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Aims: Optimal prenatal management of twin pregnancies requires diligent sonographical evaluation. In Switzerland the efficiency of routine ultrasound during pregnancy has recently become a point of debate. Aim of this study was to evaluate the quality of routine ultrasound of twin pregnancies in Kanton Aargau., Method: Standardised prospective postal interview of each practitioner caring for twin pregnancies during the time period of August 1st, 1998 to July 30th, 1999 in Kanton of Aargau. We chose the Aargau Kanton as being representative of the Swiss population in general on the basis of its average demographic and geographical condition. In addition, evaluating an entire Kanton allows the comparison of data with the official data of the Federal Statistical Office., Results: 81 twin pregnancy cases were delivered during this time period. 65 interviews could be analysed which provided full information. The first sonographic diagnosis of twin pregnancy was confirmed at a mean of 11 (5 - 32) weeks gestation. All twin pregnancies were diagnosed before the onset of labour. 2/65 of the twin pregnancies remained undiagnosed until the 3rd trimester. In one of these cases the patient had refused an ultrasound examination. In 57/65 cases clear information about amnionicity, but in only 53/65 cases additional information about chorionicity was gained., Conclusion: All twin pregnancies were detected sonographically before delivery. Determinations of amnionicity and chorionicity were possible in 87 % and 81 %, respectively, which could be improved.

In the present study we analyzed the three phospholipase A2 isoforms phospholipase A2 type I (PLA2-I), phospholipase A2 type II (PLA2-II), phospholipase A2 type IV (PLA2-IV) in chronic pancreatitis in comparison with normal pancreas. PLA2-I also named pancreatic phospholipase is a digestive enzyme while PLA2-II and PLA2-IV play an important function in inflammatory reactions. In chronic pancreatitis PLA2-I mRNA expression was significantly reduced. In contrast, PLA2-II and PLA2-IV mRNA were increased in 73% of the chronic pancreatitis samples (PLA2-II; 5.7-fold overexpressed; PLA2-IV:5.1-fold overexpressed; p < 0.05). By in situ hybridization the highest expression signals were found in chronic pancreatitis samples in areas with ductal metaplasia. Immunohistochemistry of PLA2-II revealed also the strongest immunoreactivity in ductal metaplasia. Increased PLA2-II and PLA2-IV mRNA levels were associated with a higher degree of tissue destruction, ductal metaplasia and degree of fibrosis. Our findings indicate that PLA2-II and PLA2-IV seems to play a role in the pathobiological alterations in chronic pancreatitis and contribute to the morphological changes which occur in chronic pancreatitis.