The impact of members of the Society of University Surgeons on the scholarship of American surgery

Background A core objective of the Society of University Surgeons (SUS) is research focused: to “advance the art and science of surgery through original investigation.” This study sought to determine the current impact of the SUS on academic surgical productivity. Methods Individual faculty data for numbers of publications, citations, and National Institute of Health (NIH) funding history were collected for 4,015 surgical faculty at the top 55 NIH-funded departments of surgery using SCOPUS and the NIH Research Portfolio Online Reporting Tools. SUS membership was determined from membership registry data. Results Overall, 502 surgical faculty (12.5%) were SUS members with 92.7% holding positions of associate or full professor (versus 59% of nonmembers). Median publications (P) and citations (C) among SUS members were P: 112, C: 2,460 versus P: 29, C: 467 for nonmembers (P < .001). Academic productivity was considerably higher by rank for SUS members than for nonmembers: associate professors (P: 61 vs 36, C: 1,199 vs 591, P < .001) and full professors (P: 141 vs 81, C: 3,537 vs 1,856, P < .001). Among full professors, SUS members had much higher rates of NIH funding than did nonmembers (52.6% vs 26%, P < .05) and specifically for R01, P01, and U01 awards (37% vs 17.7%, P < .01). SUS members were 2 times more likely to serve in divisional leadership or chair positions (23.5% vs 10.2%, P < .05). Conclusion SUS society members are a highly productive academic group. These data support the premise that the SUS is meeting its research mission and identify its members as very academically productive contributors to research and scholarship in American surgery and medicine

Acetyl CoA Carboxylase Inactivation and Meiotic Maturation in Mouse Oocytes

In mouse oocytes, meiotic induction by pharmacological activation of PRKA (adenosine monophosphate-activated protein kinase; formerly known as AMPK) or by hormones depends on stimulation of fatty acid oxidation (FAO). PRKA stimulates FAO by phosphorylating and inactivating acetyl CoA carboxylase (ACAC; formerly ACC), leading to decreased malonyl CoA levels and augmenting fatty-acid transport into mitochondria. We investigated a role for ACAC inactivation in meiotic resumption by testing the effect of two ACAC inhibitors, CP-640186 and Soraphen A, on mouse oocytes maintained in meiotic arrest in vitro. These inhibitors significantly stimulated the resumption of meiosis in arrested cumulus cell-enclosed oocytes, denuded oocytes, and follicle-enclosed oocytes. This stimulation was accompanied by an increase in FAO. Etomoxir, a malonyl CoA analogue, prevented meiotic resumption as well as the increase in FAO induced by ACAC inhibition. Citrate, an ACAC activator, and CBM-301106, an inhibitor of malonyl CoA decarboxylase, which converts malonyl CoA to acetyl CoA, suppressed both meiotic induction and FAO induced by follicle-stimulating hormone, presumably by maintaining elevated malonyl CoA levels. Mouse oocyte-cumulus cell complexes contain both isoforms of ACAC (ACACA and ACACB); when wild-type and Acacb−/− oocytes characteristics were compared, we found that these single-knockout oocytes showed a significantly higher FAO level and a reduced ability to maintain meiotic arrest, resulting in higher rates of germinal vesicle breakdown. Collectively, these data support the model that ACAC inactivation contributes to the maturation-promoting activity of PRKA through stimulation of FAO

Xanthogranulomatous prostatitis: Rare presentation of rare disease

Granulomatous inflammation of the prostate is a rare type of inflammation of the prostate. It is of various types, with the non-specific type of granulomatous inflammation being the most common. Xanthogranulomatous prostatitis is a rare type of granulomatous prostatitis of which very few cases have been reported. Histologically it is characterized by the presence of pale-looking foamy macrophages. It can be an incidental finding after transurethral resection of the prostate (TURP), although it may mimic prostatic malignancy clinically, biochemically, and rarely histologically. We report a rare case of xanthogranulomatous prostatitis which presented as a prostatic abscess, a presentation never reported in literature so far. The patient was managed with TURP

Study of the morphological patterns and association of <i>Epstein-Barr virus</i> and <i>human herpes virus 8</i> in acquired immunodeficiency deficiency syndrome-related reactive lymphadenopathy

Aims: Study of the morphological patterns of acquired immunodeficiency syndrome (AIDS)-related lymphadenopathy. Settings and Design: We retrospectively selected cases of AIDS-related benign lymphadenopathy. Cases with lymphomas, frank granulomas and necrosis were excluded. We analyzed different morphological patterns and correlated these with immunophenotypic markers along with viral markers human herpesvirus 8-latency-associated nuclear antigen (HHV8-LANA), and Epstein-Barr virus-encoded ribonucleic acid (EBER) studies via in situ hybridization (EBER-ISH). Materials and Methods: We present the morphological patterns of 13 cases of human immunodeficiency virus (HIV)-reactive lymph nodes and their clinical, hematological, biochemical and radiological parameters with special emphasis on the presence or absence of viral markers, including HHV8 and EBV. Results: Common patterns included follicular hyperplasia only (five cases), mixed pattern of follicular hyperplasia with burnt-out germinal centres (four cases), completely atretic follicle (two cases), folliculolysis (11 cases), dumbbell-shaped follicles (three each), progressive transformation of germinal centers (four cases), T-zone expansion (two cases), Reed Sternberg (RS) cells like immunoblasts (two cases), Castleman&#x2032;s-like features with lollipop-like follicles (three cases) and a spindle cell prominence (one case). CD8&#x002B; T-cells were predominant in 12 cases. CD8&#x002B; T-cells were prominent in germinal centers (eight cases). Plasmablasts were seen in four cases within the perigerminal center area. Immunohistochemistry for HHV8, i.e. HHV8-LANA were negative in all cases while EBER was detected in 11 cases in the centrocyte-like B cells. Two cases of multicentric Castleman&#x2032;s disease expressed EBER; however, they did not express HHV8. Conclusion: The wide spectrum of histological changes in HIV-associated lymphadenopathy requires recognition. The histological changes can mimic those of other infective lymphadenitis, follicular lymphoma, Castleman&#x2032;s disease, progressive transformation of germinal center, Hodgkin&#x2032;s disease and spindle cell neoplasms. Presence of EBV is common while HHV8 was not seen

Ultrasonic osteotome: A cutting edge technology, our experience in 96 patients

Background The ultrasonic osteotome is a tissue-specific device that allows the surgeon to make precise osteotomies while protecting collateral or adjacent soft tissue structures. The recurring impacts pulverize the noncompliant crystalline structure resulting in a precise cut. The more compliant adjacent soft tissue is not affected by the ultrasonic oscillation. Objective The purpose of this study is to present our experience of using this technology in osteotomies. Materials and Methods We reviewed 96 patients, both male and female; of different ages in which ultrasonic osteotome was used to perform an osteotomy of different manners (Craniotomy, laminotomy, facetectomy, etc.). Patients with head injury, spine injury, degenerative spine diseases, and brain tumors were included in this study. Results In all these patients, the bone cut was even with minimal surrounding bone loss. The time required for the osteotomy was reduced to half. There was no damage to underlying dura, cord or nerve structures. Conclusions Ultrasonic osteotome is a safe and effective ultrasonic bone cutting device that can be used to facilitate osteotomies in various types of cranial and spinal surgeries. This device allows precision bone cutting with minimal surrounding bone loss and obviates the risk associated with the use of high-speed burrs and oscillating saws

Impact of Gleason pattern up gradation after radical prostatectomy for carcinoma prostate patients with low biopsy score (≤ 6)

Context: Biopsy Gleason score (b-GS) is often different from the Gleason score obtained after analysis of radical prostatectomy (RP) specimen (rp-GS). Upgradation has an important implication in decision making for cancer prostate management, and is the focus of this study. Aim: To evaluate Gleason score upgradation after radical prostatectomy with low biopsy score (≤ 6) and its correlation to pathological findings and outcome. Settings and Design: This was a retrospective analysis of 257 cases of prostate cancer patients with initial b-GS ≤ 6, over a period of 14 years. Materials and Methods: Data were divided into two groups according to (rp- GS) as 1) Group A (n=151; rp-GS ≤ 6 ) 2) and Group B(n=106; rp-GS ≥7). Both groups were compared in terms of the following: 1) preoperative variables e.g. age, PSA, transurethral resection of prostate (TURP) status, clinical T stage; 2) pathological features - rp GS, pathological stage (pT), capsular penetration, cut margin, seminal vesicle and lymph node status; 3) biochemical recurrence, overall and cancer specific mortality. Statistical Analysis Used: Student's t test and Chi-square test. Results: Group B had worse pathological features, except lymph node invasion, and they received significantly more adjuvant hormonal/local radiotherapy and had higher recurrence rate. However, the overall and cancer-specific mortality were similar in both the groups. Conclusions: b-GS upgradation after radical prostatectomy is frequent and correlates with adverse pathological features, higher use of adjuvant therapy and higher recurrence rate. In Group B, adjuvant therapy delays the biochemical or clinical relapse and controls mortality in short-term follow up. Group A had favorable pathological findings and less recurrence rate

The Dynamics of Suspended Sediment in a Typical Alpine Alluvial River Reach: Insight From a Seasonal Survey

International audienceThe transport of suspended sediment is associated with important social, economic, and environmental issues. It is still unclear, however, how suspended sediments eroded on hillslopes are transferred downstream through the river system. In this study, we aimed to investigate this process by applying a sediment budget approach to a typical 3.5-km-long Alpine braided reach. Using high-frequency suspended load measurements combined with Monte Carlo simulations for uncertainty propagation, we observed a significant buffering behavior of the reach studied. Thirty-two of the 48 events observed during the 2-month campaign showed significant differences between upstream and downstream mass transported as suspension, despite the reach studied was short compared to the upstream drainage area (130 km(2)). These differences at the event scale varied widely within an envelope comprised between a net erosion equivalent to 74% of upstream suspended mass and a net deposition equivalent to 71%. Budgets were found to be controlled at a nearly instantaneous time scale by the liquid discharges and the suspended sediment concentrations in an opposite way: for low upstream concentrations, net erosion increased when the discharges increased, while above a certain concentration, net deposition increased when the concentrations increased. Moreover, coarse particles mobility in the reach (characterized via bedload transport measurements) appeared to have a strong influence on the availability of suspended particles as both quantities evolved concomitantly through time. These observations have important implications for our understanding and modeling of the transfer of suspended particles in gravel bedded streams