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Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

Surgical Science 2024年第4期15卷 278-288页

作者： Guy Aristide Bang richa.d ii mbele Fabrice Stephane Arroye Betou Arlette Joelle Moukitek Banaken Amos Bella Ela Charles Mve Mvondo Arthur Essomba department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaound&#233 I University Yaound&#233 Cameroon department of Surgery and Specialities Yaound&#233 Teaching Hospital Yaound&#233 Cameroon General Surgery Service Mvog-Ada District Hospital Yaound&#233 Cameroon department of Cardiothoracic and Vascular Surgery Laquintinie Hospital Douala Cameroon department of Cardiothoracic and Vascular Surgery Yaound&#233 General Hospital Yaound&#233 Cameroon Cardiac Center Shisong St. Elizabeth Catholic General Hospital Shisong Kumbo Cameroon

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

关键词： Thoracoscopy Single-Port Hemothorax Cameroon

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Results of Surgical Management of Malignant Obstruction of the Common Bile duct in Yaoundé

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Surgical Science 2024年第4期15卷 265-277页

作者： Eric Patrick Savom Gaël Tsanga Nomo richa.d ii mbele Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred dikongue dikongue Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the Universityof Yaoundé I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of dschang Dschang Cameroon Yaoundé Teaching Hospital Yaound&#233 Cameroon

Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBd) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBd, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBd. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.

关键词： Malignant Obstruction Common Bile duct Palliative Treatment Morbidity Mortality

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Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

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Surgical Science 2024年第5期15卷 311-320页

作者： Eric Patrick Savom richa.d ii mbele Mahamat Yannick Ekani Boukar Abdal deudeu Cédric Paterson Atangana Fred dikongue dikongue Guy Aristide Bang Marc Leroy Guifo Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaoundé Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of dschang Dschang Cameroon Yaoundé Teaching Hospital Yaoundé Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to december 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

关键词： Perforation of the Terminal Ileum Simple Suture Resection Morbidity Mortality

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BMPRⅡ^(+)neural precursor cells isolated and characterized from organotypic neurospheres:an in vitro model of human fetal spinal cord development

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Neural Regeneration Research 2024年第2期19卷 447-457页

作者： Michael W.Weible ii Michael d.Lovelace Hamish d.Mundell Tsz Wai Rosita Pang Tailoi Chan-Ling Bosch Institute Discipline of Anatomy and Histology(F13)University of SydneySydneyNSWAustralia School of Environment and Science Griffith UniversityNathanQLDAustralia discipline of Medicine Nepean Clinical SchoolFaculty of Medicine and HealthUniversity of SydneyKingswoodNSWAustralia New South Wales Brain Tissue Resource Centre School of Medical SciencesFaculty of Medicine and HealthUniversity of SydneyCharles Perkins Centre(D17)SydneyNSWAustralia

Roof plate secretion of bone morphogenetic proteins(BMPs)directs the cellular fate of sensory neurons during spinal cord development,including the formation of the ascending sensory columns,though their biology is not well ***-ⅡBMP receptor(BMPRⅡ),the cognate receptor,is expressed by neural precursor cells during embryogenesis;however,an in vitro method of enriching BMPRⅡ^(+)human neural precursor cells(hNPCs)from the fetal spinal cord is *** was undertaken on intact second-trimester human fetal spinal cord using antibodies to BMPRⅡand leukemia inhibitory factor(LIF).Regions of highest BMPRⅡ^(+)immunofluorescence localized to sensory *** and meningeal-associated BMPRⅡ^(+)vascular cells were identified in both intact fetal spinal cord and cortex by co-positivity with vascular lineage markers,Cd34/*** immunostaining identified a population of somas concentrated in dorsal and ventral horn interneurons,mirroring the expression of LIF receptor/Cd118.A combination of LIF supplementation and high-density culture maintained culture growth beyond 10 passages,while synergistically increasing the proportion of neurospheres with a stratified,*** neurospheres were characterized by BMPRⅡ^(+)/MAP2ab^(+/–)/βⅢ-tubulin^(+)/nestin^(–)/vimentin^(–)/GFAP^(–)/NeuN^(–)surface hNPCs surrounding a heterogeneous core ofβⅢ-tubulin^(+)/nestin^(+)/vimentin^(+)/GFAP^(+)/MAP2ab^(–)/NeuN^(–)multipotent *** cultures from tripotential neurospheres contained neuronal(βⅢ-tubulin^(+)),astrocytic(GFAP+),and oligodendrocytic(O4+)lineage ***-activated cell sorting-sorted BMPRⅡ^(+)hNPCs were MAP2ab^(+/–)/βⅢ-tubulin^(+)/GFAP^(–)/O4^(–)in *** is the first isolation of BMPRⅡ^(+)hNPCs identified and characterized in human fetal spinal *** data show that LIF combines synergistically with high-density reaggregate cultures to support the organotypic reorganization of neurospheres,characterize

关键词： BMPRⅡ bone morphogenetic protein histotypic human spinal cord development leukemia inhibitory factor neurosphere organotypic reaggregate sensory columns

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Surgical Management of Perforated Colon Tumours in Yaoundé: A Multicentre Retrospective Review of 30-day Postoperative Outcome

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Surgical Science 2024年第5期15卷 330-341页

作者： Eric Patrick Savom richa.d ii mbele Colman Tamboh Tankou Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred dikongue dikongue daniel Biwole Biwole Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon Yaoundé University Teaching Hospital Yaound&#233 Cameroon

Introduction: Colon cancer is often diagnosed late in our context and there is a high prevalence of complicated forms, this including perforation. The optimal surgical treatment remains controversial. The aim of this study was to improve the short-term postoperative outcomes of patients operated upon for perforated colon cancer, by identifying factors associated with complications occurring within 30 days after surgery. Patients and methods: We carried out an analytical observational study, with a retrospective collection of data from the files of patients operated upon for an in situ tumoral colon perforation. This was done in four referral hospitals in the city of Yaoundé. The period was from the 1st of January, 2012 to the 31st of december, 2021. Cox regression identified the factors associated with postoperative morbidity and mortality. Results: We collected files of 46 patients. The mean age was 54.7 ± 19.9 years with a sex ratio of 1.4. The clinical presentation on admission was dominated by the presence of signs of peritoneal irritation (91.3%) and bowel obstruction (28.3%). The diagnosis was made preoperatively in 16 cases (34.8%). The surgical procedures consisted of colectomy with anastomosis in 28 cases (60.9%) and without anastomosis in 14 cases (30.4%). Postoperative morbidity was 60.9% dominated by surgical site infection (37%). Postoperative mortality was 39.1%. The existence of generalized peritonitis was associated with the occurrence of postoperative complications (p = 0.019). The main factors associated with postoperative mortality were resection with primary anastomosis (p = 0.027), enterocutaneous fistula (p = 0.005). Conclusion: Colic resection with primary anastomosis or ideal colectomy is associated with an increased risk of mortality and should therefore not be performed in this setting.

关键词： Perforated Colon Cancer Postoperative Morbidity and Mortality Colectomy Acute Generalized Peritonitis

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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in Cameroon

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Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang Eric Patrick Savom Achille Aimé Bekolo Otiti Fred dikongue dikongue Mahamat Yannick Ekani Boukar richa.d ii mbele Cédric Paterson Atangana daniel Biwole Biwole Arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and Methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in Cameroon. data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BMI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. Conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. Compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair Composite Biface Mesh Postoperative Outcomes

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Strengthening mechanisms analysis and tailoring of bimodal grain structures for enhanced strength in CoCrFeMnNi high-entropy alloys

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Rare Metals 2024年第8期43卷 3893-3903页

作者： Jaesoung Lee Seulgi Kim Taehyun Kwon Young ii Kim Suyeon Kim Sung Ho Song Bin Lee dongju Lee department of Urban Energyand Environmental EngineeringChungbuk National UniversityCheongju 28644Republic of Korea division of Advanced Materials Engineering Kongju National UniversityChungnam 330-717Republic of Korea department of Advanced Materials Engineering for Information and Electronics Integrated-Education Institute for Frontier Science and Technology(BK21 Four)Kyung Hee UniversityYongin17104Republic of Korea

The CoCrFeMnNi high-entropy alloys(HEAs)with a(face-centered cubic) FCC structure has garnered considerable attention for its exceptional ductility and strain hardening ***,its yield strength is insufficient for structural *** this study,strengthening mechanisms in these HEAs were investigated to gain insight into the mechanical properties according to alloy powder ***,we present a novel approach to achieve both high strength and high ductility through the creation of a bimodal structure consisting of both coarse and fine grains via gas atomization and spark plasma sintering processes.A bimodally structured HEA prepared with a mass ratio of 2:8 between coarse particles(75-106 μm) and fine particles(≤25 μm)yielded optimal results,with a strength of 491.95 MPa and elongation of 19.64%.This strength value represents an~41% increase compared with the sample that displayed a fine single microstructure(347.08 MPa for yield strength).The strength enhancement was attributed to the prevention of plastic deformation initiation from the fine particles during *** innovative approach to the creation of HEAs with bimodal structures shows promise for various applications,such as structural components that require a combination of high strength and high ductility.

关键词： High-entropy alloys CrCoFeMoNi Bimodal Gas atomization Mechanical properties

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Ion heat transport in electron cyclotron resonance heated L-mode plasma on the T-10 tokamak

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Plasma Science and Technology 2024年第4期26卷 52-60页

作者： V.A.KRUPIN M.R.NURGALIEV A.R.NEMETS I.A.ZEMTSOV S.d.SUNTSOV T.B.MYALTON d.S.SERGEEV N.A.SOLOVEV d.V.SARYCHEV d.V.RYJAKOV S.N.TUGARINOV N.N.NAUMENKO National Research Centre“Kurchatov Institute” Moscow 123182Russia Bauman Moscow State Technical University Moscow 105005Russia Institution“Project Center ITER” Moscow 123098Russia JSC“SOLAR” Minsk 220034Belarus

Anomalous ion heat transport is analyzed in the T-10 tokamak plasma heated with electron cyclotron resonance heating(ECRH) in second-harmonic extra-ordinary mode. Predictive modeling with empirical scaling for Ohmical heat conductivity shows that in ECRH plasmas the calculated ion temperature could be overestimated, so an increase of anomalous ion heat transport is required. To study this effect two scans are presented: over the EC resonance position and over the ECRH power. The EC resonance position varies from the high-field side to the low-field side by variation of the toroidal magnetic field. The scan over the heating power is presented with on-axis and mixed ECRH regimes. discharges with high anomalous ion heat transport are obtained in all considered regimes. In these discharges the power balance ion heat conductivity exceeds the neoclassical level by up to 10 times. The high ion heat transport regimes are distinguished by three parameters: the ratio Te/Ti, the normalized electron density gradient R/■, and the ion–ion collisionality νii~*. The combination of high Te/Ti, high νii~*, and R/■=6-10 results in values of normalized anomalous ion heat fluxes up to 10 times higher than in the low transport scenario.

关键词： tokamak L-mode electron cyclotron resonance heating ion heat transport

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Application of flame-formed carbon nanoparticle films for ethanol sensing Author links open overlay panel

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Particuology 2024年第8期91卷 202-210页

作者： Pegah darvehi Luca Basta Mario Commodo Patrizia Minutolo Andrea d'Anna Istituto di Scienze e Tecnologie per l’Energia e la MobilitàSostenibili Consiglio Nazionale delle RicercheP.le Tecchio 8080125NapoliItaly dipartimento di Ingegneria Chimica dei Materiali e della Produzione IndustrialeUniversitàdegli Studi di Napoli Federico IIP.le Tecchio 8080125NapoliItaly

Carbon nanoparticles(CNPs)have received considerable attention due to their exceptional qualities and *** unique physical and chemical characteristics make them extremely intriguing as materials for numerous high-potential applications,such as electronics and gas *** study focused on producing carbon-based nanomaterial devices by deposition of flame-formed carbon nanoparticles on a suitable substrate and investigating their gas-sensing *** were produced in a fuel-rich laminar premixed ethylene/air flame and the collected CNP film was morphologically and electrically *** electrical conductivity of the film was investigated as a function of ethanol concentration and amount of deposited ***,CNP films exhibited high sensitivity to ambient ethanol gas concentrations,and rapid recovery times at room temperature,and showed a sensitivity increasing with the amount of deposited material and the surface *** findings demonstrate the high potential of combustion-generated CNPs as building materials for low-cost and portable ethanol sensors.

关键词： Flame synthesis Carbon nanoparticles Soot Nanostructured thin film Optical and electrical characterization Atomic force microscopy Sensors

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Reference gene panel for urinary exosome-based molecular diagnostics in patients with kidney disease

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World Journal of Nephrology 2024年第3期13卷 62-72页

作者： deendayal d Mishra Pramod K Maurya Swasti Tiwari department of Molecular Medicine and Biotechnology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

BACKGROUNd Kidney disease is a severe complication of diabetes that often leads to end-stage renal *** diagnosis is crucial for prevention or ***,the current diagnostic methods,with their limitations in detecting the disease in its early stages,underscore the urgency and importance of finding new *** encapsulated inside urinary exosomes(UEs)have potential as early biomarkers for kidney *** need for reference miRNAs for accurate interpretation currently limits their translational *** To identify consistently expressing reference miRNAs from UEs of controls and patients with type 2 diabetesmellitus(T2dM)and biopsy-confirmed kidney *** miRNA profiling was performed on UEs from 31 human urine samples using a rigorous and unbiased *** UEs were isolated from urine samples collected from healthy individuals(n=6),patients with T2dM(n=13),and T2dM patients who also had kidney diseases(including diabetic nephropathy,n=5;membranous nephropathy,n=5;and IgA nephropathy,n=2)through differential *** characterizing the UEs,miRNA expression profiling using microarray technology was *** Microarray data analysis identified 14 miRNAs that were consistently expressed in UEs from 31 human samples,representing various kidney conditions:diabetic controls,diabetic nephropathy,membrane nephropathy,IgA nephropathy,and healthy *** in silico analysis,we determined that 10 of these miRNAs had significant potential to serve as reference genes in *** We identified uniformly expressing UE miRNAs that could serve as reference genes kidney disease biomarkers.

关键词： miRNA Microarray Urinary exosomes diabetic nephropathy Type 2 diabetes mellitus Kidney disease

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