Secure and quick transumbilical initial trocar insertion with skin hooks: The skin hook method

Objective: To evaluate clinical safety and ease of the entry technique using an optical access system and skin hooks. Materials and methods: A total of 80 gynecological patients who have undergone laparoscopic surgery with either the skin hook method using skin hooks or the conventional method using Pean clamps. Results: The skin hook method was compared with the conventional method using Pean clamps (n = 40 patients each). The skin hook method required less time and there was less device slippage than in the conventional method. No other severe complications occurred after either method. Conclusion: This method is a simple and secure approach and can be applied during laparoscopic surgery and in patients other than gynecological patients

Retrospective cohort study of the risk factors for secondary infertility following hysteroscopic metroplasty of the uterine septum in women with recurrent pregnancy loss

Abstract Purpose A hysteroscopic metroplasty was performed for women with recurrent pregnancy loss owing to a uterine septum, following which some women became infertile. The aim of this study was to elucidate the risk factors of secondary infertility 1 year after hysteroscopic metroplasty for a uterine septum. Methods A retrospective, single‐center, cohort study included women with a history of at least two miscarriages that had been attributed to a uterine septum who underwent a hysteroscopic metroplasty. The patients’ background data were compared between the patients who conceived and those who remained infertile at 1 year postoperatively. The data were analyzed by using the Mann–Whitney U‐test and multivariate analyses. Results The postoperative live birth rate was 83.9% (n = 26), with persistent infertility in five women at 1 year. When comparing the pregnancy group with the infertile group, the women in the postoperative infertility group were significantly older than those in the postoperative pregnancy group. The multivariate analysis showed that age was an independent risk factor for persistent infertility. Conclusion Age was identified as an independent risk factor for postoperative secondary infertility. Therefore, surgery as early as possible is recommended

Room-temperature direct band-gap electroluminescence from germanium (111)-fin light-emitting diodes

Germanium (Ge) (111) fins of 320 nm in height were successfully fabricated using a combination of flattening sidewalls of a silicon (Si) fin structure by anisotropic wet etching with tetramethylammonium hydroxide, formation of thin Ge fins by selective Si oxidation in SiGe layers, and enlargement of Ge fins by Ge homogeneous epitaxial growth. The excellent electrical characteristics of Ge(111) fin light-emitting diodes, such as an ideality factor of 1.1 and low dark current density of 7.1 × 10−5 A cm−2 at reverse bias of −2 V, indicate their good crystalline quality. A tensile strain of 0.2% in the Ge fins, which originated from the mismatch of the thermal expansion coefficients between Ge and the covering SiO2 layers, was expected from the room-temperature photoluminescence spectra, and room-temperature electroluminescence corresponding to the direct band-gap transition was observed from the Ge fins

A new concept of minimally invasive laparoscopic surgery utilizing the vaginal route to prevent iatrogenic spillage of dermoid cysts: The bathtub method

Objective: Surgical management of dermoid cysts remains controversial, and some surgeons prefer to approach these cysts via laparotomy due to the high risk of intraperitoneal cyst rupture in laparoscopic surgery and the related risks of chemical peritonitis. In our hospital, laparoscopic-assisted cystectomy (LAC) has been performed as a gasless laparoscopic surgery using an abdominal wall lifting method with a 3–5-cm transverse suprapubic incision that enables the dermoid cyst to be approached directly, as in laparotomy. Although LAC is safe and effective, it is performed in only specific areas and limited institutes. Therefore, we developed the “bathtub method,” a modified laparoscopic method that uses an endoscopic bag inserted through the vagina. The cyst is enucleated within the bag to catch cyst spillage. We compared results of the bathtub method with those of LAC. Methods: We evaluated 37 patients scheduled for laparoscopic cystectomy with the bathtub method and 37 patients scheduled for LAC. Results: Intraoperative cyst rupture occurred in 22 patients treated with the bathtub method; the majority of the cyst contents spilled into the endoscopic bag. White blood cell count and C-reactive protein level on postoperative Day 1 were 7708.3±1920.0/μL and 0.91±1.0 mg/dL, respectively, for the bathtub method versus 9913.9±2644.9/μL and 2.7±1.9 mg/dL for LAC (p<0.01 for both). There was no secondary chemical peritonitis in either group. Conclusion: The bathtub method is less invasive than is LAC, with unremarkable scarring and minimum spillage. It is considered safe and useful

Effects of Five Amino Acids (Serine, Alanine, Glutamate, Aspartate, and Tyrosine) on Mental Health in Healthy Office Workers: A Randomized, Double-Blind, Placebo-Controlled Exploratory Trial

Background: The importance of maintaining good mental health with overall well-being has recently drawn attention from various spheres of academics and the working population. Amino acid intake has been reported to reduce depression symptoms and other mental health problems. However, the effectiveness of amino acid intake (i.e., single or combined) remains unknown. In this study, we assessed a combination of five amino acids (serine, alanine, glutamate, aspartate, and tyrosine; SAGAT) reported to regulate mental health. Methods: A randomized, double-blind, placebo-controlled exploratory trial was conducted. Participants, aged between 20 and 65 years with fatigue sensation, were randomized to receive either SAGAT or the placebo and ingested them for four weeks. A transient mental work was loaded at day 0 and after four weeks of intervention. As the primary outcomes, the fatigue sensation was assessed. The mood status, cognitive function, work efficiency, and blood marker were also measured as secondary outcomes. Results: The number of participants analyzed for the efficacy evaluation were 20 in SAGAT and 22 in the placebo. There were no significant differences in the primary outcomes. However, as the secondary outcomes, the SAGAT group showed a significant improvement in motivation and cognitive function in the recovery period after mental work loaded in a four-week intervention compared to the placebo. Conclusion: The current findings suggest that SAGAT contributes to maintaining proper motivation and cognitive function. Clinical Trial Registration: University Hospital Medical Information Network Clinical Trial Registry (ID: UMIN 000041221)

In vitro and in vivo transdermal iontophoretic delivery of naloxone, an opioid antagonist

a b s t r a c t Aim: The feasibility of transdermal delivery of naloxone, an opioid antagonist, by anodal iontophoresis patches using Ag/AgCl electrodes was investigated. Methods: To examine the effect of current strength, species variation and drug concentration on skin permeability of naloxone, in vitro skin permeation studies were performed using rat dorsal skin and porcine ear skin as the membrane. To determine in vivo transdermal absorption rate of naloxone, the iontophoretic patch system was applied to the dorsal skin of conscious rat with a constant current supply for 24 h. Results: The in vitro steady-state skin permeation flux of naloxone current-proportionally (0-360 A/cm 2 ) increased without significant differences between these two different skin types. The in vitro delivery rate through the porcine skin was found to be independent of the concentration of naloxone hydrochloride dehydrate in the donor patch over the range from 1 to 10% (w/v). In the in vivo pharmacokinetic study, plasma concentrations of naloxone steadily increased and sustained steady-state levels from 4 h to 24 h after the initiation of current application. In vivo steady-state transdermal absorption rates at 90 and 180 A/cm 2 were 136 and 305 g/h/cm 2 , respectively. Conclusion: These results suggest that the transdermal delivery rates of naloxone by anodal iontophoresis are sufficient for the management of intoxication in opioid-overdosed patients