Search

The surgical and early postoperative complications and complaints associated with laparoscopic sterilization using electrocoagulation or tubal rings for tubal occlusion were evaluated in a comparative study. Procedures were randomly assigned to subjects (electrocoagulation to 151 subjects and tubal rings to 148 subjects). Difficulties in carrying out the sterillization procedures occurred more frequently when tubal rings were used (6.1%) than when electrocoagulation was used (2.0%). Rates of complications occurring at the time of surgery were similar for the two procedures. However, one patient in the electrocoagulation group had a bowel burn. Postoperative pelvic and abdominal pain were reported by a significantly higher proportion of the tubal ring cases (32.0%) than electrocoagulation cases (19.4%). It appears that although the incidence of surgical difficulties and pain may be somewhat more frequent with the tubal ring, the avoidance of such potentially serious complications as bowel burns may make femal sterilization by the tubal ring method preferable.

50 cases of congenital diaphragmatic hernia were operated during a five year period (1978-82). Authors review surgical and postoperative treatment. Eight cases were treated with pulmonary vasodilators, including tolazoline and dopamine, with very good results. Other cases were treated with hyperventilation. Mortality rate was 30%.

The migration of amacrine neuroblasts toward the prospective amacrine cell layer in the chick embryo retina has been studied, in Golgi-stained sections, between days 5 and 9 of embryogenesis. Two distinct populations of presumptive amacrine neuroblasts have been identified on the basis of their shape and migratory behavior. One population (smooth amacrine neuroblasts) display smooth, monopolar or bipolar contours, moving freely across the retina without major changes in the original postmitotic shape, and give processes only after reaching the primitive inner plexiform layer. The second population (multipodial amacrine neuroblasts) includes multipolar neuroblasts with abundant filiform and/or lamelliform processes sprouting in various directions; these highly plastic cells begin modifying their shapes at the time of release from the ventricular lining and continue to do so as they move toward their definitive location. Thus, the well-known heterogeneity of adult amacrine cells seems to be preluded by differences in neuroblastic migratory patterns, suggesting the existence of at least two different subsets of amacrine cell precursors.

An examination of retinal structure in chick embryos, impregnated with the Golgi-Stensaas method between 2 and 6 days of incubation, discloses, on the one hand, a uniform typology of the proliferating ventricular cells, the pre- and postmitotic forms of which were tentatively identified; on the other hand, postmitotic neuroblasts are evidenced in the stages of differentiation previous to the growth of their neurites. In the earliest embryos (up to 5 1/2 days of incubation), all cells that detach from the ventricular lining to differentiate as neurons do so while the ventricular cell precursor has an interphasic configuration. This means that, although they free themselves from the scleral attachment site, they keep for a while a vitreal attachment. The vitreally-attached endfeet subsequently transform into axonal growth cones, sprouting filopodia and lamellipodia. While the axons grow towards the optic nerve head, cell bodies and remaining scleral processes are progressively retracted inwards, leading to the appearance of typical ganglion cells. After 5 1/2 days of incubation, a great number of postmitotic neuroblasts detach while still in the G1 phase of the ventricular cell cycle. Those of them that show the longest leading processes become also ganglion cells, after their leading tip has acquired a growth cone configuration and has bent into the optic fiber layer. These results on early mechanisms of ganglion cell genesis are discussed in relation to data in the literature, and a simple hypothesis is offered which explains the biphasic pattern in which presumptive ganglion cells detach from the ventricular lining of the chick retina.

To evaluate the feasibility and safety of performing laparoscopic sterilization immediately after a normal delivery, 46 patients were studied. All sterilizations were performed within 48 hours of delivery, using a single puncture technique with cautery and separation of the uterine tubes, under a neuroleptanalgesic. A description of the technique, the technical difficulties encountered in performing the procedures and the incidence of complications are presented. The technique, when performed during the early puerperium, is practicable since technical difficulties and the severity and incidence of complications are clinically acceptable. The sterilization procedure did not significantly increase the duration of hospitalization after delivery. Most patients were discharged from the hospital 1 to 2 days after the sterilization.

The safety and effectiveness of laparoscopic sterilization with electrocoagulation and separation of the tubes when performed within five days of a normal delivery is evaluated. The majority of patients (53.5%) were sterilized within 36 hours of delivery and were discharged on either the same day or the first post-sterilization day (91.0%). While some form of complications were reported for 9.5 percent of the patients, potentially serious complications occurred for only 2 patients (1.%). Most of the complications were probably unrelated to the laparoscopic procedure. At six months after sterilisation, complications were reported by 2.9 percent of the patients who returned for a follow-up visit. One patient became pregnant 3.5 months after sterilization. The results of this study suggest that performing laparoscopic sterilization in the immediate puerperium does not significantly increase the complication or failure rates of the procedure.

Two populations of morphologically different large axon terminals have been observed electron microscopically in the dorsal lateral geniculate nucleus of mice raised in complete darkness from birth up to 19 days of age. One population includes larger terminals indistinguishable from the large terminals present in control animals, i.e. they have round synaptic vesicles, rather pale mitochondria, membrane saculae, coated vesicles, and asymmetric contacts with encrusted dendritic spines of portions of dendrites of geniculo-cortical relay neurons. The other population includes large terminals which also have asymmetric contacts with encrusted dendritic spines or portions of dendrites of geniculo-cortical relay neurons, but they show darker mitochondria, absence of both membrane saculae and coated vesicles, and significantly higher synaptic vesicle density and smaller size than the large control ones. We suggest that the latter population of terminals could be inactive due to the absence of visual input.