Ultrasonographic Recordings Research Articles

Masseter muscle thickness before and after the correction of unilateral functional posterior crossbite in growing individuals: a prospective controlled clinical trial.

To evaluate whether unilateral functional posterior crossbite in growing children creates an asymmetry in masseter muscle thickness and whether this asymmetry is normalized after crossbite correction. Two groups of growing individuals were studied prospectively: (i) a treatment group: children with unilateral functional posterior crossbite, undergoing crossbite correction with maxillary expansion; and (ii) a control group: children without transversal malocclusions and orthodontic treatment. The thickness of the masseter muscles was measured bilaterally using ultrasonographic recordings at three time points: pre-treatment (T0); 9 months after (T1); and 30 months after posterior crossbite correction (T2); and at equivalent time points in the control group. Differences within and between the groups were evaluated using paired and unpaired t-tests respectively. It was found that the thickness of the masseter muscles in patients with unilateral functional posterior crossbite was significantly thinner on the crossbite side (P = .013) by 0.5mm. At T1, the masseter muscle of the treated crossbite side was thicker than that of the previous normal side (0.3mm difference; P = .046) while this difference disappeared at T2 (P > .05). The lack of the inclusion of an untreated posterior crossbite group, and the heterogeneity in appliances used are the principal limitations of this study. The masseter muscles in untreated individuals with unilateral functional posterior crossbite are thinner in the crossbite side than in the contralateral non-crossbite side. This muscular asymmetry however is eliminated some time after successful treatment of this malocclusion, possibly due to the bilateral symmetrization of the activity of the elevator masticatory muscles.

Short-term Efficacy and Mechanism of Electrical Pudendal Nerve Stimulation Versus Pelvic Floor Muscle Training Plus Transanal Electrical Stimulation in Treating Post-radical Prostatectomy Urinary Incontinence

To assess the short-term efficacy of electrical pudendal nerve stimulation (EPNS) versus pelvic floor muscle training (PFMT) plus transanal electrical stimulation (TES) for the early treatment of post-radical prostatectomy urinary incontinence (PRPUI) and explore its mechanism of action. A parallel designed randomized controlled trial was conducted at a research institute and a university hospital. Ninety-six PRPUI patients were allocated to EPNS group (64 cases) and PFMT+TES group (32 cases) and treated by EPNS and biofeedback-assisted PFMT plus TES, 3 times a week for 8 weeks, respectively. Outcome measurements were improvement rate, scores of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the number of used diapers. After 24 treatments, the efficacy rate of 68.7% in EPNS group was significantly higher than that of 34.4% in PFMT+TES group (P=0.005). The ICIQ-UI SF score, and urine leakage amount score, diaper score, symptom and quality of life improved significantly in both groups and showed Therapy x Treatment interaction, and the above scores in EPNS group were significantly lower than these in PFMT+TES group. Perineal ultrasonographic recordings showed that PFM movement amplitude during EPNS (≥1- <3 mm) was similar to that during PFMT, however, PFM movement EMG amplitude was significantly higher during EPNS than during PFMT (P <0.001). EPNS is more effective than PFMT+TES in short-term (8 weeks) treatments of early urinary incontinence after radical prostatectomy. Its mechanism of action is that EPNS can excite the pudendal nerve and simulate PFMT.

Use of ultrasonographic examination in sheep health management—A general appraisal

Accurate ultrasonographic determination of foetal number between 45 to 90days of gestation has revolutionised reproductive management in sheep over 30 years ago and is now established as an essential component of flock health planning and productivity. Ultrasonographic measurements of fat and muscle depths over ribs 12 and 13 in growing lambs can accurately reflect carcass composition and have been incorporated in breeding programmes in sheep meat breeds. These ultrasound services may often be delivered by para-professionals, who individually scan tens of thousands of sheep annually. Currently, ultrasonographic examination in small ruminant practice is largely confined to the investigation of individual valuable pedigree animals referred to veterinary schools or other centres of expertise, despite publication of clinical papers illustrating its application in a wide range of common diseases, including respiratory diseases, urolithiasis, liver and kidney pathologies. Typically, ultrasonographic examination of any organ system should take no more than 1–2min with the results available immediately, affording a much more informed diagnosis and prognosis. Presently, examination of all adult sheep in the flock for ovine pulmonary adenocarcinoma is being researched in an attempt to eliminate this disease, which has no commercially available diagnostic test or obvious flock control measure. Ultrasonographic investigation is much cheaper than common clinical biochemistry tests, e.g., haematological examination or protein measurements (albumin and globulin, acute phase proteins, fibrinogen and haptoglobin). The ability to record ultrasonographic findings as images or video files directly to mobile telephones, tablets and laptops allows clinicians to transmit such data to a specialist should a second opinion prove necessary. Tele-medicine is well established in several veterinary disciplines and will become increasingly common for diagnostic imaging in small ruminant practice during the next decade. Comparison of images collected over a period of time allows a disease process to be accurately monitored. Re-evaluation of ultrasonographic recordings is an invaluable learning exercise should necropsy results become available.

Decreasing the Uterine Blood Flow with Electroacupuncture: Bidermatomal and Monodermatomal Applications

Background: Previously we demonstrated a uterine fibroma case in which the decrease in the uterine artery blood flow was obtained with bidermatomal electroacupuncture (EA). A prospective study was conducted to validate the efficacy of bidermatomal and monodermatomal EA applications. Methods: Ten healthy women participated 3 times for 3 steps of the study. Each woman enrolled into a bidermatomal sham control group application, a bidermatomal 80 Hz EA and as a last step, a monodermatomal EA with 80 Hz. Color Doppler ultrasonographic recordings were made to detect baseline blood flow parameters by a pulsatility index (PI), volume flow, area and diameter of each uterine artery and after stimulations. Results: Doppler ultrasonographic recordings demonstrated statistically significant decreases of the blood flow both with bidermatomal (p = 0.03 for the left side PI and p = 0.04 for the right side PI) and monodermatomal EA (p = 0.006 for the left PI and p = 0.002 for the right side PI). The sham control group did not show a significant change in blood flow parameters. Conclusions: The present study validates the efficacy of the bidermatomal but also the monodermatomal EA with 80 Hz on decreasing the blood flow to the uterus.

Use of contrast-enhanced ultrasonography to characterize adrenal gland tumors in dogs.

To describe the contrast-enhanced ultrasonographic characteristics and vascular patterns of adrenal gland tumors in dogs and determine whether those features are indicative of malignancy or histologic type of tumor. 14 dogs with 16 adrenal gland lesions (10 carcinomas [8 dogs], 3 adenomas [3 dogs], and 3 pheochromocytomas [3 dogs]). Unsedated dogs with adrenal gland lesions underwent B-mode ultrasonography and contrast-enhanced ultrasonography ≤ 48 hours before adrenalectomy; contrast-enhanced ultrasonographic examinations were video-recorded. Macroscopic evaluation of the adrenal gland lesions and histologic examination of removed adrenal gland tissues were subsequently performed. Surgical and histopathologic findings and the ultrasonographic and contrast-enhanced ultrasonographic characteristics were recorded for the various tumor types. Time-intensity curves were generated from the contrast-enhanced ultrasonographic recordings and used to calculate regional blood volume (value proportional to area under the curve) and mean transit time (time the lesion began to enhance to the half-peak intensity). In adrenal gland carcinomas, tortuous feeding vessels were noticeable during the arterial and venous phases of contrast enhancement. Heterogeneity of contrast enhancement was evident only in malignant tumors. Compared with adenomas, adrenal gland carcinomas and pheochromocytomas had significantly less regional blood volume. Mean transit times were significantly shorter in adrenal gland carcinomas and pheochromocytomas than in adenomas. For dogs, evaluation of the vascular pattern and contrast-enhancement characteristics of adrenal gland tumors by means of contrast-enhanced ultrasonography may be useful in assessment of malignancy and tumor type.

The Morphology and Adhesion Mechanism of Octopus vulgaris Suckers

The octopus sucker represents a fascinating natural system performing adhesion on different terrains and substrates. Octopuses use suckers to anchor the body to the substrate or to grasp, investigate and manipulate objects, just to mention a few of their functions. Our study focuses on the morphology and adhesion mechanism of suckers in Octopus vulgaris. We use three different techniques (MRI, ultrasonography, and histology) and a 3D reconstruction approach to contribute knowledge on both morphology and functionality of the sucker structure in O. vulgaris. The results of our investigation are two-fold. First, we observe some morphological differences with respect to the octopus species previously studied (i.e., Octopus joubini, Octopus maya, Octopus bimaculoides/bimaculatus and Eledone cirrosa). In particular, in O. vulgaris the acetabular chamber, that is a hollow spherical cavity in other octopuses, shows an ellipsoidal cavity which roof has an important protuberance with surface roughness. Second, based on our findings, we propose a hypothesis on the sucker adhesion mechanism in O. vulgaris. We hypothesize that the process of continuous adhesion is achieved by sealing the orifice between acetabulum and infundibulum portions via the acetabular protuberance. We suggest this to take place while the infundibular part achieves a completely flat shape; and, by sustaining adhesion through preservation of sucker configuration. In vivo ultrasonographic recordings support our proposed adhesion model by showing the sucker in action. Such an underlying physical mechanism offers innovative potential cues for developing bioinspired artificial adhesion systems. Furthermore, we think that it could possibly represent a useful approach in order to investigate any potential difference in the ecology and in the performance of adhesion by different species.

Feasibility and reliability of Doppler flow recordings in the fetal aortic isthmus: a multicenter evaluation

To evaluate the performance of three different centers with respect to their ability to identify the fetal aortic isthmus (AoI) adequately and place a Doppler sample volume in the AoI correctly, and to address the reproducibility of the isthmic flow index (IFI) calculated from Doppler waveforms recorded in the three centers. The three collaborating centers sent several ultrasonographic recordings taken at random over a 6-week period to the Saint-Justine Fetal Cardiology Unit (StJ-FCU). A performance quotient ((number of total readings - number of unsatisfactory results)/number of total readings) was calculated for each center by each of three judges, who were experienced fetal cardiologists, to assess the ability of each center to identify the isthmus and to place the Doppler sample volume (DSV) adequately. Intraclass correlation coefficients (ICC) were computed to quantify the variability of IFI measurements ((systolic + diastolic)/systolic flow velocity integrals). Fifty-five recordings were available for this study. Concerning isthmus identification, there was 100% agreement between the three judges from StJ-FCU and the performance quotients of Centers A, B and C were: 0.90, 0.95 and 1.00, respectively. For DSV positioning, agreement between the judges varied; for Judge 1 vs. Judge 2, kappa = 0.836 (95% CI, 0.651-1.000); for Judge 1 vs. Judge 3, kappa = 0.773 (95% CI, 0.557-1.000); for Judge 2 vs. Judge 3, kappa = 0.941 (95% CI, 0.805-1.000). The performance quotients of the three centers for DSV positioning were consistently lower than were those for identification of the isthmus, being 0.85, 0.76 and 0.92, respectively. The ICC between the first and second measurements of the IFI by Rater 1 was 0.96 (95% CI, 0.93-0.98, P < 0.001) and that between Raters 1 and 2 was 0.97 (95% CI, 0.95-0.99, P < 0.001). Adequate imaging of the fetal AoI can be achieved easily by a trained sonographer, while DSV positioning is challenging. The intra- and interrater variability of the IFI are low.

Magnesium Sulfate Therapy for Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage

Object As magnesium is a potent cerebral vasodilator, we have investigated routine supplementation of magnesium (as a potent cerebral vasodilator) in patients presented with aneurysmal subarachnoid hemorrhage (ASAH) to determine whether there has been a reduction in the incidence of cerebral vasospasm. Materials and Methods A prospective randomized, placebo-controlled, clinical trial of high-dose magnesium sulfate (MgSO4) therapy after ASAH was performed in 83 patients. MgSO4 was administered intravenously as soon as possible after admission and continued until 10 days after occlusion of the aneurysm. Blood magnesium levels were obtained daily during MgSO4 therapy. Outcome measures including the evidence of vasospasm on clinical examination using transcranial Doppler ultrasonographic recordings, or control angiogram within 10 days after occlusion of the aneurysm, were obtained. The clinical outcomes were recorded using Glasgow Outcome Scale (GOS) at 3 months. Results Eighty-three patients were enrolled in the study: 40 (12 male and 28 female patients) received MgSO4 therapy and 43 (20 male and 23 female patients) comprised placebo-treated patients. The mean ages of the patients in these groups were 54 and 53 and the mean Fisher, Hunt and Hess grades were 3.02±0.97, 2.50±1.03 and 2.95±0.95, 2.32±0.96 in the treatment and control groups, respectively. The mean serum magnesium and calcium levels were 1.54±0.72, 8.24±0.94 and 0.88±0.13, 8.64±0.13 in the treatment and control groups, respectively. Ten out of 40 patients who received MgSO4 therapy developed symptomatic vasospasm, confirmed by angiography and transcranial Doppler ultrasonography, compared with 14 of 43 patients among the control group (P=0.54). The mean GOS were 3.80±1.5 and 4.11±1.43 in the treatment and control groups, respectively P=0.78. Conclusions From our study, it appears that MgSO4 therapy has no statistically significant beneficial role in the prevention of cerebral vasospasm after ASAH. We did observe, however, that the ultimate GOS was better in the treatment group than in the control group. To assess the safety and effectiveness of high-dosage MgSO4 therapy or the adverse effects, large randomized, placebo-controlled, and double-blind clinical trials are needed.

Three-Dimensional Ultrasonography can Detect the Modulation of Kidney Volume in Two-Kidney, One-Clip Hypertensive Rats

As volume changes are a typical finding in the two-kidney, one-clip hypertensive rat model (2K1C), it is of interest to investigate within what time frame these volume changes occur and their relation to hypertension. Kidney volume changes in Wistar rats were measured by three-dimensional (3D) ultrasonography (USG). Clipped induced stenosis was applied to the left renal artery in 11-wk-old animals ( n = 8), using age-matched nonclipped rats as controls ( n = 7). Ultrasonographic recordings were made before clipping and, thereafter, weekly with corresponding systolic blood pressure and body weight measurements. The nonclipped kidney showed increased volume at week 2, 5 and 7. Three wk after clipping, clipped kidneys were smaller than the nonclipped kidneys (0.47 ± 0.11 mL versus 1.28 ± 0.07 mL). No difference was found between the left and right kidney in the control group at any week. Blood pressure was significantly higher in the 2K1C hypertensive group 4 weeks after clipping (201 ± 16 versus 139 ± 4 mm Hg) with stable blood pressure thereafter. Three-dimensional USG showed that clipping caused a decrease in kidney volume from week 3 in the clipped kidney and a volume increase in the nonclipped kidney at week 2. A significant increase in blood pressure appeared after week 4. (E-mail: Knut.Matre@med.uib.no)

Congenital diaphragmatic hernia: an evaluation of the prognostic value of the lung-to-head ratio

A retrospective analysis of the prognostic significance of the lung-to-head ratio (LHR) on the outcome of fetuses with left-sided congenital diaphragmatic hernia (CDH). A total of 12 fetuses with isolated left CDH without any chromosomal abnormalities were included in this study. Twelve LHR measurements could retrospectively be calculated from the last available ultrasonographic recordings before birth. The relationship between the LHR and fetal outcome and gestational age was investigated. The cutoff levels as previously published were applied to determine their predictive value in this population. The association between other prenatal predictive variables and the fetal outcome was also determined. Survival was defined as being discharged from the hospital. The overall survival rate was 75%, and a statistically significant difference was observed between the mean LHR of the survivors and the mean LHR of the nonsurvivors (1.81 vs. 0.43), whereas the mean gestational age of these two groups did not differ. The LHR was not gestational age dependent with regard to its ability to predict the fetal outcome. The cutoff levels LHR <1, 1-1.4, and >1.4 showed good applicability for predicting fetal outcome within the present study population, with 100% survival if LHR >1.4 and 75% mortality if LHR <1. The intrathoracic position of the stomach, mediastinal shift, and polyhydramnios as individual variables and early diagnosis (<25 weeks gestation) all turned out to be poor sonographic predictors of fetal outcome. The LHR proved to be a good predictor of fetal outcome, independent of gestational age at the time of measurement. To further substantiate our observations, a prospective multicenter study is warranted.

Congenital diaphragmatic hernia: an evaluation of the prognostic value of the lung-to-head ratio and other prenatal parameters.

A retrospective analysis of the prognostic significance of the lung-to-head ratio (LHR) and other prenatal parameters on the outcome of fetuses with left-sided congenital diaphragmatic hernia (CDH). A total of 26 fetuses with isolated left CDH without chromosomal abnormalities were included. Twenty-one LHR measurements could retrospectively be calculated from the last available ultrasonographic recordings before birth. The relationship between LHR and fetal outcome and the gestational age dependency of this relation was tested. Cutoff levels as previously published were applied to determine their predictive value in this population. The association between other prenatal predictive variables and fetal outcome was also determined. Survival was defined as discharge from the hospital. The overall survival rate was 50%. There was a statistically significant difference between the mean LHR of the survivors compared to the mean LHR of the nonsurvivors (1.78 vs 1.02), whereas the mean gestational age of these two groups did not differ. LHR was not gestational age dependent in the prediction of fetal outcome. The cutoff levels LHR <1, 1-1.4, >1.4 showed a good applicability in the prediction of fetal outcome within the present study population with a 100% survival if LHR >1.4 and a 100% mortality if LHR <1. An intrathoracic position of the stomach, mediastinal shift, polyhydramnios as individual variables and early diagnosis (<25 weeks' gestation) revealed to be poor sonographic predictors for fetal outcome. LHR proved to be a good predictor for fetal outcome, independent of gestational age at the time of the measurement. To substantiate our observation, a prospective multicenter study is warranted.

Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus

Our purpose was to compare third-trimester fetal biophysical activities in normal and well-controlled insulin-dependent diabetic pregnancies. We performed serial bimonthly fetal biophysical studies from 30 to 38 weeks in 18 normal and 18 well-controlled insulin-dependent diabetic pregnancies (White classes B through D). Each study contained 60 minutes of simultaneous ultrasonographic recordings of fetal breathing movements and rates, baseline heart rate, and body movements. Mean daily blood glucose levels of diabetic patients were determined from home monitors; HbA1c was determined every 6 weeks and ultrasonographic fetal growth rates every 3 weeks. Data were compared with t tests, analysis of variance with repeated measures, and chi 2 tests. Women in the diabetic group maintained good glycemic control and were delivered of normal infants of weights similar to those of nondiabetic gravidas. Their fetuses had higher mean incidences of fetal breathing movement, fetal heart rates, and fetal breathing rates but lower fetal movements and fetal heart rate acceleration counts than did controls throughout the study. Neither short- nor long-term maternal glycemic levels correlated well with fetal biophysical performance. In spite of good maternal glycemic control fetuses of diabetic women behaved differently from those of nondiabetic women. Modulation of their biophysical activities may be affected by maternal glycemic status before the last trimester. Different standards might need to be applied to interpret their tests.

Relationships between dopamine infusions and intracranial hemodynamics in patients with raised intracranial pressure

Dopamine, 1–10 μg/kg body weight/min was infused in 6 patients suffering from cerebrovascular diseases with elevated intracranial pressure and a critical cerebral perfusion pressure. Dopamine decreased intracranial pressure in 3 and increased it moderately in the other 3 patients. In all patients, the dopamine-induced rise of mean arterial pressure led to an increase of cerebral perfusion pressure. Transcranial Doppler ultrasonographic recordings of the middle cerebral artery in patients whose intracranial pressure declined revealed a decrease of the pathologically elevated cerebrovascular resistance, and an augmentation of cerebral blood supply. In conclusion, dopamine infusions may improve cerebral hemodynamics in some patients with severe brain edema. Such patients can be identified by intracranial pressure and Doppler monitoring.

Do muscle fibre size and fibre angulation correlate in pennated human muscles?

Several studies have reported estimations of the total number of fibres in a muscle, e.g. before and after training or before and after inactivity. In those investigations a combination of computed tomographic estimations of muscle size and morphological studies of fibre size has most often been used. There have been doubts about the reliability of those studies on pennate muscles, since changes in muscle fibre size have been said to alter fibre angulation and thus the number of fibres that will cross a section. If such an alteration in fibre angulation takes place with an increase in fibre size, there ought to be some correlation between fibre size and fibre angulation. The present study was designed to test whether repetitive estimations of muscle fibre angulation could be performed in vivo and if any such correlation could be found between fibre size and fibre angulation. A group of 15 women volunteered to take part in the study. Repeated ultrasonographic recordings were made on five subjects on 3 consecutive days to test the repeatability of ultrasonographic measurement of fibre angulation. Both muscle morphological analyses and ultrasonographic measurements of fibre angulation were performed on the other 10 subjects. Ultrasonographic measurement of fibre angulation was found to be reproducible since no variation between measurements made on different days was found. When trying to correlate muscle fibre size to the muscle fibre angulation, measured ultrasonographically, no significant correlation was found.(ABSTRACT TRUNCATED AT 250 WORDS)