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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/09 15:15:46」(JST)
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| Anencephaly | |
|---|---|
| Classification and external resources | |
A front view of an anencephalic fetus |
|
| ICD-10 | Q00.0 |
| ICD-9 | 740.0 |
| OMIM | 206500 |
| DiseasesDB | 705 |
| MedlinePlus | 001580 |
| eMedicine | neuro/639 |
| MeSH | C10.500.680.196 |
Anencephaly is a cephalic disorder that results from a neural tube defect that occurs when the cephalic (head) end of the neural tube fails to close, usually between the 23rd and 26th day of pregnancy, resulting in the absence of a major portion of the brain, skull, and scalp.[1] Strictly speaking, the translation of the Greek term to English is "no brain" (that is, totally lacking), but it is accepted that children with this disorder are born without a forebrain, the largest part of the brain consisting mainly of the cerebral hemispheres, including the neocortex, which is responsible for higher-level cognition. The remaining brain tissue is often exposed, i.e. not covered by bone or skin.[2] With very few exceptions[3], most babies with this genetic disorder do not survive birth.
Contents
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Signs and symptoms
An anencephalic newborn
The National Institute of Neurological Disorders and Stroke (NINDS) describes the presentation of this condition as follows: "A baby born with anencephaly is usually blind, deaf, unconscious, and unable to feel pain. Although some individuals with anencephaly may be born with a main brain stem, the lack of a functioning cerebrum permanently rules out the possibility of ever gaining consciousness, reflex actions such as breathing and responses to sound or touch may occur."[2]
Causes
The cause of anencephaly is disputed. Generally, neural tube defects do not follow direct patterns of heredity, though there is some indirect evidence of inheritance,[4] and recent animal models indicate a possible association with deficiencies of the transcription factor TEAD2.[5] Studies show that a woman who has had one child with a neural tube defect such as anencephaly has about a 3% risk of having another child with a neural tube defect[6], as opposed to the background rate of 0.1% occurrence in the population at large[7]
It is known that women taking certain medications for epilepsy and women with insulin-dependent diabetes have a higher risk of having a child with a neural tube defect. [8] Genetic counseling is usually offered to women at a higher risk of having a child with a neural tube defect to discuss available testing.
Recent studies have shown that the addition of folic acid to the diet of women of child-bearing age may significantly reduce, although not eliminate, the incidence of neural tube defects. Therefore, it is recommended that all women of child-bearing age consume 0.4 mg of folic acid daily,[2] especially those attempting to conceive or who may possibly conceive, as this can reduce the risk to 0.03%.[9] It is not advisable to wait until pregnancy has begun, since by the time a woman knows she is pregnant, the critical time for the formation of a neural tube defect has usually already passed. A physician may prescribe even higher dosages of folic acid(4 mg/day) for women who have had a previous pregnancy with a neural tube defect.[9]
Anencephaly and other physical and mental deformities have also been blamed on a high exposure to such toxins as lead, chromium, mercury, and nickel.[10]
Relation to genetic ciliopathy
Until recently, medical literature did not indicate a connection among many genetic disorders, both genetic syndromes and genetic diseases, that are now being found to be related. As a result of new genetic research, some of these are, in fact, highly related in their root cause despite the widely varying set of medical symptoms that are clinically visible in the disorders. Anencephaly is one such disease, part of an emerging class of diseases called ciliopathies. The underlying cause may be a dysfunctional molecular mechanism in the primary cilia structures of the cell, organelles which are present in many cellular types throughout the human body. The cilia defects adversely affect "numerous critical developmental signaling pathways" essential to cellular development and thus offer a plausible hypothesis for the often multi-symptom nature of a large set of syndromes and diseases. Known ciliopathies include primary ciliary dyskinesia, Bardet-Biedl syndrome, polycystic kidney and liver disease, nephronophthisis, Alstrom syndrome, Meckel-Gruber syndrome, and some forms of retinal degeneration.[11]
Diagnosis
Ultrasound image of fetus with anencephaly
Anencephaly can often be diagnosed before birth through an ultrasound examination. The maternal serum alpha-fetoprotein (AFP screening)[12] and detailed fetal ultrasound[13] can be useful for screening for neural tube defects such as spina bifida or anencephaly.
Prognosis
| This section needs additional citations for verification. (October 2011) |
There is no cure or standard treatment for anencephaly and the prognosis for patients is death. Most anencephalic fetuses do not survive birth, accounting for 55% of non-aborted cases. If the infant is not stillborn, then he or she will usually die within a few hours or days after birth from cardiorespiratory arrest.[2][14]
To date, there are only three recorded cases of anencephalic children surviving for longer periods of time: Stephanie Keene of Falls Church, Virginia, who lived for 2 years 174 days; Vitoria de Cristo, born in Portugal in January 2010 and surviving until July 17, 2012[15]; and Nicholas Coke[16] of Pueblo, Colorado, who as of July 2012, is still living at 3 and a half years old.
In almost all cases, anencephalic infants are not aggressively resuscitated because there is no chance of the infant ever achieving a conscious existence. Instead, the usual clinical practice is to offer hydration, nutrition, and comfort measures and to "let nature take its course". Artificial ventilation, surgery (to fix any co-existing congenital defects), and drug therapy (such as antibiotics) are usually regarded as futile efforts. Some clinicians and medical ethicists view even the provision of nutrition and hydration as medically futile.[citation needed]
Epidemiology
In the United States, anencephaly occurs in about 1 out of every 10,000 births.[17] Research has suggested that, overall, female babies are more likely to be affected by the disorder.[18]
Three Types of Anencephaly
Meroanencephaly
Definition: Meronanencephaly is a rare form of anencephaly characterized by malformed cranial bones, a median cranial defect, and a cranial protrusion called area cerebrovasculosa. Area cerebrovasculosa is a section of abnormal, spongy, vascular tissue admixed with glial tissue ranging from simply a membrane to a large mass of connective tissue, hemorrhagic vascular channels, glial nodules, and disorganized choroid plexuses. [19]
Holo Anencephaly
The most common type of anencephaly, in which the brain is completely absent.[19]
Craniorachischisis
The most severe type of anencephaly where area cerebrovasculosa and area medullovasculosa fill both cranial defects and the spinal column. Craniorachischisis is characterized by anencephaly accompanied by bony defects in the spine and the exposure of neural tissue. [19][20]
Significant Anencephaly Research
Some genetic research has been conducted to determine the causes of anencephaly. It has been found that cartilage homeoprotein (CART1) is selectively expressed in chondrocytes (cartilage cells). The CART1 gene to chromosome 12q21.3–q22 has been mapped. Also, it has been found that mice homozygous for deficiency in the Cart1 gene manifested acrania and meroanencephaly, and prenatal treatment with folic acid will suppress acrania and meroanencephaly in the Cart1-deficient mutants. [21] [22]
Ethical and Legal Implications of Anencephaly
Varying Ethical Issues
Personhood
Modern philosophers define personhood as consciousness of the external world, in which a being sustains self-consciousness, self-determination, rational capacities, emotional expressions, willful direction, and communicative and social abilities.[23] However, a conflicting issue is the idea of potentiality--someone who is in a coma, asleep, or has anencephaly can still have the capacity to function. In regards to those in a coma or born with anencephaly, such individuals are said to have latent capacity. Latent capacity describes a future or delayed ability to function. Some more obscure qualifications of personhood are sentience, the possession of a soul, and severe cognitive repair. [23] The crux of the ethical and legal implications of anencephaly lies with an anencephalic's status as a person. [23]
One of the major issues concerning personhood is organ donation. Initial legal guidance came from the case of Baby Theresa in 1992, in which the boundaries of organ donation were tested for the first time.[24] Infant organs are scarce, and the high demand for pediatric organ transplants poses a major public health issue. In 1999, it was found that thirty to fifty percent of children under the age of two die while waiting for transplants. [24]In order for infant organs to be viable and used for transplant, they must be removed while the infant is still alive. However, this poses both legal and ethical issues. In the United States, some states have laws that forbid the removal of organs from a donor until after the donor has died. And from this, several questions have been posed. Are anencephalics, in fact, alive? Ultimately the arguments come down to: If it were decided that the life of a person is to be ended how should it done? Euthanasia of humans is illegal. [23]
There are three different arguments in support of or against donation of anencephalic organs: utilitarian, Kantian, and pro-life. Utilitarians believe that the choice that benefits the most amount of people is the most ethical choice. In the case of organ donation, since anencephalics cannot experience pleasure, their only good is to be organ donors. The Kantian view follows that humanity should be treated as an end and not a means. Anencephalics have no better purpose than to be organ donors and better the lives of other infants. Finally, pro-life is against organ donation, preserving that the right to life be given to all human beings beginning at conception.[23]
Underlying these three philosophies is the classification of anencephalics as persons. Ultimately, the goal of those in support of organ donation is that it will decrease the shortage in infant organs. It has been estimated that 400-500 infant hearts and kidneys and 500-1,000 infant livers are needed in the United States each year.[25] Currently, laws in some states prevent organ transplantation from living persons, and federal laws forbid the use of any form of euthanasia. Because anencephalic neonates have partially functioning brain stems, they reserve some of the body’s autonomic functions, such as those of the heart, kidneys and intestines. For this reason, some are led to believe that anencephalic neonates are functioning human beings despite their unawareness of existence.[26]
The pros of organ donations are that many children will be saved from death, and additionally, parents of anencephalic children think that some good comes from organ donation.[26] Furthermore, it saves the costs of caring for a terminally ill child and instead of two babies dying, health care providers are able to save one. [27] The cons are that several laws prevent removing organs from a living being or make organ donation from anencephalics impossible, some organs from anencephalic children cannot be transported due to abnormalities and the fear that there is not a significant amount of anencephalic donors to reach the demand for certain organs, such as kidneys.[27]
Ethically, the main issues with organ donation are a misdiagnosis of anencephaly, the slippery slope theory, that anencephalic neonates would rarely be a source of organs, and that it would undermine confidence in organ transplantation. [26] Slippery slope concerns are a major issue in personhood debates, across the board. In regards to anencephaly, organ donation could open the door for abuses of other persons who are organ donors such as an elderly person with severe dementia. Another issue is the number of children who would actually benefit. There are discrepancies in statistics; however, it is known that most anencephalic children are stillborn. [26]
Proposals have been made to bypass the legal and ethical issues surrounding organ donation. These include waiting for death to occur before harvesting organs, expanding the definition of death, creating a special legal category for anencephalic infants, and defining them as non-persons. [27]
Brain Death
There are four different concepts used to determine brain death: failure of heart and lungs, separation of body and soul, whole brain death, and neocortical death. Some argue that anencephalics experience neocortical death, in which there is an irreversible loss of consciousness and self-awareness, two determinants of a person. Brain death is another source of support for organ donation. [23]
Neocortical death, similar to a persistent vegetative state (PVS), involves loss of cognitive functioning of the brain. A proposal by law professor, David Smith, in an attempt to prove that neocortical death should legally be treated the same as brain death, involved PET scans to determine the similarities. However this is not a well-received proposal considering the contradicting views on classifying brain death. [28]
To Continue or End the Pregnancy
Anencephaly can be diagnosed prenatally with a high degree of accuracy. Given that anencephaly is a fatal condition, parents receive the option of abortion either in the second or third trimester of pregnancy, depending on the abortion laws in the state. [25] In 2012, Brazil extended the right of abortion to mothers with anencephalic fetuses. This decision is, however, receiving much disapproval by several religious and human rights groups.[29]
"Drawing the Line" Rebuttal
The “drawing the line” rebuttal seeks to establish when a fetus becomes a person and if it is able to think by itself. [30]
Legal Proceedings
The case of Baby Theresa was the beginning of the ethical debate over anencephalic infant organ donation. [24] The story of Baby Theresa remains a focus of basic moral philosophy. Baby Theresa was born with anencephaly in 1992. Her parents, knowing that their child was going to die, requested that her organs be given for transplantation. Although her physicians agreed, Florida law prohibited the infant's organs from being removed while she was still alive. By the time she died nine days after birth, her organs had deteriorated past the point of being viable.[31]
Baby K was an anenecephalic infant that was kept alive for two years and 174 days under intensive care by order of the Fourth Circuit Court of Appeals.
United States Uniform Acts
The Uniform Determination of Death Act (UDDA) is a model bill, adopted by many US states, stating that an individual who has sustained either 1) irreversible cessation of circulatory and respiratory functions or 2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. This bill was a result of much debate over the definition of death and is applicable to the debate over anencephaly. A related bill, the Uniform Anatomical Gift Act (UAGA), grants individuals and, after death, their family members the right to decide whether or not to donate organs. Because it is against the law for any person to pay money for an organ, the person in need of an organ transplant must rely on a volunteer.[25]
There have been two state bills that proposed to change current laws regarding death and organ donation. California Senate Bill 2019 proposed to amend the UDDA to define anencephalic infants as already dead, while New Jersey Assembly Bill 3367 proposed to allow anencephalic infants to be organ sources even if they are not dead.[32] [33]
See also
- Baby K
References
- ^ "Cephalic disorders - Overview, Anencephaly, Colpocephaly - neurologychannel". Archived from the original on 9 May 2008. http://www.neurologychannel.com/cephalicdisorders/index.shtml. Retrieved May 2008.
- ^ a b c d "Anencephaly Information Page: National Institute of Neurological Disorders and Stroke (NINDS)". http://www.ninds.nih.gov/disorders/anencephaly/anencephaly.htm.
- ^ koaa.com, Baby Without A Brain, Nicholas Coke, Update
- ^ Shaffer LG, Marazita ML, Bodurtha J, Newlin A, Nance WE (1990). "Evidence for a major gene in familial anencephaly". Am. J. Med. Genet. 36 (1): 97–101. doi:10.1002/ajmg.1320360119. PMID 2333913.
- ^ Kaneko KJ, Kohn MJ, Liu C, Depamphilis ML (2007). "Transcription Factor TEAD2 Is Involved in Neural Tube Closure". Genesis 45 (9): 577–87. doi:10.1002/dvg.20330. PMC 2765819. PMID 17868131. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2765819.
- ^ Cowchock, S; Ainbender, E; Prescott, G; Crandall, B; Lau, L; Heller, R; Muir, WA; Kloza, E et al. (1980). "The recurrence risk for neural tube defects in the United States: A collaborative study". American Journal of Medical Genetics 5 (3): 309–314. doi:10.1002/ajmg.1320050314. PMID 7405962.
- ^ http://www.chg.duke.edu/diseases/ntd.html
- ^ "Anencephaly". Genetics Home Reference. National Institutes of Health. 22 August 2011. http://ghr.nlm.nih.gov/condition/anencephaly. Retrieved 28 August 2011.
- ^ a b al.], [edited by] Stephen D. Ratcliffe ... [et (2008). Family medicine obstetrics (3rd ed. ed.). Philadephia: Mosby Elsevier. ISBN 0-323-04306-2.
- ^ Goldsmith, Alexander (1996, quoted by Millen and Holtz, "Dying for Growth")
- ^ Badano, Jose L.; Norimasa Mitsuma, Phil L. Beales, Nicholas Katsanis (September 2006). "The Ciliopathies : An Emerging Class of Human Genetic Disorders". Annual Review of Genomics and Human Genetics 7: 125–148. doi:10.1146/annurev.genom.7.080505.115610. PMID 16722803. http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.genom.7.080505.115610. Retrieved 2008-06-15.
- ^ Joó JG, Beke A, Papp C, et al. (2007). "Neural tube defects in the sample of genetic counselling". Prenat. Diagn. 27 (10): 912–21. doi:10.1002/pd.1801. PMID 17602445.
- ^ Cedergren M, Selbing A (2006). "Detection of fetal structural abnormalities by an 11-14-week ultrasound dating scan in an unselected Swedish population". Acta obstetricia et gynecologica Scandinavica 85 (8): 912–5. doi:10.1080/00016340500448438. PMID 16862467.
- ^ Kinsman, SL; Johnston, MV (2007). "Chapter 592: Congenital anomalies of the central nervous system". In Kliegman, BF; Behrman, RE; Jenson, HB et al.. Nelson Textbook of Pediatrics (18th ed.). Philadelphia, PA: Saunders Elsevier. ISBN 1-4377-0755-6.
- ^ "Beloved Vitoria Blog". http://www.belovedvitoria.blogspot.co.uk/2012/07/our-beloved-vitoria-is-now-with-christ.html. Retrieved 20 July 2012.
- ^ "Boy without a brain". Archived from the original on 12 July 2012. http://www.koaa.com/videos/boy-without-a-brain/?fullsite. Retrieved 2012-07-16.
- ^ "U.S. National Library of Medicine". http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002547/.
- ^ Timson, J. (1970-02-05). "The sex ratio in anencephaly". Genetica 41 (1): 457–465. doi:10.1007/BF00958926. http://www.springerlink.com/content/k5p74661061t5160/. Retrieved 2008-05-08.
- ^ a b c Isada. "Meroanencephaly: Pathology and Prenatal Diagnosis.". U.S. National Library of Medicine. http://www.ncbi.nlm.nih.gov/pubmed/8286034.
- ^ Naveen. "Craniorachischisis Totalis". U.S. National Library of Medicine. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137839/?tool=pubmed. Retrieved 19 July 2012.
- ^ Chen. "Syndromes, Disorders and Maternal Risk Factors Associated with Neural Tube Defects (III)". http://www.ncbi.nlm.nih.gov/pubmed/18603496.. Retrieved 19 July 2012.
- ^ Zhou. "Prenatal Folic Acid Treatment Suppresses Acrania and Meroanencephaly in Mice Mutant for the Cart1 Homeobox Gene". http://www.nature.com/ng/journal/v13/n3/abs/ng0796-275.html. Retrieved 19 July 2012.
- ^ a b c d e f Ryskamp, Jessica. "Anencephaly: Concepts of Personhood, Ethical Questions, and Nursing Care". http://digitalcommons.liberty.edu/cgi/viewcontent.cgi?article=1207&context=honors. Retrieved 19 July 2012.
- ^ a b c Bard, Jennifer. "The Diagnosis Is Anencephaly And The Parents Ask About Organ Donation: Now What? A Guide For Hospital Counsel And Ethics Committees.". Western New England University School of Law,. http://digitalcommons.law.wne.edu/lawreview/vol21/iss1/3/. Retrieved 19 July 2012.
- ^ a b c Meinke, Sue. "Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues". Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues. http://bioethics.georgetown.edu/publications/scopenotes/sn12.pdf. Retrieved 19 July 2012.
- ^ a b c d "CEJA Report 5 – I-94: The Use of Anencephalic Neonates as Organ Donors". American Medical Association. http://www.ama-assn.org/resources/doc/code-medical-ethics/2162a.pdf.. Retrieved 19 July 2012.
- ^ a b c Ahmad. "Anencephalic Infants as Organ Donors: Beware the Slippery Slope". http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1488368. Retrieved 19 July 2012.
- ^ Beresford. "Ethics in Neuroscience: Mind over Matter". Indiana University. http://poynter.indiana.edu/publications/m-beresford.pdf.
- ^ "Anencephaly in Brazil: A New Decision, Old Issues". http://www.genderacrossborders.com/2012/04/13/25308. Retrieved 19 July 2012.
- ^ "Navigating the Ethical Issues of Anencephaly". http://www.asfhelp.com/ethical-issue. Retrieved 19 July 2012.
- ^ Rachels, James. "What is Morality". http://hettingern.people.cofc.edu/Intro_Philosophy_SP_2011/Rachels_Ch_One.pdf. Retrieved 19 July 2012.
- ^ Meinke, Sue. [Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues "Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues"]. Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues. Anencephalic Infants as Potential Organ Sources: Ethical and Legal Issues. Retrieved 19 July 2012.
- ^ "Uniform Declaration of Death Act (UDDA)". http://www.ascensionhealth.org/index.php?option=com_content. Retrieved 19 July 2012.
External links
| Wikimedia Commons has media related to: Anencephaly |
- Anencephaly.co.uk. A place to talk to others in the UK that have experienced Anencephaly
- Genetic Basis of Anencephaly
- NINDS Anencephaly Information Page at the National Institute of Neurological Disorders and Strokes.
- Anencephaly Net. Encourages women to carry anencephalic babies to term and let them die naturally.
- Exencephaly – Anencephaly Sequence and its Sonographic Features
- Anencephaly info. General information. Encourages women to carry anencephalic infants to term and "...share the stories of the brief, but wonderful lives of babies with anencephaly." Includes
- Anencephalie-info.org. General information on anencephalic babies carried to term, including life expectancy.
- Duke University's Anencephaly page, including recruiting information for research
- Images of Anencephaly
- Specimens - Anencephaly
- Nicholas Coke
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English Journal
- An association study between SUFU gene polymorphisms and neural tube defects.
- Lu X1, Wang Z, Wang J, Shangguan S, Bao Y, Lu P, Wang L.
- The International journal of neuroscience.Int J Neurosci.2014 Jun;124(6):436-42. doi: 10.3109/00207454.2013.849249. Epub 2013 Nov 7.
- Neural tube defects (NTDs) in mammals are rooted in aberrant neural tube closure during early embryogenesis, which is caused by multiple environmental and genetic factors. The Sonic Hedgehog pathway is involved in the induction of the floor plate and participates in formation of the neural tube. Mut
- PMID 24070372
- Partial craniofacial duplication: A review of the literature and case report.
- Costa MA1, Borzabadi-Farahani A2, Lara-Sanchez PA3, Schweitzer D3, Jacobson L1, Clarke N1, Hammoudeh J1, Urata MM1, Magee WP 3rd4.
- Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.J Craniomaxillofac Surg.2014 Jun;42(4):290-6. doi: 10.1016/j.jcms.2013.05.016. Epub 2013 Aug 19.
- Diprosopus (Greek; di-, "two" + prosopon, "face"), or craniofacial duplication, is a rare craniofacial anomaly referring to the complete duplication of facial structures. Partial craniofacial duplication describes a broad spectrum of congenital anomalies, including duplications of the oral cavity.
- PMID 23969147
- Prevalence of neural tube defect in southern Thailand: a population-based survey during 2009-2012.
- Jaruratanasirikul S1, Kor-Anantakul O, Limpitikul W, Dissaneevate P, Khunnarakpong N, Sattapanyo A.
- Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery.Childs Nerv Syst.2014 Apr 17. [Epub ahead of print]
- BACKGROUND: Neural tube defects (NTDs) are a group of congenital malformation of the central nervous system that leads to permanent physical disability and requires lifelong treatment. In Thailand, there have been three published articles on NTDs, all hospital-based studies, which found prevalence o
- PMID 24740441
Japanese Journal
- A-15 Yearly changes in the incidence rates of anencephalus in Japan, 1969-1998.
- IMAIZUMI Y.
- Congenital anomalies 40(3), 202, 2000-09
- NAID 110002785681
- 34 Circadian rhythms of steroids in normal maternal plasma at during pregnancy Ist, IInd, IIIrd trimester and anencephalus.
- Miyashita Y.,Hashino M.,Komatsuzaki K.,Akiyama T.,Kawamura E.,Saitoh H.,Kosaki T.,Yanaihara T.
- 日本産科婦人科學會雜誌 42(8), 1112, 1990-08-01
- NAID 110002170926
Related Links
- anencephalus [an′ən·sef′ə·ləs] an infant with anencephaly. anencephalus An infant with anencephaly. an·en·ceph·a·lus (an'en-sef'ă-lŭs) A fetus ... Disclaimer All content on this website, including dictionary, thesaurus, literature ...
- Anencephalus symptoms, causes, diagnosis, and treatment information for Anencephalus (Anencephaly) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis. ...
Related Pictures
★リンクテーブル★
| リンク元 | 「無脳症」「無脳」「無脳体」 |
「無脳症」
参考
- 1. [charged] 無脳症と脳瘤 - uptodate [1]
「無脳」
- 英
- anencephalus、anencephaly、brain-absent baby
- ラ
- anencephalia anencephalus
- 関
- 無脳症
「無脳体」
- 英
- anencephalus
- 同
- 無脳児
- 関
- 無脳症