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Study Objective: Although a pericervical tourniquet helped reduce blood loss in myomectomy [1], a technique of triple tourniquets was more influential in occluding the uterine vessel networks [2,3]. This video demonstrates the procedures of laparoscopic triple-tourniquet constriction with the number 1 suture around the uterine isthmic portion and bilateral infundibulopelvic ligaments [4] in a case of robotic myomectomy.Design: A step-by-step, narrated video demonstration.Setting: A university hospital.Interventions: Robotic myomectomy was scheduled for a patient with menorrhagia. Magnetic resonance imaging revealed 8 uterine myomas; the maximal one was 9.1 × 8.4 × 8.6 cm in dimension. Our robotic settings included 3 ports: fenestrated bipolar in the left lower quadrant, spatula or mega needle holder in the right lower quadrant, and an umbilical glove port accessible for lens and assisted instruments. A number 1 Monocryl (Ethicon, Bridgewater, NJ) was introduced from the suprapubic area extracorporeally; then, the needle penetrated through bilateral avascular zones of broad ligaments at the isthmic level and with a sliding tie made anteriorly to the uterus. The isthmic tourniquet-we also named it as the hangman's tourniquet-was tightened by manually tensioning the suture extracorporeally and pushing down the knot intracorporeally. Bilateral infundibulopelvic tourniquets were placed by using sliding ties of 1-0 Monocryl as well. With the total occlusion of uterine vessel networks, the uterus should retain only minimal blood flow. During the enucleation of uterine myomas, the tourniquet may loosen because of newly developed, unoccupied space with increasing bleeding; therefore, the tourniquet should be tightened up regularly throughout the surgery. After the repair of all the uterine wounds, we removed the 3 tourniquets.Conclusion: The convenient and adjustable triple-tourniquet constriction is a safe and feasible laparoscopic technique to block the vessel networks temporally in uterine-preserving surgery. [ABSTRACT FROM AUTHOR]

Abstract: Moth orchids (Phalaenopsis spp.) have become the world''s most important potted flower crop. Flowers of Phalaenopsis are sensitive to ethylene, and 1-methylcyclopropene (1-MCP) pretreatment enables flowers to withstand ethylene stress. In this study, we investigated effects of 1-MCP concentration and duration of 1-MCP treatment on the protective effect in Phalaenopsis flowers. Pretreating potted Phalaenopsis amabilis with a 1-MCP concentration of as low as 0.005μLL−1 reduced the flower wilting percentage, indicating that as long as there is 1-MCP protection, the rapid wilting of flowers caused by ethylene can be delayed. However, in order to achieve absolute protection, the minimum concentration required was 0.1μLL−1. Pretreatment with 0.1μLL−1 1-MCP for 12h gave Phalaenopsis plants absolute protection such that the flowers were unaffected even when exposed to artificially high ethylene concentrations of up to 20μLL−1. The duration of 1-MCP pretreatment could substantially be reduced. A 0.5-h treatment was sufficient when the concentration of 1-MCP was increased to 0.2μLL−1. The results obtained above were then further confirmed on seven commercial cultivars, where 0.1μLL−1 1-MCP treatment for 1h was sufficient to achieve absolute protection against ethylene damage. [Copyright &y& Elsevier]

In Taiwan, freshwater clams (Corbicula fluminea) and hard clams (Meretrix lusoria) are the most frequently raised shellfish in land-based pond aquaculture, but research on the accumulation of organochlorine pesticides (OCPs) in these shellfish is limited. We detected the levels of 14 OCPs in 62 shellfish from Taiwanese aquafarms by performing gas chromatography–tandem mass spectrometry. OCP residues were detected in 4.84% of the samples including readings of 0.04 mg/kg chlordane (in a freshwater clam), 0.03 mg/g p,p ′-DDE (in a freshwater clam), and 0.02 mg/g p,p ′-DDE (in a hard clam). However, the associated estimated daily intake values were less than the acceptable daily intake levels of chlordane and p,p ′-DDE Therefore, the consumption of these shellfish presents no immediate health risks. Our findings contribute to food safety and serve as a reference for OCP screenings for aquatic shellfish. • Organochlorine pesticides residues were detected in 62 shellfishes by using GC–MS/MS. • Samples contained chlordane residues at 0.04 mg/kg, and p,p ′-DDE at 0.02–0.03 mg/g. • For Taiwanese men and women, the EDI is less than 0.1% of the ADI for OCP residues. • Collectively, no immediate health risk for shellfish consumption in Taiwan [ABSTRACT FROM AUTHOR]

Abstract: Aim of the study: We investigated the preventive effect of Momordica charantia Linn. (Cucurbitaceae) fruit, commonly known as bitter melon, on hyperglycemia and insulin resistance in rats fed with a fructose-enriched diet. Materials and methods: First, rats were divided randomly into two groups: the control group was fed with control diet, whereas the experimental group was fed with a 60% high-fructose diet for 8 weeks. After the first 6 weeks, the fructose-treated rats were further subdivided into six groups and were orally fed with or without Momordica charantia L. or rosiglitazone (ROS) for 2 weeks while rats were still on fructose diet. Results: We demonstrated that bitter melon was effective in ameliorating the fructose diet-induced hyperglycemia, hyperleptinemia, hyperinsulinemia, and hypertriglyceridemia as well as in decreasing the levels of free fatty acid (FFA) (P <0.001, P <0.05, P <0.05, P <0.05, P <0.05, respectively). Bitter melon reversed fructose diet-induced hypoadiponectinemia (P <0.05), which provides a therapeutic advantage to insulin resistance in improving insulin sensitivity. Additionally, bitter melon decreased the weights of epididymal (P <0.05) and retroperitoneal white adipose tissue (WAT) (P <0.05). Bitter melon increased the expression of peroxisome proliferator-activated receptor γ (PPARγ) in white adipose tissue (WAT). Conversely, bitter melon decreased the expression of leptin in WAT. Furthermore, we demonstrate that bitter melon significantly increases the mRNA expression and protein of glucose transporter 4 (GLUT4) in skeletal muscle. Conclusions: This study demonstrates, for the first time, the beneficial effects of two different extracts of bitter melon on insulin resistance in rats fed a high-fructose diet thereby producing evidence of the role of changes in expression of PPARγ and GLUT4. [Copyright &y& Elsevier]

Abstract: We examined the preventive effect of Momordica charantia L. fruit (bitter melon) on hyperglycemia and insulin resistance in C57BL/6J mice fed with a high-fat (HF) diet. Firstly, mice were divided randomly into two groups: the control group was fed low-fat (LF) diet, whereas the experimental group was fed with a 45% HF diet last for 12 weeks. After 8 week of induction, the HF group was subdivided into six groups and was given orally with or without M. charantia or rosiglitazone 4 weeks afterward. We demonstrated that bitter melon was effective in ameliorating the HF diet-induced hyperglycemia, hyperleptinemia, and decreased the levels of blood glycated hemoglobin (HbA1c) and free fatty acid (FFA) (P <0.01, P <0.05, P <0.05, respectively), whereas increased the adipose PPARγ and liver PPARα mRNA levels. Additionally, bitter melon significantly decreased the weights of epididymal white adipose tissue and visceral fat, and decreased the adipose leptin and resistin mRNA levels. It is tempting to speculate that at least a portion of bitter melon effects is due to be through PPARγ-mediated pathways, resulting in lowering glucose levels and improving insulin resistance, and partly be through PPARα-mediated pathways to improve plasma lipid profiles. This is the first report demonstrating that bitter melon, is a food factor, but not a medicine, itself could influence dual PPARα/PPARγ expression and the mediated gene expression, is effective in ameliorating insulin resistance and visceral obesity. [Copyright &y& Elsevier]

A series of diorganotin(IV) and triorganotin(IV) compounds of the type [R2Sn(pca)2ClSnR3]2 (R＝PhCH21, 2-ClC6H4CH22, 2-FC6H4CH23, 4-FC6H4CH24, 4-CNC6H4CH25, 4-ClC6H4CH26, 2,4-Cl2C6H3CH27; Hpca＝2-methylpyrazine-5-acid), [(nBu)3Sn(pca)]∞8, [(CH3)2Cl2Sn(pca)Sn(CH3)2(pca)]∞9, {[(nBu)2Sn(pca)]2O}210 and {[Ph2Sn(pca)]3O2[Ph2Sn(OCH3)]} 11 have been obtained by reactions of 2-methylpyrazine-5-acid with triorganotin(IV) chloride, diorganotin(IV) dichloride, and diorganotin(IV) oxide. All compounds were characterized by elemental, IR, and NMR spectra analyses. The crystal structure of compounds 1, 8–11 were determined by X-ray single crystal diffraction, which revealed that compound 1 was tetranuclear macrocyclic structures with seven-coordinate and five-coordinate tin atoms, compounds 8 and 9 were polymeric chain structures with five-coordinate and seven-coordinate tin atoms, compounds 10 and 11 were monomeric structures with six-coordinate and five-coordinate tin atoms. [Copyright &y& Elsevier]

Summary: Background: Ovarian cancer is commonly fatal and incidence has persistently risen in Taiwan over the past 20 years. Prevention strategies, however, are limited. Pelvic inflammatory disease (PID) has been suggested to increase the risk of developing ovarian cancer, but the results of studies have been inconsistent. Therefore, we investigated whether PID increases the risk of developing ovarian cancer in a large, nationwide cohort. Methods: From the Longitudinal Health Insurance Database 2005 (LHID2005) in Taiwan, we obtained data for women aged 13–65 years for whom a diagnosis of PID, confirmed by multiple episodes, had been recorded between Jan 1, 2004, and Dec 31, 2005. We also obtained data for two controls per patient, matched for age and the year of first entry into the LHID2005. All patients were followed up from the date of entry in the LHID2005 until they developed ovarian cancer or to the end of 2006, whichever was earlier. We used Cox''s regression models to assess the risk of developing ovarian cancer, with adjustment for age, comorbid disorders, and socioeconomic characteristics. Findings: We identified 67 936 women with PID and 135 872 controls. Among these 90 had developed ovarian cancer during the 3-year follow-up period (42 patients with PID and 48 controls, incidence 2·78 and 1·44 per 10 000 person-years, respectively). The adjusted hazard ratio for ovarian cancer in patients with PID was 1·92 (95% CI 1·27–2·92) compared with controls, which rose to 2·46 (1·48–4·09) in women who had had at least five episodes of PID. The adjusted hazard ratio was slightly higher for women aged 35 years or younger with PID than in older women with PID (2·23, 1·02–4·79 vs 1·82, 1·10–3·04). Interpretation: We found an association between PID and ovarian cancer. PID might, therefore, be a useful marker for ovarian cancer, and early treatment could help to improve prognosis. Whether pelvic inflammation itself accelerates the growth of ovarian cancers or affects cancer-cell differentiation in ways that adversely alter prognosis needs to be investigated. Funding: None. [Copyright &y& Elsevier]

Abstract: We present two years (January 2007–December 2008) of atmospheric SO2, NO2 and NH3 measurements from ten background or rural sites in nine provinces in China. The measurements were made on a monthly basis using passive samplers under careful quality control. The results show large geographical and seasonal variations in the concentrations of these gases. The mean SO2 concentration varied from 0.7±0.4ppb at Waliguan on Qinghai Plateau to 67.3±31.1ppb at Kaili in Guizhou province. The mean NO2 concentration ranged from 0.6±0.4ppb at Waliguan to 23.9±6.9ppb at Houma in southern Shanxi. The mean NH3 concentration ranged from 2.8±3.0ppb at Shangdianzi in northeastern Beijing to 13.7±8.4ppb at Houma. At most sites, SO2 and NO2 peaked in winter and reached minima in summer, while NH3 showed maximum values in summer and lower values in cold seasons. On the whole, the geographical distributions of the observed gas concentrations are consistent with those of emissions. The ground measurements of SO2 and NO2 are contrasted to the SCIAMACHY SO2 and OMI NO2 tropospheric columns, respectively. Although the satellite data can capture the main features of emissions and concentrations of SO2, they do not reflect the variations of SO2 in the surface layer. The situation is better for the case of NO2. The OMI NO2 columns capture the geographical differences in the ground NO2 and correlate fairly well with the ground levels of NO2 at six of the ten sites. [Copyright &y& Elsevier]