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Biomedical subjects

N Exalto

Publications and source records attributed to N Exalto.

At least 37 records · Page 2Linked to original sources

Prenatal ultrasonographic diagnosis of osteogenesis imperfecta.

Between 1982 and 1986, osteogenesis imperfecta was diagnosed by ultrasound in seven fetuses. The known heterogeneity of osteogenesis imperfecta was confirmed by the prenatal ultrasonographic findings. Dependent on the type of osteogenesis imperfecta, the appearance of the limbs varied from severely shortened and broad, with very low echogeneity and absent acoustic shadow (type IIA), to only moderately shortened and thin, with almost normal echogeneity and acoustic shadow but clearly visible fractures causing angulation of the bone (types IIC and III). Ultrasonography offers the possibility to detect or exclude the lethal and severe forms of osteogenesis imperfecta early (type IIA) or halfway (types IIB, IIC, and III) through the second trimester. Prenatal diagnosis of the disease allows the option of elective abortion or may prevent unnecessary obstetric intervention.

Adult↗

Early pregnancy wastage: relationship between chorionic vascularization and embryonic development.

The chorionic villous vascularization of 40 patients with first trimester spontaneous abortion was compared with that of 10 patients undergoing legal abortion (control group). The spontaneous abortion group was subdivided into a group with intrauterine embryonic death (n = 20) and a group with blighted ova (n = 20). Villous vascularization appeared unaffected after prolonged postmortem intrauterine retention. The incidence of vascularized villi was 89% in the control group, 26% in the group with embryonic death, and 9% in the group with blighted ova. In addition, the vascular density of vascularized villi was three to four times higher in the control group than in the two spontaneous abortion groups. The present study provides evidence that, in case of embryonic death and blighted ova, chorionic villous vascularization is deficient.

Abortion, Spontaneous↗

Sonographic investigation of the uterus during artificial uterine cavity distention.

The improvement of sonographic examination of the uterus during artificial uterine cavity distention was studied in 30 consecutive patients in whom a hysteroscopy was indicated. In 10 of 21 patients with a normal sonographic appearence of the uterus, after filling the uterine cavity with Hyskon, various pathologic conditions became visible. In 5 of 9 patients with abnormal sonographic appearance of the uterus, the procedure enabled a more precise diagnosis concerning localization of abnormal echoes in the uterus. The advantage of this method was clearly demonstrated in cases of central echogenic structures, congenital uterine anomalies, myoma's, synechiae, and corpora aliena.

Dextrans↗

An anatomic basis for ultrasound images of the human placenta.

Placentas after uneventful pregnancies were perfused under physiologic pressure in the fetal vessels, expanded to their predelivery volume, fixated with 4% formaldehyde, and compared to their ultrasound images in pregnancy. The placentas showed a side arrangement of the fetal cotyledons in contact with the basal plate. The centers of the cotyledons showed an empty space in which the spiral arteries ended. These spaces in the placenta corresponded with transsonic areas of ultrasound. The central spaces were surrounded by a relatively dense shell of villi containing the more or less fibrotic stem villi. This explained the areas of increased echo-density, as seen by ultrasound during the last trimester of pregnancy. The fetal cotyledons, composed of a central cavity and a dense villous shell, were separated by a reticular area. The veins ended at the basal plate in these intercotyledonary areas.

Adult↗

Intrauterine devices: results of a separate clinical and ultrasound follow-up study.

A separate clinical and ultrasound study was carried out in 20 unselected patients receiving an IUD (ML Cu 250 or Cu T-200). Clinical adverse effects were studied in relation to ultrasound findings after 0, 2 and 6 months of insertion. Using both the sound length and initial ultrasound measurements, it was possible to calculate that none of the 20 IUDs reached the fundal wall of the uterine cavity (distance 0.1-2.4 cm). The mean initial distance between the top of the uterine fundal wall and the top of the IUD (TOP) was 2.0 cm (range 1.3-2.4 cm). A downward displacement of more than 0.5 cm in consecutive measurements was observed in 3 patients. Malposition of one or two arms of the IUD was found in 8 patients. In 6 of these patients clinical complaints were present.

Adult↗

Twin pregnancy: case reports illustrating variations in transfusion syndrome.

The twin transfusion syndrome is diagnosed in 5.5% to 14.6% of monochorionic twins and the classical picture reveals a small anemic donor and a large plethoric recipient. Many other clinical discrepancies have been described. Today, by ultrasound it is possible to diagnose the syndrome in (early) pregnancy. In these case reports different clinical pictures and the importance of ultrasound are described. In twin pregnancies repeated ultrasound examinations should be considered with the consequences of vascular anastomoses.

Adult↗

[Chyloperitoneum in newborn infants].

The authors describe a newborn, in which a diagnosis of ascites was made before birth by ultrasound. Ascites without other signs of hydrops may be caused by meconium-peritonitis, perforation of the bile ducts, disorders of the portal or systemic circulation, flow disturbances in the lymphatic vessels, urinary obstruction or a ruptured ovarian cyst. In this case there was a chylous ascites in a child with Down's syndrome. Diagnosis, pathogenesis and treatment are discussed. With conservative treatment the child was free of symptoms at the age of 6 months.

Chylous Ascites↗

Clinical significance of 45XX, t(13q14Q) Robertsonian translocation: unexpected triploidy in third abortion of female carrier.

A case report is described of a female t(13q14q) Robertsonian translocation carrier. Her firstborn daughter appeared to be a carrier of the same translocation. Chromosomal investigation of the third of three subsequent spontaneous abortions revealed a triploidy (69XXX). Literature shows discrepancies in the reported abortion rate in the reproductive performance of t(13q14q) carriers. It is concluded that these could in part be explained by heterogenicity of the study groups due to variable presence of other factors known to influence the abortion risk. In our case report treatment for epilepsy, a luteal phase defect and high numbers of spermatozoa in the sperm count of the husband must be considered as contributory factors. It is recommended to perform systematic investigations in all cases of recurrent abortion even when a chromosomal anomaly is found in one of the partners.

Abortion, Habitual↗

Ultrasonographic measurement of the yolk sac.

Ultrasonographic measurements of the yolk sac were made during first trimester in 100 pregnancies. The results were related to the crown-rump length of the embryos and showed an increase in size from 7 to 11 weeks menstrual age. A possible relation between anomalies in yolk sac development and embryonic development was studied in six patients by means of serial weekly ultrasonographic examinations. In one case with absence of the yolk sac embryonic death occurred at 10 weeks menstrual age; the embryo had spina bifida.

Anthropometry↗

Ovarian pregnancy: a morphologic description.

This case report presents a "true" ovarian pregnancy in a women using a Dalkon shield. The gestational sac was implanted in the ovary close to the corpus luteum and contained a normally developed embryo of Carnegie Stage 11. A morphologic description of the embryo is given. The importance of a morphologic description of the conceptus in cases of ovarian pregnancy is discussed.

Adult↗

Rectus hematoma: a clinical diagnosis confirmed by ultrasound.

In 2 women the diagnosis of rectus hematoma could be established by ultrasound and the further clinical course. Echoscopy is stressed as a technique which is helpful to the patient and the clinician in avoiding unnecessary operations.

Abdominal Muscles↗

Intrauterine detection of fetal phonocardiosignals.

In this paper the application of an open-tip phonocatheter for the detection of fetal phonocardiosignals during parturition is described. The phonocatheter is easily inserted with a conventional polythene guide via the cervical route. The fetal heart sounds are detected by the sound pick-up element located in the catheter tip. Intrauterine pressure is measured simultaneously with the help of a Statham uterine pressure transducer externally connected via the lumen to the open tip of the phonocatheter. Since fetal heart sounds can also be detected before rupture of the membranes, it is possible to measure intrauterine pressure and fetal heart activity simultaneously using only one catheter and without being limited to a particular stage in parturition.

Female↗