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To investigate perinatal outcomes of fetal echogenic bowel (FEB).This is a retrospective observational study of FEB cases from Jan 2005-Dec 2010. Data from ultrasound and fetal medicine investigations, uterine artery Doppler (UAD), intra-partum care and neonatal outcome were obtained from Fetal Medicine, Obstetric and Neonatal Databases.There were 139 cases presenting at 21(+5) (15(+1) -35(+5) ) weeks gestation. Overall, 106/139 (76.2%) were live born (LB), 8/139 (5.8%) were complicated by intra-uterine deaths (IUD), 11/139 (7.9%) had termination of pregnancy (TOP) and 14/139 (10.1%) were lost to follow-up after 28 weeks gestation. Six had chromosomal/genetic abnormalities, two had congenital cytomegalovirus, none had cystic fibrosis.Uterine artery Doppler was normal in 106/130 (81.5%) cases. In this group, there were no cases of fetal growth restriction (FGR), 95/106 (89.6%) were LB, 1/106 (0.94%) had an IUD. In the abnormal UAD group, 17/24 (70.1%) developed FGR, 11/24 (45.8%) were LB, 4/24 (16.7%) had TOP, 7/24 (29.2%) had IUD.In total, 20/106 (18.9%) live births were admitted for specialist neonatal care, 12/20 (60%) for prematurity. Only one had primary bowel pathology.Pregnancies with FEB and screen positive UAD are at risk of adverse perinatal outcome. Primary bowel pathology is rare following the finding of FEB.

Breast cyst fluids from 118 women, aged 29 to 69 years, were analyzed by radioimmunoassays for beta-human chorionic gonadotropin (beta-hCG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and thyroid-stimulating hormone (TSH). Blood was drawn at the same time in many cases to compare hormonal levels in serum with those in the breast cyst fluids (BCF). The levels of beta-hCG in BCF were relatively high, with a mean (+/- standard error of the mean [SEM]) of 58.9 +/- 16.8 mIU/ml; serum levels of beta-hCG were negligible. LH and TSH also were elevated in BCF compared with serum levels, exhibiting mean values (+/- SEM) of 26.7 +/- 4.3 mIU/ml and 6.4 +/- 0.44 muIU/ml, respectively. The levels of FSH and PRL in BCF were equivalent to the levels in the serum. The presence of biologically active hCG was suggested in several BCF samples using the rat ovarian hyperemia test. Samples of BCF were assessed for the capacity to stimulate Leydig cell testosterone production in vitro in the presence or absence of an anti-hLH antiserum. Testosterone production was significantly (P less than 0.05) enhanced, even in the presence of the antiserum. These data suggest that BCF contains biologically active hCG.

The interaction of triethyllead chloride with human and rat hemoglobin has been investigated using equilibrium dialysis. In addition the uptake of triethyllead by washed human and rat erythrocytes has been studied in vitro and the distribution of the organolead between blood cells and plamsa has been examined in vivo in the rat. Total lead was determined to atomic absorption spectrophotometry. Equilibrium dialysis demonstrated that human hemoglobin had a very low affinity and capacity for the binding of triethyllead. On the other hand, each tetramer of rat hemoglobin bound 3 mol of triethyllead at sites which did not exhibit cooperativity. ATP, EDTA, Na2S, and NaNO2 had no effect on the binding of triethyllead by rat hemoglobin while urea, glutathione, and N-ethylmaleimide inhibited the interaction. Rat red cells took up more triethyllead than did human red cells and the difference was not due to a higher binding capacity of the rat cell membrane for the organometal. For 80 min following the intravenous injection of triethyllead chloride, the total blood lead in rats was about 10 times the total plasma lead. It was concluded that triethyllead binds to the globin moiety of rat hemoglobin and that organometal binding sites occur on the hemoglobin tetramer but not on the monomers. The results demonstrated that the binding of triethyllead to hemoglobin is a significant determinant of the pharmacokinetics of the organometal in the rat and that the interaction between triethyllead and human hemoglobin would not have a significant effect on the pharmacokinetics of the organometal in the human.

✓ The authors report a case of rotational fixation of the atlanto-axial joint in which the diagnosis was not reached by conventional radiographic techniques. The clinical impression of rotational fixation was ultimately confirmed by computerized tomography. This new diagnostic modality can be very helpful in arriving at a very difficult diagnosis.

Elevated levels of circulating immune complexes (IC) occur in patients with systemic lupus erythematosus (SLE) and in several strains of mice that spontaneously develop a lupus-like illness. An increase in circulating IC might occur as a result of increased IC formation or decreased IC clearance. Previous work with one murine lupus strain, NZB/W, demonstrated normal clearance of soluble IC. We studied the in vivo behavior of stable model IgG IC in two murine lupus strains. MRL/l and BXSB, and in two normal strains, C3H/HeN and BALB/c. IC were injected intravenously, and blood radioactivity was measured over 3 hr. A clearance curve was derived for each mouse using the Marquardt-Levenberg curve-fitting method. A formula is derived which predicts the formation rate of IC in each animal from the blood level of IC and the clearance curve parameters. All mice exhibited biphasic exponential clearance of IC over 3 hr. Clearance of IC was significantly slower in MRL/l mice than in normal strains (P less than 0.02), and clearance in BXSB mice was significantly faster than in normals (P less than 0.02). However, the derived formula suggests that the observed differences in IC clearance have only a small effect on the blood levels of IC in the mice studied, and therefore suggests that the major factor which accounts for increased blood levels of IC in lupus mice is an increase in the IC formation rate.