Authors:Peter Lukovich, A. Zsirka-Klein, T. Vanca, L. Szpaszkij and P. Benkő
The technical background of pure Natural Orifice Translumenal Endoscopic Surgery (NOTES) surgery has not been created yet, but ever more reports are being published on hybrid NOTES surgery and single-port surgical interventions, which have appeared as a result of device development inspired by NOTES. Surgery carried out through single ports only differ from pure NOTES in respect of the access orifice, which makes learning this technique extremely important for anyone whishing to implement a surgical intervention through a natural orifice. Numerous publications have appeared by now on the single port or hybrid NOTES surgery of various organs (gall bladder, kidney, large bowel). Based on these, most surgery is safely feasible through one port as well, but the surgery takes longer and it is not significantly less painful than a “traditional” laparoscopic intervention. Long-term results are still missing, primarily in what concerns the frequency of infections and post-operative hernia. We have received an answer to part of the dilemmas formulated in the White Paper. Besides specially bent laparoscopic devices robot technology and devices controlled by extracorporal magnets may both be a solution to the problem of triangulation. The transvaginal and transgastric paths do not seem to cause significant risks from the viewpoint of infections, but the closing of viscerotomy in the case of the stomach is far from being solved. In respect of learning and practicing new surgical techniques no method exists at the moment that could be considered the “gold standard”. Besides the earlier questions there are new ones as well awaiting partial solutions (e.g. necessity of drain following a NOTES surgery, oncologic principles).
Authors:Á. Klein, Margit Kulcsár, Virág Krízsik, R. Mátics, P. Rudas, J. Török and Gy. Huszenicza
The basic patterns of thyroid hormones [thyroxine (T4) and 3,3',5-triiodothyronine (T3)] and the T4 and T3 responses induced by thyrotropin releasing hormone (TRH) are reported in captive female barn owls (Tyto alba) during the non-breeding period. The main findings of the study, conducted on a total of 10 owls, are as follow: (1) The thyroid gland of barn owl can be stimulated by the classical TRH stimulation test. (2) T3 response was much more pronounced both under cold (around 10°C) and warm (around 20°C) conditions, whereas T4 response ranged so widely that we could not point out any significant change in it. (3) Basal T3 plasma level was significantly (p = 0.036) higher in birds exposed to cold temperature, and they responded to TRH treatment with a lower plasma T3 elevation than the birds kept in a warm chamber. This pattern, however, cannot be explained by increased food intake, but is in agreement with the fact that enhanced T3 level may account for higher avUCP mRNA expression, which results in higher heat production on the cell level. From the results it is concluded that altering T3 plasma level plays a significant role in cold-induced thermoregulation.