Sonographic features of female pelvic tuberculous peritonitis.

OBJECTIVE: The purpose of this study was to evaluate the sonographic features of tuberculous peritonitis in an attempt to facilitate the recognition of this disorder preoperatively. METHODS: The sonographic findings of 16 patients who had tuberculous peritonitis were reviewed. RESULTS: The sonographic findings showed that 14 of the 16 patients had ascites; 10 of these had fine, complete and incomplete mobile septations. Of these 10 patients, 4 had ascites with a latticelike appearance, and 2 had ascites with a parallel violin string appearance, which to our knowledge has not been described previously; 3 had particulate ascites. Peritoneal and omental thickening or nodules were identified in 9 patients. Two patients showed bilateral complex adnexal masses with multiloculated fluid with a thick wall-like tubo-ovarian abscess. CONCLUSIONS: Tuberculous peritonitis seems to have characteristic sonographic features, especially the findings of peritoneal and omental thickening and ascites with fine, mobile septations. These sonographic findings may provide valuable information to help with further investigations and may prevent unnecessary laparotomies.     

Detection of rare G3P[19] porcine rotavirus strains in Chiang Mai, Thailand, provides evidence for origin of the VP4 genes of Mc323 and Mc345 human rotaviruses

Among 175 fecal specimens collected from diarrheic piglets during a surveillance of porcine rotavirus (PoRV) strains in Chiang Mai, Thailand, 39 (22.3%) were positive for group A rotaviruses. Of these, 33.3% (13 of 39) belonged to G3P[19], which was a rare P genotype seldom reported. Interestingly, their VP4 nucleotide sequences were most closely related to human P[19] strains (Mc323 and Mc345) isolated in 1989 from the same geographical area where these PoRV strains were isolated. These P[19] PoRV strains were also closely related to another human P[19] strain (RMC321), isolated from India in 1990. The VP4 sequence identities with human P[19] were 95.4% to 97.4%, while those to a porcine P[19] strain (4F) were only 87.6 to 89.1%. Phylogenetic analysis of the VP4 gene revealed that PoRV P[19] strains clustered with human P[19] strains in a monophyletic branch separated from strain 4F. Analysis of the VP7 gene confirmed that these strains belonged to the G3 genotype and shared 97.7% to 98.3% nucleotide identities with other G3 PoRV strains circulating in the regions. This close genetic relationship was also reflected in the phylogenetic analysis of their VP7 genes. Altogether, the findings provided peculiar evidence that supported the porcine origin of VP4 genes of Mc323 and Mc345 human rotaviruses.     

Inducible nitric oxide synthase catalyzes ethanol oxidation to alpha-hydroxyethyl radical and acetaldehyde

The physiologic function of nitric oxide synthases, independent of the isozyme, is well established, metabolizing L-arginine to L-citrulline and nitric oxide (NO). This enzyme can also transfer electrons to O2, affording superoxide (O2*-) and hydrogen peroxide (H2O2). We have demonstrated that NOS1, in the presence of L-arginine, can biotransform ethanol (EtOH) to alpha-hydroxyethyl radical (CH3*CHOH). We now report that a competent NOS2 with l-arginine can, like NOS1, oxidize EtOH to CH3*CHOH. Once this free radical is formed, it is metabolized to acetaldehyde as shown by LC-ESI-MS/MS and HPLC analysis. These observations suggest that NOS2 can behave similarly to cytochrome P-450 in the catalysis of acetaldehyde formation from ethanol via the generation of alpha-hydroxyethyl radical when L-arginine is present.     

Cordocentesis in multifetal pregnancies

OBJECTIVE: To describe the experiences in diagnostic cordocentesis in twin pregnancies at midpregnancy METHODS: The database and medical records of pregnant women attending Maternal Fetal Medicine Unit of the hospital for diagnostic cordocentesis at midpregnancy between January 1989 and September 2006 were retrospectively reviewed. RESULTS: During 17 years of experience, 4,241 cordocenteses at midpregnancy were performed for prenatal diagnosis, including 59 procedures in 30 multiple pregnancies (29 twins and 1 triplet). The mean gestational age at the time of cordocentesis was 19.5 +/- 1.6 weeks. Success rate of the samplings was 98.3% with one sample was maternal blood contamination. Averaged-time used of the procedures was 8.2 minutes (range 1-45 minutes). The procedure-related complications included transient bleeding at puncture site (8.5%) and transient fetal bradycardia (22.0%). The total fetal loss rate was 10.5% but there was no cordocentesis-related fetal loss (0.0%), defined as a fetal loss within 2 weeks after the procedure. CONCLUSION: This study may provide a new insight on the safety of cordocentesis in multifetal pregnancies at midpregnancy. The procedure-related fetal loss is not as high as reported in the past. This study suggests cordocentesis be a relatively safe and highly successful in obtaining fetal blood samples.     

Effect of posture on creatinine clearance in late pregnancy and after pregnancy

AIM: To assess creatinine clearance that indicates glomerular filtration rate (GFR) and to demonstrate the effect of posture on creatinine clearance in late pregnancy compared to the non-pregnant state. METHODS: Twenty-six healthy pregnant women aged 19-30 years were studied for two sessions, first in their third trimester of pregnancy and then in a non-pregnant state at 6-12 weeks after delivery. In both sessions, creatinine clearance was assessed at three periods: the 24-h baseline, and at the end of 2-h sitting and 2-h lying (in left lateral decubitus position) periods. Urine and blood samples were collected for creatinine clearance measurement. RESULTS: The results showed that the 24-h creatinine clearance in late pregnancy was 28.3% higher than that in the non-pregnant state (122.6 +/- 26.2 vs 95.3 +/- 15.1 mL/min per 1.73 m2, P < 0.001). In late pregnancy, after 2-h sitting, creatinine clearance decreased significantly (10%) compared to the 24-h baseline (122.6 +/- 26.2 vs 110.4 +/- 28.6 mL/min per 1.73 m2, P < 0.001). Creatinine clearance rose back to the high baseline level after the pregnant woman laid in left lateral decubitus for 2 h. The decrease in creatinine clearance during prolonged sitting was not seen in the non-pregnant state.At any posture, the creatinine clearance was always higher in the pregnant state than in the non-pregnant. CONCLUSIONS: This study showed that creatinine clearance in late pregnancy was much higher than in the non-pregnant state, and was affected by sitting for up to 2 h. It might be wise for women to lay down in the left lateral decubitus position for a while after many hours of sitting when pregnancy is approaching its term.     

Can adiponectin predict abnormal glucose tolerance in Thai women with polycystic ovary syndrome?

AIM: To evaluate whether adiponectin levels could predict abnormal glucose tolerance (AGT) in Thai women with polycystic ovary syndrome (PCOS). METHODS: A 75-g oral glucose tolerance test (OGTT) with fasting adiponectin and insulin (FI) blood sampling in 170 women with PCOS were performed consecutively. RESULTS: The prevalence of AGT was 45.9%. The body mass index (BMI), waist-to-hip ratio (WHR), fasting glucose and 2-h postload glucose were greater in the PCOS women with AGT than those without AGT (P<0.001). In addition, the PCOS women with AGT had more severe insulin resistance (IR) and lower adiponectin levels than those without AGT. However, the area under the ROC curve of adiponectin and insulin in predicting AGT was smaller than that of homeostatic model of IR (HOMA-IR) (P<0.01). The arbitrary cut-off values at 12 ug/mL of adiponectin, 10 microiu/mL of FI and 2 of HOMA-IR showed the sensitivity and specificity of 80.8% and 33.7%; 87.2% and 34.8%; and 89.7% and 31.5%, respectively. With these cut-off points, 46 (27.1%), 42 (24.7%) and 37 (21.8%) women, respectively, could be eliminated from performing OGTT. However, 15 (19.2%), 10 (12.8%) and 8 (10.3%), respectively, missed the diagnosis. In addition, with WHR and acanthosis nigricans adjustment, HOMA-IR, but not adiponectin, was a significant predictor of AGT. CONCLUSION: Our study demonstrated that almost half of the women with PCOS had AGT. Adiponectin levels were significantly lower in the PCOS women with AGT than those without AGT. However, adiponectin was not shown to be as strong a predictive factor and might not be such an excellent screening test as FI and HOMA-IR.     

Sensitivity and specificity of mean corpuscular volume testing for screening for alpha-thalassemia-1 and beta-thalassemia traits

AIM: To evaluate the sensitivity, specificity, positive predictive value and negative predictive value of mean corpuscular volume (MCV) testing for screening for both alpha-thalassemia-1 and beta-thalassemia traits. METHODS: A diagnostic test was conducted on 439 pregnant women attending the antenatal care (ANC) clinic at Maharaj Nakorn Chiang Mai Hospital between April 2002 and July 2002. Blood samples were collected from the pregnant women after they were counseled and gave informed consent. The MCV was measured in all samples using an automated hematology analyzer. The hemoglobin (HbA2) level and polymerase chain reaction (PCR) were measured in all cases to test for the beta-thalassemia trait and the alpha-thalassemia-1 gene (South-East Asian [SEA] type), respectively. The data were collected and analyzed for sensitivity, specificity, positive predictive value and negative predictive value for evaluating the efficacy of MCV testing for screening for both alpha-thalassemia-1 and beta-thalassemia traits. RESULTS: Positive MCV tests (相似文献   

Sonographic features of trisomy 18 at midpregnancy

OBJECTIVE: To evaluate the sonographic characteristics of the fetuses with trisomy 18 at 16-22 weeks of gestation. METHODS: The subjects were recruited from pregnant women undergoing prenatal sonographic examinations at 16-22 weeks of gestation and subsequently proven to be trisomy 18. The results of ultrasound findings were retrospectively reviewed in 25 cases with chromosomes which were confirmed as trisomy 18. RESULTS: All cases had at least one abnormal sonographic finding. There was only one case that had no structural abnormality, but fetal growth restriction was documented. The common sonographic findings included fetal growth restriction, choroid plexus cysts, cardiac anomalies, clenched hand, omphalocele and cleft lip. Fetal growth restriction was the most common finding demonstrated in nearly half of all cases. Other less common findings were diaphragmatic hernia, abnormal head shape, polyhydramnios, single umbilical artery. CONCLUSION: Nearly all fetuses with trisomy 18 had characteristic sonographic patterns of abnormalities demonstrated at midpregnancy. Detailed ultrasound at midpregnancy could effectively screen fetuses with trisomy 18 for further genetic testing.