OBJECTIVES: To evaluate angiographic results Daporinad mouse of the cobalt chromium Vision and Mini-Vision stems (Abbott Vascular, USA).

METHODS: A total of 247 consecutive patients with 293 de novo lesions in native coronary

arteries were treated with cobalt chromium Vision (n=184; stent diameter 2.75 mm to 4.0 mm) or Mini-Vision stents (n=109; stent diameter 2.0 mm to 2.5 mm), and scheduled for six months of angiographic follow-tip. The primary end point was in-scent late loss after six months.

RESULTS: Acute coronary syndromes were present in 83.4% (n=206) of patients. The preinterventional reference diameter of Vision stents was 2.70 +/- 0.34 mm and for Mini-Vision stents, it was 2.13 +/- 0.27 mm (P<0.001). Clinical and angiographic follow-up was 98.0% and 51.2%, respectively. In the Vision group, in-scent late loss was 0.64 +/- 0.67 mm and the binary restenosis rate was 17.9%. In the Mini-Vision group, in-scent late loss wits 0.82 +/- 0.71 mm and the restenosis rate was 45.4%. No difference in occurrence of restenosis within the segments proximal or distal to the stent was observed. The restenotic pattern was predominantly focal with a short length of 7.9 +/- 4.4 mm.

CONCLUSIONS: The use of the cobalt chromium Vision stent for the

treatment of de novo lesions was associated with a low late loss and binary angiographic restenosis rate.”
“Purpose: The purpose of this study I-BET-762 was to evaluate the psychosocial support needs of teenage young adult cancer patients undergoing radiotherapy in Wales.

Method: A focus group interview was utilised to encourage dialogue and collect rich data. Transcripts were analysed through open coding and content analysis. Emergent themes in terms of psychosocial tensions were identified and categorised as external stressors and intrinsic anxieties.

Findings:

All participants indicated a desire to maintain their identity as individuals and resume as normal a life as possible throughout the treatment process and beyond. Peer support was deemed as vital to achieving this goal. Participants AZD2811 demonstrated a distinct sense of unity and group cohesion throughout the session with suggestions that they considered themselves to be very different from what they thought of as ‘usual cancer patients’. A range of information was offered prior to radiotherapy however there was variation in the efficacy of this provision between centres. At variance with literature, issues related to body image were not overtly demonstrated as significant. Support services provided by external organisations were not being signposted.

Conclusion: Psychosocial support is vital to the psychological recovery and wellbeing of young adult cancer patients. Findings suggest that issues related to peer support and age appropriate services and information are not being addressed within current service provision.

Motor variants in delirium have similar cognitive profiles, but mixed

cases differ in expression of Selleck Mocetinostat several noncognitive features. (The Journal of Neuropsychiatry and Clinical Neurosciences 2011; 23: 180-188)”
“Purpose: We compared the effect of static magnetic field (SMF) and verapamil, a potent vascular calcium channel blocking agent, on sudden elevation in blood pressure in conjunction with arterial baroreflex sensitivity (BRS) and microcirculation.

Materials and methods: Forty-four experiments were performed on conscious rabbits sedated using pentobarbital intravenous (i.v.) infusion (5 mg kg(-1) h(-1)). Mean femoral artery blood pressure (MAP), heart rate, BRS and car lobe skin microcirculatory blood flow, estimated using microphotoelectric plethysmography (MPPG), VE-822 order were simultaneously measured after a 40 min exposure of the sinocarotid baroreceptors to 350 mT SMF, generated by Nd(2)-Fe(14)-B magnets, or 30 min of verapamil i.v. administration (20 mu g kg(-1) min(-1)). BRS was assessed from heart rate and MAP responses to i.v. bolus of nitroprusside and phenylephrine.

Results: The decrease in phenylephrine-induced abrupt elevation in MAP (Delta MAP(AE)) was significantly larger after verapamil than after SMF exposure. Delta MAP(AE) inversely correlated with

verapamil-induced significant increase in Delta MPPG (r = 0.53, p < 0.000) and with SMF-induced significant increase in Delta BRS (r = 0.47, p < 0.016).

Conclusions: Our results suggest that verapamil-potentiated vascular blood pressure buffering mechanism was more effective than SMF-potentiated baroreflex-mediated

blood pressure buffering mechanism, and a potential benefit of both approaches in cardiovascular conditions with abrupt high elevation in blood pressure.”
“We demonstrated that transmittance and field intensities of a thick metal sandwiched between two dielectric photonic crystals (PCs) can be enhanced by more than two orders of magnitude and by nearly 20 times, respectively, compared to a single metal layer with the same thickness. Under the tunneling mechanism, the light can enter the sandwiched structure without reflection and localizes at the two interfaces of the metal film and PCs. This configuration of fields facilitates Quisinostat purchase the reduction of absorption in the metal. Experimental results are in good agreement with simulations. (C) 2010 American Institute of Physics. [doi:10.1063/1.3512903]“
“Purpose: To investigate radiation-induced bystander responses and to determine the role of gap junction intercellular communication and the radiation environment in propagating this response.

Materials and methods: We used medium transfer and targeted irradiation to examine radiation-induced bystander effects in primary human fibroblast (AG01522) and human colon carcinoma (RKO36) cells.

However, the kill

rates are extremely slow so that therapy takes many months to years to achieve and even then more than 40% of patients are not completely cured. Recent studies have demonstrated that assays that detect extracellular MAC have a limited predictive value. Antibiotics kill at a much slower and more disappointing rate against bacilli within macrophages. Use of pharmacodynamic/pharmacokinetic models has resulted in design of new doses and dosing schedules for disseminated MAC, as well as new susceptibility breakpoints for ethambutol and moxifloxacin.”
“Polythiophene (Pth) bilayer films each consists of a nanotube layer and a compact layer had been prepared by electrochemical SNS-032 polymerization and using anodic aluminum oxide (AAO) membranes as template. The films were treated by mechanical polishing and freeze drying to improve the degree of orientation of nanotubes and their surface smoothness. A treated Pth bilayer film can adhere strongly on glass with its nanotube surface by applying a dragging Compound C order preload. The applied dragging preload caused the original vertically aligned Pth nanotube array to tilt opposite to the direction of preload, which induced a superstrong shear adhesion force of up to 144

+/- 30 N cm-2 for the film with a tube length of 26 mu m as the film was dragged along the direction of preload. However, the shear adhesion force opposite to the direction of dragging preload was relatively low (44 +/- 17 N cm-2). The direction-dependent

force management of Pth bilayer films is quite similar to that gecko does, indicating the potential for developing advanced adhesive systems. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“In this paper, we proposed a non-destructive evaluation method combined digital image correlation with acoustic emission techniques. The method was used to in situ monitor interface failure and internal damage of brittle coating/ductile substrate systems with different size scales. The results show that there is a good relationship between digital image correlation GF120918 mw and acoustic emission signals, which can be applied to judge cracking formation and coating delamination and to determine fracture toughness of a thermal barrier coating system subjected to bending. (C) 2011 American Institute of Physics. [doi:10.1063/1.3651378]“
“Background: Effective bile duct drainage is crucial to the health-related quality of life of patients with jaundice caused by obstruction of the bile duct by inoperable malignant tumours.

Methods: All patients who were treated at Uppsala University Hospital, Sweden with percutaneous stenting between 2000 and 2005 were identified retrospectively. Data on the location of the obstruction and type of stent used, date and cause of death and date of stent failure were abstracted from the patients’ notes. Stent patency was defined as the duration from the insertion of the stent to the date of failure.

No statistically significant differences in acculturation and screening behaviours were found. In terms of CBCSB score, women who had CBEs and mammograms as recommended had significantly higher scores on the Attitudes to health checkup subscale. In addition, women who engaged

in BSE and mammogram as recommended perceived less barriers to mammographic screening.

Conclusions: Attitudes towards health check-ups and SCH772984 MAPK inhibitor perceived barriers to mammographic screening were influential in compliance with breast cancer screening among Chinese-Australian women. (C) 2011 Elsevier Ltd. All rights reserved.”
“We analysed whether pre- and post-transplant serum adiponectin levels in renal transplant patients were associated with new-onset diabetes after transplantation (NODAT). The mean post-transplant follow-up duration was 47.9 months. Of 98 previously non-diabetic renal transplant patients, 12 were diagnosed with NODAT and 86 without (non-NODAT). There was a significant inverse correlation between mean post-transplant serum adiponectin level and homeostasis model assessment for insulin resistance (HOMA-IR) (r = -0.22, P = 0.03), and

PI3K inhibitor a positive correlation between follow-up duration after transplantation and HOMA-IR (r = 0.28, P = 0.005). The mean pre- and post-transplant serum adiponectin levels in NODAT patients were significantly lower than those in non-NODAT patients (13.3 Mdivi1 vs. 21.0 mu g/ml and 13.0 vs. 16.4 mu g/ml, P = 0.01 and 0.03 respectively). In addition, the post-transplant serum adiponectin level in patients treated with tacrolimus (TAC) was significantly lower than that in patients with cyclosporine (14.3 vs. 18.7 mu g/ml, P = 0.01), while, that level in patients treated with angiotensin receptor blockers (ARB) was significantly higher than that in patients without treatment

of ARB (17.9 vs. 14.7 mu g/ml, P = 0.01). Our results indicate that post-transplant serum adiponectin levels are decreased after transplantation in association with insulin resistance in the development of NODAT, and that TAC and ARB influence the level of adiponectin in serum.”
“Sleep apnea is a major public health problem that afflicts 9% of women and 24% of men 30 to 60 years of age. It is highly treatable, but when untreated, it has been associated with (but not necessarily linked to) increased probability of cerebral and coronary vascular disease, congestive heart failure, metabolic dysfunction, cognitive dysfunction, excessive daytime sleepiness, motor vehicle accidents, reduced productivity, and decreased quality of life. The gold standard for treatment in adults is positive airway pressure (PAP) therapy: continuous PAP (CPAP), bilevel PAP, autotitrating CPAP, or autotitrating bilevel PAP.

The presence of symptoms suggestive of malaria infection in 982

women during antenatal visits (ANV), unscheduled visits and delivery were analysed. A multivariate logistic regression was used to determine the association between symptoms and a positive thick blood smear (TBS).

Results: During routine ANVs, headache AR-13324 in vitro was the only symptom associated with a higher risk of positive TBS (aOR = 1.9; p < 0.001). On the occasion of unscheduled visits, fever (aOR = 5.2; p < 0.001), headache (aOR = 2.1; p = 0.004) and shivering (aOR = 3.1; p < 0.001) were significantly associated with a malaria infection and almost 90% of infected women presented at least one of these symptoms. Two CBL0137 research buy thirds of symptomatic malaria infections during unscheduled visits occurred in late pregnancy and long after the last intermittent preventive treatment dose (IPTp).

Conclusion: The majority of pregnant women were symptomless during routine visits when infected with malaria in an endemic stable area. The only suggestive sign of malaria (fever) was associated with malaria only on the occasion of unscheduled visits. The prevention of malaria in pregnancy could be improved by reassessing the design of IPTp, i.e. by determining an optimal number of doses and time of administration of anti-malarial drugs.”
“Background: Phytanic acid, a fatty acid

predominantly obtained from foods high in ruminant fat, may have a biological role in the up-regulation

of the protein e-methylacyl-coenzyme A racemase, which is overexpressed in prostate cancer tissue.

Objective: This study aimed to ITF2357 ic50 examine the association between plasma concentrations of phytanic acid and subsequent risk of prostate cancer.

Design: Within the European Prospective Investigation into Cancer and Nutrition cohort, 566 incident prostate cancer cases from Germany, Greece, Italy, the Netherlands, Spain, and the United Kingdom were individually matched to 566 controls by study center, age at recruitment, and time of day and duration of fasting at blood collection. Phytanic acid concentrations were measured by using a gas chromatography-mass spectrometry assay.

Results: In controls, plasma phytanic acid concentration was strongly correlated with dairy fat intake (r = 0.49, P < 0.0001), varied significantly by country (P for heterogeneity < 0.0001), and decreased with age (P for trend = 0.02) and duration of fasting at blood collection (P for trend = 0.002). There was no significant association of phytanic acid with prostate cancer risk overall (odds ratio for a doubling in concentration: 1.05; 95% Cl: 0.91, 1.21; P for trend = 0.53) or by stage or grade of disease. However, in men who had fasted (>3 h) at blood collection, the odds ratio for prostate cancer was 1.27 (95% Cl: 1.01, 1.60; P for trend = 0.04).

The strain Lactobacillus agilis LPB 56 was selected among nine for presenting the highest enzymatic activity. The C:N relation in the vinasse-based inoculum medium was optimized and adjusted in 6 with yeast extract. The effects of soluble solids concentration in the fermentation medium. C:N relation and size of inoculum were investigated. Results demonstrated that the medium concentration of 30% soluble solids, with a C:N relation of 9, and size of inoculum of 25% ATM/ATR cancer (v/v) were the

best conditions for of-galactosidase production. The highest enzyme activity (11.07 U/mL) was achieved after 144 h of fermentation. (C) 2009 Elsevier Ltd. All rights reserved.”
“In recent decades, the Western world has been experiencing a societal trend to prioritize the professional careers of women who postpone motherhood to about 40 years of age, when, unfortunately, natural https://www.selleckchem.com/products/epz004777.html reproductive

potential declines. This is the reason why these women increasingly find it necessary to resort to oocyte donation to have a child. Thanks to the young age of the donors, the efficacy of oocyte donation is the highest of all assisted reproduction treatments and pregnancy rates achieved with this technique exceed 50%. Moreover, the large registries from ESHRE and ASRM show live birth rates close to this figure. However, there are patients who experience repeated failures in several oocyte-donation cycles, and so far oocyte-donation repeated implantation failure has not been clearly defined. This study analysed the results obtained

from 2531 oocyte-donation cycles carried out in 1990 patients and defines Citarinostat chemical structure oocyte-donation repeated implantation failure as failure to implant with more than two embryo transfers and more than four high-grade embryos transferred. This study observed this condition in 140 oocyte recipients (7%). Also, oocyte cohort size, uterine factors and systemic thrombophilias as important aetiological factors were identified were to offer new therapeutic strategies to patients. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“The hairless (Hr) gene encodes a transcriptional co-repressor highly expressed in the mammalian skin. In the mouse, several null and hypomorphic Hr alleles have been identified resulting in hairlessness in homozygous animals, characterized by alopecia developing after a single cycle of relatively normal hair growth. Mutations in the human ortholog have also been associated with congenital alopecia. Although a variety of hairless strains have been developed, outbred SKH1 mice are the most widely used in dermatologic research. These unpigmented and immunocompetent mice allow for ready manipulation of the skin, application of topical agents, and exposure to UVR, as well as easy visualization of the cutaneous response.

Conclusion. Caution should be exercised with rh-BMP-2 use in posterior cervical applications when a laminectomy has been performed. The safe and effective dose and technique for application have yet to be determined. Seroma formation is possible, which can cause acute stenosis with cord compression and neurologic compromise.”
“In view of the good skin tolerability, glycofurol was

used as a vehicle-based gel, and its effect in the topical penetration of Naproxen (NAP) was investigated. The aims of this study were to develop a suitable gel with bioadhesive property, spreadability, and viscosity for this website topical anti-inflammatory effect. Three gelling and adhesive agents were examined: Carbopol 974P, Gantrez AN 119, and polyvinylpyrollidone K30. Skin permeation rates and lag times of NAP were evaluated using the Franz-type diffusion cell in order to optimize the gel formulation. The permeation rate of NAP-based gel across the excised rat skin was investigated. A significant increase in permeability parameters such as steady-state flux (J(ss)), permeability coefficient (K(p)), and penetration index (PI) was observed in optimized click here formulation containing 2% Transcutol as an permeation enhancer. From skin irritation test, it was concluded that the optimized novel glycofurol-based gel formulation was

safe to be used for topical drug delivery. The developed glycofurol-based gel appeared promising for dermal and transdermal delivery of naproxen and could be applicable with water-insoluble drugs, which would circumvent most of the problems associated with drug therapy.”
“Study Design. Case reports.

Objective. A novel spinopelvic instrumentation system is introduced.

Summary of Background Data. Spinopelvic

stabilization is a problematic area of the spine. A mobile segment (spine) is fixed onto a stabile construction (pelvis). Another problem is the spinal anatomy because L5 vertebrae are affected by shear forces due to lomber lordosis so that stabilization needs extra power and 360 degrees fusion of L5-S1 level. Long instrumentation is preferred to decrease the stress on the screws and the rods. We designed iliac AS1842856 plates to support lumbopelvic instrumentation laterally. Four cases of spinopelvic pathology were treated in this way manner. The short-term results are good.

Methods. Four adult cases that had spinopelvic instability were treated with a novel spinopelvic instrument. All cases were evaluated with visual analog scale (VAS), Oswestry and radiologic studies pre- and postsurgery at 6 and 12 months.

Results. All the patients benefited from the stabilization. Preoperative mean VAS scores of all patients decreased from 7.75 to 1.75 and preoperative Oswestry disability index scores decreased from 83.50 to 24.50 at the 12 months postoperative evaluation.

Conclusion. In this study, we define four cases and report that iliac wings can be used to augment stabilization.

Here, we investigated the effect of Tamarindus indica pulp aqueous extract (TIE) in diet-induced obese selleck kinase inhibitor Sprague-Dawley rats. The animals were divided into five groups and labeled as follows: the normal control (NC)

group received normal diet; the positive control (PC) group received high-fat diet; and the TIE 5, 25, and 50 groups, after the induction of obesity via a high-fat diet, received TIE at 5, 25, or 50 mg/kg orally for 10 weeks. It was observed that TIE decreased the levels of plasma total cholesterol, low-density lipoprotein (LDL), and triglyceride, and increased high-density lipoprotein (HDL), with the concomitant reduction of body weight. Moreover, TIE decreased plasma leptin and reduced fatty acid synthase (FAS) activity and enhanced the efficiency of the antioxidant defense system. TIE exhibits antiobesity effects, as indicated by a significant reduction in adipose tissue weights, as well as lowering the degree of hepatic steatosis in the obesity-induced rats. The extract possesses hepatoprotective activity, as it reversed the plasma liver enzymes level elevation prior to the high-fat diet. In conclusion, TIE improved obesity-related

parameters in blood, liver, and adipose tissue in a rat model and suppressed obesity induced by a high-fat diet, possibly by regulating lipid metabolism and lowering plasma leptin and FAS levels. A dose-dependant effect of TIE is detected, where TIE at 50 mg/kg showed the most prominent effect, followed by TIE at 25 mg/kg and, subsequently, MK-4827 mw 5 mg/kg.”
“The mechanism to realize high luminous efficacy in a plasma display panel fabricated with a cathode see more material possessing a high secondary electron emission coefficient (gamma) for Ne and Xe ions was studied via three-dimensional numerical simulation. When a high gamma cathode material is used, the increased electron heating efficacy is responsible for increasing vacuum ultraviolet (VUV)

efficacy with 10% Xe content gas. However, the continued availability of sufficient secondary electrons during the dynamic moving phase of the cathode sheath in which the electric field remains weakened causes increasing VUV efficacy with 30% Xe content gas. It was found that the improvement of the luminous efficacy of the plasma display panel with a high gamma cathode material is maximized under the condition of high Xe content gas because of the simultaneous increase of the electron heating efficacy and Xe excitation efficacy. (C) 2011 American Institute of Physics. [doi:10.1063/1.3626455]“
“Purpose: This study aimed to verify the low complication rates (0% to 11%) previously reported in cranial reconstruction using hard-tissue replacement patient-matched implant (HTR-PMI).

Patients and Methods: A 3-year multidisciplinary experience involving 21 patients undergoing HTR-PMI reconstruction of large cranial defects was reviewed. Complications were defined as implant exposure, implant infection, or soft-tissue infection.

001).

Conclusions: Corrosion resistance of #25, #30, and #35 Mtwo files is significantly higher than that in RaCe files with similar sizes.”
“The aim of this study is to identify possible risks factors for the occurrence of cerebellar mutism syndrome (CMS) in children with posterior cranial fossa tumours. Children diagnosed with posterior fossa tumours consecutively admitted to our institution between 2006 and 2008 were the subjects of this prospective study. Besides standard neurological and radiological evaluations, all children underwent thorough neuropsychological assessments at admission and following surgery. Children under two or older

than 16 years of age and those with a severe pre-operative clinical condition precluding neuropsychological assessment were excluded. Thirty-four

children met the inclusion criteria. They were divided into two groups. Group selleck products Etomoxir ic50 I consisted of 23 children with normal language on admission and group II had 11 children showing pre-operative language impairment (PLI). PLI was observed in 11 children (32.4%: group II). Post-operatively, seven out of 34 children developed CMS (20.6%), all of them belonging to group II. In group II, indeed, the incidence of CMS was 63%. No case of CMS was observed in group I. PLI regressed after the operation in three out of the four subjects belonging to group II who did not develop CMS. PLI remained unchanged in the last child of this group. Posterior fossa tumour resection can have different effects on children with pre-existing language impairment (PLI). PLI can be considered a subclinical state of CMS in some children with posterior fossa tumour. However, in some children with PLI, the tumour resection may improve the linguistic abilities, as well as the other neurocognitive performances. In the present series, children with normal

pre-operative language function did not develop see more post-operative mutism.”
“Two new phragmalin-type limonoid orthoesters, C-15 enolic acyl type and 13/14/18-cyclopropanyl type, named chukvelutilide H (1) and tabularin R (2), together with three known limonoid orthoesters (3-5), were isolated from the stem barks of Chukrasia tabularis var. velutina. The structures of these two new compounds were elucidated on their extensive HR-ESI-MS, 1D, and 2D spectroscopic analysis including HSQC, HMBC, and ROESY experiments.”
“Phytochemicals investigation on rhizomes of Alpinia mutica has afforded five compounds namely 5,6-dehydrokawain (1), flavokawin B (2), pinostrobin (3) and pinocembrin (4) together with beta-sitosterol (5). All crude extracts of the plant demonstrated strong cytotoxicity against CEMss (human T4 lymphoblastoid) cancer cells with IC50 values less than 19 mu g/mL, while flavokawin B (2) was the most cytotoxic isolate with IC50 value 1.86 +/- 0.37 mu g/mL.

sE-selectin and VE-cadherin levels Wnt inhibitor were assessed in maternal plasma at three periods; before delivery, 3-6 days after delivery, and 12-14 weeks postpartum.

Results. Women with severe preeclampsia (SPE) and GP had significantly higher plasma sE-selectin levels as compared to controls in all three periods of sampling. In the GH group, sE-selectin levels did not differ from controls. During the study, even after 12 weeks postpartum, the plasma sE-selectin levels remained unchanged in all preeclamptic groups (PE, GH, and GP). There was no difference in VE-cadherin levels between women with preeclampsia (PE, GH, and GP) and normal pregnancies.

Conclusions. We found no changes in VE-cadherin levels in preeclamptic groups.

Increased antepartum and postpartum levels of sE-selectin in women with SPE and GP suggest that endothelial dysfunction may be one of the key processes in the pathogenesis of PE and the underlying mechanism, as well, that links PE with cardiovascular disease in later life. GP, also, appears to be BI-D1870 order a mild variant of PE.”
“The rationale of posterior musculofascial plate reconstruction during radical prostatectomy is to shorten the time to reach urinary continence recovery and to reduce the risk of bleeding and anastomosis leakage. We describe our original technique incorporating the posterior muscolofascial reconstruction into

urethrovesical anastomosis using robot-assisted radical prostatectomy (RARP). For this SNX-5422 purchase reconstructive step, we use a 30-cm V-Loc 90 3-0 barbed suture (V-20 tapered needle). Specifically, the free edge of the posterior layer of the Denonvilliers fascia is approximated to the posterior part of the sphincteric apparatus in a running fashion from left to right. The musculature of the urethral wall is incorporated in this first layer of the running suture. This suture is then continued back to the left in a second layer incorporating the anterior layer of the Denonvilliers fascia (or prostatovesical muscle), the bladder neck, and again the urethra, this time also with urethral mucosa. The urethrovesical

anastomosis is completed using a second running barbed suture (15-cm V-Loc 90 3-0 barbed suture, V-20 tapered needle). No intraoperative complications were observed during this step of the procedure. Anastomotic leakages were observed only in 2% of cases. Only 12.5% showed urinary incontinence after catheter removal (1-2 pads). At mean follow-up of 9 months, the urinary continence recovery was 95%, and an anastomosis stricture necessitating an endoscopic incision developed in only three (1.5%) patients. Recent systematic reviews of the literature showed only a minimal advantage in favor of posterior musculofascial reconstruction in terms of urinary continence recovery within 1 month after radical prostatectomy. We support the use of this step of RARP because it is simple, reproducible, with a very limited increase in operative time, and with only a slight risk of potential harm to the patient.