bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypocalcemia after Thyroidectomy: The Need for Improved Definitions
Authors: Jessie WU , Harrison Barney 
Published: June 2010

ABSTRACTIntroductionHypocalcemia and permanent hypoparathyroidism are important outcome measures after total thyroidectomy. The aim of this article is to identify and highlight the wide variation in the adequacy/definition of these complications as reported in the surgical literature.MethodsNineteen journal articles (2008) on complications of thyroidectomy and 17 journal articles (2002) on ‘prediction’ of postthyroidectomy hypocalcemia derived from a PubMed search were reviewed.ResultsOnly 21% of studies of describing outcome and complications of thyroidectomy defined hypocalcemia, temporary/permanent hypoparathyroidism. 47% of studies on the early prediction of hypocalcemia failed to quote their normal range of serum calcium. When stated, the biochemical definition of hypocalcemia varied from 1.8 to 2.12 mmol/l. There is no consistent definition of post-thyroidectomy hypoparathyroidism.ConclusionThere is no consensus apparent on literature review as to what constitutes post-thyroidectomy hypocalcemia and hypoparathyroidism. The need to benchmark and define appropriate outcome measures of thyroid surgery demands that this deficit is addressed.
Which Parameters could be Useful for Predicting Malignancy in Solid Adnexal Masses?
Authors: Alcázar Juan Luis , Royo Pedro , Pineda Laura 
Published: June 2010

Abstract
To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses.

Methods
Clinical (age, menopausal status, complaints and physical examination), biochemical (serum CA-125 levels) and other sonographic features (tumor volume, ascites, bilaterality, blood flow location and velocimetric pattern) from 163 women diagnosed as having a solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy.

Results
A total of 173 masses were analyzed. Patients mean age was 52.4 years (range: 15 to 84 years) 117 masses were malignant and 56 were benign. After univariate analysis all parameters showed statistical differences between benign and malignant tumors. After logistic regression analysis only central blood flow (odd ratio: 64.2, 95% CI: 17.07 to 242.03) and presence of ascites (odd ratio: 32.77, 95% CI: 5.38 to 199.72) were identified as independent predictors of malignancy. The presence of one of these two features correlated to malignancy in 98.6% of cases. The absence of both was found in 82.1% of benign tumors.

Conclusions
The presence or absence of ascites or central blood flow may be helpful for discriminating benign from malignant solid adnexal masses.
Ultrasound in the Diagnosis of Deep Endometriosis
Authors: Ajossa Silvia , Paoletti Anna Maria , Garau Nicoletta , Mais Valerio , Piras Bruno , Gerada Marta , Silvetti Enrico , Orrù Marisa , Floris Lucia , Melis Gian Benedetto 
Published: June 2010

Abstract
Deep pelvic endometriosis is defined as subperitoneal infiltration of endometrial implants in the uterosacral ligaments, rectum, rectovaginal septum, vagina, or bladder. Although laparoscopy and biopsy remain the gold standard for diagnosis, transvaginal ultrasonography should be considered as the first-line procedure because of its high diffusion and relatively low cost and discomfort. We analyzed in the present review the diagnostic capability of transvaginal ultrasonography in the detection of presence of deep endometriosis in some specific pelvic localizations such as bowel, uterosacral ligaments, rectovaginal septum and/or vagina. We also analyzed the few studies performed in the evaluation of bladder endometriosis. Although some studies are controversial, transvaginal ultrasonography seems to be an accurate technique in the identifications of deep endometriosis in several pelvic locations but a specific training of the operators is suggested.
Three-dimensional Ultrasonography in the Diagnosis of Müllerian Duct Anomalies
Authors: Bermejo Carmina , Cantarero Rocío , Díaz Dolores , Labrador Eva , López Laura Ruiz 
Published: June 2010

Abstract

Aims
We studied the effectiveness of three-dimensional (3D) ultrasonography in the diagnosis of uterine malformations.

Methods
175 patients with clinical or ultrasonographic suspicion of uterine malformation were studied between November 2004 and June 2008. In all women we measured uterine volume for processing and later reconstruction of 3D images. Cases in which no anomaly was detected with the 3D technique were excluded from study. A thorough physical genital examination with speculum was done before or after ultrasonography, except in three women with an imperforate hymen. Uterine malformations were recorded in detail, and the findings were catalogued according to the American Fertility Society (AFS) classification. In 32 women magnetic resonance (MR) imaging was also used, and agreement between the two techniques was calculated with the kappa index.

Results
The 175 müllerian anomalies we analyzed were diagnosed as agenesis (1 case), unicornuate uterus (1 genuine, 1 communicating), didelphys uterus (4), bicornuate uterus (22), septate uterus (80, 8 with two cervices) and arcuate uterus (68). For 1 unicornuate, 3 bicornuate, 25 septate (4 with two cervices) and 3 arcuate uteri we performed MR imaging. Diagnostic correlation between 3D ultrasonography and MR imaging was obtained in all cases according to the AFS classification (kappa = 100%); concordance was also seen for descriptions of associated uterine malformations except for two cases: 1 bicornuate uterus with the additional presence of a cervical septum as detected by MR imaging, which was not found on hysteroscopy for resection, and 1 septate uterus that appeared to have two cervices on 3D ultrasonography in a patient in whom physical examination was not possible, and in whom MR imaging showed a complete septum with hypointense signals (kappa = 93.45%; 95% confidence interval 80.75- 100%).

Discussion
Owing to its ability to clearly render contours of anatomical structures, 3D ultrasonography provides detailed images of uterine malformations and yields very similar results to those obtained with MR imaging. For an accurate comparison of the two techniques, ultrasonography should be accompanied by gynecologic physical exploration, since the two methods yield equivalent results for the relation between the uterine cavity and the fundus. MR imaging is especially useful to evaluate the cervix and vagina.
Tissue Block Ultrasound and Ovarian Cancer— A Pictorial Presentation of Findings
Authors: Crade Michael 
Published: June 2010

Abstract
Malignancy has classically been described, as having vessels “seemingly deployed without purpose.” In other words, vascularity that does not have tree like in branching with orderly distal tapering is abnormal. 3D imaging can create a virtual cast of vessels, to be “cut into” and “manipulated” on a computer monitor. This can be thought of as a most valuable “Tissue Block” of data, unlike any other imaging test, and I believe, holds the key to a more accurate diagnosis of ovarian cancer.
Impact of Ductus Venosus Assessment in Screening Down Syndrome Protocols: An Improved Strategy in a Fetal Medicine Unit
Authors: Echevarria Mónica , Comas Carmen , Rodríguez M Angeles , Nicolau Joan , Serra Bernat , Bach Concha , Sabrià Josep 
Published: June 2010

ABSTRACT

Objective
To estimate the improvement in screening efficiency when ductus venosus (DV) Doppler studies are added to existing Down syndrome (DS) screening protocols.

Methods
First-trimester combined screening for trisomy 21 was prospectively carried out, from October 2003 to March 2008, in 8842 consecutive singleton pregnancies attended in our tertiary reference center. The nuchal translucency (NT) and the pulsatility index for veins for DV were calculated. The maternal serum biochemistry was measured using the Kryptor analyzer, at the same time of the scan (one step strategy) or before it (two step strategy). The detection rate (DR) and false-positive rates for standard screening strategy (maternal age, NT and biochemistry) and the same strategy but including DV assessment were calculated.

Results
Successful DV assessment was possible in the 95.3% of cases, representing a total of 8426 cases. Down syndrome was identified in 34 pregnancies (prevalence of DS 1:250). For a fixed screen positive rate of 5%, the addition of the DV assessment improves the DR from 85 to 94% and, for a fixed DR of 85%, it reduces the number of unnecessary invasive tests from 3.7 to 3.2%.

Conclusion
Early evaluation of DV can be introduced to standard DS screening strategies in experienced centers as a first level test to reduce invasive test rate derived from the existing protocols.
Advances in Visualization of the Early Human Development
Authors: Azumendi Guillermo , Maeda Kazuo , Pooh Ritsuko K , Lausin Iva 
Published: June 2010

Abstract
The anatomy and physiology of placental and embryonic development is a field where medicine exerts its impact on early pregnancy and opens fascinating aspects of embryonic differentiation. The introduction of high frequency transvaginal transducers as well as three and four dimensional sonography has resulted in remarkable progress in ultrasonic visualization of early embryos and fetuses.
Ultrasound has been widely used in the field of early human development due to its safety, diagnostic accuracy and convenience. Normal fetal anatomy and development have been widely investigated using two-dimensional ultrasound and most of the knowledge regarding early human development were established through understanding of sectional images of fetal body and organs obtained by two-dimensional ultrasound. Usage of new techniques has produced more objective and accurate information of embryonal and early fetal development. For the first time parallel analyses of structural and functional parameters in the first 12 weeks of gestation become possible. This article deals with establishment of human life from ovum and sperm, though fertilization, detailed histological development and the establishment of the placenta, and early human development visualized by 2- and 3-dimensional ultrasonography.
Management of Multiple Pregnancy
Authors: Dudenhausen Joachim W 
Published: June 2010

Abstract

Background
Changing delivery age and successes in reproductive have medicine induced an increase in incidence of the multiples in the industrialized world.

Methods
Selective literature research was performed complemented by the autor's clinical experience and national and international guidelines

Results
The risks of prematurity, IUGR, and antenatal demise are raised. Maternal risks are pre-eclampsia, diabetes, and bleeding during delivery. Prenatal and genetic diagnostics including ultrasonography are the most important methods of supervision during pregnancy. These are significant for diagnosis of twin-to-twin transfusion syndrome and cygosity.

Consequences
Cooperation betweeen prenatal medicine, obstetrics and neonatology is important for the care of mothers with multiples.
Early Fetal Echocardiography at the Time of 11+0–13+6 Weeks Scan
Authors: Nocun Agnieszka , Wiechec Marcin , Beithon RT Jill 
Published: June 2010

Abstract
Early Fetal Echocardiography (EFE) is generally defined as a fetal cardiac scan performed until 16 weeks of gestation. Fetal indications for EFE in the first trimester are in strong connection with ultrasound findings during routine nuchal scan: early diagnosed extracardiac malformations, abnormal ductus venosus (DV) velocimetry, tricuspid valve regurgitation (TR), single umbilical artery and increased NT measurement as a major fetal factor. Essential components of EFE include: abdominal view (AbdV), four chamber view (4CV), three vessel view (3VV), origin and cross-over of the great arteries (GA), aortic arch (AoA), ductal arch (DA), superior and inferior venae cavae and at least 2 pulmonary veins.
EFE has some limitations, which determine delayed diagnosis of some CHDs. Early fetal echocardiography is feasible and reasonable. It gives parents the opportunity to exclude approximately 60% of cardiac abnormalities and to reassure them of normal heart anatomy as early as possible.
Fetal Aortic-cerebral Doppler Resistance Index Ratio: An Indicator of Physiologic Blood Flow Distribution
Authors: Tóth Zoltán , Aranyosi János , Deli Tamás , Bettembuk Péter , Kozma Bence , Kovács Tamás , Török Olga 
Published: June 2010

Abstract
Identical hemodynamic impedance and constant ratio of the fetal descending aorta and middle cerebral artery of uncomplicated pregnancies at term.
Fetal aortic-cerebral Doppler resistance index ratio: An indicator of physiologic blood flow distribution.

Objective
To interpret the physiologic fetal arterial blood flow distribution by relating the vascular impedance of the fetal descending aorta (DA) and middle cerebral artery (MCA) and to establish the reference ranges for the aortic-cerebral Doppler resistance index ratio (ACRI).

Study design
Ninety-six patients with uncomplicated pregnancies were recruited for the cross-sectional assessment of the Doppler resistance index (RI) in the fetal DA and MCA between the 38rd and 40th weeks of gestation. The normal ranges of the ACRI were calculated. A cut-off value was designed to facilitate the clinical application of the ACRI.

Results
Between the 38th and 40th weeks of gestation in normal pregnancies the ACRI of healthy fetuses is constant, the overall mean is: 1.062 (+/– 0.087). A single cut-off value of 1.2 is recommended to assist separating normal and pathologic arterial blood flow patterns.

Conclusion
The normal ACRI reflects the identical vascular resistance of the descending aorta and the cerebral vessels, which maintains the physiologic fetal central arterial blood flow. Additional clinical studies are necessary to assess the diagnostic efficacy of the abnormal ACRI (>1.2) as a potentially useful marker of the centralized arterial circulation indicating the early stage of fetal hypoxemic jeopardy.
Telemedicine and Ultrasound in Obstetrics and Gynecology
Authors: Eichbaum Quentin 
Published: June 2010

Abstract
Telemedicine refers to the use of telecommunication technologies for the purpose of transmitting medical information between physically separated clinical sites, in order to provide health care to patients at such remote locations. Additionally, telemedicine can be used to educate health care workers and students at distant locations. Telemedicine technologies can be categorized as either ‘store-andforward’ or ‘interactive’ (or ‘synchronous/asynchronous’) depending on the timing of the transmission of information. This review focuses on applications of telemedicine to the field of obstetric and gynecologic (Obs/Gyne) ultrasound. It also examines the utilization patterns of telemedicine, as well as its costs and benefits. Finally, this article examines the role of telemedicine in medical education, specifically also with reference to Obs/Gyne ultrasound.
Recognizing TORCH Group of Infections on Fetal Sonography
Authors: Patham Bhargavi , Subramanya Sandesh 
Published: June 2010

Abstract
Maternal infections with TORCH group of organisms during pregnancy pose a threat to the fetus in acquisition of congenital abnormalities. Detailed ultrasonographic screening and serological testing provide vital clues to the early diagnosis of these infections in the fetus. We summarize the clinical features associated with TORCH with special emphasis on the in utero ultrasound-guided diagnosis.
Integrative Diagnostics Approach— A Contemporary Learning Methodology at Medical Schools
Authors: Patham Bhargavi 
Published: June 2010

Abstract
Paul L Foster School of Medicine is adopting a clinical presentation based curriculum that encompasses an approach of teaching clinical knowledge, medical skills and diagnostic imaging to the first and second year medical students. This approach may help our students to better integrate knowledge they acquire during the first two years of their medical education into the years of clerkship, residency and beyond. We believe that early integration of different medical imaging modalities and basic science disciplines, in particular the anatomy and pathology, may lead to more efficient use of medical technology and cost beneficial medical practice in the future.
2D and 3D Power Doppler Ultrasound of Endometrium as Implantation Marker
Authors: Bau Santiago , Mercé Luis T , Barco María J 
Published: June 2010

Abstract
Transvaginal ultrasonography has an important role in assessing the endometrium. With 2DUS, a single measurement of endometrial thickness in the sagittal plane is widely used in assisted reproductive technology and in pregnancy prediction. Endometrial volume, measured with 3DUS, has been studied as a potentially more accurate parameter. The endometrial pattern was related to the likelihood of implantation. This pattern correlated in a positive fashion with subsequent implantation. 3D ultrasound and 3D power Doppler parameters have been applied to assisted reproductive techniques as outcome predictors, although studies are still scarce, they show very promising results.
Three-dimensional Power Doppler Ultrasonography for Discriminating Benign from Malignant Ovarian Tumors: Current Experience
Authors: Alcázar Juan Luis 
Published: June 2010

Abstract
The differential diagnosis of adnexal masses still constitutes a major clinical challenge. B-mode ultrasonography is the most used imaging technique and it is the base for this differential diagnosis with acceptable results in terms of sensitivity but a relatively high false positive rate for predicting ovarian cancer. The role of pulsed Doppler remains controversial and seems to be not reproducible in clinical practice. In the last years, a new technology such as 3D ultrasound—both morphology and 3D Angio power Doppler—has become available for discriminating between benign and malignant ovarian tumors. In this article I aim to review critically recent literature of this topic.
Three-dimensional Sonoembryology
Authors: Azumendi Guillermo 
Published: June 2010

Abstract
Three-dimensional ultrasound is advantageous in studying normal embryonic and fetal development, as well as providing information for families at risk for specific congenital anomalies by confirming normality. The introduction of highfrequency transvaginal transducers has resulted in remarkable progress in ultrasonographic visualization of early embryos and fetuses. Three-dimensional ultrasound imaging in vivo compliments pathologic and histologic evaluation of the developing embryo, giving rise to a new term: 3D sonoembryology.
Neuroscan of Normal and Abnormal Vertebrae and Spinal Cord
Authors: Pooh Ritsuko K 
Published: June 2010

Abstract
The vertebral body, neural arch and its processes develop from the sclerotome of the primitive mesodermal segments. After chondrification, separate ossification centres appear for the body and one for each of the neural arches. Vertebrae are composed of a body and a vertebral arch. The vertebral foramina, which consist of the vertebral arch and back of vertebral body, form the vertebral canal including and protecting the spinal cord. The vertebral arches are formed by two pedicles and two laminae which unite as a spinous process.
Relation between the vertebrae and spinal cord during pregnancy is interesting. In embryonal period, the CNS develops earlier than other part of embryonal structures and occupies approximately one third of the whole embryonal body. At the 3rd month of development the length of the spinal cord equals that of the vertebral column. The spinal nerves and the relationship of the spinal nerves to the vertebra are established. Therefore the spinal cord segment is at the same level as the corresponding vertebral level. In subsequent fetal period, however, fetal body structure including vertebral column develops faster than the neural tube. As the consequence of this different development of the column and nerves, caudal end of the spinal cord within the vertebral column relatively moves upward with advancing gestation and reaches to the level of the third lumber vertebra at birth.
Advances in Fetal Neurophysiology
Authors: Predojevic Maja , Kadic Aida Salihagic 
Published: June 2010

Abstract
The human brain function is certainly one of the most amazing phenomena known. All behavior is the result of the brain function. The 100 billion nerve cells are the home to our centers of feelings and senses, pleasure and satisfaction; it is where the centers for learning, memory and creative work are located; where laughing and crying areas and the centers of our mind are. Our cognitive functions, such as thinking, speaking or creating works of art and science, all reside within the cerebral cortex. One of the tasks of the neural science is to explain how the brain marshals its millions of individual nerve cells to produce behavior and how these cells are affected by the environment.1 The brain function still remains shrouded in a veil of mystery. But what is known is that over 99 percent of the human neocortex is produced during the fetal period.2 Owing to the employment of state-of-the-art methods and techniques in prenatal investigations, a growing pool of information on the development of the central nervous system (CNS) and behavioral patterns during intrauterine life has been made available. This review outlines these events, along with the development of the fetal sensory system and circadian rhythms, the senses of vision and hearing, fetal learning and memory, and long-term effects of fetal stress on behavior. In brief, this review offers a glimpse of the fascinating world of the intrauterine life.
Cerebral Hemodynamics and Fetal Behavioral States in IUGR Fetuses
Authors: Clerici Graziano , Renzo Gian Carlo Di 
Published: June 2010

Abstract
The aim of this study was to evaluate the hemodynamic patterns in the proximal (M1) and distal (M2) portions of the middle cerebral artery (MCA) during different fetal behavioral states (FBSs) in healthy and IUGR fetuses. After identification of the FBS in 20 normal (group A) and 8 IUGR (group B) singleton pregnancies (36- 40 weeks), flow velocity evaluation was performed on the M1 and M2 segment of the MCA during “quiescence” (FBS 1F) and “activity” (FBS 2F). In the group A, a statistically significant decrease of impedance to flow values was identified in both segments of the MCA during “activity”. In the group B not statistically significant differences were identified in the impedance to flow values during different FBSs. For each segments of MCA it was found significant lower impedance to flow values in the group B for all FBSs. The mean fetal heart rate during “quiescience” was significantly lower than during “activity” in both groups. The results of this study provide evidences of the influence of different FBSs on fetal cerebral hemodynamic patterns. These information should be considered in the evaluation of fetal cerebral hemodynamics.