bluuebunny/crossref_metadata_2025 huggingface dataset:
Patrimonial Reflections
Authors: Hafstein Valdimar Tr.
Published: January 2017

The author of this paper argues that the rise of cultural heritage is perhaps the chief example of a newfound valuation of cultural practices and objects in terms of their expediency for economic and political purposes. This is culture as a resource: a novel configuration in which culture is now a central expedient in everything from creating jobs to reducing crime, from changing the face of cities through cultural tourism to managing differences and conflicts within the population. In this context, heritage provides a strong but flexible language for staking claims to culture and making claims based on culture. He suggests that the 2003Convention for the Safeguarding of the Intangible Cultural Heritagesignals a reformation of global heritage policy. Where earlier UNESCO efforts were content to document and archive expressions of folklore and traditional culture, its intangible heritage initiatives aim to assure the transmission and continuity of traditional practicesin situ. This requires direct intervention in the communities involved. UNESCO enlists intangible heritage as an instrument for safeguarding community, a social and moral good perceived to be threatened by globalization. Intangible heritage has emerged as an instrument in the production of a strong (but not exclusive) sense of belonging for members of cultural communities within (and sometimes across) states. Population groups objectify their practices and expressions as “intangible heritage” and at the same time they subjectify themselves as “communities”. Government can then act on the social field through communities and by means of, among other things, heritage policies. The author also points out that many heritage practices take the body as their central objects – they turn the body into a site of performance. Indeed, intangible heritage is very much about the ways in which culture is embodied and the ways in which bodies are cultured.
Le développement durable au service du patrimoine culturel
Authors: Guèvremont Véronique
Published: January 2017

S’il est fréquent d’associer la protection de la « culture » au « développement durable » – l’idée de préservation d’un patrimoine au bénéfice des générations présentes et à venir est en effet inhérente aux deux concepts – la définition classique du développement durable et le contenu de cette notion tel que précisé par certains textes fondateurs passent généralement sous silence l’importance de la culture pour le développement des sociétés. Pourtant, des liens juridiques intimes unissent désormais les deux notions, comme en témoignent les récents développements du droit international en ce domaine. Ces évolutions normatives, qui se fondent en grande partie sur une prise de conscience de l’inestimable contribution de la culture au développement durable des sociétés, tendent cependant à passer sous silence l’autre dimension de la relation, soit le potentiel que représente la notion de développement durable pour la protection des cultures. En utilisant l’exemple de la sauvegarde du patrimoine culturel immatériel, cette contribution vise à explorer ce potentiel en trois temps : en identifiant d’abord les instruments juridiques internationaux qui ont contribué à la reconnaissance explicite d’un lien entre la culture et le développement durable (I) ; en précisant, ensuite, le contenu conceptuel et juridique de cette notion de développement durable à laquelle sont attachés certains « principes de développement durable » (II) ; en procédant, enfin, à une analyse critique de la Convention pour la sauvegarde du patrimoine culturel immatériel à la lumière de ces principes de développement durable (III).
The Selection of the Practice of Ice Canoeing on the St. Lawrence River
Authors: Genest Bernard
Published: January 2017

The purpose of this article is precisely to outline in what manner and circumstances the Quebec Society of Ethnology came to make the request to the Quebec ministry of Culture for recognition of the practice of ice canoeing. In fact, ice canoeing was the second practice to be listed on the Quebec register on intangible cultural heritage since its institution in 2012. The author points out that the process is not as simple as might be assumed, and it is fortunate that the designation in terms of the Quebec Cultural Heritage Act, adopted in 2012, is not a trivial measure. It involves the minister’s giving status to a part of the intangible heritage of which knowledge, safeguarding, promotion or transferral is in the public interest.
The Celebration of Cultural Diversity and the Politics of Difference in Safeguarding Intangible Cultural Heritage
Authors: Arantes Antonio A.
Published: January 2017

The global turn of cultural production gave new significance to objects and ideas that convey senses of localization and/or cultural singularity, raising public interest and institutional concern with inventorying and protecting cultural diversity. The implications of this shift not only concern the so-called creative industries, as this issue was the object of the Convention for the Protection of the Diversity of Cultural Contents and Artistic Expressions approved by UNESCO in its 33rd General Conference (Paris, November 2005). Traditional know-how and forms of expression, as well as exotic landscapes, are used as effective cornerstones for the implementation and promotion of humanitarian as well as social and economic development programs in the poorer regions of the globe. From an intellectual perspective, this renewed awareness of all things local stimulates critical reflection about some epistemological and legal issues related to identification, documentation and promotion of cultural heritage. Among these, intellectual authority associated with the production of inventories, the social consequences of introducing new ingredients in local level politics and cultural production, as well as juridical matters concerning rights of collective intellectual property are some of the concerns of the current debate among scholars and heritage experts on those issues. The present paper aims at contributing to the debate on the questions outlined above, by focusing on the emergent policies of safeguarding intangible cultural heritage. Since cultural heritage is not mechanical and neutral transmission of information from one generation to another, but a social construction, the understanding of its meanings and consequences depends on taking into account its historical context. This being the case, in order to provide concrete background to this discussion, the author refers to the Brazilian case suggesting, however, that it has wider implications.
Du bon usage des « vestiges »
Authors: Collomb Gérard
Published: January 2017

Au cours des deux dernières décennies, on a pu observer en Guyane française la montée en puissance d’une expression politique amérindienne construite sur l’affirmation de « l’autochtonie », et un développement notable des connaissances archéologiques et historiques relatives au monde amérindien, largement médiatisées dans l’espace régional. Mais, alors qu’en Guyane aujourd’hui le rapport au passé et l’inscription dans une histoire représentent un élément majeur des stratégies de définition de soi, il n’y a eu que peu ou pas de connexion entre ces deux processus. Le mouvement politique amérindien, dans sa composante majoritaire kali’na, ne s’est pas emparé de ces matériaux pour appuyer ses revendications dans l’espace régional et n’a pas cherché non plus à instituer les sites que l’archéologie mettait au jour en « monuments » opposables aux autres monuments que mettent en avant les autres cultures en présence. Cette situation s’explique par la manière dont le groupe pense son rapport au passé et construit sa mémoire, et par la difficulté à former un « patrimoine » commun dans une société qui s’organise sur une base familiale et qui se reproduit dans une logique factionnaliste, mais aussi par la volonté des jeunes leaders d’inscrire leur histoire dans d’autres « monuments » pour affirmer une présence dans une histoire guyanaise qui se constitue désormais comme commune.
Dentist Role in Oral Treatment Before Head Neck Cancer Therapy
Authors: Irfani Rahmatullah , Soegyanto Anandina Irmagita
Published: January 2017

Background: Various intra-oral conditions can be found in patient prior the cancer treatment that might include lesions associated with decreased immunity, such as viral infections and fungal infections. Dentist has a significant role to prepare the oral cavity to be in the best possible condition, in order to minimize oral disturbance and complaints of cancer patients.

Objective: The purpose of this article is to review the importance of intra-oral treatment prior cancer therapy in patients with head and neck cancer.

Case Report: A 35-years-old male patient was referred from the ENT Department, Cipto Mangunkusumo Hospital with suspected Nasopharyngeal Carcinoma for investigating the intra oral focal infection sources. Intra oral examination revealed various focal infection sources and pseudomembranous candidiasis. The candidiasis was completely healed after antifungal medication.

Conclusion: Dentists’ role in preparing the oral condition prior cancer treatment is very important to reduce further oral complication. All oral lesions including fungal infection should be treated before the commencement of cancer treatment.
Oral Health Status and Impact on Oral Health-Related Quality of Life in Children with Thalassemia Major
Authors: Phrai-in Nuttaya , Noikeaw Juntima , Sukprasert Nattaporn , Taya Thitirat , Samnieng Patcharaphol
Published: January 2017

Objective: The purpose of this study was to assess oral health status in children with thalassemia major, and the association of oral health status with oral-health related to quality of life.

Methods: This cross-sectional study was comprised of 81 patients from various parts of lower northern Thailand. The study consisted of an interview and intraoral examination on thalassemia children at the hospital while they were undergoing routine blood transfusions. Data regarding OHI-S, DMFT/dmft and child-OIDP were determined for all the subjects.

Results: The prevalence of oral impacts was high; 82.8% of all children reported at least one oral impact affecting their daily performance according to the Child-OIDP. The most prevalent impact was difficulty in eating.

Conclusion: The risks of oral disease in thalassemia children remain high which affect their quality of life.
Role of protein synthesis and DNA methylation in the consolidation and maintenance of long-term memory in Aplysia
Authors: Pearce Kaycey , Cai Diancai , Roberts Adam C , Glanzman David L
Published: January 2017

Previously, we reported that long-term memory (LTM) in Aplysia can be reinstated by truncated (partial) training following its disruption by reconsolidation blockade and inhibition of PKM (Chen et al., 2014). Here, we report that LTM can be induced by partial training after disruption of original consolidation by protein synthesis inhibition (PSI) begun shortly after training. But when PSI occurs during training, partial training cannot subsequently establish LTM. Furthermore, we find that inhibition of DNA methyltransferase (DNMT), whether during training or shortly afterwards, blocks consolidation of LTM and prevents its subsequent induction by truncated training; moreover, later inhibition of DNMT eliminates consolidated LTM. Thus, the consolidation of LTM depends on two functionally distinct phases of protein synthesis: an early phase that appears to prime LTM; and a later phase whose successful completion is necessary for the normal expression of LTM. Both the consolidation and maintenance of LTM depend on DNA methylation.
Symbiont-induced odorant binding proteins mediate insect host hematopoiesis
Authors: Benoit Joshua B , Vigneron Aurélien , Broderick Nichole A , Wu Yineng , Sun Jennifer S , Carlson John R , Aksoy Serap , Weiss Brian L
Published: January 2017

Symbiotic bacteria assist in maintaining homeostasis of the animal immune system. However, the molecular mechanisms that underlie symbiont-mediated host immunity are largely unknown. Tsetse flies (Glossina spp.) house maternally transmitted symbionts that regulate the development and function of their host’s immune system. Herein we demonstrate that the obligate mutualist, Wigglesworthia, up-regulates expression of odorant binding protein six in the gut of intrauterine tsetse larvae. This process is necessary and sufficient to induce systemic expression of the hematopoietic RUNX transcription factor lozenge and the subsequent production of crystal cells, which actuate the melanotic immune response in adult tsetse. Larval Drosophila’s indigenous microbiota, which is acquired from the environment, regulates an orthologous hematopoietic pathway in their host. These findings provide insight into the molecular mechanisms that underlie enteric symbiont-stimulated systemic immune system development, and indicate that these processes are evolutionarily conserved despite the divergent nature of host-symbiont interactions in these model systems.
Organizing posterior fossa hematomas simulating developmental cysts on prenatal imaging: report of 3 cases.
Authors: Folkerth R D , McLaughlin M E , Levine D
Published: January 2017

We encountered 3 organizing tentorial hematomas simulating posterior fossa lesions such as Dandy‐Walker, dermoid, or arachnoid cysts. We sought to correlate the clinical and pathologic features that allow distinction of developmental cysts from hematomas in the posterior fossa on imaging. METHODS. Prenatal sonograms in all fetuses and fetal magnetic resonance scans in 2 of the 3 were reviewed. One case proceeding to term had serial imaging up to age 11 months. Two cases had complete neuropathologic evaluation after termination. Maternal records were reviewed.

In each case, the ultrasonographic findings were reminiscent of a developmental cyst but with echogenic debris, a rim, or both. Magnetic resonance imaging suggested tentorial hemorrhage in 2, 1 also with falcine hemorrhage. Serial prenatal and postnatal imaging showed resolution in the surviving case. Pathologically, 2 fetuses had organizing tentorial hematomas causing brain displacement. Calcifications, white matter damage, germinal matrix hemorrhage, and brain stem necrosis were also present. One mother had von Willebrand disease.

Tentorial hematomas, with or without maternal coagulopathy, should be considered in the prenatal ultrasonographic diagnosis of cystlike posterior fossa abnormalities containing echogenic material. Fetal magnetic resonance imaging can suggest blood products. Hypoxic‐ischemic brain damage may be concurrent; however, resolution of the hematoma, with no apparent neurologic sequelae, can occur.
Three‐dimensional sonographic assessment of fetal behavior in the early second trimester of pregnancy.
Authors: Kuno A , Akiyama M , Yamashiro C , Tanaka H , Yanagihara T , Hata T
Published: January 2017

To evaluate the fetal behavior pattern in the early second trimester of pregnancy by use of specially developed abdominal dynamic three‐dimensional sonography.

Dynamic three‐dimensional sonographic examinations were performed on 11 healthy pregnant women at 14 to 18 weeks of gestation. This imaging system provided continuous three‐dimensional sonographic images every 1 to 2 seconds. Fetal movements were recorded continuously for 60 minutes in each fetus. The rate of occurrence of head, mouth, arm, trunk, and leg movements was evaluated. All fetal behavioral patterns were observed during the period studied.

The active phase (time with fetal movements) was 59.4%, and the resting phase was 40.6%. The most active fetal behavior pattern was an arm movement, whereas the least was a mouth movement. Moreover, each fetal movement was synchronized and harmonized with other fetal movements (a few movement patterns were found to be generated simultaneously).

Dynamic three‐dimensional sonography provides a novel means for evaluation of fetal behavior in the early second trimester of pregnancy. These results suggest that dynamic three‐dimensional sonography may be an important modality in future early fetal behavior research and in evaluation of early fetal well‐being.
Lack of association between carotid artery volume blood flow and cardiac output.
Authors: Eicke B M , von Schlichting J , Mohr-Ahaly S , Schlosser A , von Bardeleben R S , Krummenauer F , Hopf H C
Published: January 2017

The correlation of cardiac output and cerebral perfusion is unclear. We tested this potential association by correlating cardiac output data obtained by echocardiography and cerebral blood flow data as determined by color M‐mode measurements of carotid artery blood flow.

We studied 43 patients with a broad spectrum of cardiac performance by means of transthoracic echocardiography. In these patients, different cardiac indices such as stroke volume, ejection fraction, and heart minute volume were determined. The data were correlated with volumetric flow measurements (color M‐mode duplex system) of the common carotid arteries bilaterally.

Heart minute volume ranged from 1.632 to 9.836 mL/min (mean +/‐ SD, 4.652 +/‐ 1.621 mL/min); ejection fraction ranged from 18% to 76% (mean, 48% +/‐ 16%). The relative fraction of carotid volume flow compared with heart minute volume was 15% +/‐ 6%. There was no correlation between ejection fraction, stroke volume, or heart minute volume and absolute volume flow in the carotid arteries when being adjusted for age. There was a highly significant inverse correlation (r = ‐0.8; P < .0001) of the relative fraction of the carotid volume flow (carotid volume flow/heart minute volume [percent]) and the heart minute volume.

Our data support the concept that cerebral blood flow is independent of cardiac output.
Analysis of color Doppler signal intensity variation after levovist injection: a new approach to the diagnosis of thyroid nodules.
Authors: Spiezia S , Farina R , Cerbone G , Assanti A P , Iovino V , Siciliani M , Lombardi G , Colao A
Published: January 2017

The objective of this study was to evaluate the usefulness of a galactose‐based ultrasonographic contrast agent, Levovist (Schering AG, Berlin, Germany), in differentiating benign from malignant thyroid nodules by analysis of the time‐intensity curves correlating the variation of the intensity signal value during the contrast transit time. Fifty‐four patients scheduled for surgical removal of a nodule or the thyroid gland or both after cytologic examination were enrolled in this study; all of the nodules underwent a baseline color and power Doppler evaluation and then to a color Doppler examination after an intravenous bolus injection of Levovist. The time‐intensity curves were analyzed with respect to the histologic results. Carcinomas showed a significantly earlier arrival time of Levovist than nodular hyperplastic benign nodules and adenomas (8.1 +/‐ 1.41 versus 19.6 +/‐ 2.2 and 16.1 +/‐ 2.8 seconds; P < .0001), although no significant difference occurred between hyperplastic benign nodules and adenomas; carcinomas and adenomas showed an earlier time to peak than hyperplastic benign nodules (14.6 +/‐ 1.2 and 23.1 +/‐ 3.8 versus 33.0 +/‐ 3.0 seconds; P < .0001). No significant difference was found in baseline, peak, final intensity signal, and percent variation of intensity signal among hyperplastic benign nodules, adenomas, and carcinomas. Although cytologic examination still remains the standard of reference for the presurgical diagnosis of thyroid nodules, the preliminary data of this pilot study demonstrate that the analysis of time‐intensity curves after Levovist injection might provide useful, complementary, and quantitative information to differentiate benign from malignant thyroid nodules.
Gray scale sonography of breast masses in adolescent girls.
Authors: Kronemer K A , Rhee K , Siegel M J , Sievert L , Hildebolt C F
Published: January 2017

To assess the sonographic findings of breast masses in adolescents and the usefulness of sonographic patterns for suggesting a specific diagnosis.

The sonograms and medical records of 57 girls (mean age, 15.4 years) with palpable breast masses were retrospectively reviewed. Three observers reviewed the sonograms for multiple sonographic findings. Surgery or clinical findings established diagnoses. Statistical analysis was done to determine how well sonographic findings alone and in combination agreed with final histologic diagnoses.

Diagnoses included cysts (n = 12), abscesses (n = 7), fibroadenomas (n = 36), a lactating adenoma (n = 1), and a phyllodes tumor (n = 1). The sonographic findings varied significantly among lesion types (P < or = .005).

Our experience suggests that virtually all breast masses in a pediatric population are benign and that sonography has the ability to differentiate among cystic, inflammatory, and solid masses.
Ultrasonographic differentiation between tuberculous lymphadenitis and malignant lymph nodes.
Authors: Asai S , Miyachi H , Suzuki K , Shimamura K , Ando Y
Published: January 2017

To assess the usefulness of ultrasonography in the differential diagnosis of cervical tuberculous lymphadenitis versus malignant lymph nodes.

Ultrasonography of cervical lymph nodes was performed with a real‐time linear scanner using a 7.5‐ or 11‐MHz probe or both. Ultrasonographic findings were retrospectively reviewed in 73 patients: 49 with malignant lymphoma, 15 with tuberculous lymphadenitis, and 9 with metastatic lymph nodes.

Ultrasonographic features specific to cervical tuberculous lymphadenitis were strong echoes (33.3%) and an echogenic thin layer (86.7%). When the lymph nodes had at least 1 of these 2 features, tuberculous lymphadenitis was diagnosed with a sensitivity of 100% and a specificity of 100%.

Ultrasonographic evaluation of cervical lymph nodes can be useful in the diagnosis of cervical tuberculous lymphadenitis.
Identification of hepatic venous territories in liver resection by using color Doppler ultrasonography: report of two cases.
Authors: Kitamura H , Miyagawa Y , Yokoyama T , Kobayashi A , Miwa S , Miyagawa S , Kawasaki S
Published: January 2017

Resection of the hepatic vein because of the proximity of tumors may result in increased congestion in the noncancerous parenchyma, which in turn may lead to functional hepatic volume loss and postoperative hepatic failure, especially in a case of low hepatic reserve. However, to our knowledge, no technique for estimating the extent of dependent hepatic venous territories before hepatic resection has been established. We examined the possibility of using color Doppler ultrasonography for this purpose.

A color Doppler system and a linear array transducer equipped with multiple Doppler frequencies ranging from 7 to 13 MHz were used intraoperatively. Two patients with hepatocellular carcinomas were examined. By tracking entire branches of the targeted vessel, from the trunk to the terminal branches extending to the liver surface, it was possible for the boundaries of the dependent areas to be projected and marked on the liver surface with either ink or electrocautery.

In both cases, this method was effective for either minimizing the congestive area or preserving the hepatic mass that was being drained via aberrant routes.

Identification of hepatic venous territories by means of color Doppler ultrasonography may provide new information about intrahepatic blood circulation and may increase the safety and curability of hepatic resection.
Sonographic diagnosis of distal biceps tendon rupture: a prospective study of 25 cases.
Authors: Belli P , Costantini M , Mirk P , Leone A , Pastore G , Marano P
Published: January 2017

To describe the sonographic findings of distal biceps tendon ruptures and to assess the accuracy of the technique.

Twenty‐five patients with clinically indicated distal biceps tendon ruptures were prospectively studied by sonography. Five patients also underwent magnetic resonance imaging. Surgical confirmation was obtained in 14 patients.

Seventeen complete tendon ruptures and 3 partial tears were correctly shown by sonography; 1 complete rupture was incorrectly shown as a partial tear by sonography. Sonographic features of complete rupture were absence of tendon in the expected location, fluid collection in a typical tendon gap, and a mass in the antecubital fossa. Sonographic features of incomplete rupture were intratendinous hypoechogenicity and tendon thinning. Peritendinous fluid was found in complete and incomplete ruptures.

In distal biceps tendon ruptures, sonography is a cost‐effective method that can confirm the clinical indications with good accuracy and can show tendon lesions when the clinical indications are low.
Normal midtrimester (17‐20 weeks) genetic sonogram decreases amniocentesis rate in a high‐risk population.
Authors: Pinette M G , Garrett J , Salvo A , Blackstone J , Pinette S G , Boutin N , Cartin A
Published: January 2017

To evaluate a screening protocol using advanced maternal age, triple‐marker screening, and genetic sonography.

We compared adverse chromosomal outcomes of pregnancy in 1556 women referred for increased risk of aneuploidy because of either advanced maternal age or triple‐marker test results. Patients were counseled about the results of the triple‐marker test and subsequent sonography, which led to a patient decision of whether to pursue amniocentesis. Fetal measurements and structural abnormalities were compared with chromosomal findings. When patients elected amniocentesis, karyotypes were obtained.

Genetic sonography reduced the rate of amniocentesis by 61% overall and by 40% when compared with an alpha‐fetoprotein profile alone. The sensitivity of sonography combined with the triple‐marker screen for the detection of trisomy 21 was 87% compared with 91% for the triple‐marker screen alone.

This study confirmed that sonographic findings in a targeted population, in combination with other risk markers (advanced maternal age and triple‐marker screening), can be used to assess the risk of aneuploidy. Biometry provides additional information for assessing the risk of aneuploidy. Combining advanced maternal age, serum triple‐marker screening, and sonographic screening may provide better risk prediction for use in clinical counseling.
Role of Uterine Artery Doppler Flow in Fibroid Embolization
Authors: McLucas Bruce , Perrella Rita , Goodwin Scott , Adler Louis , Dalrymple Jerry
Published: January 2017

Objective. To determine whether Doppler flow measurements are useful in predicting variables associated with uterine fibroid embolization, including shrinkage of the uterus and myomas, adenomyosis, and uterine fibroid embolization failure. Methods. A group of 227 patients with menorrhagia or postmenopausal bleeding secondary to uterine myomas were evaluated with uterine artery Doppler flow sonography before uterine fibroid embolization. Doppler flow measurements were repeated 6 months after uterine fibroid embolization for 188 of the patients. Data were analyzed for correlations between peak systolic velocity and uterine fibroid embolization patient data, including size and shrinkage of the uterus and myomas, embolization particle size, adenomyosis, and uterine fibroid embolization failure. Results. Initial peak systolic velocity was positively correlated with the size and shrinkage of myomas and uterine volume. Peak systolic velocity was positively correlated with the size and load of embolization particles and was significantly lower (mean, 33.2 cm/s) in patients with adenomyosis than those without adenomyosis (mean, 39.3 cm/s). High peak systolic velocity (>64 cm/s) was a significant predictor of failure. Postembolization peak systolic velocity (mean, 21.85 cm/s) was significantly lower than preembolization peak systolic velocity (mean, 40.33 cm/s) and was not correlated with uterine fibroid embolization variables. Conclusions. Doppler flow measurements can aid in predicting adenomyosis and uterine fibroid embolization failure. Postembolization peak systolic velocity did not show value.
Contrast‐Enhanced Power Doppler Sonography of the Intestinal Wall in the Differentiation of Hypervascularized and Hypovascularized Intestinal Obstructions in Patients With Crohn's Disease
Authors: Kratzer Wolfgang , von Tirpitz Christian , Mason Richard , Reinshagen Max , Adler Guido , Möller Peter , Rieber Andrea , Kächele Volker
Published: January 2017

Objective.To use power Doppler sonography to quantify the vascularization in the area of stenosed bowel segments in patients with Crohn's disease and to draw conclusions from these findings with regard to the development of these stenoses. Methods.The study collective included 11 patients with confirmed Crohn's disease and sonographically visualized stenoses of the small bowel together with intermittent abdominal cramping as a clinical correlate. Power mode examination was repeated after application of a sonographic signal‐enhancing agent. Semiquantitative evaluation based on the sonographically indicated degree of vascularization led to the presumptive diagnosis of either inflammatory or cicatricial intestinal obstruction. Sonographic diagnoses were compared with the findings of surgery and subsequent histologic examination or with patients' clinical responses to conservative therapy. Results.Nine of 11 patients underwent surgery within 1 year of examination. All 3 cases in which sonography had facilitated the diagnosis of cicatricial stenosis were confirmed at postoperative histologic examination; similarly, the surgical and histologic findings in the other 6 patients confirmed the sonographic diagnosis of inflammatory stenosis. Conclusions.Power Doppler sonography in combination with the use of a signal‐enhancing agent appears to be effective in the recognition of predominantly cicatricial stenoses in patients with Crohn's disease.
Sonography in Primary Hyperparathyroidism
Authors: Reeder Scott B. , Desser Terry S. , Weigel Ronald J. , Jeffrey R. Brooke
Published: January 2017

Objective. To review the sonographic features and focused sonographic scanning techniques that may assist in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism. Methods. The sonographic findings were reviewed in 54 of 58 consecutive patients with pathologically proven parathyroid adenomas. A systematic scanning approach including real‐time gray scale, color and power Doppler, and graded compression gray scale imaging was used in all patients. Results. Fifty‐four (93%) of 58 proven adenomas were correctly identified by sonography. Gray scale imaging alone was sufficient for identifying 26 (100%) of 26 large (≥1‐cm) and 3 (11%) of 25 small (<1‐cm) parathyroid adenomas. However, for 25 (89%) of 28 small adenomas, a combination of color and power Doppler and graded compression real‐time gray scale imaging was required for sonographic localization and identification. Conclusions. Knowledge of typical locations and characteristic imaging features, as well as a systematic scanning approach, can result in accurate preoperative sonographic localization of parathyroid adenomas.
Twinkling Artifact in Color Doppler Imaging of the Orbit
Authors: Ustymowicz Andrzej , Krejza Jaroslaw , Mariak Zofia
Published: January 2017

Objective. To show an artifact related to color Doppler flow imaging of the orbit. Methods. Three patients with strongly reflective structures in the orbit were selected from those routinely referred by clinicians for color Doppler ultrasonography of the orbit. Gray scale and color flow images were obtained with a 7.5‐MHz linear array probe for a region with strongly reflective structures. A spectral display was acquired to confirm the presence of blood flow. Results. One patient had a metallic foreign body just behind the bulb; another had calcification within the irregular mass of phthisis bulbi; and the third had hyperechoic drusen in the periphery of the intraocular melanoma. The color mosaic, suggesting the presence of blood flow, was detected beyond all hyperechoic structures. Close vertical bands with no outer wrapping were detected in the spectrum display, obtained by placing the sample volume on the region of color flow. The artificial color flow was recognized as a color Doppler twinkling artifact. Conclusions. The color flow beyond the strongly reflecting structures in the orbit might be mistakenly interpreted as real blood flow if an examiner is not familiar with the artifact. It should prompt further imaging with spectral Doppler ultrasonography.
Genetic Sonography
Authors: DeVore Greggory R. , Romero Roberto
Published: January 2017

Objective. To determine whether offering genetic sonography to patients 35 years of age and older with negative maternal serum triple‐marker screening results will result in an increase in the detection rate of trisomy 21. Methods. The detection rate of trisomy 21 was determined in women 35 years of age and older whose pregnancies were managed according to the following 3 policies: policy I, universal amniocentesis; policy II, maternal serum triple‐marker screening followed by amniocentesis only in high‐risk women (risk >1:190); and policy III, genetic sonography in women with negative maternal serum screening results (policy II). Policy III included the offering of genetic amniocentesis to patients with abnormal genetic sonographic findings. The rate of acceptance of genetic amniocentesis was modeled, as was the sensitivity (50%–90%) and false‐positive rate (5%–25%) of genetic sonography. Results. The number of fetuses expected to have trisomy 21 was 784. For patients evaluated under policy II, 86.3% of fetuses with trisomy 21 were detected. On the basis of the detection rate for trisomy 21 of policy II, the addition of fetuses with trisomy 21 identified under policy III was significantly (P < .01) increased (93.2% to 98.6%) for genetic sonographic sensitivities ranging between 50% and 90%. Conclusions. A policy of offering genetic sonography followed by amniocentesis to patients 35 years of age and older who originally had triple‐marker maternal serum screening findings that were negative for the diagnosis of trisomy 21 results in a higher overall detection rate of trisomy 21.
Prenatal Detection of Fetal Aneuploidy by Sonographic Ear Length
Authors: Yeo Lami , Guzman Edwin R. , Ananth Cande V. , Walters Christine , Day-Salvatore Debra , Vintzileos Anthony M.
Published: January 2017

Objective. To determine the usefulness of a fetal ear length nomogram in the prenatal detection of fetal aneuploidy and to determine whether ear smallness in cases of aneuploidy is a primary or secondary event. Methods. Ear lengths of 447 singleton fetuses (October 1996 to October 1997) were prospectively evaluated between 14 and 41 weeks to establish a nomogram created by modeling the mean and SD separately. Records of aneuploid fetuses were retrospectively reviewed, and their ear lengths were plotted against the nomogram to determine detection rates, with ear length in or below the 10th and 50th percentiles for a given gestational age and biparietal diameter used as abnormal cutoffs. Results. The nomogram for fetal ear length measurements provided sufficient data to derive the 10th, 50th, and 90th percentiles on the basis of gestational age and biparietal diameter. The ear length of euploid fetuses was significantly correlated with gestational age (R2 = 0.96; P < .001) and biparietal diameter (R2 = 0.95; P < .001). From 96 aneuploid fetuses identified, 63 had ear lengths in or below the 10th percentile for gestational age (sensitivity, 66%). When using ear length against biparietal diameter, the sensitivities for all aneuploid fetuses for cutoffs at or below the 10th and 50th percentiles were 43% (40 of 93) and 83% (77 of 93), respectively. Conclusions. Most aneuploid fetuses have sonographically small ears (≤10th percentile for gestational age). This smallness is not entirely related to overall small fetal size, but in almost half the cases, the fetal ear length is disproportionately smaller than the biparietal diameter.
Contrast‐Enhanced Agent Detection Imaging
Authors: Youk Ji Hyun , Kim Chong Soo , Lee Jeong Min
Published: January 2017

Objective. To assess the value of SH U 508A‐enhanced agent detection imaging in the characterization of focal hepatic lesions. Methods. Contrast‐enhanced agent detection imaging was performed on 78 focal hepatic lesions: 34 hepatocellular carcinomas, 22 metastases, 9 hemangiomas, 9 abscesses, 3 cysts, and 1 focal nodular hyperplasia. After administration of SH U 508A, interval delay scanning with agent detection imaging was performed with intervals of approximately 7 seconds (phase I), 30 seconds (phase II), and 90 seconds (phase III) after the first arrival of the contrast agent to the liver. Two observers blinded to the final diagnosis reviewed selected images and assessed the enhancement patterns of the lesions. For quantitative analysis, we calculated the enhancement ratio of the lesions and the difference of enhancement between the lesions and the liver parenchyma. Results. Agent detection imaging showed a distinctive enhancement pattern in focal liver lesions compared with that in the liver. Hepatocellular carcinomas were characterized by early enhancement (phase I) and wash‐out (phases II and III; sensitivity, 94.1%; specificity, 93.2%; positive predictive value, 91.4%). Metastases showed peripheral rim or targetlike enhancement (phase I, phase II, or both) and a defect (phase III) and had sensitivity of 77.3%, specificity of 100%, and a positive predictive value of 100%. Hemangiomas showed peripheral nodular or inhomogeneous (phase I, phase II, or both) and gradually centripetal (phase II, phase III, or both) enhancement (sensitivity, 88.9%; specificity, 100%; positive predictive value, 100%). Abscesses were partially enhanced from phase I to phase III (sensitivity, 66.7%; specificity, 95%; positive predictive value, 85.7%). The results of the quantitative analysis of lesion enhancement were compatible with those of the qualitative analysis. Conclusions. SH U 508A‐enhanced agent detection imaging may yield distinctive enhancement characteristics in focal liver lesions that would contribute positively to the characterization of these hepatic lesions.
Acute Appendicitis Mimicking Infectious Enteritis
Authors: Tarantino Luciano , Giorgio Antonio , de Stefano Giorgio , Scala Vincenzo , Esposito Francesco , Liorre Giulia , Farella Nunzia , Ferraioli Giovanna
Published: January 2017

Objective. To verify the role of sonography in screening of acute appendicitis in patients admitted to an infectious disease unit for suspected acute infectious enteritis. Methods. One hundred eighty consecutive patients (102 male and 78 female; age range, 5–72 years; mean age, 31 years) admitted for suspected infectious enteritis or typhoid fever were prospectively studied with abdominal sonography within 48 hours after admission. None of the patients had peritoneal irritation. Forty‐six patients (25%) had white blood cell counts of more than 10,000/mm3 (range, 10,300–18,000/mm3). The diagnosis of acute appendicitis was made when a detectable appendix with an anteroposterior diameter of greater than 7 mm could be seen on sonography. Results. Eleven (6%) of 180 patients had thickened appendixes (anteroposterior diameter range, 7–14 mm); 2 of them had periappendiceal abscesses. Four (36%) of 11 patients with acute appendicitis had high white blood cell counts. All sonographic diagnoses of acute appendicitis and periappendiceal abscesses were confirmed at surgery. Sonography ruled out acute appendicitis in 169 patients. In all of them, clinical and sonographic follow‐up excluded the diagnosis of acute appendicitis. Normal appendixes were shown on sonography in 38 (22%) of 169 cases and were not detectable in 131 (78%) of 169. Conclusions. Sonography of the appendix is a useful method for early assessment of acute appendicitis in patients thought to have enteritis or typhoid fever.
Outcomes of Pregnancies With Sonographically Detected Nuchal Cords Remote From Delivery
Authors: González-Quintero Víctor Hugo , Tolaymat Lama , Muller Antoaneta Canache , Izquierdo Luis , O'Sullivan Mary J. , Martin Dibe
Published: January 2017

Objective. To evaluate the outcomes of pregnancies with sonographically detected nuchal cords remote from delivery during the second and third trimesters of gestation. Methods. A retrospective study of patients with and without nuchal cords detected by sonography during the second and third trimesters of gestation (17–36 weeks) was conducted. Variables included maternal age, parity, gestational age at sonography and at delivery, method of delivery, intrapartum fetal heart abnormalities, meconium‐stained amniotic fluid, birth weight, 5‐minute Apgar score, and neonatal intensive care unit admissions. Results. A total of 233 patients were included in this study, of which 118 had sonographically detected nuchal cords identified in our department during the study period. There were no statistically significant differences between patients with sonographically detected nuchal cords and control patients with respect to maternal age, estimated gestational age at sonography, method of delivery, meconium‐stained fluid, birth weight, intrapartum fetal heart abnormalities, 5‐minute Apgar scores of less than 7, and neonatal intensive care unit admissions. Patients with nuchal cords detected by sonography were more likely to give birth before 37 weeks' gestation than control patients (21% versus 11%; P = .040). Conclusions. A sonographically detected nuchal cord is not associated with important perinatal complications.
Sonographic Evaluation of Isolated Abnormal Axillary Lymph Nodes Identified on Mammograms
Authors: Shetty Mahesh K. , Carpenter Wendy S.
Published: January 2017

Objective. To evaluate the role of sonography in evaluation of abnormal axillary lymph nodes identified in patients with otherwise negative or benign findings on mammography. Methods. For 3 years 2 months, we retrospectively reviewed 30 consecutive cases that had undergone sonographic evaluation for abnormal axillary lymph nodes identified in patients whose mammograms had an American College of Radiology Breast Imaging Reporting and Data System final assessment of 1 or 2. Mammographic and sonographic features of the lymph nodes were analyzed and correlated with the histologic diagnosis in patients undergoing biopsy. Patients who did not undergo biopsy had clinical or imaging follow‐up. Results. Twenty of the 30 patients studied had an abnormal sonographic appearance. Biopsy was recommended in 17 of the 20 patients on the basis of an abnormal sonographic appearance. In the remaining 3 patients, there was an underlying cause for lymphadenopathy, and these patients underwent clinical and sonographic follow‐up. Eighteen patients underwent biopsy, including 1 patient with normal findings on sonography. Ten of these patients had malignant histologic findings: 6 were metastatic adenocarcinoma; 1, poorly differentiated sarcoma, and 3, lymphoma. The remaining 8 patients had benign histologic findings. The nonbiopsy group had clinical and or imaging follow‐up (mean, 17.6 months; range, 6–25 months). The sensitivity (true‐positive/true‐positive + false‐negative) of sonography for assessment of suspected abnormal lymph nodes in the patients studied was 100% (10 of 10); specificity (true‐negative/true‐negative + false‐positive), 50% (10 of 20); positive predictive value (true‐positive/true‐positive + false‐positive) for malignancy based on the presence of 2 or more abnormal sonographic features, 50% (10 of 20); and negative predictive value, 100%. Conclusions. Sonography is useful in further characterization of isolated abnormal axillary lymph nodes identified on mammography. Sonographic evaluation helps improve the specificity of imaging evaluation in assessment of these lymph nodes.
Association of Amniotic Fluid Index With Estimated Fetal Weight
Authors: Perni Sriram C. , Predanic Mladen , Cho Jennifer E. , Kalish Robin B. , Chasen Stephen T.
Published: January 2017

Objective. The relationship between amniotic fluid volume and gestational age has been described previously. The association of body weight and urine output has been observed in human neonates. Our goal was to assess the correlation of the amniotic fluid index (AFI) with estimated fetal weight (EFW) in the third trimester. Methods. We conducted a retrospective observational study on 426 pregnant women with singleton gestations who were referred to our unit for sonographic evaluation in the third trimester. The AFI, EFW, and EFW percentile corrected for gestational age were evaluated. The sonographic examinations were stratified into 3 gestational age categories: 28 through 33.9 weeks, 34 through 37.9 weeks, and 38 weeks and later. Maternal and fetal outcome variables were collected from medical records. Linear regression, Mann‐Whitney U, and Kruskal‐Wallis tests were used for statistical analysis. Results. There was no significant relationship between the AFI and EFW in the entire group of patients (R = 0.08; P = .096). There was a significant relationship between the AFI and EFW after 38 weeks' gestation (R = 0.30; P = .003). In addition, in female fetuses the EFW percentile correlated with higher AFI values at all gestational ages (R = 0.31; P < .001); this, however, was not observed in male fetuses. Conclusions. There is no relationship between the AFI and EFW during the third trimester, although a positive relationship between the AFI and EFW was noted late in gestation. In pregnancies with female fetuses, the AFI was positively associated with EFW percentile before 38 weeks' gestation.
Reproducibility of Fetal Lung Volume Measurements With 3‐Dimensional Ultrasonography
Authors: Sabogal Juan Carlos , Becker Eduardo , Bega George , Komwilaisak Ratana , Berghella Vincenzo , Weiner Stuart , Tolosa Jorge
Published: January 2017

Objective. To build a nomogram of normal fetal lung volumes and to assess the reproducibility of measurements using 3‐dimensional ultrasonography. Methods. Inclusion criteria were healthy women, singleton normal pregnancies, reliable dating, and 20 to 30 weeks' gestation. Exclusion criteria were discordance between clinical and ultrasonographic dating, patients lost to follow‐up, and birth weight disorders. Patients were scanned at intervals longer than 2 weeks. Three volumes were acquired for each patient; only data from the volume with the best image quality was used for analysis. Volumes were rated and measured by the manual tracing method. We recorded whether the clavicle was visualized. Only good‐quality volumes were included in analysis. The best volume was chosen, and each lung was measured. Results. A total of 75 patients were studied over a 9‐month period, from which 182 volumes were analyzed. Of the 182 volumes, 15 (8.2%) were excluded for poor quality. The remaining 167 volumes were included in the final analysis. In 83 volumes (50%), the clavicle was not visualized. The best fit for total lung volume was a second‐degree polynomial regression curve. Lung volume was 10.28 mL at 20 weeks and 51.49 mL at 30 weeks. Assessment of agreement was studied by selection of 40 volumes. Intraobserver variability was 5.48 mL (10.6%) and 3.07 mL (5.96%). Interobserver variability was 7 mL. Conclusions. Our findings suggest that 3‐dimensional ultrasonographically derived measurements are reliable and reproducible up to 30 weeks if a standard measurement technique is used.