Phylogenetic placement of environmental sequences using taxonomically reliable databases helps to rigorously assess dinophyte biodiversity in Bavarian lakes (Germany).

1. Reliable determination of organisms is a prerequisite to explore their spatial and temporal occurrence and to study their evolution, ecology, and dispersal. In Europe, Bavaria (Germany) provides an excellent study system for research on the origin and diversification of freshwater organisms including dinophytes, due to the presence of extensive lake districts and ice age river valleys. Bavarian freshwater environments are ecologically diverse and range from deep nutrient‐poor mountain lakes to shallow nutrient‐rich lakes and ponds. 2. We obtained amplicon sequence data (V4 region of small subunit‐rRNA, c. 410 bp long) from environmental samples collected at 11 sites in Upper Bavaria. We found 186 operational taxonomic units (OTUs) associated with Dinophyceae that were further classified by means of a phylogenetic placement approach. 3. The maximum likelihood tree inferred from a well‐curated reference alignment comprised a systematically representative set of 251 dinophytes, covering the currently known molecular diversity and OTUs linked to type material if possible. Environmental OTUs were scattered across the reference tree, but accumulated mostly in freshwater lineages, with 79% of OTUs placed in either Apocalathium, Ceratium, or Peridinium, the most frequently encountered taxa in Bavaria based on morphology. 4. Twenty‐one Bavarian OTUs showed identical sequences to already known and vouchered accessions, two of which are linked to type material, namely Palatinus apiculatus and Theleodinium calcisporum. Particularly within Peridiniaceae, delimitation of Peridinium species was based on the intraspecific sequence variation. 5. Our approach indicates that high‐throughput sequencing of environmental samples is effective for reliable determination of dinophyte species in Bavarian lakes. We further discuss the importance of well‐curated reference databases that remain to be developed in the future

Strict selection alone of patients undergoing liver transplantation for hilar cholangiocarcinoma is associated with improved survival

Liver transplantation for hilar cholangiocarcinoma (hCCA) has regained attention since the Mayo Clinic reported their favorable results with the use of a neo-adjuvant chemoradiation protocol. However, debate remains whether the success of the protocol should be attributed to the neo-adjuvant therapy or to the strict selection criteria that are being applied. The aim of this study was to investigate the value of patient selection alone on the outcome of liver transplantation for hCCA. In this retrospective study, patients that were transplanted for hCCA between1990 and 2010 in Europe were identified using the European Liver Transplant Registry (ELTR). Twenty-one centers reported 173 patients (69%) of a total of 249 patients in the ELTR. Twenty-six patients were wrongly coded, resulting in a study group of 147 patients. We identified 28 patients (19%) who met the strict selection criteria of the Mayo Clinic protocol, but had not undergone neo-adjuvant chemoradiation therapy. Five-year survival in this subgroup was 59%, which is comparable to patients with pretreatment pathological confirmed hCCA that were transplanted after completion of the chemoradiation protocol at the Mayo Clinic. In conclusion, although the results should be cautiously interpreted, this study suggests that with strict selection alone, improved survival after transplantation can be achieved, approaching the Mayo Clinic experience

Mesh infections after laparoscopic inguinal hernia repair

Several complications like hematoma and seroma have been reported after laparoscopic inguinal hernia repair (LH). Sepsis due to infection of the patch is an uncommon complication. Tn this retrospective trial, we evaluated three male patients who developed postoperative mesh infection after LH by transabdominal preperitoneal patch (TAPP) technique in two institutions. Diagnosis was confirmed by clinical symptoms, signs, ultrasonography, and computerized tomography (CT), and definitive treatment was provided by removing the mesh. In the first case, mesh infection occurred 10 months after laparoscopic left inguinal hernia repair with TAPP for recurrence. The infection manifested itself as an external fistula at the drain site. The mesh was removed laparoscopically due to persistent suppuration. Tn the second case, mesh infection occurred 3 months after transabdominal preperitoneal hernia repair on the left. The patch was removed because of the persistent suppuration despite repetitive drainage and lavage, Tn the third case, mesh infection occurred in 15 days after transabdominal preperitoneal hernia repair on the right. External drainage was performed under CT guidance, but suppuration could not be stopped. Thus the mesh was removed. In three cases, infection could not be stopped after diagnosis despite drainage and antibiotic coverage, and then it was decided to remove the mesh, The meshes were removed under general anesthesia for the first two cases and under local anesthesia for the third one. During the follow-up period. no recurrences were noted. The mesh infections of these three cases, resistant to conservative treatment methods, completely disappeared after mesh removal

Expression of intercellular adhesion molecule-1 in UVA-irradiated human skin cells in vitro and in vivo.

Ultraviolet A (UVA) radiation represents an important oxidative stress to human skin and certain forms of oxidative stress have been shown to modulate intercellular adhesion molecule-1 (ICAM-1) expression. ICAM-1 has been shown to play an important part in many immune reactions and the perturbations of this molecule by ultraviolet radiation could have implications in many inflammatory responses. An enhancement immunohistochemical method with avidin/biotin was used for analysing the early effects of UVA radiation on human cell cultures and human skin (340-400 nm). Both in vitro and in vivo data show that ICAM-1 staining in epidermal keratinocytes, which was expressed constitutively, decreased in a UVA dose-dependent manner. The decrease was most noted at 3-6 h following UVA radiation with some ICAM-1 staining returning by 48 h post-UVA. ICAM-1 positive staining in the dermis was specific for vascular structures and was increased 24 h after UVA radiation. Cultured dermal fibroblasts exhibited ICAM-1 staining which increased slightly within 6-48 h post-UVA radiation. As epidermal ICAM-1 expression is depleted following UVA radiation and dermal expression increases due to an increase in the vascular structures, ICAM-1 provides a valuable marker following UVA radiation in human skin that can be readily measured in situ

Erythema induction by ultraviolet radiation points to a possible acquired defense mechanism in chronically sun-exposed human skin.

BACKGROUND: It is generally accepted that a UVA-induced erythema is difficult to detect except in the most sensitive individuals. OBJECTIVE AND METHODS: As UVA effects on human skin and skin cells have been shown to depend strongly on anatomical body sites, UVA I, UVA I + II and solar simulator radiations were compared in their ability to induce erythema and melanin pigmentation responses in individuals with skin types I-IV on both previously sun-exposed (arms, forearms, thighs) and nonexposed body sites (buttocks). RESULTS: Erythema induction by UVA I on previously nonexposed skin sites followed a dose response in all skin types which was contrary to the absence of erythema induction seen on previously sun-exposed sites. Melanin expression followed a dose and skin type response and was shown to be more enhanced in previously exposed skin and in skin types III and IV. In contrast, UVA I + II induced erythema on nonexposed skin areas and to a lesser extent on frequently sun-exposed skin. Melanin production by UVA I + II was similar to that seen with UVA I alone in individuals of skin types II and III. Solar simulator radiation was very efficient in erythema induction regardless of previous sun exposure of skin. CONCLUSIONS: We have found that contrary to the widespread opinion that UVA and in particular UVA I could not induce a significant erythema, this waveband is capable of measurable erythema induction on skin nonexposed to sunlight. The diminished erythema induction by UVA I on chronically sun-exposed skin suggests the possibility of a defense mechanism against UVA-induced damage in this tissu

Fundoplicature selon Nissen realisee a distance du patient par robotique

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Anatomie laparoscopique virtuelle de la jonction oesogastrique

The anatomy of the GE junction is represented by computer synthetised pictures. This method allows to represent different organs from different angles, emphasis being put on the laparoscopic angle of vision. This should improve anatomical comprehension. The synthetic pictures have been constructed in a figurative representation. Fatty tissues have been omitted whereas the peritoneal layers covering organs and defining spaces are enhanced.SCOPUS: ar.jinfo:eu-repo/semantics/publishe