Corrective treatment and anatomic considerations for laparoscopic cholecystectomy injuries

BACKGROUND: Complete reports of biliary and vascular injuries after laparoscopic cholecystectomy are rare. STUDY DESIGN: Fifteen patients with complex laparoscopic cholecystectomy injuries underwent corrective operations. The injuries consisted of 14 bile duct injuries and one large laceration of a cirrhotic liver. Five of the bile duct injuries were accompanied by inadvertent occlusion of the right hepatic artery, and one was further complicated by portal vein occlusion. One hepatic artery occlusion and one portal vein occlusion were successfully reconstructed. Two patients with arterial occlusion required right hepatic lobectomy. Corrective biliary operations consisted of common hepaticojejunostomy (seven cases), right and left hepaticojejunostomies (one case), right anterior and left hepaticojejunostomies (two cases), right hepaticojejunostomy (one case), right posterior hepaticojejunostomy (one case), and left hepaticojejunostomy after right lobectomy (two cases). RESULTS: Except for a patient with a severe laceration of a cirrhotic liver who died as a result of hepatic failure, the remaining 14 patients are alive and well with normal hepatic function tests at six and 37 months after corrective operations. CONCLUSIONS: A knowledge of anatomy is critical to the prevention of injuries to the hepatobiliary tree and related structures during laparoscopic cholecystectomy

Bino Dark Matter and Big Bang Nucleosynthesis in the Constrained E6SSM with Massless Inert Singlinos

We discuss a new variant of the E6 inspired supersymmetric standard model (E6SSM) in which the two inert singlinos are exactly massless and the dark matter candidate has a dominant bino component. A successful relic density is achieved via a novel mechanism in which the bino scatters inelastically into heavier inert Higgsinos during the time of thermal freeze-out. The two massless inert singlinos contribute to the effective number of neutrino species at the time of Big Bang Nucleosynthesis, where the precise contribution depends on the mass of the Z' which keeps them in equilibrium. For example for mZ' > 1300 GeV we find Neff \approx 3.2, where the smallness of the additional contribution is due to entropy dilution. We study a few benchmark points in the constrained E6SSM with massless inert singlinos to illustrate this new scenario.Comment: 24 pages, revised for publication in JHE

High-density SNP association study of the 17q21 chromosomal region linked to autism identifies CACNA1G as a novel candidate gene.

Chromosome 17q11-q21 is a region of the genome likely to harbor susceptibility to autism (MIM(209850)) based on earlier evidence of linkage to the disorder. This linkage is specific to multiplex pedigrees containing only male probands (MO) within the Autism Genetic Resource Exchange (AGRE). Earlier, Stone et al.(1) completed a high-density single nucleotide polymorphism association study of 13.7 Mb within this interval, but common variant association was not sufficient to account for the linkage signal. Here, we extend this single nucleotide polymorphism-based association study to complete the coverage of the two-LOD support interval around the chromosome 17q linkage peak by testing the majority of common alleles in 284 MO trios. Markers within an interval containing the gene, CACNA1G, were found to be associated with Autism Spectrum Disorder at a locally significant level (P=1.9 × 10(-5)). While establishing CACNA1G as a novel candidate gene for autism, these alleles do not contribute a sufficient genetic effect to explain the observed linkage, indicating that there is substantial genetic heterogeneity despite the clear linkage signal. The region thus likely harbors a combination of multiple common and rare alleles contributing to the genetic risk. These data, along with earlier studies of chromosomes 5 and 7q3, suggest few if any major common risk alleles account for Autism Spectrum Disorder risk under major linkage peaks in the AGRE sample. This provides important evidence for strategies to identify Autism Spectrum Disorder genes, suggesting that they should focus on identifying rare variants and common variants of small effect

Molecular cloning of the cDNA encoding pp36, a tyrosine-phosphorylated adaptor protein selectively expressed by T cells and natural killer cells.

Activation of T and natural killer (NK) cells leads to the tyrosine phosphorylation of pp36 and to its association with several signaling molecules, including phospholipase Cgamma-1 and Grb2. Microsequencing of peptides derived from purified rat pp36 protein led to the cloning, in rat and man, of cDNA encoding a T- and NK cell-specific protein with several putative Src homology 2 domain-binding motifs. A rabbit antiserum directed against a peptide sequence from the cloned rat molecule recognized tyrosine phosphorylated pp36 from pervanadate-treated rat thymocytes. When expressed in 293T human fibroblast cells and tyrosine-phosphorylated, pp36 associated with phospholipase Cgamma-1 and Grb2. Studies with GST-Grb2 fusion proteins demonstrated that the association was specific for the Src homology 2 domain of Grb-2. Molecular cloning of the gene encoding pp36 should facilitate studies examining the role of this adaptor protein in proximal signaling events during T and NK cell activation

Expression of human adenosine deaminase in nonhuman primates after retrovirus-mediated gene transfer.

Primate bone marrow cells were infected with a retroviral vector carrying the genes for human adenosine deaminase (h-ADA) and bacterial neomycin resistance (neor). The infected cells were infused back into the lethally irradiated donor animals. Several monkeys fully reconstituted and were shown to express the h-ADA and neor genes at low levels in their recirculating hematopoietic cells for short periods of time

L'eclampsie au centre hospitalier et Universitaire de Brazzaville, Congo

Atravers une étude sur l’éclampsie, les auteurs avaient pour objectifs de déterminer sa fréquence, d’analyser les caractéristiques épidémiologiques des éclamptiques et d’évaluer le pronostic maternel et foetal. Il s’agit d’une étude rétrospective et analytique de 23.245 accouchements colligés en 7 ans entre le 1er janvier 2001 et le 31 décembre 2007. Pendant cette période, 136 éclamptiques ont été recensées. La fréquence de l’éclampsie a été de 0,58%. L’éclampsie était plus fréquente chez les jeunes femmes dont l’âge se situait entre 16 et 25 ans (68,4%). Elles étaient primipares dans 68,4% des cas. Près de la moitié de patientes n’avaient pas fait de consultations prénatales (46,3%). Le mode d’accouchement a été dans 61,6% la voie haute (césarienne). Le taux de létalité maternelle était de 8,8% et périnatale de 33,4%. L’éclampsie demeure encore une pathologie préoccupante et redoutable au Centre Hospitalier et Universitaire de Brazzaville. L’amélioration de son pronostic passe par l’intensification des consultations prénatales dans toutes les structures sanitaires, l’utilisation dès le début de la grossesse chez les patientes à risque toxémique de l’acide acétylsalicylique à faible dose, l’élargissement et la pose précoce de l’indication de la césarienne en cas de pré éclampsie.MOTS CLES: Eclampsie - Pronostic maternel - Pronostic foetal Brazzaville

Alcohol tolerance and Adh gene frequencies in European and African populations of Drosophila melanogaster

International audienc

Hysterectomie d'indication gynecologique au centre hospitalier et Universitaire de Brazzaville

Il s’agit d’une étude rétrospective à recueil transversal menée sur une période de 5 ans. Elle s’est déroulée du 1er janvier 2003 au 31 décembre 2007 dans les services de gynécologie obstétrique du Centre Hospitalier et Universitaire (C.H.U) de Brazzaville. Les objectifs étaient de déterminer la fréquence de l’hystérectomie, d’analyser les indications et d’inventorier les complications. Nous avons recensé et inclus toutes les patientes ayant subi une hystérectomie d’indication gynécologique. Pendant la période d’étude, la fréquence des hystérectomies par rapport à toute l’activité chirurgicale a été de 6,6%. L’âge moyen de nos patientes était de 42,7 ans. Les indications ont été dominées par les fibromes utérins (63,9%) et les prolapsus utérins (17,5%). La voie d’abord a été abdominale dans 82,5% et vaginale dans 17,5%. Les hystérectomies ont été totales dans 89,6% et subtotales dans 10,4%. Les complications les plus observées en période per-opératoire ont été les hémorragies (68,6%) et les infections (81,2%) en post-opératoire. La mortalité maternelle était de 1,6%. Ce travail a permis de constater que l’hystérectomie est fréquente au Centre Hospitalier Universitaire de Brazzaville. Son indication majeure est le fibrome utérin. Les complications sont dominées par les hémorragies en période per opératoire et les infections en post-opératoire. La lutte contre ces complications doit passer par la pose correcte de l’indication et la prise en charge précoce de ces patientes.MOTS CLES: Hystérectomie- Indications - Complications - C.H.U Brazzaville

A dust-parallax distance of 19 megaparsecs to the supermassive black hole in NGC 4151

The active galaxy NGC 4151 has a crucial role as one of only two active galactic nuclei for which black hole mass measurements based on emission line reverberation mapping can be calibrated against other dynamical methods. Unfortunately, effective calibration requires an accurate distance to NGC 4151, which is currently not available. Recently reported distances range from 4 to 29 megaparsecs (Mpc). Strong peculiar motions make a redshift-based distance very uncertain, and the geometry of the galaxy and its nucleus prohibit accurate measurements using other techniques. Here we report a dust-parallax distance to NGC 4151 of $D_A = 19.0^{+2.4}_{-2.6}$ Mpc. The measurement is based on an adaptation of a geometric method proposed previously using the emission line regions of active galaxies. Since this region is too small for current imaging capabilities, we use instead the ratio of the physical-to-angular sizes of the more extended hot dust emission as determined from time-delays and infrared interferometry. This new distance leads to an approximately 1.4-fold increase in the dynamical black hole mass, implying a corresponding correction to emission line reverberation masses of black holes if they are calibrated against the two objects with additional dynamical masses.Comment: Authors' version of a letter published in Nature (27 November 2014); 8 pages, 5 figures, 1 tabl

Reliable microsatellite genotyping of the Eurasian badger (Meles meles) using faecal DNA

The potential link between badgers and bovine tuberculosis has made it vital to develop accurate techniques to census badgers. Here we investigate the potential of using genetic profiles obtained from faecal DNA as a basis for population size estimation. After trialling several methods we obtained a high amplification success rate (89%) by storing faeces in 70% ethanol and using the guanidine thiocyanate/silica method for extraction. Using 70% ethanol as a storage agent had the advantage of it being an antiseptic. In order to obtain reliable genotypes with fewer amplification reactions than the standard multiple-tubes approach, we devised a comparative approach in which genetic profiles were compared and replication directed at similar, but not identical, genotypes. This modified method achieved a reduction in polymerase chain reactions comparable with the maximumlikelihood model when just using reliability criteria, and was slightly better when using reliability criteria with the additional proviso that alleles must be observed twice to be considered reliable. Our comparative approach would be best suited for studies that include multiple faeces from each individual. We utilized our approach in a well-studied population of badgers from which individuals had been sampled and reliable genotypes obtained. In a study of 53 faeces sampled from three social groups over 10 days, we found that direct enumeration could not be used to estimate population size, but that the application of mark–recapture models has the potential to provide more accurate results