bluuebunny/crossref_metadata_2025 huggingface dataset:
Elimination of higher modes in dispersive in‐seam multimode Love waves
Authors: Li Xiao‐Ping
Published: November 2003

A deterministic pure phase shift filter (PPSF) is developed to extract the fundamental mode from multimode surface Love waves. Because of different phase velocities of modes and hence different phase traveltimes for a fixed travel distance between source and receiver, the deterministic PPSF can be computed, provided that the dispersion relation of the medium is estimated from the existing transmission data. The process consists of (a) applying the deterministic PPSF to the multimode wave (this step of the filtering process results in a time series in which the amplitudes of the fundamental mode appear at acausal times and the amplitudes of higher modes appear at causal times); (b) setting amplitude values equal to zero for positive times; (c) applying the inverse PPSF to the filtered signal. By using such a deterministic PPSF process, the higher modes almost disappear. The method is applied to synthetic multimode data computed by the normal‐mode summation method.
Recursive seismic ray modelling: applications in inversion and VSP
Authors: Moser T.J. , Pajchel J.
Published: November 2003

The recursive nature of rays in blocky models can be exploited to solve some difficult problems in seismic modelling. Each segment of a ray travels from an initial point up to a reflecting interface, where it is split into reflected and transmitted ray segments, which each continue in a similar way. The tree structure that thus emanates is conveniently handled by a recursive scheme. Recursion allows an automatic generation of all phases on a seismogram, together with all information necessary to analyse or select them. By operating recursively with a ray cell, bounded by a pair of vicinal rays in 2D, or a triplet of vicinal rays in 3D, and two successive isochrons, the two‐point ray‐tracing problem is reduced to a simple interpolation. Also, the cellular approach allows for a stable and robust evaluation of dynamic ray quantities without any paraxial tracing, which is cumbersome in blocky models of realistic complexity. Geometric shadows are filled by recursively generated diffractions. The recursive ray tracer has found applications in the fast computation of Green's functions in target‐oriented inversion and in phase identification in VSP.
Elimination of ghost noise in vibroseis data by deconvolution
Authors: Li Xiao‐Ping
Published: November 2003

A deconvolution approach is presented to process uncorrelated vibroseis data. The recorded ground force signal, known to be a better correlator for the vibrogram than the pilot sweep itself, is used to deconvolve rather than to correlate the vibrogram. In such a way the ghost sweep (correlation noise), produced by severe harmonic distortions in the ground force signal both at negative and positive correlation times if such a signal is used as the correlator, is eliminated automatically. This type of deconvolution can eliminate the ghost sweep caused by both the upsweep or by the downsweep signal. Synthetic and real data are used to demonstrate the application of the deconvolution procedure. The results are compared with the traditional correlation procedure and show the superiority of the deconvolution approach.
Effects of long‐term atmospheric CO2 enrichment on the growth and fruit production of sour orange trees
Authors: IDSO SHERWOOD , KIMBALL BRUCE
Published: November 2003

In July of 1987, we planted eight 30‐cm‐tall sour orange tree seedlings in a field of Avondale loam at Phoenix, Arizona and enclosed them in pairs in clear‐plastic‐wall open‐top chambers. Since 18 November of that year, we have continuously pumped ambient air of ≈400 ppmv [CO2] through two of these enclosures, while through the other two we have continuously pumped air of ≈700 ppmv [CO2]. By the end of the second year of the study, the trunk plus branch volume of the [CO2]‐enriched trees was ≈2.75 times greater than that of the ambient‐treatment trees. Three years later, this factor had dropped to ≈2.0; but the decline in the [CO2]‐enriched/ambient‐treatment ratio of trunk plus branch volume was nearly perfectly offset by the relative fruit production advantage enjoyed by the [CO2]‐enriched trees over that period. In Years 6, 7 and 8, however, there was a moderate drop in total productivity enhancement. This decline may be a delayed acclimation response, or it could be due to enhanced self‐shading in the [CO2]‐enriched trees or to the fact that, starting early in Year 6, many branches of the [CO2]‐enriched trees grew all the way to the walls of their enclosures, so that many blossoms and young fruit were destroyed by intermittent physical trauma produced by the action of wind against the taut plastic in that year and in all succeeding years. Hence, we will have to maintain our experiment for several more years for this lateral growth obstruction to occur to the same degree in the ambient‐air chambers as it has in the [CO2]‐enriched chambers, in order to determine the long‐term equilibrium effects of atmospheric [CO2] enrichment in a spatially confined environment.
Growth and reproduction of aphids and levels of free amino acids in Scots pine and Norway spruce in an open‐air fumigation with ozone
Authors: HOLOPAINEN JARMO , KAINULAINEN PIRJO , OKSANEN† JARI
Published: November 2003

To estimate the susceptibility of conifer seedlings to aphids under future tropospheric ozone levels, Scots pine (Pinus sylvestris L.) and Norway spruce (Picea abies (L.) Karst.) seedlings were exposed to ambient and elevated ozone levels in an open‐air exposure system. Growth and reproduction of the aphids Schizolachnus pineti and Cinara pinea on Scots pine and Cinara pilicornis on Norway spruce were monitored. Levels of free amino acids in foliage and young shoots were used as indicators of host plant quality. In elevated treatment plots the ozone doses were between 1.2 and 1.7 times the dose in ambient plots in 1990–93. Half of the seedling material in 1992–93 was subjected to nitrogen fertilization treatment to evaluate the effects of increased N deposition.

In 1990, population density of S. pineti on pine did not differ between ambient and elevated ozone treatments during growing season, but remained higher in the elevated ozone plot than in the ambient plot at the end of the growing season. This was associated with elevated levels of glutamic acid in foliage. In August 1992, the numbers of S. pineti were consistent between the two ambient ozone plots, but deviated highly between the two ozone‐fumigated plots. Glycine concentration in pine foliage was elevated by ozone, but free amino acid concentrations were not related to aphid performance. In 1993, ozone and nitrogen did not significantly affect the relative growth rate (RGR) of S. pineti or C. pinea nymphs on Scots pine, but glutamic acid concentration in foliage was increased by nitrogen fertilization. On Norway spruce, fecundity of C. pilicornis females was higher in elevated ozone treatment, but RGR of nymphs was not affected in 1992. In 1993, RGR of C. pilicornis nymphs was increased by nitrogen fertilization in June, but not affected by ozone. Nitrogen fertilization increased the levels of total free amino acids, aspartic acid, glutamic acid and proline in elongating shoots of Norway spruce, and ozone reduced the concentrations of valine and γ‐butyric acid.

Our results suggest that availability of nitrogen from soil has a stronger impact on the concentrations of free amino acids in conifer seedlings than ozone. Some episodes of high ozone concentration may increase free amino acids in foliage. Aphid response to ozone was extremely variable, in agreement with previous laboratory experiments. The expected 20–70% increase in ambient concentrations of tropospheric ozone may in some occasions enhance aphid performance on Scots pine and Norway spruce seedlings, but in most cases the ozone effect on the susceptibility of conifer seedlings to sucking insect pests is not important.
Nitrogen cycling in microcosms of yellow birch exposed to elevated CO2: simultaneous positive and negative below‐ground feedbacks
Authors: BERNTSON G. M. , BAZZAZ F. A.
Published: November 2003

This study investigated simultaneous plant and soil feedbacks on growth enhancement with elevated [CO2] within microcosms of yellow birch (Betula alleghaniensis Britt.) in the second year of growth. Understanding the integrated responses of model ecosystems may provide key insight into the potential net nutrient feedbacks on [CO2] growth enhancements in temperate forests. We measured the net biomass production, C:N ratios, root architecture, and mycorrhizal responses of yellow birch, in situ rates gross nitrogen mineralization and the partitioning of available NH4+ between yellow birch and soil microbes. Elevated atmospheric [CO2] resulted in significant alterations in the cycling of N within the microcosms. Plant C/N ratios were significantly increased, gross mineralization and NH4+ consumption rates were decreased, and relative microbial uptake of NH4+ was increased, representing a suite of N cycling negative feedbacks on N availability. However, increased C/N ratios may also be a mechanism which allows plants to maintain higher growth with a constant or reduced N supply. Total plant N content was increased with elevated [CO2], suggesting that yellow birch had successfully increased their ability to acquire nutrients during the first year of growth. However, plant uptake rates of NH4+ had decreased in the second year. This discrepancy implies that, in this study, nitrogen uptake showed a trend through ontogeny of decreasing enhancement under elevated [CO2]. The reduced N mineralization and relatively increased N immobilization are a potential feedback which may drive this ontogenetic trend. This study has demonstrated the importance of using an integrated approach to exploring potential nutrient‐cycling feedbacks in elevated [CO2].
CO2‐mediated changes in aspen chemistry: effects on gypsy moth performance and susceptibility to virus
Authors: LINDROTH RICHARD , ROTH SHERRY , KRUGER ERIC , VOLIN JOHN , KOSS PATRICK
Published: November 2003

We investigated the effects of long‐term CO2 enrichment on foliar chemistry of quaking aspen (Populus tremuloides) and the consequences of chemical changes for performance of the gypsy moth (Lymantria dispar) and susceptibility of the gypsy moth to a nucleopolyhedrosis virus (NPV). Foliage was collected from outdoor open‐top chambers and fed to insects in a quarantine rearing facility. Under enriched CO2, levels of leaf nitrogen declined marginally, levels of starch and phenolic glycosides did not change, and levels of condensed tannins increased. Long‐term bioassays revealed reduced growth (especially females), prolonged development and increased consumption in larvae fed high‐CO2 foliage but no significant differences in final pupal weights or female fecundity. Short‐term bioassays showed weaker, and sex‐specific, effects of CO2 treatment on larval performance. Correlation analyses revealed strong, negative associations between insect performance and phenolic glycoside concentrations, independent of CO2 treatment. Larval susceptibility to NPV did not differ between CO2 treatments, suggesting that effects of this natural enemy on gypsy moths are buffered from CO2‐induced changes in foliar chemistry. Our results emphasize that the impact of enriched CO2 on plant–insect interactions will be determined not only by how concentrations of plant compounds are altered, but also by the relevance of particular compounds for insect fitness. This work also underscores the need for studies of genetic variation in plant responses to enriched CO2 and long‐term population‐level responses of insects to CO2‐induced changes in host quality.
Responses of atmospheric methane consumption by soils to global climate change
Authors: KING GARY
Published: November 2003

Soils consume about 40 Tg methane from the atmosphere annually. Thus, soils contribute significantly to the atmospheric methane budget. However, responses of atmospheric methane consumption to climate change are uncertain. Predicting these responses requires an understanding of the effect on methane consumption of specific variables (temperature and soil water content) as well as interactions among parameters (methane, ammonium, water content). Key considerations involve the limitations of diffusive transport and controls of methane diffusivity; limitation of methanotrophic activity by water stress; relatively slow growth rates of methane‐oxidizing bacteria on atmospheric methane; ammonium toxicity. Interactions among these parameters may be particularly important, and lead to responses contrary to those predicted from changes in temperature and water content alone. Results from a number of analyses indicate that atmospheric methane consumption is especially sensitive to anthropogenic disturbances, which typically decrease activity. Continued increases in wet and dry ammonium deposition are likely to exacerbate inhibition resulting from changes in land use. Changes in hydrological regimes could further decrease activity if dry periods increase water stress at soil depths currently colonized by methanotrophs. Future trends in the soil methane sink are likely to lead to enhanced accumulation of atmospheric methane.
Effects of elevated atmospheric CO2 in agro‐ecosystems on soil carbon storage
Authors: TORBERT H , ROGERS HUGO , PRIOR STEPHEN , SCHLESINGER WILLIAM , BRETT RUNION G.
Published: November 2003

Increasing global atmospheric CO2 concentration has led to concerns regarding its potential effects on the terrestrial environment. Attempts to balance the atmospheric carbon (C) budget have met with a large shortfall in C accounting (≈1.4 × 1015 g C y–1) and this has led to the hypothesis that C is being stored in the soil of terrestrial ecosystems. This study examined the effects of CO2 enrichment on soil C storage in C3 soybean (Glycine max L.) Merr. and C4 grain sorghum (Sorghum bicolor L.) Moench. agro‐ecosystems established on a Blanton loamy sand (loamy siliceous, thermic, Grossarenic Paleudults). The study was a split‐plot design replicated three times with two crop species (soybean and grain sorghum) as the main plots and two CO2 concentration (ambient and twice ambient) as subplots using open top field chambers. Carbon isotopic techniques using δ13C were used to track the input of new C into the soil system. At the end of two years, shifts in δ13C content of soil organic matter carbon were observed to a depth of 30 cm. Calculated new C in soil organic matter with grain sorghum was greater for elevated CO2 vs. ambient CO2 (162 and 29 g m–2, respectively), but with soybean the new C in soil organic matter was less for elevated CO2 vs. ambient CO2 (120 and 291 g m–2, respectively). A significant increase in mineral associated organic C was observed in 1993 which may result in increased soil C storage over the long‐term, however, little change in total soil organic C was observed under either plant species. These data indicate that elevated atmospheric CO2 resulted in changes in soil C dynamics in agro‐ecosystems that are crop species dependent.
Effect of elevated CO2 on rhizosphere carbon flow and soil microbial processes
Authors: PATERSON E. , HALL J.M. , RATTRAY E.A.S. , GRIFFITHS B.S. , RITZ K. , KILLHAM K.
Published: November 2003

Direct effects of increased above‐ground CO2 concentration on soil microbial processes are unlikely, due to the high pCO2 of the soil atmosphere in most terrestrial ecosystems. However, below‐ ground microbial processes are likely to be affected through altered plant inputs at elevated CO2. A major component of plant input is derived from litter fall and root turnover. Inputs also derive from rhizodeposition (loss of C‐compounds from active root systems) which may account for up to 40% of photoassimilate. This input fuels the activity of complex microbial communities around roots. These communities are centrally important not only to plant–microbe interactions and consequent effects on plant growth, but also, through their high relative activity and abundance, to microbially mediated processes in soil generally. This review focuses on approaches to measure C‐flow from roots, in particular, as affected by increased atmospheric CO2 concentration. The available evidence for impacts on microbial communities inhabiting this niche, which constitutes an interface for possible perturbations on terrestrial ecosystems through the influence of environmental change, will also be discussed. While methodologies for measuring effects of increased CO2 concentration on plant growth, physiology and C‐partitioning are abundant and widely reported, there is relatively little information on plant‐mediated effects on soil microbial communities and processes. Importantly, many studies have also neglected to recognize that any secondary effects on microbial communities may have profound effects on plant parameters measured in relation to environmental change. We critically review approaches which have been used to measure rhizodeposition under conditions of increased atmospheric CO2 concentration, and then consider evidence for changes in microbial communities and processes, and the methodologies which have been recently developed, and are appropriate to study such changes.
Microbial decomposition at elevated CO2 levels: effect of litter quality
Authors: BALL ANDREW
Published: November 2003

The decomposition of senesced plant litter represents an important intermediate step in the cycling of nutrients between above‐ and below‐ground systems. The rate of decomposition of plant litter is sensitive to fluctuations in a number of parameters, including environmental conditions, and particularly to changes in the quality of the litter. Increased C: N ratios of litter are thought to be one possible consequence of growth of plants under elevated [CO2]. This response is likely to reduce the rate of decomposition of the litter.

Evidence from the growth of plants in both pot and field studies suggests that growth of C3 plants in elevated atmospheric [CO2] (600–700 μmol mol–1) may lead to a significant increase in either/both the C: N and the lignin: N ratios of litter. Short‐term decomposition of litter from plants showing this response in elevated [CO2] has confirmed that decomposition occurs at a significantly lower rate. The limited studies of both the response of C4 plants to elevated [CO2] and the subsequent degradability of the senescent litter suggest that no differences in litter quality or degradability occur. In terms of litter quality the response of plants therefore appears to be dependent upon photosynthetic type; the C:N and lignin:N ratios of litter from C3 plants exposed to elevated [CO2] are increased, leading to lower degradation rates, while the nutrient ratios and degradation rates of litter from C4 plants grown in elevated [CO2] remain unchanged.

To date, very few ecosystem studies of decomposition have been carried out. Further work is required at the ecosystem level to determine whether the effects observed in laboratory, pot and field studies are also observed in long‐term, complex ecosystem studies. Clearly if these results are repeated at the ecosystem level then significant changes in the cycling of C and N in important terrestrial ecosystems may occur as a results of elevated [CO2].
Grain yield and yield components as affected by forage removal in winter and spring triticale
Authors: Royo C.
Published: November 2003

Two field experiments were carried out under irrigation and high fertility in northeastern Spain during 1992 and 1993. Ten triticale genotypes, five of spring growth habit and five winter types, were tested for their suitability for both forage and grain. Forage removal reduced grain yield per plant by about 17%, but did not have any significant effect on plant density, ear density or tiller number per plant. Tiller mortality was greater in winter types (65%) than in spring triticales (25%), but was not affected by cutting. Decreases in grain yield following cutting could be attributed to reductions in the number of grains per spike and kernel weight. Cutting decreased the number of grains per spike by about 9% by reducing the two components, spikelets per head and grains per spikelet. The average spike length was 10·6 cm in the uncut treatment and 10·1 cm in the dual‐purpose plots. Cutting reduced thousand kernel weight by about 7% in winter triticales, and around 10% in spring types, both in main spike and in first tiller. The effect of a forage harvest on yield components was in general similar for both types of triticale. Cutting when jointing commenced induced changes in the relative importance of yield components influencing future grain yield. The yield components reduced by cutting were the most important contributors to grain yield after forage removal.
The influence of weight of ryegrass per unit area and treatment at and after mowing on rate of drying
Authors: Wright D. A. , Frost J. P. , Patterson D. C. , Kilpatrick D. J.
Published: November 2003

The rates of drying of perennial ryegrass, subjected to different treatments at mowing and after mowing, were assessed in the field by weight change of grass fresh weight in wire‐mesh trays over 3·5 d (76 h). In a 5 × 3 × 3 factorial experimental design, the effects of five weights of grass per unit area [1·5, 3, 6, 12 and 24 kg fresh material (FM) m−2], three treatments at mowing (no treatment, mower‐conditioned, flail‐treated) and three treatments after mowing (no treatment, inverted, mixed) were examined. The experiment was replicated twice on 16 occasions in 1992 at the Agricultural Research Institute of Northern Ireland. This gave a total of thirty‐two replicates per treatment. The trays were weighed at 2‐h intervals from 09.00 to 17.00 h each day. Data sets were restricted to rain‐free days and also to the first day after mowing (day 1). On day 1, grass weight per unit area was a major factor dictating drying; reducing the grass weight per unit area of unconditioned grass from 6 to 3 kg FM m−2 increased grass drying rate by 47%. There was no significant (P > 0·05) benefit over the untreated grass on day 1 from mixing or turning mower‐conditioned or the unconditioned grass. Mixing of the flail‐treated grass improved drying rate significantly (P > 0·001) over the control. Over the whole 76‐h period, the relative benefit from either mower conditioning or flail treatment over no treatment was dependent upon both grass weight per unit area and initial dry‐matter (DM) concentration. At higher initial DM concentrations (>150 g kg−1) and lower grass weights (<6 kg FM m−2) both mower conditioning using a nylon brush type conditioner and intensive conditioning by flail treatment gave substantial increases in drying over no treatment. Moisture regain of grass exposed to overnight dew was small. Rain had a much greater effect than dew on subsequent moisture regain. Unconditioned grass at 12 kg m−2 retained 82% less water following rainfall than unconditioned grass at 3 kg m−2.
Laparoscopic gonadectomy in a patient with androgen insensitivity syndrome: an extracorporeal surgical technique
Authors: Bessho T. , Tsuji Y. , Shima H. , Koyama K.
Published: November 2003

Because of the increased risk of gonadal malignancy, prophylactic gonadectomy in androgen insensitivity syndrome has recently been performed using laparoscopic procedures. However, the intracorporeal approach, as a standard technique, is often time consuming, complicated and expensive. Here we describe a simple extracorporeal technique as an alternative method. This method is only suitable for some intraperitoneal gonads and adequate exclusion of gonads in the inguinal canal must occur. Several advantages and disadvantages of this procedure are discussed.
Who should have outpatient hysteroscopy?
Authors: Cutner A. , Erian J.
Published: November 2003

Objective To determine criteria by which patients may be selected as suitable for outpatient hysteroscopy. Design Patients undergoing outpatient hysteroscopy filled in visual analogue scales to assess their pain/discomfort during different parts of the procedure. Setting Outpatient hysteroscopy clinic in a district general hospital.

Subjects All women referred for outpatient hysteroscopy. Main outcome measure Degree of discomfort/pain as determined from visual analogue scores. Results Age had no effect on acceptability of the procedure. A previous vaginal delivery had an effect on pain/discomfort at insertion of the hysteroscope. Carbon dioxide was less painful than saline, and anxiety before the procedure only had a very small effect. However pain/discomfort at insertion of the speculum had the greatest predictive value with regards to discomfort both during and after the procedure. Conclusions In our study we have demonstrated that those women who found the speculum insertion particularly uncomfortable were more likely to find all parts of the procedure painful. It is this group of women who should be considered for investigation under general anaesthetic. They can be identified at the referral stage removing unnecessary distress for the patient and possible wasted investigation time for the operator.
A case of torsion of a fallopian tube endometrioma
Authors: James J.J. , Powell M.C.
Published: November 2003

A patient presented with sudden onset of abdominal pain. She was found to have a torted fallopian tube. Tubal torsion is an uncommon cause of acute abdominal pain. The condition was diagnosed and managed laparoscopically. We believe this to be one of the first cases described where such a torsion has been due to an endometrioma within the tube.
LAPAROSCOPIC TREATMENT OF OVARIAN PREGNANCY
Authors: Morice P. , Dubussion J.B. , Chapron C. , De Gayffier A. , Mouelhi T.
Published: November 2003

Ovarian pregnancy is rare. The diagnosis is often discovered unexpectedly during surgery. The treatment accepted as standard is surgery, often carried out via laparotomy. This treatment must be as conservative as possible. We report a series of four cases of ovarian pregnancy treated using laparoscopy. Our observations show that, as in the case of tubal pregnancies, laparoscopic surgery has become a first‐class alternative to laparotomy for treatment of ovarian pregnancy.
‘BLUE VOMIT’ AFTER LAPAROSCOPIC SALPINGOSTOMY
Authors: Daramola O. , Okojie A. , Annan H. G. , Singh R. , Clements E.
Published: November 2003

An unusual complication following laparoscopic surgery is reported. Following laparoscopic surgery in a 35‐year‐old woman, her vomitus was found to contain methylene blue dye. The diagnosis was confirmed by chromatographic analysis of her gastric contents and blood.
Pelvic actinomycosis which appears to be a malignancy
Authors: Hernández S.H. , Seara S. , Lopez J.F. , De Lera J. , Garcia J.A. , Falcón O.
Published: November 2003

We present the case history of a 63‐year‐old female patient with pelvic actinomycosis. She did not use an intra‐uterine device and underwent investigation for acute renal insufficiency, with a pelvic mass that suggested possible neoplasia of gynaecological origin.
Laparoscopic excision of early interstitial pregnancy with combined usage of intra‐abdominal ultrasonography
Authors: Soong Y.‐K. , Chang F.‐H. , Lee C.‐L. , Lai Y.‐M. , Lee J.‐D.
Published: November 2003

We report the cases of one patient with a right cornual pregnancy and one with a right interstitial pregnancy who were treated successfully with laparoscopic resection. In the patient with interstitial pregnancy, intra‐abdominal ultrasonography was used for definite diagnosis and confirmation of complete removal of gestational tissue during the operation. These two patients were discharged within 2 days and could return to work within 1 week after the procedure. For a well experienced laparoscopist, these dangerous forms of ectopic pregnancies may not be contraindications to be laparoscopic management. For cases with uncertain diagnosis before operation, the combined use of intra‐operative ultrasound is efficacious and recommended.
Delayed presentation of inadvertent perforation of the bladder during laparoscopic surgery
Authors: Saravelos H. , Lee C. , Li T.C.
Published: November 2003

An unusual case of delayed presentation of bladder injury is reported. During laparoscopic surgery in a 32‐year‐old woman the bladder was inadvertently perforated. The injury was not recognized intra‐operatively. The patient was re‐admitted 72 h postoperatively with lower abdominal pain, no evidence of haematuria, and blood biochemistry results similar to those of someone in acute renal failure. The diagnosis was confirmed with a retrograde cystogram and the case was successfully treated by continuous drainage with a Foley catheter.
Small bowel obstruction following laparoscopically assisted vaginal hysterectomy
Authors: Ferriman E.L. , Brightmore T.G.J. , McCormack J.
Published: November 2003

We present the case of a patient who underwent laparoscopically assisted vaginal hysterectomy in a seemingly uneventful procedure, who 4 days postoperatively, became acutely and nonspecifically unwell. A diagnosis of subacute bowel obstruction was made due to herniation of a portion of small bowel through a 10‐mm laparoscopic port wound. This case report highlights this complication, the potential pitfalls in the diagnosis of a partial bowel obstruction (Richter’s hernia) and a simple preventative measure to ensure adequate closure of the rectus sheath, using a J‐shaped needle.
Cost of unruptured ectopic pregnancy treatment: comparison of laparoscopy and methotrexate injection
Authors: Lécuru F. , Taurelle R. , Robin F. , Viens‐Bitker C.
Published: November 2003

We compared the cost of conservative treatment of unruptured ectopic pregnancy by laparoscopy or injection of methotrexate. We quantified the total costs associated with each procedure on the basis of a literature review. The tariff of the French health service (Caisse Nationale d’Assurance Maladie) was used as a cost reference. The total costs of conservative laparoscopy and transvaginal injection of methotrexate under sonographic control were similar (respectively 12.640 thousand francs (KF) and 10.627 KF per patient). Single‐dose intramuscular injection of methotrexate was the least expensive treatment (7.261 KF per patient), i.e. a cost saving of close to 40%. Laparoscopy is associated with an irreducible cost due to hospitalization and operating room charges. Transvaginal injection of methotrexate requires a shorter hospital stay (outpatient basis) but the repetition of laboratory tests during the follow up is expensive. Intramuscular injection of methotrexate does not require hospitalization and its cost is limited to the biological follow up. But the real benefit of medical therapy is probably the avoidance of the anaesthesic and surgical complications of laparoscopy.
Laparoscopic approach to acute abdomen in first trimester pregnancy: three case reports
Authors: Jansen F.W. , Van Roosmalen J. , Trimbos‐Kemper T.C.M.
Published: November 2003

The acute abdomen in the first trimester of pregnancy presents a difficult diagnosis. As a result of the wider use of ovarian stimulation and advanced reproductive technologies, traditionally rare causes of acute abdomen now occur more frequently. We report two cases of heterotopic pregnancy at 9 and 12 weeks of gestation and one case of twisted adnexa in pregnancy as causes of acute abdomen. Proper diagnosis was only possible after diagnostic laparoscoopy. Treatment by salpingectomy and detorsion was performed by a laparoscopic procedure. The pitfalls and advantages of this approach are discussed.
Serum CA‐125 elevation associated with ovarian endometriosis
Authors: Kowalczyk C. , Doty A. , Ginsburg K.A.
Published: November 2003

A 39‐year‐old woman with an adnexal mass and serum CA‐125 level of 1030 IU ml−1 was found to have pelvic adhesions and an ovarian endometrioma. This case demonstrates that significant CA‐125 elevation even in the presence of an adnexal mass is not always associated with ovarian malignancy.
An interaction between danazol and warfarin in women with menorrhagia treated for thinning the endometrium prior to resection
Authors: Tapper A.‐M. , Heinonen P.K.
Published: November 2003

Six patients on long‐term anticoagulant therapy with warfarin, and suffering from menorrhagia, underwent hysteroscopic endomyometrial resection. They received 600 mg danazol daily preoperatively for 4 weeks to suppress the endometrium. The simultaneous use of danazol and warfarin potentiated the anticoagulation effect of warfarin, the mean reduction of warfarin dosage being 52%. Three patients out of six experienced bleeding complications because of increased anticoagulation, two of them postoperatively. One patient experienced excessive bleeding after having danazol continued postoperatively. Patients on warfarin therapy who are prescribed danazol must be monitored closely to avoid excessive anticoagulation and subsequent bleeding in hysteroscopic surgery. Concomitant use of these drugs postoperatively must be avoided.
Laparoscopic oöphorectomy for trapped ovary syndrome with occlusion of the infundibulopelvic ligament prior to division by the use of the Filshie clip
Authors: Hay D. , Xenophou X. , Powell M. , Filshie M.
Published: November 2003

This study is a review of 14 cases where laparoscopic oöphorectomy was performed for women suffering from trapped ovary syndrome, in which the Filshie clip (Femcare, Nottingham, UK) was used to occlude the infundibulopelvic ligament prior to its division. All case records where this technique had been utilized were reviewed for the period commencing September 1991 until March 1994, involving 14 women, of median age 34 years and median parity 2. The main outcome measure was resolution of chronic pelvic pain at follow up. Of the women, 10 had previously undergone hysterectomy, and two others had previously required adhesiolyses. Symptoms had been present for 6–60 months (median 12). The mean theatre time was 103.3 min ± 29.8 (SEM); 11 had a unilateral and three a bilateral oöphorectomy. The mean of the maximum diameter of specimen removed was 3.9 cm (range 2.5–6). The mean postoperative stay was 2.1 days (range 1–5). There were no serious complications. At follow up, all women reported improvement in their symptoms, with 11 reporting complete resolution of their pelvic pain. There was a good outcome in all 14 patients who had this minimal access surgical technique for trapped ovary syndrome. The Filshie clip is well suited to the purpose of infundibulopelvic ligament occlusion, being simple and easy to use. Most units possess Filshie clip applicators and trocars, and with a simple laparoscopic grasper and scissor would be equipped to perform this technique.
Laparoscopic management of a case of chronic ectopic pregnancy that had been treated as dysfunctional uterine bleeding
Authors: Huang H.‐Y. , Lee C.‐L. , Soong Y.‐K.
Published: November 2003

Chronic ectopic pregnancy is often an enigma and a correct diagnosis might not be made until surgical intervention. We report a case of a woman who had initially been treated with therapeutic abortion for an unwanted pregnancy at a private clinic. She had since suffered from persistent uterine bleeding and a negative urine pregnancy test had led to mistaken treatment for dysfunctional uterine bleeding. Chronic ectopic pregnancy was diagnosed and treated with operative laparoscopy with a satisfactory outcome. Laparoscopy may provide earlier accurate diagnosis of chronic ectopic pregnancy and the possibility of conservative management instead of salpingectomy.
Does the use of pneumoperitoneum and disposable trocars prevent bowel injury at laparoscopy? A randomized experimental study in the rabbit
Authors: Lanvin D. , Elhage A. , Querleu D.
Published: November 2003

Objectives The purpose of this experimental study was twofold. The first aim was to compare the incidence of bowel injury after prior insufflation using the Veress needle versus direct trocar insertion, and the second aim was to compare bowel injury with the use of disposable versus reusable trocars, in animals with or without prior abdominal surgery.

Design A total of 80 mature New Zealand rabbits (2400–3000 g) were randomly assigned to one of two experimental groups, with (n=40) or without (n=40) prior standardized peritoneal trauma. In each group, four subgroups (n=10 each) were constituted by randomly assigning the animals to initial insufflation using the Veress needle or direct trocar insertion and/or to reusable or disposable trocar insertion. Each animal underwent five trocar insertions. The number of bowel injuries was assessed by laparotomy.

Results As expected, the presence of experimentally induced abdominal wall adhesions significantly increased (P=0.0001) the incidence of bowel injury. When abdominal wall adhesions were present, the number of perforations was lower if initial insufflation had been performed compared with those in whom direct trocar insertion was carried out (P=0.03). There was no statistical difference in the rate of injury between disposable and reusable trocars when abdominal wall adhesions were present. However, in those without abdominal wall adhesions, the use of disposable trocars significantly decreased (P=0.04) the risk of bowel injury.

Conclusions The presence of abdominal wall adhesions increased the rate of bowel injury at laparoscopy. In the cases with prior abdominal surgery and abdominal wall adhesions, initial insufflation was safer than direct trocar insertion, but the use of disposable trocars did not improve the safety of the procedure. In the absence of prior abdominal surgery, initial insufflation using the Veress needle did not prevent bowel injury; however, in this group the use of disposable trocars proved safer than the use of reusable trocars.
Richter's hernia following operative laparoscopy
Authors: Trehan A.K.
Published: November 2003

A case of Richter's hernia following laparoscopic‐assisted vaginal hysterectomy (LAVH) is presented.
Laparoscopic treatment of prolapsed fallopian tube and ovarian vault adhesion post‐hysterectomy
Authors: Katesmark M. , Lawton F.
Published: November 2003

A case of concomitant ovarian vault adhesion and fallopian tube prolapse is presented. Difficulties encountered in the diagnosis of the condition are reviewed and the advantages of a combined but predominantly laparoscopic approach outlined.
Laparoscopic‐assisted vaginal hysterectomy with bilateral salpingo‐oöphorectomy for cyclical autoimmune dermatitis
Authors: Annan H. G. , Ceiro R. , Monson J. P.
Published: November 2003

We present a case of cyclical auto‐immune dermatitis in a 39‐year‐old woman treated effectively by laparoscopic‐assisted vaginal hysterectomy with bilateral salpingo‐oöpherectomy and followed by oestrogen‐replacement therapy.
A new laparoscopic approach for enterocoele repair
Authors: Lam A. , Rosen D.
Published: November 2003

Objective

A thorough understanding of the anatomy of the defective rectovaginal septum and vaginal supports is necessary for adequate corrective surgery. We describe a new technique for laparoscopic enterocoele repair.

Method

Between February 1995 and April 1996, 40 consecutive patients underwent laparoscopic dissection and enterocoele repair. Surgery was succesfully completed in all cases.

Results

Average time of surgery was 35 min (range 15–60) and the average length of inpatient stay was 2.2 days (1–7). One complication (bladder perforation) was repaired laparoscopically, and all patients were able to return to normal activities within 1–2 weeks.

Conclusion

This paper provides details of a promising new technique for laparoscopic repair of enterocoele, which has been shown to be effective in this first cohort of patients. Larger numbers and longer follow‐up will be required to fully establish the place of this technique.
Flexible hysteroscopy: an outpatient evaluation in abnormal uterine bleeding
Authors: Coats P. M. , Haines P. , Kent A. S. H.
Published: November 2003

Objective

To investigate the value of including flexible hysteroscopy as an investigative procedure as part of a one‐stop outpatient clinic for the investigation of abnormal uterine bleeding.

Design

A prospective study comparing the information obtained at outpatient hysteroscopy with that detected by gynaecological examination and undirected endometrial biopsy. Transvaginal ultrasound was used as an adjunct to these investigations and no formal comparison was made per se between this and hysteroscopy.

Setting

The Abnormal Uterine Bleeding (AUB) Clinic, The Royal Surrey County Hospital, Guildford 1991–1996.

Subjects

These were 1022 women (age range 18–86 years) referred by their general practitioners because of abnormal uterine bleeding. No other referral criteria, such as age, were enforced.

Main outcome measures

Incidence of benign and malignant gynaecological pathology.

Results

The true failure rate where hysteroscopy was indicated and attempted was 2.7%. No significant pathology was identified in any patient under the age of 25 years. The incidence of confirmed malignancy was 6.84 per 1000. The percentage of the total pathology identified by hysteroscopy alone, in the age group 35–39 years, was 37 out of 65 abnormalities (56.9%). This was significantly greater than in the age group 25–34 years (P = 0.017), where 16 out of 47 abnormalities (34.0%) were identified. There was no significant difference between the 35–39 and the 40–89‐years age group (P = 0.078) in which hysteroscopy identified 224 out of 494 abnormalities (45.3%).

Conclusion

Flexible hysteroscopy applied on an outpatient basis is a simple and safe investigation, acceptable to patients, which greatly enhances the detection and characterization of intrauterine pathology allowing appropriately directed treatment options. In our series the incidence of intrauterine adhesions was 1.5%, endometrial polyps 13.7%, and submucous fibroids 14.6%. We would recommend that: hysteroscopy should not be performed on women under 25 years of age; outpatient hysteroscopy should be offered as a first‐line investigation to all women over the age of 35 years presenting with abnormal uterine bleeding.
Laparoscopic management of an abdominal pregnancy
Authors: Weeks A. D. , Aagaard J. , Bromham D.
Published: November 2003

A 34‐year‐old woman was admitted at 6‐weeks gestation with a suspected ectopic pregnancy. At diagnostic laparoscopy the fallopian tubes were normal, but there was a 2‐cm haemorrhagic mass adherent to the omentum. This was removed laparoscopically using bipolar diathermy and scissors. Histology revealed a haemorrhagic mass containing chorionic villi and syncytiotrophoblast. The woman made an uneventful post‐operative recovery. The pathogenesis of abdominal pregnancies is discussed, as well as the importance of comprehensive inspection of the peritoneal cavity at diagnostic laparoscopy.
Laparoscopic myomectomy: an alternative to laparotomy myomectomy or hysterectomy?
Authors: Reich H. , Thompson K.A. , Nataupsky L.G. , Grabo T.N. , Sekel L.
Published: November 2003

We retrospectively studied, by telephone interview, the overall satisfaction rate of 65 women who underwent laparoscopic myomectomy surgery performed within an 8‐year period. Satisfaction with the choice of and result of laparoscopic myomectomy was expressed by 62 patients although 13 patients later underwent hysterectomy. A total of 19 women attempted pregnancy with 14 conceiving and 11 delivering viable neonates. Of the patients, 60 reported no change or definite improvement in libido postoperatively. The average postoperative hospital stay was 0.26 days. The advantages of laparoscopic myomectomy when compared with hysterectomy include shorter hospital stay, a more rapid recovery, superior cosmetic result and decreased morbidity. In our experience, laparoscopic myomectomy is a safe gynaecological procedure when surgeons are highly skilled and well equipped.
‘Back to the suture’ for laparoscopic‐assisted vaginal hysterectomy and BSO
Authors: Hutchon D. J. R.
Published: November 2003

The high cost of disposable stapling devices for laparoscopic‐assisted vaginal hysterectomy and bilateral salpingo‐oo¨phorectomy (LAVH and BSO) limits the cost effectiveness of the technique. A suture technique is described and the results of the first 45 cases reported. A mean length of postoperative stay of 4 days and an overall complication rate of 11% are similar to those reported for LAVH and BSO using other techniques. This suture technique has cost and safety advantages over other methods using disposable stapling devices or extensive diathermy.
Surgical trauma and metabolic changes induced by surgical laparoscopy versus laparotomy
Authors: Volz J. , Ko¨ster S. , Leweling H.
Published: November 2003

Objective The aim of the research was to compare local and systemic reactions of the body to laparotomy and laparoscopy.

Design In a prospective randomized study the operative trauma and metabolic changes in 40 patients were investigated and compared in laparoscopy and laparotomy.

Main outcome measures Metabolic changes were registered by indirect calorimetry. In order to quantify intraperitoneal trauma, short‐term and medium‐term pH measurements of the peritoneal surface were made.

Results In the case of laparoscopy a severe intraoperative chemical acidosis occurred that disappeared a short time after operation. As a result, a short‐term increase of metabolic rate was observed. Following laparotomy an increase in metabolic acidosis was registered during the first postoperative hours and had not returned to normal after 24 h. A prolonged catabolism lasted over 48 h.

Conclusion In patients undergoing laparotomy the intraperitoneal trauma is more marked than in laparoscopy. Long‐term metabolic intra‐abdominal acidosis with resulting catabolism may cause increased impairment of the organism.
The use of glycine‐ethanol irrigating fluid for the early detection of fluid absorption during endometrial resection
Authors: Hall J. M. , Tingey W. R. , Gillmer M. D. G.
Published: November 2003

Objective To evaluate the use of 1.5% glycine with 1% ethanol as a marker to detect fluid absorption during endometrial resection.

Design Prospective study.

Setting Department of Obstetrics and Gynaecology, Wycombe General Hospital, High Wycombe, UK.

Subjects 60 women having an endometrial resection for menorrhagia under general anaesthesia.

Intervention 1.5% glycine and 1% ethanol solution for irrigation.

Main outcome measures Breath ethanol concentration preoperatively, at 5‐min intervals during endometrial resection and 30 and 60 min postoperatively as measured by a hand‐held breath alcohol meter. Blood ethanol concentration, urea and electrolytes and serum ammonia were analysed at the start and the end of the procedure, and at 30 and 60 min postoperatively.

Results There was a strong positive correlation (rs=0.93, P<0.000001) between the breath ethanol concentration at the end of the procedure and the total fluid absorbed. Breath ethanol measurements were able to detect absorption of 130 ml or more. Blood ethanol measurements showed the breath ethanol measurements to be reliable. There were no adverse effects attributable to the alcohol. The fall in serum sodium from the start of the operation to the end was the most useful biochemical marker of fluid absorption (rs=0.86, P<0.000001). The rise in serum ammonia from the start of the endometrial resection to the end correlated relatively poorly with fluid absorption (rs=0.44, P=0.00058) and there was no correlation between the ammonia level at the end of the procedure and fluid absorption (rs=0.06, P=0.64).

Conclusions 1.5% glycine with 1% ethanol solution provides a safe, effective and noninvasive screening test for the detection of fluid absorption during endometrial resection.