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Background Several studies have shown that there are no significant differences in anastomotic leakage associated with Transanal total mesorectal excision (taTME) versus laparoscopic TME (lapTME) for rectal cancer; however, little is known about late anastomotic leakage, such as that primarily found in the chronic presacral sinus. We aimed to compare the occurrence of anastomotic leakage and chronic presacral sinus in rectal cancer for taTME and lapTME. Methods In this retrospective cohort study, data were collected for patients with rectal cancer who underwent surgery between January 2009 and September 2019. Of the 220 patients included in this study, 182 were in the lapTME group and 38 in the taTME group. We compared factors associated with anastomotic leakage and chronic presacral sinus formation between the two groups. A binary-logistic model was used to determine the risk factors for chronic presacral sinus. Results Anastomotic leakage occurred in six patients (15.8%) in the taTME group and 36 patients (19.7%) in the lapTME group. Chronic presacral sinus occurred in three patients (7.9%) in the taTME group and 15 patients (8.2%) in the lapTME group. There was no significant difference in anastomotic leakage or chronic presacral sinus between groups (P = 0.569 and P = 1.000, respectively). Pathologic stage III or higher was significantly associated with chronic presacral sinus formation (P = 0.006). Conclusion There were no significant differences between taTME and lapTME regarding the incidence of anastomotic leakage or chronic presacral sinus. Almost one-third of anastomotic leakages developed into chronic presacral sinus.

‹ Volume 47 Issue 2, May 2022, pp. 271-291 › Articles Network Wisdom: The Role of Scaffolding in Expanding Communities of Practice and Technical Competencies in Community Networks Michael LithgowRelated informationAthabasca University Philip GarrisonRelated informationUniversity of Washington Esther Han Beol JangRelated informationUniversity of Washington Nicolas PacéRelated informationAlterMundi Michael Lithgow is Associate Professor at Athabasca University. Email: michael.lithgow@athabascau.ca. Philip Garrison is a PhD Candidate in the Paul G. Allen School of Computer Science and Engineering at the University of Washington. Email: philipmg@cs.washington.edu. Esther Han Beol Jang is a PhD candidate in the Paul G. Allen School of Computer Science and Engineering at the University of Washington. Email: infrared@cs.washington.edu. Nicolas Pacé is Community Networks Movement Builder at AlterMundi. Email: nicopace@altermundi.net Abstract Full Text References PDF EPUB Background: One of the key tensions to emerge from research on community owned and operated information and communications technology networks (“community networks”) is why some networks flourish while others fail. Analysis: These findings are based on interviews with 15 community network participants from four rural community networks in Córdoba, Argentina. Community network longevity is shaped by practices of scaffolding—knowledge sharing practices that expand what Étienne Wenger describes as “fields of negotiability” within communities of practice. Conclusion and implications: Network longevity was supported by scaffolding practices that decentralized technical capacities while encouraging deeper involvement among network participants. The network wisdom demonstrated in these cases appears to offer a promising strategy for community networks struggling to achieve longevity.

Choledochocele is the least common type of choledochal cyst. Choledochocele has a potential for carcinogenesis, but only a handful of cases with concurrent ampullary carcinoma have been reported. We recently experienced a case of choledochocele with tubulovillous adenoma with focal high-grade dysplasia, which was successfully and completely resected en bloc via endoscopic papillectomy. Prior to endoscopic papillectomy, the endoscopic ultrasonography was able to accurately diagnose the ampullary tumor arising in choledochocele. Herein, we would like to report this case and discuss the potential of malignant transformation and the usefulness of endoscopic ultrasonography in choledochocele.

Poly(1-oxotrimethylene) (POTM) was dissolved in aqueous solutions containing ZnCl2, CaCl2, and LiCl, and the effects of boric acid introduction on the phase stability of the POTM solutions over various aging times were investigated. In the absence of boric acid, aging at 70°C for 8 h notably reduced the loss tangent (tanδ) for the 7.0 wt.% POTM solutions. Addition of boric acid into unaged solutions had little effect on tanδ over the frequency range measured, regardless of its content, whereas addition of 0.3-1.0 wt.% of boric acid into aged solutions increased tanδ. The dynamic viscosity of the POTM solutions with 1.0 wt.% boric acid was affected little by aging time. Conversely, the POTM solutions without boric acid exhibited increased dynamic viscosity in the low-frequency range with aging time. In addition, the slope of the solutions in the Cole-Cole plot decreased with increasing aging time in the absence of boric acid, whereas aging time had little effect in the presence of 1.0 wt.% boric acid. For dilute POTM solutions (i.e., 0.5 g/dL), the reduced viscosity decreased with increasing aging time in the absence of boric acid, while it was affected little in solutions with the addition of 1.0 wt.% boric acid. In the UV-Vis spectra, the aging-time-dependent increase of the absorbance peak at 390 nm was associated with the generation of a chromophoric complex in the POTM solutions. Conversely, the disappearance of the peak due to the addition of boric acid indicated suppression of complex formation.

Background The aim of this study was to investigate the effects of pre-transplant serum 25-hydroxyvitamin D (25(OH)D) level on non-immunologic and immunologic aspects of post-transplant clinical outcomes in kidney transplant recipients (KTRs). Methods We investigated 174 KTRs with low immunologic risk at baseline. We divided the patients into three groups according to baseline serum 25(OH)D level and compared the post-transplant clinical outcomes of acute rejection, infectious complications, and osteoporosis among the groups. Result Thirty cases of biopsy-proven acute rejection (BPAR) were detected during the first year after KT. In the highest tertile, the rate of acute rejection (8.6%) was significantly lower than that in the lowest tertile (25.4%) (p = 0.016), and a high 25(OH)D level was independently associated with a low incidence of BPAR in multivariate analysis. In contrast, serum 25(OH)D level did not show a significant association with overall or any specific type of infectious complication. Lipid profile, intact parathyroid hormone (PTH) level, and hemoglobin level were similar among the three tertile groups. The incidence of osteoporosis and bone mineral density (BMD) score were also similar across all three groups. Conclusions Pre-transplant serum 25(OH)D level is a significant predictor of acute rejection, but it does not predict infection or metabolic complications.