Microbiota of pregnancy, placenta and newborns in the third trimester: A randomized controlled study.

Microbiota in pregnant time is vital to healthy of pregnant women and their offspring. However, few study evaluate the composition of the microbiota of health pregnancy, placenta and their newborns at different stages and the origin of the placental microbiota. Samples were obtained from a total of 31 pregnant individuals and their offspring, analyzing by 16S rRNA amplicon sequencing of the V4 region to evaluate the composition and variation of them. We found that the microbiota of pregnant individuals changes in the third trimester. The placental microbiota has its own specific dominant microbiota. The placental microbiota is correlated with the pregnancy microbiota in the gut and vagina at 32-34 weeks but not at full term. The gut microbiota in newborns changes over the first 14 days.

Investigation Into the Predictive Potential of Three-Dimensional Ultrasonographic Placental Volume and Vascular Indices in Gestational Diabetes Mellitus.

Background: The use of ultrasonography in pregnancies complicated with gestational diabetes mellitus (GDM) can vary according to clinical practice. This study aims to compare the changes of placental volume (PV) and vascular indices measured by three-dimensional (3D) Power Doppler between pregnant women with and without GDM. Materials and Methods: This was a prospective study of singleton pregnancies who took the early nuchal translucency examination from January 2018 to September 2019. Data on PV and vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between pregnant women with and without GDM were measured by 3D Power Doppler ultrasound machine. Univariate and multivariate logistic regression determined the association between risk factors and GDM. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) were applied to evaluate the diagnostic value of different parameters for GDM. Results: Of the 141 pregnant women enrolled, 35 developed GDM and 106 did not. The maternal age and gravida in the GDM group were significantly higher than that in the non-GDM group. The PV, VI, FI, and VFI in the GDM group were significantly lower than that in the non-GDM group. There were no significant differences in other clinical parameters between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in VI [odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.951-1.002], FI (OR = 0.93, 955 CI: 0.86-1.00), and VFI (OR = 0.67, 95% CI = 0.52-0.87). ROC analysis indicated that the combination of maternal age, gravida, PV, and VFI was more accurate as a marker for detecting GDM than the PV, VI, FI, or VFI alone. Conclusions: The 3D ultrasonography results suggest that PV and vascular indices (VI, FI, and VFI) during the first trimester may serve as potential markers for GDM diagnosis. The combination of maternal age, gravida, and sonographic markers may have good diagnostic values for GDM, which should be confirmed by further investigations.

A preliminary study of uterine scar tissue following cesarean section.

AIM: To compare smooth muscle cells, type I collagen, and apoptosis of the lower uterine segment of women who had/without a prior cesarean delivery. METHODS: Alpha smooth muscle actin (α-SMA), type I collagen, and nuclear apoptosis were compared between the groups from lower uterine segment. Twenty-eight controls and 82 with one prior cesarean delivery were included. The women with a prior cesarean section were classified by time since the surgery: ≤3 years, >3 and ≤5 years, >5 and ≤7 years, >7 and ≤9 years, and >9 years. RESULTS: Smooth muscle volume density (VD) % was significantly lower in women who had cesarean sections in first three groups than in the controls (all, P<0.01). Type I collagen VD% was similar among all groups and the controls. The number of apoptotic nuclei in the lower uterine segment of the scarred group was greater up to 3 years after surgery and less than in the control at 7-9 years. The number of non-apoptotic nuclei in the scarred group was greater than controls up to 7 years after surgery. CONCLUSION: The lower uterine segment scar becomes stable at 3 years after cesarean delivery, and by 9 years, the scar is mature.

Length to width ratio of the ductus venosus in simple screening for fetal congenital heart diseases in the second trimester.

Antenatal diagnosis of congenital heart disease (CHD) is still low even though screening was first introduced over 25 years ago. The purpose of our study was to determine the efficacy of a second-trimester prenatal ultrasonographic method of screening for CHD.From September 2012 to September 2013, the length and width of the fetal ductus venosus were measured sonographically in 1006 singleton fetuses, and the ratio of length to width was calculated. The accuracy of each fetal measurement and Doppler ultrasonography were determined. The standard fetal echocardiographic evaluations including 2-dimensional gray-scale imaging, color, and Doppler color flow mapping were performed. The transducer was aligned to the long axis of the fetal trunk to view the ductus venosus in its full length, including the inlet (isthmus) and outlet portions of the vessel. The diameters of the vessel inner wall and mid-point of the ductus venosus were measured using calipers. All scans and fetal measurements were conducted by a registered sonographer with more than 20 years of perinatal ultrasound screening experience.Of the 1006 singleton fetuses between 19 and 28 weeks' gestation, 36 had CHD. The ductus venosus length/width ratio (DVR) for the first CHD screening was extremely sensitive at 88.90%, with a specificity of 99.10% for the cardiac abnormalities included in this study. Chromosomal anomalies accompanied CHD in 0.4% (4/1006) of all cases and 11.11% (4/36) of the CHD cases.The DVR differed significantly between fetuses with CHD and normal fetuses during the second trimester. Careful assessment of the ratio should be a part of the sonographic examination of every fetus. In the case of a small DVR, advanced echocardiography and karyotype analysis should be performed. The ratio is a helpful tool for screening CHD abnormalities prenatally in the Chinese population.

The clinical investigation of disparity of nonalcoholic fatty liver disease in a Chinese occupational population in Taipei, Taiwan: experience at a teaching hospital.

The authors sought to explore the prevalence and factors related to nonalcoholic fatty liver disease (NAFLD) among occupational population in Taipei, Taiwan. A total of 8347 healthy adults voluntarily admitted to annual physical check-up. Blood samples and ultrasound-proved fatty liver sonography results were collected. The results showed that the prevalence of NAFLD was 48.4% and revealed a statistically significant increase with increasing population age. Males exhibited a greater prevalence of NAFLD than did females (57.8% vs 32.4%, P < .001). Using multiple logistic regression analysis, in addition to male gender, older age, higher body mass index, higher aspartate aminotransferase level, higher alanine aminotransferase level, presence of hypertension, presence of hyperuricemia, presence of hypercholesterolemia, higher fasting plasma glucose, and presence of hypertriglyceridemia were the significant factors associated with NAFLD. The differences in occupational professions were revealed. In conclusion, occupational populations are asymptomatic, and the diagnosis of NAFLD should be considered with older age, hyperuricemia, higher aspartate aminotransferase level, higher alanine aminotransferase level, and metabolic risk factors.

Prenatal ultrasonography and Doppler sonography for the clinical investigation of isolated ventricular septal defects in a late second-trimester population.

BACKGROUND: The purpose of this study was to evaluate the efficacy of prenatal ultrasonography and Doppler sonography in detecting isolated ventricular septal defects (VSDs) in a late-second-trimester population. METHODS: Fetal echocardiography, Doppler ultrasound, and biometry were used to evaluate 2,661 singleton fetuses (1,381 male fetuses and 1,280 female fetuses) between 1 August 2006 and 31 May 2010. The efficacy of each fetal biometry, Doppler ultrasound, and nasal bone length (NBL) measurement was evaluated in all of the fetuses. A standard fetal echocardiographic evaluation, including two-dimensional gray-scale imaging and color and Doppler color flow mapping, was performed on all fetuses. RESULTS: We detected isolated VSDs in 124 of the 2,661 singleton fetuses between 19 and 24 weeks of gestation. The prevalence of isolated VSDs in the study population was 4.66%. A multiple logistic regression analysis indicated that short fetal NBL (odds ratio = 0.691, 95% confidence interval: 0.551 to 0.868) and the pulsatility index (PI) of the umbilical artery (odds ratio = 8.095, 95% confidence interval: 4.309 to 15.207) and of the middle cerebral artery (odds ratio = 0.254, 95% confidence interval: 0.120 to 0.538) are significantly associated with isolated VSDs. CONCLUSION: Late-second-trimester fetal NBL, umbilical artery PI, and middle cerebral artery PI are useful parameters for detecting isolated VSDs, and can be used to estimate the a priori risk of VSDs in women at high risk and at low risk of isolated VSDs.

Focused ultrasound-modulated glomerular ultrafiltration assessed by functional changes in renal arteries.

This study demonstrates the feasibility of using focused ultrasound (FUS) to modulate glomerular ultrafiltration by renal artery sonication and determine if protein-creatinine ratios are estimated through vascular parameters. All animal experiments were approved by our Animal Care and Use Committee. The renal arteries of Sprague-Dawley rats were surgically exposed and sonicated at various acoustic power levels using a FUS transducer with a resonant frequency of 1 MHz. The mean peak systolic velocity (PSV) of the blood flow was measured by Doppler ultrasound imaging. Urinary protein-creatinine ratios were calculated during the experiments. Histological examination of renal arteries and whole kidneys was performed. The PSV, pulsatility index, and resistance index of blood flow significantly increased in the arteries after FUS sonication without microbubbles (p<0.05). The change in normalized protein-creatinine ratios significantly increased with increasing acoustic power, but such was not observed when microbubbles were administered. Furthermore, no histological changes were observed in the hematoxylin- and eosin-stained sections. Glomerular ultrafiltration is regulated temporarily by renal artery sonication without microbubbles. Monitoring vascular parameters are useful in estimating the normalized change in protein-creatinine ratios.

Microbubble-enhanced functional changes in arteries induced by pulsed high-intensity focused ultrasound exposure.

The purpose of this study is to investigate the dose-dependent effects of ultrasound contrast agent (UCA) on the changes of peak systolic velocity (PSV) and pulsatility index (PI) in the arteries of 24 male Sprague-Dawley rats. The rats were sonicated with 1.0-MHz pulsed high-intensity focused ultrasound (HIFU) at two acoustic powers, 15 W and 30 W, with UCA present at four concentrations (0, 150, 300, and 450 µL/kg). Ultrasound imaging was used to localize and to monitor the pulsed-HIFU exposure. The mean PSV of blood flow, as measured by Doppler ultrasound imaging, increased immediately in the arteries where UCA has been administrated at all four doses after pulsed-HIFU at 15 W. However, the normalized PSV change decreased with each injected dose of UCA at 30 W. Furthermore, the normalized pulsatility index changes increased as the injected dose of UCA increased at two acoustic powers. No obvious changes were found in terms of histological structures and temperature rise at the vessel wall. Our results demonstrated that the response of the artery to pulsed-HIFU was dependent on UCA dose at the same acoustic power. The value of normalized PSV change was minimal and the normalized PI change reached a maximum when the UCA dose was at the highest dose of UCA (450 µL/kg) with the two acoustic powers.

Clinical correlation of nonalcoholic fatty liver disease in a Chinese taxi drivers population in Taiwan: Experience at a teaching hospital.

BACKGROUND: To explore any gender-related differences in the prevalence of conditions-associated with non-alcoholic fatty liver disease (NAFLD) among Taiwanese taxi drivers in Taipei, Taiwan. METHODS: We studied 1635 healthy taxi drivers (1541 males and 94 females) who volunteered for physical check-ups in 2006. Blood samples and ultrasound fatty liver sonography results were collected. RESULTS: The prevalence of NAFLD was 66.4% and revealed no statistically significant decrease with increasing age (p = 0.58). Males exhibited a greater prevalence of NAFLD than did females (67.5% vs 47.9%, p < 0.0001). Gender-related differences for associated factors were found. For males, hypertension, hyperuricemia, higher AST, higher ALT, hypertriglyceridemia, and higher fasting plasma glucose were significantly related to NAFLD. These conditions were not sigfinicantly related to NAFLD in females. CONCLUSION: Several gender-related differences were noted for NAFLD among Taiwanese taxi drivers.

Real-time ultrasound image-monitored focal changes of the vascular function in rats by pulsed HIFU.

It has been shown that B-mode ultrasound can be useful for the real-time visualization of high-intensity focused ultrasound (HIFU) treatment. The aim of this study is to demonstrate the real-time ultrasound observation of functional changes when a vessel is exposed to pulsed-HIFU in the presence of preformed microbubbles. Using in vivo experiments, 12 male Sprague-Dawley rats were sonicated by 1-MHz pulsed-HIFU in the presence of ultrasound contrast agent (UCA) at four doses (0, 150, 300, and 450 microL/kg). The microbubbles passing through the aorta can be discerned with B-mode imaging. The mean peak systolic velocity (PSV) of the blood flow, as measured by Doppler ultrasound imaging, increased in arteries when the low-dose UCA groups (0 and 150 microL/kg) were examined after pulsed-HIFU at 45 W, but decreased when the high-dose UCA groups (300 and 450 microL/ kg) were examined. Additionally, the normalized pulsatility index (PI) changes increased with the injected dose of UCA. The interactions between ultrasound and the microbubbles can be seen to change the tissue permeability of the drug. Thus, monitoring of PSV or PI might be useful as an online method to ensure the correct sonicated position and to indicate when drug delivery has occurred.

Functional changes in arteries induced by pulsed high-intensity focused ultrasound.

Continuous high-intensity focused ultrasound (HIFU) at various intensities has been shown to induce functional changes in arteries. The objective of the current study was to investigate the functional changes in arteries when pulsed HIFU is used at various acoustic power levels. Sonication was applied at an ultrasound frequency of 1 MHz with a burst length of 50 ms and a repetition frequency of 1 Hz. The duration of the whole sonication was 6 s. The femoral arteries and abdominal aortas of Sprague-Dawley rats were surgically exposed and sonicated with pulsed HIFU; the pulsed-HIFU beam was aimed using color images of the blood flow. The peak systolic velocity (PSV) of the blood flow, as measured by Doppler velocimetry, increased in the arteries to which pulsed HIFU had been applied at acoustic powers of 15, 30, and 45 W. The increase in PSV was correlated with the acoustic power of the pulsed HIFU. The temperatures recorded by the thermocouples placed above and below the aorta surfaces did not change significantly during the sonication. Furthermore, no histological changes were found and the vessel wall showed no obvious temperature rise. Therefore, our results indicate that the functional changes induced by pulsed-HIFU exposure are mainly due to mechanical effects.