LAPAROSCOPIC VERSUS OPEN SURGERY FOR ACUTE ADHESIVE SMALL-BOWEL OBSTRUCTION : A PROPENSITY SCORE-MATCHED ANALYSIS

Background and Aims: The laparoscopic approach has been increasingly used to treat adhesive small-bowel obstruction. The aim of this study was to compare the outcomes of a laparoscopic versus an open approach for adhesive small-bowel obstruction. Material and Methods: Data were retrospectively collected on patients who had surgery for adhesive small-bowel obstruction at a single academic center between January 2010 and December 2012. Patients with a contraindication for the laparoscopic approach were excluded. A propensity score was used to match patients in the laparoscopic and open surgery groups based on their preoperative parameters. Results: A total of 25 patients underwent laparoscopic adhesiolysis and 67 patients open adhesiolysis. The open adhesiolysis group had more suspected bowel strangulations and more previous abdominal surgeries than the laparoscopic adhesiolysis group. Severe complication rate (Clavien-Dindo 3 or higher) was 0% in the laparoscopic adhesiolysis group versus 14% in the open adhesiolysis group (p = 0.052). Twenty-five propensity score-matched patients from the open adhesiolysis group were similar to laparoscopic adhesiolysis group patients with regard to their preoperative parameters. Length of hospital stay was shorter in the laparoscopic adhesiolysis group compared to the propensity score-matched open adhesiolysis group (6.0 vs 10.0 days, p = 0.037), but no differences were found in severe complications between the laparoscopic adhesiolysis and propensity score-matched open adhesiolysis groups (0% vs 4%, p = 0.31). Conclusion: Patients selected to be operated by the open approach had higher preoperative morbidity than the ones selected for the laparoscopic approach. After matching for this disparity, the laparoscopic approach was associated with a shorter length of hospital stay without differences in complications. The laparoscopic approach may be a preferable approach in selected patients.Peer reviewe

ALFA: First Operational Experience of the MPE/MPIA Laser Guide Star System for Adaptive Optics

The sodium laser guide star adaptive optics system ALFA has been constructed at the Calar Alto 3.5-m telescope. Following the first detection of the laser beacon on the wavefront sensor in 1997 the system is now being optimized for best performance. In this contribution we discuss the current status of the launch beam and the planned improvements and upgrades. We report on the performance level achieved when it is used with the adaptive optics system, and relate various aspects of our experience during operation of the system. We have begun to produce scientific results and mention two of these.Comment: 9 pages, 6 figures, LaTeX (spie.sty). SPIE conf proc 3353, Adaptive Optical System Technologies, March 199

Links between magnetic fields and plasma flows in a coronal hole

We compare the small-scale features visible in the Ne viii Doppler-shift map of an equatorial coronal hole (CH) as observed by SUMER with the small-scale structures of the magnetic field as constructed from a simultaneous photospheric magnetogram by a potential magnetic-field extrapolation. The combined data set is analysed with respect to the small-scale flows of coronal matter, which means that the Ne viii Doppler-shift used as tracer of the plasma flow is investigated in close connection with the ambient magnetic field. Some small closed-field regions in this largely open CH are also found in the coronal volume considered. The Doppler-shift patterns are found to be clearly linked with the field topology.Comment: 4 pages, 3 figure

Cell-Free Synthesis of the Mitochondrial ADP/ATP Carrier Protein of Neurospora crassa

ADP/ATP carrier protein was synthesized in heterologous cell-free systems programmed with Neurospora poly(A)-containing RNA and homologous cell-free systems from Neurospora. The apparent molecular weight of the product obtained in vitro was the same as that of the authentic mitochondrial protein. The primary translation product obtained in reticulocyte lysates starts with formylmethionine when formylated initiator methionyl-tRNA (fMet-tRNAfMet) was present. The product synthesized in vitro was released from the ribosomes into the postribosomal supernatant. The evidence presented indicates that the ADP/ATP carrier is synthesized as a polypeptide with the same molecular weight as the mature monomeric protein and does not carry an additional sequence

Molecular gas in the galaxy cluster Abell 262. CO observations of UGC 1347 and other galaxies of the cluster

We present millimeter CO line emission observations of 12 galaxies within the Abell 262 cluster, together with L_FIR data, in the context of a possible molecular gas deficiency within the region of the cluster center. Several indications of the presence of such a deficiency are highlighted and connected to a model of cirrus-like cloud stripping. The model predicts a drop in the average 100 micron flux density of galaxies in the core of the cluster compared to the average 100 micron flux density in the outer regions, which is actually indicated in the IRAS data of the cluster members. This drop is explained by the decrease in the total hydrogen column density N(H) and, therefore, also includes a decrease in the molecular gas content. In addition to results for the global CO content of the galaxy sample, high-resolution interferometric CO(1-0) observations of one of the cluster members, UGC 1347, exemplify the spatial distribution of the molecular gas in a galaxy of the cluster. With these observations, it was possible to confirm the existence of a bright off-nuclear CO-emission source and to derive molecular masses and line ratios for this source and the nucleus.Comment: 14 pages, 14 figures, accepted by A&

Transport of Proteins into Mitochondria

The mitochondrial ADP/ATP carrier is an integral transmembrane protein of the inner membrane. It is synthesized on cytoplasmic ribosomes. Kinetic data suggested that this protein is transferred into mitochondria in a posttranslational manner. The following results provide further evidence for such a mechanism and provide information on its details. 1. In homologous and heterologous translation systems the newly synthesized ADP/ATP carrier protein is present in the postribosomal supernatant. 2. Analysis by density gradient centrifugation and gel filtration shows, that the ADP/ATP carrier molecules in the postribosomal fraction are present as soluble complexes with apparent molecular weights of about 120000 and 500000 or larger. The carrier binds detergents such as Triton X-100 and deoxycholate forming mixed micelles with molecular weights of about 200000–400000. 3. Incubation of a postribosomal supernatant of a reticulocyte lysate containing newly synthesized ADP/ATP carrier with mitochondria isolated from Neurospora spheroplasts results in efficient transfer of the carrier into mitochondria. About 20–30% of the transferred carrier are resistant to proteinase in whole mitochondria. The authentic mature protein is also largely resistant to proteinase in whole mitochondria and sensitive after lysis of mitochondria with detergent. Integrity of mitochondria is a prerequisite for translocation into proteinase resistant position. 4. The transfer in vitro into a proteinase-resistant form is inhibited by the uncoupler carbonyl-cyanide m-chlorophenylhydrazone but not the proteinase-sensitive binding. These observations suggest that the posttranslational transfer of ADP/ATP carrier occurs via the cytosolic space through a soluble oligomeric precursor form. This precursor is taken up by intact mitochondria into an integral position in the membrane. These findings are considered to be of general importance for the intracellular transfer of insoluble membrane proteins. They support the view that such proteins can exist in a water-soluble form its precursors and upon integration into the membrane undergo a conformational change. Uptake into the membrane may involve the cleavage of an additional sequence in some proteins, but this appears not to be a prerequisite as demonstrated by the ADP/ATP carrier protein