Ultrasonic Diagnosis Research Articles

Two Atypical Severe Cda Forms Presenting as Hydrops Foetalis Are Caused by Mutations in the SEC23B Gene.

Abstract 1981Poster Board I-1003Congenital dyserythropoietic anemias (CDAs) are a heterogeneous group of disorders characterized by ineffective erythropoiesis with prominent dysplastic features of the erythroid precursors in the bone marrow. Three main subtypes (I, II and III) have been identified, but several variants or atypical forms have been reported over the years. CDA are rarely associated with hydrops foetalis. In the past we described two cases presenting with hydrops foetalis and very severe anemia that were classified as atypical CDAs since they presented CDAII-like erythroblastic morphological features lacking other diagnostic CDAII markers. Very recently we and others (Bianchi et al, Human Mutat 2009, in press; Schwarz et al, Nat Genet 2009, in press) demonstrated that mutations in SEC23B gene, coding for a protein involved in the coat protein complex responsible for vesicle budding from the endoplasmic reticulum, cause CDA II. The aim of this work was to ascertain whether atypical CDAII-like forms presenting as hydrops foetalis could be caused by mutations in SEC23B gene and reclassified as CDAII. Two patients (Cantù-Rajnoldi et al, Br J Haematol 1997, 96: 530-3; Bianchi et al, Blood 1999, 94, suppl 1, 8b) from unrelated families with a history of intrauterine death of hydropic foetuses in previous pregnancies were referred at 20th week gestation following ultrasonic diagnosis of foetal hydrops and severe anemia (2.0 and 1.3 g/dL Hb respectively). In both cases intrauterine transfusions enabled the delivery of the babies. At birth both of them underwent extensive laboratory evaluation (including red cell metabolism and membrane proteins analysis) that was not informative on the causes of anemia. Ham test was repeatedly normal as for Western blotting analysis for GRP78 and glycoslylation pattern of red cell band 3. The bone marrow examination revealed the presence of 30 and 48% of bi- or multinucleated erythroblasts, some of whom presenting typical double outer membranes at transmission electron microscopy. Both babies became transfusion dependent. The 20 exons and intronic flanking regions of SEC23B gene were analyzed by direct sequencing. Both patients displayed mutations in SEC23B gene, in particular mutations c.325 G>A/ c.2101 C>T in patient 1 and c.325 G>A/ c.197G>A in patient 2 (Glu109Lys/ Arg701Cys and Glu109Lys/ Cys66Tyr respectively). c.325 G>A is the most frequent mutation so far described in CDAII and at homozygous level is usually associated with mild anemia. When found in compound heterozygosity with a second missense mutation as in these cases it may result in a very severe clinical pattern, although we cannot exclude that factors other than SEC23B mutations may contribute to worsening the clinical picture. In conclusion, SEC23B gene analysis allowed the correct classification of two very severe CDA cases associated with hydrops foetalis. This finding indicates that CDAII may result in intrauterine death and its frequency may therefore be underestimated. These cases may present as “atypical” for the lack of band3 hypoglycosylation likely due to the early sequestration of the more severely affected cells. Disclosures:No relevant conflicts of interest to declare.

초음파 탐지기의 효과적 활용을 위한 초음파 분석프로그램의 개발

휴대용 초음파 탐지기(Ultrasonic Detector)는 전기설비에서 발생하는 부분방전, 코로나, 아킹, 트래킹 등과 같은 전기적 방전현상 탐지에 매유 유용하다. 그러나 초음파 탐지기는 측정음의 특성을 사용자가 듣고 판정함으로써 주관적 반응에 의해 그 결과가 좌우되거나 정확히 판정하기 곤란하게 된다. 따라서 초음파 음의 특성을 구별할 수 있는 새로운 분석적 방법이 요구된다. 본 연구에서는 초음파 탐지기에 의해 측정된 코로나, 아킹, 트래킹의 초음파 음을 시각화 할 수 있는 초음파 분석프로그램을 개발하였다. 개발된 프로그램에 의한 분석적 방법을 사용함으로써 초음파 음의 특성에 의존하던 기존의 방식보다 초음파 진단결과의 정확성을 높일 수 있게 된다. Portable ultrasonic detectors are useful for detection of electrical discharge phenomena like as partial discharge, corona, arching and tracking occurring in an electric system. But the general potable ultrasonic detectors have drawbacks that the results are under the influence subjective reaction of users and it is difficult to determine the type of problem by listening to sound properties and estimate results. So a new analysis method distinguishing ultrasonic characteristics is required. This paper presented ultrasonic wave analysis program to visualize ultrasonic sound of corona, arching and tracking measured by ultrasonic detector. While depending on sound properties alone can be subjective, by incorporating analytical method using the developed program, users are able to increase the accuracy of their ultrasonic diagnosis results.

Experiences from ultrasonic diagnosis of fetal congenital cordis malformation

Objective To explore the diagnostic points and promote the checkout rate of fetal congenital cor-dis malformation. Method Analyzed the ultrasonic character by reviewing the fetal congenital cordis malformation from our hospital in recent 2 years. Result 3 cases was inaccuracy in the 28 cases of congenital cordis malformation diagnosed by antepartum. Diagnostic accuracy rate was 89.3%. Conclusion The inaccuracy was reduced greatly by gradual ultrasonic diagnosis by way of four cavity heart and three vas cross section, Key words: Heart defects,congenital; Echocar diography,doppler,color; Ultrasonography,prenatal

A numerical study of rough interface reverberation suppression, clutter elimination and target resonance excitation in heterogeneous media with single channel iterative time reversal.

The presence of echo returns from the rough interface of two layered medium, and the clutter of volume scattering hinders the detection of target buried in heterogeneous media. The situations are often raised in ultrasonic breast tumor diagnosis and underwater acoustic buried mine detection. This work investigates the application of monostatic single channel iterative time reversal in mitigating the difficulties with a numerical study. Simulations based on pseudospectral finite-difference time-domain method are performed with a sphere buried in the heterogeneous media of lower layer, a transmitter is situated at the upper homogeneous domain, and the interface position is normally distributed. A wideband signal is launched to initiate the process, and the time-reversed echo received at same position is emanated as renewed interrogation pulse for next iteration. Some field snapshots are taken and the echo is recorded in each iteration. The results illustrate as the number of iteration increases, small volume scattering is eliminated, and rough interface reverberation is suppressed relatively. The echoes will converge to a narrowband waveform corresponding to an object’s dominant resonance mode. The detection of target is achieved by exploiting this important acoustic signature. [Work supported by the CAS Innovation Fund.]

Value of contrast-enhanced ultrasound for differentiation between benign and malignant gallbladder diseases

Objective To investigate the clinical value of contrast-enhanced ultrasound in differ-entiation between benign and malignant gallbladder diseases. Methods Contrast-enhanced ultrasound was performed in eighty patients who were suspicious of gallbladder cancer by conventional ultra-sound. Final diagnosis proved that it was gallbladder cancers 33 patients and benign gallbladder disease in 47. Contrast agent SonoVue and low mechanical index imaging mode were applied. The contrast en-hancement characteristics of the initial enhancement time, the enhancement pattern and the integrality of gallbladder wall adjacent to lesions were analyzed. Meanwhile, the ability of differentiating diagno-sis between benign and malignant gallbladder diseases with contrast-enhanced ultrasound was investi-gated. Results The percentages of those lesions that exhibited hyper-enhancement or iso-enhancement in the early phase and turned to hypo-enhancement within 35s after contrast agent administration were 96.8 % (30/31) in gallbladder cancers and 19.5 % (8/41) in benign lesions(P<0. 001), and the mean time to be hypo-enhancement was (29.5 ± 9.8) s in gallbladder cancers and (58. 8±13.9) s in benign lesions (P<0. 001). Inhomogeneous enhancement was found in 26 (78. 8% ,26/33) gallbladder carci-nomas and 13 (27.6% ,13/47) benign lesions (P<0. 001). Destruction of the integrality of gallblad-der wall was found in 28 (84. 8% ,28/33) gallbladder carcinomas and none (0. 0% ,0/47) of benign le-sions (P<0. 001). The accuracies for differential diagnosis between malignant and benign gallbladder diseases were 72. 5% (58/80) for conventional ultrasound and 93. 8% (75/80) for contrast-enhanced ultrasound (P<0. 001). Conclusion Contrast-enhanced ultrasound can significantly improve the abili-ty of differentiating diagnosis between benign and malignant gallbladder diseases compared with con-ventional ultrasound. The method is deserved to be popularized in clinical practice. Key words: Ultrasonic diagnosis; Gallbladder disease; Differentiating diagnosis

Possibilities of ultrasonic diagnosis in traumatology and orthopedics

The article describes possible applications of the technique of ultrasonic examination for diagnosing the state of the locomotor system in children.

Quality Control of Radiation Diagnosis

The problems of unification of exploitation parameters of X-ray apparatuses (MRI, RT, X-ray diagnosis, and ultrasonic diagnosis) are discussed. A unified system of normative methods is put forward.

Ultrasound in the field of urology.

Urological surgery has a long history. Bladder stones have been detected in the mummies of ancient Egypt dating back to 7,000 years ago. Papyrus Ebers, which is said to be the oldest medical book in the world (1550 BC), includes statements about urinary retention and urinary incontinence. In India, a medical monograph written by Susurta (600 BC) refers to urethral bougie and cystolithotomy, which is considered to be the first surgery performed in the world. In Greece, the Oath of Hippocrates (450–370 BC) includes the following statement: ‘‘Assign treatment of stones to specialists.’’ This statement suggests that cystolithotomy was performed often in ancient Greece. In the nineteenth century, anesthesia and sterilization were developed, leading to the beginning of surgical procedures similar to those often performed in the present age. Later, Nitze developed a cystoscope for clinical use, thus opening the path to endoscopic examinations and surgery. Since the advent of two-dimensional ultrasonography and computed tomography (CT) in the 1970s, diagnostic imaging has progressed. In the 1980s, treatment of stones was markedly modified. Extracorporeal shock wave lithotripsy (ESWL) and endoscopic surgery such as percutaneous nephrolithotripsy (PNL) and transurethral ureterolithotripsy (TUL) were introduced. These new procedures were the precursors of minimally invasive treatments not requiring open surgery. In the 1990s, laparoscopic nephrectomy began to be performed. In 1993, Go et al. performed adrenalectomy under laparoscopic guidance for the first time in Japan. At present, endoscopic surgery is the standard treatment for kidney and adrenal gland diseases. Many other urological surgical procedures are also beginning to be performed endoscopically. As illustrated above, surgery in the field of urology has advanced in an accelerated manner in the decades since the 1980s, following the long history of this kind of surgery beginning in 600 BC. Above all, ultrasound has played an important role in such changes in urological surgery. The advent of diagnostic ultrasound devices has allowed urological diseases such as kidney disease and urinary tract stones to be diagnosed easily. In addition, techniques for ultrasound-guided puncture were developed as an application of diagnostic technology and have been available for renal biopsy, PNL, percutaneous drainage, and so on. Transrectal ultrasonography was developed in Japan, stimulating the global spread of ultrasonic diagnosis of prostate disease. Transrectal ultrasonography has been shown to be useful particularly as a means of diagnostic imaging of prostate cancer and for prostate biopsy under ultrasound guidance. Later, Doppler ultrasonography was also developed, enabling the observation of vascular lesions, tumor blood flow distribution, and so on. More recently, elastography, which is capable of visualizing tissue hardness, has also begun to be used for the diagnosis of prostate cancer. The most important application of ultrasound to urological treatment is probably extracorporeal shock wave lithotripsy (ESWL). ESWL is used to treat urinary-tract stones by crushing the stones with shock waves (ultrasound) focused on them. The advent of this treatment technique resulted in innovative changes in the treatment of urinary tract stones. Furthermore, ultrasound is also used for lithotripters for endoscopic treatment techniques such as PNL and TUL, which were developed simultaneously with the development of ESWL. ESWL, PNL, and TUL spread across the world soon after their development. For Y. Itoh (&) Department of Urology, Kyoto Second Red Cross Hospital, 355-5 Haruobi, Kamigyo, Kyoto 602-8026, Japan e-mail: vanpra@aol.com

1452: Feature of Contrast-enhanced Ultrasound in Clear Cell Renal Cell Carcinoma: Cystic, Hemorrhagic, Debris and Necrotic Tissue and Pseudocapule

To investigate present rate of a pseudocapule and cystic,hemorrhagic,debris and necrotic tissue in clear cell renal cell carcinomas(RCCs) on contrast- enhanced sonography compared with conventional gray-scale sonography. 184 patients with RCCs proved by histologic diagnosis were prospectively studied with contrast-enhanced sonography compared with conventional gray-scale imaging. The present rate of a pseudocapule and cystic,hemorrhagic,debris and necrotic tissue in RCCs was assessed on contrast- enhanced sonography compared with conventional gray-scale sonography. On conventional sonography, the presence of a pseudocapsule was detected in 63 of 184 RCCs. Sonographic contrast-enhanced imaging revealed the in 87 0f 184 RCCs presence of pseudocapsule in 107 0f 184 RCCs (P<0.05). On conventional sonography, the presence of cystic, hemorrhagic, debris and necrotic tissue were seen in 87 0f 184 RCCs. The cystic, hemorrhagic, debris and necrotic tissue were visible in 134 of 184 RCCs. Sonogrphic contrast-ehanced imaging is effective in improving the sonographic visualization of pseudocapsule and cystic, hemorrhagic, debris and necrotic tissue in RCCs. Ultrasonic diagnosis could supply more information in RCCs.

1046: Sonographic Features of Cystic Renal Carcinomas

ObjectiveTo study the sonographic features of cystic renal carcinomas.MethodsTwenty-eight cases with cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls septums and solid mural nodules of them were studied.ResultsIrregular thickening of the cystic walls, septums and solid mural nodules in some cases were specific findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathological mechanisms and sonographic features, cystic renal carcinomas were classified into three patterns: unilocular cystic mass, multilocular cystic mass, and cystic mass with solid mural nodule.ConclusionsTypical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed in benign renal cysts by ultrasonography. For these atypical cases, it is necessary to perform a needle aspiration guided by ultrasonography to make a definite diagnosis. ObjectiveTo study the sonographic features of cystic renal carcinomas. To study the sonographic features of cystic renal carcinomas. MethodsTwenty-eight cases with cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls septums and solid mural nodules of them were studied. Twenty-eight cases with cystic renal carcinoma confirmed by operation and pathology were examined by ultrasonography, and the cystic walls septums and solid mural nodules of them were studied. ResultsIrregular thickening of the cystic walls, septums and solid mural nodules in some cases were specific findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathological mechanisms and sonographic features, cystic renal carcinomas were classified into three patterns: unilocular cystic mass, multilocular cystic mass, and cystic mass with solid mural nodule. Irregular thickening of the cystic walls, septums and solid mural nodules in some cases were specific findings for the ultrasonic diagnosis of cystic renal carcinomas. According to their pathological mechanisms and sonographic features, cystic renal carcinomas were classified into three patterns: unilocular cystic mass, multilocular cystic mass, and cystic mass with solid mural nodule. ConclusionsTypical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed in benign renal cysts by ultrasonography. For these atypical cases, it is necessary to perform a needle aspiration guided by ultrasonography to make a definite diagnosis. Typical cystic renal carcinomas can be well diagnosed, while atypical cases may be misdiagnosed in benign renal cysts by ultrasonography. For these atypical cases, it is necessary to perform a needle aspiration guided by ultrasonography to make a definite diagnosis.

Three Dimensional Beam Steering with a Divided Ring Array for Application in Medical Ultrasonic Diagnosis

Article Three Dimensional Beam Steering with a Divided Ring Array for Application in Medical Ultrasonic Diagnosis was published on January 1, 1988 in the journal Biomedical Engineering / Biomedizinische Technik (volume 33, issue s2).

Investigation of endoluminal ultrasonographic characteristics of rectal adenocarcinoma and rectal mucous adenocarcinoma.

Objective To investigate the endoluminal ultrasonographie characteristics of adenoearcinoma and mucous adenocareinoma of the rectum. Methods The ultrasonographie characteristics of thirty eases of advanced adenoeareinoma of the rectum and twenty-eight eases of rectal mucous adenoearcinoma were analyzed retrospectively in comparison with their eorresponding pathologic images. Results In advanced adenocareinoma of the rectum, 28 eases manifested rough endoluminal surface, of which 19 marked by thickened changes without arrangement of layers, 10 had indistinct arrangement of layers in some areas and one had clear arrangement of layers. In the deepest margin of infiltration, 17 eases manifested sentus, homed or knot-like protuberance, while 5 marked by wavy margins, and 8 cases had clear and fiat margins. In 25 eases of rectal mucous adenocareinoma, 20 manifested smooth endoluminal surface. With regard to infiltration of tumors to rectal wall, 6 cases manifested clear arrangement of layers, while 13 had clear arrangement of layers in part and 6 had no clear arrangement. In the deepest part of infiltration, 8 eases manifested slippery and fiat margins and 10 manifested wavy margins and 7 had a few sentus, homed or knot-like protuberance locally. According to ultrasonic results of the depth of infiltration to rectal wall in comparison with pathologic findings, 25 eases were diagnosed accurately, while in two cases the diagnosis was too shallow and in three eases it was too deep. In rectal mucous adenocarcinoma, 10 cases got correct diagnosis and 14 were diagnosed superficially and one got too deep. The accuracy of ultrasonic diagnosis on rectal mueoas adenoearcinoma was apparently lower than that of adenoeareinoma and most of the misdiagnosis were too superfieiai. Conclusion There are different ultrasonographie characteristics of rectal adenoeareinoma and rectal mucous adenoeareinoma, which can be helpful for the typing of rectal carcinoma and avoiding excessively superficial misdiagnosis. Key words: Rectal neoplasms; Endosonography

Diagnosis of thyroid space-occupying lesions using real-time contrast-enhanced ultrasonography with sulphur hexafluoride microbubbles

To explore the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of thyroid occupied lesions with injection of sulphur hexafluoride microbubbles. Fifty nine cases of conventional ultrasonic diagnosis of thyroid lesions in patients with 73 lesions re-sulfur hexafluoride microbubble ultrasound contrast real-time inspection, the use of CEUS and contrast pulse sequencing (CPS). Seventy-three lesions were satisfied with the dynamic contrast perfusion imaging. Ultrasound contrast prompted the 15 lesions (13 cases) of malignant lesions by postoperative pathology confirmed papillary thyroid carcinoma, ultrasound images showed a low or mixed echo, boundary ambiguity, accompanied by Microcalcification foci, blood flow distribution I rank or grade III. Ultrasound prompted 58 lesions (46 cases) of benign lesions, blood flow distribution of grade II or III, the performance of a variety of two-dimensional ultrasound image, showing cystic, solid or liquid-solid mass, border clearance. Contrast with the surrounding thyroid tissue, lesions<or=20 mm in diameter papillary thyroid carcinoma are poor blood supply type; diameter>or=20 mm papillary thyroid carcinoma, manifested prior to the beginning of the adjacent thyroid substance to enhance and dissection, showing the form of high-enhanced perfusion; thyroid follicular adenoma as early as the beginning of the adjacent thyroid substance to enhance and dissection, mass retained within the contrast agent longer time, showing the form of high-enhanced perfusion; nodular goiter enhanced for thyroid nodules and adjacent synchronization started to pick up in real terms, after the 6 lesions showed nodular contrast slightly earlier than the adjacent thyroid substance started to pick up, 28 lesions with synchronous real beginning of the adjacent thyroid dissection, 11 lesions of nodular dissipated early on (started receding time < or = 25 s) adjacent to thyroid substance. The real-time CEUS with injecting sulphur hexafluoride microbubbles is valuable in the diagnosis and differential diagnosis of the thyroid occupied lesions.

Medical Technology and Doctor/Patient Interaction : Ultrasonic Diagnosis in OB/GYN

Medical Technology and Doctor/Patient Interaction : Ultrasonic Diagnosis in OB/GYN

動的輪郭モデルによる心臓内壁輪郭自動抽出法―僧帽弁処理による輪郭抽出精度向上―

The necessity of ultrasonic diagnosis tools increases every year. We propose an automatic endocardium tracing method that applies active contour models(ACM) in two stages. In the first stage, an endocardium contour is detected using the result of an edge extraction based on the separability of image features. In the second stage, the endocardium contour is extracted using shape correction processing. "Mitral valve processing" not only detects the position of the mitral valve at the end-diastolic period but also corrects the detected contour after the first stage of ACM. The result of experiments using one healthy and three diseased cases demonstrate the effectiveness of the proposed method.

2A1-M08 遠隔救急超音波診断ロボット:FASTele-1の評価 : 通信遅れが及ぼす診断性能への影響

We focused on FAST [Focused Assessment with Sonography for Trauma] looking for spaces collected blood that are the source of shock in case of primary diagnosis, and have developed a portable manipulator binding around a body trunk for emergent tele-echo:FASTe1e-1. In FASTe1e-1 that was the terminal of remote-controlled ultrasonic diagnosis RT system at the injury early stage, we conducted the verification experiment concerning communication delay and the diagnosis time as one index that showed the diagnosis performance to investigate the influence that the communication delay gave the diagnosis performance, and compared it with the diagnosis time demanded from the system. Verification experiment indicated that FAST was feasible in time about 900 communication delay time, and was shown the enough operation under public Internet net(UDP/[P) environment.

A Capacitive Micromachined Ultrasonic Transducer Array for Minimally Invasive Medical Diagnosis

A capacitive micromachined ultrasonic transducer (CMUT) array for minimally invasive medical diagnosis has been developed. Unlike traditional ultrasonic transducers, which generally use a bulky piece of substrate, this transducer array was integrated on a 40--thick micromachined silicon substrate into a probe shape with a typical shank width of 50-80 and a shank length of 4-8 mm. For 1-D arrays, 24-96 CMUT devices were integrated on one such silicon probe and formed an accurately configured phase array. In addition to miniaturization, reduction of the substrate thickness also decreases the intertransducer crosstalk due to substrate Lamb waves. Due to its miniature size, this array can be placed or implanted close to the target tissue/organ and can perform high-resolution high-precision diagnosis and stimulation using high-frequency ultrasounds. The issue of conflict between resolution and penetration depth of ultrasonic diagnosis can therefore be resolved. A two-layer polysilicon surface micromachining process was used to fabricate this device. Suspended polysilicon membranes of diameters ranging from 20 to 90 and thicknesses from 1.0 to 2.5 were used to generate and detect ultrasounds of frequencies ranging from 1 to 10 MHz. B-mode imaging using this transducer array has been demonstrated.

A study on the real-time decomposition monitoring of a metal organic precursor for metal organic chemical vapor deposition processes

This study proposes a method for monitoring the decomposition state of a metal organic precursor which is used for the metal organic chemical vapor deposition (MOCVD) system. As many kinds of precursors for MOCVD such as tetrakis(dimethylamido)titanium (TDMAT) are highly likely to decompose due to the instability of their chemical structure during processing, critical problems are generated for thin film formation and its yield in this case. Although real-time monitoring technology on the decomposition degree of these precursors is essential for metallization, metal gate or electrode processes for memory devices, both commercialized technology and fundamental research have scarcely been accomplished. Therefore, this study endeavors for acknowledgment by the semiconductor industry with a proposal for a real-time monitoring method on the decomposition degree of the precursor through an ultrasonic diagnosis method. However, it is difficult to perform a degradation mechanism analysis since measuring the viscosity and physical properties of TDMAT is complicated due to its sensitivity to air. Therefore, viscosity was measured using a Pd compound (tetrakis(triphenylphosphine)palladium(0), Pd(PPh3)4) which is stable in air and has a similar chemical structure to TDMAT.

Ultrasonic diagnosis of the single screw behavior during extrusion—A case study

AbstractUltrasonic diagnostic method of screw behavior during extrusion has been designed, developed, and carried out on a 63.5‐mm single screw extruder, equipped with either a basic conveying screw or a mixing screw. It was found that the screw behavior depends on the screw speed and the die pressure. Whereas initially at low speed, the screw centered by the hydrodynamic forces rotates smoothly in the axial position, at higher screw speeds and high die pressures the screw starts vibrating. Thus, (1) the screw tip vibrated with the amplitude of 10–210 μm as the screw speed varied from 5 to 100 revolutions per minute; (2) the screw vibrations in the vertical and horizontal directions were asymmetrical; (3) the vibration pattern repeated itself at every two revolutions; (4) the vibrations originated in the poorly aligned engagement in the gearbox sleeve when the screw was pushed deeply into it by backpressure; (5) once pushed in the screw oscillated at any screw speed or die pressure. POLYM. ENG. SCI., 2009. Published by the Society of Plastics Engineers

Prenatal diagnosis and prognosis of fetal nephrohydrosis

To explore the clinical significance of prenatal ultrasonic diagnosis of fetal nephrohydrosis and its prognosis. Prenatal ultrasonography was performed on 9526 women at more than 20 weeks gestation, and 162 women whose anteroposterior diameter of the renal pelvis was > or = 8 mm were included in this study. The grade of fetal nephrohydrosis was classified according to Grignon grading method. The changes in fetal nephrohydrosis were observed regularly until delivery. (1) The incidence of fetal encephalic fluid and Grignon grade: there were 162 fetuses with fetal nephrohydrosis among 9526 fetuses, with an incidence of 1.7%. The numbers of fetuses with Grades 1 to 5 were 71, 59, 7, 3 and 22, respectively. (2) The distribution in gestational weeks of fetal nephrohydrosis: generally, fetal nephrohydrosis was first diagnosed at (33 +/- 5) weeks, and the maximum degree of nephrohydrosis was observed at (36 +/- 3) weeks. One hundred and ten fetuses with nephrohydrosis recovered during the process of gestation, at about (37 +/- 4) weeks. (3) Poor terminations of pregnancy: there were 40 (25%) fetuses with poor terminations among totally 162 cases. Among these 40 fetuses, 3 (27%) were first diagnosed at 20 to 24 weeks within 11 fetuses, 6 (24%) were first diagnosed at 25 to 28 weeks within 20 fetuses, 14 (26%) were first diagnosed at 29 to 32 weeks within 53 fetuses, 11 (23%) were first diagnosed at 33 to 36 weeks within 48 fetuses, and 6 (20%) were first diagnosed at 37 to 40 weeks within 30 fetuses. The results demonstrate that high grade of fetal nephrohydrosis according to Grignon grading method indicates a poorer prognosis of the fetus. (4) Follow-up results: there were 122 (75%, 122/162) live and healthy neonates in total, including 110 neonates whose nephrohydrosis recovered prior to birth and 12 neonates whose nephrohydrosis recovered within 1 week after birth. These neonates all developed well without any urinary sequela within the first 2 years. There were also 20 (12%, 20/162) hydronephrotic neonates who were still diagnosed as nephrohydrosis within 1 week after birth, including 11 fetuses graded below Grignon grade 3, whose nephrohydrosis recovered 3 to 12 months after birth and who developed well without any urinary symptoms. The study demonstrates that hydronephrotic fetuses who are diagnosed at earlier gestational weeks and with higher grading have poorer prognosis. The Grignon grading method can be used in the prenatal evaluation of fetal nephrohydrosis to predict the prognosis of the fetus.