A two-person, two-handed technique for laparoscopic cholecystectomy.

This manuscript describes a technique of laparoscopic cholecystectomy which permits the surgeon to use both hands. The technique can be modified to accommodate both right- and left-handed surgeons. Advantages we have appreciated in performing over 100 procedures in this manner include a less crowded operating environment, a less costly operating team, and a resident assistant closer to the patient with two hands available so that he or she can better develop the co-ordination necessary to assume increasing responsibility for the procedure.

Detection of breast cancer.

Routine screening has been shown to reduce the mortality from breast cancer in asymptomatic women. All women should be instructed in breast self-examination, and should begin a program of screening mammography and breast physical examination on an annual basis beginning at the age of 40. Most early breast cancers can be adequately treated without ablative surgery.

Endoscopic placement of feeding tubes in the critically ill patient.

Placement of the nasojejunal feeding tube under direct visual guidance using endoscopy offers an alternative method to those currently used. We found it to be a safe method easily performed by house staff. It is less burdensome than other described endoscopic techniques and does not require patient transfer or fluoroscopic facilities.

Binding of monoclonal antibody A2B5 to gangliosides.

Monoclonal antibody A2B5 (Eisenbarth et al, Proc. Nat. Acad. Sci. (1979, 76:4913-4917), which reacts with neurons, thymic epithelium and peptide-hormone secreting cells of several species, was reported to react specifically with brain tetrasialogangliosides. We have found that A2B5 binds to gangliosides GQ1b, GD3, GD2, disialolactoneotetraosylceramide, and probably to GT1a, when assayed by an immunostaining procedure that detects binding of antibody to gangliosides on a thin-layer plate. Additional data obtained by complement fixation revealed that this antibody reacted most strongly with ganglioside GQ1b almost as well with disialogangliosides GD3, GD2 and disialolactoneotetraosylceramide, weakly with GD1b and GT1b, and very weakly with GM3 and GD1a. These data indicate that A2B5 cannot be regarded as a specific reagent for the recognition of tetrasialogangliosides.