Outcome of Laparoscopic Versus Open Appendectomy for Acute Appendicitis-Results of a Propensity Score Matching Analysis of 542 Patients and Consequences for the Military Surgeon.

Introduction: Appendectomy is the treatment of choice for acute appendicitis. The procedure can be performed open or laparoscopically. However, laparoscopy is not available on military missions abroad.

Use of Indocyanine Green Fluorescence Angiography and Prophylactic Endoscopic Stenting in Esophagectomy for Acute Esophageal Necrosis.

Acute esophageal necrosis (AEN) is a rare condition with high mortality. We describe a case of an AEN accompanied with multiple esophageal perforations in a 40-year-old patient. This was addressed via emergency Ivor-Lewis-esophagectomy with intraoperative Indocyanine-Green-Angiography (ICGA) and prophylactic placement of a self-expanding metal-stent (SEMS).

A renewed rise in global HCFC-141b emissions between 2017-2021.

Global emissions of the ozone-depleting gas HCFC-141b (1,1-dichloro-1-fluoroethane, CHCClF) derived from measurements of atmospheric mole fractions increased between 2017 and 2021 despite a fall in reported production and consumption of HCFC-141b for dispersive uses. HCFC-141b is a controlled substance under the Montreal Protocol, and its phase-out is currently underway, after a peak in reported consumption and production in developing (Article 5) countries in 2013. If reported production and consumption are correct, our study suggests that the 2017-2021 rise is due to an increase in emissions from the bank when appliances containing HCFC-141b reach the end of their life, or from production of HCFC-141b not reported for dispersive uses.

Emissions of Tetrafluoromethane (CF) and Hexafluoroethane (CF) From East Asia: 2008 to 2019.

The perfluorocarbons (PFCs), tetrafluoromethane (CF) and hexafluoroethane (CF), are potent greenhouse gases with very long atmospheric lifetimes. They are emitted almost entirely from industrial sources, including the aluminum and rare earth metal smelting industries that emit them as by-products, and the semiconductor and flat panel display manufacturing industries that use them and vent unutilized amounts to the atmosphere. Despite extensive industrial efforts to quantify and curb these emissions, "top-down" PFC emission estimates derived from atmospheric measurements continue to rise and are significantly greater than reported process- and inventory-based "bottom-up" emissions.

Primary gastric squamous cell carcinoma - a case report of diagnosis, treatment, histological findings and follow-up.

Primary squamous cell carcinoma (PSCC) of the stomach is a rare oncologic disease with a reported incidence of only 0.04%. Therefore, there are no evidence-based recommendations for treatment.

[Functional Results after Laparoscopic versus Robot-assisted Sigmoid Resection in Diverticulitis].

Background: Sigmoid resection in diverticulitis is one of the most frequently performed colonic operations. A minimally invasive approach by laparoscopy is the surgical gold standard. For a few years now, sigmoid resections have also been performed robotically (da Vinci System).

[Value of laparoscopy in blunt and penetrating abdominal trauma-a systematic review].

Background: The range of indications for laparoscopic procedures has been continuously widened in recent years. At the same time, however, the diagnostic and therapeutic role of laparoscopy in the management of blunt and penetrating abdominal trauma remains controversial.

Methods: A systematic literature search was carried out in PubMed from 2008 to 2019 on the use of laparoscopy in blunt and penetrating abdominal trauma.

Tuning in C-nociceptors to reveal mechanisms in chronic neuropathic pain.

Objective: Develop and validate a low-intensity sinusoidal electrical stimulation paradigm to preferentially activate C-fibers in human skin.

Methods: Sinusoidal transcutaneous stimulation (4Hz) was assessed psychophysically in healthy volunteers (n = 14) and neuropathic pain patients (n = 9). Pursuing laser Doppler imaging and single nociceptor recordings in vivo in humans (microneurography) and pigs confirmed the activation of "silent" C-nociceptors.

[The Relevance of Surgeon-performed Ultrasound For the Detection of Acute Appendicitis: a Review of the Literature and a Practical Diagnostic Algorithm].

The relevance of ultrasound (US) in diagnosing acute appendicitis is controversial. The validity of US in comparison with other imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), is unclear, as is the difference between surgeon-performed ultrasound (SPUS) and radiologist-performed ultrasound (RPUS). On the basis of a review of current literature, our study aimed to develop a US-based algorithm to simplify the choice between additional diagnostic measures and surgery.

Extensive Chemical Modifications in the Primary Protein Structure of IgG1 Subvisible Particles Are Necessary for Breaking Immune Tolerance.

A current concern with the use of therapeutic proteins is the likely presence of aggregates and submicrometer, subvisible, and visible particles. It has been proposed that aggregates and particles may lead to unwanted increases in the immune response with a possible impact on safety or efficacy. The aim of this study was thus to evaluate the ability of subvisible particles of a therapeutic antibody to break immune tolerance in an IgG1 transgenic mouse model and to understand the particle attributes that might play a role in this process.

[A rare case of coecal volvulus after colonoskopy due to a mobile coekum - diagnosis, surgical therapy and postoperative complications].

Colonoscopy, either performed as screening or as a therapeutic proceedure, is, in general, very safe with only a few cases of serious complications. Most cases of bleeding after endoscopic polypectomy can be safely managed endoscopically. The rare cases of colonic perforations still have to be managed by surgical intervention.

Pathological nociceptors in two patients with erythromelalgia-like symptoms and rare genetic Nav 1.9 variants.

Introduction: The sodium channel Nav 1.9 is expressed in peripheral nociceptors and has recently been linked to human pain conditions, but the exact role of Nav 1.9 for human nociceptor excitability is still unclear.

SCN10A Mutation in a Patient with Erythromelalgia Enhances C-Fiber Activity Dependent Slowing.

Gain-of-function mutations in the tetrodotoxin (TTX) sensitive voltage-gated sodium channel (Nav) Nav1.7 have been identified as a key mechanism underlying chronic pain in inherited erythromelalgia. Mutations in TTX resistant channels, such as Nav1.

Factors Governing the Accuracy of Subvisible Particle Counting Methods.

A number of new techniques for subvisible particle characterization in biotechnological products have emerged in the last decade. Although the pharmaceutical community is actively using them, the current knowledge about the analytical performance of some of these tools is still inadequate to support their routine use in the development of biopharmaceuticals (especially in the case of submicron methods). With the aim of increasing this knowledge and our understanding of the most prominent techniques for subvisible particle characterization, this study reports the results of a systematic evaluation of their accuracy.

Single-Fiber Recordings of Nociceptive Fibers in Patients With HSAN Type V With Congenital Insensitivity to Pain.

Objectives: Nerve growth factor (NGF) is a protein important for growth and survival, but also for modulation of sensitivity of nociceptors and sympathetic neurons. The purpose of the present study was to investigate the effects of reduced NGF signaling in patients with hereditary sensory and autonomic neuropathies type V, congenital insensitivity to pain, caused by a mutation of the NGFβ gene, including a characterization of single nociceptive fibers using microneurography (MNG).

Materials And Methods: One homozygote and 2 heterozygote patients with this mutation were examined with electromyography/neurography, thermal testing, quantitative sudomotor axon reflex test, and electrically induced axon reflex erythema in addition to MNG.

EMMPRIN expression is involved in the development of interstitial fibrosis and tubular atrophy in human kidney allografts.

Background: Matrix metalloproteinases (MMP) are involved in the development of interstitial fibrosis and tubular atrophy (IF/TA) in renal disease. The synthesis of MMP is activated by the extracellular matrix metalloproteinases inducer protein (EMMPRIN). To analyze the role of EMMPRIN in IF/TA, we retrospectively detected EMMPRIN expression in specimens of human renal allografts with various levels of IF/TA.

Factors Governing the Precision of Subvisible Particle Measurement Methods - A Case Study with a Low-Concentration Therapeutic Protein Product in a Prefilled Syringe.

Purpose: The current study was performed to assess the precision of the principal subvisible particle measurement methods available today. Special attention was given to identifying the sources of error and the factors governing analytical performance.

Methods: The performance of individual techniques was evaluated using a commercial biologic drug product in a prefilled syringe container.