In this paper we present an uncertainty analysis of thermo-hydro-mechanical (THM) coupled processes in a typical geothermal reservoir in crystalline rock. Fracture and matrix are treated conceptually as an equivalent porous medium, and the model is applied to available data from the Urach Spa and Falkenberg sites (Germany). The finite element method (FEM) is used for the numerical analysis of fully coupled THM processes, including thermal water flow, advective-diffusive heat transport, and thermoelasticity. Non-linearity in system behavior is introduced via temperature and pressure dependent fluid properties. Reservoir parameters are considered as spatially random variables and their realizations are generated using conditional Gaussian simulation. The related Monte-Carlo analysis of the coupled THM problem is computationally very expensive. To enhance computational efficiency, the parallel FEM based on domain decomposition technology using message passing interface (MPI) is utilized to conduct the numerous simulations. In the numerical analysis we considered two reservoir modes: undisturbed and stimulated. The uncertainty analysis we apply captures both the effects of heterogeneity and hydraulic stimulation near the injection borehole. The results show the influence of parameter ranges on reservoir evolution during long-term heat extraction, taking into account fully coupled thermo-hydro-mechanical processes. We found that the most significant factors in the analysis are permeability and heat capacity. The study demonstrates the importance of taking parameter uncertainties into account for geothermal reservoir evaluation in order to assess the viability of numerical modeling.

ObjectiveTo investigate the clinical significance of systematic retroperitoneal lymphadenectomy during interval debulking surgery (IDS) in advanced epithelial ovarian cancer (EOC) patients.MethodsWe retrospectively reviewed the medical records of 124 advanced EOC patients and analyzed the details of neoadjuvant chemotherapy (NACT), IDS, postoperative treatment, and prognoses.ResultsFollowing IDS, 98 patients had no gross residual disease (NGRD), 15 had residual disease sized <1 cm (optimal), and 11 had residual disease sized ≥1 cm (suboptimal). Two-year overall survival (OS) and progression-free survival (PFS) rates were 88.8% and 39.8% in the NGRD group, 40.0% and 13.3% in the optimal group (p<0.001 vs. NGRD for both), and 36.3% and 0% in the suboptimal group, respectively. Five-year OS and 2-year PFS rates were 62% and 56.1% in the lymph node-negative (LN-) group and 26.2% and 24.5% in the lymph node-positive (LN+) group (p=0.0033 and p=0.0024 vs. LN-, respectively). Furthermore, survival in the LN+ group, despite surgical removal of positive nodes, was the same as that in the unknown LN status group, in which lymphadenectomy was not performed (p=0.616 and p=0.895, respectively). Multivariate analysis identified gross residual tumor during IDS (hazard ratio, 3.68; 95% confidence interval, 1.31 to 10.33 vs. NGRD) as the only independent predictor of poor OS.ConclusionNGRD after IDS improved prognosis in advanced EOC patients treated with NACT-IDS. However, while systematic retroperitoneal lymphadenectomy during IDS may predict outcome, it does not confer therapeutic benefits.

Intrauterine insemination (IUI) is a simple first line treatment for infertile couples (1). This inexpensive treatment, in comparison with other assisted reproductive techniques (ART), has been widely used to treat infertile couples with a variety of indications such as male subfertility, unexplained fertility, cervical mucus hostility and endometriosisrelated infertility. (2-7) Pregnancy rates after IUI differ between studies according to patient selection criteria, the presence of various infertility factors, ovarian stimulation methods, number of cycles performed, different sperm parameters, and preparation %). There was no triple or higher order multiple pregnancies. At the end of the sixth cycle, 73 clinical pregnancies had been achieved (89.0% %). After diagnostic laparoscopy, the pregnancy rate per cycle for patients 35 years age was 18% %, which is significantly higher than that of patients 35 years of age. Pregnancies occurred up to the fifth cycle after laparoscopy. The pregnancy rate (PR) per cycle was significantly higher in cases of sperm movement rates more than 30% % (PR 9.3% %) and total motile sperm counts more than 10 10 6 /ml (PR 8.2% %). A study comparing the washed and unwashed cases did not reveal any differences. Conclusion : In male sub-fertility cases of sperm parameters as motility rates 30% % and motile sperm concentration 10 10 6 /ml, IUI could be a useful option for infertility treatment J. Med. Invest. 58 : 127-133, February, 2011 ORIGINAL Effect of semen characteristics on pregnancy rate following intrauterine insemination

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Cataract extraction by phacoemulsification or ECCE combined with IOL implantation and trabeculotomy ab externo is a safe, effective treatment for patients with coexisting glaucoma and cataract.