Consensus on Recording Deep Endometriosis Surgery: the CORDES statement.

STUDY QUESTION: Which essential items should be recorded before, during and after endometriosis surgery and in clinical outcome based surgical trials in patients with deep endometriosis (DE)? SUMMARY ANSWER: A DE surgical sheet (DESS) was developed for standardized reporting of the surgical treatment of DE and an international expert consensus proposal on relevant items that should be recorded in surgical outcome trials in women with DE. WHAT IS KNOWN ALREADY: Surgery is an important treatment for symptomatic DE. So far, data have been reported in such a way that comparison of different surgical techniques is impossible. Therefore, we present an international expert proposal for standardized reporting of surgical treatment and surgical outcome trials in women with DE. STUDY DESIGN, SIZE, DURATION: International expert consensus based on a systematic review of literature. PARTICIPANTS/MATERIALS, SETTING, METHODS: Taking into account recommendations from Consolidated Standards of Reporting Trials (CONSORT), the Innovation Development Exploration Assessment and Long-term Study (IDEAL), the Initiative on Methods, Measurement and Pain Assessment in Clinical trials (IMMPACT) and the World Endometriosis Research Foundation Phenome and Biobanking Harmonisation Project (WERF EPHect), a systematic literature review on surgical treatment of DE was performed and resulted in a proposal for standardized reporting, adapted by contributions from eight members of the multidisciplinary Leuven University Hospitals Endometriosis Care Program, from 18 international experts and from audience feedback during three international meetings. MAIN RESULTS AND THE ROLE OF CHANCE: We have developed the DESS to record in detail the surgical procedures for DE, and an international consensus on pre-, intra- and post-operative data that should be recorded in surgical outcome trials on DE. LIMITATIONS, REASONS FOR CAUTION: The recommendations in this paper represent a consensus among international experts based on a systematic review of the literature. For several items and recommendations, high-quality RCTs were not available. Further research is needed to validate and evaluate the recommendations presented here. WIDER IMPLICATIONS OF THE FINDINGS: This international expert consensus for standardized reporting of surgical treatment in women with DE, based on a systematic literature review and international consensus, can be used as a guideline to record and report surgical management of patients with DE and as a guideline to design, execute, interpret and compare clinical trials in this patient population. STUDY FUNDING/COMPETING INTERESTS: None of the authors received funding for the development of this paper. M.A. reports personal fees and non-financial support from Bayer Pharma outside the submitted work; H.T. reports a grant from Pfizer and personal fees for being on the advisory board of Perrigo, Abbvie, Allergan and SPD. TRIAL REGISTRATION NUMBER: N/A.

Laparoscopic microsurgical anastomosis of the blocked, solitary post-ectopic Fallopian tube: case report.

The surgical options for the management of ectopic pregnancy include linear salpingotomy or salpingectomy. If salpingotomy is performed, subsequent tubal blockage may result and if this occurs in a solitary Fallopian tube then assisted reproductive technology is recommended as the treatment of choice. We describe a case report detailing the application of laparoscopic microsurgical tubal reanastomosis in two patients with post-ectopic blockage in a solitary Fallopian tube. Both patients conceived post-operatively and subsequently delivered term pregnancies. Laparoscopic microsurgery offers an alternative to assisted reproductive technology in patients with post-ectopic tubal obstruction in a single Fallopian tube.

Laparoscopic microsurgery: current and future status.

The successful introduction of microsuturing and microinstruments for operative laparoscopy has allowed the convergence of laparoscopy and traditional microsurgery, resulting in the evolution of the 'new microsurgery'. This more dynamic approach overcomes the limitations of open microsurgery by providing continuous magnification and the benefits of a closed environment, making laparoscopy a complete surgical tool. The test model for microsurgery is tubal anastomosis, which is very dependent on operative technique to attain well-established pregnancy rates. Our cumulative pregnancy results for laparoscopic microsurgical tubal anastomosis of 76% at 12 months, 70% at 9 months, 67% at 6 months and 44% at 3 months, compares favorably to the best results achieved by traditional open microsurgery. With this validation the technique is now employed as a complete solution for all tubal surgery. The ability to effect microsurgical repair of the ureter, bladder, bowel and vessels has expanded the surgical repertoire, allowing radical excision of deep endometriosis, severe enterolysis, and adhesiolysis.

Laparoscopic microsurgical tubal anastomosis.

The authors explored the feasibility of performing true microsurgery through the laparoscope in 1990. The first laparoscopic microsurgical tubal anastomosis was performed in February 1992. Operative laparoscopy will continue to expand as technical feasibility continues to improve, driven by both hardware advances and increased surgical dexterity. Laparoscopic microsurgery will introduce a new dimension to reproductive surgery and over time, will replace laparotomy for microsurgery.

Linear ion trap for second-order Doppler shift reduction in frequency standard applications.

The authors have designed and are presently testing a novel linear ion trap that permits storage of a large number of ions with reduced susceptibility to the second-order Doppler effect caused by the RF confining fields. This new trap should store about 20 times the number of ions as a conventional RF trap with no corresponding increase in second-order Doppler shift from the confining field. In addition, the sensitivity of this shift to trapping parameters, i.e., RF voltage, RF frequency, and trap size, is greatly reduced. The authors have succeeded in trapping mercury ions and xenon ions in the presence of helium buffer gas. Trap times as long as 2x 10(3) s have been measured.

Resonant isotopic depletion spectroscopy.

We have devised a simple new scheme to increase the isotopic selectivity in optical rare-isotope detection experiments. We can effectively remove interfering isotopes from an atomic beam by optically pumping them into a state that is invisible to the optical detection system. The selectivity of this resonant depletion scales exponentially with the isotope shift and yields almost unlimited selectivity in principle. We have demonstrated a selectivity of 2.3 x 10(5) with a single laser excitation in a beam of metastable krypton atoms. With better laser stability we may be able to improve the selectivity much further.

Acidic furo[3,2-b]indoles. A new series of potent antiallergy agents.

A series of furo[3,2-b]indole carboxylic acids, tetrazoles, and carbamoyltetrazoles was prepared and tested in vitro with use of a model of active pulmonary anaphylaxis, the modified Schultz-Dale Test (SDT). In this model, isolated guinea pig lung strips are repeatedly challenged with antigen in the presence of an antihistamine (H1). Most of the acidic furo[3,2-b]indoles tested inhibited the leukotriene-mediated lung contraction in a dose-related manner. Compounds with an N-phenyl substituent were more potent (IC50 less than or equal to 5.0 microM) inhibitors of SDT than the N-methyl analogues (IC50 greater than or equal to 22.0 microM). Most of the N-phenyl analogues were more potent in SDT than Fisons' mediator-release inhibitor proxicromil (FPL-57,787; IC50 = 6.3 microM). The most potent furo[3,2-b]indoles were those unsubstituted at C-7 and with N-phenyl, 2-carbamoyltetrazole, and 3-alkoxy substituents. All of the carboxylic acid ester analogues tested were weak or inactive at concentrations of 10-30 microM.

A new working formulation of non-Hodgkin's lymphomas. A retrospective study of the new NCI classification proposal in comparison to the Rappaport and Kiel classifications.

Two hundred thirty cases of malignant non-Hodgkin's lymphomas were reclassified in a retrospective study according to the New Working Formulation for Clinical Usage of the NCI as compared to the Rappaport and Kiel classifications. The reproducibility for the individual schemes this study was 81% (Rappaport), 79% (Kiel), and 85% (New Working Formulation). In keeping with the results of the NCI international study, all lymphomas were subdivided into 3 prognostic groups: (1) low-grade malignancy (6.0 years median survival); (2) intermediate-grade malignancy (3.5 years median survival); and (3) high-grade malignancy (1.4 years median survival). The NCI-proposed New Working Formulation for Clinical Usage is thus recommended as practical and unprejudicing classification scheme for general application; however, its usefulness as tool for translating one classification scheme into another appears limited.

Linewidth of single laser-cooled Mg ion in radiofrequency trap.

A single Mg(+) has been successfully trapped and cooled in a small radiofrequency trap. The ion was cooled by using the radiation from a single-frequency ring dye laser whose output was doubled in frequency with an NH(4) (2)H(2)PO(4) temperature phasematched crystal; a power of about 22 muW or less was sufficient for all of the experiments. The ion temperature was estimated by a computer fit of the experimental resonance line profile; the resulting linewidth was compared to previously published Mg(+) 3(2)P(3/2) Hanle-effect linewidths. The result is a temperature of 5(-5) (+15) mK, which is lower than that attained previously.