Tonatiuh II: Assisting manipulator for laparoscopic surgery

In this article we show the design of the Tonatiuh II robotic manipulator. This robotic assistant has an original electromechanical configuration and respects the laparoscope center of insertion as an invariant point for navigation in the work space. The manipulator went through several stages before reaching its final version. Surgical trials have shown the robot to be useful in the operating room and as a training assistant in specialty microsurgery.     

Aberrant DNA methylation profile of chronic and transformed classic Philadelphia-negative myeloproliferative neoplasms

Most DNA methylation studies in classic Philadelphia-negative myeloproliferative neoplasms have been performed on a gene-by-gene basis. Therefore, a more comprehensive methylation profiling is needed to study the implications of this epigenetic marker in myeloproliferative neoplasms. Here, we have analyzed 71 chronic (24 polycythemia vera, 23 essential thrombocythemia and 24 primary myelofibrosis) and 13 transformed myeloproliferative neoplasms using genome-wide DNA methylation arrays. The three types of chronic Philadelphia-negative myeloproliferative neoplasms showed a similar aberrant DNA methylation pattern when compared to control samples. Differentially methylated regions were enriched in a gene network centered on the NF-κB pathway, indicating that they may be involved in the pathogenesis of these diseases. In the case of transformed myeloproliferative neoplasms, we detected an increased number of differentially methylated regions with respect to chronic myeloproliferative neoplasms. Interestingly, these genes were enriched in a list of differentially methylated regions in primary acute myeloid leukemia and in a gene network centered around the IFN pathway. Our results suggest that alterations in the DNA methylation landscape play an important role in the pathogenesis and leukemic transformation of myeloproliferative neoplasms. The therapeutic modulation of epigenetically-deregulated pathways may allow us to design targeted therapies for these patients.     

A model program: stress management unit--a clinic run by army nurses.

People suffering from stress and stress-related disorders are a great challenge to our already depleted military health care system. Early identification and separation of soldiers not able to adjust, immediate intervention for temporarily stressed soldiers, and stress management for dependents and retirees help decrease visits to military hospitals and clinics. Immediate intervention for salvageable soldiers also helps improve work performance and productivity. A Stress Management Unit has been open for two years at Brooke Army Medical Center (BAMC), Texas. This article identifies the need for stress management clinics in the military and briefly describes the nurse-run program at BAMC.     

Effect of histamine on human placental chorionic veins: interaction with serotonin

The vasomotor effects of histamine and its interaction with serotonin were studied in isolated human placental chorionic veins. Histamine induced concentration-dependent contractions with an EC50 of 8.7 +/- 1.2 x 10(-6) mol/l. The H1 antagonist, pyrilamine (10(-9) to 10(-7) mol/l), inhibited histamine-induced contractions, with a pA2 of 8.33 +/- 0.32 at a slope of 0.635. Cimetidine (H2 antagonist) had no effect on histamine-induced contractions. Serotonin (10(-9) to 10(-8) mol/l) significantly potentiated the contractile effect of histamine. The possible implications of the interaction between both amines in the regulation of placental blood flow is discussed.     

Abnormal pregnancy: early diagnosis by US and serum chorionic gonadotropin levels

Simultaneous sonography and quantitative serum human chorionic gonadotropin (HCG) levels from 126 women with threatened abortion were compared. Of 56 women with normal outcome, 39 (70%) had a gestation sac greater than or equal to 5 mm in mean sac diameter, and in each case the HCG level was 1,800 milli-international units (mIU/ml) or greater. The serum HCG levels strongly correlated with the gestation sac sizes to a mean sac diameter of 25 mm. Of 70 abnormal pregnancies, 31 demonstrated a gestation sac. Of these, 20 women (65%) had disproportionately low HCG levels relative to sac size, including 12 in whom the HCG level was less than 1,800 mIU/ml. One woman with an early molar pregnancy had a disproportionately elevated HCG level. Correlation of sonograms with a simultaneous measurement of serum HCG level is a useful method for evaluating threatened spontaneous abortion. A disproportionately low HCG level relative to gestation sac size is evidence for an abnormal pregnancy.     

A new concept in blepharoplasty

Apart from what may be considered complications, the intervention of any aesthetic surgery can have undesired effects (scar sequelae, normal regional dynamic disorders, edema, iatrogenic acceleration of the aging process in the area). The orbital region is particularly sensitive to these undesirable effects due to its situation and the importance of the eyelids in facial sign language. The sum of these undesirable effects and not infrequent complications often place the plastic surgeon in a compromising situation. It is for this reason that in recent years we have made a special effort to analyze causes, to design new techniques, and to evaluate the combination of different techniques in an attempt to minimize these undesirable effects, so as to be able to offer patients more natural and safer results. It is with this intention that this paper records some anatomical and functional details of the eyelids, analyzes the physiology of the aging process, and examines some classic and modern techniques.