A randomised, partially observer blind, multicentre, head-to-head comparison of a two-dose regimen of Baxter and GlaxoSmithKline H1N1 pandemic vaccines, administered 21 days apart

OBJECTIVES

To evaluate the immunogenicity of a two-dose schedule of Baxter cell-cultured, non-adjuvanted, whole-virion H1N1 vaccine, and GlaxoSmithKline AS03(A)-adjuvanted split-virion H1N1 vaccine with respect to the EU Committee for Medicinal Products for Human Use (CHMP) and the US Food and Drug Administration (FDA) licensing criteria.

DESIGN

An age-stratified, randomised, observer-blind, parallel-group, multicentre controlled trial was carried out in volunteers aged ≥ 18-44, ≥ 45-64 and ≥ 65 years.

SETTING

Three teaching hospitals in the UK (Leicester Royal Infirmary, Leicester; Nottingham City Hospital, Nottingham; and Royal Hallamshire Hospital, Sheffield).

PARTICIPANTS

Three hundred and forty-seven subjects were identified and randomised to AS03(A)-adjuvanted split-virion H1N1 vaccine or whole-virion (WV) vaccine in age groups [≥ 18-44 years (n = 140), ≥ 45-64 years (n = 136) and ≥ 65 years (n = 71)].

INTERVENTIONS

Vaccine was administered by intramuscular injection into the deltoid muscle of the non-dominant arm. One hundred and seventy-five randomised subjects were allocated AS03(A)-adjuvanted split H1N1 vaccine; one hundred and sixty-nine subjects had a second dose of the same vaccine 21 days later. One hundred and seventy-two subjects were allocated WV vaccine; one hundred and seventy-one subjects had a second dose of the same vaccine 21 days later. Serum samples for antibody measurements were collected on days 0 (before the first vaccination), 7, 14, 21 (before the second vaccination), 28, 35, 42 and 180. Subjects were observed for local and systemic reactions for 30 minutes after each injection, and for the next 7 days they recorded, in self-completed diaries, the severity of solicited local (pain, bruising, erythema and swelling) and systemic symptoms (chills, malaise, muscle aches, nausea and headache), oral temperature and use of analgesic medications.

MAIN OUTCOME MEASURES

Vaccine immunogenicity using the CHMP and the FDA licensing criteria. Antibody titres were measured using haemagglutination inhibition (HI) and microneutralisation (MN) assays at baseline and 7, 14 and 21 days after each vaccination and at day 180. The three immunogenicity criteria end points were the seroprotection rate, the seroconversion rate and the mean-fold titre elevation.

RESULTS

Both vaccine doses were given in 340 subjects (98%). Data from 680 (99%) of 687 issued diary cards were returned. Sera were obtained from 340 (98.0%), 333 (96.0%), 341 (98.3%), 331 (95.4%), 329 (94.8%) and 332 (95.7%) subjects on days 7, 14, 21, 28, 35 and 42, respectively. Three hundred and forty-six and 345 subjects were included in the safety and immunogenicity analyses, respectively. Prevaccination antibody was detected by HI (titre ≥ 1 : 8) and MN (titre ≥ 1 : 10) in 14% and 31% of subjects, respectively. Among the 298 (85.9%) subjects without baseline antibody on HI assay, a titre of ≥ 1 : 40 (seroprotection) was achieved after a single dose of AS03(A)-adjuvanted vaccine and WV vaccine by day 21 in 93.0% and 65.5%, respectively, of subjects between 18 and 44 years, 76.4% and 36.1% of subjects between 45 and 64 years, and 53.1% and 30.0% of subjects ≥ 65 years. Among all 347 subjects, a titre of ≥ 1 : 40 was achieved after a single dose of AS03(A)-adjuvanted vaccine and WV vaccine by day 21 in 94.0% and 71.4%, respectively, of subjects between 18 and 44 years, 77.3% and 38.8% of subjects between 45 and 64 years, and 51.4% and 32.4% of subjects ≥ 65 years. The age-adjusted odds ratio (OR) for adjuvanted compared with WV vaccine, in terms of seroprotection, was 4.42 [95% confidence interval (CI) 2.63 to 7.44, p < 0.001]. On day 42, among subjects without baseline antibody on HI assay, a titre of ≥ 1 : 40 was achieved after the second dose of AS03(A)-adjuvanted vaccine and WV vaccine by 100% and 67.9%, respectively, of subjects between 18 and 44 years, 89.3% and 41% of subjects between 45 and 64 years, and 76.5% and 34.5% of subjects ≥ 65 years. Among all 347 subjects, a titre of ≥ 1 : 40 was achieved on day 42 after the second dose of AS03(A)-adjuvanted vaccine and WV vaccine in 100% and 73.1%, respectively, of subjects between 18 and 44 years, 90.8% and 43.9% of subjects between 45 and 64 years, and 75.7% and 36.4% of subjects ≥ 65 years. The age-adjusted OR for adjuvanted vaccine compared with WV vaccine, in terms of seroprotection, was 11.21 (95% CI 5.80 to 21.64, p < 0.001). Age-related decline in antibody response occurred after both doses of both vaccines. WV vaccine was associated with fewer local and systemic reactions and lower immune responses than was AS03(A)-adjuvanted vaccine. The most frequent solicited local event was pain, reported by 28% and 76% of subjects after either dose of WV or adjuvanted vaccine, respectively (OR 7.71, 95% CI 4.48 to 13.24, p < 0.0001). The most common systemic event was myalgia, reported by 24% and 49% of subjects after either dose of WV or adjuvanted vaccine (OR 2.99, 95% CI 1.86 to 4.80, p < 0.0001).

CONCLUSIONS

AS03(A)-adjuvanted 2009 H1N1 vaccine is more immunogenic and provides greater antigen-sparing capacity than WV 2009 H1N1 vaccine.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN92328241.

FUNDING

This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 14, No. 55. See the HTA programme website for further project information.

Coral host transcriptomic states are correlated with Symbiodinium genotypes

A mutualistic relationship between reef-building corals and endosymbiotic dinoflagellates (Symbiodinium spp.) forms the basis for the existence of coral reefs. Genotyping tools for Symbiodinium spp. have added a new level of complexity to studies concerning cnidarian growth, nutrient acquisition, and stress. For example, the response of the coral holobiont to thermal stress is connected to the host-Symbiodinium genotypic combination, as different partnerships can have different bleaching susceptibilities. In this study, we monitored Symbiodinium physiological parameters and profiled the coral host transcriptional responses in acclimated, thermally stressed, and recovered fragments of the coral Montastraea faveolata using a custom cDNA gene expression microarray. Interestingly, gene expression was more similar among samples with the same Symbiodinium content rather than the same experimental condition. In order to discount for host-genotypic effects, we sampled fragments from a single colony of M. faveolata containing different symbiont types, and found that the host transcriptomic states grouped according to Symbiodinium genotype rather than thermal stress. As the first study that links coral host transcriptomic patterns to the clade content of their Symbiodinium community, our results provide a critical step to elucidating the molecular basis of the apparent variability seen among different coral-Symbiodinium partnerships.

Administration of a probiotic associated with nasal vaccination with inactivated Lactococcus lactis-PppA induces effective protection against pneumoccocal infection in young mice

Streptococcus pneumoniae is a serious public health problem, especially in developing countries, where available vaccines are not part of the vaccination calendar. We evaluated different respiratory mucosa immunization protocols that included the nasal administration of Lactococcus lactis-pneumococcal protective protein A (PppA) live, inactivated, and in association with a probiotic (Lc) to young mice. The animals that received Lc by the oral and nasal route presented the highest levels of immunoglobulin (Ig)A and IgG anti-PppA antibodies in bronchoalveolar lavages (BAL) and IgG in serum, which no doubt contributed to the protection against infection. However, only the groups that received the live and inactivated vaccine associated with the oral administration of the probiotic were able to prevent lung colonization by S. pneumoniae serotypes 3 and 14 in a respiratory infection model. This would be related to a preferential stimulation of the T helper type 1 (Th1) cells at local and systemic levels and with a moderate Th2 and Th17 response, shown by the cytokine profile induced in BAL and by the results of the IgG1/IgG2a ratio at local and systemic levels. Nasal immunization with the inactivated recombinant strain associated with oral Lc administration was able to stimulate the specific cellular and humoral immune response and afford protection against the challenge with the two S. pneumoniae serotypes. The results obtained show the probiotic-inactivated vaccine association as a valuable alternative for application to human health, especially in at-risk populations, and are the first report of a safe and effective immunization strategy using an inactivated recombinant strain.

Deletion of 9p21 in urine specimens collected from patients with a history of hematuria and bladder cancer

11038

Background: Fluorescence in situ hybridization (FISH) of voided urine sediment is a sensitive and specific test for the detection of urothelial carcinoma. Common bladder cancer FISH testing consists of 4 DNA probes to chromosomes 3, 7, and 17 and band 9p21. The pattern of enumeration anomalies for these 4 DNA probes are not well documented. We sought to determine the incidence of chromosomal anomalies detected by these 4 probes in urine specimens. Methods: Urine samples from a total of 13,284 patients with a history of hematuria and/or bladder cancer were included for study. FISH was performed in each case using fluorescence-labeled probes to the pericentromeric regions of chromosomes 3, 7, and 17 and band 9p21; cytology was also performed in all cases. Follow-up bladder biopsy information was collected from 280 cases. Results: In total, 91.6% (12163/13284) of urine samples were sufficient for FISH analysis. The overall FISH positive rate was 5.7% (691/12163), and the most frequent patterns of chromosomal anomalies were gains of chromosomes 3 and 7 (56.5%), 7 and 17 (51.6%), and 3 and 17 (36.9%). Deletion of 9p21 was observed in only 12% of cases, and was never observed as the only chromosomal anomaly. The mean number of positive cells in FISH-positive cases was 8.8 (range 4–22). Among 280 cases with matching bladder biopsies, 178 (63.6%) had urothelial carcinoma. FISH was more sensitive than cytology for the detection of urothelial carcinoma (77.4% vs. 53.5%, respectively) (p= 0.03), but there was no significant difference in specificity (68% vs. 71.6%, respectively) (p> 0.05). Conclusions: Gains of chromosomes 3 and 7 by FISH were the most common enumeration anomalies in urine specimens, while deletion of 9p21 only was rare and never seen isolation. FISH was significantly more sensitive than cytology for the detection of urothelial carcinoma with equivalent specificity.

No significant financial relationships to disclose.

NP7 protects from cell death induced by oxidative stress in neuronal and glial midbrain cultures from parkin null mice

Parkin mutations produce Parkinson's disease (PD) in humans and nigrostriatal dopamine lesions related to increased free radicals in mice. We examined the effects of NP7, a synthetic, marine derived, free radical scavenger which enters the brain, on H(2)O(2) toxicity in cultured neurons and glia from wild-type (WT) and parkin null mice (PK-KO). NP7, 5-10 microM, prevented the H(2)O(2) induced apoptosis and necrosis of midbrain neuronal and glial cultures from WT and PK-KO mice. NP7 suppressed microglial activation and the H(2)O(2) induced drop-out of dopamine neurons(.) Furthermore, NP7 prevented the increased phosphorylation of ERK and AKT induced by H(2)O(2). NP7 may be a promising neuroprotector against oxidative stress in PD.

Echo-Doppler ultrasonographic assessment of resistance and velocity of blood flow in the ductus venosus throughout gestation in fetal lambs

It has been postulated that during fetal hypoxia, the blood flow shunted through the ductus venosus increases and may account for upto 70% of the total umbilical flow. The objectives of the present study were to use ultrasonography to determine the velocities and waveform indices of blood flow in the ductus venosus in the fetal lamb. The ductus venosus of 15 lamb fetuses was evaluated weekly from Days 45 to 143 of gestation (Day 0=day of AI). The Doppler indices measured were: S/D, the systole/diastole ratio; RI, the resistance index; and PI, the pulsatility index. The velocity waveforms studied were: SV, the peak velocity during ventricular systole; D, the peak velocity during ventricular diastole; aV, the lowest forward velocity during atrial contraction; and TAMV, the time-averaged maximum velocity. Doppler indices from Days 52 to 143 were highly correlated: S/D versus PI (r=0.96, P<0.0001), and versus RI (r=0.93, P<0.0001); and PI versus RI (r=0.97, P<0.0001). Velocity indices were also positively correlated: velocity SV versus D (r=0.87, P<0.0001), versus aV (r=0.79, P<0.05), and versus TAMV (r=0.98, P<0.0001); D versus aV (r=0.88, P<0.05), and versus TAMV (r=0.87, P<0.05); and aV versus TAMV (r=0.82, P<0.05). Doppler indices were negatively correlated with SV (r=-0.22, P<0.03); D (r=-0.37, P<0.0001); TAMV (r=-0.32, P<0.05) and with aV (r=-0.67, P<0.05). The mean value of each Doppler index decreased 40% from Days 52 to 73 (e.g., PI from 0.82+/-0.08 to 0.51+/-0.10; P<0.05), with no significant changes thereafter. Mean (+/-S.E.M.) values of velocity indices SV, D, aV, and TAMV rose twofold from Days 60 to 115 of gestation (e.g., SV from 54.4+/-8.8cm/s to 104.9+/-19.7 and aV from 24.8+/-6.9 to 54.9+/-5.9; P<0.05). In conclusion, Doppler ultrasonography facilitated assessment of the blood flow pattern in the ductus venosus in lamb fetuses between Days 52 and 143.

Potent beta-amyloid modulators

Currently, the potential to interfere with the pathology of beta-amyloid targeting a well-known drugable enzyme, the acetylcholinesterase (AChE), is opened. Peripheral or dual binding site inhibitors of AChE may simultaneously alleviate the cognitive and behavioral deficits in Alzheimer's disease (AD) patients and, more importantly, act as disease-modifying agents delaying amyloid plaque formation. As part of a rational drug design program directed to find dual binding site AChE inhibitors, several families of compounds have been synthesized as potent AChE inhibitors. From these series, several drug candidates were selected based on their potent and selective inhibition of AChE (subnanomolar activity) and their interference with the beta-amyloid aggregation in vitro (IC(50) in the low micromolar range). First in vivo data confirm our initial hypothesis. Oral treatment with NP-61 for 3 months is able to reverse the cognitive impairment (Morris water maze test) and to reduce plaque load in the brains of human amyloid precursor protein transgenic mice (Swedish mutation). These results suggest that NP-61, a potent beta-amyloid modulator, is able to reverse the AD-like neurodegenerative phenotype in transgenic mice, indicating a promising disease-modifying agent for clinical application.

32 FIRST SHEEP CLONES BORN IN SOUTH AMERICA

Since the birth of the first animal produced by nuclear transfer using adult somatic cells (Wilmut et al. 1997 Nature 385, 810–813), cloning has been used in many species. Although sheep were the first species to be cloned, the limited data available from different research groups indicate sheep to be among the lowest in terms of efficiency (0.5–2%), mainly due to high losses during pregnancy and the postnatal period. Since there were no previous reports on cloning of small ruminants in South America, the aims of the present study were to perform a larger scale sheep cloning program to evaluate the efficiency under local conditions in Argentina and describe the main postmortem findings observed in fetuses and extraembrionary membranes. Male adult fibroblast cell lines from different animals were used. Matured oocytes were recovered by flushing the oviducts of synchronized and superovulated donor ewes. From 437 ewes, 4720 oocytes were recovered (10.8 oocytes/ewe). Enucleation and nuclear transfer were performed as described previously, with modifications. Cell fusion was induced by a double electrical pulse in sorbitol medium (1.20 kV cm–1, 30 μs). Fused couplets were activated using ionomycin for 5 min and then cycloheximide and cytochalasin B for 5 h. Embryo culture was performed at 38.5°C in a 5% O2, 5% CO2, 90% N2 atmosphere, in KSOM supplemented with 2% FCS and 0.2 mm glucose on Day 3 of culture. After 6 to 7 days in culture, embryos were graded and then surgically transferred into synchronized recipients. Pregnancy rate was checked 23 days after embryo transfer and then weekly until 60 days, using a transrectal 5-MHz probe (Toshiba, Tokyo, Japan). From 70 to 150 days, a 3-MHz convex probe was used to perform monthly transabdominal scans. Most of the losses (70%) occurred within the first 90 days of pregnancy, and 15% of the fetuses were aborted late in gestation. Main ultrasound findings were fetal and placental hydrops and bilateral hydronefrosis. In addition, 6 of the ewes developed hydrallantois. Ewes beyond 148 days of gestation were induced for parturition using four IM injections of betamethasone 12 h apart (3.96 mg each). If labor did not commence, a C-section was performed (9/11). Eleven cloned lambs were born; two of them are still alive (6 months). All newborns were clinically evaluated after birth and their health assessed. Of the newborns, 80% died in the first 24 h after birth; they were depressed, with severe respiratory distress that developed into acidosis. At necropsy, fetuses were found with: collapsed lungs (9/9), fatty liver (6/9), ascitis (7/9), hydronefrosis (6/9), and placental edema with partial degeneration of placentomes (8/9). The final efficiency obtained in this large-scale cloning program (0.6%) was very similar to that reported by others in a smaller trials. Many studies on gene expression of cloned embryos and placental development have partially explained why this technique has a particular low efficiency in the sheep species; therefore further studies should be done in order to improve the outcome. Table 1. Efficiency of sheep cloning

Stage 1B cervical cancer in a pregnant woman at 25 weeks of gestation

Cervical cancer associated with pregnancy is rare (0.05%), although it is the most frequently diagnosed malignancy in pregnant women. We present the case of a 28-year-old woman at 25 weeks of gestation diagnosed with Stage 1B cervical cancer. Treatment was delayed until fetal maturity, and an elective cesarean section was performed at 33 weeks' gestation, followed by a total hysterectomy preserving the ovaries, and a pelvic lymphadenectomy. A review of the literature on the treatment of cervical cancer during pregnancy relevant to the case described is also presented.

Differential immunomodulatory properties of Bifidobacterium logum strains: relevance to probiotic selection and clinical applications

Modulation of host immunity is one of the proposed benefits of the consumption of probiotics. Nonetheless, comparative studies on the immunological properties that support the selection of strains of the same species for specific health benefits are limited. In this study, the ability of different strains of Bifidobacterium longum to induce cytokine production by peripheral blood mononuclear cells (PBMCs) has been evaluated. Live cells of all B. longum strains greatly stimulated regulatory cytokine interleukin (IL)-10 and proinflammatory cytokine tumour necrosis factor (TNF)-alpha production. Strains of the same species also induced specific cytokine patterns, suggesting that they could drive immune responses in different directions. The probiotic strain B. longum W11 stimulated strongly the production of T helper 1 (Th1) cytokines while B. longum NCIMB 8809 and BIF53 induced low levels of Th1 cytokines and high levels of IL-10. The effects of cell-surface components obtained by sonication of B. longum strains overall confirm the effects detected by stimulation of PBMCs with live cells, indicating that these components are important determinants of the immunomodulatory activity of B. longum. Genomic DNA of some strains stimulated the production of the Th1 and pro-inflammatory cytokines, interferon (IFN)-gamma and TNF-alpha, but not that of IL-10. None of the cell-free culture supernatants of the studied strains was able to induce TNF-alpha production, suggesting that the proinflammatory component of these strains is associated mainly with structural cell molecules. The results suggest that despite sharing certain features, some strains can perform a better functional role than others and their careful selection for therapeutic use is desirable.

Cancer prevalence in kidney transplant recipients in two general hospitals from Peru

21155

Background: Malignancy following kidney transplantation is an important medical problem during long-term follow-up. The accrual risk is approximately 100 times greater than the general population. We report some features of the cancers developed in our patient population Methods: We retrospectively reviewed records of 1050 kidney transplant recipients who received both unrelated or related allograft transplants from January 1972 to April 2006 and recorded the incidence of de novo malignancies that developed in this cohort. The study was carried out in two centers in Peru. The statistical method was descriptive and parametrical. Survival was calculated using the Kaplan-Meier method. Results: Forty-six cancer were diagnosed in 42 recipients (4.3%). Twenty six were men and 16 women, mean age was 46.0 years old (range:17–67). Malignancy was diagnosed between 2 to 240 months after transplantation. The tumors included Kaposi's sarcoma (KS) in ten patients, squamous cell carcinoma (SCC) in seven, basal cell carcinoma (BCC) in six, cervix cancer in four, colon and breast cancer in three and hepatocarcinoma in two. Also they were reported one case of small intestine cancer, osteosarcoma, pancreatic cancer, lung cancer, bladder cancer, schwanoma, melanoma, tongue cancer, postransplant lymphoproliferative disease, pelvis renal cancer and carcinomatosis from unknown primary. Thus, KS was the most common malignancy encountered in our series, with a prevalence of 0.95%, followed by SCC observed in 0.66% and BCC found in 0.57% of the patients. The average latency period between transplantation and development of malignancy was 25 months for KS, 72.0 months for SCC and 36.0 months for BCC. KS occurred earlier compared with the other cancers ( P < 0.05); We failed to demonstrate any correlation between age/sex and specific type of cancer. The 10 year - survival was 71%. Conclusions: The prevalence of cancer in our renal transplant recipients was 4.3%. KS and non melanoma skin cancer were the most frequent cancer. Low incidence of postransplant lymphoproliferative disease was found.

No significant financial relationships to disclose.

"In vivo" and "in vitro" tests in the diagnosis of Beta-lactams allergy

The results of "in vivo" and "in vitro" diagnostic tests in 114 patients reporting an allergic reaction to Beta-lactams are presented. Skin test gave an overall positivity of 85% and determination of specific IgE of 42%. Skin tests have a greater sensitivity but "in vitro" tests are an useful associated diagnostic method.

Hypotensive effect of hydroxylamine, an endogenous nitric oxide donor and SSAO inhibitor

The endogenous compound hydroxylamine relaxes vascular smooth muscle in vitro, apparently through conversion to the vasodilator factor nitric oxide, but its effect on blood pressure has not been characterized. We found that in the anesthetized rat the amine elicits dose-related hypotension when administered by continuous iv infusion. In experiments designed to explore the mechanism of this effect, hydroxylamine was compared with the nitric oxide donor nitroprusside and the direct-acting vasodilator hydralazine, using pretreatments known to modify diverse mechanisms of vasodilation. Hydroxylamine hypotension was enhanced by the SSAO inhibitor isoniazid and the SSAO substrate methylamine, a pattern shared by hydralazine. Responses were blocked by the guanylate cyclase inhibitor methylene blue and were increased by the nitric oxide synthase inhibitor L-NAME, a pattern shared by nitroprusside. It was concluded that hydroxylamine exerts hypotension partly through conversion to nitric oxide and partly by a "hydralazine-like" mechanism involving SSAO inhibition.

413 ULTRASONOGRAPHIC EVALUATION OF FETAL LIVER SIZE DURING PREGNANCY IN BOVINE CLONED FETUSES

In ruminants, abnormal increased liver size is a common description cited in many postmortem studies performed on aborted fetuses and stillborn cloned calves (Heyman et al. 2002 Biol. Reprod. 66, 6–13). Although fetal liver size can be accurately determined throughout pregnancy using ultrasonography as a method of monitoring fetal health in humans, there are no reports of this being done in cattle. Thus, the aim of this study was to prospectively characterize the ultrasonographic fetal liver growth pattern in IVF-derived pregnancies, and then to establish comparisons with measurements taken from cloned fetuses. For this purpose, (A) IVF-derived pregnancies were used as the control group (n = 10), and the cloned ones were split into 2 groups according to the outcome of their pregnancies: (B) clones that died between 110 and 282 days (n = 21), and (C) clones born alive (n = 16). All recipients were multiparous, nonlactating, and Aberdeen Angus breed. Measurements were done by ultrasonography (Toshiba Nemio 20, Tokyo, Japan) using a 5–10 MHz intraoperative finger probe from 72 to 114 days (transrectal) and a 3–6 MHz linear-array probe between 143 and 212 days (transabdominal). Three parameters of liver size were measured: (a) in a coronal (longitudinal) plane of the fetus, cephalocaudal diameter (CC) was taken from the dome of the right hemi-diaphragm to the tip of the right lobe; (b) in an axial (transverse) plane at right angles to one another passing through or slightly caudal to the portal umbilical venous complex: (b1) transverse diameter (TD) and (b2) sagittal diameter (SD) were determined (Gimondo et al. 1995 J. Ultrasound Med. 14, 327–333). A repeated-measure ANOVA detected significant interaction for the 3 variables included in this study (P &lt; 0.01); therefore, differences between groups at each week of gestation were analyzed using the Wald-Wolfowitz test (InfoStat V1.5; FCA, Universidad de Córdoba, Córdoba, Argentina). Results showed that CC, TD, and SD were statistically smaller in the IVF group throughout pregnancy (P &lt; 0.05). No significant differences between (B) and (C) groups were found at 72 and 87 days (P &gt; 0.05). However, from 143 days onward, liver of fetuses from the (B) group were statistically larger in CC, TD, and SD diameters than those values obtained in the (A) and (C) groups (P &lt; 0.05) (Table 1). To conclude, the present study showed that fetal liver size can be measured throughout gestation in cows using noninvasive ultrasonography. Secondly, since fetuses from (A) and (C) groups were born alive, increased abnormal size measurements after 140 days can be used as indicator of clones that fail late in gestation (B). Also, this methodology may enhance sonographic assessment of fetal growth abnormalities and conditions with fetal liver involvement. Further studies will be necessary to evaluate differences between naturally conceived and IVF fetuses and the correspondence of this three-dimensional evaluation of the liver and to estimate its weight. Table 1. TD and SD at 72, 143, and 212 days of gestation in (A), (B), and (C) groups (n = 16) (mean ± SD)