Single-Incision Cholecystectomy in about 200 Patients

Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments. Results. Single-incision surgery was successfully performed in 215 patients (98%). Three patients (1.4%) required conversion to a three-port technique and two patients (0.9%) to an open procedure. Average age of 142 women (65%) and 78 men (35%) was 47 years (range: 15–89), average ASA status 2 (range: 1–3) and BMI 28 (range: 15–49). Mean operative time was 62 minutes (range: 26–174) and 57 patients (26%) had histopathological signs of acute cholecystitis. Eleven patients (5%) developed to surgery-related complications and nine (4%) of these required a reoperation. The mean followup was 331.5 (range: 11–590) days. Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique

The Weiss conjecture and weak norms

In this note we show that for analytic semigroups the so-called Weiss condition of uniform boundedness of the operators Re(\lambda)^\einhalb C(\lambda+A)^{-1}, \qquad Re(\lambda)>0 on the complex right half plane and weak Lebesgue $L^{2,\infty}$--admissibility are equivalent. Moreover, we show that the weak Lebesgue norm is best possible in the sense that it is the endpoint for the 'Weiss conjecture' within the scale of Lorentz spaces $L^{p,q}$

Suramin analogues protect cartilage against osteoarthritic breakdown by increasing levels of tissue inhibitor of metalloproteinases 3 (TIMP-3) in the tissue

Osteoarthritis is a chronic degenerative joint disease affecting millions of people worldwide, with no disease-modifying drugs currently available to treat the disease. Tissue inhibitor of metalloproteinases 3 (TIMP-3) is a potential therapeutic target in osteoarthritis because of its ability to inhibit the catabolic metalloproteinases that drive joint damage by degrading the cartilage extracellular matrix. We previously found that suramin inhibits cartilage degradation through its ability to block endocytosis and intracellular degradation of TIMP-3 by low-density lipoprotein receptor-related protein 1 (LRP1), and analysis of commercially available suramin analogues indicated the importance of the 1,3,5-trisulfonic acid substitutions on the terminal naphthalene rings for this activity. Here we describe synthesis and structure-activity relationship analysis of additional suramin analogues using ex vivo models of TIMP-3 trafficking and cartilage degradation. This showed that 1,3,6-trisulfonic acid substitution of the terminal naphthalene rings was also effective, and that the protective activity of suramin analogues depended on the presence of a rigid phenyl-containing central region, with para/para substitution of these phenyl rings being most favourable. Truncated analogues lost protective activity. The physicochemical characteristics of suramin and its analogues indicate that approaches such as intra-articular injection would be required to develop them for therapeutic use

Rotational IMRT techniques compared to fixed gantry IMRT and Tomotherapy: multi-institutional planning study for head-and-neck cases

<p>Abstract</p> <p>Background</p> <p>Recent developments enable to deliver rotational IMRT with standard C-arm gantry based linear accelerators. This upcoming treatment technique was benchmarked in a multi-center treatment planning study against static gantry IMRT and rotational IMRT based on a ring gantry for a complex parotid gland sparing head-and-neck technique.</p> <p>Methods</p> <p>Treatment plans were created for 10 patients with head-and-neck tumours (oropharynx, hypopharynx, larynx) using the following treatment planning systems (TPS) for rotational IMRT: Monaco (ELEKTA VMAT solution), Eclipse (Varian RapidArc solution) and HiArt for the helical tomotherapy (Tomotherapy). Planning of static gantry IMRT was performed with KonRad, Pinnacle and Panther DAO based on step&shoot IMRT delivery and Eclipse for sliding window IMRT. The prescribed doses for the high dose PTVs were 65.1Gy or 60.9Gy and for the low dose PTVs 55.8Gy or 52.5Gy dependend on resection status. Plan evaluation was based on target coverage, conformity and homogeneity, DVHs of OARs and the volume of normal tissue receiving more than 5Gy (V_5Gy). Additionally, the cumulative monitor units (MUs) and treatment times of the different technologies were compared. All evaluation parameters were averaged over all 10 patients for each technique and planning modality.</p> <p>Results</p> <p>Depending on IMRT technique and TPS, the mean CI values of all patients ranged from 1.17 to 2.82; and mean HI values varied from 0.05 to 0.10. The mean values of the median doses of the spared parotid were 26.5Gy for RapidArc and 23Gy for VMAT, 14.1Gy for Tomo. For fixed gantry techniques 21Gy was achieved for step&shoot+KonRad, 17.0Gy for step&shoot+Panther DAO, 23.3Gy for step&shoot+Pinnacle and 18.6Gy for sliding window.</p> <p>V_5Gyvalues were lowest for the sliding window IMRT technique (3499 ccm) and largest for RapidArc (5480 ccm). The lowest mean MU value of 408 was achieved by Panther DAO, compared to 1140 for sliding window IMRT.</p> <p>Conclusions</p> <p>All IMRT delivery technologies with their associated TPS provide plans with satisfying target coverage while at the same time respecting the defined OAR criteria. Sliding window IMRT, RapidArc and Tomo techniques resulted in better target dose homogeneity compared to VMAT and step&shoot IMRT. Rotational IMRT based on C-arm linacs and Tomotherapy seem to be advantageous with respect to OAR sparing and treatment delivery efficiency, at the cost of higher dose delivered to normal tissues. The overall treatment plan quality using Tomo seems to be better than the other TPS technology combinations.</p

„Hamburger Note zur Digitalisierung des kulturellen Erbes“

Das Recht, insbesondere das Urheberrecht, hat große Auswirkungen darauf, was von dem großen Reichtum unseres kulturellen Erbes im kollektiven Gedächtnis verbleibt. In der digitalen Welt, in der alles Kopie und damit – im urheberrechtlichen Sinne – Vervielfältigung ist, ist auch jede Nutzung des kulturellen Erbes urheberrechtlich relevant. Auf der anderen Seite leben wir in Zeiten einer rasanten Medienentwicklung und eines Überflusses an Informationen, Bildern, Filmen und Texten. Umso größer ist die Herausforderung, die Erinnerung an unser kulturelles Erbe wachzuhalten. Es ist also eine Frage der kulturellen Selbstbehauptung, wie die rechtlichen Rahmenbedingungen für den Umgang mit unserem kulturellen Erbe gesetzt werden. Was nicht online gefunden werden kann, wird zunehmend verschwinden. Insofern können die Auswirkungen eines unausgewogenen Urheberrechts, das das kulturelle Erbe nicht ausreichend berücksichtigt, dramatisch sein. Dieses Buch versammelt verschiedene Vorschläge und Überlegungen, wie die rechtlichen Rahmenbedingungen geändert werden können, um eine stärkere Präsenz auch des urheberrechtlich geschützten kulturellen Erbes im Netz zu ermöglichen. Verfasst sind diese Vorschläge von Experten aus den Gedächtnisinstitutionen sowie aus der Rechtswissenschaft und Politik, mithin von Autoren, die mit den internationalen Rahmenbedingungen und dem urheberrechtlichen Diskurs in Deutschland gut vertraut sind.The law, in particular copyright, has a major impact on what remains in collective memory of the great wealth of our cultural heritage. In the digital world where everything is copy and therefore - in the sense of copyright - reproduction, every use of the cultural heritage is also relevant under copyright law. On the other hand, we live in times of rapid media development and an abundance of information, images, films and texts. This is why the challenge of keeping the memory of our cultural heritage alive is all the greater. It is therefore a question of cultural self-assertion how the legal framework conditions for dealing with our cultural heritage are set. What cannot be found online will increasingly disappear. In this respect, the effects of an unbalanced copyright law that does not take sufficient account of cultural heritage can be dramatic. This book brings together various proposals and reflections on how to change the legal framework in order to increase the presence of copyrighted cultural heritage on the Internet. These proposals are written by experts from memory institutions, law and politics, and thus by authors who are well acquainted with the international framework conditions and copyright discourse in Germany

A Biomedically Enriched Collection of 7000 Human ORF Clones

We report the production and availability of over 7000 fully sequence verified plasmid ORF clones representing over 3400 unique human genes. These ORF clones were derived using the human MGC collection as template and were produced in two formats: with and without stop codons. Thus, this collection supports the production of either native protein or proteins with fusion tags added to either or both ends. The template clones used to generate this collection were enriched in three ways. First, gene redundancy was removed. Second, clones were selected to represent the best available GenBank reference sequence. Finally, a literature-based software tool was used to evaluate the list of target genes to ensure that it broadly reflected biomedical research interests. The target gene list was compared with 4000 human diseases and over 8500 biological and chemical MeSH classes in ∼15 Million publications recorded in PubMed at the time of analysis. The outcome of this analysis revealed that relative to the genome and the MGC collection, this collection is enriched for the presence of genes with published associations with a wide range of diseases and biomedical terms without displaying a particular bias towards any single disease or concept. Thus, this collection is likely to be a powerful resource for researchers who wish to study protein function in a set of genes with documented biomedical significance

The global naturalized Alien Flora (GloNAF) database

This dataset provides the Global Naturalized Alien Flora (GloNAF) database, ver-sion 1.2. Glo NAF represents a data compendium on th e occurrence and identit y of naturalizedalien vascular plant taxa across geographic regions (e.g. countries, states, provinces, districts,islands) around the globe. The dataset includes 13,939 taxa and covers 1,029 regions (including381 islands). The dataset is based on 210 data sources. For each ta x on-b y-region combination, wepr ovide information on whether the tax on is consider ed to be naturalized in the specific region(i.e. has established self-sustaining popula tions in the wild). Non-native taxa are marked as“alien”, when it is not clear whether they are naturalized. To facilitate alignment with other plantdatabases, we pro v ide f or each taxon the name as given in the original data source and the stan-dardized taxon and family names used by The Plant List Version 1.1 (http://www.theplantlist.org/). We pro vide an ESRI shapefile including polygons f or each region and informa tion on whetherit is an island or a mainland region, the country and the Taxonomic Databases Working Group(TDWG) regions it is part of (TDWG levels 1–4). We also provide several variables that can beused to filter the data according to quality and completeness of alien taxon lists, which varyamong the combinations of regions and da ta sources. A pre vious version of the GloNAF dataset(version 1.1) has already been used in several studies on, for example, historical spatial flows oftaxa between continents and geographical patterns and determinants of naturalization across dif-ferent taxonomic groups. We intend the updated and expanded GloNAF version presented hereto be a global resource useful for studying plant inv asions and changes in biodiversity from regio-nal to global scales. We release these data into the public domain under a Crea ti ve CommonsZer o license waiver (https://creati v ecommons.org/share-y our -work/public-domain/cc0/). Wheny ou use the da ta in your publication, we request that y ou cite this da ta paper. If GloN AF is amajor part of the data analyzed in your study, you should consider inviting the GloNAF coreteam (see Metadata S1: Originators in the Overall project description) as collaborators. If youplan to use the GloNAF dataset, we encourage y ou to contact the GloNAF core team to checkwhether there have been recent updates of the dataset, and whether similar analyses are already ongoing

Surgical strategies for treatment of malignant pancreatic tumors: extended, standard or local surgery?

Tumor related pancreatic surgery has progressed significantly during recent years. Pancreatoduodenectomy (PD) with lymphadenectomy, including vascular resection, still presents the optimal surgical procedure for carcinomas in the head of pancreas. For patients with small or low-grade malignant neoplasms, as well as small pancreatic metastases located in the mid-portion of pancreas, central pancreatectomy (CP) is emerging as a safe and effective option with a low risk of developing de-novo exocrine and/or endocrine insufficiency. Total pancreatectomy (TP) is not as risky as it was years ago and can nowadays safely be performed, but its indication is limited to locally extended tumors that cannot be removed by PD or distal pancreatectomy (DP) with tumor free surgical margins. Consequently, TP has not been adopted as a routine procedure by most surgeons. On the other hand, an aggressive attitude is required in case of advanced distal pancreatic tumors, provided that safe and experienced surgery is available. Due to the development of modern instruments, laparoscopic operations became more and more successful, even in malignant pancreatic diseases. This review summarizes the recent literature on the abovementioned topics