Origami tubes with reconfigurable polygonal cross-sections.

Thin sheets can be assembled into origami tubes to create a variety of deployable, reconfigurable and mechanistically unique three-dimensional structures. We introduce and explore origami tubes with polygonal, translational symmetric cross-sections that can reconfigure into numerous geometries. The tubular structures satisfy the mathematical definitions for flat and rigid foldability, meaning that they can fully unfold from a flattened state with deformations occurring only at the fold lines. The tubes do not need to be straight and can be constructed to follow a non-linear curved line when deployed. The cross-section and kinematics of the tubular structures can be reprogrammed by changing the direction of folding at some folds. We discuss the variety of tubular structures that can be conceived and we show limitations that govern the geometric design. We quantify the global stiffness of the origami tubes through eigenvalue and structural analyses and highlight the mechanical characteristics of these systems. The two-scale nature of this work indicates that, from a local viewpoint, the cross-sections of the polygonal tubes are reconfigurable while, from a global viewpoint, deployable tubes of desired shapes are achieved. This class of tubes has potential applications ranging from pipes and micro-robotics to deployable architecture in buildings.

[Giant orofacial teratoma of the fetus (epignathus) - prenatal 2d and three-dimensional 3D ultrasound detection of this rare condition].

An epignathus is an extremely rare form of oropharyngeal teratoma that arises from the oral cavity, most commonly from the palate and is associated with a high mortality secondary to airway obstruction in the neonatal period. We present a case of prenatal diagnosis in 29 w.g. preterm baby with a giant epignathus, preterm birth and fetal death. We discuss the incidence of these tumors, the antenatal diagnosis and the prognosis and management of this condition.

[Transversal vaginal septum in two months old patient--case report].

The current publication describes a case of a two months old girl with a transverse vaginal septum presented. The clinical debut is with a large hydromucocolpos. It is concomitantly presented with a bilateral postaxial polydactyly of the upper limbs, typical for McKusick-Kaufmann syndrome.

[Laparoscopic ovarian drilling and biopsy in women with polycystic ovaries (PCOS) and infertility].

OBJECTIVES: To evaluate ovarian reserve according to results of biopsy of ovaries during laparoscopy. To investigate connections between hystologic results, drilling of ovaries and pregnancies. METHODS: We investigate prospectively 74 patients with polycystic ovaries (PCOS) and infertility. Operative laparoscopy have be done in 2006, 2008 and 2009 year in University Hospital "Maichin Dom" Sofia, Bulgaria. All patients had ovarian drilling and biopsy. RESULTS: Microscopic findings from biopsy of ovary in 74 women with PCOS were divided in 4 groups. In this investigation from 74 women with operative laparoscopy 33 patients (44.5%) were pregnant. CONCLUSION: The results of biopsy and registered pregnancies in PCOS patients is very difficult to analyse. Laparoscopic ovarian drilling and biopsy affect ovarian tissue. The ovary probably change own characteristics--ovarian metabolism and physiology are restored and this changes our clinical prognosis for a future pregnancies.

Regarding extremely large inguinal hernias with a contribution of two cases.

We report two men of ages 62 and 80 years, respectively, with giant inguinoscrotal hernias. They were operated with a single-stage repair by two approaches, extended preperitoneal of Nyhus and an inguinal method. After hernia content reduction, a policaproamide antimicrobial mesh Ampoxen (MEDICA SA, Sandanski, Bulgaria) with dimensions 20 x 30 cm was inserted by using Stoppa's technique. An additional inguinal reinforcement with other mesh patch was done on the external aponeurosis hernial defect. Synchronous orchiectomy and transscrotal drainage of both patients was performed. The first patient suffering from umbilical hernia was also operated at the same stage. He was prepared by preoperative pneumoperitoneum. The second patient, due to scrotal skin cellulitis with ulceration, was operated without pneumoperitoneum preparation. The latter created easier mobilization and reduction of the hernial content. The sizable mesh dimensions allowed, to some degree, an acceptable level of intra-abdominal pressure after the repair. These hernias demand interdisciplinary teamwork and their treatment has to be adapted to the individual condition of the patient using all therapeutic options.

[Gonadotropin-releasing agonist in the therapy of patients with laparoscopically confirmed endometriosis]. / Lechenie s gonadotropin rilizing agonist pri patsientki s laparoskopski dokazana endometrioza.

OBJECTIVE: To determinate the effectiveness of treatment with gonadotrophine releasing hormone agonist. METHODS: We investigated 164 patients with laparoscopy divided in two groups. Women in first group received Dipherelin 3. 75 mg /lpsen/ for 3 months. Second group had received Dipherelin 3.75 mg for 6 months. Preparation was done i.m. every 28 days. All patients in the study had endometriosis grade I-II using the AFS classification after laparoscopy. The measures according to compare in the 2 groups was as following: 1. Dysmenorhoea, dyspareunia and pelvic pain before and after treatment. 2. Rate of pregnancy. 3. Bleeding during the treatment. 4. Amenorhoea after treatment. CONCLUSIONS: After analysis of the patients in the 2 groups we decided that Dipherelin 3.75 mg is an effective treatment of sterility related to endometriosis.

[Ovarian fibroma--a case report]. / Fibrom na iaichnika--s prinos na edin sluchai.

The ovarian fibroma is a rare benign tumor growing from the connective tissue of the ovarian cortex. The authors introduce a case with primary sterility and fibroma ovarii dextra. They discuss the etiology and diagnostic methods for this kind of tumor formation as well as the predictivity of the ultrasound examination.

Balancing of nitrogen conversion in deammonifying biofilms through batch tests and GC/MS.

Growth carriers from a technical deammonifying moving-bed WWTP were used in batch tests to determine possible N-conversion reactions under varying oxygen and substrate conditions. Deammonification, denitrification, and nitrification reactions could be proved using conventional analysis, combined with gas chromatography/mass spectrometry analysis to get additional information about 15N-isotope labelled gaseous end products of the different reactions. In this orientating study N2O could be observed in some cases up to 12% of the total gas production. N2O production came from incomplete denitrification processes under anoxic or oxygen-limiting conditions and in the absence of organic substrate, as if structural components of deammonifying biofilms play a crucial role for the portion of side-reactions, leading to undesirable gaseous end products.

Deammonification in biofilm systems: population structure and function.

For the development of alternative concepts for the cost effective treatment of wastewaters with high ammonium content and low C/N-ratio, autotrophic consortia of micro-organisms with the ability to convert ammonium directly into N2 are of particular interest. Several full-scale industrial biofilm plants eliminating nitrogen without carbon source for years in a stable process, are suspected for some time to harbor active anaerobic ammonium oxidizers in deeper, oxygen-limited biofilm layers. In order to identify the processes of the single-stage nitrogen elimination (deammonification) in biofilm systems and to allocate them to the responsible micro-organisms, a deammonifying moving-bed pilot plant was investigated in detail. 15N-labelled tracer compounds were used as well as 16S rDNA libraries and in situ identification of dominant organisms. The usage of rRNA-targeted oligonucleotide probes (FISH) was particularly emphasized on the ammonium oxidizers of the beta-subclass of Proteobacteria and on the members of the order Planctomycetales. The combined application of these methods led to a deeper insight into the population structure and function of a deammonifying biofilm.

[A case of unruptured intrafollicular ovarian pregnancy diagnosed prior to operation]. / Sluchai na predoperativno diagnostitsirana nerupturirala intrafolikularna ovarialna bremennost.

A case of an unruptured intrafollicular ovarian pregnancy of 8 gestational weeks diagnosed by ultrasonography in a virtually asymptomatic patient is reported. A 32 year-old woman with 1 vaginal delivery 8 years ago presented with a history of intermittent spotting after removal of an IUD during her last menstrual period 4 weeks ago. IUD was inserted 6 years prior. The patient was symptom-free and showed no abnormal findings upon vaginal examination. Transvaginal ultrasonography however disclosed a gestational sac with a live embryo within the left ovary. The woman was operated on via laparotomy without delay. The intraoperative finding showed a normally appearing corpus luteum in the intact left ovary without any visible abnormality of the pelvic organs. Having in mind the US finding a resection of the corpus luteum was done revealing the gestational sac within it. The authors describe the following three US signs specific of unruptured intrafollicular ovarian pregnancy: extremely thickened uniformly echogenic wall of the sac, the sac is partially surrounded by ovarian structure, no corpus luteum is detected in either ovary. The essential role of transvaginal ultrasonography in the precise diagnosis of the ectopic pregnancy and its location is emphasized. The absence of specific complaints and findings until rupture of the ovary occurs and the association of ovarian pregnancy and IUD are also confirmed by the case-report.

[Complex effects of cavinton on climacteric symptoms]. / Kompleksno povliiavane na klimakterichnata simptomatika s cavinton.

The use of nonhormonal drugs in order to ameliorate climacteric symptoms makes it possible to treat also those women in whom there are some contraindications or lack of compliance for taking hormonal replacement therapy. The drugs with complex effects on the whole body functions are more widely used recently. The aim of the present study is to assess the therapeutic effect of Cavinton (vinpocetin) on the degree of climacteric symptoms and to verify its complex beneficial influence. The study comprises of three groups of women in early menopause--control group (n = 30), treatment groups with normolipidaemia (n = 32) and with hyperlipidaemia (n = 29). All women presented with moderately expressed climacteric symptoms as assessed by Kupperman menopausal index and Hamilton-Anxiety-Skala (HAMA). The women in the 2nd and 3rd groups have been taking Cavinton in an oral dose of 5 mg three times daily for 3 months. The following parameters of lipid metabolism were determined in the beginning and at the end of the study: total, HDL- and LDL-cholesterol, triglycerides, and two indexes of lipid atherogenic risk--total/HDL-cholesterol ratio and atherogenic index (AI) = total--HDL/LDL-cholesterol. The menopausal complaints were assessed by Kupperman index and HAMA. Blood vessels reactivity was determined by pulsation index (PI). Statistically significant decrease in total cholesterol and LDL-cholesterol levels as well as amelioration of atherogenic indexes was observed in the 3rd group. Kupperman index and HAMA decreased significantly on the 45th day and the 3rd month in the women under treatment. No significant changes in PI were observed but a tendency towards a decrease was seen in the 3rd group. Our data suggest that Cavinton possesses complex beneficial effects in climacteric women significantly ameliorating climacteric symptoms as well as some parameters of lipid metabolism in women with hyperlipidaemia.

[Placental location and its influence on the position of the fetus in the uterus]. / Lokalizatsiia na platsentata i neinoto vliianie v'rkhu polozhenieto na ploda v matkata.

There are different opinions concerning the influence of the placental localization on the position of the fetus in the uterus. Two options are suggested in breech presentation--placenta praevia and cornual localization as possible causes for breech presentation. The aim of the present prospective study is to establish the influence of placental localization on the fetal position in the uterus. Two groups of pregnant women were examined--the first with cephalic resentation (n = 125) and the second with breech presentation (n = 124). All of the pregnant women examined were nulliparas, with term pregnancy (37-40 weeks). Uterine and fetal abnormalities were excluded. The localization of the placenta was determined by ultrasonography. The cornu-fundal localization of the placenta was found in 4.8% in the pregnant women with cephalic presentation and 62.6% in pregnant women with breach presentation. Placenta praevia or low insertion of the placenta was found in 3.2% of the cases with breech presentation and in none of the cases with cephalic presentation. The authors conclude on the basis of the data in the study that the localization of the placenta influences the fetal position in the uterus.

[The most suitable tests for studying chlamydial infection in women with sterility]. / Nai-podkhodiashti testove za izsledvane na khlamidialna infektsiia pri zheni sus sterilitet.

The study was carried out on 280 infertile women (185 with primary and 95 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate which is the most suitable test for detection of chlamydial infection in women with infertility. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. From 196 of the patients examined, 101 were positive for antichlamydial IgG antibodies (62.7%). 84 women were examined by means of direct antigen test for Chlamydia trachomatis from the endocervix (DIF. ELISA). Tubal patient was examined by means of hysterosalpingography and/or laparoscopy. In 34 women with unilateral or bilateral tubal occlusion the endocervical direct antigen test was positive in 4 (11.8%) and in 30 women with patient tubes 2 were positive by this test (6.7) In 38 women with tubal occlusion 29 of the women with unilateral or bilateral tubal occlusion had a presence of IgG antichlamydial antibodies in their sera (76.3%) compared to 17 of 38 women with patient tubes (44.7%). The results of the present study indicate that the examination antichlamydial IgG antibodies in the sera of women with infertility has a better predictive value with regard to tubal pathology compared to the direct antigen test for detection Chlamydia trachomatis in the endocervix. Examination for latent infection or reinfection has to be carried out before the administration of more invasive methods for the management of infertility.

[The effect of chlamydial infection on tubal patency]. / Vliianie na khlamidialnata infektsiia vurkhu tubarnata prokhodimost.

The study was carried out on 162 infertile women (110 with primary and 52 with secondary infertility), patients of the University Clinic of Gynecologic Endocrinology and Infertility, Sofia. The present study was designed to estimate the effect of chlamydial infection as a cause of tubal pathology in infertile women. Evidence of past chlamydial infection was determined by the presence of antichlamydial IgG antibodies by commercial ELISA test. 101 of the patients examined were positive for antichlamydial IgG antibodies (62.3%). 76 women were examined for tubal patience by means of hysterosalpingography and/or laparoscopy. 38 women had patient tubes and 38 women had tubal occlusion (20 had bilateral and 18 unilateral occlusion). 29 of the women with unilateral or bilateral tubal occlusion had a presence of IgG antichlamydial antibodies in their sera (76.3%) compared to 17 of the women with patient tubes (44.7%). The risk for tubal obstruction in women with positive serology for Chlamydia is 3.22 compared to 0.85 risk in the women with negative serology for chlamydia. The results of the present study indicate that women with evidence of past chlamydial infection are 4 times more likely to have obstructed fallopian tubes compared to women who had no such evidence. It is mandatory to examine the patient for chlamydial serology at the beginning of the diagnostic protocol in order to ensure adequate management prior to more invasive procedures such as hysterosalpingography or laparoscopy.

[The use of the preparation Anteovin in dysfunctional uterine hemorrhages and PCOS]. / Prilozhenie na preparata Anteovin pri nepravilni matochni kruvotecheniia i PCOS.

UNLABELLED: The present prospective study is aimed at estimating the therapeutic effect of a biphasic oestrogen dominated contraceptive pill Anteovin in certain forms of dysfunctional uterine bleeding (DUB) and in polycystic ovary syndrome (PCOS) which is associated with dysfunctional bleeding. Two groups of women were studied--the first group (n = 34) consisted of women with DUB; the second group (n = 31) comprised PCOS. The nature and dynamics of uterine bleeding, contraceptive effectiveness and occurrence of side effects were followed up. In the second group the changes in the levels of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) and prolactin (Prl) were additionally investigated. RESULTS: A significant decrease in bleeding was observed in both groups. In the second group it is in parallel with a significant decrease of T even as early as on the third month and of DHEA-S on the sixth month of treatment. No significant changes in prolactin levels were found out during the treatment. CONCLUSION: The biphasic contraceptive pill Anteovin has a very good therapeutic effect in DUB and metrorrhagic forms of PCOS while at the same time the side effects are slightly expressed and transitory and an excellent contraception is achieved.

[Placenta praevia. A review of contradictory opinions on its incidence. The importance of ultrasonic study]. / Platsenta previia. Pregled na protivorechivi mneniia otnosno chestotata ì. Znachenie na ultrazvukovoto izsledvane.

Although the diagnosis of placenta previa has been known to obstetricians for some time there exist in the literature many contentious issues regarding the incidence and diagnosis of this disorder. This review seeks to highlight some of the issues of debate and outline the results of studies dealing with these problems.

[The location of the placenta in pregnant women with one or more past cesarean sections]. / Lokalizatsiia na platsentata pri bremenni, prekarali edno ili poveche tsezarovi secheniia v minaloto.

We examined 282 pregnant women who have had one or more previous cesarean sections. The localization of placenta was done with ultrasound after 32 weeks of gestation. The control group consists of 1560 pregnant women without previous operative births. Placenta praevia is found in 3.9% in patients with previous cesarean sections and in 0.45% in the control group. The bleeding in the group of placenta praevia after previous operative births is observed in 44.4% against 28.5% when the placenta praevia is in intact uterus. A significant dependence was found between the number of sections and the risk of placenta praevia and bleedings in the following pregnancy. Placenta praevia shows preference to the anterior uterine wall in 67% in scared uterus and in 33% in intact uterus. A very poor is the combination of febrile postoperative period with endometritis and very short interval to the next pregnancy. These conclusions are important for the prognosis and management of such pregnancies.

[The medicosocial aspects of contraception for teenagers]. / Niakoi mediko-sotsialni aspekti na kontratseptsiiata pri tiineidzhuri.

The authors study and examine the influence of some medical and social factors on the teenagers use of contraceptives. The study is based on the questionnaires fulfill by 568 teenagers (aged 13-19). In the enquêtes are shown the role of the family status of the parents the involvement of the family and the school in the sex education, and also are indicated the favorite teenager's contraceptive methods. The positive attitude on contraception and on this kind of researches is very characteristic for 94% of the analyzed teenagers. The authors made a conclusion on optimizing the use of modern contraceptives for teenagers.