Antley-Bixler syndrome: report of a case.
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Abnormalities, Multiple↗
Biomedical subjects
N G Osborne
Publications and source records attributed to N G Osborne.
Concerns regarding the Centers for Disease Control's published guidelines for pelvic inflammatory disease.
The International-Infectious Disease Society for Obstetrics and Gynecology-USA (I-IDSOG-USA) has concerns about the most recently published Centers for Disease Control and Prevention (CDC) guidelines for pelvic inflammatory disease (PID). I-IDSOG-USA advocates the following changes when the guidelines are revised. We recommend the use of the term "upper genital tract infection" (UGTI), followed by the designation of the etiologic agent, instead of the currently employed term, "pelvic inflammatory disease," or PID. In diagnoses, there should be greater emphasis on signs and symptoms related to subclinical or occult UGTI. Therapeutic recommendation for the treatment of UGTI should be documented for various stages of this diverse disease entity. There should be greater emphasis on hospitalization for infected nulligravida teenagers. This permits monitoring of antibiotic treatment and provides a site for medical educational efforts to teach this medically underserved segment of our society how to protect their future fertility, their health, and their lives.
Acute Disease↗
Polycystic ovarian syndrome: assessment with color Doppler angiography and three-dimensional ultrasonography.
We conducted a three-dimensional ultrasonographic evaluation of the size and structure of the ovaries of women who had clinical and biochemical findings suggestive of polycystic ovary syndrome. We carried out a comparative color Doppler frequency and color Doppler amplitude study of the vascular patterns of these ovaries. This study involved 65 women of reproductive age with polycystic ovary syndrome and 25 eumenorrheic women who were not taking hormonal contraceptives and who had a body mass index below 25 kg/m2. Compared to controls, women with polycystic ovary syndrome had larger ovaries and thicker stroma, increased impedance in the uterine arteries, increased stromal vascularity with decreased impedance that persisted throughout the menstrual cycle, and a lack of luteal conversion.
Adult↗
Preoperative contrast ultrasonographic diagnosis of patent urachal sinus.
A patent urachal sinus, as well as other congenital urachal anomalies, may be at risk of injury during laparoscopy. Leakage of fluid at the midline site of trocar entry is the usual postoperative sign of injury to a patent urachal sinus. Pre-operative diagnosis of this anomaly can prevent injury during laparoscopy. We describe a contrast ultrasound technique for diagnosis of patent urachal sinus.
Female↗
Ultrasonography as a screening tool for paravaginal defects in women with stress incontinence: a pilot study.
The aim of the study was to determine whether transabdominal ultrasonography can accurately identify paravaginal defects associated with genuine stress urinary incontinence. Sixteen women were diagnosed with genuine stress urinary incontinence (GSUI) following clinical evaluation, urethroscopy and urodynamic studies. They were then evaluated by transabdominal sonography and a full bladder and immediately following micturition. The ultrasound studies were also carried out in 8 women (5 nulliparous and 3 primiparous) who had no signs or symptoms of urinary incontinence. Paravaginal defects were detected in the 16 women with GSUI: 9 had unilateral defects and 7 had bilateral defects. Only right-sided defects were identified in women with unilateral lesions. Paravaginal defects were confirmed in all symptomatic women at the time of surgery, and corresponded with the defects identified with transabdominal ultrasound. Mild unilateral paravaginal defects were identified in 2 continent parous women. Five nulliparous women and 1 primiparous control had no ultrasound evidence of paravaginal defects. A transabdominal, transverse, suprapubic ultrasound scan with a full bladder is a promising screening technique for the diagnosis of paravaginal defect in women with GSUI. Transabdominal suprapubic longitudinal sections are not useful for the identification of paravaginal defects.
Case-Control Studies↗
First-trimester neck abnormalities: three-dimensional evaluation.
In order to study the first trimester ultrasonographic differences between nuchal translucency and hygroma colli, we rescanned 25 fetuses (13 with nuchal translucency and 12 with hygroma colli) using transvaginal and three-dimensional ultrasonography, after obtaining a fetal karyotype report. Our objective was to test the premise that the different physiopathologic mechanisms of both processes would be reflected in detectable sonographic differences. Our retrospective analysis showed that the most striking ultrasonographic difference was the presence of bullae as well as greater irregularity, extent, and amplitude of the membrane in cases of hygroma colli. Fetuses with simple nuchal translucency had a more homogeneous linear membrane. Although detailed analysis was impossible in 30% of cases, we found three-dimensional ultrasonography to be a useful technique for establishing the differences between these two entities.
Female↗
Early diagnosis of conjoined twins using two-dimensional color Doppler and three-dimensional ultrasound.
Transvaginal three-dimensional (3-D) and color Doppler ultrasound were used to establish a first-trimester definitive diagnosis and classification of thoracoomphalopagus conjoined twins following two-dimensional (2-D) transabdominal and transvaginal scans that indicated twin gestation of uncertain classification. Color Doppler in combination with 3-D ultrasound can be a useful complement to 2-D ultrasound to confirm early diagnosis and determine the extent of organ sharing and definitive classification of conjoined twins.
Abortion, Induced↗
Alternative techniques of hysterectomy.
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Female↗
Three-dimensional hysterosonography for the study of endometrial tumors: comparison with conventional transvaginal sonography, hysterosalpingography, and hysteroscopy.
We studied endometrial thickness and homogeneity in 36 patients with postmenopausal bleeding using three-dimensional ultrasound following distention of the uterine cavity with a sterile saline solution (3D-SHSG). Results with 3D-SHSG were compared with findings using transvaginal sonography, transvaginal sonohysterography, transvaginal color Doppler, and hysteroscopy. Sixteen patients (including three on tamoxifen) were undergoing hormone therapy at the time when they were studied. Visualization of the uterine cavity and of endometrial thickness was better with 3D-SHSG than with any of the other ultrasound techniques. The results with 3D-SHSG corresponded to the findings observed with hysteroscopy. Three-dimensional SHSG seems to improve ultrasound determination of myometrial and cervical invasion in cases of endometrial adenocarcinoma.
Endometrial Hyperplasia↗
Method for diagnosing paravaginal defects using contrast ultrasonographic technique.
Thirty women with pelvic relaxation and genuine stress urinary incontinence were evaluated with a contrast ultrasonography technique developed for the diagnosis of paravaginal defects. Control subjects were continent women with vaginal prolapse and nulliparous asymptomatic women. Seventeen incontinent patients had unilateral right-sided paravaginal defects and 13 had bilateral paravaginal defects. All continent controls with vaginal prolapse had bilateral paravaginal defects. None of the nulliparous controls had paravaginal defects. The contrast ultrasonographic technique also was found to be useful for postoperative evaluation and documentation of the anatomic results achieved after laparoscopic paravaginal repair.
Adult↗
Control of intrauterine device insertion with three-dimensional ultrasound: is it the future?
A comparative study was designed to determine whether three-dimensional transvaginal sonography (3D-TVS) offered advantages over two-dimensional transvaginal sonography (2D-TVS) for the identification and location of IUDs in 66 asymptomatic women. Hysteroscopy was performed in cases in which there was a discrepancy between the information obtained by both methods (n = 14). In eight cases (12.2%) the IUD was misidentified with 2D-TVS. In six cases (9.1%) it was not possible to identify the device model with 2D-TVS. In two cases (3.0%) 2D-TVS failed to identify the position of the device. In contrast, all IUDs were identified and located accurately with 3D-TVS.
Adult↗
Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound.
OBJECTIVE: To determine whether it is possible to identify and diagnose accurately Müllerian anomalies with three-dimensional (3-D) ultrasound (US). DESIGN: Controlled blinded clinical study. SETTING: Normal human volunteers undergoing infertility evaluation in a university hospital. PATIENTS: Forty-two patients who underwent laparoscopy and hysterosalpingography as part of their work up for infertility and were found to have either a normal uterus (30 patients) or a Müllerian abnormality (12 patients) consented to be evaluated with 3-D US by sonographers who were unaware of their infertility history or of their laparoscopy and hysterosalpingography diagnoses. INTERVENTIONS: Transvaginal 3-D US evaluation over a 10- to 15-minute duration. MAIN OUTCOME MEASURES: Three-dimensional imaging was successful in all cases. RESULTS: Sonographers identified a Müllerian anomaly in all cases and came up with the correct classification in 11 of 12 cases. All patients with a normal uterus were identified correctly. CONCLUSIONS: In all patients with Müllerian anomalies, 3-D US examination of the endometrial cavity correlated with hysterosalpingography. In 91.6% of patients, 3-D US correlated with the external uterine configuration observed by laparoscopy. This technique may be used reliably in an office setting to diagnose and classify Müllerian anomalies.
Adult↗
Subchorionic placental cyst: a cause of fetal growth retardation--ultrasound and color-flow Doppler diagnosis and follow-up.
Subchorionic placental cysts are ominous findings. When attached near the umbilical cord insertion, the risk of umbilical cord constriction is increased. This may cause fetal growth retardation and intrauterine asphyxia. This article reports a case of subchorionic placental cyst diagnosed in the first trimester by transvaginal ultrasound. Color Doppler ultrasound demonstrated a reduction of the umbilical cord bloodstream as the cyst increased in size. Fetal growth retardation was evident in the third trimester.
Adult↗
Three-dimensional ultrasound evaluation of ovarian masses.
Seventy-six women with ovarian masses first detected with two-dimensional (2D) ultrasound were then evaluated with three-dimensional (3D) ultrasound. Two-dimensional ultrasound detected four of five ovarian malignancies. One additional ovarian carcinoma was diagnosed by 3D scanning. Observation of papillary projections, characteristics of cystic walls, and the extent of capsular infiltration of tumors was superior with 3D ultrasound as was the calculation of ovarian volume. Fifty-seven of the women studied underwent surgery within 7 days of 3D ultrasound evaluation. Histologic examination of surgical specimens confirmed the 3D sonographic diagnoses. There was one false positive and one false negative diagnosis with 2D ultrasound. All cases of ovarian malignancy were diagnosed correctly with 3D ultrasound.
Adolescent↗
Use of three-dimensional ultrasonography for the study of normal and pathologic morphology of the human embryo and fetus: preliminary report.
Our objective was to determine whether three-dimensional ultrasonography offers advantages over two-dimensional sonography for the evaluation of normal and pathologic morphology of human embryos and fetuses at various stages of pregnancy. Our studies suggest that small fetal and embryonic malformations are better defined with 3D sonography. Our experience indicates that 3D sonography allows more detailed visualization of fetal internal structures. We believe that with technical improvements 3D sonography will permit a more complete evaluation of fetuses earlier in gestation than is possible with current 2D sonographic instruments.
Adolescent↗
Does transvaginal color Doppler sonography differentiate between developing and involuting ectopic pregnancies?
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Adolescent↗
Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler ultrasonography.
We used transvaginal color Doppler sonography to study uterine artery blood flow velocity waveforms in 345 normal postmenopausal women who had never been on hormone replacement therapy. Our objective was to establish the standard baseline flow values for normal postmenopausal women. The mean pulsatility index was 3.38 +/- 1.04 and the mean resistive index was 0.93 +/- 0.09. There was a positive correlation between arterial blood flow impedance and number of years since menopause. We believe that these levels may become important screening parameters for the detection of endometrial carcinoma in postmenopausal women.
Adult↗
Normal uterine arterial blood flow in postmenopausal women assessed by transvaginal color Doppler sonography: the effect of hormone replacement therapy.
We used transvaginal color Doppler sonography to study the effect of hormone replacement on the uterine arterial blood flow for 203 postmenopausal women. The regimens studied involved estrogen replacement alone, continuous combined estrogen and progestogen, and estrogen followed sequentially by combined estrogen-progestogen. The mean pulsatility index fell to 65% +/- 9% and the mean resistive index fell to 87% +/- 4% of baseline during the first month of therapy (P < 0.0001). The addition of a progestogen did not alter the effect of estrogen alone (P > 0.5). Our findings suggest that the increase in vascular flow occurs even in women who begin therapy long after menopause.
Arteries↗