Discrimination of intravascular lumen and dissections in single intravascular ultrasound images using subtraction, conventional averaging and saline flush

With current 30-MHz intravascular ultrasound systems, flowing blood may cause considerable backscatter which in real-time images is characterized by dynamic speckle. However, in a single intravascular ultrasound image (still-frame) the discrimination between arterial lumen and wall may be difficult due to the frozen intraluminal speckle, particularly in the presence of dissections. We compared subtraction, averaging and saline flush as methods to improve the discrimination between arterial lumen and wall in a single image. The real-time images served as gold standard. In 22 patients who underwent peripheral balloon angioplasty, ultrasound images obtained from 84 sites were examined. The sensitivity and specificity of detecting dissections were in the subtraction image 85% and 100%, in the averaged image 57% and 96%, and in the saline flush image 58% and 86%, respectively. Subtraction is a promising method to outline the irregular lumen in a single image

The Paradoxical Effects of Chronic Intra-Amniotic Ureaplasma parvum Exposure on Ovine Fetal Brain Development

Chorioamnionitis is associated with adverse neurodevelopmental outcomes in preterm infants. Ureaplasma spp. are the microorganisms most frequently isolated from the amniotic fluid of women diagnosed with chorioamnionitis. However, controversy remains concerning the role of Ureaplasma spp. in the pathogenesis of neonatal brain injury. We hypothesize that re-exposure to an inflammatory trigger during the perinatal period might be responsible for the variation in brain outcome of preterms following Ureaplasma driven chorioamnionitis. To investigate these clinical scenarios, we performed a detailed multi-modal study in which ovine neurodevelopmental outcomes were assessed following chronic intra-amniotic Ureaplasma parvum (UP) infection, either alone or combined with subsequent lipopolysaccharide (LPS) exposure. We show that chronic intra-amniotic UP exposure during the second trimester provoked a decrease of astrocytes, increased oligodendrocyte numbers and elevated 5-methylcytosine levels. In contrast, short-term LPS exposure before preterm birth induced increased microglial activation, myelin loss, elevation of 5-hydroxymethylcytosine levels and lipid profile changes. These LPS-induced changes were prevented by chronic pre-exposure to UP (preconditioning). These data indicate that chronic UP exposure provokes dual effects on preterm brain development in utero. On one hand, prolonged UP exposure causes detrimental cerebral changes which may predispose to adverse postnatal clinical outcomes. On the other, chronic intra-amniotic UP exposure preconditions the brain against a second inflammatory hit. This study demonstrates that microbial interactions, timing and duration of inflammatory insults will determine the effects on the fetal brain. Therefore, this study helps to understand the complex and diverse postnatal neurological outcomes following UP driven chorioamnionitis

Chromosome distribution studies in XXY karyotypes.

The method of 'generalised distances' was applied to characterise the relative position of the metaphase chromosomes in a population of XXY subjects (180 metaphases from 28 subjects). The most striking observation was that the presence of an extra gonosome coincided with a disturbance of the normally stable centromere-centre distribution pattern. The distribution analysis gave no clear cut evidence for the induction of gonosomal trisomy XXY by chromosome association. No significant association was observed between X and X or X and Y but there was a smaller distance between X and Y in XXY karyotypes than in XY karyotypes. As far as autosomes are concerned, the XXY karyotypes were characterised by a less central location of the acrocentrics without a clear decrease of association frequencies of these acrocentrics, and the C heterochromatin rich chromosomes were more often associated than in the XX and XY control populations. These data do not support the idea that gonosomal trisomies result from chromosome associations, but favour the hypothesis that spindle degeneration as a result of intrafollicular ageing of C heterochromatin polymorphism may be responsible for non-disjunctions