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5 results

  • Chapter 19.2 - Congenital diaphragmatic hernia

  • from Section 2 - Fetal disease
  • Edited by Mark D. Kilby, Anthony Johnson, Baylor College of Medicine, Texas, Dick Oepkes
  • Book:
    Fetal Therapy
    Published online:
    05 February 2013
    Print publication:
    13 December 2012, pp 376-388

  • Summary

    This chapter discusses congenital diaphragmatic hernia (CDH) from a perspective of antenatal management, including fetal intervention. It summarizes actual survival rates when this condition is managed after birth, essentially showing that there is no effective postnatal therapy in a subset of fetuses. Prediction methods are typically based on estimation of lung size by ultrasound and determination of liver herniation into the thorax. Three-dimensional (3D) ultrasound (US) and MRI both allow measurement of absolute lung volumetry. MRI allows better visualization of the ipsilateral lung than 3D US. Preliminary work on the use of diffusion-weighted imaging (DWI)-MRI as a tool to differentiate between normal and pathological lung development has shown a significant relationship between DWI-MRI parameters and gestational age in the normal fetus. The chapter also describes the current clinical experience with fetal surgery, including the design of trials that will have to determine the place of fetal surgery.

  • 1 - Overview and definitions of polycystic ovary syndrome and the polycystic ovary

  • Edited by Adam Balen, University of Leeds, Stephen Franks, Roy Homburg, Sean Kehoe
  • Book:
    Current Management of Polycystic Ovary Syndrome
    Published online:
    05 July 2014
    Print publication:
    01 October 2010, pp 1-12

  • Summary

    Polycystic ovary syndrome (PCOS) is a syndrome with varied manifestations both within different populations and between different populations. With recent increases in the understanding of the pathophysiology of PCOS and the recognition of the importance of ultrasound in defining the morphology of the polycystic ovary, the syndrome has now been defined as the presence of two of the following three criteria: oligo-ovulation and/or anovulation, hyperandrogenism (clinical and/or biochemical), polycystic ovaries; with the exclusion of other aetiologies of menstrual disturbance and androgen excess. There are likely to be many routes to the development of PCOS, including genetic predisposition, environmental factors and disturbances of a number of endocrine pathways. To establish the diagnosis of PCOS it is important to exclude other disorders with a similar clinical presentation, such as congenital adrenal hyperplasia, Cushing syndrome, and androgen-secreting tumours.

  • Chapter 15 - Ultrasonography of pelvic endometriosis

  • from Section 2: - Ultrasonography in infertility
  • Edited by Botros R. M. B. Rizk, University of South Alabama
  • Book:
    Ultrasonography in Reproductive Medicine and Infertility
    Published online:
    07 September 2011
    Print publication:
    25 March 2010, pp 119-125

  • Summary

    Power Doppler ultrasound (US), in combination with three-dimensional US and virtual organ computer-aided analysis (VOCAL), is a very good approach for investigating the global ovarian vascular network and its correlation with ovarian response in assisted reproductive technology (ART). An ovarian vascular map is easily obtained from a sagittal section of the ovary. Three-dimensional US has become a key tool for diagnosing uterine malformations. Leiomyomas and endometrial polyps are the most frequent benign uterine pathologies, and both can interfere with the reproductive process. The human endometrium undergoes intense angiogenesis during menstrual cycle, and angiogenesis is a key process for successful embryo implantation and development. In reproductive medicine, it is crucial to exclude ectopic pregnancy as early as possible. 3D US is a more accurate technique for evaluating the relationship between the gestational sac and uterine septum and for differentiating between a cornual pregnancy and a displaced intracavitary pregnancy.

  • 10 - Ultrasound imaging of the lower urinary tract and uterovaginal prolapse

  • Edited by Davor Jurkovic, Lil Valentin, Sanjay Vyas
  • Book:
    Gynaecological Ultrasound in Clinical Practice
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 107-120

  • Summary

    Ultrasound has the advantage of being able to visualise fluid-filled structures without the need for contrast medium. It can demonstrate soft tissue structures such as the kidney, bladder wall, urethral and anal sphincters and surrounding pelvic floor musculature. Use of the transabdominal, transvaginal, transrectal and transperineal approaches for ultrasound scanning allows for easy visualisation of different aspects of the lower urinary tract. Bladder diverticula are easily visualised with transabdominal ultrasound. Transvaginal ultrasound allows clearer visualisation of the bladder base, bladder neck, inferior border of the pubic symphysis and periurethral structures. Translabial ultrasound is used to demonstrate uterovaginal prolapse. Three-dimensional ultrasound offers new insights into the pelvic floor as it allows imaging of both the levator ani muscle hiatus and paravaginal support structures in axial and transverse planes. This gives access to transverse planes similar to magnetic resonance imaging.

  • Reproducibility of energy intake, gastric emptying, blood glucose, plasma insulin and cholecystokinin responses in healthy young males

  • Nivasinee S. Nair, Ixchel M. Brennan, Tanya J. Little, Diana Gentilcore, Trygve Hausken, Karen L. Jones, Judith M. Wishart, Michael Horowitz, Christine Feinle-Bisset
  • Journal:
    British Journal of Nutrition / Volume 101 / Issue 7 / 14 April 2009
    Published online by Cambridge University Press:
    05 August 2008, pp. 1094-1102
    Print publication:
    14 April 2009
    • Article
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  • Gastric emptying, as well as intragastric meal distribution, and gastrointestinal hormones, including cholecystokinin (CCK), play an important role in appetite regulation. The evaluation of gastrointestinal factors regulating food intake is commonly performed in healthy, lean, young male participants. It has, however, been suggested that there is a marked interindividual variability in the effects of nutrient ‘preloads’ on energy intake in this group. Whether there is significant intraindividual variation in acute energy intake after a nutrient preload, and, if so, how this relates to day-to-day differences in gastric emptying and gastrointestinal hormone release, is unclear. The purpose of the present paper is to evaluate the hypothesis that energy intake after a nutrient preload would be reproducible and associated with reproducible patterns of gastric emptying, intragastric distribution and gastrointestinal hormone release. Fifteen healthy men (age 25 (sem 5) years) consumed a glucose preload (50 g glucose in 300 ml water; 815 kJ) on three occasions. Gastric emptying and intragastric meal distribution (using three-dimensional ultrasound), blood glucose, plasma insulin and CCK concentrations and appetite perceptions were evaluated over 90 min, and energy intake from a cold buffet-style meal was then quantified. Energy intake was highly reproducible within individuals between visits (intraclass correlation coefficient, ri = 0·9). Gastric emptying, intragastric meal distribution, blood glucose, plasma insulin and CCK concentrations and appetite perceptions did not differ between visits (ri>0·7 for all). In healthy males, energy intake is highly reproducible, at least in the short term, and is associated with reproducible patterns of gastric emptying, glycaemia, insulinaemia and CCK release.