bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth of the skull of the bottlenose dolphin, Tursiops truncatus, in the Southwest Atlantic Ocean
Authors: Barreto André Silva
Published: January 2017

Defining the age of attainment of physical maturity is important for many studies, including identification of stocks, populations or species. In order to identify the age when the skull of the bottlenose dolphin, Tursiops truncatus, reaches maturity, skulls of fifty-three specimens found stranded along the coasts of southern Brazil, Uruguay and northern Argentina (27o35’S, 48o34’W-36o49’S, 55o19’W) were analyzed. Sixty skull measurements were taken to compare the growth rate of the different functional apparatuses. Age was estimated by counts of growth layer groups in the dentine of decalcified, stained longitudinal sections of teeth. Von Bertalanffy’s equation was applied to assess the growth and determine the age at maturity of each apparatus. Generally the maturation of skull starts at age two and stabilizes at age five, and the age of reaching the mature size varies amongst different characters. The braincase is the most precocious apparatus, while the feeding is the one that last stabilizes. The development patterns observed for the hearing, vision and breathing apparatuses were similar. Statistic analysis revealed significant differences among the ages at maturity, but not for von Bertalanffy’s growth equation parameters for each functional apparatus. For the studied population it is suggested that skulls can be considered mature in animals with more than five years.
Report of the Working Group on Ethnobiology and Environmental Education related to Tursiops truncatus in the Southwest Atlantic Ocean
Authors: Zappes Camilah A. , Hoffmann Lilian Sander , Morón Sérgio , Fruet Pedro Friedrich , Laporta Paula
Published: January 2017

Ethnobiological studies and educational projects related to bottlenose dolphins (Tursiops truncatus, Montagu, 1821) are still incipient in the Southwest Atlantic Ocean (SWAO). We review studies conducted in the region, especially Brazil, where more information is available. Proposals to implement studies related to ethnobiology and environmental education in relation to the species are also presented.
Intangible roles
Authors: Littler Jo
Published: January 2017

The emphasis on non-material knowledge and forms of communication in intangible cultural heritage can be related both to the expansion of curatorial interest in “experiential” displays and to the valorisation of what has, more broadly, been termed the “experience economy” in contemporary society. The recent interest in intangible cultural heritage, in other words, might usefully be situated in the context of what has been called “the cultural turn.” Given this context, the author of this article considers how the case of intangible cultural heritage throws two particular issues into stark relief: first, heated contemporary debates over the desirability of academics engaging with the administration of culture – over whether engaging with policy is an abdication of political possibility – and second, the boundaries of cultural policy, or what it is possible to administer. Positioning itself against a narrowly technocratic approach, the paper argues that we need to interrogate the cultural heritage of intangible cultural heritage itself. By doing so, we will be better equipped to consider what capacious, imaginative interactions between theory, policy, process and practice might look like.
Intangible Culture on Inland Seas, from Hudson Bay to Canadian Heritage
Authors: Brown Jennifer S.H.
Published: January 2017

The author of this article examines the ways in which theConvention for the Safeguarding of Intangible Cultural Heritageconsiders the protection of aboriginal languages and provides a case study of the challenges of the preservation of the Cree language in Canada. For Indigenous people, in Canada as elsewhere, questions arise about who speaks for whom; many of their constituents may not identify with the major political organizations that represent their interests to governments and are recognized by government agencies; and other structural and logistical barriers also arise. The paper takes a look at the richness of Aboriginal history around Hudson Bay as held in language and stories, and then discusses the many challenges that a Hudson Bay Cree storyteller, Louis Bird, and his collaborators faced in pursuing an oral history project funded by a Canadian governmental agency with its own parameters and priorities.
Intangible Heritage in France
Authors: Poulot Dominique
Published: January 2017

In this article, Dominique Poulot provides a historical overview of the notion of intangible cultural heritage and its relationship to museum studies in France. He brings the study up to the present day to examine the current impact of intangible cultural heritage on the museums. Since 2006, when France signed the UNESCO Convention for the Safeguarding of Intangible Cultural Heritage, intangible cultural heritage has emerged as an issue of current concern. In the museum world, various institutional intermediaries are being used in order to educate curators about intangible heritage, by way of ICOM France, for example. At the same time, the Mission du patrimoine ethnologique (Ethnological Heritage Mission, or MPE) has initiated a collective reflection concerning the new categories and new framework of activities for intangible cultural heritage issues only very recently considered “ethnological” in nature. Hence intangible heritage would seem to be on the agenda of various state administration bodies according to a top-down process characteristic of the centralized tradition of French museum and heritage organizations. The situation has apparently become even more propitious in this regard since a certain number of recent events have served to highlight the fact that the opposition between the notion of ever-changing social space dear to anthropologists and the enclosure of objects conserved at the museum dear to tangible-culture specialists has become a thing of the past.
Cultural rights and “Masterpieces” of Local and Translocal Actors
Authors: Giguère Hélène
Published: January 2017

This paper deals with European experiences of inscription of traditional cultural practices on UNESCO’s Representative List of Intangible Cultural Heritage (ICH). It will first establish the institutional context of the UNESCO’s listing within the framework of reflections on cultural rights. Then, the author briefly presents four European masterpieces in the Mediterranean area. A comparative analysis follows which specifically focuses on the multiplication of practitioners and on translocality; on the overlapping between institutions and artisans; on the use of intangible cultural heritage as a driver for local development via cultural tourism; and on the multimedia “museification” of the intangible. The comparative study of the listing of these intangible cultural heritage traditions also questions the value of customary law versus freedom of expression and creation. It reveals the tensions between the “purity” and “impurity” of cultural practices and social agents, as well as exclusions related to ethnicity, sex or territory. These tensions create new social divisions and remodel the link people have with cultural practices. An examination of gender sheds light on the marginality of women in public space.
Heritage Conservation, UNESCO and Intangible Cultural Heritage in Eastern Canada
Authors: MacKinnon Richard
Published: January 2017

Since Canada has signed the UNESCOConvention concerning the Protection of the World Cultural and Natural Heritageof 1972, it has had some eighteen cultural and natural sites selected for the World Heritage List that represent internationally significant nature reserves and natural wonders, significant Canadian architectural history, important sites representing Canadian aboriginal culture and geological treasures of world-wide importance. These internationally significant sites have put Canada on the world stage in both the heritage conservation field and in the national and international tourism sector. What Canada has decided to inscribe on this list has had a major impact at the local, regional, national and international arenas. The author of this paper reflects on some of the ancillary guiding charters and conventions since the World Heritage Convention was implemented that have led to where we are today in the field of heritage conservation in Canada. He goes on to predict some areas where heritage conservation will be going in Canada in the near future. He argues that Canada could likewise have its rich intangible culture play a similarly significant role if the Canadian government signed the UNESCOConvention for the Safeguarding of Intangible Cultural Heritageof 2003. Last, he discusses some of the recent developments in eastern Canada in intangible cultural heritage, conservation and the sustaining of traditions.
Changing Visions of Heritage Value
Authors: Silberman Neil
Published: January 2017

The author of this paper questions the role of the experts in heritage policies and practices. Is the voice of the heritage expert now guided by thevox populi? The current evidence for these trends, long considered anathema to heritage purists, suggests that an epoch-making change in heritage practice is now underway. The announcement of a Memorandum of Understanding between the World Bank and UNESCO to provide “very positive input for the improvement of aid effectiveness, and make the most of culture as a motor for social development and poverty alleviation, through employment and job creation” and the theme of the 17th ICOMOS General Assembly, “Heritage, a Driver of Development” are both clear indications of a pressing new concern: that heritage contribute to the economic – not only cultural – well-being of contemporary society. No less significant is the emphasis on public rights and responsibilities in the formulation of heritage policy, once the exclusive prerogative of antiquarians and professional conservators. This turn to the public as full-fledged heritage stakeholders is expressed clearly by the Council of Europe’s FrameworkConvention on the Value of Cultural Heritage for Society(2005) and the efforts of UNESCO to promote the active participation – and economic advancement – of traditional practitioners of intangible cultural heritage.
From Global Decisions and Local Changes
Authors: Schöneich Svenja
Published: January 2017

This paper analyses the transforming effects the “UNESCO intangible cultural heritage” label has on a cultural practice. It uses as a case study the ritual ceremony of the Voladores, an indigenous ritual dance practiced in different areas of Mexico since pre-colonial times. In 2009, it was declared the second of seven UNESCO intangible cultural heritages in Mexico. The following study examines ways in which perceptions and performance of the dance have changed after the declaration from an actor’s perspective. After the declaration the national and international interest of tourist and institutions increased. As a consequence, dancers were able to earn a significant amount of money and gain social recognition through public presentations of the dance, which transformed the ritual into an economic and social resource. On the one hand, the new function changed the ceremony in ways to make it more attractive to tourists. On the other hand, a tendency towards revitalizing and preserving traditional elements came to play as well. This was partly initiated through the UNESCO Safeguarding guidelines and pushed by many dancers afraid of a potential “sell-out of their culture to tourists”. These two aspects seem to be mutually exclusive at first but this paper will show that a binary model of “culture vs. commerce” does not provide an adequate conceptual framework to fully understand the complexities of culture.
Effect of Different Topical Fluoride on the Surface Roughness of Glass Ionomer Cement
Authors: Qyi Prisca Soo , Syafiar Lasminda , Harahap Kholidina Imanda
Published: January 2017

Objective: To evaluate the effect of acidulated phosphate fluoride (APF) gel and sodium fluoride (NaF) gel on the surface roughness of glass ionomer cements.

Methods: Twenty disc-shaped samples were fabricated from glass ionomer cement (Fuji II, GC Gold Label, Japan) and divided into two test groups that is group I for acidulated phosphate fluoride (APF) gel application and group II for sodium fluoride (NaF) gel application. After 24 hours, the surface roughness (Ra) was determined using a profilometer (MarSurf M300, Germany). Samples surface were applied by topical fluoride gel according test group for 4 minutes. After the treatment, the surface roughness (Ra) was determined using a profilometer. T test was used to evaluate surface roughness measurement and the differences in surface roughness values between test groups.

Results: Acidulated phosphate fluoride gel group showed the highest surface roughness than sodium fluoride group. There were significant differences between test groups (p = 0.00).

Conclusion: Acidulated phosphate fluoride gel can cause surface roughness on the glass ionomer cement more than sodium fluoride gel.

Keywords: acidulated phosphate fluoride, glass ionomer cements, sodium fluoride, surface roughness
Survey on Patients' Perceived Satisfaction towards Dental Treatment provided by Hospital Universiti Sains Malaysia (HUSM) Dental Clinic
Authors: Ibrahima Nadeerah Binti , Enna Ng Rou , Huseina Adam
Published: January 2017

Objective: Patients’ perceived satisfaction towards dental treatment provided by HUSM Dental Clinic has never been reported before. This study aimed to evaluate patients’ perceived satisfaction towards dental treatment provided by HUSM Dental Clinic and to investigate the factors influencing patients’ perceived satisfaction regarding the treatment received besides collecting suggestions for improvement of dental services in HUSM Dental Clinic.

Methods: This is a cross-sectional study targeting dental patients who seek dental treatment in HUSM Dental Clinic.200 patients were interviewed by using a structured, interviewer-guided, adapted questionnaire.

Results: 48% of the subjects were between 18-25 age group and 59.5% of all subjects were earning <RM1000 per month. 78.5% of the respondents were satisfied with the dental treatment provided whereby 53% and 21.5% were satisfied and very satisfied respectively. 7.0% of the respondents were dissatisfied. Dental specialists, dental officers, post graduate students and undergraduate students produced 1.0%, 9.7%, 0% and 4.1% of dissatisfaction respectively. The major causes of satisfaction are friendly clinic staff (46.0%), competent operator (39.5%) and low treatment cost (31.0%). As for patient dissatisfaction, the major causes are long waiting time (40.0%), failure of operator to complete treatment on time (25.0%) and poor service from clinic staff (15.0%).

Conclusion: In general, majority of the respondents were satisfied with the treatment given to them. However, improvements are needed in some areas.
Use of ultrasonographic guidance in interventional musculoskeletal procedures: a review from a single institution.
Authors: Sofka C M , Collins A J , Adler R S
Published: January 2017

We have evaluated the utility of ultrasonographic guidance for intervention in the musculoskeletal system. All interventional musculoskeletal procedures using ultrasonographic guidance performed at our institution from July 1998 through November 1999 were reviewed. Examinations were performed using either a linear or curved phased array transducer, based on depth and local geometry. The choice of needle was likewise optimized for specific anatomic conditions. One hundred ninety‐five procedures were performed on 167 patients from July 1998 through November 1999. Thirty‐one procedures had magnetic resonance correlation within 6 months beforehand. Excluding large‐joint aspirations and injections, we found that 180 of the procedures were more readily performed using ultrasonography than any other imaging modality. These included therapeutic injections into tendon sheaths (biceps, flexor digitorum longus, posterior tibial, and iliopsoas), Morton's neuromas, plantar fascia, wrist ganglia, and tarsal tunnel cysts; peritendinous hamstring injections; and synovial cyst and muscle biopsies. In all cases, the target of interest was identified easily with ultrasonography, and needle position was documented readily. Also in all cases, aspiration or medication delivery to the site of interest was observed during real time and was documented on postprocedure images of the area. No significant complications (e.g., bleeding, infection, and neurovascular compromise) were encountered during or immediately after any procedure. Ultrasonography is a readily available imaging modality useful for guiding interventional procedures in the musculoskeletal system. The ability to document exact needle placement in real time confirms accurate placement of therapeutic injections, fluid aspiration, and soft tissue biopsies.
Comparison of tubal ring and corpus luteum echogenicities: a useful differentiating characteristic.
Authors: Frates M C , Visweswaran A , Laing F C
Published: January 2017

The purpose of this report is to compare the echogenicity of the tubal ring of an ectopic pregnancy and the corpus luteum with that of the ovary for improved detection of early ectopic pregnancy. In patients with ectopic pregnancy diagnosed at sonography on the basis of the presence of an adnexal tubal ring, echogenicity of the ring was compared with the echogenicity of the ovarian parenchyma. Twenty‐six patients with tubal rings containing either a yolk sac or cardiac activity were included. Twenty‐three (88%) of the 26 tubal rings had echogenicity equal to or greater than that of ovarian parenchyma. In 13 patients with ectopic pregnancy diagnosed on the basis of an empty tubal ring, 10 rings (77%) were more echogenic than the ovary. In 45 control patients with intrauterine pregnancy, the corpus luteum was more echogenic than the ovary in only 3 (7%). The tubal ring of an ectopic pregnancy is usually more echogenic than ovarian parenchyma, and the corpus luteum is usually equal to or less echogenic than the ovary. Echogenicity of an adnexal mass may help distinguish the tubal ring of an ectopic pregnancy from a corpus luteum.
Isolated sonographic markers for detection of fetal Down syndrome in the second trimester of pregnancy.
Authors: Nyberg D A , Souter V L , El-Bastawissi A , Young S , Luthhardt F , Luthy D A
Published: January 2017

To determine whether sonographic "markers" are associated with fetal Down syndrome during the second trimester and to estimate the degree of risk of individual markers using likelihood ratios.

Second‐trimester (14‐20 weeks) sonographic findings in 186 fetuses with trisomy 21 were compared with a control group of 8728 consecutive control fetuses. Six markers were evaluated: nuchal thickening, hyperechoic bowel, shortened femur, shortened humerus, echogenic intracardiac focus, and renal pyelectasis.

Major or structural abnormalities were observed in 31 fetuses with trisomy 21 (16.7%) and 53 control fetuses (0.6%) (P< .001). Some type of sonographic finding (major abnormality, minor marker, or both) was observed in 68.8% of fetuses with trisomy 21 compared with 13.6% of control fetuses (P < .001). An isolated minor or "soft" marker was the only sonographic finding in 42 (22.6%) of 186 fetuses with trisomy 21 compared with 987 (11.3%) of 8728 control fetuses (P < .001). Nuchal thickening (P < .001; likelihood ratio, 11) and hyperechoic bowel (P < .001; likelihood ratio, 6.7) showed the strongest association with trisomy 21 as isolated markers, followed by shortened humerus (likelihood ratio, 5.1), echogenic intracardiac focus (likelihood ratio, 1.8), shortened femur (likelihood ratio, 1.5), and pyelectasis (likelihood ratio, 1.5). Echogenic intracardiac focus was the single most common isolated marker in both affected fetuses (7.1%) and control fetuses (3.9%) but carried a low risk (P= .046; likelihood ratio, 1.8).

A single soft marker is commonly encountered during the second trimester among fetuses with trisomy 21. The risk of fetal Down syndrome, reflected by likelihood ratios, was determined for 6 individual markers. This information can be combined with the a priori risk to estimate the individual patient risk for fetal Down syndrome.
Differential diagnosis of solid breast lesions: contribution of Doppler studies to mammography and gray scale imaging.
Authors: Özdemir A , Özdemir H , Maral I , Konuş O , Yücel S , Işik S
Published: January 2017

To assess the role of Doppler sonography when used in conjunction with mammography and gray scale sonography in differentiating solid breast lesions and to find out whether lesion size is a limiting factor for Doppler evaluation.

One hundred twelve lesions (70 malignant and 42 benign) detected with mammography and sonography were prospectively examined with color, power, and pulsed Doppler sonography. Vascularity was analyzed morphologically (vessel location, form, and color tone) and semiquantitatively (by spectral indices) to determine the valuable diagnostic flow characteristics. The lesions were classified by 2 observers as benign or malignant on the basis of each diagnostic technique (namely, a combination of mammography and gray scale sonography, presence or absence of blood flow, morphologic flow analysis, and spectral flow analysis). The results were compared with the histologic diagnosis in 105 lesions and with the clinical and radiologic diagnosis after at least 2 years of follow‐up in 7 lesions.

The sensitivity and specificity of the mammography‐gray scale sonography combination were 98.6% and 76.2%, respectively. Neither morphologic nor spectral Doppler analysis proved to be successful on its own, however, information obtained from investigated morphologic and spectral flow features increased the specificity of mammography and gray scale sonography for lesions 10 mm and smaller (from 88.9% to 100%) and those larger than 10 mm (from 70% to 96.6%).

Our data show that Doppler sonography is a beneficial adjunct to mammography and gray scale sonography for solid breast lesions 10 mm and smaller and those larger than 10 mm.
Postnatal outcome of fetuses with the prenatal diagnosis of asymmetric hydrocephalus.
Authors: Durfee S M , Kim F M , Benson C B
Published: January 2017

We sought to assess the sonographic findings and postnatal outcome in fetuses with the prenatal diagnosis of asymmetric hydrocephalus. The sonograms from cases of asymmetric hydrocephalus diagnosed prenatally at our institution were reviewed. Postnatal outcome was obtained from maternal, neonatal, and pediatric records. Fourteen fetuses at 17.3 to 38.9 weeks' gestational age on prenatal sonography had a maximum ventricular measurement of 10.2 to 48.8 mm, with the degree of asymmetry ranging from 2.2 to 27.3 mm. Thirteen of 14 had a normal‐sized contralateral ventricle. Other fetal anomalies identified at sonography included Dandy‐Walker malformation, intraventricular hemorrhage, porencephalic cyst, hydronephrosis, pleural effusion, and mild dilatation of a renal pelvis. Eleven fetuses had follow‐up prenatal sonography. Among these, ventricular dilatation resolved in 5, remained the same in 3, increased in 2, and decreased in 1. Postnatal outcome was normal in 6 cases (43%) and abnormal in 8 (57%), including 2 cases of in utero intracranial hemorrhage, 2 with congenital syndromes, 1 with an imperforate foramen of Monro, 1 with tuberous sclerosis, 1 with developmental delays, and 1 with cerebral palsy. Asymmetric unilateral hydrocephalus appears to represent an entity different from bilateral hydrocephalus in that there is less risk of perinatal death, there are fewer associated anomalies, and the overall prognosis is better. Outcome may be normal, but fetuses with increasing unilateral ventriculomegaly and cases associated with other brain abnormalities tend to have a poor neurologic outcome.
Spiral computed tomographic imaging related to computerized ultrasonographic images of carotid plaque morphology and histology.
Authors: Grønholdt M L , Wagner A , Wiebe B M , Hansen J U , Schroeder T V , Wilhjelm J E , Nowak M , Sillesen H
Published: January 2017

Echolucency of carotid atherosclerotic plaques, as evaluated by computerized B‐mode ultrasonographic images, has been associated with an increased incidence of brain infarcts on cerebral computed tomographic scans. We tested the hypotheses that characterization of carotid plaques on spiral computed tomographic images correlates with that on computerized B‐mode ultrasonographic images and that spiral computed tomographic imaging predicts the histomorphometric plaque content.

The study included 38 patients with neurologic symptoms and at least 50% stenosis of the ipsilateral carotid artery. High‐resolution B‐mode ultrasonographic images and spiral computed tomographic images of carotid plaques were computer processed to yield a quantitative measure, the gray scale level of the plaque.

The mean Hounsfield value for spiral computed tomographic images correlated with the gray scale median for B‐mode ultrasonographic images (univariate linear regression analysis: r = 0.45; P = .01) and the histologic content of calcification in the plaque (r = 0.34; P = .04) but not with lipid, hemorrhage, or fibrous tissue in the plaque.

Spiral computed tomographic imaging seems to correlate with B‐mode ultrasonographic imaging for showing plaque characteristics. Spiral computed tomographic attenuation was also correlated with the amount of calcification noted on histologic examination but not with lipid and hemorrhage, the components thought to characterize vulnerable, rupture‐prone plaques.
Ultrasonographic evaluation of diaphragmatic motion.
Authors: Gerscovich E O , Cronan M , McGahan J P , Jain K , Jones C D , McDonald C
Published: January 2017

To evaluate the technical feasibility and utility of ultrasonography in the study of diaphragmatic motion at our institution.

The study consisted of 2 parts. For part I, in 23 volunteers we performed 23 studies on 46 hemidiaphragms with excursions documented on M‐mode ultrasonography For part II, in 22 patients we performed 52 studies in 102 hemidiaphragms. In 50 studies both hemidiaphragms were studied, and in another 2 studies only 1 hemidiaphragm was studied. Patients' ages ranged from birth to 66 years (mean, 23 years). There were 16 male and 6 female patients. Indications for the study were (1) suggestion of paralysis of the diaphragm (n = 22); (2) if the diaphragm was already known to be paralyzed, for evaluation of response to phrenic nerve or pacer stimulation (n = 9); and (3) follow‐up of previous findings (n = 21). Patients were examined in the supine position in the longitudinal semicoronal plane from a subcostal or low intercostal approach. Motion was documented with real‐time ultrasonography and measured with M‐mode ultrasonography.

Of the 102 clinical hemidiaphragms studied, findings included normal motion (n = 42), decreased motion (n = 22), no motion (n = 6), paradoxical motion (n = 10), positive pacer response (n = 13), negative pacer response (n = 2), positive phrenic stimulation (n = 6), and negative phrenic stimulation (n = 1). There were no failures of visualization.

Ultrasonography proved feasible and useful in evaluating diaphragmatic motion. In our practice it has replaced fluoroscopy. Ultrasonography has advantages over traditional fluoroscopy, including portability, lack of ionizing radiation, visualization of structures of the thoracic bases and upper abdomen, and the ability to quantify diaphragmatic motion.
Accuracy of Real‐time Three‐dimensional Echocardiography for Quantifying Right Ventricular Volume
Authors: Schindera Sebastian T. , Mehwald Petra S. , Sahn David J. , Kececioglu Deniz
Published: January 2017

Objective. The complex structural geometry of the right ventricle hinders accurate assessment of right ventricular volume and function on conventional two‐dimensional echocardiography. We sought to evaluate the accuracy of real‐time three‐dimensional echocardiography for quantifying the volume of the right ventricle in an in vitro experimental study. Methods. We developed 39 anatomically accurate latex phantoms of human and porcine right ventricles (range, 24–108 mL) for 39 static and 10 pulsatile models. Real‐time three‐dimensional scanning was performed with the models placed in a water bath and with a 3.5‐MHz probe. In the dynamic models a pulsatile flow pump generated 2 different stroke volumes (29 and 64 mL/beat). Static chamber volumes and stroke volumes were verified by water displacement, which served as a reference standard. Three‐dimensional echo right ventricle volumes were determined by tracing derived B‐ and C‐scans, using the Simpson rule. Results. Multiple regression analyses showed an excellent correlation between real‐time three‐dimensional echocardiographic determinations and the static volumes (B‐scan, r = 0.99; C‐scan, r = 0.98; P < .001), as well as stroke volumes in the dynamic model (B‐scan, r = 0.90; C‐scan, r = 0.86; P < .001). However, the C‐scans tended to underestimate cavity and stroke volumes more than the B‐scans (mean difference for static volume: B‐scan, 1.4% ± 9.8%; C‐scan, –7.4% ± 8.0%; P < .001; mean difference for stroke volumes: B‐scan, 3.0% ± 19.1%; C‐scan, –2.5% ± 20.9%; P < .001). Conclusions. Real‐time three‐dimensional echocardiography can accurately quantify right ventricle cavity volumes and stroke volumes without geometric assumptions.
Correlation Between Sonographic and Pathologic Findings in Muscle Injury
Authors: Kim Hyoung Jung , Ryu Kyung Nam , Sung Dong Wook , Park Yong Koo
Published: January 2017

Objective. To evaluate the serial sonographic findings of experimental muscle injury and to correlate those findings with the pathologic findings at each period. Methods. A muscle injury was artificially inflicted in 18 legs of 9 rabbits. Sonographic follow‐up images were obtained 1, 3, and 7 days and 2, 3, 4, 6, and 8 weeks after infliction of muscle injury. Pathologic specimens were obtained for comparison with sonographic findings on each date. Results. There was high echogenicity in the central portion after 3 days. It changed to low echogenicity after 7 days. There were linear echogenic lines in the central portion after 4 weeks, and these lines increased in number after 6 weeks. The peripheral portion exhibited high echogenicity up to 7 days. This high echogenicity was normalized after 2 weeks. Pathologic specimens showed hematomas, fibrin, and necrotic muscle fibers in the central portion up to 3 days after injury. Fibrin occupied most of the central portion after 2 weeks. Regenerating muscle fibers appeared within the fibrin clot after 4 weeks, and they became more prominent after 6 weeks. Necrotic muscle fibers, hemorrhage, and inflammatory cells of the peripheral portion disappeared after 2 weeks. Conclusions. Serial sonography of muscle injury was well correlated with the pathologic specimen up to 7 days after injury. After 4 weeks, regenerating muscle fibers showed a good correlation with the finding on sonography. Therefore, sonography can be helpful in diagnosis of muscle injury as well as in evaluation of the regenerating muscle fibers.
Ultrasonography of the Accessory Nerve
Authors: Bodner Gerd , Harpf Christoph , Gardetto Alex , Kovacs Peter , Gruber Hannes , Peer Siegfried , Mallhoui Ammar
Published: January 2017

Objective. To determine feasibility of ultrasonography in detecting the normal accessory nerve as well as pathologic changes in cases of accessory nerve palsy. Methods. Four patients with accessory nerve palsy were investigated by ultrasonography. Three cases of accessory nerve palsy after lymph node biopsy and neck dissection were primarily diagnosed on the basis of ultrasonography using a 5‐ to 12‐MHz linear transducer. In addition, we performed ultrasonography in 3 cadaveric specimens to show the feasibility of detecting the accessory nerve. Results. Nerve transection (n = 2), scar tissue (n = 1), and atrophy of the trapezius muscle (n = 4) were confirmed by electroneurographic testing and surgical nerve inspection. In 1 case in which a patient had a whiplash injury with accessory nerve palsy, ultrasonography showed atrophy of the trapezius muscle with a normal nerve appearance. Conclusions. Ultrasonography allows visualization of the normal accessory nerve as well as changes after accessory nerve palsy.
Persistent Median Artery in the Carpal Tunnel
Authors: Gassner Eva Maria , Schocke Michael , Peer Siegfried , Schwabegger Anton , Jaschke Werner , Bodner Gerd
Published: January 2017

Objectives

To describe the ultrasonographic and color Doppler ultrasonographic findings in 2 patients with carpal tunnel syndrome associated with a persistent median artery and to report the frequency of this anatomic variation in healthy volunteers.

Methods

Two patients with the clinical appearance of carpal tunnel syndrome and 100 wrists and distal forearms of 50 asymptomatic volunteers were examined with ultrasonography and color Doppler ultrasonography. The frequency and size of a persistent median artery and its relationship to median nerve anatomy in the carpal tunnel were evaluated.

Results

A large persistent median artery of 3 mm in diameter was found in the affected hands in both patients with carpal tunnel syndrome. Findings were confirmed at surgery. Among the asymptomatic volunteers, a persistent median artery could be found in 13 (26%, 10 [20%] unilateral and 3 [6%] bilateral), with a mean diameter of 1.1 mm (range, 0.5–1.7 mm). In 10 (63%) of 16 hands, the persistent median artery was associated with high division of the median nerve or a bifid nerve configuration in the carpal tunnel.

Conclusions

A persistent median artery is a common condition in healthy individuals and in most cases is related to median nerve variations such as high division or a bifid nerve. Because a persistent median artery has a superficial course close to the transverse carpal ligament, preoperative diagnosis of this anatomic variation may be of clinical importance.
Impaired Uterine Arterial Blood Flow in Pregnant Women With Recurrent Pregnancy Loss
Authors: Nakatsuka Mikiya , Habara Toshihiro , Noguchi Soichi , Konishi Hideki , Kudo Takafumi
Published: January 2017

Objective. This study was undertaken to evaluate uterine perfusion, which regulates uterine receptivity, in women with recurrent pregnancy loss. Methods. We evaluated the blood flow resistance in the uterine arteries of 104 pregnant women at 4 to 5 weeks' gestation by transvaginal pulsed Doppler ultrasonography (control group, n = 52; and recurrent pregnancy loss group, n = 52). Blood tests for antinuclear and antiphospholipid antibodies were also performed. Results. The uterine arterial pulsatility index in the recurrent pregnancy loss group was significantly higher than that in the control group. Women with antinuclear or antiphospholipid antibodies had an elevated pulsatility index in the uterine artery, which is prominent in women with recurrent pregnancy loss. Coagulopathy and vascular dysfunction caused by autoantibodies may impair uterine perfusion. However, the uterine arterial pulsatility index in the recurrent pregnancy loss group was significantly higher than that in the control group even among women without antinuclear antibodies or among women without antiphospholipid antibodies. This observation strongly suggests that the uterine artery pulsatility index may be an independent index for recurrent pregnancy loss. Conclusions. The introduction of pulsed Doppler ultrasonography has provided the means for noninvasive evaluation of uterine impedance and may identify patients with recurrent pregnancy loss associated with impaired uterine perfusion.
Fetal Anatomic and Functional Echocardiography
Authors: Driggers Rita W. , Spevak Philip J. , Crino Jude P. , Lantz Michael , Blakemore Karin J.
Published: January 2017

Objective. To assess the concordance of fetal and postnatal echocardiography when congenital heart disease is suspected prenatally. Methods. The perinatology and pediatric cardiology ultrasound databases were searched for fetal echocardiograms obtained between June 1995 and June 2000. All cases with abnormal fetal echocardiographic findings in which postnatal echocardiography was performed were included. A perinatologist, pediatric cardiologist, or both interpreted all fetal echocardiograms; a pediatric cardiologist interpreted all postnatal echocardiograms. The fetal and postnatal echocardiograms were compared for the presence of 25 specific components. The κ statistic was calculated to evaluate concordance between fetal and postnatal studies. Positive and negative predictive values for fetal studies were calculated under the assumption that the postnatal study yielded the correct diagnosis. Results. Sixty‐five patients were included. Congenital heart disease ranged from an isolated atrial septal defect to complex disease. Images adequately showed all 25 components in more than 85% of the fetal studies. Concordance between fetal and postnatal echocardiograms was excellent (κ > 0.75) for 20 of the 25 components evaluated. Four of the remaining 5 components had fair concordance (κ = 0.4–0.75) between fetal and postnatal studies. Structural abnormalities without excellent concordance included partial anomalous pulmonary venous return, secundum atrial septal defects, and heart malposition. Concordance between fetal and postnatal right and left ventricular function was fair; however, differences may have been due to physiologic changes that occurred after birth rather than to inferior diagnostic accuracy of fetal echocardiography. Conclusions. Fetal echocardiography is an extremely useful and accurate clinical tool for prenatal and postnatal evaluation of congenital heart disease.
Three‐dimensional Sonographic Evaluation of the Common Bile Duct
Authors: Rao Ashutosh V. , Champine Julie G. , Forte Thalia B. , Brewington Cecelia C.
Published: January 2017

Objective. To assess the accuracy of three‐dimensional sonographic measurements of the common bile duct compared with standard two‐dimensional anteroposterior measurement of the common duct. Methods. Fifty‐five consecutive patients referred for abdominal sonography underwent standard two‐dimensional abdominal sonography followed by three‐dimensional sonographic data acquisition of the right upper quadrant. A radiologist blinded to the results of the two‐dimensional examination later measured the three‐dimensional long axis anteroposterior common duct diameter and three‐dimensional short axis anteroposterior and transverse common duct diameters. Results. The mean average common duct diameter as measured by two‐dimensional sonography (long axis anteroposterior) was 3.6 mm. The mean average common duct diameter as measured by long axis anteroposterior three‐dimensional sonography was 4.1 mm. The mean average common duct diameter as measured by anteroposterior short axis three‐dimensional sonography was 4.1 mm, and by transverse short axis three‐dimensional sonography, it was 4.4 mm. The two‐dimensional common duct measurement correlated with the long axis anteroposterior three‐dimensional measurement (P < .001), the short axis anteroposterior three‐dimensional measurement (P < .001), and the short axis transverse three‐dimensional measurement (P < .005) by the Spearman rank order correlation coefficient test. Conclusions. Three‐dimensional sonographic measurements of the common bile duct correlate highly with two‐dimensional measurements, validating the use of three‐dimensional sonography as a reliable method for evaluation of common bile duct size.
Effects of Hypertension and Antihypertensive Treatment on Retrobulbar Circulation Detected on Doppler Sonography
Authors: Karadeniz-Bilgili M. Yasemin , Ekmekci Yakup , Koksal Aydin , Akarsu Cengiz , Ziraman Ipek
Published: January 2017

Objective. To study the effect of antihypertensive drugs in essential hypertension and in the central retinal, posterior ciliary, and ophthalmic arteries by using Doppler sonography. Methods. Thirty patients with essential hypertension and 32 control subjects were enrolled in the study. The pulsatility and resistive indices were evaluated in the central retinal, posterior ciliary, and ophthalmic arteries before and 2 months after treatment with antihypertensive drugs as well as in the control group. The pulsatility and resistive index values for each artery in each group were compared statistically. Results. There were significant differences in the retrobulbar pulsatility and resistive index values in each artery among the patients with initially diagnosed hypertension and the control group (P < .05). There were significant reductions in the resistive and pulsatility index values of the posterior ciliary and ophthalmic arteries after treatment (P < .05). For the ophthalmic artery, posttreatment pulsatility and resistive index values did not reach the level of flow measured in the control subjects. Conclusions. The alteration of Doppler parameters of medication‐free patients with hypertension may result from a peripheral vasospasm in the retrobulbar circulation, and the improvement in the Doppler parameters with oral antihypertensive drugs may indicate the importance of early diagnosis in ameliorating hypertension‐induced retrobulbar circulation changes.
Quantification of Tumor Vascularity With Contrast‐Enhanced Sonography
Authors: Fleischer Arthur C. , Donnelly Edwin F. , Grippo Ryan J. , Black Amy S. , Hallahan Dennis E.
Published: January 2017

Objective. To correlate the quantitated tumor vascularity of implanted murine tumors as depicted by contrast‐enhanced sonography with estimates made with magnetic resonance imaging and with estimates of the percentage of viable (metabolically active) tumor as depicted by fluorodeoxyglucose autoradiography. Methods. Implanted tumors in 10 mice were imaged with contrast‐enhanced sonography, magnetic resonance imaging, and fluorodeoxyglucose autoradiography. Tumor vascularity was estimated with each modality and compared with the percentage of viable tumor. Results. Quantitated estimates of tumor vascularity with contrast‐enhanced sonography closely correlated (r = 0.95) with estimates made by magnetic resonance imaging and with the percentage of viable tumor (r = 0.93) as depicted by fluorodeoxyglucose autoradiography. Conclusions. Contrast‐enhanced sonography accurately depicts tumor vascularity in these implanted tumors. Tumor vascularity correlated with the amount of metabolically active tumor.
Sonographic Comparison of the Tubal Ring of Ectopic Pregnancy With the Corpus Luteum
Authors: Stein Marjorie W. , Ricci Zina J. , Novak Leon , Roberts Jeffrey H. , Koenigsberg Mordecai
Published: January 2017

Objective. Pregnant patients without a sonographically visible intrauterine pregnancy and with a thick‐walled cystic adnexal structure present a dilemma. This study compared the utility of various sonographic features in differentiating between the tubal ring of ectopic pregnancy and the corpus luteum. Methods. Retrospective review of first‐trimester transvaginal sonograms revealed a cystic adnexal structure in 79 women. Each structure was evaluated for 6 specific sonographic characteristics: echogenicity of its wall compared with that of the ovary and endometrium, wall thickness in 2 planes, color Doppler flow distribution and percentage of wall circumference, and internal texture. Results. Forty‐one (52%) of the 79 women had ectopic pregnancies, and 38 (48%) had corpora lutea. Eleven (32%) of 35 ectopic walls were more echogenic than the endometrium, compared with none of the corpora lutea. A cyst wall less echogenic than the endometrium was more likely in corpora lutea (84% versus 31%; P < .0001). More than twice as many ectopic rinds were more echogenic than ovarian tissue compared with corpora lutea (76% versus 34%; P < .0001). The only predictive internal texture feature was a clear pattern, which was more common in the corpora lutea (P < .01, Fisher exact test). There was no significant difference in mural flow distribution or extent between the 2 groups. Conclusions. Ancillary sonographic signs to distinguish between an ectopic pregnancy and a corpus luteum include decreased wall echogenicity compared with the endometrium and an anechoic texture, which suggests a corpus luteum.
Tuberculosis of the Parotid Gland
Authors: Chou Yi-Hong , Tiu Chui-Mei , Liu Cheng-Yi , Hong Tun-Mei , Lin Ching-Zong , Chiou Hong-Jen , Chiou See-Ying , Chang Cheng-Yen , Chen Ming-Sheng
Published: January 2017

Objective. Involvement of the parotid gland by tuberculosis (TB) is rare. If treated properly, the prognosis of TB of the parotid gland is good. In this retrospective study, we report our experience with sonography and sonographically guided aspiration in the diagnosis of parotid TB. Methods. Over 12 years, 9 adults (mean age, 48 years) with parotid gland TB had been examined with high‐resolution sonography and color Doppler sonography for their clinical problems of swelling on the mandibular angle. Sonographically guided fine‐needle aspiration was done for cytologic study, stains for acid‐fast bacilli, and cultures for mycobacterium. Results. The sonographic patterns were classified as chiefly the parenchymal type (4 patients) and chiefly the periparotid type (5 patients). The parenchymal type appeared as a diffusely enlarged, comparatively hypoechoic gland (compared with the contralateral asymptomatic gland), with or without focal intraparotid nearly anechoic zones, which might have a cavity or cavities within it. The periparotid type appeared as hypoechoic nodules located in the peripheral zone of the hyperechoic parotid gland, consistent with enlarged periglandular lymph nodes. The diagnosis of parotid TB was made in 8 of 9 patients on the basis of sonographically guided aspiration for acid‐fast bacilli stains, cytologic study, and cultures for mycobacterium. Conclusions. Sonographic examination contributes substantially in the diagnosis of parotid TB infection. In the presence of diffuse parotid echo pattern changes with periparotid lymphadenopathy, and with or without focal hypoechoic zones, TB infection should be differentiated. Sonographically guided fine‐needle aspiration may provide further diagnostic information by means of stains, cultures, and cytologic study.
Karyotyping of Fetuses With Isolated Choroid Plexus Cysts Is Not Justified in an Unselected Population
Authors: Coco Claudio , Jeanty Philippe
Published: January 2017

Objective. The main objective of this study was to determine whether isolated choroid plexus cysts are a risk factor for trisomy 18. Methods. A total of 12,672 unselected patients were examined, and the outcome of fetuses with choroid plexus cysts was assessed. The cases with choroid plexus cysts were selected from the 12,672 patients and further divided into cases with minor markers of aneuploidy and cases with associated structural anomalies. Previous similar work was reviewed, analyzed, and, where possible, compared with the results of this study. Results. The findings revealed 366 fetuses with choroid plexus cysts (2.9%). Thirty‐three percent of fetuses with trisomy 18 had choroid plexus cysts, and, in every case, structural anomalies were also present. From the 12 cases with choroid plexus cysts in addition to major associated anomalies, amniocentesis revealed 2 cases of trisomy 18. Forty‐three patients who had choroid plexus cysts and minor anomalies within our population had normal outcomes. Conclusions. These results indicate that the risk of amniocentesis is not acceptable if isolated choroid plexus cysts are isolated findings. More data are needed to establish whether choroid plexus cysts and other soft signs independently increase the risk of aneuploidy.