Volume 16, issue 2

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1118/thumbnail.jp

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Low power lasers for the treatment of heavy menstrual periods.

Two of the most frequent causes of excessive menstrual blood loss are dysfunctional uterine bleeding (DUB) and fibroids. Both can be cured by hysterectomy, but no non-surgical treatment for either is entirely satisfactory. This thesis looks at the potential of minimally invasive, low power laser techniques for treating these conditions: photodynamic therapy (PDT) for endometrial ablation for DUB and interstitial laser photocoagulation (ILP) for fibroids. PDT is the local destruction of tissue with light after prior administration of a photosensitising drug. No heat is involved. In pharmacokinetic studies, I instilled the photosensitiser aluminium disulphonated phthalocyanine (AlS2Pc) into the horns of normal rabbit uteri, using fluorescence microscopy of uterine sections to document the drug distribution. The most appropriate drug levels in endometrium and myometrium were seen at 3 hours, at which time a diffuser fibre delivered laser light (670nm) to the endometrium. Histological examination 3-28 days later showed that under optimal conditions, there was close to complete endometrial ablation with minimal myometrial damage. Studies on human hysterectomy specimens compared a range of light delivery devices for PDT. The bifurcator gave the most uniform light distribution. ILP involves inserting one or more thin needles into fibroids at laparoscopy. Laser fibres are passed through the needles to gently heat the target lesion (typically 3W for 10 minutes per fibre site). 21 symptomatic patients with 32 fibroids were treated. At 6 weeks, most lesions were oedematous, but there was a mean shrinkage of 25% at 6 months and 50% at 12 months, with corresponding symptomatic relief. These studies have shown that in the rabbit, PDT with AlS2Pc can produce endometrial ablation safely. The technique is ready for consideration for pilot clinical studies. ILP has been shown to be a safe and relatively simple treatment for moderate sized fibroids, which could be incorporated into gynaecological practice now

Faculty Publications and Creative Works 2003

Faculty Publications & Creative Works is an annual compendium of scholarly and creative activities of University of New Mexico faculty during the noted calendar year. It serves to illustrate the robust and active intellectual pursuits conducted by the faculty in support of teaching and research at UNM

Abstracts from the 50th European Society of Human Genetics Conference: Posters

International audienc

Artificial fertilization with donor gametes : a medical social work perspective

English: Artificial fertilization with donor gametes is becoming more popular amongst infertile couples as an alternative to childlessness. It allows the couple the opportunity to experience a pregnancy and the birth of their child, who is fifty percent blood-related. This form of treatment involves various medical, legal, ethical-moral, religious and psycho-social aspects, and couples requesting this form of treatment usually have limited knowledge of these aspects, are unable to make an informed decision and are unaware of the possible long-term implications. Applied and developmental research was implemented in this study. The research designs were exploratory and descriptive and the nature of this research was both quantitative and qualitative. The research population of 30 respondents were all included in this study. The hypotheses for this study were formulated as follows: Hypothesis 1: When couples request artificial fertilization with donor gametes, they have limited knowledge of all the medical, legal, ethical-moral, religious and psycho-social aspects related to this treatment. Hypothesis 2: If couples are prepared for artificial fertilization with donor gametes by means of a holistic preparation session, they will gain more knowledge regarding all the aspects related to this treatment. Hypothesis 3: If couples undergo artificial fertilization with donor gametes, they will experience long-term psycho-social implications. vi The aims of this study included: Aim 1: To develop, implement, evaluate and describe a guideline for the holistic preparation of couples for artificial fertilization with donor gametes. Aim 2: To do a longitudinal study of the same respondents to determine the long-term psycho-social implications of successful or unsuccessful artificial fertilization with donor gametes. Aim 3: To provide a medical social work guideline for the counselling of couples undergoing artificial fertilization with donor gametes. These aims were all met by means of this study. In the first empirical study, the preparation session which was developed in this study, was implemented over a half-day session, individually with each couple using the A-B-A single system design and a questionnaire. A pre-test prior to and post-test after completion of the session was conducted. These respondents' knowledge on all the aspects related to this form of treatment, which was limited in the pre-test, had increased after completion of the session in the post-test. The session was evaluated to be of high value on the short-term, as it had increased their knowledge and provided them with a thorough perspective, supporting hypothesis 1 and 2. The second empirical study was conducted with the same respondents 7 years later, by means of a longitudinal survey, using personal interviews and a questionnaire. Respondents had either donor, adopted or own biological children or were childless and had experienced successful long-term psycho-social implications as a result of or unsuccessful artificial fertilization with donor gametes, supporting hypothesis 3. Respondents valued the preparation session highly on the long-term, as it had increased their knowledge and enabled them to make an informed decision. A preparation session was recommended as a necessity for all couples undergoing this form of treatment, as well as a need for long-term counselling. Recommendations included a preparation session being a prerequisite for all couples undergoing this form of treatment and the need for long-term counselling. A guideline was provided for this purpose.Afrikaans: Kunsmatige bevrugting met donor gamete, word steeds gewilder by onvrugbare egpare, as alternatief tot kinderloosheid. Dit bied 'n egpaar die geleentheid om 'n swangerskap en die geboorte van hulle kind, wat vyftig persent bloedverwant is, te ervaar. Hierdie soort behandeling behels verskillende mediese, wetlike, eties-morele, godsdienstige en psigososiale aspekte en egpare wat hierdie soort behandeling versoek, dra gewoonlik slegs beperkte kennis van hierdie aspekte, is nie daartoe instaat om 'n ingeligte besluit te neem nie en is onbewus van die moontlike langtermyn implikasies. Toegepaste en ontwikkelingsnavorsing is in hierdie studie aangewend. Die navorsingsontwerpe was verkennend en beskrywend en die aard van die navorsing was sowel kwantitatief as kwalitatief. Die universum van 30 respondente is in hierdie studie ingesluit. Die hipoteses vir die studie is as volg geformuleer: Hipotese 1: Wanneer egpare kunsmatige bevrugting met donor gamete versoek, het hulle slegs beperkte kennis van al die mediese, wetlike, etiesmorele, godsdienstige en psigososiale aspekte wat verband hou met hierdie behandeling. Hipotese 2: Indien egpare deur middel van 'n holistiese voorbereidingsessie vir kunsmatige bevrugting met donor gamete voorberei word, sal hulle meer kennis opdoen ten opsigte van al die aspekte wat verband hou met die behandeling. Hipotese 3: Indien egpare kunsmatige bevrugting met donor gamete ondergaan, sal hulle langtermyn psigososiale implikasies ervaar. Die doelstellings van die studie het die volgende ingesluit: Doelstelling 1: Om 'n riglyn vir die holistiese voorbereiding van egpare vir kunsmatige bevrugting met donor gamete te ontwikkel, implementeer, evalueer en beskryf. Doelstelling 2: Om 'n longitudinale studie van dieselfde respondente te onderneem, om die langtermyn psigososiale implikasies van suksesvolle of onsuksesvolle kunsmatige bevrugting met donor gamete te bepaal. Doelstelling 3: Om 'n geneeskundige maatskaplikewerk-riglyn vir die berading van egpare wat kunsmatige bevrugting met donor gamete ondergaan, te verskaf. Hierdie doelstellings is almal deur middel van hierdie studie bereik. In die eerste empiriese studie is die voorbereidingsessie individueel met elke egpaar oor 'n half-dag geimplementeer en die A-B-A enkelstelselontwerp en 'n vraelys is benut. 'n Voortoets asook 'n natoets is ui tgevoer, voor en na vol tooiing van die sessie. Die respondente het v66r die voorbereidingsessie, oor beperkte kennis van al die aspekte wat met die behandeling verband hou beskik, en het na die sessie vermeerderde kennis getoon. Die sessie is van hoe waarde beskou op die korttermyn, want hulle kennis is aangevul en 'n deeglike perspektief is voorsien, wat hipoteses 1 en 2 ondersteun het. Die tweede empiriese studie is sewe jaar later met dieselfde respondente ui tgevoer, deur middel van 'n longi tudinale opname, met gebruikmaking van persoonlike onderhoude en 'n vraelys. Die respondente het donor, aangenome, of eie biologiese kinders gehad, of was kinderloos en het langtermyn psigososiale implikasies ervaar as gevolg van suksesvolle of onsuksesvolle kunsmatige bevrugting met donor gamete. Hipotese 3 is deur hierdie bevindinge ondersteun. 'n Hoe waarde is aan die sessie geheg met die langtermyn evaluasie van die voorbereidingsessie, omdat dit hulle met kennis toegerus het, en hulle in staat gestel het om 'n ingeligte besluit te neem. Aanbevelings het sowel die voorbereidingsessie as vereiste vir alle egpare wat hierdie behandeling ondergaan, ingesluit, asook die behoefte aan langtermyn berading. 'n Riglyn is vir hierdie doel voorsien.Thesis (DPhil (Social Work))--University of Pretoria, 1996.Social Work and CriminologyDPhil (Social Work)Unrestricte