Microlaparoscopic technique for partial salpingectomy using bipolar electrocoagulation.

OBJECTIVE: To describe a technique of performing a partial salpingectomy using a small-diameter (2-mm) laparoscope and bipolar electrocoagulation. STUDY DESIGN: Sixty consecutive women desiring permanent sterilization underwent laparoscopic partial salpingectomy using a 2-mm transumbilical laparoscope and secondary midline sites suprapubically and midway above the pubis. A midportion of the tube was coagulated using Kleppinger forceps, transected with scissors and removed using grasping forceps. RESULTS: Additional time to remove both coagulated tubal segments averaged 4 minutes (range, 3-10). Each segment (mean, 1.5 cm; range, 0.9-2.4 cm) was confirmed in the operating room, then histologically. The transected tubal edges were separated with no thermal injury to nearby structures and with no mesosalpingeal hemorrhage. No cases required conversion from microlaparoscopy to a traditional method, and recovery time was not prolonged. The puncture sites healed well without sutures. CONCLUSION: Successful removal of electrocoagulated tubal segments with histologic confirmation was undertaken microlaparoscopically, with minimal additional operative time.

The effect of high-dose right upper quadrant lithotripsy on normal swine tissue.

To assess the effects of high doses of shock waves to organs in the right upper quadrant of the abdomen, 36 adolescent swine were given one treatment of either 2,000 (2k), 6,000 (6k), or 10,000 (10k) shock waves at 24 kV peak pressure using a spark-gap lithotriptor. Shock waves were sonographically focused on the lumen of the gallbladder. Blood and tissue were examined for each group at 48 hours, at 35 days, and at 6 months. This study showed that administration of up to five times the accepted upper limit of shock waves produced no permanent damage. Transient injury, most commonly hematoma, was encountered. No posttreatment intra-abdominal catastrophes occurred. Although no renal injury was seen, it should be noted that the focus of maximum energy was 5 cm cephalad to the right kidney. This study suggests that an increased number of shock waves may be administered safely to this area of the abdomen.

Vulvar leiomyoma associated with estrogen/progestin therapy. A case report.

Leiomyomata of the vulva are reported rarely. A previously unrecognized leiomyoma in the area of Bartholin's gland grew rapidly during estrogen/progestin replacement therapy. Hormone receptors for both estrogen and progesterone were positive.

Cocaine and metabolites in the hair of ancient Peruvian coca leaf chewers.

Cocaine and its metabolites, benzoylecgonine (BZE) and ecgonine methylester (EME), were found in hair samples from ancient Peruvian coca-leaf chewers dating back to AD 1000. Hair was analyzed by gas chromatography/mass spectrometry (GC/MS) to quantitate the concentrations. The two metabolites were found in higher concentration than the parent drug. The metabolite levels appear to be below that of modern cocaine abusers. Gender does not appear to be a factor in the incorporation of drug into hair.

Cocaine metabolites in pre-Columbian mummy hair.

Chewing of coca leaves was an integral part of many Andean pre-Columbian populations. Since the cocaine metabolite benzoylecognine is entrapped in hair of the user, this could serve as a convenient specimen for analysis. We tested the scalp hair of 8 Chilean mummies with dates ranging from 2,000 BC to 1,500 AD. This article reports that benzoylecognine is very stable and can be found in mummy hair.