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We assessed placental perfusion based on placental vascular sonobiopsy (PVS) at 18-22 weeks of gestation in a low-risk population to predict fetal growth restriction (FGR) or pregnancy-induced hypertension [PIH; gestational hypertension (GH) and preeclampsia (PE)].PVS using three-dimensional (3D) power Doppler ultrasound with the VOCAL imaging analysis program was performed in 226 pregnancies [FGR, 25; appropriate-for-gestational age (AGA) 191; and large-for-gestational age (LGA), 10] [PIH, 13 (GH, 7 and PE, 6) and non-PIH, 213] at 18-22 weeks of gestation. 3D power Doppler indices such as the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) using PVS were calculated in each placenta.There were no significant differences in VI, FI, or VFI values among FGR, AGA, and LGA pregnancies. No significant differences in VI, FI, or VFI values between PHI and non-PIH pregnancies were noted. There were also no significant differences in VI, FI, or VFI values between GH and PE pregnancies.3D power Doppler placental vascular indices at 18-22 weeks could not be used to predict high-risk pregnancies that develop FGR or PIH in a low-risk population.

胎便性腹膜炎は新生児外科疾患としては稀なものではなく，数多くの出生前診断例が報告されている．しかし，病勢の最盛期に偶然発見された例が大部分であり，発症前後の所見については充分な知見が得られているとは言えない．今回，スクリーニング検査で認めた腸管拡張像とそれに隣接した高エコー領域の存在から経過観察をしていた児において，発症直後と考えられる時点から分娩に至るまで11週間にわたって観察し得た胎便性腹膜炎の1例を経験したので，その画像所見の変化を中心に報告する．症例は30歳の経産婦であり，妊娠28週時点で腸管拡張と高エコー領域を認めた．2週間後の再検では有意な変化を認めなかったが，32週には嚢胞性変化の消失と胎児腹水の出現を認め，胎便性腹膜炎と診断した．約4時間後に実施した搬送先における所見では，急激な腹水の増加が見られた．腸管は一塊となった高エコー像として認識されたが，拡張像は消失していた．妊娠35週には，胎児腹水はほぼ消失したが，腸管の拡張像が著明となった．2日間にわたる羊水穿刺により2,500 mlの羊水除去を行ったが，胎児心拍数図には異常を認めないままに経過した．妊娠39週5日に分娩誘発を行い，胎児心拍数図に異常を認めることなく進行，3,081 gの女児を娩出した．

Intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) activated by HCG in vitro are reported to improve implantation rates in patients with repeated failure of IVF-ET. In this study, we examined the effects of intrauterine administration of freshly isolated PBMC on clinical pregnancy and the implantation rates of patients who received frozen/thawed embryo transfer by prospective cohort study. Patients who had not achieved a successful pregnancy despite at least one or more IVF-ET sessions were enrolled in this study (n = 253, 253 cycles). Based on the patient's treatment preferences, PBMC were freshly isolated from each patient and then administered to the intrauterine cavity of that patient. Frozen/thawed embryo transfer was performed and the success of implantation in the PBMC-treated group (n = 83, 83 cycles) was compared with that in the non-treated control groups (n = 170, 170 cycles). There were no significant differences in the clinical pregnancy rate (34.9% vs. 32.9%), implantation rate (21.6% vs. 21.1%) and live birth delivery rate (21.7% vs. 21.8%) between PBMC-treated and non-treated groups. However, when the analyses were restricted to patients who had three or more implantation failures, the clinical pregnancy rate and the implantation rate in the PBMC-treated group (42.1% and 25.0%, p

The Stroop test has been already applied to many children with attention deficit/hyperactivity disorder (AD/HD). There are, however, differences in the measurement of the Stroop test, and also in the background conditions of the patients, such as the status of comorbidity with learning disorder (LD), medication and the level of Intelligence Quotient (IQ), and presumably as a result, the outcome of the Stroop test shows a diversity. This study was undertaken to compare the performances of children with AD/HD to normal controls using the modified Stroop test according to the subtypes of AD/HD. Subjects in this study were 23 unmedicated children with AD/HD, ranging from 6 to 14 years of age, and 69 normal controls who were matched on sex and age. Children with AD/HD whose verbal IQ and performance IQ were above 80 showed significant differences in such indices as Incongruent Color Naming time (ICN) and the resulting index of subtracting Color Naming time (CN) from ICN (ICN-CN). As to the analysis according to the subtypes excluding 8 cases with comorbid LD, both the predominantly inattentive type and the group putting together the predominantly hyperactive-impulsive type and the combined type showed significant differences in ICN--CN compared with the normal controls. These results suggest that the inattentiveness relevant factor affects the performance of the interference task in children with AD/HD.

Objective: To describe three-dimensional (3D) sonographic features of placental abnormalities in utero. Methods: A total of 6 cases with placental abnormalities (1 chorioangioma, 1 subchorionic hematoma, 2 placental cysts, and 2 subplacental fibromas) from 22 to 34 weeks of gestation were studied with transabdominal 3D sonography. Results: Placental abnormalities could be easily imaged with both two-dimensional (2D) and 3D sonography; however, visualization of the continuity and curvature of structures was more easily accomplished with 3D sonography. In the case with chorioangioma, the thick and rough surface of the tumor was clearly depicted. With the use of color Doppler ultrasound, only a case of chorioangioma was shown to have abundant blood flow within the tumor. In cases with placental cyst and subchorionic hematoma, the wall of the cyst becomes a transparent-like structure, so internal textures can be clearly identified. In the case with subplacental fibroma, the location in relation to the placenta was clearly recognized. Conclusion: These results suggest that 3D sonography has the potential to be a supplement to 2D sonography and color Doppler ultrasound in identifying placental masses and provides a novel means of visualizing placental abnormalities in utero.

The pre-ejection period (PEP) of the fetal cardiac cycle was studied on 22 chronically instrumented pregnant ewes. The PEP was measured from the onset of the Q wave on fetal electrocardiogram to the onset of the upstroke on the fetal arterial blood pressure curve. Lengthening of the PEP was observed in association with an increase in gestational age, fetal body weight, fetal brow-rump length, and fetal heart weight. Consequently, the PEP values were calculated to those at fetal heart weight of 10 grams. The PEPc (calculated) was prolonged by acidosis but no significant relationship was found between the PEPc and arterial blood pO2. An increase in coronary blood flow was associated with a shortening of the PEPc in the fetuses under normal physiologic conditions. Fetal hypoxemia and respiratory acidosis created by administration of 10 per cent O2 and 20 per cent CO2 with 20 per cent O2 to the mother increased fetal coronary flow and was in general associated with a prolonged pre-ejection period.

Simultaneous recordings of the fetal electrocardiogram and ultrasound Doppler-cardiogram were used for the determination of the pre-ejection period (PEP) of the fetal cardiac cycles. All 50 fetuses selected for the present study experienced uneventful perinatal lives despite maternal antepartum complications which required hospitalization. A significant positive correlation between the PEP and gestational age of the fetuses was again demonstrated. The PEP of the fetus measured within one week prior to delivery was also found to be significantly correlated with the newborn body weights at birth. Statistical analysis demonstrates that fetal body weight was more closely related to the physiologic lengthening of the PEP.

The effect of various catecholamines on fetal breathing movements (FBM) was studied in 10 established chronic fetal rhesus monkey preparations. Norepinephrine, epinephrine, isoproterenol (all 1:10 5 [w/v] in concentration), or saline was infused intravenously to the fetus, each on five separate occasions. The infusion of the catecholamines was started at 0.02 ml/min and increased in a stepwise fashion until the fetus exhibited cardiovascular responses. The infusion rate was then maintained for 30 minutes to observe FBM. The incidence of FBM was determined for each 5-minute period and also expressed as a percentage of preinfusion values. Statistical analysis revealed that the incidence of FBM was significantly increased by isoproterenol and decreased by norepinephrine. Epinephrine did not consistently alter the incidence of the FBM.