Synthesis and Performance of Biobased Surfactants Prepared by the One-Pot Reductive Amination of l-Arabinose and d-Galacturonic Acid.

Herein, we report a method for the synthesis of biobased surfactants derived from sugar beet pulp (SBP) monosaccharides, l-Ara and d-GalA. The surfactants were prepared via one-pot reductive amination, allowing the introduction of different alkyl chain lengths and methyl modifications. Optimal reaction conditions were established to achieve high yields and easy purification.

Colon carcinoma presenting as ovarian metastasis.

An adnexal mass is a common gynecological finding. Most adnexal masses are benign neoplasms, especially in premenopausal women. Yet, here we report a premenopausal woman with an adnexal mass that turned out to be an ovarian metastasis from colon cancer.

Immediate versus delayed removal of urinary catheter after laparoscopic hysterectomy: a randomised controlled trial.

Objective: To evaluate if immediate catheter removal (ICR) after laparoscopic hysterectomy is associated with similar retention outcomes compared with delayed removal (DCR).

Study Design: Non-inferiority randomised controlled trial.

Population: Women undergoing laparoscopic hysterectomy in six hospitals in the Netherlands.

Value of an objective assessment tool in the operating room.

Background: Concerns about the achievement of surgical proficiency during residency are increasing. To objectify surgical skills, the Objective Structured Assessment of Technical Skills (OSATS) was developed and proven valid, feasible and reliable for use in laboratory settings. This study aimed to evaluate the value of this tool for intraoperative use.

Are minimally invasive procedures harder to acquire than conventional surgical procedures?

Background: It is frequently suggested that minimally invasive surgery (MIS) is harder to acquire than conventional surgery. To test this hypothesis, residents' learning curves of both surgical skills are compared.

Methods: Residents had to be assessed using a general global rating scale of the OSATS (Objective Structured Assessment of Technical Skills) for every procedure they performed as primary surgeon during a 3-month clinical rotation in gynecological surgery.

Implementation of laparoscopic hysterectomy: maintenance of skills after a mentorship program.

Background: To evaluate the implementation and maintenance of advanced laparoscopic skills after a structured mentorship program in laparoscopic hysterectomy (LH).

Methods: Cohort retrospective analysis of 104 successive LHs performed by two gynecologists during and after a mentorship program. LHs were compared for indication, patient characteristics and intraoperative characteristics.

Implementation of advanced laparoscopic surgery in gynecology: national overview of trends.

Study Objective: To estimate the implementation of laparoscopic surgery in operative gynecology.

Design: Observational multicenter study (Canadian Task Force classification II-2).

Setting: All hospitals in the Netherlands.

Retention of basic laparoscopic skills after a structured training program.

The purpose of this study was to test the retention of basic laparoscopic skills on a box trainer 1 year after a short training program. For a prior study, eight medical students without prior experience (novices) underwent baseline testing, followed by five weekly training sessions and a final test. During each of seven sessions, they performed five tasks on an inanimate box trainer.

Skills training in minimally invasive surgery in Dutch obstetrics and gynecology residency curriculum.

The complexity of acquiring minimally invasive surgical (MIS) skills, combined with smaller case volumes for residents have pushed the development of skills training facilities on simulators outside the operating room (OR). Medico-legal and financial constraints have stimulated this development even more. However, the implementation of simulator training into a residency curriculum is shown to be troublesome.

Preoperative predictors of postsurgical adhesion formation and the Prevention of Adhesions with Plasminogen Activator (PAPA-study): results of a clinical pilot study.

Objective: To identify predictors of postsurgical adhesion formation in peritoneal fluid and plasma, and assess efficacy and safety of reteplase (recombinant plasminogen activator [r-PA]).

Design: Prospective randomized study.

Setting: University Medical Center.

The influence of experience and camera holding on laparoscopic instrument movements measured with the TrEndo tracking system.

Background: Eye-hand coordination problems occur during laparoscopy. This study aimed to investigate the difference in instrument movements between the surgeon him- or herself holding the camera and an assistant holding the camera during performance of a laparoscopic task and to check whether experience of the surgeon plays a role in this issue.

Methods: The participants were divided into three groups: experts, residents, and novices.

Teach the teachers: an observational study on mentor traineeship in gynecological laparoscopic surgery.

Background: To evaluate the effect of a mentor traineeship in laparoscopic surgery in a teaching hospital.

Method: This observational study was performed between January 1997 and December 2004 at Bronovo Hospital, The Hague, The Netherlands. Since January 2001, an advanced endoscopic gynecologist has mentored a trainee in laparoscopic surgery.

Implementation of the laparoscopic simulator in a gynecological residency curriculum.

Background: In view of the current emphasis on increasing patient safety and quality control in laparoscopic surgery, there is a growing need to improve laparoscopic training. This study was conducted to investigate if and when residents reached performance standards for basic laparoscopic skills on a boxtrainer and to analyze the current state of implementation of laparoscopic simulators in a gynecological residency curriculum.

Methods: Residents across all 6 years of residency (postgraduate year [PGY] 1-6) were tested once on our boxtrainer by performing five inanimate tasks (pipe cleaner, rubber band, beads, cutting circle, intracorporeal knot tying).

Implementation of hysteroscopic surgery in The Netherlands.

Objective: This study was conducted to assess the degree of diffusion of hysteroscopic surgery in gynaecological practice in The Netherlands in order to guide further implementation. The diffusion was objectified by defining the percentage of hospitals performing hysteroscopic procedures and the number of different procedures performed per gynaecologist.

Study Design: In 2003 all Departments of Gynaecology (n=102) in The Netherlands were sent a questionnaire.

Operative laparoscopy in The Netherlands: Diffusion and acceptance.

Objective: To evaluate and update the current status of the implementation of operative laparoscopy in gynaecology in The Netherlands by assessing diffusion and acceptance of each specific procedure per hospital.

Study Design: In 2003 a questionnaire was sent to all hospitals (n = 102), which addressed the total number and type of laparoscopic procedures performed in 2002 stratified by level of difficulty (level 1: diagnostic laparoscopy, sterilization, tubal patency tests; level 2: adhesiolysis, ectopic pregnancy (EP), laparoscopic treatment of endometriosis, cystectomy, oophorectomy, LAVH, tubal surgery for infertility; level 3: myomectomy, total laparoscopic hysterectomy (TLH) and sacropexy). Data were compared to previously published data of 1994.

Hysteroscopic surgery: Perspectives on skills training.

Study Objective: To assess the current exposure to hysteroscopy in gynecologic residency and daily practice in The Netherlands.

Design: Survey (Canadian Task Force Classification III).

Subject: Postgraduate year 5 and 6 residents in Obstetrics and Gynecology and gynecologists who finished residency within 1998-2003 in The Netherlands.

Implementation of advanced laparoscopy into daily gynecologic practice: difficulties and solutions.

Background: The implementation of laparoscopy into Dutch gynecologic practice is slow. This study was conducted to assess the current state of laparoscopy, to identify factors influencing the implementation and to find solutions toward a better implementation.

Methods: In 2003 a questionnaire was sent to all 151 gynecologists who finished residency within the previous 5 years.

Gynecological laparoscopy in residency training program: Dutch perspectives.

Background: Implementation of laparoscopy into residency training is difficult. This study was conducted to assess the current state of implementation of laparoscopic surgery into gynecological residency program, to identify factors influencing laparoscopic skills training, and to find solutions toward better training and implementation.

Methods: In 2003 a questionnaire was sent to all 68 postgraduate year 5 and year 6 residents in obstetrics and gynecology in The Netherlands.

Complications of laparoscopy: an inquiry about closed- versus open-entry technique.

Objective: The purpose of this study was to determine the amount of complications and the incidence of open- versus closed-entry (either by Veress needle or first trocar) technique in gynecologic laparoscopy in The Netherlands.

Study Design: Questionnaire analysis of members of the Dutch Society for Gynaecological Endoscopy and Minimal Invasive Surgery was combined with a Medline literature search. Data related to complications on entry from January 1,1997, through December 31, 2001, were collected by questionnaire and were separated into group I (Veress needle or first trocar) and group II (open-entry technique).

[Ototoxicity induced by clarithromycin].

A 76-year-old man developed a progressive bilateral hearing loss 4 days after starting a high dose of clarithromycin for atypical pulmonary tuberculosis. When the clarithromycin was discontinued the hearing improved subjectively but it worsened again upon reexposure. Halving the dose resulted in both an objective and subjective improvement in hearing, yet the original level of hearing was only obtained once clarithromycin had been permanently withdrawn.

Adventitial stripping does not strip the adventitia.

This study investigates the process of stripping the adventitia off a blood vessel, which is a normal procedure prior to performing a microvascular anastomosis. In five rats, the common carotid and the superficial femoral arteries of one side were stripped sharply, whereas the arteries of the other side were left unstripped to serve as controls. In a further set of five rats, the arteries were stripped bluntly.

Changes in the carpal tunnel due to action of the flexor tendons: visualization with magnetic resonance imaging.

Successive cross-sectional areas (CSA) of the carpal tunnel were measured with the fingers in both extension and full flexion in 12 healthy volunteers using magnetic resonance imaging. During flexion, lumbrical muscles could be observed to move into the carpal tunnel up to different levels in all volunteers. For each of the volunteers, the level of the hook of hamate was used as the reference level.