bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiography should be also performed during the third trimester in fetuses of pregestational diabetic mothers
Authors: Puerto B. , Martínez J. M. , Gomez O. , Moyano D. , Palacio M. , Martínez S. , Borrell A. , Cararach V. 
Published: March 2003

Objective:  To assess the risk and types of congenital heart disease in our population of insulin‐dependent pregestational diabetic mothers.Methodology:  Over a 3‐year period, a transabdominal echocardiography at 20–22 weeks of gestation and a second one at 32–34 weeks of gestation was performed in 142 insulin‐dependent diabetic pregnancies. In the last 30 cases, an early examination combining either the transvaginal or the transabdominal route at 13–16 weeks was also carried out. A complete heart evaluation and measurement of the interventricular septum thickness was performed, with color and pulsed Doppler assessment. An accurate postnatal cardiac examination was always performed.Results:  Twelve significant cardiac defects (8.45%) were detected, but only two of them before 22 weeks of gestation (one tetralogy of Fallot, and another one critical aortic stenosis). Both followed early termination of pregnancy, and postmortem evaluation confirmed the diagnosis. The other 10 cases were diagnosed during the third trimester: two coarctation of the aorta (one neonatal death because hemodynamic disturbance), three pulmonic stenosis, five significant hypertrophic cardiomiopathy with subaortic stenosis, and a case of supraventricular tachycardia (>240 bpm needing postnatal cardioversion). All the babies, but one are alive and well, although most of them have needed catheterization or pharmacological treatment. One case of a ventricular septal defect (2.5 mm, muscular) was overlooked during gestation, but closed by the sixth month of life.Conclusion:  Our results confirm that diabetic women are at increased risk of having a child with congenital heart disease, and therefore we recommend conventional fetal echocardiography in all pre‐gestational diabetic pregnancies at 20–22 weeks of gestation. In view of the pattern of defects we have found, we strongly suggest that a further scan during the late trimester should always be performed.
Fetal intracardiac echogenic foci: frequency of detection with respect to maternal race and other abnormalities
Authors: Fitchat E. 
Published: March 2003

Objective:  To determine if there is a racial difference in the frequency of detecting an echogenic intracardiac focus in fetuses and the incidence of other related abnormalities.Methods:  Over a 3‐month period (December 2000 to February 2001) all fetuses scanned between 12 and 30 weeks were evaluated for the presence of intracardiac echogenic foci. The sonographer indicated the maternal race (black, colored, white or other), gestational age, maternal age and the presence of other abnormalities. Amniocentesis or cordocentesis was performed when indicated. Follow up on fetuses and neonates were obtained from the patient records. The groups were compared with respect to maternal race, presence or absence of foci and other associated abnormalities.Results:  There were 725 fetuses scanned during this period where the gestation was between 12 and 30 weeks. There were 606, 98, and 21 fetuses of colored, black and white mothers, respectively. Intracardiac foci were present in 33 (5.4%) colored, 8 (8.1%) black and one (4.7%) white mother, respectively. The association with other abnormalities was 7/42 (16.6%). This was higher in the colored group 5 (15%) compared with the black group 1 (12.5%). There was only one fetus in the white group with an intracardiac focus and this was a baby born with congenital rubella syndrome. There were two (5%) fetuses with chromosomal abnormalities. One was a black fetus with trisomy 21 and one colored fetus with trisomy 18. The remaining four fetuses had markers associated with normal karyotype on culture. These were polihydramnios, hyperechogenic bowel, pyelectasis, and intrauterine growth restriction.Conclusions:  In this preliminary study the black fetus had a higher incidence of intracardiac echogenic foci. Detection of an intracardiac focus is associated with a 5% risk of chromosomal abnormalities and other associated features should be evaluated.
A critical evaluation of three‐dimensional and two‐dimensional sonographic studies, and color Doppler ultrasound in detecting nuchal cord in utero
Authors: Hanaoka U. , Yanagihara T. , Kuno A. , Tanaka H. , Hata T. 
Published: March 2003

Objective:  To evaluate whether three‐dimensional sonography is more valid than two‐dimensional sonography, and color Doppler ultrasound in diagnosing nuchal cord in utero.Methods:  Eighty‐five singleton pregnancies without nuchal cord and 35 with nuchal cord (30 single nuchal cord, four double nuchal cords, and one triple nuchal cords) were studied within 1 week before delivery using a transabdominal three‐dimensional sonography. Two‐dimensional sonography and color Doppler ultrasound were also conducted.Results:  Three‐dimensional sonography identified in utero 22 (73.3%) single and 3 (60%) multiple nuchal cords found at birth. There were no significant differences in overall diagnostic indices of each diagnostic modality for detecting nuchal cord. However, the ability to view nuchal cord was better with three‐dimensional sonography than with two‐dimensional sonography or color Doppler ultrasound.Conclusions:  Three‐dimensional surface imaging does not provide more useful diagnostic information than two‐dimensional sonography and color Doppler ultrasound for detecting nuchal cord in utero.
Transvaginal sonographic examination of the cervix in asymptomatic pregnant women: review of the literature
Authors: Rozenberg P. , Gillet A. , Ville Y. 
Published: March 2003

AbstractDifferent strategies have been developed to refine the prediction of the risk of preterm delivery in asymptomatic patients. Transvaginal sonography has been used for this reason to measure and examine the length and shape of the cervix. In this review, we focus on clinical studies involving transvaginal sonographic assessment of the cervix in asymptomatic women at high risk of preterm delivery and in the general pregnant population.Three ultrasound signs are suggestive of cervical incompetence, namely, dilatation of the internal os, sacculation or prolapse of the membranes into the cervix (with shortening of the functional cervical length) either spontaneously or induced by transfundal pressure, and short cervix in the absence of uterine contractions. Transvaginal sonography has clearly demonstrated that cerclage leads to a measurable increase in cervical length which may contribute to the success of this procedure in reducing the risk of preterm delivery. Several non‐randomized interventional studies among patients with cervical incompetence have been published. They have defined a new group of patients requiring cerclage when the women show progressive cervical modifications on transvaginal sonography, while in other studies, cerclage performed on the basis of cervical changes on transvaginal sonography did not prevent premature delivery. One prospective randomized trial in asymptomatic high‐risk women has shown two benefits of cerclage following indications for transvaginal sonography: (1) it would generate fewer prophylactic cerclages in high‐risk women; (2) therapeutic cerclage before 27 weeks may reduce the incidence of premature delivery before 34 weeks.The risk of preterm delivery is inversely correlated with cervical length. Routine transvaginal sonography of the cervix performed between 18 and 22 weeks can help identify patients at risk of preterm delivery. However, given the low prevalence of preterm births, screening would generate either a high false‐positive rate or a low sensitivity. One non‐randomized interventional study among patients with a short cervix on routine ultrasound examination found a lower risk of delivery before 32 weeks in the cerclage group than in the expectant management group. However, to date, there have been no prospective randomized trials in a general population. Although evidence is still lacking, there does appear to be a benefit in performing a cerclage rather than continuing with expectant management in cases with sonographic appearance of cervical incompetence in asymptomatic women at high risk of preterm delivery. Ultrasound can be offered to reduce the indications of cerclage for cases in which the situation is uncertain. Within the general obstetric population, transvaginal sonography might help in the selection of asymptomatic but high‐risk women. However, the benefit associated with cerclage for sonographic indication has not been demonstrated. Copyright © 2002 ISUOG
Cervical Incompetence Prevention Randomized Cerclage Trial (CIPRACT): effect of therapeutic cerclage with bed rest vs. bed rest only on cervical length
Authors: Althuisius S. , Dekker G. , Hummel P. , Bekedam D. , Kuik D. , Van Geijn H. 
Published: March 2003

AbstractObjectiveTo compare the effects of therapeutic cerclage and bed rest vs. just bed rest on cervical length and to relate these effects to the risk of preterm delivery.DesignCervical length was measured in patients at high risk of cervical incompetence. When a cervical length < 25 mm was measured before 27 weeks' gestation, randomization for therapeutic cerclage and bed rest vs. just bed rest was performed. After randomization, cervical length was measured weekly. For statistical analysis, t‐test and Fisher's exact tests were used and P < 0.05 was considered statistically significant.ResultsNineteen women were randomly allocated to receive a therapeutic cerclage and bed rest and 16 were allocated to receive bed rest only. Mean cervical lengths and mean gestational ages before randomization were comparable between both groups, overall 19.8 mm and 20.7 weeks. Cervical length was measured again at a mean gestation of 22.1 weeks. Mean cervical length (31 mm) was significantly (P < 0.0001) longer after cerclage than after bed rest only (19 mm). A cervical length ≥ 25 mm was measured in 22 of the 35 included women, 16 in the cerclage group and six in the bed‐rest group (P = 0.006). Of these 22 women, only one delivered before 34 weeks' gestation, which was significantly less frequent than six out of 13 women with a cervical length < 25 mm (P = 0.006).ConclusionsTherapeutic cerclage with bed rest increases cervical length more often than bed rest alone. A postintervention cervical length ≥ 25 mm reduces the risk of preterm delivery in women at high risk of cervical incompetence and a preintervention cervical length < 25 mm.
Management of single fetal death in twin‐to‐twin transfusion syndrome: a role for fetal blood sampling
Authors: Senat M.‐V. , Bernard J.‐P. , Loizeau S. , Ville Y. 
Published: March 2003

AbstractObjectiveIntrauterine death of one twin in monochorionic pregnancies is associated with an increased mortality and morbidity of the cotwin. This is likely to occur as a consequence of acute hemodynamic changes due to feto–fetal hemorrhage at the time of death of the cotwin. We assessed the role of fetal blood sampling and intrauterine transfusion to rescue the survivor.Materials and methodsWe managed 12 cases of single intrauterine death at between 17 and 26 weeks' gestation in monochorionic twins complicated by twin‐to‐twin transfusion syndrome (TTTS). All these cases had been treated either by laser therapy or by serial amniodrainage. When the demise of one twin occurred, ultrasound‐guided fetal blood sampling was performed in the surviving twin using a 20‐gauge needle within 24 h of death. Intrauterine transfusion was performed at the same time in cases where the survivor was anemic. All survivors were assessed in the neonatal period and at 1 year of age.ResultsSix of the 12 surviving fetuses were found to be anemic and underwent intrauterine transfusion. All fetuses survived the procedure. Four of these fetuses had normal neurological development at 1 year of age. Periventricular leukomalacia developed in one case and the patient underwent termination of pregnancy at 34 weeks. In one case delivery occurred at 34 weeks' gestation and the baby developed periventricular leukomalacia at 1 month of age. In all six non‐anemic fetuses pediatric examination was normal at birth and at 1 year of age.ConclusionIntrauterine death of one monochorionic twin in TTTS puts the survivor at high risk of intrauterine death or of developing ischemic/hypoxic lesions. Our results suggest that fetal blood sampling is a useful diagnostic tool to identify those fetuses that are not anemic and hence unlikely to be at risk of developing a cerebral lesion. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
The bulbocerebellar circumolivary bundle
Authors: DE CARO R. , MUNARI P. F. , PARENTI A. 
Published: March 2003

During the course of a systematic study on the human vertebrobasilar arterial system (De Caro et al. 1995), our attention was drawn in one case to a strange morphology of the ventrolateral aspect of one side of the medulla. While initially our impression was that we were facing an actual malformation, review of the structure of the brainstem as described in most standard anatomical texts showed that it could correspond to the circumolivary fasciculus (Williams et al. 1995).The subject was a 63‐y‐old man who had died from rupture of an atherosclerotic aneurysm of the abdominal aorta. The medical history was negative for neuropsychiatric pathology. Brain examination showed severe atherosclerosis of the cerebral arteries and hypoplasia of the initial segment of the right posterior cerebral artery. A recent infarct was found in the white matter of the right occipital lobe. After removal of the vertebrobasilar arterial system, the right pyramid showed a superficial groove extending from about 2 mm lateral to the foramen caecum obliquely downwards to the right anterolateral sulcus of the medulla, at the level of the superior margin of the inferior root of the hypoglossal nerve (Fig. 1a). Due to this groove, the lateral part of the pyramid formed a ridge that crossed the anterolateral sulcus of the medulla passing between the 2 main roots of the hypoglossal nerve and then continued, below the inferior pole of the olive, over the lateral region of the medulla ending at the level of the posterolateral sulcus (Fig. 1b). The general appearance was that of a small cord forming a loop around the anterior margin and the inferior pole of the olive, with a descending part (8 mm long), a horizontal part (6 mm long) and with a transverse diameter of 3 mm. After formalin fixation, the brainstem was cut in 8 transverse sections. At the level of the medulla the right pyramid appeared larger than the contralateral and the small lateral cord was separated from the main part of the pyramid by a thin whitish transverse stria (Fig. 1c). Macroscopic examination of the cerebellum showed nothing of relevance.
Symposium on ‘Adaptations of cells and tissues to mechanical stimuli’ or ‘Roux revisited’ held during the Joint Meeting of the Anatomical Society of Great Britain and Ireland, the Anatomical Society of Southern Africa and the Nederlandse Anatomen Vereniging, April 15–18 1998, Rolduc, The Netherlands
Authors: HILLEN BEREND 
Published: March 2003

In 1895, well over 100 years ago, Willem Roux published his collected works on the developmental mechanics of organisms in 2 volumes. Volume 1 is largely dedicated to functional adaptation and is a condensation of his investigations into causes of the size and shape of organs and tissues, postulating the influence of functional demand, mediated by mechanical stimuli, on the shaping of organs and tissues. In this classic work he contributed to the understanding of the control of the structural development and organisation of blood vessels, muscles and bone. This work has been a source of inspiration for many investigators over the years. Well known examples are Wolff's law and Pauwel's theory on trajectories. Over the past 2 decades these hypotheses and concepts have been reappraised using 2 main approaches. Firstly, in muscles and tendons a qualitative approach with classical Newtonian mechanics combined with the anatomical configuration of these structures has been used to study the direction and the nature of the mechanical stresses in the tissues, be they compressive, tensile or shear. In bone and blood vessels these stresses are less accessible and often require computer modelling to calculate the mechanics at a cellular level. Secondly, molecular biology has demonstrated, both in tissue culture and in animal experiments, that mechanical stimuli can bring about cascades of messages in and between cells, but the experimental control of mechanical stresses in biological experiments is far from simple and limits the conclusions that can be derived. In order to approach a complete picture, the gap between these 2 approaches must be bridged. In this respect modern imaging techniques are helpful because they offer the possibility of studying the shape and change of shape over time in living organisms in greater detail.The Symposium was organised in such a way that for different tissues recent advances using different approaches could be presented, helping to identify future directions for this field of morphological research. Review articles based on 2 of the 6 contributions to the Symposium are published here. One has already appeared (Benjamin & Ralphs, J. Anat. 193, pp. 481–494).
Late‐onset neurodegenerative diseases—the role of protein insolubility
Authors: JOHNSON WILLIAM G. 
Published: March 2003

Recently, mutations of the alpha‐synuclein gene were found to cause dominantly inherited Lewy‐body Parkinson's disease (PD) and alpha‐synuclein was identified as a major component of the Lewy body. However, the cause of the common form of PD, with a multifactorial rather than autosomal dominant inheritance pattern, remains unknown. Alpha‐synuclein precipitates slowly and apparently spontaneously at high concentration in solution and the mutations that cause PD accelerate precipitation. Other dominantly inherited late‐onset or adult‐onset dominantly inherited neurodegenerative diseases are associated with precipitation of proteins. In Alzheimer disease, beta‐amyloid and tau abnormalities are present and in prion disorders, prion proteins are found. In Huntington disease, a disorder with expanded CAG repeats, huntingtin precipitates occur. In dominantly inherited spinocerebellar ataxias, also expanded CAG repeat disorders, the corresponding ataxin protein precipitates are found. In multiple system atrophy, alpha‐synuclein precipitates are encountered and in progressive supranuclear palsy, tau precipitates occur. In familial amyotrophic lateral sclerosis, a group of dominantly inherited disorders, SOD1 precipitates are found. Most of these disorders can involve the basal ganglia in some way.Since similar processes seem to affect neurons of adults or older individuals and since a relatively limited group of proteins seems to be involved, each producing a form of neurodegeneration, it is possible that certain common features are present that affect this group of proteins. Candidates include a conformational shift, as in prions, an abnormality of the ubiquitin‐proteosome pathway, as seen in PD, an abnormality of a pathway preventing precipitation (e.g. chaperonins), or potentiation of a pathway promoting precipitation (e.g. gamma‐glutamyl‐transpeptidase) or apoptosis. Elucidation of the pathways causing this protein insolubilisation is the first step towards approaching prevention and reversal in these late‐onset neurodegenerative diseases.
Incidence and morphology of the brachioradialis accessorius muscle
Authors: RODRÍGUEZ‐NIEDENFÜHR M. , VÁZQUEZ T. , PARKIN I. , NEARN L. , SAÑUDO J. R. 
Published: March 2003

A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brachioradialis and inserting into the radius, pronator teres or supinator muscle has been considered as a variation of the brachioradialis muscle (Dawson, 1822; Meckel, 1823; Lauth, 1830; Halbertsma, 1864; Gruber, 1868b; Testut, 1884; LeDouble, 1897; Spinner & Spinner, 1996). However, a similar description was used to report additional heads of the brachialis or biceps brachii muscles (Gruber, 1848; Wood, 1864, 1868; Macalister, 1864–66, 1966–69, 1875; Gruber, 1868a; Wolff‐Heidegger, 1937).The innervation of these variant muscles would be a good tool to assign each variation to its associated muscle. Consequently, innervation by the radial nerve would indicate that it is a derivative of the humero–radialis group of muscles, while innervation by the musculocutaneous nerve would support it as a derivative of the anterior musculature of the arm (Rolleston, 1887; Lewis, 1989). However, no references to the innervation were found in the available literature.Therefore this study set out to establish the phylogenetic origin of the brachioradialis accessorius muscle and, with the help of its innervation, to determine its incidence and unreported detailed morphology.
In situ hybridization and immunohistochemistry of bone sialoprotein and secreted phosphoprotein 1 (osteopontin) in the developing mouse mandibular condylar cartilage compared with limb bud cartilage
Authors: Shibata Shunichi , Fukada Kenji , Suzuki Shoichi , Ogawa Takuya , Yamashita Yasuo 
Published: March 2003

AbstractMandibular condylar cartilage is often classified as a secondary cartilage, differing from the primary cartilaginous skeleton in its rapid progress from progenitor cells to hypertrophic chondrocytes. In this study we used in situ hybridization and immunohistochemistry to investigate whether the formation of primary (tibial) and secondary (condylar) cartilage also differs with respect to the expression of two major non‐collagenous glycoproteins of bone matrix, bone sialoprotein (BSP) and secreted phosphoprotein 1 (Spp1, osteopontin). The mRNAs for both molecules were never expressed until hypertrophic chondrocytes appeared. In the tibial cartilage, hypertrophic chondrocytes first appeared at E14 and the expression of BSP and Spp1 mRNAs was detected in the lower hypertrophic cell zone, but the expression of BSP mRNA was very weak. In the condylar cartilage, hypertrophic chondrocytes appeared at E15 as soon as cartilage tissue appeared. The mRNAs for both molecules were expressed in the newly formed condylar cartilage, although the proteins were not detected by immunostaining; BSP mRNA in the condylar cartilage was more extensively expressed than that in the tibial cartilage at the corresponding stage (first appearance of hypertrophic cell zone). Endochondral bone formation started at E15 in the tibial cartilage and at E16 in the condylar cartilage. At this stage (first appearance of endochondral bone formation), BSP mRNA was also more extensively expressed in the condylar cartilage than in the tibial cartilage. The hypertrophic cell zone in the condylar cartilage rapidly extended during E15–16. These results indicate that the formation process of the mandibular condylar cartilage differs from that of limb bud cartilage with respect to the extensive expression of BSP mRNA and the rapid extension of the hypertrophic cell zone at early stages of cartilage formation. Furthermore, these results support the hypothesis that, in vivo, BSP promotes the initiation of mineralization.