Four-dimensional sonography in the assessment of fetal functional neurodevelopment and behavioral patterns

During the past few decades, morphological studies of fetal brains as well as ultrasonic imaging of fetal intrauterine activities in real time have provided invaluable information about the most important events in the development of human central nervous system. It has been shown that development of fetal brain proceeds through a sequence of complicated histogenetic processes, which are reflected in the fetal behavioral patterns. Major developmental events, such as the establishment of neural connections in different regions of the brain, are accompanied by the occurrence of new patterns of fetal activities or by the transformation of existing patterns. It has been suggested that the ultrasound assessment of fetal behavior could be used for the evaluation of the integrity of fetal central nervous system and, possibly, for the detection of functional or structural brain disorders. The new, advanced imaging techniques such as four-dimensional sonography might open a new perspective for the study of fetal behavioral patterns and facilitate the development of diagnostic strategies for early detection or prevention of brain dysfunctions. The importance of these investigations is underlined by the recent findings that many environmental influences causing the fetal stress can interfere with the fetal neurodevelopment and leave long-term and profound consequences on brain structure and function. The major events in the functional development of fetal brain, as well as the influence of environmental factors on fetal neurodevelopment, are discussed in this review.     

Diagnostic utility of whole exome sequencing in patients showing cerebellar and/or vermis atrophy in childhood

Cerebellar and/or vermis atrophy is recognized in various types of childhood disorders with clinical and genetic heterogeneity. Although careful evaluation of clinical features and neuroimaging can lead to correct diagnosis of disorders, their diagnosis is sometimes difficult because clinical features can overlap with each other. In this study, we performed family-based whole exome sequencing of 23 families including 25 patients with cerebellar and/or vermis atrophy in childhood, who were unable to be diagnosed solely by clinical examination. Pathological mutations of seven genes were found in ten patients from nine families (9/23, 39.1 %): compound heterozygous mutations in FOLR1, C5orf42, POLG, TPP1, PEX16, and de novo mutations in CACNA1A, and ITPR1. Patient 1A with FOLR1 mutations showed extremely low concentration of 5-methyltetrahydrofolate in the cerebrospinal fluid and serum, and Patient 6 with TPP1 mutations demonstrated markedly lowered tripeptidyl peptidase 1 activity in leukocytes. Furthermore, Patient 8 with PEX16 mutations presented a mild increase of very long chain fatty acids in the serum as supportive data for genetic diagnosis. The main clinical features of these ten patients were nonspecific and mixed, and included developmental delay, intellectual disability, ataxia, hypotonia, and epilepsy. Brain MRI revealed both cerebellar and vermis atrophy in eight patients (8/10, 80 %), vermis atrophy/hypoplasia in two patients (2/10, 20 %), and brainstem atrophy in one patient (1/10, 10 %). Our data clearly demonstrate the utility of whole exome sequencing for genetic diagnosis of childhood cerebellar and/or vermis atrophy.     

Elevated serum homocysteine level is not associated with serum C-reactive protein in patients with probable Alzheimer’s disease

Elevated plasma homocysteine (Hcy) levels have been associated with Alzheimer’s disease (AD) and cognitive impairment. Studies have shown that Hcy may have direct and indirect neurotoxicity effects. The aim of the study was to investigate serum Hcy concentration in patients with probable AD with age-matched controls and to determine whether there was an association between serum Hcy and C-reactive protein concentration in patients with probable AD. We also aimed to determine whether there was an association between serum tHcy concentration and cognitive impairment in patients with probable AD. Serum concentration of total Hcy was determined by the fluorescence polarization immunoassay on the AxSYM system, and serum C-reactive protein (CRP) concentration was determined by means of particle-enhanced immunonephelometry with the use of BN II analyzer. Cognitive impairment was tested by the MMSE score. Body mass index (BMI) was calculated for each subject included in the study. Age, systolic and diastolic blood pressure and BMI did not differ significantly between the two groups. Mean serum tHcy concentration in the control group of subjects was 12.60 μmol/L, while in patients with probable AD the mean serum tHcy concentration was significantly higher than 16.15 μmol/L (p < 0.01). A significant negative association between serum tHcy concentration and cognitive impairment tested by the MMSE score in patients with probable AD was determined (r = −0.61634; p < 0.001). Positive, although not significant correlation between CRP and serum tHcy concentrations in patients with AD, was observed. Increased tHcy concentration in patients with probable AD, and the established negative correlation between serum tHcy concentration and cognitive damage tested by MMSE score in the same group of patients, suggests the possible independent role of Hcy in the pathogenesis of AD and cognitive impairment associated with this disease.     

The different effects of vertical social capital and horizontal social capital on dental status: A multilevel analysis

Few studies distinguish between the effects of different forms of social capital on health and of those that do none use physical indicators of health as an outcome variable. The objective of this study was to determine whether vertical and horizontal social capital had different associations with dental status of elderly Japanese.     

Evaluation of the mechanical and chemical control of dental biofilm in patients with Down syndrome

Abstract – Objective: To evaluate the mechanical and chemical control of dental biofilm in patients with Down syndrome, using different experimental dentifrices. Material and Methods: Forty institutionalized children between ages 7 and 13 years in the mixed dentition phase participated in this study. An experimental cross‐over, blind clinical trial was used, having the following protocols: fluoridated dentifrice (protocol G1); fluoridated dentifrice + chlorhexidine (protocol G2); fluoridated dentifrice + chlorhexidine + plaque‐disclosing agent (protocol G3); and fluoridated dentifrice + plaque‐disclosing agent (protocol G4). Each experimental stage lasted 10 days with a 15‐day washout. The evaluated parameters were Plaque Index and gingival bleeding. Results: The initial clinical conditions between each stage were similar. Statistical differences were observed (P < 0.001) for the clinical conditions evaluated before and after the treatments. The dentifrices containing plaque‐disclosing agent, irrespective of their association with chlorhexidine, produced a greater reduction in the final plaque index. As for gingival bleeding, the dentifrice containing erythrosine and the one containing chlorhexidine produced similar results. The dentifrice containing an association of chlorhexidine and erythrosine gave the best results. Conclusion: With the methodology employed, it was possible to conclude that the combination of drugs (chlorhexidine, fluorine and erythrosine) within one dentifrice can be useful in controlling dental biofilm and in the reduction of gingival bleeding.     

Lipid-Laden Macrophages in Tracheal Aspirates of Newborn Infants Receiving Intravenous Lipid Infusions: A Cytologic Study

Seventy-four neonates with respiratory distress syndrome had cytologic study of tracheal aspirates. Thirteen, all of whom were receiving intravenous lipid and nothing orally had abundant macrophages with foamy cytoplasm, positive for intracytoplasmic lipid by Sudan black stain, in the tracheal aspiration specimens. Cytologic surveillance of tracheal aspiration specimens may be a useful method of monitoring infants receiving intravenous lipid infusions.     

UV-induced polymerization of maleimides in solution

Maleimide and N-ethylmaleimide were irradiated in various solvents with a high pressure mercury lamp at 30°C. The polymerization of maleimides is promoted in the presence of hydrogen donating solvents such as tetrahydrofuran, 1,4-dioxane, ethanol and basic solvents such as dimethylformamide, dimethyl acetamide, pyridine. ESR spectra suggest that a radical mechanism is responsible for the polymerization in the former solvents and an anionic mechanism in the latter solvents.