Sonoelastography of the uterine cervix as a new diagnostic tool of cervical assessment in pregnant women - preliminary report.

OBJECTIVES: The study aimed at determining whether there exists a correlation between the cervical cohesion parameters assessed in the elastography and the length of the cervix. MATERIAL AND METHODS: Assessment of cervical cohesion parameters with the use of real-time sonoelastography was performed on 59 patients between 28 and 39 weeks of gestation. RESULTS: The analysis showed that there exists a statistically significant (p=0.033) correlation between the cervical length and the elasticity of the front cervical labium (strain ratio A). Correlation coefficient (r) stood at (-) 0.28. CONCLUSIONS: 1. There exists a negative correlation between the condition on the front cervical labium in elastographic imaging and the length of the cervical canal in USG imaging. 2. Elastography of the uterine cervix may be helpful in assessing the risk of premature labour or cervical insufficiency. 3. There is a need to perform a study on a larger group of patients in order to determine whether elastography may find its place among routine obstetric diagnostic methods.

Comparative analysis of placental vasculature and placental volume in normal and IUGR pregnancies with the use of three-dimensional Power Doppler.

OBJECTIVES: To evaluate the differences in placental vascular indices and placental volume between normal and IUGR pregnancies. METHODS: A prospective study was conducted on a group of 100 normal and 20 IUGR pregnancies between 22 and 42 weeks of gestation. For the purpose of evaluation of placental volume and placental vascular indices, we applied 3D Power Doppler and VOCAL technique. Only patients with entirely visualized placenta were included in the study. RESULTS: A comparative analysis of vascularization index (VI), vascularization flow index (VFI), flow index (FI), and placental volume (PV) revealed statistically significant differences between normal and IUGR pregnancies. In normal pregnancies, the volume of the placenta was on average 92.42 cm(3) larger than in pregnancies complicated by IUGR. Receiver operating characteristic (ROC) curves were used to evaluate the clinical usefulness of placental vascular indices and placental volume for discriminating IUGR and normal pregnancies. It was concluded that the VI, VFI, PV, FI parameters are the best discriminants, with the cut-off values of 5.30, 2.30, 199, and 36.0, respectively. CONCLUSIONS: The quantitative assessment of placental vasculature and placental volume by means of 3D Power Doppler and VOCAL technique is an adjunctive modality for differentiation between normal and IUGR pregnancies. Our findings further suggest that the vascularization index (VI) and vascularization flow index (VFI) are the best parameters with the most favorable discriminating potential for proper identification of IUGR pregnancies.

Selected properties of Al x Zn y O thin films prepared by reactive pulsed magnetron sputtering using a two-element Zn/Al target.

Al x Zn y O thin films were obtained by reactive pulsed magnetron sputtering. A two-element Zn/Al planar target was used as source material prepared in the form of a Zn disc (100 mm diameter) with Al rings pressed into its surface. The sputtering processes were carried out in a mixture of argon and oxygen. The films were deposited with a discharge power of P E = 400 W, which corresponded to a power density on the target surface of approximately 5 W/cm2. The films were deposited on glass strip substrates, placed symmetrically over the target, making it possible to obtain films with different composition and thickness. The film sheet resistance was measured as a function of the distance from the target axis on both sides (front and back) of the substrate. The lowest measured resistivity was about 4 × 10-3 Ω·cm. Additionally, optical properties, surface topography, and elemental composition were determined in selected areas of the substrate.

Investigation of the Microstructure, Optical, Electrical and Nanomechanical Properties of ZnOx Thin Films Deposited by Magnetron Sputtering.

The paper presents the results of an investigation of the influence of technological parameters on the microstructure, optical, electrical and nanomechanical properties of zinc oxide coatings prepared using the pulsed reactive magnetron sputtering method. Three sets of ZnOx thin films were deposited in metallic, shallow dielectric and deep dielectric sputtering modes. Structural investigations showed that thin films deposited in the metallic mode were nanocrystalline with mixed hexagonal phases of metallic zinc and zinc oxide with crystallite size of 9.1 and 6.0 nm, respectively. On the contrary, the coatings deposited in both dielectric modes had a nanocrystalline ZnO structure with an average crystallite size smaller than 10 nm. Moreover, coatings deposited in the dielectric modes had an average transmission of 84% in the visible wavelength range, while thin films deposited in the metallic mode were opaque. Measurements of electrical properties revealed that the resistivity of as-deposited thin films was in the range of 10-4 Ωcm to 108 Ωcm. Coatings deposited in the metallic mode had the lowest hardness of 2.2 GPa and the worst scratch resistance among all sputtered coatings, whereas the best mechanical properties were obtained for the film sputtered in the deep dielectric mode. The obtained hardness of 11.5 GPa is one of the highest reported to date in the literature for undoped ZnO.

Transvaginal hydrolaparoscopy for diagnosis of tubal infertility.

OBJECTIVE: Infertility problem affects more than 70 million couples worldwide, 5-15% of which are couples in their reproductive age. Less and less invasive endoscopic methods like transvaginal hydrolaparoscopy have been developed by technological progress. This method enables not only precise identification, but is now increasingly used for treatment of tubal and peritoneal factor pathology, which cause approximately 35 per cent of female infertility. AIM: Evaluation of transvaginal hydrolaparoscopy (HLTV) usefulness for diagnosis of tubal infertility comparing to standard laparoscopy and hysterosalpingography (HSG). RESULTS: In evaluation of patent fallopian tubes results of HLTV and HSG examinations are coincide in 87%, while obstruction diagnosed in HSG is confirmed only in 37% during HLTV examination. Transvaginal hydrolaparoscopy and HSG have similar sensitivity and specificity in diagnosis of hydrosalpinx, which is up to 100% . In comparison with HLTV histerosalpingography is less effective in evaluation of peritubal dilatations and adhesions. Both laparoscopic surgery and transvaginal laparoscopy have the same high sensitivity in diagnostics of the fallopian tubes patency and hydrosalpinx, which is up to 100%. In evaluation of peritubal adhesions and dilatations the results are very similar. CONCLUSIONS: 1. HLTV is a highly useful method in evaluation of the fallopian tubes pathologies which is significantly more sensitive than HSG in evaluation of such lesions as peritubal adhesions and obstructed fallopian tubes. 2. HLTV is as effective as laparoscopy in evaluation of patency and lesions of the fallopian tubes. 3. HLTV is a less invasive method, much better tolerated than laparoscopy and more suitable for the group of overweight patients. 4. Final assessment of HTLV technique will be possible following performance of a greater number of studies, where the foregoing conclusions present only initial observations.

High Power Impulse Magnetron Sputtering of In2O3/Sn Cold Sprayed Composite Target.

High Power Impulse Magnetron Sputtering (HiPIMS) was used for deposition of indium tin oxide (ITO) transparent thin films at low substrate temperature. A hybrid-type composite target was self-prepared by low-pressure cold spraying process. Prior to spraying In2O3 and oxidized Sn powders were mixed in a volume ratio of 3:1. Composite In2O3/Sn coating had a mean thickness of 900 µm. HiPIMS process was performed in various mixtures of Ar:O2: (i) 100:0 vol.%, (ii) 90:10 vol.%, (iii) 75:25 vol.%, (iv) 50:50 vol.%, and (v) 0:100 vol.%. Oxygen rich atmosphere was necessary to oxidize tin atoms. Self-design, simple high voltage power switch capable of charging the 20 µF capacitor bank from external high voltage power supply worked as a power supply for an unbalanced magnetron source. ITO thin films with thickness in the range of 30-40 nm were obtained after 300 deposition pulses of 900 V and deposition time of 900 s. The highest transmission of 88% at λ = 550 nm provided 0:100 vol. % Ar:O2 mixture, together with the lowest resistivity of 0.03 Ω·cm.

Umbilical cord morphology in pregnancies complicated by IUGR in cases of tobacco smoking and pregnancy-induced hypertension.

OBJECTIVE: The aim of this study was to determine the characteristic features of the umbilical cord morphology in selected cases of intrauterine growth restriction (IUGR): tobacco smoking, pregnancy-induced hypertension and idiopathic IUGR. MATERIALS AND METHODS: 136 pregnant women were included in the study - 86 patients with IUGR (IUGR group) and 50 women with uncomplicated course of pregnancy (control group). In the IUGR group 31 women were smokers, 27 suffered from pregnancy-induced hypertension, and 28 had an unknown reason for IUGR. Each of them underwent ultrasound examination to measure fetal growth and to assess morphological parameters of the umbilical cord. RESULTS: Significant differences between the control group and the whole IUGR group in terms of the diameter of the umbilical cord and diameter of the umbilical vein - smaller diameters in the IUGR group than in the control group. Significant differences among IUGR subgroups in terms of area of Wharton's jelly and diameters of the umbilical cord, vein and artery. Significant difference in the length of the uncoiled section among the IUGR subgroups. CONCLUSIONS: 1. The umbilical cord in IUGR and concomitant tobacco smoking is hyper-coiled with coiling index independent of fetal weight and high content of Wharton's jelly. 2. The umbilical cord in IUGR and concomitant pregnancy-induced hypertension is thinnest with thinnest vessels and the smallest content of Wharton's jelly. 3. The assessment of umbilical cord morphology should become an integral part of ultrasound exam in pregnancies complicated by IUGR.

Nonimmune hydrops fetalis.

BACKGROUND: Nonimmune hydrops fetalis (NHF) is an abnormal accumulation of fluid - especially serous - in visceral cavities and soft tissues. This condition may be caused by: cardiovascular diseases, chromosomal disorders, infections, lung, stomach, intestinal, kidneys, urinary tract and blood diseases, metabolic disorders and tumors. NHF may by diagnosed by an ultrasound scan. THE AIM of the study was to present diagnostic and therapeutic difficulties as well as management with reference to NHF. CASE STUDY: An abnormal accumulation of fluid in visceral cavities and subcutaneous tissue of two fetuses was diagnosed by an ultrasound scan. Despite a detailed and specific diagnostic proceeding which included: infections, congenital malformations, chromosomal abnormalities etc. it was impossible to establish the cause of NHF. The symptomatic therapy was performed: periodic cordocentesis with an injection of human albumin solutions. In case of the first fetus therapeutic thoracocentesis was performed. The fetuses were delivered in 32nd and 31st week of pregnancy. Both neonates survived but even after the delivery it was impossible to establish the cause of NHF. CONCLUSIONS: Multidirectional diagnostic approach is essential for the implementation of causal treatment of NHF. In case of idiopathic NHF the only management is symptomatic therapy, fetal monitoring and preterm delivery.

Application of endoscopy in pediatric and adolescent gynecology.

Early proper diagnostics and treatment of developmental age pathologies in most cases facilitate correct sex organ development, as well as reproductive functions formation. To make the foregoing possible, it is necessary to apply minimally invasive and safest methods like vaginoscopy, hysteroscopy and laparoscopy. The main application field of vaginoscopy and hysteroscopy in pediatric and adolescent gynecology is the diagnosis and treatment of vulvar and vaginal pathologies and developmental anomalies of sex organ. The laparoscopy is becoming a more and more popular method in the treatment of adnexal tumors in children, due to its little invasiveness, quick recovery and less severe pain complaints after the surgery. The application of these endoscopic procedures should always be preceded by the complex noninvasive diagnostics, such as ultrasonography and magnetic resonance imaging. The endoscopic procedures facilitate wide-ranging diagnostics and simultaneously therapeutic management, ensuring minimal invasion and high safety of the surgery. They should be considered diagnostics and treatment of choice in the pathology of vulva, vagina, developmental anomalies of sex organ and adnexal tumors in patients of the developmental age.

Detection of secondary and backscattered electrons for 3D imaging with multi-detector method in VP/ESEM.

The paper considers some major problems of adapting the multi-detector method for three-dimensional (3D) imaging of wet bio-medical samples in Variable Pressure/Environmental Scanning Electron Microscope (VP/ESEM). The described method pertains to "single-view techniques", which to create the 3D surface model utilise a sequence of 2D SEM images captured from a single view point (along the electron beam axis) but illuminated from four directions. The basis of the method and requirements resulting from them are given for the detector systems of secondary (SE) and backscattered electrons (BSE), as well as designs of the systems which could work in variable conditions. The problems of SE detection with application of the Pressure Limiting Aperture (PLA) as the signal collector are discussed with respect to secondary electron backscattering by a gaseous environment. However, the authors' attention is turned mainly to the directional BSE detection, realized in two ways. The high take off angle BSE were captured through PLA with use of the quadruple semiconductor detector placed inside the intermediate chamber, while BSE starting at lower angles were detected by the four-folded ionization device working in the sample chamber environment. The latter relied on a conversion of highly energetic BSE into low energetic SE generated on walls and a gaseous environment of the deep discharge gap oriented along the BSE velocity direction. The converted BSE signal was amplified in an ionising avalanche developed in the electric field arranged transversally to the gap. The detector system operation is illustrated with numerous computer simulations and examples of experiments and 3D images. The latter were conducted in a JSM 840 microscope with its combined detector-vacuum equipment which could extend capabilities of this high vacuum instrument toward elevated pressures (over 1kPa) and environmental conditions.

Analysis of prevalence of selected anamnestic factors among women with pelvic organ prolapse.

BACKGROUND: Pelvic organ prolapse is the most frequent medical condition in women in the postmenopausal age. The pathophysiology is multifactorial. OBJECTIVES: The purpose of this paper was to analyze the prevalence of selected anamnestic factors in the population of women treated due to pelvic organ prolapse in the 2nd Department and Clinic of Obstetrics and Gynecology Wroclaw Medical University (Poland). MATERIAL AND METHODS: A total of 104 medical histories of women treated in the 2nd Department and Clinic of Obstetrics and Gynecology in the years 2012-2013 due to pelvic organ prolapse were analyzed. RESULTS: The most frequent type of defect was the complex defect concerning both cystocele and rectocele. Intensity of dysfunctions was determined by age, obstetric history (parity, newborn's body mass and process of labor), and woman's constitutional characteristic (her BMI and height). A comparison based on the type of defect revealed no differences between the groups except for BMI, which was the highest in the rectocele group (31.15 ±5.84; p = 0.0069). CONCLUSIONS: The multifactorial ethology and differential clinical presentation including several types of this defect make this disorder difficult to prevent and treat. The obtained results confirm that there exists a relation between the data from the medical history and the prevalence of pelvic organ prolapse. Anamnesis can be useful when predicting prevalence and, in the future, may even help to decrease the prevalence of this type of disorder.

[Ultrasonographic analysis of cesarean scars features in nonpregnant uterus]. / Ultrasonograficzna ocena blizny po cieciu cesarskim w macicy nieciezarnej.

OBJECTIVES: To define and assess the new ultrasonographic parameters of cesarean hysterotomy scars and to analyze their variation depending on the number of cesarean sections. MATERIAL AND METHODS: Transvaginal ultrasound was carried out among 109 patients after cesarean section in the lower uterine segment with single-layer uterine closure. The following cesarean hysterectomy scar parameters were assessed: angle of the apex (K), basis (P) and height (W) of the anechoic triangle, the thickness of the knit tissue scar segment (G), G/P index and G/W index. RESULTS: Transvaginal ultrasound detected the cesarean hysterectomy scar in 100% of the examined woman. In 5.5% of cases the completely knit hysterectomy scar tissue was identified. All patients from this group underwent a single cesarean section. In the remaining 94.5% of women, the ultrasound detected a presence of the anechoic triangle, defined as scar defect. No difference of statistical importance considering assessed scar parameters was observed between the groups of patients after one and two cesarean sections. The decrease of the thickness of the knit tissue scar segment (G) in the group of patients after three cesarean, sections in comparison to the group of patients after single (1.3 mm vs. 6.7 mm, p = 0.0134) and two (1.3 mm vs. 7.4 mm, p = 0.0366) abdominal deliveries, was found, as well as statistically important decrease in G/P index value in the group of patients after three cesarean sections in comparison to the patients after one (0.3 vs. 1.3, p = 0.0263) and two cesarean sections (0.3 vs. 1.2, p = 0.0138). CONCLUSIONS: The new ultrasonographic parameters to assess the cesarean hysterectomy scar in nonpregnant uterus were introduced. Statistically important decrease in the thickness of the knit tissue scar segment (G) and G/P index value in the group of patients after three cesarean sections in comparison to the group of patients after single and two abdominal deliveries was revealed.

Prevalence and Relevance of Pruritus in Pregnancy.

Pregnant women are at greater risk to suffer from chronic pruritus, but data on this symptom in this group is very limited. The aim of this study was to investigate the prevalence, clinical characteristics, and the importance of pruritus in pregnant women. A total of 292 consecutive pregnant women at the 33.0 ± 6.1 weeks of gestation (WoG) were recruited into this prospective, cross-sectional study. All patients underwent thorough anamnesis and detailed physical examination with the special emphasis on pruritus. Pruritus was assessed according to Visual Analogue Scale (VAS). Quality of life was measured with the Dermatology Life Quality Index (DLQI). The point prevalence of pruritus was 20.2% (n = 59), while pruritus prevalence during the entire pregnancy was 38.0% (n = 111). Pruritus started on average at the 27.2 ± 7.6 WoG; it was significantly more common among women in third trimester. The mean VAS was 4.8 (±2.4) points. The DLQI scoring significantly correlated with VAS (r = 0.52, p < 0.001). Based on the results of our study about one-third of women suffer from pruritus during pregnancy. Many of them find it a very distressing and disturbing symptom.

[The comparison of the angles of doppler wave spectrum of blood flow in tumor vessels in case of adnexal masses]. / Porównanie katów spektrum fall dopplerowskiej przeplywu przez naczynia guza w przypadku guzów przydatków.

OBJECTIVES: To evaluate the usefulness of the measurement of angles of doppler wave spectrum in systolic phase in tumor vessels in adnexal masses and potential usefulness of this parameter in differential diagnosis of these lesions. MATERIAL AND METHODS: The study covers 173 patients with adnexal masses found on the examination. RESULTS AND CONCLUSIONS: The mean value of the measured angles in benign lesions amounted to 65.68 degrees and in malignant lesions 87.79 degrees. Additionally the readings of pulsatility index PI and flow speed: minimal -min, maximal -max and maximal mean -Ta sr max. in examined vessels were taken into consideration. The statistically significant differences in the angle values of the two groups were noticed, although the usefulness of this single parameter in differential diagnosis of the lesions is not as helpful as usefulness of RI and PI but it is more useful than Ta min, Ta max and Ta sr max.