OGBN P13 Laparoscopic splenectomy for massive splenomegaly: Is it feasible?

Background Laparoscopy has high credibility in the treatment of normal sized and mildly enlarged spleens. However, there is lack of evidence for its safety for cases with massive splenomegaly. EAES defined massive splenomegaly by maximum splenic diameter exceeding 20 cm. It recommended hand assisted laparoscopic splenectomy (HALS) or open surgery as a treatment for such cases. In this video, we demonstrated the feasibility of the use of laparoscopy in cases with massive splenomegaly with favourable outcomes.Methods We describe a video for a 36 years old female patient who is known Kikuchi syndrome. She had massive splenomegaly which reached 25 cm in its maximum length. Patient was in right lateral position. Camera port was located left to the umbilicus, another 10 mm port at left midclavicular line and two 5 mm ports were used (one at epigastrium and assistant port at left anterior axillary line). The video demonstrates the steps of laparoscopic splenectomy with the challenges of the huge size of the spleen. Specimen was taken through patient’s old caesarean scar (Pfannenstiel incision).Results Patient had CT scan on day 2 for raised inflammatory markers, which showed small collection at splenic bed which was treated conservatively. Patient was discharged on day 5 postoperatively after removal of surgical drain. Clinical review after 4 weeks post discharge didn’t show any clinical concerns.Conclusions Using a stepwise laparoscopic approach is feasible and safe for massive splenomegaly cases. Refining the selection criteria for laparoscopic versus open or HALS splenectomy should be revised with less consideration to the size of spleen as a limiting factor.</p

Fluorinated Anions Promoted “on Water” Activity of Di- and Tetranuclear Copper(I) Catalysts for Functional Triazole Synthesis

A set of di- and tetra-copper­(I) compounds [Cu₂(L¹H)₂]­[BAr^F]₂ (<b>1</b>) (L¹H = bis­(5,7-dimethyl-1,8-naphthyridin-2-yl)­amine; BAr^F = [B­{C₆H₃(CF₃)₂}₄]) and [Cu₄(L¹)₂(L²)₂]­[BNB^F]₂ (<b>2</b>) (L² = 5,7-dimethyl-1,8-naphthyridin-2-amine; BNB^F = [NH₂{B­(C₆F₅)₃}₂]), stabilized by naphthyridine-based ligands and containing fluorinated anions, is synthesized. Their catalytic utility for copper­(I)-catalyzed azide–alkyne coupling (CuAAC) reactions in organic solvents and “on water” is evaluated. The dimer analogue [Cu₂(L¹H)₂]­[BPh₄]₂ (<b>3</b>) with nonfluorinated anion is synthesized for the purpose of comparison. All three compounds show CuAAC activity in organic solvents, although the performance of <b>3</b> is considerably lower. Remarkable rate enhancement is displayed by compounds containing fluorinated anions (<b>1</b> and <b>2</b>) under “on water” conditions for the model reaction involving benzyl azide, affording 98% conversions in 15–20 min, where compound <b>3</b> gives 76% conversions in 50 min. Kinetic experiments reveal the involvement of two coppers in the cycloaddition process. Employing a host of substrates, the usefulness of fluorinated anions to dramatically improve the catalytic activity of Cu­(I) compounds under “on water” conditions is demonstrated

Polythiophene-Encapsulated Bimetallic Au-Fe₃O₄ Nano-Hybrid Materials: A Potential Tandem Photocatalytic System for Nondirected C(sp²)–H Activation for the Synthesis of Quinoline Carboxylates

Hetero-oligophenylene derivative <b>3</b> appended with thiophene moieties has been designed and synthesized which undergoes aggregation to form <i>J</i>-type fluorescent aggregates in in H₂O/THF (7/3) media. These aggregates served as reactors for the preparation of bimetallic Au-Fe₃O₄ NPs. During the reduction process, aggregates of derivative <b>3</b> were oxidized to the polythiophene species <b>4</b>. Interestingly, the polythiophene species <b>4</b>, having a fibrous morphology, served as a shape- and morphology-directed template for assembly of bimetallic Au-Fe₃O₄ NPs in a flower-like arrangement. Furthermore, polythiophene-encapsulated bimetallic <b>4</b>:Au-Fe₃O₄ nanohybrid materials served as an efficient and recyclable catalytic system for C­(sp²)–H bond activation of unprotected electron-rich anilines for the construction of synthetically versatile quinoline carboxylates via C–H activation, carbonylation, and subsequent annulation under mild and eco-friendly conditions (aqueous media, room temperature, visible-light irradiation, and aerial conditions)

Uptake of anilofos by <i>Synechocystis</i> sp. strain PUPCCC 64.

<p>(A) control (without PUPCCC 64 cells); (B) anilofos in medium; (C) anilofos uptake All presented data are the mean values of three independent experiments ± SD Data at different time intervals with same lower case letters are not significantly different from each other at the 95% confidence level (p<0.05).</p

Growth of <i>Synechocystis</i> sp. strain PUPCCC 64 in basal medium supplemented with anilofos (mg L

<p>^−<b>1</b><b>).</b> All presented data are the mean values of three independent experiments ± SD Data at different time intervals with same lower case letters are not significantly different from each other at the 95% confidence level (p<0.05).</p

Growth of <i>Synechocystis</i> sp. strain PUPCCC 64 in basal medium (A) with 0.01 g K₂HPO₄ L⁻¹, (B) with 2.5 mg anilofos L⁻¹ without phosphate and (C) without phosphate.

<p>All presented data are the mean values of three independent experiments ± SD Data at different time intervals with same lower case letters are not significantly different from each other at the 95% confidence level (p<0.05).</p

Photomicrograph of <i>Synechocystis</i> sp. strain PUPCCC 64 culture on day 4.

<p>(a): control; (b): anilofos (30 mg L⁻¹).</p

Amount of photosynthetic pigments (mg L⁻¹) of <i>Synechocystis</i> sp. strain PUPCCC 64 in anilofos-grown cultures at day 6.

<p>Data in rows are significantly different from each other at the 95% confidence level (p<0.05).</p><p>Data are means of three observations ± SD.</p><p>Chl a: Chlorophyll a; Car: Carotenoid; PC: Phycocyanin; APC: Allophycocyanin; PE: Phycoerythrin.</p

Effect of pH, temperature, and biomass on anilofos uptake (mg L⁻¹) by <i>Synechocystis</i> sp. strain PUPCCC 64.

<p>Data in rows with same lowercase letter are not significantly different from each other at the 95% confidence level (p<0.05).</p><p>One parameter was changed at a time keeping other parameters (optimum value) constant.</p><p>Data are means of three observations ± SD.</p><p>Anilofos used during experiments: 10 mg L^−1.</p

Effect of anilofos (mg L⁻¹) on GSH and Proline content of <i>Synechocystis</i> sp. strain PUPCCC 64.

<p>All presented data are the mean values of three independent experiments ± SD Data at different time intervals with same lower case letters are not significantly different from each other at the 95% confidence level (p<0.05).</p