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1.
BMC Pregnancy Childbirth ; 20(1): 81, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32033602

RESUMO

BACKGROUND: The prevalence of both placenta previa and cesarean are on the rise. Multiple adverse outcomes are critically increased when placenta previa is subsequent to prior cesarean. The purpose of the present study is to develop a pre-surgical method for predicting adverse outcomes in pregnancy complicated with both placenta previa and prior cesarean. METHODS: Clinical data was obtained from the medical history system at the First Affiliated Hospital of Sun Yat-sen University from February 2003 to December 2016. All cases with a final diagnosis of "placenta previa/low lying placenta (ICD:O44.001-105)" and "scarred uterus complicated with pregnancy (ICD: O34.200-202)" were collected and reviewed. Hysterectomy was taken as the primary outcome; and blood loss was taken as the secondary outcome. RESULTS: Of 219 pregnant women in the final analysis, 25 received a hysterectomy following delivery, and 48 had blood loss exceeding 1000 ml. Pre-surgical risk factors for hysterectomy are ultrasonic signs of vascular lacunae, central placenta previa, and loss of normal hypoechoic retroplacental zone. A pre-surgical predictive equation referred to as "Hysterectomy Index in Placenta Previa with Prior cesarean (HIPs)" was generated and each risk factor was weighted to create an 8-point scale. This index yielded an area under the curve of 0.972 for the prediction of hysterectomy. CONCLUSIONS: Application of the HIPs score may provide an effective pre-surgical prediction of cesarean hysterectomy in pregnant women complicated with both placenta previa and prior cesarean.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31909548

RESUMO

OBJECTIVES: To evaluate the feasibility of classifying sonographic images of fetal brain images taken in standard axial planes as normal or abnormal, using deep learning algorithms. METHODS: A total of 92748 prenatal examinations were used in the study. After inclusion and exclusion, 10251 normal and 2529 abnormal pregnancies were included. Abnormal cases were confirmed by neonatal ultrasound, follow-up examination or autopsy. After a series of data pretraining processes, 15372 normal and 14047 abnormal fetal brain images were included. They were divided into training and test datasets (on a case level rather than on an image level), at a ratio of approximately 8:2. Training data were used to train the algorithms to classify images as normal or abnormal, and the accuracy was then tested on the test datasets. The algorithms were trained for three purposes: image segmentation along fetal skull, classifying the image and localizing the lesion. Performance of segmentation was assessed using precision, recall, and Dice's coefficient (DICE), calculated to measure the extent of overlap between human-labeled and machine-segmented regions. Sensitivity and specificity were calculated for classification accuracy assessment. Additionally, for abnormal images, how well a lesion was localized was determined. RESULTS: Segmentation precision, recall and DICE were 97.9%, 90.9% and 94.1%, respectively. For classification the overall accuracy was 96.3%. The sensitivity and specificity for abnormal images were 96.9% and 95.9%, respectively. The area under the receiver operating characteristic curve was 0.989 (95% CI: 0.986-0.991). For 2491 abnormal fetal brain images, the lesions were precisely, closely and irrelevantly located in 61.6% (1535/2491), 24.7% (614/2491) and 13.7% (342/2491), respectively. CONCLUSIONS: Deep learning algorithms could be trained for segmentation and classification of normal and abnormal images and provide heat maps for lesion localization. This study laid a foundation for further research on the differential diagnosis of fetal intracranial abnormalities. This article is protected by copyright. All rights reserved.

3.
Arch Gynecol Obstet ; 301(1): 207-215, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31758303

RESUMO

OBJECTIVES: To establish methodological criteria for the clinical application of E-cervix technology in non-pregnant women, evaluate cervical differences between non-pregnant CI patients and normal women, and explore the predictive value of E-cervix for CI in non-pregnant women. METHODS: In all, 46 non-pregnant women with CI and 46 non-pregnant women with full-term pregnancy experience were included. Elastic parameters (HR, IOS, EOS, IOS/EOS, CL) of the cervix were measured by transvaginal examination with a mid-sagittal section as the ROI, followed by examination of the whole cervix. The pressure of the probe on the cervix was divided into three levels. The elastic data of three consecutive images were separately obtained by two doctors for three pressure levels. Image stability and the effects of pressure were evaluated and the repeatability of the measurements was tested. In the case and control groups, cervical elasticity images were selected by standardized operation methods. Differences in the parameters between the two groups were determined and the diagnostic efficiency of each parameter was analyzed. RESULTS: The HR, IOS, and EOS showed significant differences when measured on different sequential images obtained by continuous mapping (p < 0.05). The elastic parameters obtained from the first and last two images were significantly different (p < 0.05) and there were no significant differences between the elastic parameters obtained from the last two images (p > 0.05). The HR, IOS, EOS, and IOS/EOS showed significant differences among the pressure levels (p < 0.05), while the IOS showed a significant difference only between grades 0 and 2 (p < 0.05). E-cervix showed good repeatability within and among operators. The elastic parameters obtained by E-cervix in the CI group and control group were significantly different. ROC curve analysis showed that the HR was the most sensitive index for diagnosing CI. CONCLUSION: In E-cervix data acquisition, the first image should be excluded and the probe should not put pressure on the cervix. E-cervix has good retest and inter-observer reliability. Compared with normal women, CI patients showed a relatively softer and shorter cervix. E-cervix can be used as an important diagnostic tool for assessing cervical strain.

4.
J Obstet Gynaecol Res ; 46(2): 237-248, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31814257

RESUMO

AIM: To assess the reproducibility of a semiautomatic quantification tool for cervical stiffness and evaluate the normal changes in cervical elasticity during the three trimesters of pregnancy. METHODS: This longitudinal prospective pilot study evaluated cervical elasticity during the three trimesters of pregnancy (11-14, 20-24 and 28-32 weeks) in women with singleton pregnancies. Women with a history of conization, cerclage, cervical Naboth cysts (diameter > 10 mm), cervical tumors, or uterine malformation were excluded. A semiautomatic tool was used to evaluate the stiffness of the whole cervix and the internal and external cervical os with multiple quantitative elasticity parameters and the cervical length (CL) on the sagittal view via transvaginal elastography. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to assess intra- and interobserver variability. E-Cervix parameters during the three trimesters were compared using the Friedman test. RESULTS: In total, 217 women with 651 strain examinations during the three trimesters were included. The intra- and interobserver ICC for the E-Cervix parameters ranged from 0.947 to 0.991 and 0.855 to 0.989, respectively. There were significant differences in all parameters among the three trimesters. Cervical elasticity showed significant softening and became heterogeneous during the three trimesters. The median CL was significantly shorter in the first trimester than in the second and third trimesters (P = 0.004, P < 0.001). CONCLUSION: E-Cervix provides a graphical tool for operators to easily define regions of interest and obtain multiple repeatable measures of elasticity. The normal references for E-Cervix parameters during the three trimesters reflect the physiological cervical changes during pregnancy.

5.
J Matern Fetal Neonatal Med ; 33(7): 1080-1085, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30122131

RESUMO

Objectives: To study the perinatal outcomes in the women who's the different changes of an increased fetal nuchal translucency thickness.Methods: Since 2013-2016, the pregnant women whose initial measurement of fetal nuchal translucency (NT) ≥ 3.5 mm would be invited to scan the NT again after a week. Between the two measurements over 1 mm, defined as "change". According to different results between two measurements, they were divided into three groups: unchanged group, thinned group and thicken group. To follow-up and compare the perinatal outcomes among the three groups.Results: One hundred seventy-five cases met our criteria and were retrieved in the study. There are 90 cases of the unchanged group, 60 cases of the thinned group and 25 cases of thicken group. Among three groups, the chromosomal abnormalities rate is 11.11, 21.67, and 60.0% respectively, the structure abnormalities rate is 10.0, 8.51, and 20.0%, the normal delivery rate is 76.67, 70.0, and 28.0%. There all have the significantly differences in statistics except the structure abnormalities rate.Conclusion: The chromosomal abnormalities rate and adverse perinatal outcome rate were worse if NT continues to thicken. However, the perinatal outcome of the NT thinned group is no better than the NT unchanged case.

6.
J Matern Fetal Neonatal Med ; 33(7): 1211-1217, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30149741

RESUMO

Objectives: To explore chromosomal variations, including copy number variations (CNVs), in fetuses with conotruncal heart defect (CTD).Methods: During a 5-year period, a total of 129 fetuses with ascertained CTDs were investigated for chromosomal abnormalities using quantitative fluorescence PCR (QF-PCR) and chromosomal microarray analysis (CMA). Fetuses were divided into two subgroups: benign group (with normal QF-PCR results and benign CNVs) and nonbenign group [with aneuploidies, nonbenign CNVs [pathogenic CNVs and CNVs of unknown significance (VOUS)]. Data on fetal structural malformations, chromosomal variations, and pregnancy outcomes were collected and compared.Results: Of the 129 cases, 17 were found to have common aneuploidies. In the remaining 112 cases with normal a QF-PCR result, pathogenic CNVs, CNVs of VOUS, and benign CNVs were identified in 5.3, 5.3, and 4.5%, respectively. Compared with benign group, fetuses in nonbenign group had a significantly higher rate of neurologic defects (13.8 versus 3.0%, p < .05), overall extracardiac anomalies (86.2 versus 45.0%, p < .05), and perinatal death (57.1 versus 18.4%, p < .05), whereas, no significant difference in that of associated cardiovascular anomalies was noted (48.2 versus 46.0%, p = .29). Among the extracardiac anomalies, thymus abnormalities were strongly associated with nonbenign CNVs (33.3 versus 1% of fetuses in benign group, p < .05).Conclusions: Pathogenic CNVs, in addition to chromosomal aneuploidies, contributed to the pathogenesis of CTD. The presence of associated extracardiac anomalies including thymus abnormalities correlated with a higher probability of nonbenign chromosomal variations, which was associated with an unfavorable outcome.

7.
Taiwan J Obstet Gynecol ; 58(6): 827-832, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31759536

RESUMO

OBJECTIVE: To explore the early predictors for pregnancy outcomes in patients with heterotopic pregnancy (HP) following in-vitro fertilization with embryo transfer (IVF-ET). MATERIAL AND METHODS: This retrospective study reviewed 81 patients with HP following IVF-ET in our institution between January 2003 and September 2017. The relationships between clinical outcomes and general characteristics, sonographic features and different management options were analyzed by logistic regression analysis. RESULTS: The gestational age at the time of diagnosis was 50.9 ± 12.3 days. Among these cases, 76 were accurately diagnosed by TVS, 1 was misdiagnosed as adnexal torsion by TVS, and 4 were confirmed to have IUPs after the surgical treatment. Hence, the sensitivity of TVS for detecting HP was 93.8% (76/81). However, forty-seven patients (58.0%) had suspected HP when they underwent the initial TVS. Among these patients, live births occurred for 60 patients, 11 of whom delivered preterm. The miscarriage rate was 58.3% (14/24) for patients without IUP cardiac activity at HP diagnosis, and 12.3% (7/57) for patients with IUP cardiac activity; a significant correlation was identified (χ2 = 18.651, P < 0.001). Additionally, the abortion rate of patients following fresh non-donor embryo was higher than patients after frozen-thawed embryo (χ2 = 10.437, P = 0.001). Further by logistic regression analysis, patients following frozen-thawed embryo and an IUP with cardiac activity at HP diagnosis were identified as two independent factors of pregnancy outcome. (OR = 0.060, 95%CI = 0.008-0.471, P = 0.007; OR = 0.010, 95%CI = 0.001-0.124, P<0.001). CONCLUSIONS: Patients following frozen-thawed embryo and an IUP with cardiac activity at HP diagnosis could be the independent predictors for a favorable prognosis.

8.
Front Genet ; 10: 835, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31572445

RESUMO

Polyhydramnios is sometimes associated with genetic defects. However, establishing an accurate diagnosis and pinpointing the precise genetic cause of polyhydramnios in any given case represents a major challenge because it is known to occur in association with over 200 different conditions. Whole exome sequencing (WES) is now a routine part of the clinical workup, particularly with diseases characterized by atypical manifestations and significant genetic heterogeneity. Here we describe the identification, by means of WES, of novel compound heterozygous truncating variants in the LMOD3 gene [i.e., c.1412delA (p.Lys471Serfs*18) and c.1283dupC (p.Gly429Trpfs*35)] in a Chinese family with two successive fetuses affected with polyhydramnios, thereby potentiating the prenatal diagnosis of nemaline myopathy (NM) in the proband. LMOD3 encodes leiomodin-3, which is localized to the pointed ends of thin filaments and acts as a catalyst of actin nucleation in skeletal and cardiac muscle. This is the first study to describe the prenatal and postnatal manifestations of LMOD3-related NM in the Chinese population. Of all the currently reported NM-causing LMOD3 nonsense and frameshifting variants, c.1412delA generates the shortest truncation at the C-terminal end of the protein, underscoring the critical role of the WH2 domain in LMOD3 structure and function. Survey of the prenatal phenotypes of all known LMOD3-related severe NM cases served to identify fetal edema as a novel presenting feature that may provide an early clue to facilitate prenatal diagnosis of the disease.

9.
J Ultrasound Med ; 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31626344

RESUMO

OBJECTIVES: The aim of this study was to determine whether cervical elastographic parameters in addition to cervical length (CL) during the 3 trimesters of pregnancy would be predictive of spontaneous preterm birth (sPTB) among low-risk women. METHODS: This work was a prospective nested case-control study evaluating cervical elastographic parameters and CL in low-risk women during the 3 trimesters of pregnancy. A binary logistic regression analysis was used to calculate significant covariates for prediction of sPTB. The area under the curve of the prediction model was calculated by using a receiver operating characteristic curve. RESULTS: There were 286 women (26 cases and 260 controls) included in the analysis. The parameters of cervical elasticity became softened and heterogeneous during the 3 trimesters of pregnancy in both women with and without sPTB. The differences in the mean strain value at the internal os of the cervix (IOS), ratio (strain ratio of the internal os to the external os) during the second trimester and the IOS during the third trimester between the groups had statistical significance (P < .01; P = .01; P < .01, respectively). The CL had no association with sPTB during the 3 trimesters. The IOS during the second trimester was a better predictor of sPTB, with an area under the curve of 0.730, and sensitivity was 72.73%. CONCLUSIONS: We observed multiple elastographic parameters and demonstrated the physiologic changes in the cervix during the 3 trimesters of pregnancy. Furthermore, we found that the IOS during the second trimester can be helpful in predicting sPTB. However, the CL had no association with sPTB during the 3 trimesters of pregnancy.

10.
Cardiovasc Ultrasound ; 17(1): 8, 2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31060568

RESUMO

BACKGROUND: The etiology of TOF is complex and the genesis of TOF has been associated with environmental factors and genetic disorders, including chromosomal anomalies, aneuploidies, 22q11.2 deletion and single-gene disease. Previous literatures have shown that a chromosome alteration in about 30% patients with TOF and recently published articles reported that 22q11.2 deletion syndrome accounts for 16% cases with TOF diagnosed postnatally. CMA now is considered as gold standard for detecting genetic anomalies in fetuses with congenital malformations. CMA could detect a 6.6-25% incremental yield of CNVs in CHDs. The aim of this study was to assess the genetic anomalies in fetal tetralogy of Fallot (TOF) by using high-definition CMA. METHODS: This retrospective study reviewed all the fetuses diagnosed with TOF between 2013 and 2018. Prenatal ultrasongraphic findings, including cardiac angle, and the findings of CMA using Affymetrix CytoScan HD array were collected. RESULTS: Ninety-six fetuses with TOF and known genetic results were enrolled. Right aortic arch was the most common associated anomalies (22.9%). One fetus with trisomy 18, one with 46, XX, t (7;10)(q36;q22), one with 47, XYY and five with trisomy 21 were identified. Clinically significant CNVs occurred in 6.8% and uncertain significant CNVs in 3.4% fetal TOF with normal karyotype. A total of four cases with 22q11.2 microdeletion and two fetuses with Yq11.223q11.23 microduplication have been identified. Genetic anomalies, including chromosomal aberrations and pathogenic CNVs, were significantly higher in the TOF with extracardiac anomaly group than in the TOF without extracardiac anomaly group (P = 0.005). Abnormal cardiac angle was noticed in 24.0% fetal TOF. Genetic anomalies were more common in the TOF with abnormal cardiac angle than with normal cardiac angle (P = 0.001). On the other hand, abnormal cardiac angle was noticed in 64.3% fetal TOF with genetic anomalies while abnormal cardiac angle occurred in 17.1% fetal TOF with normal genetic results (P = 0.001). CONCLUSIONS: Genetic testing should be offered, specially using microarray analysis, for the fetal TOF with abnormal cardiac angle or extracardiac defects.


Assuntos
Aberrações Cromossômicas , DNA/análise , Coração Fetal/diagnóstico por imagem , Análise em Microsséries/métodos , Tetralogia de Fallot/genética , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Tetralogia de Fallot/diagnóstico , Tetralogia de Fallot/embriologia , Adulto Jovem
11.
Biol Open ; 8(3)2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30814067

RESUMO

Reef-building corals and some other cnidarians form symbiotic relationships with members of the dinoflagellate family Symbiodinaceae. As Symbiodinaceae is a highly diverse taxon, the physiological interactions between its members and their hosts are assumed to differ between associations. The presence of different symbiont types is known to affect expression levels of specific host genes, but knowledge of the effects on the transcriptome more broadly remains limited. In the present study, transcriptome profiling was conducted on the tropical corallimorpharian, Ricordea yuma, following the establishment of symbiosis with either the 'homologous' symbiont Symbiodinium goreaui (also known as Cladocopium goreaui; ITS2 type C1) or 'heterologous' symbionts (predominantly S. trenchii, which is also known as Durusdinium trenchii; ITS2 type D1a) isolated from a different corallimorpharian host (Rhodactis indosinensis). Transcriptomic analyses showed that genes encoding host glycogen biosynthesis pathway components are more highly induced during colonization by the homologous symbiont than by the heterologous symbiont. Similar patterns were also observed for several other genes thought to facilitate symbiotic nutrient exchange, including those involved in lipid translocation/storage and metabolite transport. The gene expression results presented here imply that colonization by homologous or heterologous Symbiodinium types may have very different metabolic consequences for the Ricordea host, supporting the notion that even though some cnidarians may be able to form novel symbioses after bleaching, the metabolic performance of these may be compromised.This article has an associated First Person interview with the first author of the paper.

12.
Int J Biochem Cell Biol ; 109: 17-22, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30690078

RESUMO

Dysregulation of ubiquitin-conjugating enzyme E2S (UBE2S) contributes to tumor progression. However, its clinical significance and biological function in endometrial cancer (EMC) remain unclear. Here, we show that UBE2S is upregulated in EMC and exhibits oncogenic activities via activation of SOX6/ß-Catenin signaling. High expression of UBE2S is significantly associated with poor prognosis in two independent cohorts consisting of a total of 773 patients with EMC. in vitro studies demonstrate that ectopic expression of UBE2S promotes cell proliferation and migration, whereas knockdown of UBE2S results in opposite phenotypes. Overexpression of UBE2S in EMC cells enhances the nuclear translocation of ß-Catenin, and subsequently induces the expression of c-Myc and Cyclin D1. Inhibition of ß-Catenin by XAV-939 markedly attenuates UBE2S-promoted cell growth. Mechanistically, UBE2S suppresses the expression of SOX6 to trigger ß-Catenin signaling. Re-expression of SOX6 in UBE2S-expressing EMC cells abolishes the nuclear localization of ß-Catenin. Collectively, these data suggest UBE2S may serve as a promising prognostic factor and function as an oncogene in EMC. The newly identified UBE2S/SOX6/ß-Catenin axis represents a new potential therapeutic target for EMC intervention.


Assuntos
Progressão da Doença , Neoplasias do Endométrio/metabolismo , Neoplasias do Endométrio/patologia , Fatores de Transcrição SOXD/metabolismo , Transdução de Sinais , Enzimas de Conjugação de Ubiquitina/metabolismo , beta Catenina/metabolismo , Carcinogênese , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Feminino , Humanos , Enzimas de Conjugação de Ubiquitina/genética , Regulação para Cima
14.
Int Immunopharmacol ; 64: 116-122, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30173051

RESUMO

Melatonin has important immuno-regulatory effects in inflammatory disorders but its specific role in Helicobacter pylori induced gastritis remains unclear. The aim of our study was to analyze the activity of melatonin against H. pylori induced gastritis in vivo, and explore the underlying mechanisms. The H. pylori infected mice showed extensive inflammatory cell infiltration in the gastric mucosa and submucosa, along with significantly reduced spleen and thymus weight. However, 2 and 6 weeks of treatment with 25 and 50 mg/kg melatonin restored the thymus weights relative to that of the untreated mice. TLR2 was upregulated in the gastric mucosa of the infected mice, which was restored to normal levels after 2 and 6 weeks of melatonin treatment. In contrast, TLR4 levels were similar between the treated and untreated mice. Furthermore, melatonin treatment restored spleen Foxp3 and serum TGF-ß1 levels that were respectively increased and decreased in the infected mice. H. pylori infected mice also showed a decrease in the serum levels of IL-2, IL-6, IL-10, IL-17, IFN-γ and TFN-α following 2 and 6 weeks of melatonin treatment compared to the untreated mice. Melatonin treatment also resulted in decreased CD4+CD25+Foxp3+ Treg cell count in the spleen. The expression of TLR2, MyD88, p-ERK, p-p38, p65, p50 and Foxp3 in the gastric tissues were lower in the untreated mice compared to mice treated with melatonin for 2 weeks. However, the expression levels evened out after 6 weeks of treatment. Taken together, melatonin alleviates H. pylori induced gastritis by regulating TGF-ß1 and Foxp3 expression via the TLR2 and TLR4 pathways.


Assuntos
Citocinas/biossíntese , Fatores de Transcrição Forkhead/genética , Gastrite/prevenção & controle , Infecções por Helicobacter/complicações , Helicobacter pylori , Melatonina/farmacologia , Receptor 2 Toll-Like/fisiologia , Receptor 4 Toll-Like/fisiologia , Animais , Regulação para Baixo , Melatonina/uso terapêutico , Camundongos , NF-kappa B/fisiologia , Receptor 2 Toll-Like/análise , Receptor 4 Toll-Like/análise , Fator de Crescimento Transformador beta1/sangue
18.
Fetal Diagn Ther ; 44(4): 291-298, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29268259

RESUMO

OBJECTIVE: This study aimed to determine the significance of the venous drainage pattern of bronchopulmonary sequestration (BPS) in the prenatal course. METHODS: The venous drainage pattern of fetuses with BPS was determined with high-definition flow and confirmed by postnatal three-dimensional computed tomography angiography scan or autopsy. The volume of BPS lesions during gestation was recorded by the three-dimensional ultrasonographic Virtual Organ Computer-Aided Analysis software. The relationship between venous drainage pattern and prenatal characteristics was determined. RESULTS: Seventy-one fetuses were enrolled: 35 with systemic venous drainage (SVD) and 36 with pulmonary venous drainage (PVD). The volumes of BPS lesions significantly increased from the middle second trimester to the later second trimester in the SVD group. A marked decrease from the later second trimester to the third trimester was observed in the PVD group. The incidences of associated anomalies, hydrops, and polyhydramnios in the SVD group were 14.2, 23.3, and 33.3%, respectively, significantly higher than those in the PVD group (0, 0, and 5.6%, respectively). CONCLUSIONS: Our data indicate that SVD is correlated with a higher risk of associated anomalies and an unfavorable prenatal course in fetal BPS. Identification of the venous drainage pattern is of clinical significance in predicting the prenatal behavior of fetal BPS.


Assuntos
Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/patologia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Poli-Hidrâmnios , Gravidez , Prognóstico , Ultrassonografia Pré-Natal
19.
PeerJ ; 5: e4074, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29226032

RESUMO

Background: The corallum is crucial in building coral reefs and in diagnosing systematic relationships in the order Scleractinia. However, molecular phylogenetic analyses revealed a paraphyly in a majority of traditional families and genera among Scleractinia showing that other biological attributes of the coral, such as polyp morphology and reproductive traits, are underutilized. Among scleractinian genera, the Euphyllia, with nine nominal species in the Indo-Pacific region, is one of the groups that await phylogenetic resolution. Multiple genetic markers were used to construct the phylogeny of six Euphyllia species, namely E. ancora, E. divisa, E. glabrescens, E. paraancora, E. paradivisa, and E. yaeyamaensis. The phylogeny guided the inferences on the contributions of the colony structure, polyp morphology, and life history traits to the systematics of the largest genus in Euphyllidae (clade V) and, by extension, to the rest of clade V. Results: Analyses of cytochrome oxidase 1 (cox1), cytochrome b (cytb), and ß-tubulin genes of 36 colonies representing Euphyllia and a confamilial species, Galaxea fascicularis, reveal two distinct groups in the Euphyllia that originated from different ancestors. Euphyllia glabrescens formed a separate group. Euphyllia ancora, E. divisa, E. paraancora, E. paradivisa, and E. yaeyamaensis clustered together and diverged from the same ancestor as G. fascicularis. The 3'-end of the cox1 gene of Euphyllia was able to distinguish morphospecies. Discussion: Species of Euphyllia were traditionally classified into two subgenera, Euphyllia and Fimbriaphyllia, which represented a dichotomy on colony structure. The paraphyletic groups retained the original members of the subgenera providing a strong basis for recognizing Fimbriaphyllia as a genus. However, colony structure was found to be a convergent trait between Euphyllia and Fimbriaphyllia, while polyp shape and length, sexuality, and reproductive mode defined the dichotomy better. Species in a genus are distinguished by combining polyp morphology and colony form. The cluster of E. glabrescens of the Euphyllia group is a hermaphroditic brooder with long, tubular tentacles with knob-like tips, and a phaceloid colony structure. The Fimbriaphyllia group, with F. paraancora, F. paradivisa, F. ancora, F. divisa, and F. yaeyamaensis, are gonochoric broadcast spawners with short polyps, mixed types of tentacle shapes, and a phaceloid or flabello-meandroid skeleton. Soft-tissue morphology of G. fascicularis and Ctenella chagius were found to be consistent with the dichotomy. Conclusions: The paraphyly of the original members of the previous subgenera justify recognizing Fimbriaphyllia as a genus. The integrated approach demonstrates that combining polyp features, reproductive traits, and skeletal morphology is of high systematic value not just to Euphyllia and Fimbriaphyllia but also to clade V; thus, laying the groundwork for resolving the phylogeny of clade V.

20.
Prenat Diagn ; 37(12): 1219-1224, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29025195

RESUMO

OBJECTIVES: To assess the chromosomal and subchromosomal anomalies in small for gestational age (SGA) fetuses with no additional structural anomalies and their clinical outcomes. METHODS: This study retrospectively reviewed the 128 SGA fetuses with no additional anomalies and underwent genetic testing with karyotyping and chromosomal microarray analysis (CMA). Stratified analysis was performed according to the existence of maternal risk factors for SGA (yes or no), gestational age at onset (before or after 32 weeks), presence of oligohydraminos (yes or no), and umbilical artery Doppler flow (normal or abnormal). RESULTS: Chromosomal anomalies were identified in 6 (4.7%) SGA fetuses and pathogenic subchromosomal anomalies in 4 (3.1%) by microarray analysis. Chromosomal and subchromosomal anomalies were more frequently observed in cases with oligohydraminos (P = .017) and with early-onset SGA (P = .042). No differences were observed in relation to the existence of maternal risk factors and abnormal umbilical artery Doppler flow. Overall survival rate was 75.0% with different rates in the early and the late onset group (P < .001). CONCLUSIONS: There is a 3.3% incremental yield of subchromosomal anomalies in CMA above karyotyping in SGA fetuses. Chromosomal microarray analysis is recommended in SGA fetuses with no additional structural anomalies, especially coexisting with oligohydraminos and being early onset.


Assuntos
Aberrações Cromossômicas , Retardo do Crescimento Fetal/genética , Diagnóstico Pré-Natal , Adulto , China/epidemiologia , Feminino , Retardo do Crescimento Fetal/mortalidade , Humanos , Análise em Microsséries , Gravidez , Estudos Retrospectivos , Adulto Jovem
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