Comparison of Sutures and Devices Used in Closure Following Partial Nephrectomy Suturing

Laparoscopic partial nephrectomy (LPN) is an effective surgical procedure to remove a small renal tumor, while preserving the remainder of the kidney. However, it is a technically challenging procedure to maintain hemostatic condition on the kidney during LPN suturing. Three different experiments were conducted to explore the characteristics and limitations of the current mechanism for tissue approximation during LPN procedures. During the first experiment, a standard suture anchor Hem-o-lok device, a standard stop knot, and three prototype devices were compared to each other based on the amount of tension that could be placed on a suture before there was a tear in renal tissue. The renal remnant of a standardized defect in porcine kidneys without an intact renal capsule was sutured using Vicryl 2-0 suture and different suture anchors. The approximate mean tensions at which the renal parenchymal tissue failed using these tested anchors was knots (2.7N ± 0.53N), Prototype 2(4.0 N± 1.6N), Hem-o-lok (5.4 N±0.72N), Prototype 1(5.6 N±0.75N), and Prototype 3(6.0 N±3.39N). Even with a small number of tests (8 for most configurations), there are significant differences at the 95% confidence level. Statistical analysis of the data, however, indicates that there is no significant difference between anchors Hem-o-lok, Prototype 1 and Prototype 3 with a significance level of 0.05. The second experiment was conducted to determine if different types and sizes of absorbable suture used in partial nephrectomy can sustain a tension of 4N over a 21 day period, which is necessary to achieve hemostasis in the perfused kidney. The results indicate that the sutures commonly used in LPN, i.e. Vicryl 2-0 and Vicryl 3-0 do not break within the 21 day expected life and that failure of other sutures tested before 7 days is commonly due to knot slippage. The final experiment measured and compared the holding strength of a common technique used in LPN surgery to provide anchoring of a suture, a Hem-o-lok device backstopped with a LAPRA-TY. Suture types Vicryl, Monocryl, Chromic, Stratafix and V-Loc were tested in common sizes. The results show that the holding strength of clips (Hem-o-Lok backstopped by LAPRA-TY) for Vicryl 4-0 sutures is the lowest of all types and sizes tested at a mean value of 4.2 N±1.36N and maximum for V-Loc 2-0 sutures at the mean value of 15.9 N±2.58N. The clips hold maximum tension for suture sizes “1” and “0”, whereas minimum tension for suture size 4- 0. This experiment indicates that the holding ability of these clips support the application of suture tension greater than 5.5N thought to be necessary for adequate hemostasis following LPN. However, suture types Vicryl 3-0 and Vicryl 4-0 may not be able to maintain hemostatic condition during LPN when used with this anchor method

Distinct effects of glucose and glucosamine on vascular endothelial and smooth muscle cells: Evidence for a protective role for glucosamine in atherosclerosis

Accelerated atherosclerosis is one of the major vascular complications of diabetes. Factors including hyperglycemia and hyperinsulinemia may contribute to accelerated vascular disease. Among the several mechanisms proposed to explain the link between hyperglycemia and vascular dysfunction is the hexosamine pathway, where glucose is converted to glucosamine. Although some animal experiments suggest that glucosamine may mediate insulin resistance, it is not clear whether glucosamine is the mediator of vascular complications associated with hyperglycemia. Several processes may contribute to diabetic atherosclerosis including decreased vascular heparin sulfate proteoglycans (HSPG), increased endothelial permeability and increased smooth muscle cell (SMC) proliferation. In this study, we determined the effects of glucose and glucosamine on endothelial cells and SMCs in vitro and on atherosclerosis in apoE null mice. Incubation of endothelial cells with glucosamine, but not glucose, significantly increased matrix HSPG (perlecan) containing heparin-like sequences. Increased HSPG in endothelial cells was associated with decreased protein transport across endothelial cell monolayers and decreased monocyte binding to subendothelial matrix. Glucose increased SMC proliferation, whereas glucosamine significantly inhibited SMC growth. The antiproliferative effect of glucosamine was mediated via induction of perlecan HSPG. We tested if glucosamine affects atherosclerosis development in apoE-null mice. Glucosamine significantly reduced the atherosclerotic lesion in aortic root. (P < 0.05) These data suggest that macrovascular disease associated with hyperglycemia is unlikely due to glucosamine. In fact, glucosamine by increasing HSPG showed atheroprotective effects

O PODER DA IMAGEM E O VALOR DOS BENS PATRIMONIAIS: PARA E NA (RE)INTERPRETAÇÃO E (RE)LEITURA DO PATRIMÔNIO CULTURAL ANGOLANO

O artigo sobre o poder da imagem e o valor dos bens patrimoniais, deriva das minhas reflexões e trazem objetos/imagens africanos de Angola que carregam e transmitem sensibilidades e nos remetem a ressonâncias de paisagens históricas e vivências que através da (re)intepretação e (re)leituras se pode compreender a nossa realidade angolana e de seu património histórico cultural atrelado às vivências do lugar e de suas gentes, não sendo apenas contemplados, mas vividos, usados e experimentados

STUDI NUMERIK KINERJA STEEL PLATE SHEAR WALL DENGAN SUSUNAN LUBANG LURUS AKIBAT PEMBEBANAN STATIK MONOTONIK

Gempa bumi menyebabkan kerusakan pada infrastruktur seperti bangunan gedung. Untuk mengurangi kerusakan tersebut, maka dibutuhkan suatu desain struktur yang baik dan dapat menahan beban gempa. Tujuan penelitian ini untuk mengetahui kinerja Steel Plate Shear Wall akibat pengaruh variasi jumlah perforasi lurus akibat pembebanan statik monotonik. Kemudian juga untuk menjadi acuan dalam perencanaan struktur konstruksi baja yang memakai shear wall berperforasi dan bisa turut berkontribusi dalam penelitian di dunia konstruksi. Penelitian ini dilakukan dengan prosedur metode numerik memakai aplikasi MSC. Nastran & Patran. Penelitian ini, menganalisis kinerja struktur berupa beban pada drift ratio 4% dan kekakuan pada daerah garis linear. Model yang digunakan steel plate shear wall yang diberi perforasi berdiameter 50 mm dengan konfigurasi perforasi lurus dengan ketebalan pelat 1 mm dan 2 mm. Material baja yang digunakan yaitu BJ37. Hasil penelitian menunjukkan bahwa, pertama setiap penambahan jumlah perforasi maka nilai beban akan mengalami penurunan. Kedua, untuk pelat dengan tebal 1 dan tebal 2 mengalami kenaikan pada drift ratio 4%. Ketiga, kekakuan struktur mengalami penurunan seiring dengan besarnya perforasi yang diberikan. Keempat, Tegangan awal terjadi di sisi diagonal pelat shear wall kemudian menyebar keseluruh bagian pelat shear wall

Effect of polymer architecture on Curcumin 1 encapsulation and release from PEGylated polymer nanoparticles: toward a drug delivery nano-platform to the CNS

We developed a nanoparticles (NPs) library from poly(ethylene glycol)–poly lactic acid comb-like polymers with variable amount of PEG. Curcumin was encapsulated in the NPs with a view to develop a delivery platform to treat diseases involving oxidative stress affecting the CNS. We observed a sharp decrease in size between 15 and 20% w/w of PEG which corresponds to a transition from a large solid particle structure to a “micelle-like” or “polymer nano-aggregate” structure. Drug loading, loading efficacy and release kinetics were determined. The diffusion coefficients of curcumin in NPs were determined using a mathematical modeling. The higher diffusion was observed for solid particles compared to “polymer nano-aggregate” particles. NPs did not present any significant toxicity when tested in vitro on a neuronal cell line. Moreover, the ability of NPs carrying curcumin to prevent oxidative stress was evidenced and linked to polymer architecture and NPs organization. Our study showed the intimate relationship between the polymer architecture and the biophysical properties of the resulting NPs and sheds light on new approaches to design efficient NP-based drug carriers

TRADIÇÕES ORAIS EM ZONAS DE FRONTEIRA: O USO DA HISTÓRIA ORAL NA (RE)VALORIZAÇÃO DAS PRÁTICAS CULTURAIS ATRAVÉS DAS VIVÊNCIAS, MEMÓRIAS E EDUCAÇÃO ENTRE OS BAWOYO DE YABI (CABINDA/ANGOLA).

A reflexão objetiva contribuir no uso da história oral como recurso de estudo sobre povo de tradições orais em zonas de fronteira. A história oral e a entrevista enquanto recurso nos permitiram a recolha e valorização das memórias dos Soba, anciãos e anciãs entrevistados/as. De igual modo, a (re)valorização do papel do narrador e suas experiências, sendo fundamentais para se compreender as práticas culturais locais. Pois, mesmo diante das adversidades e mudanças no contexto atual, esse povo (re)cria, (res)significa  e contextualiza suas práticas e conhecimentos mesmo repartindo sua lealdade por uma pluralidade de poderes. O trabalho por meio da história oral permitiu observar as vivências e realidades do povo da aldeia do Yabi (Cabinda/Angola), observando o que acontece e escutando o que é dito sobre suas práticas

Evaluation du statut nutritionnel et biologique d’un échantillon de personnes atteintes de glaucome à angle ouvert dans une population togolaise

Ce travail est une étude prospective menée d’octobre 2009 à juillet 2010. L’objectif a été d’évaluer dans un échantillon de population togolaise les facteurs biologiques et nutritionnels des patients atteints de glaucome à angle ouvert. L’étude a porté sur deux groupes d’individus des deux sexes : 35 patients ayant un glaucome à angle ouvert et 27 témoins. L’âge, le poids, la taille et l’IMC moyens ont été similaires entre les deux groupes. Les sujets ont tous subi le même bilan biologique. Le t-test a été utilisé pour l’évaluation statistique. Les résultats ont révélé que chez les patients, les taux moyens de glycémie, de cholestérol total, des triglycérides, de HDL-cholestérol et de LDL-cholestérol ont été plus élevés (p &lt; 0,001) comparativement à ceux des témoins. Le taux moyen de la créatinine chez les patients a été similaire à celui des témoins. Il en est de même pour les taux moyens de la protidémie. En ce qui concerne les transaminases et la GGT, les taux moyens chez les patients ont été plus élevés que chez les témoins (p &lt; 0,05). Il ressort de ces résultats que la glycémie, le cholestérol total, les HDL, les LDL, les triglycérides, les transaminases et la GGT pourraient être inclus dans les facteurs de risque du glaucome à angle ouvert. L’augmentation du taux de ces différents paramètres serait probablement d’origine alimentaire.Mots clés : Glaucome à angle ouvert, alimentation, bilan biologique

TRADIÇÕES ORAIS EM ZONAS DE FRONTEIRA: O USO DA HISTÓRIA ORAL NA (RE)VALORIZAÇÃO DAS PRÁTICAS CULTURAIS ATRAVÉS DAS VIVÊNCIAS, MEMÓRIAS E EDUCAÇÃO ENTRE OS BAWOYO DE YABI (CABINDA/ANGOLA).

A reflexão objetiva contribuir no uso da história oral como recurso de estudo sobre povo de tradições orais em zonas de fronteira. A história oral e a entrevista enquanto recurso nos permitiram a recolha e valorização das memórias dos Soba, anciãos e anciãs entrevistados/as. De igual modo, a (re)valorização do papel do narrador e suas experiências, sendo fundamentais para se compreender as práticas culturais locais. Pois, mesmo diante das adversidades e mudanças no contexto atual, esse povo (re)cria, (res)significa  e contextualiza suas práticas e conhecimentos mesmo repartindo sua lealdade por uma pluralidade de poderes. O trabalho por meio da história oral permitiu observar as vivências e realidades do povo da aldeia do Yabi (Cabinda/Angola), observando o que acontece e escutando o que é dito sobre suas práticas