Hypoproteinemia in the second trimester among patients with preeclampsia prior to the onset of clinical symptoms

Objective: To find a risk factor for “uncomplicated” preeclampsia (PE) comparing blood biochemical parameters between women with uncomplicated PE and healthy pregnant women in each trimester of pregnancy. Methods: A retrospective study was performed on 83 cases of uncomplicated PE, selected from 434 patients with PE, disregarding subjects with other complications relevant to hypertension during pregnancy. The study was limited to women with PE occurring in the third trimester, and records of blood biochemical parameters were evaluated. Controls were recruited from 108 healthy volunteers with normal singleton pregnancies. Results: A significant decrease in total protein was observed in the uncomplicated PE group in the second trimester prior to the onset of clinical symptoms. Conclusion: Hypoproteinemia during pregnancy may be a risk factor for this pathophysiology, and the maintenance of sufficient protein in early pregnancy could contribute to prophylaxis for women with uncomplicated PE.     

Detection of N-(1-deoxy-d-fructos-1-yl) Fumonisins B2 and B3 in Corn by High-Resolution LC-Orbitrap MS

The existence of glucose conjugates of fumonisin B₂ (FB₂) and fumonisin B₃ (FB₃) in corn powder was confirmed for the first time. These “bound-fumonisins” (FB₂ and FB₃ bound to glucose) were identified as N-(1-deoxy-d-fructos-1-yl) fumonisin B₂ (NDfrc-FB₂) and N-(1-deoxy-d-fructos-1-yl) fumonisin B₃ (NDfrc-FB₃) respectively, based on the accurate mass measurements of characteristic ions and fragmentation patterns using high-resolution liquid chromatography-Orbitrap mass spectrometry (LC-Orbitrap MS) analysis. Treatment on NDfrc-FB₂ and NDfrc-FB₃ with the o-phthalaldehyde (OPA) reagent also supported that d-glucose binding to FB₂ and FB₃ molecules occurred to their primary amine residues.     

Serial assessment of denervated but viable myocardium following acute myocardial infarction in dogs using iodine-123 metaiodobenzylguanidine and thallium-201 chloride myocardial single photon emission tomography

Iodine-123 metaiodobenzylguanidine (mIBG) is taken up by sympathetic nerve endings, allowing scintigraphic imaging of myocardial sympathetic innervation. We investigated the denervated but viable canine myocardium after acute myocardial infarction by serial mIBG and thallium-201 chloride (²⁰¹TIC1) single photon emission tomography (SPET). In 12 dogs, acute myocardial infarction was produced by ligation of the left circumflex coronary artery. Images of mIBG and thallium SPET were obtained 6 h, 1, 4 and 6 weeks later. The defect size was calculated in percentage points from short axial views, and the ¹²³I-mIBG/²⁰¹TlCl ratio was determined. The uptake ratio was high at 1 week but gradually decreased. Three dogs were killed at each time point, and tissue samples were obtained from infarcted (both ²⁰¹TICl and ¹²³I-mIBG defects), peri-infarcted (¹²³I-mIBG defect and ²⁰¹TICl normal) and normal myocardium (both mIBG and ²⁰¹TIC1 normal). The changes in tissue content of noradrenaline in these lesions were measured. Noradrenaline tissue content gradually recovered in the peri-infarcted area. However, no recovery was noted in the infarcted area at 6 weeks. We conclude that sympathetic denervation and re-innervation occur following acute myocardial infarction, and the denervated but viable myocardium could be detected non-invasively by combined mIBG and thallium SPET. Offprint requests to: T. Nishimura     

Rapid detection of chromosome aneuploidies by prenatal interphase FISH (fluorescence in situ hybridization) and its clinical utility in Japan

OBJECTIVE: The purpose of this study was to assess the accuracy, informative rate, detection rate, and clinical utility of prenatal interphase fluorescence in situ hybridization (FISH) analysis of amniotic fluid samples from Japanese women. METHODS: Amniotic fluid specimens from 2,639 Japanese women were received for prenatal interphase FISH and chromosome analysis. A questionnaire was designed to evaluate FISH clinical utility by collaboration sites. RESULTS: Based on 2,319 tested samples, the accuracy (100%), informative (94%), and detection (87.6%) rates were all high. The accuracy (100%), informative (90.2%), and detection (90.0%) rates were also remarkable in third-trimester pregnancies. We perceive significant advantages from this test regarding medical management and patient satisfaction. CONCLUSIONS: This novel report shows that in Japan prenatal interphase FISH testing is highly informative and accurate, not only in second-trimester pregnancies but also in third-trimester pregnancies. This test provides advantages to both physicians and patients, provided that its capabilities and limitations are understood.     

Ovarian cystic teratomas: MR imaging

Magnetic resonance (MR) imaging characteristics of ovarian cystic teratomas were evaluated in 18 patients with 23 surgically proved tumors. The fat within the tumor demonstrated characteristic intensity similar to that of subcutaneous fat and a pathognomic pattern of chemical shift artifact that helped differentiate ovarian cystic teratomas from endometrial cysts. In addition to fat, MR images of ovarian cystic teratomas had several other characteristics that allowed confident diagnosis, including gravity-dependent layering or floating debris, palm tree-like protrusions or rounded nodules (dermoid plugs), and, occasionally fat-fluid levels and globular calcification. MR images were diagnostic in 20 tumors and were able to depict a tumor measuring 2 cm in diameter. MR imaging appears to be valuable in problematic cases in which other modalities are not diagnostic.     

Posterior lobe of the pituitary in diabetes insipidus: MR findings

The posterior lobe of the pituitary gland was evaluated by 1.5 T magnetic resonance (MR) in five cases of diabetes insipidus (DI), including one primary (idiopathic) and four secondary DI cases due to germinomas (two), teratoma (one), and histiocytosis X (one). The normal posterior lobe displays high signal indistinguishable from fatty tissue on T1-weighted images (T1WI) (short T1 value). In all five DI cases the normal high signal of the posterior lobe was not detected in the pituitary fossa on T1WI. Hence, because of this characteristic finding, MR may greatly assist in the diagnosis of DI. We may speculate that the short T1 value of the posterior lobe is closely related to its functional integrity and may be due to the neurosecretory materials in the axons of the hypothalamohypophyseal tract.     

Rapid quantitative analysis of magnesium stearate in pharmaceutical powders and solid dosage forms by atomic absorption: Method development and application in product manufacturing

The distribution of magnesium stearate (MgSt) in tablet granule has a significant impact on the compression process. A rapid quantitative method for evaluating magnesium stearate content by atomic absorption was established. The MgSt was extracted from the granule in 0.1 mol/L nitric acid and the resulting free magnesium ion quantitated by atomic absorption. The total analysis time was significantly shortened in comparison to the previously used sample ignition method.     

The Japanese experience with prenatally diagnosed congenital diaphragmatic hernia based on a multi-institutional review

Purpose

To review the recent Japanese experience with prenatally diagnosed congenital diaphragmatic hernia (CDH) based on a multi-institutional survey.

Methods

A multicenter, retrospective cohort study was conducted on 117 patients born between 2002 and 2007 with isolated prenatally diagnosed CDH. All patients were managed by maternal transport, planned delivery, immediate resuscitation and gentle ventilation. The primary outcome measurements were the 90-day survival and intact discharge. The examined prenatal factors included gestational age (GA) at diagnosis, lung-to-head ratio (LHR), lung-to-thorax transverse area ratio (L/T) and liver position. Physical growth and motor/speech development were evaluated at 1.5 and 3?years of age. Data were expressed as the median (range).

Results

The mean GA at diagnosis was 29 (17?C40) weeks. The LHR and L/T were 1.56 (0.37?C4.23) and 0.11 (0.04?C0.25), respectively. There were 48 patients with liver up. The mean GA at birth was 38 (28?C42)?weeks. The 90-day survival rate and intact discharge rate were 79 and 63%, respectively. Twelve patients had major morbidity at discharge, and 71% of these patients had physical growth or developmental retardation at 3?years of age.

Conclusion

This multicenter study demonstrated that the 90-day survival rate of isolated prenatally diagnosed CDH was 79%, and that subsequent morbidity remained high. A new treatment strategy is needed to reduce the mortality and morbidity of severe CDH.