Early fetal cardiac scan as an element of the sonographic first-trimester screening

Early fetal cardiac scan (EFCS) is becoming an increasingly common element of the first trimester ultrasound screening carried out at 11-14 gestational weeks. It offers the first possibility to detect congenital heart defects (CHD) or, in ambiguous cases, to identify those pregnancies where a more detailed cardiac scan would be required later in pregnancy. The size of the fetal heart at the end of the first trimester and the associated relatively low image resolution make it impossible to capture all cardiac data to inform the ultimate picture. However, even at this stage, cues of anatomical and functional abnormalities can be picked up, which suggest not only a CHD, but also a likelihood of cardiovascular symptoms typical of genetic disorders. EFCS should focus on cardiac position, atrioventricular (AV) connections, AV valve function, initial assessment of ventriculo-arterial (VA) connections and the presence of red flag signs in the three vessel and trachea view (3VTV). Proper use of color Doppler mapping makes it possible to overcome the low resolution of B-mode to a certain extent. Here we present our long-term experience in EFCS

Pulmonary artery dilatation during normal pregnancy

Background: During pregnancy the cardiovascular system undergoes complex alterations; however, there have been few studies concerning pulmonary artery behaviour during gestation. Aim: The aim of this study was to evaluate changes in the pulmonary artery diameter (PAD) during gestation, with respect to left ventricular (LV) load and remodelling, as well as to systemic vascular resistance (SVR). Methods: It was a prospective cohort study, which included 69 consecutive healthy outpatient women with a singleton pregnancy. Echocardiography and ultrasonography of the uterine arteries were performed at two visits (V1 and V2) during pregnancy, and only echocardiography at one visit postpartum. Results: Pulmonary artery diameter increased in all women, from 20.0 mm at V1 to 22.7 mm at V2 (p < 0.001), and it returned to the reference range postpartum (19.5 mm; p < 0.001 vs. V2). Echocardiography did not reveal any other abnormalities, including the signs of intracardiac shunt or right ventricular pressure overload. During V2, PAD positively correlated with the following echocardiographic parameters: LV end-diastolic diameter (r = 0.386; p = 0.002), LV end-systolic diameter (r = 0.345 p = 0.006), LV end-diastolic volume (r = 0.308; p = 0.016), LV mass (r = 0.459; p < 0.001), left atrial area (r = 0.334; p = 0.009), LV cardiac output (r = 0.338; p = 0.011), and aortic diameter (r = 0.369; p = 0.003). Furthermore, there was a negative linear correlation between PAD and SVR (r = –0.307; p = 0.025) and pulsatility index (r = –0.318; p = 0.012). Conclusions: Our study shows pulmonary artery dilatation in healthy pregnant women without any other abnormal echocardiographic findings. These changes in PAD are associated with volume overload and low vascular resistance, and during postpartum they usually subside

Acute hepatologic and nephrologic effects of calcitriol in Syrian golden hamster (Mesocricetus auratus)

Although vitamin D is included in the group of fat-soluble vitamins, it must be considered as a prohormone. Its active forms, including calcitriol, have pleiotropic effects and play an important role in the regulation of cell proliferation, differentiation and apoptosis, as well as in hormone secretion, and they demonstrate anti-cancer properties. Since calcitriol delivery can be beneficial for the organism, and Syrian golden hamsters represent a unique experimental model, we decided to investigate its toxicity in this species. In this study, we injected calcitriol intraperitoneally at doses 0 (control), 0.180±0.009 µg/kg and 0.717±0.032 µg/kg. Animal behavior was observed for 72 hrs after injection, and afterwards blood, liver and kidneys were collected for post-mortem examination, electron microscopy, and hematology analyses. The highest dose of calcitriol induced a change in animal behavior from calm to aggressive, and the liver surface showed morphological signs of damage. Following injection of calcitriol, ultrastructural changes were also observed in the liver and kidneys, e.g. vacuolization and increased number of mitochondria. There was also a trend for increased serum levels of aspartate aminotransferase (AST), but not of alanine aminotransferase (ALT) or GGTP (gamma-glutamyl transpeptidase). There was no change in Ca, Mg and P levels, as well as in blood morphology between experimental and control groups. These results indicate that calcitriol at 0.717, but not at 0.180 µg/kg, may induce acute damage to the liver and kidneys, without inducing calcemia. We propose that the hepatotoxic effect of calcitriol in hamster constitutes the primary cause of behavioral changes

Przezkroczowa ultrasonograficzna diagnostyka zaburzeń statyki narządu rodnego i nietrzymania moczu

The examination standards developed so far, including the analysis of the quantitative parameters, greatly minimize the potential subjectivity of the assessment of the existing disorders. Apart from its low costs, the main value of the sonographic examination of the pelvic floor is the possibility to dynamically assess the changes in statics which take place during functional testing. Not only does it have a cognitive significance, but also it allows to adjust the scope of the surgical correction to the existing damages. Thus, indirectly, it can contribute to the reduction of a number of subsequent remedial surgeries. Three-dimensional sonography allows to thoroughly examine the construction and functioning of the anal levators and to detect their possible damage. It is the trauma to these muscles - occurring, among others, during childbirth - that is one of the major causes of pelvic organs descent and prolapse in women. Sonographic examination also enables to visualize the artificial material, the use of which is increasingly frequent in the surgical treatment of pelvic organs prolapse. The remedial kits currently in use are not visible in classic X-ray examinations and CT, however, they can be easily visualized by means of a sonographic test. This way it is possible to locate the positioned tapes or meshes and to establish their orientation towards the urethra, the bladder and the anus. It is also possible to observe the complications (e.g. hematomas) following the surgical procedures via the transvaginal access. Transperineal sonography is a relatively inexpensive method that may be performed in almost every ultrasonographic laboratory. Its value, approaching the MRI diagnostic value in the assessment of the pelvic floor defects and its low cost, place ultrasonography on the first place among the methods of imaging the pelvic and uro-genital diaphragm. The results of diagnostics of pelvic organs prolapse obtained by placing the sonographic head on the patient’s perineum may also help in establishing the changes of the support apparatus for the uterus and the vagina, bladder, urethra and perineum during functional testing and, thus, to verify the clinically established degree of the prolapse. It seems, also, that this method may be used during peri-urethral injections of specific substances and postapplication follow-up, an increasingly frequently employed method of urinary incontinence treatment.Postęp technologiczny jaki dokonuje się w konstrukcji aparatów ultrasonograficznych i coraz powszechniejszy do nich dostęp sprawia, że zakres diagnostycznego zastosowania badania ultrasonograficznego znacznie się poszerza. Dotyczy to także zaburzeń statyki narządu rodnego. Aktualnie stosowane w codziennej praktyce położniczo-ginekologicznej zestawy ultrasonograficzne, pozwalają uzyskać wgląd w struktury tworzące dno żeńskiej miednicy mniejszej, a uzyskane obrazy mogą stanowić wartościowe uzupełnienie badania fizykalnego. Aplikacja głowicy ultrasonograficznej na krocze pacjentki umożliwia wizualizację trzech kompartmentów żeńskiej miednicy mniejszej. Po zamrożeniu obrazu można dokonać oceny położenia struktur anatomicznych w stosunku do kości i wyznaczonych płaszczyzn , ustalić wzajemne odległości oraz zmierzyć odpowiednie kąty. Najwięcej informacji uzyskuje się w ten sposób w zakresie kompartmentu przedniego, którego uszkodzenia często łączą się z nietrzymaniem moczu. Wypracowane do tej pory standardy badania obejmujące także analizę parametrów ilościowych, w znacznym stopniu minimalizują subiektywność oceny istniejących zaburzeń. Istotną wartością ultrasonografii dna miednicy mniejszej oprócz niewysokich kosztów jest możliwość dynamicznej oceny zmian statyki do jakich dochodzi podczas testów czynnościowych. Ma to nie tylko znaczenie poznawcze lecz także pozwala na dostosowanie zakresu korekcji chirurgicznej do istniejących uszkodzeń. W sposób pośredni może więc przyczynić się do zmniejszenia ilości kolejnych operacji naprawczych. Ultrasonografia trójwymiarowa umożliwia z kolei dokładne prześledzenie budowy i funkcji mięśni dźwigaczy odbytu oraz detekcję ich ewentualnych uszkodzeń. To właśnie urazy tych mięśni do których dochodzi np. podczas porodu są jedną z głównych przyczyn obniżenia i wypadania narządu rodnego u kobiet. W badaniu ultrasonograficznym można również dokonać wizualizacji materiału sztucznego, który jest stosowany coraz częściej w chirurgicznym leczeniu zaburzeń statyki

Interactions of a Water-Soluble Glycofullerene with Glucose Transporter 1. Analysis of the Cellular Effects on a Pancreatic Tumor Model

In recent years, carbon nanomaterials have been intensively investigated for their possible applications in biomedical studies, especially as drug delivery vehicles. Several surface modifications can modulate the unique molecular structure of [60]fullerene derivatives, as well as their physicochemical properties. For this reason, covalent modifications that would enable a greater water solubilization of the fullerene buckyball have been rapidly investigated. The most exciting applications of fullerene nanomaterials are as drug delivery vectors, photosensitizers in photodynamic therapy (PDT), astransfection or MRI contrast agents, antimicrobials and antioxidants. From these perspectives, the glucose derivatives of [60]fullerene seem to be an interesting carbon nanomaterial for biological studies. It is well-known that cancer cells are characterized by an increased glucose uptake and it has also been previously reported that the glucose transporters (GLUTs) are overexpressed in several types of cancers, which make them attractive molecular targets for many drugs. This study explored the use of a highly water-soluble glycofullerene (called Sweet-C60) in pancreatic cancer studies. Here, we describe the PANC-1 cell proliferation, migration, metabolic activity and glycolysis rate after incubations with different concentrations of Sweet-C60. The final results did not show any influence of the Sweet-C60 on various cancer cellular events and glycolysis, suggesting that synthesized glycofullerene is a promising drug delivery vehicle for treating pancreatic cancer