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Multiple placental passes during chorionic villus sampling (CVS) increase the risk of fetal loss; however, specific factors that predispose to repeat aspiration have not been delineated. To identify anatomic and technical variables associated with multiple-pass procedures, a detailed review of 205 videotaped CVS procedures (single pass = 163; multiple pass = 42) was performed, blinded to pregnancy outcome. The route of sampling did not influence the need for multiple aspiration attempts (transabdominal—30/ 135; transcervical—12/70), nor was placental location alone discriminatory. However, the combination of a posterior placenta and uterine retroversion was observed more frequently in the multiple-pass cohort (8/42 vs. 9/163; p<0.05). In transabdominal cases, suboptimal needle placement (e.g., perpendicular to the placental long axis) was more common in the initial aspiration of a multiple-pass procedure (21/30 vs. 38/105;p<0.01), while limited penetration of the catheter tip (e.g., just inside the placental edge) characterized a majority of multiple-pass cases in the transcervical subset (7/12 vs. 3/58; p<0.0001). A case-control cohort was constructed to evaluate the impact of these technical variables on sampling efficacy, independent of the influence of uterine position and placental site. In that analysis, suboptimal location and/or orientation of the sampling device remained characteristic of multiple-pass cases. We conclude that further reduction in the frequency of multiple-pass procedures might be achieved by consistent placement of the device tip in the central placental mass. Unlike amniocentesis, where any point of amnion entry will suffice, this technical nuance should be emphasized with CVS to maximize the single-pass success rate. 相似文献
459.
A survey is given on fluid-dynamic effects caused by the structure and properties of biological surfaces. It is demonstrated
that the results of investigations aiming at technological applications can also provide insights into biophysical phenomena.
Techniques are described both for reducing wall shear stresses and for controlling boundary-layer separation. (a) Wall shear
stress reduction was investigated experimentally for various riblet surfaces including a shark skin replica. The latter consists
of 800 plastic model scales with compliant anchoring. Hairy surfaces are also considered, and surfaces in which the no-slip
condition is modified. Self-cleaning surfaces such as that of lotus leaves represent an interesting option to avoid fluid-dynamic
deterioration by the agglomeration of dirt. An example of technological implementation is discussed for riblets in long-range
commercial aircraft. (b) Separation control is also an important issue in biology. After a few brief comments on vortex generators,
the mechanism of separation control by bird feathers is described in detail. Self-activated movable flaps (=artificial bird
feathers) represent a high-lift system enhancing the maximum lift of airfoils by about 20%. This is achieved without perceivable
deleterious effects under cruise conditions. Finally, flight experiments on an aircraft with laminar wing and movable flaps
are presented. 相似文献
460.
The main objective of this project was to evaluate the possibility of reducing the quantity of fibre wasted at one of many hydrocyclone (centrifugal) cleaning processes in a paper mill. It was found that the application of elutriation water to both the tertiary and quaternary cleaners was essential to minimise the fibre discharged to the sewer, and the pressure of this elutriation water had a dramatic effect of reducing the fibre wastage. Accordingly, it has been shown that 150–160 kPa as the optimum pressure range to apply elutriation water to minimise the product grade fibre wasted whilst sending undesired shive fibre to the sewer. Also, monitoring of the press uhle box wastewater revealed that the paper mill has the potential to make substantial cost savings by reducing the waste stream. Further investigation is necessary to determine the types of fibre that are being wasted, and the viability of a screen to recycle the wasted fibre to the process. However, these fibres may be unsuitable to reuse in the process and alternative uses must be found. 相似文献