Cheap Retrieval Bag for Laparoscopic Cholecystectomy

Gallstone disease is one of the most common gastrointestinal conditions that require surgery and currently laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic cholelithiasis. Use of a laparoscopic bag for facilitating extraction/ morcellation of the operative specimen has been shown to minimize infection of wound and abdominal cavity. Various laparoscopic bag substitutes like latex gloves and glove fingers have been used. We described a sterilized plastic surgical drain cover as a reasonable substitute for retrieving the gallbladder after LC

Evaluation of Leishmania donovani Protein Disulfide Isomerase as a Potential Immunogenic Protein/Vaccine Candidate against Visceral Leishmaniasis

In Leishmania species, Protein disulfide isomerase (PDI) - a redox chaperone, is reported to be involved in its virulence and survival. This protein has also been identified, through proteomics, as a Th1 stimulatory protein in the soluble lysate of a clinical isolate of Leishmania donovani (LdPDI). In the present study, the molecular characterization of LdPDI was carried out and the immunogenicity of recombinant LdPDI (rLdPDI) was assessed by lymphocyte proliferation assay (LTT), nitric oxide (NO) production, estimation of Th1 cytokines (IFN-γ and IL-12) as well as IL-10 in PBMCs of cured/endemic/infected Leishmania patients and cured L. donovani infected hamsters. A significantly higher proliferative response against rLdPDI as well as elevated levels of IFN-γ and IL-12 were observed. The level of IL-10 was found to be highly down regulated in response to rLdPDI. A significant increase in the level of NO production in stimulated hamster macrophages as well as IgG2 antibody and a low level of IgG1 in cured patient's serum was observed. Higher level of IgG2 antibody indicated its Th1 stimulatory potential. The efficacy of pcDNA-LdPDI construct was further evaluated for its prophylactic potential. Vaccination with this construct conferred remarkably good prophylactic efficacy (∼90%) and generated a robust cellular immune response with significant increases in the levels of iNOS transcript as well as TNF-α, IFN-γ and IL-12 cytokines. This was further supported by the high level of IgG2 antibody in vaccinated animals. The in vitro as well as in vivo results thus indicate that LdPDI may be exploited as a potential vaccine candidate against visceral Leishmaniasis (VL)

Effect of remote ischemic preconditioning on clinical outcomes in patients undergoing coronary artery bypass graft surgery (ERICCA): rationale and study design of a multi-centre randomized double-blinded controlled clinical trial.

BACKGROUND: Novel cardioprotective strategies are required to improve clinical outcomes in high risk patients undergoing coronary artery bypass graft (CABG) ± valve surgery. Remote ischemic preconditioning (RIC), in which brief episodes of non-lethal ischemia and reperfusion are applied to the arm or leg, has been demonstrated to reduce perioperative myocardial injury following CABG ± valve surgery. Whether RIC can improve clinical outcomes in this setting is unknown and is investigated in the effect of remote ischemic preconditioning on clinical outcomes (ERICCA) trial in patients undergoing CABG surgery. (ClinicalTrials.gov Identifier: NCT01247545). METHODS: The ERICCA trial is a multicentre randomized double-blinded controlled clinical trial which will recruit 1,610 high-risk patients (Additive Euroscore ≥ 5) undergoing CABG ± valve surgery using blood cardioplegia via 27 tertiary centres over 2 years. The primary combined endpoint will be cardiovascular death, non-fatal myocardial infarction, coronary revascularization and stroke at 1 year. Secondary endpoints will include peri-operative myocardial and acute kidney injury, intensive care unit and hospital stay, inotrope score, left ventricular ejection fraction, changes of quality of life and exercise tolerance. Patients will be randomized to receive after induction of anesthesia either RIC (4 cycles of 5 min inflation to 200 mmHg and 5 min deflation of a blood pressure cuff placed on the upper arm) or sham RIC (4 cycles of simulated inflations and deflations of the blood pressure cuff). IMPLICATIONS: The findings from the ERICCA trial have the potential to demonstrate that RIC, a simple, non-invasive and virtually cost-free intervention, can improve clinical outcomes in higher-risk patients undergoing CABG ± valve surgery

Fluorescence as a tool to understand changes in photosynthetic electron flow regulation

International audienceThe physiological state of a chloroplast is stronglyinfluenced by both biotic and abiotic conditions.Unfavourable growth conditions lead to photosyntheticstress. Chlorophyll a fluorescence is a widelyused probe of photosynthetic activity (specificallyPSII), and therefore stress which specifically targetsthe electron transport pathway and associated alternativeelectron cycling pathways. By manipulating theprocesses that control photosynthesis, affecting thechlorophyll a fluorescence, yields detailed insight intothe biochemicalpathways. Light that is captured by achlorophyll molecule can be utilised in three competingprocesses; electron transport, energy dissipation(via heat) and chlorophyll a fluorescence emission.Electrons produced by water-splitting are not alwaysused in carbon fixation; if the incident irradiancegeneratesmore electrons than the dark reactionscan use in carbon fixation, damage will occur to the photosynthetic apparatus. If carbon fixation is inhibitedby temperature or reduced inorganic carbon (Ci), ATPor NADPH availability, then the photosystem dynamicallyadjusts and uses alternate sinks for electrons, suchas molecular oxygen (water-water cycle or Mehler ascorbateperoxidase reaction). The process of stress acclimationleads to a number of photoprotective pathwaysand we describe how inhibitors can be used to identifythese particular processes. In this chapter, we describethe processes controlling electron transport as influencedby light-induced stress