SummaryObjective To evaluate type I hypersensitivity to citrus red mite (Panonychus citri), its prevalence, and relationship to respiratory dysfunction, a cross-sectional survey was performed among citrus farmers on Cheju Island, Korea. Materials and methods Questionnaires, and skin prick test responses to 11 common inhalant allergens and citrus red mite were performed in 181 citrus farmers, and serumspecific IgE antibodies to citrus red mite were measured by ELISA in sera of 123 subjects. To determine airway hyperresponsiveness, methacholine bronchial provocation tests were performed in 55 subjects who complained of recurrent lower respiratory symptoms. Results The prevalence of asthma-based on presence of asthmatic symptoms on the questionnaire and airway hyperresponsiveness to methacholine, and allergic rhinitis based on presence of nasal symptoms on the questionnaire and positive skin-test response were 12.1% and 19.3%, respectively. The positive rate of skin responses to one or more of 11 common inhalant allergens excluding citrus red mite was 17.1%, and if citrus red mite was included, 25.9% of farmers had positive responses. On skin prick tests, citrus red mite (16.5%) was the most common sensitizing allergen, followed by cockroach (11.0%), Dermatophagoides pteronyssinus (9.9%), and D. farinae (9.3%). Among farmers with asthma and allergic rhinitis, the positive skin responses to citrus red mite were noted in 54.5 and 68.5%, respectively. Serum-specific IgE antibodies to citrus red mite were detected in 45 farmers (36.5%) of the 123 tested, and there was significant correlation between specific IgE level and weal (A/H ratio) to citrus red mite (r ¼ 0.57, P < 0.001). The prevalence of asthma was higher in subjects with positive skin responses or high serum-specific IgE antibodies to citrus red mite than in those without skin response or serum specific IgE (P < 0.05, respectively). Conclusion Citrus red mite is the most important allergen in citrus farmers with asthma and rhinitis in which causative allergen has not been identified. It should be included in the skin test battery for screening the causative allergen in farmers exposed to citrus red mite.

ABSTRACT

Objectives: Fetal kidney produces amniotic fluid and it is crucial for the fetal and development maturation. To evaluate fetal renal function by analyzing the hemodynamics of fetal renal artery and the renal volume, we have measured them in normal fetuses after 20 weeks of gestation using the color Doppler and 3D sonography. Methods: After obtaining informed consent from 66 pregnant women with healthy fetuses, the following investigations were performed every 4 weeks after 20 weeks of gestation.: (1) Hemodynamic analysis: maximum systolic velocity (Vmax), mean velocity (Vmean), minimal velocity (Vmin), arterial cross sectional area (Area), resistance index (RI) and pulsatility index (PI) of the fetal renal artery (2) Fetal renal volume. Results: All hemodynamic indexes except RI and PI increased significantly with the course of pregnancy. Vmax, Vmean and area of the renal artery increased significantly from 21.80 ± 0.40 cm/s, 9.56 ± 0.17 cm/s and 6.78 ± 0.25 mm 2 at 20-24 weeks to 41.59 ± 0.46, 20.15 ± 0.22 and 10.12 ± 0.19 at 37-40 weeks, respectively (P < 0.05). Renal Volume of the fetal kidney also increased significantly between the 20-24 weeks and the 37-40 weeks (1.375 ± 1.41 mm 2 vs. 11.21 ± 1.63 mm 2 , P < 0.003). Conclusions:We have clarified the changes of fetal renal hemodynamic indexes and the fetal renal volume during the normal course of pregnancy. These indices might be used for the evaluation of fetal renal function in the near future. P46.03How can we recognize the very early stage of brain sparing effect?A. Surányi 1 , A. Keresztúri 1 , T. Nyári 2 , A. Pál 1 Department of Obstetrics and Gynaecology of Szeged University, Hungary, 2 Department of Medical Informatics of Szeged University, HungaryBackground: The object of this study was to investigate the fetal renal and middle cerebral arterial blood flows in normal and hyperechogenic kidneys during the fetal period. Materials and methods: Study group consisted of 82 pregnancies with intrauterine growth retardation. Group included pregnant women from the third trimester. Hyperechogenic medullae were detected in 17 out of 82 pregnancies with intrauterine growth retardation. Results: Fetal renal hyperechogenicity appears to be an indicator of fetal arterial circulatory depression, correlated with pathological changes in the resistance index for the fetal renal arteries. The fetal renal arterial blood flow resistance index was significantly lower in hyperechogenic cases, while in the middle cerebral cerebral flow was in the normal range. This may also be an indication of subsequent intrauterine and neonatal complications, such as Cesarean section because of fetal distress (47%), treatment in a neonatal intensive care unit (71%) or increased perinatal mortality (12%). Conclusions: Detailed ultrasound of renal parenchyma and Doppler examination of renal and middle cerebral arteries appear to be a useful method in the prenatal diagnosis of reduced renal perfusion and of intrauterine hypoxia so as to detect possible pathological fetal conditions in utero.

outcome were significantly increased in infants with abnormal S/D ratio (P < 0.001). When logistic regression analysis was performed after adjusting for gestational age, the odds ratio for poor perinatal outcome was 3.7 in the group showing abnormal S/D ratio (95% confidence interval 1.42-9.54, P = 0.007). Conclusion: Umbilical artery Doppler velocimetry is shown as a significantly efficient method in predicting perinatal outcome in preterm neonates with small-for-gestational age, and it may be useful in managing preterm patients with small-for-gestational age fetuses. The results obtained in hypertensive patients: the incidence of fetal weight deficit at birth was 88.8% (25.9% the moderate form and 62.9% the severe form). The reliability of umbilical Doppler examination in the evaluation of fetal growth disorders was Se = 66.6%, Sp = 100%, PPV = 100%, NPV = 27.2%. A 15.5% error percent (8.6% false negative results and 6.9% false positive results) was obtained. P46.06 Evaluation of IUGR by umbilical Doppler examination Conclusions:In the presence of an ultrasound suspicion of IUGR, an abnormal umbilical RI value allows to confirm the alteration of fetal growth potential. A normal RI value in the context of IUGRE has a different significance depending on the presence or the absence of hypertension. P46.07Perinatal outcome according to umbilical artery blood flow velocity waveform of term pregnancies with small for gestational age pregnancies Ajou University School of Medicine, Republic of KoreaObjectives: To investigate whether umbilical artery blood flow velocity waveform is related to perinatal outcome of term pregnancies with small for gestational age. Methods: Total of 381 patients were at 37-41 weeks of gestational age who received antenatal umbilical artery Doppler blood flow and delivered singleton small-for-gestational age (SGA) infants. The ratio of peak-systolic to end-diastolic (S/D) blood flow velocities in the umbilical artery was measured in each patient. The patients were divided into a normal group (n = 307) with a S/D ratio equal to or less than 3.0, and an abnormal group with a S/D ratio of greater than 3.0 (n = 74). These groups were comparatively analyzed with respect to maternal characteristics and neonatal outcome. Results: There was no significant difference between the two groups with respect to mean maternal age, gestational age at the time of delivery, and Cesarean section rate due to fetal distress. There was significantly increased incidence of hypertensive disorders in pregnancy (12.3% vs. 25.0%, P = 0.005) and oligohydramnios (27.7% vs. 45.0%, P = 0.003) in the abnormal S/D ratio group. Significant difference was also observed between the two groups with respect to neonatal birthweight (2415.2 ± 258.9 vs. 2296.7 ± 325.0 g, P = 0.003), incidence of admission to neonatal intensive care unit (NICU) (27.0% vs. 51.3%, P < 0.001), and duration of NICU care (2.7 ± 5.9 vs. 5.7 ± 8.8 days, P = 0.005), but no difference was observed in terms of low Apgar score of less than 7 at 5 minutes (2.7%...