Theoretical determination of the Co-C bond energy dissociation in cobalamins.
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Vitamin B 12↗
Biomedical subjects
P M Kozlowski
Publications and source records attributed to P M Kozlowski.
Laparoscopic management of bladder pheochromocytoma.
Pheochromocytoma primarily involving the bladder is an uncommon pathologic finding. Patients may present with transient hypertension associated with palpitations and diaphoresis on micturition. A case of bladder pheochromocytoma treated by laparoscopic partial cystectomy is presented. The management principles of bladder pheochromocytoma for our specific case are discussed. Successful treatment requires that the correct diagnosis and tumor location be made in conjunction with the obligatory preoperative preparation of the patient.
Adult↗
Morbid obesity and the prone position: a case report.
An improperly positioned prone patient can experience serious impairment of cardiopulmonary function. However, with appropriate preparation, even an extremely obese patient can safely tolerate the prone position.
Adult↗
Quantum chemical modeling of Co--C bond activation in B(12)-dependent enzymes.
Recent progress in computational modeling of the catalytic activation of cobalt-carbon bond cleavage shows that quantum chemical calculations could be an important part of coenzyme B(12) research. Particular emphasis has been placed on density functional theory, which is now emerging as a powerful tool to elucidate the electronic structure and spectroscopic properties of the active sites of metalloenzymes.
Cobalt↗
Is the CO adduct of myoglobin bent, and does it matter?
Early reports of a severely bent CO adduct in myoglobin inspired the idea that heme proteins discriminate against CO, relative to O(2), via steric hindrance imposed by a distal histidine residue. Recent results showing that the bound CO is only slightly distorted do not by themselves overthrow the steric hypothesis, because the steric energy could be stored in displacements of the protein. However, experimental data on site-directed mutants show that the main determinant of ligand affinity changes is the polarity of the binding pocket and that H-bonding by the distal histidine accounts for about 85% of the O(2)/CO discrimination while steric hindrance accounts for the remaining 15%.
Carbon Monoxide↗
Laparoscopic partial nephrectomy and wedge resection for the treatment of renal malignancy.
The widespread use of abdominal ultrasonography, CT, and MRI has led to an increase in the number of incidentally detected renal masses, some of which are malignant. Numerous studies suggest that partial nephrectomy or wedge resection of these lesions yield cure rates similar to those obtained with radical surgery. Laparoscopic nephron-sparing surgery is one of the more challenging minimally invasive surgical techniques, and its use is largely restricted to specialized medical centers. The techniques and available results are described.
Equipment Design↗
Laparoscopic repair of incisional and parastomal hernias after major genitourinary or abdominal surgery.
BACKGROUND AND PURPOSE: Abdominal wall or parastomal hernias following major genitourinary or abdominal surgery are a significant surgical problem. Open surgical repair is difficult because of adhesion formation and poor definition of the hernia fascial edges. Laparoscopic intervention has allowed effective correction of these abdominal wall hernias. PATIENTS AND METHODS: From November 1997 to June 2000, 14 male and 3 female patients underwent laparoscopic abdominal wall herniorrhaphy at our institution. Of these, 13 patients received incisional and 4 parastomal hernia repair. All hernia defects were repaired using a measured piece of Gore-Tex DualMesh. A retrospective review of each patient's history and operative characteristics was undertaken. RESULTS: All repairs were successful. No patient required conversion to an open procedure, and there were no intraoperative complications. The average operative time was 4 (range 2.5-6.5) and 4.3 (range 3.75-5.5) hours in the incisional and parastomal group, respectively. The average hospital stay was 4.9 days (range 2-12) for the incisional group and 3.8 (range 3-4) days for the parastomal group. To date, two patients experienced a recurrence of incisional hernias, at 5 and 8 months postoperatively. No recurrences have developed in the parastomal hernia repairs at 2 to 33 months. CONCLUSION: Laparoscopic repair of abdominal wall incisional or parastomal hernias provides an excellent anatomic correction of such defects. Adhesions are lysed under magnified laparoscopic vision, and the true limits of the fascial defects are clearly identified. The DualMesh is easy to work with and has yielded excellent results. A comparison with open repair with respect to perioperative factors and long-term success is currently under way.
Abdomen↗
Laparoscopic partial nephrectomy and wedge resection.
Partial nephrectomy is a more challenging operation than radical or simple nephrectomy, primarily because of the risk of complications such as bleeding. This problem is even more troublesome with minimally invasive approaches because of the dearth of effective hemostatic instruments and supplies. The location of the lesion determines whether a transperitoneal or a retroperitoneal route will be employed. Centrally located or anterior renal lesions generally are approached transperitoneally whereas peripheral lateral or posterior lesions are accessed by retroperitoneoscopy. The Harmonic Scalpel with slow cutting and high coagulation settings is useful for incising the renal capsule and parenchyma. The argon beam coagulator is helpful to stop any persistent bleeding. The few reported series of laparoscopic partial nephrectomy indicate considerably longer operative times than are needed for open surgery and hospitalization of upwards of 5 days, largely to monitor drainage and urine leakage. It is hoped that this advanced laparoscopic technique will become more user friendly with further developments in techniques and instrumentation to provide patients with the expected benefits of minimally invasive surgery.
Blood Loss, Surgical↗
Laparoscopic lymph node dissection: pelvic and retroperitoneal.
The application of laparoscopic procedures to the field of urology continues to expand at a rapid rate. The initial animal studies performed in the late 1980s were brought into the clinical arena by 1990. The first widely accepted procedure was laparoscopic pelvic lymph node dissection for the staging of prostate cancer. Since that time, numerous laparoscopic procedures have been developed and accepted. Herein we discuss laparoscopic pelvic lymph node dissection for the staging evaluation of cancer of the prostate with possible applications to the bladder, urethra, and penis. The technique of laparoscopic retroperitoneal lymph node dissection has been used for cancer of the testes and will also be described. The indications and a brief review of the postoperative results will also be discussed for each malignancy.
Humans↗