Transabdominal Ultrasound Examination Research Articles

Nonalcoholic fatty liver disease, serum cytokines, and dementia among rural-dwelling older adults in China: Apopulation-based study.

Little is known about whether nonalcoholic fatty liver disease (NAFLD) is associated with dementia or the role of serum proinflammatory cytokines in the association. We aimed to investigate the interrelationships of NAFLD, serum cytokines, and dementia among rural-dwelling older adults. This population-based cross-sectional study included 5129 participants (aged ≥60 years; 61.79% women) who were living in rural communities and examined in March 2018-September 2018. NAFLD was defined through transabdominal ultrasound examination in the absence of hepatitis B or excessive alcohol consumption. Serum cytokines were measured in a subsample (n=1686). Dementia, Alzheimer disease (AD), and vascular dementia (VaD) were diagnosed following international criteria. Data were analyzed with logistic regression and mediation models. Of the 5129 participants, 455 (8.87%) were detected with moderate-to-severe NAFLD, and 292 (5.69%) were diagnosed with dementia (188 with AD and 96 with VaD). The multivariable adjusted odds ratios associated with moderate-to-severe (vs. no-to-mild) NAFLD were 2.22 (95% confidence interval [CI] = 1.41-3.49) for all-cause dementia, 1.88 (95% CI=1.01-3.50) for AD, and 2.62 (95% CI=1.33-5.17) for VaD. In the cytokine subsample, controlling for multiple potential confounders, moderate-to-severe NAFLD was significantly associated with higher levels of serum monocyte chemotactic protein-1, interleukin-17A, interleukin-6 (IL-6), interleukin-8, and tumor necrosis factor-α (P < 0.05). The mediation analysis showed that IL-6 mediated 12.56% of the association between NAFLD and VaD. Moderate-to-severe nonalcoholic fatty liver disease is associated with dementia and AD, especially with VaD, among rural-dwelling Chinese older adults, in which the association with VaD is partly mediated by serum inflammatory cytokines.

Measurement of the vaginal wall thickness by transabdominal and transvaginal ultrasound of women with vaginal laxity: a cross-sectional study.

An objective diagnostic method to understand vaginal laxity (VL) is still missing. The aim of our study is to determine whether vaginal wall thickness (VWT) measured by ultrasound may differ according to the abdominal or vaginal techniques and to assess whether clinical variables are associated with vaginal measurements of women with VL. A cross-sectional study conducted at a tertiary hospital included 82 women aged ≥ 18 years with VL complaints assessed by the Vaginal Laxity Questionnaire. Women who reported severe comorbidities or vulvovaginal disorders, previous treatment for VL, and use of vaginal estrogen in the last 6 months were excluded. Participants reporting VL underwent transabdominal (TAUS) and transvaginal ultrasound (TVUS) and physical examination and answered validated questionnaires. Descriptive data were given as mean and standard deviation, median (range), and absolute and relative frequency. The significance level adopted for this study was 5%. Sample size calculation was not performed for the present study. Mean age was 41.20 ± 8.64 years, and most participants were multiparous, with previous vaginal delivery and having vaginal intercourse. A statistically significant difference (up to 3 mm) between TAUS and TVUS measurements of the VWT was found in the proximal, middle-third, and distal compartments. A significant correlation was found between VWT and TAUS or TVUS in the mid-third and distal compartments. A significant correlation was found between the VWT measurements in TVUS and TAUS. Our findings might give the health professional more possibilities for investigating VWT according to patient characteristics.

Unilateral Kidney Agenesis and other Kidney Anomalies in Infertile Men with Congenital Bilateral Absence of Vas deferens: A Cross-Sectional Study.

Background:We aim to determine the prevalence of renal anomalies in patients with congenital vas deferens agenesis referred for infertility assessment.Materials and Methods:This cross-sectional study was carried out on eligible infertile men from 2016 to 2019. Infertile men who were suspected of obstructive azoospermia were referred to the Ultrasound ward and they were examined by abdominal ultrasound for detecting the genital and kidney anomalies. An informed consent form was filled out by patients. Data was entered into SPSS software 21. Patients were divided into two groups in terms of congenital bilateral absence of vas deferens (CBAVD) or congenital unilateral absence of the vas deferens (CUAVD). Using the Chi-square test kidney anomalies between groups were compared. The P<0.05 was considered significant.Results:The mean age of participants was 33.05 ± 6.35. The frequency of CBAVD was 66 and the frequency of left side VD and right side VD were 23 and 21, respectively. The percentage of other comorbidities was calculated. Out of 110 cases, 12 (11%) men had coexistence of vas deferens and kidney agenesis. Other studies are in agreement with our findings. Although the percentage of CBAVD and CUAVD were 9.1% and 1.8% respectively, the difference was not significant (P=0.07).Conclusion:Considering the fact that kidney agenesis is a remarkable congenital anomaly that coexists with the majority of vas deferens agenesis cases and could not be detected by routine laboratory tests or transrectal ultrasound examination, it should be ruled out with transabdominal ultrasound examination after detection of vas deferens agenesis.

Transabdominal ultrasound diagnostics of intestinal tumor diseases in adults

Oncological diseases account for the largest share of all diseases of the colon, making up to 45% of all intestinal diseases. The colorectal cancer incidence is increasing every year in almost all countries, including Ukraine. Usually the endoscopic methods of examination and X-ray diagnostics play a key role in colon pathology diagnostics. Transabdominal ultrasound examination was considered a poor method to diagnose a cancer of hollow organs due to the presence of gas in the intestine. The potential possibilities of this method in assessment of the intestinal diseases as well as in studying the prevalence of pathological changes beyond the intestinal wall were underestimated. However, the development of ultrasound devices with high resolution determines the increasing use of transabdominal ultrasound examination to diagnose diseases of the gastrointestinal tract. The article is based on literature review as well as on authors’ own observations of ultrasound examination of benign and malignant diseases of the large intestine. The article goes on to analyze possibilities of transabdominal ultrasound diagnostics of pathological changes in the intestine. The results show that widespread use of ultrasound equipment, increasing the resolution of sensors can significantly complement the existing methods of colorectal cancer diagnostics. The use of transabdominal ultrasound examination in cases of colorectal cancer will allow to detect a colon cancer in the preclinical and mildly symptomatic stage, while excluding the influence of ionizing radiation.

УЛЬТРАЗВУКОВАЯ ДИАГНОСТИКА ХРОНИЧЕСКОГО ЗАПОРА У ДЕТЕЙ: РЕЗУЛЬТАТЫ КЛИНИЧЕСКОГО ИССЛЕДОВАНИЯ

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

RARE CASE OF PULMONARY SEQUESTRATION DIAGNOSED ANTENATALLY.

Iind trimester anomaly scans play a vital role in identifying the anatomical abnormalities in the fetus and thus help in planning and prognosis of pregnancy. Pulmonary sequestration is an not a common condition in which a separate lung tissue is formed, which is not a anatomical structures of the lung tissue, not its blood supply, neither perform any function also. A 26 years old mother, visited our department for routine anomaly scan. Transabdominal ultrasound examination revealed a well-dened echogenic mass seen just below the left hemidiaphragm which showed vascular supply directly from the aorta. This conrmed our diagnosis of pulmonary sequestration. We further evaluated with Fetal MRI which showed T2 high signal and T1 iso signal mass, suspicion of sequestration and esophageal duplication cyst was considered. The pregnancy was carefully followed by serial scans and a male baby delivered without any complications. Postnatally abdominal ultrasonography performed showed echogenic mass seen below the left diagram which showed feeding artery from the aorta.

Combined urogenital abnormalities of development and the formation of reproductive health in girls

BACKGROUND.Anomalies in the development of the uterus and vagina in some cases are combined with defects of the urinary tract. Therefore, the analysis of clinical situations associated with combined urogenital pathology in girls is of current and practical importance.THE AIM:to assess the state of reproductive health in girls with reproductive anomalies, renal agenesis, and other diseases of the urinary tract.PATIENTS AND METHODS.The study was conducted in 5 adolescent girls, including 3 patients with kidney agenesis, 1 patient with dysmetabolic nephropathy and nephroptosis, and 1 patient with recurrent urinary tract infection. In the analysis of clinical cases, the anatomical and functional features of the reproductive system are presented.RESULTS.The first 3 clinical cases are associated with the presence of kidney agenesis in the girl. In 1 clinical case, the clinic of the Mayer-Rokitansky-Kuester-Hauser syndrome (SMRKH) type II, including aplasia of the uterus and vagina and renal malformation, is presented. In clinical case 2, it was shown that modern transabdominal ultrasound examination of the pelvic organs, similar to MRI, can reveal the Herlin-Werner-Wunderlich syndrome. Agenesis of the kidney is one of the manifestations of trisomy of 22 pairs of chromosomes, which was noted in a patient from 3 clinical cases. 4 clinical cases is associated with the fact that kidney pathology, including nephroptosis, dysmetabolic nephropathy, can be combined with impaired sexual development. In 5 clinical case, type I SMRCC was described in a patient with recurrent urinary tract infection.CONCLUSION.Congenital malformations of the female genital organs are a rare pathology that requires special attention. Due to insufficient data concerning the mechanism of development of malformations of the genitourinary system, this problem requires further detailed study.

Comparison of O-RADS, GI-RADS, and ADNEX for Diagnosis of Adnexal Masses: An External Validation Study Conducted by Junior Sonologists.

To externally validate the Ovarian-adnexal Reporting and Data System (O-RADS) and evaluate its performance in differentiating benign from malignant adnexal masses (AMs) compared with the Gynecologic Imaging Reporting and Data System (GI-RADS) and Assessment of Different NEoplasias in the adneXa (ADNEX). A retrospective analysis was performed on 734 cases from the Second Affiliated Hospital of Fujian Medical University. All patients underwent transvaginal or transabdominal ultrasound examination. Pathological diagnoses were obtained for all the included AMs. O-RADS, GI-RADS, and ADNEX were used to evaluate AMs by two sonologists, and the diagnostic efficacy of the three systems was analyzed and compared using pathology as the gold standard. We used the kappa index to evaluate the inter-reviewer agreement (IRA). A total of 734 AMs, including 564 benign masses, 69 borderline masses, and 101 malignant masses were included in this study. O-RADS (0.88) and GI-RADS (0.90) had lower sensitivity than ADNEX (0.95) (P < .05), and the PPV of O-RADS (0.98) was higher than that of ADNEX (0.96) (P < .05). These three systems showed good IRA. O-RADS, GI-RADS, and ADNEX showed little difference in diagnostic performance among resident sonologists. These three systems have their own characteristics and can be selected according to the type of center, access to patients' clinical data, or personal comfort.

Broad ligament hematoma after normal vaginal delivery: a rare case scenario

&lt;p class="abstract"&gt;Broad ligament hematoma is a very rare complication following normal vaginal delivery. This article reports broad ligament hematoma following normal vaginal delivery in a 25 years old para 2 still birth 1 woman after 3 hours of delivery. Based on clinical and transabdominal ultrasound examination broad ligament hematoma was diagnosed. She was on conservative management for 36 hours after confirming the diagnosis. Later, she developed symptoms of anemia and transabdominal ultrasound showed expanding hematoma and minimal hemoperitoneum. Surgical intervention decided and total hysterectomy was performed.&lt;/p&gt;

Transgastric Abdominal Ultrasonography in Anesthesia and Critical Care: Review and Proposed Approach.

The use of transesophageal echocardiography (TEE) in the operating room and intensive care unit can provide invaluable information on cardiac as well as abdominal organ structures and function. This approach may be particularly useful when the transabdominal ultrasound examination is not possible during intraoperative procedures or for anatomical reasons. This review explores the role of transgastric abdominal ultrasonography (TGAUS) in perioperative medicine. We describe several reported applications using 10 views that can be used in the diagnosis of relevant abdominal conditions associated with organ dysfunction and hemodynamic instability in the operating room and the intensive care unit.

Differentiation of cystic biliary atresia and choledochal cysts using prenatal ultrasonography.

PurposeThis study explored the performance of prenatal ultrasonography in the differential diagnosis of cystic biliary atresia (CBA) and choledochal cyst (CC).MethodsFetuses diagnosed with hepatic hilar cyst in the second trimester were included in this study. A series of prenatal ultrasound examinations were performed in the second and third trimesters. The diameter of the gallbladder (GB) and hepatic cyst were measured, as well as the wall thickness of the GB. The GB-cyst connection, visibility of the right hepatic artery (RHA), and other concomitant abnormalities were carefully evaluated. A neonatal transabdominal ultrasound examination was performed within 1 week after birth, and clinical data were followed up to 6 months after birth.ResultsBetween January 1, 2016 and January 31, 2020, 53 fetuses diagnosed with hepatic hilar cyst were recruited. Eight were excluded because they were lost to follow-up. Among the 45 cases included in this study, 10 were diagnosed with CBA and 35 with CC after birth. Statistically significant differences were found in GB width, wall thickness, change in GB width, change in cyst length, GB-cyst connection, and RHA visibility between the CBA and CC groups. GB width showed the best diagnostic performance with an area under the curve (AUC) of 0.899. The combination of GB width, GB wall thickness, and GB-cyst connection yielded a comparable AUC of 0.971.ConclusionThe GB should be carefully evaluated in fetuses with hepatic hilar cyst. Prenatal ultrasound findings could provide suggestive parameters for the differential diagnosis of CBA from CC.

Hyperthyroid Manifestation in Beta HCG Secreting Tumor

Background: Serum β-Human Chorionic Gonadotropin (HCG) levels can be increased not only in pregnancy but also in various malignancies such as germ cell malignancy, lung cancer, ovarian cancer, and breast cancer. The alpha subunit of HCG and TSH are homologous, so β-HCG can cross-react with the TSH receptors and induce hyperthyroidism. High level of β-HCG serum can lead to hyperthyroidism, which can aggravate the patient’s malignant manifestations. Case Presentation: A 33-year old woman admitted to our hospital with chief complaint general weakness one week before admission. The patient was 8 week-pregnant and the transabdominal ultrasound showed a gestational sac and she had also a positive urine β-HCG test. The patient had slight vaginal bleeding 1 month ago. The physical examination revealed tachycardia, pale conjunctiva, and multiple nodules in both breasts. On laboratory examination, we found low level of Hb 6.7 (n 11.7 - 15.5 g/dl), serum iron 18 (n 65 - 175 mg/dL), TIBC 164 (n 253 - 435 mg/dL), and ferritin 1971(n 4.63-204 mg/dL), positive urine β-HCG, potassium 2.5 (n 3.1 - 5.1 mmol/L). On transvaginal and transabdominal ultrasound examination, there was no gestational sac in the uterine cavity and there are no abnormalities in other gynecology organs. The chest X-ray showed a nodule in the upper right lung suggestive of metastasis with thickening of the soft tissue of the left mammary region suggestive of a left breast mass. We also found a consistent positive result of urine β-HCG, though it had passed four weeks after the occurrence of vaginal bleeding. Finally, the serum β-HCG examination was carried out and showed an increased result, 290,398 (n <5 mIU/ml). The chest CT showed a heterogeny mass (mixed iso-dense and hypodense) that enhanced contrast on the inferior lobe of left lung (4.1 cm x 12.1 cm x 14.1 cm), a mass on apical segment of right lung, subpleural nodule, a mass on the right kidney, spleen, and mediastinal lymphadenopathy. The patient had packed red cell transfusion and after the Hb level reached 11 mg/dl, she still had tachycardia, so we examined the TSHs level. TSHs was found to be low at 0.014 (n 0.48-4.17 mg/dL), and FT4 increased to 2.82 (n 0.89-1.76 mg/dL). Thyroid ultrasound showed small simple cysts in both inferior thyroid pools, no solid mass and no increased vascular flow to the thyroid parenchyma. The patient was then thought to have hyperthyroid manifestation due to β-HCG secreting tumor. She was had methimazole and propranolol therapy, and a lung biopsy was planned. Conclusion: Trophoblastic and non-trophoblastic tumors that secrete high level of β-HCG can induce hyperthyroid manifestations, particularly if the level was more than 20,000 mIU/mL

Oxytocin increases pregnancy rates after fixed time artificial insemination in Kazak ewes.

It is probable that reduced pregnancy rates in ewes after fixed time artificial insemination (FTAI) is attributable, in part, to the reduced number of normal spermatozoa that colonize the oviduct. Administration of oxytocin stimulates both cervical dilation and uterine/oviductal contractility. The hypothesis that oxytocin can enhance sperm transport into the uteri and the oviducts, and thereby increase pregnancy rates, was tested in the present study. Oestrus was synchronized in 199 multiparous Kazak ewes using intravaginal flurogestone-impregnated sponge. The sponge was left in the vagina for 12days followed with an injection of 330IU of eCG at sponge removal. Each ewe was intracervically inseminated twice at 50hr and 62hr after the removal of sponges using an insemination catheter containing 0.25ml of diluted semen. Semen was collected from seven Texel rams and all the ejaculates were pooled and diluted in ultra-high temperature-treated commercial skimmed milk without (Control group, 0.05ml of saline per mL milk, n=144) or with oxytocin supplement (Oxytocin group, 0.5U of oxytocin per ml milk, n=55). Pregnancy status was determined by transabdominal ultrasound examination 45days after insemination. Lambing performance was recorded at delivery. Significant differences were observed between the Oxytocin group and the Control group in terms of the pregnancy rate and the fecundity rate (85.5% and 92.7% versus 68.8% and 72.9%, respectively). In conclusion, low dose oxytocin supplementation of semen extender significantly increased pregnancy and fecundity rates in oestrus-synchronized Kazak ewes after FTAI.

Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice— Results From an International Survey

Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice— Results From an International Survey

In utero exposure to maternal stressful life events and risk of polycystic ovary syndrome in the offspring: The Raine Study

BackgroundPCOS is the most common endocrine disorder in reproductive age women. The origins of PCOS are unknown but experimental and limited human evidence suggests that greater prenatal exposure to androgens may predispose to PCOS. Experimental evidence suggests that maternal stressors may affect reproductive function in the offspring via changes in prenatal androgen exposure. In this present study, we aim to investigate whether maternal stressful life events during pregnancy are associated with polycystic ovary morphology (PCOM) or polycystic ovary syndrome (PCOS) in adolescent offspring. MethodIn a large population-based pregnancy cohort study (The Raine Study) continuously followed from prenatal life through to adolescence we examined the association between maternal stressful life events during pregnancy in both early and late gestation, and subsequent circulating concentrations of ovarian and adrenal androgens, PCOM and PCOS in the normal menstrual cycle of offspring age 14–16 years. Maternal stressful life events were prospectively recorded during pregnancy at 18 and 34 weeks using a 10-point questionnaire. Female offspring (n = 223) completed a questionnaire about their menstrual cycles, underwent a clinical examination for hirsutism (Ferriman-Gallwey score) and transabdominal pelvic ultrasound examination to determine ovarian morphology according to standardized criteria for classification of PCOM. Plasma samples were obtained at day 2–6 of the normal menstrual cycle for measurement of androgens. PCOM was defined according to the international consensus definition, 2003 and the evidence-based guideline for the assessment and management of PCOS, 2018. PCOS was diagnosed according to Rotterdam criteria and National Institute of Health (NIH) criteria. Multivariate linear and logistic regression analyses were used to examine the associations between maternal stressful life event exposure and ovarian morphology (PCOM), circulating ovarian and adrenal androgens (clinical and biochemical hyperandrogenism (hirsutism)) and presence of PCOS. ResultsOf 223 recruited adolescent girls, 78 (35.9%) and 68 (31.3%) had PCOM by the 2003 and 2018 criteria respectively, while 66 (29.6%) and 37 (16.6%) had PCOS, using Rotterdam and NIH criteria, respectively. Most girls (141/223, 63.2%) were exposed to at least one stressful life event in early gestation and around half (121/223, 54.3%) were exposed to at least one stressful life event in late gestation. Maternal stressful life events in early gestation were associated with a statistically significant lower prevalence of PCOM when applying the 2003 criteria [adjusted odds ratio [aOR] and 95% confidence intervals (CI): 0.74 (95% CI: 0.55; 0.99)], and a similar association was detected when applying the 2018 PCOM criteria (aOR, 0.69, 95% CI: 0.50; 0.95)]. Maternal stressful life events in early gestation were also associated with lower circulating concentrations of testosterone (β = −0.05, 95% CI: −0.09; −0.004) and androstenedione (β = −0.05, 95% CI: −0.10; −0.002) in the offspring. No similar effects for PCOM or circulating androgens were detected in late gestation. No statistically significant associations between maternal stressful life events in early or late gestation with PCOS (neither Rotterdam nor NIH criteria) in adolescence were detected. The prospective collection of maternal stressful life events during both early and late gestation and direct measurement of PCOM, PCOS and circulating androgens in adolescence and key co-variates implies minimal possibility of recall, information bias and selection bias. ConclusionMaternal exposure to stressful life events in early gestation is associated with significantly reduced circulating ovarian and adrenal androgen concentrations in adolescence (testosterone and androstenedione), and an indication of fewer cases of polycystic ovary morphology (PCOM) defined by the 2003 international consensus definition and by the 2018 international evidence-based guideline, but has no effect on polycystic ovary syndrome (PCOS), diagnosed using either Rotterdam or NIH criteria.

Prevalence and Clinical Significance of Factor V Leiden Mutation in Egyptian Preeclamptic Women

Background: Factor V [Leiden] mutation, also known as activated protein-C resistance, is the most common of the inherited thrombophilias. Aim of the work: The present study aimed to ass the prevalence of factor V Leiden mutation in a group of Egyptian pregnant women and its relation to maternal and neonatal outcomes. Patients and methods: The present prospective study included 130 preeclamptic women with a singleton pregnancy in the 3rd trimester. Blood samples were obtained for DNA analysis to assay factor V Leiden mutation. Transabdominal obstetric ultrasound examination was performed to confirm the fetal number, viability, presentation, estimated fetal weight, position & grade of the placenta, amount of liquor, biophysical profile, and gestational age. This was achieved through the measurements of the biparietal diameter, head circumference, abdominal circumference, and femur length. Flow velocity waveforms were obtained from each uterine artery. Results: Factor V Leiden [FVL] mutation was identified in 20 patients [15.4 %]. Comparison between women with FVL and women without revealed a significantly higher frequency of intrauterine growth restriction [IUGR], intrauterine fetal death [IUFD], small for gestational age [SGA], preterm labor, and intensive care unit [ICU] admission among women with FVL mutation. They also have a significantly higher frequency of abnormal Doppler findings, abruptio placenta, and placental infarction. Conclusion: The present study suggested that maternal and neonatal complications in PE patients may be related to FVL, abnormal uterine artery Doppler findings, and placental infarction.

Invasive Mole with Nephrotic Syndrome: A Case Report with Literature Review

Nephrotic syndrome(NS)associated with invasive mole (IM) is uncommon. In this report, we present a case of NS that developed from IM. A 22-year-old woman was admitted to our hospital because of left lower slightly abdominal pain with sparing vaginal bleeding and NS. Transabdominal ultrasound examination confirmed a regular shape, border clearance component with a typical honeycomb pattern in the left side of the uterus. The curettage was performed for her two times. A renal biopsy was performed and suggested minimal change disease (MCD). Interestingly, when the IM was removed, her NS was complete remission. We report the rare case to highlight the importance of considering that NS associated with IM should be kept in mind during management of a woman of childbearing age with renal involvement.

Administration of aromatase inhibitor MPV-2213ad to blue fox vixens (Vulpes lagopus) as a model for contraception in female dogs

The interest in non-surgical approaches to contraception and fertility control in female dogs has increased in recent years. In this study the effect of an aromatase inhibitor (finrozole) was evaluated in fur production animals, farmed blue fox vixens, as a model for contraception in bitches. A total of 80 vixens were divided into 4 groups, receiving orally placebo (A) or finrozole 0.5 mg/kg (B), 3.5 mg/kg (C) or 24.5 mg/kg (D) for 21 consecutive days beginning in the pre-ovulatory period of heat. Monitoring of the vixens included clinical signs of heat, measurement of vaginal electrical resistance (VER) as well as oestradiol and progesterone concentrations in plasma. The approximate relation of the start of treatment to ovulation varied from 11 days before to one day after ovulation provided that the LH peak occurred 0.5–2 days before the VER peak and ovulation was then estimated to occur 2 days after the LH peak. Seventy vixens were artificially inseminated within 8 h after a 50 Ω decline in vaginal electrical resistance was detected. Ten vixens were not inseminated. Pregnancy was confirmed by transabdominal ultrasound examination and birth of cubs was recorded. The pregnancy rates in the groups were 89.5% (A), 81.3% (B), 55.6% (C) and 52.9% (D). The average number of live born pups in the four groups was 9.4 (A), 7.0 (B), 5.8 (C), and 3.8 (D), respectively. No deleterious effects (for instance malformations) of finrozole on pups could be verified. The administration of finrozole did not have a significant effect on oestradiol parameters and VER values in vixens. Progesterone values were significantly higher in treatment groups compared with the placebo group. The results indicate that pregnancy could be avoided by finrozole provided that doses of ≥3.5 mg/kg were used and the treatment was initiated at least four days before the day of artificial insemination. This corresponds with two to six days before ovulation provided that the LH peak occurred 0.5–2 days before the VER peak and that ovulation then occurred in average 2 days after the LH peak.

Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer: A Method Description and Feasibility Study.

A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.

Prediction of latency interval of labour in preterm premature rupture of membranes by 2D ultrasound : Case control study

Introduction: PPROM occurs in 3% of pregnancies and is responsible for about 30% of preterm births. So, the prediction of latency interval is helpful to the patient and obstetrician to allow possible interventions and proper management.Aim: This study aimed to assess the relation between the myometrial thickness, cervical length, amniotic fluid index and membrane thickness (measured by transabdominal ultrasound) and latency interval of labor in cases of preterm premature rupture of membranes (PPROM).Patients and Methods: This was a case control study that was conducted at Al-zahraa University Hospital and Shebin El-Kom Teaching Hospital. One hundred pregnant women (28-34 weeks gestation) were divided into two groups: The first group (fifty cases of PPROM) and the second group (control group = fifty cases with no PPROM), they were subjected to routine transabdominal ultrasound examination to assess fetal biometry, amniotic fluid index, thickness of fetal membranes, cervical length, and the myometrial thickness in 4 areas (the lower uterine segment, mid-anterior uterine wall, uterine fundus, and posterior uterine wall).Results: The myometrial thickness of the anterior wall and LUS was significantly thinner, cervical length showed significant shortening, AFI was significantly decreased and the membrane thickness was significantly thicker in PPROM cases than in controls. The latency interval showed a significant inverse correlation with gestational age and a significant direct correlation with myometrial thickness, cervical length and AFI.Conclusion: There was a significant thinning in the anterior and LUS myometrial thickness in addition to shortening of cervical length, decrease in amniotic fluid index and increase in membrane thickness. Also, the myometrial thickness, the cervical length and the AFI were directly correlated with latency interval.