Ultrasonografia w przewidywaniu rozległości nacieku trofoblastu w obręb ściany jajowodu w ciąży bańkowej

Objective: Predictive factors of damage to the Fallopian tube may guide the treatment for patients with tubal pregnancy. The purpose of this study was to evaluate the predictive value of ultrasonographic findings in patients affected by ampullary pregnancy for the determination of the depth of trophoblastic infiltration into the tubal wall on histological examination. Material and methods: 38 patients with ampullary pregnancy undergoing salpingectomy were enrolled into the study. The patients were divided into two subgroups depending on their transvaginal sonography (TVS) findings; either an ectopic gestational sac containing an embryo with cardiac activity or those with a tubal ring. The ampullary pregnancies were histologically classified according to the depth of infiltration of trophoblastic tissue into the tubal wall as follows: stage I: limited to mucosa; stage II: extension to the muscularis layer; stage III: complete infiltration of the tubal wall with or without rupture of the serosa. The association between findings on TVS and stage of trophoblastic invasion, serum beta-human chorionic gonodatropin (β-hCG) levels was evaluated. Results: Although there was no significant difference among two groups in terms of histological stage of trophoblastic infiltration (p=0.257), patients in whom an embryo with cardiac activity had been identified were found to have higher percentage of stage II (47.8%) or stage III (8.7%) invasion. However, there was a significant difference in serum β-hCG levels on the day of surgery among the two groups (p=0.028). Conclusions: Ultrasonographic aspect of ampullary pregnancy is associated with depth of trophoblastic infiltration into the tubal wall and serum β-hCG levels.Cel: Czynniki predykcyjne zniszczenia jajowodu mogą być pomocne w leczeniu pacjentek z ciążą jajowodową. Celem badania była ocena wartości prognostycznej badania ultrasonograficznego u pacjentek z ciążą bańkową dla określenia rozległości naciekania trofoblastu w obręb ściany jajowodu potwierdzonego w badaniu histopatologicznym. Materiał i metoda: Do badania włączono 38 pacjentek z ciążą bańkową, u których wykonano usunięcie jajowodu. Pacjentki podzielono na dwie podgrupy pod względem różnych obrazów ultrasonograficznych; jeden z widocznym pęcherzykiem ciążowym i z zarodkiem z czynnością serca, drugi z widocznym pierścieniem jajowodowym. Ciąże bańkowe podzielono na podstawie wyniku histopatologicznego, pod względem głębokości nacieku trofoblastu w ścianę jajowodu: stopień I: ograniczone do śluzówki, stopień II: przechodzące na mięśniówkę, stopień III: całkowite nacieczenie ściany jajowodu z /bez pęknięcia surowicówki. Oceniono związek pomiędzy obrazem ultrasonograficznym, stopniem nacieczenia ściany jajowodu oraz poziomem surowiczego beta hCG. Wyniki: Nie znaleziono istotnych różnic pomiędzy badanymi grupami pod względem histologicznie ocenionego nacieku trofoblastu (p=0,257). Jednak kobiety, u których stwierdzano żywy zarodek częściej miały stopień II (47,8%) lub III (8,7%) inwazji trofoblastu. Znaleziono również istotną różnicę poziomu beta-hCG w dniu operacji pomiędzy dwoma grupami (p=0,028). Wnioski: Pewne ultrasonograficzne aspekty ciąży bańkowej są związane z głębokością inwazji trofoblastu w ścianę jajowodu oraz surowiczym beta-hC

Comparison of experimental and finite element analysis results of a sheet metal prototype vehicle door hinge in X, Y and Z directions

In this study, the geometric differences which have a significant effect on the simulation results of the sheet metal prototype vehicle door hinge have been revealed. This geometric difference was examined by finite element simulations and experimental tests for the loads in the X, Y and Z directions specified in the UNECE R11 regulation. As a result, the curves of the finite element simulations and the experimental tests compared for each direction were examined and it was concluded that the compatible model with the experimental tests of the sheet metal prototype vehicle door hinge was 3D scan model.Keywords: Finite element simulation, UNECE R11 regulation, Vehicle door hinge, 3D scan, Cad model.

Afyonkarahisar Bölgesinde tesis edilen gerçek bir güneş enerjisi sisteminde gölge analizi yapılması

Güneş enerjisi sistemleri günümüzde fosil yakıtların olumsuz çevresel etkileri ve ömürlerinin azalması nedeniyle günümüzde oldukça popüler hale gelmiştir. Güneş enerjisinden elektrik enerjisi üreten sistemlerin maliyetleri gün geçtikçe her ne kadar düşüyor olsa da, konvansiyonel kaynaklarla kıyaslandığında kurulum maliyetleri oldukça yüksektir. Bu nedenle, bu tür sistemler tesis edilirken sahadaki verimlerini arttırıcı önlemler alınmalıdır. Güneş takip sistemleri, maksimum güç noktası izleyicileri kullanılması sistemlerin verimini olumlu yönde etkilemektedir. Ancak, sistemlerin tesis edileceği bölgenin çevresel şartları ve olası gölgelenmeler de güneş enerjisi sistemlerinin verimlerini önemli ölçüde azaltmaktadır. Bu çalışmada gölge analizinin önemi vurgulanmış ve örnek bir proje üzerinde gölge analizinin doğru yapılmaması ve/veya sistemin doğru konumlandırılmaması durumunda güneş panellerinden üretilecek olan enerji miktarının değişimi analiz edilerek elde edilen sonuçlar yorumlanmıştır

Investigation of the Effect of Different Types of Glasses on the Solar Panel Output Power

Fotovoltaik panellerde kullanılan camlar, güneş hücrelerini çevresel etmenlere karşı korumanın yanı sıra, ışığı geçirebilme kabiliyetlerine göre panellerin çıkış gücü performansını doğrudan etkilerler. Bu nedenle güneş panellerinin en önemli parçaları arasında yer aldıkları söylenebilir. Bu çalışmada, fotovoltaik güneş panellerinde yer alan “farklı karakteristik özelliklere sahip” camların güneş paneli çıkış gücüne etkilerinin araştırılması hedeflenmiştir. Bu amaçla, piyasadan aynı özelliklere sahip iki güneş paneli temin edilmiştir. Panellerden birinin üzerindeki cam, ısı ve ışık geçirgenlikleri birbirinden farklı camlar (birbirinden farklı 3 cam kullanılarak değiştirilmiş) ile değiştirilmiş ve panelin çıkış gücü, panel çıkışına bağlanan yük üzerinden ölçülerek kaydedilmiştir. Diğer taraftan aynı ışınım ve ortam şartları altında, orijinal camlı panel çıkışına da bir yük bağlanmış ve bu panelin de çıkış gücü ölçülerek kaydedilmiştir. Elde edilen veriler karşılaştırılarak optimize edilmiş yüksek geçirgenliğe sahip olan, orijinal güneş paneli camına göre ne kadar verim kaybı olduğu yorumlanmıştırThe glasses that are used on Photovoltaic panels (PV), directly affect the output power performance of the PVs according to their ability to transmit the solar light, beside protection of the PV cells against environmental effects. Therefore, it can be said that they are among the most important parts of solar panels. In this study, it is aimed to investigate “the effects of different type of glasses having different characteristically properties” on the output power of solar panels. For this aim, two identical PV modules are obtained from the market. Consequently, the glass of one of the PV module is replaced with different type of glasses (Replaced using 3 different glasses) and the output power of the module is measured during experiments, by the help of a DC load that is connected at the output of the module. On the other hand, same load is connected to the output of the original module and the performances of each module are tested under same solar radiation conditions. Finally, the measured data are analyzed and the total efficiency lose are compared with the efficiency of the PV having original glass that was optimized to have high light transmit ability

Podwyższony poziom greliny w stanie przedrzucawkowym: czy grelina jest przyjacielem czy wrogiem?

Objectives: To investigate maternal serum ghrelin levels in pregnancies complicated by preeclampsia and to explore the relationship between ghrelin level and disease severity. Materials and methods: This case-control study included 40 healthy pregnant women, 42 women with mild preeclampsia, and 40 women with severe preeclampsia. The groups were matched in terms of maternal and gestational age and body mass index. Serum ghrelin levels were measured via enzyme immunoassay. Results: Serum ghrelin levels were significantly higher in women with mild and severe preeclampsia than in healthy controls (p < 0.001). Although serum ghrelin levels were somewhat higher in the severe compared to the mild preeclampsia group, the difference was not statistically significant (p > 0.05). In the control group, no significant correlation was observed between ghrelin level and any other parameter, but in the preeclampsia group, serum ghrelin levels were negatively correlated with uterine artery Doppler index values and both systolic and diastolic blood pressure (all p-values < 0.05). Multivariate stepwise linear regression analysis revealed that systolic blood pressure (β = 0.493, p = 0.023) was independently associated with serum ghrelin level. Conclusion: Elevated blood ghrelin levels were correlated with disease severity in pregnancies complicated by preeclampsia.Cel pracy: Ocena poziomu greliny w surowicy kobiet w ciąży powikłanej stanem przedrzucawkowym i określenie związku między poziomem greliny a ciężkością choroby. Materiał i metoda: Do badania włączono 40 zdrowych kobiet w ciąży, 42 z łagodnym stanem przedrzucawkowym i 40 z ciężkim stanem przedrzucawkowym. Grupy były dobrane pod względem wieku ciążowego, wieku matek i wskaźnika masy ciała. Poziom greliny w surowicy był mierzony metodą immunoenzymatyczną. Wyniki: Poziom greliny w surowicy był istotnie wyższy u kobiet z łagodnym i ciężkim stanem przedrzucawkowym niż w grupie kontrolnej (p < 0,001). Chociaż poziom greliny w surowicy był wyższy w grupie z ciężkim stanem przedrzucawkowym niż w grupie z łagodnym stanem przedrzucawkowym, to ta różnica nie była istotna statystycznie (p > 0,05). W grupie kontrolnej nie obserwowano żadnych istotnych związków pomiędzy poziomem greliny a jakimkolwiek innym parametrem, ale w grupie ze stanem przedrzucawkowym poziom greliny w surowicy był ujemnie skorelowany z indeksami przepływów Dopplera w tętnicy macicznej oraz ciśnieniem krwi skurczowym i rozkurczowym (all p-values < 0,05). Wieloczynnikowa analiza regresji liniowej wykazała, że skurczowe ciśnienie krwi było niezależnym czynnikiem związanym z poziomem greliny w surowicy (β = 0,493, p = 0,023). Wnioski: Podwyższony poziom greliny we krwi był związany z ciężkością choroby w ciążach powikłanych stanem przedrzucawkowym

Robotic Compartment-Based Radical Surgery in Early-Stage Cervical Cancer

A radical hysterectomy with pelvic lymphadenectomy is the recommended treatment option in patients with early-stage cervical cancer. Although various classifications were developed in order to define the resection margins of this operation, no clear standardization could be achieved both in the nomenclature and in the extent of the surgery. Total mesometrial resection (TMMR) is a novel procedure which aims to remove all components of the compartment formed by Müllerian duct in which female reproductive organs develop. TMMR differs from the conventional radical hysterectomy techniques in that its surgical philosophy, terminology, and partly resection borders are different. In this paper, a TMMR with therapeutic pelvic lymphadenectomy operation that we performed for the first time with robot-assisted laparoscopic (robotic) approach in an early-stage cervical cancer patient was presented. This procedure has already been described in open surgery by Michael Höckel and translated to the robotic surgery by Rainer Kimmig. Our report is the second paper, to our knowledge, to present the initial experience regarding robotic TMMR in the English literature