The objective of this retrospective study was to evaluate the usefulness of abdominal and vaginal sonohysterography (SHG; considered both singly and in combination) for the diagnosis of uterine polyps. Fifty fertile women hospitalized for hysterectomy for benign gynecologic indications were enrolled. Main outcome measures were preoperative conventional vaginosonography, transabdominal and vaginal SHG, hysteroscopy and histologic evaluation of the surgical specimen. Conventional vaginosonography had a sensitivity of 33.3% and a specificity of 100%; the predictive values of abnormal and normal scans were 100 and 79.5%, respectively. Transabdominal SHG had a sensitivity of 75% and a specificity of 100%. The predictive value of an abnormal scan was 100%; that of a normal scan 91.2%. Vaginal SHG had a sensitivity of 58.3% and a specificity of 100%; the predictive value of an abnormal scan was 100%, that of a normal scan 86.1 %. The combination of the two kinds of SHG had a sensitivity of 91.7% and specificity of 100%; the predictive value of an abnormal test was 100% and that of a normal test 96.9%. The sensitivity, specificity and predictive values of abnormal and normal hysteroscopic examination were all 100%. In conclusion, the presence of endouterine polyps can be effectively investigated by SHG; nevertheless, hysteroscopy is more sensitive, being capable of detecting even very small endouterine neoformations.
This report documents the activities performed by Idaho National Laboratory (INL) during the fiscal year (FY) 2018 for the DOE Light Water Reactor Sustainability (LWRS) Program, Risk-Informed System Analysis (RISA) Pathway, Enhanced Resilient Plant (ERP) Systems research. The purpose of the RISA Pathway research and development is to support plant owner-operator decisions with the aim to improve the economics, reliability, and maintain the high levels of safety of current nuclear power plants over periods of extended plant operations. The concept of ERP refers to the combinations of Accident Tolerant Fuel (ATF), optimal use of Diverse and Flexible Coping Strategy (FLEX), enhancements to plant components and systems, and the incorporation of augmented or new passive cooling systems, as well as improved fuel cycle efficiency. The objective of the ERP research effort is to use the RISA methods and toolkit in industry applications, including methods development and early demonstration of technologies, in order to enhance existing reactors safety features (both active and passive) and to substantially reduce operating costs through risk-informed approaches to plant design modifications to the plant and their characterization.
Under the auspices of the DOE LWRS Program RISMC Industry Application ECCS/LOCA, INL has engaged staff from both South Texas Project (STP) and the Texas A&M University (TAMU) to produce a generic pressurized water reactor (PWR) model including reactor core, clad/fuel design and systems thermal hydraulics based on the South Texas Project (STP) nuclear power plant, a 4-Loop Westinghouse PWR. A RISMC toolkit, named LOCA Toolkit for the U.S. (LOTUS), has been developed for use in this generic PWR plant model to assess safety margins for the proposed NRC 10 CFR 50.46c rule, Emergency Core Cooling System (ECCS) performance during LOCA. This demonstration includes coupled analysis of core design, fuel design, thermalhydraulics and systems analysis, using advanced risk analysis tools and methods to investigate a wide range of results. Within this context, a multi-physics best estimate plus uncertainty (MP-BEPU) methodology framework is proposed. The set of modeled results shows that peak clad temperature (PCT) and fuel cladding oxidation responses (measured by equivalent cladding reacted (ECR)) are well characterized by performance based modeling under large break LOCA conditions. Both PCT and ECR comply with a proposed acceptance criteria with sufficient margins available. Furthermore, these demonstration calculations indicate the importance of safety margin management and planning for future operating cycles. Since nuclear fuel stays in a reactor for multiple operating cycles, planning of loading and operating strategies needs to be well thought of.
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