bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimized differential diagnosis of breast lesions by combined B‐mode and color Doppler sonography
Authors: Schelling M. , Gnirs J. , Braun M. , Busch R. , Maurer S. , Kuhn W. , Schneider K. T. M. , Graeff H. 
Published: March 2003

AbstractTo optimize the sensitivity and specificity of gray‐scale imaging and color Doppler in breast tumor diagnosis, alone and in combination, 89 women with palpable breast masses were scanned preoperatively and standard parameters were determined in both modes. Parameters significant for differentiation of benign and malignant tumors identified using univariate analysis were combined and weighted using multivariate analysis (multiple logistic regression). Histologically 59 tumors were malignant and 30 benign. Gray‐scale sonography alone achieved a sensitivity of 88% and a specificity of 96% using the parameters of wall structure and posterior acoustic attenuation. Color Doppler achieved a sensitivity of 85% and a specificity of 79% using resistance index and pulsatility index as parameters. Combination of both methods yielded an accurate diagnosis in 84/87 patients (sonographic lesion correlates were absent in two cases), equivalent to a sensitivity of 97% and a specificity of 96%. Thus the individual diagnostic performance of gray‐scale imaging and color Doppler sonography in palpable breast disease is further enhanced using multiple logistic regression to combine independently significant parameters. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Intrauterine device localization by three‐dimensional transvaginal sonography
Authors: Lee A. , Eppel W. , Sam C. , Kratochwil A. , Deutinger J. , Bernaschek G. 
Published: March 2003

AbstractOur objective was to investigate the possible role of three‐dimensional transvaginal ultrasound in the visualization of an intrauterine device (IUD) for routine follow‐up after insertion. A total of 96 women were examined after insertion of a TCu380A IUD. Three‐dimensional ultrasonographic imaging was carried out using a special vaginal probe and a commercially available ultrasound machine at a mean interval of 22 days after insertion.Complete simultaneous imaging of all parts of the IUD was possible in 95% of cases. In the three‐plane mode, all parts of the IUD could be visualized in 44% and in a further 30 cases this was possible only after volume rendering. In two women., incomplete opening of the two arms of the device was demonstrated. In one of these cases, the entire IUD was displaced into the cervical canal. In another case, an intrauterine pregnancy was found together with an IUD in the correct position.Three‐dimensional ultrasound provides useful information on the location of the IUD following insertion. It enables imaging of the entire IUD, i.e. the shaft and the arms, simultaneously. Additionally, the examination time can be kept to a minimum with this new technique. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of body stalk anomaly in the first trimester of pregnancy
Authors: Ginsberg N. E. , Cadkin A. , Strom C. 
Published: March 2003

AbstractUltrasound examination in a 10‐week fetus demonstrated a marked deformity of the lower half of the fetus that was in the celomic cavity, and the upper half of the body was in the amniotic sac. There was abdominal wall defect with herniation of the liver and bowel, the lower limbs were deformed and the umbilical cord was short and thin. These abnormalities were suggestive of body stalk anomaly. The diagnosis was confirmed by pathological examination after termination of the pregnancy at 18 weeks. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
Pulsatility index in the fetal anterior tibial artery during the second half of normal pregnancy
Authors: Wisser J. , Kurmanavicius J. , Müller C. , Huch A. , Huch R. 
Published: March 2003

AbstractThe objective of this prospective study was to establish reference values for the pulsatility index in the fetal anterior tibial artery during the second half of pregnancy. Pulsed Doppler waveform analysis of 203 fetuses at 23–42 weeks of pregnancy was performed, each fetus being examined just once. There were neither fetal nor maternal complications detectable at the time of the examination. In the first 14 fetuses from which recordings were taken, Doppler examination was performed on both fetal legs in order to evaluate systematic differences between the right and left legs. Intraobserver variability was analyzed by repetition of the measurements by the same examiner in the first 130 cases.There was no difference between right and left tibial circulation. The repeatability coefficient, defined as the 95% range for the difference in two repeat measurements, was 1.08. The pulsatility index of the anterior tibial artery (50th centile) increased slightly from 3.29 at 23 weeks of pregnancy to 4.09 at 42 weeks. The 5th and 95th centiles were calculated, as was the 95% confidence interval of the 5th and 95th centiles.Examination of the fetal peripheral circulation during the second half of pregnancy is possible with a high degree of precision. Whether there are changes in peripheral arterial circulation in compromised fetuses remains to be evaluated. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal sonographic diagnosis of conjoined twins in the first trimester: two case reports
Authors: Lam Y. H. , Sin S. Y. , Lam C. , Lee C. P. , Tang M. H. Y. , Tse H. Y. 
Published: March 2003

AbstractConjoined twins are a rare occurrence. We present two cases of conjoined twins diagnosed by ultrasound examination at 8 and 13 weeks' gestation, respectively. These cases demonstrated the possibility of making an accurate diagnosis of conjoined twins and delineating the extent of organ sharing in the first trimester. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Three‐dimensional transvaginal sonography of conjoined twins at 10 weeks: a case report
Authors: Maymon R. , Halperin R. , Weinraub Z. , Herman A. , Schneider D. 
Published: March 2003

AbstractEarly and accurate prenatal diagnosis of conjoined twins is still a challenge, and is important when planning a favorable outcome for the mother and infants. We present a case diagnosed with transvaginal and three‐dimensional ultrasound at 10 weeks of gestation, and discuss the contribution of this relatively new scanning modality. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
O'Sullivan's hydrostatic reduction of an inverted uterus: sonar sequence recorded
Authors: Ward H. R. G. 
Published: March 2003

AbstractA case of acute uterine inversion which was successfully managed with hydrostatic reduction is reported. A sequence of sonograms demonstrating this is presented, as far as we are aware, for the first time. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal diagnosis of aortic insufficiency
Authors: Paladini D. , Russo M. , Palmieri S. , Morra T. , Pacileo G. , Martinelli P. 
Published: March 2003

AbstractThe prenatal diagnosis of various forms of left ventricular outflow tract obstruction has been reported in detail. However, the appearance and the characteristics of fetal aortic insufficiency have been described only in association with complete absence of the valve. We report here a case of aortic insufficiency associated with severe aortic stenosis. Features characteristic of insufficiency were severe cardiomegaly due to left ventricle dilatation and the hypocontractility of the myocardium. The aortic root was enormously dilated and the semilunar valve showed thick and dysplastic cusps. On color Doppler, the retrograde high‐velocity regurgitant jet was clearly visible. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology
Prenatal detection of cerebral lesions in a fetus with tuberous sclerosis
Authors: Sgro M. , Barozzino T. , Toi A. , Johnson J. , Sermer M. , Chitayat D. 
Published: March 2003

AbstractWe report a newborn, diagnosed prenatally with both cardiac rhabdomyomas and a brain tumor. To the best of our knowledge, this is the first report of central nervous system (CNS) lesions detected prenatally in a child with tuberous sclerosis with term follow‐up. At 36 months, the child has normal growth and is developing appropriately. Thus the finding of CNS tumors on fetal ultrasound examination can help in the prenatal diagnosis of tuberous sclerosis but does not necessarily indicate a poor prognosis. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology
Customized fetal weight limits for antenatal detection of fetal growth restriction
Authors: De Jong C.L.D. , Francis A. , Van Geijn H.P. , Gardosi J. 
Published: March 2003

Objective
To define cut‐off limits for individually adjustable fetal weight standards for the detection of intrauterine growth restriction.
Design
Retrospective study, with the outcome measures small‐for‐gestational age (SGA) birth weight, operative delivery for fetal distress, umbilical artery pH < 7.15, and admission to the neonatal intensive care unit.
Subjects and Methods
Two hundred and fifteen women considered to be at increased risk of uteroplacental insufficiency were recruited to a study of serial ultrasound scans. Fetal weights were derived using standard formulae and, retrospectively, weight percentiles were calculated after individual adjustment for maternal height, weight in early pregnancy, ethnic group, parity and fetal sex.
Introduction
One or more antenatal scans indicative of fetal weight below the 10th customized percentile were predictive for a SGA neonate at birth (P < 0.001), operative delivery for fetal distress (P < 0.01) and admission to neonatal intensive care (P < 0.01) but not for a low umbilical artery pH (P = 0.6). Receiver–operator curves showed the optimal customized fetal weight percentile limit for predicting an SGA neonate to be the 18th percentile (sensitivity 83%, specificity 79%, positive predictive value 63% and negative predictive value 92%). For the prediction of operative delivery for fetal distress and admission to neonatal intensive care, the optional customised cut‐off value was the 8th percentile.
Conclusions
The assessment of fetal weight using ultrasound and an individually‐adjusted standard is predictive of growth restriction and perinatal events associated with hypoxia or diminished reserve. The optimal cut‐off value for predicting operative delivery for fetal distress or admission to the neonatal intensive care unit suggests that the 10th customized percentile is a good limit for clinical use.
Fetuses and infants with congenital urinary system anomalies: correlation between prenatal ultrasound and postmortem findings
Authors: Isaksen C.V. , Eik‐Nes S.H. , Blaas H.‐G. , Torp S.H. 
Published: March 2003

Objective Detection of congenital urinary system anomalies is an important part of the prenatal ultrasound examination. The present study compares prenatal ultrasonographic findings and postmortem examinations of fetuses and infants with renal and urinary tract anomalies.Design Criteria for inclusion were an ultrasound examination at the National Center for Fetal Medicine (Trondheim, Norway) and autopsy performed during the period 1985–94. Results from the ultrasound examination and autopsy regarding urinary system anomalies were categorized according to the degree of concordance.Results Urinary system anomalies were found in 112 (27%) of 408 fetuses with congenital anomalies. The renal and/or urinary tract anomaly was the principal reason for induced abortion or cause of death in 50 cases (45%). In 97 (87%) of the 112 cases there was full agreement between the ultrasound observations and the autopsy findings. In five cases the autopsy revealed minor findings not mentioned in the ultrasound report. The main diagnosis was thus correct in 102 cases (91%). In four cases major autopsy findings had not been found by ultrasound examination; in another four, none of the autopsy findings were suspected by ultrasound, and in two, minor ultrasound findings were not confirmed at autopsy.Conclusions The accordance between ultrasound diagnoses and postmortem examinations proved to be satisfactory. The close co‐operation between ultrasonographers and perinatal pathologists is mutually beneficial. In addition to complementing prenatal diagnosis, postmortem examination is of vital importance for the quality control of ultrasonography in fetal diagnosis and plays an important role in genetic counseling.
Diagnosis of a fetal mesoblastic nephroma by 3D‐ultrasound
Authors: Schild R. L. , Plath H. , Hofstaetter C. , Hansmann M. 
Published: March 2003

AbstractWe report a case of a fetal renal tumor detected prenatally on 3D‐ultrasound. As the lesion was well encapsulated the initial sonographic diagnosis was that of a nephroblastoma. Volume calculation by the 3D technique gave a reliable estimation of the tumor size. Contrary to all published case reports concerning antenatally diagnosed mesoblastic nephromas, there was no polyhydramnios. Elective delivery was performed by Cesarean section at 38+ weeks gestation. The neonate underwent left nephrectomy on the second day of life. The subsequent course was uneventful without recurrence of the tumor. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Determination of the anatomical location of an antenatal intestinal occlusion by magnetic resonance imaging
Authors: Benachi A. , Sonigo P. , Jouannic J.‐M. , Simon I. , Révillon Y. , Brunelle F. , Dumez Y. 
Published: March 2003

AbstractIntestinal occlusion occurs in approximately 1 in 3000 births. Its diagnosis can be made in utero with ultrasound however, determination of its precise location is difficult to achieve. We report herein the feasibility of diagnosing and locating a fetal small‐intestine occlusion with the use of magnetic resonance imaging. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Quantification of fetal power Doppler: determination of the intravascular standardization point
Authors: Welsh A. W. , Rubin J. , Fowlkes B. , Fisk N. M. 
Published: March 2003

Background:  With its sensitivity to low flow, lack of aliasing and relative angle independence, power (amplitude) Doppler ultrasound is well suited to assessment of tissue perfusion. However, the influence of machine settings, depth and other factors related to attenuation means that perfusion measurements taken from deep tissue without standardization to 100% flow are relatively meaningless. Previously published adult research has proposed a technique to estimate a true value for 100% amplitude from a cumulative power distribution across a large local vessel. This standardization value allows measurement of fractional moving vascular volume as an ultrasound index of perfusion.Methods:  Fetal renal and aortic blood flow was evaluated using the power Doppler mode of the Acuson Sequoia™. Color flow information was digitally segmented to a linear 8‐bit scale and analyzed using CQ Analysis software as previously reported by our group. Using images from the fetal aorta with and without the kidney, of both segmented and unsegmented images, an attempt was made to plot the cumulative power distribution in eight fetuses (27–37 weeks' gestation). Fetal aortic amplitude information was then examined using a combination of CQ Analysis, Scion Image and Excel software. Peak amplitude was examined between different ultrasound clips in a single fetus and in 50 frames through the cardiac cycle in 10 fetuses. Spatial variation in peak aortic amplitude was examined in 50 frames from four fetuses with varying angle of insonation from 73° to 88°. Temporal variation was examined in 50 frames from a single fetus.Results:  In the human fetus, there is no peak vascular value or corresponding ‘knee point’ attributable to the effects of rouleaux. In contrast, the peak aortic value is relatively constant for 100% flow, both between multiple imaging clips and throughout the cardiac cycle in the 10 fetuses. Spatial variation for the 100% flow value increased from an average coefficient of variation of 6.5% at 79° to 28% at 89°. Temporal variation was 8% over 50 frames.Conclusions:  The human fetus has a reduced degree of rouleaux formation in part due to an altered form of fibrinogen and reduced concentration of plasma proteins, so the peak amplitude measurement in the center of large vessels represents true 100% flow. This finding is confirmed by the lack of cardiac cycle effects on the amplitude profile. The central value of larger blood vessels, such as the fetal aorta, if measured at an appropriate angle of insonation, may provide a relatively constant standardization value for vessels or regions at a similar depth. From these, true measurements of fractional moving vascular volume may be derived.Acknowledgements:  Alec Welsh was supported by a Research Training Fellowship from RCOG/WellBeing, the BUPA Research Foundation Clinical Scientist Award 2000 and the 2001 Bernhard Baron/RCOG Travelling Scholarship.
Endothelial phenotype of the materno–fetal barrier
Authors: Leach L. , Babawale M. O. , Lammiman M. J. , Dye J. F. , Clark P. , Firth J. A. 
Published: March 2003

The terminal villous capillaries of the human placenta are the sites of maximal materno‐fetal exchange. These capillaries are highly angiogenic and are formed in the last trimester of pregnancy by looped angiogenesis from existing microvessels in the intermediate villi. They represent an ‘activated’ phenotype by possessing adherens junctions which contain VE‐cadherin (– and (– catenin but lack plakoglobin, the component of well differentiated junctions. The tight junctions present here show negative immunoreactivity to occludin and claudin‐1. The conduit vessels further upstream in the stem villi have the full complement of adherens and tight junctional molecules. VEGF and angiopoietin‐2 is present in terminal villi whilst angiopoietin‐1 appears to be a predominant feature of stem villi. The phenotype of junctions present in nascent vessels of the first trimester placentae was similar to the angiogenic terminal villous capillaries. The predominant growth factor here was VEGF, localised to all villi. Isolation of endothelial cells from last trimester placenta microvessels (HPMEC) demonstrated that these cells are capable of differential expression and dynamic regulation of cell‐cell junctions. Cells grown in the presence of ECGS showed a reduction in the level and junctional localisation of plakoglobin and occludin, with associated increased permeability to macromolecules. These adhesion molecules were up‐regulated and targeted back to cell‐cell contact regions by growing HPMEC in the presence of cAMP enhancing agents. This resulted in a 1.7 times increase in transendothelial resistance whilst proliferation of HPMEC cells was inhibited by elevated cAMP. HUVEC cells isolated from the umbilical cords of these placentae contain the full repertoire of AJ molecules in normal culture conditions with no change in composition or resistance under elevated cAMP. The differential expression of junctional adhesion molecules along the placental vascular tree and their in vitro plasticity suggests there is a physiological relevance of junctional regulation in the placenta. The activated junctional phenotype of the newly formed terminal microvessels allows them to participate in increased growth, proliferation and solute exchange in the last trimester when fetal demand is at its greatest. Furthemore, this necessary junctional immaturity of new/angiogenic human vessels appear to be at the expense of barrier function.Funded by the Wellcome Trust.
Intracellular signalling involved in modulating human endothelial barrier function
Authors: Van Hinsbergh V. W. M. , Van Nieuw Amerongen G. P. 
Published: March 2003

The endothelium actively regulates the extravasation of solutes, hormones and macromolecules. In pathological conditions endothelial hyperpermeability can be induced by vasoactive agents that induce tiny leakage sites between the cells, and by cytokines, in particular vascular endothelial growth factor, that increase exchange of plasma proteins by vesicles and intracellular pores. It is generally believed that the interaction of actin and nonmuscle myosin in the periphery of the endothelial cell is required for endothelial hyperpermeability induced by vasoactive agents. Histamine causes a transient increase in endothelial permeability which normalises within seversal minutes. By H1‐receptor activation it raises the cytoplasmic Ca2+ concentration and stimulates the Ca2+/calmodulin dependent activation of the myosin light chain (MLC) kinase. The phophorylated MLC promotes actin‐non–muscle–myosin interaction in the endothelial cell. Thrombin induces a prolonged hyperpermeability in human endothelial monolayers. In addition to the Ca2± dependent activation of MLC kinase, a sensitisation of the cell occurs by activation of RhoA and Rho kinase. Furthermore, protein tyrosine kinase activity contributes to the thrombin‐induced hyperpermeability.In most types of endothelia the barrier function of endothelial cells is improved both in vivo and in vitro by agents that increase the cellular cyclic AMP concentration. Catecholamines contribute to the enforcement of the endothelial barrier function by activation of (2‐adrenergic receptors and increasing the endothelial cyclic AMP content. Nitric oxide and cyclic GMP can also counteract thrombin‐induced endothelial hyperpermeability in specific types of vessels while in other types they contribute to endothelial hyperpermeability. In human aorta endothelial cells NO induced by vasoactive agents increases the generation of cGMP, which activates cGMP‐dependent protein kinase‐I. This activity counteracts the effect on endothelial permeability by reducing the elevation of Ca2+ in the cell. Furthermore inhibitors of RhoA formation and Rho kinase represent a potentially valuable additional group of agents with endothelial hyperpermeability reducing properties. They not only reduce thrombin‐induced endothelial permeability in vitro but also reduced the interaction of leukocytes with the endothelial cells and accompanying vascular leakage in vivo.
Extracellular matrix, junctional integrity and matrix metalloproteinase interactions
Authors: Alexander J. S. 
Published: March 2003

The vascular endothelial solute barrier is formed by the regulated apposition of adherens and tight junctional proteins, and is controlled by several pharmacological and physiological mediators which govern junctional organization. We observe that barrier changes in vitro are associated with (1) the spatial redistribution of surface cadherins and occludin; (2) stabilisation of focal adhesive bonds; and (3) the progressive activation of matrix metalloproteinases. In response to peroxide, histamine and EDTA, endothelial cells sequester VE‐cadherin and alter its cytoskeletal binding. At the same time these mediators also enhance focal adhesion to the substratum. Lastly oxidants, cytokines and pharmacological mediators also trigger the activation of matrix metalloproteinases in a cytoskeleton and tyrosine phosphorylation dependent manner to degrade occludin, a tight junction element. These related in vitro phenomena may act cooperatively in inflammation to structurally stabilise cells during permeability, while remodelling cell junctions and substratum.Supported by grants HL47615, DK43785.