Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass

<p>Abstract</p> <p>Background</p> <p>Upper gastrointestinal haemorrhage is mainly caused by ulcers. Gastric varicosis due to portal hypertension can also be held responsible for upper gastrointestinal bleeding. Portal hypertension causes the development of a collateral circulation from the portal to the caval venous system resulting in development of oesophageal and gastric fundus varices. Those may also be held responsible for upper gastrointestinal haemorrhage.</p> <p>Case presentation</p> <p>In this study, we describe the case of a 69-year-old male with recurrent severe upper gastrointestinal bleeding caused by arterial submucosal collaterals due to idiopathic splenic artery thrombosis. The diagnosis was secured using endoscopic duplex ultrasound and angiography. The patient was successfully treated with a laparoscopic splenectomy and complete dissection of the short gastric arteries, resulting in the collapse of the submucosal arteries in the gastric wall. Follow-up gastroscopy was performed on the 12^thpostoperative week and showed no signs of bleeding and a significant reduction in the arterial blood flow within the gastric wall. Subsequent follow-up after 6 months also showed no further gastrointestinal bleeding as well as subjective good quality of life for the patient.</p> <p>Conclusion</p> <p>Submucosal arterial collaterals must be excluded by endosonography via endoscopy in case of recurrent upper gastrointestinal bleeding. Laparoscopic splenectomy provides adequate treatment in preventing any recurrent bleeding, if gastric arterial collaterals are caused by splenic artery thrombosis.</p

Optimizing community-driven development through sage tradition in Cameroon

Powering community development requires a re-invention of traditional authority. This paper interrogates this proposition: how does sage tradition engender social resilience and what is the impact of traditional authority on the modern governance architecture? Sage tradition construed culturally as elder-led authority is anchored on wisdom and respect for elders—a pivotal asset in community development transactions. Informed by indigenous knowledge, social capital and asset-based concepts, an empirical account of strategic leadership by the elderly is proffered, uncovering indigenous governance in the North West Region, Cameroon. A pyramidal power structure validates village elders as key players in advancing social justice. They offer counsel and arbitrate in community affairs and mobilise community members for infrastructure provision—community halls, equipping schools, digging roads, building bridges and supply of fresh water. Though elder esteemed traditions prove perfunctory, findings show communities are benefiting from the accumulated, incremental cultural assets factored into local development. The paper concludes that thriving cultural assets should be amalgamated through a policy drive that taps into the utility of traditional authority, in synergy with modern state institutions to bolster social development, address poverty and social inequality

Target Region Selection Is a Critical Determinant of Community Fingerprints Generated by 16S Pyrosequencing

Pyrosequencing of 16S rRNA genes allows for in-depth characterization of complex microbial communities. Although it is known that primer selection can influence the profile of a community generated by sequencing, the extent and severity of this bias on deep-sequencing methodologies is not well elucidated. We tested the hypothesis that the hypervariable region targeted for sequencing and primer degeneracy play important roles in influencing the composition of 16S pyrotag communities. Subgingival plaque from deep sites of current smokers with chronic periodontitis was analyzed using Sanger sequencing and pyrosequencing using 4 primer pairs. Greater numbers of species were detected by pyrosequencing than by Sanger sequencing. Rare taxa constituted nearly 6% of each pyrotag community and less than 1% of the Sanger sequencing community. However, the different target regions selected for pyrosequencing did not demonstrate a significant difference in the number of rare and abundant taxa detected. The genera Prevotella, Fusobacterium, Streptococcus, Granulicatella, Bacteroides, Porphyromonas and Treponema were abundant when the V1–V3 region was targeted, while Streptococcus, Treponema, Prevotella, Eubacterium, Porphyromonas, Campylobacer and Enterococcus predominated in the community generated by V4–V6 primers, and the most numerous genera in the V7–V9 community were Veillonella, Streptococcus, Eubacterium, Enterococcus, Treponema, Catonella and Selenomonas. Targeting the V4–V6 region failed to detect the genus Fusobacterium, while the taxa Selenomonas, TM7 and Mycoplasma were not detected by the V7–V9 primer pairs. The communities generated by degenerate and non-degenerate primers did not demonstrate significant differences. Averaging the community fingerprints generated by V1–V3 and V7–V9 primers providesd results similar to Sanger sequencing, while allowing a significantly greater depth of coverage than is possible with Sanger sequencing. It is therefore important to use primers targeted to these two regions of the 16S rRNA gene in all deep-sequencing efforts to obtain representational characterization of complex microbial communities

Gentamicin supplemented polyvinylidenfluoride mesh materials enhance tissue integration due to a transcriptionally reduced MMP-2 protein expression

<p>Abstract</p> <p>Background</p> <p>A beneficial effect of gentamicin supplemented mesh material on tissue integration is known. To further elucidate the interaction of collagen and MMP-2 in chronic foreign body reaction and to determine the significance of the MMP-2-specific regulatory element (RE-1) that is known to mediate 80% of the MMP-2 promoter activity, the spatial and temporal transcriptional regulation of the MMP-2 gene was analyzed at the cellular level.</p> <p>Methods</p> <p>A PVDF mesh material was surface modified by plasma-induced graft polymerization of acrylic acid (PVDF+PAAc). Three different gentamicin concentrations were bound to the provided active sites of the grafted mesh surfaces (2, 5 and 8 μg/mg). 75 male transgenic MMP-2/LacZ mice harbouring the LacZ reporter gene under control of MMP-2 regulatory sequence -1241/+423, excluding the RE-1 were randomized to five groups. Bilateral of the abdominal midline one of the five different meshes was implanted subcutaneously in each animal. MMP-2 gene transcription (anti-ß-galactosidase staining) and MMP-2 protein expression (anti-MMP-2 staining) were analyzed semiquantitatively by immunohistochemistry 7, 21 and 90 days after mesh implantation. The collagen type I/III ratio was analyzed by cross polarization microscopy to determine the quality of mesh integration.</p> <p>Results</p> <p>The perifilamentary ß-galactosidase expression as well as the collagen type I/III ratio increased up to the 90^thday for all mesh modifications, whereas no significant changes could be observed for MMP-2 protein expression between days 21 and 90. Both the 5 and 8 μg/mg gentamicin group showed significantly reduced levels of ß-galactosidase expression and MMP-2 positive stained cells when compared to the PVDF group on day 7, 21 and 90 respectively (5 μg/mg: p < 0.05 each; 8 μg/mg: p < 0.05 each). Though the type I/III collagen ratio increased over time for all mesh modifications significant differences to the PVDF mesh were only detected for the 8 μg/mg group at all 3 time points (p < 0.05 each).</p> <p>Conclusions</p> <p>Our current data indicate that lack of RE-1 is correlated with increased mesh induced MMP-2-gene expression for coated as well as for non-coated mesh materials. Gentamicin coating reduced MMP-2 transcription and protein expression. For the 8 μg/mg group this effect is associated with an increased type I/III collagen ratio. These findings suggest that gentamicin is beneficial for tissue integration after mesh implantation, which possibly is mediated via RE-1.</p

Situation, Figuration und Gewalt. Versuch eines gewaltsoziologischen Dialoges zwischen Randall Collins und Norbert Elias am Beispiel sexueller Kriegsgewalt

Ebner J, Stopfinger M. Situation, Figuration und Gewalt. Versuch eines gewaltsoziologischen Dialoges zwischen Randall Collins und Norbert Elias am Beispiel sexueller Kriegsgewalt. Österreichische Zeitschrift für Soziologie. 2020;45(S1):43-67.In diesem Beitrag werden zwei in der soziologischen Gewaltforschung etablierte Ansätze – die mikrosoziologisch-situationistische Gewalttheorie von Randall Collins und die figurations- bzw. prozesssoziologische Perspektive von Norbert Elias – auf ihre Eignung für die Analyse von sexueller Kriegsgewalt überprüft. Nach einer kurzen Diskussion des Forschungsstandes zu sexueller Kriegsgewalt wird dieses Thema einmal mit Collins und einmal mit Elias beleuchtet. Danach werden die beiden Zugänge einander gegenübergestellt, um Unterschiede und Gemeinsamkeiten herauszuarbeiten. Darauf aufbauend wird versucht, die Fruchtbarkeit eines „pragmatischen Dialoges“ zwischen einem mikro- und einem figurationssoziologisch inspirierten Ansatz auszuloten. Abschließend wird diskutiert, welche Folgerungen sich daraus für die Forschung zu sexueller Kriegsgewalt ergeben.In this paper, two approaches established in sociological violence research – Randall Collins’ micro-sociological theory of violence and Norbert Elias’ figuration- and process-sociological perspective—are examined for their suitability for the analysis of sexual violence in war. After a brief discussion of the current state of research on sexual violence in war, this topic will be examined once with Collins and once with Elias. The two approaches are then juxtaposed in order to highlight differences and similarities. Building on this, the fruitfulness of a “pragmatic dialogue” between a micro- and a figuration-sociologically inspired approach will be explored. The concluding section discusses the implications for research on sexual violence in war

Validation of a T-RFLP Technique for the Precise Qualitative and Quantitative Characterization of Microbioal Communities by Using an Automated High Throughput Multi-Capillary Electrophoresis Device

Background: The analysis of microbial communities is of importance in many cases of life sciences and bioengineering. Traditional techniques of investigations like culture or cloning methods are characterized by many disadvantages. They are by and large unable to give a total qualitative and quantitative view of the total amount of microorganisms themselves, their interactions among each other and with their environment. Method: We generated species specfic and fluorescently labeled 16S rRNA gene fragments by the T-RFLP technique. For this purpose bacterial DNA of clinically important microorganisms of different genome sizes (P. aeruginosa, Campylobacter jejuni, Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae, Burkholderia cepacia, Mycobacterium avium, Stenotrophomonas maltophilia, Alcaligenes xylosoxidans) were amplified by PCR using FAM-labeled 8-27f primer and unlabeled 1507-1492r primer (E. coli 16S rRNA);, using 8-27f and 1507-1492r. The amplfied DNA was digested with the restriction enzyme Hha I. For the separation of these fragments we validated a T-RFLP technique to an automated high throughput multi-capillary electrophoresis device (ABI 3100 Genetic Analysis?) with regard to a precise qualitative and quantitative characterization of microbial communities. We constructed a single stranded ROX labeled sizing standard up to for accurate sizing up to 780bp. The differences from the nominal size was less than half a base pair. Additionally we generated an internal quantification standard and investigated the minimal detectable concentration. The standard error was less than