Doppler velocimetry of fetal pericardial fluid

Objective

To investigate the flow of normal fetal pericardial fluid (PF) with increasing gestational age using Doppler velocimetry.

Method

Ninety-five fetuses between 18 and 37 weeks of gestation with PF within the normal range were studied. PF was measured in 4-chamber view using M-mode or real-time ultrasound. Color Doppler was used to display and guide the pulse wave assessment of PF flow. PF waveforms as well as systolic and diastolic velocities were recorded and correlated with gestational age.

Results

PF was detected in all of the fetuses. The mean thickness of the PF rim was 0.95 ± 0.45 mm. PF flowed toward the cardiac apex during systole and toward the atrium during diastole. PF waveforms showed bidirectional flow in all fetuses. The flow velocity PF was positively correlated with gestational age in both systole and diastole.

Conclusion

Flow velocity of fetal PF increases linearly in both systole and diastole with gestational age. This might indirectly indicate a maturational change in myocardial performance as myocardial velocity is increased.     

V-1 Immunitor: oral therapeutic AIDS vaccine with prophylactic potential

V-1 Immunitor (V1) is a therapeutic vaccine comprising pooled HIV antigens formulated into an oral pill. Recent V1 studies demonstrated body weight gain, increase in CD4 and CD8 cells, decrease in viral load, and improved survival of end-stage AIDS patients. The potential of V1 as a prophylactic vaccine has been evaluated in a phase II placebo-controlled trial on 35 volunteers. Twenty HIV-negative volunteers who received V1 b.i.d. for 4 weeks had gained 28.2 and 17.5% in absolute CD4 (825 versus 1058; P=0.007) and CD8 (597 versus 702; P=0.013) cells, while lymphocytes in placebo group did not increase, suggesting that CD4 and CD8 counts may become an easily measurable immune correlate of the efficacy of AIDS vaccines. V1 does not appear to induce HIV-specific antibodies as orally administered immunogens usually produce cell-mediated but not systemic humoral response. V1 as a preventive oral vaccine targeting cellular and mucosal immunity deserves further evaluation.