Serial Ultrasonographic Examinations Research Articles

Prenatal differential diagnosis of placental mesenchymal dysplasia and molar disease with coexistent live twin fetuses

Background: Numerous hypoechoic cysts in the placenta on prenatal ultrasonography with a live fetus may indicate twin pregnancy with a complete hydatidiform mole with a coexistent fetus, partial mole, confined placental mosaicism, or placental mesenchymal dysplasia (PMD). Ultrasonographic appearances of these are similar; however, the differential diagnosis should be made because maternal and fetal prognoses differ. Cases: We present two cases of twin pregnancies with numerous placental cystic lesions. The first case was a partial hydatidiform mole in monochorionic diamniotic twins with a diploid karyotype that underwent a spontaneous abortion at 20 gestational weeks. The second case was PMD in dichorionic diamniotic twins; live twin neonates were delivered at 34 gestational weeks. Emergency cesarean section delivery was performed due to severe preeclampsia and fetal growth restriction in twin A at 34 weeks of gestation. Conclusions: Numerous hypoechoic cysts in the placenta on prenatal ultrasonography with a normal live fetus warrants chromosomal analysis and serial ultrasonographic examination to differentiate between PMD and molar pregnancy with a coexisting normal fetus to avoid unnecessary termination.

A Comparative Study of an Anti-Thrombotic Small-Diameter Vascular Graft with Commercially Available e-PTFE Graft in a Porcine Carotid Model

Background:We have designed a reinforced drug-loaded vascular graft composed of polycaprolactone (PCL) and polydioxanone (PDO) via a combination of electrospinning/3D printing approaches. To evaluate its potential for clinical application, we compared the in vivo blood compatibility and performance of PCL/PDO + 10%DY grafts doped with an antithrombotic drug (dipyridamole) with a commercial expanded polytetrafluoroethylene (e-PTFE) graft in a porcine model.Methods:A total of 10 pigs (weight: 25–35 kg) were used in this study. We made a new 5-mm graft with PCL/PDO composite nanofiber via the electrospinning technique. We simultaneously implanted a commercially available e-PTFE graft (n = 5) and our PCL/PDO + 10%DY graft (n = 5) into the carotid arteries of the pigs. No anticoagulant/antiplatelet agent was administered during the follow-up period, and ultrasonography was performed weekly to confirm the patency of the two grafts in vivo. Four weeks later, we explanted and compared the performance of the two grafts by histological analysis and scanning electron microscopy (SEM).Results:No complications, such as sweating on the graft or significant bleeding from the needle hole site, were seen in the PCL/PDO + 10%DY graft immediately after implantation. Serial ultrasonographic examination and immunohistochemical analysis demonstrated that PCL/PDO + 10%DY grafts showed normal physiological blood flow and minimal lumen reduction, and pulsed synchronously with the native artery at 4 weeks after implantation. However, all e-PTFE grafts occluded within the study period. The luminal surface of the PCL/PDO + 10%DY graft in the transitional zone was fully covered with endothelial cells as observed by SEM.Conclusion:The PCL/PDO + 10%DY graft was well tolerated, and no adverse tissue reaction was observed in porcine carotid models during the short-term follow-up. Colonization of the graft by host endothelial and smooth muscle cells coupled with substantial extracellular matrix production marked the regenerative capability. Thus, this material may be an ideal substitute for vascular reconstruction and bypass surgeries. Long-term observations will be necessary to determine the anti-thrombotic and remodeling potential of this device.

Efficacy of Serial Ultrasonographic Examinations in Predicting Return to Play in Agility Dogs with Shoulder Lameness.

Simple SummaryAgility dog is one of the most popular canine sports among pet owners, and agility-related soft tissue injuries are becoming frequent in dogs. The need to check the progression of shoulder tendon healing in order to permit a safe return to sport is now urgent. The aim of the present study was to help veterinary sports medicine professionals check the progression of shoulder tendon healing in lesions that have been treated with a standardised physiotherapeutic program. The results showed that ultrasonographic examination could be considered a reliable method of following the progression of healing of shoulder tendon lesions when carried out every two months within the six months after injury, together with the administration of a standardised physiotherapeutic program. The ultrasonographic protocol should be associated with a clinical evaluation in order to give the correct return to play time to the owners.The aim of this study is to investigate the use of shoulder ultrasound as a method of predicting the likelihood of returning to competition in agility dogs with shoulder teno-muscular injuries after a standardised rehabilitation protocol. Thirty-two agility dogs with a clinical and ultrasonographic diagnosis of shoulder teno-muscular injury were included in a prospective study with physical and ultrasound examinations at the time of diagnosis (T0) and at two (T2), four (T4) and six (T6) months; during this period, the dogs received rehabilitation treatments. The endpoint of the study was to obtain information regarding participation in agility competitions 12 months after diagnosis, based on telephone interviews with the owners. The clinical lameness score (CLS) and the ultrasound lesion score (ULS) were used as outcome measurements. The CLS indicated partial recovery from a shoulder injury at T2 (78%), while the ULS indicated no satisfactory recovery at T2 in any patient. At 4 months, the CLS alone was not a valuable predictor of full recovery from a shoulder injury in agility dogs. Relative Risk indicated that, at T2, ultrasound was 23.8 times more valuable in identifying a shoulder lesion as compared to clinical lameness score (CLS), and it was 2.53 times more valuable at T4.

Multicenter evaluation of decompressive cystocentesis in the treatment of cats with urethral obstruction.

To investigate whether decompressive cystocentesis (DC) safely facilitates urethral catheterization (UC) in cats with urethral obstruction (UO). 88 male cats with UO. Cats were randomly assigned to receive DC prior to UC (ie, DC group cats; n = 44) or UC only (ie, UC group cats; 44). Abdominal effusion was monitored by serial ultrasonographic examination of the urinary bladder before DC and UC or before UC (DC and UC group cats, respectively), immediately after UC, and 4 hours after UC. Total abdominal effusion score at each time point ranged from 0 (no effusion) to 16 (extensive effusion). Ease of UC (score, 0 [easy passage] to 4 [unable to pass]), time to place urinary catheter, and adverse events were recorded. No significant difference was found in median time to place the urinary catheter in UC group cats (132 seconds), compared with DC group cats (120 seconds). Median score for ease of UC was not significantly different between UC group cats (score, 1; range, 0 to 3) and DC group cats (score, 1; range, 0 to 4). Median change in total abdominal effusion score from before UC and DC to immediately after UC was 0 and nonsignificant in UC group cats (range, -5 to 12) and DC group cats (range, -4 to 8). Median change in effusion score from immediately after UC to 4 hours after UC was not significantly different between UC group cats (score, -1; range, -9 to 5) and DC group cats (score, -1; range, -7 to 5). DC did not improve time to place the urinary catheter or ease of UC in cats with UO.

THE EFFECT OF TRANEXAMIC ACID, CARBETOCIN AND ARGON PLASMA COAGULATION ON UTERINE INVOLUTION AFTER REPEAT CESAREAN SECTION

Repeat cesarean sections (CS) are associated with additional risks of perioperative complications. The aim of our study was ultrasound evaluation of uterine involution in women after repeat traditional cesarean delivery and after repeat CS using argon plasma coagulation and prophylactic use of tranexamic acid and carbetocin. Materials and methods. Prospective cohort study has been conducted on 140 patients who underwent second CS. Group I included 70 women who had repeat CS with the use of argon plasma coagulation and administration of 100 mcg carbetocin after cutting the umbilical cord. Ten minutes before the operation, 15 mg/kg of tranexamic acid was injected intravenously. Group II consisted of 70 women who had traditional CS, 10 IU dose of oxytocin, divided between 5 UI intravenous bolus dose and slow intravenous infusion, was administered after delivery of the baby. A serial ultrasonographic examination was carried out on the 2nd and 5th day of the postpartum period. Results. A study of the dynamics of changes in uterine body and uterine cavity volume revealed a faster rate of uterine cavity involution in group I compared with group II (p<0.05). In group I on the 5th day in comparison to the 2nd day the mean uterine body volume decreased by 27.75%, in group II – by 20.17%. In group I mean uterine cavity volume declined in three days by 21.09%, in group II – 14.22%. Uterine subinvolution was diagnosed in 3 (4,29%) cases in group I and in 19 (27,14%) cases in group II (p<0.05). Faster uterine involution in group I is probably associated with techniques, that were applied during intraoperative period. In addition, 2.86% (2 cases) from the group I versus 31.43% (22 cases) from the group II, needed additional uterotonic therapy after surgery (methylergometrine, misoprostol) (p<0.001). Conclusion. We have found differences in the course of uterine involution in women in group I in comparison with group II, such as significantly smaller uterine length on the 2nd and 5th day, significantly smaller uterine body and uterine cavity volume, faster rates of involution of the uterine cavity during the first 5 days of the postpartum period, thinner anterior uterine wall in the sutured area. We therefore conclude that complex use of tranexamic acid, carbetocin and argon plasma coagulation appears to be effective to maintain adequate uterine involution after repeat CS and prevent postoperative complications.

Ultrasonographic features and prevalence of presumed gastric wall edema in dogs with hypoalbuminemia.

BackgroundUltrasonographic features of gastric wall edema have not been reported in dogs with hypoalbuminemia.ObjectivesTo describe the prevalence and ultrasonographic features of gastric wall thickening in dogs with hypoalbuminemia and analyze correlation with serum albumin concentrations.AnimalsForty‐two dogs with abdominal ultrasound and diagnosis of hypoalbuminemia (<2.3 g/dL).MethodsRetrospective search in the medical records from 2018 to 2019 was performed. Ultrasound studies were reviewed and >5 mm were considered gastric wall thickening. The gastric wall changes such as thickness, layering appearance, echogenicity, echotexture, distribution of lesions, and presence of peritoneal effusion were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available. Mean serum albumin concentration of dogs with and without gastric wall thickening was compared.ResultsPrevalence of gastric wall thickening in dogs with hypoalbuminemia was 21.4% (95% confidence intervals 7.4‐35.4%). Mean gastric wall thickness was 10.0 ± 2.0 mm. Preserved mucosal layer and thickening of submucosal layer were observed in all 9 dogs. Five dogs had 3‐layer appearance in thickened submucosal layer. Diffuse wall thickening was observed in 6 dogs. All 9 dogs had peritoneal effusion. Subsequent changes of gastric wall thickening were observed in 3 dogs (range 4‐70 days). Gastric wall edema was confirmed histopathologically in 2 dogs via necropsy. There was no correlation between serum albumin concentration of the dogs and gastric wall thickness.Conclusions and clinical importanceFindings indicated that gastric wall edema is a common finding in dogs with hypoalbuminemia. However, serum albumin concentrations did not correlate with the gastric wall thickness.

Longitudinal study of individually adjusted fetal growth.

To construct individualized fetal growth curves estimated by ultrasound parameters adjusted for maternal and fetal characteristics. Data were retrospectively assessed from serial ultrasonographic examinations of singleton pregnancies at 12-42 gestational weeks among women without maternal or fetal conditions and full-term delivery at the University Hospital of University of São Paulo between July 1, 2014, and December 31, 2017. Measurements included biparietal diameter, head circumference, abdominal circumference, and femur length. Mixed linear regression was used to model the ultrasound biometric parameters as a function of gestational age, parity, maternal height, pre-pregnancy weight, and fetal sex. In total, data were assessed from 1445 examinations of 434 pregnancies meeting the inclusion criteria. The estimated fetal weight model included gestational age, fetal sex, maternal height, and pre-pregnancy body mass index as covariates. The model enabled the construction of individual estimated fetal weight curves with respective percentiles covering 12-42 gestational weeks using maternal and fetal characteristics. The growth curves, which are based on a sample of the Brazilian population with low risk of maternal or fetal morbidity and mortality, will make it possible to determine whether a fetus is achieving ideal growth potential according to maternal and fetal characteristics.

Ultrasonographic features of presumed gastric wall edema in 14 dogs with pancreatitis.

BackgroundGastric wall edema has not been reported as a complication of acute pancreatitis in dogs.ObjectiveTo describe the ultrasonographic features of gastric wall thickening in dogs with acute pancreatitis.AnimalsFourteen dogs with ultrasonographic evidence and clinical diagnosis of acute pancreatitis, with ultrasonographic evidence of increased gastric wall thickness (>5 mm).MethodsA retrospective search in the medical records from 2014 to 2016 was performed to identify dogs that had ultrasonographic evidence of acute pancreatitis, that had increased thickness of the gastric wall and that were diagnosed with acute pancreatitis clinically. The gastric wall changes such as thickness, layering appearance, echogenicity, distribution of lesions, and perigastric changes were recorded. Serial ultrasonographic examination and histopathological findings were recorded if available.ResultsMean gastric wall thickness was 9.9 ± 4.0 mm (SD). A complete loss of wall layering was observed in 2 dogs. Thickening of the submucosal layer was observed in 12 dogs, and 5 of them had concurrent muscularis layer thickening. The echogenicity of thickened submucosal layer was intermediate hyperechoic. Lacy appearances were present within the thickened submucosal layer in 7 dogs and in the muscularis layer of 1 dog. Thickening was focal in 12 dogs and adjacent to the diseased pancreas. Subsequent resolution of gastric wall thickening was observed in 3 dogs (range 3‐28 days) via follow‐up ultrasound. One dog underwent necropsy, and gastric wall edema was confirmed histopathologically.Conclusions and Clinical ImportanceFindings indicated that gastric wall thickening presumably because of edema could be a complication of acute pancreatitis.

Development of specific fetometric formulas of ICC and BP for predicting the parturition date in Maine Coon queens.

The objective of study was to derive specific growth curves of ICC and BP for Maine Coon. Twenty-three pregnant queens aged 1-6years, with body weight of 4.5-7.6kg, were included in the study. In each queen, serial ultrasonographic examinations of pregnancy were performed through the abdomen with the MyLab Gold Vet scanner with a 6.6-7.5MHz microconvex probe (Turin, Italy). ICC or BP was measured, depending on the stage of pregnancy. Each examination was regarded as a separate observation. In 18 queens, ICC was measured 33 times, and in 21 queens, BP was measured 60 times. The linear regressions of specific models of ICC and BP in Maine Coon pregnancies and specific formulas for predicting the parturition date in this breed were derived. The ICC formula was: days before parturition (DBP)=-0.79*mm+57.9, and the BP formula was: DBP=-1.86*mm+49.3. The proposed fetometric formulas of ICC and BP for Maine Coons after application in clinical patients can improve obstetric management in this breed.

Development of superficial lung lesions monitored on farm by serial ultrasonographic examination in sheep with lesions confirmed as ovine pulmonary adenocarcinoma at necropsy

BackgroundThis ultrasonographic study monitored lesions involving the lung surface suspected to be the early stages of ovine pulmonary adenocarcinoma (OPA) tumours over 4 months in commercially farmed sheep. The enlargement of these lesions defined ultrasonographically, which likely represent the development of OPA tumours, have important implications for ultrasound screening schedules in veterinary management plans attempting to eliminate OPA by test-and-cull.ResultsThe lungs of 58 adult Scottish Blackface sheep with ultrasonographic changes at the lung surface consistent with early OPA tumours were examined two to six times over 40 to 290 days. Lesion development, represented in early video recordings by 2–3 mm lesions involving the visceral pleural and comet tails, then a decreasing length of the hyperechoic line representing the normal visceral pleura and increasing depth of the sharply-demarcated and largely uniform hypoechoic areas into the lung parenchyma, was found in 26 of the 58 sheep. The rate at which the sonographic lesions progressed varied considerably and in 10 of 17 Group 1 sheep developed quickly from an estimated depth of 2–30 mm up to 70 mm between 60 and 120 days later. These sonographic lesions were confirmed as OPA at necropsy; histological changes of concurrent bacterial infection were detected in one of these 10 Group 1 sheep. Thirty-one sheep had sonographic changes ≤30 mm consistent with very early OPA at the first examination which had reduced or were not observed at subsequent examination. Five of these 31 sheep were necropsied, 3 had small OPA lesions while 2 had no significant pathology.ConclusionLesions involving the visceral pleura, with sonographic changes consistent with previous published findings of early OPA, developed over 40–120 days to large masses in 10 of 17 Group 1 sheep with the provisional sonographic diagnosis confirmed histologically at necropsy. While it is possible that atalectic lung could have caused some of the minor sonographic changes there was no microscopic evidence of pathologies other than OPA in nine of 10 Group 1 sheep. We conclude that some small tumours progress to large tumours within 3 months questioning the assumption that OPA is a slow growing tumour in adult sheep taking several years to cause clinical disease. The findings that a proportion of small ultrasonographic lesions are not found again at subsequent scanning illustrates the challenges of interpreting small (< 1–2 cm) lesions during rapid whole flock ultrasonographic examination and we continue to recommend re-scanning suspicious sonographic changes 2 months later.

Specific fetometric formulas of ICC and BP for calculating the parturition date in the miniature breeds of canine.

The aim of this study was to derive the growth curves of the inner chorionic cavity and the biparietal distance in miniature dog breeds by ultrasonographic fetometry and present new specific formulas for prediction of parturition date. In this study, foetal biometry parameters were obtained using serial ultrasonographic examinations in 24 pregnant bitches of six different miniature breeds (≤5kg). The mating time was unknown. Overall, 25 inner chorionic cavity diameter (ICC) and 22 biparietal diameter (BP) measurements were taken. The relationship between ICC or BP growth and days to parturition was analysed by linear regression. The results showed a significant relationship between days before delivery and ICC or BP. The equations derived from the growth curves can be used in practical prediction of parturition date in miniature dog breeds.

Causes and Management of Ovarian Cysts

An ovarian cyst is a sac filled with liquid or semiliquid material that arises in an ovary. While the discovery of an ovarian cyst causes considerable anxiety in women owing to fears of malignancy, the vast majority of these lesions are benign. Most patients with ovarian cysts are asymptomatic, with the cysts being discovered incidentally during ultrasonography or routine pelvic examination. Some cysts, however, may be associated with a range of symptoms, sometimes severe. Many patients with simple ovarian cysts found through ultrasonographic examination do not necessitate treatment. In a postmenopausal patient, a persistent simple cyst smaller than 10 cm in dimension in the presence of a normal CA125 value may be monitored with serial ultrasonographic examinations. When ovarian cysts are large, persistent, painful or have concerning radiographic or exam findings, surgery may be required, sometimes resulting in removal of the ovary. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane database of systematic reviews and Cochrane central register of controlled trials from January 1, 1995, through January 1, 2017.

A thoracic duct cyst in 10-year-old boy: The youngest case report and review of the literature

We report the youngest case with a thoracic duct cyst located just above the diaphragm that was treated with thoracoscopic resection. The cyst was observed with serial ultrasonographic examinations during his prenatal period. No interval evidence of a deleterious effect to the fetus by this cyst was observed and born by normal vaginal delivery at term. Although the boy remained clinically asymptomatic at the age of ten, surgical excision for definitive diagnosis of the cyst was undertaken. The mediastinal cyst contained milky-white chylous fluid. Pathologically, the wall was similar in structure to the thoracic duct. The mediastinal thoracic duct cyst is an extremely rare cystic lesion. The etiology may be related to a congenital or degenerative weakness in the wall of the thoracic duct. They are generally asymptomatic but may sometimes cause pressure effects on adjacent structures. Surgical resection is the treatment of choice. The thoracoscopic resection is especially advisable for the patient with a small, asymptomatic cyst. Chylothorax is the most common postoperative complication. To avoid chylothorax after the resection of a mediastinal thoracic duct cyst, identification of the communication of the cyst with thoracic duct and ligation of its inferior pedicle without fail is necessary.

Characterization of the estrous cycle of Asinina de Miranda jennies (Equus asinus)

This study aims to characterize the estrous cycle of Asinina de Miranda jennies in the breeding season, on the basis of data collected from serial ultrasonographic examination and serum progesterone determinations in 14 females during a total of 33 cycles. The length of the interovulatory interval was 23.8 ± 0.55 days, the diestrus and estrus lasting 17.9 ± 0.46 days and 6.65 ± 0.30 days, respectively. Age and body condition score (BCS) affected the length of the interovulatory intervals; BCS also influenced the diestrus length and the time in heat after ovulation (P > 0.05). The incidence of single, double, and triple ovulations was 57.58%, 36.36%, and 6.06%, respectively. Multiple ovulations affected neither the length of the interovulatory interval nor the individual cycle stages (P > 0.05) but lengthened the interval from the beginning of estrus to the last ovulation (P = 0.01). When combined with age, higher BCS affected the ovulation rate (P = 0.001). Deviation of the dominant follicle occurred around Day 8.7 (Day 0 = ovulation) when both single and multiple ovulations were considered. The dominant follicle was larger at divergence in single ovulators (19.18 ± 0.97 mm) compared with that in multiple ovulators (18.05 ± 1.16 mm). The overall maximum follicular diameter before ovulation was smaller in multiple ovulatory cycles than that in single ovulatory cycles (37.2 ± 0.83 mm vs. 40.2 ± 1.41 mm, respectively; P = 0.03). The daily growth rate of dominant follicles was independent of the ovulation rate (P > 0.05) for the intervals before and after the estrus onset. The dominant follicle size and the follicle growth rates were independent of BCS (P > 0.05). Data collected in this study revealed resemblances between Mirandese and other Iberian and Brazilian breeds with regard to estrous cycle characteristics.

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Background/Aims: To evaluate the diagnostic accuracy of fetal thymus transverse diameter (FTTD) in predicting fetal infection in preterm premature rupture of membranes (PPROM) and compare its accuracy with cord blood tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Methods: Forty consecutive pregnancies complicated with PPROM between 26^1/7 and 36^6/7 gestational weeks were evaluated prospectively. Serial fetal ultrasonography follow-ups with 3-day intervals were performed beginning on the admission day. The FTTD was recorded on every ultrasonographic examination. Cord blood TNF-α and IL-6 values were measured after delivery. Results: FTTD was decreased below 5% according to nomograms compared to the initial measurement in 45% of all PPROM cases. Decreased FTTD had a sensitivity of 100%, specificity of 73%, positive predictive value of 55%, and negative predictive value of 100% in predicting early neonatal sepsis. Cord blood TNF-α had a sensitivity of 80% and specificity of 90%, whereas IL-6 had a sensitivity of 90% and specificity of 63.3% in predicting early neonatal sepsis. Conclusions: Assessment of the decrease in FTTD by serial ultrasonographic examinations is a promising ‘prenatal' method for the early detection of early neonatal sepsis.

Carotid endarterectomy for asymptomatic carotid stenosis in the very elderly

The indication for carotid endarterectomy (CEA) is uncertain in patients with asymptomatic severe (≥60% luminal narrowing according to the North American Symptomatic Carotid Endarterectomy Trial criteria) carotid stenosis (ASCS), especially in the very elderly, because current evidence suggests that the risk of future stroke has been dropping in the past two decades owing to the recent advances in medical therapy. The aim of this observational study was to compare early and late outcomes in patients ≥80 years old with ASCS treated with CEA plus best medical treatment (BMT) or with BMT alone. From 2005 to 2012, 69 octogenarians with ASCS underwent CEA plus BMT (group 1), and another 54 received BMT alone (group 2). All operations were eversion CEAs. BMT included lipid-lowering drugs, new antiplatelet and antihypertensive agents, avoidance of smoking, careful blood pressure and glycemic control, and lifestyle changes. Follow-up with serial ultrasonographic examination was obtained in 118 patients for a median 4.4-year period. There were no perioperative (30-day) strokes or deaths and one transient ischemic attack (1.4%). One late minor stroke developed in a CEA patient (1.5%). No late restenoses or occlusions were detected. Five patients in group 2 (9.6%) became symptomatic (one transient ischemic attack and four minor strokes) and subsequently underwent successful CEA; all their carotid plaques were complicated by ulceration and intraplaque hemorrhage (with plaque progression in four cases), confirmed by computed tomography images. The rate of freedom from cerebral ischemic events at 5 years showed a significant benefit for elderly patients who had CEA vis-à-vis those who did not (98% vs 84%; P = .04), and so did the 5-year rate of freedom from ipsilateral carotid disease progression (100% vs 91%; P = .01). At 5 years, the mortality rate was comparable for elderly patients whether they had CEA or not (66% vs 68%; P = .65). CEA is a safe, effective, and durable treatment for ASCS in patients aged 80 years or more, carrying an insignificant perioperative stroke/death risk. CEA associated with BMT seems preferable to BMT alone in preventing the risk of ipsilateral ischemic events, without translating into a longer survival.

Ultrasonographic fetometry and prenatal fetal sex assessment in camels (Camelus dromedarius)

The aims of this study were to determine the developmental patterns of some fetal parts to achieve a high accuracy level in the assessment of gestational age and to assess the feasibility and accuracy of ultrasonic prenatal fetal sex assessment in camels. Serial ultrasonographic examinations were carried out on seven pregnant dromedary camels. A total of 329 ultrasonographic examinations were conducted between the second and the 54th weeks of pregnancy. Intrauterine fluid accumulation was detected between the second and third weeks of pregnancy. The embryo proper was noticed between the third and fourth weeks. Organization of the embryo was first observed between the sixth and seventh weeks. Ossification was first detected between the seventh and ninth weeks. The accessibility during the total gestational period was 35/329 (10.6%) for crown-rump length, 35/329 (10.6%) for biparietal diameter, 42/329 (12.8%) for abdominal diameter, 42/329 (12.8%) for ruminal length, and 126/329 (38.3%) for eyeball diameter. A high correlation was found between gestational age and each of the studied parameters (P < 0.0001). The highest correlation was found with the crown-rump length and the biparietal diameter during the first trimester and with the eyeball diameter during the third trimester of pregnancy. The overall accuracy of the ultrasonic prenatal fetal sex assessment was 91.7%. The best window was found during the 11th week of pregnancy. It was concluded that sonographic fetometry can be useful for the evaluation of fetal development, the estimation of gestational age, and the prediction of prenatal fetal sex in camels.

Ultrasonographic examination of the reticulum, rumen, omasum and abomasum during the first 100 days of life in calves

The goal of this study was to examine the development of the reticulum, rumen, omasum and abomasum in six calves from birth to 100days of age by means of six serial ultrasonographic examinations. The examinations were carried out in standing animals using a 5MHz-transducer as described previously. The calves were primarily fed milk until examination 4 and then they were weaned. The reticulum was assessed for its shape and contractility, the rumen for its size and content, the omasum for its size, content and motility and the abomasum for its size and content before and after the ingestion of milk. The reticulum was seen in all calves starting at examination 2 and had biphasic and triphasic contractions; the latter were associated with eructation. The rumen was always imaged in all calves as early as Day 1 and its visible size increased progressively in all intercostal spaces (ICSs) during the study period. The omasum was best imaged in the 8th or 9th ICS; it was seen medial to the liver dorsally and usually medial to small intestines ventrally. Its visible size in these two ICSs increased progressively but omasal motility was not apparent. In newborn calves the abomasum was the largest compartment and dominated the abdominal cavity. It was visible from the 5th ICS to the flank. Except for examination 2, the mean visible abomasal length was significantly larger after feeding than before. Lateral abomasal extension to the left was greater than to the right at examinations 1–4, but was much smaller than to the right at examinations 5 and 6 because of progressive expansion of the rumen. Abomasal extension into the right hemiabdomen changed little during the study period.

Gastrocnemius Tendon Strain in a Dog Treated With Autologous Mesenchymal Stem Cells and a Custom Orthosis

To report clinical findings and outcome in a dog with gastrocnemius tendon strain treated with autologous mesenchymal stem cells and a custom orthosis. Clinical report. A 4-year-old spayed female Border Collie. Bone-marrow derived, autologous mesenchymal stem cells were transplanted into the tendon core lesion. A custom, progressive, dynamic orthosis was fit to the tarsus. Serial orthopedic examinations and ultrasonography as well as long-term force-plate gait analysis were utilized for follow up. Lameness subjectively resolved and peak vertical force increased from 43% to 92% of the contralateral pelvic limb. Serial ultrasonographic examinations revealed improved but incomplete restoration of normal linear fiber pattern of the gastrocnemius tendon. Findings suggest that autologous mesenchymal stem cell transplantation with custom, progressive, dynamic orthosis may be a viable, minimally invasive technique for treatment of calcaneal tendon injuries in dogs.

Discordance in Pena–Shokeir phenotype/fetal akinesia deformation sequence in a monoamniotic twin

We here report the first case of discordant Pena-Shokeir phenotype observed in monoamniotic twins. A 34-year-old woman, pregnant with twins, was referred at 10 weeks' gestation because one of the twins had increased nuchal translucency. Serial ultrasonographic examinations suggested that twin A may have had several other abnormalities, including pleural effusion at 21 weeks' gestation, decreased movement and contracted limbs at 24 weeks, and fetal growth restriction at 26 weeks. No abnormalities were observed in twin B. At 34 weeks of gestation, the twins were delivered by cesarean section. There were cord entanglements, and although the resuscitation of twin A was attempted, it proved difficult due to lockjaw. Twin A died during the second hour of life, and autopsy findings were consistent with the diagnosis of Pena-Shokeir phenotype. We suggest that cord entanglement during early gestation is a possible cause for the occurrence of Pena-Shokeir phenotype through an anoxic-ischemic mechanism.