The effect of single-file reciprocating systems on Substance P and Calcitonin gene-related peptide expression in human periodontal ligament.

AIM: To quantify the effect of two single-file reciprocating root canal preparation systems on Substance P (SP) and Calcitonin gene-related peptide (CGRP) expression in healthy human periodontal ligament (PDL). METHODOLOGY: Forty PDL samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Prior to extraction, 20 of these premolars were divided equally in two groups, and then, root canals were prepared using one of two different single-file systems: WaveOne and Reciproc. Ten premolars were prepared with hand files and served as a positive control group. The remaining 10 premolars where extracted without treatment and served as a negative control group. All PDL samples were processed, and SP and CGRP were measured by radioimmunoassay. RESULTS: Greater SP and CGRP expression were found in the hand instrumentation group (1.220 pmol SP and 0.084 pmol CGRP per mg of PDL), followed by the WaveOne group (0.908 pmol SP and 0.046 pmol CGRP per mg of PDL) and the Reciproc group (0.511 pmol SP and 0.022 pmol CGRP per mg of PDL). The lower SP and CGRP values were associated with the intact control group (0.453 pmol SP and 0.018 pmol CGRP per mg of PDL). The Kruskal-Wallis test revealed significant differences between groups (P < 0.001). Post hoc Tukey HSD tests revealed significant differences in SP and CGRP expression between intact teeth in the control group and all the other groups (P < 0.001) except with the Reciproc group (P = 0.165 and P = 0.42 for SP and CGRP, respectively). Hand instrumentation was associated with significant differences with all the other groups (P < 0.001). Differences between the WaveOne and Reciproc groups were also significant (P < 0.001). CONCLUSION: Substance P and CGRP expression in PDL cells increased when teeth were prepared with WaveOne as well as with hand instrumentation. Reciproc maintained SP and CGRP levels in line with the negative control group.

Proteasome activity and proteasome subunit transcripts in human spermatozoa separated by a discontinuous Percoll gradient.

Human semen is composed of a heterogeneous population of spermatozoa with varying degrees of structural and functional differentiation and normality, which result in subpopulations of different quality. Using a discontinuous Percoll gradient, we separated three subsets of spermatozoa (65/45%, 90/65% and 90% fractions) from normozoospermic semen samples from healthy donors and proceeded to characterise their morphology, viability, motility and proteasome activity. In addition, the presence of proteasome subunit transcripts was investigated using reverse transcription-polymerase chain reaction (RT-PCR). The results obtained showed significant differences in sperm motility, viability and morphology between the cells collected from each of the fractions. In particular, normal sperm morphology was 4.5 times higher in the 90% pellet in comparison with the 65/45% interface. In addition, there were significant differences in proteasomal activity between spermatozoa recovered from the 90% pellet and spermatozoa recovered from the 65/45% interface. Finally, there was a positive correlation between sperm proteasomal enzymatic activity and sperm motility and normal morphology after separation by a discontinuous Percoll gradient. The results of the RT-PCR revealed the presence of transcripts for the proteasome subunits ß1, ß2 and ß5 in the human spermatozoa analysed. In conclusion, poor quality spermatozoa isolated from a Percoll gradient display an intrinsic proteasome activity deficiency, which may be associated with their low fertilising potential.

Expression of insulin-like growth factor-1 and proliferating cell nuclear antigen in human pulp cells of teeth with complete and incomplete root development.

AIM: To quantify the expression of insulin-like growth factor-1 (IGF-1) and proliferating cell nuclear antigen (PCNA) in human pulp cells of teeth with complete or incomplete root development, to support the specific role of IGF-1 in cell proliferation during tooth development and pulp reparative processes. METHODOLOGY: Twenty six pulp samples were obtained from freshly extracted human third molars, equally divided in two groups according to root development stage (complete or incomplete root development). All samples were processed and immunostained to determine the expression of IGF-1 and PCNA in pulp cells. Sections were observed with a light microscope at 80x and morphometric analyses were performed to calculate the area of PCNA and IGF-1 immunostaining using digital image software. Mann-Whitney's test was used to determine statistically significant differences between groups (P < 0.05) for each peptide and the co-expression of both. RESULTS: Expression of IGF-1 and PCNA was observed in all human pulp samples with a statistically significant higher expression in cells of pulps having complete root development (P = 0.0009). CONCLUSION: Insulin-like growth factor-1 and PCNA are expressed in human pulp cells, with a significant greater expression in pulp cells of teeth having complete root development.

Voltage-dependent conductance induced by hemocyanin in black lipid films.

When hemocyanin is added to a black lipid film, the conductance increases in discrete steps. For negative potentials the single step conductance is constant, but for positive potentials the step conductance appears to decrease as the potential increases. At high positive potentials the conductance fluctuates between several levels. These data suggest that, in lipid membranes, hemocyanin conducts ions through discrete channels. The voltage-dependent conductance observed at high levels of conductance seems to be a consequence of the properties of the conductance of the single channel.

[Results and complications of expanded polytetrafluoroethylene in frontalis suspension ptosis surgery. Study of 59 cases]. / Resultados y complicaciones del politetrafluoroetileno expandido en la cirugía de ptosis palpebral por suspensión al frontal. Estudio de 59 casos.

PURPOSE: To evaluate the functional results and complications of the use of expanded polytetrafluoroethylene (ePTFE) in frontalis suspension surgery for the treatment of moderate-severe palpebral ptosis (> 3 mm) with poor or absent levator muscle function. METHODS: Retrospective study of 59 frontalis suspension procedures performed between 1992 and 2003 on 38 patients with palpebral ptosis (21 bilateral). Seventeen (44.7%) cases were women and 21 (55.3%) men. The mean age was 51.7 S.D. 27.6 years (range, 2 to 87). The surgical techniques used were performed by a Wright fascia needle. The etiology, ptosis grade, levator function, Bell's phenomenon and frontalis compensation were studied. RESULTS: After a median follow-up time of 35.9 S.D. 18.5 months (range, 6 to 72), we observed that the functional results were good in 55 cases (93.2%). Infection with preseptal cellulitis appeared in 1 case (1.7%) and required removal of the material, and in 2 cases (3.4%) there were foreign body granulomas that were resolved by excision. Two cases (3.4%) had to be reoperated due to recurrence. CONCLUSIONS: The ePTFE, in our experience, is a good material with excellent functional results and relatively few complications in the surgical treatment of eyelid ptosis for frontalis suspension. Other synthetic materials or fascia lata may be used, but all carry the risk of potential infection, extrusion, granuloma formation or recurrence.

[Anaesthetic management in a paediatric patient with a difficult airway due to epidermolysis bullosa dystrophica]. / Manejo anestésico en paciente pediátrico con vía aérea difícil afectado de epidermólisis ampollosa distrófica.

Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae. The anaesthetic management of patients with DEB is a challenge, even for the most experienced anaesthesiologists, but basic principles can help us prepare the plan of care. The main goals are to prevent trauma/infection of skin/mucous, and to establish a secure airway without causing bullae. Patient positioning and the instruments used to monitor vital signs and administering anaesthetic agents can cause new lesions. It is advisable to lubricate the instruments and to avoid adhesive material and shearing forces on the skin. Besides the implications of the comorbidities, there is a potential difficult intubation and difficult vascular access. Acute airway obstruction can occur due to airway instrumentation. We report the case of a patient diagnosed with EBD difficult airway and undergoing correction of syndactylyl and dental extractions.

Transmandibular, circumglossal, retropharyngeal approach for chordomas of the clivus and upper cervical spine. Technical note.

Extensive clival tumors that involve both the midline and lateral skull base compartments, or those that extend inferiorly to the anterior cervical spine, are difficult to expose in a wide fashion using any of the transmaxillary, transoral, or transcervical routes. In the transmandibular, circumglossal, retropharyngeal (TCR) approach wide access of this region can be obtained, thus allowing for a more complete resection of tumor and infiltrated bone. It also provides for an improved ability to perform dural reconstruction, should it be necessary. Over the past 4 years four patients with extensive clival chordomas underwent resection via the TCR approach. Gross-total resection was achieved in two patients, a greater than 98% resection in one patient, and a greater than 95% resection in the fourth patient. The surgical technique, all approach-related complications and morbidity, and patient outcome are discussed. If an expanded exposure of the clivus is necessary, the TCR approach is a good choice as well as a useful surgical technique to have available.

[Supposed nylon allergy after cataract surgery]. / Supuesta alergia al nylon tras cirugía de la catarata.

CASE REPORT: We present the case of a patient operated on for extracapsular cataract extraction of both eyes. Three weeks after the first operation (right eye), the patient presented a local inflammatory reaction at the incision site which was characterized by the existence of whitish exudates of different sizes surrounding the nylon suture. At one week of the second operation, the patient presented the same alteration (left eye), although it was observed sooner and had a greater intensity. The allergy skin tests for nylon and other substances were negative, however the local inflammatory reaction disappeared when the nylon suture was removed. DISCUSSION: This type of reaction, which we have observed in several other patients, has been previously described by others authors, although no clearly established cause has been demonstrated. Both toxicity and allergy to nylon have been proposed as the underlying mechanisms. We consider that a type IV hypersensitivity reaction to nylon may be the underlying mechanism of these reactions although toxicity cannot be ruled out.

Effects of the interaction of single-walled carbon nanotubes with 4-nonylphenol on their in vitro toxicity.

The aim of this study was to assess the toxicological risks arising from the coexistence of polyethylene glycol coated single-walled carbon nanotubes (SWCNTs-PEG) and a known environmental contaminant: 4-nonylphenol (NP). To this end, in vitro toxicity assays involving the exposure of 3T3-L1 cells (mouse embryonic fibroblasts) to SWCNTs-PEG alone or in combination with NP for 24 or 48 h were performed. Experimental treatments were conducted in both presence (10%) and absence of serum in order to evaluate its influence on the toxicity of SWCNTs-PEG. Although the results provided no unambiguous evidences of synergistic toxicity between SWCNTs-PEG and NP, some specific treatments with mixtures (SWCNTs-PEG+NP) resulted in an unexpected combined toxicity in relation to the individual treatments. Only in those cases the interaction between SWCNTs-PEG and NP could have a synergistic effect on the resulting toxicity. The addition of 10% serum increased the stability of SWCNTs-PEG in the culture medium-possibly by steric repulsions-and reduced the toxicity of nanoparticles as a result. Overall, the serum had a "protective effect" on cells against all treatments: SWCNTs-PEG, NP or their mixtures (SWCNTs-PEG+NP). Raman spectroscopy allowed the intracellular distribution of SWCNTs-PEG to be elucidated.

The efficiency of quartz addition on electric arc furnace (EAF) carbon steel slag stability.

Electric arc furnace slag (EAF) has the potential to be re-utilized as an alternative to stone material, however, only if it remains chemically stable on contact with water. The presence of hydraulic phases such as larnite (2CaO SiO2) could cause dangerous elements to be released into the environment, i.e. Ba, V, Cr. Chemical treatment appears to be the only way to guarantee a completely stable structure, especially for long-term applications. This study presents the efficiency of silica addition during the deslagging period. Microstructural characterization of modified slag was performed by SEM and XRD analysis. Elution tests were performed according to the EN 12457-2 standard, with the addition of silica and without, and the obtained results were compared. These results demonstrate the efficiency of the inertization process: the added silica induces the formation of gehlenite, which, even in caustic environments, does not exhibit hydraulic behaviour.

Antimicrobial hydantoin-containing polyesters.

A new N-hydantoin-containing biocompatible and enzymatically degradable polyester with antibacterial properties is presented. Different polyesters of dimethyl succinate, 1,4-butanediol, and 3-[N,N-di(ß-hydroxyethyl)aminoethyl]-5,5-dimethylhydantoin in varying molar ratios are prepared via two-step melt polycondensation. The antibacterially active N-halamine form is obtained by subsequent chlorination of the polyesters with sodium hypochlorite. Chemical structures, thermal properties, and spherulitic morphologies of the copolymers are studied adopting FT-IR, NMR, TGA, DSC, WAXD, and POM. The polyesters exhibit antibacterial activity against Escherichia coli. The adopted synthetic approach can be transferred to other polyesters in a straightforward manner.

Aislamiento y caracterización de las células madre mesenquimales de la pulpa dentaria humana / Isolation and characterization of stem cells mesenchymal of human dental pulp

Las células madre mesenquimales de la pulpa dentaria han surgido como una herramienta promisoria en la medicina regenerativa. El objetivo de la presente investigación es establecer el cultivo de las células madre mesenquimales de la pulpa dentaria humana. Estas fueron aisladas de terceros molares retenidos de pacientes entre 15 y 24 años, con técnica de disgregación enzimática y cultivadas en medio DMEM-F12, suplementado con 15% de SFB , 100 ?M L-ácido ascórbico 2-fosfato, 2 mM L-glutamina, 100 U/mL de penicilina, 100 µg/mL de estreptomicina y 2 µg/mL de anfotericina B . Las células fueron observadas diariamente bajo microscopio. Pruebas inmunohistoquímicas mostraron en las poblaciones de células aisladas la existencia de células mesenquimales STRO-1+, marcador de células madre mesenquimales, también expresaron CD146+ y no expresaron CD45-, marcador de células hematopoyéticas. Las células aisladas mostraron capacidad de autorrenovación y eficiencia de formación de colonias. En el presente estudio, en las poblaciones de células aisladas se identificaron células con características de células madre mesenquimales, como su capacidad de adherirse a las placas plásticas en cultivo, formar colonias altamente proliferativas, su morfología fusiforme y la expresión consistente de marcadores de superficie que caracteriza células madre mesenquimales adultas de pulpa dentaria. Sin embargo, faltaría determinar su capacidad de diferenciación para cumplir con los criterios básicos para definirlas como células madre

Mesenchymal stem cells dental pulp-derived have emerged as a promising tool in regenerative medicine. The objective of the present investigation is to establish the culture of mesenchymal stem cells of dental pulp human. The dental pulp mesenchymal cells were isolated from impacted third molars of patients between 15-24 year-old. The dental pulp tissue was extracted, enzymatic digestion technique and culture in medium DMEM-F12, supplemented with 15% de SFB , 100 ?M L-ascorbic acid 2- phosphate, 2 mM L-glutamine, 100 U/mL de penicillin, 100 µg/mL de streptomycin y 2 µg/mL de amphotericin B. Cells were observed daily under microscope. Immunocytochemistry tests showed cells STRO-1+ mesenchymal stem cell marker. These cells also expressed CD146+ and no expressed CD45- hematopoietic stem cell marker. The isolated cells showed self-renewal capabilities and colony-forming efficiency. In this study, isolated cell populations were identified cells with mesenchymal stem cell characteristics, such as its ability to adhere to plastic culture plates, highly proliferative colony forming, fusiform morphology and consistent expression of surface markers characterized adult mesenchymal stem cells from dental pulp. However, missing differentiating their ability to meet the basic criteria to define them as stem cells

Calcitonin gene-related peptide receptor expression in healthy and inflamed human pulp tissue.

AIM: To use radioreceptor analysis for comparing calcitonin gene-related peptide (CGRP) receptor expression in human pulp tissue samples collected from teeth having a clinical diagnosis of acute irreversible pulpitis, healthy pulps and teeth with induced inflammation. METHODOLOGY: Six pulp samples were obtained from teeth having a clinical diagnosis of acute irreversible pulpitis. Another eight pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic purposes. In four of these premolars, inflammation was induced prior to pulp collection. All the samples were processed and labelled with 125I-CGRP. Binding sites were identified by 125I-CGRP and standard CGRP competition assays. RESULTS: CGRP receptor expression was found in all human pulp tissue samples. Most receptors were found in the group of pulps from teeth having a clinical diagnosis of acute irreversible pulpitis, followed by the group of pulps having induced inflammation. The least number of receptors was expressed in the group of healthy pulps. The Kruskal-Wallis and Mann-Whitney (post-hoc) tests showed statistically significant differences between the groups (P < 0.05). CONCLUSION: CGRP receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.

[Influence of age, duration of smoking habit and cigarette consumption on keratinization indexes of the oral mucosa]. / Influencia de la edad, duración del hábito de fumar y consumo de cigarrillos sobre los indices de queratinización de la mucosa bucal.

In order to determine influence of habit of smoking black cigarettes on rhythm of cell maturity of the mucosa of palate and cheeks, cytologic samples of such regions were taken to 52 male individuals, who were smokers since more than five years ago, older than 40 years and who at the time of the clinical examination did not present evidences of any type of lesion. The samples were compared with those from a control group comprising non-smoker individuals, but with the same characteristics. The samples were obtained by scraping cheeks and palate with a wooden spatula, and were fixed with ethyl alcohol and stained by Papanicolaou's technique. Observations were performed at a light microscope. Microscopic fields for cell counting were selected at random. More than 300 cells per patient were evaluated taking into account their morphology and characteristics of staining affinity. Within the studied variables, that of smoking years was the most influencing on modifications of cell keratinization indexes in the buccal mucosa of healthy smokers (p less than 0.05).

[Oral leukoplakia. Current concepts and analysis of the term in the Spanish language]. / Leucoplaquia bucal. Conceptos actuales y análisis del término en la lengua Española.

The purpose of this paper is to carry out an analysis of the term leukoplakia since its introduction in 1877 and to expose the most accepted concepts and present classification within specialists. For this purpose attention will be paid to definitions established in the international seminary developed in Malmö City, Sweden, in June 1983. A group of observations on present status of research and diagnostic methods and its limitations to pre-establish when a lesion of this type is going to evolve toward malignancy, is included. An important part of this paper is devoted to the linguistic analysis of leukoplakia and leukoplasia expressions. An extensive argumentation demonstrating the systematic impropriety in the Spanish Language of translating the English term "leukoplakia as leukoplasia, is presented. There is in Spanish the accurate translation, given by the expression leukoplakia, which is not only the adequate one for the exactness of its translation but also the one more conceptually adjusted to contemporary definition universally accepted, that is to say, a white plaque. Finally, a comment on importance of incorporates to our language the exact translation of scientific words, not only to fit it to present science, but also to a better fulfillment of its function in allowing the communication within Latin American researches themselves and with the world scientific community, is exposed.

Deteccion de candida en cavidad bucal en un grupo de niños eutroficos y desnutridos

Candida albicans es una levadura, frecuente comensal en la microflora bucal, sin embargo, la predisposición del hospedero interviene como cofactor en la génesis de la candidiasis bucal, aunado a las deficiencias nutricionales. El objetivo de este estudio fue determinar la presencia de C. albicans y otras especies de Candida en un grupo de niños desnutridos y compararla con un grupo de niños nutridos o eutróficos. En esta investigación se estudiaron sesenta y tres niños de 3 a 6 años de edad que acudieron al Centro Atención Nutricional Infantil de Antímano (CANIA), 34 eran desnutridos y 29 eutróficos; ninguno de los niños evaluados presentó signos clínicos de candidiasis bucal. Del total de casos, 28 (44.44%) dieron positivos para levaduras, de estos 19 (67,87%) correspondieron a niños desnutridos y 9 (32,14%) a niños eutróficos. De los 35 casos de cultivos negativos para levaduras, el mayor porcentaje (57,14%) se encontró en los niños eutróficos. El análisis de test estadístico de diferencias de dos proporciones, demostró que C. albicans fue la especie mas frecuente (35,71%) en los niños desnutridos, en comparación a los eutróficos (14,28%). Otras especies de Candida también fueron encontradas. En cuanto a sexo y edad, no hubo diferencias estadísticamente significativas. La evaluación de la respuesta inmune celular en 40 niños de este estudio con el antígeno de Candidina, evidenció solo un 38% de positividad en los niños desnutridos, ante un 63% en niños eutróficos, esto nos señala la baja respuesta o defensa inmunológica que presenta el grupo de niños desnutridos frente a esta levadura, lo cual nos hace sugerir, que esto puede ser un factor predisponente en este grupo para el desarrollo de la enfermedad.

Candida albicans is a yeast, frequent diner in the oral microflora, however, the predisposition of the host acts as a cofactor in the genesis of oral candidiasis, coupled with nutritional deficiencies. The aim of this study was to determine the presence of C. albicans and other Candida species in a group of malnourished children and compare it with a group of children nourished or eutrophic. This study examined sixty-three children from 3 to 6 years of age who came to the Center for Child Care Nutrition Antímano (Cania), 34 were malnourished and 29 eutrophic; none of the children tested showed signs of clinical oral candidiasis. Of the total cases, 28 (44.44%) were positive for yeast, these 19 (67.87%) children were malnourished and 9 (32.14%) children eutrophic. Of the 35 cases negative for yeast cultivation, the highest percentage (57.14%) were found in children eutrophic. An analysis of statistical test of differences of two proportions, showed that C. albicans species was the most frequent (35.71%) in malnourished children, compared to eutrophic (14.28%). Other Candida species were also found. As for sex and age, there was no statistical difference. The evaluation of the cellular immune response in 40 children in this study with the antigen Candidina, showed only 38% of positivity in malnourished children, with 63% in eutrophic children, we noted that the low immune response or defense that presents the group of malnourished children in front of this yeast, which makes us suggest that this may be a predisposing factor in this group for developing the disease.

[Denture stomatitis: epidemiological study of 6,302 patients with removable dental prostheses]. / Estomatitis subprotesis: estudio epidemiológico en 6,302 pacientes portadores de protesis dentales removibles.

This research was performed with the purpose of being acquainted with the frequency of onset of subprosthetic stomatitis in a large group of individuals and to determine some causal variables derivative of personal customs and habits of using prosthesis. The universe of study was represented by all the patients carrier of denture-plate for six months or more, who attended to 36 stomatologic clinics during a period of three uninterrupted weeks. A total of 6,302 individuals was examined and 2,952 of them were recorded as affected by subprosthetic stomatitis, for a rote of 46.84%; corresponding 50.47% to female sex and 39.96% to male sex. The most involved decade of life was that of 30 years, for 49.8%, and higher affection was observed in individuals using prosthesis with acrylic base, accounting for 48.45%. The largest amount of lesions, 63.04%, corresponded to clinical grade I. Of the individuals who estimated at the beginning of using fixed prosthesis, that such prosthesis were suitable and well fitted, 47.14% presented alterations. Of the individuals examined, 83.38% had the habit of sleeping with prosthesis, and 51.07% of them was affected by lesions.

Hereditary hypotrichosis simplex of the scalp.

We report on a female aged 13 years, whose scalp hair began to disappear at the age of 9 years, leaving only sparse wispy hairs in the parietal-occipital region. Eyelashes, eyebrows and body hair were unaffected. There were no signs of ectodermal dysplasia on the skin, nails, teeth and eyes nor other congenital abnormalities. The family pedigree showed 15 relatives similarly affected according to an autosomal dominant mode of transmission. Clinical, genetic, histological and ultrastructural aspects led to a diagnosis of hereditary hypotrichosis simplex of the scalp (Toribio-Quiñones type).

Laparoscopic-assisted colonoscopic polypectomy: the Texas Endosurgery Institute experience.

PURPOSE: The advent of laparoscopic surgery has altered the manner by which surgical specialties address pathologies of the abdominal cavity. This advance in technology has also changed colorectal surgery. One of the more common procedures of colorectal surgery is segmental resection for polyps that are large, broad based, or inaccessible for colonoscopic removal. We present a technique combining colonoscopy and laparoscopy to remove troublesome polyps without the need for segmental resections. METHODS: From May 1990 to September 1999 laparoscopic-monitored colonic polypectomies were performed in 47 patients, with a total of 60 polyps being removed. After laparoscopic mobilization of the involved segment of the colon, the proximal bowel is cross-clamped and the colonoscope passed to the involved portion of the colon. The polyp is then presented to the colonoscopist by the laparoscopist facilitating removal. The serosal surface is monitored for any indications of transluminal injury, and the area is repaired if needed. All polyps undergo immediate frozen section analysis. If the pathologic evaluation indicates malignancy then a segmental resection may be performed, otherwise the patients are decompressed and fed within a short time before discharge. RESULTS: The polyps were located most commonly in the ascending colon (18 polyps), transverse colon (12 polyps), and cecum (12 polyps). The most common histopathologic diagnosis was tubulovillous adenoma in 28 polyps followed by villous adenoma in 11 polyps. In three cases histopathologic diagnosis revealed malignancy necessitating segmental resection (1 low anterior resection and 2 right hemicolectomies), which were performed laparoscopically. Patients received a liquid diet within 6 hours, were discharged in an average of 21 hours, and returned to full activity, usually within days. The only complication presented in this group of patients was an umbilical port seroma. Virtually all patients (97 percent) behaved as if only a colonoscopy had been performed. Pain at the trocar sites was managed with acetaminophen 600 mg by mouth as needed. CONCLUSION: Laparoscopic-monitored colonoscopic polypectomy allows patients to undergo removal of colonic polyps without a segmental resection. This less invasive procedure yields recovery times similar to that of colonoscopy alone, and the potential complications of a segmental resection are avoided. All polyps are examined by frozen section, and if a malignancy is encountered, a laparoscopic resection can be performed.