4-D sonography provides a means of evaluating fetal facial expression early in the third trimester. It may be a key to predicting fetal brain function and well-being and an important modality in future fetal neurophysiologic research.

We studied whether N-acetylaspartate (NAA), a neuronal marker, is reduced in the brain of 14 patients with clinically definite amyotrophic lateral sclerosis (ALS) and whether NAA levels in the motor area and frontal lobe correlate with the clinical features, including frontal lobe function. We also studied 14 normal controls were evaluated. We obtained peak integrals in 1H magnetic resonance spectroscopy (MRS) for NAA, creatine (Cr), and choline-containing compounds (Cho). Severity of the disease was determined using the manual muscle strength test, and the Norris limb and bulbar scales. In the patients, the NAA/Cr ratio was reduced in the motor area and frontal lobe, while the Cho/Cr ratio was normal throughout the brain. There were significant correlations between the NAA/Cr ratio in the motor area and the Norris limb scale (r = 0.50; P < 0.01) and between the NAA/Cr ratio in the frontal lobe and the number of categories achieved in the Wisconsin Card Sorting test (r = 0.71; P < 0.05), implying frontal lobe dysfunction. These correlations suggest that a reduced NAA/Cr ratio is a marker of cortical neuronal loss and dysfunction in ALS.

Objective:  The purpose of our study was to evaluate the fetal behavioral pattern in the early second trimester of pregnancy by use of a specially developed abdominal real‐time three‐dimensional sonography. Methods:  Real‐time three‐dimensional sonographic examinations were performed on 11 normal pregnant women from 14 to 18 weeks of gestation. This imaging system provides continuous three‐dimensional sonographic images every 1–2 s. The fetal movement was monitored for 60 min in each patient, and head, mouth, arm, trunk, and leg movements were evaluated. All fetal behavioral patterns were observed during the period studied. Results:  Active phase (time with fetal movements) was 59.4%, and resting phase 40.6%. The most active fetal behavioral pattern was an arm movement, whereas the least was a mouth movement. Moreover, each fetal movement was synchronized and harmonized with other fetal movements. Conclusions:  Real‐time three‐dimensional sonography provides a novel means on the evaluation of fetal behavior in the early second trimester of pregnancy. These results suggest that real‐time three‐dimensional sonography become an important modality in future early fetal behavior research and in evaluation of fetal well‐being in the second trimester of pregnancy.

Our findings suggest that liver volume may be a useful measurement for diagnosing small-for-gestational-age fetuses in the mid to late third trimester but that liver length may not be predictive. Further studies involving a larger sample size would be needed to confirm this suggestion.

Objective The aim of this study was to describe fetal hands and feet using three-dimensional ultrasonography. Design This was a randomized prospective study.Methods Ninety-seven fetuses from 12 to 40 weeks' gestation were studied with a specially developed