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Biomedical subjects

E C Wood

Publications and source records attributed to E C Wood.

At least 19 recordsLinked to original sources
PubMed1997

Lost surgical specimens.

It is an unfortunate fact that surgical specimens can become lost in the peritoneal cavity. Several reparative actions may be required, including laparotomy. The preferred method to avoid this complication, however, is to prevent it from occurring.

Adult↗
PubMed1996

Routine use of ureteric catheters at laparoscopic hysterectomy may cause unnecessary complications.

STUDY OBJECTIVE: To test the use of ureteric catheters in preventing ureteric trauma during laparoscopic hysterectomy. DESIGN: Prospective study of 492 consecutive women. SETTING: Pelosi Women's Medical Center, New Jersey, and Cliveden Hill Private Hospital, Melbourne, Australia. PATIENTS: Four hundred ninety-two consecutive women. INTERVENTIONS: Laparoscopic hysterectomy was performed in all women. Because of the reported increased risk of ureteric trauma during laparoscopic hysterectomy, we passed ureteric catheters in 92 such procedures and ceased the practice with the last 400 when further reports suggested lack of increased risk. MEASUREMENTS AND MAIN RESULTS: Oliguria and anuria occurred in 7 of 92 patients having ureteric catheterization. No ureteric trauma occurred in 400 patients without ureteric catheterization. The injury rate in this series was significantly lower than in three other series of abdominal hysterectomy. CONCLUSIONS: As long as surgical techniques incorporate various procedures to avoid ureteric injury, routine ureteric catheterization during laparoscopic hysterectomy is not indicated and may result in unnecessary complications.

Anuria↗
PubMed1996

Fresh and cryopreserved ovarian tissue samples from donors with lymphoma transmit the cancer to graft recipients.

Girls and young women who require ovariectomy or cancer therapy may consider having their own eggs, embryos or ovarian tissue stored (cryopreserved) for their own future use. Ovarian tissue is simple to collect and contains large numbers of germ cells. Transplantation of fresh and frozen-thawed ovarian tissue in healthy sheep and mice has resulted in normal live young. Similar techniques may be effective in the human but it is unclear whether ovarian tissue cryopreservation and grafting is suitable for ovaries from individuals with cancer or infections. If cancer cells were present in an ovary at the time of collection and survived cryopreservation and grafting they could establish cancer in the recipient. We therefore performed ovarian cryopreservation and transplantation trials using a mouse lymphoma model. This established that the lymphoma was transmitted by grafts of both fresh and frozen ovarian tissue. The normal healthy recipient mice died 9-43 days after receiving a small piece (1 mm3) of ovarian tissue from a donor with lymphoma. We conclude that ovarian tissue which is collected, cryopreserved and grafted while it contains cancer cells has the potential to spread the cancer to the graft recipient.

Aging↗
PubMed1995

Evolutions of an orientation concerning the nature of the male homosexualities.

None of the adults I have treated have had major disturbances in their sexual identity except for the selection of the sex of the person with whom they express their sexual feelings. Only one lives out a role that is ambisexual. All the men I have seen have been able to relate sexually to women with varying degrees of comfort. Six have had sexual intercourse with women and can function physiologically but without a sense of closeness or satisfaction, and five have been able to achieve climax. Some decided not to stay in their marriages, divorced, and adopted an overtly homosexual lifestyle. Some felt increasing ability to relate to women and decided to marry. Still others resolved current conflicts with their gay partners and felt no need for further therapy. All but one were actively employed and functioning well by external observation in demanding jobs requiring postgraduate college education. In terms of the detailed analytic work, there were no sets of insights that resulted in a major sexual partner reorientation. Those who decided to marry did so when they felt more able to resolve their narcissistic needs and make a relationship with a caring tolerant woman. They maintained their homosexual fantasies though the fantasies were more acceptable and less disruptive. It was not always the partner's penis that determined the sexual interest of these men. More often, it was the contour of the male body, the firmness of the musculature, the masculine bodily movements, the very identity and role of the father in the family. I did not see these foci of interest only as displacements from the genitals but rather as primary erotogenic stimuli. It is the seeking of a narcissistic object, the self in the other. This very orientation may be the innate variable. This position is spelled out in some detail by Leavy (1985). To varying degrees, the families of all these men were experienced as being composed of vigorous, active, articulate, determined, aspiring mothers and rather quiet, removed, passive fathers. The reported presence of this general pattern is impressive though the prominence of these characteristics differed from family to family. I have not postulated that these parental-child relations are causative in the boy's development of a homosexual life. However, they may be crucial if the genetic and/or constitutional factors discussed above are also present.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1995

Endoscopic minilaparotomy.

In a preliminary study the principles of standard gynaecological surgery, new operative laparoscopic techniques and mechanical elevation of the abdominal wall are combined. These early results indicate an advantage to both patient and hospitals from this approach. Further studies are required to verify our impressions that minilaparotomy combined with no insufflation laparoendoscopy will open up the concept of operative laparoscopic surgery to most gynaecologists.

Adult↗
PubMed1994

Decreased natural killer cell activity in endometriosis patients: relationship to disease pathogenesis.

A number of reports have measured NK cell activity in patients with endometriosis with varied results. Therefore we have examined the NK activity of PBL from 44 gynecological patients undergoing laparoscopy. This analysis has demonstrated a significant reduction in NK activity only in more severe stages of endometriosis (stages III and IV) relative to patients with milder disease and controls. These data indicate that decreased NK activity is unlikely to be a primary etiological factor in the development of endometriosis but may indicate that decreased NK activity is related to the development of the more frequent and/or larger lesions characteristic of severe endometriosis. These data could indicate potential for immunotherapy of patients with advanced endometriosis by the upregulation of NK activity in vivo.

Cytotoxicity Tests, Immunologic↗
PubMed1994

Gasless laparoscopy--useless or useful?

Carbon dioxide (CO2) pneumoperitoneum for advanced operative laparoscopy has well-documented inherent pathophysiologic risks. Problems are associated with creating and maintaining the pneumoperitoneum, lowering body temperature, infective particles in the insufflation gas, and ensuring hemostasis of port entry sites after intraabdominal pressure is reduced. When the vagina is opened to remove surgical specimens or at the time of hysterectomy, loss of vision occurs. In some patients general anesthesia and CO2 pneumoperitoneum are contraindicated, and in them such problems could be avoided by gasless laparoscopy. Three types of mechanical anterior abdominal wall elevators have been used at the Melbourne Gynoscopy Centre for a variety of laparoscopic procedures, all of which have their advantages and disadvantages.

Carbon Dioxide↗
PubMed1993

Evaluation of a unique mechanical client lift: efficiency and perspectives of nursing staff.

This study evaluated the acceptability of a mechanical client lift based on the design employed for helicopter rescue lifts. Twenty-three nursing personnel completed questionnaires which explored their preferences, intentions to use the lift, perceptions of helpfulness, and exertion. Sixteen clients in a long term care setting consented to participate. One hundred manual lifts and 100 belt lifts were observed for comparative time and staff measures. The findings suggest that: 1) nursing staff will prefer the belt lift device for changing incontinent briefs; 2) nursing staff will prefer the belt lift device for toileting; 3) nursing staff will prefer the belt lift device to the currently used lift (in cases where either lift is appropriate) for bed/chair transfer; and, 5) the time required to utilize the belt lift as compared to manual lifting methods will not increase significantly.

Back Pain↗
PubMed1992

Laparoscopically assisted hysterectomy.

OBJECTIVE: To determine the feasibility and effectiveness of laparoscopically assisted hysterectomy. DESIGN: A prospective study of the planned surgical procedure was carried out by two teams, each with two gynaecologists, who were experienced in operative laparoscopy. SETTING: The operations were carried out in a private hospital, where advanced operative laparoscopy equipment was available. PATIENTS: Seventeen patients were selected for the procedure, all of whom required hysterectomy for symptoms of pain or menorrhagia in association with uterine or other pelvic disease. Patients with carcinoma or uterine enlargement beyond 12 cm were excluded. PROCEDURE: Laparoscopically assisted hysterectomy was carried out by means of a video monitor, uterine manipulation by vaginal instrumentation, three or four abdominal punctures of less than 1 cm, and bipolar diathermy to secure vascular pedicles. The uterus was removed from the vagina by cutting vaginal skin and the cardinal ligaments. RESULTS: The operating time was 90-220 min, the blood loss was 30-200 mL, and the hospital stay lasted two to five days and convalescence two to four weeks. No serious complications occurred. CONCLUSIONS: Laparoscopically assisted hysterectomy may be valuable when adnexal or uterine abnormalities are present and vaginal hysterectomy is either contraindicated or more difficult. The procedure requires special equipment and may only be carried out by experienced gynaecological operative laparoscopists. Its acceptance will depend upon reducing the operating time to less than 90 min. It has the advantage of reducing the duration of hospital stay and the duration of convalescence when compared with abdominal hysterectomy.

Adult↗
PubMed1990

A comparison of vaginal ultrasonic-guided and laparoscopic retrieval of oocytes for in vitro fertilization.

A retrospective analysis was undertaken to compare the less invasive technique of vaginal ultrasonic-guided oocyte retrieval with the standard laparoscopic technique. We have shown that the outcome of the transvaginal technique with respect to oocytes harvested, fertilization rate, and pregnancy rate is comparable with the laparoscopy technique. We have also shown that 9 clinicians with little previous expertise in ultrasound have been able to incorporate this technique into a busy and successful in vitro fertilization unit.

Female↗
PubMed1990

Referral issues in psychotherapy and psychoanalysis.

The authors consider the complex decisions involved in the initial consultation of a person looking for treatment when this person must be referred to a professional colleague. They explore the way decisions are made in the referral processes and the complex practical and transference-countertransference issues that arise at the outset and whenever second opinions are sought during an ongoing psychotherapy. They present four clinical examples in varying detail to emphasize how readily misunderstandings can develop when even experienced consultants are not sufficiently alert to the complex conscious and unconscious motives and messages being expressed in the exchanges. They make recommendations on how to conceptualize and respond to them.

Countertransference↗
PubMed1989

A prospective study of prognostic factors in in vitro fertilization and embryo transfer.

Multiple factors influence the outcome of in vitro fertilization and embryo transfer (IVF-ET). This prospective study was designed to assess their relative importance, in order to improve prognostic ability and treatment success. Prior to IVF-ET, couples were divided into "good" (GP) and "poor" (PP) prognosis groups according to female age, semen quality, previous response to stimulation, and embryo quality. The data obtained from 716 consecutive treatment cycles then were evaluated using univariate statistics and logistic regression, a technique designed to assess the relative contribution of significant factors. The pregnancy rate per GP cycle was 14.7%, compared with 5.4% per PP cycle (chi 1(2) = 12.7, P less than 0.001). The most important prognostic factors were female age, the pregnancy rate showing a linear decline after the age of 25, and previous failed fertilization due to abnormal sperm. The rate of pregnancy also declined after 14 or more follicles were aspirated and/or nine oocytes were retrieved. A formula for the probability of pregnancy, derived from the logistic regression, provides patients with a more accurate prognosis before treatment.

Adult↗
PubMed1988

Antenatal serum levels of relaxin in patients having preterm labour.

This study is the first report of antenatal levels of relaxin measured by homologous radioimmunoassay in peripheral serum from patients who subsequently had a preterm delivery. Serial blood samples were collected antenatally from a group of subjects known to be at increased risk of preterm labour because of a past history of shortened pregnancy. Serum relaxin was measured using an homologous radioimmunoassay based on a synthetic bioactive analogue of the native hormone. In women whose pregnancies ended preterm most measurements were within the range of values previously established in normal antenatal patients although some measurements early in pregnancy were above the normal range. These findings suggest that low serum levels of relaxin are not causatively related to the onset of labour before term.

Female↗