The Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes 1

Aim: The resistance of placental blood vessels might be increased in diabetic pregnancies. This increased resistance can affect uteroplacental blood flow and influence the oxygen and nutrient supply of the fetus and fetal growth. Our aim was to compare the ultrasonographic, pathomorphologic data and vasoreactivity of umbilical and placental vessels of gestational diabetic newborns with that of normal pregnancy newborns. Methods: In this case-control study the placental vascularization of pregnant women was determined by 3D power Doppler ultrasound technique. We calculated the vascularization index (VI), flow index (FI) and vascularization flow index (VFI). We performed a tissue bath experiment (treatment with oxytocin and desmopressin) on umbilical vessels and collected pathomorphologic data according to the Royal College of Pathologists’ 2011 protocol. Results: The placental vascularization index and the umbilical artery S/D were significantly lower in the case group. The mean VI was 6.21% (±2.69 SD) in control versus 3.5% (±2.97 SD) (p<0.05) in GDM. The mean value of the umbilical artery S/D was 2.27 (±0.22 SD) and 2.18 (±0.45 SD) (p<0.05) respectively. In an isolated tissue bath experiment, oxytocin and desmopressin did not elicit significant contraction on umbilical cord vessels. Conclusion: Our results suggest that umbilical vessels might have a different receptor pathway regulation that can compensate for the rheological changes in the pregnant woman’s blood flow and gives opportunity for selective therapy to fetuses more vulnerable to hypoxia. (Jakó M, Surányi A, Kaizer L, Domokos D, Bártfai G. The Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes. SEEMEDJ 2017;1(1);40- 49

Examination of the vascularization of fetal kidney with three-dimensional power Doppler technique in pregnancies complicated by increased maternal blood pressure

The goal of this study was to investigate the fetal renal vascularization during the third trimester of gestation and the perinatal outcome in pregnancies diagnosed with hypertension. Depending on the medical history, the cases were divided into two groups: chronic hypertension group and gestational hypertension group. The vascularization and the volume of kidneys were observed in prenatal period by three-dimensional ultrasound. We monitored gestations and perinatal complications. Renal volume and vascularization were detected in 45 cases complicated by gestational hypertension and 21 cases with chronic hypertension during the 20-month study period. The alteration in fetal renal volume and vascularization may be an in utero cause of subsequent intrauterine and neonatal complications, such as Cesarean section because of fetal distress (36%), perinatal infection (24%), treatment in neonatal intensive care unit (39%), or increased perinatal mortality (1%) in affected cases. The results demonstrate that fetuses with depressed vascularization of medullae had 1.5 times the risk of an abnormal outcome compared to the control group. The volume of kidneys had a strong correlation with their vascularization. Detailed ultrasound examinations of renal parenchyma appear to be useful for the prenatal diagnosis of intrauterine hypoxia, allowing the detection of potential pathological fetal conditions in utero

Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes

Aim: The resistance of placental blood vessels might be increased in diabetic pregnancies. This increased resistance can affect uteroplacental blood flow and influence the oxygen and nutrient supply of the fetus and fetal growth. Our aim was to compare the ultrasonographic, pathomorphologic data and vasoreactivity of umbilical and placental vessels of gestational diabetic newborns with that of normal pregnancy newborns. Methods: In this case-control study the placental vascularization of pregnant women was determined by 3D power Doppler ultrasound technique. We calculated the vascularization index (VI), flow index (FI) and vascularization flow index (VFI). We performed a tissue bath experiment (treatment with oxytocin and desmopressin) on umbilical vessels and collected pathomorphologic data according to the Royal College of Pathologists’ 2011 protocol. Results: The placental vascularization index and the umbilical artery S/D were significantly lower in the case group. The mean VI was 6.21% (±2.69 SD) in control versus 3.5% (±2.97 SD) (p<0.05) in GDM. The mean value of the umbilical artery S/D was 2.27 (±0.22 SD) and 2.18 (±0.45 SD) (p<0.05) respectively. In an isolated tissue bath experiment, oxytocin and desmopressin did not elicit significant contraction on umbilical cord vessels. Conclusion: Our results suggest that umbilical vessels might have a different receptor pathway regulation that can compensate for the rheological changes in the pregnant woman’s blood flow and gives opportunity for selective therapy to fetuses more vulnerable to hypoxia

Az adverbiumok mondattani és jelentéstani kérdései = The syntax and syntax-semantics interface of adverbial modification

A határozószók és a határozók alaktani, mondattani és funkcionális kérdéseit vizsgáltuk a generatív nyelvelmélet keretében, főként magyar anyag alapján. Olyan leírásra törekedtünk, melyből a különféle határozófajták mondattani viselkedése, hatóköre, valamint hangsúlyozása egyaránt következik. A különféle határozótípusok PP-ként való elemzésének lehetőségét bizonyítottuk. A határozók mondatbeli elhelyezése tekintetében a specifikálói pozíció (Cinque 1999) ellen és az adjunkciós elemzés (Ernst 2002) mellett érveltünk. Megmutattuk, hogy a határozók szórendjének levezetéséhez bal- és jobboldali adjunkció feltételezése egyaránt szükséges. A különféle határozófajták szórendi helyét mondattani, jelentéstani és prozódiai tényezők összjátékával magyaráztuk. A jelentéstani tényezők között pl. a határozók inkorporálhatóságát korlátozó típusmegszorítást, a negatív határozók kötelező fókuszálását előidéző skaláris megszorítást, egyes határozófajták és igefajták komplex eseményszerkezetének inkompatibilitását vizsgáltuk. Az ige mögötti határozók szórendjét befolyásoló prozódiai tényező például a növekvő összetevők törvénye. Megfigyeltük az intonációskifejezés- újraelemzés kiváltódásának feltételeit és jelentéstani következményeit is. A helyhatározói igekötők egy típusát a mozgatási láncok sajátos fonológiai megvalósulásaként (a fonológiailag redukált kópia inkorporációjaként) elemeztük. A tárgykörben mintegy 60 tanulmányt publikáltunk. Adverbs and Adverbial Adjuncts at the Interfaces (489 old.) c. könyvünket kiadja a Mouton de Gruyter (Berlin). | This project has aimed to clarify (on the basis of mainly Hungarian data) basic issues concerning the category "adverb", the function "adverbial", and the grammar of adverbial modification. We have argued for the PP analysis of adverbials, and have claimed that they enter the derivation via left- and right-adjunction. Their merge-in position is determined by the interplay of syntactic, semantic, and prosodic factors. The semantically motivated constraints discussed also include a type restriction affecting adverbials semantically incorporated into the verbal predicate, an obligatory focus position for scalar adverbs representing negative values of bidirectional scales, cooccurrence restrictions between verbs and adverbials involving incompatible subevents, etc. The order and interpretation of adverbials in the postverbal domain is shown to be affected by such phonologically motivated constraints as the Law of Growing Constituents, and by intonation-phrase restructuring. The shape of the light-headed chain arising in the course of locative PP incorporation is determined by morpho-phonological requirements. The types of adverbs and adverbials analyzed include locatives, temporals, comitatives, epistemic adverbs, adverbs of degree, manner, counting, and frequency, quantificational adverbs, and adverbial participles. We have published about 60 studies; our book Adverbs and Adverbial Adjuncts at the Interfaces (pp. 489) is published in the series Interface Explorations of Mouton de Gruyter, Berlin

Milyen az összefüggés a lepényi perfúzió vizsgálata során a teljes placenta vizsgálata és a szonobiopsziás módszer között? [Correlation between placental perfusion measured in the entire placenta versus assessed by sonobiopsy]

Bevezetés: A placenta perfúziója háromdimenziós power-Doppler (3DPD )-indexekkel értékelhető in vivo, szonobiopsziás úton vagy pedig a teljes placentában. Célkitűzés: A két mérési módszer közötti kapcsolat feltárása. Normál várandós nők körében prospektív kohorsz-ultrahangvizsgálat történt a 11–40. terhességi héten. Módszer: A placenta vascularisatióját a 3DPD-indexek (vascularisatiós index [VI]; áramlási index [FI]; vascularisatiós áramlási index [VFI]) segítségével értékeltük ki gömb alakú szonobiopszás eljárással vagy pedig a teljes méhlepényben. Eredmények: Összesen 150 nőt vizsgáltunk meg, átlagosan 20,8 ± 7,22 hetes terhességi korban. Megfigyeltük, hogy a szonobiopsziás gömbtechnikával mért 3DPD-indexek a terhességi korral előrehaladva csökkennek a 11. és a 40. hét között, míg a teljes méhlepény térfogatszkennelése stabil, nem csökkenő vascularisatiós mutatókat eredményezett a várandósság alatt. Az indexek a szkennelés módjától függetlenül legalább közepes mértékben korreláltak egymással (r≥0,30). Limitáló tényezők: A terhesség előrehaladtával egyre kevesebb rész jeleníthető meg a méhlepényből egyetlen ultrahangképen, a terhesség késői szakaszában a méhlepénynek csak egy kis része vizsgálható egyszerre. Következtetés: A placentából a köldökzsinór-eredési pontnál vett szonobiopsziás minta 3DPD-indexei jobban tükrözik a várandósság alatti exponenciálisan növekvő méhlepény csökkenő erezettségét. Ennélfogva a szonobiopsziás gömbtechnika hathatósabb szűrővizsgálati lehetőséget kínálhat patológiás terhességek esetén. Introduction: Placental perfusion can be evaluated using three-dimensional power-Doppler (3DPD) indices with sonobiopsy acquisition in a sphere or throughout the entire placenta. Objective: We aimed to explore the relation between these two measurement methods. Method: A prospective cohort study was conducted among normal pregnant women recruited at 11 to 40 gestational weeks. Placental vascularization was evaluated using the 3DPD indices (vascularization index [VI]; flow index [FI]; vascularization flow index [VFI]) with the application of the sphere ultrasound technique or scanned from the entire placenta. Results: A total of 150 women were recruited at a mean gestational age of 20.8 ± 7.22 weeks. We observed that scanned 3DPD indices using sphere technique decrease by gestational age between 11 and 40 weeks, whereas whole placental volume scanning yielded stable, non-decreasing indices during gestation. The indices were correlated to each other at least moderately, irrespectively of the method of scanning (r≥0.30). Limitations: As gestation advances, less and less placentas can be visualized in one sweep for a whole view and at late period of gestation only a minority of placentas can be visualized as a whole. Conclusion: 3DPD indices acquired in a sphere of the placenta at umbilical cord insertion may reflect more to the decreasing vascularity of the exponentially growing placenta during gestation. Hence, sphere technique may have a greater screening opportunity in pathological pregnancies

Novel frameshift mutation in the CHD7 gene associated with CHARGE syndrome with preaxial polydactyly

We report a male patient with multiple congenital anomalies, including coloboma, Fallot tetralogy, bilateral choanal atresia, dysmorphic features (low set malformed ears, fronto-maxillary facial angle deviation, hypertelorism, retrognathism), micropenis, preaxial polydactyly and ureter stenosis. The major abnormalities had been diagnosed in prenatal period by ultrasound examination and the clinical diagnosis of CHARGE syndrome was established in postnatal periode by sequence analysis of the CHD7 coding region pointing to a novel heterozygous 4-basepair deletion in exon 3 that leads to an early stop codon and truncated CHD7 protein. Based on previous literature reports this is the first case of CHARGE syndrome with preaxial polydactyly characterized by this frameshift mutation. This case report allows further delineation of CHARGE syndrome polymorphism