2012年8月26日 星期日


紐約時報 生物-醫藥等的進步可能可以讓人更長壽  可是並不是每人都想活到一百多歲
How Long Do You Want to Live?
Science may give us more time, but very few people want to live to 150.

2012年8月24日 星期五

全美生態大調查30年計畫 NEON, the National Ecological Observatory Network

Terrestrial ecology

NEON light

A 30-year plan to study America’s ecology is about to begin

THE phrase “Big Science” brings to mind rockets, telescopes and particle accelerators. When it comes to grand scientific gestures—and the cash that goes therewith—those who wield field glasses and butterfly nets in the name of terrestrial ecology seldom get a look in. Which is surprising, as the habitat they study, namely dry land, is the one actually occupied by humanity. But a group of American ecologists, led by David Schimel, intend to correct this state of affairs. They plan to shake up terrestrial ecology, and introduce it to the scale and sweep of Big Science, by establishing NEON, the National Ecological Observatory Network.
Finding the money for this project, which will be based in Boulder, Colorado, has not been easy, but after a decade of discussion and planning, America’s National Science Foundation managed to persuade Congress to earmark $434m, the price of a modest space probe, to set it up. The operating budget will be around $80m a year.
Dr Schimel’s team is thus now starting to wire up the landscape. Ground has already been broken at three sites—in Colorado, Florida and Massachusetts. Eventually, 60 places across the country will be covered simultaneously. Once this network is completed, in 2016 if all goes well, 15,000 sensors will be collecting more than 500 types of data, including temperature, precipitation, air pressure, wind speed and direction, humidity, sunshine, levels of air pollutants such as ozone, the amount of various nutrients in soils and streams, and the state of an area’s vegetation and microbes.
Crucially, these instruments will take the same measurements in the same way in every place. By gathering data in this standardised way, and doing so in many places and over long periods of time, Dr Schimel hopes to achieve the statistical power needed to turn ecology from a craft into an industrial-scale enterprise. The idea is to see how ecosystems respond to changes in climate and land use, and to the arrival of new species. That will let the team develop models which can forecast the future of an ecosystem and allow policymakers to assess the likely consequences of various courses of action.

Tower records
NEON’s researchers have divided America into 20 domains (see above), each of which is dominated by a particular type of ecosystem. Each domain will have three sets of sensors within it. One set will be based in a core site—a place where conditions are undisturbed and likely to remain so—that will be monitored for at least 30 years. The other two sets will move around, staying in one place for three to five years before being transplanted elsewhere. These “relocatable” sites will allow comparisons to be made within a domain.
Every site, whether core or relocatable, will have a sensor-laden tower that reaches ten metres above the existing vegetation. In an area of a few tens of square kilometres around this tower, the researchers will place further sensors in the soil and in local streams, to measure temperature, carbon-dioxide and nutrient levels, along with rates of root growth and the activities of microbes. These sensors will indicate how efficiently different ecosystems use nutrients and water, how vegetation responds to the climate, and how carbon dioxide moves between living things and the atmosphere. That will help those who seek to understand the carbon cycle—and with it, the consequences of greenhouse-gas-induced climate change.
To complement these ground-based measurements, which can focus on only a limited area, the team will conduct aerial surveys once a year at each core site, looking at things like leaf chemistry and the health of forest canopies, and will also look down on them with satellites. In addition, NEON’s researchers can deploy a specially equipped aeroplane, fitted with lidar (an optical version of radar), a spectrometer (to measure chemical compositions) and a high-resolution camera, to assess the impact of natural disasters such as floods, wildfires and outbreaks of pests.
This aerial-surveillance system will be put to the test in a project that started on August 21st, when a team led by Tom Kampe and Michael Lefsky began studying the causes and impact of what has come to be known as the High Park fire. Between June 9th and early July this fire burned across 36,000 hectares (90,000 acres) of Colorado. Dr Kampe and Dr Lefsky will fly NEON’s aeroplane over both the burned area and some adjacent unburned stands of forest. They will record plant species, forest structure, ash cover, soil properties, river sediment and the overall topography of the burned area.
One particular question they plan to address is whether the behaviour and severity of the High Park fire was affected by the spread of mountain pine beetle, a pest that is rapidly overrunning Colorado because its breeding season has been extended by the warming climate. Repeated aerial surveys over the coming years will also give the researchers insight into how vegetation recovers from fires, how the beetles affect this process, how erosion and sedimentation affect the region’s water resources, and whether fire creates opportunities for new species to invade.
So many data, of course, require a lot of number crunching. Indeed, it might be argued that what truly distinguishes Big Science from the small stuff—as astronomers and physicists have known for decades and biologists discovered in the aftermath of the Human Genome Project—is not the amount of money involved but the volume of data that needs to be processed. When fully operational NEON is expected to generate 200 terabytes a year. That is four times as much as the Hubble space telescope, a reasonably big piece of science, churned out in its first two decades.
NEON, then, truly does represent a shift by ecologists towards bigness. No doubt that will change the practice of the subject, just as astronomy, physics and genetics changed when they became big. The days of field glasses and butterfly nets may thus be numbered. But no one doubts that in those other cases, the change was for the better. The chances are, that will be true for ecology as well.

2012年8月20日 星期一

Liquidmetal, 金屬玻璃

“新一代iPhone的機殼好像要使用金屬玻璃”,2012年春季前後,這樣的傳聞在網上四處傳播。這Liquidmetal(由液態金屬兩屬字所複合) 與 Vitreloy 是一系列由加州理工學院研究團隊所開發出來的非晶態金屬合金的商業名稱,目前由該團隊所組織的液態金屬科技公司(Liquidmetal Technologies Inc.[1])進行行銷,並是公司的產品名稱與商標名稱。



「液態金屬」這種合金內含數種原子,這些原子的大小具有顯著差異,形成一種低自由空間的緊密混合物。 這一物質不像結晶物質那樣在明顯的熔點下由固態突然轉為液態,反而更像是玻璃:隨著溫度的升高,黏滯度會逐漸降低。 由於在較高溫時具有可塑性,因此在使用模具進行成型時,可以易於控制它的機構特性。 這一黏滯性也防止原子產生足夠的移動而構成有秩序的晶格[2],因此在加熱成型與冷卻之後,仍然能保持非結晶的狀態。


Liquidmetal 結合了多種在一般金屬中所沒有的特性,因此有廣泛的應用。
用 Liquidmetal 材料所製的 iPhone 3G SIM卡取卡工具
一個知名的用途是蘋果公司在美國所發售的iPhone 3G 中所附的 SIM 卡取卡工具是使用 liquidmetal 所製,被認為是該公司對這一金屬材料的使用可行性上的操練。[3]
一傳聞的依據是,該公司擁有的幾項機殼制造專利中都有金屬玻璃的相關描述,而且,該公司還與美國制造銷售金屬玻璃的廠商Liquidmetal Technology合作……

From Wikipedia, the free encyclopedia

Liquidmetal and Vitreloy are commercial names of a series of amorphous metal alloys developed by a California Institute of Technology (Caltech) research team and marketed by Liquidmetal Technologies. Liquidmetal alloys combine a number of desirable material features, including high tensile strength, excellent corrosion resistance, very high coefficient of restitution and excellent anti-wearing characteristics, while also being able to be heat-formed in processes similar to thermoplastics. Despite the name, they are not liquid at room temperature.[1]
Liquidmetal was introduced for commercial applications in 2003.[citation needed] It is used for, among other things, golf clubs, watches and covers of cell phones.
The alloy was the end result of a research program into amorphous metals carried out at Caltech. It was the first of a series of experimental alloys that could achieve an amorphous structure at relatively slow cooling rates.[citation needed] Amorphous metals had been made before, but only in small batches because cooling rates needed to be in the millions of degrees per second. For example, amorphous wires could be fabricated by splat cooling a stream of molten metal on a spinning disk. Because Vitreloy allowed such slow cooling rates, production of larger batch sizes was possible. More recently, a number of additional alloys have been added to the Liquidmetal portfolio. These alloys also retain their amorphous structure after repeated re-heating, allowing them to be used in a wide variety of traditional machining processes.



Liquidmetal alloys contain atoms of significantly different sizes. They form a dense mix with low free volume. Unlike crystalline metals, there is no obvious melting point at which viscosity drops suddenly. Vitreloy behaves more like other glasses, in that its viscosity drops gradually with increased temperature. At high temperature, it behaves in a plastic manner, allowing the mechanical properties to be controlled relatively easily during casting. The viscosity prevents the atoms moving enough to form an ordered lattice, so the material retains its amorphous properties even after being heat-formed.
The alloys have relatively low softening temperatures, allowing casting of complicated shapes without need of finishing. The material properties immediately after casting are much better than of conventional metals; usually, cast metals have worse properties than forged or wrought ones. The alloys are also malleable at low temperatures (400 °C/752 °F for the earliest formulation), and can be molded. The low free volume also results in low shrinkage during cooling. For all of these reasons, Liquidmetal can be formed into complex shapes using processes similar to thermoplastics,[2] which makes Liquidmetal a potential replacement for many applications where plastics would normally be used.
Due to their non-crystalline (amorphous) structures, Liquidmetals are harder than alloys of titanium or aluminum of similar composition. The zirconium and titanium based Liquidmetal alloys achieved yield strength of over 1723 MPa, nearly twice the strength of conventional crystalline titanium alloys (Ti6Al4V is ~830 MPa), and about the strength of high-strength steels and some highly engineered bulk composite materials (see tensile strength for a list of common materials). However, the early casting methods introduced microscopic flaws that were excellent sites for crack propagation, and led to Vitreloy being fragile, like glass. Although strong, these early batches could easily be shattered if struck. Newer casting methods, adjustment to the alloy mixtures and other changes have improved this.
The lack of grain boundaries may contribute to the high coefficient of restitution (close to 1) these alloys exhibit. In a demonstration, ball bearings dropped on plates of metal will bounce three times as long on Liquidmetal.[3]
The lack of grain boundaries in a metallic glass eliminates grain-boundary corrosion — a common problem in high-strength alloys produced by precipitation hardening and sensitized stainless steels. Liquidmetal alloys are therefore generally more corrosion resistant, both due to the mechanical structure as well as the elements used in its alloy. The combination of mechanical hardness, high elasticity and corrosion resistance makes Liquidmetal wear resistant.
Although at high temperatures, plastic deformation occurs easily, almost none occurs at room temperature before the onset of catastrophic failure. This limits the material's applicability in reliability-critical applications, as the impending failure is not evident. The material is also susceptible to metal fatigue with crack growth; a two-phase composite structure with amorphous matrix and a ductile dendritic crystalline-phase reinforcement, or a metal matrix composite reinforced with fibers of other material can reduce or eliminate this disadvantage.[4]


Liquidmetal combines a number of features that are normally not found in any one material. This makes them useful in a wide variety of applications.
One of the first commercial uses of Liquidmetal was in golf clubs made by the company, where the highly elastic metal was used in portions of the face of the club.[5] These were highly rated by users, but the product was later dropped, in part because the prototypes shattered after fewer than 40 hits.[6] Since then, Liquidmetal has appeared in other sports equipment, including the cores of golf balls, skis, baseball and softball bats, and tennis racquets.[7]
The ability to be cast and molded, combined with high wear resistance, has also led to Liquidmetal being used as a replacement for plastics in some applications.[citation needed] It has been used on the casing of late-model SanDisk "Cruzer Titanium" USB flash drives as well as their Sansa line of flash-based MP3 player, and casings of some mobile phones, like the luxury Vertu products, and other toughened consumer electronics.[citation needed] Liquidmetal has also notably been used for making the SIM ejector tool of some iPhone 3Gs made by Apple Inc., shipped in the US. This was done by Apple as an exercise to test the viability of usage of the metal.[8] They retain a scratch-free surface longer than competing materials, while still being made in complex shapes. The same qualities lend it to be used as protective coatings for industrial machinery, including petroleum drill pipes and power plant boiler tubes.[citation needed]
It is also considered as a replacement of titanium in applications ranging from medical instruments and cars to military and aerospace industry. In military applications, rods of amorphous metals are considered as a replacement of depleted uranium in kinetic energy penetrators.[9] Plates of Liquidmetal were used in the solar wind ion collector array in the Genesis space probe.[citation needed]
Although Liquidmetal has very high strength and an excellent strength to weight ratio, its commercial success as a structural material may be limited.[citation needed] Work continues on amorphous iron-based alloys that would combine at least some of the advantages of Liquidmetal with even greater strength, estimated to be two to three times the strength of the best steels made today. This would give such an alloy a strength to weight ratio that would easily beat the best lightweight materials such as aluminium or titanium, and be much less expensive than composite materials.[citation needed]

2012年8月19日 星期日

Von Hagens, 身體標本這行業先驅的說明大連關連...

我記得前幾年好像有一具身體標本送到台灣來展覽 似乎也有一番討論
據此面談訪問 似乎有許多人希望以此方式求其生後不朽的

Gunther von Hagens


Interview: 'We don't use bodies of executed Chinese'

Von Hagens, father of plastination and of the exhibition Body Worlds, has come under fire in China amid speculation the bodies were from executed people and he had ties to Bo Xilai. His son sets the record straight.
Rurik von Hagens is son of the creator of the plastination technique, Günther von Hagens, and commercial director of the Institute for Plastination in Heidelberg and CEO of the company Gubener Plastinate.

DW: In a report by Radio Free Asia on August 15 speaks about the discussion that is currently raging in China about allegations about connections between your father and the Chinese star politician Bo Xilai, who is currently embroiled in scandal.
Rurik von Hagens: I read it for the first time in an Epoch Times article … this is the first time I am hearing anything about the story - the first time I've heard my father's and Bo Xilai's names mentioned in the same sentence. It is like this, my father, back then, when he went to Dalian, he received a Dalian friendship medal. And he did actually receive that from Bo Xilai, who, at the time, was governor of Dalian.

I think the relations discussed in the media were more of business nature?
Aside from receiving the friendship award, either right before the award ceremony or right after, they met. But aside from that, we only knew Bo Xilai from the newspapers.

As far as I could tell, your father founded his plastination company in Dalian in 2001. Would it have been possible for him to do that without the blessing of the governor or from someone else high up?
Well, it was a normal establishment of a company - I think it was before 2001 even. He was at the university in Dalian. And there he founded and opened an institute for plastination. And then he opened his own company a few years later. It might have been 1999, but I'd have to look it up to be sure. Back then, we mostly had to do with people from the Dalian High Tech Zone. And as a foreigner, I can't really say anything about internal Chinese approval procedures. Aside from that, it is the kind of company of which there are many; we are not the only ones who do plastination.

Was it not important to have political connections back then?
Well, we were definitely welcome. That was my impression at least - especially from the High Tech Zone. And of course it is important to be welcome. But how high up that went, I really can't say because I don't know.
Well the Zone was under the jurisdiction of Governor Bo …
Well I don't know. I think you know that better than I do. All I know is, we were at the Dalian High Tech Industrial Zone, and that was organized by the state. And it is probable that the governor had the final say over it all.
Is the company still active?

A body used at a Body Worlds exhibition Body Worlds uses bodies from donors
No. It exists still. But only on paper. In 2006, there was a decree from Beijing that plastinates could no longer be imported or exported for commercial purposes. So since 2006, we have not prepared any human bodies. For around three years, up until around last year, we still worked with the bodies of animals. We had, for example, an elephant in our exhibition that was from Dalian … but now there are no longer any production facilities there.

In Tianya, a Chinese forum, I came across an alleged statement from your father's company. It is in English and it was about an exhibition in New York that was said to have had something to do with the Chinese police …
The one in New York is not ours. That one is called "Bodies" and it has nothing to do with Gunther von Hagens. My father created the plastination process. We were the first ones to do such an exhibition. And when it became so popular, there were a lot of others who copied us or put on similar exhibitions.

Since 2006, we no longer do any plastination in China. But there are still plastination laboratories there. But not ours. But there are enough other laboratories in China that do it and even export their models, even though it is not allowed …

Because my father created the process of plastination, other exhibitions are thus inspired by my father and people often confuse us with other similar exhibitions. But I would like to make it clear that we are in no way connected with the one in New York.
That's good because artists and activists in China are now demanding to know where the bodies used in the exhibitions are coming from.
We are the only ones who put on exhibitions and have our own body donation program. The headquarters is in Heidelberg. My father created the program at the University of Heidelberg sometime around the early 1980s. Later on, he took it over in his private institute. Today, we have 13,000 body donors. We receive about two to three bodies per week. They are all from people who wish their bodies to be plastinated explicitly for exhibitions.

Any Chinese?
In China we tried to establish a body donor program. There were some people who were interested. But we only ended up getting one actual donor.

People are talking on the internet about thousands of bodies possibly from people who were executed. So there's nothing to that?
No. But people misconstrue information sometimes when they don't quite understand. Let me explain. There are exhibitions that use "ownerless" bodies from China. Whatever that means. That is what the exhibition in New York use, or there is also one in Las Vegas and there are other ones that travel around the world. And in most cases, it is said that the bodies used there are "ownerless" bodies from China. But they have nothing to do with our exhibitions. The only bodies used in our exhibitions are ones that people donate while they are still alive. We have only ever used donated bodies … even when we prepare bodies for universities - the bodies used for that are also ones that have been donated to us.

Interview: Xiegong Fischer / sb
Editor: John Blau

2012年8月18日 星期六

洗手間工廠/ 慈濟研發急難救助淨水艇


去年泰國爆發嚴重水患,居民和救災軍人泡在水裡,缺乏乾淨飲用水,慈濟基金 會與工研院、水利署等單位合作,研發兩艘造價150萬元的「急難救助淨水艇」,可抽取河水、雨水等濁水,加以淨化、煮沸為飲用水,基金會表示:「證嚴法師 很重視,第一碗抽取濁水製成的香積飯,就是她先嚐過的。」




A Human-Waste Gold Mine: Bill Gates Looks to Reinvent the Toilet

This post is in partnership with Worldcrunch, a new global-news site that translates stories of note in foreign languages into English. The article below was originally published in Die Welt.
Bill Gates, the founder of Microsoft who has morphed into the world's best-known philanthropist, wants to reinvent the toilet.
This next big idea for the good of mankind will now also be getting help from German taxpayers after Development Minister Dirk Niebel earmarked $10 million for a joint project with the Bill & Melinda Gates Foundation. Over the next five years, this project aims to provide 800,000 people in Kenya with access to sanitation facilities and ensure clean drinking water for 200,000.
The goal is to find "innovative solutions" for sanitation in poor urban areas. Gates says it's time to move on from the era of the classic toilet. He points out that, despite all the recent achievements, 40% of the world's population, or some 2.5 billion people, still lives without proper means of flushing away excrement. But just giving them Western-style toilets isn't possible because of the world's limited water resources. (See pictures of the global reach of the Gates Foundation.)
The matter is urgent: the lack of sanitary installations and hygienic waste removal furthers the spread of disease. UNICEF estimates that 1.1 billion people worldwide don't have access to any kind of toilet or ways of eliminating waste. That, in turn, fouls drinking water and can cause diarrhea, which spreads quickly.
According to UNICEF, at least 1.2 million children under the age of 5 die of diarrhea every year; the main cause is contact with human feces. At the end of June, U.N. Secretary-General Ban Ki-moon — together with UNICEF — approved a five-year sustainable sanitation plan under which the number of people who have no access to toilets would be halved by 2015. (See the top 10 famous toilets.)
Ban emphasized that sanitary installations not only play a decisive role in reducing world poverty, but they are crucial for sustainable development and for making it possible to achieve Millennium Development Goals.
Dutch engineer Frank Rijsberman agrees. He heads the Water, Sanitation & Hygiene department at the Bill & Melinda Gates Foundation, and he is presently working on two projects. With one project, the foundation supports the construction of pit latrines in rural areas and slums without sanitation facilities. With the other, it supports research projects, giving grants to scientists who come up with new ideas for using human excrement. He says there have been experiments to turn excrement into a kind of microwave that can be used as a source of energy.
He says there are biological bacteria that could turn waste into compost; he talks about the possibility of toilets actually turning urine into drinking water. Human waste could be a real gold mine, Rijsberman jokes. In view of the world's limited water resources, both the Gates Foundation and German Development Policy support various projects for dry toilets that do not use water to flush and that separate excrement from urine in order to dry it.
Another method put forward by the Gates Foundation in South Africa is using the urine of 400,000 people to make nitrogenous fertilizer in powder form. A similar albeit high-tech variation is currently being tested by the Society for International Cooperation in Eschborn, Germany. Germany and the Gates Foundation's projects are complementary, says the German Ministry for Development. The importance of this research is not always easy to explain, says Rijsberman, because anything having to do with human waste provokes a "yuck factor." (See pictures of Bill Gates in his younger years.)
Furthermore, hundreds of thousands of those concerned are far from convinced that it's a good idea to use toilets in the first place. "We have a lot of work ahead us," says Rijsberman, who knows he can count on his boss's full support.
And the billionaire himself seizes every opportunity to lobby for the end of the traditional Western toilet. In April, Gates met with German Chancellor Angela Merkel and President Christian Wulff in Berlin. In a press conference he told journalists that they didn't talk politics, but discussed the idea of the "ultimate toilet."

2012年8月15日 星期三

IBM claims spintronics memory breakthrough

Researchers still face significant hurdles before a memory product can be manufactured

August 12, 2012 01:58 PM ET
Computerworld - In a paper set to be published this week in the scientific journal Nature, IBM researchers are claiming a huge breakthrough in spintronics, a technology that could significantly boost capacity and lower power use of memory and storage devices.
Spintronics, short for "spin transport electronics," uses the natural spin of electrons within a magnetic field in combination with a read/write head to lay down and read back bits of data on semiconductor material.
By changing an electron's axis in an up or down orientation - all relative to the space in which it exists -- physicists are able to have it represent bits of data. For example, an electron on an upward axis is a one; and an electron on a downward axis is a zero.
Spintronics has long faced an intrinsic problem because electrons have only held an "up or down" orientation for 100 picoseconds. A picosecond is one trillionth of a second (one thousandth of a nanosecond). One hundred picoseconds is not enough time for a compute cycle, so transistors cannot complete a compute function and data storage is not persistent.
In the study published in Nature, IBM Research and the Solid State Physics Laboratory at ETH Zurich announced they had found a way to synchronize electrons, which could extend their spin lifetime by 30 times to 1.1 nanoseconds, the time it takes for a 1 GHz processor to cycle.
The IBM scientists used ultra short laser pulses to monitor the evolution of thousands of electron spins that were created simultaneously in a very small spot, said Gian Salis, co-author of the Nature paper and a scientist in the Physics of Nanoscale Systems research group at IBM Research.
Usually, such spins find electrons randomly rotating and quickly losing their orientation. In this study, IBM and ETH researchers found, for the first time, how to arrange the spins neatly into a regular stripe-like pattern -- the so-called persistent spin helix.
The concept of locking the spin rotation was originally proposed as a theory back in 2003, Salis said. Since then, some experiments found indications of such locking, but the process had never been directly observed until now, he added.
"These rotations of direction of spin were completely uncorrelated," Salis said. "Now we can synchronize this rotation, so they don't lose their spin but also rotate like a dance, all in one direction."
"We've shown we completely understand what's going on there, and we've proven that the theory works," he added.
Helical spin modes and the persistent spin helix (PSH). a, The spins of the two helical spin modes É+ and É- rotate with opposite helicity as the electron moves along y. The Sz(y) of the two modes is the same. b, Spins precess about an external magnetic field Bx such that the É+ mode is shifted towards -y if Bx < 0 is applied. c, d, Maps of Sz(y,t) show the time evolution of the PSH for Bx = 0 (c) and Bx = -1T (d). Sz(y) oscillates in both cases, but for Bx = -1T, the position of constant phase, y0, is shifted with t (marked by the dashed line). Source: Nature Physics/IBM Research Zurich

2012年8月13日 星期一

Digital Olympics



  • 8 August 2012
  • 1 May 2012
    • Entertainment & Arts / 1 May 2012The plays of Shakespeare, a hip-hop festival and a new artwork by Rachel Whiteread are among the offerings from a new on-demand digital arts service.
  • 22 February 2012
  • 11 January 2012

2012年8月2日 星期四


《奇美引進 南部跑第一》達文西「手」護 內視鏡手術再進化

3D立體影像 可深入患部


 此書我立讀'CHAPTER 2 腹腔鏡子宮肌瘤切除手術的學習曲線………童寶玲.黃景祥'…對於作者界定的"學習曲線"和" 多重回歸等手法都不甚了了或不以為然



推薦序一 楊泮池(臺大醫學院院長)…………………………………………  iv
推薦序二 陳明豐(臺大醫院院長)……………………………………………  vi
推薦序三 楊友仕(臺大醫學院婦產科教授)…………………………………viii
推薦序四 陳祈安(臺大醫院婦產部主任)……………………………………  x
推薦序五 趙有誠(佛教慈濟綜合醫院臺北分院院長)……………………… xii
前言與導讀 許博欽(臺大醫學院教授 暨 臺大醫院婦產部婦科主任)…………xiii
CHAPTER 1微創子宮肌瘤切除術的新趨勢………………………………許博欽…001
CHAPTER 2腹腔鏡子宮肌瘤切除手術的學習曲線………童寶玲.黃景祥…017
CHAPTER 3手術器械介紹……………………………………………黃佩慎…033
CHAPTER 4腹腔鏡子宮肌瘤切除技巧………………………………黃思誠…059
CHAPTER 5術前評估…………………………………………………張文君…075
CHAPTER 6術中照料與術後照料……………………………………黃佩慎…093
CHAPTER 7長期術後評估及結果……………………………………張文君…115
CHAPTER 8子宮頸肌瘤腹腔鏡切除術……………………………………張文君…135
CHAPTER 9腹腔鏡子宮肌瘤摘除手術:漿膜下肌瘤和壁內肌瘤…………張道遠…155
CHAPTER 10腹腔鏡韌帶內肌瘤切除術………………………許博欽.黃佩慎…191
CHAPTER 11腹腔鏡黏膜下肌瘤和漿膜下肌瘤切除術……………………周麗雲…223
CHAPTER 12子宮鏡肌瘤切除術………………………………楊政憲.楊友仕…241
CHAPTER 13單一切口腹腔鏡子宮肌瘤切除手術…………………………陳思宇…265
CHAPTER 14單一切口腹腔鏡手術的相關器械介紹………………………陳思宇…273

楊泮池教授(國立臺灣大學醫學院 院長)
   黃思誠教授於臺大醫學院服務逾 30 年,於教學、研究、服務均盡心盡力,多年來更帶領臺大醫院婦產部微創團隊,積極吸收國外醫療新知,經團隊間彼此切磋討論、追蹤臨床案例,累積許多寶貴經 驗,更研發出新的醫療技術,發表多篇婦產科與微創外科學門重要的醫學研究論文,屢獲國際肯定。不僅研究成果有目共睹,其研究與服務精神更為可佩。
   臺大醫院婦產部微創團隊於黃思誠教授與許博欽教授積極投入下,於婦女子宮肌瘤之微創手術技術突破與研發多年有成。繼 2009 年率先於臺大出版中心出版《婦科腹腔鏡手術精要》後,再次透過出版,無私地分享團隊寶貴的微創肌瘤切除手術臨床經驗,不僅代表著專業醫學書籍回歸大學出版 社的學術出版與教育精神,更彰顯了醫師以服務患者為職志、藉經驗傳承,進而造福更多患者的無私精神。個人欣見此寶貴醫療研究成果發表與出版,謹向黃教授與 臺大醫院婦產部微創團隊、臺大出版中心致敬與致賀。
陳明豐教授(國立臺灣大學醫學院附設醫院 院長)
  臺大醫院於 1895 年創院迄今百餘年,對於臺灣的醫療發展,凡診療技術、教學研究、教育制度與創新研發等,均有諸多輝煌成果與貢獻。此乃源於醫者秉持著對醫學志業傳承的理想、使命與堅持,亦彰顯出醫界經驗傳承、服務人群的美好精神。
   臺大醫院婦產部微創團隊在黃思誠教授與許博欽教授的積極投入下,多年來於腹腔鏡子宮肌瘤微創手術之技術日益精進:由初採用時需限制肌瘤大小與數目的生 澀,隨著臨床經驗累積、技術日益成熟,迄今團隊已能運用各種先進技巧組合,克服更大挑戰。當團隊技術純熟後,更採取新技術並加以改進成更好的手術方法,此 不僅增加手術所可取下的肌瘤數目、大小,更縮短手術所需時間;而其突破腹腔鏡子宮肌瘤切除術所遭遇的瓶頸,更造福患者,也為臺灣婦科醫療史創造新的里程 碑。
  臺大醫院婦產部微創團隊除累積豐富的臨床經驗、長期追蹤案例,經研究、謹慎分析後,發表多篇婦產科與微創外科領域極具影響力的國際 論文,更於百忙中針對微創肌瘤切除的精要技術撰寫成書,無私地提出經驗分享,實為難能可貴,是醫界與患者之福,也彰顯臺大醫院的醫者精神至極致。
   臺大醫院婦產部黃思誠教授今年年滿 65 歲屆齡退休。由於黃教授退休後將前往新店慈濟醫院幫忙,拓展他醫療生涯的另一個志業;本部微創手術團隊為了感謝黃教授過去對於團隊成員的教導及提攜,特別 發起出版《內視鏡肌瘤切除術》一書,以作為黃教授告別臺大婦產部的完美句點。
  子宮肌瘤是婦科最常見的良性腫瘤,雖然發生率高,但是大都 無礙。少數肌瘤由於生長的位置、大小或速度,在臨床上可能會造成經痛、經血過多、不孕、流產或壓迫等症狀,而需要予以手術切除。記得二十年前,肌瘤的切除 幾乎均要開腹進行,術後至少要休息一周左右。1990 年代由於子宮鏡器械的改良,生長於子宮腔內的黏膜下的肌瘤,開始有人嘗試利用子宮鏡來進行切除。隨著技術的成熟,子宮鏡肌瘤切除術已逐漸成為黏膜下肌瘤切 除的標準手術流程。
  2000 年起,由於腹腔鏡手術的廣泛應用,也開始有人嘗試利用腹腔鏡來進行肌瘤切除。早期為腹腔鏡子宮肌瘤切除時,若遇到病人要保留生育能力,則常面臨將來子宮傷 口癒合與受孕的問題。記得本部剛開始作此一手術時,病人在術中常需接受輸血及術後放置腹部引流管的處置。後來手術團隊發現肌瘤切除前先將兩側的子宮動脈結 紮,則可大大的減少手術中的出血量。而後續的研究也發現兩側動脈的結紮並不會影響將來子宮的血流量,也不會增加術後懷孕子宮破裂的風險,實為腹腔鏡肌瘤切 除技術之突破。
   臺大醫院自 1895 年創建以來,即盡力提供民眾最佳服務,肩負國家級教學醫院教學、研究、服務三大任務,所有醫護人員均以此為使命與願景,兢兢業業於工作崗位上。秉持服務的 熱忱,臺大醫院醫療團隊的臨床醫療品質、技術精進有目共睹,而這一切努力均為了提供給民眾更好的服務。臺大醫院婦女微創團隊於子宮肌瘤切除手術上的臨床經 驗與服務,則以行動實踐了此宗旨。
   為尋求達成最小傷口、減低患者術後疼痛感、術後恢復迅速、預後效果更佳之治療方式,臺大醫院婦女微創團隊於黃思誠教授與許博欽教授共同努力下,精益求 精,研究更好的子宮肌瘤微創手術與縫合技術,多年來的成果有目共睹。團隊於教學與研究之餘,更致力於微創手術經驗的傳承與分享,努力將臨床上累積的珍貴經 驗以專書紀錄下來,與更多醫療人員分享,期藉成熟的技術推廣以服務更多民眾。
  《內視鏡肌瘤切除術》一書即為婦女微創手術團隊多年來的努 力成果之一,書中詳述各類型肌瘤症狀、微創手術方式與手術時、術後應注意事項。除無私地分享經驗外,書中所有手術個案均為醫學中心臨床個案資料,許多技術 突破與豐富的臨床手術照片,既輔助讀者研讀與瞭解,也是極珍貴的教材,更是臺大醫院身為教學醫院已臻教學、研究、服務三大任務之典範。藉由本專書的出版, 本院在傳統手術與微創手術方面,長期累積的人才以及手術經驗傳承,將開創下一世紀婦科手術治療的新契機。
趙有誠教授(佛教慈濟綜合醫院臺北分院 院長)
   微創婦科手術在黃思誠及許博欽教授多年的努力之下,造福臺灣婦女,不但減少住院日數,亦讓術後疼痛及疤痕減少,功德無量。為了傳承經驗,兩位教授特別精 心將國內外,對內視鏡子宮肌瘤治療之最新進展,匯集成書,深入淺出詳細介紹手術時,需注意的細節以及過去臺大醫院病患的追蹤研究成果,分享多年累積珍貴的 經驗,供醫界專家,後學及病友參考,真是無私奉獻,特以此拙文表達感恩與祝福。
許博欽教授(國立臺灣大學醫學院教授 暨 臺大醫院婦產部婦科主任)
  每一次和黃思誠教授以及臺大醫院婦產部微創腹腔鏡手術團隊成員到日本開會,總是有新的收穫。微創內視鏡子宮肌瘤切除手術的專書構想,也是在日本開會時,大家一起許下的願景,經過多年耕耘,這個願景在今年 (2011) 黃教授榮退時實現,別具意義。
   臺大微創手術團隊,在發展腹腔鏡子宮肌瘤切除手術方面,經過不斷的討論、摸索、突破與創新的過程,終於可以把臨床經驗系統化、知識化並集結成書。繼《婦 科腹腔鏡手術精要》後,經過將近兩年的時間籌劃準備與催稿、撰寫,這一本《內視鏡子宮肌瘤切除術》的專書,終於到了文章付梓的階段。
  本 書總共有十四個章節,在第一與第二章〈微創子宮肌瘤切除術的新趨勢〉與〈腹腔鏡子宮肌瘤切除手術的學習曲線〉中,讀者可以瞭解整體腹腔鏡肌瘤切除手術的發 展過程,對於未來可能的新技術發展,與現階段新術式的學習曲線,也會有更深一層的認識;第三至七章進入〈手術器械介紹〉、〈腹腔鏡子宮肌瘤切除技巧〉、 〈術前評估〉、〈術中照料與術後照料〉與〈長期術後評估及結果〉,都是學習腹腔鏡手術與評估照料病人應具備的基本知識;第八至十一章的內容,主要介紹不同 部位子宮肌瘤微創切除手術方式,包括〈子宮頸肌瘤腹腔鏡切除術〉、〈腹腔鏡子宮肌瘤摘除手術  漿膜下肌瘤和壁內肌瘤〉、〈腹腔鏡韌帶內肌瘤切除術〉與 〈腹腔鏡黏膜下肌瘤和漿膜下肌瘤切除術〉,這部分正式進入腹腔鏡手術對於特殊部位肌瘤的臨床運用;經由傳統腹腔鏡手術技術的經驗累積與精進、深入探討特殊 部位肌瘤切除術的瓶頸技術;對於如何減少手術出血的「子宮動脈結紮術」與可迅速縮短手術時間的「子宮肌瘤原位研磨摘除術」等,都是學習腹腔鏡手術最重要的 操作基礎;而第十二章〈子宮鏡肌瘤切除術〉則是以更宏觀的角度來介紹內視鏡黏膜下肌瘤切除技術的精進經驗與整體發展;第十三、十四章主要介紹〈單一切口腹 腔鏡子宮肌瘤切除手術〉、〈單一切口腹腔鏡手術的相關器械介紹〉,這部分是全新的領域,包括相當多臺大團隊的技術突破與創新。