A Rare Case of Portal Vein Thrombosis Following a Successful Laparoscopic Cholecystectomy.

The function of the portal vein is to drain the blood mainly from the gastrointestinal tract to the liver and its thrombosis is an extremely unexpected outcome of an uncomplicated laparoscopic cholecystectomy. It is believed to be a rarely reported case to date in non-cirrhotic patients. A female patient, aged 43 years, presented to the surgical outpatient department with unexplained severe abdominal pain soon after laparoscopic cholecystectomy. A relative workup was done and radiological evidence revealed the thrombosis in the distal part of the portal vein at its bifurcation which completely occluded the left branch of the vein. Although rare, portal vein thrombosis should be concluded in the differentials for unexplained causes of abdominal pain in the postoperative period of laparoscopic cholecystectomy.

Direct measurement of interaction forces between charged multilamellar vesicles†.

Depletion-attraction induced adhesion of two giant (∼ 40 µm), charged multilamellar vesicles is studied using a new Cantilevered-Capillary Force Apparatus, developed in this laboratory. The specific goal of this work is to investigate the role of dynamics in the adhesion and de-adhesion processes when the vesicles come together or are pulled apart at a constant velocity. Hydrodynamic effects are found to play an important role in the adhesion and separation of vesicles at the velocities that are studied. Specifically, a period of hydrodynamically controlled drainage of the thin film between vesicles is observed prior to adhesion, and it is shown that the force required to separate a pair of tensed, adhering vesicles increases with increasing separation velocity and membrane tension. It is also shown that the work done to separate the vesicles increases with separation velocity, but exhibits a maximum as the membrane tension is varied.

Origins of microstructural transformations in charged vesicle suspensions: the crowding hypothesis.

It is observed that charged unilamellar vesicles in a suspension can spontaneously deflate and subsequently transition to form bilamellar vesicles, even in the absence of externally applied triggers such as salt or temperature gradients. We provide strong evidence that the driving force for this deflation-induced transition is the repulsive electrostatic pressure between charged vesicles in concentrated suspensions, above a critical effective volume fraction. We use volume fraction measurements and cryogenic transmission electron microscopy imaging to quantitatively follow both the macroscopic and microstructural time-evolution of cationic diC18:1 DEEDMAC vesicle suspensions at different surfactant and salt concentrations. A simple model is developed to estimate the extent of deflation of unilamellar vesicles caused by electrostatic interactions with neighboring vesicles. It is determined that when the effective volume fraction of the suspension exceeds a critical value, charged vesicles in a suspension can experience "crowding" due to overlap of their electrical double layers, which can result in deflation and subsequent microstructural transformations to reduce the effective volume fraction of the suspension. Ordinarily in polydisperse colloidal suspensions, particles interacting via a repulsive potential transform into a glassy state above a critical volume fraction. The behavior of charged vesicle suspensions reported in this paper thus represents a new mechanism for the relaxation of repulsive interactions in crowded situations.

Direct measurements of effect of counterion concentration on mechanical properties of cationic vesicles.

Theoretical analyses of charged membranes in aqueous solutions have long predicted that the electric double layer surrounding them contributes significantly to their mechanical properties. Here we report the first, direct experimental measurements of the effect of counterion concentration on the bending and area expansion modulus of cationic surfactant vesicles. Using the classical technique of micropipet aspiration coupled with a modified experimental protocol that is better suited for cationic vesicles, we successfully measure the mechanical properties of a double-tailed cationic surfactant, diethylesterdimethyl ammonium chloride (diC18:1 DEEDMAC) in CaCl2 solutions. It is observed that the area expansion modulus of the charged membrane exhibits no measurable dependence on the counterion concentration, in accordance with existing models of bilayer elasticity. The measured bending modulus, however, is found to vary nonmonotonically and exhibits a minimum in its variation with counterion concentration. The experimental results are interpreted based on theoretical calculations of charged and bare membrane mechanics. It is determined that the initial decrease in bending modulus with increasing counterion concentration may be attributed to a decreasing double layer thickness, while the subsequent increase is likely due to an increasing membrane thickness. These mechanical moduli measurements qualitatively confirm, for the first time, theoretical predictions of a nonmonotonic behavior and the opposing effects of ionic strength on the bending rigidity of charged bilayers.

Dilution technique to determine the hydrodynamic volume fraction of a vesicle suspension.

A simple dilution method to determine the hydrodynamic volume fraction of vesicle suspensions is presented. The vesicle suspension is diluted with a solution containing a tracer Y, which is similar to a component X already present in the suspending fluid and which does not bind to or permeate through the vesicles. The concentrations of X and Y in the suspending fluid measured after dilution are used to determine the volume fraction. Using this technique, the volume fractions of vesicle suspensions comprising cationic vesicles prepared in solutions of CaCl(2) (X) were measured by dilution with MgCl(2) (Y) solutions. Various experimental parameters such as the concentration of the MgCl(2) diluents and the dilution volume ratio were studied and their effects optimized to arrive at a robust recipe for measuring the volume fraction. It is demonstrated that the technique can be applied to concentrated suspensions containing multilamellar and polydisperse vesicles.