No abstract

A distally actuated, rotational-scanning micromotor endoscope catheter probe is demonstrated for ultrahigh-resolution in vivo endoscopic optical coherence tomography (OCT) imaging. The probe permits focus adjustment for visualization of tissue morphology at varying depths with improved transverse resolution compared with standard OCT imaging probes. The distal actuation avoids nonuniform scanning motion artifacts that are present with other probe designs and can permit a wider range of imaging speeds. Ultrahigh-resolution endoscopic imaging is demonstrated in a rabbit with <4-microm axial resolution by use of a femtosecond Cr:forsterite laser light source. The micromotor endoscope catheter probe promises to improve OCT imaging performance in future endoscopic imaging applications.

Objective  To identify sensitivity and specificity of computerised cardiotocography (CTG) analysis for fetal acidosis during delivery. Design  Retrospective observational study. Setting  Tertiary referral labour ward, Technical University München (TUM) and University Witten/Herdecke (UWH). Population  All deliveries, which had at least one fetal scalp pH measurement and electronically saved CTG traces, between 2000 and 2002 (TUM) and between 2004 and 2005 (UWH). Method  Correlation analysis of fetal scalp pH values and computerised International Federation of Obstetrics and Gynecology (FIGO) classification using ‘CTG Online®’ program of digitally saved CTG traces. Main outcome measures  Fetal scalp pH values, FIGO parameter (baseline, variability, acceleration and deceleration) using computerised analysis. Results  Both collectives showed a high sensitivity (95.0%) for computerised FIGO classification ‘suspect’ and ‘pathological’, together with a low specificity (21.8%) for fetal acidosis. The most sensitive single FIGO parameter was deceleration. Very low sensitivity (<50%) was shown for the parameters variability and acceleration. Conclusions  Computerised CTG analysis is highly sensitive for fetal acidosis and can be used as an objective adjunctive criterion during delivery. Further CTG data are needed to adjust and optimise each FIGO parameter and increase sensitivity and specificity.

In order to investigate the effect of different immunosuppressive regimens and the time interval between transplantation and pregnancy on long-term outcome, we performed a case-control study in pregnant renal allograft recipients. Eighty-one pregnancies of kidney transplanted recipients were identified [cyclosporine (CYA): n = 40; azathioprine (AZA): n = 41]. Controls were matched with respect to important prognostic factors. Posttransplant follow-up was 91.3 ± 5 months. Graft and patient survival were similar in both groups and there was no apparent effect of immunosuppression. A total of 28 recipients (33%) delivered within 2 years and 6 (8%) subjects within 1 year after transplantation, but these short transplantation-topregnancy intervals had no apparent adverse effect on long-term outcome. In contrast to AZA-treated patients, CYA-treated patients experienced an increase in serum creatinine postpartum (1.15 ± 0.2 mg/dL vs. 1.61 ± 0.1 mg/dL; p < 0.05). Whole blood CYA levels decreased transiently during pregnancy from 115.9 ± 8 ng/mL to 80.7 ± 7 ng/mL leading to a gradual increase in drug dose from 240 ± 14 mg/day to 324 ± 21 mg/day (p < 0.05). Following delivery, there was an increase in CYA concentrations to 173 ± 5.4 ng/mL, requiring rapid dose tapering to baseline of 246 ± 15 mg/day. Pregnancies in renal recipients do not affect long-term patient and graft survival, independent of the immunosuppression. No detrimental effect of short transplantation-to-pregnancy intervals on longterm graft function was detected.

Training with EPI-NO increases significantly the likelihood of having an intact perineum and reduces the episiotomy rate.