Fetal Ultrasonic Evaluation of Bronchial Morphology in Fetuses with Isomerism

<b><i>Objective:</i></b> The aim of the study was to evaluate whether fetal ultrasound could determine bronchial isomerism and distinguish left isomerism from right isomerism. <b><i>Methods:</i></b> We identified 110 healthy fetuses and 28 fetuses with isomerism. The outer angle between the tracheal midline and the inner margin of the bronchus is measured. The bronchial angles and the ratio of left/right bronchial angle were used to differentiate bronchial morphology and confirm the presence of bronchial isomerism in pathological cases. <b><i>Results:</i></b> The normal angles of the left and right bronchi were 146.98° (95% CI, 145.15–147.81°) and 167.37° (95% CI, 166.30–168.44°), separately. The cutoff bronchial angle of 156.5° was used to distinguish left bronchus from right bronchus. The bronchial isomerism could be identified in all pathological cases by autopsy and bronchial-atrial concordance occurred in 27 pathological cases (96.4%). In 21 pathological cases, the bilateral bronchial angle was &#x3c;156.5 versus &#x3e;156.5 differentiated left from right isomerism, respectively. The ratio of the left/right bronchial angle of &#x3e;0.935 identified 92.9% (26/28) of all pathological cases, with a sensitivity of 89.7%. <b><i>Conclusions:</i></b> Fetal ultrasound can detect the bronchial morphology and the presence of bronchial isomerism in fetuses with isomerism according to bronchial angles and the ratio of left/right bronchial angle.

Comparison of the Ultrasonic Evaluation of Bi-Parietal Diameter and Femoral Length in 2nd and 3rd Trimester to Estimate the Gestational Age

During the gestational period, fetal biometrics are assessed through ultrasonography to observe the growth of the fetus. This study observed the corresponding of gestational age those were measured by two of the fetal diameters; gestational age were calculated from history of last menstrual period (LMP), in the last two trimesters. This descriptive type of observational study was carried out in the Department of Radiology and Imaging of Dhaka Medical College and Hospital, during the period of July, 2004 to June, 2005. Here 291 single-ton, non-complicated pregnant women of LMP were selected purposively from valid record. Bi-parietal diameter (BPD) and femoral length (FL) estimated through ultrasonography. These two parameters compared with the gestational age in second and third trimester. The study found that, before 36th week, the BPD based gestational age varied 2 to 3 days from LMP based gestational age and after that, the variation was 1 to 4 weeks. In case of FL, the ultrasonic measurement found to be 2 to 4 days backward in the second trimester and 2 to 3 days advance in the last trimester in contrast to the LMP based gestational age. In the second trimester, it has been found that, BPD has been the superior predictor of the gestational age than the FL with the correlation coefficient of 0.999 in case of BPD and 0.998 in case of FL when correlated with LMP based gestational age. Although, in third trimester, FL versus BPD predicted the gestational age with a correlation coefficient of 0.998 versus 0.978 respectively, when correlated with gestational age based on the history of LMP. This study has observed that, later in pregnancy, FL has the better predictability over BPD to determine the gestational age. Bangladesh Med J. 2020 Sept; 49(3) : 43-48

Using Third Interface Echo TIE Response Through Inner Casing to Enucleate the Outer Casing Geometry in 3D View

Casings can deform over the life of the well due to various reasons such as changing stress regimes, geological fault and fractures causing pinching, pressure differential created due to production, increased pressure due to injection, squeezing formations such as shale and salt, etc. A detailed casing deformation evaluation can provide insights to the operators in correlating the deformation to suitable reasons in their field. There are various methods to evaluate the innermost casing or tubing using ultrasonic and mechanical caliper measurements but there is no technology available to evaluate outer or second casing deformation without first retrieving the inner casing or tubing. This work introduces and encapsulates the novel methodology of transforming the outer or second casing third interface echo (TIE) response, obtained by advanced ultrasonic and flexural measurement inside innermost casing or tubing, into a 3D wellbore view to suitably visualize and analyze the outer or second string deformations. The work involves measuring the azimuthal radius and thickness of the innermost casing with the ultrasonic evaluation technique and computing the azimuthal annular distance between the two casings using the flexural wave TIE arrival time and its velocity in the annular fluid. The computed values are then combined to generate an array of azimuthal internal radius values of the outer or second casing and is finally converted into a 3D wellbore image for better and straight-forward visualization. To validate the methodology, a shop inspection test (SIT) was carried out where the dimensions of the inner and the outer casing were precisely measured with a mechanical caliper tool. Following that, ultrasonic and flexural measurement tool was run inside the innermost casing to obtain the response of both casings. The comparison showed a close match between the actual values and the measurements. Also, the 3D wellbore shape clearly showed the geometry of the outer string validating the methodology used in the creation of the 3D shape. The work can enable the operators to carry out time lapse outer string analysis on a periodic basis to give them early indications of any deformation in the outer or second string. This novel technique or methodology also has valuable application in plug and abandonment (P&A) where the inner tubing and casing retrieval can be hindered due to outer casing deformation. This technique can also help in designing the right drilling BHA for sidetracking based on the minimum ID of the outer pipe through which slot recovery or side-track has to be performed.

Clinical Outcomes and Ultrasonic Evaluation of Percutaneous Achilles Tendon Repair

BackgroundAchilles tendon rupture remains one of the most common tendon injuries in adult population. At present, randomized studies have failed to demonstrate the optimal management of Achilles tendon rupture. Wound complications have been significantly minimized since the emergence of percutaneous repairs when compared to traditional open methods. However, some studies suggested a higher incidence of rerupture rates and iatrogenic sural nerve injuries. The goal of this study was to present the clinical outcomes and ultrasonic evaluation of percutaneous Achilles tendon repair.MethodsBetween August 2015 and May 2018, 36 patients with an acute Achilles tendon rupture, treated in percutaneous repair, were studied retrospectively. American Orthopedic Foot and Ankle Society (AOFAS) score and the 10-point visual analogue scale (VAS) for pain questionnaires were sent to assess the clinical and functional outcomes. Ultrasonic evaluation was recorded using Möller grading system as an objective measurement.ResultsThe 25 male and 11 female (mean age 47.03 years) were clinically followed-up for a minimum of 12 months (average 28.97 months). No wound complications or reruptures occurred. Four(11.1%) patients reported sural nerve hypoesthesia and one of them required additional treatment. The mean AOFAS and VAS score was 92.6 and 1.8 respectively at the 12th postoperative month. Ultrasonic evaluation was performed at the average follow-up of 18.3 months and the mean points were 1.8. All treated tendons were healthily recovered and all patients were able to return to previous work or activities.ConclusionPercutaneous Achilles tendon repair offers good clinical outcome and no apparent increased risk of reruptures. The risk of iatrogenic sural nerve injury, however, remains the most occurred complication. Ultrasound can be used to visualize and examine the repaired tendon, which demonstrated satisfying healing process.

Detection and identification of subcutaneous defects using ultrasonic waves in reflective test

Non-destructive ultrasonic evaluation is one of the methods used for inspection in mechanical engineering. This method has diverse applications in various fields, including industry and medicine. The main purpose of this research is to identify a subcutaneous defect with ultrasonic waves. This is done by sending ultrasonic waves into the skin tissue and receiving backward echoes, simulating them using a software, and calculating the time difference using the speed of sound. In this research, the behavior of longitudinal and transverse waves is investigated in collisions with a defect by describing the genesis and application history as well as the principles and definitions of ultrasonic waves. In the test, first, the method of identifying the subcutaneous defect is explained. Then, the dimensions and stiffness of the defect are determined by analyzing the information obtained from the location. Using the 3.5-MHz probe, the defect was detected at a distance of 1.8 mm, indicating a high level of reliability compared to the sonography imaging device. This was while the 10-MHz probe failed to detect the defect just near the skin surface. The results confirm the choice of this method as a suitable method for detecting the subcutaneous defect.