Rectus abdominis muscle free flap harvest by laparoscopic sheath-sparing technique

Previous reports of endoscopic rectus abdominis muscle harvest have described techniques that are hampered by the need for anterior rectus sheath division or mechanical devices to maintain the optical cavity. The authors report the first successful clinical case of a laparoscopic sheath-sparing rectus abdominis muscle harvest for free tissue transfer. It offers considerable advantages over the traditional open method and, with the help of an experienced laparoscopic surgeon, it should add little to operative time.     

Surgical methods of contraception and sterilization

Many techniques for surgically sterilizing dogs and cats have been described; each technique offers advantages and disadvantages to both the patient and surgeon. Techniques that have been described include traditional midline ovariohysterectomy, lateral flank ovariohysterectomy, castration, early age gonadectomy, ovariectomy, laparoscopic ovariohysterectomy and ovariectomy, and vasectomy. Regardless of the technique selected, strict adherence to sound surgical technique and asepsis is mandatory for good surgical outcome with minimal complications. This review will discuss surgical principles, complications, outcomes, as well as relevant current literature associated with each of these techniques of surgical sterilization.     

Hand-assisted laparoscopy in urology

Hand-assisted laparoscopy (HAL) allows surgeons direct hand contact with the operative field, maximizing tactile feedback and minimizing surgical injury to the patient. Indications for HAL include radical, donor, and partial nephrectomies, nephroureterectomy, and, most recently, dismembered pyeloplasties. The advantages of HAL surgical techniques in comparative experience with standard laparoscopic technique are described.     

Laparoscopic examination of the ovaries in goats and primates

A Semm 135 degree pediatric laparoscope 5 mm in diameter has been adapted for the study of physiology in the African pygmy goat, squirrel monkey, and cynomolgus monkey. The laparoscope was attached to a Wolf Model 4000 Projector light source via a fiber optic cable. Usually 5% CO2 in air or nitrogen distended the abdominal cavity for better observation of internal organs. Insufflation was periodic rather than continuous. Uses of the technique include determination of time of ovulation and of a contraceptive's effect on the ovary. The laparoscopic technique has been used hundreds of times in the 3 species with no adverse effects. Laparoscopic and photographic techniques are described more fully.     

Laparoscopic management of ovarian cysts: an endocrinologist view.

The management of certain ovarian cysts has evolved from the traditional and often quite radical surgical approach to a more conservative approach. Much of this change can be attributed to the improvement in laparoscopic surgical technique. After a brief discussion of the differential diagnosis and clinical presentation of ovarian cysts, ultrasonographic features of certain ovarian cysts will be reviewed. Certainly the ability to characterize cysts ultrasonographically has facilitated gynecologists' ability to predict the neoplastic potential of a cyst and therefore to justify the more conservative approach. The various techniques of laparoscopic ovarian cyst aspiration, fenestration, and cystectomy will then be described.     

Vascular clamping in liver surgery: physiology, indications and techniques

This article reviews the historical evolution of hepatic vascular clamping and their indications. The anatomic basis for partial and complete vascular clamping will be discussed, as will the rationales of continuous and intermittent vascular clamping. Specific techniques discussed and described include inflow clamping (Pringle maneuver, extra-hepatic selective clamping and intraglissonian clamping) and outflow clamping (total vascular exclusion, hepatic vascular exclusion with preservation of caval flow). The fundamental role of a low Central Venous Pressure during open and laparoscopic hepatectomy is described, as is the difference in their intra-operative measurements. The biological basis for ischemic preconditioning will be elucidated. Although the potential dangers of vascular clamping and the development of modern coagulation devices question the need for systemic clamping; the pre-operative factors and unforseen intra-operative events that mandate the use of hepatic vascular clamping will be highlighted.     

Techniques to obtain uniformly growing young roots for the study of salt effects

Summary Two techniques are described for set ups to provide seedlings with regularly growing roots which may be used as biological test material for externally applied substances. The techniques were tried out with different plant species, and a model trial with wheat only is described.     

The use of techniques of sensory evaluation as a framework for teaching experimental methods

Several simple techniques of sensory assessment are described and the conditions for their satisfactory performance stated. The manner in which these experiments can be used to provide open-ended practical exercises for classes is discussed and its advantages as a relatively cheap and simple method of teaching experimentation is described. Experiments are described in which the diffusion of salt into potatoes after cooking them in boiling salted water is investigated using several techniques of sensory assessment, and other suitable areas ofinvestigation are suggested     

Rodent laparoscopy: refinement for rodent drug studies and model development, and monitoring of neoplastic, inflammatory and metabolic diseases

The refinement of surgical techniques represents a key opportunity to improve the welfare of laboratory rodents, while meeting legal and ethical obligations. Current methods used for monitoring intra-abdominal disease progression in rodents usually involve euthanasia at various time-points for end of study, one-time individual tissue collections. Most rodent organ tumour models are developed by the introduction of tumour cells via laparotomy or via ultrasound-guided indirect visualization. Ischaemic rodent models are often generated using laparotomies. This approach requires a high number of rodents, and in some instances introduces high degrees of morbidity and mortality, thereby increasing study variability and expense. Most importantly, most laparotomies do not promote the highest level of rodent welfare. Recent improvements in laparoscopic equipment and techniques have enabled the adaptation of laparoscopy for rodent procedures. Laparoscopy, which is considered the gold standard for many human abdominal procedures, allows for serial biopsy collections from the same animal, results in decreased pain and tissue trauma as well as quicker postsurgical recovery, and preserves immune function in comparison to the same procedures performed by laparotomy. Laparoscopy improves rodent welfare, decreases inter-animal variability, thereby reducing the number of required animals, allows for the replacement of larger species, decreases expense and improves data yield. This review article compares rodent laparotomy and laparoscopic surgical methods, and describes the utilization of laparoscopy for the development of cancer models and assessment of disease progression to improve data collection and animal welfare. In addition, currently available rodent laparoscopic equipment and instrumentation are presented.     

Identification and characterization of proteins binding A + U-rich elements

A + U-Rich elements (AREs) have been extensively investigated as cis-acting determinants of rapid mRNA turnover. Recently, a number of RNA-binding proteins interacting with AREs have been described. This article presents strategies and techniques used by our laboratory to identify and characterize a family of ARE-binding proteins collectively termed AUF1. However, these techniques may be applied to the study of any protein displaying sequence-specific RNA binding activity. The techniques described here include the purification of native AUF1 from cultured cells as well as the preparation of recombinant AUF1 proteins using a bacterial expression system. Analyses of RNA-protein interactions are also described, including the use of gel mobility shift assays with synthetic RNA probes to monitor specific RNA binding activity in cell extracts or with recombinant proteins. Variations of this technique are also described to evaluate the RNA binding affinity of recombinant proteins and the use of specific RNA competitors to assess RNA determinants of protein binding specificity. Other techniques presented include the identification of specific proteins in RNA:protein complexes using antibody supershifts and the estimation of molecular weights of RNA-binding proteins by UV crosslinking. Results of individual experiments are presented as examples of some techniques. Throughout the article, suggestions are included to avoid commonly encountered problems and to assist in the optimization of these techniques for the study of other RNA-binding proteins.     

Laparoscopic total and partial nephrectomy-the new standard?

Laparoscopic radical nephrectomy has been shown in long-term follow-up to provide shorter patient hospitalization and effective cancer control with no significant difference in survival compared with open radical nephrectomy. The major technical issue for success of laparoscopic partial nephrectomy is hemostatic control, and several techniques have been developed to improve control. Laparoscopic partial nephrectomy continues to evolve along two therapeutic technical avenues: hilar clamping with ischemia versus no hilar clamping. The benefits of laparoscopy for the kidney have clearly been demonstrated in terms of less pain, decreased convalescence, and decreased narcotic requirements. With short-term outcomes demonstrating laparoscopic partial nephrectomy as an efficacious procedure, the role of laparoscopic partial nephrectomy should continue to increase.     

Survey methodology for fish population assessment within Anglian water

Basic data required for the maintenance, improvement and development of inland fisheries within the Anglian Water Authority area are derived from surveys carried out since 1977. All open river systems are sampled on a 3-year cycle and basic data are obtained on species composition, density and biomass as well as year-class structure and growth rates of dominant species.
The netting and electrofishing gear and techniques used to obtain quantitative and semi-quantitative samples from rivers, drainage channels and the Norfolk Broads are described and their advantages and disadvantages discussed. The mark and recapture and multiple removal techniques employed with these methods are described and an assessment given of sampling efficiency in different situations.     

Checking of individuality by DNA profiling

A review of methods of DNA analysis used in forensic medicine for identification, paternity testing, etc. is provided. Among other techniques, DNA fingerprinting using different probes and polymerase chain reaction-based techniques such as amplified sequence polymorphisms and minisatellite variant repeat mapping are thoroughly described and both theoretical and practical aspects are discussed.     

Techniques and Significance of Gamete Collection and Storage in the Great Apes

Rectal probe electroejaculation (RPE) is the most frequently used method for semen recovery in the great apes. Artificial insemination has been successful in the chimpanzee and gorilla. Oocytes can be recovered using laparoscopic techniques similar to those used in human medicine. At this time there has been no successful in vitro fertilization with birth of an infant in the great apes. Semen can be successfully frozen in the apes, as documented by recovery of motility of sperm after thawing. Pregnancies have been initiated in the chimpanzee and gorilla using frozen thawed semen.     

Gluteus maximus myocutaneous flaps for repair of pressure sores.

Myocutaneous flaps based on the gluteus maximus muscle, and its blood supply, have many advantages for the surgical repair of pressure sores in paraplegics. These are described, as well as the techniques used in various areas.     

Soil Sampling and Isolation of Entomopathogenic Nematodes (Steinernematidae,Heterorhabditidae)

Entomopathogenic nematodes (a.k.a. EPN) represent a group of soil-inhabiting nematodes that parasitize a wide range of insects. These nematodes belong to two families: Steinernematidae and Heterorhabditidae. Until now, more than 70 species have been described in the Steinernematidae and there are about 20 species in the Heterorhabditidae. The nematodes have a mutualistic partnership with Enterobacteriaceae bacteria and together they act as a potent insecticidal complex that kills a wide range of insect species.Herein, we focus on the most common techniques considered for collecting EPN from soil. The second part of this presentation focuses on the insect-baiting technique, a widely used approach for the isolation of EPN from soil samples, and the modified White trap technique which is used for the recovery of these nematodes from infected insects. These methods and techniques are key steps for the successful establishment of EPN cultures in the laboratory and also form the basis for other bioassays that consider these nematodes as model organisms for research in other biological disciplines. The techniques shown in this presentation correspond to those performed and/or designed by members of S. P. Stock laboratory as well as those described by various authors.     

Analysing the patterning of a sequence of discrete behavioural events

Existing techniques for analysing the organization of behavioural events are discussed. Cluster analysis, mutual replaceability, ‘melody’ detection and Markov analyses are examined in order to discover the validity and usefulness of the concepts searched for by each technique, and the mathematical and statistical background of the techniques is scrutinized. Some new techniques, designed to search for and detect possible important sequential organization patterns, are described in the light of the previous criticisms. Of these techniques, the Pre-post-state Histogram (PPSH)—a multi-order Markov graphical analysis—would appear to be the most important for future work, especially when used in conjunction with the other techniques described.     

Outcome Comparison between Laparoscopic and Open Appendectomy: Evidence from a Nationwide Population-Based Study

Background

Mounting evidence supports the use of laparoscopic techniques for the treatment of simple appendicitis. However, most of the advantages of these techniques are of limited clinical relevance. This study compares the treatment outcomes of laparoscopic appendectomies and open appendectomies performed in Taiwan.

Methods

This study uses data from the 2007 to 2009 Taiwan National Health Insurance Research Database. The study sample included 65,339 patients, hospitalized with a discharge diagnosis of acute appendicitis (33.8% underwent laparoscopic appendectomy). A generalized estimated equation (GEE) was performed to explore the relationship between the use of laparoscopy and 30-day re-admission. Hierarchical linear regressions were performed to examine the relationship between the use of laparoscopy, the length of stay (LOS), and the cost per discharge.

Results

A significantly lower proportion of patients undergoing laparoscopic appendectomies were re-admitted within 30 days of their index appendectomy, in comparison to patients undergoing open appendectomies (0.66% versus 1.925, p<0.001). Compared with patients undergoing open appendectomies, patients undergoing laparoscopic appendectomies had a shorter LOS (4.01 versus 5.33 days, p<0.001) and a higher cost per discharge (NT$40,554 versus NT$38,509, p<0.001. In 2007, the average exchange rate was US$1 = NT$31.0). GEE revealed that the odds ratio of 30-day readmission for patients undergoing laparoscopic appendectomy was 0.38 (95% CI = 0.33–0.46) that of patients undergoing open appendectomies, after adjusting for surgeon, hospital, and patient characteristics, as well as for the clustering effect of particular surgeons and the propensity score.

Conclusion

This study found that laparoscopic appendectomies had a lower 30-day re-admission rate, and a shorter LOS, but a slightly higher cost per discharge than open appendectomies.     

Numerical approaches towards life cycle interpretation five examples

The ISO-standard for LCA distinguishes four phases, of which the last one, the interpretation, is the least elaborated. It can be regarded as containing procedural steps (like a completeness check) as well as numerical steps (like a sensitivity check). This paper provides five examples of techniques that can be used for the numerical steps. These are the contribution analysis, the perturbation analysis, the uncertainty analysis, the comparative analysis, and the discernibility analysis. All five techniques are described at a non-technical level with respect to basic concept, possibilities, tabular and graphical representation, restriction and warnings, and all are illustrated with a simple example.     

A novel method for the purification of recombinant subunit I of theDolichos biflorus seed lectin

Lectins are carbohydrate-binding proteins that are ubiquitous in nature. Their ability to specifically bind carbohydrates has been used as a means of purification mainly through affinity chromatography techniques. Plant lectins are one of the most thoroughly studied class of lectins, however, details of theirin situ function remains elusive. Recent advances in recombinant DNA techniques have been used in several laboratories to study the function of these lectins by heterologous over-expression. The larger subunit of theDolichos biflorus seed lectin was described by Chao et al. in 1994 and purification through affinity chromatography techniques was described. Here we report on a new method for the purification of this recombinant protein with techniques that are not dependent on the ability of the lectin to bind sugars. This method may have uses in the purification of mutant proteins that may not bind carbohydrates. Characterization of the purified protein by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and matrix-assisted laser desorption ionization (MALDI) mass spectroscopy shows that the lectin is over 99% pure with a molecular weight of 27,090±16.17 Da, and hemagglutination assays confirm that the lectin retains its biological activity.