Publications by authors named "Michal Pomorski"

52 Publications

The clinical evaluation of internal iliac arteries balloon occlusion for placenta accreta spectrum.

Ginekol Pol 2021 Jan 15. Epub 2021 Jan 15.

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

Objectives: To evaluate the balloon occlusion of the internal iliac arteries during a caesarean section in the group of patients with placenta accreta spectrum.

Material And Methods: We analysed 29 pregnant women with placenta accreta spectrum. The study group consisted of 15 patients, who underwent a caesarean delivery with temporary bilateral internal iliac artery occlusion. In the control group, we examined 14 women who had a standard caesarean delivery without any radiologic procedure. We compared pre- and post-operative haemoglobin level, necessity of blood transfusion, intraoperative blood loss, intensive care requirement, complications, duration of surgery, anaesthesia and hospital stay.

Results: The history and obstetric outcomes were similar in both groups. The study group required fewer blood transfusions than the control group (p = 0.0176). We administered less packed red blood cells and fresh frozen plasma. Complications were more frequent in the control group (p = 0.0014). Complications related to occlusion of the internal iliac arteries did not occur. The intensive care unit transfer was more frequent in the control group (p = 0.0329). The duration of surgery and hospital stay did not differ between groups. The anaesthesia time was longer in a study group, which related to the radiologic procedure.

Conclusions: Caesarean delivery for placenta accreta spectrum with bilateral balloon occlusion of the internal iliac arteries requires fewer transfusions. It contributes to a decrease in the complication rate and maternal morbidity.
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http://dx.doi.org/10.5603/GP.a2020.0180DOI Listing
January 2021

Placental mesenchymal dysplasia and hepatic cyst.

Ginekol Pol 2020 ;91(12):779-780

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

Placental mesenchymal dysplasia (PMD) is a rare benign vascular anomaly of the placenta. It can be misdiagnosed as a molar pregnancy resulting in unnecessary termination of pregnancy. A 30-year-old woman was referred to our hospital at 18 gestational weeks due to suspicion of molar pregnancy. The ultrasound showed a bulky placenta with multiple cysts. Oligohydramnion and fetal hypoechogenic cystic area without doppler flow were diagnosed at 23 weeks. The baby was operated on after delivery, and an 80 mm multifocal cyst originating from the right lobe of the liver was removed. The placenta demonstrated swelling stem villi with enlarged vessels and increased interstitial cells without trophoblast proliferation. PMD and fetal hepatic cyst can coexist; however, the relationship between those conditions remains to be elucidated. PMD is associated with adverse pregnancy outcomes but also with a good prognosis.
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http://dx.doi.org/10.5603/GP.a2020.0129DOI Listing
January 2020

A Study of the Radiation Tolerance of CVD Diamond to 70 MeV Protons, Fast Neutrons and 200 MeV Pions.

Authors:
Lukas Bäni Andreas Alexopoulos Marina Artuso Felix Bachmair Marcin Ryszard Bartosik Helge Christoph Beck Vincenzo Bellini Vladimir Belyaev Benjamin Bentele Alexandre Bes Jean-Marie Brom Gabriele Chiodini Dominik Chren Vladimir Cindro Gilles Claus Johann Collot John Cumalat Sébastien Curtoni Anne Evelyn Dabrowski Raffaello D'Alessandro Denis Dauvergne Wim De Boer Christian Dorfer Marc Dünser Gerald Eigen Vladimir Eremin Jacopo Forneris Laurent Gallin-Martel Marie-Laure Gallin-Martel Kock Kiam Gan Martin Gastal Abderrahman Ghimouz Mathieu Goffe Joel Goldstein Alexander Golubev Andrej Gorišek Eugene Grigoriev Jörn Grosse-Knetter Aidan Grummer Bojan Hiti Dmitry Hits Martin Hoeferkamp Jérôme Hosselet Fabian Hügging Chris Hutson Jens Janssen Harris Kagan Keida Kanxheri Richard Kass Mladen Kis Gregor Kramberger Sergey Kuleshov Ana Lacoste Stefano Lagomarsino Alessandro Lo Giudice Ivan López Paz Eric Lukosi Chaker Maazouzi Igor Mandić Sara Marcatili Alysia Marino Cédric Mathieu Mauro Menichelli Marko Mikuž Arianna Morozzi Francesco Moscatelli Joshua Moss Raymond Mountain Alexander Oh Paolo Olivero Daniele Passeri Heinz Pernegger Roberto Perrino Federico Picollo Michal Pomorski Renato Potenza Arnulf Quadt Fatah Rarbi Alessandro Re Michael Reichmann Shaun Roe Olivier Rossetto Diego Alejandro Sanz Becerra Christian J Schmidt Stephen Schnetzer Silvio Sciortino Andrea Scorzoni Sally Seidel Leonello Servoli Dale Shane Smith Bruno Sopko Vit Sopko Stefania Spagnolo Stefan Spanier Kevin Stenson Robert Stone Bjarne Stugu Concetta Sutera Michael Traeger William Trischuk Marco Truccato Cristina Tuvè Jaap Velthuis Stephen Wagner Rainer Wallny Jianchun Wang Norbert Wermes Jayashani Wickramasinghe Mahfoud Yamouni Justas Zalieckas Marko Zavrtanik Kazuhiko Hara Yoichi Ikegami Osamu Jinnouchi Takashi Kohriki Shingo Mitsui Ryo Nagai Susumu Terada Yoshinobu Unno

Sensors (Basel) 2020 Nov 20;20(22). Epub 2020 Nov 20.

KEK, High Energy Accelerator Research Organization, Tsukuba, Ibaraki 305-0801, Japan.

We measured the radiation tolerance of commercially available diamonds grown by the Chemical Vapor Deposition process by measuring the charge created by a 120 GeV hadron beam in a 50 μm pitch strip detector fabricated on each diamond sample before and after irradiation. We irradiated one group of samples with 70 MeV protons, a second group of samples with fast reactor neutrons (defined as energy greater than 0.1 MeV), and a third group of samples with 200 MeV pions, in steps, to (8.8±0.9) × 10 protons/cm, (1.43±0.14) × 10 neutrons/cm, and (6.5±1.4) × 10 pions/cm, respectively. By observing the charge induced due to the separation of electron-hole pairs created by the passage of the hadron beam through each sample, on an event-by-event basis, as a function of irradiation fluence, we conclude all datasets can be described by a first-order damage equation and independently calculate the damage constant for 70 MeV protons, fast reactor neutrons, and 200 MeV pions. We find the damage constant for diamond irradiated with 70 MeV protons to be 1.62±0.07(stat)±0.16(syst)× 10 cm/(p μm), the damage constant for diamond irradiated with fast reactor neutrons to be 2.65±0.13(stat)±0.18(syst)× 10 cm/(n μm), and the damage constant for diamond irradiated with 200 MeV pions to be 2.0±0.2(stat)±0.5(syst)× 10 cm/(π μm). The damage constants from this measurement were analyzed together with our previously published 24 GeV proton irradiation and 800 MeV proton irradiation damage constant data to derive the first comprehensive set of relative damage constants for Chemical Vapor Deposition diamond. We find 70 MeV protons are 2.60 ± 0.29 times more damaging than 24 GeV protons, fast reactor neutrons are 4.3 ± 0.4 times more damaging than 24 GeV protons, and 200 MeV pions are 3.2 ± 0.8 more damaging than 24 GeV protons. We also observe the measured data can be described by a universal damage curve for all proton, neutron, and pion irradiations we performed of Chemical Vapor Deposition diamond. Finally, we confirm the spatial uniformity of the collected charge increases with fluence for polycrystalline Chemical Vapor Deposition diamond, and this effect can also be described by a universal curve.
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http://dx.doi.org/10.3390/s20226648DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699799PMC
November 2020

Polish Society of Gynecologists and Obstetricians recommendation on the use of antiseptics for treatment of inflammatory vaginitis.

Ginekol Pol 2020 ;91(7):432-437

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

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http://dx.doi.org/10.5603/GP.2020.0104DOI Listing
January 2020

The Polish Society of Gynecologists and Obstetricians statement on surgery in gynecology during the COVID-19 pandemic.

Ginekol Pol 2020;91(7):424-427

2nd Chair and Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

The publication presents recommendations on the performance of surgical procedures in gynecology during the COVID- 19 pandemic. The recommendations were prepared by the Polish Society of Gynecologists and Obstetricians, based on current knowledge of SARS CoV-2. These recommendations contain the latest guidelines of scientific societies related to the subject of operational procedures.
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http://dx.doi.org/10.5603/GP.a2020.0101DOI Listing
August 2020

Recommendations of the Polish Society of Gynaecologists and Obstetricians for removal of the uterus by vaginal, laparoscopic and abdominal routes.

Ginekol Pol 2020 ;91(6):352-361

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wrocław.

The recommendations represent the current procedure, which may be modified and changed where justified, after a thorough analysis of the given clinical situation, which may be the basis for their modification and updating in the future.
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http://dx.doi.org/10.5603/GP.2020.0081DOI Listing
January 2020

Folate receptor-mediated cervical staining as an adjunct to colposcopy which can improve the diagnostic accuracy of detecting high grade squamous intraepithelial lesions.

Ginekol Pol 2020 ;91(5):247-250

2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Wroclaw, Poland.

Objectives: Cervical cancer is rated fourth in terms of incidence and cancer-related mortality in women. Cytology-based screening programs and colposcopy provided insufficient rates of detecting cervical intraepithelial neoplasia (CIN) prompting researchers to develop new tools. The aim of this study was to evaluate whether folate receptor-mediated staining is useful in detecting CIN2+ during gynecological examination with colposcopy.

Material And Methods: In total 96 women with abnormal cytology findings were enrolled. The study was conducted on the Polish population. The diagnostic process consisted of colposcopy, receptor-mediated diagnosis (FRD), and histopathology examination. All women were subjected to the same diagnostic procedure.

Results: The patient mean age of 96 women was 38 ± 14.5 years. On colposcopy, high-grade lesions were detected in 83 women. The FRD gave positive results in 63 women. Histopathology revealed 1 case of carcinoma plano epithelial akeratodes, 21 cases of high-grade squamous intraepithelial lesions, 13 cases of low-grade squamous intraepithelial lesions. A total of 61 cases presented no pathology. FRD as an adjunct to colposcopy gave the following test results in detecting CIN2+ lesions: sensitivity - 94.29%, specificity - 46.67%, PPV - 50.77%, NPV - 93.33%, and accuracy - 64.21%. Using both techniques provided better results than using each of the tests alone.

Conclusions: FRD is a promising test for the diagnosing CIN2+ cervical pathologies because it can increase the probability of detecting CIN2+ without any additional burden posed on patients. Further studies should be conducted on large and various populations to complement current evidence.
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http://dx.doi.org/10.5603/GP.2020.0061DOI Listing
January 2020

Electronic Properties of a Synthetic Single-Crystal Diamond Exposed to High Temperature and High Radiation.

Materials (Basel) 2020 May 29;13(11). Epub 2020 May 29.

Division of Experimental Physics, Ruđer Bošković Institute, 10000 Zagreb, Croatia.

Diamond, as a wide band-gap semiconductor material, has the potential to be exploited under a wide range of extreme operating conditions, including those used for radiation detectors. The radiation tolerance of a single-crystal chemical vapor deposition (scCVD) diamond detector was therefore investigated while heating the device to elevated temperatures. In this way, operation under both high-temperature and high-radiation conditions could be tested simultaneously. To selectively introduce damage in small areas of the detector material, a 5 MeV scanning proton microbeam was used as damaging radiation. The charge collection efficiency (CCE) in the damaged areas was monitored using 2 MeV protons and the ion beam induced charge (IBIC) technique, indicating that the CCE decreases with increasing temperature. This decreasing trend saturates in the temperature range of approximately 660 K, after which CCE recovery is observed. These results suggest that the radiation hardness of diamond detectors deteriorates at elevated temperatures, despite the annealing effects that are also observed. It should be noted that the diamond detector investigated herein retained its very good spectroscopic properties even at an operation temperature of 725 K (≈2% for 2 MeV protons).
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http://dx.doi.org/10.3390/ma13112473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321309PMC
May 2020

Polish Society of Gynecology and Obstetrics statement on safety measures and performance of ultrasound examinations in obstetrics and gynecology during the SARS-CoV-2 pandemic.

Ginekol Pol 2020 ;91(4):231-234

Second Department of Gynaecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

We present recommendations on performance and safety measures of ultrasound examinations in obstetrics and gynecology during the SARS COV-2 pandemic. The statement was prepared based on the current knowledge on the coronavirus by the Ultrasound Section of the Polish Society of Obstetrics and Gynecology. It has to be noted that the presented guidance is based on limited evidence and is primarily based on experiences published by authors from areas most affected by the virus thus far, such as China, Singapore, Hong Kong, and Italy. We realize that the pandemic situation is very dynamic. New data is published every day. Despite the imposed limitations related to the necessity of social distancing, it is crucial to remember that providing optimal care in safe conditions should remain the primary goal of healthcare providers. We plan to update the current guidelines as the situation develops.
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http://dx.doi.org/10.5603/GP.2020.0045DOI Listing
May 2020

Management of bleeding in patients hospitalized in the intensive cardiac care unit: expert opinion of the Association of Intensive Cardiac Care and Section of Cardiovascular Pharmacotherapy of the Polish Cardiac Society in cooperation with specialists in other fields of medicine.

Kardiol Pol 2019 Dec 9;77(12):1206-1229. Epub 2019 Dec 9.

Intensive Cardiac Therapy Clinic, Institute of Cardiology, Warsaw, Poland

Nowadays, the intensive cardiac care unit (ICCU) provides care for patients with acute coronary syndrome, acute and exacerbated chronic heart failure, cardiogenic shock, sudden cardiac arrest, electrical storm, as well as with indications for urgent cardiac surgical treatment. Most of these patients require the use of 1, 2, or frequently even 3 drugs that act on the blood coagulation pathway. While antithrombotic drugs prevent thromboembolic events, they are associated with a higher risk of bleeding. In this population of patients, bleeding may often have a worse impact on prognosis than the primary disease. In this expert opinion of the Association of Intensive Cardiac Care, we presented practical guidelines on the management of bleeding in patients hospitalized at the ICCU, including bleeding risk reduction and treatment recommendations. Because of multiple comorbidities and diverse organs that may be the source of bleeding, we provided also recommendations from specialists in other fields of medicine. We hope that this document will facilitate the management of one of the most challenging populations at the ICCU.
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http://dx.doi.org/10.33963/KP.15097DOI Listing
December 2019

Use of electrical impedance spectroscopy as an adjunct to colposcopy in a pathway of cervical intraepithelial neoplasia diagnostics.

Ginekol Pol 2019 ;90(11):628-632

Second Department of Gynaecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

Objectives: Screening with cytology decreases cervical cancer burden, but new methods have emerged. We assessed thediagnostic value of electrical impedance spectroscopy (EIS) in the real-world gynecological setting. The study aimed todetermine the diagnostic usefulness of EIS used as an adjunct to colposcopies in the diagnosis of high-grade squamousintraepithelial lesions in women with abnormal cytology findings.

Material And Methods: A cross-sectional, single center, observational study considered 143 women. All were subjected toa colposcopy and EIS with ZedScan. ZedScan-guided or colposcopically-guided biopsies were carried out.

Results: Data from 118 women were analyzed. The average age of the included women was 38.29 } 12.52 years (range:22-86 years). Overall, 27 had a diagnosis of CIN2+ and above on histopathological examination, 99 had low-grade colposcopyresults, 18 had high-grade colposcopy results, and 80 had positive ZedScan examination. No adverse events relatedto the examination with ZedScan were observed. EIS used as an adjunct to colposcopies showed sensitivity of 96.30%(95% CI: 81.03-99.91) and specificity of 39.56% (95% CI: 29.46-50.36), and accuracy of 52.54% (95% CI: 43.15-61.81). Theprocedure allowed to detect 11 additional cases with positive histo-pathological result in comparison to colposcopies alone.

Conclusions: Colposcopies performed with ZedScan as an adjunct were effective in detecting high-grade cervical lesions.Advantages of ZedScan include real-time result display, no additional diagnostic burden posed on the patient, andgood safety profile. Studies on large patient cohorts are needed for further evaluations of this diagnostic procedure andfactors which may affect its diagnostic accuracy.
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http://dx.doi.org/10.5603/GP.2019.0107DOI Listing
June 2020

Polish Society of Gynecologists and Obstetricians Guidelines for the application of hysteroscopy in gynecology.

Ginekol Pol 2019 ;90(8):482-489

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

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http://dx.doi.org/10.5603/GP.2019.0083DOI Listing
April 2020

Natural history of caesarean scar pregnancy.

Ginekol Pol 2019 5;90(6):351-352. Epub 2019 Jun 5.

2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Wroclaw, Poland.

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http://dx.doi.org/10.5603/GP.a2019.0054DOI Listing
March 2020

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery.

Ginekol Pol 2018 ;89(8):421-424

Katedra i Klinika Anestezjologii i Intensywnej Terapii, ul. Borowska 213, 50-556 Wrocław, Poland.

Objectives: The ultrasound-guided transversus abdominis plane (TAP) block is a supporting method of pain relief after different types of surgical and gynecological procedures. The aim of the present study was to evaluate the analgesic effects of the TAP-block in patients undergoing caesarean section.

Material And Methods: 88 women undergoing elective caesarean section under spinal anaesthesia were prospectively randomized into two groups. In the first group, an ultrasound-guided bilateral TAP block was performed using 40 mL 0.25% bupivacaine, while the second group was treated without a regional nerve block. Both groups received a standard analgesia protocol with intravenous paracetamol administered every 6 hours and intravenous tramadol on-demand, delivered using the Patient Controlled Analgesia (PCA) method. Pain intensity was assessed according to the visual analogue scale (VAS) directly after the TAP block and at 3, 6 and 12 hours postoperatively. Any patient complaints and side-effects during the postoperative period were recorded.

Results: The TAP block resulted in a significant reduction of pain intensity using the visual analogue scale after 3, 6 and 12 hours (p < 0.05) and a significant decrease in tramadol administration (p < 0.05) during the first 12 hours postoperatively. No significant differences in the heart rate and blood pressure were noted between groups (p > 0.05). There were no complications related to the TAP block.

Conclusions: The TAP block is a safe and effective adjunctive method of pain relief after caesarean delivery.
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http://dx.doi.org/10.5603/GP.a2018.0072DOI Listing
April 2019

Conservative treatment of abnormally located intrauterine pregnancies (cervical and cesarean scar pregnancies): a multicenter analysis (Polish series).

J Matern Fetal Neonatal Med 2020 Mar 20;33(6):993-998. Epub 2018 Sep 20.

Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Lodz, Poland.

To analyze the effectiveness and outcome of conservative treatment in cases of abnormally located intrauterine pregnancies (cervical and cesarean scar). A retrospective analysis was performed of 30 pregnant women hospitalized due to abnormally located intrauterine pregnancies. The analyzed group comprised 24 pregnant women with abnormally located pregnancies. The patients were divided into two groups: the first group consisted of patients treated systemically with methotrexate, while the second of those treated locally by administration of methotrexate (MTX) and/or potassium chloride (KCl) by gestational sac puncture. The analyzed group comprised 24 pregnant women with abnormally located pregnancies. Eight patients were diagnosed with cervical pregnancy (CP) and 16 patients were diagnosed with cesarean scar pregnancy (CSP). Six patients were excluded from the study: two with spontaneous abortions, two heterotopic pregnancies, and two cornual pregnancies. Twelve analyzed patients underwent MTX systemic administration (five patients with CP, seven with CSP). In five patients, systemic treatment was ineffective; they were qualified for additional local therapy with gestational sac (GS) puncture and MTX or KCl administration to the sac and additional administration of MTX to the trophoblast area. In second group of 12 patients (three CP, nine CSP), local treatment (GS puncture with MTX or MTX + KCl) was used as the first line treatment. One patient underwent combined treatment (local + systemic). Conservative treatment should be the gold standard procedure in abnormally located intrauterine pregnancies. It is noticeable that MTX / KCl is more effective in a direct administration to the GS. In four cases, systemic MTX did not produce the desired effects. In these cases, the treatment was assisted by local administration of MTX or KCl, resulting in the termination of an abnormally located pregnancy.
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http://dx.doi.org/10.1080/14767058.2018.1514009DOI Listing
March 2020

Management of placenta percreta with temporary balloon occlusion of the internal iliac arteries.

Eur J Obstet Gynecol Reprod Biol 2018 Jul 14;226:71-72. Epub 2018 May 14.

Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

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http://dx.doi.org/10.1016/j.ejogrb.2018.05.014DOI Listing
July 2018

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

Adv Clin Exp Med 2018 Feb;27(2):179-184

2nd Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Poland.

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.
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http://dx.doi.org/10.17219/acem/68994DOI Listing
February 2018

X-ray position-sensitive duo-lateral diamond detectors at SOLEIL.

J Synchrotron Radiat 2018 Mar 7;25(Pt 2):399-406. Epub 2018 Feb 7.

CEA-LIST, Diamond Sensors Laboratory, 91191 Gif-sur-Yvette, France.

The performance of a diamond X-ray beam position monitor is reported. This detector consists of an ionization solid-state chamber based on a thin single-crystal chemical-vapour-deposition diamond with position-sensitive resistive electrodes in a duo-lateral configuration. The detector's linearity, homogeneity and responsivity were studied on beamlines at Synchrotron SOLEIL with various beam sizes, intensities and energies. These measurements demonstrate the large and homogeneous (absorption variation of less than 0.7% over 500 µm × 500 µm) active area of the detector, with linear responses independent of the X-ray beam spatial distribution. Due to the excellent charge collection efficiency (approaching 100%) and intensity sensitivity (0.05%), the detector allows monitoring of the incident beam flux precisely. In addition, the in-beam position resolution was compared with a theoretical analysis providing an estimation of the detector's beam position resolution capability depending on the experimental conditions (X-ray flux, energy and readout acquisition time).
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http://dx.doi.org/10.1107/S1600577517016769DOI Listing
March 2018

Thermo-Hydraulic Analysis of Heat Storage Filled with the Ceramic Bricks Dedicated to the Solar Air Heating System.

Materials (Basel) 2017 Aug 12;10(8). Epub 2017 Aug 12.

Faculty of Mechanical and Power Engineering, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland.

This article presents the results of a study into a packed bed filled with ceramic bricks. The designed storage installation is supposed to become part of a heating system installed in a single-family house and eventually to be integrated with a concentrated solar collector adapted to climate conditions in Poland. The system's working medium is air. The investigated temperature ranges and air volume flow rates in the ceramic bed were dictated by the planned integration with a solar air heater. Designing a packed bed of sufficient parameters first required a mathematical model to be constructed and heat exchange to be analyzed, since heat accumulation is a complex process influenced by a number of material properties. The cases discussed in the literature are based on differing assumptions and different formulas are used in calculations. This article offers a comparison of various mathematical models and of system operating parameters obtained from these models. The primary focus is on the Nusselt number. Furthermore, in the article, the thermo-hydraulic efficiency of the investigated packed bed is presented. This part is based on a relationship used in solar air collectors with internal storage.
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http://dx.doi.org/10.3390/ma10080940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578306PMC
August 2017

Development of a synthetic single crystal diamond dosimeter for dose measurement of clinical proton beams.

Phys Med Biol 2017 Jul 12;62(13):5417-5439. Epub 2017 Jun 12.

CEA, LIST, System Modelling and Simulation Laboratory, Gif-sur-Yvette, France. Institut Curie, Centre de Protonthérapie d'Orsay, Orsay, France.

The scope of this work was to develop a synthetic single crystal diamond dosimeter (SCDD-Pro) for accurate relative dose measurements of clinical proton beams in water. Monte Carlo simulations were carried out based on the MCNPX code in order to investigate and reduce the dose curve perturbation caused by the SCDD-Pro. In particular, various diamond thicknesses were simulated to evaluate the influence of the active volume thickness (e ) as well as the influence of the addition of a front silver resin (250 µm in thickness in front of the diamond crystal) on depth-dose curves. The simulations indicated that the diamond crystal alone, with a small e of just 5 µm, already affects the dose at Bragg peak position (Bragg peak dose) by more than 2% with respect to the Bragg peak dose deposited in water. The optimal design that resulted from the Monte Carlo simulations consists of a diamond crystal of 1 mm in width and 150 µm in thickness with the front silver resin, enclosed by a water-equivalent packaging. This design leads to a deviation between the Bragg peak dose from the full detector modeling and the Bragg peak dose deposited in water of less than 1.2%. Based on those optimizations, an SCDD-Pro prototype was built and evaluated in broad passive scattering proton beams. The experimental evaluation led to probed SCDD-Pro repeatability, dose rate dependence and linearity, that were better than 0.2%, 0.4% (in the 1.0-5.5 Gy min range) and 0.4% (for dose higher than 0.05 Gy), respectively. The depth-dose curves in the 90-160 MeV energy range, measured with the SCDD-Pro without applying any correction, were in good agreement with those measured using a commercial IBA PPC05 plane-parallel ionization chamber, differing by less than 1.6%. The experimental results confirmed that this SCDD-Pro is suitable for measurements with standard electrometers and that the depth-dose curve perturbation is negligible, with no energy dependence and no significant dose rate dependence.
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http://dx.doi.org/10.1088/1361-6560/aa70cfDOI Listing
July 2017

Morphology of the cesarean section scar in the non-pregnant uterus after one elective cesarean section.

Ginekol Pol 2017 ;88(4):174-179

Objectives: A growing number of studies suggest that the incomplete healing of the CS scar in the uterus increase the risk of uterine dehiscence or rupture during subsequent pregnancies. Thus, the factors that affect wound healing should be evaluated. We aimed to determine whether the morphology of the CS scar in non-pregnant women after one elective CS was affected by the site of the uterine incision, uterine flexion, maternal age, and fetal birth weight.

Material And Methods: 208 non-pregnant women were invited for participation in the study, but only 101 of them met inclusion criteria. Standardized scar parameters (residual myometrial thickness (RMT), depth (D) and width (W) of the hypoechoic niche) were measured using ultrasonography at least 6 weeks after the CS.

Results: Scar defect was detected in 26 of 101 subjects. Women without scar defect had significantly higher RMT values (1.87 vs. 0.87), lower newborn birth weight (3127 g vs. 3295 g), and higher scar location above the internal cervical os (62% vs. 16%), than those with scar defect. Maternal age was significantly correlated with D value (R = 0.40). Uterine retroflexion was significantly correlated with a larger D value (R = 0.63) and a larger D/RMT ratio (R = 0.24).

Conclusions: In low-risk women who have undergone one elective CS, several risk factors are associated with development of the scar defect, but only scar location can be modified during surgery. Future research is needed to determine whether a relatively higher incision location in the uterus can ensure optimal healing of the CS scar.
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http://dx.doi.org/10.5603/GP.a2017.0034DOI Listing
July 2018

Sonographic evaluation of surgical repair of uterine cesarean scar defects.

J Clin Ultrasound 2017 Oct 10;45(8):455-460. Epub 2017 Feb 10.

2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland.

Background: The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US).

Methods: Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured.

Results: The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation.

Conclusions: A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017.
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http://dx.doi.org/10.1002/jcu.22449DOI Listing
October 2017

Single α-particle irradiation permits real-time visualization of RNF8 accumulation at DNA damaged sites.

Sci Rep 2017 01 31;7:41764. Epub 2017 Jan 31.

Université de Bordeaux, Centre d'Etudes Nucléaires Bordeaux Gradignan (CENBG), Chemin du Solarium, 33175 Gradignan, France.

As well as being a significant source of environmental radiation exposure, α-particles are increasingly considered for use in targeted radiation therapy. A better understanding of α-particle induced damage at the DNA scale can be achieved by following their tracks in real-time in targeted living cells. Focused α-particle microbeams can facilitate this but, due to their low energy (up to a few MeV) and limited range, α-particles detection, delivery, and follow-up observations of radiation-induced damage remain difficult. In this study, we developed a thin Boron-doped Nano-Crystalline Diamond membrane that allows reliable single α-particles detection and single cell irradiation with negligible beam scattering. The radiation-induced responses of single 3 MeV α-particles delivered with focused microbeam are visualized in situ over thirty minutes after irradiation by the accumulation of the GFP-tagged RNF8 protein at DNA damaged sites.
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http://dx.doi.org/10.1038/srep41764DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282495PMC
January 2017

Fetal Heart Rate Monitoring Using Maternal Abdominal Surface Electrodes in Third Trimester: Can We Obtain Additional Information Other than CTG Trace?

Adv Clin Exp Med 2016 Mar-Apr;25(2):309-16

2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Poland.

Background: Cardiotocography (CTG) is the most widely used procedure despite its low specificity for fetal acidosis and poor perinatal outcome. Fetal electrocardiography (fECG) with transabdominal electrodes is a new, non-invasive and promising method with greater potential for detecting impairment of fetal circulation. This study is the first that attempts to assess the usefulness of fECG in comparison to CTG during antepartum period.

Objectives: To determine if a single fECG examination along with CTG tracing and Doppler flow measurement in the fetal vessels has any additional clinical value in normal and intrauterine growth restricted (IUGR) fetuses.

Material And Methods: The study included 93 pregnancies with IUGR, 37 pregnancies with IUGR and brain sparing effect, and 324 healthy pregnant women. The T/QRS ratio, cerebro-placental ratio (CRP), and CTG tracings were analyzed. One-way analysis of variance and Spearman's rank correlation coefficient were applied. The relationship between results of the T/QRS ratio and CTG examination among the study groups was analyzed.

Results: The highest average mean value of the T/QRS ratio was recorded in the IUGR group with a normal CPR and a pathologic CTG (0.235 ± 0.014). The highest average maximum values were observed in the groups of IUGR pregnancies with a reduced CPR with normal (0.309 ± 0.100), suspicious (0.330 ± 0.102) and pathologic (0.319 ± 0.056) CTGs. Analysis of variance revealed differences between study groups regarding maximum values and the difference between maximum and minimal values of T/QRS. Correlations between groups were insignificant.

Conclusions: Higher values of T/QRS ratio in IUGR pregnancies with normal and reduced CPR than in control group regardless of the result of CTG examination may indicate minimal worsening of intrauterine fetal well-being in growth retarded fetuses. No relationship between fECG examination and CTG tracings suggests that a single fECG does not provide any additional clinically significant information determining the condition of the fetus; however, further studies are required.
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http://dx.doi.org/10.17219/acem/60842DOI Listing
December 2016

Standardized ultrasonographic approach for the assessment of risk factors of incomplete healing of the cesarean section scar in the uterus.

Eur J Obstet Gynecol Reprod Biol 2016 Oct 24;205:141-5. Epub 2016 Aug 24.

Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland.

Objective: To identify factors related to the healing of a Cesarean uterine incision using the standardized ultrasonographic approach of scar assessment in the non-pregnant uterus.

Study Design: Measurements of the uterine scar were taken from 409 women with a history of at least one low transverse cesarean section (CS) with a single layer uterine closure. Residual myometrial thickness (RMT), width (W) and depth (D) of the triangular hypoechoic scar niche, D/RMT ratio and clinical characteristics were analyzed. For statistical analysis, the Mann-Whitney U test, chi-square test, Spearman's rank correlation coefficient, ANOVA test, and logistic regression were used.

Results: 268 women presented with a scar defect. RMT values were significantly correlated with the number of CSs (R=-0.17) and uterus retroflection (R=-0.15). The presence of a scar defect was significantly associated with lower RMT values (R=-0.33), greater gestational age (R=0.10), and younger maternal age (R=-0.11). The mean RMT value was significantly smaller in women with CSs performed in the second stage of labor (0.62) when compared to women with CSs in the first stage of labor (0.97) or without cervical dilatation (0.91).

Conclusion: A standardized approach of CS scar assessment in the non-pregnant uterus helps to identify women at risk of long-term complications of CS.
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http://dx.doi.org/10.1016/j.ejogrb.2016.08.032DOI Listing
October 2016

Perinatal outcome according to chorionicity in twins - a Polish multicenter study.

Ginekol Pol 2016 ;87(5):384-9

Objectives: The aim of the study was to analyze the perinatal outcome of twin gestations and estimate the influence of chorionicity on the outcome in a large cohort of twin pregnancies in Poland.

Material And Methods: A retrospective analysis of 465 twin deliveries in 6 Polish centers in 2012 was conducted. Baseline characteristics, the course of pregnancy and labor, as well as the neonatal outcome were analyzed in the study group and according to chorionicity.

Results: A total of 356 twin pregnancies were dichorionic (DC group) (76.6%), and 109 were monochorionic (MC group) (23.4%). There were no differences in the occurrence of pregnancy complications according to chorionicity, except for IUGR of at least one fetus (MC 43.1% vs. DC 34.6%; p = 0.003). 66.5% of the women delivered preterm, significantly more in the MC group (78% vs. 62.9%; p = 0.004). Cesarean delivery was performed in 432 patients (92.9%). Mean neonatal birthweight was statistically lower in the MC group (2074 g vs. 2370 g; p < 0.001). Perinatal mortality of at least one twin was 4.3% (2.8% in the DC group vs. 9.2% in the MC group; p = 0.004). Neonatal complications, including NICU admission, respiratory disorders, and infections requiring antibiotic therapy, were significantly more often observed among the MC twins.

Conclusions: The overall perinatal outcome in the presented subpopulation of Polish twins and its dependence on cho-rionicity is similar to the reports in the literature. Nevertheless, the rates of preterm and cesarean deliveries remain higher. It seems that proper counselling of pregnant women and education of obstetricians may result in reduction of these rates.
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http://dx.doi.org/10.5603/GP.2016.0009DOI Listing
July 2018

Signal loss during fetal heart rate monitoring using maternal abdominal surface electrodes between 28 and 42 weeks of pregnancy.

Adv Clin Exp Med 2014 Sep-Oct;23(5):813-9

2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.

Background: Fetal electrocardiography is one of the methods for monitoring the well-being of the fetus. Signal loss limits the proper interpretation of electrocardiogram traces.

Objectives: The aim of this study was to assess the average signal loss in non-invasive abdominal fetal electrocardiogram (fECG) monitoring using the KOMPOREL fetal monitoring system (ITAM, Zabrze, Poland) in women between 28 and 42 week of pregnancy. The results were compared to FIGO (International Federation of Gynaecology and Obstetric) and DGGG (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe e.V.) recommendations concerning fetal heart monitoring. The correlation between fetal ECG signal quality, week of pregnancy and patient BMI was evaluated.

Material And Methods: 773 pregnant women, hospitalized and diagnosed in the Department of Gynecology and Obstetrics, Wroclaw Medical University, underwent 30 min of abdominal fECG recordings using the KOMPOREL fetal monitoring system.

Results: The average signal loss in abdominal fECG monitoring in the study group was 32%. FIGO recommendations describe an acceptable fetal signal loss of 20%. In our study, 46% (357/773) of the recordings were up to FIGO standards, with fetal heart rate success rates above 80%. According to DGGG guidelines, with acceptable fetal signal loss of 15%, only 39% (303/773) of the recordings could be assessed as accurate. No correlation between fECG signal quality, week of pregnancy and patient BMI was proved.

Conclusions: The average signal loss in abdominal fECG monitoring in our study group was 32%. Low fECG signal quality may constitute a potentially limiting factor of the described fetal heart monitoring system. No relationship between fECG signal quality, week of pregnancy and patient BMI was proved.
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http://dx.doi.org/10.17219/acem/37258DOI Listing
December 2014

Ultra-thin optical grade scCVD diamond as X-ray beam position monitor.

J Synchrotron Radiat 2014 Nov 4;21(Pt 6):1217-23. Epub 2014 Oct 4.

European Synchrotron Radiation Facility, 6 rue Jules Horowitz, 38043 Grenoble, France.

Results of measurements made at the SIRIUS beamline of the SOLEIL synchrotron for a new X-ray beam position monitor based on a super-thin single crystal of diamond grown by chemical vapor deposition (CVD) are presented. This detector is a quadrant electrode design processed on a 3 µm-thick membrane obtained by argon-oxygen plasma etching the central area of a CVD-grown diamond plate of 60 µm thickness. The membrane transmits more than 50% of the incident 1.3 keV energy X-ray beam. The diamond plate was of moderate purity (∼1 p.p.m. nitrogen), but the X-ray beam induced current (XBIC) measurements nevertheless showed a photo-charge collection efficiency approaching 100% for an electric field of 2 V µm(-1), corresponding to an applied bias voltage of only 6 V. XBIC mapping of the membrane showed an inhomogeneity of more than 10% across the membrane, corresponding to the measured variation in the thickness of the diamond plate before the plasma etching process. The measured XBIC signal-to-dark-current ratio of the device was greater than 10(5), and the X-ray beam position resolution of the device was better than a micrometer for a 1 kHz sampling rate.
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http://dx.doi.org/10.1107/S1600577514016191DOI Listing
November 2014

The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol.

J Perinat Med 2015 Jul;43(4):467-72

Aims: To evaluate values of foetal T/QRS ratios in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol using non-invasive methods with transabdominal electrodes.

Materials And Methods: The study group consisted of 451 Caucasian women (63 preterm pregnancies and 327 healthy controls) whose pregnancies ranged from 28 to 37 gestational weeks. Foetal electrocardiograms were recorded and T/QRS ratios were calculated by KOMPOREL software (ITAM, Zabrze, Poland). The first recording was performed 30 min after the start of fenoterol infusion and the second 2 days after finishing tocolysis. T/QRS ratio variables were calculated. One-way analysis of variance was carried out.

Results: Significantly higher mean values of the T/QRS ratio were observed in pregnancies during tocolytic treatment in comparison to controls and pregnancies after tocolysis (P=0.0158 and P=0.0071, respectively). The T/QRS ratio values fall again shortly after finishing intravenous tocolysis.

Conclusions: The T/QRS ratio is one of the methods used for non-invasive foetal distress assessment that can be used in antepartum foetal monitoring in complicated pregnancies. Raised values of the T/QRS ratio in the foetus during tocolysis with fenoterol and next its fall to values observed in physiological pregnancies may indicate transient worsening of fetal well-being, however, additional research is required.
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http://dx.doi.org/10.1515/jpm-2014-0042DOI Listing
July 2015