Constructing a Novel 'Uterine Sandwich' with Simultaneous Intrauterine Balloon Tamponade and Uterine Compression Sutures to Manage Postpartum Bleeding.

The uterine sandwich is a relatively new surgical technique for managing postpartum hemorrhage, which is the leading cause of maternal mortality worldwide. The purpose of this case series is to describe a novel method of constructing the uterine sandwich by simultaneously combining intrauterine balloon tamponade and uterine compression sutures. Six patients with postpartum bleeding refractory to medical management were successfully treated with this novel method and avoided hysterectomy. There were no additional complications. This novel method of constructing a uterine sandwich appears to be a simple, safe, and effective technique that could be considered in cases of persistent postpartum bleeding. More research is needed to compare the efficacy of various techniques.

Slit1b-Robo3 signaling and N-cadherin regulate apical process retraction in developing retinal ganglion cells.

When neurons exit the cell cycle after their terminal mitosis, they detach from the apical surface of the neuroepithelium. Despite the fact that this detachment is crucial for further neurogenesis and neuronal migration, the underlying mechanisms are still not understood. Here, taking advantage of the genetics and imaging possibilities of the zebrafish retina as a model system, we show by knockdown experiments that the guidance molecule Slit1b and its receptor Robo3 are required for apical retraction of retinal ganglion cells (RGCs). In contrast, N-cadherin seems to be responsible for maintenance of apical attachment, as expression of dominant-negative N-cadherin causes RGCs to lose apical attachments prematurely and rescues retraction in slit1b morphants. These results suggest that Slit-Robo signaling downregulates N-cadherin activity to allow apical retraction in newly generated RGCs.

Poor survival for US Pacific Islander cancer patients: evidence from the Surveillance, Epidemiology, and End Results database: 1991 to 2004.

PURPOSE: Although racial and ethnic differences in cancer survival in the United States have been studied extensively, little is known about cancer survival in US Pacific Islanders (PIs), a fast-growing and economically disadvantaged minority group. METHODS: Using data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries, we compared cause-specific and all-cause survival for female breast, prostate, lung, colorectal, stomach and liver cancer for Native Hawaiians, Samoans, other PIs (including Tongans, Guamanians, and others), African Americans, and Native Americans with non-Hispanic whites using Cox proportional hazards models. Separate models were fitted adjusting for demographic factors only and demographic and disease severity variables. RESULTS: Among all groups, Samoans were the most likely to present with advanced disease and had the worst cause-specific survival for all sites considered. Samoans had particularly poor results (adjusted for demographic variables only) for female breast (relative risk [RR] = 3.05; 95% CI, 2.31 to 4.02), colorectal (RR = 1.82; 95% CI, 1.37 to 2.41) and prostate (RR = 4.82; 95% CI, 3.38 to 6.88) cancers. Native Hawaiians and other PIs also had significantly worse cause-specific survival than did non-Hispanic whites for most sites, but generally had better survival than African Americans or Native Americans. CONCLUSION: Much of the survival disadvantage for PI groups appears to be a result of late diagnosis, and thus targeted interventions have much potential to reduce cancer mortality in this group. More research is needed to find explanations for the particularly poor cancer survival for Samoans in the United States.