First nuclear moment measurement with radioactive beams by the recoil-in-vacuum technique: the g factor of the 2+1 state in 132Te.

Following Coulomb excitation of the radioactive ion beam (RIB) 132Te at HRIBF we report the first use of the recoil-in-vacuum (RIV) method to determine the g factor of the 2(+)(1) state: g(973.9 keV 2(+) 132Te) = (+)0.35(5). The advantages offered by the RIV method in the context of RIBs and modern detector arrays are discussed.

Hyperinsulinism, neonatal obesity and placental immaturity in infants born to women with one abnormal glucose tolerance test value.

Several groups have reported a risk of fetal macrosomia in pregnancies with maternal glucose intolerance which is intermediate between gestational diabetes (GDM) and normal glucose tolerance. The present study was designed to determine whether these pregnancies are also at risk for fetal obesity, hyperinsulinism and placental villous immaturity. 325 women with risk factors for GDM underwent a 75 g OGTT interpreted according to the O'Sullivan criteria. All women who met the criteria for GDM were managed with diet therapy. Insulin therapy was added for women with a mean serum glucose value > 100 mg/dl on a 24 hour glucose profile. Patients not meeting the GDM criteria were managed without special intervention. Primary outcome variables were measures of neonatal weight and skinfold thickness, fetal and neonatal insulin and glucose concentration, and placental villous maturation. Outcome parameters were compared among three groups: pregnancies with normal OGTT (control, n = 95), 1 abnormal value in the OGTT (1 abnl, n = 76) and GDM (n = 154). The outcome of pregnancies with 1 abnormal value in the OGTT was different from those with normal OGTT. Regarding fetal growth, rates of LGA were approximately twice as high in groups with one abnormal value and GDM (21% and 24%) compared to women with normal OGTTs (11%: p < 0.05 vs GDM and p = 0.07 vs 1 abnormal value). The percent of infants with skinfold thickness > 90th percentile was also greater in the 1 abnormal value and GDM groups (31.1 and 31.6% respectively) compared to controls (19.2%; p < 0.05 for GDM vs control only). Regarding fetal hyperinsulinism, AFI concentrations were similar in control and GDM groups (3.1 +/- 0.4 and 3.4 +/- 0.8 microU/ml, respectively), but were higher in the group with one abnormal OGTT value (4.3 +/- 1.2 microU/ml, p < 0.05 vs controls). Cord blood insulin: glucose ratios were elevated in both the 1 abnormal value and GDM groups (0.22 +/- 0.05 and 0.20 +/- 0.02 microU/ml per mg/dl), compared to controls (0.12 +/- 0.01 microU/ml per mg/dl, p < 0.05 vs 1 abnormal value). Neonatal glycemia < 30 mg/dl was significantly more common in the one abnormal value than in the control group (49% vs 34% of infants) and intermediate in the GDM group (40%). Severe placental villous immaturity was more than twice as frequent in the 1 abnormal value group compared to controls (24% vs 9%, p < 0.05) and the most frequent in the GDM group (33%; p < 0.001 vs controls). Pregnancies with glucose intolerance below the thresholds for diagnosis of GDM have an increased risk for fetal obesity, hyperinsulinism, postpartum hypoglycemia and placental immaturity. These findings indicate the continuum of risk for fetal morbidity associated with increasing maternal glucose intolerance in pregnancy.

[Glucose tolerance in pregnancy and amniotic fluid insulin in labor]. / Glukosetoleranz in der Schwangerschaft und Fruchtwasserinsulin bei der Geburt.

Maternal glucose tolerance in pregnancy is determined by an oral glucose tolerance test (oGTT). The presented study deals with the question whether the risk of the fetus developing hyperinsulinism can be correctly estimated by the result of the oGTT. Investigations were made if there is a correlation between the oGTT and the mean blood glucose levels (MBG) and the fetal glucose metabolism measured by amniotic fluid insulin (AFI) at birth. 158 amniotic fluid samples were collected during labour. In 136 samples insulin levels below the threshold of 7 microU/ml were found, in 22 samples above 7 microU/ml. An oGTT was performed in all pregnancies (threshold: 95/165/145/125 mg%). 52 women showed normal oGTT, 28 had impaired glucose tolerance (IGT) with one pathologic value and 78 women had gestational diabetes (GDM) with two elevated values. Elevated insulin levels > 7 microU/ml were found in 6% of the cases with normal oGTT, in 29% of the cases with IGT and in 14% when GDM was diagnosed (p = 0.02). The MBG was significantly higher in cases with elevated AFI than with normal AFI, 92 mg% versus 83 mg% (p = 0.02). Therefore hyperinsulinism of the fetus was found twice as often in cases with IGT than in GDM diagnosed by oGTT. Borderline glucose tolerance with only one pathologic value in the oGTT has more affect on the fetal glucose metabolism than has been assumed up to now. This may be caused by insufficient therapeutic intervention and deterioration of glucose tolerance during pregnancy. The diagnosis of IGT should be followed by therapeutic efforts and intensive care of the fetus as in cases of GDM.

[Postpartum diagnosis of diabetes in pregnancy in fetal macrosomia--comparison of two examinations]. / Postpartale Diagnose des Gestationsdiabetes bei makrosomen Neugeborenen--Vergleich zweier Untersuchungsmethoden.

Disorders of carbohydrate metabolism in pregnancy are often associated with macrosome newborns. There are two methods with different approach for retrospective diagnosis of gestational diabetes (GDM): 1. maternal postnatal oral glucose tolerance test (ppoGTT), 2. determination of cord blood insulin for detection of fetal hyperinsulinism. The presented study deals with the question how often macrosomia is correlated with pathologic cord blood insulin respectively pathologic ppoGTT and if both methods select identical collectives. Cord blood insulin was determined by RIA in 154 newborns with birth weight over the 90th percentile (threshold 15 microU/ml). On the 2nd day p.p. oGTT was performed in 80 women without prenatal diagnosis of GDM (threshold 95, 165, 145, 125 mg%). 37/154 (24%) newborns showed pathologic insulin values. 24/80 (30%) women had pathologic ppoGTT. In 30% of the cases pathologic results of cord blood insulin and ppoGTT selected different collectives: 17/66 pathologic ppoGTT with normal insulin values, 7/14 normal ppoGTT with pathologic insulin values. The only use of ppoGTT would fail in 50% of cases of GDM with proved fetal hyperinsulinism. The determination of cord blood insulin offers the opportunity of direct diagnostics on the child in contrast to maternal ppoGTT. For retrospective diagnosis of macrosomia due to disorders of carbohydrate metabolism determination of cord blood insulin should be given preference to oGTT in puerperium.

[Manual afterloading applicators for intracavitary brachytherapy]. / Aplikátory rucního afterloadingu pro intrakavitární brachyterapii.

A technical description of uterovaginal and rectal applicator system of manual afterloading is described. A simple solution while using domestic materials covering the requirements of present-day brachytherapy. The applicators proved to be suitable for gamma radiation sources as well as for gamma-neutron radiation of 252Cf sources.