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2.
Neumol. pediátr. (En línea) ; 15(2): 330-338, mayo 2020. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1099679

ABSTRACT

The CoVID-19 pandemic has impacted in a lesser extent and intensity to patients younger than 15 years. The role of different imaging studies of lung involvement has been extensively addressed, from the first cases of severe pneumonia and respiratory distress syndrome in adults. There are fewer reports of the comparative usefulness of conventional radiology, ultrasound, and computed axial tomography in children. Of those, ground glass opacities, crazy paving pattern and surrounding halo consolidation are the most characteristic. Even though none of them allows diagnostic confirmation, their correct interpretation helps in decision flows. Computed axial tomography is more accurate for defining the type and extent of lung parenchymal involvement. The role of the ultrasound in early stages in the emergency department is clearer in adults than in children, in whom there is a good correlation with chest tomography. This article addresses the different radiological patterns, their pathophysiological representation and differential diagnoses, in order to alert pediatricians of their interpretation, as well as the potential role of imaging diagnoses most frequently used in children with low acute respiratory infection.


La pandemia CoVID-19 ha impactado en una proporción e intensidad menor a los pacientes menores de 15 años. El rol de los diferentes estudios por imágenes del compromiso pulmonar ha sido extensamente abordado, desde los primeros casos de neumonías graves y síndrome de distrés respiratorio en adultos. En niños existen menos reportes de la utilidad de la radiología convencional, ecografía y tomografía axial computarizada. Sin embargo, los patrones más característicos observados en adultos se repiten en los niños. De ellos, el vidrio esmerilado, el patrón en empedrado y la consolidación con halo circundante son los más característicos. Aun cuando ninguno de ellos permite confirmación diagnóstica, su correcta interpretación ayuda en los flujos de decisiones. La tomografía axial computarizada es más certera para la definición de tipo y extensión del compromiso parenquimatoso pulmonar. El rol en los estadios tempranos en el servicio de urgencia de la ecografía es más claro en adultos que en niños, donde existe buena correlación con la tomografía de tórax. Este artículo aborda los diferentes patrones radiológicos, su representación fisiopatológica y diagnósticos diferenciales, con el objeto de apoyar a los pediatras en su interpretación, como también reconocer el rol de las técnicas de imágenes diagnósticas más frecuentemente utilizadas en niños con infección respiratoria aguda baja.


Subject(s)
Humans , Male , Infant, Newborn , Child , Pneumonia, Viral/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Betacoronavirus , Radiography, Thoracic , Tomography, X-Ray Computed , Ultrasonography , Pandemics
3.
Rev. argent. mastología ; 39(141): 47-115, mar. 2020. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1104372

ABSTRACT

La práctica de la imagenología mamaria ha experimentado gran variedad de avances tecnológicos desde los primeros tiempos hasta nuestros días. La técnica de la mamografía se estableció desde un comienzo como el gold standart para el estudio de la mama, pasando desde la mamografía de película de exposición directa a la mamografía digital y tomosíntesis actual. Junto con estos progresos tecnológicos, se han propuesto regulaciones basadas en la calidad de los estudios mamográficos y el desarrollo unificado de informes con la intención de estandarizar el lenguaje y el informe mamográfico, para facilitar el entendimiento entre los diferentes especialistas implicados en el manejo de la patología mamaria y como herramienta de mejora continua en la calidad. A partir del desarrollo de la ecografía y de la resonancia mamaria como complementos de la mamografía, surgen algoritmos adicionales para el diagnóstico y la selección de subgrupos de riesgo. Este acelerado avance en la detección por imágenes de la patología mamaria y de las técnicas intervencionistas las ha transformado en herramientas fundamentales no solo para el diagnóstico del cáncer de mama sino también por la utilización de esa información con vistas a guiar los futuros tratamientos. En esta presentación, se propone una descripción de la historia y evolución de las imágenes de mamografía desde su creación hasta la actualidad, entendiendo que el conocimiento del pasado ayuda a comprender mejor los debates y controversias actuales


The practice of breast imaging has undergone a variety of technological advances from the earliest times to the present day. The mammography technique was established from the beginning as the gold standard for the study of the breast, from the mammography of direct exposure film to digital mammography and current tomosynthesis. Together with these technological advances, regulations based on the quality of mammographic studies and the unified development of reports are proposed, with the intention of standardizing the language and mammographic report, to facilitate understanding between the different specialists involved in the management of breast pathology and as a tool for continuous improvement in quality. From the development of ultrasound and breast resonance, as complements of mammography, additional algorithms arise for the diagnosis and selection of risk subgroups. This accelerated progress in the detection of breast disease along with interventional techniques have been fundamental tools, not only for diagnosing breast cancer, but also for the use of this information to guide future treatments. A description of the history and evolution of mammography images from its creation to the present is proposed in this presentation, understanding that knowledge about the past helps to better understand current debates and controversies


Subject(s)
Breast Diseases , Mammography , Technological Development , Ultrasonography , History
4.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 31-37, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090554

ABSTRACT

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Salivary Gland Diseases/diagnosis , Salivary Gland Diseases/pathology , Salivary Gland Diseases/therapy , Salivary Gland Diseases/epidemiology , Parotitis/epidemiology , Sialadenitis/epidemiology , Magnetic Resonance Spectroscopy , Salivary Gland Calculi/epidemiology , Tomography, X-Ray Computed , Medical Records , Incidence , Prevalence , Retrospective Studies , Longitudinal Studies , Ultrasonography , Biopsy, Fine-Needle , Germany
5.
Arch. argent. pediatr ; 118(1): 11-17, 2020-02-00. tab, graf
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-1095278

ABSTRACT

Introducción. Las causas más frecuentes de la linfadenopatía cervical son las afecciones inflamatorias y reactivas; solo unos pocos casos representan una patología seria. El objetivo fue evaluar la relación entre los hallazgos ecográficos y el diagnóstico histopatológico. Población y métodos. Este estudio retrospectivo abarcó la linfadenopatía cervical en los menores de 20 años seguidos en nuestro centro, entre enero de 2007 y diciembre de 2016. Según los informes anatomopatológicos, se dividió a los pacientes en dos grupos: benigno y maligno. Se compararon los resultados anatomopatológicos y los hallazgos ecográficos. Resultados. Después del análisis de los resultados histopatológicos y los hallazgos ecográficos, se incluyó a 107 pacientes con linfadenopatía cervical persistente (44 casos malignos; 63, benignos). La media de edad de los grupos maligno y benigno fue de 14 ± 6,1 años y de 11,9 ± 4,8 años, respectivamente. La presencia de vascularidad hiliar fue estadísticamente significativa (p < 0,0001) en la linfadenopatía benigna, mientras que el flujo periférico y la vascularidad mixta lo fueron (p < 0,05) en la linfadenopatía maligna. No se observó una diferencia significativa en el diámetro máximo (27,3 ± 11,1 mm y 29,8 ± 12,3 mm, respectivamente), pero sí en el diámetro mínimo entre los grupos benigno y maligno (13,7 ± 7,3 mm y 18,7 ± 8,8 mm, respectivamente). Conclusiones. Este estudio sugiere que existe una relación entre los hallazgos ecográficos y de la biopsia para la diferenciación entre la linfadenopatía benigna y maligna, en especial, en el patrón vascular intraganglionar y el hilio ganglionar.


Introduction. The most common causes of cervical lymphadenopathy (LAP) are inflammatory and reactive conditions; only a small proportion have serious pathology, such as malignancy. The objective of this study was to evaluate the relationship between USG findings and histopathological diagnosis of the cervical LAP. Population and Methods. This retrospective study comprised the cases of cervical LAP in patients aged under 20 years old followed in our center between January 2007 to December 2016. Based on pathology reports, we divided the patients into two groups: benign and malignant. Pathology results and USG findings were compared. Results. After the analyze of the histopathological results and USG findings, 107 patients with persistent cervical LAP (44 malignant; 63 benign) were included in the study. Mean age of malignant and benign group were 14 ± 6.1; 11.9 ± 4.8 years, respectively. Hilar vascularity for benign LAP was highly statistically significant (P < 0.0001) and peripheral flow and mixed vascularity for malignant LAP were also statistically significant (p < 0.05). There was not a significant difference in the maximum diameter (27.3 ± 11.1 mm and 29.8 ± 12.3 mm, respectively), however, there was a significant difference in the minimum diameter between benign and malignant groups (13.7 ± 7.3 mm and 18.7 ± 8.8 mm, respectively).Conclusions. The present study suggests that there is a relationship between US and biopsy findings for the differentiation of benign from malignant LAP, especially in terms of nodal hilus and intranodal vascular pattern.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Ultrasonography , Lymphadenopathy/diagnostic imaging , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Biopsy, Fine-Needle , Lymphadenopathy/pathology , Lymph Nodes/pathology , Lymphatic Diseases/physiopathology , Lymphoma/diagnosis , Lymphoma/etiology
7.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 40-48, Jan.-Feb. 2020. tab, ilus
Article in Portuguese | LILACS (Americas), VETINDEX | ID: biblio-1088936

ABSTRACT

A ultrassonografia é um exame complementar não invasivo ainda pouco utilizado na avaliação prepucial e sem descrições detalhadas da parte livre do pênis (PLP) de bovinos. Este estudo objetivou padronizar a ultrassonografia prepucial em bovinos hígidos da raça Nelore com um ano de idade e, para tanto, descreveu o aspecto da lâmina interna prepucial (LIP) e da PLP, determinando as principais janelas acústicas, a viabilidade da utilização de contraste no lúmen da cavidade prepucial (LCP) e o melhor posicionamento do animal para a realização do exame. O escaneamento foi realizado com os animais na posição quadrupedal e em decúbito lateral direito. Foram determinadas cinco janelas acústicas a partir do óstio até a identificação do recesso prepucial. Os escaneamentos foram realizados nos planos longitudinais, transversais e dorsais, antes e após a infiltração de solução fisiológica a 0,9% no LCP. Como conclusões, o exame ultrassonográfico permitiu identificar a LIP e a PLP em todos os planos e em todas as janelas acústicas propostas. O melhor ponto de referência é a identificação da glande. O posicionamento quadrupedal é mais adequado para a realização do exame e o uso de contraste é recomendado para delimitação topográfica das estruturas.(AU)


Ultrasonography is a noninvasive complementary exam that is still rarely used in the preputial evaluation and without detailed descriptions of the bovine free end of the penis. The purpose of this study was to standardize preputial ultrasonography in one-year-old healthy Nelore cattle, describing the main acoustic windows, the viability of using contrast in the preputial cavity and the best positioning of the animal for performing the ultrasound examination. The scanning was performed with the animals in standing and decubitus position. Five acoustic windows were determined from the preputial ostium to the preputial fornix, at the free end of the penis. The scans were performed in longitudinal, transverse and dorsal planes, before and after infiltration of 0.9% saline solution into the preputial cavity. As conclusions, the ultrasound examination is able to identify the internal layer and the free part of the penis in all proposed planes and acoustic windows. The best landmark is the identification of the glans. Furthermore, standing positioning is the most appropriate to perform the exam and the use of contrast is recommended for topographic delimitation of the structures.(AU)


Subject(s)
Animals , Male , Cattle , Penis/diagnostic imaging , Foreskin/diagnostic imaging , Ultrasonography/methods
8.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 281-284, Jan.-Feb. 2020. tab, ilus
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1088906

ABSTRACT

As serpentes vindas da natureza e encaminhadas para centros de reabilitação ou de pesquisa têm uma idade incerta. Na natureza, esses animais, muitas vezes atingem um tamanho corpóreo menor do que os indivíduos cativos devido a uma menor frequência de alimentação. Assim, a idade de uma cobra recém-chegada da natureza é geralmente estimada com base em seu tamanho corpóreo, o qual é comparado com dados em cativeiro. A utilização dos meios de diagnóstico por imagem tem auxiliado a medicina na análise das serpentes em cativeiro, mediante avaliação da estrutura óssea, dos órgãos e de alterações. Este trabalho relata o uso de diagnóstico por imagem (radiografia e ultrassonografia) para identificar a presença de microchips e, consequentemente, estimar a idade de uma Bothrops insularis em cativeiro.(AU)


Subject(s)
Animals , Body Weights and Measures/veterinary , Bothrops/growth & development , Lab-On-A-Chip Devices/veterinary , Longevity , Radiography/veterinary , Ultrasonography/veterinary
9.
Article in English | WPRIM (Western Pacific) | ID: wprim-816616

ABSTRACT

BACKGROUND: We evaluated the association of visceral-to-subcutaneous fat ratio (VSR) with nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis degree based on noninvasive serum fibrosis markers in the general population with NAFLD.METHODS: This is a cross-sectional study, in 7,465 Korean adults who underwent health screening examinations. NAFLD was defined as fatty liver detected on ultrasonography, and visceral and subcutaneous abdominal fat was measured using computed tomography. We predicted fibrosis based on the fibrosis-4 (FIB-4) score and aspartate aminotransferase-to-platelet ratio index (APRI) and categorized the risk for advanced fibrosis as low, indeterminate, or high.RESULTS: The multivariable-adjusted prevalence ratios for indeterminate to high risk of advanced fibrosis based on FIB-4, determined by comparing the second, third, and fourth quartiles with the first quartile of VSR, were 3.38 (95% confidence interval [CI], 0.64 to 17.97), 9.41 (95% CI, 1.97 to 45.01), and 19.34 (95% CI, 4.06 to 92.18), respectively. The multivariable-adjusted prevalence ratios for intermediate to high degree of fibrosis according to APRI also increased across VSR quartiles (5.04 [95% CI, 2.65 to 9.59], 7.51 [95% CI, 3.91 to 14.42], and 19.55 [95% CI, 9.97 to 38.34], respectively). High VSR was more strongly associated with the prevalence of NAFLD in nonobese subjects than in obese subjects, and the associations between VSR and intermediate to high probability of advanced fibrosis in NAFLD were stronger in obese subjects than in nonobese subjects.CONCLUSION: High VSR values predicted increased NAFLD risk and advanced fibrosis risk with NAFLD, and the predictive value of VSR for indeterminate to high risk of advanced fibrosis was higher in obese subjects than in nonobese subjects.


Subject(s)
Abdominal Fat , Adult , Aspartic Acid , Cross-Sectional Studies , Fatty Liver , Fibrosis , Humans , Intra-Abdominal Fat , Liver Cirrhosis , Mass Screening , Non-alcoholic Fatty Liver Disease , Prevalence , Subcutaneous Fat, Abdominal , Ultrasonography
10.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811440

ABSTRACT

A 64-year-old man was treated with sunitinib as a first-line therapy for metastatic renal cell carcinoma. He was given oral sunitinib in cycles of 50 mg once daily for 2 weeks followed by a week off. During the 5th week of treatment right upper quadrant pain developed, but this resolved spontaneously during the 6th week (off treatment). However, on the 8th week of treatment, he was admitted to hospital because the acute right upper quadrant pain recurred with nausea, vomiting, and fever. Acute acalculous cholecystitis was then diagnosed by ultrasonography and CT. In addition, his laboratory findings indicated disseminated intravascular coagulation. Accordingly, sunitinib therapy was discontinued and broad-spectrum antibiotics initiated. He subsequently recovered after emergent percutaneous cholecystostomy. His Naranjo Adverse Drug Reaction Probability Scale score was 7, indicaing a probable association of the event with sunitinib. Suspicion of sunitinib-related acute cholecystitis is required, because, although uncommon, it can be life-threatening.


Subject(s)
Acalculous Cholecystitis , Anti-Bacterial Agents , Carcinoma, Renal Cell , Cholecystitis, Acute , Cholecystostomy , Disseminated Intravascular Coagulation , Drug-Related Side Effects and Adverse Reactions , Fever , Humans , Middle Aged , Nausea , Ultrasonography , Vomiting
11.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811322

ABSTRACT

PURPOSE: To report a case of corneal collagen cross-linking for corneal ulcer caused by the Moraxella group.CASE SUMMARY: A 77-year-old male had decreased visual acuity for several days in his right eye. The patient showed severe stromal ring infiltrates with a corneal epithelial defect measuring (5.0 × 7.0 mm), a corneal endothelial plaque, and a hypopyon measuring less than 1.0 mm in height in the anterior chamber of the right eye. There was no abnormal finding in the right eye using B-scan ultrasonography. Before starting treatment, a corneal culture was conducted. The culture tests showed the presence of the Moraxella group. Because the patient was diagnosed with a corneal ulcer caused by the Moraxella group, corneal collagen cross-linking (CXL) was performed. The antimicrobial susceptibility test confirmed that this Moraxella group was sensitive to ceftazidime, so the patient was treated with 5% ceftazidime eye drops and 0.5% moxifloxacin eye drops every 2 hours for 9 months after corneal collagen CXL. The uncorrected visual acuity was 0.1 in the right eye, and there was almost no corneal stromal melting on anterior segment optical coherence tomography.CONCLUSIONS: This is the first known case of a corneal ulcer, in the Republic of Korea, caused by the Moraxella group and treated with corneal collagen CXL. Corneal collagen CXL should be considered as a surgical treatment for patients who have an impending corneal perforation due to a corneal ulcer because it is a simple procedure and causes fewer serious complications than other treatments.


Subject(s)
Aged , Anterior Chamber , Ceftazidime , Collagen , Cornea , Corneal Perforation , Corneal Ulcer , Freezing , Humans , Male , Moraxella , Ophthalmic Solutions , Republic of Korea , Tomography, Optical Coherence , Ultrasonography , Visual Acuity
12.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811302

ABSTRACT

Due to technological advances and the establishment of evidence-based medicine, radiological examinations are playing a crucial role in modern medicine, as a result of which they have been steadily increasing, and the rate of increase has intensified in the 2000s. Although this is a global phenomenon, the increase of radiological examinations in Korea is also high due to the introduction of the National Health Insurance Coverage Expansion Policy, so-called Moon Jae-in Care, for ultrasonography and magnetic resonance imaging. For accurate and rapid diagnosis of diseases, it is necessary for doctors to order appropriate radiological studies. However, the increase in radiological examination has created many problems, such as increased medical costs, decreased diagnostic accuracy due to radiologist burnout, and increased patient exposure to radiation. To reduce unnecessary imaging studies, a number of measures could be deployed including the development of clinical guidelines to select appropriate radiological examinations for each clinical situation.


Subject(s)
Diagnosis , Evidence-Based Medicine , History, Modern 1601- , Humans , Insurance, Health , Korea , Magnetic Resonance Imaging , Moon , National Health Programs , Ultrasonography
13.
Article in English | WPRIM (Western Pacific) | ID: wprim-811267

ABSTRACT

Hydatid disease is a zoonotic infection in humans. The disease is endemic in some parts of the world, including Africa, Australia, and Asia, where cattle grazing is common; the disease is spread by an enteric route following the consumption of food contaminated with the eggs of the parasite. Failure to identify this parasite results in delayed diagnosis and increased morbidity to the patient. Upon diagnosis, every possible step should be taken, both surgical and medical, to prevent anaphylactic reactions from the cystic fluid. Postsurgical long-term follow up along with periodical ultrasonography of the liver and computed tomography scan of the abdomen is essential to rule out possible recurrence.


Subject(s)
Abdomen , Africa , Anaphylaxis , Animals , Asia , Australia , Cattle , Delayed Diagnosis , Diagnosis , Echinococcosis , Eggs , Follow-Up Studies , Humans , Liver , Ovum , Parasites , Recurrence , Ultrasonography , Zoonoses
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-782515

ABSTRACT

Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.


Subject(s)
Animals , Bony Callus , Diagnostic Imaging , Dogs , Fracture Fixation , Fracture Healing , Microbubbles , Miners , Muscle, Skeletal , Osteotomy , Perfusion , Radiography , Ultrasonography , Ultrasonography, Doppler
15.
Article in English | WPRIM (Western Pacific) | ID: wprim-782214

ABSTRACT

OBJECTIVE: To increase the rate of successful external cephalic version (ECV) and to minimize the complications, it is important to identify the predictors of success. Therefore, the purpose of this study was to investigate whether the height of the elevated fetal buttock (HOB) is a valuable predictor of successful ECV or not.METHODS: This prospective study was conducted from August 2016 to June 2018. A total of 139 pregnant women with breech presentation were enrolled in the study. HOB from the maternal pubic symphysis was measured on ultrasonography. The predictability and cut-off value of HOB for successful ECV were evaluated.RESULTS: Among the 139 patients, 114 (82%) had successful ECV. The adjusted odds ratio for multiparity, amniotic fluid index (AFI) >14 cm, and HOB >7.8 cm were 10.80 (95% confidence interval [CI], 1.57–74.94), 5.26 (95% CI, 1.06–26.19), and 10.50 (95% CI, 1.03–107.12), respectively. Areas under the curve (AUCs) for AFI, HOB, and parity were 0.66 (95% CI, 0.54–0.78), 0.74 (95% CI, 0.64–0.85), and 0.69 (95% CI, 0.62–0.76), respectively. HOB had the largest AUC, but there were no significant differences among the AUCs of other factors. The cut-off value of HOB was 6 cm.CONCLUSION: This study showed that the AUC of HOB was greater than that of parity and AFI, although it was not statistically significant. As HOB is a noninvasive and comprehensive marker to predict successful ECV, consideration of HOB would be helpful before conducting ECV. Further studies are needed.


Subject(s)
Amniotic Fluid , Area Under Curve , Breech Presentation , Buttocks , Female , Humans , Odds Ratio , Parity , Pregnancy , Pregnant Women , Prospective Studies , Pubic Symphysis , Ultrasonography , Version, Fetal
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-782206

ABSTRACT

OBJECTIVE: This study aimed to assess the effect of combined oral contraceptives (COCs) on polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels in Korean women with polycystic ovary syndrome (PCOS).METHODS: This university hospital study enrolled 36 Korean women who were newly diagnosed with PCOS based on the Rotterdam criteria and were treated with COCs for at least 1 year. We retrospectively evaluated the ovarian volume and number of antral follicles using ultrasonography and assessed serum AMH levels at baseline and after 1 year of COC treatment.RESULTS: Significant decreases in ovarian volume and antral follicle count were observed after 1 year of COC treatment. Compared to baseline, serum AMH levels were significantly decreased after 1 year.CONCLUSION: COC treatment significantly affects ultrasound-assessed PCOM and serum AMH levels of patients with PCOS.


Subject(s)
Contraceptives, Oral, Combined , Female , Humans , Polycystic Ovary Syndrome , Retrospective Studies , Ultrasonography
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-782204

ABSTRACT

Harlequin ichthyosis (HI) is a rare and severe form of ichthyosis and is characterized by thickened, hard, armor-like plates of skin that cover the entire body. This disease is caused by mutations in the adenosine triphosphate-binding cassette transporter protein A12 gene, and the pattern of inheritance is autosomal recessive. Prenatal sonographic diagnosis of HI has not been frequently reported. Here, we report a case of HI detected at 28 weeks of gestation and discuss with the sonographic findings and a brief review of literature. The diagnosis was reached mainly based on 2-dimensional and 3-dimensional ultrasound findings. Three-dimensional ultrasound applications help recognize facial morphology, and thus, greatly contributes to prenatal diagnoses.


Subject(s)
Adenosine , Diagnosis , Humans , Ichthyosis , Ichthyosis, Lamellar , Infant, Newborn , Pregnancy , Prenatal Diagnosis , Skin , Ultrasonography , Wills
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-782202

ABSTRACT

First trimester surgical abortion is an effective and safe procedure. Although its failure is uncommon, congenital uterine anomaly may be considered as one of the etiologic factors in such cases. Here, we report a rare case of surgical abortion failure that was successfully managed by operative hysteroscopy-assisted dilatation and evacuation (D&E) under ultrasound guidance in a woman with complete uterine septum. The patient was referred to Severance Hospital after two consecutive surgical abortion failures even under ultrasound guidance. A missed abortion in a left-sided hemicavity of septate uterus was noted on ultrasonography. Ultrasound-guided D&E was unsuccessful because the curette could not reach the uterine cavity with the gestational sac. Operative hysteroscopy revealed insufficient communication with the left-sided cavity just above the cervical internal os of the uterine septum. After widening the communication, ultrasound-guided D&E was successfully performed.


Subject(s)
Abortion, Induced , Abortion, Missed , Dilatation , Female , Gestational Sac , Humans , Hysteroscopy , Pregnancy Trimester, First , Pregnancy , Ultrasonography , Uterus
19.
Yonsei Medical Journal ; : 129-136, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782199

ABSTRACT

PURPOSE: Routine screening for carotid intima-media thickness (CIMT) and cardiovascular (CV) disease in asymptomatic patients has been criticized for the high costs and large number of patients required for detecting one patient with coronary artery disease (CAD). In order to overcome the low cost-effectiveness thereof, we investigated the feasibility of an economic wireless handheld ultrasound (WHUS) device for CIMT measurement in symptomatic patients.MATERIALS AND METHODS: A total of 100 consecutive patients with cardiac symptoms were enrolled. CIMT was measured in all patients. Coronary angiography was performed in 75 patients indicated for the exam.RESULTS: The mean of maximal CIMT measured from left/right common carotid artery and bulb (max-CIMT) by the WHUS device showed excellent agreement [intraclass correlation coefficient (ICC)=0.960] with a standard ultrasound device and great interobserver repeatability (ICC>0.9 between all observers). Receiver operating characteristic curve analysis showed that the predictive power for CAD was improved when max-CIMT and plaque information (plaque≥2) was added [area under the curve (AUC): 0.838] to the traditional clinical CV risk factors (AUC: 0.769). The cutoff values for CAD prediction with the standard device and the WHUS device were 1.05 mm (AUC: 0.807, sensitivity: 0.78, specificity: 0.53) and 1.10 mm (AUC: 0.725, sensitivity: 0.98, specificity: 0.27), respectively.CONCLUSION: max-CIMT measured by a WHUS device showed excellent agreement and repeatability, compared with standard ultrasound. Combined max-CIMT and plaque information added predictive power to the traditional clinical CV risk factors in detecting high-risk CAD patients.


Subject(s)
Carotid Artery, Common , Carotid Intima-Media Thickness , Coronary Angiography , Coronary Artery Disease , Humans , Mass Screening , Risk Factors , ROC Curve , Sensitivity and Specificity , Ultrasonography , Wireless Technology
20.
Yonsei Medical Journal ; : 154-160, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-782196

ABSTRACT

PURPOSE: Recently, obstetric massive transfusion protocols have shifted toward early intervention. This study aimed to develop a prediction model for transfusion of ≥5 units of packed red blood cells (PRBCs) during cesarean section in women with placenta previa.MATERIALS AND METHODS: We conducted a cohort study including 287 women with placenta previa who delivered between September 2011 and April 2018. Univariate and multivariate logistic regression analyses were used to test the association between clinical factors, ultrasound factors, and massive transfusion. For the external validation set, we obtained data (n=50) from another hospital.RESULTS: We formulated a scoring model for predicting transfusion of ≥5 units of PRBCs, including maternal age, degree of previa, grade of lacunae, presence of a hypoechoic layer, and anterior placentation. For example, total score of 223/260 had a probability of 0.7 for massive transfusion. Hosmer-Lemeshow goodness-of-fit test indicated that the model was suitable (p>0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.


Subject(s)
Area Under Curve , Blood Transfusion , Calibration , Cesarean Section , Cohort Studies , Discrimination, Psychological , Early Intervention, Educational , Erythrocytes , Female , Humans , Logistic Models , Maternal Age , Nomograms , Placenta Previa , Placenta , Placentation , Postpartum Hemorrhage , Pregnancy , ROC Curve , Ultrasonography
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