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C Nessmann

Publications and source records attributed to C Nessmann.

At least 37 records · Page 2Linked to original sources

Aryl hydrocarbon hydroxylase activity in human placenta and threatened preterm delivery.

Induction of aryl hydrocarbon hydroxylase (AHH) activity in the placenta has been well documented. This enzyme may be induced by a variety of Polycyclic Aromatic Hydrocarbons (PAHs) and the AHH inducibility is associated with harmful effects of environmental chemicals. Toxic effects of PAHs in tissues such as placenta have been demonstrated to be due to their metabolites, epoxides, which interact with DNA. Thus, environmental PAHs may be related to its alterations in fetal development. Founded on these findings the PAH metabolites could interfere with the normal course of the pregnancy and may be an aborticide, a teratogen or a carcinogen. We hypothesize that low increased activity of placental Aryl Hydrocarbon Hydroxylase (AHH) may be an important determinant of human fetotoxicity. The present investigation was designed to examine the possible implications of PAH exposure at environmental exposure levels on the normal course of the pregnancy using AHH induction as an indicator of PAH exposure. Threatened Preterm Delivery (TPD) was used as an index of problems in the normal course of pregnancy. A group of forty pregnancies at term with TPD was compared with eighty controls for placental AHH induction. Macroscopic placental examination was also performed. A significant increase in prevalence of placental AHH induction with TPD was shown (Odds-Ratio = 2.8; 95% confidence bounds [1.3-6.2]; chi 2 = 6.7 p < 0.01). No such increases were found associated with placental pathology. When taking into account the group of placenta without basal plate calcifications, the significant increase in prevalence of placental AHH induction with TPD above mentioned was greatly increased (Odds-Ratio = 8.9; 95% confidence bounds [2.4-32.9]; chi 2 = 11.1 p < 0.001) controlling for gestational age. The increase in prevalence of placental AHH induction with TPD disappeared when taking into account the subgroup with basal plate or parenchyma calcifications. It is hypothesized that the high estrogen and progesterone at term may explain these associations.

Adult↗

Placental aryl hydrocarbon hydroxylase activity and placental calcifications.

Induction of aryl hydrocarbon hydroxylase (AHH) activity in the placenta as a result of maternal exposure to polycyclic aromatic hydrocarbons contained in cigarette smoke has been well documented. Furthermore, calcifications are more prevalent in the placentas of pregnant smokers than in those of non-smokers. The present study examines whether this latter relationship could be explained by the induction of AHH activity in the placenta. AHH levels were determined at birth in 141 unselected pregnant women admitted for delivery. Macroscopic placental examination was performed for vascular lesions, abnormalities of placental shape, of the cord and parameters of placental maturity such as basal and parenchymatous calcifications. Significant increases in the prevalence of calcifications of the placental basal plates and parenchyma with the induction of placental AHH were found. A similar significant association between smoking and AHH activation was also observed. These findings remained unchanged when controlling for smoking status assessed both by questionnaire and presence of cotinine in mother's urine. Moreover, the apparent association between smoking 'factor' and calcifications disappeared when controlling for AHH induction. Therefore, the association between smoking and placental calcifications previously related could be mediated by the AHH induction.

Aryl Hydrocarbon Hydroxylases↗

The Wolf-Hirschhorn syndrome in fetuses.

Wolf-Hirschhorn syndrome (WHS) with partial deletion of the short arm of chromosome 4 has been exceptionally diagnosed in fetuses. We report prenatal diagnosis of five cases of monosomy 4p. The fetuses were karyotyped for severe intrauterine growth retardation (IUGR) diagnosed on routine ultrasound (US). In addition, cleft-lip and palate and diaphragmatic hernia respectively were found in two cases. The quantity of amniotic fluid was normal in all cases. At autopsy, the fetuses showed the typical craniofacial dysmorphy but without microcephaly. Major renal hypoplasia was the only constant visceral anomaly. Midline fusion defects were observed in all the fetuses, ranging from minor abnormalities such as scalp defect, hypertelorism, pulmonary isomerism, common mesentery, hypospadias and sacral dimple, to cleft palate, corpus callosum agenesis, ventricular septal defect, and diaphragmatic hernia. On post-mortem X-rays, a delayed bone age was always observed. All the placentae were hypotrophic, and two exhibited vascular lesions, although there was no maternal hypertension. Chromosomal studies showed that the breakpoints were within the 4p16 band in three cases, the 4p15 band in one case, and the 4p14 band in one case. The deletion was de novo in four cases, and resulted from a paternal translocation in one case. This study emphasizes the importance of karyotyping all fetuses with IUGR, especially when the quantity of amniotic fluid is normal, and suggests the possibility of recognizing on US the particular phenotype of WHS in utero.

Abnormalities, Multiple↗

Detection of 47,XYY trophoblast fetal cells in maternal blood by fluorescence in situ hybridization after using immunomagnetic lymphocyte depletion and flow cytometry sorting.

Fluorescence in situ hybridization (FISH) allows to diagnose aneuploidy in uncultured interphase nuclei. This rapid method of chromosomal analysis associated with cell-sorting techniques was realized on 47,XYY fetal cells isolated from maternal blood. Trophoblast cells were sorted by combining immunomagnetic removal of maternal lymphocytes and flow cytometry sorting using antitrophoblast monoclonal antibodies. Cells were sorted directly on slides and analyzed by FISH with a Y-centromeric probe. Among 1,387 examinable nuclei, 59 (4.25%) showed one single or two Y-specific domains.

Aneuploidy↗

Unbalanced karyotype due to adjacent 1 segregation of t(11;22)(q23.3;q13.2).

The 11q;22q translocations, whatever the breakpoints may be, are of particular interest because of their propensity to 3:1 segregation of the chromosomes at meiosis I. Until now, no unbalanced karyotype resulting from 2:2 adjacent segregation was published among offspring of 11q;22q translocation carriers. The authors report the case of an unbalanced karyotype due to adjacent 1 segregation of a maternal translocation (11;22)(q23.3;q13.2). The proband's karyotype was 46,XX,-22,+der(22)(11;22)(q23.3;q13.2)mat. This finding demonstrates that adjacent 1 segregation is possible in t(11;22) with breakpoints at 11q23 and 22q13, and can lead to birth of viable infants.

Abnormalities, Multiple↗

[Placental development and viral infections].

The stages of placental development are briefly described as well as the cellular and molecular mechanisms involved in the immunologic defense systems at the maternofetal interface. Methods available for morphologic studies of placentas with viral infection are reviewed. Routes of transmission of viruses from mother to fetus, as well as the placental lesions seen in viral infections are discussed. Emphasis is put on the value of "oriented" pathologic studies of the placenta whenever viral fetal disease is suspected.

Chorionic Villi↗

Brain damage in monozygous twins.

A series of 15 monochorionic twins with a great variety of cerebral lesions is reported. Seven cases illustrate the classical situation: the recipient twin was affected and his co-twin, the donor was macerated. In 5 cases, the lesions were described in the donor twin as well and once, as early as 22 weeks. The lesions were usually hypoxic-ischemic, in 2 they were hemorrhagic. In 1 case there was a malformation. Fetal US were performed in 11 cases and the diagnosis of either IUGR, death of a fetus and/or brain lesions in the survivor could be made in 10 cases and once as early as 21 weeks. In fetuses born alive, transfontanellar US or CT scan have confirmed the diagnosis made on fetal US. The pathogenesis of the lesions is not fully understood. Lesions in the recipient twin may result from emboli or thromboplastic material originating from the macerated co-twin. We suggest that blood pressure instability or episodes of severe hypotension might as well lead to brain and/or visceral lesions in the recipient twin. In the donor, the lesions result from hypotension and/or anemia. With improvement and generalization of imaging techniques, the vitality of the fetuses as well as biometric parameters and anatomical structures will be better controlled. However, in case of a fetal death, occurrence of lesions in the survivor is unpredictable and no uniform policy has been proposed yet. Studies with Doppler and continuous monitoring of funicular circulation should improve our knowledge on feto-fetal transfusion and permit to detect hemodynamic fluctuation or impairment.

Brain Injuries↗

Assessing the early luteal phase in in vitro fertilization cycles: relationships between plasma steroids, endometrial receptors, and endometrial histology.

The corpus luteum-endometrial unit was investigated in in vitro fertilization (IVF) cycles using endocrine, morphologic, and biochemical measurements on the day normally scheduled for embryo transfer (day 16), in 12 stimulated and 4 natural cycles. Advanced endometrial histologic maturity was recorded in 9 of the 12 stimulated cycles. No in-phase endometria were seen when the preovulatory plasma estradiol (E2) was greater than 500 pg/ml or the day 16 plasma progesterone (P) greater than 10 ng/ml in natural or stimulated cycles. Significant negative correlations were noted between both preovulatory E2 and day 16 P and the concentration of cytosolic progesterone receptor (PRc). Advanced endometrial maturity tended to be associated with low concentrations of PRc. Regardless of endometrial maturity, the natural cycle was characterized by low cytosolic E2 receptors (ERc) and high PRc, whereas the concentration of both receptors was usually greatly reduced in stimulated cycles. It is concluded that the advanced endometrial maturation observed in stimulated IVF cycles is a consequence of the production of supraphysiologic levels of sex steroids by the corpus luteum that cause profound modifications of endometrial receptor dynamics.

Clomiphene↗

[Normal placental development and ovular anomalies during the 1st trimester of gestation].

Normal placental development and ovular anomalies during the first trimester of gestation. The normal sequences of placental development are first briefly summarized to allow a better understanding of ovular pathology. Fifteen percent of recognized pregnancies end with miscarriages, and probably one out of two conceptuses fail even before implantation. Most spontaneous abortions occur before 15 weeks of gestation, and are caused by zygotic defects: abnormal karyotypes represent more than 50% of the cases. Trisomies predominate (50 to 60%), followed by triploidy (20%), monosomy X (15%) and structural anomalies (4%). The phenotype of these lethal anomalies have been meticulously described so that the pathologist is allowed to diagnose aneuploidy on morphological features. It should be emphasized that similar abnormal phenotypes have been observed with normal karyotypes suggesting undetected genetic factors. Hydatidiform mole, twinning, whose incidence is much higher among aborted material than among live births, are other zygotic causes of abortion. Embryonic death or placental insufficiency leading to miscarriage can also result from abnormal implantation or be secondary to lesions of the membranes, as observed in amniotic band syndrome. Maternal causes of spontaneous abortions, local or general, are probably rare at this stage of gestation and difficult to diagnose by the pathologist. Retroplacental haematoma, infarcts or endometritis are often undistinguishable from leucocytic infiltrates or necrosis following the usual long period of retention.

Abortion, Spontaneous↗

Ophthalmo-acromelic syndrome.

We report two sibships with children who had anophthalmia, multiple limb abnormalities, and consanguineous parents. The same association of malformations has already been reported. These further observations allow a better delineation of the syndrome and confirm its autosomal recessive mode of inheritance. We propose to name the syndrome ophthalmo-acromelic.

Abnormalities, Multiple↗

[Assessment of fetal maturation].

Few organs or tissues are convenient to use for the pathologist to assess fetal maturity: the brain, particularly the external configuration of the cerebral hemispheres: the primary and secondary sulci appear in a definite chronologic order; the lungs; four developmental stages are defined: the last stage is characterized by attenuation of alveolar epithelial lining, and increase and superficial migration of capillaries. It must be reached necessarily to have postnatal respiration; the kidneys have a typical pattern of development, especially after 28 weeks, when it is possible to count the number of immature glomerular layers in the cortex; for the differentiation of the skin, specimens taken from special regions of the body are characteristic enough to determine the maturity, especially during the second trimester.

Brain↗

[Importance of examination of the placenta].

It is necessary to examine the placenta in two conditions at least: when the fetus is still born or dies in the neonatal period, and when there is a gestational or a neonatal pathology. Placental examination is essentially macroscopic. It is recommended to practice it on fresh placenta, so that cytobacteriological investigation can be done at the same time. Histological samples are taken in one third of the cases. The principal abnormalities or lesions are described, with their clinical significance: shape abnormalities, pathology of the cord and membranes, vascular lesions (decidual haematoma, infarcts, perivillous fibrin deposition), chorioangioma, abscess. Some more "genetical" aspects of the placentology are also approached, for instance chromosomal aberrations, or multiple pregnancies.

Chromosome Aberrations↗

The "dysharmonic luteal phase" syndrome: endometrial progesterone receptor and estradiol dehydrogenase.

The dysharmonic luteal phase (DLP) syndrome is defined by delayed endometrial maturation despite normal plasma progesterone (P) values. In ten patients with DLP the actual date of the endometrial biopsy, dated retrospectively, was 24.7 +/- 2.3 days, whereas the histologic date was 20.0 +/- 2.6 days. The concentration of cytosolic P receptor in DLP endometrium tended to be lower, whereas the concentration of nuclear receptor was significantly higher in DLP than in seven matched patients with normal luteal phases. Endometrial estradiol-dehydrogenase activities were identical in both groups. The DLP syndrome cannot be explained by a decreased sensitivity of the endometrium to P and is probably merely functional in nature.

17-Hydroxysteroid Dehydrogenases↗

[Congenital toxoplasmosis. Remarks apropos of serologic surveillance in 15,000 pregnant women].

The risk of acquired toxoplasmosis during pregnancy (1.2% of susceptible women) and of transmission of Toxoplasma gondii to the fetus (1% of neonates) was estimated from results of serial serological tests done in 15 132 pregnant women from 1977 to 1982. Congenital toxoplasmosis was studied in the product of 47 induced abortions and in 34 neonates. In aborted fetuses, congenital toxoplasmosis was established by serological tests in 3 cases and based on histological findings in 4. Among the neonates, 11 cases are reported; the 5 severe cases are due to early contamination.

Abortion, Induced↗

Fetal tachycardia and meconium staining: a sign of fetal infection.

A retrospective study was carried out on 72 liveborn babies in whom perinatal infection was suspected. Twenty-nine of the 72 neonates were effectively infected. Analysis of intrapartum FHR recordings showed that tachycardia (base line FHR above 160 beats/min) during labor, occurred more often among infected babies (P less than 0.001). When fetal tachycardia is associated with meconium stained amniotic fluid (MSAF), the relative risk of fetal infection is 51 times as great as in babies without MSAF. Fetal tachycardia is not related to maternal fever nor to prematurity. It is not a sign of limited placental or amniotic fluid infection, but implies infection of the fetus itself. Since most infected babies displayed infectious diarrhea immediately at birth, it is suggested that MSAF may eventually be due to antenatal intestinal infection and intrauterine emission of infected stools. Although great caution is advocated for the management of labor in the presence of fetal tachycardia, MSAF should not be always regarded as a sign of acute fetal distress when antenatal infection of the fetus is suspected.

Bacterial Infections↗