胎儿股骨长度测量判断胎儿成熟度的探讨

本文通过对131例妊娠中晚期胎儿的股骨长度(FL)、胎盘分级(PG),胎头双顶径(BPD)羊水(AF)等超声显象观测,探讨了FL对预测胎儿成熟度的价值,并分析了四者之间的相互关系,发现不同胎龄儿FL不同,FL随胎龄增加而增长,并与PG、BPD呈正相关关系,作者认为FL是判断胎儿成熟的有效指标。     

Cellular localization of immunoreactive epidermal growth factor during Wolffian duct differentiation of the fetal mouse

Previous studies from this laboratory indicated a role for epidermal growth factor (EGF) in androgen-dependent male reproductive tract differentiation of the fetal mouse. Expression of an EGF-like protein during Wolffian duct differentiation was indicated from the determinations by radioimmunoassay (RIA) and radioreceptor assay. To further characterize the protein and to assess its role in male sexual differentiation, expression of the protein has been analyzed by Western blot assay and its tissue-specific cellular expression has been determined by immunocytochemical assay in the present study. Western blot analysis of the 18-day fetal male reproductive tract detected an immunoreactive band of the predicted 6-kDa size. Immunocytochemical analysis also detected EGF-specific immunostaining in the Wolffian duct derivatives. At day 18 of gestation, the staining was localized predominantly in the epithelial nuclei of the Wolffian duct derivatives whereas at days 14 and 16 of gestation, the staining was equally distributed in the mesenchymal and epithelial sites of the Wolffian duct derivative. The intensity of the staining increased with progression of differentiation during the 14th–18th days of gestation. Prenatal exposure to the antiandrogen flutamide significantly reduced the immunostaining of the duct. Thus, a role for EGF in Wolffian duct differentiation is indicated.     

Analysis of kidney volume growth during the fetal period in humans

Summary The growth of fetal kidney volume was studied in 290 specimens taken from 145 fresh human fetuses (85 males and 60 females) with gestational age ranging from 13 to 36 weeks postconception (WPC). Normative equations and curves of the growth of renal volume were obtained for male and female fetuses and for the whole sample in the second trimester (13–24 WPC) and in the third trimester (25–36 WPC) of gestation. There was no difference between the growth in volume of the right and left kidneys. Fetal kidney volume increases with a more intense rhythm in the early fetal period (13–24 WPC). During the second trimester, there was no difference between the values for renal volume of male and female fetuses. In the third trimester, male fetuses had renal volumes significantly greater than the female fetuses. The normative parameters of renal volume could have practical applications in detection and monitoring of renal anomalies in fetal and perinatal urology.Supported by grants 302, 369/86.4/BM-FV from the National Conucil of Scientific and Technological Development (CNPq, Brazil) and Grant E.29/170.787/89 from the Rio de Janeiro Foundation for Research Support (FAPERJ).     

改变产妇体位矫正胎儿方位的临床效果

目的:探讨产程中改变产妇体位以矫正胎位。方法:选择临产至宫口开全经B超及内诊检查为枕后位的初产妇200例,随机分为观察组与对照组各100例,在产程中指导观察组产妇取侧俯卧位,利用胎儿重力、羊水浮力、子宫间歇性收缩的合力作用,使胎头下降时逐渐从枕后位转至枕前位娩出,并与对照组比较。结果:观察组91例(91％)胎儿由枕后位转至枕前位经阴道分娩,剖宫产9例(9％);对照组经阴道分娩仅16例(16％),剖宫产84例(84％)。两组比较差异有显著性(P<0.01)。结论:在产程中指导产妇取侧俯卧位,用以矫正胎位不正是降低难产发生率的有效方法。     

综合疗法和加用人胎肝细胞悬液治疗重症肝炎30例疗效比较

重症肝炎30例随机分为两组,采用综合疗法治疗15例;另15例在综合疗法基础上加用人胎肝细胞悬液。综合治疗组病死比例为9/15例;胎肝组病死比例为4/15例,较综合疗法组明显为低。胎肝组存活11例平均退黄时间为55.4±25.4天;综合疗法组存活6例,平均退黄时间为119.7±54.9天,前者明显短于后者(P<0.01)。对胎肝组12例患者作输注前后凝血酶元时间活动度对比观察,输注后48h凝血酶元时间活动度可提高18.9％。     

A novel lamina lucida component of epithelial and endothelial basement membranes detected by LH39 monoclonal antibody.

The murine monoclonal antibody, LH39 was characterized in this study and appeared to bind to a novel basement membrane epitope. This antigen was expressed in the epithelial basement membrane of human tissue derived from all three germ cell layers and in basement membranes surrounding small blood vessels within the stroma of all organs examined. LH39 antigen could be first detected in fetal skin at the dermo-epidermal junction at 7 weeks estimated gestational age but was not present in the dermal vasculature until 16 weeks. When tested against tissue from a range of lower mammalian species, LH39 antigen appeared to be primate-specific. The epithelial basement membrane zone in organotypical cultures, where there is de novo synthesis of basement membrane components, contained abundant LH39 antigen in contrast to other basement membrane components, type IV collagen, laminin, and type VII collagen. Ultrastructural localization of LH39 epitope, using immunogold electron microscopy on unfixed freshly frozen tissue, was to the lamina lucida. No cross-reactivity could be detected between LH39 and laminin, fibronectin, and collagens I, III, IV, and V using the ELISA assay. In vitro studies with a range of proteolytic enzymes suggested that the antigen was non-collagenous in nature. LH39 precipitated a polypeptide with a molecular weight of 185 kD from extracts of metabolically labelled cultured keratinocytes, and polypeptides of 185 and 200 kD from the culture medium. The tissue distribution of LH39 antigen suggested that it may be an epitope within anchoring filaments. Potential applications of this antibody include the study of benign and malignant human vascular disorders, diseases and tumours associated with angiogenesis, epithelial neoplasms, and conditions of tissue regeneration and repair, such as wound healing.     

Ultrasonography in the detection of cervical incompetency

In 80 pregnancies with clinical and ultrasonic signs of cervical incompetency, the length of the cervix and the thickness of the anterior wall of a lower uterine segment have been evaluated ultrasonically. We have also measured the width of the endocervical canal and studied the prolapse of fetal membranes (with fetal parts) into the endocervical canal. We evaluated these same parameters in 80 healthy pregnancies. The length of the cervix, the thickness of the anterior wall of a lower uterine segment, and the width of the endocervical canal were followed longitudinally in the patients from the 10th to the 36th gestation week. No statistically significant differences between age groups were found. In four age groups at risk for cervical incompetency, cervical lengths and wall thickness were significantly different (p less than 0.001) from those in comparable controls. Forty-five percent of the patients in the at-risk group, with cervical cerclage, delivered at 37.3 (range: 32 to 41) weeks and 6.25% of pregnancies ended in abortion when the amniotic membrane herniated into the cervical canal, with or without some part of the fetus.