Minimally Invasive Surgery for the Treatment of Colorectal Cancer

Background: Reduction in operative trauma along with an improvement in endoscopic access has undoubtedly occupied surgical minds for at least the past 3 decades. It is not at all surprising that minimally invasive colon surgery has come a long way since the first laparoscopic appendectomy by Semm in 1981. It is common knowledge that the recent developments in video and robotic technologies have significantly furthered advancements in laparoscopic and minimally invasive surgery. This has led to the overall acceptance of the treatment of benign colorectal pathology via the endoscopic route. Malignant disease, however, is still primarily treated by conventional approaches. Methods and Results: This review article is based on a literature search pertaining to advances in minimally invasive colorectal surgery for the treatment of malignant pathology, as well as on personal experience in the field over the same period of time. Our search was limited to level I and II clinical papers only, according to the evidence-based medicine guidelines. We attempted to present our unbiased view on the subject relying only on the evidence available. Conclusion: Focusing on advances in colorectal minimally invasive surgery, it has to be stated that there are still a number of unanswered questions regarding the surgical management of malignant diseases with this approach. These questions do not only relate to the area of boundaries set for the use of minimally invasive techniques in this field but also to the exact modality best suited to the treatment of every particular case whilst maintaining state-of-the-art oncological principles. (C) 2016 S. Karger GmbH, Freibur

Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus

Background. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH). With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG) on these parameters was examined. Methods. 236 patients underwent ISG with intraoperative liver biopsy from December 2002 to September 2009. Besides demographic data, pre-operative weight/BMI, HbA1c, AST, ALT, triglycerides, HDL and LDL levels were determined. Results. A significant correlation of NASH with higher HbA1c, AST and ALT and lower levels for HDL was observed (P < .05, <.0001, <.0001, <.01, resp.). Overall BMI decreased from 45.0 ± 6.8 to 29.7 ± 6.5 and 31.6 ± 4.4 kg/m2 at 1 and 3 years. An impaired weight loss was demonstrated for patients with NASH and patients with elevated HbA1c (plateau 28.08 kg/m2 versus 29.79 kg/m2 and 32.30 kg/m2 versus 28.79 kg/m2, resp.). Regarding NASH, a significant improvement of AST, ALT, triglyceride and HDL levels was shown (P < .0001 for all). A resolution of elevated HbA1c was observed in 21 of 23 patients. Summary. NASH patients showed a significant loss of body weight and amelioration of NASH status. ISG can be successfully performed in these patients and should be recommended for this subgroup

Improvement of Type 2 Diabetes Mellitus in Obese and Non-Obese Patients after the Duodenal Switch Operation

Introduction. Type 2 diabetes mellitus (T2DM) is one of the most important obesity-related comorbidities. This study was undertaken to characterise the effect of the biliopancreatic diversion with duodenal switch (BPD-DS) in morbidly obese and nonmorbidly obese diabetic patients. Methods. Outcome of 74 obese diabetic patients after BPD-DS and 16 non-obese diabetic patients after BPD or gastric bypass surgery was evaluated. Insulin usage, HbA1c-levels, and index of HOMA-IR (homeostasis model assessment of insulin resistence) were measured. Results. A substantial fraction of patients is free of insulin and shows an improved insulin sensitivity early after the operation, another fraction gets free of insulin in a 12-month period after the operation and a small fraction of long-term insulin users will not get free of insulin but nevertheless shows an improved metabolic status (less insulin needed, normal HbA1c-levels). Conclusion. BPD-DS leads to an improvement of T2DM in obese and non-obese patients. Nevertheless, more data is needed to clarify indications and mechanisms of action and to adjust our operation techniques to the needs of non-obese diabetic patients

Regiony w prawie i praktyce. Polska – Ukraina

Monografię stanowią opracowania powstałe na bazie referatów wygłoszonych podczas samorządowo-prawnej sesji tematycznej Regiony w prawie i praktyce, zorganizowanej przez Wydział Prawa i Administracji Uniwersytetu Łódzkiego w ramach międzynarodowej konferencji naukowej Europa Wschodnia w XXI wieku. Polska – Ukraina: partnerstwo regionów (Łódź, 21–22 października 2014 r.). Autorzy dokonali analizy i oceny reform prawa samorządu terytorialnego i kształtowania się pozycji ustrojowej regionów oraz praktyki ich funkcjonowania w Polsce i na Ukrainie, w tym w kontekście doświadczeń innych państw europejskich. W publikacji podjęto różnorodną tematykę w szeroko rozumianym aspekcie regionalnym w prawie konstytucyjnym i administracyjnym. Doniosłe pod względem prawnym, teoretycznym i praktycznym problemy, nieraz budzące kontrowersje, wymagały od Autorów nie tylko przedstawienia własnego – często krytycznego – stanowiska, lecz także wskazania pożądanych kierunków zmian legislacyjnych. Praca dotyczy trudnej i złożonej, a jednocześnie bardzo ważnej i stale aktualnej problematyki. Zakres rozważań podjętych w pracy jest przy tym bardzo szeroki. Publikacja w sposób twórczy analizuje wspomniane problemy […]. Należy ją uznać za opracowanie o wysokich walorach naukowych, zarówno porządkujące złożoną i trudną problematykę, jak również inspirujące i zachęcające do głębszej refleksji i dyskusji. Moim zdaniem jego czytelnikami powinni być nie tylko przedstawiciele nauki, lecz także szerokie grono praktyków, tj. urzędników pracujących w instytucjach administracji publicznej.Wydanie publikacji zostało dofinansowane przez Wydział Prawa i Administracji Uniwersytetu Łódzkiego, Katedrę Prawa Konstytucyjnego UŁ, Katedrę Prawa Administracyjnego i Nauki, Administracji UŁ oraz Centrum Studiów Wyborczych UŁ

Multifragmentation and nuclear phase transitions (liquid-fog and liquid-gas)

Thermal multifragmentation of hot nuclei is interpreted as the nuclear liquid-fog phase transition. The charge distributions of the intermediate mass fragments produced in p(3.6 GeV) + Au and p(8.1 GeV) + Au collisions are analyzed within the statistical multifragmentation model with the critical temperature for the nuclear liquid-gas phase transition Tc as a free parameter. The analysis presented here provides strong support for a value of Tc > 15 MeV.Comment: 4 pages, 2 figures, Submittet to Proc. of NN2003 to be published in Nucl. Phys.

Fusicoccin Counteracts the Toxic Effect of Cadmium on the Growth of Maize Coleoptile Segments

The effects of cadmium (Cd; 0.1–1000 μM) and fusicoccin (FC) on growth, Cd2+ content, and membrane potential (Em) in maize coleoptile segments were studied. In addition, the Em changes and accumulation of Cd and calcium (Ca) in coleoptile segments treated with Cd2+ combined with 1 μM FC or 30 mM tetraethylammonium (TEA) chloride (K+-channel blocker) were also determined. In this study, the effects of Ca2+-channel blockers [lanthanum (La) and verapamil (Ver)] on growth and content of Cd2+ and Ca2+ in coleoptile segments were also investigated. It was found that Cd at high concentrations (100 and 1000 μM) significantly inhibited endogenous growth of coleoptile segments and simultaneously measured proton extrusion. FC combined with Cd2+ counteracted the toxic effect of Cd2+ on endogenous growth and significantly decreased Cd2+ content (not the case for Cd2+ at the highest concentration) in coleoptile segments. Addition of Cd to the control medium caused depolarization of Em, the extent of which was dependent on Cd concentration and time of treatment with Cd2+. Hyperpolarization of Em induced by FC was suppressed in the presence of Cd2+ at 1000 μM but not Cd2+ at 100 μM. It was also found that treatment of maize coleoptile segments with 30 mM TEA chloride caused hyperpolarization of Em and decreased Cd2+ content in coleoptile segments, suggesting that, in the same way as for FC, accumulation of Cd2+ was dependent on plasma membrane (PM) hyperpolarization. Similar to FC, TEA chloride also decreased Ca2+ content in coleoptile segments. La and Ver combined with Cd2+ (100 μM) significantly decreased Cd content in maize coleoptile segments, but only La completely abolished the toxic effect of Cd2+ on endogenous growth and growth in the presence of FC. Taken together, these results suggest that the mechanism by which FC counteracts the toxic effect of Cd2+ (except at 1000 μM Cd2+) on the growth of maize coleoptile segments involves both stimulation of PM H+-ATPase activity by FC as well as Cd2+-permeable, voltage-dependent Ca channels, which are blocked by FC and TEA chloride-induced PM hyperpolarization

Multifragmentation in Collisions of 4.4gev-Deuterons with Gold Target

The relative velocity correlation function of pairs of intermediate mass fragments has been studied for d+Au collitions at 4.4 GeV. Experimental correlation functions are compared to that obtained by multibody Coulomb trajectory calculations under the assumption of various decay timees of the fragmenting system. The combined approach with the empirically modified intranuclear cascade code followed by the statistical multifragmentation model was used to generate the starting conditions for these calculations. The fragment emossion time is found to be less than 40 fm/c.Comment: Accepted for publication in Bulletin of the Russian Academy of Sciences. Physic

Spontaneous polar and chiral symmetry breaking in ordered fluids -- heliconical ferroelectric nematic phases

It is known that the chiral interaction described by Dzyaloshinskii-Moriya (DMI) term lead to the plethora of topological structures of magnetic spins, such as helical or skyrmion phases. Here we present the that analogues electrical DMI can lead to similar structural complexity of electric dipoles in soft matter. We report on a new polar liquid phase in which achiral molecules spontaneously form a heliconical structure. The helical pitch is comparable to the wavelength of visible light and unwinds critically at the transition to a uniformly polar, ferroelectric nematic phase. Although this new liquid crystalline phase resembles the twist-bend nematic phase, the mechanism of its formation is different and is attributed to electrical interactions that cause non-collinear arrangement of electric dipoles, similarly as observed for spins in magnetic systems