíos tempranos de desarrollo embriológico y su pronóstico depende del tamaño de la lesión pulmonar. Existen muy pocos estudios que caractericen esta patología, ninguno en nuestro país. Metodología Se realizó una serie de casos para describir el resultado postnatal de los casos registrados en la Clínica Colombia entre 2005 hasta 2013. Resultados: Se incluyeron un total de 20 casos. La malformación más frecuente fue MAQ III con 45% de los casos, de localización izquierda (75%), el 65% nacieron después de la semana 35 y con un peso mayor de 2500 g. Tan solo 30 % desarrollaron hidrops asociado. Hubo una mortalidad de 35% (7 casos). Discusion La MAQ es un patología infrecuente que genera una alta morbimortalidad en la vida perinatal. Se requieren estudios con muestras más amplias para determinar los factores pronósticos para la ocurrencia de los desenlaces adversos como la necesidad de cirugía de urgencia, deterioro respiratorio o mortalidad.

Three-Dimensional Ultrasonographic Assessment of Fetal Total Lung Volume as a Prognostic Factor in Primary Pleural Effusion

Objectives-The purpose of this study was to predict perinatal outcomes using fetal total lung volumes assessed by 3-dimensional ultrasonography (3DUS) in primary pleural effusion.Methods-Between July 2005 and July 2010, total lung volumes were prospectively estimated in fetuses with primary pleural effusion by 3DUS using virtual organ computer-aided analysis software. The first and last US examinations were considered in the analysis. The observed/expected total lung volumes were calculated. Main outcomes were perinatal death (up to 28 days of life) and respiratory morbidity (orotracheal intubation with mechanical respiratory support >48 hours).Results-Twelve of 19 fetuses (63.2%) survived. Among the survivors, 7 (58.3%) had severe respiratory morbidity. The observed/expected total lung volume at the last US examination before birth was significantly associated with perinatal death (P < .01) and respiratory morbidity (P < .01) as well as fetal hydrops (P < .01) and bilateral effusion (P = .01).Conclusions-Fetal total lung volumes may be useful for the prediction of perinatal outcomes in primary pleural effusion.

História natural e ecologia das serpentes da Floresta Nacional de Caxiuanã e áreas adjacentes, Pará, Brasil

A busca por padrões de estrutura e composição das comunidades é essencial para prover informações que permitam o manejo sustentado de populações e monitoramento de atividades antrópicas. Na região neotropical, onde ocorre grande riqueza de espécies e complexas relações ecológicas entre elas, estudos envolvendo ofidiofauna ainda são escassos, o que faz com que o entendimento dos processos responsáveis pela estruturação de suas comunidades ainda seja incipiente. No Brasil, vários trabalhos foram desenvolvidos na tentativa de explicitar os fenômenos responsáveis pelos padrões de ocorrência e interações das espécies de serpentes. Objetivando esclarecer quais os fatores que determinam os padrões observados e que afinidades (ecológicas e/ou históricas) as espécies compartilham, foi realizado estudo da taxocenose de serpentes da FLONA de Caxiuanã e áreas adjacentes, durante os anos de 2005 e 2006. Utilizou-se conjuntamente quatro métodos de amostragem (Procura Limitada por Tempo-PLT, Encontros Ocasionais-EO, Armadilhas de Interceptação e Queda-AIQ e Coletas por Terceiros-CT), em cinco áreas (IBAMA e Caquajó, no interior da FLONA de Caxiuanã; Enseada e dois pontos com influência antrópica: Marinaú e Mojuá, estando esses três últimos localizados em áreas adjacentes à FLONA. Foram registrados 378 espécimes distribuídos em cinco famílias, 35 gêneros e 50 espécies. Com os novos registros obtidos nesse estudo, o número de espécies de serpentes para a FLONA de Caxiuanã e áreas adjacentes passa de 63 para 69. Os métodos que apresentaram melhor desempenho em número de indivíduos foram PLT (199/378) e CT (159/378). EO (11/378) e AIQ (9/378) foram os métodos menos eficazes. A riqueza estimada (Jackknife 1), a partir de dados obtidos através de PLT, foi de 56 (+ ou – 4) espécies. O número de espécies estimado para as áreas preservadas foi maior que para áreas antropizadas. A composição das espécies de serpentes da área estudada apresentou maior similaridade com outras taxocenoses de áreas amazônicas. As espécies mais abundantes, acessadas através de PLT, foram Imantodes cenchoa, Corallus hortulanus e Leptodeira annulata. Quando todos os métodos foram considerados, Bothrops atrox, Imantodes cenchoa e Corallus hortulanus foram as espécies mais representadas. As áreas mais antropizadas, localizadas fora da FLONA (Marinaú e Mojuá), apresentaram menores abundância e riqueza de espécies em comparação com áreas protegidas, localizadas no interior da FLONA. Nove espécies foram consideradas potencialmente especialistas: Lachesis muta (pequenos mamíferos), Atractus schach (minhocas), Dipsas catesbyi (moluscos - lesmas), Helicops trivitatus e Hydrops triangularis (peixes), Siphlophis compressus (lagartos), Xenopholis scalaris, Taeniophallus brevirostris (anfíbios anuros) e Tantilla melanocephala (centopéias). Os itens mais acessados foram “lagartos”, “anfíbios anuros” e “pequenos mamíferos”. Serpentes com hábitos primária ou exclusivamente diurnas prevaleceram na comunidade analisada. A ausência de sazonalidade reprodutiva foi característica da maioria das espécies e isso se deve, muito provavelmente, à pouca diferença na temperatura ao longo do ano. A taxocenose de serpentes da FLONA de Caxiuanã e áreas adjacentes está, basicamente, formada por grupos contendo espécies onde, em geral, hábitos diários e de dieta estão sobrepostos. Além dos diversos fatores ecológicos, também fatores históricos, como adaptações morfológicas das espécies, têm grande influência na composição da taxocenose analisada. A grande dificuldade na realização de estudos de comunidades de serpentes está na escassez de dados das espécies, portanto torna-se imperioso que estudos de Ecologia e História Natural continuem sendo exaustivamente conduzidos em uma mesma localidade, objetivando a elucidação dos padrões de respostas aos diversos fatores relacionados à existência das espécies nos diferentes biomas.

Three-Dimensional Ultrasonographic Assessment of Fetal Total Lung Volume as a Prognostic Factor in Primary Pleural Effusion

Objectives-The purpose of this study was to predict perinatal outcomes using fetal total lung volumes assessed by 3-dimensional ultrasonography (3DUS) in primary pleural effusion. Methods-Between July 2005 and July 2010, total lung volumes were prospectively estimated in fetuses with primary pleural effusion by 3DUS using virtual organ computer-aided analysis software. The first and last US examinations were considered in the analysis. The observed/expected total lung volumes were calculated. Main outcomes were perinatal death (up to 28 days of life) and respiratory morbidity (orotracheal intubation with mechanical respiratory support >48 hours). Results-Twelve of 19 fetuses (63.2%) survived. Among the survivors, 7 (58.3%) had severe respiratory morbidity. The observed/expected total lung volume at the last US examination before birth was significantly associated with perinatal death (P < .01) and respiratory morbidity (P < .01) as well as fetal hydrops (P < .01) and bilateral effusion (P = .01). Conclusions-Fetal total lung volumes may be useful for the prediction of perinatal outcomes in primary pleural effusion.

Molecular analysis of aquaporin genes 1 to 4 in patients with Menière's disease

Menière's Disease (MD) is an episodic cochleovestibular dysfunction of unknown etiology, still lacking a specific test and therapy. The proposed theories on the pathophysiology include genetic factors and factors relating to inner ear homeostasis. Various aquaporins (AQP), water channels, expressed in the inner ear and the vestibular organ, are involved in homeostasis. Mutations in AQP genes could result in disturbed inner ear homeostasis and endolymphatic hydrops, and therefore be involved in the pathogenesis of MD. Aim: To search for mutations in AQP1 to 4 in patients suffering from MD.

Pulmonary hypoplasia and anasarca syndrome in Cika cattle

BACKGROUND: Hydrops foetalis is defined as excessive fluid accumulation within the foetal extravascular compartments and body cavities. It has been described in human and veterinary medicine, but despite several descriptive studies its aetiology is still not fully clarified. Pulmonary hypoplasia and anasarca (PHA) syndrome is a rare congenital abnormality in cattle that is characterised by hydrops foetalis including extreme subcutaneous oedema (anasarca) and undeveloped or poorly formed lungs (pulmonary hypoplasia). Until now, sporadic cases of PHA were reported in cattle breeds like Australian Dexter, Belted Galloway, Maine-Anjou, and Shorthorn. This report describes the first known cases of PHA syndrome in Slovenian Cika cattle. CASE PRESENTATION: A 13-year-old cow aborted a male calf in the seventh month of pregnancy, while a male calf was delivered by caesarean section on the due date from a 14-year-old cow. The pedigree analysis showed that the calves were sired by the same bull, the dams were paternal half-sisters and the second calf was the product of a dam-son mating. Gross lesions were similar in both cases and characterized by severe anasarca, hydrothorax, hydropericardium, ascites, hypoplastic lungs, absence of lymph nodes, and an enlarged heart. The first calf was also athymic. Histopathology of the second affected calf confirmed severe oedema of the subcutis and interstitium of the organs, and pulmonary hypoplasia. The lymph vessels in the subcutis and other organs were severely dilated. Histopathology of the second calf revealed also lack of bronchus associated lymphoid tissue and adrenal gland hypoplasia. CONCLUSIONS: The findings were consistent with known forms of the bovine PHA syndrome. This is the first report of the PHA syndrome occurring in the local endangered breed of Cika cattle. Observed inbreeding practice supports that this lethal defect most likely follows an autosomal recessive mode of inheritance. In the light of the disease phenotype it is assumed that a mutation causing an impaired development of lymph vessels is responsible for the hydrops foetalis associated malformations in bovine PHA.

Osmotischer Druck und Ionenlehre in den medicinischen Wissenschaften. : Zugleich Lehrbuch physikalisch-chemischer Methoden /

Bd. I. Physikalisch-chemische Grundlagen und Methoden. Die Beziehungen zur Physiologie und Pathologie des Blutes.--Bd. II. Circulirendes Blut. Lymphbildung. Hydrops. Resorption. Harn und sonstige Secrete. Elektrochemische Aciditätsbestimmung. Reactions-Verlauf.--Bd. III. Isolirte Zellen. Colloide und Fermente. Muskel- und Nervenphysiologie. Ophtalmologie. Geschmack. Embryologie. Pharmakologie. Balneologie. Bacteriologie. Histologie.

Keratoconus:a review

Keratoconus is the most common primary ectasia. It usually occurs in the second decade of life and affects both genders and all ethnicities. The estimated prevalence in the general population is 54 per 100,000. Ocular signs and symptoms vary depending on disease severity. Early forms normally go unnoticed unless corneal topography is performed. Disease progression is manifested with a loss of visual acuity which cannot be compensated for with spectacles. Corneal thinning frequently precedes ectasia. In moderate and advance cases, a hemosiderin arc or circle line, known as Fleischer's ring, is frequently seen around the cone base. Vogt's striaes, which are fine vertical lines produced by Descemet's membrane compression, is another characteristic sign. Most patients eventually develop corneal scarring. Munson's sign, a V-shape deformation of the lower eyelid in downward position; Rizzuti's sign, a bright reflection from the nasal area of the limbus when light is directed to the limbus temporal area; and breakages in Descemet's membrane causing acute stromal oedema, known as hydrops, are observed in advanced stages. Classifications based on morphology, disease evolution, ocular signs and index-based systems of keratoconus have been proposed. Theories into the genetic, biomechanical and biochemical causes of keratoconus have been suggested. Management varies depending on disease severity. Incipient cases are managed with spectacles, mild to moderate cases with contact lenses and severe cases can be treated with keratoplasty. This article provides a review on the definition, epidemiology, clinical features, classification, histopathology, aetiology and pathogenesis, and management and treatment strategies for keratoconus.