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Total laparoscopic hysterectomy versus da Vinci robotic hysterectomy: is using the robot beneficial?
Enrique Soto,Yungtai Lo,Kathryn Friedman,Carlos Soto,Farr Nezhat,Linus Chuang,Herbert Gretz 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.4
Objective: To compare the outcomes of total laparoscopic to robotic approach for hysterectomy and all indicated procedures after controlling for surgeon and other confounding factors. Methods: Retrospective chart review of all consecutive cases of total laparoscopic and da Vinci robotic hysterectomies between August 2007 and July 2009 by two gynecologic oncology surgeons. Our primary outcome measure was operative procedure time. Secondary measures included complications, conversion to laparotomy, estimated blood loss and length of hospital stay. A mixed model with a random intercept was applied to control for surgeon and other confounders. Wilcoxon rank-sum, chi-square and Fisher’s exact tests were used for the statistical analysis. Results: The 124 patients included in the study consisted of 77 total laparoscopic hysterectomies and 47 robotic hysterectomies. Both groups had similar baseline characteristics, indications for surgery and additional procedures performed. The difference between the mean operative procedure time for the total laparoscopic hysterectomy group (111.4 minutes) and the robotic hysterectomy group (150.8 minutes) was statistically significant (p=0.0001) despite the fact that the specimens obtained in the total laparoscopic hysterectomy group were significantly larger (125 g vs. 94 g, p=0.002). The robotic hysterectomy group had statistically less estimated blood loss than the total laparoscopic hysterectomy group (131.5 mL vs. 207.7 mL, p=0.0105) however no patients required a blood transfusion in either group. Both groups had a comparable rate of conversion to laparotomy, intraoperative complications, and length of hospital stay. Conclusion: Total laparoscopic hysterectomy can be performed safely and in less operative time compared to robotic hysterectomy when performed by trained surgeons. Objective: To compare the outcomes of total laparoscopic to robotic approach for hysterectomy and all indicated procedures after controlling for surgeon and other confounding factors. Methods: Retrospective chart review of all consecutive cases of total laparoscopic and da Vinci robotic hysterectomies between August 2007 and July 2009 by two gynecologic oncology surgeons. Our primary outcome measure was operative procedure time. Secondary measures included complications, conversion to laparotomy, estimated blood loss and length of hospital stay. A mixed model with a random intercept was applied to control for surgeon and other confounders. Wilcoxon rank-sum, chi-square and Fisher’s exact tests were used for the statistical analysis. Results: The 124 patients included in the study consisted of 77 total laparoscopic hysterectomies and 47 robotic hysterectomies. Both groups had similar baseline characteristics, indications for surgery and additional procedures performed. The difference between the mean operative procedure time for the total laparoscopic hysterectomy group (111.4 minutes) and the robotic hysterectomy group (150.8 minutes) was statistically significant (p=0.0001) despite the fact that the specimens obtained in the total laparoscopic hysterectomy group were significantly larger (125 g vs. 94 g, p=0.002). The robotic hysterectomy group had statistically less estimated blood loss than the total laparoscopic hysterectomy group (131.5 mL vs. 207.7 mL, p=0.0105) however no patients required a blood transfusion in either group. Both groups had a comparable rate of conversion to laparotomy, intraoperative complications, and length of hospital stay. Conclusion: Total laparoscopic hysterectomy can be performed safely and in less operative time compared to robotic hysterectomy when performed by trained surgeons.
Enrique Soto,Carlos Soto,Farr R. Nezhat,Herbert F. Gretz,Linus Chuang 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.1
Chylous ascites is an uncommon postoperative complication of gynecological surgery. We report a case of chylous ascites following a robotic lymph node dissection for a cervical carcinoma. A 38-year-old woman with IB2 cervical adenocarcinoma with a palpable 3 cm left external iliac lymph node was taken to the operating room for robotic-assisted laparoscopic pelvic and para-aortic lymph node dissection. Patient was discharged on postoperative day 2 after an apparent uncomplicated procedure. The patient was readmitted the hospital on postoperative day 9 with abdominal distention and a CT-scan revealed free fluid in the abdomen and pelvis. A paracentesis demonstrated milky-fluid with an elevated concentration of triglycerides, confirming the diagnosis of chylous ascites. She recovered well with conservative measures. The risk of postoperative chylous ascites following lymph node dissection is still present despite the utilization of new technologies such as the da Vinci robot.
Hot Filament Chemical Vapor Deposition of Crystalline Boron Films
Soto, Gerardo The Korean Ceramic Society 2019 한국세라믹학회지 Vol.56 No.3
This article reports on the conditions required for the growth of crystalline boron films on silicon substrates by hot filament chemical vapor deposition method. The reactive gas was 3% diborane diluted in hydrogen. The films were characterized by optical, electronic, and atomic force microscopies; x-ray diffraction; and energy dispersive, electron energy loss, Raman, x-ray photoelectron, and Auger spectroscopies. The parameters that affect the morphologies of the films have been investigated. It was concluded that faceted crystals are produced at low B<sub>2</sub>H<sub>6</sub> flows and working pressures below 200 mT. α-boron is produced between 530 and 600℃. Deposition outside this range produces thin films with a wide variety of morphologies. This result indicates that the films crystallize through a process called "abnormal or discontinuous grain growth." It is assumed that this is due to the anisotropic surfaces of boron allotropes.
Mylene Soto,Park, Young Hai Asian pacific women's information network center 2003 APWIN Vol.5 No.-
In order for a country to achieve women's informatization, a certain level of literacy, IT-related skills and awareness of the benefits of ICT is required. This paper is culled from the final report of the baseline survey on women's informatization in 6 Asian countries: China, India, Indonesia, Korea, Philippines, and Sri Lanka. It provides a comparative analysis of the levels of literacy, IT-related skills and consciousness of the advantages of ICT in the said countries. It also proposes some views on the possible grounds for the resulting divergence. This study supports its findings with gender-disaggregated data whenever possible. It also looks at the existing government policies or absence thereofand how these relate to women's informatization.
Garcia-Soto, Gabriela,Lopez-Bautista, Juan The Korean Society of Phycology 2018 ALGAE Vol.33 No.3
In this study, the phylogenetic relationships among the genera Alsidium C. Agardh and Bryothamnion $K{\ddot{u}}tzing$ were investigated. Phylogenetic analyses using the plastid-encoded markers rbcL, psbA, and the mitochondrial barcode region (COI-5P) resolved a well-supported clade that included the species Alsidium corallinum, Bryothamnion seaforthii, and B. triquetrum. Our results indicated that taxonomic recognition of the genus Bryothamnion is not supported and two species of Bryothamnion are reallocated to Alsidium. A reexamination of the morphological definition of Alsidium is provided with an updated diagnosis of the genus and a morphology-based comparison of species that are currently circumscribed under this generic name. Furthermore, we reviewed morphological differences and similarities between Alsidium and the genus Digenea, both belonging to the tribe Alsidieae, discussing the most relevant morphological characters.
Lopez-Soto, M.A.,Rivera-Mendez, C.R.,Aguilar-Hernandez, J.A.,Barreras, A.,Calderon-Cortes, J.F.,Plascencia, A.,Davila-Ramos, H.,Estrada-Angulo, A.,Valdes-Garcia, Y.S. Asian Australasian Association of Animal Productio 2014 Animal Bioscience Vol.27 No.2
As a result of the cost of grains, the replacement of grains by co-products (i.e. DDGS) in feedlot diets is a common practice. This change produces diets that contain a lower amount of starch and greater amount of fibre. Hypothetically, combining feed grade urea (U) with slow release urea (Optigen) in this type of diet should elicit a better synchrony between starch (high-rate of digestion) and fibre (low-rate of digestion) promoting a better microbial protein synthesis and ruminal digestion with increasing the digestible energy of the diet. Four cannulated Holstein steers ($213{\pm}4$ kg) were used in a $4{\times}4$ Latin square design to examine the combination of Optigen and U in a finishing diet containing different starch:acid detergent fibre ratios (S:F) on the characteristics of digestive function. Three S:F ratios (3.0, 4.5, and 6.0) were tested using a combination of U (0.80%) and Optigen (1.0%). Additionally, a treatment of 4.5 S:F ratio with urea (0.80% in ration) as the sole source of non-protein nitrogen was used to compare the effect of urea combination at same S:F ratio. The S:F ratio of the diet was manipulated by replacing the corn grain by dried distillers grain with solubles and roughage. Urea combination did not affect ruminal pH. The S:F ratio did not affect ruminal pH at 0 and 2 h post-feeding but, at 4 and 6 h, the ruminal pH decreased as the S:F ratio increased (linear, p<0.05). Ruminal digestion of OM, starch and feed N were not affected by urea combination or S:F ratio. The urea combination did not affect ADF ruminal digestion. ADF ruminal digestion decreased linearly (p = 0.02) as the S:F ratio increased. Compared to the urea treatment (p<0.05) and within the urea combination treatment (quadratic, p<0.01), the flow of microbial nitrogen (MN) to the small intestine and ruminal microbial efficiency were greater for the urea combination at a S:F ratio of 4.5. Irrespective of the S:F ratio, the urea combination improved (2.8%, p = 0.02) postruminal N digestion. As S:F ratio increased, OM digestion increased, but ADF total tract digestion decreased. The combination of urea at 4.5 S:F improved (2%, p = 0.04) the digestible energy (DE) more than expected. Combining urea and Optigen resulted in positive effects on the MN flow and DE of the diet, but apparently these advantages are observed only when there is a certain proportion of starch:ADF in the diet.