Ultrasound Prediction Research Articles

Rate and predictors of spontaneous resolution of prenatally diagnosed primary nonrefluxing megaureter.

We assessed clinical and ultrasound predictors of the spontaneous resolution of prenatally diagnosed, primary nonrefluxing megaureter. Primary nonrefluxing megaureter was prenatally diagnosed in 54 neonates from 1993 to 1998, including 15 in whom it was bilateral (69 megaureters). Median followup period from birth to the last radiology examination was 25.8 months (range 2.3 to 72). Of the patients 10 underwent surgical repair for severe hydroureteronephrosis, including decreasing renal function on diuretic renography in 1, and an episode of bilateral obstruction and acute renal failure in 1. Hydroureteronephrosis resolved in 39 cases (72%) and persisted in 5 at 30 to 72 months of followup. Laterality, gender and retrovesical ureteral diameter had no significant effect on the resolution rate (p >0.05). Mean initial ureteral diameter in patients with resolution was less than in those without resolution and in those who underwent surgery (0.8 versus 1.15 and 1.32 cm., respectively). Presenting hydronephrosis grade was a significant predictor of the resolution rate (p = 0.03). Grades 1 to 3 hydronephrosis resolved at a median age of 12.9, 23.9 and 34.6 months, respectively (range 4.1 to 66). In patients in whom grades 4 and 5 hydronephrosis resolved the median age at resolution was 48.5 months. Most cases of prenatally diagnosed, primary nonrefluxing megaureter resolve spontaneously. Grades 1 to 3 hydronephrosis tend to resolve between ages 12 and 36 months. For these grades followup intervals may be progressively elongated after a pattern of improving hydronephrosis has been established. In children with grade 4 or 5 hydronephrosis, or a retrovesical ureteral diameter of greater than 1 cm. the condition may resolve slowly and require surgery.

A Retrospective Study of the Accuracy of Sonographic Chorionicity Determination in Twin Pregnancies

The aim of this study was to determine the accuracy of sonographic chorionicity determination in the largest sample of twin pregnancies to date. We retrospectively analyzed 463 twin pregnancies delivered over a 6-year period to determine in each case what the antenatal sonographic prediction of chorionicity was, and then what the subsequent post partum pathological diagnosis of chorionicity was. Out of 436 twin pregnancies, 428 were correctly diagnosed for chorionicity as confirmed by pathology reports. Sonography as a screening tool for monochorionic twin pregnancies has a sensitivity of 100%, a specificity of 97.9% and a predictive value positive of 88.2%. Transvaginal scanning in the first trimester determined twin chorionicity with a sensitivity and a specificity of 100%. This study has confirmed in the largest sample to date that sonographic chorionicity determination is best done in the first trimester using vaginal scans, where it has 100% accuracy.

A Retrospective Study of the Accuracy of Sonographic Chorionicity Determination in Twin Pregnancies

AbstractThe aim of this study was to determine the accuracy of sonographic chorionicity determination in the largest sample of twin pregnancies to date. We retrospectively analyzed 463 twin pregnancies delivered over a 6-year period to determine in each case what the antenatal sonographic prediction of chorionicity was, and then what the subsequent post partum pathological diagnosis of chorionicity was. Out of 436 twin pregnancies, 428 were correctly diagnosed for chorionicity as confirmed by pathology reports. Sonography as a screening tool for monochorionic twin pregnancies has a sensitivity of 100%, a specificity of 97.9% and a predictive value positive of 88.2%. Transvaginal scanning in the first trimester determined twin chorionicity with a sensitivity and a specificity of 100%. This study has confirmed in the largest sample to date that sono- graphic chorionicity determination is best done in the first trimester using vaginal scans, where it has 100% accuracy.

Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule

Aims: To test the reproducibility of a highly sensitive clinical decision rule proposed to predict vesicoureteral reflux (VUR) after a first febrile urinary tract infection in children. This rule combines...

Prediction of growth discordance in twins with the use of abdominal circumference ratios

The purpose of this study was to assess the accuracy of sonographic prediction of twin birth weight discordance using the abdominal circumference ratio. This was a prospective cohort of diamniotic twin gestations that underwent serial ultrasound examinations every 2 to 4 weeks from 11 to 38 weeks of gestation. Birth weight discordance was defined as > or =25% difference in birth weight, relative to the larger twin. The sensitivity, specificity, and predictive values for the abdominal circumference ratio were assessed for the prediction of growth discordance. Of 503 diamniotic twin pregnancies, 64 pregnancies (12.7%) had discordant fetal growth. The abdominal circumference ratio could be measured consistently throughout gestation in 100% of twin pairs. Receiver operating curve analysis showed that the abdominal circumference ratio was a good predictor of birth weight discordance (area under the curve = 0.80). An abdominal circumference ratio cutoff of 0.93 yielded a sensitivity and specificity of 61% and 84%, respectively. Twin birth weight discordance may be predicted at any gestational age with an abdominal circumference ratio <0.93.

Intravascular Ultrasound Predictors of Side Branch Occlusion in Bifurcation Lesions After Percutaneous Coronary Intervention

Percutaneous coronary intervention (PCI) of bifurcation lesion has been associated with a low success rate and a high incidence of procedural complications, including side branch occlusion and myocardial infarction. It remains controversial whether preintervention intravascular ultrasound (IVUS) findings can help to identify side branches likely to occlude after PCI of bifurcation lesions. From our IVUS database we identified 81 bifurcation lesions in 72 patients. Side branches were classified into 2 groups: group 1 had ostial side branch stenosis due to atherosclerotic plaque only in the main vessel (n=61), and group 2 had plaque truly involved in the side branch ostium (n=20). There was no significant difference between the 2 groups in the extent of ostial stenosis as assessed by angiography. After PCI, 7 side branches occluded in group 2, compared with 5 side branches occluded in group 1 (35% vs 8%, p=0.003). Ostial plaque distribution as assessed by IVUS may be one of the consistent predictors of side branch occlusion after PCI.

Sonographic prediction of significant intertwin birth weight discordance

Object To evaluate the usefulness of sonographic prediction of significant birth weight discordance in twin pregnancies. Study design Included in the study were live twin pairs with a gestational age of 24 weeks at birth who had received a sonographic examination within 28 days of delivery. Correlation tests and ROC curves were used to evaluate the predictability of significant intertwin growth discordance. Results A total of 575 twin pregnancies were included in the study. The estimated discordance by sonographic examination proved to be an effective predictor of discordant twin growth. The birth weight discordance estimated by sonography tended to underestimate the degree of discordant twins. Conclusion If a sonographic examination is done within 28 days of delivery, it is a reliable predictor of twin birth weight discordance at the following levels: 15%, 20%, 25% or 30%. In order to obtain a higher sensitivity, the cut-off value of estimated birth weight discordance needs to be decreased by 5%.

O uso do ultra-som intracoronariano na tomada de decisão para o tratamento das lesões coronarianas moderadas

OBJETIVO: Investigar o critério ultra-sonográfico de área mínima da luz (AML), com valor de corte igual a 4,0 mm² na tentativa de diferençar as lesões que devem ou não ser tratadas. MÉTODOS: Incluímos 173 pacientes consecutivos com lesões angiograficamente moderadas (porcentual de estenose entre 40 e 70) submetidos à realização de ultra-som, divididos em 2 grupos: grupo 1 clínico (AML > 4,0 mm²) e grupo 2 revascularização (AML < 4,0 mm²), que foram acompanhados para determinar as taxas de eventos cardíacos maiores (ECM) em dois anos, a necessidade de revascularização da lesão-alvo e identificar os preditores clínicos, angiográficos e ultra-sonográficos dos eventos. RESULTADOS: Apresentaram AML > 4,0 mm² 75 (43%) pacientes, mantidos clinicamente e 98 (57%) pacientes AML < 4,0 mm², tratados com stents coronarianos. Pela angiografia coronariana quantitativa não houve diferença significante entre o porcentual de estenose do vaso [grupo 1: 48% vs grupo 2: 53%; p=0,06]. Ao contrário das mensurações ultra-sonográficas, pois a AML mostrou-se significativamente maior no grupo 1 quando comparada ao grupo 2 [4,54 mm² vs 2,45 mm²; p<0,001)]. O impacto clínico da tomada de decisão foi favorável, não verificando-se diferença na ocorrência de eventos cardíacos maiores: [grupo 1: 5 (7%) vs grupo 2: 14 (15%); p= 0,09]. A necessidade de revascularização da lesão-alvo também não diferiu (grupo 1: 3 (4%) vs grupo 2: 11 (12%); p=0,07). As variáveis preditoras para os ECM foram: diabetes, angina CFIII pré-hospitalização e a AML avaliada pelo ultra-som. CONCLUSÃO: A estratégia de decisão de tratamento assegura baixas taxas de ECM em ambos os grupos no seguimento de 24 meses, garantindo reduzidas taxas de revascularização, sendo as variáveis preditoras de eventos cardíacos maiores: diabetes melito, angina classe funcional III e a AML ao ultra-som intracoronariano.

P14.16: Ultrasonographic prediction of birth weight in relation to different fetal weight: a comparison of eleven sonographic models

P14.16: Ultrasonographic prediction of birth weight in relation to different fetal weight: a comparison of eleven sonographic models

Abdominal circumference ratio: a useful predictor of twin birth weight discordance

To assess the accuracy of sonographic prediction of twin birth weight discordance using the abdominal circumference (AC) ratio. Additionally, to determine whether the efficacy of this method is dependent on chorionicity.

Ultrasonographic prediction of clinical pulmonary hypoplasia: measurement of the chest/trunk-length ratio in fetuses

Pulmonary hypoplasia is involved in patients with various surgical diseases. The aim of this study was to evaluate the clinical usefulness of measurement of the chest/trunk-length ratio (C/T) for predicting pulmonary hypoplasia in patients with congenital anomalies, with the exception of mass-like lesions in the thorax such as diaphragmatic hernia and cystic lung diseases. For measurement of C/T on fetal ultrasound, the sagittal section of the body trunk, including the spine, was analyzed. C/T was calculated as the chest length, defined from the top of the thorax to the top of the diaphragm, divided by the trunk length, defined from the top of the thorax to the bottom of the urinary bladder. From 1986 to 2000, measurements of C/T were undertaken in 49 healthy fetuses from 17 to 37 weeks of gestation and 98 fetuses with congenital anomalies, with the exception of intra-thoracic mass lesions, omphalocele, and fetal hydrops. Pulmonary hypoplasia was clinically assessed by the following criteria: (1) a lung-to-birth-weight ratio of 0.012 or less; (2) patients who required high-frequency oscillatory ventilation with mean airway pressure of 15 cmH(2)O or more with pure oxygen and/or who died presenting respiratory failure without evidences of meconium aspiration, congenital pneumonia, sepsis or hyaline membrane disease. For a predicting value for pulmonary hypoplasia to be obtained, sensitivity, specificity, positive predictive value and negative predictive value were quoted between C/T in patients with pulmonary hypoplasia and those without pulmonary hypoplasia. Healthy fetuses revealed the mean value as 0.38+/-0.03, with no significant change after 20 weeks of gestation. Pulmonary hypoplasia was assessed in 25 fetuses with urethral atresia and stenosis, renal agenesis, polycystic kidney, cloacal anomalies, diaphragmatic eventration, bronchopulmonary foregut malformation, chest deformity, meconium peritonitis and sacrococcygeal teratoma. As a predicting value for pulmonary hypoplasia, 0.32 or less of the maximum value of C/T indicated good accuracy, with a sensitivity of 92.0%, specificity of 95.9%, positive predictive value of 88.5% and negative predictive value of 97.2%. Ultrasonic measurement of C/T is useful in predicting postnatal respiratory conditions with regard to pulmonary hypoplasia.

Intravascular ultrasound predictors of late recurrence after stent implantation in small coronary arteries

Intravascular ultrasound predictors of late recurrence after stent implantation in small coronary arteries

Ultrasonographic prediction of term birth weight: How accurate is it?

Objective: The purpose of this study was to investigate the accuracy of 25 ultrasonic algorithms for the estimation of term fetal weight and to compare these results to an equation that is based on maternal and pregnancy-specific characteristics alone. Study design: Ultrasonography was performed in 82 nondiabetic gravid women at 35 to 41 weeks of gestation. Fetal biparietal diameter, abdominal circumference, head circumference, and femur length were measured. Twenty-five ultrasonic fetal biometric algorithms and an equation that is based only on maternal characteristics were used to predict birth weight. Results: The correlation between predicted and actual birth weight ranged from 0.44 to 0.79 for the ultrasonic algorithms and was 0.60 for the maternal characteristics equation. Ultrasonic algorithms had mean absolute prediction errors that ranged from ±263 to 646 g (±7.5%−18.8%). Accuracy for the maternal characteristics equation was not statistically different from the best performing ultrasonic algorithms (±353 g, ±10.4%). Conclusion: Term birth weight estimates that use ultrasonography are generally no more accurate than predictions that are based solely on quantitative assessment of maternal and pregnancy-specific characteristics. (Am J Obstet Gynecol 2003;188:566-74.)

P379: Application of multivariate logistic regression for the sonographic prediction of endometrial cancer: the use of three-dimensional endometrial volume and 3D blood flow indices assessment

P379: Application of multivariate logistic regression for the sonographic prediction of endometrial cancer: the use of three-dimensional endometrial volume and 3D blood flow indices assessment

OC260: Sonographic prediction of malignancy in tumors of suspected ovarian origin with the use of artificial neural networks

OC260: Sonographic prediction of malignancy in tumors of suspected ovarian origin with the use of artificial neural networks

Rate and Predictors of Spontaneous Resolution of Prenatally Diagnosed Primary Nonrefluxing Megaureter

We assessed clinical and ultrasound predictors of the spontaneous resolution of prenatally diagnosed, primary nonrefluxing megaureter. Primary nonrefluxing megaureter was prenatally diagnosed in 54 neonates from 1993 to 1998, including 15 in whom it was bilateral (69 megaureters). Median followup period from birth to the last radiology examination was 25.8 months (range 2.3 to 72). Of the patients 10 underwent surgical repair for severe hydroureteronephrosis, including decreasing renal function on diuretic renography in 1, and an episode of bilateral obstruction and acute renal failure in 1. Hydroureteronephrosis resolved in 39 cases (72%) and persisted in 5 at 30 to 72 months of followup. Laterality, gender and retrovesical ureteral diameter had no significant effect on the resolution rate (p >0.05). Mean initial ureteral diameter in patients with resolution was less than in those without resolution and in those who underwent surgery (0.8 versus 1.15 and 1.32 cm., respectively). Presenting hydronephrosis grade was a significant predictor of the resolution rate (p = 0.03). Grades 1 to 3 hydronephrosis resolved at a median age of 12.9, 23.9 and 34.6 months, respectively (range 4.1 to 66). In patients in whom grades 4 and 5 hydronephrosis resolved the median age at resolution was 48.5 months. Most cases of prenatally diagnosed, primary nonrefluxing megaureter resolve spontaneously. Grades 1 to 3 hydronephrosis tend to resolve between ages 12 and 36 months. For these grades followup intervals may be progressively elongated after a pattern of improving hydronephrosis has been established. In children with grade 4 or 5 hydronephrosis, or a retrovesical ureteral diameter of greater than 1 cm. the condition may resolve slowly and require surgery.

Outcome of treatment of aorto-ostial lesions involving the right coronary artery or a saphenous vein graft with a polytetrafluoroethylene- covered stent

Percutaneous treatment of native coronary and saphenous vein graft aorto-ostial (A-O) stenosis has been associated with lower procedural success rates of 70% to 97%, more frequent in-hospital complications of 5% to 12%, and a greater likelihood of late restenosis of 28% to 52% when compared with the treatment of nonostial lesions. 1 Eigler N.L. Weinstock B. Douglas Jr, J.S. Goldenberg T. Hartzler G. Holmes D. Leon M. Margolis J. Nobuyoshi M. O’Neill W. Excimer laser coronary angioplasty of aorto-ostial stenoses. Results of the excimer laser coronary angioplasty (ELCA) registry in the first 200 patients. Circulation. 1993; 88: 2049-2057 Crossref PubMed Scopus (56) Google Scholar , 2 Sabri M.N. Cowley M.J. DiSciascio G. DeBottis D. Kelly K. Goudreau E. Vetrovec G.W. Immediate results of interventional devices for coronary ostial narrowing with angina pectoris. Am J Cardiol. 1994; 73: 122-125 Abstract Full Text PDF PubMed Scopus (21) Google Scholar , 3 Stephan W.J. Bates E.R. Garratt K.N. Hinohara T. Muller D.W. Directional atherectomy of coronary and saphenous vein graft ostial stenoses. Am J Cardiol. 1995; 75: 1015-1018 Abstract Full Text PDF PubMed Scopus (12) Google Scholar , 4 Hoffmann R. Mintz G.S. Mehran R. Pichard A.D. Kent K.M. Satler L.F. Popma J.J. Wu H. Leon M.B. Intravascular ultrasound predictors of angiographic restenosis in lesions treated with Palmaz-Schatz stents. J Am Coll Cardiol. 1998; 31: 43-49 Abstract Full Text Full Text PDF PubMed Scopus (272) Google Scholar , 5 Heidland U.E. Heintzen M.P. Michel C.J. Strauer B.E. Risk factors for the development of restenosis following stent implantation of venous bypass grafts. Heart. 2001; 85: 312-317 Crossref PubMed Scopus (21) Google Scholar , 6 Rocha-Singh K. Morris N. Wong S.C. Schatz R.A. Teirstein P.S. Coronary stenting for treatment of ostial stenoses of native coronary arteries or aortocoronary saphenous venous grafts. Am J Cardiol. 1995; 75: 26-29 Abstract Full Text PDF PubMed Scopus (77) Google Scholar , 7 Jain S.P. Liu M.W. Dean L.S. Babu R. Goods C.M. Yadav J.S. Al-Shaibi K.F. Mathur A. Iyer S.S. Parks J.M. Baxley W.A. Roubin G.S. Comparison of balloon angioplasty versus debulking devices versus stenting in right coronary ostial lesions. Am J Cardiol. 1997; 79: 1334-1338 Abstract Full Text PDF PubMed Scopus (40) Google Scholar Stents, despite their proved benefit in other indications, do not substantially reduce the incidence of restenosis in A-O lesions. 5 Heidland U.E. Heintzen M.P. Michel C.J. Strauer B.E. Risk factors for the development of restenosis following stent implantation of venous bypass grafts. Heart. 2001; 85: 312-317 Crossref PubMed Scopus (21) Google Scholar , 6 Rocha-Singh K. Morris N. Wong S.C. Schatz R.A. Teirstein P.S. Coronary stenting for treatment of ostial stenoses of native coronary arteries or aortocoronary saphenous venous grafts. Am J Cardiol. 1995; 75: 26-29 Abstract Full Text PDF PubMed Scopus (77) Google Scholar , 8 Zampieri P. Colombo A. Almagor Y. Maiello L. Finci L. Results of coronary stenting of ostial lesions. Am J Cardiol. 1994; 73: 901-903 Abstract Full Text PDF PubMed Scopus (99) Google Scholar Balloon expandable stents covered by a polytetrafluoroethylene (PTFE) membrane have been used for the treatment of de novo lesions in saphenous vein grafts with favorable results. 9 Baldus S. Koster R. Elsner M. Walter D.H. Arnold R. Auch-Schwelk W. Berger J. Rau M. Meinertz T. Zeiher A.M. Hamm C.W. Treatment of aortocoronary vein graft lesions with membrane-covered stents a multicenter surveillance trial. Circulation. 2000; 102: 2024-2027 Crossref PubMed Scopus (74) Google Scholar , 10 Briguori C. De Gregorio J. Nishida T. Adamian M. Albiero R. Tucci G. Di Mario C. Colombo A. Polytetrafluoroethylene-covered stent for the treatment of narrowings in aorticocoronary saphenous vein grafts. Am J Cardiol. 2000; 86: 343-346 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar , 11 Baldus S. Koster R. Reimers J. Kahler J. Meinertz T. Hamm C.W. Membrane-covered stents a new treatment strategy for saphenous vein graft lesions. Catheter Cardiovasc Interv. 2001; 53: 1-4 Crossref PubMed Scopus (20) Google Scholar The membrane coverage yields a rationale to use the device in A-O lesions, to prevent proliferation through the stent struts from the aortic wall, and possibly decrease the restenosis rate. We report the angiographic and immediate and late long-term clinical results of the first published cohort of patients that received PTFE-covered stents for the treatment of A-O lesions.

Clinical and ultrasonographic weight estimation in large for gestational age fetus

Objective: To examine prospectively the effect on pregnancy outcome of a management protocol, that adds ultrasonographic weight estimation in fetuses suspected clinically as large. Study design: Prospective follow up study of all singleton deliveries during a 1 year period. All patients underwent routine clinical estimation of fetal weight. When clinical estimation of fetal weight was ≥3700 g, patients were referred for ultrasonographic estimation of fetal weight. When the latter was ≥4000 g the patient was informed about the risks of birth trauma. Cesarean section was recommended only when ≥4500 g. Ultrasonography was repeated every 4 days when possible. Predictive values of clinical and ultrasonographic estimations of fetal weight for diagnosing macrosomia, defined for the purpose of this study as 4000 g or more, and their effect on the rate of cesarean sections. Results: Five hundred fifty-five (14.4%) out of 3844 singletons were estimated as 3700 g or more. Only 315 fetuses had ultrasonographic estimation of weight within 3 days of delivery. The sensitivity of clinical and ultrasonographic prediction of macrosomia was 68 and 58%, respectively. Cesarean section rate in newborns weighing 4000 g or more was 22% when macrosomia was clinically suspected compared to 11% when it was not ( P<0.05). In fetuses estimated ultrasonographically as 4000 g or larger the cesarean section rate was doubled (50.7% versus 24.9%, P<0.05) compared to those estimated as smaller than 4000 g, although actual weight of 4500 g or more was recorded in 10.6 and 8.5% of these groups, respectively. There were no cases of shoulder dystocia in macrosomic babies when macrosomia was not detected by ultrasound compared to two cases of shoulder dystocia (2.7%) when macrosomia was detected by ultrasound. Conclusion: Antenatal suspicion of macrosomia increased the cesarean section rate while the associated improvement in pregnancy outcome remains questionable. The contribution of ultrasound, added to routine clinical estimation of fetal weight, was clinically insignificant apart from a further increase in cesarean section rate.

Effect of coronary stent overexpansion on lumen size and intimal hyperplasia at follow-up

Although previous randomized trials 1 Fischman D. Leon M.B. Baim D.S. Schatz R.A. Savage M.P. Penn I. Detre K. Veltri L. Ricci D. Nobuyoshi M. et al. for the Stent Restenosis Study InvestigatorsA randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med. 1994; 331: 496-501 Crossref PubMed Scopus (4143) Google Scholar have demonstrated lower restenosis rates in selected lesions with coronary stents than with conventional balloon angioplasty, in-stent restenosis remains an important clinical problem. 2 Kobayashi Y. De Gregorio J. Kobayashi N. Akiyama T. Reimers B. Finci L. Di Mario C. Colombo A. Stented segment length as an independent predictor of restenosis. J Am Coll Cardiol. 1999; 34: 651-659 Abstract Full Text Full Text PDF PubMed Scopus (257) Google Scholar Previous studies 3 Kuntz R.E. Gibson C.M. Nobuyoshi M. Baim D.S. Generalized model of restenosis after conventional balloon angioplasty, stenting and directional atherectomy. J Am Coll Cardiol. 1993; 21: 15-25 Abstract Full Text PDF PubMed Scopus (493) Google Scholar , 4 Hoffmann R. Mintz G.S. Mehran R. Picahrd A.D. Kent K.M. Satler L.F. Popma J.J. Hogsheng W. Leon M.B. Intravascular ultrasound predictors of angiographic restenosis in lesions treated with Palmaz-Schatz stents. J Am Coll Cardiol. 1997; 31: 43-49 Abstract Full Text Full Text PDF Scopus (272) Google Scholar have demonstrated that a major determinant of the rate of restenosis is the final minimal lumen diameter achieved after intervention, the so-called “bigger is better” principle. As a property of stents, a larger lumen could be achieved compared with that at the reference segment (stent overdilatation). However, previous animal and human clinical percutaneous coronary intervention studies 5 Schwartz R.S. Huber K.C. Murphy J.G. Edwards W.D. Camrud A.R. Vlietstra R.E. Holmes D.R. Restenosis and the proportional neointimal response to coronary artery injury results in a porcine model. J Am Coll Cardiol. 1992; 19: 267-274 Abstract Full Text PDF PubMed Scopus (1048) Google Scholar , 6 Hoffmann R. Mintz G.S. Mehran R. Kent K.M. Pichard A.D. Satler L.F. Leon M.B. Tissue proliferation within and surrounding Palmaz-Schatz stent is dependent on the aggressiveness of stent implantation technique. Am J Cardiol. 1999; 83: 1170-1174 Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar , 7 Koyama J. Owa M. Sakurai S. Shimada H. Hikita H. Higashikata T. Ikeda S. Relation between vascular morphologic changes during stent implantation and the magnitude of in-stent neointimal hyperplasia. Am J Cardiol. 2000; 86: 753-758 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar have documented that an increase in vessel wall injury promotes intimal hyperplasia. Thus, the need to achieve a larger acute lumen diameter with stents and the degree of injury is a trade-off. The present study evaluated the effect of stent overdilatation on lumen size and intimal hyperplasia at follow-up.

Ultrasonographic prediction of birth weight in diabetic pregnancies

OBJECTIVE: To compare diabetic and nondiabetic pregnant women near term regarding the accuracy of predicted birth weight by the gestation-adjusted projection method using ultrasonographic measurements. METHODS: Patients with singleton pregnancies who had diabetes and who underwent sonograms between 34.0 weeks and 36.9 weeks formed the study group. The control group was comprised of nondiabetic women who had sonograms in the same gestational age range. The absolute birth weight errors and absolute percent errors in the study group and the controls were compared with t tests. RESULTS: A total of 133 diabetic women and 1690 controls were included in the study. The mean (± standard deviation) absolute error of the predicted birth weight was 265 ± 210 g in the diabetic women and 261 ± 204 g in the control group ( P = .87). The mean (± standard deviation) absolute percent error was 7.4% ± 6.3% for diabetic women compared with 8.3% ± 6.6% for the controls ( P = .14). CONCLUSION: Prediction of birth weight using the gestation-adjusted projection method is as accurate in diabetic women as in controls.