Laparoscopic splenectomy: comparison between anterior and lateral approaches.

AIM: Splenectomy, except for a traumatic purpose, is now performed through a laparoscopic approach. There are mainly two ways for laparoscopic total or partial splenectomies. For the classic anterior dissection of the splenic vessels, patient is placed in supine position and five ports are required to elevate the spleen and proceed to vessel divisions. With a lateral approach of the pedicle, patient is placed in lateral decubitus position and three ports are sufficient, because gravity help to provide traction on the splenic ligaments and to present hilar vessels and pancreas tail. The aim of our study was to compare surgical complications of those two approaches of laparoscopic splenectomy in children. METHODS: We reviewed 84 medical records of patient operated on for hematological disease between January 1993 and December 2009. RESULTS: There were 47 anterior and 37 lateral approaches. Sex, disease, median age, operative time, blood lost or hospital stay, and associated laparotomy were not different between the two groups. Operative complications included hemorrhage (5), bowel injury (1), diaphragmatic wound (1), pancreas tail section (1), and parietal hematoma (1) in the anterior group (9 cases) versus 1 hemorrhage in the lateral group (P<.02). There were five laparotomies owing to surgical complications in the anterior group, and none in the lateral group. CONCLUSION: Splenectomy through laparoscopic approach is an effective technique. Lateral dissection of the vessels provides less operative complications in children

Government Geoscience Stimulates Mineral Exploration in the Superior Province, Northern Québec

This paper summarizes new geologic information, and highlights exploration opportunities in the northeastern part of the Superior Province since 1997, as a result of the Far North Program undertaken by Géologie Québec. The first phase of the program was a regional lake-sediment geochemical survey, where 26,000 samples were collected north of 55°N from an area of approximately 350,000 km2. The resulting database attracted many mining companies to the region and led to numerous mineral discoveries. The second phase, started in 1998, consisted of extensive geological mapping, supplemented by U-Pb geochronological work; by 2003, more than twenty, 1:250,000 mapping projects were completed. The Far North Program is now in its final phase and it will produce a comprehensive geological and metallogenic synthesis of the new data from the areas surveyed. About forty previously unknown volcano-sedimentary belts, numerous mafic-ultramafic intrusions and sixteen different mineral deposit types have been identified. Since 1997, this has resulted in a surge of exploration activity that has seen more than $38 million in expenditures by private industry. SOMMAIRE Le présent article présente un résumé des nouvelles informations géologiques disponibles et décrit des cibles d'exploration mises au jour depuis 1997 dans le nord-est de la Province du lac Supérieur et qui découlent du programme d'exploration du Grand Nord de Géologie Québec. La première étape de ce programme a consisté en un échantillonnage géochimique régional de sédiments lacustres, où 26 000 échantillons ont été prélevés au nord du 55e parallèle, sur une superficie de près de 350 000 km2. La base de données ainsi constituée a attiré de nombreuses sociétés minières dans la région et de nombreuses découvertes minérales ont été faites. Amorcée en 1998, la deuxième étape a consisté en une cartographie géologique systématique, appuyée par des datations géochronologiques U-Pb. Et, en 2003, plus de 20 cartes à l'échelle 1:250 000 avaient été complétées. Le programme du Grand Nord en est maintenant à sa dernière étape, laquelle aboutira à la production d'une synthèse géologique et métallogénique à partir des nouvelles données provenant des régions étudiées. Environ une quarantaine de bandes volcano-sédimentaires, de nombreuses intrusions mafiques et ultramatiques, et seize types de gisements minéralogiques différents y ont été décrits. Depuis 1997, ce programme a entraîné des investissements d'exploration par l'entreprise privée dépassant les 38 M$

Scleromyositis: A distinct novel entity within the systemic sclerosis and autoimmune myositis spectrum. Implications for care and pathogenesis

Systemic sclerosis and autoimmune myositis are both associated with decreased quality of life and increased mortality. Their prognosis and management largely depend on the disease subgroups. Indeed, systemic sclerosis is a heterogeneous disease, the two predominant forms of the disease being limited and diffuse scleroderma. Autoimmune myositis is also a heterogeneous group of myopathies that classically encompass necrotizing myopathy, antisynthetase syndrome, dermatomyositis and inclusion body myositis. Recent data revealed that an additional disease subset, denominated “scleromyositis”, should be recognized within both the systemic sclerosis and the autoimmune myositis spectrum. We performed an in-depth review of the literature with the aim of better delineating scleromyositis. Our review highlights that this concept is supported by recent clinical, serological and histopathological findings that have important implications for patient management and understanding of the disease pathophysiology. As compared with other subsets of systemic sclerosis and autoimmune myositis, scleromyositis patients can present with a characteristic pattern of muscle involvement (i.e. distribution of muscle weakness) along with multisystemic involvement, and some of these extra-muscular complications are associated with poor prognosis. Several autoantibodies have been specifically associated with scleromyositis, but they are not currently integrated in diagnostic and classification criteria for systemic sclerosis and autoimmune myositis. Finally, striking vasculopathic lesions at muscle biopsy have been shown to be hallmarks of scleromyositis, providing a strong anatomopathological substratum for the concept of scleromyositis. These findings bring new insights into the pathogenesis of scleromyositis and help to diagnose this condition, in patients with subtle SSc features and/or no autoantibodies (i.e. “seronegative” scleromyositis). No guidelines are available for the management of these patients, but recent data are showing the way towards a new therapeutic approach dedicated to these patients

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

La sente du bout du monde de Philippe Jaccottet

Je questionneraisur le haïkaïce papillon qui vole Bashô Il était une fois un moine zen qui s’inquiétait beaucoup du langage et de la réalité de notre monde. Un jour, ce dernier qui ne trouvait pas de réponse à son tourment, décida de se tourner vers l’un de ses supérieurs, un certain maître Fêng Hsüeh. Après la cérémonie du thé, le moine parvint à lui poser la question suivante : « La parole altère la transcendance (de la Réalité), et le silence en altère la manifestation. Comment combiner pa..

L\u27Indépendance Judiciaire et la Cour Suprême: Reconstruction Historique Douteuse et Théorie Constitutionnelle de Complaisance

The recent decision of the Supreme Court of Canada in the Reference re: Remuneration of Judges in the Provincial Court of Prince Edward Island has given judicial independence a surprising interpretation. A majority of the Court stated that this principle requires legislative bodies to establish independent procedures for setting judicial salaries. The Court maintained that the basis of judicial independence is to be found in the preamble of the Constitution Act, 1867, rather than the express provisions of the constitutional text. The authors argue in Part I of this article that the Court transformed fundamentally and without reason traditional conceptions of the sources of Canadian constitutional law. According to this new paradigm, underlying structural principles can serve to fill gaps in the protection afforded by the textual provisions which are themselves seen as incomplete expressions of the underlying principles. Part II discusses the legal relationship between a judge and the Crown. The authors conclude that judicial independence is ill-served by the majority opinion of the Court

L\u27Indépendance Judiciaire et la Cour Suprême: Reconstruction Historique Douteuse et Théorie Constitutionnelle de Complaisance

The recent decision of the Supreme Court of Canada in the Reference re: Remuneration of Judges in the Provincial Court of Prince Edward Island has given judicial independence a surprising interpretation. A majority of the Court stated that this principle requires legislative bodies to establish independent procedures for setting judicial salaries. The Court maintained that the basis of judicial independence is to be found in the preamble of the Constitution Act, 1867, rather than the express provisions of the constitutional text. The authors argue in Part I of this article that the Court transformed fundamentally and without reason traditional conceptions of the sources of Canadian constitutional law. According to this new paradigm, underlying structural principles can serve to fill gaps in the protection afforded by the textual provisions which are themselves seen as incomplete expressions of the underlying principles. Part II discusses the legal relationship between a judge and the Crown. The authors conclude that judicial independence is ill-served by the majority opinion of the Court

Place de la chirurgie dans les neuroblastomes de l'enfant

Le neuroblastome est une tumeur maligne de l'enfant qui est caractérisée par une très grande hétérogénéité clinique, d'une maladie presque bénigne à une maladie presque incurable. Les facteurs pronostiques qui expliquent cette variabilité sont dominés par l'âge, le stade, et un ensemble de caractéristiques biologiques, qui permettent le regroupement des neuroblastomes en groupes de risque similaire, qui conditionnent des stratégies thérapeutiques différentes. La chirurgie du neuroblastome doit prendre en compte ces variables. Dans ce travail, nous réalisons l analyse de la balance entre le bénéfice oncologique d une exérèse complète et le risque de complications dans une localisation particulière de neuroblastome où le risque de séquelles fonctionnelles est important (le neuroblastome pelvien), et nous étudions l intérêt de la chirurgie mini-invasive dans les tumeurs solides de l enfant, avec une évaluation de l efficacité de la laparoscopie dans les neuroblastomes abdominaux. Ces travaux apportent un éclairage particulier sur le rôle de la chirurgie dans la prise en charge de cette tumeur maligne complexe : Si la nécessité de la chirurgie est bien établie et que la qualité de l exérèse semble importante, les bénéfices d une exérèse complète sont à mettre en balance avec les risques de complications et de séquelles postopératoires. La question des séquelles se pose d autant plus qu'il s agit de tumeurs localisées, survenant chez des nourrissons où l'on connaît les possibilités de régression ou de maturation spontanée de la tumeur. Dans ce sous-groupe, l'excellente survie conduit à élaborer des stratégies de désescalade thérapeutique dans lesquelles la chirurgie a un rôle à jouer. La réduction de la toxicité du traitement passe aussi par une diminution du poids de la chirurgie, et le développement de techniques innovantes est un élément qui y participe.Neuroblastoma is a malignant pediatric tumour characterized by a wide clinical heterogeneity, from an almost benign to an almost incurable disease. Prognostic factors accounting for this variability include age, stage, and biological characteristics, and allow distribution of neuroblastoma in different risk groups with corresponding treatment strategies. Surgery of neuroblastoma has to take these variables into account. In the present work, we study the balance between oncological benefit of a complete resection and the risk of complications in a site of neuroblastoma with a high risk of neurological sequellae (pelvic neuroblastoma), and we report the use of minimally-invasive techniques with a series of children with abdominal neuroblastoma resected laparoscopically. These studies contribute to clarify the role of surgery in the treatment of this complex malignant disease : If the need for surgery is well established and if the extent of resection is important for cure, the benefits of resection need to be balanced with the risk of complications and postoperative sequellae, especially in infants in whom localized and even metastatic neuroblastomas have a potential for maturation or spontaneous regression. In this subgroup with an excellent survival, surgery and innovating minimally invasive techniques may contribute to decrease the burden of treatment.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

SCoRS -- a content and collaborative based recommender system

We designed and built a web-based movie recommender system. We used association rule mining to implement two data filtering methods. Content-based filtering identifies sets of common attributes of the movies that the user has liked in the past, while collaborative filtering associates users with each other based on similarities in taste. By combining content- and collaborative-base filtering, we obtained recommendations with a higher precision than either method individually

Caractérisation physico-chimique, palynologique et organoleptique d'un miel de sophora

National audienc