The purpose of this study was to delineate the etiology and the clinical features of liveborn neonates with hydrops fetalis, and to explore the prognostic factors for survival. Medical records of 28 liveborn neonates with hydrops fetalis between April 1995 and March 2005 were reviewed retrospectively. Demographic data, clinical manifestations, laboratory findings, and outcomes were analyzed. Most patients presented with pleural effusions (21 of 28) and ascites (22 of 28). The majority of patients had hydrops due to cardiovascular diseases (seven of 28), hematologic disorders (six of 28), lymphatic malformations (six of 28), and idiopathic origins (six of 28). The overall survival rate was 50% and was highest (83%) in infants with lymphatic malformations. By univariate analysis, risk factors for mortality are earlier ages at diagnosis and at birth, low Apgar scores, need for resuscitation in the delivery room, low serum albumin level, and severe acidemia. After using stepwise multiple logistic regression analysis, the most significant factors associated with fatality were younger gestational age at birth and lower serum albumin level. Hydrops fetalis remains a complex condition with a high mortality rate. Hydrops resulting from lymphatic malformations has a favorable outcome. Preterm birth at less than 34 weeks and serum albumin concentration lower than 2 g/dL are two poor prognostic factors for survival.

Objective. We used high-resolution peripheral vascular ultrasound imaging to assess endothelial function in hyperuricaemic patients. Methods. Hyperuricaemia was defined as a serum uric acid concentration of >7.7 mg/dl in men or >6.6 mg/dl in women. Measurements of endothelium-dependent flow-mediated vasodilation (FMD) and endothelium-independent nitroglycerin-mediated vasodilation were performed in 46 hyperuricaemic patients and an equal number of healthy age- and gender-matched normal controls by high-resolution two-dimensional ultrasonographic imaging of the brachial artery. The serum levels of glucose, creatinine, alanine aminotransferase (ALT), lipid profiles and high-sensitivity CRP were measured for both the study groups. Results. The serum uric acid levels averaged 9.24 (1.16) and 6.18 (0.99) mg/dl in the hyperuricaemic and control groups, respectively. Body weight and BMI were significantly higher in the hyperuricaemic group than in the control group. The serum levels of creatinine, ALT, triglyceride and high-sensitivity CRP were significantly different between the two groups. The FMD values were significantly lower in the hyperuricaemic patients than in the controls [4.45% (3.13%) vs 7.10% (2.48%); P < 0.001]. The FMD values were negatively associated with serum uric acid levels (r = −0.273; P = 0.009). Multivariate regression analysis showed that the presence of hyperuricaemia (β = −0.384; P < 0.001) and body weight (β = 0.215; P = 0.017) were independent determinants of low FMD values. Conclusion. Hyperuricaemia is associated with endothelial dysfunction. Decreased nitric oxide bioavailability may be the main reason.

This study was performed to identify factors that can affect the final outcome and to recognize the proper management for patients with traumatic optic neuropathy (TON). This retrospective study included 42 consecutive patients with TON after maxillofacial trauma. Megadose methylprednisolone was administered to all patients during the first 3 days after diagnosis. Twenty-four patients received treatment with megadose steroids combined with optic nerve decompression and the remaining 18 with megadose methylprednisolone alone. Initial visual acuity (IVA) was the statistically significant factor affecting the outcome of TON (P = 0.006 for improvement rate). Patients treated within 7 days after injury had a better improvement degree, P = 0.056. Patients in a surgical group with an IVA of no light perception (NLP) had a better improvement rate and degree (31.3%; 59.34 ± 22.18%) than those in nonsurgical group (0%, 0%; P = 0.272). Initial visual acuity is the critical factor that affects the outcome of TON. Surgical optic nerve decompression is considerable in maxillofacial trauma patients with an IVA of NLP.