Reproducibility of the interpretation of coronal 3D ultrasound view of the uterus to evaluate the position of Essure® 3 months after hysteroscopic procedure.

OBJECTIVE: Three-dimensional sonography is a good alternative method to assess the position of microinserts. Adequate position after three months allows for the interruption of other contraception. Objective is to evaluate inter-observer reproducibility of the interpretation of coronal transvaginal 3D ultrasound view of the uterus to evaluate the position of Essure®. STUDY DESIGN: Inter-observer reproducibility study. Fifty women underwent successful bilateral placement of microinserts (Essure®) by hysteroscopy in the Department of Gynaecology of a teaching hospital and were included in the study. At three month, 3D ultrasound coronal views of the fifty uterus (accounting for one hundred microinserts) were assessed by five different observers and microinsert position was classified according to the classification described by Legendre et al. Inter-observer reproducibility in reading the 3D coronal view of the uterus was evaluated. RESULTS: The k-value was disparate, from 0.26 to 0.82. Inter-observer reproducibility then ranged from fair to almost perfect, depending on a prior knowledge of the position classification. CONCLUSIONS: Transvaginal 3D coronal view of the uterus is sufficient to assess the positioning of the microinserts when the practionner or the surgeon is familiar with the classification method.

Enhanced sensitivity detection of protein immobilization by fluorescent interference on oxidized silicon.

We present a silicon chip-based approach for the enhanced sensitivity detection of surface-immobilized fluorescent molecules. Green fluorescent protein (GFP) is bound to the silicon substrate by a disuccinimidyl terephtalate-aminosilane immobilization procedure. The immobilized organic layers are characterized by surface analysis techniques, like ellipsometry, atomic force microscopy (AFM) and X-ray induced photoelectron spectroscopy. We obtain a 20-fold enhancement of the fluorescent signal, using constructive interference effects in a fused silica dielectric layer, deposited before immobilization onto the silicon. Our method opens perspectives to increase by an order of magnitude the fluorescent response of surface immobilized DNA- or protein-based layers for a variety of biosensor applications.

Shear with comminution of a granular material: microscopic deformations outside the shear band.

A correlation imaging velocimetry technique is applied to recover displacement fields in a granular material subjected to extended shear. A thick (10 cm) annular sand sample (grain size: 1 mm) is confined at constant pressure (sigma=0.5 MPa) against a rough moving wall displacing at very low speed (delta=83 microm s(-1)). Localization of the strain rapidly forms a shear band (seven particles wide) in which comminution develops. We focused on the strain field outside this shear band and observed a rich dynamics of large and intermittent mechanical clusters (up to 50 particles wide). Quantitative description of the radial velocity profile outside the shear band reveals an exponential decrease. However, a significant slip evolution of the associated characteristic length is observed, indicative of a slow decoupling between the shear band and the rest of the sample. This slow evolution is shown to be well described by power laws with the imposed slip, and has important implications for friction laws and earthquake physics.

Internal iliac artery ligation in post-partum hemorrhage.

Between 1978 and 1986, internal iliac artery ligation was performed on eight patients undergoing treatment for severe post-partum hemorrhage, and disseminated intra-vascular coagulation (DIVC) combined with causal pathology was detected in five patients. This procedure was effective in controlling bleeding in eight patients and no hysterectomy was necessary. Post-operative follow-up was uncomplicated in six patients. One patient suffered from post-operative occlusion. Another patient suffered from renal failure, due to secondary cortical renal necrosis. Surgery is usually simple and does not pose any technical problems. This technique allows for the conservation of the reproductive functions, and two of the women became pregnant at a later stage. Obstetric hysterectomy can be avoided by using this technique. It is recommended in cases where DIVC does not respond to medical treatment and can furthermore be used by all surgeons.