Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “insertion”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources
PubMed2002

Novel design architecture for genetic stability of recombinant poliovirus: the manipulation of G/C contents and their distribution patterns increases the genetic stability of inserts in a poliovirus-based RPS-Vax vector system.

Poliovirus has been studied as a live recombinant vaccine vector because of its attractive characteristics. The genetic instability, however, has hampered recombinant polioviruses (PVs) from being developed as an appropriate vaccine. A variety of different foreign inserts were cloned directly into our poliovirus Sabin 1-based RPS-Vax vector system, resulting in the production of recombinant PVs. The genetic stability of each recombinant PV was examined during 12 rounds of consecutive passage. It was found that the genetic stability of the recombinants was not well correlated with their insert size. Instead, elevated stability was frequently observed in recombinants with inserts of high G/C contents. Furthermore, a comparative study using different constructs of the human immunodeficiency virus env gene revealed that the internal deletion of the unstable insert was seemingly caused by the presence of the adjacent A/T-rich region. The instability of these inserts was completely remedied by (i) increasing the G/C contents and (ii) replacing the local A/T-rich region with the G/C-rich codon without a change of the amino acid. This means that stability is closely associated with the G/C content and the G/C distribution pattern. To see whether these findings can be applied to the design of genetically stable recombinant PV, we have reconstructed the heteromultimeric insert based on our design architecture, including the above-mentioned G/C rules and the template/ligation-free PCR protocol. The heteromultimeric insert was very unstable, as expected, but the manipulated insert with the same amino acid sequence showed complete genetic stability, not only in vitro, but also in vivo. Even though this guideline was established with our RPS-Vax vector system, to some extent, it can also be applied to other live viral vaccine vectors.

Amino Acid Sequence↗
PubMed2004

Hearing loss in young adults who had ventilation tube insertion in childhood.

It is known that insertion of ventilation tubes can cause damage to the tympanic membrane and hearing deterioration in the long-term. To investigate long-term effects of recurrent otitis media and of ventilation tube insertion, we used a study group (n = 358 subjects), with or without a history of otitis media and/or ventilation tube insertion, derived from a birth cohort that had been followed for 16 years. At 18 years of age, a standardized audiometric and otoscopic examination was performed. We found that ventilation tube insertion in childhood was associated with a mean persistent hearing loss in young adults of about 5 to 10 dB at the group level with a sensorineural component of 3 to 4 dB. This hearing loss could not be explained by the disease load of otitis media in childhood. Repeated insertions of ventilation tubes caused a greater deterioration of hearing than did a single insertion. Structural changes of the tympanic membrane were a mediating factor in the causal relationship between ventilation tube insertion and hearing loss. We conclude that ventilation tube insertion in childhood may induce hearing deterioration in the long-term.

Adolescent↗
PubMedDate not supplied

Clinical use of an insert earphone.

There are several applications of and advantages to using an insert earphone. An insert earphone has three parts: a transducer to convert electrical energy to sound, a conduit to deliver the sound into the ear canal, and a coupler connecting the device to the canal. The data from this study indicate that there is a distinct advantage in using insert earphones over TDH-49 phones (standard headphones) in the attenuation of low frequency ambient noise. The use of insert earphones will permit one to test hearing in areas of higher ambient noise than was previously possible. Insert earphones are used to shorten the hearing aid selection process. A technique is described in which only one real ear measurement is required for an accurate hearing aid fitting. Most, but not all, of the masking dilemmas that are encountered with standard headphones are circumvented or eliminated by using insert earphones. In brain stem auditory evoked response testing, the insert earphone reduces the stimulus artifact without influencing the acoustic signal. Finally, the insert earphone solves the collapsing ear canal problem.

Audiometry↗
PubMedDate not supplied

Mechanical complications from insertion of subclavian venous feeding catheters: comparison of de novo percutaneous venipuncture to change of catheter over guidewire.

Since a percutaneous catheter insertion into the subclavian vein can be tedious, time consuming, and risky, we have compared the morbidity of 137 de novo subclavian catheter insertions to that of 93 reinsertions over guidewire. Mechanical complications were significantly higher (p less than 0.03) in those with catheter insertions (8.8%) than in those with the guidewire insertions (2.2%). These included pneumothorax (4), arterial puncture (4), catheter-size bleed (3), and hemothorax (1) in the catheter insertion group and local bleeding (1) and hydrothorax (1) in the guidewire insertion group. The difference in complications between methods is probably inherent in the techniques. Operator experience was not a factor: 55% of the physicians in each group had previously done less than 26 subclavian venous catheterizations. Preliminary analysis indicates that the infection rate, as determined by semiquantitative, cultures, is the same in each group. When considering the equal potential for infection, we conclude that change over a guidewire is an acceptable alternative to contralateral de novo percutaneous subclavian venipuncture for feeding catheter insertion. In view of fewer mechanical complications and greater ease of insertion, change of subclavian feeding catheters by guidewire is probably the method of choice.

Arteries↗
PubMed2001

Laryngeal mask vs intubating laryngeal mask: insertion and ventilation by inexperienced resuscitators.

The laryngeal mask airway (LMA) has been shown to be useful in airway maintenance during resuscitation. The intubating laryngeal mask (ILM) is a modified LMA permitting both ventilation and rapid endotracheal intubation. We aimed to compare the LMA and the ILM with regard to ease of insertion and successful ventilation by inexperienced personnel. We have used anaesthetized, apnoeic, non-paralysed patients as a model to simulate resuscitation. Following standardized training, non-anaesthetic medical staff with no previous experience in laryngeal mask airway insertion (novices) inserted either the LMA or ILM in 55 patients following induction of anaesthesia. There were no differences between the two patient groups included in our study with regard to mean age and body mass index (BMI). The success rate for inserting the airway device and achieving a significant end-tidal CO2 recording within two minutes was 23/28 for the LMA (82.1%) and 22/27 for the ILM (81.5%). Reasons for failure included inability to insert the ILM past the teeth and insertion of the LMA upside down. There were no clinically relevant differences in the mean time to airway insertion and successful ventilation (62.6 vs 62 seconds) or expired tidal volume (781 vs 767 ml) for the LMA and ILM respectively. We conclude that the ILM is as easily inserted and effectively used as an LMA by novices and, because it allows the option offacilitating endotracheal intubation, may be the preferred device for maintaining an airway during resuscitation.

Adult↗
PubMed2004

Bone density and insertion torque as predictors of anterior cruciate ligament graft fixation strength.

BACKGROUND: Bone mineral density and interference screw insertion torque are thought to be useful predictors of anterior cruciate ligament graft fixation strength. HYPOTHESIS: Bone mineral density and insertion torque are reliable predictors of anterior cruciate ligament graft fixation strength. STUDY DESIGN: Randomized experimental study. METHODS: The volumetric bone mineral density, maximum insertion torque, and initial fixation strength (determined both as cyclic-loading-induced displacement and yield load) were recorded on 21 pairs of anterior cruciate ligament reconstructions. To assess the accuracy of bone mineral density and insertion torque in predicting the fixation strength, half of the specimens were first used to determine the regression equations between the variables, and then the data from the remaining specimens were used to validate the prediction equations. RESULTS: Despite the relatively high group correlations, the ability of bone mineral density and insertion torque to predict the strength of graft fixation was poor. Errors ranging from -150% to 92%, -22% to 50%, -56% to 121%, and -23% to 50% were observed when bone mineral density and insertion torque were used to predict individual cyclic-loading-induced displacement and yield load, respectively. CONCLUSIONS: Neither bone mineral density nor insertion torque provides a sufficiently accurate prediction of the fixation strength of an individual soft tissue anterior cruciate ligament graft. CLINICAL RELEVANCE: Bone mineral density and insertion torque cannot be used to estimate the strength of interference screw fixation in anterior cruciate ligament reconstruction.

Adolescent↗
PubMed1997

Achilles tendon insertion: an in vitro anatomic study.

Seventeen adult fresh-frozen below-knee amputation cadaver specimens were studied. Calcific Achilles tendinitis was present in three specimens. After exposing the Achilles tendon insertion on the calcaneus, the insertion was outlined with waterproof paint. The specimens were photographed on a special plexiglass apparatus to highlight important findings. For the purpose of showing the length of insertion on lateral radiographs, lead beads were placed on the most superior and most inferior aspects of the insertion. All specimens showed that the tendon terminated at the medial and lateral bone borders of the calcaneus without significant extension around the medial or lateral wall. All specimens revealed a greater distance of insertion on the medial calcaneus than on the lateral side. In the specimens that had calcific Achilles tendinitis, the posterior bone surface of the spurs was devoid of tendinous insertion, instead, the insertion occurred between the spur and the posterior wall of the calcaneus. All spurs were located laterally at the most inferior border of the tendon insertion.

Achilles Tendon↗
PubMed2000

Gastrostomy tube insertion for improvement of adherence to highly active antiretroviral therapy in pediatric patients with human immunodeficiency virus.

OBJECTIVES: Newer combination antiretroviral therapies used to treat human immunodeficiency virus (HIV)-infected individuals have resulted in dramatic delays in HIV progression, with reduction in mortality and morbidity. However, adherence to highly active antiretroviral therapy (HAART) may be problematic, particularly in HIV-infected children. Reasons for nonadherence include refusal, drug tolerability, and adverse reactions. We assess: 1) the potential benefits of gastrostomy tube (GT) for the improvement of adherence to HAART in HIV-infected children, and 2) the factors that may result in improved viral suppression after GT placement. METHODS: The medical records of 17 pediatric HIV-infected patients, in whom GT was used to improve HAART adherence, were retrospectively reviewed for clinical and laboratory parameters. Each record was reviewed for the period of 1 year before and after GT insertion. The main outcome parameters were virologic (plasma HIV RNA polymerase chain reaction quantification) and immunologic (CD4 cell counts). Documentation of adherence to medications in medical records was also assessed during the study. Parental questionnaires were used to determine GT satisfaction and medication administration times. The Wilcoxon rank sum test was used to assess change in viral load (VL) and CD4 cell percentages. RESULTS: GT was well-tolerated with minor complications, such as local site tenderness, reported by 4 patients (23%). Before GT insertion, only 6 patients (35%) were documented as being adherent, compared with all patients after GT insertion. Ten patients (58%) had >/=2 log(10) VL decline after GT insertion (median: 3.2 log(10)), compared with 7 patients (42%) who had </=2 log(10) VL decline (median: 1.27 log(10)). Both groups of patients (responders and nonresponders) did not differ significantly in baseline parameters, such as VL, CD4 cell percentages, or previous drug therapy. However, in all 10 patients with >/=2 log(10) VL decline, therapy was changed at the time of or soon after GT insertion (median:.8 months; range: 0-6 months), compared with 7 patients with <2 log(10) VL decline who had therapy changed before GT insertion (median: 3.2 months; range: 1-8 months). Parental questionnaires reported significantly shorter medication administration times after GT insertion, with 70% of patients taking >5 minutes before GT, compared with 0% after GT. Questionnaires indicated satisfaction with GT, with perceived benefits being reduced medication administration time and improved behavior surrounding taking medications. CONCLUSIONS: GT is well-tolerated in pediatric HIV-infected patients and should be considered for selected patients to overcome difficulties with medication administration and to improve adherence. For maximal virologic response, combination therapy should be changed at the time of GT insertion.

Anti-HIV Agents↗
PubMed2001

Expulsions following 1000 GyneFix insertions.

CONTEXT: The GyneFix intra-uterine device has been used in our family planning service since 1997. One of the perceived advantages is its low expulsion rate, as reported by clinical trials. OBJECTIVE: To calculate expulsion rates in routine clinical use and to look at possible reasons for expulsion. DESIGN: Retrospective casenote analysis and opportunistic client consultation. SETTING: A city centre family planning clinic. PARTICIPANTS: The first 1000 GyneFix insertions. MAIN OUTCOME MEASURES: Parity of client, experience of clinician carrying out insertion, time from device insertion to expulsion. RESULTS: Overall expulsion rate was 7.6%. There was no significant difference in parity of clients experiencing expulsion. Most (4.7%) expulsions were early, occurring within 3 months of insertion. There was considerable variation in early expulsion rate from one clinician to another. Later expulsions also occurred, up to 28 months after insertion. Increasing experience of the inserting clinician led to lower rates of late expulsion. Unnoticed expulsion led to four unplanned pregnancies. CONCLUSIONS: The GyneFix expulsion rate in our service is higher than quoted in clinical trials. Early expulsions may be related to insertion technique, representing insufficient implantation of the anchoring knot into the fundal myometrium. Late expulsions also occur, often many months after insertion; the reason for these is unclear. Users should be taught to check for the presence of the thread after each menstrual period and unnoticed expulsion should be confirmed by ultrasound and abdomino-pelvic plain X-ray.

Contraception↗
PubMed2004

Backside wear of modular ultra-high molecular weight polyethylene tibial inserts.

BACKGROUND: The capture mechanisms of modular tibial total knee components may allow relative micromotion between the insert and the base-plate, leading to wear at the nonarticulating (backside) surface. Although retrieved components often display laxity in the capture mechanism in the unloaded condition, the magnitude of the relative motion that actually occurs under physiologic conditions has not been determined. This study was performed to assess the impact of different modes of knee-loading on the relative micromotion between the insert and the base-plate and the relationship between the duration that the implant had been in situ and the severity of backside wear. METHODS: Twenty-one posterior-stabilized total knee replacements of one common design (Insall-Burstein II) were retrieved at one to 100 months after implantation. The extent and severity of backside wear was graded with use of stereomicroscopy. All components were soaked in a bath (of physiologic saline solution at 37 degrees C for four days prior to reassembly. The relative micromotion between the insert and the base-plate of each specimen was measured in vitro in two different conditions: with no axial load and with a combination of loads and torques simulating the stance phase of gait. RESULTS: The capture mechanism laxity between the insert and the tibial base-plate in the unloaded condition was approximately eight times larger than the micromotion measured during simulated gait. The capture mechanism laxity allowed a mean (and standard deviation) of 618 +/- 226 micro m of total relative micromotion compared with 103 +/- 54 micro m of relative micromotion during the gait cycle. Under both loading conditions, the predominant direction of interface motion was medial-lateral. No correlation was found between the magnitude of capture mechanism laxity and the relative micromotion measured during simulated gait (p = 0.11). Larger polyethylene protrusions on the backside surface did not correlate with less micromotion (p = 0.48) or with capture mechanism laxity (p = 0.06). CONCLUSIONS: For the implant design that was studied, capture mechanism laxity between the modular insert and the base-plate in the unloaded condition was an order of magnitude larger than and not indicative of the micromotion that occurred during simulated physiologic loading. In addition, polyethylene protrusions into the screw-holes of tibial base-plates did not seat or lock the insert in place and reduce relative motion. CLINICAL RELEVANCE: While some clearance between the insert and the base-plate is required to allow assembly of modular tibial components at the time of surgery, the amount of relative interface motion during a functional activity such as normal gait, which can produce potentially damaging wear debris, is unknown. However, the compressive forces applied to the articular surface during a functional activity may substantially reduce micromotion between the insert and the base-plate relative to the unloaded condition.

Adult↗
PubMed2002

Microanatomic characteristics of the insertion of the distal sesamoidean impar ligament and deep digital flexor tendon on the distal phalanx in healthy feet obtained from horses.

OBJECTIVE: To describe microanatomic characteristics of the insertion of the aistal sesamoidean impar ligament (DSIL) and deep digital flexor tendon (DDFT) on the distal phalanx in horses. SAMPLE POPULATION: Healthy feet obtained from 62 horses of various breeds. PROCEDURE: Feet from 23 horses were used to histologically examine the insertion of the DSIL and DDFT (n = 7), its vasculature (10), and neural elements (6). In 39 other horses, the insertion zone was examined for proteoglycan. RESULTS: The insertion of the DSIL and dorsal half of the DDFT contained bundles of collagen fibers with intervening loose connective tissue septa with arteriovenous complexes (AVC) and nerve fibers. Microscopic examination revealed adaptive changes in the insertion with regard to proteoglycan content. In young adult horses, little or no staining for proteoglycans was evident, whereas in middle-aged horses, moderate proteoglycan staining was seen. Six older horses had slight proteoglycan staining at the insertion. CONCLUSIONS AND CLINICAL RELEVANCE: The study revealed that this region contained a rich neurovascular complex between the collagen bundles. A gradual increase in production of proteoglycan, evident at the insertion of the DSIL and DDFT on the distal phalanx, indicates that adaptive responses to stress rather than age alone may be the primary determining factor. These observations indicate that this insertion site may be susceptible to stress during stance and impact loading, because this region appears to be strategically situated to regulate important neurovascular functions of the foot.

Animals↗
PubMedDate not supplied

Changes in heating patterns of interstitial microwave antenna arrays at different insertion depths.

The changes in heating patterns of interstitial microwave antennas at different insertion depths were investigated in a static phantom at 915 MHz. Antennas for the Clini-Therm Mark VI system were inserted 5-15 cm into muscle-equivalent material, through nylon catheters. The phantom was heated with arrays of antennas at 2 cm spacings for 60 s at 15 W per antenna. Midplane and transverse heating patterns were determined thermographically with the antennas inserted parallel or perpendicular to the split of the phantom. Hot spots, independent of heating near the junction plane, were observed in the midplane of the 2 x 2 and 2 x 4 arrays at 2.8 cm from the insertion end. The magnitudes of these hot spots were reduced by 40-45 per cent as insertion depth was increased from 7 to 10.5 cm. With insertion depths of more than 11.5 cm the hot spots gradually diminished and heating occurred mostly near the junction plane. The observed heating patterns were caused by changes in impedance of the antenna arrays at different insertion depths. The impedance mismatch had resulted in different wave propagation within the tissue material which produced different radiation patterns. During treatments, because heating varies with insertion depth, great care must be exercised in monitoring temperatures.

Biomedical Engineering↗
PubMed1991

Nucleotide sequence of Rhizobium meliloti insertion sequence ISRm1: homology to IS2 from Escherichia coli and IS426 from Agrobacterium tumefaciens.

Nucleotide sequencing of Rhizobium meliloti insertion sequence ISRm1 showed that it is 1319 nucleotides long and includes 32/31 nucleotide terminal inverted repeats. Analysis of five different insertion sites using sequencing primers complementary to sequences within the left and right ends demonstrated that ISRm1 generates five bp direct repeats at the sites of insertion. Although ISRm1 has shown a target preference for certain short regions (hot spots), there was no apparent similarity in the DNA sequences near the insertion sites. On one strand ISRm1 contains two contiguous open reading frames (ORFs) spanning most of its length. ISRm1 was found to have over 50% sequence homology to insertion sequences IS2 from Escherichia coli and IS426 from Agrobacterium tumefaciens. Their sizes, the sequences of their inverted repeats, and the characteristics of their insertion sites are also comparable, indicating that ISRm1, IS2 and IS426 belong to a class of related insertion sequences. Comparison of the proteins potentially encoded by these insertion sequences showed that the two ORFs found in ISRm1 are also present in IS2 and IS426, suggesting that they may be functional genes.

Agrobacterium tumefaciens↗
PubMed2003

Intravaginal progesterone insert to synchronize return to estrus of previously inseminated dairy cows.

An intravaginal progesterone insert (CIDR insert; 1.38 g of progesterone) was evaluated for synchronization of returns to estrus (SR), conception rate (CR), and pregnancy rate (PR) in dairy cows previously artificially inseminated (AI). Healthy, nonpregnant, lactating Holstein cows, > or = 40 and < or = 150 d postpartum at eight commercial farms were used. Cows detected in estrus and receiving AI 2, 3, or 4 d after one injection of PGF2alpha (25 mg) were assigned as either controls (n = 945), or to receive a CIDR insert (n = 948) for 7 d (14 to 21 +/- 1 d after AI). Cows were observed for returns to estrus from 18 to 26 +/- 1 d after initial AI (resynchrony period) and were reinseminated if in estrus. Vaginal mucus on CIDR inserts (97.3% retention) at removal was scored: 1 = no mucus; 2 = clear; 3 = cloudy; 4 = yellow; and 5 = red or brown. Percentage of cows in estrus (SR) during the 3 d after CIDR insert removal was contrasted to the highest 3-d cumulative percentage in estrus for controls. Cows conceiving to initial AI were omitted in calculations of SR, CR, and PR during resynchrony. Mucous scores of 3 or 4 (mild irritation) were observed in 65% of cows and a score of 5 (more severe irritation) was observed in 2%; otherwise, health was unaffected. The PR to initial AI was lower for cows subsequently receiving CIDR inserts than for controls (32.7 vs. 36.7%). The CIDR insert increased SR (34.1 vs. 19.3% in 3 d) and overall estrus detection (43% in 4 d vs. 36% in 9 d) compared with controls. For the 9-d resynchrony period, CR and PR for CIDR-treated (26.7, 12.2%) and control (30.9, 11.1%) cows did not differ significantly. The CIDR inserts improved synchrony of returns to estrus, slightly reduced PR to initial AI, but did not affect CR or PR to AI during the resynchrony period.

Abortion, Veterinary↗
PubMed2003

Concentrations of progesterone in milk of cows administered an intravaginal progesterone insert.

Milk from pregnant cows contains concentrations of progesterone (P4) considered safe for human consumption. The objective of this study was to determine if concentrations of P4 in milk during administration of an intravaginal progesterone insert (CIDR insert) are less than concentrations of P4 in milk associated with pregnancy. Results have implications for human use of milk from cows receiving CIDR inserts. Holstein cows (N = 64; > 40 and < 150 d after calving) were administered 25 mg of PGF2alpha i.m. (study d 0) and 20 cows detected in estrus from 2 to 4 d later were assigned randomly to either control (N = 10; no further treatment) or CIDR insert (N = 10; 1.38 g of P4) inserted on study d 17 (14 +/- 1 d after estrus) and removed 7 d later. Composite milk samples were collected contemporaneously from each of the 20 estrous cycling cows and from 10 pregnant cows (> or = 60 and < or = 220 d of gestation) twice daily from study d 17 to 27. Concentrations of P4 in defatted milk samples were quantified using a validated radioimmunoassay. Mean logs of areas under the curve of concentrations of P4 from the afternoon on study d 17 through the afternoon on study d 27 were 3.05 ng day/ml for control, 3.33 ng day/ml for CIDR insert, and 3.81 ng day/ml for pregnant cows. Therefore, increased P4 due to pregnancy was 0.76 ng day/ml (3.81-3.05), whereas the increase in P4 due to CIDR insert was only 0.28 ng day/ml (3.33-3.05). Applying a 95% confidence interval to 0.28 ng day/ml provided an upper value of 0.70 ng day/ml, lower than the increase due to pregnancy. Because milk from pregnant cows is considered safe for human consumption, it follows that milk from cows administered CIDR inserts should also be considered safe, based on concentrations of P4.

Administration, Intravaginal↗
PubMed1996

Prevention of lower limb pain in soldiers using shock-absorbing orthotic inserts.

The utility of shock-absorbing boot and sneaker inserts for reducing the occurrence of lower limb pain among male US Army basic trainees was evaluated. Every other training unit was given inserts. The inserts were issued prior to the start of training when combat boots and sneakers were fitted. According to post-training questionnaires and the participants' medical records, the inserts did not have any preventive effect on occurrence of lower limb problems during training. Five hundred seventeen trainees were issued inserts, 397 were followed but not issued inserts, and 218 were not issued but purchased them on their own. Thirty-eight percent of those issued inserts had lower limb pain problems compared with 29% of those not issued inserts and 38% of those who bought their own. There was no statistical difference between these rates of occurrence. Prior to training, there were minor differences between the groups' scores on physical fitness test scores and run times. These differences disappeared during training so that there were no differences among the groups on either training or clinical variables during or after basic training.

Adult↗
PubMed2006

Doppler color flow analysis of the uterine arteries before and after intrauterine device insertion: a prospective study.

OBJECTIVE: An intrauterine device (IUD) is one of the most frequently used methods of birth control around the world. Although a relationship between its use and menstrual disorders has been well documented, only a few studies have tried to show whether there are any vascular modifications. The aim of our study was to evaluate the influence of an IUD on uterine artery blood flow using Doppler assessment. METHODS: A total of 100 patients selected for IUD use were prospectively evaluated with Doppler analysis before and 30 days after insertion. The resistive index (RI) and pulsatility index (PI) were used to evaluate uterine artery vascular resistance. Patients were allocated in 2 groups according to whether they were (group 2) or were not (group 1) lactating. RESULTS: The PI and RI of the patients in groups 1 and 2 before and after IUD insertion were not statistically significantly different (P = .298 and .23). When we compared uterine artery blood flow indices before and after IUD insertion for groups 1 and 2 separately, we observed in group 1 that the mean +/- SD PI values were 2.45 +/- 0.62 and 2.55 +/- 0.55 (P = .38) and the RI values were 0.87 +/- 0.08 and 0.87 +/- 0.06 (P = .88) before and after IUD insertion, respectively. In group 2, the PI values were 2.31 +/- 0.55 and 2.37 +/- 0.69 (P = .68) and the RI values were 0.85 +/- 0.07 and 0.86 +/- 0.07 (P = .44) before and after IUD insertion. Finally, we used the mean blood flow indices of the uterine arteries of all patients to compare the effect of IUD insertion. Results were also not statistically significant when we compared PI and RI before and after IUD insertion. CONCLUSIONS: The presence of an IUD does not interfere with the vascular resistance of the uterine arteries that can be shown by Doppler flow assessments 1 month after insertion.

Adult↗
PubMed2002

New technique for optical control of the first trocar insertion.

BACKGROUND: In laparoscopic surgery serious complications caused by the blind insertion of the first trocar have been reported even after the pneumoperitoneum is established by means of a Veress needle. As a consequence, some techniques to safely insert the first port have been developed. Many surgeons advocate a minilaparotomy to position the first port. However, especially in obese patients, the dissection to insert the Hasson's trocar may be difficult and time consuming. As an alternative, optical disposable trocars have been studied and produced to be safely positioned under direct visualization. METHODS: A new technique to insert, under adequate optical control, a non disposable standard port is described. Personal experience in 126 consecutive patients is reviewed. Data were recorded prospectically and insertion time was recorded in every case. RESULTS: Medium time of trocar insertion was 55 sec (range 30-160 sec). Identification of distinct layers of the abdominal wall was always possible. There were no complications related to the insertion of the first reusable cannula under visual control. CONCLUSIONS: This technique may be considered a safe, simple and cost effective method to insert the first trocar.

Adult↗