The major urinary protein gene cluster knockout mouse as a novel model for translational metabolism research

Scientific evidence suggests that not only murine scent communication is regulated by major urinary proteins, but that their expression may also vary in response to metabolism via a yet unknown mechanism. Major urinary proteins are expressed mainly in the liver, showing a sexually dimorphic pattern with substantially higher expression in males. Here, we investigate the metabolic implications of a major urinary protein knockout in twelve-week-old male and female C57BL/6N mice during ad libitum feeding. Despite both sexes of major urinary protein knockout mice displayed numerically increased body weight and visceral adipose tissue proportions compared to sex-matched wildtype mice, the main genotype-specific metabolic differences were observed exclusively in males. Male major urinary protein knockout mice exhibited plasma and hepatic lipid accumulation accompanied by a hepatic transcriptome indicating an activation of lipogenesis. These findings match the higher major urinary protein expression in male compared to female wildtype mice, suggesting a more distinct reduction in energy requirements in male compared to female major urinary protein knockout mice. The observed sex-specific anabolic phenotype confirms a role of major urinary protein in metabolism and, since major urinary proteins are not expressed in humans, suggests the major urinary protein knockout mouse as a potential alternative model for translational metabolism research which needs to be further elucidated

Amniotic fluid index in low-risk pregnancy as an admission test to the labor ward.

Background. Oligohydramnios has been shown to be a predictor of intrapartal fetal distress. In a selected group of low-risk pregnancies, however, it has not yet been established that oligohydramnios contributes to intrapartal fetal distress. Methods. Ultrasonically estimated four-quadrant amniotic fluid index as a test for admission to the labor ward was evaluated as a predictive factor for fetal distress during labor in a prospective 'blind' study comprising 600 low-risk pregnancies. Oligohydramnios was defined as an amniotic fluid index <= 50 mm. The parturients were divided into two groups according to the status of the fetal membranes. The amniotic fluid index results were correlated to fetal outcome: Apgar score at 1 and 5 min, pH of blood in umbilical artery and vein, operative delivery because of fetal distress, cesarean delivery because of fetal distress, and number of babies referred to the neonatal intensive care unit. Results. Two-hundred and sixty-seven women had ruptured membranes. Among these a significant increase in operative delivery because of fetal distress was seen in cases of oligohydramnios compared with the normal amount of amniotic fluid (odds ratio 3.86, confidence interval = 1.25-11.9). No significant differences were seen regarding other variables of perinatal outcome. The group with intact membranes comprised 333 parturients. Among these, no significant differences in perinatal outcome could be seen in relationship to the amniotic fluid index, although a 50% increase in emergency operations for fetal distress was seen in women with oligohydramnios. A significant correlation might have been evident even in that group if a larger sample had been studied. Conclusion. The results indicate that measurement of the amniotic fluid index in low-risk pregnant women admitted for labor might identify parturients with an increased risk of intrapartal fetal distress

Genogroup I picobirnavirus in diarrhoeic foals: Can the horse serve as a natural reservoir for human infection?

Picobirnaviruses (PBV) are small, non-enveloped viruses with a bisegmented double-stranded RNA genome. In this study a PBV strain, PBV/Horse/India/BG-Eq-3/2010, was identified in the faeces of a 10 month old weaned female foal with diarrhoea in January 2010 from Kolkata, India. Surprisingly, sequence comparison and phylogenetic analysis of a short stretch of the RNA dependent RNA polymerase gene revealed close genetic relatedness (> 98% nucleotide identity) to a human genogroup I PBV strain (Hu/GPBV1) detected earlier from the same part of India. Our observations together with earlier findings on genetic relatedness between human and animal PBV warrant further studies on zoonotic potential

Ultrasound as predictor of perinatal outcome

The aim of the work described in this thesis was to evaluate the value of ultrasound examinations of the amniotic fluid, umbilical cord and blood flow velocity waveform of the fetal and placental vessels as predictors of the perinatal outcome. In the first study, the amniotic fluid index (AFI) measured on admission to the labour ward was evaluated in low-risk pregnancies. An increased risk of operative delivery for fetal distress (ODFD) was found among women with oligohydramnios after rupture of the membranes. However, the perinatal outcome, expressed in terms of the blood pH in the umbilical vessels, Apgar score and rate of admission to the neonatal intensive care unit did not differ between the group of fetuses with oligohydramnios and the group with normal volume of amniotic fluid. It is therefore uncertain if measurement of the AFI makes any significant contribution to improving the perinatal outcome. In the second study, it was investigated whether prenatal detection of a nuchal cord in post-term pregnancies could be used to identify fetuses at increased risk of intrapartal fetal distress and ODFD. We were unable to demonstrate a correlation between presence of a nuchal cord and increased risk of adverse perinatal outcome in post-term pregnancies. It thus seems unlikely that prenatal identification of fetuses with nuchal cord could improve the outcome of post-term pregnancies. In the third study, Doppler ultrasound examination of the uterine and umbilical arteries were compared as predictors of adverse outcome in pregnancies complicated by suspected fetal growth restriction (FGR). Increased impedance in the uterine and umbilical arteries showed equally strong relations to adverse perinatal outcome. However, Doppler ultrasound examination of the uterine arteries seems to identify fetuses at increased risk, not detected by umbilical artery Doppler ultrasound alone. It was therefore conclude that Doppler ultrasound examination of the uterine arteries should be included in the surveillance of pregnancies complicated by FGR. In the last study, intrapartal Doppler ultrasound examination of the umbilical vein was performed. Pulsation in the blood flow velocity spectrum was seen in almost one-third of fetuses with signs of acute hypoxia. Fetuses exhibiting pulsation in the umbilical vein showed an increased risk of ODFD. However, clinically useful conclusions can not be drawn until the findings are confirmed by larger randomised studies

Uterine and umbilical artery Doppler are comparable in predicting perinatal outcome of growth-restricted fetuses.

OBJECTIVE: To compare umbilical and uterine artery Doppler in predicting outcome of pregnancies suspected of fetal growth restriction (FGR). DESIGN: A prospective study included 353 singleton pregnancies complicated by an FGR fetus. SETTING: University Hospital setting. SAMPLE: Pregnancies suspected of FGR diagnosed by ultrasound fetal biometry during a 5-year period. MAIN OUTCOME MEASURE: Perinatal outcome in relation to uterine and umbilical artery Doppler. METHODS: The women underwent Doppler examination of the umbilical and uterine arteries. Results from the uterine, but not the umbilical artery, were blind to the woman and managing obstetrician. The Doppler results were related to perinatal outcomes including small for gestational age newborns, caesarean delivery, premature delivery (<37 weeks of gestation) and admission of the newborn to a neonatal intensive care unit. RESULTS: Abnormal uterine artery Doppler velocimetry was seen in 120 (33.4%) pregnancies and abnormal umbilical artery Doppler in 102 (28.4%). There was a statistically significant correlation between abnormal Doppler of both the umbilical and uterine arteries and adverse outcome of pregnancy. The two vessels were comparable in predicting adverse outcome. Women with normal umbilical artery Doppler (251) were analysed separately. Abnormal uterine artery Doppler, seen in 61 (24.3%) of those women, showed a statistically significant correlation for adverse outcome of pregnancy. CONCLUSIONS: Doppler examinations of the uterine and/or the umbilical arteries seem to be comparable as predictors of outcome in pregnancies complicated by FGR. Including uterine artery Doppler in the surveillance of growth-restricted fetuses might detect a group of pregnancies at high risk, even though the umbilical artery Doppler was normal

Nuchal cord in post-term pregnancy - relationship to suspected intrapartum fetal distress indicating operative intervention.

Abstract Color Doppler Ultrasound was performed on 202 post-term pregnancies to detect the presence of a nuchal cord. A nuchal cord was diagnosed if the umbilical cord could be followed 360 degrees around the fetal neck. The results were not disclosed to the managing obstetrician, midwife, and patient. The perinatal outcome was analyzed according to Apgar score, umbilical cord artery and vein pH and base excess (BE), perinatal death, cesarean section, operative delivery for fetal distress (ODFD) and admission to neonatal intensive care unit (NICU). A nuchal cord was detected in 69 patients (34.2%). The incidence was not affected by parity or reduced amniotic fluid volume. There was no statistically significant increased risk for 1- and 5-min Apgar scores <7, umbilical artery pH <7.1, umbilical vein pH <7.20, umbilical artery base excess <-11, umbilical vein base excess <-11, perinatal death, cesarean section, ODFD or admission to NICU. Nuchal cord in post-term pregnancies is not associated with an increased risk for signs of fetal distress and operative intervention during labor and delivery

Placental pulsatility index : a new, more sensitive parameter for predicting adverse outcome in pregnancies suspected of fetal growth restriction

Introduction: The pulsatility indices of the umbilical and uterine arteries are used as the surrogate measures of utero-placental perfusion. Combining the two might simplify the evaluation of total placental vascular impedance, possibly improve prediction of adverse outcomes, and help identify pregnancies with suspected fetal growth restriction that need more intense surveillance. Material and methods: Umbilical and uterine blood flow velocities were recorded using pulsed-wave Doppler in a longitudinal study of 53 low-risk pregnancies (248 observations) during 20–40 weeks of gestation. Pulsatility indices was calculated for each of these vessels. A new placental pulsatility index was constructed as: (umbilical artery pulsatility index + mean of the left and right uterine artery pulsatility indices)/2, and mean +2 SD defined as abnormal. Gestational age-specific reference percentiles were calculated for the second half of pregnancy and related to values obtained from 340 pregnancies with suspected intra-uterine growth restriction to test its ability to predict adverse pregnancy outcome. Results: The placental pulsatility index was closely associated with gestational age and decreased with advancing gestation in normal pregnancy. The placental pulsatility index had a higher sensitivity and comparable specificity in predicting adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction when compared with conventional umbilical and uterine artery pulsatility indices. Conclusions: The new placental pulsatility index, reflecting placental vascular impedance on both the fetal and maternal side of placenta, improves prediction of adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction