Soo-Pyung Kim

Bone Mineral Density of the Spine Using Dual Energy X-Ray Absorptiometry in Patients with Non-Insulin-Dependent Diabetes Mellitus

To evaluate the influence of non‐insulin‐dependent diabetes mellitus (NIDDM) on bone mineral density (BMD), we measured BMD in 185 female patients with NIDDM using dual energy X‐ray absorptiometry (DEXA). BMD was measured in lumbar vertebrae (L2–4). BMD is slightly higher in the diabetic patients compared with control subjects and bone loss related to menopause starts before the onset of menopause. The BMD of postmenopausal women showed a definite decrease with aging and there was abrupt bone loss after 55 years of age (p < 0.05). In relation to the duration of diabetes, the decrease of BMD for 15 years was 10.0%. BMD was negatively correlated with age, years since menopause (YSM), and disease duration (r = ‐ 0.584, r = ‐ 0.470, r = ‐0.186). These results suggest that age, YSM, and the duration of disease appear to be the risk factors for decreased BMD in the diabetic patients.

Relation of Airway Reactivity and Sensitivity with Bronchial Pathology in Asthma

Airway hyperresponsiveness in asthmatics, which may result from inflammation or remodeling, is expressed as the concentration of methacholine that causes a 20% fall in FEV1 in the concentration–response curve (PC20). A decrease in PC20 may be due to a steeper curve (hyperreactivity) and/or a curve shift to the left (hypersensitivity). Our purpose was to analyze the relation of airway sensitivity and reactivity to airway pathological changes. The PC6, as sensitivity parameter, and the slope between PC20 and PC40 as reactivity parameter, were calculated. Total and differential cell counts in the bronchoalveolar lavage fluid, and percentage of epithelial shedding, basement membrane thickness, and submucosal thickness on bronchial biopsy, were measured. The PC6 showed a correlation with the baseline FEV1%. The slope was significantly correlated with the basement membrane thickness, and also demonstrated a strong association with submucosal thickness. The PC20 showed a correlation with the baseline FEV1% and the degree of epithelial shedding. These results suggest that the airway sensitivity and reactivity measurements reflect the degree of airway caliber and remodeling, respectively.

P43.13: A comparison between prenatal ultrasound and fetal MR Imaging in life‐threatening diffuse neonatal hemangiomatosis (DHN) complicated with Kasabach‐Merritt‐syndrome

We describe 14 cases of omphalocele diagnosed by real-time sonography and submitted to magnetic resonance imaging on the third trimester. This exam allowed a precise and accurate definition of the size of the abdominal orifice, as well as the contents inside and outside the abdominal cavity and the detection of associated anomalies. The three dimensional images obtained with MRI were very useful for the neonatal surgeons in planning their intervention and counseling parents about the prognosis of their infant. MRI contributes significantly to optimize the prenatal management and counseling of cases of omphalocele.

P30.03: Value of fetal magnetic resonance imaging in fetuses diagnosed prenatally with CNS abnormalities in ultrasound

Objectives: MRI (magnetic resonance imaging) is an important complement to the ultrasound prenatal screening. It provides an excellent resolution for imaging the maternal and fetal anatomies. For the mother, it is useful for pelvimetry, diagnostics of adnexal masses or placental pathology. For the fetus MRI specifies and completes the ultrasound examination in case of fetal anomalies such as CNS, chest, abdominal, renal or gastrointestinal anomalies. In pregnancies with severe oligohydramnion MRI helps to clarify the ultrasound scan. Methods: Ultrasound examination – GE HDI 5000 and Medison Accuvix XQ, MRI – Siemens Magnetom Symphony 1.5 T. Ultrasound scan was performed by a maternal-fetal specialist directly at our department. MRI examination was done by a radiologist at the Department of Imaging Methods. Both departments are interconnected via a powerful optical network as a part of a MeDiMed (Metropolitan Digital Imaging System in Medicine) project. Images in DICOM (Digital Imaging and Communication in Medicine) format are archived and bilaterally shared using PACS (Picture Archiving and Communication System). For MRI, patients are referred after 20 weeks’ gestation. Examination takes 17 minutes an average. Results: Since October 2006 we examined mothers with placenta praevia to evaluate placental attachment (placenta accreta). Our experience proved MRI to be more accurate than ultrasound in prediction of placental attachment. Every case of MRI suspicion was clinically confirmed. Fetuses were examined for CNS anomalies, diaphragmatic hernia and sacroccoccygeal teratoma. Conclusions: There are many cases in which MRI has proved to be useful as an adjunct to ultrasound. Based on our first experience, MRI is an excellent, safe and fast modality for prenatal diagnostics. PACS enables us to share images with radiologists. In future we plan to read MRI images and evaluate them ourselves, compare them with ultrasound and clinical findings and consult the radiologist occasionally.

P11.06: Clinical characteristics and perinatal outcome with isolated oligohydramnios in low‐risk term pregnancies

Objective: This study involving 752 women at 18–24 weeks of pregnancy, to determine the distribution of cervical length. Methods: We studied 752 pregnants with 18th to 24th weeks the inclusion criteria were sonographic confirmation of gestational age in 12th weeks and the absence of any risk factors for preterm birth. Cervical length was measured in a straight line if the cervix did not show any curvature; in the presence of cervical curvature, the measurement was broken down into two or more segments. Results: A statistical divergence exist between fragmented and linear measuring procedures. An average difference of 1.67 mm (±2.67 mm) for 95% [1.48; 1.86]. Up to 21st week maintains a presence of cervical curvature (58.9%), becoming straight after this period of time (54.2%). The cervical length was constant (no have statistical difference) between 752 women at 18–24 weeks of pregnancy. Conclusions: Fragmented and linear measuring procedures for cervical length, are different. In routine ultrasound, the cervical measurement, is most recommended after 21st week (straight after this period of time in 54.2%).

P04.42: A case of fetal hydrops in maternal Sjögren's syndrome with distal renal tubular acidosis: Poster abstracts

R. Rabinowitz1, B. C. Chertin2, O. S. Shen1, A. P. Pollack2, D. K. Koulikov2, A. F. Fridmans2, H. H. I. Hadas-Halpern3, A. F. Farkas2 1Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Faculty for Health Science, Ben-Gurion University, Israel 2Department of Urology, Shaare Zedek Medical Center, Faculty for Health Science, Ben-Gurion University, Israel 3Department of Radiology, Shaare Zedek Medical Center, Faculty for Health Science, Ben-Gurion University, Israel