11-14 Wks Sonography

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  • Stem cells are “non-specialized” cells that have the potential to form into other types of specific cells, such as blood, muscles or nerves. They are unlike 'differentiated' cells which have already become whatever organ or structure they are in the body. Stem cells are present throughout our body, but more abundant in a fetus.
    Medical researchers and scientists believe that stem cell therapy will, in the near future, advance medicine dramatically and change the course of disease treatment. This is because stem cells have the ability to grow into any kind of cell and, if transplanted into the body, will relocate to the damaged tissue, replacing it. For example, neural cells in the spinal cord, brain, optic nerves, or other parts of the central nervous system that have been injured can be replaced by injected stem cells. Various stem cell therapies are already practiced, a popular one being bone marrow transplants that are used to treat leukemia. In theory and in fact, lifeless cells anywhere in the body, no matter what the cause of the disease or injury, can be replaced with vigorous new cells because of the remarkable plasticity of stem cells. Biomed companies predict that with all of the research activity in stem cell therapy currently being directed toward the technology, a wider range of disease types including cancer, diabetes, spinal cord injury, and even multiple sclerosis will be effectively treated in the future. Recently announced trials are now underway to study both safety and efficacy of autologous stem cell transplantation in MS patients because of promising early results from previous trials.
    History
    Research into stem cells grew out of the findings of two Canadian researchers, Dr’s James Till and Ernest McCulloch at the University of Toronto in 1961. They were the first to publish their experimental results into the existence of stem cells in a scientific journal. Till and McCulloch documented the way in which embryonic stem cells differentiate themselves to become mature cell tissue. Their discovery opened the door for others to develop the first medical use of stem cells in bone marrow transplantation for leukemia. Over the next 50 years their early work has led to our current state of medical practice where modern science believes that new treatments for chronic diseases including MS, diabetes, spinal cord injuries and many more disease conditions are just around the corner.
    There are a number of sources of stem cells, namely, adult cells generally extracted from bone marrow, cord cells, extracted during pregnancy and cryogenically stored, and embryonic cells, extracted from an embryo before the cells start to differentiate. As to source and method of acquiring stem cells, harvesting autologous adult cells entails the least risk and controversy.
    Autologous stem cells are obtained from the patient’s own body; and since they are the patient’s own, autologous cells are better than both cord and embryonic sources as they perfectly match the patient’s own DNA, meaning that they will never be rejected by the patient’s immune system. Autologous transplantation is now happening therapeutically at several major sites world-wide and more studies on both safety and efficacy are finally being announced. With so many unrealized expectations of stem cell therapy, results to date have been both significant and hopeful, if taking longer than anticipated.
    What’s been the Holdup?
    Up until recently, there have been intense ethical debates about stem cells and even the studies that researchers have been allowed to do. This is because research methodology was primarily concerned with embryonic stem cells, which until recently required an aborted fetus as a source of stem cells. The topic became very much a moral dilemma and research was held up for many years in the US and Canada while political debates turned into restrictive legislation. Other countries were not as inflexible and many important research studies have been taking place elsewhere. Thankfully embryonic stem cells no longer have to be used as much more advanced and preferred methods have superseded the older technologies. While the length of time that promising research has been on hold has led many to wonder if stem cell therapy will ever be a reality for many disease types, the disputes have led to a number of important improvements in the medical technology that in the end, have satisfied both sides of the ethical issue.
    CCSVI Clinic
    CCSVI Clinic has been on the leading edge of MS treatment for the past several years. We are the only group facilitating the treatment of MS patients requiring a 10-day patient aftercare protocol following neck venous angioplasty that includes daily ultrasonography and other significant therapeutic features for the period including follow-up surgeries if indicated. There is a strict safety protocol, the results of which are the subject of an approved IRB study. The goal is to derive best practice standards from the data. With the addition of ASC transplantation, our research group has now preparing application for member status in International Cellular Medicine Society (ICMS), the globally-active non-profit organization dedicated to the improvement of cell-based medical therapies through education of physicians and researchers, patient safety, and creating universal standards. For more information please visit http://www.neurosurgeonindia.org/
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11-14 Wks Sonography

  1. 1. Imaging IMAGING CENTRE Redefined Vol : 4 Iss : 3 The Sound Of Babies… R 11 – 14 week USG! Excellence in FIRST TRIMESTER ULTRASOUND SCREENING ULTRASOUND @ VITAL 11-14 WK SCAN is examination of the fetal profile in its first trimester to screen for Downs syndrome with the use At VITAL Imaging a dedicated protocol for of maternal age & nuchal translucency (NT). A blood test First Trimester Nuchal Translucency (free beta-HCG & PAPP-A) also can be added to the Measurement laid by the Fetal Medicine screening as it is associated with a higher detection rate & Foundation is followed for the lower false positive rate compared to triple screening. 11-14 wk Screening. Extensive research has now established that screening by NT can detect about 80% of affected In the 1st Trimester, Nuchal Translucency fetuses for a screen positive rate of 5%. The is taken in the sagittal plane of the fetus. combination of NT & maternal serum free ß-hCG & In the 2nd Trimester, Nuchal Fold is taken PAPP-A improves the detection to 90%. in the transverse plane of the fetus. MEASUREMENT OF NT Who should be offered 11-14 wk scan? It should be offered to all pregnant women who are CRL 45-84 mm at a high risk as well as low risk for the disorders to MID – SAG View, Neutral be screened. Therefore, the screening program position described here is also for women who are under 35 Image Size – Head & thorax years of age at the time of delivery & who do not Widest lucency away from have a positive history of a chromosomal amnion abnormality. NASAL BONE CRL 45-84 mm VITAL PREGNANCY MID – SAG VIEW Image Size – Head & thorax SONOGRAPHY PACKAGES Equal sign- Two parallel horizontal lines: DATING SCAN at 6 – 8 wks Top line – Skin Bottom line – Nasal bone FIRST TRIMESTER at 11 – 14 wks Third line – Tip of the nose SCREENING Optimum 1st trimester screening test is provided by ANOMALY SCAN at 18 - 20 wks a combination of: • Age of the mother 3D / 4D SCAN at 18 - 20 wks • Nuchal Translucency measurement • Nasal Bone (Present / Absent) 3D / 4D SCAN at 28 - 34 wks • Free b-HCG and PAPP-A levels in the mother • Tricuspid Regurgitation (Present / Absent) COLOUR DOPPLER at 30 - 40 wks • Physical abnormality (Present / Absent) Pg: 1 Website: www.vitalradiology.com Ph: 26301184 EXCELLENCE IN IMAGING… Blog: http://soundofbabies.blogspot.com 26301185 ALWAYS…
  2. 2. Imaging IMAGING CENTRE Redefined Vol : 4 Iss : 3 The Sound Of Babies… 11 – 14 week USG! NUCHAL TRANSLUCENCY (NT) - NASAL BONE (NB) - The presence of fetal nasal bone is NT is the sonographic appearance of subcutaneous reassuring & is particularly useful for accumulation of fluid behind the fetal neck in first trimester. patients with risks between 1 in 150 & 1 The term translucency is used, irrespective of in 300 who are traditionally classified as whether it is septated or not & whether it is confined screen positive, but with the presence of to the neck or envelopes the whole fetus. the nasal bone confirmed, may be The incidence of chromosomal & other abnormalities sufficiently reassured. is related to the size, rather than the appearance. During the second trimester, the translucency An absent nasal bone will increase usually resolves &, in a few cases, it evolves into dramatically the risk for Trisomy 21, but either nuchal edema or cystic hygromas with or our advice is that such patients are rescanned in one week & action is only without generalized hydrops. taken at that point if there is persistence NT increases with the gestational age, approx of the absence of the nasal bone. 17% per wk. At 11–14 wks the nasal bone is not NT is increased in fetuses with visible by USG in about 60–70% of fetuses with trisomy 21 & in about 2% of Chromosomal & other abnormalities chromosomally normal fetuses. (Trisomies 21, 18 & 13, Triploidy & Turner’s syndrome) . Cardiac defects(septal defects) Pulmonary (diaphragmatic hernia) Renal & abdominal wall defects Certain genetic syndromes & perinatal risks METHOD OF SCREENING SENSITIVITY (%) Maternal age (MA) 30 MA & maternal triple marker at 15–18 weeks 50–70 MA & fetal NT at 11–14 wks 70–80 MA & fetal NT, maternal free b-hCG & PAPP-A at 11–14 wks 85–90 MA & fetal NT & fetal NB at 11–14 wks 90 MA & fetal NT, NB, maternal free b-hCG & PAPP-A at 11–14 wks 95 (For Private Circulation Only) For more information, questions or (NT: Nuchal Translucency, NB: Nasal Bone, b-hCG: human chorionic gonadotropin, Suggestions please call us on 26301184 / 85 PAPP-A: pregnancy-associated plasma protein A) Or email us at newsletter@vitalradiology.com Pg: 2 MULTI SLICE CT SCAN DIGITAL X-RAY PATHOLOGY 24 x 7 MULTI SLICE SONOGRAPHY DIGITAL OPG ECG VITAL MOBILE IMAGING! 3D / 4D SONOGRAPHY 2D ECHO PFT COLOR DOPPLER STRESS TEST HEALTH CHECK UPS Ph: 26301184 / 85

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