Conservative Management of Vulvar Cancer-Where Should We Draw the Line?

Vulvar cancer is a rare disease, and cure rates were low until the mid-20th century. The introduction of an en bloc radical vulvectomy and bilateral groin and pelvic lymph node dissection saw them rise from 15-20% to 60-70%. However, this very radical surgery was associated with high physical and psychological morbidity.

Parental Experiences with Newborn Screening and Gene Replacement Therapy for Spinal Muscular Atrophy.

Background: Spinal muscular atrophy (SMA) is a genetic neurodegenerative disorder with onset predominantly in infants and children. In recent years, newborn screening and three treatments, including gene replacement therapy (Onasemnogene abeparvovec-xioi), have become available in the United States, aiding in the diagnosis and treatment of children with SMA.

Objective: To evaluate parents' experiences with newborn screening and gene replacement therapy and to explore best practices for positive newborn screen disclosure and counseling of families.

Groin Surveillance by Serial Ultrasonography Rather Than Sentinel Node Biopsy or Inguinofemoral Lymphadenectomy for Patients with Vulvar Cancer: A Pilot Study.

A pilot study was conducted to determine whether 3-monthly groin ultrasonography could eliminate groin dissection after a negative bilateral groin ultrasound in three groups of patients: (i) Those with a unifocal stage 1B squamous cell carcinoma of up to 20 mm in diameter. (ii) Those with an ipsilateral squamous cell carcinoma of any size which extended to within 1 cm either side of the midline. These patients underwent ipsilateral inguinofemoral lymphadenectomy and ultrasonic surveillance of the contralateral groin.

Micromachining of Alumina Using a High-Power Ultrashort-Pulsed Laser.

We report on a comprehensive study of laser ablation and micromachining of alumina using a high-power 1030 nm ultrashort-pulsed laser. By varying laser power up to 150 W, pulse duration between 900 fs and 10 ps, repetition rates between 200 kHz and 800 kHz), spatial pulse overlap between 70% and 80% and a layer-wise rotation of the scan direction, the ablation efficiency, ablation rate and surface roughness are determined and discussed with respect to an efficient and optimized process strategy. As a result, the combination of a high pulse repetition rate of 800 kHz and the longest evaluated pulse duration of 10 ps leads to the highest ablation efficiency of 0.