Outcome of alimentary tract duplications operated on by minimally invasive surgery: a retrospective multicenter study by the GECI (Groupe d'Etude en Coeliochirurgie Infantile).

BACKGROUND: Alimentary tract duplications (ATD) are a rare cause of intestinal obstruction in childhood. There are many case reports but few series about laparoscopy or thoracoscopy for ATD. The aim of our study was to report the outcome of minimally invasive surgery (MIS) for ATD. METHODS: This was a retrospective multicenter study from the GECI (Groupe d\u27Etude en Coeliochirurgie Infantile). We reviewed the charts of 114 patients operated on by MIS for ATD from 1994 to 2009. RESULTS: Sixty-two patients (54 %) had a prenatal diagnosis. Forty-nine patients (43 %) were symptomatic before surgery: 33 of those patients (63 %) with postnatal diagnosis compared to 16 (25 %) with prenatal diagnosis (P < 0.01). In this last group, the median age at onset of symptoms was 16 days (range = 0-972). One hundred and two patients had laparoscopy (esophageal to rectal duplications) and 12 patients had thoracoscopy for esophageal duplications. The mean operative time was 90 min (range = 82-98). There were 32 (28 %) resection anastomoses, 55 (48 %) enucleations, and 27 (24 %) unroofings. The conversion rate was 32 %, and in a multivariate analysis, it was significantly higher, up to 41 % for patients weighing <10 kg (P < 0.01). Ten patients (8 %) had unintentional perioperative opening of the digestive tract during the dissection. Eight patients had nine postoperative complications, including six small bowel obstructions. The median length of hospital stay was 4 days (range = 1-21) without conversion and 6 days (range = 1-27) with conversion (P = 0.01). The median follow-up was 3 months (range = 1-120). Eighteen of the 27 patients who underwent partial surgery had an ultrasound examination during follow-up. Five (18 %) of them had macroscopic residue. CONCLUSION: This study showed that MIS for ATD is feasible with a low rate of complications. Patients with prenatal diagnosis should have prompt surgery to prevent symptoms, despite a high rate of conversion in small infants

In vitro phosphorylation as tool for modification of silk and keratin fibrous materials

An overview is given of the recent work on in vitro enzymatic phosphorylation of silk fibroin and human hair keratin. Opposing to many chemical "conventional" approaches, enzymatic phosphorylation is in fact a mild reaction and the treatment falls within "green chemistry" approach. Silk and keratin are not phosphorylated in vivo, but in vitro. This enzyme-driven modification is a major technological breakthrough. Harsh chemical chemicals are avoided, and mild conditions make enzymatic phosphorylation a real "green chemistry" approach. The current communication presents a novel approach stating that enzyme phosphorylation may be used as a tool to modify the surface charge of biocompatible materials such as keratin and silk

Antimicrobial lubricant formulations containing poly(hydroxybenzene)-trimethoprim conjugates synthesized by tyrosinase

Poly(hydroxybenzene)-trimethoprim conjugates were prepared using methylparaben as substrate of the oxida- tive enzyme tyrosinase. MALDI-TOF MS analysis showed that the enzymatic oxidation of methylparaben alone leads to the poly(hydroxybenzene) formation. In the presence of tri- methoprim, the methylparaben tyrosinase oxidation leads poly(hydroxybenzene)-trimethoprim conjugates. All of these compounds were incorporated into lubricant hydroxyethyl cellulose/glycerol mixtures. Poly(hydroxybenzene)-trimetho- prim conjugates were the most effective phenolic structures against the bacterial growth reducing by 96 and 97 % of Escherichia coli and Staphylococcus epidermidis suspen- sions, respectively (after 24 h). A novel enzymatic strategy to produce antimicrobial poly(hydroxybenzene)-antibiotic conjugates is proposed here for a wide range of applications on the biomedical field.The authors Idalina Gonçalves and Cláudia Botelho would like to acknowledge the NOVO project (FP7-HEALTH- 2011.2.3.1- 5) for funding. Loïc Hilliou acknowledges the financial support by FCT – Foundation for Science and Technology, Portugal (501100001871), through Grant PEst-C/CTM/LA0025/2013 - Strategic Project - LA 25 - 2013–2014, and by Programa Operacional Regional do Norte (ON.2) through the project BMatepro – Optimizing Materials and Processes^, with reference NORTE-07-0124-FEDER-000037 FEDER COMPETE

Atypical clinical presentation of a neuroblastoma in an infant

peer reviewedA babygirl, aged six weeks, was hospitalized for rectal prolapse and isolated constipation. The investigation revealed a neuroblastoma (NB) inducing a medullar compression responsible for the sphincter disorders. NB is second among pediatric solid tumors, but is the most frequent cancer among infants. Its diagnosis is difficult because of its rarity and the variety of its symptoms. A new staging, based on imaging, has recently been proposed by the International Neuroblastoma Risk Group. With the exception of its localized, easily resectable forms, NB is best treated by chemotherapy

Modeling transport of secondary ion fragments into a mass spectrometer

The Surrey Ion Beam Centre was awarded the Engineering and Physical Sciences Research Council (EPSRC) grant for “Promoting Cross Disciplinary Research: Engineering and Physical Sciences and Social Sciences” allowing continued research into the characteristics of desorption of secondary ions by the impact of fast primary ions in the ambient pressure at the sub-micron scale. To carry out this research a new beamline has been constructed consisting of a time-of-flight secondary ion mass spectrometer combined with the current 2MV Tandem accelerator. This research has already returned many significant results such as the first simultaneous SIMS, PIXE and RBS measurement preformed on an organic sample in vacuum. However, further optimization and validation of the new beamline is still being worked on. This work focuses on the optimization of the end station geometry to allow for high sensitivity ambient pressure measurements. It is concluded that a common geometry can be adopted for a wide variety of smooth samples to ensure optimum sensitivity provided a hard edge of the sample can be found to place the mass spectrometer capillary near

On the formation of the porous structure in nanostructured a-Si coatings deposited by dc magnetron sputtering at oblique angles

The formation of the porous structure in dc magnetron sputtered amorphous silicon thin films at low temperatures is studied when using helium and/or argon as the processing gas. In each case, a-Si thin films were simultaneously grown at two different locations in the reactor which led to the assembly of different porous structures. The set of four fabricated samples has been analyzed at the microstructural level to elucidate the characteristics of the porous structure under the different deposition conditions. With the help of a growth model, we conclude that the chemical nature of the sputter gas not only affects the sputtering mechanism of Si atoms from the target and their subsequent transport in the gaseous/plasma phase towards the film, but also the pore formation mechanism and dynamics. When Ar is used, pores emerge as a direct result of the shadowing processes of Si atoms, in agreement with Thornton's structure zone model. The introduction of He produces, in addition to the shadowing effects, a new process where a degree of mobility results in the coarsening of small pores. Our results also highlight the influence of the composition of sputtering gas and tilt angles (for oblique angle deposition) on the formation of open and/or occluded porosity. © 2014 IOP Publishing Ltd.Peer Reviewe

Une nouvelle approche thérapeutique des malformations vasculaires à faible débit : la rapamycine – à propos de 6 cas

Vascular anomalies (VAs) result from the defective development of the embryonic vascular system and feature dysplastic malformed vessels, which are not always apparent at birth. They do not regress over the patient's lifetime; they usually have commensurate growth during childhood and may worsen over time if not treated. VAs may cause chronic painful swelling, bleeding, functional deficits or vital structure obstruction. These patients' quality of life is usually impaired because of the chronicity and recurrence of the disease. We report on six cases of complicated VAs, refractory to current treatments, treated with rapamycin, an mTor inhibitor recently used in VAs.Les malformations vasculaires (MV) sont des anomalies de développement des vaisseaux pendant la vie intra-utérine ; elles sont présentes à la naissance mais parfois découvertes tardivement. Elles ne présentent aucune tendance à la régression spontanée, mais au contraire une évolution progressive émaillée de poussées inflammatoires tout au long de la vie. Selon le type de MV, les complications peuvent être esthétiques, douloureuses, fonctionnelles, hémorragiques ou systémiques. La qualité de vie des patients porteurs de MV peut être fortement affectée en raison des symptômes présentés ainsi que du caractère chronique, durable et récidivant de l’affection. Nous présentons l’évolution clinique, biologique et radiologique de 6 patients souffrant de MV complexes réfractaires aux traitements conventionnels qui ont bénéficié d’une nouvelle approche thérapeutique par rapamycine (Sirolimus®), un inhibiteur de la voie mTor (pour mammalian target of rapamycin)

Cholelithiasis and cholecystectomy in infants.

editorial reviewedCholelithiasis is rare in children and even more so in infants. We report the case of a 3-month-old patient with cholestatic jaundice secondary to an obstruction of the terminal portion of the bile duct. The treatment applied in this patient was a cholecystectomy with trans-cystic cholangiography and common bile duct clearance. The evolution was excellent. The current literature on biliary lithiasis in children and infants is poor in large cohort studies. The various treatments proposed, if necessary, include biliary lavage by percutaneous puncture, endoscopic retrograde cholangiopancreatography with sphincterotomy and laparoscopic or open cholecystectomy with intraoperative cholangiography. None of these procedures has shown superiority over the others. Therefore, no treatment algorithm is currently defined. Patients are treated on a case-by-case basis according to their symptoms, previous history and the level of expertise of each centre for these rare, difficult and specific procedures