bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostate Boundary Detection From Ultrasonographic Images
Authors: Shao Fan , Ling Keck Voon , Ng Wan Sing , Wu Ruo Yun
Published: January 2017

Objective. Prostate diseases are very common in adult and elderly men, and prostate boundary detection from ultrasonographic images plays a key role in prostate disease diagnosis and treatment. However, because of the poor quality of ultrasonographic images, prostate boundary detection still remains a challenging task. Currently, this task is performed manually, which is arduous and heavily user dependent. To improve the efficiency by automating the boundary detection process, numerous methods have been proposed. We present a review of these methods, aiming to find a good solution that could efficiently detect the prostate boundary on ultrasonographic images. Methods. A full description of various methods is beyond the scope of this article; instead, we focus on providing an introduction to the different methods with a discussion of their advantages and disadvantages. Moreover, verification methods for estimating the accuracies of the algorithms reported in the literature are discussed as well. Results. From the investigation, we summarize several key issues that might be confronted and project possible future research. Conclusions. Those model‐based methods that minimize user involvement but allow for interactive guidance of experts will likely be most immediately successful.
Variation of Fetal Humeral Length in Second‐Trimester Fetuses According to Race and Ethnicity
Authors: Zelop Carolyn M. , Borgida Adam F. , Egan James F. X.
Published: January 2017

Objective. To determine the influence of race and ethnicity on the expected humeral length based on biparietal diameter measured in second‐trimester fetuses. Methods. We searched our ultrasound, obstetric, and cytogenetic databases from 1995 through 2001 for all fetuses who underwent an anatomic survey between 15 and 22 weeks' gestation. Fetuses with Down syndrome were identified and removed for separate analysis. Linear regression curves were generated for humeral length by biparietal diameter according to race and ethnicity. Analysis of variance was used to compare the mean variation of observed from expected humeral length by biparietal diameter according to race and ethnicity. Results. There were 11,278 humeral length‐by‐biparietal diameter pairs that were available for analysis in our population, including 4202 African American, 2269 Hispanic, 639 Asian, and 4168 white fetuses. Humeral length was highly correlated with biparietal diameter for each race (R2 = 0.8). There were no differences in mean variances according to race or ethnicity (P = .75). Conclusions. Race and ethnicity do not affect the mean regression line of expected humeral length by biparietal diameter among fetuses in the second trimester. Genetic sonographic norms, therefore, do not require race‐ or ethnic‐specific formulas for humeral length.
Second‐Trimester Sonographic Diagnosis of Diastrophic Dysplasia
Authors: Wax Joseph R. , Carpenter Molly , Smith Wendy , Grimes Charles , Pinette Michael G. , Blackstone Jacquelyn , Cartin Angelina
Published: January 2017

Objective. To describe the sonographic features of diastrophic dysplasia in 2 second‐trimester index offspring.Methods. Real‐time sonography was performed on 2 second‐trimester fetuses with no risk factors for skeletal dysplasia.Results. Each fetus had severe bilateral upper and lower extremity long bone shortening, hitchhiker thumbs and great toes, and clubbed feet, indicating a diagnosis of diastrophic dysplasia.Conclusions. Index cases of diastrophic dysplasia may be correctly diagnosed on the basis of second‐trimester sonography.
Hepatocellular Carcinoma
Authors: Kim Kyoung Won , Choi Byung Ihn , Park Seong Ho , Kim Hyo-Cheol , Lee Min Woo , Kim Se Hyung , Lee Kyoung Ho , Park Choong Hun , Kim Jae Soo , Won Hyung-Jin , Han Joon Koo
Published: January 2017

Objective. To evaluate the hemodynamic features of hepatocellular carcinoma on single‐level dynamic ultrasonography during the arterial phase. Methods. Twenty‐two hepatocellular carcinomas were examined by single‐level dynamic ultrasonography with high transmit intensity and SH U 508A. The scans were performed for 40 seconds with a 1‐second interval between each ultrasound transmission and with individual optimization of the scan delay time. The times of initiation of enhancement for both the hepatic artery and the tumor and the time of maximal enhancement for the tumor were recorded, and the mean echo values at every second for the tumor and hepatic parenchyma were measured. Results. Twelve tumors showed hyperechoic enhancement compared with hepatic parenchyma throughout the scans. The other 10 showed hyperechoic enhancement during some segments (range, 8–34 seconds) and either isoechoic (n = 5) or hypoechoic (n = 5) enhancement during the remaining parts; the hyperechoic segments were often short (<20 seconds, 14%). Although the times for initiation of enhancement for the hepatic artery and hepatocellular carcinoma and the time of maximal enhancement for the tumor varied, the tumor usually initiated enhancement immediately after the hepatic artery (r = 0.986; P = .000001). The interval between the time of initiation of enhancement for the tumor or hepatic artery and that of maximal enhancement for the tumor was significantly correlated with the tumor size (r = 0.700; P = .008; and r = 0.780; P = .002). Conclusions. With individual optimization of the scan delay time, single‐level dynamic ultrasonography is useful for depicting the hypervascularity of hepatocellular carcinoma during the arterial phase.
Therapeutic Response Evaluation of Malignant Hepatic Masses Treated by Interventional Procedures With Contrast‐Enhanced Agent Detection Imaging
Authors: Youk Ji Hyun , Lee Jeong Min , Kim Chong Soo
Published: January 2017

Objective. To assess the usefulness of microbubble contrast‐enhanced agent detection imaging in evaluating the therapeutic response of malignant hepatic masses to treatment with interventional procedures. Methods. Fifty‐eight patients with 68 hepatocellular carcinomas and 6 metastases who were treated with interventional procedures were evaluated with SH U 508A‐enhanced agent detection imaging and helical computed tomography. Helical computed tomography was also performed to help establish the outcome of therapy with unenhanced computed tomography 2 weeks after transcatheter arterial chemoembolization and with dynamic contrast‐enhanced computed tomography 1 day after radio frequency ablation or percutaneous ethanol injection. The studies were reviewed separately and randomly, and the sensitivity and specificity of agent detection imaging for detection of viable tumor residue were determined by follow‐up imaging performed at least 3 months later. Results. Follow‐up computed tomography or magnetic resonance imaging revealed complete tumor responses in 44 (59.5%) of 74 cases after the therapeutic procedures. The sensitivity of agent detection imaging was 94.7% after transcatheter arterial chemoembolization and 72.7% after radio frequency ablation and percutaneous ethanol injection. The specificity of agent detection imaging for the detection of residual tumors was 80% after transcatheter arterial chemoembolization and 79.2% after radio frequency ablation and percutaneous ethanol injection. The false‐positive rate for agent detection imaging in cases of radio frequency ablation or percutaneous ethanol injection was 20.8% (5 of 24), resulting from reactive hyperemia or vascularity within the safety margin. In the assessment of the therapeutic effects, the concordance of contrast‐enhanced agent detection imaging with helical computed tomography was statistically significant after transcatheter arterial chemoembolization (P < .00001) and radio frequency ablation or percutaneous ethanol injection (P < .02). Conclusions. Contrast‐enhanced agent detection imaging proved useful and as effective as helical computed tomography for evaluating the therapeutic effects of interventional therapeutic procedures for malignant hepatic masses.
Variable Breast Conditions
Authors: Kwak Jin Young , Kim Eun-Kyung , You Jai Kyung , Oh Ki Keun
Published: January 2017

Objectives. To illustrate and compare the appearances of variable breast conditions by conventional and real‐time spatial compound images. Methods. Cases illustrative of a broad range of breast conditions were collected. Each image pair consisted of conventional and real‐time compound images with a stationary probe to maintain an identical projection. Results. The various breast conditions, including normal anatomic structures and abnormal lesions, were evaluated and compared by conventional and real‐time compound images. The real‐time compound images revealed more realistic and clear images with reduced artifacts. Conclusions. Real‐time compound images are superior to conventional images of normal and abnormal breast conditions. Real‐time compound imaging is a good technique for evaluating the breast state.
First‐Trimester Sonographic Diagnosis of Holoprosencephaly
Authors: Sepulveda Waldo , Dezerega Victor , Be Cecilia
Published: January 2017

Objective. To study the value of choroid plexus dysmorphology as a screening tool for the first‐trimester sonographic diagnosis of holoprosencephaly in a high‐risk population. Methods. A total of 378 consecutive pregnancies undergoing chorionic villus sampling between 11 and 14 weeks' gestation were scanned before the procedure, following the recommendations of the Fetal Medicine Foundation (London, England). A cross‐sectional view of the fetal brain, including the visualization of both choroid plexuses (the “butterfly” sign), was obtained in all cases. Results. There were 3 cases in which the butterfly sign was not identified. In these cases, the first‐trimester diagnosis of holoprosencephaly was confirmed by the presence of a single monoventricular cavity and fused thalami. Two of these fetuses had features of facial dysmorphism at the time of presentation and 2 had extracranial anomalies, including a cystic hygroma in 1 and a small omphalocele and polydactyly in another. Chromosomal analysis showed trisomy 13 in 2 cases and a ring chromosome 13 in the other. Conclusions. This series suggests that failure to identify the butterfly sign is a warning sign of holoprosencephaly in the first trimester. Systematic identification of the butterfly sign at the time of sonographic assessment of nuchal translucency provides a valuable tool for the early screening of holoprosencephaly.
Angiographic Power 3‐Dimensional Quantitative Analysis in Gynecologic Solid Tumors
Authors: Testa Antonia Carla , Mansueto Donata , Lorusso Domenica , Fruscella Erika , Basso Danila , Scambia Giovanni , Ferrandina Gabriella
Published: January 2017

Objective. To determine the reproducibility of a simplified method of power Doppler 3‐dimensional (3D) sonographic examination. Methods. Twenty‐nine patients with solid pelvic masses underwent transvaginal 3D power Doppler evaluation. The volume of interest was obtained by drawing the margins of the largest section of the mass in the 3 orthogonal planes. The 3D vascular parameters (“relative color,” “average color,” and “flow measure”) obtained by our method were compared with those calculated by a manufacturer‐suggested model based on several parallel section planes drawn on the longitudinal frames. The intraobserver variability was quantified on 5 different 3D images acquired by the same operator at 5‐minute intervals for each patient. The intraobserver variability was also assayed in 10 patients at 24‐hour intervals. Ten patients were scanned by a second sonographer for interobserver variability. Results. There was high agreement between the 3D parameters obtained with the 2 methods. The 3D indices were similar in repeated observations at 5‐minute intervals (median coefficients of variation for relative color, average color, and flow measure, 10.9, 4.5, and 13.0, respectively) and at 24‐hour intervals (intraclass correlation coefficients for relative color, average color, and flow measure, 0.920, 0.978, and 0.978) and by the second sonographer (interclass correlation coefficients for relative color, average color, and flow measure, 0.978, 0.966, and 0.997). Conclusions. The acceptable rates of intraobserver and interobserver variability make this approach potentially suitable for research protocols.
Renal Artery Duplex Ultrasonography as a Screening and Surveillance Tool to Detect Renal Artery Stenosis
Authors: Soares Gregory M. , Murphy Timothy P. , Singha Malwinder S. , Parada Andrea , Jaff Michael
Published: January 2017

Objective. Digital subtraction angiography quantitative vessel analysis (QVA) to assess percent renal arterial stenosis (RAS) is the reference standard. Quantitative vessel analysis is not ideal for screening purposes. Renal artery duplex ultrasonography (RADUS) is a noninvasive method to screen for RAS using well‐known parameters. We investigated the direct correlation between several RADUS parameters and QVA to evaluate the acceptability of RADUS as a RAS screening and surveillance tool. Methods. We performed a multicenter retrospective study. Stenoses were evaluated in all patients with arteriograms and RADUS examinations within 30 days of each other in the span of 1 year. Percent stenosis of each stenotic renal artery segment was calculated digitally with QVA and correlated with the corresponding peak systolic velocity (PSV) and renal‐aortic ratio (RAR) obtained with RADUS. Descriptive statistics and receiver operating characteristic curves were calculated. Correlation of percent stenosis, PSV, and RAR was performed. Sensitivity, specificity, and accuracy of diagnostic cut points for each RADUS parameter were calculated. Results. Sixty‐seven renal arteries were included. Thirty‐three arteries had less than 60% stenosis; 34 had stenosis of 60% or greater. The mean values were PSV, 272.791 cm/s; RAR, 3.716; and angiographic percent stenosis, 51.731%. Receiver operating characteristic curves showed higher accuracy for RAR with stenoses of 60% or greater versus PSV. Conclusions. Renal artery duplex ultrasonographic parameters for 60% or greater RAS correlate well with QVA. For detecting stenosis of 60% or greater, RAR is the most accurate parameter at a threshold of 2.5. Renal‐aortic ratio is more accurate than PSV. Peak systolic velocity may be a useful RADUS alternative parameter for hemodynamically important stenoses in the setting of aortic disease when aortic velocities are less than 40 or greater than 100 cm/s.
Congenital Jejunal and Ileal Atresia
Authors: Wax Joseph R. , Hamilton Thomas , Cartin Angelina , Dudley Janice , Pinette Michael G. , Blackstone Jacquelyn
Published: January 2017

Objective. The purpose of this study was to describe the prenatal sonographic features and natural course of congenital jejunal and ileal atresia and correlate the findings with neonatal outcomes. Methods. We identified all neonates with surgically confirmed jejunal or ileal atresia that had prenatal sonography and neonatal surgery in our center from January 1, 1995, to April 1, 2005. Sonography reports and images were reviewed, without knowledge of neonatal outcomes, for features of intestinal obstruction. Obstetric and neonatal outcomes were evaluated. Results. Fifteen (60%) of 25 offspring with atresias (10 jejunal, 4 ileal, and 1 jejunoileal) had sonography, of which 13 (86.6%) had features of atresia. Findings, number of affected fetuses, and gestational age at recognition included fetal echogenic bowel (n = 8), mean ± SD, 21.3 ± 3.8 weeks (range, 17.7–28.4 weeks); enlarged stomach (n = 5), 27.5 ± 5.0 weeks (range, 22.0–34.3 weeks); dilated bowel (n = 13), 27.8 ± 5.8 weeks (range, 18.3–35.9 weeks); and polyhydramnios (n = 6), 33.3 ± 1.7 weeks (range, 31.0–35.6 weeks). No fetus with ileal atresia had an enlarged stomach or polyhydramnios. Delivery occurred at a mean of 34.7 ± 3.6 weeks, with 9 (60%) cesarean deliveries. Neonatal outcomes of age at surgery, neonatal intensive care unit days, hospital days, total parenteral nutrition days, and death were similar whether or not fetal echogenic bowel, enlarged stomach, dilated bowel, or polyhydramnios was present. Likewise, these outcomes did not vary by type of atresia or time of diagnosis (prenatal or neonatal). Conclusions. Jejunal and ileal atresia have specific sonographic patterns allowing specific prenatal diagnoses in most affected fetuses. Prenatal sonographic findings and time of diagnosis did not affect neonatal outcome.
A Nomogram of Fetal Lung Volumes Estimated by 3‐Dimensional Ultrasonography Using the Rotational Technique (Virtual Organ Computer‐Aided Analysis)
Authors: Ruano Rodrigo , Joubin Laurence , Aubry Marie-Cécile , Thalabard Jean-Christophe , Dommergues Marc , Dumez Yves , Benachi Alexandra
Published: January 2017

Objective. The purpose of this study was to build a nomogram of normal fetal lung volumes throughout gestational age estimated by 3‐dimensional ultrasonography using the rotational technique (Virtual Organ Computer‐Aided Analysis [VOCAL]; GE Healthcare, Kretztechnik, Zipf, Austria). Methods. Fetal lung volume was assessed in 146 healthy fetuses by 3‐dimensional ultrasonography using the technique of rotation of the multiplanar imaging (VOCAL). Inclusion criteria were healthy women with singleton normal pregnancies, normal fetal morphologic ultrasonographic findings, reliable dating established by dates and by ultrasonographic measurement of the crown‐lump length in the first trimester, and gestational age from 20 to 37 weeks. Exclusion criteria were discordance between clinical and ultrasonographic dating, patients lost to follow‐up, and birth weight disorders. Each patient was scanned once during pregnancy. Results. The right, left, and total mean pulmonary volumes ranged, respectively, from 5.37, 4.66, and 9.95 cm3 at 20 weeks to 46.06, 37.34, and 84.35 cm3 at 37 weeks. The logistic transformation analysis yielded the following formulas: right lung volume = exp(4.07/[1 + exp(21.90 − gestational age/5.44)]); left lung volume = exp(3.82/(1 + exp[22.03 − gestational age/5.17)]); and, total lung volume = exp(4.72/[1 + exp(20.30 − gestational age/6.05)]). Conclusions. A new nomogram of fetal lung (right, left, and total) volumes throughout gestational age using the rotational technique (VOCAL) is described, and reference values have been generated.
Megacystis‐Microcolon‐Intestinal Hypoperistalsis Syndrome
Authors: Hidaka Nobuhiro , Kawamata Kazuya , Chiba Yoshihide
Published: January 2017

Objective. The purpose of this report is to describe the in utero sonographic appearance of megacystis‐microcolon‐intestinal hypoperistalsis syndrome (MMIHS) and examine the role of vesicocentesis. Methods. Two cases of the sonographic appearance of MMIHS were reviewed. We performed vesicocentesis in 2 fetuses with MMIHS and performed vesicoamniotic shunting in 1 of them. The sonographic findings after these procedures were compared with those before puncture. Results. In both cases, ultrasound examination showed a massively enlarged fetal bladder and bilateral hydroureteronephrosis with a normal amount of amniotic fluid. Fetal urinary sodium and chloride concentrations were within normal limits in both cases; this suggested normal fetal renal function. Generally, it is difficult to detect the dilated fetal bowel in MMIHS, probably because of the disturbance caused by a large bladder. In our cases, however, the ultrasound examination clearly showed fetal bowel dilatation after these procedures; this made the antenatal diagnosis of MMIHS more definite. Conclusions. The sonographic features after vesicocentesis may be helpful in confirming the antenatal diagnosis of MMIHS.
Serial Transvaginal Sonographic Findings of Cervical Ectopic Pregnancy Treated With High‐Dose Methotrexate
Authors: Song Mi Jin , Moon Min Hoan , Kim Jeong-Ah , Kim Tae Jin
Published: January 2017

Objective. We analyzed transvaginal sonographic findings from patients with cervical ectopic pregnancies treated with high‐dose methotrexate (MTX). Methods. This was a retrospective analysis of cervical pregnancies diagnosed in our institution from 1996 through 2006. We divided the cases into an MTX treatment group and a surgical treatment group. We included cases treated with high‐dose MTX alone. We analyzed 9 cervical ectopic pregnancies treated with MTX, which was injected intravascularly at 100 mg/m2 plus 200 mg/m2 in 500 mL of a normal saline solution with folinic acid rescue. The gestational sac sizes and serum human chorionic gonadotropin (hCG) levels were periodically monitored to determine the resolution status. Results. Fifty cervical pregnancies were diagnosed during the study period. Thirty cases were treated with MTX, and 20 were treated with surgical procedures. Among the 30 cases in the MTX treatment group, 9 had high‐dose MTX injection without surgical procedures. Cervical mass regression appeared at a median of 40 (range, 10–88) days after treatment, whereas the serum hCG level decreased at a median of 14 (range, 9–17) days after treatment. The median time to complete regression of the cervical mass was 86 (range, 48–141) days, and the median time to complete regression of the serum hCG level was 68 (range, 19–143) days. Cervical pregnancy was noted as a gestational sac at first but coexisted with a mixed echoic lesion 19 days after treatment. At 33 days after treatment, the cervical pregnancy was completely replaced by the mixed echoic lesion. Conclusions. Resolution of the cervical mass on sonography lagged far behind resolution of the serum hCG level. The cervical mass evolved from a gestational sac into a mixed echoic lesion on serial transvaginal sonography.
Aorta Larger Than Pulmonary Artery in the Fetal 3‐Vessel View
Authors: Rollins Robert C. , Acherman Ruben J. , Castillo William J. , Evans William N. , Restrepo Humberto
Published: January 2017

Objective. Fetal great artery asymmetry may accompany congenital heart disease. The fetal echocardiographic 3‐vessel view (3VV) allows assessment of the superior vena cava, ascending aorta (AA), and main pulmonary artery (MPA). Our aim was to determine the association of congenital heart disease in fetuses with an AA/MPA ratio of greater than 1. Methods. We electronically searched our fetal echocardiographic database for studies performed between March 2002 and January 2008 that showed 3VVs with AA/MPA ratios of greater than 1 and correlated the findings with the presence of congenital heart disease. Results. In 2797 fetal echocardiograms, we identified 31 fetuses with normal 4‐chamber views showing AA/MPA ratios of greater than 1 in the 3VV. Of 31 fetuses, 25 (81%) had tetralogy of Fallot (ToF) or a ToF variant, and 6 (19%) had an aortic valve abnormality or isolated dilatation of the AA. Conclusions. Screening obstetric fetal sonography showing a 3VV AA/MPA ratio of greater than 1 suggests congenital heart disease and indicates the need for comprehensive fetal echocardiography.
Methylene Blue Dye–Related Changes in the Breast After Sentinel Lymph Node Localization
Authors: Kang Seok Seon , Han Boo-Kyung , Ko Eun Young , Shin Jung-Hee , Cho Eun Yoon , Lee Jeong Eon , Nam Seok Jin , Yang Jung-Hyun
Published: January 2017

Objectives

The purpose of this study was to investigate the frequency and appearance of changes in the breast on sonography in patients after breast cancer surgery including sentinel lymph node localization using methylene blue dye.

Methods

Three hundred thirty‐seven consecutive patients who underwent breast‐conserving surgery in 2006 underwent breast sonography during 2 years after surgery. Sentinel lymph node localization using methylene blue dye was selectively performed. We retrospectively analyzed the unexplained focal lesions not at the lumpectomy site on sonography and investigated whether these findings were associated with sentinel lymph node localization.

Results

Unexplained focal lesions were identified in 36 (14.1%) of 256 patients who had undergone sentinel lymph node localization. The lesions were in the periareolar region (n = 26; outer in 16, upper in 6, inner in 2, and lower in 2) or the retroareolar region (n = 10). The lesion appeared with a fat necrosis–like pattern in the subcutaneous fat layer in 24 (66.7%) or as an irregular mass in the glandular layer in 12 (33.3%). The unexplained focal lesions were pathologically proven benign (n = 10) or were improved or stable during 2 years of imaging follow‐up after surgery (n = 26). The unexplained focal lesions in 2 (2.5%) of 81 patients without sentinel lymph node localization were in the nonareolar region, and 1 of these was a recurrence.

Conclusions

After sentinel lymph node localization using methylene blue dye, breast sonography can show unexplained focal lesions in the periareolar and retroareolar regions. Although most of the changes suggest fat necrosis, an irregular parenchymal mass can develop and mimic a recurrence.
Fracture Status in Men Assessed by Quantitative Ultrasound Measurements at the Calcaneus
Authors: Pluskiewicz Wojciech , Wilk Robert , Wielgórecki Artur , Gołba Krzysztof S. , Drozdzowska Bogna
Published: January 2017

Objectives

The aim of the study was to assess fracture status in men by quantitative ultrasound measurements at the calcaneus. The diagnostic accuracy of quantitative ultrasound measurements was evaluated at baseline and follow‐up.

Methods

We observed 165 men (baseline age ± SD, 59.84 ± 10.6 years) recruited from an outpatient osteoporosis clinic. The mean follow‐up duration was approximately 101.3 ± 35 months. There was no difference in either age or body mass index at baseline between the patients with a fracture history (n = 30) and the others (n = 135). The following fractures were identified at baseline: ankle, 15; wrist, 10; rib, 9; foot, 5; and hip, 1. The speed of sound (meters per second), broadband ultrasound attenuation (decibels per megahertz), and stiffness index (percent) were measured with a quantitative ultrasound device. The date of fracture occurrence at follow‐up was defined as the final point.

Results

In the patients with a fracture history, the ultrasound variables were significantly lower than those in the rest of the group (P < .05). During the follow‐up period, fractures occurred in 21 patients (wrist, 11; ankle, 5; rib, 3; hip, 1; and humerus, 1), and the ultrasound outcomes were nonsignificantly lower in the fractured men. The risk of fracture was estimated by the Cox regression analysis. A prior fracture was the only factor that significantly (4 times) increased the risk of a subsequent fracture (hazard ratio, 4.21; 95% confidence interval, 1.81–9.86; P < .001).

Conclusions

Calcaneus ultrasound measurements can distinguish between patients with fractures and those without. In follow‐up, ultrasound measurements did not indicate an increased fracture risk; a prior osteoporotic fracture was the major prognostic factor.
Stage IA Ovarian Cancers
Authors: Hirai Makiko , Hirai Yasuo , Tsuchida Tomohiro , Takada Toshio , Iwase Haruko , Utsugi Kuniko , Sugiyama Yuko , Takeshima Nobuhiro , Furuta Reiko , Takizawa Ken
Published: January 2017

Objectives

The purpose of this study was to compare sonographic findings and histopathologic types of stage IA ovarian cancers between groups with normal and elevated cancer antigen 125 (CA‐125) levels.

Methods

Between 2000 and 2009, 146 stage IA ovarian cancers were treated surgically (85 invasive and 61 borderline, 73 self‐referred with tumor‐related symptoms, 20 self‐referred with nonspecific symptoms, 52 identified through screening, and 1 other). Of these, 87 cases (60%) had normal serum CA‐125 levels (<35 U/mL). Their pre‐operative sonographic findings and histopathologic types were compared to those of cases with elevated CA‐125 levels.

Results

Statistically significant differences were found between the proportions of patients with elevated CA‐125 levels in groups having tumors with maximal diameters of less than 20 cm and at least 20 cm (P = .03) and groups having tumors with less than 50% and 50% to 80% solid components (P = .02). In the group with normal CA‐125 levels, we found predominantly mucinous adenocarcinoma in multilocular cysts with less than 50% solid components (25 cases), and clear cell adenocarcinoma in unilocular cysts with less than 50% solid components (12 cases), whereas in the group with elevated CA‐125 levels, mucinous adenocarcinoma in multilocular cysts with less than 50% solid components (19 cases) and endometrioid adenocarcinoma in solid tumors (≥80% solid components) were predominant (5 cases).

Conclusions

Stage IA ovarian cancers with normal CA‐125 levels tend to be smaller, have less solid components, and have a slightly different distribution of histopathologic types than cancers with elevated CA‐125 levels.
Cervical Length Changes From the First to Second Trimester of Pregnancy, and Prediction of Preterm Birth by First‐Trimester Sonographic Cervical Measurement
Authors: Souka Athena P. , Papastefanou Ioannis , Michalitsi Vasiliki , Salambasis Konstantinos , Chrelias Charalambos , Salamalekis George , Kassanos Dimitris
Published: January 2017

Objectives

The purpose of this study was to examine the evolution of cervical length from the first to second trimester of pregnancy and the value of first‐trimester cervical measurement in the prediction of preterm delivery.

Methods

We conducted a longitudinal prospective study. Cervical length was measured by transvaginal sonography at 11 to 14 weeks (Cx1), 16 to 19 weeks (Cx2), and 20 to 24 weeks (Cx3).

Results

Eight hundred singleton pregnancies were studied. The median cervical lengths were 33 mm for Cx1 and 31 mm for Cx2 and Cx3. Significant independent predictors for cervical length were maternal weight, height, and history of cervical surgery for Cx1, maternal height, history of cervical surgery, and history of preterm delivery for Cx2, and history of cervical surgery, history of first‐trimester miscarriage, and history of spontaneous preterm delivery for Cx3. Mean cervical length shortening was 2.36 mm between Cx1 and Cx3. In the subgroups of women with previous cervical surgery and history of previous preterm birth, cervical shortening was significantly more prominent. The median Cx1 was significantly shorter in the women who subsequently delivered preterm; Cx1 predicted preterm delivery before 34 weeks (odds ratio, 0.746; 95% confidence interval, 0.649–0.869) and preterm delivery before 32 weeks (odds ratio, 0.734; 95% confidence interval, 0.637–0.912).

Conclusions

Cervical length in the first trimester depends on maternal characteristics and a history of cervical surgery. The cervix exhibits minimal changes from 11 to 24 weeks for most women, although the shortening is more prominent in women with a history of cervical surgery or preterm delivery. First‐trimester cervical length measurement can predict preterm delivery.
Adaptive Changes in the Splenic Artery and Left Portal Vein in Fetal Growth Restriction
Authors: Vedmedovska Natalija , Rezeberga Dace , Teibe Uldis , Zodzika Jana , Donders Gilbert G. G.
Published: January 2017

Objectives

The purpose of this study was to determine whether a low splenic artery pulsatility index (PI) and reduced flow through the left portal vein are involved in redistribution of fetal growth restriction.

Methods

Forty‐two women with prenatally diagnosed intrauterine growth restriction of singleton fetuses were included. The next pregnant woman with an appropriately growing fetus, matched for gestational age, was selected as a control. Blood flow velocities were measured in the splenic artery and left portal vein. Obstetric and perinatal information was obtained from standardized medical records.

Results

The blood flow through the left portal vein was significantly reduced compared with the controls (P < .0001). Placental impairment in fetal growth restriction was clearly linked to a decreased splenic artery PI (P = .0004). In growth‐restricted fetuses with reduced left portal vein flow and a splenic artery PI below the 5th percentile, perinatal mortality, a low 5‐minute Apgar score, and neonatal metabolic acidosis were observed significantly more often (P = .04, .01, and .004; P = .03, .03, and .006, respectively).

Conclusions

Reduced blood flow through the left portal vein and low resistance in the splenic artery can be found in growth‐restricted fetuses with adverse neonatal outcomes.
First In Vivo Use of a Capacitive Micromachined Ultrasound Transducer Array–Based Imaging and Ablation Catheter
Authors: Stephens Douglas N. , Truong Uyen T. , Nikoozadeh Amin , Oralkan Ömer , Seo Chi Hyung , Cannata Jonathan , Dentinger Aaron , Thomenius Kai , de la Rama Alan , Nguyen Tho , Lin Feng , Khuri-Yakub Pierre , Mahajan Aman , Shivkumar Kalyanam , O'Donnell Matt , Sahn David J.
Published: January 2017

Objectives

The primary objective was to test in vivo for the first time the general operation of a new multifunctional intracardiac echocardiography (ICE) catheter constructed with a microlinear capacitive micromachined ultrasound transducer (ML‐CMUT) imaging array. Secondarily, we examined the compatibility of this catheter with electroanatomic mapping (EAM) guidance and also as a radiofrequency ablation (RFA) catheter. Preliminary thermal strain imaging (TSI)‐derived temperature data were obtained from within the endocardium simultaneously during RFA to show the feasibility of direct ablation guidance procedures.

Methods

The new 9F forward‐looking ICE catheter was constructed with 3 complementary technologies: a CMUT imaging array with a custom electronic array buffer, catheter surface electrodes for EAM guidance, and a special ablation tip, that permits simultaneous TSI and RFA. In vivo imaging studies of 5 anesthetized porcine models with 5 CMUT catheters were performed.

Results

The ML‐CMUT ICE catheter provided high‐resolution real‐time wideband 2‐dimensional (2D) images at greater than 8 MHz and is capable of both RFA and EAM guidance. Although the 24‐element array aperture dimension is only 1.5 mm, the imaging depth of penetration is greater than 30 mm. The specially designed ultrasound‐compatible metalized plastic tip allowed simultaneous imaging during ablation and direct acquisition of TSI data for tissue ablation temperatures. Postprocessing analysis showed a first‐order correlation between TSI and temperature, permitting early development temperature‐time relationships at specific myocardial ablation sites.

Conclusions

Multifunctional forward‐looking ML‐CMUT ICE catheters, with simultaneous intracardiac guidance, ultrasound imaging, and RFA, may offer a new means to improve interventional ablation procedures.
Cumulative hazard: The case of nuisance flooding
Authors: Moftakhari Hamed R. , AghaKouchak Amir , Sanders Brett F. , Matthew Richard A.
Published: January 2017

The cumulative cost of frequent events (e.g., nuisance floods) over time may exceed the costs of the extreme but infrequent events for which societies typically prepare. Here we analyze the likelihood of exceedances above mean higher high water and the corresponding property value exposure for minor, major, and extreme coastal floods. Our results suggest that, in response to sea level rise, nuisance flooding (NF) could generate property value exposure comparable to, or larger than, extreme events. Determining whether (and when) low cost, nuisance incidents aggregate into high cost impacts and deciding when to invest in preventive measures are among the most difficult decisions for policymakers. It would be unfortunate if efforts to protect societies from extreme events (e.g., 0.01 annual probability) left them exposed to a cumulative hazard with enormous costs. We propose a Cumulative Hazard Index (CHI) as a tool for framing the future cumulative impact of low cost incidents relative to infrequent extreme events. CHI suggests that in New York, NY, Washington, DC, Miami, FL, San Francisco, CA, and Seattle, WA, a careful consideration of socioeconomic impacts of NF for prioritization is crucial for sustainable coastal flood risk management.
Snow cover response to temperature in observational and climate model ensembles
Authors: Mudryk L. R. , Kushner P. J. , Derksen C. , Thackeray C.
Published: January 2017

The relationship between land surface temperature and snow cover extent trends is examined in three distinct types of ensembles over the 1981–2010 period: an observation‐based ensemble, a representative selection of CMIP5 coupled climate model output, and two large initial condition coupled climate model ensembles. Observation‐based estimates of snow cover sensitivity are stronger than simulated over midlatitude and alpine regions. Observed sensitivity estimates over Arctic regions are consistent with simulated values. Anomalous snow cover extent trends present in one data set, the NOAA climate record, obscure the relationship to surface temperature seen in the rest of the analyzed data. The spread in modeled snow cover trends reflects roughly equal contributions from intermodel variability and from natural variability. Together, the anomalous relationship between surface temperature and snow cover expressed in the NOAA climate record and the large influence of natural variability present in the simulations highlight the importance of ensemble‐based approaches.
The statistical mechanics of solar wind hydroxylation at the Moon, within lunar magnetic anomalies, and at Phobos
Authors: Farrell W. M. , Hurley D. M. , Esposito V. J. , McLain J. L. , Zimmerman M. I.
Published: January 2017

We present a new formalism to describe the outgassing of hydrogen initially implanted by the solar wind protons into exposed soils on airless bodies. The formalism applies a statistical mechanics approach similar to that applied recently to molecular adsorption onto activated surfaces. The key element enabling this formalism is the recognition that the interatomic potential between the implanted H and regolith‐residing oxides is not of singular value but possess a distribution of trapped energy values at a given temperature, F(U,T). All subsequent derivations of the outward diffusion and H retention rely on the specific properties of this distribution. We find that solar wind hydrogen can be retained if there are sites in the implantation layer with activation energy values exceeding 0.5 eV. We especially examine the dependence of H retention applying characteristic energy values found previously for irradiated silica and mature lunar samples. We also apply the formalism to two cases that differ from the typical solar wind implantation at the Moon. First, we test for a case of implantation in magnetic anomaly regions where significantly lower‐energy ions of solar wind origin are expected to be incident with the surface. In magnetic anomalies, H retention is found to be reduced due to the reduced ion flux and shallower depth of implantation. Second, we also apply the model to Phobos where the surface temperature range is not as extreme as the Moon. We find the H atom retention in this second case is higher than the lunar case due to the reduced thermal extremes (that reduces outgassing).
Nanocarbon for Oxygen Reduction Electrocatalysis: Dopants, Edges, and Defects
Authors: Tang Cheng , Zhang Qiang
Published: January 2017

The oxygen reduction reaction (ORR) is the cornerstone of various sustainable energy‐conversion technologies. Metal‐free nanocarbon electrocatalysts with competitive activity, enhanced durability, and satisfactory cost, have been proposed as the most promising substitute for precious‐metal catalysts. However, their further development is still primarily based on trial‐and‐error approaches due to the controversial knowledge of critical active sites and mechanisms. Herein, the activity origins of nanocarbon‐based ORR electro­catalysts are comprehensively reviewed and correlated, considering the dopants, edges, and defects. Analogously, they can effectively modify the charge/spin distribution on the sp2‐conjugated carbon matrix, leading to optimized intermediate chemisorption and facilitated electron transfer. Specific doping at defective edges is expected to render practical applications for metal‐free nanocarbon electrocatalysts.
Small is Powerful: Recent Progress in Solution‐Processed Small Molecule Solar Cells
Authors: Collins Samuel D. , Ran Niva A. , Heiber Michael C. , Nguyen Thuc‐Quyen
Published: January 2017

Over the last 5 years, research on the synthesis, device engineering, and device physics of solution‐processed small molecule solar cells (SMSCs) has rapidly expanded. Improvements in molecular design and emergent device processing techniques have helped solution‐processed SMSCs overcome earlier difficulties in controlling active layer morphology, such that many systems are now at—or approaching—10% power conversion efficiency. In this review, details of the highest performing blend systems are presented in order to identify key trends and provide perspective on current progress in the field. Among the best systems, a planarized molecular structure is prevalent, which can be achieved using large fused‐ring moieties, intermolecular non‐bonding interactions, and side chain engineering. To obtain efficient devices, the highest performing systems have been optimized through the careful combination of thermal and solvent annealing procedures. Even without additional processing, some systems have been able to obtain interconnected morphologies and efficient charge generation and charge transport. Ultimately, the design of more efficient materials also requires additional understanding of the device physics and loss mechanisms. After highlighting what is known to date on processes limiting device efficiency, an outlook on the most important challenges remaining to the field is provided.
Boosting Visible‐Light‐Driven Photocatalytic Hydrogen Evolution with an Integrated Nickel Phosphide–Carbon Nitride System
Authors: Indra Arindam , Acharjya Amitava , Menezes Prashanth W. , Merschjann Christoph , Hollmann Dirk , Schwarze Michael , Aktas Mesut , Friedrich Aleksej , Lochbrunner Stefan , Thomas Arne , Driess Matthias
Published: January 2017

Solar light harvesting by photocatalytic H2 evolution from water could solve the problem of greenhouse gas emission from fossil fuels with alternative clean energy. However, the development of more efficient and robust catalytic systems remains a great challenge for the technological use on a large scale. Here we report the synthesis of a sol–gel prepared mesoporous graphitic carbon nitride (sg‐CN) combined with nickel phosphide (Ni2P) which acts as a superior co‐catalyst for efficient photocatalytic H2 evolution by visible light. This integrated system shows a much higher catalytic activity than the physical mixture of Ni2P and sg‐CN or metallic nickel on sg‐CN under similar conditions. Time‐resolved photoluminescence and electron paramagnetic resonance (EPR) spectroscopic studies revealed that the enhanced carrier transfer at the Ni2P–sg‐CN heterojunction is the prime source for improved activity.
A Photoredox‐Induced Stereoselective Dearomative Radical (4+2)‐Cyclization/1,4‐Addition Cascade for the Synthesis of Highly Functionalized Hexahydro‐1H‐carbazoles
Authors: Alpers Dirk , Gallhof Malte , Witt Julian , Hoffmann Frank , Brasholz Malte
Published: January 2017

A stereoselective synthesis of functionalized hexahydrocarbazoles was developed based on an unprecedented photoredox‐induced dearomative radical (4+2)‐cyclization/1,4‐addition cascade between 3‐(2‐iodoethyl)indoles and acceptor‐substituted alkenes. The title reaction simultaneously generates three C−C bonds and one C−H bond, along with three contiguous stereogenic centers. The hexahydro‐1H‐carbazole products are highly valuable intermediates for the synthesis of novel antibiotics, as well as unnatural ring homologues of polycyclic indoline alkaloids.
Effects of graphene oxide and chemically reduced graphene oxide on the curing kinetics of epoxy amine composites
Authors: Monteserín Cristina , Blanco M. , Aranzabe E. , Aranzabe A. , Vilas J. L.
Published: January 2017

The curing kinetics of epoxy nanocomposites prepared by incorporating graphene oxide (GO) and chemically reduced graphene oxide (rGO) have been studied using isothermal and nonisothermal differential scanning calorimetry. The kinetic parameters of the curing processes in these systems have been determined by a Kamal and Sourour phenomenological model expanded by a diffusion factor. The predicted curves determined using the kinetic parameters fit well with the isothermal DSC thermograms revealing the proposed kinetic equation clearly explains the curing kinetics of the prepared epoxy amine nanocomposites. Experimental and modeling results demonstrate the presence of an accelerating effect of the GO on the cure of the resin matrix. The use of rGO instead of GO resulted in a slight acceleration reaction rate due to the reduced presence of oxidation groups in rGO. © 2017 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2017, 134, 44803.
The fraction of East Asian interannual climate variability explained by SST in different seasons: an estimation based on 12 CMIP5 models
Authors: He Chao , Wang Leidi , Gu Dejun , Lin Ailan , Li Chunhui , Zheng Bin
Published: January 2017

Using the output of 12 models from the Coupled Model Intercomparison Project Phase 5 (CMIP5), this study assessed to what extent is the interannual climate variability over East Asia explained by sea surface temperature (SST). By comparing the atmospheric component model simulations forced by observed interannual varying SST and fixed annual cycle of SST, the fraction of interannual variability explained by SST is estimated. Although SST explains a major fraction of interannual variability of both seasonal mean surface air temperature (SAT) and precipitation over tropical western Pacific, it only explains about 0–30% of the interannual variance over East Asian land. The SST explains a greater fraction of interannual SAT variance in summer, since the SAT variance induced by non‐SST factors is relatively small possibly due to the weaker impact by mid‐latitude eddy activities. During winter and spring, SST accounts for a larger fraction of interannual precipitation variability over southern China than in summer and autumn, due to the stronger modulation of El Niño‐Southern Oscillation‐related SST anomalies through the anomalous anticyclone over western north Pacific from winter to spring.
A semi‐parametric regression approach to climatological quantile estimation for generating percentile‐based temperature extremes indices
Authors: Yang Chi , Xu Jing
Published: January 2017

A semi‐parametric regression approach to quantile estimation for daily temperature data is proposed, in which both the biases and inhomogeneity are negligible, and is applied to the calculation of the six percentile‐based Expert Team on Climate Change Detection and Indices (ETCCDI) temperature extremes indices. Comparisons of the results with those from the CLIMDEX datasets show that the three warmth indices in the latter are probably biased such that their linear trends under the RCP4.5 scenario seem to be overestimated. In order to avoid drawing misleading conclusions, it is necessary to re‐examine currently adopted algorithms and available datasets, and to develop new methods for generating the percentile‐based ETCCDI indices.