bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital microvillous inclusion disease presenting as antenatal bowel obstruction
Authors: Kennea N. , Norbury R. , Anderson G. , Tekay A. 
Published: March 2003

AbstractPrenatal ultrasound has led to confidence in the antenatal diagnosis of intestinal obstruction allowing counseling and birth planning. We describe a male infant of a diabetic mother who had an antenatal diagnosis of distal bowel obstruction. This baby was subsequently found not to have bowel obstruction, but a congenital enteropathy – microvillous inclusion disease. The antenatal scans had demonstrated polyhydramnios as well as multiple fluid‐filled dilated loops of bowel in the fetal abdomen. To our knowledge, similar prenatal ultrasound findings have not been previously described in this condition. The baby was delivered in a pediatric surgical center and postnatally there was no evidence of bowel obstruction either clinically or on abdominal X‐ray. This baby initially fed well, but became collapsed and acidotic on his third day, having lost 26% of his birth weight due to excessive stool loss. The diagnosis of microvillous inclusion disease was made by electron microscopy of a small bowel biopsy. Congenital microvillous inclusion disease is a very rare inherited enteropathy with high mortality and morbidity. This condition, and other enteropathies, should be considered in cases in which antenatally diagnosed bowel obstruction is not confirmed after birth. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Persistent right umbilical vein in a fetus with Noonan's syndrome: a case report
Authors: Bradley E. , Kean L. , Twining P. , James D. 
Published: March 2003

AbstractWe present a case of persistent right umbilical vein with Noonan's syndrome. Persistence of the right umbilical vein with no intrahepatic portion is an uncommon finding with a review of the literature revealing only five other cases. In these cases drainage was directly into the right atrium, inferior vena cava (IVC) or IVC via the iliac vein. Of the reported cases Noonan's syndrome was confirmed in one case and suspected in a second. This report represents a third case of persistent right umbilical vein with confirmed Noonan's syndrome. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Reference values of fetal aortic flow velocity waveforms and associated intra‐observer reliability in normal pregnancies
Authors: Bahlmann F. , Wellek S. , Reinhardt I. , Krummenauer F. , Merz E. , Welter C. 
Published: March 2003

AbstractObjectivesIt was the aim of the present study to calculate new Doppler reference ranges for blood flow velocities (V
max, V
mean, V
min) and resistance indices (PI, RI) for the fetal descending aorta by automatic waveform analysis.DesignCross‐sectional prospective study.SubjectsNine hundred and twenty‐six low‐risk pregnancies at 18–41 weeks' gestation.MethodsAortic blood flow velocities were derived with pulsed‐wave color Doppler. Measurements were carried out at the level of the diaphragm. Reference ranges for the individual measuring parameters were constructed based on a growth function from a four‐parameter class of monotonic continuous functions according to the smallest square principle. Further investigated were intra‐observer reliability and the influence exerted by different measuring sites (aortic arch, diaphragm, below the renal vessels) on the aortic Doppler flow spectrum.ResultsAlthough a significant increase in aortic blood flow velocity was observed at 18–41 weeks' gestation (V
max = 48.2 cm/s to 110.3 cm/s (P < 0.001), V
mean = 20 cm/s to 47.5 cm/s (P < 0.001) and V
min = 7.6 cm/s to 18.6 cm/s (P < 0.001)), there were no significant changes in the pulsatility or resistance indices. The resistance indices PI and RI as well as absolute blood flow velocities (Vmax, Vmin) were significantly lower with increasing distance from the heart. Initial decreases were measured between the aortic arch and the diaphragm: PI, 2.34 to 1.87 (P < 0.0001); RI, 0.87 to 0.79 (P < 0.0001); V
min: 8.5 cm/s to 15.0 cm/s (P < 0.0001). Furthermore, systolic blood flow velocities (V
max) were decreased below the renal vessels from 97 cm/s to 64 cm/s (P < 0.0007). No significant changes were recorded in intensity‐weighted mean flow velocities (V
mean). The intra‐observer reliability was low, but of no clinical relevance.ConclusionsAt constant measuring conditions, the reference ranges for blood flow velocities and resistance indices in the fetal aorta calculated by the authors serve as the basis for Doppler ultrasound antenatal examinations in a normal patient population and enable the early diagnosis of fetal risk. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional ultrasound of the female urethra: comparing transvaginal and transrectal scanning
Authors: Umek W. H. , Obermair A. , Stutterecker D. , Häusler G. , Leodolter S. , Hanzal E. 
Published: March 2003

AbstractObjectivesTo compare transvaginal and transrectal three‐dimensional ultrasound in determining the morphology and measurements of the female urethra.DesignSixty‐five women who had not had surgery for incontinence or pelvic floor descent had transvaginal and transrectal sonography using a 7.5‐MHz mechanical sector endoprobe with three‐dimensional facilities. The multiplanar display of the scanned volumes allowed detailed morphologic assessment of the urethra and the measurement of distances and volumes. Statistical endpoints were: sagittal urethral diameter, maximum rhabdosphincter length and thickness, maximum thickness of the smooth muscle complex, and the volumes of the rhabdosphincter and the smooth muscle complex. Values were compared between the two approaches using Student's t‐test and Bland–Altman analysis.ResultsBoth vaginal and rectal scans were feasible. However, significant differences between the two approaches were found for the sagittal diameter of the urethra (8.4 ± 1.9 mm on vaginal vs. 11.5 ± 2.2 mm on rectal scans, P < 0.01) and the transverse diameter of the urethra's smooth muscle complex (11.2 ± 0.3 mm on vaginal vs. 8.6 ± 0.2 mm on rectal scans, P < 0.001). No other variables showed significant differences. Compression of the urethra and displacement under the symphysis pubis were observed when the ultrasound probe was applied vaginally. Bland–Altman analysis showed acceptable variability for differences of distances but considerable variability for the differences of volumes.ConclusionThe female urethra can be examined both vaginally and rectally by three‐dimensional ultrasound. A transvaginally applied probe seems to have a compression effect on the urethra. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
First‐trimester diagnosis of fetal hepatic cyst
Authors: Berg C. , Baschat A. A. , Geipel A. , Krapp M. , Germer U. , Smrcek J. M. , Sigge W. , Gembruch U. 
Published: March 2003

AbstractFetal intra‐abdominal cysts seen on antenatal sonography pose a diagnostic problem as they may have many etiological origins. We present a case of a hepatic cyst measuring 11 × 7 × 7 mm that was diagnosed at 13 weeks' gestation by transvaginal sonography. The cyst increased in proportion with the growth of the fetus. Ultrasound‐guided needle aspiration of the cyst at 22 weeks' gestation helped to clearly identify the formerly displaced gall bladder and demonstrated the intrahepatic location of the cyst. The aspirated fluid was identified as bile. After aspiration the fluid reaccumulated rapidly. Shortly prior to delivery the cyst measured 75 × 44 × 46 mm. At 39 weeks of gestation a female infant was delivered by forceps (3610 g; Apgar 9/10/10 at 1, 5 and 10 min, respectively). Increasing cyst size and concomitant feeding problems prompted surgery on the 14th day postpartum. A large hepatic cyst was partially excised and marsupialized, confirming the prenatal diagnosis. The postoperative course was complicated by cholangitis, septicemia and recurrence of the cyst. Therefore Roux‐en‐Y hepatojejunostomy was performed in the second month of life. The postoperative period was uneventful and the child was doing well at the time of writing. Copyright © 2002 ISUOG
Prenatal detection of ductal‐dependent congenital heart disease: how can things be made easier?
Authors: Viñals F. , Tapia J. , Giuliano A. 
Published: March 2003

AbstractObjectiveTo improve the detection of ductal dependence in fetuses with severe anomalies of the outflow tracts by observing, with directional power Doppler, reverse flow through the aortic arch or ductus arteriosus in a transverse view of the upper mediastinum.MethodsA slight cranial move of the ultrasound beam from the three‐vessel view allows the transverse view of the aortic arch and ductus arteriosus to be visualized simultaneously. This view is orthogonal to the fetal body axis and parallel to the plane of the four‐chamber view. In normal fetuses, directional power Doppler interrogation at this level identifies forward flow in both oblique vessels.ResultsWe examined 43 fetuses with cardiac defects. In five of the cases, there was reversed flow in the aortic arch or ductus arteriosus in addition to severe anomalies of the outflow tracts, including four with hypoplastic left ventricle and one with pulmonary atresia.ConclusionsPrenatal detection of reversed flow in the aortic arch or ductus arteriosus is associated with complex congenital heart disease with major diminution of forward flow to the corresponding great vessels. Copyright © 2002 ISUOG
Sonographic features of anal atresia at 12 weeks
Authors: Lam Y. H. , Shek T. , Tang M. H. Y. 
Published: March 2003

AbstractAnorectal atresia results from abnormal development of the anorectal septum. Prenatal diagnosis is difficult but the condition may be suspected by the sonographic demonstration of a dilated colon. We present the sonographic features of a fetus with anal atresia and a ventricular septal defect at 12 weeks of gestation. This case illustrates that a dilated colon may be present in association with fetal anal atresia as early as 12 weeks. Copyright © 2002 ISUOG
Conservative management of two ectopic pregnancies implanted in previous uterine scars
Authors: Haimov‐Kochman R. , Sciaky‐Tamir Y. , Yanai N. , Yagel S. 
Published: March 2003

AbstractCesarean section scar pregnancy is rare. A variety of interventions have been implemented to terminate the pregnancy and preserve the uterus; however, the optimal treatment is unknown. We describe two cases of this rare condition diagnosed by transvaginal ultrasound. In the first case the diagnosis of an 8‐week non‐viable gestation in a uterine scar was made sonographically in a 40‐year‐old woman. The patient was treated with intramuscular methotrexate. Myometrial integrity was suggested both by ultrasound findings and laparoscopic findings. In the second case, an early cervicoisthmic pregnancy in a uterine scar was diagnosed by sonography in a 39‐year‐old woman. This patient was treated successfully with a full course of intramuscular methotrexate. Complete disappearance of the gestational sac took place 4 months following beta‐human chorionic gonadotrophin normalization. Intramuscular methotrexate may be a treatment alternative for Cesarean section scar pregnancies. Copyright © 2002 ISUOG
Increased nuchal translucency and pathological ductus venosus flow: two cases of TRAP sequence with different outcomes
Authors: Meyberg H. , Groß C. 
Published: March 2003

AbstractTwin reversed arterial perfusion (TRAP) sequence develops in 1% of monozygotic twins. One normal twin (donor) provides circulation for itself and for a more or less incomplete twin (recipient) with a high incidence of mortality in the donor twin. However, if the condition is detected and treated early, one twin or two triplets may survive. The study of TRAP sequence helps to better understand the pathophysiological pathways of this condition. We present two cases of TRAP sequence seen in our center with different courses. In these cases the increased nuchal translucency thickness and the pathological ductus venosus flow pattern may have been prognostic of the pregnancy outcome. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Blackfan–Diamond anemia and dyserythropoietic anemia presenting with increased nuchal translucency at 12 weeks of gestation
Authors: Souka A. P. , Bower S. , Geerts L. , Huggon I. , Nicolaides K. H. 
Published: March 2003

AbstractBlackfan–Diamond anemia is a congenital hypoplastic anemia with a birth prevalence of about 1 in 200 000, usually presenting in the first few months of life and commonly associated with cardiac, urogenital and digital anomalies. Congenital dyserythropoietic anemias are a group of rare congenital anemias characterized by ineffective erythropoiesis. We report on two cases of congenital fetal anemia, one with Blackfan–Diamond anemia and one with dyserythropoietic anemia, presenting with increased nuchal translucency at 12 weeks of gestation. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Abnormal maternal cardiac function and morphology in pregnancies complicated by intrauterine fetal growth restriction
Authors: Vasapollo B. , Valensise H. , Novelli G. P. , Larciprete G. , Di Pierro G. , Altomare F. , Casalino B. , Galante A. , Arduini D. 
Published: March 2003

AbstractObjectiveTo explore maternal cardiac function through an echocardiographic evaluation, in a group of nulliparous patients with intrauterine fetal growth restriction during the third trimester of pregnancy.MethodsTwenty‐one consecutive nulliparous pregnant women who had fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler pulsatility index (PI) underwent maternal echocardiographic examination during the third trimester of gestation. The data were then compared with those obtained from 21 normal nulliparous women who had fetuses with an estimated fetal weight > 10th percentile and a normal umbilical artery Doppler PI who were considered as the control group.ResultsHeart rate was slightly lower in the IUGR group, whereas blood pressure and total vascular resistance were higher compared with the control subjects. End‐diastolic volume, stroke volume and cardiac output were lower in the IUGR patients compared with normal patients. The IUGR group had smaller left atrial maximal dimensions and greater left atrial minimal areas compared with the control subjects. Left atrial function was depressed in the IUGR group. A smaller left ventricular mass was present in the IUGR patients compared with the control subjects. Isovolumetric relaxation time (IVRT) was prolonged in the IUGR patients compared with the controls.ConclusionsThe absence of a ‘correct’ maternal cardiovascular compensatory response to abnormal trophoblastic invasion, might be one of the factors that slowly determine the conditions of reduced placental perfusion and eventually of the development of fetal growth restriction. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Subependymal pseudocysts in the fetal brain: prenatal diagnosis of two cases and review of the literature
Authors: Bats A. S. , Molho M. , Senat M. V. , Paupe A. , Bernard J. P. , Ville Y. 
Published: March 2003

AbstractSubependymal pseudocysts are cerebral cysts found in 5% of all neonates. When they are isolated and typical, they result from persistence of the germinal matrix, have a good prognosis and regress spontaneously within a few months. However, associated anomalies are frequent and in such cases the prognosis is poor. They can be of infectious, vascular, metabolic or chromosomal origin. Subependymal pseudocysts have rarely been described in the antenatal period. We report the prenatal diagnosis of two cases of isolated pseudocysts at 32 and 23 weeks. Both ultrasonography and magnetic resonance imaging assisted in the diagnosis and there was normal postnatal outcome in both cases. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
The sternalis muscle: an uncommon anatomical variant among Taiwanese
Authors: JENG HELLEN , SU SHUEN‐JING 
Published: March 2003

The sternalis muscle is an uncommon anatomical variant. It is located on the human anterior pectoral wall, superficial to pectoralis major. This muscle has been reported both in males and females, and in whites, blacks and Asians (Barlow, 1934; Kida & Kudoh, 1991; Shen et al. 1992; Bradley et al. 1996).Although the importance of this muscle is still a mystery, various different interpretations have been made. Clemente (1985) considered sternalis to be a misplaced pectoralis major, although some embryologists have viewed it as part of a ventral longitudinal column muscle layer arising at the ventral tip of the hypomeres (Sadler, 1995). Sadler claimed that this muscle is represented by rectus abdominis in the abdominal region and by the infrahyoid musculature in the cervical region; in the thorax, this layer usually disappears but occasionally remains as a sternalis muscle. Kitamura et al. (1985) reported a case of congenital partial deficiency of pectoralis major accompanied by an enormous sternalis. Barlow (1934), on the other hand, claimed that sternalis represents the remains of a panniculus carnosus.
Professor J. M. F. Landsmeer (1919–1999)
Authors: KAUER JOHN M. G. , HUSON ANTHONY 
Published: March 2003

Johan Matthijs Frederik (Hans) Landsmeer, Professor Emeritus of Anatomy and Embryology at the University of Leiden, died on 12 June 1999, at the age of 80. He was a gifted scientist who had devoted his professional life to research in Anatomy and Embryology. During his career he was successful in blazing new trails in the relation of morphology to function. This resulted in an impressive list of publications frequently cited in the literature. His sharp analytical approach to problems was a striking feature and illustrated his aversion to superficiality. In this way he collected a profound and inspiring knowledge of human and comparative anatomy and embryology and he knew exactly how to pass on this knowledge to others. Therefore it is not surprising that he guided a substantial number of disciples to the completion of a PhD thesis, thus forming a school. His ability to translate his concepts in a way to have them accepted in the solution of clinical problems is also generally recognised. He was a skilful dissector. The results of his work were brought together in Landsmeer's Atlas of Anatomy of the Hand, published in 1976. This volume represents his meticulous morphological analysis of structures and his ability to intermingle the gross and fine structure of the hand to its function. This has opened perspectives for the surgeon engaged in the treatment of this most difficult area.Hans Landsmeer had a strong affiliation to the University of Leiden. Born on 14 January 1919 in Rotterdam, where he spent his youth, he started his medical studies at the Leiden University in 1935. In 1939, before graduating he entered the Department of Anatomy and Embryology, and he stayed there until his retirement. This continuity was only interrupted during World War II. In November 1940 the University of Leiden was closed by the Nazis in connection with a rectorial address on 26 November protesting against the exclusion of the Jewish professors. Without any doubt this major event made a deep impression on him. During his career he consistently refused any invitation from countries where democracy was violated.
Soluble flt‐1 and the angiopoietins in the development and regulation of placental vasculature*
Authors: Charnock‐Jones D. Stephen 
Published: March 2003

AbstractOne of the key roles of the placenta is to mediate exchange of oxygen, nutrients and waste products between the maternal and fetal circulations. While some nutrients are actively taken up, oxygen is passively transported (i.e. it moves down a simple concentration gradient). To ensure an adequate supply as gestation progresses, the vascular structures in the human placenta remodel to facilitate this transfer. Under conditions in which oxygen is limited, at high altitude for example, these adaptations become more pronounced. In placentae obtained from high altitude the mean diameter of vessels is increased and the number of perivascular cells (pericytes) is reduced. Pericytes play an important role in modulating endothelial cell function and in their absence the endothelial cells are sensitive to growth factor withdrawal. The vascular remodelling that occurs in normal pregnancy is in part mediated by soluble factors (some produced by pericytes) and the level of these may in turn be regulated by local oxygen tension. We have shown that the mRNAs encoding both angiopoietins are present in the placenta and both are regulated by local pO2. Ang‐2 mRNA transcription is increased under reduced oxygen and the stability of Ang‐1 mRNA is reduced under similar conditions. Thus the ratio of mRNAs encoding these antagonistic factors changes (in favour of Ang‐2), in the placenta in response to a reduction in pO2. The adaptations seen in the placenta and the mechanism by which they are achieved may be generally applicable.
Recombinant human alpha‐2a interferon promotes an atypical process of mast cell secretion with ultrastructural features suggestive for piecemeal degranulation
Authors: Crivellato Enrico , Candussio Luigi , Mallardi Franco , Ribatti Domenico 
Published: March 2003

AbstractPurified mast cells (MC), isolated from the rat peritoneum, were stimulated in vitro with recombinant human IFN‐α 2a (rhIFN‐α 2a) and studied ultrastructurally. Quantitative determination of histamine release was also performed. The following ultrastructural features were observed: (1) dilation of single granules, leading to the formation of cytoplasmic cavities filled with dissolved or eroded matrices; (2) induction of partially empty, non‐fused granule containers close to unaltered resting granules, a process very suggestive of piecemeal degranulation; (3) focal exocytosis, characterized by opening of single granules to the cell exterior and/or fusion of a few granules into small secretory channels. Histamine release was slightly increased in rhIFN‐α 2a‐treated MC, although not to significant levels. These results indicate that rhIFN‐α 2a induces a characteristic pattern of degranulation in rat peritoneal MC and that a small proportion of rhIFN‐α 2a‐stimulated MC shows ultrastructural features suggestive for piecemeal degranulation.