Acute Polyhydramnios Complicating Twin Pregnancies

Acute polyhydramnios in the second trimestr is a typical complication in monozygous twin pregnancies. It is caused by a feto-fetal transfusion with anemia on the donor and polycytemia on the recipient twin. Contrary to the chronic hydramnios, there is no increase in malformations. In view of the high mortality rate (100%, according to most authors), the clinical management has to be reconsidered. During the years 1979 to 1983, 10 cases of acute polyhydramnios have been observed at the University Hospital in Zurich. This corresponds to an incidence of 9% in our twin population. All cases investigated were MZ twin pregnancies. With the exception of one patient, who underwent an abortion, all women were hospitalized, had bed rest and received recurrent removals of amniotic fluid and prophylactic tocolysis. The mean gestational age at the time of diagnosis was 23 4/7 weeks and at delivery 30 3/7 weeks. In two cases - one of which is presented in detail - with an unintentional puncture of a placental vessel, the recurrence of the hydramnios did not appear. Eight of 18 newborns survived. No malformations were found. Bed rest, tocolysis and recurrent amniocenteses seem to have a positive influence on the prolongation and outcome of the gestation in acute polyhydramnio

X-ray and NMR spectroscopic characterisation of cyclic titanodiphenylsiloxanes and examination of the hydrolytic stability of their Si-O-Ti bonds

Six crystalline titanodiphenylsiloxanes have been synthesised by reaction of diphenylsilanediol (DPSD) with titanium tetraisopropoxide or its complexes with acetylacetonate (acac) as ligand. Two of them show a spirocyclic structure with the formula TiO2[O2Si2(C6H5)(4)](2) A and TiO2[O4Si4(C6H5)(8)](2) B which have already been described in the literature. Two compounds C and D were identified by X-ray analysis to have the same bicyclic structure but different coordinating solvent molecules. Tetrahydrofuran acts as a non-bridging ligand at the Ti atoms in [Ti(acac)0(1.5)](2)[OSi(C6H5)(2)](3)?2C(4)H(8)O C while dioxane acts as a bridging ligand between the Ti atoms of neighbouring molecules of [Ti(acac)O-1.5](2)[OSi(C6H5)(2)](3)?3C(4)H(8)O(2) D. The titanodiphenylsiloxanes E and F were identified by a cyclotetrameric structure and the formulas [Ti(acac)(2)O](2)[OSi(C6H5)(2)](2) and [Ti(acac)(2)O][OSi(C6H5)(2)](3), respectively. The titanodiphenylsiloxanes A-E were characterised by Si-29 and O-17 NMR spectroscopy, IR and time-of-flight mass spectrometry measurements. The hydrolytic stabilities of the Si-O-Ti bonds in the titanodiphenylsiloxanes A-E have been examined mainly by means of Si-29 NMR spectroscopy. The results reveal a strong influence of the structure type of the titanodiphenylsiloxanes on the hydrolytic stability of their Si-O-Ti bonds apart from the hydrolytic conditions (amount of water, Si, Ti and H+ concentration). The hydrolytic stability of the titanodiphenylsiloxanes A-E decreases in the order cyclotetramer (E)> spirocyclo (A, B)> bicycle (C, D). Reasons for the different hydrolytic stability are discussed. The results on the different hydrolytic stabilities of Si-O-Ti bonds can contribute to a better understanding of the synthesis of homogeneous heterometal materials on a molecular scale via the sol-gel process

Imaging of Pulmonary Infection

The spectrum of organisms known to cause respiratory infections is broad and constantly increasing as new pathogens are identified, and an increasing number of patients have impaired immunity due to disease or medications. The radiographic manifestations of a given organism may be variable depending on the immunologic status of the patient and the presence of pre- or coexisting lung disease. Moreover, the clinical data and radiographic findings often fail to lead to a definitive diagnosis of pneumonia because there are an extensive number of noninfectious processes associated with febrile pneumonitis. This chapter describes and illustrates the characteristic imaging manifestations of the most common community- acquired pneumonias, nosocomial pneumonias, and the various infections seen in both immunocompetent and immunocompromised patients

Defining Lineage Potential and Fate Behavior of Precursors during Pancreas Development

Pancreas development involves a coordinated process in which an early phase of cell segregation is followed by a longer phase of lineage restriction, expansion, and tissue remodeling. By combining clonal tracing and whole-mount reconstruction with proliferation kinetics and single-cell transcriptional profiling, we define the functional basis of pancreas morphogenesis. We show that the large-scale organization of mouse pancreas can be traced to the activity of self-renewing precursors positioned at the termini of growing ducts, which act collectively to drive serial rounds of stochastic ductal bifurcation balanced by termination. During this phase of branching morphogenesis, multipotent precursors become progressively fate-restricted, giving rise to self-renewing acinar-committed precursors that are conveyed with growing ducts, as well as ductal progenitors that expand the trailing ducts and give rise to delaminating endocrine cells. These findings define quantitatively how the functional behavior and lineage progression of precursor pools determine the large-scale patterning of pancreatic sub-compartments

Staging of uterine cervical cancer with MRI: guidelines of the european society of urogenital radiology

Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal obliqu

RNF43/ZNRF3 loss predisposes to hepatocellular-carcinoma by impairing liver regeneration and altering the liver lipid metabolic ground-state

RNF43/ZNRF3 negatively regulate WNT signalling. Both genes are mutated in several types of cancers, however, their contribution to liver disease is unknown. Here we describe that hepatocyte-specific loss of Rnf43/Znrf3 results in steatohepatitis and in increase in unsaturated lipids, in the absence of dietary fat supplementation. Upon injury, Rnf43/Znrf3 deletion results in defective hepatocyte regeneration and liver cancer, caused by an imbalance between differentiation/proliferation. Using hepatocyte-, hepatoblast- and ductal cell-derived organoids we demonstrate that the differentiation defects and lipid alterations are, in part, cell-autonomous. Interestingly, ZNRF3 mutant liver cancer patients present poorer prognosis, altered hepatic lipid metabolism and steatohepatitis/NASH signatures. Our results imply that RNF43/ZNRF3 predispose to liver cancer by controlling the proliferative/differentiation and lipid metabolic state of hepatocytes. Both mechanisms combined facilitate the progression towards malignancy. Our findings might aid on the management of those RNF43/ZNRF3 mutated individuals at risk of developing fatty liver and/or liver cancer