Five Methods of Tubal Sterilization.

We prospectively compared five methods of interval tubal sterilization: minilaparotomy Pomeroy (ML), laparoscopic coagulation (C), laparoscopic Falope ring (FR), laparoscopic Pomeroy with endoloops (E), and laparoscopic Hulka clip (H). The 114 women undergoing interval sterilization were interviewed by nurses using a structured data-abstraction instrument immediately postoperatively, and 24 hours and 2 weeks postoperatively to compare pain, vomiting episodes, overall satisfaction with the surgical experience, and time to resuming activities. Operating time, time in the recovery room, and cost of medical supplies also were compared.

A critical pathway to treat proximal lower-extremity deep vein thrombosis.

To address variation in treatment of deep vein thrombosis (DVT) while maximizing the efficiency and quality of care, our institution developed a critical pathway guideline. This paper presents this critical pathway and the clinical rationale underlying its recommendations. The DVT pathway synthesizes recommendations for all aspects of patient care, including laboratory evaluation at admission, dosing and management of heparin therapy, timing of warfarin initiation, elements of patient education, discharge planning, and anticipated duration of heparinization and hospitalization.

Informational orthogonality of two-dimensional chromatographic separations.

A qualitative informational similarity technique has been used to describe the informational orthogonality of projected two-dimensional (2-D) chromatographic separations of complex mixtures from their one-dimensional 1-D separations. The reversed-phase liquid chromatography (RPLC), supercritical fluid chromatography (SFC), gas-liquid chromatography (GLC), and micellar electrokinetic capillary chromatography (MECC) retention behavior of up to 46 solutes of varying molecular properties was studied by 2-D range-scaled retention time plots and information entropy calculations. One hundred five combinations of technique/stationary phase pairs were used to simulate the 2-D chromatographic analyses.

A simple modification to add strength to the Roeder knot.

The Roeder knot is commonly used during laparoscopic suturing because it may be tied extracorporeally and slid down to the target tissue with a single pass of a knot pusher. However, it is significantly weaker than extracorporeally tied knots with several throws. We compared the usual Roeder knot to one that was modified by adding a fourth loop around the standing end of the suture and a second half-hitch to the completed knot.

Silver(I)-mediated separations by capillary zone electrophoresis and micellar electrokinetic chromatography: argentation electrophoresis.

The addition of Ag(I) to the run buffer in capillary zone electrophoresis (CZE) and micellar electrokinetic chromatography (MEKC), containing sodium dodecyl sulfate, applies the principles of argentation chromatography to electrophoretic separations and is termed "argentation electrophoresis". This technique is shown to provide a complementary method to CZE and MEKC for the separation of specific types of solutes that selectively complex with Ag(I). Baseline resolution in the CZE separation of nine sulfonamides is achieved by the addition of 50 mM silver nitrate to the run buffer.

Segregation of autoantibodies with disease in monozygotic twin pairs discordant for systemic sclerosis. Three further cases.

Objective: To study the serologic status of 3 previously unreported monozygotic twin pairs discordant for systemic sclerosis (SSc).

Methods: Autoantibodies were measured by indirect immunofluorescence, immunodiffusion, and immunoprecipitation of 35S-labeled cell lines. Major histocompatibility complex (MHC) class II allele typing and DNA fingerprinting were used to confirm monozygosity.

Laparoscopic sacral colpopexy and other procedures for prolapse.

The repair of pelvic support defects is a demanding task. Irrespective of the route or repair chosen by the surgeon, sound surgical judgement, complete understanding of pelvic anatomy and the mechanisms involved in pelvic organ prolapse, and expertise in pelvic surgery are required if successful outcomes are to be expected. Laparoscopic surgery offers a substitute for conventional open abdominal surgery which, in our hospital, now has a record of low complication rates, speedy discharge and recovery times with outcomes that are equal to those achieved by conventional abdominal surgery.

Clinical indications for hysterectomy route: patient characteristics or physician preference?

Objectives: Our purpose was to compare the indications, characteristics, surgical management, and outcomes of patients undergoing total abdominal hysterectomy, total vaginal hysterectomy, and laparoscopically assisted vaginal hysterectomy and to assess whether patients who underwent abdominal hysterectomy might have been candidates for laparoscopically assisted vaginal hysterectomy and whether patients who underwent total abdominal hysterectomy or laparoscopically assisted vaginal hysterectomy might have been candidates for total vaginal hysterectomy.

Study Design: The hospital charts of 502 women who underwent elective inpatient hysterectomy at a single large general hospital between January 1992 and November 1993 were abstracted retrospectively by use of a structured data abstraction instrument. The study included patients operated on by 16 different experienced gynecologists.

Laparoscopic knot strength: a comparison with conventional knots.

Objective: To compare the strength of laparoscopic knots with those used at laparotomy.

Methods: Three types of laparoscopic knots commonly used (Roeder, extracorporeal sliding square, and intracorporeal two-turn flat square) and three widely used conventional knots (flat square, surgeon's square, and sliding square) were tied using seven suture materials. Each knot was tied five times in random order by a single surgeon in a pelvic training model.

Retention and selectivity of flavanones on homopolypeptide-bonded stationary phases in both normal- and reversed-phase liquid chromatography.

Three linear polymers of repeating amino acid units, or homopolypeptides, have been individually covalently bonded to microparticulate silica and evaluated for liquid chromatographic separations. The retention and selectivity of seven flavanones were investigated on these stationary phases and a structurally similar, commercially available reference stationary phase, Chiraspher. All three of the homopolypeptide stationary phases retain solutes in the normal-phase mode.

Effect of anonymous test grading on passing rates as related to gender and race.

Background: Concerns about potential bias in the grading of medical students at the Southern Illinois University School of Medicine led to a major institutional policy change whereby students' identities were masked during the test-grading process. The present study assessed the effect of this anonymous test grading policy by comparing the performance of men and women students and of white and African American students prior to and after adoption of the policy change.

Method: A test-passing rate was determined for each of 476 freshmen students in the comparison groups from the eight classes of 1988 through 1995.

Arsenic speciation by micellar liquid chromatography with inductively coupled plasma mass spectrometric detection.

Four environmentally and biologically important arsenic species, dimethylarsenic acid (DMA), monomethylarsonic acid (MMA), As(III) and As(V) are separated by micellar liquid chromatography. Linear dynamic ranges for the four species are three orders of magnitude and detection limits are in the picogram range with inductively coupled plasma mass spectrometric (ICP-MS) detection. This paper discussed in detail the development of the chromatographic conditions.

Estimation of liquid-vapor critical loci for CO2-solvent mixtures using a peak-shape method.

Critical-mixture curves for 13 CO2-solvent binary mixtures were estimated using the peak-shape method. Mixture critical points were determined within 1 degrees C and 1 atm. The results for CO2-toluene and CO2-methanol were compared to previously reported data from high-pressure view cell studies.

Bioavailability estimation by reversed-phase liquid chromatography: high bonding density C-18 phases for modeling biopartitioning processes.

There have been many attempts to estimate biological activity with either 1-octanol/water partition coefficients or chromatographic retention parameters. Bulk phases may not be appropriate, however, for modeling a partitioning process in an interphase such as biological membranes. Chromatographic stationary phases can be argued as having structure similar to a membrane because of chain organization; however, the density of the grafted stationary-phase chains in commercially available stationary phases is much too low to provide a suitable model.

Silica-based room temperature phosphorescence substrates: wide dynamic ranges, low background, and programmable figures of merit.

The use of silica-based substrates for room temperature phosphorescence (RTP) was investigated. Contrary to reports in the literature, bare silica was shown to provide higher sensitivity (S/B) for RTP than filter paper when the specific surface areas of the two substrates were similar. The surface heterogeneity of bare silica resulted in nonlinear, discontinuous response curves for a model analyte, phenanthrene.

Phosphorimetry and its potential for the study of surface heterogeneity of chromatographic silica-based stationary phases.

Phosphorimetry was applied to the study of silica-based chromatographic phase surface heterogeneity by determining the phosphorescence response of a phenanthrene probe as a function of loading on underivatized silica and reversed and ion-exchange phases. The phosphorescence response was used to "titrate" and estimate the number of strong adsorption sites on underivatized silica. By incorporating covalent vs.

Synthesis and characterization of silica-based aliphatic ion exchangers.

The chemical literature describing preparation of aliphatic ion exchangers is limited, and although such phases are available commercially, the synthetic schemes are proprietary. The course of our research required the preparation of silica-based aliphatic cation and anion exchangers for which the desired base silica and/or ligand properties were not commercially available. We developed synthetic schemes to prepare silica-based aliphatic sulfonic acid, carboxylic acid and quaternary ammonium ion-exchange phases with active exchange capacities of 0.

Metalloporphyrin speciation by liquid chromatography and inductively coupled plasma-mass spectrometry.

Inductively coupled plasma-mass spectrometry is investigated for the detection of metalloporphyrins (cobalt protoporphyrin, hemin, and zinc protoporphyrin) separated by liquid chromatography. A Hypersil SAS C1 column with mobile phase containing 68% methanol at a pH of 4.5 is used.

Laparoscopic procedures for incontinence and prolapse.

Laparoscopic surgery for genuine stress incontinence (GSI) and vaginal vault prolapse is in an early stage of development. There is a great deal of talk about the subject at meetings and postgraduate courses; however, very little has been written on the subject and there are virtually no controlled studies to compare outcomes with the conventional surgical methods that will be mentioned in this review. Most laparoscopic surgeons will emphasize that laparoscopic repairs are performed either 'exactly like' or in a similar fashion to open abdominal techniques, but there is still a need for data to prove that outcomes are equivalent.