Laparoendoscopic Single Site (LESS) Splenectomy with a Conventional Laparoscope and Instruments

LESS splenectomy appears to be a feasible procedure that can be performed safely and may have higher patient satisfaction that conventional laparoscopic splenectomy

An overview of laparoscopic closure of duodenal perforation in a tertiary care centre

Duodenal ulcer perforation is one of the most commonly encountered condition in emergency surgery. Laparoscopic repair of the perforation has been reported in many cases since the first laparoscopic repair of a duodenal perforation in the year 1990 by Mouret et al. Aim and objectives were to study the clinical outcomes of laparoscopic repair of duodenal perforation in terms of duration of surgery, post operative pain, initiation of oral feeds, surgical site infection and duration of hospital stay. Over a 2 year period, 2018-2020, 20 patients with a presumptive diagnosis of perforated duodenal ulcers were considered for laparoscopic closure. Primary closure of the perforation was done with intracorporeal suturing followed by omental patch repair. The mean age was 38.75±8.53 years, mean duration of surgery was 97.80±7.89 minutes. The mean number of analgesic injection was 2.90±0.72. The mean duration of initiation of oral feeds was 3.20±0.41 days. The mean duration of removal of drain was 4.65±0.75 days and mean duration of hospital stay was 6.20±0.41 days.  No intraoperative complications encountered. Postoperatively, none of the patients develop wound infections. In our setting, laparoscopic closure was found to be safe and a promising method in management of duodenal perforation as it appears to be more beneficial in terms of decreased post-operative pain, early initiation of oral feeds, decreased length of hospital stay and no major complications postoperatively. However, the procedure requires a surgeon with particular expertise in endoscopic suturing skills

Le faire et le dire

L’article aborde le paradoxe sur la perception et l’étude des gestes selon les images. Il analyse, plus précisément, une série de vases attiques de la période archaïque et classique montrant le gigot mou, c’est-à-dire la cuisse de l’animal sacrificiel désossée des os longs, mais avec le sabot et les os du pied. L’étude de six variations de ce motif permettent à l’auteur de mettre en valeur la polysémie d’un système de gestes, de la séquence rituelle de transfert jusqu’à son offrande comme part d’honneur, ou même son isolation dans le champ de l’image mettant ainsi le gigot mou en exergue.This article uses images to analyze the paradox of gestures, their perception and study. More precisely, it focuses on a series of attic vases of the archaic and classical period depicting a “soft leg”, namely the sacrificial animal’s thigh without the long bones, only with its hoof and the foot’s bone. The paper highlights the polysemie of a system of gestures according to six variations of this motif, beginning with the ritual sequence of transferring and moving to the “soft leg’s” offering as a share of honor, or even its isolation on the background of the image which highlights its presence

Akbar the Great (1542–1605) and Christianity. Between religion and politics

The second half of the 16th century, during the reign of India’s third, and widely regarded as the greatest, ruler of the Mughal dynasty, Jalāl ud-Dīn Muḥammad Akbar, was also the time when the Europeans were becoming increasingly present on the Indian Subcontinent. Especially active among them were the Portuguese – both in the political and economic sense as well as in the cultural and the religious dimension.The second half of the 16th century, during the reign of India’s third, and widely regarded as the greatest, ruler of the Mughal dynasty, Jalāl ud-Dīn Muḥammad Akbar, was also the time when the Europeans were becoming increasingly present on the Indian Subcontinent. Especially active among them were the Portuguese – both in the political and economic sense as well as in the cultural and the religious dimension

Non-Tensile Tunica Albuginea Plication for the Correction of Penile Curvature

Objective: To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure. Patients and Methods: From June 2004 to July 2007, 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie’s disease) underwent surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration, and a cosmetically unacceptable penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycron® 2/0 polyester fiber).Results: After a mean follow-up period of 18 months, successful results with respect to penile straightening, normal erection, penetration and sensation, confirmed both subjectively and objectively, were achieved in all patients. Post-operative penile shortening of less than 1.5 cmwas present in 50% of the cases, but did not affect intercourse. Post-operative complications were mild and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly 100% (35/43 very satisfied and 8/43 satisfied).Conclusion:NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for successful outcomes are: clear identification of the line of maximum curvature, adequate pre-operative evaluation, counseling of the patient to setappropriate expectations, and careful discussion of the location of the suture sites. There is no need for mobilization of the urethra or neurovascular bundle, which adds a great advantage to this easy and simple technique. Cutting through the tunica albuginea, which may prevent postoperative erectile dysfunction, is not necessary. A disadvantage of this procedure is that it cannot correct hour-glass deformity

Isolation and characterization of the E2F-like gene in plants11The sequences reported in this paper have been deposited in the GenBank database (accession numbers AB025347 for NtE2F and AB025029 for tobacco PCNA).

AbstractThe transcription factor E2F regulates the expression of genes involved in the progression of G1/S transition and DNA replication in mammalian cells. We cloned and characterized a cDNA (NtE2F) corresponding to a E2F homolog of tobacco (Nicotiana tabacum). The transcription of NtE2F was induced as cells progressed from G1 to the S phase and expressed much earlier than that of the proliferating cell nuclear antigen (PCNA) gene. We demonstrated that NtE2F can interact with the tobacco retinoblastoma (Rb)-related protein in a yeast two-hybrid assay. To further characterize NtE2F, the trans-activation activity of NtE2F was examined by using a transient assay in the tobacco Bright Yellow-2 (BY-2) cells with NtE2F fused to the DNA-binding domain of the yeast transcriptional activator GAL4. NtE2F activated the transcription of the β-glucuronidase (GUS) reporter gene driven by a cauliflower mosaic virus (CaMV) 35S core promoter containing the GAL4-binding sequence. This is the first report of the identification of a functionally equivalent E2F-like gene in plants