Prenatal incision of ureterocele causing bladder outlet obstruction: a multicenter case series

We reviewed data from a cohort of fetuses with ureterocele diagnosed and operated prenatally in four fetal therapy centers. Inclusion criteria were (1) ureterocele confirmed on detailed fetal ultrasound examination, (2) absence of additional fetal malformations, and (3) fetal intervention to decompress the ureterocele with local institutional review boards' approval. Data on sonographic follow-up, obstetrical, neonatal outcome, and postnatal evaluation were collected. Ten cases of prenatally treated ureterocele are described. Six cases benefited from a fetoscopy for laser incision and decompression, two cases had an ultrasound guided puncture before resorting to a fetoscopy with laser incision, one case had a balloon catheterization under ultrasound guidance, and one case had an ultrasound-guided opening of the ureterocele with a laser fiber passed through a 20-gauge needle. Mean gestational age at diagnosis was 21.6 GW. Two cases underwent termination of pregnancy. The remaining eight cases recovered normal amniotic fluid volume and delivered a liveborn child at a mean gestational age of 38.6 GW with normal creatinine levels during the first week of life. Prenatal incision provided complete treatment of severely obstructive ureteroceles in 80% of the cases and allowed improvement of urinary electrolytes, renal size and echogenicity, bladder filling in all survivors, and recollection of normal amniotic fluid volume, in case of oligoanhydramnios. © 2017 John Wiley & Sons, Ltd.     

Artificial placenta and womb technology: Past,current, and future challenges towards clinical translation

Extreme prematurity remains a major cause of neonatal mortality and severe long-term morbidity. Current neonatal care is associated with significant morbidity due to iatrogenic injury and developmental immaturity of extreme premature infants. A more physiologic approach, replacing placental function and providing a womb-like environment, is the foundational principle of artificial placenta (AP) and womb (AW) technology. The concept has been studied during the past 60 years with limited success. However, recent technological advancements and a greater emphasis on mimicking utero-placental physiology have improved the success of experimental models, bringing the technology closer to clinical translation. Here, we review the rationale for and history of AP and AW technology, discuss the challenges that needed to be overcome, and compare recent successful models. We conclude by outlining some remaining challenges to be addressed on the path towards clinical translation and opportunities for future research.     

海上注聚井渗氮油管腐蚀失效原因

渤海S油田A2井渗氮防腐油管在注聚过程中发现多处腐蚀穿孔,为避免换管柱后再次发生腐蚀失效,通过腐蚀形貌观察、腐蚀产物分析、腐蚀介质分析对A2井油管腐蚀失效原因进行了研究。认为A2井油管部分渗氮层脱落,形成了电化学腐蚀的阳极,这是造成局部腐蚀的根本原因。注入水中存在较高含量的氯离子和硫酸盐还原菌,加剧了腐蚀进程,造成油管腐蚀穿孔,形成了以FeCO_3为主的腐蚀产物。建议加强渗氮油管质量管控,防止入井前渗氮层脱落,同时在注入水中加入杀菌剂减少细菌对腐蚀的影响,并在井下安装牺牲阳极短节预防腐蚀。