The flow pattern in intrarenal veins depends on renal parenchymal histology and cardiac physiology. The intrarenal venous impedance index obtained by Doppler ultrasound is related to compliance in vein, and can be helpful in the assessment of renal parenchymal compliance. The purpose of this study was to determine whether normal pregnancy has a significant effect on intrarenal venous blood flow, and assess if the physiological pyelocaliectasis causes a measurable reduction in venous impedance indexes in pregnant women. Doppler ultrasound of intrarenal veins was performed in 35 asymptomatic pregnant women in the second and third trimester of gestation, and in 24 non-pregnant healthy women. After grading the degree of hydronephrosis, venous impedance index was obtained from the interlobar veins. The venous waveforms in pregnant women showed diminished phasic oscillations owing to elevated pre-systolic flow. The mean venous impedance indexes in pregnant women were significantly lower than the values in non-pregnant subjects, 0.30+/-0.10 versus 0.44+/-0.06 in the right (p<0.001), and 0.36+/-0.11 versus 0.41+/-0.07 in the left kidney (p=0.03). There was an inverse correlation between the grade of pelvicalyceal dilatation and the venous impedance indexes in both kidneys in pregnant women (r=-0.62, p<0.001 for the right kidney, and r=-0.38, p=0.05 for the left kidney). An abnormally reduced venous impedance index in pregnant women can at least in part be explained by reduced vascular compliance from increased interstitial pressure subsequent to partial obstruction of ureters by the gravid uterus, and caution should be exercised in interpreting it as a sign of pathological ureteral obstruction.

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Many maternally derived factors may be involved in the regulation of embryonic growth but the control mechanisms involved are poorly understood. Human placental lactogen (hPL) has been implicated in playing a role in the control of embryonic growth. Several investigators suggested that there may be a possible link between the effects of this hormone and insulin-like growth factors (IGFs). In order to determine the growth promoting potential of hPL and involvement of IGFs in the mechanism of action of the hormone, 9n5 d rat embryos were cultured in vitro for 48 h in depleted serum in the presence and absence of hPL with additional IGF antisera. The growth supporting capacity of the serum was reduced by removal of low molecular weight molecules by prolonged filtration of the serum using filters with a molecular weight exclusion of 30 kDa. Addition of hPL (3n2-25n6 ng\ml) to depleted serum significantly improved embryonic growth and development, suggesting that the developing embryo may utilise hPL. The presence of antisera against hPL, IGF-I and -II abolished the hPL-induced increase in the development in all parameters suggesting that there may be a possible link between the IGFs and the effects of hPL on rat embryonic development and this hormone may achieve its growth promoting effects via IGFs.

In the early stages of embryonic development, many growth-promoting molecules must be provided by the maternal system. The molecules involved in growth processes may be either hormones or growth factors, or molecules that interact with such factors. The pregnancy related hormone, prolactin (PRL, MW 23 kDa) has been implicated in the control of embryonic growth. The growth-promoting potential of PRL and its species-specificity was investigated by culturing 9n5 d rat embryos in vitro for 48 h in depleted serum in the presence and absence of PRL from 3 different species. The growth-supporting capacity of the serum was reduced by removal of low molecular weight molecules by prolonged filtration of the serum using filters with a molecular weight exclusion of 30 kDa. This method provided a ' semidefined ' medium (retenate) in which embryonic growth and development was significantly reduced, demonstrating that the low molecular weight fraction of serum may contain some growth-promoting factors. Addition of PRL (0n4-25n6 ng\ml) from different species (human, sheep and rat) to retenate significantly improved embryonic growth and development, suggesting that the developing embryo may utilise PRL. Amongst PRLs, rat PRL was found to be active at much lower concentrations than either of the other molecules, and human PRL had more effect in low concentrations than sheep PRL suggesting a species-specificity for this hormone. It may be that the PRL receptors of the rat embryos have greater affinity for the rat hormone as different responses for hormones from different species have been shown. These findings suggest that embryos may be able to utilise maternally derived PRL during organogenesis.

The possibility of creating a middle meningeal artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in six cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 +/- 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 +/- 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA.