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1.
Estelle Jean Dit Gautier Julien Lepage Mathias Brieu Michel Cosson Chrystele Rubod 《International urogynecology journal》2018,29(3):425-430
Introduction and hypothesis
We studied the geometry of and changes in structures that play an important role in stabilizing the pelvic system during pregnancy using a numerical system at different gestational ages and postpartum.Methods
We developed a parturient numerical model to assess pelvic structures at different gestational stages (16, 32, and 38 weeks) and postpartum (2 months and 1 year) using magnetic resonance imaging (MRI). Organs, muscles, and ligaments were segmented to generate a 3D model of the pelvis. We studied changes in the length of uterosacral ligaments (USL) and thickness of the puborectal portion of the levator ani muscle (LAM) during and after pregnancy. We used this model to perform finite element (FE) simulation and analyze deformations of these structures under stress from the increase in uterine weight.Results
Analysis reveals an increase in the length of US ligaments at 16, 32, and 38 weeks. Two months after delivery, it decreases without returning to the length at 16 weeks of pregnancy. Similar changes were observed for the puborectal portion of the LAM. Variations observed in these structures are not equivalent to other anatomical structures of pelvic suspension. FE simulation with increased uterus weight does not lead to those findings.Conclusion
This analysis brings new elements and a new focus for discussion relating to changes in pelvic balance of parturient women that are not simply linked to the increase in uterine volume.2.
3.
Jeanson-Leh L Charrier S Proust A Bilhou-Nabéra C Favier R Deswarte C Bordigoni P Galy A Delaunay J 《European journal of haematology》2011,87(4):366-371
Several pediatric patients showing symptoms consistent with the Wiskott-Aldrich syndrome (WAS) were referred to us and turned out to display the c.273+11dup change in the WAS gene. It consisted of the insertion of one C in an unusual tract of 7C near the intron 2 donor splicing site of the WAS gene. In the patients, non-synonymous WAS mutations were found twice only and one mutation was elucidated in RUNX1. In the absence of a non-synonymous mutation in the WAS gene, the c.273+11dup change affected neither the levels nor the sequence of WAS mRNA. In the presence of a non-synonymous WAS mutation, the c.273+11dup alteration failed to worsen the expected phenotype. Minor splicing abnormalities concerning exon 10 were observed both in WAS patients, and in healthy individuals carrying or not carrying the c.273+11dup. The c.273+11dup change was encountered four times in 107 normal male and female controls (172 alleles tested: 2.3%), and eight times in a series of 248 male patients (248 alleles tested: 3.2%). We conclude that the presence of the additional C in the WAS gene is a functionally neutral polymorphism. 相似文献
4.
OBJECTIVES: Little information is available to incoming students in pediatrics residency programs on the experiences of past residents. The objective of this study was to investigate the pediatrics training programs and determine the professional outcomes of graduating residents between 1990 and 2000 in the Western Interregion. POPULATION AND METHODS: Questionnaires were distributed to the 187 medical students enrolled in pediatrics residency programs between 1990 and 2000 in the six university hospital centers of the Western Interregion. The questions concerned the details of training, the modes of residency positions, and current professional and personal situations. One hundred and sixty-five (88%) individuals responded. RESULTS: Seventy-seven percent of the practicing pediatricians stated that the training they had received during residency was adapted to their current practice. This percentage was higher for hospital staff physicians (82%) than for the physicians in private practice (50%) or those with salaried positions outside the hospital system (58%). One hundred and twenty-four had either completed post-residency training (97) or were doing so (27) at the time of the survey. All but one were professionally active, three quarters of them in hospitals and, of these, most were in the hospitals where they had trained. Eighty-six percent of the practicing pediatricians said they were satisfied with their professional work and 73% said they were satisfied with their personal lives. CONCLUSION: These results support the current reflection on reforming the residency training program in pediatrics, especially with regard to its prolongation and the diversification of the training options to take into account the individual student's professional orientation. 相似文献
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Andrieux J Devisme L Valat AS Robert Y Frnka C Savary JB 《European journal of medical genetics》2005,48(2):199-206
Ring chromosome 6 (RC6) is a rare constitutional abnormality, with variable material loss, leading to a variable clinical phenotype: minimal physical anomalies and mild psychomotor retardation to severe physical and mental defects. Among the 22 published cases, only five have been prenatally detected. We describe here a RC6 prenatally diagnosed. Ultrasound follow-up showed growth retardation and cerebellar hypoplasia. Magnetic resonance imaging (MRI) confirmed this, but showed a partial corpus callosum agenesis, leading to amniocentesis and revealing the chromosomal abnormality. Imaging features were correlated with autopsy findings. 相似文献
7.
Bonnemains L Rouleau S Sing G Bouderlique C Coutant R 《European journal of pediatrics》2008,167(12):1459-1461
Subcutaneous fat necrosis is a classic, albeit uncommon, cause of neonatal hypercalcemia. It occurs in newborn infants within
the first month of life following a complicated delivery. The diagnosis is usually easy because of the presence of red-purple
plaques in fatty areas along with firm subcutaneous nodules. A 1-month-old neonate, born strangled by her umbilical cord,
presented with diarrhea and hypercalcemia (3.46 mM) with an initial physical examination considered normal. Her biological
evaluations were as follows: P = 1.37 mM (1.6–2.2); PTH = 3 ng/L (12–65); 25-OH vitamin D = 87 nM (23–113); (1,25)-OH2 vitamin D = 192 ng/L (20–46). The third day, a careful exam of the whole cutaneous surface revealed small firm subcutaneous
nodules in the ischial region. Despite the absence of any visible skin modification, the association of perinatal stress and
high (1,25)-OH2 vitamin D level with subcutaneous nodules led to the diagnosis of subcutaneous fat necrosis. She was treated with oral prednisone
for 45 days. Serum calcium levels normalized within a week, and the nodules disappeared without complications. Conclusion:
Subcutaneous fat necrosis may induce severe hypercalcemia without any visible cutaneous lesion.
No funding or grant was received for this study. 相似文献
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Laurent Bonnemains Damien Mandry Anne Menini Bertrand Stos Jacques Felblinger Pierre-Yves Marie Pierre-Andre Vuissoz 《European radiology》2013,23(9):2383-2391
Objective
To validate a new index, the surface–length index (SLI) based on area change in a short-axis view and length reduction in the horizontal long-axis view, which is used to quickly (<1 min) detect right ventricles with an abnormal ejection fraction (EF) during a cardiac MRI examination. SLI can be used to avoid a complete delineation of the endocardial contours of normal right ventricles.Methods
Sixty patients (group A) were retrospectively included to calibrate the SLI formula by optimisation of the area under the ROC curves and SLI thresholds were chosen to obtain 100 % sensitivity. Another 340 patients (group B) were prospectively recruited to test SLI’s capacity to detect right ventricles (RVs) with an abnormal EF (<0.5).Results
The appropriate threshold to obtain 100 % sensitivity in group A was 0.58. In group B, with the 0.58 threshold, SLI yielded a sensitivity of 100 % and specificity of 51 %. SLI would have saved 35 % of the RV studies in our population, without inducing any diagnostic error. SLI and EF correlation was good (r 2?=?0.64).Conclusion
SLI combines two simple RV measures, and brings significant improvement in post-processing efficiency by preselecting RVs that require a complete study.Key Points
? Assessment of right ventricle ejection fraction (RVEF) with cine-MRI is time consuming. ? Therefore, RVEF is not always assessed during cardiac MRI. ? Surface–length index (SLI) allows rapid detection of abnormal RVEF during cardiac MRI. ? SLI saves one third of the operator time. ? Every cardiac MRI could include RVEF assessment by means of SLI. 相似文献10.
Bonnemains L Mandry D Marie PY Micard E Chen B Vuissoz PA 《Magnetic resonance in medicine》2012,67(6):1740-1746
Reproducibility of the manual assessment of right ventricle volumes by short-axis cine-MRI remains low and is often attributed to the difficulty in separating the right atrium from the ventricle. This study was designed to evaluate the regional interobserver variability of the right ventricle volume assessment to identify segmentation zones with the highest interobserver variability. Short-axis views of 90 right ventricles (30 hypertrophic, 30 dilated, and 30 normal) were acquired with 2D steady-state free precession sequences at 1.5 T and were manually segmented by two observers. The two segmentations were compared and the variations were quantified with a variation score based on the Hausdorff distance between the two segmentations and the interobserver 95% limits of concordance of the global volumes. The right ventricles were semiautomatically split into four subregions: apex, mid-ventricle, tricuspid zone, and infundibulum. These four subregions represented 11%, 34%, 36%, and 19% of the volume but, respectively, yielded variation scores of 8%, 16%, 42%, and 34%. The infundibulum yielded the highest interobserver regional variability although its variation score remained comparable to the tricuspid zone due to its lower volume. These results emphasize the importance of standardizing the segmentation of the infundibulum and the tricuspid zone to improve reproducibility. 相似文献