bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of postoperative pyoderma gangrenosum with cyclosporin
Authors: Schöfer H , Baur S 
Published: March 2003

AbstractPostoperative pyoderma gangrenosum (PPG), also known as postoperative progressive gangrene of Cullen, is a rare and rapidly evolving complication of surgical procedures. Since the first description by Cullen in 1924 (Surg Gynecol Obstet 1924; 38: 579–582) various case reports have been published. Even in typical cases PPG is often misdiagnosed and therefore wrongly treated; the unknown aetiology makes treatment difficult. The therapies used for pyoderma gangrenosum include systemic corticosteroids, azathioprine, dapsone, mercaptopurine, sulphasalazine, sulphapyridine, thalidomide, cyclophosphamide, clofazimine, isotretinoin, immunoglobulins and cyclosporin. We report on two patients with PPG following breast surgery who were successfully treated with low‐dose cyclosporin (2.5–5 mg/kg per day).
Malignant eccrine poroma in an unusual location1
Authors: Sahin Mt , Türel A , Gündüz K , Kandiloglu Ar , Öztürkcan S 
Published: March 2003

ABSTRACTMalignant eccrine poroma is a rare skin appendage tumour, originating from the intraepidermal and upper dermal eccrine ducts. The tumour either arises spontaneously or develops in a long‐standing eccrine poroma, generally in elderly people over 60. Clinically, it tends to be a localized lesion, which manifests itself as a nodule or ulcerated tumour, favouring extremities. We report an 83‐year‐old female with an enlarging and bleeding tumour on her lumbosacral region. This lesion first appeared as a small pigmented papule and progressed to an erythematous patch with central papular portion and some peripheral pigmentation. Histopathology revealed malignant eccrine poroma. Also, immunohistochemically, diffuse and intense p53 staining was observed. Regular pigment pattern, brown globules and black dots were seen in dermoscopic examination. After performing a wide excision, 20 months of follow‐up revealed no recurrence or metastasis of the tumour. This case represents an unusually located malignant eccrine poroma with some pigmentation.
Cutaneous infection due to Scedosporium apiospermum in an immunosuppressed patient
Authors: Chaveiro MA , Vieira R , Cardoso J , Afonso A 
Published: March 2003

ABSTRACT Scedosporium apiospermum, the anamorphic form of Pseudallescheria boydii, is a filamentous fungus with low inherent virulence. Increasing numbers of cases of this infection have been reported probably related to the rising number of immunosuppressed persons. Apart from mycetoma, cutaneous and subcutaneous infection is rarely encountered in clinical practice.We describe a case of cutaneous infection caused by Scedosporium apiospermum in a subject with rheumatoid arthritis and diabetes mellitus who was submitted to long‐term therapy with cyclosporin and corticosteroids. Histopathologic examination of a skin biopsy showed a granulomatous infiltrate with hyaline septate hyphae. Culture of two skin biopsies taken at two different observations of the woman, 3 weeks apart, allowed isolation of Scedosporium apiospermum. Therapy with itraconazole, 400 mg/day, for 3 months was effective in curing the infection.
Quality of Life Outcomes for People with Intellectual Disabilities Living in Staffed Community Housing Services: a Stratified Random Sample of Statutory, Voluntary and Private Agency Provision
Authors: Perry Jonathan , Felce David 
Published: March 2003

Background  Small scale, community‐based, staffed housing is a significant form of residential provision for people with intellectual disabilities. Such services are provided by health and local authorities, and voluntary and private agencies, yet little is known about how provision varies between provider sectors.Methods  This study compared sectors in terms of the processes operating within residential services, and objectively and subjectively assessed quality of life (QOL) resident outcomes. Measures of setting structure and processes and resident outcomes were undertaken on a stratified random sample of 47 small scale, community‐based residential settings which accommodated a total of 154 people with intellectual disabilities.Results  In general, provider agencies did not differ in terms of the characteristics of the residents they served, the structure of settings, the processes underlying service operation or resident outcomes. However, across agencies there was considerable variation in residents' life conditions when they were measured objectively. Better outcome tended to be significantly correlated with the ability of residents. This was not the case with results on subjective measures (which were also higher than those on objective measures).Conclusions  The results reinforce the need to design services which effectively support people across the ability spectrum. Also, an argument is made for the continued utility of objective measurement in the assessment of service quality.
Patterns of Ageing in 30–35‐Year‐Olds with Down's Syndrome
Authors: Carr Janet 
Published: March 2003

Background  A population sample with Down's syndrome has been studied repeatedly since infancy, and has now been followed up again at age 35 years.Methods  Intelligence, language, reading and arithmetic were tested and daily living skills were assessed. Two memory tests, the Rivermead Behaviour Memory Test and Oliver and Crayton's Dementia Battery were given at age 30 years and again at age 35 years.Results  Results from all the tests used showed little change from those found at 21 and/or 30 years. Small, statistically insignificant, increases in mean scores were found in reading and on the British Picture Vocabulary Scale. Means of all other measures had declined, also by small and statistically insignificant amounts. Apart from one individual, who showed dramatic declines in all areas, the rest of the cohort has continued to be stable.Conclusions  These results may be characteristic of healthy adults with Down's syndrome in the fourth decade of life.
Endovaginal ultrasound scanning to identify bladder tumors as the source of vaginal bleeding in postmenopausal women
Authors: Granberg S. , Wikland M. , Norstrdm A. 
Published: March 2003

AbstractThe increasing frequency of bladder tumors with increasing age is well documented, but the incidence of bladder tumors in a subgroup at potential risk, i.e. women with postmenopausal bleeding, is, however, not known.In a prospective study of 400 women with postmenopausal bleeding, endovaginal scanning (EVS) was performed the day before planned dilatation and curettage (D & C). Five bladder tumors were identified. For comparison, the medical records of 4500 women admitted for D & C due to postmenopausal bleeding, during a 15‐year period, were reviewed. These women were not examined by ultrasound preoperatively. Eight bladder tumors were found in these women.The number of bladder tumors found in women with postmenopausal bleeding was high, especially in the group of women that underwent endovaginal ultrasound, compared to the known incidence (25/100 000 women) in this age group. On the basis of the present data, it appears evident that EVS contributes to an early detection of bladder tumors. We emphasize the importance of scanning all women with postmenopausal bleeding with endovaginal ultrasound. Copyright © 1991 International Society of Ultrasound in Obstetrics and Gynecology
First‐trimester diagnosis of cystic hygromata by transvaginal sonography
Authors: Podobnik M. , Singer Z. , Podobnik‐Sarkanji S. , Bulic M. 
Published: March 2003

AbstractThis paper reports two cases of fetal nuchal cystic hygromata diagnosed in the first trimester of pregnancy by transvaginal sonography. In the first case, at 10 weeks' gestation, in addition to the hygromata, the fetus had an exomphalos. In the second case, at 13 weeks' gestation, the fetus had hydrocephalus and pleural effusion. Transabdominal chorion villus sampling was carried out and the fetal karyotypes were trisomy 18 and trisomy 21, respectively. Copyright © 1992 International Society of Ultrasound in Obstetrics and Gynecology
Echo patterns of benign cystic teratomas by transvaginal ultrasound
Authors: Cohen L. , Sabbagha R. 
Published: March 2003

AbstractThe transvaginal ultrasound echo patterns of 39 surgically proven cystic teratomas were retrospectively reviewed. Six different ultrasound echo patterns could be differentiated, ranging from purely cystic to densely echogenic. Importantly, in 82% of the tumors, areas of dense echogenicity were noted. Although the transvaginal appearance of cystic teratomas may allow correct preoperative prediction, the variable nature of the echo patterns makes dtfferentiation from malignant tumors difficult. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Laser surgery under sonographic control: preliminary experimental investigations
Authors: Feichtinger W. , Strohmer H. , Feldner‐Busztin M. 
Published: March 2003

AbstractThe laser has gained increasing importance during recent years as a useful addition to the physician's therapeutic armoury. Reports on successful prostatectomy by ultrasound‐guided laser coagulation in an animal model encouraged us to evaluate the possibility of using this technique for gynecological indications (for example, ectopic pregnancy, endometriosis, ovarian cysts, and other areas of medicine). We used two different laser systems. The devices consisted of a real‐time abdominal scanner (4–5 MHz) or a transvaginal sector scanner (5–7.5 MHz) coupled to a neodymium : YAG laser with a 1064 nm wavelength or a holmium : YAG laser with 2120 nm wavelength. An experimental set‐up using a water bath revealed clear visibility of the fiber tip and the laser irradiation in real‐time ultrasound at 7.5 MHz. Subsequently, a needle (routinely used in transvaginal puncture of ectopic pregnancy) was placed in animal and human tissue specimens and the laser fiber was inserted. The tissue was exposed to both laser systems at different energy densities, pulse rates and pulse widths. The sonographic appearance was recorded and correlated with the macroscopic findings. Results indicate that the holmium : YAG laser at a pulse rate of 5 Hz and a power of 2 watts is effective in removing substantial amounts of tissue. Moreover, it offers immediate visualization and control of the damaged area by producing a strongly echogenic focus. The neodymium : YAG laser showed comparatively poorer sonographic visibility and a precarious thermal mode of action, which are important considerations influencing its applicability. The holmium : YAG laser system with its non‐thermal mode of action seems promising for the further clinical application of ultrasound‐guided laser surgery. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Aggressive direct treatment of a fetus with supraventricular tachycardia and hydrops fetalis
Authors: Jouppila P. , Mäkäräinen L. , Räsänen J. , Valkama M. , Paavilainen T. 
Published: March 2003

AbstractWe report a case, in which direct fetal therapy by amiodarone injected into the umbilical vein during the last trimester of pregnancy was used for the treatment of fetal supraventricular tachyarrhythmia in the presence of severe hydrops fetalis. Eight injections were needed due to the recurrence of supraventricular tachycardia 1–9 days after the initial normalization of fetal tachycardia after each puncture. A severe fetal hydrops was maintained despite the achievement of sinus rhythm, and thus two ascites draining procedures were performed during the last 3 days before delivery to expand the fetal lungs. A normorhythmic hydropic baby was born by Cesarean section at 34 weeks + 6 days. Only mild respiratory difficulties occurred after birth. Her electrocardiogram suggests a Wolff–Parkinson–White syndrome but the overall recovery has been uneventful. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Fetal eye movements
Authors: Horimoto N. , Hepper P. G. , Shahidullah S. , Koyanagi T. 
Published: March 2003

AbstractSince 1981, when eye movements of the human fetus were first reported, the study of fetal eye movements has increased, mainly focusing on the ontogenesis of eye movements and as one parameter of behavioral states. Using real‐time ultrasound, fetal eye movements can be clearly observed from 14 weeks of gestational age. Fetal eye movements may be described in terms of their pattern, frequency and incidence of periods containing eye movements and no eye movements. Furthermore, the relationship of eye movements to other behaviors may be used to give information on the integration of central nervous system function. A picture of normal fetal eye movements can be constructed and used to detect abnormalities in eye movements which can indicate underlying abnormalities of the central nervous system. This paper concludes that, although in its early stages, the study of fetal eye movements holds promise for a greater understanding of brain development and the assessment of the condition of the fetus. Copyright © 1993 International Society of Ultrasound in Obstetrics and Gynecology
Intraventricular fused fornices: a specific sign of fetal lobar holoprosencephaly
Authors: Pilu G. , Ambrosetto P. , Sandri F. , Tani G. , Perolo A. , Grisolia G. , Ancora G. 
Published: March 2003

AbstractLobar holoprosencephaly can be recognized in utero with sonography. However, a specific diagnosis is difficult and thus far has relied upon a qualitative evaluation of the morphology of the cerebral ventricles. In infants with this condition, magnetic resonance imaging demonstrates at times an abnormal appearance of the fornices, which are rudimentary and fused in to a single fascicle running within the third ventricle. In a 30‐weeks' fetus affected by lobar holoprosencephaly, this finding could be well demonstrated by sonography and was confirmed after birth by both transfontanellar ultrasound and magnetic resonance imaging. It is proposed that the antenatal demonstration of an echogenic linear structure running within the third ventricle is a specific sign of lobar holoprosencephaly, and can assist this difficult diagnosis. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Fetal arachnoid cyst: report of two cases
Authors: Langer B. , Haddad J. , Favre R. , Frigue V. , Schlaeder G. 
Published: March 2003

AbstractTwo new cases of antenatal diagnosis of arachnoid cyst are described. Diagnosis was made at 2.5 and 32 weeks' gestational age. In the first case, a slight increase in the diameter of the anechoic mass was observed in the second trimester. In the second case, ventricular dilatation was present prenatally. Appropriate surgical therapy was initiated at 2 months in the first case and at 8 days in the second and the neurological development of the two children is considered as normal at 18 months of age. Major features of in utero diagnosis, treatment and follow‐up are discussed. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Parents' needs after ultrasound diagnosis of a fetal malformation: an empirical deficit analysis
Authors: Schuth W. , Karck U. , Wilhelm C. , Reisch S. 
Published: March 2003

AbstractWe studied 56 pregnant women and 24 partners after ultrasound examination in the 18–24th gestational week revealed a fetal malformation. The subjects were followed through the process of examination, information sharing and counselling about the option of terminating the pregnancy. Regardless of sociodemographic variables or attitude towards the pregnancy, the diagnosis was always traumatic. A detailed critique of the physician's behavior and function emphasized his important role in the process of coming to terms with the malformation and gave clear indications of the positive expectations parents had. The affected patients expected the role of the professionally competent expert to be combined with that of the empathetic approachable counsellor, whose step‐by‐step explanation would allow them to decide for themselves whether to terminate the pregnancy. The partner's participation was an essential aid to adjustment. It remains to be seen to what extent the functions of the doctor and the patient's expectations of the doctor are realistic and justified. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
The value of color Doppler ultrasound in the prenatal diagnosis of hypoplastic umbilical artery
Authors: Sepulveda W. , Flack N. J. , Bower S. , Fisk N. M. 
Published: March 2003

AbstractThe prenatal diagnosis of hypoplastic umbilical artery has recently been reported, based on the visualization of discordant size between both umbilical arteries in association with discordant umbilical artery flow velocity waveforms. In this report we present two cases of hypoplastic umbilical artery and describe the use of color flow imaging and Doppler ultrasound in the prenatal evaluation of this condition. The principal advantages of these techniques include the confirmation of blood flow within the hypoplastic artery, thus ruling out the possibility of an atrophic non‐functional artery, and the demonstration of size discrepancy at the level of the intra‐abdominal portion of the umbilical arteries, validating the intra‐amniotic cord findings. Color Doppler ultrasound is an important tool for diagnosing and evaluating vascular anomalies affecting the umbilical cord. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Postmenopausal intrauterine fluid collection: correlation between ultrasound and hysteroscopy
Authors: Pardo J. , Kaplan B. , Nitke S. , Ovadia J. , Segal J. , Neri A. 
Published: March 2003

AbstractPostmenopausal intrauterine fluid is an alarming sign related to malignancy. Twenty postmenopausal women with intrauterine fluid were prospectively studied by means of sonographic evaluation, and hysteroscopic and histological examinations, to determine the correlation between ultrasound and hysteroscopy. All patients underwent endovaginal sonography, followed by hysteroscopy. Biopsies were performed on all patients with abnormal endometrium, and randomly on selected patients with normal or atrophic endometrium. In patients with abnormal endometrial structure and thickness (< 4 mm), two cases of endometrial cancer were histologically detected and one was revealed by cytology (Pup smear). Seventeen patients with thin endometrium (≤ 4 mm) had no pathology. Sonographic, hysteroscopic and histological findings correlated well in all cases. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Hysterosalpingo contrast sonography (HyCoSy) and its future role within the investigation of infertility in Europe
Authors: Campbell S. , Bourne T. H. , Tan S. L. , Collins W. P. 
Published: March 2003

AbstractAn important part of any protocol for investigation of the infertile couple is the assessment of Fallopian tube patency in the woman, as this can influence the future course of treatment. X‐ray hysterosalpingography and laparoscopy and dye tubation are currently the main procedures for investigating tubal patency, but the recent development of hysterosalpingo contrast sonography (HyCoSy) may offer some benefits over these two methods. HyCoSy involves a transvaginal ultrasound investigation of the Fallopian tubes both before and after the injection of an echo‐enhancing agent into the tubes via the uterine cavity. Evidence of tubal flow with B‐mode scanning is indicative of tubal patency. Clinical data using the echo‐enhancing agent, Echovist®, in over 600 patients, in addition to technical aspects of the HyCoSy procedures are reviewed. The data presented indicate that the sensitivity and specificity of HyCoSy compare favorably with the current ‘gold standard’ techniques. HyCoSy is a safe, well‐tolerated and relatively inexpensive procedure, which can be carried out in a short time during an outpatient consultation. Combining these undoubted benefits with the clinical results obtained to date would indicate that HyCoSy has the potential to be employed as a reliable and well‐accepted procedure for assessing tubal patency as part of the investigation of infertility. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
The use of transvaginal ultrasonography compared to routine gynecological examination to check the location of an intrauterine contraceptive device
Authors: Granberg S. , Bundsen P. , Bourne T. H. , Almén M. , Grenthe M. , Leandersson R. , Tönnberg C. 
Published: March 2003

The objective of this study was to evaluate the use of transvaginal ultrasonography compared with a routine gynecological examination to check the location of an intrauterine contraceptive device (IUCD). Fifty‐two women attending the antenatal cure unit at Lundby hospital for contraceptive guidance were included in the study. All women had an IUCD inserted at this visit and were examined bimanually and by speculum. The same examination was repeated and a transvaginal ultrasound scan was curried out at 1 week and then 3 months later.In 51 women, the threads of the device could be identified at the time of the gynecological examination and the IUCD was considered to be correctly positioned. In one woman, the threads could not be seen, but transvaginal ultrasonography confirmed that the position of the device was at the fundus of the uterus. Forty‐eight women were judged by ultrasound examination to have the device optimally placed in the uterine cavity. In four women, although the IUCD was apparently correctly located according to the gynecological examination, the device was shown by ultrasonography to be misplaced.We suggest that transvaginal ultrasonography should replace the conventional gynecological examination as the best method of checking the locution of an IUCD.
Correlations in umbilical blood flow Doppler velocities in the human fetus during breathing
Authors: Indik J. H. , Reed K. L. 
Published: March 2003

AbstractWe hypothesized that changes in intrathoracic pressure during fetal breathing episodes result in quantifiable variations in umbilical arterial and venous blood flow velocities, and that these variations are related to compliance properties of each system. We further hypothesized that these variations in velocities are different in fetuses with normal and abnormal umbilical arterial Doppler velocities. Umbilical arterial and venous Doppler velocities were measured simultaneously during breathing episodes in 15 normal fetuses and 14 fetuses with elevated systolic‐to‐diastolic (S/D) umbilical arterial Doppler velocity ratios. Umbilical arterial end‐diastolic velocity changes were less than umbilical venous velocity changes in normal fetuses, but were significantly greater in four fetuses with elevated S/D ratios (p < 0.004). Furthermore, umbilical arterial diastolic velocity minima preceded umbilical venous velocity minima by a time lag that was greater in fetuses with elevated S/D ratios (p < 0.002). These results suggest that differences in umbilical arterial and venous velocity variation during fetal breathing episodes may be related in part to vascular compliance, which may be altered in fetuses with abnormal umbilical arterial Doppler velocity. Copyright © 1994 International Society of Ultrasound in Obstetrics and Gynecology
Fetal yawning
Authors: Sepulveda W. , Mangiamarchi M. 
Published: March 2003

AbstractIncidental fetal yawning movements can rarely be observed during real‐time ultrasonographic examination. In this report we document repetitive fetal yawning movements in a 27‐week fetus over a 7‐min period. Each episode lasted for 4–6 s, and the intervals between them varied from 21 to 195 s. This case demonstrated that fetal yawning, a complex involuntary behavioral reflex, is present in its full extent during the second half of pregnancy. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology