Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been suggested that atypical, nonpigmented endometriotic lesions have an increased capacity to synthesize prostaglandin (PG)F2alpha compared with typical endometriosis, and could therefore represent the more active forms of the disease. We took biopsy specimens of various endometriotic lesions and of normal endometrium and peritoneum during operative laparoscopy in 12 infertile women. The specimens were transferred in flasks containing Krebs solution and placed in a shaking incubator for 1 hour at 37° C. The incubation solution was changed every 20 minutes and assayed by radioimmunoassay procedures for the concentration of PGF2alpha. Biopsy specimens from normal peritoneum and normal endometrium were also taken from five control patients with no evidence of endometriosis. The PGF2alpha concentration/milligram of tissue was not significantly less different between typical and atypical implants, and among the different atypical forms. Endometriotic cyst wall produced significantly less PGF2alpha than both typical and atypical peritoneal implants, and significantly more than normal peritoneum. There was no difference in production for normal tissue (endometrium or peritoneum) between patients with endometriosis and controls. We did not confirm evidence from the literature of a higher production of PGF2alpha in atypical versus typical endometriotic lesions. Our data do not support selective ablation of atypical forms, since typical endometriotic lesions could be similarly active in prostaglandin production.
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PMID:Production of Prostaglandin F2alpha by the Different Forms of Endometriosis 907 91

Theoretically, in laparoscopic surgery, a computer interface in command of a mechanical system (robot) allows the surgeon: (1) to recover a number a number of lost degrees of freedom, thanks to intraabdominal articulations; (2) to obtain better visual control of instrument manipulation, thanks to three-dimensional vision; (3) to modulate the amplitude of surgical motions by downscaling and stabilization; (4) to work at a distance from the patient. These advances improve the quality of surgical tasks in a perfect ergonomic position. The purpose of this paper is to evaluate the feasibility of utilizing a robot in laparoscopic surgery. The first robot-assisted procedure in humans was performed in March 1997 by our team. One hundred forty-six patients underwent robot-assisted laparoscopic surgery. Between March 1997 and February 2001 a nonconsecutive series was performed of 39 antireflux procedures, 48 cholecystectomies, 28 tubal reanastomoses, 10 gastroplasties for obesity, 3 inguinal hernias, 3 intrarectal procedures, 2 hysterectomies, 2 cardiac procedures, 2 prostactectomies, 2 arteriovenous fistulas, 1 lumbar sympathectomy, 1 appendectomy, 1 laryngeal exploration, 1 varicocele ligation, 1 endometriosis cure, 1 neosalpingostomy, 1 deferent canal. The robot (Da Vinci system, Intuitive Surgical, Mountain View, CA), consists of a console and a cart with three articulated robot arms. The surgeon sits in front of the console, manipulating joysticklike handles while observing the operative field through binoculars that provide a three-dimensional picture. This computer is capable of modulating these data by eliminating physiologic tremor and by downscaling the amplitude of motions by a factor 5 or 3 to one. This study has demonstrated the feasibility of several laparoscopic robotic procedures. There is no morbidity related to the system. Operating time and the hospital stay were within acceptable limits. The system seems most beneficial in intra-abdominal microsurgery or for manipulations in a very small space. Optimized ergonomics and increased mobility of the instrument tips are beneficial in many steps of abdominal surgical procedures.
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PMID:Feasibility of robotic laparoscopic surgery: 146 cases. 1176 Jul 51

Robotic technology is nothing more than an enhancement along the continuum of laparoscopic technological advances and represents only the beginning of numerous more forthcoming advances. It constitutes a major improvement in the efficiency, accuracy, ease, and comfort associated with the performance of laparoscopic operations. Instrument articulation, downscaling of movements, absence of tremor, 3-D image, and comfort for the surgeon, assistant and scrub nurse are all new to the practice of laparoscopy. In our hands, robotic operative times for simple and radical hysterectomy are shorter than those obtained by conventional laparoscopy. Robotic technology is preferable to conventional laparoscopic instrumentation for the surgical treatment of gynecologic malignancies and most operations for benign disease of certain complexity such as hysterectomy myomectomy, and invasive pelvic endometriosis.
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PMID:Robotic surgery in gynecology. 1747 65

Standard laparoscopy (SL) is the gold standard for endometriosis surgery including deep infiltrating endometriosis (DIE). DIE laparoscopic surgery can require complex surgical procedures performed by multidisciplinary surgical team. Robotic assisted laparoscopy (RAL) could offer technical advantages such as 3D vision, tremor filtration and better surgical ergonomy. RAL would be able to improve surgical performances compared to SL, decrease perioperative morbidity and decrease the risk of laparo-conversion. For these reasons, DIE could be one of the best indications for RAL in gynecologic surgery. Demonstrating the feasibility of RAL for DIE surgery, few series of cases have been already published. None of them have demonstrated differences in surgical outcomes. One randomized control trial comparing SL to RAL would be mandatory in order to define potential benefits of RAL for DIE surgery.
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PMID:Role of robotic surgery in the management of deep infiltrating endometriosis. 2677 10

The advent of robot-assisted laparoscopy (RAL) is an important innovation which has provided new perspectives for the treatment of endometriosis, and particularly of deep infiltrating endometriosis (DIE). RAL offers several technical advantages in the treatment of this complex disease, such as 3D view, tremor filtration and better surgical ergonomics, thus improving surgical performances without no increase in surgical time, blood loss, and intra- or postoperative complications, while also reducing the rate of conversion to laparotomy. Additionally, thanks to its reduced learning curve compared to conventional laparoscopy (CL), it facilitates the training of less experienced surgeons. For these reasons, DIE might be one of the best indications for RAL in gynecologic surgery. However, very few retrospective studies and small cases series, and only one randomized clinical trial have been published in this regard. Further randomized control trials comparing CL to RAL for different stages of endometriosis and different procedures performed are warranted in order to be able to define potential benefits of RAL for endometriosis surgery.
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PMID:The role of robotics in the management of endometriosis. 2827