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Background: Biliary atresia is a progressive disease presenting with jaundice, and is the most common indication for liver transplantation in the pediatric population. Prenatal series have yielded conflicting results concerning a possible association between BA and prenatal nonvisualization of the gallbladder.Aims: This retrospective case series was performed to assess the association between biliary atresia, prenatal nonvisualization of the gallbladder and other sonographic signs.Study Design/subjects: We identified biliary atresia patients who underwent a Kasai procedure by a single pediatric surgeon and/or follow up by a single pediatric gastroenterologist. Axial plane images and/or video recordings were scrutinized for sonographic signs of biliary atresia on the second trimester anomaly scan.Outcome Measures: Proportion of biliary atresia cases with prenatal sonographic signs.Results: Twenty five charts of children with biliary and high quality prenatal images were retrieved. 6/25 (24%) of cases analyzed had prenatal nonvisualization of the gallbladder or a small gallbladder on the prenatal scan. Two cases had biliary atresia splenic malformation syndrome. None of the cases had additional sonographic markers of biliary atresia.Conclusions: Our study suggests that in addition to the well-established embryonic and cystic forms, an additional type can be suspected prenatally, which is characterized by prenatal nonvisualization of the gallbladder in the second trimester. This provides additional evidence that some cases of BA are of fetal rather than perinatal onset and may have important implications for prenatal diagnosis, for counseling and for research of the disease's etiology and pathophysiology. [ABSTRACT FROM AUTHOR]

Aim: To determine the effect of a copper-medicated intrauterine device (IUD) on ovarian, uterine, arcuate, radial and subendometrial Doppler-derived indices of blood flow. Method: 23 regularly menstruating patients requested insertion of an IUD. All patients had a copper T (Nova T) IUD inserted between days 8 and 11 of the menstrual cycle. Ovarian, uterine, arcuate, radial and subendometrial artery pulsatility indices (PIs) were assessed by transvaginal color Doppler prior to insertion between days 8 and 11 of the menstrual cycle, and after 2 months in the same period of the cycle. Ovarian, uterine, arcuate, radial and subendometrial artery PIs were considered prior to and following IUD insertion. Results: No differences were recorded in any of the blood vessels sampled between pre- and post-insertion PIs. Conclusion: No significant change in ovarian or in uterine system vascular impedance is associated with the presence of a copper-medicated IUD. [ABSTRACT FROM AUTHOR]

Intraoperative assessment of ureteral intactness is performed by surgical exposure, cystoscopic visualization of the ureteral jets, or ureter-catheter insertion[3]. GLO:F0Y/01may20:uog20400-fig-0001.jpg PHOTO (COLOR): Color Doppler ultrasound images showing ureteral jet of left (a) and right (b) ureters. gl In 28/30 patients, both ureteral jets were depicted. [Extracted from the article]

Objective To evaluate the role of placental blood flow measurements by simultaneous multigate spectral Doppler imaging in pregnancies complicated by intrauterine growth restriction (IUGR), and for early detection of placental vascular abnormalities in high- and low-risk pregnancies. Methods To assess the sensitivity and specificity of abnormal placental blood flow in detecting IUGR, we followed 22 women whose pregnancies were complicated by IUGR at 28–34 weeks' gestation, and compared the findings with those obtained in 22 matched controls. We defined placental blood flow impedance as abnormal when 10% of placental pulsatility index (PI) measurements were greater than, or equal to, the mean umbilical artery PI (placental PI / umbilical PI ≥1). To determine the predictive value of abnormal placental blood flow measurement for identifying developing utero-placental insufficiency, we examined an unselected group of 100 low- and high-risk patients at 20–22 weeks' gestation. We correlated the Doppler findings with the development of pre-eclampsia, IUGR, placental abruption, oligohydramnios and the presence of persistent late decelerations during labor. Results Placental blood flow determination was more sensitive than umbilical artery blood flow in detecting abnormal umbilical-placental flow impedances as manifested by the presence of IUGR. Of the 100 mixed high- and low-risk patients examined at 20–22 weeks, 32 had abnormal placental blood flow. Of these, 19 (59.4%) subsequently developed pathologies associated with placental vascular disease. Of the 68 patients with normal placental blood flow, only six (8.8%) developed such pathologies. The sensitivity was 76% (19/25), with positive predictive value 59.4% (19/32); the specificity was 82.7% (62/75), with negative predictive value 91.2% (62/68). Conclusions Abnormal intraplacental blood flow at 28–34 weeks' gestation is strongly associated with IUGR. In addition, it has moder... [ABSTRACT FROM AUTHOR]

Objective To establish gestational age-specific nomograms of pulsatility indices in the umbilical artery and chorionic and intraplacental vessels, using novel ultrasound technology. Study design A prospective, cross-sectional study of 160 healthy singleton pregnancies between 18 and 33 weeks of gestation. Measurements Using simultaneous multigate spectral Doppler imaging specialized hardware and software, we measured the flow velocity waveforms of the umbilical artery, chorionic and intraplacental vessels. Computerized automatic mapping calculated the pulsatility indices in regions of interest. Results Data were adequately obtained for 160 fetuses. The pulsatility index values in the three sites measured decreased with advancing gestational age; the correlation coefficients r = -0.74, r = -0.67 and r = -0.68 for the umbilical artery, chorionic and intraplacental vessels, respectively, were found to be highly statistically significant (p < 0.0001). Conclusion Simultaneous multigate spectral Doppler imaging provides simultaneous measurements of the velocity waveforms in the umbilical artery, chorionic and intraplacental vessels, and is a feasible and reproducible method of obtaining these data. The normal data presented may facilitate early detection of flow disturbances in the fetoplacental circulation. [ABSTRACT FROM AUTHOR]

Clonorchiasis is an infectious disease caused by helminths of Clonorchis sinensis (C. sinensis). The adult parasite mainly inhabits the bile duct and gall bladder, and results in various complications to the hepatobiliary system. The amount of bile secreted into the intestine is reduced in cases of C. sinensis infection, which may alter the pH of the gut and decrease the amount of surfactant protein D released from the gallbladder. However, the impact of parasitic infection on the human gut microbiome remains unclear. To this end, we examined the gut microbiota composition in 47 modified Kato–Katz thick smear-positive (egg-positive) volunteers and 42 healthy controls from five rural communities. Subjects were grouped into four sub-populations based on age and infection status. High-throughput 16S rRNA gene sequencing revealed significant changes in alpha diversity between EP1 and EN1. The beta diversity showed alterations between C. sinensis-infected subjects and healthy controls. In C. sinensis infected patients, we found the significant reduction of certain taxa, such as Bacteroides and anti-inflammatory Bifidobacterium (P < 0.05). Bacteroides, a predominant gut bacteria in healthy populations, was negatively correlated with the number of C. sinensis eggs per gram (EPG, r = −0.37, P adjust < 0.01 in 20–60 years old group; r = −0.64, P adjust = 0.04 in the 60+ years old group). What’s more, the reduction in the abundance of Bifidobacterium, a common probiotic, was decreased particularly in the 60 + years old group (r = −0.50, P = 0.04). The abundance of Dorea, a potentially pro-inflammatory microbe, was higher in infected subjects than in healthy individuals (P < 0.05). Variovorax was a unique bacteria that was only detected in infected subjects. These results clearly demonstrate the significant influence of C. sinensis infection on the human gut microbiota and provided new insights into the control, prevention, diagnosis, and clinical study of clonorchiasis through the human gut microbiota.

The recently published ISUOG Practice Guideline on fetal biometry and growth[1] is a potentially important article that should have wide-reaching implications for the daily practice of ultrasound and maternal-fetal medicine in general. First, amongst the recommendations regarding fetal biometric measurements, there is one concerning caliper placement according to which: 'HC [head circumference] and AC [abdominal circumference] should be obtained using the ellipse measurement tool, by placing the calipers on the outer edges of the soft-tissue circumference'. [Extracted from the article]

A response by O. Shen and colleagues to a letter to the editor about their article "Absent gallbladder on fetal ultrasound: prenatal findings and postnatal outcome" in the 2011 issue is presented.

An abstract of the article "Elastography assessment of endometrial changes during the menstrual cycle of fertility treatment," by R. Boldes and colleagues is presented.

An abstract of the article "Simpler is better: A comparison of methods for construction of fetal reference charts" by S. Yagel and colleagues is presented.

An abstract of the article "Systematic examination of the fetal precordial veins: a large cohort study" by S. Yagel and colleagues is presented.

An abstract of the research paper "Evaluating STIC technology as a tool in training non-expert sonographers to perform comprehensive fetal echocardiography," by H. Avnet and colleagues is presented.

An abstract of the article "New approach for fetal larynx and pharynx biometry using 3DUS acquired images," by G. Liberty, R. Boldes, O. Shen, and S. Yage is presented.

An abstract of the article "The fetal pharynx and larynx: a novel approach for demonstration and evaluation by 3DUS MPR and render modes," by G. Liberty, R. Boldes, O. Shen and S. Yagel is presented.

An abstract of the article "Superior imaging the fetal cerebellar vermis with 3D ultrasound multiplanar reconstruction and VCI-C to obtain the mid-sagittal plane," by S. Yagel and colleagues is presented.

An abstract of the article "Omega shaped anomaly of the umbilical artery: a case series," by O. Shen and colleagues is presented.

An abstract of the article "Four-vessel umbilical cord," by H. Avnet and colleagues is presented.

An abstract of the article "Biometry of the fetal larynx and pharynx in the 2nd trimester of pregnancy with 3D ultrasound acquired images," by G. Liberty and colleagues is presented.

An abstract of the article "The fetal larynx and pharynx-anatomy and development," by G. Liberty and colleagues is presented.

An abstract of the conference paper "Examining the vermis: A better and easier way," by O. Shen and colleagues is presented.

An abstract of the conference paper "Prenatal sonographic findings in chromosome 18q deletion syndrome," by O. Shen and S. Yagel is presented.

An abstract of the conference paper "Evaluation and outcome of prenatal non visualization of gallbladder," by O. Shen and colleagues is presented.

An abstract of the conference paper "Comparison of TAPSE measurement between M-mode STIC and TAPSE measured in conventional M-mode," by H. Avnet and colleagues is presented.