Chirurgie hépatique mineure par laparoscopie en ambulatoire : étude rétrospective observationnelle

RésuméAu cours de la dernière décennie, la chirurgie hépatique laparoscopique (CHL) a connu un essor dans le monde entier. Parallèlement, la chirurgie ambulatoire a été développée afin d’améliorer le confort des patients et de réduire les dépenses de santé. L’objectif de cette étude est de rapporter notre expérience préliminaire de la CHL en ambulatoire. Entre 1999 et 2014, 172 patients ont été opérés dans notre institution d’une CHL, incluant 151 résections hépatiques et 21 fenestrations de kystes hépatiques. Tous les patients consécutifs, hautement sélectionnés, opérés d’une CHL en ambulatoire ont été inclus. Vingt patients ont été opérés d’une CHL en ambulatoire. Les indications étaient des kystes hépatiques dans 10 cas, un angiome hépatique dans 3 cas, une hyperplasie nodulaire focale dans 3 cas, et une métastase hépatique de cancer colorectal dans 4 cas. La durée opératoire médiane était de 92minutes (dispersion : 50–240minutes). La perte sanguine médiane était de 35mL (dispersion : 20–150mL). Il n’a pas été observé de complication ni de réhospitalisation. Tous les patients étaient hospitalisés en postopératoire dans notre unité de chirurgie ambulatoire, et ont pu quitter l’établissement 5 à 7heures après la fin de la chirurgie. Le score médian de douleur postopératoire à la sortie était de 3 (échelle visuelle analogique à 10 niveaux ; dispersion : 0–4). Le score médian de qualité de vie à la première consultation postopératoire était de 8 (dispersion : 6–10), et le score médian de satisfaction esthétique était de 8 (dispersion : 7–10). Cette série montre que la CHL ambulatoire est faisable et sûre et chez des patients sélectionnés pour des interventions mineures.SummaryOver the last decade, laparoscopic hepatic surgery (LHS) has been increasingly performed throughout the world. Meanwhile, ambulatory surgery has been developed and implemented with the aims of improving patient satisfaction and reducing health care costs. The objective of this study was to report our preliminary experience with ambulatory minimally-invasive LHS. Between 1999 and 2014, 172 patients underwent LHS at our institution, including 151 liver resections and 21 fenestrations of hepatic cysts. The consecutive series of highly selected patients who underwent ambulatory LHS were included in this study. Twenty patients underwent ambulatory LHS. The indications were liver cysts in 10 cases, liver angioma in 3 cases, focal nodular hyperplasia in 3 cases, and colorectal hepatic metastasis in 4 cases. The median operative time was 92minutes (range: 50–240minutes). The median blood loss was 35mL (range: 20–150mL). There were no postoperative complications or re-hospitalizations. All patients were hospitalized after surgery in our ambulatory surgery unit, and were discharged 5–7hours after surgery. The median postoperative pain score at the time of discharge was 3 (visual analogue scale 0–10; range: 0–4). The median quality-of-life score at the first postoperative visit was 8 (range: 6–10) and the median cosmetic satisfaction score was 8 (range: 7–10). This series shows that, in selected patients, ambulatory LHS is feasible and safe for minor hepatic procedures

Al_5+αSi_5+δN₁₂, a new Nitride compound

The family of III-Nitride semiconductors has been under intensive research for almost 30 years and has revolutionized lighting applications at the dawn of the 21st century. However, besides the developments and applications achieved, nitride alloys continue to fuel the quest for novel materials and applications. We report on the synthesis of a new nitride-based compound by using annealing of AlN heteroepitaxial layers under a Si-atmosphere at temperatures between 1350 °C and 1550 °C. The structure and stoichiometry of this compound are investigated by high resolution transmission electron microscopy (TEM) techniques and energy dispersive X-Ray (EDX) spectroscopy. Results are supported by density functional theory (DFT) calculations. The identified structure is a derivative of the parent wurtzite AlN crystal where the anion sublattice is fully occupied by N atoms and the cation sublattice is the stacking of 2 different planes along lt;0001gt;: The first one exhibits a ×3 periodicity along lt;11–20gt; with 1/3 of the sites being vacant. The rest of the sites in the cation sublattice are occupied by an equal number of Si and Al atoms. Assuming a semiconducting alloy, a range of stoichiometries is proposed, Al5+αSi5+δN12 with α being between −2/3 and 1/4 and δ between 0 and 3/4. © 2019, The Author(s)

Regulation of ABCA1 expression and cholesterol efflux during adipose differentiation of 3T3-L1 cells.

Adipose cells specialized in energy storage, contain large intracellular triglyceride-rich lipid droplets, are enriched with free cholesterol, and express sterol-regulated transcription factors such as liver X receptor (LXR). The recent identification of the LXR-dependent ATP binding cassette transporter A1 (ABCA1) pathway for cholesterol release from peripheral cells has led us to address the question of the expression and function of ABCA1 in adipocytes. In 3T3-L1 adipose cells, we observed a strong induction of ABCA1 mRNA during adipose differentiation, but only limited variations in ABCA1 protein. Lipid efflux onto apolipoprotein A-I (apoA-I), which depends on ABCA1, was comparable in adipocytes and preadipocytes, demonstrating a differential regulation of ABCA1 mRNA and cholesterol efflux. We also found that total cell cholesterol remained stable during differentiation of 3T3-L1 cells, but membrane cholesterol was lower in adipocytes than in preadipocytes, suggesting redistribution of cholesterol to the lipid droplet. Finally, we show that under standard lipolytic stimulation, 3T3-L1 adipocytes do not release cholesterol onto apoA-I, a process that required long exposures to lipolytic agents (24 h). In conclusion, despite large induction of ABCA1 mRNA during differentiation, cholesterol efflux through the ABCA1 pathway remains limited in adipocytes and requires prolonged lipolysis. This is consistent with the view of the adipocyte behaving as a cholesterol sink, with plasma cholesterol-buffering properties

Industry Stakeholder Recommendations for DOE's RD&D for Increasing Energy Efficiency in Existing Homes

This technical report documents feedback for Industry Stakeholders on the direction of future U.S. Department of Energy (DOE) research and development in the area of improving energy efficiency in existing residential buildings

Geographic variation in Juniperus drupacea: DNA sequencing and volatile leaf oils: Further evidence of putative Pleistocene genetic isolation between Europe and Asia

Recently, Sobierajska et al. (2016), using nSSR and morphology, showed that Juniperus drupacea exhibited differentiation between Greece and Turkey/ Lebanon, suggestive of Pleistocene genetic isolation. Here, we report that leaf terpenoids and DNA sequence data support their hypothesis by confirming differentiation between Greece and Turkey/ Lebanon/ Israel. The leaf oils of the Turkey/ Lebanon plants contained one unique terpene (trans-verbenol, 0.1-1.4%) that was absent in the Greece plants. The Greece oil contained three terpenes not found in the Lebanon/ Turkey plants: (ar)-curcumene (2.2%), β-alaskene (0.3%) and α-alaskene (0.4%). Four other terpenes were in higher concentration in the Greece oils: camphene (0.4%), δ-3-carene (10.9%), p-mentha-1,5-dien-8-ol, isomer (0.3%) and 4-terpineol (0.3%). Three terpenes were higher in Turkey and Lebanon oils: α-pinene (10.5 - 32.9%), hexadecanoic acid (0.4 - 1.4%) and trans-totarol (0.3 - 1.2%). Only one SNP was found (in nrDNA) that separated Greece from Turkey-Lebanon-Israel. No informative SNPs were found in petN-psbM, trnS-trnG, trnD-trnT or trnL-trnF cp regions

Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As one of HPwES's local sponsors, Austin Energy's HPwES program offers a complete home energy analysis and a list of recommendations for efficiency improvements, along with cost estimates. To determine the benefits of this program, the National Renewable Energy Laboratory (NREL) collaborated with the Pacific Northwest National Laboratory (PNNL) to conduct a statistical analysis using energy consumption data of HPwES homes provided by Austin Energy. This report provides preliminary estimates of average savings per home from the HPwES Loan Program for the period 1998 through 2006. The results from this preliminary analysis suggest that the HPwES program sponsored by Austin Energy had a very significant impact on reducing average cooling electricity for participating households. Overall, average savings were in the range of 25%-35%, and appear to be robust under various criteria for the number of households included in the analysis

Geographic variation in nrDNA and four cpDNA regions of Juniperus excelsa: Analysis of new records from Bulgaria, Cyprus and southwestern Turkey

Sequencing of nrDNA, plus four cp DNA regions: petN-psbM, trnS-trnG, trnD-trnT and trnL-trnF of newly acquired samples of J. excelsa from Bulgaria, Cyprus and Turkey showed little variation in J. excelsa (sensu stricto), except for the unusual situation in Lebanon, where J. excelsa and J. polycarpos (and likely J. p. var. turcomanica) grow near each other and may be hybridizing. The genetic composition of the eastern-most populations of J. excelsa in Turkey is unknown and deserves further study

Geographic variation in nrDNA and four cpDNA regions of Juniperus excelsa: Analysis of new records from Bulgaria, Cyprus and southwestern Turkey

Sequencing of nrDNA, plus four cp DNA regions: petN-psbM, trnS-trnG, trnD-trnT and trnL-trnF of newly acquired samples of J. excelsa from Bulgaria, Cyprus and Turkey showed little variation in J. excelsa (sensu stricto), except for the unusual situation in Lebanon, where J. excelsa and J. polycarpos (and likely J. p. var. turcomanica) grow near each other and may be hybridizing. The genetic composition of the eastern-most populations of J. excelsa in Turkey is unknown and deserves further study