Abstract Objective Evaluate accuracy of prenatal ultrasound findings in predicting the risk of bowel atresia in patients with gastroschisis. Methods A retrospective study was conducted on 18 fetuses ...with a prenatal diagnostic of gastroschisis treated at University hospital of Saint Etienne France between 2002 and 2012. Ultrasound abnormalities were used to classify them into three groups: no ultrasound abnormality (n = 4), oligohydramnios (n = 9), intra-abdominal bowel dilatation ≥ 20.5 mm (n = 5). Postnatal outcomes were compared between groups. The threshold value of 20.5 mm for the prediction of atresia was determined through the receiver operator characteristics curve. Results In the group with oligohydramnios, intra uterine growth restriction were significantly more frequent (p = 0.015) and three newborns had serositis including two with secondary complications after the initial surgery. In the group with major intra-abdominal bowel dilatation, all had a narrow defect <10 mm significantly more than other fetuses (p = 0.002). Intra-abdominal bowel dilatation reaching 20.5 mm started at a mean gestational age significantly lower than that of the other fetuses (23.3 versus 29.7 weeks p = 0.02). On the five fetuses presented intra-abdominal bowel dilatation ≥ 20.5 mm, four showed atresia and no other newborn has this complication (p = 0.0016). The threshold value of 20.5 mm has a sensitivity of 100% and a specificity of 92.9%. The area under the curve was equal to 96.4%. Conclusion Intra-abdominal bowel dilatation ≥ 20.5 mm seems to be associated with the risk of postnatal atresia. MRI could help to clarify a complicated or uncertain ultrasound aspect.
In budding yeast, the cortical structure formed by the septins is remodeled at the onset of mitotic exit and delineates a specialized compartment dedicated to cytokinesis. How this septin function is ...spatially and timely regulated remains poorly understood. In this study, we report a role of the anillin-like protein Bud4 in the formation and the disassembly of the double ring structure formed by the septins at the time of cytokinesis. Bud4 acts with Bud3 in this pathway and in parallel with septin phosphorylation by the p21-activated kinase Cla4 and the septin-dependent kinase Gin4. In addition, we show that the function of Bud4 is regulated by the cyclin-dependent protein kinase Cdk1, the master regulator of cell cycle progression. This result suggests that the Cdks, or a locally specific pool of the kinase, may have a role past mitotic exit.
Résumé
Le psoriasis est une maladie chronique inflammatoire qui inquiète beaucoup les femmes en âge de procréer. Les questions sont nombreuses sur l’hérédité de cette maladie, son impact sur la ...grossesse et le futur enfant, et le danger des thérapeutiques utilisées. La meilleure facon de les rassurer est de travailler en collaboration étroite avec les dermatologues. Une consultation préconceptionnelle auprès d’un gynécologue-obstétricien, spécialiste des grossesses pathologiques, est fortement recommandée pour un premier contact et expliquer le suivi de la grossesse. Le psoriasis en tant que maladie n’est pas dangereux pour la grossesse, mais certains traitements seront interdits, impliquant des conseils dès que la patiente est en âge d’avoir un enfant. Le premier trimestre de la grossesse est la période la plus dangereuse. Les complications obstétricales semblent plus fréquentes quand l’atteinte est sévère.
The aim of this study was to correlate placental volumes deduced from three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software with systemic concentrations of D-dimer ...and soluble endothelial protein C receptor (sEPCR).
This was a monocentric experimental prospective study conducted from October 2008 to July 2009. Forty consecutive patients at risk of placental vascular pathology (PVP) recurrence or occurrence were included. Placental volumes were systematically measured three times (11-14, 16-18 and 20-22 weeks of gestation (WG)) by two independent sonographers. D-dimers and sEPCR plasma concentrations were measured using ELISA kits (Enzyme Linked ImmunoSorbent Assay).
Eleven patients had a PVP. The plasma D-dimer level was positively correlated with placental volume (r = 0.45, p < 0.001). A smaller placental volume and placental quotient was evidenced in women who developed a PVP at the three gestational ages, and the difference was more pronounced during the third exam (20 WG). No obvious correlation could be demonstrated between the development of a PVP and the levels of D-dimer and sEPCR. There was no significant difference in the values of placental volumes measured by the two sonographers.
The placenta growth could be a major determinant of the elevation of D-dimer during pregnancy. Consideration of placental volume could allow for modulation of the D-dimer concentrations for restoring their clinical interest.
OBJECTIVE: To report the usefulness of three-dimensional (3D) ultrasonography for the assessment of parietal endometriosis. DESIGN: Case report. SETTING: Academic research hospital. PATIENT(S): A ...35-year-old woman with a noncyclic, painful abdominal nodule near a caesarean delivery scar. INTERVENTION(S): 3D ultrasonography and wide surgical resection with healthy margins. MAIN OUTCOME MEASURE(S): 3D ultrasonographic assessment of the endometriotic nodule. RESULT(S): We found that 3D ultrasonography offered a more specific description of parietal endometriosis with irregular and spiculated margins and depth infiltration as well as provided preoperative evaluation of volume measurements. CONCLUSION(S): Three-dimensional ultrasonography is a useful, noninvasive tool in extrapelvic endometriosis.
Abstract Objectives Many questions remain regarding the mechanism of perinatal stroke. Methods In a series of 100 prospectively enrolled term neonates with symptomatic arterial ischemic stroke, we ...explored family antecedents, pregnancy and delivery conditions and clinical presenting features and distinguished features of the 50 larger infants with the remainder. Cardiac and cervical arterial imaging were performed in 70 and 51 cases. Results Previous fetal loss, first pregnancy, primiparity, twin-gestation, cesarean and traumatic delivery, neonatal distress, male sex and premature rupture of membranes were statistically more common than in the general population. Normal pregnancy proportion and mean birthweight were in the normal range, arguing against a vasculo-placental origin in the majority. Furthermore, there was an excess of large babies. The larger infants were more subject to suffer from acute perinatal events, with a trend for an excess of neonatal distress ( p = 0.065) and for more severe presenting features ( p = 0.027), while the lighter were more likely to have experienced longstanding obstetrical risk factors such as complicated pregnancy ( p = 0.047) and tobacco exposure ( p = 0.028). Cervical MR angiography showed an internal carotid occlusion in two babies, whereas echo-Doppler was always normal; in one case the two methods were discordant. Echocardiography was non-informative. Interpretation The data from this prospective cohort of neonates with stroke confirm that many obstetrical and perinatal factors are risk determinants. They also suggest that birthweight and gender may be biomarkers of two populations of neonates with different pathological mechanisms. MR angiography appears more sensitive than echo-Doppler for the exploration of the neonatal cervical vasculature.
Abstract Introduction Management of pregnant women at risk for venous thromboembolism (VTE) remains complex. Guidelines do not definitively fix optimal strategies due to limited trial data. Our ...objective was to build an easy-to-use tool allowing individualised, risk-adapted prophylaxis. Materials and Methods A Delphi exercise was conducted to collect 19 French experts’ opinions on pregnancy-related VTE. Results Experts with an active interest in clinical research and care of VTE and placental vascular complications were selected. The risk score was classified by an anonymous computer vote. A scoring system for VTE risk in pregnant women was developed, each score being associated with a specific treatment: graduated elastic compression stockings, aspirin, prophylactic Low Molecular Weight Heparin (LMWH: variable durations), or adjusted-dose of LMWH through pregnancy and postpartum. Conclusions Our simple consensual scoring system offers an individual estimation of thrombosis risk during pregnancy together with its related therapeutic strategy, in accordance with most of the new international recommendations. The accuracy of our individual risk score-based therapeutic guidance is currently being prospectively evaluated in a multicenter trial (Clinicaltrials.gov registry no: NCT00745212).
Orderly progression through the eukaryotic cell cycle is a complex process involving both regulation of cyclin dependent kinase activity and control of specific substrate-Cdk interactions. In ...Saccharomyces cerevisiae, the mitotic cyclin Clb2 has a central role in regulating the onset of anaphase and in maintaining the cellular shape of the bud by inhibiting growth polarization induced in G1. However, how Clb2 and the partially redundant cyclin Clb1 confer specificity to Cdk1 in these processes still remains unclear. Here, we show that Clb2 mutants impaired in nuclear import or export are differentially affected for subsets of Clb2 functions while remaining fully functional for others. Our data support a direct role of the cytoplasmic pool of Clb1,2-Cdk1 in terminating cytoskeleton and growth polarization, independently of G1 cyclin transcriptional regulation. By contrast, the nuclear form of the cyclin is required for timely initiation of anaphase. Clb2 localization influences its stage-specific degradation as well. We report that Clb2 trapped in the cytoplasm is stabilized during anaphase but not at the time of mitotic exit. Altogether, our results demonstrate that the subcellular localization of the mitotic cyclin Clb2 is one of the key determinants of its biological function.
PDF
