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Biomedical subjects

D Jurković

Publications and source records attributed to D Jurković.

8 recordsLinked to original sources
PubMed1990

The assessment of abnormal pelvic blood flow by transvaginal color and pulsed Doppler.

Transvaginal color Doppler was used to analyze a group of 19 healthy, 48 infertile and 8 postmenopausal women; 67 patients with uterine and 151 patients with adnexal masses, and 19 patients with a suspected ectopic pregnancy. The ultrasonographer had not been informed of other clinical findings and indications for operative treatment. A 5 MHz transvaginal color Doppler probe was used to visualize the pelvic anatomy and blood flow. Each arterial blood flow velocity was classified into either of two types. In the normal flow pattern, the diastolic flow component was absent or small and the value of resistance index (RI) was greater than 0.50. In the abnormal flow pattern, a large diastolic flow component was evident and the value of RI was less than 0.50. Transvaginal color and pulsed Doppler studies in confirmed malignant uterine masses had moderate accuracy (90.2%), with a sensitivity (55.6%) and specificity (100%); and in confirmed malignant adnexal masses high accuracy (100%), sensitivity (100%) and specificity (100%). Comparison of blood flow characteristics within benign and malignant tumor tissue revealed less impedance and higher velocity in cases of malignancy. Blood flow studies in both uterine arterias have not shown clinically important values. This method can be also used in the diagnosis of ectopic pregnancy.

Blood Flow Velocity↗
PubMed1990

Is there an association between fetal viral infection and fetal malformation? I. Detection of specific IgM antibodies in the serum of malformed fetuses.

Determinations of IgG and IgM antibodies specific for cytomegalovirus (CMV), herpes simplex virus (HSV1), herpes simplex virus (HSV2), varicella-zoster virus (VZV), rubella, echo, Coxsackie and morbilli viruses were performed in 20 sera from malformed fetuses. Demonstration of a fetal infection by increased fetal serum IgM permits linkage to a detected fetal malformation. In parallel, 14 maternal sera and 17 amniotic fluid samples were examined. Laser nephelometry (a quantitative method) was used for the determination of IgM and IgG class immunoglobulins. None of the fetal sera were found to contain IgM class antibodies specific for the viral antigens studies. While IgM CMV-specific antibodies were present in one maternal serum, the specific IgM was absent in the fetus. The absence of specific IgM antibodies appears to warrant the conclusion that the malformed fetuses were uninfected by any of the above viruses. IgM antibodies were detected in two fetal sera by quantitative methods. The IgM antibodies present in two fetuses probably were generated in response to some other introduced antigen.

Antibodies, Viral↗
PubMed1989

Ultrasound diagnosis and evaluation of fetal tumors.

Fetal tumors represent a rare and heterogeneous group of abnormalities. A significant proportion of them can now be diagnosed by using modern high resolution ultrasonic equipment. During 15 years there were 57 fetal tumours detected prenatally. Hygroma colli is the most frequent fetal tumor. It should be emphasized that cystic hygroma generally carries poor prognosis, and after an early diagnosis, termination of pregnancy is most logical approach. Contrary to the general opinion our own experience showed that there are cases in which prognosis could be much better as illustrated with our 4 cases. All of the treated fetuses, after surgical resection, had normal development and are now on the age of 5, 4, 3 and 2 years of life. An ovarian cyst can be suspected if a fluid-filled structure is visualized next to a fetal kidney and female external genitalia are recognizable. The ultrasound finding suggestive of an ovarian cyst is that of a pelvic cystic or complex mass in a female fetus with normal kidneys and urinary bladder and a normal gastrointestinal tract. In most cases, the normal course of fetal ovarian cyst is a spontaneous intrauterine or postnatal involution. Prenatal diagnosis improves neonatal outcome by allowing an appropriate choice of the optimal time, mode and place of delivery in order to avoid accidental and unexpected intrapartum and postnatal complications. The management of a fetus affected by an ovarian cyst depends on the size and on the echo-pattern of the cyst. It remains unclear whether in utero puncture of the cyst and evacuation of its content should be justified in cases of particularly large ovarian cyst. In our opinion intrauterine procedure can be attempted in the presence of large cyst fulfilling the fetal abdomen. We have treated actively two cases of large ovarian cysts by ultrasonically guided puncture before delivery and both fetuses underwent surgery later without complications. If properly performed puncture of the cyst seems to be a low risk procedure in comparison to potential problems that cyst may cause to the fetus or by causing dystocia. Sacrococcygeal teratoma represents the most frequent tumor in the fetuses and newborns. Prenatal diagnosis is usually simple and based on the visualization of tumor of variable size and internal structure. Tumors may appear as completely cystic, mixed or predominantly solid with obvious calcifications. Cystic and calcified tumors are most likely to be benign. Obstetrical management of sacrococcygeal teratoma depends on numerous parameters which include size and texture of the tumor, and gestational age.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1989

Transvaginal color Doppler for the assessment of pelvic circulation.

Transvaginal color Doppler was used to analyse a group of 56 patients including 41 with proven pelvic masses and 15 infertility patients with normal pelvic anatomy. All patients were examined by ultrasound before laparoscopy or/and laparotomy. The ultrasonographer had not been informed of other clinical findings and indications for operative treatment. Comparison of blood flow characteristics within uterine fibromas and ovarian malignancies revealed less impedance and higher blood velocity in cases of malignancy. When predicting the malignant nature of pelvic tumors, no false-negative results were encountered, and only one false positive diagnosis of malignancy.

Color↗
PubMed1989

[Prenatal diagnosis of hereditary epidermolysis bullosa using ultrasonically guided biopsy of the fetal skin].

Ultrasonically guided fetal skin biopsy was performed in 5 patients who were at risk having a baby affected by epidermolysis bullosa hereditaria. Samples of the fetal skin were taken by means of Tru-cut biopsy needle that was introduced transabdominally into the amniotic cavity under continuous ultrasound control. Samples of the skin were obtained in all cases and were adequate for histopathological analysis. There were no significant clinical complications that may be related to the procedure. Prenatal diagnosis of the disease was made in 2 cases. In both cases pregnancies were interrupted. In 3 cases with normal histologic findings pregnancies resulted in term deliveries of normal babies. The authors suggest that fetal skin biopsy can be successfully performed under sonographic guidance. This diagnostic procedure may be considered the method of choice for prenatal diagnosis of hereditary skin disease.

Biopsy, Needle↗
PubMed1987

Color flow mapping in obstetrics.

Blood flow studies are now used extensively in evaluating fetal peripheral circulation. By using continuous and pulsed Doppler ultrasonic equipment the raw Doppler shifts caused by blood moving in the vessels can be analyzed in different ways. Spectral data can be used to estimate blood velocity and volume in the vessel, and pulsatility characteristics and turbulence. All these data are obtained from very restricted areas within the body so that aiming of the probe is critical, and obtaining data from an area requires long and tedious effort. Color flow mapping which has recently been introduced into clinical practice provides an overview of flow velocities and directions within an area. Color coded flow can be displayed by applying the moving target identification principle (as in radar) to an ultrasonic diagnostic instrument where sound waves are used instead of radio waves. The value of flow mapping has already been recognized in the diagnosis of congenital and acquired heart disease in adults and children. Direct visualization of intracardiac flow provides for a fast and accurate diagnosis of various cardiac defects, such as the ventricular septal defect, without cardiac catheterization. In the present study we have investigated the potential of color flow mapping in obstetrics. 211 pregnant women were examined between the 15th and 40th weeks of pregnancy. 193 of them had normal pregnancies; 18 were abnormal, including 11 cases of insulin dependent diabetes, 2 cases of Rh-immunization, 2 cases of nonimmunologic fetal hydrops, 2 cases of fetal cardiac structural defects and 1 case of intrauterine growth retardation. Intracardiac flow was clearly seen in 78% (35/45) of cases at the gestational age between the 20th and 24th weeks. After the 24th week the heart flow visualization rate gradually decreased to 31% (11/36) before term. In 2 cases of congenital heart abnormality flow mapping enabled clear visualization of reverse flow through the tricuspid valve and diagnosis of valvular insufficiency. The best results in studies of flow in peripheral vessels were obtained from umbilical vessels which were seen in all cases after the 15th week. The flow visualization rate was much lower when the fetal aorta, intrahepatic umbilical vein and internal carotid artery were studied. The comparison between the diameter of the umbilical vein measured on the B-scan and flow width in the same vessel showed no significant difference (t = 0.26; p less than 0.01; N = 209).(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Flow Velocity↗
PubMedDate not supplied

[Ovulation induction using clomiphene and human gonadotropins in combined therapy].

Stimulation of ovulation combined with the clomiphene therapy and human gonadotropins is presented. Follicular maturation was followed by changes of the cervical score and ultrasonic folliculometry from the tenth day of the stimulating cycle. Ovulation was proved by the change of quality of the cervical mucus, the increase of the BBT, the increase of the progesterone concentration in serum, then by ultrasonically proved changes inside the follicle and in endometry, and finally by pregnancy. With the combined therapy the authors stimulated ovulation in a group of 14 females, altogether 21 cycles. In all the patients, before the application of the combined therapy, induction of ovulation with clomiphane alone through at least 6 cycles proved unsuccessful. Ovulation was proved in the 20 cycles of the combined stimulation. Altogether 11 pregnancies of all induced cycles were obtained: 6 pregnancies with term delivery, 2 extrauterine pregnancies, 1 spontaneous abortion in the 24th week, 1 missed abortion, and 1 blighted ovum. Two twin pregnancies were recorded. In one patient the syndrome of hyperstimulation of the first degree occurred, while in the others there were no complications at all.

Adult↗