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1.
Cardiovasc Pathol ; 39: 38-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30623879

RESUMO

The traditional classification of congenital aortic arch abnormalities was described by James Stewart and colleagues in 1964. Since that time, advances in diagnostic imaging technology have led to better delineation of the vasculature anatomy and the identification of previously unrecognized and unclassified anomalies. In this manuscript, we review the existing literature and propose a series of modifications to the original Stewart classification of congenital aortic arch abnormalities to incorporate this new knowledge. In brief, we propose the following modifications: (1) In Group I, we further divide subgroup B into left arch atretic and right arch atretic; (2) In Group II, we add three more subgroups, including aberrant right innominate artery, "isolated" right innominate artery (RIA), "isolated" right carotid artery with aberrant right subclavian artery; (3) In Groups I, II, and III, we add a subgroup of absence of both ductus arteriosus; and (4) In Group IV, we add three subgroups, including circumflex retro-esophageal aorta arch, persistent V aortic arch, and anomalous origin of pulmonary artery from ascending aorta.


Assuntos
Aorta Torácica/anormalidades , Cardiopatias Congênitas/classificação , Terminologia como Assunto , Malformações Vasculares/classificação , Aorta Torácica/diagnóstico por imagem , Tomada de Decisão Clínica , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/terapia , Humanos , Valor Preditivo dos Testes , Prognóstico , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/terapia
2.
Chin Med J (Engl) ; 130(8): 920-928, 2017 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-28397721

RESUMO

BACKGROUND: Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation. METHODS: A cross-sectional study was designed to examine the fetal cortical sulcus development at 18-41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine fissure (CF). Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability. RESULTS: SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility. CONCLUSIONS: This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identify fetuses at risk of fetal neurological structural disorders.


Assuntos
Encéfalo/embriologia , Desenvolvimento Fetal/fisiologia , Feto/embriologia , Ultrassonografia Pré-Natal/métodos , Adulto , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Gravidez
3.
Mediators Inflamm ; 2016: 4897890, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27034591

RESUMO

Hormones (progesterone and estradiol) change greatly during pregnancy; however, the mechanism of hormonal changes on gingival inflammation is still unclear. This study is to evaluate the effects of hormonal changes during pregnancy on gingival inflammation and interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) in gingival crevicular fluid (GCF). 30 periodontally healthy pregnant women were evaluated in the first, second, and third trimesters. 20 periodontally healthy nonpregnant women were evaluated twice (once per subsequent month). Clinical parameters including probing pocket depth (PPD), bleeding index (BI), gingival index (GI), clinical attachment level (CAL), and plaque index (PLI) were recorded. GCF levels of IL-1ß and TNF-α and serum levels of progesterone and estradiol were measured. From the data, despite low PLI, BI and GI increased significantly during pregnancy; however, no significant changes in PLI, CAL, IL-1ß, or TNF-α GCF levels were observed. Although IL-1ß, not TNF-α, was higher in pregnant group than in nonpregnant group, they showed no correlation with serum hormone levels during pregnancy. GI and BI showed significant positive correlation with serum hormone levels during pregnancy. This study suggests that sex hormone increase during pregnancy might have an effect on inflammatory status of gingiva, independent of IL-1ß and TNF-α in GCF.


Assuntos
Estradiol/sangue , Gengivite/sangue , Interleucina-1beta/sangue , Progesterona/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto , Feminino , Líquido do Sulco Gengival/metabolismo , Humanos , Gravidez , Trimestres da Gravidez
4.
J Ultrasound Med ; 35(4): 739-45, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26939599

RESUMO

OBJECTIVES: The purpose of this study was to describe the echocardiographic features and perinatal outcomes of congenital absence of the aortic valve diagnosed by first-trimester echocardiography. METHODS: This retrospective study assessed the feasibility of first-trimester echocardiography in detecting absence of the aortic valve. All cases of absence of the aortic valve diagnosed by first-trimester fetal echocardiography from January 2010 to December 2014 were identified at a single referral center using an established perinatal database. Demographic information, echocardiograms, perinatal outcomes, and autopsy reports were reviewed. Echocardiographic features were described. RESULTS: A total of 50,822 fetuses underwent first-trimester echocardiography during the study period. Ten cases of congenital absence of the aortic valve were diagnosed, for an overall incidence rate of 0.019%. The earliest gestational age at diagnosis was 11 weeks 6 days. The mean crown-lump length was 61.9 mm; mean gestational age was 12 weeks; and mean maternal body mass index ± SD was 21.2 ± 3.9 kg/m(2). Nine fetuses had increased nuchal translucency ranging from 2.4 to 12.4 mm (mean ± SD, 6.4 ± 3.6 mm). Color Doppler flow imaging revealed biphasic bidirectional flow in the ascending aorta and aortic arch and reversed flow in the ductus venosus during atrial systole in all cases. Reversed diastolic flow was present in the umbilical arteries and thoracic aorta. All cases had complex cardiac malformations as well as extracardiac abnormalities. CONCLUSIONS: Our study confirms that absence of the aortic valve is a rare cardiac defect that can be diagnosed by first-trimester fetal echocardiography. A "to-and-fro" flow pattern or biphasic bidirectional flow in the great arteries is a key echocardiographic feature in fetuses with absence of the aortic valve.


Assuntos
Valva Aórtica/anormalidades , Valva Aórtica/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/epidemiologia , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal/estatística & dados numéricos , China/epidemiologia , Ecocardiografia/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Mortalidade Fetal , Humanos , Incidência , Gravidez , Resultado da Gravidez/epidemiologia , Prognóstico , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
5.
Prenat Diagn ; 36(2): 117-26, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26573084

RESUMO

OBJECTIVE: We aim to determine the accuracy of first-trimester ultrasonography in detecting fetal limb abnormalities. METHODS: This is a retrospective study of all women undergoing fetal nuchal translucency (NT) assessment and detailed fetal anatomic survey in the first trimester at a single tertiary-care referral center in China. Fetal anatomy scans were repeated in the second trimester. Detection of fetal limb abnormalities was compared between first and second trimester anatomy scans and confirmed at delivery or at autopsy. RESULTS: Analyzed were 9438 fetuses from 9197 women (241 twin pairs). The incidence of fetal limb abnormalities was 0.38% (36/9438). Of these, 28 (77.8%) were diagnosed prenatally: 23 (63.9%) on first trimester scan and 5 (13.9%) on second trimester scan. Limb reduction defects (usually transverse limb deficiencies) were the most common limb defects identified in the first trimester (n = 12), followed by clubfoot (n = 4), skeletal dysplasia (n = 3), sirenomelia (n = 1), limb dysplasia (n = 1), malposition (n = 1), and syndactyly (n = 1). Nine fetuses with isolated limb abnormalities had normal NT, while 74.1% (20/27) of limb abnormalities that were associated with other abnormalities had increased NT. CONCLUSIONS: This study demonstrates that the majority of limb abnormalities detected prenatally [23/28 (82%)] can be identified in the first trimester, especially major limb defects; however, our numbers are small and still need larger cases for further investigation.


Assuntos
Deformidades Congênitas dos Membros/diagnóstico por imagem , Primeiro Trimestre da Gravidez , Ultrassonografia Pré-Natal/métodos , Adolescente , Adulto , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , China , Pé Torto Equinovaro/diagnóstico por imagem , Ectromelia/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Translucência Nucal , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade , Sindactilia , Centros de Atenção Terciária , Adulto Jovem
6.
Mater Sci Eng C Mater Biol Appl ; 56: 348-55, 2015 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-26249600

RESUMO

Embryonic stem (ES) cells offer the potential to generate all cell types in the body, which provide a promising approach to repair tissue damage or dysfunction. In the past decade, great efforts have been made to induce the differentiation of ES cells into numerous types of cells, such as adipocytes, neurocytes and cardiomyocytes. However, the low differentiated efficiency and successful rate limit the development of induction of the differentiation of stem cells for tissue engineering. Here, we utilize ascorbic acid (AA)-loaded fluorescent TRITC-mesoporous silica nanoparticles (TMSN-AA) as a potential tool to induce the differentiation of human ES cells into cardiomyocytes. The treatment of human ES cells by TMSN-AA nanoplex arrests cell cycle at G1 phase and decreases the expression of stemness genes octamer-binding transcription factor 4 (OCT4) and sex determining region Y-box 2 (SOX2), which exhibits more significant induction efficiency of stem cell differentiation than the treatment by AA alone. Furthermore, we have tested the myocardial marker genes cardiac Troponin I (cTnI) and fetal liver kinase 1 (FLK-1), and found these genes are up-regulated by TMSN-AA nanoplex. Importantly, this work demonstrates the more efficient induction efficiency of human ES cells differentiation by the nanoparticle-drug formulation. Our studies reveal a novel approach based on MSNs as nanocarriers to induce the differentiation of human ES cells into cardiomyocytes efficiently and feasibly, and offer the potential perspectives for tissue engineering, eventually in clinical applications.


Assuntos
Ácido Ascórbico/farmacologia , Diferenciação Celular/efeitos dos fármacos , Sistemas de Liberação de Medicamentos/métodos , Células-Tronco Embrionárias Humanas/metabolismo , Miócitos Cardíacos/metabolismo , Nanopartículas/química , Dióxido de Silício , Linhagem Celular , Células-Tronco Embrionárias Humanas/citologia , Humanos , Miócitos Cardíacos/citologia , Porosidade , Dióxido de Silício/química , Dióxido de Silício/farmacologia
7.
J Clin Ultrasound ; 40(5): 301-5, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21952985

RESUMO

Diastematomyelia is a rare congenital disorder in which the spinal cord is divided longitudinally for part of its length. It can be accurately identified in the prenatal period by detailed sonographic examination of the spine. We report a case of diastematomyelia localized to spinal levels T6-T9 diagnosed prenatally at 31 weeks' gestation and review the existing literature on the diagnosis and management of this condition during pregnancy.


Assuntos
Defeitos do Tubo Neural/diagnóstico , Medula Espinal/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Aborto Terapêutico , Adulto , Diagnóstico Diferencial , Feminino , Idade Gestacional , Humanos , Imagem por Ressonância Magnética , Gravidez , Medula Espinal/anormalidades
8.
Prenat Diagn ; 31(4): 334-46, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21280058

RESUMO

OBJECTIVE: To describe the sonographic features and perinatal outcome of congenital vascular rings diagnosed prenatally at a single tertiary care institution. METHODS: All cases of congenital vascular rings diagnosed by prenatal ultrasound between July 2005 and December 2009 were identified at a single referral center using an established perinatal database. The diagnosis was confirmed by postnatal echocardiography for live-born infants or autopsy for terminated cases. RESULTS: The overall incidence of vascular ring during this 5-year period was 0.086% (81 cases among 94 321 women undergoing perinatal ultrasound examination). Forty-four cases had complete O-shaped (n = 3) or U-shaped (n = 41) vascular rings, and 37 cases had incomplete C-shaped vascular rings (vascular slings). The most common type of vascular ring seen in 50.6% (41/81) of cases was a right aortic arch with aberrant left subclavian artery. The second most common type was a left aortic arch with an aberrant right subclavian artery [39.5% (32/81)]. Chromosomal analysis was performed prenatally in 46 pregnancies, and six cases (13.0%) of fetal aneuploidy were identified. CONCLUSIONS: Congenital vascular rings can be diagnosed with prenatal ultrasound using the three-vessel trachea view and subsequent fetal echocardiography with particular attention to the relationship of the aortic arches, ductal arches, and the trachea.


Assuntos
Resultado da Gravidez/epidemiologia , Ultrassonografia Pré-Natal , Malformações Vasculares/diagnóstico por imagem , Aneurisma/diagnóstico por imagem , Aneurisma/patologia , Síndromes do Arco Aórtico/diagnóstico por imagem , Síndromes do Arco Aórtico/patologia , Anormalidades Cardiovasculares/diagnóstico por imagem , Anormalidades Cardiovasculares/patologia , Estudos de Casos e Controles , Estudos de Coortes , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/patologia , Feminino , Humanos , Recém-Nascido , Modelos Biológicos , Fenótipo , Gravidez , Prognóstico , Estudos Retrospectivos , Artéria Subclávia/anormalidades , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/patologia , Ultrassonografia Pré-Natal/estatística & dados numéricos , Malformações Vasculares/classificação , Malformações Vasculares/epidemiologia , Malformações Vasculares/patologia
9.
Rev Obstet Gynecol ; 4(3-4): 99-102, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22229061

RESUMO

Pulmonary hypoplasia is a rare congenital disorder; most cases occur in association with other congenital abnormalities, including congenital diaphragmatic hernia, oligohydramnios, and/or skeletal deformities. The authors report a case of unilateral pulmonary hypoplasia diagnosed prenatally and confirmed at autopsy.

10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 30(1): 69-74, 2008 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-18361057

RESUMO

OBJECTIVE: To study the value of prenatal ultrasound in the diagnosis of fetal malformations. METHODS: We retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006. RESULTS: The incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities. CONCLUSION: Prenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.


Assuntos
Anormalidades Congênitas/diagnóstico por imagem , Ultrassonografia Pré-Natal , Reações Falso-Negativas , Humanos , Estudos Retrospectivos
11.
Chin Med J (Engl) ; 117(3): 361-5, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15043774

RESUMO

BACKGROUND: Because of lacking skills in scanning the normal fetal facial structures and their corresponding ultrasonic features, misdiagnoses frequently occur. Therefore, we studied the appearance features and improved displaying skills of fetal facial anatomy in order to provide basis for prenatal diagnosis. METHODS: Twenty fetuses with normal facial anatomy from induced labor because of other malformations except facial anomalies were immersed in a water bath and then scanned ultrasonographically on coronal, sagittal and transverse planes to define the ultrasonic image features of normal anatomy. The coronal and sagittal planes obtained from the submandibular triangle were used for displaying the soft and hard palate in particular. RESULTS: Facial anatomic structures of the fetus can be clearly displayed through the three routine orthogonal planes. However, the soft and hard palate can be displayed on the planes obtained from the submandibular triangle only. CONCLUSIONS: The superficial soft tissues and deep bony structures of the fetal face can be recognized and evaluated by routine ultrasonographic images, which is a reliable prenatal diagnostic technique to evaluate the fetal facial anatomy. The soft and hard palate can be well demonstrated by the submandibular triangle approach.


Assuntos
Face/embriologia , Face/diagnóstico por imagem , Humanos , Técnicas In Vitro , Ultrassonografia
12.
Zhonghua Fu Chan Ke Za Zhi ; 38(5): 267-9, 2003 May.
Artigo em Chinês | MEDLINE | ID: mdl-12895307

RESUMO

OBJECTIVE: To review the value of ultrasonographic evaluation on fetal limbs anatomy and malformations in prenatal diagnosis using a systematic continuous sequence approach (SCSA). METHODS: Successive 4,932 prenatal ultrasonographic evaluation during gestation aging 14 - 40 weeks from August 2000 to September 2002 entered the present review. SCSA was applied to scan each limb of the fetus respectively. RESULTS: The anatomic structures of the four limbs of the fetus were clearly displayed and correctly recognized on ultrasonic images using the SCSA in 4 750 cases (96.3%). Ninety eight limb malformations of 34 fetuses were correctly diagnosed (87.2%). Whereas 16 malformations of 5 fetuses were missed to recognize (12.8%). The diagnoses were confirmed after subsequent labor or induced labor. The sensitivity, specificity, accuracy, positive and negative predictive values were 87.2%, 99.8%, 99.2%, 81.0% and 99.9%, respectively. CONCLUSION: The majority of fetal limb structures and malformations can be clearly demonstrated on prenatal ultrasonic imaging using SCSA. SCSA for prenatal ultrasonographic evaluation of the fetal limbs is a reliable and accurate diagnostic modality so far as the skills become more sophisticated.


Assuntos
Extremidades/diagnóstico por imagem , Doenças Fetais/diagnóstico por imagem , Deformidades Congênitas dos Membros/diagnóstico por imagem , Ultrassonografia Pré-Natal , Ultrassonografia/métodos , Adulto , Extremidades/anatomia & histologia , Feminino , Humanos , Gravidez , Resultado da Gravidez , Sensibilidade e Especificidade
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