bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the SAND balloon catheter for the laparoscopic surgery of benign ovarian cysts
Authors: Yamada Takashi , Okamoto Yukiko , Kasamatsu Hajime 
Published: March 2003

ObjectiveWe studied the advantages and disadvantages of using the newly developed SAND balloon catheter for the laparoscopic treatment of benign ovarian cysts and hydrosalpinx.MethodsThe SAND balloon catheter, which has two balloons at the tip, can hold and extend the ovarian cyst, which allows suction of the cystic fluid, and irrigation of the cystic cavity. Laparoscopic surgery using this catheter was carried out in 36 cases of ovarian or uterine cysts, or hydrosalpinx (32 patients).ResultsThe cystic fluid in all 36 cases was successfully aspirated without gross identification of spillage. Adhesiolysis of the cyst was easily done by pulling the ovarian cyst with the SAND balloon catheter. None of the 36 cysts ruptured during aspiration and irrigation. The balloon did not slide during the procedure in any of the 36 cases. In 16 of the 32 patients who underwent the laparoscopic procedure, a conservative cystectomy procedure, in which only the cyst was excised, was performed. In the remaining 16 patients, oöphorectomy was performed.ConclusionsThe SAND balloon catheter was extremely useful for aspirating the cystic fluid, and for the irrigation and excision of the cyst, during the laparoscopic surgery of benign ovarian cysts.
Cerebellar infarction after uncomplicated laparoscopic hysterectomy
Authors: Meltomaa Seija S. , Mäkinen Juha I. , Niskanen Riitta M. , Salonen Markku A. 
Published: March 2003

ObjectiveTo review a case of cerebellar infarction after uncomplicated laparoscopic hysterectomy.MethodsThe clinical course and radiological findings in a 45‐year‐old previously healthy woman are reviewed.ResultsThe patient suffered from headache and dizziness from the first postoperative day after a surgically uncomplicated laparoscopic hysterectomy. At 1 week after the operation she was readmitted because of continuing symptoms. Computer tomographic scan results of the brain were normal, while magnetic resonance imaging revealed two small infarctions in the right cerebellar hemisphere. At 3 years after the operation she still has mild neurological symptoms and is not capable of her previous work.ConclusionHaemodynamic changes related to head‐down tilt position combined with pneumoperitoneum may have hazardous effects on the brain even in previously clinically healthy patients.
Uterine serous papillary carcinoma arising inside an endometrial polyp removed by hysteroscopy
Authors: Maia Hugo , Maltez Amélia , Rodrigues Maíta , Coutinho Elsimar M. 
Published: March 2003

Objective  To describe a papillary, serous carcinoma arising in an endometrial polyp. Setting  Endoscopy unit of a private, urban hospital. Interventions  The polyp was diagnosed by hysteroscopy. Polypectomy was carried out using the 27F resectoscope. Steroid receptors and over‐expression for p53 and c‐erb B2 protein were investigated in the polyp by immunohistochemical methods. Results  There was a focal area of papillary serous carcinoma in the endometrial polyp. The malignant neoplasm showed over‐expression for p53 and c‐erb B2 oncoprotein and absence of oestrogen and progesterone receptors. Conclusions  Alteration in the p53 tumour suppressor gene was an early event in the process of carcinogenesis in the polyp of this patient. This was associated with loss of steroid receptors and c‐erb B2 amplification.
Follow‐up of complaints and recurrence after laparoscopic surgery of benign adnexal tumours
Authors: Weemhoff Mirjam , Van Beek Johannes J. 
Published: March 2003

Objective To examine the long‐term experience of laparoscopic cystectomy for benign adnexal tumours by analysing follow‐up visits, ultrasound re‐examination and questionnaires. Results Recurrence of benign nonfunctional ovarian cysts treated by cystectomy, after an average follow‐up of 23 months, was 4.8%, and 3% of the patients had some minor postoperative complications. Of the women who wanted to become pregnant after conservational treatment, 51% succeeded. Complaints decreased significantly after the operation and these changes persisted. Conclusion After conservational laparoscopic surgery of adnexal cysts, complaints decreased significantly and the patients fulfilled the desire of pregnancy in around 50% of cases. The recurrence rate is low and only a few postoperative complications occurred.
Operative transvaginal hydrolaparoscopy of a large ovarian endometrioma
Authors: Gordts Stephan , Campo Rudi , Brosens Ivo 
Published: March 2003

Objectives  The purpose of this case report is to describe the feasibility of transvaginal underwater surgery for reconstruction of the ovary with a large endometrioma. Design  Descriptive study. Setting  Tertiary referral centre for reproductive medicine. Interventions Transvaginal hydrolaparoscopy and bipolar surgery were used as the techniques for access and surgery of a large ovarian endometrioma. Results  A two‐step procedure was performed with the first step under general anaesthesia and the second under conscious sedation. Transvaginal hydrolaparoscopy allowed easy access, bloodless dissection of the adhesions and marsupialization and coagulation of the endometrioma. Conclusions  The report proves the feasibility of reconstruction of the ovary with a large endometrioma using the new technique of transvaginal hydrolaparoscopy. The technique has the advantage of easy access to the endometrioma and accurate dissection and coagulation of adhesions. The low morbidity makes a two‐step technique more acceptable to the patient.
Hysteroscopy in women aged 30 years or less
Authors: Miskry Tariq , Ruach Meir , Magos Adam 
Published: March 2003

Objective  To determine the incidence of intrauterine pathology at hysteroscopy in women aged 30 years or less. Design  Retrospective review. Setting  Minimal access surgery unit at a tertiary referral centre. Subjects  Women aged 30 years or less with persistent menstrual disturbance presenting for outpatient hysteroscopy. Intervention  All patients had diagnostic pelvic ultrasound and diagnostic hysteroscopy. Main outcome measure  Incidence of intrauterine pathology amenable to surgery. Results  41 instances of women presenting with abnormal bleeding were analysed. Hysteroscopy demonstrated intrauterine pathology in 16 patients (39%). Surgical treatment was suitable in 10 (24.4%). In over 20% of cases, hysteroscopy findings failed to agree with ultrasound appearances. Conclusions  Hysteroscopy should be considered in women under 30 presenting with persistent menstrual disturbance irrespective of the ultrasound findings.
Three minimal access procedures to treat menorrhagia in one patient: bipolar myolysis, uterine artery embolization and a transcervical fibroid resection
Authors: Jones Kevin , Walker Woodruff J. , Sutton Christopher 
Published: March 2003

Objective  To report the case history of a patient who underwent bipolar myolysis, uterine artery embolization and a transcervical fibroid resection, to treat menorrhagia. Methods The clinical records of the patient were reviewed. Results The clinical and radiological findings demonstrated large intramural fibroids that decreased in size, but were not removed completely following each of the three minimal access procedures. Conclusion This is the only case reported in the literature of three minimal access procedures being carried out in one patient to treat symptomatic fibroids.
Use of the ultrasonically activated scalpel in laparoscopic resection of a noncommunicating rudimentary uterine horn
Authors: Creighton Sarah , Minto Catherine L. , Cutner Alfred 
Published: March 2003

Objective  This case report describes for the first time a method of laparoscopic removal of a rudimentary uterine horn using the ultrasonically activated scalpel. Conclusions This instrument cuts and coagulates with minimal tissue injury and excellent haemostasis and, in conjunction with the electronic morcellator, significantly reduced our operating time. This report also highlights the common misdiagnosis of congenital müllerian anomalies, leading to increased morbidity and inappropriate surgery. We would like to alert clinicians to the importance of adequate investigation, including hysteroscopy and magnetic resonance imaging, to optimize surgical evaluation and maximize future reproductive potential.
Repetitive stereotactics: an inanimate laboratory technique to improve hand–eye coordination in laparoscopy
Authors: Kingston Ashley J. , Broome Jonathan D. , Vancaillie Thierry G. 
Published: March 2003

ObjectiveTo assess an inanimate laboratory technique to improve hand–eye coordination in laparoscopy.Subjects12 members of the medical staff at the Royal Hospital for Women, Sydney, were stratified into three groups: (1) young with no previous laparoscopic experience, i.e. first‐year resident; (2) young with some previous experience, i.e. registrar, and (3) mature with extensive experience in operative laparoscopy, i.e. established surgeon.MethodsA planned, sequentially more difficult programme of hand–eye coordination exercises using a pelvi‐trainer was established. Performance was measured by recording the time taken for each subject to successfully and accurately complete each exercise.ResultsAll subjects showed an improved performance in completing the described exercises. Group 1, showed the most improvement. Group 3 showed the least improvement but demonstrated the best performance. All groups demonstrated a similar performance by the end of the course.ConclusionThe pelvi‐trainer in conjunction with a structured series of exercises appears to allow a trainee to improve hand–eye coordination significantly. Considering that the same equipment is used as that in the operating theatre, it is reasonable to expect similar improvement in actual surgery.
Complications of laparoscopy: a tautological audit
Authors: Tsaltas Jim , Healy David L. , Lloyd David 
Published: March 2003

ObjectivesThe purpose of this study was to perform an audit continuing from the first series of 6500 consecutive laparoscopies from one centre. Since that time there have been a further 4448 consecutive laparoscopies at the same centre, making the total number 11 448 laparoscopies. The debate continues to rage concerning entry techniques at laparoscopy. One of the objectives of this study was to look again at the risks involved with the use of Veress needle and closed trocar entry techniques.DesignAll the major complications from laparoscopies performed between 1 April 1995 and 28 February 1999 were documented. This is again the largest series to date from any one centre. Each laparoscopy was registered on computer. A distinction between operative and diagnostic laparoscopy was not made.ResultsA major complication was defined as one which required laparotomy. In this second series, there was only one complication. The incidence of major complications was thus 0.2 per 1000. The incidence in our previous series was 1.23 per 1000. The combined incidence from both series is 0.78 major complications per 1000 cases. In neither series was there a vascular injury as a result of using a Veress needle or closed trocar entry technique.ConclusionThis ongoing audit, and in particular the combined figures from both our audits, shows that there is currently no evidence to suggest that the Veress needle should be banned in favour of the open Hasson technique.
Recurrent laryngeal nerve paralysis after laparoscopic surgery
Authors: Yamada Takashi , Okamoto Yukiko , Kasamatsu Hajime , Umegaki Hiroshi , Mori Hiroshi 
Published: March 2003

To present a case of recurrent laryngeal nerve paralysis after laparoscopic surgery.A 26‐year‐old nulligravid woman.The patient underwent laparoscopic left ovarian cystectomy and myomectomy under general anaesthesia. A few hours later, she complained of throat discomfort and hoarseness. Indirect laryngoscopy showed an immobile left vocal cord. The hoarseness continued for 4 weeks.Recurrent laryngeal nerve paralysis might present as a complication of laparoscopic surgery under general anaesthesia.
A national survey of outpatient hysteroscopy
Authors: Rogerson Lynne , Duffy Sean 
Published: March 2003

To look at the current practice in outpatient hysteroscopy, in particular to determine the availability, staffing levels, equipment used, and facilities throughout the UK, and to ascertain why the service is not more widely available for patients.A postal questionnaire with no follow up for non‐responders.National survey throughout the UK.All consultant gynaecologists throughout the UK.These were: the availability of outpatient hysteroscopy nationally; the reasons why outpatient hysteroscopy is presently not available in some units, and whether this facility was wanted in those units.1148 questionnaires were mailed with 637 responses (55.5%), representing 80.7% of gynaecology units throughout the UK. Of the respondents, 55.6% had access to outpatient hysteroscopy, and of the respondents without access 77.7% would have liked the facility to be available. The reasons given for the lack of an outpatient hysteroscopy service were: lack of funding (35%); unavailable facilities (35%); alternative investigations employed (21.9%); not clinically appropriate (4.9%), and not cost‐effective (3.2%).Outpatient hysteroscopy is available but its extent could be improved. The clinics are generally run once per week, with about six patients per clinic. It appears to be a consultant‐led service, and most of those consultants who do not have access to outpatient hysteroscopy would like the facility to be available but do not have the funding or facilities.
Hysteroscopic septal resection, the treatment of choice in patients with subseptate uterus: postoperative pregnancy rates
Authors: Oppelt Peter , Siebold Julia , Stähler Jan , Plathow Daniela , Kaufmann Manfred , Baumann Rudolf 
Published: March 2003

ABSTRACTObjective Hysteroscopic septal resection for subseptate uterus is a modern alternative to the classic procedures of Tompkins and Jones. We therefore investigated whether this new operation, which is less stressful for the patient, and can usually be carried out on an outpatient basis, can produce results similar to those of the classic laparotomy methods in patients receiving treatment for infertility.Design Questionnaires were sent to 14 women who had undergone hysteroscopic surgery for infertility and known subseptate uterus at the University Department of Gynaecology in Frankfurt‐am‐Main.Results Nine patients responded, six of whom had become pregnant after hysteroscopic resection of the septum. This corresponds to the results achieved with laparotomy methods.Conclusion These results, like those of the few other studies on the topic in the literature, show that hysteroscopic septal resection in infertile patients offers a low‐stress, fast and outpatient alternative to the elaborate classic techniques of Tompkins and Jones.
Therapeutic embolization and surgical excision of haemophilic pseudotumour
Authors: Sevilla  , Alvarez  , Hernández  , Canales  , De Bustos  , Magallón  , Garzón  , Hernández‐Navarro  
Published: March 2003

Haemophilic pseudotumour is a rare complication of haemophilia. Few cases of iliac haemophilic pseudotumour have been reported in the literature. These tumours can act as a focus for infection and cause cutaneous fistulas. When they present perforations and infections of endogenous origin their course is usually fatal.Suitable treatment has been investigated on numerous occasions, most of the literature agreeing that the only curative treatment is surgical resection.We present a case of haemophilic pseudotumour of the iliac and caecum with cutaneous fistulas, with a septic process of endogenous origin. It was treated with surgical resection after performing arterial embolization to reduce the vascularization of the pseudotumour, thereby reducing its size and the risk of bleeding complications during surgery.
Controlling acute bleeding episodes with recombinant factor VIIa in Haemophiliacs with inhibitor: continuous infusion and bolus injection
Authors: Chuansumrit  , Isarangkura  , Angchaisuksiri  , Sriudomporn  , Tanpowpong  , Hathirat  , Jorgensen  
Published: March 2003

The efficacy of recombinant activated factor VII (rFVIIa, NovoSeven) in five Haemophiliacs (four Haemophilia A, one Haemophilia B), with high inhibitors ranging from 70 to 1900 Bethesda units, was evaluated. The treatment regimen was divided into two groups: group I, continuous infusion of 16.5 μg h–1 kg–1 body weight (bw) after the initial bolus of 90 μg kg–1 bw in three episodes of severe bleeding and group II, bolus injection 80–150 μg kg–1 bw every 3 hours for a maximum of four doses in six haemarthroses. The bleeding was effectively controlled within 1 to 48 h in five of nine bleeding episodes. One patient in group I, who had active arterial bleeding requiring sutures, had an ineffective response and three patients in group II had partially effective responses because the rFVIIa was given after the onset of bleeding at 36, 44 and 72 h, respectively. The prothrombin time was shortened and the FVII:C levels were successfully achieved at approximately 10 U mL–1. The continuous infusion reduced the total dose of rFVIIa by 50%. Recurrent bleeding episodes were found in three patients; two occurred at the same site after ceasing rFVIIa for 51 h and while receiving rFVIIa at 144 h and one occurred at a new site after ceasing rFVIIa for 12 h.Our experience would suggest that rFVIIa is effective in controlling acute bleeding episodes in Haemophiliacs with high inhibitors either by continuous infusion or bolus injection.
Reproductive choices for couples with haemophilia
Authors: O. Oyesiku J. O. , Turner C. F. 
Published: March 2003

Summary. The impact of having a child with an inherited bleeding disorder such as haemophilia can have a far‐reaching effect on the individual as well as other close family members. This situation is further complicated in the case of human immunodeficiency (HIV) serodiscordant couples, where the haemophilic man is affected with HIV through infected blood products whilst his partner is seronegative and wanting to have children.It is essential that information on the effects of haemophilia, its inheritance, the possibilities of antenatal diagnosis, the consideration of selective abortion and the new reproductive opportunities available to these couples are made accessible so that an informed decision about proceeding with having a family can be made.Couples may wish to have a family through nonreproductive methods such as fostering or adoption. Alternatively, they may wish to remain childless. In this paper, the terms ‘having children’ and ‘having a family’ will refer to conception through biological reproduction.Pre‐implantation genetic diagnosis (PGD) offers families at risk of having a child with certain inherited genetic disorders the opportunity to give birth to an unaffected child. It may be considered as an option for couples who would not wish to have prenatal diagnosis leading to possible termination of a pregnancy.Assisted conception techniques, such as ‘sperm washing’ or the use of ‘donor sperm’, offer serodiscordant couples affected by HIV a risk‐reduced or risk‐free opportunity, respectively, to have a child without infecting the mother, who could in turn infect the fetus by vertical transmission.This article, in addition to outlining the inheritance of haemophilia and the more common prenatal screening and diagnostic tests, discusses in more detail the latest reproductive opportunities available for families affected by haemophilia and considering having a family.
The impacts of people and livestock on topographically diverse open wood‐ and shrub‐lands in arid north‐west Namibia
Authors: Sullivan Sian 
Published: March 2003

Summary 1. It is generally considered that the open woodlands of north‐west Namibia are experiencing widespread degradation due to over‐use of resources by local herders. 2. Data are presented regarding community floristics, diversity, density, cover and population structure for woody vegetation. These are analysed in relation to abiotic factors of topography and substrate, and to settlement impacts represented indirectly by distance from settlement and directly by measures of branch cutting and browsing. 3. None of the vegetation indices upheld predicted patterns of degradation except on a small scale, confined to within settlements. Moreover, in nearly all cases, local settlement effects were within the range of variability observed at larger scales. 4. It is concluded that continuing perceptions and fears of degradation in this area relate more to ideology than evidence. In particular, it is argued that factors conferring resilience and persistence on both the environment and the regional herding economy are obscured by: (1) disregard for the implications of spatial and temporal scale in interpretations of ecological data; (2) a conceptual adherence to equilibrium dynamics that stresses density‐dependent impacts of people and livestock over and above the role of abiotic factors in constraining and driving primary productivity; and (3) remnants of a colonial ideology, which tends to view ‘traditional communal farming’ practices as environmentally degrading.
Implications of land use change for the production of plant biomass in densely populated Sahelo‐Sudanian shrub‐grasslands in north‐east Nigeria
Authors: Mortimore Michael , Harris Frances M. A. , Turner Beryl 
Published: March 2003

SummaryThe production of plant biomass on small farms and in woodland in densely populated locations in the Nigerian Sahelo‐Sudan is estimated in order to test the hypothesis that conversion of land from natural vegetation to cultivation entails a loss in plant productivity. Estimates are given for reserved forest, woodland, shrubland and farmland at two sites varying in mean annual rainfall and population density. The results fail to support the hypothesis. The role of farmers in causing degradation through loss of plant productivity, and appropriate conservation strategies, may require re‐evaluation.
Macroecology and consilience
Authors: Maurer Brian A. 
Published: March 2003

AbstractConsilience means that all fields of human knowledge should be internally consistent. Within the broad span of the ecological and evolutionary sciences, there are many fields that seem only remotely related conceptually. Macroecology has emerged as a research programme that focuses on statistical patterns of ecological and biogeographically relevant traits among different species within a taxon. The concepts needed to understand these patterns require the interface of disciplines as different as systematics, ecosystem ecology, palaeontology and community ecology. By building conceptual links among a wide range of disciplines, macroecology is contributing, and will continue to contribute, to the growing realization that all of biology is indeed consilient.