A comparison of surgical devices for grade II and III hemorrhoidal disease. Results from the LigaLongo Trial comparing transanal Doppler-guided hemorrhoidal artery ligation with mucopexy and circular stapled hemorrhoidopexy

PURPOSE: Little is presently known on the impact of device type for Doppler-guided hemorrhoidal artery ligation/mucopexy (DGHAL) or circular stapled hemorrhoidopexy (CSH) when a surgical treatment is considered for hemorrhoidal disease (HD). In this study, we aimed to compare the outcome in terms of adverse events and recurrence rate, of patients included in the multicenter LigaLongo RCT ( ClinicalTrials.gov NCT01240772) according to the type of devices used. METHODS: In the DGHAL arm (N = 193), the procedure was done with transanal hemorrhoidal dearterialization (THD)™ (THD, Correggio, Italy) (104 patients) and with HAL-RAR™ (Agency for Medical Innovations (AMI) GmbH, Feldkirch, Austria) (89 patients). In the CSH arm (N = 184), procedure for prolapse and hemorrhoids (PPH)-03™ (Ethicon Endo-Surgery, Cincinnati OH) and hemorrhoidopexy and prolapse (HEM)™ (Covidien, Inc.) staplers were used in respectively 106 and 78 cases. Surgery-related morbidity at 90 postoperative days (POD) based on the Clavien-Dindo procedure-related complication score and clinical outcome in terms of recurrence and reoperation rate at 12 postoperative months (POM) was collected. RESULTS: Three hundred and seventy-seven patients were randomized according to HD grade. In the DGHAL arm, the number of ligations and mucopexies was higher in the AMI group (p < 0.0001); at 90 POD, the overall morbidity was similar between the two groups. In the CSH arm, donut sizes were similar; at 90 POD, the PPH group had a higher risk of postoperative grade 1 morbidity (anal urgency or incontinence) compared to the HEM group (p = 0.003). At 12 POM, no statistical difference was found between the two groups of each arm in terms of grade III recurrence or reoperation. CONCLUSION: Postoperative morbidity and outcome at 1 year were similar regardless of the type of devices used. These findings suggest that device type has little impact on HD treatment results. TRIAL REGISTRATION: clinicaltrials.gov -Identifier NCT01240772

Transplantation tolerance: lessons from experimental rodent models

Immunological tolerance or functional unresponsiveness to a transplant is arguably the only approach that is likely to provide long-term graft survival without the problems associated with life-long global immunosuppression. Over the past 50 years, rodent models have become an invaluable tool for elucidating the mechanisms of tolerance to alloantigens. Importantly, rodent models can be adapted to ensure that they reflect more accurately the immune status of human transplant recipients. More recently, the development of genetically modified mice has enabled specific insights into the cellular and molecular mechanisms that play a key role in both the induction and maintenance of tolerance to be obtained and more complex questions to be addressed. This review highlights strategies designed to induce alloantigen specific immunological unresponsiveness leading to transplantation tolerance that have been developed through the use of experimental models

Metals impact into the Paranaguá Estuarine Complex (Brazil) during the exceptional flood of 2011

Abstract Particulate and dissolved metal concentrations were determined after the largest flood in the last 30 years on the east-west axis of the Paranaguá Estuarine Complex (PEC) and compared to the those of the dry period at two stations. Results confirmed that the flood greatly affected riverine outflows and the behavior of metals in the PEC. In particular, a sharp decrease in salinity was followed by extremely high SPM concentrations leading to a decrease in DO concentrations at both stations. For the dissolved phase, ANOSIM analysis showed a significant dissimilarity at each station between the sampled periods, whereas for the particulate phase this dissimilarity was found only for the samplings taken at the Antonina Station. KD values suggested dissolved Cu behavior was related to the presence of organic complexes and dissolved Mn had sediment resuspension of redox sediments and or/pore water injection as sources. Metal concentrations were lower than in polluted estuaries, though high enrichment factors found after the flood pointed to the influence of anthropogenic sources. In conclusion, the flood's influence was more evident at the Antonina Station, due to its location in the upper estuary, whereas in Paranaguá a high SPM content with low metal concentration was found, following the common pattern generally found in other marine systems subject to heavy rainfall events

Valorisation de la Revue Française d'Histotechnologie. La Revue Française d'Histotechnologie: Etat de l'art, visibilité et améliorations présente et future de cette visibilité

International audienceNowadays scientific publishing knows a change in depth and on that occasion, we make a point on our journal, the Revue Française d’histotechnologie, of which the main goal is sharing histo-technological data and knowledge among the francophone community of experts in the field. We present here the existing of the journal as well as the original ways to make it evolving, notably in order to gain visibility. We started many procedures described in this special article and that should contribute to mark a turning point in the history of our journal. The attractiveness and visibility of the Revue Française d’histotechnologie should be improved.Dans un contexte de changement profond de l’édition scientifique, nous faisons ici un point sur notre Revue, vecteur original de partage de données et de connaissances histotechnologiques entre experts issus de la communauté francophone, à la fois sur l’existant mais aussi sur les moyens pour la rendre plus visible. Nous avons entamé de nombreuses démarches qui sont présentées dans cet article spécial et qui devraient contribuer à marquer un tournant dans l’histoire de notre Revue. L’attractivité et la visibilité de notre Revue devraient s’en trouver grandies

Valorisation de la Revue Française d'Histotechnologie. La Revue Française d'Histotechnologie: Etat de l'art, visibilité et améliorations présente et future de cette visibilité

International audienceNowadays scientific publishing knows a change in depth and on that occasion, we make a point on our journal, the Revue Française d’histotechnologie, of which the main goal is sharing histo-technological data and knowledge among the francophone community of experts in the field. We present here the existing of the journal as well as the original ways to make it evolving, notably in order to gain visibility. We started many procedures described in this special article and that should contribute to mark a turning point in the history of our journal. The attractiveness and visibility of the Revue Française d’histotechnologie should be improved.Dans un contexte de changement profond de l’édition scientifique, nous faisons ici un point sur notre Revue, vecteur original de partage de données et de connaissances histotechnologiques entre experts issus de la communauté francophone, à la fois sur l’existant mais aussi sur les moyens pour la rendre plus visible. Nous avons entamé de nombreuses démarches qui sont présentées dans cet article spécial et qui devraient contribuer à marquer un tournant dans l’histoire de notre Revue. L’attractivité et la visibilité de notre Revue devraient s’en trouver grandies

Reflection of structural waves at a solid/liquid interface

This paper investigates the reflection characteristics of structural or guided waves in rods at a solid/liquid interface. Structural waves, whose wavelengths are much larger than the diameter of the rod, are described in a first approximation by classical one-dimensional wave theory. The reflection characteristics of such waves at a solid/liquid (melting) interface has been reported by two different ultrasonic measurement techniques: first, measuring the fast regression rate of a melting interface during the burning of metal rod samples in an oxygen-enriched environment, and second, monitoring the propagation of the solid/liquid interface during the slow melting and solidification of a rod sample in a furnace. The second work clearly shows that the major reflection occurs from the solid/liquid interface and not the liquid/gas interface as predicted by plane longitudinal wave reflectivity theory. The present work confirms this observation by reporting on the results of some specially designed experiments to identify the main interface of reflection for structural waves in rods. Hence, it helps in explaining the fundamental discrepancy between the reflection characteristics at a solid/liquid interface between low frequency structural waves and high frequency bulk waves, and confirms that the detected echo within a burning metallic rod clearly represents a reflection from the solid/liquid interface. (C) 2003 Elsevier Science B.V. All rights reserved

L’argent (Ag, Nanoag) comme contaminant émergent dans l’estuaire de la Gironde : Evaluations scientifiques et gouvernance des risques

Cet article présente les résultats d'une recherche pluridisciplinaire (géochimie, sociologie) portant sur l'accroissement observé des concentrations d'argent sous la forme particulaire et nanoparticulaire (Ag et nanoAg) dans les milieux aquatiques de l'estuaire de la Gironde. Il propose conjointement d'analyser les risques d'une contamination des milieux aquatiques par l'argent et d'observer le processus de construction sociale et politique de ce risque par les gestionnaires de l'eau, les autorités sanitaires, les agences et comités d'expertise et d'évaluation des risques, des associations environnementales et des industriels utilisateurs d'argent. La mise à jour de quatre types de construction du risque permet de comprendre les différentes logiques d'argumentation mobilisées. Cette coopération scientifique pluridisciplinaire ouvre des perspectives sur les problématiques santé-environnement en diffusant des savoirs pour l'action et en favorisant la réflexivité des acteurs locaux confrontés au problème émergent de la concentration de l'argent dans les milieux aquatiques. / This article presents the results of multidisciplinary research (geochemistry, sociology) into the increasing concentrations of silver (Ag and nanoAg) in the environment and their potential impact on aquatic environments. We investigate simultaneously the risk of contamination of these environments by silver and the process of the social and political construction of this risk by water managers, health authorities, agencies and committees responsible for expert evaluations, environmental associations, and potential users of silver or nano-silver. Four updated models of risk construction allow us to understand the logic of arguments mobilized at this stage of the emerging risk. This interdisciplinary cooperation opens up possibilities for dealing with some environmental health issues; it highlights the benefits of an approach aiming to disseminate knowledge to enable action and to promote awareness and analysis by the local stakeholders and officials who face this emerging problem