Adequate symptom relief justifies hepatic resection for benign disease

BACKGROUND: The purpose of this study was to evaluate the long-term results of partial liver resection for benign liver lesions. METHODS: All patients operated on for benign liver lesions from 1991 to 2002 were included. Information was retrieved from medical records, the hospital registration system and by a telephonic questionnaire. RESULTS: Twenty-eight patients with a median age of 41 years (17–71) were operated on (M/F ratio 5/23). The diagnosis was haemangioma in 8 patients, FNH in 6, HCA in 13 and angiomyolipoma in 1. Eight patients were known to have relevant co-morbidity. Median operating time was 207 minutes (45–360). The morbidity rate was 25% and no postoperative mortality was observed. Twenty-two patients (79%) had symptoms (mainly abdominal pain) prior to surgery. Twenty-five patients were reached for a questionnaire. The median follow up was 55 months (4–150). In 89% of patients preoperative symptoms had decreased or disappeared after surgery. Four patients developed late complications. CONCLUSION: Long-term follow up after liver surgery for benign liver lesions shows considerable symptom relief and patient satisfaction. In addition to a correct indication these results justify major surgery with associated morbidity and mortality

Infrared neurostimulation in ex-vivo rat sciatic nerve using 1470 nm wavelength.

OBJECTIVE: To design and implement a setup for ex-vivo optical stimulation for exploring the effect of several key parameters (optical power and pulse duration), activation features (threshold, spatial selectivity) and recovery characteristics (repeated stimuli) in peripheral nerves. APPROACH: A nerve chamber allowing ex-vivo electrical and optical stimulation was designed and built. A 1470 nm light source was chosen to stimulate the nerve. A photodiode module was implemented for synchronization of the electrical and optical channels. MAIN RESULTS: Compound Neural Action Potentials (CNAPs) were successfully generated with infrared light pulses of 200-2000 µs duration and power in the range of 3-10 W. These parameters determine a radiant exposure for stimulation in the range 1.59-4.78 J/cm2. Recruitment curves were obtained by increasing durations at a constant power level. Neural activation threshold is reached at a mean radiant exposure of 3.16 ± 0.68 J/cm2 and mean pulse energy of 3.79 ± 0.72 mJ. Repetition rates of 2-10 Hz have been explored. In 8 out of 10 sciatic nerves, repeated light stimuli induced a sensitisation effect in that the CNAP amplitude progressively grows, representing an increasing number of recruited fibres. In 2 out of 10 sciatic nerves, CNAPs were composed of a succession of peaks corresponding to different conduction velocities. SIGNIFICANCE: The reported sensitisation effect could shed light on the mechanism underlying Infrared NeuroStimulation (INS). Our results suggest that, in sharp contrast with electrical stimuli, optical pulses could recruit slow fibres early on. This more physiological order of recruitment opens the perspective for specific neuromodulation of fibre population who remained poorly accessible until now. Short high-power light pulses at wavelengths below 1.5 µm offer interesting perspectives for neurostimulation

Analysing vagus nerve spontaneous activity using finite element modelling

Objective. Finite element modelling has been widely used to understand the effect of stimulation on the nerve fibres. Yet the literature on analysis of spontaneous nerve activity is much scarcer. In this study, we introduce a method based on a finite element model, to analyse spontaneous nerve activity with a typical bipolar electrode recording setup, enabling the identification of spontaneously active fibres. We applied our method to the vagus nerve, which plays a key role in refractory epilepsy. Approach. We developed a 3D model including dynamic action potential propagation, based on the vagus nerve geometry. The impact of key recording parameters – inter-electrode distance and temperature – and uncontrolled parameters – fibre size and position in the nerve – on the ability to discriminate active fibres were quantified. A specific algorithm was implemented to detect and classify action potentials from recordings and tested on six rats in vivo vagus nerve recordings. Main results. Fibre diameters can be discriminated if they are below 3 µm and 7 µm, respectively for inter-electrode distances of 2 mm and 4 mm. The impact of the position of the fibre inside the nerve on fibre diameter discrimination, is limited. The range of active fibres identified by modelling in the vagus nerve of rats is in agreement with ranges found at histology. Significance. The nerve fibre diameter, directly proportional to the action potential propagation velocity, is related to a specific physiological function. Estimating the source fibre diameter is thus essential to interpret neural recordings. Among many possible applications, the present method was developed in the context of a project to improve vagus nerve stimulation therapy for epilepsy

Public opinion and environmental policy output: a cross-national analysis of energy policies in Europe

This article studies how public opinion is associated with the introduction of renewable energy policies in Europe. While research increasingly seeks to model the link between public opinion and environmental policies, the empirical evidence is largely based on a single case: the US. This limits the generalizability of findings and we argue accordingly for a systematic, quantitative study of how public opinion drives environmental policies in another context. Theoretically, we combine arguments behind the political survival of democratic leaders with electoral success and environmental politics. Ultimately, we suggest that office-seeking leaders introduce policies that seem favorable to the domestic audience; if the public prefers environmental protection, the government introduces such policies in turn. The main contribution of this research is the cross-country empirical analysis, where we combine data on the public's environmental attitudes and renewable energy policy outputs in a European context between 1974 and 2015. We show that as public opinion shifts towards prioritizing the environment, there is a significant and positive effect on the rate of renewable energy policy outputs by governments in Europe. To our knowledge, this is the first systematic, quantitative study of public opinion and environmental policies across a large set of countries, and we demonstrate that the mechanisms behind the introduction of renewable energy policies follow major trends across European states

ESSenTIAL : EPIXfab services specifically targeting (SME) industrial takeup of advanced silicon photonics

ePIXfab brings silicon photonics within reach of European small and medium sized enterprises, thereby building on its track record and its integration into Europractice. To this end, ePIXfab offers affordable access to standardized active and passive silicon photonic IC and packaging technology, a path from design to manufacturing and hands-on training. Based on a consortium of major research institutes with silicon photonics expertise, ePIXfab reaches out to European industry and supports them to evaluate silicon photonics in the context of concrete applications and markets. In order to ensure low-cost, quick access and scalability to manufacturing, the maturity of silicon photonic IC technology is enhanced by setting up a library of generic devices, a level of process and device benchmarking and a well maintained design flow. For the first time, devices in a standard package are offered to facilitate measurements. Training programs on the IC and packaging services are also offered, including hands-on training in making designs. Maturity, standardization and sustainability are driven by a steadily growing worldwide user base

Successful radiopeptide targeting of metastatic anaplastic meningioma: Case report

A patient with anaplastic meningioma and lung metastases resistant to conventional treatment underwent radiopeptide therapy with 177Lu- DOTA-octreotate in our institute. The treatment resulted in significant improvement in patient's quality of life and inhibition of tumor progression. This case may eventually help to establish the value of radiopeptide therapy in patients with this rare condition

Attenuation of Hippocampal Evoked Potentials in vivo by Activation of GtACR2, an Optogenetic Chloride Channel

Aim GtACR2, a light-activated chloride channel, is an attractive tool for neural inhibition as it can shunt membrane depolarizations. In this study, we assessed the effect of activating GtACR2 on in vivo hippocampal CA1 activity evoked by Schaffer collateral (SC) stimulation. Methods Adult male Wistar rats were unilaterally injected with 0.5 mu L of adeno associated viral vector for induction of GtACR2-mCherry (n = 10, GtACR2 group) or mCherry (n = 4, Sham group) expression in CA1 pyramidal neurons of the hippocampus. Three weeks later, evoked potentials (EPs) were recorded from the CA1 subfield placing an optrode (bipolar recording electrode attached to an optic fiber) at the injection site and a stimulation electrode targeting SCs. Effects of illumination parameters required to activate GtACR2 such as light power densities (LPDs), illumination delays, and light-pulse durations were tested on CA1 EP parameters [population spike (PS) amplitude and field excitatory postsynaptic potential (fEPSP) slope]. Results In the GtACR2 group, delivery of a 10 ms light-pulse induced a negative deflection in the local field potential which increased with increasing LPD. When combined with electrical stimulation of the SCs, light-induced activation of GtACR2 had potent inhibitory effects on CA1 EPs. An LPD of 160 mW/mm(2) was sufficient to obtain maximal inhibition CA1 EPs. To quantify the duration of the inhibitory effect, a 10 ms light-pulse of 160 mW/mm(2) was delivered at increasing delays before the CA1 EPs. Inhibition of EPs was found to last up to 9 ms after the cessation of the light-pulse. Increasing light-pulse durations beyond 10 ms did not result in larger inhibitory effects. Conclusion Precisely timed activation of GtACR2 potently blocks evoked activity of CA1 neurons. The strength of inhibition depends on LPD, lasts up to 9 ms after a light-pulse of 10 ms, and is independent of the duration of the light-pulse given