Open lateral sphincterotomy - A method of choice in the treatment of chronic anal fissure. Indications and results

Aim: The key to the treatment of chronic anal fissures is the reduction of the abnormal values of anal resting pressure. The aim of the surgical treatment is to reduce the activity of the internal anal sphincter and to provide proper conditions for the fissure to cure, which can be achieved by internal sphincterotomy. In the modern surgical practice the internal sphincterotomy is performed away from the fissure, lateral of the last, using open or closed technique.Methods: In our study we performed open lateral internal sphincterotomy (OLST) of 82 patients with chronic anal fissure, compared to a control group of 231 patients, treated with different methods. Results: We didn`t register any recurrences in the sixth post-operative moth after OLST. 11% of patients with OLST were with registered incontinence after the sixth post-operative month compared with 4.4% in non-OLST patients. The data was statistically significant (p=0.032)Conclusion: Choosing an OLST as a method for treatment of chronic anal fissure requires careful selection of patients. It is not recommended for patients with a risk of incontinence like those with a previous birth trauma, age beyond 60 years, previous ano-rectal operations, neurological diseases and low values in anal resting pressure.Aim: The key to the treatment of chronic anal fissures is the reduction of the abnormal values of anal resting pressure. The aim of the surgical treatment is to reduce the activity of the internal anal sphincter and to provide proper conditions for the fissure to cure, which can be achieved by internal sphincterotomy. In the modern surgical practice the internal sphincterotomy is performed away from the fissure, lateral of the last, using open or closed technique.Methods: In our study we performed open lateral internal sphincterotomy (OLST) of 82 patients with chronic anal fissure, compared to a control group of 231 patients, treated with different methods. Results: We didn`t register any recurrences in the sixth post-operative moth after OLST. 11% of patients with OLST were with registered incontinence after the sixth post-operative month compared with 4.4% in non-OLST patients. The data was statistically significant (p=0.032)Conclusion: Choosing an OLST as a method for treatment of chronic anal fissure requires careful selection of patients. It is not recommended for patients with a risk of incontinence like those with a previous birth trauma, age beyond 60 years, previous ano-rectal operations, neurological diseases and low values in anal resting pressure

Deroofing - a method of choice in the treatment of suppurative perineal hidradenitis

Purpose: Suppurative hidradenitis is a chronic relapsing inflammatory disease that affects the apocrine sweat glands. Therefore, it is most often located in the axilla, groin and perianal area. Usually, people of working age affected. Perineal and perianal locations cover about 37% of the total morbidity rate and are more common in males. The objective of this study was to share our experience with the application of deroofing for the treatment of purulent perineal hidradenitis.Material and methods: This prospective interventional study covered 13 patients with suppurative fistulasing hidradenitis of perineum treated in Division of Coloproctology and Septic Surgery, Georgi Stranski University Hospital of Pleven for the period from 2008 till 2013.Results: The interval between the occurrence of disease and its surgical treatment was very long - from two to 36 years (average of 9,2 years). It resulted from the progression of the disease with enlarged soft tissue involvement. Sometimes, the disease was complicated by chroniosepsis. The average hospital stay was 13,5-day long. Operative wounds healed secondarily at an average of about 30 days. The patients were followedup for six months, one year and two years. Two patients with relapses on the sixth postoperative month were hospitalized again. The surgical intervention warranted good results.Conclusion: Treatment of suppurative hidradenitis of the perineum is complex, both in terms of local status and systematic violations resulting in chronic infection. There are numerous surgical techniques for treating this pathology. The advantages of deroofing are the following: minimal trauma to the patient, application by using local anesthesia at the early stage in order to minimize hospital stay, no need of special equipment, a lower recurrence rate than the other methods and formation of aesthetically acceptable scar

Ruthenium-Catalyzed Azide–Thioalkyne Cycloadditions in Aqueous Media: A Mild, Orthogonal, and Biocompatible Chemical Ligation

The development of efficient metal-promoted bioorthogonal ligations remains as a major scientific challenge. Demonstrated herein is that azides undergo efficient and regioselective room-temperature annulations with thioalkynes in aqueous milieu when treated with catalytic amounts of a suitable ruthenium complex. The reaction is compatible with different biomolecules, and can be carried out in complex aqueous mixtures such as phosphate buffered saline, cell lysates, fetal bovine serum, and even living bacteria (E. coli). Importantly, the reaction is mutually compatible with the classical CuAACThis work has received financial support from Spanish grants (SAF2016-76689-R and SAF2013-41943-R), the Xunta de Galicia (2015-CP082 and Centro Singular de Investigaciln de Galicia accreditation 2016-2019 ED431G/09), the European Union (European Regional Development Fund - ERDF), and the ERC (Adv. Grant 340055)S

Hybrid Interfaces in Molecular Spintronics

Molecular/inorganic multilayer heterostructures are gaining attention in molecular electronics and more recently in new generation spintronic devices. The intrinsic properties of molecular materials as low cost, tuneability, or long spin lifetimes were the original reasons behind their implementation. However, the non-innocent role played by these hybrid interfaces is a determinant factor in the device performance. In this account we will give an overview about different types of hybrid molecular system/ferromagnet interfaces, which can be of direct application in molecular spintronics. This includes the insertion of a 2D material in between the molecular system and the ferromagnet. As perspective, new hybrid interfaces able to tune the spin properties under an external stimulus, are proposed. These smart interfaces, based on switchable magnetic molecules or flexible MOFs, can open the way to new multifunctional spintronic devices able to couple the spin with a second property

Site-Specific Bioconjugation of a Murine Dihydrofolate Reductase Enzyme by Copper(I)-Catalyzed Azide-Alkyne Cycloaddition with Retained Activity

Cu(I)-catalyzed azide-alkyne cycloaddition (CuAAC) is an efficient reaction linking an azido and an alkynyl group in the presence of copper catalyst. Incorporation of a non-natural amino acid (NAA) containing either an azido or an alkynyl group into a protein allows site-specific bioconjugation in mild conditions via CuAAC. Despite its great potential, bioconjugation of an enzyme has been hampered by several issues including low yield, poor solubility of a ligand, and protein structural/functional perturbation by CuAAC components. In the present study, we incorporated an alkyne-bearing NAA into an enzyme, murine dihydrofolate reductase (mDHFR), in high cell density cultivation of Escherichia coli, and performed CuAAC conjugation with fluorescent azide dyes to evaluate enzyme compatibility of various CuAAC conditions comprising combination of commercially available Cu(I)-chelating ligands and reductants. The condensed culture improves the protein yield 19-fold based on the same amount of non-natural amino acid, and the enzyme incubation under the optimized reaction condition did not lead to any activity loss but allowed a fast and high-yield bioconjugation. Using the established conditions, a biotin-azide spacer was efficiently conjugated to mDHFR with retained activity leading to the site-specific immobilization of the biotin-conjugated mDHFR on a streptavidin-coated plate. These results demonstrate that the combination of reactive non-natural amino acid incorporation and the optimized CuAAC can be used to bioconjugate enzymes with retained enzymatic activityope