Total laparoscopic hysterectomy with obliterated anterior cul-de-sac

Endometriosis may in severe cases lead to obliteration of the anterior and/or posterior cul-de-sacs in the female pelvis. The anterior cul-de-sac is generally less commonly affected. This type of cases usually presents a challenge for the operating surgeon, whether via open route or through laparoscopy. In this paper, we present an illustrative case and explain our technique for dealing with a scarred and totally obliterated anterior cul-de-sac because of endometriosis during total laparoscopic hysterectomy

Chronic ovarian torsion treated laparoscopically

Ovarian torsion is a rare gynecological emergency that may elude diagnosis leading to delayed operative intervention and ovarian resection. We report a 39 year old female who presented with acute one-sided abdominal pain whose diagnosis was missed by the emergency physician resulting in loss of the ovary. The surgery was performed by the gynecologist laparoscopically

Office Hysteroscopy & Healthcare Efficiency

Cost-efficiency is one of the essential attributes of a highly-performing healthcare system. In this paper, we discuss the inpatient-outpatient transfer of minor gynecological procedures and attempt to suggest solutions for the rampant inefficiency in the healthcare system

Severe adhesions and advanced laparoscopic surgery

A 43 year old, status post hysterectomy, was referred for the management of ovarian retention syndrome. Extensive adhesiolysis was performed and ovaries removed. Bladder cystoscopy with hydrodistension test revealed symptoms of early interstitial cystitis. Estimated blood loss was 800 and operative time 5 hours 23 minutes. The case demonstrates the potential of minimal invasive surgery in a case of severe adhesions that looked initially impossible

A Large Fibroid Uterus Removed with a Bipolar Morcellator

We report our experience with the use of the PlasmaSord bipolar morcellator on a fibroid uterus over 1500 grams. We suggest some modifications to improve the function of this morcellator to make it more appropriate for true advanced laparoscopy

Diagnosis and laparoscopic treatment of cornual ectopic pregnancy

Cornual (interstitial) ectopic pregnancy is an uncommon variant of ectopic pregnancy which often poses a diagnostic and therapeutic challenge with a significant risk of rupturing and bleeding. We present a ruptured right cornual pregnancy and explain how to deal with such a case laparoscopically

Chronic ovarian torsion treated laparoscopically

Ovarian torsion is a rare gynecological emergency that may elude diagnosis leading to delayed operative intervention and ovarian resection. We report a 39 year old female who presented with acute one-sided abdominal pain whose diagnosis was missed by the emergency physician resulting in loss of the ovary. The surgery was performed by the gynecologist laparoscopically

Reanalysis of the Atmospheric Radiocarbon Calibration Record from Lake Suigetsu, Japan

Terrestrial plant macrofossils from the sedimentary record of Lake Suigetsu, Japan, provide the only quasi-continuous direct atmospheric record of radiocarbon (14C) covering the last 50 ka cal BP (Bronk Ramsey et al. 2012). Since then, new high precision data have become available on U-Th dated speleothems from Hulu Cave China, covering the same time range (Cheng et al. 2018). In addition, an updated varve-based chronology has also been published for the 2006 core from Lake Suigetsu (SG06) based on extended microscopic analysis of the sediments and improved algorithms for interpolation (Schlolaut et al. 2018). Here we reanalyze the radiocarbon dataset from Suigetsu based on the new varve counting information and the constraints imposed by the speleothem data. This enables the new information on the calendar age scale of the Suigetsu dataset to be used in the construction of the consensus IntCal calibration curve. Comparison of the speleothem and plant macrofossil records provides insight into the mechanisms underlying the incorporation of carbon into different types of record and the relative strengths of different types of archive for calibration purposes

IntCal09 and Marine09 radiocarbon age calibration curves, 0-50,000yeats cal BP

The IntCal04 and Marine04 radiocarbon calibration curves have been updated from 12 cal kBP (cal kBP is here defined as thousands of calibrated years before AD 1950), and extended to 50 cal kBP, utilizing newly available data sets that meet the IntCal Working Group criteria for pristine corals and other carbonates and for quantification of uncertainty in both the 14C and calendar timescales as established in 2002. No change was made to the curves from 0–12 cal kBP. The curves were constructed using a Markov chain Monte Carlo (MCMC) implementation of the random walk model used for IntCal04 and Marine04. The new curves were ratified at the 20th International Radiocarbon Conference in June 2009 and are available in the Supplemental Material at www.radiocarbon.org

Genetic complexity of miscanthus cell wall composition and biomass quality for biofuels

BACKGROUND: Miscanthus sinensis is a high yielding perennial grass species with great potential as a bioenergy feedstock. One of the challenges that currently impedes commercial cellulosic biofuel production is the technical difficulty to efficiently convert lignocellulosic biomass into biofuel. The development of feedstocks with better biomass quality will improve conversion efficiency and the sustainability of the value-chain. Progress in the genetic improvement of biomass quality may be substantially expedited by the development of genetic markers associated to quality traits, which can be used in a marker-assisted selection program. RESULTS: To this end, a mapping population was developed by crossing two parents of contrasting cell wall composition. The performance of 182 F1 offspring individuals along with the parents was evaluated in a field trial with a randomized block design with three replicates. Plants were phenotyped for cell wall composition and conversion efficiency characters in the second and third growth season after establishment. A new SNP-based genetic map for M. sinensis was built using a genotyping-by-sequencing (GBS) approach, which resulted in 464 short-sequence uniparental markers that formed 16 linkage groups in the male map and 17 linkage groups in the female map. A total of 86 QTLs for a variety of biomass quality characteristics were identified, 20 of which were detected in both growth seasons. Twenty QTLs were directly associated to different conversion efficiency characters. Marker sequences were aligned to the sorghum reference genome to facilitate cross-species comparisons. Analyses revealed that for some traits previously identified QTLs in sorghum occurred in homologous regions on the same chromosome. CONCLUSION: In this work we report for the first time the genetic mapping of cell wall composition and bioconversion traits in the bioenergy crop miscanthus. These results are a first step towards the development of marker-assisted selection programs in miscanthus to improve biomass quality and facilitate its use as feedstock for biofuel production