Validation of low-cost models for minimal invasive surgery training of congenital diaphragmatic hernia and esophageal atresia

BackgroundMinimal invasive surgery (MIS) is increasingly used for the correction of congenital diaphragmatic hernia (CDH) and esophageal atresia (EA). It is important to master these complex procedures, preferably preclinically, to avoid complications. The aim of this study was to validate recently developed models to train these MIS procedures preclinically.MethodsTwo low cost, reproducible models (one for CDH and one for EA) were validated during several pediatric surgical conferences and training sessions (January 2017–December 2018), used in either the LaparoscopyBoxx or EoSim simulator. Participants used one or both models and completed a questionnaire regarding their opinion on realism (face validity) and didactic value (content validity), rated on a five-point-Likert scale.ResultsOf all 60 participants enrolled, 44 evaluated the EA model. All items were evaluated as significantly better than neutral, with means ranging from 3.7 to 4.1 (p < 0.001). The CDH model was evaluated by 48 participants. All items scored significantly better than neutral (means 3.5–3.9, p < 0.001), with exception of the haptics of the simulated diaphragm (mean 3.3, p = 0.054). Both models were considered a potent training tool (means 3.9).ConclusionThese readily available and low budget models are considered a valid and potent training tool by both experts and target group participants.Type of studyProspective study.Level of evidenceLevel II.     

Osteosarcomatosis

A review of the 690 cases of osteosarcoma in the radiographic file of the Armed Forces Institute of Pathology revealed 29 cases of "osteosarcomatosis" (multiple skeletal sites of osteosarcoma). Fifteen of these patients were 18 years old and under and manifested rapidly appearing, usually symmetric, sclerotic metaphyseal lesions. The remaining 14 patients were more than 18 years old and had fewer, asymmetric sclerotic lesions. In most patients (28 of 29), a radiographically dominant skeletal tumor was seen. Pulmonary metastases occurred in the majority of patients and were detected at the same time as the bone lesions. These 29 patients were studied with regard to demographic data and skeletal distribution and radiographic appearance of their lesions. As a result of the findings, a metastatic origin from a primary dominant osteosarcoma is favored over a multifocal origin as the basis for osteosarcomatosis. Osteosarcomatosis is more commonly encountered in the mature skeleton than has been previously recognized.     

A critical assessment of electrochemical procedures applied to the measurement of dopamine and its metabolites during drug-induced and species-typical behaviours

Monoamine neurotransmitters and their metabolites are electro-oxidizable at the surface of electrodes implanted in brain, and this has raised the expectation that in-vivo electrochemical procedures may be used routinely to monitor dynamic changes in dopamine (DA), noradrenaline and serotonin during species-typical and drug-induced behaviours. This expectation is slowly becoming a reality as various laboratories refine electrochemical procedures and design recording electrodes that are selective for specific neurotransmitters. The most important step is to conduct rigorous assessments of these procedures in-vivo to confirm that they are indeed valid and reliable bioprobes for a given neurochemical species. The present review describes the different electrochemical procedures and recording electrode designs currently used to measure monoamines in freely moving animals. Emphasis is placed on recording electrodes used to monitor DA in the extracellular compartment of the brain. In-vitro and in-vivo validation studies, demonstrating the selectivity and stability of these electrodes, are discussed in detail with respect to five criteria: (a) voltammograms recorded in-vivo are identical to those recorded in-vitro; (b) independent confirmation of the species detected and agreement of concentration estimates with other neurochemical methods; (c) sufficient electrode sensitivity to measure impulse-flow dependent transmitter efflux; (d) the dependency of the electrochemical signal on the presence of an intact neuronal system; and (e) predictable and reproducible effects of drugs or other manipulations on the electrochemical signal. The final section discusses recent applications of in-vivo electrochemical procedures for the monitoring of DA neurotransmission in terminal regions of the mesotelencephalic DA system during: (a) operant behaviour reinforced by brain-stimulation reward or drugs of abuse; (b) species-typical motivated behaviours, as exemplified by feeding and sexual behaviour, and (c) in response to environmental stressors.