RESUMEN
OBJECTIVE: To assess the maturation of auditory evoked cortical responses in the human fetus using fetal magnetoencephalography. DESIGN: Prospective case series over a three-year period. SETTING: Antenatal clinics, university hospital. POPULATION: Singleton pregnancies at 29-40 weeks of gestation. METHODS: We used a 31-channel-SQUID-biomagnetometer in a magnetically-shielded room to perform fetal magnetoencephalography. To record auditory evoked fields from the fetal brain we applied 500 monotonal bursts generated by a computerised sound generator directly to the maternal abdominal wall near the fetal head. The continuously recorded data sets were analysed stepwise using a specially developed heart artefact rejection software, Fourier filtering, principle component analysis and half split analysis of the averaged data. RESULTS: In 36 of 64 examinations we detected signals of auditory evoked fields comparable to the P2m component in adults. The earliest recording succeeded in the 29th gestational week. The latencies of the auditory evoked responses declined during the third trimester from 300 ms to nearly 150 ms at term. The maturation of different components of the auditory evoked field could be demonstrated from the 31st gestational week onwards. CONCLUSION: The maturation of a fetal auditory cortical function using fetal magnetoencephalography could be assessed directly for the first time. We believe that this method will add information to current indirect methods of assessing the normal maturation of the human fetal brain.
Asunto(s)
Encéfalo/embriología , Electrocardiografía/métodos , Desarrollo Embrionario y Fetal/fisiología , Magnetismo , Neuronas/fisiología , Potenciales Evocados Auditivos/fisiología , Femenino , Edad Gestacional , Humanos , Embarazo , Estudios ProspectivosRESUMEN
Interventional pneumology includes both bronchological and vascular methods of diagnostic and therapy, especially in case of pneumological emergency, such as pulmonary hemorrhage and superior vena cava syndrome. In massive pulmonary hemorrhage bronchological diagnosis is needed to determine the location and activity of the bleeding, as well as angiography of bronchial arteries, and of pulmonary arteries, respectively. Bronchus occlusion by aid of balloon catheter or double lumen tube are intermediate methods to bridge over till defenitive surgery or embolisation of bronchial or pulmonal arteries as complementary methods in patients with pulmonary hemorrhage. In patients suffering from superior vena cava syndrome caused by neoplasms venous angioplasty and Wallstent implantation provide immediate clinical improvement.
Asunto(s)
Angioplastia de Balón/instrumentación , Hemorragia/etiología , Enfermedades Pulmonares/etiología , Radiología Intervencionista/instrumentación , Stents , Síndrome de la Vena Cava Superior/etiología , Arterias Bronquiales/diagnóstico por imagen , Cateterismo/instrumentación , Hemorragia/diagnóstico por imagen , Hemorragia/terapia , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/terapia , Arteria Pulmonar/diagnóstico por imagen , Radiografía , Síndrome de la Vena Cava Superior/diagnóstico por imagen , Síndrome de la Vena Cava Superior/terapiaRESUMEN
Clinical and paraclinical data of 91 neonates of the Saxon regions of Leipzig and of Torgau/Elbe were reviewed and correlated to the environmental conditions of the places of residence of their mothers during pregnancy. One of the parameters investigated was the hepatic detoxification capacity of the neonates measured by 15N elimination rates in the [15N]methacetin urine test. Because of heavy air pollution in the places of residence of some of the pregnant women, a distinct reflection of environmental influence in the parameters was expected. While some of the parameters considered, such as birth weight and bilirubin levels, did not correlate with mean exposure data of the residences of the pregnant women, the mean rate of the age-dependent maturation of hepatic 15N elimination did. This maturation was seen to be significantly decreased in heavily polluted districts of the Leipzig region compared to lower polluted places of Leipzig and to the lowly polluted region of Torgau/Elbe.