[Prenatal growth curves of the Czech population]. / Prenatální rustové krivky ceské populace.

OBJECTIVE: Determination of ultrasound biometric parameters of fetuses in the Czech population during pregnancy. METHODS: We retrospectively analyzed a data set of 20,566 pregnant women from the years 2008 to 2012 who met the following inclusion criteria: Caucasian ethnicity; measured biometric parameters biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL); body mass index (BMI) of the pregnant women < 35 kg/m2.We excluded pregnant women with multiple fibroids distorting the uterine cavity; pathologically developing fetuses; and pregnancies where we were not able to verify the correct dating. We did not carry out selection as to the method of getting pregnant. The pregnancy age was from 19+0 to 42+6 gestation weeks. As in all studies, the age of pregnancy refers to the completed gestation weeks (for instance 23+0 to 23+6 = 23rd gestation week). We then compared our newly derived growth curves with the curves currently used, for BPD, HC, AC, FL and EFW, in the 3rd or 5th percentile, 50th percentile and 95th or 97th percentile (according to data obtained from reference studies). RESULTS: The study included 40,806 observations. The number of observations exceeded 500 in all weeks except in the 42nd week. The median age of the pregnant patients was 31.9 years (min 14.9, max 52.54). In the studied group we found a lower degree of variability in all parameters. The biometric parameters had higher values for the gestation week than the reference parameters. The estimated weight of the fetuses in our group on the level of the 3rd percentile was significantly higher than the reference value. DISCUSSION: The study was based exclusively on sonographic measurements. Although we excluded from our group intrauterine pathologies that could affect the physiological growth of the fetus, we did not carry out an additional selection using information on the pathologies of fetuses obtained postnatally. However, as the study contains more than 40,000 measurements, we can assume that such additional selection would have had only a minimum effect on the resulting curve. A section of the fetuses that would have been considered eutrophic according to present reference studies could be considered hypotrophic or small for gestational age (SGA) according to our observations. CONCLUSION: We have obtained new prenatal ultrasound growth curves for the Czech population of healthy developing fetuses. In early gestation weeks, we have found statistically significant deviations from the reference studies. Fetuses in our study have significantly higher weight estimate and show a lower degree of variability compared to the reference studies. KEYWORDS: prenatal, ultrasound diagnosis, fetal biometry, percentile curves, biparietal diameter, head circumference, abdominal circumference, femur length, estimated fetal weight, Czech population.

Balloon dilatation of pediatric subglottic laryngeal stenosis during the artificial apneic pause: experience in 5 children.

INTRODUCTION: Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. PATIENTS AND METHODS: The authors performed balloon dilatation of subglottic laryngeal strictures (SGS) in 5 children (3 girls and 2 boys) without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. RESULTS: The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%). Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. CONCLUSION: Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.

The effects of flubendazole and mebendazole on cytochromes P4501A in pheasant hepatocytes.

Many benzimidazoles are known inducers of cytochromes P4501A (CYP1A) in laboratory animals and cell lines. As flubendazole and mebendazole are benzimidazole anthelmintics often used in a pheasant, in the present study an effect of these drugs in primary cultures of pheasant (Phasianus colchicus) hepatocytes was investigated. After 48 h incubation of the hepatocytes with the benzimidazoles (0.2-5 microM), CYP1A activities -- ethoxyresorufin O-deethylation (EROD) and methoxyresorufin O-demethylation (MROD) activities were measured and the CYP1A protein levels were determined by Western blotting. None of the tested benzimidazoles influenced the CYP1A protein content. No pharmacologically significant enhancement of CYP1A after exposure of the hepatocytes to flubendazole and mebendazole was found. Inhibition of the EROD/MROD activities caused by both tested substances was observed only at the highest concentration (5 microM). From a point of view of CYP1A induction or inhibition, the treatment of pheasants by both anthelmintics tested seems to be safe. Our study demonstrates the inter-species differences in CYP1A inducibility and the importance of induction/inhibition studies on target animals.