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Biomarkers in Czech workers exposed to 1,3-butadiene: a transitional epidemiologic study.

A multiinstitutional, transitional epidemiologic study was conducted with a worker population in the Czech Republic to evaluate the utility of a continuum of non-disease biological responses as biomarkers of exposure to 1,3-butadiene (BD)* in an industrial setting. The study site included two BD facilities in the Czech Republic. Institutions that collaborated in the study were the University of Vermont (Burlington, Vermont, USA); the Laboratory of Genetic Ecotoxicology (Prague, the Czech Republic); Shell International Chemicals, BV (Amsterdam, The Netherlands); the University of North Carolina at Chapel Hill (Chapel Hill, North Carolina, USA); University of Texas Medical Branch at Galveston (Galveston, Texas, USA); Leiden University (Leiden, The Netherlands); and the Health and Safety Laboratory (Sheffield, United Kingdom). Male volunteer workers (83) participated in the study: 24 were engaged in BD monomer production, 34 in polymerization activities, and 25 plant administrative workers served as unexposed control subjects. The BD concentrations experienced by each exposed worker were measured by personal monitor on approximately ten separate occasions for 8-hour workshifts over a 60-day exposure assessment period before biological samples were collected. Coexposures to styrene, benzene, and toluene were also measured. The administrative control workers were considered to be a homogeneous, unexposed group for whom a series of 28 random BD measurements were taken during the exposure assessment period. Questionnaires were administered in Czech to all participants. At the end of the exposure assessment period, blood and urine samples were collected at the plant; samples were. fractionated, cryopreserved, and kept frozen in Prague until they were shipped to the appropriate laboratories for specific biomarker analysis. The following biomarkers were analyzed: * polymorphisms in genes involved in BD metabolism (Prague and Burlington); * urinary concentrations of 1-hydroxy-2-(N-acetylcysteinyl)-3-butene and 2-hydroxy-1-(N-acetylcysteinyl)-3-butene (M2 [refers to an isomeric mixture of both forms]) (Amsterdam); * urinary concentrations of 1,2-dihydroxy-4-(N-acetylcysteinyl)-butane (M1) (Amsterdam); * concentrations of the hemoglobin (Hb) adducts N-(1-[hydroxymethyl]-2-propenyl)valine and N-(2-hydroxy-3-butenyl)valine (HBVal [refers to an isomeric mixture of both forms]) (Amsterdam); * concentrations of the Hb adduct N-(2,3,4-trihydroxybutyl)valine (THBVal) (Chapel Hill); * T cell mutations in the hypoxanthine phosphoribosyltransferase (HPRT) gene (autoradiographic assay in Galveston with slide review in Burlington; cloning assay in Leiden with mutational spectra determined in Burlington); and * chromosomal aberrations by the conventional method and by fluorescence in situ hybridization [FISH]), and cytogenetic changes (sister chromatid exchanges [SCEs] (Prague). All assay analysts were blinded to worker and sample identity and remained so until all work in that laboratory had been completed and reported. Assay results were sent to the Biometry Facility in Burlington for statistical analyses. Analysis of questionnaire data revealed that the three exposure groups were balanced with respect to age and years of residence in the district, but the control group had significantly more education than the other two groups and included fewer smokers. Group average BD exposures were 0.023 mg/m3 (0.010 ppm) for the control group, 0.642 mg/m3 (0.290 ppm) for the monomer group, and 1.794 mg/m3 (0.812 ppm) for the polymer group; exposure levels showed considerable variability between and within individuals. Styrene exposures were significantly higher in the polymer group than in the other two groups. We found no statistically significant differences in the distributions of metabolic genotypes over the three exposure groups; genotype frequencies were consistent with those previously reported for this ethnic and national population. Although some specific genotypes were associated with quantitative differences in urinary metabolite concentrations or Hb adduct dose-response characteristics, none indicated a heightened susceptibility to BD. Concentrations of both the M2 and M1 urinary metabolites and both the HBVal and THBVal Hb adducts were significantly correlated with group and individual mean BD exposure levels; the Hb adducts were more strongly correlated than the urinary metabolites. By contrast, no significant relations were observed between BD exposures and HPRT gene mutations (whether determined by the auto-radiographic or the cloning method) or any of the cytogenetic biomarkers (whether determined by the conventional method or FISH analysis). Neither the mutational nor the cytogenetic responses showed any association with genotypes. The molecular spectrum of HPRT mutations in BD-exposed workers showed a high frequency of deletions; but the same result was found in the unexposed control subjects, which suggests that these were not due to BD exposure. This lack of association between BD exposures and genetic effects persisted even when control subjects were excluded from the analyses or when we conducted regression analyses of individual workers exposed to different levels of BD.

Animals↗

SEM analysis of tooth enamel.

SEM analysis contains researches of tooth enamel surfaces of two populations. First group of samples is tooth enamel of prehistorically ancestor from Vucedol and the second group of samples is enamel of modern Croatian citizen. Even on small number of human teeth samples from cooperage site of Vucedol (3,000 BC) and today's Croatian people, we can conclude about chewing biometry of prehistorically ancestors and today's modern Croatian people, comparing interspecifically the morphology of enamel microdefects. With the interspecific comparison of morphology changes on tooth occlusal surfaces, we can connect the size and shape of abrasive particles and diet with microdefects of tooth enamel.

Anthropology, Physical↗

Myopia produced in young chicks by intermittent minimal form visual deprivation--can spectacles cause myopia?

Spectacle use has been postulated to aggravate or cause human myopia. Form visual deprivation, by complete full-time occlusion or refractive lenses, has been demonstrated to cause axial myopia in animals. We raised young chicks in conditions which closely approximate plano spectacle wear in humans. In addition, we sought to achieve more physiological conditions of form deprivation. Nine newborn chicks were raised with intermittent monocular visual deprivation and their eye growth and refraction monitored by retinoscopy, ultrasonic A-scan biometry and with a travelling microscope. After hatching, the nictitating membranes were sutured for 3-4 days. This was followed by a transparent plano plastic cover over the same eye for 3-4 days per week. After 3 weeks, the manipulated eyes were more myopic (mean refraction -0.72 D, axial length 13.11 mm) than fellow eyes (+0.83 D, 11.99 mm) (p < 0.05 and p < 0.01 respectively). These results suggest that the chick eye is exquisitely sensitive to disturbances in the visual environment; intermittent minimal manipulation by conditions simulating spectacle wear in man was myopiagenic. It is postulated that spectacles can cause form visual deprivation of foveal and nonfoveal neurons (and hence myopia) by reducing luminance and contrast, chromatic and spherical aberration (in nonfoveal neurons) and restriction and distortion from the frame.

Accommodation, Ocular↗

[Diagnostic methods for fetal malformations in the first half of pregnancy].

INTRODUCTION: Fetal abnormalities are the most common cause of perinatal and postnatal death and infant handicap. For this reason prenatal screening (for fetal malformation) has become a routine part of obstetric care in many countries. Most often used are biochemical tests and continuously developing ultrasound diagnostics which makes possible precise analysis of the fetal morphology. There is interesting to establish a noninvasive test for the early detection of fetal malformation in pregnancy which is based on ultrasound examination (NT measurement from the 10th to the 19th weeks, presence of nasal bone in the first trimester ultrasound), correlated with serum concentration of AFP, beta-HCG and oestriol in the second trimester of pregnancy (triple test). The main aim of the study was to establish a diagnostic schema for detection of fetal malformations based on NT measurement in the first and second trimester coupled with triple test performed in the second trimester. MATERIALS AND METHODS: A group of 775 pregnant women from the 10-th week of pregnancy until childbirth has been put under examination. Between the 10th and the 14th and than between 15th and 19th week of pregnancy ultrasound examination with fetal biometry and NT measurement was done. NT measurements have been performed in accordance with the standards worked out by professor K. Nicolaides. At the first ultrasound examination the presence of the nasal bone was observed. The next step was performing the triple test between the 15th and 19th week of pregnancy. On the same day as second ultrasound examination blood was taken to determine the results of the triple test (ELISA method). The obtained results have undergone statistical analysis. RESULTS: The age of women qualified for the examination oscillated between 15 and 45 (over 35 -9.4%). There were 8 fetal malformations recognized all connected with the chromosomal anomalies, namely, 4 Downs syndrome, 2 fetuses with trisomy of the 18th pair of chromosomes and 2 with triploidy. At all physiologic pregnancies nasal bone was seen during first ultrasound examination. The obtained results of nuchal fold measurements and concentrations for the parameters of the triple test have been the basis to calculate medians in the particular weeks of pregnancy. In all the cases of genetic malformations the widening of the nuchal fold above 99 percentile (MoM NT) has been observed. Fetal nasal bone were absent in 62.5% first trimester ultrasound examinations. The risk of the occurrence of a genetic malformation resulting from the mother's age combined with the risk connected with the NT measurements and the results of the triple test for the cut-off point 1:250 (which seems to be the best for this population) gave 100% sensitivity, 0.6% % of false positive results and the positive predictive value of 80%. The above mentioned results are better than the ones which were obtained within the triple test only, where for the previously fixed cut-off point 1:250 sensitivity reached 63%, positive predictive value 25% and 4.4% false positive rate. Performing the so-called integrated test in which the risk of the occurrence of any malformation is estimated on the basis of the NT measurement in the first and the second term of pregnancy seems to be far more useful. CONCLUSIONS: Diagnostic schema for detection of fetal malformations in the first half of pregnancy which is based on ultrasound examination (NT measurement from the 10th to the 19th weeks), correlated with serum concentration of AFP, beta-HCG and oestriol in the second trimester of pregnancy (triple test) is very sensitive and safe method of the prenatal diagnosis leading to significant decrease of the invasive procedures (amniocentesis).

Abnormalities, Multiple↗

[Fetal cerebral and renal circulation--a longitudinal study in the 2d half of pregnancy].

In a prospective longitudinal study 34 women were subjected to the following investigations 4-weekly from the 23rd to the 41st week of pregnancy: Doppler sonography of the umbilical artery, arteria cerebri media (ACM) and arteria renalis (AR), fetal biometry, estimation of the amniotic fluid volume and cardiotocography (CTG). 30 pregnancies ended in the birth of normal weight babies with no perinatal problems and in 108 examinations blood flow velocity waveforms of high quality were recorded in each vessel. We calculated the pulsatility index (PI), which was always within the normal range for the umbilical artery. Regression analysis was used to derive the 90% confidence intervals for the PI of ACM and AR and the PI ratio AR/ACM. A linear relationship was found between the AR PI and gestational age, while the relationship between the ACM PI and gestational age is better described by a quadratic equation. In both vessels a fall in PI was observed with advancing gestation. In the renal artery waveforms with absence of end-diastolic flow velocities were recorded up to 34 weeks only. CTG was assessed by the Fischer score, which showed a highly significant, positive correlation with gestational age (r = 0.316), but no correlation with the PI of the middle cerebral artery. The amniotic fluid volume showed a negative correlation with gestational age (r = -0.19), but no correlation with the PI of the renal artery.

Amniotic Fluid↗

Teaching prenatal ultrasound to family medicine residents.

Prenatal ultrasound is a powerful diagnostic tool, but there has been little research on how to teach ultrasound to family physicians. The available evidence supports teaching through didactics followed by supervised scanning. Didactic topics include physics and machine usage, indications, fetal biometry, anatomic survey, practice management, ethical issues, and resources. Supervised scanning reinforces the didactic components of training. A "hand-on-hand" supervised scanning technique is recommended for the transmission of psychomotor skills in these sessions. Curricula for teaching ultrasound should include information on which residents will be taught prenatal ultrasound, who will teach them, how to create time for learning ultrasound skills, and how to test for competency. The literature suggests that competency can be achieved within 25-50 supervised scans. Measures of competency include examination and qualitative analysis of scanning. Competency-based testing needs further development because no uniform standards have been established.

Clinical Competence↗

The Magdeburg Clinical Studies' Network for pediatric diseases.

New pharmaceutical technologies had created either enthusiastic hope for major improvements in the medical treatment or major doubts on the use of research data and wrongdoing in clinical trials. Clinical investigators have to consider methodological and scientific principles, to stick to ethical rules, national law and international guidelines. With the invention of General Clinical Research Centres the necessary infrastructure in hospitals with well-trained personnel and the availability of laboratory, clinical and supporting service has been created in the US. Taking GCRC as a model to improve the clinical research in pediatrics, a formal collaboration between the Department of Pediatrics and the Institute for Biometry and Medical Informatics was established at the Otto-von-Guericke-University Magdeburg in 2001. Both nation-wide quality assurance programmes in Pediatric Endocrinology and clinical trials according to the principles of good clinical practice ('GCP') were planned and currently performed. Thus with the resources of the Medical faculty and additional project bound finances the necessary infrastructure has been developed.

Clinical Trials as Topic↗

[Obstetrics and gynecology].

Three-dimensional(3D) ultrasound is getting popular rapidly in obstetrics and gynecology, especially for fetal diagnosis. Three-dimensional ultrasound provide with not only various kinds of 3D images but also any arbitrary sections that cannot be obtained by conventional two-dimensional ultrasound. Fetal biometry can be performed easily and accurately on a 3-orthogonal-plane image by 3D ultrasound. Morphological abnormalities of the fetus and their severities, especially on the face, ears, extremities and skeleton, can be depicted clearly by 3D images. Realistic surface images of a normal fetus may work well on the parents-fetus bonding. Congenital uterine abnormalities are depicted easily and clearly on coronal sections of the uterus by transvaginal 3D ultrasound.

Congenital Abnormalities↗

[The impact of low-dose aspirin therapy on umbilical and middle cerebral artery blood flow in pregnancy complicated by idiopathic intrauterine growth restriction].

AIM: Intrauterine growth restriction and its treatment still constitute a major clinical problem in perinatology. Since low doses of aspirin could improve the utero-placental circulation (by shifting the prostacyclin/thromboxane A2 balance), we have evaluated the impact of low-dose aspirin treatment of IUGR during pregnancy on umbilical (UA) and middle cerebral artery (MCA) blood flow. MATERIAL AND METHODS: The study comprised 32 pregnant women with idiopathic fetal intrauterine growth restriction (IUGR) diagnosed during pregnancy on the basis of ultrasound examination of biometric parameters (BPD, FL, AC). All the patients were treated only by low-dose aspirin (1.5 mg/kg) for 8-14 days. The: fetal biometry and calculation of blood flow indices (S/D, RI, PI) in umbilical and middle cerebral artery were performed before and after treatment. RESULTS: Mean values of all biometric parameters of the fetuses measured before and after treatment did not show statistically important differences (AC-borderline significantly). Umbilical artery blood flow indices calculated after the treatment were slightly lower and MCA indices slightly higher, as compared to those before the treatment. Cerebro-placental ratio changed from 1.37 to 1.63 (borderline significantly). CONCLUSIONS: IUGR treatment by low-dose aspirin had beneficial but non-significant impact on umbilical and middle cerebral artery blood flow. Since the number of subjects in this study was relatively small, further clinical studies are necessary to evaluate the effectiveness of IUGR treatment by low dose aspirin.

Adult↗

Validity of antenatal diagnosis of intrauterine growth restriction by umbilical Doppler waveform index.

OBJECTIVE: To evaluate the validity of systolic/diastolic (S/D) ratio of the umbilical artery in predicting intrauterine growth restriction (IUGR). STUDY DESIGN: Diagnostic test study. SETTING: Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University. SUBJECTS: Two hundred and twelve singleton pregnancies between 30 and 42 weeks' gestation with clinical suspicion of IUGR were recruited and followed-up between December 1st 1995 and June 30th 1998. They were sonographically examined for routine fetal biometry and S/D ratio of umbilical artery Doppler waveform measurement within 14 days of delivery. All of them had an accurate date of last menstrual period and were between 30-42 weeks' gestation. MATERIAL AND METHOD: The umbilical artery S/D ratio was obtained by the same experienced sonographer, using the same ultrasound machine, Aloka 680EX, (Tokyo, Japan). The S/D ratio of 3 or greater was considered abnormal, predicting IUGR prenatally for every gestational week. IUGR was defined as low birth weight of less than the 10th percentile of the standard birth weight curve of Maharaj Nakorn Chiang Mai Hospital. MAIN OUTCOME MEASURES: Sensitivity specificity positive predictive value and negative predictive value. RESULTS: The prevalence of IUGR among the study group was 50.9%. The S/D ratio of 3 or greater for predicting of IUGR gave the sensitivity, specificity, positive predictive value, and negative predictive value of 52.96%, 78.85%, 74.42% and 65.08%, respectively. CONCLUSION: The umbilical artery S/D ratio has relatively low sensitivity and is not a suitable test for IUGR screening. However, the specificity is rather high and it may be helpful in combination with other parameters.

Adolescent↗

[Ultrasound screening and diagnosis of fetal structural abnormalities between 11-14 gestational weeks].

AIM OF THE STUDY: To assess the feasibility of ultrasound screening and diagnosis of structural fetal anomalies at the 11-14 week scan. METHODS: An observational prospective follow up study from March 2000 till May 2003 was performed at three referral centers by seven experienced sonographers with high-resolution ultrasound equipment. 1135 singleton pregnancies between 11+0 and 14+6 weeks gestation (w.g.) participated in the study. The first trimester scan included assessment of fetal number, viability and biometry, nuchal translucency [NT] measurement and fetal anatomy survey performed according to standardized published protocols. Increased NT > or = 95th centile and/or diagnosis of structural fetal anomaly was considered as indication for invasive prenatal diagnosis, early fetal echocardiogram and follow-up scans, including a detailed fetal anomaly scan at 18-22 w.g. and a third scan at 28-32 w.g. Pregnancy outcome was ascertained from hospital records, referring physicians or the patients themselves. RESULTS: The overall prevalence of structural fetal anomalies in the present study was 4.6% (53/1135). 22% (12/53) of the structural anomalies were detected between 11-14 w.g. 9 of those had normal karyotype, and 3 were associated with chromosomal anomalies. Furthermore, 10 cases of increased NT, with or without non-immune hydrops fetalis, were associated with congenital heart disease, rare genetic syndromes and adverse pregnancy outcome later in gestation. The ultrasound detection rate of structural fetal anomalies in the present study increased from 22% (12/53), to 69% (37/53) and 79% (42/53) for the first trimester scan, the first and second trimester scans, and the combination of all three scans, respectively. 21% (11/53) of all structural fetal anomalies were missed by prenatal ultrasound. CONCLUSIONS: The first trimester scan is a method of choice for the diagnosis of major structural fetal anomalies. NT measurement is a useful screening test for chromosomal anomalies. In cases with increased NT subsequent development of congenital heart disease, rare genetic syndromes or adverse pregnancy outcome should be ruled out. At present, the second trimester scan constitutes an indispensable tool for the detection of most structural abnormalities. Even in advanced gestation the prenatal diagnosis of certain anomalies is difficult and often unfeasible.

Chromosome Aberrations↗

[First trimester ultrasound screening for structural and chromosomal anomalies in multiple pregnancy].

AIM OF THE STUDY: To assess the feasibility of first trimester ultrasound screening for structural and chromosomal fetal anomalies in multiple gestations. METHODS: An observational prospective follow up study was carried out in 32 cases of multiple pregnancies. Two scans were scheduled in each case--the first, between 6-9 weeks of gestation (w.g.) and the second, between 11-14 w.g. The aim was assessment of fetal number, viability, chorionicity/amnionicity and fetal biometry. In addition, nuchal translucency [NT] measurement, assessment of risk for chromosomal anomalies and fetal anatomy survey were always performed. Increased NT > or = 95 percentile and/or detection of structural anomaly were considered indications for invasive prenatal diagnosis and fetal karyotyping. Selective fetocide was considered in cases of chromosomal or structural anomalies and in high-order multiple gestations (> or = 3 fetuses). Pregnancy outcome was ascertained by the physical examination of the fetuses, placentas and membranes postpartum, the hospital records, the referring physicians or the parents. RESULTS: From 32 cases of multiple pregnancies included in the study, 28 were twins, and 4--triplets. 68% (19/28) of the twin pregnancies were bichorionic-biamniotic [Bi-Bi], 25% (7/28)--monochorionic-biamniotic [Mo-Bi] and 7% (2/28)--monochorionic-monoamniotic [Mo-Mo]. 4 cases of increased NT in one of the twins (1--associated with trisomy 21) were observed, as well as 2 cases of structural fetal anomalies (1--discordant for exencephaly, and 1--with conjoint twins), 2 cases of feto-fetal transfusion syndrome that developed in the second trimester (1--associated with increased NT between 11-14 w.g.), 1 case of TRAP syndrome [twin-reversed arterial perfusion] and 1 case of cord entanglement in monoamniotic twins. In addition, there were 4 cases of a vanishing twin in the first trimester, and in 2 other cases spontaneous miscarriage of both twins occurred before 24 w.g. In two of the triplet pregnancies selective fetocide was performed, one was successfully delivered at 33 w.g. and in the last case the parents chose to terminate the pregnancy. CONCLUSIONS: First trimester ultrasound is a method of choice for detection of major structural fetal anomalies in multiple gestations. Increased NT between 11-14 w.g. in multiple pregnancies is a useful screening tool for detection of chromosomal fetal anomalies, while in monochorionic twins its presence might predict the development of fetofetal transfusion syndrome. First trimester selective fetocide in high-order multiple gestations or in affected twins is one of the options in pregnancy management.

Abortion, Missed↗

[Factors related to the diagnosis of HELLP syndrome in patients with severe preeclampsia].

BACKGROUND: Each year, around 50,000 women die from preeclampsia-eclampsia worldwide. Thus, hypertensive disorders during pregnancy are public health problems in both developed and developing countries. OBJECTIVE: To identify prognosis factors associated with HELLP syndrome in patients with severe preeclampsia. MATERIAL AND METHODS: A retrospective, observational, cross-sectional, and analytical study was carried out. It included patients that suffered from severe preeclampsia, with and without HELLP syndrome. They were hospitalized at the Division of Obstetrics Dr. Manuel Gea González General Hospital, from January 1st, 1995 to January 1st, 2000 (study group). Only clinical files of patients with severe preeclampsia, without convulsions, HELLP syndrome, or who had not died during the days spent at the hospital were included in the control group; within at least 72 subsequent hours to the pregnancy termination. The connection of HELLP syndrome with the following variables was assessed in the control group: gestational age, maternal age, infant formula, prenatal control, hypertensive disorder history, headache, tinnitus, phosphen, nausea, vomiting, epigastric pain, edema, hyperreflexia, blood pressure values, hepatic biometry, platelet count, blood chemistry with hepatic function. RESULTS: Right upper quadrant or epigastric pain was the most important independent prognosis factor. There were significant differences in the admission laboratory values between those with HELLP syndrome and those without acute complications of preeclampsia. CONCLUSIONS: Although the contribution of right upper quadrant or epigastric pain to the risk status of a pregnant patient is difficult to quantify, it can be used to assess whether the patient is at high risk for development of HELLP syndrome.

Adult↗

Sonographic evaluation of intrauterine growth retardation.

The prenatal recognition of the growth-retarded fetus is important because of the associated increased perinatal morbidity. Clinical methods of assessing fetal growth are disappointing and necessitate that a high-risk group be identified for more intensive surveillance. This review discusses the role of ultrasound biometry in establishing whether a fetus is small. Behavioral characteristics of the fetus may also be assessed using real-time ultrasound. The realization that not all small fetuses are a result of growth failure has led to the development of Doppler ultrasound to identify the fetus at risk. This paper focuses on the evidence supporting the selected use of Doppler ultrasound to investigate high-risk pregnancy.

Female↗

[Ultrasound evaluation of NO-donor (L-arginine) therapy for intrauterine growth retardation].

UNLABELLED: There are many methods of the growth restriction therapy, but the results are still not satisfactory. Actually, we are conducting a project which main conception is based on the use of the NO donor (L-arginine) in growth retardation therapy. This amino acid is an effective NO donor and has a vasodilating effect on the vessels and anti-aggregation effect on platelets, which plays a great role in improving feto-maternal blood flow. The main aim of this paper is the ultrasound evaluation of the effectiveness of NO-donor (L-arginine) therapy for intrauterine growth retardation based on biometrical measurements (estimated fetal weight) compared with newborns weight estimation. METHODS: The investigated group comprised two groups of pregnant women with ultrasonographically diagnosed intrauterine growth retardation (biometry <10th percentile for the gestation age): --78 patients were treated by L-arginine 3 g daily p.o. in 20 days period. --30 patients not treated (no agreement for therapy) as controls. RESULTS: Ultrasound estimation of fetal weight at the start and at the end of the treatment showed a mean value increase of 642 g (SE 90g) using Shepard method and 648g (SE 94g) using Hadlock method respectively. Comparing not treated group there was assessed a mean value increase of 395 g (SE 77 g) using Shepard method and 404g (SE 82g) using Hadlock method respectively. There is statistical significant difference comparing an estimated fetal weight in both methods: p = 0.008 for Shepard calculation and p = 0.012 for Hadlock calculation. There was analyzed newborn weight also--in a treated group mean value was at 2823 g and in not treated group mean value was at 2495 g. There was no significant difference found but a positive tendency for treated group newborns weight is visible. In the treated group number of the growth retarded newborns was at 29% and in the not treated group was at 73%. There was found a significant difference comparing both newborns groups at p < 0.05. CONCLUSIONS: The ultrasound evaluation of the estimated fetal weight and after-birth weight estimation of the newborns showed an increased dynamic of the fetal development in the L-arginine treated group of pregnant women comparing to the not treated group. The ultrasound evaluation of the estimated fetal weight is a good diagnostic tool for properly monitoring the effectiveness of treatment with L-arginine for growth retarded fetuses.

Arginine↗

[Thinoptix implant--the last border in modern cataract surgery. After 7 months, results of first implants in România].

PURPOSE: To present the rollable implant and the firsts results after 7 months of usage. MATERIAL AND METHODS: The implant: ThinOptX Ultra Choice 001 in a rolled state can be implanted through 1.34 mm. 53 patients: 86.8% RF capsulorhexis, cold phacoemulsification, followed for 21 days-7 months. One implantation on broken posterior capsule. RESULTS: The objective astigmometry was unchanged in 51.3% and slightly altered in the rest of cases. In most cases, both distance UCVA and BCVA was under 5/10 in the first 3 days and better than 5/10 afterwards. Unlike the "fat" lens implanted patients, most of ThinOptX implanted patients continued to read the last line even after the correction was changed with 1.5-2 D. The near UCVA in 79.2% = J3, but for a long and comfortable reading the patients needed an addition of 0 D in 32 cases, 1 D in 8 cases, 1.5 D in 6 cases, 2 D in 6 cases and 3 D in one case. CONCLUSIONS: 1. ThinOptX Ultra Choice 001 solves the greatest part of aberrations so that the quality of vision is almost identical with the one of an emmetropic eye with 4 mm pupil and better than when the pupil is 6 mm wide; 2. Both UCVA and BCVA are in good concordance with biometry data; 3. Due to pseudo-accommodation and to an increased focus deepness, the UCVA covers both distance, intermediate and--frequently--the near vision; 4. ThinOptX implant does not put pressure on capsule equator, so that it can be implanted in a broken capsular bag without the risk of break enlargement; 5. The only discomfort, rarely observed, consists in the perception of colored halos around light sources.

Acrylic Resins↗

[Measurement of retinal thickness using optical coherence tomography in patients with myopia].

PURPOSE: Measurement of retinal thickness using optical coherence tomography in patients with myopia. MATERIAL AND METHODS: 39 patients, 23 girls and 16 boys, aged 14-18 years, were included in the study. Control group consisted of 18 patients. Each patient was subjected to routine ophthalmic investigations, which included the assessment of visual acuity for near and distant objects, autorefractometer, intraocular pressure measurement, biometry, static visual field. The macular retinal thickness was measured using the optical coherence tomograph (OCT). RESULTS: The mean macular retinal thickness in the eyes with low myopia was 162.0 microm, with medium myopia 158.5 micro, while in high myopia 125.0 microm. A statistical correlation was found between the retinal thickness in high myopia patients and in the control group. CONCLUSIONS: Optical coherence tomography can be employed to assess the retinal thickness and thus facilitate the observation of the evolution of alterations in myopia.

Adolescent↗

Assessment of placental vascularization by three-dimensional power Doppler "vascular biopsy" in normal pregnancies.

AIM: To describe the evolution of placental vascularization during a normal course of gestation and the blood flow 3D power Doppler indices obtained by "placental vascular biopsy." METHODS: A prospective study was carried out on 99 normal singleton pregnancies from 14 to 40 weeks. Placental vascularization was evaluated by 3D power Doppler ("placental biopsy"). The spherical volume acquired was analyzed using the VOCAL imaging program (Virtual Organ Computer-aided AnaLysis). Three vascular indices, vascularization index (VI), flow index (FI), and vascularization-flow index (VFI), were calculated. Equations and regression coefficients for placental volume and vascular indices (VI, FI, VFI) of the placental biopsy were calculated according to gestational age. Relationships between 3D placental flow indices and fetal growth parameters: biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal body weight, maximum systolic velocity (US), and resistance index in the umbilical artery (URI) were evaluated by calculating their correlation coefficients. RESULTS: All 3D Doppler indices had a significant relationship with gestational age. The most significant relationship was observed for FI, and the least significant for VI (r=0.58, r=0.29, respectively; P<0.01 for both). The FI increased linearly with gestation, whereas the VI showed a dispersion of values with a plateau from the 30th week onwards and a decrease from 37th week to the end of pregnancy. The VFI behaved as a combination of both VI and FI indices from which it was derived. All 3D Doppler indices were significantly related to fetal biometric parameters, except VI and fetal weight. A significant correlation was observed between 3D Doppler indices and maximum systolic velocity and URI. CONCLUSIONS: 3D power Doppler technique of placental vascular "biopsy" is an appropriate tool for routine evaluation of the human placental vascular tree during gestation. 3D Doppler indices change as pregnancy progresses and are significantly related with fetal biometry and umbilical artery Doppler velocimetry.

Adult↗