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A stepwise approach to robotic assisted excision of a cesarean scar pregnancy
Payam Katebi Kashi,Katherine L. Dengler,Eva K. Welch,Angela DiCarlo-Meacham,Araba A. Jackson,G. Scott Rose 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.3
ObjectiveTo develop a stepwise approach to robotic assisted excision of cesarean scar pregnancy (CSP) with metroplasty. MethodsThis illustrative video presentation demonstrating CSP, the criteria for ultrasound diagnosis, and a step-by-stepapproach for robotic assisted excision of CSP and multi-layer hysterotomy closure at a tertiary medical center. ResultsRobotic assisted resection is a safe and feasible method to treat cesarean scar ectopic pregnancies. Keyultrasonographic characteristics of CSP are highlighted to facilitate its diagnosis, thus allowing for early interventionwith a minimally invasive surgical treatment as necessary. Our patient was a 30-year-old gravida 2 para 1 womanwith a history of 1 prior-term low transverse cesarean delivery, who presented with vaginal bleeding in the firsttrimester and was ultimately diagnosed with CSP. After unsuccessful methotrexate therapy, the patient underwentan uncomplicated robotic assisted excision of her CSP and metroplasty in 2 layers using a stepwise approach: Step1-Creation of a bladder flap; Step 2-Isolation and excision of CSP; Step 3-Hysterotomy closure in 2 layers; and Step4-Hysteroscopy. ConclusionWhen diagnosed late, cesarean scar ectopic pregnancy can cause a significant hemorrhage from rupture. Earlyradiologic diagnosis does not only indicate minimally invasive surgery as a treatment option but also assists withrelated surgical planning. This video demonstrates a stepwise approach to the robotic assisted excision of CSP withmetroplasty. With these 4 simple steps, surgical procedure can be safe and efficient.
Electron spin resonance in Eu-based iron pnictides
Krug von Nidda, H.-A.,Kraus, S.,Schaile, S.,Dengler, E.,Pascher, N.,Hemmida, M.,Eom, M. J.,Kim, J. S.,Jeevan, H. S.,Gegenwart, P.,Deisenhofer, J.,Loidl, A. American Physical Society 2012 Physical review. B, Condensed matter and materials Vol.86 No.9
Salinity Biases and the Variability of the Atlantic Meridional Overturning Circulation in GFDL-CM3
Fernanda D. A. O. Matos,Janini Pereira,Marcus Dengler 한국해양과학기술원 2020 Ocean science journal Vol.55 No.4
The variability of the Atlantic Meridional Overturning Circulation (AMOC) and the Meridional Freshwater Transport (Mov) at 24°N, 11°S, and 30°S, simulated with the GFDL-CM3 model under the historical (1860–2005) and RCP 4.5 and 8.5 scenarios (2006–2100) are examined. The results are compared with the climatology and observations in the search for salinity biases that would compromise the accuracy of the state of the future climate predicted by this model. The AMOC wavelet analysis shows a predominant decadal variability at 24°N, whereas the annual signal is more prominent in the South Atlantic. The Mov magnitude varies considerably among the latitudes: increasing at 24°N, rather stable at 11°S and decreasing at 30°S. Such a pattern is followed by an AMOC weakening regardless of the latitude until the end of the 21st century, indicating that a reduction in Mov in the southern South Atlantic and an increase in the North Atlantic are potential drivers of the AMOC destabilization. Both model and observations agree on the stability of the circulation, even though the model projects a stronger AMOC than the latter. Besides the AMOC weakening, a shoaling of its upper limb is also observed. Salinity biases were found mostly in the South Atlantic in the upper 1000 m of the water column, with the model results significantly deviating from the observations and climatology in the mid-Atlantic, especially at 30°S. Possible causes for the abovementioned results, including potential drivers for salinity biases are discussed.