Interferons (IFNs) exert their anti-viral effects by inducing the expression of hundreds of IFN-stimulated genes (ISGs). The activity of known ISGs is insufficient to account for the antiretroviral effects of IFN, suggesting that ISGs with antiretroviral activity are yet to be described. We constructed an arrayed library of ISGs from rhesus macaques and tested the ability of hundreds of individual macaque and human ISGs to inhibit early and late replication steps for 11 members of the retroviridae from various host species. These screens uncovered numerous ISGs with antiretroviral activity at both the early and late stages of virus replication. Detailed analyses of two antiretroviral ISGs indicate that indoleamine 2,3-dioxygenase 1 (IDO1) can inhibit retroviral replication by metabolite depletion while tripartite motif-56 (TRIM56) accentuates ISG induction by IFNα and inhibits the expression of late HIV-1 genes. Overall, these studies reveal numerous host proteins that mediate the antiretroviral activity of IFNs.

We present a case of a fetus at 12 weeks of gestation with an abnormal intracranial translucency (IT). The intracranial translucency (IT) between the brain stem and the choroid plexus represents the fourth cerebral ventricle. In fetuses with spina bifida the fourth ventricle should not be visible at the 11–13 weeks scan. There are only few data about other abnormalities of the fourth ventricle at this gestational age. As a part of screening for Down syndrome, a mid-sagittal view of the face was obtained and the nuchal translucency and the intracranial translucency were measured prospectively in 164 fetuses at 11 to 13 weeks of gestation. The range of the anteroposterior diameter of the fourth ventricle was between 1.8 and 3.2 mm. One fetus was detected with an abnormal intracranial translucency, showing an enlarged fourth ventricle. The anteroposterior diameter was 4.7 mm. Re-examination of the fetus after 2 weeks revealed a normal intracranial translucency (ap-diameter 3.4 mm). A repeat sonographic examination at 29 weeks showed again normal intracranial structures. This enlarged fourth ventricle may be caused by a failure of regression of Blake's pouch (the rudimentary fourth ventricular tela choroidea) secondary to nonperforation of the Foramen Magendie.

Chorangiome sind benigne Gefäßtumore, die der Gruppe der Hamartome angehören und in etwa 1% aller Plazenten gefunden werden. Sie werden durch den fetalen Kreislauf versorgt und belasten das Kind mit zunehmender Tumorgröße cardial, und/oder durch Kompression der Plazenta. Unter der Geburt kann es für den Feten zu einer lebensbedrohlichen Blutung aus dem Gefäßstiel des Tumors kommen.

Intrauterine thrombosis of umbilical cord vessels is a rare event (2.5-4.5/10,000) and usually followed by poor fetal outcome. We present the rare case of spontaneous intrauterine thrombosis of an umbilical artery leading to severe intrauterine growth restriction (IUGR) and provide clinical and pathological findings. A 28-year-old nulliparous third gravida was referred to our institution because of IUGR at 32+4 weeks of gestation. Fetal growth had been appropriate until the 31st week of gestation and had stopped thereafter. There were no signs of abruption of the placenta and no structural abnormalities except an absent paravesical colour Doppler flow in the region of the right umbilical artery. Other Doppler measurements, karyotype and TORCH serology were normal. Intermittent non-reassuring fetal heart rate led to cesarean section at 34+3 weeks of gestation. A healthy girl with measurements on the 3rd centile was born (weight of 1,590 g, length of 41 cm and head circumference of 29 cm). Gross examination displayed an elongated, highly twisted umbilical cord with a length of 70 cm, central insertion and three umbilical vessels. Microscopic examination confirmed the diagnosis of umbilical artery thrombosis along the entire length of the umbilical cord. Calcification within the thrombus and microcalcification in occluded chorionic vessels were observed as well as hemorrhagic endovasculitis and endangiopathia obliterans in the stem villi arteries. This fetal thrombotic vasculopathy (FTV) comprised about 40% of the parenchyma. The coagulation parameters and blood counts of the mother and the infant were normal apart from transient neonatal thrombocytopenia. The reason for thrombosis remained unclear but could be attributed to the elongated and highly twisted umbilical cord. Intrauterine arterial thrombosis may cause severe IUGR. This condition might be detectable by ultrasound in the course of an IUGR workup, especially when no other reasons can be found.

Fragestellung: Bei der isolierten, congenitalen Diaphragmahernie (CDH) hängt die Prognose für das betroffene Kind vom Restlungengewebe ab. Daraus ergeben sich pränatal dann verschiedene Handlungsoptionen: Schwangerschaftsabbruch, endoskopische Trachealocclusion oder sonographische Kontrollen. Wir diskutieren die aktuellen Berechnungsmethoden anhand eines Kindes mit rechtsseitiger CDH.

Intrauterine thrombosis of umbilical cord vessels is a rare event (2.5–4.5/10.000) and usually followed by poor fetal outcome. We present the rare case of spontaneous intrauterine thrombosis of an umbilical artery leading to severe intrauterine growth restriction and provide clinical and pathological findings. A 28-year-old, G3 P0 was referred to our institution because of intrauterine growth restriction at 32 + 4 weeks of gestation. Ultrasound examination indicated fetal growth symmetrically below the third centile with an estimated weight of 1.329 g. According to earlier examinations, growth had been appropriate until the 31st week of gestation and had stopped thereafter. There were no signs of abruption of the placenta and no structural abnormalities except an absent paravesical colour Doppler flow in the region of the right umbilical artery, which led primarily to the diagnosis of left-sided single umbilical artery. Other Doppler measurements, karyotype and TORCH serology were normal and expectant management was chosen. Intermittent non reassuring fetal heart rate led to Cesarean section at 34 + 3 weeks of gestation. A healthy girl with measurements on the 3rd centile was born (birth weight of 1.590 g, length of 41 cm and head circumference of 29 cm). Gross examination displayed an elongated, highly twisted umbilical cord with a length of 70 cm, central insertion and three umbilical vessels. There was thrombotic occlusion of one (right) umbilical artery along the entire length of the umbilical cord. Calcification was found intermittently within the thrombus and there was hemorrhagic endovasculitis and endangiopathia obliterans with complete occlusion of placental vessels and fibrosis of about 40% of the villous stroma. The case will be presented including sonographic and histopathological features and a review of the literature.

Expression of indoleamine 2,3-dioxygenase (IDO) in epithelium of the endometrium and the cervix is not restricted to normal but also present in carcinomatous tissue. The enzyme was found in the majority of cases studied, pioneer cells at the invasion front of the tumors being especially strongly reactive in immunohistology. In addition, also cells in the peritumoral infiltrate of the stroma expressed IDO. Taken together, these findings together with previous data on the immunosuppressive impact of tryptophan depletion suggest IDO-induced suppression of antitumoral immune response in both adenocarcinoma and squamous cell carcinoma of endometrium and cervix. On the other hand, IDO as also known to inhibit tumor cell proliferation by tryptophan depletion.

Unter den pränatalen Infektionskrankheiten nimmt die Toxoplasmose durch die Möglichkeit der medikamentösen Behandlung eine Sonderstellung ein. Voraussetzung für den Erfolg der Behandlung, durch die der Fet vor einer Infektion geschützt werden soll, ist die rechtzeitige Diagnose der Frischinfektion durch ein serologisches Screening. Daß trotz regelrecht durchgeführtem Screening jedoch eine Infektion möglich ist, zeigt der Fall einer 22jährigen II-Gravida, bei der durch eine serologische Kontrolluntersuchung am Ende des IL Trimenons eine Frischinfektion aufgrund einer Serokonversion diagnostiziert wurde. Bei der Ultraschalluntersuchung konnten bereits ein ausgeprägter Hydrocephalus sowie Hepatomegalie und ein Ascites festgestellt werden. Die Geburt wurde in der 33. Schwangerschaftswoche eingeleitet. Postpartal erhobene Befunde, einschließlich Plazenta- und Eihauthistologie bestätigten die Diagnose einer konnatalen Toxoplasmose. Die Problematik, die bei Erhebung eines negativen serologischen Erstbefundes besteht, wird besprochen.