Spontaneous pregnancy rate after saline infusion sonogram treat done under high pressure

Background: Failure to achieve conception after 12 months of regular unprotected intercourse is defined as infertility. The aim of this study was evaluating SIS done under high pressure (SIStreat) as a treatment procedure, for relieving simple tubal obstruction and on cumulative pregnancy rate in infertile women.Methods: A prospective, interventional trial was done (October 2017 - November 2018) on 106 eligible women. All patients performed SIS. Patient with tubes patent under low pressure were assigned as control group, the rest of them were subjected to SIStreat, this group was farther divided into Group 2-a (patent under high pressure) and Group 2-b (occluded under high pressure). All patients had regular intercourse for 6 months. Pregnancy was confirmed by serum B-HCG.Results: we compared patients who performed conventional SIS (n = 100 cases) to patients who performed SIStreat afterwards (n = 84) according to the number of patent tubes. There was a high statistically significant difference in favor of SIStreat group (p < 0.001). Also, there was no significant difference in pregnancy rate between control group 62.5% and Group 2-a 45.7% (p = 0.226).Conclusions: SIStreat is a whole new procedure for opening fallopian tubes (diagnosed occluded by SIS). Patients who were successfully treated by SIStreat had cumulative pregnancy rate comparable to patients who were diagnosed to have patent tubes using conventional SIS.

Detection of Upper Abdominal Diseases by Sonogram & Prevalence in the Community (Study of One Thousand Cases)

1000 cases of positive upper abdominal diseases areevaluated by sonogram for detection of sonographic accuracyand prevalence of disease in the community of which 350male, 550 female & 100 children. Abnormal findings are seen420 in biliary systems, 460 in liver-spleen- pancreas and 120 inother upper abdominal organs. Findings are correlate withother investigation and in some cases with surgical interventionshows 95-100 % accuracy. The prevalence of its occurrence inthe community is shown below.

A Renal Size Discrepancy among the Findings of Renal Sonogram in Children with Their First Episode of Pyelonephritis is One of the Useful Parameters to Predict the Presence of Cortical Defects on the Acute DMSA Renal Scan

PURPOSE: We investigated whether a renal size discrepancy on a renal sonogram (US) in children with febrile urinary tract infection (UTI) was correlated with the presence of cortical defects on their dimercaptosuccinic acid (DMSA) renal scan. METHODS: We examined 911 children who were admitted consecutively to our hospital with their first episode of febrile UTI from March 2001 to September 2014. All enrolled children underwent a US and DMSA scan during admission. According to the US findings, including the renal size discrepancy, data were compared between children with positive and negative DMSA scan results. A positive DMSA scan result was defined as reduced or absent tracer localization and indistinct margins that did not deform the renal contour. RESULTS: Mean renal lengths of the right and left kidneys were larger in children with positive DMSA scan results than in children with negative DMSA scan results (63.2±11.3 mm vs. 58.4±7.8 mm, P<0.001; 64.9±11.2 mm vs. 59.9±7.9 mm, P<0.001; respectively). A significant difference was observed in both renal lengths between children with positive and negative DMSA scan results (4.6±3.8 mm vs. 3.3±2.6 mm, P<0.001). A multiple logistic regression analysis, revealed that a small kidney, cortical thinning, and a renal length discrepancy on US findings were significant factors for predicting the presence of cortical defects on an acute DMSA scan [P=0.028, 95% confidence interval (CI) 1.054–2.547; P=0.004, 95% CI 1.354–4.810; P<0.001, 95% CI 1.077–1.190, respectively]. CONCLUSION: In conclusion, a renal size discrepancy on US findings in children with their first episode of febrile UTI was a helpful tool for predicting the presence of cortical defects on an acute DMSA scan.

Aplicaciones clínicas del análisis acústico de la voz / Clinical applications of acoustic voice analysis

El análisis acústico de la voz es un método de evaluación vocal objetivo y no invasivo, utilizado con fines diagnósticos, terapéuticos e investigativos. Utiliza registros acústicos obtenidos directamente de la voz del paciente mediante el uso de un micrófono profesional. Existe una gran variedad de programas y métodos de graficación disponibles, que favorecen la versatilidad y especificidad del proceso. Esta revisión muestra los métodos de graficación de la voz más utilizados.

The acoustic voice analysis is an objective and non invasive vocal assessment method, used for voice diagnosis, therapy and research. It uses acoustic records obtained from the patient's voice using professional microphones. There is a variety of softwares and graphing programs available that allows process versatility and specificity. This review presents the most utilized methods of voice graphing.

Incorporación del estudio de ADN fetal en sangre materna al cribado de cromosomopatías / Incorporation of the study of fetal DNA in maternal blood to the screening of chromosomal diseases

OBJETIVO: Evaluar la efectividad del cribado combinado de primer trimestre para la detección prenatal de aneuploidías tras 6 años de implantación en nuestro servicio y su repercusión en la disminución de pruebas diagnósticas invasivas. Se propone establecer un protocolo para incorporar el estudio de ADN fetal en sangre materna a partir de las revisiones bibliográficas publicadas. MÉTODO: Se evaluó el riesgo de anomalía cromosómica fetal en 3177 gestaciones mediante cribado combinado de primer trimestre entre enero de 2011 y diciembre de 2014. Se revisaron las amniocentesis realizadas desde que se instauró el cribado combinado en 2008 comparándolas con las de los 5 años anteriores. RESULTADOS: La tasa de detección del cribado para trisomía 21 fue del 94,4% y la tasa de falsos positivos de 6,4%. En el año 2005 estábamos realizando 194 amniocentesis, tras 6 años de implantación del cribado, en el año 2013 se realizaron 35 amniocentesis lo que implica una disminución del 70%. CONCLUSIONES: El cribado combinado de primer trimestre ha demostrado una mayor tasa de detección para trisomía 21 que el cribado de segundo trimestre y/o la edad materna, además de que ha llevado a una importante reducción en el número de pruebas invasivas. En los próximos años la incorporación del estudio de ADN fetal mejorará la detección de aneuploidías, con una drástica disminución de las pruebas invasivas por lo que se hace necesario la implantación de nuevos protocolos.

AIMS: To evaluate the effectiveness of first trimester combined screening in the prenatal detection of aneuploidy after 6 years of implantation in our service and its impact in reducing invasive diagnostic tests. It is proposed to establish a protocol to incorporate the study of fetal DNA in maternal blood from published literature reviews. METHODS: The risk of fetal chromosomal anomalies was assessed in 3177 pregnancies with first trimester combined screening between January 2009 and December 2014. The amniocenteses performed were checked against those of the previous 5 years. RESULTS: The detection rate of screening for trisomy 21 was 94.4% and the false-positive rate was 6.4%. In 2005 there were 194 amniocenteses. In 2013, 5 years after the introduction of screening, 68 amniocenteses were performed, representing a 70% reduction in invasive procedures. CONCLUSIONS: First trimester combined screening has shown a higher detection rate for trisomy 21 that the second trimester screening and/or maternal age, and has substantially reduced the use of invasive prenatal diagnostics procedures. In the coming years, the incorporation of the study of fetal DNA improve the detection of aneuploidys with a drastic reduction of invasive tests so that, the implementation of new protocols is necessary.

Association of Renal and Bladder Ultrasonography Findings with Urinary Tract Infection Recurrence, High-Grade Vesicoureteral Reflux, and Renal Scarring

INTRODUCTION: This study investigated whether renal and bladder ultrasonography (RBUS) findings performed in children with the first incidence of febrile urinary tract infection (UTI) can predict UTI recurrence, high-grade vesicoureteral reflux (high-grade VUR), or acquired renal scarring (aRS). METHODS: In all, 917 children who were admitted to our hospital from January 2001 to October 2010, owing to the first incidence of febrile UTI were enrolled in this study. All children underwent RBUS during admission. The mean followup was 7.9 months (standard deviation [SD]+/-13.3). UTI recurrence rates were calculated according to various clinical parameters. By using bivariate and multiple logistic regression analyses, we determined whether age, sex, abnormal RBUS findings, abnormal dimercaptosuccinic acid renal scan findings, or RBUS findings parameters were predictive of UTI recurrence, high-grade VUR, or aRS. RESULTS: On RBUS, hydronephrosis and congenital anomaly of the kidney and urinary tract significantly predicted UTI recurrence. A small kidney, hydroureter, hydronephrosis, cortical thinning, and increased parenchymal echogenicity significantly predicted high-grade VUR. However, their odds ratios (OR) are low compared to normal RBUS findings (recurrent UTI: OR 0.432 and 0.354 vs. 0.934, respectively, high-grade VUR: .019, 0.329, 0.126, 0.058, and 0.188 vs. 2.082, respectively). No RBUS findings significantly predicted aRS. Recurrent UTI, highgrade VUR, and abnormal RBUS findings significantly predicted aRS (OR of 4.80, 4.61, and 2.58, respectively). CONCLUSION: RBUS is necessary to exclude severe congenital renal scarring, obstructive uropathy, and renal abscess at the first incidence of febrile UTI and is helpful in determining the need for subsequent clinical imaging.

Vocal patterns of adult females and juveniles Caiman yacare (Crocodilia: Alligatoridae) in Brazilian Pantanal wetland / Patrones de vocalización de jóvenes y hembras adultas de Caiman yacare (Crocodilia: Alligatoridae) en el Pantanal de Brasil

The Paraguayan caiman (Caiman yacare) is the main Caimaninae species occurring in the Brazilian Pantanal Wetland. Despite the relative availability of works focused on biology and conservation of the Paraguayan caiman, almost nothing is known about its vocal structure and behavior. We recorded aggressive calls of adult caiman females guarding nests and, afterwards, the distress calls of the new born juvenile caimans in seasonally flooded areas of the Nhecolândia (Southern Pantanal). The results of both observations and sonographic analyses diverged from studies with other crocodilian species. Aggressive vocalization of adult females of the Paraguayan caiman was longer and more complex than the same vocalization of larger Alligatoridae species. Vocalizations of the young caimans presented interspecific differences with other crocodilian offsprings. Moreover, we found statistically significant intraspecific variation in the distress call structure among different pods, even separated by few kilometers. Differences in distress call structure were tested by Canonical Discriminant Analysis (CDA). We obtained the squared Mahalanobis distances between the acoustic multivariate spaces of each pod provided by the CDA and compared with the geographic distance between the bays of origin of each pod through Mantel Test. The geographic distance by itself did not explain the differences found in the structure of the vocalization of young caimans from different pods. The adult females of Paraguayan caiman positively responded to playbacks of calls from juvenile caimans from pods of other regions, as well as to rough imitations of distress call. Since the adult caimans showed protective responses to quite heterogeneous vocalizations of distress by juveniles, we hypothesized that the variation in the distress call pattern may be associated to a low specificity in sound recognition by adult caimans.

Poco se conoce sobre la estructura vocal del Caiman yacare del Pantanal brasileño. Llamadas agresivas de hembras adultas que cuidaban de los nidos fueron registradas durante enero y febrero y llamadas de socorro de caimanes jóvenes, en abril de 1992. Hembras adultas de C. yacare presentaron una vocalización agresiva más larga y compleja que en otras especies más grandes de Alligatoridae. Las vocalizaciones de los jóvenes caimanes también presentaron diferencias interespecíficas con otros cocodrilos y variaciones intraespecíficas entre grupos separados por pocos kilómetros. Se utilizó la Prueba de Mantel para comparar las distancias de Mahalanobis entre la estructura de las vocalizaciones de los jóvenes de acuerdo con sus grupos y las distancias geográficas donde ellos estaban. La distancia geográfica en sí no explica las diferencias en las vocalizaciones de jóvenes de diferentes grupos. Hembras adultas de C. yacare han respondido a grabaciones de llamadas de caimanes de grupos de otras regiones, así como a imitaciones de llamada de socorro. Se postula que las variaciones en las llamadas de socorro pueden estar asociadas con una baja especificidad en el reconocimiento de sonido por caimanes adultos que han respondido de la misma forma protectora a las más heterogéneas expresiones de peligro de los jóvenes.

Ultrasonographic (USG) Imaging In Orofacial Disease - A Review.

Diagnostic ultrasound has become a radiology subspecialty. Ultrasonography(USG) is a procedure in which highenergy sound waves are bounced off internal tissues or organs and make echoes, which are picked up by the transducer and converted into an electrical signal and then into a real-time black, white and grey visual echo picture, which is displayed on a computer screen. The principles, various indications, advantages, disadvantages and advanced applications of ultrasonography in relation to maxillofacial region are enlightened in this review article.

Unilateral vertebral artery hypoplasia masquerading as benign paroxysmal positional vertigo: A case report.

Unilateral vertebral artery hypoplasia has been reported as possibly contributing to acute ischemia stroke or migraine with aura and could be related to episodic positional vertigo. An 88-year-old man presented with episodic vertigo whenever he rotated his head 90° to the right. He had experienced this for the last two years. Benign paroxysmal positional vertigo was initially suspected, but Epley’s canalith repositioning procedures failed to cure the symptom. The symptom was finally confirmed as related to right vertebral artery hypoplasia (VAH) after he had received a battery of studies, including an electronystagmogram, a color-coded duplex sonogram, and a magnetic resonance imaging/ angiogram. Thus, conservative treatment and life-style change were recommended and led to a decrease in recurrence. Herein we report this case and the oto-neurological significance of vertebral artery hypoplasia. In conclusion, one-sided head rotation related to episodic vertigo might be attributable to VAH.

Sonograms of Tuberculous Peritonitis / 中国医科大学学报

Objective To study the sonograms of tuberculous peritonitis and improve the diagnostic accuracy of this disease.Methods We retrispectively analyzed 138 cases of tuberculous peritonitis diagnosed by ultrasonically guided biopsy,postoperative pathology,and clinical manifestation.The characteristics of the sonograms were analyzed,including the amount and character of ascites,the changes in greater omentum,peritoneum,and mesenterium.the enlarged celiac lymph nodes,and the organ involvement.Results The sonograms of tuberculous peritonitis were characterized by thickening of greater omentum with different degrees of ascites,which usually presented cerebral fissure sign under high-frequency ultrasound,together with aggregation of intestines,thickening of peritoneum,enlarged celiac lymph nodes,hepatomegaly,splenomegaly,and pleural effusion.Conclusion Ultrasonography is of great clinical significance in the diagnosis of tuberculous peritonitis and the guidance of greater omentum biopsy.

Prenatal assessment of normal fetal pulmonary grey-scale and lung volume by three-dimensional ultrasonography / 药物分析学报

Objective To quantitatively analyze the fetal lung echo and right lung volume in the third trimester by real-time three-dimensional ultrasound (3-D US) and evaluate the feasibility of fetal lung maturity. Methods A total of 732 women with normal singleton pregnancies between 28 and 42 weeks of gestation underwent ultrasound examination. The 3-D US equipment with a 3.5-5MHz transabdominal transducer was used for the fetal biometric measurement. The echogenicity ratio between fetal lung and liver was compared. The fetal lung volume was calculated by the rotational multiplanar technique for volume measurement (VOCAL). Results The right fetal lung volume increased with the increase of gestational age with a linear positive correlation (r=0.884, P<0.01). After 34 weeks, the echogenicity ratio of fetal lung to liver was more than 1.1. Conclusion The echogenicity of lung/liver and fetal lung volume could be used as normal fetal predictable indicators for fetal lung maturity.

Maternal Perspectives of Prenatal Sonogram in a North-Eastern Population in Nigeria

Limited information exists on maternal perspectives of prenatal sonogram in north-eastern Nigeria. This study was aimed at documenting the views and expectations of pregnant women concerning prenatal sonogram as well as their level of awareness of its purpose; limitations and safety in a predominantly Moslem society. A survey was carried out on a convenience sample of 150 patients referred from ante-natal clinics for prenatal sonogram; by administering semi-structured questionnaires. The results show that 61.3of the women had prenatal sonogram; with little or no information about the purpose; capabilities and limitations of the procedure. 24.7had neither formal western nor Islamic educational background that may have influenced their perceptions. Most of the women (81.3) were sponsored by either government or their husbands; 72.7perceived sonogram to be affordable and 63.4viewed sonographic results as reliable. The perceived main reasons for having a prenatal sonogram were to determine the expected date of delivery and foetal well-being; and to obtain reassurance of maternal health. Sex determination and number of foetuses were the least considered reasons. The study indicates that providing pregnant women with adequate information and sensitising them to the purpose and limitations of sonograms is necessary to guarantee its rational utilisation. Improving patient care; enhancing the skill of sonographers and providing more facilities would improve the services and patients' perspectives of prenatal sonography

Ultrasound Screening for Fetal Down Syndrome in the Second Trimester of Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To determine the risk of Down syndrome in fetuses with sonographic markers using the likelihood ratios and individual risk assessment. METHODS: We retrospectively evaluated the midtrimester genetic sonographic features of fetuses with Down syndrome and compared them with euploid fetuses. Patients were referred for an increased risk of aneuploidy and evaluated for the presence of structural defects, a nuchal fold, short long bones, pyelectasis, brachycephaly, small stomach, and hyperechoic bowel. Outcome information included the results of genetic amniocentesis (if performed), the results of pediatric assessment, and follow-up after birth. The sensitivity, specificity, and likelihood ratios for markers ware calculated isolated findings. RESULTS: There were 59 fetuses with Down syndrome and 600 euploid fetuses. The presence of any marker resulted in sensitivity for the detection of Down syndrome of 86.4% with a false-positive rate of 13.6%. Structural defect had a likelihood ratio of 77.8. As an isolated marker, the nuchal fold, short humerus, short femur, echogenic bowel and renal pyelectasia has a likelihood ratio of 20.2, 12.7, 3.9, 2.5, 1.1 respectively. Other isolated markers had low likelihood ratios because of the higher prevalence in the unaffected population. CONCLUSION: Combining second-trimester serum testing and fetal sonography is a feasible approach to Down syndrome screening, compatible with current obstetric practice. Although an isolated marker with a low likelihood ratio may not increase a patient's risk of Down syndrome, the presence of such a marker precludes reducing the risk of aneuploidy. This information will be useful in counseling pregnant women who are at high risk for fetal Down syndrome and who prefer to undergo genetic sonography before deciding about genetic amniocentesis.

Ultrasound Screening for Fetal Down Syndrome in the Second Trimester of Pregnancy / 대한산부인과학회잡지

OBJECTIVE: To determine the risk of Down syndrome in fetuses with sonographic markers using the likelihood ratios and individual risk assessment. METHODS: We retrospectively evaluated the midtrimester genetic sonographic features of fetuses with Down syndrome and compared them with euploid fetuses. Patients were referred for an increased risk of aneuploidy and evaluated for the presence of structural defects, a nuchal fold, short long bones, pyelectasis, brachycephaly, small stomach, and hyperechoic bowel. Outcome information included the results of genetic amniocentesis (if performed), the results of pediatric assessment, and follow-up after birth. The sensitivity, specificity, and likelihood ratios for markers ware calculated isolated findings. RESULTS: There were 59 fetuses with Down syndrome and 600 euploid fetuses. The presence of any marker resulted in sensitivity for the detection of Down syndrome of 86.4% with a false-positive rate of 13.6%. Structural defect had a likelihood ratio of 77.8. As an isolated marker, the nuchal fold, short humerus, short femur, echogenic bowel and renal pyelectasia has a likelihood ratio of 20.2, 12.7, 3.9, 2.5, 1.1 respectively. Other isolated markers had low likelihood ratios because of the higher prevalence in the unaffected population. CONCLUSION: Combining second-trimester serum testing and fetal sonography is a feasible approach to Down syndrome screening, compatible with current obstetric practice. Although an isolated marker with a low likelihood ratio may not increase a patient's risk of Down syndrome, the presence of such a marker precludes reducing the risk of aneuploidy. This information will be useful in counseling pregnant women who are at high risk for fetal Down syndrome and who prefer to undergo genetic sonography before deciding about genetic amniocentesis.

Symptoms and Physical Examinations of Symptom-Giving Pelvic Girdle Relaxation in Pregnant Women / 대한산부인과학회잡지

OBJECTIVE: This prospective study was done to find out common symptoms and beneficial physical examinations, and to evaluate relations among symptom, pain severity, physical examination method and width of symphysis pubis of symptom-giving pelvic girdle relaxation (PGR) in pregnant women. METHODS: Four hundreds sixty-five pregnant women who complained pelvic pain were asked to fill out a questionnaire. Ninety-six pregnant women were diagnosed as PGR and were examined physically and took the sonogram. Statistical correlation was evaluated among symptoms, pain severity (visual analog scale: VAS), physical examination method and sonogram. RESULTS: The most common complain was difficulty of rolling in bed (100%). The most frequent positive diagnostic physical method was posterior pelvic pain provocative test (PPPT) (85.4%). There was correlation between VAS and symptoms (r= 0.340, P=0.001) but no correlations between VAS or symptoms and numbers of positive physical examination (P>0.05). CONCLUSION: It is suggested that PPPT was most beneficial diagnostic methods of PGR in pregnancy.

The Clinical Significance of Increased Serum CA 125 in Asymptomatic Women / 대한부인종양콜포스코피학회잡지

OBJECTIVES: Our study was to determine the usefulness of CA 125 screening for asymptomatic female subjects. Though CA 125 has been used as a useful marker for the detection of ovarian cancer, its efficacy to detect early ovarian cancer in asymptomatic women has not been established. STUDY DESIGN: From April 1995 to December 1997, a total of 13,038 subjects who visited our Center for Health Promotion were screened. Serum CA 125 level was measured by a radioimmunoassay kit (Centocor, USA). In most cases transvaginal ultrasound was done at the same time. The specificity, sensitivity and positive predictive value were obtained on the basis of normal CA 125 range between 2.4~36.3 U/ml. RESULT: 1) Two cases of ovarian cancer were detected out of 13,038 subjects screened. One ovarian cancer patient showed 1,625 U/ml of CA 125 level, on the other hand, the other level patient showed 27 U/ml. 2) Therefore, the sensitivity, specificity, and positive predictive value were 50%, 97.3%, and 0.3%, respectively. Since 346 cases out of 13,038 screened subjects showed false positive results on the basis of the upper limit of normal CA 125 level set at 36.3 U/ml,the false positivity was 2.6%. 3) The CA 125 levels in false positive cases ranged from 36.3 U/ml to 352.8 U/ml with the mean value of 66.19+/-51.47 (S.D.). 4) The clinical features of the false positive cases included uterine myoma including adenomoysis (150), benign ovarian cyst (19), cervicitis (6), tuberculosis (3), pregnancy (2), and each one case of breast cancer, mammary cyst, endometritis, lung cancer, liver cirrhosis, pancreatic cancer, cervical cancer, renal cyst, uterine anomaly, and post TAH state. In the remainder of false positive 156 cases, no abnormal findings were observed. Among 258 pateints who underwent combined tests of CA 125 and transvaginal ultrasound, the sensitivity of ovarian cancer was 100%. 5) The false positive rate was lower in the older age group (>50) than in the younger group (<50). CONCLUSION: The prevalance of ovarian cancer in our study was 0.0153% (15.3 per 100,000 population) which is comparable to the rate of 15.8 per 100,000 population reported by the Korean Medical Insurance Corporation. Although the CA 125 test by itself shows a low positive predictive value, its clinical usefulness as a screening test can be enhanced dramatically by the combined use of transvaginal ultrasound examination, especially in postmenopausal women.