bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Prophylactic Central Compartment Lymph Node Dissection Necessary for Papillary Thyroid Carcinoma?
Authors: Doherty Gerard M , McKenzie Travis J , Lillegard Joseph B , Grant Clive S , Hay Ian D , Fisher James E , Thompson Geoffrey B 
Published: June 2010

ABSTRACTThe need for prophylactic central compartment lymph node dissection in patients with papillary thyroid carcinoma continues to be a subject of ongoing debate. Regional lymph node metastases are a common finding with papillary thyroid carcinoma, with an incidence as high as 50% or more. With the widespread use of high resolution ultrasound and sensitive thyroglobulin assays, lymph node metastases, not appreciated at the time of surgery, are showing up in the follow-up period, creating significant angst amongst patients, endocrinologists, and their surgeons. It was previously thought that lymph node metastases in papillary thyroid carcinoma had little bearing on survival, but this has more recently been challenged. Opponents of prophylactic central compartment node dissection cite high perioperative morbidity as a word of caution in performing prophylactic central neck dissections. The following review will look at the most up-to-date literature and best evidence for arriving at logical and sensible recommendations. This review will also look at specific definitions of what is a central compartment lymph node dissection. In the hands of experienced thyroid surgeons, prophylactic central compartment lymph node dissection, performed in a meticulous manner, can limit persistent or recurrent disease in the central compartment, and can diminish the need for routine administration of radioactive iodine, with acceptable perioperative morbidit
Assessment of an Ultrasound-based Scoring System for Triaging Ovarian Tumors in Symptomatic Women
Authors: Alcázar Juan Luis , Royo Pedro , Galván Rosendo , Mínguez José Ángel , Manero Manuel García , Laparte Carmen , García Guillermo López 
Published: June 2010

Abstract

Objective
To evaluate prospectively an ultrasound-based scoring system as a method for triaging symptomatic women presenting with an adnexal mass for surgical treatment.

Methods
151 symptomatic women scheduled for surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound prior to surgery. Patients were classified as low-risk or high-risk for malignancy according an ultrasound-based scoring system. Patients with low risk for malignancy were scheduled for laparoscopy and patients for high risk for malignancy were scheduled for laparotomy. Some patients with high-risk were scheduled for advanced oncologic laparoscopic surgery. Patients with low risk but tumor size > 10 cm were scheduled for laparotomy.

Results
82 women presented with pelvic pain, 8 had uterine bleeding and 61 referred symptoms suggestive for ovarian malignancy, such as abdominal swelling, bloating and abdominal discomfort. 75 (49.7%) masses were considered as “low-risk” and treated by laparoscopy in 58 cases and by laparotomy in 7 cases, because emergency or associated pathology (All tumors were benign). 76 (50.3%) masses were considered as “high-risk” and all treated by laparotomy (56 malignant and 4 benign tumors) or by advanced laparoscopy (16 malignant tumors). Ten (6.7%) tumors were considered as “low-risk” but scheduled for primary laparotomy because of size > 10 cm (9 benign and 1 malignant). Sensitivity, specificity, PPV and NPV for this scoring system were 98.6%, 94.9%, 94.7% and 98.7%, respectively. The scoring system were more sensitive than patient's complaints (98.6% vs 79.5%, p < 0.0001) and more specific than physical examination (94.9% vs 85.9%, p < 0.0001)

Conclusions
Ultrasound based triage of symptomatic women diagnosed, as having an adnexal mass is effective for selecting surgical approach.
3D PD Imaging of Ovarian Pathology— Advantages and Limitation of the Method: How can We Standardize the Results?
Authors: Alcázar Juan Luis , Kudla Marek 
Published: June 2010

Abstract
Three-dimensional Power Doppler ultrasound is a new imaging modality for assessing tissue vascularization, which is being introduced into clinical practice and it is being increasingly used. In the last years a number of papers assessing the role of this method for assessing adnexal masses vascularization have been published. The aim of this work is to address some technical aspects of 3D US, to review critically its current status in clinical practice and to address future perspectives of its use.
Web Based Interactive Tutorials in Obstetrics and Gynecology
Authors: Patham Bhargavi , Guerra Martha 
Published: June 2010

Abstract
The challenge of integrating basic science and clinical knowledge contents has become an educational imperative at Paul L Foster School of Medicine clinical presentation based curriculum. During the first two years of our curriculum, students are introduced to clinical applications of basic science knowledge. For better understanding and appreciation of the important links between the basic science principles and clinical medicine, students return to basic science topics. To support such a progression of students' knowledge and skills, the curriculum should allow and support individual learning. Interactive tutorials created by authors of different backgrounds and expertise facilitate clinical application of basic science knowledge and provide multiple pathways in learning and inductive reasoning. Web based learning modules do not supplement traditional lectures, small groups sessions and team based learning activities, but they may significantly enrich students' learning experience.
Physical and content boundaries between basic science and clinical departments are sometimes difficult to breach. In virtual space, thematically organized modules and collective approach of interdisciplinary teaching teams allow full integration of core content. This concept of distance learning contributes to educational continuity, longitudinal experience and educational mobility.
Ultrasound—A Clinical Procedure to Motivate Preclinical Medical Students to Learn Embryology
Authors: Azumendi Guillermo , Beale Elmus G 
Published: June 2010

Abstract
A fundamental understanding of human embryology is an essential skill for the majority of practicing physicians. However, its perceived difficulty, in context of the constant competition for time needed to learn other basic science disciplines, makes teaching embryology in undergraduate medical education a universal challenge. Sonography is now commonly used in standard prenatal care because it allows safe, noninvasive imaging of early embryos and fetuses. Two-, three- and four-dimensional and Doppler ultrasound provide an astonishing arsenal of techniques to evaluate a pregnancy and screen for abnormalities. We are developing an international collaboration with ultrasound experts to introduce sonography into the teaching of embryology to preclinical medical students. The objective is to motivate students and facilitate learning by providing clinical relevance and online images that will help them visualize embryonic development. We invite members of the Ian Donald School of Ultrasound and editors and readers of the Journal to participate in this project.
Ultrasound Imaging of the Menstrual Cycle
Authors: Janssen Herbert F 
Published: June 2010

Abstract
The menstrual cycle is nature's repeating preparation for pregnancy. Each month, the uterine lining develops in anticipation of implantation by a fertilized ovum. If this occurs, hormones from the reproductive organs stabilize the vascular tissue of the endometrium which provides an environment for the developing embryo. If the awaited implantation does not occur, the endometrium is sloughed due to a rapid drop in circulating levels of progesterone. This process starts during the early teenage years of a female's development (menarche) and repeats 400-500 times over the next 40 years. Normally, this process is interrupted only by pregnancy; however, other factors can certainly influence both the cycle length, volume, and the duration of each menses. Ultrasound imaging provides a noninvasive method to visualize the internal reproductive organs, the endometrium, and the embryo if implantation occurs. This relatively inexpensive evaluation provides an easy and cost effective method to examine potential problems associated with the female reproductive organs. Advances in computer software and hardware coupled with new ultrasound equipment has provided exciting 3-D and 4-D images that generate near life-like images. In the guiding hand of a trained physician or sonographer, ultrasound enhances diagnostic capability and gives reassurance to the patient.
The Role of Ob/Gyn Ultrasound in Medical Student Education: Immunological Disorders of Pregnancy Assessed by Ultrasound
Authors: Piskurich Janet F 
Published: June 2010

Abstract
To learn immunology in the absence of visual images would be an onerous and tedious chore. Most immunology textbooks use a large number of illustrations and diagrams to assist students as they endeavor to grasp the semantics and fundamentals of immunology, which are exacting and can be confusing to the uninitiated. Likewise, ultrasound imaging can be used to elucidate the consequences of an immune incompatibility between the mother and child during pregnancy in a manner that brings both clarity and clinical relevance to the medical students' understanding of this basic concept. Here we illustrate in the context of medical student education the use of ultrasound in the assessment of immunological disorders of pregnancy.
Using Ultrasound to Teach Female Reproductive Physiology
Authors: Janssen Herbert F 
Published: June 2010

Abstract
Physiology ties together many related disciplines including anatomy, histology, biochemistry, and cell biology. Mastering the concepts of physiology is essential to understanding the principles of medicine. Learning physiology requires acquisition of facts, but this alone provides little in the way of useful knowledge. Currently, educators are challenged with the task of presenting physiology in a manner that encourages students to actively learn the required material. Didactic lectures were considered antiquated a century ago by Abraham Flexner when he reported on the status of medical education in the United States and Canada. Unfortunately, his comments did little to dissuade the use of lecture as a primary teaching method in medical education. Today we have the opportunity to develop new methods to present material in a manner that encourages active learning and understanding of concepts. Ultrasound imaging is a tool useful in presenting many organ systems in physiology. This is especially true of the female reproductive system. Ultrasound equipment can be used to develop still images of the ovaries, fallopian tubes, uterus, and the developing fetus. It can also provide video clips showing the reproductive organs in juxtaposition with the surrounding tissue or images of the fetus complete with heart sounds and vascular flow. During more advanced training, the students can develop hands-on skills using the ultrasound to identify and evaluate structures.
3-D and Power Doppler Ultrasound in Translational Research
Authors: Rajkumar Lakshmanaswamy 
Published: June 2010

Abstract
At Texas Tech University Health Sciences Center in El Paso we have developed an animal model to study mammary carcinogenesis and neovascularization. Seven-week-old female Sprague Dawley rats are injected with N-methyl-N-nitrosourea (MNU) intraperitoneally at a concentration of 50 mg/kg bodyweight. The rats are palpated twice a week for development of mammary gland tumors. On the appearance of the first palpable tumor, the animals are divided into the groups treated with aromatase inhibitor, ethanolic neem leaf extract and control group, receiving vehicle treatment. Using a high-resolution 16 MHz linear array transducer mammary glands are imaged before and every two weeks following the introduction of the therapy. 3-D US coupled with 3-D power Doppler imaging is used for evaluation of the volume and vascularity of the mammary gland lesions. Pulsatility and resistance index and vascularity, flow and vascularity flow indices are evaluated longitudinally. Our preliminary data indicate that 2-D and 3-D power Doppler ultrasound may be efficiently used for evaluation of the mammary gland tumor volumes and vascularity. 2-D and 3-D power Doppler ultrasound may also be used for evaluation of the response of mammary gland tumors to different lines of medication therapy.
Ultrasound Screening in Low-risk Obstetrical Population: Effect on Perinatal Outcome
Authors: Theodora M , Antsaklis A 
Published: June 2010

Abstract
The issue of routine sonography for low-risk pregnant women continues to be controversial since randomized trials have not been able to demonstrate a clear benefit especially in prenatal outcome in the past. Ultrasonography early in pregnancy can be definitely used for accurate gestational age determination and detection of multiple gestations. Additionally ultrasound scan is the best method for detecting fetal malformation as well as fetuses in high-risk for growth restriction. Since fetal chromosomal and structural anomalies, prematurity and poor placentation account for 90% of poor perinatal outcome, ultrasound could theoretically help in decreasing perinatal mortality and severe perinatal morbidity.
Doppler Evaluation of the Ovary: Clinical Applications and Challenges
Authors: Zalud Ivica 
Published: June 2010

Abstract
Transvaginal sonography has been shown to be an accurate technique for discriminating between benign and malignant adnexal masses. Accurate preoperative differential diagnosis of adnexal masses is essential for optimizing patients’ treatment. The advancement and wider availability of therapies of assisted conception have occurred to a large extent as a result of developments in ultrasonography. Transvaginal color Doppler has opened up exciting new possibilities for the better understanding of the physiology and pathophysiology of ovarian blood flow, resulting in a number of completely new diagnostic parameters.
Three-dimensional Ultrasound for Assessing Uterine Pathology
Authors: Alcázar Juan Luis 
Published: June 2010

Abstract
Two-dimensional ultrasound is commonly used for assessing uterine pathology. Three-dimensional ultrasound is a new imaging modality, which is being introduced into clinical practice. The aim of this paper is addressing the current status of three-dimensional ultrasound in the assessment of uterine pathology.
Bioeffects and Safety of 2D and 3D/4D Ultrasound in Obstetrics—Is there a Place for “Parental Bonding” Scans?
Authors: Abramowicz Jacques S 
Published: June 2010

AbstractUltrasound is widely used in daily clinical obstetrical practice. Many medical indications exist for performing a sonographic examination but, in addition, several researchers have published information on the importance of patients watching the ultrasound monitor during the examination, particularly during three- and fourdimensional (3D/4D) scanning, for maternal-fetal bonding. Furthermore, a certain form of ultrasound, called “entertainment” or “keepsake” ultrasound has flourished, particularly in the United States. While ultrasound is assumed to be completely safe, it is a form of energy and, as such, has effects in tissues it traverses (= bioeffects). The two most important mechanisms for effects are thermal and non-thermal. Nonthermal mechanisms include cavitation, streaming, and even release of free radicals. These two major mechanisms are indicated on-screen by two indices: The thermal index (TI) and the mechanical index (MI). It is important to be aware of these effects to be able to prevent potential harm. Ultrasound machine controls can alter the instrument acoustic energy and hence the exposure but different machines behave differently. Therefore each clinician should know how this occurs in his/her own machine. Unfortunately, it appears the general knowledge in this area is poor and an effort should be made to educate the endusers. Whether 3D/4D enhances parental-fetal bonding is still a matter of discussion.
3D/4D Echocardiography—STIC
Authors: Szymkiewicz–Dangel Joanna 
Published: June 2010

Abstract
Fetal cardiac screening is an obligation for everybody performing prenatal ultrasound. The heart, as a small and always moving object, is still the most difficult part of the fetal anatomy evaluation. Knowing this, different methods of improving antenatal screening for congenital heart defects (CHD) were introduced. Spatial temporal image correlation (STIC) is the newest one. Its target was to automatic acquisition of the fetal scan from the abdomen, through 4 chamber view toward the three vessel view and off-line analysis of the anatomy of the fetal cardiovascular system. Is that really possible? Does STIC improve screening of CHD? Would it be helpful in the more precise diagnosis of complicated heart defects? These are still the open questions, which will be discussed in the article.
Three-dimensional Ultrasound in the Fertility Clinic
Authors: Deb Shilpa , Haoula Zeina , Raine-Fenning Nick 
Published: June 2010

Abstract
The management of subfertility involves a detailed assessment of the couple to identify factors that may affect or predict the outcome of treatment. Three-dimensional imaging is one of the recent advances in the field of ultrasound which has several obvious benefits that relate to an improved spatial orientation and the demonstration of additional image planes such as the coronal plane. Many clinicians remain unconvinced by its reputed advantages and three-dimensional ultrasound is not without disadvantages. These mainly relate to the cost involved and training requirements. Threedimensional ultrasound imaging is still at a relatively early stage in terms of its role as a day-to-day imaging modality in gynecology and reproductive medicine. Other than its application in the assessment and differentiation of uterine anomalies there is little evidence that three-dimensional ultrasound results in clinically-relevant benefit or negates the need for further investigation. Future work should ensure that three-dimensional ultrasound is compared to conventional imaging in randomized trials where the observer is blinded to the outcome such that its role in reproductive medicine can be truly evaluated in an evidence-based manner.
Prenatal Diagnosis and Management of Conjoined Fetuses
Authors: Mikos Themistoklis , Athanasiadis Apostolos , Zafrakas Menelaos 
Published: June 2010

Abstract
Conjoined twins have an estimated incidence of one in 50,000 to one in 100,000 births. The first cases of prenatal diagnosis of conjoined twins using B-mode ultrasound were reported in the 1970s, followed by prenatal real-time ultrasonographic diagnosis shortly thereafter. Since then, real-time ultrasound has been the most reliable method in establishing prenatal diagnosis of conjoined twins and in detecting associated anomalies. Moreover, recent improvements in real-time ultrasound technology - in some cases coupled with use of Magnetic Resonance Imaging (MRI) - have made early diagnosis of conjoined fetuses in the first trimester possible. Prenatal diagnosis of conjoined fetuses is considered essential for further management. Parents need detailed counseling in order to decide among various management options, which include the following: (a) pregnancy continuation and scheduled neonatal surgery, (b) termination of pregnancy, and (c) multifetal pregnancy reduction or selective fetocide in cases of high-order multifetal pregnancies with a component of conjoined fetuses. An interdisciplinary medical team, involving obstetricians, neonatologists, pediatric surgeons and anesthetists, should carefully approach and assist parents in their decisions. In special cases, additional consultation may be given by other specialists, even from specialized centers in other countries, depending on the area of conjunction, the involvement of other organ systems, and the presence of associated anomalies.
Vascular Ultrasound in Gynecology
Authors: Yoshida Atsushi , Tabata Tsutomu , Okugawa Toshiharu , Sugiyama Takashi , Sagawa Norimasa 
Published: June 2010

Abstract
The usefulness of the vascular ultrasound in the filed of gynecology is now well recognized. The intima-media thickness (IMT) and the elastic property of the common carotid artery are reported to be associated with the risk of cardiovascular diseases and are thought to be influenced by menopause. The assessment of the flow-mediated vasodilation (FMD) of the brachial artery is a noninvasive method for the evaluation of vascular endothelial function and is reported to be associated with menopause or hormone replacement therapy. Certain gynecological situations such as contraceptive use or hormone replacement therapy are reported to increase the risk of thrombosis. For the screening of deep vein thrombosis of the lower extremities in the gynecological diseases, compression ultrasonography (CUS) is useful.
Sonographic Diagnosis of Ovarian Masses
Authors: Hata Kohkichi 
Published: June 2010

Abstract
Transabdominal ultrasonography was initially used for the investigation of overt abdominal swellings and much later for the detection of early ovarian cancer in asymptomatic women. The technique was undoubtedly of value for detecting transient, persistent and overt ovarian cysts. Subsequently, the resolving power of pelvic ultrasonography was increased substantially by the advent of transvaginal probes. This revolutionary development was first applied to systemic studies of overt ovarian masses in patients awaiting surgery. Over the past decade, several ultrasound-based morphological scoring systems, color Doppler parameters, logistic regression models have been proposed and tested in order to try to predict the histology of ovarian tumors. On prospective testing, no standard criterion has been published. Therefore, it is important for each operator to establish their own criteria based on individual recognition potential.
Corpus Luteum Morphology and Vascularization Assessed by Transvaginal Two-dimensional and Three-dimensional Ultrasound
Authors: Bajo JM , Gómez B , Álvarez P , Engels V , Martínez A , De la Fuente J 
Published: June 2010

AbstractBackgroundOur aim was to describe the corpus luteum morphology by two-dimensional ultrasound correlated by its vascularization and volume by 3D ultrasound and study the possible relationship between serum progesterone levels and the corpus luteum morphology.MethodsThirty-eight women were included in an intrauterine insemination program (IUI) in Santa Cristina University's Hospital. All the patients were evaluated in mesoluteal phase, the day +7 after hCG administration, by two-dimensional and three-dimensional ultrasound. The volume and vascular indices of the corpus luteum were calculated off-line using virtual organ computer-aided analysis (VOCALTM) software.ResultsFour different morphologies were described in the corpus luteum: echo-positive, echo-negative or sonoluscent, mixed echogenicity or nonvisible. Corpus luteum with mixed echogenicity was the most frequent one with 37.5% (12 cases). The corpus luteum vascular indices change in each morphology type, but there was statistically significant association just in vascularization index between echo-negative and mixed echogenicity corpus luteum morphologies, with p = 0.034. The rest of vascular indices do not change in each morphology corpus luteum types. There was statistically significant difference in mean gray value between echo-negative and mixed echogenicity morphologies, with p = 0.007. There were no statistically significant correlations between the corpus luteum morphology and the corpus luteum volume of any of the different types. There either was no statistically significant correlation between the corpus luteum morphology and progesterone serum levels on day +7 postovulation.ConclusionsThe mixed echogenicity corpus luteum morphology has more vessels and more cell mass than echo-negative ones. Progesterone serum levels in mid-luteal phase has no influence in corpus luteum morphology and vascularization.