bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac function in fetuses with intracardiac echogenic foci
Authors: Degani S. , Leibovitz Z. , Shapiro I. , Gonen R. , Ohel G. 
Published: March 2003

AbstractObjectiveTo evaluate cardiac dimensions and function in euploid fetuses with intracardiac echogenic foci.Study designForty‐eight fetuses with a single cardiac echogenic focus situated in the left ventricle had echocardiography performed at 22–24 weeks of gestation. Fifty normal fetuses at 22–24 weeks' gestation served as controls. Two‐dimensional and M‐mode directed fetal echocardiography were used to exclude cardiac anomalies and measure right and left ventricular free walls and interventricular septal thickness and ventricular systolic and diastolic dimensions. Cardiac size was expressed as a ratio of ventricular wall thickness/biparietal diameter, and cardiac function was expressed as ventricular shortening fraction. Doppler fetal echocardiography measurements included pulmonary and aortic maximum systolic velocities and time to peak velocities as indices of ventricular systolic function, and the ratio between early ventricular filling (E‐wave) and active atrial filling (A‐wave) peak velocities at the level of the atrioventricular valves as an index of ventricular diastolic function.ResultsEarly ventricular filling/active atrial filling peak velocity ratios were significantly lower in fetuses with intracardiac echogenic foci than in control fetuses. In the mitral valve the ratio was 0.37 ± 0.14 (0.039) (mean ± SD (95% confidence interval for difference between the means)) vs. 0.59 ± 0.19 (0.052) and in the tricuspid valve it was 0.42 ± 0.16 (0.045) vs. 0.62 ± 0.21 (0.058). No significant differences were found in cardiac dimensions, ventricular shortening fraction and Doppler systolic indices.ConclusionEuploid fetuses with intracardiac echogenic foci show low E/A ratio values in midtrimester echocardiography. This finding might indicate cardiac diastolic dysfunction. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Ventriculovascular physiology of the growth‐restricted fetus
Authors: Gardiner H. , Brodszki J. , Maršál K. 
Published: March 2003

AbstractObjectivesTo examine the mechanisms by which intrauterine growth restriction may influence later cardiovascular risk by comparing the ventriculovascular physiology of gestational age‐ and weight‐matched growth‐restricted and normal fetuses.DesignA prospective longitudinal observational study of 20 normal fetuses studied from 20 weeks to term at monthly intervals was compared with a growth‐restricted cohort examined in the interval between diagnosis and delivery. The last values before delivery of the growth‐restricted cohort were compared with the normal cohort in two analyses matched for weight and for gestation. Arterial and venous vessel wall physiology and aortic pulse wave velocity were examined longitudinally in the thoracic descending aorta and inferior vena cava using an ultrasonic phase‐locked echo‐tracking system. Serial echocardiographic examinations were performed assessing structure, ventricular dimensions, function and Doppler flows.ResultsThere was a linear increase in cardiac preload and relative pulse amplitude in the inferior vena cava with gestation. In normal fetuses, the aortic pulse wave velocity, maximum incremental and late decremental velocities increased with gestation whilst the relative pulse amplitude decreased reflecting falling distal impedance. In both age‐ and weight‐matched analyses, the growth‐restricted fetuses showed significantly reduced values reflecting the chronic fetal ventriculovascular responses to increased placental impedance. Pulse wave velocity increased with gestation and was significantly less in the growth‐restricted cohort.ConclusionsGrowth restriction is associated with abnormal ventriculovascular physiology that represents a successful adaptive response to raised placental impedance and reduction in wall stress as evidenced by the lower fetal pulse wave velocity in growth‐restricted fetuses. However, whilst fetal adaptive mechanisms may aid survival they may result in cerebral and vascular abnormalities that prejudice later cardiovascular health. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Sequential screening for trisomy 21 by nuchal translucency measurement in the first trimester and maternal serum biochemistry in the second trimester in a low‐risk population
Authors: Schuchter K. , Hafner E. , Stangl G. , Ogris E. , Philipp K. 
Published: March 2003

AbstractObjectiveTo evaluate screening for trisomy 21 in a low‐risk population utilizing a combination of nuchal translucency measurement in the first trimester and the triple test in the second trimester.MethodsThis was a retrospective study of 9342 women with singleton pregnancies who booked for delivery in our hospital over a period of 5 years. A nuchal translucency scan was carried out at 10–13 weeks' gestation and for those with a measurement of 3.5 mm or more chorionic villus sampling was performed. All other women were asked to return for the triple test at 16 weeks' gestation. Amniocentesis was offered to women in whom the nuchal translucency was 2.5–3.4 mm, the triple test showed a risk of ≥ 1: 250 and in women aged ≥ 35 years.ResultsThe detection rate using the combined screening method was 95% (18/19) with a screen‐positive rate of 7.2%. In comparison, screening by maternal age alone would have identified nine (47%) trisomy 21 pregnancies with a screen‐positive rate of 10.7%.ConclusionOur data suggest that the combination of nuchal translucency measurement in the first trimester and the triple test in the second trimester is associated with a very high detection rate of trisomy 21 at a relatively low screen‐positive rate. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of de novo mosaic deletion 13q associated with multiple abnormalities
Authors: Widschwendter A. , Riha K. , Duba H. C. , Kreczy A. , Marth C. , Schwärzler P. 
Published: March 2003

AbstractA case of prenatal diagnosis of de novo mosaic deletion of the long arm of chromosome 13 (del(13)(q13.3)) is presented. Routine scanning in a 27‐year‐old primigravida at 25 weeks' gestation showed fetal bilateral hydronephrosis. Detailed anomaly scanning in our tertiary referral center further demonstrated posterior meningoencephalocele, sloping forehead, microcephaly, syndactyly and hypoplastic thumbs. Both genetic amniocentesis and cordocentesis revealed a mosaic karyotype, 46,XY/46,XY,del(13)(q13.3). Sonographic findings were confirmed by postmortem autopsy and additional abnormalities such as agenesis of corpus callosum, hypoplastic cerbellum and macroglossia were diagnosed. Detailed sonography in this case thus revealed multiple malformations that prompted fetal karyotyping at 25 weeks' gestation. Copyright © 2002 ISUOG
Antenatal diagnosis and treatment of a case of fetal goitrous hypothyroidism associated with high‐output cardiac failure
Authors: Morine M. , Takeda T. , Minekawa R. , Sugiyama T. , Wasada K. , Mizutani T. , Suehara N. 
Published: March 2003

AbstractA case of fetal goitrous hypothyroidism associated with high‐output cardiac failure is presented. At 32 weeks of gestation, the antenatal diagnosis of goiter was made based on ultrasound examination, and the fetal thyroid function was examined by amniocentesis and cordocentesis. Color and pulsed Doppler examinations demonstrated a high vascular flow pattern in the goiter and marked elevation of the maximum velocity in the common carotid artery at the level of the neck. It was suspected that arteriovenous shunting through the large goiter resulted in high‐output cardiac failure with cardiomegaly and pleural effusion. The fetus was treated by injection of levothyroxine sodium into the amniotic fluid at 33 weeks of gestation and the goiter thereafter decreased in size, with subsequent improvement of the high‐output cardiac failure. The maximum velocity in the common carotid artery fell rapidly before the shrinkage of the fetal goiter and in parallel with the fetal level of thyroid stimulating hormone. Copyright © 2002 ISUOG
Prenatal diagnosis and management of fetuses with liver hemangiomata
Authors: Gembruch U. , Baschat A. A. , Gloeckner‐Hoffmann K. , Gortner L. , Germer U. 
Published: March 2003

AbstractObjectivesTo study the relationship between prenatal appearance and perinatal outcome of fetuses with hepatic hemangiomata with special emphasis on criteria that may help to improve perinatal management.MethodsIn a tertiary referral center six fetuses with hepatic hemangiomata were evaluated by gray‐scale, color, and pulsed wave Doppler ultrasound between 1994 and 2000. Fetal blood sampling was performed in four cases. All data (computerized files and video tapes) were analyzed retrospectively.ResultsTwo fetuses showed very similar sonographic findings. They had an isolated large (‘giant’) round hepatic hemangioma (diameter 43 and 68 mm, respectively) supplied by one hepatic artery and drained by one hepatic vein, both of them showing high velocity and low pulsatility blood flow. Fetal blood count and coagulation parameters were normal in one case, whereas the other fetus showed a Kasabach–Merritt sequence with severe thrombocytopenia (10 platelets/nL) and mild disseminated intravascular coagulation. Intrauterine platelet transfusion was performed immediately prior to planned Cesarean delivery. Rapid platelet consumption continued postnatally, requiring several thrombocyte transfusions. Platelet counts stabilized only after tumor resection on the second day of life. One fetus with diffuse neonatal hemangiomatosis developed high‐output cardiac failure with hydrops in addition to Kasabach–Merritt sequence (15 platelets/nL), and died following premature delivery. Three fetuses, however, showing an isolated small hyperechogenic hepatic hemangioma (5, 5, and 6 mm in diameter, respectively) did not develop any perinatal complications.ConclusionLarge fetal liver hemangiomata and diffuse hemangiomatosis may cause severe perinatal complications, particularly high‐output cardiac failure and/or Kasabach–Merritt sequence with severe consumption of platelets and clotting factors and hemolytic anemia. Fetal blood sampling enables the prenatal detection of these potential complications, allowing critical modification of perinatal management such as intrauterine platelet transfusion, especially directly before delivery. In contrast, isolated small hyperreflexic hepatic hemangiomata do not appear to be associated with any of these fetal and postnatal sequelae. Copyright © 2002 ISUOG
Clinical implications of fetal magnetocardiography
Authors: Quartero H. W. P. , Stinstra J. G. , Golbach E. G. M. , Meijboom E. J. , Peters M. J. 
Published: March 2003

AbstractObjectivesTo test the usefulness and reliability of fetal magnetocardiography as a diagnostic or screening tool, both for fetuses with arrhythmias as well as for fetuses with a congenital heart defect.MethodsWe describe 21 women with either a fetal arrhythmia or a congenital heart defect discovered during prenatal evaluation by sonography. Four fetuses showed a complete atrioventricular block, two an atrial flutter, nine ventricular extrasystole, and one a complete irregular heart rate. Five fetuses were suspected to have a congenital heart defect. In all cases magnetocardiograms were recorded.ResultsNine fetuses with extrasystole showed a range of premature atrial contractions, premature junctional beats or premature ventricular contractions. Two fetuses with atrial flutter showed typical flutter waves and four fetuses with complete atrioventricular block showed an uncoupling of P‐wave and QRS complex. One fetus showed a pattern suggestive of a bundle branch block. In three of four fetuses with confirmed congenital heart defects the magnetocardiogram showed abnormalities.ConclusionFetal magnetocardiography allows an insight into the electrophysiological aspects of the fetal heart, is accurate in the classification of fetal arrhythmias, and shows potential as a tool in defining a population at risk for congenital heart defects.
Transvaginal sonography in the diagnosis of acute appendicitis
Authors: Molander P. , Paavonen J. , Sjöberg J. , Savelli L. , Cacciatore B. 
Published: March 2003

AbstractObjectivesTo evaluate transvaginal sonography with power Doppler capacity in the diagnosis of acute appendicitis and in discriminating appendicitis from pelvic inflammatory disease.Patients and methodsWe describe transvaginal sonographic findings of six women with acute appendicitis selected from 31 women seen in an emergency room setting for clinically suspected pelvic inflammatory disease. The study population underwent gray‐scale transvaginal sonography, and specific sonographic landmark findings for acute appendicitis and pelvic inflammatory disease were used. Hyperemia of any infectious complex was identified by power Doppler. Laparoscopy was performed after transvaginal sonography and was used as the gold standard.ResultsLaparoscopy showed acute appendicitis in six (19%) of the 31 patients. A thick walled non‐compressible gas‐containing tubular structure with a diameter exceeding 6 mm was seen by transvaginal sonography in four of the six cases, consistent with uncomplicated appendicitis. A heterogeneous complex with surrounding hyperechogenic soft tissue was seen in two cases with gangrenous appendicitis. Power Doppler detected hyperemia in all six cases. Normal adnexal structures were imaged next to the inflamed appendix. The sonographic criteria consistent with acute appendicitis were clearly different from those of acute pelvic inflammatory disease.ConclusionsTransvaginal sonography provides an opportunity to distinguish between appendicitis and acute pelvic inflammatory disease. Prospective trials are needed in order to evaluate the impact of transvaginal sonography in the diagnosis of acute appendicitis. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Muscle fibre size and type distribution in thoracic and lumbar regions of erector spinae in healthy subjects without low back pain: normal values and sex differences
Authors: MANNION A. F. , DUMAS G. A. , COOPER R. G. , ESPINOSA F. J. , FARIS M. W. , STEVENSON J. M. 
Published: March 2003

This study sought to investigate the normal muscle fibre size and type distribution of the human erector spinae, both in thoracic and lumbar regions, in a group of 31 young healthy male (n=17) and female (n=14) volunteers. Two percutaneous muscle biopsy samples were obtained under local anaesthesia, from the belly of the left erector spinae, at the levels of the 10th thoracic and 3rd lumbar vertebrae. Samples were prepared for routine histochemistry for the identification of fibre types. Fibre size (cross‐sectional area (CSA) and narrow diameter (ND)) was quantified using computerised image analysis. The mean CSA/ND for each fibre type was greater in the thoracic than the lumbar region, but there was no difference between the 2 regions either for percentage type I (i.e. percentage distribution by number), percentage type I area (i.e. relative area of the muscle occupied by type I fibres) or the ratio describing the size of the type I fibre relative to that of the type II. Men had larger fibres than women, for each fibre type and at both sampling sites. In the men, each fibre type was of a similar mean size, whereas in the women the type I fibres were considerably larger than both the type II A and type II B fibres, with no difference between the latter two. In both regions of the erector spinae there was no difference between men and women for the proportion (%) of a given fibre type, but the percentage type I fibre area was significantly higher in the women.The erector spinae display muscle fibre characteristics which are clearly very different from those of other skeletal muscles, and which, with their predominance of relatively large type I (slow twitch) fibres, befit their function as postural muscles. Differences between thoracic and lumbar fascicles of the muscle, and between the muscles of men and women, may reflect adaptive responses to differences in function. In assessing the degree of any pathological change in the muscle of patients with low back pain, it seems clear that (1) sex cannot be disregarded and (2) ‘atrophied’ (using the criteria from other muscles) type II fibres are not necessarily abnormal for the erector spinae, particularly in women.
Early development of the neural plate, neural crest and facial region of marsupials
Authors: SMITH KATHLEEN K. 
Published: March 2003

abstractMarsupial mammals have a distinctive reproductive strategy. The young are born after an exceptionally short period of organogenesis and are consequently extremely altricial. Yet because they must be functionally independent in an essentially embryonic condition, the marsupial neonate exhibits a unique suite of adaptations. In particular, certain bones of the facial region, most cranial musculature and a few additional structures are accelerated in their development. In contrast, central nervous system structures, especially the forebrain, are markedly premature at birth, resembling an embryonic d 11 or 12 mouse. This review examines the developmental processes that are modified to produce these evolutionary changes. The focus is on the early development of the neural plate, neural crest and facial region in the marsupial, Monodelphis domestica, compared with patterns reported for rodents. Neural crest begins differentiation and migration at the neural plate stage, which results in large accumulations of neural crest in the facial region at an early stage of development. The early accumulation of neural crest provides the material for the accelerated development of oral and facial structures. The first arch region is massive in the early embryo, and the development of the olfactory placode and frontonasal region is advanced relative to the forebrain region. The development of the forebrain is delayed in marsupials relative to the hindbrain or facial region. These observations illustrate how development may be modified to produce evolutionary changes that distinguish taxa. Further, they suggest that development is not necessarily highly conserved, but instead may be quite plastic.
Axons and glial interfaces: ultrastructural studies*
Authors: Fraher John 
Published: March 2003

AbstractAt most vertebrate nerve transitional zones (TZs) there is a glial barrier which is pierced by axons passing between the CNS and PNS. Myelinated axons traverse this in individual tunnels. The same is true of larger non‐myelinated axons. This holds widely among the vertebrates, for example, the large motor axons of the sea‐lamprey Petromyzon (which also possess TZ specializations not found in mammals). Smaller non‐myelinated axons traverse the TZ glial tunnels as fascicles and so the barriers are correspondingly less comprehensive for them. Accordingly, in nerves composed of non‐myelinated axons, such as the vomeronasal or the olfactory, a TZ barrier stretching across the nerve is effectively absent. The chordate Amphioxus differs from the vertebrates in lacking a TZ barrier throughout. Invertebrates also lack glial barriers at the TZs between ganglia and interconnecting nerve trunks. The glial barrier at the dorsal spinal root TZ (DRTZ) has considerable value for analysing protocols aimed at achieving CNS regeneration, because it provides a useful model of the gliotic reaction at sites of CNS injury. Also, it is especially amenable to morphometric analysis, and so enables objective quantification of different protocols. Being adjacent to the subarachnoid space, it is accessible for experimental intervention. The DRTZ was used to investigate the value of neurotrophin 3 (NT3) in promoting axon regeneration across the TZ barrier and into the CNS following dorsal root crush. It promoted extensive regeneration and vigorous non‐myelinated axonal ensheathment. On average, around 40% of regenerating axons grew across the interface, compared with virtually none in its absence. These may have traversed the interface through loci occupied by axons prior to degeneration. Many regenerating axons became myelinated, both centrally and peripherally.
The amounts and deposition patterns of fibrin‐type fibrinoid at the villous surface are altered in pregnancy at high altitude
Authors: Mayhew T. M. , Bowles C. , Yücel F. 
Published: March 2003

In pregnancy at high altitude, there is preplacental (hypobaric) hypoxia and intrauterine fetal growth is restricted. Previous studies on placentas from Amerindian and nonindigenous women completing term pregnancies at low (LA; 400 m) and high (HA; 3600 m) altitudes in Bolivia showed that HA placentas had smaller surface areas of villi and smaller volumes of fibrin type fibrinoid (FTF). Recently we devised a stereological method for testing whether perivillous FTF (pFTF) is randomly distributed at the surface of villous trophoblast. Here the method is applied to test 2 experimental hypotheses: [1] deposition of pFTF is nonrandom regardless of altitude and [2] deposition patterns differ between altitudes. Uniform random samples of microscopical fields were drawn from Masson trichrome stained sections and intersection counts used to estimate the surface areas of, and patterns of pFTF on, 4 regions of trophoblast: nonsyncytial knots (nonSK), syncytial knots (SK), syncytial bridges (SB) and denudation sites (DEN). Absolute areas were compared by 2‐way analyses of variance. Expected and observed distributions were compared by (2 and contingency table analyses. At LA the mean (SEM) volume of FTF was 8.4 (1.54) cm3 and villous surface area was 7.0 (0.43) m2. At HA FTF volume was reduced by about 50% (P < 0.01) and villous surface by 20% (P < 0.01). The surface composition of trophoblast in LA placentas was nonSK (91%), SK (5%) and SB and DEN (both less than 3%). Relative surfaces were not significantly altered in HA placentas but, due to the impoverished growth of villi at HA, the changes represented a real decline in absolute surface of nonSK. At HA, the total surface of pFTF on trophoblast decreased by about 40%, from 4430 (564) cm2−2570 (406) cm2 (P < 0.01). At both altitudes pFTF deposition was preferentially found at DEN (12‐fold greater than expected for a random distribution). Pattern differences were detected between altitudes. In HA placentas the amount of pFTF deposited on nonSK regions was about 45% less (P < 0.05); apparent changes on SK and SB regions were not significant. These histometric findings suggest that the coagulation‐fibrinolysis steady state is altered at HA and favours greater fibrinolysis. At least some of the fibrinolytic or anticoagulant activity seems to reside in or on thinner regions of villous trophoblast and the placenta may be a relatively privileged site in terms of fibrinolysis. Also, reduced deposition of pFTF is probably linked to changes in the steady state of trophoblast turnover which seems to be perturbed in HA pregnancies.