Primary Port Research Articles

Localization of sex hormone binding globulin in the rat vomeronasal organ

Volatile and non-volatile derivates of gonadal steroids are known to act as pheromones in many mammalian species. Pheromones have multiple effects on the brain via the olfactory system. Their primary port of entry seems to be the vomeronasal organ (VNO) but the underlying cellular and molecular mechanisms are unclear so far. Recently we localized sex hormone binding globulin (SHBG) in both the main and the accessory olfactory system of rat with immunocytochemistry and RT-PCR. The accessory olfactory system consisting of VNO and accessory olfactory bulb showed high expression of SHBG.In the present paper we studied SHBG expression in the VNO in greater detail. In semithin sections we found SHBG immunostaining in the perinuclear cytoplasm of some of the sensory neurons, in sensory cilia and in their axons. A portion of the basal cells and some of the goblet cells in the non-sensory epithelium showed intense SHBG staining. SHBG was abundant in exocrine cells of the vomeronasal glands, perhaps compartimentalized in secretory vesicles. In situ hybridization revealed specific signals in sensory and non-sensory cells of the VNO. Our findings indicate that SHBG expressed in the VNO may be liberated into nasal secretions to bind aerosolic steroids. SHBG in sensory cells may be involved in signaling actions of pheromones.

Injection matched approach for wideband tunable electrically small antennas

In this study, an approach for making electrically small antennas is proposed. In this technique, a two port configuration is utilised in which one port is exploited (the secondary port) in order to match the other port (the primary port) to the source. Based on the proposed approach a microstrip patch antenna is designed and fabricated. The simulated and measured results show that utilising the proposed technique allows the patch antenna to resonate at a frequency much lower than its intrinsic resonance frequency. Moreover, not only it considerably improves the bandwidth of operation, but also it allows frequency reconfiguration in a wide range.

The Incidence and Patterns of Failure in Patients With Stage I/II Squamous Cell Carcinoma of the Oral Cavity (SCC-OC) Treated With Surgery Alone: Implications for Adjuvant Radiation Therapy

Materials/Methods: From August 2001 through May 2012, 183 patients with cancer of the oral cavity were identified. Following exclusion of patients with prior head and neck cancer, non-squamous histology, no surgery, N2c or greater or M1 staging, or PORT plans unavailable or bilateral necks treated, 57 patients remained for analysis. Patient demographics, tumor, treatment, and outcome information were abstracted from the charts. Regional recurrence was estimated via Kaplan-Meier method and groups were compared via log-rank test. Results: Median follow-up from diagnosis was 21 months range. Primary sites included alveolar ridge (17.5%), buccal (8.8%), floor of mouth (21.1%), hard palate (5.3%), retromolar trigone (5.3%), and oral tongue (42.1%). Primary site was staged T1-2 in 59.6% and T3-4 in 40.4%. Of the cohort, 12% did not undergo neck dissection, while 18% underwent bilateral and 70% ipsilateral neck dissection. Concurrent chemotherapy was used in 26.3% of patients. Of the cohort, 34 (59.6%) patients were found to be clinically or pathologically node negative, out of which 22 (38.5%) were treated with PORT only to the primary site and 12 (21.1%) had primary site and ipsilateral neck PORT; actuarial regional control (RC) at 2 years was 78.6% and 80%, respectively. Of the 4 total regional failures in the PORT-primary only group, 1 patient had a regional only relapse, the remainder failed both locally and regionally. Of the 2 total regional failures in the PORT-primary/ipsilateral neck, both were in the treated neck, and one was both local and regional. Of the node positive patients, all 23 were treated with primary and ipsilateral PORT with 2 year RC rate of 94.7%. The one patient with regional failure relapsed in the treated neck. Conclusions: In selected patients with lateralized oral cavity squamous cell carcinoma it may be reasonable to exclude the N0 bilateral neck, or in ipsilateral node positive neck the contralateral neck, from the post-operative radiation therapy volumes. Author Disclosure: J.A. Contreras: None. N.G. Rao: None. A.M. Trotti: None. J.J. Caudell: None.

PTU-155 Lessons Learnt from the First 50 Consecutive Primary Laparoscopic Nissen Fundoplications in a Single Surgeon’S Practice

IntroductionLaparoscopic Nissen fundoplication (LNF) is widely used in the surgical management of gastroesophageal reflux disease (GORD). However, it is a complex operation that requires advanced laparoscopic skills. Very few studies...

Laparoscopic cholecystectomy in patients with a previous history of gastrectomy.

Laparoscopic cholecystectomy (LC) in patients with a previous history of upper abdominal surgery is a difficult procedure with a high conversion rate. Forty-two patients with a previous history of gastrectomy (gastrectomy group) were compared to patients without previous abdominal surgery (no surgery group, n=1375). Patients in the gastrectomy group were divided into two groups for comparison: first, an umbilicus-group (n=12, at the umbilicus) and a side-group (n=23, right of the umbilicus) by the location of the primary port insertion, second, a benign group (n=31) and a malignant group (n=11). Patients in the gastrectomy group had similar operative morbidity but a significantly higher conversion rate and a longer postoperative hospital stay than patients in the no-surgery group. Conversion was performed in four patients in the gastrectomy group (9.5%): 3 in the umbilicus-group and one in a side-group. Two patients in the umbilicus-group had adhesion only just around the primary port site. Patients in the malignant group had similar postoperative hospital stay and morbidity but a significantly longer operating time than patients in the benign group. Previous gastrectomy for benign or malignant diseases is no longer considered a relative contraindication for performance of safe LC.

Listeria monocytogenes: No Spreading without NO

In infectious disease immunology, inducible nitric oxide (NO) synthase-derived NO is believed to function primarily as an antimicrobial and immunoregulatory molecule. In this issue of Immunity, Cole etal. (2012) show that NO helps the intracellular bacteria Listeria monocytogenes to spread.

A new variable-view rigid endoscope evaluated in advanced gynecologic laparoscopy: a pilot study

This pilot study aimed to evaluate the optical performance and clinical handling of a new variable-view rigid endoscope with angulation from 0 º to 120 º in gynecologic laparoscopic surgery. The EndoCAMeleon endoscope was assessed by experienced surgeons and assistants during a variety of advanced gynecologic laparoscopic procedures. After each procedure, both the surgeon and the assistant each completed questionnaires designed to assess the endoscope's ease of handling and optical performance. The endoscope was assessed during 21 advanced procedures. Questionnaire responses confirmed surgeon and assistant satisfaction with the mechanical handling and vision provided by the endoscope. In particular, the ability to vary the viewing angles enabled the surgeon to visualize the surgical site without moving the endoscope shaft. The new endoscope performed well in the hands of experienced surgeons and assistants undertaking advanced procedures. The variable-view rigid endoscope allows the use of visual ports during primary port entry and enhances vision. Further study is required to evaluate its performance in routine practice.

Laparoscopy Entry in Patients With Previous Abdominal and Pelvic Surgery

The background of this investigation is based on a common surgical problem: The access in laparoscopic surgery is more difficult in women with previous abdominopelvic surgery, since adhesions and viscera could be close to the point of trocar insertion. The authors analyzed the safety and the efficacy of a modified direct optical entry (DOE) method versus the Hasson's method by open laparoscopy (OL) in women with previous abdominopelvic surgery in a preliminary prospective case-control study. A total of 168 women underwent laparoscopic surgery in university-affiliated hospitals: 86 were assigned to abdominal DOE (group A) and 82 to OL (group B). The main outcome measures were statistically compared: time required for entry into abdomen, blood loss, and occurrence of vascular and/or bowel injury. All patients had an intraperitoneal view of the primary port site during surgical procedure. Statistical differences, in favor of the DOE group (P < .01), were found in duration of entry and blood loss. The vascular and bowel injuries in OL versus DOE were not statistically different. Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in patients with previous abdominopelvic surgery, since it can become a difficult, time-consuming, and occasionally hazardous procedure. The study results suggest that DOE is advantageous when compared with OL in terms of saving time enabling a safe and expeditious visually guided entry for laparoscopy.

Robust genital gag‐specific CD8+ T‐cell responses in mice upon intramuscular immunization with simian adenoviral vectors expressing HIV‐1‐gag

Most studies on E1-deleted adenovirus (Ad) vectors as vaccine carriers for antigens of HIV-1 have focused on induction of central immune responses, although stimulation of mucosal immunity at the genital tract (GT), the primary port of entry of HIV-1, would also be highly desirable. In this study, different immunization protocols using chimpanzee-derived adenoviral (AdC) vectors expressing Gag of HIV-1 clade B given in heterologous prime-boost regimens were tested for induction of systemic and genital immune responses. Although i.n. immunization stimulated CD8(+) T-cell responses that could be detected in the GT, this route induced only marginal cellular responses in systemic tissues and furthermore numbers of Gag-specific CD8(+) T cells contracted sharply within a few weeks. On the contrary, i.m. immunization induced higher and more sustained frequencies of vaccine-induced cells which could be detected in the GT as well as systemic compartments. Antigen-specific CD8(+) T cells could be detected 1 year after immunization in all compartments analyzed. Genital memory cells secreted IFN-γ, expressed high levels of CD103 and their phenotypes were consistent with a state of activation. Taken together, the results presented here show that i.m. vaccination with chimpanzee-derived (simian) adenovirus vectors is a suitable strategy to induce a long-lived genital CD8(+) T-cell response.

Laparoscopic anatomy of caprine abdomen and laparoscopic liver biopsy

This study was carried out on apparently healthy adult non pregnant female Baladi goats to provide normal laparoscopic anatomy of the abdomen and to assess feasibility of laparoscopy for liver biopsy. Following preparation of animals, equipments and instruments, the primary port and laparoscope was placed on the umbilicus and 360° scan was performed for orientation and exploration of the abdominal cavity. Secondary ports were placed under direct laparoscopic observation to allow insertion of accessory instruments for tissue grasping, coagulation and severing. The obtained results cleared that ventral laparoscopic approach and tilting and rotating the animal during laparoscopic procedures provided better exposure of internal abdomen. Laparoscopy provided a comprehensive description of cranial and caudal abdominal regions. Laparoscopic liver biopsy required two secondary ports; one assisting port inserted in right subcostal area and one operating port inserted subxiphoid. The procedure was safe, practical and easily performed.

Using an Optical Trocar for Laparoscopic Access in Overweight and Obese Children

The open Hasson technique with a purse-string suture is generally favored among pediatric surgeons performing laparoscopy. This is a challenge in overweight and obese children and often leads to delays or conversion to laparotomy. In this article, we report our experience with an optical trocar for primary port access in overweight and obese children.

Polarization-dependent loss compensation on silicon-wire waveguide tap by complex refractive index of metals

A photodetector can be applied onto a silicon-wire waveguide tap to monitor light signals on waveguides. To meet the complexity of optical integrated circuits, the proposed photodetector would be positioned onto a wafer base instead of being employed and terminated at the edge end of an optical component. Because the silicon-wire-based optical directional coupler shows an undesirably high level of polarization-dependent loss on the tap port compared with the primary port, the complex refractive index of the reflective metal layer was proposed integrated into the direction-changing tap region, made using a 54.7 degrees angle from anisotropic silicon wet etching. This structure compensates for the polarization dependent loss of the tapping signal power for the primary port monitoring.

Detection and identification by PCR of Clostridium chauvoei in clinical isolates, bovine faeces and substrates from biogas plant

BackgroundClostridium chauvoei causes blackleg, an acute disease associated with high mortality in ruminants. The apparent primary port of entry is oral, during grazing on pasture contaminated by spores. Cases of blackleg can occur year after year on contaminated pastures. A method to determine the prevalence of C. chauvoei spores on pasture would be useful.The standard method for C. chauvoei detection is culture and biochemical identification, which requires a pure culture. In most muscle samples from cattle dead from blackleg the amount of C. chauvoei in samples is high and the bacterium can easily be cultured, although some samples may be contaminated. Detection by PCR would be faster and independent of contaminating flora.Digested residues from biogas plants provide an excellent fertiliser, but it is known that spore-forming baeria such as Clostridium spp. are not reduced by pasteurisation. The use of digested residues as fertiliser may contribute to the spread of C. chauvoei. Soil, manure and substrate from biogas plants are contaminated with other anaerobic bacteria which outgrow C. chauvoei. Therefore, detection by PCR is would be useful. This study applied a PCR-based method to detect of C. chauvoei in 25 muscle and blood samples, 114 manure samples, 84 soil samples and 33 samples from the biogas process.MethodsMuscle tissues from suspected cases of blackleg were analysed both by the standard culture method followed by biochemical identification and by PCR, with and without preculture. To investigate whether muscle tissue samples are necessary, samples taken by swabs were also investigated. Samples from a biogas plant and manure and soil from farms were analysed by culture followed by PCR. The farms had proven cases of blackleg. For detection of C. chauvoei in the samples, a specific PCR primer pair complementary to the spacer region of the 16S-23S rRNA gene was used.ResultsClostridium chauvoei was detected in 32% of muscle samples analysed by culture with identification by biochemical methods and in 56% of cases by culture in combination with PCR. Clostridium chauvoei was detected in 3 (out of 11) samples from the biogas plants collected before pasteurisation, but samples taken after pasteurisation and after digestion all tested negative. Clostridium chauvoei was not detected in any soil or silage samples and only one manure samples tested positive.ConclusionThe diagnostic method used for C. chauvoei was not applicable in estimating the risk of blackleg on particular pastures from manure or soil samples, but found to be highly useful for clinical samples.

Characteristics of GaAs transformers for RFIC applications

AbstractIn this article, stacked transformers, coupling stacked transformers, interleave transformers, and symmetrical transformers on GaAs substrate are systematically studied. Two kinds of stacked transformer are under study. One has the symmetrical electric property while the other one has a better quality factor for the primary port. The stack transformers have achieved the highest coupling coefficient (∼0.9) at the cost of lower self‐resonance frequency. The interleave transformers have the identical electrical properties for the primary and the secondary ports. However, the layout is incompatible with the differential operation. On the other hand, the symmetrical transformer is compatible with the differential operation and can have the center‐tapped biasing option. The data established here provides a useful design library for the GaAs RFIC. © 2008 Wiley Periodicals, Inc. Microwave Opt Technol Lett 50: 2937–2942, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.23853

Analysis and Optimization of a Two-Way Valve using Response Surface Methodology

AbstractThis paper describes the use of a numerical procedure developed by the authors for the analysis and optimization of hydraulic components. The element taken as reference is a two-way priority spool valve, typically utilized in steering systems with a load sensing control strategy in the presence of other actuators. The valve's purpose is to control the primary port flow rate, the exceeding flow being discharged to the secondary output port.The optimization algorithm is based on Response Surface Methodology techniques, adopting the path search method known as Steepest Descent. For this purpose, the component's behaviour is analytically described by means of a properly defined objective function. The procedure approximates this objective function with a simple model whose coefficients are evaluated using an AMESim® model of the valve, previously verified using test results. The simulations required to find the fitting model are planned using Design Of Experiments (DOE) methods.Because of the large nu...

Direct Trocar Insertion: A Safe Laparoscopic Access

Background: The most important and potentially dangerous first step in laparoscopy is safe and successful insertion of a primary port. Techniques for the creation of pneumoperitoneum at laparoscopy include the standard technique of insufflation after insertion of the Veress needle (VN) via the umbilicus, open laparoscopy, optical trocar insertion and direct trocar insertion (DTI) as well as variations on these techniques. The DTI technique without pre-insufflation is an alternative to VN insertion and open laparoscopy for accessing the abdominal cavity for operative laparoscopy. It recommends elevation of anterior abdominal wall with the non-dominant hand while inserting the sharp primary trocar directly and blindly towards the peritoneal cavity with the other. Conclusion: After reviewing the methods available and surveying the existing data concerning the rates of failure and complications, we conclude that, DTI at laparoscopy is a safe alternative to the VN technique and is associated with fewer minor complications.

Positional Anatomy of Vessels That May Be Damaged at Laparoscopy: New Access Criteria Based on CT and Ultrasonography to Avoid Vascular Injury

To study the relations of major blood vessels (aortoiliac bifurcation and iliocaval confluence) and the inferior epigastric arteries to the umbilicus and the anterior superior iliac spine (ASIS) planes and to apply this information to define ideal, anatomically based locations for primary and secondary laparoscopic port insertions to minimize vascular injuries. Two hundred randomly selected postcontrast CT images of the abdomen and pelvis were assessed by two radiologists. The position of the umbilicus (mobile point), ASIS (fixed point), and relations with the great vessels were measured. The angle of the umbilicus with the aortic bifurcation, theta (theta), was calculated using trigonometric principles. The position and course of the inferior epigastric arteries (IEA) was analyzed in 103 patients with color Doppler ultrasonography. The median distance of the aortoiliac bifurcation was 8 mm (interquartile range [IQR] 28.8 mm] and that of the iliocaval venous confluence 25 mm (IQR 32 mm) below the umbilicus. The aorta divided 48 mm (IQR 16 mm) and the iliac veins joined 33 mm (IQR 9 mm) above the ASIS plane. The angle of the umbilicus to the aortoiliac bifurcation in the sagittal plane had a range of 14 degrees to 34 degrees with a median of 21.6 degrees . The median distance from the right IEA to the midline at the umbilicus was 4.75 cm (IQR 0.7 cm), and the same distance in the ASIS plane was 4.8 cm (IQR 0.7 cm). The distance of the IEA to the midline did not exceed 6 cm in any patient on either side or in either plane. The position of the umbilicus should not be relied on for access planning. The relation between the level of the ASIS and the aortic bifurcation is more consistent. The ideal primary port entry (or Veress needle site) is at the ASIS plane in the midline, and the ideal lateral port entry is in the same plane >6 cm from the midline. If the umbilicus is to be used, a Hasson insertion is desirable, but if a Veress needle is used at the umbilicus, an angle of 45 degrees in the sagittal plane should be used.

Detention at Angel Island: First Empirical Evidence

Between 1910 and 1940 the Angel Island Immigration Station was the primary port of entry for Asians into the United States, the place of enforcement of the Chinese Exclusion Act and other anti-Asian immigration policies. Even in the absence of substantiating data, it is frequently asserted that almost all entering Chinese were detained at Angel Island and that they were detained for weeks, months, even years. This article presents the first empirical evidence on how long people arriving at San Francisco were detained at the Angel Island Immigration Station. The use of newly discovered data on passengers of the Pacific Mail Steamship Company (PMSS) for the period 1913–19 adds an empirical basis to our understanding of how immigration laws were administered in classifying and detaining aliens seeking to enter the United States, which arrivals were detained at Angel Island, and for how long. Results show that many Chinese were not detained at all; there was great variation in length of detention for Chinese who were detained; only some of this variation can be explained by the type of exempt status claimed for admission under the Chinese exclusion laws; Japanese arrivals had an even higher incidence of detention; and many detainees were either non-Asian, had come on ships from Central or South America, or were not immigrants at all.

Detention at Angel Island

Between 1910 and 1940 the Angel Island Immigration Station was the primary port of entry for Asians into the United States, the place of enforcement of the Chinese Exclusion Act and other anti-Asian immigration policies. Even in the absence of substantiating data, it is frequently asserted that almost all entering Chinese were detained at Angel Island and that they were detained for weeks, months, even years. This article presents the first empirical evidence on how long people arriving at San Francisco were detained at the Angel Island Immigration Station. The use of newly discovered data on passengers of the Pacific Mail Steamship Company (PMSS) for the period 1913-19 adds an empirical basis to our understanding of how immigration laws were administered in classifying and detaining aliens seeking to enter the United States, which arrivals were detained at Angel Island, and for how long. Results show that many Chinese were not detained at all; there was great variation in length of detention for Chinese who were detained; only some of this variation can be explained by the type of “exempt” status claimed for admission under the Chinese exclusion laws; Japanese arrivals had an even higher incidence of detention; and many detainees were either non-Asian, had come on ships from Central or South America, or were not “immigrants” at all.

Minimally invasive retroperitoneoscopic ureterolithotomy.

We assessed the efficacy of modified technique of retroperitoneal ureterolithotomy for managing ureteral stones. Between December 1999 and March 2002, 31 patients underwent retroperitoneal ureterolithotomy. In most cases only 3 ports (a 10 mm., 2 5 mm. and in a few 2, 3 mm.) were used without any ureteral stent or catheter. The stone was removed from the primary port site, while visualizing retrieval through the 3/5 mm. port using fine laparoscope. Ureterotomy closure was performed by intracorporeal interrupted sutures of 4-zero polyglactin. The 20 males and 11 females had a mean age of 38.5 years. Mean operative time was 67 minutes and mean hospital stay was 2.4 days. The mean analgesic requirement was 42.2 mg. meperidine. Mean followup was 8 months. There were no significant postoperative complications except persistent urine leakage in 2 patients 48 hours after surgery. An internal stent was placed and leakage subsided without any consequences. The modified, minimally invasive technique of retroperitoneal ureterolithotomy is highly effective and efficient without an associated increase in the complication rate.