Does the Choice of Extraction Site During Minimally Invasive Colorectal Surgery Change the Incidence of Incisional Hernia? Protocol for a Systematic Review and Network Meta-Analysis.

BACKGROUND: Various sites are used for specimen extraction in oncological minimally invasive colorectal surgery. The objective is to determine if the choice of extraction site modulates the incidence of incisional hernia (IH). METHODS/DESIGN: A systematic review will be performed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. MEDLINE, Embase and CENTRAL will be searched to look for original studies reporting the incidence of IH after minimally invasive colorectal surgery. Studies will be excluded from the analysis if: 1) they do not report original data, 2) the outcome of interest (incidence of incisional hernia) is not clearly reported and does not allow to extrapolate and/or calculate the required data for network meta-analysis, 3) they include pediatric patients, 4) they include a patients' population with a conversion rate to laparotomy >10%, 5) they do not compare at least two different extraction sites for the operative specimen, 6) they report patients who underwent pure (and not hybrid) natural orifice transluminal endoscopic surgery (NOTES). Network meta-analysis will be performed to determine the incidence of IH per extraction site. DISCUSSION: By determining which specimen extraction site leads to reduced rate of IH, this systematic review and network meta-analysis will help colorectal surgeons to choose their extraction site and reduce the morbidity and costs associated with IH. REGISTRATION: The systematic review and meta-analysis protocol is registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with number CRD42021272226. HIGHLIGHTS: Various sites are used for specimen extraction in oncological minimally invasive colorectal surgery, and the choice of the site may probably modulate the incidence of incisional hernia.The present protocol aims to design a systematic review which will identify original studies comparing two extraction sites during minimally invasive colorectal surgery in terms of incidence of incisional hernia.Network meta-analysis will be performed to determine the incidence of IH per extraction site

Laryngeal Reinnervation Using Ansa Cervicalis for Thyroid Surgery-Related Unilateral Vocal Fold Paralysis: A Long-Term Outcome Analysis of 237 Cases

To evaluate the long-term efficacy of delayed laryngeal reinnervation using the main branch of the ansa cervicalis in treatment of unilateral vocal fold paralysis (UVFP) caused by thyroid surgery.UVFP remains a serious complication of thyroid surgery. Up to now, a completely satisfactory surgical treatment of UVFP has been elusive.From Jan. 1996 to Jan. 2008, a total of 237 UVFP patients who underwent ansa cervicalis main branch-to-recurrent laryngeal nerve (RLN) anastomosis were enrolled as UVFP group; another 237 age- and gender-matched normal subjects served as control group. Videostroboscopy, vocal function assessment (acoustic analysis, perceptual evaluation and maximum phonation time), and electromyography were performed preoperatively and postoperatively. The mean follow-up period was 5.2±2.7 years, ranging from 2 to 12 years.>0.05, respectively). Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle.Delayed laryngeal reinnervation with the main branch of ansa cervicalis is a feasible and effective approach for treatment of thyroid surgery-related UVFP; it can restore the physiological laryngeal phonatory function to the normal or a nearly normal voice quality

The metastasis associated protein S100A4: role in tumour progression and metastasis

The metastasis associated protein S100A4 is a small calcium binding protein that is associated with metastatic tumors and appears to be a molecular marker for clinical prognosis. Below we discuss its biochemical properties and possible cellular functions in metastasis including cell motility, invasion, apoptosis, angiogenesis and differentiation

Gene Therapy Restores Auditory and Vestibular Function in a Mouse Model of Usher Syndrome Type 1c

Because there are currently no biological treatments for deafness, we sought to advance gene therapy approaches to treat genetic deafness. We reasoned that gene delivery systems that target auditory and vestibular sensory cells with high efficiency would be required to restore complex auditory and balance function. We focused on Usher Syndrome, a devastating genetic disorder that causes blindness, balance disorders and profound deafness, and used a knock-in mouse model, Ush1c c.216G>A, which carries a cryptic splice site mutation found in French-Acadian patients with Usher Syndrome type IC (USH1C). Following delivery of wild-type Ush1c into the inner ears of neonatal Ush1c c.216G>A mice, we find recovery of gene and protein expression, restoration of sensory cell function, rescue of complex auditory function and recovery of hearing and balance behavior to near wild-type levels. The data represent unprecedented recovery of inner ear function and suggest that biological therapies to treat deafness may be suitable for translation to humans with genetic inner ear disorders

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Braided Carbon Fiber Rope Flow Characteristics

I am submitting the following technical subject for consideration as a thesis topic for the master degree: The reusable solid rocket motor (RSRM) nozzle internal joints are being evaluated for the incorporation of a carbon fiber rope (CFR) as a thermal barrier. The CFR is approximately 0.260 in. diameter and is composed of approximately 12,000 carbon fibers, woven in ten sheaths or layers. The CFR is manufactured by a sub-tier vendor and subsequently several of its manufacturing details are proprietary to that vendor. The CFR design intent is to prevent hot motor combustion products and slag from intruding into the joint scaling area while still approaching a vented joint design to avoid the detriments of gas jet impingement. As a member of the Heat Transfer section at Thiokol Propulsion, two main goals exist as part of this NASA funded design effort: (1) development of flow model through the CFR and (2) development of a heat transfer model through the CFR. While both models are needed and most probably interrelated, the gas flow model is being targeted as the subject matter. Essentially, the topic would be "Modeling of Gas Flow through a Braided Carbon Fiber Rope". An AIAA journal or conference paper is being considered through Thiokol/NASA as well. A sub-scale CFR flow test fixture was designed to simulate the relative levels of CFR compression. The test fixture provides the means to measure gas mass flow rate upstream of the CFR and the pressure and temperature both upstream and downstream of the CFR. The test fixture was designed to eliminate the possibility of dynamic gapping at the CFR location and provide minimal flow resistance to ambient for gases exiting the rope. The data collected in the experiment will be evaluated to define a permeability/flow resistance model. Two possibilities exist for the flow characteristics through the CFR from choked flow to strictly friction driven. A test matrix for evaluating the CFR has been compiled, which addresses both of these characteristics. The range of pressures to be tested covers a relatively low delta pressure where non-choked flow is impossible, while the high pressure shown is dictated by the RSRM joint operating pressure where choking is possible. The test matrix, was also designed for a range of rope compressions or test fixture gaps ranging from 0.025" to 0.070". These gaps are controlled by the range of RSRM full-scale hardware joint gaps that will be expected by virtue of the joint design