Evaluation of CA 15-3 serum levels in breast cancer patients

A case of opacity in the fetal gallbladder was diagnosed by ultrasound. The lesion resolved spontaneously in the postnatal period. Careful follow-up ultrasound examinations are necessary for fetal cholelithiasis in the pre- and postnatal periods, and conservative management is mandatory.     

Prenatal myocardial infarction suspected by fetal echocardiography

Myocardial infarction is rare in the newborn period. We describe a case in which myocardial infarction was suspected at 25 weeks of gestation by fetal echocardiography. There was an aneurysm of the left ventricular apex with paradoxical motion and bulging of the left ventricular free wall during systole. The diagnosis was confirmed by postnatal electrocardiogram, vectorcardiogram, and thallium myocardial perfusion imaging.     

''Farmer''s ear'': sudden sensorineural hearing loss due to Chlamydia psittaci infection

Idiopathic dilation of the right atrium (IDRA) is a rare cardiac anomaly of unknown etiology. Whether it is an acquired or congenital lesion is controversial. A case of IDRA detected in utero and confirmed postnatally is reported. The postnatal course was complicated by the development of atrial flutter successfully treated with sotalol. A review of the literature concerning IDRA is presented.     

Postpartum depression and symbiotic illusion.

Discusses the phenomenon of postpartum depression from a transgenerational perspective. The concept of symbiosis is taken from the mother's point of view as well as from the baby's. Symbiosis is defined as a delusional 2-person fantasy of mutual dependence rather than as a normal phase of development. Analysis of a case of postnatal depression is presented to illustrate the clinical and theoretical implications of this viewpoint and how it was applied in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prenatal diagnosis and management of fetal hydrocephaly and lissencephaly

Two cases of prenatal diagnosis of lissencephaly are presented in the context of a series of 118 cases of prenatally diagnosed hydrocephalus. Within this series there was one case of Walker-Warburg syndrome and another of Miller-Dieker syndrome. It is stressed that the cases reported here of ventriculomegaly diagnosed in utero show a very different outcome from those in published studies of fetal hydrocephalus which only deal with patients in whom the diagnosis was determined after birth. In those postnatal series there is a considerable selection bias, and the fate of the fetuses reported here was much worse than in postnatal series. Of the 118 fetuses 6 had fetal infections, 6 had chromosomal abnormalities, 26 had associated spina bifida, 64 fetuses had associated other anomalies, and only 28 had isolated hydrocephalus. Although it is difficult to determine the prognosis individually after prenatal diagnosis of ventriculomegaly, the data presented here may be helpful in counseling parents prenatally. The counseling should be performed with the collaboration of obstetricians, pediatricians, surgeons, and geneticists.     

Region-specific developmental patterns of atrial natriuretic factor- and nitric oxide-activated guanylyl cyclases in the postnatal frontal rat brain

In the rat central nervous system, cyclic GMP can be produced by two isoforms of guanylyl cyclase: a cytosolic isoform, which is activated by nitric oxide, and a membrane-bound isoform, activated by atrial natriuretic factor. We studied the development of guanylyl cyclase activity upon maturation of the rat forebrain from postnatal days 4 to 24, using a combined immunocytochemical and biochemical approach. Atrial natriuretic factor-activated particulate guanylyl cyclase activity was found to decrease in the frontal cortex, in the lateral septum and in the piriform cortex upon maturation. A transient expression of atrial natriuretic factor-sensitive guanylyl cyclase activity was observed at postnatal day 8 in the caudate putamen complex, whereas an increase was observed in the lateral olfactory tract from postnatal days 8 to 24. Biochemical and immunocytochemical studies using the nitric oxide synthase inhibitor N(G)-nitro-L-arginine methyl ester, or the inhibitor of soluble guanylyl cyclase 1H-[1,2,4]oxadiazolo[4,3-a]quinaloxin-1-one, indicated high levels of endogenous nitric oxide release at postnatal days 4 and 8. This activity decreased strongly in all brain areas examined. From postnatal day 8 onwards, atrial natriuretic factor-responsive cyclic GMP-immunoreactive cells could be characterized as astrocytes, with the exception of those in the the lateral olfactory tract, where the myelinated fibers became cyclic GMP producing. Furthermore, our results on activation of both guanylyl cyclases at postnatal day 8 leads to the suggestion that both isoforms might be found in the same cells. This study shows that there are pronounced differences between various frontal brain areas in the development of the responsiveness of both the particulate and soluble isoforms of guanylyl cyclase, and lends further support to the hypothesis that natriuretic peptides have a role in neuronal growth and plasticity of the rat brain.     

Amylase-producing lung cancer: ultrastructural and biochemical studies

A case of lung cancer with elevated amylase activity in serum, urine, and tumor tissue was studied electron microscopically and biochemically. Ultrastructurally, there were numerous electron-dense granules in the cytoplasm of most tumor cells. These granules were located in the apical region of tumor cells and had a single limiting membrane, associated with a clear zone just beneath it. Furthermore, circular, lamellar and annulate structures, which closely resembled those observed within zymogen granules of the salivary glands in postnatal mice and rats, were sometimes recognized within these granules. These observations suggested that these granules were identical to a postnatal or immature form of zymogen granules in salivary glands. Biochemical analysis confirmed that the amylases obtained from the tumor tissue were composed of the sialic acid-containing glycoprotein, which was not found in normal amylases. A possible histogenesis of the amylase-producing lung cancer was briefly discussed.     

Capillary hemangioma of the neck: prenatal MR findings

Prenatal MR findings of a case of extracranial capillary hemangioma simulating an encephalocele at sonography are reported. MR imaging had an adjunctive diagnostic role in excluding the possibility of an encephalocele. The capillary hemangioma had diffuse T2 hypointensity prenatally, which is atypical of postnatal imaging findings.     

Changes in subcellular localization of metabotropic glutamate receptor subtypes during postnatal development of mouse thalamus

High resolution immunoelectron microscopy was used to study subcellular localization patterns of three metabotropic glutamate receptor subtypes (mGluR1alpha, mGluR5, and mGluR2/3) during postnatal development of mouse ventral posterior (VP) thalamic nucleus. Immunoreactivity for all three mGluRs was detected from birth (postnatal day 0, P0), but mGluR1alpha showed dramatic changes in localization with age. In the first postnatal week, mGluR1alpha immunoreactivity was mainly found in proximal dendrites and somata and not usually associated with synaptic contacts. From the second postnatal week, it became concentrated in distal dendrites and preferentially associated with corticothalamic (RS) synapses. mGluR5 immunoreactivity was weaker than mGluR1alpha immunoreactivity at all postnatal ages and showed a similar change in subcellular distribution to that of mGluR1alpha. It was also localized in astrocytic processes. mGluR2/3 immunoreactivity was mainly localized in astrocytic processes surrounding neuronal somata and synapses and this pattern was consistently maintained through all postnatal ages. A small number of presynaptic axon terminals were labeled for mGluR2/3 immunoreactivity and formed asymmetrical synapses. This study demonstrates that Group I mGluR proteins (mGluR1alpha and mGluR5) become redistributed in association with the development of corticothalamic function as demonstrated physiologically, whereas Group II mGluR proteins (mGluR2/3) are mainly associated with neuroglia.     

Hypoplastic left heart syndrome in the second trimester

Hypoplastic left heart syndrome is a relatively common congenital anomaly with a high mortality even after palliative postnatal surgery. The case presented had a normal cardiac cavity and great artery dimensions at 19 weeks of gestation but bright left ventricular myocardial echoes, impaired left ventricular shortening, and no detectable forward flow in the left ventricular outflow tract. Autopsy showed left ventricular subendocardial calcification. This demonstrates a likely early stage in the evolution of hypoplastic left heart syndrome, which has a variable time course. The abnormal left ventricular myocardial performance associated with low left ventricular output results in a failure of growth of the left heart rather than there being a primary failure of embryogenesis.     

Co-ordinated care for women with postnatal depression

In many cases, postnatal depression is not identified or treated early enough, often as a result of poor co-ordination between the health professionals involved. This article outlines a project to develop multidisciplinary working to improve the care provision for women with postnatal depression.     

Pathological evidence of prolonged umbilical cord encirclement as a cause of fetal death

A case is presented in which autopsy findings (deep groove around the fetal waist and buttock), and gross and microscopic umbilical cord and placental examination (linear ulcer of umbilical cord histologically rimmed by fetal epidermal implants with evidence of remote bleeding) established the diagnosis of umbilical cord encirclement as a cause of intrauterine fetal death despite the lack of prenatal or postnatal obstetrical evidence.     

Long-term somatic and mental development of children after periconceptional multivitamin supplementation

The preventive effect of periconceptional folic acid-containing multivitamin supplementation compared to placebo-like trace element tablets on the number of first-occurring neural-tube defects was well documented in the Hungarian randomized double-blind trial. The effect of this new primary prevention on the early (first 11 months) postnatal development has also been studied. This follow up was expanded to children at the 2nd and 6th years of age studied previously by a blind examination of their somatic and mental development. Confounding factors and case histories were evaluated and paediatric, ophthalmological, audiological and psychometric examinations were performed on 625 children. CONCLUSION: There were no differences in the rate and distribution of disorders including allergies (except otitis media), ophthalmological and audiological anomalies, anthropometric and mental development between children who belonged to the multivitamin or to the trace element group.     

Calcitonin gene-related peptide and alpha-CGRP mRNA expression in cranial motoneurons after hypoglossal nerve injury during postnatal development

Changes in calcitonin gene-related peptide (CGRP) immunoreactivity and alpha-CGRP mRNA expression were determined in the hypoglossal nucleus after the nerve was crushed or transected in rats at 10, 14 and 21 days postnatal. alpha-CGRP mRNA expression was determined in normal, noninjured, hypoglossal nuclei at the three ages and after both injuries in 10 and 21 days postnatal rats. Reinnervation and neuronal survival were assayed. Although the three age groups expressed comparable levels of alpha-CGRP mRNA and its peptide in intact, hypoglossal nuclei, axonal injury produced age-dependent alterations in alpha-CGRP mRNA and CGRP. In the 21 days postnatal rats, changes in alpha-CGRP mRNA and peptide mimicked those reported in adult motoneurons after the same injuries. CGRP was elevated until reinnervation after nerve crush, whereas biphasic elevations occurred after nerve transection. In 21 days postnatal rats, increases in alpha-CGRP mRNA preceded elevations of the peptide but a greater increase resulted initially after nerve transection. An upregulation of alpha-CGRP mRNA also developed initially after both injuries in 10 days postnatal rats but subsequent elevations of alpha-CGRP mRNA did not materialize. In contrast, CGRP immunoreactivity did not increase after either injury in 10 days postnatal rats and, in fact decreased. Levels of CGRP immunoreactivity did not differ from normal amounts after either nerve injury in 14 days postnatal rats. Substantial neuronal cell loss occurred after each injury in 10 and 14 days postnatal rats but was not found in 21 days postnatal rats. Tongue reinnervation by surviving motoneurons was established after all injury paradigms except 10 days postnatal transection. The current findings demonstrate an age-dependent correlation between injury-induced expression of CGRP and hypoglossal motoneuron survival.     

Delusions in Alzheimer''s disease: a review

To understand the developing processes of gamma-aminobutyric acid (GABA)-containing chromaffin cells and nerve fibers in the mouse adrenal gland, we examined the tissues in various postnatal stages by immunohistochemistry using a GABA antibody. From birth until postnatal week 1, GABA-immunoreactivity was seen in very few nerve fibers, and in none of the chromaffin cells. At postnatal week 2, GABA-immunoreactivity appeared weakly in clusters of chromaffin cells and strongly in relatively numerous varicose nerve fibers. The immunoreactive nerve fibers were densely distributed in the small immunonegative chromaffin cells and large ganglion cells, but only sparsely so in the weak immunoreactive chromaffin cells. At postnatal week 3, the number of the immunoreactive chromaffin cells and nerve fibers further increased compared to that at postnatal week 2. The staining pattern of GABA-immunoreactive nerve fibers in the medullas was similar to that at postnatal week 2. From postnatal week 4 until postnatal week 8, the distribution and frequency of the immunoreactive chromaffin cells and nerve fibers were also similar to those at postnatal week 3. These results suggest that the expression of GABA in the chromaffin cells and in the nerve fibers of the mouse adrenal gland may be completed by postnatal week 3.     

Psychometric quality of a Processes of Change (POC) Scale in a maternal smoking sample.

There has been broad application of the Transtheoretical Model (TTM) to the assessment of behavior change in health psychology. Existing outcome and selection measures have been borrowed to evaluate intervention programs in many new clinical settings. It is essential to examine the usefulness of TTM scales with new populations, in this case, for new mothers who smoke. This study examines the reliability, structure, and criterion validity of responses to the Processes of Change Scale for Maternal Smokers in a community sample of 226 pregnant and postnatal female smokers (aged 16–44 yrs). Results furnished evidence of adequate score reliability and validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The involvement of innervation in the regulation of fetal adrenal steroidogenesis

Over the last decade, great interest has been generated in evaluation of the extent of neural control of the adrenal cortex and in adrenal cortical/medullary paracrine interactions. The purpose of this review is to summarize current knowledge of fetal adrenal cortical innervation and to present an overview of those studies of fetal adrenal function indicating that adrenal innervation plays a functional role in the control of glucocorticoid secretion under basal conditions and in response to a variety of homeostatic challenges. It will be helpful in understanding both the innervation of the adrenal cortex and the role of adrenal innervation in steroidogenesis during fetal development to briefly review experimental studies that have shed light on adrenal steroidogenesis during postnatal life. This is helpful for two reasons: 1) the vast majority of studies of adrenal innervation and its effect on steroidogenesis have utilized postnatal animals and 2) since the fetus is preparing for postnatal life, evaluating the level of function achieved postnatally provides crucial insights into the developmental stages of adrenal innervation and its role in steroidogenesis in preparing the fetus for an independent postnatal existence.     

Mutagenesis of human Mel1a melatonin receptor expressed in yeast reveals domains important for receptor function

Mechanisms of organization of the striatal compartments are poorly understood, although involvement of cell adhesion molecules in the compartmentalization has been suggested. Cadherin-8 distribution in the neonatal rat striatum was immunohistochemically studied using a rabbit anti-cadherin-8 antiserum. Intensity of cadherin-8 immunolabeling in the striatum was heterogeneous from postnatal day 0 to postnatal day 7. At postnatal day 9, cadherin-8 immunoreactivity was so weak that heterogeneity was no longer clearly seen. Cadherin-8 immunoreactivity was not detectable at postnatal day 14. Cadherin-8-rich and cadherin-8-poor areas were identical to calbindin-rich areas and tyrosine hydroxylase-rich patches, respectively, in allocation, indicating that cadherin-8 was predominantly expressed in the striatal matrix. These results suggest that cadherin-8 is involved in formation of the striatal compartmentalized structures during brain development.     

Expect the worse or hope for the best? Prenatal diagnosis of geleophysic dysplasia

Geleophysic dysplasia is a rare, autosomal recessive disorder which causes disproportionate short stature associated with severe physical handicaps, but is compatible with survival into adulthood. We present a case, a first-born child, where genetic counselling difficulties arose following ultrasound recognition of short-limbed dwarfism in association with polyhydramnios and an initial incorrect prenatal diagnosis of lethal chondrodysplasia. After birth of the surviving affected infant, the parents had great difficulty accepting that there had been a prenatal misdiagnosis and they were greatly disappointed by our inability to predict the postnatal survival of an infant to whom no hope of life had previously been given. The correct diagnosis was not made until the proband was nearly 1 year old, and the true prognosis then became clearer. This experience underlines the relative ease of prenatal recognition of skeletal growth abnormalities compared with the considerable difficulties experienced in reaching a precise diagnosis. Thus, following prenatal diagnosis of unspecified chondrodysplasia when parents seek definite information about the prognosis, the temptation to be either overpessimistic or overoptimistic should be avoided.     

First-time mothers' perceptions of efficacy during the transition to motherhood: Links to infant temperament.

This investigation examined associations between pre- and postnatal reports of 1st-time mothers' depression, anxiety, and marital quality and postnatal reports of infant temperament and changes in feelings of efficacy. Maternal efficacy measured prenatally was associated with concurrent measures of depression, anxiety, marital conflict, and levels of previous child-care experience. Mothers' perception of infant temperament postnatally accounted for a significant proportion of variance in postnatal reports of maternal efficacy. Although individual differences in women's feelings of efficacy were fairly stable, significant increases in maternal efficacy were also observed over time. Findings suggest that 1st-time mothers' beliefs about their ability to perform nurturing routines may change from a global sense of self-competence to more differentiated perceptions of nurturing efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)