Ultrasound screening for fetal major abnormalities at 11-14 weeks

BACKGROUND: This study was planned to evaluate the efficiency of the 11-14 week scan in detecting fetuses with major fetal structural abnormalities. METHODS: Some 1,290 pregnant women were submitted to a routine ultrasound scan between the 11th and 14th week after the detection of the fetal viability. The fetal anatomy was examined transabdominally, and in suspected cases transvaginally. Following the scans, the patients were examined in the second or third trimester of pregnancy. Fetal structural abnormalities classified as major and early onset were noted. Isolated choroid plexus cysts, cardiac defects not requiring treatment, mild ventriculomegaly, and mild renal pelviectasis in second trimester were not included. RESULTS: Twenty-four (1.86%) fetuses with various defects were identified, and 17 of these were diagnosed at the 11-14 week scan. The antenatal ultrasound detection rate of the fetuses with major anomalies was 95%, and 70% were detected in the first-trimester assessment. Four cardiac defects associated with genetic syndromes or requiring operation were included (0.31%) in this series. Two of the fetuses with cardiac defects (50%) had an increased nuchal translucency thickness. In this group, none of the fetuses with karyotype anomalies was born alive. CONCLUSIONS: The first-trimester scan is important in routine antenatal care for early detection of fetal defects, and determination of the fetuses at risk of cardiac anomalies and genetic syndromes.     

Self-Healing Systems in Silicon Anodes for Li-Ion Batteries

Self-healing is the capability of materials to repair themselves after the damage has occurred, usually through the interaction between molecules or chains. Physical and chemical processes are applied for the preparation of self-healing systems. There are different approaches for these systems, such as heterogeneous systems, shape memory effects, hydrogen bonding or covalent–bond interaction, diffusion, and flow dynamics. Self-healing mechanisms can occur in particular through heat and light exposure or through reconnection without a direct effect. The applications of these systems display an increasing trend in both the R&D and industry sectors. Moreover, self-healing systems and their energy storage applications are currently gaining great importance. This review aims to provide general information on recent developments in self-healing materials and their battery applications given the critical importance of self-healing systems for lithium-ion batteries (LIBs). In the first part of the review, an introduction about self-healing mechanisms and design strategies for self-healing materials is given. Then, selected important healing materials in the literature for the anodes of LIBs are mentioned in the second part. The results and future perspectives are stated in the conclusion section.     

Experimental Investigations on Dry Sliding Wear Behavior of Kevlar and Natural Fiber-Reinforced Hybrid Composites through an RSM–GRA Hybrid Approach

The present work aimed to investigate the dry sliding wear behaviors of hybrid polymer matrix composites made up of Kevlar, bamboo, palm, and Aloe vera as reinforcement materials of varying stacking sequences, along with epoxy as the matrix material. Three combinations of composite laminates with different stacking sequences such as AB, BC, and CA were fabricated by a vacuum-assisted compression molding process. The influence of composite laminates fabricated through various stacking sequences and dry sliding wear test variables such as load, sliding distance, and sliding velocity on the specific wear rate and co-efficient of friction were investigated. Experiments were designed and statistical validation was performed through response surface methodology-based D-optimal design and analysis of variance. The optimization was performed using grey relational analysis (GRA) to identify the optimal parameters to enhance the wear resistance of hybrid polymer composites under dry sliding conditions. The optimal parameters, such as composite combinations of CA, a load of 5 N, a sliding velocity of 3 m/s, and a sliding distance of 1500 m, were obtained. Furthermore, the morphologies of worn-out surfaces were investigated using SEM analysis.     

Epileptic Activity Intrinsically Generated in the Human Cerebellum

Neoplastic or dysplastic neuronal tissue in the brain stem and cerebellum can become epileptogenic in pediatric patients. However, it is unknown whether such tissue may transform intrinsic properties of the human cerebellum, making it capable of generating epileptic population activity. We noninvasively detected epileptiform signals unaveraged in a pediatric patient with epilepsy due to a tumor in the middle cerebellar peduncle. Analysis of generators of the signals revealed that the cerebellum ipsilateral and contralateral to the tumor was the dominant interictal spike generator and could initiate ictal activity, suggesting that human cerebellum may become capable of intrinsically generating epileptic activity. ANN NEUROL 2020;88:418–422.     

Prevention of complications in laparoscopic hysterectomy: experience with 1120 cases performed by a single surgeon

STUDY OBJECTIVE: The aim of this study is to describe a safe technique without any ureteral, bladder, and major vessel injuries in laparoscopic hysterectomy with a CO2 laser technique. DESIGN: Prospective study (Canadian Task Force classification II-3). SETTING: Centre Hospitalier Interrégional Edith Cavell, Department of Obstetrics and Gynecology, Endoscopic Laser Surgery Center, Bruxelles, Belgium; and Kadir Has University, Metropolitan Florence Nightingale Hospital, Istanbul, Turkey. PATIENTS: One thousand one hundred twenty women with benign diseases. INTERVENTIONS: Laparoscopic-assisted vaginal hysterectomy (LAVH) or laparoscopic hysterectomy (LH). MEASUREMENTS AND MAIN RESULTS: Between 1992 and 2004, in 1120 women with benign diseases, consecutive LAVH or LH was planned. During laparoscopic hysterectomy, at all stages, bipolar forceps was used for hemostasis, and a CO2 laser was used for vaporization and excision. The total operating time was 35 to 180 minutes, with a median of 52 minutes (range 35-163) for LAVH (n = 542) and 55 minutes (range 42-180) for LH (n = 552). Operations were successfully completed laparoscopically in 98.8% of the patients. The mean hospital stay was 2 days. The overall major complication rate was 1%. No ureteral, bladder, or major vascular injury occurred. CONCLUSION: The technique we used in our study is safe and effective in the prevention of ureteral, vesical, and vascular injuries during LAVH and LH; moreover, the use of bipolar coagulation and a CO2 laser in endoscopic surgery results in a shorter duration of operation. This technique provides all the advantages of both laparoscopic and vaginal surgery.     

Laparoscopic versus open resection of colorectal liver metastasis

Background

Findings have shown laparoscopic liver resection (LLR) to be feasible and safe, but the data in the literature regarding oncologic outcomes are scant. This study aimed to compare the perioperative and short-term oncologic outcomes between LLR and open resection of colorectal liver metastasis (CLM).

Methods

Between January 2006 and April 2012, 40 patients underwent LLR of CLM. These patients were compared with a consecutive matched group of 40 patients who underwent open resection within the same period. Data were obtained from a prospective institutional review board (IRB)-approved database. Statistical analysis was performed using t test, Chi-square, and Kaplan–Meier survival.

Results

The groups were similar in terms of age, gender, tumor size, number of tumors, and type of resections performed. The operative time was similar in the two groups, but the estimated blood loss was less in the LLR group than in the open resection group. The length of stay was shorter in the LLR group (3.7 vs 6.5 days; p < 0.001). The 2-year overall survival rate was 89 % for LLR and 81 % for open resection. The median disease-free survival time was 23 months in each group.

Conclusions

The findings suggest that LLR is associated with less blood loss and a shorter hospital stay than open resection for CLM. According to our short-term results, LLR is equivalent to open resection in terms of oncologic outcomes.