It is widely recognized that changes in livestock grazing in Mongolia after the early 1990s has increased concerns regarding land management and a need for better management strategies. Traditional ...knowledge and experiences of the Mongolian pastoralists should be used for such strategies.
If pastoralists recognize the seriousness of 'overgrazing' or signs of overgrazing, management can be guided to use this traditional ecological knowledge to develop more effective strategies. This paper describes vegetation changes caused by grazing and how pastoralists assess these changes.
We have found that pastoralists use certain types of plants as indicators to assess vegetation changes. They consider 'nariin' (narrow) plants, which often include short grasses and sedges, as good because livestock prefer them. However, most of the interviewed pastoralists thought
that the main reason for vegetation degradation is temperature increase, not overgrazing. This case study suggests the usefulness of such interviews together with vegetation surveys.
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BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background
Early laparoscopic cholecystectomy (ELC) for acute cholecystitis (AC) poses multiple challenges. The Tokyo Guidelines 2018 (TG18) eliminated the time limit (< 72 h) and expanded the ...surgical indication to severe AC. This study aimed to evaluate the clinical outcomes of ELC for AC following the TG18 in a single high-volume center.
Methods
From 2019 to 2021, we managed all AC patients with a TG18 flowchart and prospectively enrolled those who underwent ELC within 7 days of symptom onset. The primary outcome was overall morbidity, with a comparison between mild (Grade I) and moderate/severe (Grade II/III) AC.
Results
During the study period, 201 patients underwent ELC was for Grade I (56.2%), II (40.3%), and III (3.5%) ACs. Mean age was 69 ± 15.2 years and time to surgery from symptom onset was 0 (12.9%), 1–3 (66.7%), and 4–7 days (20.4%). Mean operative time and blood loss were 118.9 ± 42.7 min and 57.8 ± 99.4 mL, respectively. The critical view of safety (CVS) was achieved in 76.1% of patients, and bailout procedures were performed in 21.4%. There were no open conversions or bile duct injuries. Major morbidities (Clavien–Dindo classification ≥ IIIa) were observed in 5.5% of cases and mortality in 0.5%. Comparing Grades II/III to Grade I, operative time was longer (112.3 vs. 127.3 min,
p
= 0.014), blood loss was higher (40.3 vs. 80.1 mL,
p
= 0.005), the CVS rate was lower (83.2 vs. 67.0%,
p
= 0.012), and the major morbidity rate was higher (1.8 vs. 10.2%,
p
= 0.012). In the subgroup analysis of Grade II/III, there were no significant differences in major morbidities (
p
= 0.288) between the two groups (0–3 vs. 4–7 days).
Conclusion
ELC for AC following TG18 is feasible with low morbidity rates. However, ELC for Grade II/III ACs remains challenging, and surgeons must carefully assess intraoperative difficulties and surgical risks before proceeding.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background
The Arnt3 (also termed as BMAL1 or MOP3)/Clock heterodimer is a positive regulator of circadian rhythm and activates the transcription of target genes such as per1 and vasopressin.
Results
...We investigated the transcriptional mechanism of mArnt3/mClock heterodimer. While mClock did not possess any distinct activation domain, mArnt3 contained a transcriptional activation domain at the most C‐terminal end, the activity of which was not expressed, even in the one hybrid system, until it was bound by mClock. It has been suggested that mClock plays a regulatory or structural role in exerting a transcription enhancing effect of the mArnt3/mClock heterodimer. Deletion proceeding from amino acids 559–492 of mClock markedly reduced the transactivation activity of mArnt3/mClock heterodimer, in consistence with the results of the Clock‐Δ19 mutant. Yeast and mammalian two‐hybrid systems revealed that CBP and p300 interacted with mArnt3 via the CREB binding domain. The In vivo interaction between mArnt3 and CBP was confirmed by the GST pull down assay.
Conclusion
Taken together, these results suggest that the mArnt3/mClock heterodimer exerted its transactivation activity via CBP or p300 interacting with mArnt3 in the heterodimer with mClock playing a structural or regulatory role in the transactivation process.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Anatomical resection (AR) has been reported to achieve better long-term outcomes than non-anatomical resection for the treatment of hepatocellular carcinoma (HCC). The surgical feasibility and ...oncological significance of laparoscopic AR (LAR), especially “subsegment resection”, “cone unit resection”, and repeat LAR for HCC, remain unproven. We present a 67-year-old patient with alcoholic liver cirrhosis and HCC who underwent full LAR three times, focusing on the technical aspects of the Glissonean approach. Repeating LAR for recurrent HCC could be a safe and feasible procedure. However, HCC recurred in the neighboring segment twice, even though pathological vascular invasion and marginal remnants were not confirmed. We should investigate the oncological significance and advancements in subsegmentectomy and cone unit resection, in the future.
Based on recent reports from the field of digestive surgery, laparoscopic surgery has made rapid progress. However laparoscopic appendectomy (LA) has not been a common procedure. We investigated the ...current state of the treatment of acute appendicitis in a suburban municipal hospital. Appendectomies performed in Sanda city hospital from April 2009 to March 2011 were evaluated. Thirty four cases (male: female 23: 11) were treated with laparoscopic appendectomy, 43 cases (male: female 37: 6) with open appendectomy (OA). The operation time of LA was significantly longer than that of OA (LA 81.8±28.5minutes and OA 65.8±22.8minutes). Most of the LA procedures were performed in the daytime whereas OA tended to be performed during the night or on holidays. The hospital stay in LA was 6.4±2.6 days, and 7.5±5.8 days in OA. The frequency of surgical site infection (SSI) of LA was lower than that of OA. On review of our 77 patients, we conclude that the laparoscopic approach is useful for treatment of acute appendicitis and will develop in many hospitals.
Two patients were admitted to Ageo Central General Hospital for refractory pleural effusion. Case 1, a 53-year-old man with alcoholic cirrhosis and ascites, presented with respiratory distress. A ...plain chest radiograph showed massive right pleural. Since administration of albumin and diuretics did not improve his condition, thoracoscopy and laparoscopy were performed, which revealed a fistula in the diaphragm; the defect in the diaphragm was sealed using a tissue adhesive sheet (TacoSealⓇ︎), polyglycolic acid sheet (PGA) (Neover SheetⓇ︎), and fibrin glue (Veriplast PⓇ︎). Case 2 was a 67-year-old female patient with HCV hepatitis. Thoracic drainage was performed to relieve the pleural effusion-related respiratory discomfort. Suspecting pleuroperitoneal communication, the chest cavity was closed as in the first case. Both patients were discharged without postoperative complications. The minimally invasive laparoscopic and thoracoscopic approach is useful for the treatment of pleuroperitoneal communication. When suturing poses a challenge, reinforcement with tissue adhesive sheets may be a useful option.
To evaluate the utility of robot-assisted laparoscopic transabdominal preperitoneal repair (R-TAPP) of postprostatectomy inguinal hernia (PIH) in patients who underwent robot-assisted laparoscopic ...radical prostatectomy (RALP).
This was a prospective, single-centre retrospective cohort study. R-TAPP was conducted in 74 consecutive patients from September 2016 to March 2020. With the exception of women and patients who underwent previous abdominal surgery, 70 patients were classified into two groups based on the absence or presence of PIH. Their data were retrospectively compared to those who had not undergone RALP.
The median operative time for the PIH group was longer compared to the non-PIH group. However, postoperative complications, including seroma formation, haematoma and surgical site infections, were not significantly different between the groups. The estimated blood loss was small, and hospitalisation duration was 1 day in all cases. Moreover, there were no hernia recurrences within the 90-day follow-up period in either group.
R-TAPP is a feasible and safe approach for inguinal hernia repair, even in patients who undergo RALP for prostate cancer.
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