Follicle-stimulating hormone receptor polymorphisms in a population of infertile women.

Background: There are two known polymorphisms of clinical relevance in the follicle-stimulating hormone (FSH) receptor exon 10, alanine or threonine at position 307, and asparagine or serine at position 680, giving rise to two discrete allelic variants: Thr307/Asn680 and Ala307/Ser680. At position 680, three FSH receptor variants are possible: Asn/Asn, Asn/Ser, and Ser/Ser. We hypothesized an association between FSH receptor polymorphisms and ovarian reserve.

Preoperative evaluation of laparoscopic living renal donors with computerized tomography and its effect on donor morbidity and graft function.

Objective: To assess the efficacy of CT angiography (CTA) in evaluating the renovascular anatomy in 50 patients who underwent laparoscopic donor nephrectomy, and to correlate results with donor morbidity and recipient outcome.

Methods: Forty-eight patients were evaluated by CTA prior to laparoscopy. Donors with aberrant renovasculature and their respective recipients were divided into: 1) accurate preoperative CTA ("predictive group", PG), 2) inaccurate CTA ("non-predictive group", NPG).

Myelopathy associated with melorheostosis: a case report.

A man in his mid thirties presented with lower-extremity weakness and spasticity because of a myelopathy caused by a rare disorder of bone known as melorheostosis. The primary pathology involved was compression of the cord at the cervicothoracic levels by dystrophic osseous formation within the vertebral bodies. Based on a review of existing literature, it was evident that the spine is an uncommon location to find melorheostosis, making this disease entity a unique cause of myelopathy.

Validity of the MISTELS simulator for laparoscopy training in urology.

Background And Purpose: The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) consists of a series of five laparoscopic exercises performed in an endotrainer box. MISTELS has been validated for use in both training and evaluation of general surgery residents in fundamental laparoscopic skills. The purpose of this study was to demonstrate the construct validity of MISTELS for urology residents.

A global assessment tool for evaluation of intraoperative laparoscopic skills.

Background: There is a pressing need for an intraoperative assessment tool that meets high standards of reliability and validity to use as an outcome measure for different training strategies. The aim of this study was to develop a tool specific for laparoscopic skills and to evaluate its reliability and validity.

Methods: The Global Operative Assessment of Laparoscopic Skills (GOALS) consists of a 5-item global rating scale.

Effect of laparoscopic colon resection on postoperative glucose utilization and protein sparing: an integrated analysis of glucose and protein metabolism during the fasted and fed States using stable isotopes.

Hypothesis: Using a stable isotope method to quantify postoperative changes in glucose and protein metabolism, patients undergoing laparoscopic-assisted colon resection and receiving 4 mg . kg(-1) . min(-1) of dextrose intravenously will (1) have more pronounced suppression of endogenous glucose production, leading to (2) a greater reduction in whole-body protein breakdown.

Intraoperative fluid management in laparoscopic live-donor nephrectomy: challenging the dogma.

Background: Patients undergoing laparoscopic live donor nephrectomy (LLDN) commonly receive large amounts of fluid intraoperatively to counter the negative effects of pneumoperitoneum on renal function. Our aim is to demonstrate that a low-volume fluid management strategy does not adversely affect donor or recipient outcomes.

Methods: Fifty-two patients underwent LLDN between December 2000 and January 2004.

Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator.

Background: The aim of this study was to develop summary metrics and assess the construct validity for a virtual reality laparoscopic simulator (LapSim) by comparing the learning curves of three groups with different levels of laparoscopic expertise.

Methods: Three groups of subjects ('expert', 'junior', and 'naïve') underwent repeated trials on three LapSim tasks. Formulas were developed to calculate scores for efficiency ('time-error') and economy of 'motion' ('motion') using metrics generated by the software after each drill.

Should laparoscopic paraesophageal hernia repair be abandoned in favor of the open approach?

Background: The most appropriate approach to the repair of large paraesophageal hernias remains controversial. Despite early results of excellent outcomes after laparoscopic repair, recent reports of high recurrence require that this approach be reevaluated.

Methods: For this study, 60 primary paraesophageal hernias consecutively repaired at one institution from 1990 to 2002 were reviewed.

Estrogen receptor beta is expressed in human embryonic brain cells and is regulated by 17beta-estradiol.

In order to study estrogen effects on developing human neurons, we have established primary cultures of neurons and glia from 8-13-week human embryo cortex and spinal cord. The neuronal identity of the cultures was verified using the neuronal synaptic vesicle and neuronal endosomal membrane markers synaptotagmin, synapsin and synaptophysin, and the glial contribution to the mixed glial-neuronal cultures was verified using the glial marker glial fibrillary acidic protein (GFAP). We here report expression of estrogen receptor beta (ERbeta) in these cells using RT-PCR and sequencing, RNAse protection assay, immunohistochemistry and immunoblotting.

Culture and expansion of the human embryonic stem cell line HS181, evaluated in a double-color system.

An approach of using RFP-transfected human foreskin fibroblasts (hFS-RFP) to support the growth of GFP expressing human embryonic stem cells (hES; HS181-GFP) is reported. The two-color system was applied to detect interactions between hFS and human embryonic stem cells (hES). After overnight culture, the hES cell colonies showed a behavior of "pushing away" the underlying feeder cells.

Proving the value of simulation in laparoscopic surgery.

Objective: To assess the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) physical laparoscopic simulator for construct and predictive validity and for its educational utility.

Summary Background Data: MISTELS is the physical simulator incorporated by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in their Fundamentals of Laparoscopic Surgery (FLS) program. MISTELS' metrics have been shown to have high interrater and test-retest reliability and to correlate with skill in animal surgery.

Cyclin-dependent kinase 5 associated with p39 promotes Munc18-1 phosphorylation and Ca(2+)-dependent exocytosis.

Cyclin-dependent kinase 5 (Cdk5) is a proline-directed serine/threonine protein kinase that requires association with a regulatory protein, p35 or p39, to form an active enzyme. Munc18-1 plays an essential role in membrane fusion, and its function is regulated by phosphorylation. We report here that both p35 and p39 were expressed in insulin-secreting beta-cells, where they exhibited individual subcellular distributions and associated with membranous organelles of different densities.

An ultrasound-based approach to the assessment of infertility, including the evaluation of tubal patency.

An optimal initial infertility investigation protocol would be a process that is diagnostically accurate, expeditious, cost-effective, reliable and as minimally invasive as possible. In addition, the investigation should provide the clinician with useful prognostic information regarding possible future treatment. At present, extensive use of invasive procedures such as diagnostic hysteroscopy and laparoscopy is the standard at many fertility centres.

Progesterone withdrawal causes endothelin release from cultured human uterine microvascular endothelial cells.

Background: Current theories on the physiology of menstrual bleeding in humans offers an explanation for the shedding of the endometrium as a result of a breakdown of the extracellular matrix due to an inflammatory reaction. The link between the fall in progesterone levels and these events is not clear. Neither has an explanation been presented for the vasoconstriction in the coiled arteries occurring during menses.

J-tip spring guidewire entrapment by an inferior vena cava filter.

The number of complications between guidewires and inferior vena cava filters is unknown and most likely underreported. Since 1993, at least 17 cases of central venous catheter guidewires entangled in inferior vena cava filters have been reported. The placement of both devices in the intensive care setting has increased the number of incidents in which a guidewire from a central venous catheter becomes entrapped in an inferior vena cava filter.

Early respiratory abnormalities in emergency services police officers at the World Trade Center site.

The effects of exposure to the environment around the World Trade Center after the attack of September 11, 2001, are not fully described. We evaluated 240 police first-responders; respiratory symptoms occurred in 77.5% but resolved or improved in around three fourths of subjects by the time of their evaluation (mean 69 days after the attack).

Optimization of cardiac preload during laparoscopic donor nephrectomy: a preliminary study of central venous pressure versus esophageal Doppler monitoring.

Background: While the popularity of laparoscopic donor nephrectomy (LDN) has increased, concern persists about the potential deleterious effects of pneumoperitoneum on renal function. Thus, preload optimization with vigorous intravenous hydration has been recommended. The purpose of this study was to compare central venous pressure (CVP) monitoring with a noninvasive measure of cardiac preload (esophageal Doppler) during LDN.

Relationship between objective assessment of technical skills and subjective in-training evaluations in surgical residents.

Background: Technical skills of residents have traditionally been evaluated using subjective In-Training Evaluation Reports (ITERs). We have developed the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS), an objective measure of laparoscopic technical ability. The purpose of the study was to assess the concurrent validity of the MISTELS by exploring the relationship between MISTELS score and ITER assessment.

Spinal cord injury and use of botulinum toxin in reducing spasticity.

Spasticity is commonly seen after spinal cord injury, and a large percentage of patients with spinal cord injury will need treatment to control it. Although oral medications do a fair job of controlling spasticity in most patients, some patients will need additional forms of treatment. In many cases, oral medications alone do not adequately control spasticity or the patient cannot tolerate the side effects.

Endothelin-1 and macrophage colony-stimulating factor are co-localized in human amnion membrane cells and secreted into amniotic fluid.

We have examined the cellular localization and human amniotic fluid content of endothelin-1 (ET-1) and macrophage colony-stimulating factor (M-CSF). The study material consisted of amniotic fluid from 20 patients referred for amniocentesis, and placental samples from normal deliveries. ET-1 and M-CSF were analysed by radioimmunoassay and enzyme-linked immunosorbent assay respectively.