Do retractile testes have anatomical anomalies?

ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05). Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies.

Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester.

Caracterización de estadios del desarrollo embrio-fetal, vesícula coriónica y de placenta en la gata doméstica (Felis catus) mediante método ecográfico / Characterization of stages of embrio-fetal, chorionic vesicle and placenta development in the domestic cat (Felis catus) by ultrasonography

La ecografía es uno de los métodos de diagnóstico gestacional más utilizados, que permite confirmar una gestación temprana y realizar seguimientos del desarrollo embrio-fetal. En este estudio se emplearon 10 gatas gestantes, entre 10 meses a 6 años de edad, con fecha de cruza conocida. Se realizaron exámenes ecográficos seriados en los días 15 (estadio 1), 18 (estadio 2), 21 (estadio 3), 38 (estadio 4), y 45 (estadio 5) de gestación para medir parámetros biométricos. Vesícula coriónica: diámetro transversal (DTVC), diámetro longitudinal (DLVC); Placenta: grosor (GP); Feto: longitud céfalo-caudal (LCC), diámetro toraco-abdominal (DTA), diámetro cefálico (DC), tomándose un registro fotográfico de cada estadio. En el estadio 1, no se logró visualizar el embrión. En el estadio 2, el embrión se observó cercano a la pared midiendo en promedio 4,7 milímetros de LCC, el tubo endocárdico se observó funcional. En el estadio 3, se observó el cordón umbilical, pero resultó difícil distinguir los diferentes órganos, excepto el corazón, debido al movimiento causado por sus latidos. En el estadio 4, el feto adquiere movimientos, se observó órganos como el encéfalo, pulmones, el tabicamiento del corazón, diafragma, hígado, estómago, asas intestinales, vejiga y la osificación de huesos. Se observó la flexión de los miembros. En los miembros anteriores se visualizaron los dedos separados, con garras y cojinetes plantares. En el estadio 5, además de las características observadas en el estadio anterior, los riñones muestran la corteza y médula, las cámaras del corazón se visualizaron claramente. Se realizó una correlación lineal entre los parámetros biométricos estudiados y los resultados dieron valor significativo (p<0,0001) para la mayoría de éstos. Se logró caracterizar los estadios gestacionales estudiados. Siete de las diez gatas presentaron una gestación normal, mientras que una de ellas presentó en uno de sus fetos una malformación congénita y en las otras dos gatas se presentó muerte embrio-fetal.

Ultrasound is one of the most widely used methods for gestational diagnosis, allowing the detection of early pregnancy and evaluation of fetal growth and development. Ten pregnant cats (aged 10 months to-6 years) were used in this study, with known dates of mating. Serial ultrasound testings were performed on days 15th (stage 1), 18th (stage 2), 21st (stage 3), 38th (stage 4) and 45th (stage 5) of gestation, to measure biometric parameters (Chorionic vesicle: transverse diameter (DTVC), longitudinal diameter (DLVC); Placenta: thickness (GP); Fetus: cephalocaudal length (LCC), thoraco-abdominal diameter (DTA), cephalic diameter (DC). Photographic records were made at each stage. In stage 1, it was impossible to visualize the embryo. In stage 2, the embryo was observed near the wall measuring 4.7 mm on average LCC, and the endocardial tube was functioning. In stage 3, the umbilical cord was observed, but it was difficult to distinguish different organs, with the exception of the heart, which was detected by heartbeat movements. In stage 4, the fetus begins to move. Organs, such as the brain, lungs, heart septation, diaphragm, liver, stomach, bowel, bladder and bone ossification were observed. In the forelimbs, fingers apart with claws and footpads were visualized. In stage 5, in addition to the features observed in the previous stage, the kidneys show the cortex and medulla, and the heart chambers are clearly visualize. A linear correlation analysis among the biometric parameters was performed. Results were statistically significant for most parameters studied (p<0.0001). We characterized the gestational stages studied. Out of the ten cats studied, seven cats had a normal pregnancy. One cat showed one congenitally malformed fetus, and one fetal death occurred in the other two cats.

The importance of the gubernaculum in testicular migration during the human fetal period

Objectives The objective of this review is to study the role of the gubernaculum in the testicular migration process during the human fetal period. Materials and Methods We performed a descriptive review of the literature about the role of the gubernaculum in testicular migration during the human fetal period. Results In the first phase of testicular migration, the gubernaculum enlarges to hold the testis near the groin and in the second phase the gubernaculum migrates across the pubic region to reach the scrotum. The proximal portion of the gubernaculum is attached to the testis and epididymis and the presence of multiple insertions in the distal gubernaculum is extremely rare. The presence of muscle and nerves in the human gubernaculum is very poor. The gubernaculum of patients with cryptorchidism has more fibrous tissue and less collagen and when the patients are submitted to hormonal treatment, the gubernaculum components alter significantly. Conclusions The gubernaculum presents significant structural modifications during testicular migration in human fetuses. .

Gestação gemelar com mola hidatiforme completa e feto vivo após ovodoação e fertilização in vitro: relato de caso / Twin pregnancy with a complete hydatiform mole and a live fetus following egg donation and in-vitro fertilization: case report

Introdução: a gestação gemelar com mola hidatiforme completa e feto vivo é um evento raro e tem, na maior parte dos casos, evolução para aborto ou interrupção médica por causa dos riscos para a mãe e para o feto. Quando associada à reprodução assistida, a decisão de finalização é mais difícil por causa do desejo do casal em manter a gestação. Método: este artigo apresenta um caso de gestação gemelar dizigótica com mola hidatiforme completa em coexistência com feto diploide e placenta normal em uma paciente de 45 anos após fertilização in vitro por ovodoação. Resultados: paciente optou por manter a gestação e o parto ocorreu com 29 semanas, sem complicações maternas. Recém-nascido evoluiu com bom desenvolvimento neuropsicomotor, sem sequelas. Conclusão: este relato de caso ilustra a possibilidade de conduta expectante, porém não podemos ignorar o fato de que existe um alto risco de permanência da doença trofoblástica gestacional. Infelizmente, a raridade do caso torna o manejo clínico ainda controverso.

Introduction: twin pregnancy with complete hydatiform mole and live fetus is a rare event with the most cases resulting in abortion or medical interruption due to maternal and fetal risks. When associated with assisted reproduction, the decision of pregnancy interruption is more difficult due to the desire of the couple to maintain the pregnancy. Method: this study will present a case of twin dizygotic pregnancy with complete hydatiform mole coexisting with fetus diploid and normal placenta in a patient 45 years old, after in-vitro fertilization by egg donation. Results: patient chose to keep the pregnancy and the delivery occurred at 29 weeks without major maternal complications. Newborn evolved with good psychomotor developmentwithout sequelae. Conclusion: this case report illustrates the possibility of expectant management, but wecannot ignore the fact that there is a high risk of persistent gestational trophoblastic disease. Unfortunately, the rarity of the case makes the clinical management still controversial.

Morphological characterization of the nasopalatine region in human fetuses and its association to pathologies

The nasopalatine region is composed of structures such as the vomeronasal organ and nasopalatine duct. The nasopalatine duct may provide the communication of the mouth to the nasal cavity in human fetuses and can be obliterated in an adult human. Knowledge on the development of the nasopalatine region and nasopalatine duct in humans is necessary for understanding the morphology and etiopathogenesis of lesions that occur in this region. Objective The aim of the present study was to describe the morphological aspects of the nasopalatine region in human fetuses and correlate these aspects with the development of pathologies in this region. Material and Methods Five human fetuses with no facial or palatine abnormalities were used for the acquisition of specimens from the nasopalatine region. After demineralization, the specimens were histologically processed. Histological cuts were stained with methylene blue to orient the cutting plane and hematoxylin-eosin for the descriptive histological analysis. Results The age of the fetuses was 8.00, 8.25, 9.00 and 9.25 weeks, and it was not possible to determine the age in the last one. The incisive canal was observed in all specimens as an opening delimited laterally by the periosteum and connecting oral and nasal cavity. The nasopalatine duct is an epithelial structure with the greatest morphological variation, with either unilateral or bilateral occurrence and total patent, partial patent and islet forms. The vomeronasal organ is a bilateral epithelized structure located alongside the nasal septum above the incisive canal in all the fetuses. Conclusions The incisive canal, nasopalatine duct and vomeronasal organ are distinct anatomic structures. The development of nasopalatine duct cysts may occur in all forms of the nasopalatine duct. .

Evaluation of histological changes after tracheal occlusion at different gestational ages in a fetal rat model

OBJECTIVES: To evaluate the histological changes of tracheal cartilage and epithelium caused by tracheal occlusion at different gestational ages in a fetal rat model. METHODS: Rat fetuses were divided into two groups: a) External control, composed of non-operated rats, and b) Interventional group, composed of rats operated upon on gestational day 18.5 (term = 22 days), divided into triads: 1) Tracheal occlusion, 2) Internal control and 3) Sham (manipulated but not operated). Morphological data for body weight, total lung weight and total lung weight/body weight ratio were collected and measured on gestational days 19.5, 20.5 and 21.5. Tracheal samples were histologically processed, and epithelial, chondral and total tracheal thicknesses were measured on each gestational day. RESULTS: The tracheal occlusion group exhibited an increase in total lung weight/body weight ratio (p<0.001). Histologically, this group had a thicker epithelial thickness (p<0.05) and thinner chondral (p<0.05) and total tracheal thicknesses (p<0.001). These differences were more prominent on gestational days 20.5 and 21.5. CONCLUSION: Tracheal occlusion changed tracheal morphology, increased epithelial thickness and considerably decreased total tracheal thickness. These changes in the tracheal wall could explain the development of tracheomegaly, recently reported in some human fetuses subjected to tracheal occlusion.

Desenvolvimento do abomaso de bovinos no período pré-natal / Development of bovine abomasum in prenatal period

Para esta pesquisa, amostras de abomaso de fetos da raça Nelore (Bos taurus indicus) foram divididos em cinco grupos: 1º – fetos com 9 a 15 semanas (8 a 21cm) de gestação, 2º – fetos com 16 a 22 semanas (23 a 37 cm), 3º – fetos com 23 a 29 semanas (40 a 58 cm), 4º – fetos com 30 a 36 semanas (61 a 77 cm) e 5º – fetos com 37 a 43 semanas (79 a 88 cm). Os cortes histológicos foram corados com Hematoxilina e Eosina, picrossirius e Tricrômico de Mallory e examinados ao microscópio de luz. No feto de 11 cm, observaram-se pregas mucosas largas, vilosidades revestidas por epitélio simples cilíndrico, lâmina própria, tela submucosa, túnica muscular com estratos interno e externo e serosa. Aos 13,5 cm, as vilosidades eram evidentes com formação da lâmina muscular da mucosa. Aos 16,5 cm, houve aumento em número e tamanho das glândulas mucosas. No feto de 26 cm, observou-se aumento das túnicas e ramificações das glândulas. Aos 29 cm, observou-se aumento no tamanho das pregas. Com 37 cm, houve aumento do epitélio glandular, lâmina muscular da mucosa e túnica muscular. Com 42 cm, as glândulas eram profundas com células mucosas e lâmina pró- pria delgada. Concluiu-se que as os valores histomorfométricos da túnica muscular e parede total do abomaso foram crescentes para todos os grupos, com exceção dos grupos 4 e 5 para os quais houve queda dos valores, sem diferença significante e não houve crescimento contínuo para os demais constituintes da parede do abomaso.

For this purpose, samples of Nelore fetus abomasum (Bos taurus indicus) were classified into five groups: 1 – fetuses with 9 to 15 weeks (8 to 21 cm) of gestation, 2 – fetuses with 16 to 22 weeks (23 to 37 cm), 3 – fetuses at 23 to 29 weeks (40 to 58 cm) 4 – fetuses with 30 to 36 weeks (61 to 77 cm) and 5 – fetuses with 37 to 43 weeks (79 to 88 cm). Histologic sections were stained with Hematoxylin and eosin, picrosirius and Mallory’s trichrome methods and examined underlight microscopy. In fetus with 11 cm of length showed deep mucosa, wide folds and villi lined by single cylindrical epithelium, lamina propria, submucosa, muscular sublayers and serosa. Fetus with 13.5 cm, villi were evident and muscular layer of the mucosa was formed. At 16.5 cm, could be seen an increase in mucosa glands size and number. In fetus of 26 cm, showed gastric mucous glands at great number and ramifications. At 29 cm large folds, were observed.At 37 cm, showed glandular epithelium, muscular layer of the mucosa and muscular layer well development. Fetus with 42 cm, showed deep glands with corresponding mucous cells surrounding by thin lamina propria. It was concluded that the histomorphometric values of muscular layer and total abomasum wall were increased for all groups except for groups 4 and 5 which there was a decline of values, without presenting a significant difference and there was no continuous pattern of growth for other components of abomasum wall.

Síndrome de ovario poliquístico y embarazo / Polycystic ovary syndrome and pregnancy

Background: Polycystic ovary syndrome (PCOS) is a common endocrine metabolic dysfunction closely associated with insulin resistance and obesity, which predisposes to pregnancy complications and prenatal programming of the offspring. The aim of this review is to report our experience in PCOS patients who became pregnant and were followed during the whole pregnancy. Firstly, we analyzed the effect of pregnancy on PCOS pathophysiology and secondly the role of PCOS in pregnancy outcomes. Regarding the firstpoint, during normal pregnancy a progressive insulin resistance, serum lipid changes and an increase in androgen levels is observed, which is exacerbated in the PCOS condition. This adverse intrauterine environment could have a prenatal programming effect with detrimental consequences for female or male fetuses. Regarding the second point, PCOS is associated with an increased risk for maternal complications such as gestational diabetes (GDM) and pregnancy-induced hypertension. Moreover, these adverse pregnancy outcomes are more frequently associated with an increase in low birth weight and high birth weight newborns. According to our clinical experience, PCOS patients who became pregnant and were not treated with metformin during the whole pregnancy, showed a higher prevalence of gestational diabetes and SGA newborns, which was improved with metformin treatment. In summary, pregnancy may constitute a period in which an abnormal condition is established or aggravated in the fetus of a PCOS mother. Moreover, PCOS enhanced adverse obstetric and neonatal outcomes.

Morphometric analysis of lumbosacral canal in human foetuses / Análisis morfométrico del canal lumbosacro en fetos humanos

Lumbosacral part of the spinal canal requires special attention because this is the site commonly involved in spina bifida, tethered cord syndrome and some other pathologies like fatty tumours in the spine, cysts and syrinxes. The diagnosis as well as the treatment of neural tube defects mandates an accurate knowledge of morphometry of lumbosacral vertebral canal. There are various reports on radiological morphometric measurements in human foetuses by various authors but these possess inherent variability due to imaging techniques, patient positioning, observer's measuring techniques and normal and pathological variations. To overcome all these limitations, direct measurements by vernier calliper were preferred. 30 Formalin preserved human foetuses, of all age groups and both sexes, free of congenital craniovertebral anomalies, were obtained from the museum of Dept. of Anatomy, J. N. Medical College AMU Aligarh for the present study. Foetuses were divided into five groups (I-V) based on their gestational ages. Group I foetuses were of less than 17 weeks, II of 17-20 weeks, III of 21-25 weeks, IV of 26-30 weeks and V of more than 30 weeks. Each group contained 6 foetuses having both male and female, 3 each. Morphometric parameters taken into account were length of lumbar canal, maximum transverse diameters of lumbar vertebral canal at different vertebral levels, heights of the posterior surfaces of bodies of all lumbar vertebrae and length of sacral canal. Readings of adjacent groups were compared and results were analyzed by using Student's 't' test. Lumbar canal starts growing in length significantly in group III foetuses onward. There was consistency in the growth of lumbar canal diameters with gestational age at all levels. Heights of vertebral bodies of Ist two lumbar vertebrae showed variability in some adjacent groups. The same in the next three grew constantly with the growth of foetuses. Sacral canal showed variable growth in lengths in different grou...

La porción lumbosacra del canal espinal requiere una atención especial; es un sitio frecuentemente implicado en la espina bífida, el síndrome de médula anclada y algunas otras patologías como tumores de grasa en la columna vertebral, quistes y siringomelia. El diagnóstico y el tratamiento de los defectos del tubo neural requieren de un conocimiento preciso de la morfometría del canal vertebral lumbosacro. Existen diversos informes radiológicos sobre mediciones morfométricas en fetos humanos por parte de diversos investigadores, pero estos poseen una variabilidad inherente debido a las técnicas de imagen, posicionamiento del paciente, técnicas de medición del observador y, las variaciones normales y patológicas. Para superar todas estas limitaciones, para las mediciones directas se utilizó un caliper vernier. 30 fetos humanos conservados en formalina, de todas las edades y de ambos sexos, sin anomalías congénitas craneovertebrales, fueron obtenidos del museo del Departamento de Anatomía, J. N. Facultad de Medicina de la UMA, Aligarh. Los fetos fueron divididos en cinco grupos (I-V) sobre la base de su edad gestacional. El grupo I de fetos fueron los menores de 17 semanas, el II de 17-20 semanas, el III de 21-25 semanas, IV de 26 a 30 semanas, V de más de 30 semanas. Cada grupo contenía 6 fetos de ambos sexos (1:1/H:M)). Los parámetros morfométricos tomados en cuenta fueron la longitud del canal lumbar, el diámetro transversal máximo del canal vertebral lumbar en diferentes niveles, la altura de las superficies posteriores de los cuerpos de todas las vértebras lumbares y la longitud del canal sacro. Las mediciones de los grupos fueron comparadas y analizadas mediante el uso de la prueba de "t". El canal lumbar comenzó a aumentar en longitud significativamente desde el grupo de fetos III en adelante. No hubo consistencia en el crecimiento de los diámetros del canal lumbar con la edad gestacional en todos los niveles. Las alturas de los primeros dos cuerpos verte...

The position of the testis during the fetal period: an additional parameter to estimate fetal weight

PURPOSE: To establish a correlation between testicular position and fetal weight, in order to provide an additional prenatal parameter for fetal weight estimation. MATERIALS AND METHODS: We studied 288 testes from 144 human fetuses. The fetuses were assessed as regards weight, total length, crown-rump length and foot length. Fetal age was calculated according to the foot length criteria. The position of the testis was classified as abdominal, inguinal or scrotal. RESULTS: One hundred and ninety seven testes (68.4 percent) were abdominal, 43 (14.9 percent) were inguinal and 48 (16.6 percent) were scrotal. In the fetuses weighing up to 500 grams, 147 testes (93.5 percent) were abdominal and 5 testes (6.5 percent) were inguinal. In fetuses weighing between 501 and 1000 grams, 54 testes (68.6 percent) were abdominal, 28 testes (32.5 percent) were inguinal and 4 testes (4.6 percent) were scrotal. In fetuses weighing between 1001 and 1500 grams, 4 testes (13.3 percent) were abdominal, 3 (10 percent) were inguinal and 23 (76.6 percent) were scrotal. All fetuses weighing more than 1500 grams presented the testes with a migration to the scrotum (10 fetuses - 20 testes). CONCLUSIONS: To our knowledge, this is the first study correlating the testicular position to the fetal weight during testicular migration in human fetuses. Identification of the testes during the prenatal period could be a useful alternative parameter for estimating fetal weight.

Bilateral variations and sexual dimorphism in morphometric parameters of infraorbital groove, canal and foramen in human foetuses / Variaciones bilaterales y dimorfismo sexual en los parámetros morfométricos del surco, canal y foramen infraorbitario en fetos humanos

Foetal anatomy seems to be highly promising developing speciality in the recent past. Maxilla is the key to facial skeleton. Its anatomy in general and bilateral variations along with sexual dimorphism in particular are of great surgical and forensic importance. Thirty two maxillae of sixteen human foetuses (21 wks to 34 wks) were considered to measure lengths of infraorbital groove and canal, widths of ends of infraorbital groove, diameters of infraorbital foramen and the distances of latter from infraorbital margin and nasal notch. Groups I (21-25 wks) and II (26-30 wks) foetuses were crucial for bilateral variations for most of the parameters. Distance between infraorbital foramen and nasal notch showed variations on two sides in maximum foetal groups. Infraorbital canal was found to be larger in groups II and III foetuses in females. Width of the posterior end of infraorbital groove was less in group I, equal in group II and more in group III in males. Sexual dimorphism was noticed in all the groups for the distance of infraorbital foramen from infraorbital margin. Distance of infraorbital foramen from nasal notch did not show sexual dimorphism in most of the groups except group I where value was more in males. Rule of generalized phenomenon of larger skeleton in male was not applicable in most of the groups.

La anatomía fetal, con su desarrollo en los últimos años, parece ser especialidad muy prometedora. El maxilar es la clave del esqueleto facial. Su anatomía en general y las variaciones bilaterales junto al dimorfismo sexual en particular, son de gran importancia quirúrgica y forense. Fueron estudiados 32 maxilares de 16 fetos humanos (21 semanas a 34 semanas) en los cuales se midió la longitud del surco y canal infraorbitario, anchos de los extremos de surco infraorbitario, diámetros del foramen infraorbitario y las distancias de este último desde el margen infraorbitario hasta la escotadura nasal. Las variaciones bilaterales en la mayoría de los parámetros fue en los grupos de fetos I (21-25 semanas) y II (26-30 semanas). La distancia entre el foramen infraorbitario y escotadura nasal mostró variaciones máximas en dos partes en los grupos de fetos. El canal Infraorbitario resultó ser más largo en los grupos II y III de fetos femeninos. El ancho del extremo posterior del surco infraorbitario fue menor en el grupo de fetos masculino I, igual en el grupo II y mayor en el grupo III. El dimorfismo sexual se observó en todos los grupos en la distancia desde el foramen infraorbitario hasta el margen infraorbitario. La distancia desde el foramen infraorbitario hasta la escotadura nasal no mostró dimorfismo sexual en la mayoría de los grupos a excepción del grupo I, donde el valor fue mayor en los hombres. La norma generalizada que el esqueleto más grande es del género masculino no fue aplicable en la mayoría de los grupos.

Sexo fetal: identificação ultra-sonográfica precoce / Fetal sex: early ultrasonographic identification

Objetivo: Verificar a incidência de acerto na identificação ultra-sonográfica precoce do sexo fetal. Método: Foram estudados prospectivamente 1.931 fetos, por meio de exames ultra-sonográficos transvaginais e complementados por exames transabdominais, em gestações entre nove e 12 semanas, na Clínica Obstétrica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro (UFRJ) e na Clínica de Ultra-Sonografia Fórum. O falo (tubérculo genital) foi determinado como horizontal no sexo feminino e vertical no sexo masculino, através da imagem em plano sagital ao corpo fetal, e correlacionado ao sexo quando do exame morfológico realizado aós a 18ª semana de gestação. Resultados: O sexo fetal determinado pela avaliação ultra-sonográfica precoce coincidiu com o sexo avaliado em 81,7 por cento dos casos em gestações com nove semanas, em 95,5 por cento nas gestações com 10 semanas, em 92,9 por cento naquelas com 11 semanas e em 99,8 por cento nas gestações com 12 semanas. O sucesso da identificação aumenta com o progredir da gestação, obtendo-se a média global de 94,2 por cento de acerto no período estudado. O acerto no diagnóstico do sexo fetal aumenta com a experiência do operador. Conclusão: A determinação ultra-sonográfica do posicionamento do falo genital pode predizer o sexo fetal precocemente.

Purpose: To establish the percentage of correct early diagnosis of fetal gender. Methods: A prospective study was developed in a University Federal of Rio de Janeiro, Departament of Obstetrics an Gynecology and Clinic of Ultrasonographic Forum. 1,931 women underwent transvaginal and transabdominal sonography at 9-12 weeks gestation. Fetal gender was identified according to genital falo position (vertical-men or horizontal-female) at sagittal plane and confirmed after 18 weeks pregnancy, morphologic, karyotyping analysis or after birth. Results: The overall accuracy of correctly assigning fetal gender was 94,2 per cent. The sucess of identification increased with gestational age, being 81,7 per cent, 95,5 per cent, 92,9 per cent and 99,8 per cent at nine, 10, 11 and 12 weeks, respectively. The accuracy of correctly identifying fetal sex significantly changed with operator training. Conclusion: Early ultrasound can accurately determine fetal gender.

Molecular genetics of fetal organogenesis in the Quran: Tracking a modern concept in an original religious text

Over the recent decades, science especially in the fields of medicine and molecular genetics has been developed with incredible extension and provide us the huge bulk of new concepts in biological phenomena and all these findings result in discovering the mysteries of life more deeply. A distinct and valuable aspect of these investigations would be tracking of these newly discovered themes in original religious records. The Qur'an as an original religious text had pointed so many times to the creation of human beings and its complex process by specification. These considerations and discussions have many things in common with newly found scientific facts. This paper is a brief study between these two apparently different discussions which shows the high similarities between the facts about organogenesis stages in scientific texts with its counterpart descriptions in the Quran

Efeitos de diferentes sistemas de cultivo in vitro sobre o crescimento de folículos pré-antrais isolados de ovários de fetos bovinos / Effects of different systems of in vitro culture on the isolated preantral follicles from fetal bovine ovaries

O objetivo deste estudo foi aplicar diferentes sistemas de cultivo in vitro para folículos pré-antrais de fetos bovinos da raça Nelore no último trimestre de gestação e para identificar o sistema mais eficiente durante o crescimento dos folículos isolados. Para isso, folículos pré antrais foram isolados mecanicamente e submetidos ao cultivo individual, por 9 dias, em meio não suplementado ou suplementado com soro fetal bovino (SFB), albumina sérica bovina (BSA) ou suplemento definido sintético substituto do soro KnockoutSR(KNO). Avaliou-se ainda, o efeito do gel de colágeno ou monocamada de fibroblastos fetais bovinos como substrato para o cultivo in vitro. A avaliação do aumento de diâmetro folicular foi realizada no dia da colheita (0 hora) e a cada 72 horas de cultivo. A associação entre meio suplementado com SFB e uso de gel de colágeno como substrato foram significativamente mais efetivos sobre o aumento do diâmetro folicular quando comparados aos demais tratamentos. Quando fragmentos de tecido ovariano foram submetidos ao cultivo in vitro, não houve preservação da ultraestrutura folicular por mais de 3 dias de cultivo, em qualquer dos tratamentos utilizados. Ainda não está estabelecido um sistema de cultivo adequado que sustente a diferenciação e multiplicação das células da granulosa e que mantenha o contato das mesmas com o oócito para prover moléculas e fatores que supram a demanda metabólica. Entendemos que esta pesquisa apresentou avanços promissores na busca pelo estabelecimento um sistema de cultivo in vitro de folículos pré-antrais em bovinos.

The objective of this study is to use different in vitro culture systems of preantral follicles from Nelore breed bovine fetuses in the last gestation quarter. The evaluation of treatments considered the time of growth of isolated follicles. Preantral follicles were mechanically isolated and submitted to the individual culture, for 9 days, in mediano supplemented or supplemented with fetal calf serum (FCS), bovine serum albumin (BSA) or synthetic defined supplement substitute of serum KnockoutSR (KNO). We have also evaluated the effects of collagen gel or fetal calf fibroblast monolayer as substratum for in vitro cultures. The increase on the follicular diameter was followed in the first day (0 h), at the 72 h, 144 h and 216 h. Considering cultures of isolated follicles, the results have shown that the association between media supplemented with FCS and collagengel was significantly more efficient on the increase of the follicular diameter than other treatments. It is not still established a system ofappropriate cultivation that sustains the differentiation and multiplication of the granular cells and that maintains the contact of the same ones with the oocyte to provide molecules and factors that supply the metabolic demand. We also under stand that our results also represent another promising step on the search for the ultimate system of in vitro culture of preantral follicles from bovines.

Morphometric Analysis of Developing Maxillary Sinuses in Human Foetuses / Análisis Morfométrico del Desarrollo de los Senos Maxilares en Fetos Humanos

El desarrollo de los senos paranasales en humanos y en muchos mamíferos ha permanecido como un enigma hace ya varios milenios. Análisis morfométricos de los senos maxilares en fetos humanos no han sido suficientemente documentados y en la India son inexistentes. El presente estudio fue llevado a cabo para determinar los diferentes diámetros, el padrón de crecimiento, el dimorfismo sexual y las variaciones bilaterales en los senos maxilares de 37 fetos humanos de diferentes edades (16-34 semanas de vida intrauterina), los cuales fueron divididos en 5 grupos etarios. Los senos maxilares fueron disecados por la parte nasal del maxilar y los diversos diámetros fueron medidos con la ayuda de un caliper. El crecimiento porcentual del diámetro AP fue +48 por ciento en los fetos de 17-20 semanas (p <0.001), el diámetro vertical fue de +60 por ciento (p <0.001).Los diámetros AP de ambos lados de un feto tuvieron una variación significativa (p <0.005) en menores de 17 semanas. Los diámetros AP fueron invariablemente mayores en fetos masculinos, pero una variación significativa (p <0.001) fue encontrada solamente en individuos de 26 a 36 semanas, mientras que una variación significativa (p <0.02) fue observada en los diámetros transversos en fetos masculinos de 21-25 semanas. Las dimensiones anteroposteriores mostraron un crecimiento más rápido, mientras que otros diámetros fueron en concordancia con la circcunferencia craneal. Se puede concluir que: 1) Diámetros diferentes del seno maxilar tienen una aceleración de crecimiento en diferentes periodos de la vida intrauterina. 2) Valores de los diámetros AP permanecen más altos, desde el inicio al término de la vida intrauterina. 3) Los senos maxilares permanecen relativamente más amplios en fetos masculinos a través de su vida.

The development of the paranasal sinuses, in human race and in many mammals remained as much an enigma as it did nearly two millennia ago. Morphometric analysis of maxillary sinuses in human foetuses are not fully documented and also their morphological studies in Indian population are non-existent. So the present study was conducted to determine the different diameters, the pattern of growth, sexual dimorphism and bilateral variations in maxillary sinuses. 37 human foetuses of different age groups (16 - 34 wks of IUL) were divided into five groups on the basis of age. Maxillary sinuses were dissected out from the nasal aspects of maxillae and their various diameters were measured with the help of Vernier callipers. The percent growth of AP diameter was +48% in 17-20 wks (p <0.001), of vertical diameter was +60% in 17-20 wks (p <0.001) and of transverse diameter was + 47% in 17-20 wks (p <0.001). Out of 3,anteroposterior diameters were maximum throughout foetal life. AP diameters of both sides of a foetus had significant variation (p <0.005) in <17 wks. AP diameters were invariably more in males but significant variation (p <0.001) was found only in 26-36 wks while significant variation (p <0.02) was observed in transverse diameters in males of 21-25 wks. Anteroposterior dimensions showed faster growth while other diameters were in pace with the head circumference. It was concluded that: 1) Different diameters of maxillary sinus have spurt of growth in different periods of IUL. 2) Values of anteroposterior diameter remain higher, right from the beginning to the end of intra-uterine life. 3) Maxillary sinuses remain relatively larger in males throughout life.

Comportamento do fluxo pelo forame oval em fetos de mães diabéticas com hipertrofia miocárdica / Bahavior of the foramen ovale flow in fetuses of diabetic mothers and myocardial hypertrophy

Introdução: O forame oval (FO) tem extrema importância na circulação fetal, pois conduz o sangue oxigenado proveniente da placenta diretamente ao átrio esquerdo. Frequentemente fetos de mães diabéticas(FMD) apresentam hipertrofia miocárdica(HM), com alterações na função diastólica ventricular esquerda, podendo acarretar modificações do fluxo pelo FO, com reflexo no índice de pulsatilidade. Objetivo: Testar a hipótese de que o fluxo pelo FO apresenta índice de pulsatilidade maior em FMD com HM do que em fetos sem HM de mães com ou sem diabetes. Métodos: Trata-se de um estudo transversal controlado comparando FMD com HM com FMD sem hipertrofia e fetos controles normais. Pacientes: 16 FMD com HM(grupo I), 36 FMD sem HM(grupo II) e 39 fetos controles normais(grupo III), A ecocardiografia fetal com Doppler foi realizada para obter o índice de pulsatilidade do forame oval(IPFO), através da razão velocidade sistólica-velocidade pré-sistólica/velocidade média. Foram utilizados ANOVA e teste das diferenças mínimas significativas, com alfa crítico de 0,05. Resultados: O IPFO médio foi de 4,07 mais ou menos 1,33 no grupo I, 2,28 mais ou menos 0,58 no grupo II e 2,78 mais ou menos 0,55 no grupo III. Houve diferença estatisticamente significante entre os grupos (p menor 0,001); os valores de IPFO do grupo I foram significativamente maiores dos que o do grupo II e III (p menor 0,001). Os valores do IPFO do grupo II não foram significativamente diferentes em relação ao grupo III (p igual 0,604). Conclusão: Fetos de mães diabéticas com hipertrofia miocárdica têm o índice de pulsatilidade do fluxo do forame oval maior do que os fetos sem hipertrofia miocárdica e fetos controles normais. Sugere-se que sua diferença ocorra por uma complacência diminuída do ventriculo esquerdo secundária à hipertrofia do septo interventricular.

Contribuição da ultra-sonografia para o diagnóstico precoce do sexo fetal entre 11 e 14 semanas de gestação por meio do estudo do tubérculo genital / Ultrasonography contribution for early diagnosis of fetal sex between 11 and 14 weeks of gestation through the study of genital tubercule

Visa avaliar a contribuição da ultra-sonografia para o diagnóstico precoce do sexo fetal entre !! e 14 semanas de gestação por meio do estudo do tubérculo genital, comparando-se os resultados obtidos neste período, semana a semana e como um único período. Submeter os resultados obtidos à análise estatística com objetivo de procurar estabelecer o melhor valor de corte para os ângulos estudados. Estudo propectivo de 153 pacientes submetidas à ultra-sonografia obstetríca entre 11 e 14 semanas de gestação, sendo avaliados os ângulos do tubérculo genital em relação à superfície da pele da região lombo-sacral no plano médio sagital, e em relação à reta que se forma unindo-se 2 pontos na pele fetal, junto à base do tubérculo genital, que eq6uidista 1 mm de cada lado da base do tubérculo genital no plano mádio sagital da pele.It aims to analyse the contribution of ultrasonography to the early diagnosis of fetal sex between 11 and 14 weeks of gestation through the study of genital tubercule, comparing the obtained results to statistic analysis with the aim of stablish the best cutting value for the studied angles. Prospective study of 153 patients submitted to obstetric ultrasonography between 11 and 14 weeks of gestation. The angles of genital tubercule are evaluated in relation to the skin surface of the lombosacral area on mid-sagittal plane and in relation to the skin surface of the lombosacral area on mid-sagittal plane and in relation to the straight which is formed by unifying 2 points on fetal skin, together with the base of genital tubercule, equidistant 1mm of each side of genital tubercule base on skin mid-sagittal plane...

Diferenciación sexual embrio-fetal: de las móleculas a la anatomía / Fetal sex differentiation: from molecules to anatomy

El sexo del embrión queda determinado en el momento de la fecundación según que el espermatozoide contenga un cromosoma X o un cromosoma Y. Sin embargo, trascurren varias semanas durante la embriogénesis humana sin que existan diferencias evidentes-aún al microscopio- entre un feto de sexo femenino y uno de sexo masculino. A partir de la expresión del gen SRY en los fetos XY, las futuras gónadas inician una serie de eventos caracterizados por expresión de proteínas, que determinan cambios citológicos, histológicos y funcionales característicos de los testículos. Este evento relativamente temprano en el desarrollo del sexo se denomina determinación sexual, dada su importancia determinante en el resto de los eventos que se suceden luego. Los testículos secretan dos hormonas, hormona ani-Mülleriana y testorona, cuya acción provoca la masculinización de los esbozos de los órganos genitales internos y externos, que no mostraban hasta entonces diferencias entre los sexos. El proceso de diferenciación de los genitales se denominan diferenciación sexual fetal. Poco se conoce hasta hoy sobre los mecanismo que inducen a las gónadas a tomar caminos ováricos en el feto XX. Es sabido desde hace tiempo, en cambio, que la falta de las hormonas testiculares resulta en la feminización de los genitales internos y externos, independientemente de la existencia o ausencia de ovarios. El conocimiento de los mecanismos moleculares, celulares y endocrinos involucrados en el desarrollo sexual fetal permiten comprender mejor la patología resultante de sus respectivas alteraciones que generan cuadros clínicos conocidos como ambigüedades sexuales