Three-dimensional ultrasound evaluation of the fetal brain: the three horn view.

OBJECTIVE: To describe an easy technique for obtaining one of the most important views of the fetal brain and image. The entire lateral ventricle including the anterior, posterior and inferior horns is demonstrated on one image. We propose to call this view, obtained in an oblique plane 'the three horn view'. METHODS: Depending upon the scanning technique employed there are two ways to obtain the three horn view: (1) by two-dimensional (2D) transvaginal transfontanelle sonography obtained by using the left and right Oblique-1 sections, and (2) by three-dimensional (3D) imaging of the fetal brain, is obtained by acquiring a volume scan of the brain orienting the fetal head in the three main orthogonal planes and by rotating or tilting the midcoronal section to the left and right. RESULTS: To illustrate the technique of obtaining the three horn view four normal fetal brains were scanned. Two scans utilized the 2D transvaginal transfontanelle approach and two scans utilized the 3D scanning technique. The same technique was then applied to six fetuses with various brain malformations with inflicted changes in the shape of the proposed three horn view. CONCLUSION: The three horn view, depicting the anterior, posterior, and inferior horns on the same image, was easy to obtain using both the 2D and the 3D ultrasound techniques. It provided diagnostic and clinically useful information much like neonatal transfontanelle ultrasound imaging after which it was emulated.     

First-trimester diagnosis of sacrococcygeal teratoma: the role of three-dimensional ultrasound.

A fetus was suspected of having a sacrococcygeal teratoma (SCT) on routine nuchal translucency evaluation by sonography at 12+3 weeks. The patient was referred for three-dimensional (3D) sonography to further delineate the extent of the mass. In this case, real-time scanning of the mass in 3D mode assisted the diagnosis of the mass and patient counseling. We present what we believe to be the first case of SCT imaged in the first trimester using 3D ultrasound.     

Laparoscopic radical hysterectomy with paraaortic and pelvic node dissection.

We report the first case of a laparoscopic radical hysterectomy and paraaortic and pelvic lymphadenectomy to treat a stage IA2 carcinoma of the cervix. To our knowledge, a laparoscopic radical hysterectomy with laparoscopic paraaortic lymphadenectomy has not been previously described.     

The single case format: Proposal for a structured message for the telematic transmission of information on individual case reports in pharmacovigilance

The development of telematic exchange of information in pharmacovigilance has as a consequence the necessary development of the messages used to transmit the information. The first of these messages is the one used to transmit information on individual case reports. Common formats exist on paper, but these have not been applied to electronic transmission. A structured message for the transmission of single case information has been developed within the ENS European research programme, by three National Pharmacovigilance administrations, and reviewed by the relevant European bodies. It has been submitted to the Western European Edifact Board MD9 for admission as an EDIFACT message, so that it will be possible to exchange information concerning these single cases, using standard EDI methodology.     

Hemostatic effect of platelet von Willebrand factor.

In type III von Willebrand disease (vWD) patients, the bleeding time was only partially corrected or not modified after cryoprecipitate infusion, although the levels and the multimeric structure of plasma von Willebrand factor (vWF) were normal. However, the adhesion of normal platelets on the vessel wall subendothelium in the presence of postinfusion patient plasma improved more significantly than the bleeding time. These results suggest a role of the vWF released from normal platelets which is absent in type III vWD platelets. In 5 patients transfusion of normal platelet concentrates performed 1 h after cryoprecipitate infusion without modification of the bleeding time (> 30 min) normalized this parameter, and platelet adhesion to the subendothelium elicited a marked improvement. These last results confirm the suggestion that platelet vWF plays an important 'in vivo' role in the hemostatic process, particularly in patients suffering from severe vWD.     

Hipertricosis cervical anterior esporádica

Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a «tuft» of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding.