bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of hydrological balance and its variability in arid and semi‐arid regions of Eurasia from ECMWF 15 year reanalysis
Authors: Yatagai Akiyo
Published: September 2003

Hydrometeorological cycles over arid and semi‐arid regions in mid‐latitude Eurasia (the Silk Road region) were investigated using meteorological reanalysis data for the period 1979–93, available from the European Centre for Medium‐range Weather Forecasts (ECMWF).

Results show that seasonal changes of moisture balance in Turkey and central Asia, hereafter referred to as the western region, differ from those in the Taklimakan Desert and Loess Plateau, hereafter referred to as the eastern region. Here, we equate evaporation minus precipitation with the divergence field of the vertically integrated water vapour flux. In the western region, precipitation and positive convergence C of moisture primarily occurs during October–March. In contrast, the eastern region receives precipitation and has its positive C occurring during June–August. As a result, the eastern region has nearly simultaneous seasonal peaks in precipitation P and evapotranspiration E, whereas the western region has minimum P and maximum E in summer.

The main annual moisture route for the Silk Road region is from the west to east; however, moisture also comes from the north in July. Over Turkey, moisture arrives from the west and south. In central Asia, however, most of the moisture comes from the west, the convergence peaks in March, and moisture from the south and west is also greater during this month. In the Loess Plateau, moisture enters from the west, the north, and the south, and exits to the east. In July, the peak precipitation and convergence season, all moisture flows are greater for the entire region, and a large influx of moisture from the south occurs during the summer season. The moisture from the south, the monsoonal flow, has a large interannual variability. Copyright © 2003 John Wiley & Sons, Ltd.
Global potential soil erosion with reference to land use and climate changes
Authors: Yang Dawen , Kanae Shinjiro , Oki Taikan , Koike Toshio , Musiake Katumi
Published: September 2003

A GIS‐based RUSLE model is employed to study the global soil erosion potential for viewing the present situation, analysing changes over the past century, and projecting future trends with reference to global changes in land use and climate. Scenarios considered in the study include historical, present and future conditions of cropland and climate. This research gives the first overview of the global situation of soil erosion potential considering the previous century as well as the present and future. Present soil erosion potential is estimated to be about 0·38 mm year−1 for the globe, with Southeast Asia found to be the most seriously affected region in the world. It is estimated that nearly 60% of present soil erosions are induced by human activity. With development of cropland in the last century, soil erosion potential is estimated to have increased by about 17%. Global warming might significantly increase the potential for soil erosion, and the regions with the same increasing trend of precipitation and population might face much more serious problems related to soil erosion in the future. Copyright © 2003 John Wiley & Sons, Ltd.
Numerical simulation of thermally induced gyres in Lake Biwa
Authors: Yamashiki Yosuke , Kumagai Michio , Jiao Chunmeng , Nezu Iehisa , Matsui Saburo
Published: September 2003

The formation process of three gyres in Lake Biwa, as observed using an acoustic Doppler current profiler, is simulated using three different SGS models: Smagorinsky Model, Dynamic Mixed Model (DMM) and Mixed Scaling Formulation Model (MSFM) based on very large eddy simulation (VLES). The driving force of gyre formation is assumed to be differential heating due to heat volume differences between the middle lake and shoreline areas. This condition is created in the simulation by setting the initial temperature distribution in the lake based on field observation data. The significant patterns of gyre formation are calculated both by DNM and MSFM. Owing to the huge disproportion of horizontal and vertical grid spacing, the isotropic subgrid scale (SGS) model (such as the Smagorinsky model) does not perform well when using normal grid spacing. According to the comparison between field observation data and numerical simulation, it is concluded that the surface heat transfer process is one of the main driving forces for gyre formation in Lake Biwa. Copyright © 2003 John Wiley & Sons, Ltd.
Three‐dimensional eutrophication model for Lake Biwa and its application to the framework design of transferable discharge permits
Authors: Yamashiki Yosuke , Matsumoto Miyuki , Tezuka Tetsuo , Matsui Saburo , Kumagai Michio
Published: September 2003

The main goal of this study is to evaluate the eutrophication status under different management approaches in a basin, by combining the Biwa3D model (three‐dimensional eutrophication analysis model) with several nutrient‐reduction cases to calculate their effects on the water quality in Lake Biwa, Japan, and by applying the model to evaluate the cost‐effectiveness between different scenarios designed to control eutrophication. A non‐hydrostatic hydrodynamic model featuring very large eddy simulation (VLES) concepts, combined with ecological components that consider three types of phytoplankton species, one zooplankton, and nutrient cycling in each grid, is developed as the basic component of the research. Nitrogen and phosphorus loads from 111 sub‐basins that supply Lake Biwa are set as the boundary condition for the numerical simulation. The chlorophyll a concentration calculated near the water intake, weighted in proportion to the intake discharge, is set as the water quality index. Transferable discharge permits are introduced for estimating the total reduction cost for achieving the objective water quality. Two types of scenario are tested: one considers the difference in location of nutrient reduction in the north and south basins, and the other ignores this difference. Initially, the effect of nutrient loads on the water quality of Lake Biwa was calculated using the Biwa3D model, using estimated nitrogen and phosphorus loads from the basin as the boundary condition. Transferable discharge permits were then designed according to the impact factor on each basin calculated by the model in order to compare the cost‐effectiveness of the reduction scenarios. It is concluded that consideration of the characteristics of each basin and the distribution of effluent in designing transferable discharge permits reduces the total costs by around 4–25% of that required for achieving the target concentration of chlorophyll a. Copyright © 2003 John Wiley & Sons, Ltd.
Fractal concept in numerical simulation of hydraulic fracturing of the hot dry rock geothermal reservoir
Authors: Fomin S. , Hashida T. , Shimizu A. , Matsuki K. , Sakaguchi K.
Published: September 2003

Hydraulic fracturing or hydraulic stimulation is one of the most effective methods of enhancing hot dry rock (HDR) geothermal system productivity. The 3D structure of the fractured rock is approximated by the network models of ‘fractal geometry’. The models of fracture networks are generated by distributing fractures randomly in space and assuming the fractal correlation Nr = Cr−D that incorporates the number of fractures Nr, fractal length r, fractal dimension D and fracture density within the rock mass C. This procedure makes it possible to characterize the geothermal reservoirs using parameters measured from field data. Based on this approach, a mathematical model of the hydraulic rock fracturing is proposed. The model incorporates approximations of the fracture mechanical behaviour drawn from the rock mechanics literature, a very simplified analysis of the operative physical processes and mapping of the connectivity of fracture network to a cubic regular grid. Along with the fractal‐type distribution of the fracture lengths, the fracture surfaces are also assumed to follow fractal geometry. The latter allows numerical simulation of the natural rock fracture dilation caused by fracture shear offset. The other problem that can be resolved by fracture surface modelling is the apparent limitation on the number of fractures that can be analysed experimentally. In this respect, the suggested mathematical model can be used to simulate fractal surfaces identical to fractures found in the natural rocks. Taken together, these tools permit the approximate engineering resolution of the multi‐parametric, highly complex mechanical problem. The reliability of the developed model was validated by comparisons with the experimentally determined data for the Hijiori deep reservoir. This implicitly justifies the numerical results and conclusions drawn in the present research. In particular, a series of computations indicate that the connectivity of the fracture network is greatly affected by the fractal dimension of the fracture network. The strong effect of the fractal dimension on the reservoir's size is also observed. The numerical results illustrate the controlling effect of the pressure and flow rate in the stimulating well for reservoir growth. Copyright © 2003 John Wiley & Sons, Ltd.
Osteointegration of biomimetic apatite coating applied onto dense and porous metal implants in femurs of goats
Authors: Barrère F. , van der Valk C. M. , Meijer G. , Dalmeijer R. A. J. , de Groot K. , Layrolle P.
Published: September 2003

Biomimetic calcium phosphate (Ca‐P) coatings were applied onto dense titanium alloy (Ti6Al4V) and porous tantalum (Ta) cylinders by immersion into simulated body fluid at 37 °C and then at 50 °C for 24 h. As a result, a homogeneous bone‐like carbonated apatitic (BCA) coating, 30 μm thick was deposited on the entire surface of the dense and porous implants. Noncoated and BCA‐coated implants were press‐fit implanted in the femoral diaphysis of 14 adult female goats. Bone contact was measured after implantation for 6, 12, and 24 weeks, and investigated by histology and backscattered electron microscopy (BSEM). After 6 weeks, bone contact of the BCA‐coated Ti6Al4V implants was about 50%. After 12 and 24 weeks, bone contact was lower in comparison with the 6‐week implantations at, respectively 24 and 39%. Regarding the BCA‐coated porous Ta implants, bone contacts were 17, 30, and 18% after 6, 12, and 24 weeks, respectively. However, bone contact was always found significantly higher for BCA‐coated dense Ti6Al4V and porous Ta cylinders than the corresponding noncoated implants. The results of this study show that the BCA coating enhances the bone integration as compared to the noncoated implants. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 67B: 655–665, 2003
Influence of dental biofilm on release of mercury from amalgam exposed to carbamide peroxide
Authors: Steinberg Doron , Blank Ori , Rotstein Ilan
Published: September 2003

Tooth bleaching is a popular procedure in modern aesthetic dentistry. Bleaching agents may affect amalgam restorations by altering the release of mercury. The aim of this study was to explore the effect of biofilm‐coated amalgam restorations on the release of mercury in the presence of carbamide peroxide. Samples of SDI and Valliant amalgams were submerged for either 14 days or 7 months in buffered KCl after which they were coated with saliva, bacteria, and polysaccharides. The samples were exposed to 10% carbamide peroxide (CP) for 24 h. The amount of mercury released was examined for 120 h. Results showed that most of mercury release occurred within the first 24 h, after which the release rate decreased sharply. After 120 h the release of mercury from the tested samples was minimal and similar to the control group. The presence of biofilm coating on the amalgam samples did not induce the release of mercury but tended to reduce mercury release into the surrounding environment. CP induces the release of mercury from amalgam samples. However, the presence of biofilm did not prevent large amounts of mercury release from amalgam coated with biofilms and exposed to CP. This study indicates that dental biofilm may retard the release of mercury from amalgam restorations. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 67B: 627–631, 2003
Three‐dimensional hyaluronic acid grafts promote healing and reduce scar formation in skin incision wounds
Authors: Hu Min , Sabelman Eric E. , Cao Yang , Chang James , Hentz Vincent R.
Published: September 2003

Hyaluronic acid (HA) has been found to play important roles in tissue regeneration and wound‐healing processes. Fetal tissue with a high concentration of HA heals rapidly without scarring. The present study employed HA formed into three‐dimensional strands with or without keratinocytes to treat full‐thickness skin incision wounds in rats. Wound closure rates of HA strand grafts both with and without keratinocytes were substantially enhanced. The closure times of both HA grafts were less than 1 day (average 16 h), about 1/7 that of the contralateral control incisions (114 h, p < .01). Average wound areas after 10 days were HA‐only graft: 0.151 mm2 ± 0.035; HA + cell grafts: 0.143 mm2 ± 0.036 and controls: 14.434 mm2 ± 1.175, experimental areas were 1% of the controls (p < 0.01). Transforming growth factor (TGF) β1 measured by immunostaining was remarkably reduced in HA‐treated wounds compared to the controls. In conclusion, HA grafts appeared to produce a fetal‐like environment with reduced TGF‐β1, which is known to be elevated in incipient scars. The HA strands with or without cultured cells may potentially improve clinical wound healing as well as reduce scar formation. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 67B: 586–592, 2003
Isolated cardiomegaly in the second trimester as an early sign of fetal hydrops due to intracranial arteriovenous malformation
Authors: Henrich Wolfgang , Fuchs Ilka , Bührer Christoph , van Landeghem Frank K. H. , Albig Matthias , Stoever Brigitte , Dudenhausen Joachim W.
Published: September 2003

We report the case of a 27‐year‐old pregnant woman in whom isolated mild fetal cardiomegaly, diagnosed prenatally on sonographic examination at 22 weeks' menstrual age, was the first sign of development of an arteriovenous malformation of the vein of Galen. The arteriovenous malformation was visualized on sonographic examination at 29 weeks' menstrual age; prenatal MRI at 32 weeks confirmed the diagnosis. At 34 weeks' menstrual age, repeat sonographic examination demonstrated polyhydramnios, cardiomegaly, and generalized hydrops with ascites and pleural effusion. After vaginal delivery, the male neonate died of respiratory distress. We present the findings of prenatal gray‐scale, color Doppler, and power Doppler sonography; MRI; and postmortem examination. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:445–449, 2003
Secretory carcinoma of the breast
Authors: Paeng Mi Hye , Choi Hye‐Young , Sung Sun Hee , Moon Byung In , Shim Sung Shine
Published: September 2003

Secretory carcinoma of the breast is a rare but histologically distinct variant of invasive ductal carcinoma that has an indolent growth pattern and a more favorable prognosis than that of typical ductal carcinoma. We present the imaging and histopathologic findings of a case of this tumor that initially manifested as a palpable mass in the left breast of a 31‐year‐old woman. It appeared sonographically as a round, well‐circumscribed but microlobulated hypoechoic solid mass. Secretory carcinoma of the breast may resemble other well‐circumscribed breast carcinomas as well as some benign masses, including fibroadenomas. Breast imagers should be aware of this rare tumor's nonspecific imaging features and clinical implications when making a differential diagnosis of solid breast masses. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:425–429, 2003
Real‐Time three‐dimensional echocardiography versus two‐dimensional echocardiography in the diagnosis of left ventricular apical thrombi: Preliminary findings
Authors: Chamoun Antonio J. , McCulloch Marti , Xie Tianrong , Shah Sangeeta , Ahmad Masood
Published: September 2003

Purpose

Real‐time 3‐dimensional transthoracic echocardiography (RT‐3D‐TE) with real‐time volume rendering (RTVR) offers multiple simultaneous views and spatial definition of intracardiac structures superior to that attainable by 2‐dimensional transthoracic echocardiography (2D‐TE). We hypothesized that RT‐3D‐TE would therefore improve identification of left ventricular apical thrombi (LVT).

Methods

Patients were referred to our echocardiography laboratory over an 8‐month period. Those diagnosed with a “suspicious” or “definite” LVT on the basis of 2D‐TE images underwent RT‐3D‐TE on the same day. All 2D‐TE, RT‐3D‐TE, and RTVR images were reviewed by 2 independent observers. RT‐3D‐TE findings were considered positive for LVT if LVT was visualized in both B‐scan (apical orthogonal) and C‐scan (short axis, with and without tilting angle) planes and on RTVR images, nondiagnostic (or suspicious) for LVT if it was not visualized in all planes, and negative for LVT if it was not visualized in any plane.

Results

Thirty patients (19 men and 11 women) with a mean age (± standard deviation) of 52 ± 13 years were enrolled. The interobserver agreement coefficient was 63% for 2D‐TE interpretations of LVT and 93% for RT‐3D‐TE interpretations of LVT (p < 0.05). The final interpretations by RT‐3D‐TE with RTVR were positive for LVT in 16 patients (53%), suspicious for LVT in 4 patients (13%), and negative for LVT in 10 patients (30%).

Conclusions

RT‐3D‐TE with RTVR offers dramatically clearer echocardiographic findings than does 2D‐TE. In particular, RT‐3D‐TE is able to provide a clear diagnosis of LVT/non‐LVT when 2D‐TE images are merely suggestive of the disorder. Therefore, RT‐3D‐TE with RTVR, which is a clinically feasible alternative to 2‐dimensional echocardiography, has great potential to positively affect the diagnosis, follow‐up, and care of patients with suspected LVT. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:412–418, 2003
Treatment of a radial artery pseudoaneurysm with ultrasound‐guided percutaneous thrombin injection in a patient with Behçet's syndrome
Authors: Reus Manuel , Vázquez Victoria , Alonso José , Morales Dolores , Rodríguez José M.
Published: September 2003

A 57‐year‐old man with Behçet's syndrome and recurrent deep vein thrombosis of the lower limbs presented with a painful, pulsating mass on the volar aspect of the radial edge of his left wrist. One month before this visit, he had had venous blood drawn from the same site. Using color Doppler sonography, we diagnosed an iatrogenic pseudoaneurysm of the left radial artery, which was then treated with an ultrasound‐guided percutaneous injection of thrombin. A follow‐up examination 6 months after the treatment revealed complete resolution of the pseudoaneurysm. To our knowledge, this is the first case report to demonstrate the use of this technique for thrombosis of a pseudoaneurysm in a patient with Behçet's syndrome. We believe that the safety, efficiency, speed, and minimal invasiveness of this procedure make it feasible for use as a treatment for peripheral pseudoaneurysms in such patients. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:440–444, 2003
Development of new methodologies for the mass spectrometry study of bioorganic macromolecules
Authors: Cristoni Simone , Bernardi Luigi Rossi
Published: September 2003

I.
Introduction
370

II.
Techniques That Are Usually Employed in the Study of Bioorganic Macromolecules
371

A. Proteins and Peptides
371

B. Oligonucleotides
374

C. Oligosaccharides and Glycoconjugates
375

D. Various Complexes (DNA–Protein, Antigen–Antibody, Macromolecules–Metals)
377

III.
Common Problems and Developments in the Analysis of Bioorganic Macromolecules by Mass Spectrometry
377

A.  Ionization Source Problems and Developments
377

    1.  Sensitivity
377

    2.  Problems with Buffers
379

    3.  Multicharge Effect
381

B.  Mass Analyzer Problems and Developments
381

    1.  Linear Dynamic Range
381

    2.  Tandem Mass Spectrometry
382

    3.  Sensitivity
382

    4.  Resolution
383

    5.  Mass Accuracy
383

IV.
New Promising Technologies
384

A.  Interfaces and Ionization Sources
384

    1.  Improvements in the Coupling of Liquid‐Phase Separation Systems to Mass Spectrometry
384

    2.  AP‐MALDI
384

    3.  Deprotonant Agents
385

    4.  Sonic Spray Ionization
388

    5.  APCI without Corona Discharge
391

B.  Mass Analyzers
393

    1.  Linear Quadrupole Ion Trap
394

    2.  TOF Analyzers with New Detectors
395

    3.  Multiple Mass Analyzers
396

 V.
Software for Data Treatment
397

 VI.
Conclusions and Future Developments
399

Acknowledgments

400

References

400

In recent years, mass spectrometry has been increasingly used for the analysis of various macromolecules of biological, biomedical, and biochemical interest. This increase has been made possible by two key developments: the advent of electrospray ionization (ESI) and matrix‐assisted laser desorption ionization (MALDI) sources. The two new techniques produce a significant increase in mass range and in sensitivity that led to the development of new applications and of new analyzer designs, software, and robotics. This review, apart from the description of the status of mass spectrometry in the analysis of bioorganic macromolecules, is mainly devoted to the illustration of the more recent promising techniques and on their possible future evolution. © 2003
Wiley Periodicals, Inc., Mass Spec Rev 22:369–406, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mas.10062
Non‐specific, on‐probe cleanup methods for MALDI‐MS samples
Authors: Xu Yingda , Bruening Merlin L. , Watson J. Throck
Published: September 2003

I.
Introduction
429

 II.
Decontamination with Films of Commercial Polymers
431

A.  Polyvinylidenedifluoride and Nitrocellulose
431

B.  Nylon
431

C.  Nafion
432

D.  Polyethylene (PE) and Polypropylene (PP)
432

E.  Polyurethane
432

F.  Paraffin and Teflon
432

G.  Ion‐Exchange Materials
433

III.
Decontamination with Thin Layers of Matrix Crystals
433

A.  Mechanism of Adsorption to Matrix Crystals
434

B.  Preparation of Desalting Matrix Crystals
434

    1.  Thin Layers of Matrix Crystals
434

    2.  Hydrophilic Spots of Matrix in Hydrophobic Polymer Layers
435

IV.
Decontamination with SAMs and Ultrathin Polymer Films
435

A.  Decontamination with Hydrophobic Interactions
435

B.  Decontamination with Electrostatic Interactions
436

C.  Patterned SAM/Polymer Films
437

  V.
Conclusions
438

Acknowledgments

438

References

438

High concentrations of contaminants such as salts and surfactants are often present in biological samples to solubilize or stabilize analytes such as proteins. Unfortunately, the presence of those contaminants often precludes direct analysis by MALDI‐MS. Selective adsorption of analytes directly on modified MALDI probes, followed by rinsing to remove contaminants, overcomes this problem. This review focuses on various modifications of MALDI probes to allow the adsorption of proteins and DNA, even in a large excess of salt or surfactant. Interfaces deposited on the MALDI probes to adsorb analytes include films of commercial polymers, thin layers of matrix crystals, self‐assembled monolayers, and ultrathin polymer films. Hydrophobic and ionic interactions both effect analyte adsorption on those interfaces, and patterned interfaces allow the concentration and purification of analyte molecules. © 2003 Wiley Periodicals, Inc., Mass Spec Rev 22:429–440, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mas.10064
Parallel computational strategies for structural optimization
Authors: Papadrakakis Manolis , Lagaros Nikolaos D. , Fragakis Yannis
Published: September 2003

The objective of this paper is to investigate the efficiency of various computational algorithms implemented in the framework of structural optimization methods based on evolutionary algorithms. In particular, the efficiency of parallel computational strategies is examined with reference to evolution strategies (ES) and genetic algorithms (GA). Parallel strategies are implemented both at the level of the optimization algorithm, by exploiting the natural parallelization features of the evolutionary algorithms, as well as at the level of the repeated structural analysis problems that are required by ES and GA. In the latter case the finite element solutions are performed by the FETI domain decomposition method specially tailored to the particular type of problems at hand. The proposed methodology is generic and can be applied to all types of optimization problems as long as they involve large‐scale finite element simulations. The numerical tests of the present study are performed on sizing optimization of skeletal structures. The numerical tests demonstrate the computational advantages of the proposed parallel strategies, which become more pronounced in large‐scale optimization problems. Copyright © 2003 John Wiley & Sons, Ltd.
Dispersion analysis of a non‐conforming finite element method for the Helmholtz and elastodynamic equations
Authors: Zyserman Fabio I. , Gauzellino Patricia M. , Santos Juan E.
Published: September 2003

We investigate the dispersive properties of a non‐conforming finite element method to solve the two‐dimensional Helmholtz and elastodynamics equations. The study is performed by deriving and analysing the dispersion relations and by evaluating the derived quantities, such as the dimensionless phase and group velocities. Also the phase difference between exact and numerical solutions is investigated. The studied method, which yields a linear spatial approximation, is shown to be less dispersive than a conforming bilinear finite element method in the two cases shown herein. Moreover, it almost halves the number of points per wavelength necessary to reach a given accuracy when calculating the mentioned velocities in both cases here presented. Copyright © 2003 John Wiley & Sons, Ltd.
Time‐decomposed parallel time‐integrators: theory and feasibility studies for fluid, structure, and fluid–structure applications
Authors: Farhat Charbel , Chandesris Marion
Published: September 2003

A methodology for squeezing the most out of massively parallel processors when solving partial differential evolution equations by implicit schemes is presented. Its key components include a preferred implicit time‐integrator, a decomposition of the time‐domain into time‐slices, independent time‐integrations in each time‐slice of the semi‐discrete equations, and Newton‐type iterations on a coarse time‐grid. Hence, this methodology parallelizes the time‐loop of a time‐dependent partial differential equation solver without interfering with its sequential or parallel space‐computations. It is particularly interesting for time‐dependent problems with a few degrees of freedom such as those arising in robotics and protein folding applications, where the opportunities for parallelization over the degrees of freedom are limited. Error and stability analyses of the proposed parallel methodology are performed for first‐ and second‐order hyperbolic problems. Its feasibility and impact on reducing the solution time below what is attainable by methods which address only parallelism in the space‐domain are highlighted for fluid, structure, and coupled fluid–structure model problems. Copyright © 2003 John Wiley & Sons, Ltd.
Fetal loss following ultrasound diagnosis of a live fetus at 6–10 weeks of gestation
Authors: Makrydimas G. , Sebire N. J. , Lolis D. , Vlassis N. , Nicolaides K. H.
Published: September 2003

Objective

To examine prospectively the value of demographic characteristics and ultrasound findings in the prediction of subsequent fetal loss in pregnancies with live fetuses at 6–10 weeks of gestation.

Methods

Transvaginal ultrasound examination was performed in 866 pregnancies at 6–10 weeks of gestation. The relation of demographic data and ultrasound findings at the time of the initial assessment to subsequent fetal loss was examined.

Results

In the 668 singleton pregnancies with live fetuses and complete follow‐up there were 50 (7.5%) fetal losses. The incidence of fetal loss increased significantly with maternal age and decreased with gestation. In the pregnancies resulting in fetal loss, compared to those with live births, the incidence of vaginal bleeding and cigarette smoking was higher, the fetal heart rate was significantly lower and the gestation sac diameter was smaller but the yolk sac diameter was not significantly different.

Conclusion

In pregnancies with a live fetus at 6–10 weeks' gestation the rate of subsequent fetal loss is related to maternal age, gestation, cigarette smoking, history of vaginal bleeding and the ultrasound findings of small gestation sac diameter and fetal bradycardia, relative to crown–rump length. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Spatio‐temporal image correlation (STIC): new technology for evaluation of the fetal heart
Authors: DeVore G. R. , Falkensammer P. , Sklansky M. S. , Platt L. D.
Published: September 2003

Spatio‐temporal image correlation (STIC) is a new approach for clinical assessment of the fetal heart. It offers an easy to use technique to acquire data from the fetal heart and to aid in visualization with both two‐dimensional and three‐dimensional (3D) cine sequences. The acquisition is performed in two steps: first, images are acquired by a single, automatic volume sweep. Second, the system analyzes the image data according to their spatial and temporal domain and processes an online dynamic 3D image sequence that is displayed in a multiplanar reformatted cross‐sectional display and/or a surface rendered display. The examiner can navigate within the heart, re‐slice, and produce all of the standard image planes necessary for a comprehensive diagnosis. The advantages of STIC for use in evaluation of the fetal heart are as follows: the technique delivers a temporal resolution which corresponds to a B‐mode frame rate of approximately 80 frames/s; it provides the examiner with an unlimited number of images for review; it allows for correlation between image planes that are perpendicular to the main image acquisition plane; it may shorten the evaluation time when complex heart defects are suspected; it enables the reconstruction of a 3D rendered image that contains depth and volume which may provide additional information that is not available from the thin multiplanar image slices (e.g. for pulmonary veins, septal thickness); it lends itself to storage and review of volume data by the examiner or by experts at a remote site; it provides the examiner with the ability to review all images in a looped cine sequence. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Uterine intramural bone after mid‐trimester termination of pregnancy may not affect fertility: a case report
Authors: Van den Bosch T. , Van Schoubroeck D. , Timmerman D. , Deprest J.
Published: September 2003

We present a case of a 27‐year‐old asymptomatic woman, gravida 2 para 0 abortus 2, diagnosed with uterine intramural fetal bone 30 days after a mid‐trimester termination of pregnancy (TOP) by dilatation and evacuation (D&E). On ultrasound part of a fetal spine was seen within the right lateral isthmocervical area, adjacent to the descending branch of the uterine artery. Within 4 months after TOP the patient conceived again. This case illustrates the risk of myometrial penetration during mid‐trimester TOP by D&E. Removal of intramural bony fragments may not be needed in an asymptomatic patient, as their presence does not seem to compromise fertility. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Acardiac twin: a systematic review of minimally invasive treatment modalities
Authors: Tan T. Y. T. , Sepulveda W.
Published: September 2003

This review of the literature aimed to determine pregnancy outcomes after minimally invasive treatment for occluding vascular supply to acardiac twins. A MEDLINE search was performed until 2002 using the terms ‘acardiac’, ‘acardius’, ‘twin reversed arterial perfusion (TRAP) sequence’ and ‘chorangiopagus parasiticus’ and 207 articles published in the English‐language literature were identified. These articles and the corresponding cited references in English were reviewed. We identified 32 reports involving 74 cases of acardiac twin treated by minimally invasive techniques. Seventy one cases were included for analysis including 40 treated by cord occlusion and 31 by intrafetal ablation. Cord occlusion was first attempted by embolization (n = 5), cord ligation (n = 15), laser coagulation (n = 10), bipolar diathermy (n = 7) and monopolar diathermy (n = 3). Intrafetal ablation was performed by alcohol (n = 5), monopolar diathermy (n = 9), interstitial laser (n = 4) and radiofrequency (n = 13). The overall median gestational ages at treatment and delivery were 21 (range, 14–28) weeks and 36 (range, 19–42) weeks, respectively, with a median treatment–delivery interval of 13 (range, 0–25) weeks. The overall pump twin survival rate was 76% (n = 54). Intrafetal ablation was associated with later median gestational age at delivery (37 vs. 32 weeks, P = 0.04) and higher median treatment–delivery interval (16 vs. 9.5 weeks, P = 0.02) compared with cord occlusion techniques. It was also associated with a lower technical failure rate (13% vs. 35%, P = 0.03), lower rate of premature delivery or rupture of membranes before 32 weeks (23% vs. 58%, P = 0.003) and higher rate of clinical success (77% vs. 50%, P = 0.02) than cord occlusion techniques. There were no statistically significant differences in terms of outcome between the subgroups of fetoscopic‐ or ultrasound‐guided cord occlusion techniques. This review suggests that intrafetal ablation is the treatment of choice for acardiac twins because it is simpler, safer and more effective when compared with the cord occlusion techniques. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
First‐trimester uterine artery blood flow and birth weight
Authors: Hollis B. , Prefumo F. , Bhide A. , Rao S. , Thilaganathan B.
Published: September 2003

Objectives

To determine reference values for first‐trimester uterine artery resistance index (RI) in healthy pregnant women with uncomplicated pregnancies and to investigate the relationship between uterine artery Doppler indices and birth weight.

Methods

This was a cross‐sectional study of 265 consecutive pregnant women attending routine ultrasound examination at 11–14 weeks' gestation. Both uterine arteries were identified using color Doppler ultrasound and the RI was measured. The presence or absence of an early diastolic notch was also noted. Pregnancy outcomes were obtained from the delivery suite database and birth weight was expressed as Z‐scores.

Results

The 5th, 50th and 95th centiles for uterine artery RI between 11 and 14 weeks' gestation were 0.53, 0.71 and 0.85, respectively. Complete pregnancy outcome data were available for 246 fetuses. There was a significant negative correlation between birth‐weight Z‐scores and first‐trimester uterine artery mean RI (r = − 0.219, P = 0.001). The difference in birth weight between fetuses with absent and those with bilateral diastolic notches was also significant (P < 0.001). Multiple regression analysis demonstrated that both mean RI (standardized regression coefficient = − 0.14, P = 0.039) and uterine artery notching (standardized regression coefficient = − 0.17, P = 0.017) contributed independently towards the prediction of birth‐weight Z‐score.

Conclusions

A significant negative correlation exists between birth weight and first‐trimester uterine artery Doppler parameters, a reliable and non‐invasive method of examining uteroplacental perfusion. The value of first‐trimester uterine artery Doppler as a prognostic screening tool, either in isolation or in conjunction with maternal biochemistry, remains to be determined. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Retrograde aortic isthmus net blood flow and human fetal cardiac function in placental insufficiency
Authors: Mäkikallio K. , Jouppila P. , Räsänen J.
Published: September 2003

Objective

Retrograde aortic isthmus (AoI) net blood flow has been associated with diminished oxygen delivery to cerebral circulation. This study was designed to characterize the cardiac function in human fetuses with retrograde AoI net blood flow in pregnancies complicated by placental insufficiency.

Methods

The control group comprised 43 fetuses in uncomplicated pregnancies. Study groups consisted of fetuses with placental insufficiency, and either antegrade (Group 1; n = 18) or retrograde (Group 2; n = 11) AoI net blood flow. Volume blood flows (Q) of left (LVCO) and right (RVCO) ventricles, ductus arteriosus (QDA), pulmonary arterial bed (QP) and foramen ovale (QFO) were calculated and their proportions (%) of combined cardiac output (CCO) were determined. Ventricular ejection forces were calculated. Blood velocity waveforms of the mitral (MV) and tricuspid (TV) valves were obtained. The proportion of left ventricular isovolumetric relaxation time (IRT%) of the cardiac cycle, and index of myocardial performance (IMP) were calculated.

Results

In Group 1, QDA% was increased (P < 0.05) and QP% decreased (P < 0.05) compared with the control group, and QFO% was greater (P < 0.01) compared with the control group and Group 2. In Group 2, the distribution of CCO did not differ from that of the control group. Ventricular ejection forces were similar among the groups. In Group 2, the MV early filling/atrial contraction time‐velocity integral ratio was greater (P < 0.05) compared with those of the control group and Group 1. In Groups 1 and 2, IRT% and IMP were increased (P < 0.001) compared with the control group.

Conclusions

In placental insufficiency, fetuses with antegrade AoI net blood flow show a shift in RVCO from the pulmonary to the systemic circulation, and QFO makes up the majority of LVCO. Fetuses with retrograde AoI net blood flow fail to demonstrate these changes, suggesting a relative drop in the oxygen content of the blood entering the left ventricle. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
The role of the three vessels and trachea view (3VT) in the diagnosis of congenital heart defects
Authors: Viñals F. , Heredia F. , Giuliano A.
Published: September 2003

Objective

To analyse the anomalies seen at the three vessels and trachea (3VT) view in fetuses with antenatally diagnosed congenital heart disease (CHD), specifically in defects involving the upper mediastinum, including the outflow tracts and/or arteries.

Methods

Seventy‐four consecutive fetuses of singleton pregnancies with antenatally diagnosed structural heart defects were initially included in the study. We selected those in which there was an anomaly seen on the 3VT view and classified them into groups: abnormalities detected on the upper mediastinum (abnormal vessel size, alignment, arrangement and number), abnormal location of the transverse aortic arch in relation to the trachea, and abnormal functional behavior of the arterial vessels (reversed flow and turbulent flow) detected using color Doppler. The abnormalities detected were confirmed postnatally by a pediatric cardiologist, echocardiography and/or autopsy.

Results

Thirty‐four of the 74 fetuses showed an abnormal 3VT view that could be classified into one of the groups. We classified the lesions according to the most evident abnormal finding during the examination. Gestational age ranged from 17 to 39 (mean, 30) weeks. Abnormal vessel size was found in 20 of the 74 fetuses, abnormal vessel alignment was found in two fetuses, and abnormal vessel arrangement in three fetuses. Two vessels instead of three were found in five fetuses and four vessels were found in two fetuses. Abnormal visualization of the trachea, between the pulmonary artery and the transverse arch, occurred in one fetus with isolated right aortic arch. We found reversed flow in the transverse aortic arch in three fetuses with aortic atresia and in two fetuses with severe coarctation of the aorta. Reversed flow in the pulmonary trunk was seen in a fetus with pulmonary atresia and double outlet right ventricle. Turbulent flow was found in two fetuses with outflow tract stenosis.

Conclusion

Our study, descriptive in nature, demonstrates that the 3VT view is a reliable method with which to determine abnormalities in the upper mediastinum. It proved to be efficient in identifying an important group of critical heart defects involving the outflow tracts and the aortic arch. It also provided important clues to the diagnosis of minor anomalies considered as markers of other CHD. We believe that use of the 3VT view should become routine in screening for CHD. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Spatio‐temporal image correlation (STIC): a new tool for the prenatal screening of congenital heart defects
Authors: Viñals F. , Poblete P. , Giuliano A.
Published: September 2003

Objective

To assess the feasibility and capability of STIC acquisition, performed by a general obstetrician performing antenatal ultrasound, to visualize fetal cardiac structures in women undergoing routine obstetric ultrasound examination, in order to obtain information to confirm normality of the fetal heart during intrauterine life.

Methods

This was a prospective study of one hundred fetuses with echocardiographically confirmed normal hearts and no extracardiac anomalies with gestational ages ranging between 18 and 37 weeks. A general obstetrician was invited to acquire the STIC volumes. The four‐chamber view was obtained as a starting point. A standard 7.5‐s acquisition time and 30° angle of acquisition were used and the resulting STIC was stored for later offline analysis by a fetal echocardiologist. For each patient, the stored STIC data were first evaluated by sweeping from the initial acquisition plane, in the caudal direction and then cranially, zooming, slowing or stopping the cardiac motion to visualize views and structures. If a structure or view was rated as inadequate or not identifiable, a multiplanar three‐dimensional (3D) examination of the STIC volume was taken in order to try to visualize it adequately. The rates obtained using just the STIC sweeps were compared independently, and then the 3D multiplanar study was added.

Results

STIC acquisition was possible in all cases. The mean time required for STIC acquisition was 7.5 min. A complete cardiac examination according to the set criteria was achieved in 94.2% (95% confidence interval (CI), 90–99) of cases. We obtained a 94.2% success rate of visualizing different structures and views of the fetal heart using the STIC sweep alone (95% CI, 90–99) and 96.2% adding 3D multiplanar examination (95% CI, 92–100).

Conclusion

STIC acquisition of the fetal heart is feasible with high success rates in visualization of the principal connections. The STIC data acquired by a general obstetrician can subsequently be used by a fetal echocardiologist for prenatal confirmation of normal cardiac structure or exclusion of major cardiac malformations. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
In Search of the Lost Mode: Improvisation and All That Jazz
Authors: Barker Clive
Published: September 2003

Years ago, NTQ co-editor Clive Barker was tantalized by a passing and lost reference on a radio programme to a source of inspiration for musicians of the Be Bop generation: this had showed them ‘a way forward by taking them away from music based on chords and riffs to music based on modes’. Can acting aspire to an analogous state to the improvisations of jazz musicians, in which spontaneity is modulated by the discipline of true respect for the ensemble? Drawing on his own experience as an actor with Theatre Workshop – whose orchestration came close to that of jazz – and on teaching actors to break down inhibitions through the work described in his seminal Theatre Games (1977), Clive Barker looks towards a ‘next step’ in actor training and rehearsal techniques. This would work towards integrating the controlled freedom of jazz with the results he knows can be achieved through his own work with actors – the creation of ‘great and beautiful physical poetry in small rooms’. Oh – and can anyone offer a lead towards that elusive book which inspired the jazz musicians of the 'forties?
Still In-Yer-Face? Towards a Critique and a Summation
Authors: Sierz Aleks
Published: September 2003

The dramatic upsurge of contemporary new writing on British stages in the past decade, and the emergence of a fresh generation of playwrights led by such talents as Mark Ravenhill, Philip Ridley, Joe Penhall, Phyllis Nagy, Patrick Marber, and the late Sarah Kane, has been variously characterized as the ‘New Brutalism’ or even, in Germany, as the ‘Blood and Sperm Generation’. Here, Aleks Sierz summarizes the argument for ‘In-Yer-Face Theatre’ as the most pertinent and inclusive description for the phenomenon, listing its salient characteristics and suggesting the areas in which it is most vulnerable to criticism. Aleks Sierz is theatre critic of Tribune and writes about theatre for several publications. He is the author of In-Yer-Face Theatre: British Drama Today (London: Faber, 2001) and teaches journalism at Goldsmiths College, University of London. An earlier version of this article was given as a paper at the In-Yer-Face Theatre: Sarah Kane and the New British Dramaturgy conference at Stendhal University 3, Grenoble, in May 2001.
The RSC Goes Walkabout: ‘The Dillen’ in Stratford, 1983
Authors: Prentice Catherine , Leongamornlert Helena
Published: September 2003

This article describes and analyzes Barry Kyle's production of The Dillen, a community project staged by the RSC in 1983, in which The Other Place became no more than a base from which the play, its actors, and its audiences set out into the streets, fields and river in Stratford, to re-enact the life of a working-class Stratford man, George Hewins, born around a century earlier. In addition to placing the play in its social, political, and local context, the authors raise questions about the implications of the production for the RSC and the people of Stratford today. The kernel of this article was part of an English M.A. dissertation by Catherine Prentice at the University of Warwick in Summer 1998, supervised by Tony Howard. Catherine Prentice and Helena Leongamornlert, a University of Warwick graduate in English and American Literature, have collaborated in further research and interviews to present the version which follows, and both plan further work on community drama. The authors extend their grateful thanks to Tony Howard for his support and advice.
After Grotowski – the Next Generation
Authors: Allain Paul
Published: September 2003

In NTQ62, Joanna Ostrowska reported on Grotowski's last visit to his native Poland before his death in 1999. Here, Paul Allain assesses the Grotowksi inheritance in Pontedera, Italy, which had been the base for Grotowski's research since 1986 – specifically, on the second Generazioni International Theatre Festival, held there in June 2001. Paul Allain's doctoral research on the Gardzienice company took him to Poland during the years of ferment around the fall of Communism. He is presently Senior Lecturer in Drama in the University of Kent, and was co-editor of the recent Cambridge Companion to Chekhov.