bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural history of fetal hydronephrosis diagnosed on mid‐trimester ultrasound
Authors: Sairam S. , Al‐Habib A. , Sasson S. , Thilaganathan B. 
Published: March 2003

AbstractObjectivesRenal tract dilatation is a common finding in routine prenatal ultrasound. However, there is no consensus as to the criteria used for differentiating pathological from physiological dilatation. The aim of this study was to evaluate the natural history and postnatal outcome of fetal hydronephrosis in an unselected obstetric population.DesignThis was a prospective study of fetal hydronephrosis, detected at 18–23 weeks' gestation, in a routine obstetric population. Fetal hydronephrosis was diagnosed as ‘mild’ if the antero‐posterior renal pelvic diameter (APRPD) measured ≥ 4 mm and as ‘moderate/severe’ if the APRPD measured ≥ 7 mm or if there was associated calyceal dilatation. The postnatal outcome of fetuses with persistent hydronephrosis (≥ 10 mm in the third trimester) was determined from a postal questionnaire.ResultsDuring the study period, 11 465 women underwent an anomaly scan at 18–23 weeks of gestation. Fetal hydronephrosis was identified in 2.3% (268/11 465) of women. Mild hydronephrosis was present in 80.6% (216/268) and moderate/severe hydronephrosis in 19.4% (52/268). The hydronephrosis resolved in the antenatal or early neonatal period in 88% of fetuses. None of the fetuses with mild hydronephrosis and approximately one in three fetuses with persistent moderate/severe hydronephrosis required postnatal surgery. Overall, only one in every 1000 total births in the study population required postnatal urological surgery.ConclusionsThe current study highlights the natural history of antenatally detected hydronephrosis. Mild fetal hydronephrosis appears to be associated with an excellent prognosis and probably represents the group with physiological renal pelvic dilatation. Moderate/severe fetal hydronephrosis is associated with poorer outcome and is perhaps the group that will need more intense follow up both antenatally and postnatally. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Comparative analysis of pattern, management and outcome of pre‐ versus postnatally diagnosed major congenital heart disease: a population‐based study
Authors: Jaeggi E. T. , Sholler G. F. , Jones O. D. H. , Cooper S. G. 
Published: March 2003

AbstractObjectivesMost pregnant women in New South Wales undergo obstetric ultrasound examination, including some assessment of fetal cardiac anatomy. We aimed to review the spectrum of cardiac defects, management and outcome data of all fetuses with diagnosis of major congenital heart disease between 1994 and 1996 and compare them to major congenital heart disease in infants born during the same 3‐year study period.MethodsDescriptive comprehensive study of the New South Wales population. Study centers included the single fetal echocardiographic referral service and the two pediatric cardiac centers of New South Wales.ResultsNinety‐seven fetuses and 562 infants with major congenital heart disease were identified (240 000 livebirths), resulting in a prenatal detection rate of 15%. Anomalies detectable by cardiac four‐chamber views were diagnosed at an average rate of 30% (68/229) in utero. By contrast, lesions associated with abnormal ventricular outflow and great artery views were detected in only 6.7% (29/430; P < 0.0001) of cases prior to birth. Of the 97 fetuses, 29 were aborted, 16 died in utero, and 9 died early postnatally without treatment. Within 2 weeks of age, 23% with fetal and 40% (P < 0.05) with infant major congenital heart disease diagnosis required an intervention, mainly for patent ductus arteriosus dependent lesions. Postnatal survival was similar for the fetal and infant series up to 2 years of age: 77% (95% confidence interval 64–90%) vs. 85% (95% confidence interval 82–88%).ConclusionsPrenatal diagnosis has important implications for pregnancy outcome, in particular for univentricular lesions. However, the present mode of obstetric routine ultrasound scanning fails to identify most ductus arteriosus dependent cardiac lesions with a predictable need for early postnatal intervention. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Doppler studies on the fetal renal artery in the severely growth‐restricted fetus
Authors: Stigter R. H. , Mulder E. J. H. , Bruinse H. W. , Visser G. H. A. 
Published: March 2003

AbstractObjectivesTo examine changes with time in the fetal renal circulation by Doppler sonography in the severely growth‐restricted preterm fetus during the period of gradual deterioration prior to delivery, and to examine the relationship between Doppler measurements, amniotic fluid index, birth weight and fetal condition at birth.MethodsThis was a prospective observational study in 16 preterm growth‐restricted fetuses between 26 and 35 weeks of gestational age. Serial Doppler measurements were made of the renal artery, umbilical artery, middle cerebral artery and ductus venosus.ResultsThe pulsatility index in the renal artery did not show any correlation with cord blood pH, birth weight or amniotic fluid index corrected for gestational age (Δ/SDAFI). However, peak systolic velocities in the renal artery showed a significant reduction with time (n = 7, P < 0.05) and a significant correlation with: venous cord pH at delivery (n = 12, r = 0.84, P < 0.001), Δ/SDAFI (n = 16, r = 0.67, P < 0.01), and birth weight (n = 16, r = 0.61, P < 0.02). Birth weight correlated significantly with: Δ/SDAFI (n = 15, r = 0.57, P < 0.05), pulsatility index values of the middle cerebral artery (n = 15, r = −0.61, P < 0.02), and pulsatility index values of the ductus venosus (n = 16, r = 0.55, P < 0.05), and Δ/SDAFI correlated significantly with: pulsatility index values of the ductus venosus (n = 15, r = 0.51, P < 0.05) and arterial cord pH values at delivery (n = 8, r = 0.78, P < 0.05).ConclusionsProgressive redistribution of the circulation occurs with deterioration of the fetal condition in the growth‐restricted preterm fetus. On spectral Doppler this is reflected by changes in peak systolic velocities, but not by changes in pulsatility values of the fetal renal artery waveforms. Copyright © 2001 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal sonographic pattern of peritoneal inclusion cysts
Authors: Savelli L. , Cacciatore B. , Pilu G. , De Iaco P. , Ceccarini M. , Rosati F. , Bovicelli A. , Bovicelli L. 
Published: March 2003

Purpose:  To assess the transvaginal sonographic pattern of peritoneal inclusion cysts, a common consequence of adhesions formation often related to pelvic surgery, endometriosis and pelvic inflammatory disease.Patients and methods:  Twenty‐two patients (mean age: 40 years; range: 22–56 years) with surgically proved peritoneal inclusion cysts, examined by transvaginal sonography with power Doppler within 7 days before surgery were retrospectively recruited. Indication to surgery was pelvic pain (55%), an adnexal mass (50%) or abdominal discomfort and increasing abdominal girt (27%). Ten patients (45%) had been previously submitted to some form of pelvic surgery, nine (41%) had ovarian endometriosis and two patients had a positive anamnesis for pelvic inflammatory disease.Results:  In 20 cases (91%), peritoneal inclusion cysts appeared as a pelvic mass close but separated from the ovary. Mean cyst diameter was 6 cm (range 3–20 cm) and the walls were irregular in 18 (82%) cases, due to invaginations of surrounding pelvic organs (bowel loops, uterus, broad ligaments …). Cystic content was anechoic in 16 (77%) and hypoechoic in 5 (23%) cases. In one case of multilocular cyst, both hypo‐ and anechoic content was seen. A mean of five septa were found inside each cyst (range 1–15): these appeared as being of <3 mm in thickness in 17 (85%) cases and >3 mm in 3 (15%), while in two cysts both thick and thin septa were present. Septa were complete in 15 patients, incomplete in one while in six cases both complete and incomplete septa were detected. Septa had a random distribution in 12 cysts with more than one septum (67%) and a spider appearance in 6 (33%) cases, departing from the ovary and reaching the opposite wall of the cyst. Echoic projections of the cystic walls were detected in 41% of the cases, usually of few millimeters in diameter.Conclusion:  Peritoneal inclusion cysts show a wide range of dimensions and morphology and can mimic malignant adnexal masses as septa and solid projections are common findings. In a woman with previous pelvic surgery or a history of ovarian endometriosis, the detection of an irregularly shaped hypo/anechoic cyst, close but separated from the ovary and attached to normal pelvic organs should suggest the peritoneal nature of the mass.
Congenital diaphragmatic hernia: evaluation of prenatal diagnosis in 20 European regions
Authors: Garne E. , Haeusler M. , Barisic I. , Gjergja R. , Stoll C. , Clementi M. 
Published: March 2003

AbstractObjectiveTo evaluate prenatal diagnosis of congenital diaphragmatic hernia by ultrasound in well‐defined European populations.DesignData from 20 registries of congenital malformations in 12 European countries were included. The prenatal ultrasound screening programs in the countries ranged from no routine screening to three ultrasound investigations per patient being routinely performed.ResultsThere were 187 cases with congenital diaphragmatic hernia, with an overall prenatal detection rate of 59% (110/187). There was considerable variation in prenatal detection rate between regions. There was a significant difference in the detection rate of isolated congenital diaphragmatic hernia (59/116, 51%) compared with congenital diaphragmatic hernia associated with multiple malformations, karyotype anomalies or syndromes (51/71, 72%) (P = 0.01). Termination of pregnancy was performed in 39 cases (21%) of which 14 cases were isolated congenital diaphragmatic hernia. Mean gestational age at discovery was 24.2 weeks (range, 11–38 weeks).ConclusionsThe overall prenatal detection rate of congenital diaphragmatic hernia is high (59%) but varies significantly between European regions. The gestational age at discovery was greater than 24 weeks in half of the prenatally diagnosed cases. Copyright © 2002 ISUOG
Sonographic diagnosis of spina bifida at 12 weeks: heading towards indirect signs
Authors: Buisson O. , De Keersmaecker B. , Senat M. V. , Bernard J. P. , Moscoso G. , Ville Y. 
Published: March 2003

AbstractRetrospective examination of ultrasound images obtained at 12 weeks of gestation in two fetuses with spina bifida demonstrated retraction of the frontal bones, resulting in an acorn‐shaped head, the cerebral peduncles appearing parallel to each other. These craniocerebral signs may improve the accuracy of first‐trimester diagnosis of spina bifida by sonography. Copyright © 2002 ISUOG
Prenatal diagnosis and perinatal management of left coronary artery to right atrium fistula
Authors: Mielke G. , Sieverding L. , Borth‐Bruns T. , Eichhorn K. , Wallwiener D. , Gembruch U. 
Published: March 2003

AbstractSerious complications due to coronary artery fistulae have been described. Most authors recommend early intervention at the time of diagnosis. We present a case of a fistula originating from a dilated left coronary artery and draining into the right atrium, which was diagnosed prenatally by color Doppler echocardiography. During pregnancy, the echocardiographic findings remained unchanged, and there were no signs of heart failure. After birth, the fistula was confirmed by angiography. Additionally, a persistent left superior vena cava draining into the coronary sinus and a very small ventricular septal defect were detected. The fistula was closed successfully by transcatheter coil embolization. At 17 months old the child was in good clinical condition. Prenatal diagnosis of coronary artery fistulae may be possible and may improve perinatal management and outcome. Copyright © 2002 ISUOG
British National Health Service's and women's costs of antenatal ultrasound screening and follow‐up tests
Authors: Henderson J. , Bricker L. , Roberts T. , Mugford M. , Garcia J. , Neilson J. 
Published: March 2003

AbstractObjectiveTo estimate resource use and costs associated with routine obstetric ultrasound and follow‐up tests from both the British National Health Service and women's perspectives.MethodsWomen attending Liverpool Women's Hospital (UK) in 1998 and 1999 were involved in the study. Bottom‐up and top‐down costings of National Health Service resources using questionnaires and diaries to record staff time associated with procedures were performed. Questionnaires were used to assess women's costs of attending for antenatal ultrasound scans.ResultsRoutine antenatal ultrasound scans at Liverpool Women's Hospital cost the National Health Service between £14 and £16 per scan. More detailed secondary scans and other follow‐up procedures cost substantially more. Costs to women, their families and their employers were estimated at between £9 and £15 per scan, depending on assumptions about the opportunity costs of time when not in paid employment and costs to employers of women who were in paid employment.ConclusionsAccurate estimates of costs to the National Health Service associated with routine antenatal ultrasound scanning are substantially lower than that cited in much of the literature. Costs to women are very similar to National Health Service costs. Economic evaluations should attempt to include costs to users of the service, particularly when the burden of cost is likely to shift.
An algorithm including results of gray‐scale and power Doppler ultrasound examination to predict endometrial malignancy in women with postmenopausal bleeding
Authors: Epstein E. , Skoog L. , Isberg P.‐E. , De Smet F. , De Moor B. , Olofsson P.‐Å. , Gudmundsson S. , Valentin L. 
Published: March 2003

AbstractObjectiveTo determine if power Doppler ultrasound examination of the endometrium can contribute to a correct diagnosis of endometrial malignancy in women with postmenopausal bleeding and endometrium ≥ 5 mm.MethodsEighty‐three women with postmenopausal bleeding and endometrium ≥ 5 mm underwent gray‐scale and power Doppler ultrasound examination using predetermined, standardized settings. Suspicion of endometrial malignancy at gray‐scale ultrasound examination (endometrial morphology) was noted, and the color content of the endometrium at power Doppler examination was estimated subjectively (endometrial color score). Computer analysis of the most vascularized area of the endometrium was done off‐line in a standardized manner. Stepwise multivariate logistic regression analysis was carried out to determine which subjective and objective ultrasound and power Doppler variables satisfied the criteria to be included in a model to calculate the probability of endometrial malignancy.ResultsEndometrial thickness, vascularity index (vascularized area/endometrial area), and use of hormone replacement therapy (HRT) satisfied the criteria to be included in the model used to calculate the ‘objective probability of endometrial malignancy’. Endometrial morphology, endometrial color score and HRT use satisfied the criteria to be included in the model to calculate the ‘subjective probability of malignancy’. Endometrial thickness ≥ 10.5 mm had a sensitivity with regard to endometrial cancer of 0.88 and a specificity of 0.61. At a fixed sensitivity of 0.88, the specificity of the ‘objective probability of malignancy’ (0.81) was superior to all other ultrasound and power Doppler variables (P = 0.001–0.02). The ‘objective probability of malignancy’ detected more malignancies at endometrium 5–15 mm than endometrial morphology (5/7 vs. 1/7, i.e. 0.71 vs. 0.14; P = 0.125) with a similar specificity (49/57 vs. 51/57, i.e. 0.86 vs. 0.89).ConclusionsPower Doppler ultrasound can contribute to a correct diagnosis of endometrial malignancy, especially if the endometrium measures 5–15 mm. The use of regression models including power Doppler results to estimate the risk of endometrial cancer deserves further development. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
The three vessels and trachea view (3VT) in fetal cardiac scanning
Authors: Yagel S. , Arbel R. , Anteby E. Y. , Raveh D. , Achiron R. 
Published: March 2003

AbstractObjectiveComprehensive evaluation of the fetal heart has become a major part of targeted organ scanning to rule out fetal malformations. Evaluation of the mediastinal major vessels seems to be the most difficult and time‐consuming part of fetal heart examination. Our aim was to define and evaluate the three vessels and trachea (3VT) view, a novel and simple method to examine the great vessels in the mediastinum, and its applicability in the clinical practice of fetal echocardiography, while establishing nomograms for cardiac vessel measurements obtained in this view.MethodsThe three vessels and trachea view was examined in 379 low‐risk gravidae between 14+0 and 23+6 weeks' gestation. Six parameters in this plane were measured to establish nomograms. In another group of 984 mixed high‐ and low‐risk patients we compared the time required to identify the aortic arch using the 3VT view as compared to the long‐axis view.ResultsThe 3VT view was readily and satisfactorily demonstrated in all but two of the 1363 cases examined. In 17 cases (out of a total of 982) more than 10 min were required to identify the aortic arch using the 3VT view and in 71 patients when employing the long‐axis view (P < 0.001).ConclusionThe clinical applicability of the 3VT view to evaluate the anatomy of the major vessels in the mediastinum is demonstrated. Although a wide variation in the six parameters of the 3VT view used here precludes their use in diagnosing great vessel anomalies, some of the ratios between them have promising potential in the evaluation of great vessel malformations. Further, the 3VT view seems to be more efficient in identifying the aortic arch than does the long‐axis view. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Regeneration as an evolutionary variable
Authors: BROCKES JEREMY P. , KUMAR ANOOP , VELLOSO CRISTIANA P. 
Published: March 2003

abstractRegeneration poses a distinctive set of problems for evolutionary biologists, but there has been little substantive progress since these issues were clearly outlined in the monograph of T. H. Morgan (1901). The champions at regeneration among vertebrates are the urodele amphibians such as the newt, and we tend to regard urodele regeneration as an exceptional attribute. The ability to regenerate large sections of the body plan is widespread in metazoan phylogeny, although it is not universal. It is striking that in phylogenetic contexts where regeneration occurs, closely related species are observed which do not possess this ability. It is a challenge to reconcile such variation between species with a conventional selective interpretation of regeneration. The critical hypothesis from phylogenetic analysis is that regeneration is a basic, primordial attribute of metazoans rather than a mechanism which has evolved independently in a variety of contexts. In order to explain its absence in closely related species, it is postulated to be lost secondarily for reasons which are not understood. Our approach to this question is to compare a differentiated newt cell with its mammalian counterpart in respect of the plasticity of differentiation.
The development and evolution of crossveins in insect wings
Authors: MARCUS JEFFREY M. 
Published: March 2003

abstractThe formation of crossveins inDrosophilawas an important early case study in understanding the role of the environment in the development and evolution of morphological structures. More recent work has shown that signalling processes play a crucial role in the formation of crossveins inDrosophilaand that the interaction of a heat shock factor, Hsp90, with components of signal transduction pathways may account for the sensitivity of these structures to environmental perturbations. A new model for the development of crossveins is presented that divides the formation of crossveins into 3 separate stages. First, the number and placement of the crossveins is determined by signalling along the proximal‐distal axis of the wing. This signal may involve the cdc42 gene product and the Jun‐N‐terminal Kinase signal transduction pathway. Then, during the second stage, an inductive signal from the dorsal wing epithelium is sent to the ventral wing epithelium at locations specified by the first signal. The second signal appears to involve theBMP‐like signalling pathway. Finally, in the third stage, a domain of vein competent cells is defined by the signalling from the EGF‐receptor‐Map Kinase signal transduction pathway, and the exact location of the veins is eventually determined within that domain by Notch‐Delta signalling interactions. By altering components of these 3 stages, insects can independently regulate the presence or absence, the number and placement, and the thickness and flexibility of the crossveins. This capacity for the modulation of crossvein structure in many different ways may have contributed to the evolution of different modes of insect flight.
The sternalis muscle in the Bulgarian population: classification of sternales
Authors: JELEV L. , GEORGIEV G. , SURCHEV L. 
Published: March 2003

The sternalis muscle (musculus sternalis) is the name usually given to this common anatomical variant, but the terms ‘episternalis’, ‘presternalis’, ‘sternalis brutorum’, ‘rectus thoracis’, ‘rectus sterni’, ‘superficial rectus abdominis’ and ‘japonicus’ have also been used in the literature (for reviews see Le Double, 1879; Calori, 1888; Pichler, 1911; Blees, 1968). According to Turner (1867), Cabrolius was the first, in 1604, to describe sternalis. Nevertheless this muscle is often unknown even in clinical practice (Bailey & Tzarnas, 1999; Vandeweyer, 1999).Thus far, investigations on the incidence of sternalis have been made both in large populations such as the American (Barlow, 1935) and small populations, for example in Taiwan (Shen et al. 1992; Jeng & Su, 1998). In Europe, all studies on the frequency of this muscle have been made amongst subpopulations in Western (e.g. Cunningham, 1888; Le Double, 1890, 1897) and Northern Europe (Gruber, 1860) although the reported frequencies have been quite different. There is a lack of information about sternalis in Eastern European populations. We therefore present data from a study on the incidence of sternalis muscle in Bulgaria.
Systematic reviews of treatment for inflammatory demyelinating neuropathy*
Authors: Hughes R. A. C. 
Published: March 2003

AbstractThis review describes the progress made in preparing Cochrane systematic reviews of randomized controlled trials for Guillain–Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN) and the demyelinating neuropathies associated with paraproteins. The discovery of antibodies against myelin and axolemmal glycolipids and proteins has not yet replaced the clinicopathological classification on which treatment trials have been based. Systematic reviews have endorsed the equivalence of plasma exchange (PE) and intravenous immunoglobulin (IVIg) and the lack of efficacy of steroids in GBS. Systematic reviews have also endorsed the value of steroids, PE and IVIg in CIDP but randomized controlled trials have only shown benefit from IVIg in MMN. There is a paucity of evidence concerning the efficacy of treatments in paraproteinaemic demyelinating neuropathy apartment from small trials showing short‐term benefit from PE or IVIg. There is a lack of good quality controlled trials of immunosuppressive agents in any of these conditions. As the number of treatment trials increases, Cochrane systematic reviews will be an increasingly valuable resource for summarizing the evidence from randomised controlled trials on which to base clinical practice. They already demonstrate major deficiencies in the existing evidence base.